Abstract:AIM: To assess the visual acuity and visual quality of cataract patients who received femtosecond laser-assisted cataract surgery(FLACS)and multifocal intraocular lens(MIOL)implantation with an improved polishing technique during a 1-year follow-up period.

METHODS: This study included 74 eyes from 37 patients, comprising 17 males and 20 females, with a mean age of 51.74±7.80 years. Using a coin toss method, one eye per patient was randomly selected for improved anterior capsular polishing, while the other eye received standard irrigation/aspiration(I/A)polishing. The polishing group consisted of 37 eyes, including 21 right and 16 left eyes, while the control group comprised the contralateral fellow eyes of the same individuals in the polishing group. Visual acuity and quality of the patients were evaluated before surgery and at 1 wk, 1, 6, and 12 mo after surgery. The OPD-Scan III was utilized to assess high-order aberrations, while the optical quality analysis system(OQAS)was employed to evaluate modulation transfer function(MTF cutoff), Strehl ratio(SR), and objective scatter index(OSI)for the purpose of visual quality assessment. Paired t-tests and repeated measures analysis of variance(ANOVA)were utilized to compare the results, and the SNK-q post hoc test was applied to identify significant differences.

RESULTS:The polishing group's uncorrected distant visual acuity(UDVA)and uncorrected near visual acuity(UNVA)significantly improved 1-week post-surgery(all P<0.05). At 12-months, UDVA, UNVA, and corrected distant visual acuity(CDVA)were better than the control group(P<0.05). The MTF cutoff, SR, OSI, and high-order aberrations in the polishing group also showed significant improvements compared to the control group at 12 mo(P<0.05).

CONCLUSION:The improved capsular polishing method has been demonstrated to effectively maintain visual acuity and visual quality in patients with MIOL after FLACS within 1 a.

Abstract:AIM: To investigate the underlying causes of surgical failure and reoperation management in patients with rhegmatogenous retinal detachment(RRD)who underwent scleral buckle surgery at our institution.

METHODS: This was a single-center, retrospective, descriptive study. The clinical data of 368 patients(387 eyes)with RRD who underwent scleral buckling(SB)surgery between August 2013 and July 2023 at our institution were collected. The aim was to analyze the causes of recurrence and the rationale for selecting reoperation methods.

RESULTS: Totally 368 patients(387 eyes)were included in the analysis, comprising 222 males and 146 females. The average age was 30.26±14.18 years, and the mean follow-up duration was(48.33±20.39)mo. The success rate of SB surgery was 90.2%. Recurrent retinal detachment occurred in 38 eyes. Based on surgical records, the causes of SB failure were analyzed. The recurrence causes included abnormal compression ridge position(position, height, or width)in 14 eyes(36.8%, 14/38), hole omission in 11 eyes(29.0%, 11/38), proliferative vitreoretinopathy(PVR)in 10 eyes(26.3%, 10/38), and new holes in 3 eyes(7.9%, 3/38). Among these, 8 eyes(21.1%, 8/38)underwent repeat SB surgery, while the remaining 30 eyes(78.9%, 30/38)underwent pars plana vitrectomy(PPV). Regarding tamponade agents, silicone oil was used in 11 eyes(36.7%, 11/30), C₃F₈ gas in 12 eyes(40.0%, 12/30), and sterile air in 7 eyes(23.3%, 7/30).

CONCLUSION: SB surgery demonstrates a high success rate in the treatment of RRD. However, abnormal compression ridge position, missed holes during surgery, and PVR are the primary causes of SB failure. After addressing the reasons for failure, re-SB surgery or PPV can be effective alternatives.

Abstract:AIM:To investigate the neuroprotective effects of soy isoflavones(SI)against glucocorticoid-induced retinal ganglion cells(RGCs)injury in a rat model of acute ocular hypertension(AOH), and to explore the underlying mechanism involving the PI3K/Akt/Caspase-3 signaling pathway.

METHODS:A total of 48 Sprague-Dawley(SD)rats(48 eyes)were randomly assigned to four groups(n=12 per group): a control group(received normal saline), an AOH control group, a low-dose SI intervention group [LSI+AOH, 360 mg/(kg·d)], and a high-dose SI intervention group [HSI+AOH, 540 mg/(kg·d)]. The AOH, LSI+AOH, and HSI+AOH groups received subconjunctival injections of dexamethasone to induce AOH control group. From the 3 wk of modelling, SI was administered via intraperitoneal injection until 4 wk. Intraocular pressure(IOP)was monitored, RGC density was assessed, and the protein expression levels of PI3K/phosphorylated Akt(p-Akt)/Caspase-3, and key inflammatory cytokines were evaluated.

RESULTS:IOP was significantly higher in the AOH control group compared to the control group(P<0.01). Both the LSI+AOH and HSI+AOH groups exhibited a marked reduction in IOP compared to the AOH control group(all P<0.01). RGC density was significantly lower in the AOH control group than in the control group(P<0.01), but was notably increased in the LSI+AOH group and the HSI+AOH group compared with the AOH control group(all P<0.01). Compared with the control group, the AOH control group demonstrated downregulated protein expression of PI3K and p-Akt, alongside upregulated expression of activated Caspase-3(all P<0.05). After intervention, the expression of PI3K and p-Akt was upregulated, while Caspase-3 was downregulated in the LSI+AOH group and the HSI+AOH group(all P<0.01).

CONCLUSION: SI ameliorates glucocorticoid-induced RGCs injury, potentially by activating phosphorylated Akt(p-Akt)and subsequently inhibiting Caspase-3-mediated apoptosis. These neuroprotective effects appear to be dose-dependent.

Abstract:AIM: To investigate the role of the ABCA4 gene in the pathogenesis of dry age-related macular degeneration(ARMD)through bioinformatics and cellular experiments.

METHODS: Integrating bioinformatics and cellular experiments, differential expression genes(DEGs)associated with ARMD were screened based on the GEO dataset GSE29801. Hub genes were identified through PPI network analysis(using the STRING database)and topological parameter screening. A lentivirus-mediated stable ABCA4 knockdown cell line in human retinal pigment epithelial cells(ARPE-19; ABCA4-KD group)and a negative control were constructed. An oxidative stress model was established using NaIO₃, and the cells were divided into four treatment groups: NC group(negative control lentivirus+PBS), NaIO₃+NC group(negative control lentivirus+oxidative stress injury), ABCA4-KD group(ABCA4 knockdown lentivirus+PBS), NaIO₃+ABCA4-KD group(ABCA4 knockdown lentivirus+oxidative stress injury). Knockdown efficiency was verified via Western blot, cell viability was assessed using the CCK-8 assay, and the apoptosis rate was measured by Hoechst 33342 and Annexin V-FITC/PI double staining.

RESULTS: Bioinformatics analysis identified 5 069 DEGs(2 493 upregulated/2 576 downregulated), of which 118 key genes were obtained by intersecting with ARMD disease targets. PPI network analysis identified the top 5 hub genes(ABCA4, RPE65, PRPH2, RHO, PDE6B), with ABCA4 showing the highest degree centrality(Degree=58). ROC curve analysis demonstrated that ABCA4 had excellent discriminative efficacy for ARMD(AUC=0.986). Further cellular experiments revealed that ABCA4 protein expression in the ABCA4-KD group was significantly lower than that in the NC group(P<0.05). Under oxidative stress conditions, the NaIO₃+ABCA4-KD group exhibited lower cell viability compared to the NaIO₃+NC group(P<0.01), while the apoptosis rate was significantly increased(all P<0.01). In the absence of oxidative stress, knockdown of ABCA4 alone did not affect cell survival(P>0.05).

CONCLUSION: Loss of ABCA4 function contributes to the pathology of ARMD by exacerbating oxidative stress-induced RPE cell apoptosis, and is expected to serve as a novel therapeutic target for dry ARMD.

Abstract:AIM: To discuss the efficacy of sutureless intrascleral intraocular lens(IOL)fixation with the modified Yamane technique in patients with incomplete lens capsule.

METHODS: Retrospective study. Patients with incomplete lens capsular bags who were treated in our hospital from January 2022 to December 2024 were selected. According to the treatment plan, the patients were divided into a modified group, who were treated with the modified Yamane method for sutureless IOL fixation between the sclera layers. The traditional group was treated with the traditional ciliary sulcus suture suspension surgery. Postoperative follow-up was conducted for 6 mo. The operation time, best corrected visual acuity(BCVA), visual quality score, intraocular pressure, IOL position and complications were compared between the two groups of patients.

RESULTS: A total of 84 patients(84 eyes)were included in this study. Among them, 42 patients(42 eyes)were in the modified group, and 42 patients(42 eyes)were in the traditional group. There was no difference in the general preoperative data between the two groups(all P>0.05). The surgical time of the modified group was(26.97±6.58 min), which was shorter than the traditional group's(33.42±7.64 min; P<0.01). At 1, 3, and 6 mo after surgery, the modified group showed better visual quality score and BCVA than the traditional group(all P<0.05). At 6 mo after surgery, the intraocular pressure and the vertical deviation of the IOL in the modified group were both lower than those in the traditional group(all P<0.05). During the follow-up period, the complication rate in the traditional group was 19%, while that in the modified group was 7%. There was no statistically significant difference in postoperative complications between the two groups(χ²=1.816, P>0.05).

CONCLUSION:For patients with incomplete lens capsule, the modified Yamane method of sutureless intrascleral fixation of IOL is effective in treating this condition. It can improve vision, shorten the operation time, reduce the occurrence of complications, and ensure better vertical position stability of the IOL.

Abstract:AIM: To evaluate corneal biomechanical changes before surgery and different postoperative time in patients with varying degrees of myopia undergoing either femtosecond laser in situ keratomileusis(FS-LASIK)or small incision lenticule extraction(SMILE)procedures by ocular response analyzer(ORA), and to investigate potential differences in how these two surgical techniques and varying degrees of myopia affect corneal biomechanical properties.

METHODS: Case series study. A total of 132 eyes that underwent FS-LASIK or SMILE surgery at Lanzhou Huaxia Eye Hospital between December 2023 and June 2024 were enrolled. Based on the surgical procedure, they were categorized into FS-LASIK and SMILE groups and further stratified into a high myopia group(-10.00 DRESULTS: The corneal biomechanical status in the FS-LASIK group and the SMILE group was well comparable. At 3 mo postoperatively, both the FS-LASIK and SMILE groups showed a significant increase in SE compared with preoperative values, whereas UCVA, CCT, and IOPcc were significantly decreased(all P<0.05). No statistically significant differences were observed in these parameters between the two groups(all P>0.05). At 1 d after surgery, both CH and CRF decreased significantly in the FS-LASIK and SMILE groups(all P<0.05). The reduction was more pronounced in the FS-LASIK group than in the SMILE group(P<0.05). By 1 and 3 mo postoperatively, CH and CRF in both groups exhibited recovery relative to early postoperative levels and tended to stabilize, though they remained lower than preoperative values(all P<0.05). Furthermore, the FS-LASIK group had lower CH and CRF than the SMILE group at these time points(all P<0.05). Within the SMILE group, the high myopia subgroup demonstrated more pronounced decreases in CH and CRF at 1 d and 1 wk after surgery compared with the moderate-to-low myopia subgroup(all P<0.05).

CONCLUSION: Both FS-LASIK and SMILE procedures demonstrated good safety, predictability, and effectiveness postoperatively. However, both techniques resulted in reduced corneal biomechanical parameters, with FS-LASIK causing a more significant decrease. In the early postoperative period, patients in the high myopia group showed a more pronounced reduction in corneal biomechanics. By 3 mo after surgery, no statistically significant difference was observed in the effect of myopia degree on corneal biomechanical properties.

Abstract:AIM: To analyze the global research status, hotspots, and trends in the field of dry eye disease(DED), aiming to provide a theoretical basis and reference for researchers and to promote further development in this field.

METHODS: A comprehensive literature search was conducted across the China National Knowledge Infrastructure(CNKI), Wanfang Medical Database, VIP Database, Web of Science Core Collection and PubMed for publications on DED up to July 10, 2025. CiteSpace 6.2.R3 and VOSviewer software were used to perform bibliometric and visualization analyses, focusing on countries/institutions, contributing authors, and high-frequency keywords.

RESULTS: Global research on DED has led to the formation of established scientific communities across various countries. The top three countries in terms of publication volume are the United States(3 956 articles), China(2 255 articles), and Japan(1 053 articles). Among research institutions worldwide, Keio University in Japan ranked first with 395 publications, followed by Harvard University(243 articles)and Harvard Medical School(242 articles)in the United States. In China, the leading institutions are Beijing Tongren Hospital, Capital Medical University(83 articles), Zhongshan Ophthalmic Center, Sun Yat-sen University(67 articles), and the First Affiliated Hospital of Nanchang University(63 articles). Analysis of high-frequency and emerging keywords in both Chinese and English literature identified research hotspots, including artificial intelligence, intense pulsed light(IPL)therapy, animal models of DED, pathophysiological mechanisms, and drug delivery systems.

CONCLUSION: In global DED research, clinical studies are increasingly focused on diagnostic applications of artificial intelligence and therapeutic strategies such as IPL therapy. Basic research trends emphasize pathophysiological mechanisms including oxidative stress and the development of novel pharmacological therapies based on animal models of dry eye disease.

Abstract:Glaucoma is the leading cause of irreversible blindness worldwide, characterized by progressive degeneration and axonal loss of retinal ganglion cells(RGCs). Despite extensive research, the mechanisms driving this disease remain incompletely understood. Long non-coding RNA(lncRNA)have recently emerged as critical regulators of glaucoma pathogenesis, modulating gene expression and influencing key processes, including disease onset, progression, and therapeutic response. This review summarizes recent progress on lncRNA in glaucoma and outlines future research directions.

Abstract:In vivo confocal microscopy(IVCM)is a real-time and non-invasive imaging technology that allows for the evaluation of morphological changes in ocular surface tissues under both physiological and pathological conditions. It offers detailed and cellular-level insight into the microscopic architecture of the ocular surface. In recent years, a growing body of research has incorporated IVCM into the study of bulbar conjunctival diseases. By providing high-resolution imaging and quantitative analysis of cellular features, IVCM not only offers novel insights into the mechanisms underlying these diseases but also supplies valuable longitudinal data for clinical diagnosis, treatment, and therapeutic evaluation. Therefore, this review elucidates the current applications, limitations and future clinical potential of IVCM in bulbar conjunctival diseases, with the aim of providing theoretical reference and practical guidance for clinical practice.

Abstract:Sex hormones play a pivotal role in the pathogenesis and progression of numerous ophthalmic diseases. Steroid hormones—including estrogen, progesterone, and androgen—exert significant regulatory effects on ocular tissues such as the lacrimal gland, cornea, retina, and conjunctiva. Growing evidence suggests that sex hormones are closely associated with the onset and progression of dry eye disease, keratoconus, uveitis, primary open angle glaucoma, and retinopathy of prematurity. Moreover, clear gender-related differences in disease prevalence have been observed, while hormonal fluctuations during key life stages—such as puberty, pregnancy, and menopause—further influence susceptibility to these conditions. This review summarizes current understanding of the mechanisms by which sex hormones affect ocular disorders and highlights the therapeutic potential of hormone-based interventions, including hormone replacement therapy. A deeper insight into the intricate interplay between sex hormones and ocular pathology may open new avenues for the prevention and management of hormone-sensitive eye diseases.

Abstract:In recent years, the incidence of ophthalmic diseases has been on a steady rise, with traditional therapeutic approaches facing considerable limitations in terms of drug delivery efficiency, bioavailability, and targeting capability. As a novel class of functional nanomaterials with enzyme-mimetic catalytic activity, nanozymes not only possess the highly efficient catalytic properties of natural enzymes but also integrate the unique advantages of nanomaterials, such as a large specific surface area, excellent biocompatibility, and targeted delivery potential, thereby offering innovative insights for the treatment of ophthalmic diseases. The synergistic integration strategy of nanozymes with drug molecules can optimize drug release kinetics, enhance targeted accumulation in lesion tissues, and reduce nonspecific damage, which has demonstrated remarkable potential in the treatment of various ophthalmic conditions. This review systematically summarizes the classification system of nanozymes, focuses on elaborating the latest research progress of nanozyme-drug combinations in the management of ophthalmic diseases including glaucoma, dry eye, keratitis, diabetic retinopathy, and retinal neovascularization, and thoroughly analyzes the core advantages of such combinations in improving drug bioavailability, enhancing the precision of targeted delivery, and minimizing adverse effects. It is anticipated to provide theoretical references for the development and clinical translation of innovative therapeutic strategies for ophthalmic diseases.

Abstract:Astigmatism, a common form of refractive error, results from an asymmetric curvature of the anterior corneal surface or the lens. In the context of refractive cataract surgery, corneal astigmatism has a substantial impact on postoperative visual outcomes. Toric intraocular lenses(Toric IOL)have become a critical option for managing cataracts accompanied by astigmatism, effectively correcting a broad spectrum of astigmatic errors and significantly improving postoperative uncorrected visual acuity. However, the rotational stability of Toric IOL following implantation is a key determinant of final visual quality. This review systematically examines factors influencing the postoperative stability of Toric IOL and discusses potential strategies for enhancement, with the aim of providing evidence-based guidance for clinical Toric IOL selection and future developments in IOL design.

Abstract:Diabetic retinopathy(DR)is one of the most common microvascular complications of diabetes, and its pathogenesis is closely related to immune-inflammatory responses. As a core inflammatory factor, the role of interleukin-6(IL-6)in DR has gained increasing attention. IL-6 exerts neuro- and vaso-protective effects via the classical signaling pathway, while it drives pathological processes primarily through the trans-signaling pathway. The specific mechanisms include disruption of the blood-retinal barrier, promotion of the release of inflammatory factors such as vascular endothelial growth factor(VEGF), induction of neurodegenerative changes, and exacerbation of oxidative stress. Regarding treatment, strategies targeting IL-6 are diverse, including IL-6/IL-6R antagonists, selective inhibition of the trans-signaling pathway, combination therapy with anti-VEGF agents, and interventions based on gene polymorphisms. This review will summarize the research progress on IL-6 in DR from three aspects, including its expression regulation, mechanisms of action, and intervention strategies.

Abstract:Collateral vessels serve as a compensatory pathway for local circulatory disturbances induced by branch retinal vein occlusion(BRVO)and represent a manifestation of retinal capillary remodeling. The early establishment of these vessels plays an important role in improving the prognosis of visual function in patients with BRVO. This article systematically reviews recent domestic and international literature on the generation mechanism and influencing factors of collateral vessels. It aims to further reveal the anatomical structure and prognostic significance of collateral vessel formation, explore its clinical value in research, provide an evidence-based foundation for ischemic control in the clinical management of retinal vascular diseases, and offer novel insights for clinical diagnosis and treatment.

Abstract:Diabetic optic neuropathy(DON)is a common yet frequently overlooked complication of diabetes mellitus(DM), characterized by an insidious onset, nonspecific clinical manifestations, and frequent co-occurrence with diabetic retinopathy(DR), which often leads to delayed diagnosis and irreversible optic nerve damage. Optical coherence tomography(OCT)and optical coherence tomography angiography(OCTA)provide non-invasive, high-resolution imaging of the retinal layers, choroid, and optic nerve head, enabling detailed visualization of structural and microvascular changes in DON. This review summarizes recent advances in the application of OCT/OCTA for evaluating peripapillary retinal nerve fiber layer(pRNFL)thickness, ganglion cell complex(GCC)integrity and vessel density(VD)in DON, highlighting that microvascular impairment may precede measurable structural loss. Furthermore, the potential of OCT/OCTA in disease staging, treatment monitoring, and its integration with artificial intelligence(AI)for early screening and risk prediction is discussed. By combining structural and hemodynamic metrics, OCT/OCTA holds promise for improving early detection, risk stratification, and precision management of DON, thereby helping to preserve visual function in affected patients.

Abstract:Scleral lenses are large-diameter rigid gas permeable contact lenses specifically designed based on the morphology of the ocular surface. These lenses feature a larger diameter, higher sagittal height, and limited movement to provide superior stabilization and wearer comfort. Scleral lenses have been developed over several centuries, with breakthroughs achieved in material oxygen permeability, manufacturing processes, and fitting equipment, creating the necessary conditions for innovative designs. From the initial spherical design, scleral lenses have evolved into various design categories such as toric, quadrant, and notched designs, making them suitable for a wide range of ocular surface shapes. Currently, scleral lenses are widely used for irregular corneal astigmatism, high refractive errors, and ocular surface diseases, with their clinical efficacy and safety having been confirmed by clinical studies. This comprehensive review systematically examines recent developments in scleral lenses, encompassing lens design, production and quality inspection, fitting, clinical applications, as well as complications and their management strategies.

Abstract:Dry eye is a common ocular condition characterized by multifactorial etiology, involving abnormalities in the quality, quantity, and dynamics of tears, leading to tear film instability and imbalance of the ocular surface microenvironment. Its pathogenesis is complex and not only associated with local ocular factors but also linked to various systemic diseases, making it an interdisciplinary disorder that increases the challenge of clinical diagnosis and treatment. This review systematically elaborates on the associations between dry eye disease and systemic factors such as autoimmune, metabolic, endocrine, and psychiatric disorders, and further investigates the core pathogenic mechanisms, namely inflammatory responses, oxidative stress, neuro-immune interactions, and tear film compositional changes. Thus, this review provides a theoretical basis for understanding the multisystem etiology of dry eye and offers novel insights for comprehensive clinical management and fundamental research.

Abstract:Early-onset myopia refers to myopia that develops before the age of 13. Characterized by rapid initial progression and a significantly increased risk of developing high myopia in the future, it has become a major public health problem threatening children's visual health. Early diagnosis and systematic intervention represent a critical window for slowing refractive progression and reducing the risk of high myopia and associated ocular fundus complications, holding significant importance for improving long-term visual outcomes in children. This review aims to systematically summarize recent advances in early-onset myopia, focusing on the mechanisms of gene-environment interactions, advances in treatment technologies, and innovations in comprehensive management strategies. It integrates the latest achievements from both basic research and clinical practice related to the treatment of early-onset myopia, aiming to provide theoretical support for precise diagnosis and treatment, public health policy formulation, and technological innovation. Furthermore, it serves as a valuable reference for ophthalmologists, researchers, and policy makers.

Abstract:Presbyopia is an age-related physiological phenomenon characterized by a gradual decline in the accommodation of the eye leading to difficulty in near vision. With the acceleration of population aging, presbyopia has gradually become a global public health problem. At present, the correction methods of presbyopia mainly include optical correction, surgical correction and drug treatment, which can improve the near vision disorder. However, each of the above treatments has its own advantages and disadvantages. Optical correction can be fitted with single focal convex lens, progressive multifocal glasses, etc., which are the most common and economical correction methods, but frequently removal of glasses will cause inconvenience in life. Surgical correction can be carried out by changing the refractive performance of the cornea, replacing the intraocular lens and scleral surgery, and patients can get rid of glasses after surgery, but each surgical method has its own advantages and disadvantages. Drug treatment, including miosis drugs and lens softeners, is expected to become a new method for non-invasive presbyopia correction, but there is currently a lack of clinical trials and evidence-based medical evidence. This article reviews the treatment methods and research progress of presbyopia.

Abstract:AIM: To investigate the predictive value of tear secretion-related protein 5(SFRP-5), hypoxia-inducible factor-1α(HIF-1α), and interferon regulatory factor 4(IRF4)for postoperative dry eye in patients with age-related cataracts.

METHODS: A total of 212 patients with age-related cataracts admitted to our hospital from January 2024 to December 2024 were prospectively selected(study group). According to whether postoperative dry eye occurred, they were divided into a dry eye group(96 cases)and a non-dry eye group(116 cases). Additionally, 110 individuals who underwent health check-ups during the same period were selected as the control group. The correlation between tear fluid levels of SFRP-5, HIF-1α, and IRF4 and the history of keratoconjunctival disease, tear film break-up time(BUT), and fluorescein(FL)in dry eye syndrome patients was analyzed through Pearson and Spearman methods. Logistic regression analysis was used to identify factors for postoperative dry eye; relative risk analysis was conducted to assess the impact of different levels of tear SFRP-5, HIF-1α, and IRF4 on postoperative dry eye; ROC curve analysis was performed to evaluate the predictive value for postoperative dry eye.

RESULTS: The general data of the study group and the control group were comparable. The study group showed lower expression of SFRP-5 in tears and higher expression of HIF-1α and IRF4 in tears compared to the control group(all P<0.05). The proportion of patients with a history of corneal and conjunctival disease was higher in the dry eye group than in the non-dry eye group(P<0.05). Tear SFRP-5 expression was lower and tear HIF-1α and IRF4 expression was higher in the dry eye group compared to the non-dry eye group(all P<0.05). According to Pearson correlation analysis, tear SFRP-5, HIF-1α, and IRF4 correlated with BUT and FL(all P<0.05). SFRP-5 was a protective factor for postoperative dry eye, while HIF-1α, IRF4, and a history of corneal and conjunctival disease were risk factors(all P<0.05). The risk of postoperative dry eye in patients with low expression of SFRP-5 was 1.678 times that of patients with high expression of SFRP-5, the risk of postoperative dry eye in patients with high expression of HIF-1α was 1.536 times that of patients with low expression of HIF-1α, and the risk of postoperative dry eye in patients with high expression of IRF4 was 1.616 times that of patients with low expression of IRF4. The AUCs for predicting postoperative dry eye using tear SFRP-5, HIF-1α, and IRF4 individually and in combination were 0.772, 0.699, 0.724, and 0.872, respectively, with combined prediction outperforming individual markers(all P<0.05).

CONCLUSION: In patients with age-related cataracts, tear SFRP-5 expression is downregulated, while HIF-1α and IRF4 expression are upregulated, and this is associated with the development of dry eye after surgery. Combined detection can improve the predictive value for postoperative dry eye.

Abstract:AIM:To evaluate the efficacy of conbercept combined with subthreshold micropulse laser(SML)in the treatment of diabetic macular edema(DME)and its effect on macular perfusion and visual function.

METHODS: A retrospective analysis was conducted on 70 patients with DME admitted to our hospital from June 2023 to December 2024. Based on their treatment regimens, the patients were divided into two groups: 35 patients receiving anti-VEGF monotherapy served as the control group, and 35 patients receiving combined conbercept and SML therapy comprised the observation group. The clinical efficacy, macular perfusion parameters \〖superficial capillary plexus(SCP)vessel density, deep capillary plexus(DCP)vessel density, central macular thickness(CMT)\〗, visual function metrics \〖best-corrected visual acuity(BCVA), foveal thickness(FT), hemorrhagic spot area\〗, and the incidence of complications during treatment were compared between the two groups before and after treatment.

RESULTS:The baseline data of the two groups were comparable. The total effective rate was significantly higher in the observation group than in the control group(97% vs 83%, P<0.05). At 6 mo after treatment, SCP and DCP vessel densities increased in both groups compared to pre-treatment levels, with greater improvements observed in the observation group(all P<0.05). Conversely, CMT, BCVA, FT, and hemorrhagic spot area decreased in both groups, with more significant reductions in the observation group(all P<0.05). No statistically significant difference was found in the incidence of complications between the two groups during the treatment period(P>0.05).

CONCLUSION: The combination of conbercept and SML therapy demonstrates significant clinical efficacy in treating DME. It effectively improves macular blood perfusion and visual function with a favorable safety profile.

Abstract:AIM: To explore the long-term efficacy and influencing factors of intravitreal injection of anti-vascular endothelial growth factor(VEGF)drugs in patients with choroidal neovascularization secondary to pathological myopia(PM-CNV).

METHODS: Retrospective case control study. The clinical data of 145 patients with PM-CNV who received intravitreal injection of anti-VEGF drugs at Nanshi Hospital of Nanyang from January 2020 to February 2023 were analyzed. The best corrected visual acuity(BCVA)and central macular retinal thickness(CMT)of the patients at different time points before and after treatment were observed. According to the prognosis after 2-year follow-up, the patients were divided into good therapeutic effect group and poor therapeutic effect group. The general data of the two groups of patients were compared, and multivariate Logistic regression analysis was conducted to analyze the related factors affecting the poor therapeutic effect of the patients. A risk prediction model for poor therapeutic effect on PM-CNV patients was constructed based on relevant factors, and the predictive value of this model was evaluated by using the receiver operating characteristic(ROC)curve.

RESULTS: Compared with before treatment, CMT significantly decreased and BCVA significantly increased at 1, 3, 6, 12 and 24 mo after treatment(all P<0.05). Compared with 1 mo after treatment, CMT was significantly decreased and BCVA was significantly increased at 3, 6, 12, and 24 mo after treatment(all P<0.05). Compared with 3 mo after treatment, CMT was significantly decreased and BCVA was significantly increased at 6, 12, and 24 mo after treatment(all P<0.05). Compared with 6 mo after treatment, BCVA significantly improved at 24 mo after treatment(P<0.05). Compared with the good therapeutic effect group, the proportion of patients aged ≥50 years in the poor therapeutic effect group was larger, the disease course was longer, the number of injections was more, the BCVA before treatment was poorer and the CMT was thicker(all P<0.05). Long disease course, large number of injections, low BCVA before treatment, and thick CMT are the related factors for poor efficacy of intravitreal injection of anti-VEGF drugs in patients with PM-CNV(all P<0.05). A combined prediction model was constructed based on influencing factors. The ROC results showed that the area under the curve(AUC)of this combined model for predicting poor therapeutic effect in PM-CNV patients was 0.756(95% CI: 0.678-0.824), with a sensitivity of 86.27%, a specificity of 62.77%, and a Youden index of 0.490. The combined model has good predictive performance.

CONCLUSION: Anti-VEGF drugs can improve visual acuity and reduce CMT in patients with PM-CNV. Among them, long disease course, more injection times, lower BCVA before treatment, and thick CMT are related factors for poor therapeutic effect on patients with PM-CNV.

Abstract:AIM: To investigate the clinical efficacy of intravitreal ranibizumab injection(IVR)combined with 577 nm subthreshold micropulse laser(STML)in the treatment of pathological myopic choroidal neovascularization(PM-CNV).

METHODS: Totally 52 patients(52 eyes)who were diagnosed with PM-CNV at Baotou Eye Hospital from December 2021 to December 2023 were selected in the study. Patients were randomly assigned in a 1:1 ratio using digital randomization to two groups: control group(26 eyes)treated with IVR monotherapy, and experimental group(26 eyes)was treated with IVR-STML combined therapy. The best corrected visual acuity(BCVA), central macular thickness(CMT), CNV area, and total number of IVR were compared before treatment and at 3, 6, 9, and 12 mo after treatment.

RESULTS: The general data of the two groups before treatment were comparable. The BCVA was improved, CMT was decreased, and CNV area was reduced at 3, 6, 9, and 12 mo after the initial treatment(all P<0.05). The experimental group exhibited significantly lower CMT at 3 and 6 mo, and reduced CNV area at 6, 9, and 12 mo compared to the control group(all P<0.05). The average times of IVR in the experimental group was significantly less than that of the control group(P<0.05).

CONCLUSION:Both IVR monotherapy and IVR-STML combined therapy for PM-CNV can improve BCVA with comparable improvement. IVR-STML therapy offers durable macular stabilization, effectively controls CNV progression, and reduces anti-VEGF injections. It lowers treatment burden and improves long-term outcomes and is recommended as a preferred treatment strategy.

Abstract:AIM: To investigate the effect of decentration tilt of intraocular lens on higher-order aberrations(HOAs)in patients with high myopic cataract after surgery.

METHODS: Totally 100 patients(100 eyes)with high myopic cataract were retrospectively analyzed and treated with phacoemulsification and intraocular lens implantation. Then follow up was conducted 3 mo after surgery. The Pentacam 3D anterior segment analyzer was used to measure the tilt degree and decentration value of intraocular lens. The i-Trace aberration analyzer was used to collect HOAs from patients under 3.0 mm and 5.0 mm pupils. Pearson linearity was used to analyze the correlation of the decentration tilt of intraocular lens with HOAs.

RESULTS: The tilt degree was 1.49°±0.32°, decentration value was 0.33±0.05 mm, and the tilt degree was positively related to decentration value of intraocular lens. When the pupil diameter was 3 mm or 5 mm, the postoperative tilt degree of intraocular lens was positively related to total HOAs(r=0.351, P=0.003; r=0.287, P=0.015)and total coma(r=0.389, P=0.002; r=0.332, P=0.005), while not correlated with total spherical aberration(r=0.382, P=0.235; r=0.149, P=0.207). In addition, the decentration value of intraocular lens not correlated with total HOAs(r=0.011, P=0.930; r=-0.146, P=0.215), total coma(r=0.023, P=0.856; r=-0.102, P=0.393), and total spherical aberration(r=0.085, P=0.476; r=-0.165, P=0.162).

CONCLUSION: The tilt of intraocular lens in high myopic cataract patients after surgery can affect total HOAs and total coma, thereby affecting their postoperative vision.

Abstract:AIM: To construct and validate a risk prediction model for the changes of intraocular pressure in patients with glaucoma.

METHODS: A total of 480 glaucoma patients who had surgery in the ophthalmology department of First Hospital of Anhui University of Science and Technology were selected between January 1, 2023, and September 30, 2025. They were divided into a good intraocular pressure group(288 cases)and a poor intraocular pressure group(192 cases)according to the intraocular pressure at 1 mo after surgery. Univariate analysis was conducted on the general information, preoperative intraocular pressure, preoperative axial length, preoperative corneal thickness, interleukin-6(IL-6), transforming growth factor-β(TGF-β), and nitric oxide(NO)levels of all patients. The factors with significant variation underwent Logistic multivariate analysis, a nomogram prediction model was constructed, and the calibration curve and the receiver operating characteristic(ROC)curve were used for validation.

RESULTS: Patients in the poor intraocular pressure group aged 68.07±12.57 years, had 78 males(40.6%), 131 history of hypertension(68.2%), preoperative corneal thickness of 553.44±32.97 μm, IL-6 of 6.38±1.97 pg/mL, TGF-β of 5.72±1.72 ng/mL, and NO of 76.46±8.04 μmol/L, which were all better than the good intraocular pressure group(all P<0.05). The Logistic regression analysis indicated that the age of glaucoma patients(OR=1.031, β=0.030), history of hypertension(OR=2.089, β=0.737), preoperative corneal thickness(OR=1.013, β=0.013), and IL-6(OR=1.362, β=0.309)and NO(OR=1.125, β=0.117)were risk factors for the postoperative changes of intraocular pressure(all P<0.05). The ROC curve showed that the AUC of postoperative changes of intraocular pressure in glaucoma patients was 0.785(95% CI: 0.743-0.827). The prediction curve was basically fitted to the standard curve, as shown in the Hosmer-Lemeshow test, χ²=4.742 and P=0.785.

CONCLUSION: The age of glaucoma patients, history of hypertension, preoperative corneal thickness, and levels of IL-6 and NO were risk factors affecting postoperative intraocular pressure, these factors were of clinical practicality when combined with constructed nomogram.

Abstract:AIM: To analyze the influencing factors of dry eye after ciliary photocoagulation in patients with refractory glaucoma, and to build a risk prediction model.

METHODS:From January 2021 to January 2024, the clinical data of 303 patients(308 eyes)with refractory glaucoma in our hospital were analyzed retrospectively, and the incidence of dry eye was counted 3 mo after operation. They were divided into two groups according to the incidence of dry eye after operation: an occurrence group(n=105)and a non-occurrence group(n=198). The medical records of the two groups were collected, and the influencing factors of dry eye were analyzed by Logistic regression. The Nomogram model was made by R3.4.3 software based on the results of Logistic regression analysis. The risk prediction ability of Nomogram model was evaluated by receiver operating characteristic(ROC)curve, and the calibration degree of Nomogram model was detected by calibration curve.

RESULTS:The incidence of dry eye in refractory glaucoma patients after ciliary photocoagulation was 34.65%. Age(OR=1.343, 95% CI: 1.102-1.637), diabetes(OR=1.219, 95% CI: 1.044-1.423), Sjogren's syndrome(OR=1.289, 95% CI: 1.070-1.553), keratoconjunctival diseases(OR=1.366, 95% CI: 1.116-1.672), eyelid fat viscosity 3-4 grade(OR=1.168, 95% CI: 1.040-1.311), conjunctival relaxation 3-4 grade(OR=1.158, 95% CI: 1.028-1.305), exposure time under glasses during operation(OR=1.415, 95% CI: 1.129-1.773), the average daily use time of electronic products after operation(OR=1.366, 95% CI: 1.108-1.685)and the auxiliary use of hormone eye drops after operation(OR=1.231, 95% CI: 1.026-1.477)were the influencing factors of dry eye after ciliary body photocoagulation in refractory glaucoma patients(all P<0.05). ROC curve showed that the area under the curve, sensitivity and specificity of Nomogram model in predicting postoperative dry eye syndrome were 0.930(95% CI: 0.895-0.956), 96.19% and 82.83%, respectively. The internal verification of Nomogram model showed that the C-index value was 0.859, Hosmer-Lemeshow goodness-of-fit test(χ²=1.972, P=0.396)showed a good fit.

CONCLUSION: Age, diabetes, Sjogren's syndrome, keratoconjunctival disease, eyelid fat viscosity 3-4 grade, conjunctival relaxation 3-4 grade, exposure time under glasses during operation, average daily use time of electronic products after operation, and adjuvant use of hormone eye drops after operation are the influencing factors of dry eye in refractory glaucoma patients after ciliary body photocoagulation, the risk prediction model based on the above factors can predict the risk of dry eye after operation.

Abstract:AIM: To evaluate the efficacy and safety of ab-externo microcatheter-guided 360° or 120° trabeculotomy combined with peripheral iridectomy in lowering intraocular pressure(IOP), reducing the need for antiglaucoma medications, and improving clinical outcomes in patients with open angle glaucoma(OAG).

METHODS:This retrospective study included 55 patients with OAG who underwent the procedure in the Enshi region between October 2019 and March 2024. Follow-up examinations were conducted at 1, 3, 6, and 12 mo postoperatively to record IOP, best-corrected visual acuity(BCVA), use of anti-glaucoma medications, and postoperative complications. The primary outcome measures were changes in IOP before and after surgery and surgical success rates(complete success: IOP ≤18 mmHg without medication; partial success: IOP ≤18 mmHg with medication).

RESULTS:The mean preoperative IOP was 26.7±4.4 mmHg. Postoperatively, the IOP showed a continuous decreasing trend at 1, 3, 6, and 12 mo, with all time points demonstrating a significant reduction compared with baseline(all P<0.001). At 12 mo postoperatively, the complete success rate was 62%, and the partial success rate was 38%. The use of anti-glaucoma medications was significantly reduced, with most patients maintaining target IOP without pharmacological assistance at 12 mo. No significant difference was observed in BCVA between preoperative and 12-month postoperative assessments(P=0.19). The most common postoperative complication was transient hyphema(20%), which resolved spontaneously within 1 wk, and no severe complications were observed.

CONCLUSION: Ab-externo microcatheter-guided 360° or 120° trabeculotomy combined with peripheral iridectomy significantly lowers IOP, reduces medication dependence, and demonstrates a high safety profile, making it an effective and reliable surgical option for patients with OAG.

Abstract:AIM: To investigate the prevalence of ocular diseases among premature infants in the Dan'ao area of Huizhou city, and to explore the relevant risk factors for retinopathy of prematurity(ROP), so as to provide a theoretical basis for promoting the implementation of universal ocular disease screening for all premature infants in our city.

METHODS: A retrospective analysis was performed on the data of premature infants who underwent ocular disease screening in our hospital from June 2023 to December 2024 in the Dan'ao area of Huizhou city. The types and detection rates of ocular diseases in premature infants in this area were statistically analyzed, and the factors influencing the occurrence of ROP were further explored.

RESULTS:A total of 715 premature infants(1 430 eyes)who received ocular disease screening in our hospital were enrolled in this study, including 428 males and 287 females, with a mean gestational age at birth of 34.59±1.98 wk and a mean birth weight of 2218.64±509.08 g. Among them, 178 were twins and 537 were singletons. A total of 70 cases of 10 types of ocular diseases were detected in the 715 preterm infants, with an overall detection rate of 9.79%. Specifically, 26 cases(3.64%)were diagnosed with ROP, including 20 cases of stage 1, 4 cases of stage 2, and 2 cases of stage 3. Among the ROP patients, 73.08%(19/26)had a gestational age ≤34 wk at birth, and 69.23%(18/26)had a birth weight <2 000 g. Multivariate Logistic regression analysis revealed that maternal gestational diabetes mellitus(OR: 3.493, 95% CI: 1.292-9.445, P<0.05), gestational hypertension(OR: 2.858, 95% CI: 1.067-7.659, P<0.05), neonatal anemia(OR: 3.636, 95% CI: 1.295-10.212, P<0.05), respiratory distress syndrome(OR: 11.128, 95% CI: 3.369-36.756, P<0.05), and history of oxygen inhalation(OR: 5.531, 95% CI: 1.697-18.031, P<0.05)were all independent risk factors for ROP in premature infants. Additionally, a higher gestational age at birth was identified as a protective factor against ROP(OR: 0.557, 95% CI: 0.389-0.798, P<0.05).

CONCLUSION:The significance of ocular diseases screening for premature infants lies not only in the detection of ROP but also in the identification of other blinding ocular lesions. Early screening and timely diagnosis and treatment can prevent impairment of visual development in children.

Abstract:AIM: To evaluate the clinical efficacy of a novel anti-blue light film in alleviating dry eye symptoms, improving visual function, and reducing visual fatigue.

METHODS: This study was a prospective trial. From April 2023 to March 2024, participants meeting the inclusion criteria were recruited from Ningbo Eye Hospital. They were randomly divided using a random number table into a novel anti-blue light film group, an ordinary anti-blue light film group, and a transparent film group without blue-light filtering properties. After intervention for 3 mo, tear film break-up time(BUT), accommodative facility, accommodative amplitude, and visual fatigue scores were compared among the three groups before and after the intervention.

RESULTS: A total of 82 participants(164 eyes)were included in this study, comprising 26 participants(52 eyes)in the novel anti-blue light film group, 26 participants(52 eyes)in the ordinary anti-blue light film group, and 30 participants(60 eyes)in the transparent film group without blue-light filtering properties. All participants completed the entire study with no loss to follow-up. After the 3-month intervention, the BUT of both the left and right eyes in the novel anti-blue light film group was significantly prolonged compared to before the intervention(all P<0.05), and the BUT of right eyes was superior to those in both the ordinary anti-blue light film group and the transparent film group without blue-light filtering properties(all P<0.05). After the 3-month intervention, the right eye accommodative facility and the accommodative amplitude of both eyes in the novel anti-blue light film group improved(P<0.05); the accommodative facility of both eyes in the ordinary anti-blue light film group significantly worsened(P<0.05). The visual fatigue score increased in the ordinary anti-blue light film group(P<0.001), while no significant changes were observed before and after intervention in the transparent film group without blue-light filtering properties or the novel anti-blue light film group.

CONCLUSION: The novel anti-blue light film can effectively prolong tear film BUT and improve accommodative function, but its effect on alleviating visual fatigue is limited; the ordinary film exacerbates visual fatigue and impairs visual function.

Abstract:AIM: To compare the differences, correlations, and consistency of vault and related parameters measured by the novel swept-source anterior segment optical coherence tomography(CASIA2)with the three-dimensional anterior segment analyzer(Pentacam)after implantable collamer lens(ICL)implantation.

METHODS: A cross-sectional study was conducted on myopic patients who underwent ICL implantation at the Department of Refractive Surgery, Sichuan Eye Hospital, between August 2021 and August 2023. At 1 mo postoperatively, vault, central corneal thickness(CCT), pupil diameter, anterior chamber depth(ACD), and the distance from the corneal endothelium to the anterior surface of the ICL(ACD-ICL)were measured using both CASIA2 and Pentacam. The correlation, differences and agreement of these parameters were analyzed from the two devices.

RESULTS: A total of 100 myopia patients(187 eyes)were included. Significant differences were found between CASIA2 and Pentacam in the measurements of CCT, ACD, pupil diameter, ACD-ICL, and vault(all P<0.05). The correlation analysis showed that the CCT, ACD-ICL, vault, ACD and pupil diameter measured by the two devices were positively correlated(r/r_s=0.99, 0.91, 0.91, 0.71, and 0.49, all P<0.05). Bland-Altman analysis showed excellent agreement for CCT, but less agreement for the other parameters.

CONCLUSION: CASIA2 produces marginally higher postoperative vault readings than Pentacam. Besides instrumental design, the discrepancy is likely attributable to pupillary constriction and accommodation induced by Pentacam's brighter illumination. CASIA2 may better reflect physiologic conditions, whereas Pentacam reflects bright-light status. Combined use of both devices provides clinicians with more comprehensive and accurate post-ICL assessments.

Abstract:Traumatic submacular hemorrhage often leads to a rapid decline in visual acuity, and prolonged retention of blood can cause irreversible retinal damage. By comparing two cases with similar clinical features but different treatment approaches and outcomes, and reviewing relevant domestic and international literature, this article proposes that such trauma-induced submacular hemorrhage should be considered an indication for ophthalmic“emergency surgery”. This recommendation is based on the understanding that subretinal blood accumulation exerts definite mechanical compression and chemotoxic damage on retinal tissue. Furthermore, submacular hemorrhage resulting from trauma differs in etiology and pathological mechanism from hemorrhage caused by primary macular diseases such as age-related macular degeneration. Therefore, it warrants distinct management and proactive intervention.