液氮冷冻疗法治疗老年性进行期白内障的疗效观察

背景:20世纪80年代初,作者用液氮治疗眼科疾病,在一次对翳状胬肉患者的治疗中,意外发现该患者同时患有的老年性白内障也明显好转,晶状体混浊基本消失。目的:探讨冷冻治疗老年性进行期白内障的疗效。设计:自身对照的研究。地点和对象:1985/1989长春中医学院附属医院眼科收治老年性进行期白内障患者274例518只眼,年龄40～50岁12例24眼,51～60岁106例209眼,61～70岁114例213眼,>70岁42例72眼。干预:治疗白内障冷冻穴位直径2mm,2/3在巩膜缘上,1/3在角膜缘上。治疗前患眼先以5g/L地卡因滴眼液点眼,作角结膜表面麻醉,冷冻5s,以穴位表现出白色冻斑为宜。冷冻后结膜有轻微充血,患者有轻微的胀痛感。可给予氯霉素眼药水点眼以预防感染。冷冻1次/周,5次为1个疗程,1个疗程后复查。主要观察指标:观察治疗前后患者晶状体的浑浊程度。结果:观察274例518只眼,显效190眼(36.68%,190/518);有效241眼(46.53%,241/518);无效87眼(16.80%,87/518),总有效率为83.20%。随访228例患者,随访0.5～3年337只眼,视力下降20眼;4～5年81眼,有8眼视力减退。结论:祛障穴冷冻疗法治疗老年性白内障,改善其视功能效果确实可靠。

Effect of liquidnitrogen cryotherapy in the treatment of progressive senile cataract

BACKGROUND: At the beginning of 1980s, the author used liquid nitrogen to treat ophthalmological diseases and accidentally found, in treating one case of pterygium, the lenticular opacity of a patient with also senile cataract showed obvious improvement after the treatment along with the visual acuity.OBJECTIVE: To explore the therapeutic effect of cryotherapy in treating progressive senile cataract.DESIGN: A self-controlled study was conducted.SETTING and PARTICIPANTS: Totally 274 patients(518 eyes) with progressive senile cataract hospitalized in the Department of Ophthalmology, the Affiliated Hospital of Changchun College of Traditional Chinese Medicine from 1985 to 1989 were enrolled in this study. Twelve patients(24 eyes) were 40 to 50 years old, 106 patients(209 eyes) 51 to 60 years old, 114 patients(213eyes) 61 to 70 years old, and 42 patients(72 eyes) over 70 years old.INTERVENTIONS: The acupuncture points for administration of the cryotherapy were located around the corneoscleral junction, measuring approximately 2 mm in diameter, 2/3 of which fell on the scleral limbus and the rest 1/3 on the corneal limbusAfter anesthesia with a few drops of 5 g/L dicaine, liquid hydrogen was delivered with the tip of a glass stick for freezing for 5 seconds until white spot appears. The cryotherapy was performed once a week for a total of 5 times as a treatment course. Chioramphenicol eyedrops were given to prevent infections after cryotherapy.MAIN OUTCOME MEASURES: The opacity in the patient' lens was observed before and after cryotherapy.RESULTS: Of the 518 eyes, the total efficiency was 83.20%, including 190 eyes(36.68%, 190/518) showing obvious effect, 241(46.35%,241/518) showing improvement, and 87(16.80%, 87/518) failing to respond. Follow-up study was conducted in the 228 cases after the treatment, including 337 eyes followed up for 0. 5 - 3 years of which visual acuity decreased in about 20 eyes, 81 eyes for 4 - 5 years of which visual acuity decreased in 8 eyes.CONCLUSION: Cryotherapy is safe and effective in treating progressive senile cataract.