Ocuton S眼压计自测法:青光眼患者的眼压测量准确性评价

Background: To compare two methods of measuring intraocular pressure (IOP) and to evaluate whether repeated measurements taken with the Ocuton S applanation s elf-tonometer can improve reliability. Methods: Ocuton S and Goldmann applanati on tonometry (GAT), and corneal thickness measurements taken with the Orbscan to pography system, were successfully performed in 64 of 68 glaucoma patients. Resu lts: The median IOPs were 15.5mmHg using GAT, and 16 mmHg using the first self- taken Ocuton S measurement (n=64). The differences between the median of the GAT measurements and the first Ocuton S measurement, and the medians of the three a nd six separate Ocuton S measurements were within 3 mmHg in 52%, 59%and 67%of cases, respectively. The mean corneal thickness of all evaluated eyes was 545.3 μm. There was no effect of corneal thickness on the accuracy of either of the two devices (P > 0.05). Conclusion: Repeated measurements can improve the reliab ility of the Ocuton S. However, ever with repeated measurements only every secon d patient succeeds in obtaining reliable measurements.

光学材料和外观设计对前囊混浊和撕囊收缩的影响

PURPOSE: To examine the influence of optic material (silicone and hydrophobic acrylic) and haptic design (one-piece and three-piece open loop) of sharp optic edge intraocular lenses (IOL) on anterior capsule opacification (ACO) and capsulorrhexis contraction. DESIGN: Randomized,controlled,double-blind clinical trial with intraindividual comparison. METHODS: This study was performed at the Department of Ophthalmology,Medical University of Vienna,Austria,and comprised 210 eyes of 105 patients with bilateral age-related cataract. In group 1 (n=53 patients),a three-piece acrylic IOL was compared with a three-piece silicone IOL. In group 2 (n=52 patients),the three-piece acrylic IOL was compared with the one-piece acrylic IOL. One year after the operation,standardized digital slit-lamp images of ACO were taken; 1 week and 1 year after the operation,digital retroillumination images were taken to assess capsulorrhexis size. The intensity of ACO was graded objectively (score,0% to 100% ),and the capsulorrhexis area (square millimeters) was determined objectively. RESULTS: One year after surgery,the mean ACO score was 21% for the acrylic and 20% for the silicone IOL (P =.4) in group 1 and 18% for both the three-piece and one-piece acrylic IOLs (P=.87) in group 2. Concerning the amount of capsulorrhexis contraction,there was no significant difference between the IOL types that were evaluated in this study (after Bonferroni-Holm correction,P > .05). CONCLUSION: In the hydrophobic sharp optic edge IOLs that were examined,neither the optic material nor the haptic design had an influence on the amount of ACO or capsulorrhexis contraction.

玻璃体内注射曲安奈德治疗视网膜中央静脉阻塞引起的黄斑水肿

Purpose: To evaluate treatment of macular oedema due to central retinal vein o cclusion (CRVO) with intravitreal triamcinolone acetonide. Methods: In a prospec tive case series, 13 patients with macular oedema due to non-ischaemic CRVO rec eived an intravitreal injection of 4 mg triamcinolone acetonide. Examination inc luded assessment of best corrected visual acuity (BCVA) for distance and reading , measurement of intraocular pressure (IOP), fluorescein angiography and high re solution imaging by optical coherence tomography, preoperatively and 1 week, 1 m onth, 3, 6 and 9 months postoperatively. Results: Preoperative mean BCVA was 0.9 ±0.4 for distance vision and 1.0±0.3 for reading acuity, respectively. A signi ficant improvement in distance VA (0.5±0.3, p< 0.001) and reading acuity (0.7± 0.3, p=0.03) was observed until 3 months and 6 months, respectively. Mean macula r thickness was significantly reduced until 9 months postoperatively. Conclusion : Intravitreal injection of triamcinolone acetonide led to a significant improve ment in mean VA in patients with macular oedema due to CRVO. However, the signif icant effect was not permanent and persisted for a maximum of 6 months.

玻璃体腔内注射曲安奈德治疗糖尿病性黄斑水肿的疗效观察

Background: Diabetic macular oedema is a frequent cause of visual loss in pati ents with diabetic retinopathy. The purpose of this study was to assess the effi cacy of intravitreal triamcinolone acetonide in reducing diabetic macular oedema and improving visual acuity. Methods: In this prospective study 12 eyes of 12 p atients with diabetic macular oedema unresponsive to prior laser treatment recei ved an intravitreal injection of 4 mg triamcinolone acetonide. Examinations were performed 1 day preoperatively and at 1 week and 1, 3, 6, and 9 months after su rgery and included slit-lamp examination, measurement of IOP, assessment of dis tance as well as reading visual acuity and assessment of macular thickness using optical coherence tomography (OCT). Results: Mean age of the patients (mean±SD ) was 66.6±8.6 years. Mean best-corrected visual acuity (BCVA) for distance (L ogMAR using ETDRS charts) improved from 1.0±0.4 preoperatively to 0.9±0.4 (p=0 .01) 1 week and to 0.9±0.4 (p=0.02) 1month postoperatively. Mean BCVA for readi ng vision (LogRAD using Radner Reading Charts) improved from 1.1±0.4 preoperati vely to 0.9±0.4 (p=0.002) 1 month postoperatively. Mean macular thickness decre ased from 450±190 (μm) preoperatively to 305±153 (p=0.02) 1 month postoperati vely. No significant improvement in VA and no significant reduction of macular thickness could be observed 3, 6 , and 9 months postoperatively. Mean intraocular pressure significantly increase d from 14.7±2.7mmHg preoperatively to 16.9±3.0 mmHg at 1 month (p=0.02). Concl usion: A single intravitreal injection of triamcinolone acetonide led to a signi ficant improvement in mean VA in patients with diabetic macular oedema. However, the significant effect was not permanent and persisted for only 1 month.