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With the development of posterior chamber phakic intraocular lenses implantation and the constant improvement of the implantable collamer lens(ICL), ICL V4c implantation has become one of the main methods for correcting moderate and high myopia. Vault is an important indicator to evaluate the security of posterior chamber intraocular lens implantation. In recent years, optimizing surgical procedures to obtain the ideal vault in ICL V4c implantation surgery has become a research hotspot. This paper aims to provide help for improving surgical safety by summarizing and analyzing the optimized programs of ICL V4c implantation surgery. The focus will be on preoperative examination, intraoperative surgical design, and postoperative follow-up.
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AIM:To observe the early variation trend of the vault after phakic posterior chamber implantable collamer lens/toric implantable collamer lens(ICL/TICL V4c)implantation and analyze the related influencing factors.METHODS:In this retrospective study, a total of 49 patients(98 eyes)who underwent ICL/TICL V4c implantation in the Lanzhou Huaxia Eye Hospital from October 2020 to March 2021 were enrolled. Preoperative ocular biometric parameters were collected, including spherical equivalent(SE), intraocular pressure, axial length, anterior chamber depth(ACD), lens thickness(LT), central corneal thickness, anterior chamber angle(ACA), anterior chamber volume(ACV), white to white corneal diameter(WTW), mean keratometry K1 and K2, and intraoperative implantation size of ICL. The vault was measured by anterior segment optical coherence tomography(AS-OCT)at 1, 3d, 1wk and 1mo after surgery. The patients were divided into insufficient vault group(<250μm, 12 eyes), normal vault group(250-750μm, 62 eyes)and excessive vault group(>750μm, 24 eyes)according to the vault at 1mo after surgery. The factors affecting the postoperative vault were analyzed.RESULTS:The mean vault values at 1 and 3d, 1wk and 1mo after surgery were 591.05±293.44, 599.62±309.78, 592.22±301.49 and 586.69±285.63μm, respectively. There were significant differences in WTW, ACA, ACV, ACD, ICL size and LT at 1mo after surgery(all P<0.05). The regression equation of vault at 1mo after surgery was as follows: vault(μm)=-3142.19+388.25×WTW+10.40×ACA-301.63×LT(R=0.674, R2=0.454, adjusted R2=0.436). WTW had the greatest influence on vault at 1mo after surgery(β=0.47, P<0.001), followed by LT(β=-0.34, P<0.001)and ACA(β=0.17, P=0.047).CONCLUSION:WTW, ACA and LT were the main factors that affected and predicted the vault at 1mo after ICL/TICL V4c implantation.
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AIM:To explore the changes of intraocular pressure measured by noncontact tonometer (IOPNCT) with high myopia and analyze the relative fators after small incision lenticule extraction(SMILE).METHODS:A retrospective study.Totally 108 cases (216 eyes) with high myopia received SMILE during March 2015 to October 2016 were involved.The IOPNCT, corneal central thickness (CCT) and corneal curvature for 3mo were recorded and analyzed by ANOVA, LSD t test.The Pearson correlation analysis and multiple linear regression model analysis were used to evaluate the relationship between IOPNCT and its influence factors.RESULTS:(1) There was significant statistical difference in IOPNCT after SMILE at 1d, 1wk, 1 and 3mo compare with preoperative (t=17.785, P=0.019;t=17.981, P=0.016;t=18.841, P=0.012;t=19.364, P=0.001);the IOPNCT after SMILE decreased.The IOPNCT values at every time after SMILE was no statistical difference (t=1.871, P=0.818;t=3.062, P=0.328;t=1.143, P=0.373).(2) The IOPNCT in high myopia were positive correlated with CCT and corneal curvature after SMILE (r=0.4356, 0.295;P<0.05), respectively.(3) The multiple linear regression model analysis revealed that Y=-14.601+0.348X1+0.03X2 (Y was IOPNCT, X1 was corneal curvature, X2 was CCT,P<0.001);Y=3.679+0.28X1+0.012X2 (Y was△IOPNCT,X1 was variation of corneal curvature,X2 was△CCT, P<0.001).CONCLUSION:The IOPNCT decreased after SMILE in high myipia, and it showed that there was no significant influence to use glucocorticoid eye drops in short terms.There was positive correlation among IOPNCT, CCT and corneal curvature after SMILE.
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AIM:To explore the clinical effect of capsule membrane phacoemulsification and capsular bag in phacoemulsification in treatment of hard nuclear cataract with high myopia. METHODS:A total of 297 patients(322 eyes) with hard nucleus cataract(Ⅳ-Ⅴ grade nucleus) and high myopia were selected from Mar. 2014 to Mar. 2016 in our hospital. They were randomly divided into the observation group with 149 cases(162 eyes) and the control group with 148 cases(160 eyes). The observation group received capsule membrane phacoemulsification and the control group received capsular bag in phacoemulsification. The therapeutic effect and safety of patients in two groups were compared. The comparison of phacoemulsification time, energy parameters and corneal endothelial cell density used t-test, post-operative visual acuity and the occurrence of complications were tested by Chi-square test. RESULTS: The harder the nucleus was, the longer the phacoemulsification time and higher the average phacoemulsification energy was, and the differences were statistically significant(P 0. 05 ). After operation, the density of corneal endothelial cell in two groups was significantly lower than the density before operation ( P 0. 05 ). The intraoperative complication rate of observation group was significantly lower than that of the control group ( P0. 05). CONCLUSION: For the treatment of hard nuclear cataract with high myopia, capsule membrane phacoemulsification and capsular bag in phacoemulsification have similar effect, but capsule membrane phacoemulsification has better safety.
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AIM:To evaluate the efficacy and stability by comparing acuity and diopter of small incision lenticule extraction ( SMILE) , femtosecond laser in situ keratomileusis ( FS-LASIK ) and laser in situ keratomileusis ( LASIK ) in treating myopia with a follow-up of 6mo. METHODS: A retrospective study, 42 cases ( 84 eyes ) received SMILE, 37 cases ( 74 eyes ) received FS-LASIK and 31cases (62 eyes) undergone LASIK in our hospital during Apr. 2014 to Jun. 2014 were involved. The follow-up data of 6mo was analyzed. The preoperative spherical equivalent was -5. 91±1. 83D, -5. 89±1. 96D, -5. 88±1. 68D in SMILE, FS-LASIK and LASIK group, respectively. The differences of preoperative best corrected visual acuity ( BCVA ) , pupil diameter ( PD ) and central corneal thickness ( CCT ) had no statistically significant between three groups. The postoperative uncorrected visual acuity ( UCVA) , BCVA and diopter were comparative analyzed at 1wk, 1, 3 and 6m after surgery. RESULTS:1) No patients lost to follow-up of 1wk and 1mo. A total of 10 eyes (5 cases), 10 eyes (5 cases) and 8 eyes (4 cases) lost to follow-up of 3m in SMILE、FS-LASIK and LASIK group, respectively, and raised to 18 eyes (9 cases), 12 eyes (6 cases) and 14 eyes (7 cases) in follow-up of 6m. 2) At 1wk follow-up, the differences of UCVA between SMILE group, FS- LASIK group vs LASIK group was statistically significant respectively ( t=4. 098, P=0. 000;t=2. 493, P=0. 004). 3) In LASIK group, the differences of UCVA between 1wk vs 3, 6m follow-up was statistically significant respectively (t=3. 410, P=0. 001;t=3. 771, P=0. 000), the differences of UCVA between 1m and 6m follow-up was statistically significant (t=2. 283, P=0. 026). 4) The differences of diopter were not statistically significant among three groups at 1wk, 1, 3 and 6mo follow-up respectively (χ2=0. 119, P=0. 942;χ2=1. 504, P=0. 471;χ2=0. 949, P=0. 622; χ2=0. 277, P=0. 871). 5) the differences of eyes with UCVA≥5. 0 was statistically significant between SMILE group vs FS-LASIK group, LASIK group at 1wk follow-up (χ2=9. 249, P=0. 002<0. 05/3;χ2=12. 906, P=0. 000<0. 05/3), there was no significant statistical difference between FS-LASIK group and LASIK group (χ2=0. 500, P=0. 604). 6) there was no significant statistical difference of eyes with SE (±0. 50D) at any time post operation among three groups (χ2=0. 809, P=0. 697;χ2=1. 176, P=0. 634;χ2=0. 871, P=0. 736;χ2=0. 683, P=0. 770).CONCLUSION: All of SMILE, FS-LASIK and LASIK are effective and stable on treating myopia according to follow-up of 6mo. However, in this study, SMILE group shows more effective than FS-LASIK and LASIK at 1wk, which could enhance postoperative UCVA more rapidly.
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?The small incision lenticule extraction ( SMILE ) with femtosecond laser is a new mode of corneal refractive surgeryrecently. The safety, efficacy, stability and predictability of SMILE lead the corneal refractive surgery to a new world that only use femtosecond laser to correct myopia.With the development and popularity of SMILE, the clinical effect has aroused much concern.But there remain exited disputes in refractive stability, visual quality and corneal biomechanical property, contrast sensitivity and glare symptoms, corneal sensitivity and dye eye, corneal endothelial cells and intraocular pressure.These will be summarized in this review.
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In the past, the ways to amblyopia neural mechanism research are given priority to visual electrophysiology and so on, which express the result use two -dimensional form, these ways mainly research the functions of the state before the lateral geniculate body. For the study of optic center, animal models are used to research it. But these kinds of methods are unable to accurately detect amblyopia neural mechanisms of human beings. Vulnerable to a variety of factors, it is difficult to finish the amblyopia treatment effect evaluation. Functional magnetic resonance imaging ( fMRI ) can reflect the three-dimensional visual cortex neuron activity noninvasively and accurately, and give rise to amblyopia neural mechanism and therapeutic effect evaluation. Therefore, in this paper, the amblyopia neural mechanisms and visual center after treatment effect evaluation of fMRI research progress are summarized.
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AIM:To evaluate the recovery about the visual cortex function of stereopsis in anisometropic amblyopia after regular amblyopia treatment 6, 12 and 18mo with blood oxygenation level dependent - function magnetic resonance imaging techniques ( BOLD-fMRI) . METHODS: In this study, self-controlled study before and after treatment was used, and blocks-designed fMRI was performed on 11 children which was the first phase of research for amblyopic treatment. Functional MRI data were processed by using SPM8 which based on the Matlab 7. 12. 0. 635. Through the hypothesis drive method, the differences range of activated area in each group were compared by before and after amblyopia treatment matched t-test. RESULTS: The functional area that was left occipital lobe (BA18), middle occipital gyrus (BA19), limbic lobe (BA19), lingualis gyrus of the right occipital lobe (BA17) and the bilateral parietal lobe ( BA7 ) expanded after amblyopia treatment 6, 12mo, compared those treatment phase, mean t value was 1. 5762, 1. 6856 respectively (P CONCLUSION: In children anisometropic amblyopia, the speed of function reconstruction about visual cortical functional mediating stereopsis increase slowly after amblyopia treatment 1a.
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AIM: To observe the efficacy of Medpor porous polyethylene implants in treatment of enophthalmos combined with orbital fracture. METHODS: Seventeen cases ( 17 eyes ) with enophthalmos caused by orbital fracture underwent surgical treatment with Medpor porous polyethylene implants. All accepted a 6-mo follow-up and the data of enophthalmos, eyeball movement and diplopia were collected. RESULTS: The average difference of exophthalmos between damaged eyes and undamaged eyes was (3. 4±1. 5 ) mm preoperatively, two cases had residual 1mm enophthalmos 6mo after surgery, while other 15 cases were completely corrected. Seventeen cases suffered from eyeball movement restriction and diplopia preoperatively, 16 cases had normal eyeball movement without diplopia 6mo after surgery, 1 case with limitation of abduction and horizontal diplopia. There was no extrusion, rejection, infection or other complications occurred during follow-up. CONCLUSION: Medpor porous polyethylene implants can effectively improve the orbit volume to repair enophthalmos caused by orbital fracture.
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AIM:To analyze the recovery of visual cortex activation range of color vision in anisometropia amblyopia children after treatment by using blood oxygen level dependence-functional magnetic resonance imaging ( BOLD- fMRI ) and SPM8 software. METHODS:Self-control study. This fMRI study directly compared activity in visual cortex produced by color monocular stimulation in 13 monocular anisometropia amblyopia children. The project of study was blocked design. The data of functions and anatomical MRI was stimulated by three-primary colors and was preprocessed and analyzed by SPM8 that based on MATLAB software. According to the data, we compared the change of the central area of color vision when first visit and 1, 2 ,4wk after treatment. RESULTS: The BA17, BA18, BA19 and BA37 of amblyopia children were different activated after they accepted the three-primary colors stimulation (PCONCLUSION: After 4wk treatment, visual cortex activation of color vision of anisometropia amblyopic children is expanded, but with low extent, after the short-term treatment of amblyopia, visual cortex activation of color vision has a certain degree of recovery but not obvious.
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Acupuncture manipulations on Fengchi (GB 20) of famous doctors were taken through force feedback device, then the data was input into a digitized virtual human. Virtual Fengchi (GB 20) acupuncture force feedback simulation system was built through the virtual reality technology to achieve one-to-one high simulative manipulation effect for acupuncture students. The interaction force of the needle body and human tissues was analyzed during the acupuncture process on the 3D digital human integrated with information of Fengchi (GB 20) according to the physical characteristics of the tissues under this point. The mechanical model which is used to imitate the stress received by the body of the needle was established, and transmitted truly to the operator by the force feedback device. Thus, Fengchi (GB 20) virtual acupuncture force feedback simulation was preliminary established, and the sense of touch could be reproduced lively on the visualized virtual acupuncture human. It is held that Fengchi (GB 20) acupuncture force feedback research is a preliminary exploration for virtual acupuncture that integrated with the information of visual, tactile and force feedback. And it also provided a dynamic one-to-one simulation approach for acupuncture teaching.
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Humans , Acupuncture , Education , Acupuncture Points , Acupuncture Therapy , Methods , Computer Simulation , NeedlesABSTRACT
<p><b>OBJECTIVE</b>To observe the anatomic structure of Huantiao (GB 30) visually, to imitate the inserting process of the needle to explore the safty of needle insertion and improve the therapeutic effect of acupuncture in clinic.</p><p><b>METHODS</b>Combined with anatomic structure of acupoint, muscles and other tissues related with Huantiao (GB 30) were interactively segmented in VOXEL-MAN with the computer graphics technology. Nerves and blood vessels were reconstructed by establishing mathematic model, and the needle-inserting animation of Huantiso (GB 30) was obtained by running script file.</p><p><b>RESULTS</b>The three-dimensional (3-D) visualization of Huantiao (GB 30) on needle-inserting animation was accomplished, the spatial location and expression of Huantiao (GB 30) in the digitized virtual human body were observed, the virtual inserting process was imitated realistically, and the 3-D animation of needle insertion at Huantiao (GB 30) was created.</p><p><b>CONCLUSION</b>Building mathematic model is favorable for expressing the anatomic structure of Huantiao (GB 30) in 3-D space, imitating the process of needle insertion realistically and observing the spatial structure of the point and the around tissues, which can provide a solid foundation for the safety of needle insertion of acupoints and improve therapeutic effect of acupuncture in clinic.</p>
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Humans , Acupuncture Points , Acupuncture Therapy , Computer Graphics , Imaging, Three-DimensionalABSTRACT
<p><b>OBJECTIVE</b>To discuss the mechanical virtual reality when acupuncture on Jianliao (TE 14) so as to get perform perceptual knowledge of acupuncture for beginners through studying 3D reconstruction of surrounding tissues of this acupoint.</p><p><b>METHODS</b>Related tissues were segmented and reconstructed by establishing mathematics model based on the operational platform of VOXEL-MAN (vision reappearance); and mechanical model was constructed and fused with related data of virtual human (touch reappearance); data communication between the force feedback apparatus and the operational platform of virtual human were set up by interchanging vision reappearance module and touch reappearance module.</p><p><b>RESULTS</b>In Linux system, the operator could experience the mechanical changes while needle-tip passing various tissues of Jianliao (TE 14) as well as lifting and thrusting evenly in needling process through the force feedback apparatus.</p><p><b>CONCLUSION</b>Based on the platform of VOXEL-MAN, the sensation of needling at jianliao (TE 14) could be reappeared idealy by strength feedback instrument, so that the beginners could imitate, learn and practice the virtual acupuncture.</p>
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Humans , Acupuncture Points , Acupuncture Therapy , Biomechanical Phenomena , Computer Simulation , Imaging, Three-Dimensional , Therapy, Computer-Assisted , User-Computer InterfaceABSTRACT
This paper discusses the application of virtual reality technology in the 3-D visible human body and acupuncture research. Based on the 3-D visible human fused with the localization information and hierarchy of acupoints, the paper analyzes the force against the needle and haptic rendering during the needle manipulation according to the physical properties of different tissues. A haptic model is constructed to demonstrate the force behaviors during acupuncture, and the force will be produced and passed to the manipulator by a force feedback device. It enriches the contents of 3-D visible human project, provides a dynamic simulation instrument for acupuncture teaching, and supplies a platform for acupuncture research.
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Humans , Acupuncture Therapy , Methods , China , Computer Simulation , Feedback , Imaging, Three-Dimensional , User-Computer Interface , Visible Human ProjectsABSTRACT
AIM: To assess the prevalence of refractive errors in middle school students in Lanzhou city and explore the risk factors for myopia.METHODS: A cross-sectional survey was conducted. A questionnaire assessed the students' socioeconomic background and visual tasks followed by visual acuity assessment and a full eye examination including slit lamp examination, fundus evaluation, retinoscopy, and subjective refraction.RESULTS: Among 2 256 enumerated students aged 15-19 years, 2 037 (90.3%) students had significant refractive errors. Myopia was the leading refractive error (1 951/2 256,86.5%), astigmatism was the second most common refractive error (921/2 256, 40.8%), but amblyopia (10/2 256, 0.4%),strabismus (5/2 256, 0.2%), hyperopia (4/2 256, 0.2%) and other treatable eye disorders were uncommon. Almost 95.3% of students with significant refractive errors wore spectacles before the survey. Age, sex, visual tasks, and a parental history of myopia were risk factors for myopia.CONCLUSION: The prevalence of refractive errors and the risk factors for myopia in schoolchildren in Lanzhou city are similar to those reported in other regions of China.Interventions of myopia progression should be performed to protect the visual acuity of school-aged students.
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By comparing and analyzing the similarity among the international scalp acupuncture, JIAO's scalp acupuncture and ZHU's scalp acupuncture, it is believed that the international scalp acupuncture is a combination of traditional acupuncture and other scalp acupuncture on the basis of channel theory of TCM, and this combination is worthy of discussion. However JIAO's scalp acupuncture lacks scientific evidence. So, the international scalp acupuncture following most contents of JIAO's scalp acupuncture is worthy of discussion.
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Humans , Acupuncture Therapy , Methods , ScalpABSTRACT
<p><b>OBJECTIVE</b>To discuss the problem difficult to be presented for nerves and blood vessels in the 3D reconstruction of acupoints through studying 3D reconstruction of Jianliao (TE 14).</p><p><b>METHODS</b>Muscles and other tissues were segmented by applying cointeractive segmentation method based on chromatic characteristic space; the nerve and blood vessels can be reconstructed by establishing mathematics model, and the needle-inserting animation of Jianliao (TE 14) could be obtained by running script file.</p><p><b>RESULTS</b>During the course of 3D needle-inserting animation of Jianliao (TE 14), the spatial location between all kinds of tissues including the nerve and blood vessels and the needle body could be systematically observed.</p><p><b>CONCLUSION</b>The difficulty of presenting the nerve and blood vessels in the study on 3D reconstruction of acupoints can be resolved by establishing mathematics model. The generation of 3D animation for acupoints with the nerve and blood vessels is benefit to acupuncture teaching and study on the essence of acupoints and channels.</p>
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Humans , Acupuncture Points , Imaging, Three-Dimensional , Muscles , Nervous SystemABSTRACT
<p><b>OBJECTIVE</b>To study on visible display of Meridian on the dummy human body.</p><p><b>METHODS</b>Tube model-building method and computer technique were used, and data came from Voxel-Man dummy human body development platform.</p><p><b>RESULTS</b>The visual effect of re-building Meridian is very good and it can display the different layers of anatomic structures on the Meridian lines.</p><p><b>CONCLUSION</b>The visible display of Meridian on the dummy human body is preliminary realized, which provides data carriers for establishing the platform of Meridian study.</p>