玻璃体切除术后白内障放置后节眼内灌注行超声乳化人工晶状体植入术

目的:探讨玻璃体切除术后白内障在行超声乳化人工晶状体植入术时放置后节眼内灌注的临床效果。方法:对31例35眼玻璃体切除术后的白内障患者行超声乳化吸出及人工晶状体植入术,手术时常规放置后节眼内灌注,观察术后视力、眼底状况及手术并发症。结果:35眼中,术后最佳矫正视力≥0.5者4眼,0.3～0.4者8眼,0.1～0.2者18眼,数指～0.1者5眼;并发症:角膜轻度水肿4例,玻璃体出血1眼,脉络膜脱离1眼,术后晶状体后囊混浊2眼。结论:玻璃体切除术后发生的白内障,在选择超声乳化摘出及人工晶状体植入术的同时,放置后节眼内灌注是一种比较安全而有效的方法。     

扶贫白内障超声乳化手术1 800例疗效分析

目的:评价1800例扶贫白内障超声乳化手术的效果。方法:对2010-06/2012-11期间经我院筛查适合手术的白内障患者1800例1800眼,实施免费白内障超声乳化及人工晶状体植入术,并主要对年龄相关性白内障的术后效果与并发症进行分析。结果:手术患者中年龄相关性白内障为1326眼(73.67%);年龄相关性白内障手术后第1d脱盲率达98.72%,脱残率达89.52%。术中并发症:后囊膜破裂32眼(2.41%);平衡液逆流7眼(0.53%);悬韧带完全断裂1眼(0.075%),部分断裂5眼(0.38%)。术后并发症:角膜水肿103眼(7.77%),轻度角膜水肿79眼(5.96%),中重度角膜水肿24眼(1.81%);反应性葡萄膜炎6眼(0.45%);一过性高眼压9眼(0.68%);人工晶状体夹持3眼(0.23%);黄斑水肿6眼(0.45%)。未发生大泡性角膜炎、暴发性脉络膜上腔出血、感染性眼内炎等严重并发症。结论:白内障超声乳化术在患有年龄相关性白内障的手术患者中疗效显著,超声乳化术手术时间短,创伤小,术后视力恢复快,并发症少,在白内障复明手术中优势明显。     

角巩膜缘切口在超声乳化白内障手术转型中的应用

目的:探讨角巩膜缘切口在小切口向超声乳化白内障手术转型中的应用.方法:选取我院在2012-02/2013-02接受手术的200例200眼白内障患者,行角巩膜缘切口超声乳化手术,术中如遇不安全因素即改为SICS+IOL术,手术均顺利完成.结果:顺利实施超声乳化白内障手术者共172眼(86％),28眼(14％)改为角巩膜缘切口SICS+IOL术,术后视力≥0.5者176眼(88％),0.1～0.4者22眼(11％),0.1以下者2眼(1％).术后均无严重并发症.结论:在小切口转型超声乳化白内障手术初期时,运用角巩膜缘切口能提高手术的可操作性和安全性,是具有小切口白内障手术经验眼科医生很好的选择方式.     

超声乳化人工晶状体植入治疗葡萄膜炎并发性白内障

目的：探讨白内障超声乳化联合人工晶状体植入手术治疗葡萄膜炎并发性白内障的手术疗效。
　　方法：本研究采用系统性回顾研究,选取2015-01/12在南京军区南京总医院眼科诊断为葡萄膜炎并发性白内障的患者57例57眼,所有患者均行白内障超声乳化联合人工晶状体植入术,对患者的术中并发症,术后效果及并发症情况进行回顾分析。对手术前后视力进行非参数Wilcoxon检验。
　　结果：所选患者超声乳化术中发生虹膜出血21眼(37%),后囊膜破裂4眼(7%),人工晶状体无法植入4眼(7%),术后裸眼视力获得不同程度提高,术前裸眼视力≥0.1者8眼(14%),术后3mo裸眼视力≥0.1者42眼(74%),差异有统计学意义(Z=23.42,P<0.001)。术后1 d发生角膜水肿17眼(30%)、葡萄膜炎2眼(4%)、高眼压1眼(2%),术后1wk发生角膜水肿3眼(5%),术后1mo发生葡萄膜炎1眼(2%),术后3mo发生角膜水肿1眼(2%)、葡萄膜炎2眼(4%)、高眼压1眼(2%)、后发性白内障3眼(5%)。
　　结论：白内障超声乳化联合人工晶状体植入手术治疗葡萄膜炎并发性白内障,术后效果好,并发症少。     

高度近视合并年龄相关性白内障超声乳化手术并发症处理及预防

目的:探讨高度近视合并年龄相关性白内障患者超声乳化手术的并发症处理及预防.方法:回顾性分析研究.选取2015-01/12我院收治的高度近视合并年龄相关性白内障超声乳化手术患者90例134眼,其中男39例68眼,女51例66眼,平均年龄62.7±7.2岁,平均眼轴长度29.54±1.54(27 ～ 32) mm,术前矫正视力指数至0.5,随访6mo.观察术后1、3d,1、3、6tmo的视力、眼压、裂隙灯检查,必要时进行眼底检查.结果:选取90例134眼患者术中发生后囊膜破裂7眼(5.2％),其中4眼合并玻璃体脱出(3.0％),晶状体半脱位2眼(1.5％),全脱位1眼(0.7％).术后发生一过性高眼压9眼(6.7％),角膜水肿17眼(12.7％),视网膜脱离1眼(0.7％),均给予积极对症处理,术后视力均超过术前.随访6mo内,37眼(27.6％)患者因为视力下降就医,发生后发性白内障,予以Nd:YAG激光后囊膜切开术治疗.术中无1眼发生暴发性脉络膜上腔出血、虹膜损伤、瞳孔变形、眼内炎等严重并发症.结论:对于高度近视合并年龄相关性白内障患者尽量早期手术,术前充分检查,术中规范操作,对于术中及术后可能发生的并发症积极预防并正确处理,使患者获得更好、更舒适的视觉质量.     

白内障超声乳化治疗持续高眼压状态下急性闭角型青光眼的临床观察

目的:探讨急性闭角型青光眼在高眼压状态下行白内障超声乳化术的临床疗效。方法:对31例31眼持续高眼压状态下的急性闭角型青光眼合并白内障患者行白内障超声乳化联合后房折叠人工晶状体植入术,随访6mo～2a,观察术后视力、眼压及前房角的变化。结果:术后视力明显改善,矫正视力≤0.1者2眼(6%),0.1～0.2者8眼(26%),0.3～0.6者15眼(48%),0.8～1.0者6眼(19%)。术后1wk眼压均控制正常。术中或术后未出现脉络膜上腔出血、视网膜出血或睫状环阻塞性青光眼等严重并发症。结论:急性闭角型青光眼持续高眼压状态下行白内障超声乳化吸出是安全有效的。     

葡萄膜炎并发白内障行超声乳化人工晶状体植入术

目的 研究葡萄膜炎并发白内障行超声乳化联合人工晶状体植入术的效果.方法 回顾性分析我科2005年1月至2011年12月葡萄膜炎并发白内障68例(82眼)行超声乳化联合后房人工晶状体植入术,术后随访6 ～36个月,观察患者的视力及其并发症.结果 视力提高76眼(92.7％),术后1周,矫正视力≥0.6者48眼(58.5％),0.3 ～0.5者22眼(26.8％),0.1 ～0.2者8眼(9.8％),＜0.1者4眼(4.9％),术后后囊浑浊21眼(25.6％),葡萄膜炎复发9眼(10.9％),黄斑水肿6眼(7.3％).结论 葡萄膜炎并发白内障行超声乳化联合人工晶状体植入术可获得较好的视力.     

白内障超声乳化联合囊袋张力环植入术治疗晶状体半脱位

目的:探讨白内障超声乳化术中植入囊袋张力环治疗晶状体半脱位的疗效.方法:选取2013-01/2015-12在本院眼科中心进行白内障超声乳化术患者39例40眼进行回顾性分析,所有患者均于术中同时植入囊袋张力环,随访6mo,观察患者的手术前后的视力变化、晶状体位置及并发症的发生情况.结果:术后随访6mo,人工晶状体基本保持正位;术前患者视力＜0.1者19眼(48％)、0.1 ～0.3者21眼(52％);术后6mo,0.1 ～0.3者14眼(35％),0.4 ～0.6者25眼(63％),术后有1眼视力达到0.8.有13眼(33％)发生手术相关并发症,其中9眼(23％)发生角膜水肿,2眼(5％)出现高眼压情况,2眼(5％)出现玻璃体脱出.结论:白内障超声乳化手术联合囊袋张力环植入治疗晶状体半脱位的效果可靠,安全性较好.     

白内障超声乳化人工晶状体植入术965例临床分析

目的:探讨白内障超声乳化人工晶状体植入术的临床疗效,分析手术并发症及其处理。方法:对965例1024眼白内障患者行透明角膜或巩膜隧道切口白内障超声乳化人工晶状体植入术,总结分析术后低视力原因及手术并发症。结果:顺利完成超声乳化术998眼(97.46%),26眼改为ECCE+IOL术;术后最佳矫正视力(术后1mo):视力<0.3者141眼(13.77%),视力0.3～0.8者730眼(71.29%),视力≥1.0者153眼(14.94%);术中后囊膜破裂41眼(4.00%),撕囊失败16眼(1.56%)。虹膜损伤5眼(0.49%),核坠入玻璃体腔者2眼(0.20%)。术后角膜水肿98眼(9.57%),一过性高眼压31眼(3.03%),人工晶状体坠入玻璃体腔者1眼(0.10%),眼内炎4眼(0.39%),眼球萎缩2眼(0.20%)。结论:白内障超声乳化人工晶状体植入术具有创伤小、恢复快,术后视力满意等优点,但是了解手术并发症原因,减少和避免并发症的发生以及正确处理并发症,是手术成功的保障。     

超声乳化白内障吸出术中和术后早期并发症的观察

目的:探讨超声乳化白内障吸出手术并发症的原因和处理方法。方法:观察了采用原位碎核和虹膜平面碎核法分别对212例(233眼)患者行超声乳化白内障吸出术的术中和术后早期并发症。结果:术中玻璃体脱出20眼(8.6％),虹膜损伤13眼(5.6％),前房出血1眼(0.4％)。术后角膜持续水肿3眼(1.3％),后囊膜混浊7眼(3.0％),炎症反应2眼(0.9％),人工晶体偏位1眼(0.4％),切口渗漏2眼(0.9％),术后前房出血1眼(0.4％)。结论:玻璃体脱出及虹膜损伤是初期进行超声乳化白内障吸出术较常见的并发症。采用原位碎核法出现的玻璃体脱出及虹膜损伤少于虹膜平面碎核法。眼科学报1998;14:105—107。     

Strabisme Alternant - Etude clinique - traitement

The author defines motor and sensory alternation: the term alternation should not be used in isolation, it should always be accompanied by the name of the parameter concerned. Sensory alternation is always found together with motor alternation but the reverse is not true.The examining criteria for a diagnosis of sensory alternation are given, sensory alternation must not be confused with alternating inhibition. Working from clinical observations of cases of motor alternating strabismus, the author selects 2 types of binocular sensory relations which allow one to differentiate between:- cases of primary alternating strabismus- cases of secondary alternating strabismusThese forms will develop in different ways; in both cases a cure is possible providing that the right treatment is prescribed and once prescribed carefully followed, etc. It is always a case of serious forms of strabismus whose developmental period is spread over several years.According to the authors, the frequency of cases of true primary strabismus is from 1–3%, the frequency of cases of secondary alternating strabismus varies according to the type of therapy practised on cases of monocular strabismus with amblyopia. These latter will become cases of alternating strabismus under the influence of certain types of therapy carried out over several years (penalization, rocking, alternated occlusion, etc...).Experimental data on kittens confirm clinical data; kittens placed in abnormal environments during the sensitive period will show modification in the distribution of cortical cells and the absence of binocular cells (either because the excitation of the two eyes was not simultaneous, or not identical: artificial strabismus, occlusion, opaque glasses). This disturbances become irreversible after a certain period of exposure (a function of age, length of exposure, etc...).It is thus necessary to bear in mind: 1) the iatrogenic risks of certain orthoptic treatments, 2) the necessity for a binocular form of treatment as soon as possible, as once a certain stage is passed, cortical plasticity diminishes and the elaboration of normal binocular relations becomes impossible.

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Effects of Adenosine Agonists on Intraocular Pressure and Aqueous Humor Dynamics in Cynomolgus Monkeys

The effects of single or multiple topical doses of the relatively selective A₁adenosine receptor agonists (R)-phenylisopropyladenosine (R-PIA) and N⁶-cyclohexyladenosine (CHA) on intraocular pressure (IOP), aqueous humor flow (AHF) and outflow facility were investigated in ocular normotensive cynomolgus monkeys. IOP and AHF were determined, under ketamine anesthesia, by Goldmann applanation tonometry and fluorophotometry, respectively. Total outflow facility was determined by anterior chamber perfusion under pentobarbital anesthesia. A single unilateral topical application of R-PIA (20–250 μg) or CHA (20–500 μg) produced ocular hypertension (maximum rise=4.9 or 3.5 mmHg) within 30 min, followed by ocular hypotension (maximum fall=2.1 or 3.6 mmHg) from 2–6 hr. The relatively selective adenosine A₂antagonist 3,7-dimethyl-1-propargylxanthine (DMPX, 320 μg) inhibited the early hypertension, without influencing the hypotension. Neither 100 μg R-PIA nor 500 μg CHA clearly altered AHF. Total outflow facility was increased by 71% 3 hr after 100 μg R-PIA. In conclusion, the early ocular hypertension produced by topical adenosine agonists in cynomolgus monkeys is associated with the activation of adenosine A₂receptors, while the subsequent hypotension appears to be mediated by adenosine A₁receptors and results primarily from increased outflow facility.