Bimanual微切口白内障摘除术的临床研究

Objective To study and explore the feasibility ofbimanual micro-incision cataract extrac-tion technology, and to evaluate it's clinical efficacy objectively. Methods Ultrasound energy, lime and emul-sified surgical astigmatism were observed in bimanual micro-incision phaeoemulsification group (A),and compared with conventional phacoemulsification group (B). Results The application of ultrasonic emulsifi-cation time and energy in group A: when nuclear hardness was degree Ⅱ, an average of 3.9 % energy was ap-plied,with an average time of the emulsion 0.56±0.40 rain; when nuclear hardness was degree Ⅲ ,an average of 8.3 % energy was applied,with an average time for the emulsification 0.65±0.58; when nuclear hardness was degree Ⅳ ,an average of 12% energy was applied,with an average time of emulsion 1.35±0.82rain. The first day postoperative uncorrected visual acuity ≥ 0.5 accounted for 95.8%,≥1.0 accounted for 39.8%. There were no corneal incision bums, incision leakage, anterior chamber abnormalities and other complications. After 7 days of operation,an average of astigmatism surgery was 0.42±0.55D in group A, 1.26±1.14 in group B,after 3 months of operation,an average of astigmatism surgery was 0.35±0.25D in group A,0.87±0.62 in group B. The changes of astigmatism in the two groups were statistically significant. Conclusion Bimanual micro-incision in phacoemulsification cataract surgery possesses good clinical efficacy, stability, and small inci-sion with technological superiority. This method has good clinical prospects.     

不同多焦视网膜电图系统在评估视网膜功能上的比较

目的 评估VERIS mfERG （EDI Inc）和Espion multifocal imager （Diagnosys）两种不同系统测量正常眼多焦视网膜电图（mfERG）的电位波反应的差异及其相关性,并用两个不同系统分别测量黄斑前膜患眼的mfERG并进行分析.方法 这是一项横断面研究,在VERIS系统使用Burian-Allen （BA）电极,Espion系统使用BA和DTL电极分别测量25只正常眼的mfERG,将3次测得的一阶反应的相应数据进行配对t检验及Pearson相关分析.两个系统用BA电极分别测量19只黄斑前膜患眼的mfERG,对一阶反应的相应数据进行Fisher＇s exact test分析.结果 VERIS BA测得正常眼N1波、P1波振幅密度值最大,其次为Espion BA,Espion DTL最小;VERIS BA测得N1波、P1波潜伏期最长,Espion BA与Espion DTL差异无统计学意义.Espion BA与VERIS BA测得的P1波振幅密度、潜伏期皆有明显的相关性.黄斑前膜患眼中,VERIS BA比Espion BA能检测到更多P1波振幅密度和P1波潜伏期的异常.结论 不论VERIS或Espion系统都能成功记录多焦视网膜电图,当两种系统都使用Burian-Allen电极时,两者mfERG一阶反应P1波振幅密度及潜伏期有着良好的相关性.     

Bimanual微切口白内障摘除术的临床研究

Objective To study and explore the feasibility ofbimanual micro-incision cataract extrac-tion technology, and to evaluate it's clinical efficacy objectively. Methods Ultrasound energy, lime and emul-sified surgical astigmatism were observed in bimanual micro-incision phaeoemulsification group (A),and compared with conventional phacoemulsification group (B). Results The application of ultrasonic emulsifi-cation time and energy in group A: when nuclear hardness was degree Ⅱ, an average of 3.9 % energy was ap-plied,with an average time of the emulsion 0.56±0.40 rain; when nuclear hardness was degree Ⅲ ,an average of 8.3 % energy was applied,with an average time for the emulsification 0.65±0.58; when nuclear hardness was degree Ⅳ ,an average of 12% energy was applied,with an average time of emulsion 1.35±0.82rain. The first day postoperative uncorrected visual acuity ≥ 0.5 accounted for 95.8%,≥1.0 accounted for 39.8%. There were no corneal incision bums, incision leakage, anterior chamber abnormalities and other complications. After 7 days of operation,an average of astigmatism surgery was 0.42±0.55D in group A, 1.26±1.14 in group B,after 3 months of operation,an average of astigmatism surgery was 0.35±0.25D in group A,0.87±0.62 in group B. The changes of astigmatism in the two groups were statistically significant. Conclusion Bimanual micro-incision in phacoemulsification cataract surgery possesses good clinical efficacy, stability, and small inci-sion with technological superiority. This method has good clinical prospects.     

Bimanual微切口白内障摘除术的临床研究

Objective To study and explore the feasibility ofbimanual micro-incision cataract extrac-tion technology, and to evaluate it's clinical efficacy objectively. Methods Ultrasound energy, lime and emul-sified surgical astigmatism were observed in bimanual micro-incision phaeoemulsification group (A),and compared with conventional phacoemulsification group (B). Results The application of ultrasonic emulsifi-cation time and energy in group A: when nuclear hardness was degree Ⅱ, an average of 3.9 % energy was ap-plied,with an average time of the emulsion 0.56±0.40 rain; when nuclear hardness was degree Ⅲ ,an average of 8.3 % energy was applied,with an average time for the emulsification 0.65±0.58; when nuclear hardness was degree Ⅳ ,an average of 12% energy was applied,with an average time of emulsion 1.35±0.82rain. The first day postoperative uncorrected visual acuity ≥ 0.5 accounted for 95.8%,≥1.0 accounted for 39.8%. There were no corneal incision bums, incision leakage, anterior chamber abnormalities and other complications. After 7 days of operation,an average of astigmatism surgery was 0.42±0.55D in group A, 1.26±1.14 in group B,after 3 months of operation,an average of astigmatism surgery was 0.35±0.25D in group A,0.87±0.62 in group B. The changes of astigmatism in the two groups were statistically significant. Conclusion Bimanual micro-incision in phacoemulsification cataract surgery possesses good clinical efficacy, stability, and small inci-sion with technological superiority. This method has good clinical prospects.     

透明晶状体摘除治疗原发性闭角型青光眼

晶状体在原发性闭角型青光眼(PACG)发病过程中起着至关重要的作用。其生物解剖学、临床及流行病学等越来越多的研究表明单独白内障超声乳化摘除术可以加深PACG的前房、开放房角,降低其眼压。近年来一些学者尝试采用透明晶状体摘除治疗PACG,但超声乳化手术适应证选择、术者技术操作水平、术后患者调节力损失、担心过度治疗以及成本效果等问题均是透明晶状体摘除术治疗PACG的争议点。     

手法劈核治疗老年性白内障

目的观察手法劈核治疗老年性白内障的临床效果。方法对98例（107眼）老年性白内障行手法劈核,植入硬性人工晶体,术后3个月内观察视力、角膜散光度变化及手术并发症。结果术后第1周视力大于等于0.5者76眼(71.03％),0.8-1.0者20眼(22.47％)。角膜平均散光度术后3个月与术前比较差异无统计学意义（P＞0.05）,术中4眼出现后囊膜破裂(3.74％)。 结论手法劈核治疗老年性白内障术后视力恢复好,手术方法简单且安全有效。     

36例屈光不正性弱视儿童多焦视诱发电位研究

目的 应用临床视觉电生理的方法对屈光不正性弱视眼视野各部位的视功能的损害进行探讨。方法 采用德国Roland公司的RETIscan^3.15多焦视觉电生理仪，选用Pattern-LT刺激方式，刺激图形选用CRT Combs，由61个六边形组成，每个六边形内均由黑白相同的小区填充，在刺激时作黑白翻转，每个六边形的刺激翻转分别由一个二级伪随机时间序列（m序列）控制，是随机和相互独立的，用RETI多焦电生理仪的分析软件提取FOK（一阶反应）。共记录和分析了36例屈光不正性弱视儿童72眼，并与正常对照组儿童作比较。结果 弱视眼N1－P1波振幅密度平均值和P1－N2波振幅平均值较正常组儿童在中央视野有下降，周边部分无明显异常，P1波潜伏期平均值与正常对照组儿童比较在视野各部分无明显异常。结论 屈光不正性弱视眼在中央视野，部分视功能下降。     

Bimanual微切口白内障摘除术的临床研究

Objective To study and explore the feasibility ofbimanual micro-incision cataract extrac-tion technology, and to evaluate it's clinical efficacy objectively. Methods Ultrasound energy, lime and emul-sified surgical astigmatism were observed in bimanual micro-incision phaeoemulsification group (A),and compared with conventional phacoemulsification group (B). Results The application of ultrasonic emulsifi-cation time and energy in group A: when nuclear hardness was degree Ⅱ, an average of 3.9 % energy was ap-plied,with an average time of the emulsion 0.56±0.40 rain; when nuclear hardness was degree Ⅲ ,an average of 8.3 % energy was applied,with an average time for the emulsification 0.65±0.58; when nuclear hardness was degree Ⅳ ,an average of 12% energy was applied,with an average time of emulsion 1.35±0.82rain. The first day postoperative uncorrected visual acuity ≥ 0.5 accounted for 95.8%,≥1.0 accounted for 39.8%. There were no corneal incision bums, incision leakage, anterior chamber abnormalities and other complications. After 7 days of operation,an average of astigmatism surgery was 0.42±0.55D in group A, 1.26±1.14 in group B,after 3 months of operation,an average of astigmatism surgery was 0.35±0.25D in group A,0.87±0.62 in group B. The changes of astigmatism in the two groups were statistically significant. Conclusion Bimanual micro-incision in phacoemulsification cataract surgery possesses good clinical efficacy, stability, and small inci-sion with technological superiority. This method has good clinical prospects.     

Bimanual微切口白内障摘除术的临床研究

Objective To study and explore the feasibility ofbimanual micro-incision cataract extrac-tion technology, and to evaluate it's clinical efficacy objectively. Methods Ultrasound energy, lime and emul-sified surgical astigmatism were observed in bimanual micro-incision phaeoemulsification group (A),and compared with conventional phacoemulsification group (B). Results The application of ultrasonic emulsifi-cation time and energy in group A: when nuclear hardness was degree Ⅱ, an average of 3.9 % energy was ap-plied,with an average time of the emulsion 0.56±0.40 rain; when nuclear hardness was degree Ⅲ ,an average of 8.3 % energy was applied,with an average time for the emulsification 0.65±0.58; when nuclear hardness was degree Ⅳ ,an average of 12% energy was applied,with an average time of emulsion 1.35±0.82rain. The first day postoperative uncorrected visual acuity ≥ 0.5 accounted for 95.8%,≥1.0 accounted for 39.8%. There were no corneal incision bums, incision leakage, anterior chamber abnormalities and other complications. After 7 days of operation,an average of astigmatism surgery was 0.42±0.55D in group A, 1.26±1.14 in group B,after 3 months of operation,an average of astigmatism surgery was 0.35±0.25D in group A,0.87±0.62 in group B. The changes of astigmatism in the two groups were statistically significant. Conclusion Bimanual micro-incision in phacoemulsification cataract surgery possesses good clinical efficacy, stability, and small inci-sion with technological superiority. This method has good clinical prospects.     

活化增视冲剂对PVR视网膜上PDGF及IL-6表达的影响

目的 研究活化增视冲剂对兔实验性增殖性玻璃体视网膜病变( proliferative vitreoretinopathy,PVR)模型视网膜中PDGF及IL-6表达的影响,探讨活化增视冲剂防治PVR的作用机制.方法 将45只新西兰大白兔采用随机数字表分为空白组5只10只眼,模型对照组、活化增视冲剂组各20只40只眼,通过兔眼玻璃体内注射同种异体巨噬细胞的方法建立PVR的动物模型,造模后第2天开始给药,空白组与模型对照组均予温生理盐水灌胃,5 ml/kg,2次/d.活化增视冲剂组,予活化增视冲剂灌胃0.75 g/(5 ml·kg)(含生药0.25 g/ml)灌胃,2次/d.每周用间接眼底镜检查玻璃体眼底,观察PVR的形成与发展情况,空白组于3、7、14、21、28 d时处死1只兔,余各组各处死4只兔,通过免疫组化检测兔视网膜PDGF及IL-6表达.结果 活化增视冲剂组在14、21、28 d时2级以上PVR的发生率均低于对照组,差异有统计学意义(P＜0.05);对照组视网膜上PDGF与IL-6的表达在14 d时达到高峰,活化增视冲剂组在7d时能够明显降低视网膜上PDGF与IL-6的表达,14 d以后下降平缓,视网膜上PDGF与IL-6在7、14、21、28 d时与对照组相比差异均有统计学意义(P＜0.01).结论 活化增视冲剂能够在PVR的早期通过降低视网膜中PDGF及IL-6的表达,抑制增殖细胞过度增生,从而抑制PVR的发生发展.