重组人表皮生长因子滴眼液在治疗电光性眼炎中的应用

0引言电光性眼炎是常见眼科急诊疾病之一,多发生在电焊操作及室内紫外线消毒的场所。常规治疗方法是给予5g/L地卡因滴眼液表面麻醉、局部冷敷等,以对症处理为主。临床常因多次地卡因滴眼液滴眼后出现角膜上皮松     

结膜下注射法治疗重症电光性眼炎

电光性眼炎是眼科最常见的一种辐射伤 ,我科 1999年用结膜下注射法治疗重症电光性眼炎 ,疗效确切 ,现介绍如下 :门诊收治电光性眼炎患者 2 2例 ,44眼。其中男性 2 0例 ,女性 2例。年龄 15～ 47岁 ,平均年龄 2 9岁。患者均有长时间紫外线接触史。初次发病 ,眼剧痛 ,结膜充血 ,伴不同程度的角膜上皮剥脱。治疗 :1%地卡因局麻患眼 ,结膜下注射 1%普鲁卡因 0 .4ml 盐酸肾上腺素 0 .1ml,涂抗生素眼膏后包扎患眼。结果 :2 2例患者剧痛症状全部消失 ,且结膜充血消退明显。随诊观察无反复 ,第二天角膜上皮愈合良好。无视力障碍 ,未发现并发症 ,治愈…     

对“复方点眼液治疗电光性眼炎”的异议

《实用眼科杂志》第4卷第6期360页刊登“复方点眼液治疗电光性眼炎”一文,笔者读后有几点看法:①0.25%氯霉素眼水8ml,1%丁卡因0.6ml,肾上腺素1ml配方,早已被眼科医师用于临床。②电光性眼炎主要是紫外线过度照射角膜上皮细胞,抑制细胞核的有丝分裂,细胞破裂及上皮脱落,产生光电性损伤。用局部麻醉剂丁卡因     

中学生群体发生电光性眼炎临床分析

目的探讨群体电光性眼炎的临床特征及救治措施。方法中学生325人（650眼）同日突发电光性眼炎，经先后滴1％的卡因及1％荧光素钠滴眼液后作眼部检查。根据临床表现，分轻重2型。轻型：209例（64．30％）418眼。重型：116例（35．61％）232眼。给患者滴促进角膜损伤修复和预防感染的眼液治疗。结果患者经药物治疗3天后，先后均痊愈。结论对群体突发电光性眼炎宜现场救治，以赢得时间。日常应加强卫生健康教育，严格管理紫外线灯的正确使用。     

电光性眼炎频滴地卡因致角膜上皮剥脱伤

我院地处城市工业区,电光性眼炎发病较多。作者现将10余年来所遇到因电光性眼炎频繁滴地卡因液所致角膜上皮剥脱伤(简称剥脱伤)28例(52眼)临床结果报告如下。     

频点地卡因治疗电光性眼炎致角膜上皮糜烂

电光性眼炎是常见的职业性眼病,多发生于有电焊操作的各种工厂及有产生紫外线辐射的各个部门。笔者遇到二例电光性眼炎患者,经应用地卡因频繁点眼使角膜上皮糜烂,现报告如下:例1 韩××男47岁电焊工于89年10月15日上午做电焊工作时,未戴保护眼镜,工作三小时后,自觉双眼异物感,畏光,轻度流泪,下午开始工作时戴普通变色镜,坚持工作4小时,下班后在某医院就诊,应用地卡因点眼治疗,并给予氧霉素眼液中     

电光性眼炎频滴地卡因致角膜上皮脱落糜烂3例诊治

在电焊作业时因未戴防护面罩而致电光性眼炎是常见的职业性眼病。门诊常用 0 5 %地卡因眼液滴眼以缓解症状 ,但若使用不当则可造成不良后果。最近 4月内我院门诊收治 3例因地卡因眼液滴眼不当而致角膜上皮脱落糜烂患者 ,报告如下。一般资料 :3例男 ,2 5～ 3 5岁 ,均为非正式电焊工 ,电焊作业时均未戴防护面罩 ,作业时间 2 0分钟至 3小时不等 ,作业后 3～ 6小时出现电光性眼炎症状 ,表现为双眼刺痛、畏光、流泪等。均自购“电光眼水”(含 0 5 %地卡因 ,以下同 )滴眼 10～ 2 0次 ,症状曾有缓解 ,但 1天后症状加重。症状体征 :眼异物感加重 ,…     

电光性眼炎70例临床分析

紫外线所致的电光性眼炎是较为常见的眼科急诊 ,多发生于电焊操作等产生紫外线辐射的场所。近年来 ,由于城市的发展 ,电焊使用频繁 ,从事电焊作业的人员日益增多 ,加之一些工人的防护意识薄弱 ,防护设施不全 ,电光性眼炎发病率增高。此外 ,室内紫外线消毒等 ,因疏于防护亦可导致电光性眼炎。我院地处北京市区东部 ,是东半部唯一一所综合医院 ,接诊电光性眼炎较多。现总结我院近 2年病例情况 ,报告如下。(一 )一般资料1999年 10月至 2 0 0 1年 10月 2年间共治疗电光性眼炎 70例 ,男 64例 (91 43 % ) ,女 6例 (8 5 7% ) ,年龄 2 0～ 62岁 ,平…     

儿童电光性眼炎24例分析

电光性眼炎儿童患者较为罕见,我科近5年来共诊治12周岁以下儿童电光性眼炎24例,现分析如下。 临床资料 一般资料　本组24例中,男14例(58.33％),女10例(41.67％)。年龄6月-12岁,平均9.1岁。均为双眼发病。 临床表现　24例均为因突发双眼疼痛,畏光,流泪而来院急诊。临床检查可见双眼眼睑痉挛、皮肤红肿,球结膜充血。裂隙灯检查见角膜上皮呈弥漫性点状脱落,角膜荧光素染色可见弥漫性点状着色。其中1例为儿科住院女婴。因晚间哭闹,双眼红肿而请我眼科医师急会诊,当时检查见双眼结膜充血,角膜荧光素染色可见弥漫性点状着色。     

不同眼用营养剂对电光性眼炎的疗效

目的 比较不同的眼用营养剂对电光性眼炎患者角膜上皮愈合时间、痛觉和泪膜稳定性的影响。方法 将12例24眼随机分成3组,分别加用含碱性成纤维细胞生长因子、10g/L羧甲基纤维素钠、多种氨基酸的滴眼液作为辅助治疗。结果 加用碱性成纤维细胞生长因子滴眼液组角膜愈合时间较其它两组缩短,加用10g/L羧甲基纤维素钠滴眼液组泪膜稳定性较其它两组增高。结论 碱性成纤维细胞生长因子有利于电光性眼炎角膜上皮的愈合,羧甲基纤维素钠有利于患者泪膜的稳定。     

Marginal corneal abscess associated with adult chlamydial ophthalmia.

In four patients with an adult chlamydial ophthalmia small, marginal corneal abscesses were detected. These corneal abscesses were associated with unilateral papillary and follicular conjunctivitis and punctate keratitis. In these patients no bacteria was isolated from the abscesses, but Chlamydia trachomatis was isolated from materials collected from the abscesses and from the conjunctival swabbings. In addition all patients had microbiologically proved concomitant chlamydial genital infections. The clinical signs resolved after topical treatment with rifampicin or tetracycline eye ointment for six weeks or systemic treatment with tetracycline for two weeks. Because of concomitant chlamydial genital infection it is advisable to treat patients with adult chlamydial ophthalmia with systemic tetracycline and to refer these patients and their consorts for investigation and treatment of their genital infection.     

Clinical profile and demographic distribution of ophthalmia nodosa: An electronic medical record-driven big data analytics from a multitier eye care network

Purpose:To describe the demographics and clinical profile of ophthalmia nodosa in patients presenting to a multitier ophthalmology hospital network in India.Methods:This cross-sectional, hospital-based study included 3,082,727 new patients presenting between August 2010 and December 2021. Patients with a clinical diagnosis of ophthalmia nodosa in at least one eye were included as cases. The data were collected using an electronic medical record system.Results:Overall, 434 (0.014%) patients were diagnosed with ophthalmia nodosa. Most of the patients were male (71.43%) and had unilateral (97.7%) affliction. The most common age group at presentation was during the third decade of life with 116 (26.73%) patients. The overall prevalence was higher in patients from a higher socioeconomic status (0.015%) presenting from the urban geography (0.019%) and in professionals (0.027%). The setae were identified and removed at presentation in 287 (66.13%) patients. The most common location of the setae was conjunctiva (45.72%) followed by cornea (39.64%). Most of the eyes (355; 79.95%) had mild or no visual impairment (<20/70). The most documented ocular signs were eye lid edema (35.81%), conjunctival congestion (73.87%), and corneal abrasion (29.05%). Less than one-tenth of the eyes required a surgical intervention for removal of the setae, corneal foreign body removal was performed in 10 (2.25%) eyes and conjunctival foreign body removal in four (0.90%) eyes.Conclusion:Ophthalmia nodosa more commonly affects males presenting during the third decade of life and is predominantly unilateral. The setae are most commonly lodged in the conjunctiva followed by the cornea, and the majority of the eyes have mild or no visual impairment.     

泪液缺乏性干眼治疗转归的定量检测

目的：应用角膜共焦显微镜、结膜印迹细胞学在泪液缺乏性干眼治疗前后定量测定病变角膜上皮细胞、结膜细胞,以期进一步准确评价干眼的治疗效果及预后。 方法：选择临床确诊为泪液缺乏性干眼症患者21例41眼,根据患者病史、症状、角结膜体征及相关检查确诊为泪液缺乏性干眼。应用聚乙二醇滴眼液及卡波姆凝胶联合治疗所有干眼患者,治疗前后依据结膜印迹细胞检查对干眼患者结膜细胞的鳞状化生及杯状细胞数量的多少进行分级,并对治疗前后印迹细胞分级进行统计学比较。应用海德堡激光共聚焦显微镜观察干眼治疗前后角膜上皮下神经纤维的形态学改变,定量评价同级结膜细胞干燥程度下治疗前后角膜上皮细胞密度的变化。 结果：印迹细胞检查:治疗前≤Ⅱ级6眼,Ⅲ级25眼,≥Ⅳ级10眼;治疗6mo后≤Ⅱ级19眼(46.3%),Ⅲ级17眼(41.5%),≥Ⅳ级5眼（12.2%）。治疗前后不同级别印迹细胞患者比例显著改变(P＜0.05）。共焦显微镜下细胞形态学改变：治疗前明显的角膜上皮细胞坏死脱落区,细胞密度下降,角膜上皮下神经纤维出现分支杂乱、异常走行,未见上皮下神经纤维5眼。治疗6mo后区域性细胞密度增加,所有患者均可见上皮下神经纤维,少数病例仍可见分支杂乱、异常走行。共焦显微镜显示在同级结膜印迹细胞程度下,角膜上皮细胞密度治疗前后进行比较,统计学上具有显著性差异（P<0.05）。治疗后细胞密度明显增加。 结论：应用角膜激光共焦显微镜和结膜印迹细胞定量观察泪液缺乏性干眼的治疗转归,从而确定以上两种方法在干眼治疗评价中具有重要价值。     

睫状体冷凝联合全结膜瓣遮盖术治疗并发角膜溃疡的绝对期青光眼

目的探讨睫状体冷凝联合全结膜瓣遮盖术治疗并发角膜溃疡的绝对期青光眼的临床疗效。方法并发角膜溃疡的绝对期青光眼18例（18眼）施行睫状体冷凝联合全结膜瓣遮盖术。术后观察眼部症状,角膜、结膜愈合情况及眼压等。结果随访平均（9．4±1．9）个月。所有患眼球结膜瓣与角膜牢固贴附。术后2d眼压开始下降,而后呈逐渐下降的趋势,至术后1个月时基本稳定。结论在严格病例选择的基础上,睫状体冷凝联合全结膜瓣遮盖术治疗并发角膜溃疡的绝对期青光眼的初步效果良好。     

Cyclosporine in the treatment of nonmicrobial inflammatory ophthalmic disease.

Eighteen patients with severe, progressive nonmicrobial inflammatory ophthalmic disease (including five with intermediate uveitis, four with sympathetic ophthalmia and three with serpiginous choroiditis) that had not responded to conventional therapy were treated with cyclosporine. Three of the four patients with sympathetic ophthalmia responded quickly and maximally, and the fourth showed partial improvement. One patient, with several corneal graft failures in the right eye, started cyclosporine therapy after undergoing left corneal transplantation; at the last follow-up visit the graft had been clear for almost 3 years. The response was inconsistent in patients with other types of eye disease. In general, the drug was well tolerated; however, two patients stopped treatment because of unpleasant side effects. No serious or irreversible complications developed. The results suggest that cyclosporine therapy is useful in the treatment of sympathetic ophthalmia and in high-risk corneal transplantation.     

急性氯气中毒眼部并发症的临床研究

目的：观察急性氯气中毒患者眼部并发症的发生情况。

方法：回顾性分析2009-02/2013-02就诊于临沂市人民医院的急性氯气中毒患者121例,其发生眼部刺激症状、干眼及其它一些眼部并发症的情况。

结果：在121例患者中,有117例(96.7%)并发有眼部刺激症状及角结膜上皮的损伤,随着氯气中毒程度的加重,眼表损伤也加重。在115例随访患者中,出院3,6mo后分别有32,7例患者存在干眼。1例轻度氯气中毒患者在激素治疗肺部并发症过程中并发泡状视网膜脱离,经停用激素和加用促进液体吸收药物治疗后,症状及体征逐渐好转。1例重度氯气中毒伴有昏迷患者在治疗过程中出现角膜溃疡,药物+结膜瓣遮盖术溃疡愈合,但留下永久性角膜白斑。

结论：急性氯气中毒会导致角结膜上皮损伤及干眼发生,在激素治疗过程中要警惕与激素应用相关的眼部并发症,比如泡状视网膜脱离。对于一些重度中毒的患者,在抢救生命治疗中,重视眼部角结膜上皮损伤的治疗,以免造成不可挽回的后果。     

主视眼非视觉优势与视疲劳的相关性观察

目的探讨主视眼非视觉优势与视疲劳的相关性。方法符合视疲劳诊断标准的门诊患者共956例。用卡洞法确定患者的主视眼,进行视觉优势的确定并进行非视觉优势的原因分析,对主视眼及非主视眼的各视级视力进行统计学处理。结果右眼主视眼者为702例,占73.4%;左眼主视眼者为254例,占26.6%;视疲劳的原因中屈光不正包括屈光参差、角膜结膜病、玻璃体混浊及早中期白内障、斜视及隐斜4项占总量的50%,不明原因的约占8%;主视眼非视觉优势是引起视疲劳的重要因素,在本组中主视眼非视觉优势总计588例,占总视疲劳患者的61.5%,屈光不正包括屈光参差、角膜结膜病、玻璃体混浊及早中期白内障是引起主视眼非视觉优势的主要原因;主视眼及非主视眼的视力呈弧形分布,低视力级(0.5视力以下)及高视力级(0.9视力以上)的病例数(眼数)相对较少,0.6～0.8视力级的患者总计为1104只眼,占总数的57.74%,提示在0.6～0.8视力级视疲劳有高发趋势,0.8及以上视力段的主视眼非视觉优势眼为958只眼,约占总数的50%,此阶段的视力差表现的较为明显。经统计学处理,主视眼的视觉优势明显差于非主视眼(P<0.001),主视眼的非视觉优势在视疲劳的发生中有着临床意义。结论主视眼非视觉优势与视疲劳具有相关性。     

Topical mitomycin C for extensive, recurrent conjunctival-corneal squamous cell carcinoma

PURPOSE: To evaluate the efficacy of topical mitomycin C for extensive recurrent conjunctival and corneal squamous cell carcinoma (SCC). DESIGN: Interventional case series. METHODS: A prospective study was conducted in a single institution. Ten patients (ten eyes) with extensive recurrent conjunctival and corneal SCC were studied. The patients received topical mitomycin C 0.04% one drop four times daily in the eye with SCC. Treatment cycles were defined as 1 week using medication followed by 1 week without medication. Such treatment cycles were repeated until resolution of the conjunctival malignancy was clinically evident. The main outcome measures were tumor response and medication-related complications. RESULTS: Of the ten patients, the median age was 66 years (range 33-77 years). Before referral, the patients had undergone a median of two previous conjunctival tumor resections revealing the diagnosis of in situ SCC in three cases and locally invasive SCC in six cases. At presentation, the tumor involved the limbus and cornea in all ten eyes, forniceal conjunctiva in three eyes, and tarsal conjunctiva in one eye. The extensive tumor affected a median of 10 clock hours of limbal conjunctiva and 10 clock hours of cornea, with corneal epithelial invasion for a median of 50% (range 20%-100%) of its surface. Mitomycin C 0.04% four times daily was applied for a median of three cycles (range 1-4 cycles). Complete tumor regression was documented in all ten cases (100%). There was no recurrence over a mean follow up of 22 months (range 6-50 months). Mitomycin C caused moderate temporary local irritation and conjunctival erythema and chemosis, but no long-term intraocular or extraocular complications. CONCLUSIONS: Based on this small series, topical mitomycin C 0.04% appears to be a safe and effective therapy for conjunctival or corneal SCC, even when there is extensive recurrent tumor.     

Visiplug?泪小管塞栓治疗中度以上干眼的临床疗效分析

目的　探讨应用眼表综合分析仪评估VisiPlug^?泪小管塞栓治疗中度以上干眼的临床疗效。方法　选择2015年1月至2016年3月于我院诊断为干眼并使用人工泪液及普拉洛芬滴眼液4周后仍有症状并再次评分为中度以上干眼的患者32例（64眼）,分成治疗组和对照组,每组各16例32眼,治疗组使用泪小管塞栓联合人工泪液及普拉洛芬滴眼液进行治疗,对照组继续使用人工泪液和普拉洛芬滴眼液治疗,随访6~12个月,分别观察治疗前及治疗后2周、1个月、3个月、6个月、末次随访时干眼主观症状问卷调查得分、眼表综合分析仪中泪膜破裂时间、泪河高度、眼红指数及角膜荧光素染色检查情况并评估临床疗效。结果　治疗后1 a,主观症状问卷调查评分治疗组由术前（16.95±5.12）分降至（4.36±0.16）分,对照组由术前（17.22±5.20）分降至（5.50±0.29）分,两组治疗前差异无统计学意义（P>0.05）,治疗后1 a差异有统计学意义（P<0.01）。治疗组、对照组治疗前与治疗后不同时间点的泪膜破裂时间、泪河高度、眼红指数、角膜荧光素染色评分的差异均有统计学意义（均为P<0.05）。两组在治疗后泪膜破裂时间均较治疗前显著延长、泪河高度均较治疗前显著增加,眼红指数评分和角膜荧光素染色评分均较治疗前显著降低,差异均有统计学意义（均为P<0.05）,但治疗组与对照组相比,泪膜破裂时间更长,泪河高度改善更为明显,眼红指数评分与角膜荧光素染色评分更低。结论　VisiPlug^?泪小管塞栓治疗中度以上干眼具有良好的临床效果。应用眼表综合分析仪评估VisiPlug^?泪小管塞栓治疗中度以上干眼的临床疗效更加客观、简便。     

单眼双侧翼状胬肉联合手术临床疗效观察

目的:观察患眼带自体角膜缘干细胞的结膜瓣移植加健眼带自体角膜缘干细胞的结膜瓣移植治疗单眼双侧胬肉的临床疗效.方法:对24例24眼患者单眼双侧胬肉行翼状胬肉切除及自体角膜缘干细胞移植术,鼻侧结膜瓣自患眼上方取,颞侧行结膜瓣自健眼取,随访7~16mo,观察临床疗效.结果:所有患者伤口愈合良好,1例复发,复发率为4%.结论:患眼带自体角膜缘干细胞的结膜瓣移植加健眼带自体角膜缘干细胞的结膜瓣移植治疗单眼双侧胬肉临床疗效好,复发率低,为解决单眼双侧翼状胬肉复发率较高的问题提供一种较好治疗方法.