Volume 57 · Issue 01 · 2021

Without the health of the whole people, there will be no comprehensive moderately prosperous society. People's health is an important symbol of national prosperity and national prosperity. The report of the 19th National Congress of the Communist Party of China proposed that in the 15 years from 2020 to 2035, on the basis of building a moderately prosperous society in an all-round way, socialist modernization will be basically realized, and at the same time, China's scientific and technological strength will jump substantially, and it will rank among the forefront of innovative countries. In October 2020, the Central Committee of the Communist Party of China once again proposed in the "Recommendations of the Central Committee of the Communist Party of China on Formulating the 14th Five-Year Plan for National Economic and Social Development and the Long-term Goals for 2035" that achieving major breakthroughs in key core technologies and entering the forefront of innovative countries is the long-term goal of socialist modernization. Accelerating the construction of an innovative country requires medical science and technology workers to aim at the forefront of world science and technology, carry out forward-looking clinical and basic research, and make major breakthroughs. At the same time, it is necessary to pay attention to and strengthen the application and protection of intellectual property rights, which puts forward new and higher requirements for China to build a world-class medical science and technology journal.

Chinese Journal of Ophthalmology was born on October 1, 1950, the first National Day after the founding of New China. Since then, China has its own ophthalmology professional magazine, which has opened up a garden for domestic ophthalmology professional academic exchange. Since its birth and development, it has been cared for by many people and accompanied many people to grow up on the extraordinary road. Looking back at history is to remember the hard work and foundation laid by our predecessors; To be grateful to our predecessors is to let us know the responsibility on our shoulders and to encourage us to continue to work hard.

Multifocal intraocular lens (MIOL) can help cataract patients get a full range of vision, restore binocular stereopsis, improve pseudo-accommodation power, and correct regular corneal astigmatism with limits. However, MIOL also have shortcomings, including decreased contrast sensitivity, night glare, halos and other negative dysphotopsias, despite strictly controlled indications. Sometimes dysphotopsia can be relieved spontaneously after surgery in a period of time. During this process neuroadaptation plays an important role. This article explains the concept and mechanism of neuroadaptation, the location of neuroadaptation in the central nervous system, cognitive training, the preoperative evaluation of MIOL implantation, and the treatment for postoperative dissatisfaction. Correct understanding of the important role of neuroadaptation will provide theoretic foundation for cataract specialists and facilitate the handling of complications after MIOL implantation. (Chin J Ophthalmol, 2021, 57: 6-10)

Congenital cataract is the first main cause of avoidable blindness in children. The manifestations of congenital cataract are diverse and complex, often associated with other ocular structural abnormalities. The infantile eyeballs are in the growth and development stage, the structure of eyeball wall is fragile, and the blood-ocular barrier is immature. Therefore, congenital cataract surgery features relatively higher surgical technical requirements with higher postoperative complications occurrence. Congenital cataract is not a miniature version of age-related cataract, which has its own unique surgical principles. In this article, issues including the preoperative characteristics of congenital cataract, surgical timing and techniques, and follow-up treatment, were discussed based on expert clinical experiences of Zhongshan Ophthalmic Center and relevant literatures.(Chin J Ophthalmol, 2021, 57: 11-16)

Dry eye is a common ocular surface disease that can occur in part of patients before cataract surgery. A variety of incentives during the perioperative period can decrease the stability of the tear film, cause or aggravate dry eye symptoms, and therefore reduce the visual outcome and life quality of the patients. In order to standardize the management of dry eye during the perioperative period of cataract surgery, the Cataract Group of the Ophthalmology Branch of the Chinese Medical Association conducted a comprehensive discussion on the evaluation and improvement of the preoperative ocular surface conditions, the intraoperative ocular surface protection, as well as the diagnosis and treatment of postoperative dry eye. The consensus of opinions has been reached for reference of Chinese ophthalmologists. (Chin J Ophthalmol, 2021, 57:17-22)

Whether cataract extraction in high myopia is suitable for implantation of multifocal intraocular lens is controversial in clinic. This paper expounds the progress of fundus examination methods, the development of visual quality detection methods, the improvement of biological measurement accuracy, the optimization of intraocular lens calculation formula, the improvement of multifocal intraocular lens design and the improvement of surgical equipment and technology, etc. It is proposed that with the development of various cataract extraction surgical techniques, on the premise of selecting good indications, through strict preoperative examination, accurate calculation of intraocular lens power, selection of appropriate intraocular lens, accurate minimally invasive surgical operation and long-term standardized clinical follow-up, multifocal intraocular lens can obtain good clinical results in high myopia.(Chinese Journal of Ophthalmology, 2021, 57:23-27)

Whether to implant multifocal intraocular lenses in patients with high myopia and cataract is currently controversial. This paper expounds the problems faced by the implantation of multifocal intraocular lens in patients with high myopia and cataract, and the details that should be paid attention to when implanting multifocal intraocular lens in patients with high myopia and cataract. It is proposed that in view of the complex fundus lesions, poor biometric accuracy, poor intraocular lens fit, multiple intraoperative and postoperative complications and the increasing number of patients after refractive correction, the implantation of multifocal intraocular lens in patients with high myopia and cataract should not be rushed.(Chinese Journal of Ophthalmology, 2021, 57:28-33)

To investigate the changes of axial length, corneal refractive power, and refractive state in infants with congenital cataract surgery.

Retrospective cohort study. Medical records of 103 patients who underwent congenital cataract surgery in the Eye Hospital of Wenzhou Medical University Hangzhou Branch from January 1, 2015 to December 31, 2018 were reviewed. There were 61 boys and 42 girls in the study. The mean age at the surgery of 103 congenital cataract patients was (3.95±1.94) months. In patients receiving bilateral cataract surgery, only the left eye was selected for analysis. The patients were followed up for at least 1 year. The patients were divided into the groups of <4 months old and 4-12 months old according to the age at cataract surgery. The change in the axial length, corneal refractive power, and refractive state of each patient at 1 year after surgery was analyzed. Independent sample t-test, one way variance analysis and simple linear regression were used for statistical analysis.

There were 71 cases of bilateral cataract, including 33 in the group of <4 months old and 38 in the group of 4-12 months old, and 32 cases of unilateral cataract, including 17 in the group of <4 months old and 15 in the group of 4-12 months old. The change in the axial length of bilateral cataract children in the <4-month-old group was (2.46±1.33) mm at 1 year after surgery, which was greater than (1.52± 1.00) mm in the group of 4-12 months old ( t=3.21; P<0.01). In the same surgery age group, there was no significant difference in the change of axial length among bilateral cataract eyes, unilateral cataract eyes and the contralateral eyes at 1 year after surgery (bothP>0.05). One year after surgery, the axial length of the eyes in patients with bilateral cataract, the affected eyes and the fellow eyes in patients with unilateral cataract all was highly correlated with the logarithm of the actual age (r=0.68, 0.52, 0.73; all P<0.01). The corneal refractive power showed a decreased trend with the increase of age. The change in the corneal refractive power of the bilateral cataract children in the <4-month-old group at 1 year after surgery was (1.43±2.87) D, and in the group of 4-12 months old was (0.68±2.10) D, but the difference was not statistically significant (P>0.05). The chang in spherical equivalent of bilateral cataract children was (2.02±2.60) D in the <4-month-old group, greater than that in the group of 4-12 months old [(0.69±1.89) D;t=2.15; P<0.05]. The change of spherical equivalent one year after surgery in 4-12 months group, unilateral cataract eyes was significantly greater than that of bilateral cataract eyes [(2.05±0.95) Dvs.(0.69±1.89) D; t=2.49; P<0.05]. The spherical equivalent of both bilateral and unilateral cataract children was highly correlated with the actual age (r=-0.51, -0.54; both P<0.01).

The axial length is increased, the corneal refractive power is decreased, and the spherical equivalent is decreased at 1 year after surgery for congenital cataract in infants. The younger the age at cataract surgery, the greater the change in the axial length, myopia drift, and corneal refractive power.(Chin J Ophthalmol, 2021, 57: 34-40)

To evaluate the clinical safety and efficacy of A1-UV aspheric intraocular lens (IOL) implantation over the postoperative 5 years.

Prospective cohort study. The subjects came from a finished multicenter, randomized and controlled clinical trial with a follow-up period of 1 year from April to November 2012. The clinical research centers were Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Peking University Third Hospital, Tianjin Medical University Eye Hospital, and Daping Hospital of Army Medical University. Cataract patients in the experimental group were implanted with A1-UV type IOL, while cataract patients in the control group were implanted with SN60WF type IOL, and monocular patients were enrolled. From April to May 2018, patients enrolled in the previous study were recalled for follow-up and continued observation. The visual acuity, spherical equivalent, postoperative complications, non-contact intraocular pressure and subjective evaluation results were statistically analyzed preoperatively, at 1 to 2 days, 1 week, 1 month, 3 months, 6 months, 1 year and 5 years after operation. The main statistical methods included Mann Whitney Utest, Wilcoxon signed rank test, independent samplet test, chi square test and Fisher exact test.

A total of 42 subjects (22 in the experimental group and 20 in the control group) completed 5-year continuous observation. Among the 42 subjects, 28 were female and 14 were male. The age was (70±9) years, and the time from surgery to recall was (5.77±0.19) years. The age, gender distribution, left/right eye distribution, axial length, IOL power and nucleus hardness classification data of the experimental group and the control group were balanced and comparable (all P>0.05). At different visiting time points, there was no significant difference in the best corrected distance visual acuity (BCDVA), best corrected near visual acuity (BCNVA), uncorrected distance visual acuity (UCDVA) and uncorrected near visual acuity (UCNVA) between the groups (allP>0.05). At 5 years after operation, the UCDVA, BCDVA and BCNVA of the two groups were significantly improved compared with the baseline [allP<0.01; UCDVA was improved from 0.75 (0.30 to 1.30) to 0.10 (-0.10 to 0.70) in the experimental group and from 0.75 (0.30 to 1.60) to 0.20 (-0.10 to 0.80) in the control group; BCDVA was from 0.60 (0.10 to 1.00) to 0.00 (-0.10 to 0.54) in the experimental group and from 0.60 (0.10 to 1.60) to 0.10 (-0.10 to 0.50) in the control group; BCNVA was from 0.55 (0.00 to 1.10) to 0.10 (-0.10 to 0.60) in the experimental group and from 0.55 (0.10 to 1.60) to 0.10 (-0.20 to 0.60) in the control group], but there was no significant change in the UCNVA (bothP>0.05). There were no significant differences in the spherical equivalent, intraocular pressure, subjective evaluation of visual adverse symptoms, distance vision spectacle independence and comprehensive evaluation of satisfaction between the groups (allP>0.05). In the experimental group, one eye (4.5%) had an abnormal pupil, one eye (4.5%) had an abnormal IOL with a few particles on the surface of the IOL but no glistening, and 3 eyes (13.6%) had posterior capsular opacification (PCO); in the control group, one eye (5.0%) had an abnormal cornea, five eyes (25.0%) had abnormal IOLs [one eye (5.0%) had IOL calcification, and four eyes (20.0%) had IOL glistening], and one eye (5.0%) had PCO with posterior capsular folds and IOL tilt. There was no significant difference in PCO and IOL abnormality between the two groups (bothP>0.05), but there was significant difference in the occurrence of IOL glistening (P=0.04).

The long-term effect of A1-UV aspheric IOL on improving the UCDVA is stable and good, with high subjective satisfaction of patients, a low incidence of PCO, no glistening and good biocompatibility, over the postoperative 5 years. (Chin J Ophthalmol, 2021, 57: 41-47)

To compare the difference and agreement of corneal refractive power and astigmatism measured by the new swept-source anterior segment optical coherence tomography (SS-AS-OCT) device (CASIA2) and Scheimpflug imaging device (Pentacam) in age-related cataract patients.

In this cross-sectional study, 112 eyes of 112 patients with age-related cataract were examined before phacoemulsification in the Tianjin Medical University Eye Hospital from April to May 2020. The steep keratometry (Ks), flat keratometry (Kf), mean keratometry (Km), degree and axis of astigmatism of the corneal anterior and posterior surfaces and the total cornea were recorded. The difference in astigmatism was analyzed by the arithmetic method and the vector method. The difference of data was evaluated using Paired t test or Wilcoxon test. The agreement of data was evaluated using Bland-Altman plots.

The patients were 44 males and 68 females with an average age of (67±10) years. There were no statistically differences in the Ks and Km values of the corneal anterior surface between the Pentacam and the CASIA2 (both P>0.05). There was significant difference in the Kf values of the corneal anterior surface between the Pentacam and the CASIA2 [(44.24±1.73) Dvs. (44.14±1.64) D;t=2.278; P<0.05]. The Ks, Kf, and Km values of the posterior surface of the cornea measured by the Pentacam and the CASIA2 were (-6.60±0.29) Dvs. (-6.45±0.28) D, (-6.34±0.27) D vs. (-6.17±0.25) D, and (-6.47±0.26) D vs. (-6.31±0.25) D, respectively. The Ks, Kf, and Km values of the total cornea measured by the two instruments were (45.08±1.84) D vs. (43.94±1.64) D, (44.18±1.85) D vs. (43.02±1.64) D, and (44.63±1.82) D vs. (43.48±1.60) D, respectively. There were significant differences in the Ks, Kf, and Km values of the posterior surface of the cornea and the total cornea (t=-14.440, -13.522, -17.186, 21.016, 21.819, 22.981; all P<0.01). The degree and axis of astigmatism of the corneal anterior and posterior surfaces and the total cornea showed no statistically significant difference (allP>0.05). Vector operation results showed that the astigmatism difference vector (DV) of the Pentacam and the CASIA2 on the anterior surface of the cornea was 0.06 D@57°±0.64 D,>0.50 D in 47 eyes (41.96%). The astigmatism DV on the posterior surface of the cornea was 0.07 D@174°±0.21 D, >0.50 D in 2 eyes (1.79%). The astigmatism DV on the total cornea was 0.13 D@3°±0.69 D,>0.50 D in 59 eyes (52.68%). The results of the two devices were positively correlated (rvalues of the Ks, Kf, Km, and astigmatism degree on the anterior surface of the cornea were 0.970, 0.968, 0.976, and 0.697, respectively, on the posterior surface of the cornea were 0.918, 0.875, 0.925, and 0.517, respectively, and on the total cornea were 0.951, 0.955, 0.959, and 0.622, respectively; all P<0.01). Bland-Altman analysis showed that the Ks, Kf, Km, and astigmatism degree of the corneal anterior and posterior surfaces measured by the two devices were consistent, with 2.68% to 8.04% of the measured values outside 95% limits of agreement (95%LoA). The 95%LoA of the total corneal Ks, Kf, and Km between the two devices was 0.01 to 2.28 D, 0.06 to 2.27 D, and 0.10 to 2.20 D, respectively, with a wide 95%LoA range and poor consistency.

The corneal refractive power and astigmatism measured by the CASIA2 and the Pentacam shows little difference on the anterior surface of the cornea, with good agreement. However, the refractive power results of the posterior surface of the cornea and the total cornea show great difference, suggesting that these two instruments cannot be used interchangeably in clinical practice. (Chin J Ophthalmol, 2021, 57: 48-55)

To analyze the distribution characteristics of the anterior corneal astigmatism in 140 000 cataract patients from 18 hospitals in China.

Retrospective study. A total of 143 889 patients (143 889 right eyes) over the age of 40 years with age-related catarac were admitted to 18 Aier eye hospitals in China from July 2015 to October 2018. The average values of the three measurements of the magnitude of anterior corneal astigmatism, the meridian of corneal astigmatism, anterior chamber depth, corneal refractive power, and axial length measured by IOLMaster 500 were obtained. The data acquisition method of each sub-center was to collect and analyze the electronic case data in accordance with the inclusion and exclusion criteria, and to provide them for the sponsor Wuhan Aier Eye Hospital. Non-normal distribution data are presented as M(P₂₅, P₇₅). Mann-Whitney test, Kruskal-Wallis test, Chi-square test were used to analyze the distribution differences of the magnitude of corneal astigmatism and the meridian of corneal astigmatism in gender, age, anterior chamber depth, corneal refractive power and axial length.

Among the 143 889 patients, 84 319 were females and 59 570 were males, the median age was 72 (65, 78) years old, the median corneal astigmatism was 0.84 (0.51, 1.33) D; the corneal astigmatism was ≥0.75 D in 80 895 patients (56.22%) and was ≥1.00 D in 57 304 patients (39.83%). The median corneal astigmatism was 0.87 (0.53, 1.37) D in women and 0.82 (0.50, 1.29) D in men; with statistical difference (U=-14.891; P<0.05). The proportion of with-the-rule (WTR) astigmatism was 33.26% (28 046/84 319) for women and 34.26% (20 408/59 570) for men; The proportion of against-the-rule (ATR) astigmatism was 49.08% (41 385/84 319) for women and 46.91% (27 945/59 570) for men, with statistical difference (χ²=70.913;P<0.05). With the increase of age, the magnitude of corneal astigmatism first decreased from 0.94 (0.57, 1.48) D to 0.75 (0.46, 1.18) D, and then increased to 1.19 (0.74, 1.79) D, with statistical difference (H=1 263.438; P<0.05), and the change was at 61 to 70 years old. With the increase of age, the proportion of WTR astigmatism decreased from 77.50% (396/511) to 12.50% (3/24), the proportion of ATR astigmatism increased from 11.15% (57/511) to 79.07% (34/43), and the proportion of oblique astigmatism changed little from 17.02% (16/94) to 19.92% (245/1 230), the distribution difference was significant (χ²=10 174.496;P<0.05). As the anterior chamber became shallow, the magnitude of corneal astigmatism significantly increased from 0.82 (0.51, 1.31) D to 1.05 (0.61, 1.56) D, and the proportion of ATR astigmatism increased from 47.32% (60 207/127 227) to 51.69% (184/356) (H=409.961, χ²=120.995, both P<0.05). With the corneal refractive power rising, the magnitude of corneal astigmatism increased from 0.80 (0.49, 1.33) D to 0.95 (0.58, 1.53) D, the proportion of ATR astigmatism decreased from 52.84% (4 963/9 392) to 39.97% (9 023/22 577); the difference was significant (H=808.562, χ²=752.147, bothP<0.05). When the axial length was>25.00 mm, the magnitude of corneal astigmatism was highest [1.04 (0.62, 1.65) D], and the proportion of ATR astigmatism was also highest [49.00% (10 964/22 376)]; the difference was significant (H=2 071.198, χ²=131.130, all P<0.05).

The meridian of corneal astigmatism in middle-aged and elderly cataract patients is mainly ATR astigmatism. With the increasing of age, the magnitude of corneal astigmatism decreases first and then increases. The turning point from the proportion of WTR astigmatism to the proportion of ATR astigmatism is 65 years old. The shallower the anterior chamber is, the more the magnitude of corneal astigmatism and the proportion of ATR astigmatism increase. When the axial length is>25.00 mm, both the magnitude of corneal astigmatism and the proportion of ATR astigmatism reach the peak.(Chin J Ophthalmol, 2021, 57: 56-62)

To explore the visual outcome of cataract surgery and its influencing factors in China.

A case-control study. The information of 2 078 479 patients who underwent cataract extraction of 31 provinces (municipalities and autonomous regions) recorded in the National Cataract Surgery Information Reporting System during January to December, 2017 were analyzed. The postoperative visual outcomes of 3 days after surgery and 3 months after surgery were analyzed. The effects of age, gender, preoperative corrected visual acuity, past medical history, and surgical methods on the results of cataract surgery were analyzed. Surgery effect was divided into ideal effect, moderate effect and poor effect according to the best corrected visual acuity after operation. Wilcoxon rank sum test and multinomial logistic regression model were used for statistical analysis.

There were 1 197 942 female patients (57.64%) and 880 537 male patients (42.36%) in all 2 078 479 cases. The average age was (69±11) years old. The main type of cataract was age-related (1 928 440 cases; 92.78%). There were 1 608 385 cases, 1 126 961 cases and 389 020 cases with complete corrected visual acuity before surgery, 3 days after surgery and 3 months after surgery, respectively. The median difference of corrected visual acuity of preoperative versus three days after surgery, and preoperative versus three months after surgery were -0.48, -0.52 respectively (after logarithm of the minimum angle of resolution conversion). The interquartile ranges were 0.60 and 0.73 respectively. The differences were statistically significant (Z=551 599.30, 206 815.35; both P<0.01). Multivariate analysis showed that postoperative complications (moderate effect:OR=0.50, 95%CI: 0.46 to 0.55; ideal effect: OR=0.31, 95%CI: 0.28 to 0.33), preoperative pupil abnormal (moderate effect: OR=0.52, 95%CI: 0.44 to 0.61; ideal effect: OR=0.55, 95%CI: 0.47 to 0.63), preoperative intraocular pressure abnormalities (moderate effect: OR=0.86, 95%CI: 0.79 to 0.93; ideal effect: OR=0.45, 95%CI: 0.42 to 0.49), history of hypertension (moderate effect: OR=0.90, 95%CI: 0.85 to 0.95; ideal effect: OR=0.88, 95%CI: 0.83 to 0.93) and history of diabetes (moderate effect: OR=0.86, 95%CI: 0.80 to 0.93; ideal effect: OR=0.92, 95%CI: 0.86 to 0.99) were predictors of worse outcome. Good preoperative corrected visual acuity (0.2 to 0.4 for moderate effect: OR=2.20, 95%CI: 2.06 to 2.34; for ideal effect: OR=5.25, 95%CI: 4.94 to 5.59; 0.5 to 0.7 for moderate effect: OR=1.08, 95%CI: 0.96 to 1.21; for ideal effect: OR=6.35, 95%CI: 5.69 to 7.08; above 0.8 for moderate effect: OR=0.73, 95%CI: 0.60 to 0.89; for ideal effect: OR=6.58, 95%CI: 5.51 to 7.86), small incision extracapsular extraction (moderate effect: OR=3.19, 95%CI: 2.35 to 4.33; ideal effect: OR=6.79, 95%CI: 5.13 to 8.97) and phacoemulsification (moderate effect: OR=2.12, 95%CI: 1.60 to 2.81; ideal effect: OR=3.34, 95%CI: 2.59 to 4.32) were predictors of better outcome.

Visual acuity of patients in China improve significantly after cataract surgery. However, some patients still suffer moderate visual impairment. The effect of surgery can be affected by many factors, such as preoperative corrected visual acuity, preoperative intraocular pressure, preoperative pupil status, surgical approach and postoperative complications, etc. (Chin J Ophthalmol, 2021, 57: 63-70)

Tian Bei, MD, Chief Physician, Associate Professor. Member of the Standing Committee of the Chinese Institute of Sports Rehabilitation Education of the Chinese Medical Association, Member of the Sports Medicine Branch of the Chinese Medical Association, Member of the Optometry Group of the Ophthalmologist Branch of the Chinese Medical Doctor Association, Member of the Standing Committee of the Diabetes Professional Committee of the Chinese Geriatric Health Care Association, Member of the Ophthalmology Professional Committee of the Chinese Medical Equipment Association, Member of the Diabetes Ophthalmology Group of the Diabetes Professional Committee of the Chinese Research Hospital Association, and Member of the 12th Health and Wellness Committee of the China Democratic League. Senior visiting scholar of China Study Abroad Fund (State Administration of Foreign Experts), corresponding editorial board of Chinese Journal of Ophthalmology. Honorary research fellow, Royal Eye Hospital, Murphy, UK, and a member of the Vitreoretinal Surgery Association, UK and Ireland. He has been engaged in the first-line clinical work of ophthalmology in Beijing Tongren Ophthalmology Center, Beijing Tongren Hospital affiliated to Capital Medical University for more than 20 years. He is good at vitrectomy, phacoemulsification cataract aspiration, fundus laser surgery, etc. So far, he has more than 10,000 surgical experiences.

The patient was a 70-year-old female. Due to the loss of vision in his left eye for 1 year, he went to Jinan Mingshui Eye Hospital. Left eye phacoemulsification cataract aspiration intraocular lens implantation was performed 10 years ago. No previous history of systemic diseases such as hypertension and diabetes. Ocular examination: Left eye corrected visual acuity of 0.6 (-1.75 DS), IOP of 16 mmHg (1 mmHg =0.133 kPa), transparent cornea, deep anterior chamber, round pupil; The intraocular lens is centered, and the gap with the posterior capsule is enlarged; Fundus examination showed no obvious abnormalities. The examination of the anterior segment of the eye after dilated pupil is shown in A in Essence Picture 1. The observation image of IOL Master 700 new frequency sweeping optical biometry instrument shows that the space between the intraocular lens and the posterior capsule is enlarged, and the posterior capsule is bulged backward, showing high reflection inside it (B in Extract Picture 1). Coherence optical tomography examination of the anterior segment of the eye showed that the space between the intraocular lens and the posterior capsule was enlarged, and the posterior capsule bulged downward with intermediate reflection (C in Quintessential Picture 1). Diagnosis: Left eye lens capsular bag block syndrome.

Incomplete lens dislocation is mostly secondary to congenital, trauma or other ocular diseases, and the ocular symptoms are complex. At the same time, due to the occlusion of iris tissue, it is difficult to intuitively evaluate the scope and severity of suspensory ligament rupture, which makes its diagnosis and treatment more difficult. At present, there are no clinical guidelines in ophthalmology for the treatment of incomplete lens dislocation. The choice of refractive glasses correction or surgical treatment, surgical timing and surgical plan have a profound influence on the prognosis of patients and the improvement of visual quality. By exploring various clinical examination methods, evaluating surgical indications, paying attention to intraoperative operation, paying attention to intraocular lens stability and strengthening postoperative follow-up, this paper proposes that comprehensive and meticulous examination and diagnosis should be carried out for patients with incomplete lens dislocation, strict selection of surgical indications and surgical opportunity, and individual treatment plan design should be carried out to maximize the visual quality of patients and improve the prognosis.(Chinese Journal of Ophthalmology, 2021, 57:72-76)