<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

目的探讨手术治疗伴有神经症状的胸腰椎转移瘤的效果。方法 11例胸腰椎转移瘤患者,6例患者行前路病灶清除,骨水泥或自体髂骨移植并前路内固定治疗4,例行后路椎板减压,后路椎弓根定内固定术,1例行前后路联合手术治疗,观察治疗效果。结果随防6～48个月。11例患者均得到随访,其中2例患者术后1 a内死亡9,例生存。术后患者疼痛较术前均缓解,其中4例患者疼痛消失,无一例患者出现术后疼痛加重。术后Frankel分级升高1～3级。结论手术能够重建脊椎的稳定性,缓解疼痛,维护或改善患者的神经功能,从而改善脊椎转移肿瘤患者的生存质量。故椎体转移瘤患者如条件许可应尽早手术。

Objective:To present a new grading system for evaluating the Magnetic Resonance Image(MRI)appearance of epidural fibrosis 3 months after microendoscopic discectomy(MED),and to evaluate its reliability as well as clinical practice.Method:Between March 2010 and August 2010,32 patients undergoing MED were enrolled for the research.MRI of the lumber spine were obtained following a standard protocol at three months postoperatively,without and with gadolinum intensifying.Three individuals evaluated the MRI independently.Epidural scar area and epidural fibrosis index were obtained.Intraclass correlation coefficient(ICC) statistic was used to estimate the reliability of the new grading system.Result:The epidural scar area in three groups showed no difference(P0.05).The estimated ICC value was 0.771 with 95% confidence interval of [0.715,0.819].There was no statistical significance with respect to epidural fibrosis index among three groups(P0.05).The ICC of epidural fibrosis index for the three groups was 0.788 with 95% confidence interval of [0.659,0.881] which showed excellent agreement.Conclusion:The new grading system is of high efficiency and excellent agreement to evalutate the degree of epidural fibrosis appeared in MRI after discectomy.

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。

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.·

目的探讨Moria-M2显微角膜板层刀在准分子激光原位角膜磨镶术(LASIK)中应用的并发症及预防。方法2126例(4226只眼)LASIK术中采用法国Moria-M2显微角膜板层刀制作角膜瓣。结果LASIK术中并发症有角膜瓣形成不全、角膜瓣完全游离、角膜瓣偏位、角膜瓣下基质床出现"岛屿现象"、发生走空刀、角膜瓣周边渗血、球结膜下出血、小角膜瓣。结论法国Moria-M2显微角膜板层刀安装方便,安全性、稳定性好,值得临床推广应用。

Objective To evaluate the effectiveness of the Optos-Panoramic200 scanning laser ophthalmoscope in preoperative eyeground examination before LASIK. Methods A research method was used to compare the results of the Optos-Panoramic200 scanning laser ophthalmoscope exam of LASIK patients with the results of the Goldman three-mirror contact lens examination for diagnosis. This study involved the examination of 1262eyes with myopia. Results The Optos-Panoramic200 scanning laser ophthalmoscope examination identified 45 pathological eyes with identifiable retinal abnormality, but 50 pathological eyes were identified with the Goldman three-mirror contact lens examination. The sensitivity of the Optos-Panoramic200 scanning laser ophthalmoscope for screening retinal disease reached 90%. Conclusion The Optos-Panoramic200 scanning laser ophthalmoscope as a nonmydriatic camera captures a wide-angle retinal field and is aconvenient, effective apparatus to examine the retinas of LASIK patients. However, it cannot completely replace the Goldman three-mirror contact lens exam.

<正> 准分子激光原位角膜磨镶术(laser in situ keratomileusis,LASIK)后球结膜下出血是 LASIK 的常见并发症,尤其长期配戴接触镜的受术者,发生率更高。为减少此并发症的发生,本文在 LASIK 手术前,应用能够明显收缩血管的那素达滴眼液,观察其降低球结膜下出血的效果,现报告如下。

目的探讨Moria-M2自动旋切式显微角膜板层刀在用激光辅助原位角膜磨镶术（LASIK）治疗近视中的安全性和操作特点。方法采用法国Moria-M2自动旋切式显微角膜板层刀为558例、1 104只眼行准分子LASIK患者制作角膜瓣。刀头选择110（130μm）或130（160μm）厚的固定板层刀头;根据中央角膜曲率选负压吸引环（中央角膜曲率K值小于42D选-1 环,42-43D选0环,43-45D选+1环,45-47D选+2环）;负压吸引环上的停止器档位选择7．5或8。结果作瓣过程中无卡刀、中途停顿及停停走走现象,角膜瓣边缘整齐,无锯齿样改变,角膜基质床光滑。术中并发症有“纽扣”瓣,发生率为 0．27％;游离瓣,发生率为0．09％;角膜瓣下基质床出现“岛屿现象”,即在基质床有不规则隆起,发生率为0．36％;走空刀发生率为0．09％;角膜瓣周边渗血发生率为0．45％;小角膜瓣发生率为0．09％。术中不良角膜瓣的发生率为0．815％。结论法国Moria-M2自动旋切式显微角膜板层刀安装方便,按角膜曲率选择负压吸引环及止刀器档位,制作角膜瓣效果好,无严重并发症,该刀安全性,稳定性好,值得临床推广应用。