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AIM: To investigate long-term efficacy and safety of patients after excimer laser in situ keratomileusis(LASIK)surgery in 20a.METHODS: A retrospective study.Patients who underwent LASIK in our hospital from January 1998 to December 2001 were recruited. The patients were notified by telephone to the outpatient for follow-up. The collected data included demographic characteristics(gender and age), preoperative uncorrected distance visual acuity(UCVA)and best corrected visual acuity(BCVA), preoperative diopter, intraoperative corneal flap thickness and corneal stromal residual thickness(RST). The main indicators were long-term efficacy index, safety index, UCVA, BCVA, corneal thickness and axial length. The slit lamp, fundus and optical coherence tomography(OCT)examination were performed at the same time.RESULTS: A total of 95 patients(190 eyes)were recruited. At the final postoperative visit, there were 71 patients(142 eyes, 74.7%)had UCVA≥1.0, and 82 patients(164 eyes, 86.3%)had BCVA≥1.0. There were 2 eyes among them had bad BCVA(≤0.6)due to macular retinoschisis and glaucoma, respectively, while other patients' BCVA was 0.8. There was no significant correlation between the UCVA and BCVA of patients after surgery in 20a and the factors such as age at surgery, preoperative diopter and corneal thickness(P>0.05), but there was a negative correlation with the increase of axis length(rs=-0.32, -0.31, all P<0.05). UCVA and BCVA were positively correlated with corneal stromal residual thickness at the last postoperative follow-up(P<0.05). The safety and efficacy indexes of LASIK after surgery in 20a were 1.00±0.10 and 0.83±0.27, respectively. During the follow-up, no patients were found to have corneal ectasia and complications related to corneal flap, and no patients underwent secondary surgery. No patients with corneal dryness were found after silt lamp examination.CONCLUSION: LASIK after surgery in 20a shows good safety and efficacy.
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AIM: To report a two- year's results of iontophoresis-assisted transepithelial corneal cross-linking (I-CXL) for progressive keratoconus. METHODS: Thirty - four eyes in 24 patients with progressive keratoconus ( mean age 21. 0 ± 5. 6 years;range: 14-32 years) were treated. After 1g/ L riboflavin-distilled water solution was administered by iontophoresis-assited (current 1mA) transepithelial method for 5min in total, standard surface UVA irradiation ( 370nm, 3mW/cm2 ) was performed at a 1 - cm distance for 30min. The best corrected visual acuity ( BCVA ) measured as LogMAR number, corneal refractive astigmatism, K1, K2, Kmean, Kmax, intraocular pressure, endothelial cell density, the thickness at corneal apex and the thinnest point were measured preoperatively and 2a postoperatively. RESULTS:At 2a after the procedure, BCVA (LogMAR) improved from 0. 32 ± 0. 25 to 0. 25 ± 0. 19 ( t = 2. 849, P =0. 015). K1 decreased from 47. 12±4. 33 to 46. 06±4. 77 (t =2. 652, P= 0. 015). K2 decreased from 51. 36±5. 59 to 50. 40±6. 16 (t= 2. 121, P= 0. 047). Kmean decreased from 49. 12±4. 76 to 48. 10±5. 25(t = 2. 663, P = 0. 015). Kmax decreased from 57. 57±8. 30 to 55. 91±8. 14 (t = 2. 398, P = 0. 026). The corneal apex thickness decreased from 476. 90±38. 71μ m to 454. 43 ± 40. 86μ m ( t = 2. 853, P = 0. 010 ). The thinnest thickness decreased from 464. 38 ± 39. 92μ m to 433. 86 ±50. 78μ m ( t = 3. 485, P = 0. 002 ). Corneal refractive astigmatism, intraocular pressure and endothelial cell density did not show significant changes. CONCLUSION: I - CXL for progressive keratoconus is safe and effective which can prevent deterioration of progressive keratoconus within 2a, but further long-term studies are necessary still.
ABSTRACT
<p><b>OBJECTIVE</b>To study on the efficacy, prognosis and security of high-intensity focused ultrasound (HIFU) combined with transcatheter arterial chemoembolization (TACE) in the treatment of hepatocellular carcinoma (HCC).</p><p><b>METHODS</b>Totally 72 HCC patients treated by HIFU from December 2009 to January 2011 were divided into two groups according to treatment methods: 40 cases in HIFU group, 32 cases in TACE + HIFU treatment group (combined group). Then set up a control group include 40 cases treated by only TACE in the same period (TACE group). The improvement of clinical symptoms, AFP, reduce rate of tumor volume, survival rate of 1 year after operation and postoperative complications in front and behind the treatment were analyzed.</p><p><b>RESULTS</b>There was no significant statistical difference on the improvement of clinical symptoms in all these three groups (P > 0.05) after treatment for HCC. There is no significant statistical difference also on reduce rate of tumor volume and decrease rate of AFP in both HIFU group (35.0%, 41.4%) and TACE group (37.5%, 41.9%) (χ² = 0.054, P = 0.816; χ² = 0.002, P = 0.965). Both reduce rate of tumor volume (62.5%) and decrease rate of AFP (72.0%) in combined group were better than HIFU group (χ² = 5.394, P = 0.020; χ² = 5.098, P = 0.024) and TACE group (37.5%, 41.9%) (χ² = 4.448, P = 0.035; χ² = 5.062, P = 0.024). Kaplan-Meier survival curve showed that there was no significant statistical difference on short-term survival rate in the 3 groups. But the long-term survival rate of combined group was better than TACE group and HIFU group.</p><p><b>CONCLUSION</b>TACE combined with HIFU is a effective, safe and noninvasive treatment method to HCC.</p>