超声乳化术中单纯灌注冲洗法清除晶状体硬核碎块的应用

目的:探讨在超声乳化术中应用单纯灌注冲洗法清除晶状体硬核碎块的临床效果。方法:应用单纯灌注冲洗法治疗在超声乳化术中存在核碎块或皮质硬核的白内障病人和成熟期白内障病人共146例(160眼)。观察其手术并发症和视力恢复情况。结果:视力:所有患者视力均有明显提高。术后3个月最佳矫正视力:0.3～0.5者,38只眼(23.75%),0.5～1.0者,108只眼(67.5%)。术后最佳矫正视力<0.3者均并发有其他眼疾。并发症:术中无后囊破裂及悬韧带离断发生,无角膜内皮细胞失代偿。术后切口水肿消失快,均无渗漏,前房形成良好,散光轻,视力恢复快。随访半年至1年,虹膜部分后粘连2眼,小切口组瞳孔轻度上移1眼,后囊膜混浊2眼。结论:在超声乳化手术中,应用单纯灌注法冲洗法能安全、准确的、有效地清除晶状体核碎块或皮质硬核。     

高龄自内障超声乳化吸除手术的临床观察

目的观察高龄白内障患者实施白内障手术的临床效果。方法对80～92岁老人98眼白内障超声乳化吸除术作回顾分析。结果视力：t〉0．5者46眼,0-3～0．5者35眼,0．1～0．3者15眼,2眼视力指数／30cm。其中有5例后囊裂口,改为囊外摘除,人工晶体植入睫状沟。术后10例角膜内皮水肿,无大泡性角膜炎。结论高龄白内障患者行白内障手术疗效良好,安全可行,无严重全身并发症。     

白内障超声乳化与现代囊外摘除术对眼表的影响研究

目的对比研究白内障超声乳化术和现代囊外摘除术后眼表功能的变化。方法选择156例186眼白内障患者,分为两组,分别进行白内障超声乳化联合人工晶体植入术(PHACO组,98例114眼)和白内障现代囊外摘除联合人工晶体植入术(ECCE组,58例72眼)。术后1个月对干眼相关症状、体征、泪液分泌试验(schirmer I试验)、泪膜破裂时间(BUT)、角膜荧光素染色、眼表虎红染色等项目进行检查和评分比较。结果两组间在症状、体征、干眼诊断性试验等各项指标评分上均有显著性差异(P<0.05),ECCE组评分明显高于PHACO组,ECCE组干眼症发病率(27.78%)也高于PHACO组(4.38%),其差别同样具有显著性意义(P<0.05)。结论白内障现代囊外摘除术较超声乳化术在术后短期内更易对眼表功能造成影响,使泪膜稳定性受到破坏而产生干眼症。     

白内障超声乳化联合人工晶体植入手术后干眼症的临床观察

目的:观察白内障超声乳化联合人工晶体植入手术后干眼症的相关情况.方法:收集2008年10月至2010年6月间我院眼科诊治的白内障患者60例,共72只眼.经角膜缘切口行白内障超声乳化联合人工晶体植入术.分别于术前3d、术后1d、1周、1个月及3个月观察并记录下列指标:干眼症状评分;Sehirmer I试验;泪膜破裂时间;...     

超声针头斜面向下乳化劈裂技术在白内障超声乳化术中的应用

目的评估超声针头斜面向下乳化劈裂技术的手术效果,探讨超声乳化术中角膜内皮细胞机械性损伤的机制。方法对251眼白内障施行超声乳化及人工晶体植入术。术中采用超声针头斜面向下乳化劈裂技术127眼（A组）,其中Ⅱ级核28眼,Ⅲ级核69眼,Ⅳ～Ⅴ-级核30眼。采用传统的超声针头斜面向上乳化劈裂技术124眼（B组）,其中Ⅱ级核31眼,Ⅲ级核65眼,Ⅳ～Ⅴ-级核28眼。对两组的累计能量复合参数及术后6个月角膜内皮细胞丢失率分别对照研究。结果A组累计能量复合参数：Ⅱ级核（2.7±0.5）秒;Ⅲ级核（11.9±2.1）秒;Ⅳ～Ⅴ-级核（30.2±8.1）秒。角膜内皮细胞丢失率：Ⅱ级核（5.1±0.6）%;Ⅲ级核（8.9±0.4）%;Ⅳ～Ⅴ-级核（12.5±1.6）%。B组累计能量复合参数：Ⅱ级核（2.6±0.4）秒;Ⅲ级核（12.2±2.5）秒;Ⅳ～Ⅴ-级核（31.7±8.9）秒。角膜内皮细胞丢失率：Ⅱ级核（5.0±0.5）%;Ⅲ级核（11.2±0.8）%;Ⅳ～Ⅴ-级核（20.6±1.4）%。Ⅱ级核组间差异无统计学意义（P〉0.05）,Ⅲ级核组间差异有统计学意义（P〈0.05）,Ⅳ～Ⅴ-级核组间差异有统计学意义（P〈0.01）。结论 超声乳化术中采用超声针头斜面向下乳化劈裂技术可有效地降低角膜内皮细胞的损失率。对于硬核白内障的超声乳化,采用此技术更有利于对角膜内皮细胞的保护。     

衍射型多焦点与单焦点人工晶状体在青光眼合并白内障病例中的应用

目的比较在白内障合并青光眼病例中植入Acrysof ReSTOR(衍射型多焦点人工晶状体)及Acrysof Natural(单焦点人工晶状体)后人工晶状体眼的视功能状态,评价多焦点人工晶状体在白内障合并青光眼病例中应用的临床效果及安全性。方法将24例青光眼合并白内障患者(已行滤过性手术或虹膜根切术)在随机化基础上按自愿选择的原则分为两组,多焦点人工晶状体组11例(11眼),单焦点人工晶状体组13例(13眼),行白内障超声乳化吸除术,按分组植入不同类型的人工晶状体。术后1周、1个月、3个月观察术眼非矫正远、近视力,最佳矫正远、近视力,矫正远视力下近视力。结果多焦点人工晶体组患者术后3个月平均裸眼远视力(0.78±0.11),平均裸眼近视力(0.63±0.09),矫正远视力下近视力(0.67±0.17)。术后裸眼远近视力较术前有显著提高。单焦点人工晶体组患者术后3个月平均裸眼远视力(0.77±0.11),平均裸眼近视力(0.36±0.17),矫正远视力下近视力(0.13±0.09)。结论通过适当的选择患者,衍射型多焦点人工晶状体可为青光眼合并白内障患者提供良好的远、近视力,降低患者术后对眼镜的依赖。     

微创青光眼手术在原发性闭角型青光眼联合手术中的应用研究进展

青光眼是世界首位不可逆性致盲眼病, 中国作为原发性闭角型青光眼发病率最高国家, 重视和改进其治疗方法是降低致盲率的有效途径。随着微创青光眼手术(MIGS)技术的发展, 原发性闭角型青光眼的治疗方法更新迭代。本文汇总目前国内外相关文献, 总结MIGS在原发性闭角型青光眼联合手术治疗中的应用进展, 提示MIGS可能成为未来治疗原发性闭角型青光眼的优选联合方法, 为临床提高青光眼治疗水平提供参考。     

Corrección de la presbicia tras cirugía cristaliniana. ¿Dónde nos encontramos en 2020?

IntroductionPresbyopia is the progressive and irreversible loss of accommodation due to aging. It is one of the main causes of loss of quality of life in people from 45 years of age, due to the, often novel, dependence on spectacles. The eagerness to correct it by ophthalmologists impulsed by the desire of millions of people who suffer from it, has become one of the main drivers for the development of intraocular lens (IOL) technology over the last twenty years.Material and methodsThis review briefly presents the different alternatives that have allowed us to improve the crystalline lens surgical approach of presbyopia; from monofocal lenses and monovision technique, accommodative, refractive, and diffractive multifocal lenses, and finally the most recent extended depth of focus/field lenses known as EDOFs.ResultsEach IOL has its advantages, limitations and disadvantages. Furthermore, there is no single lens that suits the needs of all patients.ConclusionsIt is necessary to know the variety of lenses available, and to have an in-depth understanding of their optical properties, as well as the impact that these will have later on their clinical performance and on the visual quality of the patients. This should help us to select the best alternative for each of them.     

Hematoma endocapsular: complicación inusual tras facoemulsificación y esclerectomía profunda no perforante

Case reportA 68-year-old male with a cataract and uncontrolled primary open angle glaucoma with maximal tolerated medication underwent non-penetrating deep sclerectomy combined with phacoemulsification surgery in right eye. There were no complications during the procedure, but shortly after the surgery, he lost visual acuity after a Valsalva manoeuvre due to an endocapsular haematoma. Neodymium:YAG laser posterior capsulotomy was performed for the treatment of an unresolving endocapsular haemorrhage at the third month of the follow-up, with immediate visual improvement and optimal control of intraocular pressure.DiscussionTo the best of our knowledge, this is the first reported case of endocapsular haematoma as a complication of non-penetrating glaucoma surgery that has been successfully solved by a YAG capsulotomy.