200 Hz flying-spot technology of the LaserSight LSX excimer laser in the treatment of myopic astigmatism: six and 12 month outcomes of laser in situ keratomileusis and photorefractive keratectomy.
PURPOSE: To evaluate safety, efficacy, predictability, and stability in the treatment of myopic astigmatism with laser in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK) using the 200 Hz flying-spot technology of the LaserSight LSX excimer laser. SETTING: SynsLaser Clinic, Tromsø, Norway. METHODS: This retrospective study included 110 eyes treated with LASIK and 87 eyes treated with PRK that were available for evaluation at 6 and 12 months, respectively. The mean preoperative spherical equivalent (SE) was -5.35 diopters (D) +/- 2.50 (SD) (range -1.13 to -11.88 D) in the LASIK eyes and -4.72 +/- 2.82 D (range -1.00 to -15.50 D) in the PRK eyes. The treated cylinder was 4.00 D in both groups. Eleven (8.5%) LASIK eyes and 8 (7.4%) PRK eyes had secondary surgical procedures before 6 and 12 months, respectively, and were excluded when the 6 and 12 month outcomes were analyzed. RESULTS: None of the eyes lost 2 or more lines of best spectacle-corrected visual acuity. Seventy-seven percent of the LASIK eyes and 78% of the PRK eyes achieved an uncorrected visual acuity of 20/20 or better; 98% in both groups achieved 20/40 or better. The SE was within +/-0.5 D of the desired refraction in 83% of the LASIK eyes and 77% of the PRK eyes; it was within +/-1.0 D in 97% and 98%, respectively. The cylinder correction had a mean magnitude of error of 0.04 +/- 0.31 D (range -0.96 to +0.85 D) in the LASIK eyes and 0.02 +/- 0.37 D (range -1.44 to +0.72 D) in the PRK eyes. Refractive stability was achieved at 1 month and beyond in the LASIK eyes and at 3 months and beyond in the PRK eyes. CONCLUSION: The outcomes of this study are comparable to those achieved with lasers that use small-beam technology with a lower frequency, as well as with other types of delivery systems. They suggest that the 200 Hz technology used in the LaserSight LSX excimer laser is safe, effective, and predictable and that with LASIK and PRK the results are stable when treating low to moderate myopia and astigmatism up to 4.0 D.
The aim of the study was to investigate whether chronic cigarette smoke habit is associated with changes of laser Doppler (LD) skin blood flowmotion (SBF). We performed spectral analysis of skin forearm LD signal detected by a LD flowmetry (Periflux PF4, Perimed, Sweden) before and during forearm post-ischemic hyperaemia, in 14 healthy chronic smoker subjects and 14 age and sex matched nonsmoker subjects. Forearm skin ischemia was obtained by a pneumatic cuff, positioned at the right arm and inflated for 3 minutes to 30 mmHg above systolic blood pressure. Power spectral density (PSD) of the SBF total spectrum (0.009-1.6 Hz), as well as 0.009-0.02 Hz , 0.02-0.06 Hz, 0.06-0.2 Hz, 0.2-0.6 Hz and 0.6-1.6 Hz frequency intervals (FI), referred to endothelial, sympathetic, myogenic, respiratory and heart activity, respectively, were measured in LD conventional perfusion units (PU)/Hz. Smokers showed a basal SBF total spectrum PSD mean values not significantly different from nonsmokers (2.14+/-1.58 PU/Hz and 1.93+/-1.35 PU/Hz, respectively). Following ischemia, PSD mean value of SBF total spectrum, as well of five FI considered, significantly increased in nonsmokers (p
The aim of the study was to evaluate the acceptability of CO2 laser excisional conization for cervical intraepithelial neoplasia under local anaesthesia in an outpatient setting. Seventy-seven patients, who underwent this procedure, were interviewed three months later concerning pain during treatment, pain and bleeding in the immediate postoperative period, and their general opinion about this procedure. The median duration of surgery was 11 minutes. The postoperative median observation time was 90 minutes. Seventy-one women experienced no discomfort during treatment. Thirty-one patients needed mild analgesics for an average of three days. Bleeding continued for a mean of 7.7 days after treatment and 73% experienced the bleeding as less, 8% as more as compared to menstrual bleeding. Ninety-two percent of the women would prefer this procedure if they had to undergo conization once again. In conclusion, we found a high acceptability in women treated with CO2 laser excisional conization under local anaesthesia in an outpatient setting.
Based on the findings from the examination of 133 patients with stable angina pectoris, it was shown that He-Ne laser therapy with the irradiation being applied to the liver projection area in combination with the prolonged-action nitrates is superior to similar application of irradiation to the precordial region and Head's zones or intravenous irradiation of blood. Revealed in the examination of the above patients was a reaction of antiproteolytic enzymes to He-Ne laser therapy, which appeared to be varying with methods of laser therapy. It is suggested that a reaction of the realization of the components of proteolysis might be involved in the realization of therapeutic effect of the He-Ne laser energy in patients with ischemic heart disease.
A series of 40 patients with acoustic neuromas were operated on using the suboccipital or the translabyrinthine approach. Some patients were operated on using both routes. The series extends back to 1977 and contain predominantly large tumours. There was no mortality in the translabyrinthine series of 14 patients. In the suboccipitally treated series of 29 patient, 3 were previously treated using translabyrinthine approach. In this series there was one death directly due to sequelae of neuroma extirpation and in another, additional causes were present. Preoperative facial pareses were frequent. There were several additional pareses in the translabyrinthine series and also several additional in the suboccipital series. Facial pareses were operated on by a plastic surgeon and they did not markedly detract from working capacity. Only 2 patients in the total series had small tumours and useful preoperative hearing. Cochlear function was preserved in them.
Adult-onset calorie restriction (A-CR) is an experimental model of life extension and healthy aging less explored, compared with calorie restriction begun at early ages, but one more realistic for human application. We examined the effect of A-CR on the aging rat kidney with respect to common structural age-dependent changes and the accumulation of mitochondrial enzyme abnormalities in tubular epithelial cells. A 40% calorie restriction was initiated in middle-aged rats, before the onset of significant age-related changes in the Fischer x Brown Norway rat kidney. This dietary intervention effectively reduced glomerulosclerosis and tubular atrophy within 6 mo and changed the rate of interstitial fibrosis formation within 1 yr and vascular wall thickening and the expression cytochrome c oxidase (COX)-deficient tubular epithelial cells in 18 mo compared with age-matched ad libitum-fed rats. Our histological approach (histochemical staining for mitochondrial enzyme activity and laser capture microdissection) coupled with mitochondrial DNA (mtDNA) PCR analyses demonstrated that COX-deficient renal tubular epithelial cells accumulated mtDNA deletion mutations and that these cells contained unique, clonally expanded mtDNA deletion mutations. Renal tubular epithelial cells with mitochondrial abnormalities presented cellular characteristics indicative of physiological dysfunction.
Age-related macular degeneration (AMD) is the main reason for blindness today in the western hemisphere. According to Björn Olafsson, who was the first ophthalmologist in Iceland a century ago, this disease was not found in Iceland. In the blindness-registry of 1950 6% blindness was due to this disease. Today, AMD is responsible for 54% of legal blindness in Iceland. The incidence of the disease increases with age. Heredity and environmental factors are thought to influence its etiology. Indirect methods, including twin studies and increased frequency of this disease in some families, have demonstrated that hereditary factors may be important. This has been confirmed recently by demonstrating that genes on chromosome 1 and chromosome10 play a role. This disease is classified as early stage, with drusen and pigmentary changes and insignificant visual loss. Treatment options for this stage are limited. The use of vitamin E and C and Zinc has, however, been shown to delay its progress. The second and end stage involves visual loss, either as a dry form with pigment epithelial atrophy or wet form, with new vessel formation. Treatment options for the dry form are limited. The second form is more common in Iceland than in other countries. Treatment options for the wet form have increased. Localised laser and drug treatment to neovascular membranes, either alone or as a combination treatment with drugs that have anti-proliferate effect on new vessels (anti-VEGF) are increasingly used. New treatment methods are also used in assisting those that are already visually handicapped. The use of computers is increasing as are the patients' computer skills. As the number of the elderly increases, AMD will be an increasing health problem in Iceland as in other Western countries. It is therefore important to improve the treatment options and the service and counselling of patients.
Age-related macular degeneration, AMD, is the commonest cause of legal blindness in the industrialised world. Epidemiological data suggest that in Denmark more than 80,000 persons suffer impaired vision in at least one eye, because of AMD. More than 4000 are legally blind owing to this disease. AMD has two major phenotypes: wet and dry. Most severe visual losses are caused by wet AMD, where new blood vessels form under the macula. A new treatment of this condition is now available. Photodynamic therapy with verteporfin has been investigated in a double-blind, randomised clinical trial with more than 600 patients. This study has been scrutinised by a Cochrane review, which has recommended criteria for the treatment. For eyes meeting these inclusion criteria, photodynamic therapy can reduce the occurrence of moderate and severe visual loss over a two-year period by more than 60%. It is estimated that around 1000 eyes in Denmark will meet the inclusion criteria for photodynamic therapy.
