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@#AIM: To investigate the early changes of corneal higher-order aberrations(HOAs)of the anterior surface, posterior surface, and total cornea after femtosecond laser-assisted <i>in situ</i> keratomileusis(FS-LASIK)in mild to moderate myopic and high myopic patients. <p>METHODS: This retrospective study included 129 patients(129 eyes)underwent FS-LASIK surgery from December 2018 to December 2019. Treated eyes were divided into two groups, according to the preoperative spherical equivalent(SE): mild to moderate myopic group(<-6.0D, 76 eyes)and high myopic group(≥-6.0D, 53 eyes). Corneal HOAs of the anterior surface, posterior surface, and total cornea were measured by Pentacam anterior segment analysis system preoperatively and 6mo postoperatively. <p>RESULTS: The tHOAs, spherical aberrations and horizontal coma of the anterior surface and total cornea, significantly increased in both groups 6mo postoperatively(all <i>P</i><0.01). And more tHOAs, spherical aberrations and horizontal coma of the anterior surface and total cornea were induced in high myopic group than mild to moderate myopic group postoperatively(all <i>P</i><0.01). The horizontal coma of the posterior surface, significantly increased in both groups 6mo after operation(all <i>P</i><0.01). And more horizontal coma of the posterior surface were induced in high myopic group than mild to moderate myopic group postoperatively(<i>P</i><0.01). Changes in anterior surface and total corneal tHOAs, spherical aberrations and horizontal coma were related to the SE(all <i>P</i><0.01).<p>CONCLUSION:Anterior and total corneal tHOAs, spherical aberrations and horizontal coma, significantly increased after FS-LASIK, and aberration changes were related to SE. Whereas posterior corneal HOAs remained stable except horizontal coma. The long-term effect should be investigated in the future.
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Objective To investigate the efficacy of security and validity of posterior sclera reinforcement (PSR) for high myopic retinopathy (MR).Methods This study included 76 eyes in 41 patients with MR who underwent PSR and were followed up for two years.Preoperative and postoperative axial length,best-corrected visual acuity,the reattachment of retinoschisis and the complications were evaluated.Results The axial length was shortened 3 days,1 month,3 months and 6 months after operation compared with preoperation[(27.71 ± 1.60) mm,(28.11 ± 1.62) mm,(28.58 ± 1.80)mm and (29.01 ± 1.92) mm vs.(30.29 ± 2.01) mm],and the difference was statistically significant (all P =0.000).The axial length gradually increased to preoperative level at 1 year after surgery,and there was no significant difference in the postoperative 2-year and preoperative axial length (P =0.300).The best corrected visual acuity was improved 1 month after surgery,but the improvement had no significantly difference compared with the preoperative one (P =0.080).The best corrected visual acuity was improved at 3 months,6 months,1 year and 2 years postoperatively continuously,and the improvement had significantly difference compared with the preoperative ones (all P ＜0.05).In addition,there were 34 eyes with retinoschisis before surgery,and the retina was completely attached postoperatively in 27 eyes (79.41％),almost attachment was observed in 4 eyes (11.76％),and improvement was in 3 eyes (8.82％).No complications occurred during surgery.Conjunctival irritation,high intraocuiar pressure,orbital inflammation,diplopia and visual deformation and macular bleeding recurrence occurred postoperatively and all recovered in 3 months.Conclusion During 2-year follow-up,it is safe and effective for PSR to treat MR,which can control myopic progression effectively in patients with pathological myopia.
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·AIM:To observe the changes of anterior and posterior corneal curvature and anterior chamber depth after small incision lenticule extraction ( SMILE ) for low and high myopic astigmatism.·METHODS: Sixty-three cases ( 88 eyes ) undergone SMILE in our hospital were included. The patients were divided into two groups based on astigmatism degree:the Group A: -2. 00D to -4. 00D astigmatism, the Group B: - 0. 25D to - 1. 00D astigmatism. Patients were examined at 1wk, 1 and 3mo after operations. Visual acuity, intraocular pressure, refraction, corneal curvature and anterior chamber depth were recorded. The change of anterior and posterior corneal curvature and anterior chamber depth was compared. Spearman correlation analysis and independent t test were used for statistical analysis.·RESULTS: Surgery was done well in all patients without complications. No statistically significant difference was found between the two groups in posterior corneal curvature and anterior chamber depth preoperatively, postoperatively 7d,1 and 3mo (P>0. 05). One week postoperatively, the anterior corneal curvature was statistically significant from that of preoperative in both groups (P<0. 05), while there were no significant differences at 1 and 3mo after operation (P>0. 05).·CONCLUSION: No significant change of anterior and posterior corneal curvature and anterior chamber depth was found after SMILE for correcting low and high myopic astigmatism. One week after SMILE the anterior corneal curvature become stable.
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The rate of blinding caused by high myopic maculopathy is high, vitrectomy is the most common treatment. However, the effectiveness of vitrectomy for high myopic patients who have serious posterior scleral staphyloma is not ideal. Recent years, posterior scleral reinforcement is used as a supplementary method with vitrectomy in clinical, treating for high myopic maculopathy. lt achieves a positive curative effect especially in macular foveoschisis and macular hole cases. ln this article, we introduced a review of history, current situation, material and surgery operand of scleral reinforcement. lt also makes a further discussion of its prospects used in retina surgery.
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Objetivo: Determinar las características clínicas y los resultados quirúrgicos en pacientes con esotropía miópica adquirida progresiva. Métodos: Se realizó un estudio prospectivo en 9 pacientes remitidos al servicio de oftalmología pediátrica y estrabismo desde septiembre de 2006 a diciembre de 2009. Se analizaron las siguientes variables: edad, defecto refractivo, longitud axial, limitación de movimientos oculomotores, desviación horizontal y vertical antes y después de la cirugía. Se aplicaron retrocesos amplios de rectos medios para resolver la esotropía y diferentes variantes quirúrgicas para eliminar la hipotropía. Resultados: La edad promedio fue de 44,3 años. En el 67 % de los pacientes la afectación era bilateral. La media de la longitud axial para el ojo derecho fue de 28,1 mm y para el ojo izquierdo de 29,7 mm. La media del ángulo de desviación horizontal preoperatorio fue de 74,4 dioptrías prismáticas; la media de la desviación vertical fue de 14,4 dioptrías prismáticas. El 67 % obtuvo ortotropía horizontal y vertical, mientras el 22 % quedó estéticamente aceptable y el 11 % resultó en un estrabismo residual horizontal y vertical. Conclusiones: La recesión amplia de los rectos medios resolvió la esotropía en las 3/4 partes de los pacientes. La técnica de Yokoyama no produjo la corrección de la hipotropía en 1/4 parte de los pacientes; mientras que con la técnica de supraposición del recto lateral se obtuvo un 100 % de éxito.
Objective: To determine the clinical characteristics and surgical outcomes in patients with acquired progressive myopic esotropia. Methods: A prospective study of nine patients referred to the Service of Pediatric Ophthalmology and Strabismus from September 2006 to December 2009 was conducted. It analyzed the following variables: age, refractive error, axial length, limited ocular movements, horizontal and vertical deviation before and after surgery. There were applied wide recessions of medial rectuses to resolve esotropia and several different variants to eliminate hypotropia. Results: The mean age of the sample was 44,3 years. In 67 % of patients, the disorder was bilateral. The mean axial length for the right eye was 28,1 mm and for the left eye was 29,7 mm. The mean preoperative horizontal angle of deviation was 74,4 diopters and the mean vertical deviation was 14,4 diopters. Orthotropy was achieved in 67 % horizontally and vertically, whereas 22 % was aesthetically acceptable and 11 % of cases resulted in residual horizontal and vertical strabismus. Conclusions: The wide recession of both medial rectuses resolved esotropia in 75 % of the patients. Yokoyama's technique did not achieve hypotropia correction in 25 % of the patients, whereas the lateral rectus supraposition technique was 100 % successful.