超声乳化人工晶状体植入术治疗糖尿病并发白内障

目的探讨超声乳化人工晶状体植入术治疗糖尿病并发白内障的临床治疗效果。方法选择2012年4月—2014年4月在该院接受治疗的糖尿病并发白内障患者60例,将所有患者按治疗方法分为人数均等的两组,其中对照组用现代囊外摘除术联合人工晶状体植入术进行治疗,观察组用超声乳化联合人工晶状体植入术进行治疗。比较两组的术后视力以及并发症发生率。结果观察组视力0.5有88%,对照组视力0.5有64%,差异有统计学意义(P0.05);观察组术后并发症发生率明显低于对照组,差异有统计学意义(P0.05)。结论采用超声乳化人工晶状体植入术治疗糖尿病并发白内障,效果显著,患者术后视力恢复比较好,且术后并发症少,因此在临床上值得推广。     

超声乳化联合人工晶体植入术治疗年龄相关性白内障合并糖尿病的疗效

目的分析年龄相关性白内障合并糖尿病患者行超声乳化联合人工晶体植入术治疗后的视力与并发症。方法将98例(110眼)年龄相关性白内障患者按有无合并糖尿病分为两组,均行超声乳化白内障吸除联合人工晶体植入术,分析术后视力与糖尿病病程、术前空腹血糖的关系及术后并发症情况。结果糖尿病与非糖尿病患者白内障术后并发症有差异,视力无差异。糖尿病组术后视力与糖尿病病程有关,病程越长,眼底病变发生率越高,术后视力相对越低;与术前血糖无关。结论年龄相关性白内障合并糖尿病患者术后视力与糖尿病病程有关。     

超声乳化联合人工晶体植入术治疗白内障合并糖尿病患者的价值探讨

目的 探讨超声乳化联合人工晶体植入术治疗白内障合并糖尿病患者的应用价值。方法 选取2018年6月—2022年12月至江苏省淮安市洪泽区人民医院眼科就诊的74例白内障合并糖尿病患者为研究对象,依照计算机随机分组模式分为对照组（37例,小切口白内障摘除+人工晶体植入术）与观察组（37例,超声乳化+人工晶体植入术）,对比两组的临床疗效、角膜散光度、视力水平与并发症发生率。结果 观察组总有效率明显高于对照组,差异有统计学意义（P<0.05）。观察组术后7 d、1个月、3个月的角膜散光度均明显低于对照组,差异有统计学意义（P<0.05）。观察组并发症发生率明显低于对照组,差异有统计学意义（P<0.05）。结论 对白内障合并糖尿病患者采取超声乳化联合人工晶体植入术治疗后效果显著,安全性较高。     

超声乳化联合人工晶体植入术治疗年龄相关性白内障合并糖尿病的效果探讨

目的探讨超声乳化联合人工晶体植入术治疗年龄相关性白内障合并糖尿病的效果。方法从该院于2013年—2014年9月收治的年龄相关性白内障合并糖尿病患者中抽取30例患者作为实验组;另抽取30例年龄相关性白内障患者作为对照组;对这60例患者均进行超声乳化联合人工晶体植入术治疗,对比两组患者的治疗效果。结果对照组的患者治疗效果明显优于实验组,术后并发症明显少于实验组,两组对比差异有统计学意义,P0.05。结论超声乳化联合人工晶体植入术治疗年龄相关性白内障合并糖尿病的效果与患者患糖尿病的时间有着密切的关系,并且相较于没有患糖尿病的患者,更容易发生并发症。     

非球面散光型人工晶状体植入治疗合并角膜散光白内障患者的临床研究

目的研究非球面散光型人工晶状体植入治疗合并角膜散光白内障患者的临床疗效。方法将合并角膜规则散光1 D的年龄相关性白内障患者117例(158眼)分为两组,行超声乳化白内障吸出术后,Toric组69例(92眼)联合植入非球面散光型人工晶状体,对照组48例(66眼)联合植入非球面人工晶状体,术后比较两组患者的自觉症状、视力、全眼散光、客观视觉质量等指标。结果平均随访15.2月。术后3个月时,Toric组的全眼散光(0.65±0.38)D明显小于对照组(1.84±0.46)D,Toric组的裸眼视力(0.80±0.23)明显高于对照组(0.59±0.14),Toric组对比敏感度、MTF cut off值、100%对比度下视力、20%对比度下视力及患者主观视觉质量的改善程度均优于对照组。Toric组在末次随访时人工晶状体旋转(7.1±4.2)°。结论非球面散光型人工晶状体可以为合并角膜散光的白内障患者提供良好的术后主观、客观视觉质量。     

超声乳化白内障吸除、人工晶状体植入联合小梁切除术治疗白内障合并青光眼效果观察

目的观察超声乳化白内障吸除、人工晶状体植入联合小梁切除术治疗白内障合并青光眼的疗效。方法对48例白内障合并青光眼患者采用超声乳化白内障吸除、人工晶状体植入联合小梁切除术治疗（观察组）,并以采用囊外白内障摘除、人工晶状体植入联合小梁切除术治疗的40例同类患者为对照（对照组）。两组患者年龄、病情等资料比较,P均〉0．05。结果术后两组视力均恢复良好,总有效率近似（P〉0．05）;观察组术后3个月角膜平均散光度与术前比较无变化,对照组术后平均散光度明显高于术前及观察组术后（P〈0．05或〈0．01）。结论采用超声乳化白内障吸除、人工晶状体植入联合小梁切除术与囊外白内障摘除、人工晶状体植入联合小梁切除术治疗白内障合并青光眼疗效均好,但前一术式对患者的散光度影响较小。     

角膜地形图引导超声乳化治疗2型糖尿病年龄相关性白内障

目的观察角膜地形图引导超声乳化治疗2型糖尿病年龄相关性白内障患者角膜散光及泪膜稳定性。方法术前存在角膜散光的2型糖尿病年龄相关性白内障患者80例(80眼),随机分为A、B组,各40例(40眼)。A组采用常规上方透明角膜切口行超声乳化白内障吸除联合人工晶状体(IOL)植入术,B组在角膜地形图引导下作切口行超声乳化白内障吸除联合IOL植入术,术后l周及3个月复查角膜地形图并观察泪膜改变情况。结果角膜垂直散光失量J0和水平散光失量P,A组术前与术后1周相比,P<0.01,与术后3个月相比,P>0.01;B组术前与术后l周和3个月相比,P均<0.01。两组术后1周泪膜破裂时间(BUT)明显缩短,与术前相比,P均<0.05,但B组BUT较A组明显延长(P<0.05);术后3个月,两组BUT基本恢复至术前水平(P均>0.01)。结论对于合并角膜散光的2型糖尿病年龄相关性白内障,在角膜地形图引导下作切口行超声乳化联合I0L植入术可以部分矫正患者术前的角膜散光,并可以较早稳定泪膜,提高患者的视觉质量。     

两种术式治疗糖尿病视网膜病变合并白内障疗效比较

目的探讨超声乳化玻璃体切除＋人工晶体植入术、晶状体玻璃体切除＋人工晶体植入术治疗糖尿病视网膜病变（DRP）合并白内障的临床疗效。方法将58例DRP合并白内障患者分为A组28例（32眼）、B组30例（34眼）,A组行超声乳化玻璃体切除＋人工晶体植入术,B组行晶状体玻璃体切除＋人工晶体植入术。结果术后随访1-3 a,A组视力改善26眼,B组20眼;A组出现黄斑水肿、虹膜新生血管者分别为5、0眼,B组分别为11、5眼,两组比较均有统计学差异（P均〈0.05）。结论超声乳化玻璃体切除＋人工晶体植入术治疗DRP合并白内障疗效好,并发症少。     

小切口非超声乳化白内障摘除术联合巩膜咬切术的疗效

目的探讨小切口非超声乳化白内障摘除联合人工晶状体植入联合巩膜咬切术治疗成熟期年龄相关性白内障合并急性闭角型青光眼的临床疗效。方法对2013年1¹2月在吉林大学第二医院白内障科就诊的成熟期年龄相关性白内障合并急性闭角型青光眼患者27例(27眼),年龄5612月在吉林大学第二医院白内障科就诊的成熟期年龄相关性白内障合并急性闭角型青光眼患者27例(27眼),年龄56⁷8岁,平均69岁,行小切口非超声乳化白内障摘除联合人工晶状体植入联合巩膜咬切三联术,观察术后1 w、1、3个月的裸眼视力、最佳矫正视力及眼压控制状况,判定手术疗效。结果小切口非超声乳化白内障摘除联合人工晶状体植入联合巩膜咬切术术后裸眼视力,最佳矫正视力均较术前明显好转,术后眼压得到有效控制。结论小切口非超声乳化白内障摘除联合人工晶状体植入联合巩膜咬切术能有效控制眼压,提高视力,是较为安全可靠的治疗成熟期年龄相关性白内障合并急性闭角型青光眼的手术方式。     

分析糖尿病合并白内障患者行两种不同手术方式的临床效果

目的分析对比糖尿病合并白内障患者行两种不同方式白内障手术的临床效果。方法选取2018年10月—2020年11月该院收治糖尿病合并白内障患者70例,根据治疗方法不同分为对照组(小切口白内障摘除联合人工晶体植入术)和观察组(超声乳化吸除联合人工晶体植入术),各35例,观察两组患者的临床血糖指标水平、并发症情况以及者裸眼视力。结果观察组患者HbA1c、FPG、2 hPG等血糖指标与对照组,差异无统计学意义(P>0.05);观察组患者角膜水肿、后囊破裂、前房炎性渗出、黄斑水肿以及低血糖等并发症发生率与对照组差异无统计学意义(P>0.05);观察组患者术后裸眼视力提高优于对照组,差异有统计学意义(P<0.05)。结论对糖尿病合并白内障患者实施超声乳化吸除联合人工晶体植入术是安全有效的,能使患者得到更好的术后视力,跟小切口白内障摘除联合人工晶体植入术相比更有其优势。     

糖尿病性白内障超声乳化术的临床观察

目的探讨糖尿病性白内障行超声乳化吸出及人工晶体植入术的临床效果。方法对52例（62眼）糖尿病性白内障与同时期52例（60眼）老年性白内障行超声乳化吸出联合人工晶体植入术进行临床分析与比较。结果糖尿病性白内障术后并发症多,但经术后积极正确处理均能得到控制,视力恢复满意。结论白内障超声乳化吸出及人工晶体植入术治疗糖尿病性白内障是安全有效的。     

小切口非超声乳化囊外摘除人工晶体植入术治疗白内障的效果观察

目的观察小切口非超声乳化囊外摘除人工晶体植入术治疗白内障的效果及安全性。方法选取2011-02～2012-02该院眼科收治的639例白内障患者,随机分成两组,实验组339例采用小切口非超声乳化囊外摘除人工晶体植入术,对照组300例采用超声乳化手术,比较两组术后视力恢复情况及并发症发生情况。结果实验组的疗效优于对照组（P＜0.05）,两组并发症发生率比较差异无统计学意义（P＞0.05）。结论小切口非超声乳化囊外摘除人工晶体植入术治疗白内障有较好的临床疗效及安全性,是治疗白内障的主要方法,具有重要的临床应用价值。     

80岁及以上患者老年性白內障超声乳化的疗效及安全性

目的 探讨80岁及以上患者老年性白内障超声乳化吸除及人工晶状体植入术的疗效及安全性。方法 将95例(10O只眼)80～96岁的老年性白内障患者定为高龄老年组，经角膜缘隧道切口进行超声乳化吸除及人工晶状体植入术，同期收治665例(671眼)60～79岁老年性白内障患者定为低龄老年组，使用相同的手术方法作对照。结果 高龄老年组术后第1天、1周和1个月视力达到或超过0．5者分别是30只眼、52只眼、74只眼。两组患者术后随访时间3个月～3年，随访时的视力达到0．5以上高龄老年组患者82只眼(82．0％)，低龄老年组583只眼(86．9％)。并发症主要有后囊膜破裂、玻璃体脱出、晶状体核碎块脱位、角膜水肿、后囊膜混浊。结论 高龄与低龄老年性白内障经超声乳化吸除及人工晶状体植入术均有较好的疗效及安全性。     

预见性护理在高龄糖尿病性白内障患者围手术期中的效果

目的关于预见性护理对高龄糖尿病性白内障患者围手术期的效果分析。方法以2017年10月—2019年1月该院收治的50例高龄糖尿病性白内障患者作为该文观察组,另选50例作为该文对照组,均采用白内障手术治疗。两组患者分别采用预见性护理和常规护理进行干预,评价效果。结果比较两组患者的视力改善率,观察组为92.00%(46/50),对照组为78.00%(39/50)(P<0.05);观察组并发症发生率为6.00%(3/50),其中眼压升高、角膜水肿和感染患者各1例,对照组为18.00%(9/50),眼压升高患者3例,角膜水肿患者4例,感染患者2例(P<0.05)。结论对高龄糖尿病性白内障患者围手术期通过预见性护理进行指导能够有效提升患者的视力改善优良率,同时可以降低并发症对患者的影响,值得推广。     

Risks and outcomes associated with primary intraocular lens implantation in children under 2 years old with congenital and infantile cataract: the UK and Ireland IoLunder2 cohort study

BackgroundPublic health initiatives to prevent childhood blindness have emphasised the importance of effective intervention for congenital cataract. Primary intraocular lens implantation, an important recent management innovation, has been rapidly adopted despite the absence of robust supporting evidence. The IoLunder2 study aimed to provide much needed insights into visual and adverse outcomes after surgery with and without primary intraocular lens implantation in children aged under 2 years.MethodsActive surveillance case identification of cataract surgery and systematic data collection were undertaken through the British Congenital Cataract Interest Group (comprising 173 ophthalmologists who manage affected children in the UK and Ireland), which identified more children undergoing surgery for cataract than were reported to the National Health Service statutory databases. Multivariable regression analysis was used to estimate associations of intraocular lens use with visual outcome (assessed with standard hospital-specific but harmonised protocols) and incidence of adverse events at 1 year after surgery, with adjustment for all relevant confounding factors (eg, ocular comorbidity or age at surgery), which were agreed a priori on the basis of previous research or biological plausibility. All reported odds ratios (ORs) are fully adjusted.FindingsOf 221 children, 56 of 131 with bilateral cataract and 48 of 90 with unilateral cataract had primary intraocular lens implantation. Implantation was independently associated with better visual outcome in bilateral (OR 5·4, 95% CI 1·09–26·4, p=0·04) but not unilateral disease, and with increased odds of reoperation (bilateral OR 5·5, 95% CI 2·3–13·2, p=0·002; unilateral 16·7, 4·1–68·9, p=0·009). Intraocular lens use did not reduce the odds of postoperative glaucoma, the key sight-threatening complication, after surgery in bilateral or unilateral cataract.InterpretationUse of intraocular lenses in young children, particularly in settings where follow-up is limited, should be critically reassessed. The absence of visual benefit and the lack of a previously postulated protective effect against postoperative glaucoma question the value of intraocular lens implantation in unilateral disease. The association between intraocular lens implantation and better early visual outcomes in bilateral disease needs to be balanced against the risk of reoperation and exposure to general anaesthetics during a key neurodevelopmental period.FundingUlverscroft Vision Research Group, Great Ormond Street Hospital/UCL Institute of Child Health National Institute for Health Research Biomedical Research Centre, and Moorfields Eye Hospital NHS Foundation Trust/UCL Institute of Ophthalmology National Institute for Health Research Biomedical Research Centre.     

老年白内障患者超声乳化吸除联合人工晶状体植入术后生存质量的变化

目的：探讨老年白内障患者超声乳化吸除联合人工晶状体植入术后生存质量的提高状况。方法：超声乳白内障化吸除联合人工晶状体植入术治疗的老年白内障患者116例，分别在手术前，手术后1周和1、3、6个月作眼科检查并完成生存质量问卷。结果：生存质量得分及自理，活动，社交和心理4个指标的得分在手术后1周和1、3、6个月4个时点比较，两两之间比较差异无显著性（P＞0．05），但术后4个时点均高于手术前得分，且差异有显著性（P＜0．05）。结论：老年性白内障患者在行白内障超声乳化吸除联合人工晶状体入术后1周，生存质量即提高，从术后1周至6个月，生存质量无明显变化。     

Intraoperative malignant glaucoma during femtosecond laser-assisted cataract surgery: A case report

Rationale:Femtosecond laser-assisted cataract surgery (FLACS) has grown in popularity among ophthalmologists as a novel surgical technique. However, malignant glaucoma (MG) is a complication of FLACS. Herein, we report a case of MG following FLACS.Patient concerns:A 66-year-old woman presented with complaints of blurred vision in the right eye and a foreign body sensation in both eyes. Ophthalmological examinations showed that the corrected distance visual acuity was 20/50 and 20/25 in the right and left eyes, respectively. Without any topical anti-glaucoma medication, the intraocular pressure (IOP) was 20 mmHg in the right eye and 17 mmHg in the left eye. Slit-lamp examination of the right eye revealed a transparent cornea with a defect in the punctate overlying epithelium; the central anterior chamber depth was shallow the peripheral iris laser shot was visible, the pupil was normal, and the lens was mainly cortical opacified.Diagnoses:Based on the patient''s symptoms, examination results, and preliminary diagnoses, age-related cataract in the right eye, binocular post-antiglaucoma surgery, pseudophakicin in the left eye, and Sjogren syndrome were included.Interventions:FLACS was performed to facilitate anterior capsulotomy and segmentation of the nucleus in the right eye. MG occurred after the femtosecond procedure, and with the treatment of medicines combined with phacoemulsification, IOP was eventually normal without further antiglaucoma therapy.Outcomes:IOP was 16 mmHg on postoperative day 1. Ocular ultrasonography revealed no choroid detachment or hemorrhage in the right eye. Two weeks postoperatively, uncorrected visual acuity was 20/25, and IOP remained normal with no further antiglaucoma treatment on 1 month postoperatively.Conclusions:We describe the occurrence of MG after FLACS and illustrate that miosis and bubble formation after FLACS may be risk factors for MG during FLACS.     

高龄白内障人工晶体植入术的要点及安全性

目的　探讨 75岁以上高龄老年人植入人工晶体的手术要点及安全性。方法　统计 1 0年来 75岁以上高龄白内障患者术前、术中、术后的局部及全身合并症。结果　 1 0 4例病人中无一例发生心脑血管意外 ;眼部并发症与其他年龄组比未见增多。结论　只要给予足够重视并采取必要措施 ,人工晶体植入术对高龄老人不失为一安全理想的术式。