AIM:To evaluate the visual outcomes of standard amblyopic treatment add-on training via perceptual learning in refractive amblyopic children and to identify the risk factors for treatment failure.METHODS:Retrospective...AIM:To evaluate the visual outcomes of standard amblyopic treatment add-on training via perceptual learning in refractive amblyopic children and to identify the risk factors for treatment failure.METHODS:Retrospective charts were reviewed in children with refractive amblyopia who received standard treatment and add-on Cambridge Visual Stimulator(CAM)training.The add-on CAM group that was enrolled had worn full-corrected glasses for at least 2mo before training.A control group received only the standard treatment.Treatment success was defined as best-corrected visual acuity(BCVA)≥20/25.The age,sex,initial BCVA,refractive errors,sessions and duration of training,and final BCVA were recorded.RESULTS:A total of 209 children(129 children in add-on CAM group and 80 children in control group)were enrolled.Seventy-six percent of unilateral and 87%of bilateral amblyopic children achieved treatment success.In children with unilateral or bilateral moderate amblyopia,the duration to reach BCVA≥20/25 was significantly shorter in add-on CAM group than in control group.Poor initial BCVA(P<0.001)and high astigmatism(P=0.007)were risk factors for treatment failure after add-on CAM training.Age,sex,and types of refractive error were not associated with treatment success.CONCLUSION:Add-on CAM training is an effective strategy for visual improvement and can shorten the treatment course when the effect of standard treatment is limited in amblyopic children.展开更多
Aim: To report a series of varicocelectomy performed under pure local anesthesia. Methods: From July 1988 to June 2003, a total of 575 patients, aged between 15 and 73 years, underwent high ligation of the internal ...Aim: To report a series of varicocelectomy performed under pure local anesthesia. Methods: From July 1988 to June 2003, a total of 575 patients, aged between 15 and 73 years, underwent high ligation of the internal spermatic vein for treatment of a varicocele testis under a regional block in which a precise injection of 0.8 % lidocaine solution was delivered to involved tissues after exact anatomical references were made. A 100-mm visual analog scale (VAS) was used to assess whether the pain level was acceptable. Results: The surgeries were bilateral in 52 cases, and unilateral in 523 cases. All were successfully performed on an outpatient basis except in the case of two patients, who were hospitalized because their surgeries required general anesthesia. Overall, 98.6 % (567/575) of men could go back to work by the end of the first post-operative week and only 8 (1.4 %) men reported feeling physical discomfort on the eighth day. The VAS scores varied from 11 mm to 41 mm with an average of (18.5 ± 11.3) mm that was regarded as tolerable. Conclusion: This study has shown varicocelectomy under local anesthesia to be possible, simple, effective, reliable and reproducible, and a safe method with minimal complications. It offers the advantages of more privacy, lower morbidity, with no notable adverse effects resulting from anesthesia, and a more rapid return to regular physical activity with minor complications.展开更多
基金Supported by the Kaohsiung Chang Gung Memorial Hospital and University College of Medicine(No.CMRPG8L1231,No.CMRPG8L1232,Kaohsiung,Taiwan).
文摘AIM:To evaluate the visual outcomes of standard amblyopic treatment add-on training via perceptual learning in refractive amblyopic children and to identify the risk factors for treatment failure.METHODS:Retrospective charts were reviewed in children with refractive amblyopia who received standard treatment and add-on Cambridge Visual Stimulator(CAM)training.The add-on CAM group that was enrolled had worn full-corrected glasses for at least 2mo before training.A control group received only the standard treatment.Treatment success was defined as best-corrected visual acuity(BCVA)≥20/25.The age,sex,initial BCVA,refractive errors,sessions and duration of training,and final BCVA were recorded.RESULTS:A total of 209 children(129 children in add-on CAM group and 80 children in control group)were enrolled.Seventy-six percent of unilateral and 87%of bilateral amblyopic children achieved treatment success.In children with unilateral or bilateral moderate amblyopia,the duration to reach BCVA≥20/25 was significantly shorter in add-on CAM group than in control group.Poor initial BCVA(P<0.001)and high astigmatism(P=0.007)were risk factors for treatment failure after add-on CAM training.Age,sex,and types of refractive error were not associated with treatment success.CONCLUSION:Add-on CAM training is an effective strategy for visual improvement and can shorten the treatment course when the effect of standard treatment is limited in amblyopic children.
文摘Aim: To report a series of varicocelectomy performed under pure local anesthesia. Methods: From July 1988 to June 2003, a total of 575 patients, aged between 15 and 73 years, underwent high ligation of the internal spermatic vein for treatment of a varicocele testis under a regional block in which a precise injection of 0.8 % lidocaine solution was delivered to involved tissues after exact anatomical references were made. A 100-mm visual analog scale (VAS) was used to assess whether the pain level was acceptable. Results: The surgeries were bilateral in 52 cases, and unilateral in 523 cases. All were successfully performed on an outpatient basis except in the case of two patients, who were hospitalized because their surgeries required general anesthesia. Overall, 98.6 % (567/575) of men could go back to work by the end of the first post-operative week and only 8 (1.4 %) men reported feeling physical discomfort on the eighth day. The VAS scores varied from 11 mm to 41 mm with an average of (18.5 ± 11.3) mm that was regarded as tolerable. Conclusion: This study has shown varicocelectomy under local anesthesia to be possible, simple, effective, reliable and reproducible, and a safe method with minimal complications. It offers the advantages of more privacy, lower morbidity, with no notable adverse effects resulting from anesthesia, and a more rapid return to regular physical activity with minor complications.