中低度近视FS-LASIK、SMILE及ICL植入术的效果比较

目的比较飞秒激光制瓣准分子激光原位角膜磨镶术(FS-LASIK)、全飞秒激光小切口角膜基质透镜取出术(SMILE)和有晶状体眼后房型人工晶状体(ICL V4c)植入术三者矫正中低度近视的效果。方法采用回顾性研究。以惠州爱尔眼科医院2019年6月至2020年4月矫正中低度近视120例(120眼)作为研究对象,受术者分为FS-LASIK组、SMILE组及ICL组,每组40例(40眼),各组分别接受相应的手术,术后随访3个月比较其矫正效果。结果术后1个月及3个月,3组间视力及有效性指数对比差异无统计学意义(P>0.05);ICL组安全性指数高于SMILE组及FS-LASIK组(P<0.05)。术后3个月FS-LASIK组的三叶草像差、彗差和球差出现明显变化,而SMILE组的变化较小,ICL组变化最小(P<0.05)。结论对中低度近视FS-LASK、SMILE及ICL植入术三者均有确切疗效,而ICL V4c植入术的安全性最高,患者的视觉质量最好。     

Exposición al aire libre en niños de la Provincia de Buenos Aires,Argentina

ObjectivesTo evaluate myopia risk factors, mainly outdoor exposure and reading habits, in a country with low prevalence of myopia (Buenos Aires Province, Argentina).MethodsConsecutive children interviewed in a clinical private practice setting were autorefracted under cycloplegia with cyclopentolate 1%. Their parents consented to fill a questionnaire about schooling, tutorial classes, outdoor exposure, reading habits, and cellphone use, both on weekdays and weekends. The Spanish questionnaire was based on past English questionnaires of myopia clinical trials. The spherical equivalent of the right eye was used for the refractive distribution. The average daily hours spent for each activity were calculated.ResultsThis study involved 115 children aged 10.48±3.65 years (range 5 to 18 years), with 56.5% being girls. Children had 8 h of schooling per day in 62.6% of cases, and only 14.8% had tutorial classes after school. There were 38.3% myopes (< ?0.50 D), 24.3% hyperopes (> +2.00 D) and the rest were emmetropes. The mean time that these children spent outdoors per day was 3.94±1.45 hs. (27.60±10.16 hs. per week). The total mean time spent reading and writing per day was 1.50±0.98 h, and that spent using cellphones and tablets was 2.43±1.66 h.ConclusionIn an environment with low myopia prevalence, children spend almoast 4 hours per day outdoors, much more than the usual recommendation of 2 hours a day for myopia prevention.     

重视角膜屈光手术操作规范及并发症防治

当今各种治疗近视眼技术的手段很多,激光角膜屈光手术是矫正屈光不正的重要方式之一。屈光手术中任何环节的质量控制对手术成功与否、减少并发症至关重要。严格的手术适应证把控、个性化的手术方式选择、规范的围手术期处方用药等等都有助于手术质量提高,保证整体手术安全。     

充分认识后巩膜加固术的临床价值

在科技高速发展的今天,临床对高度近视眼的屈光矫正虽然有许多较好的解决方法,但矫正后往往仍有屈光进展;对于高度近视眼底病变虽有一些先进的治疗技术在应用,但往往难以逆转和控制已发生的眼底病变,成为患者致盲的主要威胁.而从临床观察角度来看,高度近视的屈光进展及眼底病变的发生和加重与患者的病程进展有关,屈光进展是后巩膜扩张眼轴延长引起的,眼底病变是脉络膜、视网膜对抗后巩膜扩张的表现.后巩膜加固术作为控制后巩膜扩张的方法,其机制的合理性毋容置疑,但既往受科技发展水平的限制,术式和材料难以符合手术机制的要求,不能发挥其真正的作用,故未能得到临床的广泛认同.近年来随着术式和材料的改进,后巩膜加固术稳定眼轴和治疗黄斑劈裂、裂孔、脱离等方面的疗效,在进一步地得到证实和肯定.临床应重视对高度近视病程进展进行控制,充分认识后巩膜加固术的临床价值,把控制和治疗高度近视眼底病变作为手术适应证选择的要旨在临床稳步开展.随着术式和材料的逐步改进和规范,后巩膜加固术的临床疗效将不断提高,有望成为高度近视盲防控的一项关键技术.