开信封式与开罐式晶体前囊切除的疗效比较

前囊切除术是白内障囊外摘除联合后房型人工晶体植入手术中最有决定性的步骤之一，本文分析在同等手术条件下开信封式囊切开与开罐式囊切除的两种不同方法的临床效果。１１６例人分为两组，每组５８例。平均随访３．８个月（１－２４个月）。     

连续弧形撕囊与开罐式截囊的效果比较

目的 探讨连续弧形撕囊的效果。方法 采用连续弧形撕囊行老年性白内障囊外摘出及囊袋内人工晶状体植入术,６４例８０眼;同时以开罐式截囊６１例７３眼作为对照。结果 术后１周散瞳后房角镜检查。连续弧形撕囊组７２眼（９０．０％）人工晶状体双襻在囊袋内,虹膜色素脱落１６眼（２０．０％）。而开罐组４０眼（５４．８％）双襻在囊袋内,虹以素脱落３８眼（５２．１％）。结论 连续弧形撕囊增加了人工晶状体囊袋内固定比例,     

信封式截囊保留前囊瓣人工晶状体植入术体会

于1997年1月-3月，对16例16眼白内障行信封式截囊及囊袋内摘出，植入后房型人工晶状体，不撕去前囊瓣，收到较好效果，报告如下：临床资料：本组16例16眼，男6例，女10例，年龄54一秘岁，平均万岁。其中老年性白内障13例，先天性白内障1例，并发性白内障2例。手术方法：所有病例均采用球后及眼轮匝肌麻醉，瞳孔充分散大，按常现显微手术操作，作以上穹隆部为基底的结膜瓣，角膜线外1．5－Znun阶梯状板层切开巩膜，穿刺前房，注入粘弹剂，用4H号注射针头自制的截囊针在距赤道部l－Zmm处水平将前囊截一小口，用囊剪弧形扩大此口达6mm。囊袋…     

保留晶状体前囊的晶状体玻璃体切除术人工晶状体植入术

目的 分析晶状体玻璃体切除术联合人工晶体一期植入术的效果,评估白内障合并玻璃体病变的联合手术效果,方法 采用保留晶体状前囊的晶状体玻璃体切除联合人工晶状体一期植入术。结果 术后随访１２～３８周。视力提高者１９眼（９０．４９％）,０．０５～０．２者３眼（１４．３％）。结论 这种手术方式由于保留了晶状体前囊,为一期植入人人工晶状体创造了良好的条件,是一种较理想的手术方法。     

儿童人工晶状体植入一期后囊截囊术

目的 研究儿童人工晶状体植入术后后囊浑浊的预防及处理。方法 对６８例８５眼儿童白内障摘出术的同时,将后囊中央环形撕除、截除或玻璃体切除器切除一３～４ｍｍ之孔洞。植入后房型人工晶状体。结果 随访１～３８月,平均７．６月,７８眼（９１．２％）后囊中央有一透明区,０．５～１．２者５４眼占６３．５％。结论一期后囊截囊术,避免了儿童术后后囊浑浊的发生,保证了视轴区的透明,避免了再次手术。     

三种截囊法在老年性白内障囊袋内人工晶状体植入术中效果观察

对132眼老年性白内障施行白内障囊外搞出及囊袋内人工晶状体植入术,按前囊截开方式不同分为3组：（1）开罐式截囊;（2）线状截囊;（3）连续环形撕囊。观察人工晶状体排在囊袋内固定形式并与开罐组相比,线状组和撕囊组与其差异有显著性（P＜0.05）。后囊浑浊发生率分别为：开罐组22％;撕囊组9.4％;线状组4％。提示：选用一种既能有效地清除晶体上皮细胞又能确保人工晶状体并完全植入囊袋内的截囊方式,对防止后囊浑浊提高视力是一种有效而实用的方法。     

人工晶状体前膜形成的临床分析

报告１６６例（１７７眼）人工晶状体植入术后前膜形成１１眼,发生率为６．２１％,其中合并其它眼病,全身病及双眼手术间隔１月以内者共８眼,占前膜形成的７２．２７％,对其形成的病因,易患因素,治疗及预防作了简要讨论。     

糖尿病白内障人工晶状体植入与单纯囊外摘出比较

人工晶状体植入术已在我国普遍开展，糖尿病不再是植入人工晶状体的禁忌症。本文对48例50眼糖尿病白内障囊外摘出联合人工晶状体植入与单纯囊外摘出对照分析，报告如下：一般资料：无选择性住院糖尿病白内障囊外摘出联合后房型人工晶状体植入48例50眼。男12例12眼；女36例38眼。年龄50～86岁，平均71．3岁。胰岛素治疗8例，8眼；口服药物及饮食控制40例42眼。血糖控制在6mmol/L以下16例16眼；6～9mmol/L24例，26眼；9mmol／L以上8例8眼。无糖尿病视网膜病变17例18眼；单纯性糖尿病视网膜病变28例29眼；增殖性糖尿病视网膜病变3例3眼。对照…     

后囊缺损的弹性开襻前房型人工晶状体II期植入术

对１５例后囊缺损的无晶状体眼施行Ⅱ期植入新型弹性开襻前房型人工晶状体的临床观察，术毕常规行眼压及前房角镜检查。认为此手术具有性能稳定，操作简单，术后反应轻，手术时间短等优点。尤其适用于虹膜广泛后粘连、瞳孔不能散大者。     

Anterior vitrectomy and partial capsulectomy via anterior approach to treat chronic postoperative endophthalmitis

AIM:To describe the results of vitrectomy and partial capsulectomy via anterior approach surgical technique in treatment of chronic postoperative endophthalmitis (CPE).METHODS:Clinical records of 9 patients treated for CPE between 2006 and 2010 were reviewed retrospectively. All of these patients were treated with vitrectomy and partial capsulectomy via anterior approach.RESULTS:Six of 9 patients were male. The average patients’ age was (60±8.1) years. The average period between cataract extraction and onset of signs and symptoms was (3.6±1.3) weeks. The average presenting visual acuity was 0.3±0.1 and the average final post operative visual acuity was 0.7±0.2. The mean follow-up period was (28.1±8.9) weeks. In all patients, the inflammation subsided after surgery.CONCLUSION:Our results suggest that anterior vitrectomy and partial capsulectomy via anterior approach may be considered as potentially useful and relatively less invasive technique to treat CPE.     

两种不同截囊方法的后房型人工晶状体植入术比较

目的比较白内障囊外摘出及后房型人工晶状体植入术中2种不同的截囊方法的术后效果。方法将70例患者随机分为A、B2组,A组38例41眼,采用开罐式截囊后房型人工晶状体植入术．B组32例37眼采用信封式截囊囊袋内人工晶状体植入术。随访3mo～2a,比较2组视力恢复情况和并发症。结果术后ld视力＞0．1者,A组70．7％,B组81％,术后3mo～2a视力≥0．5者,A组90．24％．B组94．6％,2组比较无显著性差异（P＞0．05）。A、B2组并发症发生率分别为53．6％和13．5％组比较有显著性差异（P＜0．01）。结论信封式截囊囊袋内植入人工晶状体优于开罐式截囊后房型人工晶状体植入。     

剪开法前囊截囊术在晶状体半脱位白内障手术中的应用

目的探讨剪开法前囊截囊术在晶状体半脱位白内障囊外摘出术中应用的临床效果。方法晶状体半脱位白内障23例（23眼）。进行手法小切口白内障囊外摘出联合人工晶状体囊袋内植入术。术中采用剪开法进行前囊截囊。术后随诊6～24个月,平均10．5个月。结果手术中均未出现晶状体脱离范同扩大或玻璃体脱出增加,术后最佳矫正视力≥1．0者2眼（8．70％）,≥0．5者7眼（30．43％）,〈0．5者16眼中：2眼为视网膜色素变性、7眼为眼挫伤伴有不同程度的视网膜挫伤、2眼为外伤性视神经萎缩、2眼为玻璃体浑浊（陈旧血性）、1眼为外伤性黄斑孔、2眼为≥-10．00D高度近视。结论应用剪开法前囊截囊术进行晶状体半脱位手法小切口白内障囊外摘出人工晶状体植入术是安全的．效果良好。     

白内障囊外摘除人工晶体植入术中不同截囊方式与其后囊混浊发生率的观察比较

对白内障83眼，施行白内障囊外摘除及人工晶体植入术。按前囊截开方式不同分为三组，分别施行开罐式截囊、连续撕囊及线形截囊。术后随访观察12～24个月，后囊混浊发生率分别为：开罐组28％，撕囊组15％，线形截囊组7％。与开罐组相比，线形截囊组与其差异有显著性（P＜0．05），撕囊组与其差异无显著性（P＞0．05）。提示：选用一种既能有效地清除晶体上皮细胞，又能确保人工晶体袢完全植入囊袋内的截囊方式，如线形截囊，对防止后囊混浊是一种有效而实用的方法。     

Mathematical models for describing the shape of the in vitro unstretched human crystalline lens

We developed orthogonal least-squares techniques for fitting crystalline lens shapes, and used the bootstrap method to determine uncertainties associated with the estimated vertex radii of curvature and asphericities of five different models. Three existing models were investigated including one that uses two separate conics for the anterior and posterior surfaces, and two whole lens models based on a modulated hyperbolic cosine function and on a generalized conic function. Two new models were proposed including one that uses two interdependent conics and a polynomial based whole lens model. The models were used to describe the in vitro shape for a data set of twenty human lenses with ages 7-82 years. The two-conic-surface model (7 mm zone diameter) and the interdependent surfaces model had significantly lower merit functions than the other three models for the data set, indicating that most likely they can describe human lens shape over a wide age range better than the other models (although with the two-conic-surfaces model being unable to describe the lens equatorial region). Considerable differences were found between some models regarding estimates of radii of curvature and surface asphericities. The hyperbolic cosine model and the new polynomial based whole lens model had the best precision in determining the radii of curvature and surface asphericities across the five considered models. Most models found significant increase in anterior, but not posterior, radius of curvature with age. Most models found a wide scatter of asphericities, but with the asphericities usually being positive and not significantly related to age. As the interdependent surfaces model had lower merit function than three whole lens models, there is further scope to develop an accurate model of the complete shape of human lenses of all ages. The results highlight the continued difficulty in selecting an appropriate model for the crystalline lens shape.     

The axial misalignment between ocular lens and cornea observed by MRI (I)--at fixed accommodative state

Lens tilt and decentration relative to the corneal axis are two of the factors which cause aberration in human eyes. Although many techniques have been developed to quantitatively measure these factors, however, they are mostly confined in 2D observations. To extend the view from 2D to 3D, MR imaging technique becomes a good candidate due to its capability of 3D-image reconstruction and with fairly good spatial resolution for that purpose. In this study a total of six eyes of six young students at this Institute were examined by using a 1.5T MRI machine incorporating with a commercial 3-in. surface coil at Taipei Veterans General Hospital. From a 45 degrees flipped reflective mirror, the subject could focus to a target at a distance of 60 cm from the eye for MR imaging in monocular vision. Quadric surface models were used to fit cornea and lens surfaces in the post image processes. Tilts of the two lens surfaces and the decentration of lens centre with respect to corneal axis were determined through coordinate transformations. One month later, retest was carried out on five of the six subjects. The results show that the average tilts of anterior and posterior lens surfaces, and lens decentration are 3.7+/-2.5 degrees, 3.3+/-1.4 degrees and 0.11+/-0.07 mm (H), -0.06+/-0.38 mm (V), respectively, for the test; 2.1+/-2.4 degrees, 1.9+/-1.8 degrees and -0.02+/-0.28 mm (H), -0.45+/-0.28 mm (V) for the retest. No statistically significant difference (by Wilcoxon Signed Ranks test) is revealed for the tilts of both lens surfaces (p(phia)=0.375, p(phip)=0.225) and for decentration (p(H)=0.343, p(V)=0.345) between test and retest in this longitudinal observation. The surface shapes of the ocular anterior components do not seem to be unified by only one type but ellipsoid, elliptic paraboloid, hyperboloid and paraboloid are all possible. Changes in shape type in the ocular anterior components were also found when measured in a period of one month.     

比较全氟丙烷气体和消毒空气泡在眼外伤前房重建术中的作用

目的:比较全氟丙烷气体和消毒空气泡在眼外伤前房重建术中的作用。方法:回顾性分析53例(53眼)角膜穿孔伤伴虹膜脱出的病例,角膜裂伤缝合后,28例前房注入消毒空气泡,25例前房注入C3F8气体,比较两者术后视力,气泡消失时间,前房形成情况,术后并发症等。结果:两组术后视力、并发症比较差别无统计学意义。前房注入消毒空气泡组气泡消失时间1.2±0.5d,注入C3F8组气泡消失时间14.0±7.1d,两组比较差别有显著统计学意义。两组术后并发症均为前房再出血、眼压升高、角膜水肿等。结论:前房注入C3F8气体术后视力、并发症与前房注入消毒空气泡基本相同,但其在前房内存留时间明显延长,可以良好地维持前房,是复杂性眼外伤眼前段重建的有效治疗方法。     

Pentacam与A型超声测量前房深度及晶状体厚度的比较

目的比较Pentacam与A型超声测量前房深度(ACD)及晶状体厚度(LT)的差异及重复性。方法对正常人49例(49只眼)分别用Pentacam与A型超声测量散瞳后的ACD及LT。结果 Pentacam测量的ACD为(3.81±0.22)mm,A型超声测量结果为(3.70±0.31)mm,两者相差0.11 mm,差异有统计学意义(P<0.01)。Pentacam测量的LT为(3.43±0.23)mm,A型超声测量结果为(3.54±0.34)mm,两者相差0.11 mm,差异有统计学意义(P<0.05)。Pentacam测量ACD及LT的组内相关系数分别为0.98～1.00和0.92～0.97,变异系数分别为0.09和0.10;A型超声测量测量ACD及LT的组内相关系数分别是0.98～0.99和0.99～1.00,变异系数分别为0.16和0.18。结论 Pentacam与A型超声测量屈光不正患者ACD、LT的差值较小,但两者能否相互替代仍需进一步研究。     

复合式与常规小梁切除术后浅前房的对比分析

目的:对比分析复合式与常规小梁切除术后浅前房的发生情况。方法:青光眼56例(71眼)分为2组。复合式手术组(A组)29例(36眼)行复合式小梁切除术;对照组(B组)27例(35眼)行常规小梁切除术。观察两组术后浅前房的发生情况,并作统计学分析。结果:A组术后浅前房发生率为14%(5眼),B组为37%(13眼),两者差异有统计学意义(χ2=5.07,P<0.05)。结论:复合式小梁切除术较传统的小梁切除术能较迅速恢复和维持术后前房深度,有效减少术后浅前房发生,提高手术成功率。