【摘要】 目的 探讨在藏区白内障术前人工晶体度数的测定的必要性。方法 回顾性分析2009年8月—12月在拉萨光明眼科康复诊疗院进行白内障手术的170例患者,其中85例术前行人工晶体度数的测定,85例未行晶体度数的测定,比较两组术后3 d的视力。结果 测定组:术后视力≥0.3为51例,占60％；0.1lt;视力lt;0.3为24例,占28.24%;视力lt;0.1为10例,占11.76％。未测定组:术后视力≥0.3为48例,占56.47％；0.1lt;视力lt;0.3为17例,占20%;视力lt;0.1为20例,占23.53％。两组术后3 d最佳视力的比较有统计学意义(P＜0.05)。结论 术前测定人工晶体度数有助于改善白内障患者术后视力,在藏区有必要行白内障术前人工晶体度数的测定。
Objective To investigate the effects of phacoemulsification on macula in diabetics． Methods Thirty eyes of cataract in diabetics were chosen randomly for measurement of the thickness of fovea of retina using OCT before phacoemulsification and 1 month after surgery ． The other eyes in these patients and 30 eyes of cataract in nondiabetic pati ents with phacoemulsification were as control． Results In 30 eyes of diabetics with phacoemulsification, the mean fovea thickness were (148．5plusmn;27．7) mu;m preoperatively and (219．4plusmn;68．23) mu;m postoperatively, and the difference was significant (Plt;0．05)． In 30 eyes of diabetics without surgery, the mean foveal thickness were (147.4plusmn;27.5) mu;m preoperatively and (148.2plusmn;27.3) mu;m postoperatively and the difference was not significant (Pgt;0．05)． In 30 eyes of cataract in nondiabetic patients, the mean fovea thickness were (142．37plusmn;12．7) mu;m preoperatively and (151．9plusmn;23．7) mu;m postoperatively and the difference was not significant (Pgt;0．05)． In 30 eyes of diabetic s with phacoemulsification, 11 eyes had new macula edema after surgery and 3 eye s had significant retinal thickening． In 6 eyes with macular edema before surgery, the macular edema were aggravated in 3 eyes after surgery． The macular stru ctural changes were not found in two control groups． Conclusion The thickness of retina is inreased after phacoemulsification in deabetics,and morbidity and its severity of postopevative macular edema are increas ed as well． (Chin J Ocul Fundus Dis, 2001,17:175-177)
【摘要】 目的 观察在表面麻醉下不作结膜瓣和传统的以穹窿为基底结膜切开的小切口白内障摘除联合5.5 mm直径人工晶状体植入术的临床效果。 方法 收集2007年1月－2010年12月资料较完整的老年性白内障160例，将160例320只眼随机分成两组，每组各80例160只眼。在表面麻醉下行小切口白内障手术。A组不做结膜瓣，行长5.5 mm角巩膜缘的平行切口； B组行以穹窿为基底的传统的结膜瓣，做长5.5 mm角巩膜平行切口；两组均行手法小切口白内障劈核摘除联合5.5 mm直径硬质人工晶状体植入。观察术后效果及术后并发症。 结果 术后1个月，患者眼部舒适者:A组154只眼（96.25%），B组141只眼（88.13%），两组差异有统计学意义（χ2=7.332，Plt;0.05）。术后结膜退缩、下垂、巨大瘢痕：A组7只眼（4.38%），B组29只眼（18.13%），两组差异有统计学意义（χ2=15.149，Plt;0.01），两组患者术后1 d、1周及1个月视力比较：1 d，A组120只眼（75.00%），B组128只眼（80.00%）（χ2=1.467，Pgt;0.05）；1周，A组130只眼（81.25%），B组132只眼（82.25%）（χ2=0.084，Pgt;0.05）；1个月，A组138只眼（86.25%），B组139只眼（86.86%）（χ2=0.027，Pgt;0.05）；角膜水肿于术后2周后均消退。 结论 在表面麻醉下不做结膜瓣较做结膜瓣小切口白内障劈核摘除术联合人工晶状体植入术省时、对眼表面破坏小，角巩膜切口较小且较为隐闭，术后恢复快。在基层医院是一种较好的白内障手术方法。【Abstract】 Objective To observe the clinical effect of non-conjunctival flaps and traditional conjunctival flaps choper extracapsular cataract extraction (ECCE) on patients with senile cataracts. Methods The clinical data of 160 patients with cataracts between January 2007 and December 2010 were collected. The patients were randomly divided into two groups with 80 patients (160 eyes) in each group. The patients in group A underwent the small-incision choper ECCE surgery with non-conjunctival flaps; while the patients in group B underwent the traditional conjunctival flaps. Then the total effective rate, incidence of complications, and satisfaction rate of the two groups were analyzed and compared. Results One month after the surgery, the comfort was found in 154 eyes (96.25%) in group A and in 141 eyes (88.13%) in group B; the difference was significant (χ2=7.332，Plt;0.05). The complications after the surgery including conjunctiva retraction, nutation, and huge scar were found in 7 eyes (4.38%) in group A and in 29 eyes (18.13%) in group B, and the difference was significant (χ2=15.149，Plt;0.01) . The visual acuity of the patients one day, one week and one month after the surgery in the two groups were: one day: 120 eyes (75.00%) in group A and 128 eyes (80.00%) in group B (χ2=1.467，Pgt;0.05); one week: 130 eyes (81.25%) in group A and 132 eyes (82.25%) in group B (χ2=0.084，Pgt;0.05); one month: 138 eyes (86.25%) in group A and 139 eyes (86.86%) in group B (χ2=0.027，Pgt;0.05). The cornea edema was alleviated half month after the surgery. Conclusion Compared with the traditional way, non-conjunctival flaps ECCE may save the surgical time, reduce the damage of the ocular surface, improve the visual acuity and received higher satisfaction rate and less conjunctive complication, which is a good surgical method in local hospital.
We assayed the levels of free radical and scavenger in the blood and lens of streptozotocin-in-duced diabetic SD rats, and found that the levels of lipoperoxide(LPO),MDA were higher than that of normal SD rats, and the total superoxygen dismutase (T-SOD), Cu-Zn-SOD) were lower that that of normal rats ( P lt;0.01 ). Simultaneous injection of streptozotocin and large dose of SOD could no avoid the occurence of diabetes mllitus, but did improve the metabolism of free radical in blood and lens. Hence, we think that large dose of SOD might be effective in preventing to development of diabetic cataract which is related to deterioration of free radical metabolism. （Chin J Ocul Fundus Dis,1994,10:25-27）
Among 21 cases (27 eyes)of complicated cataract of uveitis that underwent surgery of cataract extraction, 22 eyes (81%) attained the visual acuity of 0.1 or better without apparent side-effect. The results indicated that cataract extraction is recommendable to improve visual acuity and alleviate intraocular inflammation in some eases of complicated cataract of uveltis accompanied with relatively high doage of cortical steroid therapy before and after operation,and the operation could be performed even flare and cells in aqueous humor or keratic precipitates were observed. （Chin J Ocul Fundus Dis,1994,10:162-164）
ObjectiveTo observe the short-term efficacy of sub-Tenon’s triamcinolone acetonide (TA) in the treatment of cystoid macular edema (CME) after cataract surgery.MethodsA retrospective study. From October 1, 2013 to October 1, 2018, 21 patients (21 eyes) with CME after cataract surgery diagnosed at The Affiliated Eye Hospital of Wenzhou Medical University were included in this study. All eyes underwent BCVA, intraocular pressure, frequency domain OCT examination. The standard logarithmic visual acuity chart was used for BCVA examination, which was converted into logMAR visual acuity when recorded. A frequency domain OCT instrument was used to measure the foveal retinal thickness (CRT). Among 21 eyes of 21 patients, 9 eyes were male and 12 eyes were female; the average age was 66.38±10.88 years. The average logMAR BCVA was 0.46±0.23; the average CRT was 519.90±131.59 μm; the average intraocular pressure was 11.01±3.97 mmHg (1 mmHg=0.133 kPa). All eyes underwent a single treatment of 100 mg/ml TA suspension 0.4 ml (containing TA 40 mg) under Tenon's capsule. The average follow-up time after treatment was 32.86±20.2 days. The changes of BCVA, CRT and intraocular pressure were observed 1 month after treatment. The BCVA, CRT and intraocular pressure before and after treatment were compared by paired t test.ResultsOne month after treatment, the average logMAR BCVA, CRT, and intraocular pressure of the CME eyes were 0.29±0.22, 307.71±35.82 μm and 14.19±6.30 mmHg, respectively. Compared with those before treatment, the differences were statistically significant (t=5.252, 8.166, 4.128; P=0.000, 0.000, 0.001). Among 21 eyes, 13 eyes (61.90%) of the retinal cysts in the macular area completely disappeared; 8 eyes (38.1%) were still visible between the retinal layers. Three eyes with intraocular pressure over than 21 mmHg were treated with lowering intraocular pressure and returned to normal.ConclusionSub-Tenon’s capsular injection of TA to treat CME after cataract surgery can reduce CRT and improve vision in a short time.