ABSTRACT
Background The ultrasonography for silicone tamponade eye is a problem in diagnosis and treatment of eye diseases,especially for the calculation of intraocular lens (IOL) power.IOL Master is usually used to the biometric measurement of the silicone tamponade eye in well-equipped hospital,but it is still disabled in serious cataractous eyes.Corrective B or A-type ultrasound methods have been used for a fewer years,but these measured results are incomparable probably due to the difference of viscosity of silicone oils.Objective This study attempted to investigate the accuracy of B-type ultrasonography for ocular axial length (AL) measurement in silicone tamponade eyes.Methods The transmitting speed of ultrasonic wave in the silicone oil was determined by comparing the outcomes between balance solution mesuring and 5 500 mPas silicone oil,and a calculating formula for corrective ocular AL in 5 500 mPas silicone filled eyes was further established.Thirty-two eyes of 30 patients who received 5 500 mPas silicone oil tamponade due to complex retinal detachment were enrolled in Qingdao Hiser Medical Group from May 2012 to March 2014.The eyes were assigned to the AL＜26 mm group (18 eyes of 16 patients) and AL≥26 mm group (14 eyes of 14 patients).B-scan ultrasound and IOL Master were used to measure the AL before the removal of the silicone oil,and the Als were measured again using A-scan ultrasound and B-scan ultrasound 3 months after the removal of the silicone oil.The outcomes were compared and the correlations were evaluated among different measuring methods.The vitrous length values before and after removal of the oils,and the diopters before and after intraocular pressure (IOP) implantation were compared to varify the results of B-type sonography for 5 500 mPas silicone-tamponade eyes.Results The transmitting speed of sound wave in 5 500 mPas silicone oil was 1 023 m/second with the conversion factor 0.668 between silicon oil eyes and vitreous cavity,and the corrected formula for AL measurement was:the length form cornea apex to the posterior pole of lens or the center of the capsular membrane+ 0.668×the length form posterior pole of lens or the center of the capsular membrane to the macular area.No significnant differences were found in the AL values among the corrective-B scan,IOL Master method,postoperative Bscan method and A-scan method both in the AL＜26 mm group and the AL≥26 mm group (AL＜26 mm:F=0.108,P =0.955;AL ≥ 26 mm:F =0.011,P =0.998),and the AL values by corrective B-scan was significantly correlated with that by IOL Master,postoperative B-scan and A-scan,respectively (AL＜26 mm group:r =0.876,0.921,0.809,all at P＜0.01;AL ≥ 26 mm group:r =0.943,0.956,0.955,all at P＜0.01).The vitreous cavity depth was (20.78 ±2.13)mm by corrective B-scan in 1 day before the removal of silicone,and that in 3 months after removal of silicone was (20.89±2.16) mm,without statistical diference between them (t =0.795,P =0.219).The actual postoperative refraction in 16 eyes with IOL was (-1.25 ± 1.69) D,and preoperative refrection was (-1.50 ±0.00) D,the difference was not statistically significant (t =0.585,P =0.284).Conclusions The biometry of B-scan ultrasonography for silicone-tamponade eye is accurate and simple,with a good feasibility in clinical measurement.
ABSTRACT
Objective To investigate the clinical application of ultrasound biomicroscopy in the treatment of congenital corneal opacities.Methods Medical records of 20 eyes (15 patients) with congenital corneal opacity treated at our hospital from July 2004 to November 2011 were retrospectively reviewed.Best corrected visual acuity testing,intraocular pressure testing,slit-lamp anterior segment examination,fundus examination,slit-lamp microscopic photography,B scan examination,and ultrasound biomicroscopy were performed for analysis of complications of congenital corneal opacity and selection of surgical approaches.Results The ultrasound biomicroscopic examination showed that 5 eyes had no Descemet's membrane and corneal endothelium,20 eyes had anterior synechia,5 eyes had aniridia,3 eyes had loss of lens cortex,13 eyes had cataract,14 eyes had closed angle,and 3 eyes had pupillary membrane.14 of 20 eyes received surgical treatment,including penetrating keratoplasty combined with cataract extraction and trabeculectomy (5 eyes),penetrating keratoplasty combined with pupil angioplasty (3 eyes),penetrating keratoplasty combined with cataract extraction (3 eyes),penetrating keratoplasty combined with trabeculectomy (2 eyes),and lamellar keratoplasty (1 eye).Conclusions Ultrasound biomicroscopy is important to guide the diagnosis and treatment of congenital corneal opacity.
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Objective To evaluate the security of intravitreal injection with ciproflaxacin to retina. Methods Tweenty-four rabbits were randomly divided into 4 groups with 6 rabbits in each group. 0.1 ml ciproflaxacin in doses of 2 500, 5 000, and 10 000 ?g was intravitreally injected into the rabbits eyes, retrospectively. And 0.1 ml saline solution was injected into the vitreous body of the rats in the control group. Indirect microscope, light microscope and electroretinogram (ERG) were used to observe the changes of ocular fundus. Results Normal results of light microscopy and ultrastructure were found in 250 ?g and 500 ?g groups; irregularly arranged outer and inner nuclear layers, dropsical or even lost ganglion cells, and ultrastructural changes were in 1 000 ?g group. There was no apparent difference of ERG′s a and b amplitudes before and after intravitreal injection with ciproflaxacin in each group. Conclusion Intravitreal injection with ciproflaxacin is safe, and 500 ?g or less is the secure dosage in rabbits' eyes.
ABSTRACT
Objective To explore the clinical efficacy of modified corneal ulcer debridement combining with anti-fungal agents in the treatment of keratomycosis(fungal corneal ulcer).Design Prospective case series.Participants Criteria for inclusion:1)fungal corneal ulcer was diagnosed under direct 10% KOH wet film microscopic examination;2)corneal ulcer located away from the center with superficial infiltration,or located in the center but in small size;3)depth of corneal infiltration was uncertain.From January,2007 to December,2009,141 cases of fungal corneal ulcer patients in Shandong Eye Institute affiliated to Qingdao Eye Hospital were recruited into this study.Methods All patients received modified corneal ulcer debridement including stripping off ulcer lesion as well as infiltrated tissue,and repairing ulcer fringe.For postoperative treatment,0.25% amphotercin B or 5% natamycin and 0.5% fluconazol eye drops were topically administrated with high frequency to the diseased eye.In the meantime,itraconalzole was orally taken as systematic treatment.Clinical efficacy of the above therapy was evaluated at last.Main Outcome Measurs Corneal ulcer infiltration,corneal epithelium reparation and recovery of vision acuity were closely observed following surgery.Results 10% KOH wet film examination showed that hypha was found in all of the 141 cases.The average time for postoperative follow-up was 29 days(from 14 to 60 days).All 141 cases of fungal corneal ulcer were completely healed,of which 127 cases were healed by taking corneal ulcer debridement surgery and anti-fungal medication,and the other 14 cases had to take penetrating keratoplasty(10 cases) or lameller keratoplasty(4 cases) due to uncontrolled infection.No recurrence was found during follow-up.The average time for healing in the 127 cases was 8.5 days,and among these cases,29 cases had a preoperative visual acuity below 0.05,80 cases between 0.05 and 0.3,and 32 cases between 0.3 and 1.0.Postoperative evaluation showed that 6 cases had a visual acuity below 0.05,42 cases between 0.05 and 0.3,93 cases(65.96%) between 0.3 and 1.0,and among 93 cases,81 cases(57.45%) had a visual acuity between 0.5 and 1.0.Conclusions The modified corneal ulcer debridement combining with anti-fungal agents has proved to be an effective treatment for fungal corneal ulcer.It greatly improves patient's visual acuity and shortens the disease duration.For cases of superficial or uncertain infiltration,corneal ulcer debridement enables better ulcer observation and provides guidance for further treatment.