OBJECTIVE: Surgical and anesthetic technological advancement have made both cataract and noncataract anterior segment surgery significantly less invasive and time-intensive, facilitating the transition of some of these procedures from the operating room under monitored anesthesia care (MAC) to the office-based setting without MAC. This transition has been aided by the popularization of nonintravenous approaches to achieving patient sedation for these procedures. In this review, we discuss the literature surrounding traditional and nontraditional methods of achieving patient sedation for anterior segment surgery.
RESULTS: Our survey of the literature suggests that nonintravenous (IV) approaches to sedation for these procedures may be just as safe, effective, and satisfactory to patients as traditional IV approaches.
CONCLUSIONS: As anterior segment surgery becomes less invasive and less time-intensive, providers considering transitioning their cataract and anterior segment surgery out of the operating room and into the office-based setting without MAC anesthesia should consider the non-IV sedation options outlined in this review to achieve adequate patient sedation and comfort.

Toxic anterior segment syndrome (TASS) is an acute, sterile, postoperative inflammatory reaction of the anterior segment without vitreous involvement, following an uncomplicated and uneventful ocular surgery, having broad and multiple etiologies. The symptoms of decreased visual acuity and ocular discomfort generally occur within the first 12-48 h after intraocular surgery. The clinical signs include prominent limbus-to-limbus corneal edema, anterior chamber cells, aqueous flare, fibrinous inflammation, and/or keratic precipitates. There can be sight-threatening complications of TASS, such as permanent corneal decompensation, intractable glaucoma, and cystoid macular edema. The causes of TASS are emerging and being reported, so are the newer treatment options for managing the inflammation and its complications. Prevention guidelines for TASS are being updated, and a traceability system for surgical instruments and intraocular fluids used during the surgery is being perpetually developed. It is important to recognize TASS and start treatment on an immediate effect. Hereby, we review the literature on TASS, emphasizing its etiology, pathophysiology, management, prognosis, complications, and the importance of prevention as well as prompt recognition.

Primary angle closure glaucoma is a visually debilitating disease that is under-detected worldwide. Many of the challenges in managing primary angle closure disease (PACD) are related to the lack of convenient and precise tools for clinic-based disease assessment and monitoring. Artificial intelligence (AI)- assisted tools to detect and assess PACD have proliferated in recent years with encouraging results. Machine learning (ML) algorithms that utilize clinical data have been developed to categorize angle closure eyes by disease mechanism. Other ML algorithms that utilize image data have demonstrated good performance in detecting angle closure. Nonetheless, deep learning (DL) algorithms trained directly on image data generally outperformed traditional ML algorithms in detecting PACD, were able to accurately differentiate between angle status (open, narrow, closed), and automated the measurement of quantitative parameters. However, more work is required to expand the capabilities of these AI algorithms and for deployment into real-world practice settings. This includes the need for real-world evaluation, establishing the use case for different algorithms, and evaluating the feasibility of deployment while considering other clinical, economic, social, and policy-related factors.

BACKGROUND: To report a case of sutureless scleral-fixated hydrophilic intraocular lens (FIL SSF IOL, Soleko, Italy) opacification following pars plana vitrectomy surgery using sulfur hexafluoride (SF6) for traumatic lens luxation associated with retinal detachment.
METHODS: A 77-year-old woman was referred to our emergency department after blunt trauma in her right eye. At the ophthalmic evaluation, visual acuity was hand movement, biomicroscopy showed pseudoexfoliation syndrome and a traumatic lens luxation in the vitreous chamber. The patient underwent pars plana vitrectomy, subluxated cataract explantation, and FIL SSF IOL implant. During surgery, an inferior retinal detachment was encountered, requiring 20% SF6 gas tamponade. No adverse events were encountered. One month postoperatively, visual acuity (BCVA) improved to 0,3 logMAR. At the 3-month follow-up, the patient presented with BCVA of 0,5 logMAR, and biomicroscopy showed a minimal IOL opacification. Six months postoperatively, BCVA decreased to 1.0 logMAR, and diffuse, IOL opacification was noted at slit lamp examination. The patient refused any other surgical intervention for IOL exchange.
CONCLUSIONS: Although hydrophilic IOL opacification gas related is known, to the best of our knowledge, this is the first case reported in the literature of FIL SSF IOL opacification after pars plana vitrectomy with gas tamponade for retinal detachment.

暂无摘要。

To conduct a systemic review and meta-analysis on the normative range of ocular biometry in healthy children under seven years of age.
A literature search was performed using the PubMed (MEDLINE) database. The main outcomes were normative values of axial length (AL), central corneal thickness (CCT), cornea curvature (CC), anterior chamber depth (ACD), lens thickness (LT) and vitreous chamber depth (VCD). Pooled estimates were obtained with a random-effects meta-analysis. Multivariate meta-regressions ascertained the moderator-related trends.
We included 47 studies for a total of 33,559 subjects. The pooled ALs for 0.0-1.9 years, 2.0-3.9 years and 4.0-6.9 years were 18.33 mm (95% confidence interval [CI] 17.57-19.09), 21.71 mm (21.49-21.93) and 22.37 mm (22.29-22.45), respectively. Children aged 0.0-1.9 years had a greater CCT (576.70 μm, 567.20-586.21), steeper cornea (7.41 mm, 7.16-7.65) and shallower ACD (2.46 mm, 2.23-2.69). LT ranged from 3.65 to 3.74 mm for 0-6 years, and VCD increased from 11.94 mm at birth to 15.36 mm at 4.0-6.9 years. Differences in AL between East Asian and non-East Asian children were found below two years of age (17.30 mm vs. 18.40 mm, p = 0.008) and for CC at 4.0-6.9 years of age (7.82 mm vs. 7.79 mm, p = 0.004). In a multivariate meta-regression, AL, CC, ACD and VCD increased with age (p < 0.05 for all), while CCT decreased with age (p = 0.0007).
This study reports normative data for ocular biometry in children. Few differences were found with ethnicity in the ocular biometry of infants and pre-schoolers.

UNASSIGNED: Scleritis and episcleritis are an overlapping spectrum of diseases and accurate diagnosis is of utmost importance as the treatment and prognosis are vastly different. Predominantly a clinical diagnosis, the challenge lies in those cases with equivocal clinical features. Furthermore, clinical grading of scleritis is subjective and hence is neither very reliable nor reproducible. Existing modalities such as slit lamp examination and clinical photographs in scleritis describe macroanatomy but do not provide details on the microanatomy of the sclera. A recent adjusted algorithm for anterior segment optical coherence tomography (AS-OCT) imaging has improved the ability of this device to aid in the diagnosis of all the major forms of scleritis.
UNASSIGNED: To highlight the role of AS-OCT in delineating various anatomical forms of episcleritis and scleritis and explore this tool in monitoring disease course and response to therapy.
UNASSIGNED: A comprehensive literature search was carried out in various medical databases using keywords AS-OCT and scleritis; AS-OCT and episcleritis; anterior segment imaging in scleritis; scleritis and episcleritis; Recent advances in anterior segment imaging. Original articles and novel reports describing the potential role of AS-OCT in the diagnosis and management of scleritis and episcleritis were included.
UNASSIGNED: After a thorough assessment, it was clear that published literature lacks guidelines for uniform interpretation and also for classification and follow-up in scleritis. We describe a uniform protocol for AS-OCT image acquisition, interpretation of images and list the advantages and limitations.
UNASSIGNED: AS-OCT can be used to localize the level of scleral inflammation thus helping in the diagnosis of scleral inflammatory disease. It can be a valuable tool in studying progression.

UNASSIGNED: We conducted a systematic search of literature to understand the various methods of imaging of the ciliary body.
UNASSIGNED: PubMed, Science Direct, Cochrane Library and Google Scholar were searched comprehensively and systematically to find studies related to the various modalities of ciliary body imaging.
UNASSIGNED: The various ciliary body parameters that have been described are Ciliary body thickness, Ciliary body length, ciliary muscle thickness, ciliary process length, ciliary muscle length, ciliary muscle anterior length, trabecular ciliary process distance and Iris ciliary process distance. The various angles which have been measured, which mostly have a significance in Primary angle closure glaucoma (PACG) are Iris ciliary angle, Trabecular ciliary angle, scleral ciliary process angle. Various authors have defined them in various ways with subtle differences. Plateau iris and PACG mechanisms, not forgetting malignant glaucoma are better understood with imaging of the ciliary body using the ultrasound biomicroscopy (UBM). The anterior segment optical coherence tomography (ASOCT) imaging of the ciliary body has been described albeit with its own disadvantages. A few other fields dependant on the importance of ciliary body imaging are intravitreal injections, pars plana vitrectomy, measurements for implantable collamer lens (ICL) and of utmost importance, the differentiating features of ciliary body masses.
UNASSIGNED: The UBM is still preferred over the ASOCT for imaging of the ciliary body. A lot of lacunae of knowledge still exists and consensus has to be reached on defining all the parameters universally. Future studies will be able to shed more light on the role of the ciliary body in the many ocular disorders mentioned in this review.

Anterior segment optical coherence tomography (AS-OCT) constitutes an important imaging modality to examine the anterior eye, which is commonly used in research and clinical practice. Since its introduction, a range of image analysis methods have been developed to quantify these images using different analysis techniques for various applications. This systematic review aims to provide an in-depth summary and to classify image analysis techniques found in the literature applied to AS-OCT images.
Scopus and Engineering Village databases were searched to retrieve relevant studies up to and including January 2022. Customized search statements were used along with cross reference and hand search techniques to ensure a complete coverage. Performance metrics were extracted, analyzed, and compared (when possible).
Three main application categories were identified: glaucoma assessment, corneal segmentation, and anterior segment biometry. These three categories constitute 66% of the total studies reported in this review. Studies were also analyzed by year of publication, and since 2019 deep learning methods were favored over traditional programming or machine learning methodologies. Overall, the AS-OCT image analysis field is less developed compared to posterior segment OCT imaging.
This review presents the state of the art in the field of AS-OCT image analysis. It highlights the opportunities for future areas of research, such as the expansion of DL methods and the extension to specific clinical areas that have received limited attention including surgical monitoring, contact lenses, and specific clinical conditions such as keratoconus and corneal lesions.

BACKGROUND: Peters\' anomaly (PA) and Axenfeld-Rieger syndrome (ARS) are typical classifications of anterior segment dysgenesis (ASD) and ascribed to congenital eye diseases that encompass developmental defects in anterior segment structures. The aim of this study is to discuss the unusual association between PA and ARS and to determine the results of penetrating keratoplasty combined with extracapsular cataract extraction and anterior vitrectomy for this unusual ophthalmic phenotype.
METHODS: A 72-year-old female was referred to Changzhou No. 2 People\'s Hospital for a progressive decrease in visual acuity in both eyes in the past few decades.
METHODS: The patient was diagnosed with PA with cone-shaped polar cataracts in the left eye based on a series of ophthalmic examinations. ARS with retinal detachment was diagnosed in the right eye 2 years prior.
METHODS: Penetrating keratoplasty combined with extracapsular cataract extraction and anterior vitrectomy were performed to manage PA with cataracts in the left eye.
RESULTS: Her best corrected visual acuity did not improve significantly after the operation. Patients with ARS and PA should be treated cautiously because of fundus lesions.
CONCLUSIONS: This study revealed that cases with PA accompanied by iridocorneal adhesions, or other ocular anomalies, need to be treated cautiously for a very low success rate. It is of reference value for the evaluation of treatment prognosis for this joint occurrence of ophthalmic phenotypes.