目的 探究抗青光眼滤过术联合术后药物治疗对老年青光眼患者功能性滤过泡形成率的影响.方法 抽选老年青光眼患者120例为研究对象,获得医院伦理会批准.其中左眼78例,右眼42例,据随机数字法分成两组,每组60例.对照组单行小梁切除术治疗,研究组在小梁切除术后联合氟尿嘧啶治疗,比较两组治疗总有效率、术后并发症总发生率、功能性滤过泡形成率及术前术后两组眼压变化.结果 研究组临床总有效率(96.67％)显著高于对照组(85.00％),差异有统计学意义(P<0.05);功能性滤过泡形成率(86.67％)明显高于对照组(68.33％),差异有统计学意义(P<0.05);两组术后并发症发生率相当,差异无统计学意义(P>0.05).治疗后,两组眼压均下降,研究组显著低于对照组,差异有统计学意义(P<0.05).结论 抗青光眼滤过术后联合氟尿嘧啶治疗可有效提升青光眼患者的临床疗效,降低滤过泡瘢痕化的产生,促进功能性滤过泡形成,降低眼压,从而有效提高手术成功率,且并未明显增加并发症,疗效显著,安全性高.

目的 分析妥布霉素地塞米松滴眼液(典必殊)联合普拉洛芬眼液对中老年白内障术后炎症因子水平的影响.方法 选取1300例中老年白内障患者为研究对象,按电脑随机法分为观察组和对照组,各650例.对照组给予典必殊治疗,观察组在其基础上加用普拉洛芬眼液治疗,对比两组效果及对炎症因子的影响.结果 两组治疗前眼部症状和体征评分比较差异无统计学意义(P>0.05),两组治疗后1 d、3 w和5 w眼部症状和体征评分均较治疗前明显降低(均P<0.05),观察组治疗后各时间段眼部症状和体征评分均明显低于对照组(均P<0.05);两组治疗前眼压比较差异无统计学意义(P>0.05),治疗后1 d、3 w和5 w两组眼压均有所下降且观察组治疗后各时间段眼压水平均明显低于对照组(P<0.05);治疗前两组C反应蛋白(CRP)、白细胞介素(IL)-6和肿瘤坏死因子(TNF)-α水平比较差异无统计学意义(P>0.05),两组治疗后各炎症指标水平均有所降低且观察组各指标水平均明显低于对照组(P<0.05);观察组不良反应发生概率明显低于对照组(P<0.05).结论 中老年白内障患者给予典必殊联合普拉洛芬眼液治疗,可改善患者症状,降低眼压,消除炎症反应,降低不良反应发生概率.

Objective:To study the effect oftriamcinolone acetonide on the tumor necrosis factor (TNF)-α,interleukin (IL)-1β and IL-6 levels in the aqueous fluid of patients after age-related cataract surgery.Methods:92 patients with age-related cataract who were treated from June 2014 to June 2016 in our hospital were selected and divided into the observation group (n=46) and the control group (n=46) according to the random number table.All the patients underwent phacoemulsification combined with intraocular lens implantation.The observation group was injected with triamcinolone acetonide in the anterior chamber after IOL implantation,the control group was injected with compound balanced salt solution,at 24h postoperation,pranoprofen Eye Drops was used,continuous medication was treated for 1 months.The changes of intraocular pressure,corneal endothelial cell count,uncorrected visual acuity,best corrected visual acuity,ocular signs and inflammatory factors were compared between the two groups before and at 7 days after operation,the anterior chamber reaction at 1 day and 7 days postoperation and the incidence of adverse reactions were compared between two groups.Results:There was no significant change in the intraocular pressure and corneal endothelial cell count before and after operation between the two groups (P ＞0.05);after operation,the uncorrected visual acuity,best corrected visual acuity and ocular signs score of both groups were significantly improved(P＜0.05),the uncorrected visual acuity,the best corrected visual acuity and the integral of ocular signs of observation group were significantly better than those of the control group (P＜0.05);compared with preoperation,the TNF-α,IL-1β and IL-6 levels in the aqueous fluid were significantly decreased (P ＜0.05),the levels of TNF-α,IL-1β and IL-6 in the aqueous fluid of observation group were significantly lower than those of the control group (P ＜0.05);the anterior chamber reaction of observation group at 1 day and 7 days after the operation were higher than those of the control group at 1 grade the 3 and the 4 grade of the anterior chamber reaction were lower than those of the control group (P ＜ 0.05);the incidence of adverse reactions in the observation group was significantly lower than that of the control group(P＜0.05).Conclusion:Triamcinolone acetonide anterior chamber injection is effective for age-related cataract patients after surgery,which can effectively alleviate the postoperative anterior uveitis,reduce the complications and promote the postoperative visual recovery,which may be related to the inhibition of the expressions of TNF-α,IL-1βand IL-6 in the aqueous fluid.

Objective: To esitimate the security and effectiveness of posterior chamber(phakic) intraocular lens(ICL) implantation for the correction of high myopia.Methods: This study included twinty-five eyes of eighteen patients received ICL implantation from March 2010 to July 2012.The range of preoperative myopia was-14.75.0 D to-20.25 D,mean-17.52 ± 1.73 D.All of the patients had been followed up for 3 to 24months.The examinations included uncorrected visual acuity(UCVA),best corrected visual acuity(BCVA),slit lamp examination,intraocular pressure,endothelial cell morphometry,etc.Results: All of 25 eyes were implanted ICL successfully.After operation,the uncorrected visual acuity(UCVA) of every eye was the same or even better than preoperative best-corrective visual acuity(BCVA).The spherical equivalent(SE),uncorrected visual acuity(UCVA),corneal endothelium counting before and three months after the operation had significant difference(SE: t =-59.21,P = 0.00;UCVA: t =-12.41,P = 0.00;corneal endothelium counting: t = 11.86,P = 0.00).No siginificant differences were found between the best-corrective visual acuity preoperation and the uncorrected visual acuity three months after the operation(UCVA: t = 0.84,P = 0.41).There was no siginificant differences in intraocular pressure before and three months after the operation(t = 0.99,P = 0.33).Dazzling sensation occurred in 2 cases(2 eyes).No cataract occurred during the follow-up duration.Conclusions: Short-term observation shows that ICL implantation on the basis of preserving the natural lens appears to be an effective and safe method for high myopic.