OBJECTIVE: This systematic review and meta-analysis aims to assess the refractive outcomes of the Yamane technique for intrascleral fixation of intraocular lenses (SF-IOL) and compare the predictive ability of the various intraocular lens power calculation formulae commonly used in conjunction with the technique.
METHODS: A literature search was conducted in the Medline, Scopus, and Cochrane Library databases for articles published from January 2014 to May 2023. Studies that met the predetermined inclusion criteria were included and subjected to analysis. The primary outcome evaluated was the refractive predictive error, defined as the difference between predicted refraction and post-operative manifest refraction.
RESULTS: Eleven studies met the inclusion criteria, with a cumulative sample size of 615 patients (mean age: 66.6 years). Various IOL formulae were used, with SRK/T being the most frequently adopted formula. The overall mean refractive predictive error for all formulae combined was -0.02 D, which was not statistically significant (p = 0.99). Subgroup analysis for individual formulae also showed no significant difference from predicted error for any formula (p > 0.05).
CONCLUSIONS: The Yamane technique for SF-IOL shows promising refractive outcomes, and the choice of IOL power calculation formula should be tailored based on patient characteristics and surgeon preference. No formula demonstrated superior predictive ability over others. Further research is needed to develop formulae specifically for eyes with secondary aphakia and poor capsular support.

Individuals with Down syndrome are known to have a greater prevalence of ocular conditions such as strabismus, nystagmus, elevated refractive error, poor accommodative function, elevated higher-order optical aberrations and corneal abnormalities. Related to these conditions, individuals with Down syndrome commonly have reduced best-corrected visual acuity at both far and near viewing distances across their lifespan. This review summarises the various optical sources of visual acuity reduction in this population and describes clinical trials that have evaluated alternative spectacle prescribing strategies to minimise these optical deficits. Although refractive corrections may still have limitations in their ability to normalise visual acuity for individuals with Down syndrome, the current literature provides evidence for eye care practitioners to consider in their prescribing practices for this population to maximise visual acuity. These considerations include accounting for the presence of elevated higher-order aberrations when determining refractive corrections and considering bifocal lens prescriptions, even for young children with Down syndrome.

OBJECTIVE: After infantile cataract surgery, axial elongation, induces a myopic shift that cannot be fully compensated by corneal flattening and the rate is unpredictable owing to the non-linear growth of the eye. The current prospective study assesses the myopic shift and visual outcomes in children undergoing cataract surgery in infancy over a follow-up period of 5 years.
METHODS: A prospective study conducted at a tertiary eye care center to evaluate the five-year myopic shift, refractive and visual outcomes in infants, who underwent surgery for congenital cataract in infancy. The visual acuity, myopic shift and biometric changes are compared between the aphakia and pseudophakia group.
RESULTS: The mean best-corrected visual acuity (BCVA) recorded in logMAR at 5 years for aphakia group was 0.92±0.44 and for pseudophakia group was 0.66±0.42. (pvalue: 0.002102). The myopic shift was noted to be -5.9+/-5.16 in the aphakia group whereas it was -9.01+/- 3.11 in the pseudophakia group (P value= 0.002101) at 5 years after surgery for infantile cataract.
CONCLUSIONS: IOL implantation in eyes of infants undergoing cataract surgery is feasible in eyes that strictly satisfy the pre-operative inclusion criteria and the visual outcomes in these eyes are better compared to aphakia group at 5 years follow up. Eyes with primary IOL implantation had a higher myopic shift compared to ones without primary IOL implantation. Eyes undergoing primary IOL implantation, need higher under correction compared to the current available formulae.

Cataracts are characterized by the crystalline lens of the eye becoming cloudy, and dry eye disease (DED) is a multifactorial disease in which the homeostasis of the tear film is lost. As the prevalence of both diseases increases with age, there is a high prevalence of DED among patients who are candidates for cataract surgery. In recent years, cataract surgery has evolved from vision restoration surgery to refractive surgery. To achieve good surgical outcomes, it is necessary to minimize postoperative refractive error in intraocular lens (IOL) power calculation, which requires accurate preoperative keratometry measurements. A stable tear film is important for the accuracy and reproducibility of keratometry measurements, and DED may have a deleterious effect. In this study, original articles that focused primarily on findings related to this topic were evaluated. A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Although appropriate DED diagnoses were not presented in the articles evaluated in this review, it was confirmed that the clinical signs of DED, particularly the shortening of the tear film break-up time (TBUT), negatively impact IOL power calculations. Improvement in these clinical signs might mitigate the negative effects on these calculations.

UNASSIGNED: This meta-analysis was conducted to collect all available data and estimate the relationship between refractive error and the risk of diabetic retinopathy (DR) in patients with diabetes, and to assess whether vision-threatening DR (VTDR) is associated with refractive error.
UNASSIGNED: We systematically searched several literature databases including PubMed, Embase, Cochrane Library, Web of Science, CNKI, CBM, Wan Fang Data, and VIP databases. Pooled odds ratios (OR) and 95% confidence intervals (CI) were calculated using fixed or random effects models. Four models were developed to assess the relationship between refractive error and the risk and DR, VTDR: hyperopia and DR, VTDR; myopia and DR, VTDR; spherical equivalent (SE per D increase) and DR, VTDR; and axial length (AL per mm increase) and DR, VTDR. The included literature was meta-analyzed using Stata 12.0 software, and sensitivity analysis was performed. Publication bias in the literature was evaluated using a funnel plot, Begg\'s test, and Egger\'s test.
UNASSIGNED: A systematic search identified 3,198 articles, of which 21 (4 cohorts, 17 cross-sectional studies) were included in the meta-analysis. Meta-analysis showed that hyperopia was associated with an increased risk of VTDR (OR: 1.23; 95% CI: 1.08-1.39; P = 0.001), but not with DR (OR: 1.05; 95% CI: 0.94-1.17; P = 0.374). Myopia was associated with a reduced risk of DR (OR: 0.74; 95% CI: 0.61-0.90; P = 0.003), but not with VTDR (OR: 1.08; 95% CI: 0.85-1.38; P = 0.519). Every 1 diopter increase in spherical equivalent, there was a 1.08 increase in the odds ratio of DR (OR: 1.08; 95% CI: 1.05-1.10; P<0.001), but not with VTDR (OR: 1.05; 95% CI: 1.00-1.10; P = 0.06). AL per mm increase was significantly associated with a decreased risk of developing DR (OR: 0.77; 95% CI: 0.71-0.84; P<0.001) and VTDR (OR: 0.63; 95% CI: 0.56-0.72; P<0.001). Analysis of sensitivity confirmed the reliability of the study\'s findings.
UNASSIGNED: This meta-analysis demonstrates hyperopia was associated with an increased risk of VTDR in diabetes patients. Myopia was associated with a reduced risk of DR. AL is an important influencing factor of refractive error. Every 1 mm increase in AL reduces the risk of DR by 23% and the risk of VTDR by 37%.
UNASSIGNED: identifier: CRD42023413420.

UNASSIGNED: The recent increase in myopia is a major public health concern worldwide, including in the Eastern Mediterranean Region (EMR).
UNASSIGNED: To provide data on the prevalence of myopia among school-age children in the EMR.
UNASSIGNED: This study was conducted using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) protocol. We searched the Web of Sciences, Scopus, Index Medicus for the Eastern Mediterranean Region, ProQuest, PubMed, and Medline for studies on the prevalence of myopia in the EMR published from January 2000 to May 2022. The data were analysed using MedCalc version 19.6.1 and myopia was defined as refractive error ≥ 0.50 D. The overall pooled prevalence of myopia was estimated using a random-effects model and its associated 95% confidence intervals.
UNASSIGNED: The meta-analysis included 27 quality-assessed studies from 13 countries among 51 111 school-age children. The overall pooled prevalence of childhood myopia from 2000 to 2022 was 5.23%, which was significantly higher among females than males (4.90% vs 3.94%). The prevalence of myopia was significantly higher among children aged 11-17 years than among those aged 5-10 years (7.50% vs 3.90%). There was a higher prevalence of myopia with cycloplegic refraction than noncycloplegic refraction (5.95% vs 3.73%). There was highly significant heterogeneity between the studies.
UNASSIGNED: Prevalence of myopia among school-age children in the EMR was high, particularly among older children, and it was more common among females. Early intervention to slow myopia progression is essential in the EMR to protect children from irreversible vision loss.
استعراض منهجي وتحليل تلوي لانتشار قصر النظر بين الأطفال في سن المدرسة في إقليم شرق المتوسط.
سيف الرشيد، وليد الغامدي.
UNASSIGNED: تمثِّل الزيادة الأخيرة في الإصابة بقصر النظر شاغلًًا رئيسيًّا من شواغل الصحة العامة في جميع أنحاء العالم، وخاصة إقليم شرق المتوسط.
UNASSIGNED: هدفت هذه الدراسة الى تقديم بيانات عن انتشار قصر النظر بين الأطفال في سن المدرسة في إقليم شرق المتوسط.
UNASSIGNED: أُجريت الدراسة باستخدام بروتوكول بنود التبليغ المفضَّلة للاستعراضات المنهجية والتحليلات التلوية (PRISMA). وبحثنا في \" ويب العلوم\" و\"سكوبوس\" و\"الفهرس الطبي لإقليم شرق المتوسط\" و\"برو-كويست\" و\"بب ميد\"، و\"نظام استرجاع المعلومات البيليوجرافية الطبية والبيولوجية (قاعدة بيانات مدلاين)\" عن الدراسات المتعلقة بانتشار قصر النظر في إقليم شرق المتوسط التي نُشرت في الفترة من يناير / كانون الثاني 2000 إلى مايو / أيار 2022. وحُللت البيانات بالإصدار 19.6.1 من برنامج Med Calc، وعُرِّف قِصََر النظر بأنه خطأ انكساري ≥ 0.50 ديوبتر. وقُدِّر معدل الانتشار الإجمالي المجمَّع لقصر النظر باستخدام نموذج التأثيرات العشوائية، وما يرتبط به من فواصل ثقة قدرها 95٪.
UNASSIGNED: شمل التحليل التلوي 27 دراسة مُقيّمة الجودة من 13 بلدًا شملت 51111 طفلًًا في سن الدراسة. وبلغ معدل الانتشار الإجمالي المجمّع لقِصََر النظر بين الأطفال في الفترة من عام 2000 إلى عام 2022 نسبة 5.23٪ ، وكان أعلى كثيرًا بين الإناث منها بين الذكور (4.90٪ مقابل 3.94٪). وتبين أن معدل انتشار قصر النظر أعلى كثيرًا بين الأطفال الذين تتراوح أعمارهم بين 11 و17 سنة منه بين أولئك الذين تتراوح أعمارهم بين 5 و10 سنوات (7.50٪ مقابل 3.90٪). وتبيََّّن أيضًا أن معدل انتشار قِصََر النظر المصحوب بالانكسار تحت تأثير موسع الحدقة أعلى من معدل الانكسار دون توسيع الحدقة (5.95٪ مقابل 3.73٪). وتبين وجود تباين كبير بين الدراسات.
UNASSIGNED: إن معدل انتشار قصر النظر بين الأطفال في سن المدرسة في إقليم شرق المتوسط مرتفع، لا سيَّما بين الأطفال الأكبر سِنًّا، وهو أكثر شيوعًا بين الإناث. لذا، فإن التدخل المبكر لإبطاء تطور قصر النظر أمرٌ ضروري في الإقليم لحماية الأطفال من فقدان البصر الذي لا رجعة فيه.
Analyse systématique et méta-analyse de la prévalence de la myopie chez les enfants d\'âge scolaire dans la Région de la Méditerranée orientale.
UNASSIGNED: L\'augmentation récente des cas de myopie est un problème majeur de santé publique dans le monde entier, y compris dans la Région de la Méditerranée orientale.
UNASSIGNED: Fournir des données sur la prévalence de la myopie chez les enfants d\'âge scolaire dans la Rég ion de la Méditerranée orientale.
UNASSIGNED: La présente étude a été menée selon le protocole PRISMA (lignes directrices pour la rédaction d\'analyses et de méta-analyses systématiques). Nous avons effectué des recherches dans Web of Sciences, Scopus, Index Medicus pour la Région de la Méditerranée orientale, ProQuest, PubMed et Medline pour les études sur la prévalence de la myopie dans la Région qui ont été publiées entre janvier 2000 et mai 2022. Les données ont été analysées au moyen de la version 19.6.1 de MedCalc et la myopie a été définie comme un défaut de réfraction supérieur ou égal à 0,50 D. La prévalence globale groupée de la myopie a été estimée à l\'aide d\'un modèle à effets aléatoires et des intervalles de confiance à 95 % qui y sont associés.
UNASSIGNED: La méta-analyse a porté sur 27 études, dont la qualité a été évaluée, réalisées dans 13 pays auprès de 51 111 enfants d\'âge scolaire. Entre 2000 et 2022, la prévalence globale groupée de la myopie chez l\'enfant était de 5,23 %, ce qui était significativement plus élevé chez les filles que chez les garçons (4,90 % contre 3,94 %). Cette prévalence était significativement plus élevée chez les enfants âgés de 11 à 17 ans que chez ceux âgés de 5 à 10 ans (7,50 % contre 3,90 %). De plus, elle était plus élevée avec la réfraction cycloplégique qu\'avec la réfraction non cycloplégique (5,95 % contre 3,73 %). L\'hétérogénéité entre les études était hautement significative.
UNASSIGNED: La prévalence de la myopie chez les enfants d\'âge scolaire dans la Région de la Méditerranée orientale était élevée, en particulier chez les enfants plus âgés, et elle était d\'autant plus fréquente chez les filles. Une intervention précoce visant à ralentir la progression de la myopie est essentielle dans la Régio n pour protéger les enfants contre une perte de vision irréversible.

A significant contributor to blindness and visual impairment globally is uncorrected refractive error. To plan effective interventions, eye care professionals must promptly identify people at a high risk of acquiring myopia, and monitor disease progress. Artificial intelligence (AI) and machine learning (ML) have enormous potential to improve diagnosis and treatment. This systematic review explores the current state of ML and AI applications in the diagnoses and treatment of refractory errors in optometry. A systematic review and meta-analysis of studies evaluating the diagnostic performance of AI-based tools in PubMed was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. To find relevant studies on the use of ML or AI in the diagnosis or treatment of refractive errors in optometry, a thorough search was conducted in various electronic databases such as PubMed, Google Scholar, and Web of Science. The search was limited to studies published between January 2015 and December 2022. The search terms used were \"refractive errors,\" \"myopia,\" \"optometry,\" \"machine learning,\" \"ophthalmology,\" and \"artificial intelligence.\" A total of nine studies met the inclusion criteria and were included in the final analysis. ML is increasingly being utilized for automating clinical data processing as AI technology progresses, making the formerly labor-intensive work possible. AI models that primarily use a neural network demonstrated exceptional efficiency and performance in the analysis of vast medical data, rivaling board-certified, healthcare professionals. Several studies showed that ML models could support diagnosis and clinical decision-making. Moreover, an ML algorithm predicted future refraction values in patients with myopia. AI and ML models have great potential to improve the diagnosis and treatment of refractive errors in optometry.

This review article explores the relationship between hyperglycemia during pregnancy and the visual development of offspring, specifically focusing on refractive error. The authors conducted a comprehensive search for relevant articles in various databases and assessed the methodological quality of the included studies. The findings consistently indicate that hyperglycemia during pregnancy can have a detrimental impact on the structural and functional aspects of visual development in offspring. The intrauterine hyperglycemic environment appears to negatively affect the retina and lens, leading to refractive errors. In conclusion, there is likely an association between hyperglycemia during pregnancy and the development of refractive errors in offspring.

In phakic patients Descemet stripping automated endothelial keratoplasty (DSAEK) or Descemet membrane endothelial keratoplasty (DMEK) are frequently combined with phacoemulsification and intraocular lens (IOL) implantation (triple procedure). This surgery might cause a refractive shift difficult to predict. Early DMEK and DSAEK results have shown a tendency toward a hyperopic shift. Myopic postoperative refraction is typically intended to correct this postoperative refractive defect and to bring all eyes as close to emmetropia as possible. We sought to understand the mechanism underlying the hyperopization and to identify predictive factors for poorer refractive outcomes, the most suitable target refraction and IOL calculation methods in patients undergoing combined cataract extraction and lamellar endothelial corneal transplantation (DSAEK or DMEK) for endothelial dysfunctions. Of the 407 articles analyzed, only 18 were included in the analysis. A myopic target between -0.50 D and -0.75 was the most common (up to -1.50 for DSAEK triple procedures), even though no optimum target was found. Hyperopic surprises appeared more frequently in corneas that were flatter in the center than in the periphery (oblate posterior profile). Among the numerous IOL calculation formulas, there was no apparent preference.

OBJECTIVE: To report the visual and refractive characteristics and the prevalence of amblyopia in patients with different types of Duane\'s Retraction Syndrome (DRS).
METHODS: This retrospective study was performed on hospital records of 582 DRS patients at Farabi Hospital, Iran, from 2012 to March 2022.
RESULTS: The mean age of patients was 19.4 ± 11.9 (range, 3-70) years [335 (57.6 %) females and 247 (42.4 %) males (P < .001)]. DRS type I, II, III, and IV were presented in 347 (59.6 %), 148 (25.4 %), 82 (14.1 %), and 5 (0.9 %) patients, respectively. There were 530 (91.1 %) patients with unilateral and 52 (8.9 %) with bilateral involvement. In the unilateral patients, the DRS eyes\' corrected distance visual acuity (CDVA) and astigmatism were significantly worse than the Non-DRS Eyes (P < .001). The mean amount of all refractive and visual parameters in bilateral patients\' right or left eyes was significantly lower than in unilateral patients\' non-DRS eyes (all P < .05). Anisometropia was observed in 75(12.9 %) of the patients. Amblyopia was observed in 18.5 % (98 patients) and 36.5 % (19 patients) of unilateral and bilateral DRS patients, respectively (P < .001). In unilateral patients, amblyopia was found in 57 (16.4 %) patients with Type I, 22 (14.9 %) patients with Type II, 16 (19.5 %) patients with Type III, and 3 (60 %) patients with Type IV. Forty-four (37.6 %) of patients with amblyopia had anisometropia.
CONCLUSIONS: This large-scale study indicates that DRS types differ in terms of refractive error, visual acuity, and the prevalence of amblyopia and anisometropia. Clinicians should be aware of the clinical features associated with different types of DRS.