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@#AIM: To analyze the hemostatic effect and mechanism of triamcinolone acetonide in the treatment of proliferative diabetic retinopathy(PDR).<p>METHODS: Totally 400 patients were treated in our hospital for PDR between January 2013 and March 2014. All subjects were divided into groups. The control group was treated with vitrectomy directly. The observation group was treated with triamcinolone acetonide at 4-14d before surgery. The differences of the indexes and complications in postoperative vision correction were compared between the two groups.<p>RESULTS: The expression levels of u-PA, t-PA and PAI-1 in the observation group were significantly higher than those in the control group(<i>P</i><0.01). The operation time and blood loss during the observation period were significantly lower in the observation group than in the control group(<i>P</i><0.01). The incidence of retinal breaks and vitreous hemorrhage in the group was significantly lower than that in the control group(<i>P</i><0.05). The incidence of macular edema after the operation was significantly lower than that in the control group(<i>P</i><0.01).<p>CONCLUSION: Vitrectomy in patients with PDR is often accompanied by hemorrhage and various complications. The use of triamcinolone acetonide can regulate the level of multiple clotting factors in the vitreous cavity of the patient, thereby reducing the amount of bleeding or directly exerting hemostasis, increasing surgical safety, reducing the incidence of complications, which is worthy of clinical application.
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To compare the safety, efficacy, predictability, stability and complications of wavefront-guided laser-assisted subepithelial keratectomy ( LASEK ) in low myopia, myopic astigmatism and high myopia correction.METHODS: A retrospective analysis of 416 eyes were assigned to 3 groups:159 eyes with low myopia ( LM) and mean refractive spherical equivalent (MRSE) of-3. 68±1. 33 dioptre ( D ); 161 eyes with myopic astigmatism ( MA ) and MRSE of -5. 99 ± 2. 24D and mean cylinder of 2. 41 ± 1. 07D;and 96 eyes with high myopia (HM) and MRSE of- 7. 41 ± 0. 80D. After an epithelial flap creation, a wavefront-based excimer laser ablation was performed. Safety, efficacy, predictability and stability were evaluated at day 10, 2, 6 and 12mo postoperatively.RESULTS:At 12mo, the MRSE was -0. 36 ± 0. 31D in LM group, 0. 15 ± 0. 41D in MA group and 0. 58 ± 0. 68D in HM group. The uncorrected visual acuity ( UCVA) was 20/20 in 90. 60% of patients in LM group, 78. 90% in MA group and 67% in HM group. Efficacy indices were 0. 98, 1. 04 and 0. 92 in LM, MA and HM groups, respectively. Safety indices were 1. 00, 1. 07 and 1. 05 in LM, MA and HM respectively. Five eyes (3. 1%) in the LM group gained 1 line. Forty-four eyes (27. 3%) in MA gained 1-3 lines and eighteen eyes (19. 2%) of HM group gained 1-2 lines of BSCVA. Only 2 eyes in LM group developed corneal haze. There were not statistically significant differences in efficacy and safety indices amongst three groups.CONCLUSlON:Wavefront-guided LASEK is an effective and safe procedure for the treatment of LM, MA, and HM. although in myopic astigmatism the predictability, efficacy and safety indices had been better.
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PURPOSE: To report the dynamic nature of human optical aberrations in the scotopic condition. METHODS: A total of 20 eyes who were candidates for laser vision correction were included in the present study. Repeated wavefront data were obtained using WavescanTM (AMO/VISX). From the wavefront analysis data, the sphere, astigmatism, average pupil size, spherical aberration, coma and trefoil were selected and used to investigate any correlation among the parameters. RESULTS: The sphere, spherical aberration, coma and pupil size showed a dynamic change in the scotopic condition. The spherical aberration and pupil size decreased by the amount of 0.10 +/- 0.04 microm and 0.55 +/- 0.37 mm as the sphere changed 1 D in myopic direction. There was significant positive correlation between the sphere and spherical aberration in 13 eyes of 9 patients (65%), between the sphere and pupil size in 5 eyes of 4 patients (25%), and between the sphere and coma in 3 eyes of 3 patients (15%). The spherical aberration decreased significantly in 4 eyes of 4 patients (20%) as the pupil size decreased. CONCLUSIONS: The optical aberration of human eyes showed a dynamic nature in the scotopic condition. In particular, there was significant correlation between the sphere and spherical aberration. The observed correlations have the potential to be used as helpful indicators to select the optimal wavefront data for the laser vision correction.