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AIM: To investigate the influencing factors of vault after the posterior chamber phakic refractive lens(PC-PRL)implantation for patients with super high myopia.METHODS: Retrospective case study. A total of 40 patients with super high myopia(77 eyes)who underwent PC-PRL implantation in the Haixiang Eye Hospital from January 2019 to January 2021 were selected. They were followed up for at least 2a, postoperative anterior segment parameters, such as the uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), central anterior chamber depth(ACD), anterior chamber volume(ACV), anterior chamber angle(ACA), lens thickness and vault were evaluated, and then the influencing factors of postoperative vault were analyzed.RESULTS: The UCVA and BCVA of the patients significantly improved after PC-PRL implantation(P<0.001). Average safety index(postoperative BCVA/preoperative BCVA)was 1.36±0.32, and average effective index(postoperative UCVA/preoperative BCVA)was 1.23±0.31 in 2a after surgery. The vault in 2a after surgery was correlated with preoperative ACD, ACV, ACA and lens thickness, and the preoperative ACV and lens thickness had significant impact on vault in 2a after surgery.CONCLUSIONS: The PC-PRL implantation is safe and effective in super high myopia, and it can significantly improve visual acuity. Furthermore, preoperative ACV and lens thickness are important influencing factors of postoperative vault.
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Objective:To observe and analyze the superficial retinal blood flow density and its related influencing factors in the macular area of adolescents with different types of non-pathological high myopia (HM).Methods:A retrospective clinical study. From March to August 2022, 117 eyes of 117 adolescents who were admitted to Liaocheng Aier Eye Hospital due to myopia were included in the study. According to equivalent spherical degree (SE) and corneal curvature, subjects were divided into mild myopia or emmetropia group (control group), HM group, occult HM (OHM) group, and super HM (SHM) group, with 30 eyes, 28 eyes, 35 eyes, and 24 eyes, respectively. All subjects underwent medical optometry, intraocular pressure, optical coherence tomography (OCT), OCT angiography (OCTA), axial length (AL) and corneal curvature measurements. The diopter was SE. OCTA instrument was used to scan the macular region in the range of 6 mm×6 mm, and the software automatically divided it into three concentric circles centered on the fovea of the macular, namely, the central area with a diameter of 1 mm, the inner ring area with a diameter of 1-3 mm, and the outer ring area with a diameter of 3-6 mm. The superficial retinal vascular density (SRVD), vascular perfusion density (SBPD), the area, perimeter (PERIM), avascular index (AI) of foveal avascular area (FAZ) and retinal thickness were measured in the macular region as a whole and in different regions. One-way analysis of variance was used to compare the data among groups, and the least significant difference t-test was used to compare the data among groups. The correlation of AL, corneal curvature and intraocular pressure with SRVD and SBPD in macula was analyzed by Pearson correlation analysis. Results:There were significant differences in SRVD and SBPD in the central, inner and outer regions of macula in control group, HM group, OHM group and SHM group ( P<0.05). There were statistically significant differences in the thickness of the retina above, below and on the temporal side of the central and outer ring regions ( P<0.05). However, no statistically significant difference was in the thickness of the retina on the nasal side ( P>0.05). There was no significant difference in PERIM ( P>0.05). There were significant differences in FAZ area and AI ( P<0.05). Correlation analysis showed that AL was negatively correlated with SRVD and SBPD in macular whole and central, inner and outer ring regions ( P <0.05). Corneal curvature and SE were positively correlated with the SRVD and SBPD of macular whole, central area and outer ring area ( P<0.05). AL was negatively correlated with retinal thickness in the outer ring region ( P<0.05). SE was positively correlated with the thickness of the retina above, below and temporally in the outer ring region ( P<0.05). AL was negatively correlated with FAZ area and AI ( P<0.05). SE was positively correlated with FAZ area and PERIM ( P<0.05). Retinal thickness was positively correlated with SRVD and SBPD ( P<0.05). Conclusions:The SRVD and SBPD of different types of HM in adolescents decreases to different degrees. The thickness of the retina in the central region is thicker, and the retina in the outer ring region is thinner. With the decrease of SRVD, the retinal thickness gradually is thinner.
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BACKGROUND: To evaluate the long-term safety, efficacy, predictability, and stability of implantable collamer lens with a central hole (EVO ICL) implantation for correcting high myopia (HM) and super high myopia (SHM). METHODS: This prospective study evaluated 83 eyes of 46 patients who were divided into groups based on their spherical equivalent refractive error (SE): HM group (- 12 D ≤ SE < - 6 D) and SHM group (SE < - 12 D). They were followed up for 5 years after ICL implantation; assessments of uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refractive error, axial length, intraocular pressure, corneal endothelial cell density, and vault were conducted, and a questionnaire was administered. RESUITS: At 5 years postoperatively, the safety indices of the HM and SHM groups were 1.03 ± 0.10 and 1.32 ± 0.39, and the efficacy indices were 0.83 ± 0.25 and 0.86 ± 0.32, respectively. In the HM group, 60.47% and 79.07% of the eyes were within ± 0.50 D and ± 1.00 D of the attempted correction, while it was achieved for 22.50% and 47.50% of the eyes in the SHM group, respectively. The SE of the HM group decreased from - 9.72 ± 1.41 D preoperatively to 0.04 ± 0.39 D 1 month postoperatively and - 0.67 ± 0.57 D 5 years postoperatively, while in the SHM group, it decreased from - 15.78 ± 3.06 D preoperatively to - 0.69 ± 0.97 D 1 month postoperatively and - 1.74 ± 1.19 D 5 years postoperatively. CONCLUSION: EVO ICL implantation is safe, effective, and predictable for correcting HM and SHM. CDVA improved more after surgery for SHM, but the growth of axial length still needs attention.
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The aim of the present study was to investigate the potential changes in the choroidal thickness (CT) after surgical implantation of collamer lens (ICL) and to determine whether the variations in CT were associated with the degree of myopia. In the study, 98 eyes from 98 myopia patients were divided into two groups according to the degree of myopia: High myopia and super-high myopia. All eyes were measured using the swept-source optical coherence tomography (SS-OCT) technique. CT and CT variations were also recorded. The foveal CT increased significantly in high-myopia patients at 2 h after surgery and 3 months after surgery; the same tendency was observed in the inner nasal CT and outer nasal CT at the same time-points. In patients with super-high myopia, the subfoveal CT increased significantly at 2 h and 3 months after surgery compared with the pre-operative values. No statistically significant differences were obtained in any of the nine different choroidal regions evaluated at post-operative week 1 and post-operative month one. Furthermore, the increase in the subfoveal CT in the super-myopia group was significantly higher than that in the high-myopia group at 2 h and at 3 months after ICL. The results of the present study indicated that the CT significantly increased 2 h after the surgery and then reached a peak at 3 months, particularly in the subfoveal and nasal areas. A higher degree of myopia was associated with greater subfoveal choroidal changes.
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AIM: To investigate the clinical effect of small incision lenticule extraction (SMILE) for super high myopia.METHODS: Totally 64 cases (128 eyes) patients with super high myopia, were randomly divided into observation group and control group, 32 cases (64 eyes) in each group.The two groups were separately treated with SMILE or femtosecond laser LASIK (FS-LASIK).We calculated the effectiveness index and safety index by contrastive observation of clinical effects in all patients included uncorrected visual acuity, best corrected visual acuity and postoperative spherical equivalent at preoperative and postoperative 1d, 1wk, 1, 3 and 6mo.RESULTS: The safety index: the observation group and the control group at 6mo after operation were respectively 1.10±0.10 and 1.08±0.12, the difference between the two groups was not statistically significant (P>0.05).The validity index: the observation group and the control group at 6mo after operation were respectively 1.08±0.12 and 1.06±0.14 and there was no significant difference between the two groups (P>0.05).Postoperative spherical equivalent at 6mo in the observation group was 0.09±0.36D, that in the control group was 0.36±0.46D.After 6mo, the count of spherical equivalent refraction within ±0.50D were 58 eyes (90.1%) in observation group and 49 eyes (76.6%) in the control group, within±1.0D were 64 eyes (100%) and 60 eyes(93.8%).CONCLUSION: SMILE is safe and effective in the treatment for super high myopia.The postoperative visual acuity and diopter can be stabilized earlier by comparing with FS-LASIK.
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AIM: To retrospectively analyze selection of operation, surgery effect, complications and treatment methods of super high myopia combined with rhegmatogenous retinal detachment( RRD) . METHODS:A total of 47 cases(47 eyes) with the super high myopia patients combined with RRD who accepted scleral buckling of external pressure, vitrectomy combined silicone oil filling, or intravitreous gas injection were chosen in our hospital from Jan. 1, 2011 to Jan. 1, 2016. Best corrected visual acuity ( BCVA), intraocular pressure, retinal reattached rate, closure rate of holes and the postoperative complications of patients in half year were analyzed. RESULTS:Half a year postoperation, BCVA of twenty-four cases underwent vitrectomy combined silicone oil filling were improving(71%), and eight cases with scleral buckling surgery were enhanced ( 73%) . Statistical test showed the surgical treatment could significantly improve patients'eyesight, especially PPV with silicone oil, but the BCVA of patients with scleral buckling of external pressure in this study had no obvious significance according to the rank sum test. Compare with other surgery, pars plana vitrectomy( PPV ) combined silicone oil filling had more complications, such as high intraocular pressure and diplopia. CONCLUSION: The therapy of super high myopia patients with rhegmatogenous retinal detachment need many years' clinical experience, surgical skill of clinician and according to the number, the shape and the site of the retinal holes and area of detached retina, they need to choose the right means of surgery, and timely deal with postoperative complications, in order to improve the patients' postoperative retina, reset rate and visual function.
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AIM: To observe the clinical effect of phacoemulsification combined with intraocular lens implantation for high myopia ( axis oculi ≥ 30mm ) cataract, and to explore the causes and treatment methods of operation complications. METHODS: Selected 64 cases ( 86 eyes ) of cataract with high myopia patients (axis oculi ≥30mm), vision correction≤ 0. 1. Phacoemulsification combined with intraocular lens implantation was used. During 1a follow-up, the improvement of visual acuity and complications were observed. RESULTS: Postoperative best corrected visual acuity was ≥0. 4 in 35 eyes (41%), 0. 2-0. 3 in 23 eyes (27%), 0. 1-0. 15 in 25 eyes (29%), CONCLUSION: Phacoemulsification combined with intraocular lens implantation is a safe and ideal operation method for high myopia cataract, can obtain good effects, and the postoperative complications can be controlled. Because of the particularity of high myopia, operation should be gentle, technical parameters should be adjusted as appropriate, to achieve the best postoperative effects.
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Objective To investigate the clinical effect of implantable collamer lens ( ICL) in the treatment of super high myopia. Methods 20 patients with high myopia were given ICL,and changes in patients with visual acuity,intraocular pressure and corneal endothe-lial cells,and surgery-related complications and outcome were observed. Results Before surgery,the visual acuity of patients was (0. 10±0. 05),and postoperative (0. 60±0. 20),the difference was statistical significance(P<0. 05);the intraocular pressure and corneal endothe-lial cells of patients did not change significantly after surgery,with less postoperative complications. Conclusion The ICL has a very signifi-cant effect in the treatment of super high myopia,which can help to improve the patient's quality of life,and it is worthy of wide promotion and application.
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Objective:Iris-fixed IOL implantation is a new and effective therapy for phakic eyes. Because the patients are young,they know very few about the operation,which mandated delicate pre-and postoperative nursing. This article discussed how to nurse the patients receiving iris-fixed IOL implantation operation in phakic eyes for super high myopia. Methods:Fifty eight eyes of 30 patients with super-high myopia received iris-fixed IOL (Verisyse IOL) implantation. Pre-and postoperative nursing course were summarized. Results:Focused education through preoperative visits,active cooperation in the operation and meticulous postoperative nursery were beneficial for the operation. Significant vision improvement was found after surgery. Conclusion:The planned,step by step,focused nursing course can improve the effects of operation and reduce the postoperative complication.
