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22 December 2023, Volume 47 Issue 6
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Application progress of custom artificial iris
Nie Zetong, Hu Bojie
2023, 47(6): 481-487. doi:
10.3760/cma.j.issn.1673-5803.2023.06.001
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Iris defects often cause severe glare, photophobia, decreased contrast sensitivity, decreased best corrected visual acuity and cosmetic problems. There are various ways of iris reconstruction, recent studies have found that implantation of a custom artificial iris can safely and effectively treat congenital and acquired iris defects. Custom artificial iris has achieved good results in stability, visual function, and aesthetics, making it a novel and effective treatment option. (Int Rev Ophthalmol, 2023, 47: 481-487)
Research status of optic disc structure in peripapillary hyper-reflective ovoid mass-like structures
Meng Jiaxin, Liu Xia, Zhao Ying
2023, 47(6): 488-493. doi:
10.3760/cma.j.issn.1673-5803.2023.06.002
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Peripapillary hyper-reflective ovoid mass-like structures (PHOMS) are a novel finding observed through enhanced-depth imaging optical coherence tomography (EDI-OCT), appearing as annular or partially annular complexes containing vascular structures surrounding the optic disc on EDI-OCT images. PHOMS frequently coexist with tilted optic disc, optic disc drusen, demyelinating optic neuritis, Leber hereditary optic neuropathy, ischemic optic neuropathy, idiopathic intracranial hypertension, pseudopapilledema and other diseases related to axoplasmic flow stasis. However their pathophysiology and significance remain unclear. (Int Rev Ophthalmol, 2023, 47: 488-493)
Application of optical coherence tomography angiography in postoperative follow-up of rheogenic retinal detachment
Ye Hongli, Jiao Kangwei, Xiao Libo, Bao Zheng Yilin, Huang Yue
2023, 47(6): 493-497. doi:
10.3760/cma.j.issn.1673-5803.2023.06.003
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Rhegmatogenous retinal detachment (RRD) is mainly treated by surgery, and anatomical reattachment can be achieved in most patients after surgery, but the visual improvement is often not obvious. Optical coherence tomography angiography (OCTA) can observe the area of foveal avascular zone in the fovea of macular, the vessels density of retinochoroid in macular area and the capillary density around optic disc. Dynamic follow-up of postoperative choroidal and optic disc microvascular changes has important guiding value for the analysis and prediction of visual function in patients with RRD. (Int Rev Ophthalmol, 2023, 47: 493-497)
The role of retinal microglia in blinding eye diseases
Li Wanqian, Hou Shengping
2023, 47(6): 498-503. doi:
10.3760/cma.j.issn.1673-5803.2023.06.004
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Microglia are retinal resident immune cells, which are particularly critical for maintaining the dynamic balance of the retinal microenvironment. Microglia have diverse functions, strong plasticity, and activated microglia can play a dual role in protecting tissue and exacerbating damage in response to external stimuli. There is growing evidence that retinal microglia are involved in the development of a variety of blinding eye diseases, such as uveitis, age-related macular degeneration (AMD) and diabetic retinopathy (DR). (Int Rev Ophthalmol, 2023, 47: 498-503)
Animal models and induction methods of myopia
Ma Yao, You Yuxia
2023, 47(6): 503-507. doi:
10.3760/ cma.j.issn.1673-5803.2023.06.005
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Many kinds of myopia animal models are commonly used, including guinea pigs, mice, chickens, tree shrews, etc. The traditional form deprivation method is still the most widely used method for myopia modeling, and the modeling is relatively stable after multiple methods of improvement. However, due to the limited occurrence of form deprivation in humans, the application of experimental results to humans still requires caution. With the development of laser surgery, optical defocusing has provided new modeling methods, which are similar to the naturally occurring myopia in humans. However, the current application scope is still limited. The frequency flash stimulation method can induce moderate to low myopia, but the induction range for myopia diopter is still limited. Different animals have different feeding conditions, induction methods, inducible myopia, and model stability. Currently, there is a lack of recognized and high-quality animal model production standards. (Int Rev Ophthalmol, 2023, 47: 503-507)
Dry eye after small incision femtosecond laser lenticule extraction in different degrees of myopia
Reyila·Ainiwaer, Ding Lin
2023, 47(6): 508-512. doi:
10.3760/cma.j.issn.1673-5803.2023.06.006
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Dry eyes is one of the most common complications after laser vision correction. Although small incision lenticule extraction (SMILE) has the lowest incidence of dry eye compared with other refractive procedures. The prevalence of dry eye in patients with different degrees of myopia after SMILE is different, and the related influencing factors may also be different. The higher the degree of myopia, the more denervation caused by SMILE surgery leads to the increased release of substance P (SP) and calcitonin gene-related peptide (CGRP) from corneal sensory nerve fibers, the increased occurrence of neurogenic inflammation and the severer dry eye symptoms. Dry eye related examinations such as corneal staining, Schirmer test, tear film break-up time, tear osmolality, corneal sensitivity and ocular surface disease index score were more abnormal. (Int Rev Ophthalmol, 2023, 47: 508-512)
Morphological changes of vitreoretinal interface in myopic individuals
Wu Suming, Zhang Zhengwei
2023, 47(6): 512-516. doi:
10.3760/ cma.j.issn.1673-5803.2023.06.007
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Pathological myopia is the main cause of visual impairment in myopic individuals, and its complications are closely related to the vitreoretinal interface. Optical coherence tomography (OCT) can observe its morphological changes, mainly including the posterior precortical vitreous pocket, posterior vitreous detachment, residual vitreous cortex, traction, and anterior retinal membrane. These changes play an important role in the occurrence and development of pathological myopia.(Int Rev Ophthalmol, 2023, 47: 512-516)
Application of posterior scleral reinforcement surgery in the treatment of high myopia
Wu Jiale, Xiong Zhaohui, Xu Yincong, Sun Miaomiao, Gao Jie
2023, 47(6): 517-523. doi:
10.3760/cma.j.issn.1673-5803.2023.06.008
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The most obvious feature of pathological myopia is the gradual increase of the eye axis and the appearance of posterior staphyloma. Posterior scleral reinforcement surgery is currently an effective surgical method for delaying or preventing axial elongation in the treatment of pathological myopia. It mainly uses reinforcement materials to cause inflammatory reactions, neovascularization, and collagen fiber proliferation in the sclera to strengthen the weak posterior sclera and prevent further increase in axial length. This surgical method has been improved on the basis of strip method, patch method, and injection method, and currently, single strip reinforcement method is still the main method. Posterior scleral reinforcement materials are mainly divided into two categories: biological and non-biological, each with its own advantages and disadvantages. Currently, artificial pericardial patches and allogeneic sclera are the main types. Although posterior scleral reinforcement surgery has significant advantages in controlling the development of high myopia, imaging examination suggests that the shape and location of staphyloma in the sclera are diverse, making it difficult for this surgery to conform to the surgical mechanism, leading to controversy over the postoperative efficacy. (Int Rev Ophthalmol, 2023, 47: 517-523)
Advances in surgical treatment of cataract with high myopia
Liu Jianying, Li Jing, Wan Xiuhua
2023, 47(6): 524-530. doi:
10.3760/cma.j.issn.1673-5803.2023.06.009
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Cataract surgery with high myopia is complex cataract surgery, which is difficult and risky, and is more prone to intraoperative and postoperative complications such as posterior capsule rupture and retinal detachment. Femtosecond laser-assisted cataract surgery have further improved the surgical accuracy, safety, and efficacy. Pathological changes in the anatomical structure and intraocular microenvironment of high myopic eyes affect the accuracy of the intraocular lens (IOL) calculation formula and the stability of the IOL. The fifth-generation Barrett Universal II formula has proven to be more accurate in patients with high myopia, and the vertically placed one-piece plate-haptic IOL is more stable in the capsular bag and suitable for cataract patients with high myopia. (Int Rev Ophthalmol, 2023, 47: 524-530)
Advances in the application of lens capsule grafting
Guo Zhaoqiong, Yu Fangliang
2023, 47(6): 530-535. doi:
10.3760/cma.j.issn.1673-5803.2023.06.010
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As a scraffold for good cell growth, the lens capsule is elastic, malleable, transparent, and available in cataract surgery, and is a simple and widely derived autologous material, which can be used as a graft in anti-glaucoma, treatment of refractory macular hole and corneal ulcer surgery. In trabeculectomy combined with cataract extraction and intraocular lens implantation, the autologous anterior capsule liner is padded under the scleral flap, which can not only play a good role in mechanical barrier, but also inhibit the occurrence of neovascularization and prevent the formation of cicatricial filter vesicles. Lens capsular flap transplantation promotes the proliferation and migration of Müller cells during macular hole surgical repair, thereby promoting macular hole healing; In vitro experiments, the lens capsule promotes corneal epithelial cell growth, adhesion and replacement of the Descemet's layer, maintaining corneal transparency. It may provide a new method for treating corneal ulcers.(Int Rev Ophthalmol, 2023, 47: 530-535)
Advances in intraocular lens design
Zheng Xin, Wan Xiuhua
2023, 47(6): 536-541. doi:
10.3760/ cma.j.issn.1673-5803.2023.06.011
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The visual quality after cataract surgery has continuously improved, which is closely related to the continuous improvement and refinement of intraocular lens (IOL) materials and functional design. In terms of material selection, a series of new materials have emerged, such as silicone, hydrogel, and hydrophilic acrylic. In terms of functional design, various trifocal IOLs, adjustable, depth of field extension, astigmatism correction, etc. have been introduced. The Symfony extended range of vision IOL can provide clear and high-quality full range vision for elderly patients, while the ZMB00 multifocal IOL has better near vision. Personalized IOL selection should be performed based on the different needs of patients in order to achieve precise treatment. (Int Rev Ophthalmol, 2023, 47: 536-541)
Research progress of PANoptosis in the mechanism and treatment of glaucoma
Ye Dan, Xu Yue, Huang Jingjing
2023, 47(6): 542-547. doi:
10.3760/cma.j.issn.1673-5803.2023.06.012
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Glaucoma is a group of irreversible blinding ophthalmopathies characterized by progressive loss of retinal ganglion cells (RGC) and axonal damage. The specific damage mechanism has not been clarified. PANoptosis is an inflammatory cell death pathway, including apoptosis, necroptosis and pyroptosis. There are three activation pathways of cell death and molecular crosstalk in the retina of glaucoma patients and experimental animal models of glaucoma, which are closely related to the occurrence and development of glaucomatous RGC death. Targeted intervention with PANoptotic related molecules can inhibit retinal damage and RGC loss in glaucoma. (Int Rev Ophthalmol, 2023, 47: 542-547)
Clinical application progress of antibacterial photodynamic therapy in ocular infectious diseases
Li Mengxi, Zhang Zhen, Zhang Yue, Li Li
2023, 47(6): 548-552. doi:
10.3760/cma.j.issn.1673-5803.2023.06.013
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Antibacterial photodynamic therapy (aPDT) is a new treatment method, which uses radiation within a specific electromagnetic spectrum as a light source to activate photosensitizers enriched in the lesion and generate reactive oxygen radicals (ROS), and finally kill pathogenic microorganisms. Compared with traditional anti-infection therapy, aPDT shows the advantage of lower cytotoxicity, extremely low drug resistance and accurate localization. Because of the excellent optical properties of eyeballs, aPDT is especially suitable for the treatment of eye infections such as bacterial keratoconjunctivitis, viral keratitis, fungal keratitis, acanthamoeba keratitis and various infectious endophthalmitis.(Int Rev Ophthalmol, 2023, 47: 548-552)
Influence of high altitude on dry eye
Yang Qi, Cai Yan
2023, 47(6): 553-557. doi:
10.3760/cma.j.issn.1673-5803.2023.06.014
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The high altitude, low humidity, hypoxia, and strong ultraviolet rays in the plateau environment are risk factors for inducing dry eye. The combination of low pressure and humidity increases the rate of tear evaporation and decreases tear film stability. Additionally, the strong winds and sand cause inflammatory changes on the ocular surface while hypoxia can lead to corneal oedema. Moreover, ultraviolet rays destabilize the tear film and increase the evaporation of tears. All these environmental factors prevalent in highland areas can cause dry eye by either damaging the tear film or raising the rate of tear evaporation. (Int Rev Ophthalmol, 2023, 47: 553-557)
Diagnosis and treatment of eye diseases related to autoimmune diseases in children
Shang Liya, Wang Jiancang, Tang Guangxian, Ren Shenggang, Hua Huilan
2023, 47(6): 558-563. doi:
10.3760/ cma.j.issn.1673-5803.2023.06.015
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Autoimmune diseases in children have the characteristics of multi-system, multi-organ, multi-tissue involvement, including the damage to the vision system. Juvenile idiopathic arthritis, systemic lupus erythematosus, Behet’s syndrome, Sjgren's syndrome and so on, may cause the various ocular tissues immune venereal lesions in varying degrees, can lead to uveitis, retinal vasculitis, dry eye, scleritis, eyelid disease, conjunctivitis and so on. Immunosuppressants and biological agents are used for treatment. (Int Rev Ophthalmol, 2023, 47: 558-563)
The risk factors and prevention of postoperative strabismus infection
Zhang Feie, Cai Yan
2023, 47(6): 564-569. doi:
10.3760/cma.j.issn.1673-5803.2023.06.016
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Infection after strabismus surgery is a rare complication, but it affects postoperative recovery and surgical outcomes. Post-strabismus infection often manifests as keratoconjunctivitis, subconjunctival abscess, Tenon's capsule abscess, orbital cellulitis, periorbital abscess or endophthalmitis. The type, depth and location of the infection determine the treatment. Superficial infections recover well with topical antibiotic treatment; abscesses require incision and drainage as well as systemic antibiotics; infections involving deeper tissues require systemic treatment; and severe endophthalmitis can lead to vision loss or even blindness, requiring vitreous cavity injection antibiotics or vitrectomy.(Int Rev Ophthalmol, 2023, 47: 564-569)
The unfolded protein response in physiological aging and neurovascular degenerative diseases
Jin Yifan, Zou Jiayu, Wu Binrong, Zhang Shaodan
2023, 47(6): 570-576. doi:
10.3760/ cma.j.issn.1673-5803.2023.06.017
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The unfolded protein response (UPR) is a crucial pathway for cells to maintain protein homeostasis. The protein homeostasis of cells will be disrupted, when the internal and external environment of cells is stimulated, such as redox, inflammation or calcium imbalance. Then it will cause protein aggregation or accumulation of abnormal proteins, which further induces endoplasmic reticulum stress, followed by a series of reactions to restore protein homeostasis. If the adaptive UPRs fail to restore protein homeostasis, it will further induce apoptosis. UPR is an important factor affecting physiological and pathological aging, as well as the occurrence and development of neurovascular degenerative diseases.(Int Rev Ophthalmol, 2023, 47: 570-576)
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