To investigate the characteristics and associated factors of intraocular lens (IOL) tilt and decentration after transscleral suture-fixated IOL surgery in congenital ectopia lentis (CEL).

CEL patients undergoing transscleral suture-fixated IOL surgery were divided into two groups based on implanted IOL type (three-piece IOL or one-piece IOL). The IOL tilt and decentration at 3-month and 1-year postoperative were measured. Multivariate regression analyses were performed to identify the associated factors of IOL tilt and decentration as well as longitudinal changes.

The 61 CEL patients (mean age 9.07±5.05y) in three-piece IOL (M/F: 14/7) group had a greater tilt than those with one-piece IOL (M/F: 28/12) group both at 3-month postoperative (horizontal: P=0.024; vertical: P=0.048) and 1-year postoperative (horizontal: P=0.011; vertical: P=0.001). Three-piece IOL group had a greater longitudinal change between 3-month postoperative to 1-year postoperative in IOL tilt (horizontal: P=0.028; vertical: P=0.026) and a greater longitudinal change in horizontal IOL decentration than one-piece IOL group (P<0.05). The longer axial length (AL) was associated with the longitudinal changes in IOL tilt (P=0.039), while the three-piece IOL was associated with the longitudinal changes in horizontal IOL decentration 1-year postoperatively (P=0.011).

IOL tilt is greater in the three-piece IOL group than that in the one-piece IOL group 1-year postoperatively. The three-piece IOL is associated with greater longitudinal changes of IOL decentration, while longer AL is associated with longitudinal changes of IOL tilt. For CEL patients, more stable IOL type should be selected and patients with longer AL warrant closer monitoring.

To explore the hotspots and frontiers of genetic research on pediatric cataracts.

Global publications from 2013 to 2022 related to genes in pediatric cataracts were extracted from the Web of Science Core Collection, and were analyzed in terms of the publication counts, countries, journals, authors, keywords, cited references, subject categories, and the underlying hotspots and frontiers.

Totally 699 publications were included in the final analysis. The predominant actors were identified, with China (n=240) and PLoS One (n=33) being the most productive country and journal respectively. The research hotspots extracted from keywords were crystallin gene mutations, pathogenicity evaluation, phenotypes of ocular and neurodevelopmental abnormalities, genes encoding membrane proteins, and diagnosis of multisystemic disorders. The co-cited articles formed 10 clusters of research topics, including FYCO1 (56 items), mutation screening (43 items), gap junction (29 items), the Warburg Micro syndrome (29 items), ephrin-A5 (28 items), novel mutation (24 items), eye development and function (22 items), cholestanol (7 items), OCRL (6 items), and pathogenicity prediction (3 items). The research frontiers were FYCO1, ephrin-A5, and cholestanol. Cell biology showed the strongest bridging effects among different disciplines in the field (betweenness centrality=0.44).

With the progress in next-generation sequencing and multidisciplinary collaboration, genetic research on pediatric cataracts broadens the knowledge scope of the crystalline lens, as well as other organs and systems, shedding light on the molecular mechanisms of systemic diseases. Cell biology may integrate multidisciplinary content to address cutting-edge issues in the field.