Objective:To compare the clinical manifestations of congenital cataracts across different age groups and investigate the clinical characteristics and risk factors associated with infantile congenital cataracts.Methods:A cross-sectional study was conducted.The medical records of 156 children aged under 6 years diagnosed with congenital cataracts at Peking University People's Hospital were collected.Participants were divided into two groups, the infantile group (107 cases) and the non-infantile group (49 cases) according to whether the first diagnosis was ≤12 months.Clinical presentations were compared between the two groups.Risk factors for infantile congenital cataracts was analyzed by multivariate logistic regression.This study adhered to the Declaration of Helsinki, and the study protocol was reviewed and approved by the Ethics Review Committee of Peking University People's Hospital (No.2023PHB150-001).Results:The incidence rate of both eyes in the infantile group was 80.37%(86/107), which was significantly higher than 48.98%(24/49) in the non-infantile group ( χ2=15.931, P<0.001).The proportion of chief complaint of leucocoria in the infantile group was 87.85%(94/107), which was significantly higher than 44.90%(22/49) in the non-infantile group ( χ2=32.521, P<0.001).There were significant differences in the proportion of gestational age, birth weight, and neonatal oxygen therapy between the two groups ( χ2=13.300, 8.363, 13.283; all P<0.05).Multivariate logistic regression analysis showed that preterm birth ( OR=2.901, P=0.026), low birth weight ( OR=3.316, P=0.047), history of oxygen inhalation ( OR=3.040, P=0.012), and a family history of cataracts ( OR=14.224, P=0.013) were the main risk factors for congenital cataracts in infancy.The age of first diagnosis in children diagnosed with congenital cataracts through hospital screening was younger than that through parent observation ( Z=1 416.00, P=0.045). Conclusions:Infantile congenital cataracts predominantly present in both eyes with leukocoria as main manifestation.Preterm birth, low birth weight, neonatal oxygen exposure, and family history of cataracts are risk factors for infantile congenital cataracts.Systematic hospital screening is essential for the early detection of congenital cataracts in infants.

Lens injury is an important etiological factor in the reduction of visual function following ocular trauma.Currently, there are no clear standards for the classification of lens injury, and comprehensive diagnostic tools are lacking.This deficiency leads to numerous controversies and challenges in critical areas, such as diagnosis and preoperative evalution, timing of surgery, surgical strategy, and assessment of postoperative prognosis.Tomographic imaging technology, such as computed tomography, magnetic resonance imaging, optical coherence tomography, has introduced a new dimension to the evaluation of lens injury, which is crucial for assessing the transparency, texture, location, morphology, and integrity of the lens, as well as the zonules and nearby intraocular structures.However, the use of tomographic imaging technology is somewhat limited due to the limitations of relying on a single method.With the ongoing advancement of imaging technologies and the rapid development of big data and artificial intelligence, tomographic imaging will become an increasingly essential tool in the future management of lens injury.Our expert group reviewed the epidemiological characteristics and classification of lens injury and the major challenges currently faced in the diagnosis and treatment of lens injury, and provided expert recommendations mainly focusing on the application, shortcomings and limitations of current tomographic imaging technology in the diagnosis and treatment of lens injury, and future development directions.

Objective:To investigate the prevalence and risk factors of cornea guttata in patients with age-related cataract.Methods:A cross-sectional study was conducted.A total of 1 472 patients aged 50-89 years with complete medical records, who were diagnosed with age-related cataract and to undergo surgery, were enrolled at Peking University People's Hospital from August 2018 to July 2019.The presence of guttata was determined according to the specular microscopy images and the overall prevalence of guttata was calculated, as well as the prevalence rates of different gender, eye, and age distribution.Patients were divided into a guttata group (96 cases 130 eyes) and a non-guttata group (1 376 cases 2 814 eyes), and the differences in general information between groups were compared.The corneal endothelial cell density (CD), coefficient of variation of cell size (CV), fraction of hexagonal cells (6A), axial length (AL), white to white (WTW), anterior chamber depth, and corneal vertex thickness were compared between the two groups, and only the right eye of the patient with both eyes affected was included for analysis.The risk factors of guttata were analyzed by multivariate logistic regression.Differences in influencing factors among different guttata grades were compared, and the differences in biometric parameters of each eye in both eyes of guttata patients were compared.This study adhered to the Declaration of Helsinki, and the study protocol was approved by the Ethics Committee of Peking University People's Hospital (No.2023PHB198-001).Results:Of the 1 472 patients, 96(6.52%) patients had cornea guttata.The prevalence rate of guttata in males was 4.04%, which was significantly lower than 8.20% in females ( χ2=10.058, P=0.002).The average age of patients in the guttata group was (71.19±8.57) years old, with 24 males and 72 females, including 62 patients with monocular guttata and 39 patients with isolated guttata.Multivariate logistic regression analysis showed that female (odds ratio [ OR]=2.124, 95% confidence interval [ CI]: 1.306-3.455), greater AL ( OR=1.201, 95% CI: 1.083-1.332), shallow anterior chamber depth ( OR=0.439, 95% CI: 0.252-0.766), and greater corneal vertex thickness ( OR=1.008, 95% CI: 1.001-1.015) were risk factors for guttata.There were statistically significant differences in the proportion of monocular guttata and biocular guttata among different grades groups, and between isolated guttata and non-isolated guttata ( χ2=25.492, 15.362; both P<0.05).Differences in CD and corneal vertex thickness among different grades groups were statistically significant ( F=3.264, 5.784; both P<0.05).The CD was significanty higher and the corneal vertex thickness was significantly thinner in the grade 1 than in the grade ≥3 (both P<0.017).There was no statistically significant difference in binocular CD, CV, 6A, AL, WTW, anterior chamber depth, and corneal vertex thickness between both eyes of monocular or binocular guttata patients (all P>0.05). Conclusions:The risk factors of guttata include female, long AL, shallow anterior chamber depth, and thick corneal vertex thickness.The guttata grade of monocular guttata and isolated guttata patients is lower.With the increase of grade, the corneal vertex thickness increases.There is no difference in ocular structure between both eyes of guttata patients.

Objective:To compare the clinical manifestations of congenital cataracts across different age groups and investigate the clinical characteristics and risk factors associated with infantile congenital cataracts.Methods:A cross-sectional study was conducted.The medical records of 156 children aged under 6 years diagnosed with congenital cataracts at Peking University People's Hospital were collected.Participants were divided into two groups, the infantile group (107 cases) and the non-infantile group (49 cases) according to whether the first diagnosis was ≤12 months.Clinical presentations were compared between the two groups.Risk factors for infantile congenital cataracts was analyzed by multivariate logistic regression.This study adhered to the Declaration of Helsinki, and the study protocol was reviewed and approved by the Ethics Review Committee of Peking University People's Hospital (No.2023PHB150-001).Results:The incidence rate of both eyes in the infantile group was 80.37%(86/107), which was significantly higher than 48.98%(24/49) in the non-infantile group ( χ2=15.931, P<0.001).The proportion of chief complaint of leucocoria in the infantile group was 87.85%(94/107), which was significantly higher than 44.90%(22/49) in the non-infantile group ( χ2=32.521, P<0.001).There were significant differences in the proportion of gestational age, birth weight, and neonatal oxygen therapy between the two groups ( χ2=13.300, 8.363, 13.283; all P<0.05).Multivariate logistic regression analysis showed that preterm birth ( OR=2.901, P=0.026), low birth weight ( OR=3.316, P=0.047), history of oxygen inhalation ( OR=3.040, P=0.012), and a family history of cataracts ( OR=14.224, P=0.013) were the main risk factors for congenital cataracts in infancy.The age of first diagnosis in children diagnosed with congenital cataracts through hospital screening was younger than that through parent observation ( Z=1 416.00, P=0.045). Conclusions:Infantile congenital cataracts predominantly present in both eyes with leukocoria as main manifestation.Preterm birth, low birth weight, neonatal oxygen exposure, and family history of cataracts are risk factors for infantile congenital cataracts.Systematic hospital screening is essential for the early detection of congenital cataracts in infants.

Lens injury is an important etiological factor in the reduction of visual function following ocular trauma.Currently, there are no clear standards for the classification of lens injury, and comprehensive diagnostic tools are lacking.This deficiency leads to numerous controversies and challenges in critical areas, such as diagnosis and preoperative evalution, timing of surgery, surgical strategy, and assessment of postoperative prognosis.Tomographic imaging technology, such as computed tomography, magnetic resonance imaging, optical coherence tomography, has introduced a new dimension to the evaluation of lens injury, which is crucial for assessing the transparency, texture, location, morphology, and integrity of the lens, as well as the zonules and nearby intraocular structures.However, the use of tomographic imaging technology is somewhat limited due to the limitations of relying on a single method.With the ongoing advancement of imaging technologies and the rapid development of big data and artificial intelligence, tomographic imaging will become an increasingly essential tool in the future management of lens injury.Our expert group reviewed the epidemiological characteristics and classification of lens injury and the major challenges currently faced in the diagnosis and treatment of lens injury, and provided expert recommendations mainly focusing on the application, shortcomings and limitations of current tomographic imaging technology in the diagnosis and treatment of lens injury, and future development directions.

Objective:To investigate the prevalence and risk factors of cornea guttata in patients with age-related cataract.Methods:A cross-sectional study was conducted.A total of 1 472 patients aged 50-89 years with complete medical records, who were diagnosed with age-related cataract and to undergo surgery, were enrolled at Peking University People's Hospital from August 2018 to July 2019.The presence of guttata was determined according to the specular microscopy images and the overall prevalence of guttata was calculated, as well as the prevalence rates of different gender, eye, and age distribution.Patients were divided into a guttata group (96 cases 130 eyes) and a non-guttata group (1 376 cases 2 814 eyes), and the differences in general information between groups were compared.The corneal endothelial cell density (CD), coefficient of variation of cell size (CV), fraction of hexagonal cells (6A), axial length (AL), white to white (WTW), anterior chamber depth, and corneal vertex thickness were compared between the two groups, and only the right eye of the patient with both eyes affected was included for analysis.The risk factors of guttata were analyzed by multivariate logistic regression.Differences in influencing factors among different guttata grades were compared, and the differences in biometric parameters of each eye in both eyes of guttata patients were compared.This study adhered to the Declaration of Helsinki, and the study protocol was approved by the Ethics Committee of Peking University People's Hospital (No.2023PHB198-001).Results:Of the 1 472 patients, 96(6.52%) patients had cornea guttata.The prevalence rate of guttata in males was 4.04%, which was significantly lower than 8.20% in females ( χ2=10.058, P=0.002).The average age of patients in the guttata group was (71.19±8.57) years old, with 24 males and 72 females, including 62 patients with monocular guttata and 39 patients with isolated guttata.Multivariate logistic regression analysis showed that female (odds ratio [ OR]=2.124, 95% confidence interval [ CI]: 1.306-3.455), greater AL ( OR=1.201, 95% CI: 1.083-1.332), shallow anterior chamber depth ( OR=0.439, 95% CI: 0.252-0.766), and greater corneal vertex thickness ( OR=1.008, 95% CI: 1.001-1.015) were risk factors for guttata.There were statistically significant differences in the proportion of monocular guttata and biocular guttata among different grades groups, and between isolated guttata and non-isolated guttata ( χ2=25.492, 15.362; both P<0.05).Differences in CD and corneal vertex thickness among different grades groups were statistically significant ( F=3.264, 5.784; both P<0.05).The CD was significanty higher and the corneal vertex thickness was significantly thinner in the grade 1 than in the grade ≥3 (both P<0.017).There was no statistically significant difference in binocular CD, CV, 6A, AL, WTW, anterior chamber depth, and corneal vertex thickness between both eyes of monocular or binocular guttata patients (all P>0.05). Conclusions:The risk factors of guttata include female, long AL, shallow anterior chamber depth, and thick corneal vertex thickness.The guttata grade of monocular guttata and isolated guttata patients is lower.With the increase of grade, the corneal vertex thickness increases.There is no difference in ocular structure between both eyes of guttata patients.

Despite the continuous improvement and development of modern cataract surgery technology, posterior capsule opacification (PCO) is still the common long-term complication causing secondary visual acuity decline after cataract surgery.Previous studies have shown that the occurrence of PCO is closely related to the proliferation, migration, epithelial-mesenchymal transition (EMT) and myofibroblast fibrosis of lens epithelial cells in the anterior capsule and lens equator.In terms of pathogenesis, recent research focuses on the role of cytokines, especially various growth factors.Vascular endothelial growth factor (VEGF) is a kind of growth factor that can promote vascular endothelial cell proliferation and migration, extracellular matrix degeneration and angiogenesis.In addition, there is increasing evidence showing that VEGF plays an important role in fibrosis, inflammation, neuroprotection and other aspects.In recent years, VEGF has been found to promote PCO formation directly or cooperatively with transforming growth factor-β2.Based on the function of VEGF and the relationship between VEGF and EMT, this paper mainly reviewed the advances in the role of VEGF in the eye and the pathogenesis of posterior capsule opacification.

Objective:To explore the application of artificial intelligence (AI) assistant system combined with case-based learning (CBL) in the teaching of strabismus specialty for ophthalmic residents.Methods:Forty ophthalmic residents who were trained in the Department of Ophthalmology of the People's Hospital of Peking University from January 2020 to December 2021 were divided into control group and experimental group, with 20 people in each group. The control group used the traditional teaching mode, and the experimental group used AI assistant system combined with CBL teaching. At the end of specialized training, the two groups were assessed for theoretical knowledge, clinical skills, clinical thinking and questionnaire survey, and the teaching effect was evaluated. SPSS 26.0 was used for Chi-square test, one-way ANOVA and independent-samples t-test. Results:The scores of theoretical knowledge [(34.10±1.33) points], clinical skills [(24.75±1.02) points] and clinical thinking [(24.80±0.77) points] in the experimental group were significantly higher than those in the control group [(33.15±1.35) points, t=2.24, P=0.031; (23.60±0.82) points, t=3.93, P<0.001; (24.20±0.83) points, t=2.37, P=0.023]. For the evaluation of teaching effect, the experimental group improved the learning interest ( t=11.47, P<0.001), clinical thinking ability ( t=9.36, P<0.001), knowledge and skill level ( t = 17.71, P < 0.001), knowledge sharing ( t=31.17, P< 0.001) and overall satisfaction ( t=10.60, P<0.001), and these 5 aspects were scored higher in experimental group compared with the control group. Conclusion:The teaching mode combining AI assistant system and CBL teaching can improve the independent diagnosis and treatment ability of ophthalmic residents for strabismus diseases, establish a correct clinical thinking path, and obtain a better teaching effect than the traditional teaching mode.

Any kind of surgery method has the risk of the corresponding surgical complications,so is eye surgery.Recent years,cataract surgery technology is being constantly progress and develop,but the complications related to these surgical techniques exist in clinic comprehensively.Recognizing the updated clinical problems associated with each different technique should be necessary and helpful to the available clinical application of new technique,which will enhance the good results of the development of cataract surgery and improve the visual quality of patients.Meanwhile,the experience of understanding and preventing the techinique-related-complications would promote the novel technology of cataract surgery and the innovation of the medical equipment.It is important for us to attach importance to the complications associated with the development of cataract surgery technique.

Background Bilateral congenital cataract is one of the vision-threating diseases during infant age.Intraocular lens (IOL) implantation is an ideal refraction correction method for children who have already received bilateral cataract extraction.However,the timing and effectiveness of secondary IOL implantation are still under debate.Objective This study was to analyze the visual changes and affecting factors before and after secondary IOL implantation and explore the operative timing.Methods The clinical data of 58 eyes of 29 patients who received bilateral cataract extraction-refractive correction and vision training-secondary IOL implantation in Peking University People's Hospital from January 2012 to December 2014 were retrospectively analyzed.All the patients received bilateral cataract extraction and posterior capsulotomy with anterior vitrectomy during their first year of life firstly,followed by the wearing of refractive spectacles or visual training,and secondary IOL implantation was simultaneously performed until ＞2 years old.Best corrected visual acurity (BCVA) (LogMAR) was examined at 1 week before and 3 months after secondary surgery under the mydriasis.Changes,distribution alternation of BCVA and the relationship of visual prognosis with preoperative visual acuity were evaluated.Results The average age at surgery of the patients was (3.26±2.07) months and that at secondary IOL implantation was (4.79± 1.38) years,with the operative interval of (4.28± 1.33) years.The BCVA before and after secondary IOL implantation was 0.790± 0.422 and 0.570±0.307 respectively,showing a significant difference between them (t =3.223,P＜0.001).The number of eyes with BCVA ≥ 0.5 after surgery was significantly more than that before surgery (x2=53.931,P＜0.001).A positive correlation in unilateral BCVA was seen between before and after secondary IOL implantation (R2 =0.232,F =17.037,P ＜ 0.001).Conclusions A systemic management of bilateral cataract extractionrefractive correction and vision training-secondary IOL implantation for congenital cataract is beneficial to BCVA improvement and amblyopia treatment,and it should be performed as early as possible on the premise of ensuring the safety of life.Secondary IOL implantation should be timely carried out for aphakic children with poor compliance and outcomes during vision training after congenital cataract extraction.