论著

The safety and effi cacy of modifi ed minimally invasive trabeculectomy for the treatment of primary chronic angle-closure glaucoma

The safety and effi cacy of modifi ed minimally invasive trabeculectomy for the treatment of primary chronic angle-closure glaucoma

:160-166
 
Background: Primary chronic angle-closure glaucoma (PCACG) is one of the main types of glaucoma in China. Trabeculectomy is the most commonly used glaucoma filtration surgery for glaucoma in the world. Conventional trabeculectomy is prone to anesthesia-related complications intraoperative and operationrelated complications postoperative in PCACG treatment. Modified minimally invasive trabeculectomy maybe can reduce the incidence of complications.
Methods: We conducted a prospective case series study and performed modified fornix-based trabeculectomy in 27 patients (30 eyes) under topical anesthesia; we then observed intraoperative anesthesia and cooperation effect, intraoperative and postoperative complications, preoperative and postoperative visual acuity, intraocular pressure (IOP), visual field, and the use of ocular hypotensive drugs. The patients were followed up for at least 12 months.
Results: All operations were completed successfully with no intraoperative complications. All 27 patients (30 eyes) were followed up for at least 12 months. No significant decrease in visual acuity was observed at days 1 or 7 and at months 1, 3, 6, and 12 after operation; however, a significant decrease in IOP was observed at days 1 and 7 and at months 1, 3, 6, and 12 after operation. Moreover, no significant progression in visual field mean defect was observed at month 12 after operation, and the number of ocular hypotensive drugs required was significantly reduced at months 6 and 12 after operation. By month 12 after operation, the overall success rate was 93.33% (28/30).
Conclusions: Modified minimally invasive trabeculectomy is safe and effective for the treatment of PCACG.
Background: Primary chronic angle-closure glaucoma (PCACG) is one of the main types of glaucoma in China. Trabeculectomy is the most commonly used glaucoma filtration surgery for glaucoma in the world. Conventional trabeculectomy is prone to anesthesia-related complications intraoperative and operationrelated complications postoperative in PCACG treatment. Modified minimally invasive trabeculectomy maybe can reduce the incidence of complications.
Methods: We conducted a prospective case series study and performed modified fornix-based trabeculectomy in 27 patients (30 eyes) under topical anesthesia; we then observed intraoperative anesthesia and cooperation effect, intraoperative and postoperative complications, preoperative and postoperative visual acuity, intraocular pressure (IOP), visual field, and the use of ocular hypotensive drugs. The patients were followed up for at least 12 months.
Results: All operations were completed successfully with no intraoperative complications. All 27 patients (30 eyes) were followed up for at least 12 months. No significant decrease in visual acuity was observed at days 1 or 7 and at months 1, 3, 6, and 12 after operation; however, a significant decrease in IOP was observed at days 1 and 7 and at months 1, 3, 6, and 12 after operation. Moreover, no significant progression in visual field mean defect was observed at month 12 after operation, and the number of ocular hypotensive drugs required was significantly reduced at months 6 and 12 after operation. By month 12 after operation, the overall success rate was 93.33% (28/30).
Conclusions: Modified minimally invasive trabeculectomy is safe and effective for the treatment of PCACG.
综述

Application of visual electrophysiology for the diagnosis and treatment of cataracts

Application of visual electrophysiology for the diagnosis and treatment of cataracts

:190-197
 
Visual electrophysiology is widely used in clinical ophthalmology. It is also of significant value in the objective assessment of visual function in adult and pediatric cataract patients and for the diagnosis of and research on retinal and visual pathway diseases. This article systematically reviews visual electrophysiology techniques, their applications in the diagnosis and treatment of adult and pediatric cataracts, and factors influencing the application of visual electrophysiology during surgical treatment for cataracts.
Visual electrophysiology is widely used in clinical ophthalmology. It is also of significant value in the objective assessment of visual function in adult and pediatric cataract patients and for the diagnosis of and research on retinal and visual pathway diseases. This article systematically reviews visual electrophysiology techniques, their applications in the diagnosis and treatment of adult and pediatric cataracts, and factors influencing the application of visual electrophysiology during surgical treatment for cataracts.
Editorial
Editorial
论著

Smart plug泪小管塞治疗水液缺乏型干眼的长期并发症

Long-term complications of Smart plug insertion in the treatment of aqueous tear deficiency dry eye

:134-137
 
目的:评估Smart plug泪小管塞治疗水液缺乏型干眼的长期并发症。方法:收集汕头国际眼科中心2011至2016年门诊确诊的水液缺乏型干眼患者300例(600眼),进行Smart plug泪小管塞治疗,随访观察术后临床并发症,中位随访时间为术后3年(术后1~5年)。结果:3例患者(3眼)术后患有泪小管炎(0.5%),发病时间为术后1~3(中位2)年,取出泪小管塞后并给予局部抗生素滴眼液治愈。2例患者 (4眼)因植入上下泪小管塞后流泪症状不能耐受,单纯取出下泪小管塞后症状缓解(0.7%);4例患者(8眼)因只植入下泪小管塞症状未能明显好转,1个月后再次植入上泪小管塞(1.3%);291例患者干眼主观症状改善,有效率为97.5%,长期随访未发现并发症。结论:虽然Smart plug泪小管塞治疗水液 缺乏型干眼具有明确的疗效,但Smart plug泪小管塞植入后的长期并发症不容忽视,需要长期观察。
Objective: To evaluate the long-term complication associated with the use of the Smart plug in the treatment of aqueous tear deficiency dry eye. Methods: A total of 300 patients (600 eyes) were collected in Joint Shantou International Eye Center from 2011 to 2016, all the patients accepted the treatment with Smart plug, and were followed up for clinical complications. The median follow-up time was postoperative 3 years (1–5 years after surgery). Results: Three patients (3 eyes) developed canaliculitis, the rate was 0.5%. The median time from Smart plug insertion to the onset of canaliculitis was 2 (1–3) years, leaving the Smart plug and resolved the application of topical antibiotics. Two patients (4 eyes) could not suffer from implantation of the upper and lower Smart plug, removed the below, the ratio was 0.7%; 4 patients (8 eyes) need upper Smart plug insertion after implantation of the lower one month later, the rate was 1.3%; 291 cases of dry eye improved by long-term followup, the effective rate was 97.5%. Conclusion: Although the Smart plug is effective in the treatment of aqueous tear deffciency dry eye, the later complications of Smart plug insertion cannot be neglected and need the long-term follow-up.
综述

激光周边虹膜切除术在原发性房角关闭治疗中的进展

Progress of laser peripheral iridotomy in the treatment of primary angle closure

:170-176
 

青光眼是全球第二大致盲眼病,第一大不可逆性致盲眼病,其中原发性闭角型青光眼(primary angle closure glaucoma,PACG)占 25%。激光周边虹膜切除术(laser peripheral iridotomy,LPI)已成为 PACG 和原发性房角关闭的一线治疗。LPI 机制为利用激光在周边虹膜上打孔,解除 PACG 的瞳孔阻滞,加深前房,扩大房角,恢复生理性房水排出途径,从而降低眼压。研究表明 LPI 在原发性房角关闭各个疾病进程中均能比较好的控制眼压,是相对安全的治疗方法。

Glaucoma is the second leading cause of blindness and the most common cause of irreversible blindness worldwide. Primary angle closure glaucoma (PACG) accounts for 25% of glaucoma. Laser peripheral iridotomy (LPI) has become the first line treatment for PACG and primary angle closure (PAC). The mechanism of LPI is to use laser to create a hole in peripheral iris to relieve pupil block, deepen anterior chamber, expand chamber angle, restore pathway of physiological aqueous discharge and reduce intraocular pressure. Studies have shown that LPI can control intraocular pressure well in all stages of PAC, which is safe for PAC.

综述

原发性干燥综合征相关性干眼在眼科诊疗中的现状及研究进展

Current status and research advances in diagnosis and treatment of primary Sjogren’s syndrome associated dry eye disease in ophthalmology

:163-169
 

原发性干燥综合征 (primary Sjogren' s syndromeSS) 是一种主要累及外分泌腺体的自身免疫性疾病,患者通常因为严重的干眼症状首先就诊于眼科,大多数临床医师对原发性干燥综合征相关性干眼 (Sjogren' s syndrome dry eye diseaseSS-DED) 认识不足,可能导致漏诊和误诊。侵入性极小的客观检查及生物标志物的发展,将有助于发现 SS-DED 的真面目,并可能从新的角度阐释其发病机制,为其诊断、分类及治疗提供新的思路。SS-DED 的治疗没有特效的药物,大多数患者需接受多种方法的治疗,以了解哪些方法最有效。

Primary Sjogren' s syndrome is an autoimmune disease that mainly affects exocrine glands. Patients usually refer to ophthalmologists because of severe dry eye symptoms. Most clinicians have insufficient knowledge with dry eye disease associated with primary Sjogren' s syndrome probably leading to misdiagnosis or missing the diagnosis. The diagnosis of Sjogren' s syndrome dry eye disease (SS-DED) is difficult, but the extremely invasive objective examination and the development of biomarkers will help to understand this disease and explain its pathogenesis from a new perspective. There is no specific treatment for the SS-DED, and most patients should receive multiple treatments to select the optimal treatment. 

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

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.
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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