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AIM: To compare the accuracy of different intraocular lens(IOL)calculation formulas in cataract patients with axial length longer than 28mm and a history of radial keratotomy(RK).METHODS: Retrospective study. The medical records of 19 cataract patients(29 eyes)after RK and with axial length longer than 28mm who underwent cataract surgery from January 2011 to July 2020 in Beijing Tongren Hospital were analyzed. The absolute error(AE)of the difference among three different formulas was calculated. AE refers to the absolute value between the actual spherical equivalent after cataract surgery and the spherical equivalent predicted by the IOL formula. The AE values of the three formulas and the percentages of eyes with AE≤0.5, 0.75, 1.0, and 2.0D were calculated and compared.RESULTS: The AE values of the three formulas were significantly different(χ2=8.759, P=0.013). The Barrett True-K formula had the smallest median AE, which was only 0.62(0.20, 1.15)D, followed by the Haigis formula 0.76(0.34, 1.26)D, and the Holladay 1(D-K)formula had the largest 1.01(0.49, 1.62)D. The percentages of affected eyes with AE ≤0.5, 0.75, 1.0, and 2.0D for the Barrett True-K formula were 48%, 59%, 69%, and 93%, which were equal to or higher than the other two formulas.CONCLUSION: The Barrett True-K formula is more recommended among the three formulas for cataract patients after RK and with axial length longer than 28 mm.
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@#AIM:To analyze the prevalence and influence factors of macular choroidopathy secondary to high myopia, so as to better understand the development of macular choroidopathy in patients with high myopia.<p>METHODS: The current study carried out a retrospective analysis on highly myopic patients aged 40 and above(2016-01/2019-07). A total of 232 patients(461 eyes)with high myopia were included. The fundus images and OCT results of all patients were evaluated to divide the cases into two main categories, non-choroidopathy 99 patients(255 eyes)and choroidopathy 133 patients(206 eyes), with choroidopathy including choroidal atrophy and choroidal neovascularization. The statistical analysis on the prevalence of different disorders and the multivariate regression between the influence factors were performed.<p>RESULTS: The prevalence of macular choroidopathy was 36.0%(166 eyes), of which, the prevalence of choroidal atrophy was 19.5%(90 eyes), and the prevalence of choroidal neovascularization was 16.5%(76 eyes). Multivariate Logistic regression analysis showed that axial length was the influence factor of choroidal atrophy(P<0.01), age and axial length were the influence factors of choroidal neovascularization(all P<0.01), gender, age and axial length were the influence factors of choroidopathy(all P<0.01).<p>CONCLUSION: Choroidal atrophy and choroidal neovascularization were prone to occur in patients with high myopia, and the prevalence was higher in women. In addition, the prevalence increased with the increase of age and diopter.
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@#Posterior scleral reinforcement surgery is a common method for the treatment for high myopia, which can strengthen the intensity of sclera and inhibit the progression of high myopia. The posterior scleral reinforcement materials are very important, including biological materials such as pericardium, donor sclera, umbilical cord, dura mater, acellular allograft dermis and so on; non biological synthetic materials such as polyester fiber, polyester mesh sponge and plasma-modified silicone graft and so on. These materials were used in the experimental animals and clinical patients, and showed obvious effect on controlling the progress of high myopia.
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Objective To assess the outcomes of OASIS iris expander in phacoemulsification surgery of cataract with small pupil.Methods A prospective case-control study was conducted in 22 microcoria cataract patients (22 eyes).And they were randomly divided into group A and B,in which the pupils of group A were dilated by tearing instruments in 13 eyes,and the pupils of group B were dilated using OASIS iris expander in 9 eyes.All patient underwent phacoemulsification with 3.2 mm clear corneal incision and were followed up at postoperative 1 week,1 month,3 months and 6 months.Finally,the best corrected visual acuity (BCVA),intraocular pressure (IOP),corneal endothelial cell counts,pupil size before and after surgery were recorded and analyzed by an independent sample t test.Results All procedures were completed successfully by the same skilled doctor.Intraocular lenses were implanted in capsule completely,and no complications occurred.At 6 months after operation,patients'BCVA in group A (0.41 ± 0.30) and group B (0.77 ± 0.23) was significantly higher than that in group A (0.17 ±0.14) and group B (0.16 ±0.14) before operation,but there was no statistical difference between the two groups (all P ＞0.05);whereas there was no significant change in the IOP of group A and B at 6 months after operation (1 kPa =7.5 mmHg) and before operation [(14.22 ±6.00) mmHg vs.(15.70 ± 5.70) mmHg)] (all P ＞ 0.05).Moreover,corneal endothelial cell counts in group A [(1486 ±718) cells · mm-2] and B [(1246 ±516)cells · mm-2] were significantly smaller than those before operation [(2498 ±564)cells · mm-2 vs.[(2424 ± 640) cells · mm-2],with no significant difference (P=0.091).The postoperative diameter of the pupil in group A [(4.00 ±0.88) mm] and group B [(4.70 ± 1.57) mm] after operation was larger than that in group A [(2.30 ±0.35)mm] and group B [(1.94 ±0.50)mm] before operation,and there was no statistical difference between the two groups (all P ＞0.05).Conclusions OASIS iris expander can help to dilate and hold pupils and does not affect the postoperative visual acuity and intraocular pressure in mlcrocoria cataract phacoemulsification.The postoperative pupils become larger,and it is necessary to pay attention to protect corneal endothelial cell during usage of OASIS iris expander.
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Objective To investigate the correlation of wavefront aberration and myopic development in school-age children.Methods Together 150 school-age children (300 eyes) in Beijing city were collected and underwent cycloplegic refractometry for detect the refraction status and Allegretto wavefront aberrometry for the measurement of wavefront aberration for 1-year follow up.Results Totally 132 children were successfully followed up and only 120 children were included in this study.The average increased diopter was (0.74 ± 0.55) D.It was found that the development of myopia was correlated with age,myopic duration and the baseline diopter (all P ＜ 0.01),and the wavefront aberration was correlated with age (P ＜ 0.05).There were significant difference in the third order RMS value and C7 (coma) between the myopic children with rapid progress and slow progress.C12 (spherical aberration) was significantly correlated with the change of diopter (P ＜ 0.05).Conclusion Both third order RMS and C7 (coma) may be the major contributors for myopia progress in school-age children,and the increased diopter may polarize the spherical aberration toward minus values.