To examine possible differences in clinical outcomes between sub-threshold micro-pulse diode laser photocoagulation (SDM) and traditional modified Early Treatment Diabetic Retinopathy Study (mETDRS) treatment protocol in diabetic macular edema (DME). A comprehensive literature search using the Cochrane Collaboration methodology to identify RCTs comparing SDM with mETDRS for DME. The participants were type I or type II diabetes mellitus with clinically significant macular edema treated by SDM from previously reported randomized controlled trials (RCTs). The primary outcome measures were the changes in the best corrected visual acuity (BCVA) and the central macular thickness (CMT) as measured by optical coherence tomography (OCT). The secondary outcomes were the contrast sensitivity and the damages of the retina. Seven studies were identified and analyzed for comparing SDM (215 eyes) with mETDRS (210 eyes) for DME. There were no statistical differences in the BCVA after treatment between the SDM and mETDRS based on the follow-up: 3mo (MD, -0.02; 95% CI, -0.12 to 0.09; P=0.77), 6mo (MD, -0.02; 95% CI, -0.12 to 0.09; P=0.75), 12mo (MD, -0.05; 95% CI, -0.17 to 0.07; P=0.40). Likewise, there were no statistical differences in the CMT after treatment between the SDM and mETDRS in 3mo (MD, -9.92; 95% CI, -28.69 to 8.85; P=0.30), 6mo (MD, -11.37; 95% CI, -29.65 to 6.91; P=0.22), 12mo (MD, 8.44; 95% CI, -29.89 to 46.77; P=0.67). Three RCTs suggested that SDM laser results in good preservation of contrast sensitivity as mETDRS, in two different follow-up evaluations: 3mo (MD, 0.05; 95% CI, 0 to 0.09; P=0.04) and 6mo (MD, 0.02; 95% CI, -0.10 to 0.14; P=0.78). Two RCTs showed that the SDM laser treatment did less retinal damage than that mETDRS did (OR, 0.05; 95% CI, 0.02 to 0.13; P<0.01). SDM laser photocoagulation shows an equally good effect on visual acuity, contrast sensitivity, and reduction of DME as compared to conventional mETDRS protocol with less retinal damage.

Purpose: The aim of this study was to evaluate the effect of residual astigmatism on postoperative visual outcomes after trifocal intraocular lens implantation.Methods: In this prospective observational study, we divided 156 eyes into two groups according to postoperative astigmatism measured by subjective optometry and followed them up for 3 months. Visual acuity, modulation transfer function (MTF) curves, Strehl ratio (SR), Visual Function Index-14 scores, and photic phenomena were compared.Results: Linear regression analysis revealed a weak correlation between residual astigmatism and uncorrected distance visual acuity (UDVA) (r = 0.190, P = 0.016) at 3 months and a significant between-group difference at 1- and 3-month postoperative UDVA (P = 0.038, P = 0.018, respectively). MTF curve values and SR (MTF-10 total, MTF-10 cornea, MTF-30 total, MTF-30 cornea, SR Total, and SR cornea) were significantly worse (P < 0.001), and the Visual Function Index-14 scores were lower in the 0.5 < astigmatism ≤ 1.25 D group (P < 0.05) than in the astigmatism ≤ 0.5 D group. No significant differences were found in the frequency, severity, and bothersomeness of photic phenomena (P > 0.05).Conclusion: Postoperative residual astigmatism affects the UDVA of the trifocal intraocular lens-implanted eyes. Although we found no significant differences in uncorrected intermediate and near visual acuity, both objective and subjective visual quality were affected, suggesting the need for surgical planning when the anticipated postoperative astigmatism is >0.5 D.

This prospective, non-randomized, comparative study aimed to compare the visual outcomes and patient satisfaction after implantations of three presbyopia-correcting intraocular lenses (IOLs) after myopic refractive surgery. It was conducted from January 2020 to December 2021 in Shanghai Heping Eye Hospital. Patients were divided into three groups based on the type of IOL implanted. The visual acuity, refractive stability, high-order aberrations, objective visual quality, spectacle independence, and visual function index 14 questionnaire scores of the three groups were compared. This study included 78 eyes of 39 patients: 26 eyes with 839MP, 26 eyes with MF30, and 26 eyes with ZXR00. Uncorrected distance visual acuity improved significantly for all three groups. For a pupil diameter of 4.0 mm, the spherical aberrations of the three groups were 0.33 ± 0.16μ, 0.50 ± 0.08μ, and 0.39 ± 0.10μ, respectively. The spectacle independence for distance vision was over 90% in each group; for near vision, it was only 25% for the ZXR00 group. All three types of presbyopia-correcting IOLs improved visual quality in post-LASIK or PRK patients. However, the high incidence of photic phenomena after presbyopia-correcting IOL implantation in patients who have undergone myopic LASIK should not be neglected.

Purpose. To investigate the benefits of multifocal lens in patients with high myopic cataract and compare the clinical effects between AT LISA tri 839MP and MPlus LS-313 MF30 intraocular lenses (IOLs) in high myopic eyes. Methods. This retrospective cohort study analyzed 60 eyes with axial length >26 mm in 40 patients. Thirty eyes were implanted with MF30, and the remaining 30 eyes were implanted with 839MP. Postoperative uncorrected distance visual acuity (UDVA), best corrected distance visual acuity (BCDVA), uncorrected intermediate visual acuity (UIVA) and uncorrected near visual acuity (UNVA), defocus curve, modulation transfer function (MTF) curve, Strehl ratio (SR), and complications were compared between the two groups. Results. All vision outcomes were significantly improved in both groups ( ). There was no significant between-group difference in UDVA at 1 and 3 months postoperatively ( ). However, UIVA and UNVA were significantly better in the 839MP group ( ). The VF-14 score, especially for near vision quality, was significantly higher in the MF30 group (2.2 ± 0.9 vs. 0.8 ± 0.7; ). The SR of both groups significantly increased postoperatively ( ). All the 3-month MTF curve values (MTF 10 total, MTF 10 internal, MTF 30 total, and MTF 30 internal) were significantly better in the 839MP group ( ). Meanwhile, all the high-order aberration values (coma, spherical aberration, and trefoil) were significantly greater in the MF30 group ( ). Conclusion. Multifocal IOL implantation achieves good quality of distance, intermediate, and near vision in patients with high myopia, improving their quality of life. Both 839MP and MF30 IOLs can provide good distance vision, but 839MP performs better in near and intermediate vision. However, for some patients with an extra-long optic axis, MF30 may be a good choice because of its wider range of degrees.

To evaluate changes in the anterior chamber depth (ACD), crystalline lens thickness (LT) and its refractive power after laser in situ keratomileusis (LASIK). In all cases, the preoperative and postoperative central ACD which were measured with Pentacam, Orbscan, IOL-Master and A-scan ultrasonography, central corneal true net power which was measured with the Pentacam, Orbscan and IOL-Master, axial length (AL) which was measured with IOL-Master and LT which was measured with the A-scan ultrasonography were compared using the paired sample t test. Ocular refractive errors and lens refractive power at corneal plane were calculated and their correlations were also evaluated before and after LASIK. At 1 week after LASIK, LT and crystalline lens refractive power at corneal plane (Dlens) which were associated with the IOL-Master and Pentacam increased significantly (P≤0.005), ACD decreased significantly (P≤0.001), but no significant increase was observed in the Dlens which was associated with the Orbscan (P=0.261). Significant correlations between the changes in the ocular refractive errors and Dlens which were associated with the Pentacam were observed at 1 week and 6 months after LASIK (P=0.028; P=0.001). LT increased significantly after LASIK, and this might partially lead to ACD decrease, Dlens increase and a small quantity of myopic regression.

To appraise the effect of treatment for diabetic macular edema (DME) in proliferative stage with sufficient panrentinal photocoagulation (PRP) therapy and intravitreal injections (IV) Conbercept and posterior subtenon's triamcinolone acetonide (STTA) sequential therapy. This prospective clinical randomized controlled trial of cross-over design was conducted in three phases. The participants included cases of DME in proliferative stage. They were divided into two groups and treated with PRP before enrollment. Group A were treated with IV-Conbercept 0.5 mg for one month in the 1st phase. Group B were treated with STTA 40 mg (twice per two weeks). The interventions were exchanged in the second phase (2mo) between the two groups. In the third phase (3-6mo) no other treatment was given. Best corrected visual acuity (BCVA), central macular thickness (CMT) measured by OCT and complications were compared. After phase I: in Group A, BCVA improved from 0.201±0.17 to 0.37±0.24 (F=5.88, P=0.004). CMT changed from 449±155.10 to 304.1±84.70 µm (F=14.9, P0.05). After phase III: in Group A, BCVA maintained 0.42±0.25 (F=0.22, P=0.001), CMT maintained 267.8±58.34 µm, (F=-0.27, P<0.01); in Group B, BCVA was 0.47±0.25 (F=-0.27, P<0.01), CMT was 272.71±49.16 µm (F=-191.1, P<0.01). No serious complications happened in all phases. PRP+Conbercept is better than PRP+STTA in DME with proliferative stage but PRP+Conbercept+STTA sequential therapy may be a wiser choice for persistent effectiveness on anatomical as well as functional status.