Cost-effectiveness and cost-utility of a digital technology-driven hierarchical healthcare screening pattern in China.

Utilization of digital technologies for cataract screening in primary care is a potential solution for addressing the dilemma between the growing aging population and unequally distributed resources. Here, we propose a digital technology-driven hierarchical screening (DH screening) pattern implemented in China to promote the equity and accessibility of healthcare. It consists of home-based mobile artificial intelligence (AI) screening, community-based AI diagnosis, and referral to hospitals.

Comparing the impact of three-dimensional digital visualization technology versus traditional microscopy on microsurgeons in microsurgery: a prospective self-controlled study.

Background: Emerging three-dimensional digital visualization technology (DVT) provides more advantages than traditional microscopy in microsurgery; however, its impact on microsurgeons' visual and nervous systems and delicate microsurgery is still unclear, which hinders the wider implementation of DVT in digital visualization for microsurgery.

Methods And Material: Forty-two microsurgeons from the Zhongshan Ophthalmic Center were enrolled in this prospective self-controlled study. Each microsurgeon consecutively performed 30 min conjunctival sutures using a three-dimensional digital display and a microscope, respectively.

Comparison of robot-assisted vitreoretinal surgery and manual surgery in different preclinical settings: a randomized trial.

Background: Progress in the field of surgical robotics has the potential to allow surgeons to reduce the limitations of human hands and has substantially improved the dexterity and accuracy of surgery. This study aimed to compare robot-assisted vitreoretinal surgery with manual surgery in a simulated setting involving donor porcine eyes.

Methods: A randomized controlled trial was conducted involving 10 experienced vitreoretinal experts and 10 residents.

Intelligent cataract surgery supervision and evaluation via deep learning.

Purpose: To assess the performance of a deep learning (DL) algorithm for evaluating and supervising cataract extraction using phacoemulsification with intraocular lens (IOL) implantation based on cataract surgery (CS) videos.

Materials And Methods: DeepSurgery was trained using 186 standard CS videos to recognize 12 CS steps and was validated in two datasets that contained 50 and 21 CS videos, respectively. A supervision test including 50 CS videos was used to assess the DeepSurgery guidance and alert function.

Automated detection of retinal exudates and drusen in ultra-widefield fundus images based on deep learning.

Background: Retinal exudates and/or drusen (RED) can be signs of many fundus diseases that can lead to irreversible vision loss. Early detection and treatment of these diseases are critical for improving vision prognosis. However, manual RED screening on a large scale is time-consuming and labour-intensive.

Associations Between Regional Environment and Cornea-Related Morphology of the Eye in Young Adults: A Large-Scale Multicenter Cross-Sectional Study.

Purpose: To investigate environmental factors associated with corneal morphologic changes.

Methods: A cross-sectional study was conducted, which enrolled adults of the Han ethnicity aged 18 to 44 years from 20 cities. The cornea-related morphology was measured using an ocular anterior segment analysis system.

Polar value analysis of astigmatic change and rotational stability after implantation of V4c toric implantable collamer lens.

Background: To evaluate the clinical results and rotational stability of V4c toric implantable collamer lens (TICL, STAAR Surgical Company, Monrovia, CA, USA) in patients with moderate to high myopic astigmatism. Retrospective, interventional case series was performed at Shenzhen Eye Hospital, Shenzhen, Guangdong, China.

Methods: This study enrolled 43 patients (72 eyes) who received TICL implantation to correct myopia and myopic astigmatism.

Deep learning from "passive feeding" to "selective eating" of real-world data.

Artificial intelligence (AI) based on deep learning has shown excellent diagnostic performance in detecting various diseases with good-quality clinical images. Recently, AI diagnostic systems developed from ultra-widefield fundus (UWF) images have become popular standard-of-care tools in screening for ocular fundus diseases. However, in real-world settings, these systems must base their diagnoses on images with uncontrolled quality ("passive feeding"), leading to uncertainty about their performance.

Deep learning for automated glaucomatous optic neuropathy detection from ultra-widefield fundus images.

Background/aims: To develop a deep learning system for automated glaucomatous optic neuropathy (GON) detection using ultra-widefield fundus (UWF) images.

Methods: We trained, validated and externally evaluated a deep learning system for GON detection based on 22 972 UWF images from 10 590 subjects that were collected at 4 different institutions in China and Japan. The InceptionResNetV2 neural network architecture was used to develop the system.

Development and Evaluation of a Deep Learning System for Screening Retinal Hemorrhage Based on Ultra-Widefield Fundus Images.

Purpose: To develop and evaluate a deep learning (DL) system for retinal hemorrhage (RH) screening using ultra-widefield fundus (UWF) images.

Methods: A total of 16,827 UWF images from 11,339 individuals were used to develop the DL system. Three experienced retina specialists were recruited to grade UWF images independently.

Deep learning for detecting retinal detachment and discerning macular status using ultra-widefield fundus images.

Retinal detachment can lead to severe visual loss if not treated timely. The early diagnosis of retinal detachment can improve the rate of successful reattachment and the visual results, especially before macular involvement. Manual retinal detachment screening is time-consuming and labour-intensive, which is difficult for large-scale clinical applications.

Polar Value Analysis of Low to Moderate Astigmatism with Wavefront-Guided Sub-Bowman Keratomileusis.

Purpose: To evaluate the astigmatic outcomes of wavefront-guided sub-Bowman keratomileusis (WFG-SBK) for low to moderate myopic astigmatism.

Methods: This study enrolled 100 right eyes from 100 patients who underwent WFG-SBK for the correction of myopia and astigmatism. The polar value method was performed with anterior and posterior corneal astigmatism measured with Scheimpflug camera combined with Placido corneal topography (Sirius, CSO) and refractive astigmatism preoperatively and 1 month, 3 months, and 6 months postoperatively.

The Effect of High Intensity Focused Ultrasound Keratoplasty on Rabbit Anterior Segment.

To evaluate the safety of high-intensity focused ultrasound keratoplasty as a treatment for presbyopia by examining its effect on the rabbit anterior segment. The right corneas of 36 New Zealand rabbits were treated with HIFU keratoplasty. The animals were sacrificed at 1, 7, 15, 30, 60, and 90 days after operation.

Keratorefractive Effect of High Intensity Focused Ultrasound Keratoplasty on Rabbit Eyes.

Purpose. To evaluate high intensity focused ultrasound (HIFU) as an innovation and noninvasive technique to correct presbyopia by altering corneal curvature in the rabbit eye. Methods.

[Evaluation of quality of vision in early stage after sub-bowman keratomileusis].

Objective: To assess the quality of vision in the early stage after sub-bowman keratomileusis (SBK) for the correction of moderate and high myopia.

Methods: Retrospective case series. Sixty eight myopic eyes of 35 consecutive patients in Chongqing Medal Eye Institute from May to November 2011 were enrolled in this study.

Minor influence of sub-bowman keratomileusis on the posterior corneal surface at early stage.

Purpose: To evaluate the changes in posterior corneal surface (Q value and elevation) measured with Pentacam after femtosecond laser assisted Sub-Bowman Keratomileusis (SBK).

Methods: The Q values and elevation of posterior corneal surface were determined in 166 myopic/myopic astigmatism eyes of 88 patients using Scheimpflug imaging (Pentacam; Oculus, Wetzlar, Germany), which estimates asphericity and elevation for several areas of cornea analysed (Q value: 6, 7, 8 and 9 mm; elevation: 2, 4, 6 and 8 mm) before 1 and 3 months after SBK. The correlations between the changes of Q value or elevation and the mean preoperative spherical equivalent (SE), central corneal thickness (CCT), central ablation depth (AD), estimated residual bed thickness (RBT) and RBT/CCT ratio were investigated.

Anterior segment variations after posterior chamber phakic intraocular lens implantation in myopic eyes.

Purpose: To evaluate anterior segment variations after posterior chamber phakic intraocular lens (pIOL) implantation in myopic eyes.

Setting: Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.

Design: Cohort study.

Anterior segment variations with age and accommodation demonstrated by slit-lamp-adapted optical coherence tomography.

Objective: To investigate anterior segment variations with age and accommodation by slit-lamp-adapted optical coherence tomography (SL-OCT) and determine a safe central vault distance between the implantable contact lens (ICL) and the crystalline lens to avoid contact cataract formation.

Design: Evaluation of diagnostic test or technology.

Participants: Eighty-six patients (126 eyes) under regular review from the Optometry Clinic and Outpatient Department in Zhongshan Ophthalmic Center.

[Slit lamp optical coherence tomography study of anterior segment changes after phacoemulsification and foldable intraocular lens implantation].

Objective: To investigate quantitative changes of the anterior segment configuration after clear corneal incision phacoemulsification and foldable intraocular lens (IOL) implantation with slit-lamp-adapted optical coherence tomography (SL-OCT).

Methods: In prospective consecutive case series, clear corneal incision phacoemulsification and foldable intraocular lens implantation were performed in 44 eyes of 40 patients. The changes of the anterior segment configuration were performed by SL-OCT before and 1 day, 1 week, 2 weeks and 1 month after surgery.

Primary culture of human blood-retinal barrier cells and preliminary study of APOBEC3 expression: an in vitro study.

Purpose: To develop methods for primary culture of human blood-retinal barrier (BRB) cells and to explore the expression of APOBEC3 (apolipoprotein B mRNA-editing enzyme, catalytic polypeptide-like 3) family gene, novel host-defense factors to HIV-1.

Methods: Cellular components of human BRB (human retinal capillary endothelial cells [HRCECs], human retinal capillary pericytes, and human retinal pigment epithelial cells) were isolated separately and subjected to primary culture according to procedures modified in our laboratory. Immunocytochemistry and immunofluorescence were used to identify specific markers of the primary cells and to analyze their purity by flow cytometry.

[Selection of accurate IOL formula in patients with cataract and high hyperopia].

Objective: To audit intraocular lens (IOL) power predictions for cataract surgery in high hyperopia by comparing the accuracy of different formulae of Haigis, SRKII, Hoffer Q, Hollady, and SRK/T.

Methods: A comparative study was used in 31 eyes with cataract and high hyperopia underwent phacoemulsification and posterior chamber IOL implantation. Eyes were examined with A-scan and IOL Master before the operation.

[An analysis about the safe range of thickness of the residual corneal stroma bed after LASIK].

Objective: To ascertain the safe range of thickness of the residual corneal stroma bed and the length of stable time after LASIK operation.

Methods: Two hundred and twenty seven eyes were randomly selected from cases treated with LASIK in 2000. The posterior curvature of cornea was measured by Obscan II preoperatively and 1, 2, 3, 6 months, 1 year and 2 year postoperatively.