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 determine the normative distribution of axial length(AL),anterior chamber depth(ACD),anterior chamber volume(ACV),anterior chamber angle(ACA),and some of their associated factors in subjects aged 60 and over.ME...AIM:To determine the normative distribution of axial length(AL),anterior chamber depth(ACD),anterior chamber volume(ACV),anterior chamber angle(ACA),and some of their associated factors in subjects aged 60 and over.METHODS:In this cross-sectional study,160 clusters were sampled using multi-stage cluster sampling in Tehran,Iran.After a preliminary interview,the participants underwent optometric examinations including visual acuity and refraction measurement followed by slit lamp biomicroscopy.Finally,ocular imaging was done using the Pentacam AXL to measure AL,ACD,ACV,and ACA.RESULTS:A total of 4519 eyes of 2436 participants were evaluated,of whom 58.0%(n=1412)were female.The mean age of the subjects was 67.32±6.05y(range:60-95y).The mean AL,ACD,ACV,and ACA was 23.22 mm(23.18-23.27 mm),2.61 mm(2.59-2.62 mm),126.56 mm3(125.08-128.04 mm3),and 30.61°(30.3°-30.92°),respectively.In the multivariable model,after adjusting for the effect of both eyes,the longest and shortest AL was seen in myopic and hyperopic subjects,respectively.AL,ACD,ACV and ACA were significantly larger in men compared to women(P<0.001).Except ACA,other evaluated parameters showed an inverse correlation with age(P<0.001),however,this correlation was insignificant for AL(P=0.623).CONCLUSION:Normative value of AL,and other biometric parameters are specific for each ethnicity,age and sex group.Any alteration in these parameters and their effect on refraction should be considered in this age group,especially in case of cataract surgery.展开更多
AIM:To describe the outcome of using low-dose laser cycloplasty(LCP)in chronic angle-closure glaucoma(CACG).METHODS:A retrospective case series.Medical charts of CACG patients who underwent LCP in the Eye Hospital of ...AIM:To describe the outcome of using low-dose laser cycloplasty(LCP)in chronic angle-closure glaucoma(CACG).METHODS:A retrospective case series.Medical charts of CACG patients who underwent LCP in the Eye Hospital of Wenzhou Medical University were reviewed.The main outcomes included intraocular pressure(IOP),the number of glaucoma medication,anterior segment parameters and surgery-related complications.RESULTS:A total of 7 eyes of 7 CACG patients(age 38.9±11.0y)underwent LCP with a mean follow-up of 27.1±13.7mo(range 16-48mo).Following LCP,mean IOP and glaucoma medications decreased from 26.1±6.1 mm Hg with 3.1±1.1 glaucoma medications pre-treatment to 14.9±3.1 mm Hg(P=0.027)with 0.4±1.1 glaucoma medications(P=0.001)at final follow-up.The anterior chamber depth(ACD),angle opening distance500 and trabecular-iris angle increased from 1.65±0.33 mm,0.05 mm(range 0-0.30 mm)and 5.1°(range,0-31.97°)at baseline to 1.98±0.43 mm(P=0.073),0.53 mm(range 0.42-0.91 mm,P=0.015),45.9°(range,40.2°-59.4°),(P=0.015)in the long-term follow-up,respectively.The deepening of ACD and reopening of anterior chamber angle(ACA)was observed in 6 eyes(85.7%).CONCLUSION:LCP is a promising treatment option for patients with CACG via reducing IOP and glaucoma medication without serious complications.In addition,LCP can bring a significant deepening in ACD and reopening of ACA.展开更多
Background: The burden of cataract and glaucoma has been increasing. Primary angle closure occurs as a result of crowded anterior segment anatomy causing appositional contact between peripheral iris and trabecular mes...Background: The burden of cataract and glaucoma has been increasing. Primary angle closure occurs as a result of crowded anterior segment anatomy causing appositional contact between peripheral iris and trabecular meshwork. Lens extraction has been proposed as a method of deepening anterior chamber and managing intraocular pressure. Purpose: To assess changes in anterior chamber depth after phacoemulsification with intraocular lens implantation in narrow angle eyes. Design: Prospective controlled trial (before-after) study. Method: The study was conducted from March 2015 to August 2017 among the patients of department of Ophthalmology of BSMMU who were diagnosed as cataract with narrow angles. Anterior chamber angle grading of 2 or less (Shaffer grading) in 3 or more quadrants was considered narrow angle (NA). The purposive type sampling technique was applied to collect sample from the study population, as per inclusion and exclusion criteria. Complete clinical evaluation including history, physical examination, relevant ocular examinations and systemic examinations were performed. In this prospective study, subjects underwent phacoemulsification with foldable lens implantation. A scan ultrasonography was performed preoperatively and 10<sup>th</sup> and 30<sup>th</sup> postoperative days of surgery. Results: Thirty eyes of 29 patients included in the study, male: female ratio was 1:1, with an overall mean age of 62.03 ± 8.95 years. The mean preoperative central ACD was 2.95 ± 0.35 mm. At 10<sup>th</sup> and 30<sup>th</sup> POD mean central ACD were 3.94 ± 0.32, and 3.92 ± 0.28 mm respectively. Mean of increase in central ACD at final follow-up was 0.96 mm (p Conclusion: Phacoemulsification with posterior chamber in bag lens implantation can deepen the anterior chamber depth in patients with narrow angles. Based on these findings, it is concluded that phacoemulsification with foldable intraocular lens implantation is an effective tool in deepening the anterior chamber.展开更多
AIM:To assess the changes of anterior chamber angle in patients with shallow anterior chamber after phacoemulsification combined with intraocular lens(IOL)implantation,based on anterior segment swept-source optical co...AIM:To assess the changes of anterior chamber angle in patients with shallow anterior chamber after phacoemulsification combined with intraocular lens(IOL)implantation,based on anterior segment swept-source optical coherence tomography(AS-SS-OCT)measurements.METHODS:This was a prospective case control study;sixty eyes of sixty case were scheduled for cataract surgery with normal intraocular pressure(IOP).Based on anterior chamber depth(ACD)and gonioscopy findings,the eyes were divided into two groups:group of shallow anterior chamber and narrow angle(SAC group,30 eyes);and group of normal anterior chamber group with wide angle(NAC group,30 eyes).Measurements of ACD,anterior chamber volume(ACV),iris volume(IV),lens vault(LV),angle opening distance(AOD),angle recess area(ARA),trabecular iris space area(TISA),and trabecular iris angle(TIA)were conducted in each group before and 3mo after surgery.RESULTS:There was no significant difference in age,axial length(AL),corneal curvature,corneal diameter,intraocular pressure,and IV between two groups before surgery,except for the LV(P=0.000).ACD and ACV were prominently larger in the NAC group than the SAC group 3mo after operation(3.69±0.38 vs 3.85±0.39 mm,P=0.025;161.37±19.47 vs 178.26±20.30 mm3,P=0.002).AOD750,ARA750 in nasal and inferior quadrants,TISA750 in all quadrants except temporal,and TIA750 in all quadrants in SAC group were significantly smaller than those in NAC group after operation(all P<0.05).CONCLUSION:Cataract surgery can deepen anterior chamber and increase the width of anterior chamber angle in Chinese subjects,but the angle related parameters including AOD750,ARA750,TISA750,TIA,TISA750,and ACV in patients with shallow anterior chamber and narrow angle do not reach the normal level.展开更多
AIM: To measure the depths of different regions of the anterior chamber(AC) in healthy Chinese adults, and to explore possible correlations with age or gender.METHODS: The AC was imaged by swept-source optical coheren...AIM: To measure the depths of different regions of the anterior chamber(AC) in healthy Chinese adults, and to explore possible correlations with age or gender.METHODS: The AC was imaged by swept-source optical coherence tomography in healthy Chinese adults. The horizontal scan of the right eye was used to measure the anterior chamber depth(ACD) at 199 points.RESULTS: A total of 309 images from 309 subjects were analyzed. The ACD values at nearly all locations were negatively correlated with age(all P<0.05), except for ACD1, 2, 198, and 199(correspond to the iris roots). The mean annual decrease 0.013±0.005 mm/y for all ACDs combined, 0.008±0.004 mm/y for the peripheral region, 0.017±0.003 mm/y for the middle peripheral region, and 0.014±0.001 mm/y for the central region. The mean annual decrease was significantly different among these three regions(P<0.001). The ACD was greater in males than in females(P<0.05). The mean difference in ACD between males and females was 0.081±0.025 mm.CONCLUSION: This study showed that optical coherence tomography can be used to measure the ACD of different regions of the AC. We found reductions in ACD with age, although the reduction varied among different points, in healthy Chinese adults.展开更多
AIM: To investigate the incidence rate and risk factors for grade Ⅲ flat anterior chamber(FAC) after glaucoma filtration surgery based on 5-year data.METHODS: Patients who underwent glaucoma filtration surgery in Dap...AIM: To investigate the incidence rate and risk factors for grade Ⅲ flat anterior chamber(FAC) after glaucoma filtration surgery based on 5-year data.METHODS: Patients who underwent glaucoma filtration surgery in Daping hospital from January 2009 to December 2013 were enrolled in this retrospective study. The incidence of grade Ⅲ FAC following glaucoma filtration surgery was determined. Regression analysis was performed to investigate the influence of glaucoma type, surgical approach, age, and preoperative intraocular pressure(IOP) on the risk of postoperative FAC.RESULTS: A total of 2179 eyes receiving anti-glaucoma surgery were included. Ninety-one eyes suffered from postoperative FAC, with an overall incidence rate of 4.18%. Of 471 eyes with primary open angle glaucoma(POAG), grade Ⅲ FAC occurred in only 3 eyes(0.64%). Primary angleclosure glaucoma(PACG) was diagnosed in 1076 eyes, 39(3.62%) of which developed grade Ⅲ FAC, including 12 eyes(12/300, 4%) with acute PACG(aP ACG) and 27 eyes(27/776, 3.48%) with chronic PACG(c PACG). Six of 259 eyes(2.32%) with secondary glaucoma, 28 of 186 eyes(15.05%) with neovasular glaucoma, 1 of 66 eyes(1.52%) with congenital glaucoma, and 14 of 115 eyes(12.17%) with remnant glaucoma suffered from grade Ⅲ FAC. Of 6 eyes with mixed glaucoma, none developed grade Ⅲ FAC after surgery. When stratified by surgical approach, 24 of 766 eyes(3.13%) undergoing trabeculectomy, 21 of 924 eyes(2.27%) treated by trabeculectomy plus mitomycin C(MMC), 18 of 109 eyes(16.51%) undergoing Ahmed glaucoma valve implantation, 23 of 201 eyes(11.44%) managed by Ahmed implantation plus MMC, and 5 of 133 eyes(3.76%) treated by Ahmed implantation plus lens extraction or vitrectomy developed grade Ⅲ FAC. Logistic regression analysis revealed that factors including neovasular glaucoma, remnant glaucoma, glaucoma valve implantation, glaucoma valve implantation+MMC, glaucoma valve implantation+vitrectomy, age>60 y, and IOP at admission >50 mm Hg were significantly associated with an increased risk for grade Ⅲ FAC.CONCLUSION: The overall incidence of grade Ⅲ FAC after glaucoma filtration surgery is 4.18%. Patients with neovasular glaucoma and remnant glaucoma are at a higher risk of developing FAC. Ahmed glaucoma valve implantation is associated with a higher risk for grade Ⅲ FAC compared with trabeculectomy. No significant correlation was observed between the use of MMC in glaucoma filtration surgery and the risk of postoperative FAC. Higher IOP at admission(>50 mm Hg) and old age(>60 y) are risk factors for grade Ⅲ FAC.展开更多
BACKGROUND Glaucoma is an irreversible optic neuropathy with the loss of visual field and decrease of vision.The variable clinical manifestations may result in differential diagnostic difficulties.The early screening ...BACKGROUND Glaucoma is an irreversible optic neuropathy with the loss of visual field and decrease of vision.The variable clinical manifestations may result in differential diagnostic difficulties.The early screening and diagnosis of glaucoma are currently experiencing a demand for anterior segment analysis tools that can gather more information with one short measurement.Therefore,we analyzed the agreement,difference,and correlation of chamber angle parameters such as angel opening distance at 500μm(AOD500)and trabeculo-iris space area at 500μm^2(TISA500)measured by anterior segment optical coherence tomography(ASOCT)and ultrasound biomicroscopy(UBM).AIM To compare the differences,correlation,and agreement in measuring AOD500 and TISA500 by AS-OCT and UBM.METHODS Both AS-OCT and UBM were performed to measure AOD500 and TISA500 in 45 subjects(72 eyes).All subjects without glaucoma were collected from October 2015 to August 2016 at the Ophthalmology Department of the Fourth Affiliated Hospital of China Medical University.Data of the two groups(AOD500 and TISA500)were compared by nonparametric tests.Pearson correlative analysis and Bland-Altman analysis were used to compare the correlation and agreement.RESULTS There were no significant differences between AS-OCT and UBM in measuring AOD500(P1=0.110,P2=0.633,P3=0.078,and P4=0.474)and TISA500(P1=0.584,P2=0.889,P3=0.297,and P4=0.550)of the four quadrants of the anterior chamber angle.There was a high correlation in measuring AOD500(r1=0.562,r2=0.671,r3=0.635,and r4=0.720;P<0.001)and TISA500(r1=0.584,r2=0.889,r3=0.297,and r4=0.550;P<0.001).There was a good agreement in measuring AOD500 and TISA500 by the two modalities.CONCLUSION There is a high correlation and agreement between AOD500 and TISA500 measurements by AS-OCT and UBM.They are interchangeable under some circumstances.AS-OCT proves to be a better early screening tool for glaucoma.展开更多
AIM:To evaluate the effect of axial length(AL)and anterior chamber depth(ACD)on peripheral refractive profile in myopic patients compared to emmetropic participants.METHODS:This cross-sectional study was conducted in ...AIM:To evaluate the effect of axial length(AL)and anterior chamber depth(ACD)on peripheral refractive profile in myopic patients compared to emmetropic participants.METHODS:This cross-sectional study was conducted in right eyes of 58 participants of whom 38 were emmetropic and 20 were myopic.Central and peripheral refraction were measured at 10°,20°,and 30°eccentricities in nasal and temporal fields using an open-field autorefractor.The Lenstar LS900 was used to measure ACD and AL.The participants were divided into three groups of short(<22.5 mm),normal(22.5-24.5 mm),and long eye(>24.5 mm)according to AL and three groups of low ACD(<3.00 mm),normal ACD(3.00-3.60 mm),and high ACD(>3.60 mm)according to ACD.RESULTS:The mean age of the participants was 22.26±3.09 y(range 18-30 y).The peripheral mean spherical refractive error showed a hypermetropic shift in myopic and emmetropic groups although this shift was more pronounced in the myopic group.The results showed significant changes in the spherical equivalent,J0,and J45 astigmatism in all gazes with an increase in eccentricity(P<0.001).The pattern of refractive error changes was more noticeable in long and short eyes versus normal AL eyes.Moreover,the pattern of peripheral refractive changes was much more prominent in the high ACD group versus the normal ACD group and in the normal ACD group versus the low ACD group.CONCLUSION:Peripheral refraction changes are greater in participants with AL values outside the normal range and deeper ACD values compared to participants with normal AL and ACD.展开更多
Dear Editor,C ases involving spontaneous aphakic change in the visual axis are rare in Outpatient Clinics.However,we can often ascertain the past events affecting the patient’s eye by examining its current status.The...Dear Editor,C ases involving spontaneous aphakic change in the visual axis are rare in Outpatient Clinics.However,we can often ascertain the past events affecting the patient’s eye by examining its current status.The placement of the展开更多
Objective Previous studies have shown that the autonomic nervous system(ANS),which can be affected by emotions,is important in the occurrence or progression of glaucoma.The autonomic innervation distributed in the ant...Objective Previous studies have shown that the autonomic nervous system(ANS),which can be affected by emotions,is important in the occurrence or progression of glaucoma.The autonomic innervation distributed in the anterior chamber(AC)structures might play an efferent role in the neural regulation of intraocular pressure(IOP).This study aimed to investigate the anatomic neural connection from the emotional brain to autonomic innervation in the AC.Methods A retrograde trans-multisynaptic pseudorabies virus encoded with an enhanced green fluorescent protein(PRV531)and non-trans-synaptic tracer FAST Dil were injected into the right eye of mice,respectively.Fluorescent localization in the emotional brain and preganglionic nuclei was studied.Five and a half days after PRV531 injection into the right AC,fluorescent signals were observed in several emotional brain regions,including the amygdala,agranular insular cortex,lateral septal nuclei,periaqueductal gray,and hypothalamus.Autonomic preganglionic nuclei,including Edinger-Westphal nucleus,superior salivatory nucleus,and intermediolateral nucleus,were labeled using PRV531.Results The sensory trigeminal nuclei were not labeled using PRV531.The fluorescence signals in the nuclei mentioned above showed bilateral distribution,primarily on the ipsilateral side.Seven days after injecting FAST Dil into the AC,we observed no FAST Dil-labeled neurons in the central nervous system.Conclusion Our results indicate a neural connection from the emotional brain to autonomic innervation in the AC,which provides anatomical support for the emotional influence of IOP via the ANS.展开更多
Objective This study aimed to evaluate the ability of a digital fundus camera to observe the development of the anterior chamber angle(ACA)in premature infants.Methods Forty-eight eyes of preterm infants(n=48)were exa...Objective This study aimed to evaluate the ability of a digital fundus camera to observe the development of the anterior chamber angle(ACA)in premature infants.Methods Forty-eight eyes of preterm infants(n=48)were examined by a digital fundus camera to observe the development of the ACA.ACA grading was performed based on the visualization of the anterior chamber structures according to the Scheie Angle Depth Evaluating System.Results ACA images from all 48 infants were successfully acquired using RetCam3.The corrected gestational age ranged from 30 weeks to 49 weeks,which covered the period from 2 months preterm to>2 months post-term.As the corrected gestational age increased,the corrected gestational age grading was significantly decreased.The mean corrected gestational ages of the infants corresponding to the ACA classification from grade IV to grade 0 were 32.75±1.89,37.20±1.30,39.75±2.38,40.56±2.24,and 44.23±2.14 weeks,respectively,which were all significantly different(P<0.05).The regression analysis showed a linear correlation between the grading of the ACA and the corrected gestational age(R2=0.724,P=0.0001).Conclusion The ACA of a full-term newborn can be fully detected and evaluated by a digital fundus camera.For premature infants,part of the ACA is not visible physiologically;however,it should not be misdiagnosed as angle closure or a narrow angle.展开更多
AIM:To investigate the incidence and the predisposing factors of anterior chamber(AC)gas bubbles during femtosecond laser(FS)flap creation for laser in situ keratomileusis(LASIK).METHODS:All patients who underwent FS-...AIM:To investigate the incidence and the predisposing factors of anterior chamber(AC)gas bubbles during femtosecond laser(FS)flap creation for laser in situ keratomileusis(LASIK).METHODS:All patients who underwent FS-LASIK surgery at CMU LASIK Center between January 2013 and May 2016 were retrospective reviewed.Preoperative and intraoperative data including keratometry,white-towhite(WTW)corneal diameter,flap parameters(diameter,thickness,hinge position,and tunnel length)and pulse energy were reviewed and compared between incident group and control group.To determine the risk factors,univariate and multivariate conditional logistic regression were used;the eye was unit of analysis.RESULTS:The incidence of AC gas bubbles was 1.6%(22 out of 1378 eyes).The median WTW in the AC bubbles group was 11.5 mm(range 11.1-12.1),which was significantly different from the control group(11.7 mm,range 10.5-12.8,P=0.021).The result of the median WTW minus the flap diameter in the AC bubbles group was 2.5 mm(range 2.1-3.2),which was statistically different to the control group(2.7 mm,range 1.5-3.8,P=0.008).The logistic regression analysis showed that the result of the WTW minus the flap diameter in the AC bubbles group had an adjusted odds ratio of 0.204(95%CI;0.056-0.747,P=0.016).CONCLUSION:Development of AC gas bubbles during FS flap creation is not an uncommon event in Asian eyes which typically have a small WTW.The flap diameter when adjusted relatively to the WTW is a predisposing factor to the possibility of AC gas bubbles occurrence.展开更多
Dear Editor,Adenocarcinoma of the nonpigmented ciliary epithelium(NPCE)is a rare malignant tumor which is not easy to be found in the early stage^([1]).Herein,we report a case of adenocarcinoma of the NPCE in a Chines...Dear Editor,Adenocarcinoma of the nonpigmented ciliary epithelium(NPCE)is a rare malignant tumor which is not easy to be found in the early stage^([1]).Herein,we report a case of adenocarcinoma of the NPCE in a Chinese boy and discuss展开更多
<strong>Purpose:</strong> Biometry measurement of pre-operative cataract patients plays<span "=""> a major role in calculating intraocular lens power. This study aimed to review and de...<strong>Purpose:</strong> Biometry measurement of pre-operative cataract patients plays<span "=""> a major role in calculating intraocular lens power. This study aimed to review and determine the distribution of biometry components, such as axial length (AL), anterior chamber depth (ACD), and lens thickness (LT) of pre-operative cataract patient in Indonesian population. <b>Methods: </b>A cross-sectional study data w</span>ere obtained from 2015-2018 cataract surgery at Prima Husada Citra Hospital, Surabaya, East Java, Indonesia. A total of 1295 eyes with cataract was included in the study based on their medical record. We analyzed the data using descriptive analysis and correlated<span "=""> each variable using the Spearman’s Rho analysis. <b>Results: </b>Mean AL, LT and ACD was 23.81 </span>± 1.46 mm, 4.49 ± 0.55 mm, 3.25 ±<span "=""> 0.70 mm respectively. Male has longer AL and deeper ACD with (<i>p</i> < 0.001), while LT was found thicker in female (<i>p</i></span><span "=""> </span>=<span "=""> </span><span "="">0.005). The increase of AL was accompanied by ACD (<i>r</i> = 0.457;<i>p</i> < 0.001) and a thinner LT (<i>r </i>= </span><span "=""><span style="color:#4F4F4F;">-</span>0.101;<i>p</i> < 0.001). <b>Conclusions: </b>LT is increased with age while AL and ACD are shortened with age. There was a positive correlation between AL and ACD, but a</span>n inverse correlation between AL and LT.展开更多
<strong>Background:</strong> Phacoemulsification surgery is the most frequent cataract surgery performed in developed countries because of its effectiveness and safety. However, some degree of endothelial ...<strong>Background:</strong> Phacoemulsification surgery is the most frequent cataract surgery performed in developed countries because of its effectiveness and safety. However, some degree of endothelial loss is inevitable in any type of cataract surgery, including phacoemulsification. Anterior chamber depth (ACD) could be considered as one of important anatomical parameters for preserving endothelial loss from the mechanical and thermal damage that can occur during the procedure. <strong>Purpose:</strong> To evaluate the effects of ACD on endothelial cell density, hexagonality, coefficient variation (CV) and central corneal thickness (CCT) at one and four weeks after phacoemulsification using transversal ultrasound. <strong>Method:</strong> This was a prospective study conducted at Cicendo National Eye Hospital Indonesia from April to August 2018, where we performed phacoemulsification in 148 patients with ACD < 3 mm group, ACD ≥ 3 mm group. Specular microscopy examination was performed prior to phacoemulsification and repeated at one and four weeks after surgery. The changes in endothelial density, percentage of hexagonality, CV and CCT between two groups were evaluated and compared. <strong>Result:</strong> Mean (SD) endothelial density in ACD < 3 mm group and ACD ≥ 3 mm group at 1-week evaluation was 1761.9 (503.3) and 1966.1 (530.6) cells/mm2 respectively, with p value 0.030. At 4-week evaluation, endothelial cell density in ACD < 3 mm group and ACD ≥ 3 mm group was 1537.8 (504.9) and 1798.7 (554.0) cells/mm2 respectively, with p value 0.010. There was no statistical difference regarding hexagonality, CV and CCT between both groups at 1-week and 4-week evaluation. Endothelial density changes percentage also higher in ACD < 3 mm group at 1-week and 4-week evaluation. <strong>Conclusion:</strong> Endothelial cell density in ACD < 3 mm group was significantly lower compared to ACD ≥ 3 mm group at 1-week and 4-week evaluation after phacoemulsification.展开更多
Background: Anterior chamber angle (ACA) can be measured by many different techniques. In order for a technique to be a part of the routine eye examination, it has to be quick and easy in good agreement with gonioscop...Background: Anterior chamber angle (ACA) can be measured by many different techniques. In order for a technique to be a part of the routine eye examination, it has to be quick and easy in good agreement with gonioscopy both nasally and temporally. Aim: To investigate variation in ACA measurement between gonioscopy, van Herick technique, anterior segment optical coherence tomography (AS-OCT) and Sirius Scheimpflug-Camera both nasally and temporally. Method: The ACA of 50 eyes of 25 healthy subjects was measured with gonioscopy, van Herick technique, AS-OCT and Sirius Scheimpflug-Camera. The angle was measured both nasally and temporally. Results: No statistically significant difference could be found between gonioscopy, van Herick technique and AS-OCT either nasally or temporally. The Sirius Scheimpflug-Camera on the other hand showed statistically significant difference to gonioscopy (p < 0.0001) both nasally (p = 0.03, p = 0.001, p < 0.0001) and temporally (p = 0.0002, p = 0.001, p Conclusion: This study showed good agreement between three of the four techniques. ACA measurements obtained by the Sirius Scheimpflug-Camera should therefore not be considered interchangeable with those obtained by the remaining three methods.展开更多
We have reviewed a set of recently published studies that compared the anterior chamber depth(ACD) and/or white-to-white(WTW) distance obtained by means of different measuring devices.Since some of those studies reach...We have reviewed a set of recently published studies that compared the anterior chamber depth(ACD) and/or white-to-white(WTW) distance obtained by means of different measuring devices.Since some of those studies reached contradictory conclusions regarding device interchangeability,this review was carried out in attempting to clarify which clinical devices can or cannot be considered as interchangeable in clinical practice to measure ACD and/or WTW distance,among these devices:A-scan,ultrasound biomicroscopy,Orbscan and Orbscan Ⅱ(Bausch&Lomb Surgical Inc.,San Dimas,California,USA),Pentacam and Pentacam HR(Oculus,Wetzlar,Germany),Galilei(Ziemer,Switzerland),Visante optical coherence tomography(Visante OCT,Carl Zeiss Meditec Inc.,Dublin,California,USA),lOLMaster(Carl Zeiss Meditec,Jena,Germany),and Lenstar LS 900/Biograph(Haag-Streit AG,Koeniz,Switzerland/Alcon Laboratories Inc.,Ft Worth,Texas,USA).展开更多
To evaluate post-miosis changes in the anterior chamber structures in various angle-closure glaucomas(ACG). Totally 14 eyes of primary chronic angle-closure glaucoma(PCACG), 12 eyes of lens-induced secondary chronic a...To evaluate post-miosis changes in the anterior chamber structures in various angle-closure glaucomas(ACG). Totally 14 eyes of primary chronic angle-closure glaucoma(PCACG), 12 eyes of lens-induced secondary chronic angleclosure glaucoma(LSACG) and 14 healthy eyes were recruited. After miosis, for PCACG group, intraocular pressure(IOP) and anterior chamber depth(ACD) changed not significantly, while anterior chamber angle widened significantly. LSACG group showed a significant increase in IOP, decrease in ACD, and narrowing in anterior chamber angle. Healthy eyes showed significant decreases in IOP and anterior chamber parameters. Thus, miosis could widen the anterior chamber angle of patients with PCACG, while increase the narrowing of anterior chamber angle and IOP of patients with LSACG. We should pay attention to the distinction between PCACG and LSACG patients and the proper administration of pilocarpine in the treatment of patients with chronic ACG.展开更多
Purpose:To analyze the causes of shallow anterior chamber after glaucoma surgery,and explore effective treatments correspondingly. Methods:A total of 183 glaucoma patients. (218 eyes).underwent trabeculectomy,and shal...Purpose:To analyze the causes of shallow anterior chamber after glaucoma surgery,and explore effective treatments correspondingly. Methods:A total of 183 glaucoma patients. (218 eyes).underwent trabeculectomy,and shallow anterior chambers were observed after surgery.The causes were analyzed and appropriate approaches were employed accordingly. Results:Postoperatively,shallow anterior chamber occurred in 42 eyes. (19.3% ).Among those, 24 eyes. (57.1% ).had excessive filtrations,8 eyes (19.0% )showed delayed anterior chamber formation,5 eyes (11.9% )presented with choroidal detachments ,4 eyes (9.5% )displayed conjunctival flap leak ages,and 1 eye (2.4% )had ciliary block. Most shallow anterior chambers can be effectively improved after appropriate treatment. Conclusion:Shallow anterior chamber can be caused by a variety of reasons, mainly by excessive filtration. We should actively take reasonable measures to improve the symptom and try to avoid its occurrence.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.
基金Supported by National Institute for Medical Research Development(NIMAD)affiliated with the Iranian Ministry of Health and Medical Education(No.963660).
文摘AIM:To determine the normative distribution of axial length(AL),anterior chamber depth(ACD),anterior chamber volume(ACV),anterior chamber angle(ACA),and some of their associated factors in subjects aged 60 and over.METHODS:In this cross-sectional study,160 clusters were sampled using multi-stage cluster sampling in Tehran,Iran.After a preliminary interview,the participants underwent optometric examinations including visual acuity and refraction measurement followed by slit lamp biomicroscopy.Finally,ocular imaging was done using the Pentacam AXL to measure AL,ACD,ACV,and ACA.RESULTS:A total of 4519 eyes of 2436 participants were evaluated,of whom 58.0%(n=1412)were female.The mean age of the subjects was 67.32±6.05y(range:60-95y).The mean AL,ACD,ACV,and ACA was 23.22 mm(23.18-23.27 mm),2.61 mm(2.59-2.62 mm),126.56 mm3(125.08-128.04 mm3),and 30.61°(30.3°-30.92°),respectively.In the multivariable model,after adjusting for the effect of both eyes,the longest and shortest AL was seen in myopic and hyperopic subjects,respectively.AL,ACD,ACV and ACA were significantly larger in men compared to women(P<0.001).Except ACA,other evaluated parameters showed an inverse correlation with age(P<0.001),however,this correlation was insignificant for AL(P=0.623).CONCLUSION:Normative value of AL,and other biometric parameters are specific for each ethnicity,age and sex group.Any alteration in these parameters and their effect on refraction should be considered in this age group,especially in case of cataract surgery.
基金Supported by the Program for Zhejiang Leading Talent of S&T Innovation(No.2021R52012)Key Research and Development Projects of Zhejiang Province(No.2022C03112)the Basic Scientific Research Program of Wenzhou(No.Y2020365).
文摘AIM:To describe the outcome of using low-dose laser cycloplasty(LCP)in chronic angle-closure glaucoma(CACG).METHODS:A retrospective case series.Medical charts of CACG patients who underwent LCP in the Eye Hospital of Wenzhou Medical University were reviewed.The main outcomes included intraocular pressure(IOP),the number of glaucoma medication,anterior segment parameters and surgery-related complications.RESULTS:A total of 7 eyes of 7 CACG patients(age 38.9±11.0y)underwent LCP with a mean follow-up of 27.1±13.7mo(range 16-48mo).Following LCP,mean IOP and glaucoma medications decreased from 26.1±6.1 mm Hg with 3.1±1.1 glaucoma medications pre-treatment to 14.9±3.1 mm Hg(P=0.027)with 0.4±1.1 glaucoma medications(P=0.001)at final follow-up.The anterior chamber depth(ACD),angle opening distance500 and trabecular-iris angle increased from 1.65±0.33 mm,0.05 mm(range 0-0.30 mm)and 5.1°(range,0-31.97°)at baseline to 1.98±0.43 mm(P=0.073),0.53 mm(range 0.42-0.91 mm,P=0.015),45.9°(range,40.2°-59.4°),(P=0.015)in the long-term follow-up,respectively.The deepening of ACD and reopening of anterior chamber angle(ACA)was observed in 6 eyes(85.7%).CONCLUSION:LCP is a promising treatment option for patients with CACG via reducing IOP and glaucoma medication without serious complications.In addition,LCP can bring a significant deepening in ACD and reopening of ACA.
文摘Background: The burden of cataract and glaucoma has been increasing. Primary angle closure occurs as a result of crowded anterior segment anatomy causing appositional contact between peripheral iris and trabecular meshwork. Lens extraction has been proposed as a method of deepening anterior chamber and managing intraocular pressure. Purpose: To assess changes in anterior chamber depth after phacoemulsification with intraocular lens implantation in narrow angle eyes. Design: Prospective controlled trial (before-after) study. Method: The study was conducted from March 2015 to August 2017 among the patients of department of Ophthalmology of BSMMU who were diagnosed as cataract with narrow angles. Anterior chamber angle grading of 2 or less (Shaffer grading) in 3 or more quadrants was considered narrow angle (NA). The purposive type sampling technique was applied to collect sample from the study population, as per inclusion and exclusion criteria. Complete clinical evaluation including history, physical examination, relevant ocular examinations and systemic examinations were performed. In this prospective study, subjects underwent phacoemulsification with foldable lens implantation. A scan ultrasonography was performed preoperatively and 10<sup>th</sup> and 30<sup>th</sup> postoperative days of surgery. Results: Thirty eyes of 29 patients included in the study, male: female ratio was 1:1, with an overall mean age of 62.03 ± 8.95 years. The mean preoperative central ACD was 2.95 ± 0.35 mm. At 10<sup>th</sup> and 30<sup>th</sup> POD mean central ACD were 3.94 ± 0.32, and 3.92 ± 0.28 mm respectively. Mean of increase in central ACD at final follow-up was 0.96 mm (p Conclusion: Phacoemulsification with posterior chamber in bag lens implantation can deepen the anterior chamber depth in patients with narrow angles. Based on these findings, it is concluded that phacoemulsification with foldable intraocular lens implantation is an effective tool in deepening the anterior chamber.
文摘AIM:To assess the changes of anterior chamber angle in patients with shallow anterior chamber after phacoemulsification combined with intraocular lens(IOL)implantation,based on anterior segment swept-source optical coherence tomography(AS-SS-OCT)measurements.METHODS:This was a prospective case control study;sixty eyes of sixty case were scheduled for cataract surgery with normal intraocular pressure(IOP).Based on anterior chamber depth(ACD)and gonioscopy findings,the eyes were divided into two groups:group of shallow anterior chamber and narrow angle(SAC group,30 eyes);and group of normal anterior chamber group with wide angle(NAC group,30 eyes).Measurements of ACD,anterior chamber volume(ACV),iris volume(IV),lens vault(LV),angle opening distance(AOD),angle recess area(ARA),trabecular iris space area(TISA),and trabecular iris angle(TIA)were conducted in each group before and 3mo after surgery.RESULTS:There was no significant difference in age,axial length(AL),corneal curvature,corneal diameter,intraocular pressure,and IV between two groups before surgery,except for the LV(P=0.000).ACD and ACV were prominently larger in the NAC group than the SAC group 3mo after operation(3.69±0.38 vs 3.85±0.39 mm,P=0.025;161.37±19.47 vs 178.26±20.30 mm3,P=0.002).AOD750,ARA750 in nasal and inferior quadrants,TISA750 in all quadrants except temporal,and TIA750 in all quadrants in SAC group were significantly smaller than those in NAC group after operation(all P<0.05).CONCLUSION:Cataract surgery can deepen anterior chamber and increase the width of anterior chamber angle in Chinese subjects,but the angle related parameters including AOD750,ARA750,TISA750,TIA,TISA750,and ACV in patients with shallow anterior chamber and narrow angle do not reach the normal level.
基金Supported by research grants from the National Key R&D Program of China(No.2017YFC0108200)the Shanghai Committee of Science and Technology(No.16140901000+1 种基金 No.13430710500 No.15DZ1942204)
文摘AIM: To measure the depths of different regions of the anterior chamber(AC) in healthy Chinese adults, and to explore possible correlations with age or gender.METHODS: The AC was imaged by swept-source optical coherence tomography in healthy Chinese adults. The horizontal scan of the right eye was used to measure the anterior chamber depth(ACD) at 199 points.RESULTS: A total of 309 images from 309 subjects were analyzed. The ACD values at nearly all locations were negatively correlated with age(all P<0.05), except for ACD1, 2, 198, and 199(correspond to the iris roots). The mean annual decrease 0.013±0.005 mm/y for all ACDs combined, 0.008±0.004 mm/y for the peripheral region, 0.017±0.003 mm/y for the middle peripheral region, and 0.014±0.001 mm/y for the central region. The mean annual decrease was significantly different among these three regions(P<0.001). The ACD was greater in males than in females(P<0.05). The mean difference in ACD between males and females was 0.081±0.025 mm.CONCLUSION: This study showed that optical coherence tomography can be used to measure the ACD of different regions of the AC. We found reductions in ACD with age, although the reduction varied among different points, in healthy Chinese adults.
文摘AIM: To investigate the incidence rate and risk factors for grade Ⅲ flat anterior chamber(FAC) after glaucoma filtration surgery based on 5-year data.METHODS: Patients who underwent glaucoma filtration surgery in Daping hospital from January 2009 to December 2013 were enrolled in this retrospective study. The incidence of grade Ⅲ FAC following glaucoma filtration surgery was determined. Regression analysis was performed to investigate the influence of glaucoma type, surgical approach, age, and preoperative intraocular pressure(IOP) on the risk of postoperative FAC.RESULTS: A total of 2179 eyes receiving anti-glaucoma surgery were included. Ninety-one eyes suffered from postoperative FAC, with an overall incidence rate of 4.18%. Of 471 eyes with primary open angle glaucoma(POAG), grade Ⅲ FAC occurred in only 3 eyes(0.64%). Primary angleclosure glaucoma(PACG) was diagnosed in 1076 eyes, 39(3.62%) of which developed grade Ⅲ FAC, including 12 eyes(12/300, 4%) with acute PACG(aP ACG) and 27 eyes(27/776, 3.48%) with chronic PACG(c PACG). Six of 259 eyes(2.32%) with secondary glaucoma, 28 of 186 eyes(15.05%) with neovasular glaucoma, 1 of 66 eyes(1.52%) with congenital glaucoma, and 14 of 115 eyes(12.17%) with remnant glaucoma suffered from grade Ⅲ FAC. Of 6 eyes with mixed glaucoma, none developed grade Ⅲ FAC after surgery. When stratified by surgical approach, 24 of 766 eyes(3.13%) undergoing trabeculectomy, 21 of 924 eyes(2.27%) treated by trabeculectomy plus mitomycin C(MMC), 18 of 109 eyes(16.51%) undergoing Ahmed glaucoma valve implantation, 23 of 201 eyes(11.44%) managed by Ahmed implantation plus MMC, and 5 of 133 eyes(3.76%) treated by Ahmed implantation plus lens extraction or vitrectomy developed grade Ⅲ FAC. Logistic regression analysis revealed that factors including neovasular glaucoma, remnant glaucoma, glaucoma valve implantation, glaucoma valve implantation+MMC, glaucoma valve implantation+vitrectomy, age>60 y, and IOP at admission >50 mm Hg were significantly associated with an increased risk for grade Ⅲ FAC.CONCLUSION: The overall incidence of grade Ⅲ FAC after glaucoma filtration surgery is 4.18%. Patients with neovasular glaucoma and remnant glaucoma are at a higher risk of developing FAC. Ahmed glaucoma valve implantation is associated with a higher risk for grade Ⅲ FAC compared with trabeculectomy. No significant correlation was observed between the use of MMC in glaucoma filtration surgery and the risk of postoperative FAC. Higher IOP at admission(>50 mm Hg) and old age(>60 y) are risk factors for grade Ⅲ FAC.
文摘BACKGROUND Glaucoma is an irreversible optic neuropathy with the loss of visual field and decrease of vision.The variable clinical manifestations may result in differential diagnostic difficulties.The early screening and diagnosis of glaucoma are currently experiencing a demand for anterior segment analysis tools that can gather more information with one short measurement.Therefore,we analyzed the agreement,difference,and correlation of chamber angle parameters such as angel opening distance at 500μm(AOD500)and trabeculo-iris space area at 500μm^2(TISA500)measured by anterior segment optical coherence tomography(ASOCT)and ultrasound biomicroscopy(UBM).AIM To compare the differences,correlation,and agreement in measuring AOD500 and TISA500 by AS-OCT and UBM.METHODS Both AS-OCT and UBM were performed to measure AOD500 and TISA500 in 45 subjects(72 eyes).All subjects without glaucoma were collected from October 2015 to August 2016 at the Ophthalmology Department of the Fourth Affiliated Hospital of China Medical University.Data of the two groups(AOD500 and TISA500)were compared by nonparametric tests.Pearson correlative analysis and Bland-Altman analysis were used to compare the correlation and agreement.RESULTS There were no significant differences between AS-OCT and UBM in measuring AOD500(P1=0.110,P2=0.633,P3=0.078,and P4=0.474)and TISA500(P1=0.584,P2=0.889,P3=0.297,and P4=0.550)of the four quadrants of the anterior chamber angle.There was a high correlation in measuring AOD500(r1=0.562,r2=0.671,r3=0.635,and r4=0.720;P<0.001)and TISA500(r1=0.584,r2=0.889,r3=0.297,and r4=0.550;P<0.001).There was a good agreement in measuring AOD500 and TISA500 by the two modalities.CONCLUSION There is a high correlation and agreement between AOD500 and TISA500 measurements by AS-OCT and UBM.They are interchangeable under some circumstances.AS-OCT proves to be a better early screening tool for glaucoma.
文摘AIM:To evaluate the effect of axial length(AL)and anterior chamber depth(ACD)on peripheral refractive profile in myopic patients compared to emmetropic participants.METHODS:This cross-sectional study was conducted in right eyes of 58 participants of whom 38 were emmetropic and 20 were myopic.Central and peripheral refraction were measured at 10°,20°,and 30°eccentricities in nasal and temporal fields using an open-field autorefractor.The Lenstar LS900 was used to measure ACD and AL.The participants were divided into three groups of short(<22.5 mm),normal(22.5-24.5 mm),and long eye(>24.5 mm)according to AL and three groups of low ACD(<3.00 mm),normal ACD(3.00-3.60 mm),and high ACD(>3.60 mm)according to ACD.RESULTS:The mean age of the participants was 22.26±3.09 y(range 18-30 y).The peripheral mean spherical refractive error showed a hypermetropic shift in myopic and emmetropic groups although this shift was more pronounced in the myopic group.The results showed significant changes in the spherical equivalent,J0,and J45 astigmatism in all gazes with an increase in eccentricity(P<0.001).The pattern of refractive error changes was more noticeable in long and short eyes versus normal AL eyes.Moreover,the pattern of peripheral refractive changes was much more prominent in the high ACD group versus the normal ACD group and in the normal ACD group versus the low ACD group.CONCLUSION:Peripheral refraction changes are greater in participants with AL values outside the normal range and deeper ACD values compared to participants with normal AL and ACD.
文摘Dear Editor,C ases involving spontaneous aphakic change in the visual axis are rare in Outpatient Clinics.However,we can often ascertain the past events affecting the patient’s eye by examining its current status.The placement of the
文摘Objective Previous studies have shown that the autonomic nervous system(ANS),which can be affected by emotions,is important in the occurrence or progression of glaucoma.The autonomic innervation distributed in the anterior chamber(AC)structures might play an efferent role in the neural regulation of intraocular pressure(IOP).This study aimed to investigate the anatomic neural connection from the emotional brain to autonomic innervation in the AC.Methods A retrograde trans-multisynaptic pseudorabies virus encoded with an enhanced green fluorescent protein(PRV531)and non-trans-synaptic tracer FAST Dil were injected into the right eye of mice,respectively.Fluorescent localization in the emotional brain and preganglionic nuclei was studied.Five and a half days after PRV531 injection into the right AC,fluorescent signals were observed in several emotional brain regions,including the amygdala,agranular insular cortex,lateral septal nuclei,periaqueductal gray,and hypothalamus.Autonomic preganglionic nuclei,including Edinger-Westphal nucleus,superior salivatory nucleus,and intermediolateral nucleus,were labeled using PRV531.Results The sensory trigeminal nuclei were not labeled using PRV531.The fluorescence signals in the nuclei mentioned above showed bilateral distribution,primarily on the ipsilateral side.Seven days after injecting FAST Dil into the AC,we observed no FAST Dil-labeled neurons in the central nervous system.Conclusion Our results indicate a neural connection from the emotional brain to autonomic innervation in the AC,which provides anatomical support for the emotional influence of IOP via the ANS.
文摘Objective This study aimed to evaluate the ability of a digital fundus camera to observe the development of the anterior chamber angle(ACA)in premature infants.Methods Forty-eight eyes of preterm infants(n=48)were examined by a digital fundus camera to observe the development of the ACA.ACA grading was performed based on the visualization of the anterior chamber structures according to the Scheie Angle Depth Evaluating System.Results ACA images from all 48 infants were successfully acquired using RetCam3.The corrected gestational age ranged from 30 weeks to 49 weeks,which covered the period from 2 months preterm to>2 months post-term.As the corrected gestational age increased,the corrected gestational age grading was significantly decreased.The mean corrected gestational ages of the infants corresponding to the ACA classification from grade IV to grade 0 were 32.75±1.89,37.20±1.30,39.75±2.38,40.56±2.24,and 44.23±2.14 weeks,respectively,which were all significantly different(P<0.05).The regression analysis showed a linear correlation between the grading of the ACA and the corrected gestational age(R2=0.724,P=0.0001).Conclusion The ACA of a full-term newborn can be fully detected and evaluated by a digital fundus camera.For premature infants,part of the ACA is not visible physiologically;however,it should not be misdiagnosed as angle closure or a narrow angle.
文摘AIM:To investigate the incidence and the predisposing factors of anterior chamber(AC)gas bubbles during femtosecond laser(FS)flap creation for laser in situ keratomileusis(LASIK).METHODS:All patients who underwent FS-LASIK surgery at CMU LASIK Center between January 2013 and May 2016 were retrospective reviewed.Preoperative and intraoperative data including keratometry,white-towhite(WTW)corneal diameter,flap parameters(diameter,thickness,hinge position,and tunnel length)and pulse energy were reviewed and compared between incident group and control group.To determine the risk factors,univariate and multivariate conditional logistic regression were used;the eye was unit of analysis.RESULTS:The incidence of AC gas bubbles was 1.6%(22 out of 1378 eyes).The median WTW in the AC bubbles group was 11.5 mm(range 11.1-12.1),which was significantly different from the control group(11.7 mm,range 10.5-12.8,P=0.021).The result of the median WTW minus the flap diameter in the AC bubbles group was 2.5 mm(range 2.1-3.2),which was statistically different to the control group(2.7 mm,range 1.5-3.8,P=0.008).The logistic regression analysis showed that the result of the WTW minus the flap diameter in the AC bubbles group had an adjusted odds ratio of 0.204(95%CI;0.056-0.747,P=0.016).CONCLUSION:Development of AC gas bubbles during FS flap creation is not an uncommon event in Asian eyes which typically have a small WTW.The flap diameter when adjusted relatively to the WTW is a predisposing factor to the possibility of AC gas bubbles occurrence.
基金Supported by Beijing Natural Science Foundation(No.7162036)
文摘Dear Editor,Adenocarcinoma of the nonpigmented ciliary epithelium(NPCE)is a rare malignant tumor which is not easy to be found in the early stage^([1]).Herein,we report a case of adenocarcinoma of the NPCE in a Chinese boy and discuss
文摘<strong>Purpose:</strong> Biometry measurement of pre-operative cataract patients plays<span "=""> a major role in calculating intraocular lens power. This study aimed to review and determine the distribution of biometry components, such as axial length (AL), anterior chamber depth (ACD), and lens thickness (LT) of pre-operative cataract patient in Indonesian population. <b>Methods: </b>A cross-sectional study data w</span>ere obtained from 2015-2018 cataract surgery at Prima Husada Citra Hospital, Surabaya, East Java, Indonesia. A total of 1295 eyes with cataract was included in the study based on their medical record. We analyzed the data using descriptive analysis and correlated<span "=""> each variable using the Spearman’s Rho analysis. <b>Results: </b>Mean AL, LT and ACD was 23.81 </span>± 1.46 mm, 4.49 ± 0.55 mm, 3.25 ±<span "=""> 0.70 mm respectively. Male has longer AL and deeper ACD with (<i>p</i> < 0.001), while LT was found thicker in female (<i>p</i></span><span "=""> </span>=<span "=""> </span><span "="">0.005). The increase of AL was accompanied by ACD (<i>r</i> = 0.457;<i>p</i> < 0.001) and a thinner LT (<i>r </i>= </span><span "=""><span style="color:#4F4F4F;">-</span>0.101;<i>p</i> < 0.001). <b>Conclusions: </b>LT is increased with age while AL and ACD are shortened with age. There was a positive correlation between AL and ACD, but a</span>n inverse correlation between AL and LT.
文摘<strong>Background:</strong> Phacoemulsification surgery is the most frequent cataract surgery performed in developed countries because of its effectiveness and safety. However, some degree of endothelial loss is inevitable in any type of cataract surgery, including phacoemulsification. Anterior chamber depth (ACD) could be considered as one of important anatomical parameters for preserving endothelial loss from the mechanical and thermal damage that can occur during the procedure. <strong>Purpose:</strong> To evaluate the effects of ACD on endothelial cell density, hexagonality, coefficient variation (CV) and central corneal thickness (CCT) at one and four weeks after phacoemulsification using transversal ultrasound. <strong>Method:</strong> This was a prospective study conducted at Cicendo National Eye Hospital Indonesia from April to August 2018, where we performed phacoemulsification in 148 patients with ACD < 3 mm group, ACD ≥ 3 mm group. Specular microscopy examination was performed prior to phacoemulsification and repeated at one and four weeks after surgery. The changes in endothelial density, percentage of hexagonality, CV and CCT between two groups were evaluated and compared. <strong>Result:</strong> Mean (SD) endothelial density in ACD < 3 mm group and ACD ≥ 3 mm group at 1-week evaluation was 1761.9 (503.3) and 1966.1 (530.6) cells/mm2 respectively, with p value 0.030. At 4-week evaluation, endothelial cell density in ACD < 3 mm group and ACD ≥ 3 mm group was 1537.8 (504.9) and 1798.7 (554.0) cells/mm2 respectively, with p value 0.010. There was no statistical difference regarding hexagonality, CV and CCT between both groups at 1-week and 4-week evaluation. Endothelial density changes percentage also higher in ACD < 3 mm group at 1-week and 4-week evaluation. <strong>Conclusion:</strong> Endothelial cell density in ACD < 3 mm group was significantly lower compared to ACD ≥ 3 mm group at 1-week and 4-week evaluation after phacoemulsification.
文摘Background: Anterior chamber angle (ACA) can be measured by many different techniques. In order for a technique to be a part of the routine eye examination, it has to be quick and easy in good agreement with gonioscopy both nasally and temporally. Aim: To investigate variation in ACA measurement between gonioscopy, van Herick technique, anterior segment optical coherence tomography (AS-OCT) and Sirius Scheimpflug-Camera both nasally and temporally. Method: The ACA of 50 eyes of 25 healthy subjects was measured with gonioscopy, van Herick technique, AS-OCT and Sirius Scheimpflug-Camera. The angle was measured both nasally and temporally. Results: No statistically significant difference could be found between gonioscopy, van Herick technique and AS-OCT either nasally or temporally. The Sirius Scheimpflug-Camera on the other hand showed statistically significant difference to gonioscopy (p < 0.0001) both nasally (p = 0.03, p = 0.001, p < 0.0001) and temporally (p = 0.0002, p = 0.001, p Conclusion: This study showed good agreement between three of the four techniques. ACA measurements obtained by the Sirius Scheimpflug-Camera should therefore not be considered interchangeable with those obtained by the remaining three methods.
文摘We have reviewed a set of recently published studies that compared the anterior chamber depth(ACD) and/or white-to-white(WTW) distance obtained by means of different measuring devices.Since some of those studies reached contradictory conclusions regarding device interchangeability,this review was carried out in attempting to clarify which clinical devices can or cannot be considered as interchangeable in clinical practice to measure ACD and/or WTW distance,among these devices:A-scan,ultrasound biomicroscopy,Orbscan and Orbscan Ⅱ(Bausch&Lomb Surgical Inc.,San Dimas,California,USA),Pentacam and Pentacam HR(Oculus,Wetzlar,Germany),Galilei(Ziemer,Switzerland),Visante optical coherence tomography(Visante OCT,Carl Zeiss Meditec Inc.,Dublin,California,USA),lOLMaster(Carl Zeiss Meditec,Jena,Germany),and Lenstar LS 900/Biograph(Haag-Streit AG,Koeniz,Switzerland/Alcon Laboratories Inc.,Ft Worth,Texas,USA).
基金Supported by the National Natural Science Foundation of China(No.81471744)
文摘To evaluate post-miosis changes in the anterior chamber structures in various angle-closure glaucomas(ACG). Totally 14 eyes of primary chronic angle-closure glaucoma(PCACG), 12 eyes of lens-induced secondary chronic angleclosure glaucoma(LSACG) and 14 healthy eyes were recruited. After miosis, for PCACG group, intraocular pressure(IOP) and anterior chamber depth(ACD) changed not significantly, while anterior chamber angle widened significantly. LSACG group showed a significant increase in IOP, decrease in ACD, and narrowing in anterior chamber angle. Healthy eyes showed significant decreases in IOP and anterior chamber parameters. Thus, miosis could widen the anterior chamber angle of patients with PCACG, while increase the narrowing of anterior chamber angle and IOP of patients with LSACG. We should pay attention to the distinction between PCACG and LSACG patients and the proper administration of pilocarpine in the treatment of patients with chronic ACG.
文摘Purpose:To analyze the causes of shallow anterior chamber after glaucoma surgery,and explore effective treatments correspondingly. Methods:A total of 183 glaucoma patients. (218 eyes).underwent trabeculectomy,and shallow anterior chambers were observed after surgery.The causes were analyzed and appropriate approaches were employed accordingly. Results:Postoperatively,shallow anterior chamber occurred in 42 eyes. (19.3% ).Among those, 24 eyes. (57.1% ).had excessive filtrations,8 eyes (19.0% )showed delayed anterior chamber formation,5 eyes (11.9% )presented with choroidal detachments ,4 eyes (9.5% )displayed conjunctival flap leak ages,and 1 eye (2.4% )had ciliary block. Most shallow anterior chambers can be effectively improved after appropriate treatment. Conclusion:Shallow anterior chamber can be caused by a variety of reasons, mainly by excessive filtration. We should actively take reasonable measures to improve the symptom and try to avoid its occurrence.
