Volume 61 · Issue 06 · 2025

2025 coincides with the 110th anniversary of the founding of the Chinese Medical Association, and the series of magazines of the Chinese Medical Association set up a column "110th Anniversary of the Founding of the Chinese Medical Association" for this purpose. As one of the series of magazines, Chinese Journal of Ophthalmology has launched three column drafts. Written by editor-in-chief Yao Ke, "One Hundred Ten Years of Medical Road Fenghua Ophthalmology Career Goes Forward with Light" expounds the outstanding contributions made by Ophthalmology Branch of Chinese Medical Association and Chinese Journal of Ophthalmology in discipline construction, academic leadership, talent training, health and benefit the people, and shows the development and progress of China's ophthalmology in different historical stages. In the article "Passing down the fire from generation to generation for a hundred years, deeply cultivating the corneal road: looking at the leadership and inheritance of the Ophthalmology Branch of Chinese Medical Association from the perspective of personal growth", Academician Xie Lixin described the key role played by the Ophthalmology Branch of Chinese Medical Association in promoting academic exchanges, formulating medical standards, carrying out medical education and talent training, and the achievements made by the keratology group in discipline construction and academic norm system construction. Academician Fan Xianqun, "Forty Years of Initial Heart and Mission, Start a New Journey", reviews his own path of exploration in the field of ophthalmology, and relies on the platform of Chinese Medical Association in the construction of ophthalmoplastic orbital diseases, scientific and technological innovation, talent training, international cooperation, etc., and depicts the picture of the rapid development of ophthalmology in China. These manuscripts jointly outline the continuous progress of China's ophthalmology industry under the guidance of the Chinese Medical Association, and highlight the brilliant achievements and future development potential in the field of ophthalmology.

This year, the Chinese Medical Association celebrated its 110th anniversary, which is not only an important milestone in the development of the society, but also a vivid witness of the vigorous development of China's medical and health undertakings. The Chinese Medical Association is the oldest and largest medical academic group in China, and it is an important social force in developing Chinese medical science, technology and health undertakings. Ophthalmology Branch of Chinese Medical Association (hereinafter referred to as "Ophthalmology Branch") and Chinese Journal of Ophthalmology have always kept pace with the times, shouldered the mission, pioneered and enterprised, and written a brilliant chapter in discipline construction, academic leadership, talent training, health and benefit the people, and made outstanding contributions to China's health cause.

In 2025, the Chinese Medical Association will celebrate its 110th anniversary. After a hundred years of hard work, the Chinese Medical Association has become the most influential academic group in China's medical field, the core platform to promote the leap-forward development of China's medical science, technology and health undertakings, and the home of medical science and technology workers in China. Looking back, since I joined the Ophthalmology Branch of Chinese Medical Association, I have personally experienced the vicissitudes of Chinese ophthalmology from weak to strong, and witnessed the irreplaceable and key role played by Chinese Medical Association in promoting academic exchanges, setting medical standards, and carrying out medical education and talent training. On the occasion of the birthday of the Chinese Medical Association, I would like to review the deep relationship between personal growth and the development of the Chinese Medical Association with this article, pay tribute to the brilliant achievements of the Chinese Medical Association passed down from generation to generation over the past 100 years, and look forward to the mission and challenges of ophthalmology in the new era.

2025 marks the 110th anniversary of the founding of the Chinese Medical Association. After 100 years of development, the Chinese Medical Association has become a medical academic group with 690,000 members, making outstanding contributions to the development of Chinese medical cause. In April 1937, ophthalmology representatives attending the National Congress of the Chinese Medical Association established the Ophthalmology Branch of the Chinese Medical Association. Since its establishment, the Ophthalmology Branch has actively promoted the cultivation of ophthalmology talents, scientific and technological innovation, clinical diagnosis and treatment, and the development of health science popularization, and has become an important academic organization that gathers ophthalmologists all over the country. In October 1950, Chinese Journal of Ophthalmology was founded, becoming the first professional academic journal in the field of ophthalmology in China, and the most authoritative and influential academic journal in the field of ophthalmology in China. Ophthalmology colleagues in China work together to forge ahead and join hands to promote the high-quality development of ophthalmology.

This article highlights the significant impact of complications following intraocular lens (IOL) implantation on visual recovery and quality of life, urging a multifaceted approach to address these challenges. The author discusses the clinical complexities of IOL opacification, uveitis-glaucoma-hyphema syndrome, capsular block syndrome, and optical disturbances, which are often overlooked or misdiagnosed. A comprehensive strategy involving optimized IOL design, enhanced clinical recognition, and improved patient communication is advocated. Continued research into new materials and techniques, alongside standardized clinical practices, is proposed to improve surgical safety and patient satisfaction.

With the intensification of global population aging, the demand for presbyopia correction continues to rise, and various types of presbyopia-correcting intraocular lenses (IOLs) are being increasingly applied in clinical practice. The experts form the Chinese Cataract and Refractive Surgery Society and Cataract Group of Chinese Ophthalmologist Association, based on the current evidence-based data and through thorough discussions, have reached a consensus regarding the definition and clinical application of presbyopia-correcting IOLs. This consensus aims to provide guidance for clinical practice, ensuring the appropriate utilization of presbyopia-correcting IOLs to meet the personalized visual needs of diverse patient populations.

To evaluate the accuracy of the Barrett Universal Ⅱ, Haigis, and SRK/T formulas for intraocular lens (IOL) power calculation in cataract patients with axial length >28 mm undergoing phacoemulsification combined with capsular tension ring implantation.

A retrospective case series study was conducted. Data from 26 eyes (26 patients) with cataract (axial length>28 mm), treated at the Department of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, from January to October 2023 were analyzed. Patients had a median age of 59 years (interquartile range: 51-63), with 14 males and 12 females. All patients underwent biometric measurements using the IOL Master, had uneventful surgeries without intraoperative or postoperative complications, and completed objective refraction at 1 month postoperatively. Primary outcomes included mean prediction error (MPE), mean absolute error (MAE), and the percentage of eyes with prediction errors within ±0.25 D,±0.50 D, and ±1.00 D. Inter-group comparisons were performed using the one-way ANOVA with Bonferroni correction, and categorical data were analyzed using the Chi-square test.

The Barrett Universal Ⅱ formula yielded the smallest MPE of (-0.08±0.28) D, compared to (0.35±0.43) D for Haigis and (0.31±0.47) D for SRK/T. The MAE was lowest with Barrett Universal Ⅱ (0.22 D), significantly lower than Haigis (0.43 D) and SRK/T (0.45 D) (P<0.05). Within the ±0.25 D prediction error range, Barrett Universal Ⅱ achieved 19/26 eyes (73.08%), significantly higher than Haigis (10/26, 38.46%) and SRK/T (8/26, 30.77%) (P<0.05). For the ±0.50 D range, Barrett Universal Ⅱ included 24/26 eyes (92.31%), surpassing Haigis (17/26, 65.38%) and SRK/T (16/26, 61.54%) (P<0.05). Within ±1.00 D, Barrett Universal Ⅱ achieved 26/26 eyes (100%), compared to Haigis (25/26, 96.15%) and SRK/T (24/26, 92.31%).

In cataract patients with axial length >28 mm and capsular tension ring implantation, the Barrett Universal Ⅱ formula is recommended for its superior accuracy in IOL power calculation, with an MPE closer to zero, lower MAE, and significantly higher percentages of eyes within ±0.25 D and ±0.50 D prediction error ranges compared to Haigis and SRK/T.

To explore the influencing factors of early cognitive impairment in patients with age-related cataract, and to construct a risk prediction model, for the management of patients undergoing day surgery.

This was a cross-sectional study. A total of 137 patients with age-related cataract admitted to the Department of Ophthalmology, Chinese PLA General Hospital from November 2023 to June 2024 were included. Among them, there were 48 males and 89 females, with an average age of 66.3 years, and one eye of each patient was included. According to the scores of the Montreal Cognitive Assessment Scale, the patients were divided into the cognitive impairment group (score<26, n=91) and the control group (score≥26, n=46). All patients received comprehensive ophthalmic examinations, including visual acuity, intraocular pressure, refractive status, biometry, fundus examination, optical coherence tomography, optical coherence tomography angiography and ultrasound examination of the vessels behind the eyeball. The main observation indicators included morphological parameters in different ocular regions (such as axial length, lens thickness, etc.), parameters related to the retina and optic disc [such as retinal thickness, ganglion cell-inner plexiform layer (GC-IPL) thickness, peripapillary retinal nerve fiber layer (pRNFL), etc.], and ocular hemodynamic parameters (such as the flow velocity, pulsatility index and resistance index of the central retinal artery, posterior ciliary artery and ophthalmic artery, etc.). Variables with P<0.1 in the univariate analysis were included in the multivariate logistic regression analysis to construct a risk prediction model, the odds ratio (OR) and its 95% confidence interval (CI) were calculated to identify the independent risk factors for early cognitive impairment in patients with age-related cataract. And the receiver operating characteristic (ROC) curve was plotted to evaluate the predictive value of the model.

The univariate analysis showed that advanced age (P<0.001), decreased diastolic blood pressure (P=0.012), shallower anterior chamber (P=0.001) and thickened lens (P=0.003) were associated with early cognitive impairment. Increased flow velocities of the ophthalmic artery and central retinal artery (P=0.001, 0.006), and increased pulsatility index and resistance index of the short posterior ciliary artery (P=0.006, 0.005) were associated with cognitive impairment. In the cognitive impairment group, the inferior pRNFL was thinner (P=0.005), and the cup-to-disc ratio was larger (P=0.021). The multivariate logistic regression analysis identified advanced age (OR=1.127, 95%CI: 1.020-1.245, P=0.019), history of hypertension (OR=5.173, 95%CI: 1.588-16.849, P=0.006), decreased diastolic blood pressure (OR=0.942, 95%CI: 0.869-0.983, P=0.012), increased flow velocity of the central retinal artery (OR=1.268, 95%CI: 1.069-1.504, P=0.006) and thinner thickness of the inferior pRNFL region (OR=0.959, 95%CI: 0.932-0.987, P=0.005) as independent risk factors. The area under the ROC curve of the prediction model constructed based on the above indicators was 0.883 (95%CI: 0.824-0.943). with P=0.576 as the prediction probability cutoff, the sensitivity was 87.9%, the specificity was 76.1%, and the model had a good fit.

Advanced age, history of hypertension, decreased diastolic blood pressure, increased flow velocity of the central retinal artery and thinner inferior pRNFL region are independent risk factors for early cognitive impairment in patients with age-related cataract. The prediction model constructed based on these ocular markers has good predictive efficacy, in the preoperative assessment on intraoperaive patient cooperation and helps provide an important basis for evaluating the cooperation of patients during surgery before optimize the management process of day surgery.

To investigate the consistency between automatic corneal marking using a surgical navigation system and manual corneal marking assisted by a slit-lamp microscope.

This was a retrospective case series study. Patient data from the Ophthalmology Outpatient Department of Shanghai Sixth People′s Hospital, Shanghai Jiao Tong University School of Medicine, from June 2021 to July 2023 were continuously collected. All patients underwent manual corneal marking assisted by a slit-lamp microscope, followed by automatic marking using a surgical navigation system. Patients were divided into two groups: the manual marking group and the automatic marking group. The manual marking group was further divided into three subgroups based on the marking measurement methods: manual marking (upper to lower edge), manual marking (lower to upper edge), and manual marking (midpoint). The horizontal meridian angle and the deviation of the central axis were calculated for the four marking methods using the image processing software. Statistical differences among the measurement methods were compared, and the consistency was evaluated using the Bland-Altman plots and intraclass correlation coefficient (ICC).

A total of 143 cataract patients (201 eyes) were included in the study, with an average age of (60.27±19.13) years, including 58 males and 85 females. The absolute mean deviations of the horizontal meridian angle for manual marking (upper to lower edge), manual marking (lower to upper edge), manual marking (midpoint), and automatic marking were 3.61°, 4.76°, 3.20°, and 2.45°, respectively, with statistically significant differences among them (P<0.001). The differences between automatic marking and the three manual marking methods were also statistically significant (P<0.05). The mean deviations of the central axis were 2.35, 2.35, 2.24, and 0.40 mm, respectively, with statistically significant differences among them (P<0.001). The deviation of the automatic marking method was significantly lower than that of the manual marking methods (P<0.001), while no significant difference was observed between the three edge-based manual marking methods (P>0.05). The ICC for the horizontal meridian angle between manual marking (midpoint) and automatic marking was 0.88, while the ICC for the central axis deviation was -0.04, indicating good consistency in the horizontal meridian angle between manual marking (midpoint) and automatic marking, but poor consistency in the central axis deviation.

The horizontal meridian angle values of automatic corneal marking using a surgical navigation system and manual corneal marking (midpoint) assisted by a slit-lamp microscope showed good consistency. However, digital navigation automatic marking demonstrated significantly better control in the centralization of the radial offset, providing a robust basis for accurate axis positioning during toric intraocular lens implantation.

To investigate the efficacy and safety of limbal relaxing incisions (LRI) combined with implantable Collamer lens (ICL) implantation and Toric ICL (TICL) implantation in correcting high myopia with astigmatism.

A prospective nonrandomized controlled clinical study was conducted. Patients with high myopia and astigmatism who underwent ICL implantation at Beijing Tongren Eye Center of Beijing Tongren Hospital Affiliated to Capital Medical University from March 1, 2022 to February 15, 2023 were enrolled in this study. These patients were divided into the TICL group (TICL implantation) and the LRI group (LRI combined with ICL implantation). The uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (recorded as the logarithm of the minimum resolution angle), refractive power, corneal and anterior chamber conditions, surgically induced astigmatism, and target-induced astigmatism before and 1 and 3 months after surgery were observed. The correction index, efficiency index, and safety index were calculated, and predictability was observed. Statistical analysis was conducted using the independent sample t-test, Mann Whitney U test, and linear regression equation.

Twenty patients (20 right eyes) were included in the TICL group, and 17 patients (17 right eyes) were included in the LRI group. There was no statistically significant difference in preoperative visual acuity, refractive error, corneal astigmatism, corneal and anterior chamber conditions between the two groups (all P>0.05). At 1 and 3 months postoperatively, the UDVA of the TICL group [-0.10 (-0.10, 0.00), 0.00(-0.08, 0.00)] showed statistically significant differences compared to the preoperative value [1.30 (1.11, 1.49)] (both P<0.05). The postoperative UDVA in the LRI group [-0.10 (-0.10, 0.00), -0.08 (-0.08, -0.04)] also showed statistically significant differences compared to the preoperative value [1.30 (1.22, 1.46)] (both P<0.05). The difference in UDVA between the LRI group and the TICL group at 3 months postoperatively was statistically significant (P<0.05). The corneal astigmatism degree in the LRI group at 3 months postoperatively [(-0.87±0.47) D] was significantly different from that before surgery [(-1.32±0.91) D] (P<0.05). There was no statistically significant difference in the safety index (1.17±0.17 and 1.16±0.14) and efficacy index (1.12±0.18 and 1.18±0.16) between the two groups at 3 months postoperatively (both P>0.05). The achieved correction of refractive power of all operated eyes in both groups was within ±0.50 D of the attempted correction of refractive power at 3 months. There was no statistically significant difference in surgically induced astigmatism and target-induced astigmatism between the two groups (both P>0.05), and the correction index of both groups was slightly greater than 1. There were no complications during or after the surgical treatment in both groups.

For high myopia with low to moderate astigmatism, LRI combined with ICL implantation has good efficacy, safety, and predictability in the early to mid-term postoperative period.

To explore the influencing factors of intraocular residual astigmatism (RIA) after the implantation of non-toric intraocular lens (IOL), and to analyze the differences in the positional characteristics of the IOL and RIA between the eyes.

This was a retrospective case series study. The data of 122 cataract patients (122 eyes, 67 right eyes and 55 left eyes) in the Eye Hospital of Tianjin Medical University from October 2022 to September 2023 were included. The patients′ age was (68.80±8.82) years old, with 57 males and 65 females. All patients underwent phacoemulsification combined with the implantation of non-toric IOL. Swept-source optical coherence tomography (SS-OCT) was used to measure the decentration displacement, tilt vector of the lens and IOL, and anterior segment parameters before and 1 month after the surgery. The main indicators included the magnitude and direction of RIA, the tilt vector and decentration displacement of the IOL.

The absolute value of the overall RIA was (0.67±0.39) D. The absolute value of RIA in the left eyes [(0.81±0.43) D] was significantly greater than that in the right eyes [(0.56±0.31) D, P<0.001]. The tilt angle of the IOL was 5.00°±1.54°. The tilt angle in the left eyes (5.51°±1.59°) was greater than that in the right eyes (4.58°±1.36°, P=0.001). RIA was positively correlated with the tilt angle of the IOL (r=0.22, P=0.016). Multiple regression showed that for every 1° increase in the tilt angle of the IOL, RIA increased by 0.06 D (β=0.06, P=0.016). The anterior chamber depth (r=-0.24, P=0.008) and axial length (r=-0.38, P<0.001) were negatively correlated with the tilt angle of the IOL, and the refractive power of the IOL (r=0.37, P<0.001) was positively correlated with the tilt angle.

After the implantation of non-toric IOL, RIA is significantly correlated with the tilt angle of the IOL, but not with the decentration distance. IOL tilt is an important factor affecting the postoperative visual quality. Both the tilt angle of the IOL and RIA in the left eyes are significantly greater than those in the right eyes. The eye side may be an important factor affecting the position of the IOL and the postoperative visual quality.

A 75-year-old female patient was diagnosed with primary acquired melanosis (PAM) of the conjunctiva in 2004. The patient voluntarily chose not to undergo any pharmacological or surgical interventions and only received follow-up observation. During a follow-up visit in 2021, a significant reduction in conjunctival melanin pigmentation was found. Anterior segment optical coherence tomography revealed a marked decrease in the high reflectivity of the corneal epithelial cell layer and a reduction in the highly reflective melanin granules within the corneal epithelium. In vivo confocal microscopy showed a decrease in the oval, short spindle-shaped, highly reflective melanin granules within the corneal epithelium compared to previous examinations, and these granules had not penetrated the basement membrane. These examination results collectively confirmed the reduction in conjunctival melanin pigmentation in the patient.

The patient was an 11-year-old female. Because of the physical examination, fundus lesions in the left eye were found for 6 years, and he went to the Department of Ophthalmology, General Hospital of Eastern Theatre of the People's Liberation Army. Ocular examination: The best corrected visual acuity was 4.7 in both eyes, with intraocular pressure of 14.1 mmHg (1 mmHg =0.133 kPa) in the right eye and 14.5 mmHg in the left eye. There were no obvious abnormalities in the anterior segment of both eyes; The blood vessels above the optic disc in the left eye were tortuous (A in Quintessence Picture 1), and there was no obvious abnormality in the fundus of the right eye. The examination of fluorescein fundus angiography in the left eye is shown in B in Essence Picture 1. Clinical diagnosis: Abnormal haptic of left eye optic disc.

The development of artificial vision systems offers the potential to restore vision for patients with severe visual impairments or blindness. This review provides an overview of the current advancements in artificial vision technologies, focusing on retinal prostheses, optic nerve prostheses, cortical prostheses, and other emerging devices. Retinal prostheses are categorized into epiretinal devices, subretinal devices, and suprachoroidal implants, which work by electrically stimulating the retina or adjacent tissues to partially restore visual function. Optic nerve prostheses target the optic nerve to transmit visual signals directly to the brain, providing a potential solution for patients with retinal damage but intact optic nerves. Cortical prostheses bypass both the retina and optic nerve, directly stimulating the visual cortex, and hold promise for restoring vision in patients who are otherwise untreatable through conventional approaches. Additionally, this review discusses other emerging devices, including ultrasonic visual prostheses, liquid retina, and chemical retinal prostheses, which offer alternative strategies for specific patient populations. Finally, the review highlights cutting-edge advancements in nanomaterials, image processing, and novel electrode technologies, which are driving the development of artificial vision systems towards higher resolution, greater efficiency, and personalized solutions, paving the way for more effective visual restoration in the future.

Occult macular dystrophy is an inherited macular disorder associated with cone degeneration. The characteristic clinical feature is decreased visual acuity despite a normal fundus appearance on ophthalmoscopy. Optical coherence tomography, infrared reflectance imaging, visual field testing, and multifocal electroretinography may detect structural and functional abnormalities in the macular region. This article reviews the latest advances in both domestic and international research, summarizing the clinical characteristics, pathogenic genes, genetic features, and molecular mechanisms, aiming to enhance clinical understanding of the disease and provide insights for further research and therapeutic exploration.

In 2013, femtosecond laser-assisted cataract extraction (FLACS) was approved for clinical application in China. So far, the surgical technology and clinical application have reached a mature state, but some problems have also been exposed, especially for complex cataracts. In order to further standardize and guide the application of FLACS in the treatment of complex cataract, this paper combines the national conditions of China and the research results at home and abroad, aiming at seven kinds of complex cataract in clinic, to explore the standardized methods of clinical application of FLACS, in order to provide reference for clinical work.