小切口非乳化白内障摘出术在防盲中的应用

目的探讨小切口非乳化白内障囊外摘出术在防盲中的应川。方法在608例（639眼）防盲白内障复明手术中采用巩膜隧道小切口，旋转晶状体核至前房，利刷注水晶状体圈匙摘出晶状体核，植入后房人上晶状体。结果术后第1天视力≥0．5者362眼（56．65％），术后第3天视力≥0．5者405眼（63．38％）。脱盲601例（脱盲率98．84％），脱残572例（脱残率94．08％）。结论在大规模白内障复明手术中应用小切口非乳化白内障囊外摘出术无需昂贵的超乳仪及其特殊器械，手术操作步骤简化安全，术后效果好。     

小切口手法碎核白内障手术在农村复明中的应用

目的 探讨小切口手法碎核白内障手术在农村白内障集中复明中的优点及缺点,为基层白内障复明治疗找出一个安全有效、方便价廉的手术方法。方法 通过一次白内障集中复明活动,观察115例（116只眼）实施了小切口手法碎核白内障摘除及／或人工晶状体植入手术患者的术中、术后反应,以及术后的视力恢复等,分析手术的优点及缺点。结果 术后1周视力≥O．5者86只眼（占74．1％）,0．1～0．4者26只眼（占22．4％）,〈0．1者4只眼（占3．5％）。术中、术后并发症少。结论 小切口手法碎核白内障手术操作方便,切口小,术后反应轻,恢复快,复明效果好,费用低廉,住院时间短或不住院。适合在中小医院和基层医院推广。特别是在农村白内障患者复明工作中能发挥明显的优势。     

手法小切口白内障手术在基层复明工程中的应用

目的探讨基层复明工程中手法小切口白内障手术的应用。方法在60例（60眼）慈溪市残联白内障复明手术中，采用一字型或反眉形巩膜隧道小切口，利用旋转法或水压翻转法将晶状体核盘入前房，用注水圈匙托出晶状体核，植人后房型硬性人工晶状体，切口不予缝合。结果术后第1天裸眼视力≥0．5者38眼（63．33％）；〈0．5者22眼（36．67％）。术后1个月，最佳矫正视力≥0．5者49眼（81．67％）；〈0．5者11眼（18．33％）。所有患者全部脱盲，脱残55眼，脱残率为91．67％。结论在基层白内障复明工程中，采用手法小切口白内障手术，快捷、安全、术中术后并发症少，视力恢复佳，取得了大规模，低成本，高质量的效果。     

在贫困山区开展白内障复明手术

目的 评价现代白内障囊外摘出术联合后房型人工晶状体植入术在贫困山区开展白内障复明手术的效果。方法 对105例白内障患者行白内障囊外摘出术联合后房型人工晶状体植入术。结果 人工晶状体眼术后第1天裸眼视力0．1－0．2占20．0％，0．3－0．5占67．7％，0．6－0．8占12．3％。结论 采用国产化设备和材料行现代白内障囊外摘出术联合后房型人工晶状体植入术是贫困山区白内障患者得明最佳手术方式。     

贫困山区开展规模化白内障手术的体会

目的 探讨在贫困山区规模化开展白内障摘出手术的初步经验。方法 对2002年10月开展白内障复明手术108例(124眼)的工作进行回顾性总结。结果 124眼术后视力均有不同程度的较好恢复。脱盲率93．24％，脱残率84．68％。结论 贫困山区条件很差，但因地制宜，准备充分，技术过硬，优化操作，还是可以规模化开展白内障复明手术的。     

高龄患者白内障人工晶状体植入术后并发症分析

目的探讨高龄患者白内障摘出联合人工晶状体植入术的临床效果及并发症。方法对189例80～97岁高龄白内障实施白内障瞧外摘出联合人工品状体植入术，分析手术效果及并发症。结果术后视力≥0．05者，175例，脱盲率92．59％。术后视力≥0．3者，97眼，脱残率51．32％；并发症的发生率；后囊破裂（34例）17．99％，眼内无菌性炎症（23例）12．17％，高眼压（27例）14．29％，人工晶状体瞳孔夹持（5例）2．6％。结论白内障摘出联合人工晶状体植入术是一种适合基层医院开展的技术，通过手术，可使多数白内障患者复明，而且痛苦小，视力恢复快。术中术后并发症经及时恰当的处理后均恢复有用视力。     

小切口白内障囊外摘出人工晶状体植入在复明行动中的应用

目的探讨小切口白内障囊外摘出人工晶状体植入的优点及在基层开展复明行动的应用。方法分析复明行动中160例（170眼）老年性白内障术后视力及术中、术后的并发症。结果术后1周，视力≥0．5者148例（152眼，占89．41％）。术中无虹膜脱出，术后无切口渗漏或浅前房。结论小切口白内障囊外摘出人工晶状体植入术有广泛的实用性，并发症少，术后视力恢复快，适宜在基层复明行动中应用。     

外伤性白内障手术方式的选择与术后视力的关系

目的探讨外伤性白内障不同手术方式的选择与临床疗效的关系。方法将148例（148眼）外伤性白内障,根据其眼部外伤情况,分别选用不同的手术方式,包括：一期和二期人工晶状体植入术或手术过程中行二次撕囊联合后囊撕囊术。观察术后视力恢复的情况及并发症防治。结果术后视力0．05～0．25者占18．25％,0．3—0．4者占16．89％,0．5～0．6者占31．08％,0．7～1．2者占27．70％。脱盲率为92．2％,脱残率为78．9％。未见严重并发症。结论外伤性白内障选择恰当的手术方式可获得最佳的临床效果。     

民生工程白内障复明项目中诊治流程与治疗策略

目的探讨白内障复明手术流程图在定点医院应用。方法按计划组织病员，制定手术方案，分期、分批实施手术。结果本院在25天内完成120例白内障小切口手法碎核＋10L植入手术，术后1个月视力≥0．3者116例（占96．67％）；人工晶体植入116只眼（占96．67％）。术中、术后无严重并发症发生。结论大规模的白内障复明手术，有计划按白内障手术诊步骤地进行作业，实施白内障手术治疗策略，保证了手术的安全性，有效性。     

白内障超声乳化手术临床观察及手术方法探讨

目的 观察白内障超声乳化术的治疗效果及探讨其手术方法。方法 对98例（112眼）白内障超声乳化术进行分析讨论。本组患者年龄40～92岁，平均年龄67．23岁；术前视力指数／20cm～0．5，观察术后视力及手术方法。结果 术后第1天视力〈0．3，占18．75％；0．3≤视力〈0．8，占61．60％；视力≥0．8，占19．64％；术后1周视力〈0．3，占9．82％；0．3≤视力〈0．8，占65．18％；视力≥0．8，占25％。术后第1天角膜轻度水肿占12％，术后2～4天恢复透明，术后1例患者发生视网膜脱离，3例患者发生虹膜后粘连。结论 白内障超声乳化术效果好，术后视力恢复好。我们眼科工作者只有不断提高自身业务水平，熟练手术方法，掌握手术技巧，才能更好地为眼疾患者服务。     

Population-based assessment of the outcome of cataract surgery in an urban population in southern India

PURPOSE: To assess the outcome of cataract surgery in an urban population in southern India. METHODS: As part of a population-based cross-sectional epidemiologic study, the Andhra Pradesh Eye Disease Study, 2,522 people of all ages, including 1,399 individuals 30 years of age or older, from 24 clusters representative of the population of Hyderabad in southern India underwent a detailed interview and ocular evaluation including logarithm of minimal angle of resolution (logMAR) visual acuity, refraction, slit-lamp biomicroscopy, applanation tonometry, gonioscopy, dilation, cataract grading, aphakia/pseudophakia status, and stereoscopic fundus evaluation. Automated threshold visual fields and slit-lamp and fundus photography were performed when indicated by standardized criteria. Very poor outcome in an eye that had undergone cataract surgery was defined as presenting distance visual acuity worse than 20/200, and poor outcome was defined as visual acuity worse than 20/60 to 20/200. RESULTS: In subjects 50 years of age or older, after adjustment for age and sex distribution, the rate of having had cataract surgery in one or both eyes was 14.6% (95% confidence interval [CI], 11.4% to 17.8%). Of 131 eyes (91 subjects) that had undergone cataract surgery, 28 (21.4%; 95% CI, 14.4% to 28.4%) had very poor outcome and another 40 (30.5%; 95% CI, 22.6% to 38.4%) had poor outcome. The very poor outcome in 20 (71.4%) of 28 eyes and poor outcome in 23 (57.5%) of 40 eyes could be attributed to surgery-related causes or inadequate refractive correction. With multivariate analysis, very poor outcome as a result of surgery-related causes or inadequate refractive correction was more likely to be associated with intracapsular cataract extraction than with extracapsular cataract extraction (odds ratio, 9.34; 95% CI, 2.49 to 35.06) in subjects belonging to the lowest socioeconomic status (odds ratio, 4.92; 95% CI, 1.16 to 20.93) and with date of surgery 3 or fewer years before the survey than with more than 3 years (odds ratio, 4.52; 95% CI, 1.33 to 15.39). Also, very poor or poor outcome as a result of surgery-related causes or inadequate refractive correction was associated with women (odds ratio, 2.55; 95% CI, 1.06 to 6.16). CONCLUSIONS: The very high rate of very poor and poor visual outcome, predominantly as a result of surgery-related causes and inadequate refractive correction, in this urban population of India suggests that more attention is needed to improve the visual outcome of cataract surgery. In order to deal with cataract-related visual impairment in India, as much emphasis on surgical quality, refractive correction, and follow-up care is necessary as on the number of surgeries.     

Benefits and risks of immediately sequential bilateral cataract surgery: a literature review

Immediately sequential bilateral cataract surgery (ISBCS) is a highly contended issue in ophthalmology, mainly due to the risk of bilateral endophthalmitis and financial penalties that many ophthalmologists face when performing simultaneous cataract surgeries. The purpose of this review is to understand the current status of the knowledge of ISBCS, mainly its benefits and risks and how they compare with the standard of care, delayed sequential bilateral cataract surgery. Evidence, although limited, increasingly supports ISBCS for providing faster rehabilitation, improved visual outcomes, and cost and time savings. Evidence does not support the fear of bilateral endophthalmitis resulting from the simultaneous procedure. However, stronger and greater evidence is needed before ISBCSs can be considered the standard of care. Where ISBCS can potentially create the most beneficial impact is in public eye health programmes in developing countries, but this has not yet been explored.     

白内障手术服务快速评估法在白内障干预工作中的应用及意义

白内障手术服务快速评估法(RACSS)是WHO推出的用于评估一个国家或地区白内障盲情的一种简单方法。建议国内各级防盲机构在评估中国的每年白内障手术量时采用白内障手术覆盖率指标。为了提高评估效率,我们建议筛查人群为≥60岁者。为了了解每年的手术趋势,在其白内障手术服务调查记录表中加入“哪年做的白内障手术”的内容。     

Cataract surgical reach: Falling short to catch white cataracts!

Purpose:The aim of this study was to know proportion of white cataracts from among patients coming for cataract surgery, and to find causes delaying uptake of cataract surgery.Methods:A hospital-based, prospective study enrolled patients of senile cataract between April 2018 and March 2019. The proportion of white cataract was calculated and underlying causes delaying uptake of cataract surgery studied.Results:White cataracts constituted 13.5% of total 3634 senile cataract patients, with gender disparity disfavoring women. Bilateral white cataract was presentation in 39 (8%) patients and lens-related glaucoma in 24 (5%) patients. Pseudophakia in the other eye was single most common cause of delay.Conclusion:A large proportion of white cataracts suggest that penetration of cataract surgical services in not reaching to the most eligible individual.     

Congenital Anterior Polar Cataract: A Review of 63 Cases

Sixty-three patients with congenital anterior polar cataracts seen over a period of 15 years at The Children's Hospital, Boston, were reviewed to determine their clinical course and visual outcome. Over one-third of the patients were found to have strabismus, refractive anisometropia, or some form of amblyopia. Seven other patients had additional ocular pathology which affected their visual prognosis. One patient manifested progressive lens opacification that eventually warranted cataract surgery. These findings suggest a less benign prognosis for congenital anterior polar cataracts than has generally been described. In our series early ophthalmological examination did not always allow us to forecast later visual disability. We therefore recommend regular follow-up of all children with anterior polar cataracts until a secure assessment of vision can be made.     

发展中国家白内障手术的现状

随着人口的老龄化白内障的发病率也在升高,白内障已经成为发展中国家最常见的致盲眼病,在发展中国家中,盲和视觉损伤已经成为严重的公共卫生、社会和经济问题。虽然白内障手术是最具有成本效益的干预方式,但在发展中国家提供白内障手术服务仍存在很多问题和挑战,在过去10a中一些国家在治疗白内障时采用手法小切口白内障摘除术这种手术方式并取得了较好的效果。另外,制定不同的可持续发展的防盲模式在这些发展中国家也是一个挑战。本文就近年发展中国家的白内障手术情况做一综述。     

白内障术后感染性眼内炎治疗11例

目的探讨白内障术后感染性眼内炎相关因素及治疗方法。方法对我院1999年11月至2005年10月11例11眼白内障术后感染性眼内炎进行回顾性分析。结果7眼细菌培养阳性，培养细菌包括：表皮葡萄球菌2眼，粪肠球菌1眼，催产克雷白菌1眼，腐生葡萄球菌1眼，异型枸橼酸杆菌1眼，醋酸不动杆菌1眼。行后部玻璃体切割术者5眼，其中眼球摘除1眼；单纯前房冲洗加注药2眼；前房冲洗注药联合玻璃体腔注药4眼。结论前房和玻璃体注药，后部玻璃体切割术是治疗的有效方法。     

Second nonocular cancers in retinoblastoma: a unified hypothesis The Franceschetti Lecture

The procedure for congenital cataract surgery and its indications are discussed.