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Comparison of the Effects of 0.05% and 0.1% Cyclosporine for Dry Eye Syndrome Patients after Cataract Surgery 白内障手术后干眼症患者使用 0.05% 和 0.1% 环孢素的效果比较
Pub Date : 2023-11-15 DOI: 10.3341/jkos.2023.64.11.987
Heeyong Han, Sangkyung Choi
Purpose: We compared the effects of 0.05% and 0.1% cyclosporine on dry eye symptoms following cataract surgery.Methods: We retrospectively reviewed the medical records of patients with dry eye syndrome who underwent cataract surgery. The patients were separated into 0.05% and 0.1% cyclosporine groups. Each group had been treated with their routine eye drops for 3 months after cataract surgery. We evaluated dry eye symptoms and signs using the Schirmer test, tear film breakup time (TBUT), corneal and conjunctival staining score, ocular surface disease index (OSDI), and matrix metalloproteinase 9 (MMP-9) testing of the tear film preoperatively and at 2 weeks, 1 month, and 3 months postoperatively. We also compared dry eye symptoms between the groups by dividing all patients according to dry eye severity.Results: The study included 84 eyes (84 patients). The 0.05% cyclosporine group had an increase in the Schirmer test and improved corneal and conjunctival staining scores at 3 months postoperatively. The 0.1% cyclosporine group had improved corneal and conjunctival staining scores at 1 and 3 months postoperatively. The OSDI and MMP-9 results indicated a significant decrease in both groups at 2 weeks, 1 month and 3 months postoperatively. There were no significant differences in the change in dry eye symptoms after cataract surgery between the 0.05% and 0.1% cyclosporine groups. In the patients with level II dry eye syndrome, the 0.05% cyclosporine group showed a significant increase in the Schirmer test compared to the 0.1% cyclosporine group at 3 months postoperatively. The 0.1% cyclosporine group showed a significant improvement in TBUT compared to the 0.05% cyclosporine group at 3 months postoperatively.Conclusions: Both 0.05% and 0.1% cyclosporine are effective treatments for improving dry eye symptoms and ocular surface inflammation after cataract surgery. Both eye drops are considered to have similar effectiveness.
目的:我们比较了 0.05% 和 0.1% 环孢素对白内障手术后干眼症状的影响:我们回顾性地查看了接受白内障手术的干眼症患者的病历。患者被分为 0.05% 和 0.1% 环孢素两组。每组患者都在白内障手术后使用常规眼药水治疗了 3 个月。我们使用施尔默试验、泪膜破裂时间(TBUT)、角膜和结膜染色评分、眼表疾病指数(OSDI)以及术前、术后 2 周、1 个月和 3 个月的泪膜基质金属蛋白酶 9(MMP-9)检测来评估干眼症状和体征。我们还根据干眼症的严重程度对所有患者进行了分组,比较了各组之间的干眼症状:研究包括 84 只眼睛(84 名患者)。术后 3 个月时,0.05% 环孢素组的施尔默试验结果有所提高,角膜和结膜染色评分也有所改善。术后 1 个月和 3 个月时,0.1% 环孢素组的角膜和结膜染色评分有所改善。OSDI和MMP-9结果显示,两组在术后2周、1个月和3个月时都有显著下降。在白内障手术后干眼症状的变化方面,0.05% 和 0.1% 环孢素组之间没有明显差异。在 II 级干眼症患者中,术后 3 个月时,0.05% 环孢素组与 0.1% 环孢素组相比,Schirmer 试验结果明显增加。与 0.05% 环孢素组相比,0.1% 环孢素组的 TBUT 在术后 3 个月有明显改善:结论:0.05% 和 0.1% 环孢素都能有效改善白内障手术后的干眼症状和眼表炎症。两种眼药水的疗效相似。
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引用次数: 0
Clinical Manifestations and Prognosis in Patients with Infectious Endophthalmitis after Ahmed Glaucoma Valve Implant Surgery 艾哈迈德青光眼瓣膜植入手术后感染性眼内炎患者的临床表现和预后
Pub Date : 2023-11-15 DOI: 10.3341/jkos.2023.64.11.1048
C. Hong, Gyu-nam Kim, Y. Cho, Seong-Jae Kim, I. Chung, Woong-Sun Yoo
Purpose: We studied the clinical features and assessed the treatment outcomes of infectious endophthalmitis subsequent to Ahmed glaucoma valve (AGV) implant surgery.Methods: We performed a retrospective review of the medical records of patients who underwent AGV implant surgery between January 1, 2010 and May 31, 2022. Clinical course, microbiological lab results, and the treatment data of patients who developed infectious endophthalmitis were analyzed.Results: Of 310 eyes that underwent AGV implant surgery, 9 (2.90%) developed endophthalmitis. The average time interval between AGV implant surgery and the diagnosis of endophthalmitis was 3.59 years. As initial treatment, all affected eyes received injections of intravitreal antibiotics, while four underwent primary pars plana vitrectomy. The implanted valve was removed in seven instances. Microorganisms were found in cultures from four cases. Two patients achieved a final best-corrected visual acuity (BCVA) above 20/200, while the other five had a final BCVA of hand motion or worse.Conclusions: AGV implant-related endophthalmitis is uncommon and often results in poor visual outcomes, with unpredictable onset. Consequently, it is crucial to educate patients undergoing AGV implant surgery during regular follow-ups. Immediate evaluation and treatment are necessary for patients exhibiting symptoms after surgery.
目的:我们研究了艾哈迈德青光眼瓣膜(AGV)植入手术后感染性眼内炎的临床特征并评估了治疗效果:我们对 2010 年 1 月 1 日至 2022 年 5 月 31 日期间接受 AGV 植入手术的患者病历进行了回顾性分析。对发生感染性眼内炎的患者的临床过程、微生物实验室结果和治疗数据进行了分析:结果:在接受AGV植入手术的310只眼睛中,有9只(2.90%)发生了眼内炎。从 AGV 植入手术到确诊眼内炎的平均间隔时间为 3.59 年。在最初的治疗中,所有患眼都接受了玻璃体内抗生素注射,有四只患眼接受了原发性玻璃体旁切除术。有 7 例患者的植入瓣膜被移除。在四个病例的培养物中发现了微生物。两名患者的最终最佳矫正视力(BCVA)超过了20/200,而另外五名患者的最终BCVA为手部运动或更差:与 AGV 植入物相关的眼内炎并不常见,通常会导致不良的视觉效果,而且发病时间难以预测。因此,对接受 AGV 植入手术的患者进行定期随访教育至关重要。对于术后出现症状的患者,必须立即进行评估和治疗。
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引用次数: 0
Comparison of Results between Hahn Test and D-15 Test in Patients with Optic Neuritis 视神经炎患者哈恩测试与 D-15 测试结果的比较
Pub Date : 2023-11-15 DOI: 10.3341/jkos.2023.64.11.1087
Hayoung Lee, Jongwon Moon, Donghun Lee
Purpose: The results of the Hahn Chun Suk color test (Hahn test) and the Farnsworth-Munsell D-15 test (D-15 test) were compared in patients with acute optic neuritis.Methods: Patients with acute optic neuritis evaluated using both the Hahn and D-15 tests in the acute phase and 2 months later were evaluated. The results of the acute phase tests were compared. Correlations were sought between color deficiency and all of visual acuity, the visual field index (VFI), and the severity of optic disc edema. Changes in the test results 2 months later were also evaluated and correlated with other visual functions.Results: Twenty-seven eyes of 22 patients were enrolled. The mean patient age was 49.4 years and the logarithm of the minimum angle of resolution visual acuity 0.5. In the acute phase, the perception number was 10.06 in the Hahn test. On the D-15 test, the ‘strong’ grade predominated (40.7%). The concordance rates of severity and type were 55.6 and 54.5% between the two tests. In 9 of 12 eyes exhibiting inconsistent severity, the D-15 test afforded better results than did the Hahn test. A significant positive correlation was evident between the Hahn test results and visual acuity (r = 0.560, p = 0.002). The mean deviation (MD) and the VFI also correlated with the results of the Hahn test (r = -0.432, p = 0.027 for the MD; r = -0.517, p = 0.007 for the VFI). The D-15 test results correlated only with visual acuity (r = 0.476, p = 0.012). After 2 months, the results of both tests correlated significantly only with visual acuity.Conclusions: In the acute phase, the concordances of the Hahn and D-15 test results were 55.6% in terms of severity and 54.5% in terms of type. The Hahn test results correlated with the visual acuity and VFI. In contrast, the D-15 test results correlated with visual acuity only.
目的:比较急性视神经炎患者的哈恩春淑色试验(Hahn 试验)和法恩斯沃斯-蒙塞尔 D-15 试验(D-15 试验)的结果:方法:对急性视神经炎患者在急性期和 2 个月后使用哈恩试验和 D-15 试验进行评估。对急性期测试结果进行比较。寻找色弱与所有视敏度、视野指数(VFI)和视盘水肿严重程度之间的相关性。此外,还评估了 2 个月后测试结果的变化,并将其与其他视觉功能相关联:结果:22 名患者的 27 只眼睛接受了治疗。患者平均年龄为 49.4 岁,最小解像角视力的对数为 0.5。在急性期,哈恩测试的感知数为 10.06。在 D-15 测试中,"强 "级占多数(40.7%)。两种测试的严重程度和类型的一致率分别为 55.6% 和 54.5%。在严重程度不一致的 12 只眼睛中,有 9 只眼睛的 D-15 检验结果优于 Hahn 检验结果。Hahn 测试结果与视力之间存在明显的正相关性(r = 0.560,p = 0.002)。平均偏差(MD)和 VFI 也与哈恩测试结果相关(MD 的 r = -0.432,p = 0.027;VFI 的 r = -0.517,p = 0.007)。D-15 测试结果仅与视力相关(r = 0.476,p = 0.012)。2 个月后,这两项测试结果仅与视力显著相关:结论:在急性期,Hahn 和 D-15 测试结果在严重程度上的一致性为 55.6%,在类型上的一致性为 54.5%。哈恩测试结果与视力和 VFI 相关。相比之下,D-15 测试结果仅与视力相关。
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引用次数: 0
Novel Method Measuring Conjunctival Microvascular Blood Flow Velocity by Zoom-lens, Ultra-high-speed Camera Attached Slit-lamp Biomicroscope 用变焦镜头、超高速相机附加裂隙灯生物显微镜测量结膜微血管血流速度的新方法
Pub Date : 2023-11-15 DOI: 10.3341/jkos.2023.64.11.1001
Hyo Sin Kim, Da Ran Kim, Y. Yoon, Soonwon Yang, Young Sik Yoo, Woong-Joo Whang, Y. Byun, H. Hwang, Kyung Sun Na, Hyun Soo Lee, So Hyang Chung, Eun Chul Kim, Y. Cho, Hyun Seung Kim, Ho Sik Hwang
Purpose: To introduce an intuitive method for measuring conjunctival microvascular blood flow velocity by imaging bulbar conjunctival microvessels using a slit-lamp biomicroscope equipped with a zoom lens and an ultra-high-speed camera.Methods: After obtaining consent from 10 patients (1 male, 9 females) who visited Yeouido St. Mary’s Hospital from August 21, 2020, to June 12, 2021, the patients were examined under a slit lamp microscope equipped with an ultra-high-speed camera and zoom lens. The blood flow in the conjunctival microvessels was photographed. The captured images were analyzed with ImageJ software to measure the blood flow velocity in the conjunctival microvessels, and we investigated whether the blood flow velocity correlated with the vessel diameter and age.Results: The median age of the subjects was 49.0 years. The mean conjunctival blood flow velocity in 53 microvessels was 0.786 ± 0.468 mm/s. The median conjunctival microvascular diameter was 7.06 μm (interquartile range 5.84 to 9.23 μm). The conjunctival microvascular diameter and blood flow velocity were not significantly correlated (Spearman’s p = 0.177), and the subjects’ age and conjunctival microvascular blood flow velocity were also not correlated (Spearman’s p = 0.669).Conclusions: In this study, the blood flow velocity in the bulbar conjunctival microvessels could be measured easily by means of image analysis using a slit-lamp microscope equipped with an ultra-high-speed camera with a zoom lens.
目的:通过使用配备变焦镜头和超高速相机的裂隙灯生物显微镜对球结膜微血管进行成像,介绍一种测量结膜微血管血流速度的直观方法:在征得2020年8月21日至2021年6月12日到汝矣岛圣玛丽医院就诊的10名患者(1男9女)的同意后,在配备了超高速相机和变焦镜头的裂隙灯显微镜下对患者进行检查。对结膜微血管的血流情况进行了拍照。用 ImageJ 软件对拍摄的图像进行分析,测量结膜微血管的血流速度,并研究血流速度是否与血管直径和年龄相关:结果:受试者的中位年龄为 49.0 岁。53 个微血管的平均结膜血流速度为 0.786 ± 0.468 mm/s。结膜微血管直径的中位数为 7.06 μm(四分位距为 5.84 至 9.23 μm)。结膜微血管直径与血流速度无明显相关性(Spearman's p = 0.177),受试者年龄与结膜微血管血流速度也无相关性(Spearman's p = 0.669):本研究利用配备变焦镜头的超高速照相机的裂隙灯显微镜,通过图像分析法轻松测量了球结膜微血管的血流速度。
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引用次数: 0
Clinical Characteristics and Outcomes after Augmented Medial Rectus Muscle Recession in Patients with Acute Acquired Comitant Esotropia 急性后天性合并内斜视患者的内侧直肌增强后的临床特征和疗效
Pub Date : 2023-11-15 DOI: 10.3341/jkos.2023.64.11.1078
Young-Eun Kim, Haeng-Jin Lee
Purpose: To analyze the clinical characteristics of patients with acute acquired comitant esotropia, evaluate the outcomes of augmented medial rectus muscle recession, and propose indicators for determining the appropriate surgical dosage.Methods: Data of patients with acute acquired esotropia who underwent medial rectus recession between 2016 and 2022 were retrospectively analyzed. The amount of medial rectus muscle recession was 1-2 mm greater than for other types of esotropia. Surgical success was assessed by reference to the angle of deviation and diplopia status 6 months after surgery. We investigated the amount of additional recession required for favorable surgical outcomes, the characteristics of groups that required augmentation, and changes in surgical amount according to the deviation angle.Results: A total of 38 patients were included; the average refractive error was -3.79 ± 3.11 diopters (D). Patient age at the time of surgery was 25.6 ± 18.2 years and the preoperative deviation angle was 38.1 ± 11.5 prism diopters (PD). The amount of medial rectus muscle recession was 6.25 ± 1.4 mm, i.e., 1.2 ± 1.0 mm greater than during other surgeries. The average augmentation was 24.1 ± 18.8%. The motor surgical success rate was 92.1% and the sensory success rate was 97.4%. The required augmentation was 26.9% for those with angles of deviation < 30 PD, 25.5% for patients with angles between 30 and 40 PD, and 20.0% for those with angles > 40 PD. Patients who required augmentation > 25% were older, and the surgical effect was greater as the angle of deviation increased.Conclusions: To ensure successful surgical outcomes of patients with acute acquired comitant esotropia, it is essential to increase the amount of medial rectus recession compared to that during other surgeries; the average augmentation was 24% in this study.
目的:分析急性获得性合并内斜视患者的临床特征,评估增强内直肌后移术的疗效,并提出确定合适手术剂量的指标:回顾性分析2016年至2022年期间接受内侧直肌缩窄术的急性后天性内斜视患者的数据。与其他类型的内斜视相比,内侧直肌后退的幅度要大1-2毫米。手术成功与否的评估参考了偏斜角度和术后6个月的复视状况。我们研究了获得良好手术效果所需的额外后退量、需要增加手术量的组别特征以及手术量随偏斜角度的变化:结果:共纳入 38 名患者,平均屈光不正为 -3.79 ± 3.11 迪普(D)。手术时患者年龄为(25.6 ± 18.2)岁,术前偏斜角度为(38.1 ± 11.5)个棱镜屈光度(PD)。内侧直肌后退量为 6.25 ± 1.4 毫米,即比其他手术多 1.2 ± 1.0 毫米。平均增强率为 24.1 ± 18.8%。运动手术成功率为 92.1%,感觉手术成功率为 97.4%。偏差角度小于 30 PD 的患者需要扩容的比例为 26.9%,偏差角度在 30 至 40 PD 之间的患者需要扩容的比例为 25.5%,偏差角度大于 40 PD 的患者需要扩容的比例为 20.0%。需要增加手术量大于 25% 的患者年龄较大,偏斜角度越大,手术效果越好:为确保急性获得性合并内斜视患者的手术效果,与其他手术相比,增加内侧直肌后退量至关重要;本研究中的平均增加量为24%。
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引用次数: 0
Neuro-ophthalmological Consultations in the Emergency Department of a Tertiary Referral Emergency Center 一家三级转诊急救中心急诊科的神经眼科就诊情况
Pub Date : 2023-11-15 DOI: 10.3341/jkos.2023.64.11.1095
Jiehoon Kwak, Yeji Moon, Byung Joo Lee
Purpose: We report the clinical features, diagnoses, and treatments of patients with neuro-ophthalmological diseases presenting to a tertiary referral center emergency room (ER) of South Korea.Methods: We retrospectively analyzed the medical records of 205 patients who visited the ER of the Asan Medical Center and then were referred to our neuro-ophthalmology department from May 2020 to April 2022. The initial diagnoses of ophthalmology residents were compared to the final diagnoses of neuro-ophthalmologists. We describe the symptoms, diagnoses, and treatments.Results: The median time from the onset of symptoms to the ER visit was 3 days; diplopia (49.1%) and vision loss/a visual field defect (38.9%) were the chief complaints. The most common causes of diplopia were isolated cranial nerve 4 (37.5%), 6 (22.9%), and 3 palsy (18.4%) and supranuclear palsy (9.2%). In patients with vision loss/visual field defect, the most common causes were optic (20.5%), ischemic (17.1%), and compressive (8.0%) optic neuropathies. For 121 cases (59.0%), multidisciplinary consultations with the departments of neurology, neurosurgery, and internal medicine were scheduled. After initial management in the ER, 38 diagnoses (18.5%) changed after evaluation by neuro-ophthalmologists.Conclusions: Over half of all neuro-ophthalmology patients presenting to an ER required comprehensive interdisciplinary evaluation and over a third required inpatient treatment.
目的:我们报告了在韩国一家三级转诊中心急诊室就诊的神经眼科疾病患者的临床特征、诊断和治疗方法:我们回顾性分析了2020年5月至2022年4月期间前往牙山医疗中心急诊室就诊并转诊至神经眼科的205名患者的病历。我们将眼科住院医师的初步诊断与神经眼科医师的最终诊断进行了比较。我们对症状、诊断和治疗进行了描述:从症状出现到急诊就诊的中位时间为 3 天;复视(49.1%)和视力下降/视野缺损(38.9%)是主诉。复视最常见的原因是孤立性颅神经4(37.5%)、6(22.9%)、3麻痹(18.4%)和核上麻痹(9.2%)。在视力下降/视野缺损的患者中,最常见的原因是视神经病变(20.5%)、缺血性视神经病变(17.1%)和压迫性视神经病变(8.0%)。121例患者(59.0%)接受了神经内科、神经外科和内科的多学科会诊。在急诊室进行初步处理后,有38个病例(18.5%)的诊断在经过神经眼科专家评估后发生了改变:结论:在急诊室就诊的所有神经眼科患者中,一半以上需要进行跨学科综合评估,三分之一以上需要住院治疗。
{"title":"Neuro-ophthalmological Consultations in the Emergency Department of a Tertiary Referral Emergency Center","authors":"Jiehoon Kwak, Yeji Moon, Byung Joo Lee","doi":"10.3341/jkos.2023.64.11.1095","DOIUrl":"https://doi.org/10.3341/jkos.2023.64.11.1095","url":null,"abstract":"Purpose: We report the clinical features, diagnoses, and treatments of patients with neuro-ophthalmological diseases presenting to a tertiary referral center emergency room (ER) of South Korea.Methods: We retrospectively analyzed the medical records of 205 patients who visited the ER of the Asan Medical Center and then were referred to our neuro-ophthalmology department from May 2020 to April 2022. The initial diagnoses of ophthalmology residents were compared to the final diagnoses of neuro-ophthalmologists. We describe the symptoms, diagnoses, and treatments.Results: The median time from the onset of symptoms to the ER visit was 3 days; diplopia (49.1%) and vision loss/a visual field defect (38.9%) were the chief complaints. The most common causes of diplopia were isolated cranial nerve 4 (37.5%), 6 (22.9%), and 3 palsy (18.4%) and supranuclear palsy (9.2%). In patients with vision loss/visual field defect, the most common causes were optic (20.5%), ischemic (17.1%), and compressive (8.0%) optic neuropathies. For 121 cases (59.0%), multidisciplinary consultations with the departments of neurology, neurosurgery, and internal medicine were scheduled. After initial management in the ER, 38 diagnoses (18.5%) changed after evaluation by neuro-ophthalmologists.Conclusions: Over half of all neuro-ophthalmology patients presenting to an ER required comprehensive interdisciplinary evaluation and over a third required inpatient treatment.","PeriodicalId":504314,"journal":{"name":"Journal of the Korean Ophthalmological Society","volume":"BME-29 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139274100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
An Eosinophilic Variant of Orbital Granulomatosis with Polyangiitis with Ocular Motility Disorder 伴有眼球运动障碍的眼眶多发性肉芽肿病的嗜酸性粒细胞变异型
Pub Date : 2023-11-15 DOI: 10.3341/jkos.2023.64.11.1104
Sung Eun Im, Ji Eun Lee
Purpose: To present the case of a patient with localized orbital granulomatosis with polyangiitis (GPA) characterized by a significant ocular motility disorder, increased eosinophilia, and hyper-immunoglobulin E (hyper-IgE).Case Summary: A 61-year-old male, with no previous history of allergy, atopy, asthma, sinonasal disease, respiratory disease, or renal disease, came to our hospital due to a 2-day history of binocular diplopia. His left eye exhibited inward and upward deviation, along with gaze limitation. His vision was 20/20 in both eyes, and the pupillary light reflex and color test were normal. He had severe eyelid swelling and conjunctival injection without tenderness in his left eye, and retinal vessel congestion around the optic nerve, without proptosis. Laboratory tests revealed a positive cytoplasmic antineutrophil cytoplasmic antibody (cANCA), a normal WBC count, elevated eosinophils at 28.3% (2,462/mm3), and high serum levels of IgE (400 KU/L). Magnetic resonance imaging showed an inferolateral orbital mass with an enlarged lacrimal gland and myositis of the extraocular muscles. A biopsy of the lacrimal gland revealed nonspecific chronic inflammation with an eosinophilic infiltrate. The presence of cANCA, in combination with clinical and pathological findings, led to the diagnosis of an eosinophilic variant of localized orbital GPA. This variant was primarily confined to the orbital tissue, marked by elevated eosinophil and IgE levels, and was treated with oral steroids without requiring surgery for the ocular motility disorder.Conclusions: GPA may present as acute strabismus with orbital inflammation, even in the absence of systemic signs. Therefore, it should be considered in the differential diagnosis of unexplained acute orbital syndromes.
病例摘要:患者男性,61 岁,既往无过敏、过敏性鼻炎、哮喘、鼻窦疾病、呼吸系统疾病或肾脏疾病史。他的左眼表现为向内和向上偏斜,并伴有注视受限。他的双眼视力均为 20/20,瞳孔对光反射和颜色测试正常。他的左眼有严重的眼睑肿胀和结膜注射,但无压痛,视神经周围视网膜血管充血,但无眼球突出。实验室检查显示细胞质抗中性粒细胞胞浆抗体(cANCA)阳性,白细胞计数正常,嗜酸性粒细胞升高 28.3%(2,462/mm3),血清 IgE 水平较高(400 KU/L)。磁共振成像显示,患者眼眶下外侧有肿块,泪腺肿大,眼外肌有肌炎。泪腺活组织检查显示存在非特异性慢性炎症和嗜酸性粒细胞浸润。结合临床和病理结果,该患者被诊断为嗜酸性粒细胞变异性局部眼眶 GPA。这种变异型主要局限于眼眶组织,以嗜酸性粒细胞和IgE水平升高为特征,口服类固醇治疗后无需手术治疗眼球运动障碍:结论:即使没有全身症状,GPA 也可能表现为伴有眼眶炎症的急性斜视。因此,在对原因不明的急性眼眶综合征进行鉴别诊断时,应将其考虑在内。
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引用次数: 0
Predictive Accuracy of Refraction after Transscleral Fixation of Intraocular Lenses in Trabeculectomized Eyes with Glaucoma 小梁切除术后青光眼患者经巩膜固定眼内透镜后屈光度的预测准确性
Pub Date : 2023-11-15 DOI: 10.3341/jkos.2023.64.11.1022
Dong Seon Kim, B. Park, H. Kwon, Sung Who Park, I. Byon
Purpose: To investigate the predictive accuracy of refraction and any change in intraocular pressure (IOP) after transscleral fixation of intraocular lenses (IOLs) in trabeculectomized eyes with glaucoma.Methods: We retrospectively reviewed the medical records of glaucoma patients who underwent trabeculectomy, followed by transscleral fixation of dislocated IOLs combined with vitrectomy. The refraction predicted by the SRK/T formula and the postoperative refraction were converted into spherical equivalents. Predictive refraction accuracies were analyzed when the differences between the two values were within ± 0.5 diopters (D) and ± 1.0 D. The IOP was measured before and after surgery.Results: Eleven eyes of 11 men (mean age, 67.27 ± 10.55 years) were included. The mean axial length was 23.64 ± 1.26 mm; the mean predicted and postoperative refractions were -0.02 ± 0.46 D and -0.80 ± 0.98 D, respectively (p = 0.029). The refractive outcome was more myopic (by -0.78 ± 1.11 D) than predicted. The predictive accuracies were 36.4% and 72.7% when the differences were ± 0.5 and ± 1.0 D, respectively. The IOP did not change during follow-up (13.18 ± 4.56, 12.82 ± 5.88, and 12.73 ± 4.58 mmHg at baseline, 1 week, and 3 months, respectively).Conclusions: In trabeculectomized eyes, transscleral IOL fixation did not affect the IOP, but the refractive outcome was more myopic than predicted. This difference should be considered when choosing IOL target power.
目的:研究小梁切除术后青光眼患者经巩膜固定人工晶体(IOL)后屈光度的预测准确性以及眼压(IOP)的任何变化:我们回顾性地查看了接受小梁切除术、经巩膜固定脱位人工晶体术和玻璃体切除术的青光眼患者的病历。将 SRK/T 公式预测的屈光度和术后屈光度转换为球面当量。当两个数值的差异在± 0.5屈光度(D)和± 1.0屈光度(D)范围内时,对预测屈光度的准确性进行分析:结果:共纳入 11 名男性的 11 只眼睛(平均年龄为 67.27 ± 10.55 岁)。平均轴长为 23.64 ± 1.26 mm;预测屈光度和术后屈光度分别为 -0.02 ± 0.46 D 和 -0.80 ± 0.98 D(p = 0.029)。屈光结果比预测值更近视(-0.78 ± 1.11 D)。当差异为 ± 0.5 和 ± 1.0 D 时,预测准确率分别为 36.4% 和 72.7%。随访期间,眼压没有变化(基线、1 周和 3 个月时分别为 13.18 ± 4.56、12.82 ± 5.88 和 12.73 ± 4.58 mmHg):在小梁切除的眼睛中,经巩膜固定人工晶体不会影响眼压,但屈光结果比预测的更近视。在选择人工晶体目标功率时应考虑到这一差异。
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引用次数: 0
The Clinical Outcomes of Manual Continuous Curvilinear Capsulorhexis and Precision Pulse Capsulotomy 手动连续曲线巩膜切除术和精确脉冲巩膜切开术的临床效果
Pub Date : 2023-11-15 DOI: 10.3341/jkos.2023.64.11.1014
Man Ji, Hye Jin Lee, Ahnul Ha, Ki Tae Nam, Jinho Jeong
Purpose: To compare the safety and consistency of manual capsulorhexis and precision pulse capsulotomy performed using pulsed energy during bilateral cataract surgery and to explore the differences in clinical outcomes.Methods: A total of 101 patients with bilateral cataracts were selected. Precision pulse capsulotomy was performed on one eye and manual continuous curvilinear capsulorhexis on the other. The independent-samples t-test was used to compare the duration of continuous curvilinear capsulorhexis, incisional size and roundness, complications such as radial tears, the cumulative dissipated energy, the visual acuity after surgery, and the corneal epithelial cell count.Results: There was no significant difference in the capsulorhexis time between the pulse energy and manual groups. The extent of capsulorhexis was significantly smaller and the circularity of capsulorhexis was higher in the former group. Complications occurred in two manual capsulorhexis patients but in no pulse energy capsulotomy patient. There was no significant between- group difference in any of postoperative visual acuity, best-corrected visual acuity, or the corneal endothelial cell count.Conclusions: During bilateral cataract surgery on the same patients, precision capsulotomy using pulse energy afforded smaller and more circular capsulorhexis and fewer complications than did manual capsulorhexis. However, there was no significant between- group difference in the postoperative clinical outcomes.
目的:比较在双侧白内障手术中使用脉冲能量进行人工晶体囊外摘除术和精确脉冲晶体囊切开术的安全性和一致性,并探讨临床结果的差异:方法:共选取 101 名双侧白内障患者。方法:共选取了 101 名双侧白内障患者,一只眼进行精确脉冲囊袋切除术,另一只眼进行人工连续曲线囊袋切除术。采用独立样本 t 检验比较连续曲线帽状切除术的持续时间、切口大小和圆度、径向撕裂等并发症、累计耗散能量、术后视力和角膜上皮细胞计数:结果:脉冲能量组和人工组的角膜塑形时间无明显差异。前者的角膜瓣剔除范围明显更小,角膜瓣剔除的圆度更高。有两名人工虹膜睫状体切除术患者出现并发症,但没有脉冲能量虹膜睫状体切除术患者出现并发症。术后视力、最佳矫正视力和角膜内皮细胞计数在组间无明显差异:结论:在对同一患者进行双侧白内障手术时,使用脉冲能量进行精确的囊膜切开术比人工囊膜切开术的囊膜更小、更圆,并发症更少。然而,在术后临床结果方面,组间差异并不明显。
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引用次数: 0
Differences between the Results Assessed by Slit Lamp Examination and Anterior Segment Photography in Terms of Cataract Grading 裂隙灯检查和眼前节摄影在白内障分级方面的评估结果差异
Pub Date : 2023-11-15 DOI: 10.3341/jkos.2023.64.11.1009
Woojin Kim, Sumin Yoon, Dong Hyun Kim, Y. Eom, J. Song
Purpose: We compared the cataract grades with slit lamp examination and anterior segment photography using the Lens Opacities Classification System (LOCS) III criteria. We also explored the effect of a yellow filter on the photographic results.Methods: Eighty eyes with cataracts were examined by three inspectors (1, 2, and 3). Anterior segment photographs taken by inspector 1 were divided into two groups depending on whether cortical opacity or nuclear sclerosis predominated. In each group, the cataract grades determined by inspector 1 on slit lamp examination and anterior segment photography were compared. Also, after randomly assigning the anterior segment photographs taken by inspector 1 to inspectors 2 and 3, the cataract grades of these photographs were compared to the grades of photographs taken by all inspectors using a yellow filter.Results: The average cortical opacity evaluated by inspector 1 on slit lamp examination (3.48 ± 0.91) was significantly higher than that apparent on anterior segment photographs (2.35 ± 0.77) (p < 0.001). In the photographs, the average cortical opacity when a yellow filter was used was significantly higher for both inspectors 1 (p < 0.001) and 2 (p = 0.022) than when the filter was absent. The average extent of nuclear sclerosis evaluated by inspector 1 on slit lamp examination (4.08 ± 0.94) was significantly higher than that of anterior segment photography (3.73 ± 1.24) (p = 0.042).Conclusions: Cataract evaluation via anterior segment photography underestimates the extent of damage compared to direct slit lamp examination. However, use of a yellow filter during photography aids cataract evaluation, especially cortical opacity.
目的:我们比较了裂隙灯检查和前段照相的白内障等级,并采用了晶状体混浊分类系统(LOCS)III 标准。我们还探讨了黄色滤光片对摄影结果的影响:方法:由三位检查员(1、2 和 3)对 80 只患有白内障的眼睛进行检查。检查员 1 拍摄的眼前节照片根据皮质混浊还是核硬化为主分为两组。在每组中,比较检查员 1 根据裂隙灯检查和眼前节照片确定的白内障等级。此外,将检查员 1 拍摄的前段照片随机分配给检查员 2 和 3 后,将这些照片的白内障等级与所有检查员使用黄色滤光片拍摄的照片的等级进行比较:检查员 1 在裂隙灯检查中评估的平均皮质混浊度(3.48 ± 0.91)明显高于前段照片上的明显混浊度(2.35 ± 0.77)(p < 0.001)。在照片中,使用黄色滤光片时,1 号检查员(p < 0.001)和 2 号检查员(p = 0.022)的平均皮质不透明度明显高于不使用滤光片时。检查员 1 在裂隙灯检查中评估的核硬化平均程度(4.08 ± 0.94)明显高于前节摄影(3.73 ± 1.24)(p = 0.042):结论:与直接裂隙灯检查相比,通过眼前节摄影进行的白内障评估会低估白内障的损伤程度。结论:与直接裂隙灯检查相比,通过前段摄影进行的白内障评估低估了白内障的损伤程度,但在摄影过程中使用黄色滤光片有助于评估白内障,尤其是皮质混浊。
{"title":"Differences between the Results Assessed by Slit Lamp Examination and Anterior Segment Photography in Terms of Cataract Grading","authors":"Woojin Kim, Sumin Yoon, Dong Hyun Kim, Y. Eom, J. Song","doi":"10.3341/jkos.2023.64.11.1009","DOIUrl":"https://doi.org/10.3341/jkos.2023.64.11.1009","url":null,"abstract":"Purpose: We compared the cataract grades with slit lamp examination and anterior segment photography using the Lens Opacities Classification System (LOCS) III criteria. We also explored the effect of a yellow filter on the photographic results.Methods: Eighty eyes with cataracts were examined by three inspectors (1, 2, and 3). Anterior segment photographs taken by inspector 1 were divided into two groups depending on whether cortical opacity or nuclear sclerosis predominated. In each group, the cataract grades determined by inspector 1 on slit lamp examination and anterior segment photography were compared. Also, after randomly assigning the anterior segment photographs taken by inspector 1 to inspectors 2 and 3, the cataract grades of these photographs were compared to the grades of photographs taken by all inspectors using a yellow filter.Results: The average cortical opacity evaluated by inspector 1 on slit lamp examination (3.48 ± 0.91) was significantly higher than that apparent on anterior segment photographs (2.35 ± 0.77) (p < 0.001). In the photographs, the average cortical opacity when a yellow filter was used was significantly higher for both inspectors 1 (p < 0.001) and 2 (p = 0.022) than when the filter was absent. The average extent of nuclear sclerosis evaluated by inspector 1 on slit lamp examination (4.08 ± 0.94) was significantly higher than that of anterior segment photography (3.73 ± 1.24) (p = 0.042).Conclusions: Cataract evaluation via anterior segment photography underestimates the extent of damage compared to direct slit lamp examination. However, use of a yellow filter during photography aids cataract evaluation, especially cortical opacity.","PeriodicalId":504314,"journal":{"name":"Journal of the Korean Ophthalmological Society","volume":"1 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139272929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Journal of the Korean Ophthalmological Society
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