We describe a rapid anterior capsule contraction following phacoemulsifiction and intraocular lens(IOL) implantation in an old woman with high myopia. The patient with high myopia complicated with cataract received ph...We describe a rapid anterior capsule contraction following phacoemulsifiction and intraocular lens(IOL) implantation in an old woman with high myopia. The patient with high myopia complicated with cataract received phacoemulcification and IOL implantation bilaterally .The best-corrected visual acuity (BCVA) improved from 0.1 to 0.4 in the right eye and 0.5 in the left eye 1 week after surgeries.5 weeks after surgery of the right eye and 4 weeks after surgery of the left eye, the patient complained blurred vision in the right eye. BCVA of the right eye was 0.06 and that of the left was 0.1. Slit-lamp examination revealed anterior capsule contraction in both eyes and a fully closed capsulorhexis opening in the right eye. The IOLs were centered but almost completely enclosed, with numerous linear fibrous folds radiating from the hick central fibrosis. We surgically excised the central part of the anterior capsule of the eyes with microscissors, resulting again in BCVA of 0.4 and 0.5 in the right and left eyes respectively. Anterior capsule contraction might appear much earlier than three months after phacoemulsification and IOL implantation surgery in case of high myopia complicated with cataract. Patients with high myopia receive cataract and IOL surgery should be monitored carefully for the rapid development of anterior capsule contraction.展开更多
Background: complex proximal tibial fractures (Types V & VI of Schautzker classification) are the major problems in orthopedic surgery and associated with high complication rates. There are many alternatives in tr...Background: complex proximal tibial fractures (Types V & VI of Schautzker classification) are the major problems in orthopedic surgery and associated with high complication rates. There are many alternatives in treatment of these fractures. Aim: to evaluate the results of double plating with single anterior incision in complex proximal tibial fractures (Types V& VI of Schautzker classification).Methods and Materials: 22 patients (16 males and 6 females) with Types V and VI of Schautzker classification of proximal tibial fractures (14 cases were Type V and 8 cases were Type VI) were treated by double plating with single anterior incision method between May 2006 and May 2011. The bony and functional outcome was evaluated according to Knee Society Score. Results: According to Knee Society Score, the results were as follows: excellent in 19 patients (86.4%), good in 2 patients (9.1%), fair in 1 patient (4/5%), and poor in no patient (0%).Conclusion: the double plate fixation with single anterior incision is the best, effective and simple procedure in treatment of complex proximal tibial fractures (Types V and VI of Schautzker classification).展开更多
AIM: To evaluate the safety of using 0.03% trypan blue under air for anterior capsule staining in cataract surgery.METHODS: The current study involved a retrospective analysis of the medical records of 86 patients wit...AIM: To evaluate the safety of using 0.03% trypan blue under air for anterior capsule staining in cataract surgery.METHODS: The current study involved a retrospective analysis of the medical records of 86 patients with vitreous hemorrhage, who underwent pars plana vitrectomy and cataract surgery.The patients were classified into two groups.The trypan blue group(n=45) comprised patients who underwent anterior capsule staining with 0.03% trypan blue under an air bubble.The control group(n=41) comprised of patients who underwent intracameral illuminator-assisted capsulorhexis.The status of endothelial cell density(ECD) in both the groups was analyzed.RESULTS: The trypan blue group displayed significant decline in ECD at 1 mo(7.91% loss, P<0.001) and 3 mo(9.65% loss, P<0.001) after the surgery, whereas no significant changes were observed in the control group.Moreover, the number of patients who did not display a postoperative decline in ECD was significantly higher in the control group(43.9%;18 patients) than in the trypan blue group(17.1%;7 patients, P=0.004).CONCLUSION: Anterior capsule staining with trypan blue under the air bubble would not be as safe as the intracameral illuminator.The ECD loss might be attributed to the air bubble rather than to the deleterious effects of 0.03% trypan blue.Further studies are required to clarify this.展开更多
Objective: To explore the effect of gardenia blue pigment on the anterior capsule staining and its safety performance. Methods: In this study, New Zealand white rabbits were used as the research object to test the eff...Objective: To explore the effect of gardenia blue pigment on the anterior capsule staining and its safety performance. Methods: In this study, New Zealand white rabbits were used as the research object to test the effect of gardenia blue pigment on the anterior capsule staining and anterior segment toxicity. In this study, gardenia blue stains of different concentrations (5%, 4%, 3%, 2%, 1%, 0.5%) were prepared to stain the anterior capsule of rabbit crystals, and the effect of the stain was observed to determine the optimal concentration of the stain. Twenty-seven healthy New Zealand white rabbits without eye disease were randomly divided into three groups: gardenia blue staining group;bio-blue positive drug group;physiological saline group. The intraocular pressure, anterior chamber inflammation, corneal endothelial injury, and anterior chamber angle pathological changes were measured in 1D, 7D, and 14D. Results: The results of this study showed that the effect of gardenia blue pigment on the anterior capsule of the lens was the best when the concentration of blue pigment was 2%. There was no change in intraocular pressure in the anterior chamber for a short period of time. There is no damage to the corneal endothelium. Conclusion: The results of this study show that the effect of gardenia blue pigment on the anterior capsule is best when the concentration of blue pigment is 2%, and the stain has no obvious toxic and side effects on the anterior segment of the eye.展开更多
Purpose: To determine the effect of anterior capsule polishing (APC) on the rate of posterior capsule opacification (PCO) as assessed by the need for laser posterior capsulotomy. Setting: University-based clinical pra...Purpose: To determine the effect of anterior capsule polishing (APC) on the rate of posterior capsule opacification (PCO) as assessed by the need for laser posterior capsulotomy. Setting: University-based clinical practice, Jules Stein Eye Institute, Los Angles, California, USA. Methods: This study involved a retrospective review of eyes that underwent phacoemulsification and intraocular lens implantation between September 1991 and June 1999. Lens epithelial cells in the 763 study eyes were mechanically debrided or polished from the inside surface of the anterior capsules using a pair of Shepherd-Rentsch (Morning STAAR Inc.) capsule polishers. The 484 control eyes that had surgery earlier in the series were not polished. The rate of laser capsulotomy in the ACP and the non-ACP groups was compared using a Kaplan-Meier survival analysis. Multivariate regression was performed to determine if variables other than ACP influenced the need for laser posterior capsulotomy. Results: We identified 763 eyes that had ACP and 484 that did not. At the 24-month follow-up interval, 26.6% of the eyes in the ACP group had received a capsulotomy versus 19.50% in the non-APC. Next, a separate study was done using only one eye per patient, taking the patient as the unit of analysis. Again the capsulotomy rate was higher in the ACP group compared to the non-ACP (1.02 per 100 person-months of follow-up vs. 0.74 per 100 person-months of follow-up). Finally, a third Kaplan-Meier analysis was done on 52 patients that had one eye treated with the ACP procedure and the other eye with the non-ACP procedure. Although the log-rank test showed the statistical significant of this analysis to be borderline, the results again favored the non-ACP group with a lower capsulotomy rate. Multivariate analysis showed very similar results to the above univariate studies. The mean time to capsulotomy was 46 months for the polished group and 70 months for the unpolished group. The severity of cataract (p = 0.46) and the type of haptics (p = 0.86) did not influence the rate of capsulotomy. Plate haptic IOLS had a higher rate of capsulotomy than loop haptic IOLS (p = 0.001). Conclusions: Polishing of the anterior capsule with Shepherd-Rentsch polishers may unexpectedly increase the rate of posterior capsule opacification in eyes with round-edge silicone lenses.展开更多
Purpose: To observe the effect of preservation of anterior capsule on the incidence of complications associated with silicone oil.
Methods: 82 patients(82 eyes) accepted trans pars plana vitrectomy(TPPV) combined with...Purpose: To observe the effect of preservation of anterior capsule on the incidence of complications associated with silicone oil.
Methods: 82 patients(82 eyes) accepted trans pars plana vitrectomy(TPPV) combined with lensectomy of whom , 30 eyes with preservation of anterior capsule(PAC) and 52eyes with no preservation of anterior capsule (NPAC). Analysis of the incidence of complications associated with use of oil.
Results:The incidence rate was 50.0 % in NPAC group, and 23.3 % in PAC group( P < 0. 025 ). There were seconda'y glaucoma (21. 1% ), band keratopathy ( 13.5 % ) and corneal decompensation(9.6 % ) in NPAC group, while there was none of them in PAC group.
Conclusions: Preservation of anterior capsule is an eftective method to reduce the complications associated with silicone oil. Eye Science 2001; 17:39 ~ 41.展开更多
AIM: To assess the early structural changes at clear corneal cataract incision sites and surgical outcomes using anterior segment optical coherence tomography(AS-OCT).METHODS: We evaluated 80 eyes of 59 patients who u...AIM: To assess the early structural changes at clear corneal cataract incision sites and surgical outcomes using anterior segment optical coherence tomography(AS-OCT).METHODS: We evaluated 80 eyes of 59 patients who underwent phacoemulsification with a clear corneal incision. All incisions were evaluated 1 wk, 1, and 3 mo postoperatively using AS-OCT and analyzed regarding angle, length of the incision, maximal corneal thickness at the incision, and if present, corneal endothelial gap length and incision gap area. The patients were divided into two groups according to whether or not an endothelial gap was present at 1 wk postoperatively(endothelial gap, group 1;no endothelial gap, group 2). We analyzed the difference in patient and surgical factors between the two groups, and compared the surgical outcome and the refractive outcome.RESULTS: An endothelial gap was observed in 56(70.0%) of 80 eyes at 1 wk postoperatively but not at 3 mo postoperatively. The mean patient age was significantly higher in group 1 than in group 2. The longer the length of the corneal incision and the steeper the incision angle, the greater the length and area of the endothelial gap. In group 1, the mean change in mean keratometry of the anterior cornea was significantly greater than in group 2, and the spherical equivalent(SE) and mean numerical error indicated significant myopic changes at 1 wk postoperatively. CONCLUSION: The risk of an endothelial gap increases with patient age and a long corneal incision and steep incision angle. The presence of an endothelial gap aftersurgery may affect the early postoperative corneal curvature and SE.展开更多
AIM:To introduce a novel measurement method of static cyclotorsion in small incision lenticule extraction(SMILE)and to investigate the effect of preoperative parameters on cyclotorsion and the effect of cyclotorsion o...AIM:To introduce a novel measurement method of static cyclotorsion in small incision lenticule extraction(SMILE)and to investigate the effect of preoperative parameters on cyclotorsion and the effect of cyclotorsion on postoperative outcomes.METHODS:The medical records of 242 patients and 484 eyes who under went SMILE surger y were retrospectively reviewed.Preoperative intraocular pressure,refractive error,and corneal thickness were investigated.Refractive values and visual acuity were measured at 1d,1,3,and 6mo.Ocular cyclotorsion in the supine position was measured by calculating the location and angle of the incision site of the cornea in the anterior slit photograph taken after surgery.RESULTS:Of the total 484 eyes in 242 patients,preopera tive means phericale quivalent(SE)was-4.10±1.64 D,and the mean astigmatism was-0.82±0.74 D.Uncorrected distance visual acuity(UCVA)and SE improved significantly after the surgery.Moreover,219(45.2%)eyes had excyclotorsion,235(48.6%)eyes had incyclotorsion,and 30(6.2%)eyes had no torsion.The right eyes tended to be excyclotorted,and the left eyes tended to be incyclotorted(P<0.01).The mean cyclotorsion was 1.18°±3.69°,and the mean absolute value of cyclotorsion was 3.14°±2.26°.The range of cyclotorsion was 0.5°–11.4°.It was found that the smaller the preoperative sphere,the higher the amount of cyclotorsion(r=0.11,P=0.016).There was no significant association between the amount of cyclotorsion and preoperative astigmatism.There was no correlation between sex,preoperative corneal thickness,preoperative intraocular pressure,amount of cyclotorsion,and direction of cyclotorsion.The ratio of right eye excyclotorsion and left eye incyclotorsion on 1d was higher than that at 1,3,and 6mo(all P<0.01).There was no difference between the 1,3,and 6mo results in the right and left eyes(P=0.15,P=0.16,respectively).CONCLUSION:The newly devised ocular cyclotorsion measurement method can be used to evaluate ocular cyclotorsion after SMILE.Preoperative SE is associated with the amount of cyclotorsion,however,cyclotorsion doesn't have a significant effect on the results of SMILE surgery.展开更多
AIM: To analyze and compare five different variables over one year follow-up(1 wk, 1, 3, 6 and 12 mo): anterior capsule(AC), and posterior capsule(PC) area densitometry values, AC and PC linear densitometry va...AIM: To analyze and compare five different variables over one year follow-up(1 wk, 1, 3, 6 and 12 mo): anterior capsule(AC), and posterior capsule(PC) area densitometry values, AC and PC linear densitometry values, and AC opening area reduction ratio after femtosecond laserassisted cataract surgery. METHODS: This was a prospective comparative study. Seventy-one patients underwent femtosecond laser-assisted cataract surgery on single eye between June 2014 and December 2015. A 5.0 mm diameter laser assisted anterior capsulotomy was performed on all eyes. In every postsurgery evaluation, AC opacificaction(ACO) and PC opacification(PCO) density levels were provided by Oculus Pentacam·HR using area and linear densitometry methods. Digital images were captured with a slit-lamp Topcon photographic camera and IMAGEnet· 5 software. The AC opening area on the digital images was measured using the Sketchandcalc area calculator and converted to reduction ratio levels.RESULTS: Using Pearson correlation coefficient(PCC), we found no correlation(r=-0.091, P=0.46) in the twelfth month assessment between the evolution of ACO area densitometry values and PCO area densitometry values considered as independent variables. We found no correlation, using PCC(r=-0.096, P=0.43) between the evolution of ACO linear densitometry values and PCO linear densitometry values, in the twelfth month visit, working both as independent variables. AC linear densitometry levels and AC area densitometry levels continued to grow strongly from sixth to twelfth months. Analysis of the values of AC opening area reduction ratio(1 wk, 1, 3, 6, 12 mo) revealed statistically significant differences between the values of successive examinations but the magnitude of the change decreased. In the final period of monitoring between six and twelve months the magnitude of change was low.CONCLUSION: Our results show strong increases of Scheimpflug ACO densitometry values from the sixth to the twelfth month while capsulorhexis area reduction ratio levels displayed a considerable decrease. We found no correlation between ACO area and linear densitometry values and PCO area and linear densitometry values, in the twelfth month examination, working as independent variables.展开更多
AIM:To evaluate the application of anterior segmentoptical coherence tomography(AS-OCT)in posterior capsule opacification(PCO)severity assessment and analyse the relationship between PCO severity and intraocular lens(...AIM:To evaluate the application of anterior segmentoptical coherence tomography(AS-OCT)in posterior capsule opacification(PCO)severity assessment and analyse the relationship between PCO severity and intraocular lens(IOL)characters.METHODS:PCO patients were prospectively recruited.Cross-sectional images of the anterior segment at horizontal and vertical meridians were acquired with AS-OCT.The area of the IOL-PC(posterior capsular)space and PCO severity(area,thickness,and density at 3 mm and 5 mm IOL optic regions)were measured.The relationship between PCO severity and visual acuity,comparisons of PCO severity and IOL-PC space using varied IOL designs were analysed.RESULTS:One hundred PCO eyes were enrolled.IOL-PC space,PCO thickness and area were positively correlated with axial length.In addition,PCO area and thickness were positively correlated with visual acuity when it was≤0.52 log MAR.The cut-off level of visual acuity should be 0.52 log MAR.With varied IOL designs,3-piece C haptic IOL showed a smaller PCO area and thickness than the 1-piece 3 haptic IOL and 1-piece 4 haptic IOL.PCO area and thickness values for an IOL with a diameter≤11.0 mm was greater than for an IOL with a diameter of 12.5 mm,and the differences were statistically significant.PCO area and thickness increased when IOL haptic angulation increased(from 0 to 12 degrees).CONCLUSION:In PCO eyes,cut-off level of visual acuity is 0.52 log MAR.With more severe PCO,visual acuity maybenot enough to describe the visual function impairment.PCO severity and IOL-PC space are significantly correlated with axial length and IOL design and material.展开更多
Background: Cataract surgery is the most frequently performed surgery worldwide. Posterior capsule rupture (PCR) remains one of the most common complications of cataract surgery and a major risk factor for poor visual...Background: Cataract surgery is the most frequently performed surgery worldwide. Posterior capsule rupture (PCR) remains one of the most common complications of cataract surgery and a major risk factor for poor visual outcomes. Cataract surgeries complicated by PCR and vitreous loss are managed with anterior vitrectomy at the time of surgery. However, the situation can be further complicated by dropping lens particles into the vitreous cavity necessitating a secondary pars plana vitrectomy (PPV). Purpose: To compare the visual outcomes and risk of rhegmatogenous retinal detachment (RRD) between eyes that required anterior vitrectomy (AV) alone for the management of vitreous loss and eyes that required AV and subsequent PPV for the management of dropped nuclear lens fragments (DNLF) following cataract surgery complicated by PCR in a tertiary care teaching hospital in Saudi Arabia. Methods: Medical records of patients in whom PCR occurred during phacoemulsification cataract surgery requiring AV or subsequent PPV for DNLF were retrospectively reviewed over a 6-year period from January 2016 to December 2021. Results: PCR occurred in 183 (2.3%) of 7757 consecutive eyes that underwent phacoemulsification cataract surgery during the study period. Seven eyes were excluded from analysis for missing data or short follow-up. Of the 176 eyes, 147 eyes (83.5%) were managed with AV alone, and the remaining 29 eyes (16.5%) underwent a secondary PPV for DNLF. After excluding eyes with pre-existing ocular pathology, final best-corrected visual acuity (BCVA) was similar in both groups with a mean of 0.32 logMAR (P = 0.99). Two of 147 eyes (1.4%) in the AV group developed RRD with poor final BCVA whereas none of the eyes in DNLF group developed RRD. Conclusion: The risk of RRD is lower in eyes that required PPV for DNLF than in eyes that were managed with AV alone following PCR during cataract surgery. The poor visual outcomes in eyes that suffered RRD underscore the importance of postoperative retinal examination and early detection of retinal breaks.展开更多
BACKGROUND The tibial stop of anterior cruciate ligament(ACL) is fan-shaped and attached to the medial groove in front of the intercondylar spine,which is located between the anterior horn of the medial and lateral me...BACKGROUND The tibial stop of anterior cruciate ligament(ACL) is fan-shaped and attached to the medial groove in front of the intercondylar spine,which is located between the anterior horn of the medial and lateral meniscus.The incidence of this fracture is low previously reported,which is common in children and adolescents.With the increase of sports injury and traffic injury and the deepening of understanding,it is found that the incidence of the disease is high at present.AIM To explore the difference between open reduction and internal fixation with small incision and high-intensity non-absorbable suture under arthroscopy in the treatment of tibial avulsion fracture of ACL.METHODS Seventy-six patients with tibial avulsion fracture of anterior cruciate ligament diagnosed and treated in Guanyun County People’s Hospital from April 2018 to June 2020 were retrospectively analyzed.According to the surgical methods,they were divided into group A(40 cases) and group B(36 cases).Patients in group A were treated with arthroscopic high-strength non-absorbable suture,and patients in group B were treated with small incision open reduction and internal fixation.The operation time,fracture healing time,knee joint activity and functional score before and after operation,and surgical complications of the two groups were compared.RESULTS The operation time of group A was higher than that of group B,and the difference was statistically significant(P < 0.05);the fracture healing time of group A was compared with that of group B,and the difference was not statistically significant(P > 0.05);The knee joint function activity was compared between two groups before operation,3 mo and 6 mo after operation,and the difference was not statistically significant(P > 0.05);the knee joint function activity of group A and group B at 3 mo and 6 mo after operation was significantly higher than that before operation(P < 0.05);the limp,support,lock,instability,swelling,upstairs,squatting,pain and Lysholm score were compared between the two groups before and 6 mo after operation,and the difference was not statistically significant(P > 0.05);the scores of limp,support,lock,instability,swelling,upstairs,squatting,pain and Lysholm in group A and group B at 6 mo after operation were significantly higher than those before operation(P > 0.05);the surgical complication rate of group A was 2.63%,which was lower than 18.42% of group B,and the difference was statistically significant(P > 0.05).CONCLUSION Both small incision open reduction and internal fixation and arthroscopic high-strength nonabsorbable sutures can achieve good results in the treatment of anterior cruciate ligament tibial avulsion fractures.The operation time of arthroscopic high-strength non-absorbable sutures is slightly longer,but the complication rate is lower.展开更多
文摘We describe a rapid anterior capsule contraction following phacoemulsifiction and intraocular lens(IOL) implantation in an old woman with high myopia. The patient with high myopia complicated with cataract received phacoemulcification and IOL implantation bilaterally .The best-corrected visual acuity (BCVA) improved from 0.1 to 0.4 in the right eye and 0.5 in the left eye 1 week after surgeries.5 weeks after surgery of the right eye and 4 weeks after surgery of the left eye, the patient complained blurred vision in the right eye. BCVA of the right eye was 0.06 and that of the left was 0.1. Slit-lamp examination revealed anterior capsule contraction in both eyes and a fully closed capsulorhexis opening in the right eye. The IOLs were centered but almost completely enclosed, with numerous linear fibrous folds radiating from the hick central fibrosis. We surgically excised the central part of the anterior capsule of the eyes with microscissors, resulting again in BCVA of 0.4 and 0.5 in the right and left eyes respectively. Anterior capsule contraction might appear much earlier than three months after phacoemulsification and IOL implantation surgery in case of high myopia complicated with cataract. Patients with high myopia receive cataract and IOL surgery should be monitored carefully for the rapid development of anterior capsule contraction.
文摘Background: complex proximal tibial fractures (Types V & VI of Schautzker classification) are the major problems in orthopedic surgery and associated with high complication rates. There are many alternatives in treatment of these fractures. Aim: to evaluate the results of double plating with single anterior incision in complex proximal tibial fractures (Types V& VI of Schautzker classification).Methods and Materials: 22 patients (16 males and 6 females) with Types V and VI of Schautzker classification of proximal tibial fractures (14 cases were Type V and 8 cases were Type VI) were treated by double plating with single anterior incision method between May 2006 and May 2011. The bony and functional outcome was evaluated according to Knee Society Score. Results: According to Knee Society Score, the results were as follows: excellent in 19 patients (86.4%), good in 2 patients (9.1%), fair in 1 patient (4/5%), and poor in no patient (0%).Conclusion: the double plate fixation with single anterior incision is the best, effective and simple procedure in treatment of complex proximal tibial fractures (Types V and VI of Schautzker classification).
文摘AIM: To evaluate the safety of using 0.03% trypan blue under air for anterior capsule staining in cataract surgery.METHODS: The current study involved a retrospective analysis of the medical records of 86 patients with vitreous hemorrhage, who underwent pars plana vitrectomy and cataract surgery.The patients were classified into two groups.The trypan blue group(n=45) comprised patients who underwent anterior capsule staining with 0.03% trypan blue under an air bubble.The control group(n=41) comprised of patients who underwent intracameral illuminator-assisted capsulorhexis.The status of endothelial cell density(ECD) in both the groups was analyzed.RESULTS: The trypan blue group displayed significant decline in ECD at 1 mo(7.91% loss, P<0.001) and 3 mo(9.65% loss, P<0.001) after the surgery, whereas no significant changes were observed in the control group.Moreover, the number of patients who did not display a postoperative decline in ECD was significantly higher in the control group(43.9%;18 patients) than in the trypan blue group(17.1%;7 patients, P=0.004).CONCLUSION: Anterior capsule staining with trypan blue under the air bubble would not be as safe as the intracameral illuminator.The ECD loss might be attributed to the air bubble rather than to the deleterious effects of 0.03% trypan blue.Further studies are required to clarify this.
基金Liaoning Natural Science Foundation:Research on functional dyes for intraocular biofilms(No.20180550004)Shenyang Science and Technology Plan Project:Preparation of Chitosan Bioactive Dressing and Study on Reconstruction of Bulbular Conjunctiva(No.19-112-4-069)Liaoning Provincial Natural Science Foundation:A study on the role of a degradable bioactive dressing in the repair of bulbar conjunctiva(No.2019-MS-257)
文摘Objective: To explore the effect of gardenia blue pigment on the anterior capsule staining and its safety performance. Methods: In this study, New Zealand white rabbits were used as the research object to test the effect of gardenia blue pigment on the anterior capsule staining and anterior segment toxicity. In this study, gardenia blue stains of different concentrations (5%, 4%, 3%, 2%, 1%, 0.5%) were prepared to stain the anterior capsule of rabbit crystals, and the effect of the stain was observed to determine the optimal concentration of the stain. Twenty-seven healthy New Zealand white rabbits without eye disease were randomly divided into three groups: gardenia blue staining group;bio-blue positive drug group;physiological saline group. The intraocular pressure, anterior chamber inflammation, corneal endothelial injury, and anterior chamber angle pathological changes were measured in 1D, 7D, and 14D. Results: The results of this study showed that the effect of gardenia blue pigment on the anterior capsule of the lens was the best when the concentration of blue pigment was 2%. There was no change in intraocular pressure in the anterior chamber for a short period of time. There is no damage to the corneal endothelium. Conclusion: The results of this study show that the effect of gardenia blue pigment on the anterior capsule is best when the concentration of blue pigment is 2%, and the stain has no obvious toxic and side effects on the anterior segment of the eye.
文摘Purpose: To determine the effect of anterior capsule polishing (APC) on the rate of posterior capsule opacification (PCO) as assessed by the need for laser posterior capsulotomy. Setting: University-based clinical practice, Jules Stein Eye Institute, Los Angles, California, USA. Methods: This study involved a retrospective review of eyes that underwent phacoemulsification and intraocular lens implantation between September 1991 and June 1999. Lens epithelial cells in the 763 study eyes were mechanically debrided or polished from the inside surface of the anterior capsules using a pair of Shepherd-Rentsch (Morning STAAR Inc.) capsule polishers. The 484 control eyes that had surgery earlier in the series were not polished. The rate of laser capsulotomy in the ACP and the non-ACP groups was compared using a Kaplan-Meier survival analysis. Multivariate regression was performed to determine if variables other than ACP influenced the need for laser posterior capsulotomy. Results: We identified 763 eyes that had ACP and 484 that did not. At the 24-month follow-up interval, 26.6% of the eyes in the ACP group had received a capsulotomy versus 19.50% in the non-APC. Next, a separate study was done using only one eye per patient, taking the patient as the unit of analysis. Again the capsulotomy rate was higher in the ACP group compared to the non-ACP (1.02 per 100 person-months of follow-up vs. 0.74 per 100 person-months of follow-up). Finally, a third Kaplan-Meier analysis was done on 52 patients that had one eye treated with the ACP procedure and the other eye with the non-ACP procedure. Although the log-rank test showed the statistical significant of this analysis to be borderline, the results again favored the non-ACP group with a lower capsulotomy rate. Multivariate analysis showed very similar results to the above univariate studies. The mean time to capsulotomy was 46 months for the polished group and 70 months for the unpolished group. The severity of cataract (p = 0.46) and the type of haptics (p = 0.86) did not influence the rate of capsulotomy. Plate haptic IOLS had a higher rate of capsulotomy than loop haptic IOLS (p = 0.001). Conclusions: Polishing of the anterior capsule with Shepherd-Rentsch polishers may unexpectedly increase the rate of posterior capsule opacification in eyes with round-edge silicone lenses.
文摘Purpose: To observe the effect of preservation of anterior capsule on the incidence of complications associated with silicone oil.
Methods: 82 patients(82 eyes) accepted trans pars plana vitrectomy(TPPV) combined with lensectomy of whom , 30 eyes with preservation of anterior capsule(PAC) and 52eyes with no preservation of anterior capsule (NPAC). Analysis of the incidence of complications associated with use of oil.
Results:The incidence rate was 50.0 % in NPAC group, and 23.3 % in PAC group( P < 0. 025 ). There were seconda'y glaucoma (21. 1% ), band keratopathy ( 13.5 % ) and corneal decompensation(9.6 % ) in NPAC group, while there was none of them in PAC group.
Conclusions: Preservation of anterior capsule is an eftective method to reduce the complications associated with silicone oil. Eye Science 2001; 17:39 ~ 41.
文摘AIM: To assess the early structural changes at clear corneal cataract incision sites and surgical outcomes using anterior segment optical coherence tomography(AS-OCT).METHODS: We evaluated 80 eyes of 59 patients who underwent phacoemulsification with a clear corneal incision. All incisions were evaluated 1 wk, 1, and 3 mo postoperatively using AS-OCT and analyzed regarding angle, length of the incision, maximal corneal thickness at the incision, and if present, corneal endothelial gap length and incision gap area. The patients were divided into two groups according to whether or not an endothelial gap was present at 1 wk postoperatively(endothelial gap, group 1;no endothelial gap, group 2). We analyzed the difference in patient and surgical factors between the two groups, and compared the surgical outcome and the refractive outcome.RESULTS: An endothelial gap was observed in 56(70.0%) of 80 eyes at 1 wk postoperatively but not at 3 mo postoperatively. The mean patient age was significantly higher in group 1 than in group 2. The longer the length of the corneal incision and the steeper the incision angle, the greater the length and area of the endothelial gap. In group 1, the mean change in mean keratometry of the anterior cornea was significantly greater than in group 2, and the spherical equivalent(SE) and mean numerical error indicated significant myopic changes at 1 wk postoperatively. CONCLUSION: The risk of an endothelial gap increases with patient age and a long corneal incision and steep incision angle. The presence of an endothelial gap aftersurgery may affect the early postoperative corneal curvature and SE.
文摘AIM:To introduce a novel measurement method of static cyclotorsion in small incision lenticule extraction(SMILE)and to investigate the effect of preoperative parameters on cyclotorsion and the effect of cyclotorsion on postoperative outcomes.METHODS:The medical records of 242 patients and 484 eyes who under went SMILE surger y were retrospectively reviewed.Preoperative intraocular pressure,refractive error,and corneal thickness were investigated.Refractive values and visual acuity were measured at 1d,1,3,and 6mo.Ocular cyclotorsion in the supine position was measured by calculating the location and angle of the incision site of the cornea in the anterior slit photograph taken after surgery.RESULTS:Of the total 484 eyes in 242 patients,preopera tive means phericale quivalent(SE)was-4.10±1.64 D,and the mean astigmatism was-0.82±0.74 D.Uncorrected distance visual acuity(UCVA)and SE improved significantly after the surgery.Moreover,219(45.2%)eyes had excyclotorsion,235(48.6%)eyes had incyclotorsion,and 30(6.2%)eyes had no torsion.The right eyes tended to be excyclotorted,and the left eyes tended to be incyclotorted(P<0.01).The mean cyclotorsion was 1.18°±3.69°,and the mean absolute value of cyclotorsion was 3.14°±2.26°.The range of cyclotorsion was 0.5°–11.4°.It was found that the smaller the preoperative sphere,the higher the amount of cyclotorsion(r=0.11,P=0.016).There was no significant association between the amount of cyclotorsion and preoperative astigmatism.There was no correlation between sex,preoperative corneal thickness,preoperative intraocular pressure,amount of cyclotorsion,and direction of cyclotorsion.The ratio of right eye excyclotorsion and left eye incyclotorsion on 1d was higher than that at 1,3,and 6mo(all P<0.01).There was no difference between the 1,3,and 6mo results in the right and left eyes(P=0.15,P=0.16,respectively).CONCLUSION:The newly devised ocular cyclotorsion measurement method can be used to evaluate ocular cyclotorsion after SMILE.Preoperative SE is associated with the amount of cyclotorsion,however,cyclotorsion doesn't have a significant effect on the results of SMILE surgery.
文摘AIM: To analyze and compare five different variables over one year follow-up(1 wk, 1, 3, 6 and 12 mo): anterior capsule(AC), and posterior capsule(PC) area densitometry values, AC and PC linear densitometry values, and AC opening area reduction ratio after femtosecond laserassisted cataract surgery. METHODS: This was a prospective comparative study. Seventy-one patients underwent femtosecond laser-assisted cataract surgery on single eye between June 2014 and December 2015. A 5.0 mm diameter laser assisted anterior capsulotomy was performed on all eyes. In every postsurgery evaluation, AC opacificaction(ACO) and PC opacification(PCO) density levels were provided by Oculus Pentacam·HR using area and linear densitometry methods. Digital images were captured with a slit-lamp Topcon photographic camera and IMAGEnet· 5 software. The AC opening area on the digital images was measured using the Sketchandcalc area calculator and converted to reduction ratio levels.RESULTS: Using Pearson correlation coefficient(PCC), we found no correlation(r=-0.091, P=0.46) in the twelfth month assessment between the evolution of ACO area densitometry values and PCO area densitometry values considered as independent variables. We found no correlation, using PCC(r=-0.096, P=0.43) between the evolution of ACO linear densitometry values and PCO linear densitometry values, in the twelfth month visit, working both as independent variables. AC linear densitometry levels and AC area densitometry levels continued to grow strongly from sixth to twelfth months. Analysis of the values of AC opening area reduction ratio(1 wk, 1, 3, 6, 12 mo) revealed statistically significant differences between the values of successive examinations but the magnitude of the change decreased. In the final period of monitoring between six and twelve months the magnitude of change was low.CONCLUSION: Our results show strong increases of Scheimpflug ACO densitometry values from the sixth to the twelfth month while capsulorhexis area reduction ratio levels displayed a considerable decrease. We found no correlation between ACO area and linear densitometry values and PCO area and linear densitometry values, in the twelfth month examination, working as independent variables.
基金the Science and Technology Foundation of Tianjin Eye Hospital(No.YKQN2003)。
文摘AIM:To evaluate the application of anterior segmentoptical coherence tomography(AS-OCT)in posterior capsule opacification(PCO)severity assessment and analyse the relationship between PCO severity and intraocular lens(IOL)characters.METHODS:PCO patients were prospectively recruited.Cross-sectional images of the anterior segment at horizontal and vertical meridians were acquired with AS-OCT.The area of the IOL-PC(posterior capsular)space and PCO severity(area,thickness,and density at 3 mm and 5 mm IOL optic regions)were measured.The relationship between PCO severity and visual acuity,comparisons of PCO severity and IOL-PC space using varied IOL designs were analysed.RESULTS:One hundred PCO eyes were enrolled.IOL-PC space,PCO thickness and area were positively correlated with axial length.In addition,PCO area and thickness were positively correlated with visual acuity when it was≤0.52 log MAR.The cut-off level of visual acuity should be 0.52 log MAR.With varied IOL designs,3-piece C haptic IOL showed a smaller PCO area and thickness than the 1-piece 3 haptic IOL and 1-piece 4 haptic IOL.PCO area and thickness values for an IOL with a diameter≤11.0 mm was greater than for an IOL with a diameter of 12.5 mm,and the differences were statistically significant.PCO area and thickness increased when IOL haptic angulation increased(from 0 to 12 degrees).CONCLUSION:In PCO eyes,cut-off level of visual acuity is 0.52 log MAR.With more severe PCO,visual acuity maybenot enough to describe the visual function impairment.PCO severity and IOL-PC space are significantly correlated with axial length and IOL design and material.
文摘Background: Cataract surgery is the most frequently performed surgery worldwide. Posterior capsule rupture (PCR) remains one of the most common complications of cataract surgery and a major risk factor for poor visual outcomes. Cataract surgeries complicated by PCR and vitreous loss are managed with anterior vitrectomy at the time of surgery. However, the situation can be further complicated by dropping lens particles into the vitreous cavity necessitating a secondary pars plana vitrectomy (PPV). Purpose: To compare the visual outcomes and risk of rhegmatogenous retinal detachment (RRD) between eyes that required anterior vitrectomy (AV) alone for the management of vitreous loss and eyes that required AV and subsequent PPV for the management of dropped nuclear lens fragments (DNLF) following cataract surgery complicated by PCR in a tertiary care teaching hospital in Saudi Arabia. Methods: Medical records of patients in whom PCR occurred during phacoemulsification cataract surgery requiring AV or subsequent PPV for DNLF were retrospectively reviewed over a 6-year period from January 2016 to December 2021. Results: PCR occurred in 183 (2.3%) of 7757 consecutive eyes that underwent phacoemulsification cataract surgery during the study period. Seven eyes were excluded from analysis for missing data or short follow-up. Of the 176 eyes, 147 eyes (83.5%) were managed with AV alone, and the remaining 29 eyes (16.5%) underwent a secondary PPV for DNLF. After excluding eyes with pre-existing ocular pathology, final best-corrected visual acuity (BCVA) was similar in both groups with a mean of 0.32 logMAR (P = 0.99). Two of 147 eyes (1.4%) in the AV group developed RRD with poor final BCVA whereas none of the eyes in DNLF group developed RRD. Conclusion: The risk of RRD is lower in eyes that required PPV for DNLF than in eyes that were managed with AV alone following PCR during cataract surgery. The poor visual outcomes in eyes that suffered RRD underscore the importance of postoperative retinal examination and early detection of retinal breaks.
文摘BACKGROUND The tibial stop of anterior cruciate ligament(ACL) is fan-shaped and attached to the medial groove in front of the intercondylar spine,which is located between the anterior horn of the medial and lateral meniscus.The incidence of this fracture is low previously reported,which is common in children and adolescents.With the increase of sports injury and traffic injury and the deepening of understanding,it is found that the incidence of the disease is high at present.AIM To explore the difference between open reduction and internal fixation with small incision and high-intensity non-absorbable suture under arthroscopy in the treatment of tibial avulsion fracture of ACL.METHODS Seventy-six patients with tibial avulsion fracture of anterior cruciate ligament diagnosed and treated in Guanyun County People’s Hospital from April 2018 to June 2020 were retrospectively analyzed.According to the surgical methods,they were divided into group A(40 cases) and group B(36 cases).Patients in group A were treated with arthroscopic high-strength non-absorbable suture,and patients in group B were treated with small incision open reduction and internal fixation.The operation time,fracture healing time,knee joint activity and functional score before and after operation,and surgical complications of the two groups were compared.RESULTS The operation time of group A was higher than that of group B,and the difference was statistically significant(P < 0.05);the fracture healing time of group A was compared with that of group B,and the difference was not statistically significant(P > 0.05);The knee joint function activity was compared between two groups before operation,3 mo and 6 mo after operation,and the difference was not statistically significant(P > 0.05);the knee joint function activity of group A and group B at 3 mo and 6 mo after operation was significantly higher than that before operation(P < 0.05);the limp,support,lock,instability,swelling,upstairs,squatting,pain and Lysholm score were compared between the two groups before and 6 mo after operation,and the difference was not statistically significant(P > 0.05);the scores of limp,support,lock,instability,swelling,upstairs,squatting,pain and Lysholm in group A and group B at 6 mo after operation were significantly higher than those before operation(P > 0.05);the surgical complication rate of group A was 2.63%,which was lower than 18.42% of group B,and the difference was statistically significant(P > 0.05).CONCLUSION Both small incision open reduction and internal fixation and arthroscopic high-strength nonabsorbable sutures can achieve good results in the treatment of anterior cruciate ligament tibial avulsion fractures.The operation time of arthroscopic high-strength non-absorbable sutures is slightly longer,but the complication rate is lower.