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Wavefront-optimized surface retreatments of refractive error following previous laser refractive surgery: a retrospective study

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Eye and Vision 2016年第1期3卷 22-28页

作者： kevin M.Broderick rose k sia Denise S.Ryan Richard D.Stutzman Michael J.Mines Travis C.Frazier Mark F.Torres kraig S.Bower Ophthalmology Service Walter Reed National Military Medical Center8901 Wisconsin AvenueBethesdaMD 20814USA Warfighter Refractive Eye Surgery Program and Research Center Ft.BelvoirVAUSA Ophthalmology Service Madigan Army Medical CenterTacomaWAUSA The Wilmer Eye Institute Johns Hopkins UniversityBaltimoreMDUSA

Background:Retreatments are sometimes necessary to correct residual or induced refractive errors following refractive surgery.Many different combinations of primary treatment methods and retreatment techniques have been studied,however,few studies have investigated wavefront-optimized(WFO)technology for retreatment following primary refractive surgery.This study aimed to report the outcomes of WFO photorefractive keratectomy(PRk)retreatments of refractive error following previous laser refractive surgery with PRk,laser in situ keratomileusis(LASIk),or laser-assisted subepithelial keratectomy(LASEk).Methods:We reviewed records of patients who underwent WFO PRk retreatments using the Allegretto Wave Eye-Q 400 Hz Excimer Laser System(Alcon Surgical)between January 2008 and April 2011 at Walter Reed Army Medical Center and Madigan Army Medical Center.Outcomes were recorded in terms of uncorrected distance visual acuity(UDVA),manifest refraction spherical equivalent(MRSE),corrected distance visual acuity(CDVA),and complications at 1 month(M),3 M,and 6 M post-op.Results:Seventy-eight patients(120 eyes)underwent WFO PRk retreatment during the study period.Primary surgery was surface ablation in 87 eyes(78 PRk,9 LASEk)and LASIk in 33 eyes.The mean spherical equivalent before retreatment was−0.79±0.94 D(−3.00 to 1.88 D).UDVA was≥20/20 in 69 eyes(60.0%)at 1 M,54 eyes(71.1%)at 3 M,and 27 eyes(73.0%)at 6 M follow-up.MRSE was within±0.50 D of emmetropia in 78 eyes(67.8%)at 1 M,59 eyes(77.6%)at 3 M,and 25 eyes(67.6%)at 6 M follow-up.CDVA was maintained within±1 line of pre-op in 113 of 115 eyes(98.3%)at 1 M,74 of 76 eyes(97.4%)at 3 M,and 37 eyes(100%)at 6 M follow-up.Conclusion:Although follow-up was limited beyond 3 M,WFO PRk retreatments in patients with residual refractive error may be a safe and effective procedure.Further studies are necessary to determine the long-term safety and stability of outcomes.

关键词： Wavefront-optimized PRk LASIk LASEk Retreatment Enhancement

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Preliminary evaluation of the VIsion PERformance(VIPER) simulator

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Military Medical Research 2020年第3期7卷 312-323页

作者： Denise S.Ryan rose k.sia Jennifer B.Eaddy Lorie A.Logan Jide O.Familoni Hind Beydoun Samantha B.Rodgers Bruce A.Rivers Warfighter Refractive Eye Surgery Program and Research Center Fort Belvoir Community HospitalFort BelvoirVA 22060USA Night Vision and Electronic Sensors Directorate Fort BelvoirVA 22060USA Department of Research Programs Fort Belvoir Community HospitalFort BelvoirVA 22060USA

Background:This study evaluated the VIsion PERformance(VIPER)simulator’s ability to assess the functional visual performance in warfighters conducting civilian and military tasks.Methods:Thirty service members,aged 25–35 years old with a best corrected distance visual acuity(VA)better than or equal to 20/20 or logarithm of the minimum angle of resolution(logMAR)0.00,were randomized to locate and identify road signs and mock improvised explosive devices(IEDs)under either daytime conditions or with infrared imagery,with(cc)and without(sc)wearing their habitual correction.Participants also underwent binocular uncorrected(UDVA)and corrected(CDVA)visual assessment,refraction,contrast sensitivity testing and wavefront aberrometry.Results:The mean age was 28.47 years.The manifest spherical equivalent was–3.16±1.75 diopters(D),the UDVA in both eyes(OU)was logMAR 0.83±0.47,and the CDVA OU was–0.11±0.06.For VIPER,the mean difference in the detection distance(DD)for road signs ccDD vs.scDD was(76.7±52.8)m(P<0.001).The average difference in identification distance(ID)ccID vs.scID was(13.9±6.3)m(P<0.001).The mean accuracies were 83.5%and 27.9%for cc and sc,respectively(P<0.001).The regression analysis indicated that a 1.6 m change in the distance accounts for a 1%change in the accuracy(P=0.002).Without correction,a 4.1 m change accounts for a 1%change in the accuracy(P<0.001).The average IED ccDD was(29.9±8.2)m,and that for scDD was(13.2±13.6)m(P<0.001).The average IED ccID was(32.2±6.2)m and that for the scID was(7.4±10.3)m(P<0.001).The mean IED identification accuracy was 46.7 and 11.4%for cc and sc,respectively(P<0.001).Conclusions:The preliminary results reflect VIPER’s ability to assess functional visual performance when detecting and identifying signs and IEDs.Furthermore,VIPER is able to detect performance changes with and without correction.

关键词： Functional visual performance Military task performance

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Prevention of Mother-to-Child Transmission of Hepatitis B in the Urban District Health Baskuy Burkina Faso

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Open Journal of Gastroenterology 2016年第6期6卷 175-187页

作者： Alice Nanelin Guingané Nicolas Meda Roger Sombié Christiane Béré/Somé Lydie sia rose Ido/Da Issa Guiraud Alain Bougouma Service d’Hépatogastroentérologie CHU-Yalgado Ouédraogo Ouagadougou Burkina Faso Aix Marseille University IRD UMR-S912 Marseille France Faculty of Health Sciences (UFR-SDS) University of Ouaga I Pr Joseph Ki-Zerbo Ouagadougou Burkina Faso Centre MURAZ Bobo-Dioulasso Burkina Faso Institute of Research on Health Sciences Ouagadougou Burkina Faso

Few studies have been conducted on the epidemiology in pregnancy in sub-Saharan Africa. This study aimed to improve the care of pregnant women infected with hepatitis B virus (VHB) and their newborns in the urban district health. Method: This study was conducted from 01/09/2014 to 01/09/2015. Study involved three types of data collection: a collection of data from health facilities involved in the project;repeated cross-sectional survey among health personnel;a pros- pective study of pregnant women identified positive for HBsAg and followed at the University Hospital Yalgado Ouédraogo (CHU-YO). knowledge assessment was made among health staff and pregnant women using a knowledge score. Construction of the score came after a factorial analysis of multiple correspondences on population health workers surveyed in the first round (N = 119) on one hand and all pregnant women (N = 266) on the other hand. This had identified among the 79/19 questions, those that discriminated best knowledge of paramedics and pregnant women. For pregnant women, this score was then dichotomized from the center and logistic regression was performed to determine the sociodemographic, medical and obstetric characteristics that influenced it (p value knowledge was good on targeted knowledge, both before and after training. No health worker routinely offered screening for hepatitis B among pregnant women attending antenatal clinics. Altogether 266 pregnant women HBsAg-positive were referred and followed CHU-YO. Half of the patients had a score lower than 2/17. Univariate analysis showed that variables such as education level influenced significantly the level of knowledge. Women with higher levels of education had a higher level of knowledge about the disease, compared to those of primary level [OR = 1.63;[1.34 to 1.99], p value < 0,001]. Newborns during the study period numbered 128 and the vaccine was made in the first 24 hours of life for 83.6% of

关键词： Hepatitis B Paramedics knowledge Practices Pregnant Women Immunization Newborn

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