自体血清滴眼液治疗严重干眼症的疗效:前瞻性随机病例对照研究

Purpose: To evaluate the effectiveness of the autologous serum eyedrops in the treatment of severe dry eye patients. Design: Prospective randomized case- control study. Methods: Thirty- seven eyes of twenty severe dry eye patients without punctal occlusion were enrolled in this study. After 2 weeks of washout, they were randomly assigned to two groups. Group A patients used only preservative- free artificial tears, and group S patients used only autologous serum eyedrops. We evaluated the results of Schirmer test, fluorescein and rose bengal staining scores, tear film breakup time (BUT), and subjective symptom scores before and 2 weeks after treatment. Results: Mean BUT and fluorescein and rose bengal staining scores, as well as subjective symptom scores, showed significant improvement in the patients assigned to autologous serum eyedrops compared with subjects assigned to preservative- free artificial tears after 2 weeks of treatment. Conclusions: Autologous serum eyedrops were found effective in the treatment of severe dry eye disease, as evidenced by improvement of tear stability and ocular surface vital staining scores.

连续性功能性视力测定系统在干眼症中的应用

Purpose: To evaluate the efficacy of a new continuous functional visual acuity measurement (FVAM) system for the assessment of dry eye patients. Design: Prospective comparative study. Methods: Monocular recognition acuity measured continuously by the FVAM system during a 30- second blinkfree period was defined as functional visual acuity (FVA). Examinations using the FVAM system were conducted in 35 eyes of 20 healthy controls and 19 eyes of 13 dry eye patients. Tear function examinations including the Schirmer test, tear film break- up time, and fluorescein and Rose Bengal staining were performed in all subjects. Functional visual acuity and tear functions were also examined before and after insertion of punctumplugs in dry eye patients. Functional visual acuity results at 10, 20, and 30 seconds were compared. Results: Functional visual acuity in dry eyes were significantly lower than control subjects at all time points (P < .05). Functional visual acuity after punctum plugs insertion improved significantly at all time points (P < .05).Conclusions: FVAM system seemed not only to be an effective tool in the assessment of dynamic visual acuity changes in dry eye and normal subjects but in evaluating the outcome of management of dry eye disease by punctum plugs.

代谢综合征可作为非酒精性脂肪性肝病的一个预测因素

Background: The frequent association of nonalcoholic fatty liver disease with components of the metabolic syndrome such as obesity, hyperglycemia, dyslipidemia, and hypertension is well known. However, no prospective study has examined the role of the metabolic syndrome in the development of this disease. Objective: To characterize the longitudinal relationship between the metabolic syndrome and nonalcoholic fatty liver disease. Design: A prospective observational study. Setting: A medical health checkup program in a general hospital. Participants: 4401 apparently healthy Japanese men and women, 21 to 80 years of age, with a mean body mass index (BMI) of 22.6 kg/m2 (SD, 3.0). Measurements: Alcohol intake was assessed by using a questionnaire. Biochemical tests for liver and metabolic function and abdominal ultrasonography were done. Modified criteria of the National Cholesterol Education Program Adult Treatment Panel III were used to characterize the metabolic syndrome. Results: At baseline, 812 of 4401 (18%) participants had non-alcoholic fatty liver disease. During the mean follow-up period of 414 days (SD, 128), the authors observed 308 new cases (10%) of nonalcoholic fatty liver disease among 3147 participants who were disease-free at baseline and who completed a second examination. Regression of nonalcoholic fatty liver disease was found in 113 (16%) of 704 participants who had the disease at baseline and who completed a second examination. Men and women who met the criteria for the metabolic syndrome at baseline were more likely to develop the disease during follow-up (adjusted odds ratio, 4.00 [95%CI, 2.63 to 6.08] and 11.20 [CI, 4.85 to 25.87], respectively). Nonalcoholic fatty liver disease was less likely to regress in those participants with the metabolic syndrome at baseline. Limitations: Ultrasonography may lead to an incorrect diagnosis of nonalcoholic fatty liver disease in 10%to 30%of cases and cannot distinguish steatohepatitis from simple steatosis. Selfreported alcohol intake may cause bias. Because all of the participants were Japanese, generalizability to non-Japanese populations is uncertain. Conclusions: The metabolic syndrome is a strong predictor of nonalcoholic fatty liver disease.

弧形刀片在白内障手术中的临床评价

Purpose: To evaluate the efficacy of the arched blade for making clear corneal incisions in cataract surgery. Methods: This prospective study comprised 112 ey es of 74 patients scheduled for cataract surgery. Temporal clear corneal incisio ns were made with either a 3.2-mm conventional flat blade or the arched blade. The choice of knife was randomly assigned. Two surgeons, one with substantial ca taract surgery experience and the other with less experience, performed the surg ery. Corneal topography and aberration were examined pre-and postoperatively. T he degree of surgically induced astigmatism (SIA) and high order aberration was analysed. The self-sealing ability of the wound was also compared between both blades. Results: For the less experienced surgeon, the degree of SIA was signifi cantly higherwith the 3.2-mmflat blade thanwith the 3.2-mm arched blade as mea sured at any time during postoperative follow-up. For the more experienced surg eon, the degree of high order aberration increased significantly with the 3.2-m m flat blade. The incision’s self-sealing ability was significantly better whe n the wound was made with the arched blade rather than with the flat blade. Conc lusion: The arched blade proved to be effective in reducing surgically induced a stigmatism and high order aberration in cataract surgery, particularlywhen used by the less experienced surgeon. Using the arched blade should lead to better wo und self-sealing and, therefore, safer surgical results.