RESUMO
Objective To assess the treatment outcomes of anterior segment optical coherence tomography(OCT) assisted excimer laser phototherapeutic keratectomy (PTK) for fungal corneal ulcer.Methods Twenty-four patients (24 eyes) suffered from fungal corneal keratitis were collected by a retrospecive chart review with at least 6 months of follow-up data available.All corneal ulcer depth did not exceed 1/3 corneal thickness and were resistant to local and systemic medication therapy for at least 1 week.Patients were divided into 2 groups.14 patients with 14 eyes were taken PTK and 10 patients with 10 eyes were treated with lamellar keratectomy.Follow-up time was at least 6 months.Visual acuities,corneal thickness,confocal microscope,healing of the epithelial defect and inflammation and complications were recorded.Results The postoperative visual acuity in two groups were significantly improved,visual acuity of PTK treatment group improved significantly better than the control group (P ＜ 0.05).Healing time of PTK treatment group (19.43 ± 5.68) days was shorter than that of the control group (34.40 ± 5.38) days,the difference was statistically significant (P ＜0.05).There was no significant difference in the residual central corneal thickness between the PTK treatment group and the control group (P ＞ 0.05).Residual mycelium after operation in the treatment group was significantly decreased than that of control group.Healing time of epithelial in PTK treatment group (4.0 ± 1.1) days was shorter than that of the control group (6.20 ± 1.39) days,the difference was statistically significant (P ＜ 0.05).There was no corneal dilation in two groups.No recurrence in PTK treatment group was occurred.3 cases in control group had recurrence after 6 months,drug control was effective in 1 case,and other 2 cases undertook corneal transplantation.Conclusion Anterior segment OCT assisted PTK for corneal ulcer can effectively clear the lesion,accelerate epithelial healing,provide a new choice for the treatment of early superficial fungal corneal ulcer.
RESUMO
Objective To investigate the efficacy,adverse effect and the incidence of cardiovascular and cerebrovascular events by comparative study on simvastatin combined with ezetimibe on therapy of lowing blood lipids in metabolic syndrome patients.Methods One hundred and twenty metabolic syndrome patients were divided into experiment group (n=60) and control group (n=60).The experiment group was treated with 20 mg of simvastatin associated 10 mg of ezetimibe daily.The control group was treated with conventional-dose 20 mg of simvastatin.The period of treatment was 4 years in both groups.The efficacy,adverse effect and the occurrence of cardiovascular and cerebrovascular events were observed and analyzed.Results Blood lipid were significantly decreased in both groups after the treatment.There was significant difference on total cholesterol ( TC ) [ ( 3.05±1.17 ) mmol/L vs (4.94 ± 1.13 ) mmol/L,P ＜ 0.05 ],low density lipoprotein cholesterol ( LDLC) [ (2.12±1.03) mmol/L vs (3.16 ± 1.11 ) mmol/L,P ＜0.05] and triglyceride(TC) (1.02±0.29) mmol/Lvs (1.65 ± 0.32)mmol/L,P ＜ 0.05 ) between experiment group and control group.There were 3 cases of cardiovascular events in experiment group and 10 cases in control group,5 cases of cerebrovascular events in experiment group and 13 cases in control group.The incidence of cardiovascular and cerebrovascular in experiment group was significantly lower than that in control group (x2 =4.08 and 4.37,respectively,P ＜ 0.05 ).Conclusion Combination therapy with simvastatin and ezetimibe is more effective and it can significantly decrease the incidence of cardiovascular and cerebrovascular events in metabolic syndrome patients.