目的:研究结膜瓣遮盖用于难治性角膜溃疡的疗效和安全性.方法:选取2017年6月～2018年6月来我院就诊的120例难治性角膜溃疡病例进行临床试验,通过SPSS数据分析进行抽签分组将所有病例分成观察组(n=60)和对照组(n=60).术前收集每位患者泪液并记录分析结果,术后与术前结果进行对比.对照组采用羊膜移植对患者进行治疗,观察组采用结膜瓣遮盖对患者进行治疗.两组患者均于治疗1个月后进行复诊,对比两组临床疗效及术后并发症发生率情况,另外对比两组治疗前后视力恢复情况及泪液指标变化[三羧酸循环(TAC)、丙二醛(MDA)、一氧化碳(NO)、谷胱甘肽过氧化物酶(GSH-Px)].结果:观察组临床疗效总有效率83.33％与对照组临床疗效总有效率73.33％比较差异无统计学意义.术前两组视力0.05～0.3者居多,术后两组视力0.4～1.0者居多,组间对比差异无统计学意义.两组患者术前及术后三羧酸循环(TAC)、丙二醛(MDA)、一氧化碳(NO)、谷胱甘肽过氧化物酶(GSH-Px)指标数值比较差异无统计学意义;术后与术前相比观察组TAC、NO、GSH-Px数值显著增高,MDA数值显著降低,比较差异有统计学意义.两组病例均有不同程度并发症症存在,观察组并发症状总显著低于对照组28.33％,差异有统计学意义.结论:结膜瓣遮盖术用于难治性角膜溃疡能够取得显著的临床疗效,可提高患者疾病恢复速度,且该手术操作简单、安全性较高、并发症发生率低,值得临床推广.

目的 探讨认知行为疗法在原发性急性闭角型青光眼(APACG)手术患者中的应用效果.方法 选择2018年1月至2019年6月收治的APACG手术患者78例,按治疗方法分为观察组42例、对照组36例.对照组给予常规护理干预,观察组联合应用认知行为疗法,比较2组疾病认知水平、自我管理能力、生活质量等指标.结果 出院时,观察组患者发病原因、用药管理、睡眠管理、心理调护、复查时间与项目、疾病认知知晓率高于对照组(P＜0.05);随访6个月,健康知识水平、自我概念、自我责任感、自我护理技能、自我管理能力总分高于对照组(P＜0.05),远视力/移动和光感、调节能力、读与精细工作、生活质量总分高于对照组(P＜0.05).结论 认知行为疗法有助于增强原发性急性闭角型青光眼手术患者疾病认知水平,促进自我管理能力的养成,改善患者生活质量.

目的 比较羊膜移植术与自体角膜缘干细胞移植术对翼状胬肉患者术后屈光状态、美容效果的影响及安全性.方法 选取84例翼状胬肉患者作为研究对象,采用随机数字表法分为对照组和观察组,每组42例.对照组采用翼状胬肉切除联合自体角膜缘干细胞移植术治疗,观察组采用翼状胬肉切除联合羊膜移植术治疗,比较2组患者手术前后视力、屈光度情况,并比较2组创面愈合时间、术后并发症发生情况和美容效果.结果 术后1周、1个月时,2组视力均高于术前,屈光度均低于术前,差异有统计学意义(P＜0.05);2组术后1个月时的视力、屈光度与术后1周时比较,差异无统计学意义(P＞0.05);术前、术后1周、术后1个月时,2组间视力、屈光度比较,差异无统计学意义(P＞0.05).观察组创面愈合时间长于对照组,复发率高于对照组,差异有统计学意义(P＜0.05).2组总并发症发生率比较,差异无统计学意义(P＞0.05).结论 羊膜移植术、自体角膜缘干细胞移植术均为翼状胬肉安全有效的手术治疗方法,均可促进患者视力恢复,改善角膜屈光状态,但相较于羊膜移植术,自体角膜缘干细胞移植术可促进创面愈合,降低翼状胬肉术后复发率,获得满意的美容效果.

Objective: To investigate the surgical resection combined with glucocorticoids therapy clinical effects of orbital inlfammatory pseudotumor.Methods:Hospital between January 2011 to January 2012 orbital pseudotumor treated 50 patients were randomly divided into control group and observation group,25 patients in each group ,the control group only take surgery treatment ,observation group to take surgical resection combined with corticosteroid therapy ,the effect of the two groups were observed after treatment and follow-up of recurrence three years.Results:The overall treatment effective rate of 92 %,68 % of the treatment group compared with the control efifciency was signiifcantly higher,P<0.05,the observation group to complete the follow-up of 22 patients ,one case found the recurrence rate was 4.54% the control group,21 patients completed follow-up found in four cases the recurrence rate was 19.05%,signiifcantly higher,P<0.05. Conclusion:Glucocorticoids therapy and surgical resection of orbital pseudotumor can get a good effect,low recurrence rate and high cure rate,worthy of further promotion and clinical applications.

Objective To compare the clinical curative effect between combined trabeculectomy and 810 nm laser through scleral ciliary body photocoagulation method in the treatment for glaucoma patients.Methods Selected 70 patients who were diag-nosed with glaucoma from January 2013 to June 2014 in our hospital.According to different operation, they were divided into observa-tion group and control group.47 cases of 57 eyes in the observation group received ciliary body photocoagulation and 23 cases of 31 eyes in the control group received combined trabeculectomy.Compared visual acuity, intraocular pressure before and after treatment , postoperative complications and outcome in two groups.Results The visual acuity in the two groups before and after treatment had no significant difference.1 week and 3 months after treatment, intraocular pressure in observation group was better than control group, while at the time of the last follow-up, there was no significant difference ( P>0.05 ) .Reoperation rate of observation group was 27.66%(13/47) and control group was 8.70%(2/23).There was significant differences between the two groups (P<0.01).Con-clusion Compared with trabeculectomy operation, TDCP in the treatment of glaucoma is more simple but its short-term effects is not as good as trabeculectomy and should be treated with auxiliary drug or reoperation.Long-term effects and restored vision effect has no ob-vious difference between two methods.

目的 探讨淋巴细胞浸润型和硬化型眼眶炎性假瘤(orbital inflammatory pseudotumor,OIP)的临床病理特征,以及手术切除联合皮质类固醇治疗硬化型OIP的疗效.方法 选择32例淋巴细胞浸润型和54例硬化型OIP患者,检测血清中IgG4的水平,组织病理分析IgG4阳性细胞的表达情况.淋巴细胞浸润型OIP患者采取糖皮质激素治疗,硬化型OIP患者均进行手术切除联合低剂量糖皮质激素治疗.结果 硬化型患者血清IgG4水平(1.87±0.38)g· L-1明显高于淋巴细胞浸润型OIP患者(0.93±0.21)g·L-1,病理学检查结果显示淋巴细胞浸润型OIP中有2例表现为浆细胞IgG4阳性,硬化型OIP患者中有26例表现为浆细胞IgG4表达阳性;淋巴检查细胞浸润型OIP患者随访3 a内有2例复发,硬化型OIP患者经手术切除联合糖皮质激素治疗后,随访3a无一例复发.结论 在对OIP患者进行诊治时,应首先根据临床症状和病理检查明确病变类型,对于硬化型OIP患者应尽早行手术治疗,术后联合长期低剂量皮质类固醇治疗可明显改善硬化型OIP患者的临床症状,提高治愈率.

Objective To explore the age difference of the changes in anterior chamber angle (ACA) in the patients after cataract ultrasonic emulsification operation(CUEA) .Methods A total of 174 patients(174 eyes) with cataract was assigned into three groups of A(<60 years old ,36 cases) ,B (60‐75 years old ,75 cases) and C (> 75 years old ,63 cases) .The ACA parameters of the anterior chamber depth (ACD ) ,ACD angle (ACAA ) ,anterior chamber angle opening distance (AOD ) and trabecular iris space area(TISA) at 270 degrees and 750 μm in horizontal and vertical levels were measured by anterior segment optical coherence tomography (as‐OCT ) before and in one week ,one month ,three months and 6 months after operation .Results Compared to before ,the ACD ,ACA ,AOD and TISA were all significantly increased after CUEA(P<0 .05) ,which were more in groups of B and C than those in group A(P<0 .05) .Conclusion The increases of ACD ,ACA ,AOD and TISA after CUEA are more in cataract patients aged greater than 60 years old than in the youngers with cataract .

While Medical interns begin riding career, they are usually full of passion,self-assured.However,their professional emotion is frustrated because of various factors. This article will search how to train Ophthalmology interns’ psychological quality from the perspective of ophthalmology tutors,so as to consolidate and enhance the intern's professional emotion,make intern dedication to the career,and take harmonious interaction with their patients.

目的：观察和探讨替莫唑胺治疗视神经胶质瘤的疗效。方法对我院2010-01-2013-01收治的40例视神经胶质瘤患者的临床资料进行回顾性分析，患者均使用外科手术进行治疗，按随机数字表法将患者随机分为观察组和对照组，每组20例，观察组在术后使用替莫唑胺进行化疗，对照组在术后未给予替莫唑胺，对2组患者的疗效进行对比、分析。结果经化疗后，观察组肿瘤病灶完全缓解8例，部分缓解5例，病情稳定4例，有效率为85％；随访中观察组无复发。对照组在随访中有4例出现视神经胶质瘤复发，为多形性母细胞瘤。观察组的视力恢复情况优于对照组，肿瘤复发率低于对照组。经治疗后，观察组出现脑水肿1例，恶心、呕吐1例；对照组脑水肿7例，血液学毒性4例，恶心、呕吐6例，2组对比差异具有统计学意义（ P＜0.05）。结论作为新型抗肿瘤药物，替莫唑胺具有不良反应小，血脑屏障通透性能优良，耐受性佳，耐药率较低等优点，在视神经胶质瘤患者术后化疗效果显著，值得临床推广使用。

AIM: To integrate the individual and various items of refractive examination to one software, and made it applicated conveniently. METHODS: On the basis of every examination system, the computer software was designed and developed, the modules were established and maintained. RESULTS: The computer software could fulfill the examinations of visual acuity, strabismus (Hess screen), color vision, stereopsis. CONCLUSION: After 10 years' application, the effect is significant. It can nearly replace the items using projector of integrated refractometer, stereopsis exam and color blind exam.

目的分析首诊眼科确诊为青年高血压病患者的眼部情况。方法对45例(50眼)以视力下降为主要症状就诊的疑为青年高血压病患者,给予眼前后节检查、眼底荧光血管造影及视野检查、血压测定等。结果所有患眼中视网膜动脉阻塞18眼,视网膜静脉阻塞19眼,缺血性视神经病变13眼。45例均确诊为青年高血压病。结论因眼部并发症而首诊于眼科的青年高血压病患者缺乏高血压病的典型症状,临床应加以重视,以免延误治疗。

目的观察中年糖尿病患者治疗前后屈光度的改变。方法对113眼糖尿病患者治疗前的屈光检查,通过内分泌科正规冶疗后再行屈光检查。结果经过半年的随访观察,大多数患者裸眼视力不及治疗前,治疗后二月内为远视状态,而治疗后三月远视度开始减退,近视度开始增加,治疗后半年基本回复原来近视状态。结论糖尿病屈光改变(糖尿病性屈光不正)与血糖波动有关,血糖高时,晶状体变凸,产生近视现象,反之血糖降低晶状体变扁平形成远视。

Objective To evaluate the curative effect of laser in situ keratomileusis (LASIK) for the correction of myopia and the importance for the military physical examination. Methods To compare,analyze and follow up the vision and diopter of 813 eyes before and after LASIK. Results At one year,no eyes lost more than one line of BCVA. No severe complications occurred. All the patients passed the military physical examina-tion. Conclusion LASIK is effective,safe and stable for the correction of mild,moderate and high myopia. It is an good choice for the myopic patients who want to pass the military physical examination.

中老年复视在临床上越来越引起重视,中老年人的眼外肌麻痹大多数与血管病联系紧密.现将我院自2001年以来门诊73例明确有血管病的复视患者的临床特征加以总结分析.

角膜被致病微生物感染后会出现炎症的典型表现:红、痛、视力下降、畏光、流泪、分泌物增多等.2007年5～7月我院收治的20例角膜炎患者临床表现特殊,不同于以往所见的各种类型,现报告如下.