Objective To investigate the effect of preoperative dosage of ralizumab on surgical outcome and ocular safety in patients with proliferative diabetic retinopathy（PDR）. Methods A total of 102 patients with PDR admitted to The Third People’s Hospital of Luoyang from June 2019 to March 2022 were divided into three groups according to random number table method. The control group（34 cases） received vitrectomy only（PPV）, and the half-volume group（34 cases） received 0.25 mg/0.025 mL radizumab +PPV before surgery, and the standard group（34 cases） received 0.5 mg/0.05 mL ralizumab +PPV before operation. The perioperative indexes（intraoperative blood loss, intraoperative silicone oil utilization rate, times of electric coagulation, postoperative intraocular pressure and operation time）, preoperative and postoperative serum Levels of bFGF, VEGF and VE, and the incidence of postoperative complications were compared among the three groups. Results Compared with the control group, the amount of blood loss, times of electrocoagulation and operation time in standard group and half group were lower（P＜0.05）. The postoperative intraocular pressure and silicone oil utilization rate in standard group were lower than that of control group and half-volume group（P＜0.05, P＜0.0125）. The levels of VEGF, bFGF and VE in standard group and half volume group were significantly lower than those in control group（P＜0.05）, and the level of VEGF in standard group was lower than that of control group（P＜0.05）. The complication rate of standard group and half-volume group was significantly lower than that of control group（P＜0.0125）. Conclusions Preoperative vitreous injection of ralizumab can effectively reduce serum growth factor levels in PDR patients undergoing vitrectomy, and ensure drug safety and improve surgical progress, but the overall effect of high dose injection is slightly better than that of low dose.

目的 探讨青光眼滤过术联合人工晶状体植入术及白内障小切口囊外摘除术治疗老年白内障合并急性闭角型青光眼(AACG)的临床效果.方法 选取该院2019年1月至2020年1月收治的84例老年白内障合并AACG患者,根据治疗方案不同分为对照组和观察组,每组各42例.对照组给予白内障小切口囊外摘除术+人工晶状体植入术治疗,观察组于对照组基础上加用青光眼滤过术.对比两组术前、术后3个月视力、眼压、前房深度、前房角度、角膜内皮细胞密度、六角形细胞的百分数、并发症发生率及低视力者生活质量量表(LVQOL)评分.结果 术前、术后3个月两组视力差异无统计学意义(P>0.05);术后3个月两组前房深度差异无统计学意义(P>0.05),观察组眼压低于对照组(P<0.05),前房角度高于对照组(P<0.05);术后3个月两组角膜内皮细胞密度、六角形细胞的百分数低于术前(P<0.05),但术前及术后3个月两组间上述指标比较,差异无统计学意义(P>0.05);两组并发症发生率差异无统计学意义(P>0.05);术后3个月,两组LVQOL评分高于术前,且观察组高于对照组(P<0.05).结论 青光眼滤过术联合人工晶状体植入术及白内障小切口囊外摘除术治疗老年白内障合并AACG患者疗效确切,安全性高,可作为首选方案.

目的 探讨雷珠单抗对视网膜分支静脉阻塞(BRVO)继发黄斑水肿患者视网膜深层和浅层血流密度的影响.方法 选取2019年7月至2020年7月洛阳市第三人民医院眼科收治的BRVO继发黄斑水肿患者62例(62眼)作为病例组,同期以年龄、性别等为匹配条件选取健康者36人(36眼)作为对照组.采用OCTA扫描模式对两组受试者黄斑区视网膜浅层毛细血管丛(SVC)血流密度、深层毛细血管丛(DVC)血流密度、黄斑中心凹无血管区域(FAZ)面积、FAZ周长、非圆度指数(AI)及FAZ范围300μm宽度内的血流密度(FD-300)等参数进行测量.病例组患者接受玻璃体内注射雷珠单抗治疗,连续治疗3个月(每月注射1次),治疗后随访6个月,观察治疗后1个月、3个月、6个月病例组患者各项视网膜血流参数及最佳矫正视力(BCVA).采用Pearson相关性分析法分析病例组患者治疗后的BCVA与各项视网膜血流参数的相关性.结果 治疗前病例组患者SVC血流密度、旁中心凹SVC血流密度、DVC血流密度、旁中心凹DVC血流密度、FD-300均小于对照组,差异均有统计学意义(均为P<0.05);治疗前病例组患者黄斑中心凹SVC血流密度、黄斑中心凹DVC血流密度、FAZ面积、FAZ周长、AI均大于对照组,差异均有统计学意义(均为P<0.05).与治疗前相比,病例组患者治疗后1个月、3个月、6个月的黄斑中心凹SVC血流密度、黄斑中心凹DVC血流密度均降低,差异均有统计学意义(均为P<0.05);与治疗前相比,病例组患者治疗后3个月、6个月的FAZ面积均增加,差异均有统计学意义(均为P<0.05);与治疗后1个月相比,病例组患者治疗后6个月的FAZ面积增加,差异有统计学意义(P<0.05);与治疗前相比,病例组患者治疗后1个月、3个月、6个月的AI均降低,差异均有统计学意义(均为P<0.05);病例组患者BCVA随治疗时间的延长逐渐改善,不同时间点两两比较,差异均有统计学意义(均为P<0.05).治疗后6个月病例组患者BCVA与黄斑中心凹SVC血流密度、黄斑中心凹DVC血流密度、AI均呈正相关性(r=0.341、0.339、0.308,P=0.013、0.015、0.042),BCVA与FAZ面积呈负相关性(r=-0.337,P=0.017).结论 BR-VO继发黄斑水肿患者视网膜血流密度等参数存在异常,经雷珠单抗治疗后部分参数得到改善.

目的:探讨玻璃体腔内注射雷珠单抗辅助治疗伴玻璃体积血的新生血管性青光眼的效果.方法:选取2018年1月—2020年8月某院伴玻璃体积血的新生血管性青光眼患者98例,根据治疗方案不同分为观察组(51例)和对照组(47例).对照组采用复合式小梁切除术,观察组采用玻璃体腔内注射雷珠单抗联合复合式小梁切除术,对比2组治疗效果、并发症发生率,随访3个月,对比2组不同时间眼压水平、最佳矫正视力及滤过泡眼数.结果:观察组总有效率为94.12％,高于对照组的78.72％(P<0.05);随访3个月,2组均无脱落病例,有效随访98例,术后1周、术后1个月眼压逐渐降低,术后3个月眼压升高,观察组低于对照组(P<0.05);术后1个月、术后3个月最佳矫正视力改善,观察组优于对照组(P<0.05);术后1个月、术后3个月观察组功能性滤过泡眼数和术后3个月非功能性滤过泡眼数高于对照组(P<0.05);2组并发症发生率比较,差异无统计学意义(P>0.05).结论:玻璃体腔内注射雷珠单抗联合复合式小梁切除术治疗伴玻璃体积血的新生血管性青光眼效果显著,能有效控制眼压,保护视功能且并发症少.

目的：探讨应用半导体激光经巩膜睫状体光凝治疗难治性青光眼的临床疗效及并发症。方法回顾性分析经巩膜睫状体光凝术治疗的难治性青光眼患者35例(35眼)，随访观察患者治疗前后眼压、视力变化及并发症。结果35例患者经治疗后1 d、1周、1个月的眼压均明显下降，差异均有统计学意义(P<0.01)。术后视力无变化33眼(94.3%)，视力提高2眼(5.7%)，视力下降0眼。患者对手术均能耐受，少数患者出现眼部酸困不适、前房渗出、前房积血。结论810 nm半导体激光经巩膜睫状体光凝治疗难治性青光眼，在针对激光能量、击射点数、击射范围进行个体化设计后，能显著的降低患者眼压。

Objective To compare the clinical efficacy and complications of probing of lacrimal passages combined with retrograde intubation of Y shape silicone tube with or without Ofloxacin eye gel on treating lacrimal duct obstruction.Methods Eighty eyes of 75 cases of lacrimal duct obstruction who underwent surgeries in our hospital from 2012 to 2013 were investigated retrospectively.The success rate and complications of two operation methods were compared.Results All the patients were followed up for 3 months.The success rate of probing of lacrimal passages combined with retrograde intubation of Y shape silicone tube and Ofloxacin eye gel was higher than that of Y shape silicone tube intubation only,and the difference was statistically significant (x2 =4.694 P =0.03).It also significantly reduced the complications.Conclusion The probing of lacrimal passages combined with retrograde intubation of Y shape silicone tube and Ofloxacin eye gel can significantly reduce the early operative complications,and improve the success rate.

Objective To discuss the therapeutic efficacy and adverse reactions of traumatic optic neuropathy treated with high-dose corticosteroid.Methods The 23 cases (23 eyes) of traumatic optic neuropathy in our hospital in 2008~2013 used high-dose methylprednisolone or dexamethasone pulse therapy.The efficacy was analyzed according to out-come visual acuity.Results 12 cases vision improvement≥0.1, 5 cases vision improvement <0.1,6 cases vision did not improve.The total effective rate was 73.91%.Conclusions The pulse therapy of high-dose corticosteroid treated traumatic optic neuropathy had the better efficacy.The therapeutic efficacy and prognosis associated with the patients′ar-rival time.

目的 探讨氧氟沙星眼用凝胶注入联合逆行性Y型硅胶管植入治疗泪道阻塞性疾病的临床效果.方法 回顾性分析本院201 1年6月～2014年2月行氧氟沙星眼用凝胶注入联合逆行性Y型硅胶管植入的患者113例共120眼.结果 术后跟踪随访3个月,治疗总有效率为87.5％.结论 逆行性Y型硅胶管植入治疗泪道阻塞是一种安全、简单、有效的方法,结合术中注入氧氟沙星眼用凝胶更加降低了泪道逆行性置管的手术早期并发症发生率,同时又提高了整体手术成功率,有较强的实用性.

Objective To observe the topical medication and conditions of dry eye occurred.Methods 423 cases(423 eyes) of phacoemulsification patients combined intraocular lens implantation were randomly divided into two groups: group A of 211 cases(211 eyes) were given compound neomycin topical medication 4 times daily,decreased 1 time per week to withdrawal.Group B of 212 cases(212 eyes) were given compound neomycin topical eye 6 times daily,decreased 1 time per week to withdrawal.Symptoms of dry eye,tear breakup time(BUT),corneal fluorescein staining were observed after 1 week,1 month,3 months.And the data with statistical analysis was given.Results In group A after 1 week,1 month and 3 months,the occurrence of symptoms of dry eye and corneal fluorescein staining score was significantly lower than that of group B,while the tear breakup time(group A) was significantly longer than the group B.The differences were significant(P 0.05,P 0.01).Conclusion Rational topical medication after phacoemulsification combined intraocular lens implantation can effectively reduce the occurrence of dry eye.

Objective To analyze the reasons,treatment and preventive measure of shallow anterior chamber after trabeculectomy for glaucoma.Methods A total of 146 cases(177 eyes)with different type glaucoma underwent trabeculectomy,the shallow anterior chamber 45 cases(79 eyes)were observed and treated.Results Shallow anterior chamber occurred in 79 eyes(44.68%).The reason included excessive smooth of drainage 55 eyes,conjunctival flap water leaking 5 eyes,detachment of choroids 9 eyes,iridocyclitis 7 eyes,obstructive glaucoma in annulus ciliaris 3 eyes,among of total 57 eyes adapted expectant treatment,22 eyes were recovered anterior chamber by operation.Conclusion Shallow anterior chamber was early main complication underwent trabeculectomy.Strong filter was the primary cause,should control ophthalmotonus before operation and observed closely after operation,make the corresponding measure in view of the different cause to restored anterior chamber promptly.