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中国实用眼科杂志

中国实用眼科杂志

北大核心

CSCD

CSTPCD

Chinese Journal of Practical Ophthalmology
本刊是以瞄准国内外眼科先进技术理论的前题下，以提高我国第一线眼科工作者的理论水平、技术能力为目的，面向临床侧重实用，故深受我国眼科医生的欢迎，其发行量居我国18本眼科杂志的首位。2007年中华医学会与万方数据携手推动医药信息服务，该刊电子版已独家授权万方数据来实现其数字化服务推广。
  • 发文量：9097
  • 被引量：36248
  • H指数：3
  • 开始收录时间：1989,7(1)
  • CNKI综合因子：0.0
  • 维普期刊影响因子： 0.464
  • 万方期刊影响因子：0.79
  • 创刊时间：1983
  • 国内刊号/CN：21-1348/R
    国际刊号/ISSN：1006-4443
  • 发行周期：月刊
    邮发代号：8-169
  • 主管单位：中华人民共和国卫生部
    主办单位：中华医学会　中国医科大学
中国实用眼科杂志-联系信息
  • 主编：张忠志
  • 电话：024-83282622
  • 邮箱：cjpo@cmu.edu.cn
  • 地址：沈阳市和平区南京北街155号
  • 邮编：110001
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中国实用眼科杂志 >2018年第8期

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  • 摘要：儿童视神经炎是一种引起儿童的亚急性视力丧失的疾病.与成人相比,儿童视神经炎鉴别诊断则更进一步,神经影像学和血清学检查是必要的,以便排除感染或肿瘤的发展.目前治疗小儿视神经炎的方法是甲基泼尼松龙静脉注射3-5天,然后是口服皮质类固醇,避免复发.对于这种自限性疾病,儿童能否用高剂量皮质类固醇静滴治疗目前仍存在争议;但对于单、双眼严重视力丧失的儿童,这种治疗方法却是神经眼科标准.
  • 摘要：Objective To compare the effect of Travoprost and Timolol in treating patients with primary open angle glaucoma.Methods Using randomized,parallel group control study and choosing patients with primary open angle glaucoma (POAG),0.004％ Travoprost was applied once a day (7:00PM) in 58 patients of the experiment group and 0.5％ Timolol (7:00AM&7:00PM) in 30 patients of the control group for 1 year.Intraocular pressure (IOP),visual field and adverse reaction were observed.Results The IOP in the experiment group decreased 8.21±3.44mmHg and the visual field score reduced 0.45±1.10,the reduction in the control group was 5.44±l.78mmHg and the score increased 0.47±1.01.Visual field score of the two groups were stable.Conclusions Comparing with Timolol,Travoprost is more effective and stable in reducing IOP in patients with POAG.%目的 观察曲伏前列素与噻吗洛尔治疗原发性开角型青光眼的临床效果.方法 采用平行、随机对照研究.对2010年9月至2012年9月在昆明医科大学第一附属医院眼科使用0.004％曲伏前列素滴眼液1次/d (7:00PM)或0.5％马来酸噻吗洛尔滴眼液2次/d(7:00AM&7:00PM)治疗原发性开角型青光眼,入选有效的88例,随访监测1年,分别观察两组治疗前、后Goldmann眼压及视野的变化.结果 曲伏前列素组治疗1年眼压从(23.43±5.07) mm Hg降至(15.27±2.60)mm Hg,眼压平均降低(8.21±3.44) mm Hg,平均降压幅度为34.09％;噻吗洛尔组眼压从(23.84±3.78) mm Hg降至(18.47±2.61) mm Hg,眼压平均降低(5.44±1.78) mm Hg,平均降幅22.31％.曲伏前列素组视野评分平均降低(0.45±1.10)分;噻吗洛尔组评分平均升高(0.47±1.01)分,两组治疗前、后视野评分均维持稳定.结论 曲伏前列素、噻吗洛尔均可降低原发性开角型青光眼患者眼压,而前者降压效果更强、更稳定,同时停止或延缓视神经损伤,维持视野稳定.
  • 摘要：Objective To observe the course of myopization during 12 years schooldays.Methods A total of 5757 students in 4 primary schools and middle schools were examined.The collected data included object ophthalmic examinations,which were non-cycloplegic objective refraction,visual acuity,intraocular pressure,fundus evaluation,weight,height,and the special designed questionnaire investigation.The special designed inventory scale was filled in and input special computer program,then the data were statistically analyzed with SPSSll.0.Results The emmetropization shifted to myopization gradually during 12 years' schooldays,and from low myopia to moderate myopia continually.Myopization began at 7 years old and progressed to moderate degree at 18 years old with the-0.22D average increase per year.There were 2 slow-down periods at 13-and 16-year-old and 3 speed-up periods at 10-,15-,18-year-old.Conclusions Early onset myopization or over-emmetropization may guide our prediction of myopia,that is,enough hyperopia may buffer the myopic shift to reduce the myopic development.The ocular features of development and progression in schoolchildren implicate us to set up a concept of persistent control.For this purpose,we suggest a schoolchildren' classification of refractive error and set a predict formula and key point of myopia control.%目的 通过对在校中小学生包括小学1年级至高中3年级的12个年级近视患病率及程度构成比的变化趋势进行调查,观察在校学生近视化形成的自然病程.方法 采用自动验光仪(NIKON SPEEDY-K)对中小学生5757人(男生2978人,占51.7％,女生2779人,占48.3％.)动态眼屈光状态等指标进行采集,输入编辑的专项应用程序,用SPSSll.0软件行统计分析.结果 正视眼不断近视化,近视程度由轻度逐渐发展到中度.7岁进入近视化-0.78 D,高中三年时的平均-3.57 D达到中度近视水平.7～18岁12年间年近视化幅度为-0.22 D.学生的近视化年增长在13岁和16岁有2个缓进,在10岁、15岁和18岁有3个递增.女生先进入近视化,男生随之,最终在18岁趋于一致.右眼先进入近视化,左眼随之,最终在18岁趋于一致.结论 在校期间7～ 18岁的-3.0 D眼球近视化是正常青少年发育过程中眼球从22 mm到23 mm的1 mm增长结果,并不因为近距离阅读而增加.中国的过度近视化关键是青少年丧失了对其正常的缓冲补偿能力,即3～6岁间的+3.0 D远视缓冲和22.5 mm以内的眼轴程度控制.故而提出近视防控策略:(1)过度过早的眼球正视化指导近视的预测性,学龄前充足的远视缓冲可以减少近视形成.(2)儿童青少年近视的发育性、进行性的临床意义在于树立学龄期的12年持续对近视控制的观念,并提出儿童青少年屈光度的分类建议.(3)提出眼球屈光发育的“预测公式”和近视防控的“关键年龄点”.
  • 摘要：目的 了解河北省沧州市10～14岁学龄儿童干眼患病情况,并探讨干眼发病的相关危险因素.方法 横断面研究.2011年3月至2012年10月,沧州眼科医院在沧州市单纯随机抽取40所学校作为调查点,对约7万名五、六年级学龄儿童整群随机抽样,抽取调查对象3150人.所有受检者均接受干眼症状、眼表疾病指数问卷调查及体征检查.依据目前公认的国内于眼诊断标准进行诊断,采用t检验、Pearson卡方检验、Logistic回归分析法对数据进行统计.结果 共计3007人进入本次研究,应答率为95.46％.诊断为干眼的有858例,患病率为28.53％.其中男性489例,患病率为30.07％,女性369例,患病率为26.72％,男性高于女性.干眼组年龄、睑板腺功能分级、角结膜荧光染色均高于非干眼组;泪液分泌试验(Schirmer I test,SIT)、泪膜破裂时间(break-up time,BUT)均低于非于眼组(P＜0.05).干涩感、异物感、烧灼感、眼睑沉重感、分泌物多在干眼组与非干眼组差异有统计学意义(P＜0.05).干眼组眼表疾病指数评分总分高于非干眼组(t =-2.623,P=0.009).性别与挑食是干眼的危险因素(P＜0.05).结论 沧州市10～14岁学龄儿童干眼患病率很高,且男性高于女性.家庭和社会应引起足够重视,引导儿童用眼卫生,均衡饮食,预防干眼的发生.%Objective To obtain the data of the prevalence of dry eye in school children age of 10 to 14 years old in Cangzhou,Hebei,China.To investigate the relative risk factors of dry eye.Methods A cross-sectional study.From March 2011 to October 2012,40 schools including 70000 people of 5 and 6 grade school children were randomly selected as survey venues by Cangzhou Eye Hospital.Then,3150 people as the selected residents were enrolled,which was figured out through the random cluster sampling procedure.Every participant completed dry eye questionnaire,the ocular surface disease index (OSDI) and a series of examination.The diagnosis of dry eye was referred to the well-accepted domestic diagnostic criteria.The t test,Pearson 2 test and Logistic regression were used for analysis.Results Of 3007 residents finally took part in this study,and the inclusion ratio was 85.7％; 858 individuals,including 489 men and 369 women,were diagnosed as dry eye,and the prevalence rate was 28.53％.The prevalence of dry eye in the male (30.07％) was higher than that of female (26.72％).The age,Meibomian glands functional classification and Grading of corneal and conjunctival staining were higher in dry eye group.Meanwhile,the Schirmer I test (S I T) and break-up time (BUT) were lower in dry eye group (P ＜0.05).There were significant differences between dry eye group and non-dry eye group including sensation of dryness,foreign body sensation,burning sensation,eyelid heaviness,more secretions (P ＜0.05).The score of OSDI in dry eye children was significantly higher than that in non-dry eye individuals (t =-2.623,P =0.009).The relative risk factors of dry eye were gender and choosy in food.Conclusions The prevalence of dry eye is fairly high in school children age of 10 to 14 years old in Cangzhou,which in male is higher than that in the female.Family and community should pay sufficient attention to conduct children's eye health and prepare a balanced diet,to prevent the occurrence of dry eye.
  • 摘要：脉络膜新生血管(CNV)的形成是一种涉及到多个步骤的复杂病理过程,是导致中心视力丧失的最常见原因之一.近来的研究显示,将针对CNV不同发病机制的方法联合应用可获得较好地治疗效果.联合治疗的形式主要有光动力疗法(PDT)联合抗血管内皮生长因子(VEGF)药物、PDT联合曲安奈德(TA)、抗VEGF联合TA、PDT联合抗VEGF和抗炎治疗的三联及多联疗法等.研究的趋势是探讨联合治疗的利弊,弥补单独使用一种方法的不足,以求得最大疗效及减少治疗的并发症.
  • 摘要：Sturge-Weber综合征(Sturge-Weber syndrome,SWS),即脑三叉神经血管瘤病,是一种罕见的包括皮肤、眼和脑血管畸形的先天性神经皮肤综合征,眼部表现为单侧的继发性开角型青光眼,眼底孤立性或弥漫性脉络膜血管瘤,继发性视网膜脱离,继发性色素上皮病变等.伴发青光眼是SWS的一个主要特征,现就SWS病因与发病机制的基础研究、眼部合并症的发病机制、眼部临床特征与治疗进展进行概述.
  • 摘要：线粒体是真核细胞中一种重要的细胞器,通过氧化呼吸作用提供细胞生命活动所需的能量,同时与人体内的氧化应激、细胞凋亡等有关,具有自身的遗传物质和遗传体系.线粒体在耗能较高的器官中有广泛分布,视网膜和视神经含有丰富的线粒体,为视觉信号传导和细胞内物质运输提供所必需的能量.由于线粒体自身的结构和功能特点,若线粒体出现异常,如线粒体DNA突变、呼吸功能异常、ATP合成障碍、参与氧化应激、诱导细胞凋亡等,将引起多种视神经相关疾病,如Leber病,常染色体显性视神经萎缩,青光眼和视神经炎等.了解与线粒体相关的致病机制有助于更精确的临床诊断,同时也可以为各种视神经疾病的治疗提供新的方向.
  • 摘要：目的 探讨糖尿病周围神经病变(diabetic peripheral neurpathy,DPN)患者视网膜神经纤维层(retinal nerve fiber layer,RNFL)厚度的变化.方法 临床病例对照研究.选取2012年3～9月在河南大学淮河医院临床诊断为DPN的2型糖尿病患者112例分为无视网膜病变组(NDR) 61例及合并轻、中度非增殖性糖尿病视网膜病变组(NPDR) 51例,按CSS(cfinical scoring system)评分将DPN患者分为轻度41例、中度38例和重度33例三组,对照组为排除DPN和DR的2型糖尿病患者48例;应用傅立叶域光学相干断层扫描仪进行以视盘中点为圆心,直径为3.45 mm圆周的RNFL厚度的测量,测量参数包括:视盘圆周平均,颞侧、上方、鼻侧和下方RNFL厚度,分析各组间RNFL厚度的差异.结果 DPN患者视盘圆周平均和下象限RNFL厚度较对照组明显下降;NPDR组、NDR组和对照组三组比较各象限RNFL厚度下降;NDR组和对照组比较视盘圆周平均值和下象限RNFL厚度下降,NPDR组和NDR组比较视盘圆周平均值,上象限和下象限RNFL厚度值均变薄;DPN患者轻、中、重度三组比较各象限RNFL厚度明显变薄;重度组和中度组及重度组和轻度组之间比较各象限RNFL厚度均明显下降.结论 DPN患者在出现DR之前就已经出现RNFL的变薄,并随着DR的出现RNFL厚度进一步降低;随着DPN病情的加重,RNFL厚度呈进行性下降.%Objective To investigate retinal nerve fiber layer (RNFL) thickness changes using fourier domain optical coherence tomography (OCT) in patients with diabetic peripheral neuropathy (DPN).Methods One hundred and twelve cases with DPN diagnosed with type 2 diabetes were included in NDR group (61 cases) and NPDR group (51 cases).According the Clinical Scoring System (CSS),all patients were divided into mild group (41 cases),moderate group (38 cases) and severe group (33 cases).The control group included 48 patients with type 2 diabetes but non-DPN and NDR.The RNFL thickness was measured with fourier domain OCT.Each subject had circular scans around the optic nerve with a circle size of 3.45mm.The measuring parameter included the RNFL thickness of the temporal,superior,nasal,inferior quadrant and the mean of the whole layer.The RNFL thickness in different group was analyzed.Results The RNFL thickness of the mean and inferior quadrant in DPN group was descended obviously compared with the control group; Compared with the NPDR group,NDR group and the control group,the RNFL thickness of each quadrant were descended significantly.In NPDR group,the RNFL thickness of mean and inferior quadrant was significantly descended than that of the control group.In NPDR group the RNFL thickness of mean,superior and inferior quadrant were thinner than that in NDR group.In DPN cases,compared with mild group,moderate group and severe group,the RNFL thickness of each quadrant became thinner significantly.The RNFL thickness of each quadrant in severe group descended more significantly than that in mild group and moderate group.Conclusions The RNFL thickness become thinner before DR in DPN patients,and will reduce more significantly following the emerging of DR.Along with the aggravating of the DPN,the RNFL thickness descend progressively.
  • 摘要：Objective To explore for surgery control of concurrent malignant glaucoma.Methods A retrospective study was set up for operative treatment of 32 patients (41 eyes) who suffered from angle-closure glaucoma with short axial length and shallow anterior chamber.Results Visual acuity had no significant difference between before and after surgery (P ＞0.05).There was statistical difference between the IOP before treatment (34.61±7.42mmHg) and after treatment (13.20±2.22mmHg)(P ＜0.01).The depth of anterior chamber also had no significant difference between before and after surgery (Z =-0.108,P ＞0.05).Conclusions According to short optic axis and shallow anterior chamber of primary angle-closure glaucoma patients,given anterior chamber gas injection,atropine eye ointment and glucocorticoids application preventively,can effectively control the occurrence of malignant glaucoma.%目的 探讨手术控制恶性青光眼风险的经验体会.方法 对临床收治的32例41只眼眼轴短、前房浅的原发闭角型青光眼患者,抗青光眼手术降低恶性青光眼风险进行回顾性分析.结果 手术前后视力差异无统计学意义(P＞0.05);眼压术前术后比较具有统计学意义(t =19.40,P＜0.01),术前眼压平均为(34.61±7.42) mm Hg,术后第7天平均(13.20±2.22) mm Hg.前房深度术前术后无明显变化,无统计学意义(P＞0.05).结论 针对眼轴短、前房浅的原发闭角型青光眼患者,预防性地给予前房注气,术毕阿托品眼膏和糖皮质激素的应用,能有效控制恶性青光眼的发生.
  • 摘要：Objective To study the clinical observation of removal of the necrotic corneal tissue combined with conjunctival flap covering surgery in treatment of deep corneal ulcer caused by herpes simplex virus.Methods A retrospective study was done to 20 patients (20 eyes) who had accepted removal of the necrotic corneal tissue combined with conjunctival flap covering surgery for deep corneal ulcer caused by herpes simplex virus.Antiviral therapy was applied more than one month for all patients after the surgery.The follow-up visit ranges from 5 to 20 months to observe the curative effect.Results Sixteen patients had success done with the surgery; the corneal ulcer was not enlarge and healing after operation.Fore cases were failed to keep the eyeball.Conclusions It is safe and effective to perform removal of the necrotic corneal tissue combined with conjunctival flap covering surgery in treatment of deep corneal ulcer caused by herpes simplex virus.%目的 观察病灶切除联合结膜瓣遮盖术治疗单纯疱疹病毒性深层角膜溃疡的治疗效果.方法 回顾性分析行病灶切除联合结膜瓣遮盖术的单纯疱疹病毒性深层角膜溃疡患者20例(20只眼),对上述患者行病灶清除+结膜瓣遮盖术治疗,彻底切除病灶,依病灶大小自患眼角膜上方切取游离结膜瓣或带蒂结膜瓣缝合于植床,术后针对原发病进一步进行抗病毒治疗1月以上,并随访5～20月不等,观察疗效.结果 20例中16例控制了炎症,治愈角膜溃疡,4例失败.结论 病灶切除联合结膜瓣遮盖术可以为单纯疱疹病毒性深层角膜溃疡提供较好地治疗手段.
  • 摘要：Objective To discuss the necessity and possibility of rebuilding the capsule bag in children with aphakia eye who need secondary intraocular lens (IOL) implantation.Methods Retrospective analyzed 196 aphakic eyes of 110 children who experienced secondary IOL implantation.All the patients implanted the IOL under general anesthesia,groupA was 108 eyes of 60 patients,the technical of rebuilding the capsule bag was used and the IOL was implanted in the capsule bag,group B were 88 eyes of 50 patients,the IOL implanted in the ciliary groove.All the patients were implanted acrylic three-piece IOL (SensarAR40e:America AMO).The visual outcome and complication in early (1 day to 1 month post-operation),middle (1 month to 3 months post-operation) and later (3 to 12 months) stage of post-operation were observed.Results The visual outcome:all the patients had increased the vision after lyear post-operation.Group A,all the eyes had increased the vision to equal or more than 3 Snellen lines.Group B 70％ of patients had increased the vision to equal or more than 3 snellen lines.There was significant changes between the two group (u=6.158,P ＜0.05).The complication in early stage post-operation:formation of exudation lemma in the anterior chamber 2 eyes in the group A,and 12 eyes in the group B.The difference was statistically significant (x2=8.453,P ＜0.005).Pupil retardancy glaucoma had not happened in the group A but happened 2 eyes in the group B.The difference was statistically significant.The complication in middle stage post-operation:exudation membrane in the anterior chamber observed 1 eye in the group A and 10 eyes in the group B,The difference was statistically significant (x2=8.099,P ＜0.005).Pupil retardancy glaucoma was happened no eye in the group A but happened 2 eyes in the group B.The difference was statistically significant.The complication in later stage post-operation:formation of exudation membrane in the anterior chamber 1 eye in the group A and 8 eyes in the group B.The difference was statistically significant (x2=5.633,P ＜0.025).The IOL transposition occurred 0 eye in the group A and 6 eyes in the group B.The difference was statistically significant.Conclusions The application of rebuilding the capsule bag in children with aphakic eye can not only make the IOL implanted in the capsule bag,but also can decrease the complication of post-operation%目的 探讨在儿童无晶状体眼二期人工晶状体植入术中应用囊袋重建术的可能性及必要性.方法 回顾性临床病例对照研究.对2007年10月至2011年8月在邢台市眼科医院就诊的儿童无晶状体眼二期人工晶状体植入110例196只眼,均在全麻下行二期人工晶状体植入,其中A组采用囊袋重建术行人工晶状体囊袋内植入60例108只眼.B组直接行人工晶状体睫状沟植入50例88只眼.所有患者均植入AMO公司Sensar三片式人工晶状体.观察术后视力及术后早期(1天至1月)、中期(1～3月)、晚期(3～12月)并发症等情况.结果 (1)术后视力:所有患儿术后一年视力均有不同程度的提高.A组100％患儿视力提高≥3行,B组70％患儿视力提高≥3行,差异有统计学意义(u值=6.158,P＜0.05).(2)术后早期并发症:A组前房渗出膜2只眼,B组前房渗出膜12只眼,差异有统计学意义(x2值=8.453,P＜0.005).A组瞳孔阻滞继发青光眼0只眼,B组瞳孔阻滞继发青光眼6只眼.(3)术后中期并发症:A组前房渗出膜1只眼,B组前房渗出膜10只眼,差异有统计学意义(x2值=8.099,P＜0.005).A组瞳孔阻滞继发青光眼0只眼,B组瞳孔阻滞继发青光眼2只眼,差异有统计学意义.(4)术后晚期并发症:A组前房渗出膜1只眼,B组前房渗出膜8只眼,差异有统计学意义(x2值=5.633,P＜0.025);A组人工晶状体移位0只眼,B组人工晶状体移位6只眼,差异有统计学意义.结论 应用囊袋重建术可以使儿童无晶状体眼二期人工晶状体囊袋内植入并可以有效减少术后并发症.
  • 摘要：Objective To observe and evaluate the effect of S-Curve design for orthokeratology on correction of refractive error for adolescents with high myopia (-6.00D＜equivalent sphere lens≤-8.00D) and low corneal curvature (39.00D≤flat K＜41.00D).Methods In this study,90 teenagers (90 eyes) with myopia were included.They were divided into three groups,high myopia group (30 eyes),low corneal curvature group (30 eyes) and general design for orthokeratology group (30 eyes).High myopia group and low corneal curvature group were corrected by S-Curve design for orthokeratology,general design for orthokeratology group were corrected by general design for orthokeratology.All patients were fitted with overnight orthokeratology for 8-10h.UCVA,diopter,corneal curvature,axial length (AL) were measured at pre-wear and 1 day,1 week,1 month,3 months,6 months after orthokeratology.Data were analyzed with a paired t test and randomized block ANOVA.Results UCVA of three groups increased significantly at 6-month visit (t =2.012,t =3.134,t =4.221; P ＜0.01),general design for orthokeratology group became stable after 1-month lens wearing,the other two groups got stable UCVA at 3-month following.Refraction (equivalent sphere lens) of all wearers decreased at 1-week visit (t =5.053,t =7.235,t =8.123; P ＜0.01),general design for orthokeratology group decreased more quickly.Corneal curvature of all wearers decreased at 1-week visit (t =5.245,t =14.332,t =11.223; P ＜0.01),general design for orthokeratology group decreased fastest within the first week and almost did not change after l-month lens wearing.High myopia group and low corneal curvature group decreased fastest within the first month and reached the stable level at 3-month visit.The changes of AL did not show significant differences among three groups at 6 months after wearing orthokeratology lenses (F =52.123,P ＞0.05).Conclusions S-Curve design for orthokeratology can correct myopia and reduce myopia progression for adolescents with high myopia and low corneal curvature effectively and safely.%目的 观察并探讨S型角膜塑形镜对近视度数高(-6.00 D＜等效球镜≤-8.00 D)和角膜曲率低(39.00 D≤平坦K＜41.00 D)的青少年近视矫正和控制的临床效果.方法 将青少年近视患者90例(90只眼)分为高度近视组30例(30只眼)、低角膜曲率组30例(30只眼)和常规型角膜塑形镜矫正组30例(30只眼).高度近视组和低角膜曲率组配戴S型角膜塑形镜,常规矫正组配戴普通设计的角膜塑形镜,夜间戴镜8～10 h.观察戴镜后1d,1周,1个月,3个月,6个月患者裸眼视力(UCVA)、屈光度、角膜曲率和眼轴长度的变化情况.对相关数据进行配对样本t检验和随机区组方差分析.结果 三组患者戴镜6个月UCVA比戴镜前均显著提高(t=2.012、3.134、4.221;P均＜0.01),常规矫正组戴镜1个月视力达到稳定,高度近视组和低角膜曲率组戴镜3个月视力达到稳定.三组患者戴镜1周屈光度(等效球镜)均比戴镜前降低,差异有统计学意义(t =5.053、7.235、8.123;P均＜0.01),第1周内常规矫正组比高度近视组和低角膜曲率组屈光度降低快.三组患者戴镜1周角膜曲率均比戴镜前降低(t =5.245、14.332、11.223;P均＜0.01),常规矫正组戴镜第1周内下降最快,1个月后变化趋于稳定,高度近视组和低角膜曲率组戴镜1个月内下降最快,3个月后趋于稳定.三组患者戴镜6个月时眼轴长度的改变量之间差异无统计学意义(F =52.123,P＞0.05).结论 S型角膜塑形镜能够安全有效地矫正高度近视和低角膜曲率青少年的近视状态,并能够在一定程度上控制近视进展.
  • 摘要：Objective To investigate the postoperative vision in idiopathic epiretinal macular membranes (IEM),and its influencing factors.Methods A retrospective interventional case series of 76 eyes in 68 patients with IEM.All patients underwent micro-invasive vitrectomy with peeling off of the epiretinal macular membrane.All the patients had underwent the examinations of best corrected visual acuity (BCVA),slit lamp microscope,direct ophthalmoscope,binocular indirect ophthalmoscope,optical coherence tomography (OCT) and underwent 3-port pars plana vitrectomy using 23-guage instrumentation and 25-gauge infusion.Follow-up duration varied from 6 to 36 months,with the mean of (6.9+4.3) months.The multiple factors related with age,course,preoperative best-corrected visual acuity (BCVA),preoperative mean central macular thickness (CMT),internal limit membrane peeling technique,triamcinolone-assisted internal limiting membrane peeling technique and the integrity of the IS/OS junction were analyzed.Logistic regression analysis was performed to predict the prognosis of visual acuity.Results The postoperative visual acuity was improved in 52 eyes (68.4％),decreased in 24 eyes (31.6％).No ocular complications such as fundus hemorrhage,low or high intraocular pressure,endophthalmitis were found.The course,preoperative BCVA (r =0.793,P =0.008),preoperative CMT (r =0.979,P =0.011) and the photoreceptor inner and outer segment (IS/OS) junction line continuity (r =1.358,P =0.010) were closely related to visual prognosis.Conclusions The effect of surgery on the treatment of IEM determined by several factors.The course,BCVA,preoperative CMT and photoreceptor defects,were present in patients with IEM.Estimation of those changes may be an important prognostic factor in cases of epiretinal membranes.And the integrity of the IS/OS junction reading is closely related to patients' visual acuity.%目的 探讨特发性黄斑前膜(IEM)患者微创玻璃体切割术后视力预后的影响因素.方法 回顾性连续性病例研究.回顾性分析68例(76只眼)IEM患者的临床资料.患者均行BCVA、眼压、裂隙灯联合前置镜双目间接眼底镜检查、眼底照相及SD-OCT眼底扫描检查,并均采用23G联合25G经结膜无缝合微创玻璃体切割手术治疗,剥除视网膜前膜.手术后随访6～24个月,平均随访时间(6.9±4.3)个月.采用多因素Logistic回归分析法分析年龄、病程、术前最佳矫正视力、术前黄斑中心凹平均厚度、术前感光细胞层内外节(IS/0S)是否连续、术中是否剥除内界膜、术中是否曲安奈德染色等因素对视力预后的影响.结果 视力提高52只眼,占68.4％;未提高24只眼,占31.6％.随访期间,所有患者均未发生眼底出血、低眼压、高眼压、眼内炎等并发症.多因素Logistic回归分析显示,病程(r =0.793,P=0.008)、手术前黄斑中心凹平均厚度(r=0.979,P=0.011)及术前IS/OS连续状态(r=1.358,P=0.010)与视力预后密切相关.结论 特发性黄斑前膜的手术疗效受多种因素的影响,病程、术前最佳矫正视力、术前黄斑中心凹平均厚度、术前感光细胞层内外节(IS/0S)是否连续是影响玻璃体视网膜手术治疗视力预后的重要因素.其中感光细胞层IS/0S状态关系与预后关系更为密切,可作为良好评判指标.
  • 摘要：眼部新生血管性疾病常继发于各种眼部疾病,其形成不仅给治疗带来困难,而且严重影响患者的预后.目前,关于眼部新生血管性疾病的形成机制尚不十分清楚,而神经轴突导向因子Ne-trins在眼部新生血管性疾病方面的作用尚未引起重视,现将神经轴突导向因子Netrins及相关受体在眼部新生血管性疾病中的研究进展做一综述,为进一步研究眼部新生血管性疾病的形成机制提供参考.
  • 摘要：Objective To discuss the clinical effect of Puncture of Posterior Chamber Central Canal of Stilling in the treatment of Infusion Misdirection Syndrome.Methods Twelve patients with Infusion Misdirection Syndrome received the treatment of puncture of posterior chamber central canal of stilling (0.15-0.3ml) instantly,which reduced the perfusate pressure and adjust the perfusate afflux appropriately in the phacoemulsification and small-incision non-phacoemulsifiation for cataract or transparent lens (Hereinafter referred to as lens surgery).The successful rate of extracted fluid,the frequency needed of extracted fluid,the effect of pressure reducing and some possible complications were observed.Results Although all of the 12 patients had low posterior chamber pressure and high anterior chamber volume,their lens surgery were fulfilled successfully after puncture of posterior chamber central canal of stilling 1～4 times (2.58 times in average) and without any serious complications such as intraocular hemorrhage,retinal detachment and so on.Conclusions For the lens surgery patients having infusion misdirection syndrome,puncture of posterior chamber central canal of stilling is a safe,effective,convenient,easy emergency treatment measure.It is worthy of clinical trial.%目的 探讨后房玻璃体中央管穿刺在灌注液迷流综合征中的应用效果.方法 对在白内障或透明晶状体超声乳化或手法小切口摘除联合人工晶状体植入手术(以下简称晶状体手术)中遇到的12例灌注液迷流综合征患者,即刻给予后房玻璃体中央管穿刺抽液0.15～0.30ml,并酌情降低灌注液压力、调整灌注液流向.观察其液体抽取成功率、需抽取液体次数、降压效果,以及可能发生的并发症等.结果 12例患者均经1～4次(平均2.58次)后房玻璃体中央管穿刺抽液得以继续在低后房压力、高前房容积情形下顺利完成晶状体手术,未见眼内出血、视网膜脱离等严重并发症发生.结论 对在晶状体手术中发生的灌注液迷流综合征患者,后房玻璃体中央管穿刺不失是一种安全、有效、快捷、简便地处理措施,值得临床推广试用.
  • 摘要：目的 评价Eyesi模拟操作系统对培训白内障超声乳化手术连续环形撕囊技术水平提高方面的作用.方法 实验研究.选取住院医师24名,随机分为2组,分别进行2h模拟操作手术钳夹持任务或2h的模拟操作系统撕囊模块训练.随后进行共12次模拟撕囊测试,系统会自动提供每次操作所用时间、周围组织损伤程度、囊口位置、形态和大小的评价以及操作时失误评估,将两组测试结果进行比较.结果 完成效果等级评价在每个任务和总体的统计上,两组间的差异均有统计学意义.而撕囊评价得分和撕囊所用时间的比较方面,在任务1,两组间差异比较均没有统计学意义,任务2和任务3的两组间差异比较均有统计学意义.撕囊成功率两组间比较,差异没有统计学意义.结论 Eyesi模拟操作系统培训能够有效提高被培训者白内障超声乳化手术连续环形撕囊的技术水平.%Objective To evaluate the effectiveness of the Eyesi simulator system in promoting the continuous circular capsulorhexis (CCC) skill level of the trainers in the phacoemulsification procedure.Methods An experimental study.Twenty-four residents were randomly divided into two groups; one group was designed to perform the forceps module,while the other group was designed to perform the CCC module.After that,the residents were assigned to 3 tasks,totally 12 times of CCC tests.The system would automatically evaluate the time of each procedure,the injury of the surrounding tissue,the location,form and size of the capsule and the mistakes during the procedure.Finally,results of the two groups were statistically compared.Results The difference between the two groups was statistically significant in the effects of grade evaluation.As for the score and time in CCC,there were no statistical significance between the two groups in task 1,but there were statistical significance differences in task 2 and 3.There was no statistical significance in the success rate of CCC.Conclusions The Eyesi simulator system can effectively promote the CCC skill level of the trainers in the phacoemulsification procedure.
  • 摘要：目的 探讨血清中甘油三脂与高密度脂蛋白(TG/HDL)比值与糖尿病视网膜病变之间的关系及临床意义.方法 临床病例对照研究.对2011年11月至2012年5月在郑州大学第一附属医院眼科就诊的131例内分泌科住院的2型糖尿病病人按眼底照相所见分为三组,其中非糖尿病视网膜病变组(NDR) 28例,非增值型糖尿病视网膜病变(NPDR)组85例,增值性糖尿病视网膜病变(PDR)18例.检测并评估总胆固醇(CHOL)、甘油三脂(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)及载脂蛋白A1 (APOPAl)、载脂蛋白B100 (APOB100)及TG/HDL值;及其他可能影响糖尿病视网膜病变进展的相关临床指标.结果 NDR组、NPDR组和PDR的TG/HDL值分别为(2.79±1.11)、(2.85±0.83)和(4.00±1.72),三组之间TG/HDL比值的差异有统计学意义(P ＜0.001),Logistic回归分析显示TG/HDL比值与糖尿病视网膜病变程度呈明显正相关(B=1.795,P=0.032).结论 TG/HDL比值可作为评估糖尿病视网膜病变的一个有效指标,有助于糖尿病视网膜病变的早期诊断和治疗.%Objective To investigate the relationship between serum triglyceride/high-density lipoprotein cholesterol (TG/HDL) ratio with Type 2 diabetic retinopathy and its clinical significance.Methods One hundred and thirty-one patients with Type 2 diabetes mellitus were divided into three groups according to their fundus condition,28 patients with no diabetic retinopathy (NDR),85 with non-proliferative diabetic retinopathy (NPDR),18 with proliferative diabetic retinopathy (PDR).Clinical parameters related to the progression of DR,including cholesterol triglycerides (TG),high-density lipoprotein cholesterol (HDL),LDL,and apolipoproteinAI (apoAI),apolipoproteinB (apoB),TG/HDL were determined and assessed.Results TG/HDL ratio was 2.79±1.11,2.85±0.83 and 4.00±1.72 in NDR,NPDR and PDR group respectively.Difference of TG/HDL ratio among the three groups were statistical significance (P ＜0.001).Logistic regression analysis showed a positive correlation displayed between TG/HDL ratio and DR (B =1.795,P =0.032).Conclusions TG/HDL ratio may be used as an effective indicator for the assessment and treatment of DR.
  • 摘要：Objective To explore the characteristics and application value of the infection of treponema pallidum among age-related cataract patients.Methods The age-related cataract patients hospitalized in Affiliated Hospital of Weifang Medical University in the period between Jan.2009 and Jan.2011 were undertaken.The first step was detecting the treponema pallidum antibodies of the patients by ELISA assay,and those positive samples were confirmed by TPPA.Then the serum,aqueous humor and tears of those confirmed positive were collected and tested by fluorescence quantitative PCR treponema pallidum DNA testing.Results Tewlve patients' treponema pallidum antibodies were positive among 54 patients' serum,and the positive rate was 3.26％,4 patients' were positive among 50 patients' aqueous humor,and 3 patients' among 46 patients' tears.The positive rate was 23.08％,8％ and 6.52％,respectively.There were significant difference among these three groups (x2=7.0021,P ＜0.05).But it showed no significant differences of positive rate of treponema pallidum DNA between aqueous humor and tears (x2=0.0141,P ＞0.05).Besides,the positive rate of treponema pallidum DNA in serum were significantly higher than that in aqueous humor and tears (x2=6.9854,P ＜0.05).Conclusions The age-related cataract patients with the infection of treponema pallidum perform recessive syphilis and latent syphilis mostly.And it is not the exact cause for uveitis after operation.%目的 探讨老年白内障患者梅毒螺旋体感染的特点及应用价值.方法 回顾性临床病例分析研究.选取潍坊医学院附属医院在2009年1月至2011年1月收治的老年白内障患者为研究对象,首先进行ELISA梅毒螺旋体抗体筛查,阳性标本进行TPPA确证,对确证阳性患者血清、房水与泪液进行荧光定量PCR梅毒螺旋体DNA检测.结果 在梅毒螺旋体抗体阳性老年白内障患者中,检测54例血清,梅毒螺旋体DNA12例阳性,阳性率23.08％;检测50例房水,梅毒螺旋体DNA阳性4例,阳性率8％;检测46例泪液,梅毒螺旋体DNA阳性3例,阳性率6.52％.抗体阳性老年白内障患者血清、房水与泪液梅毒螺旋体DNA检测阳性率差异有统计学意义(x2=7.0021,P＜0.05),房水与泪液梅毒螺旋体DNA阳性率差异无统计学意义(x2=0.0141,P＞0.05),血清梅毒螺旋体DNA阳性率明显高于房水与泪液(x2=6.9854,P＜0.05).结论 老年白内障患者梅毒螺旋体感染多表现为隐性梅毒或潜伏梅毒,不是术后出现葡萄膜炎的确切病因.
  • 摘要：Objective To observe the effect of using endoscope-assisted silicone tube double-passage intubation in anastomosis for lacrim · al canalicular laceration.Methods Twenty-seven cases (27 eyes) of traumatic lacrimal canalicular laceration,under operating microscope implementation of lacrimal duct anastomosis,using endoscope-assisted silicone tube for stent,silicone tube inserted through the lacrimal punctum using the double-passage model.Results Silicone tube was removed 3～ 6 months postoperative,eyelid shape remained normal.No obvious discomfort occurred.After 3 ～ 6 months followed-up,3 cases of lacrimal duct flushing was not free and clear tears overflowed,2 cases of lacrimal duct flowed but still with mild overflow tears,24 cases of lacrimal duct flow had no tears overflow.Conclusions Using endoscope-assisted silicone tube double-passage intubation in anastomosis for lacrimal canalicular laceration,to avoid the traditional silicone tube catheter anastomosis insufficiency,make the effect of lacrimal duct anastomosis more accurate and minimally invasive,is an ideal treatment of lacrimal canalicular laceration.%目的 观察内窥镜辅助下硅胶软管双路泪道插入法在泪小管断裂吻合术中的应用效果.方法 对27例(27只眼)外伤性泪小管断裂,在手术显微镜下实施泪小管断裂吻合术,内窥镜辅助下硅胶软管作支撑物,硅胶软管的一端自下泪小点插入,另一端自上泪小点插入.结果 术后3～6月拔除硅胶软管,眼睑外形保持正常,无明显不适.拔除硅胶软管后随访3～6个月,3例泪道冲洗不畅并有明显溢泪,2例泪道通畅但仍轻度溢泪,22例无溢泪且泪道通畅.结论 内窥镜辅助下硅胶管双路置人泪小管断裂吻合术治疗泪小管断裂,避免了传统硅胶管置管吻合术的不足,使泪小管吻合术的疗效更确切,且操作微创,将是治疗泪小管断裂伤较理想的方法.
  • 摘要：Objective To search for the characteristics of early congenital aniridic keratopathy (CAK) in corneal topography and thickness.Methods Twelve patients (24 eyes) with early CAK and 12 volunteers (24 eyes) were recruited in this clinical prospective and comparative series study.Instruments applied included the Orbscan IIZ Corneal Topography.Results In this study,there was no statistically significance between the two groups in ages,gender and axis length (P ＞0.05).Flat cornea (less than 41.5D) ratio and topography of the oval,irregular bow-shaped and irregular-shaped were increased significantly in patients with early CAK.There were statistically significance in the thinnest thickness of cornea,mean A,mean K,sim K,corneal thickness index (CTI),3.0mm Zone Irreg and 5.0mm Zone Irreg between the early CAK and control (P ＜0.05).A significant increase of pachymetry appeared in the early CAK group compared with the control group.There were no statistically significance in mean A and 3.0mm Zone Irreg in both groups (P ＞0.05).Conclusions The characteristic of early CAK in corneal topography is that corneal axial refractive power descend and corneal thickness decrease.%目的 先天性无虹膜(congenital aniridic keratopathy,CAK)是一种常见的常染色体显性遗传性眼病,文中研究通过对比观察CAK早期患者的角膜地形图,以了解此疾病角膜的形态及厚度变化特点.方法 采用前瞻性病例对照研究方法.对12名(24只眼)健康志愿者及12例(24只眼)临床确诊为CAK早期患者进行角膜地形图检查,并进行对比分析,了解CAK早期患者角膜地形图的参数改变特点.结果 两组在年龄、性别及眼轴长度上的差异无统计学意义(P值均＞0.05).在角膜前表面屈光力图形态上,CAK早期患者椭圆形、不规则蝴蝶结形和不规则形地形图的比例以及扁平角膜比例均明显升高.角膜地形图参数中,角膜最薄点厚度、角膜3 mm区屈率(mean K)、模拟角膜屈率(sim K)、角膜厚度指数(Corneal thickness index,CTI)、角膜3 mm区不规则性(3.0 mm Zone Irreg)及5 mm区不规则性(5.0 mm Zone Irreg)等在CAK组与正常对照组之间差异均有统计学意义(均P＜0.05);角膜3 mm区散光度数(mean A),模拟角膜散光度数(sim A)在CAK组与对照组之间差异无统计学意义(均P ＞0.05).与正常对照组相比,九个区域中的其他八个区域的平均角膜厚度明显增加.结论 CAK早期患者角膜的屈光力下降及厚度增加.
  • 摘要：目的 检测单核细胞趋化蛋白-1(MCP-1)在急性前葡萄膜炎(AAU)及小柳原田综合征(VKH)患者血清中的表达,探讨其在葡萄膜炎发病中的可能机制.方法 收集62例葡萄膜炎患者(AAU患者43例、VKH患者19例),14例正常对照组,提取血清.将AAU患者分为HLA-B27阳性组17例和HLA-B27阴性组26例;并将VKH患者就诊时是否已使用糖皮质激素治疗分为未使用激素组11例和已使用激素组8例.采用ELISA法检测各组血清中MCP-1的含量,对其进行统计分析.结果 AAU患者HLA-B27阳性组与阴性组血清中MCP-1浓度分别为(115.220±22.698)pg/ml、(102.210±38.689)pg/ml,与正常对照组血清MCP-1浓度(107.900±21.655) pg/ml比较差异无统计学意义(P＞0.05).未使用激素治疗的VKH患者外周血清中MCP-1含量(217.370±38.751) pg/ml较正常组显著增高(P＜0.05).激素治疗VKH组MCP-1含量(195.480±19.977) pg/ml略低于未治疗组(P ＞0.05),但仍高于正常组(P＜0.05).结论 与正常对照组比较,AAU患者血清MCP-1的表达无明显改变;而VKH患者血清MCP-1的表达上调,推测其可能参与了VKH的病理生理过程,全身使用糖皮质激素可能通过抑制MCP-1表达控制眼部炎症.%Objective To explore the effect of monocyte chemoattractant protein-1 (MCP-1) in uveitis pathogenetic mechanism by detecting the concentration of MCP-1 in serum of AAU and VKH.Methods Sixty-two patients suffered uveitis were collected (43 AAU patients,19 VKH patients),and 14 healthy individuals served as control group.Patients with AAU were divided into HLA-B27 (+) group and HLA-B27 (-) group.Meanwhile,patients with VKH were divided into two groups according to whether steroid was administered systematically or not (VKH patients who had administered steroid systematically (group A); patients without any systemic therapy of steroid (group B).The level of serum MCP-1 was detected by ELISA.Statistic analysis was performed to compare the difference between groups.Results Serum concentration of MCP-1 in HLA-B27 positive AAU,HLA-B27 negative AAU and control group were 115.220±22.698 pg/ml,102.210±38.689 pg/ml,107.900±21.655 pg/ml respectively,there were no significant difference among three groups (P ＞0.05).The concentration of MCP-1 in VKH group B (217.370±38.751 pg/ml) was much higher than that of control group (P ＞0.05).The concentration of MCP-1 in VKH group A (195.480±19.977 pg/ml) decreased slightly when compared with group B,but still higher than that of control group (P ＞0.05).Conclusions There is no change of the expression of MCP-1 in AAU.While the increased MCP-1 in VKH patient serum may participate in the pathogenesis of VKH,and steroid may suppress ocular inflammation by inhibiting the production of MCP-1.
  • 摘要：Objective To analyze the macroscopical shifting trends and laboratory diagnosis of pathogenic bacteria in fungal keratitis,to provide a dependable basis for the diagnosis and treatment of the disease.Methods This study retrospectively reviewed 530 cases that diagnosed as fungal keratitis in Tangshan ophthalmic hospital between 2008 and 2012,and statistic analyzed their smear Giemsa stain cytology,fungal culture.These data was compared by using chi-square test and percentages,and compared those with data in the period of 1999-2003.Its seasonal distribution of the disease was analyzed.Results Of 233 cases of fungal hyphae from the 530 samples were revealed,through Giemsa stained smear cytology examination,and the positive rate was 43.97％,and 296 cases of fungal culture was positive,the positive rate 55.84％.And the season of incidence focused on the 9-12 month,accounted for 60.6％.In 2008-2012 Fusarium species,No-spore species,Aspergillus,Altemaria species were the top four pathogens,respectively,accounted for 67.24％,19.26％,7.43％ and 5.07％ respectively.Conclusions Fungal keratitis cases need treatment in our hospital is increasing in recent 10 years.Smear staining method is a rapid diagnosis method of suspected fungal keratitis.Fusarium species is the major fungal pathogens in our area,accounting for 67.24％ and is always the first pathogen.Aspergillus species and no-spore species are uptrend,however Alternaria species decline.%目的 对真菌性角膜炎的病原菌变化及实验室诊断进行总结,为该病的诊断治疗提供可靠的依据.方法 分析2008～2012年5年间在唐山市眼科医院拟诊为真菌性角膜炎的病例530份,统计其涂片Giemsa染色细胞学检查及真菌培养阳性率,应用卡方检验和百分比统计方法,将这些资料与1999～2003年的材料进行比较,并分析其发病的季节性分布规律.结果 在530份标本中涂片Giemsa染色细胞学检查发现真菌菌丝233例,阳性率43.97％,真菌培养阳性296例,阳性率55.84％.且发病季节多集中于9～12月份,占60.6％.2008～2012年镰孢菌属、无孢菌属,曲霉菌属,链格孢菌属分别是前四位的致病菌属,各占:67.24％,19.26％,7.43％和5.07％.结论 近十年就诊的真菌性角膜炎患者呈增加趋势;涂片染色法是快速诊断可疑真菌性角膜炎的首选方法;镰孢菌属是我地区真菌性角膜炎的主要致病菌属,占67.24％;无孢菌属和曲霉菌属呈上升趋势,链格孢菌属呈下降趋势.
  • 摘要：目的 观察白内障超声乳化摘除联合折叠式人工晶状体植入术后前房角结构及眼压的变化.方法 临床病例对照研究.对2012年3～9月在宁夏医科大学总医院眼科选取具有正常前房深度、宽房角结构和浅前房、窄房角结构的白内障患者各30例(30只眼),均接受白内障超声乳化摘除联合人工晶状体植入术.使用超声生物显微镜(UBM)于术前及术后1个月、3个月对所有患者的前房角结构包括中央前房深度(ACD)、小梁虹膜夹角(TIA)、房角开放距离(AOD500)、小梁睫状体距离(TCPD)进行测量,同时进行前房角镜检查并记录眼压.对各项数据进行统计学分析.结果 手术后1个月、3个月,两组患者均较术前前房加深、房角加宽、眼压下降,差异有统计学意义(P＜0.05),其中,浅前房窄房角组患者各项指标较术前变化更为明显,差异有统计学意义(P＜0.05)；对两组患者术后1个月、3个月的各前房角参数及眼压进行组内比较,差异无统计学意义(P＞0.05).结论 超声乳化摘除联合折叠式人工晶状体植入术能明显加深前房、开放房角、降低眼压,并且术后前房角结构及眼压的变化于1月后趋于稳定,可作为治疗闭角型青光眼合并白内障的一种手术方法.%Objective To study the influence on anterior chamber angle structure and intraocular pressure (IOP) of phacoemulsification and intraocular lens implantation.Methods Phacoemulsification and intraocular lens implantation were performed in 60 eyes of 60 patients whom were divided into two groups:one group with shallow anterior chamber and narrow anterior chamber angle structure,another group with normal anterior chamber structure.All of the patients were measured values by ultrasound biomicroscopy (UBM) of ACD (anterior chamber distance),TIA (trabecular iris angle),AOD500 (angle-opening distance at 500μm from the scleral spur),and TCPD (Trabecular ciliary processes distance) at the time before surgery and 1 month and 3 months after surgery.The IOP was also recorded at the same time.Results In both groups,the measurements of ACD,AOD500,TIA and TCPD were increased significantly and the lOP was reduced significantly after the operation (P ＜0.05).The measurements and the IOP changed more significantly in the shallow anterior chamber group than in normal anterior chamber group (P ＜0.05).Comparing the measurements and the IOP one month after surgery with three months after surgery,there were no significant differences (P ＞0.05).Conclusions Phacoemulsification and foldable intraocular lens implantation can significantly deepen the anterior chamber,open the anterior chamber angle and reduce the IOP of the patients.So that it can avoid the occurrence of glaucoma and can be a surgery method of treating angle-closure glaucoma combined cataract patients.
  • 摘要：Objective To observe the clinical effect and safety of the coaxial 1.8mm micro incision cataract operation in treatment of complicated cataract after silicone oil infusion.Methods Thirty-six cases (36 eyes) of complicated cataract after silicone oil infusion in our hospital were randomly divided into two groups.Micro incision group:18 cases (18 eyes) received coaxial 1.8mm micro incisions for phacoemulsification combined with intraocular lens implantation operation; small incision group:18 cases (18 eyes) received traditional coaxial 3.0mm small incision phacoemulsification combined with intraocular lens implantation operation.Postoperative 1D,1 week,1 month,3 months follow-up,visual acuity,corneal topography,corneal endothelial cell count and complication was recorded.Results Postoperative visual acuity of the two groups was improved significantly.One week after operation,the best corrected visual acuity of micro incision group was increased than that of the small incision group,and there was significant difference between the two groups,(P ＜0.05); postoperative corneal topographic astigmatism in micro incision group less than in the small incision group,there was significant difference between the two groups (P ＜0.05); postoperative 1 D,corneal endothelial cell average density in micro incision group was higher than in the small incisiongroup and there was significant difference between the two groups (P ＜0.05).The two groups were successfully implanted intraocular lens without posterior capsular rupture of the membranes.After a follow-up of 3 months,2 cases with recurrent retinal detachment in the small incision group,and micro incision group did not occur.Conclusions The coaxial 1.8mm micro incision cataract operation in treatment of complicated cataract after silicone oil infusion is more safe and effective.It is worthy of clinical application.%目的 观察同轴1.8 mm微切口超声乳化白内障手术治疗硅油填充眼并发性白内障的临床效果和安全性.方法 选取硅油填充眼并发性白内障患者36例(36只眼),随机分为两组.微切口组:同轴1.8 mm微切口超声乳化白内障吸除联合人工晶状体植入手术18例(18只眼)；小切口组:传统同轴3.0 mm小切口超声乳化白内障吸除联合人工晶状体植入手术18例(18只眼)；术后ld、1周、1个月、3个月随访,观察视力,角膜地形图,角膜内皮细胞计数和手术中及术后并发症.结果 两组患者术后视力均明显提高,术后1周,微切口组的最佳矫正视力高于小切口组,两组间比较,差异有统计学意义(P＜0.05)；微切口组术后角膜地形图散光小于小切口组,两组间比较,差异有统计学意义(P＜0.05)；术后ld,微切口组角膜内皮细胞平均密度大于小切口组两组间比较,差异有统计学意义(P＜0.05).两组患者术眼手术顺利,无后囊膜破裂,均顺利植入人工晶状体；术后随访3个月,视网膜脱离复发者小切口组2例,微切口组未发生.结论 同轴1.8 mm微切口超声乳化白内障手术治疗硅油填充眼并发性白内障更安全有效,值得临床推广应用.
  • 摘要：Objective To study the clinical character and imaging feature of the epithelial tumors of lacrimal gland.Methods A retrospective study of the epithelial tumors of lacrimal gland was performed to investigate the histopathological feature,clinical and imaging data.Results The most common kind of benign tumor was pleomorphic adenoma 95.8％ (23/24),the top malignant tumors was adenoid cystic carcinoma 66.6％ (12/18).The main clinical manifestations of epithelial tumors of lacrimal gland were ocular proptosis,dyskinesia,malposition,diplopia,soreness and vision depression,but a different histopathological feature of the epithelial tumors of the lacrimal gland,the clinical character and imaging feature also distinct.Conclusions The benign and malignant epithelial tumors of lacirmal gland are both easy to relapse,it is important for primary diagnosis with combination of clinical and imaging appearances to development a reasonable surgical treatment options.%目的 研究泪腺上皮性肿瘤的临床特征和影像学表现.方法 收集近2年经病理确诊为泪腺上皮性肿瘤42例患者的石蜡切片标本,观察组织切片病理学特点,并结合患者的临床及影像学资料进行归纳分析,探讨不同类型泪腺上皮性肿瘤的组织病理学特点与临床表现及影像学表现之间的关系.结果 此组良性泪腺上皮性肿瘤中多形性腺瘤占95.8％ (23/24),最多见,恶性肿瘤以腺样囊性癌66.6％ (12/18)为多,共同的临床表现主要为眼球突出、眼球运动障碍、眼球移位、复视、疼痛、视力下降等,但肿瘤的组织病理学特点不同,其各自的临床特征及影像学表现也各异.结论 良恶性泪腺上皮性肿瘤均易复发,应该结合患者的临床特征及影像学检查综合分析,进而制定合理手术治疗方案.
  • 摘要：微小切口白内障手术的优点在于其组织损伤小,切口愈合快；引起的手术源性角膜散光更小,对角膜的像差变化影响也变小.但随着手术切口逐渐减小,临床手术操作中会面临手术方式的微小改变,尤其是撕囊方式的改进、手术器械及超声乳化机器的更新、人工晶状体的选择、硬核白内障的处理等新问题.所以,应该平衡手术切口与手术过程的安全性这一重要问题,依据病情及患者所采用的人工晶状体合理选择超声乳化方式.

    中国实用眼科杂志的期刊信息

    • 曾用名：实用眼科杂志
    • 创刊时间：1983
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    • 语言：中文
    • 热门主题：中华医学会;中国医科大学
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    • • 北大核心期刊（2011版）
    • • 中国科学引文数据库（2011-2012）
    • • 中国科学引文数据库（2013-2014）
    • • 日本科学技术振兴机构数据库

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