AIM:To study the methods and effect of aphakia eye secondary posterior chamber intraocular lens(IOL) implantation with suture fixation under anterior chamber irrigation after vitrectomy.METHODS:Thirty aphakia eyes underwent secondary posterior chamber IOL implantation with suture fixation under anterior chamber irrigation after vitrectomy.All the cases were followed up for 1.5 years.RESULTS:Thrity cases(30 eyes) underwent posterior chamber IOL implantation successfully.The complications included hemorrhage of the ciliary body(1 case) in the operation and vitreous hemorrhage(1 case) and choroid detachment(2 cases) after the operation.The visual acuity of all cases was more improved than before,24 cases(80%) had obtained post-operative visual acuity ≥0.3,of these,8 cases(27%) ≥0.5;6 cases(20%)<0.3,of these,2 cases(7%) <0.1.CONCLUSION:The method of anterior chamber irrigation is safe and successful which can obtain stableintraocular pressure during and after the operation and lower complications.The operation is an effective method for improving the visual acuity after vitrectomy.

Objective:To explore the skills of operations and it’s curative effect of suspended intraocular lens (IOL) implantation after lensectomy and vitrectomy.Method:Suspended intraocular lens were implanted into 17 cases 17 eyes after lensectomy and vitrectomy. 7 eyes were primary implanted and 10 eyes were secondary implanted,To explore the skills of the operations,the operative effects and the postoperative complications.All the cases were followed up 3~6 months.Result:All the eyes were successful in suspension once,The position of IOL was normal,2 cases happened vitreous chamber hemorrhage,1 case happened corneoscleral leakage,3 cases happened transitionally increased tension.The vision of 17 cases rasied obviously.Conclusion:The implantation of suspended IOL are safe and effective ways after lensectomy and vitrectomy.Some skills are used during the operation,The operative adaptations are controlled on primary implanted.

<正>糖尿病视网膜病变(diabetic retinopathy,DR)是糖尿病最常见的眼部并发症。我院引进了英国生产的全景200广角激光眼底镜于2010年6月至2011年5月对805例(1610只眼)糖尿病患者进行详细的筛查并指导治疗。现报告如下。一、资料与方法1.一般资料:对2010年6月至2011年5月在我院内分

目的评价恒磁吸铁器在玻璃体切除术中辅助眼后段磁性异物取出中的作用。方法采用随机对照研究,将需行一期玻璃体切除联合眼内异物摘出术的45例眼后段磁性异物伤患者随机分为两组,试验组行玻璃体切除联合恒磁吸铁器辅助异物取出术(22例22眼),对照组行玻璃体切除异物取出术(23例23眼),比较两组异物脱落率、取出所需时间。结果试验组均未发生异物脱落,经单次操作取出异物;对照组有5例异物脱落一次后取出,1例脱落两次,第三次联用恒磁吸铁器取出异物,两组异物脱落率差异有统计学意义(P=0.046)。同时两组异物取出所需时间差异也差异有统计学意义(P=0.029)。结论恒磁吸铁器辅助应用于眼后段磁性异物取出术,具有方法简单、效果确切、并发症少的优点,尤其适用于较大的眼内磁性异物取出术。

目的 研究玻璃体切割术后高眼压的发生率、探讨其发生原因与处理方法.方法 分别测量196例(眼)行玻璃体切割患者的术后眼压,术后高眼压的患者进行药物治疗,药物治疗无效者行手术治疗.结果 196例(196眼)术后眼压高的56例(56眼),占28.57％,其中48例(48眼)药物控制有效,8例(8眼)经手术治疗控制眼压.眼外伤病例术后高眼压的发生率高于糖尿病视网膜病变和孔源性视网膜脱离,差异具有显著性.术中联合环扎、眼内填充、晶状体摘除手术的病例术后高眼压发生率高于不联合环扎、眼内填充、晶状体摘除手术的病例,差异具有显著性.结论 玻璃体手术后高眼压是常见并发症,其发生率与原发眼病和手术方式有关,大部分可以通过药物治疗控制；房水引流阀植入等手术可以有效控制药物治疗失败的玻璃体手术后高眼压.

AIM:To explore the causes of dacryocystorhinostomy failure and the clinical therapeutic effects of reoperation.METHODS:Seventeen cases (17 eyes) with failure dacryocystorhinostomy were reoperated. The causes of the first operation failure were analyzed,and the reoperation skills and effects were explored.RESULTS:Patients were followed up from 4 to 12 months. All reoperations were successful. The main reason of failure was small bone hole and improper location,dacryocyst not fully incised, lower end of blind pouch and contact adhesion of anterior flap with posterior flap.CONCLUSION:Mastering the surgical skills and key points, correctly dealing with the problems of the first operation, the reoperation will be successful.

目的:评价显微镜下外路视网膜复位术治疗孔源性视网膜脱离的安全性及有效性。方法:将48例孔源性视网膜脱离的患者随机分为两组,显微组24例在手术显微镜下行外路视网膜复位术,对照组24例在间接眼底镜下行外路视网膜复位术,比较两组并发症和手术疗效。结果:两组视网膜复位率、术后视力、术后冷凝反应、术中术后并发症差异均无统计学意义(P>0.05)。结论:显微镜下外路视网膜复位术具有术野清晰、效果确切、并发症少的优点。

AIM:To investigate the application of suture fixation of intraocular lens(IOL)implantion in posterior chamber in the following cases:posterior capsule broken in extracapsular cataract extration,injury cataract,lens dislocation and post eperative vitrectomy.METHODS:From April 2010 to April 2011,24 cases(24 eyes) used ciliary groove suture with posterior chamber type of intraocular lens and all cases acquired satisfied result.In 7 cases with two remaining quadrants posterior capsule due to lens posterior capsule damage,relying on the remaining posterior capsule,one side of the IOL loop was placed on it,the other side of the loop were implemented ciliary groove suture fixation,which was "one point fixation".Severe post-traumatic 17 cases without lens posterior capsule were implemented the ciliary groove suture fixation of both sides loops,which was "two-point fixation".RESULTS:Following up for 4-12 months(average 6 months),the BCVA was from 0.01 to 1.2 and 15 eyes' vision were more than 0.6(62.5%).Poor vision was because of the corneal scar and injury fundal diseases.Transplanting the IOL secondarily made the vision better than pre-operation best-corrected visual acuity(BCVA).The intraocular pressure(IOP) in all eyes were normal and all had no complication.CONCLUSION:The method of suture fixation of intraocular lens implantion in posterior chamber is the best select to the lens with the posterior capsule broken or disappearance and large range ligaments loose.

Objective To observe the character of cyclosporin a-loaded chitosan nanoparticles[CS (CsA)-NP],and study the inhibitive effect of CS(CsA)-NP in rabbit's conjunctival fibroblasts(RCFs) proliferation in vitro.Methods The rabbit's conjunctival fibroblasts were divided into four groups;CS (CsA)-NP,original CsA,blank chitosan nanoparticle(CS-NP) and the control group.Different concentrations of drugs were test.The incubation time of drug was 24～72 hours.The cells growth conditions were observed with light microscope and the inhibition of the drugs to the RCFs were determined with the method of methyl thiazolyl tetrazolium(MTT) colorimetric assay.Results CS(CsA)-NP,original CsA and CSNP inhibited RCFs proliferation in experimental groups in comparison with that in the control group in a dose-dependent and time- dependent manner.The inhibitive effect of CS(CsA) -NP was more effective than in original CsA and CS-NP(P0.01).Conclusion CS(CsA)-NP can inhibit the proliferation of RCFs and can be be proposed as a potential controlled and targeted ophthalmic delivery system.

[Objective]To study the curative effect of three types of operations for senile glaucoma combined with cataract.[Methods]120 cases(142 eyes) of senile glaucoma combined with cataract were randomly divided into three groups.Group A was given phacoemulsification and foldable intraocular lens implantation,group B received phacoemulsification and foldable intraocular lens implantation combined with trabeculectomy,and group C was treated by phacoemuisification combined with goniosynechialysis.The changes of visual acuity and intraocular pressure before and after operation,and postoperative complications were observed.[Results]Compared with preoperative visual acuity and average intraocular pressure,the visual acuity and average intraocular pressure at 1 week,l months,3 months and 6 months after operation were significantly improved(P<0.05),but the difference among three groups was not significant(P>0.05).There was no severe postoperative complication in three groups.[Conclusion]Phacoemulsification and foldable intraocular lens implantation combined with trabeculectomy,and phacoemuisification combined with goniosynechialysis are effective methods for senile glaucoma combined with cataract,and the curative effect of them has no obvious difference.

·AIM:To investigate the clinical effect of small-incision extracapsular cataract extraction with posterior chamber intraocular lens implantation and trabeculectomy for glaucoma and cataract.·METHODS:Totally 17 patients with glaucoma and cataract underwent the extracapsular cataract extraction with posterior chamber intraocular lens implantation and trabeculectomy,postoperative visual acuity,intraocular pressure and complications were observed.·RESULTS:All the patients were returned to normal intraocular pressure range.Visual acuity was improved in different degrees.Early shallow anterior chamber occurred in 1 eye,and transient corneal edema occurred in 2 eyes.·CONCLUSION:The small-incision glaucoma and cataract surgery is a safe and effective way.·

目的评价小切口手法碎核白内障囊外摘除人工晶体植入联合小梁切除术治疗急性闭角型青光眼合并白内障患者持续高眼压的安全性和有效性。方法分别对高眼压组23例(25眼)急性闭角型青光眼合并白内障患者在持续性高眼压状态下、对照组26例(28眼)急性闭角型青光合并白内障患者在眼压控制后行小切口手法碎核白内障囊外摘除人工晶体植入联合小梁切除术,术后随访3~6个月。结果两组术前眼压差异有高度显著性(P<0.01);两组术后眼压均控制在2.8kPa以下,差异无显著性(P>0.05),但均比术前显著下降(P<0.01)。两组术后视力均较术前有不同程度的提高。并发症有术中前房出血、虹膜脱出、术后角膜水肿、前房出血、前葡萄膜炎、人工晶状体表面渗出膜等,高眼压组比对照组出现机会增加,但两组均无暴发性脉络膜出血、角膜失代偿等严重并发症发生。结论在持续高眼压状态下行小切口手法碎核白内障囊外摘除人工晶体植入联合小梁切除术,出现并发症的机会较眼压控制后手术稍多,但对于药物难以控制眼压时,本手术仍是安全和有效的,不仅可缩短病程和减少视力损失,而且还能取得与正常眼压下行抗青光眼手术治疗同样的疗效,适合基层医院开展。

目的观察LASEK术中撕瓣联合水复位法治疗中高度近视的临床效果。方法LASEK术中撕瓣联合水复位法治疗162例(324眼)中高度近视,随访3~6个月,观察症状、视力、屈光状态、角膜并发症等情况。结果术后刺激症状较PRK轻,无明显上皮下雾状混浊出现。患者术后6个月时裸眼视力≥0.8者321眼(99.07%);≥1.0者300眼(92.59%)。结论LASEK术中撕瓣联合水复位法治疗中高度近视安全性更高,术后视觉效果更好,降低了上皮下雾状混浊的发生率。

肾移植术后患者由于原发病及手术创伤对机体的影响,以及术后长期应用免疫抑制剂,导致患者机体免疫功能低下,易发生机会性感染,但并发内源性真菌性眼内炎的报道较罕见,且眼部病变早期症状不典型,早期诊断困难,治疗较为棘手[1].现将江阴市人民医院眼科收治的肾移植术后双眼内源性真菌性眼内炎晚期患者1例报告如下.

目的观察玻璃体切割术治疗眼外伤的临床疗效。方法分析我院自2007年以来收治的眼外伤患者31例31眼,其中钝挫伤14眼,眼球破裂伤9眼,眼内异物8眼。全部患者均经睫状体平坦部行闭合式巩膜三通道玻璃体切割术,其中单纯晶状体玻璃体切割者5例,晶状体玻璃体切割联合眼内注油8例,玻璃体切割眼内激光联合眼内注气8例,晶状体玻璃体切割联合IOL植入4例,单纯玻璃体切割6例。结果术后随访6个月～2年,31例患者眼球萎缩2例,视力无提高2例,其余29例术后视力均较术前提高,其中1例玻璃体异物行玻璃体切割术后视力达0.8,1例病人术后出现继发性青光眼,药物不能控制眼压,后行青光眼硅胶阀植入后眼压控制正常。结论玻璃体切割术治疗眼外伤临床疗效明显。

随着显微手术的不断发展,对同时患有白内障青光眼的患者,近年来多采用白内障囊外摘除人工晶状体植入联合小梁切除术(三联手术),一次手术解决两种疾病,既迅速恢复视力,又有效降低眼压.我院2001～2006年行白内障三联手术52例(58眼),取得良好效果.

近年来,我国青少年近视眼患病率不断攀升,近视患者升学,参军和工作都会受到限制,近视眼的防治成为一个全球性的医学和社会问题.为探讨现代角膜塑形镜控制青少年近视眼的近期疗效,选取2009年5月至2010年8月在我院眼科门诊配戴现代角膜塑形镜资料完整的136例(264眼)进行分析研究,报告如下.

·AIM:To observe the clinical effect of perioperative intervention treatment for dry eye in LASIK.·METHODS:Totally 568 patients 1124 eyes with myopia and astigmatism in LASIK surgery underwent preoperative screening and perioperative intervention.Dry eye symptoms were observed before and 1 week;1 month,3 months after operation.Tear secretion test,tear film break-up time and corneal fluorescein staining were performed.·RESULTS:Mild dry eye was found in 158 eyes(14.57%)1 week,136 eyes(12.10%)1 month,58 eyes(5.16%)3 months after operation.·CONCLUSION:The screening before surgery and reasonable perioperative intervention play on important role in reducing the occurrence of dry eye.·

目的比较翼状胬肉逆行切除联合生物羊膜移植术与单纯翼状胬肉逆行切除的临床疗效。方法分析原发性翼状胬肉85例(94眼)的临床资料,随机分为两组,A组为单纯翼状胬肉逆行切除组38例(42眼)、B组为翼状胬肉逆行切除联合生物羊膜移植术组47例(52眼),比较两组疗效。结果术后随访12～24个月,A组复发10眼(23.8%);B组复发4眼(7.7%),两组比较差异有统计学意义(P<0.05)。结论翼状胬肉逆行切除联合及生物羊膜移植疗效优于单纯逆行切除组。

Objective To investigate the timing of vitrectomy on complicated open injury of the eyeballs.Methods Analyzed 45 cases (45 eyes)with complicated open injury of the eyeball who underwent vitreous surgery as the primary method in our hospital from Aug.2006 to Mar.2010.The early-operation group enrolled 21 cases (2 weeks before who undergone bi-operation after the primary suture),the advanced stage group enrolled 24 cases(2 weeks later who undergone bi-operation after the primary suture).All cases were followed up 3~2 months to observe and compare the complexity of the vitreous surgrey. All the factors were analyzed with STATA11.0 statistical package,usingχ2 analysis,α=0.05 was used as the test standard.Results 5 cases (23.8%)who undergone the padding off silicone oil in the early-operation group and 13 cases (54.2%) in the advanced stage group,the incidence rate distinction had statistical significance(χ2=4.300,P=0.038).The best corrected vision after the surgery:The vision of the two groups improved obviously,de-blind rate(the vision≥0.05):the early-operation group was 85.7%(18/21),the advanced stage group 58.3%(14/24),the incidence rate distinction had statistical significance(χ2=4.087,P=0.043).There were 2 eyes with retinal detachment after vitrectomy,of which was 0 eye in the early-operation group and 2 eyes in the advanced stage group.Conclusion The vitreous operation is the effective treatment method in the complicated open injury of the eyeballs.Early operation can improve the vision of the injury eye better and lower the complexity of the vitreous surgrey.