糖尿病患者的视网膜电图分析

目的分析糖尿病(DR)患者视网膜电图(F-ERG)的振幅、峰潜时、OPS总和振幅及其与病程的相关性.方法将53例102眼糖尿病患者分为三组(NDR、BDR、PDR),并采用美国UATA-2000型视觉电生理仪对53DR例进行F-ERG检查,主要分析其a、b波峰潜时、振幅、OPS总和振幅.结果随着DR病情的加重,ERG及OPS无波的情况所占比例增大.a波峰潜时BDR组和正常组比较差异有极显著性(P<0.01),BDR组和DM无DR组比较差异有显著性(P[WTBZ〗<0.05);a波振幅正常对照组与其他各组比较差异均有极显著性(P<0.01).b波振幅正常对照组与BDR、PDR间以及DM无DR组与BDR、PDR组间均有极显著性差异(P<0.01).OPS总和振幅除了BDR与PDR间外,其他各组比较差异均有极显著性(P<0.01).结论OPS、ERG之a、b波振幅,尤其是b波振幅,可以作为早期诊断DR患者以及估计预后的敏感指标;良好的血糖控制,可以延缓DM的病情发展.     

Peripapillary choroidal neovascularisation in sarcoidosis

Purpose : To describe a rare manifestation of sarcoidosis. Methods : Case report of a patient with histologically proven sarcoidosis, who developed peripapillary choroidal neovascularisation in the absence of uveitis or optic nerve disease. Results : Oral corticosteroids achieved reduction in the size of the peripapillary choroidal neovascularisation. Laser treatment was effective in treating the remaining peripapillary choroidal neovascularisation, resulting in improvement of visual acuity. Conclusions : Isolated peripapillary choroidal neovascularisation is a previously unreported complication of sarcoidosis. A combination of oral corticosteroids and laser can be successful in treating this type of lesion, thereby preventing permanent visual loss.     

视网膜色素变性的ERGs观察

目的：为研究视网膜色素变性的视网膜电图（ＥＲＧｓ）,测定了７５例１５０眼视网膜色素变性病人的ＥＲＧｓ,分析了其ｂ波振幅情况。方法：用视觉电生理仪测量ＥＲＧｓ的ｂ波振幅。分析从５个月到７０岁的７５例１５０多膜色素变性病人的ＥＲＧｓ的ｂ波振幅情况。结果：（１）ｂ波振重度降低或记录不到波形者１３０眼,占８７％,平均年龄２５岁,其最好视力达１．５,最低右无光感。（２）ｂ波振幅轻度或中度降低者１０例２０眼,     

Application of the Metaireau tube (M-tube) in conjunctivodacryocystorhinostomy (CDCR)

PurposeA new tube, Metaireau tube (M-tube), was examined for its proficiency, durability, and safety for use in conjunctivodacryocystorhinostomy (CDCR). The frequent complications associated with this procedure and Jones tubes, such as tube migration, pyogenic granuloma, and tube obstruction, were particularly checked.MethodsThe study was a retrospective interventional case series conducted at a single institution between January 2009 and October 2012. An M-tube was used in 13 cases of external CDCR and four endoscopic CDCR. Ten cases were females and seven were males. Patients aged from 20 years old to 82 years old, mean 52.7 years. Six cases were complicated traumatic canalicular laceration. Five cases were replacement of lost or dislocated Jones tubes. The M-tube is flexible and slick. The tube length that remains in the nasal cavity is adjustable by scissor trimming with endoscopic observation.ResultsThe surgery was uneventful. The tear drainage function works well when the tube is in situ. Twelve cases developed dry eye requiring artificial tear postoperatively. Nasal migration of the tube is frequently encountered in the early postoperative period (5/17, 29.4%). Reposition is easy using an endoscope. The tube is pulled out from the nose and replaced in the original tract. Mild tube extrusion occurred in one case without epiphora. Granuloma developed in one case. The follow-up took place from 2 months to 36 months, mean 21.6 months.ConclusionThe M-tube is easy to use in either external or endoscopic CDCR. When dislocated, the tube is simple to reposition. Frequent follow-up in the postoperative 6 months is suggested for early detection of minor migration.     

Transpupillare Thermotherapie bei okkulten subretinalen Neovaskularisationen

ZusammenfassungZiel In diesem Beitrag sollen die Ergebnisse der transpupillaren Thermotherapie (TTT) bei alterskorrelierter exsudativer Makuladegeneration (AMD) durch Regressionsberechnungen beschrieben werden.Patienten und Methode TTTs wurden bei AMD mit okkulten subretinalen Membranen (CNV) mit einem Diodenlaser (Iridex, USA) nach Standardangaben durchgeführt. Nach der Erstbehandlung erfolgten Kontrollen nach einem, 3 und danach nach jeweils 6 Monaten. Neben den üblichen klinischen Untersuchungen wurden Fluoreszeinangiographien und 10^°-Schwellentests (Humphrey) durchgeführt.Ergebnisse Hinsichtlich des Visus war der Abfall der Regressionsgeraden bei den kleinen CNV nicht signifikant, Unterschiede in den Steigungen zwischen den 3 TTT-Gruppen (klein — mittel — groß) waren hingegen signifikant (p<0,001). Hinsichtlich der 10°-Schwellentests waren die Unterschiede in den Steigungen in den 3 Untergruppen nicht signifikant (p=0,867).Schlussfolgerungen Bei kleinen CNV konnte keine signifikante Visusminderung nachgewiesen werden. Somit ist unter klinischer Betrachtungsweise bei frühzeitiger therapeutischer Intervention mittels TTT bei bis zu 1 PD großen okkulten CNV eine Visusstabilisierung zu erwarten.Vortrag gehalten auf der 101. Tagung der Deutschen Ophthalmologischen Gesellschaft, Berlin 2003.     

Multifocal electroretinogram in diabetic subjects

PurposeTo identify local retinal abnormalities and evaluate the nature and extent of retinal dysfunction in diabetics using full field electroretinogram (ERG) and multifocal ERG (MF-ERG) and to determine the correlation between features of optical coherence tomography (OCT) and MF-ERG.MethodsTwenty-eight normal subjects (Control Group; 56 eyes) and 37 patients (72 eyes) with diabetes mellitus (DM Group) were evaluated. In the DM Group, 17 eyes had no retinopathy (grade 1), 18 eyes had early non proliferative diabetic retinopathy (NPDR) (grade 3), 16 eyes had late NPDR (grade 4), 21 eyes had proliferative diabetic retinopathy (PDR) (grade 5). Full field ERG and MF-ERG, were used to assess the effects of diabetic retinopathy on retinal function. OCT and fluorescein angiography were used to assess and compare morphological changes with functional changes in diabetes mellitus.ResultsIn diabetic patients without retinopathy (17 eyes), the amplitudes of the second order component of MF-ERG were reduced and implicit times were delayed, while only implicit times of first order component of MF-ERG were delayed but the amplitudes of first order component were normal. In diabetic patients with retinopathy (55 eyes), the overall amplitudes were reduced and peak implicit time increased in the first order component and second order component.OCT of the DM Group showed the fovea of eyes with edema were thicker than the Normal Group. The fovea of eyes with cystoid macular edema (CME) were significantly thicker than the fovea of eyes with diffuse swelling. The implicit times of MF-ERG were directly correlated with foveal thickness.ConclusionMF-ERG reveals local retinal dysfunction in diabetic patients. MF-ERG offers the advantage of topographic mapping of retinal dysfunction. The magnitude of delay of MF-ERG implicit time reflects the degree of local clinical abnormalities in eyes with retinopathy. Local response delays found in eyes without retinopathy detects subclinical local retinal dysfunction in diabetics. The combination of OCT and MF-ERG may provide objective criteria for evaluation and assessment of diabetic retinopathy.     

Laserassistierte subepitheliale Keratektomie (LasEk)

Zusammenfassung Der vorliegende Beitrag bietet eine Übersicht über den aktuellen Kenntnisstand zu den Ergebnissen und Techniken der laserassistierten subepithelialen Keratektomie (LasEk). Die wenigen verfügbaren klinischen und experimentellen Studien zu dieser neuen Technik werden kritisch analysiert. Es wird außerdem der Frage nachgegangen, inwieweit hinsichtlich der Indikationsstellung eine Abgrenzung zur photorefraktiven Keratektomie (PRK) und Laser-in-situ-Keratomileusis (Lasik) sinnvoll erscheint. Dabei sind die persönlichen Ansichten und klinisch-wissenschaftlichen Erfahrungen der Autoren mit den angesprochenen Techniken in diesen Beitrag mit eingeflossen.

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The Analysis of Electroretinography of Diabetes Mellitus

Purpose: In order to get deeper understanding of Diabetic Retinopathy (DR), we analyzed and evauated the results of the amplitude and latency of F-ERG a-wave, b-wave and the total amplitudes of oscillatory potentials(OPs).Methods: F-ERG of 105 eyes from 55 cases of DM were diagnosed by the medical department from July 1997 to July 1998. The 105 eyes were examined by ophthalmoscope and fluorescing in angiography and divided into there groups: 22 eyes with DM without DR(NDR), 56 eyes with background DR(BDR)and 27 eyes with proliferate DR(PDR). In addition, 30 eyes were regard as normal control group(NCG) . We used VATA-2000 type vision electrophysiological instrument and inter-national standard for clinical ERG to do measure meat and recording automatically by computer.Results: 1. The proportion of eyes number of invisible wave of a-wave, b-wave of F-ERG and Ops increased with the development of DR. 2. There were significant differences ( P< 0. 01) in the latency of a-wave between NCG and BDR and statistic     

经瞳温热疗法治疗湿性年龄相关黄斑变性的疗效观察

目的：探讨经瞳温热疗法（transpupillary thermotherapy,TTT）治疗湿性年龄相关黄斑变性（age-related macular degeneration,ARMD）的初步疗效.方法：对9例14眼经眼底检查、荧光素眼底血管造影（fundus fluorescein angiography,FFA）和吲哚菁绿眼底血管造影（indocyanine green angiography,ICGA）确诊为湿性ARMD（12眼为隐匿型、2眼为经典型）的患眼行TTT治疗.根据脉络膜新生血管膜（choroidal neovascular membrane,CNV）的范围选择不同的光斑大小和能量,术后对眼底改变、视力、眼底血管造影复查,随访1～22（平均11.67）mo,以观察疗效.结果：经TTT治疗后,至末次复查时11眼（79%）出血、水肿、渗出消失、病灶斑痕化,3眼（21%）的出血、水肿、渗出明显减轻.5位患者的8眼患眼有TTT后的FFA及ICGA复查,显示其中6眼的原病灶渗漏消失、CNV消退,2眼的渗漏明显减轻.治疗后视力提高的有4眼（29%）,稳定的有7眼（50%）,下降的有3眼（21%）.除2位患者的2只患眼（14%）分别在第一次治疗后的第4和第5mo经造影复查后,接受了原病灶的再次TTT外,其余患眼（86%）均只进行了一次TTT.结论：TTT对湿性ARMD有较明确的疗效,经济安全,其远期疗效需更多病例观察.     

全视网膜光凝治疗糖尿病性视网膜病变的疗效观察

本文对氩激光全视网膜光凝（ＰａｎｒｅｔｉｎａｌＰｈｏｔｏｃｏａｇｕｌａｔｉｏｎ，ＰＲＰ）治疗糖尿病性视网膜病变（ＤｉａｂｅｔｉｃＲｅｔｉｎｏｐａｔｈｙ，ＤＲ）１００例１４９眼的疗效进行回顾性研究。结果：增殖前期糖尿病性视网膜病变（ｐｒｅｐｒｏｌｉｆｅｒａｔｉｖｅｄｉａｂｅｔｉｃｒｅｔｉｎｏｐａｔｈｙ，ＰＰＤＲ）４２例７９眼，有效率为９５％，增殖期糖尿病性视网膜病变（ｐｒｏｌｉｆｅｒａｔｉｖｅｄｉａｂｅｔｉｃｒｅｔｉｎｏｐａｔｈｙＰＤＲ）５８例７０眼，有效率为８１％。经ｘ２检验ｐ＜０．０１，二者有显著性差异，显示了ＤＲ病人早期ＰＲＰ治疗的重要性。     

Down-regulation of inducible co-stimulator (ICOS) by intravitreal injection of small interfering RNA (siRNA) plasmid suppresses ongoing experimental autoimmune uveoretinitis in rats

Background  RNA interference (RNAi) is now being exploited as a powerful tool for gene knockdown. Recently, we had shown that inducible co-stimulator (ICOS) was up-regulated in experimental autoimmune uveoretinitis (EAU). The aim of this study was to investigate whether intravitreal injection of small interfering RNA (siRNA) plasmid, targeting ICOS, suppresses the ongoing experimental autoimmune uveoretinitis (EAU) in rats. Methods  Oligonucleotide targeting ICOS was cloned into linearized pRNAT-U6.1/Neo eukaryotic expression vector to construct the recombinant plasmid (pRNAT-U6.1/Neo-ICOS). After transfecting activated rat T cells with the recombinant plasmid, ICOS mRNA and protein expression levels were determined by real-time RT-PCR and Western blot analysis respectively. Rats were immunized with IRBP R16 peptide emulsified in complete Freund’s adjuvant (CFA) and given an intravitreal injection of pRNAT-U6.1/Neo-ICOS on day 6 after immunization. After 13days of immunization, the ICOS protein expression and CD4 ⁺ ICOS ⁺ T cells were identified in retinae through Western blot analysis and flow cytometry respectively. Intraocular inflammation was assessed by the scores of the clinical and histological appearances. Delayed-type hypersensitivity (DTH) and lymphocyte proliferation were detected to evaluate the systemic effect of intravitreal injection of pRNAT-U6.1/Neo-ICOS. Result  The recombinant plasmid (pRNAT-U6.1/Neo-ICOS) for the ICOS siRNA was successfully constructed. In vitro studies using the recombinant plasmid has showed the down-regulation of ICOS gene expression both at the mRNA and protein levels. Clinical and pathological scores showed that ocular inflammation of pRNAT-U6.1/Neo-ICOS-treated eyes was markedly less than that of vehicle-treated eyes. The expression of ICOS protein and the amount of CD4 ⁺ ICOS ⁺ T cells in retinae significantly decreased by intravitreal injection of the recombinant plasmid, whereas delayed-type hypersensitivity response and lymphocyte proliferation were not impaired in rats treated with the recombinant plasmid. Conclusion  Intravitreal injection of siRNA plasmid targeting ICOS effectively down-regulated the expression of ICOS, and was highly effective in suppressing the ongoing process of EAU without any side-effects on systemic cellular immunity. Yongsheng Hou and Lin Xing contributed equally to this study     

Microstructural Deformations Within the Depth of the Lamina Cribrosa in Response to Acute In Vivo Intraocular Pressure Modulation

PurposeThe lamina cribrosa (LC) is a leading target for initial glaucomatous damage. We investigated the in vivo microstructural deformation within the LC volume in response to acute IOP modulation while maintaining fixed intracranial pressure (ICP).MethodsIn vivo optic nerve head (ONH) spectral-domain optical coherence tomography (OCT) scans (Leica, Chicago, IL, USA) were obtained from eight eyes of healthy adult rhesus macaques (7 animals; ages = 7.9–14.4 years) in different IOP settings and fixed ICP (8–12 mm Hg). IOP and ICP were controlled by cannulation of the anterior chamber and the lateral ventricle of the brain, respectively, connected to a gravity-controlled reservoir. ONH images were acquired at baseline IOP, 30 mm Hg (H1-IOP), and 40 to 50 mm Hg (H2-IOP). Scans were registered in 3D, and LC microstructure measurements were obtained from shared regions and depths.ResultsOnly half of the eyes exhibited LC beam-to-pore ratio (BPR) and microstructure deformations. The maximal BPR change location within the LC volume varied between eyes. BPR deformer eyes had a significantly higher baseline connective tissue volume fraction (CTVF) and lower pore aspect ratio (P = 0.03 and P = 0.04, respectively) compared to BPR non-deformer. In all eyes, the magnitude of BPR changes in the anterior surface was significantly different (either larger or smaller) from the maximal change within the LC (H1-IOP: P = 0.02 and H2-IOP: P = 0.004).ConclusionsThe LC deforms unevenly throughout its depth in response to IOP modulation at fixed ICP. Therefore, analysis of merely the anterior LC surface microstructure will not fully capture the microstructure deformations within the LC. BPR deformer eyes have higher CTVF than BPR non-deformer eyes.     

应用改良激光虹膜周边切除术治疗闭角型青光眼临床观察

目的 在激光虹膜切除术治疗中,应用改进的操作技术和给药方式,观察其治疗效果和术中、术后并发症发生情况,以进一步指导临床治疗.方法 观察需行激光虹膜切除术治疗的闭角型青光眼患者60例91只眼,应用多波长氪离子激光联合Nd:YAG激光行激光虹膜切除术,记录一次透切成功率、手术时间、患者自觉反应、术中及术后并发症等情况.结果 应用改良的治疗方法全例一次透切成功,手术时间短,患者自觉反应轻微,术后虹膜炎症反应轻,一过性高眼压发生率低.结论 经过技术改进的激光虹膜切除术具有手术时间短、一次透切成功率高、并发症少的优点,值得在临床工作中推广.     

30天连续配戴硬性透氧性角膜接触镜的安全性研究

目的为了评价Menicon Z硬性接触镜30 d连续配戴的安全性与有效性,进行了两个为期一年的临床比较试验.方法分别选用了可以7 d连续配戴的Hydrogel材料的Acuvue(1)及可以30 d连续配戴的Si H材料的Focus Night & Day(2)软性接触镜作为对照镜片.结果临床试验(Ⅰ)中,317人参加了Menicon Z组群,313人参加了Acuvue组群.Menicon Z组群有258人(占81.4%)完成了为期一年的试验,而Acuvue组群仅有210人(占67.1%).Acuvue组群中比较常见的副作用为浸润性角膜炎与细菌性结膜炎.相比之下,Menicon Z组群常见的不适症状是由异物飞入角膜造成角膜上皮擦伤所致的.各有50人参加了临床试验(Ⅱ)的Menicon Z组群与Night & Day组群.Menicon Z组群有35人(占70.0%)完成了为期一年的试验,Night & Day组群有33人(占66.0%).Menicon Z组群中常见的副作用表现为3～9点角膜染色,Night & Day组群为接触镜相关性充血、接触镜性角膜周边溃疡、乳头性结膜炎、角膜上方弓状损伤与细菌性角膜炎.结论Menicon Z 30 d连续配戴具有安全性.     

糖尿病视网膜1期病变多焦视网膜图变化分析

目的 通过检测糖尿病视网膜1期病变患者多焦视网膜电图(multifocal electroretino-gram,mfERG),评价1期糖尿病视网膜病变患者早期视功能的变化.方法 检测正常对照组31只眼,1期糖尿病视网膜病变组46只眼的mtERG在视野30°的测试范围内6个不同离心度的环形区N1、P1波潜伏期、P1波反应密度改变.结果 在视野30°的测试范围内6个不同离心度的环形区,1期糖尿病视网膜病变组(DR组)与正常对照组之间比较N1、P1波潜伏期显著延长;环1、2区DR组与正常对照组之间比较P1波反应密度显著降低.结论 尚未出现肉眼可见眼底改变的1期糖尿病视网膜病变即可出现视功能的异常,mfERG能够定量的检测1期糖尿病视网膜病变的局部视功能变化,为糖尿病视网膜病变的早期诊断提供有效方法.     

光动力疗法治疗中心性渗出性脉络膜视网膜病变疗效观察

目的 评价光动力疗法(photodynamictherapy,PDT)治疗中心性渗出性脉络膜视网膜病变(centralexudativehorioretinopathy,CEC)的临床疗效.方法 对比分析中心性渗出性脉络膜视网膜病变所致黄斑部脉络膜新生血管(choroidaineovascularization,CNV)患眼21例,治疗前与单次PDT治疗后3个月的视力、眼底、固视性质、光学相干断层扫描(optic coherence tomograph,OCT)图像及荧光素钠血管造影(fundus fluoresein angiography,FFA)、吲哚菁绿血管造影(indocyanine greenan giography,ICGA)的变化.结果 PDT治疗后3个月11只眼视力提高(52.38%),10只眼视力稳定(47.62%),其中5例由偏心固视恢复为中心固视.眼底检查可见出血渗出明显减少,部分患者完全吸收.FFA联合ICGA检查显示CNV病灶渗漏停止10只眼(47.62%),渗漏减少10只眼(47.62%);OCT检查表现为CNV缩小.组织水肿减轻.结论 PDT治疗可以部分或完全封闭中心性渗出性脉络膜视网膜病变所致的CNV,减少CNV引起的视力下降的危险性.     

Assessment of Detailed Photoreceptor Structure and Retinal Sensitivity in Diabetic Macular Ischemia Using Adaptive Optics-OCT and Microperimetry

PurposeThe purpose of this study was to assess density and morphology of cone photoreceptors (PRs) and corresponding retinal sensitivity in ischemic compared to nonischemic retinal capillary areas of diabetic eyes using adaptive optics optical coherence tomography (AO-OCT) and microperimetry (MP).MethodsIn this cross-sectional, observational study five eyes of four patients (2 eyes with proliferative diabetic retinopathy (DR) and 3 eyes moderate nonproliferative DR) were included. PR morphology and density was manually assessed in AO-OCT en face images both at the axial position of the inner-segment outer segment (IS/OS) and cone outer segment tips (COSTs). Retinal sensitivity was determined by fundus-controlled microperimetry in corresponding areas (MP-3, Nidek).ResultsIn AO-OCT, areas affected by capillary nonperfusion showed severe alterations of cone PR morphology at IS/OS and COST compared to areas with intact capillary perfusion (84% and 87% vs. 9% and 8% of area affected for IS/OS and COST, respectively). Mean reduction of PR signal density in affected areas compared to those with intact superficial capillary plexus (SCP) and deep capillary plexus (DCP) perfusion of similar eccentricity was –38% at the level of IS/OS (P = 0.01) and –39% at the level of COST (P = 0.01). Mean retinal sensitivity was 10.8 ± 5.4 in areas affected by DCP nonperfusion and 28.2 ± 1.5 outside these areas (P < 0.001).ConclusionsCone PR morphology and signal density are severely altered in areas of capillary nonperfusion. These structural changes are accompanied by a severe reduction of retinal sensitivity, indicating the importance of preventing impaired capillary circulation in patients with DR.     

多次经瞳孔温热疗法的湿性年龄相关性黄斑变性视网膜色素上皮和脉络膜萎缩:病例报告

目的:报告1例湿性年龄相关性黄斑变性(AMD)在多次经瞳孔温热疗法(TTT)后,脉络膜新生血管(CNV)消退,但发生了视网膜色素上皮(PRE)和脉络膜的萎缩并伴低视力.方法:复习包括眼底照相、眼底荧光素血管造影(FFA)、靛青绿血管造影和干涉光断层扫描在内的临床资料.结果:男性72岁主诉左眼视物模糊,FFA证实为黄斑部息肉状脉络膜血管病变.其左眼的CNV未经任何治疗在6 a间保持0.1的视力.约2 a后,右眼出现一片CNV.在此后3a内,病灶保持或大(3×5 PD)或小(1×2 PD)并伴有明显渗出和出血,先后做了7次TTT,参数为80～280 mW、2 mm光斑、曝光60 s,每次间隔3 mo以上.CNV病灶最终消退,但黄斑部遗留白色区,视力由0.3降至0.04.结论:TTT可使CNV病灶消退,但可发生明显的RPE和脉络膜萎缩,这无益于视力.如果对亚洲患者应用TTT,其参数可低于120 mW/mm,限于2次.     

肼屈嗪对视网膜色素上皮细胞的抗氧化作用及其治疗老年黄斑变性的潜在作用(英文)

目的:探讨在缺氧性损害下肼屈嗪对视网膜色素上皮(ARPE-19)细胞的抗氧化效果以及活性氧(ROS)在此效果中的作用。方法:用人视网膜色素上皮细胞研究肼屈嗪对氧化应激的作用,包括特丁基氢过氧化物(t-BHP)、过氧化氢(H2O2)、叠氮化钠(NaN3),以及缺氧引起的细胞坏死。用MTT检验测试细胞活性。结果:用ROS诱导的氧化应激治疗ARPE-19细胞,肼屈嗪在抵抗t-BHP、H2O2、缺氧引起的细胞坏死中表现出浓度依赖性,但对NaN3不具有浓度依赖性。这一作用中不涉及到一氧化氮(NO)。结论:肼屈嗪在ARPE-19细胞中表现出抗氧化应激诱导的破坏,这一作用可能是因为对ROS的净化剂作用。所以肼屈嗪可能用于治疗老年黄斑变性。     

0.7毫米微创自内障手术改良法的临床学习效果观察

目的观察初学者学习0．7毫米微创白内障手术改良法的临床效果。方法随机选取门诊和住院白内障患者50人,由初学者在老师指导下应用0．7毫米微创白内障手术改良法施行手术。研究内容包括手术时间,术中灌注液应用量,术中并发症等。结果手术时间随着学习的进程总体呈下降趋势,从开始10例平均时间61分22秒下降到第5个10例的18分54秒。特别是30例后下降明显。共7例9次并发症发生。第4例出现后囊破裂,未行玻璃体切割的情况下成功植入人工晶状体于睫状沟内。前10例中共有2例,第2和4个10例中各1例术中角膜上皮水肿。另外还有1例发生后弹力层撕裂,两例切口撕裂,1例结膜水肿。结论经过短期的0．7毫米微创白内障手术改良法训练,初学者可从传统同轴超声乳化安全转换至0．7毫米微创白内障手术。