可折叠式人工玻璃体球囊在严重眼外伤及硅油依赖眼中的应用

目的：探讨可折叠式人工玻璃体球囊(FCVB)在治疗严重眼外伤及硅油依赖眼中的有效性和安全性。

方法：回顾性分析2018-05/2019-10于我院住院因严重眼外伤及硅油依赖眼行FCVB植入的患者20例,作为观察组; 同时纳入我院既往严重眼外伤未行FCVB植入的患者10例,作为对照组。记录观察组及对照组中各病例的术前及术后视力、眼压、眼球突出度、眼轴长度、视网膜复位情况及有无发生并发症等,并进行为期1a的随访,比较观察组观察指标的变化,以及观察组与对照组观察指标的比较,以此来评价FCVB的有效性和安全性。

结果：观察组术后1a视力、眼球突出度、眼轴长度与术前无差异,眼压明显升高(P<0.05); 对照组术前眼球突出度及眼轴长度与观察组相比更大,但术后随访1a与观察组相比则更小(P<0.05),并且对照组术后1a眼球突出度与眼轴长度与术前基线相比也明显减小(P<0.05)。观察组病例中视网膜均贴附良好,且未出现硅油乳化、继发性青光眼、眼内炎等严重不良事件。

结论：可折叠式人工玻璃体球囊在严重眼外伤及硅油依赖眼的治疗中具有较好地防止眼球萎缩的效果,且安全性较高。     

折叠式人工玻璃体球囊在严重眼外伤眼及硅油依赖眼的应用

目的 观察折叠式人工玻璃体球囊(FCVB)用于眼球破裂伤伴眼内容物缺失患眼Ⅰ期植入及硅油依赖眼Ⅱ期植入的效果.设计回顾性病例系列.研究对象2017-2020年北京爱尔英智眼科医院接受FCVB植入的眼球破裂伤(7例)及硅油依赖眼(14例)的患者.方法 回顾患者的病历资料.平均随访(15.6±9.8)个月.主要指标视力、眼...     

折叠式人工玻璃体球囊植入术在眼外伤和硅油依赖眼中的疗效

目的:观察折叠式人工玻璃体球囊植入术在眼外伤和硅油依赖眼中的临床效果。方法:前瞻性病例研究。2017-10/2022-04在长沙市第一医院就诊的眼外伤和硅油依赖眼患者17例17眼,植入折叠式人工玻璃体球囊或者硅油取出术联合折叠式人工玻璃体球囊植入术。术后随访6mo,观察术前,术后1wk, 6mo视力、眼压和眼轴情况,以及眼球结构及球囊情况。结果:术前残存视力患者6例,术后1wk, 6mo视力与术前相比均无差异(P>0.05)。术前眼压偏低,术后1wk, 6mo眼压与术前相比眼压升高。术后1wk, 6mo眼轴长度没有变化。随访期内眼球外观及结构维持良好,球囊稳定,眼球没有萎缩。结论:折叠式人工玻璃体球囊植入术可保存眼球外观,阻止眼外伤后眼球萎缩,避免多次手术或摘除眼球,对眼外伤或硅油依赖眼有良好的应用价值。     

折叠式人工玻璃体球囊植入73例临床观察及体会

目的：探讨折叠式人工玻璃体球囊植入术的手术方法,并对其治疗效果进行评价。

方法：回顾性分析2018-04/2020-03于我院行人工玻璃体球囊植入手术治疗的严重眼球破裂伤及眼外伤玻璃体切除术后硅油依赖患者73例73眼。术后随访1～20mo,观察患者的视力、角膜、前房深度、眼压、眼底情况、人工玻璃体球囊状态及对外观满意度等。

结果：本组患者73例均顺利完成手术,术中玻璃体球囊内硅油注入量2.4～4.2(平均3.5±0.36)mL。术后随访视力无光感22眼,光感及手动46眼,眼前指数5眼; 角膜清亮或基本清亮19眼,角膜局限性混浊31眼,角膜灰白色明显混浊23眼; 前房深度基本正常32眼,浅前房23眼,前房完全消失18眼; 眼压由于角膜原因不能测试者22眼,眼压<8mmHg者17眼,眼压8～21mmHg者34眼; 裂隙灯显微镜检查示人工玻璃体球囊位置均无明显偏位; 对术后外观满意和基本满意者52例(71%); 所有患者均未见球囊排斥、交感性眼炎及其他明显手术并发症。

结论：折叠式人工玻璃体球囊植入治疗严重的眼球破裂伤和硅油依赖眼,可使患者免于眼球摘除,手术安全、有效,能够较好地维持眼球形态和眼内压。     

折叠式人工玻璃体球囊植入术与外伤眼睫状体功能关系的初步分析

目的：探讨折叠式人工玻璃体球囊(FCVB)植入术治疗重度眼外伤患者的有效性和安全性,初步分析睫状体功能对FCVB植入手术的影响。

方法：回顾性分析。纳入2018-01/2020-07在南方医科大学附属小榄人民医院接受FCVB植入手术的重度眼外伤患者10例10眼。根据患者术前检查结果进行睫状体功能评分,评分≤5分者判定睫状体功能衰竭：其中评分>5分者8眼,评分≤5分者2眼。术后随访1～31mo,检查患者BCVA、眼压,观察前房、视网膜复位情况、球囊位置及术后不良反应。

结果：纳入9眼无晶状体眼患者FCVB植入过程顺利,术中无并发症; 1眼有晶状体眼患者在FCVB植入过程中出现上方部分虹膜根部离断。至末次随访,所有患者FCVB位置良好,视网膜复位率100%。无严重不良事件发生。术前和末次随访的BCVA和眼压比较均无差异(P>0.05)。术前睫状体评分>5分组(8眼)中,有2眼各补充手术1次,1眼补充手术2次。睫状体功能评分≤5分组(2眼),1眼补充手术1次,1眼补充手术5次。

结论：FCVB可用于治疗重度眼外伤患者,但不能有效提高患者视力。患者术前的睫状体功能状态可能与FCVB植入术后持续性低眼压、浅前房相关。     

折叠式人工玻璃体球囊植入在玻璃体视网膜疾病治疗中的应用

目的探讨折叠式人工玻璃体球囊(foldablecapsularvitreousbody,FCVB)治疗玻璃体视网膜疾病的临床效果。方法回顾性分析2017年9月至2019年1月行玻璃体切割联合FCBV植入术的43例(43眼)患者的临床资料。术后随访6个月,观察术后视力、眼压、视网膜复位情况和FCBV状态。结果术后6个月,43例视力无明显变化,手术前后差异无统计学意义(P=1.000)。术后6个月,4例眼压降低,39例眼压正常,手术前后差异有统计学意义(P=0.002)。眼底照相、B超、OCT检查结果显示:所有患者视网膜复位良好,FCVB在玻璃体内均匀地支撑视网膜。双眼外观对称,眼球活动正常。随访期末1例眼球轻微萎缩、1例出现角膜血管化,经治疗后情况好转。结论在患者6个月的植入期内,FCVB是安全、有效的玻璃体替代物,可以维持眼球形态和稳定眼压。     

Evaluation of the long-term effect of foldable capsular vitreous bodies in severe ocular rupture

AIM: To evaluate the long-term effect of foldable capsular vitreous body (FCVB) in the treatment of severe ocular rupture to provide a practical basis for clinical selection. METHODS: A total of 26 patients (26 eyes), 23 men and 3 women, with severe ocular rupture who underwent FCVB implantation between March 2018 and September 2018 were retrospectively analysed. All open ocular wounds located in zone III, with preoperative visual acuity grade IV and above (Snellen less than 4/200). The best corrected visual acuity (BCVA), intraocular pressure (IOP), cornea, anterior chamber, iris, lens, choroid, and retina were evaluated before and after the surgery. The subjective feeling and the location of FCVB were also assessed. RESULTS: The average age of the 26 patients was 36y (20-60y). Postoperative follow-up was from 10 to 14mo. At the end of follow up, BCVA was light perception (LP) in 10 cases, no light perception (NLP) in 13 cases, hand motions (HM) in 3 cases. IOP was 11±5 mm Hg. Corneal degeneration was in 3 cases and corneal endothelial dystrophy was in 7 cases. Shallow anterior chamber was in 8 cases and hyphema was in 8 cases. Organized membrane in the pupil was in 14 cases. Epiphora occurred in 3 cases. FCVB drainage tube exposed in 3 cases. All FCVBs were in their normal location and no rejection occurred. CONCLUSION: FCVB implantation is a long-term effective treatment and may provide a practical selection for severe ocular rupture.     

Vitreous substitutes:challenges and directions

Thenatural vitreous body has a fine structure and complex functions. The imitation of the natural vitreous body by vitreous substitutes is a challenging work for both researchers and ophthalmologists. Gases, silicone oil, heavy silicone oil and hydrogels, particularly the former two vitreous substitutes are clinically widely used with certain complications. Those, however, are not real artificial vitreous due to lack of structure and function like the natural vitreous body. This article reviews the situations, challenges, and future directions in the development of vitreous substitutes, particularly the experimental and clinical use of a new artificial foldable capsular vitreous body .     

折叠式人工玻璃体球囊植入的初步临床实践

目的：初步评价折叠式人工玻璃体球囊(foldable capsular vitreous body, FCVB)植入治疗严重眼外伤及复发性视网膜脱离导致的硅油依赖眼的安全性及有效性。

方法：回顾性分析2017-11以来在我院施行FCVB植入患者4例4眼。其中男2例,女 2例,平均年龄31.5岁,平均眼压5.6mmHg,严重眼球破裂伤术后硅油眼3例,复发性视网膜脱离术后硅油眼1例。对4例患者行玻璃体切除术和FCVB植入手术,术后观察患者的视力、眼压、视网膜和FCVB状态。

结果：患者4例植入手术顺利,FCVB位置适当。术后随访1～3mo,视力无变化,平均眼压10mmHg,B超显示视网膜未脱离,FCVB回声平滑,未见排斥等并发症。

结论：初步实践提示FCVB植入治疗严重的眼球破裂伤和硅油依赖眼安全、有效,可以很好地维持眼球形态和眼内压。     

Experimental retinal tolerance to very low viscosity silicone oil (100 cs) as a vitreous substitute compared to higher viscosity silicone oil (5000 cs)

We evaluated the toxicity of very low viscosity (100 centistokes) and higher viscosity silicone oil (5000 centistokes) in rabbit eyes as a short-to-long-term postoperative vitreous substitute (6 weeks to 5 months). Emulsification of 100-cs and 5000-cs silicone oil did not occur in eyes which were followed for as long as 5 months. No toxic effects to retinal cells were detected by light or electron microscopy. Because no toxic effects were seen with 100-cs silicone oil, it can be used in an outpatient setting as a short-term postoperative tamponading agent. Electroretinographic responses of silicone-injected eyes were normal.     

折叠顶压球囊与传统巩膜外加压治疗孔源性视网膜脱离的对比研究

目的:对折叠顶压球囊(FCB)与传统巩膜外加压术(SB)治疗孔源性视网膜脱离(RRD)的疗效及并发症进行对比研究。方法:回顾性分析2019-03/2022-04我院81例82眼RRD患者的临床资料,对比两种治疗方式下患者术后的视网膜复位率、最佳矫正视力和视网膜下积液吸收的疗效差异,以及术后不适、并发症的发生率。结果:术后FCB组视网膜复位率为96%,SB组复位率为92%,两组无差异(P>0.05)。两组波及黄斑患眼的最佳矫正视力手术前后比较均有差异(P<0.01)。两组均可促进患眼视网膜下积液吸收。FCB组手术时间为16.50(12.75,25.00)min, SB组手术时间为38.00(36.25,41.75)min(P<0.001)。FCB组患者术后眼睑肿胀不适发生率明显低于SB组(P<0.001),术后1d FCB组VAS疼痛评分1.00(0.00,2.00)分,SB组3.00(2.00,3.00)分(P<0.001)。结论:FCB治疗RRD是一种安全有效且可减轻患者痛苦的手术方法,相较于SB,手术时间明显缩短,患者术后不良反应轻。     

可折叠球囊在视网膜脱离患者治疗中的应用

目的 观察可折叠球囊治疗视网膜脱离(RD)的临床效果。方法 回顾性分析2018年1月至2021年12月于中国人民解放军联勤保障部队第九八八医院接受可折叠顶压球囊(FCB)治疗的32例单纯孔源性RD(RRD)患者(FCB组)和接受可折叠人工玻璃体球囊(FCVB)治疗的68例严重眼外伤和硅油依赖眼伴RD患者(FCVB组)的临床资料,术后随访12个月,观察最佳矫正视力、眼压、视网膜复位情况及并发症发生情况。结果 FCB组和FCVB组患者术后最佳矫正视力均优于术前,差异均有统计学意义(均为P<0.05)。FCB组和FCVB组患者术前眼压分别为(14.26±2.05)mmHg(1 kPa=7.5 mmHg)、(28.34±3.17)mmHg,术后眼压分别为(15.19±3.02)mmHg和(10.82±3.79)mmHg,两组患者术前与术后眼压相比差异均有统计学意义(均为P<0.05)。术后两组患者视网膜均成功复位,均未见与FCB、FCVB相关的严重并发症发生。结论 可折叠球囊治疗RD安全、有效。     

The use of silicone oil following failed vitrectomy for retinal detachment with advanced proliferative vitreoretinopathy

We have used silicone oil injection in a consecutive series of 44 patients with retinal detachment and advanced proliferative vitreoretinopathy, all of whom had previously failed to reattach with vitrectomy, membrane peeling, and scleral buckling. After a minimal follow-up period of six months, complete anatomic retinal reattachment posterior to the encircling scleral buckle was obtained in 64% of these eyes, and visual acuity of 5/200 or better was achieved in 57% of the anatomically successful cases. Silicone oil removal was performed in 69% of the anatomically and visually successful eyes without recurrent retinal detachment.     

Comparison of iris-fixated foldable lens and scleral-fixated foldable lens implantation in eyes with insufficient capsular support

AIM: To compare the outcomes of vision using two different intraocular lens (IOL) replacement techniques, iris-fixated foldable intraocular lens (IF-IOL) and scleral-fixated foldable intraocular lens (SF-IOL) in patients with insufficient capsular support. METHODS: Total 63 eyes (62 patients) with insufficient posterior capsule support underwent replacement of IF-IOL or SF-IOL between January 2008 and August 2011. Outcome measures included changes in visual acuity, slit lamp examination, refractive indices and corneal curvatures. RESULTS: The mean improvement of uncorrected visual acuity (UCVA) was greater in IF-IOL group compared to the SF-IOL group (0.43 D±0.19 D vs 0.35 D±0.18 D, P<0.05). Moreover, 12 (38.71%) eyes in IF-IOL group and 4 (12.50%) in SF-IOL group had a higher postoperative UCVA than preoperative best corrected visual acuity (BCVA) while 9 (29.03%) eyes in IF-IOL group and 18 (56.25%) in SF-IOL group had a lower postoperative UCVA than preoperative BCVA. The myopic mean manifest sphere and mean cylinder magnitude were lower in the IF-IOL group than that in the SF-IOL group (-0.47 D±0.58 D vs 0.50 D±0.43 D, P<0.01; 0.84 D±0.53 D vs 1.23 D±0.70 D, P<0.05). No difference of corneal astigmatism and surgically induced astigmatism was found between the two groups. In addition, fewer complications were observed in IF-IOL eyes. CONCLUSION: IF-IOL implantation can give a significant improvement in vision with fewer complications than SF-IOL in patients with insufficient capsular support.     

Ⅱ期折叠型人工晶状体植入术治疗玻璃体切除术后囊膜残余无晶状体眼

目的：：探讨Ⅱ期折叠型人工晶状体植入术治疗玻璃体切除术后囊膜残余无晶状体眼的手术方法及疗效评价。方法：选取2012-01/2014-01期间我院通过行Ⅱ期折叠型人工晶状体植入术治疗玻璃体切除术后囊膜残余无晶状体眼的患者47例47眼,距前次晶状体玻璃体切除术3~6mo。所有患者随访6~12(平均8.21±2.63)mo。结果：本次研究中47例患者人工晶状体均植入顺利,未见位置偏斜情况。最后一次术后随访的裸眼视力(0.44±0.19),与术前最佳矫正视力(0.41±0.23)相比,差异不具有统计学意义(t=0.879,P=0.342)。无明显术中及术后并发症。结论：Ⅱ期折叠型人工晶状体植入术治疗玻璃体切除术后囊膜残余无晶状体眼患者的效果良好,有效减少了并发症,对于改善患者视力安全有效。     

硅油填充眼并发性白内障手术探讨

目的探讨硅油充填眼术后并发性白内障行超声乳化联合硅油取出及人工晶状体植入术的临床效果。方法对26例（26眼）硅油填充术后并发性白内障进行超声乳化经睫状体平坦部切口取硅油联合折叠式人工晶状体植入术。术后随访4-15个月（平均8个月）。结果手术后最佳矫正视力：光感-眼前数指者2眼,0.02-0.1者5眼,〉0.1-0.2者11眼,≥0.3者8眼。1眼因视网膜脱离复发,经再次手术硅油充填后视网膜复位。所有患者均无角膜内皮失代偿、人工晶状体移位或硅油残留等。结论硅油填充眼合并白内障行超声乳化联合硅油取出及折叠式人工晶状体植入术能有效提高视力,减少手术次数,提高手术安全性。     

视网膜脱离玻璃体切除及硅油注入术后并发症的临床观察

目的：探讨视网膜脱离玻璃体切除及硅油注入术后并发症的发生、发展，对术后视力恢复的影响及硅油取出后的转归。方法：对视网膜脱离玻璃体切除及硅油注入术后113例(116只眼)，94只眼行单纯硅油取出，其余的22只眼根据眼底情况分别处理后再取硅油。结果：经6～8个月(平均6．5个月)随访，109只眼视网膜复位良好，5只眼视网膜再脱离，2只眼失访。结论：视网膜脱离玻璃体切除硅油注入术后应及时随访复查，在视网膜复位最佳时间取出硅油可以减少术后并发症发生，及时准确处理好并发症，对保证术后视力的恢复有重要意义。     

硅油下玻璃体视网膜手术治疗复发性视网膜脱离△

目的研究硅油下玻璃体视网膜手术治疗硅油填充眼复发性视网膜脱离的方法和效果。方法对32例(32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。结果视网膜脱离复发的原因由PVR引起者21眼,周边未封闭裂孔所致3眼,巨大裂孔后瓣滑脱5眼,黄斑裂孔未贴伏3眼,手术后均获得解剖复位,视力达0.05以上者共15眼,随访0.5a5眼复发。结论保留硅油的玻璃体视网膜手术操作简单、安全,取得较好的解剖复位和视功能恢复。     

玻璃体切除硅油填充治疗无网脱外伤性眼内炎

目的探讨玻璃体切除联合硅油填充手术治疗无视网膜脱离的外伤性眼内炎的疗效,并分析相关因素。方法18例(18眼)因外伤性眼内炎接受玻璃体切除联合硅油填充手术,其中10眼于术后6月将硅油取出,并且6眼同时植入人工晶状体。术前视力光感至0.1。眼压平均为9 mmHg(5~23 mmHg),(1 mmHg=0.133kPa)。平均随访18月(3~43月)。结果术后视力手动至0.8,视力提高15眼(83.33%),不变3眼(16.67%)。眼压平均为17 mmHg(10~20 mmHg),显著高于术前眼压(P<0.05)。无视网膜脱离或眼球萎缩。并发症主要包括前房炎性渗出(16眼),术后短暂高眼压(3眼)。结论玻璃体切除联合硅油填充手术是治疗无视网膜脱离的外伤性眼内炎安全有效的方法。     

硅油下玻璃体视网膜手术治疗复发性视网膜脱离

目的研究硅油下玻璃体视网膜手术治疗硅油填充眼复发性视网膜脱离的方法和效果。方法对32例（32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。结果视网膜脱离复发的原因由PVR引起者21眼，周边未封闭裂孔所致3眼，巨大裂孔后瓣滑脱5眼，黄斑裂孔未贴伏3眼，手术后均获得解剖复位，视力达0．05以上者共15眼，随访0．5a 5眼复发。结论保留硅油的玻璃体视网膜手术操作简单、安全，取得较好的解剖复位和视功能恢复。【眼科新进展2006；2613）：198—199】