简介:目的:探讨无囊膜支撑的无晶状体眼植入Artisan人工晶状体的有效性和安全性。方法:前瞻性地分析24例24眼无囊膜支撑的无晶状体眼植入虹膜固定Artisan人工晶状体的手术后结果。纳入病例包括外伤性晶状体脱位、视网膜脱离或球内异物行晶状体玻璃体切除术后及晶状体摘出术后囊膜缺失。手术前后进行完整的眼部检查,包括裸眼视力、眼压、角膜内皮计数、瞳孔形态、人工晶状体固定情况、虹膜玻璃体视网膜情况,记录手术中和手术后出现的并发症。结果:患者随访12~24mo。所有手术眼视力均有提高,手术前裸眼视力为手动~0.2(logMAR1.91±0.89),手术后末次随访裸眼视力为0.2~1.0(logMAR0.46±0.59)。手术后1,3,12mo术眼平均等效球镜度数分别为-1.26,-0.43,-0.35D,±2.0D以内者术后3mo和12mo分别占66.7%和83.3%,±1.0D以内者分别占41.7%和50%。手术前及术后3,12mo眼压分别为16.95±7.85,12.38±4.68,15.96±5.25mmHg。手术前及手术后3,12mo平均角膜内皮计数分别为2493.8,2270.3,2263.7个/mm2,手术后1~3mo,4~12mo内皮细胞丢失率分别为8.96%,0.27%,手术后12mo内皮细胞总丢失率为9.23%。手术后无持续性葡萄膜炎,虹膜无明显手术损伤和萎缩,瞳孔形态无变化,Artisan人工晶状体正位牢固固定,对玻璃体视网膜无影响。玻璃体切除眼手术中使用前房灌注可避免眼球塌陷。结论:无囊膜支撑的无晶状体眼植入虹膜固定Artisan人工晶状体是有效和安全的方法,但仍需要长期的随访观察以进一步对Artisan人工晶状体植入术作出评价。
简介:AIM:Tostudyclinicalfeaturesandgenemutationswithinthepaired-likehomeodomaintranscriptionfactor2(PITX2)geneinapedigreeofbilaterallimbaldermoids.METHODS:Completeeyeexaminationshavebeenperformedoneachindividualofthefamily.Exonsofpaired-likehomeodomaintranscriptionfactor2(PITX2)wereamplifiedbypolymerasechainreaction,sequenced,andcomparedwithareferencedatabase.RESULTS:Wedescribedthephenotype,clinicfindingsinafamilywithtwoaffectedmembers.Themassesoftheproband’seyeswereexcisedsurgicallydemonstratingadermoidcystbyhistopathologicalexamination.NomutationwasdetectedinthegenePITX2inthispedigree.CONCLUSION:Afamilyoflimbaldermoidcystwasreported.Inaddition,nopathogenicsequencevariationswerefoundinPITX2,indicatingthatthisphenotypeinthisfamilyisadistinctiveentity.
简介:AIM:Tofindouttheoutcomeoflaserphotocoagulationinclinicallysignificantmacularedema(CSME)byopticalcoherencetomography(OCT).·METHODS:Itwasaprospective,non-controlled,caseseriesstudyenrolling81eyesof64patientswithCSMEbetweenAugust2008andJanuary2010.AllpatientsreceivedmodifiedgridphotocoagulationwithfrequencydoubledNd:YAGlaser.Eachpatientwasevaluatedintermsofbest-correctedvisualacuity(BCVA)andregressionorprogressionofmaculopathyafterlasertherapyat1,3and6months.Spearman’scorrelationtestwasusedtoshowthecorrelationbetweenBCVAandtotalmacularvolume(TMV).Analysisofvariance(ANOVA)wasusedtocompareamonggroupsandindependentt-testwasusedtocompareineachgroup.·RESULTS:ThereishighcorrelationbetweenBCVAandTMV(P≤0.001).BCVAimprovedin50.6%,remainedstaticin39.5%anddeterioratedin9.9%patientsafter6monthoftreatment.TheBaselineTMV(meanandSD)were9.26±1.83,10.4±2.38,11.5±3.05,8.89±0.75and9.47±1.98mm3fordifferentOCTpatterns,ST(spongelikethickening),CMO(cystoidmacularedema),SFD(subfovealdetachment),VMIA(Vitreomacularinterfaceabnormality)andaverageTMVrespectively(P=0.04).After6monthsoflasertreatment,themeanTMVdecreasedfrom9.47±1.98mm3to8.77±1.31mm3(P=0.01).InSTtherewassignificantdecreaseinTMV,P=0.01,Furtherwithinthesegroupsat6months,theyweresignificantlydifferent,P=0.01.·CONCLUSION:OCTshowedthedifferentmorphologicalvariantofCSMEwhiletheresponseoftreatmentisdifferent.TMVdecreasedthemostandhenceshowedtheimprovementinvisionafter6monthsoflasertreatment.IntheeraofAntivascularendothelialgrowthfactors(VEGFs),efficacyoflaserseemstobeinshadowbutitisstillfirstlineoftreatmentindevelopingnationlikeNepalwhereantiVEGFsmaynotbeeasilyavailableandaffordable.
简介:<正>DirSir,IamdoctorGuo-YuanYang,fromtheDepartmentofOphthalmologyofWestChinaHospitalofSichuanUniversityinChengdu,SichuanProvince,China.Iwritetopresentacasereportofposteriorlentiglobuswithcataract.
简介:对有晶状体眼植入后房型人工晶状体是矫正屈光不正的有效方法,植入的后房型人工晶状体目前主要有可植入式接触镜(implantablecontactlens,ICL)和有晶状体眼屈光性晶状体(phakicrefractivelens,PRL)。对术后患者主观视觉质量(视力、对比敏感度)、客观视觉质量(波前像差、点扩散函数、斯特尔比率及光学传递函数)的研究显示,主观视力的提高也伴随着客观视觉质量的改善,但部分患者术后出现光晕及眩光症状。本文主要对ICL和PRL植入术后主观及客观视觉质量的临床研究做一综述,对可影响视觉质量的术后并发症如晶状体前囊膜下混浊、青光眼及角膜内皮功能异常等需进一步远期随访。
简介:AIM:Toinvestigatetheefficacyofnon-buckledvitrectomywithclassicalendotamponadeagentsinthetreatmentofprimaryretinaldetachment(RD)complicatedbyinferiorbreaksandproliferativevitreoretinophathy(PVR).METHODS:Aretrospective,consecutiveandcaseseriesstudyof40patientswithinferiorbreakRDandPVR≥C1wasconducted.Allpatientsunderwentastandard3-port20-gaugeparsplanavitrectomy(PPV)withgasorsiliconeoiltamponadewithoutsupplementaryscleralbuckling.Thevitreousandallproliferativemembranewerecompletelyremoved,andretinectomywasperformedwhennecessary.Themeanfollow-upwas12.5months.Theprimaryandfinalanatomicsuccessrate,visualacuityandcomplicationswererecordedandanalyzed.RESULTS:Primaryanatomicsuccessratewasachievedin35of40eyes(87.5%)andthefinalanatomicsuccessratewas100%.ThemostcommoncauseofredetachmentwasrecurrentPVR.Thebest-correctedvisualacuity(BCVA)atfinalfollow-upwasimprovedin34eyes(85%),remainedstablein1eye(2.5%),andworsenedin5eyes(12.5%).Themeanvisualacuityatfinalfollow-upwasimprovedsignificantly(P=0.000).CONCLUSION:ThisretrospectivestudyprovidesevidencethatvitrectomywithoutscleralbucklingseemedtobeaneffectivetreatmentforinferiorbreakRDwithPVR.Withcompleteremovalofvitreousandproliferativemembranesandtimingofretinectomy,theinferiorbreakswhichcomplicatedwithPVRcouldbeclosedsuccessfullywithoutadditionalscleralbuckling.
简介:AIM:ToinvestigatetheeffectofY-27632onthesurvivalandneuriteoutgrowthoftheculturedretinalneurocytes.METHODS:Afterthepostnatalday2-3,Sprague-Dawleyretinalneurocyteswereculturedfor48hours,theculturemediawasreplacedwithserum-freemedia(controlgroup)andserum-freemediacontained30μmol/LY-27632(Y-27632group),andthecellswerecontinuallyculturedanother48hours.Theculturedretinalneurocyteswereidentifiedwithanti-neuronspecificenolase(NSE)immunocytochemistry.ThesurvivalstateofthosecellswasestimatedbyMTTassay,andtheneuriteoutgrowthofthosecellswasevaluatedbythecomputerizedimage-analysissystem.RESULTS:Comparedwiththecontrolgroup,theabsorbancevaluesofcellssurvivalinY-27632groupincreased12.90%and33.33%respectivelyafter72and96hoursculture.Y-27632hadnosignificanteffectonthediameterofculturedretinalneurocytes.Comparedwiththecontrolgroup,Y-27632inducedastableimprovementofneuriteoutgrowthofretinalneurocytesafter72and96hoursculture(P=0.001).CONCLUSION:Y-27632couldpromotethesurvivalandneuriteoutgrowthoftheearlypostnatalculturedretinalneurocytes.
简介:AIM:ToevaluatetheefficacyofSeprafilmtransplantationfollowingadhesiolysisforpreventingpostoperativereadhesionandimprovingsurgicaloutcomes.METHODS:Primaryblepharoplastywascarriedoutonbotheyelidsof18albinorabbits.After2weeks,anewskinincisionwasmade,andadhesiolysiswasperformedonbotheyelids.Therabbitswerecategorizedintotwogroups,onewithadhesiolysisaloneinthelefteyelid(controlgroup),andtheotherwithadhesiolysiswithaSeprafilmgraftintherighteyelid(Seprafilmgroup).Thedegreesofinflammationandfibrosiswereexaminedwithhematoxylin-eosin(HE)andMasson’strichromestains.Expressionofα-smoothmuscleactin(α-SMA)wasalsoimmunohistochemicallyexamined.RESULTS:Eyelidexaminationimmediatelyaftertheoperationrevealedmildswellingandhemorrhageinbothgroups,butthesesymptomsresolvedafter1week-2weeks,andeyelidshapehadrecoveredcompletelyinbothgroups.MicroscopicassessmentsdemonstratedthattheSeprafilmgroupshowedlessinflammationandfibrosisthanthecontrolgroup.TheSeprafilmgroupalsoexhibitedfewerα-SMA-positivecellsthanthecontrolgroup.CONCLUSION:Basedonthesefindings,weconcludethatSeprafilmgraftwithadhesiolysisisaneffectivemethodforpreventingpostoperativereadhesionsaftereyelidsurgery.
简介:·AIM:Toinvestigatethetherapeuticeffectsofnanophtha-locyaninephotosensitizersonanexperimentalratchoroidalneovescularization(CNV)model,aswellastoevaluatethecytotoxicityofwhichonhumanretinalpigmentepithelia(HRPE)andhumanretinalendothelialcells(HRECs).·METHODS:Twotypesofphotosensitizers,G1-ZnPc(COOH)8andG1-ZnPc(COOH)8/mrespectively,wereadministratedforphotodynamictherapy(PDT)afterasuccessfulestablishmentofCNVmodelonBrown-Norway(BN)ratsviafundusphotocoagulation.Thetherapeuticeffectsofthetwodrugswereassessedthroughopticalcoherencetomography(OCT),fluoresceinfundusangiography(FFA)andtransmissionelectronmicroscopy(TEM).Forcytotoxicitytests,cellcountingkit-8(CCK-8)assaysandchangesofmitochondrialtransmembranepotential(△Ψm)wereconductedonHRPEandHRECsafterinitialuptakeofthetwodrugs.·RESULTS:Bothphotosensitizersdemonstratedanimprove-mentofvascularleakageandclosureofCNV1weekafterPDTasconfirmedbyfundusimage,OCT,FFAandTEM.TwoweeksafterPDT,G1-ZnPc(COOH)8/mshowedabetterCNVclosureeffectversusG1-ZnPc(COOH)8(P<0.05).Asignificantdifference(P<0.01)wasfoundinuptakeofthetwodrugsinHRPEandHRECs,withnodifferencebetweenthedrugs(P>0.05).BothphotosensitizersshowedcytotoxicityonHRPE,butG1-ZnPc(COOH)8/minducedalowercellviability.·CONCLUSION:G1-ZnPc(COOH)8/mmediatedPDTisbetterthanG1-ZnPc(COOH)8inCNVclosureandalsohavetheadvantageoffastmetabolismleadingtolesssideeffect.·
简介:AIM:Tocharacterizetemporalpatternofresolutionandrecurrenceofnaivechoroidalneovascularization(CNV)secondarytowetage-relatedmaculardegeneration(AMD)treatedwithintravitrealbevacizumabonasneededregimen,andtoanalyzebaselineriskfactorsforCNVresolutionorrecurrence.METHODS:Ninety-oneeyesof80patientswithnewlydiagnosedwetAMDwereretrospectivelystudied.Alleyesweretreatedwitharoundofthreemonthlyintravitrealbevacizumabinjections,followedbyoneadditional’bonus’injectionafterresolutionofCNVactivity.Duringfollow-up,eyesweremonitoredwithfluoresceinangiography,opticalcoherencetomography,andbest-correctedvisualacuity(BCVA).IncaseofrecurrencesofCNVactivity,eyeswereretreatedwithotherroundsofbevacizumabinjectionsfollowingthesametreatmentprotocol.RESULTS:Overamedianfollow-upof532d,themedianresolutiontimeofCNVactivityinthefirst,second,andthirdtreatmentroundwas98d,126d,and111d,respectively.Themedianrecurrencetimeforthethreeroundswas154d,126d,and151d,respectively.Nosignificantdifferenceinresolutiontime(P=0.09)orinrecurrencetime(P=0.11)wasdetectedamongtreatmentrounds.Age(P=0.0082)andlensstatus(P=0.035)werefoundtobeassociatedwithCNVresolution;forevery1-yearincreaseinagetherewas4%greaterchanceofCNVresolution;Phakiceyesdemonstrateda33%betterchancetoexperienceCNVresolutionthanpseudophakiceyes.ForCNVrecurrence,lensstatus(P=0.0009)andgender(P=0.0446)werefoundtobepredictive;pseudophakiceyeshada3.69-foldgreaterrisktoexperiencerecurrenceofCNVactivitycomparedtophakiceyes;maleshada2.19-foldgreaterrisktoexperiencerecurrenceofCNVactivitythanfemales.NosignificantBCVAchangesamongthreetreatmentroundswerenoted(P=0.56).CONCLUSION:ResolutiontimeandrecurrencetimeofCNVactivitywerenotsignificantlydifferentamongtreatmentrounds,suggestingabsenceoftachyphylaxistobevacizumab.Acautiousdecisionshouldbemadeupondisco
简介:AIM:Tocomparetheeffectoftopicallyadministeredandsubconjunctivallyinjectedbevacizumabonexperimentalcornealneovascularizationinratsfortwoweeksaftertreatment.METHODS:Twenty-eightSprague-Dawleyratsweredividedintofourgroupsof7animals.Eachcornealcenterofrighteyewascauterizedwithsilver/potassiumnitratefor8s.Aftercornealburning,bevacizumab(12.5mg/mL)wastopicallyadministeredthreetimesperday(TBgroup)fortwoweeksorsubconjunctivallyinjectedondays2and4aftercauterization(0.02mL;SBgroup).Asnegativecontrols,ratsreceived0.9%salinetopicallythreetimesperday(TSgroup)orsubconjunctivallyondays2and4(0.02mL;SSgroup).Digitalphotographsofthecorneaweretaken1and2weeksaftertreatmentandanalyzedtodeterminetheareaofcorneacoveredbyneovascularizationasthepercentageofcornealneovascularization.RESULTS:Oneweekaftertreatment,thepercentageofcornealneovascularizationwassignificantlylowerintheTBandSBgroupsthanintheTSandSSgroups(allP<0.05).Twoweeksaftertreatment,thepercentageofcornealneovascularizationwassignificantlylowerintheTBgroupthanintheTSgroup(P<0.05).Inallgroups,thepercentageofneovascularizationwasdecreasingastimepassed(allP<0.05)CONCLUSION:Topicallyadministeredbevacizumabhaslongerstandinganti-angiogeniceffectthansubconjunctivallyinjectedbevacizumabincornealneovascularizationfollowingchemicalinjuryinrats.
简介:Choroidalneovascularization(CNV)isanuncommoncomplicationassociatedwithamacularhole.Inthiscasereportofararecondition,wepresentapathologicmyopiapatientwithaco-existentmacularholeandchoroidalneovascularmembrane.ThepatientwastreatedwithphotodynamictherapyforCNV,andthenvitreoussurgeryfortheretinaldetachmentandmacularhole.Attheendof4yearsfollow-up,hervisualacuitywasimprovedto0.1whilethemacularholeremainedopen.OpticalcoherencetomographyisausefulinspectionmethodofthediagnosisofCNVandmacularhole.
简介:AIM:Tostudytheimpactofscleralflapposition,underwhichtheposteriorchamberintraocularlenses(PC-IOL)weresulcus-fixedbytrans-scleralsuture,oncorneaastigmatism.METHODS:Twenty-sixaphakicorcataracteyeswerecomprisedinthisprospectivenoncomparativecaseseriesstudy.Eleveneyeshadtraumaticcataractremovedwithoutsufficientcapsularsupport,3hadblunttraumawithsubluxatedtraumaticcataract,8hadundergonevitreoretinalsurgeryand4hadcongenitalcataractremoved.Theaverageagewas54years(range21-74years),with17menand7women.ThefoldablePC-IOLwasfixedinsulcusbytrans-scleralsuture.TheincisionforIOLimplantationwasmade1mmposteriortolimbusalongthesteepestmeridianofcornea,whilescleralflapstoburytheknotsoftrans-scleralsutureweremadealongtheflattestmeridian.Allthesurgerieswereperformedbyasingledoctor(MaL),andthefollowupwasatleast13months(range13-28months).Thepreoperative,3monthsand1yearpostoperativecornealcurvaturealongthesteepestandflattestcorneameridianandoverallcorneaastigmatismwerecompared.RESULTS:Thecurvaturealongthesteepestmeridianchangedfrom44.25±2.22Dpreoperativelyto44.08±2.16Dat3monthspostoperatively,and43.65±5.23Dat1yearpostoperatively(P>0.05);thecurvaturealongtheflattestmeridianchangedfrom41.24±2.21Dpreoperativelyto43.15±3.94Dat3monthspostoperatively,and42.85±5.17Dat1yearpostoperatively(P<0.05);andthesurgeryinducedastigmatism(SIA)oncorneawascalculatedbyvectoranalysis,whichwas2.42±2.13Dat3monthspostoperatively,and2.18±3.42Dat1yearpostoperatively,thedifferencewasstatisticallysignificant(P<0.05).CONCLUSION:Thescleralflapmadealongtheflattestmeridian,underwhichtheposteriorchamberintraocularlenses(PCIOL)weresulcus-fixedbytrans-scleralsuture,cansteepenthecorneainvaryingdegrees,thusreducingpreexistingcornealastigmatism.
简介:AIM:Todeterminewhethersinglenucleotidepolymorphism(SNP)rs641153isassociatedwiththeriskofage-relatedmaculardegeneration(AMD),weperformedasystematicmeta-analysisof15eligiblestudies.SNPinthecomplementfactorB(CFB)geneisconsideredtohavesignificantassociationwithAMDsusceptibility,butthereisgreatdiscrepancyintheseresults.METHODS:TheeligiblestudieswereidentifiedbysearchingthedatabasesofPubMed,EMBASE,andWebofScience.Oddsratios(ORs)with95%confidenceintervals(CIs)wereusedtoassesstheassociation.AlldatawereanalyzedusingStatasoftware.RESULTS:Theassociationbetweenrs641153andAMDriskwasstatisticallysignificantunderthehomozygousmodel(AAvsGG:OR=0.26,95%CI=0.15-0.45,P_h=0.973,/~2=0.0%,fixedeffects),dominantmodel(AA+GAvsGG:OR=0.49,95%CI=0.40-0.59,P_h=0.004,/~2=56.4%,randomeffects)andrecessivemodel(AAvsGA+GG:OR=0.30,95%CI=0.17-0.51,R_n=0.983,I~2=0.0%,fixedeffects).Thesameresultswerealsoobservedinthestratifiedanalysesbyethnicity,sourceofcontrolandsamplesize.CONCLUSION:Ourmeta-analysissuggeststhatrs641153intheCFBgenemayplayaprotectiveroleinAMDsusceptibility,thelateAMDinparticular,bothinCaucasiansandinAsians.