Abstract AIM: To evaluate the changes of choroid thickness in adolescence with different types of high myopia. METHODS: From January to November 2021, 134 eyes of 78 adolescents with myopia in Liaocheng Aier Eye Hospital were collected and analyzed. According to the Mean Spherical Equivalent(MSE) and Corneal Curvature(CC), subjects are divided into mild myopia or emmetical eye group (ME group), high myopia group (HM group), occult high myopia group(OHM group) and super high myopia group(SHM group). The macular foveal choroidal thickness(CT) of the four groups was analyzed by Using Zeiss frequecy domain optical coherence tomography (Cirrus HD OCT), acquire horizontal and vertical cross-sectional images of macular. The CT values were measured manually subfoveal choroidal thickness(SFCT) and 1mm,3mm from the fovea at 9 sites, including the superior, nasal, inferior, temporal. The same operator completed the measurement 3 times ,and took the average numerical value as the final reference data.RESULTS:. There were significant differences in choroid thickness at 1mm and 3mm in macular fovea (P < 0.05). Compared with the ME group, SFCT, 1mm and 3mm in the HM group, OHM group and SHM group were significantly thinner than those in ME group (P < 0.05). Compared with SHM, HM and OHM group were significant differences in CT (P < 0.05). There was no statistical significance in CT of each point in HM group and OHM group (P > 0.05). CONCLUSION: The CT of SHM is significantly lower than that of HM and OHM. Although OHM has a lower degree of myopia, the CT has become significantly thinner, and the degree of choroid thinning is almost the same as that of OHM.

目的 探讨青少年高度近视(HM)和超高度近视(SHM)患者视网膜微血管的变化.方法 收集2021年1月至2021年11月在聊城爱尔眼科医院就诊的37例(64眼)近视青少年患者进行分析.根据平均等效球镜度(MSE)和眼轴长度(AL),将受试者分为HM组(23例41眼,-9.0 D<MSE≤-6.0 D,25 mm≤AL≤27 mm)和SHM组(14例23眼,MSE≤-9.0 D,AL>27 mm).将黄斑中心凹6 mm范围内划分为以黄斑中心凹为中心的3个同心圆,直径为1 mm的黄斑中心凹、1～3 mm的内环区、3～6 mm的外环区,应用光学相干断层扫描血流成像(OCTA)对3个区域的浅层视网膜血管长度密度(SRVD)、浅层视网膜血管灌注密度(SBPD)和直径6 mm完整图像(整体黄斑区)的SRVD和SBPD及其内环区和外环区各个象限的患者SRVD和SBPD进行分析,并对两组患者视网膜厚度和黄斑中心凹无血管区(FAZ)面积进行分析.结果 SHM组患者整体黄斑区、黄斑中心凹、内环和外环的SRVD分别为(15.63±1.91)mm-1、(4.99±3.05)mm-1、(14.09±2.71)mm-1和(16.49±1.78)mm-1,HM组患者整体黄斑区、黄斑中心凹、内环和外环的SRVD分别为(16.94±1.30)mm-1、(7.46±2.96)mm-1、(16.18±2.12)mm-1和(17.52±1.15)mm-1,两组患者间的各区域SRVD比较差异均有统计学意义(均为P<0.05);SHM组患者整体黄斑区、黄斑中心凹、内环和外环SBPD分别为(37.33±4.87)％、(11.01±7.07)％、(32.60±6.69)％和(39.50±4.92)％,HM组患者整体黄斑区、黄斑中心凹、内环和外环SBPD别为(40.57±3.26)％、(15.95±6.68)％、(37.77±5.24)％和(42.33±2.89)％,两组患者间各区域SBPD比较差异均有统计学意义(均为P<0.05);两组患者间内环和外环各象限比较,除外环区鼻侧和下方SRVD和SBPD比较差异均无统计学意义(均为P>0.05)外,其余内环区和外环区各象限SRVD和SBPD比较差异均有统计学意义(均为P<0.05).SHM组和HM组患者各区域视网膜厚度和FAZ面积比较差异均无统计学意义(均为P>0.05).结论 SHM患者黄斑区视网膜SRVD和SBPD明显低于HM患者,而视网膜厚度和FAZ保持稳定.

目的:探讨飞秒激光制瓣LASIK治疗屈光不正的临床疗效.方法:选取我院2017年7月~2018年7月间我院收治的120例屈光不正患者作为研究对象,根据治疗方案不同分为研究组(n=60)以及对照组(n=60).对照组采取角膜刀制瓣LASIK治疗,研究组采取飞秒激光制瓣LASIK治疗,对比两组患者屈光以及总高阶像差水平.结果:经过治疗,研究组屈光以及总高阶像差水平均要低于对照组(P<0.05).结论:飞秒激光制瓣LASIK治疗屈光不正效果较优.

目的:探讨并分析双眼屈光不正性弱视患者单纯屈光矫正后的治疗效果.方法:本研究于某医院内部选取了2016年1月～2017年1月收治的46例双眼屈光不正性弱视患者作为研究对象,比较治疗后3个月和6个月的视力恢复情况.结果:治疗3个月后,治疗的有效率为80.43％,治疗6个月后,治疗的有效率为93.48％,后者显著优于前者(P<0.05);随访1年后,视力提高在2行以上的患者达到95.65％.结论:对双眼屈光不正性弱视患者,采用单纯屈光矫正具有较好的治疗效果,值得在临床中应用.

Objective To evaluate the efficacy of intravitreal vitreous injection in the treatment of primary retinal detachment (RRD).Methods A retrospective analysis was performed on 27 eyes with intraocular gas injection (RRD).All patients underwent anesthesia under the intraocular vitreous injection.After operation,the patients were asked to maintain the specific head position according to the location of the hole.The laser photocoagulation was used to close the retinal hole.Results Of 27 patients with preoperative BCVA 0.02～0.8 were followed up for 2 years,24 cases (88.89％) after the first injection achieved retinal reattachment.The left 3 cases were cured by other operation.Eight patients (rate:33.33％) had retinal detachment recurrence at 4 days to 4 months.IN recurrence patients,3 cases for the original hole did not closed,5 cases had new hole.BCVA in follow-up,21 patients (77.8％) had improved,3 cases (11.1％) unchanged,and 3 patients (11.11％) decreased.Conclusions For primary retinal detachment (RRD),intravitreal cavity injection gas is a simple and convenient method,and it can be used in the right patients.Postoperative retinal detachment recurrence rate is relatively high,but does not affect the re-operation.

目的:探讨白内障术后特殊致病菌导致眼内炎患者的易感因素及预防措施.方法:将诊治的两例白内障术后特殊致病菌眼内炎患者进行病例回顾分析,包括疾病发展、治疗过程等方面.结果:两例感染性眼内炎患者的致病菌分别为洛菲氏不动杆菌和真菌.结论:白内障术前应充分了解患者的全身情况,术后发生的感染性眼内炎,可能具有潜伏性,需要适当延长治疗周期.

目的:探讨开放囊袋-人工晶状体(IOL)单襻睫状沟固定术治疗先天性晶状体半脱位的安全性和有效性.方法:收集2011-03-01/2013-12-31影响视力的先天性晶状体半脱位患者10例13眼,做角巩膜缘隧道切口,环形撕囊后,使用虹膜拉钩,固定脱位晶状体,完成超声乳化手术.植入IOL,剪开晶状体脱位一侧囊袋,翻转前囊,上襻位于囊袋内,下襻单针经缝合固定于睫状沟.结果:所有患者最佳矫正视力均不同程度提高,IOL稳定,没有进展性偏位.结论:虹膜拉钩可以稳定脱位的晶状体,使超声乳化手术顺利完成.开放下方囊袋,IOL呈半游离状态,下襻睫状沟缝合固定可维持IOL的长期稳定,避免囊袋进行性偏移,造成IOL偏位.

目的：探讨视网膜下脓肿的临床特征,减少误诊误治。方法回顾性分析铜绿假单胞菌引发视网膜下脓肿1例的临床资料。结果本例因右眼视物模糊1个月,视物不见、眼痛1 d入院。40年前患肺结核,已治愈。查体：右侧瞳孔不规则散大,对光反射消失,虹膜后粘连,玻璃体灰黄色混浊。视力：右眼光感,左眼4．8；眼压：13 mmHg (右),15 mmHg(左)；眼眶CT示：玻璃体腔内可见一5 mm ×3 mm大小的高密度影。初步诊断：眼内炎(右),葡萄膜炎(右),老年性白内障(双)。急诊手术治疗,术后细菌培养及药敏试验结果回报：有铜绿假单胞菌生长,对氨基糖苷类和喹诺酮类药物敏感,确诊为视网膜下脓肿(右)予对症治疗。术后右眼眼压升高,先后行右眼激光虹膜切开术+前房穿刺放液和巩膜外切开排脓+妥布霉素视网膜下灌洗,但效果欠佳,右眼光感丧失。后患者要求摘除眼球,术后病理诊断为眼球炎性坏死组织侵及脉络膜。结论临床遇及视网膜下脓肿患者,应尽早行相关医技检查,争取早诊断、早治疗,以减轻眼部损伤。

Objective To investigate the efficient treatment of cornea flap folds and striae after laser in situ keratomileusis (LASIK).To review the management and results of cases with severe flap wrinkling or dislodgment after LASIK.Methods Eleven patients with cornea flap folds and striae after LASIK are described.To make retrospective analysis of etiology and treatment in 11 cases who had cornea flap folds and striae after LASIK.Surgical repositioning of the flap was performed in all cases.Under the operating microscope the flap was refloated and hydrated with sterile deionized water for 2 minutes without stretching or ironing the flap.A bandage contact lens was then applied for 24 hours.Flap status,refractive changes,and final uncorrected and best corrected visual acuities were used to evaluate the outcome of flap repositioning.Results Relocation flap and bandage contact lens were used in such cases.Scraping epithelial and hydrating the cornea flap with sterile deionized water were used under operation.Twenty-four hours after treatment with sterile deionized water and a bandage contact lens,the cornea was smooth and wrinkle free.All patients who received those treatments had regalned the best-uncorrected visual acuity.Cornea was clear and had no obvious folds and striae.The flap had perfect location and no epithelial cell ingrowth.Conclusion Flap dislodgment and wrinkling are serious postoperative complications of LASIK.Early recognition of these complications and prompt surgical management are crucial to achieve a successful surgical and visual outcome.Relocation flap、hydration the cornea flap with sterile deionized water and a bandage contact lens may be a safe and efficient choice in such cases.

回顾分析33例(39只眼)单纯行白内障超声乳化联合人工晶状体植入术治疗闭角型青光眼的临床资料.结果 术后眼压为(15.11±3.18) mmHg,明显低于术前眼压,前房明显加深,房角情况不同程度改善.术后矫正视力显著提高,并发症很少.认为单纯白内障超声乳化联合人工晶状体植入术是闭角型青光眼安全有效的治疗方法 .

脉络膜上腔出血是指内眼手术中或术后出现的不明原因脉络膜下出血,为内眼手术最严重的并发症之一,若诊治不当,可致患者视力完全丧失.我院收治2例脉络膜上腔出血,现报告如下.