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- 实验方案
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Current review of Excimer laser Trabeculostomy
摘要： Background: Excimer laser trabeculostomy (ELT) is a microinvasive glaucoma surgery (MIGS) that creates multiple laser channels through the trabecular meshwork using a cold laser system, which minimizes tissue fibrosis and aids in bypassing the main area of resistance to aqueous outflow. The purpose of this review is to evaluate the current body of evidence surrounding ELT in terms of efficacy and review the safety profile of the procedure. Main text: Studies screened had to show clear inclusion and exclusion criteria as well as well-defined outcome measures. PubMed, MEDLINE, EMBASE and the Cochrane Controlled Trial Database were searched. Preferred Reporting Items of Systematic Reviews (PRISMA) guidelines were used to assess for study quality and for any bias. Sixty-four articles were initially identified with 18 meeting preliminary screening criteria. Ultimately, 8 studies met inclusion criteria and 2 additional non-referenced publications were also included: 1 randomized control trial, 4 prospective case series and 5 retrospective studies. Overall studies showed moderate intraocular pressure (IOP) lowering of between 20% and 40% from baseline without medication washout and mostly a decrease in glaucoma medications with few complications. Conclusion: Current literature shows a significant IOP-lowering effect of ELT with a favorable safety-profile in standalone cases or combined with cataract surgery. Limitations to these studies are the lack of controls and washout IOP. Overall, ELT is an attractive MIGS option that does not require any residual device remaining in the angle.
关键词： Excimer laser trabeculostomy,ELT,Trabeculotomy,MIGS,Cataract,Intraocular pressure,Glaucoma
更新于2025-09-23 15:21:01
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Experimental and clinical study of simultaneous dual-wavelength laser action in energetic cataract surgery
摘要： A new technique of energy cataract surgery with the simultaneous use of two wave-length of laser emission acting as high-intensity laser—endodissector (Nd:YAG, wave-length λ = 1.44? μm) and a low-intensity laser—endobiostimulator (He–Ne, wavelength λ = 0.632? μm) is represented. The surgical technique is bimanual. The radiation of high-intensity laser ensures the destruction of cataract lens of any density level without addi-tional assistance of ultrasound and without manual fragmentation. The laser tip, which contacts the eye tissues, does not heat up. In the process of high-intensity laser action split-ting and spalling of the eye lens core occurs. Laser energy does not go beyond the lens capsule as it is almost completely absorbed by the liquid of the anterior chamber (water) at less than 1?mm from the distal end of the laser tip. Simultaneous exposure to radiation of high-intensity and low-intensity lasers delivered to the eye lens via one laser tip provide to prevent the progression of posttraumatic inflammatory process in the eye at the initial stage of the start of pathophysiological intracellular changes. This ensures high efficiency and safety of simultaneous dual-wavelength laser cataract extraction (DW LCE).
关键词： 0.632?μm He–Ne laser,Phacoemulsification,1.44?μm Nd:YAG laser,Dual-wavelength laser cataract extraction,Intraoperative endoocular bio-stimulation
更新于2025-09-23 15:21:01
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Change in Axial Length Pre and Post Cataract Surgery Measured with IOL Master
摘要： Objective: Cataract surgery with intraocular lens (IOL) implantation tries to get a refractive result nearby to the optic emmetropia. So an accurate IOL power calculation is mandatory, and axial length (AL) measurement is one of the most influential parameter in this calculation. IOL Master is one of the most popular devices to measure AL, which uses the same group refractive index of the lens for all patients, independently of the cataract grade. But lens refractive index is higher as cataract grade increases. Nowadays cataract tends to be operated earlier, so moderate cataracts are the most extracted in clinical practice. Therefore, it is important to study the influence of moderate lens opacity in AL measurements. The objective of this study was to compare the AL value measures with IOL Master, before and after uncomplicated cataract surgery in patients with moderate cataracts. Material and methods: This study included 153 eyes of 105 patients (67.51 ± 13.56 years old) undergoing uncomplicated cataract surgery. Lens opacity was determined with the LOCSIII scale and AL was measured using optical biometry (IOL Master; Carl Zeiss Meditec) before and one month after intervention. Intraoperative measurements (ultrasound time and fluid volume) were also registered. Results: Mean preoperative AL of 25.10 ± 3.19 mm (range 20.54 to 36.06; IC95% 24.59 to 25.60 mm) and postoperative of 24.88 ± 3.16 mm (IC 95% 24.37 to 25.39; range 20.43 to 35.79 mm). The mean AL difference before and after surgery was 0.19 ± 0.05 mm (p=0.549 ANOVA) with agreement limits from 0.09 to 0.29 mm. It was observed more difference in eyes with larger AL (r2=0.14 p<0.01). The average cataract grade in each category was: nuclear opacity 2.25 ± 1.00 (range 1 to 5) (p=0.564 ANCOVA), cortical opacity 2.04 ± 0.73 (range 0 to 4) (p=0.543 ANCOVA), posterior subcapsular opacity 0.44 ± 0.90 (range 0 to 4) (p=0.563 ANCOVA), and nuclear color 2.40 ± 1.05 (range 0 to 5) (p=0.558 ANCOVA), without statistical significant effect in the AL difference pre and after cataract surgery. The ultrasound time used during the surgery was 43 ± 29 seconds (p=0.525 ANCOVA) and the fluid volume was 4.73 ± 1.31 (p=0.560 ANCOVA) cubic centimeters without statistically significant relationship between these parameters and the difference in the AL measurement. Conclusions: The difference in AL measurement with IOL Master before and after cataract surgery in eyes with low grade of cataract should be related with IOL Master reproducibility especially in extreme-long eyes. Moderate cataract showed non-statistically effect on AL measurement with IOL Master biometry.
关键词： IOL master biometry,Cataract surgery
更新于2025-09-23 15:21:01
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Cataract quantification using swept-source optical coherence tomography
摘要： To develop and evaluate a cataract quantification method using a swept-source optical coherence tomography (SS-OCT) device (IOLMaster 700).
关键词： SS-OCT,swept-source optical coherence tomography,IOLMaster 700,LOCS II,cataract quantification
更新于2025-09-23 15:21:01
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Active Maintenance of the Gradient of Refractive Index Is Required to Sustain the Optical Properties of the Lens
摘要： To determine whether the cellular physiology of the lens actively maintains the optical properties of the lens and whether inhibition of lens transport affects overall visual quality. One lens from a pair of bovine lenses was cultured in artificial aqueous humor (AAH), while the other was cultured in either AAH-High-K+ or AAH + 0.1 mM ouabain for 4 hours. Lens pairs or whole enucleated eyes were then imaged in 4.7 Tesla (T) high-field small animal magnet. Lens surface curvatures, T1 measurements of water content, and T2 measurements of water/protein ratios were extracted from cultured lenses, while the geometrical parameters that define the optical pathway were obtained from whole eyes. Gradients of refractive index (GRIN), calculated from T2 measurements, and the extracted geometric parameters were inputted into optical models of the isolated lens and the whole bovine eye. Inhibiting circulating fluxes by inhibiting the Na/K-ATPase with ouabain or depolarization of the lens potential by High K+ caused changes to lens water content, the water/protein ratio (GRIN) and surface geometry that manifested as an increase in optical power and a decrease in negative spherical aberration in cultured lenses. Changes to optical properties of the lens resulted in a myopic shift that impaired vision quality in the optical model of the bovine eye. The cellular physiology of the lens actively maintains its optical properties and inhibiting the Na/K/ATPase induces a myopic shift in vision similar to that observed clinically in patients who go on to develop cataract.
关键词： physiological optics,optical modeling,cataract,gradient of refractive index,lens physiology,magnetic resonance imaging
更新于2025-09-23 15:21:01
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[EAI/Springer Innovations in Communication and Computing] Applications of Intelligent Technologies in Healthcare || Survey Analysis of Automatic Detection and Grading of Cataract Using Different Imaging Modalities
摘要： Automatic detection and grading of cataract alleviate the burden of ophthalmologists and clinicians. It also provides an objective way to measure the severity of cataract and helps reduce the vision loss by timely and accurate diagnosis. In this survey-based paper, we presented an overview of the methods and techniques developed for cataract detection and gradation. We mainly investigated the usage of four types of imaging modalities used for automatic diagnosis of cataract using digital image processing. These types include slit-lamp images, retro-illumination images, retinal images, and digital eye images. We also discuss the shortcomings of these methods and future research possibilities to improve these methods.
关键词： automatic detection,imaging modalities,digital image processing,grading,cataract
更新于2025-09-23 15:21:01
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A new parameterization of the UV irradiance altitude dependence for clear-sky conditions and its application in the on-line UV tool over Northern Eurasia
摘要： A new method for calculating the altitude UV dependence is proposed for different types of biologically active UV radiation (erythemally-weighted, vitamin-D-weighted and cataract-weighted types). We show that for the specified groups of parameters the altitude UV amplification (AUV) can be presented as a composite of independent contributions of UV amplification from different factors within a wide range of their changes with mean uncertainty of 1% and standard deviation of 3% compared with the exact model simulations with the same input parameters. The parameterization takes into account for the altitude dependence of molecular number density, ozone content, aerosol and spatial surface albedo. We also provide generalized altitude dependencies of the parameters for evaluating the AUV. The resulting comparison of the altitude UV effects using the proposed method shows a good agreement with the accurate 8-stream DISORT model simulations with correlation coefficient r>0.996. A satisfactory agreement was also obtained with the experimental UV data in mountain regions. Using this parameterization we analyzed the role of different geophysical parameters in UV variations with altitude. The decrease in molecular number density, especially at high altitudes, and the increase in surface albedo play the most significant role in the UV growth. Typical aerosol and ozone altitude UV effects do not exceed 10-20%. Using the proposed parameterization implemented in the on-line UV tool (http://momsu.ru/uv/) for Northern Eurasia over the PEEX domain we analyzed the altitude UV increase and its possible effects on human health considering different skin types and various open body fraction for January and April conditions in the Alpine region.
关键词： UV radiation,altitude dependence,RT modelling,cataract-weighted irradiance,erythemally-weighted irradiance,vitamin D-weighted irradiance,interactive UV-tool
更新于2025-09-23 15:21:01
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Zukunftsperspektiven des Femtosekundenlasers in der Vorderabschnittschirurgie; Future perspectives of the femtosecond laser in anterior segment surgery;
摘要： Around 12 years after its introduction laser cataract surgery (LCS) has enabled remarkable progress, such as extremely precise capsulotomy and lens fragmentation with reduced or no ultrasound energy at all (zero phako); however, another innovation push is necessary to bring this technology to its full potential. Among the many benefits that have not yet been fully explored are primary posterior laser capsulotomy (PPLC) and the use of the femtosecond laser in pediatric cataract patients. In the present collective of patients in whom a PPLC was carried out at the end of the operation, a clearly reduced prevalence of secondary cataract could be observed, whereas the short additional intervention was not associated with notable complications. The LCS in infants is best carried out as an off-label procedure, which has been rendered more precise by the Bochum formula. In the near future, postoperative laser fine tuning will enable the target refraction to be achieved in most patients. Laser-induced refractive index change (LIRIC) will enable very exact refraction alterations on an already implanted intraocular lens (IOL), on a contact lens and on a treatment native cornea. A new version of the Scheimpflug camera will be used just prior to surgery to analyze the morphology and kernel density of the lens opacity and to carry out a real-time grading of lens hardness. Based on this categorization, where the system classifies the results into five different density grades, the surgeon is automatically provided with an individualized fragmentation pattern defined preoperatively by the operator. A further innovation of the same system involves microcorneal incisions for fine tuning of residual refractive deficits.
关键词： Femtosecond laser-assisted cataract surgery,Bochum formula,Postoperative refractive enhancement/fine tuning,Primary posterior laser capsulotomy,Laser-induced refractive index change
更新于2025-09-23 15:19:57
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Comparison of astigmatism correction between anterior penetrating and intrastromal arcuate incisions in eyes undergoing femtosecond lasera??assisted cataract surgery
摘要： To compare the safety, efficacy, and predictability of femtosecond laser–enabled anterior penetrating and intrastromal arcuate incisions for the correction of preoperative astigmatism at the time of cataract surgery.
关键词： anterior penetrating incisions,femtosecond laser,cataract surgery,astigmatism correction,intrastromal incisions
更新于2025-09-23 15:19:57
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The Role of Subthreshold Micropulse Yellow Laser as an Alternative Option for the Treatment of Refractory Postoperative Cystoid Macular Edema
摘要： Background: To evaluate the efficacy and the safety of subthreshold micropulse yellow laser (SMYL) in the treatment of chronic postoperative cystoid macular edema (PCME), which is refractory to standard therapies. Methods: A retrospective chart review of ten eyes of ten patients affected by refractory PCME who underwent SMYL was performed. Five PCME cases were subsequent to uncomplicated cataract surgery (CS), two cases to complicated CS (CCS) with posterior capsule rupture and three cases occurred after retinal detachment surgery (RD). All conditions were refractory to conventional treatments prior to SMYL interventions for at least 4 months, including nonsteroidal anti-inflammatory eyedrops, topical steroids, oral indomethacin, sub-Tenon’s triamcinolone injections and Dexamethasone intravitreal implants. All patients underwent one or more treatments with 577 nm SMYL photo-stimulation, with 7 × 7 grids with confluent spots and a 5% duty cycle covering the whole edematous retina, including the foveal center. Best corrected visual acuity (BCVA) and central macular thickness (CMT) were obtained using OCT, and evaluated before and after the treatment at 1, 2, 3 and 6-month follow-ups. Results: A complete subfoveal macular edema resolution was observed in all of the eyes, with statistically significant improvements in terms of BCVA and CMT in all of the follow-up timelines (at 6 months, p = 0.002 and p = 0.005, respectively). The mean number of laser treatments was 1.3. At the final follow-up, a complete subfoveal edema reabsorption was observed in all patients with visual acuity improvement. No complications were observed in any case. Conclusions: SMYL seems to be a safe and effective treatment for the long-term resolution of refractory PCME and may be a useful alternative to expensive and invasive therapeutic options.
关键词： micropulse yellow laser,cataract surgery,refractory macular edema,post-surgical cystoid macular edema
更新于2025-09-23 15:19:57