改良结膜瓣遮盖全角膜术

在传统结膜瓣遮盖全角膜术的基础上设计了改良术式,并为12例患者成功施行了手术,术后患者配戴义眼外观满意,未发生结膜瓣后退等并发症。本文介绍改良术式的手术步骤,并讨论传统结膜瓣盖全角膜术的主要并发症及其原因以及改良术式的可靠性和优越性。     

A new surgical technique for congenital distichiasis

Purpose: To describe a new technique to treat congenital distichiasis.

Methods: Case series of three distichiatic patients undergoing a novel surgical technique combining splitting of the lid margin with the distichiatic lashes, marginal tarsectomy in the affected area, and tarsoconjunctival graft obtained from the upper region of the tarsus. The graft was sutured at the exposed region of the marginal tarsectomy.

Results: Good cosmesis was obtained in all cases and the lids margins healed completely with good surgical outcome and no lashes contacted the cornea postoperatively.

Conclusions: The split lamellae with a composite tarsoconjunctival graft results in satisfactory functional and cosmetic outcomes. The upper tarsal region represents an ideal donor site.     

A new surgical technique for management of conjunctivochalasis

PURPOSE: To present a new surgical technique for severe, symptomatic conjunctivochalasis and our hypothesis of the pathogenesis of this condition. METHODS: Six eyes of three patients with conjunctivochalasis (average age +/-SD, 70.0 +/- 9.6 years; range, 56-78 years) were treated with a conjunctival fixation to sclera with three 6-0 Vicryl (Johnson & Johnson, New Brunswick, New Jersey) stitches. RESULTS: With a mean follow-up period of 209.5 days (range, 181-219 days), we achieved successful treatment in all eyes, with no recurrence of conjunctival folds. CONCLUSION: We successfully treated conjunctivochalasis with conjunctival fixation to sclera, which strongly suggests that conjuctival folds are caused by the folding and the elevating of loosely adherent bulbar conjunctiva of the lower eyelid.     

A new technique for retrieval or repositioning of damaged or migrated silicone punctal plugs

A new technique for retrieval or repositioning of migrated or malpositioned silicone punctal plugs is described. Malposition is known to occur secondary to either spontaneous migration or forceful insertion. This technique offers considerable advantages over current treatment options including simplicity and minimal trauma to both the plug and the nasolacrimal system.     

A combined technique for surgical repair of Descemet's membrane detachments.

BACKGROUND AND OBJECTIVE: Descemet's membrane detachments are an uncommon complication after cataract surgery that can result in severe visual loss. A combined technique of intracameral gas injection and transcorneal suturing for the repair of Descemet's membrane detachments is described. PATIENTS AND METHODS: In this interventional case series, four cases of Descemet's membrane detachments with associated corneal edema observed following cataract surgery were successfully repaired using a combined technique of intracameral gas injection and transcorneal suturing. RESULTS: In all cases, Descemet's membranes were successfully reattached using the aforementioned technique. In three cases, the associated corneal edema resolved postoperatively. In the fourth case, the patient required a penetrating keratoplasty for persistent corneal edema despite immediate anatomical success following reattachment. CONCLUSIONS: Combined intracameral gas and transcorneal suturing appears to be an effective technique in the repair of Descemet's membrane detachments. Early intervention may prevent persistent or recurrent corneal edema.     

真菌性角膜溃疡手术治疗方式的探讨

目的 研究不同手术方式对真菌性角膜溃疡的效果。方法 根据不同的局部病变程度分别采用结膜遮盖术、板层角膜移植术、穿透性角膜移植术及眼前段重建术等4种手术方式进行治疗。结果 103例（103眼）中96例治愈（93．2％0,手术无效7例（6．8％）。结论 根据不同病情早期采用适当手术方式可提高临床治愈率。     

A new surgical technique for the management of orbital fat prolapse

PURPOSE: To present a new surgical technique for the management of orbital fat prolapse. METHODS: Four eyes of three patients (average age +/- SD: 73.0 +/- 6.9 years; range, 69 to 81 years) who presented with orbital fat prolapse were treated with conjunctival fixation to the sclera approximately 8 to 10 mm posterior to the corneoscleral limbs in the area of orbital fat prolapse with four to seven 6.0 Vicryl (polyglactin 910, Johnson & Johnson, New Brunswick, New Jersey) stitches. RESULTS: The treatment with conjunctival fixation to the sclera was successful in all four eyes, and during a mean follow-up period of 357.5 days (+/-SD: +/-189 days; range, 641 to 263 days), there has been no recurrence of orbital fat prolapse. CONCLUSION: We successfully treated orbital fat prolapse with conjunctival fixation to the sclera, a new surgical approach for this condition.     

外伤性白内障手术方法探讨

目的:探讨外伤性白内障超声乳化摘出或联合人工晶状体植入术的手术技巧,总结外伤性白内障术中、术后并发症及其注意事项。方法：对44例（44眼）外伤性白内障进行超声乳化摘出,对其中的37例联合人工晶状体植入术。术后随访5月－3年。结果：随访裸眼和矫正视力≥0.5者分别为38.8％、52.8％。本组术后并发症主要为角膜水肿、膜性渗出、瞳孔夹持、人工晶状体移位、后发性白内障、瞳孔粘连等。结论：外伤 性白内障可以安全而有效地施行超声乳化摘出术,且多数可以联合人工晶状体植入术。