孔源性视网膜脱离的治疗进展

孔源性视网膜脱离（ RRD）是以玻璃体和视网膜共同参与视网膜裂孔形成为特征,是视网膜神经上皮层（ NSR）及视网膜色素上皮层（ RPE）分离的一类视网膜病变,严重威胁患者的视功能,因此早期的发现预防及选择恰当的治疗方法在临床上显得至关重要。本文将对孔源性视网膜脱离的治疗进展做一综述。     

诺和针头用于聚肌胞皮损内注射治疗扁平疣效果

目的：探讨诺和针头用于聚肌胞皮损内注射治疗扁平疣的效果。方法：收集2015年1月—2016年1月的扁平疣患者114例,均给予聚肌胞皮损内注射治疗。按注射针头不同,将患者随机分成诺和针头组（试验组）57例和注射器原针头组（对照组）57例。比较两组患者穿刺部位疼痛的感知评分、拔针后药液外流情况、注射成功率和治疗效果。结果：试验组治愈率为91.23%（52/57）,高于对照组的64.91%（37/57,P＜0.05）。试验组治疗周期、疼痛感知评分及药液外流量均明显低于对照组,差异有统计学意义（P＜0.05）。试验组注射成功率为98.25%（56/57）,高于对照组的80.70%（46/57,P＜0.05）。结论：诺和针头应用于聚肌胞皮损内注射治疗扁平疣效果较好,治愈率较高,能有效缩短疗程,减轻疼痛,注射成功率高,药液外流发生情况较少,临床应用价值较高。     

玻璃体切割联合内界膜填塞或内界膜翻转对特发性大黄斑裂孔患者治疗效果的对比研究

目的　比较玻璃体切割联合内界膜填塞或内界膜翻转在特发性大黄斑裂孔患者治疗中的效果。方法　回顾性非随机临床研究。24例24眼特发性大黄斑裂孔患者均行睫状体平坦部三通道25G玻璃体切割术,术中使用内界膜反折填塞于黄斑裂孔中者12例12眼为内界膜填塞组,使用内界膜反折覆盖于黄斑裂孔中者12例12眼为内界膜翻转组。术后随访6个月,对比两组患者最佳矫正视力（best corrected visual acuity,BCVA）、裂孔闭合率、OCT检查结果及并发症等情况。结果　术后6个月,内界膜填塞组12眼黄斑裂孔全部闭合,黄斑裂孔闭合率为100%;内界膜翻转组12眼中11眼黄斑裂孔闭合,黄斑裂孔闭合率为91.67%,两组黄斑裂孔闭合率差异无统计学意义（Z=-1.00,P=0.32）。术后6个月,内界膜填塞组BCVA为（1.13±0.40）logMAR,内界膜翻转组为（1.03±0.36）logMAR,均较术前明显改善,差异均有统计学意义（均为P=0.00）;术后6个月内界膜翻转组BCVA优于内界膜填塞组,但差异无统计学意义（t=0.59,P=0.56）。OCT检查示,内界膜翻转组有3眼（25.00%）视网膜外层结构部分恢复,内界膜填塞组均未见视网膜外层结构恢复患者。结论　玻璃体切割联合内界膜填塞或内界膜翻转治疗特发性大黄斑裂孔,均能提高黄斑裂孔的闭合率,稳定及改善BCVA。     

An open,comparative clinical study on the efficacy and safety of 10% trichloroacetic acid, 25% trichloroacetic acid and cryotherapy for verruca plana

Objective: Although there are several methods to treat Verruca plana, warts do not respond well to the common therapeutic options. In this study, we compared the safety and efficacy of 10% trichloroacetic acid, 25% trichloroacetic acid, and cryotherapy for the treatment of warts caused by Verruca plana.

Methods: Ten percent and 25% trichloroacetic acid were applied to warts weekly until all lesions cleared. Cryotherapy was performed by liquid nitrogen spray for 5–10 seconds for each lesion per week until the lesions cleared. The number of Verruca plana lesions and adverse effects were evaluated five times during the treatment (the initial visit, week 2, week 4, week 6, and week 8).

Results: The number of lesions decreased through week 8 for all three treatments, and the reductions in the mean numbers of lesions were statistically similar (p?>?0.05). Those in the cryotherapy group exhibited more erythema, pain, erosions, bullae, and hyperpigmentation (p?p?p?p?p?=?0.001, respectively) than those in either TCA group. Itching was more common among those in the trichloroacetic acid groups than in the cryotherapy group (p?p?p?p?p?Conclusion: Ten percent trichloroacetic acid, 25% trichloroacetic acid, and cryotherapy are effective methods to treat Verruca plana. 10% trichloroacetic acid offers a safer and easier treatment than either 25% trichloroacetic acid or cryotherapy.     

平坦部切口摘出眼前段非磁性异物

作者设计了一种经平坦部切口摘出非磁性异物的方法，用于摘出术前术中难以经瞳孔看到的，位于玻璃体前段周边部或前部眼球内壁的非磁性异物。１９９１－１９９３年内共进行３２例，全部一次手术成功。术中术后并发症少，远期效果稳定。讨论了手术方法和术后视力恢复问题。此手术方法简单，安全，损伤小，成功率高，解决了临床上处理这种位置非磁性异物摘出的难题。     

地白液治疗青年扁平疣的疗效观察

目的　观察地白液治疗青年扁平疣的效果。方法　地白液涂搽疣体 ,2 0天为一疗程 ;对照组为西咪替丁口服 ,疗程结束后 ,观察疣体消失情况 ,判断疗效。结果　地白液对青年扁平疣治愈率为 75 .2 3% ,西咪替丁组为 5 1.2 3% ,治疗组显著高于对照组 (P <0 .0 1)。结论　地白液治疗扁平疣疗效高 ,疗程短 ,无任何副作用     

Diagnostic Ultrasound and Pars Plana Vitrectomy in Endophthalmitis

Purulentendophthalmitisistheinfectiousinflammationofeye.Whensevereendophtha鄄lmitisoccurs,vitreousbodyisofteninvolved,whichshowsopaqueandabscessformation.Whentheuveaandretinaareinvolved,theyshowswelling,ischemiaandexudates.Whenthelensisinvolved,itshowedopaqueanddegener鄄ated.Inclinical,mediaopacitiessuchastheex鄄udatesinanteriorchamber,cataractorcornealinfiltrationprecludetheophthalmoscopicevalua鄄tionofvitreousbody,whichmayaffectthedeci鄄sionofsurgery.B鄄scanultrasonographycanpro鄄videmuchin…     

双眼内源性化脓性眼内炎的诊断与治疗

目的 探讨双眼内源性化脓性眼内炎的诊断和治疗。方法 报告1例双眼内源性化脓性眼内炎的诊治过程,并复习有关献。结果 1例罕见严重双眼内源性化脓性眼内炎患,多次误诊,治疗无效,后经正确诊断,并及时采用玻璃体切割及眼内注射等非常规治疗,不仅保住了眼球而且视力恢复良好。结论 当双眼葡萄膜炎对激素、抗生素等治疗不敏感时,应当考虑内源性眼内炎的可能,及时的玻璃体切割术,对挽救视力有决定性作用。     

特发性黄斑裂孔OCT影像与术后早期视力恢复的相关性研究

目的 研究特发性黄斑裂孔(idiopathic macular holes,IMH)患者术前光学相干断层扫描技术(optical coherence tomography,OCT)测量的相关参数与术后早期视力恢复的相关性.方法 收集24例(25眼)IMH患者,均行玻璃体切割+内界膜剥离+玻璃体内注气术,术前、术后12周均行最佳矫正视力(best corrected visual acuity,BCVA)检查,术前1周内OCT影像上直接测量裂孔最大高度,通过Image-Pro Plus 6.0软件测量黄斑裂孔最小径、基底径及外界膜光感受器断裂点与视网膜色素上皮层的最大垂直高度,并计算黄斑孔指数(macular hole index,MHI)、牵拉孔指数(tractional hole index,THI)、黄斑孔指数’(macular hole index’,MHI’)及牵拉孔指数’(tractional hole index’,THI’),应用SPSS 22.0软件包进行Spearman相关性分析,得出各参数与术后12周时BCVA的相关性,受试者工作特征曲线拟合分析得出MHI、THI、MHI’、THI’界值.结果 IMH患者术后12周BCVA较术前明显提高且差异有统计学意义(P=0.000).相关性分析结果表明:术后12周BCVA与术前MHI、THI、MHI’、THI’具有相关性(均为P＜0.05).MHI ≥0.705组术后12周时BCVA平均为0.297,好于MHI＜0.705组的0.103(P=0.023);THI≥1.425组术后12周时BCVA平均为0.288,好于THI＜1.425组的0.163(P =0.001).结论 THI≥1.425或MHI ≥0.705者术后12周时能获得较好的BCVA,可作为预测IMH患者术后早期视力恢复情况的指标.     

Comparison of Efficacy and Safety of Loteprednol Etabonate 0.5% and Topical Dexamethasone 1% in Post-Vitrectomy Inflammation

Purpose: To compare the efficacy and safety of postoperative topical loteprednol etabonate (LE) 0.5% with dexamethasone (DEX) 0.1% for the treatment of inflammation following pars plana vitrectomy (PPV).

Methods: A total of 150 eyes of 150 patients who underwent transconjunctival PPV for various diagnoses were included in this prospective, randomized study. The patients were assigned into two groups as Group LE (n = 75) and Group DEX (n = 75). Intraocular inflammation, intraocular pressure (IOP), and the intensity of postoperative pain were compared between the groups.

Results: The mean IOP was higher in the patients treated with DEX (p > 0.05). The need for anti-glaucoma medications was significantly lower in Group LE (5.3%) than in Group DEX (17.3%) (p = 0.020). Tyndall scores were less in Group DEX at postoperative Days 1 (p = 0.01) and 3 (p = 0.017). On Day 1, it was more likely for patients to have mild or moderate pain in Group LE (p < 0.001). On Day 3, the number of the patients with no pain was higher in Group DEX (p = 0.005).

Conclusions: Although DEX is more effective in the early postoperative days, LE appears to be as effective in controlling inflammatory response following PPV in the long-term. Topical LE is associated with less increase in the IOP and a lower need for anti-glaucoma medications.