大规模白内障复明手术中同时行胬肉切除联合球结膜瓣转移手术的应用

目的:探讨大规模白内障复明手术中对合并翼状胬肉的患者同时施行胬肉切除联合球结膜瓣转移术的安全性和有效性。方法:对36例老年性白内障合并翼状胬肉的患者,使用前房维持器行小切口非超声乳化白内障摘除联合人工晶状体植入术,并行胬肉切除联合球结膜瓣移植,术后随访30～90(平均43.5)d。观察术后单纯球镜矫正视力、并发症、角膜愈合、角膜缘新生血管及球结膜是否有薄层胬肉样组织增生。结果:34例视力>0.3。角膜创面3～5d愈合,无1例胬肉复发,无新生血管生长及瘢痕组织增生现象。结论:防盲手术中对合并翼状胬肉的患者同时施行胬肉切除联合球结膜瓣转移术是安全和有效的。     

Can lubrication of the eyelid speculum reduce overall pain perception associated with cataract surgery by phacoemulsification performed under topical anesthesia?

Purpose:This study aimed to evaluate the effect of using the lubricated eyelid speculum on the overall pain perception by the subject patients who underwent cataract surgery by phacoemulsification technique under topical anesthesia.Methods:A prospective interventional randomized comparative study was conducted at the tertiary eye care center, wherein adult patients scheduled for bilateral cataract surgery with phacoemulsification techniques under topical anesthesia were randomized to undergo surgery with two different modes of eyelid speculum insertion, either with or without lubrication of the eyelid speculum. Fifty percent of the patients underwent surgery with eyelid speculum without lubrication, and 50% with lubrication of the eyelid speculum. The primary outcome was to compare the level of overall pain perception among the subject patients of the two groups by using the Visual Analogue Scale (VAS) in the immediate postoperative period.Results:The study included 130 patients who underwent bilateral cataract surgery (n = 260 eyes) under topical anesthesia, wherein n = 130 eyes underwent surgery using lubricated eyelid speculum and n = 130 eyes underwent surgery with dry eyelid speculum. Pain perception score assessed on the VAS (0–10 cm) ranged from 0.5 to 6, with a mean ± standard deviation of 2.06 ± 1.12. A significant correlation was found with two different methods of eyelid speculum insertion with reduced overall pain perception in patients with the use of lubricated eyelid speculum compared to the dry eyelid speculum (P = 0.0001).Conclusion:The overall pain perception associated with cataract surgery performed by phacoemulsification technique under topical anesthesia can be further minimized by lubricating the eyelid speculum prior to insertion for exposing the globe.     

Comparing surgical efficiencies between phacoemulsification systems: a single surgeon retrospective study of 2000 eyes

AIM: To compare under similar conditions intraoperative surgical efficiencies metrics between an active fluidics and a gravity based phacoemulsification systems. METHODS: Adult patients who were diagnosed with a cataract that compromised visual acuity inferior to 20/40 were included in the study. Patients were excluded from the study if they had a history of severe retinal disorders, clinically significant corneal endothelial dystrophy or history of corneal disease. All phacoemulsification surgeries were performed by a single surgeon. Both phacoemulsification systems used the 0.9 mm 45-degree aspiration bypass system Intrepid Balanced tip and the 0.9 mm Intrepid Ultra infusion sleeve. All cataracts were classified using the Lens Opacities Classification System III, cumulative dissipated energy (CDE) and aspiration fluids were measured in each surgery. RESULTS: Totally 2000 eyes were included in the study. Phacoemulsification was performed in 1000 (50%) eyes with an active fluid dynamics system and in 1000 (50%) eyes with a gravity-based fluidic system. Mean CDE until fracture of the lens was 1.1 and 1.9 percent-seconds and total mean CDE used was 5.6 and 7.2 percent-seconds using an active fluidics dynamics system and gravity-based fluidic system, respectively (P<0.001). Mean aspiration fluids used were 70 mL using an active fluidics dynamics system and 84 mL using a gravity-based fluidic system (P<0.001). CONCLUSION: This study evidences that surgeries performed under similar conditions (same surgeon, phaco tip and sleeve) with the active fluidics dynamics system required significantly lower CDE and aspiration fluids.     

Mitochondrial DNA in human hair shafts – existence of intra-individual differences?

The sequences of the hypervariable region 1 (HV1) of the mitochondrial DNA control region from multiple hair shafts from 10 unrelated individuals were compared to determine the frequency of differences in hairs from one individual. The extraction method described herein showed an average success rate of 67% for all 150 hair shafts tested in HV1. The mtDNA sequences from the hair shafts matched the sequences from the corresponding blood and saliva samples taken from the same donor and no evidence of heteroplasmy was found. The results emphasize the reliability of DNA extraction and mtDNA typing from human hair shafts for forensic purposes. Received: 16 July 1998 / Received in revised form: 31 August 1998     

高龄老年人白内障囊外摘出术30例临床分析

本文对30例（42眼）75岁以上高龄老年人白内障囊外摘出术的眼部手术与全身状况进行分析，其中80％以上息全身多系统疾病，以高血压病、冠心病为多。如果处理适当，均能承受手术。全部病例视力较术前改善。术后7～15d的矫正视力：≥0．3．14眼（33％）；0．05～＜0．3，23眼（55％）；＜0．05，5眼（12％）。随访半年～3年，部份视力稳定，大部份有所提高。眼部并发症不高于一般老年人。     

秃疮花提取物对红细胞氧化性溶血的抑制机制

目的探讨秃疮花提取物对鼠红细胞氧化性溶血的影响及其机理。方法以H2O2诱导体外鼠红细胞发生氧化性溶血,以乙酰苯肼引发小鼠体内溶血性贫血,观察不同浓度或剂量秃疮花对鼠红细胞溶血率,细胞形态、小鼠体内红细胞、白细胞数量,血红蛋白含量,血浆丙二醛含量,以及红细胞内各种抗氧化酶活性的影响,并分析其作用机理。结果外秃疮花提取物对H2O2诱导的鼠红细胞溶血的抑制率可达78%。小鼠腹腔注射秃疮花提取物后,与模型组比较,红细胞数目增加,血红蛋白含量提高,白细胞数目减少,血浆丙二醛含量降低,四项指标均接近正常组(腹腔注射DLF 1.5 g/(kg.d),红细胞数目为8.49×1012/L);损伤小鼠腹腔注射秃疮花提取物后,红细胞内超氧化物歧化酶活性和血浆总抗氧化力无明显改变,而过氧化氢酶和谷胱甘肽过氧化物酶的活性显著提高,葡萄糖6磷酸脱氢酶活性上升极显著(较损伤组提高44.7%)。结论秃疮花提取物在体内外可分别抑制由H2O2和乙酰苯肼引发的鼠红细胞氧化性溶血,效果明显。小鼠腹腔注射秃疮花提取物后,红细胞内抗氧化酶活性普遍提高,提示秃疮花提取物通过增强红细胞的自由基清除能力而使细胞膜免受氧化性损伤,其中葡萄糖6磷酸脱氢酶活性的上升尤为显著,据此推测秃疮花提取物有可能通过抑制乙酰苯肼对葡萄糖6磷酸脱氢酶的干扰而缓解鼠红细胞的氧化性溶血。     

Nd－YAG激光治疗后发障后高眼压分析

观察６０例以Ｎｄ－ＹＡＧ激光切开后发障术后急性高眼压患者。结果显示，激光术后ｌｈ眼压升高，３ｂ达高峰，２４ｈ大多数恢复正常。眼压升高程度与激光能量大小、射次，膜混浊程度及前房碎屑无明显相关。激光光波引起的色素膜反应可能是眼压急性升高的原因之一。     

A Randomized,Controlled Trial to Investigate the Effect of Ciclesonide and Beclomethasone Dipropionate on Eye Lens Opacity

Background. Inhaled corticosteroids (ICS) are recommended first-line therapy for the treatment of persistent asthma. However, reports from observational studies have suggested that the use of ICS may be associated with systemic adverse events, such as glaucoma and cataract (opacity of the lens) formation. Objective. To compare two ICS over 1 year regarding the formation/progression of lenticular opacities in patients with asthma. Methods. Adults (≥ 18 years of age) with moderate-to-severe asthma were randomized to ciclesonide 640 μ g/day (n = 785) or beclomethasone dipropionate 640 μ g/day (n = 783) in a multinational, double-blind, active-controlled, parallel-group study. The primary endpoint was the occurrence of a positive Class I grading shift (increase [worsening] in Lens Opacities Classification System [LOCS] III score of ≥ 0.5 for nuclear opalescence, ≥ 0.8 for cortical opacification, or ≥ 0.5 for posterior subcapsular opacification, or cataract surgery) in either eye at any visit over the 12-month, double-blind treatment period. Results. Mean changes (± standard error) in nuclear opalescence and cortical and posterior subcapsular opacification were small and similar between groups (ciclesonide 640 μ g/day: 0.10 ± 0.02, 0.07 ± 0.02 and 0.04 ± 0.01, respectively; beclomethasone dipropionate 640 μ g/day: 0.11 ± 0.02, 0.09 ± 0.02 and 0.03 ± 0.01, respectively). Class I shifts were observed in 34.3% versus 36.8% of ciclesonide-treated and beclomethasone dipropionate-treated patients, respectively. Ciclesonide 640 μ g/day was non-inferior to beclomethasone dipropionate 640 μ g/day regarding Class I shifts (risk ratio of ciclesonide to beclomethasone dipropionate, 0.940 [95% confidence interval, 0.820–1.077]); the 95% confidence interval upper bound was lower than the pre-specified non-inferiority bound of 1.333 (p < 0.0001), thereby excluding the possibility of higher risk ratio values. Conclusions. Mean changes in LOCS III scores were very small in both groups. Treatment with ciclesonide 640 μ g/day or beclomethasone dipropionate 640 μ g/day for 1 year has a minimal impact on lenticular opacities development and/or progression.