Excimer laser

准分子激光器
  • 文章类型: Journal Article
    评估准分子激光辅助深板层角膜移植术(Exc-DALK)和准分子激光辅助穿透性角膜移植术(Exc-PKP)对晚期圆锥角膜眼中央凹下脉络膜厚度(SFCT)的影响。回顾性比较临床研究,比较了术后2个月(T1)和2年(T2)接受Exc-DALK(G1)治疗的24只眼与接受Exc-PKP(G2)治疗的配对组的43只眼的结局。主要结果包括最佳矫正视力(BCVA),黄斑中心厚度(CMT),和SFCT。术前,两组之间的BCVA没有显着差异,CMT或SFCT(p>0.05)。在两次随访中,两组之间的BCVA没有显着差异(p>0.05)。在两次随访中,两组之间的CMT没有显着差异(p>0.05)。在两次随访中,G2的SFCT均高于G1(p<0.01)。与术前SFCT相比,在两次随访中,G1期SFCT均无明显变化(p>0.05)。在G2中,SFCT在T1时显着增加(p<0.01),在T2时没有显着差异(p=0.17)。SFCT在Exc-PKP后显著增加,但在Exc-DALK后没有,这可能表明Exc-DALK对脉络膜的影响较小,因此与Exc-PKP相比,对眼部组织的创伤较小。
    To evaluate the impact of excimer laser-assisted deep anterior lamellar keratoplasty (Exc-DALK) and excimer laser-assisted penetrating keratoplasty (Exc-PKP) on subfoveal choroidal thickness (SFCT) in eyes with advanced keratoconus. A retrospective comparative clinical study, which compares the outcomes of 24 eyes treated with Exc-DALK (G1) against matched group of 43 eyes treated with Exc-PKP (G2) at both 2 months (T1) and 2 years (T2) postoperatively. Main outcomes included best-corrected visual acuity (BCVA), central macular thickness (CMT), and SFCT. Preoperatively, there were no significant differences between both groups regarding BCVA, CMT or SFCT (p > 0.05). There were no significant differences between both groups regarding BCVA at both follow-ups (p > 0.05). There were no significant differences between both groups regarding CMT at both follow-ups (p > 0.05). SFCT was higher in G2 than G1 at both follow-ups (p < 0.01). Compared to preoperative SFCT, there were no significant changes in SFCT in G1 at both follow-ups (p > 0.05). In G2, SFCT increased significantly at T1 (p < 0.01) and did not differ significantly at T2 (p = 0.17). SFCT increased significantly after Exc-PKP but not after Exc-DALK, which might indicate that Exc-DALK affects the choroid less and thus could represent a less traumatic approach to ocular tissue than Exc-PKP.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    额叶纤维性脱发(FFA)代表了原发性淋巴细胞性瘢痕性脱发的一种独特形式,其特征是额颞叶毛发退缩和眉毛脱发。虽然主要影响绝经后妇女,FFA也发生在育龄女性和男性中,不同种族之间观察到的差异。遗传易感性,环境因素和炎症途径有助于其发病机制,随着不断发展的诊断标准,提高了准确性。FFA治疗缺乏标准化,涵盖局部,全身和物理治疗,而头发移植仍然是一个暂时的解决方案。本文回顾了目前对FFA的理解,旨在为临床医生提供有关其管理的最新见解。
    Frontal fibrosing alopecia (FFA) represents a distinctive form of primary lymphocytic scarring alopecia characterized by fronto-temporal hair recession and eyebrow hair loss. While predominantly affecting postmenopausal women, FFA also occurs in women of reproductive age and men, with variations observed across different ethnic groups. Genetic predisposition, environmental factors and inflammatory pathways contribute to its pathogenesis, with evolving diagnostic criteria enhancing accuracy. FFA treatment lacks standardization, encompassing topical, systemic and physical therapies, while hair transplantation remains a temporary solution. This article reviews the current understanding of FFA, aiming to provide clinicians with updated insights for its management.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Case Reports
    暂无摘要。
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    目的:该研究的目的是分析与引入Streamlight™相关的时间节省(AlconLaboratories,沃思堡,TX,美国)表面角膜消融中的跨上皮屈光性角膜切除术(PRK)。
    方法:所有屈光手术均在ArtLife诊所使用AlconWaveLight®EX500进行,格但斯克,波兰。该研究包括2019年4月至2021年10月期间接受跨上皮PRK治疗的屈光不正患者,这些患者与同期接受酒精辅助PRK治疗的患者相匹配。仅分析左眼的结果。
    结果:有105名患者接受了经上皮PRK(年龄33.42±8.67岁),与105名接受酒精辅助PRK的患者(年龄33.05±10.16岁;p=0.11)相匹配。术前平均等效球面屈光度为-2.04±2.28D,跨上皮和酒精辅助PRK组的-1.9±1.71D,分别(p=0.20)。与酒精辅助PRK(354.93±137.63s;p=0.7)相比,跨上皮PRK(349.46±47.83s)的总手术时间没有显着缩短;但是,经上皮PRK的手术时间差异显著较低(p<0.001).经上皮PRK的激光治疗持续时间(41.78±17.2s)大于酒精辅助PRK的激光治疗持续时间(8.48±6.12s;p<0.001),激光治疗期间的断裂次数也是如此(0.95±0.63vs.分别为0.53±0.88;p<0.001)。
    结论:经上皮PRK的引入并没有为屈光手术套件带来显著的时间相关节省。
    OBJECTIVE: The aim of the study was to analyze the time-savings associated with introduction of Streamlight™ (Alcon Laboratories, Fort Worth, TX, USA) transepithelial photorefractive keratectomy (PRK) in surface corneal ablations.
    METHODS: All refractive surgeries were performed using the Alcon WaveLight® EX500 at the ArtLife Clinic, Gdańsk, Poland. The study included patients treated for refractive errors with transepithelial PRK between April 2019 and October 2021, who were matched with patients treated with alcohol-assisted PRK during the same period. Only results for the left eye were analyzed.
    RESULTS: One-hundred-five patients underwent transepithelial PRK (age 33.42 ± 8.67 years) and were matched with 105 patients that underwent alcohol-assisted PRK (age 33.05 ± 10.16 years; p = 0.11). The mean preoperative spherical equivalent refraction was - 2.04 ± 2.28 D, and - 1.9 ± 1.71 D for the transepithelial and alcohol-assisted PRK group, respectively (p = 0.20). The total surgery time was non-significantly shorter in transepithelial PRK (349.46 ± 47.83 s) than in alcohol-assisted PRK (354.93 ± 137.63 s; p = 0.7); however, the variance of surgical time was significantly lower in transepithelial PRK (p < 0.001). The laser treatment duration was greater in transepithelial PRK (41.78 ± 17.2 s) than in alcohol-assisted PRK (8.48 ± 6.12 s; p < 0.001), and so was the number of breaks during the laser treatment (0.95 ± 0.63 vs. 0.53 ± 0.88, respectively; p < 0.001).
    CONCLUSIONS: The introduction of transepithelial PRK did not bring significant time-associated savings into the refractive surgery suite.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    紧凑的高频阵列对于临床和临床前应用是感兴趣的,其中需要小占用面积或内窥镜装置来到达目标解剖结构。然而,紧凑阵列的制造需要通过阵列末端的柔性印刷电路板和成像系统的微同轴电缆的组合来将几十个小元件连接到成像系统。目前使用的方法,如引线键合,导电胶,或与柔性电路的干连接,大大增加阵列占用空间。这里,我们提出了一种使用真空沉积金属的互连方法,激光构图,和电镀来实现直角,紧凑型,阵列元件和柔性电路迹线之间的可靠连接。使用图案化的铜迹线在边缘处加厚阵列元件,这增加了它们的横截面积,便于连接。我们制造了2.3毫米×1.7毫米,64元件线性阵列,间距为36μm的元件连接到4厘米长的柔性电路,其中互连仅向阵列的每一侧增加100μm。脉冲回波测量产生的平均中心频率为55MHz,-6dB带宽为41%。我们测量了轴向35μm和横向114μm的成像分辨率,并证明了猪食管组织的离体成像和禽类胚胎脉管系统的体内成像。
    Compact high-frequency arrays are of interest for clinical and preclinical applications in which a small-footprint or endoscopic device is needed to reach the target anatomy. However, the fabrication of compact arrays entails the connection of several dozens of small elements to the imaging system through a combination of flexible printed circuit boards at the array end and micro-coaxial cabling to the imaging system. The methods currently used, such as wire bonding, conductive adhesives, or a dry connection to a flexible circuit, considerably increase the array footprint. Here, we propose an interconnection method that uses vacuum-deposited metals, laser patterning, and electroplating to achieve a right-angle, compact, reliable connection between array elements and flexible-circuit traces. The array elements are thickened at the edges using patterned copper traces, which increases their cross-sectional area and facilitates the connection. We fabricated a 2.3 mm by 1.7 mm, 64-element linear array with elements at a 36 μm pitch connected to a 4 cm long flexible circuit, where the interconnect adds only 100 μm to each side of the array. Pulse-echo measurements yielded an average center frequency of 55 MHz and a -6 dB bandwidth of 41%. We measured an imaging resolution of 35 μm in the axial direction and 114 μm in the lateral direction and demonstrated the ex vivo imaging of porcine esophageal tissue and the in vivo imaging of avian embryonic vasculature.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    在过去的几十年中,屈光手术的类型和性质已大大增加,允许几乎所有患者群体都得到非常高的满意度治疗。传统的屈光性角膜切除术涉及通过机械清创术或稀释酒精滴注去除角膜上皮。对这种方法的改进是在称为跨上皮屈光性角膜切削术(tranepk)的单步过程中利用激光上皮去除。我们从早期采用tranPRK作为一个两步过程来探索其历史,识别来自主要制造商的不同transPRK平台,并描述了tranPRK在屈光手术中的作用。这是对文献的叙述性综述。这篇综述发现,TransPRK是一种安全有效的程序,适用于各种患者人群。尽管与其他提供更快,更舒适恢复的基于角膜的手术相比,通常不被视为主要治疗选择,在许多情况下,这些程序是不可能的。这些包括,但不限于,角膜不稳定的情况下,以前的屈光手术,或移植,其中高阶像差会以不适合眼镜或隐形眼镜矫正的方式损害视力。我们讨论了对程序的改进,这将有助于改善结果,包括优化手术后患者的不适,以及减少角膜雾霾和屈光消退。
    The type and nature of refractive surgery procedures has greatly increased over the past few decades, allowing for almost all patient populations to be treated to extremely high satisfaction. Conventional photorefractive keratectomy involves the removal of the corneal epithelium through mechanical debridement or dilute alcohol instillation. An improvement to this method utilises laser epithelial removal in a single-step process termed transepithelial photorefractive keratectomy (transPRK). We explore the history of transPRK from its early adoption as a two-step process, identify different transPRK platforms from major manufacturers, and describe the role of transPRK in the refractive surgery armamentarium. This is a narrative review of the literature. This review finds that TransPRK is a safe and effective procedure that works across a variety of patient populations. Though often not seen as a primary treatment option when compared to other corneal-based procedures that offer a faster and more comfortable recovery, there are many scenarios in which these procedures are not possible. These include, but are not limited to, cases of corneal instability, previous refractive surgery, or transplant where higher-order aberrations can impair vision in a manner not amenable to spectacle or contact lens correction. We discuss refinements to the procedure that would help improve outcomes, including optimising patient discomfort after surgery as well as reducing corneal haze and refractive regression.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    最近,微/纳米流体通道领域已经引起了相当大的关注。然而,目前制造微/纳米通道的方法很复杂,昂贵的,时间密集。在目前的工作中,我们使用简单的激光工艺成功地在熔融石英基板(SiO2)上制造了透明的亚微米通道。为了实现这一点,采用背面配置的单脉冲准分子激光照射通过透明SiO2基板处理吸收紫外线的低价氧化硅(SiOx)薄膜。在激光曝光之前,将聚二甲基硅氧烷(PDMS)覆盖层(涂层)施加在SiOx膜上,作为由激光诱导的受控结构形成的限制。在最佳激光通量下,薄的SiOx薄膜弯曲,导致形成宽度为10至20μm,高度为800至1200nm的通道,表现出遵循所谓的欧拉屈曲模式的钟形横截面。较宽的通道显示类似于静脉曲张或电话线模式的形态。随后的高温退火导致SiOx的氧化,在熔融石英基板上形成透明SiO2通道。制造的纳米通道显示出有效输送不同粘度的流体的有希望的潜力。通过毛细管作用并根据Lucas-Washburn方程通过这些纳米通道输送各种流体。
    Recently, considerable attention has been drawn to the field of micro/nanofluidic channels. However, current methods for fabricating micro/nanochannels are complex, costly, and time-intensive. In the present work, we successfully fabricated transparent submicron-channels on fused silica substrates (SiO2) using a straightforward laser process. To achieve this, a single-pulse excimer laser irradiation in a rear side configuration was employed to treat a thin film of UV-absorbing silicon suboxide (SiOx) through the transparent SiO2 substrate. A polydimethylsiloxane (PDMS) superstrate (coating layer) was applied over the SiOx film before laser exposure, serving as a confinement for controlled structure formation induced by the laser. Under optimal laser fluence, the thin SiOx film buckled, leading to the formation of channels with a width ranging from 10 to 20 µm and a height of 800 to 1200 nm, exhibiting a bell-like cross-sections following the so-called Euler buckling mode. Wider channels displayed morphologies resembling varicose or telephone cord modes. Subsequent high-temperature annealing led to the oxidation of SiOx, resulting transparent SiO2 channels on the fused silica substrate. The manufactured nanochannels exhibited promising potential for effectively transporting fluids of diverse viscosities. Various fluids were conveyed through these nanochannels via capillary action and in accordance with the Lucas-Washburn equation.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Meta-Analysis
    本研究旨在探讨308nm准分子激光(308nmEL)和他克莫司软膏(TO)治疗面部白癜风(FV)的疗效和安全性。我们搜索了科克伦图书馆,pubmed,EMBASE,CNKI,和万丰自成立至2023年6月1日。结果包括总体反应率(ORR),总不良反应率(TARR),3个月复发率(RR-3)和6个月复发率(RR-6)。结果数据以比值比(OR)和95%置信区间(CI)表示。通过Cochrane偏差风险工具评估偏差风险,并通过RevMan5.4软件进行数据分析。这项研究共纳入19项试验,涉及2085名患者。当比较308nmEL单药治疗与308nmEL加TO时,ORR的显著差异(OR=4.29,95%CI[2.97,6.19],I2=0%,P<0.001),RR-3(OR=0.18,95%CI[0.05,0.69],I2=0%,P=0.01),和RR-6(OR=0.38,95%CI[0.14,1.03],I2=39%,在两个管理之间发现P=0.06)。比较TO单药治疗与TO加308nmEL时,结果显示ORR存在显著差异(OR=4.21,95%CI[2.90,6.11],I2=0%,P<0.001),TARR(OR=0.42,95%CI[0.22,0.81],I2=4%,P=0.009),和RR-3(OR=0.32,95%CI[0.01,8.03],两种模式之间的P=0.49)。该研究的结果表明,对于FV的治疗,308nmEL和TO的组合比单独的任一治疗更有效。
    This study aimed to investigate the effects and safety of 308 nm excimer laser (308 nm EL) and tacrolimus ointment (TO) in the treatment of facial vitiligo (FV). We searched Cochrane Library, PUBMED, EMBASE, CNKI, and WANGFANG from inception to June 1, 2023. Outcomes included overall response rate (ORR), total adverse reaction rate (TARR), recurrence rate at 3-month (RR-3) and recurrence rate at 6-month (RR-6). The outcome data were presented as odds ratios (OR) with 95% confidence intervals (CI). The risk of bias was assessed by Cochrane risk-of-bias tool and data analysis was performed by RevMan 5.4 software. This study included a total of 19 trials involving 2085 patients. When comparing 308 nm EL monotherapy with 308 nm EL plus TO, significant differences in the ORR (OR = 4.29, 95% CI [2.97, 6.19], I2 = 0%, P < 0.001), RR-3 (OR = 0.18, 95% CI [0.05, 0.69], I2 = 0%, P = 0.01), and RR-6 (OR = 0.38, 95% CI [0.14, 1.03], I2 = 39%, P = 0.06) were found between the two managements. When comparing TO monotherapy with TO plus 308 nm EL, its results showed significant differences in the ORR (OR = 4.21, 95% CI [2.90, 6.11], I2 = 0%, P < 0.001), TARR (OR = 0.42, 95% CI [0.22, 0.81], I2 = 4%, P = 0.009), and RR-3 (OR = 0.32, 95% CI [0.01, 8.03], P = 0.49) between the two modalities. The results of this study suggest that the combination of 308 nm EL and TO is more effective than either treatment alone for the treatment of FV.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    目的:评价LASIK与早期白内障超声乳化术(PE)的相关性。
    方法:进行匹配的病例对照研究。病例为有LASIK病史的健康成人。根据矫正视力(CDVA)对两组进行配对,轴向长度,和白内障等级。
    结果:共纳入213例患者。85名患者被归类为LASIK术后组,128名患者被归类为对照。LASIK时的平均年龄为42.32±9.24岁。LASIK术后PE前平均CDVA为0.29±0.19LogMAR,对照组为0.34±0.22LogMAR(p=0.07)。LASIK术后组的平均眼轴长度为23.99±1.78mm,对照组为23.62±0.98mm(p=0.085)。LASIK术后核性白内障的平均分级为1.36,对照组为1.47(p=0.34)。LASIK术后PE时的平均年龄为60.18±7.46岁,对照组为67.35±9.28岁(p<0.0005)。LASIK的平均年龄与PE的平均年龄之间的差异为17.85±5.72岁。LASIK术后患者与PE≤55岁之间呈正相关(OR:4.917,95%CI:2.21-10.90,p<0.001)。
    结论:LASIK可能与早期PE相关。与匹配的对照组相比,LASIK患者的PE早7年。
    OBJECTIVE: To evaluate the association between LASIK and early cataract phacoemulsification surgery (PE).
    METHODS: A matched case-control study was conducted. Cases were otherwise healthy adults with a history of LASIK. Groups were paired according to corrected-distance visual acuity (CDVA), axial length, and cataract grade.
    RESULTS: A total of 213 patients were included. 85 patients were classified as post-LASIK group and 128 as controls. The mean age at the time of LASIK was 42.32 ± 9.24 years. The mean CDVA before PE was 0.29 ± 0.19 Log MAR in post-LASIK group and 0.34 ± 0.22 Log MAR in controls (p = 0.07). The mean axial length was 23.99 ± 1.78 mm in post-LASIK group and 23.62 ± 0.98 mm in controls (p = 0.085). The mean nuclear cataract grading was 1.36 in post-LASIK group and 1.47 in controls (p = 0.34). The mean age at the time of PE was 60.18 ± 7.46 years in post-LASIK group and 67.35 ± 9.28 in controls (p < 0.0005). The difference between the mean age of LASIK and the mean age of PE was 17.85 ± 5.72 years. There was a positive association between the post-LASIK group and the age of PE ≤ 55 years (OR: 4.917, 95% CI: 2.21-10.90, p < 0.001).
    CONCLUSIONS: LASIK may be associated with early PE. Patients with LASIK had a 7-year earlier PE compared to a matched control group.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Meta-Analysis
    本研究旨在比较基于准分子激光(EL)的组合方案在改善色素沉着方面的功效和安全性。
    在PubMed中进行了全面搜索,WebofScience,科克伦图书馆,和Embase于2023年7月1日进行,包括符合标准的EL联合治疗白癜风的随机对照试验。主要结果指标是色素沉着率≥75%,次要结局指标为色素沉着率≤25%和不良事件.
    共纳入了348例患者的11项研究。网络Meta分析显示,EL与抗氧化剂联合使用(SUCRA=98.8%),EL联合卡泊三醇(SUCRA=59.8%)和EL联合他卡西醇(SUCRA=59.6%)是三种最佳干预措施,其色素沉着率≥75%。单独EL(SUCRA=77.6%),EL联合他卡西醇(SUCRA=61.7%)和EL联合抗氧化剂(SUCRA=57.2%)是治疗失败率最高的三种干预措施。各组不良事件主要包括红斑,灼烧感和色素沉着过度。根据目前的研究结果,EL联合治疗是安全的,有轻度不良事件。
    EL联合抗氧化剂是治疗白癜风的首选方案,而单纯EL是白癜风治疗失败率最高的方案。
    UNASSIGNED: This study aimed to compare the efficacy and safety of excimer laser (EL)-based combination regimens in improving repigmentation.
    UNASSIGNED: A comprehensive search was conducted in PubMed, Web of Science, Cochrane Library, and Embase on July 1, 2023, to include randomized controlled trials of EL combination treatments for vitiligo that met the criteria. The primary outcome measure was a repigmentation rate ≥ 75%, and the secondary outcome measures were a repigmentation rate of ≤ 25% and adverse events.
    UNASSIGNED: Eleven studies involving 348 patients were included. Network Meta-Analysis showed that EL combined with antioxidants (SUCRA = 98.8%), EL combined with calcipotriol (SUCRA = 59.8%) and EL combined with tacalcitol (SUCRA = 59.6%) were the three optimal interventions achieving repigmentation rates ≥ 75%. EL alone (SUCRA = 77.6%), EL combined with tacalcitol (SUCRA = 61.7%) and EL combined with antioxidants (SUCRA = 57.2%) were the three interventions with the highest rates of treatment failure. Adverse events in all groups mainly included erythema, burning sensation and hyperpigmentation. Based on the results of the current study, EL combination therapies were safe with mild adverse events.
    UNASSIGNED: EL combined with antioxidants was the preferred regimen for vitiligo, whereas EL alone was the regimen with the highest rate of treatment failure in vitiligo.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

公众号