ABSTRACT
@#AIM: To evaluate the centration of the SBL-3 multifocal intraocular lens, the size of the distant and near power zone in the pupil area and the area of the visual axis using Itrace visual function analyzer. <p>METHODS: Retrospective case study. From January 2018 to January 2019, 51 eyes of 36 patients underwent phacoemulsification cataract combined with regional refraction multifocal intraocular lens implantation at Beijing Aier-Intech Eye Hospital were enrolled. The centration, visual axis, angle α, angle Kappa and the orientation of the intraocular lens measured by Itrace were used to calculate the position of the visual axis in the intraocular lens and the changes in the proportions of the distant and near power zones in the pupil area. <p>RESULTS: The centration(R)of intraocular lens is 0.217±0.09mm. The distribution of the visual axis in the intraocular lens is 0.217±0.09mm. The visual axis is evenly distributed in the distant and near power zones. There was no statistical significance between the two groups with postoperative visual acuity ≥0.8 and <0.8(<i>P</i>>0.05). The size of the angle Kappa is 0.187±0.079mm. The displacement of angle Kappa on the y-axis is 0.10±0.06mm. There was no statistical significance between the changes in the pupil size of distant and near power zones in the pupil area caused by the deviation of the pupil and the postoperative visual acuity ≥0.8 and <0.8(<i>P</i>>0.05). <p>CONCLUSION: The intraocular lens centration and axial data measured by the Itrace visual function analyzer can be used to estimate the area where the visual axis is located and the size of the distant and near power zones in the pupil area, thereby assisting in evaluating the postoperative visual quality of the regional refraction multifocal intraocular lens implanted after cataract surgery.
ABSTRACT
Objective To determine the minimum alveolar concentration (MAC)of sevoflurane for blunting the responses to surgical incision in 50% adult patients diagnosed as gastric carcinoma and treated with neoadjuvant chemotherapy.Methods Twenty-five ASA physical statusⅠor Ⅱ,and aged 30-50 years patients (14 males and 11 females)diagnosed with gastric carcinoma were enrolled.At least 1 month before the operation,all these patients received 2 cycles (1 chemotherapy cycle was 14 days)of chemotherapy including oxaliplatin and tegafur.At first,the anesthesia induc-tion was started by inhaling 6% sevoflurane.After the patient lost consciousness,the endotracheal in-tubation was performed.And then,the end tidal sevoflurane concentration was adjusted to the target concentration and maintained stable for 15 min.After that,the surgical incision was executed.The Dixon's up-and-down method was used to calculate the MAC.The initial end tidal sevoflurane con-centration was 2.2% and it was increased or decreased by 0.2% in the next patient according to the surgical incision response.If the surgical incision response was positive,the end tidal sevoflurane con-centration was increased;if the surgical incision response was negative,the end tidal sevoflurane con-centration was decreased.The midpoint from negative response to positive response was set as the balance point and the mean value of the concentrations of sevoflurane at all the balance points were calculated as MAC.Results Minor physical activity occurred when the surgical incision started.No body twisting,eye opening or intraoperative awareness occurred.Body moving occurred in 11 patients (44%)when the surgical incision started.The end tidal sevoflurane concentration for blunting the re-sponses to surgical incision in 50% adult patients diagnosed as gastric carcinoma and treated with neo-adjuvant chemotherapy was 1.52%,and the 95% CI was 1.37%-1.65%.Conclusion The MAC of sevoflurane for blunting the responses to surgical incision in 50% adult patients diagnosed as gastric carcinoma and treated with neoadjuvant chemotherapy is 1.52%.
ABSTRACT
Objective To assess the effects of femtosecond laser-assisted anterior capsulotomy versus manual continuous curvilinear capsulorhexis on intraocular lens (IOL) centration by measuring and comparing shape,size and positional parameters.Methods Eighty cases (80 eyes) with age-related cataract from March 2015 to July 2016 in our hospital were collected.Forty patients (40 eyes) in the femtosecond group underwent femtosecond laser anterior capsulotomy and 40 patients (40 eyes) in the annular group were treated with annular continuous capsulorhexis.At postoperative 1 week,1 month,1 year,the slit lamp digital photography and Pentacam anterior segment analyzer were used to collect the anterior segment images,and the parameters include horizontal and vertical diameter,roundness,package and partial centre of IOL were analyzed by image analysis software image-pro-plus 6.0.Using repeated measurement of variance analysis,Fisher exact probability,and Generalized estimation equations (GEE),the differences between parameters of the groups and IOL decentration predictor were analyzed.Results The vertical diameter,roundness,maximum distance,minimum distance,package and horizontal deviation were statistically significant between the femtosecond group and the annular group at 1 week and 1 month after operation (all P ＜ 0.05),and there was no significant difference in horizontal diameter and vertical deviation between two groups (all P ＞ 0.05).At 1 year after operation,the maximum distance,minimum distance,package and horizontal deviation between two groups were statistically significant (all P ＜ 0.05).There was no significant difference in vertical and horizontal diameter,roundness,and vertical deviation between two groups (all P ＞ 0.05).There was no patient with horizontal shift ＞ 0.4 mm in the femtosecond group at 1 week,1 month and 1 year;The ratio of cases with horizontal shift ＞0.4 mm and ＜0.4 mm in the annular group at 1 week,1 month and 1 year were 2/38,4/36,8/32,respectively.There was significant difference in the horizontal shift ＞ 0.4 nun between the two groups after 1 year(P ＜ 0.05).In the univariate generalized estimating equation model,the capsulorhexis type was a significant predictor of horizontal shift.Of all the capsulorhexis parameters,the difference of inclusion degree was statistically significant (P =0.001).There was negative correlation between the horizontal shift and package at different time points in the femtosecond group at 1 week,1 month and 1 year (r =-0.89,P ＜ 0.05;r =-0.72,P ＜ 0.05;r =-0.58,P ＜ 0.05);There was negative correlation between the horizontal shift and package at different time points in the annular group at 1 week(r =-0.68,P ＜ 0.05),but no correlation at 1 month and 1 year (r=-0.41,P＞0.05;r=-0.33,P＞0.05).Conclusion The anterior capsule made by femtosecond laser anterior capsulotomy is more round,centered and accurate,pocket IOL position is more stabled and neutral.
ABSTRACT
Objective To determine the minimum alveolar concentration for endotracheal intu-bation (MACEI )of sevoflurane for curbing the responses to endotracheal intubation in 50% premature infants less than 37 weeks of corrected age.Methods Twenty-seven ASA Ⅰ or Ⅱ premature infants less than 37 weeks of corrected age were enrolled in this study.At first,the anesthesia induction was started by inhaling 6% sevoflurane.After the patient lost consciousness,the end tidal sevoflurane concentration (CET Sev)was adjusted to the target concentration and maintained stable for 1 5 min.En-dotracheal tube was then intubated.The up-and-down sequential method was used to calculate the MAC.The initial CET Sev was 3.0% and it was increased or decreased by 0.2% in the next patient ac-cording to the endotracheal intubation response.If the intubation response was positive,the CET Sev was increased;if the intubation response was negative,the CET Sev was decreased.The midpoint from negative response to positive response was set as a balance point and the mean value of the concentra-tions of sevoflurane at all the balance points were calculated as MACEI .Results The end tidal sevoflurane concentration for blunting the responses to endotracheal intubation in 50% premature in-fants was 2.55%±0.20%,and the MAC9 5 was 2.81% (95% confidence interval 2.67%-3.58%). Conclusion The MACEI of sevoflurane for curbing the responses to endotracheal intubation in 50%premature infants less than 37 weeks of corrected age is 2.55%,which is lower than that in the full-term children.
ABSTRACT
PURPOSE: To report a case that underwent successful centration of intraocular lens (IOL) and visual acuity improvement after cataract extraction in a megalocornic eye in our medical center. CASE SUMMARY: A 27-year-old man with bilateral megalocorneas came to our medical center. The patient had progressive loss of vision and floaters in both eyes for 3 months. His horizontal corneal diameter was approximately 14 mm in both eyes. The initial best corrected visual acuity was 0.02 in the right eye and 0.5 in the left eye. There was a white cataract and nuclear sclerotic cataract without lens luxation, respectively. The cataract was extracted from the patient's right eye after anterior continuous curvilinear capsulorrhexis (CCC), the preloaded custom IOL was inserted in the bag, and pars plana vitrectomy was performed. Two months later, after the cataract was extracted from the left eye, optic capture through a posterior capsule was attempted but converted to anterior capsule (reverse optic capture) because of the posterior CCC's radial tear, and pars plana vitrectomy performed. The IOL had a 6 mm optic and an overall length of 12.5 mm. The IOL in the right eye was decentrated inferiorly in the bag due to a large capsule diameter, but the IOL captured through the anterior capsule in the left eye had good centration. The best corrected visual acuity of both eyes improved to 0.8 without other complications.
Subject(s)
Adult , Humans , Capsulorhexis , Cataract , Cataract Extraction , Lens Implantation, Intraocular , Lenses, Intraocular , Patient Rights , Visual Acuity , VitrectomyABSTRACT
In order to get a good visual outcome following excimer laser photorefractive keratectomy(PRK) the centration of ablation is very important. In this study, the ablation center of excimer laser PRK using VISX 20/20 B(R) with VisionKeyTM(VISX, Inc. Santa Clara, CA) was evaluated by using corneal topography. Corneal topography was performed before operation and one month after operation to 190 eyes of 123 patients. The location and distance of center of ablation from center of the entrance pupil were calculated by using EyeSys Corneal Analysis System(R) with pupil-finding software(EyeSys Laboratories, Inc. Houston, TX). Supero-nasal displacement of ablation center occurred in 84 eyes(44%) after excimer laser PRK. The mean distance was 0.33 +/- 0.21mm(range: 0.02~1.36mm). The distance less than 0.5mm was found in 157 eyes(83%) and that between 0.5mm and 0.75mm was found in 26 eyes(14%). The decentering amount following excimer laser PRK was not depending on laterality(OD vs. OS), sex, age, amount of attempted correction(6D down vs. 6D up), type of software(ver 3.20 vs. 4.01) or type of procedure(PRK vs. PARK). In contrast, the second eye receiving excimer laser PRK showed a better centration of ablation than the first eye. And the centration results improved with surgeon's experience in the most recent 50 eyes(0.28 +/- 0.16mm). However, there was no relation between amount of decentration and visual improvement. In this study, it was found that decentering of ablation center less than 0.75mm did not influence the visual outcome in excimer laser PRK.