Treatment Of Myopia Research Articles

Refractive Effect of Epithelial Remodelling in Myopia after Transepithelial Photorefractive Keratectomy.

(1) Introduction: We analysed epithelial changes after the treatment of moderate myopia with transepithelial photorefractive keratectomy. (2) Materials and Methods: We used optical coherence tomography data and analysed changes in the stroma and epithelium after ablation. We aimed to ascertain how much epithelium hyperplasia occurred after TransPRK; for this, we used data from 50 eyes treated with TransPRK with the AMARIS 1050 Hz, with a minimum follow-up of 4 months. (3) Results: The measured epithelial changes corresponded to a less than 0.1 ± 0.2D of spherical effect, less than 0.2 ± 0.2D of astigmatic effect, and less than 0.5 ± 0.2D of comatic effect. (4) Conclusions: The changes in epithelial thickness after aberration-neutral transepithelial photorefractive keratectomy for moderate myopia were very small, indicating a low level of epithelial hyperplasia without resembling a regression-inducing lentoid.

Characterization of Femtosecond Laser and Porcine Crystalline Lens Interactions by Optical Microscopy.

The use of ultrafast laser pulses for eye anterior segment surgery has seen a tremendous growth of interest as the technique has revolutionized the field, from the treatment of myopia, hyperopia, and presbyopia in the cornea to laser-assisted cataract surgery of the crystalline lens. For the latter, a comprehensive understanding of the laser-tissue interaction has yet to be achieved, mainly because of the challenge of observing the interaction zone in situ with sufficient spatial and temporal resolution in the complex and multi-layered tissue of the crystalline lens. We report here on the dedicated characterization results of the laser-tissue interaction zone in the ex vivo porcine lens using three different methods: in situ and real-time microscopy, wide-field optical imaging, and phase-contrast microscopy of the histological cross sections. These complementary approaches together revealed new physical and biological consequences of laser irradiation: a low-energy interaction regime (pulse energy below ~1 µJ) with very limited cavitation effects and a stronger photo-disruption regime (pulse energy above 1 µJ) with a long cavitation duration from seconds to minutes, resulting in elongated spots. These advances in the understanding of the ultrafast laser's interactions with the lens are of the utmost importance for the preparation of the next-generation treatments that will be applied to the lens.

Clinical efficacy of posterior chamber phakic refractive lens implantation in the treatment of ultra-high myopia

Clinical efficacy of posterior chamber phakic refractive lens implantation in the treatment of ultra-high myopia

Clinical observation of orthokeratology with increased compression factor in the treatment of myopia

Objective: To discuss the efficacy and safety of orthokeratology with increased compression factor (ICF) in myopia correction in children. Methods: It was a prospective cohort study. Data of the right eyes of myopic children who visited the First Affiliated Hospital of Chengdu Medical College for orthokeratology were collected continuously from May 2016 to Dec 2018. All children had low myopia (<3.00 D) or moderate myopia (≥3.00 D), and were grouped using random numbers in Excel to receive orthokeratology with ICF or conventional compression factor (CCF). The axial length (AL), spherical equivalent (SE), best corrected visual acuity (BCVA), near visual acuity (NVA), Efron grade, corneal hysteresis (CH), corneal resistance factor (CRF), corneal-compensated intraocular pressure (IOPcc), tear film break-up time (BUT), higher-order aberrations (HOAs), accommodative amplitude (AA) and accommodative facility (AF) were compared between groups during the 1-year treatment period. The Chi-squared test was used to compare the categorical data, while the independent-sample t-test was performed to assess the measurement data. Results: After 1 year of treatment, there were no statistical differences in AL, SE, BCVA, NVA, Efron grade, CH, CRF, IOPcc, BUT, HOAs, AA and AF between the low myopia ICF group and the low myopia CCF group (all P>0.05). After 6 months of treatment, the AL increased by (0.05±0.03) mm in the moderate myopia ICF group and by (0.08±0.04) mm in the moderate myopia CCF group (t=-3.416, P=0.001). After 1 year of treatment, the AL increased by (0.12±0.04) mm in the moderate myopia ICF group and by, (0.16±0.05) mm in the moderate myopia CCF group (t=-4.017, P<0.001). The SE was (-0.16±0.40) D in the moderate myopia ICF group, significantly different from that in the moderate myopia CCF group [(-0.58±0.60) D; t=3.529, P=0.001]. There were also statistical differences in HOAs, spherical aberrations and AF (all P<0.05), but no statistical differences in BCVA, NVA, Efron grade, CH, CRF, IOPcc, BUT and AA between the two groups (all P>0.05). Conclusions: Orthokeratology with ICF safely and effectively corrected myopia in children during the observation period. It could control the progression of moderate myopia more effectively than that of low myopia.

Ocular Cyclopentolate: A Mini Review Concerning Its Benefits and Risks.

Cycloplegic and mydriatic agents are essential in ophthalmological clinical practice since they provide the means for diagnosing and treating certain eye conditions. In addition, cyclopentolate has proven to possess certain benefits compared to other available cycloplegics and mydriatics. Still, the incidence of some adverse drug reactions related to this drug, especially in susceptible patients, has created interest in reviewing the literature about the benefits and risks of using cyclopentolate. A literature search was conducted in Medline/PubMed and Google Scholar, focusing on identifying cyclopentolate's benefits and risks; the most important benefit was its usefulness for evaluating refractive errors, especially for hyperopic children, pseudomyopia, anterior uveitis, treatment of childhood myopia, idiopathic vision loss, and during examinations before refractive surgery, with particular advantages compared to other cycloplegics. While the risks were divided into local adverse drug reactions such as burning sensation, photophobia, hyperemia, punctate keratitis, synechiae, and blurred vision, which are relatively frequent but mild and temporary; and systemic adverse drug reactions such as language problems, visual or tactile hallucinations and ataxia, but unlike ocular, systemic adverse drug reactions are rare and occur mainly in patients with risk factors. In addition, six cases of abuse were found. The treatment with cyclopentolate is effective and safe in most cases; nevertheless, special care must be taken due to the potential severe ADRs that may occur, especially in susceptible patients like children, geriatrics, patients with neurological disorders or Down's syndrome, patients with a low blood level of pseudocholinesterase, users of substances with CNS effects, and patients with a history of drug addiction. The recommendations are avoiding the use of 2% cyclopentolate and instead employing solutions with lower concentrations, preferably with another mydriatic such as phenylephrine. Likewise, the occlusion of the nasolacrimal duct after instillation limits the drug's absorption, reducing the risk of systemic adverse events.

One-Year Visual Outcomes and Corneal Higher-Order Aberration Assessment of Small-Incision Lenticule Extraction for the Treatment of Myopia and Myopic Astigmatism.

We present a retrospective, single-center report of one-year visual outcomes for Small Incision Lenticule Extraction (SMILE) to treat myopia and myopic astigmatism, as well as to compare outcomes with other published literature, including results from the United States Food and Drug Administration (US FDA). A total of 405 eyes with a mean preoperative spherical equivalent of -5.54 diopters (D) underwent SMILE between April 2017 and April 2022. The outcomes measured included visual acuity, manifest refraction, vector analysis, and wavefront aberrometry at various time points, specifically pre-operative and twelve months post-operatively. Results were compared to other similar published studies of SMILE outcomes between 2012 and 2021. A total of 308 and 213 eyes were evaluated at three and twelve months, respectively. At twelve months, 79% of eyes achieved UDVA ≥ 20/20, and 99% had ≥20/40, with no patients losing ≥2 lines of vision. For accuracy, 84% of eyes were within 0.5 D of target SEQ, and 97% were within 1 D. Total corneal higher order aberrations (HOA) increased from 0.33 to 0.61 um. Significant change was found in vertical coma and spherical aberration at twelve months. SMILE remains a safe and effective treatment for myopia and myopic astigmatism. Clinical outcomes are likely to improve with increased surgeon experience and refinement of technology and nomograms.

Investigation of children's habits of smartphone usage and parental awareness of myopia control in underdeveloped areas of China.

To investigate the behaviors of smartphone usage and parental knowledge of vision health among primary students in the rural areas of China. In this school-based, cross-sectional study, a total of 52 606 parents of students from 30 primary schools in the Xingguo County were investigated through an online questionnaire from July 2020 to August 2020. The self-designed questionnaire contained three parts: the demographic factors of both children and parents, parental knowledge and attitude toward myopia, and the preventive treatment of myopia. A total of 52 485 appropriately answered questionnaires were received, showing an effective response rate of 95.1%. The average age of the primary students was 10.1±0.98y and the prevalence of myopia among the primary students was 40.3%. The age of myopia occurrence in elementary students was significantly correlated with the parents' educational level (95%CI: 0.82-0.98, P=0.013), children's gender (95%CI: 1.08-1.20, P<0.001), school location (county or countryside) (95%CI: 0.59-0.66, P<0.001), children's smartphone ownership (95%CI: 1.09-1.26, P<0.001), and the average time spent on smartphone per day (95%CI: 0.78-0.88, P<0.001). School location in the county town, high family income, and high parents' educational level significantly affected both parents' myopia awareness and children's vision-threatening behaviors (P<0.01). Left-behind children showed a higher incidence of vision-threatening habits than those who lived with their parents (P<0.01). The results reveal the current situation of myopia development among rural primary school students and their parents. This survey will serve as a guidance for designing myopic prevention policies in the rural areas of China.

Tropane alkaloids (hyoscyamine, scopolamine and atropine) from genus Datura: extractions, contents, syntheses and effects

Belonging to family Solanaceae , genus Datura is widely distributed all over the world and famous for its narcosis and acesodyne in ancient China. And Datura is also annoying due to the poisoning and hallucinogenic effects. Besides the medicine, it plays a magical role in seed germination and plant growth, and has good effects against plant diseases, insectsand weeding. Its main function components are tropane alkaloids (TAs), including hyoscyamine , scopolamine and atropine (HSA). They share a common tropane fragment (N-methyl-8-azabicyclo[3.2.1] octane). L -hyoscyamine and scopolamine are natural active ingredients in Datura , while atropine is an equal mixture of L -hyoscyamine and D -hyoscyamine, produced by the racemization of L -hyoscyamine during the extraction. As competitive antagonists of acetylcholine muscarinic (M-) choline receptors, HSA potently regulates the central nervous system (CNS). In addition, scopolamine shows effectiveness in the treatment of the respiratory and digestive system diseases, such as acute respiratory distress syndrome (ARDS) and gastrointestinal motility disorders. Hyoscyamine has remarkable effects on treating Parkinson's disease, bradyarrhythmias and genitourinary symptoms. Atropine is widely used in the treatment of myopia, amblyopia and organophosphorus poisoning. Recently, scopolamine-induced disease models play an important role in the exploration of the effects of drugs in amnesia, cognitive impairment and neuronal damage. In this review, we aim to summarize the contents of HSA in different Datura species and their influencing factors, performe an overview of the biosynthesis and chemical synthesis pathways and analyze the key synthetase in the NCBI database, highlight the effect of Datura extract and HSA on resisting plant insects and diseases, controlling weeds and treating different kinds of diseases in human. • The efficient extraction methods of Datura extract are sorted and compared. • The contents of HSA in different Datura species and plant organs vary greatly. • The key HAS synthase genes identified in Solanaceae are less studied in Datura . • HSA play important role in medicine, plant disease control and insect resistance. • HSA have potential in biological control and medicinal industrialized production.

The Effectiveness and Rotational Stability of Vertical Implantation of the Implantable Collamer Lens for the Treatment of Myopia.

To explore the effectiveness and rotational stability of vertical implantation of the Implantable Collamer Lens (ICL) (STAAR Surgical) to treat myopia. This was a prospective, randomized, controlled study, including 78 eyes from 46 patients with myopia who underwent ICL implantation. The patients were randomly divided into vertical and horizontal implantation groups. At 1 day, 1 week, 1 month, and 3 months after surgery, rotational stability was evaluated using the postoperative axis deviation from the intended axis by the digital anterior segment photograph. The vault, crystalline lens rise, anterior chamber depth, manifest refraction spherical equivalent, intraocular pressure, and visual acuity values were obtained before and after surgery. A 3-month follow-up period showed significant differences between the efficacy indexes in the horizontal (1.11 ± 0.02) and vertical (1.13 ± 0.02) groups (P = .455). No significant difference was observed in the postoperative manifest refraction spherical equivalent between the horizontal (-0.27 ± 0.18 diopters) and vertical (0.01 ± 0.08 diopters) groups (P = .151). Also, no statistically significant difference was observed in the corneal endothelial cells and intraocular pressure between groups (P = .555, P = .464). The rotation angle of the horizontal group was greater at 1 week, 1 month, and 3 months (3.14° ± 2.13°, 2.97° ± 2.01°, 3.27° ± 2.12°, respectively) compared to that of the vertical group (1.30° ± 1.29°, 1.85° ± 1.60°, 1.74° ± 1.33°, respectively) (P < .001 for all). From 1 week to 3 months, the changing angle of horizontal (0.31° ± 1.86°) and vertical (0.49° ± 1.33°) ICL rotation displayed a positive correlation with the changing vault of horizontal (48.41 ± 86.02 mm) and vertical (39.64 ± 78.43 mm) ICL rotation (r = 0.242, 0.335, P = .033, .037). The study supports great efficacy and safety in both vertical and horizontal implantation, with the vertical implantation group displaying better stability. [J Refract Surg. 2022;38(10):641-647.].

Vector analysis of astigmatic correction after single-step transepithelial photorefractive keratectomy and femtosecond-assisted laser in-situ keratomileusis for low to moderate myopic astigmatism.

This study aimed to evaluate the outcomes of astigmatic correction by single-step transepithelial photorefractive keratectomy (TransPRK) and femtosecond-assisted laser in-situ keratomileusis (Femto-LASIK) surgeries. A total of 218 subjects received TransPRK or Femto-LASIK surgery for the treatment of myopia and astigmatism (-2.25 to -0.25 D). Refraction errors and uncorrected (UDVA) and corrected distance visual acuity (CDVA) were examined before and at 3 months after surgery. Astigmatism changes were assessed by vector analysis. Preoperative parameters of the TransPRK group were similar to the Femto-LASIK group. UDVA and CDVA at 3 months were similar between both groups. Manifest refraction (MR) spherical equivalent in the TransPRK group (0 ± 0.20 D) was slightly lower compared with the Femto-LASIK group at 3 months (0.11 ± 0.25 D, P = 0.001). MR cylinder was -0.06 ± 0.19 D in the TransPRK group and -0.02 ± 0.15 D in the Femto-LASIK group at 3 months (P = 0.135). The index of success (IS) was 0.15 ± 0.36 in the TransPRK group and 0.06 ± 0.17 in the Femto-LASIK group (P = 0.125). The correction index (CI) was 1.03 ± 0.19 in the TransPRK group and 1.01 ± 0.11 in the Femto-LASIK group (P = 0.815). For low to moderate myopic astigmatism, TransPRK provided a comparable astigmatic treatment effect as Femto-LASIK. Myopic astigmatism was both slightly overcorrected after TransPRK and Femto-LASIK surgeries.

Long-term results in patients with iris-fixated foldable phakic intraocular lenses for myopia and astigmatism.

To evaluate the long-term results of iris-fixated foldable phakic intraocular lens (pIOL) implantation for the management of myopia and astigmatism. Centro Hospitalar Universitário do Porto, Oporto, Portugal. Prospective clinical study. Patients who underwent Artiflex Myopia or Artiflex Toric iris-fixed pIOL implantation for the treatment of myopia or astigmatism between 2003 and 2011 were included. Refractive stability, refractive predictability, safety, efficacy, and cumulative probability of success were evaluated at 5 years, 10 years, and 15 years of follow-up. 5-year, 10-year, and 15-year follow-ups were completed by 199 of 217 (91.7%), 187 of 217 (86.2%), and 43 of 45 (95.6%) eyes implanted with pIOLs, respectively. The mean spherical equivalent was -8.36 ± 2.75 diopters (D), -0.11 ± 0.31 D, -0.33 ± 0.62 D, and -0.80 ± 1.32 D preoperatively and after 5 years, 10 years, and 15 years after surgery. At 5 years, 10 years, and 15 years after surgery, 100%, 95.6%, and 81.6% were within ±1.00 D. The safety and efficacy indexes were 1.07 and 1.06 at 5 years, 1.04 and 0.99 at 10 years, and 1.05 and 1.00 at 15 years of follow-up, respectively. Kaplan-Meier analysis showed survival rates of 97% at 5 years, 73% at 10 years, and 43% at 15 years of follow-up. Long-term results demonstrated that the implantation of Artiflex pIOLs was a stable, predictable, and effective procedure at 5 years, 10 years, and 15 years of follow-up. Annual follow-up visits to evaluate endothelial cell density and anterior chamber depth decrease, to alert patients to this need in the preoperative evaluation, is recommended.

Physiotherapy in Ophthalmology – a Systematic Review

Introduction: Eye disease or visual impairment, such as myopia and hyperopia, is now a common problem. Various types of vision therapy and eye exercises are available. Objective: To estimate publications assessing the impact of various eye exercises on visual parameters in order to determine their effectiveness in the treatment and prevention of visual impairment. Data sources: Ebsco, PubMed and Medline were searched between April 10-15, 2021. Study selection: The study comprised a controlled trial, randomised clinical trial, case control study, nested case-control study and comparative study in which the effects were examined of eye therapy or eye exercise among adults, adolescents and children with refractive eye errors or regular eyes. Data extraction and synthesis: The analysis was based on the PRISMA recommendations (Preferred Reporting Items for Systematic Review and Meta-Analysis). Results: Nineteen publications were analysed in detail. Considering visual parameters, the largest number of studies (16 articles) concerned refractive defects of the eye, such as myopia or hyperopia. Various interventions were used, the most popular being the Bates method (8 articles), eye yoga exercise (7 articles), Chinese eye exercises and vision therapy (1 article). The most commonly used eye assessment tools were the autorefractometer (4 articles) and Snellen’s chart (6 articles). Conclusions: Eye exercises have a positive effect on the treatment of myopia and improve binocular vision.

Anterior Chamber Iris-Fixated Phakic Intraocular Lens Implantation for Treatment of High Anisometropia in Children: Long-term Results.

To evaluate the long-term efficacy of anterior chamber iris-fixated phakic intraocular lens (PIOL) implantation in the treatment of high myopic (> -9.00 diopters [D]) or hyperopic (> +6.00 D) anisometropia in children with intolerance to spectacles or contact lenses. A total of 58 children with anisometropic myopia (range: -9.25 to -18.50 diopters [D]) and 13 children with anisometropic hyperopia (range: +6.00 to +8.50 D) underwent unilateral iris-claw PIOL implantation from 2008 to 2018. The mean age was 6.7 years. The mean follow-up was 38.5 months. Target refraction was emmetropia. The cycloplegic refraction (mean spherical equivalent) improved from -12.47 D (range: -9.25 to -18.50 D) to -0.73 D (range: +0.75 to -1.50 D) in myopic eyes and reduced from +7.15 D (range: +6.00 to +8.50 D) to +0.94 D (range: -0.50 to + 1.75 D) in hyperopic eyes. Eighty-four percent of eyes were corrected to within ±1.00 D of emmetropia. The mean uncorrected distance visual acuity (UDVA) improved from 1.74 ± 0.36 to 0.45 ± 0.28 logarithm of the minimum angle of resolution (logMAR) (P = .0014). The mean corrected distance visual acuity (CDVA) changed from 0.68 ± 0.32 to 0.27 ± 0.15 logMAR (P = .02179). The safety index was 2.18 and the efficacy index was 1.51. The mean preoperative endothelial cell count of 2,874.7 cells/mm2 changed to 2,685.3 cells/mm2 at 2 to 6 years postoperatively. Binocular vision quality was improved in 55 patients. No patient had serious complications or lost any Snellen lines of CDVA. Iris-fixated PIOL implantation is an effective and safe method in the treatment of high anisome-tropic myopia and hyperopia and amblyopia in pediatric patients who are noncompliant with spectacles or contact lenses. [J Pediatr Ophthalmol Strabismus. 2023;60(3):203-209.].

Eyeball segmentation and measurement in MRI images of myopic children

Myopia occurs when the light beam stops before entering the retinal layer, resulting in blurred long-distance vision. Myopia in children is very common nowadays, requiring prompt intervention and effective treatment. Thus, research on myopia among children is aggressively conducted to propose better treatment technology. One of the aspects of myopia research is to analyse the shape of the eyeball and its association with this abnormality. Eyeball imaging is commonly conducted via magnetic resonance imaging (MRI). Thus, this paper presents eyeball segmentation in MRI images of myopic children based on the Chan-Vese Level Set method. MRI eye images of 35 myopic children were used. The measurement of pertinent lines was also done. The accuracy of the lines’ measurement was compared with the manual measurement. An average difference of 0.2825 mm (std 0.2386mm) for the left eye and 0.2677 mm (std 0.2526 mm) for the right eye were obtained. Also, statistical t-test evaluation showed that both measurements were statistically similar, confirming the agreement between the two. In conclusion, the process of segmentation and measurement of the eyeball is important to furnish the need for myopia treatment research and study on any treatment efficacy.

Myopia, its prevalence, current therapeutic strategy and recent developments: A Review.

Myopia is a widespread and complex refractive error in which a person's ability to see distant objects clearly is impaired. Its prevalence rate is increasing worldwide, and as per WHO, it is projected to increase from 22% in 2000 to 52% by 2050. It is more prevalent in developed, industrial areas and affects individuals of all ages. There are a number of treatments available for the control of myopia, such as glasses, contact lenses, laser surgery, and pharmaceuticals agents. However, these treatments are less beneficial and have significant side effects. A novel molecule, 7-methylxanthine (7-MX), has been found to be a highly beneficial alternate in the treatment of myopia and excessive eye elongation. Many preclinical and clinical studies showed that 7-MX is effective for the treatment of myopia and is presently under phase II of clinical investigation. We have also investigated preclinical toxicity studies such as acute, sub-acute, sub-chronic, and chronic on rats. In these studies, 7-MX was found to be non-toxic as compared to other reported anti-myopic agents. Moreover, as an ideal drug, 7-MX is observed to have no or low toxicity, brain permeability, non-allergic, higher oral administration efficacy, and low treatment costs and thus qualifies for the long-term treatment of myopia. This review article on 7-MX as an alternative to myopia treatment will highlight recent findings from well-designed preclinical and clinical trials and propose a potential future therapy.

A review of myopia treatment methods and their research progress

Myopia is a refractive error in which light is focused in front of the retina. In recent years, with the change of people's lifestyle and the widespread use of electronic products, the number of people suffering from myopia is on the rise year by year. Therefore, how to effectively prevent and treat myopia has attracted a lot of attention. At present, the common treatments for myopia mainly include five major categories, such as drug therapy, optical correction, surgery, Chinese medicine treatment and environmental behavior therapy. In this paper, we summarize the latest research advances in myopia through the above five levels in order to provide a reference basis for the development of a more comprehensive and personalized myopia treatment plan in the future.

Changes in the Choroidal Thickness of Children Wearing MiSight to Control Myopia.

Background: Due to the importance of choroidal thickness in the development of myopia, this study examined the effect of MiSight contact lenses (CLs) on the choroidal thickness of myopic children and the differences between responders and non-responders to the treatment with these CLs. Methods: A total of 41 myopic children were fitted with MiSight CLs and 33 with single-vision spectacles. They were followed up for two years. Subfoveal choroidal thickness and choroidal thickness 1 and 3 mm temporal and nasal to the fovea were measured by OCT at baseline and one and two years after the treatment. Differences in all the choroidal thickness parameters were assessed in each group over time. Patients from the MiSight group were classified based on a specific range of changes in axial length at the end of the second year of treatment as “responders” (AL change < 0.22 mm/per year) and “non-responders”, and the choroidal thickness of both groups was analyzed. Results: The subfoveal choroidal thickness of the MiSight and single-vision spectacle groups did not show any changes over time. Wearing MiSight CLs induced relative choroidal thickening in the responder group in the first year of treatment. Conclusion: Choroidal thickness might work as a predictor of the effectiveness of MiSight in myopia treatment.

Computational modeling of corneal and scleral collagen photocrosslinking

Scleral photocrosslinking is increasingly investigated for treatment of myopia and glaucoma. In this study a computational model was developed to predict crosslinking efficiency of visible/near infrared photosensitizers in the sclera. Photocrosslinking was validated against riboflavin corneal crosslinking experimental studies and subsequently modeled for the sensitizer, methylene blue, administered by retrobulbar injection to the posterior sclera and irradiated with a transpupillary light beam. Optimal ranges were determined for treatment parameters including light intensity, methylene blue concentration, injection volume, and inspired oxygen concentration. Additionally, sensitivity of crosslinking to various parameters was quantified. The most sensitive parameters were oxygen concentration in the injection solution, scleral thickness, and injection reservoir thickness (i.e., injection volume).

Phakic intraocular lenses: an update and review for the treatment of myopia and myopic astigmatism in the United States.

To review all phakic intraocular lenses (pIOLs) available in the United States for the correction of myopia or myopic astigmatism and offer a clinical approach to their proper use, postoperative follow-up, and analysis of visual and adverse outcomes. In March 2022, the FDA approved the EVO/EVO+ Visian ICL for widespread use, adding this lens to the two others available (Verisyse, Visian ICL). Cataract formation, endothelial cell loss (ECL) and surgical reintervention remain the most common adverse events. There are discrepancies between studies on ECL following implantation with pIOLs, although trends can be deduced with meta-analysis. Posterior Chamber-pIOLs (PC-pIOLs), especially the EVO/EVO+, have an overall lower mean adverse effect and subjective patient symptom profile when compared to Iris Fixated-pIOLS (IF-pIOLs). Advancements in PC-pIOL sizing have provided a noticeable difference in visual and safety outcomes. All pIOLs available in the United States provide high-quality visual correction of moderate to high myopia and/or myopia with astigmatism. Proper follow-up for ECL and cataract formation is warranted.

Advances in OCT Imaging in Myopia and Pathologic Myopia.

Advances in imaging with optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) technology, including the development of swept source OCT/OCTA, widefield or ultra-widefield systems, have greatly improved the understanding, diagnosis, and treatment of myopia and myopia-related complications. Anterior segment OCT is useful for imaging the anterior segment of myopes, providing the basis for implantable collamer lens optimization, or detecting intraocular lens decentration in high myopic patients. OCT has enhanced imaging of vitreous properties, and measurement of choroidal thickness in myopic eyes. Widefield OCT systems have greatly improved the visualization of peripheral retinal lesions and have enabled the evaluation of wide staphyloma and ocular curvature. Based on OCT imaging, a new classification system and guidelines for the management of myopic traction maculopathy have been proposed; different dome-shaped macula morphologies have been described; and myopia-related abnormalities in the optic nerve and peripapillary region have been demonstrated. OCTA can quantitatively evaluate the retinal microvasculature and choriocapillaris, which is useful for the early detection of myopic choroidal neovascularization and the evaluation of anti-vascular endothelial growth factor therapy in these patients. In addition, the application of artificial intelligence in OCT/OCTA imaging in myopia has achieved promising results.