白内障术后生物学参数变化及IOL计算公式的准确性研究

目的：运用新型光学生物测量仪IOL Master 700测量白内障超声乳化手术前后眼部生物学参数的变化，并探讨人工晶状体(IOL)屈光度数计算公式的选择。

方法：前瞻性研究。收集2021-01/06在苏州大学附属第一医院就诊的白内障患者52例57眼。术前和术后3mo使用IOL Master 700完成眼轴长度(AL)、前房深度(ACD)、角膜曲率(Km)的测量并分析。对不同IOL公式计算时预留的目标屈光值与术后3mo全自动验光仪实际屈光值结果进行比较并分析。

结果：手术前后测量的AL平均值分别为24.20±1.86、24.09±1.86mm，术后AL缩短了0.11mm； ACD值分别为3.08±0.44、4.55±0.36mm(P<0.001)，术后ACD加深1.49mm； Km值分别为44.14±1.86、44.14±1.82D(P>0.05)。术前选用Barrett Universal Ⅱ公式所测结果的屈光误差最小，其次是Holladay Ⅱ及SRK/T公式，Holladay Ⅰ公式所测结果的误差最大(P<0.05)。

结论：白内障术后AL缩短以及ACD加深，度数测算时可考虑增加0.1mm的校正因子。IOL屈光度数计算公式中Barrett Universal Ⅱ公式预测性最佳，其次是Holladay Ⅱ及SRK/T公式。     

Understanding congenital vertical talus

Congenital vertical talus (CVT) is a rare foot deformity that presents with a rigid flat foot at birth. CVT can present as an isolated abnormality in the newborn, however in at least 50% of cases in association with other conditions. Full neuro-axial imaging is essential to detect any associated neurologic problems. Radiographs of the foot, including forced plantar and dorsiflexion laterals, are diagnostic. Gold standard modern treatment uses the Dobbs method of serial manipulation and casting with minimally-invasive stabilization of the talonavicular joint and Achilles tendon tenotomy.     

The complete spectrum of pentalogy of Cantrell in one of a set of dizygotic twins: A case report of a rare congenital anomaly

Rationale:Pentalogy of Cantrell (POC) is an extremely rare syndrome with an estimated incidence of 1:65,000 to 200,000 live births. Its complete form includes a midline epigastric abdominal wall defect, defects affecting the lower sternum, anterior diaphragm, diaphragmatic pericardium, and various intracardiac defects.Patient concerns:We report a case of complete POC affecting only the first-born of a set of premature dizygotic twins.Diagnosis:A giant omphalocele with an eviscerated liver and bowel on prenatal, obstetric ultrasonography at 24 gestational weeks was observed. At birth, physical examination confirmed a massive (10 × 8 cm) epigastric omphalocele in which a significant part of the liver was seen. A postnatal echocardiogram revealed the presence of an ostium secundum atrial septal defect, perimembranous ventricular septal defect, and moderate pulmonary stenosis. X-ray showed an abnormal intrathoracic positioned stomach, which was confirmed with a plain x-ray of the upper intestinal tract with hydrosoluble contrast. Computed tomography (CT) scan revealed the sternum''s absence and a close connection between the pericardial sac and the stomach wall.Interventions:The patient underwent surgical intervention at 18 days of age.Outcomes:Despite adequate and appropriate postoperative treatment, the baby rapidly deteriorated and died 72 hours after surgery.Lessons:POC is a complex, high-mortality syndrome whose management requires a multidisciplinary approach and meticulous planning. Despite all efforts, POC carries a poor prognosis, particularly in patients affected by its complete form.