· AIM: To compare the effect of pars plana vitrectomy ( PPV) combined with internal limiting membrane peeling ( ILMP) for macular hole retinal detachment ( MHRD) . · METHODS: Totally 78 patients with MHRD from December 2013 to December 2015 in our hospital were randomly divided into control group(39 patients 43 eyes) and experimental group ( 39 patients 40 eyes ) . The control group was treated with PPV, experimental group with PPV combined with ILMP. We observed the therapeutic effect and recorded the occurrence of postoperative complications. After 6mo follow-up, the vision improvement of the two groups were compared as the average of the best corrected visual acuity ( BCVA ) before and at 3, 6mo after surgery. · RESULTS: The reattachment rate of experimental group was 92%( 37/40 ) with significant difference compared with control group (x2=6. 882, P=0. 009). The improvement of visual acuity in the experimental group was better than that in the control group (x2=14. 216, P<0. 001). The postoperative BCVA of the experimental group at 3 and 6mo was significantly higher than that of the control group ( t =7. 119, P<0. 001; t=10. 573, P<0. 001). There were less patients with the situation of increased intraocular pressure and visual field defect (x2=11. 323, P=0. 001;x2=8. 573, P=0. 003). The lens opacity occurrence rate had not significantly changed (x2=1. 835, P=0. 176). · CONCLUSION: MHRD patients treated with PPV combined with ILMP recovered better and the incidence of complications was lower. It can improve the patient's retinal restoration effect more.

目的 探讨532激光治疗早期翼状胬肉的临床疗效.方法 门诊早期翼状胬肉46眼,表面麻醉,激光击射供应翼状胬肉生长的血管和翼状胬肉头部.观察疗效,以药物治疗组42例作对照比较.结果 治疗组激光治疗后42只眼翼状胬肉变小或消失,效果良好,治疗组1例效果差,优良率为91.3％；对照组1例良好,40例效果差,优良率为2.4％,差异有显著统计学意义(P＜0.01).结论 532激光治疗早期翼状胬肉安全有效.

<正>糖尿病视网膜病变病程进展主要与患糖尿病时限和控制程度有关,而与患者发病时的年龄、性别及糖尿病类型关系不大。增殖性糖尿病性视网膜病变是糖尿病视网膜病严重预后不良的阶段。目前,在增殖前期给予眼底激光光凝治疗是延缓该病变发展的有效手段。我院自2008年来应用激光光凝术对94例188眼增殖前期糖尿病性视网膜病变进行了视网膜光凝治疗,取得了满意效果。现报告如下。

目的探讨白内障超声乳化技术联合人工晶体植入和房角分离术治疗慢性闭角型青光眼的疗效。方法回顾分析我院眼科2009年1月—2011年10月收治的患慢性闭角型青光眼合并白内障患者32例(42只眼),年龄55～82岁,平均(65.5±6.8)岁。入选患者中房角粘连≤180°,视野缺损≤100 db。采用白内障超声乳化联合人工晶体植入技术+房角分离术。术后随访6～24个月。结果随访患者眼压为(13.16±4.7)mmHg。比术前控制眼压(25.30±6.10)mmHg明显下降。差异有统计学意义(P<0.01)。全部患者前房加深房角加宽。术后最佳矫正视力提高4～8行,与术前比较,差异有统计学意义(P<0.01)。结论白内障摘除联合人工晶体植入术+房角分离术是治疗白内障合并慢性闭角型青光眼的可行且有效的方法。

目的探讨白内障超声乳化手术初期阶段的学习方法和如何规避或减少手术并发症。方法经理论学习、猪眼练习、选择适合病例,对100例老年性白内障患者行超声乳化手术治疗。结果术后视力达0.5以上者66例(66%),0.3以上者94例(94%),主要并发症为后囊破裂7例(7%),虹膜损伤9例(9%),角膜水肿13例(13%),前囊裂开6例(6%),黄斑水肿5例(5%),并发症大多发生在前30例中。结论 初学者在有经验的老师指导下经正规训练,循序渐进,选择合适病例,正确及时地处理术中并发症,可较快渡过超声乳化初期阶段,缩短学习曲线时间。

目的探讨羊膜移植在角膜溃疡及眼角膜化学伤的临床疗效。方法选择本院角膜溃疡78例(78只眼),眼角膜化学伤12例(12只眼)临床连续住院患者病例,分别行单纯羊膜移植术89例(89只眼),羊膜移植联合板层角膜移植术1例(1只眼)。通过观察患者术后的角结膜情况、视功能等来评价疗效,术后随访观察6~18个月。结果所有病例术后均未见羊膜植片急性排斥反应,角结膜无进行性溶解和穿孔,溃疡术后未见复发,视力有不同程度的提高。结论羊膜移植能抑制纤维组织增生,减轻炎性反应,减少新生血管,对治疗角膜溃疡及急性眼角膜化学伤安全有效。

Objective To investigate the efficacy of keratoplasty for treatment of traumatic corneal defects and the correlative risk factors which effect the surgical operation efficacy.Methods Traumatic corneal defects were treated with keratoplasty.Postoperative corneal clarity,as well as ocular pressure and complications was recorded.Results Grafts were all transparent and anterior chamber formed well.In the 24 cases,immune rejection in 6,secondary glaucoma in 6 and ocular vascularization in 5 were found.All the 24 cases improved in sight in spite of astigmatism to some extent.Conclusion Keratoplasty is an efficient method to the therapy of traumatic corneal defects,and prevention and treatment of glaucoma and ocular immune rejection after keratoplasty are also very important.

目的应用临床视觉电生理的方法对屈光不正性弱视眼视野各部位的视功能的损害进行探讨.方法采用德国Roland公司的RETIscan33-15多焦视觉电生理仪,选用Pattern-LT刺激方式,刺激图形选用CRT Combs,由61个六边形组成,每个六边形内均由黑白相间的小区填充,在刺激时作黑白翻转,每个六边形的刺激翻转分别由一个二极伪随机时间序列(m序列)控制,是随机和相互独立的,用RETI多焦电生理仪的分析软件提取FOK(一阶反应).共记录和分析了36例屈光不正性弱视儿童72眼,并与正常对照组儿童作比较.结果弱观眼N1-P1波振幅密度平均值和P1-N2波振幅平均值较正常组儿童在中央视野有下降,周边部分无明显异常,P1波潜伏期王均值与正常对照组儿童比较在视野各部分无明显异常.结论屈光不正性弱视眼在中央视野,部分视功能下降.