论著

氦氖激光联合干扰素α-2b、加巴喷丁对急性眼周带状疱疹的疗效

Curative effect of He-Ne laser combined with interferon α-2b and gabapentin on acute herpes zoster ophthalmicus

:905-912
 
目的:探讨分析联合应用氦氖激光、重组人干扰素α-2b抑菌软膏与加巴喷丁对急性眼周带状疱疹患者皮损愈合、睡眠、疼痛及病程的改善效果。方法:收集2017年1月至2020年1月在河南大学淮河医院就治的急性眼周带状疱疹患者60例。依据治疗方案不同将其分为实验组与对照组,实验组32例,对照组28例。对照组进行常规基础治疗包括抗病毒、营养神经、重组人干扰素α-2b抑菌软膏与加巴喷丁胶囊治疗,实验组较对照组加用氦氖激光治疗。收集皮疹消肿、止疱、结痂、脱痂与止痛时间,疼痛视觉模拟量表(Visual Analogue Scale,VAS)评分、睡眠时间、不良反应以及有无遗留后神经痛等情况并进行比较分析。结果:两组治疗前各项观察指标均无明显差别,差异无统计学意义(P>0.05);经治疗后,实验组皮疹观察指标(消肿、止疱、结痂、脱疱)时间及止痛时间均明显少于对照组,治疗后4 d与7 d结痂率均明显高于对照组;治疗后两组患者睡眠时长均延长,VAS评分均降低,差异具有统计学意义(P<0.05);对于缓解疼痛,延长睡眠时长实验组均优于对照组(P<0.05)。而治疗后2、14、28 d结痂率差异均无统计学意义(均P>0.05)。实验组有效率(93.75%)显著高于对照组(75%),差异有统计学意义(P=0.047);两组发生PHN与不良反应差异无统计学意义(P>0.05)。结论:氦氖激光联合重组人干扰素α-2b抑菌软膏与加巴喷丁治疗急性眼周带状疱疹安全有效,可明显缓解患者急性期疼痛,促进皮疹痊愈,改善睡眠质量,缩短病程,可在临床积极推广使用。
Objective: To investigate and analyze the effect of He-Ne laser, recombinant human interferon α-2b ointment and gabapentin on skin lesion healing, sleep, pain and disease course in acute herpes zoster ophthalmicus. Methods: Sixty patients with acute herpes zoster ophthalmicus were collected from January 2017 to January 2020 in our hospital. According to the different treatment, they were divided into an experimental group (32 cases) and a control group (28 cases). The patients in the control group received routine basic treatment including antiviral, neurotrophic therapy, interferon α-2b ointment and gabapentin, and the experimental group was treated with He-Ne laser on the basis of control group treatment. The time of detumescence, blister stopping, scab formation, scab removal and pain relief, Visual Analogue Scale (VAS) score, sleep time, adverse reactions, and postherpetic neuralgia were collected and analyzed. Results: Before treatment, there was no significant difference in the observation indexes between the two groups (P>0.05); after treatment, the observation indexes of skin rash (detumescence, blister stopping, scab formation, scab removal) and pain relief time in the experimental group were significantly less than those in the control group, and the scab removal rate on the 4th and 7th days post-treatment in the experimental group was significantly higher than that in the control group; after treatment, the sleep duration was prolonged, and the VAS score was decreased. For pain relief and prolonging sleep time, the experimental group was better than the control group, and the difference was statistically significant P<0.05).There was no significant difference in scab removal rate on 2, 14 and 28 days post-treatment (P>0.05). The effective rate in the experimental group (93.75%) was significantly higher than that in the control group (75%), and the difference was statistically significant (P=0.047); there was no significant difference in PHN and adverse reactions between the two groups (P>0.05). Conclusion: He-Ne laser combined with interferon α-2b ointment and gabapentin is safe and effective in the treatment of acute herpes zoster ophthalmicus. It can significantly relieve the acute pain, promote the recovery of rash, improve sleep quality, shorten the disease course, and can be actively promoted in clinical usage.
论著

中药超声雾化联合针灸治疗睑板腺功能障碍的临床疗效

Clinical effect of ultrasonic atomization of traditional Chinese medicine combined with acupuncture on meibomain gland dysfunction

:897-904
 
目的:观察中药超声雾化联合针灸治疗睑板腺功能障碍(meibomain gland dysfunction,MGD)的临床疗效。方法:选取在新华医院就诊的7 7例(154眼)双 眼MGD患者,随机分为对照组(27例5 4眼)、中药超声雾化治疗组(雾化组;2 5例5 0眼)和中药超声雾化联合针灸治疗组(联合治疗组;2 5例5 0眼)。对照组接受睑板腺按摩治疗,雾化组在睑板腺按摩的基础上行中药超声雾化治疗,联合治疗组为进一步加用针灸治疗,治疗周期为4周。治疗前后收集患者双眼泪膜破裂时间(tear breakup time,BUT)、双眼基础泪液分泌试验数据(Schirmer I test,SIT)、双眼角膜荧光素染色评分(fluorescent,FL)、睑板腺分泌物性状评分(Meibomian Glandyielding Secretion Score,MGYSS)、睑缘异常评分(Eyelid Margin Abnormality Score,EMAS)以及主观症状积分等资料,并评价临床疗效。结果:治疗前三组BUT、SIT、F L、MGYSS、EMAS和主观评价得分等组间差异均无统计学意义(均P >0.05)。治疗4周后,各组受试者的BUT、SIT、F L评分、MGYSS评分、EMAS评分和主观评价评分与治疗前相比差异均具有统计学意义(均P < 0.05);联合治疗组的上述指标分别与雾化组及对照组相比,差异均有统计学意义(P <0.05)。治疗后对照组的总有效率为51.85%(28眼/54眼),雾化组为84%(42眼/50眼),联合治疗组为96%(48眼/50眼),联合治疗组总有效率与雾化组相比差异有统计学意义(P <0.05)。结论:中药超声雾化联合针灸治疗在改善MGD患者的睑板腺功能和减轻患者的干眼症状方面具有较好的临床疗效。
Objective: To observe the clinical efficacy of ultrasonic atomization fumigation of traditional Chinese medicine combined with acupuncture in the treatment of meibomian gland dysfunction (MGD). Methods: A total of 77 MGD patients (154 eyes) in Xinhua Hospital were selected and randomly divided into a control group (27 cases,54 eyes), a ultrasonic atomization of traditional Chinese medicine group (atomization group; 25 cases, 50 eyes),and a ultrasonic atomization of traditional Chinese medicine combined with acupuncture group (combined treatment group; 25 cases, 50 eyes). The control group received meibomian gland massage, the atomization group received meibomian gland massage and ultrasonic atomization of traditional Chinese medicine, and the combined treatment group received additional acupuncture treatment. The treatment period was 4 weeks. Tear breakup time (BUT), basal tear secretion test data (Schirmer I Test, SIT), corneal fluorescein staining score (FL), and Meibomian Gland Yielding Secretion Score (MGYSS), Eyelid Margin Abnormality Score (EMAS), Subjective Symptom Score (SSS) were collected and conduct clinical efficacy were evaluated. Results: There were no significant differences in BUT, SIT, FL, MGYSS, EMAS and SSS among the three groups (all P>0.05).After treatment of 4 weeks, the BUT, SIT, FL, MGYSS, EMAS and SSS in each group were improved significantly compared to baseline (P<0.05). The above indicators in combined treatment group were significantly different from atomization group (P<0.05) and control group (P<0.05). The total effective rates after treatment were 51.85% (28/54) in control group, 84% (42/50) in atomization group, and 96% (48/50) in combined treatment group. The difference in total effective rate between combined treatment group and atomization group was significant (P<0.05). Conclusion: Ultrasonic atomization of traditional Chinese medicine combined with acupuncture presents good clinical effects in improving the meibomian gland function of patients with MGD and alleviating the dry eye symptoms.
论著

硬膜外导管辅助双路置管术与传统术式在泪小管断裂吻合术中的疗效比较

Comparison of the efficacy of bicanalicular silicone intubation assisted with epidural catheters and traditional surgery in anastomosis for canalicular laceration

:888-893
 
目的:比较硬膜外导管辅助双路置硅胶管术与传统双路置硅胶管术在泪小管断裂吻合术中的疗效。方法:随机将连云港市第二人民医院52例(52眼)行泪小管断裂吻合术的患者分成两组,使用硬膜外导管辅助双路置硅胶管术为A组(30例);使用传统手术方式(双路置硅胶管术)为B组(22例)。比较两组患者术中置管时间、平均手术时间、鼻腔出血率、术中疼痛评分、一次性吻合成功率的差异。结果:在术中置管时间方面,A组为(11.20±3.80) min,B组为(21.50±12.60) min;在平均手术时间方面,A组为(42.70±5.50) min,B组为(62.20±15.20) min;在术中疼痛评分方面,A组为(3.10±0.80)分,B组为(4.60±1.25)分;在鼻腔出血率方面,A组为3.33%(1/30),B组为18.2%(4/22),以上差异均有统计学意义(均P<0.05);但在一次性吻合成功率方面,A组有效率为93.3%(28/30),B组有效率为86.4%(19/22),差异无统计学意义(P>0.05)。结论:在泪小管断裂吻合术中,应用硬膜外导管辅助双路置硅胶管术较传统双路置硅胶管术,在术中置管时间、手术平均时间、鼻腔出血率、患者疼痛程度等方面具有优势,2种置管一次性成功率的差异无统计学意义,硬膜外导管辅助双路置硅胶术方法安全、可靠、优势明显,值得临床手术推广。
Objective: To compare the efficacy of bicanalicular silicone intubation assisted with epidural catheters and traditional bicanalicular silicone intubation in the anastomosis of lacrimal canaliculus rupture. Methods: Fifty-two patients (52 eyes) were randomly divided into two groups. Patients in group A (30 cases) were treated by bicanalicular silicone intubation assisted with epidural catheters, while patients in group B (22 cases) were treated with conventional operation (bicanalicular silicone intubation). The intubation time, average operation time, nasal bleeding rate, intraoperative pain score and one-time success rate were compared between the 2 groups. Results: Intubation time in group A was (11.20±3.80) min and that in group B was (21.50±12.60) min(P<0.05). The mean operation time of group A was (42.70±5.50) min and that of group B was (62.20±15.20) min(P<0.05). Intraoperative pain score was 3.10±0.80 in group A and 4.60±1.25 in group B (P<0.05). The rate of nasal hemorrhage was 3.33% (1/30) in group A and 18.2% (4/22) in group B (P<0.05). With respect to one-time anastomosis success rate assessment, the effective rate was 93.3% (28/30) in group A, and 86.4% (19/22) in group B (P>0.05). Conclusion: During lacrimal canalicular anastomosis, bicanalicular silicone intubation assisted with epidural catheters is superior to bicanalicular silicone intubation in intubation time, average operation time, nasal bleeding rate and pain degree. There is no significant difference between the two methods in one-time success rate. Bicanalicular silicone intubation assisted with epidural catheters is safe, reliable, and worthy of promotion.
论著

黏膜瓣泪小点成形术治疗慢性泪小管炎的疗效

Efficacy of mucosal flap punctoplasty in the treatment of chronic canaliculitis

:881-887
 
目的:观察黏膜瓣泪小点成形术用于治疗慢性泪小管炎的疗效。方法:回顾性病例系列研究。收集2018年1月至2020年12月中山眼科中心眼整形科就诊的44例慢性泪小管炎患者的临床资料,分析其性别、年龄、患病眼别、临床症状、泪道冲洗结果等临床特点。采用黏膜瓣泪小点成形术进行治疗,术后随访评估其疗效。结果:44例慢性泪小管炎患者以女性为主(男女比例1:3.9),单侧发病,多累及下泪小管(上下泪小管比例1:3),主要表现为分泌物增多、溢泪以及内眦部位红肿,结石阳性率为95.7%,病原微生物检查结果显示以放线菌感染为主(78.3%)。大部分患者术后1周内症状得到明显改善,其中1例上下泪小管炎患者于术后2个月出现上泪小管炎复发。总体治愈率为97.8%,随访时间为(20.7±10.9)个月。结论:黏膜瓣泪小点成形术治疗慢性泪小管炎的临床疗效确切,方法可靠。
Objective: To evaluate the efficacy of mucosal flap punctoplasty in patients with chronic canaliculitis. Methods: In this retrospective serial case study, the clinical data of 44 patients with chronic canaliculitis were collected from the Oculoplastic Department of Zhongshan Ophthalmic Center at Sun Yat-sen University between January 2018 and December 2020. Demographic data such as gender, age, affected eye, clinical presentations and lacrimal duct irrigation results were analyzed. The efficacy of the procedure, symptom resolution and complications were assessed. Results: Of the 44 patients, most (male:female 1:3.9) were female, and the disease most often (upper:lower 1:3) involved the lower lacrimal canaliculus of only one eye. Main symptoms included increased secretion, tearing, and swelling of the inner canthus. Stones were present in 95.7% of patients and Actinomyces israelli was found to be the most common pathogen (78.3%). Most patients’ symptoms improved significantly within 1 week after surgery. Only one patient, who had infections in both the upper and lower canaliculi, had recurrence of upper canaliculitis 2 months after the surgery. The overall cure rate was 97.8%, and the follow-up time was (20.7±10.9) months. Conclusion: Mucosal flap punctoplasty is an efficacious and reliable method in the treatment of chronic canaliculitis.
论著

激光光凝及抗VEGF治疗早产儿视网膜病变阈值前病变1型的疗效对比

Comparison of the efficacy of laser photocoagulation and anti-VEGF in the treatment of type 1 prethreshold retinopathy of prematurity

:776-780
 
目的:观察视网膜激光光凝术(laser photocoagulation,LP)及玻璃体腔注射雷珠单抗(intravitreal ranibizumab,IVR)对病变位于II区的阈值前病变1型早产儿视网膜病变(retinopathy of prematurity,ROP)的疗效。方法:收集2015年10月至2019年12月厦门市儿童医院收治的病变位于II区的阈值前病变1型44例(81眼)。根据手术方式分为LP组、IVR组。观察各组术后病变消退、视网膜血管化情况、全身及眼部并发症,分析不同手术方式的效果。结果:LP组20例(37只眼)行视网膜激光光凝治疗,术后未出现复发,首次治愈率100%;术后(3.42±1.57)周病情控制,术后(9.84±4.75)周可观察到周边视网膜血管化。IVR组24例(44只眼)注射雷珠单抗,39只眼行单次手术后病情控制,首次治愈率88.6%,5眼术后病情未控制。术后(2.95±2.58)周病情控制,术后(14.19±4.95)周可观察到周边视网膜血管化。两组手术方式首次治愈率、视网膜血管化时间差异有统计学意义(P<0.05)。结论:视网膜LP及IVR治疗病变位于II区的阈值前病变1型均有较好疗效,IVR复发率较高,手术方式的选择需慎重。
Objective: To observe the efficacy of laser photocoagulation (LP) and intravitreal ranibizumab (IVR) injection in the treatment of type 1 prethreshold retinopathy of prematurity (ROP) with lesions located in zone II. Methods:Forty-four patients (81 eyes) with type 1 prethreshold retinopathy of prematurity with lesions located in zone II staying in our hospital from October 2015 to December 2019 were collected and divided into LP group and IVR group according to the operation method. Through observation of the postoperative disease involution, retinal vascularization, systemic and ocular complications in each group, the effects of different surgical methods were analyzed. Results: In LP group, 20 patients (37 eyes) underwent retinal laser photocoagulation treatment, with no recurrence occurred after the operation; the cure rate after the first operation was 100%; the disease was controlled at (3.42±1.57) weeks after the operation; and peripheral retinal vascularization was observed at (9.84±4.75) weeks after the operation. In IVR group, 24 patients (44 eyes) were injected with ranibizumab; 39 eyes were under control after a single operation; the cure rate after the first operation was 88.6%; and 5 eyes were not under control after surgery. The disease was controlled for an average of (2.95±2.58) weeks after operation; peripheral retinal vascularization was observed at (14.19±4.95) weeks after operation; there were statistically significant differences in the cure rate after the first operation and retinal vascularization time between the two groups. Conclusion:Retinal laser photocoagulation and IVR have good effects in the treatment of type 1 prethreshold retinopathy of prematurity with lesions located in zone II. However, the recurrence rate using IVR is relatively high. Therefore,the surgical method needs to be cautious and still requires clinical observation.
论著

双眼视网膜母细胞瘤46例的临床特点及疗效

Clinical characteristics and therapeutic effect of 46 cases of bilateral retinoblastoma

:704-710
 
目的:分析46例双眼视网膜母细胞瘤(retinoblastoma,RB)的临床特点及治疗效果。方法:回顾性分析2008年12月至2019年12月重庆市陆军军医大学陆军特色医学中心收治的46例接受静脉化疗联合经瞳孔温热疗法(transpupillary thermotherapy,TTT)或眼摘治疗的双眼RB住院患儿的临床资料,对患儿的保眼率、摘眼率、视力情况及化疗不良反应进行评估。结果:46例患儿中,男27例,女19例,初诊年龄为(13.21±11.13)个月。单纯化疗10例,化疗+TTT治疗11例,化疗+TTT+眼摘治疗17例,化疗+冷凝治疗2例,化疗+冷凝+眼摘治疗6例。46例92眼总保眼率73.1%(57/78),残留视力眼占64.1%(50/78),各期保眼率:A、B期均100.0%,C期86.7%,D期94.1%,E期35.7%。手术摘除24眼,总摘眼率26.1%(24/92),E期手术摘除21眼,占E期患眼60.0%(21/35)。平均化疗(4.1±1.9)次,化疗的骨髓抑制主要表现为白细胞减少、血小板减少及血红蛋白减少。46例患儿随访时间(35.4±23.8)个月,死亡7例,总病死率15.2%(7/46);存活39例,总存活率为84.8%(39/46),5年累积生存率为80.2%。结论:静脉化疗联合局部治疗总体疗效较好,在双眼RB患儿治疗中占据重要地位。化疗具有骨髓抑制作用,停止化疗后骨髓抑制逐渐恢复。
Objective: To analyze the clinical characteristics and therapeutic effect of 46 patients with bilateral retinoblastoma(RB). Methods: The clinical data of 46 patients with bilateral retinoblastoma who received intravenous chemotherapy combined with transpupillary thermotherapy (TTT) or enucleation from December 2008 to December 2019 in our department were analyzed retrospectively. The eye salvage rate, enucleation rate, visual acuity, and chemotherapy side effects were evaluated. Results: The 46 enrolled patients were 27 males and 19 females, at an average age of (13.21±11.13) months at the first visit. Among them, 10 received chemotherapy, 11 received chemotherapy combined with TTT, 17 received chemotherapy combined with TTT and enucleation,and 2 received chemotherapy combined with freezing, 6 received chemotherapy combined with freezing and enucleation. After treatment, 58 eyes were salvaged, with a total salvage rate of 73.1% (57/78), and the eyes that preserved vision account for 64.1% (50/78). The eye salvage rate in each stage were 100.0% for stage A and B, 86.7% for stage C, and 94.1% for stage D, 35.7% for stage E. Twenty-four eyes were enucleated, with a total enucleation rate of 26.1% (24/92), and among 35 eyes at stage E, 21 eyes were enucleated, accounting for 60.0%(21/35). The average time of chemotherapy was 4.1±1.9 and the myelosuppressive effects of chemotherapy include leucopenia, thrombocytopenia and hemoglobinopenia. During the mean follow-up time of (35.4±23.8) months, 7 (15.2%) patients died, and 39 (84.8%) cases survived. The 5-year cumulative survival rate was 80.2%. Conclusion: Intravenous chemotherapy combined with local treatment has a good overall effect and plays an important role in the treatment of bilateral retinoblastoma. Intravenous chemotherapy leads to myelosuppression, and the myelosuppression gradually recovered after stopping intravenous chemotherapy.
论著

2种角膜塑形镜矫治近视复合散光的疗效

Effect of two kinds of orthokeratology lens for compound myopic astigmatism

:503-508
 
目的:探究球面塑形镜、环曲面塑形镜在矫治近视复合散光的有效性及安全性。方法:回顾分析宜昌市第一人民医院2016年3月至2018年3月角膜塑形镜治疗青少年近视94例(178眼),按佩戴塑形镜类型分为球面塑形镜组(48例,90眼)与环曲面塑形镜组(46例,88眼)。记录配镜前、佩戴1年后、停戴1周后的视力、角膜散光、眼轴长、球镜屈光度、眼压、泪膜破裂时间及角膜着染率。结果:戴镜1年后,2组组内相比,散光、球镜度数、眼压、泪膜破裂时间均降低,但2组组间相比,仅散光度数差异有统计学意义(P<0.01)。戴镜1年后,两组视力较戴镜前显著提高,停戴后近视度数较佩戴前增加,但组间差异无统计学意义(P>0.05);2种塑形镜角膜着染发生率差异无统计学意义(P>0.05)。结论:2种塑形镜均能够降低近视复合散光患者度数,有效提高患者视力,但并不能完全阻止近视的进展。虽然环曲面塑形镜在矫正散光方面有优势,但总有效性与安全性并不占优势。
Objective: To observe the effectiveness and safety of orthokeratology lens and toric design othokeratology treatment for compound myopic astigmatism. Methods: From March 2016 to March 2018, 94 teenagers(178 eyes) were selected as the subjects of study. They were divided into two groups according to the type of orthokeratology: the orthokeratology lens group (48 cases, 90 eyes) and the toric design othokeratology group(46 cases, 88 eyes). Visual acuity, corneal astigmatism, axial length, spherical lens refraction, intraocular pressure,tear film rupture time and corneal staining rate were recorded before, after 1 year and after 1 week. Results: After 1 year of wearing the lens, astigmatism, spherical lens degree, intraocular pressure and tear film rupture time were all decreased in the 2 groups compared with each other, but only astigmatism degree was statistically significant between the 2 groups compared with each other (P<0.01). After wearing the glasses for 1 year, the visual acuity of the two groups was significantly improved compared with that before wearing the glasses, and the myopia degree was increased after stopping wearing the glasses compared with that before wearing the glasses, but the difference between the two groups was not statistically significant (P>0.05). There was no statistical significance in the incidence of corneal staining between the two types of shaping lenses (P>0.05). Conclusion: Both of the two shaping lenses can reduce the degree of myopic patients with complex astigmatism and effectively improve the visual acuity of patients, but they can not completely prevent the progress of myopia. Although toroidal shaping mirror has advantages in correcting astigmatism, its overall effectiveness and safety are not.
论著

内下壁减压联合脂肪减压治疗中重度甲状腺相关眼病的疗效观察

Medial-inferior wall orbital decompression combined with fat decompression in the treatment of moderate-to-severe thyroid associated ophthalmopathy

:381-386
 
目的:中重度甲状腺相关眼病内下壁骨性减压联合脂肪减压术的临床疗效观察。方法:回顾性分析25例(31眼)在浙江大学医学院附属第二医院眼科行内下壁骨性减压联合脂肪减压术治疗的甲状腺相关眼病患者,观察时间为2020年1月至2022年1月。术前所有患者均进行了眼眶CT检查,并对双眼视力、眼球突出、复视及双眼外观形态进行了测量。手术效果评价指标为:术后眼球突出度、视力和复视程度,并对相关数据进行统计和分析。结果:术后眼球突出度回退2~6 mm,平均回退(3.45±0.93)mm,切除眶内脂肪1.4~3.6 mL,平均切除(2.33±0.66)mL,外观恢复满意。4例患者术前存在复视,2例患者术后新发复视,术前已存在复视的患者,术后复视程度并未加重,新发的2例复视患者均为轻度复视。术后CT检查显示眼眶减压效果良好。结论:内下壁骨性减压与脂肪减压术联合,可以有效扩大眼眶容积,对眼球进行回纳,减少眼球突出程度,改善容貌外观,且手术切口隐蔽美观,具有较好的临床疗效果。
Objective: To observe the clinical efficacy of medial-inferior wall orbital decompression combined with fat decompression in the treatment of moderate-to-severe thyroid associated ophthalmopathy (TAO). Methods:retrospective analysis was performed on 25 patients (31 eyes) with moderate-to-severe TAO from January 2020 to January 2022 in Eye Hospital of Zhejiang University, who were treated with medial-inferior wall orbital decompression combined with fat decompression. All of patients were given orbital computed tomography to measure visual acuity, exophthalmos, diplopia and ocular appearance before operation. The preoperative and postoperative exophthalmos, visual acuity and diplopia before and after operation were taken as efficacy evaluating indicators. The related data was counted and analyzed statistically. Results: After operation, the reduction of exophthalmos was 2-6 mm, with an average of (3.45±0.93) mm, the volume of intrazonal fat-removal was 1.4-3.6 mL, with an average of (2.33±0.66) mL, with a satisfactory appearance. There were 4 cases of preoperative diplopia and 2 cases of new diplopia after operation, all of which were mild diplopia. Diplopia did not exacerbate after operation in the patients who had diplopia before operation. Conclusion: Medial-inferior wall orbital decompression combined with fat decompression in the treatment of moderate-to-severe TAO can effectively expand orbital volume, reduce exophthalmos, improve appearance with a concealed beautiful surgical incision, showing its good clinical efficacy.
小儿眼病专题

不同剂量康柏西普治疗早产儿视网膜病变的疗效对比

Comparison of the efficacy of different doses of conbercept in the treatment of retinopathy of prematurity

:786-794
 
目的:观察玻璃体腔内注射不同剂量康柏西普治疗早产儿视网膜病变(retinopathy of prematurity,ROP)的疗效以及术后的眼压变化。方法:前瞻性随机对照研究。将2018年1月1日至2021年6月30日在厦门市妇幼保健院确诊为Ι型阈值前期ROP、阈值期ROP、急进性ROP(aggressive ROP,A-ROP)的患儿纳入研究。随机分为减量组和常量组,分别玻璃体腔注射10 mg/mL康柏西普注射液0.015 mL(含康柏西普0.15 mg)和0.025 mL(含康柏西普0.25 mg)。测量并记录注射前5min、注射后5min、30min、1h、12h及24 h的眼压情况。术后1周开始随访眼底情况。疗效评价分为一次治愈、复发和加重。结果:共49例98眼纳入研究,常量组27例54眼,一次治愈成功率79.6%(43/54),复发率16.7%(9/54),加重率3.7%(2/54);减量组2 2例44眼,一次治愈成功率68.2%(30/44),复发率27.3%(12/44),加重率4.5%(2/44);两组间差异无统计学意义(χ 2=1.672,P=0.196)。治疗前5min两组眼压差异无统计学意义(P=0.494);注药后5 min、1 h、12h两组眼压差异有统计学意义(均P<0.05);注药后24 h两组间的眼压差异无统计学意义(P=0.101)。常量组注药前5 min和注药后24 h眼压差异有统计学意义(P=0.03),减量组注药前5 min和注药后24h眼压差异无统计学意义(P=0.84)。结论:减量剂量康柏西普(0.15mg)治疗ROP有效,疗效与常规剂量(0.25 mg)相近,且术后眼压升高幅度较低,更快恢复至术前水平,更安全。
Objective: To evaluate the effectiveness of intravitreal injection of various doses of conbercept in the treatment of retinopathy of prematurity (ROP) and change of intraocular pressure (IOP) after operation. Methods: It was a prospective randomized controlled study. Children who were diagnosed with pre-threshold ROP, threshold phrase ROP, and aggressive ROP (A-ROP) in Xiamen Maternity and Child Healthcare Hospital from January 1, 2018 to June 30, 2021 were included in the study. The children were randomly divided into a reduction group and a constant group, and received intravitreal injection of10 mg/mL conbercept at 0.015 mL (containing 0.15 mg of conbercept) and 0.025 mL (containing 0.25 mg of conbercept) respectively. IOP was measured and recorded 5 min before injection, 5 min, 30 min, 1 h, 12 h and 24 h after injection. The fundus condition was followed up 1 week after the operation. The efficacy evaluation is divided into one cure, recurrence and exacerbation. Results: A total of 98 eyes of 49 cases were included in thestudy. For 27 cases of 54 eyes in the constant group, the one-time cure success rate was 79.6% (43/54), the recurrence rate was 16.7% (9/54), and the exacerbation rate was 3.7% (2/54). In the reduction group, there were 22 cases (44 eyes). The one-time cure success rate was 68.2% (30/44), the recurrence rate was 27.3% (12/44), and the exacerbation rate was 4.5% (2/44). There was no significant difference between the two groups (χ2=1.672,P=0.196). There was no significant difference in IOP between the 2 groups 5 min before treatment (P=0.494). There were statistically significantdifferences in IOP between the 2 groups at 5 min after injection, 1 h after injection, and 12 h after injection (all P<0.05). There was no difference in IOP between the two groups 24 h after injection (P=0.101). There was a statistically significant difference in IOP between 5 min before and 24 h after injection in the constant group (P=0.03), and there was no significant difference in IOP between 5 min before and 24 h after injection in the reduction group (P=0.84). Conclusion: Reduced dose of conbercept (0.15 mg) is effective in the treatment of ROP, and the efficacy is similar to that of conventional dose (0.25 mg). The reduction can help lower the increase of postoperative IOP, returning to the preoperative level more rapidly and safely.
小儿眼病专题

镜下改良眼轮匝肌手术治疗先天性下睑内翻的临床疗效

Clinical efficacy of modified orbicularis oculi surgery under microscope in the treatment of congenital lower eyelid entropion of children

:780-785
 
目的:分析临床应用镜下改良眼轮匝肌手术治疗儿童先天性下睑内翻的效果。方法:回顾性分析安康市中医医院2年期间,应用镜下改良眼轮匝肌手术治疗61例(112眼)儿童先天性下睑内翻,根据睑内翻程度决定缝线跨度、松紧度及去除肌皮瓣量,0/6缝线将睑缘下眼轮匝肌与下睑缩肌缝合,0/8缝线连续缝合皮肤伤口,并做好术后护理。结果:所有患儿随访6~24个月,刺激症状缓解,106眼治愈,2眼好转,4眼复发,总有效率达96.43%。结论:镜下改良眼轮匝肌手术治疗儿童先天性下睑内翻美观、易操作、复发率低。
Objective: To analyze the clinical efficacy of modified orbicularis oculi surgery under microscope in the treatment of congenital lower eyelid entropion of children. Methods: Sixty-one cases (112 eyes) of children with congenital lower eyelid entropion treated by modified orbicularis oculi surgery in Ankang Hospital of Traditional Chinese Medicine from Aug 2020 to Sep 2022 were retrospectively analyzed. The suture span, tightness and the amount of myocutaneous flap removed were determined according to the degree of entropion. The orbicularis oculi muscle of lower eyelid margin was suturedwith 0/6 suture, and the skin wound was sutured continuously with 0/8 suture, and postoperative nursing was done well. Results: All children were followed up for 6–24 months, and the irritation symptoms were relieved, 106 eyes were cured, 2 eyes turned well, and 4 eyes relapsed. The total effective ratereached 96.43%. Conclusion: The modified orbicularis oculi surgery for treatment of children with congenital lower eyelid entropion conforms to visual aesthetics. In addition, it is easy to operate and have a low recurrence rate.
其他期刊
  • 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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