Objective:To investigate the influence of double incision vs single incision phacoemusification aspiration(PEA) on cornea of patients with Age-related cataract (ARC) .Methods:Clinical data of 256 cases(272 eyes) of patients with Age-related cataract(ARC) by PEA combined with intraocular lens implantation were analyzed, retrospectively, including control group(150 eyes of 137 cases)with double incision PEA and observation group(122 eyes of 119 cases )with single incision PEA. The surgical time, cumulative dissipated energy(CDE), ultrasound time, perfusion volume, vision, surgically induced astigmatism(SIA), 10mm-cornea volume(10mm-CV), central corneal thickness(CCT) and corneal endothelial cell parameters of 2 groups were compared.Results:The difference in the surgical time, CDE, ultrasound time and perfusion volume between 2 groups were not significant( P >0.05). The levels of naked eye vision and corrected distant vision of 1 week after operation in observation group were significantly higher than that in. control group ( P <0.05). The levels of cornea anterior surface SIA of 1 week after operation in observation group was significantly lower than that in control group( P <0.05). The levels of 10mm-CV and CCT of 1 week after operation in observation group were significantly lower than that in control group( P <0.05). The levels of endothelial cells loss of 1 week, 4 weeks and 12 weeks after operation in observation group were significantly lower than that in control group ( P <0.05). The levels of corneal endothelial cell average size in 1 week after operation in observation group were significantly lower than that in control group ( P <0.05). Conclusions:Compared with double-incision PEA, single-incision PEA combined with intraocular lens implantation in the treatment of patients with ARC can effectively relieve corneal injury, accelerate the recovery process after operaiton and be helpful to improve visual quality.
Objective:To observe the effect of endoscopic transnasal optic canal decompression (ETOCD) on the treatment of traumatic optic neuropathy.Methods:A retrospective analysis of 47 patients with TON. The patients were divided into Non-surgical treatment group(16 eyes of 14 cases)and surgical treatment group(33 eyes of 33 cases, ETOCD).Results:In 47 cases of TON(49 eyes), 3 eyes' visual acuity was improved in non-operation(3/16);25 eyes' visual acuity was improved in operation group(8/33);the difference between the two groups was significant( P <0.05). Among the surgical treatment group, 16 eyes' visual acuity was improved in 21 eyes (16/21)with the interval time between injury and operation less than 72 hours. 9 eyes' visual acuity was improved in 12 eyes(9/12)with the time more than 72 hours after injury, there was no significant difference between the two groups( P >0.05). Conclusions:ETOCD has the advantages of minimally invasive, adequate surgical exposure and clear field, and also has a significant effect on patients who have been more than 72 hours after injury and less than two weeks.
急性眶腔综合征（Acute Orbital Compartment Syndrome，AOCS）可使眶内压快速升高，具有极高的致盲风险。AOCS常继发于外伤和术后继发眶内出血。此征出现的两小时内进行急诊干预可最大程度保留视力，否则眶内压的急剧升高将导致不可逆性失明。初步处理、视觉恢复之后，应进行后期恢复管理以及必要的进一步干预，如外眦切开术、眶壁减压术以及其他针对病因的治疗手段。
Objective:To observe the clinical efficacy and safety of Conbercept Ophthalmic Injection in the treatment of wet age-related macular degeneration(wAMD), and to explore the relevant factors that affect its prognosis.Methods:The data of 61 patients(65 eyes)with wAMD were retrospectively collected, and they received the 3?+?PRN intravitreal treatments of Conbercept 0.5 mg/0.05ml. The best corrected visual acuity(BCVA)and OCT were performed at 1, 2, 3, 6 and 12 months after the treatment. The data of BCVA and central retinal thickness(CRT), before and after treatment were compared. The BCVA, CRT, subretinal fluid(SRF), intraretinal fluid(IRF), subretinal hyperreflective material(SHRM), retinal pigment epithelial detachment(PED), ellipsoidal zone(EZ)were analyzed. Patients were divided into two groups based on the Log MAR difference between the final follow-up BCVA and baseline BCVA:the vision improvement group and the vision loss group. the changes in vision before and after treatment, and the factors associated with poor vision prognosis were screened.Results:BCVA increased and CRT decreased of 1, 2, 3, 6, 12 months after treatment. The characteristics of SRF and SHRM at baseline affected the changes in BCVA after 3 months and 1 year after treatment, and the difference was statistically significant( P <0.05). PED characteristics were correlated with the recovery of CRT, and the fracture of EZ indicated the possibility of poor vision prognosis, but IRF not. No treatment-related ocular complications and systemic adverse reactions occurred during the follow-up period. Conclusions:Intravitreal injection of Conbercept for wAMD can effectively improve patients' vision, reduce macular fovea thickness, and it can improve and restore macular structure. The long-term effect is good without increasing treatment risks. SRF, SHRM, PED and EZ can be used as important indicators for comprehensive evaluation of the efficacy of anti-VEGF treatment.
Objective:To observe the the clinical application of xanthelasma palpebrarum with kite flap.Methods:The clinical data of 32 cases of xanthelasma palpebrarum which area>5mm2 in our hospital from 2016-2018 were analyzed, After surgical removal of the xanthelasma palpebrarum, we release the surrounding skin around the coloboma and design the kite flap accoding with dermatoglyph direction. Under the orbicularis oculi muscle strip forming with the kite flap pedicled with orbicularis oculi muscle, skin defect area, incise the skin according to the design line. formed under the orbicularis oculi muscle strip with the kite flap pedicled with orbicularis oculi muscle, placed in the skin defect area, with a 6-0 silk suture of incision.Results:Flap I healing, followed up for 3 months to 2 years, eyelid shape bilateral symmetry, incision scar is not obvious.Conclusions:For larger xanthelasma palpebrarum excision, direct suture can cause eyelid deformity, so we can use the kite flap repair of eyelid defect, .The method is simple, reliable effect, short recovery time after the surgery, has convenient use, easy to promote.
有晶状体眼后房型人工晶状体（implantable contact lens，ICL）植入术，在国内已逐渐普遍，其急性并发症也愈受关注。本文报道2例，并进行了调位处理。
Objective:To evaluate the accuracy and safety of 3D printed orbital model assisted preforming titanium mesh in repairing orbital wall fracture.Methods:Thirty-six patients with orbital fracture were divided into two groups:18 patients in group A were in the experimental group. 3D printed orbital model was used to assist the pre-formed titanium mesh to repair orbital wall fracture. Eighteen patients in group B were used as the control group to repair orbital wall fracture with traditional 3D preformed titanium mesh. Postoperative observation was made of the improvement of orbital CT, enophthalmia and diplopia in the two groups, and the therapeutic effect of 3D printed orbital model assisted with preformed titanium mesh in repairing orbital wall fracture was evaluated.Results:In the experimental group, the edge of titanium mesh was exactly consistent with the fracture edge on postoperative orbital CT. Correction rate of enophthalmia:there were statistically significant differences between group A 2 weeks after surgery and 3 and 6 months after surgery( P <0.05), and there were no statistically significant differences between group A 3 months after surgery and 6 months after surgery( P >0.05). There was no statistically significant difference in each postoperative stage in group B( P >0.05). Corrections of diplopia:There was no significant difference between group A and group B 2 weeks after operation, 3 months and 6 months after operation(P > 0.05). Conclusions:Using 3D printed orbital model to assist preformed titanium mesh can repair the orbit more accurately and safely, and improve the cure rate of enophthalmos and diplopia.
Objective:To investigate the effect of nasal endoscopic salvage surgery optic nerve injury caused by bone fiber benign tumor of nasal cavity and paranasal sinuses.Methods:10 patients with optic nerve lesion caused by benign bone fiber tumor of nasal cavity and paranasal sinuses were randomly divided into observation group and control group, with 5 cases in each. The control group received open salvage surgery, the observation group received nasal endoscopic salvage surgery. The improvement of vision, the incidence of complications and the recurrence rate were compared between the two groups.Results:The total effective rate of vision improvement in the observation group was 100%, higher than that in the control group 60%, the postoperative visual field of the observation group was higher than that of the control group, the incidence of complications was 20% The recurrence rate was 0%in observation group, while the datawas 80% and 20% in control group.Conclusions:The endoscopic salvage surgery can effectively improve visual acuity, reduce the incidence of complications and disease recurrence.
甲状腺相关眼病（Thyroid associated ophthalmopathy，TAO）是由多因素所致的一种自身免疫性疾病。其病因复杂，发病机制未完全阐明。近年来，国内外不断有学者提出各种治疗TAO的新型手术方法，虽仍尚未发现单一特效的治疗方法，但在手术目的、手术方案的选择、术中及术后效果的要求、术式、新型手术辅助技术等方面均有不同程度的改变及优化，本文就近年来TAO的眼眶减压术治疗的研究进展进行综述，希望通过归纳总结，理清TAO治疗方法观念的改变及技术的优化，更好的为临床医师及患者服务。
Objective:To investigate the changes of FAZ, BCVA and F-ERG after RRD.Methods:A retrospective analysis was performed on 40 cases of 40 eyes with RRD as the first diagnosis in our hospital. The data of BCVA, FAZ and F-ERG were recorded at different time points after operation.Results:the blood flow density of the SCP and DCP in the total 3 mm×3 mm area was higher in both groups 6 months after the operation( P=0.001).Partial correlation analysis showed that the change of FAZ area was negatively correlated with the BCVA( r =-0.215, P =0.014).Six months after surgery, the amplitude of F-ERG in group B was lower than that in group A, and the peak time was longer than that in group A, ( P < 0.05). Conclusion:PPV is superior to SB in the recovery of RRD patients with macular retinal blood flow density and visual function.
Objective:To observe the changes in biological parameter after the use of orthokeratology.Methods:Thirty-one subjects (fifty-seven eyes) were enrolled and fitted for OK lens. Visual acuity, the curvature of the cornea, the astigmatism of the cornea, the irregular coefficients of the cornea, the central corneal thickness, the density of corneal endothelial cell and the axial lengths of eyes were measured before and 1 month,3 months after orthokeratology. These data at three time points were analyzed statiscally.Results:All subjects had better visual acuity significantly after orthokeratology. The cornea were flatten after orthokeratology. There was no significant change in the amount of cornea astigmatism, but the irregular coefficients of the cornea rose. There was no significant change in the central corneal thickness of the cornea and the density of corneal endothelial cell after orthokeratology. The axial lengths of eyes were shorten after 1 month's use, and changed back to the baseline after 3 month's use.Conclusions:Orthokeratology could correct myopia effectively, and the short-term use of orthokeratology was safe.
视网膜大动脉瘤（retinal macroaneurysm ）又称获得性视网膜大动脉瘤（acquired retinal macroaneurysm），其视网膜动脉管壁呈现纺锤状或梭形血管瘤样膨胀 [1]。绝大多数动脉瘤位于颞侧血管上，多见于视网膜动脉的第3分支以前，偶可见于主干上的小分支。患者多单眼发病，常伴有高血压及动脉硬化等相关疾病 [2]。患者在早期可无任何不适，当动脉瘤壁发生渗漏、破裂时，可导致视网膜水肿、渗出、出血，可累及黄斑区。患者多因突发的视力下降而就诊。作者曾诊治一例视网膜大动脉瘤的病例，该病例患者瘤体突然破裂出血引起视力下降，未累及黄斑区，通过控制血压，在全身状态稳定的情况下口服改善微循环药物治疗，随诊过程中出血逐渐吸收，瘤体自然萎缩，预后良好。
Objective:To demonstrate the features and the outcomes of the Langerhans cells (LCs) during the treatment of endotheliitis by in vivo confocal mircroscopy(HRT-II).Method:32 patients diagnosed of corneal endotheliitis were involved. Changes of LCs and inflammatory cells in cornea were detected using HRT-II before and after treatment.Result:HRT-II images revealed that (1) epithelium cells swelled, blurred, but they arranged more structured after 2 weeks treatment. (2) A numerous LCs presented in the anterior stromal layer and gradually abated with disease regression.(3) The density of sub-basal nerve plexus was significantly lower than that of normal, which was denser after treatment. (4) The endothelial cells could not be visualized at the beginning which recovered 7 or 14 days after treatment.Conclusion:HRT-II can provide detailed histopathology proofs and appear dynamically the transformation after treatment.
Objective:To analyze the clinical efficacy of hyperbaric oxygenation in the different timing treatment of retinal artery occlusion.Methods:Retrospective analysis of 68 patients with retinal artery occlusion who were treated in our ophthalmology department from June 2018 to June 2019 divided into three groups: the control group ; the early intervention group ; the late intervention group . there were 34 patients in the control group; there were 17 patients in the early intervention group those were treated by hyperbaric oxygen therapy within 24 hours of onset; there were 17 patients in the late intervention group those were treated by hyperbaric oxygen therapy 24 hours after the onset of onset.The visual acuity, the average sensitivity of the visual field, the filling time of the retinal artery, the thickness of the retinal neuroepithelial layer in the foveal fovea, and the effective rate of treatment were observed in each group of patients.Results:After treatment, the average sensitivity of vision and visual field in each group was higher than before treatment ( P <0.05), the average sensitivity of visual acuity and visual field in the early intervention group was greater than that in the late intervention group after treatment( tvision=2.273, Pvision=0.030; tMS=2.42, PMS=0.021), after treatment, the difference in the average RNL thickness reduction of the foveal fovea and the average retinal artery filling time reduction in each group was statistically significant ( Fthickness=12.65, Pthickness<0.05; FFT=16.07, PFT<0.05), the decrease in average RNL thickness of the macular fovea and the average filling time of retinal artery in the early intervention group were greater than those in the late intervention group after treatment( tthickness =2.718, Pthickness =0.010; tFT=3.186, PFT=0.003), The total effective rate of the control group was 61%, the total effective rate of the early intervention group that was higher than that of the late intervention group(71.4%) was 82.4%( χ2=4.61, P <0.05). Conclusions:The effect of hyperbaric oxygen combined with conventional treatment of retinal artery occlusion is better than conventional treatment, and interventional hyperbaric oxygen treatment is more effective within 24 hours of onset.
Objective:To analyze the occurrence of posterior capsule rupture (PCR) in the first 3000 cases of phacoemulsification cataract extraction (PCE) and posterior chamber IOL (PO-IOL) surgery for doctor just finished training.Methods:Retrospectively analyzed the data of PCR occurred in the first independently completed 3000 cases of PCE and PC-IOL surgery.Results:37 cases (1.2%) of posterior capsule rupture occurred, the incidences in early, middle and late 1000 cases of the surgery were 2.5%, 0.9% and 0.3%. 20 cases of PCR occurred in inhaling the cortex, 6 cases when phaco nuclear block, 2 cases in lens implantation, 2 cases when inhaling the lens rear, former capsule tearing caused 2 cases, 1 case in polishing, position adjustment, injecting visco, watertight incision and unknown, respectively.Conclusions:PCR during PCE and PC-IOL has the highest incidence in the first 1000 cases of surgery, it can occur at any step of the operation, but the procedure with highest incidence is in inhaling the cortex of lens.
目的:近年来，随着电子类产品使用的增加，近视患者的数量也日益增多。因配戴眼镜存在诸多不便且影响美观，所以行近视手术矫正的患者也逐年增多。屈光性角膜激光手术因其良好的手术安全性和稳定的术后效果，成为近视患者首选的治疗方式。目前屈光性角膜激光手术方式主要有：准分子激光屈光性角膜切削术（photo refractive keratectomy，PRK）、准分子激光原位角膜磨镶术（laser in situ keratomileusis，LASIK）、飞秒激光辅助的准分子激光角膜磨镶术（femtosecond-laser in situ keratomileusis，FS-LASIK）、飞秒激光小切口基质微透镜取出术（small incision lenticule extraction，SMILE）等。但角膜切削后伴随的像差改变可引起术眼视觉质量变化，此外，角膜厚度的变化也可引起角膜生物力学参数的改变。本文就激光角膜屈光术后患者的视觉质量及角膜生物力学的变化进行综述，以期为临床工作提供参考。
Objective:To investigate the clinical effect of cortical aspiration and intraocular lens implantation under continuous perfusion.Methods:A total of 114 eyes of 100 age-related cataract patients from January to July 2018 were selected and randomly divided into continuous perfusion group and conventional viscoelastic group. The clinical effects of the two groups were analyzed and compared.Results:Compared with the conventional viscoelastic group, the continuous perfusion group had shorter operation time, lower incidence of high intraocular pressure, lower rate of corneal endothelial cell loss, and higher postoperative comfort ( P <0.05). Conclusions:Continuous subcortical aspiration and intraocular lens implantation during phacoemulsification can shorten the operation time, reduce the incidence of high intraocular pressure, reduce the loss of corneal endothelial cells and improve the comfort of patients.
Objective:To investigate the changes in retinal thickness in monocular hyperopia amblyopia compared with the follow eyes.Methods:This study enrolled 32 patients with monocular hyperopia amblyopia. The macular of the amblyopic and follow eyes was imaged using OCT, which were analyzed within 3 mm of diameter centered on the fovea. The differences of the thicknesses between the amblyopic and follow eyes were compared.Results:At the fovea, the thicknesses of retinal nerve fiber layer, ganglion cells layer, inner plexiform layer, inner nuclear layer and outer plexiform layer increased in the amblyopic eyes, while the outer nuclear layer decreased. The BCVA of amblyopic eyes was positively correlated with retinal pigmental epithelium (RPE).Conclusion:There were alterations of retinal thicknesses in the amblyopic eyes. The decreased visual acuity of amblyopic eyes was related with increased RPE layers.
Objective:To describe the characteristics of fundus fluorescein angiography in Zone Ⅲ retinopathy of prematurity (ROP) and lay the foundation of clinical treatment for ROP.Methods:From January to December 2017, 42 eyes of 21 cases of stage 1~3 ROP were screened and diagnosed in our hospital were be collected. There were 11 males and 10 females. RetCam Ш were used to complete the fluorescein fundus angiography for all children under general anesthesia. If found in the inspection of fluorescence leakage, "popcorn" kind of change immediately 810nm laser photocoagulation. After treatment, fundus examination was performed at 1 week, 4 weeks, 8 weeks and 12 weeks respectively, and every 6 months thereafter. The regression and progression of ROP were observed. SPSS13.0 statistical software analysis was used for data measurement, the results were mean±standard deviation ( ± s) said. Results:42 eyes of 21 cases were examined by fluorescein fundus angiography, which 22 eyes of 12 cases, the number of branches of temporal retinal vessels increased, blood vessels tortuous, uneven thickness, mainly vein and brush-like distribution, and the peripheral vascular coincide with each other to form a short circuit, and showed ridge-like changes, with significant fluorescence leakage, visible in the crest or ridge crest, popcorn-like fluorescence change, so retinal laser treatment. The other 20 eyes, the temporal retinal blood vessels distal branches increased, tortuous, with "brush" like or "wing" like changes, vascularization and vascularization area clear distinction between late non-fluorescent angiography leakage, so no laser treatment were comformed. Follow-up no progress of the disease, the formation of a good laser class, ridges and blood vessels circuitous subsided.Conclusions:The activity of Zone Ⅲ ROP is clearly observed on fundus fluorescein angiography.It is a good guide to the value of the treatment for zone 3 ROP lesions.
