To pursue the least corneal implication during cataract surgery, this study aimed to monitor corneal wound injury after cataract surgery with a novel method. The prospective cohort study involved thirty-two patients, who were assessed by a Scheimpflug tomography AxL^® (Oculus GmbH, Wetzlar, Germany) via the following two kinds of indices: whole corneal optical density (COD) and corneal thickness (CT), two weeks before and one month after cataract surgery. The results of the COD revealed that corneal annuli 0.0–2.0 mm and 2.0–6.0 mm, and the average and maximal values at the incisional site significantly increased postoperatively. Also, the anterior and central stroma of 0.0–2.0 mm, and all three depths of 2.0–6.0 mm, increased remarkably after the operation. For the CT, all ranges of diameters plus incisional sites showed significant increases postoperatively. Furthermore, we analyzed the differences (delta) of COD and CT between pre- and post-operation, and found significant correlations between the delta of COD and the delta of CT, regarding annuli 0.0–2.0 mm, 2.0–6.0 mm, and 6.0–10.0 mm, but no correlation at the incisional site, with either average density or maximal density, was detected. We concluded that whole COD and CT, especially at the central zones of the cornea (annulus < 6 mm), are both valuable parameters in the assessment of corneal damage post-cataract surgery, and are independent indices at the incisional site.

The study aimed to investigate the extended effects and interrelations of corneal biomechanics, corneal optical density (COD), corneal thickness (CT), and intraocular pressure (IOP) following cataract surgery. Sixteen eyes were analyzed prospectively. The Corneal Visualization Scheimpflug Technology (Corvis ST) device assessed corneal biomechanics, while the Pentacam AxL^® (Pentacam) measured COD and CT. Postoperative data were collected around six months after surgery, with a subgroup analysis of data at nine months. The Pearson correlation was used to examine the relationship between surgical-induced changes in corneal biomechanics and COD. At six months, significant postoperative differences were observed in various biomechanical indices, including uncorrected IOP (IOPuct) and biomechanics-corrected IOP (bIOP). However, many indices lost statistical significance by the nine-month mark, suggesting the reversibility of postoperative corneal changes. Postoperative COD increased at the anterior layer of the 2−6 mm annulus and incision site. The changes in COD correlated with certain biomechanical indices, including maximal (Max) deformative amplitude (DA) and stiffness parameter (SP). In conclusion, despite significant immediate postoperative changes, corneal biomechanics, COD, and IOP experienced a gradual recovery process following cataract surgery. Clinicians should maintain vigilance for any unusual changes during the short-term observation period to detect abnormalities early.

Background: Visual training based on perceptual learning and dichoptic stimulation has been developed for amblyopic treatment. However, reports on virtual reality-assisted (VR) training for amblyopia are limited. The aim of this study was to evaluate the effects of VR training and compare the visual outcomes of different treatments in children with bilateral refractive amblyopia. Methods: Children aged 4–8 years with a best-corrected visual acuity (BCVA) less than 20/25 were included. All of the patients had worn glasses for at least 2 months before enrollment. At enrollment, age, gender, refractive status, baseline BCVA, and amblyopia severity were recorded. The treatment outcomes were evaluated in terms of BCVA at 24 weeks, the change in BCVA from baseline to 24 weeks, and the time taken to achieve treatment success (BCVA ≥ 20/25). Results: The longitudinal study included 30 patients in the Cambridge Visual Stimulator (CAM) training group, 14 in the VR training group, and 26 in the control group (glasses only). Among patients with an initial BCVA between 20/100 and 20/40, a significantly higher proportion of those in the VR training group achieved treatment success compared to the control group (p = 0.022). Among those who achieved treatment success, the time taken to achieve success was significantly shorter in the CAM and VR training groups compared to the control group (p < 0.001). Conclusions: Visual training can shorten the time taken to achieve treatment success compared to glasses alone. While VR training seems more effective than CAM training, both are valuable strategies for amblyopic children who respond poorly to glasses alone.

Background/Objectives: Dry eye disease (DED) is an ocular surface disease with unstable tear film hemeostasis that could influence the corneal biomechanics. The study aimed to elucidate the impact of dry eye severity on corneal biomechanics. Methods: This is a prospective cohort study that enrolled 72 participants with or without dry eye severity. All subjects received dry eye and corneal biomechanic assessment. Dry eye patients were divided into non-DED (>6 s) and DED (<6 s) groups based on the average non-invasive keratograph tear break-up time to compare their performance in corneal biomechanics. We further analyzed the correlation between the corneal biomechanic parameters and dry eye indexes for these patients. Results: In this study, 38 non-DED patients and 34 DED patients were enrolled for analysis. The two groups showed significant differences in first applanation (A1) deflection area (p = 0.002), A1 delta arc length (p = 0.024), second applanation (A2) deformation amplitude (p = 0.024), and whole eye movement [mm] (p = 0.021). Moreover, both A1 deflection area and A1 delta arc length revealed significantly correlated with tear meniscus height in DED patients. Conclusions: DED and its severity can affect corneal biomechanics. Tear volume on the ocular surface could be one of the important factors to influence corneal biomechanics.