翼状胬肉切除术式对术后眼表修复的影响

目的 观察比较翼状胬肉不同手术方式对术后眼表修复的影响.方法 选择2009年10月至2011年4月于我院行翼状胬肉切除术的单眼鼻侧原发性翼状胬肉患者,根据术前3d泪膜破裂时间(break-up time,BUT)、泪液分泌试验Ⅰ(Schirmer Ⅰ test,SIt)、结膜印迹细胞学检查结果,筛选出三项指标均异常患者96例(96眼),随机分为3组,分别接受单纯翼状胬肉切除术(A组)、翼状胬肉切除联合结膜瓣转移术(B组)及翼状胬肉切除联合自体角膜缘干细胞移植术(C组),另选择三项指标均正常的患者25例(25眼),行翼状胬肉切除联合自体角膜缘干细胞移植术(D组).术后3个月行BUT、SIt、结膜印迹细胞学检查,对测量结果进行统计学分析.结果 A组、B组、C组术后3个月BUT分别为(9.8±1.5)s、(9.6±1.9)s和(10.2±1.5)s,与术前(6.7±1.3)s、(6.2±1.0)s、(6.6±1.3)s相比,差异均有统计学意义(均为P＜0.05);D组术后3个月BUT为(13.8±1.1)s,与术前(14.1±1.0)s相比,差异无统计学意义(P＞0.05).A组、B组、C组术后3个月SIt、结膜杯状细胞计数较术前提高或增加,差异均有统计学意义(均为P＜0.05);D组术前SIt、结膜杯状细胞计数与术后3个月比较,差异均无统计学意义(均为P＞O.05).结论 翼状胬肉切除对眼表损伤有修复作用,翼状胬肉切除联合自体角膜缘干细胞移植术后眼表损伤的修复作用较好.     

Fundus biomicroscopy: a comparison of four methods

Funduscopic examination utilizing the biomicroscope is extremely valuable in the detection, diagnosis, and management of ocular disease. A variety of lenses are currently available for detailed examination of the posterior vitreous cavity and the retina. This paper discusses the optical principles and the various attributes of four lenses relative to magnification, field of view, clinical application and ease of use.     

Cataract and ocular parameters: sexual comparison

A retrospective study of 330 cataract surgery patients was undertaken to verify some of the differences between men and women. Six parameters were analyzed: the age of the patient at the time of surgery, the axial length, the lens implant power selected for emmetropia, the keratometry readings, and the corneal astigmatism. We found only one significant difference between the male and female groups. More women required cataract surgery than men by a 2:1 ratio. There were no significant differences in the other parameters. We conclude that these parameters need not be considered in the decision-making process regarding cataract and intraocular lens implant patients.     

两种手术方法在白内障术中应用的比较

目的 观察隧道式小切口环形撕囊和信封式截囊劈核法在白内障治疗中的应用效果。方法 对172例172眼白内障按手术随机顺序分为两组,分别采用上述两种方法进行手术并比较其结果和特点。结果 88例隧道切口吲哚靛青绿(ICGA)染色环形撕囊法手术中,连续环形撕囊成功80例占90.91％,人工晶状体完全植入囊袋者82例;占93.18％,角膜出现轻度水肿10例占11.36％。与之相对比,84例小切口信封式截囊劈核法人工晶状体植入囊袋者70例占83.33%(P<0.05),角膜轻度水肿6例占7.14%(P>0.05),均用10-0尼龙线缝合。结论 两种手术方法具有相应的特点和难点,环形撕囊法人工晶状体囊袋内植入率高而不需缝合,接近超声乳化手术效果。     

Measurement of choroidal melanomas: a comparison of methods

The prognosis for death from metastatic choroidal melanoma following enucleation has been shown to be strongly correlated with a number of risk factors of which the most important are age of onset, aggressive cell types and tumour volume. The advantages of enucleation for the treatment of choroidal melanomas are put into question by the singular lack of a parallel increase in life expectancy following this treatment, and evidence that it may promote the development of metastatic disease. Alternative forms of treatment have been introduced including observation of small and asymptomatic tumours. We are using a computer-aided system for serial measurement and statistical analysis of area and volume of choroidal melanomas. A comparison of results using our method and the conventional method of estimating volume by the product of basal area and height for 51 measurements on 15 eyes over a 6-month period showed an overestimation of volume by conventional methods which could be corrected by applying a "shape constant" determined by linear regression. Calculation of tumour growth rates is also shape-dependent, and a slowing in growth rate or even a reduction in melanoma size is possible.     

Effects of caffeinated coffee consumption on intraocular pressure, ocular perfusion pressure, and ocular pulse amplitude: a randomized controlled trial

Purpose

To examine the effects of caffeinated coffee consumption on intraocular pressure (IOP), ocular perfusion pressure (OPP), and ocular pulse amplitude (OPA) in those with or at risk for primary open-angle glaucoma (POAG).

Methods

We conducted a prospective, double-masked, crossover, randomized controlled trial with 106 subjects: 22 with high tension POAG, 18 with normal tension POAG, 20 with ocular hypertension, 21 POAG suspects, and 25 healthy participants. Subjects ingested either 237 ml of caffeinated (182 mg caffeine) or decaffeinated (4 mg caffeine) coffee for the first visit and the alternate beverage for the second visit. Blood pressure (BP) and pascal dynamic contour tonometer measurements of IOP, OPA, and heart rate were measured before and at 60 and 90 min after coffee ingestion per visit. OPP was calculated from BP and IOP measurements. Results were analysed using paired t-tests. Multivariable models assessed determinants of IOP, OPP, and OPA changes.

Results

There were no significant differences in baseline IOP, OPP, and OPA between the caffeinated and decaffeinated visits. After caffeinated as compared with decaffeinated coffee ingestion, mean mm Hg changes (±SD) in IOP, OPP, and OPA were as follows: 0.99 (±1.52, P<0.0001), 1.57 (±6.40, P=0.0129), and 0.23 (±0.52, P<0.0001) at 60 min, respectively; and 1.06 (±1.67, P<0.0001), 1.26 (±6.23, P=0.0398), and 0.18 (±0.52, P=0.0006) at 90 min, respectively. Regression analyses revealed sporadic and inconsistent associations with IOP, OPP, and OPA changes.

Conclusion

Consuming one cup of caffeinated coffee (182 mg caffeine) statistically increases, but likely does not clinically impact, IOP and OPP in those with or at risk for POAG.     

不同手术方法对初发性翼状胬肉患者眼表的影响

目的:评价不同手术方法对初发翼状胬肉患者眼表的影响。方法:将39眼随机分为3组(A,B,C)。A组(13眼)接受单纯翼状胬肉切除术,B组(13眼)接受翼状胬肉切除联合自体干细胞移植术,C组(13眼)接受翼状胬肉切除联合术中应用0.2g/L MMC。对所有眼术前、术后7d;1,3mo进行Schirmer s test和泪膜破裂时间(BUT)检查,然后进行统计学分析。结果:术前、术后3组患者Schirmer s test和BUT检查未见明显异常。结论:经过短期随访,3种不同手术方式对初发翼状胬肉患者的眼表无明显影响。     

原发性开角型青光眼患者不同体位眼灌注压昼夜波动趋势分析

Objective To characterize the circadian fluctuation of ocular perfusion pressure (OPP) in different position  in patients with newly diagnosed, untreatedprimary open-angle glaucoma（POAG）. Design Cohort study. Participants Nineteen patients with POAG (19 eyes) and eighteen healthy controls (18 eyes) were included in the Peking University Shenzhen Hospital. Methods POAG patients and healthy controls were included and underwent 24-hour monitoring of IOP and blood pressure. On 10:00, 14:00, 18:00 and 22:00 o’clock in the daytime, all the subjects were monitored in sitting position, then POAG patients were monitored again after lying down for 5 minutes. On 2:00, 5:00 and 7:00 o’clock at night all the subjects were monitored in supine position, then POAG patients were monitored again after sitting for 5 minutes. Calculating the mean ocular perfusion pressure (MOPP), the systolic ocular perfusion pressure (SOPP) and diastolic perfusion pressure (DOPP) by the formula and analyzing the data. Main Outcome Measures  MOPP, SOPP, DOPP. Results In both groups of habitual position (sitting position in day and supine position in night), the nocturnal MOPP, SOPP and DOPP were lower than diurnal. In both groups, the nocturnal MOPP was lower than diurnal in habitual position (POAG group t=4.092, P=0.000; healthy group t=4.513, P=0.000). However, there was no obvious difference between those two groups (t=-0.973, P=0.350). POAG group had higher 24-hour fluctuation of MOPP (t=2.204, P=0.039), higher nocturnal fluctuation of SOPP (t=3.097, P=0.018), higher nocturnal and 24-hour fluctuation of DOPP than healthy group, all the differences had statistical significance (all P<0.05).  In POAG group , there was no statistical difference between the nocturnal MOPP and the diurnal MOPP in sitting position or in supine position of 24 h (all P>0.05). POAG group had higher 24-hour mean MOPP in sitting position than in supine position, the difference had statistical significance (t=4.306, P=0.001).  Comparing the MOPP of  POAG group  in habitual position with in sitting position of 24 h, there was no statistical difference(t=-2.101, P=0.080). However, POAG group had higher 24-hour mean MOPP in habitual position than in supine position of 24 h, the difference had statistical significance (t=2.707, P=0.035). Conclusions There circadian fluctuation of  OPP in different position in POAG pations can not be treated as the same. The nocturnal MOPP  was lower than diurnal in habitual position, but there was no obvious difference in the 24h-sitting position and 24h-supine position.  (Ophthalmol CHN, 2017, 26: 20-25）     

The ocular pulse amplitude at different intraocular pressure: a prospective study

Purpose: To investigate changes in ocular pulse amplitude (OPA) during a short‐term increase in intraocular pressure (IOP) and to assess possible influences of biometrical properties of the eye, including central corneal thickness (CCT) and axial length. Methods: In a prospective, single centre study, OPA and IOP as measured by dynamic contour tonometry (DCT) were taken before baseline‐ and post‐OPA (delta) intravitreal injection of 0.05 ml anti‐vascular endothelial growth factor agents. Analysis was performed employing linear regression with baseline‐ and post (delta)‐OPA differences as the dependent and post‐IOP as well as delta IOP as the independent variable. A multilinear regression analysis with delta OPA as the dependent variable and baseline IOP, post‐IOP, CCT and axial length as independent variables was conducted. Results: Forty eyes of 40 patients were included. IOP and OPA increased significantly after injection (IOP mean increase ± SD: 17.83 ± 9.83 mmHg, p < 0.001; OPA mean increase ± SD: 1.39 ± 1.16 mmHg, p < 0.001). For every mmHg increase in IOP, the OPA showed a linear increase of 0.05 mmHg (slope 0.05, 95% CI: 0.02–0.09, p = 0.003, r² = 0.20). Multiple regression analysis with delta OPA as the dependent variable revealed a partial correlation coefficient of 0.47 (p = 0.003) for post‐IOP as the only significant contribution. Conclusion: A clear positive relationship between OPA measurements and IOP levels was shown in a clinical routine setting using DCT focusing on baseline and postinterventional comparisons of OPA values after intravitreal injections in patients with exudative age related macular degeneration. When considering the OPA for diagnostic purposes, we recommend indication of corresponding IOP values.     

Biofeedback stimulation in patients with age-related macular degeneration: comparison between 2 different methods

Objective

To evaluate changes in patient’s visual performance after rehabilitation training with 2 different biofeedback training programs offered by the MP-1 microperimeter. Spontaneous retinal location of preferred retinal loci (PRLs) and fixation stability are not always optimal for best visual performances. MP-1 microperimeter biofeedback techniques have been suggested as modalities for training for better fixation stability and to find a better location of the new PRL in a more useful area of the retina in nonoptimal cases. The MP-1 microperimeter offers different biofeedback strategies, such as acoustic biofeedback and structured light stimulus plus acoustic biofeedback.

Design

Retrospective study.

Participants

Thirty subjects affected by age-related macular degeneration with absolute central scotoma.

Methods

A standard protocol of examination before and after visual rehabilitation training was performed on all study subjects. Assessment included demographics data, visual acuity, fixation stability, retinal sensitivity, and reading speed. Rehabilitation training was performed with standard and structured stimulus biofeedback. The whole sample was divided into 2 groups of 15 patients attending the 2 different stimulation training biofeedback.

Results

Mean reading speed was found to be significantly increased for both groups (p < 0.05 and p < 0.01). Also, a statistically significant improvement of fixation stability was registered for both groups (p < 0.01). Only patients trained with the flickering pattern biofeedback stimulation increased retinal sensitivity (p < 0.01).

Conclusions

Both regular biofeedback and flickering pattern biofeedback training seem to improve visual functions. More benefits seem to be accrued, however, with flickering pattern biofeedback training.