The Institute of Ophthalmology of the University of London

With the technological revolution in medicine that occurred between the two World Wars came awareness of a need for an ophthalmic institution that would combine clinical and basic scientific research, professional training, and patient services. The history of the Institute of Ophthalmology of the University of London is reviewed by Sir Stewart Duke-Elder, who was instrumental in the foundation and development of the Institute and who currently serves as its President.     

U型插管法在泪道重建中的应用

目的：探讨U型插管法在泪道重建中的应用价值。方法：用硬膜外麻醉导管U型泪道插管的方法,对下泪小管断裂、泪小点狭窄、鼻泪管阻塞患者进行治疗。结果：21例下泪小管断裂者全部成功(其中2例泪囊切开,逆行找泪小管鼻侧断端),3例泪小点狭窄者2例成功,14例鼻泪管阻塞者11例成功。结论：U型插管法在泪道重建中方法简便、固定良好、不影响美观、留置时间长、效果确切。     

准分子激光原位角膜磨镶术后屈光回退与术中角膜床厚度的关系

目的　探讨准分子激光原位角膜磨镶术（ｅｘｃｉｍｅｒ ｌａｓｅｒ ｉｎｓｉｔｕ ｋｅｒａｔｏｍｉｌｅｕｓｉｓ ＬＡＳＩＫ） 矫治高度近视后屈光回退与术中角膜床厚度的关系。方法　对４７６ 例９３８ 只眼在我院接受Ｌａｓｉｋ 治疗的患者中,发生屈光回退的病例９６ 例,１８９ 只眼与未发生屈光回退的病例３８０ 例７４９ 只眼术中角膜床厚度及术前、术后１ ｗ ｋ 、１ 、３ 、６ ｍ ｏ 屈光状态的资料进行对比分析。结果　有屈光回退眼组比无屈光回退眼组平均角膜床厚度小;屈光回退眼组屈光回退程度（ 术后６ ｍｏ 时） 与角膜床厚度呈负相关系,上述结果经统计学检验均有显著性差异（ Ｐ ＜ ００１） ;有屈光回退眼组术后早期（１ ｗｋ） 屈光状态略成过矫,但其后屈光回退程度在０ ．５ａ 内呈加重趋势。结论　高度近视准分子激光原位角膜磨镶术中的角膜床厚度是影响术后屈光稳定性的重要因素     

北京同仁医院眼科2005-2009年就诊患者病种分析

目的了解北京同仁医院眼科就诊患者的病种分布情况,为有效地配置医疗资源提供依据。设计回顾性分析。研究对象2005-2009年北京同仁医院统计室及眼科行政部的工作量统计数据。方法回顾性分析各专科门诊工作量及手术量数据。主要指标专科门诊工作量及手术量。结果五年来门诊量排在前5位的病种依次为白内障(16.53%)、眼底病(15.65%)、斜弱视(15.11%)、屈光不正(13.88%)和角膜病(12.57%);手术病种前5位依次为白内障(31.85%)、屈光不正(21.98%)、眼底病(9.83%)、青光眼(8.58%)和角膜病(7.54%)。结论北京同仁医院眼科门诊量与手术量整体呈逐年上升趋势。就诊患者构成比较大的是白内障、眼底病和斜弱视。手术比例增长较多的为角膜病专科和眼肿瘤专科。     

羟基磷灰石在眼窝成形中不同术式的临床观察

目的 观察羟基磷灰石（HA）在眼窝成形中不同术式的手术效果。方法 据病眼条件采用不同术式的HA植入眼窝成形术，并对其手术效果进行比较分析。结果 不同术式的HA眼窝植入成形术手术效果有较大差异。50例中一期植入31例，随访期无显并发症，二期植入19例，其中下穹窿变浅3例，结膜切口裂开6例，义眼台裸露2例。结论 HA适于各种需行眼窝成形的患者，一期植入术，尤其是一期眼内容剜除自体巩膜囊盖HA植入术并发症少，义眼运动好。     

Measurement of the oscillatory potentials of the electroretinogram in the domains of frequency and time

The dark-adapted and light-adaped electroretinograms of 13 subjects with 23 normal eyes were analyzed by means of Fourier spectrum. The oscillatory potentials in the time domain were filtered out from the electroretinogram after a corresponding bandpass was given in the frequency domain. The coefficient of variation of total power, dominant power and dominant frequency of the isolated oscillatory potentials in the frequency domain, summed amplitudes and area of the isolated oscillatory potentials, each amplitude and implicit time of the first four major oscillatory potential wavelets in the time domain were compared. The implicit time showed the smallest coefficient of variation; summed amplitudes of OP1 to OP4 showed smaller coefficients of variation than those of the area, the amplitude of each oscillatory potential wavelet, dominant frequency and dominant and total power. The coefficient of variation of these measurement parameters in light-adapted electroretinograms was smaller than those in dark-adapted electroretinograms.Abbreviations CV coefficient of variation - OP oscillatory potential     

玻璃体内注射C_3F_8气体治疗复杂性陈旧性视网膜脱离

目的 探讨非玻璃体切割治疗复杂性视网膜脱离,尤其是PVH C级以上的病人。方法 对各种病因的复杂性视网膜脱离30只眼,采用改良的巩膜外扣带缝合方法,玻璃体腔内注入C_3F_8(全氟丙烷)气体。结果 术后随防半年～5年,平均1年半,视网膜复位25眼,术后18眼视力均有不同程度的提高。结论 在设备受限的情况下,对复杂性、陈旧性视网膜脱离的治疗。本方法简便易行,疗效可靠。     

显微镜下泪小管断裂吻合术的疗效观察

目的:探讨外伤性泪小管断裂吻合的有效方法。方法:63例均为外伤引起的下泪小管断裂。利用手术显微镜在粘弹剂与美兰混合液帮助下均一次性吻合成功,术后随访6mo～2a。结果:远期治愈47例,好转9例,不成功3例,未回访者4例,主要并发症为睑外翻,瘢痕增生导致失败。结论:显微镜下行泪小管断裂修复有效可行,远期疗效好。     

Stenoses and functional disorders of the lacrimal drainage apparatus. Radiological examination

The diagnosis of epiphora can be greatly aided by a special radiologic technique, performed during bilateral injection of contrast medium into the lacrimal passages and utilizing seriography, magnification and image subtraction. The authors describe the technique, discuss the interpretation of the various radiologic patterns, and stress the importance of this method for evaluating inflammation, stenoses and functional alterations of the lacrimal passages.     

高透氧硬性角膜接触镜减少儿童远视屈光不等差异的疗效

目的：探讨在非弱视性远视屈光不等儿童中,使用高透氧硬性角膜接触镜（ rigid gas permeable lens,RGP）矫正高屈光度眼视力,对双眼屈光度等效球镜差值（△SE ）、眼轴差值（△AL ）的影响。方法：选择我院视光门诊远视性屈光不正的6～12岁儿童95例190眼,且双眼屈光度差值（△SE）1D≤△SE＜2．0D和矫正视力不等,但每一眼的矫正视力均在同龄儿童正常范围内,即均非弱视。随机分为两组：A组48例,给屈光度较高眼（视力较差眼）配戴RGP,另一眼不戴镜处理;B组47例,不配镜作为对照组。用1％环戊酮散瞳验光计算等效球镜（SE）,测量眼轴（AL）,并随访1．5a。分别计算A组和B组等效球镜差值（△SE ）、眼轴差值（△AL ）,进行统计学分析。结果：A组双眼之间等效球镜度差值（△SE ）小于B组,差异有统计学意义（F＝18．508,P＝0．002＜0．05）;A组双眼之间眼轴差值（△AL ）小于B组,差异有统计学意义（ F＝1116．765,P＝0．000＜0．05）。结论：在非弱视性远视屈光不等儿童中,用RGP矫正高屈光度眼视力是有必要的,可以明显减少双眼屈光度、矫正视力差异,避免屈光参差所带来的视觉功能异常等一系列问题。     

早产儿视网膜病变的筛查分析

Objective To investigate the incidence of retinopathy of prematurity(ROP)in Dongguan People's Hospital. Methods Records of premature infants who had undergone ROP screening in our hospital between June 2009 and October 2010 were analyzed retrospectively. Results Twenty-one cases out of 126 screened infants had developed ROP. Both eyes suffered from ROP in all the cases. The incidence of ROP was 16.67%. Of 19 cases(15.08%)developed ROP less than prethreshold and 2 cases(1.59%)developed threshold ROP. Among the 126 screened infants, 13(31.71%)out of 41 premature infants with birth weight(BW)<1500g and 8(9.41%)out of 85 with 1500g≤BW<2000g developed ROP, 15(30.61%)out of 49 with gestational age (GA)<32W and 6(7.79%)out of 77 with GA≥ 32W developed ROP. The incidence of ROP either among the groups of BW<1500g andl500g≤BW<2000g(x2=9.899, P <0.01), or among the groups of GA<32W and GA≥32W(x2=11.227, P<0.01)had statistical differences. Conclusions The incidence of ROP is 16.67% in Dongguan People's Hospital in present study. The incidence of severe ROP is low. Birth weight and gestational age are important factors to affect ROP incidence.     

视盘倾斜及反向与屈光不正

目的探讨屈光不正的视盘表现。方法对500例1000只屈光不正眼进行视力检查、标准屈光检查、遮盖试验、立体视盘摄影、Humphrey自动视野计检查,观察分析屈光不正眼的视盘特征。结果1000只眼中25 眼(2.5%)发生了视盘倾斜,且24眼(96%)都存在近视或近视散光,其中球性屈光度>3.00D组与≤3.00D组和散光度>1.50D组与≤1.50D组比较,均有显著性差异,P<0.01,即球性近视高于3.00D或散光大于1.50D的近视眼出现视盘倾斜的发生率高。最常见的相关特征有:散光(5.8%)、弧形斑(4.98%)、斜视(4.76%)、视野缺损(16%)、后葡萄肿(4.29%)。结论视盘倾斜并不少见,且与散光或高度屈光不正密切相关,特别是近视。临床上要将视盘倾斜引起的视野缺损与其他病因引起的视野缺损相鉴别。     

艾滋病眼部并发症的资料分析

目的:通过调查分析,了解艾滋病眼部并发症的临床表现、治疗及预后。方法:收集赞比亚卡布韦总医院眼科2008-08/2009-08就诊患者。结果:艾滋病眼部并发症症状重,病程长,致盲率高。结论:充分认识、掌握艾滋病眼部并发症的临床表现,提高艾滋病的检出率,早发现、早治疗,提高艾滋病患者的生活质量。同时应强调预防是降低艾滋病发生率的关键。     

苏丹喀土穆地区春季卡他性角结膜炎720例临床分析

目的:探讨非洲热带沙漠干旱气候人群春季卡他性角结膜炎(vernalkeratoconjunctivitis,VKC)的病因,临床特点,流行病学特征,治疗和预防措施。方法:VKC患者720例1440眼进行回顾性分析,包括一般临床资料(表现和临床类型),实验室检测以及和我国VKC高发地区的比较,综合分析。结果:男460例,女260例,年龄2～36(平均12±3.6)岁,裂隙灯检查结果全部为角膜缘型,轻型者576例占80.0%,中型者130例占18.0%,重型者14例占2.0%。治疗采用局部点滴皮质类固醇类加1g/L肾上腺素液720例。合并全身用药者110例。临床观察平均用药时间2～4wk。治疗效果各年龄段比较差异不大(t=0.71,P>0.05),热带沙漠干旱地区VKC的发病率和我国新疆及宁夏相似,但临床类型和我国有别,全为角膜缘型,好发于青少年,少数严重者病史可长达20a。结论:VKC与地理和气候环境的影响至关重要,常规的临床治疗只能缓解症状而不能根治。     

环型全泪道插管术与顺行泪道插管术的比较

目的研究环型全泪道插管术与顺行泪道插管术治疗泪道阻塞疾病的临床疗效。方法207例259眼泪道阻塞患者随机分为2组，其中A组94例117眼行环型全泪道插管术，B组113例142眼行顺行泪道插管术，随访拔管后泪道通畅情况。结果术后随访1～9a，A组治愈108眼，治愈率92，3％；B组治愈114眼，治愈率80．3％．2组间差异有显著意义（P=0.006〈0.01）。结论环型全泪道插管术疗效明显优于顺行泪道插管术。     

泪小管阻塞探通新术式-套管探针及钳卡固定应用的临床报告

目的探讨泪小管阻塞手术中准确打通及支撑管固定的简便方法。方法局麻后以自制的套管针按泪道探通方法进针,到阻塞处后将外套管稍前推,稍扩张泪小管,再将内芯强行穿通就较容易地准确插入阻塞后的泪道。抽出内芯试通水后,将拉细到0.8 mm的硬膜外麻醉管插入外套管中达鼻泪管。拔出外套管留下硬膜外麻醉管,在其近泪点处剪断后稍外拔,接上作者研制的钳卡头后重新推入,将其钳卡于泪点处的睑缘即可固定支撑管。视阻塞情况留管1~3月后拔除。结果自2000年10月开始6年间共行46例均为单眼,追踪半年以上44例,其中治愈39例,占88.64%,无效5例,占11.36%,并发症少而轻。结论泪小管阻塞疏通手术中,应用作者研制的套管探针进行扩张定位、穿通、置管,三步操作连续进行,使探通及置入支撑管准确、简便。钳卡固定法使支撑管保留时间长而并发症少,能有效解决本手术的两个难点,从而提高疗效。     

双腰穿针法治疗陈旧性泪小管断裂

目的 介绍双腰穿针法治疗陈旧性泪小管断裂。方法 第一根腰穿针经上泪点泪道探通,并以其为支撑行泪总管或泪囊切开。第二根穿针经下泪下管、泪总管或泪囊切口泪道探通的同时退出第一根腰穿针。泪道冲洗挂线,逆行硅胶棒置入,下泪小管与泪总管或泪囊吻合。结果 １４例中除１例泪点撕裂轻微溢阳外,均一次治愈。结论 该术式操作及术后处理简便,成功率高。     

Nordisk ophthalmologisk tidsskrift 1889–1892

In the second half of the nineteenth century several ophthalmological journals appeared (Germany, England, France, United States). In the northern countries (Denmark, Finland, Norway, Sweden) an initiative lead to ‘Nordisk ophthalmologisk Tidsskrift’ published in the scandinavian languages in the years 1889–92. The ‘driving force’ behind the journal was the first professor in Ophthalmology in Copenhagen, Dr. Edmund Hansen Grut. The purpose with this presentation is to give the background for the rise and fall of the journal which was an attempt to promote Nordic Ophthalmology. The authors turned out, however, to be mainly those involved as editors. The journal never gained broad acceptance and it simply stopped in 1892, without any closing remarks. In spite of its short life the journal should be remembered for the very first publication on the arcuate scotoma, the Bjerrum scotoma from 1889. Although shortlived the initiative was not in vain, as can be read in the preface to the very first volume of Acta ophthalmologica.     

屈光不正性弱视儿童黄斑中心凹和视神经纤维层厚度测量

目的:利用第三代光学相干断层扫描仪(3D-OCT)对屈光不正性弱视儿童患者黄斑中心凹及视神经纤维层厚度进行定量分析,比较其与正常儿童的差异。方法:选取于我院就诊的屈光正性弱视患者20例40眼,年龄4～10(平均6.15±1.64)岁,等效球镜1.50～7.00D,眼轴22.07±0.97mm;正常对照组25例50眼,年龄4～15(平均8.62±2.42)岁,等效球镜0.57±1.07D;眼轴22.81±0.72mm。利用第三代光学相干断层扫描仪(3D-OCT)分别对其黄斑中心凹和视神经纤维层厚度进行测量,所得数据应用SPSS13.0统计软件进行独立样本t检验、Pearson检验,比较其与正常对照组的差异。结果:弱视眼与正常眼黄斑中心凹厚度分别为132.98±14.99μm和136.60±13.82μm,比较无显著性差异(P>0.05);平均视神经纤维层厚度分别为116.95±9.59μm和110.40±7.63μm,比较有显著性差异(P<0.01);正常对照组平均视神经纤维层厚度与眼轴呈负相关(r=-0.31,P<0.05),弱视组平均视神经纤维层厚度与眼轴无明显相关性(r=0.12,P>0.05)。结论:屈光不正性弱视可能影响视神经纤维层厚度,但具体机制尚需进一步研究。