refractive surgeries

  • 文章类型: Journal Article
    背景:眼前节参数的评估在眼科手术如眼内手术和隐形眼镜试镜中至关重要。然而,在糖尿病患者中使用托吡卡胺面临挑战,因为其对生物特征测量的潜在影响.这项研究旨在调查和比较0.5%和1%的托吡卡胺对糖尿病患者眼前节参数的影响。
    方法:这项双盲随机临床试验纳入了98名糖尿病患者。参与者被随机分配接受0.5%或1%的托吡卡胺。使用PentacamHR(OculusOptikgeräteGmbH,Wetzlar,德国)在给予托吡卡胺之前和之后30分钟。参数包括前房深度(ACD),前房容积(ACV),前房角(ACA),角膜曲率测量,中央角膜厚度(CCT),白到白距离(WTW),和瞳孔直径(PD)。
    结果:浓度为0.5%和1%的托吡卡胺均引起眼前节参数的显着变化。PD显着增加(分别为2.99±0.62,3.11±0.55,两个P值<0.001),ACD(均为0.10±0.05,均P值<0.001),ACV(分别为16.69±9.56,17.51±9.26,两个P值<0.001),和WTW(分别为0.06±0.14、0.03±0.30,两个P值<0.001),随着ACA的减少(分别为-3.50±10.65,-3.30±6.87,P值<0.001和P值=0.001),和CCT(分别为-6.10±8.06,-6.39±9.97,两个P值<0.001)扩张后。然而,角膜曲率测量无明显变化(前Km(分别为-0.03±0.19,-0.04±0.21),回Km(分别为0.01±0.05,0.004±0.05),P值>0.05)。
    结论:两种浓度的托吡卡胺对糖尿病患者的眼前节参数具有相当的影响。这些扩张后的变化应被考虑,以准确的人工晶状体屈光力计算和白内障的决策,有晶状体眼人工晶状体,和屈光手术。
    BACKGROUND: Evaluation of anterior segment parameters is crucial in ophthalmic procedures such as intraocular surgeries and contact lens fitting. However, the use of tropicamide in diabetic patients presents challenges due to its potential impact on biometric measurements. This study aims to investigate and compare the effects of 0.5% and 1% tropicamide on anterior segment parameters in diabetic patients.
    METHODS: This double-masked randomized clinical trial enrolled 98 patients with diabetes mellitus. Participants were randomly assigned to receive either 0.5% or 1% tropicamide. Anterior segment parameters were measured using Pentacam HR (Oculus Optikgeräte GmbH, Wetzlar, Germany) before and 30 minutes after tropicamide administration. Parameters included anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle (ACA), keratometry, central corneal thickness (CCT), white-to-white distance (WTW), and pupillary diameter (PD).
    RESULTS: Both concentrations of 0.5% and 1% tropicamide induced significant changes in anterior segment parameters. There was a notable increase in PD (2.99 ± 0.62, 3.11 ± 0.55, respectively, both P-values < 0.001), ACD (both 0.10 ± 0.05, both P-values < 0.001), ACV (16.69 ± 9.56, 17.51 ± 9.26, respectively, both P-values < 0.001), and WTW (0.06 ± 0.14, 0.03 ± 0.30, respectively, both P-values < 0.001), along with a decrease in ACA (-3.50 ± 10.65, -3.30 ± 6.87, P-value < 0.001 and P-value=0.001, respectively), and CCT (-6.10 ± 8.06, -6.39 ± 9.97, respectively, both P-values < 0.001) post-dilation. However, no significant changes were observed in keratometry (front Km (-0.03 ± 0.19, -0.04 ± 0.21, respectively), back Km (0.01 ± 0.05, 0.004 ± 0.05, respectively), P-values> 0.05).
    CONCLUSIONS: Both concentrations of tropicamide exhibited comparable effects on anterior segment parameters in diabetic patients. These post-dilation changes should be considered for accurate intraocular lens power calculation and decision-making for cataract, phakic intraocular lens, and refractive surgeries.
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  • 文章类型: Journal Article
    本研究旨在介绍沙特成年人口对屈光手术的认识程度和决定因素,并建议提高知识水平。
    这项基于网络的横断面研究是在2020年6月至2021年5月之间在沙特阿拉伯各个地区对成年沙特人口进行的。共有11个关于适应症的封闭式问题,禁忌症,准备和手术程序被要求。意识得分分为“好”(≥6)或“差”(≤5)。人口统计学和眼部参数与结果相关。
    在6,746名参与者中,6,580(回复率=97.5%)完成了调查。年轻妇女和老年男子的参与率高于其在人口中的比例,而老年妇女参与的比例低于她们的比例。1,165名(17.7%;95%置信区间:16.2-18.0)参与者对屈光手术有良好的认识。女性(P<0.001),18-29岁年龄组(P<0.001),沙特阿拉伯中部地区居民(P<0.001),卫生专业人员(P<0.001),卫生部门学生(P=0.0004),近视(P<0.001)和屈光手术史(P<0.001)的人与良好的认知相关。女性(调整后的比值比[AOR]=1.5;P<0.001),卫生部门学生(AOR=1.57;P<0.001),和中部地区居民(AOR=1.27;P<0.001)是知晓率的独立预测因子。超过三分之一的参与者对手术禁忌症的了解很好。在535名过去接受手术的参与者中,452人(84.5%)对他们的结果感到满意。
    沙特成年人口对屈光手术的认识很低。建议有针对性的咨询,以提高屈光手术的知识和接受度。
    UNASSIGNED: This study aimed to present the magnitude and determinants of awareness about refractive surgery among the adult Saudi population and recommend knowledge improvement.
    UNASSIGNED: This web-based cross-sectional study was conducted between June 2020 and May 2021 across various regions of Saudi Arabia on the adult Saudi population. A total of 11 close-ended questions regarding indication, contraindication, preparation and surgery procedures were asked. The awareness scores were grouped as \'good\' (≥6) or \'poor\' (≤5). Demographic and ocular parameters were associated with the outcomes.
    UNASSIGNED: Of the 6,746 participants, 6,580 (response rate = 97.5%) completed the survey. The participation of younger women and older men was greater than their proportions in the population, while older women participated less than their proportion. Good awareness about refractive surgery was noted in 1,165 (17.7%; 95% confidence interval: 16.2-18.0) participants. Women (P <0.001), the 18-29 age group (P <0.001), residents of the central region of Saudi Arabia (P <0.001), health professionals (P <0.001), health sector students (P = 0.0004), people with myopia (P <0.001) and history of refractive surgery (P <0.001) were associated with good awareness. Women (adjusted odds ratio [AOR] = 1.5; P <0.001), health sector students (AOR = 1.57; P <0.001), and residents in the central region (AOR = 1.27; P <0.001) were independent predictors of awareness. Knowledge about contraindications for surgery was good in more than one-third of the participants. Of the 535 participants who underwent surgery in the past, 452 (84.5%) were satisfied with their outcomes.
    UNASSIGNED: Awareness of refractive surgeries is low in the adult Saudi population. Targeted counseling is recommended to improve the knowledge and acceptance of refractive surgery.
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  • 文章类型: Journal Article
    背景技术老花眼是由于晶状体内的调节丧失而产生的生理状况。调节机制最广泛接受的理论之一是响应睫状肌收缩,晶状体厚度增加,透镜直径减小,晶状体的前后曲率都增加了,因此,导致透镜状力量的增加,住宿。对比理论表明,睫状肌收缩导致赤道小带张力的选择性增加,随着晶状体赤道向巩膜移动,晶状体赤道直径增大。这导致透镜光焦度的变化。直到现在,矫正老花眼的临床方法包括单视,多焦点,和扩展的聚焦深度,所有这三种都可以通过角膜手术或晶状体手术来实现。方法这是一项横断面研究,在塔伊夫市接受过Presbyond手术的患者中进行,沙特阿拉伯,年龄在40岁以上。数据是通过进行电话访谈来收集的,目的是通过准备好的问卷来提高反应率,该问卷被研究以实现参与者之间的平等,以确定他们对手术后的结果是否满意。联系信息是根据接受Presbyond手术的患者的医院记录检索的。使用IBMSPSSStatisticsforWindows分析数据,版本22(2013年发布;IBMCorp.,Armonk,纽约,美国)。数据是从2019年1月1日开始到2023年2月1日收集的。结果从研究结果来看,大量参与者(28.1%,n=25)报告在手术后1-30天内经历完全改善并恢复正常生活。略大的百分比(39.2%,n=35)在1-3个月内经历了这种情况。大多数参与者(80.9%,n=72)报告了手术后其生活质量的总体改善。这包括阅读和使用移动电话等活动。这表明手术对他们的日常生活和活动产生了积极影响。在建议方面,共有49人(55.1%,n=49)参与者表示,他们很可能向遇到视力问题的家庭成员或朋友推荐屈光手术。研究发现,手术一个月后患者的平均满意度评分比手术前的平均满意度评分高2.494个单位。这种差异具有统计学意义(p<.001)。结论大多数参与者在手术期间没有出现任何问题,大多数人能够在相对较短的时间内恢复正常活动。手术达到了大多数参与者的目标,从而提高了他们的生活质量。然而,报告了一些短期不适或调整期.总的来说,参与者对手术感到满意,大多数人很可能会推荐给其他人。在解决视力模糊等问题方面还有改进的空间,需要眼镜,和干涩的眼睛。研究还发现,手术一个月后患者满意度显著提高,完全改善的时机和实现手术目标的感知与感知结果密切相关.
    Background Presbyopia is a physiological condition arising due to the loss of accommodation within the crystalline lens. One of the most widely accepted theories of the mechanism of accommodation was that in response to ciliary muscle contraction, the crystalline lens thickness increases, the lens diameter decreases, and both the anterior and posterior curvature of the lens increase, resulting in an increase in lenticular power therefore, accommodation. A contrasting theory suggests that ciliary muscle contraction leads to a selective increase in equatorial zonular tension, with the lens equator moving toward the sclera and the equatorial diameter of the lens increasing. This results in a change of lens optical power. Until now, clinical approaches to correct presbyopia have included monovision, multifocality, and extended depth of focus, all three of which can be achieved surgically on the cornea or by lens surgery. Methods This was a cross-sectional study adopted among patients who had Presbyond surgery in Taif City, Saudi Arabia, and were aged 40 years and older. The data was collected by conducting phone interviews to increase the response rate with a prepared questionnaire that was studied to achieve equality between participants to determine whether they were satisfied or not about the results after this surgery. The contact information was retrieved based on hospital records about patients who underwent Presbyond surgery. Data was analyzed using IBM SPSS Statistics for Windows, Version 22 (Released 2013; IBM Corp., Armonk, New York, United States). The data was collected for the period beginning on the first of January 2019 until the first of February 2023. Results From the study findings, a significant number of participants (28.1%, n=25) reported experiencing complete improvement and returning to normal life within 1-30 days after surgery. A slightly larger percentage (39.2%, n=35) experienced this within 1-3 months. Most of the participants (80.9%, n=72) reported an overall improvement in their quality of life after the surgery. This included activities such as reading and using a mobile phone. This indicates that the surgery had a positive impact on their daily lives and activities. In terms of recommendations, a total of 49 (55.1%, n=49) participants stated that they were very likely to recommend refractive surgery to a family member or friend experiencing vision problems. The study found that the mean patients\' satisfaction score after one month of surgery is 2.494 units higher than the mean satisfaction score before surgery. This difference was statistically significant (p < .001). Conclusion The majority of participants did not experience any problems during the surgery, and most were able to resume their normal activities within a relatively brief period of time. The surgery achieved its goals for the majority of participants, resulting in an improvement in their quality of life. However, some short-term discomfort or adjustment period was reported. Overall, the participants were satisfied with the surgery, with the majority being very likely to recommend it to others. There is room for improvement in addressing concerns such as blurred vision, the need for glasses, and dry eyes. The study also found that patient satisfaction increased significantly after one month of surgery, and the timing of complete improvement and perception of achieving surgical goals were strongly associated with perceived outcomes.
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  • 文章类型: Journal Article
    目的比较经上皮屈光性角膜切削术(PRK)与酒精辅助PRK治疗伴有或不伴有散光的中低至中度近视的视觉效果。设置Dhahran眼科专科医院,达兰,沙特阿拉伯。设计这是一项回顾性研究。方法对22例屈光度为-0.75至-6.00的近视患者40只眼进行研究,其中有或没有散光为0至-3D。收集并分析了11例接受跨上皮PRK的患者的20只眼的术前和术后数据,并与11例接受酒精辅助PRK的患者的20只眼进行了比较。未矫正的远距视力(UDVA),矫正视力(CDVA),明显球形等价(SE),清单气瓶,散光的矢量分析,术后平均随访1年,比较两组间的疗效和安全性指数.结果组间基线特征相似,除了跨上皮PRK组比酒精辅助PRK组低0.69D的圆柱体值。回归分析用于控制所有结果参数的圆柱体差异。两组的平均UDVA相似(p=0.73),CDVA(p=0.98),两组中达到(20/20,20/25和20/30)UDVA的眼睛比例(分别为p=0.72,0.68和0.31)和失去两行CDVA的眼睛百分比(p=1.0).在疗效和安全性指数方面,两组之间没有统计学上的显着差异(分别为p=0.55和0.67)。两组的残余SE相似(p=0.72),SE±0.5D范围内的眼睛比例(p=0.29),和残余屈光散光(p=0.87)。两组都有相似的差异向量,手术引起的散光,和校正指数(分别为p=0.82、0.10和0.26)。然而,经上皮PRK组有较低的靶诱导散光(TIA;p=0.01),较高的误差幅度(ME;p=0.05),与酒精辅助PRK组相比,误差角(AE;p=0.02)更高。结论经上皮PRK与酒精辅助PRK具有相似的视觉和屈光结果。这种方法被认为与酒精辅助PRK治疗伴有或不伴有散光的中低度近视患者一样安全有效。
    Purpose To compare the visual outcome of transepithelial photorefractive keratectomy (PRK) against alcohol-assisted PRK in treating low-to-moderate myopia with or without astigmatism. Setting Dhahran Eye Specialist Hospital, Dhahran, Saudi Arabia. Design This is a retrospective study. Methods Forty eyes of 22 patients with myopia from -0.75 to -6.00 diopters (D) with or without astigmatism from 0 to -3D were included in this study. Preoperative and postoperative data of 20 eyes from 11 patients who underwent transepithelial PRK were compared with 20 eyes from 11 patients who underwent alcohol-assisted PRK were collected and analyzed. The uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest spherical equivalence (SE), manifest cylinder, vector analysis of astigmatism, and efficacy and safety indices were compared between the groups at a mean follow-up of one year postoperatively. Results Baseline characteristics were similar between groups, except the transepithelial PRK group had lower cylinder values than the alcohol-assisted PRK group by 0.69D. Regression analysis was used to control for the difference in the cylinder in all outcome parameters. Both groups had similar mean UDVA (p=0.73), CDVA (p=0.98), the proportion of eyes in either group achieved (20/20, 20/25, and 20/30) UDVA (p=0.72, 0.68 and 0.31 respectively) and percentage of eyes lost two lines of CDVA (p=1.0). There was no statistically significant difference between the two groups in regard to both efficacy and safety indices (p=0.55 and 0.67, respectively). Both groups had similar residual SE (p=0.72), the proportion of eyes within ±0.5D of SE (p=0.29), and residual refractive astigmatism (p=0.87). Both groups had similar difference vectors, surgically induced astigmatism, and correction index (p=0.82, 0.10, and 0.26, respectively). However, the transepithelial PRK group had lower target-induced astigmatism (TIA; p=0.01), higher magnitude of error (ME; p=0.05), and higher angle of error (AE; p=0.02) than the alcohol-assisted PRK group. Conclusion Transepithelial PRK had similar visual and refractive outcomes as alcohol-assisted PRK. This approach was considered as safe and effective as alcohol-assisted PRK in treating patients with low-to-moderate myopia with or without astigmatism.
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  • 文章类型: Journal Article
    UNASSIGNED: Refractive errors are the most common vision problem and prove to be a significant health issue. There are several methods for correction of refractive errors including spectacles, contact lenses and refractive surgery. Nowadays, the reliance on contact lenses and glasses is decreased by means of refractive eye surgery. Our study aimed to determine the awareness of refractive surgery among undergraduate medical students and their preferred method of refractive error correction.
    UNASSIGNED: This was a cross-sectional study that was conducted among a sample size of 374 medical students at King Abdul-Aziz University Hospital, Jeddah, Saudi Arabia in June-August 2020. Data were collected through a questionnaire which consisted of 20 questions to assess the demographics, awareness about refractive surgery and preferred method of correction. The data were entered using Microsoft Excel 2016 and analyzed by SPSS version 21.
    UNASSIGNED: Our results showed that 177 of participants had refractive errors. Most participants complained of myopia (66.7%) and the most preferred correction method was spectacles (45.8%). Among users of spectacles, 53.7% found the spectacles comfortable due to ease of use. Majority of the students (92.1%) were aware of refractive surgery and 73% of them were willing to undergo refractive surgery. Many obtained their information regarding these procedures from family and friends (55.1%). The remaining refused to undergo surgery and the primary reason was fear of the complications of the procedure (14.1%).
    UNASSIGNED: Though corrective refractive surgery is a commonly performed procedure, extensive knowledge regarding this correction method and its complications is poor among medical students. The results showed that the majority have heard of refractive surgery, however, fear of undergoing surgery was still present. We suggest that refractive error correction surgery be taught by physicians during Ophthalmology rotations so that knowledge may be gained from more reliable sources.
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  • 文章类型: Journal Article
    评估成人近视和近视散光受试者的前角膜和眼球残余散光对自屈光散光的贡献以及它们如何相互补偿。
    这项回顾性研究是在私人眼睛中心完成的,伊斯梅利亚,埃及,2017年9月至2019年11月。该研究包括近视(0.5至10.0D)或近视散光(0至8.5D)的眼睛。屈光不正,包括自屈光散光,在使用1%环戊酸酯与自动折射仪(Topcon,东京光学有限公司Ltd.,日本)。角膜地形图(天狼星;CSO,佛罗伦萨意大利)用于测量角膜前散光。通过从角膜平面确定的自屈光散光中矢量减去前角膜散光来测量眼部残留散光。
    这项研究包括582名参与者(206名男性,406只眼,376名女性,752只眼)的1158只眼睛(右582只和左576只)患有近视或近视散光。参与者的平均±SD年龄为26±5.7岁,范围(21至50年)。球面误差的平均值±SD为-3.2±1.9D,范围(-0.5至-10.0D)。自屈光散光的平均值±SD为1.13±1.1D;范围(0.5至8.5D)。前角膜散光的平均值±SD为1.22±0.8D;范围(0.03至5.6D)。眼球残余散光的平均值±SD为0.6±0.5D;范围(0至4.8D)。在整个眼睛中,75.4%有明显的自屈光散光,82.5%有明显的角膜前散光,16.8%有明显的眼球残余散光。
    明显的自屈光散光(>0.5D)的百分比为75.4%,主要是前角膜。在26.8%的参与者中,角膜前散光由眼球残余散光补偿。
    UNASSIGNED: To evaluate the contributions of anterior corneal and ocular residual astigmatism to autorefraction astigmatism in adult myopic and myopic astigmatic subjects and how these compensate each other.
    UNASSIGNED: This retrospective study was completed in private eye centre, Ismailia, Egypt, between September 2017 and November 2019. The study included eyes with myopia (0.5 to 10.0D) or myopic astigmatism (0 to 8.5D). The refractive errors, including autorefraction astigmatism, were measured after using 1% cyclopentolate with autorefractometer (Topcon, Tokyo Optical Co., Ltd., Japan). Corneal topography (Sirius; CSO, Florence, Italy) was used to measure anterior corneal astigmatism. Ocular residual astigmatism was measured by vectorial subtraction of the anterior corneal astigmatism from autorefraction astigmatism determined to the corneal plane.
    UNASSIGNED: This study included 1158 eyes (right 582 and left 576) with myopia or myopic astigmatism of 582 participants (206 males with 406 eyes and 376 females with 752 eyes). The mean±SD age of the total participants was 26±5.7 years, range (21 to 50 years). The mean±SD of spherical error was -3.2±1.9D, range (-0.5 to -10.0D). The mean±SD of autorefraction astigmatism was 1.13±1.1D; range (0.5 to 8.5D). The mean±SD of anterior corneal astigmatism was 1.22±0.8D; range (0.03 to 5.6D). The mean±SD of ocular residual astigmatism was 0.6±0.5D; range (0 to 4.8D). Of the total eyes, 75.4% had significant autorefraction astigmatism, 82.5% had significant anterior corneal astigmatism, and 16.8% had significant ocular residual astigmatism.
    UNASSIGNED: The percentage of the significant autorefraction astigmatism (>0.5D) was 75.4% which is mainly anterior corneal. In 26.8% of participants, anterior corneal astigmatism is compensated by ocular residual astigmatism.
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