To analyze the visual acuity and complications between primary intraocular lens (IOL) implantation and contact lens wearing, this literature search was performed with data on patients with congenital cataract younger than 2 years published in March 2019. Seven identified studies enrolling 675 eyes were selected for analysis. Patients with primary IOL implantation owned better visual acuity than those with aphakia who wore the contact lens (weighted mean difference = 0.161; 95% CI, 0.108-0.214). For visual axis opacification (VAO), primary IOL implantation increases the incidence of VAO compared with contact lens wearing (relative risk = 0.23; 95% CI, 0.13-0.42). No statistically significant difference was found between the 2 groups about the prevalence of glaucoma and strabismus. Primary IOL implantation achieved better visual outcomes after cataract extraction in patients younger than 2 years. In addition, no higher risk for complications among primary IOL implantation compared with contact lens wearing was noted. Therefore, implanting a primary IOL during congenital cataract surgery is a better therapy for children younger than 2 years than wearing a contact lens.
Background
There are increasing studies showing that the use of a lung-protective ventilation strategy has a lung protection effect in patients undergoing abdominal surgery; however, the appropriate positive end-expiratory pressure (PEEP) has not yet defined. Adopting a suitable PEEP may prevent postoperative pulmonary complications. Robot-assisted laparoscopic surgery is the newest and most minimally invasive treatment for bladder cancer or prostate cancer. It is also necessary to consider the effects of Trendelenburg position with pneumoperitoneum on airway pressure and pulmonary function. The role of PEEP during the intraoperative period in preventing postoperative pulmonary complications for robot-assisted laparoscopic surgery is not clearly defined.
Methods/design
A total of 208 patients undergoing robot-assisted laparoscopic radical resection for bladder cancer or prostate cancer will be enrolled and then randomly assigned to a standard PEEP (6–8 cm H
2
O) group and a low PEEP (≤2 cm H
2
O) group. Both groups will receive an inspired oxygen fraction of 0.50 and a tidal volume of 8 mL/kg ideal body weight. Standard perioperative fluid management standardization and analgesic treatments will be applied in both groups. The primary endpoint is postoperative pulmonary complications within 7 days after surgery. Secondary endpoints are the modified clinical pulmonary infection score, postoperative extrapulmonary complications, postoperative surgical complications, intensive care unit length of stay, hospital length of stay, and 30-day mortality.
Discussion
This trial aimed to assess the effects of low tidal volumes combined with intraoperative PEEP ventilation strategy on postoperative pulmonary complications in patients undergoing robot-assisted laparoscopic radical resection for bladder cancer or prostate cancer.
Trial registration
ID:
ChiCTR1800019867
. Registered on December 2, 2018.
Electronic supplementary material
The online version of this article (10.1186/s13063-019-3363-y) contains supplementary material, which is available to authorized users.
Background: There are increasing studies shown that the use of a lung-protective ventilation strategy has a lung protection effect in patients undergoing abdominal surgery, however, the appropriate PEEP has not yet defined. Adopting a suitable PEEP may prevent PPCs. Robot-assisted laparoscopic surgery is the newest and most minimally invasive care for bladder cancer or prostate cancer. It is also necessary to consider the effects of trendelenburg position with pneumoperitoneum (PnP) on airway pressure and pulmonary function. The role of PEEP during the intraoperative period in preventing PCC for robot-assisted laparoscopic surgery is not clearly defined.
Methods/design: A total number of 208 patients undergoing robot-assisted laparoscopic radical resection for bladder cancer or prostate cancer will be enrolled and randomized into a standard PEEP (6-8 cmH2O) group and a low PEEP (≤ 2 cm H2O) group. Both groups will receive an inspired oxygen fraction (FiO2) of 0.50 and a tidal volume of 8 ml/kg ideal body weight (IBW). Standard perioperative fluid management standardization and analgesic treatments will be applied in both groups. The primary endpoint was postoperative pulmonary complications within 7 days after surgery. Secondary endpoints will be: the modified clinical pulmonary infection score (mCPIS), postoperative extrapulmonary complications, postoperative surgical complications, intensive care unit (ICU) length of stay, hospital length of stay, thirty-day mortality.
Discussion: This trial is aimed to assess the effects of low tidal volumes combined a intraoperative PEEP ventilation strategy on postoperative pulmonary complications in patients undergoing robot-assisted laparoscopic radical resection for bladder cancer or prostate cancer.
Background: There are increasing studies shown that the use of a lung-protective ventilation strategy has a lung protection effect in patients undergoing abdominal surgery, however, the appropriate PEEP has not yet defined. Adopting a suitable PEEP may prevent PPCs. Robot-assisted laparoscopic surgery is the newest and most minimally invasive care for bladder cancer or prostate cancer. It is also necessary to consider the effects of trendelenburg position with pneumoperitoneum (PnP) on airway pressure and pulmonary function. The role of PEEP during the intraoperative period in preventing PCC for robot-assisted laparoscopic surgery is not clearly defined. Methods/design: A total number of 208 patients undergoing robot-assisted laparoscopic radical resection for bladder cancer or prostate cancer will be enrolled and randomized into a standard PEEP (6-8 cmH2O) group and a low PEEP (≤ 2 cm H2O) group. Both groups will receive an inspired oxygen fraction (FiO2) of 0.50 and a tidal volume of 8 ml/kg ideal body weight (IBW). Standard perioperative fluid management standardization and analgesic treatments will be applied in both groups. The primary endpoint was postoperative pulmonary complications within 7 days after surgery. Secondary endpoints will be: the modified clinical pulmonary infection score (mCPIS), postoperative extrapulmonary complications, postoperative surgical complications, intensive care unit (ICU) length of stay, hospital length of stay, thirty-day mortality. Discussion: This trial is aimed to assess the effects of low tidal volumes combined a intraoperative PEEP ventilation strategy on postoperative pulmonary complications in patients undergoing robot-assisted laparoscopic radical resection for bladder cancer or prostate cancer.
Purpose: The study is to evaluate the effect of demodex mite infection on the ocular surface characteristics changes of patients with dry eye disease (DED) using non-invasive instruments.
Methods: 127 patients with DED and 52 normal control subjects were enrolled in this study. All DED patients were divided into demodex negative group and demodex positive group based on the result of the demodex mite infection under microscope. Non-invasive tear break-up time (NIBUT), tear meniscus height (TMH), ocular redness, meibomian gland secretions (MGS), morphology of palpebral margin, meibomian gland loss score (MGLS), and cornea fluorescence staining (CFS) were evaluated under oculus corneal topography and slit-lamp.
Results: The demodex positive group showed longer NIBUT (P=0.003), lower TMH(P=0.021), worse morphology of palpebral margin (P<0.001) and worse MGS (P=0.007) than demodex negative group. The score of ocular redness in patients with DED were higher than in the control group (P<0.05). In demodex positive group, age had a positive correlation with the degree of palpebral margin morphological damage (rs=0.332 P<0.05) and a negative correlation with the severity of meibomian gland loss (rs=-0.345 P<0.05).
Conclusion: A significant association between demodex mite infection and abnormal morphology of the palpebral margin, a lower meibomian gland quality, and lacrimal gland hyposecretion in patients with DED. Prompt recognition of the possible co-occurrence of demodex mite infection in patients with DED is crucial for optimal management and improved patient comfort and prognosis.
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