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BACKGROUND: To compare the in-the-bag stability and visual function of single-piece intraocular lenses (IOLs) and three-piece IOLs. METHODS: A total of 65 patients with age-related cataracts (80 eyes) were enrolled and randomly assigned to receive in-the-bag implantation of either a single-piece IOL (40 eyes) or a three-piece IOL (40 eyes). Follow-up visits were conducted at 1 week, 1 month and 3 months postoperatively. Visual acuity, refraction and total aberration were examined. IOL position stability (including axial movement, decentration and tilt) was measured using a Scheimpflug imaging system. RESULTS: At the 3-month follow-up visit, single-piece IOLs did not exhibit significant axial movement (0.07 ± 0.30 mm, p = 0.13) compared with their axial position at 1 week postoperatively, whereas three-piece IOLs displayed forward axial movement of -0.22 ± 0.23 mm (p < 0.0001). The mean manifest spherical equivalence (SE) of eyes with single-piece IOL was 0.15 ± 0.18D, whereas in eyes with three-piece IOLs, the mean manifest SE was -0.34 ± 0.15D (p < 0.001). There was no statistically significant difference in IOL decentration, tilt, uncorrected visual acuity, best-corrected visual acuity or total spherical aberration between the two groups. CONCLUSIONS: Three months after implantation, single-piece IOLs exhibit better axial stability and more stable refractive outcome than three-piece IOLs, but both IOLs perform equally well in terms of decentration, tilt, visual acuity and total aberration. TRIAL REGISTRATION: ClinicalTrial.gov, NCT02609997 , 11/18/2015, retrospectively registered.
Assuntos
Implante de Lente Intraocular , Lentes Intraoculares , Facoemulsificação , Idoso , Idoso de 80 Anos ou mais , Segmento Anterior do Olho/patologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Desenho de Prótese , Refração Ocular/fisiologia , Estudos Retrospectivos , Acuidade Visual/fisiologiaRESUMO
PURPOSE: To investigate whether lymphatic microvessel density (LMVD) could be used as a predictive marker for the recurrence time of pterygia. METHODS: This was a prospective case series study. Ninety-six patients with unilateral eye primary nasal pterygia were included. The patients were clinically evaluated to grade the severity of their pterygia (32 were Grade 1, 29 were Grade 2, and 35 were Grade 3) before they underwent bare sclera resection with the use of mitomycin C. Excised tissues from the 96 patients and the ten normal nasal conjunctiva obtained from age-matched donor eyeballs (controls) were immunostained with LYVE-1 and CD31 monoclonal antibodies to evaluate LMVD and blood microvessel density (BMVD). The patients were followed up for three years or until pterygium recurrence was identified, which was defined as fibrovascular regrowth past the limbus in a previously compromised area. The recurrence time (RT) for a pterygium was calculated, and its relationship with LMVD and/or BMVD was statistically analyzed. RESULTS: In total, there were 24 cases of pterygium recurrence. The recurrence rate of Grade 1 was 28.1% (9/32), Grade 2 was 24.1% (7/29), and Grade 3 was 22.9% (8/35), as classified in the primary pterygium (p>0.05); the overall recurrence rate was 25% (24/96) for all patients during the three-year follow-up. In the tissue analysis, there were a small number of CD31 (+), LYVE-1(-) BMVD and only a few CD31 (weak), LYVE-1(+) LMVD in the ten normal nasal conjunctiva tissues. BMVD and LMVD increased significantly in the pterygium tissue compared to the control tissue and were significantly correlated with the width and area of pterygium in Grades 1-3 (all p values <0.05). RT was not correlated with BMVD or pterygium grade, but LMVD was significantly and negatively correlated with RT within each group and in the total patient cohort. Furthermore, we determined that an LMVD greater than 20 in the surgical specimens predicted pterygium recurrence. CONCLUSIONS: The LMVD of surgical specimens is an independent risk factor and a valuable predictive factor for the recurrence time of pterygia.
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Vasos Linfáticos/patologia , Pterígio/patologia , Estudos de Casos e Controles , Feminino , Seguimentos , Humanos , Linfangiogênese , Vasos Linfáticos/fisiopatologia , Masculino , Pessoa de Meia-Idade , Neovascularização Patológica/patologia , Neovascularização Patológica/fisiopatologia , Estudos Prospectivos , Pterígio/etiologia , Pterígio/cirurgia , Recidiva , Fatores de Risco , Fatores de TempoRESUMO
OBJECTIVE: Regular follow-up is essential to successful management of childhood cataract. We sought to assess whether a mobile phone short message service (SMS) for parents of children with cataract could improve follow-up adherence and the proportion of procedures performed in timely fashion. DESIGN: Randomized, controlled trial. This trial is registered with ClinicalTrials.gov, NCT01417819. PARTICIPANTS: We included 258 parent-child pairs involved in the Childhood Cataract Program of the Chinese Ministry of Health. METHODS: Participants were randomized (1:1) to a mobile phone SMS intervention or standard follow-up appointments. All participants were scheduled to attend ≥ 4 follow-up appointments according to the protocol. Parents in the intervention group received SMS automated reminders before scheduled appointments. The control group parents did not receive SMSs or any alternative reminder of scheduled appointments. Regular ocular examinations and analyses were performed by investigators masked to group allocation; however, study participants and the manager in charge of randomization and sending SMSs were not masked. MAIN OUTCOME MEASURES: Number of follow-up appointments attended, additional surgeries, laser treatments, changes in eyeglasses prescription, and occurrence of secondary ocular hypertension. RESULTS: Among parent-child participants, 135 were randomly assigned to the SMS intervention and 123 to standard appointments. Attendance rates for the SMS group (first visit, 97.8%; second, 91.9%; third, 92.6%; fourth, 83%) were significantly higher than those for the control group (first visit, 87.8%; second, 69.9%; third, 56.9%; fourth, 33.3%). The increase in attendance rate for total number of follow-up visits with SMS reminders was 47.2% (relative risk [RR] for attendance, 1.47; 95% confidence interval [CI], 1.16-1.78; P = 0.003). The number needed to remind (NNR) to gain 1 additional visit by 1 child was 3 (95% CI, 1.8-4.2). A total of 247 clinical interventions were carried out in the SMS group and 134 in the control group (RR, 1.68; 95% CI, 1.37-1.99; P = 0.007). The NNR to result in 1 additional clinical intervention was 5 (95% CI, 3.5-6.5). CONCLUSIONS: The SMS reminders significantly improved follow-up adherence in pediatric cataract treatment. Using readily available mobile phone resources may be an effective and economic strategy to improve management of childhood cataract in China. FINANCIAL DISCLOSURE(S): The authors have no proprietary or commercial interest in any of the materials discussed in this article.
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Agendamento de Consultas , Catarata/terapia , Telefone Celular/estatística & dados numéricos , Atenção à Saúde/métodos , Cooperação do Paciente/estatística & dados numéricos , Sistemas de Alerta , Envio de Mensagens de Texto , Adolescente , Opacificação da Cápsula/cirurgia , Extração de Catarata , Método Duplo-Cego , Óculos/estatística & dados numéricos , Feminino , Humanos , Terapia a Laser/estatística & dados numéricos , Masculino , Hipertensão Ocular/terapiaRESUMO
AIMS: Posttraumatic endophthalmitis (PTE) managed with pars plana vitrectomy (PPV) and a variety of other methods often resulted in retinal detachment (RD), which deteriorates postoperative visual acuity (VA). We investigated initial ocular conditions, surgical management and outcomes of PTE patients and analyzed their relationship in order to find the necessary management for different patients' conditions. METHODS: Retrospective study. Medical records of 62 consecutive patients who were diagnosed with PTE and managed with PPV were retrospectively analyzed. The included patients were divided into two groups depending on their initial VA, with light perception (LP) as borderline: group A (12 cases; VA=LP) and group B (50 cases; VA>LP). Specific variables related to surgical outcomes were analyzed, including: initial VA; intraocular foreign body; location and length of the wound; microbiologic test; cataract extraction; scleral buckling; silicon oil tamponade; gas tamponade, and retinal restoration. Data were statistically analyzed by the χ2 test, by univariate analysis for predictors and by multivariate logistic regression analysis. RESULTS: RD happened in 19 (30.6%) of the 62 cases included. There were 6 cases (50%) in group A and 13 cases (26%) in group B which resulted in RD. Statistical analysis demonstrated that none of the related factors were correlated to the occurrence of RD (all factors: p>0.05) in group A, but in group B, scleral buckling (with: 2/22, 9%; without: 11/28, 39%; p<0.05) and silicone oil tamponade (with: 0/6; without: 13/44, 30%; p<0.05) were statistically significantly correlated to the occurrence of RD. CONCLUSIONS: Preventive scleral buckling and silicone oil tamponade are important for patients with good initial VA (VA>LP) to be successfully managed by PPV.
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Endoftalmite/cirurgia , Ferimentos Oculares Penetrantes/cirurgia , Complicações Pós-Operatórias , Descolamento Retiniano/prevenção & controle , Recurvamento da Esclera , Óleos de Silicone/administração & dosagem , Vitrectomia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Tamponamento Interno/métodos , Humanos , Pessoa de Meia-Idade , Retina/lesões , Descolamento Retiniano/etiologia , Estudos Retrospectivos , Acuidade VisualRESUMO
This study attempts to investigate the relationship among electricity consumption, economic growth, and employment in China. Distinct from most of the previous studies, our empirical research identifies a long-run equilibrium cointegration relationship among the three covariates during the period of 1971-2009 with the recently developed autoregressive distributed lag (ARDL) bounds testing approach. The parameters are estimated through a long-run static solution of the estimated ARDL model and short-run dynamic solutions of the error correction model. The estimated models successfully pass diagnostic tests and both the long-run and short-run elasticities are found to be statistically significant. The study also indicates the existence of short-run and long-run causalities from electricity consumption and employment to economic growth. Results of this study show that electricity serves as an important driver of economic growth. Based on these results, several policy prescriptions on energy use and economic development are suggested for China.
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Desenvolvimento Econômico , Fontes Geradoras de Energia , China , Conservação dos Recursos Naturais , Desenvolvimento Econômico/estatística & dados numéricos , Eletricidade , Emprego/estatística & dados numéricos , Modelos TeóricosRESUMO
PURPOSE: Several methods have been reported to treat pupil deformities. However, there are some disadvantages to these methods. Here, we introduce the new technique of pupilloplasty. METHODS: We retrospectively collected five patients who underwent pupilloplasty by radiofrequency diathermy (RFD) in eyes with acorea or a severe pupillary fibrous membrane. The RFD tip was inserted into the anterior chamber after injection of an ophthalmic viscosurgical device (OVD). It was then used to resect the iris and fibrous membrane around the pupillary centre to restore a centred and round pupil. RESULTS: No obvious bleeding was observed during resection of the iris or fibrous membrane with the RFD technique. All cases were successfully treated, and pupil transparency was restored. CONCLUSION: We introduced a new technique of pupilloplasty by RFD that is easily manageable, reduces bleeding, and is suitable for most types of pupillary seclusion, especially for acorea and severe pupillary fibrous membrane.
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Diatermia/métodos , Iris/cirurgia , Procedimentos Cirúrgicos Oftalmológicos/métodos , Procedimentos de Cirurgia Plástica/métodos , Distúrbios Pupilares/cirurgia , Criança , Feminino , Seguimentos , Humanos , Lactente , Masculino , Estudos Retrospectivos , Adulto JovemRESUMO
OBJECTIVES: Depression and depressive symptoms are common mental disorders that have a considerable effect on patients' health-related quality of life and satisfaction with medical care, but the prevalence of these conditions varies substantially between published studies. The aim of this study is to conduct a systematic review and meta-analysis to provide a precise estimate of the prevalence of depression or depressive symptoms among outpatients in different clinical specialties. DESIGN: Systematic review and meta-analysis. DATA SOURCES AND ELIGIBILITY CRITERIA: The PubMed and PsycINFO, EMBASE and Cochrane Library databases were searched to identify observational studies that contained information on the prevalence of depression and depressive symptoms in outpatients. All studies included were published before January 2016. Data characteristics were extracted independently by two investigators. The point prevalence of depression or depressive symptoms was measured using validated self-report questionnaires or structured interviews. Assessments were pooled using a random-effects model. Differences in study-level characteristics were estimated by meta-regression analysis. Heterogeneity was assessed using standard χ2 tests and the I2 statistic. The study protocol has been registered with PROSPERO under number CRD42017054738. RESULTS: Eighty-three cross-sectional studies involving 41 344 individuals were included in this study. The overall pooled prevalence of depression or depressive symptoms was 27.0% (10 943/41 344 individuals; 95% CI 24.0% to 29.0%), with significant heterogeneity between studies (p<0.0001, τ2=0.3742, I2=96.7%). Notably, a significantly higher prevalence of depression and depressive symptoms was observed in outpatients than in the healthy controls (OR 3.16, 95% CI 2.66 to 3.76, I2=72.0%, χ 2 =25.33). The highest depression/depressive symptom prevalence estimates occurred in studies of outpatients from otolaryngology clinics (53.0%), followed by dermatology clinics (39.0%) and neurology clinics (35.0%). Subgroup analyses showed that the prevalence of depression and depressive symptoms in different specialties varied from 17.0% to 53.0%. The prevalence of depression and depressive symptoms was higher among outpatients in developing countries than in outpatients from developed countries. Moreover, the prevalence of depression and depressive symptoms in outpatients slightly decreased from 1996 to 2010. Regarding screening instruments, the Beck Depression Inventory led to a higher estimate of the prevalence of depression and depressive symptoms (1316/4702, 36.0%, 95% CI 29.0% to 44.0%, I2=94.8%) than the Hospital Anxiety and Depression Scale (1003/2025, 22.0%, 95% CI 12.0% to 35.0%, I2=96.6%). CONCLUSION: Our study provides evidence that a significant proportion of outpatients experience depression or depressive symptoms, highlighting the importance of developing effective management strategies for the early identification and treatment of these conditions among outpatients in clinical practice. The substantial heterogeneity between studies was not fully explained by the variables examined.
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Depressão/epidemiologia , Pacientes Ambulatoriais/psicologia , Transtorno Depressivo/epidemiologia , Humanos , Escalas de Graduação Psiquiátrica , Qualidade de VidaRESUMO
PURPOSE: Inflammatory cataracts secondary to Behcet's disease (BD) or Vogt-Koyanagi-Harada disease (VKH) are thought to result from a pathological dysregulation of cytokines that is different from that of age-related (AR) cataracts. However, little is known about the function of cytokines in the development of inflammatory cataracts. The purpose of this study was to identify possible differences in cytokine expression in inflammation- and age-related cataract patients. METHODS: Analysis techniques involving the concomitant use of a cocktail of antibody-coated non-magnetic beads were used to determine the cytokine expression profiles of BD, VKH and AR cataract patients. Furthermore, anterior chamber aqueous flares and inflammatory cells were quantitatively measured with a laser flare cell meter (LFCM). RESULTS: The expressions of interleukin-2 (IL-2), IL-4, IL-6, IL-10, IL-17A, and interferon-γ (IFN-γ) were analyzed in aqueous humor (AqH), phytohemagglutinin (PHA)-stimulated and non-PHA-stimulated cultures of peripheral blood mononuclear cells (PBMCs) from the three types of cataract patients. IL-6 and IFN-γ were identified above the detection limits, but, among the BD and VKH cataract patients, only the levels of IL-6 were significantly higher in both the AqH and PBMC non-PHA cultures compared with the levels observed in the AR cataract patients. In contrast, IFN-γ was significantly elevated in the AqH of the BD cataract patients compared with the VKH and AR cataract patients. In the PHA-stimulated PBMC cultures, IL-2, IFN-γ, IL-6, and IL-17A were significantly increased, and the IL-6 level was significantly higher in the VKH patients than in the BD and AR cataract patients. The correlation analyses of the cytokines and inflammation indexes of the AqH obtained with the LFCM revealed that only IL-6 was significantly correlated with the inflammation index. CONCLUSION: Distinct expression profiles of cytokines and the correlations of these profiles with in vivo inflammatory indexes for inflammatory and AR cataract patients were identified.
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Câmara Anterior/patologia , Humor Aquoso/metabolismo , Catarata/metabolismo , Citocinas/metabolismo , Inflamação/metabolismo , Adulto , Catarata/imunologia , Catarata/patologia , Citocinas/sangue , Feminino , Humanos , Inflamação/imunologia , Inflamação/patologia , Masculino , Pessoa de Meia-IdadeRESUMO
Congenital cataract (CC) is the primary cause of treatable childhood blindness. Population-based assessments of prevalence and surgery age of CC, which are critical for improving management strategies, have been unavailable in China until now. We conducted a hospital-based, cross-sectional study of the hospital charts of CC patients younger than 18 years old from January 2005 to December 2010 at Zhongshan Ophthalmic Center (ZOC) in Guangzhou, China. Residence, gender, age at surgery, hospitalization time, and the presence of other ocular abnormalities were extracted and statistically analyzed in different subgroups. The search identified 1314 patients diagnosed with CC from a total of 136154 hospitalizations, which accounted for 2.39% of all the cataract in-patients and 1.06% of the total in-patients over the six-year study period. Of the identified CC patients, 9.2% had ≥ 2 hospitalizations due to the necessity of additional surgeries, with a total ratio of boys to girls of 1.75 ⶠ1. Based on a subgroup analysis according to age, patients 2-6 years old constituted the highest proportion (29.22%) of all hospitalized CC patients, and those 13-18 years old constituted the lowest proportion (13.47%) of the total number. The average age at surgery was 27.62 ± 23.36 months, but CC patients ≤ 6 years old (especially ≤ 6 months old) became increasingly prevalent throughout the 6-year study period. A total of 276 cases (20.93%) of CC were associated with one or more other ocular abnormalities, the highest incidence rates were observed for exotropia (6.24%), nystagmus (6.16%), and refractive error (3.65%). In conclusion, CC patients accounted for 2.39% of all cataract in-patients in a review of 6 years of hospitalization charts from ZOC. The age at the time of surgery decreased over the 6-year study period, which probably reflects the continuing improvement of public awareness of children's eye care in China.
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Extração de Catarata , Catarata/congênito , Catarata/epidemiologia , Adolescente , Catarata/complicações , Extração de Catarata/estatística & dados numéricos , Extração de Catarata/tendências , Criança , Pré-Escolar , China/epidemiologia , Estudos Transversais , Exotropia/epidemiologia , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Nistagmo Congênito/epidemiologia , Prevalência , Erros de Refração/epidemiologiaRESUMO
Monitoring intraocular pressure (IOP) is essential for pediatric cataract treatment but always difficult due to lack of cooperation in young children. We present the baseline characteristics and the first-year results of a long-term prospective cohort study, which are aimed to determine the relationship of the incidence of ocular hypertension (OH) in children after cataract surgery during the first-year period and the risk of developing late-onset glaucoma. Children were included with the following criteria: they were ≤10 years old and scheduled to undergo cataract surgery with/without intraocular lens implantation; they were compliant with our follow-up protocol, which included monitoring IOP using a Tono-Pen under sedation or anesthesia. Incidence of OH, peak OH value, OH onset time and OH duration within a 12-month period following surgery were measured. In brief, 206 patients (379 eyes) were included and OH developed in 66 of 379 (17.4%) eyes. The mean follow-up period was 14.0±3.2 months (median, 12 months; range, 10-16 months). Moreover, 33 of 196 (16.8%) aphakic eyes and 33 of 183 (18.0%) IOL eyes were diagnosed with OH. The peak OH onset times were at 1-week (34/66, 51.5%) and 1-month (14/66, 21.2%) appointments postsurgery. The peak IOP value in the OH eyes was 29.9±7.5 mmHg (median, 29 mmHg; range, 21-48 mmHg). The duration of OH was 30.9±31.2 days (median, 30 days; range, 3-150 days). OH recurred in 13 eyes with a history of OH diagnosed within 1 month postsurgery (13/54, 24.1%), which needed temporary or long term use of antiglaucoma medications. In conclusion, the incidence of OH in children after cataract surgery was 17.4% during the first-year period. Children who have suffered elevated IOP in the first year after cataract surgery should be followed closely to determine if there is an increased risk of developing late-onset glaucoma.
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Extração de Catarata/efeitos adversos , Hipertensão Ocular/fisiopatologia , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , MasculinoRESUMO
Congenital cataract is a major cause of visual impairment and childhood blindness. The solubility and stability of crystallin proteins play critical roles in maintaining the optical transparency of the lens during the life span. Previous studies have shown that approximately 8.3%~25% of congenital cataracts are inherited, and mutations in crystallins are the most common. In this study, we attempted to identify the genetic defect in a four-generation family affected with congenital cataracts. The congenital cataract phenotype of this four-generation family was identified as membranous cataract by slit-lamp photography. Mutation screening of the candidate genes detected a heterozygous c.465G â C change in the exon6 of the ßB2-crystallin gene (CRYBB2) in all family members affected with cataracts, resulting in the substitution of a highly conserved Tryptophan to Cystine (p.W151C). The mutation was confirmed by restriction fragment length polymorphism (RFLP) analysis and found that the transition resulted in the absence of a BslI restriction site in the affected members of the pedigree. The outcome of PolyPhen-2 and SIFT analysis predicted that this W151C mutation would probably damage to the structure and function of ßB2-crystallin. Wild type (wt) and W151C mutant ßB2-crystallin were expressed in human lens epithelial cells (HLECs), and the fluorescence results showed that Wt-ßB2-crystallin was evenly distributed throughout the cells, whereas approximately 34.7% of cells transfected with the W151C mutant ßB2-crystallin formed intracellular aggregates. Taken together, these data suggest that the missense mutation in CRYBB2 gene leads to progressive congenital membranous cataract by impacting the solubility and function of ßB2-crystallin.
Assuntos
Catarata/congênito , Catarata/genética , Progressão da Doença , Mutação de Sentido Incorreto , Cadeia B de beta-Cristalina/química , Cadeia B de beta-Cristalina/genética , Sequência de Aminoácidos , Animais , Catarata/patologia , Linhagem Celular , Núcleo Celular/metabolismo , Criança , Biologia Computacional , Células Epiteliais/metabolismo , Feminino , Humanos , Cristalino/patologia , Masculino , Pessoa de Meia-Idade , Dados de Sequência Molecular , Linhagem , Fenótipo , Agregados Proteicos , Alinhamento de Sequência , Solubilidade , Cadeia B de beta-Cristalina/metabolismoRESUMO
A monthly measurement of soil CH4 uptake rate (V(CH4)) in a natural Castanopsis carlesii forest in Wanmulin Natural Reserve of Fujian Province, East China was conducted from March 2010 to February 2011. The VCH4 showed a pronounced seasonal fluctuation, being higher in summer-autumn than in winter-spring, with the maximum value (95.13 microg x m(-2) x h(-1)) in September and the minimum value (9.13 microg x m(-2) x h(-1)) in March. With the increase of soil temperature and moisture, the V(CH4) showed an increasing and a decreasing trend, respectively, but the correlations of the V(CH4) with soil temperature and moisture were not significant. The annual soil CH4 flux of the forest (3.93 kg x hm(-2) x a(-1)) was higher than the average value of global natural forests (2.4 kg x hm(-2) x a(-1)) and of Asian tropical natural forests (2.07 kg x hm(-2) x a(-1)), but lower than that of Asian temperate natural forests (8.12 kg x hm(-2) x a(-1)).