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1.
PURPOSE: To evaluate the effects of bevacizumab pretreatment combined with intravitreal infusion of C3F8 10% on the clearance speed of early postoperative vitreous hemorrhage in diabetic vitrectomy for eyes with active fibrovascular proliferation. DESIGN: Prospective, nonrandomized, comparative case study. METHODS: Sixteen eyes (15 patients) that underwent primary pars plana vitrectomy for active proliferative diabetic retinopathy (PDR) were prospectively enrolled with a follow-up period of six months or more. These cases received an intravitreal injection of bevacizumab (1.25 mg/0.05 ml) one week prior to surgery and intravitreal C3F8 10% infusion during surgery. The severity of intraoperative bleeding, vitreous clear-up time, percentage of prolonged vitreous clear-up (> or = three weeks), and recurrent hemorrhage respectively were compared with those in a control group (24 eyes in 24 patients) that received gas infusion alone. RESULTS: The severity of intraoperative bleeding was significantly lower in the study group than in the control group. Vitreous clear-up time for the study group and the control group was 7.2 +/- 5.6 days and 15.2 +/- 11.4 days, respectively (P = .04). Prolonged vitreous clear-up time (> or = three weeks) was observed in one of 16 (6.3%) and nine of 24 (37.5%) of the cases, respectively (P = .03). Early recurrent vitreous hemorrhage rates in the two groups were zero of 16 (0%) and one of 24 (4.2%), respectively (P = .41). Multiple logistic regression analyses showed that bevacizumab pretreatment reduced vitreous clear-up time. CONCLUSIONS: Bevacizumab pretreatment combined with C3F8 10% infusion could be an effective adjunct to vitrectomy in accelerating postoperative vitreous clear-up for eyes with active PDR.  相似文献
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AIMS: The purposes of this study are to describe the visual outcome of highly myopic eyes undergoing cataract surgery, to investigate associated risk factors for poor postoperative vision and to assess the postoperative complication frequency among the myopic Taiwanese population. METHODS: We conducted a retrospective, noncomparative case series study at the Department of Ophthalmology, Zhongxing Branch, Taipei City Hospital, Taiwan. High myopia was defined as axial length > or =26.0 mm. The main study outcomes were visual acuity for the initial 6-month postoperative period (including visual acuities and improvement of postoperative vision) and postoperative complications (including subsequent cataract formation and postoperative retinal detachment). RESULTS: Fifty-two highly myopic eyes were enrolled between January 2002 and December 2004. The mean follow-up interval was 43.3 +/- 20.2 weeks (range 25-103). Thirty-two eyes (61.5%) had good postoperative visual improvement (> or =4 lines of Snellen chart). Thirty-seven eyes (71.2%) achieved good postoperative vision (20/40 or better). Fifteen eyes (28.8%) demonstrated poor postoperative vision. Pre-existing maculopathy was an independent risk factor for failure to achieve good postoperative vision [odds ratio (OR): 6.84, 95% confidence interval (CI): 1.12-41.8] and improvement (OR: 16.1, 95% CI: 2.2-119.9). Diabetic history was considered another independent risk factor for poor postoperative vision (OR: 15.6, 95% CI: 0.97-267.6). Six eyes (11.5%) developed subsequent posterior capsular opacification requiring Nd:YAG laser capsulotomy. Two eyes (3.8%) developed retinal detachment during follow-up. CONCLUSIONS: Most highly myopic eyes achieved good visual improvement and good postoperative visual acuity after cataract surgery. Pre-existing maculopathy was an independent risk factor of postoperative visual improvement and status. It is crucial to examine retinal status prior to cataract surgery to prevent poor vision improvement, poor postoperative vision or retinal complications.  相似文献
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BACKGROUND: To compare the effects of perceptual learning or patching on improving visual acuity and contrast sensitivity in patients with anisometropic amblyopia. METHODS: Patients with anisometropic amblyopia received either patching or perceptual learning treatment. Corrected amblyopic logMAR visual acuity and contrast sensitivity function were measured at four-weekly intervals until visual acuity stabilized or amblyopia resolved. Improvements in visual acuity, contrast sensitivity and resolution of amblyopia were compared between the two groups. RESULTS: The mean visual acuities of the amblyopic eyes improved by 0.34 logMAR (95% CI: 0.22-0.47 logMAR) with patching and 0.25 logMAR (95% CI: 0.16-0.35 logMAR) with perceptual learning (p=0.125). Resolution of amblyopia was achieved in 10 of 26 patients (38%) in the perceptual learning group and 17 of 27 patients (63%) in the patching group (p=0.809). Amblyopia improved by two or more lines in 20 of 26 (76%) patients in the perceptual learning group and 26 of 27 (96%) patients in the patching group (p=0.0001). The mean time for patching was 37.3 weeks (522.2 h) and the average number of training sessions in the perceptual learning group was 48 (29.5 h) (p=0.0001). CONCLUSIONS: Visual acuity can be improved with perceptual learning and patching in older children and adult patients with anisometropic amblyopia. The improvements in visual acuity achieved with patching were one line better than those achieved with perceptual learning. Perceptual learning might provide an alternative treatment in patients with anisometropic amblyopia.  相似文献
4.
AIMS—To report the special clinical manifestations and determine the appropriate management of infectious scleral ulceration.
METHODS—A retrospective study was performed on 30 eyes with infectious scleral ulceration. Information was recorded on patients' age, onset and course of disease, pathogenic organism, clinical presentations, methods of diagnosis, treatment, and outcome.
RESULTS—10 cases (33.3%) were accompanied by corneal involvement. Subconjunctival abscess was noted in 16 cases (53.3%). 17 cases (56.7%) gave positive results of pathogen culture and all were Pseudomonas aeruginosa. Two cases had combined bacterial infections and one case was complicated by fungal infection. A total of 26 cases had surgical debridement in this series. Extensive involvement of the sclera with the presence of a `tunnel lesion' or a `satellite subconjunctival abscess' were found during debridement. All of the eyeballs involved were salvaged except one.
CONCLUSION—The results of this study were contrary to the poor prognosis presented in previous reports. Early and repetitive surgical debridement is believed to be mandatory in the intractable cases to shorten the admission period and to save these eyes.

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Purpose  To report our experience with combined use of balloon dacryocystoplasty and monocanalicular intubation with Monoka tubes for treating congenital nasolacrimal duct obstruction. Design  Retrospective consecutive interventional case series. Materials and methods  This retrospective study consisted of 25 consecutive pediatric patients with congenital nasolacrimal duct obstruction who underwent balloon dacryocystoplasty and monocanalicular intubation with Monoka tubes between November 2003 and November 2006. Outcome evaluations included an ophthalmologic examination and a dye appearance test postoperatively. Age, history of a prior probing and complications related to the main outcome were also analyzed. Results  Thirty-three eyes of 25 patients aged 8 months to 9 years (3.5 ± 2.4 years old) were included. Of the obstructed ducts treated, 97% (32/33) showed complete resolution of epiphoria. When analyzed by age groups, patients more than 1 year of age had higher success rate (30 successes in 30 patients) than patients less than 1 year of age (two successes in three patients). Statistical analysis revealed no statistically significant difference in success rate between both age groups (p = 0.09). The mean duration of intubation was 5.7 ± 2.2 months. No significant complication was noted, except that early tube dislodgements occurred in six out of 31 Monoka intubations (19%). Conclusions  The combined use of balloon dacryocystoplasty and monocanalicular intubation with Monoka tubes is an effective procedure for children with congenital nasolacrimal duct obstruction after failure of conservative treatment or probing.  相似文献
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PURPOSE: To compare vision-related quality of life and higher-order aberrations (HOAs) with an aspherical intraocular lens (IOL) (AcrySof IQ SN60WF) and a conventional spherical IOL (AcrySof SA60AT) (both Alcon) after phacoemulsification. SETTING: Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan, Republic of China. METHODS: Sixty-five patients were prospectively randomized to receive an Alcon AcrySof IQ SN60WF IOL (30 eyes) or an AcrySof SA60AT IOL (35 eyes). All patients had a complete ophthalmologic examination including uncorrected visual acuity, best spectacle-corrected visual acuity (BSCVA), and wavefront analysis preoperatively and 3 months postoperatively. Patients also completed the National Eye Institute Visual Functioning Questionnaire (NEI VFQ-25) to evaluate vision-related quality of life. RESULTS: The mean postoperative BSCVA (logMAR) was 0.09 +/- 0.07 (SD) in the aspherical IOL group and 0.12 +/- 0.08 in the spherical IOL group; the difference was not statistically significant. Spherical aberrations were statistically significantly lower in the aspherical IOL group (mean 0.12 +/- 0.23 microm) than in the spherical IOL group (mean 0.33 +/- 0.20 microm) (P = .001). Both IOL types improved most aspects of patients' vision-related quality of life. The aspherical IOL group had clinically significant improvement on more NEI VFQ-25 subscales, although the difference between groups in vision-related quality of life was not statistically significant. CONCLUSION: Eyes with the aspherical AcrySof IQ SN60WF IOL had reduced HOAs and spherical aberrations compared with eyes with the spherical AcrySof SA60AT IOL; however, there were no statistically significant differences in visual acuity or vision-related quality of life between groups.  相似文献
9.
PURPOSE: To explore inflammation and wound healing in the rabbit eye following topical ethanol treatment or mechanical debridement. METHODS: Seventy-six pigmented rabbit corneas were divided into four groups: mechanical group (n = 33), which received mechanical epithelial debridement; ethanol-30 (n = 18) and ethanol-60 groups (n = 18), which were treated with 20% ethanol for 30 and 60 seconds, respectively; and control group (n = 7), which remained untreated. Corneal epithelial and stromal keratocyte changes were examined with hematoxylin-eosin and terminal deoxynucleotidyltransferase-mediated dUPT nick end labeling (TUNEL) staining at 3 hours (day 0) and days 1, 2, 3, 5, and 7. Interleukin (IL)-1alpha, IL-8, monocyte chemotactic protein (MCP-1), and transforming growth factor (TGF)-beta1 expression were examined using real-time polymerase chain reaction. RESULTS: Stromal keratocyte cell death was higher in the mechanical group on day 0 (P = .002) and in the ethanol-60 group on days 3, 5, and 7 (P < .05). Keratocyte cell death was more pronounced in the ethanol-60 group than in the ethanol-30 group. In the mechanical group, IL-1alpha, IL-8, and MCP-1 expression was up-regulated starting on day 0 (P < .05) and returned to baseline on day 5 to 7. TGF-beta1 expression was up-regulated in the mechanical group throughout the experiment (P < .05). In the ethanol-30 and ethanol-60 groups, IL-1alpha expression was up-regulated on day 0, IL-8 expression was slightly up-regulated on day 0, and MCP-1 and TGF-beta1 expression were not up-regulated. CONCLUSIONS: Mechanical epithelial removal initially induces more keratocyte cell death, but deep stromal keratocyte death persists longer with ethanol treatment. In this rabbit model, mechanical epithelial removal upregulated inflammatory cytokines and TGF-beta1 gene expression more than ethanol treatment.  相似文献
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PURPOSE: Pterygium is an invasive and highly vascularized growth, thought to arise from activated and proliferating limbal epithelial stem cells. Epidemiologic studies have found the increase of active angiogenic and epithelial growth factors in pterygia, and implicated that these molecules could be involved directly or indirectly in the pathogenesis of pterygia as causative factors. The aim of this study was to investigate the association of polymorphisms of transforming growth factor (TGF) and vascular endothelial growth factor (VEGF) with pterygium. METHODS: A total of 133 pterygium patients and 105 volunteers without pterygium were enrolled in this study. Polymerase chain reaction based restriction fragment length polymorphism analysis was used to resolve the TGF-Beta1-509 and VEGF-460 genotypes. RESULTS: There was no significant difference in the allele frequency or genotype of TGF-Beta1-509 or VEGF-460 between total pterygium and the control group. No interaction between TGF-Beta1-509 and VEGF-460 was found either. CONCLUSIONS: These results indicate that TGF-Beta1-509 and VEGF-460 polymorphisms were not highly associated with the pathology of pterygium. However, it may still be worthwhile to continue to search for angiogenic gene polymorphisms in order to predict the development of pterygium.  相似文献
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