Preoperative evaluation of human crystalline lens hardness using A-scan ultrasound biometry： a pilot study

Dear Editor,I write to present the results of a study on the correlation between the ultrasound energy consumed during phacoemulsification with various preoperative parameters,including best corrected distance visual acuity（BCDVA）,the signal to noise ratio（SNR）obtained by partial coherence laser interferometry and primarily,lens spikes measurements derived by A-scan ultrasound biometry.Quantification of crystalline lens hardness before cataract removal has been attempted by several researchers in the past.These have been in humans and in animals,in vivo and in vitro,and have used a variety of imaging modalities.

Posterior segment nucleotomy for dislocated sclerotic cataractous lens using chandelier endoilluminator and sharp tipped chopper

· AIM: To describe a new surgical technique for managing dislocated sclerotic cataractous lens.· METHODS: Six patients with advanced posteriorly dislocated cataracts were operated at a tertiary care centre and analyzed retrospectively. After standard 3 port23 G pars plana vitrectomy and perfluorocarbon liquid(PFCL) injection, the dislocated white cataract was held with occlusion using phaco fragmatome and then chopped into smaller pieces with a sharp tipped chopper using 25 G chandelier endoilluminator. Each piece was emulsified individually. Following aspiration of PFCL,Fluid Air Exchange was done in all the cases and surgery completed uneventfully.·RESULTS: Best corrected visual acuity(BCVA) in all the patients was better than 6/12 after one month of follow up. No serious complications were noted till minimum 6mo of follow up.·CONCLUSION: Four port posterior segment nucleotomy with a chandelier endoilluminator, fragmatome and a chopper appears to be a safe, easy and effective procedure for managing dislocated sclerotic cataractous nuclei. Ultrasonic energy used and adverse thermal effects of the fragmatome on the sclera may be lesser.

日戴或夜戴硬性角膜接触镜对青少年近视防控效果的影响研究

比较日戴或夜戴硬性角膜接触镜对青少年近视防控效果的影响。选取2022年1月—2023年8月河北省眼科医院收治的68例近视青少年为研究对象,采用随机数字表法将其分为对照组和观察组两组,每组各34例。对照组采取日戴硬性角膜接触镜的干预方案,观察组采取夜戴硬性角膜接触镜的干预方案。比较两组青少年裸眼视力、屈光度、角膜平均厚度、并发症发生情况与生活质量。结果显示,干预前,两组青少年裸眼视力、屈光度、角膜平均厚度相比,无统计学差异(P>0.05);干预1周、4周、8周时,观察组青少年裸眼视力高于对照组、屈光度低于对照组、角膜平均厚度小于对照组,组间差异均有统计学意义(P<0.05);观察组青少年干预期间并发症总发生率低于对照组,组间差异有统计学意义(P<0.05);观察组青少年各项生活质量评分均高于对照组,组间差异有统计学意义(P<0.05)。研究发现,夜戴硬性角膜接触镜的效果和安全性要优于日戴硬性角膜接触镜,能够有效控制青少年的近视发展,可推广使用。

斜仰卧截石位单通道经皮肾镜联合经皮软镜治疗复杂肾结石的疗效观察

目的观察斜仰卧截石位单通道经皮硬性肾镜联合经皮肾软镜治疗复杂上尿路结石的临床效果。方法 2013年5月-2016年1月于该院住院的肾多发结石及鹿角状结石患者,其中40例行斜仰卧截石位球囊扩张建立标准通道,单通道经皮硬镜与经皮软镜联合碎石,分析患者临床资料,包括手术时间,出血量、结石清石率、住院时间和手术并发症发生情况等指标。结果该组患者均I期单通道顺利实施手术,手术中位时间52.5 min,结石清石率100%、手术前后出血量变化无差异,患者无需输血,随访3~6个月,无明显手术并发症发生。结论斜仰卧截石位单通道经皮硬镜联合经皮软镜治疗复杂肾结石,可提高结石清除率,增加患者术中舒适感,避免多通道对肾脏的损伤,手术时间短,治疗效果明显。

树脂镜片抗磨加硬膜层的研究进展

树脂光学镜片以其优异的性能逐步取代玻璃镜片,占据了国内外大部分市场,但由于硬度低,耐磨损性差,所以使用寿命较短。研究发现在其表面镀制抗磨加硬膜可显著提高耐磨损性。综述了国内外近年来在树脂镜片上涂镀有机硅、石英等抗磨加硬膜的制备方法和性能研究进展,并介绍了在树脂镜片上沉积新型类金刚石(DLC)抗磨加硬膜的研究现状及发展前景。

角膜切口单手超声乳化术治疗不同硬度核白内障

目的:总结单手超声乳化术治疗硬核性白内障的临床疗效并介绍手术经验。方法:对493例572眼白内障施行颞侧透明角膜切口单手法超声乳化术,520眼同期植入硅胶折叠式人工晶体;核硬度为Ⅰ级36眼、Ⅱ级107眼、Ⅲ级320眼、Ⅳ级109眼。结果:术后随访时间一个月,视力为≥0.5,术后一天、一周分别为20.83%和55.66%;术后一月≥0.8为71.91%。术后早期的不同硬度核的视力恢复有差异(P<0.01),角膜水肿发生率Ⅲ-Ⅳ级核高于Ⅰ-Ⅱ级核(P<0.01)。结论:单手法超声乳化术是一种安全有效的乳化技术,可以被用于治疗硬核性白内障。

硬核白内障手法小切口摘出术与超乳对比分析

目的比较硬核白内障两种术式的优缺点。方法IV、V级硬核白内障146眼随机分为超声乳化组和手法小切口摘出术组,比较两组手术时间、术中及术后并发症、术后视力。结果手法小切口摘出术手术时间短,术中后囊破裂低于超乳组P>0.05,无统计学意义,术后并发症中手法小切口摘出术角膜水肿,反应性虹膜炎较超乳组轻且P<0.05,差异有显著性意义。结论硬核白内障术后视力恢复较好,手术小切口白内障摘除方法安全有效,简便易行。