AIM: To evaluate contrast visual acuity(CVA) after implantation of an aspheric apodized diffractive intraocular lens(IOL) or a spherical apodized diffractive IOL in cataract surgery. ·METHODS: This prospective ra...AIM: To evaluate contrast visual acuity(CVA) after implantation of an aspheric apodized diffractive intraocular lens(IOL) or a spherical apodized diffractive IOL in cataract surgery. ·METHODS: This prospective randomized controlled study with a 12-month follow-up compared the results of cataract surgery with implantation of an aspheric AcrySof ReSTOR SN6AD3 IOL(30 eyes) and a spherical AcrySof ReSTOR SN60D3 IOL(30 eyes). CVA with best distance correction was measured at 4 contrast levels(100%,25%,10% and 5%) under 3 levels of chart luminance [250,85 and 25 candelas per square meter(cd/m2)] using a multi-functional visual acuity tester(MFVA-100). ·RESULTS: At 12 months after surgery,there were no statistically significant differences in 100% CVA and 25% CVA under 250cd/m2(P100% =0.875 and P25% =0.057) and 85cd/m2(P100% =0.198 and P25% =0.193) between the aspheric group and the spherical group. However,the 10% CVA and 5% CVA were significant better in aspheric group than spherical group under 250cd/m2(P10% =0.042 and P5% = 0.007) and 85cd/m2(P10% =0.002 and P5%=0.039). Under the luminance level of 25cd/m 2,no significant differences was found in the 100% CVA between the 2 group(P100% = 0.245),while aspheric group had better visual acuity in the remaining 3 contracts(P25% =0.023,P10% =0.026 and P5% = 0.002,respectively). ·CONCULSION: The aspheric AcrySof ReSTOR SN6AD3 IOL provided patients with better low-contrast visual acuity than the spherical AcrySof ReSTOR SN60D3 IOL.展开更多
Glaucoma is closely related to elevation of intraocular pressure (IOP). Many studies have done on the effect of chronic elevation of lOP on the retina and optic nerve, but less attention was paid to the effect of ac...Glaucoma is closely related to elevation of intraocular pressure (IOP). Many studies have done on the effect of chronic elevation of lOP on the retina and optic nerve, but less attention was paid to the effect of acute elevated lOP. Here we briefly review experimental studies on functional changes of the visual system from the retina to the visual cortex under acute elevated lOP condition, which is similar to that of acute primary angle-closure glaucoma.展开更多
Dear Sir,Triamcinolone acetonide(TA)is worldwide available therapeutic agent that is commonly used throughout medicine.TA remains a safe and important ophthalmic therapeutic agent even after the advent of angiogenes...Dear Sir,Triamcinolone acetonide(TA)is worldwide available therapeutic agent that is commonly used throughout medicine.TA remains a safe and important ophthalmic therapeutic agent even after the advent of angiogenesis inhibitors[1-2].展开更多
·AIM: To evaluate the visual function after bilateral implantation of aspheric diffractive multifocal Tecnis ZMA00, aspheric monofocal ZA9003 versus spherical monofocal Akreos Adapt intraocular lenses (IOLs). ...·AIM: To evaluate the visual function after bilateral implantation of aspheric diffractive multifocal Tecnis ZMA00, aspheric monofocal ZA9003 versus spherical monofocal Akreos Adapt intraocular lenses (IOLs). ·METHODS: Tecnis ZMA00, Tecnis ZA9003 or Akreos Adapt IOLs were bilaterally implanted in 180 eyes from 90 patients. The following parameters were assessed 3 months postoperatively: monocular and binocular uncorrected visual acuity (UCVA) and distance-corrected visual acuity (DCVA) for distance, intermediate and near, spherical aberration (SA), contrast and glare sensitivity, near point refractive power, uncorrected and best corrected near stereoscopic acuity (NSA). Patient satisfaction was assessed by a questionnaire. ·RESULTS:Threemonthspostoperatively,themonocular and binocular UCVA and DCVA at near of Tecnis ZMA00 were significantly better than other two groups. The mean SA for 5.0mm optical zone in Tecnis ZMA00 and Tecnis ZA9003 was significantly lower than that in Akreos Adapt. Mean contrast sensitivity and glare sensitivity were better for Tecnis ZA9003 group than for other two groups. Patients with Tecnis ZMA00 had higher monocular and binocular near point refractive power and uncorrected NSA than monofocal groups. The patients in Tecnis ZMA00 had higher mean values for halo compared with other two groups. ·CONCLUSION: Tecnis ZMA00 provided better near VA and uncorrected NSA and higher near point refractive power than monofocal IOLs and patients were spectacle independent. The IOLs with Tecnis aspheric design improved contrast and glare sensitivity. Patients with Tecnis ZMA00 reported more disturbances on visual phenomena of halo. ·展开更多
AIM: To systematically review whether the increased fluctuation of intraocular pressure(IOP) is a risk factor for open angle glaucoma(OAG) progression. METHODS: Scientific studies relevant to IOP fluctuation and glau...AIM: To systematically review whether the increased fluctuation of intraocular pressure(IOP) is a risk factor for open angle glaucoma(OAG) progression. METHODS: Scientific studies relevant to IOP fluctuation and glaucoma progression were retrieved from MEDLINE,EMBASE and CENTRAL databases, and were listed as references in this paper. The hazard ratio(HR) was calculated by using fixed or random-effects models according to the heterogeneity of included studies. RESULTS: Individual data for 2211 eyes of 2637 OAG patients in fourteen prospective studies were included in this Meta-analysis. All studies were longitudinal clinical studies with follow-up period ranging from 3 to 8.5 y. The combined HR was 1.23(95%CI 1.04-1.46, P=0.02) for the association between IOP fluctuation and glaucoma onset or progression with the evidence of heterogeneity(P<0.1).Subgroup analyses with different types of IOP fluctuation were also evaluated. Results indicated that the summary HR was 0.98(95%CI 0.78-1.24) in short-term IOP fluctuation group, which showed no statistical significance with heterogeneity, whereas, the combined HR was 1.43(95%CI1.13-1.82, P=0.003) in long-term IOP fluctuation group without homogeneity. Sensitivity analysis further showed that the pooled HR was 1.10(95%CI 1.03-1.18, P=0.004) for long-term IOP fluctuation and visual function progression with homogeneity among studies(P=0.3). CONCLUSION: Long-term IOP fluctuation can be a risk factor for glaucoma progression based on the presentedevidence. Thus, controlling the swing of IOP is crucial for glaucoma or glaucoma suspecting patients.展开更多
AIM:To investigate short-and long-term intraocular pressure(IOP)fluctuations and fur ther ocular and demographic parameters as predictors for normal tension glaucoma(NTG)progression.METHODS:This retrospective,longitud...AIM:To investigate short-and long-term intraocular pressure(IOP)fluctuations and fur ther ocular and demographic parameters as predictors for normal tension glaucoma(NTG)progression.METHODS:This retrospective,longitudinal cohort study included 137 eyes of 75 patients with NTG,defined by glaucomatous optic disc or visual field defect with normal IOP(<21 mm Hg),independently from therapy regimen.IOP fluctuation,mean,and maximum were inspected with a mean follow-up of 38 mo[standard deviation(SD)18 mo].Inclusion criteria were the performance of minimum two 48-hour profiles including perimetry,Heidelberg retina tomograph(HRT)imaging,and optic disc photographs.The impact of IOP parameters,myopia,sex,cup-to-disc-ratio,and visual field results on progression of NTG were analyzed using Cox regression models.A sub-group analysis with results from optical coherence tomography(OCT)was performed.RESULTS:IOP fluctuations,average,and maximum were not risk factors for progression in NTG patients,although maximum IOP at the initial IOP profile was higher in eyes with progression than in eyes without progression(P=0.054).The 46/137(33.5%)eyes progressed over the followup period.Overall progression(at least three progression confirmations)occurred in 28/137 eyes(20.4%).Most progressions were detected by perimetry(36/46).Longterm IOP mean over all pressure profiles was 12.8 mm Hg(SD 1.3 mm Hg);IOP fluctuation was 1.4 mm Hg(SD 0.8 mm Hg).The progression-free five-year rate was 58.2%(SD 6.5%).CONCLUSION:Short-and long-term IOP fluctuations do not result in progression of NTG.As functional changes are most likely to happen,NTG should be monitored with visual field testing more often than with other devices.展开更多
Purpose: To assess the visual outcome after implantation of the new Hydrophylic IOL type 41 B/G accommodating intraocular lens (AIOL). Methods: The presented lens was implanted during cataract surgery. All patients we...Purpose: To assess the visual outcome after implantation of the new Hydrophylic IOL type 41 B/G accommodating intraocular lens (AIOL). Methods: The presented lens was implanted during cataract surgery. All patients were offered follow-ups, allowing two postoperative measurements to be performed at 3 months and between 2020 and 2021. The mean time between lens implantation and last follow-up was 5.3 years (min. 1 year, max. 10 years). Excluded were patients with age-related macular degeneration or amblyopia. Patients with a foreign lens implanted into the second eye were included in a separate control group. Corrected distance (CDVA) and uncorrected distance visual acuity (UDVA) at 5 m, and corrected near (CNVA) and uncorrected near visual acuity (UNVA) at 40 cm were assessed. Furthermore, the postoperative spherical equivalent (SE), the dependence on spectacles and the occurrence of optical phenomena were evaluated. Results: The final study cohort consists of 65 patients with 119 implanted AIOLs. Significantly better visual results were obtained in both postoperative follow-ups compared with the preoperative results. The mean values of the last follow-up for the UNVA, CNVA, UDVA, and CDVA were 0.107 ± 0.10;0.039 ± 0.08;0.097 ± 0.11;and 0.040 ± 0.09 logMAR, respectively. Visual outcomes remained on a high level for up to 10 years and showed significantly better results compared to the control group. Postoperative SE was significantly improved. Nearly 70% of patients were no longer dependent on glasses. Furthermore, the occurrence of disturbing optical phenomena was denied by all patients. Conclusion: The results of this AIOL are particularly promising, especially since gratifying visual results could still be measured 10 years after implantation.展开更多
Objective:To explore the effect of phacoemulsification in combined with intraocular lens implantation incision site selection on the visual function, intraocular pressure, and corneal astigmatism in patients with cata...Objective:To explore the effect of phacoemulsification in combined with intraocular lens implantation incision site selection on the visual function, intraocular pressure, and corneal astigmatism in patients with cataract.Methods:A total of 72 patients (85 eyes) with cataract who were admitted in our hospital from April, 2015 to October, 2016 were included in the study. All the patients were performed with phacoemulsification in combined with intraocular lens implantation. The patients were divided into the observation group (n=36, 43 eyes) and the control group (n=36, 42 eyes) according to different surgical incision sites. A transparent corneal incision with a length of 3.0 mm was made along the meridian axial position with the maximum corneal refractive power in the observation, while a transparent corneal incision with a length of 3.0 mm was made above the temple or nose in the control group. Routine disposition and follow-up visit were given for the patients in the two groups after operation. BCVA, intraocular pressure, corneal astigmatism, and corneal endothelial cell count in the two groups before and after operation were compared.Results:BCVA after operation in the two groups was significantly elevated, while the corneal endothelial cell count was significantly reduced, but the comparison of BCVA and corneal endothelial cell count between the two groups was not statistically significant. The intraocular pressure after operation in the two groups was elevated first and reduced later. The intraocular pressure 2 h and 1 d after operation was significantly elevated when compared with before operation. The intraocular pressure 2 d after operation was not significantly different from that before operation. The comparison of intraocular pressure at each timing point after operation between the two groups was not statistically significant. The corneal astigmatism after operation in the two groups was elevated first and reduced later. The surgically induced astigmatism 7 d-6 months after operation was significantly reduced, and the average corneal astigmatism 7 d-6 months after operation in the observation group was significantly lower than that in the control group. The surgically induced astigmatism 1-6 months after operation in the observation group was significantly lower than that in the control group.Conclusions: Phacoemulsification in combined with intraocular lens implantation incision site selection including maximum corneal refractive power site and routine surgical incision can improve the patients' vision, but the maximum corneal refractive power site surgical incision can reduce the postoperative corneal astigmatism, and has a certain advantage.展开更多
AIM:To evaluate the surgical treatment and visual outcomes of eyes with cataract and persistent hyperplastic primary vitreous(PHPV).METHODS:This retrospective study included patients with cataract and PHPV treated...AIM:To evaluate the surgical treatment and visual outcomes of eyes with cataract and persistent hyperplastic primary vitreous(PHPV).METHODS:This retrospective study included patients with cataract and PHPV treated with various strategies.Anterior PHPV was treated using phacoemulsification with underwater electric coagulation on posterior capsule neovascularization,posterior capsulotomy,anterior vitrectomy,and intraocular lens(IOL)implantation. Posterior PHPV was treated with lensectomy,posterior vitrectomy,retinal photocoagulation,and IOL implantation or silicone oil tamponade. Visual acuity(VA),pattern visual evoked potential(P-VEP),anatomic recovery,postoperative complications,and amblyopia outcome were examined.Subjects were followed-up for 3-48 mo after surgery.RESULTS:Of the 30 patients(33 eyes)with congenital cataract and PHPV included(average age,39.30±35.47mo),9 eyes had anterior PHPV and 24 had posterior PHPV. Thirty-two eyes were surgically treated. Eyes with anterior PHPV received an IOL during one-stage(6 eyes)and twostage(3 eyes)implantation. Postoperative complications included retinal detachment(1 eye)and recurrent anterior chamber hemorrhage(1 eye). In eyes with posterior PHPV,6 and 11 eyes received IOLs in one-and two-stage procedures,respectively. Silicone oil was retained in 2 eyes,and IOLs were not implanted in 4 eyes. VA significantly improved in 25 eyes following operations and 3-48 mo of amblyopia treatment. P-VEP P_(100) was improved following surgery in both PHPV types.CONCLUSION:Our surgical strategies are appropriate and effective for anterior and posterior PHPV. Early surgical intervention and amblyopia therapy result in positive treatment outcomes.展开更多
AIM:To compare the corneal biomechanical properties difference by ocular response analyzer(ORA) in normal tension glaucoma(NTG) patients with different visual field(VF) progression speed. METHODS:NTG patients ...AIM:To compare the corneal biomechanical properties difference by ocular response analyzer(ORA) in normal tension glaucoma(NTG) patients with different visual field(VF) progression speed. METHODS:NTG patients with well-controlled Goldmann applanation tonometer(GAT) who routinely consulted Kitasato University Hospital Glaucoma Department between January 2010 and February 2014 were enrolled.GAT and ORA parameters including corneal compensated intraocular pressure(lOPcc),Goldmann estimated intraocular pressure(lOPg),corneal hysteresis(CH),corneal resistance factor(CRF) were recorded.VF was tested by Swedish interactive threshold algorithm(SITA)-standard 30-2 fields.All patients underwent VF measurement regularly and GAT did not exceed 15 mm Hg at any time during the 3y follow up.Patients were divided into four groups according to VF change over 3y,and ORA findings were compared between the upper 25th percentile group(slow progression group) and the lower 25th percentile group(rapid progression group).RESULTS:Eighty-two eyes of 56 patients were studied.There were 21 eyes(21 patients) each in rapid and slow progression groups respectively.GAT,lOPcc,lOPg,CH,CRF were 12.1+1.4 mm Hg,15.8±1.8 mm Hg,12.8±2.0 mm Hg,8.4±1.1 mm Hg,7.9±1.3 mm Hg respectively in rapid progression group and 11.5±1.3 mm Hg,13.5±2.1 mm Hg,11.2±1.6 mm Hg,9.3±1.1 mm Hg,8.2±0.9 mm Hg respectively in slow progression group(P=0.214,〈0.001,0.007,0.017,0.413,respectively).In bivariate correlation analysis,lOPcc,lOPcc-GAT and CH were significant correlated with m△MD(r =-0.292,-0.312,0.228 respectively,P =0.008,0.004,0.039 respectively).CONCLUSION:Relatively rapid VF progression occurred in NTG patients whose lOPcc are rather high,CH are rather low and the difference between lOPcc and GAT are relatively large.Higher lOPcc and lower CH are associated with VF progression in NTG patients.This study suggests that GAT measures might underestimate the IOP in such patients.展开更多
Researches of glaucoma visual function damage, hemorrheololgy, ocular rheography and other related multiplex factors, with computed multifactorial stepwise regresion analysis, indicate that the elevation of intraocula...Researches of glaucoma visual function damage, hemorrheololgy, ocular rheography and other related multiplex factors, with computed multifactorial stepwise regresion analysis, indicate that the elevation of intraocular pressure (IOP) is not the only factor to induce visual impairment. POAG patients are shown to have markedly reduced diastolic purfussion pressure in ophthalmic artery, besides prolonged filling time of the retinal artery and vein, diminished erythrocyte deformability and increased platele...展开更多
BACKGROUND Phakic intraocular lens(pIOL)implantation has been commonly prescribed and is considered as a safe and effective option for correcting high myopia.However,it is associated with multiple complications.CASE S...BACKGROUND Phakic intraocular lens(pIOL)implantation has been commonly prescribed and is considered as a safe and effective option for correcting high myopia.However,it is associated with multiple complications.CASE SUMMARY This report describes a case of full-thickness macular hole(MH)in a patient with a history of bilateral pIOL implantation for the correction of myopia of–12.00 diopters in both eyes 7 mo ago.The MH closed after pars plana vitrectomy with internal limiting membrane removal and the best-corrected visual acuity improved to 20/40 in the left eye.CONCLUSION In rare cases,MH can occur following pIOL.In this present case report,we analyzed the formation process of MH following the surgery and emphasized that it is important to inform highly myopic patients about the risk of MH occurrence while being aware of the symptoms of this complication.展开更多
文摘AIM: To evaluate contrast visual acuity(CVA) after implantation of an aspheric apodized diffractive intraocular lens(IOL) or a spherical apodized diffractive IOL in cataract surgery. ·METHODS: This prospective randomized controlled study with a 12-month follow-up compared the results of cataract surgery with implantation of an aspheric AcrySof ReSTOR SN6AD3 IOL(30 eyes) and a spherical AcrySof ReSTOR SN60D3 IOL(30 eyes). CVA with best distance correction was measured at 4 contrast levels(100%,25%,10% and 5%) under 3 levels of chart luminance [250,85 and 25 candelas per square meter(cd/m2)] using a multi-functional visual acuity tester(MFVA-100). ·RESULTS: At 12 months after surgery,there were no statistically significant differences in 100% CVA and 25% CVA under 250cd/m2(P100% =0.875 and P25% =0.057) and 85cd/m2(P100% =0.198 and P25% =0.193) between the aspheric group and the spherical group. However,the 10% CVA and 5% CVA were significant better in aspheric group than spherical group under 250cd/m2(P10% =0.042 and P5% = 0.007) and 85cd/m2(P10% =0.002 and P5%=0.039). Under the luminance level of 25cd/m 2,no significant differences was found in the 100% CVA between the 2 group(P100% = 0.245),while aspheric group had better visual acuity in the remaining 3 contracts(P25% =0.023,P10% =0.026 and P5% = 0.002,respectively). ·CONCULSION: The aspheric AcrySof ReSTOR SN6AD3 IOL provided patients with better low-contrast visual acuity than the spherical AcrySof ReSTOR SN60D3 IOL.
基金grants of the National Natural Science Foundation of China (No. 90208013, No. 30170249).
文摘Glaucoma is closely related to elevation of intraocular pressure (IOP). Many studies have done on the effect of chronic elevation of lOP on the retina and optic nerve, but less attention was paid to the effect of acute elevated lOP. Here we briefly review experimental studies on functional changes of the visual system from the retina to the visual cortex under acute elevated lOP condition, which is similar to that of acute primary angle-closure glaucoma.
文摘Dear Sir,Triamcinolone acetonide(TA)is worldwide available therapeutic agent that is commonly used throughout medicine.TA remains a safe and important ophthalmic therapeutic agent even after the advent of angiogenesis inhibitors[1-2].
基金Zhejiang Key Innovation Team Project(No. 2009R50039)Doctoral Fund of Ministry of Education of China (No: 20100101120135)Key Lab Fund of Zhejiang Province, China (No. 2011E10006)
文摘·AIM: To evaluate the visual function after bilateral implantation of aspheric diffractive multifocal Tecnis ZMA00, aspheric monofocal ZA9003 versus spherical monofocal Akreos Adapt intraocular lenses (IOLs). ·METHODS: Tecnis ZMA00, Tecnis ZA9003 or Akreos Adapt IOLs were bilaterally implanted in 180 eyes from 90 patients. The following parameters were assessed 3 months postoperatively: monocular and binocular uncorrected visual acuity (UCVA) and distance-corrected visual acuity (DCVA) for distance, intermediate and near, spherical aberration (SA), contrast and glare sensitivity, near point refractive power, uncorrected and best corrected near stereoscopic acuity (NSA). Patient satisfaction was assessed by a questionnaire. ·RESULTS:Threemonthspostoperatively,themonocular and binocular UCVA and DCVA at near of Tecnis ZMA00 were significantly better than other two groups. The mean SA for 5.0mm optical zone in Tecnis ZMA00 and Tecnis ZA9003 was significantly lower than that in Akreos Adapt. Mean contrast sensitivity and glare sensitivity were better for Tecnis ZA9003 group than for other two groups. Patients with Tecnis ZMA00 had higher monocular and binocular near point refractive power and uncorrected NSA than monofocal groups. The patients in Tecnis ZMA00 had higher mean values for halo compared with other two groups. ·CONCLUSION: Tecnis ZMA00 provided better near VA and uncorrected NSA and higher near point refractive power than monofocal IOLs and patients were spectacle independent. The IOLs with Tecnis aspheric design improved contrast and glare sensitivity. Patients with Tecnis ZMA00 reported more disturbances on visual phenomena of halo. ·
基金Supported by National Natural Science Foundation of China (No.81200687)Innovative Spark Grant of Sichuan University (No.2018SCUH0062)
文摘AIM: To systematically review whether the increased fluctuation of intraocular pressure(IOP) is a risk factor for open angle glaucoma(OAG) progression. METHODS: Scientific studies relevant to IOP fluctuation and glaucoma progression were retrieved from MEDLINE,EMBASE and CENTRAL databases, and were listed as references in this paper. The hazard ratio(HR) was calculated by using fixed or random-effects models according to the heterogeneity of included studies. RESULTS: Individual data for 2211 eyes of 2637 OAG patients in fourteen prospective studies were included in this Meta-analysis. All studies were longitudinal clinical studies with follow-up period ranging from 3 to 8.5 y. The combined HR was 1.23(95%CI 1.04-1.46, P=0.02) for the association between IOP fluctuation and glaucoma onset or progression with the evidence of heterogeneity(P<0.1).Subgroup analyses with different types of IOP fluctuation were also evaluated. Results indicated that the summary HR was 0.98(95%CI 0.78-1.24) in short-term IOP fluctuation group, which showed no statistical significance with heterogeneity, whereas, the combined HR was 1.43(95%CI1.13-1.82, P=0.003) in long-term IOP fluctuation group without homogeneity. Sensitivity analysis further showed that the pooled HR was 1.10(95%CI 1.03-1.18, P=0.004) for long-term IOP fluctuation and visual function progression with homogeneity among studies(P=0.3). CONCLUSION: Long-term IOP fluctuation can be a risk factor for glaucoma progression based on the presentedevidence. Thus, controlling the swing of IOP is crucial for glaucoma or glaucoma suspecting patients.
基金a DFG(German Research Foundation)Grant(HO 3277/2-1)。
文摘AIM:To investigate short-and long-term intraocular pressure(IOP)fluctuations and fur ther ocular and demographic parameters as predictors for normal tension glaucoma(NTG)progression.METHODS:This retrospective,longitudinal cohort study included 137 eyes of 75 patients with NTG,defined by glaucomatous optic disc or visual field defect with normal IOP(<21 mm Hg),independently from therapy regimen.IOP fluctuation,mean,and maximum were inspected with a mean follow-up of 38 mo[standard deviation(SD)18 mo].Inclusion criteria were the performance of minimum two 48-hour profiles including perimetry,Heidelberg retina tomograph(HRT)imaging,and optic disc photographs.The impact of IOP parameters,myopia,sex,cup-to-disc-ratio,and visual field results on progression of NTG were analyzed using Cox regression models.A sub-group analysis with results from optical coherence tomography(OCT)was performed.RESULTS:IOP fluctuations,average,and maximum were not risk factors for progression in NTG patients,although maximum IOP at the initial IOP profile was higher in eyes with progression than in eyes without progression(P=0.054).The 46/137(33.5%)eyes progressed over the followup period.Overall progression(at least three progression confirmations)occurred in 28/137 eyes(20.4%).Most progressions were detected by perimetry(36/46).Longterm IOP mean over all pressure profiles was 12.8 mm Hg(SD 1.3 mm Hg);IOP fluctuation was 1.4 mm Hg(SD 0.8 mm Hg).The progression-free five-year rate was 58.2%(SD 6.5%).CONCLUSION:Short-and long-term IOP fluctuations do not result in progression of NTG.As functional changes are most likely to happen,NTG should be monitored with visual field testing more often than with other devices.
文摘Purpose: To assess the visual outcome after implantation of the new Hydrophylic IOL type 41 B/G accommodating intraocular lens (AIOL). Methods: The presented lens was implanted during cataract surgery. All patients were offered follow-ups, allowing two postoperative measurements to be performed at 3 months and between 2020 and 2021. The mean time between lens implantation and last follow-up was 5.3 years (min. 1 year, max. 10 years). Excluded were patients with age-related macular degeneration or amblyopia. Patients with a foreign lens implanted into the second eye were included in a separate control group. Corrected distance (CDVA) and uncorrected distance visual acuity (UDVA) at 5 m, and corrected near (CNVA) and uncorrected near visual acuity (UNVA) at 40 cm were assessed. Furthermore, the postoperative spherical equivalent (SE), the dependence on spectacles and the occurrence of optical phenomena were evaluated. Results: The final study cohort consists of 65 patients with 119 implanted AIOLs. Significantly better visual results were obtained in both postoperative follow-ups compared with the preoperative results. The mean values of the last follow-up for the UNVA, CNVA, UDVA, and CDVA were 0.107 ± 0.10;0.039 ± 0.08;0.097 ± 0.11;and 0.040 ± 0.09 logMAR, respectively. Visual outcomes remained on a high level for up to 10 years and showed significantly better results compared to the control group. Postoperative SE was significantly improved. Nearly 70% of patients were no longer dependent on glasses. Furthermore, the occurrence of disturbing optical phenomena was denied by all patients. Conclusion: The results of this AIOL are particularly promising, especially since gratifying visual results could still be measured 10 years after implantation.
文摘Objective:To explore the effect of phacoemulsification in combined with intraocular lens implantation incision site selection on the visual function, intraocular pressure, and corneal astigmatism in patients with cataract.Methods:A total of 72 patients (85 eyes) with cataract who were admitted in our hospital from April, 2015 to October, 2016 were included in the study. All the patients were performed with phacoemulsification in combined with intraocular lens implantation. The patients were divided into the observation group (n=36, 43 eyes) and the control group (n=36, 42 eyes) according to different surgical incision sites. A transparent corneal incision with a length of 3.0 mm was made along the meridian axial position with the maximum corneal refractive power in the observation, while a transparent corneal incision with a length of 3.0 mm was made above the temple or nose in the control group. Routine disposition and follow-up visit were given for the patients in the two groups after operation. BCVA, intraocular pressure, corneal astigmatism, and corneal endothelial cell count in the two groups before and after operation were compared.Results:BCVA after operation in the two groups was significantly elevated, while the corneal endothelial cell count was significantly reduced, but the comparison of BCVA and corneal endothelial cell count between the two groups was not statistically significant. The intraocular pressure after operation in the two groups was elevated first and reduced later. The intraocular pressure 2 h and 1 d after operation was significantly elevated when compared with before operation. The intraocular pressure 2 d after operation was not significantly different from that before operation. The comparison of intraocular pressure at each timing point after operation between the two groups was not statistically significant. The corneal astigmatism after operation in the two groups was elevated first and reduced later. The surgically induced astigmatism 7 d-6 months after operation was significantly reduced, and the average corneal astigmatism 7 d-6 months after operation in the observation group was significantly lower than that in the control group. The surgically induced astigmatism 1-6 months after operation in the observation group was significantly lower than that in the control group.Conclusions: Phacoemulsification in combined with intraocular lens implantation incision site selection including maximum corneal refractive power site and routine surgical incision can improve the patients' vision, but the maximum corneal refractive power site surgical incision can reduce the postoperative corneal astigmatism, and has a certain advantage.
基金Supported by the Science and Technology Research Projects of Henan Province,China(No.201202010)
文摘AIM:To evaluate the surgical treatment and visual outcomes of eyes with cataract and persistent hyperplastic primary vitreous(PHPV).METHODS:This retrospective study included patients with cataract and PHPV treated with various strategies.Anterior PHPV was treated using phacoemulsification with underwater electric coagulation on posterior capsule neovascularization,posterior capsulotomy,anterior vitrectomy,and intraocular lens(IOL)implantation. Posterior PHPV was treated with lensectomy,posterior vitrectomy,retinal photocoagulation,and IOL implantation or silicone oil tamponade. Visual acuity(VA),pattern visual evoked potential(P-VEP),anatomic recovery,postoperative complications,and amblyopia outcome were examined.Subjects were followed-up for 3-48 mo after surgery.RESULTS:Of the 30 patients(33 eyes)with congenital cataract and PHPV included(average age,39.30±35.47mo),9 eyes had anterior PHPV and 24 had posterior PHPV. Thirty-two eyes were surgically treated. Eyes with anterior PHPV received an IOL during one-stage(6 eyes)and twostage(3 eyes)implantation. Postoperative complications included retinal detachment(1 eye)and recurrent anterior chamber hemorrhage(1 eye). In eyes with posterior PHPV,6 and 11 eyes received IOLs in one-and two-stage procedures,respectively. Silicone oil was retained in 2 eyes,and IOLs were not implanted in 4 eyes. VA significantly improved in 25 eyes following operations and 3-48 mo of amblyopia treatment. P-VEP P_(100) was improved following surgery in both PHPV types.CONCLUSION:Our surgical strategies are appropriate and effective for anterior and posterior PHPV. Early surgical intervention and amblyopia therapy result in positive treatment outcomes.
文摘AIM:To compare the corneal biomechanical properties difference by ocular response analyzer(ORA) in normal tension glaucoma(NTG) patients with different visual field(VF) progression speed. METHODS:NTG patients with well-controlled Goldmann applanation tonometer(GAT) who routinely consulted Kitasato University Hospital Glaucoma Department between January 2010 and February 2014 were enrolled.GAT and ORA parameters including corneal compensated intraocular pressure(lOPcc),Goldmann estimated intraocular pressure(lOPg),corneal hysteresis(CH),corneal resistance factor(CRF) were recorded.VF was tested by Swedish interactive threshold algorithm(SITA)-standard 30-2 fields.All patients underwent VF measurement regularly and GAT did not exceed 15 mm Hg at any time during the 3y follow up.Patients were divided into four groups according to VF change over 3y,and ORA findings were compared between the upper 25th percentile group(slow progression group) and the lower 25th percentile group(rapid progression group).RESULTS:Eighty-two eyes of 56 patients were studied.There were 21 eyes(21 patients) each in rapid and slow progression groups respectively.GAT,lOPcc,lOPg,CH,CRF were 12.1+1.4 mm Hg,15.8±1.8 mm Hg,12.8±2.0 mm Hg,8.4±1.1 mm Hg,7.9±1.3 mm Hg respectively in rapid progression group and 11.5±1.3 mm Hg,13.5±2.1 mm Hg,11.2±1.6 mm Hg,9.3±1.1 mm Hg,8.2±0.9 mm Hg respectively in slow progression group(P=0.214,〈0.001,0.007,0.017,0.413,respectively).In bivariate correlation analysis,lOPcc,lOPcc-GAT and CH were significant correlated with m△MD(r =-0.292,-0.312,0.228 respectively,P =0.008,0.004,0.039 respectively).CONCLUSION:Relatively rapid VF progression occurred in NTG patients whose lOPcc are rather high,CH are rather low and the difference between lOPcc and GAT are relatively large.Higher lOPcc and lower CH are associated with VF progression in NTG patients.This study suggests that GAT measures might underestimate the IOP in such patients.
基金This Study was supported by China National Ministry of Health Young Grants(1987)Dr. Y. T. Fox Fund for Young Education of China NationaI Committee of Education(1989)
文摘Researches of glaucoma visual function damage, hemorrheololgy, ocular rheography and other related multiplex factors, with computed multifactorial stepwise regresion analysis, indicate that the elevation of intraocular pressure (IOP) is not the only factor to induce visual impairment. POAG patients are shown to have markedly reduced diastolic purfussion pressure in ophthalmic artery, besides prolonged filling time of the retinal artery and vein, diminished erythrocyte deformability and increased platele...
文摘BACKGROUND Phakic intraocular lens(pIOL)implantation has been commonly prescribed and is considered as a safe and effective option for correcting high myopia.However,it is associated with multiple complications.CASE SUMMARY This report describes a case of full-thickness macular hole(MH)in a patient with a history of bilateral pIOL implantation for the correction of myopia of–12.00 diopters in both eyes 7 mo ago.The MH closed after pars plana vitrectomy with internal limiting membrane removal and the best-corrected visual acuity improved to 20/40 in the left eye.CONCLUSION In rare cases,MH can occur following pIOL.In this present case report,we analyzed the formation process of MH following the surgery and emphasized that it is important to inform highly myopic patients about the risk of MH occurrence while being aware of the symptoms of this complication.