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近年来,内窥镜下手术在眼科的应用有了很大进展,并且逐渐展现出其创伤小、并发症少、直视下操作、安全有效的优点。眼内窥镜联合激光可应用于青光眼前房角手术、青光眼睫状体光凝术、周边部视网膜玻璃体手术等等;另外泪道内窥镜在泪器疾病中的应用、鼻内窥镜在鼻眼相关手术中的应用也有很大的发展。眼内窥镜的应用开创了眼科微创手术时代。本文就眼用内窥镜的基本工作原理、应用现状和发展前景进行综述。 相似文献
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OBJECTIVE: To evaluate the efficacy and safety of intracameral lidocaine in cataract surgery compared to peribulbar anesthesia. DESIGN: A prospective, randomized, controlled study. PARTICIPANTS: A total of 200 consecutive cataract patients (200 eyes) participated. INTERVENTION: Eyes were randomly assigned to two groups: one group received 0.15 ml intracameral 1% unpreserved lidocaine combined with topical anesthesia (oxybuprocaine); the other group received 6 ml prilocaine peribulbar before phacoemulsification with sclerocorneal tunnel incision. MAIN OUTCOME MEASURES: Duration of surgery was measured; implicit time and amplitudes of the b-waves of the photopic electroretinogram (ERG) potentials (single-flash ERG and the 30-Hz flicker ERG) were recorded; frequencies of intraoperative problems, complications, intraoperative, and postoperative pain were evaluated. RESULTS: After lidocaine anesthesia combined with topical anesthesia, similar complications were found, longer operation time (P < 0.001), and significantly better visual acuity immediately after surgery (P < 0.001). The ERG amplitudes were not significantly reduced after 0.15-ml intracameral lidocaine half an hour after surgery (P > 0.05). CONCLUSION: Intracameral lidocaine 1% combined with topical anesthesia can be recommended as an alternative procedure to peribulbar anesthesia in cataract surgery with corneoscleral tunnel incision. 相似文献
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《Journal of the National Medical Association》2021,113(4):431-435
ImportanceStudent-run free clinics (SRFCs) primarily service the uninsured and are a unique way for medical students to gain hands-on exposure to ophthalmology. The free clinic model takes many different forms- some with episodic and longitudinal models-- and this is mirrored in corresponding eye services.ObjectiveTo describe SRFC ophthalmology services nationwide.DesignThis was a telephone survey study administered from June through July of 2018.SettingThis study surveyed medical school SRFC clinics across the United States.ParticipantsSurvey request was sent to 19 SRFCs previously identified as having ophthalmology services via internet search. Fourteen SRFCs (73%) participated; participants were either student clinic leaders or medical directors. One respondent no longer had a distinct eye clinic so was excluded from relevant results.Main Outcome and MeasureCharacteristics of ophthalmology SRFCs including participants, frequency of sessions, common diagnoses treated, and challenges encountered were assessed through this survey.ResultsOn average, each SRFC provided 5.15 hours per month of ophthalmology services. The mean number of medical students involved per session was 8.7. Lack of infrastructure to ensure adequate patient follow-up and faculty recruiting were cited as the main challenges in providing ophthalmology services. Most SRFC leaders indicated exposure to ophthalmology and practice with the exam as the main experiences that students sought and achieved. The most common conditions treated were refractive error (92.3%) and diabetic retinopathy (69.2%).ConclusionThere are a small number of SRFCs that have ophthalmology services, and they share common features in terms of participants, staffing, and, barriers to sustainability. Ophthalmology services at SRFCs offer a unique venue for medical students to gain exposure to an under-represented field in medical school curricula. The growth of this critical venue for medical student training could be enhanced by recruitment strategies aimed at ophthalmology faculty with a strong interest in service and teaching. 相似文献
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Vaidehi Garg Jayabalan Nirmal Yassine Riadi Prashant Kesharwani Kanchan Kohli Gaurav Kumar Jain 《Journal of pharmaceutical sciences》2021,110(2):871-875
This work was aimed to improve the efficacy of tacrolimus in the treatment of endotoxin-induced uveitis (EIU) using propylene glycol modified lipid vesicles termed as proglycosome nano-vesicles (PNVs). PNVs were prepared by modified film hydration method. Experimental uveitis in rabbit eye was induced by an intravitreal injection of 20 μL of the endotoxin solution containing 100 ng of lipopolysaccharide endotoxin. In vivo efficacy of PNVs was determined by studying clinical symptoms of uveitis using slit lamp examination and by quantitatively measuring levels of tumor necrosis factor-alpha, interleukin-6, leukocytes and total proteins in aqueous humor, 24 h after intravitreal injection of endotoxin. Comparison was made with healthy, untreated and tacrolimus solution treated eyes. PNVs developed were nano-sized, deformable and showed sustained release of tacrolimus over period of 12 h. In vivo results indicated statistically significant difference between the effects of PNVs in the treatment of EIU compared to tacrolimus. PNV treatment not only subsides clinical symptoms of uveitis but also prevented breakdown of blood aqueous barrier. Tacrolimus loaded PNVs are potential new topical treatment for uveitis. 相似文献