目的: 比较新鲜羊膜和保存羊膜治疗睑球粘连的疗效差异, 分析影响疗效的因素。

方法: 共 51 例 55 只眼因陈旧性化学伤、热烧伤或 Stevens-Johnson 综合征而发生睑球粘连的临床连续病例接受睑球粘连分离联合新鲜羊膜移植(22 只眼) 或保存羊膜移植(33 只眼) 。其中男 30 例 32 只眼, 女 21 例 23 只眼。年龄 4～51 岁, 平均(34.2 ± 4.3) 岁。其中 11 只眼在烧伤后5～11个月, 平均(7.4 ± 1.6) 个月时接受手术, 40 只眼在烧伤后 1～8 年, 平均(2.0 ± 0.7) 年进行手术。

结果: 术后随访 12～32 个月, 平均(19.3 ± 4.1) 个月 。所有移植在结膜眼表面的羊膜(包括新鲜羊膜) 植片在术后早期均未见溃烂和溶解, 周边对合良好。31/55(56.4%) 只眼形成了足够深的穹窿部且恢复了眼球运动功能。9/55(16.4%) 只眼发生部分睑球粘连, 眼球运动轻度受限,但其面积远较术前为小。15 /55(27.3%) 眼术后发生中度以上的睑球粘连。新鲜羊膜和保存羊膜重建眼结膜表面的效果相似( X ² = 0.466, P = 0.797) ; 不同程度睑球粘连的患者其羊膜移植术后的效果不同(新鲜羊膜, X²=27.995, P=0.000; 保存羊膜, X²=33.610, P=0.000) ; 在眼表烧伤后1年内手术比 1 年以上进行羊膜移植的效果也不同(X ²= 4.243, P = 0.039) 。

结论: 新鲜羊膜和保存羊膜一样可以有效地用于重建睑球粘连解除后的结膜眼表。患眼术前睑球粘连程度以及烧伤后其眼表炎症是否处于安静状态等因素都会直接影响羊膜移植重建眼结膜表面的远期疗效。

Purpose: To compare the effect of fresh versus preserved amniotic membrane transplant-ation for conjunctival surface reconstruction after symblepharon lysis and analyze the associated factors.

Methods: Fifty-one consecutive cases (55 eyes) with symblepharon at different degree due to eye burns or Stevens-Johnson syndrome were accepted lysis of symblepharon and amniotic membrane transplantation. Twenty-two eyes of them were performed with fresh amnion grafts, the others (33 eyes) with preserved human amniotic membrane. Eleven eyes were performed within 1 year and forty eyes in 1 to 8 years (mean value, 2.0 ± 0.7 years) after eye burns.

Results: The follow-up time varied from 12 to 32 months (mean value, 19.3 ± 4.1 months) . Fifty-six point four percent (31/55) eyes got enough deep conjunctival fornix and resolution of eye movement restrict. Sixteen percent of them (9/55) recurred less symblepharon and remained slightly eye movement restrict. Fifteen- five eyes of them (27.3%) recurred moderate symblepharon. The effects of surgery were similar between fresh and preserved AMT (X ² = 0.466, P = 0.797) . The effects of AMT for those patients with symblepharon at different degree had significant difference statistically (fresh amnions, X ²= 27.995, P = 0.000; preserved amnions, X ² =33.610, P = 0.000) . The same results were observed between those patients who were performed in different time periods after eye burns ( X ² = 4.243, P = 0.039) .

Conclusion: Fresh amnion has the same effect as preserved one for conjunctival surface reconstruction. The degree of symblepharon and the surgical environment of the ocular surface in the affected eye before surgery will influence the results of amniotic membrane transplantation for conjunctival surface reconstruction.

目的: 探讨小梁切除术两种不同结膜瓣术后功能性滤过泡形成情况。

方法: 比较 372 例(372 只眼) 原发性青光眼不同结膜瓣小梁切除术术后功能性滤过泡形成情况, 其中以角巩缘为基底的结膜瓣 165 只眼, 以穹窿部为基底的结膜瓣 207 只眼。

结果: 术后 1 周对所有患者进行了观察, 3 个月时只有 127 只眼进行了随访。以角巩缘为基底的结膜瓣手术组术后 1 周滤过泡成功率为 83.03 %, 3 个月时为 78.69 %。以穹窿部为基底的结膜瓣手术组术后 1 周滤过泡成功率为 55.07 %, 3 个月时为 53.03 %。两组比较有明显差别。

结论: 本组研究发现, 传统的以角巩缘为基底的结膜瓣术后滤过泡成功率高于以穹窿部为基底的结膜瓣, 其术后降压效果相应亦较好。

Purpoes: To assess the success rate of the formation of functional filtration bleb in eyes undergoing different incision of conjunctiva flap after trabeculectomy.

Methods: To study the formation of functional filtration bleb after trabeculectomy, the result of trabeculectomy with the limbus based conjunctival flap in 165 eyes and the fornix based conjunctival flap in 207 eyes (372 eyes in 372 cases with primary glaucoma in total) was compared.

Results: All patients were observed after trabeculectomy in 1 week, but only 127 eyes were followed up in 3 months. In patients with trabeculectomy using the limbus based conjunctival flap, the success rate of the formation of the filtration bleb was 83.03 % in 1 week and 78.69 % in three months postoperatively, while in those using the fornix based conjunctival flap, the success rate was 55.07 % in 1 week and 53.03 % in 3 months. There was significant difference between the two groups in terms of the success rate of the formation of the filtration bleb.

Conclusions: The result showed that limbus based conjunctival flap was especially effective and had better postoperative intraocular pressure decline.

目的: 探讨泪膜改变对 Goldmann 压平眼压计测量值的影响。

方法: 将 68 例(136 只眼) 受检者随机分为 2 组, 每组 34 例。随机选择一只眼作为实验眼, 另一只眼作为对照眼。A 组的实验眼采用右旋糖苷 70 滴眼液滴眼, B 组的实验眼采用粘弹剂 Viscoat 滴眼。采用 Goldmann 眼压计测量 2 次眼压, 比较滴眼前、后测量值的差异。

结果: A 组对照眼第 1、2 次的眼压测量值分别为(14.44±2.68) mmHg(1 mmHg = 0.133 KPa) 、(14.47 ± 2.69) mmHg, 两次眼压测量值的差异无统计学意义(t = - 0.329, P = 0.744) 。实验眼滴右旋糖苷 70 滴眼液前、后的眼压测量值分别为(14.41 ±2 .63) mmHg、(12.94 ± 2.59) mmHg, 两次眼压测量值的差异有统计学意义 (t = 13.949, P = 0.000) 。B 组对照眼第 1、2 次的眼压测量值分别为(14.29 ± 2.96) mmHg、(14.35 ± 3.12) mmHg, 两次眼压测量值的差异无统计学意义(t = - 0.466, P = 0.644) 。实验眼滴 Viscoat 前、后的眼压测量值分别为 (14.53 ± 3.13) mmHg、(11.18 ± 3.07) mmHg, 两次眼压测量值的差异有统计学意义( t = 22.126, P = 0.000) 。两组的实验眼滴眼后的眼压均呈一致性的下降。

结论: 泪膜的改变可以使 Goldmann 压平眼压计的测量值产生偏差。

Purpose: To explore the effect of tear film changes on the intraocular pressure (IOP) measurement by Goldmann applantion tonometer.

Methods: Sixty-eight normal subjects were randomly divided into two groups (Gruop A and B) , 34 in each group. One eye of each subject by random selection was given Dextran (in Group A) and Viscoat (in Group B) , respectively. And the fellow eyes were used as controls. IOP was measured in all subjects twice using Goldmann applantion tonometer. And the difference between first and second measurements was compared.

Result: In the control eyes of Group A, the average IOP of first and second measurements were (14.44 ± 2.68) mmHg (1 mmHg= 0.133 KPa) and (14.47 ± 2.69) mmHg, there was no difference between the two measurements (t =- 0.329, P = 0.744) . In eyes given Dextran, the average IOP of two measurements were (14.41 ± 2.63) mmHg and (12.94 ± 2.59) mmHg, there was significant difference between the two mea-surements (t =13.949, P= 0.000) . In control eyes of Group B, the average IOP of first and second measurements were (14.53 ± 3.13) mmHg and (11.18 ± 3.07) mmHg, and there was no difference between the two measurements (t = -0.466, P = 0.644) . In eyes given Viscoat, the average IOP of two measurements were (14.53 ± 3.13) mmHg and (11.18 ± 3.07) mmHg, and there was significant difference between the two measurements (t = 22.126, P = 0.000) . After being given Dextran or Viscoat, the IOP values decreased consistently in both Group A and Group B.

Conclusions: The change of tear film components can affect IOP values by Goldmann applantion tonometer.

目的: 分析高度近视眼行白内障摘除及后房型人工晶状体植入术后并发裂孔源性视网膜脱离的发生率、相关危险因素及临床特点。

方法 : 回顾性分析高度近视眼行白内障摘除及后房型人工晶状体植入术患者 146 例(232 只眼) 。裂孔源性视网膜脱离在术后随访的3年时间发生。所有眼均进行了详细的眼科检查, 包括: 最佳矫正视力、眼底检查、A 超眼轴长度测量。

结果: 15 只眼发生裂孔源性视网膜脱离(6.4%) , 均需行玻璃体视网膜手术进行视网膜复位。从白内障手术到发生视网膜脱离的平均时间为10 ± 9 个月(0.5～32 个月) 。视网膜脱离经手术治疗后视力为手动 /10 cm～0.06, 12 只眼(80%) 最终视力低于白内障术前。术中后囊膜破裂与术后视网膜脱离的发生显著相关 (P < 0.01) , 60%(9/15) 的视网膜脱离患者术中发生了后囊膜破裂。

结论: 高度近视眼白内障术后并发裂孔源性视网膜脱离的发生率为 6.4%, 其预后差。术中发生后囊膜破裂患者术后发生视网膜脱离的危险性更高, 对术中后囊膜破裂患者需密切随访。

Aim: To analyze the clinical characteristics, incidence and risk of retinal detachment (RD) after cataract surgery and posterior chamber intraocular lens implantation in high myopic patients.

Methods:The medical records of 146 high myopic patients (232 eyes) who underwent cataract surgery and posterior chamber intraocular lens implantation were studied retrospectively. The development of RD was followed up over a 3-year period, and its characteristics were determined. All of the eyes received a comprehensive ophthal-mological examination, including best-corrected visual acuity measurements, a dilated fundus examination and axial length measured by A-scan ultrasonography.

Results: RD developed in 15 eyes of 15 patients. All the 15 eyes needed vitreo-retinal surgery. The mean interval between cataract surgery and the development of RD was 10 ± 9 months (range 0.5～32 months) . The visual results of the eyes after anatomical successful vitreo-retinal surgery ranged from finger count /10 cm to 0.06. 80% (12/15) of the eyes had a worse vision after the surgery than that before cataract surgery. Posterior capsular tear were associated significantly with RD (P < 0.01). Approximately 60%( 9/15) of retinal detachment was attributable to posterior capsule tear during cataract surgery.

Conclusion: Incidence of RD in high myopic patients after cataract surgery was 6.4%. RD was the potentially serious complication and tended to develop more frequently in eyes with posterior capsular rupture during cataract surgery. It is crucial to examine retinal status after cataract surgery and to have a close follow-up to prevent retinal complications, especially for patients with posterior capsular disruption. 

目的: 建立人晶状体上皮细胞原代培养的简便方法并比较不同来源人晶状体上皮细胞的生物学特性。

方法: 取胎龄 20 周合法引产胚胎眼晶状体囊膜、中山眼科中心眼库眼晶状体囊膜和白内障患者术中撕取的前囊膜, 分别在培养皿中铺平, 加10 μL 10%DMEM 培养液润湿后加盖盖玻

片防止卷曲并促进粘贴, 添加培养液浸没盖玻片, 37℃培养。同时取相同来源的囊膜按照组织块法培养。观察细胞增殖情况并比较原代人晶状体上皮细胞与人晶状体上皮细胞系 SRA01/04 β晶体蛋白的表达差异。

结果: 在盖玻片辅助下, 胚胎眼晶状体囊膜第2天即可见明显的增殖细胞由囊膜缘长出, 眼库眼囊膜和白内障患者术中撕取的囊膜在3～4 d 的潜伏期后亦可见增殖细胞长出; 组织块法培养出现部分组织块漂浮, 且胚胎眼囊膜潜伏期延长至3～4 d, 眼库眼囊膜和白内障患者晶状体囊膜潜伏期延长至4～5 d。

结论: 盖玻片辅助的改良组织块培养法能尽快获得体外培养的原代晶状体上皮细胞, 且操作简便, 值得推广应用于晶状体病的研究。

Purpose: To set up an easy procedure of tissue culture for human lens epithelial cells in vitro and to observe the biological characteristics.

Methods: Capsules from embryo of 20 weeks, eye bank of Zhongshan Ophthalmic Centre and patients with cataract were spread on culture utensil. 10 μ L of 10% DMEM medium was added and a piece of coverslip was lay to prevent crimp. Then the capsules were cultured under 37℃after adding enough medium. Capsules from the same source were cultured by traditional tissue culture method. Expressions of β crystallin between primary tissue culture cells and SRA01/04 cell line were compared by western blotting.

Results: With coverslip assisted, the cells could be observed proliferated and migrated from the edge of embryo capsule 2 days later, and for capsules from eye bank and age-related cataract patients, the interval time was 3 to 4 days. By traditional tissue culture method, the interval time of embryo capsule was 3 to 4 days, and for capsules from eye bank and age-related cataract patients, the interval time was the same. And capsules floated sometimes.

Conclusions: By coverslip assisted primary tissue culture human lens epithelial cells could grow faster and easier, and the method is worthy to be spread in research of lens diseases.

目的: 测量单眼挫伤患者瞳孔对光反射的改变, 分析瞳孔对光反射与眼挫伤后其他视功能评价方法的相关性。

方法: 使用红外线自动瞳孔仪分别检测 26 例单眼挫伤患者双眼瞳孔对光反射, 并行视力、视野、图形视觉诱发电位等视功能检查。检查的瞳孔对光反射参数包括瞳孔面积, 对光反应潜伏期、反应幅度。

结果: 眼挫伤患者健眼直接、间接反应幅度比与双眼视力差具有显著相关性(r =- 0.648) ; 瞳孔对光反应幅度差、反应幅度比均与视野平均偏差具有显著相关性(r =0.5 和 r =- 0.535) ; 瞳孔对光反应幅度比与双眼视觉诱发电位振幅比具有显著相关性; 多重线性回归分析显示瞳孔对光反应幅度和 VEP 振幅结合可提高预测视力预后的可能性。

结论: 在瞳孔对光反射各参数中, 瞳孔对光反应幅度在反映眼挫伤后视功能改变方面优于其它参数, 眼挫伤患者瞳孔对光反应幅度与视力、视野、VEP 波幅具有中度相关性, 其与 VEP 联合应用可提高眼挫伤后准确预测视功能的可能性。

Subjects and objective: To measure the quantitative pupil light reflex after unilateral ocular contusion, analyze the correlation of pupil light reflex and other tests of visual function.

Methods: The pupil light reflex in 26 patients who suffered unilateral ocular contusion was tested by infrared video pupillography, psychophysical and electrophysiological tests including visual acuity, visual field, and visual evoked potentials were also tested. Pupil area, the latency and amplitude of pupil light reflex were recorded.

Results: The correlation of the ratio of pupil light reflex amplitude and the differences of visual acuity between 2 eyes in 26 contusion patients was statistically significant. The correlation coefficient r was - 0.648. There were significant correlation between amplitude of pupil light reflex and median defect of visual field. The correlation coefficients r were 0.5 and 0.535. The significant correlations were found in the ratio of amplitudes between pupil light reflex and visual evoked potentials. Multiple linear regression analysis showed combining pupil light reflex amplitude and visual evoked potential amplitude could elevate the possibility of predicting visual acuity.

Conclusion: Pupil light reflex amplitude measurement is superior to other pupil measurements for reflection of the changes of visual function after ocular contusion. The correlations of pupil light reflex amplitude and visual acuity, visual field, visual evoked potential are significant in the ocular contusion patient. Pupil light reflex combined with visual evoked potential could elevate the possibility of predicting visual function precisely after ocular contusion.

目的:探讨垂体腺瘤对眼视功能损害的临床表现。

方法:对 126 例( 252 只眼)垂体腺瘤患者进行视力、视野、荧光眼底血管造影(Fundus fuorescein angiography, FFA)、图形视诱发电位(Pattem visual evoked potential, PVEP)及眼底检査。

结果:视力下降 186 只眼,占73.8%。眼底原发性视神经萎缩 130 只眼,占51.6%。视野缺损 156 只眼,占69.6%。PVEP异常 160 只眼,占88.9%。26.2%的患者以眼部异常为首诊症状,其中16.7%曾被诊断为眼科疾病。

结论:垂体腺瘤可引起视功能的损害,充分认识垂体腺瘤在眼部的临床特点,有助于早期诊断及时治疗。

Purpose : To investigate the clinical manifestation of damage of visual function causedby pituitary adenoma.

Methods: Visual acuity, visual field, fundus fluorescein angiography (FFA), pattemvisual evoked potential (PVEP) and examination fundus were performed in 126 cases(252 eyes)of pituitary tumor.

Results :There was 73.8% (186 eyes) of patients with decreased visual acuity, 51.6%(130 eyes) with primary optic atrophy, 69.6 %(156 eyes) with the defects of visualfield and 88.9%(160 eyes) with abnormal PVEP. Abnormal ophalmological manifestationwas the first diagnostic symptom in 26.2%, and 16.7% was misdiagnosed as eye diseases.

Conclusions: Pituitary tumor could cause defection of visual function. lt is helpful toearly diagnosis and timely treatment by fully understanding clinical features in the eyewith pituitary tumor.

前段巨眼(anterior megalophthalmos, AM)是一种罕见的双侧非进展性先天性眼前段扩大疾病，表现为大角膜、角膜厚度正常或轻中度变薄、前房明显加深、睫状环扩大和悬韧带松弛。早期症状可仅表现为角膜散光和屈光不正等，并发性白内障和晶状体脱位是AM患者视力下降的主要原因。眼前段解剖结构的异常使AM患者的白内障手术具有很大的挑战性。首先，极端前房深度引起的有效晶状体位置(ELP)预测误差及公式选择不当是导致其术后较大屈光误差的主要原因；其次，悬韧带松弛易导致晶状体脱位、后囊膜破裂和玻璃体脱出等术中并发症的发生；由于超大囊袋及悬韧带松弛，人工晶状体(IOL)偏心甚至脱位也是术后常见的并发症。因此，需根据患者悬韧带情况、晶状体混浊程度采取合适的手术方式及谨慎选择IOL的类型。采用手法小切口晶状体囊外摘除术，可避免超声乳化的高灌注压对悬韧带的进一步损伤，增加手术的安全性；植入光学面及襻宽大的IOL术后具有较好的稳定性；新公式如Barrett Universal Ⅱ、Kane和EVO等公式具有较好的屈光预测准确性。然而，目前关于AM患者的白内障手术治疗报道仍属于个案报道，未来还需要更大样本量的临床研究进一步证实。

前段巨眼(anterior megalophthalmos, AM)是一种罕见的双侧非进展性先天性眼前段扩大疾病，表现为大角膜、角膜厚度正常或轻中度变薄、前房明显加深、睫状环扩大和悬韧带松弛。早期症状可仅表现为角膜散光和屈光不正等，并发性白内障和晶状体脱位是AM患者视力下降的主要原因。眼前段解剖结构的异常使AM患者的白内障手术具有很大的挑战性。首先，极端前房深度引起的有效晶状体位置(ELP)预测误差及公式选择不当是导致其术后较大屈光误差的主要原因；其次，悬韧带松弛易导致晶状体脱位、后囊膜破裂和玻璃体脱出等术中并发症的发生；由于超大囊袋及悬韧带松弛，人工晶状体(IOL)偏心甚至脱位也是术后常见的并发症。因此，需根据患者悬韧带情况、晶状体混浊程度采取合适的手术方式及谨慎选择IOL的类型。采用手法小切口晶状体囊外摘除术，可避免超声乳化的高灌注压对悬韧带的进一步损伤，增加手术的安全性；植入光学面及襻宽大的IOL术后具有较好的稳定性；新公式如Barrett Universal Ⅱ、Kane和EVO等公式具有较好的屈光预测准确性。然而，目前关于AM患者的白内障手术治疗报道仍属于个案报道，未来还需要更大样本量的临床研究进一步证实。

青光眼是一组以病理性眼压升高为主要危险因素的，以青光眼性神经萎缩和视野缺损为主要特征的全球首位不可逆性致盲眼病。超声睫状体成形术(UCP)是一种新型非侵入性青光眼治疗技术，其降眼压主要原理为利用高强度聚焦超声破坏睫状突上皮细胞以减少房水生成，并增加葡萄膜巩膜通道的房水流出。UCP适应证广泛，早期主要用于各类难治性青光眼患者，特别是晚期及绝对期患者，研究者发现其除降眼压外，还能够显著缓解该类患者的局部疼痛。近年来，UCP在未经手术治疗的青光眼患者和早、中期青光眼病例中，也表现出了良好的降眼压效果，同时显示出较少的并发症和较轻的术后反应，并可重复治疗。然而不同类型青光眼UCP疗效存在一定差异，且为达最佳治疗效果，其治疗需匹配恰当的探头型号以及适当的治疗扇区。现有较广泛应用于国外的基于眼轴和白到白参数的公式计算方法，测算精度并不适用于国人，然而精准度更高的模型法，其便捷性仍有待进一步提高。UCP虽可减少降眼压药物用量，但术后用药策略的调整仍可能导致眼压波动。综上，针对UCP手术的适应证选择、手术参数设计、疗效预判以及术后管理策略等，仍有待开展相关临床研究，以期为其临床应用提供更加可靠的依据。

青光眼是一组以病理性眼压升高为主要危险因素的，以青光眼性神经萎缩和视野缺损为主要特征的全球首位不可逆性致盲眼病。超声睫状体成形术(UCP)是一种新型非侵入性青光眼治疗技术，其降眼压主要原理为利用高强度聚焦超声破坏睫状突上皮细胞以减少房水生成，并增加葡萄膜巩膜通道的房水流出。UCP适应证广泛，早期主要用于各类难治性青光眼患者，特别是晚期及绝对期患者，研究者发现其除降眼压外，还能够显著缓解该类患者的局部疼痛。近年来，UCP在未经手术治疗的青光眼患者和早、中期青光眼病例中，也表现出了良好的降眼压效果，同时显示出较少的并发症和较轻的术后反应，并可重复治疗。然而不同类型青光眼UCP疗效存在一定差异，且为达最佳治疗效果，其治疗需匹配恰当的探头型号以及适当的治疗扇区。现有较广泛应用于国外的基于眼轴和白到白参数的公式计算方法，测算精度并不适用于国人，然而精准度更高的模型法，其便捷性仍有待进一步提高。UCP虽可减少降眼压药物用量，但术后用药策略的调整仍可能导致眼压波动。综上，针对UCP手术的适应证选择、手术参数设计、疗效预判以及术后管理策略等，仍有待开展相关临床研究，以期为其临床应用提供更加可靠的依据。

目 的: 比 较 不 同 能 量 氪 离 子 黄 绿 光 联 合 Nd ∶YAG 激 光 行 周 边 虹 膜 切 开 术 的 临 床 疗 效 和 对 眼压、血- 房 水 屏 障 的 影 响。

方 法: 使 用 激 光 蛋 白 细 胞 仪 及 压 平 式 眼 压 计 对 31 例(62 只 眼) 接 受 高 能 量 组 700 mW, 低 能量 组 400 mW的 氪 离 子 联 合 Nd: YAG 激 光 行 周 边 虹 膜 切 除 术 前、术 后 的 房 水 蛋 白 浓 度、前 房细 胞 数 和 眼 压 进 行 比 较。术 后 随 访 1 个 月。

结 果: 激 光 周 边 虹 膜 切 开 术 两 组 周 切 口 通 畅 无 闭 合, 无 角 膜 损 伤 及 晶 体 混 浊。 术 前 和 术 后1 h、3 d、7 d 及 1 个月的平均 Goldmann 眼压值在高能量组分别为 ( 15.68±2.41) 、(27.13±3.48) 、(20.97±5.27) 、(16.35±1.14) 、(15.06±2.02) , 在 低 能 量 组 分 别 为( 15.35±1.78) 、(22.77±3.26) 、(16.26±2.41) 、(15.68±2.06) 、( 15.06±1.36) 。术 前 和 术 后 3 d、7 d 及 1 个 月 的 平 均 房 水 闪 光 值在 高 能 量 组 分 别 为( 4.65±1.50) 、(10.41±2.47) 、(7.31±2.31) 、(6.15±2.16) , 在 低 能 量 组 分 别 为(4.45±1.19) 、(6.47±1.11) 、(4.81±0.55) 、(4.98±1.48) pc/ms; 前 房 细 胞 数 平 均 值 在 高 能 量 组 分别 为( 0.47±0.42) 、( 36.22±9.16) 、(18.54±3.60) 、( 6.29±0.98) , 在 低 能 量 组 分 别 为(0.58±0.52) 、(24.73±6.09) 、(10.61±1.70) 、(2.96±1.35) 。高 能 量 组 术 后 1 h 及 第 3 天 眼 压 的 升 高 幅 度 较 低能 量 组 高, 术 后 各 点 的 房 水 闪 光 值 和 前 房 细 胞 数 升 高 幅 度 均 较 低 能 量 组 明 显, 术 后 1 个 月 两组 前 房 细 胞 数 及 高 能 量 组 房 水 闪 光 值 仍 未 能 降 至 术 前 水 平, 差 异 有 显 著 性 意 义( P < 0.05) 。

结 论: 低 能 量 与 高 能 量 氪 黄 绿 激 光 联 合 Nd ∶YAG 激 光 周 边 虹 膜 切 开 术 两 组 周 切 口 通 畅, 临 床效 果 相 同; 低 能 量 组 术 后 一 过 性 眼 压 升 高 恢 复 至 正 常 较 快, 前 房 蛋 白 较 快 恢 复 正 常。提 示 在 进行 激 光 周 边 虹 膜 切 开 术 时 应 尽 可 能 用 低 能 量。两 组 术 后 1 个 月 前 房 仍 有 细 胞, 应 继 续 随 访。

Purpose: To compare the influence of krypton laser with different power densities combined with Nd: YAG laser peripheral iridotomy (LPI) on the intraocular pressure, blood-aqueous barrier and inflammatory of anterior chamber as well as the therapeutic effect.

Methods: Using a laser flare cell meter and Goldmann tonometer, the level of aqueous protein, the number of cells in the anterior chamber and intraocular pressure of 31 patients (62 eyes) who underwent krypton laser with different power densities combined with Nd: YAG laser peripheral iridotomy were examined and recorded preoperatively and postoperatively.

Results: The mean preoperative and 1-hour, 3-day, 7-day, 1-month postoperative intraocular pressure ( IOP) of the high power-density group were (15.68±2.41) , (27.13 ±3.48) , (20.97 ±5.27) , (16.35 ±1.14) and (15.06 ±2.02) mmHg, while those of the low were (15.35±1.78) , (22.77±3.26) , (16.26±2.41) , (15.68±2.06) and (15.06±1.36) mmHg. The mean preoperative and 3-day, 7-day, 1-month postoperative flare intensity of the high power-density group were (4.65±1.50) , (10.41±2.47) , (7.31±2.31) and (6.15±2.16) pc /ms, while those of the low were (4.45±1.19) , (6.47±1.11) , (4.81±0.55) and (4.98±1.48) pc/ms. The number of aqueous cells of the high was (0.47±0.42) , (36.22±9.16) , ( 18.54±3.60) and (6.29±0.98) , while that of the low was (0.58±0.52) , (24.73±6.09) , (10.61±1.70) and (2.96±1.35) . The mean 1-hour and 3-day postoperative IOP of the high was higher than that of the low. Both the mean flare intensity and the mean number of aqueous cells of the high power-density group were higher than those of the low. The differences were of statistical significance (P <0.05) . The mean flare intensity of the high power-density group in the 1-month postoperative follow-up was still higher than the baseline. The mean number of aqueous cells of both the high and the low power-density groups in the 1- month postoperative follow-up was still higher than the baseline. During 1-month follow-up, no obvious visual damage, diffuse corneal endothelial burns or corneal decompensation, lens injury and closure of the peripheral iris incision were observed.

Conclusion: When krypton laser combined with Nd: YAG laser peripheral iridotomy is under consideration, relatively low power-density krypton laser is recommended because it can achieve the similar therapeutic effects as high power-density krypton laser but leads to less complications and a briefer recovery. More follow-ups are needed after LPI, because the number of aqueous cells in 1-month follow-up was still abnormal.