论著

超脉冲C02激光治疗眼睑肿物的疗效与安全性评估

Efficacy and safety assessment of ultrapulse carbon dioxide laser in treating eyelid tumors

:541-550
 
目的:评估超脉冲二氧化碳(CO2)激光治疗不同类型眼睑肿物的疗效和安全性。方法:纳入50例眼睑肿物患者,其中男12例、女38例。患者年龄4~84岁。肿物类型包括眼睑色素痣、睑黄瘤、分裂痣、眼睑疣等,其中25例累及眼睑灰线,10例肿物直径>10 mm。所有患者接受超脉冲CO2激光治疗,并进行术后随访。治疗效果通过术后数码照片评估,同时记录术后1个月并发症发生情况。结果:50例眼睑肿物总体治愈率为92%,有效率达到100%。4例眼睑色素痣在治疗后1个月内复发。术后并发症主要包括轻微倒睫(5例)、睫毛稀疏部分缺失(4例)和瘢痕增生及色素沉着(4例),未出现其他严重并发症。结论:对于眼睑肿物,特别是睑缘肿物及大肿物,超脉冲CO2激光是一种更为精确、微创、安全有效的治疗方法,可作为眼睑肿物治疗的优选方案。
Objective: To evaluate the efficacy and safety of ultrapulse carbon dioxide (CO2) laser in the treatment for various types of eyelid tumors. Methods: A total of 50 patients, including 12 males and 38 females,with eyelid tumors were included in the study The age range is  from 4 to 84 years, with an average age of 37.9±20.0 years. The tumors found in our study include eyelid pigmented nevus, xanthelasma, divided nevus, and molluscum. Among them, 25 cases involved the gray line of the eyelid,and 10 cases had a tumor diameter greater than 10 mm. All patients underwent ultrapulse CO2 laser treatment and postoperative follow-up. The treatment outcomes were assessed through digital photos, and complications were recorded one month after surgery. Results: The total cure rate of the 50 cases of eyelid tumors in our study was 92%, with the effective rate reaching 100%. 4 cases of eyelid pigmented nevi recurred within one month after treatment, while all other patients were cured. Postoperative complications mainly included minor trichiasis (5 cases), partial sparse to absent eyelashes (4 cases), and hypertrophic scar with hyperpigmentation (4 cases). No other serious complications were reported in our study. Conclusions: For eyelid tumors, especially eyelid margin and larger tumors, the ultrapulse CO2 laser is a more precise, minimally invasive, safe and effective treatment method. It can be used as a preferred treatment option for eyelid tumors, and should be promoted widely in clinical practice.

论著

改良的“Z”形无线结经巩膜缝线固定后房型人工晶状体手术治疗先天性晶状体脱位的临床疗效评价

Clinical evaluation of modified "Z"-shaped knotless transscleral suture fixation posterior chamber intraocular lens surgery for Congenital ectopia lentis

:83-91
 
目的:通过对改良“Z”形无线结经巩膜缝线固定人工晶状体手术和传统有线结巩膜缝线固定人工晶状体手术治疗先天性晶状体脱位的比较来评价改良术式的临床疗效。方法:回顾性病例研究。纳入2018年1月—2021年3月期间于中山大学中山眼科中心行手术治疗的先天性晶状体脱位患者73例73眼,按手术方式不同将患者分为无线结组36例36眼和有线结组37例37眼。比较两组患者术前和术后1年的球镜度(DS)、柱镜度(DC)、等效球镜(SE)、最佳矫正视力(BCVA)、眼压(IOP)、眼轴长度(AL)、角膜内皮细胞计数和术后并发症的发生率。结果:两组患者术前各项观察指标组间比较差异无统计学意义(均P>0.05)。两组患者术后1年 BCVA 均较术前提高(均P<0.05),SE均较术前降低(均P<0.05)。两组患者术后1年 BCVA 、DS、DC、SE、IOP、AL、角膜内皮细胞丢失率组间比较差异均无统计学意义(均P>0.05)。术后1年,有线结组有5例(13.5%)出现缝线暴露,无线结组未出现缝线暴露,组间比较差异有统计学意义(P<0.05)。结论:改良无线结 IOL 巩膜缝线固定手术可改善CEL患者的最佳矫正视力和屈光不正,有效减少缝线暴露及相关并发症。
Objective: To evaluate the clinical efficacy of modified “Z”-shaped knotless transscleral suture fixation intraocular lens (IOL) and traditional knotted transscleral suture fixation IOL in congenital ectopia lentis. Methods: A retrospective case study. A total of 73 eyes of 73 patients with congenital ectopia lentis who underwent surgical treatment in our hospital from January 2018 to March 2021 were included. According to different surgical methods, the patients were divided into the knotless group (36 eyes) and knotted group (37 eyes). Preoperative and postoperative of 1-year diopter sphere (DS), diopter cylinder (DC), spherical equivalent (SE), best corrected visual acuity (BCVA), intraocular pressure (IOP), and axial length (AL), corneal endothelial cell counts and the occurrence of postoperative complications rate were analyzed among two groups. Results: There was no significant difference in preoperative outcome measures between the two groups (P>0.05). BCVA at 1-year postoperative was significantly better (P<0.05), and SE at 1-year postoperative was significantly lower (P<0.05). There was no significant difference in BCVA, DS, DC, SE, IOP, AL, and corneal endothelial cell loss rate between the two groups at 1-year after operation (P>0.05). One year after the operation, there were 5 cases of suture exposure (13.5%) in the knotted group and no suture exposure in the knotless group, and the difference was statistically significant (P<0.05). Conclusions: The modified knotless IOL transscleral suture fixation can improve the best corrected visual acuity and alleviate ametropia of CEL patients, and reduce suture exposure and related complications effectively.
封面简介

内镜下泪囊鼻腔吻合联合人工泪管植入术治疗小泪囊型泪囊炎的疗效分析

Efficacy of endoscopic dacryocystorhinostomy combined with bicanalicular silicone tube intubation for the management of chronic dacryocystitis with small lacrimal sac

:0-0
 
       小泪囊型慢性泪囊炎是泪道阻塞性疾病中的特殊亚型,目前尚无针对小泪囊的确切定义,传统内镜下泪囊鼻腔吻合术(endoscopic dacryocystorhinostomy, En-DCR)治疗小泪囊型慢性泪囊炎因泪囊体积小手术操作难度大、术后吻合口易闭锁和成功率低而被视为相对禁忌。本研究通过CT泪囊造影(CT dacryocystography, CT-DCG)三维精准测量、定义小泪囊(水平径≤3 mm、前后径≤3 mm、垂直径≤6 mm),提出开放泪总管平面技术以扩大泪囊鼻腔吻合口,同时联合双管人工泪管植入术的En-DCR治疗方案,术后予以肾上腺皮质激素(激素)喷鼻剂辅助,显著提升手术疗效。
      研究纳入61例小泪囊型泪囊炎患者,术后9个月随访显示,解剖成功率达80. 33%(49/61),功能成功率为75.41%(46/61)。术中开放泪总管平面技术有效扩大手术窗口;短期双管人工泪管植入(术后3个月取出)联合激素喷鼻剂使用可降低吻合口闭锁风险同时未增加肉芽增生和感染风险。与传统治疗相比,该方案突破小泪囊手术禁忌,为患者提供更优选择。
       小泪囊型慢性泪囊炎是泪道阻塞性疾病中的特殊亚型,目前尚无针对小泪囊的确切定义,传统内镜下泪囊鼻腔吻合术(endoscopic dacryocystorhinostomy, En-DCR)治疗小泪囊型慢性泪囊炎因泪囊体积小手术操作难度大、术后吻合口易闭锁和成功率低而被视为相对禁忌。本研究通过CT泪囊造影(CT dacryocystography, CT-DCG)三维精准测量、定义小泪囊(水平径≤3 mm、前后径≤3 mm、垂直径≤6 mm),提出开放泪总管平面技术以扩大泪囊鼻腔吻合口,同时联合双管人工泪管植入术的En-DCR治疗方案,术后予以肾上腺皮质激素(激素)喷鼻剂辅助,显著提升手术疗效。
      研究纳入61例小泪囊型泪囊炎患者,术后9个月随访显示,解剖成功率达80. 33%(49/61),功能成功率为75.41%(46/61)。术中开放泪总管平面技术有效扩大手术窗口;短期双管人工泪管植入(术后3个月取出)联合激素喷鼻剂使用可降低吻合口闭锁风险同时未增加肉芽增生和感染风险。与传统治疗相比,该方案突破小泪囊手术禁忌,为患者提供更优选择。
泪器病专栏

内镜下泪囊鼻腔吻合联合双管人工泪管植入术治疗小泪囊型慢性泪囊炎的疗效

Efficacy of endoscopic dacryocystorhinostomy combined with bicanalicular silicone tube intubation for the management of chronic dacryocystitis with small lacrimal sac

:295-302
 
目的:探讨内镜下泪囊鼻腔吻合(endoscopic dacryocystorhinostomy, En-DCR)联合双管人工泪管植入(bicanalicular silicone tube intubation, BSTI)术治疗小泪囊型慢性泪囊炎的疗效。方法:回顾2020年7月—2023年3月在温州医科大学附属眼视光医院通过CT泪囊造影术(CT dacryocystography, CT-DCG)确诊的单眼小泪囊型慢性泪囊炎并接受手术的患者69例(69眼),手术采取术中开放泪总管平面的En-DCR并联合BSTI术治疗。术后3个月取出人工泪管,通过术前和术后9个月随访资料,记录和分析了纳入患者的基本资料、手术治疗、治疗效果(包括解剖成功率和功能成功率)和并发症情况。结果:本研究最终纳入61例(61眼)患者,其中男21例、女40例,右眼33眼、左眼28眼。平均年龄为(55.31±12.28)岁(范围为27~75岁)。所有患者均顺利完成术中开放泪总管平面的En-DCR并联合BSTI术治疗。随访9个月,En-DCR的解剖成功率为80.33%(49/61),功能成功率为75.41%(46/61),在随访过程中未出现视力下降、眶内出血、感染扩散等并发症。结论:En-DCR联合BSTI术治疗小泪囊型慢性泪囊炎可取得较为满意疗效。

Objective: To evaluate the efficacy of endoscopic dacryocystorhinostomy (En-DCR) Combined with bicanalicular silicone tube intubation (BSTI) for the Management of Chronic dacryocystitis with Small Lacrimal sac. Methods: total of 69 patients (69 eyes) with chronic dacryocystitis with small lacrimal sac diagnosed by CT dacryocystography (CT-DCG) treated with En-DCR combined with BSTI at the Eye Hospital of Wenzhou Medical University from July 2020 to March 2023 were reviewed. The surgery procedure exposed the plane of common canalicular, and followed by BSTI. The tube was removed 3 months after surgery. The basic data, surgical treatment, therapeutic effect (including anatomical and functional success rates) and complications of the included patients were recorded and analyzed through the follow-up data before and 9 months after surgery. Results: Ultimately, 61 patients (61 eyes) were included in this study—21 males and 40 females—with a distribution of 33 right eyes and 28 left eyes. The mean age was calculated at 55.31±12.28 years (range: 27 to 75 years). All patients underwent a successful En-DCR with exposed the plane of common canalicular and BSTI. At the nine-month follow-up, the anatomical success rate of En-DCR was 80.33%(49/61), the functional success rate was 75.41%(46/61). No complications such as visual impairment, intraorbital hemorrhage, or spread of infection occurred during the follow-up period. Conclusions: The combination of En-DCR and BSTI surgery for chronic dacryocystitis with small lacrimal sac can achieve a satisfactory therapeutic effect.
论著

玻璃体切除术联合地塞米松玻璃体内植入剂治疗黄斑前膜的临床疗效分析

Clinical analysis of vitrectomy combined with dexamethasone intraveal implant in the treatment of epiretinal membrane

:113-126
 
目的:对比玻璃体切割术(pars plana vitrectomy, PPV)联合或不联合注射地塞米松玻璃体内植入剂(dexamethasone intraveal implant, DEX)治疗特发性黄斑前膜(idiopathic macular epiretinal membrane, IMEM)的临床疗效。
方法: 采用回顾性研究设计,收集2022年1月—2023年6月于惠州市中心人民医院就诊,被
诊断为IMEM(Gass 2期)并行PPV联合phaco+IOL植入的患者49例(49只眼)。根据其治疗方案分为非联合注射DEX组(25例共25只眼)及联合注射DEX组(24例共24只眼)。记录所有患者术前术后的最佳矫正视力(best corrected visual acuity, BCVA)、黄斑中心凹视网膜厚度(central macular thickness, CMT)、平均神经节细胞层(ganglion cell layer, GCL)厚度,椭圆体带(ellipsoidal zone, EZ)完整性。使用OCTA测量视网膜浅层毛细血管层(superficial capillary plexus, SCP)、中心区域血管密度(vessel densities, VDs)及中心凹无血管区(foveal avascular zone, FAZ)面积。使用非接触性眼压计测量患者眼压。随访至术后6个月,记录上述指标,其中BCVA及CMT随访至1年。使用SPSS 29.0软件进行数据的统计分析(独立样本t检验、Mann-Whitney U检验、Pearson χ2检验等)。使用重复测量方差检验分析各项指标的时间差异及交互差异性。采用线性回归分析CMT、平均GCL厚度、EZ完整性、VDs、FAZ面积及联合注射DEX与BCVA的相关性。
结果:本研
究两组间性别、年龄、眼压及术前各项指标差异均无统计学意义(P>0.05)。两种术式均能改善黄斑区结构、功能及微循环障碍,术后的BCVA在两组患者中均较术前有所改善,且持续至术后6个月,CMT的变化趋势同BCVA有高度一致性,而平均GCL厚度于术后3个月时开始恢复,而SCP中心凹VDs及FAZ面积于术后6个月时才有明显恢复,两种术式术后以上各指标均具有时间差异及交互差异性(P≤0.015),且6个月内联合注射DEX组表现更佳(P=0.036)。相较于非联合注射DEX组,只有联合注射DEX组在术后6个月时,EZ完整性的改善具有统计学意义(P=0.009)。但随访至1年时,两组之间BCVA及CMT差异均无统计学意义(P=0.079)。术后6个月内BCVA的改善与术后6个月的CMT、平均GCL厚度、SCP中心凹VDs、FAZ面积的改善及EZ完整性及是否注射DEX与术后6个月内BCVA的改善均有相关性。随访期间两组患者均未发生眼内炎、玻璃体积血、视网膜脱离等眼部或全身严重并发症。
结论:微创玻璃体切割术联合
玻璃体内注射DEX治疗相较于非联合注射DEX治疗组在6个月内疗效更佳。联合单次注射DEX治疗方案与非联合注射DEX治疗方案相比,在手术1年后对BCVA及CMT的改善无明显差异。
Objective: To analyze the efficacy and safety of minimally invasive vitrectomy (PPV) with or without intraoperative injection of dexamethasone intravitreal implant (DEX) for the treatment of Idiopathic Macular Epiretinal Membrane (IMEM), by comparing the relevant indicators.
Methods: A retrospective study design was used to collect 49 patients (49 eyes) who were diagnosed with IMEM (Gass2) and underwent surgical treatment(PPV+phaco+IOL implantation) at Huizhou Central People’s Hospital from January 2022 to June 2023. According to their treatment plan, they were divided into a non-combined injection DEX group (25 cases, 25 eyes) and a combined injection DEX group (24 cases,24 eyes). All patients underwent comprehensive optometry before and after surgery, and their best corrected visual acuity (BCVA) was recorded. Scan the central macular thickness (CMT) within 6x6mm of the macular area, while scanning the average ganglion cell layer (GCL) thickness. Record whether the elliptical zone (EZ) within 1x1mm of the macular area is complete and continuous. Use OCTA mode to scan the superficial capillary layer (SCP) of the retina within a range of 6x6mm, and record the measurements of vascular density (VDs) in the central area and the area of the foveal avascular zone (FAZ). Measure the patient's intraocular pressure using a non-contact tonometer. Follow up for 6 months and record the above indicators, with BCVA and CMT followed up for 1 year. Perform statistical analysis of data using SPSS 29.0 software (Independent sample t-test, Mann Whitney U-test and Pearson χ2-test). Use repeated measures ANOVA to analyze the time differences and interaction differences of various indicators. Linear regression analysis was used to examine the correlation between CMT, mean GCL thickness, EZ integrity, VDs, FAZ area, and combined injection of DEX with BCVA.
Results: There were no statistically significant differences in gender, age, intraocular pressure, and preoperative indicators between the two groups (P>0.05). Both surgical methods can improve the structure, function, and microcirculation disorders in the macular area. The postoperative BCVA in both groups of patients improved compared to before, and persisted until 6 months after surgery. The trend of CMT changes was highly consistent with BCVA, while the average GCL thickness began to recover at 3 months after surgery. The SCP fovea VDs and FAZ area did not show significant recovery until 6 months after surgery. Both surgical methods showed time differences and interaction differences in the above indicators after surgery (P=0.015), and the combined injection of DEX group performed better within 6 months (P=0.036). Compared to the non combined injection of DEX group, only the combined injection of DEX group showed statistically significant improvement in EZ integrity at 6 months after surgery (P=0.009). However, at 1 year of follow-up, there was no statistically significant difference in BCVA and CMT between the two groups (P≥0.079). The improvement of BCVA within 6 months after surgery is correlated with the improvement of CMT, average GCL thickness, SCP fovea VDs, FAZ area, EZ integrity, and injection of DEX within 6 months after surgery. During this study, no serious ocular or systemic complications such as endophthalmitis, vitreous hemorrhage, or retinal detachment occurred in either group of patients at each follow-up time point.
Conclusions: The efficacy of PPV combined with intravitreal injection of DEX is better within 6 months compared to the non-combined injection of DEX treatment group. There was no significant difference in the improvement of BCVA and CMT after one year of surgery between the combined single injection DEX treatment regimen and the non-combined injection DEX treatment regimen.
论著

鼻内镜下泪囊鼻腔吻合术疗效的影响因素分析

Analysis of influencing factors of the efficacy of endoscopic dacryocyst orhinostomy

:20-26
 
目的:分析鼻内镜下泪囊鼻腔吻合术手术疗效的影响因素。方法:纳入2021年1月—2023年7月在成都中医药大学附属医院眼科行鼻内镜下泪囊鼻腔吻合术(endoscopic dacryocystorhinostomy, En-DCR)治疗的单眼慢性泪囊炎患者90例(90只眼)。所有患者均进行泪道CT造影检查及鼻内镜下泪囊鼻腔吻合术,术后随访6个月,评估手术疗效,分析手术疗效的影响因素。结果:本研究显示,慢性泪囊炎患者中女性占比为90%,平均年龄为(49.97±13.10)岁。单因素分析结果显示,术中是否置入引流管、下鼻甲肥厚与EnDCR手术疗效有关(< 0.05)。Logistic多因素回归分析结果显示,下鼻甲肥厚为En-DCR手术疗效的危险因素(P < 0.05)。结论:慢性泪囊炎多发生于中老年女性。下鼻甲肥厚为En-DCR手术疗效的危险因素。
Objective: To analyze the influencing factors for effect of endoscopic dacryocystorhinostomy. Methods: A total of 90 patients (90 eyes) diagnosed with unilateral chronic dacryocystitis undergoing endoscopic dacryocystorhinostomy in the Department of ophthalmology, Hospital of Chengdu University of Traditional Chinese Medicine from January 2021 to July 2023 were included. All patients underwent lacrimal duct CT imaging and endoscopic dacryocystorhinostomy, and were followed up for 6 months to evaluate the efficacy of surgery. Results: This study showed that 90% of patients with chronic dacryocystitis were female, and the average age of patients was (49.97±13.096) years. The results of univariate analysis showed that there was a correlation between intraoperative drainage tube placement and inferior turbinate hypertrophy and the efficacy of En-DCR (< 0.05). The results of Logistic regression analysis showed that inferior turbinate hypertrophy was a risk factor for the efficacy of En-DCR (< 0.05). Conclusions: Dacryocystitis mostly occurs in middle-aged and elderly women. Inferior turbinate hypertrophy are the influencing factors of surgical effect. Chronic dacryocystitis mostly occurs in middle-aged and elderly women. Inferior turbinate hypertrophy is a risk factor affecting the curative effect of En-DCR surgery.
论著

M22优化脉冲光对睑板腺功能障碍所致干眼的疗效

Effect of M22 Optimal Pulsed Technology in the treatment of dry eye caused by meibomian gland dysfunction

:223-228
 
目的:研究M22优化脉冲光技术治疗睑板腺功能障碍(meibomian gland dysfunction,MGD)所致干眼的疗效,并用keratograph 5M干眼分析仪分析评估患者治疗前后病情变化。方法:收集汕头博德眼科医院门诊患者46例,年龄31~85(55.39±14.02)岁,行M22优化脉冲光治疗1个疗程(每月1次,共3次),治疗前后均采用keratograph 5M干眼分析仪分析评估患者泪河高度情况、泪膜破裂时间(break-up time,BUT)、脂质层、睑板腺情况的变化,采用t检验分析对比治疗前后 变化情况。结果:患者治疗后泪河高度较强脉冲光治疗前明显增高,由(0.20±0.11) mm增加到(0.35±0.11) mm,BUT时间延长,由(4.98±2.13) s延长到(10.12±1.86) s,脂质层异常情况好转,有效率达93.48%,睑板腺阻塞情况减轻,有效率达84.78%以上,治疗后与治疗前差异有统计学意义(P<0.01)。结论:M22优化脉冲光技术在治疗MGD导致的干眼有较好的效果,没有出现并发症,是较安全有效地治疗方法,且keratograph 5M干眼分析仪可以较全面的对该病进行评估。
Objective: To study the efficacy of M22 Optimal Pulsed Technology in the treatment of dry eye caused by meibomian gland dysfunction and to evaluate the changes of patients affer treatment with keratograph 5M dry eye analyzer. Methods: Forty-six patients collected from Shantou Balder Eye Hospital receiving M22 Optimal Pulsed Technology treatment for three times, once a month, then using keratograph 5M dry eye analyzer to assess the height of tears river, break-up time (BUT), lipid layer, and meibomian gland. The results before and affer laser treatment were compared using t-test in this study. Results: Affer treatment, there was signiffcant effect than those of before treatment, the BUT time was prolonged from (0.20±0.11) mm to (0.35±0.11) mm, the abnormalities of the lipid layer were alleviated, the cure rate exceeded 93.48%, and the obstruction of the meibomian gland was reduced, the cure rate was higher than 84.78%. TTe difference before and affer corresponding treatment was statistically signiffcant (P<0.01). Conclusion: M22 Optimal Pulsed Technology has a good effect in the treatment of MGD-induced dry eye without complications. So M22 Optimal Pulsed Technology is a safe and effective treatment method. And keratograph 5M dry eye analyzer can deliver comprehensive assessment of dry eye. 

眼睑基底细胞癌控制性切除联合眼睑一期修复的疗效

Curative effect of controlled excision combined with eyelid reconstruction in treatment of basal cell carcinoma of eyelids

:18-20
 

目的:探讨眼睑基底细胞癌在控制性切除联合眼睑一期修复的疗效。方法:通过对 47 例经病理诊断为眼睑基底细胞癌患者行控制性切除联合眼睑一期修复手术治疗,对其疗效进行回顾性分析。结果:术后修复皮瓣均成活,眼睑功能良好,随访 个月~10 年,期间无复发及转移病例。结论:对于眼睑部的基底细胞癌,采用显微控制下切除肿瘤联合一期修复的手术方法提高了患者的治愈率,同时最大限度地保留了眼睑的正常组织,达到了保持眼睑功能和美容的双重目的。

Objective: To evaluate the clinical efficacy of controlled excision combined with eyelid reconstruction in the treatment of basal cell carcinoma of eyelids. Methods: Clinical data of 47 patients pathologicall diagnosed with eyelid basal cell carcinoma were treated by controlled excision combined with eyelid reconstruction were retrospectively analyzed. Results: All skin flaps survived after operation, and the eyelid function was excellent. No recurrence or metastasis occurred during the follow-up. Conclusion: For basal cell carcinoma of the eyelids, controlled excision combined with eyelid reconstruction can improve the cure rate, and retain the normal tissues of the eyelid as much as possible, which both maintains eyelid function and improves cosmetic appearance.

论著

中央孔后房型人工晶体植入术矫正屈光不正的疗效

Effect of posterior chamber phakic intraocular lens with a central hole on refractive errors

:206-212
 
目的:观察后房型有晶体眼人工晶体(implantable collamer lens,ICL)V4c植入术后2年的有效性、安全性和稳定性,评估ICL V4c矫正屈光不正的中远期临床疗效。方法:回顾性病例研究。收集在河 北省沧州市中心医院眼一科行ICL V4c手术治疗的屈光不正患者,观察并记录术前至术后2年的裸眼视力、最佳矫正视力、屈光状态、对比敏感度、高阶像差、眼压、人工晶体拱高、角膜内皮细胞 计数、不良反应、主观视觉质量等临床资料,进行统计学分析。结果:完成随访的96例术眼,术后2年的平均裸眼视力(LogMAR)为0.021±0.065,平均最佳矫正视力(LogMAR)为0.002±0.041,优于术前最佳矫正视力,有效性指数为1.05,安全性指数为1.09,等效球镜数值稳定,对比敏感度提升,高阶像差有所增加,但主观视觉质量良好,眼压基本稳定,内皮细胞丢失率为1.6%,平均拱高为(549.6±50.0) μm,随访期间未发现眼内感染、继发性青光眼、晶状体混浊、黄斑水肿、视网膜脱离等并发症。结论:ICL V4c植入术矫正屈光不正具有良好的中远期临床效果。
Objective: To assess the medium-long term efffcacy, safety and stability of a newly developed posterior chamber phakic intraocular lens (model V4c Visian Implantable Collamer Lens) to correct refractive errors. Methods: Retrospective case series. This study evaluated eyes that had implantation of ICL V4c to correct ametropia for at least two years. Uncorrected and corrected distance visual acuities, refraction, contrast sensitivity, high-order aberration, quality of life, intraocular pressure, endothelial cell density, pIOL vault, and adverse events were evaluated to assess the efffcacy, safety and stability of V4c. Results: The study comprised 96 eyes of 50 patients. At 2 years postoperatively, the mean uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) were 0.021±0.065 logMAR and 0.002±0.041 logMAR, which were better than preoperative CDVA. The efffcacy and safety indices were 1.05 and 1.09, respectively. The spherical equivalent was stable with improved contrast sensitivity and increased high-order aberrations, but the subjective visual quality was well. The IOP remained stable over time. The mean vault was (549.6±50.0) μm and the mean endothelial cell loss was 1.6%. No eye developed intraocular infection, secondary glaucoma, lens opacity, macular edema or retinal detachment.Conclusion: The good medium-long term outcomes support the use of ICL V4c for the correction of myopia. 
论著

全视网膜光凝及术后应用羟苯磺酸钙治疗糖尿病视网膜病变的疗效观察

Curative effect observation of full retinal laser photocoagulation and postoperative application of calcium dobesilate in the treatment of diabetic retinopathy

:246-250
 
目的:探讨全视网膜光凝及术后应用羟苯磺酸钙治疗糖尿病视网膜病变的疗效。方法:选取96例患者,共175只眼,随机分为对照组(48例,86只眼)和研究组(48例,89只眼)。两组均予全视网膜激光光凝治疗,其中研究组术后再予羟苯磺酸钙继续12周治疗。12周后,观察两组患者治疗前后视力、血液流变学的变化。结果:治疗后研究组在视力>1.0范围的患者明显多于对照组(χ2=6.779,P=0.009), 而2组在视力≤0.4,0.4~0.6,0.7~1.0范围患者视力差异比较分别为( χ2=0.003,P=0.955),(χ2=1.640,P=0.200),(χ2=2.148,P=0.143)。治疗后研究组患者的血浆粘度、红细胞压积、红细胞变形指数、纤维蛋白原改善均优于对照组(P<0.05)。研究组总有效率89.9%,对照组75.6%,两组差异比较(χ2 =6.302,P=0.012)。结论:全视网膜激光光凝及术后应用羟苯磺酸钙治疗糖尿病性视网膜病,能有效提高视力及临床疗效,可能与改善患者血液流变相关。
Objective: To investigate the curative effect of the postoperative retinal laser photocoagulation and calcium dobesilate in the treatment of diabetic retinopathy. Methods: Selected 96 patients, 175 eyes, randomly divided into control group (48 cases, 86 eyes) and study group (48 cases, 89 eyes). Two groups were all given retinal laser photocoagulation treatment, while the study group continued to receive calcium dobesilate for 12 weeks after treatment. After 12 weeks, observed the eyesight, change of blood rheology of the two groups. Results: After the treatment, the patients with vision >1.0 in the study group were significantly more than the control group (χ2 =6.779, P=0.009), in the vision range of ≤0.4, 0.4~0.6, 0.7~1.0, the difference between the two groups was (χ2 =0.003, P=0.955), (χ2 =1.640, P=0.200), (χ2=2.148, P=0.143), respectively. After treatment, plasma viscosity, erythrocyte deposited, erythrocyte deformation index, fibrinogen in the study group were better than those in the control group (P<0.05). The total effectiveness in the study group was 89.9%, in the control group was 75.6%, the difference was statistically significant (χ2=6.302, P=0.012). Conclusion: The whole retinal laser photocoagulation and postoperative application of calcium dobesilate in treating the diabetic retinopathy can effectively improve eyesight and clinical curative effect, which may be associated with improving blood rheology.
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  • 眼科学报

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
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  • Eye Science

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
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