简介:目的:观察单眼严重白内障合并外斜视患者术后临床效果。方法:回顾我院2010-03/2012-12单眼严重白内障合并外斜视行白内障摘除联合人工晶状体植入手术的患者资料45例。术前44例较差眼视力均〈0.05,1例2岁患儿无法配合视力检查。随诊观察术后6mo患者的最佳矫正视力、眼底、斜视度、双眼单视功能及复视情况。结果:先天性白内障患者2例中有1例患儿2岁,无法配合视力及复视检查,眼底正常;另1例患儿术后无同时知觉,无复视。5例不明原因中青年单眼白内障患者中,有3例患者术后视力〉0.6,眼底正常,术后眼位正,有双眼单视;2例患者术后视力为指数,眼底有异常,术后斜视度与术前无变化,无同时知觉,无复视。38例老年性白内障患者中,有31例患者术后有双眼单视;3例患者术后斜视度与术前无差异,无同时知觉,无复视;3例患者术后斜视度与术前无差异,有复视,6mo内复视均自行消除;1例患者外斜10o,术后出现复视,且6mo内无改善,可用12?矫正,建议戴镜治疗。结论:单眼严重视力障碍合并外斜视的成年患者多数术后可自行纠正眼位,获得一定的双眼单视功能。
简介:目的:通过临床的系统观察研究泪点发生炎症的原因及泪点炎发展转归的临床规律,以及设计实施相应的手术治疗等,显示把泪点炎作为独立疾病列出的必要性。方法:用裂隙灯观察泪点和眼表,并泪道冲洗、探通检查;用微距照相记录泪点典型病变,其中有24眼泪点切除组织进行病理学检查。结果:泪点炎病临床特征:几乎所有泪点炎患者都合并急、慢性结膜炎;多数为泪点单独发炎,少数与后续泪道炎性阻塞疾病合并存在。急性泪点炎少见,溢热泪,泪点局部红肿、痒痛,泪点壁贴合关闭泪点口,以抗炎药物治疗为主。慢性泪点炎多见,溢冷泪,主要有泪点壁软缩,泪点乳头平坦,泪点口向心性缩小;增殖膜覆盖泪点口;泪点壁肿胀、增生贴合关闭泪点口;增生的睑结膜包裹稀薄的积脓包埋泪点口,形成白色隆起的泪点外观四种类型。以手术治疗为主,效果良好。结论:本研究结果显示,泪点炎病多发而常见,有独特的发展转归临床规律,和单独的手术治疗方法,把泪点炎作为独立疾病单独列出,以减少泪道病诊治的疏漏和错误等非常必要。
简介:AIM:Tocharacterizetheclinicalfeatures,diagnosis,treatmentandprognosisofuveitisassociatedwithankylosingspondylitis(AS)inChinesepatients.·METHODS:TwohundredandthreepatientswithuveitisassociatedwithASfollowed-upintheThirdMilitaryMedicalUniversityDapingHospitalbetween2005and2010wereretrospectivelyevaluatedinthisstudy.Completeophthalmologicalexaminationswereevaluatedatbaselineandduringthefollow-upperiod.Thegender,age,follow-uptime,meanfrequencyofuveitisonset,andaccompanyingeyeexaminationfindings,history,demographicalparameterswerereviewed.Allthepatientspresentedcompleteclinicalandradiologic(sacroiliac,lumbar,dorsalandcervicalspine,knee,ankle,shoulder,hip,elbow)evaluation.HLA-B27typingwasalsosearched.·RESULTS:Therewere203patientsdiagnosedwithASassociateduveitis.AllshowedsacroiliacX-raychangesindicativeofAS.Therewere184maleand19femalepatients.Theaverageageofpatientswas35±12(range18-50).Meanfollow-upperiodwas2.4years(1-5years).Acuteanterioruveitiswasthemostcommontypeofuveitisinbothgenders.121eyespresentedunilateralinvolvement(55.2%),and92eyespresentedbilateralinvolvement(45.3%)withonsetalternately.22eyesoccurredhypopyon,16eyeswerefoundanteriorvitreouscells,7eyeswerenotedreactivemacularedemaorexudation,29eyespresentedposteriorsynechiaeofiris,and14eyespresentedcataract,9eyespresentedsecondaryglaucoma,2eyespresentedbendcornealdegenerationand1eyespresentedatrophyofeyeball.Atthefinalvisit,uveitiswaswellcontrolledinmostpatients.·CONCLUSION:ASassociatedwithuveitisinChinesepatientsmainlymanifestsasacuteanterioruveitis.AcombinationofcorticosteroidswithothermydriasisagentsiseffectiveformostASassociatedwithuveitispatients.Ingeneral,theprognosisisgoodinthesecases.
简介:目的:眶颧复合体骨折后眼球内陷的手术矫正方法及其疗效。方法:回顾性分析1999.01/2006—05我院眼科收治的45例眶颧复合体骨折合并眼球内陷患者行骨折复位和眼眶重建的手术资料和随访结果。其中早期手术11例,晚期手术34例。通过眉弓外侧切口、下睑切口、前庭沟切口和冠状切口联合人路,在建立良好咬合关系的基础上,恢复和加强眶颧复合体正常解剖结构,微型钛板坚强内固定,Medpor充填修复眶壁骨折矫正眼球内陷。45例患者术后随访12~30mo。结果:所选45例患者术后外观获得显著改善,眼球内陷矫正,复视得到改善。早期手术病例组骨折复位和功能恢复均优于晚期组。结论:眶颌颧复合体骨折手术可以恢复正常面中部外形、矫正眼球内陷和改善复视症状。早期手术更容易达到解剖复位,提高疗效。
简介:AIM:Toevaluatetheeffectsandsafetyofphacoemu-lsification(Phaco)orsmall-incisionextracapsularcataractsurgery(SICS)andintraocularlens(IOL)implantationforagedpatients.METHODS:Totally137agedpatients(149eyes)underwentcataractoperationinthecaseofstablesystemiccondition,thebloodpressurelessthan160/95mmHg,bloodglucoselessthan8mmol/L,andunderthehelpofelectrocardiogramsurveillancebyanesthesiologistsduringtheoperation.106agedpatients(114eyes)underwentPhacowhile31agedpatients(35eyes)underwentSICS.Thepostoperativevisualacuity,cornealendothelialcellloss,surgerytimeandmajorcomplicationswereobservedandanalyzedretrospectively.RESULTS:Thebest-correctedvisualacuity(BCVA)of≥0.6wasachievedin135eyes(92.6%)at1monthpostoperatively(χ2=259.730,P<0.001).Foragedpatients,bothPhacoandSICScouldsignificantlyimprovevisualacuitywithnosignificantdifference(χ2=4.535,P>0.05).Postoperativecornealendothelialcelllosswas18.6%,inPHACOgroup,theratewas18.5%;inSICSgroup,theratewas19.0%,thedifferenceofwhichwasnosignificant(χ2=0.102,P>0.05).Thesurgerytimewasdifferentintwogroups.Noseverecomplicationsoccurred.CONCLUSION:BothPhacoandSICScombinedwithIOLimplantationforagedpatientsareeffectiveandsafe.Beforesurgery,detailedphysicalexaminationshouldbeperformed.Whenthesystemicconditionisstable,cataractsurgeryforagedpatientsissafe.