AIM: To investigate the outcomes of off label singlepiece acrylic intraocular lenses(SPA-IOL) ciliary sulcus placement compared to three-piece IOL(3P-IOL). METHODS: The charts of eight consecutive eyes of patients who...AIM: To investigate the outcomes of off label singlepiece acrylic intraocular lenses(SPA-IOL) ciliary sulcus placement compared to three-piece IOL(3P-IOL). METHODS: The charts of eight consecutive eyes of patients who received sulcus-placed SPA-IOLs between 2006 and 2009 were reviewed. None of the patients underwent IOL exchange. Charts of six age-matched patients who received sulcus placed 3P-IOLs were reviewed as a control group. RESULTS: Mean follow up was 16 mo for SPA-IOL and 23 mo for 3P-IOL. Five of 8 patients in the SPA-IOL group required chronic use of IOP lowering medications at final follow up. Of these, one patient needed glaucoma implant surgery for uncontrolled IOP. One patient in the 3P-IOL group used chronic aqueous suppression pre- and postoperatively. Four of eight eyes with SPAIOL were treated with chronic topical steroids and or non-steroidal anti-inflammatory drugs for cystoid macu-la edema, chronic uveitis, pigment dispersion syndrome or a combination of the above, compared to none in the control group. Mean best-corrected visual acuity was 20/35 in the SPA-IOL group and 20/47 in the 3PIOL group.CONCLUSION: Sulcus placed SPA-IOLs are associated with increased ocular morbidity. In select cases good visual acuity may be achieved. Due to postoperative rotation of sulcus placed toric SPA-IOLs stable astigmatism correction cannot be achieved. Alternative intraocular lenses should be considered when in-the-bag placement of SPA-IOL is not possible.展开更多
Purpose. To study the interleukin 1 (IL-1)levels in aqueous humor after transscleral fixation of in- traocular lenses (IOLs) implantation in rabbits and discuss the effect of IL-1 on postoperative anterior ocular infl...Purpose. To study the interleukin 1 (IL-1)levels in aqueous humor after transscleral fixation of in- traocular lenses (IOLs) implantation in rabbits and discuss the effect of IL-1 on postoperative anterior ocular inflammation. Methods. Twenty-seven pigmented rabbits were divided into three groups: GI, transscleral fixation of posterior chamber (PC) IOLs implantation; G2, Lens of rabbits were removed without IOLs implanta- tion; G3, the control group, without surgical intervention. On the 1st, 3rd, 7th and 14th postoperative days, aqueous humor samples were obtained. Methyl thiazolyl tetrazolium (MTT) colormetry was used to detected for the presence of IL-1. The data were analyzed by using analysis of variance of SAS soft ware. Results’ It was found that IL-1 level in aqueous humor was increased after transscleral fixation of I- OLs implantation, IL-1 level reached its maximum on the 14th postoperative days in the IOL implanted group. IL-1 levels on 1st, 3rd, 7th and 14th days postoperatively was significantly higher (P<0. 05) in I- OLs implanted group than that of only extracapsular lenses extraction but no IOLs implantation group and that of the none surgical intervention group. COnclusions.IL-1 levels increased had a close relationship with a specific response to IOL implanta- tion. The increase of IL-1 may be suggested as the principal mediators of immunological and inflammatory responses, so that may play critical role in anterior ocular inflammative response after IOL implantation.展开更多
Objective:To explore the corrective effect of posterior chamber intraocular lens implantation with phakic eyes in the treatment of high myopia and astigmatism.Methods:From May 2023,the hospital began to collect the ca...Objective:To explore the corrective effect of posterior chamber intraocular lens implantation with phakic eyes in the treatment of high myopia and astigmatism.Methods:From May 2023,the hospital began to collect the case data of diagnosis and treatment of high myopia and astigmatism.By May 2024,310 cases were included,all of which were treated with posterior chamber intraocular lens implantation.The visual acuity,astigmatism and axial position of the intraocular lens were observed before and after treatment.Results:At different time points after the operation,the patient’s vision was significantly improved compared with that before the operation(P<0.05),and the vision level was equal to or greater than the best-corrected vision before the operation.At different time points after the operation,the average rotation of the intraocular lens was less than 5 degrees.Astigmatism was significantly lower than that before the operation(P<0.05).After the operation,the intraocular pressure increased in 11 cases,accounting for 3.55%,with no adverse complications such as lens turbidity,glare and obvious halo occurring.Conclusion:The posterior chamber intraocular lens implantation with phakic eyes has an ideal correction effect in the treatment of high myopia and astigmatism,which can effectively improve the vision level of patients and reduce the degree of astigmatism,and has high effectiveness and safety.展开更多
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 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
AIM：To introduce a novel approach in removal of anterior chamber angle foreign body（ACFB） using a prism contact lens and 23-gauge foreign body forceps.METHODS：Data of 42 eyes of 42 patients who had undergone remov...AIM：To introduce a novel approach in removal of anterior chamber angle foreign body（ACFB） using a prism contact lens and 23-gauge foreign body forceps.METHODS：Data of 42 eyes of 42 patients who had undergone removal of ACFB using a prism contact lens and 23-gauge foreign body forceps from January 2008 to October 2013 were collected and analyzed. Twenty eyes in group A received the conventional approach by using toothed forceps through corneal limbus incision, and 22 eyes in group B underwent the novel method through the opposite corneal limbus incision. RESULTS：The success rate of ACFB once removal was 75%（15/20） in group A, and 100%（22/22） in group B. The average operation time of group A was significantly longer compared with group B（34.9±9.88 min vs 22.13±8.85min; P〈0.05）. The average size of corneal limbus incision in group A was significantly larger than that of group B（4.85±1.89 mm vs 3.95±1.17 mm; P〈0.05）. The corneal limbus incision suturing were conducted in all eyes in group A, and only 5 eyes in group B. CONCLUSION：Removal of ACFB using a prism contact lens and 23-gauge foreign body forceps is a safer, more effective, and convenient technique compared with the conventional approach.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
Cases 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...Cases 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 dislocated internal material of the lens, the remnant lens capsular bag status, lens and zonular status of the contralateral eve.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
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
Intraocular metastases are the most common malignancies of the eye. Carcinoma of the breast is the most common malignancy to metastasize to the uvea usually posterior uvea. Anterior chamber metastasis is extremely rar...Intraocular metastases are the most common malignancies of the eye. Carcinoma of the breast is the most common malignancy to metastasize to the uvea usually posterior uvea. Anterior chamber metastasis is extremely rare. We describe a patient of breast cancer who presented with pain and impaired vision in tight eye 8.5 months after metastasis to bone and other viscera were detected and more than 10 years after her primary disease was diagnosed. Multiple yellowish white deposits were noted scattered in anterior chamber giving rise to symptoms of acute narrow angle glaucoma. Metastatic deposits of duct cell carcinoma cells were found by fine needle aspiration cytology. Patient received local external beam radiotherapy to right eye with moderate improvement in her symptoms. The rare features in this case were clinical presentation of acute glaucoma and anterior chamber as the site of metastasis.展开更多
Extracapsular cataract extraction was performed combined with posterior chamber intraocular lens implantation on 120 inpatients (122 eyes) with traumatic cataract from 1992 to 1997. The results revealed that this comb...Extracapsular cataract extraction was performed combined with posterior chamber intraocular lens implantation on 120 inpatients (122 eyes) with traumatic cataract from 1992 to 1997. The results revealed that this combined operation can make most of them get useful visual acuity, although they were often accompanied with several comlicated eye injuries. We think the most important thing is to choose suitable opertion time, the reasonable operation method and take close followup after operation.展开更多
This narrative review aimed to have an algorithmic approach to microphthalmos by a systematic search.The definition can be related to a number of special phenotypes.In the more challenging cases of complex microphthal...This narrative review aimed to have an algorithmic approach to microphthalmos by a systematic search.The definition can be related to a number of special phenotypes.In the more challenging cases of complex microphthalmos,relative anterior microphthalmos,and nanophthalmos,the surgeon can approach these cases more safely if they have a deep understanding of the anatomical variations and ideal formulae for intraocular lens computation and knows how to avoid intra-and post-operative complications.In this article,we review the criteria by which we recognize and describe pre-,intra-,and post-operative considerations,as well as discuss the ideal intraocular lenses for microphthalmos,given the intricate varieties of small eye phenotypes.展开更多
AIM:To report a one-year clinical outcomes of low-dose laser cycloplasty(LCP)among malignant glaucoma patients.METHODS:In this prospective,multicenter,noncomparative clinical study,participants with malignant glaucoma...AIM:To report a one-year clinical outcomes of low-dose laser cycloplasty(LCP)among malignant glaucoma patients.METHODS:In this prospective,multicenter,noncomparative clinical study,participants with malignant glaucoma were recruited and underwent LCP at eight ophthalmic centers in China.Patients were followed up at 1wk,1,3,6,and 12mo.Intraocular pressure(IOP),number of glaucoma medications,anterior chamber depth(ACD),and complications were recorded.Anatomical success was defined as the reformation of the anterior chamber based on slit-lamp biomicroscopy.Recurrence was defined by the presence of a shallow orflat anterior chamber after initial recovery from treatment.RESULTS:A total of 34 eyes received LCP.Mean IOP and medications decreased from 36.1±11.5 mm Hg with 3.3±1.5 glaucoma medications pre-treatment to 20.9±9.8 mm Hg(P<0.001)with 2.9±1.6 medications(P=0.046)at 1d,and 17.4±6.7 mm Hg(P<0.001)with 1.3±1.7 medications(P<0.001)at 12mo.The ACD increased from 1.1±0.8 mm at baseline to 1.7±1.0 mm and to 2.0±0.5 mm at 1d and 12mo,respectively.A total of 32(94.1%)eyes achieved initial anatomical success.During follow-up,2(5.9%)eyes failed and 8(23.5%)eyes relapsed,yielding a 12-month anatomical success rate of 64.3%.Complications including anterior synechia(8.82%),choroidal/ciliary detachment(5.88%)and hypopyon(2.94%)were observed within 1wk.CONCLUSION:LCP is simple,safe,and effective in reforming the anterior chamber in malignant glaucoma.展开更多
AIM：To compare the agreement of anterior chamber depth（ACD）and central vault measurements obtained by anterior segment optical coherence tomography（AS-OCT）and ultrasound biomicroscopy（UBM）of post surgical high ...AIM：To compare the agreement of anterior chamber depth（ACD）and central vault measurements obtained by anterior segment optical coherence tomography（AS-OCT）and ultrasound biomicroscopy（UBM）of post surgical high myopic eyes with posterior chamber phakic intraocular lens（Visian ICL;STAAR Surgical）implantation.·METHODS：Fifty-two phakic eyes of 28 high myopic patients who underwent implantable Collamer lens（ICL）surgery for the correction of high myopia were studied.The postoperative ACD,the distance between the corneal endothelium and the anterior surface of ICL（cornea-ICL）and the central vault were measured with the AS-OCT system and the UBM system.Intraclass correlation coefficient（ICC）and the Bland-Altman plot were used to evaluate the repeatability and agreement of two devices.·R ESULTS：The mean ACD,cornea-ICL and central vault in the 52 phakic eyes after ICL surgery was 3.19±0.28 mm,2.47±0.28 mm,0.50±0.19 mm by AS-OCT and3.13±0.25 mm,2.49±0.25 mm,0.44±0.19 mm by UBM,respectively.Pairwise comparison of ACD and central vault measurements showed significant differences between AS-OCT and UBM（〈0.05）.However,no statistically significant difference was found between these imaging techniques in cornea-ICL（〉0.05）.The Pearson correlation coefficient（）between AS-OCT and UBM measurements for ACD,cornea-ICL and vault was0.88,0.80 and 0.89,respectively（〈0.001）.The ICC was0.89-0.94 for the measurements of AS-OCT and UBM.Bland-Altman analysis showed the 95%limits of agreement of ACD,cornea-ICL,central vault measurements between these two devices were-0.20 to 0.32 mm,-0.36to 0.32 mm and-0.12 to 0.24 mm,respectively.58·CONCLUSION：Central ACD and vault measurements using AS-OCT demonstrated a slight significantly higher value than using UBM in phakic eyes after ICL surgery.These two devices should not be used interchangeably for measurements of central ACD and vault in patients after phakic intraocular lens implantation.展开更多
AIM:To predict postoperative intraocular lens(IOL)position using the Sirius anterior segment analysis system and investigate the effect of lens position and IOL type on postoperative refraction.METHODS:A total of 97 p...AIM:To predict postoperative intraocular lens(IOL)position using the Sirius anterior segment analysis system and investigate the effect of lens position and IOL type on postoperative refraction.METHODS:A total of 97 patients(102 eyes)were enrolled in the final analysis.An anterior segment biometry measurement was performed preoperatively with Sirius and Lenstar.The results of predicted lens position(PLP)and IOL power were automatically calculated by the software used by the instruments.Effective lens position(ELP)was measured manually using Sirius 3 mo postoperatively.Pearson's correlation analysis and linear regression analysis were used to determine the correlation of lens position to other parameters.RESULTS:PLP and ELP were positively correlated to axial length(AL;r=0.42,P<0.0001 and r=0.49,P<0.0001,respectively).There was a weak correlation between the peLP(ELP-PLP)and the prediction error of spherical refraction(peSR;r=0.34,P<0.0001).The peLP of Softec HD IOL differed statistically from those of both the TECNIS ZCB00 and Sensor AR40E IOLs.Multiple linear regression was used to obtain the prediction formula:ELP=0.66+0.63×[aqueous depth(AQD)+0.6 LT](r=0.61,P<0.0001),and a new variable(AQD+0.6 LT)was found to have the strongest correlation with ELP.CONCLUSION:The Sirius anterior segment analysis system is helpful to predict ELP,which reduces postoperative refraction error.展开更多
基金Supported by NIH Center Core,No.P30EY014801Research to Prevent Blindness Unrestricted Grant,Department of Defense,No.DOD-Grant#W81XWH-09-1-0675
文摘AIM: To investigate the outcomes of off label singlepiece acrylic intraocular lenses(SPA-IOL) ciliary sulcus placement compared to three-piece IOL(3P-IOL). METHODS: The charts of eight consecutive eyes of patients who received sulcus-placed SPA-IOLs between 2006 and 2009 were reviewed. None of the patients underwent IOL exchange. Charts of six age-matched patients who received sulcus placed 3P-IOLs were reviewed as a control group. RESULTS: Mean follow up was 16 mo for SPA-IOL and 23 mo for 3P-IOL. Five of 8 patients in the SPA-IOL group required chronic use of IOP lowering medications at final follow up. Of these, one patient needed glaucoma implant surgery for uncontrolled IOP. One patient in the 3P-IOL group used chronic aqueous suppression pre- and postoperatively. Four of eight eyes with SPAIOL were treated with chronic topical steroids and or non-steroidal anti-inflammatory drugs for cystoid macu-la edema, chronic uveitis, pigment dispersion syndrome or a combination of the above, compared to none in the control group. Mean best-corrected visual acuity was 20/35 in the SPA-IOL group and 20/47 in the 3PIOL group.CONCLUSION: Sulcus placed SPA-IOLs are associated with increased ocular morbidity. In select cases good visual acuity may be achieved. Due to postoperative rotation of sulcus placed toric SPA-IOLs stable astigmatism correction cannot be achieved. Alternative intraocular lenses should be considered when in-the-bag placement of SPA-IOL is not possible.
文摘Purpose. To study the interleukin 1 (IL-1)levels in aqueous humor after transscleral fixation of in- traocular lenses (IOLs) implantation in rabbits and discuss the effect of IL-1 on postoperative anterior ocular inflammation. Methods. Twenty-seven pigmented rabbits were divided into three groups: GI, transscleral fixation of posterior chamber (PC) IOLs implantation; G2, Lens of rabbits were removed without IOLs implanta- tion; G3, the control group, without surgical intervention. On the 1st, 3rd, 7th and 14th postoperative days, aqueous humor samples were obtained. Methyl thiazolyl tetrazolium (MTT) colormetry was used to detected for the presence of IL-1. The data were analyzed by using analysis of variance of SAS soft ware. Results’ It was found that IL-1 level in aqueous humor was increased after transscleral fixation of I- OLs implantation, IL-1 level reached its maximum on the 14th postoperative days in the IOL implanted group. IL-1 levels on 1st, 3rd, 7th and 14th days postoperatively was significantly higher (P<0. 05) in I- OLs implanted group than that of only extracapsular lenses extraction but no IOLs implantation group and that of the none surgical intervention group. COnclusions.IL-1 levels increased had a close relationship with a specific response to IOL implanta- tion. The increase of IL-1 may be suggested as the principal mediators of immunological and inflammatory responses, so that may play critical role in anterior ocular inflammative response after IOL implantation.
文摘Objective:To explore the corrective effect of posterior chamber intraocular lens implantation with phakic eyes in the treatment of high myopia and astigmatism.Methods:From May 2023,the hospital began to collect the case data of diagnosis and treatment of high myopia and astigmatism.By May 2024,310 cases were included,all of which were treated with posterior chamber intraocular lens implantation.The visual acuity,astigmatism and axial position of the intraocular lens were observed before and after treatment.Results:At different time points after the operation,the patient’s vision was significantly improved compared with that before the operation(P<0.05),and the vision level was equal to or greater than the best-corrected vision before the operation.At different time points after the operation,the average rotation of the intraocular lens was less than 5 degrees.Astigmatism was significantly lower than that before the operation(P<0.05).After the operation,the intraocular pressure increased in 11 cases,accounting for 3.55%,with no adverse complications such as lens turbidity,glare and obvious halo occurring.Conclusion:The posterior chamber intraocular lens implantation with phakic eyes has an ideal correction effect in the treatment of high myopia and astigmatism,which can effectively improve the vision level of patients and reduce the degree of astigmatism,and has high effectiveness and safety.
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 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AIM：To introduce a novel approach in removal of anterior chamber angle foreign body（ACFB） using a prism contact lens and 23-gauge foreign body forceps.METHODS：Data of 42 eyes of 42 patients who had undergone removal of ACFB using a prism contact lens and 23-gauge foreign body forceps from January 2008 to October 2013 were collected and analyzed. Twenty eyes in group A received the conventional approach by using toothed forceps through corneal limbus incision, and 22 eyes in group B underwent the novel method through the opposite corneal limbus incision. RESULTS：The success rate of ACFB once removal was 75%（15/20） in group A, and 100%（22/22） in group B. The average operation time of group A was significantly longer compared with group B（34.9±9.88 min vs 22.13±8.85min; P〈0.05）. The average size of corneal limbus incision in group A was significantly larger than that of group B（4.85±1.89 mm vs 3.95±1.17 mm; P〈0.05）. The corneal limbus incision suturing were conducted in all eyes in group A, and only 5 eyes in group B. CONCLUSION：Removal of ACFB using a prism contact lens and 23-gauge foreign body forceps is a safer, more effective, and convenient technique compared with the conventional approach.
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Cases 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 dislocated internal material of the lens, the remnant lens capsular bag status, lens and zonular status of the contralateral eve.
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Intraocular metastases are the most common malignancies of the eye. Carcinoma of the breast is the most common malignancy to metastasize to the uvea usually posterior uvea. Anterior chamber metastasis is extremely rare. We describe a patient of breast cancer who presented with pain and impaired vision in tight eye 8.5 months after metastasis to bone and other viscera were detected and more than 10 years after her primary disease was diagnosed. Multiple yellowish white deposits were noted scattered in anterior chamber giving rise to symptoms of acute narrow angle glaucoma. Metastatic deposits of duct cell carcinoma cells were found by fine needle aspiration cytology. Patient received local external beam radiotherapy to right eye with moderate improvement in her symptoms. The rare features in this case were clinical presentation of acute glaucoma and anterior chamber as the site of metastasis.
文摘Extracapsular cataract extraction was performed combined with posterior chamber intraocular lens implantation on 120 inpatients (122 eyes) with traumatic cataract from 1992 to 1997. The results revealed that this combined operation can make most of them get useful visual acuity, although they were often accompanied with several comlicated eye injuries. We think the most important thing is to choose suitable opertion time, the reasonable operation method and take close followup after operation.
文摘This narrative review aimed to have an algorithmic approach to microphthalmos by a systematic search.The definition can be related to a number of special phenotypes.In the more challenging cases of complex microphthalmos,relative anterior microphthalmos,and nanophthalmos,the surgeon can approach these cases more safely if they have a deep understanding of the anatomical variations and ideal formulae for intraocular lens computation and knows how to avoid intra-and post-operative complications.In this article,we review the criteria by which we recognize and describe pre-,intra-,and post-operative considerations,as well as discuss the ideal intraocular lenses for microphthalmos,given the intricate varieties of small eye phenotypes.
基金Supported by the Program for Zhejiang Leading Talent of S&T Innovation(No.2021R52012)Development Projects of Zhejiang Province(No.2022C03112)Innovation Team Program of Wenzhou.
文摘AIM:To report a one-year clinical outcomes of low-dose laser cycloplasty(LCP)among malignant glaucoma patients.METHODS:In this prospective,multicenter,noncomparative clinical study,participants with malignant glaucoma were recruited and underwent LCP at eight ophthalmic centers in China.Patients were followed up at 1wk,1,3,6,and 12mo.Intraocular pressure(IOP),number of glaucoma medications,anterior chamber depth(ACD),and complications were recorded.Anatomical success was defined as the reformation of the anterior chamber based on slit-lamp biomicroscopy.Recurrence was defined by the presence of a shallow orflat anterior chamber after initial recovery from treatment.RESULTS:A total of 34 eyes received LCP.Mean IOP and medications decreased from 36.1±11.5 mm Hg with 3.3±1.5 glaucoma medications pre-treatment to 20.9±9.8 mm Hg(P<0.001)with 2.9±1.6 medications(P=0.046)at 1d,and 17.4±6.7 mm Hg(P<0.001)with 1.3±1.7 medications(P<0.001)at 12mo.The ACD increased from 1.1±0.8 mm at baseline to 1.7±1.0 mm and to 2.0±0.5 mm at 1d and 12mo,respectively.A total of 32(94.1%)eyes achieved initial anatomical success.During follow-up,2(5.9%)eyes failed and 8(23.5%)eyes relapsed,yielding a 12-month anatomical success rate of 64.3%.Complications including anterior synechia(8.82%),choroidal/ciliary detachment(5.88%)and hypopyon(2.94%)were observed within 1wk.CONCLUSION:LCP is simple,safe,and effective in reforming the anterior chamber in malignant glaucoma.
文摘AIM：To compare the agreement of anterior chamber depth（ACD）and central vault measurements obtained by anterior segment optical coherence tomography（AS-OCT）and ultrasound biomicroscopy（UBM）of post surgical high myopic eyes with posterior chamber phakic intraocular lens（Visian ICL;STAAR Surgical）implantation.·METHODS：Fifty-two phakic eyes of 28 high myopic patients who underwent implantable Collamer lens（ICL）surgery for the correction of high myopia were studied.The postoperative ACD,the distance between the corneal endothelium and the anterior surface of ICL（cornea-ICL）and the central vault were measured with the AS-OCT system and the UBM system.Intraclass correlation coefficient（ICC）and the Bland-Altman plot were used to evaluate the repeatability and agreement of two devices.·R ESULTS：The mean ACD,cornea-ICL and central vault in the 52 phakic eyes after ICL surgery was 3.19±0.28 mm,2.47±0.28 mm,0.50±0.19 mm by AS-OCT and3.13±0.25 mm,2.49±0.25 mm,0.44±0.19 mm by UBM,respectively.Pairwise comparison of ACD and central vault measurements showed significant differences between AS-OCT and UBM（〈0.05）.However,no statistically significant difference was found between these imaging techniques in cornea-ICL（〉0.05）.The Pearson correlation coefficient（）between AS-OCT and UBM measurements for ACD,cornea-ICL and vault was0.88,0.80 and 0.89,respectively（〈0.001）.The ICC was0.89-0.94 for the measurements of AS-OCT and UBM.Bland-Altman analysis showed the 95%limits of agreement of ACD,cornea-ICL,central vault measurements between these two devices were-0.20 to 0.32 mm,-0.36to 0.32 mm and-0.12 to 0.24 mm,respectively.58·CONCLUSION：Central ACD and vault measurements using AS-OCT demonstrated a slight significantly higher value than using UBM in phakic eyes after ICL surgery.These two devices should not be used interchangeably for measurements of central ACD and vault in patients after phakic intraocular lens implantation.
基金Supported by Jiangsu Provincial Medical Innovation Team(No.CXTDA2017039)the Soochow Scholar Project of Soochow University(No.R5122001)。
文摘AIM:To predict postoperative intraocular lens(IOL)position using the Sirius anterior segment analysis system and investigate the effect of lens position and IOL type on postoperative refraction.METHODS:A total of 97 patients(102 eyes)were enrolled in the final analysis.An anterior segment biometry measurement was performed preoperatively with Sirius and Lenstar.The results of predicted lens position(PLP)and IOL power were automatically calculated by the software used by the instruments.Effective lens position(ELP)was measured manually using Sirius 3 mo postoperatively.Pearson's correlation analysis and linear regression analysis were used to determine the correlation of lens position to other parameters.RESULTS:PLP and ELP were positively correlated to axial length(AL;r=0.42,P<0.0001 and r=0.49,P<0.0001,respectively).There was a weak correlation between the peLP(ELP-PLP)and the prediction error of spherical refraction(peSR;r=0.34,P<0.0001).The peLP of Softec HD IOL differed statistically from those of both the TECNIS ZCB00 and Sensor AR40E IOLs.Multiple linear regression was used to obtain the prediction formula:ELP=0.66+0.63×[aqueous depth(AQD)+0.6 LT](r=0.61,P<0.0001),and a new variable(AQD+0.6 LT)was found to have the strongest correlation with ELP.CONCLUSION:The Sirius anterior segment analysis system is helpful to predict ELP,which reduces postoperative refraction error.
