Minimum Angle Research Articles

Early outcomes of 5-0 Prolene gonioscopy-assisted transluminal trabeculotomy combined with phacoemulsification in eyes of Indian glaucoma patients.

To study the early postoperative efficacy and safety of 5-0 Prolene gonioscopy-assisted transluminal trabeculotomy (GATT) combined with phacoemulsification in Indian eyes. This was a prospective, interventional study. Patients with primary and secondary glaucoma who underwent GATT combined with phacoemulsification (Phaco-GATT) or standalone GATT were included. All patients were evaluated on postoperative days 1, 15, and 30, as well as 3 months and 6 months postoperatively. Baseline and follow-up visits were compared to determine the significant difference in the number of intraocular pressure (IOP), antiglaucoma medications (AGM), and best corrected visual acuity (BCVA). Other outcome measures included surgical success, complications, and interventions. A P value of < 0.05 was considered statistically significant. One hundred and five eyes (95 patients) were included. Seventy-five eyes underwent GATT along with phacoemulsification and 30 eyes underwent GATT. In the Phaco-GATT group, the mean IOP reduced significantly from 17.71 ± 6.85 to 12.29 ± 4.44, 12.33 ± 4.44, and 12.18 ± 3.49 mmHg and in the GATT group, it reduced from 21.67 ± 11.42 mmHg to 16.38 ± 8.42, 16.47 ± 10.26, and 13.10 ± 3.25 mmHg at 1, 3, and 6 months, respectively (P < 0.001). The number of AGM also significantly reduced from 1.67 ± 1.22 to 0.41 ± 0.87 and 0.34 ± 0.82 in the phaco-GATT group and from 2.63 ± 1.19 to 0.67 ± 1.09 and 0.60 ± 1.25 in the GATT group at 3 and 6 months, respectively (P < 0.001). Complete success (IOP > 6-≤21 mmHg/20% reduction without AGM) was 96.7% in the Phaco-GATT group and 91.2% in the GATT group. BCVA improved from log of minimum angle of resolution 0.30 to 0.00 (P < 0.001) in phaco-GATT group. Hyphema was the most common complication. Macrohyphema (>1 mm) was seen in six patients, out of which two patients required anterior chamber wash. IOP spikes (>30 mmHg) were seen in three patients. In Indian eyes, GATT combined with phacoemulsification and standalone GATT are efficacious and safe with good surgical outcomes.

Optimizing Diabetic Macular Edema Treatment: A Meta-Analysis of Subthreshold Micropulse Laser and Anti-Vascular Endothelial Growth Factor Combination Therapy.

Background: Diabetic macular edema (DME) is the primary cause of visual impairment in individuals with diabetes. Anti-vascular endothelial growth factor (VEGF) is the current first-line treatment for DME owing to its effectiveness. However, frequent anti-VEGF injections may be inconvenient for patients. Therefore, this study aimed to investigate whether the addition of subthreshold micropulse laser (SML) to anti-VEGF therapy could reduce the requirement for anti-VEGF injections while maintaining the treatment efficacy for DME. Methods: Clinical trials retrieved from the databases of PubMed, EMBASE, and the Cochrane Library were evaluated to determine the effectiveness of combination treatment with SML and anti-VEGF medication compared with that of anti-VEGF treatment alone. The primary outcome measures were the changes in CMT, best-corrected visual acuity (BCVA), and the total number of intravitreal injections (IVIs). Results: The IVI + SML group revealed a substantial increase in the logarithm of the minimum angle of the resolution BCVA and a reduction in CMT at the 12-month follow-up (BCVA: random-effects; mean difference [MD], -0.05; 95% confidence interval [CI]: -0.10 to -0.01; p-value = 0.28, and CMT: random-effects; MD, -18.27; 95% confidence interval, -27.36 to -9.18; p-value = 0.20). The number of required IVIs in the IVI + SML group was lower than that in the IVI only group (random-effects; MD, -2.22; 95% CI: -3.13 to -1.31; p-value < 0.01). Conclusions: Combining SML therapy with anti-VEGF injections may reduce the total number of injections required, improve VA, and reduce CMT at the 12-month follow-up. Although the included studies used different SML regimens and anti-VEGF agents, this review indicates that the application of additional SML therapy results in positive clinical outcomes.

A Motion Capture Dataset on Human Sitting to Walking Transitions

Sit-to-walk (STW) is a crucial daily task that impacts mobility, independence, and thus quality of life. Existing repositories have limited STW data with small sample sizes (n = 10). Hence, this study presents a STW dataset obtained via the time-up-and-go test, for 65 healthy adults across three age groups – young (19–35 years), middle (36–55 years) and older (above 56 years). The dataset contains lower body motion capture, ground reaction force, surface electromyography, inertial measurement unit data, and responses for the knee injury and osteoarthritis outcome score survey. For validation, the within subjects intraclass correlation coefficients for the maximum and minimum lower body joint angles were calculated with values greater than 0.74, indicating good test-retest reliability. The joint angle trajectories and maximum voluntary contractions are comparable with existing literature, matching in overall trends and range. Accordingly, this dataset allows STW biomechanics, executions, and characteristics to be studied across age groups. Biomechanical trajectories of healthy adults serve as a benchmark in assessing neuromusculoskeletal impairments and when designing assistive technology for treatment or rehabilitation.

Ten-Year Clinical Outcomes of V4c Implantable Collamer Lens Implantation: Longitudinal Analysis of Visual Acuity, Endothelial Cell Density, and Vault Dynamics

This study aimed to evaluate the long-term clinical outcomes of V4c Implantable Collamer Lens (ICL) implantation for myopia correction over a 10-year period. Retrospective interventional case series METHODS: This retrospective interventional study involved 103 myopic eyes from 54 patients. Visual outcomes, including visual acuity and manifest refraction were assessed. Annual measurements of endothelial cell density (ECD), vault, anterior chamber depth, and intraocular pressure were analyzed using mixed-effects models. At the 10-year follow-up, the mean Logarithm of the Minimum Angle of Resolution (logMAR) uncorrected distance visual acuity and corrected distance visual acuity (CDVA) were -0.037 ± 0.052 and -0.041 ± 0.046, respectively. The mean efficacy and safety indices were 1.11 ± 0.13 and 1.12 ± 0.12. A loss of one line of CDVA occurred in 2% of cases, while 59% gained one or more lines. Postoperative manifest refraction spherical equivalent (MRSE) was within ±0.5 diopters (D) and ±1.0 D in 74% and 99% of cases, respectively, with a mean MRSE of -0.19 ± 0.41 D. Data for ECD and vault fit an exponential decay model, demonstrating a continuous yet gradually slowing decrease over time. Decay rates were 0.012 ± 0.001 per year for ECD and 0.056 ± 0.003 per year for the vault. Notably, ECD lower outliers had significantly lower preoperative ECD values. There were no instances of cataract formation, angle closure, glaucoma, or ICL removal throughout the study. The 10-year outcomes of V4c ICL implantation demonstrate effective and safe visual results. Both ECD and vault exhibit exponential decay patterns over the decade. Patients with lower preoperative ECD values require careful post-implantation monitoring.

Q-value-guided femtosecond laser-assisted in situ keratomileusis for low-to-moderate myopia with age-related accommodation deficiency

Objective: To evaluate clinical outcomes and visual quality after femtosecond laser-assisted in situ keratomileusis (FS-LASIK) performed with the Q-value-guided optimized monocular vision protocol (Custom-Q) for correction of low-to-moderate myopia and compensation for age-related accommodation deficiency. Methods: A prospective study was performed based on patients with myopia and age-related accommodation deficiency, who underwent Custom-Q FS-LASIK in the Peking University Third Hospital from October 2022 to October 2023. Monocular and binocular distance, intermediate, and near visual acuities, simulated whole-course visual acuity (binocular defocus curve), objective and subjective refractions, anterior corneal Q factor, anterior corneal higher-order aberrations and a subjective questionnaire assessing near visual acuity and visual quality were evaluated at 3 months postoperatively. Visual acuity was recorded using the logarithm of the minimum angle of resolution. The data were analyzed using the t-test and the Wilcoxon rank-sum test. Results: A total of 45 patients (90 eyes) who met the inclusion criteria and completed the 3-month follow-up were included in the study. The mean age of the 21 men (42 eyes) and 24 women (48 eyes) was (42.82±2.72) years. During the 3-month follow-up, all the patients achieved binocular uncorrected distance visual acuity not less than 0.00 and uncorrected near visual acuity not less than 0.20. Defocus curves revealed better results at 3 months postoperatively [0.00 (-0.08, 0.00), -0.08 (-0.08, 0.00)] at intermediate and near vergence (-1.50 to -1.00 D) compared to the preoperative values [0.00 (-0.08, 0.05), -0.08 (-0.08, 0.00)] (P<0.05). All the 45 patients maintained 0.10 or better vision at the defocus range from -2.50 to 0.00 D. The Q value in the dominant eyes was more positive postoperatively (0.01±0.26 vs.-0.15±0.14, P<0.05), while in the nondominant eyes, the Q value and corneal spherical aberration coefficient became more negative than those before surgery (-0.27±0.32 vs.-0.14±0.11, P<0.05; 0.08±0.05 vs. 0.12±0.03, P<0.05). The questionnaire demonstrated 42 (93.3%) patients were satisfied with near vision. The three most commonly reported visual discomforts after surgery were blurred vision, glare and halos. These symptoms were all mild to moderate in severity and did not interfere with daily life. Conclusion: For myopic patients with age-related accommodation deficiency, the Custom-Q algorithm proved to be a safe and effective way to achieve acceptable near vision and visual quality without compromising distance vision.

The effects of core muscle fatigue on lower limbs and trunk during single-leg drop landing: A comparison between recreational runners with and without dynamic knee valgus

BackgroundA deficit in neuromuscular trunk control can impact the lower limb motion, predisposing runners to injuries. This deficit may show a greater impact on runners with dynamic knee valgus. This study aimed to compare the effect of core fatigue on kinetic, kinematic, and electromyographic parameters of the trunk and lower limbs during single-leg drop landing between runners with and without dynamic knee valgus. MethodsTwenty-seven recreational runners were allocated to the valgus (n = 14) and non-valgus groups (n = 13). They performed the test before and after a fatigue protocol, taking a step forward and landing on the force platform while maintaining balance. The fatigue protocol included isometric and dynamic exercises performed consecutively until voluntary exhaustion. The vertical ground reaction force, the sagittal and frontal plane angles, and the electromyographic activity were evaluated. The integral of electromyographic activity was calculated into three movement phases. ANOVA with repeated measures was used to verify the group, time, and interaction effects. ResultsAfter fatigue, both groups showed a significant reduction in the minimum (p = 0.01) and maximum (p = 0.02) knee angles in the frontal plane (more dynamic knee valgus) and greater gluteus medius activity (p = 0.05) from the peak of knee flexion to the end of the movement. The valgus group had a greater hip excursion (p = 0.01) and vertical linear shoulder displacement (p = 0.02) than the non-valgus. ConclusionOur results suggest that core fatigue can impact the local muscle and the distal joint and that the groups presented different strategies to deal with the demand during landing.

The Activation of Magnesium Sintering by Zinc Addition

Light alloys based on magnesium are widely used in most areas of science and technology. However, magnesium powder alloys are quite difficult to sinter due to the stable film of oxides that counteracts diffusion. Therefore, finding a method to activate magnesium sintering is urgent. This study examines the effect of adding 5 wt. % and 10 wt. % zinc to the sintering pattern of magnesium powders at 430 °C; a dwell of 30 min was used to homogenize at the densification’s temperature. Scanning electron microscopy (SEM) was used to characterize the alloy’s microstructure, while the phase composition was characterized using X-ray diffraction (XRD) and energy dispersion spectroscopy (EDS). The sintering densities of Mg–5Zn and Mg–10Zn were found to be 88% and 92%, respectively. The results show that after sintering, a heterophase structure of the alloy is formed based on a solid solution and phases MgZn and Mg50Zn21. To establish the sintering mechanism, the interaction at the MgO and Zn melt phase interface was analyzed using the sessile drop method. The minimum contact angle—65°—was discovered at 500 °C with a 20 min holding time. It was demonstrated that the sintering process in the Mg–Zn system proceeds through the following stages: (1) penetration of zinc into oxide-free surfaces; (2) crystallization of a solid solution, intermetallics; and (3) the removal of magnesium oxide from the particle surface, with oxide particles deposited on the surface of the sample.

Efficacy and Safety of Phaco-Goniosynechialysis in Advanced Primary Angle Closure Glaucoma With Severe Visual Field Loss.

Phacoemulsification with goniosynechialysis (phaco-GSL) demonstrates promise in safely and efficiently managing advanced primary angle closure glaucoma (PACG) cases with tunnel vision or limited temporal visual field. However, caution is advised for patients with only one functioning eye or high visual expectations. To assess the efficacy and safety of phaco-GSL in patients with end-stage PACG exhibiting tubular vision or temporal field island. This retrospective study evaluated 68 patients (74 eyes) diagnosed with advanced PACG and exhibiting either tubular vision or temporal field island. All patients underwent phaco-GSL and were monitored for at least 1 month postoperatively. The study analyzed changes in visual acuity (VA), intraocular pressure (IOP), medication use for antiglaucoma, and postoperative complications. The mean follow-up time was 9.11 ± 10.49 months. The mean preoperative visual field deviation and VA were -28.01 ± 3.30dB and 0.36 ± 0.37 log minimum angle of resolution unit, respectively. Postoperatively, the VA for over half (54.1%) of the eyes increased, 29.7% remained unchanged, and 16.2% worsened. The final IOP decreased significantly from 24.65 ± 8.61 to 14.81 ± 3.54mm Hg. Glaucoma medication use also reduced from 1.46 ± 1.43 to 0.88 ± 1.18. The success rate was 48.6% for complete and 89.2% for qualified. IOP spikes (27.0%) and wipe-out (8.1%) were the most common postoperative complications. Vision recovered gradually in 5 of 6 wipe-out patients. One eye (1.4%) developed permanent vision loss with VA decreasing to hand motion. Phaco-GSL appears safe and effective in treating advanced PACG cases with tubular vision or temporal field island. However, caution is warranted when considering this treatment option for patients at high wipe-out risk or those with high expectations for visual outcomes.

Degradation in Binaural and Spatial Hearing and Auditory Temporal Processing Abilities as a Function of Aging.

Sensorineural hearing loss is common with advancing age, but even with normal or near normal hearing in older persons, performance deficits are often seen for suprathreshold listening tasks such as understanding speech in background noise or localizing sound direction. This suggests there is also a more central source of the problem. Objectives of this study were to examine as a function of age (young adult to septuagenarian) performance on: 1) a spatial acuity task examining lateralization ability, and a spatial speech-in-noise (SSIN) recognition task, both measured in a hemi-anechoic sound field using a circular horizontal-plane loudspeaker array, and 2) a suprathreshold auditory temporal processing task and a spectro-temporal processing task, both measured under headphones. Further, we examined any correlations between the measures.DesignSubjects were 48 adults, aged 21 to 78, with either normal hearing or only a mild sensorineural hearing loss through 4000 Hz. The lateralization task measured minimum audible angle (MAA) for 500 and 4000 Hz narrowband noise (NBN) bursts in diffuse background noise for both an on-axis (subject facing 0°) and off-axis (facing 45°) listening condition at signal-to-noise ratios (SNRs) of -3, -6, -9, and -12 dB. For 42 of the subjects, SSIN testing was also completed for key word recognition in sentences in multi-talker babble noise; specifically, the separation between speech and noise loudspeakers was adaptively varied to determine the difference needed for 40% and 80% correct performance levels. Finally, auditory temporal processing ability was examined using the Temporal Fine Structure test (44 subjects), and the Spectro-Temporal Modulation test (46 subjects). Mean lateralization performances were poorer (larger MAAs) in older compared to younger subjects, particularly in the more adverse listening conditions (4000 Hz, off-axis, and poorer SNRs). Performance variability was notably higher for older subjects than for young adults. The 4000 Hz NBN bursts produced larger MAAs than did 500 Hz NBN bursts. The SSIN data also showed declining mean performance with age at both criterion levels, with greater variability again found for older subjects. Spearman rho analyses revealed some low to moderate, but significant correlation coefficients for age versus MAA and age versus SSIN results. A low but significant correlation was also observed between the most adverse MAA and SSIN conditions. Results from both the TFS and STM assessments showed decreased mean performance with aging, and revealed moderate, significant correlations, with the strongest relationship shown with the TFS test. Finally, of note, extended-high-frequency (EHF) hearing loss (measured between 9000 and 16,000 Hz) was found in older but not young subjects, and correlated with decreasing performance on several tasks. Particularly for more adverse listening conditions, age-related deficits were found on both of the spatial hearing tasks and in temporal and spectro-temporal processing abilities. It may be that deficits in temporal processing ability contribute to poorer spatial hearing performance in older subjects due to inaccurate coding of binaural/interaural timing information sent from the periphery to the brainstem. In addition, EHF hearing loss may be a coexisting factor in the reduced performance in older subjects.

Surface characteristics and machining rate of SS 316L coating developed using hydroxyapatite-mixed EDM process

Hydroxyapatite (HA) or bioceramic-based coatings on stainless steel (SS) 316L significantly enhance the biofunctionality of the base material's surface. However, HA's low thermal conductivity and brittleness limit its effectiveness as a coating material. This study investigates HA coating on SS 316L using electric discharge machining (EDM) with varying discharge energies and powder concentrations. Surface morphology, elemental composition, and phase analysis of untreated and coated samples were characterised using field emission scanning electron microscopy (FESEM), energy dispersive X-ray (EDX), and X-ray diffraction (XRD). The results demonstrate that the HA-assisted EDM process creates a coating comprising biocompatible oxides, phosphates, carbides, and intermetallic compounds. The coating exhibits a thin resolidified layer of 10.74 μm, characterised by redeposited spherical debris, shallow cavities, and a surface texture of 2.688 μm. The layer's hydrophilic nature is confirmed by a minimum contact angle of 47.68°. Taguchi analysis indicates that the machining rate is optimised at an HA powder concentration of 16 g/l, with peak current and HA powder concentration being the most influential parameters affecting resolidified layer thickness, surface texture, and wetting angle. The research intends to motivate SS 316L medical device manufacturers to implement the HA-assisted EDM process for bioimplant's dual machining and coating.

Early and Late Treatment Influence on Chorioretinal Microvasculature in Vogt-Koyanagi-Harada Patients Using Optical Coherence Tomography Angiography.

To study the impact of early and late treatment on chorioretinal microvasculature in Vogt-Koyanagi-Harada (VKH) disease using optical coherence tomography angiography (OCTA). A total of 103 patients with VKH disease were divided into early (group 1, starting treatment within 2months after disease onset) and late (group 2, starting treatment 2months after disease onset) treatment groups. Flow area (FA) and vessel density (VD) of the retinal superficial vascular complex (SVC) and deep vascular complex (DVC), FA of the choriocapillaris, three-dimensional choroidal vascular volume (CVV), and choroidal vascularity index (CVI) were analyzed and compared to 103 healthy individuals. The relationship between the final best-corrected visual acuity (BCVA) and the aforementioned parameters was also analyzed. FA of the SVC (all P < 0.05, except 0-1mm P = 0.087), DVC (all P < 0.05), choriocapillaris (1-2.5mm P = 0.033), and CVV (all P < 0.05) were lower in group 2 as compared to group 1. Compared to healthy controls, FA of the SVC (all P < 0.001, except 0-1mm P = 0.104) and DVC (all P < 0.05), VD of the SVC (1-2.5mm P = 0.001) and DVC (1-5mm P = 0.003, 2.5-5mm P < 0.001), FA of the choriocapillaris (all P < 0.05), and CVV (total area P = 0.049, 1-5mm P = 0.045, 2.5-5mm P = 0.041) were lower in group 2, while FA (all P < 0.05, except 0-1mm P = 0.925) and VD (1-5mm P = 0.003, 2.5-5mm P = 0.004) of the DVC and FA of the choriocapillaris (total area P = 0.007, 0-1mm P < 0.001, 1-2.5mm P = 0.007) were lower in group 1. There was no significant difference concerning CVI among groups (all P > 0.05). FA of the SVC, DVC, and choriocapillaris and VD of DVC and CVI were negatively associated with the final logarithm of the minimum angle of resolution BCVA. Patients with VKH disease who are treated within 2 months of disease onset showed a better chorioretinal microvascular outcome as defined by OCTA compared to those treatedlate. Our study employs OCTA to design three-dimensional metrics for the retina and choroid, bridging the gap between traditional two-dimensional OCTA findings and enhanced clinical outcomes for patients with VKH disease.

Comparative Analysis of Combined Topography-Guided Photorefractive Keratectomy and Corneal Crosslinking in Progressive Versus Stable Keratoconus.

To perform a comparative analysis of visual, refractive, and tomographic outcomes of combined topography-guided photorefractive keratectomy (TG-PRK) and corneal crosslinking (CXL) in patients with progressive versus stable keratoconus. Longitudinal retrospective case-control study. Patients with keratoconus submitted to simultaneous TG-PRK and CXL were included, with a minimum follow-up of 12 months up to 3 years. According to predefined disease progression criteria, patients were considered as progressive or stable. A total of 101 eyes from 93 patients were included, 62 considered progressive and 39 stable keratoconus. All baseline characteristics were similar between groups, except for age at surgery (progressive: 23.40 ± 4.22 years; stable: 35.97 ± 9.09; P < 0.001). Logarithm of the minimum angle of resolution CDVA improved significantly in progressive (baseline: 0.48 ± 0.24; 12 months: 0.33 ± 0.29; P < 0.001) and stable (baseline: 0.51 ± 0.24; 12 months: 0.28 ± 0.21; P < 0.001) patients, with no differences between groups. Maximum keratometry decreased significantly in progressive (baseline: 59.18 ± 5.63 diopters; 12 months: 54.73 ± 5.95; P < 0.001) and stable (baseline: 57.77 ± 5.02; 12 months: 53.59 ± 4.20; P < 0.001) patients, with no differences between groups. Index of surface variance significantly improved in progressive (baseline: 109.18 ± 31.74 diopters; 12 months: 94.11 ± 34.11; P < 0.001) and stable (baseline: 102.87 ± 29.52; 12 months: 86.95 ± 27.21; P < 0.001) patients, with no differences between groups. Other tomographic outcomes were also similar between groups. Pachymetry significantly decreased after surgery but remained stable throughout the follow-up. Combined TG-PRK and CXL is a safe and effective procedure for improving CDVA and regularizing the cornea, with comparable visual, refractive, and tomographic outcomes in both progressive and stable keratoconus. Combined TG-PRK and CXL may be added to the armamentarium of therapeutic tools for visual rehabilitation in patients with stable keratoconus.

Intraocular Lens Opacification After Descemet's Membrane Endothelial Keratoplasty-Risk Factors and Outcomes After Intraocular Lens Exchange.

To determine risk factors for intraocular lens opacification (IOLop) after Descemet membrane endothelial keratoplasty (DMEK) and to analyze clinical outcomes after IOL exchange. Cross-Sectional Study: Analysis of all cases of IOL exchange because of post-DMEK IOLop with a minimum of 6-month postoperative follow-up observed in clinic between November 2021 and April 2022. Main outcomes analyzed at the study visit were change in logarithm of the minimum angle of resolution (logMAR) best-corrected visual acuity after IOL exchange, endothelial cell loss (ECL), and graft survival. An historical cohort of 232 pseudophakic DMEK eyes was retrospectively analyzed to determine risk factors for post-DMEK IOLop. Cross-Sectional Study: Four eyes were observed (median follow-up = 45 (35.5-86.8) months). IOL materials were hydrophilic acrylic IOLs in 2 eyes and hydrophobic-hydrophilic in the other 2. At the study visit, improvement in median best-corrected visual acuity after IOL exchange was statistically significant (0.25 (0.19-0.41) logMAR to 0.00 (0-0.10) logMAR; P = 0.041). ECL ranged between 57.7% and 85.3%, without cases of graft failure. In the historical cohort, 21 eyes (9.05%) had some IOLop. In multivariate logistic regression model (105 eyes where IOL material data was available), IOLs with high water content material (odds ratio = 65.5, P = 0.0005) and rebubbling (odds ratio = 9.51, P = 0.0138) were independent risk factors for post-DMEK IOLop. Post-DMEK IOLop is infrequent, but a non-neglectable proportion of cases may require IOL explantation. IOL exchange is safe and effective in these eyes but may pose a risk for increased ECL. This study confirms that IOL material and number of rebubblings are major risk factors for post-DMEK IOLop.

Bonebridge implants versus atresiaplasty in children with unilateral congenital aural atresia: A comparison study of audiological outcomes

ObjectivesTo evaluate and compare audiological outcomes of atresiaplasty and Bonebridge (BB) implantation in patients with unilateral congenital aural atresia (UCAA), to guide clinical decision-making. MethodsTwenty-seven subjects diagnosed with UCAA were included in the study. Thirteen were implanted with the BB, while 14 undergone atresiaplasty. All patients underwent pre-and post-surgery examinations, including pure-tone audiometry, sound field threshold (SFT), speech reception threshold (SRT), word recognition score (WRS), and horizontal sound source localization tests. Results(1) Postoperatively, the average SFT decreased by 11.79 ± 5.93 dB HL in the atresiaplasty group and by 24.46 ± 9.36 dB HL in the BB group, with a significantly greater decrease in the BB group compared to the atresiaplasty group (P < 0.05). (2) Both groups demonstrated a significant improvement in average disyllabic WRS postoperatively under normal ear-masking conditions, with the BB group showing a significantly higher improvement than the atresiaplasty group. (3) When the speech signal was presented from the CAA side with noise from the normal hearing side, both surgical groups exhibited a significant decrease in postoperative signal-to-noise ratio compared to preoperative levels, with improvements of 2.14 ± 2.95 dB SNR in the atresiaplasty group and 4.92 ± 5.83 dB SNR in the BB group (P < 0.05). (4) The average minimum audible angle preoperative in the atresiaplasty group was 29.71 ± 18.42°, which decreased to 18.1 ± 10.07° at 6 months postoperatively, showing a statistically significant improvement (P < 0.05). ConclusionWe concluded that both atresiaplasty and Bonebridge implantation can significantly improve speech perception under both quiet and noisy conditions in children with UCAA. BoneBridge implantation appears to provide better audiological outcomes than atresiaplasty. Atresiaplasty can significantly improve the accuracy of sound localization. No significant improvement in sound localization accuracy was observed in the short period after Bonebridge implantation. Further research should be conducted with a larger sample size and longer follow-up time.

Body Mass and Foot-dominance Disparities in the Foot Plantar Pressure Parameters of Older Women.

To examine the effects of foot dominance and body mass on foot plantar pressures in older women of regular, overweight, and obese weights. 96 female adults were divided into regular-weight group (68.30 ± 4.19 yr), overweight group (69.88 ± 3.76 yr), and obesity group (68.47 ± 3.67 yr) based on their body mass index scores. Footscan® plantar pressure test system was used to assess the dynamic plantar pressures, and parameters were collected from risk analysis, foot axis analysis, single foot timing analysis, and pressure analysis. (1) The local risks of lateral forefoot and midfoot, the minimum and maximum subtalar joint angles, the flexibility of subtalar joint, foot flat phase, as well as the average pressures on toes, metatarsals,, midfoot, and lateral heel, with the peak pressures on toe 2-5, metatarsal 2, metatarsal 5, midfoot, and lateral heel had significant within-subject differences. (2) The phases of initial contact and foot flat, the average pressures on toe 2-5, metatarsals, midfoot, and heels, with the peak pressures on metatarsal 1-4, midfoot, and heels exhibited significant between-subjects differences. (3) There was an interaction effect of foot dominance and body mass index on the flexibility of subtalar joint. The non-dominant foot works better for stability, especially when touching on and off the ground. The dominant foot works better for propulsion but is more susceptible to pain, injury, and falls. For obese older women, the forefoot and midfoot are primarily responsible for maintaining stability, but the lateral midfoot and hindfoot are more prone to pain and discomfort.

Visual outcomes following bilateral implantation of a non-diffractive extended depth of focus toric intraocular lens using a mini-monovision approach.

To evaluate the clinical outcomes following bilateral implantation of the AcrySof™ IQ Vivity™ toric extended depth of focus (EDOF) intraocular lens (IOL). Prospective interventional case series. Patients with bilateral significant cataracts and pre-existing corneal astigmatism underwent cataract surgery and implantation with the AcrySof™ IQ Vivity™ toric IOL. Dominant eyes were targeted at emmetropia and non-dominant eyes at -0.50D. Primary endpoints were binocular uncorrected distance (UDVA), intermediate (UIVA at 66cm) and near (UNVA at 40cm) acuities at 3months. Secondary outcomes were corrected distance (CDVA), distance corrected intermediate (DCIVA) and distance corrected near (DCNVA), refractive predictability, rotational stability, binocular defocus curve, contrast sensitivity, Questionnaire for Visual Disturbances (QUVID) and Visual Function Index (VF-14) questionnaire scores. All visual acuities were converted to logarithm of minimum angle of resolution (logMAR) for analysis. 30 patients underwent uneventful phacoemulsification. The mean binocular UDVA, UIVA and UNVA were 0.06 ± 0.12, 0.11 ± 0.10 and 0.26 ± 0.10 respectively. The mean refractive spherical equivalent (MRSE) for dominant and non-dominant eyes were - 0.07D ± 0.27 and - 0.12D ± 0.54 respectively. 92.4% of dominant eyes and 84.6% of non-dominant eyes within 0.50D of target. The mean IOL rotation was 3.85° ± 5.09 with 86.7% of eyes with less than 5° of rotation. 26.7%, 20% and 36.7% of patients reported starbursts, haloes and glare respectively. The mean VF-14 score was 91.77. Bilateral implantation of the AcrySof™ IQ Vivity™ Toric IOL resulted in very good unaided visual acuities for far and intermediate distance with functional near vision. Dysphotopsias were reported but despite this, a high level of visual function was achieved.

Bietti’s crystalline dystrophy: genotyping and deep qualitative and quantitative phenotyping in preparation for clinical trials

PurposeTo qualitatively and quantitatively characterise the genotypes and phenotypes of Bietti’s crystalline dystrophy (BCD) in a cohort of patients.DesignCross-sectional and observational study.MethodsClinically confirmed BCD patients were recruited for genotyping and...

Effect of nystagmus on VEP-based objective visual acuity estimates

In order to determine the effect of nystagmus on objective visual acuity (VA) estimates, we compared subjective (VApsych) and objective (VEP, VAVEP) VA estimates in participants with nystagmus. For this purpose, 20 participants with nystagmus (NY) caused by idiopathic infantile nystagmus, albinism, achiasma or acquired nystagmus were recruited in this study. Estimates of BCVA (best corrected visual acuity) were determined psychophysically (VApsych; FrACT, Freiburg visual acuity test) and electrophysiologically (VAVEP; EP2000) according to ISCEV (International Society of Clinical Electrophysiology of Vision) guidelines. For each participant the eye with the stronger fixation instability [Nidek microperimeter (MP-1), Nidek Instruments] was included for further analysis. VApsych vs VAVEP were compared via paired t-tests and the correlation of the difference between VApsych and VAVEP (∆VA) vs the degree of fixation instability was tested with Pearson correlation (r). We found VAVEP to be better than VApsych [by 0.12 Logarithm of the Minimum Angle of Resolution (logMAR); mean ± standard error (SE) of VAVEP vs VApsych: 0.176 ± 0.06 vs. 0.299 ± 0.06, P = 0.017] and ∆VA to be correlated linearly with the degree of fixation instability (r2 = 0.21,p = 0.048). In conclusion, on average we report a small VA overestimation, around 1 line, for VAVEP compared to VApsych in NY. This overestimation depended on the magnitude of the fixation instability. As a rule of thumb, a reduction of the fixation probability in the central 4° from 100 to 50% leads on average to a VAVEP overestimation of around 0.25 logMAR, i.e. 2.5 lines.

Relationship between Tilt Sensation Ability and Lower Limb Injuries in Junior Athletes.

The purpose of this study was to devise a tilt sensation measurement method to evaluate ankle proprioception and to examine its reliability. It was also used to determine the relationship among tilt sensation abilities, physical development, and lower limb injuries in junior athletes. In this study, a step platform created tilt angles. Participants with eye masks answered "yes" or "no" to sensing a tilt, evaluated over nine or seven trials. Experiment 1 involved 22 university students (20.6 ± 0.9 years). The minimum angle at which a tilt could be sensed while standing on both feet was determined, and measurements were taken again to examine reliability. Experiment 2 involved 40 junior athletes (12.3 ± 2.0 years), where the minimum angle for tilt sensation was obtained, and medical checks were conducted to assess injuries in the knee, lower leg, and foot. Reliability studies showed a moderately significant correlation between the first and second sessions (r = 0.504, p = 0.017), suggesting the reliability of the experimental method. The proportion capable of sensing a tilt of 1.1° and 1.6° was significantly higher in junior high school students than in elementary school students (1.1°; χ2 = 8.839, p = 0.003. 1.6°; χ2 = 4.038, p = 0.044). The group unable to sense a tilt of 1.6° and 2.1° had a significantly higher positive rate of knee injuries compared to the sensed group among junior high school students (1.6°; χ2 = 4.622, p = 0.032. 2.1°; χ2 = 4.622, p = 0.032). Our findings suggested that a reduced tilt sensation ability was associated with knee injuries in junior high school students. Utilizing our devised tilt sensation assessment could play a crucial role in preventing and detecting early injuries in junior high school students.

Descemet Membrane Endothelial Keratoplasty in Aphakic, Aniridic, and Vitrectomized Eyes: A Review.

The aim of this review is to examine the techniques, complications, and outcomes of Descemet membrane endothelial keratoplasty (DMEK) in aphakic, aniridic, and vitrectomized eyes. A literature search was conducted in the MEDLINE database (via PubMed), using as keywords "(DMEK) AND (aphakia OR aniridia OR vitrectomy OR vitrectomized)." The research was limited to 10 years (January 2014-March 2024), in view of lack of literature before 2014. Articles, including case reports and case series, were included. Twenty articles were included. No randomized controlled trials were found nor comparative studies with more than 1 technique used. Mean rebubbling rate in complex eyes was 29%, whereas mean endothelial cell loss at 6 months was 37%. The mean postoperative visual acuity improved from 1.47 logarithm of the minimal angle of resolution to 0.7 logarithm of the minimal angle of resolution. Despite being more challenging, compared with the techniques reported in literature, DMEK can be considered a valid option for the management of endothelial decompensation in complex eyes, with rebubbling rate and endothelial cell loss at 6 months, which are similar to non-complex eyes.