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Objective:To evaluate the effect of peripheral defocus soft contact lenses (PDSCLs), single-vision spectacles and single-vision contact lenses (SVCLs) on the progression of myopia in children and adolescents.Methods:A meta-analysis was conducted.To collect relevant studies on the myopia control effect of PDSCLs in children, English databases including PubMed, Medline, Embase and Cochrane library were searched with myopia, contact lens, children, adolescents, myopia progression, axial length, refractive error and relevant free English terms as key words.Chinese databases including CNKI, Wanfang and VIP were searched with corresponding Chinese phrases and relevant free Chinese terms as key words.Randomized controlled trials (RCTs) on the myopia control effect in children and adolescents, with PDSCLs wearer as experimental group and single-vision spectacles or SVCLs wearer as control group, were independently collected by two researchers.Quality of included studies was evaluated with the Cochrane tool to assess risk of bias for RCTs.Combined effects of change in refraction and axial length between experimental and control groups was calculated by weighted mean difference (WMD) and 95%confidence interval ( CI). The heterogeneity of included studies was evaluated by I2 statistic.The refraction and axial length of experimental and control groups were compared by Z test.Myopia control effect of different PDSCLs add powers was analyzed by subgroup analysis.The experimental data with add power ≤+ 2.00 D, low aberration and low depth of focus were assigned to low-medium add power subgroup, and the experimental data with add power >+ 2.00 D, high aberration and high depth of focus were assigned to high add power subgroup. Results:A total of 378 publications were retrieved.Finally, 10 high-quality RCTs and 14 groups of data were included in this meta-analysis.In these studies, 1 645 myopic children aged from 6 to 18 years were enrolled, including 808 cases in experimental group and 837 in control group.The follow-up ranged from 10 to 36 months.Among the 10 studies, there were two crossover trials without a washout period, so only the first intervention results were included.According to the meta-analysis, the change in refraction in experimental group was significantly less than that in control group (WMD=0.22 D, 95% CI: 0.15-0.30, Z=5.65; P<0.05). The change in axial elongation was significantly less in experimental group than control group (WMD=-0.10 mm, 95% CI: -0.12--0.09, Z=12.28; P<0.05). Subgroup analysis showed that the WMD of refraction change and axial elongation between experimental and control groups were 0.21 D (95% CI: 0.10-0.31) and-0.10 mm (95% CI: -0.13-0.08) in the low-medium add power subgroup, respectively, and were 0.26 D (95% CI: 0.13-0.38) and -0.13 mm (95% CI: -0.15--0.10) in the high add power subgroup, respectively. Conclusions:PDSCLs have better myopia control effect than single-vision spectacles and SVCLs in children and adolescents.When the add power is higher, PDSCLs can slow the progression of myopia more effectively.
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@#With the formation of an aging society, cataract caused by age has become a public common concern about health problem all over the world. Surgery by intraocular lens replacement is the only effective mean to treat cataract. The most important thing to treat cataract is accurately calculating the intraocular lens diopter. However, some patients did not feel satisfied because the error of calculation of intraocular lens diopter. With big data analysis and self-learning, artificial intelligence can deeply analyze and autonomously decide on complex clinical data. Therefore, this technology is expected to improve the calculation accuracy of intraocular lens diopter, to reduce postoperative refractive error and to improve patients' satisfaction. By referring to relevant literature at domestic and abroad, this paper is aimed to introduce the basic principle of artificial intelligence in intraocular lens diopter calculation, analyze and compare the characteristics, advantages and limitations of artificial intelligence based on different principles.
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Objective:To investigate the efficacy and safety of Xiatianwu eye drops in the treatment of pseudomyopia in children. Methods:A total of 8 000 children with pseudomyopia who received treatment in Jiaxing Hospital of Traditional Chinese Medicine between June 2018 and June 2019 were included in this study. They were randomly assigned to receive treatment with either raceanisodamine eye drops (control group, n = 4 000) or Xiatianwu eye drops combined with raceanisodamine eye drops (observation group, n = 4 000) for 30 successive days (1 treatment course). The uncorrected visual acuity and diopter in each group were detected by an 'E' chart and optometry. Axial eye length and intraocular pressure in each group were measured using an ophthalmic A/B ultrasound scanner and a non-contact tonometer to assess the therapeutic effects. The incidence of adverse reactions during the treatment period was calculated. Results:After 30 days of treatment, the uncorrected visual acuity in the observation group was significantly higher than that in the control group [(0.88 ± 0.33) vs. (0.81 ± 0.29), t = 10.077, P < 0.001]. The diopter in the observation group was significantly lower than that in the control group [(-0.99 ± 0.36) D vs. (-1.07 ± 0.39) D, t = 9.533, P < 0.001]. Total effective rate in the observation group was significantly higher than that in the control group (91.10% vs. 88.18%, χ2 = 18.422, P < 0.001). There were no significant differences in the axial eye length, intraocular pressure and the incidence of adverse reactions between the two groups (all P > 0.05). Conclusion:Xiatianwu eye drops combined with raceanisodamine eye drops in the treatment of pseudomyopia in children can improve uncorrected visual acuity, increase therapeutic effects, and does not increase the incidence of adverse reactions.
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@#AIM:To find out the prevalence of myopia among children and teenagers aged from 3 to 18 years in Qingyang District of Chengdu, and to provide evidence for the prevention and control of myopia. <p>METHODS: A cross-sectional study was designed. A total of 72 270 students, including 37 278 males(51.58%)and 34 992 females(48.42%), aged from 3 to 18 years old were screened in 38 schools in Qingyang District of Chengdu from October 2019 to January 2020, with an average age of(10.22±3.22)years old. The incidence of myopia, high myopia, anisometropia, refractive status and axial development were analyzed. <p>RESULTS: The incidence of myopia is 57.50%, high myopia 3.33%, moderate anisometropia 9.80%, and high anisometropia 4.24%. The age group between two adjacent two comparison: the myopia prevalence of 6-14 years old difference was statistically significant(all <i>P</i><0.0033), high myopia incidence between 9-14 and 15-16 difference was statistically significant(all <i>P</i><0.0033), the incidence of moderate anisometropia 7-11, 12 and 13 years old(all <i>P</i><0.0033), high incidence of anisometropia, 5 and 6, and 8-12 years old(all <i>P</i><0.0033). Axial length: the axial length of the right eye(23.658±1.258)mm, the left eye(23.611±1.246)mm, and the axial length of the left and right eyes between 5 and 18 years old showed statistical differences(all <i>P</i><0.05), and the axial length of the right eye was longer than that of the left eye. The axial length of emmetropia and myopia of the eyes(take the right eye)in the same age group was statistically significant between the ages of 6 and 18(all <i>P</i><0.01). The relationship between the refractive state and the axial length(right eye analysis): with the increase of age, the axial length increased, and the refractive index of the equivalent spherical mirror of hyperopia decreased gradually, and myopia increased gradually after emmetropia. The mean value of the equivalent spherical mirror(SE)was positive between 3-6 years old. From the age of 7, the mean value of SE turned to a negative value, presenting a myopic change, and the axial length was 22.923±0.759mm. Under different refractive conditions, the axial length was hyperopia as 22.489±0.853mm, and the emmetropia as 23.023±0.802mm, low myopia as 23.860±0.965mm, moderative myopia as 25.137±0.929mm, and high myopia as 26.252±1.040mm. <p>CONCLUSION: Compared with the past, the prevalence of myopia and the incidence of high myopia are on the rise. Prevention of myopia before the age of 7, and prevention of the development of high myopia should start at the age of 10. It is suggested that good eye hygiene habits should be formed before the age of 8 to prevent the occurrence and development of moderate and high refractive errors. Myopia changes at the age of 7, and myopia is more likely to occur in the right eye. We can predict the trend of myopia by axial length at different ages, and also assess the severity of myopia by axial length.
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@#AIM: To investigate the temperary changes in the refraction, axial length, and choroidal thickness after a Chinese herb(Zhujing formula)feeding or injection of ranibizumab in a guinea pig myopia model.<p>METHODS: A Guinea pigs model of form-deprived(FD)myopia were randomly divided into 3 groups: Zhujing formula group, ranibizumab group and saline group(<i>n</i>=20 for each group). Zhujing formula group were fed daily with Zhujing formula solution 3.285g/(kg·d)(1.5mL/d)for 1wk. Ranibizumab group were treated with(intravitreal injections of 0.02mg)ranibizumab at the first day. Saline group were fed with 1.5mL 0.9% saline at the first day. The refraction(Diopter), axial length and choroidal thickness were measured before and at day 1, 3 and 7d postoperative. <p>RESULTS: The spherical equivalent(SE), axial length and choroidal thickness in ranibizumab group showed no significant trend after intravitreal injection(<i>P</i>>0.05). However, SE and axial length showed trendency to greater myopic shift in the Zhujing formula group and the saline group(<i>P</i><0.05). The effect began to appear on the first day after administration, achieved the maximum effect after 3d, and faded completely until 7d. On the first day after administration, the diopter and the axial length in ranibizumab group showed the lowest among three groups(<i>P</i><0.05), and choroid thickness showed the thickest among three groups(<i>P</i><0.05). At 3d after administration, the diopter and the axial length in the saline group showed the lowest among three groups, and choroid thickness showed the thickest among three groups(<i>P</i><0.05). There was no significant difference in the parameters among the three groups at 1wk after administration(<i>P</i>>0.05).<p>CONCLUSION: There is a temperary choroidal thickening of the form deprivation myopia recovery period. The ranibizumab inhibited the thickening of the choroid in the whole recovery period of form deprivation myopia, Zhujing formula slight inhibited the thickening at 3d, and the all change persisted only for 1wk.
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@#AIM: To observe the high-order aberrations, diopters, ocular structural parameters and their correlation in adolescents with high myopia.<p>METHODS: Cross sectional study. Totally 116 adolescent high myopia patients(116 eyes)were selected from the Center of Optometry of the First Affiliated Hospital of Harbin Medical University on July 9, 2019. The axial length and intraocular pressure were measured. The high-order aberrations(RMSg, RMSh, Z22, Z33, Z31,Z40,RMS3-RMS7), corneal curvature(minimum K1, maximum K2, average km), central cornea thickness(CCT), anterior chamber depth(ACD)and anterior chamber angle(ACA)were measured with Sirius three-dimensional anterior segment analyzer. The correlation between the above eye parameters was analyzed.<p>RESULTS: There was a significant negative correlation between diopter and axial length(<i>r</i>= -0.400, <i>P</i><0.001); a positive correlation between axial length and anterior chamber depth(<i>r</i>= 0.433, <i>P</i><0.05), a negative correlation between axial length and corneal curvature(K1, K2, Km)(<i>P</i><0.05); a negative correlation between total higher-order aberrations and diopter(<i>r</i>=-0.189, <i>P</i><0.05), which was negatively correlated with the axial length(<i>r</i>=-0.228, <i>P</i><0.05). There was no correlation between the higher-order aberrations and the sphericity(<i>P</i>>0.05), Z40 was positively correlated with the corneal curvature(K1, K2, Km)(<i>P</i><0.05), and no correlation between higher-order aberrations and CCT, ACD, ACA was found.<p>CONCLUSION: With the increase of myopia degree, the axial length and total higher-order aberrations of adolescent high myopia increase, and the total higher-order aberrations are negatively correlated with the axial length. The increase of axial length may be a compensatory way to reduce the high-order aberrations and promote the development of myopia.
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@#AIM: To explore the correlation between plasma insulin level and refractive development.<p>METHODS: Collected 293 adolescents aged 11-12 who were examined in our hospital from January to June 2019.According to the refractive power, they were divided into emmetropia group(76 cases), low and moderate myopia group(144 cases), high myopia group(35 cases), and hyperopia group(38 cases). Measure and compare the plasma insulin and related indexes(blood sugar, glycosylated hemoglobin, C-peptide levels)of the four groups of subjects on an empty stomach and 2h after a meal. Person correlation was used to analyze the correlation between plasma insulin and its related indexes and diopter. The receiver operating characteristic(ROC)curve was used to explore the diagnostic value of plasma insulin levels for refractive dysplasia.<p>RESULTS: The average levels of insulin, blood glucose, glycosylated hemoglobin, and C-peptide in the low and moderate myopia group and the high myopia group on an empty stomach or 2h after a meal were higher than those in the emmetropia group and the hyperopia group. The levels of insulin, blood sugar and glycosylated hemoglobin in the high myopia group were higher than those in the low and moderate myopia group(all<i> P</i><0.01). Plasma insulin, blood glucose, glycosylated hemoglobin, and C peptide levels were negatively correlated with diopter 2h after a meal(<i>r</i>=-0.691, -0.756, -0.546, -0.311, all <i>P</i><0.05). The ROC curve showed that the cut-off value of plasma insulin level 2h after meal for identifying refractive errors was 0.367, the maximum area under the curve was 0.708(<i>P</i><0.001, 95% <i>CI</i>: 0.576-0.840), the sensitivity was 63%, and the specificity was 73.7%.<p>CONCLUSION: Elevated plasma insulin level may affect refractive development, the higher the level, the higher the degree of myopia. Therefore, regular high-glycemic carbohydrate diets during the growth period may lead to the development of refractive errors and permanent visual impairment.
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@#AIM: To evaluate the clinical effect and safety of orthokeratology for minor to moderate myopia in adolescents.<p>METHODS:Sixty-three adolescent patients with mild to moderate myopia were selected in our hospital from January 2016 to January 2018. Visual acuity, corneal curvature, central corneal thickness, diopter, macular retinal thickness, axial length, intraocular pressure, tear film rupture time, corneal staining and complications were observed before and after wearing glasses for 1wk, 1, 6mo and 1a respectively.<p>RESULTS: There were significant differences in naked vision, diopter, corneal curvature and tear film rupture time before and after wearing glasses in this group(<i>P</i><0.001). And there were no differences in axial length, central corneal thickness, macular retinal thickness and intraocular pressure(<i>P</i>>0.05).<p>CONCLUSION: Corneal plastic lens is a safe and effective non-surgical method for myopia correction in adolescents at the stage of growth and development.
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@#AIM: To study the subfoveal choroidal thickness(SFCT)and its influencing factors in children with different degree of myopia.<p>METHODS: This is prospective cohort study. Eighty-nine eyes of 45 school-age children aged 5-14 years old were studied, and according to the equivalent sphericity(SE)into different refractive groups. Mild, moderate and high myopia groups had 27, 42 and 20 eyes respectively, apply the enhanced depth scanning mode(EDI-OCT)of an optical coherence tomography(OCT)scanner to measure SFCT to compare choroid thickness differences among myopia groups, to find out the change rule of SFCT between myopia groups, and Pearson correlation analysis was used to analyze the related influencing factors.<p>RESULTS:SFCT of mild myopia, moderate myopia and high myopia respectively were(253.22±43.56)μm,(223.19±54.93)μm,(185.90±50.99)μm, SFCT differences between different refractive groups were statistically significant(<i>P</i><0.05), Pearson correlation analysis found that there was a significant correlation between SFCT and SE and axial length(<i>r</i>=0.430, -0.499, 0.425, all <i>P</i><0.001); slightly related to K1 and K2, and the correlation of AL, retinal nerve fiber layer(RNFL)thickness were better than that of SE. There were statistically significant differences in family history of myopia among the myopic groups(χ2=7.44, <i>P</i><0.05). <p>CONCLUSION: The degree of myopia in children was deepened and SFCT became thinner. The degree of myopia in children is related to the family history of myopia.
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@#AIM: To investigate the relationship between the prevalence of peripheral retinal degeneration and myopic degree by using the fort ultra wide angle scanning laser ophthalmoscope(Daytona P200T)for small, early and high middle school period of low, medium and high myopia students peripheral retinal scan.<p>METHODS: With method of stratified random cluster sampling, to select myopia students in two primary schools, one junior middle school and one senior high school in Mianyang. According to different degrees, the myopia was divided into low, medium and high myopia, with 300 people and 600 eyes respectively. Application of Daytona P200T in natural pupil downward fundus image acquisition, and then the senior ophthalmologist performed the fundus examination under the slit lamp after pupil dilation.<p>RESULTS: The prevalence of peripheral retinal degeneration was different among different refractive groups, and the higher the myopia, the higher the prevalence of peripheral retinal degeneration(χ2=75.76, <i>P</i><0.001). Comparison between different degree groups prevalence of peripheral retinal degeneration: frost degeneration(STD)no statistical difference between the three groups(χ2=5.66,<i> P</i>=0.059), lattice degeneration(LD), snail track degeneration(SD), non-oppressive whitening(WWP), cystic degeneration(CD), hiatal(DRP), pigment degeneration(RP)were differences among three groups. For further comparison, except WWP(χ2=9.385, <i>P</i>=0.002), low height both two(<i>P</i>>0.017). Moderately and highly group compared, in addition to the CD(χ2=8.525, <i>P</i>=0.004)and the RP(χ2=6.454, <i>P</i>=0.011), the rest were not tested statistically. Compared with the prevalence of peripheral retinal degeneration in different segments, retinal degeneration was observed in 34 eyes(5.7%)in primary school, 90 eyes(14.9%)in junior middle and 130 eyes(21.9%)in senior high. The prevalence of peripheral retinal degeneration increased with the increase of medical grade(χ2=64.79, <i>P</i><0.001). The prevalence of WWP and CD showed no statistical difference between junior middle school and primary school and senior high school(<i>P</i>>0.05). For further comparison, except LD(χ2=6.209, <i>P</i>=0.013)and STD(χ2=9.953, <i>P</i>=0.002), no statistical difference in the primary schools and junior middle, junior middle and senior high(<i>P</i>>0.017), statistical difference was detected between the primary schools and senior high school(<i>P</i><0.017).<p>CONCLUSION: The prevalence of peripheral retinal degeneration of myopia was positively correlated with myopia and learning period.
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Objective To investigate the effects of amphiregulin antibody on the axial length,diopter and posterior sclera thickness in eyes of bilateral lens-induced myopic guinea pigs.Methods A total of 60 healthy three-colored short-hair guinea pigs were randomly divided into 5 groups:myopic model group,low dose group,medium dose group,high dose group and normal control group,12 rats in each group,and both eyes of the guinea pigs in the former four groups were induced by-10 D lens,while the normal group did not make any treatment.After wearing of goggles for 2 weeks,the right eyes of guinea pigs were intravitreally administrated with 5 μg,10 μg,20 μg anphiregulin antibody for the low,medium and high dose group,respectively.At the same time,the left eyes of these groups were given the same dose of Ringer' s buffer (buffer group).Continuous wearing of the lenses before and after injection of antibody was allowed.Diopter and axial length of guinea pigs were measured before wearing of the lenses,2 weeks after wearing lenses and 5 weeks after the experiment (after 3-times injections of antibody).Moreover,the thicknesses of retina,choroid and sclera in the posterior pole were detected by PAS staining.Finally,the expression of amphiregulin and EGFR mRNA and protein was detected by real time quantitative PCR and immunofluorescence.Results After 2 weeks of lens induction,the axial length of the myopic model group increased,but the diopter decreased when compared with the normal control group,and the differences were statistically significant (both P ＜ 0.05).Compared with the buffer group,after intravitreal injection of amphiregulin antibody,the axial length in the low,medium,and high dose groups decreased,while the diopter increased,and the scleral thickness at the posterior pole increased significantly in a dose-dependent manner,with statistically significant differences (all P ＜ 0.05).However,there was no significant change in retinal thickness at the posterior pole of all groups.Real-time quantitative PCR and immunofluorescence showed the expression of amphiregulin mRNA and protein in the retina was upregulated the myopic model group and buffer group,but downregulated in the high,medium,and low dose groups.Furthermore,when compared with the buffer group,the expression level of epidermal growth factor receptor in the retina of the low dose group was decreased (t =2.606,P =0.022),but there was no significant difference in the other groups.Conclusion After injection of amphiregulin antibody into the eyes of bilateral lens-induced myopic guinea pigs,the diopter increases,but the axial length is significantly shortened,and the posterior sclera is thickened,which may involve a decrease in the expression of amphiregulin.
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@#AIM: To explore the effects of overnight orthokeratology lens and conventional frame glasses on the myopic diopter, uncorrected visual acuity and ocular parameters of myopia adolescent. <p>METHODS: Totally 102 cases of(204 eyes)of adolescent myopia patients were randomly divided into observation group and control group with 51 cases(102 eyes)in each group during April 2014 to April 2017. Control group was only given conventional frame glasses, and observation group was given overnight orthokeratology lens. The myopic diopter and uncorrected visual acuity(UCVA)before wearing glasses and at 1wk, 1, 3, 6mo and 1a of wearing glasses, and the ocular parameters before wearing glasses and at 1a after wearing glasses were observed in the two groups, and the occurrence of complications was compared between the two groups. <p>RESULTS: After 1wk to 1a of wearing glasses, the myopic diopter in observation group was gradually decreased(<i>P</i><0.05), and there was no significant difference in control group(<i>P</i>>0.05), but there was statistically significant difference between-groups at different time points(<i>P</i><0.05). After 1wk to 1a of wearing glasses, the UCVA in observation group showed a increasing tendency(<i>P</i><0.05), and the UCVA in observation group after 6mo to 1a of wearing glasses was significantly higher than that in control group(<i>P</i><0.05). At 1a after wearing glasses, the axial length, corneal endothelial cell density, central anterior chamber depth, and intraocular pressure in observation group were not significantly different from those before wearing glasses(<i>P</i>>0.05), and the axial length in control group was significantly longer than that before wearing glasses and that in observation group(<i>P</i><0.05). The total incidence rates of complications in observation group and control group were 10.8% and 6.9% respectively(<i>P</i>>0.05).<p>CONCLUSION: Overnight orthokeratology lens for adolescent myopia can effectively correct the myopic diopter, and improve the uncorrected visual acuity. It is less harmful to the eyes and less complications, and it is safe and reliable in clinical application.
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Objective:To investigate the effect of astaxanthin on the refractive status and pathological morphology of the guinea pig myopia models induced by concave lens,and to elucidate the improvement effect of astaxanthin on the refractive status of myopia.Methods:A total of 48 healthy guinea pigs were randomly divided into blank control group (n=12) and model group (n=36);the guinea pig myopia models (right eyes) were established with far vision optical method (left eyes were used as control).The guinea pig models were divided into model control group,high of astaxanthin (50 ig · kg-1) group and low dose of astaxanthin (25 ig · kg 1) group.After 2 and 4 weeks treatment,the diopters and the lengths of optic axis of both eyes of each guinea pig in various groups were tested,and at 4 weeks the right eyes of the pigs were removed and the pathomorphology was observed by HE staining.Results:The diopters of the model eyes in model group were lower than those of left eyes used as control (P＜0.05) and those of right eyes in blank control group after 2 and 4 weeks (P＜0.05 or P＜0.01).The length of optic axis of the model eye in model group was increased compared with left eye used as controls and blank control group after 2 weeks (P＜0.05) and especially at 4 weeks (P＜0.01).Compared with model group,the axial oculi and diopters of the guinea pigs in astaxanthin groups were increased (P＜0.05);the pathohistological changes were improved,the collagen fracture was obviously decreased,and the collagen fibers were orderly arranged.Conclusion:Astaxanthin can recover the length of optic axis,diopter and histomorphology of sclera of guinea pig myopia models in some extents.
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Objective:To investigate the effect of astaxanthin on the refractive status and pathological morphology of the guinea pig myopia models induced by concave lens,and to elucidate the improvement effect of astaxanthin on the refractive status of myopia.Methods:A total of 48 healthy guinea pigs were randomly divided into blank control group (n=12) and model group (n=36);the guinea pig myopia models (right eyes) were established with far vision optical method (left eyes were used as control).The guinea pig models were divided into model control group,high of astaxanthin (50 ig · kg-1) group and low dose of astaxanthin (25 ig · kg 1) group.After 2 and 4 weeks treatment,the diopters and the lengths of optic axis of both eyes of each guinea pig in various groups were tested,and at 4 weeks the right eyes of the pigs were removed and the pathomorphology was observed by HE staining.Results:The diopters of the model eyes in model group were lower than those of left eyes used as control (P＜0.05) and those of right eyes in blank control group after 2 and 4 weeks (P＜0.05 or P＜0.01).The length of optic axis of the model eye in model group was increased compared with left eye used as controls and blank control group after 2 weeks (P＜0.05) and especially at 4 weeks (P＜0.01).Compared with model group,the axial oculi and diopters of the guinea pigs in astaxanthin groups were increased (P＜0.05);the pathohistological changes were improved,the collagen fracture was obviously decreased,and the collagen fibers were orderly arranged.Conclusion:Astaxanthin can recover the length of optic axis,diopter and histomorphology of sclera of guinea pig myopia models in some extents.
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AIM: To evaluate the effect of orthokeratology on progression of juvenile myopia and analysis its influencing factors.METHODS: Totally 97 patients (189 eyes,aging from 8 to 17 years old) who received orthokeratology lenses treatment in our hospital from January 2012 to December 2014,were followed up for 2a.The visual acuity,corneal curvature,diopter,and ocular axial length were observed.Factors of influencing myopia progress in juvenile were analyzed.RESULTS: At 1mo after receiving orthokeratology contact lenses,the visual acuity and corneal curvature were changed compared with that of before(P<0.001).After 2a of receiving orthokeratology contact lenses,the difference was significant compared with baseline: spherical equivalence (-0.51±0.64D,t=10.864,P<0.001),axial length(0.33±0.31mm,t=14.879,P<0.001),corneal astigmatism (-0.25±0.43D,t=5.375,P<0.001).Statistic analysis showed that there was a negative correlation between the spherical equivalence and age,baseline of diopter or ocular axial length(P<0.05).CONCLUSION: Orthokeratology can effectively improve the visual acuity of patients.Although there is slightly progression in diopter and ocular length after 2a of wearing orthokeratology contact lenses.Orthokeratology is an effective treatment on controlling progression of juvenile myopia,especially in the elder children who with the longer basic axial length and the greater diopter.
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@#AIM:To discuss the clinical features and operation methods on small-diopter intermittent exotropia. <p>METHODS:Totally 206 in-patients with small-diopter intermittent exotropia(IXT)in different operation groups, from September 2013 to September 2014,were observed for the eyesight, refraction, dominant eye, exotropia degree, synoptophore and near stereopsis before and after operation. Three types were divided in 206 cases. One hundred and thirty-two cases of basic IXT were the first type, in which 52 cases underwent nondominant eye unilateral recess-resection(nondominant eye unilateral recess-resection, ndR& R), 40 cases underwent dominant eye unilateral recess-resection(dominant eye unilateral recess-resection, dR& R), 40 cases underwent bilateral lateral rectus recession(bilateral lateral rectus recession, BLR-rec). Sixty-one cases of convergence insufficiency IXT were the second type, in which 40 cases underwent ndR& R, 21 cases underwent bilateral medial rectus amputation. Thirteen cases of divergence excess IXT were the third type, in which 7 cases underwent ndR& R, 6 cases underwent BLR-rec. The rates of the orthophoria, undercorrection, overcorrection and the recovery of synoptophore and near stereopsis after surgery in 1, 6, 12, 24mo were compared in 3 types. <p>RESULTS: The clinical features of 206 cases with small-diopter IXT were: in the most cases, between 5 and 12 years old; nondominant eye was left eye; the eyesight of nondominant eye was lower than another eye; refraction status were myopia, astigmatism and anisometropia; basic IXT was the most common type; exotropia degree was between 40<sup>△</sup> and 60<sup>△</sup>; some cases owned binocular function and near stereopsis. Comparison of operation methods in 3 groups: orthophoria comparisons in basic IXT among ndR& R group, d R& R group and BLR-rec group were significant difference(<i>P</i><0.05)after operation in 12 and 24mo. Orthophoria comparison in insufficiency IXT between ndR& R group and BMR-amp group was not significant difference(<i>P</i>>0.05)after operation. The operation of divergence excess IXT was effective. Orthophoria comparison in ndR& R group between basic IXT and convergence insufficiency IXT was significant difference(<i>P</i><0.05)after operation in 6, 12 and 24mo. Synoptophore and near stereopsis of some cases were improved after operation. <p>CONCLUSION:Early surgical treatment of the pediatric patients with small-diopter IXT is benefit for the establishment of binocular function and stereopsis. Adult surgical treatment can improve the appearance and alleviated eyestrain. In 206 cases, the operation method of ndR& R is obvious curative effective in each type of small-diopter IXT. The operation methods of BMR-amp and BLR-rec are obvious effective in insufficiency intermittent and divergence excess IXT.
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@#AIM: To study the SRK-II and SRK-T in clinic for calculating intraocular lens(IOL)in cataract patients, and to provide the basis for preoperative selection of IOL measurement formula and prediction of appropriate IOL diopter in cataract patients with different axial. <p>METHODS: Randomized selection of 160 cataract patients of 200 eyes with different axial from April 2013 to November 2015 admitted to the hospital were taken. There were 92 males with 120 eyes, 68 females with 80 eyes, the average age of 66.2 ± 4.36 years old. The axial length(AL)was measured by type A ultrasonography. They were divided into four groups according to AL. Patients with shorten AL were Group A, with normal AL were Group B, with lengthening AL were Group C, with extremely AL were Group D. The IOL diopter of the four groups were calculated by SRK-Ⅱ and SRK-T, and the corresponding IOL(American AMO intraocular lens)was implanted. The actual diopter at best corrected visual acuity(best corrected visual acuity, BCVA)was measured by optometry and retinoscopy at 1wk, 1, 3mo after operations. The mean absolute refractive error(MAE)was calculated.<p>RESULTS: The MAE of the SRK-Ⅱ and SRK-T at 1wk after operations was different with that at 1mo and at 3mo(<i>P</i><0.05), that at 1mo was not significantly different with that at 3mo(<i>P</i>>0.05). there was no difference between SRK-Ⅱ and SRK-T in Group A(<i>P</i>>0.05), but there were significant differences in Group B, Group C and Group D(<i>P</i><0.05). Patients of Group A more tended to become myopia at 1mo than at 1wk(<i>P</i>=0.035). Patients of Group B and C both got myopia shift at 1wk and 1mo after operation(<i>P</i> =0.84, 0.88). Patients of Group D tended to become hyperopia at 1mo than at 1wk(<i>P</i>=0.041). <p>CONCLUSION: This study shows that refraction become stable at 1mo after operations; the accuracy of the two methods are nearly same in Group A and B, while in Group C and D, SRK-Ⅱ is better than SRK-T on the comparison of MAE. SRK-T is better than SRK-Ⅱ on IOL calculation in patients with different AL.
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PURPOSE: In the present study, the surgical outcome and postoperative exodrift pattern between bilateral lateral rectus recession (BLR) and unilateral lateral rectus recession (ULR) in intermittent exotropia of 20 prism diopters (PDs) were compared. METHODS: In this retrospective study, 5.0 mm BLR or 8.5 mm ULR was performed on 82 patients for the treatment of intermittent exotropia of 20 PDs with a follow-up period of 2 years. The main outcome measures were postoperative 1-week, 1-month, 6-month, 1-year and 2-year exodeviation angles with their patterns and success rates. A surgical success was considered an alignment within 10 PDs and sensory success was defined at 100 seconds of arc. RESULTS: The mean deviation angles at postoperative 1 week were 4.7 ± 5.1 PD esodeviation in the BLR group (44 patients) and 1.2 ± 4.2 PD esodeviation in the ULR group (38 patients). The BLR group was significantly more overcorrected than the ULR group (p = 0.001), but postoperative exodrift occurred in the BLR group at 1 week, 1 month, 6 months, 1 year, and 2 years. In the ULR group, the postoperative exodrift occurred at 1 week, 1 month, and 6 months which was followed by stabilized alignment. Surgical success rate at the postoperative 2-year follow-up was 75.0% in the BLR group and 81.6% in ULR group (p = 0.717). CONCLUSIONS: ULR showed less overcorrection and early exodrift up to only 6 months, resulting in stabilization of the alignment afterwards; surgical success rate at the final 2-year follow-up was similar to BLR.
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Humans , Esotropia , Exotropia , Follow-Up Studies , Outcome Assessment, Health Care , Retrospective StudiesABSTRACT
AlM: To compare the impact of different thickness of corneal cap design on small incision lenticule extraction ( SMlLE) operation.METHODS: Forty-six cases of myopia patients ( 92 eyes) intends to SMlLE operation in our hospital were collected , and were randomly divided into 2 groups:corneal cap thickness design for 110μm in group A and 120μm in group B. Other operation parameters designs were consistent. All patients were surgeried by the same surgeon. The incidence of opaque bubble layer ( OBL ) , the ratio of difficult separation of lens, uncorrected visual acuity ( UCVA ) of each time points, and spherical equivalent ( SE) were compared.RESULTS: lntraoperative OBL incidence rate of 110μm group was higher than that of 120μm group with significant difference between the two group (P0. 05). SE were compared at 7d and 6mo after operation, showed no significant difference (P>0. 05)CONCLUSlON: Compared with 120μm group, corneal cap design SMlLE operation in 110μm group are more prone to OBL and difficult separation of lens, thus affects UCVA and postoperative recovery rate. There is no significant difference in long-term UCVA.
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To observe the diopter after cataract surgery for vision gain in high myopia and its effect on visual outcomes.METHODS: Sixty ( 120 eyes ) high myopia combined with cataract cases received phacoemulsification and intraocular lens implantation in our hospital were retrospective studied. The patients were divided into three groups based on postoperative diopter: -1. 0 ~ -2. 0D (group A), -2. 25~-3. 0D (group B) and -3. 25 ~-4. 0D ( group C ) . The uncorrected distance visual acuity ( UCDVA) , best corrected distant visual acuity ( BCDVA) , uncorrected near visual acuity ( UCNVA ) and questionnaire of Activities of Daily Vision Scale ( ADVS ) were collected to assess the vision gain at 3mo after cataract surgery.RESULTS: At 3mo after surgery, UCDVA of group A was better than that of group B, and UCDVA of group B was better than that of group C. There were no differences in BCDVA among groups. There were significant differences between the three groups' UCNVA, it was best for the group C, followed by the group B, group A was the worst. For questionnaire, no difference was observed in patients' satisfactory for surgical results, but a significant difference was detected in postoperative glasses wearing frequency between groups.CONCLUSlON: For cataract surgery in high myopia combined cataract, postoperative diopter should be calculated based on patients' daily requirements. For patients had not used to wearing glasses and near distant working condition, it's appropriated to reserve a minor degree of myopia. Conversely, for patients require near distant working and received wearing moderate and low hyperopia mirror, higher degree of myopia can be reserved.