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Qian Y, Ding L, Ding Y, Jiang L, Liu Z, Zhou X. Measurement of the distance between corneal apex and pupil center in patients following small-incision lenticule extraction or implantable collamer lens implantation and its correlation with the surgical-induced astigmatism. BMC Ophthalmol 2024; 24:110. [PMID: 38454381 PMCID: PMC10918991 DOI: 10.1186/s12886-024-03352-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 02/15/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND To investigate the change in the distance between corneal apex and pupil center after small-incision lenticule extraction (SMILE) or implantable collamer lens (ICL) implantation and its correlation with surgical-induced astigmatism (SIA). METHODS This study included patients who had undergone SMILE (n = 112) or ICL implantation (n = 110) to correct myopia and myopic astigmatism. The angle kappa was measured using a Scheimpflug imaging device (Pentacam) and represented as Cartesian values between the pupil center and the corneal vertex (X, Y) and chord u ([Formula: see text]orientation), and was compared pre- and post-operative. RESULTS Following SMILE, the magnitude of chord u[Formula: see text]) significantly increased in both eyes (Wilcoxon signed-rank test, OD: P<0.001; OS: P=0.007), while no significant change was observed in the orientation. A significant correlation was found between the J0 component of SIA and the change in the magnitude of chord u for both eyes (OD: R2=0.128, P<0.001; OS: R2=0.033, P=0.004). After ICL implantation, the orientation of the chord u was significantly different in the right eye (Wilcoxon signed-rank test, P = 0.008), and the Y-intercept significantly decreased in both eyes (Wilcoxon signed-rank test, P<0.001). A significant correlation was found between J0 of SIA and the change in the magnitude of chord u for the right eyes (R2=0.066, P=0.002). A significant correlation was found between J45 of SIA and the change in the magnitude of chord u for the left eyes (R2=0.037, P=0.044). CONCLUSIONS The magnitude of the chord u increased following the SMILE procedure, whereas the Y-intercept significantly decreased after ICL implantation. SIA was related to the change in the magnitude of chord u.
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Affiliation(s)
- Yishan Qian
- Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, People's Republic of China.
- NHC Key Laboratory of Myopia, Fudan University, 83th Fenyang Rd, Shanghai, 200031, People's Republic of China.
| | - Lan Ding
- Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, People's Republic of China
- NHC Key Laboratory of Myopia, Fudan University, 83th Fenyang Rd, Shanghai, 200031, People's Republic of China
| | - Yanlan Ding
- Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, People's Republic of China
- NHC Key Laboratory of Myopia, Fudan University, 83th Fenyang Rd, Shanghai, 200031, People's Republic of China
| | - Lin Jiang
- Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, People's Republic of China
- NHC Key Laboratory of Myopia, Fudan University, 83th Fenyang Rd, Shanghai, 200031, People's Republic of China
| | - Zesheng Liu
- Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, People's Republic of China
- NHC Key Laboratory of Myopia, Fudan University, 83th Fenyang Rd, Shanghai, 200031, People's Republic of China
| | - Xingtao Zhou
- Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, People's Republic of China.
- NHC Key Laboratory of Myopia, Fudan University, 83th Fenyang Rd, Shanghai, 200031, People's Republic of China.
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Yang Y, Long Z, Lei B, Liu W, Ye J. Clinical decision support system based on deep learning for evaluating implantable collamer lens size and vault after implantable collamer lens surgery: a retrospective study. BMJ Open 2024; 14:e081050. [PMID: 38365302 PMCID: PMC10875548 DOI: 10.1136/bmjopen-2023-081050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 01/23/2024] [Indexed: 02/18/2024] Open
Abstract
OBJECTIVES To aid doctors in selecting the optimal preoperative implantable collamer lens (ICL) size and to enhance the safety and surgical outcomes of ICL procedures, a clinical decision support system (CDSS) is proposed in our study. DESIGN A retrospective study of patients after ICL surgery. SETTING China Tertiary Myopia Prevention and Control Center. PARTICIPANTS 2772 eyes belonging to 1512 patients after ICL surgery. Data were collected between 2018 and 2022. OUTCOME MEASURES A CDSS is constructed and used to predict vault at 1 month postoperatively and preoperative ICL dimensions using various artificial intelligence methods. Accuracy metrics as well as area under curve (AUC) parameters are used to determine the CDSS prediction methods. RESULTS Among the ICL size prediction models, conventional neural networks (CNNs) achieve the best prediction accuracy at 91.37% and exhibit the highest AUC of 0.842. Regarding the prediction model for vault values 1 month after surgery, CNN surpasses the other methods with an accuracy of 85.27%, which has the uppermost AUC of 0.815. Thus, we select CNN as the prediction algorithm for the CDSS. CONCLUSIONS This study introduces a CDSS to assist doctors in selecting the optimal ICL size for patients while improving the safety and postoperative outcomes of ICL surgery.
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Affiliation(s)
- Yixuan Yang
- Department of Ophthalmology, The Third Hospital Affiliated to the Third Military Medical University Department of Ophthalmology, Chongqing, China
| | - Zhengqin Long
- Chongqing University Qianjiang Hospital, Chongqing, China
| | - Bo Lei
- Department of Ophthalmology, The Third Hospital Affiliated to the Third Military Medical University Department of Ophthalmology, Chongqing, China
| | - Wei Liu
- Department of Ophthalmology, The Third Hospital Affiliated to the Third Military Medical University Department of Ophthalmology, Chongqing, China
| | - Jian Ye
- Department of Ophthalmology, The Third Hospital Affiliated to the Third Military Medical University Department of Ophthalmology, Chongqing, China
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Miao A, Lin P, Ren S, Xu J, Yang F, Qian D, Lu Y, Zheng T. Influence of Ocular Biometry Parameters on the Predictive Accuracy of IOL Power Formulas in Patients with High Myopia. Ophthalmol Ther 2024; 13:435-448. [PMID: 38048035 PMCID: PMC10776536 DOI: 10.1007/s40123-023-00856-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 11/08/2023] [Indexed: 12/05/2023] Open
Abstract
INTRODUCTION The aim of this study was to investigate the influence of ocular biometry parameters on the predictive accuracy of 10 intraocular lens (IOL) power formulas in patients with high myopia (HM). METHODS We analyzed 202 eyes of 202 patients. The ocular biometry was determined preoperatively using an IOLMaster 700. The associations between the biometry parameters and the prediction error (PE) 1 month postoperatively were assessed. HM was defined as an axial length exceeding 26.50 mm. RESULTS In patients with HM (n = 108), the K6, Emmetropia Verifying Optical (EVO), Olsen, and Barrett Universal II (BUII) formulas had the lowest absolute PEs among the 10 formulas. The ocular biometry parameters were not associated with the PE of K6, EVO, Olsen, or BUII. A longer axial length in HM eyes was associated with myopic outcomes by Kane, Hoffer QST, and VRF and hyperopic outcomes by Holladay 2 and T2. Steeper keratometry, a deeper anterior chamber, and a thicker lens were associated with a hyperopic shift in HM eyes when using VRF, Kane, and Hoffer QST, respectively. In patients without HM (n = 94), there was no difference between the formulas in absolute PE. The significant associations between the biometry parameters and PE in patients with HM were not present in patients without HM. CONCLUSIONS K6, EVO, Olsen, and BUII displayed high accuracy in HM eyes and were not influenced by preoperative biometry parameters. For the remaining formulas, the preoperative keratometry, anterior chamber depth, lens thickness, and axial length were possible error sources underlying an inaccurate IOL power prediction in patients with HM.
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Affiliation(s)
- Ao Miao
- Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Peimin Lin
- Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Shaolong Ren
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Jie Xu
- Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Fan Yang
- Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Dongjin Qian
- Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Yi Lu
- Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Tianyu Zheng
- Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, 200031, China.
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China.
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Du Y, Meng J, He W, Lu Y, Zhu X. Challenges of refractive cataract surgery in the era of myopia epidemic: a mini-review. Front Med (Lausanne) 2023; 10:1128818. [PMID: 37795415 PMCID: PMC10546203 DOI: 10.3389/fmed.2023.1128818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 09/04/2023] [Indexed: 10/06/2023] Open
Abstract
Myopia is the leading cause of visual impairment in the world. With ever-increasing prevalence in these years, it creates an alarming global epidemic. In addition to the difficulty in seeing distant objects, myopia also increases the risk of cataract and advances its onset, greatly affecting the productivity of myopes of working age. Cataract management in myopic eyes, especially highly myopic eyes is originally more complicated than that in normal eyes, whereas the growing population of cataract with myopia, increasing popularity of corneal and lens based refractive surgery, and rising demand for spectacle independence after cataract surgery all further pose unprecedented challenges to ophthalmologists. Previous history of corneal refractive surgery and existence of implantable collamer lens will both affect the accuracy of biometry including measurement of corneal curvature and axial length before cataract surgery, which may result in larger intraocular lens (IOL) power prediction errors and a compromise in the surgical outcome especially in a refractive cataract surgery. A prudent choice of formula for cataract patients with different characteristics is essential in improving this condition. Besides, the characteristics of myopic eyes might affect the long-term stability of IOL, which is important for the maintenance of visual outcomes especially after the implantation of premium IOLs, thus a proper selection of IOL accordingly is crucial. In this mini-review, we provide an overview of the impact of myopia epidemic on treatment for cataract and to discuss new challenges that surgeons may encounter in the foreseeable future when planning refractive cataract surgery for myopic patients.
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Affiliation(s)
- Yu Du
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Jiaqi Meng
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Wenwen He
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Yi Lu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Xiangjia Zhu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
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