AIM:To evaluate the ocular outcomes and to elucidate possible mechanisms underlying intraocular pressure(IOP)change following the head-down tilt(HDT)test.METHODS:The study included 21 participants at the Department of...AIM:To evaluate the ocular outcomes and to elucidate possible mechanisms underlying intraocular pressure(IOP)change following the head-down tilt(HDT)test.METHODS:The study included 21 participants at the Department of Ophthalmology of Tongji Hospital.Subjects received the test of I-care tonometry,enhanced depth imaging optical coherence tomography and heart rate variability(HRV)analysis before and after 15 min HDT test.The lumen area of Schlemm’s canal(SCAR),IOP,HRV were calculated.RESULTS:IOP increased significantly after 20°head down position from 14.0±3.0 to 17.0±3.3 mm Hg(P<0.001).SCAR decreased from 13449.0±5454.9μm^(2) at sitting condition to 9576.6±4130.9μm^(2) post 15 min HDT test.High frequency(HF)indices increased significantly from 1462±865 Hz at baseline to 2128±824 Hz.Heart rate(HR)decreased significantly from 76±11.48 to 70±11.52 bpm after the HDT.The linear regression analysis showed that the difference of HF and SCAR significantly correlated with each other during the HDT(R^(2)=20%,P=0.04).CONCLUSION:These outcomes perform the first evidence of the activation of autonomic nervous system of HDT may cause the collapse of Schlemm’s canal lumen,which in turn leading to the increased IOP.展开更多
AIM:To observe the changes in Schlemm’s canal(SC),trabecular meshwork(TM),and anterior chamber relevant parameters after small incision lenticule extraction(SMILE) of myopia patients.METHODS:A total of 58 eyes from 3...AIM:To observe the changes in Schlemm’s canal(SC),trabecular meshwork(TM),and anterior chamber relevant parameters after small incision lenticule extraction(SMILE) of myopia patients.METHODS:A total of 58 eyes from 30 patients who underwent SMILE were divided into a low and moderate myopia group(group A,32 eyes) and a high myopia group(group B,26 eyes).The diameter and area of the SC,the width and thickness of TM obtained by CIRRUS HD-OCT5000,and the related anterior chamber parameters obtained by Pentacam anterior segment analysis system,accommodation amplitude(AMP) were observed pre-and postoperatively.The preoperative intraocular pressure(IOP) and postoperative correction of intraocular pressure(IOPcc) were measured.RESULTS:The diameter and area of the SC in the two groups were significantly increased postoperatively(all P<0.01).The TM width of the patients in the two groups were increased at 1mo after surgery(both P<0.01),but the TM thickness did not change(P>0.05).The corneal curvature,central anterior chamber depth,and anterior chamber volume decreased after SMILE surgery(all P<0.01).There was a weak negative correlation between the SC area change and AMP change in group A(r=-0.362,P<0.01).The postoperative IOP decreased after correction by Shah formula(P<0.05).CONCLUSION:SC and TM in myopia patients change in the early postoperative stage of SMILE and the IOP is decline.展开更多
AIM： To present a new, simple, inexpensive Schlemm canal microcatheter for circumferential canaloplasty in a rabbit model. METHODS： A rabbit glaucoma animal model was established by intravitreal injection of triamci...AIM： To present a new, simple, inexpensive Schlemm canal microcatheter for circumferential canaloplasty in a rabbit model. METHODS： A rabbit glaucoma animal model was established by intravitreal injection of triamcinolone acetonide. Circumferential canaloplasty with a new Schlemm canal microcatheter（patent license number： 201220029850.0） was performed. The Schlemm canal microcatheter was composed of microcatheter wall and lumen. The wall was made of high refractive index plastic optical fiber that could be attached to an illuminant so that the whole lighted microcatheter was visible during circumferential canaloplasty. The lumen could be attached to an injector for injection of viscoelastic during catheterization. Rabbits were divided randomly into the control, model and treatment groups. Intraocular pressure（IOP） was measured with a Tono-pen tonometer pre-operation and 3, 7, 14, 21 and 28 d post-operation. Ultrasound biomicroscopy was performed to visualize the Schlemm canal microcatheter in the Schlemm canal and the sclera pool.RESULTS： The Schlemm canal microcatheter could be used to perform circumferential canaloplasty in the rabbit glaucoma animal model. IOP was lower in the treatment group than that in the model group 3, 7, 14 and 28 d after operation. There were no significant differences in IOP between the control group and treatment group. The differences among the three groups were statistically significant（3 d： F=41.985, P〈0.001; 7 d： F=65.696, P〈0.001; 14 d： F=114.599, P〈0.001; 28 d： F=55.006, P〈0.001）.CONCLUSION： Circumferential canaloplasty is safe and effective in control of experimental glaucoma model in rabbits.展开更多
AIM: To study the long-term efficacy and safety of modified viscocanalostomy in Chinese people with open angle glaucoma(OAG).METHODS: This retrospective study included a total of 100 eyes from 100 Chinese patients wit...AIM: To study the long-term efficacy and safety of modified viscocanalostomy in Chinese people with open angle glaucoma(OAG).METHODS: This retrospective study included a total of 100 eyes from 100 Chinese patients with medically uncontrolled OAG. All the patients underwent modified viscocanalostomy with injection of viscoelastic material in the surgically created ostia of Schlemm's canal(SC). The modifications included peeling of the inner wall of SC and the juxtacanalicular meshwork, use of mitomycin C, and loosely suturing the superficial scleral flap. Intraocular pressure(IOP), visual acuity, number of medications, laser goniopuncture data and complications were recorded. The definition of complete(qualified) success was an IOP equal to or lower than 21, 18, 16 mm Hg without(with or without) anti-glaucoma medications. RESULTS: The mean IOP was 33.5±9.9 mm Hg before surgery, 15.2±3.6 mm Hg(mean IOP reduction of 51%) at 5 y after surgery, and 15.6±2.8 mm Hg(mean IOP reduction of 49.9%) at 10 y after surgery(P<0.001). The number of anti-glaucoma medications dropped from 2.39±0.5 preoperatively to 0.47±0.8 at 5 y and 0.67±0.8 at 10 y postoperatively(P<0.001). The follow-up period was 104.5±37.0 mo. The qualified success rate for an IOP of 21, 18 or 16 mm Hg or less was 84% [95% confidence interval(CI): 0.80-0.88], 73%(95%CI: 0.68-0.78), and 59%(95%CI: 0.52-0.66) after 5 y, and 80%(95%CI: 0.76-0.84), 69%(95%CI: 0.64-0.74), 51%(95%CI: 0.44-0.58) after 10 y, respectively. There was a relationship between age, preoperative IOP and success rate(P<0.01, P<0.05). A total of 31 eyes(31.3%)in 31 patients underwent laser goniopuncture, decreasing the IOP from 22.9±4.3 mm Hg to 16.3±2.5 mm Hg(P<0.01). Neither blebitis nor endophthalmitis occurred.CONCLUSION: Modified viscocanalostomy could be performed to lower IOP, decrease multiple anti-glaucoma drops use as well. It's a safe procedure with less complications over 10 y in Chinese individuals with OAG.展开更多
Ear canal exostoses are bilateral, usually symmetric multiple bony growths occurring in the medial portion of the external auditory canal. Also known as surfer's ear, exostosis is thought to be a reactive process ...Ear canal exostoses are bilateral, usually symmetric multiple bony growths occurring in the medial portion of the external auditory canal. Also known as surfer's ear, exostosis is thought to be a reactive process from repeated stimulation by cold water and is much more common than external auditory osteoma. Exostoses are usually asymptomatic and discovered on routine otoscopy. Indications for surgical treatment are recurrent otitis externa, hearing loss, otalgia and other conditions in which access medial to the exostoses is required. Surgery is not risk-free and postoperative complications are the most important factor for negative impact on the patient's health-related quality of life. Thisreview offers an overview of the recent advances in the understanding of this condition, with a special focus on the etiology and physiopathology of this condition, the different surgical procedures and their outcomes, the risk factors for recurrence and the results of preventive measures. Finally, this review suggests the need for the otological surgeon to acquire a great deal of experience before undertaking surgical treatment of exostoses as it is a challenging operation and, besides expertise, demands great patience and extreme care in order to achieve good results.展开更多
Spontaneous cerebrospinal fluid rhinorrhoea with encephalocele restricted to the sphenoid sinus is rare clinical finding. As of today, only 17 cases encephalocele protruding through the Sternberg’s canal and extendin...Spontaneous cerebrospinal fluid rhinorrhoea with encephalocele restricted to the sphenoid sinus is rare clinical finding. As of today, only 17 cases encephalocele protruding through the Sternberg’s canal and extending into the lateral recess of sphenoid sinus, have been described in literature. Patients presenting with this special clinical entity usually do not have any history of trauma, tumour or iatrogenic injury. Thus the lesions are considered to originate from a congenital bony defect in the lateral wall of the sphenoid sinus, first described by Sternberg in 1888 as the lateral craniopharyngeal canal (Sternberg’s canal). In our experience each patient of spontaneous CSF rhinorrhea should have suspicion of intrasphenoid encephalocele though cribriform plate is a common site. Endoscopic tranasnasal approach is one of the best modalities for such cases.展开更多
Aim: the aim of this study was to investigate the shaping ability of thermomechanically treated files manufactured by twisting(Twisted files)and compare it to conventional rotary system (K3, Sybron Endo, Orange, CA) i...Aim: the aim of this study was to investigate the shaping ability of thermomechanically treated files manufactured by twisting(Twisted files)and compare it to conventional rotary system (K3, Sybron Endo, Orange, CA) in S-shaped canals, including formation of ledges, zipping, elbow, outer widening, danger zone, perforation and file deformation. Materials & Methods: Forty S-Shaped canals in resin blocks were randomly divided into 2 groups of 20 each. Pre-instrumentation images of the canals were taken via a digital camera and superimposed on images taken after preparation with TF and K3 systems to apical size of 25/06 and 30/06. Canal aberrations were measured from the superimposed image at five levels using AutoCAD system. Fisher exact test and Mann Whitney test were used for analysis of the data. Results: the incidence of zipping, elbow and apical transportation was significantly lower in the TF group (P = 0.04). Generally the incidence of aberration increased when the apical size increased to 30/0.06 regardless of the file system. Significant file deformation was evident in the TF after single use (P ? 0.001). Conclusion: Under the conditions of this study, TF manufactured by new technique performed better than K3 systems when used up to size 25/06 in simulated S-shaped canals. Clinical significance: The flexibility of thermomechanically treated files is beneficial in canals with multiple curvatures;however, attention should be paid to the instrument taper and final apical size of the preparation.展开更多
The Monument for Building Qarqi Canal was inscribed in the sixth year of Guangxu s reign in the Qing Dynasty(1880).This inscription made a detailed record of the event when the Qing army expelled the invading army of ...The Monument for Building Qarqi Canal was inscribed in the sixth year of Guangxu s reign in the Qing Dynasty(1880).This inscription made a detailed record of the event when the Qing army expelled the invading army of Mohammad Yaqub Beg,whenever the Qing army regained a place,it immediately started recruiting exiled people,restoring agriculture,building water conservancy and did other rehabilitation works.The army of the Qing Dynasty successively established rehabilitation bureaus in various parts of southern Xinjiang to be responsible for the rehabilitation works.These once again set off a climax in the development of water conservancy in multi-ethnic areas in Xinjiang,and laid the foundation for the rapid development of agricultural development and water conservancy in Xinjiang during the Guangxu s reign in the Qing Dynasty.展开更多
文摘AIM:To evaluate the ocular outcomes and to elucidate possible mechanisms underlying intraocular pressure(IOP)change following the head-down tilt(HDT)test.METHODS:The study included 21 participants at the Department of Ophthalmology of Tongji Hospital.Subjects received the test of I-care tonometry,enhanced depth imaging optical coherence tomography and heart rate variability(HRV)analysis before and after 15 min HDT test.The lumen area of Schlemm’s canal(SCAR),IOP,HRV were calculated.RESULTS:IOP increased significantly after 20°head down position from 14.0±3.0 to 17.0±3.3 mm Hg(P<0.001).SCAR decreased from 13449.0±5454.9μm^(2) at sitting condition to 9576.6±4130.9μm^(2) post 15 min HDT test.High frequency(HF)indices increased significantly from 1462±865 Hz at baseline to 2128±824 Hz.Heart rate(HR)decreased significantly from 76±11.48 to 70±11.52 bpm after the HDT.The linear regression analysis showed that the difference of HF and SCAR significantly correlated with each other during the HDT(R^(2)=20%,P=0.04).CONCLUSION:These outcomes perform the first evidence of the activation of autonomic nervous system of HDT may cause the collapse of Schlemm’s canal lumen,which in turn leading to the increased IOP.
基金Supported by the National Natural Science Foundation of China (No.81974133)。
文摘AIM:To observe the changes in Schlemm’s canal(SC),trabecular meshwork(TM),and anterior chamber relevant parameters after small incision lenticule extraction(SMILE) of myopia patients.METHODS:A total of 58 eyes from 30 patients who underwent SMILE were divided into a low and moderate myopia group(group A,32 eyes) and a high myopia group(group B,26 eyes).The diameter and area of the SC,the width and thickness of TM obtained by CIRRUS HD-OCT5000,and the related anterior chamber parameters obtained by Pentacam anterior segment analysis system,accommodation amplitude(AMP) were observed pre-and postoperatively.The preoperative intraocular pressure(IOP) and postoperative correction of intraocular pressure(IOPcc) were measured.RESULTS:The diameter and area of the SC in the two groups were significantly increased postoperatively(all P<0.01).The TM width of the patients in the two groups were increased at 1mo after surgery(both P<0.01),but the TM thickness did not change(P>0.05).The corneal curvature,central anterior chamber depth,and anterior chamber volume decreased after SMILE surgery(all P<0.01).There was a weak negative correlation between the SC area change and AMP change in group A(r=-0.362,P<0.01).The postoperative IOP decreased after correction by Shah formula(P<0.05).CONCLUSION:SC and TM in myopia patients change in the early postoperative stage of SMILE and the IOP is decline.
基金Supported by Fujian Provincial Science and Technology Department (No.2014Y4003)
文摘AIM： To present a new, simple, inexpensive Schlemm canal microcatheter for circumferential canaloplasty in a rabbit model. METHODS： A rabbit glaucoma animal model was established by intravitreal injection of triamcinolone acetonide. Circumferential canaloplasty with a new Schlemm canal microcatheter（patent license number： 201220029850.0） was performed. The Schlemm canal microcatheter was composed of microcatheter wall and lumen. The wall was made of high refractive index plastic optical fiber that could be attached to an illuminant so that the whole lighted microcatheter was visible during circumferential canaloplasty. The lumen could be attached to an injector for injection of viscoelastic during catheterization. Rabbits were divided randomly into the control, model and treatment groups. Intraocular pressure（IOP） was measured with a Tono-pen tonometer pre-operation and 3, 7, 14, 21 and 28 d post-operation. Ultrasound biomicroscopy was performed to visualize the Schlemm canal microcatheter in the Schlemm canal and the sclera pool.RESULTS： The Schlemm canal microcatheter could be used to perform circumferential canaloplasty in the rabbit glaucoma animal model. IOP was lower in the treatment group than that in the model group 3, 7, 14 and 28 d after operation. There were no significant differences in IOP between the control group and treatment group. The differences among the three groups were statistically significant（3 d： F=41.985, P〈0.001; 7 d： F=65.696, P〈0.001; 14 d： F=114.599, P〈0.001; 28 d： F=55.006, P〈0.001）.CONCLUSION： Circumferential canaloplasty is safe and effective in control of experimental glaucoma model in rabbits.
文摘AIM: To study the long-term efficacy and safety of modified viscocanalostomy in Chinese people with open angle glaucoma(OAG).METHODS: This retrospective study included a total of 100 eyes from 100 Chinese patients with medically uncontrolled OAG. All the patients underwent modified viscocanalostomy with injection of viscoelastic material in the surgically created ostia of Schlemm's canal(SC). The modifications included peeling of the inner wall of SC and the juxtacanalicular meshwork, use of mitomycin C, and loosely suturing the superficial scleral flap. Intraocular pressure(IOP), visual acuity, number of medications, laser goniopuncture data and complications were recorded. The definition of complete(qualified) success was an IOP equal to or lower than 21, 18, 16 mm Hg without(with or without) anti-glaucoma medications. RESULTS: The mean IOP was 33.5±9.9 mm Hg before surgery, 15.2±3.6 mm Hg(mean IOP reduction of 51%) at 5 y after surgery, and 15.6±2.8 mm Hg(mean IOP reduction of 49.9%) at 10 y after surgery(P<0.001). The number of anti-glaucoma medications dropped from 2.39±0.5 preoperatively to 0.47±0.8 at 5 y and 0.67±0.8 at 10 y postoperatively(P<0.001). The follow-up period was 104.5±37.0 mo. The qualified success rate for an IOP of 21, 18 or 16 mm Hg or less was 84% [95% confidence interval(CI): 0.80-0.88], 73%(95%CI: 0.68-0.78), and 59%(95%CI: 0.52-0.66) after 5 y, and 80%(95%CI: 0.76-0.84), 69%(95%CI: 0.64-0.74), 51%(95%CI: 0.44-0.58) after 10 y, respectively. There was a relationship between age, preoperative IOP and success rate(P<0.01, P<0.05). A total of 31 eyes(31.3%)in 31 patients underwent laser goniopuncture, decreasing the IOP from 22.9±4.3 mm Hg to 16.3±2.5 mm Hg(P<0.01). Neither blebitis nor endophthalmitis occurred.CONCLUSION: Modified viscocanalostomy could be performed to lower IOP, decrease multiple anti-glaucoma drops use as well. It's a safe procedure with less complications over 10 y in Chinese individuals with OAG.
文摘Ear canal exostoses are bilateral, usually symmetric multiple bony growths occurring in the medial portion of the external auditory canal. Also known as surfer's ear, exostosis is thought to be a reactive process from repeated stimulation by cold water and is much more common than external auditory osteoma. Exostoses are usually asymptomatic and discovered on routine otoscopy. Indications for surgical treatment are recurrent otitis externa, hearing loss, otalgia and other conditions in which access medial to the exostoses is required. Surgery is not risk-free and postoperative complications are the most important factor for negative impact on the patient's health-related quality of life. Thisreview offers an overview of the recent advances in the understanding of this condition, with a special focus on the etiology and physiopathology of this condition, the different surgical procedures and their outcomes, the risk factors for recurrence and the results of preventive measures. Finally, this review suggests the need for the otological surgeon to acquire a great deal of experience before undertaking surgical treatment of exostoses as it is a challenging operation and, besides expertise, demands great patience and extreme care in order to achieve good results.
文摘Spontaneous cerebrospinal fluid rhinorrhoea with encephalocele restricted to the sphenoid sinus is rare clinical finding. As of today, only 17 cases encephalocele protruding through the Sternberg’s canal and extending into the lateral recess of sphenoid sinus, have been described in literature. Patients presenting with this special clinical entity usually do not have any history of trauma, tumour or iatrogenic injury. Thus the lesions are considered to originate from a congenital bony defect in the lateral wall of the sphenoid sinus, first described by Sternberg in 1888 as the lateral craniopharyngeal canal (Sternberg’s canal). In our experience each patient of spontaneous CSF rhinorrhea should have suspicion of intrasphenoid encephalocele though cribriform plate is a common site. Endoscopic tranasnasal approach is one of the best modalities for such cases.
文摘Aim: the aim of this study was to investigate the shaping ability of thermomechanically treated files manufactured by twisting(Twisted files)and compare it to conventional rotary system (K3, Sybron Endo, Orange, CA) in S-shaped canals, including formation of ledges, zipping, elbow, outer widening, danger zone, perforation and file deformation. Materials & Methods: Forty S-Shaped canals in resin blocks were randomly divided into 2 groups of 20 each. Pre-instrumentation images of the canals were taken via a digital camera and superimposed on images taken after preparation with TF and K3 systems to apical size of 25/06 and 30/06. Canal aberrations were measured from the superimposed image at five levels using AutoCAD system. Fisher exact test and Mann Whitney test were used for analysis of the data. Results: the incidence of zipping, elbow and apical transportation was significantly lower in the TF group (P = 0.04). Generally the incidence of aberration increased when the apical size increased to 30/0.06 regardless of the file system. Significant file deformation was evident in the TF after single use (P ? 0.001). Conclusion: Under the conditions of this study, TF manufactured by new technique performed better than K3 systems when used up to size 25/06 in simulated S-shaped canals. Clinical significance: The flexibility of thermomechanically treated files is beneficial in canals with multiple curvatures;however, attention should be paid to the instrument taper and final apical size of the preparation.
文摘The Monument for Building Qarqi Canal was inscribed in the sixth year of Guangxu s reign in the Qing Dynasty(1880).This inscription made a detailed record of the event when the Qing army expelled the invading army of Mohammad Yaqub Beg,whenever the Qing army regained a place,it immediately started recruiting exiled people,restoring agriculture,building water conservancy and did other rehabilitation works.The army of the Qing Dynasty successively established rehabilitation bureaus in various parts of southern Xinjiang to be responsible for the rehabilitation works.These once again set off a climax in the development of water conservancy in multi-ethnic areas in Xinjiang,and laid the foundation for the rapid development of agricultural development and water conservancy in Xinjiang during the Guangxu s reign in the Qing Dynasty.
