Objective To observe the effects on the stereopsis after posterior chamber phackic implantable collamer lens (pICL)implantation.Design Retrospective case series.Participants 77 eyes of 40 myopia patients were involved,who were performed pICL implantation in Affiliated Hospital of Guizhou Medical University from October 2014 to October 2015.Methods Preoperative best corrected visual acuity (BCVA) and stereopsis were compared with uncorrected visual acuity (UCVA) and stereopsis postoperative 1 month and 3 month respectively.Main Outcome Measures UCVA、BCVA and stereopsis.Results UCVA and BCVA preoperatively was (0.06±0.06) and (0.85±0.22) respectively.Postoperative 1 month and 3 month,mean UCVA was (0.92±0.24)and (0.97±0.25) respectively.The UCVA of postoperative 1 month and 3 month were obviously improved comparison with the BCVA of preoperative (all P=0.000).The preoperative near stereopsis was no statistically significant difference from that at postoperative 1 month(P=-0.259).The near tereopsis at the postoperative 3 month more significant improve than preoperatively (P=-0.016).In the group of the anisometropia less than 2.50 D,the near stereopsis at the postoperative 3 month more significant improve than preoperatively (P=0.046).In the group of the anisometropia greater than or equal to 2.50 D,there was no statistically significant difference when comparison of the near stereopsis vision between the two groups (P=0.343,0.158,0.774,respectively).The far stereopsis at the postoperative 1 month and postoperative 3 month were more significant improve than preoperatively (P=0.010,0.000,respectively).In the group of the anisometropia less than 2.50 D,the far stereopsis at the postoperative 3 month were more siginificant improve than preoperatively (P=-0.001).In the group of the anisometropia greater than or equal to 2.50 D,the far stereopsis at the postoperative 3 month more siginificant improve than preoperatively (P=0.009).Conclusion The pICL implantation can significantly reduce anisometropia and improve the vision acuity,the near and distance stereopsis.

目的研究基层医院白内障术后残留屈光不正的相关因素。方法筛选白内障术后残留屈光不正的50例(58眼)纳入观察组，白内障术后未残留屈光不正的50例(60眼)纳入研究的对照组，比较两组患者的一般资料以及手术情况。结果观察组患者合并存在糖尿病、青光眼、眼底病变明显多于对照组(38.00%vs 14.00%,26.00%vs 4.00%,22.00%vs 6.00%)；手术情况：两组患者白内障超声乳化时间比较差异无统计学意义；观察组经验方式测量、大切口手术、术后发生角膜水肿、人工晶体移位、玻璃体混浊、后发性白内障明显多于对照组(66.00%vs 36.00%,42.00%vs 18.00%,26.00%vs 6.00%,22.00%vs 4.00%,18.00%vs 2.00%,26.00%vs 8.00%)；合并存在糖尿病、青光眼、眼底病变、经验测量方式、术后发生角膜水肿、人工晶体移位、玻璃体混浊、后发性白内障以及大切口手术是造成白内障术后残留屈光不正的危险因素(β=1.039~2.691,OR=2.483~3.682,95%CI=1.469-3.392~2.557-4.254,p<0.05)。结论白内障术后残留屈光不正受到患者自身因素以及手术因素的影响，需要在临床中加以预防。

Objective: To investigate the curative efficacy of vitreous cavity injection of monoclonal antibody( lucentis) on wet age-related macular degeneration( w AMD). Method: A total of 38 patients with w AMD were given lucentis in vitreous cavity,best corrected visual acuity( BCVA) and macular central foveal thickness( CFT) were observed before operation,two weeks,one month and three months after operation; postoperative adverse reactions and complications such as high intraocular pressure,inflammation,anterior chamber hemorrhage,retinal hemorrhage,cataracts were detected;curative effect was analyzed. Results: Two weeks,1 month and 3 months after treatment,BCVA was higher than that before treatment,and showed rising trend,while CFT was lower than that before treatment,and showed descending trend,the differences were statistically significant( P 0. 05). There was no serious adverse reaction and complication. Conclusion: Vitreous cavity injection of lucentis shows obvious curative effects and few adverse reactions.

微型角膜刀上皮瓣下准分子激光磨镶术(Epi-LASIK)是继准分子屈光性角膜切削术(PRK)、准分子激光上皮瓣下角膜磨镶术(LASEK)和准分子激光角膜原位磨镶术(LASIK)之后的一种新型手术方式,与LASIK比较,ep-i LASI K具有以下优点:(1)无LASI K角膜基质瓣相关并发症,操作更安全;(2)保留了更厚的基质床,术后出现继发角膜扩张的风险低于LASI K;(3)避免了制作角膜基质瓣导致新像差的产生.因此,在波前像差引导的个体化切削应用中优于LASI K,适应证更广,可适合于从事对抗性职业或其他容易伤及眼睛工作的患者以及角膜偏薄不适合LASI K患者.初期的临床研究显示患者EPI-LASIK术后刺激症状轻,Haze不明显,但仍不能完全避免.

目的 探讨机械法准分子激光上皮瓣下角膜磨镶术(Epi-LASIK)和准分子激光上皮瓣下角膜磨镶术(LASE)治疗高度近视的疗效.方法 Epi-LASIK组高度近视患者16例(32眼),行Epi-LASIK矫治,LASEK组高度近视患者20例(40眼)行LASEK治疗,对治疗结果进行比较.结果 Epi-LASIK组患者术后裸眼视力达到最佳矫正视力或高于最佳矫正视力的眼数比例明显高于LASEK组(P＜0.05);屈光度明显优于LASEK组(P＜0.05);术后角膜上皮愈合明显好于LASEK组(P＜0.05);上皮下雾状混浊的发生率明显低于LASEK组(P＜0.05).结论 Epi-LASIK矫治高度近视操作简单、安全、有效,较LASEK有着明显的优势,值得临床推广应用.

目的:通过对患者进行健康教育,预防和减轻宫颈癌患者后装治疗的不良反应和并发症。方法:对35例宫颈癌患者在后装治疗的前、中、后进行健康教育。结果:35例宫颈癌患者均能顺利完成治疗计划,达到预期效果。结论:通过健康教育的实施,消除病人恐惧心理,避免和减少了并发症的发生率,提高了患者的治疗质量。

<正>2010年5月肿瘤治疗中心作为包钢医院首批优质护理服务示范病房正式启动运行,护理理念的更新,护理模式的改变,提升了护理水平,不仅实现了"大综合、小专科"的护理专科有效融合,也为肿瘤患者提供科学、规范、合理的个体化多角度综合护理服务,护士们用爱心和责任心换来了患者的舒心和家属的放心。回顾开展优质护理服务两年的体会,总结

目的 探讨中药“糖明汤”对糖尿病视网膜病变(DR)和合并神经病变(DON)、黄斑水肿(DME)的临床疗效及光学相干断层扫描(OCT)、荧光血管造影(FFA)特点.方法 将100例(200眼)DR患者随机分为治疗组和对照组,治疗组50例(100眼)均采用光凝术联合中药“糖明汤”治疗；对照组50例(100眼)仅接受视网膜光凝治疗.对两组的眼底及OCT、FFA等临床资料和有效率进行分析.结果 本组100例200眼糖尿病视网膜病变临床表现各异,合并DON可无视力损害,也可有严重的视力下降.而合并DME者均有不同程度的视力损害.治疗组有效率84.00％,对照组有效率72.00％,两组相比具有统计学意义(P＜0.05).结论 糖尿病视网膜病变合并视神经病变或黄斑水肿时,可采用OCT、FFA早期诊断,及时的视网膜激光光凝联合中药“糖明汤”治疗对黄斑水肿吸收、视网膜新生血管消退和视力的提高显著优于对照组,表明视网膜光凝围手术期中药治疗糖尿病视网膜病变具有一定的优势.

目的观察单独使用曲伏前列素及曲伏前列素与布林佐胺、噻吗洛尔联合使用治疗原发性开角型青光眼(POAG)的疗效,并对部分患者实施护理干预,探讨原发性开角型青光眼的最佳治疗方案。方法将56例108只眼POAG患者纳入为期1年的研究,测量眼压基线值。用药后于不同时限对眼压、视力、视野、视神经OCT进行检查。对部分患者实施护理干预。结果单独使用曲伏前列素组治疗半年70.37%患者达目标眼压,1年62.96%患者达目标眼压,实施护理干预的患者半年73.20%达目标眼压,1年66.55%达目标眼压。联合用药组治疗半年83.33%患者达目标眼压,1年72.22%患者达目标眼压。实施护理干预的患者半年85.82%达目标眼压,1年74.70%达目标眼压。结论单独使用曲伏前列素及曲伏前列素与布林佐胺、噻吗洛尔联合使用治疗POAG均有效,对单独使用曲伏前列素效果不佳者可采用联合用药。对患者实施护理干预有助于提高药物治疗的有效性。

<正>穿透性角膜移植手术是角膜病致盲复明的重要方法。随着手术设备和技术的改进及抗排斥反应药物的开发应用,穿透性角膜移植手术成功率已明显提高,但术后角膜规则或不规则散光成为影响术后视力恢复的主要因素之一[1,2]。本文对穿透性角膜移植手术后1～3年出现严重散光、经框架眼镜矫正不满意的患者采用RGP高透氧性硬性角膜接触镜矫治,取得较满意效果。现报告如下。

<正>正常眼表面覆盖一层泪膜,稳定的泪膜是维持眼表面健康的基础,而稳定的泪膜依赖于组成泪膜各层(从外到内分别为脂质层、水液层及黏蛋白层)的量和质的正常及泪液动力学的正常。干眼(dryeye)是由于泪液的质或量异常,或泪液的动力学异常引起的泪膜不稳定及眼表面的损害,从而导致眼

目的:探讨准分子激光角膜原位磨镶术(LASIK)与上皮瓣下角膜磨镶术(LASEK加Epi-LASIK)后高眼压的发生情况及治疗效果。方法:LASIK组826例1 646只眼术后滴用皮质类固醇滴眼液4周,LASEK加Epi-LASIK组903例1 793只眼术后滴用皮质类固醇滴眼液8周,观察两组眼压变化,对高眼压者给予治疗。结果:行LASIK术后1周发生高眼压1例2眼,术后1个月发生高眼压19例38眼,总发生率2.43%,经停用皮质类固醇滴眼液并予噻吗洛尔滴眼液滴眼,3例加用布林佐胺滴眼液后眼压控制正常;LASEK+Epi-LASIK术后1周发生高眼压1例2眼,术后2周发生高眼压7例14眼,术后1个月发生高眼压67例133眼,术后2个月发生高眼压4例8眼,共79例157眼,总发生率8.76%。经停用皮质类固醇滴眼液并予噻吗洛尔滴眼液滴眼,23例加用布林佐胺滴眼液后眼压控制正常,2例降眼压药物控制不理想。结论:行准分子激光角膜屈光术后应用皮质类固醇可引起高眼压,LASEK及Epi-LASIK较LASIK发生率高,因此术后需定期随访,及时发现激素性高眼压,有助于提高手术安全性。

Objective:To observe the clinical effects on the treatment of local retinal detachment after laser therapy with self-prescribed strengthening spleen and promoting urination prescription.Method: Not more than 1 quadrant of t local retinal detachment in 71 patients(72 eyes).The Argon laser therapy with photocoagulation 2-3 laps at the outer edges of the retinal detachment zone.The patients were randomly divided into two groups,control group without drug treatment,the treatment group with Self-prescribed strengthening spleen and promoting urination prescription treatment 2-3 weeks,1 year follow-up observation two groups of subretinal effusion absorption.Result: Control group 36 patients(36 eyes) 13 eyes cured,15 eyes effective,8 eyes is invalid.The treatment group 35 patients(36 eyes) 22 eyes cured,13 eyes effective,1 eye is invalid.Add the strengthening spleen and promoting urination prescription had better effects than control group,the difference was statistically significant(P0.05).Observe the subretinal effusion absorption time,the treatment group significantly shorter than in the control groups.Conclusion: Laser for the treatment of localized retinal detachment is to avoid surgery safety and effective method,add to the traditional Chinese medicine strengthening spleen and promoting urination prescription treatment can significantly improve the effect of laser treatment.

Objective Application of anterior segment OCT for the purposes of phakic posterior chamber intraocular lens implantation in patients before surgery,should be examined to assess the safety of operation.Methods The proposed line of phakic posterior chamber intraocular lens implantation in patients with preoperative anterior segment OCT measurement of anterior chamber depth,angle width,after 3 hours,1 day,1 week,1 month,3 months,six months,a in measuring anterior chamber depth,angle width,intraocular lens surface and the distance between the front surface of the natural lens(high arch).Results Preoperative measurement of anterior chamber depth less than 3mm to give up surgery and postoperative measurements do not form a high arch or high arch in patients with large,high intraocular pressure in time if the wash chamber,to avoid secondary glaucoma,mydriasis,and other adverse the consequences.Conclusion Anterior segment OCT in phakic posterior chamber intraocular lens implantation in the preoperative risk of investigation,monitoring of postoperative complications has an important role.

<正>干眼是由于泪液的质或量异常,或泪液的动力学异常引起的泪膜不稳定及眼表面的损害,从而导致眼不适等症状的一类疾病。我院于2011年7～11月对门诊确诊为干眼症的69例患者,通过睑板腺按摩联合普拉洛芬滴眼液治疗,取得较好疗效。现报告如下。临床资料:本文确诊为干眼症(经人工泪液滴眼治疗无效)的患者69例,男25例、女44例,年龄

目的:观察和血明目片联合氪激光治疗视网膜静脉阻塞(retinal vein occlusion, RVO)的疗效.方法:选择经眼底血管荧光造影(FFA)、光学相干断层扫描(OCT)确诊的57例60眼视网膜静脉阻塞患者,随机分为治疗组29例30眼采用和血明目片联合氪激光光凝治疗.对照组28例30眼采用单纯氪激光光凝治疗.观察两组治疗前后视力、眼底和FFA,全部病例随访6mo.结果:氪激光联合中成药和血明目片治疗视网膜静脉阻塞较对照组视力改善明显,出血吸收快(P＜0.05).结论:在视网膜静脉阻塞行氪激光光凝时联合中成药和血明目片治疗,能较好的促进视网膜出血的吸收,有效的改善患者视功能.

Objective To discuss the laser treatment method to the ischemic retinal vein occlusion (RVO) with more hemorrhage. Methods Fifty-two eyes in 49 cases suffering from ischemic RVO with more hemorrhage were treated with local or panretinal photocoagulation in red light, big spot size, long pulse duration and lower power. Results The hemorrhage and edema in the retina disappeared quickly in the 2-3 weeks after laser in 18 eyes (34.62％) and the visual acuity improved in 9 eyes (17.31％), no changes in 8 eyes (15.38％) and declined in 1 eye (1.92％). In 31 eyes (59.62％), the hemorrhage and edema disappeared partly in the 2-3 weeks after laser and it disappeared completely after 3 months and the visual acuity improved in 8 eyes (15.38％),no change in 20 eyes (38.46％) and declined in 3 eyes (5.77％). FFA verified that most of the nonperfusion areas covered over by photocoagulation and did not enlarged, the neovascular disappeared completely or partly. There were no new bleeding in vitreous and neovascular glaucoma in these patients during the follow up. In the 3 eyes with neovascular glaucoma, the condition had been controlled and stabilized in some extent. Conclusion In the ischemic retinal vein occlusion with more hemorrhage, the laser of red light,big spot size, long pulse duration and lower power can make effective photocoagulation and help the absorb of the hemorrhage and edema in the retina, reduce the incidence of serious complication such as vitreous bleeding and neovascular glaucoma.

目的:观察近视患者Epi-LASIK术前行预防性视网膜激光光凝的疗效。方法:Epi-LASIK术前对近视患者常规行双目间接眼底镜及90D前置镜眼底详细检查,明确有周边视网膜变性或(伴)裂孔者43例(62只眼)进行预防性多波长氪离子激光光凝治疗。结果:对43例62只眼行预防性多波长氪离子激光光凝治疗,Epi-LASIK术后周边视网膜变性和裂孔区封闭良好,激光色素斑形成明显;术后随访一年,视网膜病变情况较术前无明显变化,无孔源性视网膜脱离的发生。结论:Epi-LASIK术前对明确有周边视网膜变性或(伴)裂孔的近视患者行预防性多波长氪离子激光光凝治疗是预防术后出现孔源性视网膜脱离的有效措施。

目的:探讨中药糖明汤对糖尿病视神经病变(DON)的临床疗效及光学相干断层扫描(OCT)、荧光血管造影(FFA)的特点。方法:对100例糖尿病性视网膜病变(DR)患者的眼底及OCT、FFA等临床资料进行分析。结果:采用中药糖明汤治疗DON视力提高28眼(68.29%)、视野改善8眼(19.51%)、视盘新生血管消退5眼(12.20%)。结论:中药糖明汤治疗DON可减轻视盘水肿,改善视野,迅速提高视力,有效防治视功能损害。