●AIM:To assess effectivity and safety of trifocal intraocular lenses(IOLs)and capsular tension rings in treating cataract patients with axial high myopia.●METHODS:A prospective nonrandomized controlled clinical tria...●AIM:To assess effectivity and safety of trifocal intraocular lenses(IOLs)and capsular tension rings in treating cataract patients with axial high myopia.●METHODS:A prospective nonrandomized controlled clinical trial was conducted.Totally 98 eyes(74 patients)who underwent femtosecond laser-assisted cataract surgery(FLACS)with trifocal IOLs were enrolled in the study and followed up for 2y after surgery:46 eyes(33 patients)with capsular tension ring implantation in the long axial lengths(AL)group(26<AL<29 mm)and 52 eyes(41 patients)in the normal AL group(22<AL<24.5 mm).Postoperative outcomes about effectivity and safety,including the subjective and objective visual quality,and postoperative complications were assessed.●RESULTS:Uncorrected distance visual acuity at 5 m and uncorrected intermediate visual acuity at 60 and 80 cm in the long AL group were significantly worse than those in the normal AL group at 3mo postoperatively(P<0.05).The differences in reading speed,spectacle independence and potential visual complaints between the two groups were not statistically significant(P>0.05).The dysfunctional lens index and total modulation transfer function(MTF)average height were similar between the two groups.The postoperative internal coma aberrations in the axial high myopia eyes were significantly higher than that in the normal AL group(P<0.05).The total satisfaction score in the long AL group(91.32±2.76)was slightly higher than that in the normal AL group(90.36±3.47),but there was no difference(P=0.136).A statistically negative correlation was found between corrected distance visual acuity(CDVA)and dysfunctional lens index(r=-0.382,P=0.009),and between CDVA and the total MTF average height(r=-0.374,P=0.01).But there was no significant correlation between CDVA and total satisfaction score(r=0.059,P=0.696).Postoperative complications mainly presented as posterior capsular opacity(PCO),retinal detachment and cystoid macular edema.There was no difference in the incidence of fundus disease(6.5%vs 3.8%,P=0.663)or PCO(17.4%vs 7.7%,P=0.217)between the two groups at two years.●CONCLUSION:The utilization of trifocal IOL and capsular tension ring implantation is beneficial for cataract patients with axial high myopia undergoing FLACS.This approach not only ensures excellent subjective feelings and objective visual quality,but also does not increase the incidence of postoperative complications.展开更多
AIM： To compare the axial lengths （ALs） measured with Lenstar, IOLMaster and A-scan contact ultrasound （Ultrasound） in normal and high myopia （HM）. METHODS： Eighty-four normal eyes and 49 HM eyes were include...AIM： To compare the axial lengths （ALs） measured with Lenstar, IOLMaster and A-scan contact ultrasound （Ultrasound） in normal and high myopia （HM）. METHODS： Eighty-four normal eyes and 49 HM eyes were included. Three consecutive measurements were performed on each eye in the following order： Lenstar, IOLMaster, and Ultrasound. The repeatabilities of the AL measurements for each instrument were assessed by calculating the pooled coefficients of variation （CVs） of 18 eyes in each group. Comparisons between the HM and normal groups were made with independent sample t-tests. The inter-device agreements were evaluated with Bland-Altman analyses and paired two-tailed t-tests. RESULTS： For normal group, the CVs of the AL measurements taken with the Lenstar, IOLMaster and Ultrasound were 0.001%, 0.01% and 0.14%, respectively. The corresponding CVs for the HM group were 0.005%, 0.02% and 0.15%, respectively. There was significant difference between the Lenstar and the IOLMaster in normal group （P=0.031） but not in HM group （n=0.100）. In the two groups, the Lenstar and the IOLMaster produced higher values than did the Ultrasound （all P〈 0.001）. All three instruments exhibited good agreement in terms of AL values. For the intraocular lens （IOL） power calculation using SRK II formula, the Lenstar and the IOLMaster showed 0.5 D higher than Ultrasound in both groups （all P〈0.001）. No significant difference existed between the Lenstar and the IOLMaster for the IOL power calculation in both normal （n=0.474） and HM group （P= 0.103）. CONCLUSION： The three devices exhibited excellent intra-visit repeatabilities in the AL measurements. The AL and IOL power difference between partial coherence interferometry and ultrasound instruments should be noticed.展开更多
AIM:To evaluate the accuracy of axial length(AL)measurements obtained from immersion B-scan ultrasonography(immersion B-scan)for intraocular lens(IOL)power calculation in patients with high myopia and cataracts.METHOD...AIM:To evaluate the accuracy of axial length(AL)measurements obtained from immersion B-scan ultrasonography(immersion B-scan)for intraocular lens(IOL)power calculation in patients with high myopia and cataracts.METHODS:Immersion B-scan,contact A-scan ultrasonography(contact A-scan),and the IOLMaster were used to preoperatively measure the AL in 102 eyes from 102 patients who underwent phacoemulsification and IOL implantation.Patients were divided into two groups according to the AL:one containing patients with22 mm≤AL【26 mm(group A)and the other containing patients with AL≥26 mm(group B).The mean error(ME)was calculated from the difference between the AL measurement methods predicted refractive error and the actual postoperative refractive error.RESULTS:Ingroup A,ALs measured byimmersion Bscan(23.48±1.15)didn’t differ significantly from those measured by the IOLMaster(23.52±1.17)or from those by contact A-scan(23.38±1.20).In the same group,the standard deviation(SD)of the mean error(ME)of immersion B-scan(-0.090±0.397 D)didn’t differ significantly from those of IOLMaster(-0.095±0.411 D)and contact A-scan(-0.099±0.425 D).In group B,ALs measured by immersion B-scan(27.97±2.21 mm)didn’t differ significantly from those of the IOLMaster(27.86±2.18 mm),but longer than those measured by Contact A-scan(27.75±2.23 mm,P=0.009).In the same group,the standard deviation(SD)of the mean error(ME)of immersion B-scan(-0.635±0.157 D)didn’t differ significantly from those of the IOLMaster(-0.679±0.359 D),but differed significantly from those of contact A-scan(-0.953±1.713 D,P=0.028).CONCLUSION:ImmersionB-scanexhibitsmeasurement accuracy comparable to that of the IOLMaster,and is thus a good alternative in measuring AL in eyes with high myopia when the IOLMaster can’t be used,and it is more accurate than the contact A-scan.展开更多
AIM：To evaluate the influence of age and axial length（AL） on the position of the fovea in patients with high myopia（HM）.METHODS：In this prospective study,96 patients（186 eyes） with HM were consecutively recrui...AIM：To evaluate the influence of age and axial length（AL） on the position of the fovea in patients with high myopia（HM）.METHODS：In this prospective study,96 patients（186 eyes） with HM were consecutively recruited from the Third Affiliated Hospital of Nanchang University.DRI-OCT Atlantis,fundus imaging,and IOL Master were used in this study.Three indices were measured：the distance between the fovea and the optic nerve head（ONH） center（DFO）,the vertical distance between the fovea and the horizontal line pass of the ONH center（VDFO）,and the horizontal distance between the fovea and the vertical line pass of the ONH center（HDFO）.These measurements were used to analyze the effects of different age groups（A1,A2,A3 groups） and AL（AL1,AL2,AL3,AL4 groups） on these indices.RESULTS：The results showed that there was no statistical significance in DFO among the age and AL groups（F=0.46,0.37;P=0.62,0.76,respectively）.In HDFO,there was also no statistical significance among the age and AL groups（F=0.10,0.48;P=0.90,0.69,respectively）.In VDFO,however,the difference in the age and AL groups was statistically significant（F=3.21,3.12;P=0.04,0.02,respectively）.Thus,VDFO were correlated with age and AL（r=0.21,0.23,all P〈0.01）,while HDFO and DFO were not correlated with age and AL（r=0.30,P〉0.05）.CONCLUSION：In high myopia,the foveal position changes mainly in the vertical direction along with factors of age and AL.展开更多
目的分析低龄幼儿早发性高度近视(eoHM)的临床特点,为临床诊疗提供指导。方法纳入首次采用睫状肌麻痹检影验光确诊为eoHM的患儿[任意一眼等效球镜(SE)≤-6.00 D],统计分析眼位、裂隙灯、彩色眼底照相、眼部生物测量等检查结果。结果共收...目的分析低龄幼儿早发性高度近视(eoHM)的临床特点,为临床诊疗提供指导。方法纳入首次采用睫状肌麻痹检影验光确诊为eoHM的患儿[任意一眼等效球镜(SE)≤-6.00 D],统计分析眼位、裂隙灯、彩色眼底照相、眼部生物测量等检查结果。结果共收集10例eoHM患儿的临床资料,其中男7例,女3例;首诊月龄35~60个月,平均(47.70±8.53)个月。10例(20眼)患儿中,SE≤-6.00 D 12眼。单眼近视4例,双眼对称性近视4例,双眼不对称性近视2例。屈光参差8例,其中6例为重度屈光参差。SE≤-6.00 D 12眼,首诊时裸眼视力及最佳矫正视力均为视力低下。7例(14眼)完成眼部生物学测量,其中高度近视9眼,平均SE(-8.19±2.99)D,平均眼轴(AL)(25.28±0.92)mm,平均角膜曲率(Km)(44.38±1.03)D,平均AL/角膜曲率半径(CR)(3.32±0.17)。SE与AL及AL/CR均呈明显负相关(P<0.05),与Km无明显相关性(P=0.132)。2例单眼高度近视合并视网膜有髓神经纤维;1例单眼高度近视合并白内障及玻璃体混浊;1例双眼合并视网膜色素变性;1例双眼合并牵牛花综合征、眼球震颤;3例合并斜视。结论eoHM多表现为轴性近视及屈光参差,对视力影响明显,易合并视网膜病变等先天异常,重视eoHM患儿早期筛查和诊治,有利于提高视功能和有效防治弱视。展开更多
文摘●AIM:To assess effectivity and safety of trifocal intraocular lenses(IOLs)and capsular tension rings in treating cataract patients with axial high myopia.●METHODS:A prospective nonrandomized controlled clinical trial was conducted.Totally 98 eyes(74 patients)who underwent femtosecond laser-assisted cataract surgery(FLACS)with trifocal IOLs were enrolled in the study and followed up for 2y after surgery:46 eyes(33 patients)with capsular tension ring implantation in the long axial lengths(AL)group(26<AL<29 mm)and 52 eyes(41 patients)in the normal AL group(22<AL<24.5 mm).Postoperative outcomes about effectivity and safety,including the subjective and objective visual quality,and postoperative complications were assessed.●RESULTS:Uncorrected distance visual acuity at 5 m and uncorrected intermediate visual acuity at 60 and 80 cm in the long AL group were significantly worse than those in the normal AL group at 3mo postoperatively(P<0.05).The differences in reading speed,spectacle independence and potential visual complaints between the two groups were not statistically significant(P>0.05).The dysfunctional lens index and total modulation transfer function(MTF)average height were similar between the two groups.The postoperative internal coma aberrations in the axial high myopia eyes were significantly higher than that in the normal AL group(P<0.05).The total satisfaction score in the long AL group(91.32±2.76)was slightly higher than that in the normal AL group(90.36±3.47),but there was no difference(P=0.136).A statistically negative correlation was found between corrected distance visual acuity(CDVA)and dysfunctional lens index(r=-0.382,P=0.009),and between CDVA and the total MTF average height(r=-0.374,P=0.01).But there was no significant correlation between CDVA and total satisfaction score(r=0.059,P=0.696).Postoperative complications mainly presented as posterior capsular opacity(PCO),retinal detachment and cystoid macular edema.There was no difference in the incidence of fundus disease(6.5%vs 3.8%,P=0.663)or PCO(17.4%vs 7.7%,P=0.217)between the two groups at two years.●CONCLUSION:The utilization of trifocal IOL and capsular tension ring implantation is beneficial for cataract patients with axial high myopia undergoing FLACS.This approach not only ensures excellent subjective feelings and objective visual quality,but also does not increase the incidence of postoperative complications.
文摘AIM： To compare the axial lengths （ALs） measured with Lenstar, IOLMaster and A-scan contact ultrasound （Ultrasound） in normal and high myopia （HM）. METHODS： Eighty-four normal eyes and 49 HM eyes were included. Three consecutive measurements were performed on each eye in the following order： Lenstar, IOLMaster, and Ultrasound. The repeatabilities of the AL measurements for each instrument were assessed by calculating the pooled coefficients of variation （CVs） of 18 eyes in each group. Comparisons between the HM and normal groups were made with independent sample t-tests. The inter-device agreements were evaluated with Bland-Altman analyses and paired two-tailed t-tests. RESULTS： For normal group, the CVs of the AL measurements taken with the Lenstar, IOLMaster and Ultrasound were 0.001%, 0.01% and 0.14%, respectively. The corresponding CVs for the HM group were 0.005%, 0.02% and 0.15%, respectively. There was significant difference between the Lenstar and the IOLMaster in normal group （P=0.031） but not in HM group （n=0.100）. In the two groups, the Lenstar and the IOLMaster produced higher values than did the Ultrasound （all P〈 0.001）. All three instruments exhibited good agreement in terms of AL values. For the intraocular lens （IOL） power calculation using SRK II formula, the Lenstar and the IOLMaster showed 0.5 D higher than Ultrasound in both groups （all P〈0.001）. No significant difference existed between the Lenstar and the IOLMaster for the IOL power calculation in both normal （n=0.474） and HM group （P= 0.103）. CONCLUSION： The three devices exhibited excellent intra-visit repeatabilities in the AL measurements. The AL and IOL power difference between partial coherence interferometry and ultrasound instruments should be noticed.
基金Supported by National Key Basic Research Program of China(973 Program,No.2013CB967000)National Natural Science Foundation of China(No.81271052)
文摘AIM:To evaluate the accuracy of axial length(AL)measurements obtained from immersion B-scan ultrasonography(immersion B-scan)for intraocular lens(IOL)power calculation in patients with high myopia and cataracts.METHODS:Immersion B-scan,contact A-scan ultrasonography(contact A-scan),and the IOLMaster were used to preoperatively measure the AL in 102 eyes from 102 patients who underwent phacoemulsification and IOL implantation.Patients were divided into two groups according to the AL:one containing patients with22 mm≤AL【26 mm(group A)and the other containing patients with AL≥26 mm(group B).The mean error(ME)was calculated from the difference between the AL measurement methods predicted refractive error and the actual postoperative refractive error.RESULTS:Ingroup A,ALs measured byimmersion Bscan(23.48±1.15)didn’t differ significantly from those measured by the IOLMaster(23.52±1.17)or from those by contact A-scan(23.38±1.20).In the same group,the standard deviation(SD)of the mean error(ME)of immersion B-scan(-0.090±0.397 D)didn’t differ significantly from those of IOLMaster(-0.095±0.411 D)and contact A-scan(-0.099±0.425 D).In group B,ALs measured by immersion B-scan(27.97±2.21 mm)didn’t differ significantly from those of the IOLMaster(27.86±2.18 mm),but longer than those measured by Contact A-scan(27.75±2.23 mm,P=0.009).In the same group,the standard deviation(SD)of the mean error(ME)of immersion B-scan(-0.635±0.157 D)didn’t differ significantly from those of the IOLMaster(-0.679±0.359 D),but differed significantly from those of contact A-scan(-0.953±1.713 D,P=0.028).CONCLUSION:ImmersionB-scanexhibitsmeasurement accuracy comparable to that of the IOLMaster,and is thus a good alternative in measuring AL in eyes with high myopia when the IOLMaster can’t be used,and it is more accurate than the contact A-scan.
基金Supported by the Research and Development Project of Science and Technology of the Jiangxi Province(No.20171BBG70100)the Ophthalmic Innovation Project of Nanchang City(No.2016114)
文摘AIM：To evaluate the influence of age and axial length（AL） on the position of the fovea in patients with high myopia（HM）.METHODS：In this prospective study,96 patients（186 eyes） with HM were consecutively recruited from the Third Affiliated Hospital of Nanchang University.DRI-OCT Atlantis,fundus imaging,and IOL Master were used in this study.Three indices were measured：the distance between the fovea and the optic nerve head（ONH） center（DFO）,the vertical distance between the fovea and the horizontal line pass of the ONH center（VDFO）,and the horizontal distance between the fovea and the vertical line pass of the ONH center（HDFO）.These measurements were used to analyze the effects of different age groups（A1,A2,A3 groups） and AL（AL1,AL2,AL3,AL4 groups） on these indices.RESULTS：The results showed that there was no statistical significance in DFO among the age and AL groups（F=0.46,0.37;P=0.62,0.76,respectively）.In HDFO,there was also no statistical significance among the age and AL groups（F=0.10,0.48;P=0.90,0.69,respectively）.In VDFO,however,the difference in the age and AL groups was statistically significant（F=3.21,3.12;P=0.04,0.02,respectively）.Thus,VDFO were correlated with age and AL（r=0.21,0.23,all P〈0.01）,while HDFO and DFO were not correlated with age and AL（r=0.30,P〉0.05）.CONCLUSION：In high myopia,the foveal position changes mainly in the vertical direction along with factors of age and AL.
文摘目的分析低龄幼儿早发性高度近视(eoHM)的临床特点,为临床诊疗提供指导。方法纳入首次采用睫状肌麻痹检影验光确诊为eoHM的患儿[任意一眼等效球镜(SE)≤-6.00 D],统计分析眼位、裂隙灯、彩色眼底照相、眼部生物测量等检查结果。结果共收集10例eoHM患儿的临床资料,其中男7例,女3例;首诊月龄35~60个月,平均(47.70±8.53)个月。10例(20眼)患儿中,SE≤-6.00 D 12眼。单眼近视4例,双眼对称性近视4例,双眼不对称性近视2例。屈光参差8例,其中6例为重度屈光参差。SE≤-6.00 D 12眼,首诊时裸眼视力及最佳矫正视力均为视力低下。7例(14眼)完成眼部生物学测量,其中高度近视9眼,平均SE(-8.19±2.99)D,平均眼轴(AL)(25.28±0.92)mm,平均角膜曲率(Km)(44.38±1.03)D,平均AL/角膜曲率半径(CR)(3.32±0.17)。SE与AL及AL/CR均呈明显负相关(P<0.05),与Km无明显相关性(P=0.132)。2例单眼高度近视合并视网膜有髓神经纤维;1例单眼高度近视合并白内障及玻璃体混浊;1例双眼合并视网膜色素变性;1例双眼合并牵牛花综合征、眼球震颤;3例合并斜视。结论eoHM多表现为轴性近视及屈光参差,对视力影响明显,易合并视网膜病变等先天异常,重视eoHM患儿早期筛查和诊治,有利于提高视功能和有效防治弱视。
