Search

Background: The capsular tension ring is a novel assistant tool for cataract surgery; however, controversy exists in its co-implantation. The potential for hyperopic or myopic shift resulting from the co-implantation of the capsular tension ring and intraocular lens remains unclear. This study aimed to determine the postoperative refractive prediction error and the direction of refractive shift in cataract patients who underwent capsular tension ring co-implantation., Methods: We conducted a systematic review and meta-analysis,searching electronic databases for studies of individuals diagnosed with cataracts receiving surgery with or without capsular tension ring implantation. Systematic searches were performed based on five databases: PubMed, Cochrane Library, Web of Science, Medline, and China National Knowledge Infrastructure. The primary outcome was the mean arithmetic refractive prediction error. Secondary outcomes were mean absolute refractive prediction error and the number of eyes within a certain refractive prediction error range. We applied a fixed-effectsmodel to pool effect sizes across trials using weighted mean differences (WMD) and risk ratios (RR) with their 95% confidence intervals (95% CI). Statistical heterogeneity scores were assessed with the I 2 statistic., Results: A total of 407 affected eyes were included in eight independent clinical studies. Meta-analysis suggested significant differences both in short-term (≤1 month) co-implantation (WMD = 0.16, p  < .001, 95% CI: -0.13 ~ 0.19) and long-term (≥3 months) co-implantation between the capsular tension ring co-implantation group and the control group (WMD = 0.19, p  < .001, 95% CI: 0.15 ~ 0.23). However, no significant difference was observed in the high myopia subgroup whether capsular tension ring co-implantation (WMD = 0.03, p  = .083, 95% CI: -0.27 ~ 0.34). Heterogeneity was not found among the studies., Conclusion: Compared to simple intraocular lens implantation, capsular tension ring co-implantation is more susceptible to developing hyperopic shifts in non-myopic cataract patients, probably related to anterior chamber depth. It requires careful consideration by clinicians when determining the target diopter preoperatively. However, interpretation is limited, because there is a lack of studies available for analysis. There still needs to be additional studies to expand the evidence base.

Purpose: Danio rerio zebrafish constitute a popular model for studying lens development and congenital cataracts. However, the specific deletion of a gene with a Cre/LoxP system in the zebrafish lens is unavailable because of the lack of a lens-Cre-transgenic zebrafish. This study aimed to generate a transgenic zebrafish line in which Cre recombinase was specifically expressed in the lens., Methods: The pTol2 cryaa :Cre-polyA- cryaa :EGFP (enhanced green fluorescent protein) plasmid was constructed and co-injected with Tol2-transposase into one-to-two-cell-stage wild-type (WT) zebrafish embryos. Whole-mount in situ hybridization (ISH), tissue section, hematoxylin and eosin staining, a Western blot, a split-lamp observation, and a grid transmission assay were used to analyze the Cre expression, lens structure, and lens transparency of the transgenic zebrafish., Results: In this study, we generated a transgenic zebrafish line, zTg( cryaa :Cre- cryaa :EGFP), in which Cre recombinase and EGFP were driven by the lens-specific cryaa promoter. zTg( cryaa :Cre- cryaa :EGFP) began to express Cre and EGFP specifically in the lens at the 22 hpf stage, and this ectopic Cre could efficiently and specifically delete the red fluorescent protein (RFP) signal from the lens when zTg( cryaa :Cre- cryaa :EGFP) embryos were injected with the loxP -flanked RFP plasmid. The overexpression of Cre and EGFP did not impair zebrafish development or lens transparency. Accordingly, this zTg( cryaa :Cre- cryaa :EGFP) zebrafish line is a useful tool for gene editing, specifically with zebrafish lenses., Conclusions: We established a zTg( cryaa :Cre- cryaa :EGFP) zebrafish line that can specifically express an active Cre recombinase in lens tissues. This transgenic zebrafish line can be used as a tool to specifically manipulate a gene in zebrafish lenses., (Copyright © 2024 Molecular Vision.)