白内障超声乳化吸除术和囊外摘除术初学者玻璃体脱出危险因素分析

Objective To investigate the risk factors related to vitreous loss of phacoemulsification and extracapsular cataract extraction. Methods The clinical data of the initial continuous 350 cases of pha-coemulsification and 350 cases of extracapsular cataract extraction were reviewed. Vitreous loss rate related to each risk factors (gender, age, laterality of the eye,type of cataract, IOL power,success of capsulorhexis,coordinafion of the patients, etc) were measured. Chi-square and Logistic analysis were used to identify the differ-ence of each rate. Results In the ECCE group, there is no significance among each risk factor. In the Phaco group,type of cataract,IOL power and capsulorhexis successful or not affected the vitreous loss rate. Grade IV nuclear,unsuccessful capsulorhexis, IOL power ≥ 24.5D, IOL power ≤ 15.0D and grade Ⅰ nuclear are the risk factors related to the vitreous loss rate,while grade Ⅱ nuclear is a significant protect factor (p <0.05). Conclu-sion The trainees are suggested to choose patients with emmetropia,cataract with grade n nuclear and relative young age and to perform phacoemulsification with successful capsulorhexis.     

Alagille综合征眼部病变一例

Alagille综合征是一种累及多系统的遗传疾病,眼部异常是其重要表现之一.北京大学第一医院眼科诊治伴有典型眼部改变的Alagille综合征患儿1例,现报道如下.     

眼科确诊的Wegener肉芽肿一例

Wegener肉芽肿是一种罕见的致死性的自身免疫性疾病,病理表现为坏死性肉芽肿性血管炎,主要累及上下呼吸道和肾脏,还可累及关节、眼、皮肤,亦可侵及心脏、神经系统及耳等.现将北京大学第一医院眼科排查确诊的1例Wegener肉芽肿患者的临床资料报道如下.     

白内障超声乳化吸除术和囊外摘除术初学者玻璃体脱出危险因素分析

Objective To investigate the risk factors related to vitreous loss of phacoemulsification and extracapsular cataract extraction. Methods The clinical data of the initial continuous 350 cases of pha-coemulsification and 350 cases of extracapsular cataract extraction were reviewed. Vitreous loss rate related to each risk factors (gender, age, laterality of the eye,type of cataract, IOL power,success of capsulorhexis,coordinafion of the patients, etc) were measured. Chi-square and Logistic analysis were used to identify the differ-ence of each rate. Results In the ECCE group, there is no significance among each risk factor. In the Phaco group,type of cataract,IOL power and capsulorhexis successful or not affected the vitreous loss rate. Grade IV nuclear,unsuccessful capsulorhexis, IOL power ≥ 24.5D, IOL power ≤ 15.0D and grade Ⅰ nuclear are the risk factors related to the vitreous loss rate,while grade Ⅱ nuclear is a significant protect factor (p <0.05). Conclu-sion The trainees are suggested to choose patients with emmetropia,cataract with grade n nuclear and relative young age and to perform phacoemulsification with successful capsulorhexis.     

白内障超声乳化吸除术和囊外摘除术初学者玻璃体脱出危险因素分析

Objective To investigate the risk factors related to vitreous loss of phacoemulsification and extracapsular cataract extraction. Methods The clinical data of the initial continuous 350 cases of pha-coemulsification and 350 cases of extracapsular cataract extraction were reviewed. Vitreous loss rate related to each risk factors (gender, age, laterality of the eye,type of cataract, IOL power,success of capsulorhexis,coordinafion of the patients, etc) were measured. Chi-square and Logistic analysis were used to identify the differ-ence of each rate. Results In the ECCE group, there is no significance among each risk factor. In the Phaco group,type of cataract,IOL power and capsulorhexis successful or not affected the vitreous loss rate. Grade IV nuclear,unsuccessful capsulorhexis, IOL power ≥ 24.5D, IOL power ≤ 15.0D and grade Ⅰ nuclear are the risk factors related to the vitreous loss rate,while grade Ⅱ nuclear is a significant protect factor (p <0.05). Conclu-sion The trainees are suggested to choose patients with emmetropia,cataract with grade n nuclear and relative young age and to perform phacoemulsification with successful capsulorhexis.     

素高捷疗眼膏治疗角膜病的临床观察

角膜表层慢性疾病是眼科的常见病。由于它具有症状明显,病程缓慢、病情顽固等特点,因此,仅使用一般的常规治疗往往不能获得满意疗效。近年,我们引进了瑞士素高药厂生产的素高捷疗眼膏(solcosryl Eye-Gel SEG)作为治疗的辅助药物,治疗了一些角膜疾患,获得了一定疗效。现将观察结果报告如下。     

那素达滴眼液治疗非感染性结膜炎的临床疗效及安全性观察

目的 :评价那素达滴眼液 (Naphcon -A)治疗非感染性结膜炎的临床效果及安全性。方法 :多中心应用那素达滴眼液治疗 14 0例 2 66眼非感染性结膜炎病人 ,分别于用药前及用药后 10分钟、 3 0分钟、 1小时、 1天、 3天、 7天、 14天评估患者的症状及体征 (共 11项指标 ) ,并观察药物的副作用。结果 :经那素达滴眼液治疗后 ,眼痒、流泪、烧灼感、异物感、睑痉挛、畏光、结膜充血、分泌物及总分于用药后 10分钟积分即明显下降 (P <0 0 0 0 0 ) ,睑结膜乳头与滤泡 (P <0 0 0 0 0 )、角膜荧光素染色 (P <0 0 0 0 0 )、角膜缘胶样增生 (P <0 0 0 2 )于用药后 3天积分下降。除结膜充血于用药后三天较用药后 1小时积分有轻微反弹外 (P <0 0 5 ) ,其余各项指标积分均逐渐下降。随着用药时间的延长 ,有效率逐渐上升 (P <0 0 5 )。用药两周有效率为 96 99% ,其中显效 77 44 % ,有效 19 5 5 %。不良反应发生率为 5 77%。用药前后视力、瞳孔、眼压、脉率和血压变化无统计学上差异 (P >0 0 5 )。结论 :那素达滴眼液能迅速、有效地缓解非感染性结膜炎 (特别是变应性结膜炎 )的症状和体征 ,是一种安全有效的治疗变应性结膜炎的药物。     

氟康唑治疗霉菌性角膜炎

由于抗菌素及皮质类固醇的广泛应用,霉菌性角膜炎的发病率明显增加,但常用的抗霉菌药物毒性大、疗效差,使霉菌性角膜炎成为临床治疗的一个难问题。氟康唑(Fluconazole)是新近推出的一种广谱全身、局部均可用的抗霉菌药物,具有水溶性、与血浆蛋白结合低、半衰期长等优点。我们在国内首次在眼科应用法国产氟康唑治疗两例用其它抗霉菌药物治疗无效的霉菌性角膜炎,取得了良好的临床效果。现报告如下:例1 女21岁患者因右眼红,伴轻度畏光、眼痛两天来本科就诊。既往右眼有单疱病毒性角膜炎史4年,反复发作多次。检查:右视力0.2~(+(?))、J_(?),右眼无明显刺激症状,睫状充血(+),角膜颞上部     

两种干眼症状问卷评分与干眼临床检查的关联性研究

背景 目前常用的干眼症状评估问卷有两种,但二种问卷结果的关联性及问卷与临床检查的关联性研究尚未见到.如何有效地评估干眼症状,将患者的主观症状进行量化有助于临床上干眼的正确诊断. 目的 评价标准干眼症状评估(SPEED)问卷和眼表疾病指数(OSDI)问卷两种干眼问卷诊断干眼的一致性及其与干眼体征的相关性.方法 采用前瞻性队列研究设计.对66例干眼患者先依据SPEED问卷进行评分,并分为轻度症状组(＜10分)和重度症状组(≥10分);然后对同一批患者依据OSDI问卷进行评分,并分为轻度症状组(≤20分)、中度症状组(21～ 45分)和重度症状组(≥46分).所有患者行泪膜镜、泪膜破裂时间(BUT)、角膜荧光素染色、Schirmer Ⅰ试验等干眼临床检查,分析两种问卷与干眼临床检查结果之间的关系. 结果 SPEED问卷评分和OSDI问卷评分与BUT值均呈负相关(r=-0.390,P=0.001;r=-0.395,P=0.001),两种问卷评分与Schirmer Ⅰ试验结果间无明显相关性(r=-0.081,P=0.515;r=-0.080,P=0.525),与泪膜镜分级结果也均无明显相关(r=0.158,P=0.204;r=0.219,P=0.077).SPEED问卷轻度症状组BUT明显长于重度症状组,差异有统计学意义(t=2.339,P=0.022),而2个组间Schirmer Ⅰ试验和泪膜镜分级差异均无统计学意义(t=0.404,P=0.687;t=-0.947,P=0.347);2个组间荧光素染色阳性率的差异无统计学意义(x2=0.164,P=0.685).OSDI问卷评分轻度症状组、中度症状组、重度症状组间BUT值比较,差异有统计学意义(F=11.871,P=0.000),轻度症状组BUT明显长于中度症状组和重度症状组(P=0.000、0.000);3个组间Schirmer Ⅰ试验、泪膜镜分级差异均无统计学意义(F=1.432,P=0.246;F=2.799,P=0.068);3个组间荧光素染色阳性率的差异无统计学意义(x2=6.026,P=0.050).SPEED问卷评分值与OSDI问卷评分值间呈正相关( r=0.697,P=0.000).结论 SPEED问卷和OSDI问卷都是客观评估干眼症状的有效方法,与BUT有相关性,可作为临床诊断干眼的辅助手段;两种问卷可联合使用.