爱尔卡因表麻下白内障超声乳化吸出术临床观察

目的：探讨表麻下行白内障超声乳化吸出及人工晶体植入术的可行性并对其效果进行评估。方法：随机选择手术病例共１１５例１１７只眼进行表麻下白内障超声乳化吸出及人工晶体植入术,但除外儿童、复杂白内障及不合作者,观察麻醉效果、术中术后并发症、术前术后视力对照等。结果：１１７只眼表麻成功率９７．４％,术中术后并发症、术后视力、Ｐｈａｃｏ参数等均与常规麻醉无大差异。结论：表麻是白内障手术一大进步,其优点是安全性     

青光眼滤过术后透明角膜切口白内障超声乳化摘除人工晶体植入术

介绍经透明角膜切口的青光眼滤过术后白内障超声乳化摘除人工晶体植入的方法及疗效。方法：对１８例１８眼施行手术,上方透明角膜内１ｍｍ处做３．２ｍｍ切口,。超声乳化白内障摘除后扩大切口中至５．５－６ｍｍ,植入人工晶体。结果１８眼术后视力全部提高,术中术后无严重并发症。     

高度近视白内障超声乳化摘除及后房型人工晶体植入术

评价高度近视白内障超声乳化摘除及后房型人工晶体植入术的疗效。方法对２１例老年性、并发性和先天性白内障施行巩膜隧道切口超声乳化吸除,通过３．２ｍｍ切口植入折叠式人工晶体,通过５．５ｍｍ切口植入ＰＭＭＡ硬性人工晶体。     

我国白内障的流行病学调查资料分析

目的 探讨我国白内障的患病率与各地检查条件、诊断标准及地理环境的关系。方法 采用世界卫生组织盲与低视力标准,对全国抽样调查资料进行统计学分析。结果 双眼视力〈０．３的白内障患者约５００万人,患病率为０．４６％;盲与低视力的患病率分别为０．４３％和０．５８％。盲人中白内障致盲占４１．０６％;低视力患者中４９．３８％为白内障所致;白内障致老年盲（年龄≥６０岁）及低视力占７３．１３％。以晶体混及视力〈０     

外伤性白内障术前B超检查的临床意义

目的 探讨外伤性白内障术前采用Ｂ超检查后囊破损情况的临床意义。方法 外伤性白内障３０只眼,术前采用Ｂ超检查评估后囊情况,显微镜下白内障摘除术中直接观察后囊情况并记录。结果 １４只眼术前Ｂ超检查后囊完整,手术证实１２只眼后囊完整,２只眼后囊小破坏。１６只眼术前Ｂ超检查后囊破损,手术证实１４只眼后囊存在大小不等的破损,２只眼后囊完整。结论 外伤性白内障术前Ｂ超检查为非侵入性、无痛性检查方法,操作简便,     

The effect of technology on the indications for cataract surgery

Before the introduction of modern ophthalmic surgical technology following World War II, cataract extraction was easier and safer to perform if the cataract was far advanced (mature) and both eyes were involved. The surgeon was constrained from early surgery by the frequency of severe complications, the long convalescent period, and the distortions of aphakic glasses. Now it is easier to perform phacoemulsification and implant lenses in the early stages of cataract formation when the nucleus is soft and the posterior lens capsule has not been weakened with age. Also, modern small-incision extracapsular cataract extraction has a low rate of complications and a short convalescent period. It is feasible to extract a clear lens or one with minimal opacifications and have a grateful patient. The surgeon is capable of improving the refractive state of the eye by selecting the power of the intraocular lens. These facts have led to instances where cataracts have been extracted that were responsible for minimal or no symptoms. This revised version was published online in July 2006 with corrections to the Cover Date.     

Macular edema induced by phacoemulsification

Purpose: To characterise the association between lens phacoemulsification and the development of macular edema. Methods: We studied 15 patients who underwent lens phacoemulsification in our clinic between January and April 1998 performed by the same surgeon. Ultrasound power and cumulative time was noted. Follow-up was performed at 1 day, 1 week, 1, 3 and 6 months after operation. On each visit corneal thickness, best corrected visual acuity, biomicroscopy and fluorescein angiography were performed. Patients with systemic diseases and/or retinal diseases were not included. Results: Visual acuity was inversely related to the amount of energy delivered during phacoemulsification. In patients who had received more than 1 Joule of energy, fluorescein angiography revealed a higher incidence of blood retinal barrier breakdown. Corneal thickness was not correlated with the ultrasound energy used. Conclusions: Excessive use of power during phacoemulsification may hamper the postoperative evolution of cataract surgery. This revised version was published online in July 2006 with corrections to the Cover Date.     

Strabismus and diplopia as complications after cataract surgery with IOL implantation

Summary In our Department of Orthoptics we have seen an increasing number of patients suffering from diplopia after cataract surgery with IOL implantation. Between 1993 and 1997 the total number of patients with this problem was 24 (2.7 % of all patients, mean age 71 years, age range 38–88). We addressed the question of whether there is a common pattern of motility dysfunction. Methods: After evaluation of the clinical history and the basic ophthalmological findings the following parameters were examined: binocular function (Bagolini test), squint angles (Maddox cross), ocular motility. Results: The 24 patients could be divided up into three groups. Group 1 consisted of 9 patients (mean age 82 years, range 64–88) who complained about diplopia because of strabismus incomitans with vertical deviation and restricted motility on the first day after surgery. In 8 of the 9 patients strabismus surgery was done. Group II consisted of 10 patients (mean age 66 years, range 38–77) who noticed diplopia and strabismus within 7 days after surgery. We found various kinds of heterotropia. Seven of these patients were operated on and two had a prism correction. Group III consisted of 5 patients (mean age 67 years, range 61–78). Their already known strabismus paralyticus or concomitans deteriorated, leading to diplopia in some cases. All patients in this group were operated on. Discussion: For group I we believe that retro-, para- or peribulbar anesthesia caused the motility dysfunction. In groups II and III it is unlikely that local anesthesia had a causative role. The prolonged disruption of binocular vision and the abrupt change in the sensory situation after the cataract operation with lens implantation may be the leading causes for strabismus or deterioration of a preexisting strabism, respectively. Conclusions: These patients need a subtil meticulous diagnostic work-up and follow-up because of the possibility of early surgical therapy, which has a good prognosis. Evaluation of binocular vision and eye movements prior to cataract surgery appears to be helpful for later strabismic surgery.      

白内障术后视力相关因素的分析

对白内障术后３个月裸眼视力≥０．８者４６６例,包括术后第一天裸眼视力≥０．８者１９９例进行统计分析,发现在同等条件下,３．５ｍｍ小切口ＰＨＡＣＯ术优于６ｍｍ切口ＰＨＡＣＯ术,更优于ＥＣＣＥ术;术前视力与术后裸眼视力正相关,患者年龄与术后视力负相关。     

超声乳化白内障手术中小瞳孔的处理

探讨超声乳化白内障手术中处理小瞳孔的方式。采用粘弹剂或非切开方式的瞳孔成形术扩大瞳孔。２０例小瞳孔术中均得到扩大,且成功地行前囊连续环形撕囊和超声乳化手术。采用粘弹剂或非切开方式的瞳孔成形术扩大瞳孔,是有效的经济的手术方法,几乎适用于所有的小瞳孔白内障手术。