bluuebunny/crossref_metadata_2025_split huggingface dataset:
Phacoemulsification without hydroprocedure
Authors: Bardoloi Narayan , Sarkar Sandip , Das Himangshu , Burgute Pankaj S. 
Published: May 2024

PURPOSE:
The purpose of the study was to describe a new phacoemulsification technique without hydroprocedures in patients of posterior polar cataract (PPC) and determine the posterior capsular rupture (PCR) and postoperative outcomes.

METHODS:
We conducted a retrospective study with 115 eyes of 77 patients. After capsulorhexis, we insert the phaco tip inside the eye and do shaving of the cortex and epinucleus within the capsulorhexis area. The tip of the phacoemulsification probe is buried deep into the center of the nucleus and a anterior-poserior crack is fashioned. Then, the tip is placed at 7 o'clock position to chop away a triangular piece of the nucleus. A similar maneuver is done at 4 o'clock position to take out another piece. The phacoemulsification tip and the chopper are now positioned at the cracked site of the lower fragments. Using the two instruments, the fragments are now pushed away and easily emulsified.

RESULTS:
The mean age of the study population was 51.87 ± 14.19 years (range: 22–87 years). Of 77 patients, 39 (50.64%) patients had unilateral PPC and 38 (49.35%) had bilateral PPC. PCR occurred in 9 eyes (7.82%), among them two patients had fragment drop and only 1 (0.87%) patient was left aphakic. Best-corrected visual acuity (BCVA) at postoperative day 30 was 20/20 or better in 102 (88.69%) eyes, 20/32–20/80 was in 11 (9.56%) eyes, and BCVA 20/80–20/200 was in 2 (1.73%) eyes.

CONCLUSION:
Phacoemulsification without hydroprocedure is a novel technique that can be successfully implemented in cases of PPC and can expect an excellent visual outcome.
Changing trends in the corneal transplantation and the impact of the COVID-19 pandemic on corneal transplant recipient selection
Authors: Tanyildiz Burak , Oklar Murat , Günaydın Nesrin T. , Kandemir Baran 
Published: May 2024

PURPOSE:
The aim of this study was to analyze the trends in the major indications and types of keratoplasty over a 15-year period and to determine the effect of the coronavirus disease-2019 (COVID-19) pandemic on the selection of corneal transplant recipients at a tertiary referral center in Turkey.

METHODS:
We retrospectively reviewed the data of patients who underwent keratoplasty at the center from January 2006 to March 2021. The keratoplasty indications and types of surgery were evaluated after classification into three groups (period I – January 2006–December 2012; period II – January 2013–March 2020; COVID-19 period – April 2020–March 2021).

RESULTS:
A total of 5016 corneal transplants were performed in 3862 patients. Lamellar keratoplasty (LK) techniques were found to demonstrate a statistically significantly increasing trend compared to penetrating keratoplasty in the period between 2006 and 2021 (χ2 = 240.55, P < 0.001). The top 4 indications over the 15-year period were aphakic/pseudophakic bullous keratopathy (BK) (1105, 22%), keratoconus (1085, 21.6%), regraft (1084, 21.6%), and keratitis (645, 12.8%). The most common keratoplasty indication during the COVID-19 period was regraft (27, 54.0%), followed by BK (13, 26.0%) and corneal perforation (5, 10%).

CONCLUSION:
BK was the most common keratoplasty indication at our clinic during the 15-year period. LK rates have been found to increase in recent years, although still not reaching the rates of developed countries. There was a marked decrease in the number of keratoplasties during the COVID-19 pandemic and patients requiring urgent keratoplasty or those who suffered from a painful eye were prioritized.
Assessing public awareness of daily eyelid hygiene habits in Saudi Arabia
Authors: Alhamazani Manal A. , Alnabri Maram S. , Alreshidi Meshael N. , Alsulaiman Hamad M. , Strianese Diego , Althaqib Rawan N. 
Published: May 2024

PURPOSE:
Incidences of ocular conditions, including meibomian gland dysfunction (MGD), blepharitis, and dry eye have been increasing globally. Eyelid hygiene is key to maintaining ocular surface health and improving ocular symptoms. This study investigated the awareness of eyelid hygiene among the Saudi population.

METHODS:
This cross-sectional survey was conducted between April 2020 and May 2020 across all regions of Saudi Arabia through the distribution of an electronic self-administered questionnaire among the Saudi population.

RESULTS:
A total of 1102 responses were received (women, 76.3%; men, 23.7%). Only 33.2% respondents reported consciously washing their eyelids, while 70.1% had never heard about MGD; however, most of the respondents (93.2%) had heard about dry eye. Based on the questionnaire results, the Saudi population had suboptimal (18.4%) level of awareness of eyelid hygiene. At least one ocular symptom was reported by 98.1% of the respondents.

CONCLUSION:
The level of awareness of eyelid hygiene in Saudi Arabia was found to be suboptimal, particularly among patients with MGD and dry eyes. Poor knowledge about the benefits of daily eyelid hygiene was the primary barrier to its practice. We recommend that ophthalmologists raise awareness of good eyelid hygiene among patients with MGD and eye dryness. Despite the current findings, further studies and evidence are required before recommending daily eyelid hygiene practices in the general population, including those without clinical symptoms of MGD or eye dryness.
Long-term clinical outcomes obtained with bilateral implantation of a multifocal intraocular lens through two different-sized corneal incisions
Authors: Karmiris Efthymios , Chalkiadaki Evangelia , Papakonstantinou Evangelia , Georgalas Ilias 
Published: May 2024

PURPOSE:
To evaluate the long-term visual function and patient satisfaction in patients implanted bilaterally with the same type of multifocal intraocular lens (MIOL), using either a 2.2 mm small corneal incision with bimanual irrigation/aspiration (I/A) or a conventional 2.75 mm incision with coaxial I/A.

METHODS:
Prospective nonrandomized study including 100 eyes of 50 patients who underwent bilateral implantation of ReSTOR SN6AD1 through a 2.2 mm or 2.75 mm corneal incision. Outcomes included visual function measures (near, intermediate, and distance visual acuity [VA]), achievement of targeted refraction and postoperative astigmatism. Patient satisfaction was evaluated using a subjective questionnaire.

RESULTS:
Three and 12 months postoperatively, distance uncorrected best VA (UBVA) was 0.98 ± 0.07, UBVA at 30 cm was J1 in 100% of cases and UBVA at 60 cm was J3 in 72% of cases. Targeted refraction was achieved in 84% of cases and postoperative astigmatism was −0.4 ± 0.3 diopters. There was no statistically significant difference in UBVA in all distances, targeted refraction and postoperative astigmatism between the small-incision bimanual and the conventional coaxial group. Sixty percent of the patients were satisfied, 30% were very satisfied and 10% declared that the result did not meet their expectations. Three out of 5 nonsatisfied patients had an angle kappa of 4° and the MIOL was not well-centered.

CONCLUSION:
An incision size of 2.2 mm compared to 2.75 mm, did not appear to result in less surgically induced astigmatism after the implantation of a MIOL. SN6AD1 is a reliable MIOL choice for spectacle independence. Good preoperative patient selection is of crucial importance for the outcome in MIOLs.
Demographic and clinical variations of keratoconus in Saudi population
Authors: Al Qahtani Nasser A. , Abahussin Mohammad O. , Assiri Abdullah A. 
Published: May 2024

PURPOSE:
The aim of this prospective study was to identify the demographic and clinical variations of keratoconus (KC) in Saudi Arabia.

METHODS:
A self-administered survey was completed by patients in Saudi hospitals. The survey included questions on demographics, educational level, treatment options, dry eye, eye rubbing because of allergy, residence, family history, and consanguineous marriage.

RESULTS:
Six hundred and forty-eight patients (375 – male, 273 – female; mean age: 26.89 [standard deviation: 7.04] years; range: 11–50 years) were conducted at 13 central hospitals in all 13 administrate areas of Saudi Arabia over a 1-year period. Five hundred and forty-three (83.8%) patients had a secondary school diploma or diploma's degree of education and mostly were from the Aseer and Riyadh regions. The geographical distribution rate of KC was highest in the mountainous areas. For dry eye, 21.9% and 44.8% of the patients, respectively, reported frequent or occasional dryness and 13.4% and 48.9% of the patients, respectively, reported frequent or occasional bouts of eye allergy. Furthermore, 17.9% and 61.9% of the patients, respectively, reported that they constantly or sometimes rubbed their eyes. Marriages were endogamous in 53.5% of the patients and the family history was positive by 56.8%. There was a history of ocular disease in 27% of the patients and the systemic disease was 13%.

CONCLUSION:
This study is the first to describe the regional demographic and clinical variations of KC in Saudi Arabia. Its findings suggest that the different distribution of keratoconic patients between provinces is attributable to genetic and/or environmental factors.
Prevalence of refractive errors in school-going children of Taif region of Saudi Arabia
Authors: AlThomali Talal A. , AlQurashi Majed , AlGhamdi Abdulhamid S. , Ibrahim Afra , AlSwailmi Farhan K. 
Published: May 2024

PURPOSE:
To determine the prevalence of refractive errors in the pediatric population in Taif, Saudi Arabia.

METHODS:
This cross-sectional study included 7356 eyes of 3678 primary and secondary school children (males = 1837; females = 1841) with a mean age of 11.8 ± 2.2 years (range: 7–18) (males = 11.4 ± 2.0 [range: 8–16]; females = 12.2 ± 2.3 [range: 7–18]). All participants were selected from the school registers. The participants underwent noncycloplegic refraction to determine refractive errors. Students who refused visual acuity assessment or eye examination and were inconsistent in visual acuity assessment were excluded.

RESULTS:
The manifest refraction spherical equivalent of the study population was 0.37 ± 1.52 D (range from − 18.4 to 8.8 D) (males = −0.32 ± 1.4 D [range − 15.88–8.8 D]; females = −0.42 ± 1.6 D [range − 18.38–8.0 D]). The overall prevalence of uncorrected refractive errors among school children in this study was 50.91%. The overall distribution of astigmatism (cylinder error of ≥0.50 D) in the current study population was found to be 50.14% (3688/7356 eyes).

CONCLUSION:
Nearly half of the study population in this area was affected with at least one type of refractive error. The findings reveal the necessity for implementing timely and sensitive screening programs/methods to identify and correct refractive errors in this age group.
Accelerated versus conventional corneal collagen crosslinking
Authors: Aldairi Walaa , AlQahtani Reham , Alzaid Salem , Mousa Ahmed , Khandekar Rajiv , Al-Swailem Samar A. 
Published: May 2024

PURPOSE:
The purpose of the study is to compare the short-term outcomes of corneal collagen crosslinking (CXL) using the conventional (Dresden) protocol and an accelerated CXL (ACXL) protocol to stop keratoconus (KC) progression.

METHODS:
A chart review was performed for all the patients with KC who underwent CXL in the last 7 years. Data were compared at baseline and at all follow-up examinations for uncorrected visual acuity (UCVA), best spectacle corrected visual acuity (BCVA), keratometry (K), central corneal thickness, and complications of CXL. Pre- and post-intervention values were compared for each group. P < 0.05 was statistically significant.

RESULTS:
After the treatment, there was a statistically greater improvement in UCVA in the conventional CXL (CCXL) group (49%) compared to the ACXL group (34%) (P = 0.028). The improvement in BCVA was similar between the groups (P = 0.060). Gain of two lines of UCVA and stability were comparable between groups (P = 0.078 and P = 0.060, respectively). The average flat K and steep K values fluctuated remarkably across different follow-up assessments in both the groups. At 3 months of follow-up, there was a statistically significantly faster return to baseline levels of flat and steep Ks in the CCXL group (P = 0.028 and P = 0.002, respectively).

CONCLUSION:
The findings of the current study confirm the efficacy and safety of accelerated high-fluence CXL compared to CCXL. Both protocols were effective in stabilizing KC at 9th-month and the last follow-up visit. Larger prospective randomized controlled trials and longer follow-up are required to confirm our findings.
Comparison of optical low coherence interferometry and Scheimpflug imaging combined with partial coherence interferometry biometers in cataract eyes
Authors: Kim Moonjung , Han Eui S. 
Published: May 2024

PURPOSE:
The purpose of the study was to evaluate the agreement between measurements by optical low-coherence interferometry (OLCI, Aladdin) and those by Scheimpflug imaging combined with partial coherence interferometry (Scheimpflug-PCI, Pentacam AXL) in cataract patients.

METHODS:
This was a retrospective comparative study conducted in the United Arab Emirates. Axial length (AL), corneal power (keratometry, K), anterior chamber depth (ACD), and corneal astigmatism in patients with cataracts were measured with both devices. Difference and correlation were evaluated with paired t-test (p) and Pearson's correlation coefficient®, respectively.

RESULTS:
A total of 164 eyes of 95 patients were analyzed (164 eyes for K, 155 for ACD, and 112 for AL). The mean AL taken by OLCI was longer than that by Scheimpflug-PCI (23.25 mm vs. 23.23 mm, P ≤ 0.0001), showing an excellent correlation between the two (r = 0.9990). ACD measured by OLCI was 0.08 mm shallower than that by Scheimpflug-PCI (P = 0.0003, r = 0.7386). Corneal power measured by OLCI was lower than that by Scheimpflug-PCI (differences in mean K, flat K, and steep K were 0.05 diopters (D), 0.08 D, and 0.02 D, respectively), showing very strong correlations between the two devices (r = 0.9614, 0.9445, and 0.9535, respectively). Only flat K values measured with the two devices were significantly different (P = 0.0428). There were no statistically significant differences in the magnitude of astigmatism or J45 vector between the two devices (P = 0.1441 and P = 0.4147, respectively). However, J0 vector values were significantly different (P = 0.0087).

CONCLUSION:
Although OCLI and Scheimpflug-PCI showed strong correlations for measurements of AL, K, ACD, and corneal astigmatism in cataract patients, there were small but statistically significant differences in AL, ACD, flat K, and J0 vector. Thus, these two devices are not interchangeable for calculating intraocular lens power.
Conditional survival of uveal melanoma using The Cancer Genome Atlas (TCGA) classification (Simplified Version) in 1001 cases
Authors: Shields Carol L. , Dockery Philip W. , Mayro Eileen L. , Bas Zeynep , Yaghy Antonio , Lally Sara E. , Orloff Marlana , Sato Takami , Shields Jerry A. 
Published: May 2024

PURPOSE:
To understand conditional prognostic value of the Cancer Genome Atlas (TCGA) for uveal melanoma metastasis based on event-free survival at 1, 2, 3, 4, and 5 years.

METHODS:
A retrospective study of eyes with uveal melanoma categorized according to TCGA and studied for nonconditional and conditional risks for metastasis at 5 and 10 years.

RESULTS:
Of 1001 eyes with uveal melanoma, the nonconditional (standard, at presentation) 5-year/10-year metastatic rate was 18%/25%. The conditional 5-year/10-year metastatic rate (for those without metastasis at 2 years) revealed 10%/18% and the conditional 10-year metastatic rate (for those without metastasis at 5 years) revealed 9%. The TCGA categories included Group A (n = 486, 49%), B (n = 141, 14%), C (n = 260, 26%), and D (n = 114, 11%). The non-conditional 5-year/10-year metastatic rate revealed Group A (4%/6%), Group B (12%/20%), Group C (23%/49%), and Group D (60%/68%). The conditional 5-year/10-year metastatic rate (for those without metastasis at 2 years) revealed Group A (2%/5%), Group B (8%/18%), Group C (21%/40%), and Group D (38%/50%). The conditional 10-year metastatic rate (for those without metastasis at 5 years) revealed Group A (2%), Group B (10%), Group C (33%), and Group D (20%). The peak incidence of metastasis for Groups A and B occurred during years 5–6, C during years 4–6, and D during years 1–2.

CONCLUSION:
Survival outcomes for uveal melanoma as non-conditional (at presentation) and conditional (event-free survival during follow-up) reveal reduction in metastatic rate over time. For those with 5-year metastasis-free survival, the 10-year conditional risk for metastasis was 9%.
Preoperative universal screening for COVID-19 in patients undergoing ophthalmic surgeries
Authors: Al-Essa Rakan S. , Alkharashi Majed S. 
Published: May 2024

PURPOSE:
This study aims to determine the frequency of coronavirus disease-2019 (COVID-19) among patients scheduled for elective and emergency ophthalmic surgeries in a tertiary eye care center in Saudi Arabia.

METHODS:
This observational retrospective study was performed between June 1, 2020, and October 31, 2020, in a single tertiary eye care center in Riyadh, Saudi Arabia. All patients who were given appointments for elective or emergency surgeries were included in the study. All patients underwent preoperative nasopharyngeal and oropharyngeal reverse transcription-polymerase chain reaction testing for severe acute respiratory syndrome coronavirus-2 virus. Retrospective chart review of all patients who tested positive for COVID-19 was performed for the demographic and clinical information; presence of symptoms upon presentation, nature, and urgency of the scheduled surgical intervention; and the overall outcomes.

RESULTS:
A total of 727 patients were scheduled for elective or emergency ophthalmic surgeries during the study period. The mean age of all patients was 61.3 years, 407 were males (55.9%) and 320 were females (44.1%). Of 727 patients tested for COVID-19, the test was positive in 17 (2.3%) patients. All patients who tested positive for COVID-19 were asymptomatic at the time of swabbing. No patient-related perioperative complications or health-care workers’ affection secondary to exposure to positive cases were documented.

CONCLUSION:
The study showed that almost 1 in 43 patients scheduled for elective or emergency ophthalmic surgeries may be positive for COVID-19. All positive cases were asymptomatic at the time of swabbing, underscoring the importance of the routine preoperative screening for COVID-19.
Regulatory Mechanism of Xiaozheng Tongluo Method on Hepatic Lipid Metabolism in ApoE-/- Mice: Insights from the Sterol Regulatory Element-binding Protein-2/3-hydroxy-3-methylglutaryl Coenzyme A Reductase/Low-density Lipoprotein Receptor Signaling Pathway
Authors: Zhang Xin , Ge Jian-Li , Su Kun , He Jian-Ming , Zhang Min-Mei , Zhang Jing , Ma Yun-Long , Sun Yun-Chao , Chu Xin-Qiang 
Published: May 2024

Objective:
The objective of the study was to explore the regulatory mechanism of the Xiaozheng Tongluo method on lipid metabolism in liver tissue based on the sterol regulatory element-binding protein-2/(SREBP2)/3-hydroxy-3-methylglutaryl coenzyme A reductase (HMGCR)/low-density lipoprotein receptor (LDLR) signaling pathway.

Materials and Methods:
C57BL/6 mice were selected as the blank group. The apolipoprotein E-deficient (ApoE-/-) mice were randomly divided into the model group, traditional Chinese medicine (TCM) group, and control group. The general condition of the mice was determined by the mouse’s state and liver weight. Liver hematoxylin and eosin staining and Oil Red O staining were used to observe the pathological changes and lipid droplet deposition of the liver. The protein expression levels of SREBP2, HMGCR, and LDLR were detected by Western blotting and polymerase chain reaction.

Results:
(1) The rats in the model group were in poor condition, and their liver weight increased significantly. Compared with the model group, the condition of the TCM group and the control group improved to varying degrees, and their liver weight decreased significantly. (2) Compared with the normal group, the hepatocytes in the model group were arranged in a disorderly manner, and the red-stained lipids of stem cells increased significantly. Compared with the model group, the degree of liver lesions in the control group and TCM group was reduced, and the red-stained lipid of hepatocytes was significantly reduced. (3) Compared with the blank group, the expression of SREBP2 and HMGCR protein in the model group increased significantly, and the expression of LDLR protein decreased significantly (P < 0.05). Compared with the model group, the expression of SREBP2 and HMGCR protein in the TCM group decreased significantly, and the expression of LDLR protein increased significantly (P < 0.05).

Conclusions:
The method detailed in this paper can increase the expression of SREBP2 and HMGCR protein and decrease the expression of LDLR protein, thus regulating liver cholesterol metabolism and delaying the progression of atherosclerosis.
Արևելահայերենի բայի եղանակների աբեղյանական մեկնաբանությունը՝ դիտարկված արդի լեզվաբանության տեսանկյունից
Authors: Ավետյան Սարգիս 
Published: May 2024

Փաստարկվում է, որ արդի արևելահայերենի այսպես կոչված ըղձական եղանակի և ենթադրական/պայմանական եղանակի ավանդական մեկնաբանությունը (որն առաջարկվել է Մ․ Աբեղյանի կողմից) առարկություն է հարուցում ընդհանուր լեզվաբանության և լեզվաբանական տիպաբանության տեսանկյունից։ Բանն այն է, որ արդի արևելահայերենի ըղձականը համատեղում է տիպաբանորեն հայտնի ստորադասականի և ըղձականի իմաստային գործառույթների մեծ մասը, հետևաբար բառիս բուն իմաստով ըղձական (optativus) չէ։ Ավելի տեղին կլիներ այն բնորոշել որպես ստորադասաըղձական։
Ինչ վերաբերում է արդի արևելահայերենի կ(ը)- ապառնիին (որն ավանդաբար ոչ ճիշտ կերպով մեկնաբանվում է որպես ենթադրական/պայմանական եղանակ), իրականում այն չի տարբերվում այլ լեզուների սահմանական ապառնիից իմաստագործառութային տեսնակյունից։ Ինչպես ցույց են տվել մի շարք հետազոտողներ, ապառնի ժամանակը երբեք մաքուր ժամանակային կարգ չէ․ ապառնիությունն անհրաժեշտաբար ներառում է կանխատեսման տարր կամ դրան առնչակից որևէ եղանակային հասկացություն։ Ըստ այդմ՝ արդի արևելահայերենի կ(ը)- ապառնին նույնպես ներառում է և՛ ժամանակային և՛ եղանակային իմաստային բաղադրիչներ, որոնց հարաբերակցությունը կարող է տարբեր լինել՝ կոնկրետ համատեքստից և բայաձևի դեմքից կախված։ Սակայն կ(ը)- ապառնիի համապատասխան անցյալի ձևերը արդի արևելահայերենում հիմնականում գործառում են որպես պայմանական եղանակ (conditionalis)։
The Evolution of Legal Assistance
Authors: Danielyan Gevorg 
Published: May 2024

The article reveals the evolution of the legal foundations of legal support in the countries that gained independence in the post-Soviet era, as well as its socio-political and ideological antecedents based onthe example of Armenia. Particularly, it is shown, that in the Soviet state legal system, the positions regarding the advocacy, at least as a part of the state structure, have not been completely overcomed, but are accompanied by new excuses.
On the other hand, we discussed the problem that formation of an advocacy called to guarantee the right to a fair trial is obstacled by the so-called «state mentality».
In particular, an advocade is perceived as a litigant who defends criminals by all means, therefore a state is not obliged to «excessively» cover the needs of free legal support.
The article thoroughly discusses the prerequisites for the evolution of legal assistance/legal support, especially the factor of legal culture, clear positions are expressed relating the issues arising from the scientific and practical dimension, and for overcoming the existing problems, and a number of legislative recommendations are offered, reference was made in a form of predictions.