目的:观察前弹力层下角膜磨镶术(sub-Bowman's keratomileusis,SBK)术中应用板层角膜刀制作的角膜瓣特点及相关影响因素。方法:用Moria One Use-Plus SBK板层角膜刀对98例196眼进行手术,预设角膜瓣厚度为100μm,术中用A型超声测量...目的:观察前弹力层下角膜磨镶术(sub-Bowman's keratomileusis,SBK)术中应用板层角膜刀制作的角膜瓣特点及相关影响因素。方法:用Moria One Use-Plus SBK板层角膜刀对98例196眼进行手术,预设角膜瓣厚度为100μm,术中用A型超声测量角膜瓣厚度,分析角膜瓣的均匀性、稳定性及相应的瓣并发症,并与预设角膜瓣厚度进行差异性分析,与术前等效球镜、角膜直径、角膜厚度、角膜中央最大K值等进行相关性分析。结果:实际角膜瓣平均厚度为100.96±5.35μm,先做眼(左眼)平均角膜瓣厚度103.56±5.22μm,后做眼(右眼)平均角膜瓣厚度98.12±5.50μm,两组差异有统计学意义(t=2.36,P<0.05)。角膜瓣的均匀性良好,各眼角膜中心、鼻侧、颞侧和上下方距中心3mm处角膜厚度无统计学差异(F=0.438,P>0.05)。实际角膜瓣厚度与患者术前中央角膜厚度(r=0.312,P<0.05)、角膜中央最大K值(r=0.452,P<0.01)呈正相关,与术前等效球镜、角膜直径等无明显相关性。常见制瓣并发症为上方瓣缘出血(34眼)、根部瓣缘粗糙(38眼)以及微小皱褶(25眼),未见其他严重并发症。结论:SBK术中机械板层角膜刀制作角膜瓣厚度均匀,预测性好,瓣相关并发症少,角膜瓣厚度与术前中央角膜厚度及角膜中央最大K值呈正相关。展开更多
AIM: To compare the morphologic characteristics between thin-flap laser in situkeratomileusis (LASIK) and Sub-Bowman keratomileusis (SBK), and to evaluate the uniformity of flap and to explore the correlative factors ...AIM: To compare the morphologic characteristics between thin-flap laser in situkeratomileusis (LASIK) and Sub-Bowman keratomileusis (SBK), and to evaluate the uniformity of flap and to explore the correlative factors of corneal flap thickness. METHODS: A prospective, randomized, comparative clinical study was performed in Department of Ophthalmology, West Hospital of China, Chengdu, Sichuan Province, China. Totally 59 patients 114 eyes underwent LASIK or SBK to correct myopia, 29 patients 57 eyes underwent SBK, 30 patients 57 eyes underwent LASIK. Anterior optical coherence tomography (OCT) was used to measure corneal flap thickness in all the patients 1 week after surgeries, 16 positions were set to be measured in each eye. Comparisons of flap thickness in each group and between 2 groups were evaluated. Correlative factors of flap thickness were evaluated. RESULTS: Coefficient of variation(CV, s/((X) over bar)x%)in SBK group were lesser than that in LASIK group, ttest showed there was significant statistical difference between 2 groups (P=0.000). Comparisons of the difference of 2 paired positions (temporal-nasal; superior-inferior) showed there were no significant differences in each group, but between 2 groups, there were statistical significance of value of difference (D-value) of superior and inferior positions between SBK and LASIK group (P =0.036). Linear regression analysis of correlative factors of flap thickness showed there were no statistic significances related to central corneal thickness(CCT) (P =0.060, t=1.921)and corneal curvature( P=0.083, t=1.766). CONCLUSION: SBK is better than LASIK in a-eating much uniform corneal flap. There was no evidence showing correlations between flap thickness and CCT or corneal curvature.展开更多
Introduction: Noma is a severe and mutilating gangrenous stomatitis of the orofacial sphere, starting on periodontal side. It is rare and occurs mainly in children that land is weakened by malnutrition. We report a ca...Introduction: Noma is a severe and mutilating gangrenous stomatitis of the orofacial sphere, starting on periodontal side. It is rare and occurs mainly in children that land is weakened by malnutrition. We report a case of mandibular sequela noma requiring plastic surgery. Clinical case: This was a 7-year-old patient with moderate acute malnutrition. She was referred from a peripheral care facility for gangrene of the left cheek, communicating the oral cavity with the outside, through an orostoma. This lesion had been evolving for two months, with a tendency towards progressive destruction of the soft tissues of the cheek and the mandibular bone. The neck and facial CT-Scan demonstrated destruction of the mandibular bone exposed on the left side, without signs of tumor invasion. After correction of nutritional status and local infection, the patient was treated with a metal plate recovered by sub-mental flap. Conclusion: Noma is a severe gangrenous stomatitis that transforms patients’ faces into ghosts by destroying soft tissues and underlying bone planes. The management of his sequelae is surgical, sometimes using complex techniques of plastic surgery.展开更多
文摘目的:观察前弹力层下角膜磨镶术(sub-Bowman's keratomileusis,SBK)术中应用板层角膜刀制作的角膜瓣特点及相关影响因素。方法:用Moria One Use-Plus SBK板层角膜刀对98例196眼进行手术,预设角膜瓣厚度为100μm,术中用A型超声测量角膜瓣厚度,分析角膜瓣的均匀性、稳定性及相应的瓣并发症,并与预设角膜瓣厚度进行差异性分析,与术前等效球镜、角膜直径、角膜厚度、角膜中央最大K值等进行相关性分析。结果:实际角膜瓣平均厚度为100.96±5.35μm,先做眼(左眼)平均角膜瓣厚度103.56±5.22μm,后做眼(右眼)平均角膜瓣厚度98.12±5.50μm,两组差异有统计学意义(t=2.36,P<0.05)。角膜瓣的均匀性良好,各眼角膜中心、鼻侧、颞侧和上下方距中心3mm处角膜厚度无统计学差异(F=0.438,P>0.05)。实际角膜瓣厚度与患者术前中央角膜厚度(r=0.312,P<0.05)、角膜中央最大K值(r=0.452,P<0.01)呈正相关,与术前等效球镜、角膜直径等无明显相关性。常见制瓣并发症为上方瓣缘出血(34眼)、根部瓣缘粗糙(38眼)以及微小皱褶(25眼),未见其他严重并发症。结论:SBK术中机械板层角膜刀制作角膜瓣厚度均匀,预测性好,瓣相关并发症少,角膜瓣厚度与术前中央角膜厚度及角膜中央最大K值呈正相关。
文摘AIM: To compare the morphologic characteristics between thin-flap laser in situkeratomileusis (LASIK) and Sub-Bowman keratomileusis (SBK), and to evaluate the uniformity of flap and to explore the correlative factors of corneal flap thickness. METHODS: A prospective, randomized, comparative clinical study was performed in Department of Ophthalmology, West Hospital of China, Chengdu, Sichuan Province, China. Totally 59 patients 114 eyes underwent LASIK or SBK to correct myopia, 29 patients 57 eyes underwent SBK, 30 patients 57 eyes underwent LASIK. Anterior optical coherence tomography (OCT) was used to measure corneal flap thickness in all the patients 1 week after surgeries, 16 positions were set to be measured in each eye. Comparisons of flap thickness in each group and between 2 groups were evaluated. Correlative factors of flap thickness were evaluated. RESULTS: Coefficient of variation(CV, s/((X) over bar)x%)in SBK group were lesser than that in LASIK group, ttest showed there was significant statistical difference between 2 groups (P=0.000). Comparisons of the difference of 2 paired positions (temporal-nasal; superior-inferior) showed there were no significant differences in each group, but between 2 groups, there were statistical significance of value of difference (D-value) of superior and inferior positions between SBK and LASIK group (P =0.036). Linear regression analysis of correlative factors of flap thickness showed there were no statistic significances related to central corneal thickness(CCT) (P =0.060, t=1.921)and corneal curvature( P=0.083, t=1.766). CONCLUSION: SBK is better than LASIK in a-eating much uniform corneal flap. There was no evidence showing correlations between flap thickness and CCT or corneal curvature.
文摘Introduction: Noma is a severe and mutilating gangrenous stomatitis of the orofacial sphere, starting on periodontal side. It is rare and occurs mainly in children that land is weakened by malnutrition. We report a case of mandibular sequela noma requiring plastic surgery. Clinical case: This was a 7-year-old patient with moderate acute malnutrition. She was referred from a peripheral care facility for gangrene of the left cheek, communicating the oral cavity with the outside, through an orostoma. This lesion had been evolving for two months, with a tendency towards progressive destruction of the soft tissues of the cheek and the mandibular bone. The neck and facial CT-Scan demonstrated destruction of the mandibular bone exposed on the left side, without signs of tumor invasion. After correction of nutritional status and local infection, the patient was treated with a metal plate recovered by sub-mental flap. Conclusion: Noma is a severe gangrenous stomatitis that transforms patients’ faces into ghosts by destroying soft tissues and underlying bone planes. The management of his sequelae is surgical, sometimes using complex techniques of plastic surgery.
