曲安奈德治疗复发性翼状胬肉24例疗效观察

目的 探讨曲安奈德治疗早期复发性翼状胬肉的疗效.方法 复发性翼状胬肉20例(24只眼)体部注射曲安奈德0.1ml,注射后随诊6个月,观察胬肉消褪与进展情况.结果 24只眼中16只眼复发性胬肉消退,好转6只眼.治疗后未发现明显并发症.结论 曲安奈德翼状胬肉体部注射对复发性翼状胬肉有明显治疗效果.     

曲安奈德局部注射治疗小儿眼睑慢性肉芽肿临床观察

目的 评价曲安奈德治疗小儿眼睑慢性肉芽肿的效果.方法 323例(345只眼)小儿眼睑慢性肉芽肿病例,采用曲安奈德肉芽肿内局部注射1～4次,回顾分析其治疗效果.结果 345只眼小儿眼睑肉芽肿经过1～4次注射,337只眼(97.7％)痊愈,8只眼(2.3％)好转,总有效率100％.结论 局部注射曲安奈德治疗小儿眼睑慢性肉芽肿疗效确切.     

曲安奈德玻璃体腔注射治疗脉络膜脱离型视网膜脱离的初步研究

目的探讨玻璃体腔注射曲安奈德治疗脉络膜脱离型视网膜脱离的疗效及安全性。方法选择未经有效治疗的脉络膜脱离型视网膜脱离患者,于手术前经睫状体平坦部向玻璃体腔内注入曲安奈德混悬液0．1ml(4mg),注药后观察葡萄膜炎反应及脉络膜脱离消失情况,并于5—10d后行视网膜脱离复位手术。结果有葡萄膜炎反应的13只眼其症状均不同程度减轻,裂孔检出率由注药前的2／13只眼提高至注药后的7／13只眼,绝大多数脉络膜脱离眼于注药后10d内消失,5只眼采用巩膜扣带术,6只眼采用玻璃体切除联合眼内填充术,2例患者放弃手术治疗。手术后平均随访4．45个月,接受手术者最终视网膜全部复位,无1例出现全身应用糖皮质激素的副作用。结论玻璃体腔注射曲安奈德能迅速、安全、有效地治疗脉络膜脱离型视网膜脱离,减轻葡萄膜炎反应,提高脉络膜脱离型视网膜脱离的手术复位率。(中华眼科杂志,2005,41：606-609)     

合并脉络膜脱离的裂孔性视网膜脱离曲安奈德玻璃体腔注射的疗效评价

目的通过曲安奈德玻璃体腔注射寻求治疗合并脉络膜脱离的裂孔性视网膜脱离的有效方法。方法对19例(19只眼)合并脉络膜脱离的裂孔性视网膜脱离,给予曲安奈德玻璃体腔注射4mg,并对病人症状、眼压、手术条件的改善以及术后增殖性玻璃体视网膜病变的发生进行观察。结果曲安奈德成功注入18只眼的玻璃体腔,1只眼误入脉络膜上腔。注药后所有患者的症状都有缓解;前房闪辉、浮游细胞及玻璃体情况改善;17只眼眼压回升,UBM检查脉络膜、睫状体复位;2只眼眼压不升,UBM检查脉络膜、睫状体未能复位;视网膜复位手术一次性成功17只眼(89.5%),2只眼需行二次手术。随访2个月至13个月,18只眼视网膜复位。1只眼发生增殖性玻璃体视网膜病变需再次手术治疗。结论曲安奈德玻璃体腔注射能迅速减轻患者症状,对合并脉络膜脱离的裂孔性视网膜脱离的治疗及预后的改善具有积极的辅助作用。     

贝伐单抗联合曲安奈德玻璃体腔内注射治疗DME的疗效

目的:探讨贝伐单抗联合曲安奈德玻璃体腔内注射治疗糖尿病性黄斑水肿(diabetic macular edema,DME)的临床疗效。方法:将105例105眼DME患者随机分为贝伐单抗联合曲安奈德组、单纯曲安奈德组和单纯激光组各35例35眼,三组分别采用玻璃体腔内注射贝伐单抗联合曲安奈德注射液、玻璃体腔内注射曲安奈德注射液和多波长激光光凝的不同治疗方法。结果:所有患者在治疗后均进行6mo的随访,根据患者视力、眼压、裂隙灯、FFA和OCT等检查结果进行疗效判定。激光组中,显效12例(34.3%),有效14例(40.0%),无效9例(25.7%),总有效率74.3%。曲安奈德组中,显效15例(42.9%),有效18例(51.4%),无效2例(5.7%),总有效率94.3%。贝伐单抗联合曲安奈德组中,显效23例(65.7%),有效12例(34.3%),没有无效病例,总有效率100%。经统计学处理,贝伐单抗联合曲安奈德组的有效率高于曲安奈德组和激光组,差异均具有统计学差异(P<0.05,P<0.01),贝伐单抗联合曲安奈德组和曲安奈德组的总有效率均显著高于激光组(P<0.01,P<0.01),贝伐单抗联合曲安奈德组和曲安奈德组之间的总有效率相比较,无统计学差异(P>0.05)。结论:贝伐单抗联合曲安奈德玻璃体腔内注射治疗DME的临床疗效显著,值得进一步研究和应用。     

药物辅助下玻璃体切除术治疗增生性糖尿病视网膜病变

目的:探讨曲安奈德联合Bevacizumab(Avastin)辅助玻璃体切除术治疗严重糖尿病视网膜病变的临床应用价值。方法:回顾性分析药物辅助下玻璃体切除治疗的严重增生性糖尿病视网膜病变13例15眼,15眼均于术前3~14d行Bevacizumab(Avastin)1.25mg/0.05mL玻璃体腔注射,常规玻璃体切除术中使用曲安奈德辅助切除残留的玻璃体皮质、视网膜增殖膜,其中9例合并牵拉性视网膜脱离及黄斑水肿者硅油填充并留置4mg/0.1mL曲安奈德,4眼未使用硅油填充眼因合并黄斑水肿大量硬性渗出予曲安奈德留置。2眼单纯玻璃体积血者未注射曲安奈德。结果:除1例玻璃体腔注射Avastin 3d后术中出血较多特别是在剥离纤维新生血管膜过程中,其余病例术中出血很少,并能迅速自凝。联合曲安奈德辅助可清晰地辨别残留皮质、视网膜前膜甚至内界膜,黄斑水肿术后明显减轻,所有病例术后炎症反应轻,眼压控制良好,硅油眼中留置曲安奈德无明显并发症。结论:严重的增生性糖尿病视网膜病变玻璃体切除术前7~14d玻璃体腔注射Bevacizumab(Avastin),明显减少术中出血,术中使用曲安奈德辅助可视性良好。术毕留置4mg曲安奈德可有效减轻黄斑水肿及术后反应。     

醋酸曲安奈德注射治疗儿童霰粒肿的临床观察

目的观察醋酸曲安奈德皮下注射治疗儿童霰粒肿的临床效果。方法124名3—12岁霰粒肿患儿，病变区皮下注射4％曲安奈德0．3—0．5ml＋2％利多卡因0．2ml。结果97名患儿（78．22％）1次注射后3—17d眼睑无红肿，囊肿完全消退，11名患儿（8．87％）再次注射后痊愈，总有效率87．10％，未观察到明显并发症。讨论病变区皮下注射曲安妥德注射儿童霰粒肿是一种有效、简便、安全的治疗方法。     

曲安奈德局部注射治疗泪腺炎(附10例临床观察)

目的探讨长效皮质类固醇激素曲安奈德局部注射治疗泪腺炎的效果。方法自2002年6月-2005年9月对10例不愿或不能接受全身激素治疗的患者采取曲安奈德局部注射的方法进行治疗,10例患者均为单侧泪腺炎。取曲安奈德混悬液20mg(0.5ml)加2%利多卡因0.5ml注射于眶外上缘泪腺组织内,局部加压20分钟,隔周后重复注射至病情稳定或局部肿块消失,最多注射5次。结果10例中5例(其中4例为第一次发病,1例曾有过2次复发)患者注射3-5次后治愈,观察6个月-3年未见复发;3例患者(均有过2次以上复发病史者)注射后好转,其中1例又复发2次在再次注射曲安奈德后病情稳定;2例有过多次复发史且多次不规律用口服激素治疗的患者局部注射5次无效,且因反复发作最后接受手术摘除泪腺。结论曲安奈德局部注射治疗泪腺炎对于不愿接受或全身情况不允许大剂量激素治疗的患者为一可行而有效的方法,尤其对于初次发病的患者效果显著。     

曲安奈德球结膜下注射治疗前部非坏死性巩膜炎的疗效观察

目的：观察曲安奈德球结膜下注射治疗前部非坏死性巩膜炎的临床疗效。方法回顾性病例系列。前部巩膜炎患者12例（14只眼）,弥漫性2例,结节性10例。曲安奈德4～8 mg巩膜病灶处结膜下注射,小于二象限做1点注射,大于二象限做2点注射。观察治疗方法的有效性及局部和全身的不良反应。结果注射后病变轻者1周显效,重者2周显效,一次注射后均治愈。结论曲安奈德结膜下注射治疗前部非坏死性巩膜炎简单安全有效。     

头皮注射曲安奈德致双眼视网膜中央动脉阻塞诱发急性闭角型青光眼发作一例

患者男性,46岁.因头皮注射曲安奈德后,自觉双眼胀感、视物不清6h,于2009年2月15日到邢台市眼科医院急诊治疗.患者曾于2009年1月21日,因患头皮毛囊炎自行注射曲安奈德治疗,每次注射曲安奈德20 mg/2 ml,开始两次注射时,自感头皮部有隆起包块;第3次注射曲安奈德35.0mg/3.5 ml,注射后约10 min时,虽未见头皮有包块,但自感心慌、四肢无力,双眼发黑伴胀痛,之后出现短暂意识丧失,家人急送至当地医院就诊.行头颅CT及心电图检查均未发现异常,请眼科会诊,发现双眼瞳孔散大,眼压高,诊断为双侧"青光眼",急行双眼前房穿刺降低眼压,给予1%毛果芸香碱眼液缩瞳,0.5%马来酸噻吗洛尔眼液滴双眼,静脉滴注20%甘露醇250 ml,症状无好转,遂转入我院治疗.     

Botulinum toxin A injection for primary and recurrent chalazia

Background  To study the efficacy and safety of subcutaneous botulinum toxin A injections in the treatment of primary and recurrent chalazia. Methods  Prospective, placebo-controlled consecutive case-series trial. Sixty three patients were divided into two groups: group 1 consisting of 32 patients previously diagnosed with and treated for primary or recurrent chalazia with 2–5 international units (IU) in 0.2–0.5 ml of preserved saline solution of botulinum toxin injection, and group 2 consisting of 31 patients receiving placebo. The main outcome measures were localization and duration of the disease, size of chalazion before and after treatment, clinical resolution of chalazion, time to resolution, and complications of treatment. Results  There was a clinically and statistically significant between-group difference in the rate of therapeutic success and post-therapeutic chalazion regression, but not in the rate of complications. Conclusions  Botulinum toxin A injection is effective and safe treatment for primary and recurrent chalazia. Lesion regression that did not respond to the average of two injections would benefit more from surgical excision or systemic antibiotic therapy. The authors have no financial interests in this study. The authors have full control of all primary data and they allow Graefe’s Archive for Clinical and Experimental Ophthalmology to review data of study.     

Treatment of chalazia with injectable triamcinolone

Twenty patients with a total of 22 chalazia unresponsive to conservative medical treatment were randomized for treatment with either intralesional triamcinolone acetonide or placebo. Eight of 12 lesions treated with triamcinolone acetonide resolved. In all ten of those treated with normal saline injection, treatment failed to achieve a clinical cure. Nine of the normal saline treatment failures were then injected with triamcinolone acetonide. Eight of nine in this group achieved clinical resolution. When the two treatment groups were combined, a total of 16 of 21 chalazia (76%) resolved with intralesional steroid therapy. Intralesional steroid therapy can be used successfully to treat chalazia, and its effect is not merely due to a mechanical disruption of the lesion. Pain and discomfort from intralesional injections is a common complaint.     

Treatment of chalazia with intralesional triamcinolone injection

Chalazia are commonly encountered lesions of the eyelids. They often resolve spontaneously or respond to a conservative therapeutic regimen. Chalazia not responding to this type of treatment are often referred for surgical extirpation. This article presents an alternative to surgery, namely intralesional injection of a synthetic glucocorticoid. Reports show a high success rate with few complications using this procedure. A patient with chronic bilateral chalazia was given intralesional injections after conservative therapy was unsuccessful. Two corticosteroid injections produced complete resolution of the lesions.     

Subconjunctival total excision in the treatment of chronic chalazia.

A technique of subconjunctival total excision was used to treat 34 chronic chalazia. Another 34 were treated by incision and curettage and a further 32 by intralesional injection of long acting steroid. Subconjunctival total excision showed a higher success rate (94.12%) compared to the incision and curettage group (76.47%) and the injection group (75%). As the difference was statistically significant and due to other advantages we recommend subconjunctival total excision as a primary approach in the treatment of chronic chalazia.     

Intralesional corticosteroid treatment of chalazia

Thirty-eight chalazia in 29 patients were treated with intralesional corticosteroid injections; 71% resolved after one injection, and another 15.8% resolved after a second injection. Only two large chalazia required surgery. Intralesional corticosteroid injection offers an easy, quick, and effective way of treating small and medium-size chalazia and does not require special instruments or any additional treatment. The method is convenient for the patient as well as for the ophthalmologist.     

Intralesional corticosteroid injection in the treatment of chalazion

OBJECTIVE: To evaluate the efficacy of intralesional corticosteroid injection in the treatment of chalazia in black African patients. METHODS: In a prospective study conducted between February 1999 and February 2000, 25 black African patients with chalazion (25 eyes, 29 chalazia), ranging in age from 15 to 54 years (mean age +/- SD, 30.6+/-9 years), were treated with intralesional triamcinolone (injection of 0.075 - 0.5 ml triamcinolone acetate at a 5-mg/ml concentration). RESULTS: Success was achieved in 18 (72%) of 25 patients [20 (74%) out of 27 eyes, 22 (76%) out of 29 chalazia)]. In 11 of 25 patients, two intralesional injections were necessary to obtain these results. Recurrence occurred in five eyes (five chalazia, 17%) after 5-6 weeks. During a mean +/- SD of 4.68 months (range, 3.5-12 months) of follow-up, no postinjection ocular complication occurred. CONCLUSION: Intralesional corticosteroid injection appears to be effective in managing chalazion in black African patients, as reported in previous studies in Caucasian patients. This treatment can be used when curettage is contraindicated.     

Adrenocorticosteroid injection vs. conservative therapy in the treatment of chalazia

Three methods of treating chalazia were compared in a controlled trial. Group A (conservative therapy of warm soaks and lid hygiene) consisted of six patients with seven chalazia. Group B (intralesional adrenocorticosteroid injection) had five patients with five chalazia. Group C (conservative therapy with intralesional steroid injection) included nine patients with ten chalazia. Success rates after six weeks of follow-up were: Group A: 3 of 7 (43%), Group B: 4 of 5 (80%), and Group C: 9 of 10 (90%). Intralesional steroid injection with or without concurrent conservative therapy was more effective than conservative management alone.     

Periorbital Lipogranuloma after Facial Autologous Fat Injection and Its Treatment Outcomes

Purpose

To investigate periorbital lipogranuloma cases that developed after autologous fat injection and to determine various treatment outcomes from these cases.

Methods

This retrospective study involved 27 patients who presented with periocular mass (final diagnosis of lipogranuloma) and had history of facial autologous fat injection. The collected data included information on patient sex, age, clinical presentation, number and site of fat injections, interval between injections, duration from injection to symptom onset, fat harvesting site, use of cryopreservation, and treatment outcome.

Results

The most common presenting symptom was palpable mass (92.6%), followed by blepharoptosis and eyelid edema. The mean time from injection to symptom onset was 13.6 ± 29.2 months (range, 2 to 153 months). Patients were managed by intralesional triamcinolone injection (six patients) and surgical excision (three patients); 18 patients were followed without treatment. Among the six patients who underwent intralesional triamcinolone injection, five showed complete resolution, and one showed partial resolution. Among the 18 patients who were followed without management, three showed spontaneous resolution over a 5-month follow-up period.

Conclusions

Lipogranuloma can develop in the eyelid after autologous fat injection into the face. Both surgical excision and intralesional triamcinolone injection yield relatively good outcomes. Simple observation can be a good option because spontaneous resolution can occur in a subset of patients.     

Intralesional corticosteroid therapy of chalazia: a comparison with incision and curettage.

Patients with chalazia were randomly allocated to treatment by intralesional triamcinolone injection or incision and curettage. Incision and curettage resulted in a significantly higher rate of resolution by two weeks after treatment.     

A prospective randomized treatment study comparing three treatment options for chalazia: triamcinolone acetonide injections, incision and curettage and treatment with hot compresses

BACKGROUND: Three methods of treating chalazia were compared: intralesional triamcinolone acetonide injections (0.2 mL of 10 mg/mL), incision and curettage and advice regarding the application of hot compresses to the affected eyelid. METHODS: This was a single centre randomized treatment study. Patients with a chalazion underwent either of the three treatment options. Chalazion resolution, pain, satisfaction and inconvenience experienced because of treatments were the outcomes assessed via a telephone interview at 3 weeks. RESULTS: 136 consecutive patients were enrolled into the study. At the 3-week follow up, the resolution rates in the triamcinolone acetonide injection and surgical treatment groups were not significantly different from each other at 84% (47/56) and 87% (39/45), respectively (P < 0.001), but was significantly lower in the conservative treatment group at 46% (16/35) (P < 0.001). Pain scores were higher in the surgical treatment group compared with the triamcinolone injection group (P < 0.003). Inconvenience experienced by patients was reported as significantly less in the triamcinolone group compared with the conservative and surgical treatment groups (P < 0.001). Patient satisfaction scores were lower in the conservative treatment group compared with each of the other two groups which in turn, were no different from each other regarding this outcome (P < 0.001). CONCLUSIONS: To our knowledge, this is the first prospective randomized study comparing the three methods of chalazia treatment. Results suggest that a single triamcinolone acetonide injection followed by lid massage is almost as effective as incision and curettage in the treatment of chalazia and with similar patient satisfaction and less pain and patient inconvenience.