The triple procedure: in the bag placement versus ciliary sulcus placement of the intraocular lens

AIMS: To evaluate the influence of intraocular lens (IOL) placement on triple procedure clinical results and to investigate whether it is appropriate to use phacoemulsification in patients with large lens nucleus. METHODS: 40 consecutive penetrating keratoplasties combined with cataract extraction performed in a single institution were studied. Whenever possible a capsulorhexis was performed and the IOL was placed into the capsular bag. Phacoemulsification was used when the nucleus was too large to pass through the capsulorhexis. RESULTS: Out of 25 patients with an intact capsulorhexis phacoemulsification was used in 13 (52.0%) whereas the entire nucleus passed through the capsulorhexis in the remaining 12 patients (48%). The average 12 month visual acuity was 0.46 (SD 0.21) in patients with in the bag IOL (n = 23) and 0.29 (0.08) in patients with ciliary sulcus IOL (n = 13) (p = 0.04). Elevated intraocular pressure occurred in 26.1% (6/23) of patients with in the bag IOL and 61.5% (8/13) of patients with ciliary sulcus IOL (p = 0.08). The average postoperative graft thickness at 18 months was 552 (27) microns in the former group and 650 (29) microns in the latter group (p = 0.04). No significant difference in graft survival, postoperative endothelial cell density, astigmatism, and videokeratoscopic measurements was found between both groups. CONCLUSION: In the bag placement of the intraocular lens during the triple procedure results in better outcome of transplantation than ciliary sulcus placement of the IOL. Phacoemulsification allows removal of large nuclei through a 5 mm capsulorhexis without performing relaxing incisions out towards the periphery of the capsule.     

角膜针刺伤外伤性白内障的视觉电生理改变

评价因注射针头等针刺所造成的角膜穿孔伤及外伤性白内障的视觉电生理检查结果。方法对１５例视觉电生理检查结果进行分析。包括受伤眼与对侧眼的ＥＲＧ,Ｆ－ＶＥＰ及ＯＰｓ波。结论眼前段的针刺伤可引起视觉电生理检查结果的明显异常,故应考虑其累及眼后段的问题。     

The set of variable-contrast visual acuity charts and its clinical application

Ｉｎｖｉｅｗｐｏｉｎｔｏｆｖｉｓｉｏｎａｌｌｏｂｊｅｃｔｓｉｎｔｈｅｗｏｒｌｄｉｓｃｏｍｐｏｓｅｄｏｆｖａｒｉｏｕｓｌｉｎｅｓ,ｗｈｉｃｈｈａｖｅｄｉｆｆｅｒｅｎｔｓｉｚｅａｎｄｂｒｉｇｈｔｎｅｓｓ［１］．Ｔｈａｔｍｅａｎｓｏｂｊｅｃｔｓｈａｖｅｔｗｏｐａｒａｍｅｔｅｒｓ：ｓｐａｔｉａｌｆｒｅｑｕｅｎｃｙａｎｄｃｏｎｔｒａｓｔ．Ｔｈｅｈｉｇｈｅｒｓｐａｔｉａｌｆｒｅｑｕｅｎｃｙｔｈｅｖｉｓｕａｌｓｙｓｔｅｍｃａｎｄｅｔｅｃｔ,ｔｈｅｂｅｔｔｅｒｉｔｓｆｏｒｍｓｅｎｓｅ．Ｉｎｃｌｉｎｉｃｔｈｅｆｏ…     

Dynamic visual acuity during linear acceleration along the inter-aural axis

We investigated visual-vestibular interactions during linear acceleration along the inter-aural axis. Eighteen healthy volunteers and two patients with central neurological diseases were subjected to transaural linear acceleration in the direction of gravity force (frequency: 0.5–1.5 Hz; amplitude: 5 cm). During linear acceleration, eye movements were recorded under three test conditions: eyes closed (EC), while staring at an imaginary target (IT) and during the testing of dynamic visual acuity (DVA). As parameters of evaluation we used the amplitude of horizontal eye movements, phase shift and the decrease of DVA threshold (DVAT). Under all test conditions, eye amplitude increased with rising stimulus frequency and exceeded, especially in the higher frequency range, a hypothetically calculated eye amplitude for smooth pursuit. The combination of a visual and vestibular input (DVA and IT) led to a better compensation (lower phase shift) than under vestibular stimulation alone (EC). Eye movements during low-frequency stimulation depended more on the visual system while responses in the higher frequency range were mainly triggered by the otolith organ. At 1.5 Hz the compensatory function of the visual-vestibular system was limited (rising phase shift) and DVAT decreased even in a significant number of healthy subjects. Patients with diseases of the central nervous system showed a higher phase shift and thus a stronger decrease of DVAT (two levels) already at a stimulus frequency of 1.25 Hz. Received: 29 May 1999 / Accepted: 2 September 1999     

伴有视力障碍的内侧型蝶骨嵴脑膜瘤治疗及预后分析

目的探讨伴有视力障碍的内侧型蝶骨嵴脑膜瘤的手术治疗及术后视力改善情况。方法回顾性分析我院手术治疗的32例伴有视力障碍的内侧型蝶骨嵴脑膜瘤患者临床资料及术后随访结果。结果32例内侧型蝶骨嵴脑膜瘤患者,视力改善20例,未改善12例;肿瘤全切21例,次全切除8例,大部切除3例。术前有视神经萎缩的8例患者,术后随访6例视力无变化,2例视力恶化。小型肿瘤手术后视力改善（改善率90．0％）优于肿瘤较大者（大型及巨大型50．0％）;肿瘤全切的患者视力改善（改善率81．0％）优于未行全切者（改善率27．3％）。结论手术后视力改善与术前肿瘤大小、是否全切及术前有无视神经萎缩有关。     

Inhibition of c-Kit signaling is associated with reduced heat and cold pain sensitivity in humans

The tyrosine kinase receptor c-Kit is critically involved in the modulation of nociceptive sensitivity in mice. Ablation of the c-Kit gene results in hyposensitivity to thermal pain, whereas activation of c-Kit produces hypersensitivity to noxious heat, without altering sensitivity to innocuous mechanical stimuli. In this study, we investigated the role of c-Kit signaling in human pain perception. We hypothesized that subjects treated with Imatinib or Nilotinib, potent inhibitors of tyrosine kinases including c-Kit but also Abl1, PDFGFRα, and PDFGFRβ, that are used to treat chronic myeloid leukemia (CML), would experience changes in thermal pain sensitivity. We examined 31 asymptomatic CML patients (14 male and 17 female) receiving Imatinib/Nilotinib treatment and compared them to 39 age- and sex-matched healthy controls (12 male and 27 female). We used cutaneous heat and cold stimulation to test normal and noxious thermal sensitivity, and a grating orientation task to assess tactile acuity. Thermal pain thresholds were significantly increased in the Imatinib/Nilotinib-treated group, whereas innocuous thermal and tactile thresholds were unchanged compared to those in the control group. In conclusion, our findings suggest that the biological effects of c-Kit inhibition are comparable in mice and humans in that c-Kit activity is required to regulate thermal pain sensitivity but does not affect innocuous thermal and mechanical sensation. The effect on experimental heat pain observed in our study is comparable to those of several common analgesics; thus modulation of the c-Kit pathway can be used to specifically modulate noxious heat and cold sensitivity in humans.     

影响巩膜扣带术后视功能恢复因素的临床观察

目的:探讨孔源性视网膜脱离行巩膜扣带术后,影响其视力恢复的相关因素。方法:回顾性分析孔源性视网膜脱离患者102例102眼,均行一次巩膜扣带术成功治疗视网膜脱离。术后随访3～6mo,观察术后最佳矫正视力,χ2检验用于分析影响视力恢复的相关因素。结果:黄斑是否脱离、术前最佳矫正视力、视网膜脱离范围及术中是否行视网膜下放液均与术后最佳矫正视力相关(P<0.01)。黄斑脱离在1wk内与1wk以上术后视力恢复差异有统计学意义(P<0.05)。结论:黄斑是否脱离及脱离时间、术前最佳矫正视力、视网膜脱离范围和术中放液是影响术后视力恢复的重要因素,术前应详细分析病情,术中尽可能避免行视网膜下放液。     

Subclinical white matter lesions and medial temporal lobe atrophy are associated with EEG slowing in a memory clinic cohort

Objective

The aim of the study was to describe the relationship between electroencephalographic (EEG) findings obtained by standardized visual analysis, subclinical white matter lesions (WML) and brain atrophy in a large memory clinic population.

Selective magnocellular deficits in dyslexia: a "phantom contour" study

A technique by Rogers-Ramachandran and Ramachandran [Vis. Res. 38 (1998) 71-77] was adapted to evaluate magnocellular (M) and parvocellular (P) visual processing efficiency, with identical task structure, in normal and dyslexic children. A battery of phonological, orthographic and cognitive tasks was administered to assess reading ability and component reading skills in both groups. For the visual processing experiment, children identified shapes created by patterns of dots flickering in counter-phase. The dots were black and white in the M condition, versus isoluminant red and green in the P condition. A staircase procedure determined the children's threshold flicker rate for shape identification. Dyslexics displayed selectively slower visual processing in the M condition but not in the P condition. Across all subjects, performance in the M condition was correlated with measures of orthographic skill, consistent with previous findings linking M processing and orthographic skill. Within the dyslexic group, processing in the M condition was negatively correlated with level of phonological awareness. The results are not consistent with the argument that dyslexics with phonological impairments suffer from deficits across all sensory modalities, as those children with the poorest phonological awareness displayed magnocellular processing well within the normal range.