复方血栓通胶囊治疗外伤性前房积血32例

目的 观察复方血栓通胶囊治疗外伤性前房积血的临床效果。方法 对32例外伤性前房积血给予复方血栓通胶囊口服为主之治疗，前房有炎症反应者辅以皮质类固醇口服，疑有高眼压者辅以甘露醇静脉滴注。结果 前房积血Ⅰ级者平均3天吸收，Ⅱ级者平均5天吸收，Ⅲ级者平均10天吸收。除1例Ⅲ级前房积血合并玻璃体积血视力无提高外，其余患者均恢复到原有视力。结论 复方血栓通胶囊治疗外伤性前房积血有效。     

复方血栓通胶囊治疗外伤性前房积血

目的观察复方血栓通胶囊治疗外伤性前房积血的临床效果。方法对外伤性前房积血给予复方血栓通胶囊口服为主之治疗,前房有炎症反应者辅以皮质类固醇口服,伴有高眼压者辅以甘露醇静脉滴注。结果前房积血吸收时间：Ⅰ级者3d左右,Ⅱ级者5d左右,Ⅲ级者10d左右。除2例Ⅲ级前房积血合并玻璃体积血视力无提高外,其余患眼均恢复到原有视力。结论复方血栓通胶囊治疗外伤性前房积血是有效的。     

血栓通治疗外伤性前房积血

目的 观察血栓通治疗外伤性前房积血的疗效.方法 外伤性前房积血40例(40眼).使用以血栓通为主的药物治疗,根据积血程度,对积血吸收的时间,视力恢复情况等全面进行观察.结果 前房积血Ⅰ级者22眼(55.0%).积血吸收平均时间3 d,Ⅱ级者8眼(20.0%),积血吸收平均时间为5 d,Ⅲ级者10眼(25.0%),积血吸收平均时间为8.5 d.经用血栓通治疗后,40眼前房积血37眼治愈,治愈率达92.5%.除2眼因合并外伤性白内障,1眼第6 d义发生再次出血合并玻璃体积血,视力未能恢复正常外,其余37眼视力或矫正视力均达1.0.结论 血栓通治疗外伤性前房积血,积血吸收快,无明显副作用.     

挫伤性前房积血临床分析

目的 分析挫伤性前房积血的治疗方法和临床疗效。方法 对我院2000年1月-2004年6月78例挫伤性前房积血进行治疗，方法 是双眼包扎，半卧位，休息，应用止血剂，根据病情应用甘露醇、皮质类固醇激素，有的做前房冲洗。观察积血吸收时间、并发症和视力。结果 积血吸收时间：Ⅰ级前房积血吸收时间1-5天，Ⅱ级积血吸收时间6～10天，Ⅲ级积血吸收时间11-19天。前房积血吸收后视力：0．1以下者5例，0．1～0．3者11例，0．4～0．9者23例，1．0以上者39例。结论 挫伤性前房积血的视力恢复程度与积血量多少有关，也与挫伤程度有关。并发症少和治疗早者，视力恢复较好。     

挫伤性前房积血56例临床分析

目的探讨挫伤性前房积血的治疗时机和治疗措施。方法对挫伤性前房积血56例患者进行回顾性分析,其中I级33眼,II级17眼,III级6眼,给予相应的药物保守治疗及手术治疗,观察其前房积血吸收时间、视力预后及相关并发症等。结果积血吸收时间:2d内吸收者36眼,3～7d内吸收者14眼,8～14d内吸收者5眼,14d以上仍未吸收者1眼。I级和II级前房积血的视力恢复较满意,III级前房积血视力恢复欠佳。继发青光眼15眼,晶状体脱位1眼,玻璃体积血合并视网膜脱离1眼,角膜血染1眼。结论挫伤性前房积血视力预后与治疗是否及时、出血量多少、出血部位、就诊时间及并发症有密切关系。     

挫伤性前房积血112例临床分析

目的 分析挫伤性前房积血的治疗方法。方法 对我院1993年10月～2003年10月收治的112例(112眼)挫伤性前房积血进行治疗，方法 是双眼包扎，半卧位，制动休息，止血剂、甘露醇、皮质类固醇等的应用，有的作前房冲洗。观察积血吸收时间、并发症和视力。结果 积血吸收时间：Ⅰ级1～5天，Ⅱ级6～10天，Ⅲ级和Ⅳ级11—20天。积血吸收后视力：0．05以下6例，0．05～0．111例，0．2．0．39例，0．4～0．610例，0．7～0．925例，1．0以上51例。结论 挫伤性前房积血的视力恢复程度与积血量多少有关，也与挫伤的程度有关。并发症少和治疗早者，视力恢复较好。     

儿童外伤性前房积血50例

小儿挫伤性前房积血在小儿眼外伤中较为常见。现将我院1987年6月～1997年6月诊治的14岁以下小儿挫伤性前房积血50例回顾分析如下:一般资料:50例挫伤性前房积血患儿,年龄2～14岁,平均7岁。男38例,女12例,均为单眼。致伤物:石块、砖块和土块击伤25例,居首位。木块(棒)伤8例,鞭炮伤9例,弹弓及塑料子弹伤4例,其他物致伤4例。按ＥｄｗａｎｋｓＬａｙｄｅｎ(1973)分级法,本组50例中,Ⅰ级10例,Ⅱ级32例,Ⅲ级8例。伤后48小时入院治疗20例;3～15天入院10例;15天～1月入院2例;伤后48小时内门诊治疗18例。前房积血平均吸收时间:Ⅰ级2天,Ⅱ级4天,Ⅲ级6天…     

挫伤性前房积血的临床分析

目的 探讨挫伤性前房积血的治疗方法和临床疗效。方法 回顾性分析148例(148只眼)挫伤性前房积血患者采用非手术或手术治疗及其效果。结果 非手术治疗121例，前房积血在2～13天吸收，27例手术治疗后25例眼压恢复正常，积血吸收，2例发生角膜血染。结论 对挫伤性前房积血患者应尽早发现和治疗并发症，对眼压持续不降及眼压正常、但积血无改善者均应及时行手术治疗。     

小切口白内障囊外摘除及人工晶状体植入术前房积血的分析

目的：探讨小切口白内障囊外摘除及人工晶状体术术中和术后前房积血的原因。方法：分析近5年内小切口白内障囊外摘除及人工晶状体植入术中及术后发生前房出血者23例（23只眼）的病例资料。前房积血采用OKsala分级法。结果：Ⅰ～Ⅱ级前房积血16只眼,Ⅲ级前房积血9只眼。经治疗,18只眼3～5d天痊愈,3只眼伴后囊下积血的病例有1只眼发生后发性白内障,4只眼伴玻璃体积血者经综合治疗25～38d后积血基本吸收。结论：白内障手术所致前房积血原因较多。应注意预防,以提高手术质量。     

挫伤性前房积血128例临床分析

目的 探讨挫伤性前房积血的治疗时机和方案。方法 挫伤性前房积血 128例,其中Ⅰ级64例,Ⅱ级28例,Ⅲ级36例,运用相应的中西医疗法治疗。结果 出血吸收时间:1～3天内吸收41例,占32％;4～6天35例,占27％;7～10天23例,占19％;11～15天17例,占13％;15天以上的 12例,占 9％。视力恢复较满意。结论 中西医结合治疗挫伤性前房积血疗效较好,但愈后视力恢复与治疗是否及时,出血量多少及并发症有一定关系。     

超声乳化联合前房角分离治疗伴白内障的青光眼

目的：：观察晶状体超声乳化联合前房角分离术对伴有白内障的慢性闭角型青光眼患者的治疗效果。方法：无并发症伴有白内障的慢性闭角型青光眼50例50眼,施行晶状体超声乳化吸出人工晶状体植入联合前房角分离术。术后随访3mo,记录并比较术前及术后最佳矫正视力、眼压、前房深度及前房角。各指标均采用均数±标准差(x±s)表示,术前及术后3mo的最佳矫正视力、眼压、前房深度及前房角的情况进行比较。结果：术后3 mo的最佳矫正视力较术前明显提高,差异有统计学意义( t=8.76, P=0.001);术后3 mo 的眼压为15.63±3.11mmHg,较术前(45.12±5.30mmHg)明显下降,差异有统计学意义(t=6.27,P=0.000);术后3mo的前房深度为3.57±0.02mm,较术前(1.43±0.25mm)明显加深,差异有统计学意义(t=8.16,P=0.001);术前、术后前房角情况的比较,差异有统计学意义(Z=-4.432,P=0.000;Z=-2.432,P=0.016;Z=-4.379,P=0.000;Z=-4.538, P=0.000)。结论：晶状体超声乳化吸出人工晶状体植入联合前房角分离术治疗伴有白内障的慢性闭角型青光眼,能够有效控制眼压,提高视力,是一种安全、有效的手术方法。     

环喷托酯在屈光参差儿童散瞳验光中的应用

目的比较分析1%盐酸环喷托酯与1%阿托品对3~12岁屈光参差儿童散瞳验光效果。设计回顾性病例系列。研究对象2010年10月~2011年2月在北京同仁医院眼科斜弱视门诊就诊的3~12岁屈光参差儿童40例(80眼)。方法对以上40例患儿按年龄分成3组,即3~6岁组,7~9岁组和10~12岁组。全部患儿均首先用1%盐酸环喷托酯进行散瞳验光,待其瞳孔完全恢复正常(1周后)再行1%阿托品散瞳验光,比较两种方法的验光结果。主要指标屈光值(球镜度数、柱镜度数及轴向)。结果用1%盐酸环喷托酯散瞳验光结果(球镜:+1.18 D±4.90 D,柱镜:+1.47 D±1.16 D,散光轴向:80.50°±38.62°)与用1%阿托品散瞳验光结果(球镜:+1.20 D±4.91 D,柱镜:+1.47 D±1.15 D,散光轴向:80.06°±38.48°)比较,差异均无统计学意义(P均>0.05)。在80眼中,球镜值相同或相差≤0.50 D者77眼,符合率为96.25%;柱镜值在69眼中,结果相同或相差≤0.50 D者65眼,符合率为94.20%;散光轴向在69眼中,结果相同或相差≤5°者67眼,符合率为97.10%。三个年龄组间的球镜、柱镜和散光轴向符合率差异均无统计学意义(P均>0.05)。结论 1%盐酸环喷托酯可以替代1%阿托品用于3~12岁屈光参差儿童散瞳验光,其结果可以作为配镜的依据。     

滤过试验结合可拆缝线在小梁切除术中的应用

目的　探讨小梁切除术术中做滤过试验结合可拆缝线的应用对预测和控制术后滤过量及预防浅前房的疗效。方法　对 92例 ( 113眼 )原发性青光眼 ,在小梁切除术术中根据滤过试验结果来决定固定缝线和可拆缝线缝合的位置和数量。术后 1～ 7天 ,抽出可拆缝线。回顾性总结术中缝合种类、数量及术后前房深度、眼压、滤过泡、视野。结果　术中 40眼 ( 3 5 40 % )采用一针固定缝线和一至二针可拆缝线 ,5 1眼 ( 45 14 % )采用二针固定缝线和一至二针可拆缝线。术后无一例持续性浅前房。术后第 7天眼压平均 13 5± 3 3 0mmHg。追踪观察 6～ 2 4个月 ,形成功能性滤过泡 89眼( 78 76% ) ,眼压控制 <2 1mmHg 91眼 ( 80 5 3 % ) ,视野不变 98眼 ( 86 73 % )。结论　小梁切除术术中根据滤过试验的结果 ,通过对固定缝线和可拆缝线缝合的位置和数量的选择能有效预测和控制术后滤过量并预防术后浅前房     

Bilateral CNV associated with optic nerve drusen treated with photodynamic therapy with verteporfin

PURPOSE: To report a case of bilateral choroidal neovascularization (CNV) associated with optic nerve drusen (OND) treated with photodynamic therapy (PDT) with verteporfin. METHODS: A 10-year-old girl with juxtapapillary CNV in the right eye and juxtapapillary and juxtafoveal CNV in the left eye associated with OND underwent PDT with verteporfin in both eyes. RESULTS: Visual acuity increased from 20/160 to 20/25 in the right eye and from 20/1000 to 20/25 in the left eye after two sessions of PDT and 2 years of follow-up. CNV showed no leakage after two PDT sessions in both eyes and no recurrence was observed. CONCLUSIONS: Subfoveal CNV is an uncommon complication of OND and excellent anatomic and functional results can be obtained with PDT.     

合并成型性渗出的急性前葡萄膜炎与HLA-B27的相关性研究

目的 探讨急性渗出性前葡萄膜炎与HLA-B27的相关性。方法 对53例前房内出现成型性渗出的急性前葡萄膜炎（AAUPE）患者及61例前房内无成型性渗出的急性前葡萄膜炎（AAU）患者进行HLA-B27的检测,并结合临床表现加以分析。结果 成型性渗出的AAUPE患者的HLA-B27阳性率为100％,而无成型性渗出的AAU患者的HLA-B27阳性率仅为50.8％。二者有显著差异性（P<0.01）。两组HLA-B27阳性的病人强直性脊柱炎发生率分别为50.0％和42.9％。结论 结果进一步证实了HLA-B27与成型性渗出密切相关的论点。提示检测AAU患者HLA-B27的阳性率,发现成型性渗出裂隙灯检查似与血清法检测同样准确。     

小梁切除联合超声乳化白内障吸除术治疗青光眼合并白内障

目的：观察小梁切除联合超声乳化白内障吸除术在原发性闭角型青光眼(包括急性闭角型青光眼与慢性闭角型青光眼)合并白内障患者中的临床治疗效果及对并发症的影响。

方法：选取2014-01/2016-07在我院诊治的青光眼合并白内障患者60例60眼,采用随机数字方法分为对照组(30例30眼)和观察组(30例30眼)。对照组采用小梁切除术治疗,观察组采用小梁切除联合超声乳化白内障吸除治疗,比较两组临床效果及并发症发生率情况。

结果：观察组术后视力与对照组相比差异无统计学意义(P>0.05); 观察组术后眼压水平低于对照组,差异有统计学意义(P<0.05); 观察组术后前房深度大于对照组,差异有统计学意义(P<0.05); 观察组术后并发症发生率为7%,显著低于对照组的23%,差异有统计学意义(P<0.05)。

结论：原发性闭角型青光眼合并白内障患者在小梁切除术基础上联合超声乳化白内障吸除术治疗效果理想,并发症发生率相对较低。     

Levodopa-carbidopa with occlusion in older children with amblyopia

PURPOSE: To study the role of levodopa-carbidopa in supplementing occlusion therapy in older children with strabismic or anisometropic amblyopia. Methods: A clinical study was performed on 40 amblyopic children (19 strabismic and 21 anisometropic), 6 to 18 years old (mean age, 10.9 years). They received an average dose of 1.86 mg/kg/day (1.33-2.36 mg/kg/day) of levodopa and carbidopa (4:1 ratio) or a placebo in 3 divided doses over a 4-week period, combined with full-time occlusion. The occlusion was continued for the study duration of 3 months. Early Treatment Diabetic Retinopathy Study visual acuity charts and Cambridge low-contrast gratings for contrast sensitivity (CS) were used to assess visual functions. Tolerance and compliance with occlusion and capsule consumption were assessed. RESULTS: Visual acuity of the nonamblyopic eye did not deteriorate during the study in either group. CS decreased by 22 units in the levodopa group and increased in the placebo group by 53 units at the first month. The CS in the levodopa group recovered later by the third month of follow-up. Both the levodopa and the placebo groups showed significant improvement in visual function in the amblyopic eye (P <.001). Overall changes in logarithm of minimum angle of resolution values and CS in the amblyopic eyes were similar in both groups (P >.05). Strabismic and anisometropic amblyopes did not behave differently. Drug tolerance, occlusion compliance, and capsule ingestion compliance were similar between the groups, with no significant side effects. CONCLUSIONS: Clinically, levodopa supplementation does not offer any advantage over occlusion alone. Moreover, the risk of occlusion amblyopia could increase with the use of drugs like levodopa that might affect the plasticity of the visual cortex.     

Phacotrabeculectomy with mitomycin C in patients with uveitis

PURPOSE: To evaluate the safety and efficacy of combined phacoemulsification, intraocular lens implantation, and trabeculectomy with mitomycin C for the management of uveitic complications. DESIGN: Retrospective case-control study. METHODS: We conducted a retrospective review of the records of 23 consecutive eyes with chronic noninfectious uveitis (uveitic group) and 43 nonuveitic eyes (control group) that had received primary phacotrabeculectomy. Mitomycin C was used in all the uveitic eyes. Considering the high preoperative intraocular pressure (IOP) of the uveitic group, nonuveitic eyes that had a preoperative IOP of >or=20 mm Hg or that had been given two or more medications were included in the control group. All patients were followed for at least one year. The main outcome measures were postoperative vision, IOP control, complications, and acute uveitis relapse rates. RESULTS: Visual outcome of the uveitic group was similar to the control group. In the uveitic group, the success rate of IOP control (91.3% at one year, 84.8% at two years) was favorable but was significantly lower than in the control group (P = .0423). Complications were comparable between the groups. Primary surgical failure in the uveitic group was associated with the postoperative acute uveitis attack. In the uveitic group, the acute uveitis attack rate showed no change after surgery (P = .283). CONCLUSION: With adequate inflammation suppression, phacotrabeculectomy with mitomycin C is an effective and safe therapeutic option for the management of secondary cataract and glaucoma in uveitic eyes. A lower surgical success rate of the uveitic group might be attributable to the postoperative inflammation recurrence.     

Epikeratoplasty with nonlyophilized tissue in children with aphakia

We studied 75 epikeratoplasty procedures using nonlyophilized tissue performed by eight ophthalmic surgeons in 70 eyes (47 patients) to correct for aphakia in children less than 8 years of age (mean age, 3.4 +/- 2.1 years). Of the 47 patients in the study, 24 were girls and 23 were boys; 23 patients had bilateral surgery. Seven of the epigrafts required removal; two were not replaced, and five underwent successful repeat epikeratoplasty. Overall, the success rate (that is, the percentage of epigrafts that remained optically and functionally clear throughout the course of this study) for the epikeratoplasty procedure was 89% (62 of 70 eyes) for initial surgery and 96% (67 of 70 eyes) for repeat surgery. The average spherical equivalent was +14.4 +/- 3.7 diopters preoperatively and +0.3 +/- 2.9 diopters one year after the operation. One year after the final surgical procedure, 42 of 56 eyes (75%) were within 3 diopters of emmetropia. In the 29 verbal patients, best-corrected visual acuity was 20/100 or better in 25 (86.2%) one year after the operation.