lens/cataract

晶状体 / 白内障
  • 文章类型: Journal Article
    目的:建立生命最初十年的眼轴长度和角膜曲率的规范曲线。
    方法:这是一项来自美国单个机构的横断面研究。前瞻性招募0至10岁无潜在眼部病理的儿童,在麻醉下进行不相关的手术时进行超声生物测量和手持式角膜曲率测量。年龄较大的合作儿童在办公室获得了光学生物测量。使用对数分位数回归模型来确定轴向长度和平均角膜曲率随年龄的变化。
    结果:纳入100名儿童的单眼测量。75%的儿童是白人,49%是女性。中间轴向长度范围为20.6mm(IQR,20.2至21.1毫米)一岁至23.1毫米(IQR,22.5至23.8毫米),年龄为10岁。平均角膜曲率测量的中位数范围为44.1D(IQR,42.6至45.4D)一岁至43.5岁(IQR,42.2至44.0D),年龄为10岁。随着年龄的增长,轴向长度显着增加(每加倍年龄0.74mm;95%CI,0.62至0.82mm),并且平均角膜曲率降低的趋势不明显(每倍增年龄-0.21D;95%CI,-0.62至0.08D)。
    结论:我们提供了一组关于眼轴长度和角膜曲率的规范图表,这可能有助于识别超出正常范围的眼睛,并有助于治疗青光眼或白内障等眼部疾病。
    OBJECTIVE: To establish normative curves for axial length and corneal curvature in the first decade of life.
    METHODS: This is a cross-sectional study from a single institution in the United States. Children from 0- to 10-years of age with no underlying ocular pathology were prospectively enrolled to obtain ultrasound biometry and hand-held keratometry while under anaesthesia for an unrelated procedure. Older cooperative children had optical biometry obtained in-office. Logarithmic quantile regression models were used to determine the change in axial length and average keratometry as a function of age.
    RESULTS: Single-eye measurements from 100 children were included. 75% of children were White and 49% female. Median axial length ranged from 20.6 mm (IQR, 20.2 to 21.1 mm) at age one year to 23.1 mm (IQR, 22.5 to 23.8 mm) at age ten years. Median average keratometry ranged from 44.1 D (IQR, 42.6 to 45.4 D) at age one year to 43.5 (IQR, 42.2 to 44.0 D) at age ten years. As age increased, there was a significant increase in axial length (0.74 mm per doubling of age; 95% CI, 0.62 to 0.82 mm), and a non-significant trend towards lower average keratometry (-0.21 D per doubling of age; 95% CI, -0.62 to 0.08 D).
    CONCLUSIONS: We provide a set of normative charts for axial length and corneal curvature which may facilitate the identification of eyes outside the normal range and assist in the management of ocular conditions such as glaucoma or cataract.
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  • 文章类型: Journal Article
    目的:调查患者的第一手经验,对立即序贯双侧白内障手术(ISBCS)的满意度和态度。
    方法:伯恩茅斯皇家医院,大学医院多塞特郡NHS基金会信托基金,CastleLaneEast,伯恩茅斯,英国。
    方法:使用半结构化电话访谈和定性内容分析进行回顾性研究。
    方法:半结构化电话面试由独立面试官进行,探索患者对ISBCS的体验,术后至少四周。使用定性内容分析对开放式答复进行了分析。分类和含义单位被列出,提供每个类别的患者数量和百分比。
    结果:纳入25例患者。所有患者对ISBCS的总体满意度均为“非常满意”,并将再次选择在同一天进行双眼手术。22名患者(88%)报告了“非常好/舒适”的手术经验。手术后,24名患者(96%)感觉完全安全回家,大多数人组织家人或朋友开车送他们回家。所有患者在术后均未出现任何并发症。24名患者(96%)在完成手术后的日常生活活动方面仅略有减少,24名患者(96%)表示他们会向家人和朋友推荐ISBCS。
    结论:从患者的角度和经验来看,结果支持更广泛地实施ISBCS。建议提供解决共同主题和问题的书面信息,以增加患者术前接受和吸收ISBCS。
    OBJECTIVE: To investigate patients\' first-hand experience, satisfaction and attitudes towards immediate sequential bilateral cataract surgery (ISBCS).
    METHODS: Royal Bournemouth Hospital, University Hospitals Dorset NHS Foundation Trust, Castle Lane East, Bournemouth, UK.
    METHODS: Retrospective study using semi-structured phone interviews and qualitative content analysis.
    METHODS: Semi-structured telephone interviews were conducted by an independent interviewer, to explore patients\' experiences of ISBCS, at least four weeks postoperatively. The open-ended responses were analysed using qualitative content analysis. Categories and meaning units were tabulated, with the number and percentage of patients contributing to each category provided.
    RESULTS: 25 patients were included. All patients rated their overall satisfaction of ISBCS as \'very satisfied\' and would opt again to have both eyes operated on the same day. 22 patients (88%) reported a \'very good/comfortable\' surgery experience. After surgery, 24 patients (96%) felt completely safe going home, with most organizing for family or friends to drive them home. None of the patients experienced any complications in the postoperative period. 24 patients (96%) experienced only minimal reduction in accomplishing daily living activities after surgery and 24 patients (96%) said they would recommend ISBCS to family and friends.
    CONCLUSIONS: The results support wider implementation of ISBCS from the patient\'s perspective and experience. Providing written information addressing common themes and concerns is recommended to increase patient acceptance and uptake of ISBCS preoperatively.
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  • 文章类型: Journal Article
    目的:比较原发性开角型青光眼患者行超声粘管造口术和超声粘管造口术的疗效。
    方法:这种非随机,前瞻性比较研究纳入了168例原发性开角型青光眼(POAG)患者的168只眼.在94只眼的POAG和白内障中进行了声囊吻合术,在74只眼的POAG中进行了声囊吻合术。术前和术后眼压(IOP),抗青光眼药物的数量,在整个随访期间记录术中和术后并发症。
    结果:术后平均随访时间为20.13±7.9个月。两组患者术后1个月的平均IOP均显著降低(p<0.001),且在所有随访中,平均IOP均显著低于其术前值。末次随访时,声囊吻合术和声囊吻合术的术后平均眼压为14.98±4.8mmHg和16.84±5.0mmHg,分别(p=0.001)。超声粘孔造口术和粘孔造口术组的完全成功率分别为83.1%和56.8%,分别(p=0.008)。超声粘孔造口术组89.4%的眼睛和粘孔造口术组83.8%的眼睛达到了合格的成功率(p=0.534)。超声粘孔造口术组的最佳矫正视力(BCVA)在术后显着提高(p=0.001)。两组术后抗青光眼药物均明显低于术前(p=0.001)。
    结论:对于患有和不患有白内障的POAG患者,Phosoclikocanalalomaloscalomalstic和粘canalomy都是控制IOP的有效方法。在超声粘孔造口术中获得了更高的完全成功率和BCVA。因此,对于医学上未控制的原发性开角型青光眼伴或不伴白内障的患者,建议行超声粘管造口术和粘管造口术。
    OBJECTIVE: To compare the outcomes of phacoviscocanalostomy and viscocanalostomy in patients with primary open angle glaucoma.
    METHODS: This non randomized, prospective comparative study included 168 eyes of 168 patients with primary open angle glaucoma (POAG). Phacoviscocanalostomy was performed in 94 eyes with POAG and cataract and viscocanalostomy was performed in 74 eyes with POAG. Preoperative and postoperative intraocular pressures (IOP), number of antiglaucoma medication, intraoperative and postoperative complications were recorded throughout the follow-up period.
    RESULTS: The mean follow-up after surgery was 20.13 ± 7.9 months. Mean IOP decreased significantly 1 month after surgery in both groups (p < 0.001) and remained significantly lower from its preoperative value at all follow-up visits. The postoperative mean IOP at the last follow up in phacoviscocanalostomy and viscocanalostomy was 14.98 ± 4.8 mmHg and 16.84 ± 5.0 mmHg, respectively (p = 0.001). Complete success rate in phacoviscocanalostomy and viscocanalostomy groups was 83.1% and 56.8%, respectively (p = 0.008). Qualified success rate was achieved in 89.4% eyes in the phacoviscocanalostomy group and 83.8% of viscocanalostomy group (p = 0.534). The Best corrected visual acuity (BCVA) in phacoviscocanalostomy group improved significantly post-operatively (p = 0.001). Postoperative antiglaucoma medication in both groups were significantly less than the preoperative values (p = 0.001).
    CONCLUSIONS: Both Phacoviscocanalostomy and viscocanalostmy are effective procedures in the control of IOP in patients with POAG with and without cataract. Higher complete success rates and BCVA were achieved in phacoviscocanalostomy. Therefore, phacoviscocanalostomy and viscocanalostomy are recommended in eyes with medically uncontrolled primary open-angle glaucoma with and without coexisting cataract.
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  • 文章类型: Journal Article
    OBJECTIVE: To describe features of uveitis-glaucoma-hyphema (UGH) syndrome, using Anterior Segment-Optical Coherence Tomography (AS-OCT) and Ultrasound Biomicroscopy (UBM) and to evaluate the diagnostic role of AS-OCT as an imaging technique alternative to UBM.
    METHODS: Retrospective case series.
    METHODS: Four eyes of 4 patients with UGH syndrome were analyzed. All patients reported previous uncomplicated cataract surgery with in-the-bag implantation of single-piece-intraocular lens (IOL). They underwent at presentation complete ophthalmological examination and imaging with slit-lamp anterior segment photographs, UBM and AS-OCT.
    RESULTS: Although AS-OCT did not allow to visualize the structures behind the iris, it displayed a contact between IOL (plate and/or haptics) and iris and IOL tilting in 3 out of 4 eyes. AS-OCT directly detected the cause of UGH syndrome in one eye, 2 eyes required some expedients to display the iris chafing, like scans in mydriasis and/or patient\'s gaze direction change. AS-OCT did not allow to appreciate the IOL-iris contact (showed by UBM technique) only in one eye, probably due to the change of patient position from supine to sitting, and consequent anteriorization of iris diaphragm. Furthermore AS-OCT showed fine details, as capsular bag collapse and indirect signs of haptic malposition in 3 out of 4 eyes.
    CONCLUSIONS: AS-OCT is a non-invasive technique that allows to determine IOL position and IOL-uveal contact in selected cases of UGH syndrome. Considering AS-OCT and UBM advantages and limitations, AS-OCT should be used as first imaging modality when clinical diagnosis is uncertain. When UGH diagnosis cannot be verified using AS-OCT, UBM should be performed.
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  • 文章类型: Journal Article
    目的:使用掺钕钇铝石榴石激光囊切开术治疗后囊膜混浊,导致眼压升高。这里,我们比较了盐酸多佐胺+马来酸噻吗洛尔与溴莫尼定对眼压的影响。我们还研究了掺钕钇铝石榴石激光囊切开术后的副作用。在这些患者中,以前没有研究比较这两种药物的结果。
    方法:90例后囊混浊患者参与了这项研究。他们接受了钇铝石榴石激光囊切开术。钇铝石榴石激光囊切开术后,他们被随机分为三组.第1组接受盐酸多佐胺+马来酸噻吗洛尔;第2组服用溴莫尼定;第3组,对照组,没有服用任何药物。第1组在手术前1小时和第一天的第三个小时服用盐酸多佐胺+马来酸噻吗洛尔滴眼液,第二天和第七天之间每天两次。第2组在手术前1小时和第一天的第三个小时服用溴莫尼定滴眼液,在第二天和第七天之间每天两次。
    结果:溴莫尼定具有与固定组合相似的副作用。第1组(盐酸多佐胺+马来酸噻吗洛尔)第1天(p=0.87)和第3天(p=0.124)的眼压相似,第2组(溴莫尼定)和对照组。对照组的平均眼压值显著高于第1组和第2组,因为药物的抗青光眼作用在第7天变得突出(p=0.041)。在第1组和第2组中,第7天的眼压明显低于对照组(p=0.041)。刺痛,瘙痒,第1组、第2组及对照组的充血率和耳痛率相似。在第7天,溴莫尼定组的水眼要比盐酸多佐胺-马来酸噻吗洛尔和对照组少(p=0.02)。溴莫尼定在第3天(p=0.04)和第7天(p=0.03)也显着降低了化学生成率。
    结论:我们建议溴莫尼定和多佐胺+噻吗洛尔的组合在降低常规病例的眼压方面同样有效。如果眼内压发作的风险更高,使用多佐胺+噻吗洛尔组合将是更合适的。
    OBJECTIVE: Posterior capsular opacification is treated using neodymium-doped yttrium aluminium garnet laser capsulotomy that leads to increased intraocular pressure. Here, we compare the effects of dorzolamide hydrochloride + timolol maleate versus brimonidine on intraocular pressure. We also investigate their side effects after neodymium-doped yttrium aluminium garnet laser capsulotomy. In these patients, there are no prior studies comparing the results of these two drugs.
    METHODS: Ninety patients with posterior capsule opacification contributed to the study. They received yttrium aluminium garnet laser capsulotomy. After yttrium aluminium garnet laser capsulotomy, they were randomized into three groups. Group 1 received dorzolamide hydrochloride + timolol maleate; Group 2 took brimonidine; and Group 3, the control group, took no drug. Group 1 took dorzolamide hydrochloride + timolol maleate eye drops 1 h before the procedure and on the third hour of the first day and two times per day between the second and the seventh days. Group 2 took brimonidine eye drops 1 h before the procedure and on the third hour of the first day, two times per day between the second and the seventh days.
    RESULTS: Brimonidine had a similar side effect profile to the fix combination. Intraocular pressure on the first (p = 0.87) and third days (p = 0.124) were similar in Group 1 (dorzolamide hydrochloride + timolol maleate), Group 2 (brimonidine) and the control group. The mean intraocular pressure value of the control group was significantly higher than Groups 1 and 2 because the anti-glaucomatous effects of the drugs become prominent on the seventh day (p = 0.041). In Group 1 and Group 2, intraocular pressure was significantly lower than the control group on the seventh day (p = 0.041). Stinging, itching, hyperemia and Tyndall rates were similar in Group 1, Group 2 and the control group. Watery eyes were less common in the brimonidine group than in the dorzolamide hydrochloride-timolol maleate and the control groups on the seventh day (p = 0.02). Brimonidine also significantly lowered the chemosis rate on the third (p = 0.04) and seventh (p = 0.03) days.
    CONCLUSIONS: We suggest that brimonidine and a combination of dorzolamide + timolol are similarly effective at reducing eye pressure for routine cases. In cases where intraocular pressure attacks might be at higher risk, using the dorzolamide + timolol combination would be more appropriate.
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  • 文章类型: Journal Article
    UNASSIGNED: The aim of this study was to determine a reliable combination of vision-specific measures and general health measures to assess the improvement on the patient\'s QoL following cataract surgery either when patients had first time surgery or had already received successful surgery in the fellow eye for cataract.
    UNASSIGNED: Study sample included two waves of data measurement in 150 patients undergoing uncomplicated cataract surgery who were assessed for visual acuity, vision-specific quality of life, and general health. Data were acquired pre-surgery and 2 months post-surgery. About 90 patients haven\'t had prior cataract surgery while 60 patients had prior successful cataract surgery in the fellow eye.
    UNASSIGNED: There was considerable improvement in all outcome measures following cataract surgery. Patients who have had prior surgery presented with modestly higher scores in the vision-specific QoL measures and minimal benefit pre-operatively compared to those who haven\'t had any surgery in the general health measure. They also had more gains post-surgery in the vision-specific QoL measures only.
    UNASSIGNED: There is a possibility that gains in QoL plateau after a certain level of visual acuity improvement. While improvement can be detected with a general health QoL measure, this measure may require additional psychometric validation to the particular population beforehand. Otherwise, a combination of vision-specific outcome measures will provide the most reliable estimate.
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  • 文章类型: Journal Article
    UNASSIGNED: To assess the patterns of patient generated aerosol in the context of ophthalmic surgery and ophthalmic examinations. To inform medical teams regarding potential hazards and suggest mitigating measures.
    UNASSIGNED: Qualitatively, real-time time videography assessed exhalation patterns from simulated patients under different clinical scenarios using propylene glycol from an e-cigarette. Quantitatively, high-speed Schlieren imaging was performed to enable high resolution recordings analysable by MATLAB technical computing software.
    UNASSIGNED: Without a face mask, the standard prior to COVID 19, vapour was observed exiting through the opening in the drape over the surgical field. The amount of vapour increased when a surgical mask was worn. With a taped face mask, the amount of vapour decreased and with inclusion of a continuous suction device, the least amount of vapour was seen. These results were equivocal when the patient was supine or sitting upright. High-speed Schlieren imaging corroborated these findings and in addition showed substantial increase in airflow egress during coughing and with ill-fitting face masks.
    UNASSIGNED: Advising patients to wear a surgical mask at the time of ophthalmic interventions potentially contaminants the ocular field with patient generated aerosol risking endophthalmitis. Surgeon safety can be maintained with personal protective equipment to mitigate the increased egress of vapour from the surgical drape and taping, with or without suction is advisable, whilst meticulous hygiene around lenses is required at the time of slit lamp examination.
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  • 文章类型: Journal Article
    评估先前植入单焦点人工晶状体的假晶状体患者在睫状沟中二次背负式附加人工晶状体植入的临床结果,他们在IOL手术后追求无眼镜选择。
    一个前瞻性病例系列,包括7名接受袋内单焦点人工晶状体植入的假晶状体患者。所有眼睛都在睫状沟中植入了新设计的A4AddOnIOL,作为人工晶状体患者的辅助手术,在IOL手术后寻求无眼镜的近距离和中距离选择。
    这项研究纳入了6名患者的7只眼睛,其中4人(71.43%)为女性,平均年龄58.33±3.5岁(范围54-63;95%CI54.66,62.01)。术后3个月随访时的球形当量为-0.10m±0.82。此外,UDVA为0.11±0.08logMAR,手术后3个月,UIVA为0.01±0.03,UNVA为0.01±0.03。
    A4AddOn多焦点IOL的二次背负式植入物是寻求老花眼解决方案的单焦点假晶状体患者的有效替代方案。这种沟设计的IOL为近距离和远距离视觉提供了最佳的视觉效果。
    UNASSIGNED: Evaluate the clinical outcomes of the secondary piggyback add-on IOL implantation in the ciliary sulcus for pseudophakic patients previously implanted with a monofocal IOL, who pursue a spectacle-free option after IOL surgery.
    UNASSIGNED: A prospective case series including seven pseudophakic patients who underwent an in-the-bag monofocal IOL implantation. All eyes underwent a piggyback IOL implantation of the new sulcus designed A4 AddOn IOL in the ciliary sulcus as a secondary procedure for pseudophakic patients pursuing a spectacle-free option for near and intermediate distance after IOL surgery.
    UNASSIGNED: Seven eyes from six patients were included in this study, from which 4 (71.43%) were female, with a mean age of 58.33 ± 3.5 years (range 54-63; 95% CI 54.66, 62.01). The postoperative spherical equivalent at the 3-month visit was -0.10 m ± 0.82. Also, the UDVA was 0.11 ± 0.08 logMAR, the UIVA 0.01 ± 0.03, and the UNVA 0.01 ± 0.03 3 months after their surgical procedure.
    UNASSIGNED: The A4 AddOn multifocal IOL\'s secondary piggyback implant is an efficient alternative for monofocal pseudophakic patients seeking presbyopia solutions. This sulcus-designed IOL provides an optimal visual outcome for near and distance vision.
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  • 文章类型: Journal Article
    为了检查过去十年中每个眼科亚专业在一般高级眼科期刊上发表的文章的绝对数量和比例,并检查研究期间的出版趋势。
    2010年1月至2019年12月在选定的一般临床眼科期刊上发表的所有原创文章均纳入研究。审查了所有原始文章的摘要,并认为与11个眼科亚专业中的1个有关。
    共审查了6种期刊和10,232篇摘要。专注于医学视网膜的文章在过去十年中最常见(35.22%),而专注于斜视的文章最不常见(2.11%)。在过去十年中,每年发表的文章总数有所下降(p<0.01)。每年专注于前房的出版物数量显着减少(p=0.012),白内障和屈光手术(p=0.014),眼塑(p<0.01),和斜视(p=0.011)。在过去十年的每一年,出版物的比例最高的是医学视网膜,而大多数年份中出版物的比例最低的是斜视.在这几年中,专注于眼可塑性的文章比例显着下降(p<0.01)。
    在过去的十年中,在高影响因子期刊中,不同眼科亚专业的出版物比例存在差异。这可能源于人口统计学的变化以及诊断和治疗的进步。在所有年份中,专注于医学视网膜的文章比例最高,而专注于斜视的文章比例始终最低。
    UNASSIGNED: To examine the absolute number and the proportions of articles published in general high-ranked ophthalmology journals for each ophthalmic subspecialty during the last decade, and to examine the publishing trends over the study period.
    UNASSIGNED: All original articles published between January 2010 and December 2019 in the selected general clinical ophthalmic journals were included in the study. All abstracts of original articles were reviewed and deemed to be related to 1 of the 11 ophthalmic subspecialties.
    UNASSIGNED: Six journals and 10,232 abstracts were reviewed. Articles focused on medical retina were the most common in the last decade (35.22%) while articles focused on strabismus were the least common (2.11%). The total number of articles published per year decreased during the last decade (p < 0.01). There was a significant reduction in the number of publications per year focused on anterior-chamber (p = 0.012), cataract and refractive-surgeries (p = 0.014), oculoplastic (p < 0.01), and strabismus (p = 0.011). In each year during the last decade, the highest proportion of publications was focused on medical retina while the lowest proportion of publications in most of the years was focused on strabismus. There was a significant decrease during the years in the proportion of articles focused on oculoplastic (p < 0.01).
    UNASSIGNED: During the last decade, there have been differences in the proportion of publications of different ophthalmology subspecialties in high impact factor journals. This probably derives from demographic changes and advances in diagnosis and treatment. The proportion of articles focused on medical retina was the highest during all years while the proportion of articles focused on strabismus was consistently the lowest.
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  • 文章类型: Journal Article
    吸烟是包括白内障和年龄相关性黄斑变性在内的几种眼部疾病的公认危险因素。虽然许多人被告知各种不利的健康影响,关于患者对吸烟与眼病之间关系的认识以及这可能对减少吸烟行为的潜在影响的研究有限。我们的研究结果记录了英国三级眼科单位对吸烟导致失明风险的认识水平低,并强调需要增加眼保健专业人员的参与,同时开展健康运动,教育公众吸烟的后果。
    Smoking is a well-established risk factor for several eye disorders including cataracts and age-related macular degeneration. While many individuals are informed of the various adverse health effects, there is limited research into patients\' awareness of the relationship between smoking and eye disease and the potential impact this might have on reducing smoking behaviour. Our findings document the low level of awareness of the risk of blindness from smoking at a tertiary eye unit in the United Kingdom and highlight the need for increased involvement from eye care professionals, alongside health campaigns to educate the public of this consequence of smoking.
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