特殊类型白内障摘除人工晶体植入术

近年来,IOL植入术的适应范围不断扩大,但对特殊情况IOL植入的手术适应症、手术时机、IOL的选择、超常规的手术操作方法以及术后处理等尚未取得共识。1 儿童白内障IOL植入术 对儿童无晶体眼的矫正目前有四种办法,即眶架眼镜、角膜接触镜、角膜表面镜及IOL。前三种办法尚存在一定的缺点,而后一种在某些方面可加以弥补。但由于儿童眼的固有特点,对IOL植入术仍存在诸多问题,亦缺乏长期观察的资料。关于手术时机,生后2～3个月是固视反射发育的关键时期,故先天白内障(特别是单眼)理应在生后2～3个月内进行手术,并及时矫正其无晶体状态。对双眼者如程度不十分严重,对正常生活影响不大,则可随访观察,不急于手术。     

儿童外伤性白内障人工晶体植入术体会

目前,人工晶体植入已成为儿童白内障术后无晶体屈光矫正的主要方法之一。1991～1995年,我们为38例(38眼)患儿行外伤性白内障人工晶体植入术。现将体会报告如下。1 临床资料 本组男32例,女6例;年龄3～14岁,平均6.9岁。右眼16只,左眼22只。眼球穿通伤30例,钝挫伤8例(其中3只眼前囊破裂,晶体皮质溢出到前房内)。术前视力均为数指或手动,伤后5天至2年(平均3.7个月)施术。2 手术方法 术前常规行B超检查,排除玻璃体和视网膜病变。除2只眼为二期植入外,余均为一期植入。采用爱尔康改良“J”型或“C”型后房型人工晶体,行囊袋内植入式或睫状沟     

老年性白内障患者超声乳化及人工晶体植入术

我院自 1997年 5月至 2 0 0 0年 6月对老年性白内障患者施行超声乳化及人工晶体植入术 ,现就手术并发症与相关的老年人疾病进行分析如下。　　一、资料与方法　　 1.一般资料 :老年性白内障患者 5 82例 (6 73眼 ) ,男 374例 (4 2 7眼 ) ,女 2 0 8例 (2 46眼 )。年龄 6 0～ 86岁 ,平均(6 7 4± 8 7)岁 ;其中 6 0～ 6 9岁 2 81例 (334眼 ) ,70～ 79岁2 37例 (2 6 3眼 ) ,80岁以上 6 4例 (76眼 )。Ⅰ级核 6 9眼(10 3% ) ,Ⅱ级核 2 5 3眼 (37 5 % ) ,Ⅲ级核 314眼 (4 6 7% ) ,Ⅳ级核 37眼 (5 5 % )。术前视力为光感～ 0 4。随访3个月～ 3年 …     

白内障摘除与人工晶体植入术的进展概况

白内障为当今致盲的首要原因,手术仍为复明的主要有效手段。我国白内障手术从公元8世纪就有针拨术的记载,到20世纪60年代又出现了针拨套出术。Daviel 1745年首次报告囊外白内障摘除术(Extracapsular Cataract Extraction,ECCE),也经历了囊内摘除术到现代囊外摘除术。50年代国内多采用囊外摘除术,由于术中残留皮质多,并发症多,矫正视力差,故60年代引进了各种囊内摘除术,如Arruga囊镊法、Knaf吸盘法、α-糜蛋白酶断带法Krawavicz冷冻摘除法及各种粘出法等。囊内摘除虽然解决了皮质残留问题,却存在破囊率高、术后黄斑囊样水肿等严重并发症。     

白内障摘除人工晶体植入术部分并发症及处理

现就目前眼科普遍关注的并发症一散光及后囊混浊等研究概况简述如下。1 散光 产生散光的原因除了患者原有的散光之外,与手术切口,特别是角膜切口(包括切口的长度、整齐与否、缝线的种类、缝合深浅度、结扎缝线的松紧度、两针间距以及前后唇的宽度等)均有密切关系。因此,术时应尽量做到准确对位缝合,针距均匀一致,缝线松紧适度,尤其不要太紧。对缝合过     

白内障超声乳化摘除及后房型PMMA人工晶体植入术

报告老年性白内障超声乳化摘除及后房型人工晶体植入术３２例。平均超声能量Ⅱ、Ⅲ级核为２０－４０％，Ⅳ级核为６０－８０％；平均超声时间为２分２０秒。术后视力≥５．０者为术后１周４４％，１个月５６％，３个月以上６６％，术后平均角膜内皮素损失率为２２％，并对并发症及术中应注意的问题进行了探讨 。     

糖尿病患者白内障摘除及人工晶体植入术62例分析

20 0 0年 2月～ 2 0 0 2年 2月 ,我院行糖尿病白内障囊外摘除及人工晶体植入术 62例。现报告如下。一般资料 :本组 62例 (65只眼 ) ,男 34例 ,女 2 8例 ,年龄78岁 1例 ,60～ 75岁 49例 ,45～ 60岁 1 2例。 1型糖尿病 3例 ,2型糖尿病 59例。住院时 ,血糖控制在 3 9～ 6 1 1ｍｍｏｌ/Ｌ2 1例 ,6 1 2～ 7 2 2ｍｍｏｌ/Ｌ1 2例 ,7 2 3～ 8 33ｍｍｏｌ/Ｌ1 5例 ,8 34～1 1 1 1ｍｍｏｌ/Ｌ9例 ,1 1 1 2～ 1 3 9ｍｍｏｌ/Ｌ5例 ,62例中 ,合并冠心病 2 1例 ,合并高血压 1 6例 ,合并视网膜病变 1 2例。尿液检查尿糖 ++以下者 43例 ,+++以上者 1 9例…     

外伤性白内障一期后房型人工晶体植入术28例临床分析

外伤性白内障一期后房型人工晶体植入术２８例临床分析蒙阴县人民医院（２７６２００）朱琳琳王丽１９９４～１９９６年，我们对２８例外伤性白内障患者行一期后房型人工晶体植入术。现报告并分析如下。１临床资料１．１一般资料本组２８例（３０眼）中，男２０例，女８例...     

白内障超声乳化及人工晶体植入术的并发症及其防治

白内障超声乳化及人工晶体植入术具有术后散光度数小、视力恢复快、对眼组织损伤小及手术快捷等优点,目前应用广泛。1997年5月以来,我们对427例（519眼）患者行巩膜隧道切口白内障超声乳化术,现对其并发症的防治进行讨论。     

白内障超声乳化人工晶体植入术731例临床体会

１９９６年以来，我院应用文丘里氏泵超声乳化仪行白内障超声乳化摘除人工晶体植入术７３１例（８９１眼），效果较好，现报告如下。资料与方法：本组男３３５例，女３９６例；年龄２８～９２岁，平均５９．４岁。右眼２９０例，左眼２８１例，双眼１６０例。老年性白内障...     

飞秒激光辅助白内障手术联合Toric人工晶状体植入术治疗糖尿病合并年龄相关性白内障疗效探讨

目的 讨论飞秒激光辅助白内障手术联合Toric人工晶状体植入术在糖尿病合并年龄相关性白内障患者临床治疗中的应用价值.方法 选取2019年4月—2020年4月在该院实施白内障手术的糖尿病合并年龄相关性白内障患者75例(86眼),按治疗方法不同分为两组.观察组在白内障术中应用Len Sx飞秒激光进行辅助治疗,参照组采用传统...     

高度近视白内障摘除及后房型人工晶体植入术（附46例报告）

对４６例（５２只眼）高度近视患者施行白内障囊外摘除或超声乳化摘除及后房型人工晶体植入术。治疗结果：眼轴为２６￣３０ｍｍ组中术后矫正视力≥０．５者占９２．５％,眼轴〉３０ｍｍ者则视力恢复差。认为白内障摘除及后房型人工晶体植入术是治疗高度近视白内障的有效方法。     

糖尿病性白内障患者人工晶状体植入术后低视力的原因分析

目的对糖尿病性白内障患者人工晶状体植入术后的低视力原因进行分析探讨。方法以该院2012年1月—2013年7月期间收治的94例(123眼)糖尿病白内障患者按照眼底糖尿病视网膜病变(DR)程度分为观察组与对照组,对照组45例(61眼)为无明显DR患者,观察组49例(62眼)为非增生性DR患者,所有患者均行人工晶状体植入术,术后均行1~2年的随访,总结患者术后低视力的影响因素。结果对照组患者术后1周、1个月、3个月及6个月的视力低下率明显低于观察组,差异有统计学意义(P0.05)。结论糖尿病性白内障患者行人工晶状体植入术后出现低视力的原因主要为糖尿病病程、DR病变程度、年龄等,术前及术后积极进行相应治疗,对于预防低视力的发生具有重要价值。     

老年人急性心肌梗死QT离散度变化的探讨

目的观察老年急性心肌梗死(AMI)病人溶栓前后QT离散度(QTd)的变化,分析其与室性心律失常的关系。方法测量40例老年AMI病人的QT间期,计算其QTd及校正后的QT离散度(QTdc)。结果QTd及QTdc>100ms病人中,室性心动过速、心室颤动发生率明显高于QTd、QTdc<100ms者(72.7%及6.9%,P<0.001)。溶栓再通组溶栓后QTd及QTdc分别为51.2ms±21.4ms及62.8ms±21.9ms,较溶栓前缩短(分别为77.4ms±21.1ms及90.0ms±30.6ms,P<0.05)。结论老年AMI病人QTd、QTdc延长者,室性心动过速及心室颤动发生率增高,溶栓后QTd及QTdc缩短提示溶栓后血管再通。     

超高龄白内障患者人工晶状体植入术疗效观察

目的：探讨基层医院对90岁以上超高龄白内障患者进行小切口白内障囊外摘除术联合人工晶状体植入术的可行性、安全性、疗效和体会。方法回顾性分析2007-10～2012-10该院对90岁以上超高龄白内障患者43例（52眼）进行小切口白内障囊外摘除＋人工晶状体植入术的麻醉效果、手术安全性和临床效果进行分析。结果43例（52眼）白内障患者均顺利完成手术,术后视力恢复良好,术后1周矫正视力≥0.5者37眼（71.2％）,矫正视力在0.1～0.3者10眼（19.2％）,0.05～0.08者5眼（9.6％）,术后随访均无视网膜脱离、眼内炎、继发青光眼、角膜内皮失代偿和人工晶状体脱位等严重并发症发生。结论在基层医院对超高龄白内障患者实施小切口白内障囊外摘除术联合人工晶状体植入术,切口愈合快,术后反应小,术后散光小,易于操作,费用低,只要把握好适应证,同样可取得良好的效果。     

老年戊型肝炎患者NO及脂质过氧化的研究

目的 探讨老年戊型肝炎患者血清ＮＯ、ＭＤＡ、ＳＯＤ与发病的关系。方法 采用Ｇｒｉｅｒｓ比色法测定ＮＯ,以ＴＢＡ法测定ＭＤＡ,以分光光度法测定ＳＯＤ。结果 老年戊型肝炎患者血清ＮＯ、ＭＤＡ浓度明显高于正常老年对照组（Ｐ〈０．０５）,ＳＯＤ明显低于正常老年对照组（Ｐ〈０．０５）。血清胆红素〉８５．５ｎｍｏｌ／Ｌ者表ＮＯ之间差异无显著性,而血清ＭＤＡ、ＳＯＤ差异有显著性（Ｐ〈０．０５￣０．０１）。发生重     

Innovations in Aged Care: What are the first quality reports from the Transition Care Program in Australia telling us?

Transition Care is a new program in Australia, jointly funded by the Commonwealth and State/Territory Governments. Implementation is undertaken by state health departments, in some cases through aged care organisations, against a set of key requirements. This paper examines reports from providers to reveal enablers and barriers to compliance with the requirements and to highlight emerging patterns of practice. The first 23 self‐reports were content analysed. Person‐centred and goal‐orientated care was evidenced. General practitioner, pharmacist and geriatrician involvement in care planning and review was low. While service agreements between Transition Care services, referring hospitals and community providers improved the efficiency of information transfer and discharge arrangements, these were rare, hindering entry and discharge from the program. Transition Care offers older people a flexible model of care. While the flexibility of the model is a strength, service providers are struggling to achieve integration with existing services.     

The potential role of machine learning in modelling advanced chronic liver disease

The use of artificial intelligence is rapidly increasing in medicine to support clinical decision making mostly through diagnostic and prediction models. Such models derive from huge databases (big data) including a large variety of health-related individual patient data (input) and the corresponding diagnosis and/or outcome (labels). Various types of algorithms (e.g. neural networks) based on powerful computational ability (machine), allow to detect the relationship between input and labels (learning). More complex algorithms, like recurrent neural network can learn from previous as well as actual input (deep learning) and are used for more complex tasks like imaging analysis and personalized (bespoke) medicine. The prompt availability of big data makes that artificial intelligence can provide rapid answers to questions that would require years of traditional clinical research. It may therefore be a key tool to overcome several major gaps in the model of advanced chronic liver disease, mostly transition from mild to clinically significant portal hypertension, the impact of acute decompensation and the role of further decompensation and treatment efficiency. However, several limitations of artificial intelligence should be overcome before its application in clinical practice. Assessment of the risk of bias, understandability of the black boxes developing the models and models’ validation are the most important areas deserving clarification for artificial intelligence to be widely accepted from physicians and patients.     

Measurement of Lens Autofluorescence Can Distinguish Subjects With Diabetes From Those Without

Lens autofluorescence is increased in patients with diabetes mellitus, but clinical application has been limited by the lack of an instrument suitable for routine clinical use. We investigate possible uses of a new scanning confocal biomicroscope (1) to identify subjects with undiagnosed type 2 diabetes and (2) as a marker for the progression of diabetes. One hundred seventy-eight subjects self-reported as normal and 53 subjects physician-diagnosed with diabetes or prediabetes were recruited. Measurements were collected using a ClearPath DS-120 Lens Fluorescence Biomicroscope calibrated with standards traceable to National Institute of Standards and Technology (NIST). Fluorescence intensities were corrected for age by subtracting the value expected from a regression of intensity versus age for normal subjects. This “fluorescence deviation” showed progressively higher values for normal, prediabetes, type 2 diabetes, and type 1 diabetes and a high degree of predictability of diabetes diagnosis. A receiver operating characteristics curve was used to determine sensitivity and specificity for prediction of diabetes type 2. At a fluorescence deviation of 2500, a sensitivity of 67% at 94% specificity was observed detection of type 2 diabetes. The progressively higher fluorescence deviations are consistent with the physiological mechanisms of accumulation of fluorescent advanced glycation end products as the subject ages. The sensitivity and specificity performance of the lens autofluorescence test for type 2 diabetes is comparable to the performance of glucose threshold tests. The statistically significant difference between fluorescence deviations of normal and type 2 diabetes supports the feasibility of lens autofluorescence to screen subjects for undiagnosed type 2 diabetes. Ophthalmic practices are points of care at which there may be a public health benefit for screening patients for undiagnosed diabetes.