AIM: To compare and calculate the 3-year refractive results, higher-order aberrations (HOAs), contrast sensitivity (CS) and dry eye parameters after small incision lenticule extraction (SMILE) and wavefront-gui...AIM: To compare and calculate the 3-year refractive results, higher-order aberrations (HOAs), contrast sensitivity (CS) and dry eye parameters after small incision lenticule extraction (SMILE) and wavefront-guided femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) for correction of high myopia and myopic astigmatism. METHODS: In this prospective, non-randomized comparative study, 78 eyes with spherical equivalent (SE) of -8.11±1.09 diopters (D) received a SMILE surgery, and 65 eyes with SE of -8.05±1.12 D received a wavefront-guided FS-LASIK surgery with the VisuMax femtosecond laser (Carl Zeiss Meditec, Jena, Germany) for flap cutting. Visual acuity, manifest refraction, CS, HOAs, ocular surface disease index (OSDI) and tear break-up time (TBUT) were evaluated during a 3-year follow-up. RESULTS: The difference of uncorrected distance visual acuity (UDVA) postoperatively was achieved at lmo and at 3mo, whereas the difference of the mean UDVA between two groups at 3y were not statistically significant (t=-1.59, P=-0.13). The postoperative change of SE was 0.89 D in the FS-LASIK group (t=5.76, P=0.00), and 0.14 D in the SMILE group (t=-0.54, P=0.59) from lmo to 3y after surgery. At 3-year postoperatively, both HOAs and spherical aberrations in the SMILE group were obviously less than those in the FS-LASIK group (P=0.00), but the coma root mean square (RMS) was higher in the SMILE group (0.59±0.26) than in the FS-LASIK group (0.29±0.14, P=0.00). The mesopic CS values between two groups were not statistically significant at 3y postoperatively. Compared with the FS-LASIK group, lower OSDI scores and longer TBUT values were found in the SMILE group at Imo and 3mo postoperatively. With regard to safety, no eye lost any line of CDVA in both groups at 3y after surgery. CONCLUSION: Both SMILE and wavefront-guided FS- LASIK procedures provide good visual outcomes. Both procedures are effective and safe, but SMILE surgery achieve more stable long-term refractive outcome and better control of early postoperative dry eye as compared to FS-LASIK.展开更多
目的研究探讨经膝关节镜引导小切口手术治疗胫骨平台骨折(Fracture of Tibial Plateau,FTP)疗效及对患者日常生活活动(Activity of Daily Living,ADL)评分的影响。方法方便选择该院骨外科收治的60例胫骨平台骨折患者(2015年1月-2018年12...目的研究探讨经膝关节镜引导小切口手术治疗胫骨平台骨折(Fracture of Tibial Plateau,FTP)疗效及对患者日常生活活动(Activity of Daily Living,ADL)评分的影响。方法方便选择该院骨外科收治的60例胫骨平台骨折患者(2015年1月-2018年12月)进行前瞻性研究,随机分为2组各30例,对照组实施传统切开复位内固定术,观察组实施经膝关节镜引导小切口切开复位内固定术,比较手术情况、术后并发症发生率、术后疼痛评分、临床疗效、膝关节活动度、膝关节功能评分、ADL评分。结果①两组手术用时比较差异无统计学意义(P>0.05),但观察组的术中出血量(84.12±23.45)mL较对照组更少,其术后并发症发生率(0.00%)较对照组更低,(t=5.973,χ^2=4.286,P<0.05)。②在术后各个时间点,观察组的疼痛评分均较对照组更低(t=3.801、4.115、4.349、4.422,P<0.05)。③优良率分别为93.33%(观察组)、73.33%(对照组),观察组较对照组更高(χ^2=4.320,P<0.05)。④治疗后,观察组的伸膝最大角度、屈膝最大角度均较对照组更大,其膝关节功能评分、ADL评分均较对照组更高(P<0.05)。结论在膝关节镜引导下行小切口切开复位内固定术可有效减少胫骨平台骨折患者的手术创伤和术后并发症,减轻其术后疼痛感,有利于提高其临床疗效,更好地改善其膝关节功能和日常生活活动功能。展开更多
文摘AIM: To compare and calculate the 3-year refractive results, higher-order aberrations (HOAs), contrast sensitivity (CS) and dry eye parameters after small incision lenticule extraction (SMILE) and wavefront-guided femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) for correction of high myopia and myopic astigmatism. METHODS: In this prospective, non-randomized comparative study, 78 eyes with spherical equivalent (SE) of -8.11±1.09 diopters (D) received a SMILE surgery, and 65 eyes with SE of -8.05±1.12 D received a wavefront-guided FS-LASIK surgery with the VisuMax femtosecond laser (Carl Zeiss Meditec, Jena, Germany) for flap cutting. Visual acuity, manifest refraction, CS, HOAs, ocular surface disease index (OSDI) and tear break-up time (TBUT) were evaluated during a 3-year follow-up. RESULTS: The difference of uncorrected distance visual acuity (UDVA) postoperatively was achieved at lmo and at 3mo, whereas the difference of the mean UDVA between two groups at 3y were not statistically significant (t=-1.59, P=-0.13). The postoperative change of SE was 0.89 D in the FS-LASIK group (t=5.76, P=0.00), and 0.14 D in the SMILE group (t=-0.54, P=0.59) from lmo to 3y after surgery. At 3-year postoperatively, both HOAs and spherical aberrations in the SMILE group were obviously less than those in the FS-LASIK group (P=0.00), but the coma root mean square (RMS) was higher in the SMILE group (0.59±0.26) than in the FS-LASIK group (0.29±0.14, P=0.00). The mesopic CS values between two groups were not statistically significant at 3y postoperatively. Compared with the FS-LASIK group, lower OSDI scores and longer TBUT values were found in the SMILE group at Imo and 3mo postoperatively. With regard to safety, no eye lost any line of CDVA in both groups at 3y after surgery. CONCLUSION: Both SMILE and wavefront-guided FS- LASIK procedures provide good visual outcomes. Both procedures are effective and safe, but SMILE surgery achieve more stable long-term refractive outcome and better control of early postoperative dry eye as compared to FS-LASIK.
文摘目的研究探讨经膝关节镜引导小切口手术治疗胫骨平台骨折(Fracture of Tibial Plateau,FTP)疗效及对患者日常生活活动(Activity of Daily Living,ADL)评分的影响。方法方便选择该院骨外科收治的60例胫骨平台骨折患者(2015年1月-2018年12月)进行前瞻性研究,随机分为2组各30例,对照组实施传统切开复位内固定术,观察组实施经膝关节镜引导小切口切开复位内固定术,比较手术情况、术后并发症发生率、术后疼痛评分、临床疗效、膝关节活动度、膝关节功能评分、ADL评分。结果①两组手术用时比较差异无统计学意义(P>0.05),但观察组的术中出血量(84.12±23.45)mL较对照组更少,其术后并发症发生率(0.00%)较对照组更低,(t=5.973,χ^2=4.286,P<0.05)。②在术后各个时间点,观察组的疼痛评分均较对照组更低(t=3.801、4.115、4.349、4.422,P<0.05)。③优良率分别为93.33%(观察组)、73.33%(对照组),观察组较对照组更高(χ^2=4.320,P<0.05)。④治疗后,观察组的伸膝最大角度、屈膝最大角度均较对照组更大,其膝关节功能评分、ADL评分均较对照组更高(P<0.05)。结论在膝关节镜引导下行小切口切开复位内固定术可有效减少胫骨平台骨折患者的手术创伤和术后并发症,减轻其术后疼痛感,有利于提高其临床疗效,更好地改善其膝关节功能和日常生活活动功能。