astigmatism

散光
  • 文章类型: Case Reports
    胶体囊肿是一种可引起头痛的罕见脑肿瘤,记忆问题,和愿景问题。早期诊断和治疗对预防并发症至关重要。
    作者报告了一例20多岁的患者,有2年头痛和视力模糊的病史。计算机断层扫描(CT)扫描显示第三脑室有胶体囊肿。患者被诊断为散光,并使用矫正镜片和定期CT扫描进行治疗。
    患者的散光可能与胶体囊肿有关,可能是由于囊肿位置引发的偏头痛。需要进一步的研究来理解这种关系。
    此案例突出了胶体囊肿可能导致视力问题。仔细评估和个性化管理对于胶体囊肿和视力障碍的患者至关重要。
    UNASSIGNED: Colloid cysts are rare brain tumors that can cause headaches, memory problems, and vision issues. Early diagnosis and treatment are crucial to prevent complications.
    UNASSIGNED: The authors report a case of a patient in their 20s with a 2-year history of headaches and blurry vision. A computed tomography (CT) scan revealed a colloid cyst in the third ventricle. The patient was diagnosed with astigmatism and managed with corrective lenses and regular CT scans.
    UNASSIGNED: The patient\'s astigmatism may be linked to the colloid cyst, potentially due to migraines triggered by the cyst\'s location. Further research is needed to understand this relationship.
    UNASSIGNED: This case highlights the potential for colloid cysts to contribute to vision problems. Careful evaluation and individualized management are essential for patients with colloid cysts and vision disturbances.
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  • 文章类型: Case Reports
    背景:有报道对后部多形性角膜营养不良(PPCD)的眼睛进行安全的白内障手术;然而,根据我们的知识,在患有PPCD的眼中没有微创青光眼手术(MIGS)的报道。在这里,我们报告一例术中能见度差的房角镜检查,术后角膜水肿,小梁微旁路支架联合白内障手术治疗PPCD的角膜散光。
    一名78岁的男子因MIGS被转诊到我们医院。患者出现双侧角膜内皮囊泡改变和带状病变。内皮细胞密度为2983/2871细胞/mm2(右/左眼),中央角膜厚度为581μm/572μm,最佳矫正视力值(相当于Snellen)为20/32(右)和20/100(左),右眼角膜散光为-2.7D,左眼为-2.5D。
    白内障超声乳化术和人工晶状体植入术后,双眼角膜切口为2.4毫米,尽管房角镜检查术中可见性差,但小梁微旁路支架仍成功插入。手术后一周,中央角膜厚度为614μm/609μm,观察到Descemet膜褶皱和轻度角膜水肿。右眼的最佳校正十进制视敏度为20/40,左眼为20/50。在左眼,总角膜散光从-2.5D增加到-5.5D角膜散光和水肿逐渐改善。
    结论:虽然有报告显示白内障手术可以安全地在PPCD患者眼中进行,患有PPCD的眼睛中的MIGS可能需要注意术中可见性以及术后早期的前角镜检查和视觉功能。
    BACKGROUND: There are reports of safe cataract surgery in eyes with posterior polymorphous corneal dystrophy (PPCD); however, to our knowledge, there are no reports of minimally invasive glaucoma surgery (MIGS) in eyes with PPCD. Herein, we report a case of poor intraoperative visibility with gonioscopy, postoperative corneal edema, and corneal astigmatism in eyes with PPCD treated with trabecular micro-bypass stent combined with cataract surgery.
    UNASSIGNED: A 78-year-old man was referred to our hospital for MIGS. He presented with bilateral corneal endothelial vesicular changes and band lesions. Endothelial cell density was 2983/2871 cells/mm2 (right/left eye), central corneal thickness was 581 μm/572 μm, best-corrected visual acuity values (Snellen equivalent) were 20/32 (right) and 20/100 (left), and corneal astigmatism was -2.7D in the right eye and -2.5D in the left eye.
    UNASSIGNED: After phacoemulsification and aspiration with intraocular lens implantation with a 2.4-mm corneal incision in both eyes, trabecular micro-bypass stents were inserted successfully despite the poor intraoperative visibility with gonioscopy. One week after surgery, the central corneal thickness was 614 μm/609 μm, and Descemet\'s membrane folds and mild corneal edema were observed. Best-corrected decimal visual acuity was 20/40 for the right eye and 20/50 for the left eye. In the left eye, total corneal astigmatism increased from -2.5D to -5.5D. Corneal astigmatism and edema showed gradual improvement.
    CONCLUSIONS: Although reports have shown that cataract surgery can be safely performed in eyes with PPCD, MIGS in eyes with PPCD may require caution regarding intraoperative visibility with gonioscopy and visual function in the early postoperative period.
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  • 文章类型: Case Reports
    有或没有人工晶状体的人工虹膜植入的不同技术,根据镜头状态,在文献中描述。我们描述了一种定制的人工虹膜和复曲面人工晶状体巩膜内凸缘固定的手术技术。我们修改了“背包”人工虹膜植入手术技术,以促进无晶状体眼患者的复曲面人工晶状体的准确对准,无虹膜,和高度不对称散光继发于钝性创伤。手术后两个月,未矫正视力为20/30,屈光度球内屈光度-2.00矫正至20/25,无残余散光。人工虹膜植入物和复曲面人工晶状体居中。患者对视觉和美容结果感到满意。这个程序,然而,并非无并发症,因为我们的患者在术后期间出现葡萄膜炎和眼压升高,治疗成功。
    Different techniques for artificial iris implantation with or without an intraocular lens, depending on lens status, are described in the literature. We describe a surgical technique for a custom-made artificial iris and toric-intraocular lens intrascleral flange fixation. We modified the \"Backpack\" artificial iris implantation surgical technique to facilitate an accurate alignment of the toric-intraocular lens in a patient with aphakia, aniridia, and high asymmetric astigmatism secondary to blunt trauma. Two months after the surgery, uncorrected visual acuity was 20/30, corrected to 20/25 with a refraction of -2.00 in the diopter sphere with no residual astigmatism. The artificial iris implant and toric-intraocular lens were well-centered. The patient was satisfied with the visual and cosmetic outcomes. This procedure, however, is not complication-free as our patient developed uveitis and increased intraocular pressure during the postoperative period, which was treated successfully.
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  • 文章类型: Journal Article
    放射状角膜切开术(RK)通常在1980年代和1990年代进行。我们旨在阐明RK后屈光矫正和治疗的现状。我们回顾性回顾了70例有RK病史的患者的图表。70名患者中,44例被确定为临床结果。屈光或治疗性干预(刚性透气性隐形眼镜贴合,眼镜处方,角膜手术,RK术后视力恶化的59%的患者可能使用盐酸毛果芸香碱治疗畏光);其余41%的患者,治疗干预是不可能的。适合角膜不规则散光的刚性透气性隐形眼镜是最常见的屈光干预措施,在大学医院中有36%的病例有效。
    UNASSIGNED: Radial keratotomy (RK) was commonly performed in the 1980s and 1990s. We aimed to clarify the current status of post-RK refractive correction and treatment. We retrospectively reviewed the charts of 70 patients with a history of RK. Of the 70 patients, 44 were identified for clinical outcomes. Refractive or therapeutic intervention (rigid gas-permeable contact lens fit, spectacle prescription, corneal surgery, and use of pilocarpine hydrochloride for photophobia) was possible in 59% of patients with postoperative visual deterioration after RK; in the remaining 41%, therapeutic intervention was not possible. Rigid gas-permeable contact lens fit for corneal irregular astigmatism was the most common refractive intervention and was effective in 36% of cases in the university hospital.
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  • 文章类型: Journal Article
    使用新型飞秒激光系统评估SmartSight透镜提取近视散光的结果的中度至高度散光矫正。
    在6个月的随访中评估了连续治疗散光幅度大于1.00屈光度(D)的近视散光的92只眼。患者的平均年龄为29±6岁,平均球面当量为-5.06±2.20屈光度(D),屈光散光的平均幅度为1.74±0.61D。
    在6个月时,散光为0.10±0.20D。未矫正视力和矫正视力(UDVA和CDVA,分别)均为0.0±0.1logMAR。术后UDVA与术前CDVA之间的差异以及CDVA的变化均比术前好0.4±0.7线(P<.0003)。
    使用Smart-Sight的微透镜提取治疗在6个月时是安全有效的。研究结果表明,在治疗近视散光时,SmartSight透镜摘除后,中度至高度散光得到改善。[JRefractSurg.2024;40(5):e328-e335。].
    UNASSIGNED: To evaluate moderate to high astigmatism corrections on the outcomes of SmartSight lenticule extraction for myopic astigmatism with a new femtosecond laser system.
    UNASSIGNED: Two hundred ninety-two eyes consecutively treated for myopic astigmatism with astigmatism magnitude greater than 1.00 diopter (D) were evaluated at the 6-month follow-up visit. The mean age of the patients was 29 ± 6 years with a mean spherical equivalent of -5.06 ± 2.20 diopters (D) and a mean magnitude of refractive astigmatism of 1.74 ± 0.61 D.
    UNASSIGNED: At 6 months, astigmatism was 0.10 ± 0.20 D. Uncorrected and corrected distance visual acuities (UDVA and CDVA, respectively) were both 0.0 ± 0.1 logMAR. Differences between postoperative UDVA and preoperative CDVA and the change in CDVA were both +0.4 ± 0.7 lines better than preoperatively (P < .0003).
    UNASSIGNED: Lenticule extraction treatment using Smart-Sight is safe and efficacious at 6 months. Findings suggest that moderate to high astigmatism improves after SmartSight lenticule extraction in the treatment of myopic astigmatism. [J Refract Surg. 2024;40(5):e328-e335.].
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  • 文章类型: Case Reports
    Lamb-Shaffer综合征(LSS)是一种罕见的神经发育障碍,在全世界不到100个人中进行基因诊断。我们介绍了6例LSS儿科患者的病例系列,并描述了其眼科表现。5例患者出现斜视,外斜视是最常见的。所有受试者均有明显的屈光不正;5例散光至少为2D。所有患者均有视神经异常,包括苍白(4),发育不全(2),和异常外观(1),在单个受试者中表现出视网膜神经纤维层变薄。检测到的其他眼科疾病是上睑下垂(1),鼻泪管阻塞(1),和眼球震颤(2)。
    Lamb-Shaffer syndrome (LSS) is a rare neurodevelopmental disorder, genetically diagnosed in fewer than 100 individuals worldwide. We present a case series of 6 pediatric patients with LSS and describe its ophthalmic manifestations. Strabismus was present in 5 patients, with exotropia being most common. All subjects had significant refractive errors; 5 had astigmatism of at least 2 D. All patients had optic nerve abnormalities, including pallor (4), hypoplasia (2), and anomalous appearance (1), with retinal nerve fiber layer thinning demonstrated in a single subject. Other ophthalmic disorders detected were ptosis (1), nasolacrimal duct obstruction (1), and nystagmus (2).
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  • 文章类型: Case Reports
    我们报告了1例晚期透明样边缘性变性(PMD)病例的序贯治疗方法。根据患者的角膜地形图和角膜散光程度定制管理。在PMD的情况下,全层角膜移植具有延长的康复期和移植物失败的风险。该病例包括板层楔形切除术,然后进行波前引导的跨上皮屈光性角膜切削术(wTPRK)结合加速角膜交联(aCXL),以准备人工晶状体白内障摘除。
    一位患有高级PMD的68岁绅士接受了右眼超声乳化与复曲面人工晶状体(T-IOL)和板层楔形切除术,随后wTPRK联合aCXL用于对侧眼。左眼接受了顺序方法来调整角膜,将高阶像差(HoA)和角膜散光程度降至最低。实现了有效的视觉康复,并显着改善了视觉。
    尽管高级PMD在视觉康复方面的选择可能有限,在这种情况下,可以考虑采用顺序逐步的方法,允许更好的质量与更少的侵入性的选择。
    UNASSIGNED: We report a sequential approach in the management of a case with advanced pellucid marginal degeneration (PMD). The management was tailored based on the patient\'s corneal topography and degree of corneal astigmatism. Full thickness corneal transplants in cases of PMD carry a prolonged rehabilitation period and the risk of graft failure.This case consisted of lamellar wedge resection followed by wavefront guided transepithelial photorefractive keratectomy (wTPRK) combined with accelerated corneal crosslinking (aCXL) in preparation for a cataract extraction with intraocular lens.
    UNASSIGNED: A 68-year-old gentleman with advanced PMD underwent phacoemulsification with toric intraocular lens (T-IOL) for the right eye and a lamellar wedge resection, followed by wTPRK combined with aCXL for the contralateral eye. The left eye underwent a sequential approach to regularize the cornea, minimize the higher order aberrations (HoA) and degree of corneal astigmatism. Effective visual rehabilitation was achieved with significant visual improvement.
    UNASSIGNED: Although advanced PMD may have limited options for visual rehabilitation, a sequential stepwise approach may be considered in such cases, permitting a better quality with less invasive options.
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  • 文章类型: Journal Article
    目的:本研究的目的是描述特拉维夫方案(上皮性屈光性角膜切削术和角膜交联术)作为手术后角膜扩张症治疗的安全性和有效性。
    方法:本研究包括7名患者的8只眼,每个患者在屈光手术后数年被诊断为手术后扩张症,并接受特拉维夫方案治疗。该程序包括使用EX500准分子激光的跨上皮PRK,上皮和前基质的50μm激光消融,在视觉轴上进行旋转校正,治疗高达50%的屈光散光。上皮性屈光性角膜切除术后,所有患者均接受角膜交联.
    结果:平均角膜曲率(K)和最大K均下降[从43.37±2.23降至41.84±2.01(P=0.03),从44.95±3.08降至42.78±2.19(P=0.03),分别]。散光显着降低(从3.53±2.36降至0.88±0.89屈光度;P=0.02)。所有患者的未矫正视力均从平均0.56±0.32到0.15±0.14logMAR显着提高(P=0.01)。最佳矫正视力从0.22±0.24提高到0.06±0.06logMAR(P=0.07;1尾P=0.04)。所有患者在随访期间均保持视力,长达25个月,平均值=329天。特拉维夫方案被发现是安全的[平均安全指数:1.63±1.03(范围:1.00-4)]和有效的[平均疗效指数:1.29±0.66(范围:0.71-2.1)]。
    结论:特拉维夫议定书,最初开发用于圆锥角膜治疗,是一种安全且有希望的方法,可以阻止手术后扩张进展,同时显着改善视力,从而避免角膜移植术。
    OBJECTIVE: The aim of this study was to describe the safety and efficacy of the Tel-Aviv Protocol (epithelial photorefractive keratectomy and corneal cross-linking) as a treatment for postrefractive surgery corneal ectasia.
    METHODS: This study includes 8 eyes from 7 patients, each diagnosed with postrefractive surgery ectasia years after refractive surgery and treated with the Tel-Aviv Protocol. The procedure included transepithelial PRK using the EX500 excimer laser, a 50-μm laser ablation of the epithelium and anterior stroma, delivered on the visual axis with cyclotorsion correction, treating up to 50% of refractive astigmatism. After the epithelial photorefractive keratectomy, all patients underwent corneal cross-linking.
    RESULTS: The mean keratometry (K) and maximal K both decreased [from 43.37 ± 2.23 to 41.84 ± 2.01 ( P = 0.03) and from 44.95 ± 3.08 to 42.78 ± 2.19 ( P = 0.03), respectively]. Astigmatism was significantly reduced (from 3.53 ± 2.36 to 0.88 ± 0.89 diopter; P = 0.02). Uncorrected visual acuity improved significantly in all patients from a mean of 0.56 ± 0.32 to 0.15 ± 0.14 logMAR ( P = 0.01). Best-corrected visual acuity improved from 0.22 ± 0.24 to 0.06 ± 0.06 logMAR ( P = 0.07; 1-tail P = 0.04). All patients maintained visual acuity during the follow-up period, up to 25 months, mean = 329 days. The Tel-Aviv Protocol was found to be safe [mean safety index: 1.63 ± 1.03 (range: 1.00-4)] and effective [mean efficacy index: 1.29 ± 0.66 (range: 0.71-2.1)].
    CONCLUSIONS: The Tel-Aviv Protocol, developed initially for keratoconus treatment, is a safe and promising procedure to stop postrefractive surgery ectasia progression while significantly improving vision, thereby avoiding keratoplasty.
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  • 文章类型: Case Reports
    上皮向内生长是一种罕见的疾病,通常在准分子激光原位角膜磨镶术(LASIK)后可见,并且在文献中报道了小切口微透镜摘除(SMILE)手术后的少数病例。SMILE手术后早期视力下降且外观类似于上皮向内生长的患者也应考虑“上皮接种”。一名23岁的妇女向我们的诊所提出了屈光手术的要求。她的明显屈光度右眼为-7.50-1.00x180°,左眼为-7.25-1.00x150°,双眼最佳矫正视力为10/10。用Visumax飞秒激光(CarlZeissMeditecAG)进行SMILE程序。术后1周的裂隙灯检查显示,右眼中央光轴上有一个小的灰白色基质内混浊,类似于上皮向内生长。使用冲洗套管用平衡盐溶液进行界面的冲洗,并去除上皮簇。患者在手术后6个月保持临床稳定,没有复发。当在SMILE手术后早期观察到上皮接种时,立即冲洗界面似乎是一种有效和安全的治疗方法。
    Epithelial ingrowth is a rare condition that is generally seen after laser in situ keratomileusis (LASIK) and has been reported in the literature in a small number of cases after small-incision lenticule extraction (SMILE) surgery. \"Epithelial inoculation\" should also be considered in patients presenting with decreased vision and an appearance similar to epithelial ingrowth in the early period after SMILE surgery. A 23-year-old woman presented to our clinic with a request for refractive surgery. Her manifest refractions were -7.50 -1.00 x 180° in the right eye and -7.25 -1.00 x 150° in the left eye, and best corrected distance visual acuity was 10/10 in both eyes. The SMILE procedure was performed with the Visumax femtosecond laser (Carl Zeiss Meditec AG). Slit-lamp examination at postoperative 1 week revealed a small grayish-white intrastromal opacity resembling epithelial ingrowth in the central optic axis of the right eye. Irrigation of the interface was performed with balanced salt solution using an irrigation cannula and the epithelial cluster was removed. The patient remained clinically stable 6 months after surgery and has experienced no recurrence. When epithelial inoculation is observed early after SMILE surgery, immediate irrigation of the interface appears to be an effective and safe treatment.
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  • 文章类型: Case Reports
    背景技术先前已经报道了可植入的结晶体(ICL)在矫正高散光中的功效和安全性。它们通常被用作激光屈光手术的替代品,因为它们具有不受影响的角膜等优点,诱导更少的高阶像差,导致更好的光学和视觉质量,这是一个可逆的过程。我们的目的是介绍ICL治疗单侧双豆状结肠缺损的无白内障的屈光参差的结果。病例报告一名27岁的男性患有Marfanoid身体习性,正在寻求屈光手术以矫正右眼的高散光。在介绍时,右眼和左眼的最佳矫正视力为20/30和20/20,分别。裂隙灯检查显示下晶状体缺损从5点延伸到7点30点的右眼位置,瞳孔扩张后。完成屈光检查后,复曲面ICL植入术被认为是合适的手术.术后三周,中央拱顶很低,他的ICL半脱位,先前植入的颞部脚板位于透镜状缺损的下方。高分辨率超声生物显微镜检查证实在9点位置存在睫状体(CB)囊肿。进行不稳定ICL的紧急外植体。结论本病例报告强调了在双豆状结肠瘤和CB囊肿并存的患者中与ICL植入相关的挑战和局限性。选择较小的双凸透镜瘤并避免弱小带区域与ICL触觉之间的直接相互作用是确保植入晶状体稳定性的重要步骤。
    BACKGROUND The efficacy and safety of the implantable collamer lens (ICL) in correcting high astigmatism have been previously reported. They are commonly used as an alternative to laser refractive surgery due to advantages such as leaving the cornea untouched, inducing fewer higher-order aberrations, resulting in better optical and visual quality, and it is a reversible procedure. We aim to present the outcome of ICL in managing anisometropia without cataract in an eye with unilateral lenticular coloboma. CASE REPORT A 27-year-old man with a Marfanoid body habitus was seeking refractive surgery for the correction of high astigmatism in the right eye. On presentation, the best corrected visual acuity was 20/30 and 20/20 in the right eye and left eye, respectively. Slit lamp examination indicated inferior lens coloboma extending from the 5 o\'clock to the 7: 30 o\'clock position in the right eye, after dilation of pupil. Following a complete refractive work-up, a toric ICL implantation was the presumed suitable surgery. Three weeks postoperatively, central vaulting was low, his ICL subluxated inferiorly, and the previously implanted temporal footplates were resting over the lenticular defect inferiorly. A high-resolution ultrasound biomicroscopy confirmed the presence of a ciliary body (CB) cyst at 9 o\'clock position. Urgent explantation of the unstable ICL was performed. CONCLUSIONS This case report emphasizes the challenges and limitations associated with ICL implantation in patients with lenticular colobomas and coexisting CB cyst. Selecting smaller lenticular colobomas and avoiding direct interaction between the weak zonules area and the ICL haptics are important steps to ensure the stability of implanted lens.
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