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Purpose: Low-concentration atropine is an emerging therapy for myopia progression, but its efficacy and optimal concentration remain uncertain. Our study aimed to evaluate the efficacy and safety of low-concentration atropine eye drops at 0.05%, 0.025%, and 0.01% compared with placebo over a 1-year period., Design: Randomized, placebo-controlled, double-masked trial., Participants: A total of 438 children aged 4 to 12 years with myopia of at least -1.0 diopter (D) and astigmatism of -2.5 D or less., Methods: Participants were randomly assigned in a 1:1:1:1 ratio to receive 0.05%, 0.025%, and 0.01% atropine eye drops, or placebo eye drop, respectively, once nightly to both eyes for 1 year. Cycloplegic refraction, axial length (AL), accommodation amplitude, pupil diameter, and best-corrected visual acuity were measured at baseline, 2 weeks, 4 months, 8 months, and 12 months. Visual Function Questionnaire was administered at the 1-year visit., Main Outcome Measures: Changes in spherical equivalent (SE) and AL were measured, and their differences among groups were compared using generalized estimating equation., Results: After 1 year, the mean SE change was -0.27±0.61 D, -0.46±0.45 D, -0.59±0.61 D, and -0.81±0.53 D in the 0.05%, 0.025%, and 0.01% atropine groups, and placebo groups, respectively (P < 0.001), with a respective mean increase in AL of 0.20±0.25 mm, 0.29±0.20 mm, 0.36±0.29 mm, and 0.41±0.22 mm (P < 0.001). The accommodation amplitude was reduced by 1.98±2.82 D, 1.61±2.61 D, 0.26±3.04 D, and 0.32±2.91 D, respectively (P < 0.001). The pupil sizes under photopic and mesopic conditions were increased respectively by 1.03±1.02 mm and 0.58±0.63 mm in the 0.05% atropine group, 0.76±0.90 mm and 0.43±0.61 mm in the 0.025% atropine group, 0.49±0.80 mm and 0.23±0.46 mm in the 0.01% atropine group, and 0.13±1.07 mm and 0.02±0.55 mm in the placebo group (P < 0.001). Visual acuity and vision-related quality of life were not affected in each group., Conclusions: The 0.05%, 0.025%, and 0.01% atropine eye drops reduced myopia progression along a concentration-dependent response. All concentrations were well tolerated without an adverse effect on vision-related quality of life. Of the 3 concentrations used, 0.05% atropine was most effective in controlling SE progression and AL elongation over a period of 1 year., (Copyright © 2018 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)

Purpose: To compare the refractive and visual outcomes between 2 ablation centration points, 80% and 100% from the pupil center toward the coaxially sighted corneal light reflex., Setting: Hong Kong Sanatorium and Hospital, Hong Kong, China., Design: Retrospective comparative study., Methods: All eyes had myopic laser in situ keratomileusis with the ablation 80% or 100% from the pupil center toward the coaxially sighted corneal light reflex. Three months postoperatively, the refractive and visual outcomes were compared between groups. Subgroup analysis was also performed for the large-angle κ and small-angle κ groups., Results: There were no differences in the preoperative variables between groups. Three months postoperatively, the sphere was significantly more hyperopic in the 80% group than in the 100% group (0.19 diopter [D] versus 0.09 D) (P = .009) and the cylinder was significantly lower in the 80% group (0.25 D versus 0.33 D) (P = .011). More eyes achieved zero astigmatism in the 80% group than in the 100% group (43.9% versus 34.2%), and fewer eyes had astigmatism greater than 0.75 D in the 80% group (0.9% versus 6.1%) (P = .039). The error from the target refraction indicated that the 80% group tended to have significantly less undercorrection (P = .045). There were no significant differences in the other outcomes. Subgroup analysis did not show significant findings for the large-angle κ., Conclusions: Both 80% centration and 100% centration were safe and effective. Compared with the 100% group, the 80% group had less astigmatism and less undercorrection., (Copyright © 2016 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.)

Purpose: To report the early experience and complications during cataract surgery with a noncontact femtosecond laser system., Setting: Hong Kong Sanatorium and Hospital, Hong Kong Special Administrative Region, China., Design: Retrospective case series., Methods: All patients had anterior capsulotomy or combined anterior capsulotomy and lens fragmentation using a noncontact femtosecond laser system (Lensar) before phacoemulsification. Chart and video reviews were performed retrospectively to determine the intraoperative complication rate. Risk factors associated with the complications were also analyzed., Results: One hundred seventy eyes were included. Free-floating capsule buttons were found in 151 eyes (88.8%). No suction break occurred in any case. Radial anterior capsule tears occurred in 9 eyes (5.3%); they did not extend to the equator or posterior capsule. One eye (0.6%) had a posterior capsule tear. No capsular block syndrome developed, and no nuclei were dropped during irrigation/aspiration (I/A). Anterior capsule tags and miosis occurred in 4 eyes (2.4%) and 17 eyes (10.0%), respectively. Different severities of subconjunctival hemorrhages developed in 71 (43.8%) of 162 eyes after the laser procedure. The mean surgical time from the beginning to the end of suction was 6.72 minutes ± 4.57 (SD) (range 2 to 28 minutes)., Conclusions: Cataract surgery with the noncontact femtosecond laser system was safe. No eye lost vision because of complications. Caution should be taken during phacoemulsification and I/A to avoid radial anterior capsule tears and posterior capsule tears., (Copyright © 2013 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.)