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1.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde, LIS-bvsms | ID: lis-LISBR1.1-46943

RESUMO

Miopia é um distúrbio visual cuja principal característica é a dificuldade de ver de longe.


Assuntos
Miopia , Visão Ocular , Oftalmologia
2.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 51(1): 102-106, 2020 Jan.
Artigo em Chinês | MEDLINE | ID: mdl-31950798

RESUMO

Objective: To study the changes of tear film after short-term overnight orthokeratology wearing in adult myope. Methods: Fifty adult myope aged 18 to 38 years old were enrolled in this study. The patients wore orthokeratology 6-10 h every night during this study. Data such as non-invasive tear break-up time (NITBUT), fluorescent tear break-up time (FTBUT), lower tear meniscus height (LTMH), corneal fluorescent staining as well as ocular surface disease index (OSDI) questionnaire score were measured at baseline, 1 d, 7 d, 14 d, 30 d and 90 d. Results: Forty-four subjects completed the follow-up study. Tear break-up time (TBUT) decreased and became stable at 14 d after overnight orthokeratology wearing. LTMH sustained decreased and there was a difference after 90 d overnight wearing ( P<0.05). Compared with baseline, the grade of corneal staining increased at all time points ( P<0.05). As for the OSDI score, there was no difference at all time points. Conclusion: After overnight orthokeratology wearing, tear film stability and tear secretion decreased. Adult myope seems easily to suffer corneal injury after overnight orthokeratology wearing.


Assuntos
Miopia , Procedimentos Ortoceratológicos , Adolescente , Adulto , Córnea/patologia , Seguimentos , Humanos , Miopia/terapia , Procedimentos Ortoceratológicos/efeitos adversos , Procedimentos Ortoceratológicos/normas , Lágrimas , Adulto Jovem
3.
Medicine (Baltimore) ; 99(2): e17992, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31914011

RESUMO

INTRODUCTION: The study aimed to determine the effectiveness of an intervention for unhealthy visual behaviors of school-age children using a wearable device (Clouclip). METHOD: The design was a self-controlled prospective study. Clouclip, with the vibration alert disabled, was first applied to measure baseline near-work behaviors in the first week. The vibration alert was then enabled to signal unhealthy visual behaviors (near-work distance < 30 cm and >5 seconds, or near-work distance <60 cm for >45 minutes) for 3 weeks. Near-work behaviors were measured again at the first week and the first month after intervention, respectively. The changes in behaviors between the baseline and the first week and the first month after intervention were analyzed. RESULTS: Sixty-seven subjects were eligible for this experiment (the mean age 10.45 ±â€Š0.50 years, 34 boys). Children who logged sufficient wearing time (12.30 ±â€Š0.18 hours on weekdays and 12.16 ±â€Š0.23 hours on weekends) were included for analysis. The average daily near-work distance was significantly increased after the vibration intervention. The time ratio of near-work activity <30 cm to the total <60 cm and the frequency of continuous near-work (distance <60 cm and continuous time >30 minutes) were significantly decreased after the intervention. Although some of the effects were reversed with time following the intervention, some were observed to be maintained until the end of the observation period, and the improvement of the behaviors was more prominent in children who had a shorter near-work distance (<30 cm) at baseline. CONCLUSIONS: In conclusion, Clouclip can significantly modify near-work behaviors in school-age children and it can last a certain period of time. If these behaviors are causes of myopia development and progression, Clouclip might provide a strategy for managing myopia.


Assuntos
Comportamento Infantil/psicologia , Miopia/terapia , Transtornos da Visão/psicologia , Dispositivos Eletrônicos Vestíveis/efeitos adversos , Criança , Saúde da Família/educação , Saúde da Família/estatística & dados numéricos , Feminino , Humanos , Masculino , Miopia/etiologia , Miopia/psicologia , Prevalência , Estudos Prospectivos , Leitura , Transtornos da Visão/epidemiologia , Transtornos da Visão/prevenção & controle
4.
Diving Hyperb Med ; 49(4): 245-252, 2019 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-31828742

RESUMO

INTRODUCTION: A temporary myopic shift is a well-recognized complication of hyperbaric oxygen treatment (HBOT). Oxidation of proteins in the crystalline lens is the likely cause. Direct exposure of the eye to hyperbaric oxygen may exacerbate the effect. Our aim was to measure the magnitude of the myopic shift over a course of HBOT when using two different methods of oxygen delivery. METHODS: We conducted a randomised trial of oxygen delivery via hood versus oronasal mask during a course of 20 and 30 HBOT sessions. Subjective refraction was performed at baseline and after 20 and 30 sessions. We repeated these measurements at four and 12 weeks after completion of the course in those available for assessment. RESULTS: We enrolled 120 patients (mean age 57.6 (SD 11.2) years; 81% male). The myopic shift was significantly greater after both 20 and 30 sessions in those patients using the hood. At 20 treatments: refractory change was -0.92 D with hood versus -0.52 D with mask, difference 0.40 D (95% CI 0.22 to 0.57, P < 0.0001); at 30 treatments: -1.25 D with hood versus -0.63 with mask, difference 0.62 D (95% CI 0.39 to 0.84, P < 0.0001). Recovery was slower and less complete in the hood group at both four and 12 weeks. CONCLUSIONS: Myopic shift is common following HBOT and more pronounced using a hood system than an oronasal mask. Recovery may be slower and less complete using a hood. Our data support the use of an oronasal mask in an air environment when possible.


Assuntos
Oxigenação Hiperbárica , Miopia , Feminino , Humanos , Oxigenação Hiperbárica/efeitos adversos , Oxigenação Hiperbárica/instrumentação , Oxigenação Hiperbárica/métodos , Masculino , Máscaras , Pessoa de Meia-Idade , Miopia/etiologia , Oxigênio/administração & dosagem
5.
Medicine (Baltimore) ; 98(50): e18342, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31852130

RESUMO

BACKGROUND: The study aims to evaluate the effectiveness and safety of Tuina for children with myopia. METHODS: The following electronic databases will be searched from establishment to July 2019: Cochrane Library, MEDLINE, EMBASE, Web of Science, Springer, World Health Organization International Clinical Trials Registry Platform (ICTRP), China National Knowledge Infrastructure (CNKI), Wan-fang database, Chinese Scientific Journal Database (VIP), Chinese Biomedical Literature Databases (CBM), and other databases. All published randomized controlled trials (RCTs) about this topic will be included. Two independent researchers will operate article retrieval, duplication removing, screening, quality evaluation, and data analyses by Review Manager (V.5.3.5). Meta-analyses, subgroup analysis, and/or descriptive analysis will be performed based on the included data conditions. RESULTS: High-quality synthesis and/or descriptive analysis of current evidence will be provided from improvement of distant vision, improvement of myopic diopter, and side effects. CONCLUSION: This study will provide the evidence of whether Tuina is an effective and safe intervention for children with myopia. PROSPERO REGISTRATION NUMBER: CRD42019142283.


Assuntos
Medicina Tradicional Chinesa/métodos , Miopia/tratamento farmacológico , Criança , Humanos , Projetos de Pesquisa , Revisão Sistemática como Assunto , Resultado do Tratamento
6.
Medicine (Baltimore) ; 98(47): e17906, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31764789

RESUMO

BACKGROUND: Femtosecond laser (FL) is an effective method to treat patients with myopia, but its relative efficacy and safety is still unclear. Thus, this study will be conducted to assess the efficacy and safety of FL for myopia systematically. METHODS: This study will systematically retrieve the following electronic databases up to the present: Cochrane Library, PubMed, EMBASE, Web of Science, PsycINFO, Allied and Complementary Medicine Database, Chinese Biomedical Literature Database, Wanfang, VIP, and China National Knowledge Infrastructure. All electronic databases will be searched without any limitations of language and publication status. RevMan 5.3 software will be utilized for statistical analysis. RESULTS: We will summarize the targeted results evaluating the efficacy and safety of FL for patients with myopia. CONCLUSIONS: This study will provide a comprehensive evidence summary on FL for patients with myopia.PROSPERO registration number: PROSPERO CRD42019148659.


Assuntos
Terapia a Laser/métodos , Miopia/cirurgia , Projetos de Pesquisa , Revisão Sistemática como Assunto , Humanos , Procedimentos Cirúrgicos Oftalmológicos , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de Tempo , Resultado do Tratamento
7.
Invest Ophthalmol Vis Sci ; 60(14): 4882-4888, 2019 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-31752017

RESUMO

Purpose: To describe the morphological features of posterior precortical vitreous pockets (PPVP) and Cloquet's Canal in patients with myopia using swept-source optical coherence tomography (SS OCT). Methods: A total of 96 eyes of 51 volunteers (range, 5-18 years) were enrolled in this study, and all individuals underwent OCT (Optovue Inc., Fremont, CA, USA) examinations. From the collected PPVPs images, the widths and heights of the PPVPs were measured, and connections between PPVPs and Cloquet's Canal were identified. The PPVPs widths and heights, width:height ratios and proportions of connections were compared among different age (5-8, 9-14, 15-18 years), axial length (AL; 21-23, 23-25, 25-29 mm) and myopia groups (hyperopia, low to moderate myopia, high myopia); the group data were analyzed to determine their relationship with myopia. Results: PPVPs were identified in 89 of 96 eyes; 6 eyes were excluded for poor image quality. The PPVPs width was positively correlated with age, especially in the low to moderate myopia group (F = 7.715, P = 0.001). There was a significant difference in the PPVPs height between the refractive error groups in the 9 to 14 years group (F = 4.905, P = 0.005). The PPVPs width:height ratio was different among the refractive error groups in the 9 to 14 years group (F = 3.335, P = 0.041) and among the different age groups in the low to moderate myopia group (F = 6.077, P = 0.004). A total of 22 eyes (22.4%) were identified as having a connection between the PPVP and Cloquet's Canal. The connections began to increase with AL at 5 to 8 years (χ2 = 7.363, P = 0.025). Conclusions: PPVPs existed in most myopia patients from 5 to 18 years old. PPVPs width was positively correlated with age, especially in the low to moderate myopia group. PPVPs height decreased in the 9 to 14 years group with myopia. An imbalance in the horizontal and vertical enlargement of PPVP was the main feature in the 9- to 14-year-old group with myopia. The connections between the PPVP and Cloquet's Canal were associated with AL extension in the 5- to 8-year-old group.


Assuntos
Oftalmopatias/diagnóstico , Miopia/diagnóstico , Corpo Vítreo/patologia , Adolescente , Envelhecimento/fisiologia , Criança , Pré-Escolar , Progressão da Doença , Oftalmopatias/diagnóstico por imagem , Feminino , Humanos , Masculino , Tomografia de Coerência Óptica/métodos , Corpo Vítreo/diagnóstico por imagem
8.
Invest Ophthalmol Vis Sci ; 60(14): 4896-4903, 2019 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-31752019

RESUMO

Purpose: The geometry of retinal nerve fibers may be altered with myopia, a known risk factor for glaucoma. Recent developments in high resolution imaging have enabled direct visualization of nerve fiber bundles at the temporal raphe with clinical hardware, providing evidence that this area is sensitive to glaucomatous damage. Here, we test the hypothesis that nerve fiber geometry is altered by myopia, both at the temporal raphe and surrounding the optic nerve head. Methods: Seventy-eight healthy individuals participated, with refractive errors distributed between emmetropia and high myopia (+0 to -13 DS). Custom high-density OCT scans were used to visualize RFNL bundle trajectory at the temporal raphe. A standard clinical OCT protocol was used to assess papillary minimum rim width (MRW) and peripapillary retinal nerve fiber layer (RNFL) thickness. Results: Measures of raphe shape-including position, orientation, and width-did not depend significantly on axial length. In 7.5% of subjects, the raphe was rotated sufficiently that inversion of structure-function mapping to visual field space is predicted in the nasal step region. Low concordance to ISNT and related rules was observed in myopia (e.g., for RNFL, 8% of high axial myopes compared with 67% of emmetropes). Greater robustness to refractive error was observed for the IT rule. Conclusions: High density OCT scans enabled visualization of marked interindividual variation in temporal raphe geometry; however, these variations were not well predicted by degree of myopia as represented by axial length. That said, degree of myopia was associated with abnormal thickness profiles for the papillary and peripapillary nerve fiber layer.


Assuntos
Comprimento Axial do Olho/patologia , Emetropia/fisiologia , Miopia/patologia , Fibras Nervosas/patologia , Nervo Óptico/patologia , Retina/patologia , Células Ganglionares da Retina/patologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Nervo Óptico/diagnóstico por imagem , Retina/diagnóstico por imagem , Tomografia de Coerência Óptica , Campos Visuais , Adulto Jovem
9.
Medicine (Baltimore) ; 98(44): e17677, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31689784

RESUMO

The purpose of this retrospective study was to evaluate the visual quality, objective scattering index, aberration, etc after Implantable Collamer Lens with center hole (EVO-ICL) implantation to treat patients with hypermyopia (diopter > -10 D).A total of 30 eyes underwent EVO-ICL implantation. The uncorrected distance visual acuity (UDVA), best-corrected visual acuity (BCVA), equivalent spherical degree, aberration, visual quality parameters, and corneal endothelial cell density were compared preoperative and postoperative. Fill in the National Eye Institute Refractive Error Quality of Life Instrument-42 before and after surgery.The modulation transfer function (MTF), Optical Quality Analysis System (OQAS) II values (OV 100%, 20%, 9%), and Stahl ratio 1 and 3 months after surgery were higher than the respective preoperative values. The objective scatter index value increased 1 week after surgery, but decreased 1 and 3 months after surgery compared with the preoperative values. Total aberration (TA), total low-order aberration (tLOAs), and defocus decreased at 1 week and 3 months after EVO-ICL implantation. Total high-order aberration (tHOAs) and spherical aberration were significantly increased 1 week after surgery and decreased 3 months after surgery, and the difference was statistically significant. Astigmatism, coma, and clover were not significantly different in each time period. TA, tLOAs, tHOAs, defocus, and spherical aberration were higher at 1 week than 3 months after surgery. At 3 months after surgery, the scores of the patients' NEI-RQL-42 scale were all improved except that the glare was lower than that before surgery. There was no significant difference in the density of corneal endothelial cells before and 3 months after surgery.For patients with hypermyopia, the postoperative subjective and objective visual quality of EVO-ICL implantation was better than preoperative.


Assuntos
Implante de Lente Intraocular/métodos , Miopia/cirurgia , Lentes Intraoculares Fácicas , Adulto , Feminino , Humanos , Pressão Intraocular , Implante de Lente Intraocular/efeitos adversos , Masculino , Complicações Pós-Operatórias/epidemiologia , Qualidade de Vida , Estudos Retrospectivos , Acuidade Visual , Adulto Jovem
10.
Vestn Oftalmol ; 135(5): 13-23, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31714508

RESUMO

PURPOSE: To compare the effectiveness, safety, predictability and stability of FemtoLASIK procedure in low to moderate myopia using Femto Visum and Femto LDV Z6 femtosecond laser platforms and to evaluate the effect of these procedures on corneal higher-order aberrations. MATERIAL AND METHODS: Russian femtolaser platform (1 MHz) was used to form the corneal flap in the main group consisting of 98 patients (98 eyes) with mean spherical equivalent (SE) of -3.73±1.42 D. Swiss femtolaser platform (5 MHz) was used in the control group (94 patients, 94 eyes; mean SE -3.81±1.44 D). Excimer laser ablation was performed using the Russian platform (500 Hz) in both groups. All patients underwent complete ophthalmological examination. The follow-up period was 12 months. RESULTS: Twelve month postoperatively, in the '1 MHz' group uncorrected visual acuity (UCVA) of 1.0 or better was achieved in 91.8% of patients, and in the '5 MHz' group - in 90.4% (p>0.05). There were no registered losses of 2 or more lines of best-corrected visual acuity (BCVA) in either group. In the '1 MHz' group, predictability of targeted refraction within ±0.5 D was achieved in 91.8% of patients, within ±1.0 D - in 99.0%; in the '5 MHz' group - in 91.5% and 98.9% of patients, respectively (p>0.05). Root-mean-square (RMS) deviation of corneal higher-order aberrations in the 6-mm optical zone was increased by 0.072 µm (by 1.21 times) and by 0.077 µm (by 1.22 times) in the '1 MHz' and '5 MHz' groups (p>0.05), respectively. CONCLUSION: The FemtoLASIK procedures performed using Russian (1 MHz) and Swiss (5 MHz) femtosecond laser platforms are effective, safe, predictable, have stable postoperative visual and refractive outcomes, and lead to increase in RMS of corneal higher-order aberrations using both platforms in patients with low to moderate myopia. There were no statistically significant differences between the two femtolaser platforms (p>0.05) for all examined parameters.


Assuntos
Miopia , Seguimentos , Humanos , Ceratomileuse Assistida por Excimer Laser In Situ , Lasers de Excimer , Refração Ocular , Federação Russa , Resultado do Tratamento
11.
Vestn Oftalmol ; 135(5): 99-106, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31714520

RESUMO

Small incision lenticule extraction (SMILE) keratorefractive surgery technique is a laser surgery alternative to common methods that doesn't require laser ablation of the cornea. Despite its novelty, SMILE technique has already demonstrated positive clinical results comparable to Photorefractive Keratectomy (PRK) and Laser-Assisted in Situ Keratomileusis (LASIK), which led to its widespread application in clinical practice. Compared with other keratorefractive techniques, SMILE has a number of distinct advantage including high biomechanical stability of the cornea, low risk of dry eye syndrome, absence of a corneal flap and associated complications, preservation of corneal epithelium. The article describes the most common SMILE modifications, its weak points and possible complications, as well as methods of additional correction of remaining ametropy.


Assuntos
Ceratoplastia Penetrante , Ceratectomia Fotorrefrativa , Córnea , Humanos , Ceratomileuse Assistida por Excimer Laser In Situ , Lasers de Excimer , Miopia/cirurgia
12.
Korean J Ophthalmol ; 33(5): 458-466, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31612657

RESUMO

PURPOSE: To investigate the clinical effects of different orientation and magnitude of cyclotorsion on the compensation capacity of the WaveLight EX500 photorefractive keratectomy (PRK) platform. METHODS: This retrospective study comprised 400 eyes of 200 patients who underwent bilateral simultaneous PRK due to compound myopic astigmatism. The subjects were separated according to the orientation of cyclotorsion into incyclotorsion and excyclotorsion groups, and by the magnitude of cyclotorsion into group 1 (0.50 to 2.50 degrees), group 2 (3.00 to 5.00 degrees), group 3 (5.50 to 7.50 degrees), and group 4 (8.00 to 9.50 degrees). RESULTS: The mean magnitude of cyclotorsion was 3.50 ± 2.4 degrees (0.50 to 9.50 degrees) in the incyclotorsion group and 3.32 ± 2.3 degrees (0.50 to 9.50 degrees) in the excyclotorsion group (p = 0.617). The postoperative refractive outcomes of the incyclotorsion and excyclotorsion groups were similar (p > 0.05 for all). The postoperative mean cylindrical refractive error was -0.32 ± 0.3 diopters (D, -1.25 to 0.00 D) in group 1, -0.47 ± 0.2 D (-2.00 to 0.00 D) in group 2, -0.62 ± 0.2 D (-1.00 to -0.25 D) in group 3, and -0.91 ± 0.2 D (-1.50 to -0.50 D) in group 4 (p < 0.001). Preoperative cylindrical refractive error was positively correlated with magnitude of cyclotorsion (r = 0.125 and p = 0.013), which was also positively correlated with postoperative cylindrical refractive error (r = 0.600 and p < 0.001). CONCLUSIONS: Incyclotorsion and excyclotorsion can be equally compensable in the WaveLight EX500 PRK platform for compound myopic astigmatism. A value of ≤2.50 degrees cyclotorsion magnitude was observed to be more compensable than higher degrees of cyclotorsion magnitude. Preoperative high astigmatism was associated with high cyclotorsion magnitude, which was also associated with a high degree of postoperative astigmatism.


Assuntos
Astigmatismo/cirurgia , Córnea/cirurgia , Lasers de Excimer/uso terapêutico , Miopia/cirurgia , Ceratectomia Fotorrefrativa/métodos , Refração Ocular/fisiologia , Acuidade Visual , Adolescente , Adulto , Astigmatismo/complicações , Astigmatismo/fisiopatologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Miopia/complicações , Miopia/fisiopatologia , Período Pós-Operatório , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
14.
Invest Ophthalmol Vis Sci ; 60(13): 4319-4327, 2019 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-31622468

RESUMO

Purpose: To investigate the effects of high ambient lighting on refraction and ocular biometry in guinea pig models of form-deprivation myopia (FDM). Methods: Forty 3-week-old guinea pigs were randomly assigned to groups exposed to either high light (HL, 10,000 lux) or normal light (NL, 500 lux) with normal vision or form deprivation. Throughout the 10-week rearing period, animals were exposed to high light or normal light for 12 hours with a 12-hour light/dark cycle. Refraction, axial length (AL), and radius of corneal curvature (CCR) were measured by cycloplegic retinoscopy, A-scan ultrasonography, and keratometer, respectively. Results: At the end of treatment, form-deprived eyes under high ambient lighting exhibited more hyperopic refraction and shorter AL than those under normal ambient lighting (2.06 ± 1.68 diopters [D; mean ± SD] vs. -0.59 ± 1.56 D, P < 0.001; 8.36 ± 0.13 mm vs. 8.56 ± 0.16 mm, P < 0.001). Deprived eyes under high ambient lighting were relatively more myopic than their contralateral control eyes at the end of treatment (2.06 ± 1.68 D vs. 5.44 ± 0.66 D, P < 0.001). High lighting induced a significant hyperopic shift in normal eyes after 4 weeks of exposure. There were no significant differences in CCR between eyes exposed to high and normal light, nor between deprived eyes and contralateral eyes. Conclusions: High ambient lighting could retard, but not fully inhibit, the development of FDM. High light levels contributed to a greater hyperopic shift in normal eyes during the first 4 weeks of treatment. Corneal curvature was unaffected by either high ambient lighting or form deprivation.


Assuntos
Luz/efeitos adversos , Miopia/etiologia , Privação Sensorial , Animais , Comprimento Axial do Olho/patologia , Biometria , Córnea/anatomia & histologia , Modelos Animais de Doenças , Cobaias , Hiperopia/etiologia , Refração Ocular/fisiologia , Retinoscopia
15.
Asia Pac J Ophthalmol (Phila) ; 8(5): 371-376, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31567264

RESUMO

Small incision lenticule extraction (SMILE) is a new paradigm for refractive surgery, and was first performed by Sekundo and Blum in 2008. It uses only a femtosecond laser to carve out a lenticule within the corneal stroma, and then achieves refractive correction by extracting the lenticule through a small incision. A number of studies have shown that SMILE leads to stable and efficacious outcomes, combined with high safety. Long-term studies also indicate that SMILE has excellent outcomes combined with high safety. Although relatively safe, SMILE can have some intraoperative and postoperative complications, including suction loss during the procedure, lenticule tears, incision tears, epithelial ingrowth, diffuse lamellar keratitis, and residual refractive error. Studies indicate that SMILE leads to less postoperative dry eyes. It is thus preferred over laser-assisted in-situ keratomileusis (LASIK) in cases wherein there is mild dry eye preoperatively. It is also preferred over LASIK in cases wherein the patient is likely to engage in contact sports. LASIK may be preferred over SMILE for the treatment of hyperopia, and in cases of significant higher order wavefront aberrations or topographic irregularities.


Assuntos
Ceratomileuse Assistida por Excimer Laser In Situ/métodos , Lasers de Excimer/uso terapêutico , Miopia/cirurgia , Refração Ocular/fisiologia , Acuidade Visual , Humanos , Miopia/fisiopatologia
16.
Asia Pac J Ophthalmol (Phila) ; 8(5): 385-390, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31567265

RESUMO

The advent of "flapless" small-incision lenticule extraction (SMILE), employing all-in-one technology, has resulted in a revolutionary breakthrough in refractive surgeries. SMILE has been gaining popularity due to fewer potential complications, such as postoperative dry eyes and greater biomechanical stability, etc. However, attention must be given to 1) the centration on the corneal vertex, 2) the proper alignment of the astigmatic axis, and 3) the relationship between pupil size and treatment diameter, to achieve good SMILE results. There is no pupil-tracking system to ascertain the accuracy of centration during the SMILE surgery. To improve the centration accuracy, our center uses two corneal topographers (Pentacam and Sirius) to measure and determine corneal vertex. Proper predicted optical zone diameter is not clearly defined yet in SMILE. Some scholars insist that mesopic pupil size should be taken into consideration when setting the predicted optical zone. Meanwhile, the issue of "functional optical zone" still has many unresolved issues and warrants further studies.


Assuntos
Substância Própria/cirurgia , Ceratomileuse Assistida por Excimer Laser In Situ/métodos , Lasers de Excimer/uso terapêutico , Miopia/cirurgia , Refração Ocular/fisiologia , Acuidade Visual , Substância Própria/diagnóstico por imagem , Topografia da Córnea , Humanos , Miopia/diagnóstico , Miopia/fisiopatologia
18.
Invest Ophthalmol Vis Sci ; 60(13): 4408-4415, 2019 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-31639827

RESUMO

Purpose: We study the density and excitatory response of neurites, and Schwann cells (SCs) in fresh and cryopreserved stromal lenticules derived from small incision lenticule extraction (SMILE). Methods: Human stromal lenticules (n = 23) were immunostained for ß III-tubulin and imaged using spinning disk confocal laser microscopy, followed by three-dimensional reconstruction, to reveal neurite distribution. The lenticule neurite density (LND) was assessed using a validated neurite tracing and length measurement method with NeuronJ. LND was compared among groups of different lenticule thickness (71-165 µm) obtained from -3 to >-6 diopters (D) corrections. SCs were identified by marker expression and the laser effect on SC-neurite interaction was examined under transmission electron microscopy (TEM). Fresh porcine SMILE-lenticules (n = 18) were used for LND comparison among storage conditions and functional excitatory calcium response assay. Results: Using a validated neurite length measurement method, we found an inverse correlation of LND with lenticule thickness. Higher LND was found in thinner lenticules obtained from lower power of correction (r = -0.8925, P < 0.0001), whereas total lenticule neurite lengths did not alter significantly with regards to lenticule thickness. SCs were identified by GAP43 and p75NTR expression and were closely associated with lenticule neurites under TEM. In porcine lenticules, LND and excitatory calcium response were reduced after cold and cryogenic storage, when compared to fresh lenticules. Conclusions: The stromal neurites showed variations in density related to SMILE lenticule thickness and cryopreservation. With the presence of SC support and excitatory response, these neurite residues could retain minimal functionality that might serve as a potential advantage in the event of lenticule implantation.


Assuntos
Substância Própria/cirurgia , Cirurgia da Córnea a Laser/métodos , Neuritos/metabolismo , Adulto , Cálcio/metabolismo , Substância Própria/metabolismo , Criopreservação , Feminino , Proteína GAP-43/metabolismo , Humanos , Processamento de Imagem Assistida por Computador , Imagem Tridimensional , Masculino , Microscopia Confocal , Microscopia Eletrônica de Transmissão , Microcirurgia , Miopia/cirurgia , Proteínas do Tecido Nervoso/metabolismo , Neuritos/patologia , Receptores de Fator de Crescimento Neural/metabolismo , Células de Schwann/metabolismo
19.
Vestn Oftalmol ; 135(4): 3-9, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31573551

RESUMO

INTRODUCTION: One important question for patients with both myopia and glaucoma is comparability of optical coherence tomography (OCT) data obtained before and after a significant change in eye refraction following cataract extraction surgery with implantation of intraocular lens (IOL). PURPOSE: To assess the impact of correcting moderate and high myopia during cataract phacoemulsification with IOL implantation (Phaco/IOL) on the parameters measured by OCT. MATERIAL AND METHODS: OCT was performed in 31 patients (31 eyes) with axial eye length of more than 25.5 mm before and the day after Phaco/IOL. Changes in 17 parameters of the retina, retinal ganglion cells-inner plexiform layer (GCIPL), peripapillary retinal nerve fiber layer (RNFL) and optic nerve head (ONH) were analyzed. RESULTS: Axial eye length was 26.94±1.09 mm in average (25.57-29.39 mm). The average refractive effect of the intervention was 8.44±4.16 D (3.75-19.0 Diopters). Signal strength in all OCT protocols was no lower than 5. Changes in the average values of OCT parameters after surgery were insignificant. They exceeded 1% of the pre-operation values only in 7 cases, including all 5 parameters of the ONH, and were significant only in 5 out of 17 parameters. For GCIPL and RNFL thickness, the changes on average did not exceed 0.9 µm, for retinal thickness in the macular area - 2.1 µm. In relative terms, the largest decrease (an average of -0.03 mm2; -2.5%) was in the optic disc area. CONCLUSION: In patients with high and moderate myopia, the parameters of the retina, RNFL, GCIPL, and ONH, as measured by OCT, changed insignificantly on the first day after Phaco/IOL (considering the signal strength of Cirrus HD-OCT device was not lower than 5).


Assuntos
Miopia , Disco Óptico , Catarata , Extração de Catarata , Humanos , Implante de Lente Intraocular , Miopia/cirurgia , Células Ganglionares da Retina , Tomografia de Coerência Óptica
20.
Vestn Oftalmol ; 135(4): 60-69, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31573558

RESUMO

INTRODUCTION: Peripheral defocus was experimentally found to control the development of refraction. PURPOSE: To evaluate peripheral refraction (PR) of myopic eyes in terms of different means of correction and the direction of gaze. MATERIAL AND METHODS: The study examined 128 patients (256 eyes) aged 8-14 years (average 11.07±0.39 years) with myopia from -1.0 to -7.0 (average -3.57±0.27 D). PR was measured without correction, in perifocal (PF), monofocal (MF), progressive glasses (PAL), monofocal soft contact lenses (ΜCL) and after orthokeratological (OCL) correction with the gaze directed straightforward or head angled outward, inward, upward and downward; all measurements were performed using binocular open-field auto ref/keratometer. RESULTS: PR profile without correction and with contact (OCL, ΜCL) correction does not depend on the direction of the gaze. In glasses, peripheral defocus is different with straightforward and skewed gaze directions. OCL forms a significant myopic defocus throughout the periphery of the retina. When using MCL, hyperopic defocus increases in all zones except the extreme temporal. In MF glasses, hyperopic defocus is formed and enhanced in all areas, significantly greater with skewed gaze than with straightforward. In PALs, myopic defocus is formed with gaze directed upward and downward, as well as at the extreme temporal periphery of the retina with straightforward gaze. In all other zones, hypermetropic defocus increases. In PF, in most zones myopic defocus is formed with all gaze directions. The greatest inhibitory effect on myopia progression is provided by OCL (YPR=0.28 D/year) and PF glasses (YPR=0.26 D/year). CONCLUSION: In contrast to correction with contact lenses, PR in glasses does depend on the direction of gaze. The inhibitory effect of the optics correlates with correction of hypermetropic defocus in myopic eyes.


Assuntos
Lentes de Contato Hidrofílicas , Hiperopia , Miopia , Adolescente , Criança , Óculos , Humanos , Refração Ocular
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