AIM:To evaluate the postoperative refractive prediction error(PE)and determine the factors that af fect the refractive outcomes of combined pars plana vitrectomy(PPV)or silicone oil removal(SOR)with cataract surgery.M...AIM:To evaluate the postoperative refractive prediction error(PE)and determine the factors that af fect the refractive outcomes of combined pars plana vitrectomy(PPV)or silicone oil removal(SOR)with cataract surgery.METHODS:The study is a retrospective,case-series study.Totally 301 eyes of 301 patients undergoing combined PPV/SOR with cataract surgery were enrolled.Eligible individuals were separated into four groups according to their preoperative diagnoses:silicone oil-filled eyes after PPV(group 1),epiretinal membrane(group 2),macular hole(group 3),and primary retinal detachment(RD;group 4).The variables af fecting postoperative refractive outcomes were analyzed,including age,gender,preoperative best-corrected visual acuity(BCVA),axial length(AL),keratometry average,anterior chamber depth(ACD),intraocular tamponade,and vitreoretinal pathology.The outcome measurements include the mean refractive PE and the proportions of eyes with a PE within±0.50 diopter(D)and±1.00 D.RESULTS:For all patients,the mean PE was-0.04±1.17 D,and 50.17%of patients(eyes)had a PE within±0.50 D.There was a significant difference in refractive outcomes among the four groups(P=0.028),with RD(group 4)showing the least favorable refractive outcome.In multivariate regression analysis,only AL,vitreoretinal pathology,and ACD were strongly associated with PE(all P<0.01).Univariate analysis revealed that longer eyes(AL>26 mm)and a deeper ACD were correlated with hyperopic PE,and shorter eyes(AL<26 mm)and a shallower ACD were correlated with myopic PE.CONCLUSION:RD patients have the least favorable refractive outcome.AL,vitreoretinal pathology,and ACD are strongly associated with PE in the combined surgery.These three factors affect refractive outcomes and thus can be used to predict a better postoperative refractive outcome in clinical practice.展开更多
AIM: To study the clinical observation of removal of the necrotic corneal tissue combined with conjunctival flap covering surgery under the guidance of the AS-OCT in treatment of fungal keratitis. METHODS:A retrospect...AIM: To study the clinical observation of removal of the necrotic corneal tissue combined with conjunctival flap covering surgery under the guidance of the AS-OCT in treatment of fungal keratitis. METHODS:A retrospective study was done to 10 patients (10 eyes) who had accepted removal of the necrotic corneal tissue combined with conjunctival flap covering surgery for fungal keratitis,the diagnosis by corneal scraping and smear examination or confocal microscopy check hyphae. Local and systemic antifungal therapy more than one week for all patients, corneal ulcer enlarge or no shrink. Slit lamp microscope examination the diameter of corneal ulcer about 2mm-4mm. Anterior segment optical coherence tomography (AS-OCT)examine the depth of corneal ulcer between 1/3-1/2, infiltrate corneal stroma about 20um-80um,the diameter of corneal ulcer about 3mm-6mm.Type-B ultrasonic exclusion endophthalmitis. Complete removal lesions until transparent of stoma, make conjunctival flap equal or greater than ulcer 1mm nearby conjunctiva. Continued antifungal therapy. The vision, fungal recurrence, conjunctival flap rollback or desquamate were analysed. ' RESULTS:Ten patients had success done this surgery, the corneal ulcer was not enlarge and healing afteroperation. 7 cases were bridging conjunctival flap and 3cases were single conjunctival flap. Preoperation vision above 0.1 had 8 cases,7 cases had vision above 0.1 one week after surgery, while 1 cases vision droped from 0.3 to 0.05.There was not recurrent for fungal,2 cases conjunctival flap rollback:1 case was bridging and 1case was single flap, no conjunctival flap desquamate. CONCLUSION: It is safe and effective to perform removal of the necrotic corneal tissue combined with conjunctival flap covering surgery under the guidance of the AS-OCT in treatment of fungal keratitis which werenot sensitive or aggravate for antifungal drugs.展开更多
At present, the incidence of infectious endophthalmitis after cataract surgery has been significantly reduced, but it is still a serious complication. Removal or not of the intraocular lens(IOL) during vitrectomy in c...At present, the incidence of infectious endophthalmitis after cataract surgery has been significantly reduced, but it is still a serious complication. Removal or not of the intraocular lens(IOL) during vitrectomy in cases with a moderate or severe inflammation is controversial. In order to call upon more discussion, we publish the article entitled “Timely vitrectomy without intraocular lens removal for acute endophthalmitis after cataract surgery” written by Guo et al in this issue. With recent advanced vitrectomy techniques, and critical measures for management of risk factors related to occurrence of infection, IOL remaining during timely vitrectomy for acute endophthalmitis can possibly be safe and effective in selected cases.展开更多
目的:观察iRoot BP plus盖髓治疗恒牙深龋3年后的临床疗效,探讨此类治疗方法的可行性及影响因素。方法:选取2019年1月至2020年9月于我科就诊,诊断为深龋或可复性牙髓炎成熟恒牙112颗,在牙科手术显微镜下选择性去龋后完成盖髓治疗,随访3...目的:观察iRoot BP plus盖髓治疗恒牙深龋3年后的临床疗效,探讨此类治疗方法的可行性及影响因素。方法:选取2019年1月至2020年9月于我科就诊,诊断为深龋或可复性牙髓炎成熟恒牙112颗,在牙科手术显微镜下选择性去龋后完成盖髓治疗,随访3年,通过影像学检查及临床指标评估患牙治疗效果。采用Kaplan-Meier生存分析统计活髓生存率,采用χ^(2)检验分析各个变量对疗效的影响。结果:Kaplan-Meier生存曲线显示112例成熟恒牙盖髓术后3年生存率为91.1%,82例患牙行间接盖髓术,30例患牙去龋时露髓行直接盖髓术,3年生存率分别为92.7%与86.7%。盖髓疗效与性别、年龄、术前诊断、牙型(前牙、前磨牙、磨牙)、洞形(Ⅰ类洞、Ⅱ类洞、Ⅲ类洞)、牙位及盖髓方式无相关性(P>0.05)。结论:iRoot BP plus作为盖髓剂对诊断为深龋或可复性牙髓炎的成熟恒牙行盖髓治疗疗效良好,研究变量对预后均无显著影响。展开更多
Minimal invasion is an important trend in surgery.However,the endoscope,as one of the key devices for monitoring the process of minimally invasive surgery,is limited by its size and working space it operates in,which ...Minimal invasion is an important trend in surgery.However,the endoscope,as one of the key devices for monitoring the process of minimally invasive surgery,is limited by its size and working space it operates in,which result in a considerably narrow field of view.In particular,when a surgical instrument enters through the tool channel,the instrument occupies most of the area in an endoscopic image.This hampers the surgeon’s field of view and has a negative impact on the surgery.This study proposes a novel method for removing the occlusion caused by surgical instruments in endoscopic images by making foreground occlusions on endoscopic images transparent using image restoration and interframe information filling.Compared with unprocessed images,this method can provide a clearer field of view that is necessary for minimally invasive endoscopic surgeries and improve the quality of surgeries.Clinical endoscopic images are used to verify the feasibility of the proposed method,and the results show that the proposed method improves the visual effect of endoscopic images by removing surgical-instrument occlusions.This demonstrates the considerable potential of the proposed method for use in clinical applications.展开更多
基金Supported by the National Natural Science Foundation of China (No.81770972,No.81970843)。
文摘AIM:To evaluate the postoperative refractive prediction error(PE)and determine the factors that af fect the refractive outcomes of combined pars plana vitrectomy(PPV)or silicone oil removal(SOR)with cataract surgery.METHODS:The study is a retrospective,case-series study.Totally 301 eyes of 301 patients undergoing combined PPV/SOR with cataract surgery were enrolled.Eligible individuals were separated into four groups according to their preoperative diagnoses:silicone oil-filled eyes after PPV(group 1),epiretinal membrane(group 2),macular hole(group 3),and primary retinal detachment(RD;group 4).The variables af fecting postoperative refractive outcomes were analyzed,including age,gender,preoperative best-corrected visual acuity(BCVA),axial length(AL),keratometry average,anterior chamber depth(ACD),intraocular tamponade,and vitreoretinal pathology.The outcome measurements include the mean refractive PE and the proportions of eyes with a PE within±0.50 diopter(D)and±1.00 D.RESULTS:For all patients,the mean PE was-0.04±1.17 D,and 50.17%of patients(eyes)had a PE within±0.50 D.There was a significant difference in refractive outcomes among the four groups(P=0.028),with RD(group 4)showing the least favorable refractive outcome.In multivariate regression analysis,only AL,vitreoretinal pathology,and ACD were strongly associated with PE(all P<0.01).Univariate analysis revealed that longer eyes(AL>26 mm)and a deeper ACD were correlated with hyperopic PE,and shorter eyes(AL<26 mm)and a shallower ACD were correlated with myopic PE.CONCLUSION:RD patients have the least favorable refractive outcome.AL,vitreoretinal pathology,and ACD are strongly associated with PE in the combined surgery.These three factors affect refractive outcomes and thus can be used to predict a better postoperative refractive outcome in clinical practice.
文摘AIM: To study the clinical observation of removal of the necrotic corneal tissue combined with conjunctival flap covering surgery under the guidance of the AS-OCT in treatment of fungal keratitis. METHODS:A retrospective study was done to 10 patients (10 eyes) who had accepted removal of the necrotic corneal tissue combined with conjunctival flap covering surgery for fungal keratitis,the diagnosis by corneal scraping and smear examination or confocal microscopy check hyphae. Local and systemic antifungal therapy more than one week for all patients, corneal ulcer enlarge or no shrink. Slit lamp microscope examination the diameter of corneal ulcer about 2mm-4mm. Anterior segment optical coherence tomography (AS-OCT)examine the depth of corneal ulcer between 1/3-1/2, infiltrate corneal stroma about 20um-80um,the diameter of corneal ulcer about 3mm-6mm.Type-B ultrasonic exclusion endophthalmitis. Complete removal lesions until transparent of stoma, make conjunctival flap equal or greater than ulcer 1mm nearby conjunctiva. Continued antifungal therapy. The vision, fungal recurrence, conjunctival flap rollback or desquamate were analysed. ' RESULTS:Ten patients had success done this surgery, the corneal ulcer was not enlarge and healing afteroperation. 7 cases were bridging conjunctival flap and 3cases were single conjunctival flap. Preoperation vision above 0.1 had 8 cases,7 cases had vision above 0.1 one week after surgery, while 1 cases vision droped from 0.3 to 0.05.There was not recurrent for fungal,2 cases conjunctival flap rollback:1 case was bridging and 1case was single flap, no conjunctival flap desquamate. CONCLUSION: It is safe and effective to perform removal of the necrotic corneal tissue combined with conjunctival flap covering surgery under the guidance of the AS-OCT in treatment of fungal keratitis which werenot sensitive or aggravate for antifungal drugs.
文摘At present, the incidence of infectious endophthalmitis after cataract surgery has been significantly reduced, but it is still a serious complication. Removal or not of the intraocular lens(IOL) during vitrectomy in cases with a moderate or severe inflammation is controversial. In order to call upon more discussion, we publish the article entitled “Timely vitrectomy without intraocular lens removal for acute endophthalmitis after cataract surgery” written by Guo et al in this issue. With recent advanced vitrectomy techniques, and critical measures for management of risk factors related to occurrence of infection, IOL remaining during timely vitrectomy for acute endophthalmitis can possibly be safe and effective in selected cases.
文摘目的:观察iRoot BP plus盖髓治疗恒牙深龋3年后的临床疗效,探讨此类治疗方法的可行性及影响因素。方法:选取2019年1月至2020年9月于我科就诊,诊断为深龋或可复性牙髓炎成熟恒牙112颗,在牙科手术显微镜下选择性去龋后完成盖髓治疗,随访3年,通过影像学检查及临床指标评估患牙治疗效果。采用Kaplan-Meier生存分析统计活髓生存率,采用χ^(2)检验分析各个变量对疗效的影响。结果:Kaplan-Meier生存曲线显示112例成熟恒牙盖髓术后3年生存率为91.1%,82例患牙行间接盖髓术,30例患牙去龋时露髓行直接盖髓术,3年生存率分别为92.7%与86.7%。盖髓疗效与性别、年龄、术前诊断、牙型(前牙、前磨牙、磨牙)、洞形(Ⅰ类洞、Ⅱ类洞、Ⅲ类洞)、牙位及盖髓方式无相关性(P>0.05)。结论:iRoot BP plus作为盖髓剂对诊断为深龋或可复性牙髓炎的成熟恒牙行盖髓治疗疗效良好,研究变量对预后均无显著影响。
基金supported by the National Key Research and Development Program of China(2022YFB4703000)the National Natural Science Foundation of China-Shenzhen Robotics Research Center Project(U2013209).
文摘Minimal invasion is an important trend in surgery.However,the endoscope,as one of the key devices for monitoring the process of minimally invasive surgery,is limited by its size and working space it operates in,which result in a considerably narrow field of view.In particular,when a surgical instrument enters through the tool channel,the instrument occupies most of the area in an endoscopic image.This hampers the surgeon’s field of view and has a negative impact on the surgery.This study proposes a novel method for removing the occlusion caused by surgical instruments in endoscopic images by making foreground occlusions on endoscopic images transparent using image restoration and interframe information filling.Compared with unprocessed images,this method can provide a clearer field of view that is necessary for minimally invasive endoscopic surgeries and improve the quality of surgeries.Clinical endoscopic images are used to verify the feasibility of the proposed method,and the results show that the proposed method improves the visual effect of endoscopic images by removing surgical-instrument occlusions.This demonstrates the considerable potential of the proposed method for use in clinical applications.
