农民眼外伤495例调查分析

目的探讨农民眼外伤临床特点及处理方法。方法将我院近几年收治的495例(515眼)农民眼外伤进行回顾性分析。结果农民眼外伤995例占同期收治的眼外伤病例的72．26％。农民眼外伤最多是植物性伤，占43．03％；车祸伤次之，占13．94％：致伤物主要是农田秸杆、麦芒、谷粒、芦苇等：治疗前视力≤0．05者28眼占5．44％，0．7以上5眼，占0．97％；治疗后视力≤0．05者减至9眼占1．75％；0．7以上增至214眼，占41．55％。结论农民眼外伤严重危害视功能，及时正确处理可获较好疗效。     

玻璃体手术治疗复杂眼外伤临床分析

目的评价玻璃体手术在治疗复杂眼外伤中的应用价值。方法对30例复杂眼外伤患者行玻璃体手术的效果和手术时机进行回顾性分析。结果术后视力较术前提高者22例(占73．33％)，术后视力下降或不变者8例(占26．67％)。11例眼内异物患者均一次成功摘出，7例复杂性视网膜脱离复位6例(占85．71％)。结论严格掌握玻璃体手术在复杂眼外伤中的适应证及手术时机，能挽救大多数受伤眼球并恢复一定的有用视力。     

玻璃体切除联合手术治疗严重眼外伤82例

目的：观察玻璃体切除联合手术治疗严重眼外伤的临床效果。方法：采用标准三切口玻璃体切除联合白内障人工晶状体植入，眼内异物摘出，视网膜脱离复位术等治疗严重眼外伤82例，结果：术后视力提高60例，占73．2％，盲率由治疗前84．1％降至31．7％,其中27例视力提高到0．3以上，29例视力在0．05－0．3，35例眼内异物均一次手术摘出，视网膜脱离复位率达81．3％。结论：玻璃体切除联合手术治疗严重眼外伤术后视力恢复较好，并发症少。     

晶体玻璃体切割术治疗眼外伤的临床观察

报道用美国产Ｍｃｒｏｖｉｔ切割器治疗眼外伤１０４例，其中眼前段切割８０例，眼后段切割２４例。治愈率８０．８％，视力０．０２５～０．６者占４７．８％，视力好转者占６５．４％。２９例平均随访２２．５个月，远期治愈率７９．３％。作者认为该手术是治疗眼外伤较好的方法之一，若治疗及时可治愈常规手术不能治愈的病例。     

严重眼外伤中玻璃体手术的应用

目的 观察玻璃体手术治疗严重眼外伤的效果。方法 严重眼外伤采用闭合式玻璃体切除，联合视网膜脱离复位术、眼内异物摘出、视网膜切开、注入过氟化碳液体、眼内光凝、眼内注药、C3F8气体或硅油填充。结果 严重眼外伤178例182眼中116眼视力提高，占63．74％；57眼视力不变，占31．32％；9眼下降，占4．95％。术前无光感的19眼中，7眼恢复光感以上视力。摘出36眼玻璃体内或视网膜前异物及20眼后段眼球壁异物。有4眼视网膜下异物未施行摘取。6l眼视网膜脱离，其中55眼视网膜复位，视网膜解剖复位率90．16％。结论 经过适时恰当的玻璃体手术，大多数严重眼外伤都能挽救眼球并恢复有用的视力。     

玻璃体手术治疗严重眼外伤

目的：探讨玻璃体视网膜手术治疗复杂眼外伤的效果。方法：应用玻璃体视网膜手术方法治疗严重眼外伤15例（15眼），结果：术后随访6－12月最终视力在0．02最终视力在0．02以上者7例占46．7％，4例因复发网脱二次手术，3例复位。结论：严格掌握玻璃体手术在复杂眼外伤中的适应症及手术时机，正确操作 ，可使大多数伤眼获得解剖修复。     

玻璃体手术治疗儿童后节眼外伤

目的：观察玻璃体手术治疗儿童后节眼外伤的疗效。方法：应用玻璃体手术治疗了１０例眼外伤儿童，受伤眼均有玻璃体和视网膜的并发症。结果：术后视力在０．０５以上的４例（占４０％），最终行眼球摘除术者１只眼。结论：尽管后节眼外伤的手术疗效不理想，但经过显微缝合和玻璃体手术，半数眼能重建眼球并部分恢复视力，因此建议除个别例外尽量避免行初期眼球摘除术。     

眼外伤的玻璃体手术疗效观察

目的 评估玻璃体手术治疗眼外伤的临床疗效。方法 采用闭合式玻璃体切除术联合视网膜脱离手术、异物摘出,松解性视网膜切开等治疗３８例眼外伤。结果 随访３￣１０月,视网膜复位率８３．３％,视力提高３５眼,占９２．１％,术后视力０．１以上者３０眼,占７８．９％,结论 眼外伤合并玻璃体视网膜病变,眼内异物或眼内炎时,只要适时行玻璃体手术,大多数都能重建眼球并恢复有用视力。     

基层医院儿童眼外伤的急救及护理

目的 探讨基层医院儿童眼外伤救治及护理特点.方法 回顾分析70例儿童眼外伤病例的治疗护理措施和治疗效果.结果 70例眼外伤患儿,手术治疗38例,非手术治疗32例.治疗后比治疗前视力均有提高,治疗前视力＜0.5者43例,占61％,治疗后视力＜0.5者21例,占30％,有明显统计学差异,P＜0.05.并发症及后遗症主要为角膜白斑2例,占3％,外伤性白内障3例,占4％.结论 基层医院儿童眼外伤多见,及时救治和有针对的护理能有效提高患儿视力.     

穿孔性眼外伤玻璃体手术的视力恢复和影响因素

目的 探讨穿孔性眼外伤显微玻璃体视网膜手术(Micro—vitreoretinal surgery，MVRS)后视力恢复和影响因素。方法 用MVRS联合眼内异物取出、视网膜切开、氟碳液、内光凝及内填充等治疗穿孔性眼外伤113例患者。结果 出院时≥数指(CF)视力88只眼(78％)，≥0．1视力16只眼(24％)。55例随访6～28个月≥CF视力50只眼(90％)，0．1～1．2视力27只眼(49％)。出院时视网膜复位111只眼(98％)，远期视网膜解剖复位率90．9％。在伤后14天之内手术，视力达优(视力≥0．1)。者占34．8％，但10处理无显著差别。IOL及保留晶体组、非视网膜切开组、无填充组及单纯玻璃体积血组视力达优者，分别占35．6％、25．2％、39．5％和41％。经X^2处理前二者无显著差别；后二者有显著差别。结论 MVRS术后视力恢复与手术并发症和外伤严重程度等因素有关，预防术后PVR发展和牵引性视网膜脱离(Traction retinal detachment，TRD)是提高术后视力恢复的关键。     

眼科手术后斜视和复视的临床分析

目的　探讨眼科手术后继发性斜视的发生机制和防治方法。方法　检查 79例不同眼科手术后发生继发性斜视患者的眼位、眼球运动、复视及预后情况 ,并进行牵拉试验。对部分患者行斜视矫正术 ,术中观察眼部受累组织的情况。结果　在全部患者中 ,视网膜脱离术后患者占 38 0 %(30 / 79) ,白内障摘除手术后患者占 31 7% (2 5 / 79) ,眼眶手术后患者占 13 9% (11/ 79) ,其他为青光眼、翼状胬肉及上睑下垂术后患者。视网膜脱离手术和白内障摘除手术后部分继发性斜视症状持续时间 >6个月的患者 ,受累肌纤维化并 (或 )与结膜、巩膜及外加压物广泛粘连 ,牵拉试验呈阳性 ;眼眶手术后患者眼球主要表现为牵制性运动障碍 ;翼状胬肉切除术后患者内直肌及其周围组织损伤明显 ;抗青光眼手术后患者继发性斜视症状于术后 2～ 14d自行缓解。结论　内眼和外眼手术均可导致继发性斜视的发生 ;斜视的发生机制主要包括眼肌损伤、限制及机械压迫 3个因素。眼科手术医师应高度重视 ,积极采取针对性预防和治疗措施。     

Postoperative aphakia in modern cataract surgery: part 1: analysis of incidence and risks based on 5-year data from the Swedish National Cataract Register

PURPOSE: To study the incidence of aphakia after cataract extraction and evaluate the relative risk for this outcome in subgroups of patients based on preoperative conditions. SETTING: Sixty-two community-run or private clinics participating in the Swedish National Cataract Register. METHODS: Data on cataract extractions were collected prospectively from 1997 through 2001. The set of data also covered type of surgery and type of intraocular lens (IOL), including a "no lens implanted" option. All data were stored in a database. Database calculations were made of frequencies and risk ratios of postoperative aphakia in the subgroups of patients based on preoperative conditions. RESULTS: For the entire study period, postoperative aphakia was reported in 1410 of 287,951 surgeries for which complete IOL data were available, corresponding to an overall frequency of 0.49%. The occurrence of ocular comorbidity and poor preoperative visual acuity (< or = 0.1) in the eye to be operated on was significantly related to postoperative aphakia for each year of the study (P<.001). Glaucoma and poor visual acuity (< or =0.1) in the surgical eye meant a 12.8 higher risk for aphakia after surgery than a better visual acuity (>0.1) and no ocular comorbidity. CONCLUSIONS: This national 5-year survey showed that in routine cataract surgery performed during the study, 1 of every 200 operations ended in postoperative aphakia. Poor visual acuity (< or =0.1) in the eye to be operated on combined with ocular comorbidity was the highest risk factor for postoperative aphakia.     

Postoperative aphakia in modern cataract surgery: part 2: detailed analysis of the cause of aphakia and the visual outcome

PURPOSE: To study the incidence of aphakia after cataract surgery, the surgical complications that can lead to it, and the visual outcome. SETTING: Six community-run eye clinics participating in the Swedish National Cataract Register. METHODS: Data on cataract extractions were collected prospectively from 1997 through 2001. The data also covered the type of surgery and type of intraocular lens, including a "no lens implanted" option. All data were stored in a database. These data were supplemented with data on the intended type of surgery, type of complications, possible second surgery, and visual outcome. RESULTS: The overall incidence of postoperative aphakia was 0.65%. In 87.1% of cases, the aphakia was not planned, corresponding to an incidence of 0.48%. Unplanned aphakia was significantly related to poor preoperative vision, old age, and the presence of ocular comorbidity. The most frequent reasons for unplanned aphakia were intraoperative capsule problems and vitreous loss. In two thirds of cases, a second operation was performed. In 41% of all cases, the final visual acuity was 0.5 or better and in 27.7%, worse than 0.1. CONCLUSIONS: During the study period, 1 of every 200 routine cataract surgeries ended in unplanned aphakia. The incidence of surgical complications leading to unplanned aphakia and a final visual acuity worse than 0.1 (20/200) was 7.8 per 10,000 operations in cases with no ocular comorbidity and 27.6 per 10,000 operations in cases with ocular comorbidity.     

玻璃体切除硅油填充术后高眼压的临床治疗

目的探讨玻璃体切除硅油填充术后高眼压的治疗方法。方法对视网膜脱离患者行玻璃体切除硅油填充术,术后眼压大于25 mm Hg的86例（86只眼）进行药物或手术治疗。结果 61只眼（70.9%）经药物治疗眼压控制。14只眼（16.2%）经前房穿刺术后眼压控制。8只眼（9.3%）出现虹膜周切口阻塞,其中6只眼经激光打孔再通,2只眼只行手术切除周边虹膜。3只眼（3.4%）出现新生血管性青光眼,其中1只眼行睫状体冷凝,2只眼行睫状体光凝联合硅油取出后眼压控制。眼压控制后8,4只眼（97.6%）视力有不同程度提高。结论及时发现并针对病因进行药物或手术治疗可有效控制玻璃体切除硅油填充术后高眼压。     

Eye health care in the Czech Republic

OBJECTIVE: An analysis of eye health care in the Czech Republic as of 1998 was performed. METHODS: A questionnaire was used to obtain information from all 59 in-patient eye departments. RESULTS: The number of ophthalmologists per 1 million inhabitants was 95. The number of cataract operations per 1 million inhabitants was 4,209: phaco-emulsification (36,926 surgeries, 85.2%), extracapsular extraction (6,094 surgeries, 14.1%) and intracapsular extraction (90 surgeries, 0.2%). Intra-ocular lenses were implanted in 99% of cases; 404 corneal transplantations and 1,220 operations for retinal detachment were performed. The number of pars plana vitrectomies for diabetic eye complications was 661. CONCLUSION: Selected regional clinical centres should be equipped and preferred by health insurance companies to provide comprehensive eye health care services and training.     

The birth of global ocular traumatology

In the developing world, ocular trauma is an important cause of monocular blindness. However, little is known about the epidemiology of eye injuries in rural Africa. This study presents five- year data on hospitalized ocular injuries in a rural region in Tanzania. Data were collected from Mvumi Hospital, a tertiary hospital serving rural Dodoma, and the only hospital during this time period able to care for serious trauma. All in-patient charts from January 1, 1985 to December 31, 1989 were reviewed for cases of ocular trauma who presented within 30 days of injury. Data on demographics, cause of injury, visual acuity, and current diagnosis were ed. A total of 157 cases were recorded, of whom 69% were male. A third of the injuries occurred in those less than age 20. Injury with a stick was the most common cause, accounting for 67% of the cases. A third of the cases presented to the hospital 8 or more days after the injury, and most had poor visual acuity in the affected eye. In those age 20 or younger, 82% of females and 67% of males presented with visual acuity &;lt;3/60. Ruptured globe and uveitis were the most common diagnosis made at presentation. Preventive ophthalmology efforts in this area should focus on decreasing stick-related ocular injuries and improving rapid access to appropriate care when injuries occur.     

眼外伤术后二期人工晶状体植入术前后患者生存质量变化

目的 探讨眼外伤术后无晶状体眼二期人工晶状体植入术前后生存质量的变化及其影响因素.方法 采用于强等开发的视功能损害眼病患者生活质量量表( AQOL - DVI)对眼外伤术后无晶状体眼98例行二期人工晶状体植入手术.对术前2d、术后3个月的生存质量进行比较,以配对t检验,并采用多元逐步回归分析方法筛选影响生存质量的因素.结果 植入术后3个月量表得分明显高于术前2d者,差异具有统计学意义.影响手术后得分改变的首要独立因素是患眼视力的变化.多元回归分析筛选出5个主要影响因子:术后3个月视力(Bs =0.408)、用眼时间(Bs=-0.172)、社会保障(Bs=0.324)、晶状体位置(Bs=-0.216)、术后眩光(Bs=-0.143).结论 二期人工晶状体植入术后眼外伤患者的生存质量得到明显提高.根据术后生存质量的影响因子,不仅要重视患者的单纯的视力提高,同时还要了解患者的职业、经济状况及术后舒适度等.     

临时人工角膜用于严重眼外伤的眼前后段联合手术

目的评价临时人工角膜下眼前后段联合手术对严重眼外伤病变的治疗价值。方法对眼球穿通伤所致的眼球前后段严重的病变１８例（１８只眼）,按伤眼的适应证,施行临时人工角膜下的玻璃体切除、眼内异物取出术、视网膜复位术及相关各种眼内显微技术（视网膜前膜剥离、重水液下操作、眼内硅油填充、眼内电凝和眼内激光等）和穿透性角膜移植术或自体角膜片转位移植术,观察其术后的转归及恢复情况。结果所有术眼的眼球均得到了保留,１４只眼的视力较术前提高,其中５只眼的视力达到０．１以上,３／１０只眼术后再次出现视网膜脱离,２只眼出现角膜植片混浊,各有１只眼出现玻璃体混浊和继发性青光眼,其中１只眼与术前一样为眼球萎缩。结论临时人工角膜下的眼前后段联合手术是目前治疗严重眼外伤病变的唯一有效的方法     

眼部拳击伤临床分析

本文报告54例（55眼）眼部拳击伤，占我院同期住院眼外伤总数的11．73％。眼部拳击伤为多处限组织受损，经治疗后大多数患者视力恢复较好。本文对拳击伤患者眼部表现作了描述，并对拳击所致的视网膜病变、前房积血、巩膜破裂的临床特点、发病机制和治疗进行了讨论和分析。     

儿童严重眼外伤玻璃体视网膜手术效果分析

目的 评价儿童严重眼外伤玻璃体视网膜手术的效果.方法 儿童严重眼外伤施行玻璃体视网膜手术38例（38眼）,进行回顾性分析.结果 38例中,术前术后检查视力合作者30例,其中出院时视力好转者17例（56.67%）,不变者11例（36.67%）,下降者2例（6.66%）.另视力检查不合作者8例.复诊硅油取出者14例,取出后视力提高者10例（71.43%）,视力不变者4例（28.57%）.结论 玻璃体视网膜手术是治疗儿童严重眼外伤,挽救视力和保全眼球的重要手段.