目的：探讨白内障小切口非超声乳化术向超声乳化术转型中的技术转变。

方法：对 2009 年 4 月 - 2009 年 12 月“光明工程”中白内障超声乳化手术转型期 193 例 193 眼的情况进行回顾性分析，同期行小切口非超声乳化吸除术患者 43 例 48 眼作对照。

结果：对照组术后第 1 日裸眼视力大于或等于 0.5 的比例高于治疗组（P < 0.05），术后第 1 周、 第 1 个月裸眼视力大于或等于 0.5 及术后第 1 个月最佳矫正视力大于或等于 0.5 的比例，两组比较差异无统计学意义（均 P > 0.05）。对照组术后主要并发症比率均低于治疗组（均 P < 0.05）。

结论：小切口非超声乳化术向超声乳化术转型中，由于技术差异较大，发生后囊破裂和角膜内皮水肿的几率较高，转型此手术要有熟练的显微手术基础、处理并发症的能力和一定的设备条件。

Purpose: To investigate the clinical outcome during the conversion from small incision sutureless cataract surgery (SICS) to phacoemulsification cataract surgery (phaco).

Methods: During the conversion period from SICS to phaco, 241 cataract cases were assigned to SICS and phaco surgery procedures. The intraoperative complications and early postoperative outcomes were assessed.

Results: The 1st day visual acuity outcome (VA 0.5 or better) was lower in the phaco group (P < 0.05); however, the visual acuity outcomes were no longer statistically different at 1 week and 1 month visits (P > 0.05 for each visit). Among 193 cases operated in the phaco group, 51 cases (26.4%) developed corneal edema at the 1 day visit, 13 cases (6.7%) had posterior capsular rupture, 5 cases (2.6%) had zonular rupture, and 5 cases (2.6%) failed to implant IOL. These rates were higher than those found in the SICS group.

Conclusion: The outcome of phaco cataract surgery is comparable with SICS during this conversion period. Techniques that the surgeons may pay attention to are also discussed.

目的：评价玻璃体腔注射曲安奈德（IVTA）联合视网膜激光对糖尿病性黄斑水肿（DME）的疗效

方法：将黄斑部出现微血管瘤的 DME 患者 25 例（32 眼）随机分为 A、B、C、D 组，每组 8 眼。A 组行单纯倍频 532 激光光凝治疗，B 组行倍频 532 激光光凝联合经瞳孔温热疗法，C 组行倍频 532 激光光凝联合曲安奈德玻璃体腔注射治疗，D 组行倍频 532 激光光凝、经瞳孔温热疗法加曲安奈德玻璃体腔注射治疗，C、D 组在激光治疗后 1 周行玻璃体腔注射曲安奈德 4 mg。观察 4 组治疗前及治疗后 1、3、6 个月视力、眼压、黄斑中心凹厚度（FT）。

结果：4 组患者治疗前视力、眼压、黄斑中心凹厚度差异均无统计学意义（P > 0.05）；4 组治疗后 1、3、6 个月，视力、眼压、黄斑中心凹厚度：A 组与 B 组、C 组与 D 组差异无统计学意义（P > 0.05），A、B 组分别与 C、D 组比较差异有统计学意义（P < 0.05）。

结论：激光联合曲安奈德玻璃体注射、激光、经瞳孔温热疗法联合曲安奈德玻璃体腔注射治疗 DME 效果优于单纯激光和激光联合经瞳孔温热疗法。

Objective: To evaluate the effect of intravitreal injection of triamcinolone acetonide (IVTA) combining with retinal laser treatment for diabetic macular edema (DME).

Methods: Twenty five patients (32 eyes) with DME who have microangioma in macula lutea were randomly divided into group A, B, C, and D (8 eyes each group). Eyes in group A were treated with laser photocoagulation. Eyes in group B were treated with multiplier-532 laser photocoagulation and transpupillary thermotherapy. Eyes in group C were treated with multiplier-532 laser photocoagulation and intravitreal triamcinolone acetonide. Eyes in group D were treated with multiplier-532 laser, transpupillary thermotherapy plus triamcinolone acetonide injection. Intravitreal injection of 4 mg triamcinolone acetonide was done 1 week after laser photocoagulation in group C and D. The visual acuity, intraocular pressure, macular thickness (foveal thickness) of the eyes in 4 groups were observed before and 1, 3, and 6 months after treatment.

Results: The visual acuity, intraocular pressure, and foveal thickness of the 4 groups before treatment showed no significant difference (P > 0.05). The visual acuity, intraocular pressure, macular thickness of eyes in group A, B were better than those of group C, D at 1, 3, and 6 months after treatment, and they had significant difference (P < 0.05), while they didn’t show significant difference between group A and B, group C and D (P > 0.05).

Conclusion: The effect of laser photocoagulation and intravitreal triamcinolone acetonide, laser photocoagulation combining with transpupillary thermotherapy plus triamcinolone acetonide injection treating for DME was better than laser photocoagulation alone, laser photocoagulation combining with transpupillary thermotherapy.