Purpose: The purpose of this study was to compare total keratometry (TK) and posterior keratometry (PK) obtained by two swept-source optical biometers (IOLMaster 700 and CASIA2) and one Scheimpflug-based topography (Pentacam AXL). Methods: The TK and PK in cataract surgery candidates obtained by IOLMaster 700, CASIA2, and Pentacam AXL were compared. Intraclass correlation coefficients (ICCs), limit of agreement, and Bland-Altman plots were used to assess the agreement. Results: One hundred two patients with a mean age of 68.21 ± 8.70 years were included. There were significant differences among IOLMaster 700, CASIA2, and Pentacam AXL in the mean TK (TK_m) (44.23 ± 1.59 diopters [D] vs. 43.25 ± 1.53 D vs. 43.94 ± 1.68 D; all P < 0.001), mean PK (PK_m; −5.90 ± 0.24 D vs. −6.25 ± 0.25 D vs. −6.37 ± 0.26 D; all P < 0.001) and TK-J0 (−0.34 ± 0.65 D vs. −0.23 ± 0.53 D vs. −0.12 ± 0.62 D; all P < 0.001). We also observed significant differences in PK-J45 between IOLMaster 700 and Pentacam AXL as well as between CASIA2 and Pentacam AXL (both P < 0.001). There was a good agreement in TK_m, TK-J0, TK-J45, and PK-J0 (ICC = 0.887, 0.880, 0.751, and 0.807, respectively), a moderate agreement in PK-J45 (ICC = 0.626), and a poor agreement in PK_m (ICC = 0.498) among these 3 biometers. Conclusions: TK, PK, and the corresponding astigmatism obtained by IOLMaster 700, CASIA2, and Pentacam AXL showed significant differences, and could not be used interchangeably. Translational Relevance: Our study may help to guide preoperative keratometry measurement for intraocular lens (IOL) power calculation and astigmatism evaluation for patients with cataract.

Purpose: To explore the risk factors and construct nomogram models to predict the risks of clinically significant intraocular lens (IOL) tilt and decentration after cataract surgery in patients with age-related cataract. Setting: Zhongshan Ophthalmic Center, Guangzhou, China. Design: Prospective cohort study. Methods: 207 patients (207 eyes) who underwent phacoemulsification combined with IOL implantation were enrolled in the study. Casia2 was used to measure the tilt and decentration of crystalline lenses and IOLs before and 3 months after surgery. Univariate and multivariate logistic regression analyses were used to determine the risk factors of clinically significant IOL tilt and decentration, and nomogram prediction models were constructed according to the results of the multivariate logistic regression analysis. Results: Two hundred and seven patients were included in analysis. 24 eyes (11.59%) and 16 eyes (7.73%) had clinically significant IOL tilt and decentration at 3 months after cataract surgery. Multivariate logistic regression analysis revealed that preoperative crystalline lens tilt and decentration were the risk factors for clinically significant IOL tilt (odds ratio [OR], 3.519, P < .001) and decentration (OR, 410.22, P = .001), respectively. Axial length was another association factor for clinically significant IOL decentration (OR, 2.155, P = .019). The risk models demonstrated good calibrations and discriminations for the predictions of clinically significant IOL tilt (receiver operating characteristic [ROC] area = 0.833, cutoff value = 6.5) and decentration (ROC area = 0.757, cutoff value = 0.08). Conclusions: The good performances of our models suggested that they may be useful risk prediction tools for postoperative IOL tilt and decentration. The measurement of preoperative crystalline lens tilt and decentration should be one of the routine examinations before cataract surgery, especially for toric and multifocal IOLs.

Autophagy plays a crucial role in intracellular quality control of crystalline lens and AMPK has regulatory effect on autophagy. However, whether AMPK regulated autophagy is involved in diabetic ca...

Importance: Capsular tension rings (CTRs) can support weak zonules and inhibit capsular shrinkage, thus potentially reducing intraocular lens (IOL) decentration and tilt. However, it has been debated whether CTRs can reduce IOL decentration and tilt in highly myopic eyes and whether CTR implantation is necessary for all highly myopic eyes.Objective: To evaluate the influence of CTR implantation on IOL decentration and tilt in highly myopic eyes.Design, Setting, and Participants: This randomized clinical trial was conducted between November 2021 and September 2023 at the Zhongshan Ophthalmic Center, Guangzhou, China. Patients with cataract and an axial length (AL) of 26 mm or longer were enrolled.Interventions: Participants were stratified into 3 groups based on the AL (stratum 1, 26 mm ≤ AL <28 mm; stratum 2, 28 mm ≤ AL <30mm; stratum 3, AL ≥30 mm), and further randomly assigned to the CTR group (a C-loop IOL combined with a CTR) or the control group (only a C-loop IOL) within each stratum.Main Outcomes and Measures: IOL decentration at 3 months after cataract surgery was evaluated using anterior segment optical coherence tomography.Results: A total of 186 eyes of 186 participants (mean [SD] age, 57.3 [10.9] years; 118 female [63.4%]) were randomized into the CTR group (93 [50%]) or control group (93 [50%]), with 87 eyes (93.6%) and 92 eyes (98.9%) completing follow-up at 3 months, respectively. The CTR group showed smaller IOL decentration (0.19 mm vs 0.23 mm; difference, −0.04 mm; 95% CI, −0.07 to −0.01 mm; P = .02) and tilt at 3 months, and lower proportions of clinically significant IOL decentration (≥0.4 mm) and tilt (≥7°) at 3 months compared with the control group. Similar results were only found in eyes with an AL of 30 mm or longer (IOL decentration: 0.20 mm vs 0.28 mm; difference, −0.08 mm; 95% CI, −0.14 to −0.02 mm; P = .01). Additionally, the CTR group showed a smaller change in IOL decentration from 1 week to 3 months, higher prediction accuracy, and better visual quality and patient satisfaction in this stratum. No differences were observed between the CTR and control groups in eyes with an AL less than 30 mm.Conclusions and Relevance: CTR implantation reduced C-loop IOL decentration and tilt, increased position stability, and improved visual quality in eyes with an AL of 30 mm or longer. These findings support use of CTR implantation in eyes with an AL of 30 mm or longer and implanted with C-loop IOLs.Trial Registration: ClinicalTrials.gov Identifier: NCT05161520

Purpose: To compare the performance of new-generation and traditional intraocular lens (IOL) calculation formulas in eyes undergoing combined silicone oil (SO) removal and cataract surgery and to evaluate the prediction accuracy of Wang-Koch (WK) adjustment in SO-filled long eyes. Setting: Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China. Design: Retrospective consecutive case-series study. Methods: New-generation formulas (Barrett Universal II, Emmetropia Verifying Optical, Kane, and Ladas Super formulas) and traditional formulas (Haigis, Hoffer Q, Holladay 1, and SRK/T formulas) were compared. The performance of WK adjustment was assessed in eyes with axial length more than 26 mm. The median absolute error (MedAE) was the main parameter to evaluate the accuracy of formulas. Results: A total of 211 participants (211 eyes) who underwent combined SO removal and phacoemulsification with IOL implantation were included. Four new-generation formulas displayed statistically significant lower MedAE (0.32 to 0.35 diopter [D]) and higher percentage of eyes within ±1.00 D of prediction error (85.31% to 87.20%) compared with those of the traditional formulas (MedAE: 0.39 to 0.50 D; ±1.00 D: 81.04% to 81.99%, P < .05). For SO-filled long eyes, all traditional formulas showed hyperopic bias (0.36 to 0.65 D, P < .05), except for Haigis formula (0.28 D, P = .083), and this bias could be corrected by WK adjustment (P > .05). EVO formula displayed the lowest MedAE both in total (0.32 D) and in long eyes (0.33 D). Conclusions: New-generation formulas and traditional formulas with WK adjustment showed satisfactory prediction accuracy in eyes undergoing combined SO removal and cataract surgery. EVO formula displayed the highest accuracy.