目的：通过光学相干断层扫描技术(optical coherence tomography，OCT)观察不同临床类型原发性闭角型青光眼(primary angle-closure glaucoma, PACG)行激光周边虹膜切开术(laser peripheral iris, LPI)前、后前房角开放距离变化，评价治疗效果。方法：选择明确诊断为PACG患者46例50眼，其中 急性闭角型青光眼临床前期及缓解期眼26例27眼，慢性闭角型青光眼20例23眼，行LPI治疗，通过OCT分别检查术前、术后2周距巩膜突500及750 μm处前房角开放距离，采用配对t检验。结果：急性闭角型青光眼LPI术前、术后2周前房角开放距离差异有统计学意义(P<0.05)；慢性闭角型青光眼术 前、术后2周前房角开放距离差异无统计学意义(P>0.05)。结论：急性闭角型青光眼LPI术后前房角开放距离增加，治疗效果较好；慢性闭角型青光眼LPI术后前房角开放距离增加不明显，术后仍存在前房角闭塞趋向。

Objective: To observe the anterior chamber angle opening distance before and after laser peripheral iris (LPI) in patients with different clinical types of primary angle closure glaucoma (PACG) by using optical coherence tomography (OCT), and evaluate the effect of the treatment. Methods: Selected 46 cases (50 eyes) of patients with PACG, including 26 cases (27 eyes) of acute angle closure glaucoma at the preclinical stage and remission phase of ocular and 20 cases (23 eyes) of chronic angle closure glaucoma, implemented LPI, examined the anterior chamber angle opening distance at the point of 500 and 750 μm from posterior to the scleral before and after surgery for 2 weeks by OCT, using a paired t-test. Results: Compared the anterior chamber angle opening distance before and after surgery for 2 weeks, the difference in patients with acute angle closure glaucoma was statistically significant (P<0.05), but not statistically significant in patients with chronic angle closure glaucoma (P>0.05). Conclusion: The opening distance of the anterior chamber angle of the patients with acute angle  closure glaucoma after LPI was increased, and the treatment effect was better; but of the patients with chronic angle closure glaucoma after LPI, the distance was not obviously increased, the tendency of anterior chamber angle occlusion still existed after LPI.

Background: Evaluation of corneal biomechanical properties 3 months after using rigid gas permeable (RGP) contact lenses in keratoconus.

Methods: In this prospective trial study, cases were 32 keratoconic eyes with no history of RGP lens wear. All eyes were examined with the Ocular Response Analyzer (ORA) and the Corneal Visualization Scheimpflug Technology (CORVIS-ST) to measure corneal hysteresis (CH), corneal resistance factor (CRF), deformation amplitude (DA), applanation velocity (AV) 1 and 2, applanation length (AL) 1 and 2, and peak distance before and 3 months after fitting aspheric RGP lenses. The effect of the correlation between contralateral eyes and maximum keratometry were controlled for in the analysis. Results were compared using repeated measures analysis of covariance.

Results: At 3 months, neither the increases in mean CH (0.14±2.77 mmHg, P=0.789), CRF (0.41±4.35 mmHg, P=0.612), AV1 (0.03±0.17 m/s, P=0.301), AV2 (0.11±0.59 m/s, P=0.299), AL1 (0.44±1.56 m/s, P=0.118), AL2 (1.16±5.06 m/s, P=0.211), and peak distance (0.19±1.29 m/s, P=0.409), nor the decrease in mean DA (0.03±0.17 mm, P=0.402) was statistically significant.

Conclusions: Results in our series of patients indicated that 3 months of RGP lens wear had no significant impact on corneal biomechanics, and perhaps non progression of keratoconus. Therefore, RGP lenses can be regarded safe and appropriate in keratoconic patients.

Background: Evaluation of corneal biomechanical properties 3 months after using rigid gas permeable (RGP) contact lenses in keratoconus.

Methods: In this prospective trial study, cases were 32 keratoconic eyes with no history of RGP lens wear. All eyes were examined with the Ocular Response Analyzer (ORA) and the Corneal Visualization Scheimpflug Technology (CORVIS-ST) to measure corneal hysteresis (CH), corneal resistance factor (CRF), deformation amplitude (DA), applanation velocity (AV) 1 and 2, applanation length (AL) 1 and 2, and peak distance before and 3 months after fitting aspheric RGP lenses. The effect of the correlation between contralateral eyes and maximum keratometry were controlled for in the analysis. Results were compared using repeated measures analysis of covariance.

Results: At 3 months, neither the increases in mean CH (0.14±2.77 mmHg, P=0.789), CRF (0.41±4.35 mmHg, P=0.612), AV1 (0.03±0.17 m/s, P=0.301), AV2 (0.11±0.59 m/s, P=0.299), AL1 (0.44±1.56 m/s, P=0.118), AL2 (1.16±5.06 m/s, P=0.211), and peak distance (0.19±1.29 m/s, P=0.409), nor the decrease in mean DA (0.03±0.17 mm, P=0.402) was statistically significant.

Conclusions: Results in our series of patients indicated that 3 months of RGP lens wear had no significant impact on corneal biomechanics, and perhaps non progression of keratoconus. Therefore, RGP lenses can be regarded safe and appropriate in keratoconic patients.

The present study reports a case of a patient with choroidal neovascularization (CNV) associated with pseudoxanthoma elasticum (PXE). We observed the functional and anatomical improvement of the patient treated with intravitreal vascular endothelial growth factor (VEGF) inhibitor bevacizumab. The study also systematically searched the database for similar cases to provide a literature review. Data concerning the clinical features, treatment strategies and outcomes were extracted and analyzed. Retrospective interventional case report and systematic literature review. A 56-year-old healthy Chinese woman with CNV secondary to PXE was reported. Examinations included best corrected visual acuity (BCVA), biomicroscopy, optical coherence tomography (OCT), fluorescein and indocyanine green angiography and digital fundus photography. The patient managed with intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections (bevacizumab 1.25 mg/0.05 mL). The Cochrane Library, PubMed, OVID, and UpToDate databases were searched using the term pseudoxanthoma elasticum or Gr?nblad-Strandberg syndrome with the limits English. Articles that predated the databases were gathered from current references. Fundus examination revealed angioid streaks bilaterally and CNV in left eye (LE). After the patient underwent three intravitreal injections of bevacizumab, the LE showed absorption of the subretinal fluid and shrinkage of the CNV. Visual acuity (VA) was improved in her treated LE. Bevacizumab treatment was well tolerated with no adverse events reported. Approximately ten articles about 45 patients (49 eyes) describing CNV secondary to angioid streaks in PXE treated with anti-VEGF were found in the literature search. In the present case, bevacizumab of an initial three injection loading dose, achieved maintenance of visual function in the treatment of CNV associated with angioid streaks in PXE. Literature articles concluded that the intravitreal application of anti-VEGF is highly efficient for improving and stabilizing the lesion as well as the eyesight. So we believe that anti-VEGF therapy can be a great choice of treatment for CNV secondary to angioid streaks related PXE.

The present study reports a case of a patient with choroidal neovascularization (CNV) associated with pseudoxanthoma elasticum (PXE). We observed the functional and anatomical improvement of the patient treated with intravitreal vascular endothelial growth factor (VEGF) inhibitor bevacizumab. The study also systematically searched the database for similar cases to provide a literature review. Data concerning the clinical features, treatment strategies and outcomes were extracted and analyzed. Retrospective interventional case report and systematic literature review. A 56-year-old healthy Chinese woman with CNV secondary to PXE was reported. Examinations included best corrected visual acuity (BCVA), biomicroscopy, optical coherence tomography (OCT), fluorescein and indocyanine green angiography and digital fundus photography. The patient managed with intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections (bevacizumab 1.25 mg/0.05 mL). The Cochrane Library, PubMed, OVID, and UpToDate databases were searched using the term pseudoxanthoma elasticum or Gr?nblad-Strandberg syndrome with the limits English. Articles that predated the databases were gathered from current references. Fundus examination revealed angioid streaks bilaterally and CNV in left eye (LE). After the patient underwent three intravitreal injections of bevacizumab, the LE showed absorption of the subretinal fluid and shrinkage of the CNV. Visual acuity (VA) was improved in her treated LE. Bevacizumab treatment was well tolerated with no adverse events reported. Approximately ten articles about 45 patients (49 eyes) describing CNV secondary to angioid streaks in PXE treated with anti-VEGF were found in the literature search. In the present case, bevacizumab of an initial three injection loading dose, achieved maintenance of visual function in the treatment of CNV associated with angioid streaks in PXE. Literature articles concluded that the intravitreal application of anti-VEGF is highly efficient for improving and stabilizing the lesion as well as the eyesight. So we believe that anti-VEGF therapy can be a great choice of treatment for CNV secondary to angioid streaks related PXE.

眼科日间手术显著提高了医疗效率、节约了医疗资源，眼科麻醉复苏体系的建立则是眼科日间全身麻醉手术的重要安全保障，也是提高眼科手术室效率的重要举措。在眼科手术结束后，全身麻醉患者被即刻转运至麻醉恢复室(post-anesthesia care unit, PACU)，此时患者仍处于麻醉状态，密切的监测和呼吸机辅助通气是必不可少的，从而保障患者从麻醉状态逐渐恢复至清醒状态。当患者清醒后，拔除喉罩，各项监测指标达到PACU的转出标准，可进入到Ⅱ期复苏并日间手术离院。然而，在PACU复苏期间，患者易出现喉罩移位、呛咳等引起急性缺氧等呼吸道不良事件的发生，小儿患者则由于术后眼罩遮盖等原因，出现苏醒期躁动的概率高，从而影响到患者顺利转出PACU，间接影响到手术患者的周转。因此，如何预防这些并发症的发生，对提高眼科麻醉复苏质量显得十分重要。

眼科日间手术显著提高了医疗效率、节约了医疗资源，眼科麻醉复苏体系的建立则是眼科日间全身麻醉手术的重要安全保障，也是提高眼科手术室效率的重要举措。在眼科手术结束后，全身麻醉患者被即刻转运至麻醉恢复室(post-anesthesia care unit, PACU)，此时患者仍处于麻醉状态，密切的监测和呼吸机辅助通气是必不可少的，从而保障患者从麻醉状态逐渐恢复至清醒状态。当患者清醒后，拔除喉罩，各项监测指标达到PACU的转出标准，可进入到Ⅱ期复苏并日间手术离院。然而，在PACU复苏期间，患者易出现喉罩移位、呛咳等引起急性缺氧等呼吸道不良事件的发生，小儿患者则由于术后眼罩遮盖等原因，出现苏醒期躁动的概率高，从而影响到患者顺利转出PACU，间接影响到手术患者的周转。因此，如何预防这些并发症的发生，对提高眼科麻醉复苏质量显得十分重要。

      总结32例飞秒激光辅助角膜移植术患者的护理，认为做好心理护理、术前完善眼部检查和做好充分的准备，术后严密观察敷料、眼压和角膜植片的情况，做好特殊体位和角膜接触镜的护理，并做好出院指导是提高手术的成功率及预防并发症的关键。

This paper summarized the nursing care of 32 patients received femtosecond laser assisted corneal transplantation. The key points to increase the success rate of surgery and prevent complications were psychological nursing, preoperative examinations and fully prepared, postoperative observation of dressing, intraocular pressure and corneal glass, care of special position and corneal contact lens, and discharge guidance.