Purpose To compare 4 methods for intraoperative pupil dilatation in eyes with pseudoexfoliation syndrome and insufficient pupil size during phacoemulsificatio n. Design Prospective, randomized, comparative, interventi...Purpose To compare 4 methods for intraoperative pupil dilatation in eyes with pseudoexfoliation syndrome and insufficient pupil size during phacoemulsificatio n. Design Prospective, randomized, comparative, interventional case series. Part icipants Forty eyes of 40 patients with pseudoexfoliation and maximally dilated pupil size smaller than 3.5 mm. Intervention Mechanical pupil dilatation with ir is-retractor hooks (group I), polymethyl methacrylate (PMMA) pupil dilator-rin g (Morcher, Stuttgart, Germany) (group II),Beehler pupil dilator (group III), an d bimanual stretching (group IV). Main outcome measures Performance (pupil size achieved), complications, and added surgical time. Results The mean pupil sizes achieved with the PMMA pupil-dilator ring, Beehler pupil dilator, and bimanual stretching were 5.9±0.6 mm, 5.5±0.8 mm, and 4.9±0.7 mm, respectively. A squar e-shaped pupil was achieved with iris-retractor hooks, and the mean size of th e largest circle that can fit in this square was 5.6±0.6mm. There were no stati stically significant differences in the postdilatation pupil sizes between the 4 study groups (P >0.05). Apart from self-limited intraoperative hemorrhage from pupil margin, iris sphincter rupture was the only observed complication related to mechanical pupil dilatation. This occurred in 4 eyes in groups I and III, 3 eyes in group IV, and 1 eye in group II (P >0.05). The mean added surgical time for placement of iris-retractor hooks and for implantation of a PMMA pupil-dil ator ring was 297±51 and 176±54 seconds, respectively. The additional time req uired for pupil dilatation with the Beehler pupil dilator and bimanual stretchin g was 65±8 and 55±10 seconds, respectively. The time needed for pupil dilatati on in groups I and II is significantly longer than that in groups III and IV(P< 0.001). Conclusions All 4 methods used in this study were effective procedures f or the mechanical dilatation of small pupils secondary to pseudoexfoliation synd rome. Iris-retractor hooks and the PMMA pupil dilator ring are the most time co nsuming techniques but have the advantage of a stable pupil size throughout the surgery. The PMMA pupil dilator ring causes the least iris trauma. The Beehler p upil dilator and bimanual stretching technique were the least time consuming met hods for mechanical pupil dilatation.展开更多
Purpose: To examine whether standardized, preoperative evaluation of pupil siz es can predict the risk of night vision visual disturbances after bilateral lase r in situ keratomileusis (LASIK) for myopia. Methods: A p...Purpose: To examine whether standardized, preoperative evaluation of pupil siz es can predict the risk of night vision visual disturbances after bilateral lase r in situ keratomileusis (LASIK) for myopia. Methods: A prospective study was ca rried out involving 46 patients who underwent bilateral LASIK for myopia. Pupil sizes were measured before surgery using an infrared pupillometer under standard ized settings. Pre-and postoperative refraction and best spectacle-corrected v isual acuity (BSCVA) were registered. At the 3-month follow-up visit, the pati ents completed a questionnaire regarding night vision pre-and postoperatively. Results: The mean bilateral, spherical equivalent refraction (SE) was-8.76 D (r ange 6.32 to-12.0 D) preoperatively, and-1.69 D (range 0 to-4.38 D) postopera tively. The mean bilateral BSCVA was not changed by the operations. We found a s ignificant correlation between large scotopic pupil sizes and the impression of worsened night vision (P < 0.01). A significant correlation between gender (male s) and subjectively reduced night vision postoperatively was also found (P < 0.0 5). Conclusion: Large pupil size measured preoperatively is correlated with an i ncreased frequency of subjectively experienced post-LASIK visual disturbances d uring scotopic conditions. We recommend preoperative evaluation of pupils size in all patient s prior to LASIK surgery.展开更多
资料患者男性,18岁。诊断：1双眼高度近视;2双眼散光;3双眼玻璃体混浊。术前情况,裸眼视力：右眼0.06,左眼0.08;矫正：右眼-9.00 DS/-2.0 DC×11°→0.8,左眼-9.75DS/-2.75 DC×17°→0.8;眼压：右眼17 mm Hg（1 mm Hg=...资料患者男性,18岁。诊断：1双眼高度近视;2双眼散光;3双眼玻璃体混浊。术前情况,裸眼视力：右眼0.06,左眼0.08;矫正：右眼-9.00 DS/-2.0 DC×11°→0.8,左眼-9.75DS/-2.75 DC×17°→0.8;眼压：右眼17 mm Hg（1 mm Hg=0.133 k Pa）,左眼17 mm Hg;双眼眼表正常,角膜透明,展开更多
文摘Purpose To compare 4 methods for intraoperative pupil dilatation in eyes with pseudoexfoliation syndrome and insufficient pupil size during phacoemulsificatio n. Design Prospective, randomized, comparative, interventional case series. Part icipants Forty eyes of 40 patients with pseudoexfoliation and maximally dilated pupil size smaller than 3.5 mm. Intervention Mechanical pupil dilatation with ir is-retractor hooks (group I), polymethyl methacrylate (PMMA) pupil dilator-rin g (Morcher, Stuttgart, Germany) (group II),Beehler pupil dilator (group III), an d bimanual stretching (group IV). Main outcome measures Performance (pupil size achieved), complications, and added surgical time. Results The mean pupil sizes achieved with the PMMA pupil-dilator ring, Beehler pupil dilator, and bimanual stretching were 5.9±0.6 mm, 5.5±0.8 mm, and 4.9±0.7 mm, respectively. A squar e-shaped pupil was achieved with iris-retractor hooks, and the mean size of th e largest circle that can fit in this square was 5.6±0.6mm. There were no stati stically significant differences in the postdilatation pupil sizes between the 4 study groups (P >0.05). Apart from self-limited intraoperative hemorrhage from pupil margin, iris sphincter rupture was the only observed complication related to mechanical pupil dilatation. This occurred in 4 eyes in groups I and III, 3 eyes in group IV, and 1 eye in group II (P >0.05). The mean added surgical time for placement of iris-retractor hooks and for implantation of a PMMA pupil-dil ator ring was 297±51 and 176±54 seconds, respectively. The additional time req uired for pupil dilatation with the Beehler pupil dilator and bimanual stretchin g was 65±8 and 55±10 seconds, respectively. The time needed for pupil dilatati on in groups I and II is significantly longer than that in groups III and IV(P< 0.001). Conclusions All 4 methods used in this study were effective procedures f or the mechanical dilatation of small pupils secondary to pseudoexfoliation synd rome. Iris-retractor hooks and the PMMA pupil dilator ring are the most time co nsuming techniques but have the advantage of a stable pupil size throughout the surgery. The PMMA pupil dilator ring causes the least iris trauma. The Beehler p upil dilator and bimanual stretching technique were the least time consuming met hods for mechanical pupil dilatation.
文摘Purpose: To examine whether standardized, preoperative evaluation of pupil siz es can predict the risk of night vision visual disturbances after bilateral lase r in situ keratomileusis (LASIK) for myopia. Methods: A prospective study was ca rried out involving 46 patients who underwent bilateral LASIK for myopia. Pupil sizes were measured before surgery using an infrared pupillometer under standard ized settings. Pre-and postoperative refraction and best spectacle-corrected v isual acuity (BSCVA) were registered. At the 3-month follow-up visit, the pati ents completed a questionnaire regarding night vision pre-and postoperatively. Results: The mean bilateral, spherical equivalent refraction (SE) was-8.76 D (r ange 6.32 to-12.0 D) preoperatively, and-1.69 D (range 0 to-4.38 D) postopera tively. The mean bilateral BSCVA was not changed by the operations. We found a s ignificant correlation between large scotopic pupil sizes and the impression of worsened night vision (P < 0.01). A significant correlation between gender (male s) and subjectively reduced night vision postoperatively was also found (P < 0.0 5). Conclusion: Large pupil size measured preoperatively is correlated with an i ncreased frequency of subjectively experienced post-LASIK visual disturbances d uring scotopic conditions. We recommend preoperative evaluation of pupils size in all patient s prior to LASIK surgery.
文摘资料患者男性,18岁。诊断：1双眼高度近视;2双眼散光;3双眼玻璃体混浊。术前情况,裸眼视力：右眼0.06,左眼0.08;矫正：右眼-9.00 DS/-2.0 DC×11°→0.8,左眼-9.75DS/-2.75 DC×17°→0.8;眼压：右眼17 mm Hg（1 mm Hg=0.133 k Pa）,左眼17 mm Hg;双眼眼表正常,角膜透明,
