BACKGROUND: The mechanism of high-myopic cataract (HMC) is not fully understood yet. The ultrastructure of anterior lens capsule (aLC) and lens epithelial cells (LECs) may provide some clues to this issue.METHODS: Capsulorhexis samples from 10 eyes with HMC and 10 eyes with age-related cataract (ARC) were analyzed for morphologic characteristics using transmission electron microscopy (TEM).RESULTS: Several common pathologic disorders of LECs, including pleomorphic cellular structure, extensive intracellular vacuoles, swollen organelles, degeneration and necrotic lesions, could be observed in both HMC group and ARC group, to a similar extent. Specimens of HMC group disclosed remarkable extracellular spaces, interdigitation of LECs as well as protuberances of aLC towards LECs. CONCLUSIONS: The ultrastructure of aLC and LECs in HMC demonstrated some specific pathologic disorders in comparison with ARC, which might play a role in the formation of cataract in high myopes.

Purpose: To assess the safety, efficacy, and long-term clinical outcomes of primary tailored phacoemulsification (phaco) combined with goniosynechialysis (GSL; phaco-GSL) in refractory acute primary angle closure (APAC) eyes with uncontrolled high intraocular pressure (IOP). Methods: This retrospective case series comprised 51 eyes of 42 consecutive patients with refractory APAC and high IOP who were treated using primary tailored phaco-GSL at 3 hospitals in China, from 2014 to 2021. Preoperative and postoperative IOP, corrected distant visual acuity (CDVA), corneal endothelial cell density (CECD), intraoperative and postoperative complications were recorded. The safety, efficacy and subsequent long-term clinical outcomes were analyzed. Results: The mean CDVA (LogMAR) was improved from 1.67±0.94 preoperatively to 0.23±0.26 postoperatively (P <0.001). Preoperative CECD was 2309.39±541.03 cells/mm2 in 33 eyes and inaccessible in 18 eyes due to severe corneal edema; at the final follow-up, the mean CECD of all patients was 1823.50±533.40 cells/mm2 (P <0.001). The mean IOP decreased from 48.51±6.25 mmHg preoperatively to 15.66±2.27 mmHg at the final follow-up (P <0.001). Among 51 eyes, additional tailored procedures performed were corneal indentation in 42 eyes, epithelial debridement in 9 eyes, giant epithelial bullae view in 4 eyes, pars-plana fluid aspiration in 3 eyes, and secondary intraocular lens implantation in 7 eyes. The IOP of all eyes was well controlled eventually and 47 eyes (92.16%) were successfully treated by phaco-GSL alone. No significant intraoperative or postoperative complications were observed. Conclusions: Primary tailored phaco-GSL is a safe and effective surgical management strategy for patients with refractory APAC and high IOP.

Purpose: To compare binocular anterior segment structures in Chinese patients with dark iris and unilateral Fuchs’ uveitis syndrome (FUS).Methods: This was a cross-sectional study including 34 phakic eyes (17 patients) with unilateral FUS. Anterior segment parameters were measured by rotating Scheimpflug imaging camera, noncontact specular microscopy and anterior segment optical coherence tomography.Results: Corneal volume was higher in FUS eyes compared to unaffected eyes (p<0.05). The iridocorneal angles were larger in FUS eyes compared to contralateral eyes (p<0.05). Mean endothelial cell density (ECD) was lower, and the coefficient of variation in endothelial cell size (CV) and average cell area of endothelial cells (ACA) were higher, in FUS eyes (p<0.05). Mean densitometry values of the midstromal cornea (zones with a diameter of 0-2, 2-6, or 10-12 mm), posterior (0-2, 2-6, 10-12, or 0-12 mm), or total thickness (0-2 or 2-6 mm) were higher in FUS eyes compared with unaffected eyes (p<0.05). ECD, CV, and ACA were negatively related to densitometry values of the midstromal and posterior cornea in the FUS eyes (p<0.05). Smoothness index of iris was lager in affected eyes (p<0.05).Conclusion: In Chinese patients with unilateral FUS, loss of endothelial cells, wider iridocorneal angle, thicker cornea, higher corneal densitometry of midstromal and posterior layer, and smoother iris were observed in affected eyes compared to contralateral eyes. These data can help to elucidate anterior segment characteristics of unilateral FUS in this population.

Purpose To compare binocular anterior segment structures in Chinese patients with dark iris and unilateral Fuchs’ uveitis syndrome (FUS). Methods This was a cross-sectional study including 34 phakic eyes (17 patients) with unilateral FUS. Anterior segment parameters were measured by rotating Scheimpflug imaging camera, noncontact specular microscopy, and anterior segment optical coherence tomography. Results Corneal volume was higher in FUS eyes compared to unaffected eyes (p < 0.05). The iridocorneal angles were larger in FUS eyes compared to contralateral eyes (p < 0.05). Mean endothelial cell density (ECD) was lower, and the coefficient of variation in endothelial cell size and average cell area of endothelial cells (ACA) were higher, in FUS eyes (p < 0.05). Mean densitometry values of the midstromal cornea (zones with a diameter of 0–2, 2–6, or 10–12 mm), posterior (0–2, 2–6, 10–12, or 0–12 mm), or total thickness (0–2 or 2–6 mm) were higher in FUS eyes compared with unaffected eyes (p < 0.05). ECD, percentage of hexagonal cells, and ACA were strongly related to densitometry values of the midstromal and posterior cornea in the FUS eyes (p < 0.05). Smoothness index of iris was lager in affected eyes (p < 0.05). Conclusion In Chinese patients with unilateral FUS, loss of endothelial cells, wider iridocorneal angle, thicker cornea, higher corneal densitometry of midstromal and posterior layer, and smoother iris were observed in affected eyes compared to contralateral eyes. These data can help to elucidate anterior segment characteristics of unilateral FUS in this population.