重庆市永川地区50岁以上人群中青光眼患病率调查

目的 调查重庆市永川地区50岁以上人群中青光眼的患病率.方法 选取2005年4～6月采用分层整群随机抽样法在永川地区行青光眼调查.在该地区城区、近郊、远郊,抽取29个抽样自然村或居委会,每一位≥50岁受检者接受了问卷调查、视力和一般眼部检查外,以VanHerick法测量周边前房深度,用Perkins手持压平眼压计测量眼压,用直接眼底镜检查眼底,主要观察视乳头,包括杯/盘比,杯盘比差,横竖径,盘沿切迹及盘沿出血.结果 5938人完成了检查,受检率85.19%.青光眼的患病率为3.55%.其中原发性闭角性青光眼患病率为2.49%,且随年龄增加而增加,女性明显高于男性,文化程度低的明显高于文化程度高的,三者差异均有统计学意义.原发性开角型青光眼患病率为0.86%,继发性青光眼患病率为0.20%.在青光眼患者中,仅有2例双眼视力≥0.3,有209例有视功能损害.其中单眼低视力8例,双眼低视力4例,单眼肓168例,双眼盲29例.结论 重庆永川地区城乡人口中青光眼总患病率较1996年北京顺义地区高,原发性闭角型青光眼仍是该地区主要青光眼类型.青光眼患者的眼球摘除率和盲目率高,与永川地区经济和文化和教育程度等社会因素有关.通过筛查对前房≤1/4角膜厚度的人群密切随访或干预治疗可以降低青光眼的致盲率.     

自体角膜缘干细胞移植治疗翼状胬肉的临床分析

目的进一步评价自体角膜缘干细胞移植治疗翼状胬肉的临床效果.方法对89例128眼翼状胬肉患者,在切除胬肉后,用自身带角膜缘干细胞的结膜组织行移植术.结果 119眼在移植后3d内完全上皮化,角膜光滑透明;9眼在7d内恢复,留有云翳;62例随访2～46个月,有2例(3.2%)复发.结论自体角膜缘干细胞移植治疗翼状胬肉复发率低,术后角膜光泽度好,部分病例视力有所改善.     

Prevalence of Open-angle Glaucoma in Southwestern China: the Yongchuan Glaucoma Study简

This study examined the prevalence of primary open-angle glaucoma（POAG） among residents aged ≥50 years living in Yongchuan district of Chongqing. Stratified cluster sampling was employed in random selection to estimate the prevalence of glaucoma from April to June, 2005. Twenty-nine villages or neighborhood communities were randomly selected in urban area（Zhongshan Road）, suburban area（Shanjiao Town） and exurban area（Zhutuo Town） of this district. All the respondents underwent detailed ophthalmic examinations. The examinations included questionnaire investigation, visual acuity test, naked-eye examination, measurement of peripheral anterior chamber depth（Van Herrick＇s technique）, detection of intraocluar pressure（IOP） with a Perkins hand-held applanation tonometer（HA-2） and examination of the optic disc by using a 78 diopters（D） lens（including the cup-disc ratio, cup/disc ratio asymmetries, horizontal and vertical diameter, notching and optic disc hemorrhages）. A total of 5938 residents were actually examined, and the response rate was 85.19%. The crude prevalence of POAG was 0.86%（n=51/5938, 95% CI 0.64%–1.11%）. There were 24 males and 27 females in the glaucoma group. The glaucoma prevalence was not significant different in case number between the male and female subjects（P=0.4900）. Furthermore, no association between age or schooling and POAG was noted（P=0.8030, 0.0734）. Out of 51 subjects with POAG, unilateral glaucoma-related blindness occurred in 38 subjects（74.5%） and bilateral glaucoma-related blindness was found in 7 subjects（13.7%）. This study exhibited that the prevalence of POAG was 0.86% among residents aged ≥50 years living in Yongchuan District of Chongqing. The vision loss caused by POAG in this population was obviously higher than that previously reported in other studies. Glaucoma management, detection of affected persons and handling of the burden of glaucoma should be the priorities of the agenda of local health authorities of Western China.