地塞米松缓释剂在葡萄膜炎并发白内障人工晶体植入术中的应用

目的观察地塞米松缓释剂前房内植入对葡萄膜炎并发白内障人工晶体植入术后炎症反应,后囊混浊的预防和治疗效果。方法将近4年来我院就诊的46例（46眼）葡萄膜炎并发白内障患者随机分为两组,一组（22例）行超声乳化术＋人工晶体植入术后前房内植入地塞米松缓释剂,另一组（24例）为对照组,只做超声乳化术＋人工晶体植入,观察两组术后视力,眼压,前房炎症及后发障的发生率。结果术后视力：植入组≥1.0者9例,0.5～0.8者8例,0.1～0.4者5例,〈0.1者2例。术后高眼压、前房炎症和后囊混浊发生情况：植入组明显低于对照组,差异有统计学意义（P〈0.05）。结论前房内植入地塞米松缓释剂可有效地减轻葡萄膜炎并发白内障人工晶体植入术后炎症反应,预防后发障的发生,是一种安全有效的给药途径。     

地塞米松缓释剂在外伤性白内障人工晶状体植入术中的临床应用

目的 :观察地塞米松缓释剂前房内植入对外伤性白内障人工晶状体植入术后炎症反应、后囊混浊的预防和治疗效果。方法 :将近 2年来在我院就诊的 2 2例外伤性白内障患者随机分为两组 ,一组 (1 0例 )行白内障摘除人工晶状体植入后 ,前房内植入地塞米松缓释剂 (植入组 ) ,另一组 (1 2例 )为对照组只做白内障摘除人工晶状体植入。观察两组术后视力、前房炎症以及后发障的发生率。结果 :术后视力 :植入组 :1 0者 6例 ,0 6者 2例 ,0 3者 3例 ;对照组 :1 0者 4例 ,0 6者 2例 ,0 3者 4例 ,0 1者 2例。术后前房炎症反应和后囊混浊发生情况 :植入组明显低于对照组 ,差异有显著性 (P <0 0 5)。结论 :前房内植入地塞米松缓释剂可有效地减轻外伤性白内障人工晶状体植入术后炎症反应 ,预防后发障的发生。是一种安全有效的给药途径。     

地塞米松缓释剂在白内障超声乳化摘除人工晶状体植入术中的临床应用

目的　观察地塞米松缓释剂 (思诺迪清 )前房植入对白内障超声乳化摘除人工晶状体植入术后后囊混浊的预防效果。方法　将 2 0 0 1年 6月～ 2 0 0 2年 1月在我院手术的年龄相关性白内障患者随机分为 A、B两组。A组 (右眼 ,5 0例 )术中前房植入地塞米松缓释剂一粒 ,B组 (左眼 ,4 6例 )作为对照组 ,术中前房未植入地塞米松缓释剂。随访 2年 ,观察两组术后前房炎症及后发障的发生率。结果　术后前房炎症反应有显著性差异 (P <0 .0 5 )。后囊混浊的发生情况 :轻度者有显著性差异 (P <0 .0 5 ) ,重度者无显著性差异 (P >0 .0 5 )。结论　前房内植入地塞米松缓释剂可以减轻炎症 ,但不能有效地预防后发障的发生。     

并发性白内障术中前房注射曲安奈德的临床研究

目的探讨前房注射曲安奈德对前葡萄膜炎并发性白内障人工晶状体植入术后前房渗出的预防效果及安全性。方法将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的患者随机分为两组：实验组34例,术中前房内注射曲安奈德2mg（0.05ml）;对照组34例,术中未注射曲安奈德。观察并比较两组术后前房渗出情况及角膜内皮细胞密度、眼压等指标。结果实验组术后前房渗出明显低于对照组,差异有统计学意义（P〈0.05）;曲安奈德对角膜内皮及眼压无明显影响。结论前房注射曲安奈德可减轻前葡萄膜炎并发性白内障人工晶体植入术后前房渗出,是一种安全有效的给药方法。     

小切口葡萄膜炎并发性白内障摘出术

目的 探讨小切口葡萄膜炎并发性白内障摘除人工晶状体植入术的手术技巧及临床效果。方法 对32例33眼葡萄膜炎并发性白内障采用6mm巩膜隧道式小切口摘除并人工晶状体植入术。结果 手术时间15～30min，术后7d视力0．05～1．0不等，未发生严重的角膜水肿浑浊，术后丁道征阳性17眼，前房絮状渗出5眼，人工晶状体前膜形成2眼。结论 葡萄膜炎并发性白内障采用6mm巩膜隧道式小切口摘除并人工晶状体植入术，手术切口小，操作时间短，术后反应轻，是一种行之有效的方法。     

地塞米松眼内灌注液应用于白内障超声乳化术

目的 观察地塞米松眼内灌注液应用于白内障超声乳化术后炎症的作用.方法 将198例白内障患者行白内障超声乳化术合并人工晶状体植入术者随机分为两组,平衡盐液加地塞米松组96例,对照组96例,观察术后角膜、前房、后囊的反应炎症反应.结果 术后前房炎症和角膜水肿、后囊混浊,地塞米松加入组明显低于对照组,差异有统计学意义(P＜0.05).结论 平衡盐液加入地塞米松后用在白内障手术,可减轻白内障超声乳化术合并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、方便、有效的给药途径.     

葡萄膜炎并发性白内障术中及术后应用曲安奈德的疗效观察

目的 探讨术中前房及术后球旁注射曲安奈德对前葡萄膜炎并发性白内障人工晶状体植入术后前房渗出的预防效果.方法 将75例(75只眼)前葡萄膜炎并发性白内障行白内障摘出及人工晶状体植入术的患者随机分为三组:实验一组25例,术中前房内注射曲安奈德3 mg,实验二组25例,术后球旁注射曲安奈德20 mg,对照组25例未注射曲安奈德,观察并比较三组术后前房渗出情况及眼压指标.结果 实验一组术后前房渗出与实验二组比较,差异无统计学意义(P＞0.05),实验一组及二组与对照组比较,差异有统计学意义(P＜0.05),曲安奈德对眼压无明显影响.结论 前房注射及球旁曲安奈德均可减轻前葡萄膜炎并发性白内障人工晶体植入术后前房渗出,但前者增加患者的依从性,优于后者.     

探讨曲安奈德在并发性白内障手术中应用的效果

目的 探讨小剂量曲安奈德在葡萄膜炎并发性白内障及糖尿病性白内障手术中的应用和临床效果.方法 将43例(48眼)葡萄膜炎并发白内障及糖尿病性白内障随机分为两组:试验组21例(24眼)行晶状体超声乳化吸出人工晶状体植入术,手术完成后前房内注入曲安奈德0.1ml(1 mg).对照组22例(24眼)行超声乳化吸出人工晶状体植入术,手术完成后前房内不注入曲安奈德,观察并对比两组术后前房渗出、眼压变化、后囊浑浊及视力恢复情况.结果 试验组与对照组术后1d、2d、3d视力比较差异有统计学意义(x2=5.371,P=0.020).试验组与对照组术后前房渗出比较差异有统计学意义(x2=4.269,P=0.039).术后后囊浑浊两组间差异有统计学意义(x2=4.547,P=0.033).两组术后眼压均在正常范围,两组间差异无统计学意义(t=0.345,P=0.551).结论 并发性白内障手术完成后前房内注射曲安奈德与对照组比较,术后视力恢复快,前房渗出与后囊浑浊明显减轻,曲安奈德对眼压无明显影响,无明显并发症发生.     

葡萄膜炎并发白内障术中植入肝素修饰人工晶状体

目的评价葡萄膜炎并发白内障术中植入肝素表面修饰的PMMA人工晶状体的效果。方法98例（146眼）葡萄膜炎并发白内障行超声乳化吸出术,术中分别植入肝素修饰的PMMA人工晶状体56例（98眼）（肝素组）和未修饰PMMA人工晶状体42例（48眼）（对照组）。对两组术后视力、眼前段反应、后囊浑浊情况进行回顾性对比分析。结果矫正视力≥0．5者,肝素组86眼（87．76％）,对照组27眼（56．25％）,（P〈0．05）。眼前段反应：人工晶状体表面纤维素样渗出、房水细胞,均在术后1周时差异最显著（P〈0．05）,虹膜后粘连在6个月后两组差异最显著（P〈0．05）。后囊浑浊发生率6个月后对照组明显高于肝素组,分别为54．17％和12。24％（P〈0．05）。结论葡萄膜炎并发白内障术中植入肝素修饰人工晶状体能显著减轻术后眼前段的炎症反应,降低后囊浑浊的发生率。     

葡萄膜炎并发白内障术后前房注射地塞米松的疗效观察

目的:探索白内障摘除术后前房注射0.1mL地塞米松对葡萄膜炎并发白内障患者术后的影响。方法:试验组术后前房注射0.1mL地塞米松,对照组前房未注射地塞米松,观察两组术后炎症反应。结果:术后前2d两组患者视力间差别有统计学意义(P<0.05),术后第1d角膜水肿程度两组间有统计学差异(P<0.05),前房闪辉差异有统计学意义(P<0.05),且试验组术后患者视力提高者百分比高于对照组。结论:葡萄膜炎并发白内障患者行白内障超声乳化+人工晶状体植入术,术毕前房注射0.1mL地塞米松者可减轻短期术后炎症反应,可更早提高患者视力,对患者术后短期眼压未见明显影响。     

Intercapsular cataract surgery with lens epithelial cell removal. Part I: Without capsulorhexis

Endocapsular phacoemulsification or intercapsular cataract extraction with lens epithelial cell removal using an ultrasound technique was performed on 30 eyes. The anterior capsule was not removed after posterior chamber intraocular lens implantation. After a mean follow-up period of 16.4 +/- 2.8 months, anterior capsule opacification was observed in six eyes, posterior synechias in six eyes, and shrinkage of the anterior capsule below the pupillary area, which resulted from the large opening needed for the intercapsular extraction, in 11 eyes. Other postoperative complications caused by lens epithelial cells such as posterior capsule opacification, intraocular lens dislocation, and fibrinous reaction did not occur. These results suggest it is necessary to remove the lens epithelial cells and the anterior capsule after posterior chamber lens implantation in intercapsular cataract extraction.     

白内障术后用地塞米松5-Fu预防后发障的观察

目的 观察白内障囊外摘出人工晶状体植入术后应用地塞米松和5－Fu预防后发障的效果。方法 预防组：于术后每天结膜下注射地塞米松2mg，共3次；术后第4日起结膜下注射5－Fu6mg，隔日一次共3次；1周后每周1次结膜下注射5－Fu6mg，共5次。对照组：为常规术后处理的病人，结膜下不规则应用庆大霉素和地塞米松。观察比较两组术后角膜、前房、人工晶状体表面、后囊和视力。结果 两组角膜内皮水肿无明显差异，预防组前房渗出少于对照组。术后后囊浑浊，对照组32眼中有17眼发生占60％，预防组30眼有6眼发生占18％（P＜0.01)。结论 本方法预防后发障的发生有一定效果。     

曲安奈德在糖尿病性白内障手术中的应用研究

目的观察糖尿病性白内障术中前房内注射曲安奈德的效果和安全性。方法47例（47眼）糖尿病性白内障随机分为两组：试验组（23例）术中前房内注入曲安奈德2mg;对照组（24例）术中前房内注入生理盐水。观察并比较两组术后眼压变化、角膜内皮细胞密度、前房纤维蛋白渗出情况及后发障的发生率等。结果术后前房纤维蛋白渗出和后发障,试验组明显低于对照组,差异有统计学意义（P〈0．05）;而术后眼压变化、角膜内皮细胞密度两组比较差异无统计学意义（P〉0．05）。结论糖尿病性白内障术中前房内注入曲安奈德,可减轻术后炎症反应,减少近期及远期并发症。     

Cystoid macular edema in anterior chamber lens implantation following posterior capsule rupture

By comparing the incidence of cystoid macular edema (CME) in three groups of patients having different surgical procedures, we attempted to assess the role of vitreous loss as a risk factor for CME development. In the first group (n = 470), the surgical procedure was extracapsular cataract extraction followed by implantation of posterior chamber lens (EC-CE + PC-IOL). The second group (n = 42) had extracapsular cataract extraction which was complicated by posterior capsule rupture, and therefore anterior vitrectomy followed by implantation of anterior chamber lens had to be performed (ECCE + anterior vitrectomy + AC-IOL). In the third group (n = 22) the surgery was intracapsular cataract extraction followed by anterior chamber lens implantation (ICCE + AC-IOL). The third group was included in this follow up study to assess the role of AC-IOL as a possible causative factor for development of CME in uncomplicated cases of ICCE and AC-IOL. The difference of incidences of CME in the second and third group would therefore depend mostly on the vitreous loss. The incidence of CME diagnosed by fluorescein angiography in the first, second and third group was 1.5% (7/470), 35.7% (15/42) and 9.0% (2/22), respectively. All patients who developed CME were treated with combination of corticosteroid-antibiotic drops, dexamethasone retrobulbarly (40 mg/day) and peroral indomethacine (25 mg/day/6 weeks). This therapeutic regime resulted in only moderate improvement of visual acuity.Abbreviations AC-IOL anterior chamber intraocular lens - CME cystoid macular edema - ECCE extracapsular cataract extraction - ICCE intracapsular cataract extraction - IOL intraocular lens - PC-IOL posterior chamber intraocular lens     

Postoperative anterior chamber inflammation after posterior chamber intraocular lens implantation concurrent with pars plana vitrectomy and lensectomy]

The authors compared postoperative anterior chamber inflammation of triple procedure; diabetic pars plana vitrectomy, lensectomy with anterior capsule left intact and posterior chamber intraocular lens implantation anterior to anterior capsule, to those of various cataract surgeries with posterior chamber intraocular lens implantation and vitrectomies in diabetic retinopathy eyes. The inflammation was evaluated in terms of the incidence of inflammatory complications (fibrin reaction and posterior synechia of iris), and by periodical measurement of flare counts for postoperative 6 months using a laser flare-cell meter. The inflammation was more intense than those after the following 3 surgeries; phacoemulsification and in the bag intraocular lens implantation after continuous curvilinear capsulorhexis, extracapsular extraction and in the bag intraocular lens implantation after can opener capsulotomy, and vitrectomy alone. The inflammation, however, was less intense compared with that of another method of triple procedure; pars plana vitrectomy, phacoemulsification and in the bag intraocular lens implantation after continuous curvilinear capsulorhexis or can opener capsulotomy, and development of posterior synechia was rarely observed.     

后囊破裂型外伤性白内障人工晶状体二期植入

目的探讨人工晶状体二期睫状沟植入在眼球穿孔伤所致后囊破裂型外伤性白内障手术中的应用。方法我院2011年1月至2013年1月收治眼球穿孔伤所致后囊破裂型外伤性白内障82例（82眼）,在一期眼球清创缝合白内障摘出联合前段玻璃体切除手术时尽量保留残余囊袋。3～6个月后行二期人工晶状体植入术。根据囊袋残留情况分为两组：A组：残留囊袋足够支撑后房型人工晶状体者（48例）,进行后房型人工晶状体睫状沟植入。B组：囊袋无残留或残留囊袋无法支撑后房型人工晶状体者（34例）,进行缝线固定晶状体襻于巩膜壁的后房型人工晶状体睫状沟植入。结果两组患者术后视力均有提高。B组BCVA明显低于A组。A组2例（4．17％）人工晶状体光学中心轻度偏移,4例（8．33％）体部轻度倾斜;B组6例（17．65％）人工晶状体光学中心轻度偏移,6例（17．65％）体部倾斜,其中3例（8．82％）眼球转动时有不适感。结论对于眼球穿孔伤所致后囊破裂型外伤性白内障,于一期行眼球清创缝合、白内障摘出联合前段玻璃体切除手术时尽量保留残余囊袋组织,可为二期植入人工晶状体创造良好条件。二期手术时选择后房型人工晶状体睫状沟植入术,符合人体解剖结构,稳定性好。     

地塞米鬆緩釋顆粒在糖尿病性白内障手術中的應用

目的 研究Tenon’s囊下植入地塞米松缓释颗粒控制糖尿病性白内障术后前房炎症反应的有效性和安全性。方法双眼糖尿病性白内障患者37例(74眼),一眼仅于白内障术毕Tenon’s囊下植入地塞米松缓释颗粒,术后不再使用激素性眼液,作为实验组;另一眼不植入地塞米松缓释颗粒,术后常规滴典必舒眼液,作为对照组。分别观察术后1、3、7、15天的前房炎症反应、睫状充血、眼压、角膜上皮、伤口愈合状况及血糖水平等指标。结果 术后1、15天时,两组的前房炎症反应无显著性差异;术后3、7天,实验组较对照组前房炎症反应轻(P<0.05);术后1、3、7、15天,两组睫状充血评分无显著差异;两组术后各天眼压无显著性差异;地塞米松缓释颗粒对血糖、角膜上皮及伤口愈合状况无明显影响。结论 对合并糖尿病的白内障患者,术毕Tenon’s囊下植入地塞米松缓释颗粒是一种安全有效的控制术后前房炎症反应的方式。     

白内障后囊破裂人工晶状体睫状沟固定与植入前房疗效比较

目的:比较睫状沟缝线固定人工晶状体术和前房人工晶状体植入术治疗白内障后囊破裂的疗效。方法:回顾性分析采用睫状沟缝线固定人工晶状体术、前房人工晶状体植入术治疗白内障后囊破裂45例45眼,比较两组手术的疗效。结果:睫状沟缝线固定人工晶状体术组和前房人工晶状体植入术组均能有效治疗白内障后囊破裂。但后者术后有2例6mo后出现虹膜睫状体炎及眼压升高,其余视力均改善。前者视力均改善,未见有明显的并发症。结论:睫状沟缝线固定人工晶状体术和前房人工晶状体植入术均能有效治疗白内障后囊破裂,改善视力,但前者更接近于生理位置,术后并发症更少。     

The madurai intraocular lens study IV: posterior capsule opacification

PURPOSE: To estimate the cumulative incidence of posterior capsule opacification 4 years after surgery in patients who participated in the Madurai Intraocular Lens Study and had extracapsular cataract extraction with posterior chamber intraocular lens implantation. METHODS: In the Madurai Intraocular Lens Study, 1,700 patients with best-corrected visual acuity 20/120 or worse in the better eye had extracapsular cataract extraction with posterior chamber intraocular lens implantation, and 1,474 (86.7%) of these completed the 1-year follow-up examination. From this group of 1,474 pseudophakic patients, 400 were randomly selected for reexamination 4 years after the original surgery. The eye that was operated on was examined by an ophthalmologist who was involved in the 1-year follow-up examinations and posterior capsule opacification grading. A grading of I to III was used to reflect the degree of opacification. With grades II and III, posterior capsule opacification detectable with an undilated pupil was present in the central axis. RESULTS: Three hundred twenty-seven (81.8%) of the selected population were examined between October 1997 and December 1998. Thirty-four (8.5%) were confirmed as being deceased, and 39 (9.8%) were unavailable for follow-up. The median age was 60 years, and 57.2% were women. The 4-year incidence of grade II or III posterior capsule opacification, including eyes already treated with laser capsulotomy, was 13.1% (95% confidence interval [CI], 9.7% to 17.3%). Each year of increased age was associated with a decreased risk of posterior capsule opacification (odds ratio, 0.96; 95% CI, 0.92 to 1.00). Based on best-corrected visual acuity of 20/40 or worse without co-existing pathology, the 4-year incidence of posterior capsule opacification was 13.5%. CONCLUSION: Because patients with relatively mature cataracts routinely receive extracapsular cataract extraction with posterior chamber intraocular lens implantation instead of the traditional intracapsular extraction, the subsequent need for laser capsulotomy may be less than that anticipated, based on previous reports.