Twenty-Year Follow-Up of Excimer Laser Photorefractive Keratectomy: A Retrospective Observational Study

Background:It remains unclear whether self-regulated exercise is sufficient to maintain the benefits acquired during formal cardiac rehabilitation (CR). This retrospective observational study investigated the effects of a home-based exercise intervention after discharge from CR upon anthropometric and aerobic capacity markers in clinically stable patients.Methods:Fifty patients with cardiovascular disease were discharged after 6 months of CR and encouraged to maintain aerobic exercise without supervision. Subsequent to 6 months of follow-up, patients were assigned to compliant (n = 34) or noncompliant (n = 16) groups according to their compliance to the home-based program. Maximal aerobic capacity (VO2peak) and anthropometric data were assessed before CR, at discharge, and after 6 months of follow-up.Results:No statistical differences between compliant and noncompliant groups were observed at baseline and at discharge from CR. At the end of the follow-up, statistical differences across groups were not found for body mass or body mass index, but increases in VO2peak (+3.6 vs. –0.6 ml/kg·min, P = 0.004) and oxygen pulse (+1.5 vs. +0.2 ml/bpm, P = .03) were greater in compliant than noncompliant group.Conclusions:Self-regulated exercising following CR discharge seems to be effective to maintain gains in exercise capacity acquired during supervised center-based programs.

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Anemia and the use of antihypertensive medications in hemodialysis patients: multicenter retrospective observational study

Ukrainian Journal of Nephrology and Dialysis ◽

10.31450/ukrjnd.1(61).2019.04 ◽

2019 ◽

pp. 29-38

Author(s):

N. Stepanova ◽

V. Novakivskyy ◽

L. Snisar ◽

M. Kutsenko

Keyword(s):

Observational Study ◽

Cox Regression ◽

Erythropoietin Receptor ◽

Retrospective Observational Study ◽

Antihypertensive Medications ◽

Increased Risk ◽

Interest Statement ◽

The Impact ◽

Anemia Treatment

Abstract. We hypothesized that the use of antihypertensive medications in patients treated by hemodialysis (HD) may interfere with the activity of erythropoietin and leads to an increase in the dose of erythropoiesis stimulating agents (ESAs). The aim of our study was to analyze the impact of antihypertensive medications on the effectiveness of anemia treatment. Methods. We conducted a multicenter retrospective observational study. The archival medical data from 379 patients treated by HD or hemodiafiltration (HDF) were used. The medical records of 142 patients were excluded from the study. The study group consisted of 237 patients: 108 (45.6%) women and 129 (54.4%) men, with an average age of 54 [41-62.5] years. Results. The analysis of the mean hemoglobin (Hb) stratified by the administration of antihypertensive medications in the dynamics of dialysis treatment demonstrated a significant impact of angiotensin-converting enzyme (ACE) inhibitors (F = 3.97; p = 0.048) and amlodipine (F = 6.9; p = 0.01) on the effectiveness of anemia correction. The significant effect of amlodipine on the need to increase the dosage of iron-containing medications (OR = 3.9; 95% CI (1.27-12.06), p = 0.002; RR = 1.9 95% CI (1.27-2.9) and continuous erythropoietin receptor activator (CERA) (OR = 5.2, 95% CI (1.2-24.4), p = 0.03; RR = 1.3 95% CI (1, 08-1.6), p = 0.006) weas showed by logistic regression analysis. The increased risk of failure to achieve of the target Hb level in HD patients received amlodipine was confirmed by Cox regression model (HR = 2.7 (95% CI 1.5-4.7)). Conclusions: The results of our study demonstrated a significant increase in the frequency of appointment and amount of anti-anemia therapy in HD patients when amlodipine is co-administered. Follow-up studies to determine the effect of amlodipine mechanism for anemia will avoid unreasonable prescriptions for the treatment of НD patients. Conflict of interest statement: the authors declared no competing interests.

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Comparison of refractive outcomes after photorefractive keratectomy with different optical zones using Mel 90 excimer laser

10.21203/rs.2.10534/v5 ◽

2020 ◽

Author(s):

Dae Hwan Shin ◽

Yong Woo Lee ◽

Ji Eun Song ◽

Chul Young Choi

Keyword(s):

Excimer Laser ◽

Corneal Thickness ◽

Ablation Depth ◽

Photorefractive Keratectomy ◽

Q Value ◽

Thickness Change ◽

Refractive Outcomes ◽

Significant Difference ◽

Optical Zone

Abstract Background: A larger optical zone for photorefractive keratectomy may improve optical quality and stability. However, there is need for limiting ablation diameter in that a larger ablation diameter requires greater ablation depth, and minimizing ablation depth may reduce adverse effects on postoperative wound healing, haze and keratoectasia. In this study, we compared the changes in clinical outcomes and the degree of regression between a 6.0 mm optical zone and 6.5 mm optical zone following PRK. Methods: The records of 95 eyes that had undergone PRK with a 6.0 OZ ( n = 40) and a 6.5 OZ ( n = 55) were retrospectively reviewed. We compared data including the spherical equivalent of manifest refraction (SE of MR), simulated K (Sim K), thinnest corneal thickness, change in thinnest corneal thickness (the initial value divided by corrected diopter [ΔTCT/CD]), Q value, corneal higher order aberrations (HOAs) and spherical aberration (SA) pre-operation, at 3 and 6 months postoperative and at the last follow-up visit (Mean; 20.71 ± 10.52, 17.47 ± 6.57 months in the 6.0 and 6.5 OZ group, respectively). Results: There were no significant differences in the SE of MR, Sim K and UDVA between the 6.0 OZ group and the 6.5 OZ group over 1 year of follow-up after PRK, and the 6.0 OZ group required less ΔTCT/CD than the 6.5 OZ group. The 6.5 OZ group showed better results in terms of post-operative HOAs of RMS, SA and Q value. When comparing that pattern of change in Sim K, there was no significant difference between the 6.0 OZ group and the 6.5 OZ group. Conclusions: The clinical refractive outcomes and regression after PRK using Mel 90 excimer laser with a 6.0 OZ were comparable to those with a 6.5 OZ.

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Outcomes of Wavefront-Optimized Laser-Assisted In-Situ Keratomileusis and Photorefractive Keratectomy for correction of Myopia and Myopic Astigmatism over One Year Follow-Up

The Open Ophthalmology Journal ◽

10.2174/1874364101812010256 ◽

2018 ◽

Vol 12 (1) ◽

pp. 256-263 ◽

Cited By ~ 1

Author(s):

Mohammad M. Shehadeh ◽

Mohammad T. Akkawi ◽

Ammar A. Aghbar ◽

Muna T. Musmar ◽

Malak N Khabbas ◽

...

Keyword(s):

Visual Acuity ◽

Excimer Laser ◽

Photorefractive Keratectomy ◽

Distance Visual Acuity ◽

Visual Outcomes ◽

Corrected Distance Visual Acuity ◽

One Year ◽

Myopic Astigmatism

Background: Laser corneal refractive surgery suits, technology and nomograms are improving with time. This may improve the refractive and visual outcomes of the patients. Objectives: To evaluate the safety, efficacy, stability, and predictability of wavefront-optimized photorefractive keratectomy and Laser-assisted in-situ keratomileusis in patients with myopia and myopic astigmatism over 1-year using WaveLight® EX500 Excimer Laser machine. Methods: In this prospective cohort study, refractive and visual outcomes in 596 eyes (365 patients), either having myopia or myopic astigmatism were assessed. Patients were divided into Two groups: 1) Patients who underwent PRK (53 eyes have myopia and 217 eyes have myopic astigmatism), 2) Patients who underwent LASIK (53 eyes have myopia and 273 eyes have myopic astigmatism). Results: At 12 months postoperatively 94.3% of the myopic patients reached their preoperative best corrected distance visual acuity at the final one year follow up visit post PRK and LASIK. In patients with myopic astigmatism who underwent LASIK and PRK, 95.2%, and 96.3% of the patients reached their preoperative best corrected distance visual acuity at the final one year follow up visit post LASIK and PRK, respectively. The efficacy and safety indices were 1.00 or more for all groups with no eye lost any line of best corrected distance visual acuity. Conclusion: Our study results confirm the excellent efficacy, safety, good predictability and stability of myopia / myopic astigmatism correction by either wavefront- optimized LASIK or PRK over 1-year follow-up without significant differences between them using the WaveLight® EX500 excimer laser system.

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Photoreceptor morphology and correlation with subretinal fluid chronicity associated with choroidal nevus

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2019-314755 ◽

2019 ◽

Vol 104 (6) ◽

pp. 863-867 ◽

Cited By ~ 2

Author(s):

Antonio Yaghy ◽

Michael D Yu ◽

Lauren A Dalvin ◽

Mehdi Mazloumi ◽

Sandor R Ferenczy ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Observational Study ◽

Subretinal Fluid ◽

Retrospective Observational Study ◽

Optical Coherence ◽

Progressive Change ◽

Choroidal Nevus ◽

Over Time ◽

Choroidal Nevi

BackgroundSubretinal fluid (SRF) can be associated with choroidal nevus and can cause progressive change in the morphology of overlying photoreceptors.MethodsA retrospective observational study was performed using optical coherence tomography to assess nevus and SRF features, as well as photoreceptor morphology over time.ResultsThere were 232 choroidal nevi that presented with or developed SRF. Photoreceptor morphology at presentation was classified as normal (n=60, 26%), shaggy (elongated) (n=73, 31%), retracted (stalactite appearance) (n=76, 33%), or absent (n=23, 10%). There was a progression in photoreceptor morphology with increasing SRF chronicity (p=0.003). For nevus presenting with normal photoreceptors and later developed SRF (n=60), photoreceptors became shaggy in 29 (48%), retracted in 24 (40%), and absent in 7 (12%) after 15, 19 and 22 months, respectively. For nevus presenting with SRF and shaggy photoreceptors (n=73), progression to retracted photoreceptors occurred in 31 (42%) after a mean of 22 months; for nevus with SRF and retracted photoreceptors (n=76), progression to absent photoreceptors occurred in 19 (25%) after a mean of 34 months; and for nevus with absent photoreceptors (n=23), photoreceptor morphology showed no change after mean follow-up of 33 months. Risk of nevus growth to melanoma was not associated with photoreceptor morphology at presentation (p=0.19).ConclusionIn eyes with choroidal nevus and SRF, there is a longitudinal evolution in photoreceptor morphology from normal to shaggy to retracted then absent with increasing SRF chronicity. SRF chronicity, as indicated by photoreceptor morphology on presentation, did not correlate with nevus growth to melanoma.

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