首页 > 最新文献

Clinical ophthalmology最新文献

英文 中文
Cumulative Dissipated Energy (CDE) in Three Phaco-Fragmentation Techniques for Dense Cataract Removal. 累积耗散能量(CDE)在三种晶状体碎裂技术中的应用。
IF 2.2 Q3 OPHTHALMOLOGY Pub Date : 2023-01-01 DOI: 10.2147/OPTH.S407705
Erika Fernández-Muñoz, Yolanda Chávez-Romero, Ricardo Rivero-Gómez, Rebeca Aridjis, Roberto Gonzalez-Salinas

Purpose: To determine the energy expenditure in phacoemulsification surgery expressed as cumulative dissipated energy (CDE) among the divide and conquer, ultrachopper-assisted divide and conquer, and phaco-chop techniques for dense cataract removal.

Patients and methods: The clinical data were obtained from the medical charts of dense cataracts patients undergoing routine phacoemulsification employing any of three phaco-fragmentation techniques, including divide and conquer using the Kelman 0.9 mm tip, the ultrachopper tip, and the phaco-chop technique using the Kelman 0.9 mm tip. Cumulated dissipated energy (CDE), longitudinal ultrasound time (UST), and endothelial cell loss were compared among groups at the one-month postoperative.

Results: Surgeries from 90 eyes were analyzed, among whom the conventional divide-and-conquer technique group included 30 patients, 32 in the ultrachopper group, and 28 in the phaco-chop technique group. The average CDE in the conventional divide and conquer group was 44.52 ± 23.00, the ultrachopper technique was 43.27 ± 23.18, and 20.11 ± 11.06 in the phaco-chop group. Phaco-fragmentation chop demonstrated significantly lower CDE than the other techniques (p= <0.0001). The phaco-chop technique showed statistically significantly lower CDE when compared to the other two groups (p=<0.0001) with 93.96 ± 39.71 seconds. There were no statistically significant differences in postoperative endothelial cell density between groups (p=0.4916).

Conclusion: The use of the phaco-chop technique in hard cataract phacoemulsification represents a lower energy expenditure than divide and conquer and ultrachopper techniques; nevertheless, no differences regarding endothelial density loss were evidenced.

目的:探讨以累加耗散能量(CDE)表示的超声乳化手术能量消耗在分治、超直升机辅助分治和超声切割技术中对致密性白内障摘除的影响。患者和方法:临床资料来自于接受常规超声乳化术的致密性白内障患者的病历,这些患者采用三种超声破碎技术中的任何一种,包括使用Kelman 0.9 mm尖端的分治技术、超直升机尖端和使用Kelman 0.9 mm尖端的超声切割技术。比较各组术后1个月的累积耗散能(CDE)、纵向超声时间(UST)和内皮细胞损失。结果:对90只眼的手术进行分析,其中常规分治法组30例,超斩刀组32例,超斩刀组28例。常规分治组平均CDE为44.52±23.00,超斩术组平均CDE为43.27±23.18,斩术组平均CDE为20.11±11.06。结论:在硬性白内障超声乳化术中,使用phaco-chop技术比分治法和超直升机技术能耗更低;然而,内皮密度损失方面没有差异。
{"title":"Cumulative Dissipated Energy (CDE) in Three Phaco-Fragmentation Techniques for Dense Cataract Removal.","authors":"Erika Fernández-Muñoz,&nbsp;Yolanda Chávez-Romero,&nbsp;Ricardo Rivero-Gómez,&nbsp;Rebeca Aridjis,&nbsp;Roberto Gonzalez-Salinas","doi":"10.2147/OPTH.S407705","DOIUrl":"https://doi.org/10.2147/OPTH.S407705","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the energy expenditure in phacoemulsification surgery expressed as cumulative dissipated energy (CDE) among the divide and conquer, ultrachopper-assisted divide and conquer, and phaco-chop techniques for dense cataract removal.</p><p><strong>Patients and methods: </strong>The clinical data were obtained from the medical charts of dense cataracts patients undergoing routine phacoemulsification employing any of three phaco-fragmentation techniques, including divide and conquer using the Kelman 0.9 mm tip, the ultrachopper tip, and the phaco-chop technique using the Kelman 0.9 mm tip. Cumulated dissipated energy (CDE), longitudinal ultrasound time (UST), and endothelial cell loss were compared among groups at the one-month postoperative.</p><p><strong>Results: </strong>Surgeries from 90 eyes were analyzed, among whom the conventional divide-and-conquer technique group included 30 patients, 32 in the ultrachopper group, and 28 in the phaco-chop technique group. The average CDE in the conventional divide and conquer group was 44.52 ± 23.00, the ultrachopper technique was 43.27 ± 23.18, and 20.11 ± 11.06 in the phaco-chop group. Phaco-fragmentation chop demonstrated significantly lower CDE than the other techniques (p= <0.0001). The phaco-chop technique showed statistically significantly lower CDE when compared to the other two groups (p=<0.0001) with 93.96 ± 39.71 seconds. There were no statistically significant differences in postoperative endothelial cell density between groups (p=0.4916).</p><p><strong>Conclusion: </strong>The use of the phaco-chop technique in hard cataract phacoemulsification represents a lower energy expenditure than divide and conquer and ultrachopper techniques; nevertheless, no differences regarding endothelial density loss were evidenced.</p>","PeriodicalId":10442,"journal":{"name":"Clinical ophthalmology","volume":"17 ","pages":"2405-2412"},"PeriodicalIF":2.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f3/a0/opth-17-2405.PMC10440113.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10107566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Real-World Outcomes of Canaloplasty and Trabeculotomy Combined with Cataract Surgery in Eyes with All Stages of Open-Angle Glaucoma. 小梁切开术联合白内障手术治疗各阶段开角型青光眼的实际疗效。
IF 2.2 Q3 OPHTHALMOLOGY Pub Date : 2023-01-01 DOI: 10.2147/OPTH.S422132
Arkadiy Yadgarov, Kallista Dentice, Qays Aljabi
Purpose To evaluate the long-term safety and efficacy of sequential canaloplasty and trabeculotomy combined with cataract surgery in patients with mild, moderate, and advanced open-angle glaucoma. Patients and Methods Case records of 171 consecutive patients (171 eyes) who had undergone cataract surgery followed by canaloplasty (≥180°) and trabeculotomy (≥90°) for mild, moderate, or advanced open-angle glaucoma (Shaffer grade ≥3) using the OMNI Surgical System (Sight Sciences, Inc., Menlo Park, CA) were analyzed retrospectively. Efficacy endpoints included change in mean IOP and number of medications from baseline to postoperative 12- and 24-months for the overall dataset and stratified by each stage of glaucoma. Kaplan–Meier survival analysis of success (eyes that did not require secondary surgical interventions (SSI)) by postoperative 24 months was also performed. Results Postoperatively, there was a statistically significant reduction in IOP (baseline of 17.2 mmHg on 1.3 medicines reduced to 14.3 on 0.8 medicines (12 months) and 14.0 on 0.9 medicines (24 months), p<0.001 for both time points). Eyes with advanced glaucoma (N=63) maintained significant IOP reduction (17.8 mmHg on 1.6 medicines at baseline reduced to 13.6 mmHg on 1.3 medicines (12 months) and 13.0 on 1.5 medicines (24 months), p<0.001). Kaplan–Meier analysis showed a 93.0% survival probability for the avoidance of SSI at 2 years after surgery. Conclusion Canaloplasty and trabeculotomy combined with cataract surgery provided effective IOP reduction for eyes with all stages of glaucoma at postoperative 12 and 24 months, and the procedure yielded a 93% survival rate for SSI avoidance at 2 years.
目的:评价轻、中、晚期开角型青光眼患者行序贯小管成形术、小梁切开术联合白内障手术的长期安全性和有效性。患者和方法:回顾性分析使用OMNI手术系统(Sight Sciences, Inc., Menlo Park, CA)治疗轻度、中度或晚期开角型青光眼(Shaffer分级≥3级)的171例连续患者(171只眼)的病例记录,这些患者接受了白内障手术,随后进行了小管成形术(≥180°)和小叶切开术(≥90°)。疗效终点包括整个数据集从基线到术后12个月和24个月的平均IOP变化和药物数量,并按青光眼的每个阶段分层。还进行了术后24个月成功(不需要二次手术干预(SSI)的眼睛)的Kaplan-Meier生存分析。结果:术后,IOP的降低具有统计学意义(基线值为17.2 mmHg,使用1.3种药物后降低到14.3 mmHg,使用0.8种药物后降低到12个月,使用0.9种药物后降低到14.0 mmHg,使用24个月)。结论:在术后12个月和24个月,所有阶段青光眼患者的IOP都得到了有效的降低,该手术在2年避免SSI的生存率为93%。
{"title":"Real-World Outcomes of Canaloplasty and Trabeculotomy Combined with Cataract Surgery in Eyes with All Stages of Open-Angle Glaucoma.","authors":"Arkadiy Yadgarov,&nbsp;Kallista Dentice,&nbsp;Qays Aljabi","doi":"10.2147/OPTH.S422132","DOIUrl":"https://doi.org/10.2147/OPTH.S422132","url":null,"abstract":"Purpose To evaluate the long-term safety and efficacy of sequential canaloplasty and trabeculotomy combined with cataract surgery in patients with mild, moderate, and advanced open-angle glaucoma. Patients and Methods Case records of 171 consecutive patients (171 eyes) who had undergone cataract surgery followed by canaloplasty (≥180°) and trabeculotomy (≥90°) for mild, moderate, or advanced open-angle glaucoma (Shaffer grade ≥3) using the OMNI Surgical System (Sight Sciences, Inc., Menlo Park, CA) were analyzed retrospectively. Efficacy endpoints included change in mean IOP and number of medications from baseline to postoperative 12- and 24-months for the overall dataset and stratified by each stage of glaucoma. Kaplan–Meier survival analysis of success (eyes that did not require secondary surgical interventions (SSI)) by postoperative 24 months was also performed. Results Postoperatively, there was a statistically significant reduction in IOP (baseline of 17.2 mmHg on 1.3 medicines reduced to 14.3 on 0.8 medicines (12 months) and 14.0 on 0.9 medicines (24 months), p<0.001 for both time points). Eyes with advanced glaucoma (N=63) maintained significant IOP reduction (17.8 mmHg on 1.6 medicines at baseline reduced to 13.6 mmHg on 1.3 medicines (12 months) and 13.0 on 1.5 medicines (24 months), p<0.001). Kaplan–Meier analysis showed a 93.0% survival probability for the avoidance of SSI at 2 years after surgery. Conclusion Canaloplasty and trabeculotomy combined with cataract surgery provided effective IOP reduction for eyes with all stages of glaucoma at postoperative 12 and 24 months, and the procedure yielded a 93% survival rate for SSI avoidance at 2 years.","PeriodicalId":10442,"journal":{"name":"Clinical ophthalmology","volume":"17 ","pages":"2609-2617"},"PeriodicalIF":2.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ed/cf/opth-17-2609.PMC10478966.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10177847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Four-Year Outcome of XEN 45 Gel Stent Implantation in a Swedish Population. XEN 45凝胶支架植入术在瑞典人群中的四年疗效
IF 2.2 Q3 OPHTHALMOLOGY Pub Date : 2023-01-01 DOI: 10.2147/OPTH.S412400
Tobias Busch, Dragana Skiljic, Thiemo Rudolph, Anders Bergström, Madeleine Zetterberg

Purpose: To report the long-time success rate of XEN 45 gel stent implantation in a Scandinavian population.

Patients and methods: This was a retrospective single-center analysis of all patients undergoing XEN 45 stent surgery between December 2015 and May 2017. The main outcome was success rate according to several definitions of success. Subgroup analysis was performed. Secondary outcomes were change in intraocular pressure (IOP) and number of IOP-lowering agents. Need for secondary glaucoma surgery, needling rate and complications were recorded.

Results: A total of 103 eyes could be evaluated after four years. Mean age was 70.6 years. Primary open-angle glaucoma (POAG) accounted for 46.6% and exfoliative glaucoma (PEXG) for 39.8%. Mean IOP dropped from 24.0 to 15.9 mmHg (p<0.001) and IOP-lowering agents from 3.5 to 1.5 (p<0.001). The success rate with individual target pressures after four years was 43.7%. Secondary glaucoma surgery was performed in 45 (43.7%) of cases. Combined cases (n=12) were not statistically different to stand-alone procedures (p=0.28). No difference between PEXG and POAG could be detected (p=0.44). During the learning curve, stent misplacement was common and resulted in worse outcome for less experienced surgeons.

Conclusion: The overall success rate of XEN 45 gel stent surgery in the present cohort is relatively low in a long-time follow-up under the given circumstances if all initial patients are included to follow-up. The influence of the surgeon's learning curve is obvious, and improvement in success can be expected when used by experienced and high-volume surgeons. No significant differences were found in PEXG compared to POAG or in XEN surgery combined with cataract surgery compared to stand-alone.

目的:报告XEN 45凝胶支架植入术在斯堪的纳维亚人群中的长期成功率。患者和方法:这是一项回顾性单中心分析,纳入了2015年12月至2017年5月期间接受XEN 45支架手术的所有患者。根据几种成功的定义,主要结果是成功率。进行亚组分析。次要结果是眼压(IOP)的变化和降眼压药物的数量。记录继发性青光眼手术需求、针刺率及并发症。结果:术后4年共检查103只眼。平均年龄70.6岁。原发性开角型青光眼(POAG)占46.6%,剥脱性青光眼(PEXG)占39.8%。结论:在给定情况下,如果纳入所有初始患者,本队列XEN 45凝胶支架手术在长时间随访中的总体成功率相对较低。外科医生的学习曲线的影响是明显的,当有经验和高容量的外科医生使用时,成功率的提高是可以预期的。PEXG与POAG相比,XEN手术联合白内障手术与单独手术相比,无显著差异。
{"title":"Four-Year Outcome of XEN 45 Gel Stent Implantation in a Swedish Population.","authors":"Tobias Busch,&nbsp;Dragana Skiljic,&nbsp;Thiemo Rudolph,&nbsp;Anders Bergström,&nbsp;Madeleine Zetterberg","doi":"10.2147/OPTH.S412400","DOIUrl":"https://doi.org/10.2147/OPTH.S412400","url":null,"abstract":"<p><strong>Purpose: </strong>To report the long-time success rate of XEN 45 gel stent implantation in a Scandinavian population.</p><p><strong>Patients and methods: </strong>This was a retrospective single-center analysis of all patients undergoing XEN 45 stent surgery between December 2015 and May 2017. The main outcome was success rate according to several definitions of success. Subgroup analysis was performed. Secondary outcomes were change in intraocular pressure (IOP) and number of IOP-lowering agents. Need for secondary glaucoma surgery, needling rate and complications were recorded.</p><p><strong>Results: </strong>A total of 103 eyes could be evaluated after four years. Mean age was 70.6 years. Primary open-angle glaucoma (POAG) accounted for 46.6% and exfoliative glaucoma (PEXG) for 39.8%. Mean IOP dropped from 24.0 to 15.9 mmHg (p<0.001) and IOP-lowering agents from 3.5 to 1.5 (p<0.001). The success rate with individual target pressures after four years was 43.7%. Secondary glaucoma surgery was performed in 45 (43.7%) of cases. Combined cases (n=12) were not statistically different to stand-alone procedures (p=0.28). No difference between PEXG and POAG could be detected (p=0.44). During the learning curve, stent misplacement was common and resulted in worse outcome for less experienced surgeons.</p><p><strong>Conclusion: </strong>The overall success rate of XEN 45 gel stent surgery in the present cohort is relatively low in a long-time follow-up under the given circumstances if all initial patients are included to follow-up. The influence of the surgeon's learning curve is obvious, and improvement in success can be expected when used by experienced and high-volume surgeons. No significant differences were found in PEXG compared to POAG or in XEN surgery combined with cataract surgery compared to stand-alone.</p>","PeriodicalId":10442,"journal":{"name":"Clinical ophthalmology","volume":"17 ","pages":"1897-1910"},"PeriodicalIF":2.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/89/9a/opth-17-1897.PMC10328829.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10186414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Influence of Preoperative Parameters on the Ratio of Keratometric Change per Diopter of Attempted Spherical Equivalent (∆K/∆SEQ) for Myopic Correction Within LASIK, PRK, and SMILE. 术前参数对LASIK、PRK和SMILE内近视矫正中每屈光度尝试球面等效角膜变形比(∆K/∆SEQ)的影响
IF 2.2 Q3 OPHTHALMOLOGY Pub Date : 2023-01-01 DOI: 10.2147/OPTH.S423087
Majid Moshirfar, Joshua S Theis, David S Cha, Kaiden B Porter, Carter J Payne, Phillip C Hoopes

Purpose: To compare 3 of the most common corneal refractive procedures; PRK, LASIK, and SMILE assessing ΔK/ΔSEQ ratio and its correlation with preoperative demographics including age, keratometry, pachymetry, cylinder value, and attempted myopic correction. The goal was to analyze the relative strength of each preoperative parameter in accounting for changes in ∆K/∆SEQ.

Patients and methods: A total of 370 eyes from 102 male and 97 female patients (173 eyes PRK, 153 LASIK, and 44 SMILE) with ages ranging from 20 to 51 underwent refractive surgery for myopia between -0.25 and -7.71 D manifest refraction spherical equivalent (MRSE). All surgeries were performed at a single surgery center in Draper, Utah. The Pentacam was used for all optical measurements and data were gathered pre-operatively and then again 1-year post-operatively. Only patients who achieved emmetropia at a visual acuity of 20/25 or better were included.

Results: The mean ΔK/ΔSEQ ratio for LASIK (0.839 ± 0.020) was significantly greater than that of PRK (0.775 ± 0.022) and SMILE (0.709 ± 0.046). Age was found to negatively correlate with ΔK/ΔSEQ for both LASIK (r = -0.177) and SMILE (r = -0.451) procedures. Pre-op keratometry was found to negatively correlate with ΔK/ΔSEQ for LASIK (r = -0.202) but not for PRK or SMILE. Pre-op pachymetry was not correlated with ΔK/ΔSEQ for any of the procedures. Attempted myopic spherical equivalent (SEQ) correction was positively correlated with ΔK/ΔSEQ for LASIK (r = 0.236), PRK (r = 0.459), and SMILE (r = 0.304). Lastly, pre-op cylinder value was found to be correlated to ΔK/ΔSEQ in SMILE (r = -0.367), but not in LASIK or PRK.

Conclusion: The ΔK/ΔSEQ ratio not only differs depending on the procedure being done but also by pre-operative factors such as age, keratometry, attempted correction, and cylinder value. Multiple linear regression analysis revealed that the attempted correction had the greatest effect on ∆K/∆SEQ out of all parameters in LASIK and PRK. For SMILE, age had the greatest predictive value of the change in ∆K/∆SEQ. While the exact effect of these parameters will vary by surgeon, all of these should be factored into a refractive surgeon's nomograms in order to achieve optimal visual outcomes for their patients.

目的:比较3种最常见的角膜屈光手术;PRK、LASIK和SMILE评估ΔK/ΔSEQ比率及其与术前人口统计数据的相关性,包括年龄、角膜测量、视厚测量、柱面值和近视矫正尝试。目的是分析术前各参数的相对强度,以解释∆K/∆SEQ的变化。患者和方法:年龄在20 ~ 51岁,男性102眼,女性97眼,共370眼(PRK 173眼,LASIK 153眼,SMILE 44眼),均为-0.25 ~ -7.71 D明显折射球等效(MRSE)近视,行屈光手术。所有的手术都在犹他州德雷珀的一个手术中心进行。Pentacam用于术前和术后1年的所有光学测量和数据收集。仅包括视力达到20/25或更好的患者。结果:LASIK手术的平均ΔK/ΔSEQ比值(0.839±0.020)显著高于PRK手术(0.775±0.022)和SMILE手术(0.709±0.046)。年龄与LASIK手术(r = -0.177)和SMILE手术(r = -0.451)的ΔK/ΔSEQ呈负相关。术前角膜度数与LASIK的ΔK/ΔSEQ呈负相关(r = -0.202),但与PRK或SMILE无关。术前厚测与任何手术的ΔK/ΔSEQ均无相关性。LASIK (r = 0.236)、PRK (r = 0.459)、SMILE (r = 0.304)的近视球面等效度数(SEQ)矫正与ΔK/ΔSEQ呈正相关。最后,术前柱体值在SMILE中与ΔK/ΔSEQ相关(r = -0.367),而在LASIK或PRK中不相关。结论:ΔK/ΔSEQ的比例不仅取决于所做的手术,而且还取决于术前因素,如年龄、角膜比例尺、矫正次数和柱体值。多元线性回归分析显示,在LASIK和PRK的所有参数中,尝试矫正对∆K/∆SEQ的影响最大。对于SMILE,年龄对∆K/∆SEQ的变化有最大的预测价值。虽然这些参数的确切效果会因外科医生而异,但所有这些参数都应该考虑到屈光外科医生的图中,以便为患者获得最佳的视力结果。
{"title":"Influence of Preoperative Parameters on the Ratio of Keratometric Change per Diopter of Attempted Spherical Equivalent (∆K/∆SEQ) for Myopic Correction Within LASIK, PRK, and SMILE.","authors":"Majid Moshirfar,&nbsp;Joshua S Theis,&nbsp;David S Cha,&nbsp;Kaiden B Porter,&nbsp;Carter J Payne,&nbsp;Phillip C Hoopes","doi":"10.2147/OPTH.S423087","DOIUrl":"https://doi.org/10.2147/OPTH.S423087","url":null,"abstract":"<p><strong>Purpose: </strong>To compare 3 of the most common corneal refractive procedures; PRK, LASIK, and SMILE assessing ΔK/ΔSEQ ratio and its correlation with preoperative demographics including age, keratometry, pachymetry, cylinder value, and attempted myopic correction. The goal was to analyze the relative strength of each preoperative parameter in accounting for changes in ∆K/∆SEQ.</p><p><strong>Patients and methods: </strong>A total of 370 eyes from 102 male and 97 female patients (173 eyes PRK, 153 LASIK, and 44 SMILE) with ages ranging from 20 to 51 underwent refractive surgery for myopia between -0.25 and -7.71 D manifest refraction spherical equivalent (MRSE). All surgeries were performed at a single surgery center in Draper, Utah. The Pentacam was used for all optical measurements and data were gathered pre-operatively and then again 1-year post-operatively. Only patients who achieved emmetropia at a visual acuity of 20/25 or better were included.</p><p><strong>Results: </strong>The mean ΔK/ΔSEQ ratio for LASIK (0.839 ± 0.020) was significantly greater than that of PRK (0.775 ± 0.022) and SMILE (0.709 ± 0.046). Age was found to negatively correlate with ΔK/ΔSEQ for both LASIK (r = -0.177) and SMILE (r = -0.451) procedures. Pre-op keratometry was found to negatively correlate with ΔK/ΔSEQ for LASIK (r = -0.202) but not for PRK or SMILE. Pre-op pachymetry was not correlated with ΔK/ΔSEQ for any of the procedures. Attempted myopic spherical equivalent (SEQ) correction was positively correlated with ΔK/ΔSEQ for LASIK (r = 0.236), PRK (r = 0.459), and SMILE (r = 0.304). Lastly, pre-op cylinder value was found to be correlated to ΔK/ΔSEQ in SMILE (r = -0.367), but not in LASIK or PRK.</p><p><strong>Conclusion: </strong>The ΔK/ΔSEQ ratio not only differs depending on the procedure being done but also by pre-operative factors such as age, keratometry, attempted correction, and cylinder value. Multiple linear regression analysis revealed that the attempted correction had the greatest effect on ∆K/∆SEQ out of all parameters in LASIK and PRK. For SMILE, age had the greatest predictive value of the change in ∆K/∆SEQ. While the exact effect of these parameters will vary by surgeon, all of these should be factored into a refractive surgeon's nomograms in order to achieve optimal visual outcomes for their patients.</p>","PeriodicalId":10442,"journal":{"name":"Clinical ophthalmology","volume":"17 ","pages":"2563-2573"},"PeriodicalIF":2.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ba/a1/opth-17-2563.PMC10474859.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10207701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pediatric Eye Care Treatment Rates and Community Compliance to a Spectacle Provision Program in an Underserved School District in San Diego, CA. 在加州圣地亚哥一个服务不足的学区,儿童眼科护理治疗率和社区对眼镜提供计划的依从性。
IF 2.2 Q3 OPHTHALMOLOGY Pub Date : 2023-01-01 DOI: 10.2147/OPTH.S409075
Matthew C H Rohn, Flynn O'Sullivan, Stuart I Brown, Eric Hernandez, Shyamanga Borooah, Iliana Molina

Significance: The need for early identification and treatment of young children's refractive error needs has become a public health concern. The UCSD Eyemobile for Children (EyeMobile) provides vision screenings and comprehensive eye exams on the Eyemobile among a population of underserved, predominantly Hispanic preschool and elementary school children. The program also provides spectacles for children who fail eye exams due to refractive error.

Methods: We performed a retrospective cross-sectional analysis of all children screened from 2011 to 2017 by the Eyemobile across 10 San Diego elementary schools. We examined demographics, distance and near visual acuity, autorefraction, stereopsis, and color vision. To measure compliance to our spectacle program, we checked if children who were prescribed spectacles were wearing them, as instructed, at the following year's screening. Differences between compliance measures with respect to school, age, ethnicity, and gender were determined using chi-square analysis, while all other measures were fit to a binary logistic regression to determine statistically significant factors.

Results: A total of 12,176 elementary school children were screened between 2011 and 2017. Of these children, 5269 (43.3%) were referred for a comprehensive eye examination. Across six years, 3163 (60.0%) of the children referred completed their eye examinations. There was a significant increase (p < 0.001) in exam completion in the successive years. Exam completion was significantly higher in ten-year-olds (p = 0.0278) and in 3 of the 10 schools (p < 0.0001, p = 0.0027, and p = 0.0309). A total of 1089 (8.9% of screened) children were prescribed spectacles. Of the 409 children that were recorded with the compliance method, 342 (83.6%) were found to be fully compliant and wearing their spectacles as prescribed.

Conclusion: The Eyemobile program demonstrated high levels of compliance for both eye examination completion and prescribed spectacle wear in underserved populations in the San Diego region, compared to similar national programs.

意义:早期识别和治疗幼儿屈光不正的需要已经成为一个公共卫生关注的问题。加州大学圣地亚哥分校儿童眼部移动设备(Eyemobile)为服务不足的人群提供视力筛查和全面的眼部检查,主要是西班牙裔学龄前儿童和小学儿童。该项目还为因屈光不正而没有通过眼科检查的儿童提供眼镜。方法:我们对2011年至2017年通过Eyemobile筛查的10所圣地亚哥小学的所有儿童进行了回顾性横断面分析。我们检查了人口统计学、远近视敏度、自折射、立体视和色觉。为了衡量我们的眼镜计划的依从性,我们检查了那些被规定戴眼镜的孩子是否在第二年的放映中按照指示戴上了眼镜。依从性测量在学校、年龄、种族和性别方面的差异采用卡方分析确定,而所有其他测量采用二元逻辑回归来确定统计学上显著的因素。结果:2011年至2017年共筛查了12176名小学生。在这些儿童中,5269人(43.3%)接受了全面的眼科检查。在六年的时间里,3163名(60.0%)儿童完成了眼科检查。在连续几年中,完成考试的人数显著增加(p < 0.001)。10岁学生的考试完成率显著较高(p = 0.0278), 10所学校中有3所(p < 0.0001, p = 0.0027和p = 0.0309)。共有1089名(8.9%)儿童配戴了眼镜。在409名儿童中,342名(83.6%)完全遵守规定,并按规定佩戴眼镜。结论:与类似的国家项目相比,在圣地亚哥地区服务不足的人群中,Eyemobile项目在眼科检查完成和处方眼镜佩戴方面表现出了很高的依从性。
{"title":"Pediatric Eye Care Treatment Rates and Community Compliance to a Spectacle Provision Program in an Underserved School District in San Diego, CA.","authors":"Matthew C H Rohn,&nbsp;Flynn O'Sullivan,&nbsp;Stuart I Brown,&nbsp;Eric Hernandez,&nbsp;Shyamanga Borooah,&nbsp;Iliana Molina","doi":"10.2147/OPTH.S409075","DOIUrl":"https://doi.org/10.2147/OPTH.S409075","url":null,"abstract":"<p><strong>Significance: </strong>The need for early identification and treatment of young children's refractive error needs has become a public health concern. The UCSD Eyemobile for Children (EyeMobile) provides vision screenings and comprehensive eye exams on the Eyemobile among a population of underserved, predominantly Hispanic preschool and elementary school children. The program also provides spectacles for children who fail eye exams due to refractive error.</p><p><strong>Methods: </strong>We performed a retrospective cross-sectional analysis of all children screened from 2011 to 2017 by the Eyemobile across 10 San Diego elementary schools. We examined demographics, distance and near visual acuity, autorefraction, stereopsis, and color vision. To measure compliance to our spectacle program, we checked if children who were prescribed spectacles were wearing them, as instructed, at the following year's screening. Differences between compliance measures with respect to school, age, ethnicity, and gender were determined using chi-square analysis, while all other measures were fit to a binary logistic regression to determine statistically significant factors.</p><p><strong>Results: </strong>A total of 12,176 elementary school children were screened between 2011 and 2017. Of these children, 5269 (43.3%) were referred for a comprehensive eye examination. Across six years, 3163 (60.0%) of the children referred completed their eye examinations. There was a significant increase (p < 0.001) in exam completion in the successive years. Exam completion was significantly higher in ten-year-olds (p = 0.0278) and in 3 of the 10 schools (p < 0.0001, p = 0.0027, and p = 0.0309). A total of 1089 (8.9% of screened) children were prescribed spectacles. Of the 409 children that were recorded with the compliance method, 342 (83.6%) were found to be fully compliant and wearing their spectacles as prescribed.</p><p><strong>Conclusion: </strong>The Eyemobile program demonstrated high levels of compliance for both eye examination completion and prescribed spectacle wear in underserved populations in the San Diego region, compared to similar national programs.</p>","PeriodicalId":10442,"journal":{"name":"Clinical ophthalmology","volume":"17 ","pages":"1729-1737"},"PeriodicalIF":2.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b5/9c/opth-17-1729.PMC10289299.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9715947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Intraocular Pressure and Medication Changes Associated with Xen Gel Stent: A Systematic Review of the Literature. 与Xen凝胶支架相关的眼压和药物变化:文献的系统回顾。
IF 2.2 Q3 OPHTHALMOLOGY Pub Date : 2023-01-01 DOI: 10.2147/OPTH.S390955
Joseph F Panarelli, Vanessa Vera, Arsham Sheybani, Nathan Radcliffe, Richard Fiscella, Brian A Francis, Oluwatosin U Smith, Robert J Noecker

The Xen gel stent (Allergan Inc, an AbbVie company; Dublin, Ireland) was conceived as an option for patients requiring modest IOP reduction but for whom trabeculectomy was not yet indicated. As with any glaucoma surgery, establishing criteria for patient selection and identifying factors that contribute to a high likelihood of success are important. To help guide clinical decision-making, a systematic review of published studies on the gel stent was performed, with the goal of understanding postoperative outcomes based on clinical and patient factors. Results were organized around a series of pertinent clinical questions based on scenarios encountered in clinical practice. Criteria for including studies were intentionally broad, with the objective of simulating the diverse population of glaucoma patients encountered in real-world practice. Outcomes for IOP and medication reduction postoperatively were assessed in various analyses, including in eyes with various glaucoma types and severity; in eyes naïve to surgery as well as those with a history of prior incisional glaucoma surgery; and when surgery was performed as a standalone procedure or at the time of cataract surgery. The results of each of the various analyses were consistent in demonstrating that successful gel stent surgery achieved a postoperative IOP of approximately 14.0 mm Hg and reduction to fewer than 1 glaucoma medication. Additional data are shown on outcomes by method of implant (ab interno vs ab externo); intraoperative use of antifibrotics; and rates of needling in published studies.

Xen凝胶支架(Allergan Inc ., AbbVie公司;都柏林,爱尔兰)被认为是需要适度降低IOP但尚未需要小梁切除术的患者的选择。与任何青光眼手术一样,建立患者选择标准和确定高成功率因素非常重要。为了帮助指导临床决策,我们对已发表的关于凝胶支架的研究进行了系统回顾,目的是了解基于临床和患者因素的术后结果。结果是根据临床实践中遇到的情况,围绕一系列相关的临床问题组织的。纳入研究的标准是有意广泛的,目的是模拟现实世界中遇到的青光眼患者的不同人群。通过各种分析评估术后IOP和药物减少的结果,包括不同青光眼类型和严重程度的眼睛;手术后naïve以及既往有切口青光眼手术史的患者;当手术作为一个独立的程序进行或者在白内障手术的时候。各种分析的结果都一致表明,成功的凝胶支架手术使术后IOP约为14.0 mm Hg,减少到少于1种青光眼药物。其他数据显示了不同植入方式的结果(内植入vs外植入);术中抗纤维化药物的使用;以及发表的研究中针刺的比率。
{"title":"Intraocular Pressure and Medication Changes Associated with Xen Gel Stent: A Systematic Review of the Literature.","authors":"Joseph F Panarelli,&nbsp;Vanessa Vera,&nbsp;Arsham Sheybani,&nbsp;Nathan Radcliffe,&nbsp;Richard Fiscella,&nbsp;Brian A Francis,&nbsp;Oluwatosin U Smith,&nbsp;Robert J Noecker","doi":"10.2147/OPTH.S390955","DOIUrl":"https://doi.org/10.2147/OPTH.S390955","url":null,"abstract":"<p><p>The Xen gel stent (Allergan Inc, an AbbVie company; Dublin, Ireland) was conceived as an option for patients requiring modest IOP reduction but for whom trabeculectomy was not yet indicated. As with any glaucoma surgery, establishing criteria for patient selection and identifying factors that contribute to a high likelihood of success are important. To help guide clinical decision-making, a systematic review of published studies on the gel stent was performed, with the goal of understanding postoperative outcomes based on clinical and patient factors. Results were organized around a series of pertinent clinical questions based on scenarios encountered in clinical practice. Criteria for including studies were intentionally broad, with the objective of simulating the diverse population of glaucoma patients encountered in real-world practice. Outcomes for IOP and medication reduction postoperatively were assessed in various analyses, including in eyes with various glaucoma types and severity; in eyes naïve to surgery as well as those with a history of prior incisional glaucoma surgery; and when surgery was performed as a standalone procedure or at the time of cataract surgery. The results of each of the various analyses were consistent in demonstrating that successful gel stent surgery achieved a postoperative IOP of approximately 14.0 mm Hg and reduction to fewer than 1 glaucoma medication. Additional data are shown on outcomes by method of implant (ab interno vs ab externo); intraoperative use of antifibrotics; and rates of needling in published studies.</p>","PeriodicalId":10442,"journal":{"name":"Clinical ophthalmology","volume":"17 ","pages":"25-46"},"PeriodicalIF":2.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/74/7e/opth-17-25.PMC9845068.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9103304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Clinical Outcomes of a Non-Diffractive Extended Depth-of-Focus IOL in Eyes with Mild Glaucoma. 非衍射扩展焦深人工晶体治疗轻度青光眼的临床效果。
IF 2.2 Q3 OPHTHALMOLOGY Pub Date : 2023-01-01 DOI: 10.2147/OPTH.S404369
Tanner J Ferguson, Caroline W Wilson, Brian M Shafer, John P Berdahl, Daniel C Terveen

Purpose: To evaluate the clinical outcomes of a non-diffractive, wavefront-shaping extended depth-of-focus (EDOF) intraocular lens (IOL) in eyes with mild open-angle glaucoma (OAG).

Setting: Private practice; Sioux Falls, South Dakota.

Design: Prospective, open-label, interventional study.

Methods: In total, 52 eyes of 26 patients with mild OAG were enrolled and completed the study. All patients were bilaterally implanted with a non-diffractive, wavefront-shaping EDOF IOL. Seventy-seven percent of the patients were implanted with a trabecular microbypass stent at the time of surgery. Primary outcome measures included binocular corrected and uncorrected distance visual acuity (CDVA and UDVA), uncorrected intermediate and near visual acuity (UIVA and UNVA) and contrast sensitivity as measured by a Pelli-Robson chart. A subjective questionnaire was also administered to patients.

Results: At 4 months postoperative, the mean binocular UDVA and CDVA was 0.03 ± 0.12 and -0.06 ± 0.07, respectively. The mean UIVA and UNVA were 0.18 ± 0.12 and 0.31 ± 0.18, respectively. Eighty-five percent of the subjects achieved ≥20/25 UDVA and 77% of the subjects achieved ≥20/32 UIVA at 4 months postoperative. The mean binocular mesopic contrast sensitivity was 1.76 ± 0.16 at a spatial frequency of 1 cycle-per-degree (cpd). Eighty-five percent of the subjects reported they would choose the same lens and 1 subject reported they would choose a different IOL if it meant reduced spectacle independence.

Conclusion: The non-diffractive, wavefront-shaping EDOF IOL can be safely implanted in eyes with mild, pre-perimetric open-angle glaucoma with favorable uncorrected distance and intermediate visual acuity. The contrast sensitivity measurements were favorable and the subjective questionnaire revealed satisfactory spectacle independence and patient satisfaction.

目的:评价无衍射波前整形扩展焦深人工晶状体(IOL)治疗轻度开角型青光眼(OAG)的临床效果。背景:私人执业;苏福尔斯,南达科他州。设计:前瞻性、开放标签、介入性研究。方法:选取26例轻度OAG患者共52眼完成研究。所有患者均双侧植入无衍射、波前成形的EDOF人工晶体。77%的患者在手术时植入了小梁微搭桥支架。主要结果测量包括双眼矫正和未矫正的距离视力(CDVA和UDVA),未矫正的中间和近视力(UIVA和UNVA)和对比敏感度(通过Pelli-Robson图表测量)。还对患者进行了主观问卷调查。结果:术后4个月双眼平均UDVA为0.03±0.12,CDVA为-0.06±0.07。UIVA平均值为0.18±0.12,UNVA平均值为0.31±0.18。术后4个月,85%的受试者UDVA≥20/25,77%的受试者uva≥20/32。平均双眼介观对比敏感度为1.76±0.16,空间频率为1周期/度(cpd)。85%的受试者报告说他们会选择相同的晶状体,1名受试者报告说如果这意味着降低了眼镜的独立性,他们会选择不同的人工晶体。结论:无衍射波前成形型EDOF人工晶状体可安全植入轻度周距前开角型青光眼,未矫正距离良好,视力中等。对比敏感度测量结果良好,主观问卷调查结果显示眼镜独立性和患者满意度较好。
{"title":"Clinical Outcomes of a Non-Diffractive Extended Depth-of-Focus IOL in Eyes with Mild Glaucoma.","authors":"Tanner J Ferguson,&nbsp;Caroline W Wilson,&nbsp;Brian M Shafer,&nbsp;John P Berdahl,&nbsp;Daniel C Terveen","doi":"10.2147/OPTH.S404369","DOIUrl":"https://doi.org/10.2147/OPTH.S404369","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the clinical outcomes of a non-diffractive, wavefront-shaping extended depth-of-focus (EDOF) intraocular lens (IOL) in eyes with mild open-angle glaucoma (OAG).</p><p><strong>Setting: </strong>Private practice; Sioux Falls, South Dakota.</p><p><strong>Design: </strong>Prospective, open-label, interventional study.</p><p><strong>Methods: </strong>In total, 52 eyes of 26 patients with mild OAG were enrolled and completed the study. All patients were bilaterally implanted with a non-diffractive, wavefront-shaping EDOF IOL. Seventy-seven percent of the patients were implanted with a trabecular microbypass stent at the time of surgery. Primary outcome measures included binocular corrected and uncorrected distance visual acuity (CDVA and UDVA), uncorrected intermediate and near visual acuity (UIVA and UNVA) and contrast sensitivity as measured by a Pelli-Robson chart. A subjective questionnaire was also administered to patients.</p><p><strong>Results: </strong>At 4 months postoperative, the mean binocular UDVA and CDVA was 0.03 ± 0.12 and -0.06 ± 0.07, respectively. The mean UIVA and UNVA were 0.18 ± 0.12 and 0.31 ± 0.18, respectively. Eighty-five percent of the subjects achieved ≥20/25 UDVA and 77% of the subjects achieved ≥20/32 UIVA at 4 months postoperative. The mean binocular mesopic contrast sensitivity was 1.76 ± 0.16 at a spatial frequency of 1 cycle-per-degree (cpd). Eighty-five percent of the subjects reported they would choose the same lens and 1 subject reported they would choose a different IOL if it meant reduced spectacle independence.</p><p><strong>Conclusion: </strong>The non-diffractive, wavefront-shaping EDOF IOL can be safely implanted in eyes with mild, pre-perimetric open-angle glaucoma with favorable uncorrected distance and intermediate visual acuity. The contrast sensitivity measurements were favorable and the subjective questionnaire revealed satisfactory spectacle independence and patient satisfaction.</p>","PeriodicalId":10442,"journal":{"name":"Clinical ophthalmology","volume":"17 ","pages":"861-868"},"PeriodicalIF":2.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/27/77/opth-17-861.PMC10024873.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9160830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Posterior Vitreous Detachment and Its Role in the Evolution of Dry to Wet Age Related Macular Degeneration. 后玻璃体脱离及其在干性到湿性年龄相关性黄斑变性演变中的作用。
IF 2.2 Q3 OPHTHALMOLOGY Pub Date : 2023-01-01 DOI: 10.2147/OPTH.S403242
Anastasia Bakaliou, Constantine Georgakopoulos, Miltiadis Tsilimbaris, Nikolaos Farmakakis

Purpose: To examine the state of the posterior vitreous in eyes with exudative age-related macular degeneration, AMD, non-exudative AMD and in normal eyes.

Study: This is a prospective, cross-sectional study.

Methods: B-scan ultrasonography and Optical Coherence Tomography, OCT were performed in 165 patients older than 65 years with any AMD and in 22 patients older than 65 years with normal eyes in order to diagnose the eyes with complete posterior vitreous detachment, PVD and the eyes with persistent central vitreomacular adhesion, VMA. All patients were selected from the outpatient clinic of the Ophthalmology Department in the University Hospital of Patras. Fundus Fluoroangiography, FFA was used in order to determine the development of exudative AMD from non-exudative AMD. Follow up time was 48 months.

Results: 16/171 eyes with exudative AMD (9.36%) had complete PVD, and the rest 155/171 (90.64%) had central VMA. Eleven of 138 eyes with non-exudative AMD (7.97%) had complete PVD and the remaining 127 eyes (92.03%) had central VMA. During the 48 months of the study, 28 eyes, all with central VMA progressed to exudative AMD.

Conclusion: Vitreomacular adhesion is associated with both exudative and non-exudative AMD. Progression of the non-exudative eyes to exudative AMD seems to be lower in eyes with complete PVD. On the other hand, the progression of normal eyes to exudative AMD appears to be independent of the posterior vitreous status. Larger and longer studies need to replicate these findings and support the potential of a protective role of complete posterior vitreous detachment in the evolution of the disease.

目的:探讨老年性黄斑变性、老年性黄斑变性、非老年性黄斑变性及正常眼的后玻璃体状态。研究:这是一项前瞻性横断面研究。方法:对165例65岁以上黄斑变性(AMD)患者和22例65岁以上正常眼患者进行b超和OCT检查,诊断为完全性玻璃体后脱离(PVD)和持续性中央玻璃体黄斑粘连(VMA)。所有患者均选自Patras大学医院眼科门诊。眼底荧光血管造影,FFA用于确定渗出性AMD与非渗出性AMD的发展。随访时间为48个月。结果:渗出性AMD 16/171眼(9.36%)为完全性PVD,其余155/171眼(90.64%)为中枢性VMA。非渗出性AMD 138眼中11眼(7.97%)为完全性PVD,其余127眼(92.03%)为中心性VMA。在48个月的研究中,28只眼,均为中枢性VMA,进展为渗出性AMD。结论:玻璃体黄斑粘连与渗出性和非渗出性黄斑变性均有关。在完全PVD的眼睛中,非渗出性眼睛向渗出性AMD的进展似乎较低。另一方面,正常眼睛向渗出性黄斑变性的进展似乎与后玻璃体状态无关。更大规模和更长期的研究需要复制这些发现,并支持完全后玻璃体脱离在疾病演变中的潜在保护作用。
{"title":"Posterior Vitreous Detachment and Its Role in the Evolution of Dry to Wet Age Related Macular Degeneration.","authors":"Anastasia Bakaliou,&nbsp;Constantine Georgakopoulos,&nbsp;Miltiadis Tsilimbaris,&nbsp;Nikolaos Farmakakis","doi":"10.2147/OPTH.S403242","DOIUrl":"https://doi.org/10.2147/OPTH.S403242","url":null,"abstract":"<p><strong>Purpose: </strong>To examine the state of the posterior vitreous in eyes with exudative age-related macular degeneration, AMD, non-exudative AMD and in normal eyes.</p><p><strong>Study: </strong>This is a prospective, cross-sectional study.</p><p><strong>Methods: </strong>B-scan ultrasonography and Optical Coherence Tomography, OCT were performed in 165 patients older than 65 years with any AMD and in 22 patients older than 65 years with normal eyes in order to diagnose the eyes with complete posterior vitreous detachment, PVD and the eyes with persistent central vitreomacular adhesion, VMA. All patients were selected from the outpatient clinic of the Ophthalmology Department in the University Hospital of Patras. Fundus Fluoroangiography, FFA was used in order to determine the development of exudative AMD from non-exudative AMD. Follow up time was 48 months.</p><p><strong>Results: </strong>16/171 eyes with exudative AMD (9.36%) had complete PVD, and the rest 155/171 (90.64%) had central VMA. Eleven of 138 eyes with non-exudative AMD (7.97%) had complete PVD and the remaining 127 eyes (92.03%) had central VMA. During the 48 months of the study, 28 eyes, all with central VMA progressed to exudative AMD.</p><p><strong>Conclusion: </strong>Vitreomacular adhesion is associated with both exudative and non-exudative AMD. Progression of the non-exudative eyes to exudative AMD seems to be lower in eyes with complete PVD. On the other hand, the progression of normal eyes to exudative AMD appears to be independent of the posterior vitreous status. Larger and longer studies need to replicate these findings and support the potential of a protective role of complete posterior vitreous detachment in the evolution of the disease.</p>","PeriodicalId":10442,"journal":{"name":"Clinical ophthalmology","volume":"17 ","pages":"879-885"},"PeriodicalIF":2.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8d/dd/opth-17-879.PMC10029933.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9163981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Factors Affecting Visual Recovery in Patients with Ethambutol-Induced Optic Neuropathy. 影响乙胺丁醇性视神经病变患者视力恢复的因素。
IF 2.2 Q3 OPHTHALMOLOGY Pub Date : 2023-01-01 DOI: 10.2147/OPTH.S401916
Supaporn Srithawatpong, Pareena Chaitanuwong, Yosanan Yospaiboon

Purpose: To study visual recovery and identify the factors that may affect it in patients with ethambutol-induced optic neuropathy (EON).

Patients and methods: Medical charts of patients who developed optic neuropathy after ethambutol (EMB) treatment for tuberculosis infection were retrospectively reviewed. Demographic details and clinical data were examined to assess visual recovery after discontinuation of ethambutol treatment. The univariate and multivariate relationships between various factors and visual recovery were evaluated using regression analysis.

Results: Of 5394 patients diagnosed with tuberculosis infection and treated with EMB, 23 patients (0.43%) were diagnosed with EON. Logistic regression analysis found that female sex was the categorical factor significantly associated with good visual recovery with an odds ratio of 12.0 (95% confidence interval 1.56, 92.29; p = 0.02), while linear regression analysis identified good initial visual acuity as the numerical factor significantly related with it (p < 0.001). After adjustment with multivariate analysis, initial visual acuity was found to be the only significant factor associated with visual recovery. All patients with initial visual acuity of better than 20/200 at first visit achieved good visual recovery.

Conclusion: The incidence of EON in patients treated with EMB was 0.43% in this hospital-based study. Good visual recovery was noted in 39.13% of these patients, and initial visual acuity was the factor that affected visual recovery. It is recommended that patients on EMB have regular screening by an ophthalmologist for early detection of the disease, and if it is discovered, that the use of the drug be immediately discontinued in order to prevent potentially devastating visual loss.

目的:探讨乙胺丁醇性视神经病变(EON)患者视力恢复情况及影响因素。患者与方法:回顾性分析乙胺丁醇(EMB)治疗结核感染后发生视神经病变患者的病历。检查了人口统计细节和临床数据,以评估停止乙胺丁醇治疗后的视力恢复情况。采用回归分析评价各因素与视力恢复之间的单因素和多因素关系。结果:5394例诊断为结核感染并接受EMB治疗的患者中,有23例(0.43%)诊断为EON。Logistic回归分析发现,女性是与视力恢复良好相关的分类因素,比值比为12.0(95%可信区间为1.56,92.29;P = 0.02),而线性回归分析发现良好的初始视力是与之显著相关的数值因素(P < 0.001)。经多因素分析调整后,发现初始视力是唯一与视力恢复相关的显著因素。所有患者初诊视力均在20/200以上,视力恢复良好。结论:以医院为基础的研究中,EMB治疗患者的EON发生率为0.43%。39.13%的患者视力恢复良好,初始视力是影响视力恢复的因素。建议使用EMB的患者定期接受眼科医生的筛查,以便早期发现疾病,如果发现疾病,应立即停止使用该药物,以防止潜在的破坏性视力丧失。
{"title":"Factors Affecting Visual Recovery in Patients with Ethambutol-Induced Optic Neuropathy.","authors":"Supaporn Srithawatpong,&nbsp;Pareena Chaitanuwong,&nbsp;Yosanan Yospaiboon","doi":"10.2147/OPTH.S401916","DOIUrl":"https://doi.org/10.2147/OPTH.S401916","url":null,"abstract":"<p><strong>Purpose: </strong>To study visual recovery and identify the factors that may affect it in patients with ethambutol-induced optic neuropathy (EON).</p><p><strong>Patients and methods: </strong>Medical charts of patients who developed optic neuropathy after ethambutol (EMB) treatment for tuberculosis infection were retrospectively reviewed. Demographic details and clinical data were examined to assess visual recovery after discontinuation of ethambutol treatment. The univariate and multivariate relationships between various factors and visual recovery were evaluated using regression analysis.</p><p><strong>Results: </strong>Of 5394 patients diagnosed with tuberculosis infection and treated with EMB, 23 patients (0.43%) were diagnosed with EON. Logistic regression analysis found that female sex was the categorical factor significantly associated with good visual recovery with an odds ratio of 12.0 (95% confidence interval 1.56, 92.29; p = 0.02), while linear regression analysis identified good initial visual acuity as the numerical factor significantly related with it (p < 0.001). After adjustment with multivariate analysis, initial visual acuity was found to be the only significant factor associated with visual recovery. All patients with initial visual acuity of better than 20/200 at first visit achieved good visual recovery.</p><p><strong>Conclusion: </strong>The incidence of EON in patients treated with EMB was 0.43% in this hospital-based study. Good visual recovery was noted in 39.13% of these patients, and initial visual acuity was the factor that affected visual recovery. It is recommended that patients on EMB have regular screening by an ophthalmologist for early detection of the disease, and if it is discovered, that the use of the drug be immediately discontinued in order to prevent potentially devastating visual loss.</p>","PeriodicalId":10442,"journal":{"name":"Clinical ophthalmology","volume":"17 ","pages":"545-554"},"PeriodicalIF":2.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3f/5a/opth-17-545.PMC9925387.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9291901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Significance of Inter-Eye Osmolarity Difference in Dry Eye Diagnostics. 眼间渗透压差在干眼诊断中的意义。
IF 2.2 Q3 OPHTHALMOLOGY Pub Date : 2023-01-01 DOI: 10.2147/OPTH.S402556
Christian Nilsen, Per Graae Jensen, Morten Gundersen, Øygunn A Utheim, Bjørn Gjerdrum, Kjell Gunnar Gundersen, David Jahanlu, Rick Potvin

Purpose: The purpose of this study was to evaluate the diagnostic value of inter-eye osmolarity differences in relation to dry eye symptoms and other non-osmolar signs of dry eye disease.

Patients and methods: One hundred ninety one participants who attended a larger interventional study of dry eye disease prior to and after cataract surgery were analyzed for dry eye disease (DED). Dry eye diagnostics were performed for all subjects according to the DEWS II criteria: tear osmolarity was collected from both eyes with the TearLab system, non-invasive Tear film break up time (NIKBUT) was obtained on the test eye with Keratograph and ocular surface staining (OSS) was evaluated using the Oxford schema. The Ocular Surface Disease Index (OSDI) questionnaire was used to assess symptoms. Inter-eye osmolarity greater than 8, which is considered as a sign of DED according to the TearLab user manual, was evaluated and compared with other non-osmolar signs of DED.

Results: The 191 subjects were divided into three groups according to osmolarity measurements. Sixty-five subjects had normal osmolarity (below 308 mOsmol/L in both eyes and less than 9 mOsmol/L difference between the eyes), 107 had high osmolarity (308 mOsmol/L or higher in one of the eyes) and 19 had an inter-eye difference >8 mOsmol/L or higher, with neither eye having osmolarity higher than 307 mOsmol/L. Signs and symptoms in this last group were not correlated with the high osmolarity group or the normal group, though they appeared more similar to the normal group.

Conclusion: The diagnostic value of inter-eye osmolarity difference in predicting symptoms or other non-osmolar signs of dry eyes appears weak. Our study suggests that the criterion of an inter-eye difference of 8 mOsmol/L is not a useful cut-off for diagnosing dry eyes based on osmolarity.

目的:本研究的目的是评估眼间渗透压差异对干眼病症状和其他非渗透压体征的诊断价值。患者和方法:191名在白内障手术前后参加干眼病介入研究的参与者被分析为干眼病(DED)。根据DEWS II标准对所有受试者进行干眼诊断:使用TearLab系统收集双眼泪液渗透压,使用角膜摄影仪获得测试眼的无创泪膜破裂时间(NIKBUT),使用Oxford模式评估眼表染色(OSS)。眼表疾病指数(OSDI)问卷用于评估症状。根据TearLab用户手册,对大于8的眼间渗透压进行评估,并与DED的其他非渗透压体征进行比较。结果:191例受试者按渗透压测定分为3组。65名受试者渗透压正常(双眼渗透压低于308 mOsmol/L,双眼渗透压差小于9 mOsmol/L), 107名受试者渗透压高(单眼渗透压高于308 mOsmol/L), 19名受试者眼间渗透压差>8 mOsmol/L或更高,两眼渗透压均不高于307 mOsmol。最后一组的体征和症状与高渗透压组或正常组没有相关性,尽管它们看起来与正常组更相似。结论:眼间渗透压差对预测干眼症症状或其他非渗透性体征的诊断价值较弱。我们的研究表明,8 mOsmol/L的眼间差标准不是基于渗透压诊断干眼症的有用截止值。
{"title":"The Significance of Inter-Eye Osmolarity Difference in Dry Eye Diagnostics.","authors":"Christian Nilsen,&nbsp;Per Graae Jensen,&nbsp;Morten Gundersen,&nbsp;Øygunn A Utheim,&nbsp;Bjørn Gjerdrum,&nbsp;Kjell Gunnar Gundersen,&nbsp;David Jahanlu,&nbsp;Rick Potvin","doi":"10.2147/OPTH.S402556","DOIUrl":"https://doi.org/10.2147/OPTH.S402556","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to evaluate the diagnostic value of inter-eye osmolarity differences in relation to dry eye symptoms and other non-osmolar signs of dry eye disease.</p><p><strong>Patients and methods: </strong>One hundred ninety one participants who attended a larger interventional study of dry eye disease prior to and after cataract surgery were analyzed for dry eye disease (DED). Dry eye diagnostics were performed for all subjects according to the DEWS II criteria: tear osmolarity was collected from both eyes with the TearLab system, non-invasive Tear film break up time (NIKBUT) was obtained on the test eye with Keratograph and ocular surface staining (OSS) was evaluated using the Oxford schema. The Ocular Surface Disease Index (OSDI) questionnaire was used to assess symptoms. Inter-eye osmolarity greater than 8, which is considered as a sign of DED according to the TearLab user manual, was evaluated and compared with other non-osmolar signs of DED.</p><p><strong>Results: </strong>The 191 subjects were divided into three groups according to osmolarity measurements. Sixty-five subjects had normal osmolarity (below 308 mOsmol/L in both eyes and less than 9 mOsmol/L difference between the eyes), 107 had high osmolarity (308 mOsmol/L or higher in one of the eyes) and 19 had an inter-eye difference >8 mOsmol/L or higher, with neither eye having osmolarity higher than 307 mOsmol/L. Signs and symptoms in this last group were not correlated with the high osmolarity group or the normal group, though they appeared more similar to the normal group.</p><p><strong>Conclusion: </strong>The diagnostic value of inter-eye osmolarity difference in predicting symptoms or other non-osmolar signs of dry eyes appears weak. Our study suggests that the criterion of an inter-eye difference of 8 mOsmol/L is not a useful cut-off for diagnosing dry eyes based on osmolarity.</p>","PeriodicalId":10442,"journal":{"name":"Clinical ophthalmology","volume":"17 ","pages":"829-835"},"PeriodicalIF":2.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2d/8f/opth-17-829.PMC10015967.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9514514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
期刊
Clinical ophthalmology
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1