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The purpose of this study was to investigate the effectiveness and practicability of phacoemulsification and intraocular lens implantation for subluxated cataracts. A retrospective review of subluxated cataract surgeries of 19 eyes performed in Kunhua Hospital Affiliated with Kunming University of Science and Technology between January 2017 and June 2021 was conducted. We choose to use the rotate-and-chop phacoemulsification techniques described when the crystal nucleus is rotated out of the capsular bag and simultaneously perform horizontal chops over the capsule. The viscoelastic agent was the important material that filled the capsule to support the capsular bag, and capsular hooks were used in 10 eyes necessarily. Anterior vitrectomy was undergone in 15 eyes. Single-piece intraocular lenses (IOL) were implanted in the capsular bag in 12 eyes including 8 capsular tension ring (CTR) implantation. Three-piece IOLs were fixed scleral layer in 7 eyes. Follow-up was 6 months to 2 years, and all eyes were successfully implanted with centered IOL. The best corrected visual acuity (BCVA) increased from 0.06 ± 0.04 to 0.62 ± 0.15. The cornea of all patients was clear, the intraocular lens was centered, the pupil was round, and the intraocular pressure was normal. Subluxated cataracts are a challenging surgery. The technique of phacoemulsification in subluxated cataract surgery is a key procedure to rotate and remove the lens from the capsule and at the same time horizontal chops and emulsification over the capsular bag to be performed. Viscoelastic agents and capsular hooks were important choices to support the capsule to reduce the incidence of complications related to the vitreous and retina and prevent the range enlarging of the zonular dialysis. A capsular tension ring was also an effective device to maintain capsular stability. Double-needle-guided scleral interlamellar fixation is an effective and practical method for IOL. Overall, the incision technique explored in this study and the surgical technique to support capsular stabilization provide a safe approach and satisfactory results in cataract surgery for subluxation.

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Suprachoroidal hemorrhage (SCH) is a rare but serious sight-threatening complication of inner eye surgery. Despite continuous advances in treatment, visual prognosis remains poor. The disease has a more typical clinical presentation, the etiology and pathogenesis are not well defined, and intraoperative ocular and systemic factors may induce fulminant SCH. To investigate risk factors and treatments of SCH-associated intraocular surgeries, summarize diagnosis, characteristics, management, and prevention of SCH developed during and after intraocular surgeries. A retrospective study of SCH occurred in six cases of intraocular surgeries including cataract, glaucoma, pars plana vitrectomy (PPV), and silicone oil removal surgery. Assess baseline systemic and ocular characteristics of SCH eyes. Analyze the second surgery timing and technique, and visual outcomes were measured. SCH occurred in six patients including five eyes during surgeries and one eye after the surgery. Three eyes that underwent cataract surgery had hard nucleuses (nuclear sclerotic 4+). One eye was due to hypotony during the vitrectomy procedure. One eye developed SCH when silicone oil was extracted from the eyeball. One eye developed delayed SCH after glaucoma surgery. Incision closure and anterior chamber deepening were performed. B-scan ultrasonography was used to diagnose SCH, and determine the timing and location of sclerotomy for the second surgery. Vitrectomy and sclerotomy were performed in five eyes. The median follow-up time was six months. The final best-corrected visual acuity (BCVA) was 0.3 in one eye, one eye had light perception with retinal adherence, and four eyes had no light perception with retinal detachment. The results showed that risk factors including advanced age, hypertension, taking anticoagulants, antiplatelet drugs, and cardiovascular drugs were systemic risk factors, and hard nucleus (nuclear sclerosis 4 +) cataract, long-term uncontrolled ocular hypertension glaucoma, vitrectomy, silicone oil removal, high myopia, aphakia, previous intraocular surgery, intraocular pressure during surgery, and others were ocular risk factors. The most important risk factor is a sudden drop in intraocular pressure during or after surgery. The outcome of visual acuity depends on retinal status. Because of the poor prognosis, the prevention of SCH is of utmost importance during intraocular surgery.

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BACKGROUND: Matrix metalloproteinase-2 (MMP-2) polymorphisms have been considered as risk factors of cataracts, but the results still remain controversial. In this study, we have performed a systematic meta-analysis to evaluate the association between MMP-2 polymorphisms and cataract risks. METHODS: Published literature was retrieved from Wanfang, Chinese Biomedical Literature Database, Chinese National Knowledge Infrastructure, Chongqing VIP Chinese Science and Technology Periodical Database, PubMed, Embase, and Web of Science databases. The case-control studies that explored the association between MMP-2 polymorphisms and cataract risks were included. Pooled odds ratio (OR) and 95% confidence interval (CI) were calculated using random- or fixed-effects model. RESULTS: This study could provide high-quality and evidence-based medical evidence for the correlation between MMP-2 polymorphisms and cataract risks. CONCLUSION: The study could provide updated evidence for the evaluation of the relationship between MMP-2 polymorphism and cataract risk. ETHICS AND DISSEMINATION: The private information from individuals will not be published. This systematic review also will not involve endangering participant rights. Ethical approval is not available. The results may be published in a peer-reviewed journal or disseminated in relevant conferences. OSF REGISTRATION NUMBER: DOI 10.17605/OSF.IO/KU9NE.

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PURPOSE: To compare the efficiency of releasable scleral buckling (RSB) and pars plana vitrectomy (PPV) in the treatment of phakic patients with primary rhegmatogenous retinal detachment. METHODS: The current study was a prospective randomized clinical trial. One hundred and ten eyes from 110 patients with primary rhegmatogenous retinal detachment and proliferative vitreoretinopathy of Grade B or less were included in this study. The patients were randomly allocated into an RSB group and a PPV group. The functional and anatomical success was compared between groups. RESULTS: The primary anatomical success rate (PPV 41/43 [95.35%] and RSB 38/41 [92.68%]) and final anatomical success rate (PPV and RSB 100%) showed a nonsignificant difference. The best-corrected visual acuity, intraocular pressure, and complications were not different between the groups. However, the incidence of cataract progression was higher in the PPV group (26 of 43 [60.47%]) than in the RSB group (4 of 41 [9.76%]) at the 12-month follow-up. The subfoveal choroidal thickness increased significantly in the RSB group 3 months after surgery, but no longer differed at the postoperative 6-month and 12-month follow-ups. The axial length had increased significantly 1 month after surgery, but the difference was no longer significant at 3 months, 6 months, and 12 months. CONCLUSION: The RSB and PPV procedures have the same effects on the functional and anatomical success for patients with phakic primary rhegmatogenous retinal detachment. Nevertheless, based on the few cases of intraocular complications and cataract progression, we believe that the RSB technique should be preferentially recommended.

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AIM: To analyze peripapillary atrophy ß/γ zone (PPA-ß/γ) and the optic disc ovality index, and to assess their associations with the axial length (AL), refractive error, best corrected visual acuity (BCVA), choroidal thickness (CT), and age in highly myopic eyes. METHODS: This was a retrospective observational case series. The study included 667 patients consecutively examined for highly myopic eyes [spherical equivalent ≤-6.0 diopters (D) and AL≥26 mm] with or without myopic retinopathy. Each patient went through a comprehensive ophthalmological examination that included spectral domain optical coherence tomography (SD-OCT) of the macula, A-mode ultrasonography, and a cycloplegic refraction test. The ovality index and PPA-ß/γ area were measured from optic disc photographs. RESULTS: A significant association was seen between PPA-ß/γ area and the ovality index (P=0.000, r=-0.232). The PPA-ß/γ area increased significantly with a longer AL, older age, worse BCVA, higher refractive error, and thinner choroid (P<0.01). The oval disc was significantly correlated with a longer AL, older age, worse BCVA, higher refractive error, larger PPA-ß/γ area, and thinner choroid (P<0.01). CONCLUSION: The PPA-ß/γ zone and ovality index in highly myopic eyes show distinct associations with the AL, refractive error, BCVA, age, and CT.