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Extensive Descemet's membrane detachment (DMD) is a rare but potentially serious complication of cataract surgery.1 Sometimes, the diagnosis may be difficult because corneal oedema can obscure visualisation of the Descemet's membrane.2 If a larger or more progressive detachment results in corneal opacification and is responsible for loss of vision, many doctors have favoured early surgical intervention.3 In this report, we describe a method of anterior segment optical coherence tomography (OCT)-guided aqueous fluid drainage and intracameral air injection for treatment of DMD in three patients. Three patients, who had cataract extraction with intra-ocular lens implantation, were referred to us from three other hospitals. Case 1 (a 70-year-old man) had received manual uneventful small incision cataract surgery 15 days earlier. Case 2 (a 64–year-old man) had clear corneal phacoemulsification for treatment of acute primary closed angle glaucoma combined with intumescent cataract. The surgeon realised the occurrence of DMD at the first day after surgery and intracameral air was injected partially filling the anterior chamber. On the fourth postoperative day, corneal oedema became more generalised. Case 3 (a 71-year-old man) had clear corneal phacoemulsification …

Two three-piece hydrophobic acrylic intraocular lenses (IOLs) were explanted from two patients at 7 and 9 years, respectively, after implantation, because of poor fundus visualisation and/or a clinically significant decrease in visual acuity related to their opacified IOLs. In addition to light microscopy, scanning electron microscopy and energy dispersive X-ray spectroscopy, confocal laser scanning microscopy was used for the first time to observe the explanted IOLs. The clinical aspect seemed to correspond to the phenomenon of surface light scattering, while laboratory analyses showed dense glistenings in the central layer of the IOL optic, which had no change next to the surface. Further studies on these phenomena are needed.

Objective To compare tumor characteristics and clinical outcome of patients with cervical locally advanced adenocarcinoma (AC)/adenosquamous carcinoma (ASC) and squamous cell carcinoma (SCC). Design Retrospective study. Setting National Taiwan University Hospital, Taipei, Taiwan. Population All patients with cervical SCC (n = 35), AC or ASC (n = 194) with FIGO stage ≥IIB who received definitive radiotherapy or concurrent chemoradiotherapy (CCRT) from January 1995 to December 2009. Method Medical and histopathological record review. Main outcome measures Progression-free survival (PFS), local recurrence-free survival, distant metastasis-free survival, and overall survival (OS). Results Compared with the SCC subgroup, patients with AC/ASC were significantly younger (p = 0.007), more of them without clinical symptoms were diagnosed by abnormal Pap smear findings (p = 0.043), and less responded to treatment (p = 0.018). After a median follow-up of 59.3 months, patients with AC/ASC had worse 5-year PFS (30.0% vs. 47.6%, p = 0.044), worse 5-year distant metastasis-free survival (41.5% vs. 69.9%, p = 0.005), and trends toward worse 5-year local recurrence-free survival (64.4% vs. 76.2%, p = 0.165) and worse 5-year OS (41.3% vs. 58.1%, p = 0.090) than patients with SCC. In univariate analysis, early FIGO stage and complete treatment response were significantly associated with PFS and OS. Histology of non-AC/ASC and Point A biologically equivalent doses in 2-Gy fractions >85 Gy were significantly associated with better PFS, and CCRT was significantly associated with better OS. In multivariate analysis, complete treatment response and early FIGO stage remained significant factors for predicting better PFS and OS. Conclusions Cervical AC/ASC may be more aggressive than is SCC. For cervical AC/ASC, more comprehensively effective treatments are warranted.

To compare the clinical performances of patients in different ages with implantation of a accommodating IOLs.It was a retrospective study. Forty-seven eyes (47 patients) were enrolled in 3 groups for phacoemulsification and a accommodating IOL implantation. According to their ages, they were divided into 3 groups: ≤ 45 years, 46 - 59 years, and ≥ 60 years. Parameters analyzed after more than 3 months postoperation were uncorrected distance, best-corrected distance, uncorrected near, and distance-corrected near visual acuities; changes of anterior chamber depth(ACD) during accommodative measured using the ultrasound biomicroscopy (UBM);changes of ACD by instilling 2% pilocarpine using the A-ultrasonic scan; and the amplitude of accommodation using the pushing-up test.No significant difference was observed between distance and near visual acuities of IOL groups. The mean changes of ACD measured with UBM in the group of ≤ 45 years [(0.16 ± 0.12) mm] was significantly higher than the other age groups [46 - 59 years, (0.06 ± 0.06) mm, P = 0.00; ≥ 60 years, (0.07 ± 0.05) mm, P = 0.008)]. The mean changes of ACD stimulated by pilocarpine measured with A-ultrasonic scan in the group of ≥ 60 years [(0.17 ± 0.14) mm] was significantly lower than the other age groups [≤ 45 years, (0.68 ± 0.44) mm, P = 0.00; 46 - 59 years, (0.43 ± 0.20) mm, P = 0.00]. The accommodative amplitude of the ≥ 60 years groups ((2.32 ± 0.88) D) was lower than the group of ≤ 45 years [(2.87 ± 0.52) D, P = 0.005].The accommodative amplitude of patients implanted with accommodating IOLs stepped down following the increase of age. However, no statistical differences were found in distance and near visual acuities between the different age groups.

AIM: To evaluate the etiologies, management, and outcomes of pediatric traumatic cataract in eastern China. METHODS:Pediatric traumatic cataract were reviewed for demographic information, type of injury, mode of injury, time of injury, interval between injury and first visiting doctors, hospital of first visiting, surgeries, complications and prognosis. RESULTS:A total of 117 eyes of 117 patients (96 boys and 21 girls) with unilateral injuries (66 right and 51 left eyes) were included in the study. The mean (SEM) age at diagnosis was (6.6±3.2) years (range, 1.3-13.8 years). Each cataract was categorized according to the type of trauma:closed-globe (n=26) or open-globe (n=91) injuries. The most common injuring objects were sharp metal objects (37.61%). The most common complication in open-globe injuries was corneal laceration, whereas traumatic mydriasis was most common in closed-globe injuries. Of 68 eyes in patients with open-globe injuries who received cataract extraction, intraocular lens (IOLs) were primarily implanted in 47 eyes (68.12%), whereas 18 eyes with closed-globe injuries received cataract extraction, and IOLs were primarily implanted in 17 eyes (94.4%). The surgical procedures included reconstruction of the anterior segment, synechiolysis, excision of the membrane, lensectomy, vitrectomy and related techniques. Postoperative vision was significantly improved compared with preoperative vision. CONCLUSION: Pediatric traumatic cataract should be treated in time to attenuate the complications, and education on pediatric traumatic cataract and improvements in pediatric health care are needed for the early detection of cataract in children.

To analyze the factors that influence the prediction error (PE) after intraocular lens (IOL) implantation in pediatric cataract.The medical records of cataract patients of no more than 14 years old who had primary IOL implantation were reviewed from 2006 to 2010. The PE, absolute value of PE (APE), and predictability between in different axial length, mean corneal curvature, corneal astigmatism, and age at the surgery were analyzed.Seventy-five children (119 eyes) were included, with a mean age of (5.09±2.54) years. At the follow-up of (1.19±0.69) months, the mean postoperative PE was (-0.22±1.12) D, and APE was (0.87±0.73)D. The PE in eyes with an axial length20mm but ≤22mm were significantly under-corrected than that in eyes with longer axis, and the APE in eyes with an axial length ≤20mm was more obvious compared with the others. The correlations between PE and axial length, as well as corneal astigmatism, and between APE and axial length were significant. The predictability was significantly poorer in the eyes with an axial length ≤20mm than the others.The axial length is closely related with the PE after IOL implantation in pediatric cataract patients, especially when it is ≤20mm, PE is more significant. The formula that is more suitable to very short axial length should be explored.

To analyze the cause of flexible open-loop anterior chamber intraocular lenses (AC-IOL) extraction and to evaluate the safety of these lenses implantation.This retrospective study comprised 28 patients (28 eyes) who had received open-loop AC-IOL extraction from 1999 to 2009 in our hospital. Several factors of these patients were analyzed, including the type of AC-IOL, primary disease, the intraocular duration of AC-IOL, the cause of AC-IOL extraction and therapeutic result.All of the AC-IOL used were modern flexible open-loop AC-IOL. Twenty one patients were implanted AC-IOL because of ocular trauma; the average intraocular duration of the AC-IOL was (6.1 ± 3.1) years. In the causes of AC-IOL extraction, bullous keratopathy was the most common cause, accounted for 42.9% (12/28); secondary glaucoma, retinal detachment and lens dislocation accounted for 32.1% (9/28), 17.9% (5/28) and 7.1% (2/28), respectively. In the 12 cases with bullous keratopathy, 6 cases just received AC-IOL extraction and the others received penetrate corneal transplantation. Six cases with secondary glaucoma received AC-IOL extraction combined with trabeculectomy.Bullous keratopathy and secondary glaucoma are the two most common causes for open-loop AC-IOL extraction. The patients who will receive AC-IOL implantation need an adequate selection and must be followed properly.

To study the conjunctival bacteria flora in eyes of patients undergoing cataract surgery and determine the efficacy of reducing conjunctival bacteria with different methods.A total of 135 eyes of 135 patients scheduled to undergo cataract surgery were randomized into 3 groups (45 each). They received topical prophylactic treatment with three different kinds of antibiotics (0.5% levofloxacin, 0.3% levofloxacin and 0.3% tobramycin). Each group was randomized into one-day group and three-day group. All the eyes underwent irrigation of fornices with 2.5% povidone-iodine (PVI) before surgery. Conjunctival cultures were obtained at various time points.The total positive rate of conjunctival cultures was 66.7%. The eliminating rate of conjunctival bacteria in one-day groups were 72.7%, 72.7% and 61.1% (P = 0.667) while 70.0%, 70.0% and 55.5% in the three-day groups respectively (P = 0.751). Immediately after PVI irrigation, the eliminating rate in one-day groups added up to 86.4%, 77.3% and 88.9% (P = 0.564) as compared with 90.0%, 80.0% and 66.7% in the three-day groups respectively (P = 0.749). And there was no statistically significant difference between one-day groups and three-day groups in the eliminating rate of conjunctival bacterial after the topical antibiotic application. The MIC test revealed that the antibiotic sensitivity of Gram-positive cocci (G(+)C) to levofloxacin was 94.8% versus 74.1% to tobramycin (P = 0.000) while the antibiotic sensitivity of Gram-negative bacillus (G(-)B) to levofloxacin was 94.4% versus 83.3% to tobramycin (P = 0.289).G(+)C accounts for the most among the conjunctival bacteria flora in eyes of patients undergoing cataract surgery and there is no statistically significant difference in the efficacy of reducing conjunctival bacteria between the application of topical antibiotic for one day and for three days. Both G(+)C and G(-)B retain a high sensitivity to levofloxacin. Topical antibiotic in combination with 2.5% PVI irrigation further reduces conjunctival bacteria.

To investigate the safety and efficacy of low-molecular-weight heparin drug delivery system (LMWH DDS) for prevention of posterior capsular opacification (PCO) in rabbit eyes.(1) To prepare the LMWH DDS by freeze-drying way with Polylactic-co-glycolic acid (PLGA) as the carrier, and evaluate its release properties in vitro. (2) Fifty New Zealand albino rabbits (50 eyes) undergoing phacoemulsification were equally divided into five groups: receiving normal saline eye drops (group A), 3 different dose (1 mg, 0.5 mg and 0.25 mg) of LMWH DDS respectively implanted into the posterior chamber (group B, C and D), and a carrier DDS implanted into the posterior chamber (group E). All the 50 eyes were examined by slit-lamp microscopy. The low-molecular-weight heparin levels in aqueous humor were measured, and the wet posterior capsules were weighed.The LMWH DDS prepared with a freeze-dried way has high encapsulation efficiency, and the equation of 49-day release curve fitting in vitro were were similar to zero order. The fibrin exudation in group B, C and D were lower than in Group A and E during the first postoperative day. There were 10, 2, 3, 9 and 10 eyes that developing PCO in the group A, B, C, D and E, respectively. The mean wet-weight of the posterior capsule were (114.59 +/- 14.58) mg, (24.14 +/- 6.08) mg, (39.23 +/- 17.13) mg, (99.35 +/- 29.37) mg, (115.29 +/- 19.87) mg respectively in 5 trial groups. There were stable and high concentration of low molecular weight heparin in aqueous of group B and C during the 4 weeks (20 mg/L), while a instable and lower concentrations in group D. The result of optical microscopy and electron microscopy examination indicated that fibroblast proliferation was quite active in groups A, D and E, but inactive in group B and C. Neither infiltration of inflammatory cells at the cornea, iris, trabecular meshwork and ciliary body nor retinal degeneration or necrosis was found in any group at 12 weeks. There was no intraocular bleeding in all the five groups in the following 12 weeks.The LMWH DDS prepared by freeze-drying way with PLGA as the carrier has good slow-release and biological tolerance. Implantation of LMWH DDS into the posterior chamber of experimental animals can significantly reduce postoperative fibrin exudation, and can safe and effective prevent the occurrence of PCO, and also there were some dose-effect relationship.

To describe the initial surgical experience and report the safety and feasibility of dry pars plana capsulotomy and anterior vitrectomy using a 25-gauge vitrectomy system in pediatric cataract surgery.This was a prospective case series study. After anterior continuous curvilinear capsulorhexis (ACCC) and phacoemulsification with intraocular lens (IOL) implantation in the capsule for all patients, a pars plana capsulotomy and anterior vitrectomy was performed with a 25-gauge vitrectomy system using a dry technique in 40 eyes of 30 children with cataracts.All procedures were uneventful and all IOLs were implanted in the capsular bag. No intraoperative complications were noted attributable to the small-gauge instruments. The average follow-up period was eight months (range, 4 to 30). Postoperative intraocular pressure remained stable in most cases, except two eyes (5%) with transient hypotony during the first day after surgery. The postoperative inflammatory response was mild. Ultrasound biomicroscopy showed complete healing of the sclerotomy at four weeks after surgery. No posterior synechia, posterior capsule opacification, IOL capture, vitreous prolapse, choroidal detachment or retinal detachment was observed throughout the follow-up period.Dry pars plana capsulotomy and anterior vitrectomy using a 25-gauge vitrectomy system is safe and effective for the management of posterior lens capsules and anterior vitreous in pediatric cataract surgery. Prospective and comparative study is recommended to evaluate this procedure and traditional method.

To evaluate and compare the visual performance between the patients with the diffractive multifocal and monofocal intraocular lens (IOL).It was a prospective nonrandomized controlled study. Sixty-five patients (80 eyes) received phacoemulsification and IOL implantation were divided into two groups, 41 patients (50 eyes) in the multifocal group, and 24 patients (30 eyes) in the monofocal group. Three months or longer after surgery, the results of the uncorrected distance, intermediate and near vision; the best-corrected distance, intermediate and near vision; the intermediate and near vision after the distance vision corrected; the contrast sensitivity and the wave-front aberrations were recorded. The subjective visual performance after surgery was evaluated by the questionnaire. The chi-square test was applied to compare categorical variables, and the independent-samples t test was used to compare the measure data.The difference of the uncorrected distance, intermediate vision; the best-corrected distance, intermediate and near vision; intermediate vision after the distance vision corrected between the multifocal and monofocal groups was no statistical significance. The uncorrected near vision (0.82 +/- 0.20 vs 0.33 +/- 0.14, t = 8.99, P = 0.000) and the near vision after the distance vision corrected (0.83 +/- 0.17 vs 0.32 +/- 0.11, t = 9.83, P = 0.000) were statistically better in the multifocal group than the monofocal group. Photopic contrast sensitivity at high spatial frequency (18 c/d) and mesopic sensitivity with glare at medium frequency (6 c/d) was statistically lower in the multifocal group (P0.05). The total aberration and spherical aberration of the multifocal group were smaller than the monofocal group (t = 3.74, P = 0.00; t = 3.56, P = 0.00). The spectacle independent rate of multifocal and monofocal group were 70.73% (29/41) and 8.33% (2/24) respectively (chi(2) = 23.63, P = 0.00). The mild and moderate glare and halo were existent in both groups (chi(2) = 0.50, P = 0.78).Moderate visual disturbances were reported 24% (12/50) in the multifocal group and 26.67% (8/30) in the monofocal group.No serious glare and halo phenomenon were reported.Compared with the monofocal intraocular lens, the diffractive multifocal intraocular lens could provide a satisfactory recovery of vision function and good visual performance except the slight decrease of the contrast sensitivity.

Intraocular lens power calculation after corneal refractive surgery is complicated. It is common to have a great postoperative deviation with the traditional method. The reasons for IOL power calculation error after corneal refractive surgery are analysed and many solutions are listed in this article, which we hope could provide basis for these patients.

To establish a new model of posterior capsule opacification (PCO) in rat, and detect the expression of alpha-, beta-, and gamma-crystalline gene.An extracapsular lens extraction (ECLE) was performed in SD rats. Eyes were enucleated and processed for light microscopy at various time-points. Semi-quantitive RT-PCR were performed to detect the expression of alphaA, alphaB, betaB1, betaB2, betaA2, and gammaD crystalline.Immediately after ECLE, lens epithelial cells (LECs) were present in the inner surface of the anterior capsule and lens bow. 24 hours after surgery, LECs started to migrate toward the center of the posterior capsule. PCO was noted at first 3 days after ECLE, multilayered LECs were present throughout the lens capsule, and lens fibre differentiation occurred in peripheral capsular bag. All eyes showed development of clinically evident PCO and Soemmering's ring 7 days post-ECLE. 2 weeks after surgery, Soemmering's ring was even more significant. 1 month after surgery, all capsular bags were filled with new semitransparent lenticular structures, displaying an established equator with well differentiated bow regions. 2 - 3 month after surgery, new lenticular structures continue to increase in slower speed. The mRNA-expression quantity of alphaA, alphaB, betaB1, betaB2, betaA2 and gammaD crystalline increased gradually postoperatively.PCO occurs soon after ECLE in SD rat, and express alpha-, beta-, and gamma-crystalline. This model appears to be valuable for studying the pathogenic mechanisms of PCO after cataract surgery or lens regeneration.

To evaluate the long-term outcome in eyes had flexible open-loop anterior chamber intraocular lens (ACIOL) implantation.Cataract extraction with primary flexible open-loop ACIOL and anterior vitrectomy were performed in 34 eyes (group I), and secondary AC IOL implantation were performed in 49 eyes (group II). Visual acuity, intraocular pressure (IOP), corneal endothelial cell, anterior chamber angle and the presence of associated complication were examined in a mean follow up of 4.8 years (range 3 to 7 years).The final best correct visual acuity was 0.5 or better in 65 eyes (78.3%). The IOP were (13.55 +/- 3.21) mm Hg preoperatively and (13.40 +/- 4.29) mm Hg (1 mm Hg = 0.133 kPa) at the last follow-up (t = 0.5427, P = 0.5888). In group I, the corneal endothelial cell density were (2497 +/- 629)/mm(2) preoperatively, while at the last follow-up it was (1995 +/- 648)/mm(2) and the rate of endothelial cell loss was (20.6 +/- 14.1)%; In group II, the corneal endothelial cell density before and after operation was (2459 +/- 681)/mm(2) and (2238 +/- 817)/mm(2) respectively. The rate endothelial cell loss was higher in group I compared with group II (P = 0.023). Postoperative complication include transient secondary glaucoma caused by block of pupil in 4 eyes and remain of viscoelastic substance in 3 eyes, hypotension in 5 eyes, persistent glaucoma in 2 eyes, hyphema in 2 eyes, IOLs slightly dislocation and shift in 3 eyes, pupil deformation in 1 eye, retina detachment in 2 eyes, and corneal decompensation in 2 eyes.Flexible open-loop ACIOL is relatively safe and effective in selected cataract surgery. Postoperative complication could be reduced if operative indication and surgical technique were emphasized.

To evaluate the surgical technique and outcome of pars plana capsulotomy and vitrectomy with infusion through the limbus to remove the posterior capsule opacification (PCO) in children with pseudophakic eyes.This technique was performed in 51 cases (57 eyes) of complicated PCO with pseudophakic eyes, which was almost impossible to remove through the Nd:YAG capsulotomy. Pre- and post-operative visual acuity, intraocular pressure, density of cornea endothelium and complications during and after the operation were observed. The mean follow up time was 30 months.The central opaque posterior capsule and anterior vitreous were successfully removed in all patients without complication. A round hole with 3-4 mm diameter was obtained at the central part of the posterior capsule. In all 57 eyes, a clear visual axis was obtained. The visual acuity in all patients was improved and achieved the best level in their history. Visual acuity equal to or better than 0.3 was obtained in 51.9% of all eyes at 3 months. There were no complications during the postoperative follow-up period, such as dislocation or damage of the IOL, corneal edema, vitreous prolapse, retina detachment and reocclusion of the visual axis.Pars plana capsulotomy and vitrectomy with infusion through the limbus is a safe and effective procedure to remove the PCO in pseudophakic eye, especially for the cases with dense and thick opaque capsule formed after IOL implantation in the children, which cannot be removed through the Nd:YAG capsulotomy.

To observe refractive change and axial growth in children with bilateral congenital cataract after intraocular lens (IOL) implantation.38 patients (76 eyes) with congenital cataract, who undergone cataract extraction, posterior continuous curvilinear capsulorhexis, anterior vitrectomy and primary IOL implantation in the capsular bag, were included. Patients were divided into four groups based on their age at surgery: 2 - 3 years (group A), 4 - 5 years (group B), 6 - 7 years (group C) and 8 - 12 years (group D). The refraction, axial length and corneal curvature in the follow-up for five years were reviewed. The correlation between best corrected visual acuity (BCVA) and refractive or axial change was analyzed.The mean myopic shift was -2.06, -1.81, -0.56 and -0.25 D respectively in the four groups (P0.01). The axial elongation was 1.21,1.13,0.47 and 0.34 mm respectively (P0.01). There was no statistically significant difference among the four groups in corneal curvature preoperatively (P0.05) or postoperatively (P0.05). 50 eyes (65.8%) had a final BCVA of 0.5 or better. No statistically significant correlation was found between BCVA and refractive change (P0.05) or axial growth (P0.05).Cataract extraction combined with primary anterior vitrectomy and bilateral IOL implantation is safe and effective for bilateral congenital cataract. There is a mild trend of myopic shift postoperatively, and the pattern of axial length is similar to normal eyes. Refractive change and axial growth tend to be stable in older patients. It is recommended to set the immediate postoperative refraction under correction slightly in patients with age 2 - 5 years.

To investigate the reasons why patients suffering hypermature or mature cataract in the urban Qingdao city do not undergo cataract surgery in time.104 inpatients with mature or hypermature age-related cataract were interviewed with a questionnaire concerning medical, economic, social and psychological factors.The factors related with the surgery delay were medical factor 44.3%, economic factor 7.1%, social factor 20.7% and psychological factor 27.9%. In the lists of detailed reasons, 'cataract being not mature' ranked the first (17.1%), 'unaware of cataract' (14.3%) and "still able to see something" (10.0%) were followed. The history of cataract surgery, age, degree of education, the knowledge of cataract and individual income all played some roles in the delay of cataract surgery (P0.05).It is important to educate people about cataract knowledge and clarify the role of cataract surgery in order to convince patients to have cataract surgery done in time and improve life quality.

An 80-year-old woman was diagnosed with hepatocellular carcinoma and underwent transarterial chemoembolization (TACE). The procedure went smoothly without any complications. However, she presented with a dry cough 3 months after the intervention. On physical examination, she did not appear cyanotic. Chest auscultation revealed a minimal crackle sound in the perihilar lung fields; other respiratory system examination findings were nonspecific. Pulse oximetry revealed an oxygen saturation …

To introduce a grading system for corneal edema after phacoemulsification and to study the corneal endothelial damage and its repair after phacoemulsification.One hundred and five senile cataracts after phacoemulsification were included. Corneal edema was categorized into grades 0 to 4. Endothelial densities at various locations of the cornea were measured with specular microscopy before and three months after surgery.The corneal endothelial cell loss rate was 4.6%, 14.9%, 40.8%, 67.0% and 84.4% in eyes with corneal edema from grades 0 to 4, respectively. Time required for resolution of corneal edema was (2.1 +/- 0.7) days (grade 1), (5.6 +/- 1.9) days (grade 2) and (21.8 +/- 7.1) days (grade 3). The endothelial cell densities at superior, mid and inferior portions of the cornea were (2006 +/- 546) cells/mm(2), (1979 +/- 545) cells/mm(2) and (1754 +/- 543) cells/mm(2) respectively at 3 months after phacoemulsification. Postoperative endothelial cell loss at superior, mid and inferior portions of the cornea was (627 +/- 496) cells/mm(2), (656 +/- 492) cells/mm(2) and (1026 +/- 509) cells/mm(2) respectively. The difference in postoperative endothelial cell densities between the superior and inferior portions of the cornea was statistically significant (P = 0.017), so was the difference between mid and inferior portions of the corneas (P = 0.027). There was no statistically significant difference between the superior and mid portions of the cornea (P = 0.867).The grading system for corneal edema is helpful in evaluating the severity of endothelial damage after phacoemulsification and can be used to predict the outcome of the cornea. The major area of endothelial injury after phacoemulsification occurs at the inferior portion of the cornea.

To evaluate the result of surgery for senile cataract with Fuchs' endothelial dystrophy and emphasize the importance of the preoperative examination by specular microscopy.In the review of 2,026 consecutive senile cataract cases, 17 Fuchs' endothelial dystrophy cases were found before cataract surgery by specular microscopy. Operative procedures and corneal endothelial protective measures were recorded, and postoperative corneal transparency was observed. The examination of specular microscopy was performed 3 months after the cataract surgery.The incidence of Fuchs' endothelial dystrophy in senile cataract was 0.8% (17/2,026) in our study. The loss rate of endothelial cells was 16.2%. No bullous keratopathy occurred in all cases during follow-up period.Reasonable measures to protect the endothelium in the surgery by an experienced operator is helpful to the success of surgery. Observing the endothelium by specular microscopy before cataract surgery is very important.

A 45-year-old woman had an asymptomatic abnormality on a screening abdominal radiograph. The radiopaque mass in her right upper abdomen was surrounded by numerous "pearls" and resembled an abalone on the supine abdominal radiograph. We advised an additional upright abdominal radiograph, which showed a calcium fluid level. We also clarified the location of the cystic lesion at the right floating kidney, which changed its location between the supine and upright positions. Computed tomography of the abdomen revealed a right renal cyst with a calcium-fluid interface owing to the milk of calcium. The patient was then followed up without additional investigation or the need for intervention.

Two types of reproducing heads without gap-nulls for inductive longitudinal magnetic recording have been modeled theoretically. The first type of head is a superposition of several infinitely long and current-carrying thin-film sheets with the sheet width varying linearly and flush with one side. The second type of head has the form of the continuous distribution of thin films, that is, a current head with trapezoidal cross section. The spectral responses of these heads are compared with that of a conventional Karlquist head. It is concluded that these two types of current heads can reproduce signals at much shorter wavelengths than conventional Karlquist heads and yield no gap-nulls. >

We aimed to evaluate the influence of mammographic breast density at diagnosis on the risk of cancer recurrence and survival outcomes in patients with invasive breast cancer after modified radical mastectomy. This case-control study included 121 case-control pairs of women diagnosed with invasive breast cancer between 2004 and 2009, and who had undergone modified radical mastectomy and had mammographic breast density measured before or at diagnosis. Women with known locoregional recurrence or distant metastasis were matched by pathological disease stage, age, and year of diagnosis to women without recurrence. Locoregional recurrence was defined as recurrence in the ipsilateral chest wall, or axillary, internal mammary, or supraclavicular nodes. The median follow-up duration was 84.0 months for case patients and 92.9 months for control patients. Patients with heterogeneously dense (50–75% density) and extremely dense (>75% density) breasts had an increased risk of locoregional recurrence (hazard ratios 3.1 and 5.7, 95% confidence intervals 1.1–9.8 and 1.2–34.9, p = 0.043 and 0.048, respectively) than did women with less dense breasts. Positive margins after surgery also increased the risk of locoregional recurrence (hazard ratio 3.3, 95% confidence interval 1.3–8.3, p = 0.010). Multivariate analysis that included dense breasts (>50% density), positive margin, no adjuvant radiotherapy, and no adjuvant chemotherapy revealed that dense breasts were significant factors for predicting locoregional recurrence risk (hazard ratio 3.6, 95% confidence interval 1.2–11.1, p = 0.025). Our results demonstrate that dense breast tissue (>50% density) increased the risk of locoregional recurrence after modified radical mastectomy in patients with invasive breast cancer. Additional prospective studies are necessary to validate these findings. The study is retrospectively registered with ClinicalTrials.gov, number NCT02771665 , on May 11, 2016.