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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 evaluate the clinical effects of secondary suspensory foldable intraocular lens ( IOL ) implanted in aphakia eyes after vitrectomy.? METHODS: The clinical data were retrospectively analyzed in 25 eyes of 25 patients treated with secondary suspensory intraocular lens implantation after vitrectomy. The surgery was performed through a incision 2. 4mm away from corneal edge, followed by solarometer positioning 8:00 and 2:00, and foldable intraocular lens was loaded and implanted by an injector, after that suspension line knot of lens was made, which length was equal to the distance between the loops of intraocular lens. The intraocular lens was fixed to sclera by a "W"shaped suspension suture. The patients were followed up for 3 ～ 26mo postoperatively, and visual acuity, intraocular pressure, cornea, anterior chamber reaction, intraocular lens position, fundus were observed.? RESULTS: All patients received preoperatively best corrected visual acuity at 1wk after surgery, and the refractive condition was within ± 1. 5 DC. The intraocular pressure was all normal. The number of corneal endothelial cells ( n/mm2 ) was 2394. 33 ± 201. 31 before surgery, and was 2283. 30±217. 82 at 3mo(P>0. 05). The percentage of corneal hexagonal endothelials was 52. 67％±6. 28％ preoperatively, and came to 51. 81％± 6. 41％ at 3mo ( P>0. 05 ). The central corneal thickness (mm) was 541.10±40.31 at the beginning, and was 543.10 ±41. 77 at 3mo (P>0. 05). Small amount of bleeding under choroid occurred in one eye, and intraocular lens dropped into vitreous body in another. Dislocation or shifting of intraocular lens, corneal decompensation or retinal detachment was not observed.? CONCLUSION: The clinical effect of secondary suspensory foldable intraocular lens implanted in aphakia eyes after vitrectomy was satisfactory. Minimal invasive surgery through small incision and accurate implantation are applied to increase safety while reducing complications, thus improve the effects of surgery.
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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.
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AIM: To observe the clinical effects of intravitreal injection of triamcinolone acetonide ( TA ) before vitrectomy for retinal detachment associated with choroidal detachment. · METHODS: Totally 23 cases ( 23 eyes ) of retinal detachment associated with choroidal detachment in our hospital were treated by intravitreal injection of TA 4-5d before 23-Gauge micro-invasive vitrectomy combined with silicone oil injection. All the cases were followed up between 6 to 9mo. The anatomic retinal reattachment, visual acuity, intraocular pressure and postoperative complications were observed and analyzed. ·RESULTS: After the surgery, the visual acuity of all patients were improved, with 9 eyes better than 0. 3 (39%), and 18 eyes better than 0. 05 (78%). The BCVA at 1wk, 1 and 3mo and last follow up were different compared with before operations (P<0. 05). The mean intraocular pressure was 4. 02±1. 47mmHg before injection, 13.69±4. 68mmHg before operation (P<0. 05), and17.72±5.87 mmHg after operation (P<0.05). The retina of all patients treated were reattached 2wk post-operatively. The retinal reattachment rate after the primary surgery and the secondary surgery was 87% and 100%, respectively. Post-operative complications included 7 eyes of transient high intraocular pressure, occurred during 12-14d after operations and returned to normal after less glucocorticoid eye drops and giving IOP lowering drugs. There were no intraocular hemorrhage, iatrogenic retinal breaks, infections, or lens injuries. · CONCLUSION: Intravitreal injection of TA before vitrectomy for retinal detachment associated with choroidal could improve the clinical effects, and decrease the difficulty of surgery while the injection itself is pretty safe.