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AIM: To evaluate the diopter errors and safety of secondary intraocular lens(IOL)implantation in the ciliary sulcus using a modified incision procedure in children with bilateral aphakia.METHODS: The data of 12 children(24 eyes)with bilateral aphakia who had undergone secondary foldable IOL implantation in the ciliary sulcus using a modified incision procedure from 2020 to 2021 were retrospectively reviewed. Incision-related complications were analyzed intraoperatively and at 1 d and 1 mo postoperatively. Best-corrected visual acuity(BCVA), axial length(AL), white-to-white(WTW), and refractive outcomes in terms of preoperative reserved diopters(PRD)and actual equivalent spherical diopters(AESD). The patients were divided into two groups by age(≤7 and >7 a), AL(11.5mm), and the diopter errors between their AESD and PRD predicted based on the measurement results were compared.RESULTS: The patients comprised 9(75%)boys and 3(25%)girls. Two(17%)patients had anterior subcapsular cataracts, 4(33%)had posterior polar cataracts, and 6(50%)had nuclear cataracts. The mean age at cataract extraction was 6.4±1.61(3.4-8.9)mo. The mean interval between cataract extraction and secondary IOL implantation was 6.8±1.82(4.4-11.5)a. The mean preoperative BCVA was 0.49±0.33(1.0-0.1)LogMAR. The mean postoperative BCVA was 0.38±0.32(1.0-0.0)LogMAR. The mean AL was 23.56±1.96(19.00-26.38)mm, and the mean WTW was 11.5±0.92(9.3-13.9)mm. The mean PRD was 1.57±0.60(0.73-2.77)D, the mean AESD was 0.57±0.55(-0.50 to 1.75)D, and the mean difference between the AESD and PRD was -0.99±0.52(-2.22 to 0.32)D. The differences in the AESD and PRD between the groups according to age, AL and WTW were not statistically significant(P=0.59, 0.56, and 0.53, respectively).CONCLUSION: IOL implantation in the ciliary sulcus after a modified incision is safe and feasible for children with aphakia. It is necessary to subtract approximately 1 D of IOL power from the formula-selected power when implanting an IOL in the ciliary sulcus. Age, AL, and WTW do not significantly affect the difference.

Background: Congenital microcoria has been extensively reported and usually leads to visual dysfunction or blindness. However, micropupil development secondary to cataract surgery has never been reported. Here, we describe a rare case of micropupil development in infancy that occurred secondary to combined cataract extraction and intraocular lens implantation for treatment of congenital cataract. When the patient reached adulthood, the affected eye not only gained good vision but also showed better ocular development and refractive status than the fellow eye. Case presentation: A 17-year-old boy presented to our outpatient clinic with decreased vision in his left eye related to congenital cataract surgery at 6 months of age. The affected eye had exhibited a pinhole pupil since the third month postoperatively. The condition had been managed with observation and regular monocular occlusion treatment. Upon presentation to our clinic, the best-corrected visual acuity (BCVA) in his fellow eye was 0.0 logMAR(20/20) with a refraction of − 5.75 diopters cylinder/−2.25 diopters sphere, and the BCVA in his affected eye was 0.5 logMAR(20/40) with a refraction of 0.00 diopters. Ophthalmic examination of the affected eye revealed a pinhole pupil (approximately 0.5 mm) with high light reflex sensitivity but no response to pupil-dilating drugs. The patient underwent pupilloplasty of the affected eye under corneal surface anesthesia. Postoperative examination revealed better ocular development in the affected eye than in the fellow eye (axial length: 24.21 vs. 27.02 mm, respectively) as well as better refractive status in the affected eye (BCVA of 0.0 logMAR(20/20) with a refraction of − 2.23 diopters cylinder/−3.00 diopters sphere vs. 0logMAR(20/20) with a refraction of -5.75 diopters cylinder/-2.25 diopters sphere). Conclusions: We have reported a rare case of micropupil development secondary to congenital cataract surgery, which is an uncommon complication, especially in children. However, unlike congenital microcoria, the secondary pinhole pupil may have reduced imaging haze and halos, possibly favoring the development of the affected eye. This case provides further insight into the treatment of congenital cataract. [ABSTRACT FROM AUTHOR]

Introduction: Blau syndrome (BS) is a rare autoimmune disease. We report here an atypical case of BS. Case Presentation: We present a case of late-onset eye manifestations in a Chinese girl of 18 years old with sporadic BS, presenting with panuveitis. We performed comprehensive ocular examinations including fluorescein fundus angiography and indocyanine green angiography for her. The oral hormone plus local anti-inflammatory eye drops have well controlled the inflammation of her eyes. Conclusion: Our case highlights the necessity of systemic medical history inquiry for every eye discomfort. [ABSTRACT FROM AUTHOR]

Objective: To investigate the mechanisms of ocular injuries in astronauts due to gravity deficit by examining changes in retinal microcirculation and visual electrophysiology in macaques subjected to simulated weightlessness., Methods: The head-down recumbency of macaques was used to simulate the movement of blood to the side of the head that occurs without microgravity. Head-down recumbency was performed with the head tilted downwards at a recommended angle of 10°. The macaques in the control group were similarly tethered to the rope but could be held in a normal position. The whole experiment lasted for 6 weeks and retinal microcirculation and visual electrophysiology information was collected at weeks 0, 3 and 6., Results: The retinal microcirculation of macaques was affected by 3 weeks of weightlessness. This includes morphological changes, such as dilation and tortuosity of the retinal microvasculature in macaques at day 21. OCT and OCTA results showed an increase in retinal and choroidal thickness and a significant decrease in vessel length density within 6×6 mm of the macula. Sustained simulated weightlessness (42 days) significantly exacerbated retina-related damage. This was evidenced by a significant decrease in the perfusion density of microcirculatory vessels, such as the macular 3×3 mm mesial vessels and the macular 6*6 mm central and medial vessels. The FAZ density in the macula 3×3 mm area began to increase. Retinal oxygen saturation testing showed a slight increase in arterial oxygen saturation. Simultaneous changes in visual electrophysiology occurred, including a significant decrease in a- and b-wave amplitudes on the dark-vision electroretinogram and a significant decrease in the amplitude of the bright-vision negative wave response. The peak timing of the flash visual evoked potential component P1 was significantly delayed compared to its baseline and time-matched control., Conclusions: Sustained simulated weightlessness (42 days) significantly exacerbated retina-related damage, with both reduced macular blood supply and increased FAZ density suggesting the development of retinal ischemic changes, which disrupt visual electrophysiology. Retinal damage in human astronauts under long-term outer space conditions may be prevented by intervening in ischemic changes in the retina during the early stages of weightlessness.