目的 对比口服复方血栓通胶囊联合视网膜光凝与玻璃体腔注射雷珠单抗联合视网膜光凝和口服复方血栓通胶囊治疗视网膜分支静脉阻塞合并黄斑水肿的治疗效果.方法 回顾性分析确诊为视网膜分支静脉阻塞合并黄斑水肿的42例患者42眼,按不同治疗方案分为2组:试验组(21眼)为玻璃体腔注射雷珠单抗联合复方口服血栓通胶囊和视网膜光凝治疗组,对照组(21眼)为复方血栓通联合视网膜激光光凝治疗组.试验组先行雷珠单抗玻璃体腔注射,同时口服复方血栓通胶囊,3个月后行视网膜激光光凝;对照组行视网膜光凝和口服复方血栓通胶囊.观察治疗6个月2组患者的最佳矫正视力,黄斑中心凹视网膜厚度变化.结果 治疗6个月后2组最佳矫正视力均提高,试验组优于对照组;眼科光学相干断层扫描显示试验组黄斑中心凹厚度平均降低415.51μm(61.45％),对照组黄斑中心凹厚度平均降低120.51μm(27.40％),试验组优于对照组.结论 玻璃体腔注射雷珠单抗联合口服复方血栓通胶囊和视网膜光凝治疗视网膜分支静脉阻塞合并黄斑水肿安全有效.

AIM: To determine the factors associated with primary angle-closure(PAC)progression to glaucoma(PACG)after laser peripheral iridotomy(LPI)at baseline.METHODS: This was a prospective cohort study. Subjects were consecutively enrolled among the patients with PAC at the ophthalmology clinic of our Hospital between January 2017 and December 2017. Among these 86 eyes of 86 PAC patients who fulfilled the inclusion criteria, 65 eyes of 65 patients who fulfilled the inclusion criteria of 5 or more VFs and 2 years or more of follow-up were selected. The mean follow-up period was 2.65±0.27 years. According to the occurrence of visual field defects and corresponding glaucomatous optic nerve damage, the patients were divided into the progressive group and the non-progressive group, and the correlative factors of PAC progression after LPI were analyzed in PAC patients.RESULTS: PAC progression after LPI was observed in 9 of 65 eyes(14%). There were significant differences in age and inter-visit IOP fluctuations between the progressive group(68.67±7.03 years, 10.11±4.17mmHg)and the non-progressive group(61.95±8.03 years, 5.54±2.73mmHg)(P<0.05). The frequency of PAC progressing into PACG with VCDR≥0.6, PAS≥1 quadrants, all angle-closure>2 quadrants was significantly higher in the progressing eyes than in the non- progressing eyes(P<0.05). PAC progression was significantly positively correlated with age, inter-visit IOP fluctuations, VCDR≥0.6, PAS≥1 quadrants, and all angle-closure >2 quadrants(rs=0.304, 0.396, 0.495, 0.268, 0.309).CONCLUSION:PAC patients after LPI with PAS≥1 quadrants and all angle-closure >2 quadrants, VCDR≥0.6, older age,higher inter-visit IOP fluctuations were more likely to progress to glaucoma.

目的:分析IKAP模式对玻璃体视网膜手术患者高眼压的预防及生活质量的影响.方法:选取2015年7月—2016年9月在我院进行玻璃体视网膜手术的患者70例作为研究对象,将所有患者采用随机数字表法分为两组,各35例.对照组采用常规护理,观察组采用IKAP模式护理,对比两组术后高眼压发生率、护理前后心理状态及生活质量评分、并发症发生率.结果:对照组术后高眼压发生率及并发症发生率均明显高于观察组,差异有统计学意义(P<0.05).护理前,两组患者心理状态及生活质量评分比较,差异无统计学意义(P>0.05);护理后,对照组SAS及SDS评分均高于观察组,生活质量评分低于观察组,差异有统计学意义(P<0.05).结论:IKAP模式对玻璃体视网膜手术患者高眼压的预防具有较好的作用,可有效降低高眼压的发生率,同时提高患者术后生活质量,减少不良情绪的发生,在临床应用中值得推广.

目的观察上直肌分流埋藏术治疗视网膜色素变性的手术治疗效果。方法对49例89眼行上直肌肌束中间分别游离出的直肌束,距附着点8mm处直肌两侧巩膜上做巩膜板层(接近棕黑层)分离呈口袋状(长约3mm),把游离的直肌束埋藏并缝合固定于巩膜口袋内。结果术后1个月视力均有不同程度的提高。术后3个月视野检查,视野较前增大一个象限者37眼,增大两个象限者16眼。结论采用上直肌分流埋藏术对视网膜色素变性有不同程度的改善。

· AIM: To explore the effective treatment of the new-vascular glaucoma. · METHODS: Forty-six patients (46 eye) of new-vascular glaucoma were treated by creating leak at the plane part combined trabeculectomy with intraoperative application of mitomycin C. The follow-up period was ranged from 6 to 12 months. · RESULTS: The intraocular pressure was controlled during 12-21mmHg in 41 eyes. With antiglaucoma medications, intraocular pressure could be controlled during 12-24mmHg in 2 eyes. Two eyes were performed second operation for recurrence, and obtained better effect. One eye occurred atrophy of the eyeball. The success rate was 89.1%. · CONCLUSION: The creating leak at the plane part combined trabeculectomy with intraoperative application of mitomycin C is an effective method to treat the new-vascular glaucoma. ·