Objective:To compare the efficacy of two different surgical methods for treating primary pterygium.Methods:This was a prospective randomized controlled study. A total of 48 patients (48 eyes) with primary pterygium were enrolled in Luoyang Central Hospital Affiliated to Zhengzhou University from May 2023 and September 2024. They were divided into group A (24 eyes) and group B (24 eyes) using a random number table method. Group A underwent conventional pterygium excision combined with limbal stem cell transplantation, while group B underwent modified pterygium excision with conjunctiva combined with limbal stem cell transplantation. Surgical duration, corneal wound healing time, tear film break-up time (BUT), and recurrence rates were compared between the two groups.Results:The surgical time was (25.46±3.50) min in group A and (18.83±2.16) min in group B, with a statistically significant difference between the groups ( t= 7.94, P<0.001). Corneal wound healing time was (3.83±1.27) d in group A and (3.67±1.13) d in group B, with no statistically significant difference ( t=0.48, P=0.634). Preoperative and postoperative BUT at 2 weeks, 1 month, 3 months, and 6 months were as follows: (10.71±2.14), (6.04±2.26), (7.08±2.02), (9.13±2.58), and (10.25±1.92) s in group A (10.42±2.06), (6.00±1.98), (7.38±1.64), (10.50±1.86), and (10.17±1.40) s in group B, respectively. Compared with preoperative values, BUT decreased in both groups at 2 weeks and 1 month postoperatively (all P<0.05). At 3 and 6 months postoperatively, there were no statistically significant differences in BUT compared to the preoperative values in the two groups (all P>0.05). There was no statistically significant difference between the groups ( P>0.05). Recurrence occurred in 1 eye in group A, with a recurrence rate of 4.2%, while no recurrence was observed in group B. However, the difference was not statistically significant ( χ2=1.02, P=0.312). Conclusion:The modified pterygium excision with conjunctiva technique is more technically efficient and time-saving compared to conventional excision with limbal stem cell transplantation.
为维护中华医学会系列杂志的声誉和广大读者的利益,现将中华医学会杂志对一稿两投和一稿两用问题的处理声明如下:(1)本声明中所涉及的文稿均指原始研究的报告或尽管 2 篇文稿在文字的表达和讨论的叙述上可能存在某些不同之处,但这些文稿的主要数据和图表是相同的.
我刊近期收到作者举报,有假冒《中华眼外伤职业眼病杂志》官网(. zgzzsl. com/index. php? s=/index/view/cz/tgxz/id/2877. html),误导作者在该网站在线投稿,并以收取版面定金(200 元)等名义骗钱牟利.
Objective To analyze the influence of lens opacity in radiation workers under low dose ionizing radiation.Methods This was a cross-sectional study.Physical examination data of 1 455 radiation workers who underwent occupational disease physical examination in Hangzhou Occupational Disease Prevention and Treatment Center from Jan.2020 to Dec.2021 were collected and the individual radiation dose monitored during the 10 years from 2011 to 2021 were statistically analyzed.The influence factors of lens opacity and gender,age,radiation dose,types of work and radiological working age were analyzed.Multivariate logistic regression analysis was used to analyze the data.Results A total of 105 cases of lens opacity were detected among 1 455 radiation workers with a turbidity rate at 7.22%,among which 52 cases of posterior subcapsular turbidity(49.52%).The opacity rate of lens increased with the increase of age and working age,showing a linear trend(χ2age =111.97,χ2working age = 78.69,all P<0.001).With the increase of total radiation dose and average annual radiation dose,the proportion of lens opacity gradually increased(χ2total radiation dose = 46.90,χ2annual average radiation dose = 15.82,all P<0.001).Age,types of work and total dose were independent risk factors for posterior subcapsular turbidity(age:B= 0.066,OR:1.068,95%CI:1.035-1.103,P<0.05;total radiation dose:B=0.105,OR=1.111,95%CI=1.033-1.194,P=0.005).Top three work types were nuclear medicine(6/51),radiotherapy(14/240),and interventional radiology(18/340).Conclusion The opacity rate of ocular lens of radiation workers is related to age,radiation dose,types of work and radiological seniority,and the risk of subcapsular opacity is the highest after the emergence of nuclear medicine.
Objective To observe the changes of intraocular lens(IOL)position and anterior chamber after Nd:YAG laser posterior capsulotomy for the treatment of posterior capsular opacification(PCO).Methods This was a prospective randomized controlled study.A total of 70 eyes of 60 cases with PCO who received Nd:YAG laser posterior capsulotomy were collected in Kaifeng Central Hospital from May 2022 to Jul.2022.Best corrected visual acuity(BCVA,logMAR),intraocular pressure and anterior segment were examined before and right after the operation and at 1 week after operation.The inclination,eccentricity and anterior chamber depth of IOL were quantitatively analyzed by Pentacam anterior segment analyzer and AutoCAD software.Results Before surgery,immediately after surgery and at 1 week after surgery:BCVA was 0.60±0.14,0.27±0.20,and 0.25±0.23,respectively.The IOP was(13.79±2.50)mmHg,(14.49±2.28)mmHg and(14.10±1.92)mmHg(1 mmHg=0.133 kPa),respectively.The IOL inclinations were 3.0(2.0,4.0)degrees,2.0(1.0,4.0)degrees and 3.0(1.0,4.0)degrees,respectively.The eccentricity of IOL was 0.104(0.100,0.200)mm,0.104(0.100,0.200)mm and 0.102(0.000,0.200)mm,respectively.The anterior chamber depth was(4.63±0.40)mm,(4.11±0.49)mm,and(3.72±0.65)mm,respectively.There were significant differences in BCVA and anterior chamber depth among different time points before and after surgery(F=15.58,P<0.001;F=57.13,P<0.001).There were no differences in IOL inclination(H=1.12,P=0.490),eccentricity(H=0.91,P=0.633)or intraocular pressure(F=1.51,P= 0.223)among different time points before and after surgery.Conclusion BCVA after Nd:YAG laser posterior capsulotomy significantly improves,with little influence on IOP,IOL tilt or eccentricity.
Objective To observe the pathogenesis and therapeutic efficacy of secondary macular epiretinal membrane(MEM).Methods This was a retrospective case series study.A total of 149 patients(149 eyes)with macular epiretinal membrane were included in the First Affiliated Hospital of Zhengzhou University from Jan.2020 to Dec.2021.After a complete preoperative examination for all patients to find the primary disease,95 patients(95 eyes)with secondary MEM were included.The etiology included 2 cases of retinal vascular proliferative tumors,3 cases of ocular trauma,3 cases of toxocara infection,4 cases of retinal vein occlusion,7 cases of high myopia,7 cases of cataract surgery,9 cases of uveitis,13 cases of diabetes,14 cases of retinal detachment after vitrectomy,and 33 cases of retinal peripheral holes and lesions.All patients were treated for the active primary disease firstly,then 94 eyes underwent vitrectomy combined with MEM and internal limiting membrane peeling except for 1 eye whose MEM separated spontaneously after laser treatment.The follow-up examinations were performed for 6 to 18 months after operation to observe and compare the etiology and incidence of different secondary MEM,visual distribution,the central macular thickness(CMT),the microscopic field and postoperative complications.Results The postoperative visual distribution at 6 months after surgery was significantly different from that before surgery(χ2=24.09,P<0.001).The CMT decreased from(457.98±88.61)μm before operation to(256.72±46.00)μm after operation(t=26.01,P<0.001).The mean retinal light sensitivity(MLS)significantly improved from(17.67±6.43)dB before surgery to(21.36±5.90)dB after surgery(t=-13.74,P<0.001).In this group,92 patients were cured with a cure rate at 96.84%(92/95).Conclusion By screening and stabilizing the primary disease of secondary MEM before operation,the visual function of patients effectively improves and postoperative complications can be reduced.
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Objective To evaluate the efficacy of intravitreal dexamethasone implant(Ozurdex)in the treatment of Vogt-Koyanagi-Harada(VKH)syndrome.Methods This was a retrospective case series study.Seven cases of VKH syndrome in Jiaxing Traditional Chinese Medicine Hospital from Mar.2020 to Feb.2021 were included.There were 2 cases of severe disease and 5 cases of mild to medium disease.In severe cases,prednisone was taken orally for 8 weeks and injected with intravitreal dexamethasone implant at the 3rd day.Patients with mild to medium disease were treated with the same treatment as severe patients except for those who did not take prednisone tablets orally.The follow-up period was 12 months and the changes of best corrected visual acuity(BCVA),intraocular pressure and central macular thickness(CMT)before and after injection,adverse eye reactions and systemic complications were observed.Results BCVA increased by more than 5 lines,vitreous turbidity turned mild,posterior polar exudation retinal detachment basically disappeared,CMT of both severe and mild to medium patients were lower than that before treatment in all affected eyes from this study.After 2 months of treatment,BCVA returned to normal,and the posterior polar retinal structure recovered.After 10 months of treatment,there was no recurrence in all cases,and there were no serious complications.Conclusion The mild and moderate VKH are simply treated by intravitreal dexamethasone,and the oral treatment of systemic corticosteroids in severe cases has made a successful preliminary attempt.
Objective To compare the efficacy of botulinum A injection and surgery in the treatment of esotropia,and analyze the influencing factors.Methods A prospective cohort study was carried out by selecting 160 cases of acute concomitant esotropia diagnosed and treated in Zhoukou Eye Hospital from Jan.2019 to Dec.2021,and they were divided into a control group(81 cases)and a study group(79 cases)based on random number table method.The control group was treated with external rectus shortening or internal rectus retraction or internal rectus retraction+external rectus shortening,while the study group was treated with Botox A injection.The strabismus,diopter and astigatism axis between the two groups were compared before treatment,at 1 month and 1 year after treatment,and visual tertiary function,clinical effective rate,complications and influencing factors of curative effect were compared between the two groups.Results At 1 month and one year after treatment,strabismus in both groups decreased(all P<0.05),and diopter in both groups increased(P<0.05).At 1 month and one year after treatment,astigmatism axis of the two groups changed(P<0.05),but there was no significant difference in strabismus,diopter,astigmatism axis or visual function between the study group and the control group(all P>0.05).The total effective rate of clinical treatment in the study group was 79.78%(63/79),compared with the 79.01%(64/81)in the control group,the difference was not statistically significant(P>0.05).The incidence of complications in the study group was 2.53%(2/79),which was significantly lower than the 14.81%(12/81)in the control group(P<0.05).By univariate analysis,age,course of disease,oblique visual angle before treatment,diopter before treatment and axial astigmatism before treatment were the influencing factors of clinical therapeutic effect(P<0.05).According to the analysis of binary Logistic regression,age was the related factor affecting the clinical efficacy of patients with acute concomitant esotropia(P<0.05).Conclusion Botulinum A injection therapy is equivalent to surgical treatment of acute concomitant esotropia,which can effectively improve the squint angle and promote the recovery of visual function,but Botulinum A injection therapy is safer.Age is a related factor affecting the clinical efficacy of patients with acute concomitant esotropia.
Objective To study the effects of combination therapy with sodium hyaluronate eye drops for moderate to severe dry eyes after cataract surgery.Methods This was a prospective random control study.A total of 123 eyes of 123 patients with moderate to severe dry eyes after cataract surgery admitted to Anyang District Hospital in Puyang City from May 2021 to Feb.2022 were included.The patients were divided into the control group with 41 cases(41 eyes),the cyclosporin group with 41 cases(41 eyes),and the loteprednol group with 41 cases(41 eyes)based on random number table method.The control group was treated with sodium hyaluronate eye drops only,the cyclosporin group was treated with cyclosporin combined with sodium hyaluronate eye drops,and the loteprednol group was treated with loteprednol combined with sodium hyaluronate eye drops.They were followed up for 1 month after treatment.Dry eye symptom scores,ocular surface disease index(OSDI)scores,best corrected visual acuity(logMAR),eye surface function indicators[schirmer Ⅰ test(SIt),break-up time of tear film(BUT),fluorescence staining(FL)score],and levels of oxidative stress factors in tears[malondialdehyde(MDA),superoxide dismutase(SOD),lipid peroxide(LPO),and total antioxidant capacity(TAC)]among the three groups were compared before and at 1 month after treatment,along with the incidence of adverse reactions(elevated intraocular pressure,foreign body sensation,and eyelid congestion).Results At 1 month after treatment,the total clinical effective rates of the loteprednol group and the cyclosporine group were 97.56%(40/41)and 92.68%(38/41),respectively,which were higher than the 73.17%(30/41)of the control group(all P<0.05);the dry eye symptom score and OSDI score[(0.74±0.25)scores,(20.11±3.47)scores]of the loteprednol group were lower than those of the cyclosporine group[(0.97±0.24)scores,(24.43±3.69)scores]and the control group[(1.76±0.33)scores,(29.67±3.15)scores],and the best corrected visual acuity(0.15±0.03)was higher than that of the cyclosporine group(0.17±0.10)and the control group(0.22±0.05)(P<0.05);The SIt and BUT of the loteprednol group[(15.22±3.11)mm/5 min,(13.04±2.47)s]were higher than those of the cyclosporine group[(12.14±2.73)mm/5 min,(11.12±2.36)s]and the control group[(9.05±2.34)mm/5 min,(8.13±2.14)s](all P>0.05).The FL score of the loteprednol group[(2.06±0.38)scores]were lower than that of the cyclosporine group[(2.44±0.32)scores].The levels of MDA and LPO in tear fluid of the cyclosporin group[(2.39±0.35)U/L,(1.03±0.12)μmol/L]were lower than those of the cyclosporine group[(3.67±0.32)U/L,(1.19±0.14)μmol/L]and the control group[(4.25±0.41)U/L,(1.76±0.15)μmol/L],and the levels of SOD and TAC in tears[(0.21±0.04)mmol/L,(15.74±3.08)kU/L]were higher than those of the cyclosporine group[(0.18±0.03)mmol/L,(13.12±3.11)kU/L]and the control group[(0.14±0.02)mmol/L,(9.63±2.61)kU/L](all P<0.05).The incidence rates of adverse reactions in the loteprednol group,the cyclosporin group,and the control group were 7.32%(3/41),9.76%(4/41),and 4.88%(2/41),respectively.There was no statistically significant difference among the groups(P>0.05).Conclusion The combination of clopidogrel and cyclosporine,combined with sodium hyaluronate,has a certain effect on the treatment of moderate to severe dry eyes after cataract surgery,while the combination of clopidogrel and sodium hyaluronate has a better effect.
Objective To analyze the differences in vault size between fellow eyes with similar anterior segment biometry.Methods This was a retrospective case series study.The study included 162 eyes of 81 patients who underwent implantable collamer lens(ICL)implantation in Shanxi Eye Hospital from Mar.to Sep.2022.Preoperative anterior chamber depth,horizontal sulcus-to-sulcus diameter(hSTS),ICL spherical equivalent,lens thickness,interoperative ICL size and the horizontal pressure(ICL size-hSTS)were recorded.Vaults were measured with anterior segment optical coherence tomography at 1 d,1 week and 1 month postoperatively.Bivariate correlation was applied to seek for factors affecting vault inter-eye differences.Results At 1 month postoperatively,mean vault inter-eye difference was 18.0(-43.5,79.5)μm,and the mean absolute vault inter-eye differences was 71.0(28.5,105.5)μm.Vault inter-eye differences were positively correlated with the level of horizontal compression(r = 0.25,P = 0.023)and negatively correlated with anterior chamber depth,hSTS,preoperative spherical equivalent,lens thickness,ICL size,or vault(all P>0.05).Conclusion Vaults measured in fellow eyes may present similar size,but there is some degree of baseline variability in the vault.
Objective To observe the efficacy and safety of intravitreal aflibercept(IVA)injection in stage Ⅲ neovascular glaucoma(NVG).Methods This was a retrospective case series study.The data of 43 eyes of 43 patients with NVG in stage Ⅲ from Mar.2021 to Jun.2022 in Xi'an First Municipal Hospital were collected.All eyes had received Ahmed glaucoma valve implantation previously and the intraocular pressures(IOP)raised again.Patients were divided into two groups based on the treatment modality.There were 20 cases in the observation group who received IVA injection combined with ciliary body photocoagulation.The other 23 cases in the control group received ciliary body photocoagulation only.All patients were followed up for 6 months.Best corrected visual acuity(BCVA,logMAR),IOP and complications were observed in both groups.Results At the end of the follow-up,BCVA(1.30±0.64)improved compared with the(1.74±0.76)before surgery in the observation group(t=2.39,P=0.027).BCVA in the control group was 1.56±0.68,with no significant difference compared with 1.69±0.72 before surgery(t=1.14,P=0.267).There was no significant difference on BCVA between the two groups at the last follow-up(t=1.29,P=0.196).IOP in the observation group was(39.20±4.92)mmHg,(22.20±3.41)mmHg,(19.80±4.31)mmHg,(20.70±4.58)mmHg and(18.30±2.52)mmHg before surgery(1 mmHg=0.133 kPa),at 2 weeks,1 month,3 months and 6 months after operation,respectively.IOP in the control group was(39.70±4.82)mmHg,(20.20±4.13)mmHg,(18.60±4.09)mmHg,(18.20±3.98)mmHg,and(16.70±2.36)mmHg preoperatively,at 2 weeks,1 month,3 months and 6 months after operation,respectively.IOP reduced at 2 weeks,1,3 and 6 months in the observation group(t=12.75,13.27,12.32,16.93;all P<0.05)and the control group(t=14.72,16.04,16.51,20.55;all P<0.05)compared with that before surgery.IOP of the control group was better than that of the observation group at the end of the follow-up(t=2.09,P=0.037).There was one vitreous hemorrhage in each group during follow-up.Other complications were not observed.Conclusion IVA combined with ciliary body photocoagulation is safe and effective for patients with stage Ⅲ NVG who have received Ahmed glaucoma valve implantation previously with subsequent IOP rising.The intravitreal Aflibercept injection can improve patients'vision.
Objective To observe the efficacy of Phaco-Tanito microhook ab-interno trabeculotomy for the treatment of primary angle-closure glaucoma.Methods This was a retrospective case series study.From Dec.2021 to Dec.2022,the clinical data of 21 eyes of 21 cases with primary angle-closure glaucoma with cataract in Changshu No.2 People's Hospital were analyzed retrospectively.All cases underwent Phaco-Tanito microhook ab-interno trabeculotomy.Best corrected visual acuity(BCVA,logMAR),intraocular pressure(IOP),angle-opening distance at 500 μm(ADD500),retina nerve fiber layer and complications were observed.The follow-up time was 6 months.Results In all patients,preoperative IOP was 26.00(23.50,29.50)mmHg,and IOP was 17.00(14.00,21.50)mmHg at 1 day postoperatively,18.00(15.25,23.00)mmHg at 7 days after operation,16.50(14.00,18.00)mmHg at 1 month after operation,15.50(13.75,18.25)mmHg at 3 months after operation and 15.00(13.25,19.50)mmHg at the last follow-up,respectively(1 mmHg=0.133 kPa).Postoperative IOP decreased at each time point after operation(χ2=16.38,df=5,P<0.006).BCVA improved from 0.82(0.35,1.00)preoperatively to 0.22(0.10,0.35)postoperatively at the final examination(χ2 = 20.19,df=2,P<0.001).AOD500 was 0.16(0.09,0.36)mm preoperatively and 0.63(0.52,0.66)mm at the final examination(Z=-2.67,P=0.008).There were 4 patients with hyphema after operation,and 1 patient received anterior chamber irrigation.Conclusion Phaco-Tanito microhook ab-interno trabeculotomy is effective for primary angle closure glaucoma with cataract.It helps to control the intraocular pressure,to relieve retinal nerve fiber layer,and to improve visual function.
Objective To observe the effect of Fufang Xueshuantong capsule on postoperative visual function recovery in patients with idiopathic macular hole.Methods This was a prospective randomized control study.A total of 49 patients(49 eyes)with idiopathic macular hole who underwent surgical treatment at the eye center of the Second Affiliated Hospital,School of Medicine,Zhejiang University from Dec.2018 to Dec.2022 were selected.All patients had idiopathic macular hole closure after surgery.The patients were divided into the clinical trial group(22 cases)and the control group(27 cases)based on a simple random grouping method.Both groups were treated with levofloxacin eye drops and prednisolone acetate eye drops after surgery,while the clinical trial group was additionally treated with Fufang Xueshuantong.The best corrected visual acuity(BCVA,logMAR)of the patients at 1,3,and 6 months after surgery were observed,and the central retinal thickness(CRT),area of the foveal avascular zone(FAZ)in the superficial capillary plexus(SCP)and deep capillary plexus(DCP),and the choriocapillary blood flow area(CBFA)were also measured by optical coherence tomography(OCT)and optical coherence tomography angiography(OCTA),respectively.Results CBFA in the clinical trial group patients significantly increased at 3 months[(2.58±0.04)mm2]and 6 months[(2.49±0.02)mm2]after surgery compared with that in the control group[(1.96±0.03)mm2 and(1.89±0.05)mm2](t=3.16,2.46;P=0.023,0.043,respectively);However,there were no significant differences in BCVA,CRT,and the FAZ of SCP and DCP between the two groups at 1,3,and 6 months after surgery(P>0.05).Conclusion Fufang Xueshuantong capsule can improve and normalize the postoperative choroidal blood flow in patients with idiopathic macular hole.
Objective To analyze the efficacy of amniotic membrane combined with limbal stem cell transplantation on ocular surface diseases.Methods This was a prospective randomized controlled study.A total of 82 eyes of 82 patients with ocular surface diseases from Mar.2019 to Mar.2021 in Nanyang Nanshi Hospital were divided randomly into two groups:the control group with 41 cases which received limbal stem cell autologous transplantation,and the observation group with 41 cases which was treated with amniotic membrane transplantation.The clinical efficacy,corneal thickness,neovascular area,tear secretion test results,postoperative corneal epithelial repair time,visual improvement rate,postoperative recurrence rate and surgical satisfaction were compared between the two groups before and at 3 months after surgery.Results The total effective rate of the observation group(40/41,97.56%)was higher than the(33/41,80.49%)of the control group(χ2 =4.49,P=0.034).The neovascularization area(25.17±6.84)mm2 in the observation group was smaller than the(31.25±5.44)mm2 in the control group,and the tear secretion experiment length[(10.31±1.08)mm was longer than the(8.64±1.33)mm in the control group(t= 4.46,6.24;all P<0.001);The time of corneal epithelial repair in the observation group was shorter[(3.17±0.64)days]than that in the control group[(3.81±0.71)days](t=4.29,P<0.001),and the visual acuity improvement rate in the observation group(41/41,100.00%)was higher than that in the control group(35/41,85.37%)(χ2 =4.49,P=0.021).There was no significant difference in recurrence rate at 1 year after surgery between the two groups(χ2 = 1.99,P= 0.158).The satisfaction rate of the observation group(39/41,95.12%)was significantly higher than that of the control group(32/41,78.05%)(χ2 = 5.15,P = 0.023).Conclusion The application of amniotic membrane combined with limbal stem cell transplantation for ocular surface diseases is feasible,which can reduce the area of neovascularization in cornea and conjunctiva,promote corneal repair,improve visual acuity and improve patients'satisfaction in treatment.
Objective To evaluate the clinical efficacy of modified internal limiting membrane(ILM)peeling combined with vitrectomy in the treatment of persistent diabetic macular edema(DME).Methods A retrospective case-control study was carried out.The clinical data of 41 eyes of 40 cases with persistent diabetic macular edema in Huai'an Second People's Hospital from Jan.2019 to Jan.2023 were collected.Vitrectomy was performed for every patient.Based on surgical methods,18 eyes of 18 cases were included in group A which received modified ILM peeling;and 23 eyes of 22 cases in group B received routine ILM peeling.Postoperative vision and central macular thickness(CMT)between the two groups were compared.Results Preoperative visual acuity were 1.9±0.6 in group A and 1.7±0.5 in group B,and 0.9±0.5 in group A and 0.7±0.3 in group B at 6 months postoperatively.Improvements were shown in both groups compared with preoperation,and the difference in visual acuity between the two groups was not statistically significant(t=1.08,P=0.288).Preoperative CMT was preoperative(346.9±68.7)μm in group A and(404±125.3)μm in group B,and(222.8±24.9)μm in group A and(239.9±44.5)μm in group B at 6 months postoperatively,with a decrease in both groups compared with preoperation,and there was no statistical significance in the difference in CMT between the two groups(t = 1.46,P= 0.153).Conclusion Modified ILM peeling combined with vitrectomy in the treatment of persistent diabetic macular edema can effectively relieve macular edema while preserving the inner limiting membrane.
目的 观察 3%地夸磷索钠滴眼液早期应用对轻中度眼化学伤的治疗效果.方法 前瞻性随机对照研究.连续选取武汉爱尔眼科汉阳医院 2022 年 11 月至 2023 年 3 月眼化学伤 21 例(21 只眼),年龄 35～55 岁,均为眼表碱烧伤,且伤后 1 h内到院.在充分冲洗结膜囊后按随机数字表法分为两组:对照组 10 例滴用小牛血清去蛋白滴眼液及抗生素眼膏,临床试验组 11 例在此基础上联合使用 3%地夸磷索钠滴眼液,观察两组患者角膜上皮愈合时间、眼表疾病指数(OSDI)、泪膜破裂时间(BUT)、泪液分泌试验(SIt)及有无睑球粘连.结果 两组患者年龄、性别、烧伤分级及角膜上皮缺损面积差异均无统计学意义(均P＞0.05).试验组角膜上皮愈合时间为(3.09±1.30)d,短于对照组的(4.80±1.75)d(t=-2.56,P=0.019);伤后 3 个月,试验组的OSDI评分(16.45±5.05)分低于对照组的(26.40±12.08)分(t=-2.42,P=0.033),试验组BUT(11.38±2.18)s高于对照组(6.18±2.72)s(t=4.87,P＜0.001);两组SIt差异无统计学意义(t=1.20,P=0.244).结论 3%地夸磷索钠能够促进眼表碱烧伤的角膜上皮愈合,对结膜也具有保护作用.
目的 观察 577 nm微脉冲激光光凝联合口服中药四苓散治疗急性中心性浆液性脉络膜视网膜病变(aCSC)的效果.方法 前瞻性随机对照研究.纳入兰州爱尔眼科医院 2021 年 1 月至2022 年 12 月收治的aCSC 91 例(91 只眼)作为研究对象.所有患者行荧光素眼底血管造影(FFA)荧光渗漏点在距黄斑中心区 500 μm以内随机分为 4 组:577 nm微脉冲激光光凝联合口服中药四苓散治疗组(31 例),单独微脉冲激光光凝治疗组(20 例),中药治疗组(20 例)和空白对照组(20 例).随访 6 个月,观察 4 组患者黄斑中心区厚度(CMT)、黄斑中心区下方脉络膜厚度、黄斑旁中心区下方脉络膜厚度及最佳矫正视力(BCVA,logMAR).结果 治疗后 2 周联合治疗组CMT降低,与空白对照组比较差异有统计学意义[(333.45±85.73)μm vs(414.45±84.71)μm;t=-3.29,P=0.001],同一时间点微脉冲激光治疗组和中药组分别与空白对照组比较差异无统计学意义[(375.15±87.11)μm vs(414.45±84.71)μm,(424.80±86.06)μm vs(414.45±84.71)μm;t=-1.45,0.38;P=0.151,0.704];微脉冲激光治疗组治疗后 1 个月,较空白对照组CMT降低,差异有统计学意义[(353.85±103.81)μm vs(409.45±85.43)μm;t=-2.35,P=0.021],同一时间点,中药治疗组较空白对照组差异无统计学意义[(399.90±76.04)μm vs(409.45±85.43)μm;t=-0.40,P=0.688].治疗后1个月BCVA联合治疗组较空白对照组视力提高(0.33±0.12 vs 0.53±0.13;t=-5.88,P＜0.001),同一时间点,微脉冲治疗组及中药组较空白对照组比较差异无统计学意义(0.47±0.11 vs 0.53±0.13,0.51±0.09 vs 0.53±0.13;t=-1.52,-0.55;P=0.132,0.581);治疗后2个月,微脉冲激光治疗组BCVA较空白对照组恢复,差异有统计学意义(0.43±0.09 vs 0.52±0.11;t=-3.03,P=0.003),同一时间点,中药组较空白对照组差异无统计学意义(0.48±0.08 vs 0.52±0.11;t=-1.35,P=0.182).结论 577 nm微脉冲激光光凝联合口服中药四苓散治疗aCSC,可促进CMT及视功能尽快恢复,视网膜下浆液快速吸收.
目的 评估术前玻璃体内注射雷珠单抗联合视网膜激光光凝对 2 型糖尿病视网膜病变的疗效.方法 前瞻性随机对照研究.纳入河南省焦作市人民医院 2020 年 9 月至 2022 年 7 月收治的 2 型糖尿病视网膜病变患者 46 例(92 眼),按随机数字表法分为单纯激光组 23 例(46 眼)和联合组 23 例(46 眼).所有患者均给予视网膜激光光凝治疗,联合组于激光光凝术前给予玻璃体内注射雷珠单抗.比较两组视力(logMAR)、视野敏感度,血流动力学参数[阻力指数(RI)、搏动指数(PI)、平均血流速度(MV)、峰值血流速度(PSV)、最低血流速度(Vmin)及最大血流速度(Vmax)],黄斑中心区厚度(CMT)及生活质量[中文版低视力者生存质量量表(CLVQOL)].结果 重复测量方差分析显示,两组视力、视野敏感度、CMT组间、时间比较,差异均具有统计学意义(均P＜0.05),术后联合组治疗后 2 周视力 0.15±0.05、视野敏感度(22.68±2.27)dB,4 周视力 0.11±0.05、视野敏感度(24.35±2.46)dB明显高于单纯激光组[0.19±0.05、(21.05±2.11)dB,0.15±0.05、(22.12±2.25)dB](均P＜0.05);联合组 2 周、4 周CMT明显低于单纯激光组(均 P＜0.05);术后联合组 PI 1.05±0.1、RI 0.56±0.06 明显低于单纯激光组 1.23±0.13、0.65±0.07(均P＜0.05);术后联合组MV(7.68±0.79)cm/s、EDV(4.11±0.42)cm/s、PSV(12.79±1.31)cm/s、日常生活能力(17.87±1.74)分、调节能力(13.78±1.41)分、读和精细动作(15.65±1.61)分、远视、观感及移动(35.74±3.62)分和CLVQOL总分(83.04±8.23)分均高于单纯激光组[(6.12±0.63)cm/s、(3.75±0.38)cm/s、(10.68±1.12)cm/s、(15.08±1.47)分、(12.35±1.23)分、(13.13±1.32)分、(32.13±3.15)分和(72.69±7.31)分](P＜0.05).结论 术前玻璃体内注射雷珠单抗联合视网膜激光光凝治疗 2 型糖尿病视网膜病变可有效改善视力,降低CMT,调节血流动力学,提高生活质量.
目的 比较两种切口超声乳化白内障吸除术的临床效果.方法 前瞻性随机对照研究.纳入漳州市芗城区通北社区卫生服务中心 2021 年 4 月至 2022 年 10 月行超声乳化白内障吸除术的 114 者(114 眼)白内障,以数字抽签法随机分为两组,每组各 57 例.对照组术中采用颞侧透明角膜切口,观察组术中采用陡峭经线透明角膜切口.术后对两组手术效果进行比较.结果 术后 3个月,观察组裸眼视力(logMAR)为 0.14±0.03,最佳矫正视力(logMAR)为 0.04±0.01,均优于对照组的0.17±0.05(t=3.88,P＜0.05)及 0.06±0.02(t=6.75,P＜0.05),角膜散光度(0.72±0.16)D较对照组(0.93±0.20)D低(t=6.19,P＜0.05);术后 1 周,试验组第一次泪膜破裂时间(8.26±1.33)s、泪河高度(0.34±0.08)mm及平均泪膜破裂时间(8.82±1.37)s高于对照组的(7.35±1.27)s、(0.29±0.06)mm及(8.13±1.28)s(t=3.74、3.78、2.78,均P＜0.05);术后并发症发生率试验组为 5.26%(3/57)低于对照组的 17.54%(10/57)(χ2 =4.25,P=0.039).结论 在超声乳化白内障吸除术陡峭经线透明角膜切口比颞侧透明角膜切口效果好.
