Effectivity and safety of trifocal intraocular lenses and capsular tension rings implantation for cataract patients with axial high myopia

●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.

Transcapsular scleral fixation of the standard capsular tension ring and in-the-bag intraocular lens implantation for severely subluxated lenses

AIM:To present a technique of transcapsular scleral fixation of the standard capsular tension ring(CTR)through equatorial capsulotomy and in-the-bag intraocular lens(IOL)implantation in subluxated lenses.METHODS:This retrospective consecutive case series included patients with subluxated lenses by more than 180 degrees who underwent lens extraction,transcapsular scleral fixation of the standard CTR through equatorial capsulotomy,in-the-bag IOL implantation and with at least 6mo follow-up.Preoperative and postoperative best corrected visual acuity(BCVA),intraocular pressure(IOP),complications,and postoperative IOL tilt and decentration were recorded.RESULTS:Nine eyes of 7 patients with a mean followup of 11.0±3.7mo were included in this study.The BCVA was significantly improved from 0.64±0.22 logMAR preoperatively to 0.21±0.19 logMAR postoperatively(P<0.001).The IOP was within the normal range postoperatively.The mean tilt of the IOL was 4.30°±2.31°(range,1.0°to 8.9°)and the mean decentration of the IOL was 0.37±0.12 mm(range,0.14 to 0.50 mm).No visually threatened intraoperative and postoperative complications were detected during the follow-up period.CONCLUSION:This is a safe and effective surgical technique for managing patients with severely subluxated lenses.It has achieved favorable outcomes with fewer surgical manipulations and less need for advanced capsular support devices.

Comparative evaluation of rotational stability of toric IOLs with four-eyelet vs two-eyelet capsular tension rings in eyes with high myopia

AIM:To compare the rotational stability of Toric intraocular lens(IOLs)implantation combined with foureyelet or two-eyelet capsular tension rings(CTRs)in eyes with high myopia and cataract.METHODS:This prospective randomized controlled interventional study in cluded 33 eyes which had preoperative corneal astigmatism≥1.5 D and ocular axial length≥25.5 mm.These eyes were randomly divided into two groups to undergo phacoemulsification and toric IOL implantation with either four-eyelet CTR implantation(group A,n=16)or two-eyelet CTR implantation(group B,n=17).Uncorrected visual acuity(UCVA),best-corrected visual acuity(BCVA),phoropter examination results,and toric IOL rotation degrees were tested 6 mo after the surgery.RESULTS:In both groups,the toric IOL was in the capsular sac 6 mo after surgery.The difference between the two groups in terms of visual outcome was not found to be statistically significant(P>0.05)at a follow-up of 6 mo.The mean residual astigmatism values were 0.56±0.22 D and 0.92±0.24 D in A and B groups,respectively(P<0.001).The mean rotation degree of IOL was 1.00°±0.73°in group A and 3.53°±1.46°in group B(P<0.001).CONCLUSION:In cataract patients with high myopia and astigmatism,four-eyelet CTR can effectively increase the rotation stability of toric IOLs,achieving the desired goal of correcting corneal astigmatism.

Technique of using Cionni-modified capsular tension ring in the management of severely traumatic lens subluxation

AIM:To investigate the effect of Cionni-modified capsular tension ring(CTR)implantation in patients with severely traumatic subluxated cataracts.METHODS:All patients who totally had traumatic cataracts and lost zonule support and underwent cataract surgery were retrospectively analyzed.Corrected distance visual acuity(CDVA),extent of zonulysis,intraocular lens(IOL)position,intraoperative presentation,and complications were assessed.The primary outcomes included IOL centration stability and other postoperative complications.RESULTS:Twenty patients(20 eyes)were included in this study.The mean age in this study was 58.0±11.3y,and the average follow-up time was 17.3±12.8mo.Capsule bags were saved by Cionni-modified CTR.Nine eyes(45%)underwent simultaneously anterior vitrectomy due to the presence of vitreous in the anterior chamber.The preoperative mean CDVA was 0.83±0.24 log MAR,and the postoperative average CDVA was 0.23±0.30 log MAR(P<0.05).The horizontal and vertical IOL decentration after surgery was 0.27±0.12 mm and 0.41±0.19 mm,respectively;the vertical and horizontal IOL tilt after surgery was 5.5°±2.5°and 6.1°±2.2°,respectively.None of the eyes had obvious IOL decentration during the follow-up time.Eight eyes(40%)had posterior capsule opacification(PCO)that was severe enough to cause poor vision.Neodymium:YAG laser capsulotomy were performed on these eyes when the CTR was stabilized.CONCLUSION:With the help of Cionni-modified CTR,capsular bag preservation and better IOL concentration can be achieved without major complications in patients with severely traumatic subluxated cataracts.

Stability of neodymium:YAG laser posterior capsulotomy in eyes with capsular tension rings

·AIM: To evaluate the stability of neodymium(Nd):YAG laser posterior capsulotomy in eyes with capsular tension rings(CTRs).·METHODS: A total of 60 eyes that underwent cataract surgery and laser posterior capsulotomy postoperatively were included in this retrospective cohort study. To evaluate the safety and stability of capsulotomy, changes in the size of posterior capsulotomy and anterior chamber depth(ACD) in three groups: the group without CTR, the group with 12 mm CTRs, and the group with 13 mm CTRs, at 1wk, 3, 12, and 15mo after capsulotomy, were compared. ·RESULTS: In the group without CTR and the group with 12 mm CTR, there was no significant change in ACD at every post-laser follow-up. In the group with 13 mm CTR, the ACD change was significant until 3mo after capsulotomy. In all groups, there was a significant increase in the area of capsulotomy between 1wk and 3mo post-laser. Between 3 and 12mo post-laser, only the group with 13 mm CTR showed a significant increase in the area of capsulotomy(P<0.01). ·CONCLUSION: Laser posterior capsulotomy is safe in all three groups. The capsulotomy and ACD become stabilized and have not shown significant changes since 1y postlaser, even with larger CTRs. The maintenance of centrifugal capsular tension can last longer with larger CTRs, and the stability of the capsulotomy site can be reached about 12mo after capsulotomy in pseudophakic eyes with larger CTRs.

Effective treatment for secondary angle-closure glaucoma caused by traumatic lens subluxation:phacoemulsification with capsular-tension-ring implantation combined with ophthalmic endoscope-controlled goniosynechialysis

AIM:To investigate the safety and efficacy of phacoemulsification with capsular-tension-ring implantation and posterior chamber intraocular lens implantation combined with ophthalmic endoscope-controlled goniosynechialysis(Phaco-CTR-IOL-OE-GSL)for treating secondary angle-closure glaucoma induced by traumatic lens subluxation.METHODS:A retrospective and descriptive study was performed on patients with lens subluxation,angle closure,goniosynechia,and evaluated intraocular pressure(IOP)that cannot be controlled with medication,who underwent Phaco-CTR-IOL-OE-GSL.The postoperative best-corrected visual acuity(BCVA),IOP,range of goniosynechia and complications were retrospectively observed.RESULTS:Nine patients with secondary angle-closure glaucoma induced by traumatic lens subluxation were included.The follow-up period was 51.1±8.6 mo.The preoperative range of zonule rupture was 158.2°±33.0°,and the range of goniosynechia was 220.0°±92.5°.The baseline BCVA was 0.9±1.0 logMAR,IOP was 30.7±17.3 mm Hg and number of anti-glaucoma medication was 3.2±1.1.Mild intraoperative hyphaemia with 8 eyes(88.8%)in the anterior chamber,and was absorbed two days postoperatively.One eye(11.1%)had postoperative ciliary body detachment and was recovered after five days of topical drug treatment.BCVA was 0.2±0.2 logMAR at 3 mo postoperatively.The average IOP at the last follow-up was 16.7±2.0 mm Hg,and no anti-glaucoma medications were used.The average range of recurrent goniosynechia was 54.9°±33°at the final postoperative gonioscopic examination.CONCLUSION:Phaco-CTR-IOL-OE-GSL is safe and effective in the treatment of secondary angle-closure glaucoma induced by traumatic lens subluxation.The use of an endoscope provides a more direct and clear examination for GSL,and 360°dissection is easily achieved.

Placement of dual capsular tension rings for the combined management of traumatic cyclodialysis cleft and zonular dialysis

Background:To evaluate the efficacy and safety of placing dual capsular tension rings for the combined management of traumatic cyclodialysis cleft and zonular dialysis.Methods:A modified capsular tension ring was inserted into the ciliary sulcus and a capsular tension ring or modified capsular tension ring was inserted into the capsular bag in 20 eyes in 20 consecutive patients showing signs of ocular hypotony and ectopia lentis.Outcome measures included intraocular pressure,best-corrected visual acuity,and postoperative complications.Results:Dual capsular tension ring placement was performed in 20 patients with a mean age of 48.7 years.The cyclodialysis cleft extended over 2.9 clock hours(range 0.5-6.5).The modified capsular tension ring was successfully inserted into the ciliary sulcus and a capsular tension ring or modified capsular tension ring in the capsular bag in all eyes.At the last follow-up,the cyclodialysis cleft was closed in 16/20(80.0%)eyes.The intraocular lens was stable in all patients postoperatively.Best-corrected visual acuity,in terms of the logarithm of the minimal angle of resolution,improved from 1.3±0.8 before surgery to 0.4±0.3 after surgery(P<0.001).Intraocular pressure increased significantly from 10.6±3.2 mmHg before surgery to 13.0±4.8 mmHg after surgery(P=0.040).Postoperative complications included a painful reversible intraocular pressure spike in four patients(20.0%).Logistic regression revealed no significant factors associated with successful cleft closure and a stable final intraocular pressure of≥10 mmHg.Conclusions:The placement of two capsular tension rings into the ciliary sulcus and the capsular bag is a safe,successful procedure combined for repairing a traumatic cyclodialysis cleft and managing zonular dialysis.

Placement of dual capsular tension rings for the combined management of traumatic cyclodialysis cleft and zonular dialysis

Background:To evaluate the efficacy and safety of placing dual capsular tension rings for the combined management of traumatic cyclodialysis cleft and zonular dialysis.Methods:A modified capsular tension ring was inserted into the ciliary sulcus and a capsular tension ring or modified capsular tension ring was inserted into the capsular bag in 20 eyes in 20 consecutive patients showing signs of ocular hypotony and ectopia lentis.Outcome measures included intraocular pressure,best-corrected visual acuity,and postoperative complications.Results:Dual capsular tension ring placement was performed in 20 patients with a mean age of 48.7 years.The cyclodialysis cleft extended over 2.9 clock hours(range 0.5-6.5).The modified capsular tension ring was successfully inserted into the ciliary sulcus and a capsular tension ring or modified capsular tension ring in the capsular bag in all eyes.At the last follow-up,the cyclodialysis cleft was closed in 16/20(80.0%)eyes.The intraocular lens was stable in all patients postoperatively.Best-corrected visual acuity,in terms of the logarithm of the minimal angle of resolution,improved from 1.3±0.8 before surgery to 0.4±0.3 after surgery(P<0.001).Intraocular pressure increased significantly from 10.6±3.2 mmHg before surgery to 13.0±4.8 mmHg after surgery(P=0.040).Postoperative complications included a painful reversible intraocular pressure spike in four patients(20.0%).Logistic regression revealed no significant factors associated with successful cleft closure and a stable final intraocular pressure of≥10 mmHg.Conclusions:The placement of two capsular tension rings into the ciliary sulcus and the capsular bag is a safe,successful procedure combined for repairing a traumatic cyclodialysis cleft and managing zonular dialysis.

Computation and Measurement of Winding Tension in Ring Spinning

By studying the variations of balloon height and of wind-ing radius in any one winding layer of ring spinning, the formula for determining the winding tension in any layer is derived, and then the overall tension variation throughout all winding layers can be computed. A meth-od of measuring the winding tension is also introduced here, with the measured results agreeing with the com-puted ones, and so the reliable relationship between winding tension, speed and ring traveller weight can be thus obtained. The highest allowable spindle speed is also discussed.

VISUAL ESTIMATE OF WORSTED YARN SPINNING TENSION

A method of visual estimate of yarn spinning tension on worsted ring spinning frame is pro-posed. This method is based on pragmatized classical theory of spinning balloon, and is supportedby experimental data.

INVESTIGATION OF NEW COTTON RING AND TRAVELLER

A new Ω type cotton ring and traveller is introduced.The idea of its design is based on thefacts that running travellers deviate from normal profile in three coordinate directions and such adeviation can be utilized when the balloon expands.The contact between ring and traveller at outerrace can be increased to prevent the balloon from expanding and the traveller from continuous in-clination.Consequently,the wear of inner corner of ring can be reduced.This proves the maincourse of deterioration of ring.With small sized balloon,the outer contact diminishes.The yarntension is thus adjusted and average tension is cut down.Experiments on 13 and 29 texcotton-polyester yarn spinning prove the above idea correct.With the wear of ring greatly reduced,running life is more than doubled,end breakage rate falls 30% and power consumption falls 2%.The economic profit,estimated by pilot test,is an increase of production 6.1% and 130,000 YuanRenminbi per ten thousand apindles each year.

Characterization of optimal resting tension in human pulmonary arteries

AIM To determine the optimum resting tension(ORT) for in vitro human pulmonary artery(PA) ring preparations.METHODS Pulmonary arteries were dissected from disease free sections of the resected lung in the operating theatre and tissue samples were directly sent to the laboratory in Krebs-Henseleit solution(Krebs).The pulmonary arteries were then cut into 2 mm long rings.PA rings were mounted in 25 m L organ baths or 8 m L myograph chambers containing Krebs compound(37 ℃,bubbled with 21% O_2:5% CO_2) to measure changes in isometric tension.The resting tension was set at 1-gram force(gf) with vessels being left static to equilibrate for duration of one hour.Baseline contractile reactions to 40 mmol/L KCl were obtained from a resting tension of 1 gf.Contractile reactions to 40 mmol/L KCl were then obtained from stepwise increases in resting tension(1.2,1.4,1.6,1.8 and 2.0 gf).RESULTS Twenty PA rings of internal diameter between 2-4 mmwere prepared from 4 patients.In human PA rings incrementing the tension during rest stance by 0.6 gf,up to 1.6 gf significantly augmented the 40 mmol/L KCl stimulated tension.Further enhancement of active tension by 0.4 gf,up to 2.0 gf mitigate the 40 mmol/L KCl stimulated reaction.Both Myograph and the organ bath demonstrated identical conclusions,supporting that the radial optimal resting tension for human PA ring was 1.61 g.CONCLUSION The radial optimal resting tension in our experiment is 1.61 gf(15.78 m N) for human PA rings.

囊袋张力环联合Toric人工晶状体植入治疗高度近视合并角膜散光的白内障

目的研究伴有角膜散光的高度近视白内障患者进行超声乳化+环曲面人工晶状体(Toric intraocular lens,Toric IOL)及囊袋张力环(capsular tension ring,CTR)植入术的临床效果及稳定性。方法通过回顾性研究,分析在武汉市第一医院行白内障超声乳化吸除术的高度近视伴有角膜散光的患眼54例(76眼),其中31例(38眼)联合植入Toric IOL及CTR(联合组),23例(38眼)单纯植入Toric IOL(对照组)。术后随访6个月,比较两组患者术前及术后视力、角膜内皮细胞密度、人工晶状体旋转度、残余散光度,以及并发症发生情况。结果术后6月,两组患者裸眼远视力(uncorrected distance visual acuity,UCVA)、最佳矫正视力(best corrected visual acuity,BCVA)均显著高于术前,联合组术后UCVA(LogMAR)优于对照组,差异有统计学意义[(0.34±0.15)vs.(0.46±0.25),P<0.05]。术后1周、1月、3月及6月,联合组散光分别为(0.38±0.31)、(0.45±0.25)、(0.47±0.23)、(0.56±0.26),均明显低于对照组各时间点(均P<0.01)。术后6月联合组IOL平均旋转(2.63±0.94)°,显著低于对照组的(4.00±1.43)°(P<0.01)。两组间各时间点角膜内皮细胞密度比较,差异无统计学意义(均P>0.05)。联合组术后并发症总发生率低于对照组(P<0.05)。结论对于高度近视伴角膜散光的白内障患者,术中植入Toric IOL的同时联合应用CTR,安全性好,能够改善Toric IOL旋转稳定性,提高视觉质量,并且减少并发症。

囊袋张力环对高度近视患者Barrett universalⅡIOL计算公式准确性的影响

目的:评估囊袋张力环(CTR)对Barrett universalⅡ人工晶状体(IOL)计算公式在高度近视合并白内障患者术后屈光状态的稳定性与准确性的影响。方法:本研究为前瞻性研究。选取2022-01/06于我院就诊的高度近视白内障患者40例80眼。采用随机数字表法分为CTR组和空白组,每组40眼,所有患者均用IOL Master测量,并按照Barrett universalⅡ公式计算实际植入IOL屈光度及预测术后屈光度。记录患者术后6 mo的裸眼视力(UCVA)、最佳矫正视力(BCVA),比较术后6 mo两组平均绝对屈光误差(MAE),评估术后屈光状态的稳定性及预测术后屈光度与CTR的关系。结果:术后6 mo两组患者UCVA、BCVA均较术前改善(P>0.05),不同时间点两组UCVA、BCVA比较无差异(均P>0.05);80眼按照Barrett universalⅡ公式植入IOL后,CTR组预计术后屈光度为-2.01±0.71 D,术后实际屈光度为-1.64±0.88 D,MAE为0.37±0.98 D;空白组预计术后屈光度为-2.12±0.64 D,术后实际屈光度为-1.54±0.88 D,MAE为0.58±0.31 D,组间比较有差异(P<0.05)。根据眼轴长度进行分组,对于任意眼轴长度CTR的植入均能有效地减少屈光误差(P>0.05)。随着眼轴的增长,MAE的值越大,眼轴≥30 mm的患者术后MAE值比较两组间有差异(P<0.05)。CTR组、空白组中出现远视漂移的比例分别是18%(7/40)、30%(12/40),组间比较有差异(P<0.05)。结论:对高度近视合并白内障患者,Barrett universalⅡ公式在预测术后屈光度方面具有较高的准确性,术中植入CTR既能够保持囊袋的形态,有效防止术中晶状体悬韧带断裂,使IOL居中性更佳,又能有利于白内障患者术后屈光度的早期稳定,并提供更加稳定的屈光结果,减少屈光漂移。对于术中考虑植入CTR的近视患者,建议术前增加-0.50 D的预留屈光度,以达到理想屈光状态。

不同尺寸囊袋张力环对高度近视合并白内障患者术后囊袋稳定性的影响

目的探讨植入不同尺寸囊袋张力环(CTR)对高度近视合并白内障患者术后囊袋稳定性的影响。方法前瞻性研究。选取2022年1月至6月于河北省眼科医院就诊的高度近视合并白内障患者75例(150眼)为研究对象,采用随机数字表法分为大尺寸组、小尺寸组和对照组,每组25例(50眼)。所有患眼均行超声乳化吸出联合人工晶状体(IOL)植入术,其中,大尺寸组患者术中联合植入CTR1311(开放直径13 mm),小尺寸组患者术中联合植入CTR1210(开放直径12 mm),对照组不植入CTR。比较各组患者术前和术后1周、1个月、3个月、6个月、1年的裸眼视力(UCVA)、最佳矫正视力(BCVA)、眼压、角膜内皮细胞密度、有效IOL位置(ELP)、平均屈光误差绝对值、前囊口面积及并发症发生情况。结果术后1年,三组患者UCVA、BCVA均优于术前(均为P<0.05),眼压、角膜内皮细胞密度与术前相比差异均无统计学意义(均为P>0.05)。术后不同时间点,大尺寸组、小尺寸组IOL倾斜度均较对照组明显降低(均为P<0.05),小尺寸组IOL倾斜度均高于大尺寸组(均为P<0.05)。术后不同时间点,三组患者间IOL偏心量相比差异均无统计学意义(均为P>0.05)。术后6个月,眼轴长度>30 mm大尺寸组患者术后IOL偏心量及倾斜度均较小尺寸组小(均为P<0.05)。术后不同时间点对照组前囊口面积均较大尺寸组和小尺寸组明显缩小(均为P<0.05),大尺寸组患者前囊口面积与小尺寸组相比差异均无统计学意义(均为P>0.05)。术后6个月,对照组患者术后平均屈光误差绝对值均较大尺寸组和小尺寸组大,差异均有统计学意义(均为P<0.05),大尺寸组与小尺寸组组间比较差异无统计学意义(P>0.05)。随访1年示,三组均未见严重并发症发生。结论白内障超声乳化吸除联合CTR植入对高度近视合并白内障患者疗效明确。大尺寸CTR较小尺寸CTR术后IOL更稳定,对于眼轴长度>30 mm的高度近视白内障患者,建议植入较大尺寸CTR。

巩膜固定囊袋张力环联合超声乳化人工晶状体植入术治疗外伤性晶状体半脱位

目的:探讨巩膜固定囊袋张力环(SFCTR)植入联合晶状体超声乳化吸除加人工晶状体(IOL)植入术治疗外伤性晶状体半脱位的临床疗效。方法:连续选取2018-12/2023-02行SFCTR植入联合晶状体超声乳化吸除加IOL植入术治疗的外伤性晶状体半脱位患者14例14眼。术后随访行视力、眼压、眼前段照相、超声生物显微镜(UBM)等检查,并记录IOL的位置及术后并发症等情况。结果:纳入患者均成功植入SFCTR和囊袋内IOL。术后平均随访1.92±1.36 a,末次随访时,UDVA(0.20±0.18 LogMAR)和CDVA(0.16±0.17 LogMAR)均较术前UDVA(1.13±0.56 LogMAR)显著改善(P<0.01),眼压(17.64±3.67 mmHg)较术前(22.00±9.92 mmHg)降低(P<0.05)。随访期间,裂隙灯检查见IOL位于囊袋内,位置居中;UBM检查见CTR和IOL位于囊袋内,囊袋赤道部与睫状突的距离在各个方向相等。结论:SFCTR植入联合晶状体超声乳化吸除加IOL植入术是治疗外伤性晶状体半脱位的一种微创有效的手术方法。

改良囊袋张力环联合囊袋内人工晶状体植入治疗马方综合征晶状体不全脱位术后人工晶状体脱位的临床特征及手术治疗

目的观察接受改良囊袋张力环(MCTR)联合囊袋内人工晶状体(IOL)植入治疗的马方综合征(MFS)晶状体不全脱位患者术后IOL脱位的发生率,并总结接受IOL复位或取出术MFS患者的临床特征。方法通过随访观察2015年1月—2020年6月于我院同一手术医师行MCTR植入术且术后随访3年以上的MFS患者术后IOL脱位情况,计算其IOL脱位发生率。通过回顾分析我院同期就诊的MFS合并IOL脱位患者的临床资料,分析其临床特征和手术选择。结果本研究共纳入同一手术医师行MCTR植入术患者115例(192眼),大部分患者为儿童(80.21%,154/192),中位随访时间4年(四分位范围:3.50,4.67)。随访期间共出现MCTR-IOL复合体脱位3例(3眼),脱位发生率为1.56%(3/192),其中2例为不全脱位、1例为全脱位。3例患者均为成人,IOL脱位发生时间为术后2~3年,均无明显诱因,直接原因均为缝线断裂。同期在我院接受IOL复位或取出术的MFS患者共16例。IOL脱位最常见的直接原因是缝线断裂(62.50%,10/16)、其次是缝线或可植入式囊袋拉钩在巩膜层间出现滑动松脱(18.75%,3/16)。对于出现不全脱位的CTR或MCTR患者,通过缝线再次固定张力环或植入囊袋拉钩可实现IOL复位;MCTR脱位进入玻璃体腔的患者接受了MCTR取出和经巩膜后房型IOL缝线固定术;对于其他手术方式的IOL脱位患者,多数患者实现了脱位IOL复位术(54.55%,7/13),少数患者进行了IOL置换术(30.77%,4/13),2例IOL取出后未植入IOL。结论MCTR植入术是治疗MFS合并晶状体不全脱位的一种安全、有效的手术方式,IOL脱位是其罕见并发症。MFS患者术后定期随访十分必要,甚至需要终生随访,早期干预IOL脱位可以取得较好的疗效。

大型储液罐内外基础环墙抗不均匀沉降性能分析

大型储液罐对地基沉降变形非常敏感,需要采用基础环梁来防止其对上部结构的危害,因此,基础环梁设计是大型储罐建设的重要一环。本文采用有限元软件对大型储罐-基础环梁-地基土层的共同作用进行了数值模拟,主要考察了大型储油罐基础环墙环向拉力的分布,探讨了影响环墙受力的主要因素。研究表明,垫层参数对环墙环向拉力的影响较大,压缩性低,抗剪强度大并经过压实处理的垫层材料对应的环墙环向拉力最小,环墙环向拉力随环墙半径的增大先近似线性增加而后略微减小。

超声乳化白内障吸出联合CTR植入对高度近视白内障术后囊袋稳定性的影响

目的探究高度近视白内障患者行超声乳化白内障吸出联合囊袋张力环(CTR)植入术后囊袋的稳定性。方法纳入高度近视合并白内障的患者80例(80眼),随机均分为试验组和对照组。试验组行超声乳化白内障吸出联合CTR植入治疗,对照组未联合CTR植入,其余干预完全一致。比较2组术前和术后1、3、6个月时的裸眼视力(UCVA)、远距最佳矫正视力(BCVA)、角膜生物力学、对比敏感度、人工晶状体倾斜度、术后前囊口面积,并在术后6个月统计后发性白内障(PCO)发生率。结果2组术后1、3、6个月UCVA、BCVA均较术前改善。2组患者术后角膜生物力学参数Ambrosio水平关系厚度(ARTh)、角膜硬度参数(SP-A1)和比较差异均无统计学意义。试验组Corvis生物力学指数(CBI)在术后3个月后较对照组显著升高(P<0.05),2组间其余时间点比较差异无统计学意义。术后各时间点,2组对比敏感度比较差异无统计学意义(P>0.05);术后3个月和6个月,与对照组相比,试验组前囊口面积增大,人工晶状体植入术(IOL)倾斜角减小(P<0.05)。术后6个月时试验组未发生PCO 38眼,PCOⅠ级2眼;对照组未发生PCO 33眼,PCOⅠ级3眼,Ⅱ级2眼,Ⅲ级2眼。结论超声乳化白内障吸出联合CTR植入治疗对高度近视白内障患者术后囊袋具有较高的稳定性,远期临床效果及视觉质量更高,值得临床推广应用。

超声乳化联合囊袋张力环及人工晶状体植入术治疗高度近视合并白内障

目的:观察超声乳化联合囊袋张力环及人工晶状体植入术治疗高度近视合并白内障患者的疗效。方法:回顾性研究。选取2021-12/2023-04我院白内障科收治的高度近视合并白内障患者82例82眼,根据术中是否使用囊袋张力环分为两组:对照组39眼采用单纯超声乳化联合人工晶状体植入术治疗,联合组43眼采用超声乳化联合囊袋张力环及人工晶状体植入术治疗。比较两组患者手术前后最佳矫正视力、中央前房深度、小梁睫状突距离、视觉质量和并发症。结果:术后1mo,两组患者的最佳矫正视力(LogMAR)较术前明显改善(联合组:0.64±0.28 vs 0.12±0.14;对照组:0.62±0.26 vs 0.23±0.25,均P<0.001);中央前房深度均高于术前(联合组:2.57±0.56 vs 1.97±0.40 mm;对照组:2.22±0.45 vs 1.89±0.37 mm,均P<0.001),联合组最佳矫正视力和中央前房深度优于对照组(均P<0.05);两组患者手术前后小梁睫状突距离比较均无差异(联合组:0.68±0.22 vs 0.74±0.20 mm;对照组:0.74±0.19 vs 0.78±0.17 mm,均P>0.05)。术后1 mo视觉质量评分联合组均高于对照组[看电视3.00±0.38 vs 2.22±0.46分;看书2.85±0.42 vs 2.21±0.44分;夜间视物:2.71±0.34 vs 2.37±0.41分;精细操作2.82±0.38 vs 2.33±0.40分,均P<0.001]。联合组并发症发生率显著低于对照组(33%vs 14%,P<0.05)。结论:超声乳化联合囊袋张力环及人工晶状体植入术治疗高度近视合并白内障患者能有效促进患者视功能恢复,改善房角结构,降低并发症发生率。