泪道疏通联合典必殊眼膏留置治疗泪道阻塞

目的:观察泪道探通、激光泪道成形术联合典必殊眼膏泪道注药留置治疗泪道阻塞的临床疗效.方法:接受泪道探通、激光泪道成形术的患者128例196眼,术中联合泪道注入典必殊眼膏,术后每5～7 d酌情再次或多次注药,回顾分析应用效果.结果:泪道探通联合注药154眼,有效119眼,有效率为77.3%;激光泪道成形联合注药42眼,有效34眼,有效率为81.0%;总有效率为78.1%.结论:典必殊眼膏泪道注药留置在泪道探通、激光泪道成形术联合应用具有较好疗效.     

两种泪道探通冲洗术治疗先天性鼻泪管阻塞的疗效比较

目的:比较改良的冲洗式泪道探通术与泪道探通冲洗一体式治疗先天性鼻泪管阻塞的治疗效果。方法:选取2008-07/2012-09在我院门诊就诊的252例273眼先天性鼻泪管阻塞的患儿,作为本次的观察对象;其中140例156眼行改良的冲洗式泪道探通,112例117眼行泪道探通冲洗一体式治疗,比较两种方法的治疗效果,并随访1wk～1mo。结果:改良冲洗式泪道探通术一次性探通成功152眼,术后随访有2眼再次阻塞;泪道探通冲洗一体式一次性探通成功107眼,术后随访有8眼再次阻塞;两组比较差异明显具有统计学意义(P<0.05)。结论:改良的冲洗式泪道探通术对先天性鼻泪管阻塞的治疗效果明显优于泪道探通冲洗一体式。     

KTP激光联合药物灌注治疗泪道阻塞性疾病

目的：探讨KTP激光泪道成形术联合药物灌注治疗泪道阻塞性疾病的临床效果。方法：对不同类型泪道阻塞性疾病385例(492眼)，随机分为2组，Ⅰ组(275眼)激光泪道成形术后，地塞米松 庆大霉素混悬液冲洗泪道，四环素可的松眼膏 5-氟脲嘧啶注入泪道。Ⅱ组(217眼)激光泪道成形术后，地塞米松 庆大霉素混悬液冲洗泪道后，仅给予四环素可的松眼膏注入泪道。术后口服抗生素、激素及局部点抗生素、激素眼液，定期泪道冲洗。结果：Ⅰ组(275眼)，术后前期治愈好转率为98％，3mo后为94％；Ⅱ组(217眼)，术后前期治愈好转率为96％，3mo后为92％。结论：KTP激光泪道成形术联合药物灌注治疗泪道阻塞性疾病，有良好疗效，值得临床进一步推广应用。     

激光泪道成形术

目的　探讨倍频 YAG激光及 Nd:YAG泪道激光行泪道成形术的疗效。方法　将带针芯的泪道探针按常规泪道探通方法探至泪道阻塞处 ,拔出针芯 ,将倍频 YAG或N d:YAG激光的光纤插入泪道探针达到泪道阻塞处 ,反复击射至击通为止。然后注入生理盐水及抗生素 ,术后泪道冲洗或进一步扩张 1wk～ 3mo不等。结果　共治疗 5 5 4眼 ,随访496眼 ,随访时间 3～ 2 2 m o,单纯性泪道阻塞经 1～ 2次治疗泪道通畅者 412眼。17眼外伤性泪道断裂吻合术后阻塞病例全部再通 ,慢性泪囊炎 5 6眼中 5 0眼治愈 ,复发者有 6例 ,其中再次激光治愈 3例 ,3例术后又发生阻塞。 11例泪囊鼻腔吻合术失败者 ,经激光治疗 8眼症状完全消失。结论　泪道激光治疗泪道阻塞性疾病安全有效 ,并发症少     

泪道探通术治疗新生儿泪囊炎1856例临床研究

目的:观察应用泪道探通术治疗新生儿泪囊炎的临床效果。方法:选取1856例2217眼新生儿泪囊炎在泪道冲洗无效时采用泪道探通术治疗,术后泪道冲洗1次/d,连续2d;托百士眼液滴眼,3次/d,连续1wk。随访6～12mo。结果:所有2217眼行泪道探通术,行1次探通术2143眼,行2次探通术62眼,行3次以上探通术12眼。共治愈2208眼,治愈率为99.59%。结论:泪道探通术治疗新生儿泪囊炎安全可靠,疗效好。2～6mo婴儿是最佳探通时机。     

KTP激光泪道成形术联合微孔导管植入术治疗难治性泪道阻塞

目的:观察KTP激光泪道成形术联合微孔导管植入术治疗难治性泪道阻塞的临床疗效。方法:将难治性泪道阻塞患者50例按年龄、性别及阻塞部位相匹配随机分为A,B两组:A组25例为治疗组行KTP激光泪道成形术联合微孔导管植入术,术后用庆大霉素地塞米松及糜蛋白酶的混合液冲洗泪道1次/wk至术后1mo,1mo后拔除导管,以后3mo内每月冲洗泪道1次,随访6～12mo;B组25例为对照组,行KTP激光泪道成形联合药物灌注术,术后泪道冲洗及随访同A组,分别观察两组的疗效。结果:在泪小(总)管阻塞中,A,B两组的治愈率分别是80%,30%;在鼻泪管阻塞中,A,B两组的治愈率分别是66.7%,26.7%。无论是泪小(总)管阻塞,还是鼻泪管阻塞,A,B两组的治愈率均有显著差异(P<0.05)。结论:KTP激光泪道成形术联合微孔导管植入术是治疗难治性泪道阻塞的有效方法。     

氧氟沙星眼膏联合透明质酸钠在鼻泪管阻塞中的应用

目的 探讨氧氟沙星眼膏联合透明质酸钠在鼻泪管阻塞中的治疗方法与效果.方法 112例鼻泪管阻塞或狭窄随机分成两组:泪道探通联合冲洗术同时用氧氟沙星眼膏联合透明质酸钠58眼为治疗组,单纯行泪道探通 冲洗术54眼为对照组.两组患者均采用带针心的自制探针治疗,每5 d 1次,6次为1疗程,各治疗1～2个疗程,并随访6～18个月.结果 治疗组治愈率、有效率明显高于对照组,随访后治疗组复发率低于对照组.与对照组比较差异有统计学意义(P＜0.01).结论 氧氟沙星眼膏联合透明质酸钠治疗鼻泪管阻塞效果良好.     

泪道激光成形联合泪道植管术治疗泪道阻塞

目的探讨泪道激光成形联合泪道植管术对泪道阻塞的治疗效果。方法68例（85眼）泪道阻塞行泪道激光成形联合泪道植管手术，术后随访，观察泪道引流泪液功能的恢复情况。结果随访半年以上，经泪道冲洗，77眼泪道保持通畅（90．59％），7眼通而不畅（8．3％），1眼不通（1．18％）。结论泪道激光联合泪道植管术治疗泪道阻塞是一种有效的方法。     

泪道激光术后留置泪道引流管与药物灌注治疗泪道阻塞的疗效对比观察

目的:比较泪道激光术后药物灌注与留置泪道引流管两种方法治疗阻塞性泪道疾病的临床效果。方法:将Nd:YAG激光疏通泪道,A组38例40眼,激光疏通泪道后联合新型泪道引流管留置3mo。B组45例49眼,激光疏通泪道后注入典必殊药膏。术后随访3～6mo,对比分析两组的治疗效果。结果:泪道激光疏通术后留置泪道引流管与药物灌注,两种方法均有明显效果。治愈33眼,治愈率82.5%,好转4眼,好转率10.0%,总有效率92.5%;B组:治愈21眼,治愈率42.9%,好转13眼,好转率26.5%,总有效率69.4%。经统计学分析两组间差异有显著性意义(χ2=7.291,P<0.05)。结论:泪道激光治疗泪道阻塞性疾病安全有效,联合留置新型泪道引流管治疗泪道阻塞方法疗效明显提高。     

表麻下单侧孔钝头泪道探针治疗新生儿泪囊炎

目的:探讨表面麻醉下单侧孔钝头泪道探针治疗新生儿泪囊炎的疗效。方法:对年龄满4月龄～5岁泪囊炎患儿75例86眼经泪囊按摩治疗1mo无效且行常规加压泪道冲洗不通畅者,在表面麻醉下用单侧孔钝头泪道探针行泪道探通术,术后隔日行泪道冲洗最少3次。结果:一次探通痊愈84眼,第二次探通后痊愈2眼。全部病例无感染、假道或泪点撕裂等并发症,经过3mo随诊观察,86眼痊愈患儿无1例复发。结论:表面麻醉下单侧孔钝头泪道探针治疗新生儿泪囊炎安全有效。     

Choroidal filling patterns in sickle cell patients

Two choroidal occlusion syndromes are recognized: the triangular syndrome after ciliary artery occlusions, and the multifocal lesions associated with choroidal arteriolar occlusions. Both syndromes have been described in sickle cell patients. We compared early venous phase fluorescein angiograms of 51 Hb SS or Hb SC patients and 15 age and race matched controls, to test whether geographic early filling defects of the choriocapillaris might be more common in these Theologically impaired patients. We found no difference in occurrence of these filling defects between the two groups, and conclude that choriocapillaris filling defects in the early venous phase only are not pathological.     

Peripheral arterial filling time and peripheral retina fluorescence features in ultra-widefield angiography

AIM: To evaluate the peripheral arterial filling time (PAFT) and venous filling time (VFT) in eyes without known diseases that may influence filling process using ultra-widefield (UWF) fluorescein angiography (FA), and to review the peripheral retina fluorescence features. METHODS: A total of 30 eyes of 30 patients were retrospectively reviewed in this observational study. UWF-FA was performed using Optos 200Tx. PAFT and VFT was recorded. The interval between the arterial or venous filling completion and the previous photo was documented. The appearance of the far peripheral retina was described as either granular background fluorescence or mottled fluorescent band or vascular leakage. Terminal vascular patterns was described as loop pattern or branching pattern. Microvascular abnormalities such as arteriovenous shunting, vessels crossing the horizontal raphe, right angle vessels, terminal networks, capillary nonperfusion, drusen or microaneurysms were evaluated. RESULTS: The normal limits of PAFT was 3.397-8.984s and 4.399-11.753s for VFT. The appearance of the far peripheral retina, defined as granular background (63%), mottled fluorescence (20%), or vascular leakage (17%), was symmetrical between both eyes. Capillary nonperfusion (23%) and microaneurysms (40%) were more frequently found in eyes with loop pattern than in eyes with branching pattern. Other peripheral signs such as right angle vessels (73%), and terminal networks (80%) were commonly seen on UWF-FA in the normal peripheral retina. CONCLUSION: The main courses of retinal artery and vein filling time are overlapping with each other on UWF-FA. Notably, the arterial filling process is completed in the arteriovenous phase rather than the traditionally named arterial phase. There are various manifestations in the peripheral retina of normal eyes.     

板层角膜移植层间角膜填垫治疗角膜溃疡穿孔

目的 探讨板层角膜移植联合层间填垫角膜片治疗严重角膜溃疡穿孔的疗效。方法 对12例（12眼）角膜溃疡穿孔行角膜溃疡板层切除，层间填垫角膜片联合板层角膜移植。术后观察3～12月。结果 术后10眼植片成活（83．33％），无双前房发生。视力较术前提高者8眼（66．67％），无进步4眼（33．33％）。术后原发病复发1眼（8．33％），植片融解1眼（8．33％）。结论 该手术不仅具有治疗性，而且术后有一定的增视效果。     

Aerocyst urethral catheter insertion compared to expansion sponges application in external dacryocystorhinostomy

AIM: To evaluate the clinical effect and complications of two different filling materials (aerocyst urethral catheter and expansion sponges) applying in external dacryocystorhin- ostomy (EXT-DCR) and compare their advantages and disadvantages. METHODS: A retrospective study was made in the period from April, 1 2000 to April, 1 2005. Totally 180 patients (240 eyes) underwent the EX-DCR using different filling materials and divided into three groups randomly: negative control groups (group 1), expansion sponges group (group 2) and aerocyst urethral catheter group (group 3). The gender, etiology, clinical findings, surgical technique, filling materials, the condition of ocular surface and complications were analyzed. Filling materials were removed during day 7. Postoperative success was determined by lacrimal patency to irrigation, a positive dye test, hemorrhage and errhysis conditions after extubation and subjective resolution of epiphora and liquor puris. RESULTS: During a mean follow-up of 5.14±1.69 years, the success rate were 73.7％ (group 1), 86.5％(group 2), 98.7％ (group 3) in three groups. There was significant statistical difference among three groups in the surgical success rate and the operative complications (including hemorrhage, errhysis, periorbital ecchymosis after extubation)(P<0.05). CONCLUSION: EXT-DCR with aerocyst urethral cathete intraoperatively have higher success rate,fewer operative complications and a high patient satisfaction ,and can be used to simplify and speed up traditional EXT-DCR.     

玻璃体切除术后并发性白内障的超声乳化手术治疗

目的 探讨玻璃体切除术后并发性白内障的超声乳化手术治疗方法.方法 回顾性分析了2001年1月至2007年5月玻璃体切除术后并发性白内障共256例256只眼.玻璃体切除术后时间6～24月,平均15.2月,玻璃体切除术后视力开始下降即白内障发生时间1～21月,平均8.9月.采用超声乳化白内障摘除+人工晶状体植入术,其中玻璃体腔液体灌注组132例,无玻璃体腔液体灌注组124例,观察术中、术后并发症、术后视力等.结果 (1)术后3月,256只眼术后视力都有不同程度的提高.(2)无玻璃体腔液体灌注组术中后囊破裂10例,其中晶状体核坠入玻璃体腔5例,玻璃体腔液体灌注组术中后囊破裂1例,其中晶状体核坠入玻璃体腔0例,差别有统计学意义(χ2=6.61,P<0.025).(3)无玻璃体腔液体灌注组术后脉络膜脱离3例,玻璃体腔液体灌注组1例,差别无统计学意义(χ2=0.321,P>0.50).结论 玻璃体切除术后并发性白内障的超声乳化手术治疗时玻璃体液体灌注可以有效减少术中并发症.     

兔眼玻璃体切割术后填充物对并发性白内障的影响

目的:探讨兔眼玻璃体切割术后晶状体混浊的情况变化。方法:选用Dutch Bbelted兔63只,随机分为3组,玻璃体切割联合平衡盐填充(平衡盐组);玻璃体切割联合200mL/LC3F8填充(气体组);玻璃体切割联合硅油填充(硅油组)。观察3mo晶状体混浊变化情况及术后不同时间眼压变化情况。结果:玻璃体切割术后玻璃体腔内填充200mL/LC3F8气体,术后并发性白内障的发生率为85.7%;填充硅油术后并发性白内障的发生率为19.1%;填充平衡盐术后并发性白内障的发生率为14.3%,各组术后眼压较术前变化稳定,无统计学意义。结论:兔眼玻璃体切割术后气体注入组晶状体混浊的发生率最高,术后尽早取出硅油可以降低术后晶状体混浊的发生率。     

超声乳化手术治疗玻璃体切除术后并发性白内障

目的探讨玻璃体切除术后并发性白内障的超声乳化手术治疗方法。方法回顾性分析了2007年1月至2009年3月玻璃体切除术后并发性白内障共106例（100只眼）,玻璃体切除术后时间7—23个月,平均13．4个月。采用超声乳化白内障摘除联合人工晶状体植入术,其中玻璃体腔液体灌注组55只眼,无玻璃体腔液体灌注组51只眼,观察术中、术后并发症以及术后视力等。绪果术后3个月,106只眼术后视力都有不同程度的提高;无玻璃体腔液体灌注组术中后囊破裂13只跟,其中晶状体核坠入玻璃体腔5只眼,玻璃体腔液体灌注组术中后囊破裂2只眼,无晶状体核坠人玻璃体腔病例,差别有统计学意义（χ^2=10．04,P〈0．01）;无玻璃体腔液体灌注组术后脉络膜脱离3只眼,玻璃体腔液体灌注组2只眼,差别无统计学意义（χ^2=0．29,P〉0．05）。结论玻璃体切除术后并发性白内障的超声乳化手术治疗时,玻璃体腔液体灌注可以有效减少术中并发症。     

多层羊膜填塞术治疗单疱病毒性角膜溃疡

目的 评价多层羊膜填塞术在治疗单疱病毒性角膜溃疡中的效果．方法 临床选择单疱病毒引起的坏死性角膜基质溃疡患者40例（46眼），均行多层羊膜填塞术，随访观察其临床疗效。结果 平均随访（16±2．4）周，成功率达86．9％（40／46眼），溃疡的平均愈合时间为（4.2±1．4）周，术前角膜基质厚度为（407±32）μm，术后2个月增加至（428±21）μm，差异有非常显著性（P〈0．01）。6例（6眼）角膜溃疡未愈合，其中2例（2眼）因渍疡穿孔改行穿透性角膜移植术。结论 多层羊膜填塞术可有效治疗单疱病毒引起的坏死性角膜基质炎．该手术可以快速修复角膜创面．为后期角膜移植术创造良好的局部条件．     

Measurement of fluorescein angiograms of the optic disc and retina using computerized image analysis

Computerized image analysis was used to quantify objectively fluorescein angiograms of the optic disc, peripapillary choroid, and retina. Techniques were developed to measure fluorescein filling rates of the optic disc and the retinal vessels and the area of fluorescein filling defects within the optic disc. Two subjects, one with glaucoma and the other with ocular hypertension, showed increases of areas of fluorescein filling defects of the optic disc on follow-up and are presented here as examples of the application of these techniques. This methodology can be applied to the longitudinal follow-up of individual patients with glaucoma and retinal diseases, as well as to cross-sectional studies of patient populations.     

硅油填充眼复发性视网膜脱离的手术治疗

目的:探讨硅油填充眼复发性视网膜脱离的原因、手术方法选择及临床疗效。方法:对29例29眼硅油填充眼复发性视网膜脱离的原因、手术方式、解剖复位和视功能恢复结果进行分析。结果:复发性视网膜脱离由增生性玻璃体视网膜病变(proliferative vitreoretinopathy,PVR)引起者15眼行硅油取出+剥膜+注气或硅油填充术;裂孔未封闭者行剥膜+硅油填充+光凝,其中周边裂孔8眼,黄斑裂孔2眼,巨大裂孔后瓣漏脱者2眼,7眼联合巩膜扣带(外加压);2眼行环扎巩膜扣带+外加压+外放液+冷凝;术后均获得解剖复位,视功能提高者15眼,随访4mo,6眼复发。结论:硅油填充眼视网膜脱离的原因是多种的,根据不同的眼底表现应该选择不同的手术方法。