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@#AIM: To systematically evaluate changes in dioptre, keratometry results, uncorrected visual acuity, and ocular axis in teenage patients with myopia using orthokeratology lens for different durations. To understand and determine the duration for using orthokeratology lens more accurately in these patients and to provide correct and reliable treatment guidance for these patients.<p>METHODS: Computerised search was conducted to retrieve studies from PubMed, CBM, WanFang Data, VIP, and CNKI databases, from the establishment of the databases to April 2019. The search yieldedrelevant studies on the use of orthokeratology to control the development of myopia in teenage patients. After two researchers independently conducted literature screening, data extraction, and methodological quality evaluation, a Meta-analysis was performed using RevMan 5.3 software.<p>RESULTS: Finally, 8 relevant studies were selected, which included 1 136 teenage patients with myopia. The Meta-analysis revealed that after wearing orthokeratology lens for 1wk, keratometry results changed without statistical significance \〖1wk: <i>MD</i>=0.91, 95% <i>CI</i>(-0.01-1.83), <i>P</i>=0.05\〗. However, after using orthokeratology lens for 1, 3, 6, and 12mo, keratometry results decreased \〖1mo: <i>MD</i>=0.82, 95% <i>CI</i>(0.12-1.53), <i>P</i>=0.02; 3mo: <i>MD</i>=1.31, 95% <i>CI</i>(0.63-2.00), <i>P</i><0.05; 6mo: <i>MD</i>=1.35, 95% <i>CI</i>(0.62-2.09), <i>P</i><0.05; 12mo: <i>MD</i>=1.41, 95% <i>CI</i>(0.68-2.41), <i>P</i><0.05\〗. Further, after 12mo of using orthokeratology lens, the increase in dioptre was effectively controlled \〖12mo: <i>MD</i>=2.61, 95% <i>CI</i>(1.52-3.71), <i>P</i><0.05\〗, and the uncorrected visual acuity improved \〖12mo: <i>MD</i>=-0.81, 95% <i>CI</i>(-0.84--0.79), <i>P</i><0.05). The ocular axis did not show a statistically significant increase \〖12mo: <i>MD</i>=-0.06, 95% <i>CI</i>(-0.21-0.09), <i>P</i>=0.44\〗. <p>CONCLUSION: The use of orthokeratology lens cannot only reducekeratometry values, but also control the growth of the ocular axis. However, these results can be achieved only after long-term wear.
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·AIM: To compare the incidence of posterior capsule folds among different types of intraocular lens (IOL) to determine risk factors of posterior capsule folds. ·METHODS:It was a retrospective study. We collected the cases in which the patients underwent phacoemulsification (PHACO) and IOL implantation and at least one of the three types of IOL was implanted, including 2 - haptic 3 - piece IOLs (HOYA PY60AD), 4-haptic 1-piece IOLs (Bausch &Lomb AO),2-haptic 1-piece IOLs (AMO Tecnis ZCB00). The posterior capsule folds were measured using slit lamp microscope 2d after the surgery. Information of patient's age, gender, length of ocular axis, intraocular pressure, types of IOL were recorded. Posterior capsule fold risk indicators were identified by using logistic regression analysis. ·RESULTS: One hundred eighty-seven patients (242 eyes) had been collected, including 80 eyes implanted with HOYA PY60AD IOLs, 81 eyes implanted with Bausch&Lomb AO IOLs, 81 eyes implanted with AMO Tecnis ZCB00 IOLs. The incidence of posterior capsule folds of patients implanted with HOYA PY60AD IOLs was significantly higher than those of patients implanted with AMO Tecnis ZCB00 IOLs(56.3% vs 38.3%, P=0.027). While the incidence of patients implanted with Bausch &Lomb AO IOLs was significantly lower than those of patients implanted with AMO Tecnis ZCB00 IOLs(14.8% vs 38.3%, P= 0.001). Multi-factor logistics regression analysis demonstrated that independent risk factors were type of IOLs and length of ocular axis. Compared with AMO Tecnis ZCB00 IOLs, using HOYA PY60AD IOLs increased the risk of posterior capsule folds[P=0.020,OR (95% CI)= 2. 145 ( 1. 129, 4. 073 )], while using Bausch &Lomb AO IOLs reduced the risk [P=0.001, OR (95% CI)= 0. 274 (0.127, 0. 591)]. Shorter ocular axis might increase the risk of posterior capsule folds [P =0.012,OR (95% CI)=0.669(0.489,0.915)].·CONCLUSION: Haptic design should be an important consideration in IOL design. Compared with AMO Tecnis ZCB00 IOLs, using HOYA PY60AD IOLs is more likely to lead to posterior capsule folds formation, while using Bausch & Lomb AO IOLs is less likely to lead the formation. The posterior capsule folds are more engendered in eyes with shorter ocular axis.
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Objective To explore the difference of ocular biological measurements between type 1 and type 2 diabetic patients with proliferative diabetic retinopathy.Methods A total of 66 type 2 diabetic patients (67 eyes) with PDR (aged 37-77 years old),10 type 1 diabetic patients (19 eyes) with PDR (aged 18-57 years old) and 35 idiopathic macular hole patients (35 eyes,aged 21-74 years old) from September,2014 to July,2016 in our hospital were retrospectively analyzed,and the differences of axial length,corneal endothelial cell and age among three groups were compared.Results The average axial length of type 1 diabetic patients with PDR was (21.74 ± 0.68) mm,type 2 diabetic patients with PDR was (23.06 ± 0.65) mm,idiopathic macular hole patients was (23.39 ± 0.65) mm,the difference was statistically significant (P ＜ 0.001).There was no statistical difference in average corneal endothelial cells number among three groups (P =0.103),but there was statistical difference in the age (P ＜ 0.001).Conclusion The axial length in patients with type 2 and type 1 diabetic patients with PDR are less than the normal,while type 1 diabetic patient is shorter than type 2 diabetic patient,and the onset time of type 1 diabetic patients with PDR is earlier than that of type 2 diabetic patients with PDR.
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To discuss long-term changes of refractive status in children after congenital cataract intraocular lens ( lOL) implantation and analyze its related influence factors.METHODS: Seventy cases ( 110 eyes ) with congenital cataract from January 2013 to January 2014 in our hospital were selected, according to the age of patients, they were divided into group A (0. 05 );The differences had statistical significances of the corneal curvature of group A after surgery and 3mo after operation (P0. 05);the corneal curvature 3mo after operation of group A was significantly higher than that of groups B and C (P0. 05 ); There were no statistical significances on axial length after operation in groups A, B, and C (P>0. 05);Ocular axial length difference of group A 3mo after surgery was significantly higher than that of groups B and C ( P 0. 05). Refractive status of three groups after operation showed myopia moving trend, refractive change rate and refractive diopter of group A after operation was significantly higher than that of group B, group C, the difference was statistically significant (P<0. 05). CONCLUSlON: After congenital cataract extraction combined with lOL implantation, patients present myopia refractive state trend. Performance of children below 2 years old is significant. The main factor of myopia is axial growth.
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Background Idiopathic macular epiretinal membrane (IMEM) combined with age-related cataract (ARC)is a common eye disease and the primary managing approach is the combination of phacoemulsification,intraocular lens (IOL) implantation and vitrectomy.However,whether the ocular length measured by IOL Master is accurate for the calculation of IOL refraction in the eye with IMEM remains unclear.Objective The aim of this study was to evaluate the refractive outcomes of combination surgery of phacoemulsification,IOL implantation and vitrectomy in IMEM eyes.Methods A prospective cohort study was designed.Forty-two eyes of 42 patients with IMEM combined with ARC (IMEM+ARC group) were enrolled in Peking University People's Hospital and the combination of phacoemulsification,IOL implantation and vitrectomy was performed from September 2010 to August 2011,and 47 eyes of 47 patients with ARC were included for the phacoemulsification combined with IOL implantation in the corresponding period (ARC group) under the approval of Ethic Committee of Peking University People's Hospital and informed consent of the patients.Ocular length and corneal curvature were measured using IOL Master,and the expected IOL diopter was calculated with SRK-T formula.Regular eye examination and medical optometry were performed 1 month and 3 months after operation to obtain the actual diopter and the refractive error.The outcomes were compared between the two groups.The correlations of refractive error with change of fovea thickness were evaluated after operation in the IMEM+ARC group.Results There were no statistically significant differences in the age,ocular length and corneal curvature between the two groups before operation (P =0.863,0.704,0.770).The visual acuity was improved 3 months after operation in comparison with before operation in both groups (P=0.001,0.000).The negative diopters were obviously higher 1 month and 3 months after operation than those before operation in both groups (all at P＜0.001),but no significant difference was seen between the IMEM+ ARC group and ARC group (Fgroup =0.417,P =0.520).The diopter deviations 1 month and 3 months after operation were (-0.727±0.666)D and (-0.628±0.627)D in the IMEM+ARC group,and those in the ARC group were (-0.664±0.644) D and (-0.642±0.550) D,showing insignificant differences between the two groups (Fgroup =0.036,P =0.849 ; Ftime =1.523,P =0.221).In IMEM + ARC group,the macular fovea thickness was (474.89 ± 135.76)μm in preoperation,and the shift values of macular fovea thickness were (-83.84 ±91.12)μm and (-158.53±113.03) μm in postoperative 1 month and 3 months.No positive correlations were presented between the diopter deviations and change of fovea thickness 1 month and 3 months after operation in the IMEM+ARC group (r=0.200,P =0.229 ; r =0.065,P =0.698).Conclusions Myopia shift after operation is similar in the IMEM combined with ARC patients to the only ARC patients,suggesting that the ocular length and corneal curvature measured by IOL Master is not affected by epiretinal membrane.