Background: Evaluation of corneal biomechanical properties 3 months after using rigid gas permeable (RGP) contact lenses in keratoconus.

Methods: In this prospective trial study, cases were 32 keratoconic eyes with no history of RGP lens wear. All eyes were examined with the Ocular Response Analyzer (ORA) and the Corneal Visualization Scheimpflug Technology (CORVIS-ST) to measure corneal hysteresis (CH), corneal resistance factor (CRF), deformation amplitude (DA), applanation velocity (AV) 1 and 2, applanation length (AL) 1 and 2, and peak distance before and 3 months after fitting aspheric RGP lenses. The effect of the correlation between contralateral eyes and maximum keratometry were controlled for in the analysis. Results were compared using repeated measures analysis of covariance.

Results: At 3 months, neither the increases in mean CH (0.14±2.77 mmHg, P=0.789), CRF (0.41±4.35 mmHg, P=0.612), AV1 (0.03±0.17 m/s, P=0.301), AV2 (0.11±0.59 m/s, P=0.299), AL1 (0.44±1.56 m/s, P=0.118), AL2 (1.16±5.06 m/s, P=0.211), and peak distance (0.19±1.29 m/s, P=0.409), nor the decrease in mean DA (0.03±0.17 mm, P=0.402) was statistically significant.

Conclusions: Results in our series of patients indicated that 3 months of RGP lens wear had no significant impact on corneal biomechanics, and perhaps non progression of keratoconus. Therefore, RGP lenses can be regarded safe and appropriate in keratoconic patients.

Background: Evaluation of corneal biomechanical properties 3 months after using rigid gas permeable (RGP) contact lenses in keratoconus.

Methods: In this prospective trial study, cases were 32 keratoconic eyes with no history of RGP lens wear. All eyes were examined with the Ocular Response Analyzer (ORA) and the Corneal Visualization Scheimpflug Technology (CORVIS-ST) to measure corneal hysteresis (CH), corneal resistance factor (CRF), deformation amplitude (DA), applanation velocity (AV) 1 and 2, applanation length (AL) 1 and 2, and peak distance before and 3 months after fitting aspheric RGP lenses. The effect of the correlation between contralateral eyes and maximum keratometry were controlled for in the analysis. Results were compared using repeated measures analysis of covariance.

Results: At 3 months, neither the increases in mean CH (0.14±2.77 mmHg, P=0.789), CRF (0.41±4.35 mmHg, P=0.612), AV1 (0.03±0.17 m/s, P=0.301), AV2 (0.11±0.59 m/s, P=0.299), AL1 (0.44±1.56 m/s, P=0.118), AL2 (1.16±5.06 m/s, P=0.211), and peak distance (0.19±1.29 m/s, P=0.409), nor the decrease in mean DA (0.03±0.17 mm, P=0.402) was statistically significant.

Conclusions: Results in our series of patients indicated that 3 months of RGP lens wear had no significant impact on corneal biomechanics, and perhaps non progression of keratoconus. Therefore, RGP lenses can be regarded safe and appropriate in keratoconic patients.

The present study reports a case of a patient with choroidal neovascularization (CNV) associated with pseudoxanthoma elasticum (PXE). We observed the functional and anatomical improvement of the patient treated with intravitreal vascular endothelial growth factor (VEGF) inhibitor bevacizumab. The study also systematically searched the database for similar cases to provide a literature review. Data concerning the clinical features, treatment strategies and outcomes were extracted and analyzed. Retrospective interventional case report and systematic literature review. A 56-year-old healthy Chinese woman with CNV secondary to PXE was reported. Examinations included best corrected visual acuity (BCVA), biomicroscopy, optical coherence tomography (OCT), fluorescein and indocyanine green angiography and digital fundus photography. The patient managed with intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections (bevacizumab 1.25 mg/0.05 mL). The Cochrane Library, PubMed, OVID, and UpToDate databases were searched using the term pseudoxanthoma elasticum or Gr?nblad-Strandberg syndrome with the limits English. Articles that predated the databases were gathered from current references. Fundus examination revealed angioid streaks bilaterally and CNV in left eye (LE). After the patient underwent three intravitreal injections of bevacizumab, the LE showed absorption of the subretinal fluid and shrinkage of the CNV. Visual acuity (VA) was improved in her treated LE. Bevacizumab treatment was well tolerated with no adverse events reported. Approximately ten articles about 45 patients (49 eyes) describing CNV secondary to angioid streaks in PXE treated with anti-VEGF were found in the literature search. In the present case, bevacizumab of an initial three injection loading dose, achieved maintenance of visual function in the treatment of CNV associated with angioid streaks in PXE. Literature articles concluded that the intravitreal application of anti-VEGF is highly efficient for improving and stabilizing the lesion as well as the eyesight. So we believe that anti-VEGF therapy can be a great choice of treatment for CNV secondary to angioid streaks related PXE.

The present study reports a case of a patient with choroidal neovascularization (CNV) associated with pseudoxanthoma elasticum (PXE). We observed the functional and anatomical improvement of the patient treated with intravitreal vascular endothelial growth factor (VEGF) inhibitor bevacizumab. The study also systematically searched the database for similar cases to provide a literature review. Data concerning the clinical features, treatment strategies and outcomes were extracted and analyzed. Retrospective interventional case report and systematic literature review. A 56-year-old healthy Chinese woman with CNV secondary to PXE was reported. Examinations included best corrected visual acuity (BCVA), biomicroscopy, optical coherence tomography (OCT), fluorescein and indocyanine green angiography and digital fundus photography. The patient managed with intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections (bevacizumab 1.25 mg/0.05 mL). The Cochrane Library, PubMed, OVID, and UpToDate databases were searched using the term pseudoxanthoma elasticum or Gr?nblad-Strandberg syndrome with the limits English. Articles that predated the databases were gathered from current references. Fundus examination revealed angioid streaks bilaterally and CNV in left eye (LE). After the patient underwent three intravitreal injections of bevacizumab, the LE showed absorption of the subretinal fluid and shrinkage of the CNV. Visual acuity (VA) was improved in her treated LE. Bevacizumab treatment was well tolerated with no adverse events reported. Approximately ten articles about 45 patients (49 eyes) describing CNV secondary to angioid streaks in PXE treated with anti-VEGF were found in the literature search. In the present case, bevacizumab of an initial three injection loading dose, achieved maintenance of visual function in the treatment of CNV associated with angioid streaks in PXE. Literature articles concluded that the intravitreal application of anti-VEGF is highly efficient for improving and stabilizing the lesion as well as the eyesight. So we believe that anti-VEGF therapy can be a great choice of treatment for CNV secondary to angioid streaks related PXE.

眼科日间手术显著提高了医疗效率、节约了医疗资源，眼科麻醉复苏体系的建立则是眼科日间全身麻醉手术的重要安全保障，也是提高眼科手术室效率的重要举措。在眼科手术结束后，全身麻醉患者被即刻转运至麻醉恢复室(post-anesthesia care unit, PACU)，此时患者仍处于麻醉状态，密切的监测和呼吸机辅助通气是必不可少的，从而保障患者从麻醉状态逐渐恢复至清醒状态。当患者清醒后，拔除喉罩，各项监测指标达到PACU的转出标准，可进入到Ⅱ期复苏并日间手术离院。然而，在PACU复苏期间，患者易出现喉罩移位、呛咳等引起急性缺氧等呼吸道不良事件的发生，小儿患者则由于术后眼罩遮盖等原因，出现苏醒期躁动的概率高，从而影响到患者顺利转出PACU，间接影响到手术患者的周转。因此，如何预防这些并发症的发生，对提高眼科麻醉复苏质量显得十分重要。

眼科日间手术显著提高了医疗效率、节约了医疗资源，眼科麻醉复苏体系的建立则是眼科日间全身麻醉手术的重要安全保障，也是提高眼科手术室效率的重要举措。在眼科手术结束后，全身麻醉患者被即刻转运至麻醉恢复室(post-anesthesia care unit, PACU)，此时患者仍处于麻醉状态，密切的监测和呼吸机辅助通气是必不可少的，从而保障患者从麻醉状态逐渐恢复至清醒状态。当患者清醒后，拔除喉罩，各项监测指标达到PACU的转出标准，可进入到Ⅱ期复苏并日间手术离院。然而，在PACU复苏期间，患者易出现喉罩移位、呛咳等引起急性缺氧等呼吸道不良事件的发生，小儿患者则由于术后眼罩遮盖等原因，出现苏醒期躁动的概率高，从而影响到患者顺利转出PACU，间接影响到手术患者的周转。因此，如何预防这些并发症的发生，对提高眼科麻醉复苏质量显得十分重要。

      总结32例飞秒激光辅助角膜移植术患者的护理，认为做好心理护理、术前完善眼部检查和做好充分的准备，术后严密观察敷料、眼压和角膜植片的情况，做好特殊体位和角膜接触镜的护理，并做好出院指导是提高手术的成功率及预防并发症的关键。

This paper summarized the nursing care of 32 patients received femtosecond laser assisted corneal transplantation. The key points to increase the success rate of surgery and prevent complications were psychological nursing, preoperative examinations and fully prepared, postoperative observation of dressing, intraocular pressure and corneal glass, care of special position and corneal contact lens, and discharge guidance.

Background: Few prevalence studies on intermittent exotropia (IXT) based on Chinese populations. Furthermore, longitudinal change in this pattern within a local setting has not been reported in the past. This study aims to determine the pro?le of children with IXT in China.

Methods: A total of 7,537 subjects from nine multi-layer primary and secondary schools participated in this investigation. The position of eyes was examined by using Hirschberg test and alternate cover test. The obtained results were classi?ed according to respective features and analyzed statistically.

Results: The prevalence of IXT among the participants was 7.98%, accounting for 73.04% of all types of strabismus. Junior high school students had a lower prevalence of IXT than elementary and senior high school counterparts. Logistic regression analysis showed that IXT was mainly found in male pupils at high grades in rural areas and in male secondary students at high grade in urban regions.

Conclusions: IXT was shown to be more prevalent than other types of strabismus in Chinese children. Furthermore, the distribution and characteristics of IXT greatly varied among participants.

Background: Few prevalence studies on intermittent exotropia (IXT) based on Chinese populations. Furthermore, longitudinal change in this pattern within a local setting has not been reported in the past. This study aims to determine the pro?le of children with IXT in China.

Methods: A total of 7,537 subjects from nine multi-layer primary and secondary schools participated in this investigation. The position of eyes was examined by using Hirschberg test and alternate cover test. The obtained results were classi?ed according to respective features and analyzed statistically.

Results: The prevalence of IXT among the participants was 7.98%, accounting for 73.04% of all types of strabismus. Junior high school students had a lower prevalence of IXT than elementary and senior high school counterparts. Logistic regression analysis showed that IXT was mainly found in male pupils at high grades in rural areas and in male secondary students at high grade in urban regions.

Conclusions: IXT was shown to be more prevalent than other types of strabismus in Chinese children. Furthermore, the distribution and characteristics of IXT greatly varied among participants.

Background: Corneal ectasia is a serious complication after laser in situ keratomileusis (LASIK). Ideally, patients at risk of ectasia should be identified prior to laser as unsuitable for LASIK, however, at present, there is no absolute test, system, or marker that can unequivocally identify patients at risk of developing ectasia. It has been suggested that changes in the forward protrusion of the posterior cornea or posterior corneal elevation (PCE) may be a key to the early detection of ectasia after LASIK. The purpose of this study was to examine the long term changes of the PCE after myopic LASIK using the ORBSCAN® IIz (Bausch & Lomb, Rochester, USA) and to evaluate the contributory preoperative factors to PCE changes.

Methods: This was a retrospective longitudinal case series. Forty-two eyes of 23 consecutive myopic patients who underwent uneventful LASIK surgery 6 years ago were recalled for a postoperative follow-up examination using the ORBSCAN® IIz to determine the elevation changes to the posterior corneal surface from the preoperative measurements. A forward shift of the posterior surface was given a negative value. Correlation analyses and forward stepwise regression analyses were performed to evaluate the effect of each of the preoperative parameters on the changes in PCE. Statistical and graphical analyses were performed.

Results: There was no statistical difference between the mean best-fit sphere (BFS) pre-LASIK and 6 years postop (P=0.25). Forty-two post-LASIK eyes had a mean posterior displacement of -9.38±9.84 μm (range, 12 to -31 μm) 6 years after LASIK. Forward stepwise multiple linear regression analysis indicated that the ablation spherical equivalent (ASE) was the only indicator of the forward shift of the posterior cornea after LASIK.

Conclusions: The present study identified a significant forward shift of the posterior cornea 6 years after LASIK. The ASE was the most significant prognostic determinant for forward protrusion of the posterior cornea after LASIK. 

Background: Corneal ectasia is a serious complication after laser in situ keratomileusis (LASIK). Ideally, patients at risk of ectasia should be identified prior to laser as unsuitable for LASIK, however, at present, there is no absolute test, system, or marker that can unequivocally identify patients at risk of developing ectasia. It has been suggested that changes in the forward protrusion of the posterior cornea or posterior corneal elevation (PCE) may be a key to the early detection of ectasia after LASIK. The purpose of this study was to examine the long term changes of the PCE after myopic LASIK using the ORBSCAN® IIz (Bausch & Lomb, Rochester, USA) and to evaluate the contributory preoperative factors to PCE changes.

Methods: This was a retrospective longitudinal case series. Forty-two eyes of 23 consecutive myopic patients who underwent uneventful LASIK surgery 6 years ago were recalled for a postoperative follow-up examination using the ORBSCAN® IIz to determine the elevation changes to the posterior corneal surface from the preoperative measurements. A forward shift of the posterior surface was given a negative value. Correlation analyses and forward stepwise regression analyses were performed to evaluate the effect of each of the preoperative parameters on the changes in PCE. Statistical and graphical analyses were performed.

Results: There was no statistical difference between the mean best-fit sphere (BFS) pre-LASIK and 6 years postop (P=0.25). Forty-two post-LASIK eyes had a mean posterior displacement of -9.38±9.84 μm (range, 12 to -31 μm) 6 years after LASIK. Forward stepwise multiple linear regression analysis indicated that the ablation spherical equivalent (ASE) was the only indicator of the forward shift of the posterior cornea after LASIK.

Conclusions: The present study identified a significant forward shift of the posterior cornea 6 years after LASIK. The ASE was the most significant prognostic determinant for forward protrusion of the posterior cornea after LASIK.