同轴微切口与传统小切口超声乳化术的临床疗效及术后并发症对比分析

目的　比较1.8 mm同轴微切口超声乳化术与传统同轴3.0 mm小切口超声乳化术的临床疗效及术后并发症。方法　收集2015年5月至10月北京同仁医院北京同仁眼科中心收治的老年性白内障患者48例（48眼），将患者分为微切口组和小切口组。微切口组主切口长1.8 mm，前房内注入透明质酸钠，行直径约为5.0 mm的中央连续环形撕囊，水分离后用劈核钩劈核，扭动模式超声乳化吸出术，自动灌注系统吸出残留皮质。小切口组角膜主切口大小为3.0 mm，术中植入常规折叠式人工晶状体。术后行裂隙灯、眼底镜以及角膜地形图检查，电脑验光检查患者最佳矫正视力。结果　术后1周、1个月、3个月两组患者最佳矫正视力比较，差异均无统计学意义（均为P>0.05）。术后1个月和3个月两组间手术源性散光比较，微切口组均明显低于小切口组，差异均有统计学意义（均为P<0.01）。在微切口组组内术后1个月和3个月手术源性散光无明显差异（P>0.05），微切口组手术源性散光在术后1个月保持稳定。在小切口组组内术后3个月手术源性散光明显低于术后1个月 （P<0.01）。微切口组术前角膜厚度为（567±27）μm，小切口组为（564±25）μm，两组差异无统计学意义（P>0.05）；术后1个月与3个月两组间角膜厚度变化差异亦均无统计学意义（均为P>0.05）。在随访期间两组患者均未发生后发性白内障。结论　1.8 mm同轴微切口白内障超声乳化吸出术安全可靠，术后散光恢复快，可有效减少术后角膜手术源性散光。     

Modified Scleral Flap Incision to Reduce Corneal Astigmatism after Intraocular Lens Implantation

To investigate a simple method during extracapsular cataract extraction with posterior chamber intraocular lens implantation in order to reduce surgically induced corneal astigmatism.Methods: A modified scleral flap incision was used in the extracapsular cataract extraction with intraocular lens implantation and the postoperative changes in conreal astigmatism was observed.Results: The peak value of postoperative corneal astigmatism was 3. 60 D, and the corneal astigmatism regression was 2. 11 D, surgically induced astigmatism was less significant in modified scleral flap incision group than that in conventional limbal incison group (P<0. 05).Conclusions: The modified scleral flap incision is an ideal incision for cataract extraction with intraocular lens implantation when phacoemulsifier is not available. Eye Science 1995; 11-. 136-139.     

RGPCL矫正60例中低度近视的初步观察

目的评价高透氧性硬性角膜接触镜(RGPCL)矫正控制中低度近视屈光不正的效果。方法采用RGPCL矫正120眼中低度近视性屈光不正,统计矫正后当天、1年时近视屈光度、散光度的变化。结果观察组的近视度和散光度随戴镜时间延长相对稳定。结论RGPCL对中低近视的度数控制有效。     

Proximity factor in image size magnification for optical instruments in general

A general expression is derived for the proximity factor in near image size magnification for an arbitrary instrument in front of an arbitrary eye. The proximity factor is a 2 x 2 matrix. The instrument and eye may be astigmatic and have decentred elements. The image on the retina may be blurred or not. The analysis is exact within the limitations of linear optics. The general results are specialized for the case of a stigmatic instrument and a stigmatic eye. The results are applied to the case of a thick, possibly bitoric, spectacle lens. The Appendix treats two numerical examples.     

Contact lens fitting following corneal graft surgery

Contact lens fitting may be required following keratoplasty for either optical or thera‐peutic reasons. Optical indications for contact lens fitting include the correction of irregular astigmatism, high regular astigmatism, anisometropia and secondary aniseikonia, as well as simple ametropia, where the patient desires to wear contact lenses in preference to spectacles. Therapeutic lenses are not routinely fitted following kerate plasty, although this management is advised in certain cases, such as when there are protruding sutures or epithelial healing is impaired. Designing a contact lens for a patient who has undergone keratoplasty will require the practitioner to carefully assess all the relevant features of the corneal graft. In this regard, there are many factors that need to be considered including the diameter of the graft zone, the topographical relationship between the host cornea and donor cornea, the corneal (graft) toricity and the location of the graft. Special designs, such as reverse geometry lenses, or more complex contact lens modalities, such as piggyback contact lens systems, may be required to achieve success in fitting.     

原发性肝细胞癌86例行不规则切除疗效分析

目的 :评价不规则切除术治疗原发性肝细胞癌 ( PHCC)的疗效。方法 :行不规则切除术治疗 PHCC86例。结果 :全组手术死亡 1例 ,1、3年生存率为 6 5例 ( 75 .6 % ) ,5 3例 ( 6 1.6 % )。 <3cm、3～ 5 cm、>5 cm的 1、3年生存率分别为 18例 ( 90 .0 % ) ,16例 ( 80 .0 % ) ,2 1例 ( 75 .0 % ) ,19例 ( 6 7.9% ) ;2 5例 ( 6 5 .8% ) ,18例 ( 4 7.4 % )。单纯手术组和手术加行肝动脉灌注 ( HAI)和门静脉灌注组 ( PVI)的 1、3年生存率分别为 72 .1%、6 0 .7% ,84 .0 %、6 8.0 %。结论 :采用不规则切除术对机体创伤小 ,减少了术后并发症的发生 ,其临床疗效与规则性肝切除相仿。对大肝癌不要轻易放弃手术 ,术后辅助治疗有待改善     

Necessary optimality conditions for a generalized problem of production scheduling

This communication concerns a derivation and study of necessary optimality conditions for production scheduling. The continuous-time optimal control problem is stated for the analysis of extremal behaviour of a flexible flow shop. This is accomplished by means of the maximum principle, which is applied to the problem with irregular constraints and three typical forms of objective function.     

准分子激光屈光性角膜切削术治疗近视和近视散光3年疗效分析

目的 :评价准分子激光角膜切削术 (photorefoactivekeratecomy ,PRK)治疗近视、近视散光的远期疗效。方法 :按术前屈光度将 2 0 9例 (3 77例 )屈光度为 - 1 5 0～ 1 6 0D的患者分为二组 ,低中度组 (I组 )为 - 1 5 0～ - 6 0 0D(2 3 8眼 ) ,高度组 (II组 )为 - 6 2 5～ - 1 6 0 0D(1 3 9眼 )。应用美国Visx2 0 /2 0准分子激光仪对上述二组患者行PRK治疗 ,并对患者术后 3年的屈光度、视力、角膜屈光力、角膜厚度、并发症进行随访观察。结果 :I组、II组中屈光度 <± 1D者分别占 94 5 %和 6 1 9% ;≥± 2 0 0D分别占 0 % ,2 3 7%。术后裸眼视力≥ 0 5者在I组、II组中分别占 99 6 %和 79 9% ;≥ 1 0者分别占 85 3 % ,48 2 %。角膜屈光力两组均在术后 6个月稳定 ,角膜上皮下雾状混浊O级在I组、II组分别为1 0 0 %和 98 6 % ,术后眼压两组均正常。结论 :准分子激光屈光性角膜切削术治疗近视、近视散光效果肯定 ,尤对低中度患者疗效更佳     

抗青光眼术后的白内障摘除术对角膜高度散光的矫正

目的：探讨抗青光眼术后的白内障摘除术根据术前角膜散光轴向选择不同位置切口对角膜高度散光的矫正效果。方法：伴有角膜高度散光的34例(34眼)抗青光眼术后行白内障囊外摘除加后房型人工晶状体植入术患者，根据术前角膜散光轴向选择白内障切口位置，同时保护原有滤过泡。观察术后1W、4W、12W和24W角膜散光度的变化情况。结果：术后1W、4W、12W、24W角膜散光度较术前降低，差异有显著性(P=0．003，0．010，0．(109，0．011)；术后1W、4W、12W和24W角膜散光度相比差异无显著性(P=0．121)。结论：抗青光眼术后的白内障摘除术选择不同位置切口所产生的手术性散光使切口方向上的屈光力减少，而使与其垂直轴向上屈光力增加，从而在一定程度上矫正术前角膜高度散光。