急诊手术治疗角巩膜穿通伤的临床体会

目的：观察急诊手术治疗角巩膜穿通伤的应用效果。方法角巩膜穿通伤患者56例（56只眼）,清创缝合术时,联合色素膜复位术29只眼,虹膜根部离断缝合修补术3只眼,前房形成术19只眼,前房冲洗术8只眼,白内障囊外摘除术20只眼,白内障囊内摘除＋前段玻璃体切割术4只眼,玻璃体磁性异物取出术3只眼,白内障囊外摘除＋晶状体异物取出术4只眼。结果56例（56只眼）患者中5只眼视力无恢复,其中包括术前视力无光感2只眼,光感3只眼;51只眼均恢复了部分视力。术后视力院无光感者2只眼,光感~0.02者18只眼,0.02~0.1者23只眼,0.1~0.3者9眼,0.3以上者4只眼。结论急诊手术时娴熟技术水平和恰当手术方案可提高患者伤眼视功能恢复的可能性。     

高压氧联合左氧氟沙星治疗细菌性角膜炎

目的观察高压氧联合左氧氟沙星治疗细菌性角膜炎的疗效。方法采用随机对照实验,随机选取58例（58眼）,治疗组29例（29眼）,行高压氧治疗1-2疗程,并左氧氟沙星滴眼液每日6次滴眼,左氧氟沙星眼膏每晚睡前涂眼。对照组29例（29眼）,应用左氧氟沙星滴眼液每日6次滴眼,左氧氟沙星眼膏每晚睡前涂眼。观察两组患者疗效及治疗时间。结果治疗组29只眼治愈27只眼,好转1只眼,无效1只眼。总有效率为96.6%.治疗时间为7～15d。对照组治愈25眼,好转2眼,无效2眼,有效率93.1%,治疗时间12～25d。结论高压氧联合左氧氟沙星治疗细菌性角膜炎疗效确切,高压氧治疗可以缩短病程。     

综合视觉刺激治疗儿童弱视的疗效观察

目的探讨视觉刺激治疗儿童弱视的疗效。方法选择我院弱视患儿42例51只眼,在训练师的规范指导下采用综合视觉刺激治疗弱视3个月,对其疗效做统计分析。结果51只眼中屈光不正性弱视20眼治愈16眼（80％）;屈光参差性弱视17眼治愈8眼（47％）;斜视性弱视13眼治愈0眼（O％）;形觉剥夺性弱视1眼治愈。眼（O％）。按年龄分析5—8岁25眼治愈16眼（64％）;9-12岁21眼治愈8眼（38％）;13～17岁5眼治愈0眼（0％）。按弱视程度分析轻度6眼治愈6眼（100％）;中度28眼治愈16眼（57％）;重度17眼治愈2眼（12％）。结论弱视的疗效与类型、程度,患儿的年龄密切相关。弱视治疗的关键在于早诊断、早治疗。     

自身血清治疗细菌性角膜溃疡效果研究

目的探讨自身血清治疗细菌性角膜溃疡的疗效。方法对已确诊的120例120眼细菌性角膜炎,随机分为两组。实验组60例（60眼）,行自身血清制备滴眼液联用抗生素全身治疗及局部点眼治疗。对照组60例（60眼）,行抗生素全身治疗及局部点眼治疗。治疗天数平均15d左右。结果实验组60眼,治愈50眼,好转7眼,无效3眼,有效率95.00%。对照组60眼,治愈37眼,好转11眼,无效12眼,有效率80.00%。结论用自身血清治疗细菌性角膜溃疡费用低廉,制作简单,疗效肯定,值得推广应用。     

眼缺血综合征患者的临床特征分析

目的分析眼缺血综合征的临床特征,提高临床诊断率。方法回顾分析笔者所在医院8例(10眼)眼缺血综合证患者的临床资料。结果 8例(10眼)眼缺血综合征患者中,男3例4眼,女5例6眼。年龄32～68岁,平均(52.0±4.3)岁。均行TCD检查,均可见颈内动脉狭窄或闭塞。10眼都进行了治疗。其中视网膜激光光凝治疗2眼,视网膜新生血管有所控制,视力未提高;睫状体冷凝治疗3眼,疼痛症状有所缓解,视力无提高,1眼已无光感;3眼行扩血管、促进循环、促进积血吸收等治疗,1眼眼部积血部分吸收,视力提高0.1,2眼视力无提高。结论眼缺血起病隐匿,应予重视,做到早诊断与治疗。     

糖尿病性白内障摘除及人工晶体植入术的临床分析

目的 探讨糖尿病性白内障摘除及人工晶体植入术的临床疗效.方法回顾分析150例患者的临床资料.结果≤0.1者15眼,～0.3者45眼,～0.6者105眼,～1.0者20眼.其中无糖尿病视网膜病变者115眼,视力≥0.3者70眼;非增殖性糖尿病视网膜病变48眼,视力≥0.3者17眼.术中后囊膜破裂12眼;术后角膜内皮水肿62眼,前房纤维素性渗出膜30眼,晶体表面色素沉着12眼,前房出血5眼,后囊浑浊10眼.结论 应用小切口非超声乳化白内障摘除及人工晶体植入术治疗糖尿病性白内障是安全、有效的方法.     

自体巩膜在羟基磷灰石义眼座植入中的应用

目的 探讨眼内容物摘除后自体巩膜遮盖羟基磷灰石义眼座植入术的临床效果.方法 自2000年5月-2005年5月,66例自体巩膜遮盖羟基磷灰石义眼座植入,Ⅰ期植入51眼(77.27%),Ⅱ期植入15眼(22.73%).结果 随访3个月～4年,2眼义眼座暴露,经保守治疗有效,其余效果满意.结论 眼内容物摘除后自体巩膜遮盖羟基磷灰石义眼座植入术,符合生理状态,减少义眼座排出.     

探析眼外伤诊断中CT检查的应用价值

目的探讨对CT眼外伤患者的诊断及其应用价值。方法选取自2009年1月至2011年1月在我院治疗的90例(100眼)眼外伤的患者,其中男40例,女50例,致伤原因有爆炸伤、锐器伤、摔伤以及撞击伤,所有的患者都在24h内进行CT检查,对所有患者的CT图像进行回顾性的分析。根据受伤后CT的图像分析,可以将眼外伤分为眼眶的骨折、眼眶的软组织损伤以及眼球的损伤。结果在选取的90例眼外伤的患者中,眼眶的骨折:70眼,直接的骨折23眼,爆裂性的骨折39眼,复合型的骨折8眼;眼眶的软组织损伤:81眼,视神经肿胀4眼,眼眶内积血20眼,眼眶内积气40眼,眼眶内进入异物9眼,眼直肌肿胀8例;眼球的损伤:15眼,眼环不完整3眼,眼环局部增厚3眼,眼球变形2眼,晶状体脱位3眼,晶状体缺如2眼,玻璃体内积血13眼,玻璃体内异物4眼。结论眼外伤的病变复杂多样,可以通过CT图像观察眼外伤的病变,可以正确估计眼球的损伤程度,为临床诊断和尽早地进行手术治疗提供了重要的依据。     

新鲜多层羊膜与单层羊膜移植术治疗角膜溃疡的临床探讨

目的：探讨新鲜多层羊膜与单层羊膜移植术治疗角膜溃疡的临床效果。方法：采用新鲜羊膜移植术治疗角膜溃疡28眼(细菌性角膜溃疡15眼,病毒性角膜溃疡6眼,真菌性角膜溃疡5眼,原因不明性角膜溃疡2眼)。其中多层羊膜移植16眼,单层羊膜移植12眼。术后随访6～18个月。结果：16眼多层羊膜移植术中,治愈10眼,有效6眼,12眼单层羊膜移植术中,治愈5眼,有效3眼,无效2眼。新鲜羊膜移植术后均未见新鲜羊膜移植片发生急性排斥反应,术后5～14d,炎症控制,疼痛消失,2～4周角膜上皮愈合,溃疡灶留下不同程度瘢痕,视力均有不同程度提高。结论：新鲜多层羊膜移植治疗角膜溃疡明显优越于单层羊膜移植。     

羟基磷灰石义眼台两种植入方法的临床观察

目的观察两种不同手术方法植入羟基磷灰石(HA)义眼台的临床效果。方法眶内Ⅰ期植入HA义眼台共41例(41眼),20例采用眼球摘除带线义眼台直接植入法,21例采用眼内容剜除改良巩膜覆盖法。结果术后随访3个月~3年,手术效果良好,其中20例眼球摘除带线义眼台直接植入者,2例出现义眼台暴露。21例眼内容剜除改良巩膜覆盖者,1例出现义眼台暴露。结论 HA义眼台植入术后主要并发症是义眼台暴露。眼内容剜除改良巩膜覆盖法创伤小,早期义眼运动度好,发生义眼台暴露并发症的概率变小。     

糖尿病视网膜病变患者围手术期散瞳策略

目的：探讨糖尿病视网膜病变患者围手术期最佳散瞳方法,以利于玻璃体切割手术顺利进行。方法：回顾性分析我院2007年6月-2011年6月所有糖尿病视网膜病变患者的手术资料,选取术前常规应用复方托吡卡胺滴眼液、术中瞳孔直径≥7mm的患者手术时散瞳药的应用记录,共189例,204眼。术前点复方托吡卡胺滴眼液,每5min1次,共6次。点滴眼液后,0.5h内瞳孔散大（直径≥7mm）者为A组（78眼）;超过0.5h,但瞳孔散大时间在1h以内者为B组（75眼）;瞳孔散大时间大于1h者为C组（51眼）。B、C组于术前一天随机应用硫酸阿托品眼用凝胶或盐酸环喷托酯滴眼液,术前1h频点复方托吡卡胺滴眼液。结果：术中瞳孔直径能维持≥7mm的眼数比例,B、C组应用硫酸阿托品眼用凝胶者与应用盐酸环喷托酯滴眼液者差异均无统计学意义（P〉0.5）。术中有134眼因白内障同时行超声乳化白内障摘除术,其术中瞳孔直径能维持≥7mm的眼数比例,B组应用盐酸环喷托酯滴眼液者瞳孔维持的比例较用硫酸阿托品眼用凝胶者高（P〈0.5）,C组中二者比较差异无统计学意义（P〉0.5）。结论：对于术前单用复方托吡卡胺滴眼液散瞳时间超过0.5h者,术前点硫酸阿托品眼用凝胶或盐酸环喷托酯滴眼液有利于维持术中瞳孔大小,且二者效果差异无统计学意义。     

In vitro evaluation for corneal damages by anti-glaucoma combination eye drops using human corneal epithelial cell (HCE-T)

The combination of anti-glaucoma eye drops is frequently used in clinical treatment, and it is known that the combination can cause corneal damage. Recently, an anti-glaucoma combination eye drops is developed, and the treatment by the combination eye drops is expected to enhance quality of life. However, effects of the combination eye drops on corneal epithelial cell damage have not been clarified. In this study, we investigated the corneal epithelial cell damage of commercially available anti-glaucoma combination eye drops, such as Xalacom? (latanoprost/timolol maleate combination eye drops), Duotrav? (travoprost/timolol maleate combination eye drops) and Cosopt? (dorzolamide hydrochloride/timolol maleate combination eye drops) using the human corneal epithelial cell (HCE-T). The cytotoxicity in Xalacom? was higher than that in Xalatan? (eye drops containing latanoprost) and Timoptol? (eye drops containing timolol maleate), and the benzalkonium chloride (BAC) and timolol maleate were related to cytotoxicity in Xalacom?. The cytotoxicity in Duotrav? and Cosopt? was lower than that in Timoptol?. The Duotrav? is preserved with a non-BAC system (POLYQUAD, polidronium chloride). Therefore, it was suggested that the POLYQUAD related to the low cytotoxicity in Duotrav?. On the other hand, the D-mannitol reduced the cytotoxicity by BAC in this study. This result suggested that the cytotoxicity in Cosopt? was reduced by D-mannitol. The Duotrav? and Cosopt? may be less damaging to the ocular surface of glaucoma patients receiving long-term eye drop therapy in compared with the combination of anti-glaucoma eye drops.     

注射用帕米膦酸二钠致虹膜睫状体炎

1例70岁男性患者,确诊左肺腺癌Ⅳ期,全身骨扫描示多发骨转移,为预防骨转移产生骨痛和高钙血症,给予注射用帕米膦酸二钠静脉滴注.用药第2天,患者出现虹膜睫状体炎,给予普拉洛芬眼液、妥布霉素地塞米松眼液、复方托吡卡胺眼液等治疗,第5天症状好转.     

Pharmaceutical investigation of vancomycin hydrochloride eye drops and their topical application to MRSA eye infection]

Two formulations of 0.5% vancomycin hydrochloride (VM) eye drops (VM-B and VM-C eye drops) were prepared by dissolving commercial VM powder for injection with preserved water B (PWB) containing phosphate buffer and preserved water C (PWC) containing only antimicrobial preservative, respectively. The VM-B eye drops have neutral pH (about 6.3), and the VM-C eye drops acidic pH of about 3.5. The pharmaceutical examination of these eye drops was performed regarding its clinical application to MRSA eye infection. In an irritability test using a rabbit's eye, the average number of winks after instillation of one drop of VM-B eye drops was 0.8 times/min and significantly smaller than that of VM-C eye drops (2.0 times/min). In dark storage at 4 degrees C, no change of VM concentration in both eye drops was observed for 25 weeks after preparation and the mean residual concentrations as determined by the HPLC-UV (240 nm) method were constant over 90% for 8 weeks, of the initial concentration. However, the residual VM concentration of VM-B eye drops under a room condition declined to 58% after 4 weeks and 20% after 8 weeks, and VM in light storage at 40 degrees C was not detectable after 8 weeks. The drug concentration of VM-C eye drops declined to 83% after 4 weeks and 74% after 8 weeks under a room condition, and to 46% after 4 weeks and 20% after 8 weeks under light storage at 40 degrees C. Under these storage conditions, the precipitation of VM related crystals was observed in both the eye drops when the residual percentage of VM was lower than 80%. Judging from HPLC chromatograms of a solution of the precipitated crystals, it was suggested that this crystal was degradation products of VM. The VM-B eye drops was applied to a patient with MRSA eye infection, because other medication was not effective. After continuous instillation of a drop per times every hour to both eyes, MRSA in corneal culture turned out negative after one week, and the clinical condition was remarkably improved. On the basis of the result of eye-irritability, VM-B eye drops with neutral pH was suggested to be superior to acidic VM-C eye drops from a safety point of view. It was also indicated that VM-B eye drops can be effectively used for 8 weeks under dark storage at 4 degrees C for MRSA eye infection, which is a useful piece information for the proper usage of the VM eye drops.     

角膜病患者滴眼液使用规范现况的调查分析

目的　调查角膜病患者滴眼液规范使用现况,为正确使用滴眼液的健康教育提供指导。方法　将2021年8月至2022年2月在济南市第二人民医院眼科病房接收的角膜病患者346例作为调查对象,由经过培训后的1名眼科专科护士观测患者未开展滴眼液使用相关教育前的滴眼液使用过程,并评价其眼药水滴注行为的规范性;采用济南市第二人民医院眼科病房设计的《滴眼液规范使用认知调查表》调查角膜病患者滴眼液规范使用相关认知。结果　346例患者中,男156例（45.09%）,女190例（54.91%）;年龄30岁及以下36例（10.40%）,>30～40岁32例（9.25%）,>40～50岁47例（13.58%）,>50～60岁87例（25.14%）,>60～70岁94例（27.17%）,>70岁50例（14.45%）。专科护士对346例角膜病患者1次滴眼液使用行为观测发现,43.93%（152/346）的患者在滴注眼药水前未洗手;41.53%（49/118）的患者滴注混悬液型眼药水前未摇匀;41.62%（144/346）的患者滴注眼药水未选择正确的仰卧头后仰位;43.93%（152/346）的患者滴注眼药水时眼睛未向头顶方向看;43.06%（149/346）的患者眼药水孔直接与眼球接触;53.47%（185/346）的患者滴注时瓶口和睫毛接触;63.29%（219/346）的患者眼药水滴注时未按压鼻泪管;仅27.27%（42/154）的患者在眼药水外溢后正确选择了纸巾擦拭;36.13%（125/346）的患者滴注后立即揉按眼睛;69.08%（239/346）的患者滴注完毕后未执行牵拉眼睑并闭眼1 min以上的正确行为。问卷调查显示,346例患者中,34.97%（121/346）的患者认为滴注2种及以上眼药水时,间隔时间>10 min;53.18%（184/346）的患者认为滴眼液需兼顾温度、光线,参考说明书妥善保存;56.36%（195/346）的患者认为需根据医生或滴眼液说明书的建议滴眼;55.49%（192/346）的患者认为滴眼液开封后,需注意保质期;56.07%（194/346）的患者认为在2种及以上滴眼液滴注时需先滴刺激性弱的,后滴刺激性强的;58.96%（204/346）的患者认为每次眼药水滴注量为1～2滴;73.41%（254/346）的患者认为滴眼后出现异常症状需立即停药/就医;73.70%（255/346）的患者认为滴眼液药品颜色改变、浑浊时立即停用;47.40%（164/346）的患者认为滴眼液使用期间,无需限制饮食,52.60%（182/346）的患者认为滴眼液使用期间应根据说明书或医嘱限制某些食物摄入;仅56.36%（195/346）的患者在使用滴眼液前阅读了说明书。结论　角膜病患者滴眼液规范使用行为及认知并不理想,眼科护理人员需重视滴眼液使用的相关宣教,促进滴眼液的规范使用。     

羟糖甘滴眼液治疗准分子激光原位角膜磨镶术术后干眼症的临床观察

目的评价羟糖甘滴眼液对准分子激光原位角膜磨镶术(LASIK)术后干眼症患者的治疗效果。方法选取LASIK术后1个月诊断为干眼症的患者45例90眼,应用羟糖甘滴眼液治疗30d。观察干眼症症状、泪膜破裂时间(BUT)和泪液分泌试验(SchirmerI)的变化。结果治疗后BUT(4.33±1.47)s比治疗前(2.86±1.62)s明显延长,差异有统计学意义(P<0.05),治疗后SchirmerI试验值为(7.97±3.48)mm,明显高于治疗前的(6.14±3.55)mm,差异有统计学意义(P<0.05),主观自觉症状治疗后明显改善者29例58眼(64.44%),改善者8例16眼(17.78%),稍改善者6例6眼(13.33%),未改善者2例4眼(4.44%),未发现任何不良反应。结论羟糖甘滴眼液是治疗LASIK术后干眼症安全有效的药物。     

国产与进口复方妥布霉素滴眼液及眼药膏的临床疗效比较

目的 :评价国产复方妥布霉素滴眼液和眼药膏对白内障术后和细菌性结膜炎的疗效及安全性。方法 :试验组 162例 (男性 74例 ,女性 88例 ,年龄 54a±s 18a) ,用国产复方妥布霉素滴眼液及眼药膏。对照组 10 0例 (男性 4 3例 ,女性 57例 ,年龄55a± 18a) ,用进口复方妥布霉素滴眼液和眼膏。治疗前和治疗后 3,7d进行检查、评分。结果 :2组对白内障术后炎症控制和细菌性结膜炎的总有效率均为 10 0 %,组间无显著性差异 (P >0 .0 5)。 2组均无明显不良反应。结论 :国产复方妥布霉素滴眼液和眼膏对白内障术后炎症控制和细菌性结膜炎疗效明显且安全 ,与进口复方妥布霉素滴眼液和眼膏相似。     

汕头市公众眼药水认知情况及使用行为调查分析

目的：调查研究汕头市公众眼药水认知情况及使用行为,为开展相关健康教育提供参考。方法：在居民小区、公园、广场和医院候诊室等处随机进行问卷调查,用Epi-data 3.0建立数据库,用Excel和SPSS 18.0软件进行处理分析,计数资料组间比较采用R×C χ²检验。结果：受访者单次单眼使用剂量为1～3滴,联合用药间隔为1～30 min,滴眼药水后带回隐形眼镜的时间间隔为5～60 min,62.6%的受访者认为使用眼药水会产生不良反应,61.1%的受访者认为眼药水中的防腐剂会危害使用者的健康,42.4%的受访者会在使用前检查眼药水是否异常,43.6%的受访者会在使用眼药水前洗手,71.2%的受访者会在使用眼药水前阅读说明书,21.4%的受访者滴眼药水时瓶口会碰到他处且有20.6%的受访者表示不介意瓶口是否碰到他处,37.7%的受访者患眼和健康眼一起滴眼药水,75.9%的受访者用纸巾擦拭溢出的眼药水,62.6%的受访者在使用眼药水出现不适时会停止使用眼药水,61.9%的受访者将眼药水贮藏在阴凉处,47.5%的受访者开封后的眼药水贮藏时间超过3个月。结论：专业机构和媒介应加强眼药水知识的宣传教育。     

拉坦前列素滴眼液诱发支气管哮喘

1例65岁女性患者，因右眼青光眼给予拉坦前列素滴眼液0．1ml，1次／d点眼，首次用药2h后患者出现呼吸困难、发绀、大汗淋漓，HR120次／min，P160／100mmHg，双肺闻及哮鸣音。立即给予患者沙美特罗替卡松粉吸入剂，10min后症状缓解。以后改用1％布林佐胺滴眼液，支气管哮喘未再出现。     

Effects of the rational use of corticosteroids eye drops for the prevention of ocular toxicity in high-dose cytosine arabinoside therapy

Although the use of corticosteroid (CS) eye drops of the use of eye washing by artificial tears was effective for the prevention of ocular toxicity such as keratitis and photophobia in the high-dose cytosine arabinoside (Ara-C) therapy, the toxicity was not prevented perfectly. We studied the effects of the rational use of CS eye drops, and the combined use of CS eye drops and eye washing by physiological saline in order to prevent the ocular toxicity. Before the study, the instillation of 0.1% sodium bethamethazone phosphate (BM) eye drops was carried out at 4-6 times per day during the high-dose Ara-C therapy, and continued for several days after the high-dose Ara-C therapy. However, the rational use of "eyelid closure" and "naso-lacrimal occlusion" after the instillation was not performed Consequently, the ocular toxicity was observed in 3 (19%) of 16 cases of the patients. When the instillation of BM eye drops at 4 times per day was carried out rationally according to the consultation of pharmacist during the high-dose Ara-C therapy and for additional 10 days after the therapy, no ocular toxicity was observed in all cases (0 of 6 cases). Furthermore, the combined use of eye washing by physiological saline and instillation of BM eye drops was effective for the decrease of the risk of ocular toxicity, because no ocular toxicity was observed in the high-dose Ara-C therapy (0 of 34 cases). Our procedure in this study would be effective for the prevention of ocular toxicity in the high-dose Ara-C therapy.