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AIM:To assess the changes in higher order aberrations after wavefront guided femtosecond laser assisted laser in situ keratomileusis ( FS-LASIK ) for moderate to high astigmatism.?METHODS: Eighty-eight eyes of 50 myopia patients with moderate to high astigmatism were included in this prospective study. There were 51 eyes with moderate astigmatism (≥-1. 50D and <-3. 00D) and 37 eyes with high astigmatism (≥-3. 00D). All patients underwent wavefront guided FS-LASIK. Uncorrected distance visual acuity ( UDVA ) , corrected distance visual acuity (CDVA), keratometry, central corneal thickness ( CCT)and higher order aberrations ( HOAs ) were evaluated before operation and 3mo postoperatively.?RESULTS:At the 3mo after operation, the mean UDVA of all eyes was above 20/20, better than before operation (P<0. 05), but CDVA remained unchanged (P=0. 36) and no eyes lost ≥2 lines of CDVA. Mean astigmstism of 85 eyes ( 97%) was reduced below - 1. 00D, mean astigmatism of 70 eyes ( 80%) was reduced below-0.50D(P<0. 05). The average corneal curvature was flatter by 3. 81 ± 1. 97D and CCT was reduced by 78. 66 ± 37. 22μm, postoperatively (P<0. 05). Coma and trefoil aberrations remained unchanged(P=0. 078, 0. 065). The spherical aberration, secondary astigmatism and the HOA root mean square ( RMS ) increased from 0. 19 ± 0. 06, 0.05±0. 02 and 0. 42±0. 12, preoperatively to 0. 32± 0. 17, 0. 26 ± 0. 08 and 0. 78 ± 0. 28 ( P < 0. 05 ), postoperatively.?CONCLUSION: Wavefront-guided FS-LASIK is a safe and effective option for the patients with moderate to high astigmstism although parts of HOAs increased.
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?AIM: To observed the clinical effect of twice fluid-gas exchange in vitrectomy for retinal detachment at the equator.?METHODS: The retrospective analysis of the 74 cases (74 eyes) with retinal detachment at the equator from January 2014 to September 2015 were reviewed. All these patients were performed standard three channel 23G vitrectomy under a wide angle lens, in which, the 37 cases ( 37 eyes ) were randomly selected and performed single fluid-gas exchange, and the other 37 cases ( 37 eyes) were performed twice fluid-gas exchange. The intraoperative surgical complications and the postoperative success rate of retinal reposition in 1wk, 1, 3mo after surgery of the two group patients were observed.? RESULTS: The intraoperative surgical complication rates of the twice fluid-gas exchange group were less than that of the single fluid-gas exchange group. The postoperative success rate of retinal reposition in the twice fluid-gas exchange group significantly increased in 1wk and 1mo after surgery, and the difference was statistically significant (P0. 05).?CONCLUSION:The twice fluid-gas exchange operation was simple and it was beneficial for beginners to master. The incomplete drainage of the single fluid-gas exchange and the pore drainage in the posterior pole or in the peripheral part of the retina were avoided during the surgery. The intraoperative surgical complication rates were reduced and the postoperative success rate of retinal reposition were improved. This operation method had great application value in clinic.
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AlM: To investigate the effect of endocapsular phacoemulsification cataract extraction and intraocular lens (lOL) implantation with a 1. 8mm or 3. 0mm clear corneal incision on total root mean square ( RMS ) value of the cornea, corneal astigmatism, spherical aberration, coma, trefoil and tear film. METHODS:ln a prospective study, 156 age- related patients ( 196 eyes ) were randomly distributed into two groups. 1. 8mm-group comprised 94 eyes that had a silicone lOL inserted through a 1. 8mm sutureless clear corneal incision, while, 3. 0mm- group comprised 102 eyes through a 3. 0mm clear corneal incision. Postoperatively, the changes in the total RMS value of the cornea, corneal astigmatism, spherical aberration, coma, trefoil and tear film at 1wk, 1 and 3mo were determined respectively. RESULTS:ln both groups, postoperatively at 1wk,there were statistically significant differences ( P 0. 05 ) between two groups at 3mo postoperative. CONCLUSlON:This study confirms that incision size has strong impact on the corneal higher-order aberrations, especially, 3. 0mm incision caused significant differences in the total RMS value of cornea, corneal astigmatism, spherical aberration, coma, trefoil and tear film compared with 1. 8mm micro-incision, therefore, micro-incision is very beneficial for clinical use in phacoemulsification.
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AIM:To observed the variation regularity of corneal endothelial cells in patients with different diabetes duration after phacoemulsification, and investigate the effects of diabetes and its disease duration on corneal endothelial cells. METHODS: Ninety-seven ( 135 eyes ) cataract patients with diabetes were selected randomly and divided into GroupⅠ( which diabetes duration ≥10a) and GroupII(which diabetes duration RESULTS:The corneal endothelial CD and proportion of hexagonal cell in the three group were decreased after surgery compared with preoperative. But the CV of corneal endothelial cells was increased on the 1 st wk and in 1st mo after surgery compared with the preoperative. The difference was statistically significant (P0. 05). The proportion of hexagonal cell in Group Ⅰ was lower than which in GroupIIafter surgery. While the CV was higher than which in Group II. The difference was statistically significant (P CONCLUSION: Phacoemulsification has some damage on the corneal endothelial. Since the impact of diabetes on the morphology and function of corneal endothelial cell was related to the diabetic duration. So phacoemulsification has more obvious damage on the corneal endothelial in diabetic patients. And the diabetic duration was longer, the damage on the corneal endothelial in phacoemulsification was more easily.