葡萄膜炎并发白内障的人工晶状体植入术

目的 探讨葡萄膜炎并发白内障人工晶状体植入的手术时机、方法和疗效。方法 对３６例（３８眼）葡萄膜炎并发白内障囊外摘出的同时植入后房型人工晶状体。平均随访１８月（１６～３０月）。结果 ７８．９％的患者术后矫正视力达０．５以上,术后并发症包括晶状体后囊浑浊与虹膜后粘连。结论 对葡萄膜炎并发白内障囊外摘出联合后房型人工晶状体植入术是可行的。但应有选择地进行,以减少手术并发症的发生。     

葡萄膜炎并发白内障超声乳化人工晶状体植入

目的探讨葡萄膜炎并发白内障超声乳化吸出及人工晶状体植入术的效果。方法26例（26眼）均于炎症稳定3月以后进行透明角膜切口晶状体乳化吸出术，植入后房人工晶状体。术中慎重处理小瞳孔和虹膜后粘连，尽量避免刺激虹膜。结果26眼中有2眼轻度炎症反应，术后1月裸眼视力≥0．5者20眼（76．92％），0．3～0．4者4眼（15．38％）．〈0．05者2眼（7．69％）。结论超声乳化白内障吸出人工晶状体植入术治疗葡萄膜炎并发白内障，选好手术时机，术中慎重操作，则术后炎症反应轻，视力恢复好。     

葡萄膜炎并发小瞳孔白内障摘除及人工晶状植入术

目的：探讨葡萄膜炎并发小瞳孔白内障摘除及人工晶状植入术的疗效。方法：对24例（24只眼）葡萄膜炎并发的小瞳孔白内障患者，行巩膜隧道小切口囊外摘除，植入后房型人工晶状体。结果：术后视力≥0．5者20只眼（83．3％），≥0．3者3只眼（12．5％），术后瞳孔呈圆形，无明显并发症。结论：小瞳孔白内障行巩膜隧道小切口囊外摘除及人工晶状体植入，只要方法得当，有选择性手术，术后反应轻，视力恢复好。     

葡萄膜炎并发白内障的人工晶状体植入术

目的探讨葡萄膜炎并发白内障的手术方式和疗效。方法对28例（28眼）葡萄膜炎并发白内障行白内障摘出及人工晶状体植人术，观察其视力变化及术中、术后并发症。结果术后26眼（92．86％）视力较术前提高。其中〉0．5者10眼，0．3。0．5者10眼，0．1。0．2者6眼，〈0．1者2眼。结论葡萄膜炎并发白内障植人人工晶状体。效果可靠。     

儿童Ⅱ期人工晶状体植入术两种手术方式的对比研究

目的探讨儿童无晶状体眼Ⅱ期人工晶状体植入术的两种手术方式的效果。方法3．5～9岁儿童白内障术后无晶状体眼58例（71眼）,随机分成2组：A组36眼,行后囊切开、前段玻璃体切除及后房人工晶状体植入;B组35眼,单纯行后囊切开及人工晶状体植入。结果术后3月,矫正视力〉10．05者,A组30跟（83．33％）,B组30眼（85．71％）;≥0．3者,A组21眼（58．33％）,B组20眼（57．14％）。脱盲率及脱残率2组之间差异均无显著性（P〉0．05）,但两组分别与术前相比差异均有统计学意义（P〈0．01）。两组术后各种并发症之间差异也无统计学意义。结论儿童无晶状体眼Ⅱ期人工晶状体植入术的两种术式均是安全的、有效的,单纯的后囊切开更符合患儿的生理特点。     

前部玻璃体切除在先天性白内障手术中的作用

目的探讨存先天性白内障手术中前部玻璃体切除对术后视轴区后囊浑浊的预防作用。方法对61例（122眼）2～8岁的儿童双眼先天性白内障施行晶状体超声乳化联合人工晶状体植入。右眼为对照组（61眼）联合后囊连续环形撕囊;左眼为研究组（61眼）联合后囊连续环形撕囊及前部玻璃体切除。随访6～66月,平均31．6月观察记录两组视轴区浑浊情况和其它并发症.结果视轴区浑浊发生率,对照组为36．07％,研究组为8．20％,研究组明显低于对照组（P〈0．01）。在能够进行视力检查的48例（96眼）中,术后最佳矫正视力≥0．3者,对照组为30只眼（62．50％）;研究组为39只眼（81．25％）,研究组高于对照组,差异有统计学意义（P〈0．05）。结论对于（2～8岁）儿童先天性白内障,在施行晶状体超声乳化联合人工晶状体植入的同时,联合后囊连续环形撕囊及前部玻璃体切除,可安全有效的减低术后视轴区浑浊的发生率。     

葡萄膜炎并发白内障人工晶状体植入术

目的 探讨葡萄膜炎所致并发白内障的人工晶状体植入术。方法 37例（40眼）葡萄膜炎后严重后粘连并发白内障采用切除瞳孔区机化前囊、瞳孔缘切开、充分水分离晶状体核,完成人工晶状体植入。并对手术技巧和术后处理进行探讨。结果 术后视力：0.1及以下者3眼（7.5%）,0.2－0.5者13眼（32.5%）,0.6-1.0者24眼（60％）;无严重并发症。结论 葡萄膜炎并发白内障人工晶状体植入术临床效果良好。     

地塞米松缓释剂在并发性白内障术中前房植入

目的　评价地塞米松缓释剂前房内植入对前葡萄膜炎并发性白内障术后炎症反应和后囊浑浊的预防效果。方法　 68例 ( 68眼 )前葡萄膜炎并发性白内障行白内障摘出人工晶状体植入术者随机分为两组 ,植入组 3 6例 ,术中前房内植入地塞米松缓释剂 ;对照组 3 2例 ,术中未植入该缓释剂。观察并比较两组术后炎症反应情况及后发障发生率。结果　术后前房炎症和后囊浑浊 ,植入组明显低于对照组 ,差异有显著性意义 (P <0 .0 5 )。结论　前房内植入地塞米松缓释剂可减轻葡萄膜炎并发性白内障人工晶状体植入术后炎症反应 ,减少后发性白内障。是一种安全有效的给药途径。     

葡萄膜炎并发白内障乳化吸出人工晶状体植入

目的 探讨晶状体超声乳化吸出联合人工晶状体植入术在葡萄膜炎并发白内障治疗中的应用。方法 对36例(44眼)葡萄膜炎并发白内障术后，观察其疗效及并发症。结果 所有患者术后视力均有不同程度的提高，其中27眼(61．36％)术后最佳矫正视力≥0．5。术中发生前房积血2眼(4.55％)，后囊破裂1眼(2.27％)；术后瞳孔均能维持圆形居中。术后并发症：早期角膜水肿14眼(31．82％)；前房轻度炎症反应39眼(88.64％)；1周后出现成形性前房渗出1眼(2．27％)；后囊浑浊7眼(15．91％)。结论 超声乳化品状体摘出联合人工晶状体植入术治疗葡萄膜炎并发白内障是安全有效的。     

AcrySof和PMMA人工晶状体植入致后发性白内障发生率的比较

目的：评价植入聚甲基丙烯酸甲酯（PMMA）人工晶状体和软性人工晶状体（AcroSof）致后发性白内障的严重程度。方法：总共100人（110眼）进行了人工晶状体植入术，随机分为两组植入不同类型的晶状体。组Ⅰ：AcrySof（SA60AT）人工晶状体，组Ⅱ：PMMA（LXIOBD）人工晶状体。分别在术后3，6，12和18mo，通过测定最佳矫正视力和数码照片拍摄评价后囊膜浑浊的密度。结果：术后3mo，PMMA组后囊膜浑浊的密度明显增加（3．6％），而Acrylic组并未发现增加。术后18mo，显著后囊膜浑浊两组的发生率相比较，Acrylic组（14．5％）较PMMA组（34．5％）低。由于PMMA人工晶状体比AcrySof人工晶状体所致后囊膜浑浊的范围广，故其导致更严重的视力降低。结论：与PMMA人工晶状体相比较，植入AcrySof人工晶状体在一定程度上有助于降低后发性白内障的发生率。     

Heparin surface modified intraocular lenses in uveitis

A retrospective analysis of the results of cataract surgery using heparin surface modified intraocular lenses (HSM-IOL) performed on patients with uveitis between August 1989 and July 1993 was undertaken. In total, 32 eyes of 28 patients with various types of uveitis underwent extracapsular cataract extraction and implantation of a posterior chamber HSM-IOL. In four patients, cataract extraction was combined with trabeculectomy. The post-operative follow-up period ranged from two to 51 months (average 16 months). The visual acuity improved in 31 of 32 eyes (96.8%) with 28 eyes (87.5%) seeing 6/18 or better. In four eyes (12.5%), the visual acuity was only 6/60 due to longstanding, pre-operative cystoid macular oedema. Posterior synechiae developed in eight eyes (25%), inflammatory deposits were noticed on the IOL surface in five eyes (15.6%), and three eyes (9.3%) required YAG laser posterior capsulotomy. These results suggest that HSM lenses are associated with minimal post-operative complications and appear safe to be used in human uveitic eyes.     

Cataract extraction and intraocular lens implantation in children with uveitis

AIM: To evaluate the long term results of cataract surgery with intraocular lens implantation (IOL) in children with uveitis. METHODS: The study included 10 eyes in seven children (age 3.5-10 years, mean 6.5 years). The cataract surgery included capsulorhexis of the anterior and the posterior capsule, anterior vitrectomy in some eyes, and implantation of a heparin surface modified (HSM) poly(methyl methacrylate) (PMMA) IOL into the capsular bag. RESULTS: Follow up periods ranged from 1 to 5 years. Best corrected visual acuity after surgery reached 20/50-20/20 in all but two eyes. Opacities or membranes requiring reoperation developed in seven eyes. Glaucoma developed in three eyes after the cataract operation. CONCLUSION: These results suggest that implantation of a HSM PMMA IOL is an alternative to correct aphakia also in children with uveitis.     

肝素处理人工晶体在糖尿病性白内障的应用

为观察肝素表面处理人工晶体在糖尿病性白内障手术后的作用。对４５例糖尿病白内障患者行现代囊外白内障摘除，分别植入ＨＳＭ－ＩＯＬ２２眼和ＰＭＭＡ－ＩＯＬ２３眼，对二组术后视力及眼前节反应等进行了回顾性对比分析。结果：二组比较，矫正视力大于０．５者，在术后２周及３个月时差异最显著（Ｐ＜０．０５）；晶体表面纤维蛋白样渗出和色素沉着均在术后２周时差异最显著（Ｐ＜０．０５）；虹膜后粘连在６个月后差异最显著（Ｐ＜０．０５）。结论：ＨＳＭ—ＩＯＬ在术后能减轻糖尿病白内障术后眼前节炎性反应，提高术后视力。     

安徽省贫困白内障患者复明术后视力效果评估

目的了解安徽省2013-2014年度贫困白内障患者复明术后中远期恢复情况。方法横断面调查研究。采用整体随机抽样方法抽取8个受检点（舒城县、庐江县、潜山县、池州市贵池区、郎溪县、太和县、毫州市谯城区、灵璧县）调查1 140例（1 557眼）白内障术后患者,所有受检人员均接受详细眼科检查,包括视力、裂隙灯显微镜、直接检眼镜、眼压和验光等。结果共718例（985眼）完成检查,受检率为83.0%。术后最佳矫正视力（BCVA）≥0.05者940眼（95.4%）,≥0.3者826眼（83.8%）,≥0.5者670眼（68.0%）。979眼（99.4%）植入人工晶状体（IOL）;963眼（97.8%）角膜透明,904眼（91.8%）瞳孔正圆无移位,953眼（96.8%）IOL居中正位,623眼（63.2%）后囊透明,眼压为（14.3±4.9）mmHg。284眼（28.8%）伴屈光不正。主诉最多者为流泪[313眼（31.8%）]。BCVA低于0.05的眼中,原因依次为年龄相关性黄斑变性、高度近视性视网膜病变、后发性白内障、角膜斑翳和视神经萎缩等;在BCVA低于0.3的眼中,主要原因依次为年龄相关性黄斑变性、后发性白内障、高度近视性视网膜病变、角膜斑翳和糖尿病视网膜病变等。结论安徽省80%以上的免费白内障手术患者达到康复视力,约30%的患者伴有屈光不正和后发性白内障,术后低视力和盲的患者主要由术前原有的眼底病变导致。     

A retrospective analysis of Heparin-surface-modified intraocular lenses versus regular polymethylmethacrylate intraocular lenses in patients with uveitis

Background: Several studies described the benefits of the heparin-surface-modified intraocular lens (HSM IOL) with regard to the reduced inflammation in routine extracapsular cataract extractions. However, limited information is available about the advantages of the HSM IOL in patients with an intraocular inflammation. Aim: To assess the eventual benefits of the HSM IOL compared to the regular polymethylmethacrylate intraocular lens (PMMA IOL) in patients with uveitis. Methods: A retrospective study of 43 patients with uveitis of various origins who underwent an extracapsular cataract extraction (24 with HSM, 19 with PMMA IOL). The activity of intraocular inflammation, visual acuity, eventual complications, and medications were examined. Standardized follow-up dates were used (before surgery, one and fourteen days, five and eleven months after surgery.) Results: No difference in the inflammatory activity was noted between HSM and PMMA groups; neither at short term clinical evaluation, nor at five months after surgery. Despite a slightly better visual acuity in the HSM group before surgery, no long term differences were observed. After surgery the increase in visual acuity was similar for both groups, as well as the frequency of cystoid macular oedema (CMO) and synechiae. Fewer patients in HSM group required Nd:YAG posterior capsulotomy, but the difference was not significant. Conclusion: No clinical advantage was found when the HSM IOL was compared with the regular PMMA IOL in 43 patients with uveitis.     

葡萄膜炎并发白内障患者的手术疗效观察

目的 探讨葡萄膜炎并发白内障的手术治疗效果.方法 回顾性系列病例研究.选择2000年1月至2006年8月在中国医学科学院北京协和医院眼科诊治的51例(69只眼)葡萄膜炎并发白内障患者的手术资料,分析所选手术方式、术后视力、术后葡萄膜炎复发及并发症等情况.应用非参数Wilcoxon检验,对术前、后视力进行统计学分析.结果 64只眼(92.8%)施行白内障超声乳化摘除术,5只眼(7.2%)行白内障囊外摘除术.61只眼(88.4%)植人人工晶状体,8只眼(11.6%)未植入人工晶状体,其中6只眼是对侧眼已失明的单眼患者.38只眼(55.0%)术后末次随诊小孔视力≥0.5,较术前视力(仅1只眼的术前视力≥0.5,占1.4%)明显提高(Z=8.26,P＜0.001).术后19只眼(27.5%)出现前葡萄膜炎复发,其中18只眼是植入人工晶状体眼,5只眼前葡萄膜炎复发≥3次.术后24只眼(34.8%)因后囊膜混浊行YAG激光治疗,其中23只眼是人工晶状体眼,7只眼行至少2次钇铝石榴石激光治疗.结论 手术治疗葡萄膜炎并发白内障的疗效较好,不植入人工晶状体可能更安全,术后并发症少,适用于对侧眼已失明的单眼患者.     

Exfoliation syndrome and heparin surface modified intraocular lenses.

Either heparin surface modified (HSM) or regular polymethyl methacrylate (PMMA) intraocular lenses (IOLs) were implanted after extracapsular cataract extraction in 40 human eyes with exfoliation syndrome in a double-masked, randomized study. The patients were investigated preoperatively, and then 1 day, 1 week, 3, 6 and 12 months postoperatively. In eyes implanted with the HSM IOL, 26% had a fibrinoid reaction anterior to the IOL, while this complication was found in 50% of eyes implanted with the regular IOL. Pigment and cell deposits were more frequent on the regular IOLs than on the HSM lenses postoperatively. Posterior synechia formation between the iris and the implant or lens capsule was more common in the eyes with regular IOL compared to HSM IOL. No difference in visual acuity between the two groups was found either before or after surgery. The results suggest that in eyes with exfoliation syndrome, a heparin surface modified IOL reduces clinical complications associated with cataract surgery.     

双撕囊联合前部玻璃体切除治疗儿童先天性白内障

目的:观察双撕囊联合前部玻璃体切除治疗先天性白内障的疗效。方法:对31例52眼2月龄～12岁先天性白内障患儿实行白内障囊外摘除、后囊连续环形撕囊、前部玻璃体切除术,联合Ⅰ期或Ⅱ期IOL植入,平均随访16mo。结果:31例患儿之中有27例44眼术后能检查视力,最佳矫正视力>0.5者23眼,>0.3者12眼,<0.3者9眼,另外,<2岁的患儿4例8眼无法进行视力表检查,但相对术前跟随光亮或有注视目标的能力有所提高。术后并发症:后发性白内障3眼、葡萄膜炎7眼、角膜水肿5眼,人工晶状体偏位、黄斑囊样水肿、视网膜脱离等严重并发症尚未出现。结论:双撕囊联合前部玻璃体切除术联合IOL植入能预防后发性白内障等并发症的发生,是比较安全有效的治疗儿童先天性白内障的手术方式。     

柔红霉素预防后囊膜混浊的临床研究

目的　观察柔红霉素预防后囊膜混浊的临床效果。方法　对62只患白内障眼行白内障囊外摘出术及白内障囊外摘出并后房型人工晶状体植入术，分为实验组和对照组，实验组28眼，术中前房灌注液加入柔红霉素(7.5mg     

Cellular response one year after extracapsular cataract extraction--comparison of regular and heparin surface modified PMMA intraocular lenses

PURPOSE: To compare the heparin-surface-modified and the regular polymethylmethacrylate posterior chamber intraocular lenses regarding cellular reactions one year after extracapsular cataract extraction. MATERIAL AND METHODS: 62 patients of either sex, with senile cataract, without diabetes and any preoperative pathology of the eye, were included in the study. 30 patients received HSM PMMA PC IOL and 32 patients received unmodified PMMA PC IOL. All patients had a standard extracapsular cataract extraction. At the examination after one year the best corrected visual acuity was defined, anterior segment of the eye was evaluated biomicroscopically, cell deposits were assessed and the state of posterior capsule was noticed. RESULTS: One year postoperatively all patients in both groups had the best corrected visual acuity better than 0.5. Significantly fewer eyes with the HSM PMMA PC IOLs had cell deposits on the anterior surface of the lens (20% vs. 37.5%). The amount of cell deposits per patients was small. Irregularity of the pupil with presence of posterior synechias did not differ significantly between the groups. The percentage of patients with clear posterior capsule was greater in the group with implanted heparin-modified artificial lenses. CONCLUSION: The study suggests that heparin-surface-modified posterior intraocular lenses result in less postoperative cellular response observed one year after extracapsular cataract extraction.