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1.
Oded Sagiv Elkanah Rosenfeld Elinor Kalderon Tamar Brutman Barazani Ofira Zloto Uriel Martinowitz Guy J. Ben Simon Isaac Zilinsky 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2018,53(6):600-604
Objective
Postoperative ecchymoses or hematomas can prolong healing from surgery, and a search for locally administered agents that decrease bleeding is warranted. The objective of this study is to evaluate whether preoperative subcutaneous injection of tranexamic acid (TXA) reduces intra- and postoperative bleeding or ecchymoses in skin-only upper eyelid blepharoplasty surgery.Design
This is a prospective randomized, double-blind, controlled study.Participants
We included 34 consecutive patients who were referred to an upper eyelid blepharoplasty surgery in our institution.Methods
The patients were equally randomized to a preoperative local injection of lidocaine mixed with either TXA or normal saline. All patients stopped antiaggregates 1 week before surgery. All surgeries were performed by a single surgeon who was unaware of group assignment. Total surgical time, cumulative time of cautery use, blood loss, the surgeon’s assessment of bleeding extent, pain level reported by the patient, periocular ecchymoses during the first postoperative week, and time for patient’s return to normal daily activity were recorded.Results
There was a trend toward smaller ecchymoses in the TXA group compared with the placebo group on the seventh day (p = 0.072). There were no group differences in total surgery time, cumulative cautery time, net blood weight in surgical pads, patient-reported pain level, surgeon’s assessment of hemostasis, or periocular ecchymosis size on the first postoperative day.Conclusions
Subcutaneous TXA was associated with similar intra- and postoperative hemorrhage in upper eyelid blepharoplasty compared with placebo. The effect of TXA in patients who did not stop antiaggregate use before surgery warrants further study. 相似文献2.
Steven Lapere Ezekiel Weis 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2018,53(5):471-473
Objective
To investigate the validity and safety of tele-ophthalmology evaluations as a clinical assessment tool when performed by an ophthalmologist to detect lesion growth in patients with low-, medium-, and high-risk choroidal and iris nevi.Design
Retrospective observational pilot study.Methods
Consecutive patients with low-/medium-/high-risk choroidal or iris nevi who underwent tele-oncology examinations over 5 months. All patients had a dilated fundus or anterior segment photography, A- and B-scan ultrasonography or ultrasound biomicroscopy (UBM), and spectral domain optical coherence tomography (SD-OCT) depending on the nature of their lesion. Patients who followed up with in-person examinations had an additional ophthalmoscopic examination.Results
Seventy-one eyes of 71 patients were included. The diagnoses were 47 low-risk choroidal nevi, 10 medium-risk choroidal nevi, 5 high-risk choroidal nevi, and 9 iris nevi. The tele-ophthalmology examinations found a sensitivity of 100%, specificity of 92%, positive predictive value of 57%, and negative predictive value of 100% to detect growth of a lesion.Conclusions
Tele-ophthalmology assessment for choroidal and iris nevi is a sensitive clinical tool to evaluate growth with 100% sensitivity and negative predictive value when performed by trained ultrasound technicians and reviewed by an ophthalmologist with expertise in ocular oncology. It has the potential to alleviate patient- and physician-related treatment burden. 相似文献3.
Étienne Bénard-Séguin Jason Kwok Walter Liao Stephanie Baxter 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2018,53(5):480-485
Objective
To determine whether practice using an online fundus photograph program results in a long-term increase in proficiency with direct ophthalmoscopy skills in medical students.Design
This study was a prospective medical education trial. Students were enrolled to participate in a voluntary Objective Structured Clinical Examination (OSCE) using 5 patients with ocular findings. Students who matched a minimum of 6 discs 16 months before the study were assigned to the intervention group and were compared with students who did not participate in the exercise.Participants
Forty-six second-year medical students at Queen’s University: 15 in the intervention group and 31 in the control group.Methods
Students were evaluated using the Queen’s University Ophthalmoscopy OSCE Checklist (QUOOC). Students were asked to calculate the cup-to-disc ratio, comment on disc margins, and whether there was any macular pathology. Students participated in a summative OSCE as part of the curriculum in which all students attempted to match fundus photographs.Results
Students in the intervention group performed significantly better on the QUOOC, with a mean score of 78.3% (± 4.2), compared with the control, who had a mean score of 69.4% (± 4.2) (p = 0.005). The intervention group was significantly more accurate at matching optic nerve photographs, with 100% (15/15) of the students correctly identifying the correct optic nerve on first attempt compared with 53.3% (16/30) in the control group (p = 0.0014).Conclusions
The use of an online peer fundus photograph program leads to a long-term increase in examination technique, proficiency in ophthalmoscopy, and accuracy at matching optic nerve photographs. 相似文献4.
Gavin Docherty Jiyoung Hwang Michelle Yang Brennan Eadie Kathryn Clapson Jodi Siever Simon J. Warner 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2018,53(5):497-502
Objective
This study was conducted to analyze data from emergency ophthalmology referrals after hours from different hospitals to identify the most common pathologies and compare accuracy of diagnoses. Additionally, examination findings, including visual acuity (VA), intraocular pressure (IOP), and pupils from referring service and ophthalmic examination, were compared to assess agreement.Design
This was a prospective study that reviewed information collected from referring services to the emergency on-call ophthalmology service and compared it with ophthalmic examination between February 2017 and July 2017.Methods
The number of referrals from each hospital was reviewed. Referring physician provisional diagnosis, VA, IOP, and pupil assessment were collected to analyze the agreement between ophthalmic examination and diagnosis.Results
The observed agreement rate was 67.0% between referring source and ophthalmic diagnosis. Posterior vitreous detachment (12.2%) was the most common diagnosis, followed by corneal abrasion (7.4%) and retinal detachment (5.3%). Referring services measured VA to be worse than on-call ophthalmology service (right eye Z = ?5.47, p < 0.001; left eye Z = ?5.44, p < 0.001), and IOP measurement by referring services was significantly higher (p < 0.05). The observed agreement rate of pupillary assessment was 91% between referring services and ophthalmology services.Conclusion
Data suggest that there is moderate agreement for diagnostic category between referring service and ophthalmology examination in regard to provisional diagnosis and pupillary assessment. Both VA and IOP were measured to be higher by referring services. This study highlights common emergency ophthalmic referrals and suggests potential areas for teaching initiatives for primary care physicians assessing ophthalmic emergency patients. 相似文献5.
Jinhwan Park Joohyun Kim Hwa Lee Minsoo Park Sehyun Baek 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2018,53(4):373-379
Objective
The purpose of this study was to evaluate the structure and function of the meibomian gland and the incomplete blinking rate to understand the pathophysiology of dry eye in thyroid eye disease (TED) patients.Methods
Patients who were diagnosed with TED were enrolled between October 2015 and February 2016. Clinical measurements were performed in the following order: (i) external examination (Hertel exophthalmometer and palpebral fissure height), (ii) LipiView interferometer (lipid layer thickness [LLT], incomplete blinking rate, and meibography), (iii) slit-lamp biomicroscopy (corneal surface staining, tear breakup time, meibum expression, Marx line).Results
Thirty eyes of 30 TED patients (male = 8; female = 22) were included in this study. The TED patient population had a mean age of 42.9 ± 11.8 years and a mean clinical activity score (CAS) of 2.33 ± 1.60. The meiboscore was 1.17 ± 0.90 in the upper eyelid and 0.70 ± 0.65 in the lower eyelid; scores were significantly higher in the upper eyelid (p < 0.001). The mean LLT was 82.43 ± 24.52 nm, and the mean incomplete blinking rate was 51.04 ± 33.62% (0–100%). CAS was the only variable that correlated with the meiboscore. There was no significant correlation between incomplete blinking and a degree of palpebral fissure height or proptosis.Conclusions
Tear film instability due to increased incomplete blinking can cause dry eye in TED. In addition to the increase in CAS, meibomian gland dysfunction may also be a cause of dry eye in TED. However, further comparative studies are needed to confirm these results. 相似文献6.
Gordon Ngo Graham Trope Yvonne Buys Ya-Ping Jin 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2018,53(3):260-265
Objective
To describe patterns of access to eyeglass insurance by Canadians.Design
A population-based, cross-sectional survey.Participants
A total of 134 072 respondents to the Canadian Community Health Survey 2003 who were aged ≥12 years.Methods
We compared self-reported insurance coverage for eyeglasses or contact lenses provided by private, government, or employer-paid plans.Results
Overall, 55.0% of Canadians aged ≥12 years had insurance that covers all or part of the costs of optical correction. School-age children (63.3%) and individuals aged 20–39 years (55.9%) and 40–64 years (59.5%) had higher coverage rates than seniors (aged ≥65 years) (33.8%, p < 0.05). Canadians residing in the 3 territories had the highest coverage (76.9%), while those in Quebec had the lowest coverage (39.1%, p < 0.05). Lower coverage was reported among immigrants (47.3%) versus nonimmigrants (57.4%, p < 0.05), nonwhites (49.2%) versus whites (56.4%, p < 0.05) and aboriginals (70.7%), and the self-employed (38.5%) versus employees (63.8%). Among Canadians in the 20–64 years age group, individuals in the lower or middle income bracket were 40% (prevalence ratio [PR] 0.60, p < 0.05) less likely to have insurance than those in the upper-middle or higher income bracket after adjusting for ethnicity, immigrant status, and education. Compared to those with university or college education, individuals with less than secondary school education were 13% (adjusted PR 0.87, p < 0.05) less likely to have insurance.Conclusions
Significant disparities exist in eyeglass insurance coverage in Canada. Individuals with low levels of income and education, and the self-employed, seniors, immigrants, nonwhites, and residents of Quebec had less coverage. Studies are needed to understand whether these disparities contribute to the visual impairment burden in Canada. 相似文献7.
Michelle M. Porter Andrew W. Cull 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2018,53(5):538-541
Objective
Cataract surgery can have many benefits for older adults, including enabling continued ability to drive. However, it is not known how objectively measured driving patterns change after cataract surgery. The purpose of this study was to examine how participants drove before and after cataract surgery.Design
Longitudinal study.Participants
Individuals from the Winnipeg site of Candrive (a longitudinal study of older drivers in Canada).Methods
An in-vehicle device monitored all trips taken in 1-second intervals, allowing for the analysis of distances driven, number of trips, time of trips, speeding, excessive braking/accelerating, and types of roadways.Results
Over the 4 years of data collection, there were 16 cases of participants having cataract surgery, whereby there was also suitable driving data for analyses. Participants drove 28% further after surgery (p = 0.022). They also drove further from home and more on primary roads (p < 0.05) and had fewer episodes of hard braking per distance travelled (p < 0.001). No other variables significantly changed.Conclusions
This study suggests that older drivers changed some of their driving patterns after cataract surgery. Future studies could explore the effects of increased driving exposure, in conjunction with potentially safer driving behaviors, on overall driving safety after cataract surgery. 相似文献8.
Oded Ohana Igor Kaiserman Yuval Domniz Eyal Cohen Oz Franco Tzahi Sela Gur Munzer David Varssano 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2018,53(5):523-528
Objective
To report the outcomes and complications of combined photorefractive keratectomy (PRK) and collagen crosslinking (CXL).Design
A retrospective cohort study of consecutive patients undergoing combined PRK-CXL between 2011 and 2013 at Care Laser, Inc, Tel Aviv, Israel.Participants
Ninety-eight eyes of 56 patients were included. Only patients without keratoconus were included.Methods
Data were collected from the patients’ files and imaging devices. Main outcome measures were corrected and uncorrected distance visual acuity (CDVA/UDVA); spherical equivalent (SE); refractive, keratometric, and pachymetric stability; and the occurrence of postoperative complications.Results
Mean age was 27.69 ± 6.6 years. UDVA improved from 1.38 ± 0.60 to 0.15 ± 0.24 logMAR (p < 0.001). SE improved from ?4.45 ± 2.87 diopter (D) to +0.20 ± 0.90 D (p < 0.001), and 69% of the patients were within ±0.50 D from emmetropia. Four eyes had significant corneal haze; of them 3 eyes lost more than 2 Snellen lines. No cases of corneal ectasia were recorded.Conclusions
In our cohort PRK-CXL achieved significantly improved UDVA and SE compared to baseline. Corneal haze was a significant complication. Refractive results were less accurate than published for patients undergoing PRK procedures. Although no cases of corneal ectasia were seen, given the rarity of such complication, the added benefit of CXL remains to be proven. 相似文献9.
Milad Modabber Andrei F. Dan Razek G. Coussa Michael Flanders 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2018,53(6):621-626
Objective
To characterize the ocular response to retrobulbar anaesthesia and to evaluate the efficacy of retrobulbar anaesthesia for adjustable strabismus surgery in adults.Design
Prospective observational study.Participants
Adult patients undergoing adjustable strabismus surgery under retrobulbar anaesthesia.Methods
Surgical success was defined by ocular alignment within 10 prism diopters (PD) of orthotropia for horizontal rectus surgery and within 5 PD for vertical rectus surgery. After retrobulbar injection of Xylocaine with epinephrine, the onset time and the degree of visual impairment, ocular akinesia, and analgesia were evaluated. Postoperative parameters included the restoration of vision, onset of pain, resolution of ptosis, normalization of pupil, resolution of extraocular motility deficits, and the timing of postoperative adjustment. Perioperative complications were also documented.Results
A total of 33 patients were initially included in this study. Two patients experienced complications (perioperative retrobulbar hemorrhage, postoperative suprachoroidal hemorrhage) and were excluded from data analysis. Of the remaining 31 patients (mean age, 50.2 ± 14.8 years), surgical outcome was satisfactory in 30/31 (96.8%) patients at the first postoperative visit and in 15/19 (78.9%) cases at last follow-up (mean, 6.1 ± 1.6 months). Excellent intraoperative ocular akinesia and analgesia was achieved with retrobulbar anaesthesia. After retrobulbar injection, visual impairment was the first to resolve to preoperative levels within (mean ± SD) 3.7 ± 1.9 hours postinjection, followed by onset of pain at 4.1 ± 1.0 hours, resolution of ptosis at 4.3 ± 1.9 hours, and normalization of pupil reactivity at 6.1 ± 1.0 hours. The resolution of anaesthesia upon extraocular motility occurred within 5.7 ± 1.0 hours postinjection (range, 4.5–8.0 hours), allowing for subsequent same-day postoperative adjustment.Conclusions
Retrobulbar anaesthesia in the context of adult, adjustable strabismus surgery is a relatively safe and effective technique. It provides excellent intraoperative analgesia and akinesia. Retrobulbar anaesthesia enables for same-day suture adjustments to be reliably performed. 相似文献10.
Kelsey A. Roelofs Chris J. Rudnisky 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2018,53(5):533-537
Objective
To evaluate the refractive outcomes after anterior capsular tear (ACT).Design
Retrospective case–control study.Participants
After ethics approval, the surgical operative records of 4301 consecutive patients undergoing cataract surgery by a single surgeon were reviewed for cases of ACT.Methods
All ACTs were managed using a balancing incision of the capsulorrhexis margin 180 degrees away from the tear. If the patient’s other eye had undergone cataract surgery by the same surgeon, it was included as a control.Results
Fifty-one eyes of 51 patients were complicated by ACT (incidence = 1.2%). The mean age of patients in the study was 64.2 ± 12.1 years. Of the 51 patients with ACT, 34 underwent contralateral surgery. These eyes were used as the control group. There was no significant difference in preoperative visual acuity (p = 0.683) or proportion of eyes that received in-the-bag intraocular lens placement (p = 0.347) between groups (ACT = 92.2%; control = 97.1%). In 3 ACT eyes, the tear extended into the posterior capsule (5.9%), and although this did not occur in control eyes, this difference was not statistically significant (p = 0.150). There was no difference in best-corrected final logMAR visual acuity between groups (p = 0.424) or postoperative spherical equivalent between ACT (?0.23 ± 1.2D) and control (?0.15 ± 0.62D) eyes (p = 0.985).Conclusions
Cataract extraction complicated by ACT can result in equivalent visual and refractive outcomes as in uncomplicated surgery. The technique used in this study prevented extension of ACT to the posterior capsule in 94.1% of cases. 相似文献11.
David S. Sands Stephanie C.Y. Chan Chloe C. Gottlieb 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2018,53(4):349-353
Objective
To assess corticosteroid-sparing and inflammation control in patients with noninfectious scleritis treated with methotrexate.Design
Retrospective review.Participants
Patients who received methotrexate treatment for noninfectious scleritis and who had 12 months of follow-up after treatment initiation were included in this review.Methods
The clinical records of noninfectious scleritis patients presenting at the University of Ottawa Eye Institute between September 1, 2010 and December 31, 2014 treated with methotrexate were retrospectively reviewed. Seventeen patients (21 eyes) were included in the study. Main outcome included inflammation control and corticosteroid-sparing success. Secondary outcomes were reduction of immunosuppression load and best-corrected visual acuity.Results
The proportion of eyes with corticosteroid-sparing success was 69.2% at 3 months and 92.3% at 12 months. The proportion of eyes that achieved inflammation control was 61.9% at 3 months and 90.5% at 12 months. The corticosteroid immunosuppression load at treatment start was 1.9 ± 2.07 and at 12 months was 0.48 ± 1.03 (p < 0.01). There was no statistically significant difference in best-corrected visual acuity.Conclusions
The treatment of noninfectious scleritis with methotrexate appears to be effective at both achieving steroid-sparing success and controlling inflammation during 12 months of therapy. Immunosuppression load decreased significantly over 12 months of therapy while best corrected visual acuity was stable. 相似文献12.
Maram Isaac Wanrudee Isaranuwatchai Nasrin Tehrani 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2018,53(2):162-167
Objective
To compare costs of 2 screening modalities for retinopathy of prematurity (ROP): telemedicine imaging with remote interpretation versus in-person binocular indirect ophthalmoscopy (BIO).Design
Retrospective chart review.Participants
Infants from an existing telemedicine screening program at 2 cities in Ontario, Canada.Methods
We conducted a cost analysis comparison from the perspective of the Ministry of Health. Patient level data was used for the telemedicine group. A hypothetical control group consisted of the minimum number of BIO and interhospital transfers if the existing patients were screened in person. Costs included in-person examinations, transfers, setting up, and ongoing costs of telemedicine screening. Costs were compared using the Mann–Whitney U test and are reported in 2014 Canadian dollars.Results
A total of 102 and 72 infants were screened from Sudbury and Barrie, respectively; 3% and 2% of infants in the telemedicine group were transferred for BIO from Sudbury and Barrie, respectively. All infants in the control group would have required at least one transfer for BIO. The average total cost per eye examination was $4855 ± $5616 and $4540 ± $3129 for the telemedicine group and $19 834 ± $13 814 and $2429 ± $1664 for the control group from Sudbury and Barrie, respectively (p < 0.001). Interhospital transfer cost for the control group was $19 489 ± $13 605 and $2055 ± $1471 compared to $635 ± $3968 and $30 ± $197 for the telemedicine group (p < 0.001) in Sudbury and Barrie, respectively.Conclusions
Telemedicine appears to be an economically attractive option depending on the location and number of infants screened. This information is useful for planning similar ROP screening programs. 相似文献13.
Verena R. Juncal Mostafa Hanout Filiberto Altomare David R. Chow Louis R. Giavedoni Rajeev H. Muni David T. Wong Alan R. Berger 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2018,53(4):408-414
Objective
To report the anatomical and visual outcomes of patients with thick submacular hemorrhage (SMH) treated with pars plana vitrectomy (PPV), subretinal tissue plasminogen activator (t-PA), and pneumatic displacement.Design
Single-centre, retrospective case series.Participants
A total of 99 eyes of 99 consecutive patients with thick SMH secondary to any underlying etiology treated with PPV with subretinal t-PA and pneumatic displacement by 6 vitreoretinal surgeons at St. Michael’s Hospital, Toronto, between July 2004 and August 2016.Methods
All medical records and colour fundus photographs were reviewed for data collection. Blood displacement was evaluated at follow-up visits and classified as complete, partial, or none. Main outcome measures included blood displacement at final follow-up, postoperative Snellen best-corrected visual acuities (BCVA), and complication and recurrence rates.Results
Patients had a mean age of 77.7 ± 12.3 years and were followed up for an average of 18.4 ± 22.3 months. Wet age-related macular degeneration was the most common etiology associated with thick SMH (80.8%). Complete blood displacement was observed by final follow-up in 85.9% of the cases, partial displacement in 12.1%, and none in 2.0%. Mean logMAR BCVA improved from 2.03 ± 0.81 (Snellen 20/2143) at baseline to 1.80 ± 1.00 (Snellen 20/1262; p = 0.009) at final follow-up, and baseline BCVA was a significant predictor of final BCVA (p < 0.001). Early postoperative complications included vitreous hemorrhage in 13 eyes and rhegmatogenous retinal detachment in 8. Recurrent SMH was observed in 12 cases.Conclusions
Vitrectomy with subretinal t-PA and pneumatic displacement seems to be an effective treatment for SMH in terms of blood displacement and visual outcomes. 相似文献14.
Christopher R. McLaughlin Michelle Biehl Brian J. Chan Sarah J. Mullen Lily Zhao Laura Donaldson Nirojini Sivachandran Prima Moinul Joshua Barbosa Varun Chaudhary 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2018,53(5):491-496
Objective
To characterize emergency optometrist referrals triaged at a tertiary ophthalmology care centre by physical examination findings and provisional diagnosis accuracy.Design
Prospective case review.Participants
Consecutive patients referred to a tertiary eye care clinic for an after-hours ocular consult.Methods
Variables extracted from the patient charts included date of referral, age, sex, eye(s) under examination, referral visual acuity (VA), referral intraocular pressure (IOP), the referring optometrist’s provisional diagnosis, VA at the time of the ophthalmologist consultation, IOP at the time of the ophthalmologist consultation, number of days between referral and ophthalmic consultation, and the ophthalmologist’s diagnosis. Optometrist VA measures were correlated against ophthalmologist measures for left eye, right eye, diseased eye, and nondiseased eye. The independent t test was used to compare IOP measures between clinicians, and the absolute frequency of agreement between localization of eye pathology was reported.Results
After categorizing disease by anatomic location, absolute agreement between optometrist provisional diagnosis and ophthalmologist diagnosis was 60.0%. Strong correlations were found between optometrist and ophthalmologist VA measurements. IOP measurements were reported less frequently by optometrists. In cases in which referral IOP was documented, no significant difference was observed between clinician measures.Conclusions
VA and IOP measurements by optometrists are reliable, although IOP measurements were included less frequently in optometrist referrals. Optometrist referrals correctly localized eye pathology in 60.0% of cases. Two cases of retinal tear and 2 cases of retinal detachment, for which a precise reason for referral is ideal, were referred for other reasons. 相似文献15.
Jingwen Ding Xuan Ma Yue Xin Dongmei Li 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2018,53(5):458-461
Objective
Lower eyelid retraction is a common and challenging complication of the anophthalmic socket. The underlying pathophysiology includes contraction of the posterior lamellae of the eyelid, shortening of the inferior fornix, and lateral canthal tendon laxity. This study aimed to evaluate the surgical efficacy of hard palate mucosa as a posterior spacer graft in the lower eyelid retraction repair in the anophthalmic socket.Methods
The surgical technique involved hard palate grafting combined with recession of inferior retractors and lateral tarsal strip suspension to lengthen the posterior lamellar and strengthen the support of the lower eyelid. The records of anophthalmic patients with lower eyelid retraction who underwent this technique from January 2009 through August 2014 were reviewed. Postoperative outcomes were determined by lower eyelid elevation, presence of lagophthalmos, complications, prosthesis fitting, and patient satisfaction.Results
A total of 12 patients (12 eyelids) were included. The mean age at surgery was 36 years (range, 29–52 years) and the mean follow-up period was 53 months (range, 20–71 months). The lower eyelids of the operated eyes significantly elevated by 2.9 ± 0.8 mm, and mild residual lagophthalmos was observed in 3 patients. All patients were satisfied with the surgical outcomes. Minor complications occurred in 3 cases, including mild recurrent retraction, granuloma, and mucous discharge. There were no complications detected at the donor site.Conclusion
Hard palate grafting combined with recession of lower eyelid retractors achieves long-term stable outcomes in lower eyelid retraction repair in the anophthalmic socket. 相似文献16.
Zaid Shalchi Mali Okada Alice Bruynseels David Palethorpe Ammar Yusuf Rohan Hussain Christina Herrspiegel Antonio Scazzarriello Abubakar Habib Razia Amin Ranjan Rajendram 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2018,53(4):415-419
Objective
To investigate the effect of serum glycosylated hemoglobin (HbA1c) on the outcomes of ranibizumab therapy for diabetic macular edema (DME).Design
Retrospective cohort study.Participants
Patients receiving ranibizumab injections for centre-involving DME in a National Health Service setting.Methods
The Moorfields OpenEyes database was used to study eyes with DME treated with ranibizumab from October 2013 to November 2015 at the Moorfields City Road, Ealing, Northwick Park, and St George’s Hospital sites. Only eyes receiving a minimum of 3 injections and completing 12 months of follow-up were included. If both eyes received treatment, the first eye treated was analyzed. When both eyes received initial treatment simultaneously, random number tables were used to select the eye for analysis. HbA1c was tested at the initiation of ranibizumab treatment. Multivariate regression analysis was used to identify relationships between HbA1c and the outcome measures.Outcomes
The primary outcome was change in visual acuity (VA) Early Treatment of Diabetic Retinopathy study (ETDRS) letters. The secondary outcomes were change in central subfield thickness (CSFT) and macular volume (MV), as well as number of injections in year 1.Results
Three hundred and twelve eyes of 312 patients were included in the analysis. HbA1c was not related to change in VA (p = 0.577), change in CSFT (p = 0.099), change in MV (p = 0.082), or number of injections in year 1 (p = 0.859).Conclusions
HbA1c is not related to functional or anatomical outcomes at 1 year in DME treated with ranibizumab. 相似文献17.
P. Plaza-Ramos H. Heras-Mulero P. Fanlo A. Zubicoa 《Archivos de la Sociedad Espa?ola de Oftalmología》2018,93(9):447-450
Objective
To present a case report of a patient with a bilateral acute iris transillumination syndrome (BAIT).Methods
BAIT syndrome is a new clinical condition characterised by severe transillumination of the iris, acute onset of pigment dispersion in the anterior chamber, and a medial mydriatic pupil that is unresponsive or poorly responsive to light, due to a sphincter paralysis. Patients with BAIT generally present with acute ocular pain, photophobia, and red eyes.Discussion
The case is presented of a 53 year-old woman, who, after being treated with moxifloxacin for an upper respiratory tract infection, developed a BAIT syndrome, which was initially diagnosed as acute anterior uveitis.Conclusion
As far as is known this is the first case reported in Navarra, but more case reports are needed to establish clear patterns about this condition. 相似文献18.
19.
Nilufer Yesilirmak Vasilios F. Diakonis Juan F. Batlle Ibrahim O. Sayed-Ahmed Zachary Davis Daniel P. Waren Sonia H. Yoo Terrence P. O’Brien Kendall E. Donaldson 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2018,53(5):542-547
Objective
To compare the nucleus removal time (NRT) and cumulative dissipated energy (CDE) outcomes of traditional phacoemulsification and femtosecond laser-assisted cataract surgery (FLACS) performed by cornea attendings and fellows.Design
Prospective nonrandomized comparative study.Participants
A total of 410 eyes of 410 patients.Methods
Nucleus removal time and CDE were recorded from patients who underwent cataract surgery using either FLACS (Catalys, LenSx, or Victus) or traditional phacoemulsification technique performed by 3 cornea attendings and 4 cornea fellows. One-way analysis of variance with Bonferroni post hoc tests and unpaired t tests were used to determine the differences between groups.Results
There was no statistically significant difference in cataract grade between groups. NRT was significantly lower only when using the Catalys system compared with the LenSx and Victus platforms and the traditional surgery, in both the attending group (p = 0.006, p = 0.002, p < 0.000, respectively) and the fellow group (p = 0.049, p = 0.038, p = 0.011, respectively). With respect to CDE, there was no significant difference when using the laser systems compared with the traditional surgery in both attending and fellow groups (p > 0.05). NRT and CDE were significantly higher in the fellow group (NRT = 269.10 ± 117.67, CDE = 7.30 ± 4.83) compared with the attending group (NRT = 218.87 ± 109.67, CDE = 5.76 ± 3.66) in traditional cases; however, in FLACS cases, there was no significant difference in NRT and CDE between the fellow group and the attending group.Conclusions
Inexperienced surgeons seem to require more time and use more ultrasound energy during traditional phacoemulsification when compared with experienced surgeons. The use of FLACS seems to significantly improve the NRT of experienced and inexperienced surgeons. 相似文献20.
Priya Narang Amar Agarwal 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2018,53(5):503-509