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@#AIM:To compare the clinical effects of removing or reserving the epithelial flap in high myopia correction by laser subepithelial keratomileusis(LASEK). <p>METHODS: Retrospective analysis of 58 patients(115 eyes)with high myopia received LASEK were selected and divided into reserving the epithelial flap group(30 patients, 59 eyes)and removing epithelial flap group(28 patients, 56 eyes)according to the order of the alternating vists. The changes of corneal irritation, epithelial healing time,uncorrected visual acuity and the occurrence of haze after surgery were observed.<p>RESULTS:Postoperative 1d, 2d, 3d, respectively, the pain score of the two groups were 1.64±0.64, 1.57±0.57; 0.83±0.49, 0.84±0.56; 0.36±0.48, 0.34±0.47, respectively, the differences were not significant(<i>P</i>>0.05). Postoperative 1wk, 1mo, 3mo, respectively, the uncorrected visual acuity of two group was 0.15±0.06, 0.12±0.05; 0.032±0.004, 0.041±0.003; 0.018±0.004, 0.022±0.005, and the differences were not significant(<i>P</i>>0.05). After 1mo, 3mo of surgery, the differences of the haze less than grade one of the two group, respectively, and were not significant(<i>P</i>>0.05), the differences of the haze of grade two of the two groups, respectively, and the differences were significant(<i>P</i><0.05). The epithelial healing time of the two groups were 4.22±0.30d, 3.89±0.32d(<i>P</i><0.05). The number of epithelial delayed healing of two groups was 0 eye and 10 eyes(<i>P</i><0.05).<p>CONCLUSION:It was similar both the changes of corneal irritation and uncorrected visual acuity of two groups,the rate of level two haze was higher in removing epithelial flap group. The time of healing of epithelium was quick than reserving the epithelial flap group,but the rate of delayed healing and poor healing of epithelium was higher than reserving the epithelial flap group. Therefore, for high myopia, it is worthy of clinical application of reserving the epithelial flap by LASEK.
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· AIM:To observe the surgical results of large astigmatism with small incision lenticule extraction (SMILE) for 2a.· METHODS:Totally 33 eyes of 17 consecutive patients were enrolled in this retrospective study,aged from 18 to 36 years old,which included 24 eyes of 12 patients with astigmatism within-3.50D to-4.00D and 9 eyes of 5 patients within-4.25D to-5.00D,7 eyes of 4 patients with sphere within 0 to +1.00D and 26 eyes of 13 patients within-1.00D to 0.Intended cap diameters was 7.3-7.5mm,lenticule diameter was 6.6-6.8mm,the thickness of cap was 120μm,the surgical incision was 2mm.We observed the results after 1d,1wk,1,3,6mo,1 and 2a.Preoperative best corrected visual acuity,spherical equivalent refraction,postoperative uncorrected visual acuity,SimK equivalent value and SimK value was observed.· RESULTS:Compared with preoperation,uncorrected visual acuity showed significant difference statistically at 1d postoperatively (P＜ 0.05).Compared with 1wk postoperatively,uncorrected visual acuity showed no significant difference statistically at postoperative 1,3,6mo,1 and 2a(P＞0.05).Uncorrected visual acuity did not increase or decrease more than two lines.The target diopter was +0.25D.Compared with 1d postoperatively,the spherical equivalent refraction and residual astigmatism showed no significant difference statistically at each postoperative period (P＞ 0.05).postoperative SimK equivalent value and SimK value difference showed no significant difference statistically compared with each postoperative period (P＞0.05).· CONCLUSION:It is both safe,effective,predictable and stable to correct large astigmatism with SMILE by long-term observation,postoperative 2a.The corneal morphology is good and worthy of clinical application.
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AIM:To investigate the protective effect of nerve growth factor combined with Ginkgo biloba extract on retinal ischemia-reperfusion (RIR) injury in rabbits with experimental high intraocular pressure.METHODS:Establishment of rabbit glaucoma ischemia reperfusion model.Twenty-four New Zealand white rabbits were randomly divided into three groups:nerve growth factor group, Ginkgo biloba extract group and combination group.Respectively, in the continuous administration of 1, 7, 14d.We observed the morphological changes of the tissues of the retina.The levels of superoxide dismutase(SOD), nitric oxide(NO) and malondialdehyde(MDA) in retinal tissue were measured.RESULTS:Respectively, first, in the continuous administration of 1, 7, 14d, the contents of MDA and NO in Ginkgo biloba extract group and nerve growth group were higher than that in combination group (P<0.05).Secondly, the SOD content of Ginkgo biloba extract group and nerve growth group were lower than that of combination group at each time point (P<0.05).At each time point, the number of HE staining of retinal ganglion cells (RGCs) showed that the loss of RGCs in the combination group was significantly lower than that in the other groups, and the ganglion cell count showed that the Ginkgo biloba extract group and the neuronal growth group were lower (P<0.05).CONCLUSION:Nerve growth factor combined with Ginkgo biloba extract has better protective effect on retinal ischemia-reperfusion injury.The mechanism may be related to the decrease of free radicals and increase the activity of SOD in retinal tissue.
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AIM:To observe the efficacy and safety of 1g/L bromfenac sodium hydrate ophthalmic solution in the partial substitution of glucocorticoid after laser subepithelial keratomileusis (LASEK).METHODS: Totally 104 cases (208 eyes) were received LASEK, which were selected and divided into study group and control group.The study group were adopted 1g/L bromfenac sodium hydrate ophthalmic solution combined with tobramycin dexamethasone eye drops and fluorometholone eye drops, the control group were adopted tobramycin dexamethasone eye drops and fluorometholone eye drops.The changes of visual acuity and intraocular pressure of two groups were recorded before and after surgery, and the score of painness and the occurrence of haze were observed after surgery.RESULTS: At postoperative 1, 2, 3d, respectively, the pain score of the study group were 1.70±0.35, 1.25±0.34, 0.82±0.32, the pain score of the control group were 2.30±0.43, 1.68±0.44, 1.12±0.33, the differences were significant (P0.05), and the differences were not significant(P>0.05).At preoperative and postoperative 1, 2wk, 1 and 3mo of surgery, respectively, the intraocular pressure of study group were 17.33±1.58, 7.54±1.28, 7.23±1.58, 7.26±1.47, and 7.30±1.36 mmHg;the intraocular pressure of control group were 17.53±1.43,7.57±1.32,7.73±1.55,7.80±1.38,7.86±1.43 mmHg,the differences were not significant between before and at 2wk after surgery(P>0.05), the differences were significant between the two groups at 2wk, 1mo and 3mo (P0.05).CONCLUSION: It is safe and effective that 1g/L bromfenac sodium hydrate ophthalmic solution in the partial substitution of glucocorticoid after laser subepithelial keratomileusis.The patient has a lower intraocular pressure, has similar therapeutic effect as glucocorticoid in vision and antiinflammatory.