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Intraocular lens power calculations in patients with extreme myopia

JOURNAL OF CATARACT AND REFRACTIVE SURGERY 2000年第5期26卷 668-674页

作者： Zaldivar, R Shultz, MC Davidorf, JM Holladay, JT Inst Zaldivar RA-5500 Mendoza Argentina Dept Texas Med Sch Houston TX USA

Purpose: To determine the variables that might contribute to improved intraocular lens (IOL) power calculations preoperatively in cataract patients with extreme myopia. Methods: This retrospective study included 50 patients with extreme myopia and axial lengths longer than 27.0 mm. All patients had clear corneal phacoemulsification by the same surgeon and implantation of the Domilens SiFlex 1 IOL (power range -6.0 to +5.0 diopters [D]). The performances of the SRK/T, Hoffer Q, Holladay 1, and Holladay 2 formulas in predicting an IOL power that would meet the target refraction of +/- 1.00 D were compared. Results: The formulas tended to suggest underpowered IOLs, more severe in eyes with axial lengths greater than 30.00 mm. These eyes accounted for most of the minus-power IOLs implanted, Back calculations of axial lengths in patients with minus-power IOLs showed that, on average, emmetropia could have been predicted by choosing shorter axial lengths (up to 2.72 mm shorter) than those used in the original IOL power calculations. Preoperative B-scan ultrasonography demonstrated the presence of a staphyloma temporal to the optic nerve in several patients who required IOLs, which suggests that axial length measurement problems were a of IOL calculation errors in these patients. Conclusions: In eyes with axial lengths longer than or equal to 27.0 mm, current third- and fourth-generation lens calculation formulas have a tendency to over minus patients between -1.0 and -4.0 D. The formulas appear to perform better for plus-power IOL implantation than for minus-power IOL implantation. The use of B-scan ultrasonography to locate posterior pole staphylomas may improve the accuracy of IOL calculations in eyes with extreme myopia. J Cataract Refract Surg 2000;26:668-674 (C) 2000 ASCRS and ESCRS.

关键词：调节眼角膜/外科学扩张病理性/诊断扩张病理性/诊断显像眼/诊断显像眼/病理学晶体植入眼内晶体人工数学近视/并发症近视/外科学光学和光子学超声乳化白内障吸除术屈光眼回顾性研究超声检查视敏度人类

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Ultrasonographic measurement of induced myopia associated with capsular bag distention syndrome

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OPHTHALMOLOGY 2000年第5期107卷 902-908页

作者： Sorenson, AL Holladay, JT Kim, T Kendall, CJ Carlson, AN Univ Texas Houston TX USA Innovat Imaging Inc Sacramento CA USA Duke Univ Ctr Eye Durham NC USA

Objective: To determine the causes of postoperative myopia associated with capsular bag distention syndrome (CBDS) and characterize the associated findings. Design: Prospective, multicenter, nonrandomized, comparative (self-controlled) trial. Participants: Six eyes from six patients had CBDS develop after phacoemulsification and posterior chamber intraocular lens implantation. Methods: Keratometric values, axial length, visual acuity, and manifest refraction were assessed in each eye. Using 20-MHz ((ISYSTEM)-S-3-ABD, Innovative Imaging Inc, Sacramento, CA) and 50-MHz (Ultrasound Biomicroscope, Zeiss Humphrey Systems, Dublin, CA) ultrasonographic probes, images and measurements of the anterior segment were obtained. After neodymium:yttrium-aluminum-garnet (Nd:YAG) capsulotomy, these measures were repeated and correlated with predicted and actual refractive changes. Main Outcome Measures: Uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), manifest refraction, and anterior chamber depth before and after treatment of CBDS. Results: Although intended postoperative refraction averaged -0.58 diopters (D) (range, -0.12 to -1.63 D), eyes with CBDS had an average spherical equivalent refraction of -2.35 D (range, +0.13 to -4.50 D), P < 0.05 (one-tailed, paired t test). BCVA averaged 20/24 (range, 20/15-20/40-1), but UCVA averaged 20/133 (range, 20/60 to 20/400). Average distance from the corneal surface to the anterior intraocular lens (IOL) optic surface was 3.55 mm in eyes with CBDS, and 4.30 mm after Nd:YAG capsulotomy. Posterior movement of theIOL optic after capsulotomy accounted for 1.23 D of hyperopic shift or 82% of the CBDS-induced myopia. Treatment of CBDS resulted in both improved UCVA and BCVA. Nd:YAG capsulotomy also released the colloidal suspension within the capsular bag posterior to theIOL optic. The incidence of CBDS was 0.3% in one of the practices reviewed. Conclusions: Capsular bag distention syndrome includes unexpected myopia and poo

关键词：前房/诊断显像前房/病理学晶体囊撕裂术/副作用扩张病理性/诊断显像扩张病理性/病因学晶体囊/诊断显像晶体囊/病理学晶体囊/外科学晶体疾病/诊断显像晶体疾病/病因学晶体疾病/外科学晶体植入眼内/副作用近视/诊断显像近视/病因学超声乳化白内障吸除术/副作用前瞻性研究屈光眼综合征超声检查视敏度老年人老年人 80以上人类婴儿新生中年人

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Diagnosis of teat stenosis in dairy cattle by real-time ultrasonography

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VETERINARY RECORD 2000年第10期147卷 270-272页

作者： Dinç, DA Sendag, S Aydin, I Univ Selcuk Fac Vet Med Dept Obstet & Gynaecol TR-42079 Konya Turkey

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Early and intermediate-term complications of self-expanding stents limit its potential application in children with congenital heart disease

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JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY 2000年第4期35卷 1007-1015页

作者： Cheung, YF Sanatani, S Leung, MP Human, DG Chau, AKT Culham, JAG Univ Hong Kong Grantham Hosp Div Pediat Cardiol Dept Pediat 125 Wong Chuk Hang Rd Aberdeen Peoples R China British Columbia Childrens Hosp Div Pediat Cardiol Vancouver BC V6H 3V4 Canada

OBJECTIVES We report on the early and intermediate-term follow-up results of self-expanding Wallstent (Schneider, Switzerland) implanted in children with congenital heart disease. BACKGROUND The inherent shortcomings of balloon-expandable stents prompted the trial of an alternative stent. METHODS Twenty patients underwent 22 implantations of 25 self-expanding Wallstents between December 1993 and June 1997 in two institutions. The mean age and weight were 10.8 +/- 4.5 years and 30.5 +/- 14.2 kg, respectively. The patients were divided into two groups: 1) Group I comprised 17 patients with pulmonary arterial stenoses, 2) Group II comprised four patients with venous stenoses (one belonged to both groups). Sixteen patients underwent recatheterization at a median of 5.8 months (range 0.5 to 31, mean 8.1 months) after stenting. Hemodynamic and angiographic changes after the interventional procedures and complications were documented. RESULTS All the stents were successfully deployed in the intended position. In Group I, the narrowest diameter of the stented vessel increased from 4.1 +/- 1.5 to 8 +/- 2 mm (95% increase, p < 0.0001) while the systolic pressure gradient across decreased from 24.6 +/- 15.8 to 12.1 +/- 11.4 mm Hg (51% decrease, p = 0.001). In Group II, the dimensional changes of the narrowest segment increased from 4.3 +/- 0.5 to 7.5 +/- 0.4 mm (75% increase, p = 0.003), and the pressure gradient reduced from 5.0 +/- 2.9 to 0.9 +/- 1.0 mm Hg (82% decrease, p = 0.04) across the stented venous channel. Distal migration of two optimally positioned stents occurred within 24 h of implantation. At recatheterization, significant neointimal ingrowth (>30% of the expanded diameter) was noted in 7 (28%) of the 25 implanted stents. This responded poorly to balloon dilation. Predisposing factors for the neointimal ingrowth included stents of smaller diameter (<9 mm) and longer period after implantation. CONCLUSIONS Self-expanding Wallstent could be deployed easily and saf

关键词：血管造影术血管成形术气囊/仪器和设备缩窄病理性/诊断显像缩窄病理性/治疗设备失效分析随访研究心脏缺损先天性/诊断显像心脏缺损先天性/治疗血流动力学/生理学假体设计肺动脉/畸形肺动脉/诊断显像肺静脉闭塞性疾病/诊断显像肺静脉闭塞性疾病/治疗再治疗支架治疗结果青少年儿童儿童学龄前女(雌)性人类男(雄)性

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Ultrasonographic diagnosis of pericardial effusion and atrial dilation in a spur-thighed tortoise (Testudo graeca)

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VETERINARY RECORD 2000年第7期146卷 183-185页

作者： Redrobe, SP Scudamore, CL Univ Edinburgh Dept Vet Clin Studies Royal Dick Sch Vet Studies Easter Bush Vet Ctr Roslin EH25 9RG Midlothian Scotland Univ Edinburgh Dept Vet Pathol Royal Dick Sch Vet Studies Easter Bush Vet Ctr Roslin EH25 9RG Midlothian Scotland

Ultrasonography was used to diagnose pericardial effusion, atrial dilatation and liver masses in a spur-thighed tortoise which was more than 80 years old and suffering from posthibernation anorexia. lethargy. oedema and pneumonia. The tortoise was treated twice with frusemide and ceftazidime for the pneumonia, resulting each time in a temporary remission for about a month. After a further recurrence, the animal was euthanased and the lesions predicted by ultrasound were confirmed postmortem. It is suggested that ultrasound may be useful for the differentiation of cardiac problems from other causes of posthibernation lethargy in the tortoise.

关键词：厌食/病因学厌食/兽医学扩张病理性/诊断显像扩张病理性/兽医学心房/诊断显像心房/病理学冬眠心包积液/诊断显像心包积液/兽医学龟超声检查/兽医学动物男(雄)性

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Contrast-enhanced, three-dimensional power Doppler sonography for differentiation of adnexal masses

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OBSTETRICS AND GYNECOLOGY 2000年第3期96卷 452-458页

作者： Kupesic, S Kurjak, A Univ Zagreb Sch Med Dept Obstet & Gynecol Sveti Duh Hosp Zagreb 10000 Croatia

Objective: To investigate the potential usefulness of contrast-enhanced, three-dimensional power Doppler sonography in the differentiation of benign and malignant adnexal lesions. Methods: A total of 45 patients with complex adnexal lesions of uncertain malignancy at transvaginal B mode and/or color Doppler sonography were prospectively evaluated with three-dimensional power Doppler sonography before and after injection of contrast agent. Presence of a penetrating pattern and a mixed penetrating and peripheral pattern suggested adnexal malignancy. All the results were compared with histopathology. Results: There were 12 cases of ovarian malignancy and 33 benign adnexal lesions. Of the 12 ovarian cancers, seven (58.3%) showed vascular distribution suggestive of malignancy at nonenhanced three-dimensional power Doppler sonography. After injection of contrast agent, a penetrating vascular pattern and/or a mixed penetrating and peripheral pattern were detected in all cases of ovarian malignancy. One cystadenofibroma demonstrated penetrating vessels at initial scan, whereas two benign lesions (fibroma and cystadenofibroma) were misdiagnosed as malignant at contrast-enhanced, three-dimensional power Doppler sonography. The use of a contrast agent with three-dimensional power Doppler sonography showed diagnostic efficiency (95.6%) that was superior to that of nonenhanced three-dimensional power Doppler sonography (86.7%). Conclusion: Contrast-enhanced, three-dimensional power Doppler sonography provides better visualization of tumor vascularity in complex adnexal masses. If used together with three-dimensional morphologic ultrasound assessment, enhanced three-dimensional power Doppler imaging might precisely discriminate benign from malignant adnexal lesions. (Obstet Gynecol 2000;96:452-8. (C) 2000 by The American College of Obstetricians and Gynecologists.).

关键词：血流速度/生理学造影剂诊断鉴别图像增强图像处理计算机辅助新生血管化病理性/诊断显像卵巢肿瘤/血液供给卵巢肿瘤/诊断显像卵巢/诊断显像多糖类试验预期值超声检查多普勒成年人老年人女(雌)性人类中年人

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Gynecology

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ULTRASOUND IN MEDICINE AND BIOLOGY 2000年第Sup1期26卷 S90-S91页

作者： Hsieh, FJ Natl Taiwan Univ Hosp Dept Obstet & Gynecol Taipei Taiwan

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Breast

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ULTRASOUND IN MEDICINE AND BIOLOGY 2000年第Sup1期26卷 S110-S115页

作者： Cosgrove, DO Eckersley, RJ Hammersmith Hosp Imperial Coll Sci Technol & Med Sch Med Dept Imaging London W12 0NN England

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Narrowing of the superior vena cava-right atrium junction during radiofrequency catheter ablation for inappropriate sinus tachycardia: Analysis with intracardiac echocardiography

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JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY 1999年第6期33卷 1667-1670页

作者： Callans, DJ Ren, JF Schwartzman, D Gottlieb, CD Chaudhry, FA Marchlinski, FE Allegheny Univ Hosp Clin Electrophysiol Lab MCP Div Philadelphia PA USA Allegheny Univ Hosp Clin Electrophysiol Lab Hahnemann Div Philadelphia PA USA

OBJECTIVES The study explored the potential for tissue swelling and venous occlusion during radiofrequency (RF) catheter ablation procedures using intracardiac echocardiography (ICE). BACKGROUND Transient superior vena cava occlusion has been reported following catheter ablation procedures for inappropriate sinus tachycardia (IST). Presumably, venous occlusion could occur owing to thrombus formation or tissue swelling with resultant narrowing of the superior vena cava-right atrial (SVC-RA) junction. METHODS Intracardiac echocardiography (9 MHz) was used to guide ablation catheter position and for continuous monitoring during RF application in 13 ablation procedures in 10 patients with IST. The SVC-RA junction was measured prior to and following ablation. Successful ablation was marked by abrupt reduction in the sinus rate and a change to a superiorly directed p-wave axis. RESULTS Eleven of 13 procedures were successful, requiring 29 +/- 20 RF lesions. Prior to the delivery of RF lesions, the SVC-RA. junction measured 16.4 +/- 2.9 mm. With RF delivery, local and circumferential swelling was observed, causing progressive reduction in the diameter of the SVC-RA junction to 12.6 +/- 3.3 mm (24% reduction, p = 0.0001). A reduction in SVC-RA orifice diameter of greater than or equal to 30% compared to baseline was observed in five patients. CONCLUSIONS The delivery of multiple RF ablation lesions, often necessary for cure of IST, can cause considerable atrial swelling and resultant narrowing of the SVC-RA junction. Smaller venous structures, such as the coronary sinus and the pulmonary veins, would also be expected to be vulnerable to this complication. Thus, ICE imaging may be helpful in preventing excessive tissue swelling leading to venous occlusion during catheter ablation procedures. (C) 1999 by the American College of Cardiology.

关键词：导管消融术/仪器和设备缩窄病理性/诊断显像缩窄病理性/预防和控制缩窄病理性/外科学超声心动描记术/仪器和设备腔内超声检查/仪器和设备设备设计心房/诊断显像心房/外科学图像处理计算机辅助/仪器和设备手术中并发症/诊断显像手术中并发症/预防和控制手术中并发症/外科学监测手术中/仪器和设备危险因素外科器械换能器腔静脉上/诊断显像腔静脉上/外科学成年人女(雌)性人类男(雄)性中年人

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Preoperative assessment of congenital bile duct dilatation using intraductal US

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GASTROINTESTINAL ENDOSCOPY 1999年第4期49卷 488-492页

作者： Tamada, K Yasuda, Y Tomiyama, T Oohashi, A Kanai, N Aizawa, T Wada, S Tano, S Miyata, T Satoh, Y Ido, K Kimura, K Jichi Med Sch Dept Gastroenterol Yakushiji Tochigi 3290498 Japan Jichi Med Sch Dept Surg Yakushiji Tochigi 3290498 Japan Jichi Med Sch Dept Pathol Yakushiji Tochigi 3290498 Japan

Background: Although congenital bile duct dilatation is frequently associated with biliary tract cancer, conventional cholangiography often does not demonstrate small ductal tumors. This is the first prospective study of the value of intraductal ultrasonography (US) in the examination of the extrahepatic bile ducts in patients with congenital bile duct dilatation. Methods: Intraductal US via a transpapillary route was used in consecutive patients with congenital bile duct dilatation. A 2.0 mm diameter, 20 MHz frequency catheter probe was used. The images were correlated with the results of histologic examination of the resection specimens. Results: Intraductal US was performed successfully via the transpapillary route in 8 of 10 patients. In the other 2 patients, the percutaneous transhepatic route was used. In the 6 patients with cylindrical dilatation, intraductal US demonstrated the entire extrahepatic bile duct. In 1 patient, it showed a bile duct cancer not demonstrated by cholangiography. In 2 of the 4 patients with cystic dilatation, intraductal US did not demonstrate the entire extrahepatic bile duct because of the low penetration depth of the probe. Percutaneous transhepatic cholangioscopy was required in these patients. Conclusions: Intraductal US is useful for demonstrating cancers in the extrahepatic bile ducts in patients with congenital cylindrical ductal dilatation.

关键词：胆管疾病/并发症胆管疾病/先天性胆管疾病/诊断显像胆管肿瘤/并发症胆管肿瘤/诊断显像胆管肝外/诊断显像扩张病理性/并发症扩张病理性/先天性扩张病理性/诊断显像腔内超声检查前瞻性研究成年人女(雌)性人类男(雄)性

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