表面角膜镜片术治疗儿童外伤性白内障术后无晶体眼

本文报告了１０例儿童外伤性白内障术后无晶体眼，不适宜作人工晶体植入而接受了表面角膜镜片术。术后角膜屈光力平均增加９．２５Ｄ，裸眼视力均达０．２以上，矫正视力在０．４￣０．８之间，并恢复了双眼单视功能且矫正了弱视。经１￣３年追踪观察，表面角膜镜片保持透明，视力稳定且未出现并发症。结果表明该手术是一项近年来逐渐发展起来的操作简便、安全可靠、疗效确切的屈光性角膜手术。     

青光眼术后白内障人工晶体植入术

对２１例（２１只眼）青光眼术后白内障患者在白内障囊外摘除的同时植入后房型人工晶体。术后平均随访６．４个月（３—２８个月），８５．７％的患者术后矫正视力达０．１以上，９５．２％术后眼压维持正常，术后并发症包括晶体后囊混浊（３８．０％）和前房出血（９．５％）。提出术中避开滤泡在颞侧角膜缘切口和仔细选择好病例对手术成败十分重要。     

表面角膜镜片术联合白内障摘除术的临床研究

将无明显角膜散光（≤１．００ＤＣ）的白内障病人１５例施行表面角膜镜片术联合白内障摘除术（Ⅰ期手术），另将无明显角膜散光（≤１．００ＤＣ）的无晶体眼病人１９例施行表面角膜镜片术（Ⅱ期手术）。术后二组病人裸眼视力的提高程度相似；角膜屈光度增加分别为９．７７±２．８４Ｄ和９．８４±２．３５Ｄ；发生明显角膜散光（＞１．００ＤＣ）者分别为９例（６０％）和１０例（５２．６３％），二组间均无显著性差异（Ｐ＞０．０５）。术后二组病人屈光效应稳定时间分别为５．３７±０．８４个月及４．４５±１．０５个月，有显著性差异（Ｐ＜０．０１）。研究结果表明表面角膜镜片术联合白内障摘除术是可行的。     

儿童单侧性白内障后房型人工晶体植入术

总结４３例（外伤性３５例，先天性８例）儿童单侧性白内障后房型人工晶体植入术。术后矫正视力在０．５以上者外伤性白内障组占６５．７％；先天性白内障组占２５．０％。随访发现儿童眼对后房型人工晶体耐受良好，未见顽固性色素膜炎、大泡性角膜病变或继发性青光眼等严重并发症。影响儿童术后视力恢复的主要因素是弱视和后囊混浊，并讨论了防治方法。     

儿童外伤性白内障的人工晶体植入

报告５５例（５５只眼）４～１４岁儿童外伤性白内障摘除和人工晶体植入后随访３～３３个月的结果，矫正视力在０．５以上者３５只眼（６３．６４％）。术后影响视力的主要原因是后囊混浊，激光截囊术的成功率仅为７１．４３％。并对人工晶体植入屈光度的选择进行了讨论。作者指出，儿童外伤性白内障行人工晶体植入并非是单纯手术学问题，而是一项复杂的理论和实践相结合的体现，应非常慎重地进行处理。     

玻璃体切除在外伤性白内障人工晶体植入术中的应用

总结６１眼外伤性白内障人工晶体植入术中应用玻璃体切除术的情况及治疗效果。其中穿孔性眼外伤５２眼（７眼伴有球内非磁性异物），眼挫伤晶体脱位９眼。术后裸眼视力≥０．５者４３眼（７０．５％），矫正视力≥０．５者５４眼（８８．５％），矫正视力≥０．８者３１眼（５０．８％）。     

无缝线切口超声乳化白内障摘除及人工晶体植入术

报告７６例超声乳化白内障摘除及人工晶体植入手术的结果，术后１周矫正视力在１．０以上者４９例（６４．４％），术后３个月矫正视力在１．０以上者５７例（７５％），术中主要并发症为后囊膜破裂和虹膜损伤，术后为角膜内皮混浊。     

门诊后房型人工晶体植入术的体会

对５３例（５４眼）门诊白内障手术合并后房型人工晶体植入进行随访，其中老年性自内障２９眼，并发性白内障１４眼，外伤性白内障９眼，人工晶体二期植入２眼。术后视力≥０．５者２５眼（４６．３％），矫正视力≥０．５者４９眼（９０．７％）。术后并发症和国内其他报道相似。     

糖尿病患者人工晶体植入的临床观察

目的观察糖尿病患者白内障人工晶体植入的疗效。方法对２６例（３５眼）糖尿病患者和２６例（３４眼）非糖尿病患者行白内障囊外摘除联合后房型人工晶体植入。结果糖尿病患者３５眼中术后矫正视力０．５以上者１０眼（２８．６％）,非糖尿病患者３４眼中术后矫正视力０．５以上者１１眼（３２．４％）。差异无显著性（Ｐ＞０．０５）。两组术中术后并发症的发生率差异无显著性（Ｐ＞０．０５）。结论糖尿病患者血糖控制在相对安全范围内行此类手术安全可靠,能达到预期复明效果     

超声乳化白内障摘除和折叠人工晶体植入初步报告

目的：对３．２ｍｍ切口行白内障超声乳化同期植入折叠式人工晶体的手术结果行回顾性总结。方法：随机选择白内障２２例２８只眼行上述手术，对术后视力、屈光状态、角膜内皮细胞损失率等进行分析。结果：术后１周矫正视力在１．０以上者２３只眼（８２％），术后３个月矫正视力在１．０以上者２４只眼（８６％），术后角膜内皮细胞损失率１３％，角膜散光在术后１周、１月、３月与术前角膜散光相比，差别无显著性。结论：该手术的主要优点是患者在术后早期获得较好的裸眼视力及矫正视力，角膜散光轻微，同时减少了缝合所需要的时间及消除了缝线引起的不良反应。     

外伤性白内障人工晶体植入术的初步报告

对15例15眼外伤性白内障行运外摘除及一期后房型人工晶体植入木，随访7月～21月，平均12月，矫正视力在0.5以上者80％，1.0以上者26．7％，手术后反应与非外伤性白内障人工晶体植入术后相仿，不增加额外并发症。针对外伤性白内障特点，着重讨论了手术技巧，认为手术的灵活性尤其值得重视。人工晶体植入为外伤性白内障患者重建双眼单视功能提供了理想的手段。     

The Preliminary Report of Epikeratophakia in the Treatment of Pediatric Aphakia after Traumatic Cataract Extraction

Purpose: To study the role of epikeratophakia in treating pediatric unilateral aphakia after traumatic cataract extraction.Methods: We performed epikeratophakia in 43 children to treat aphakia after traumatic cataract extraction, using the corneal lenses made by ourselves. The rehabilitation of the the postoperative vision and the prevention of amblyopia were observed with a mean follow-up period of 20 months.Results: All the lenses remained transparent. Postoperatively, 31 cases (72. 1%) achieved uncorrected visual acuities (V. A) over 0. 2, 32 cases (74. 4%) achieved corrected V. A over 0. 4. Most of the cases achieved the best preoperative corrected V. A with spectacles of less than 3 diopters. No severe complication occurred. Conclusion: Epikeratophakia is predictable with quality lens and correct surgical technique. The result suggests that the epikeratophakia is one of the best treatment for the pediatric aphakia especially for those who are not optimal for IOL implantation. Eye Science 1997 ;13:3     

外伤性一过性近视的临床观察

目的：观察外伤性一过性近视的临床特点和预后。方法：对20例（25眼）外伤性一过性近视患者的临床资料进行回顾性分析。结果：小瞳检影验光发现所有外伤眼均存在近视，其中84％的外伤眼表现为轻、中度近视。睫状肌麻痹剂散瞳后验光发现所有外伤眼的近视度数均显著减轻。经合适的凹透镜矫正后所有外伤眼视力均可达1．0。对症治疗后4周内所有外伤眼的视力均恢复至≥1．0。结论：外伤性一过性近视病程短，对药物治疗反应好，且预后佳。     

外伤性白内障的手术疗效分析

目的:探讨外伤性白内障的手术时机、手术方式及术后疗效。方法:对50例行手术的外伤性白内障患者根据伤情给予不同处理后的疗效进行回顾性分析。结果:术后随访6～12mo,全部患者术后视力均有提高。术后6mo,最佳矫正视力0.05～0.25者12眼(24%),0.3～0.5者22眼(44%),>0.5者16眼(32%)。结论:根据眼部外伤的情况,选择适宜的手术时机和方式,外伤性白内障可取得较好的手术疗效。     

Epikeratophakia for keratoconus. Long-term results using fresh, free-hand made lamellar grafts.

Epikeratophakia using fresh, free-hand made corneal grafts was done in 16 patients with keratoconus. The follow-up period averaged 27.8 months (range 13-45 months). A significant improvement of visual acuity was obtained (p = 0.002), and 14 of the 16 eyes (87.5%) achieved a corrected visual acuity greater than or equal to 6/12. The spherical equivalent and the cylindrical refractive error were reduced (p less than 0.05), and a significant flattening of the central corneal curvature was obtained (p less than 0.002). The mean postoperative central corneal astigmatism was 4.25 D. Postoperatively, the mean central corneal thickness was 0.670 mm, and the mean central thickness of the epithelialized graft was 0.336 mm. Six patients reported some postoperative glare or blurring of vision, despite a visual acuity greater than or equal to 6/9 on the Snellen chart. No significant subjective or objective changes were noticed after the 6-month postoperative follow-up visit.     

F—ERG及F—VEP检查对外伤性白内障术后视力的预测

对92例眼外伤性白内障术前行闪光视网膜电图及闪光视诱发电位检测.92眼中,F—ERG预测正确的有65眼,可靠性为70.7%,F—VEP预测正确的有80眼,可靠性为87.0%.二者正常与异常之间术后矫正视力0.3以上者有显著性差异(P<0.01).结果说明二者对预测外伤性白内障术后视力有一定价值.     

高透氧硬性角膜接触镜对外伤性角膜浑浊合并无晶状体眼的矫治

目的探讨高透氧硬性角膜接触镜（RGPCL）对外伤性角膜浑浊合并无晶状体眼的矫治效果。方法对外伤性角膜浑浊合并无晶状体眼439例（441眼）配戴RGPCL,随诊5年,比较插片视力与RGPCL的矫正视力;随访5年观察配戴RGPCL角膜内皮改变情况。结果外伤性角膜浑浊合并无晶状体眼的插片视力和配戴RGPCL的矫正视力分别为0．47±0．22和0．69±0．21,（P〈0．0005）,差异有统计学意义。配戴RGPCL比插片能获得更好的矫正视力。角膜内皮计数5年后无明显改变。结论RGPCL对外伤性角膜浑浊合并无晶状体眼有较好的矫正视力,对角膜内皮代谢无明显影响。     

超声乳化联合人工晶体植入术治疗外伤性晶体半脱位的临床观察

目的观察超声乳化联合人工晶体机入术对外伤性晶体半脱位的疗效方法对33例外伤性晶体半脱位采用超声乳化晶体吸除联合人工晶状体植入术,人工晶状体采用睫状沟缝线固定或囊袋内植入。结果 33例(33眼)脱位的晶体均顺利取出,随访3-12个月(平均6个月),术后矫正视力>0.5 18例,0.3-0.5 13例,<0.2 2例结论超声乳化联合人工晶体植入治疗外伤性晶体半脱化取得了良好疗效。     

Visual outcome and complications after posterior capsule rupture during phacoemulsification surgery

Purpose: To determine the visual outcome and incidence of complications after posterior capsule rupture during phacoemulsification surgery. Methods: Forty-four eyes of 43 patients which sustained posterior capsule rupture or zonulysis during phacoemulsification surgery between April 1993 and May 1996 were retrospectively studied. Eyes With pseudoexfoliation syndrome, traumatic cataract and myopia > 6 dioptres were excluded from the study. The mean postoperative follow-up period was 26 months (range 3 to 47 months). Results: Forty-one eyes had posterior capsule rupture and 3 eyes had zonulysis. Of these 44 eyes, 41 eyes had vitreous loss and anterior vitrectomy at the time ofsurgery or subsequently. Excluding 2 eyes with pre-existing conditions that precluded good vision, 36 out of 42 eyes (85.7%) achieved spectacle corrected visual acuity of 6/12 or better post-operatively. Of all 42 eyes, 20 had anterior chamber intraocular lens (ACIOL) implantation while the others had posterior chamber intraocular lens (PCIOL) implantation. For eyes with ACIOL, 17 out of 20 eyes (85.0%) had best corrected visual acuity of 6/12 or better. For eyes with PCIOL, 19 out of 22 eyes (86.4%) had best corrected visual1 acuity of 6/12 or better. Conclusions:Phacoemulsification surgery, even if complicated by posterior capsule rupture or zonulysis, is compatible with good visual outcome. This is provided prompt attention is paid to the management of complications