Effect of High-Order Aberrations and Satisfaction on Cataract Patients Implanted with Four Types of AcrySof Blue Light Filtering Intraocular Lens

Objective: The objective is to evaluate the visual acuity, high-order aberrations and satisfaction in the cataract patients with the implantation of different types of AcrySof blue light filtering intraocular lens, which would provide the clinical guidance for the selection of individualized intraocular lens. Methods: From January 2019 to December 2020, the patients with age-related cataract in Guangzhou Red Cross Hospital were equally randomized to be divided into four groups. 20 patients (20 eyes) were implanted with AcrySof (SN60WF), which was the blue light filtering single focus group;20 patients (20 eyes) were implanted with blue light filtering aspheric multifocal intraocular lens (AcrySof ReSTOR IOL +3.0D, SN6AD1), which was the multifocal intraocular lens group;20 patients (20 eyes) were implanted with aspheric astigmatism correction intraocular lens (Toric SN6AT), which was the astigmatism group;20 patients (20 eyes) were implanted with blue filtering aspheric multifocal astigmatism correction intraocular lens (AcrySof ReSTOR IOL +2.5D IQ, SV25T0), which was the ART group. Three months after the operation, the patients were followed up with slit lamp to check the visual acuity, including uncorrected distance visual acuity (UCDVA), uncorrected near visual acuity (UCNVA), best corrected distance visual acuity, (BCDVA);the questionnaire surveys on the satisfaction of different intraocular lens implantation (far and near vision, glare, halo and abnormal visual symptoms);the iTrace visual function analyzer was used to check the total high-order aberrations (spherical aberration, wisdom aberration and Clover aberration) in the 3 mm pupil diameter. Results: Three months after cataract surgery, American Simplified version of questionnaire survey showed that the scores of near removing glasses in the multifocal group and the ART group were significantly better than those in the single focus group and the astigmatism group (P < 0.05);there was no significant difference in the satisfaction of far removing glasses, glare and halo in each group (P > 0.05). Three months after cataract surgery, there were statistically significant differences about UCDVA, BCDVA and UCNVA among the four groups (F = 18.189, P < 0.001), the UCNVA in the multifocal group and ART group was significantly better than that in the single focus group and the astigmatism group (P < 0.01). The difference of higher-order aberrations (total higher-order aberrations, wisdom aberrations, spherical aberrations, clover aberrations) was no statistically significant among the four groups (P > 0.05). Conclusion: Different types of AcrySof blue light filtering intraocular lens implantation could improve the far vision and satisfaction of cataract patients, without different higher-order aberrations. Multifocal intraocular lens and ART intraocular lens could significantly improve the far vision of patients and reduce the dependence on near glasses.

Efficacy Analysis of Glucocorticoids in the Treatment of Allergic Purpura in Tibetan Children

Background: Henoch Schonlein Purpura (HSP) is a common immune-related allergic disease in children. It is very important to understand the clinical features of this disease for doctors. Objective: To explore the clinical efficacy of glucocorticoids in the treatment of HSP in Tibetan children at high altitude, and to analyze the possible causes of HSP in children at high altitude. The risk factors of the disease provide a reference for the treatment of HSP in children in high altitude areas. Methods: Selecting January 2015 to November 2020, 88 children diagnosed with Henoch-Schonlein Purpura in the outpatient and inpatient departments of the People’s Hospital of Bomi County, Tibet Autonomous Region were the subjects of the study. Its gender, age of onset, season of onset, predisposing factors, allergy history, first symptoms, clinical manifestations, laboratory examinations, etc., perform retrospective analysis. Results: Among 88 children with allergic purpura, 55 were boys, accounting for 62.5%, and 33 were girls, accounting for 37.5%. Men have more cases than women. All have clinical manifestations of purpura of the skin, among which 35 cases have obvious triggers, of which the above there were 26 cases of respiratory infections, 6 cases of dietary factors, and 3 cases of contact with allergic substances. Simple skin type: 18 cases, accounting for 20.45%;Abdominal type: 6 cases, accounting for 6.82%;2 male cases, accounting for 33.33%;4 female cases, accounting for 66.67%;Articular type: 8 cases, accounting for 33.33%;Renal type: 2 cases, accounting for 2.27%;54 cases of mixed type, accounting for 61.36%. After glucocorticoids, the rashes disappeared, no any adverse reactions. Conclusion: Allergic purpura in children is more common in school-age children, and upper respiratory tract infection is the main predisposing factor. Skin purpura is the main clinical manifestation, often associated with lower extremity joint swelling and pain. There is no significant difference in the efficacy and course of the disease between intravenous and oral treatment. Therefore, clinicians should strictly grasp the indications of glucocorticoids to reduce the occurrence of complications.