目的:观察评价和血明目片联合西药治疗视网膜挫伤的临床疗效.方法:选取148例(172眼)视网膜挫伤患者,随机分为对照组和治疗组,每组74例(86眼).对照组口服地塞米松、维生素C治疗,治疗组在对照组治疗的基础上口服和血明目片治疗.15d为1个疗程,根据病情可连续用药2～4个疗程.比较两组患者的临床疗效.结果:治疗后,两组患者视力均优于治疗前(P＜0.05),且治疗组视力明显优于对照组(P＜0.05);治疗组治疗15 d、1个月、两个月后总有效率明显优于对照组(P＜0.05).结论:和血明目片联合西药对视网膜挫伤恢复疗效显著,可明显缩短治疗时间,是一种有效的治疗方法.

Background Vitreous amyloidosis is an autosomal dominant hereditary disease,often leads to reduction of visual acuity and affects life quality of patients.Vitrectomy is the main treatment for vitreous amyloidosis,but the analysis of curative efficacy in China is rarely reported.Objective The study was to observe and analyze the efficacy of vitrectomy for vitreous amyloidosis.Methods The clinical data of 11 eyes from 6 patients with vitreous amyloidosis who received vitrectomy from March 2011 to February 2013 in Affiliated Hospital of Guizhou Medical University.The best corrected visual acuity (BCVA),intraocular pressure (IOP),manifestations under the slit lamp microscope,findings of ocular fundus and results of fundus fluorescence angiography (FFA) were observed after surgery.Pathological examination for vitreous samples was carried by Congo red staining.Results Before surgery,the visual acuity was counting fingers for 30 cm in 5 eyes and hand movement for 30 cm in 6 eyes,and the mean IOP was (13.09±2.12)mmHg (1 mmHg=0.133 kPa).Fixed white flocks in vitreous and white membrane on the posterior lens capsule were seen under the slit lamp microscope.The BCVA remained 1.0 in 7 eyes and 0.8 in 4 eyes 1 week,6 months and 2 years after vitrectomy,and the mean IOP was (13.32±2.07),(14.09±2.47),(12.32±1.87)mmHg at 1 week,6 months and 2 years after vitrectomy,respectively.FFA showed a little fluorescein leakage at peripheral retinal vessel in all eyes at 1 week after vitrectomy but the leakage disappeared at 6 months after vitrectomy.The white flocks increased at peripheral retina in 4 eyes at 2 years after vitrectomy,but the BCVA remained the same in the eyes.Pathological examination of vitreous specimens comfirmed the diagnosis of vitreous amyloidosis.Conclusions Vitrectomy is an effective method for the treatment of vitreous amyloidosis,which can effectively improve the visual acuity of patients.Postoperative recurrence of vitreous amyloidosis appear in parts of patients,but the BCVA is unaffected.

Objective To investigate the clinical effect of vitrectomy for Terson syndrome .Methods The clinical data of 18 patients ( 19 eyes ) with Terson syndrome undergoing vitrectomy was analyzed retrospectively .Re-sults The vitreous cavities of 19 eyes were all clear after operation , retina were flat ,and there was not complications related to operation, the visual acuity of 18 eyes(94.7%) improved and that of one eye(5.3%) decreased after op-eration;the improving rate of visual acuity was 100.0%(19 eyes) and retinal detachment was found in one patient (5.3%) 2 months after operation .Conclusion Vitrectomy was an effective method for Terson syndrome and with low complications .

<正>眼睑基底细胞癌是眼睑最常见的恶性肿瘤,占眼睑恶性上皮性肿瘤的80%～90%,好发于下睑及内、外眦部〔1〕,多见于50岁以上的老年人,男性多于女性。基底细胞癌是低度恶性肿瘤,早期诊断和及时治疗,可保存眼睑功能和视力,治疗以手术切除为主〔2〕。我院眼科于2009年10月接诊2例下睑基底细胞癌患者,行手术切除,术中冰冻切片确认肿瘤切除干净,予下睑I期成形,随诊至今未复发。

玻璃体淀粉样变性是一种罕见的眼病,为常染色体显性遗传病,临床表现为双眼玻璃体的进行性混浊,该病部分患者可合并青光眼.本文就在我院就诊一家系进行报告.

Objective To disucss and summarize the vitrectomy treatment techniques and outcome on retinal detachment with giant retinal tear. Methods Analyze retrospectively 11 cases(11 eyes)of retinal detchment with giant retinal tear 10 of which were treated by pars plana vitrectomy combined with scleral bucking and intraocular retinal photocoagulation.One case was without scleral bucking surgery.6 cases of which were treated by perfluorocarbon liquid(heavy water)-silicone oil replacement,silicone oil tamponade;5 cases of which were adopted gas-liquid exchange,silicone oil tamponade. Results All the patients got anatomic retinal reattachment.All retinas were showed reattached well in the followed investigations.Silicone oil had been removed in two of them.However,due to a new retinal break,one of them occured retinal detachment after oil removement and silicone oil tamponade was done again.Besides,there were two cases of secondary glaucoma occurred,two cases of complicated cataract occurred in which one of them had under gone the cataract surgery.No complications such as perfluorocarbon liquid(heavy water) intraocular residue or corneal degeneration occurred. Conclusion Vitrectomy treatment combined with scleral buckling,silicone oil tamponade and retinal laser photocoagulation can effectively cure the retinal detachment with giant retinal tear.

原发性闭角型青光眼在我国占青光眼病例的79.60%～86.13%,是我国青光眼的主要类型,致盲的主要原因之一,而手术治疗是各型青光眼的有效途径.在进行青光眼滤过手术治疗前,原则上先用药物尽量将患者的眼压控制在正常范围,但临床上有些患者在使用局部和全身多种药物治疗,眼压仍不能控制,为保护患者残余的视功能,常常要在高眼压下行滤过手术,然而高眼压下行小梁切除术很容易引起低眼压性浅前房、前房出血、恶性青光眼等并发症[1].

眼内炎通常是指细菌或真菌引起的玻璃体的感染性炎症,最常见的是外源性细菌性眼内炎,常发生在眼球穿孔伤,其次为内眼手术后[1].感染性眼内炎是眼外伤、内眼术后的最严重的、破坏性最大的并发症,病原菌进入眼内使眼内组织在短时间内造成严重的损害,引起视功能的严重丧失,甚至眼球萎缩,若延误诊断与治疗,还会发展到毁坏眼球,需作眼内容物摘除术,给患者造成终生残废的严重后果[2].随着玻璃体视网膜手术的进一步发展与完善,以及抗生素的发展和应用,眼内炎的治疗效果得到了明显的提高,大部分患者能保住眼球并能恢复一定的视功能.回顾我院2006年5月～2007年12月收治的的感染性眼内炎12例(12眼),经玻璃体切除联合硅油填充术后,取得良好的治疗效果,现报道如下.

节段状视网膜动脉周围炎临床少见,现将我科于2004年收治的1例节段状视网膜动脉周围炎并发视网膜脱离患者的临床与图像(图1～4)资料分析报告如下.

增殖性糖尿病患者在玻璃体切割术中由于其角膜上皮基底膜的异常,术中极易发生角膜水肿而影响手术操作.为此我们以50%高渗糖应用于角膜表面,于术中大为减少了这一病理改变的发生,同时也减轻了术后的晶体混浊过程.

小梁切除术是治疗青光眼较为成功的术式,但术中眼压波动大,影响手术操作,并可引发多种并发症.文献报告[1,2]在术中合并应用前房穿刺以调控眼压取得满意效果.现将我科2003年5月至2004年3月对29例(32眼)青光眼施行的小梁切除术患者作前房穿刺调压的效果报告如下.

外伤性眼内异物常伴有眼内多种组织的损伤及异物损害引起的多种并发症,传统的治疗方法常需行多次手术,尤其是眼后极部异物处理更感困难[1].自从采取玻璃体切割术后,使复杂的眼内异物伤及其继发病可在异物取出的同时一次性处理,疗效大为改观[2].我院自2003年3月至2004年1月,应用玻璃体切割术治疗眼内异物14例(14眼),取得较满意效果,报告如下.

In order to prevent the retinal detachment complication after LASIK operation in myopia with retinal degeneration,the preventive laser photocoagulation management was used before LASIK operation and the result were observated. 52 eyes(46 patients)with retinal degeneration in myopia were treated by preventive laser photocoagulation before LASIK operation.All myopia cases underwent LASIK who had been treatde by laser photocoagulation were followed up for 3-12 months.No retinal detachment were found.When retinal degeneration occurred on myopia,the preventive laser photocoagulation on retinal degeneration is effective to prevent the retinal detachment in myopia after LASIK.

原发性闭角型青光眼在我国占青光眼病例的79.60%～86.13%,是我国青光眼的主要类型,致盲的主要原因之一,而手术治疗是各种类型青光眼的有效途径.

视网膜中央静脉阻塞是眼科学常见的眼底血管疾病,是视力障碍的重要原因之一,各种药物治疗效果不能令人满意.我科1997年引进北京海达精密系统工程研究所研制生产的LI-A型电脑半导体激光内照射治疗仪,两年来对38例(41眼)中央静脉阻塞病人进行治疗,收到明显效果,报告如下.

我们从1995年至1998年对14例难治性青光眼施行小梁切除术中一并应用丝裂霉素C(Mitomycin C,MMC)取得了较好的疗效,现总结报告如下. 一般资料:我院1995年3月～1998年3月间收治新生血管性青光眼1例,继发性青光眼1例,青光眼滤过术失败12例,其中3例为多次滤过术失败者.