中西医结合治疗扁平疣

目的　评价中西医结合治疗扁平疣的疗效。方法　 12 8例患者随机分为治疗组 (89例 )和对照组 (39例 ) ,治疗组用中药内服和外搽维甲酸霜治疗 ,对照组以聚肌胞注射液治疗。结果　治疗组总有效率为 95 .5 % ,对照组为 5 9%。结论　中西医结合治疗是治疗扁平疣的有效方法。     

多次环行切除法治愈巨大跖疣1例

报道顽固性巨大难治跖疣 1例。患者男,38例,左足跟疼痛性增生物4年。增放疗、肌注干扰素,多次分区分片清除 皮损,皮损仍反复复发,后改用农层向内环行切除皮损的方法治愈。     

One-port pars plana vitrectomy (by 25-G micro-incision)

Purpose  A pilot study to test a novel, minimal invasive vitrectomy, through one-port pars plana sclerotomy, by 25-G instruments, for selected vitreous, macular and vitreomacular interface disorders. Methods  Setting: institutional. Design: interventional, prospective case series of 14 eyes of 14 patients. The “one-port pars plana vitrectomy” (OPPPV) by 25-G micro-instruments was performed on seven pseudophakic eyes, and the “phacoemulsification OPPPV” (phaco OPPPV) by 25-G on seven presbyopic/cataract phakics. Minimal vitrectomy on eight eyes. Subtotal vitrectomy on six eyes. Follow-up: 12 months. Main outcome endpoints: surgical feasibility/suitability, patient tolerability, post-operative recovery time. Intra- and post-operative complications were recorded. Results  All OPPPVs by 25 G were completed as planned. Anatomical surgical objectives were fulfilled on all eyes; functional ones on 13 out of 14 eyes. The whole OPPPV group and four of the phaco OPPPV subset of patients tolerated comfortably less than 30′ surgical time, and three phaco OPPPV ones less than 45′. Full regimen anti-inflammatory therapy for 2 weeks kept ten eyes out of 14 stable. Post-operatively, two eyes developed a transient alteration of the intraocular pressure. At the end of the follow-up, neither retinal detachment nor endophthalmitis occurred. Conclusions  OPPPV by 25 G techniques promise to be an effective,comfortable, possible office-based alternative “micro-incisional, minimal invasive vitreous surgery” for selected vitreous, macula and vitreomacular interface disorders. Future research on the safety of the OPPPV by 25 G techniques compared to conventional ones is encouraged. Dr. William Gualtieri (video) presented the ”one-port pars plana vitrectomy” technique at the British and Eire Vitreoretinal Society (BEAVRS) Annual Meeting 23 November 2006, London, England, UK The Author has no proprietary interest. Neither grants nor funds supported this work.     

Treatment of Co-existent occult choroidal neovascular membrane and macular hole

The co-existence of a macular hole and a choroidal neovascular membrane can represent a diagnostic and therapeutic dilemma. In this noncomparative case report, we report on a patient with co-existent macular hole and choroidal neovascular membrane. The patient initially was found to have an occult choroidal neovascular membrane. The patient was not treated and the vision remained stable for almost 1 year until the patient noted further visual decline. The patient was treated with intravitreal pegaptanib and the patient's vision remained stable for 6 months. However, on follow-up the patient presented with visual decline and a full thickness macular hole was confirmed by optical coherence tomography (OCT). The patient underwent repair and vision improved with closure of the macular hole. The occult choroidal neovascular membrane remained stable with no evidence of disease progression. Fundus photos, intravenous fluorescein angiograms, and OCT were obtained before and after therapy and confirmed the diagnosis. This report highlights how the detection of co-existent macular hole and choroidal neovascular membrane may require OCT scanning. When treatment is entertained, therapy should be directed first toward the neovascular complex and then to repair the macular hole.     

扁平部造瘘术治疗角膜葡萄肿

探讨睫状体扁平部造瘘术治疗角膜葡萄肿的效果。方法 16例16眼角膜葡萄肿施行了扁平部造瘘术,并对术后临床效果进行了分析、评价。结果 经随访观察3个月－1年,16眼中15眼角膜葡萄肿消失,4眼视力有不同程度提高,12眼眼压保持正常范围。结论 扁平部造瘘术是治疗角膜葡萄肿、保留眼球、挽救部分视力的有效方法之一。     

皮肤CT对扁平疣和早期脂溢性角化病的特征分析

目的应用共聚焦激光扫描显微镜（confocal laser scanning microscopy,CLSM）对扁平疣（verruca planae）和早期脂溢性角化病（seborrheic keratosis）的图像特征进行归纳,从而对之进行鉴别。方法对2012年6～10月来解放军第二五二医院门诊皮肤科就诊患者30例扁平疣患者和30例早期脂溢性角化病患者皮损进行CLSM检测,获得扁平疣和脂溢性角化病皮损特征性图像。结果扁平疣患者图像显示表皮上部细胞体积大,大小较一致、胞质折光性低的空泡细胞形成,排列呈玫瑰花瓣样改变;脂溢性角化病患者图像显示明亮的角质层增厚,假性角质囊肿的形成,棘层增厚,乳头瘤样增生。结论应用CLSM有助于区分临床上容易混淆的扁平疣和早期脂溢性角化病。     

Retinal detachment in eyes treated with Aurolab aqueous drainage implant for refractory glaucoma - Incidence and outcomes

Purpose:To analyze the incidence of rhegmatogenous retinal detachment (RRD) in patients who have undergone prior Aurolab aqueous drainage implant (AADI) surgery and report outcomes in terms of anatomic, visual acuity, and intraocular pressure (IOP) findings.Methods:Case records of all patients who underwent RRD repair after AADI surgery from 2013 to 2019 were retrospectively analyzed. Data collected included patient demographics, ocular examination findings at all visits including IOP and best-corrected visual acuity (BCVA) and clinical findings related to RRD both at baseline and postoperatively.Results:Ten eyes of nine patients were included in study. The mean age of patients was 28.2 years (median: 15 years, range: 6–83 years). Mean duration between AADI and RRD was 14 months (median 2.5 months; range 2 days-72 months). All eyes underwent pars plana vitrectomy with silicon oil injection. The preoperative LogMAR BCVA (logarithm of the minimum angle of resolution) was 2.52 ± 0.15 which improved to 2.29 ± 0.58 at final follow-up; however, only one eye had vision ≥ 20/400 largely due to recurrent RRD and advanced glaucomatous disc damage. Postoperatively retina was attached in 6 eyes (60%) and IOP was ≤ 21 mmHg in 5 out of 6 eyes with anatomic successConclusion:The incidence of RRD following AADI was found to be 0.86% in our study. Pars plana vitrectomy (PPV) with silicon oil tamponade was the preferred approach in the management of these eyes with IOP being well controlled post PPV. However, visual acuity outcomes were largely unsatisfactory due to recurrent RRD and preexisting advanced glaucoma.     

玻璃体切割术后高眼压的药物治疗观察

目的比较不同抗青光眼滴眼剂在睫状体平坦部玻璃体切割术后对高眼压的控制效果。方法将年龄在18—65岁、术前基线眼压为（16．62±3．40）mmHg、术后基线眼压为（30．76±7．47）mmHg的175例玻璃体切割术（pars plana vitrectomy,PPV）后发生高眼压的患者分为4组,分别使用3种抗青光眼药物滴眼。第1组56例（56眼）,单一应用β阻滞剂;第2组36例（36眼）,单一应用α激动剂;第3组48例（48眼）,协同应用β阻滞剂与碳酸酐酶抑制剂;第4组35例（35眼）,协同应用α激动剂与碳酸酐酶抑制剂。分别观察用药3d后和9d后的降眼压效果。结果用药3d后,4组观察对象的眼压下降幅度为：第1组（9．87±5．16）mmHg,第2组（7．87±6．00）mmHg,第3组（13．03±8,43）mmHg,第4组（9．48±6．42）mmHg;在用药9d后为：第1组（13．16±5．09）mmHg,第2组（10．61±6．16）mmHg,第3组（16．60±8．93）mmHg,第4组（13．63±7．96）mmHg。对用药后3d和用药后9d的眼压测量数据进行统计学分析后．确定4个用药组眼压下降幅度差异都具有统计学意义（P〈0．01）。在降低术后高眼压的应用中,单独使用β阻滞剂或α激动剂在疗效上无明显差异（P〉0．05）;与碳酸酐酶抑制剂合用时,β阻滞刺的降眼压效果优于α激动剂（P〈0．05）。β阻滞剂与碳酸酐酶抑制剂的联合降眼压作用不仅优于单独使用β阻滞剂（P〈0．05）,更明显优于单独使用α激动剂（P〈0．01）。结论在降低术后高眼压的药物治疗中,联合应用抗青光眼药物比单独应用疗效更显著。     

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。