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Efficacy and safety of deep sclerectomy with uveoscleral implant plus collagen matrix implant overcoming the superficial scleral flap in glaucoma surgery

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International Journal of Ophthalmology(English edition) 2023年第11期16卷 1806-1813页

作者： Jéssica Botella-García Marta Balboa Pau Romera-Romero Theo Stijnen Adrián Sánchez-Fortún Karl Mercieca Jordi Loscos-Arenas Department of Ophthalmology Hospital Germans Trias i PujolBadalona 08916Spain International university of Catalonia(UIC) Barcelona 08017Spain Department of Surgery Barcelona Autonomous University(UAB)Barcelona 08035Spain Department of Biomedical Data Sciences Leiden University Medical CenterLeiden 2333The Netherlands university hospitals bonn eye clinic Bonn53127Germany Germans Trias i Pujol Research Institute(IGTP) Badalona 08916Spain

AIM:To assess the efficacy and safety of non-penetrating deep sclerectomy(NPDS)with uveoscleral implant plus subconjunctival and intrascleral collagen matrix overcoming the superficial scleral flap lips(modified deep sclerectomy technique,DS)and minimal use of mitomycin C in glaucoma ***:A retrospective review of 47 consecutive glaucoma patients who underwent NPDS with DS between January 2017 and May ***-corrected visual acuity,intraocular pressure(IOP),post-operative need for glaucoma medications,visual field mean deviation(MD),re-interventions,needling revisions and laser goniopuncture were *** success was defined as IOP≤18 mm Hg without topical *** success was defined as the same criteria but with the addition of any antihypertensive *** over 18 mm Hg on two consecutive followup visits was considered as a ***:Fifty-two eyes of 47 patients were *** preoperative IOP was 25.37±6.47 mm Hg,and decreased to 15.04±4.73 at 12mo and 12.21±4.1 at 24mo(all P<0.0001).Requirement for topical medications dropped from a mean of 3.06±0.25 per patient to 0.51±0.99 and 1.11±1.23 respectively after 12 and 24mo(all P<0.0001).No medications were required in 45.5%of patients after *** and absolute success rate at 24mo were 85.5%±5%and 48.5%±7.4%,***:DS is a safe and effective nonpenetrating glaucoma surgery *** aims to retain the patency of all pathways created for aqueous humor drainage:the intrascleral bleb,the supraciliary space and the open communication between intrascleral and subconjunctival compartments.

关键词： deep sclerectomy glaucoma surgery uveoscleral implant

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Task sharing: situation analysis about capacity and resources for management of diabetic retinopathy in Pakistan

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International Journal of Ophthalmology(English edition) 2019年第5期12卷 809-814页

作者： Mufarriq Shah Ayesha Noor C Alex Harper Jill Elizabeth Keeffe Pakistan Institute of Community Ophthalmology Hayatabad Medical Complex Vision and Dental Care clinic Centre for eye Research Australia Department of OphthalmologyUniversity of Melbourneand Royal Victorian Eye and Ear Hospital LV Prasad eye Institute

AIM: To assess the capacity and resources of eye care facilities, using the WHO Health Systems Framework, to manage diabetic retinopathy(DR) through task ***: Using purposive sampling, four participants(administrators) from four selected hospitals in two provinces in Pakistan were recruited for this cross-sectional study. A survey, to assess the capacity and resources of the selected eye care facilities for the feasibility to adopt task sharing in management of DR to prevent vision loss, was emailed to participants who were asked to complete. Responses to open-ended questions were entered into a Microsoft Excel spread sheet and inductive approach was applied for ***: All the surveyed eye care facilities offer eye care services for people with diabetes and DR. All surveyed eye care facilities have a shortage in the number of human resources across all cadres. Optometrists and mid-level eye care workers did not have active roles in DR screening and management in all four hospitals. All the hospitals surveyed did not have a computerized record management system for patients who visit ophthalmologists for eye examinations. Equipment for detection and management of DR were short in number and main users were ophthalmologists. There was no policy for population-based screening program for detection of DR in any of the surveyed ***: A system-based approach to manage DR is needed. The capacity of eye care facilities and the potential to improve access of people with diabetes to eyecare services can be enhanced through implementation of task sharing.

关键词： task sharing capacity diabetes diabetic retinopathy Pakistan

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An enhanced functional ability questionnaire(faVIQ) to measure the impact of rehabilitation services on the visually impaired

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International Journal of Ophthalmology(English edition) 2014年第1期7卷 77-85页

作者： James Stuart Wolffsohn Jonathan Jackson Olivia Anne Hunt Charles Cottriall Jennifer Lindsay Richard Gilmour Anne Sinclair Robert Harper Aston university Life and Health SciencesOphthalmic Research Group Australian College of Optometry Royal Victoria Hospital Oxford eye Hospital Royal Victoria Hospital Belfast Altnagelvin Area Hospital Low Vision clinic Fife Low Vision Centre for the Blind Manchester Royal eye Hospital and Manchester Academic and Health Science Centre Central Manchester University Hospitals NHS Foundation Trust

AIM: To develop a short,enhanced functional ability Quality of Vision(faVIQ) instrument based on previous questionnaires employing comprehensive modern statistical techniques to ensure the use of an appropriate response scale,items and scoring of the visual related difficulties experienced by patients with visual impairment. · METHODS: Items in current quality-of-life questionnaires for the visually impaired were refined by a multi-professional group and visually impaired focus groups. The resulting 76 items were completed by 293 visually impaired patients with stable vision on two occasions separated by a month. The faVIQ scores of 75 patients with no ocular pathology were compared to 75 age and gender matched patients with visual impairment. ·RESULTS: Rasch analysis reduced the faVIQ items to 27. Correlation to standard visual metrics was moderate(r =0.32-0.46) and to the NEI-VFQ was 0.48. The faVIQ was able to clearly discriminate between age and gender matched populations with no ocular pathology and visual impairment with an index of 0.983 and 95% sensitivity and 95% specificity using a cut off of 29.·CONCLUSION: The faVIQ allows sensitive assessment of quality-of-life in the visually impaired and should support studies which evaluate the effectiveness of low vision rehabilitation services.

关键词： quality of life visual impairment low vision functional ability sensitivity specificity

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VISCOCANALOSTOMY AS A TREATMENT FOR THE DYSGENETIC GLAUCOMAS

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国际眼科杂志 2003年第1期3卷 27-27页

作者： A.Stangos G.Sunaric-Megevand F.Panarello P.Leuenberger eye clinic university hospitals SwitzerlandEye Clinic University Hospitals SwitzerlandEye Clinic University Hospitals SwitzerlandEye Clinic University Hospitals Switzerland

Purpose: To determine the surgical outcome of viscocanalosto-my (VCS) for the treatment of the dysgenetic glaucomas. Methods and patients: Prospective study including 23 eyes of 19 consecutive patients who underwent VCS for dysgenetic glaucoma. Pre-operatively, intra-ocular pressure (IOP), visual acuity, anti-glaucoma medication and previous surgery were documented. Post-operatively IOP was measured at day one, first week,

关键词：发育不全性青光眼粘丝体管切除手术治疗

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Periocular basal cell carcinoma-current treatment concepts

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Annals of eye Science 2021年第2期6卷 62-77页

作者： Yongwei Guo Alexander C.Rokohl Adam Kopecky Ludwig M.Heindl eye Center Second Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhouChina Department of Ophthalmology University of CologneFaculty of Medicine and University Hospital CologneCologneGermany clinic of Ophthalmology University Hospital OstravaOstravaCzech Republic Faculty of Medicine Department of Craniofacial SurgeryUniversity of OstravaOstravaCzech Republic Center for Integrated Oncology(CIO)Aachen-bonn-Cologne-Duesseldorf CologneGermany

Basal cell carcinoma(BCC)is by far the most common human skin *** Caucasians,BCCs account for around 90%of periocular ***,periocular BCCs are usually neglected due to their slow and painless growth,unless presenting complaints,e.g.,large size,bleeding,recurrent infections of the tumor,or secondary symptoms resulting from adjacent structures involvement as epiphora,limited eye globe motility as well as globe ***,although the tumor can usually be cured with local excision,local recurrence can occur in up to 20%of eyelid BCC *** BCCs of the eyelid show a poorer overall prognosis than the primary *** addition,the management of advanced diseases,such as orbital or intracranial invasion as well as metastatic lesions,is challenging and often involves a multidisciplinary *** this paper,we reviewed the recent research progress of pathogenesis,clinical presentation,and therapeutics of periocular *** introduced the molecular pathogenesis of BCCs[multi-step ultraviolet(UV)-induced carcinogenesis model,genetic predisposition,and epigenetic changes],clinical classification,and tumor-node-metastasis(TNM)clinically stage of eyelid skin *** also emphasized the treatment of BCCs,i.e.,surgical resection,oculoplastic reconstruction,and alternative therapies(radiation therapy,systemic therapy,topical therapy,and prophylactic therapy).In the end,we proposed that considering the possible iatrogenic damage to the surface of the eye by surgical excision,the treatment of periocular BCCs is recommended to be performed by or in the presence of an oculoplastic surgeon.

关键词： Periocular basal cell carcinoma(periocular BCC) pathogenesis diagnosis therapeutics precaution

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Axon injury induced endoplasmic reticulum stress and neurodegeneration

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Neural Regeneration Research 2016年第10期11卷 1557-1559页

作者： Yang Hu Shriners hospitals Pediatric Research Center (Center for Neural Repair and Rehabilitation) Temple University School of Medicine

Injury to central nervous system axons is a common early characteristic of neurodegenerative diseases. Depending on its location and the type of neuron, axon injury often leads to axon degeneration, retrograde neuronal cell death and progressive permanent loss of vital neuronal functions. Although these sequential events are clearly connected, ample evidence indicates that neuronal soma and axon degenerations are active autonomous processes with distinct molecular mechanisms. By exploiting the anatomical and techni- cal advantages of the retinal ganglion cell （RGC）/optic nerve （ON） system, we demonstrated that inhibition of the PERK-eIF2a-CHOP pathway and activation of the X-box binding protein 1 pathway synergistically protect RGC soma and axon, and preserve visual function, in both acute ON traumatic injury and chronic glaucomatous neuropathy. The autonomous endoplasmic reticulum （ER） stress pathway in neurons has been implicated in several other neurodegenerative diseases. In addition to the emerging role of ER mor- phology in axon maintenance, we propose that ER stress is a common upstream signal for disturbances in axon integrity, and that it leads to a retrograde signal that can subsequently induce neuronal soma death. Therefore manipulation of the ER stress pathway may be a key step toward developing the effective neuro- protectants that are greatly needed in the clinic.

关键词： endoplasmic reticulum stress axonopathy retinal ganglion cell optic nerve neurodegeneration CHOP XBP-1

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Vascular changes in age-related macular degeneration

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Annals of eye Science 2019年第1期 8-9页

作者： Enrico Borrelli Pasquale Viggiano Rodolfo Mastropasqua Ophthalmology clinic Department of Medicine and Science of AgeingUniversity G.D'Annunzio Chieti-PescaraChietiItaly Bristol eye Hospital University Hospitals Bristol NHS Foundation TrustBristolUK

Age-related macular degeneration(AMD)is considered one of the principal causes of vision impairment among older individuals in developed *** this,new technologies which may increment insights elucidating the morphological characteristics of this disorder are expected to improve the visual prognosis in *** development of optical coherence tomography angiography(OCTA)has outstandingly extended our knowledge on the AMD pathophysiology.

关键词： individual degeneration AMD

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Socket discomfort in anophthalmic patients-reasons and therapy options

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Annals of eye Science 2020年第4期5卷 50-56页

作者： Alexander C.Rokohl Marc Trester Yongwei Guo Adam Kopecky Ming Lin Vladimir Kratky Ludwig M.Heindl Department of Ophthalmology University of CologneFaculty of Medicine and University Hospital CologneCologneGermany Trester-Institute for Ocular Prosthetics and Artificial eyes CologneGermany eye Center Second Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhouChina Ophthalmology clinic University Hospital OstravaOstravaCzech Republic Faculty of Medicine University OstravaCzech Republic Department of Ophthalmology Ninth People’s HospitalShanghai Jiao Tong University School of MedicineShanghaiChina Department of Ophthalmology School of MedicineQueen’s UniversityKingstonCanada Center for Integrated Oncology(CIO)Aachen-bonn-Cologne-Dusseldorf CologneGermany

A smooth and timely fitting of a visually appealing,custom-made eye prosthesis after the loss of an eye is not only essential from a cosmetic point of view but above all facilitates good social and psychological *** glass prostheses must be replaced at least once a year,PMMA prostheses polished once a year and renewed every five *** children,especially in growth phases,the fit of the prosthesis should be checked at least every six months and adjusted,if *** and ophthalmologists should determine an individual cleaning procedure together with the patient,which depends on both the prosthesis material and external *** such as allergic,giant papillary,viral,and bacterial conjunctivitis or even blepharoconjunctivitis sicca must be detected and treated at an early stage to avoid discomfort and to maintain the ability of prosthesis *** the case of inflammation-induced shrinkage of the conjunctival fornices or post-enucleation socket syndrome,surgical interventions are *** summary,an early supply with an eye prosthesis,adequate treatment of complications,and attention to psychological aspects,form the basis for a successful long-term rehabilitation of anophthalmic patients.

关键词： Cryolite glass PMMA prosthetic eye eye prosthesis anophthalmia

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Improving refractive outcomes in cataract surgery: A global perspective

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World Journal of Ophthalmology 2014年第4期4卷 140-146页

作者： Petros Aristodemou Nathaniel E Knox Cartwright John M Sparrow Robert L Johnston Department of Ophthalmology University of BristolBristol Eye HospitalBristol BS1 2LXUnited Kingdom Vitreous Retina Macula clinic Limassol 3025 Cyprus West of England eye Unit Royal Devon and Exeter NHS Foundation TrustExeter EX2 5DWUnited Kingdom Gloucestershire hospitals NHS Foundation Trust Cheltenham GL53 7AN United Kingdom

This review summarises the current evidence base and provides guidelines for obtaining good refractive outcomes following cataract surgery. Important background information is also provided. In summary, the requirements are:(1) standardisation of biometry equipment used for axial length and keratometry measurement and the use of optical or immersion ultrasound biometry;(2) sutureless cataract surgery with "in the bag" intraocular lens(IOL) placement;(3) an appropriate 3rd, 4th or 5th Generation IOL power formula should be used;(4) IOL formula constants must be optimized;(5) under certain conditions, the refractive outcome of the 2nd eye can be improved based on the refractive error of the first eye; and(6) results should be audited for refinement and to ensure that standards are met.

关键词： Biometry Cataract extraction Ocular refraction Intraocular lens Intraocular lens Power Formula

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Periodontitis:An often-neglected complication of diabetes

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World Journal of Diabetes 2024年第3期15卷 318-325页

作者： Marina G Kudiyirickal Joseph M Pappachan Primary Care Dental Practice The Smile ClinicPreston PR16PZUnited Kingdom Department of Endocrinology and Metabolism Lancashire Teaching Hospitals NHS TrustPreston PR29HTUnited Kingdom Faculty of Science Manchester Metropolitan UniversityManchester M156BHUnited Kingdom Faculty of Biology Medicine and HealthThe University of ManchesterManchester M139PLUnited Kingdom

The bidirectional association between type 2 diabetes mellitus(T2DM)and periodontitis is now well established,resulting in periodontal disease being considered as the 6th major complication of diabetes mellitus(DM)after cardiovascular disease,eye disease,neuropathy,nephropathy,and peripheral vascular *** can worsen the virulence and invasiveness of pathogenic oral microbial flora aggravating the local inflammation and infection in those with periodontal *** the other hand,the chemical and immunological mediators released into the circulation as part of periodontal inflammation worsen the systemic insulin resistance with worsening of *** if undiagnosed or left untreated can also result in eventual tooth loss.A study by Xu et al in the World Journal of Diabetes examined the predictive factors associated with periodontitis in Chinese patients with *** prevalence of periodontitis was found to be 75.7%in this *** on logistic regression analysis,the predictive factors for higher risk were low tooth brushing frequency[odds ratio(OR)=4.3],high triglycerides(TG;OR=3.31),high total cholesterol(TC;OR=2.87),higher glycated hemoglobin(HbA1c;OR=2.55),and higher age(OR=1.05)while higher education level was protective(OR=0.53).However,the most influential variables were HbA1c followed by age,TC,TG,low education level,brushing frequency,and sex on the random forest model(this model showed higher sensitivity for predicting the risk).A good understanding of the predictors for periodontitis in T2DM patients is important in prevention,early detection of susceptible patients,and intervention to improve periodontal health and enable long-term glycaemic control as observed by Xu et al.

关键词： Diabetes mellitus Periodontitis Predictive factors Cardiovascular disease Glycaemic control

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