葡萄膜炎并发白内障超声乳化手术前后的血-房水屏障功能变化

目的通过检测超声乳化白内障吸除联合人工晶状体植入手术前后，葡萄膜炎并发白内障患者房水蛋白浓度，并以老年性白内障患者为对照，了解手术对葡萄膜炎并发白内障患者血-房水屏障的影响，评价术后前房炎性反应的特点。方法对24例（26只眼）葡萄膜炎并发白内障患者及60例（64只眼）老年性白内障患者施行超声乳化联合人工晶状体植入手术，应用激光蛋白细胞检测仪定量检测并比较手术前后的前房蛋白浓度。结果葡萄膜炎并发白内障患者与老年性白内障患者在超声乳化吸除联合折叠式人工晶状体植入术前及术后1、7、30、90d术眼房水的平均光粒子数分别为（25．12±11．62）、（6．94±0．34）；（44．70±11．12）、（26．27±1．37）；（31．69±10．12）、（13．96±1．05）；（27．59±11．55）、（9．07±0．43）及（23．88±10．43）、（7．16±0．27）photon counts／ms，其中术后1d、7d、30d均高于术前，且差异均有统计学意义（P〈0．05）；而术后90d与术前比较，差异无统计学意义（P〉0．05）。两组同一时期比较差异均有统计学意义性（P〈0．05）。结论超声乳化手术引起葡萄膜炎并发白内障患者血-房水屏障功能的损伤，但在术后短期内可得到重建。超声乳化手术对这类患者是一种安全的、有效的术式。     

葡萄膜炎并发白内障超声乳化吸除联合折叠人工晶状体植入术

目的 探索葡萄膜炎并发白内障行颞侧透明角膜切口超声乳化吸除联合折叠人工晶状体植入术的效果及安全性。方法 对34例47眼葡萄膜炎并发白内障碍患者行透明角膜切口超声乳化白内障吸除联合可折叠人工晶状体植入术。术中对小瞳孔的处理包括部分瞳孔括约肌剪开或环形切除。结果 术后第1天裸眼视力0．5以上者14只眼(29．78％)，0．3以上者23只眼(48．93％)，0．1以上者35只眼(74．5％)，低于0．05者7只眼(14．19％)。术后随访矫正视力0．5以上者达39只眼(82．97％)。并发症有术中前房出血2只眼，术后不同程度的角膜水肿8只眼。7只眼因黄斑水肿和视网膜病变视力提高不明显。结论 葡萄膜炎并发白内障患者行透明角膜切口白内障超声乳化吸除联合折叠人工晶状体植入可获得理想的疗效。     

分析超声乳化加人工晶体植入在葡萄膜炎并发白内障治疗中应用的价值

目的分析超声乳化加人工晶体植入在葡萄膜炎并发白内障治疗中的应用价值。方法2012年3月至2014年3月我院眼科收治148例葡萄膜炎并发白内障患者,依据随机数字表法将这些患者分为研究组(70例,70只眼)和对照组(78例,78只眼)两组。对照组接受单纯超声乳化加人工晶状体植入治疗,研究组接受超声乳化加人工晶状体植入联合前房地塞米松注射,然后对两组患者的晶体混浊程度、眼压情况、视力、前房渗出、闪辉及角膜水肿情况进行统计分析。结果两组患者的晶体混浊程度及眼压之间的差异均不显著(P0.05);研究组患者术后1 d、2 d视力提高的眼睛比例均明显比对照组高(P0.05),前房闪辉阳性的患者比例均明显比对照组低(P0.05),但术后7 d两组患者的视力提高、前房闪辉阳性的眼睛比例之间的差异均不显著(P0.05);研究组患者术后1 d角膜水肿程度明显比对照组轻(P0.05),但术后2d、7d角膜水肿程度之间的差异均不显著(P0.05);两组患者术后1 d、2 d、7 d前房渗出的眼睛比例之间的差异均不显著(P0.05)。结论超声乳化加人工晶体植入在葡萄膜炎并发白内障治疗中具有较高的应用价值,值得推广。术中前房注射地塞米松有助于加强治疗效果。     

非超声乳化显微手术治疗青光眼术后白内障的临床观察

目的 观察青光眼术后白内障非超声乳化显微手术的临床疗效.方法对青光眼滤过术后白内障66例(69眼)均在手术显微镜下采用颞上象限小切口非乳化白内障囊外摘出的人工晶状体植入,分析术后视力、眼压及术后并发症情况.结果 66例(69)眼术后视力恢复较满意,术后1周矫正视力＜0.05者3眼(4.35%),0.05～0.25者12眼(17.39%),0.30～0.50者24眼(34.78%),0.60～1.00者18眼(26.09%),＞1.00者12眼(17.39%).术后眼压稳定,平均眼压(15.66±3.62)mmHg(1 mmHg=0.133 kPa).手术并发症为早期角膜水肿及葡萄膜反应,均较轻,2～7 d内消退.结论 非超声乳化显微手术操作较为简便,术后并发症少,视力恢复快眼压控制较好.     

超声乳化白内障吸除联合人工晶体植入术治疗闭角型青光眼的临床疗效观察

目的观察超声乳化白内障吸除联合折叠式人工晶体植入术治疗急性闭角型青光眼合并白内障患者的临床疗效。方法收集2002年7月至2005年9月于中山眼科中心青光眼病区收治的急性闭角型青光眼合并白内障31例(31眼),患者均接受超声乳化白内障吸除联合折叠式人工晶体植入术,术后随访3个月。结果术后最佳矫正视力,较术前显著提高(P<0·05);患者术后3个月眼压平均为(15·3±3·2)mmHg,较术前用药前后眼压相比均显著下降(P<0·05);超声生物显微镜检查发现术后前房深度较术前均显著增加,平均为(3·01±0·47)mm(P<0·05);术后患者房角均较术前增宽,房角粘连关闭象限不同程度开放。结论超声乳化白内障吸除联合折叠式人工晶体植入术可有效降低眼压、提高视力,为急性闭角型青光眼同时合并白内障患者安全有效的治疗途径。     

原发性闭角型青光眼合并白内障超声乳化术治疗的临床观察

目的研究白内障超声乳化联合后房人工晶状体植入术在原发性闭角型青光眼合并白内障的『临床效果。方法对2008年3月至2012年2月在本院治疗的早期原发性闭角型青光眼合并白内障患者42例（48只眼）,施行白内障超声乳化联合后房人工晶状体植入术,术后随访3-12个月。结果术后所有患者术后视力均有明显提高,眼压得到控制,前房均有不同程度的加深,术前关闭的房角有不同程度的开放。结论白内障超声乳化联合后房人工晶状体植入术对于原发性闭角型青光眼合并白内障患者具有提高视力,控制眼压的效果。     

超声乳化吸除联合房角分离术治疗白内障合并急性原发性闭角型青光眼效果观察

目的探讨超声乳化吸除联合房角分离术治疗白内障合并急性原发性闭角型青光眼(APACG)的效果。方法对2013-09—2015-09间收治的42例(45眼)白内障合并APACG患者施行超声乳化吸除联合房角分离术。分析患者手术前后眼压、视力、房角变化、前房深度及术后并发症。结果患者术后1 d、1个月、3个月、6个月眼压均小于术前,差异具有统计学意义(P0.05);术后6个月眼视力明显优于术前,中央及周边前房深度大于术前,房角分级明显改善,差异均具有统计学意义(P0.05)。术后发生角膜水肿5例、瞳孔区絮状渗出3例、前房炎症2例,经对症处理后逐渐消失。结论超声乳化吸除联合房角分离术治疗白内障合并APACG,可明显降低眼压、提高视力、增加前房厚度、改善房角开放程度,安全、有效。     

双切口小梁切除联合超声乳化显微手术治疗青光眼合并白内障

目的　探讨双切口小梁切除联合超声乳化白内障显微手术治疗青光眼合并白内障的临床疗效。　方法　施行双切口小梁切除联合超声乳化白内障吸除术 46例 ( 4 8眼 ) ,术后随访 6～ 3 6个月 ,分析术后眼压、视力等情况。　结果　术前眼压 15 2 8～ 3 2 17mmHg ,术后随访最终眼压 7 10～ 2 0 5 5mmHg ,两者差异有显著性 (t=8 92 ,P <0 0 0 1) ;术前视力眼前光感～ 0 3 ,术后视力大于 0 2者 41眼 ,较术前明显好转 ,经配对 χ2 检验 ,差异有显著性 χ2 =14 0 3 ,P <0 0 0 1)。　结论　双切口小梁切除联合超声乳化白内障显微手术治疗青光眼合并白内障 ,能达到恢复有用视力及降低眼压等效果。     

超声乳化治疗青光眼合并白内障临床观察

目的:观察超声乳化白内障摘除人工晶状体植入联合虹膜周边切除术或小梁切除术治疗青光眼合并白内障的疗效。方法:采用单纯表麻下超声乳化白内障摘除人工晶状体植入治疗白内障继发青光眼不伴房角损害9眼(术式Ⅰ);表麻下超声乳化白内障摘除人工晶状体植入加周边虹膜切除术治疗病人14眼(术式Ⅱ);球周麻醉超声乳化白内障摘除人工晶状体植入加小梁切除术治疗病人13眼(术式Ⅲ);术后随访3个月～2年。结果:术前平均视力0.06,术后平均视力0.5;术前平均眼压(27.63±2.31)mmHg,(1mmHg=0.133KPa),术后平均眼压(15.62±1.76)mmHg。结论:上述三种术式治疗青光眼合并白内障,具有恢复有用视力,控制眼压满意的理想效果。     

白内障超声乳化显微手术治疗急性闭角型青光眼的临床体会

目的 分析、探讨超声乳化白内障吸除联合人工晶状体植入术治疗原发性急性闭角型青光眼的疗效.方法 回顾急性闭角型青光眼合并明显白内障21例(21眼)的临床资料,分析超声乳化白内障吸除联合人工晶状体植入术的术前、术后视力、眼压、前房深度、前房角及C值的变化.结果 随访1～2年,21眼眼压控制正常,其中4眼需滴降眼压药物.全部病例手术后前房加深.最佳矫正视力有不同程度提高.结论 白内障超声乳化手术治疗急性闭角型青光眼效果良好,并发症少.     

小切口非超声乳化白内障摘除术的疗效分析

目的探讨小切口非超声乳化白内障摘除术的临床效果。方法将笔者所在单位收治的白内障患者284例302眼,分别采用小切口超声乳化吸除术（142例147眼）和小切口非超声乳化白内障摘除术（142例155眼）进行治疗,观察两组术后视力恢复情况与并发症发生率。结果术后3d及1周超乳组裸眼视力≥0．5者显著多于非超乳组（P〈0．05）,术后3个月裸眼视力≥0．5者两组比较差异无统计学意义（P〉0．05）;两组术后的并发症发生率无显著性差异（P〉0．05）。结论小切口非超声乳化白内障摘除术疗效可靠,手术费用低,适合在基层医院推广应用。     

光眼术后白内障的超声乳化显微手术治疗

目的 评价经颞侧透明角膜切口的超声乳化白内障吸出及折叠式人工晶体植入对青光术后白内障的治疗效果。方法 采用颞侧透明角膜隧道切口，对３２例（３６眼）青光眼术后白内障施行超声乳化白内障吸出及人工晶体植入术，术后观察视力、眼压、滤泡等情况。结果随访３～６个月，全部患者视力较术前提高０．１以上３１例（８６％），最好视力０．８。眼压与术前基本一致，滤泡形态无改变。结论 颞侧透明角膜切口的超声乳化显微手术时     

闭角型青光眼合并白内障患者应用超声乳化白内障吸除人工晶状体植入联合小梁切除术治疗的效果观察

目的分析超声乳化白内障吸除人工晶状体植入联合小梁切除术治疗闭角型青光眼合并白内障的临床疗效。方法对39例(42眼)闭角型青光眼合并白内障患者实施超声乳化白内障吸除人工晶状体植入联合小梁切除手术。随访6个月,评价治疗的效果。结果42眼的眼压均恢复至正常范围。40眼(93.02%)视力较术前显著改善,2眼维持视力不变。滤过泡I型19眼、Ⅱ型21眼、Ⅲ型2眼。出现浅前房3眼,经注入无菌空气后前房形成。1眼术后出现前房少许出血,经止血、制动对症处理后出血完全吸收。未发生晶状体后囊破裂、角膜失代偿、恶性青光眼等严重并发症。结论对合并白内障的闭角型青光眼患者予以超声乳化白内障吸除联合小梁切除术,控制眼压可靠且能加深前房及改善视力,安全性高。     

双手微切口超声乳化手术治疗白内障的初步临床观察

目的:观察双手微切口超声乳化手术治疗白内障的临床疗效.方法:对老年性白内障患者28例(30眼)行白内障双手微切口超声乳化吸除及人工晶体植入术,术后随访时间1～6月.结果:术后1天视力≥0.5者16只眼(53.3%);角膜内皮计数减少率为8.9%;术中破后囊1只眼(3.3%),睫状沟固定人工晶体;内皮皱褶、角膜水肿4只眼(13.3%).结论:双手微切口超声乳化手术治疗老年性白内障,具有术后视力恢复快、对眼内组织损伤小、术后并发症少等优点.     

改良显微小梁切除术治疗葡萄膜炎继发性青光眼

目的 探讨小梁切除术中采用虹膜节段切除联合应用丝裂霉素C(MMC)及粘弹剂治疗葡萄膜炎继发性青光眼的临床疗效.方法 术中根据患者的年龄、炎症和结膜Tenon囊情况选用不同浓度的MMC(0.25～0.33 mg/ml),应用粘弹剂分离虹膜前后粘连和瞳孔区机化膜并剪除机化膜,节段切除虹膜,可控缝线缝合巩膜瓣.观察手术前后视力、眼压、炎症和术后并发症情况.结果 葡萄膜炎继发性青光眼共38例42眼,平均随访时间(12.01±3.56)月.术后末次复查与术前比较,视力提高14眼,不变28眼;前房炎症消失35眼,减轻7眼;平均眼压(15.20±4.64)mmHg与术前(38.37±12.93)mmHg比较差异有统计学意义(t=8.255,P=0.000).手术总成功率92.9%,无严重并发症发生.结论 小梁切除术术中联合应用MMC、粘弹剂、虹膜前后粘连分离、虹膜节段切除及可控缝线技术能够提高较严重葡萄膜炎继发性青光眼的手术成功率,减少手术并发症及术后炎症反应,减少葡萄膜炎复发.     

超乳联合房角分离术治疗白内障合并青光眼疗效观察

目的:观察改良超声乳化手术治疗超高龄白内障的临床疗效.方法:对超高龄老年性白内障患者48例(55眼)行白内障改良超声乳化吸除及人工晶体植入术,回顾性分析超高龄老年性白内障患者42例(50眼)行白内障超声乳化吸除及人工晶体植入术,术后随访时间1～6个月.结果:(1)术后1周改良超乳组视力＜0.1者1只眼(1.8%);超乳组视力＜0.1者5只眼(10.0%),两组视力分布无统计学差异(P值均＞0.05).(2)改良超乳组角膜内皮计数减少率为9.3%、超乳组为17.8%.两组术后角膜内皮密度之间差异均有统计学意义(P＜0.05).(3)改良超乳组术中1只眼(1.8%)睫状沟固定人工晶体.超乳组术中破后囊3只眼(6.0%),其中2只眼(4.0%)未植入人工晶体,2只眼(4.0%)睫状沟固定人工晶体;内皮皱褶、角膜水肿4只眼(8.0%);黄斑水肿1只眼(2.0%).结论:改良超声乳化手术治疗超高龄白内障,具有术后视力恢复快、对眼内组织损伤小、术后并发症少等优点.     

超声乳化白内障吸出术与小切口非超声乳化囊外摘除术治疗高龄白内障的疗效比较

目的：比较超声乳化白内障吸出术与小切口非超声乳化囊外摘除术治疗高龄白内障的临床疗效。方法回顾性分析高龄白内障患者58例的临床资料。其中30例患者采用超声乳化白内障吸出术治疗,28例患者采用小切口非超声乳化囊外摘除术治疗,比较两组的临床疗效。结果两组术后视力均有显著提高（P＜0.01）。超声乳化组在术后1周视力高于小切口组（P＜0.01）,但术后1个月和3个月,两组视力没有显著差异（P＞0.05）。两组术后并发症发生率比较差异无统计学意义（P＞0.05）。结论小切口非超声乳化囊外摘除术治疗高龄白内障与超声乳化白内障吸出术疗效相似,但具有操作更简单,设备要求简单,费用低等优点。     

改良显微小梁切除术治疗葡萄膜炎继发性青光眼

Objective To investigate the effect of trabeculectomy combined with segmental iridectomy, mitomycin C (MMC) and viscoelastic agents usage on the treatment of glaucoma secondary in uveitis. Methods According to the age, degree of inflammation and the condition of Tenon capsule of patients, differ-ent concentration of MMC (0.25-0.33 mg/ml) was used during the operation, with separation of the anterior and posterior synechia, resection of pupillary organization membrane using viscoelastic agents. Segmental iridec-tomy and releasable sutures were also performed on the patients. The visual acuity of preoperation and postoper-ation, intraocular pressure, inflammation and the complication were record. Results Forty-two eyes of 38 cases with glaucoma secondary in uveitis were studied, the mean follow-up time was (12.01±3.56) months. The postoperative visual acuity improved in 14 eyes, didn't change in 28 eyes. The postoperative inflammation of anterior chamber disappeared in 35 eyes, relieved in 7 eyes. And the average postoperative intraocular pres-sure (15.20± 4.64) mmHg was significantly lower than the preoperative intraocular pressure (38.37±12.93) mmHg (t = 8.255, P = 0.000). The total success rate was 92.9%. There were no severe complication. Conclusion Trabeculeetomy combined with MMC, viscoelastic agents usage, separation of anterior and poste-rior syneehia, segmental iridectomy and releasable suture could increase the success rate of operation on pa tients with glaucoma secondary in uveitis, decrease the complication and inflammation reaction of operation, and the recurrence of uveitis.     

改良显微小梁切除术治疗葡萄膜炎继发性青光眼

Objective To investigate the effect of trabeculectomy combined with segmental iridectomy, mitomycin C (MMC) and viscoelastic agents usage on the treatment of glaucoma secondary in uveitis. Methods According to the age, degree of inflammation and the condition of Tenon capsule of patients, differ-ent concentration of MMC (0.25-0.33 mg/ml) was used during the operation, with separation of the anterior and posterior synechia, resection of pupillary organization membrane using viscoelastic agents. Segmental iridec-tomy and releasable sutures were also performed on the patients. The visual acuity of preoperation and postoper-ation, intraocular pressure, inflammation and the complication were record. Results Forty-two eyes of 38 cases with glaucoma secondary in uveitis were studied, the mean follow-up time was (12.01±3.56) months. The postoperative visual acuity improved in 14 eyes, didn't change in 28 eyes. The postoperative inflammation of anterior chamber disappeared in 35 eyes, relieved in 7 eyes. And the average postoperative intraocular pres-sure (15.20± 4.64) mmHg was significantly lower than the preoperative intraocular pressure (38.37±12.93) mmHg (t = 8.255, P = 0.000). The total success rate was 92.9%. There were no severe complication. Conclusion Trabeculeetomy combined with MMC, viscoelastic agents usage, separation of anterior and poste-rior syneehia, segmental iridectomy and releasable suture could increase the success rate of operation on pa tients with glaucoma secondary in uveitis, decrease the complication and inflammation reaction of operation, and the recurrence of uveitis.     

改良显微小梁切除术治疗葡萄膜炎继发性青光眼

Objective To investigate the effect of trabeculectomy combined with segmental iridectomy, mitomycin C (MMC) and viscoelastic agents usage on the treatment of glaucoma secondary in uveitis. Methods According to the age, degree of inflammation and the condition of Tenon capsule of patients, differ-ent concentration of MMC (0.25-0.33 mg/ml) was used during the operation, with separation of the anterior and posterior synechia, resection of pupillary organization membrane using viscoelastic agents. Segmental iridec-tomy and releasable sutures were also performed on the patients. The visual acuity of preoperation and postoper-ation, intraocular pressure, inflammation and the complication were record. Results Forty-two eyes of 38 cases with glaucoma secondary in uveitis were studied, the mean follow-up time was (12.01±3.56) months. The postoperative visual acuity improved in 14 eyes, didn't change in 28 eyes. The postoperative inflammation of anterior chamber disappeared in 35 eyes, relieved in 7 eyes. And the average postoperative intraocular pres-sure (15.20± 4.64) mmHg was significantly lower than the preoperative intraocular pressure (38.37±12.93) mmHg (t = 8.255, P = 0.000). The total success rate was 92.9%. There were no severe complication. Conclusion Trabeculeetomy combined with MMC, viscoelastic agents usage, separation of anterior and poste-rior syneehia, segmental iridectomy and releasable suture could increase the success rate of operation on pa tients with glaucoma secondary in uveitis, decrease the complication and inflammation reaction of operation, and the recurrence of uveitis.