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Diagnostics
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Advances in Diagnostics of the Cornea, Cataract and Refractive Surgery
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Advances in Diagnostics of the Cornea, Cataract and Refractive Surgery

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: 31 January 2025 | Viewed by 15072

Special Issue Editor

Prof. Dr. Sang Beom HAN

E-Mail Website
Guest Editor
Department of Ophthalmology, Kangwon National University School of Medicine, Kangwon National University Hospital, Chuncheon 24289, Korea
Interests: cornea; cataract; dry eye disease
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues, 

Rapid development of new diagnostic technology enabled more precise and reproducible assessment of changes in anterior segment structures, such as, cornea, conjunctiva, sclera, anterior chamber and lens. Application of these technology has become essential for better diagnosis of anterior segment disorders. Use of novel imaging devices also contributed to the improvement of outcomes of cornea, cataract and refractive surgery. Therefore, introduction of new methods and devices would provide improved treatment outcomes as well as enhanced diagnostic accuracy in anterior segment disorders. Development of more reliable diagnostic criteria for anterior segment diseases, e.g., dry eye disease, would be helpful for more accurate diagnosis, which may result in better monitoring and treatment of the diseases.

In this special issue, research or review papers on the diagnosis of anterior segment disorder would be welcome. Any papers on devices or methods for assessment or visualization of anterior segment disorders would also be welcome.

Prof. Dr. Sang Beom HAN
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • anterior segment disorder
  • cornea
  • cataract
  • anterior segment imaging
  • refractive surgery

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Published Papers (7 papers)

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13 pages, 6515 KiB  
Article
Histopathological Analysis of Pseudoexfoliation Material in Ocular Surgeries: Clinical Implications
by Laura Denisa Stejar, Anca-Maria Istrate-Ofițeru, Ioana Teodora Tofolean, Dana Preoteasa and Florian Baltă
Diagnostics 2024, 14(19), 2187; https://doi.org/10.3390/diagnostics14192187 - 30 Sep 2024
Viewed by 694
Abstract
Background: Pseudoexfoliation syndrome (PEX) is a common age-related ocular condition characterized by the accumulation of a fibrillar, pseudoexfoliative material on the anterior segment of the eye. This study aims to investigate the histopathological characteristics of pseudoexfoliative material within different ocular structures, including the [...] Read more.
Background: Pseudoexfoliation syndrome (PEX) is a common age-related ocular condition characterized by the accumulation of a fibrillar, pseudoexfoliative material on the anterior segment of the eye. This study aims to investigate the histopathological characteristics of pseudoexfoliative material within different ocular structures, including the eyelid, conjunctiva, and anterior lens capsule. Methods: A total of 32 anterior lens capsules, 3 eyelid fragments, and 12 conjunctival specimens were obtained from patients clinically diagnosed with PEX during ocular surgeries at the Onioptic Hospital of Ophthalmology. The tissue specimens were subsequently processed using the classical histological technique of paraffin embedding. This process enabled the production of serial sections with a thickness of 4 microns, facilitating the microscopic examination of fine details. The sections were stained with the hematoxylin-eosin (HE) method for the observation of microscopic structures. Results: This study’s findings reveal that PEX material, characterized by its fibrillar and amorphous components, is consistently present across multiple ocular structures, including the anterior lens capsule, eyelid, and conjunctiva. When stained with H&E, the PEX material typically appears as amorphous, eosinophilic deposits. Under higher magnification, these deposits exhibit a fibrillar structure, often appearing as irregular, granular, or filamentous aggregates. Conclusions: The deposit of fibrillar material in the eyelid and conjunctiva, though less commonly emphasized compared to other structures, is a significant finding that sheds light on the systemic nature of the syndrome. The consistent identification of fibrillar eosinophilic deposits across these structures highlights the systemic distribution of PEX material, reinforcing the notion that PEX syndrome is not confined to the anterior segment of the eye. Full article
(This article belongs to the Special Issue Advances in Diagnostics of the Cornea, Cataract and Refractive Surgery)
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13 pages, 1480 KiB  
Article
Impacts and Correlations on Corneal Biomechanics, Corneal Optical Density and Intraocular Pressure after Cataract Surgery
by Fang-Yang Lin, Ren-Wen Ho, Hun-Ju Yu, I-Hui Yang, Po-Chiung Fang and Ming-Tse Kuo
Diagnostics 2024, 14(14), 1557; https://doi.org/10.3390/diagnostics14141557 - 18 Jul 2024
Viewed by 766
Abstract
The study aimed to investigate the extended effects and interrelations of corneal biomechanics, corneal optical density (COD), corneal thickness (CT), and intraocular pressure (IOP) following cataract surgery. Sixteen eyes were analyzed prospectively. The Corneal Visualization Scheimpflug Technology (Corvis ST) device assessed corneal biomechanics, [...] Read more.
The study aimed to investigate the extended effects and interrelations of corneal biomechanics, corneal optical density (COD), corneal thickness (CT), and intraocular pressure (IOP) following cataract surgery. Sixteen eyes were analyzed prospectively. The Corneal Visualization Scheimpflug Technology (Corvis ST) device assessed corneal biomechanics, while the Pentacam AxL® (Pentacam) measured COD and CT. Postoperative data were collected around six months after surgery, with a subgroup analysis of data at nine months. The Pearson correlation was used to examine the relationship between surgical-induced changes in corneal biomechanics and COD. At six months, significant postoperative differences were observed in various biomechanical indices, including uncorrected IOP (IOPuct) and biomechanics-corrected IOP (bIOP). However, many indices lost statistical significance by the nine-month mark, suggesting the reversibility of postoperative corneal changes. Postoperative COD increased at the anterior layer of the 2−6 mm annulus and incision site. The changes in COD correlated with certain biomechanical indices, including maximal (Max) deformative amplitude (DA) and stiffness parameter (SP). In conclusion, despite significant immediate postoperative changes, corneal biomechanics, COD, and IOP experienced a gradual recovery process following cataract surgery. Clinicians should maintain vigilance for any unusual changes during the short-term observation period to detect abnormalities early. Full article
(This article belongs to the Special Issue Advances in Diagnostics of the Cornea, Cataract and Refractive Surgery)
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10 pages, 597 KiB  
Article
Clinical Outcomes of Cataract Surgery in Patients with Sjögren’s Syndrome
by Donghyeon Lee, Charm Kim, Kyeongjoo Lee and Jin Kwon Chung
Diagnostics 2023, 13(1), 57; https://doi.org/10.3390/diagnostics13010057 - 25 Dec 2022
Viewed by 3597
Abstract
This study compared the biometric accuracy and refractive outcomes, and ocular surface changes after cataract surgery in patients with Sjögren’s syndrome (SS, S group), non-SS dry eye patients (D group), and healthy controls (C group). The medical records of patients who underwent cataract [...] Read more.
This study compared the biometric accuracy and refractive outcomes, and ocular surface changes after cataract surgery in patients with Sjögren’s syndrome (SS, S group), non-SS dry eye patients (D group), and healthy controls (C group). The medical records of patients who underwent cataract surgery and met certain inclusion criteria were reviewed. In total, 167 eyes of 87 patients were enrolled. Refractive parameters were analyzed via optical biometry and combined ultrasound biometry and automated refractokeratometry. The mean absolute errors (MAEs), the uncorrected distance visual acuities (UDVAs), changes in the ocular staining score (OSS), and anterior chamber cell grades were compared for 12 months postoperatively. The S group evidenced more severe and persistent OSS exacerbation after cataract surgery; the OSS returned to baseline by 3 months postoperatively. The mean keratometric values showed a significant linear correlation. There was no significant intergroup difference in either the MAEs (p > 0.530) or anterior chamber inflammation (p > 0.436). The postoperative UDVA of the S group was poorer than that of the C group from 3 months postoperatively (p < 0.047) but not different from that of the D group (p > 0.311). With preoperative ocular surface optimization and optimal postoperative treatment of superficial keratitis, the refractive outcomes of SS patients were comparable to those of other groups and the postoperative UDVA was not inferior to that of non-SS dry eye patients. Full article
(This article belongs to the Special Issue Advances in Diagnostics of the Cornea, Cataract and Refractive Surgery)
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17 pages, 5386 KiB  
Article
The Role of Widefield and Ultra Widefield Optical Coherence Tomography in the Diagnosis and Management of Vitreoretinal Diseases
by Matteo Ripa, Lorenzo Motta, Teresa Florit, Jean-Yves Sahyoun, Veronika Matello and Barbara Parolini
Diagnostics 2022, 12(9), 2247; https://doi.org/10.3390/diagnostics12092247 - 17 Sep 2022
Cited by 12 | Viewed by 3541
Abstract
Background: This study reports on the advantages of wide-field (WF)- and ultra-widefield (UWF)- optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) in managing different vitreoretinal diseases in a real-life setting using the new WF—Swept Source (SS)—OCT Xephilio S1 (Canon, Tokyo, Japan). [...] Read more.
Background: This study reports on the advantages of wide-field (WF)- and ultra-widefield (UWF)- optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) in managing different vitreoretinal diseases in a real-life setting using the new WF—Swept Source (SS)—OCT Xephilio S1 (Canon, Tokyo, Japan). Methods: We conducted an observational retrospective case series study involving 1472 eyes that underwent retinal scans with Canon Xephilio® OCT-S1 between 1 March 2021 and 1 December 2021 at Eyecare Clinic (Brescia, Italy). All patients underwent routine ophthalmologic examinations along with WF and UWF color fundus retinography with Clarus 500™ (Carl Zeiss Meditec, Inc., Dublin, CA, USA) and Xephilio® OCT-S1. WF SS-OCT, UWF-OCT, WF-OCTA, and UWF-OCTA were taken by using Xephilio® OCT-S1. Results: We analyzed 122 peripheral retinal lesions, 144 retinal detachment, 329 high myopic eyes, 37 pediatric cases, 60 vascular retinopathies, 15 choroidal lesions, and 90 eyes as follow-up post vitreoretinal surgery. The OCT-S1 was the only reliable and diagnostic exam for peripheral lesions, pediatric and high myopic cases, and significantly influenced the management in 10% of cases and the postoperative follow-up. Conclusions: WF and UWF OCT and OCTA imaging may help in the management of several vitreoretinal diseases, becoming an indispensable tool for the high-quality management of patients. Full article
(This article belongs to the Special Issue Advances in Diagnostics of the Cornea, Cataract and Refractive Surgery)
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9 pages, 1426 KiB  
Article
Characterization of Dysfunctional Lens Index and Opacity Grade in a Healthy Population
by Elena Martínez-Plaza, Pedro Ruiz-Fortes, Roberto Soto-Negro, Carlos J. Hernández-Rodríguez, Ainhoa Molina-Martín, Alfonso Arias-Puente and David P. Piñero
Diagnostics 2022, 12(5), 1167; https://doi.org/10.3390/diagnostics12051167 - 7 May 2022
Cited by 3 | Viewed by 1885
Abstract
This study enrolled 61 volunteers (102 eyes) classified into subjects < 50 years (group 1) and subjects ≥ 50 years (group 2). Dysfunctional Lens Index (DLI); opacity grade; pupil diameter; and corneal, internal, and ocular higher order aberrations (HOAs) were measured with the [...] Read more.
This study enrolled 61 volunteers (102 eyes) classified into subjects < 50 years (group 1) and subjects ≥ 50 years (group 2). Dysfunctional Lens Index (DLI); opacity grade; pupil diameter; and corneal, internal, and ocular higher order aberrations (HOAs) were measured with the i-Trace system (Tracey Technologies). Mean DLI was 8.89 ± 2.00 and 6.71 ± 2.97 in groups 1 and 2, respectively, being significantly higher in group 1 in all and right eyes (both p < 0.001). DLI correlated significantly with age (Rho = −0.41, p < 0.001) and pupil diameter (Rho = 0.20, p = 0.043) for all eyes, and numerous internal and ocular root-mean square HOAs for right, left, and all eyes (Rho ≤ −0.25, p ≤ 0.001). Mean opacity grade was 1.21 ± 0.63 and 1.48 ± 1.15 in groups 1 and 2, respectively, with no significant differences between groups (p ≥ 0.29). Opacity grade significantly correlated with pupil diameter for right and all eyes (Rho ≤ 0.33, p ≤ 0.013), and with some ocular root-mean square HOAs for right and all eyes (Rho ≥ 0.23, p ≤ 0.020). DLI correlates with age and might be used complementary to other diagnostic measurements for assessing the dysfunctional lens syndrome. Both DLI and opacity grade maintain a relationship with pupil diameter and internal and ocular HOAs, supporting that the algorithms used by the device may be based, in part, on these parameters. Full article
(This article belongs to the Special Issue Advances in Diagnostics of the Cornea, Cataract and Refractive Surgery)
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7 pages, 212 KiB  
Brief Report
Modified “C” Haptic Intraocular Lens Orientation and Negative Dysphotopsia
by Valeria Cuevas-Lozano, Rosario Gulias-Cañizo and Oscar Guerrero-Berger
Diagnostics 2024, 14(12), 1288; https://doi.org/10.3390/diagnostics14121288 - 18 Jun 2024
Viewed by 700
Abstract
Phacoemulsification is the standard of care in cataract surgery in the developed world, with patients having high expectations regarding visual results. Postoperative dissatisfaction due to negative dysphotopsia (ND) ranges from rare to very frequent; its etiology is unclear, and it affects postoperative satisfaction. [...] Read more.
Phacoemulsification is the standard of care in cataract surgery in the developed world, with patients having high expectations regarding visual results. Postoperative dissatisfaction due to negative dysphotopsia (ND) ranges from rare to very frequent; its etiology is unclear, and it affects postoperative satisfaction. Since one of the most frequently used strategies to avoid ND is related to intraocular lens (IOL) haptic orientation, we conducted a prospective interventional study that enrolled 197 patients who underwent standard phacoemulsification. All patients had a one-piece hydrophobic acrylic IOL implanted; in one group, the haptics were placed in any meridional axis except inferotemporal (IT) meridians, and in the other group, the IOL was implanted with the haptics in an IT position. Our results showed no statistically significant differences between groups when analyzing the correlation between the position of IOL haptics and the presence of ND in week one and month one. Also, pupillary diameter showed no statistically significant differences between patients with or without ND. Despite some studies claiming that haptic orientation prevents ND, we found that haptic orientation does not correlate with ND incidence and that ND decreases from day 1 to month 1. Our results support previous findings on the decrease in ND over time and that haptic orientation should not be considered an intraoperative strategy to avoid this unwanted phenomenon. Full article
(This article belongs to the Special Issue Advances in Diagnostics of the Cornea, Cataract and Refractive Surgery)
15 pages, 1647 KiB  
Systematic Review
Three-Dimensional Heads-Up vs. Standard Operating Microscope for Cataract Surgery: A Systematic Review and Meta-Analysis
by Matteo Ripa, Nikolaos Kopsacheilis, Kanellina Kanellopoulou, Mikes Nomikarios and Lorenzo Motta
Diagnostics 2022, 12(9), 2100; https://doi.org/10.3390/diagnostics12092100 - 30 Aug 2022
Cited by 7 | Viewed by 2552
Abstract
Background: The surgical time duration, the postoperative best-corrected visual acuity (BCVA), and the incidence rate of intraoperative complications, alongside the vision and posturing parameters, were estimated by systematic review and meta-analysis to compare the three-dimensional (3D) heads-up visualization system (HUVS) and standard operating [...] Read more.
Background: The surgical time duration, the postoperative best-corrected visual acuity (BCVA), and the incidence rate of intraoperative complications, alongside the vision and posturing parameters, were estimated by systematic review and meta-analysis to compare the three-dimensional (3D) heads-up visualization system (HUVS) and standard operating microscope (SOM) in cataract surgery. Methods: A literature search was conducted using PubMed, Embase, and Scopus on 26 June 2022. The weighted mean difference (WMD) was used to present postoperative BCVA and the mean surgical time duration, whereas the risk ratio (RR) was used to present the incidence rate of intraoperative complications. Publication bias was evaluated with Egger’s test. The Cochrane Collaboration’s Tool for randomized clinical trials, the methodological index for non-randomized, and the Newcastle-Ottawa Scale were used to assess the risk of bias. The research has been registered with the PROSPERO database (identifier, CRD42022339186). Results: In the meta-analysis of five studies with 1021 participants, the pooled weighted mean difference (WMD) of the postoperative BCVA showed no significant difference between patients who underwent HUVS versus SOM cataract surgery (WMD = −0.01, 95% confidence interval (CI): −0.01 −0.02). In the meta-analysis of nine studies with 5505 participants, the pooled WMD of mean surgical time duration revealed no significant difference between patients who underwent HUVS versus SOM cataract surgery (WMD = 0.17, 95% CI: −0.43–0.76). In the meta-analysis of nine studies with 8609 participants, the pooled risk RR associated with intraoperative complications was 1.00 (95% CI, 1.00–1.01). Conclusions: 3D HUVS and SOM provide comparable surgical time duration, postoperative BCVA, and incidence rate of intraoperative complications. Full article
(This article belongs to the Special Issue Advances in Diagnostics of the Cornea, Cataract and Refractive Surgery)
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