贵州省黔西南地区291例儿童眼球穿孔伤调查分析

目的探讨贵州省黔西南州少数民族地区儿童眼球穿孔伤临床特点，分析眼球穿孔伤的原因。方法对我科15年间291例（318眼）2～14岁儿童眼球穿孔伤进行回顾性分析。结果儿童眼球穿孔伤发生的年龄段主要集中在5～10岁，平均年龄6．8岁。农村儿童较多，男性多于女性，损伤重。绝大部分均须手术治疗。术后盲74眼占（26．06％）及低视力140眼（49．30％）。二者共占75．36％之多。结论儿童眼球穿孔伤大多伤势严重，没有及时到医院就诊，治疗结果较差。故必须加强宣传教育并且提高基层医院眼科医生眼外伤的认识和诊疗技术水平，才能提高儿童眼球穿孔伤的诊治水平。     

眼球穿孔伤80例临床分析

目的评价眼球穿孔伤的临床疗效。方法80例（80眼）眼球穿孔伤进行了手术治疗，随访0．5～3年。结果76眼得以保留眼球，60眼手术后视力提高，无一例发生交感性眼炎。结论适当合理的伤口处理联合手术治疗，可以为眼球穿孔伤保留眼球并恢复视力提供了机会。     

表面麻醉加前房内麻醉在眼外伤处理中的应用

眼球穿孔伤是眼科常见急诊之一。由于眼球穿孔伤创口存在，常规的球后及球周麻醉，增加眼内压，对眼球产生挤压现象，增加了限内容物脱出的程度或危险。球后麻醉本身的并发症如球后出血等则会造成更大的损伤，处理颇为棘手。我院自1995年起采用表面麻醉加前房内麻醉成功地处理24例眼球穿孔伤。麻醉效果满意。临床资料：24例24眼眼球穿孔伤患者，年龄17～67岁，平均年龄32．2岁；眼球穿孔伤类型：单纯角膜穿孔伤8例，角膜穿孔伤合并外伤性白内障6例，角巩膜破裂眼内容物脱出6例，合并有前房出血者8例，2例角膜穿孔合并虹膜根部断离，1例人工…     

眼球穿孔伤的处理与探讨（附92例）

目的 探讨眼球穿孔伤的处理,提高其防治技术。方法 对９２例（９６眼）因眼球穿孔伤住院患者进行回顾性分析总结。结果 眼球穿孔伤占同期住院患者１１．０７％。一级损伤８眼占８．３３％;二级损伤３７．５０％;三有损伤５４．１８％。铁类损伤４９．９１％。治疗后视力≤０．０２２６眼占２７．０８％;≥０．０５占６０．４２％;检查不合作９．３８％。结论 眼球穿孔伤发生率高。显微手术和粘弹剂使用眼球穿孔伤的修复起到     

眼球穿孔伤87例临床分析

眼球穿孔伤是致盲的主要原因之一,尤其是在基层医院中,眼球穿孔伤病人占有相当大的比例。因此,应努力提高基层医院眼科医生对眼球穿孔伤病人的正确处理的水平。同时也应尽可能地提高非眼科专业医生对眼外伤病人的识别能力,以免延误治疗,给病人带来不可挽回的损失。本文对我院自1995年7月至1997年至11月间收治的87例88眼眼球穿孔伤病人分析报告如下：临床资料1．发生率：本文报告眼球穿孔伤87例,占同期眼科住院病人620例的14．03％,占同期跟外伤病人346例的25．15％。2.性别、年龄：男70例,女17例,男：女＝4：1。年龄最小3岁,最大7…     

儿童外伤性白内障52例

外伤性白内障在儿童眼外伤中所占比例较大 ,我们 1994年8月～ 2 0 0 1年 4月收治 12岁以下眼外伤患者 15 5例 ,其中发生外伤性白内障 5 2例 ,占 33 6 %。临床资料 :年龄 3岁以下 1例 ,4～ 6岁 13例 ,7～ 9岁 18例 ,10～ 12岁 2 0例。男 42例 ,女 10例 ,男女比例为 4 2∶1。受伤情况 :眼球穿孔伤 46例 ,其中单纯穿孔伤 40例 ,复合裂伤 6例 ,合并眼内异物 3例 ;眼挫伤 6例 ,其中晶状体半脱位 2例。首诊 42例 ,外院转来 10例 ,伤后迅速发生白内障者 ,眼球穿孔伤居多 ,眼挫伤发生白内障较晚。治疗结果 :5 2例中 41例行白内障手术 ,8例保守治疗 ,…     

眼球穿孔伤分度及其并发症、合并症处理探讨(摘要)

眼球穿孔伤及其并发症是主要致盲原因之一。分析我院1983～1988年收治的239例(243眼),探讨眼球穿孔伤损伤分度与预后关系,及其并发症处理。本组病例男198例,女41例。儿童青年居多。生活伤为主。笔者根据损伤程度分为     

眼球全层切裂伤的临床分析

目的探讨眼球全层切裂伤临床诊断和治疗。方法对眼球穿孔伤和全层破裂伤183眼进行回顾性分析。结果眼球全层切裂伤183眼治疗后，绝大部分眼球的完整性和视功能恢复良好，视力明显提高。结论眼球穿孔伤和全层破裂伤的正确诊断、及时治疗和正确地处理并发症，对预后都是十分重要的。     

眼球穿孔伤分度及并发症处理探讨

眼球穿孔伤及其并发症是致盲的主要原因之一,占住院盲目原因的第二位。处理正确、及时,能减少盲目的发生。现将我院1983～1988年收治眼球穿孔伤239例243眼进行分析,探讨眼球穿孔伤及并发症的正确处理。     

眼球摘除138例病因、病理及临床分析

目的 探讨造成眼球摘除相关因素.方法 回顾138例(140眼)眼球摘除的病历资料进行统计分析.结果 眼球摘除病因以眼球破裂伤55眼(39.28%)占首位,角膜溃疡穿孔32眼(22.85%)占第2位,眼球萎缩22眼(15.71%)占第3位.结论 眼外伤是导致眼球摘除的主要原因,提高基层医院医疗水平,早期治疗各种眼病是降低眼球摘除率的关键.     

Resource use and costs of patients with glaucoma or ocular hypertension: a one-year study based on retrospective chart review in the Netherlands.

PURPOSE: To estimate resource use and costs associated with the diagnosis and treatment of glaucoma and ocular hypertension in the Netherlands in 1996 and to determine how costs differed between patients, diagnoses, and hospitals. PATIENTS AND METHODS: Patient characteristics and glaucoma-related resource use were collected for 500 patients with glaucoma or ocular hypertension from the medical records of 10 hospitals. Costs were calculated by multiplying the health care resource use of each patient with actual unit costs. Multiple least-squares regression was used to analyze the relationship between costs and patient characteristics, diagnosis, and type of hospital (general or academic). RESULTS: The mean annual frequency of visits to the ophthalmologist for patients with ocular hypertension and glaucoma was 2.43 and 3.74, respectively, and the mean cost per patient was $280 and $559, respectively. The mean cost of patients with glaucoma who had no changes in medication therapy was $347 and increased to $1,765 in patients with more than three adjustments in medication therapy. Outpatient visits to the ophthalmologist and medication contributed most to total costs. Regression analysis showed that costs were significantly related to intraocular pressure, diagnosis, severe excavation of the optic nerve head, and type of hospital. CONCLUSIONS: The costs of patients with glaucoma were twice as high as the costs of patients with ocular hypertension. Aside from diagnosis, differences in costs between patients could partly be explained by baseline patient characteristics. Patients in academic hospitals had more severe glaucoma and treatment was considerably more expensive than for patients in nonacademic hospitals.     

开放性眼球损伤109例的临床流行病学分析

目的对开放性眼球损伤的眼外伤患者进行临床流行病学探讨。方法选取1990/2000间我院住院眼外伤患者1087例(1233眼),其中开放性眼球损伤109例(109眼),记录患者年龄、性别、职业、受伤原因、时间与就诊时间、视力、眼球被伤部位、大小、有无虹膜嵌顿、有无白内障、前房积血、玻璃体脱出及治疗情况。结果开放性眼球损伤发生率8.92%,16～45岁年龄层占59.62%,0～7岁年龄组发生率也占13.76%,男女比例为8.08∶1,受伤职业上工人(包括建筑工地的临时工,乡镇企业工人)明显多于其他行业。治疗后视力恢复与受伤原因、部位、就诊时间、及时处理预防并发症关系密切。结论近年来,开放性眼外伤有增加趋势,应加强防护。要培训基层医务人员掌握现场抢救知识,如医疗条件不够,迅速转院,努力降低开放性眼球损伤的发生率,有效减少受伤后的致盲率。     

Pseudomonas aeruginosa scleritis

In two patients Pseudomonas aeruginosa scleral infection led to ocular perforation. In one patient, a scleral abscess was identified anteriorly. A scleral perforation occurred at a more posterior focus, but the eye was salvaged with minimal residual visual function. In the other patient, perforation at the corneoscleral limbus occurred after initial corneal improvement with antibiotic therapy; histopathologic examination of the enucleated globe disclosed an abscess extending from the corneoscleral limbus to the equator superiorly.     

Ocular manifestations of graft versus host disease

PURPOSE OF REVIEW: A review of the current literature regarding the ocular manifestations and management of graft versus host disease is presented. RECENT FINDINGS: A variety of systemic and topical anti-inflammatory or immunomodulatory agents, including prednisolone acetate, cyclosporine A, FK506, autologous serum, and retinoic acid show promise in controlling ocular graft versus host disease. SUMMARY: Graft versus host disease is a common manifestation of allogeneic stem cell transplantation. Ocular manifestations are found in a majority of patients and may be the presenting symptom. Ocular findings include keratoconjunctivitis sicca, pseudomembranous conjunctivitis, corneal ulceration and perforation, and microvascular retinopathy. Systemic and local therapy may be used to control ocular disease.     

Severe visual loss caused by ocular perforation during chalazion removal

PURPOSE: To report two cases of ocular perforation during chalazion removal procedures leading to severe vision loss. DESIGN: Observational case series. METHODS: Two patients presented with unilateral decreased vision after chalazion removal procedures. Complete ophthalmologic examinations were performed. RESULTS: Examination revealed a cherry red spot and perforation site in the first patient. In the second patient, there was an intraocular gas bubble and ischemic retina. CONCLUSIONS: Local anesthetic injections for procedures such as chalazia removal can result in ocular perforation. We postulate that the intraocular injections led to extremely high pressures, compromising the blood supply to the retina and optic nerve. Anesthetic injections for all procedures, even chalazia removal, should be done with great caution. It is imperative to avoid injection if ocular perforation is suspected, as the high pressure may cause the majority of the visual morbidity.     

Repair of an extensive corneoscleral perforation in a case of ocular rosacea with a keratoplasty

BACKGROUND: A 58-year-old female patient with rosacea and a 7year history of eye trouble presented with a spontaneous corneoscleral perforation of the left eye. METHODS: The persisting ocular hypotonia with retinal folds made a closure of the leakage area necessary. Covering with a corneal transplant was chosen from among several possibilities available for the repair of eye-surface defects. The involved parts of the sclera and cornea were removed in a diameter of 7 mm. RESULTS AND CONCLUSIONS: The almost 6-year postoperative course with virtually no problems confirmed the keratoplasty as being effective therapy also in the case of perforation in rosacea scleroperikeratitis.     

Inadvertent globe perforation during retrobulbar injection in high myopes

Purpose: To report ocular perforation that occurred duringretrobulbar injection in 7 highly myopic eyes.Methods: Seven patients with a diagnosis of globe injuryduring retrobulbar injection for ocular anesthesia beforecataract surgery were managed by vitreoretinal surgery. Allinjections were performed by ophthalmologists. The surgeonrecognized the perforation in 4 cases at the time of injection.The preoperative vision was hand motion perception in 4 eyes andlight perception in 3 eyes. All patients underwent vitreoretinalsurgery because of the presence of vitreous hemorrhage and/orretinal detachment diagnosed by funduscopy or ultrasonography. Atthe time of surgery, all eyes had vitreous hemorrhage and 4 eyeshad rhegmatogenous retinal detachment. The number ofvitreoretinal procedures performed was: 1 procedure in 4patients, 2 procedures in 2 patients, and 3 procedures in 1patient. The period of follow-up ranged from 4 months to 4 years,averaging 20 months.Results: At the end of the follow-up period, the retinawas attached in 6 patients. The postoperative vision was 20/400in 3 eyes, finger counting in 3 eyes, and light perception in 1eye.Conclusion: Special care should be taken in retrobulbarinjection of highly myopic globes, which have an increased riskof perforation. The functional outcome of surgical repair ofthese eyes was poor.     

Hornhautperforationen bei Vitamin-A-Mangel

PURPOSE: Vitamin A has been identified as a substantial substrate for ocular surface integrity. Vitamin A deficiency, which can be caused by different etiologies, may lead to severe complications including corneal perforation. PATIENTS: Case reports of three patients with vitamin A deficiency. The observed etiologies leading to vitamin A deficiency were: (1) primary biliary cirrhosis, (2) malnutrition induced by alcohol abuse, and (3) malabsorption syndrome caused by a graft-versus-host disease of the intestine after bone marrow transplantation. RESULTS: In all three cases vitamin A serum levels were below normal values. In two patients retinol binding protein was also reduced. Two of three had corneal perforation, which required penetrating keratoplasty (pKP). In one of these cases, pKP was performed three times on both eyes due to a rapid corneal stromal melting leading always to corneal perforation. The third case developed severe corneal thinning of both eyes with the formation of a descemetocele. Vitamin A substitution improved symptoms and ocular surface integrity. CONCLUSION: Vitamin A in combination with zinc is a crucial factor for maintaining conjunctival and corneal ocular surface integrity. Moreover, vitamin A regulates mucin production of the ocular surface epithelium, which is known to be an important part of the ocular surface defense. Several different primary diseases might cause vitamin A deficiency. Especially patients with rapid progressive corneal ulceration should be examined for vitamin A deficiency. Substitution of vitamin A should be initiated as early as possible to prevent serious disease progression.     

A study of familial occurrence of Behçet's disease with and without ocular lesions

PURPOSE: To examine retrospectively the features of Beh?et's disease patients with familial occurrence and make a comparison between familial Beh?et's patients with ocular lesions and those without ocular lesions. METHODS: We sent questionnaires about Beh?et's disease patients with familial occurrence to 114 hospitals that reported treating such patients in previous nationwide hospital surveys, and to 341 hospitals selected at random in Japan. RESULTS: We obtained reports on 83 Beh?et's patients with familial occurrence. The positive rate of HLA-B51 was 53.1%. The positive rate of HLA-B51 among patients with ocular lesions was 64.0%, that in patients without ocular lesions was 14.3%, and that in patients with genital ulcers was 40.9%. The mean birth year and onset year of the patients with ocular symptoms was significantly lower than that of the patients without ocular symptoms. Although there was no significant difference between these two groups, parent-child involvement was more common among the patients without ocular lesions than in those with ocular lesions. CONCLUSIONS: The findings of this study suggest that the number of familial Beh?et's disease patients with ocular lesions and high HLA-B51 positivity has been decreasing recently. To elucidate the etiology of familial occurrence, larger scale epidemiological studies and further molecular studies of Beh?et's disease are needed.     

Clinical characteristics and outcome of current standard management of central retinal artery occlusion

Background: To investigate the visual outcomes in acute central retinal artery occlusion (CRAO) with current standard therapy at two university teaching hospitals. Methods: Retrospective analysis of two cohorts of CRAO patients from John Hopkins Hospital (JHH; USA), and Flinders Medical Centre (FMC; Australia), treated with current standard therapy. The outcome measures were visual acuity, and subsequent ocular and systemic ischaemic events. Results: The mean follow‐up period was 11.2 ± 13.1 months in the JHH cohort and 35.4 ± 34.9 months in the FMC cohort. The frequency distribution of vascular risk factors and the incidence of subsequent ischaemic events were similar for the patients from both institutions. All patients from JHH were treated as inpatients, whereas 79% of patients from FMC were treated as outpatients. More patients in the JHH cohort underwent paracentesis, ocular massage or were treated with intraocular hypotensive agents (76%) than in the FMC cohort (26%); however, there was no significant difference in visual outcome between the two cohorts (P = 0.114). Conclusion: Despite differences in management of CRAO between two institutions in different countries, visual outcomes were similar. This suggests a lack of efficacy of current standard treatment in acute CRAO.