Influence of Uncomplicated Phacoemulsification on Central Macular Thickness in Diabetic Patients: A Meta-Analysis

<div><p>Objective</p><p>To evaluate the effect of uncomplicated phacoemulsification on central macular thickness (CMT) and best corrected visual acuity (BCVA) in both diabetic patients without diabetic retinopathy (DR) and diabetic patients with mild to moderate non-proliferative diabetic retinopathy (NPDR).</p><p>Methods</p><p>Potential prospective observational studies were searched through PubMed and EMBASE. Standardized mean difference (SMD) and 95% confidence interval (CI) for changes in CMT and BCVA were evaluated at postoperative 1, 3 and 6 months. The pooled effect estimates were calculated in the use of a random-effects model.</p><p>Results</p><p>A total of 10 studies involving 190 eyes of diabetic patients without diabetic retinopathy and 143 eyes of diabetic patients with NPDR were identified. CMT values demonstrated a statistically significant increase after uncomplicated phacoemulsification at 1 month (SMD, -0.814; 95%CI, -1.230 to -0.399), 3 months (SMD, -0.565; 95%CI, -0.927 to -0.202) and 6 months (SMD, -0.458; 95%CI, -0.739 to -0.177) in diabetic patients with NPDR. There was no statistical difference in CMT values at postoperative 1 month (SMD, -1.206; 95%CI, -2.433 to 0.021)and no statistically significant increase in CMT values at postoperative3 months (SMD, -0.535; 95%CI, -1.252 to 0.182) and 6 months (SMD, -1.181; 95%CI, -2.625 to 0.263) in diabetic patients without DR.BCVA was significantly increased at postoperative 1 month (SMD, 1.149; 95%CI, 0.251 to 2.047; and SMD,1.349; 95%CI, 0.264 to 2.434, respectively) and 6 months (SMD, 1.295; 95%CI, 0.494 to 2.096; and SMD, 2.146; 95%CI, 0.172 to 4.120, respectively) in both diabetic patients without DR and diabetic patients with NPDR. Sensitivity analysis showed that the results were relatively stable and reliable.</p><p>Conclusion</p><p>Uncomplicated phacoemulsification in diabetic patients with mild to moderate NPDR seemed to influence significantly the subclinical thickening of the macular zones at postoperative 1, 3 and 6 months compared with diabetic patients without DR. BCVA was significantly improved in both diabetic patients without DR and diabetic patients with mild to moderate NPDR.</p></div

Flow chart of study selection process.

<p>Flow chart of study selection process.</p

Characteristics of enrolled studies in the meta-analysis.

<p>No., number; NDR, no diabetic retinopathy; NPDR, non-proliferative diabetic retinopathy; NR, not reported.</p><p>Characteristics of enrolled studies in the meta-analysis.</p

Forest plots of random-effects for pooled SMDs of central macular thickness (CMT) after uncomplicated phacoemulsification in diabetic patients with mild to moderate non-proliferative diabetic retinopathy.

<p>Forest plots of random-effects for pooled SMDs of central macular thickness (CMT) after uncomplicated phacoemulsification in diabetic patients with mild to moderate non-proliferative diabetic retinopathy.</p

Meta- sensitivity analyses on central macular thickness (A) and best corrected visual acuity (B) in both diabetic patients without diabetic retinopathy and diabetic patients with non-proliferative diabetic retinopathy.

<p>Meta- sensitivity analyses on central macular thickness (A) and best corrected visual acuity (B) in both diabetic patients without diabetic retinopathy and diabetic patients with non-proliferative diabetic retinopathy.</p

Forest plots of random-effects for pooled SMDs of central macular thickness (CMT) after uncomplicated phacoemulsification in diabetic patients without diabetic retinopathy.

<p>Forest plots of random-effects for pooled SMDs of central macular thickness (CMT) after uncomplicated phacoemulsification in diabetic patients without diabetic retinopathy.</p

Electrochemical Control of Copper Intercalation into Nanoscale Bi₂Se₃

Intercalation of exotic atoms or molecules into the layered materials remains an extensively investigated subject in current physics and chemistry. However, traditionally melt-growth and chemical interaction strategies are either limited by insufficiency of intercalant concentrations or destitute of accurate controllability. Here, we have developed a general electrochemical intercalation method to efficaciously regulate the concentration of zerovalent copper atoms into layered Bi₂Se₃, followed by comprehensive experimental characterization and analyses. Up to 57% copper atoms (Cu_6.7Bi₂Se₃) can be intercalated with no disruption to the host lattice. Meanwhile the unconventional resistance dip accompanied by a hysteresis loop below 40 K, as well as the emergence of new Raman peak in Cu_<i>x</i>Bi₂Se₃, is a distinct manifestation of the interplay between intercalated Cu atoms with Bi₂Se₃ host. Our work demonstrates a new methodology to study fundamentally new and unexpected physical behaviors in intercalated metastable materials

Contrast Sensitivity and Spherical Aberration in Eyes Implanted with AcrySof IQ and AcrySof Natural Intraocular Lens: the Results of a Meta-Analysis

<div><p>Background</p><p>To systematically evaluate the visual performance of aspheric AcrySof IQ and spherical AcrySof Natural intraocular lens (IOL) after cataract surgery.</p> <p>Methodology/Principal Findings</p><p>Potential randomized controlled trials (RCTs) that involved implanting AcrySof IQ and AcrySof Natural were searched from PubMed, Web of science, EMBASE, Chinese Science and Technology Periodicals Databases and Cochrane Central Register of Controlled Trials. The methodological quality of the studies was assessed by the Jadad method. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) of best-corrected visual acuity (BCVA), contrast sensitivity and spherical aberration were pooled using a random-effects model. Seven studies were identified and analyzed to compare AcrySof IQ (236 eyes) with AcrySof Natural (232 eyes) after phacoemulsification. There was no significant difference in postoperative BCVA between AcrySof IQ and AcrySof Natural (<i>p</i> =0.137) after a follow up of 3 months. For contrast sensitivity, these differences reached statistical significance under photopic conditions at two spatial frequencies (3 cycles per degree (cpd), 6 cpd, 12 cpd, and 18 cpd; <i>p</i> =0.022, <i>p</i> =0.017, <i>p</i> = 0.065, and <i>p</i>=0.191, respectively) and under mesopic conditions at three spatial frequencies (3 cpd, 6 cpd, 12 cpd, and 18 cpd; <i>p</i> =0.007, <i>p</i> =0.033, <i>p</i> =0.030, and <i>p</i> =0.080, respectively). Eyes with AcrySof IQ also had statistically significant less spherical aberration than eyes with AcrySof Natural (<i>p</i><0.001). Sensitivity analysis showed that the results were relatively stable and reliable.</p> <p>Conclusions/Significance</p><p>The overall findings indicate that AcrySof IQ with a modified aspheric surface induced significantly less spherical aberration than AcrySof Natural. Contrast sensitivity in eyes with AcrySof IQ is better than that in eyes with AcrySof Natural, especially under mesopic conditions.</p> </div

Standardized mean difference (SMD) in spherical aberration: This forest plot showed the SMD in spherical aberration along with associated 95% confidence interval (CI), comparing AcrySof IQ and AcrySof Natural intraocular lens.

<p>Standardized mean difference (SMD) in spherical aberration: This forest plot showed the SMD in spherical aberration along with associated 95% confidence interval (CI), comparing AcrySof IQ and AcrySof Natural intraocular lens.</p

Funnel plot for the results between AcrySof IQ and AcrySof Natural intraocular lens.

<p>Egger’ publication bias test result (<i>p</i> =0.476).</p