B型超声扫描在眼内异物中的应用价值

目的 评价Ｂ型超声检查在眼内异物中的诊断及对手术的指导意义。方法 回顾性分析了１９９５年１月至１９９７年１２月经Ｂ超检查的眼内异物５６例,其中２１例对照手术所见及ＣＴ检查结果。结果 Ｂ超检查的诊断符合率８０．１％。结论 Ｂ超检查对近球壁异物的定位有独到之处,并对玻璃体手术有重要的指导意义。     

玻璃体腔内注气联合光凝术治疗玻璃体切除术后视网膜脱离

目的探讨玻璃体切除术后视网膜脱离的治疗方法。方法从我院2005年6月至2009年11月玻璃体切除术后视网膜脱离中选择16例（16眼）行玻璃体腔内注气联合视网膜光凝术,术后随访1～24个月。结果16眼中有10眼视网膜复位,随访3—24个月,未见复发,治愈率为62．5％。结论对于玻璃体切除术后视网膜脱离,裂孔小且位于周边部,视网膜脱离范围小者用玻璃体腔内注气联合视网膜光凝治疗可以获得良好疗效。     

Four cases of hypotony maculopathy caused by traumatic cyclodialysis and treated by vitrectomy, cryotherapy, and gas tamponade

Purpose We report our results in four cases of hypotony maculopathy caused by traumatic cyclodialysis and treated by combined vitrectomy and cataract surgery.Methods The patients' visual acuities ranged from light perception to 0.2, and intraocular pressures ranged from 4.7 to 5.7 mmHg (mean 5.1 mmHg) before surgery. Ultrasound biomicroscopy (UBM) revealed cyclodialysis associated with ciliary body detachment of 180° to 360°. We performed combined vitrectomy and cataract surgery, with pars plana cryopexy for detached ciliary body and an SF₆ gas tamponade.Results Postoperative UBM showed that cyclodialysis and/or ciliary body detachment disappeared in the whole circumference of two eyes, while it partially remained at 15° in one eye and at 30° in one eye. Postoperative visual acuity ranged from 0.06 to 1.2, with IOP ranging from 9.0 to 14.7 mmHg (mean 12.2 mmHg).Conclusions Based on our results, we consider that the present combined therapy is highly reliable for closing and adhering traumatic cyclodialysis and normalizing hypotony.     

B超在近视眼巩膜后葡萄肿诊断中的应用价值

目的 :探讨B超在近视眼巩膜后葡萄肿中的应用价值。方法 :用B型超声仪检查 >3.0 0D的 38例76眼进展性近视眼的巩膜后葡萄肿的发生情况。结果 :76眼中 5 8眼发生后葡萄肿。其中各级后葡萄肿的平均屈光度及眼轴差异均有非常显著性意义 (P <0 .0 1和P <0 .0 0 1)。 1～ 4级后葡萄肿与 0级葡萄肿的弧形斑发生率比较差异有非常显著性意义 (P <0 .0 1)。结论 :B超是诊断巩膜后葡萄肿最安全、快速、可靠的方法 ,对近视眼的预后判断有着重要作用。近视眼的屈光度和眼轴随巩膜后葡萄肿的加重而增加 ,眼底弧形斑的形成与后葡萄肿的形成有密切关系     

渗出型老年性黄斑变性的B型超声表现

目的：研究渗出型老年性黄斑变性的B超声像学表现。方法：对19例(20眼)经荧光素眼底血管造影确诊的渗出型老年性黄斑变性，行B型超声检查。结果：19例(20眼)B型超声检查：均表现为不同程度黄斑区球壁局限性增厚、粗糙、隆起，以及增厚球壁形成层间透声裂隙。结论：B型超声检查是诊断渗出型老年性黄斑变性的一种简便和有效的方法，尤其在屈光间质混浊的病人中可作为诊断渗出型老年性黄斑变性的重要辅助依据。     

抗白内障药物在玻璃体切割术后早期的临床应用

目的　评估局部和全身应用抗白内障药物对玻璃体切割术后 ,眼内注气所致早期晶状体后囊下混浊的临床效果。方法　各种病因所致玻璃体切割保留晶状体术中惰性气体充填 2 16例 (2 16只眼 ) ,其中手术伤及晶状体 9只眼 ,术后均口服维生素 E,其中 12 6只眼即刻局部用卡林 U眼药水 ,观察局部用药和未用药患者晶状体后囊下混浊的程度和持续时间及原有白内障的发展。结果　 5天后晶状体后囊下混浊的发生比率 :局部应用抗白内障药物 N1=4 3/ 12 6 (34.1% ) ,未用药患者 N2 =5 6 / 90 (6 2 .2 % ) ,两组有显著差异 (P <0 .0 5 ) ;用药患者后囊下混浊的持续时间为 (4± 2 .3)天 ,未用药患者 (7± 3.2 )天 ,两组间有显著差异 (P <0 .0 5 )。但对手术中伤及晶状体后所致的混浊用药无效。结论　局部应用抗白内障药物可明显减轻玻璃体切割术后眼内注气所致晶状体后囊下混浊的程度 ,缩短混浊持续时间 ,有利于术后及时的眼底观察和补激光。对手术中伤及晶状体所致的混浊用药不能阻止其发展     

下班体术后连续气体充填治疗视网膜巨大裂孔

目的 观察玻璃体切割联合术后眼内连续气-液交换术治疗巨大视网膜裂孔的临床效果。方法 采用玻璃体切割、巩膜宽环扎和眼内光凝或眼冷凝,治疗23例巨大视网膜裂孔,PVR-B-D1级。术后反复行徒手眼内气-液交换术,连续延长有效气体充填,19眼行晶状体切除。结果 气体完全消失3mo后,21眼视网膜复位,2眼失败。视功能在0.02以上18眼,主要并发症高眼压。结论 连续延长眼内气体充填可良好的封闭巨大视网膜裂孔,不影响术后激光治疗。优点：充填的时间和量更具有可控性,并发症少且易控制,无需再次手术取出。     

B型超声在眼挫伤诊断中的应用

目的探讨B型超声检查在眼后段挫伤诊断中的临床价值。方法对58例（65眼）眼后段挫伤进行眼部B型超声检查,并对其眼底表现与B超检查结果进行比较分析。结果眼底表现：黄斑水肿26眼（40．0％）、视网膜出血及视网膜下出血17眼（26．2％）、黄斑区色素紊乱9眼（13．8％）、玻璃体积血8眼（12．3％）、视盘水肿7眼（10．8％）、视网膜脱离3眼（4．6％）等。B型超声的阳性发现率：玻璃体积血、视网膜脱离均为100．0％,视盘水肿85．7％,视网膜出血及视网膜下出血84．2％,黄斑水肿69．2％,对黄斑色素紊乱不能显示。结论B型超声对眼后段挫伤是一种安全、有效的检查方法,对玻璃体积血、视网膜脱离、视盘水肿、视网膜大量出血、黄斑水肿等诊断具有重要价值。     

B型超声检查诊断外伤性眼内膜性病变

目的:探讨B型超声检查对眼外伤后眼内病理性膜性病变的鉴别诊断作用.方法:对我院B超室诊断为眼内病理性膜性病变的103例眼外伤眼的临床资料进行分析,考察其B型超声图像的特征.结果:根据B超图像特征区分5种主要的外伤性眼内膜性病变,与临床的符合率达86.4%.结论:B型超声检查可以较好地区分和诊断眼外伤后眼内病理性膜性病变.     

Evaluation of immersion 20 MHz B-scan ultrasonography in observing lens in the alkali burn eyes

AIM:To evaluate the accuracy of 20 MHz immersion B-scan ultrasonography in observing lens and to investigate the value of this noninvasive preoperative diagnosis method in alkali burn eyes.METHODS: It was a comparative study. Fifty-six cases (56 eyes) of alkali burn eyes were examined by ultrasound biomicroscopy (UBM) and immersion 20 MHz B-scan ultrasonography from June 2011 to April 2013, the images were analyzed, and the ultrasonographic diagnosis compared with the operation results.RESULTS: In 56 alkali burn eyes examined by UBM, the lens were not detected in 16 eyes; the IOL could be detected in 2 eyes; the anterior lens capsule surface or/and the front lens could be detected in 18 eyes, and lens opacification in 3 eyes of them; suspected abnormal lens were detected in the other 20 eyes. In all the same eyes examined by immersion 20 MHz B-scan ultrasonography, the lens were not detected in 16 eyes; the IOL could be detected in 2 eyes; 24 abnormal lens (opacity, lens expansion, shrinkage) and 14 normal lens were found. Compared with the intraoperative findings, the diagnostic accordance rate of the immersion 20 MHz B-scan appearance of lens was 100% (56/56), which was significantly higher than examined by UBM 57.14% (32/56) (χ²=30.55, P=0.0000).CONCLUSION:Immersion 20 MHz B-scan ultrasonography can observe the lens accurately in alkali burn eyes. It has important clinical value to combine with UBM in eyes of alkali burn.     

B-scan ultrasonography in optic nerve lesions

After a short introduction to the method used in the Royal Dutch Eye Hospital in Utrecht, for B-scan ultrasonography with Coleman's apparatus, the normal echo pattern of the optic nerve and a number of abnormalities are considered. Excavation or prominence of the disc can be established, even when the media are opaque. In retrobulbar neuritis, certain anomalies in the echo pattern are found in a high percentage of cases, as one of the few objective changes in this condition. Leber's optic atrophy appears to give a typical echo pattern. The echographic pictures of a glioma of the optic nerve and of displacement of the optic nerve, probably due to a metastasis from a cutaneous melanoma, are described.     

白内障摘除联合玻璃体切割气体填充术治疗特发性黄斑裂孔

目的：探讨特发性黄斑裂孔(idiopathic macular hole,IMH)不同分期行白内障摘除玻璃体切割气体填充术后视力的恢复情况。

方法：选取2014-08/2016-08于我院治疗的IMH合并白内障患者75例75眼,所有患者均行白内障摘除玻璃体切割过氟丙烷(C₃F₈)气体填充术治疗,按IMH不同Gass分期分为Ⅱ期组(18眼)、Ⅲ期组(36眼)、Ⅳ期组(21眼)。比较术后1、3mo黄斑裂口闭合情况; 手术前后进行常规视力检查,比较各组患眼视力提高情况; 光学相干断层扫描(optical coherence tomography,OCT)检查手术前后黄斑厚度。

结果：术后1mo,Ⅱ期组黄斑裂口闭合率显著高于Ⅲ期与Ⅳ期组,Ⅲ期组显著高于Ⅳ期组,差异有统计学意义(P<0.05); 术3moⅡ期组、Ⅲ期组黄斑裂孔闭合率比较,差异无统计学意义(P>0.05)。所有患者手术前后视力数指、0.02～0.08、0.10～0.20、0.25～0.40、≥0.50人数比例比较,差异有统计学意义(P<0.05),Ⅱ期组视力提高率为94%,显著高于Ⅲ期(83%)与Ⅳ期组(67%)。Ⅱ期、Ⅲ期组手术后黄斑厚度较手术前均显著降低,Ⅳ期组手术前后差异无统计学意义(P>0.05),Ⅱ期、Ⅲ期组降低幅度差异无统计学意义(P>0.05),均显著高于Ⅳ期组,差异具有统计学意义(P<0.05)。

结论：白内障摘除玻璃体切割气体填充术有助于IMH视力恢复,但不同Gass分期疗效具有差异,应尽早进行手术,有助于黄斑裂孔闭合,改善视力。     

硅油填充眼术后继发性青光眼的临床分析

目的探讨玻璃体切割硅油填充术后继发性青光眼的原因及处理方法。方法168例玻璃体切割硅油填充眼，对其中的33例继发性青光眼病例进行总结、分析。探讨其发生的原因及处理方法。结果本组继发性青光眼病例，通过及时对症处理，眼压均控制在〈21mmHg。结论玻璃体切割硅油填充术后继发青光眼是这类手术的常见并发症，早期预防，及时发现并正确处理会减少对视功能的损害。     

玻切联合硅油填充术后并发性白内障的手术治疗

探讨白内障超声乳化吸除+硅油取出+人工晶状体植入+后囊膜环形切除术治疗玻璃体切割联合硅油填充术后并发性白内障的疗效。 方法：回顾分析2007-11/2011-11玻璃体切割联合硅油填充术后白内障患者102例102眼,距离玻璃体手术时间3~9（平均6.1）mo,采用玻璃体腔灌注,先行白内障超声乳化手术,前房注入黏弹剂,行硅油置换,然后人工晶状体植入,环形后囊切开,观察术中、术后并发症,术后视力等。 结果：术后 4wk,102例102眼中,97眼视力不同程度提高,5眼术后视力无改善;后囊破裂2例,无晶状体核坠入玻璃体,无脉络膜脱离。 结论：玻璃体切割联合硅油填充术后行白内障超声乳化吸除+硅油取出+人工晶状体植入+后囊膜环形切除术治疗玻璃体切割联合硅油填充术后并发性白内障,可有效减少术中、术后并发症,同时避免二次手术所带来的风险。     

正常人眼外肌厚度的标准化A超测量

目的建立标准化A超测量正常人眼外肌厚度的正常值范围。方法使用标准化的A/B型超声仪,采用标准化A超联合B超的方法测量107例214眼的眼外肌厚度。结果测得正常人内直肌厚度为(4.34±0.29)mm,外直肌为(4.07±0.32)mm,上直肌为(4.36±0.26)mm,下直肌为(4.02±0.28)mm,双侧对应眼外肌之间以及与不同年龄、性别、身高、体重及眼轴比较,差异均无显著性(P>0.05)。结论标准化A超测得正常人眼外肌厚度的范围为3.98~4.40 mm,对于以眼外肌病变为主的眶内病变具有重要的诊断和鉴别诊断意义。     

玻璃体切除硅油填充术后高眼压临床分析

目的探讨玻璃体切除硅油填充术后高眼压的原因及处理。方法回顾性分析2010年1月到2010年12月本院160例（178只眼）玻璃体切除硅油填充术后早期发生高眼压31例（31只眼）的临床资料。结果术后高眼压发生原因如下：葡萄膜炎症反应（18只眼,58.1%）、无晶状体眼（4只眼,12.9%）、激素引发（4只眼,12.9%）、硅油填充过量（3只眼,9.7%）、眼内炎（2只眼,6.5%）。给予降眼压药物、停用激素类药物、硅油部分取出、前房穿刺或换用敏感抗生素等治疗后,眼压均降至正常。结论玻璃体切除硅油填充术后高眼压在本研究的发生率为17.4%,术后葡萄膜炎症反应为常见原因,及时的预防和处理能减少视功能的损害。     

Long-term outcome of highly myopic foveoschisis treated by vitrectomy with or without gas tamponade

AIM: To evaluate the long-term safety and efficacy of vitrectomy and internal limiting membrane (ILM) peeling with or without gas tamponade for highly myopic foveoschisis. METHODS: We performed an open-label, observer-blinded clinical trial of 85 patients with myopic foveoschisis between 2000 and 2012. Patients were randomly allocated to one of two groups, those who received vitrectomy and ILM peeling without gas tamponade (no-gas group) or those who with gas tamponade (gas group) and follow up at least 5y. RESULTS: Visual acuity of gas group improved from 0.82±0.33 to 0.79±0.73 in 6mo, improved to 0.71±0.67 in 1y and within this range in the following 4y. Visual acuity of no-gas group improved from 0.81±0.46 to 0.78±0.66 in 6mo, improved to 0.70±0.65 in 1y. The finial visual acuity of two groups were significantly increased compared with the baseline (P<0.05). The visual acuity was improved in 35 of 40 eyes (87.5%) in gas group and 29 of 33 eyes (87.9%) in no-gas group, while there were no significant differences between gas group and no-gas group in the visual acuity. The foveoschisis on optical coherence tomography (OCT) completely resolved in 5 of 40 eyes in 1mo, 14 eyes in 6mo and 40 eyes in 1y in the gas group. While the foveoschisis completely resolved in 4 of 33 eyes in 1mo, 10 eyes in 6mo and 33 eyes in 1y in the no-gas group. CONCLUSION: Vitrectomy and ILM peeling without gas tamponade appears to be as effective in the treatment of myopic foveoschisis as vitrectomy and ILM with gas tamponade. However, eyes treated with no-gas tamponade showed more rapid resolution of myopic foveoschisis.     

Better success of retinal reattachment with long-standing gas tamponade in highly myopic eyes

Background To evaluate the efficacy of long-term gas tamponade after pars plana vitrectomy (PPV) for retinal detachment (RD) due to a macular hole (MH) in highly myopic eyes.Methods A retrospective study was conducted at two institutions. The study included 25 highly myopic eyes with RD resulting from a MH. C₃F₈ gas tamponade was used in 13 eyes (C₃F₈ gas group), and SF₆ gas tamponade was used in 12 eyes (SF₆ gas group) following PPV. C₃F₈ gas has a longer half-life time in the vitreous cavity than SF₆ gas. The main outcome measures were the anatomic reattachment rate and the visual acuity (VA). Follow-up periods were at least 24 months.Results The anatomic reattachment rate and MH closure following the initial surgery were significantly higher in the C₃F₈ gas group (100%) than in the SF₆ gas group (66.7%; P=0.039). The differences in the postoperative VAs were not significant both for all eyes and only for eyes with initial anatomic success. (P=0.42 and P=0.54, respectively). In addition, no significant difference was found in the improvement of VA both for all eyes and for the initial success eyes (P=0.66 and P=0.56, respectively).Conclusion We conclude that the longer duration of tamponade with C₃F₈ gas results in a higher rate of successful closure and that C₃F₈ gas tamponade is an effective treatment for MH with RD in highly myopic eyes.None of the authors or their family members has any proprietary or financial interest in the instruments used in this study.     

玻璃体视网膜手术眼内外填充后的B超观察

目的描述玻璃体视网膜手术眼内气体、硅油、眼外环扎、加压填充后眼部的B超表现。方法用HumphreyA／B835超声诊断仪，10MHz探头，B超直接接触法对62例玻璃体视网膜手术中用以上方法处理的眼进行观察、分析。结果B超下，硅胶环扎带、加压块、硅海绵及它们的位置可以查出。气泡后的结构不能看到；眼球部分充满气体时，通过改变头位，可以全方位探查玻璃体、视网膜。评估硅油后方结构较困难，部分病例可查出视网膜脱离，部分不能。结论用B超评估以上手术后的眼部情况是可能的。     

玻璃体切除联合气体充填术后高眼压的处理

目的 探讨玻璃体切除联合全氟丙烷气体(C3F8)充填术后高眼压的处理方法.方法 对43例玻璃体切除联合C3F8填充术后高眼压者采取观察和应用局部、全身降眼压治疗,并对6例采取穿刺术处理.结果 10例未用降眼压药物,眼压1周内恢复正常(10 ～21 mm Hg),27例应用药物治疗眼压恢复正常,6例经前房和或玻璃体腔穿刺,眼压恢复正常.术后随访2～4个月眼压均在正常范围,未出现严重并发症.结论 玻璃体切除联合C3F充填术后高眼压经过及时恰当的降眼压治疗,眼压均能恢复正常,从而有效地保护了视功能.