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Efficacy of extraocular muscle adjustment suture operation under microscope in the treatment of complex strabismus 显微镜下眼外肌调节缝合术治疗复杂斜视的疗效观察
Pub Date : 2020-02-25 DOI: 10.3760/CMA.J.ISSN.2095-1477.2020.02.010
Xiao-li Zhang, Lumin Zhang, Dan Liu
Objective To observe the efficacy of extraocular muscle adjustment suture operation under microscope in the treatment of complex strabismus. Methods A retrospective analysis. The clinical data of 191 patients with complex strabismus admitted to the Zhengzhou Second Hospital from Jan. 2015 to Dec. 2018 were analyzed. Under general anesthesia, all patients underwent strabismus correction with adjustable suture of extraocular muscles under microscope. Eighty-three patients underwent super-long recession. Ocular position and whether there was diplopia or whether diplopia disappeared were observed after recovery of general anesthesia or the next day. Suture was adjusted under local anesthesia or general anesthesia if necessary. The followed-up time was 6 months. Results After sugery all patients had good correction of ocular position, diplopia disappeared, and none of them had muscle slippage and other complication. Conclusion For complex strabismus, the strabismus correction with extraocular muscle adjustment suture operation under microscope can significantly increase the success rate of one-time operation and reduce the surgical response. Key words: Strabismus, complex; Surgery, adjustable suture, under microscope
目的观察显微镜下眼外肌调节缝合术治疗复杂斜视的疗效。方法回顾性分析。分析2015年1月至2018年12月郑州市第二医院收治的191例复杂斜视患者的临床资料。全麻下,显微镜下行眼外肌可调节缝合斜视矫正术。83名患者经历了超长衰退。全麻恢复后或第二天观察眼位、复视是否出现或复视消失。在局麻或全麻下调整缝线。随访时间6个月。结果所有患者术后眼位矫正良好,复视消失,无肌肉滑脱等并发症。结论显微镜下眼外肌调节缝合矫正斜视可显著提高一次性手术成功率,降低手术反应。关键词:斜视;复视;手术,可调节缝线,在显微镜下
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引用次数: 0
Comparison of efficacy between 577 nm micropulse laser and traditional laser retinal photocoagulation for the treatment of acute central serous chorioretinopathy 577 nm微脉冲激光与传统激光视网膜光凝治疗急性中枢性浆液性脉络膜视网膜病变的疗效比较
Pub Date : 2020-02-25 DOI: 10.3760/CMA.J.ISSN.2095-1477.2020.02.004
Jingjing Wan, Yue Chen
Objective To compare the clinical efficacy between 577 nm micropulse laser and traditional laser retinal photocoagulation for the treatment of acute central serous chorioretinopathy (CSC). Methods Prospective clinical randomized controlled study.Fifty-four eyes of 45 cases diagnosed as acute CSC from Jul.2017 to Jun.2018 in the First Affiliated Hospital of Zhengzhou University were included in this study.Patients were randomly divided into two groups.Group A, 29 eyes of 23 cases, received 577 nm laser photocoagulation, and group B, 25 eyes of 22 cases, received traditional laser photocoagulation.The efficacy of the two groups were observed in followed up time. Results BCVA of two groups were improved at 1 and 3 months after treatment, and the difference was statistically significant between before and after treatment (P 0.05). In the last follow-up, the fundus examination and OCT showed no laser spot or damage of retinal pigment epithelium in group A, while 13 eyes (52.00%, 13/25) in the laser pigmentation change or slight pigment epithelial hyperplasia could be seen, and 6 eyes (24.00%, 6/25) on OCT local retinal pigment epithelial change or defect could be seen in group B. Conclusion Both 577 nm micropulse laser and traditional laser photocoagulation are effective for acute CSC, which can improve BCVA, reduce CMT and SRF.But the damage of 577 nm micropulse laser is slight. Key words: Chorioretinopathy, serous, central; Photocoagulation, laser; Efficacy
目的比较577 nm微脉冲激光与传统激光视网膜光凝治疗急性中央浆液性脉络膜视网膜病变(CSC)的临床疗效。方法前瞻性临床随机对照研究。选取郑州大学第一附属医院2017年7月至2018年6月诊断为急性CSC的45例患者的54只眼作为研究对象。患者随机分为两组。A组29眼(23例)行577nm激光光凝,B组25眼(22例)行传统激光光凝。随访时间观察两组疗效。结果两组患者治疗后1、3个月BCVA均有改善,治疗前后比较,差异有统计学意义(P < 0.05)。在最后的随访,眼底检查和10月显示没有激光点或损伤的视网膜色素上皮组织,13眼(52.00%,13/25)在激光色素改变或轻微的色素上皮增生可以看到,和6眼(24.00%,6/25)10月当地视网膜色素上皮改变或缺陷可以看到在b组。结论577海里肪冲激光和传统的激光光凝术对急性CSC有效,它可以提高BCVA,降低CMT和SRF。而577nm微脉冲激光的损伤较小。关键词:脉络膜视网膜病变,浆液性,中枢性;激光光凝术;功效
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引用次数: 0
The clinical analysis of the ocular trauma caused by wood 木材致眼外伤的临床分析
Pub Date : 2020-02-25 DOI: 10.3760/CMA.J.ISSN.2095-1477.2020.02.005
S. Gu, Jian-wei Liu
Objective To analyze the clinical features and treatment of the ocular trauma caused by wood. Methods A total of 25 eyes of 25 cases with ocular trauma caused by wood from Aug. 2018 to Dec. 2018 in Affiliated Hospital of Weifang Medical University were retrospectively analyzed. Results There were 15 cases with closed ocular trauma, the complications included hyphema, lens injury and cyclodialysis cleft. There were 2 cases with 3 kinds of complications, 2 cases with 2 kinds of complications and 11 cases with only 1 kind of complication. All the 15 cases underwent lens surgery, and among them 4 cases received cilliary suture and 10 cases received vitrectomy combined with lens surgery. Among 10 cases with open ocular trauma, the range of injury in zone Ⅰ was 7 cases, 2 cases in zone Ⅱ and 1 case in zone Ⅲ. The 10 cases underwent one stage debridement and suturing, which combined with lens surgery in 4 cases, 2 cases with vitrectomy and 10 cases with vitrectomy and lens surgery. The difference was statistically significant between types of complications in group A and visual acuity impairment (P<0.05). The difference was statistically significant between locations of trauma and visual acuity impairment in group B (P<0.05). The difference in postoperative visual acuity was statistically significant between two groups. Conclusion With the increase of complications in closed ocular trauma, the visual impariment is obviously influenced. The range of injury is a significant factor affecting visual prognosis in open ocular trauma. The visual acuity of patient with injury in zoneⅠis better than that in zone Ⅱ and zoneⅢ. Open ocular trauma has a worse prognosis of visual acuity than that of closed ocular trauma. Key words: Trauma, ocular, wood; Severity, injury; Method, surgery
目的分析木材致眼外伤的临床特点及治疗方法。方法回顾性分析潍坊医科大学附属医院2018年8月至2018年12月收治的25例木质眼外伤患者的25只眼。结果闭合性眼外伤15例,并发症有前房积血、晶状体损伤、睫状体裂。3种并发症2例,2种并发症2例,1种并发症11例。15例均行晶状体手术,其中4例行睫状体缝合,10例行玻璃体切除联合晶状体手术。10例开放性眼外伤中,Ⅰ区损伤范围7例,Ⅱ区2例,Ⅲ区1例。10例患者行一期清创缝合术,其中4例合并晶状体手术,2例合并玻璃体手术,10例合并玻璃体手术。A组并发症类型与视力障碍的比较,差异有统计学意义(P<0.05)。B组外伤部位与视力损害的差异有统计学意义(P<0.05)。两组术后视力差异有统计学意义。结论闭合性眼外伤并发症的增加对视力损害有明显影响。损伤范围是影响开放性眼外伤视力预后的重要因素。Ⅰ区损伤患者的视力优于Ⅱ区和Ⅲ区。开放性眼外伤的视力预后较闭合性眼外伤差。关键词:外伤,眼,木材;严重损伤;方法,手术
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引用次数: 0
Management practices of ophthalmology clinic for COVID-19 新型冠状病毒肺炎眼科门诊管理实践
Pub Date : 2020-02-25 DOI: 10.3760/CMA.J.ISSN.2095-1477.2020.02.016
Ke Wang, Lijie Li, Yuying Wang
This paper briefly describes the management measures of ophthalmic out-patient department during the epidemic of COVID-19.The outpatient prevention and control managements should be carried out, including the aspects of appointment, pre-examination triage, zone management, treatment of emergency patients such as ocular trauma and health education. Meanwhile, the protection of medical staff should be strengthened, and the equipment should be strictly cleaned and disinfected.This article can provide new ideas and methods for ophthalmologists to avoid COVID-19 outbreak between doctors and patients and between patients during the epidemic of COVID-19. Key words: COVID-19; Trauma, ocular; Management, emergency, outpatient, ophthalmic
本文简要介绍新冠肺炎疫情期间眼科门诊的管理措施。开展门诊防控管理,包括预约就诊、预诊分诊、分区管理、眼外伤等急诊患者救治、健康教育等方面。同时,要加强对医护人员的防护,对设备进行严格的清洁消毒。本文可为眼科医生在新冠肺炎疫情期间避免医患之间和患者之间的疫情爆发提供新的思路和方法。关键词:COVID-19;创伤,眼部;管理、急诊、门诊、眼科
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引用次数: 0
Risk and protective analysis of ophthalmic diagnosis and treatment during the period of COVID-19 新型冠状病毒肺炎期间眼科诊疗风险及防护分析
Pub Date : 2020-02-25 DOI: 10.3760/CMA.J.ISSN.2095-1477.2020.02.013
Zhiqi Chen, C. Deng, K. Ma, Junming Wang
At present, ophthalmologists should try their best to treat the COVID-19, and should do well in the diagnosis and treatment of ocular diseases. In order to help to finish the work more efficiently and safely, this paper analyzed the risk of ophthalmological diagnosis and treatment during the period of COVID-19 and put forward protective suggestions for reference. Key words: COVID-19; Ophthalmology; Protection
目前,眼科医生应全力救治新冠肺炎,做好眼部疾病的诊治工作。为了帮助更高效、安全地完成工作,本文分析了2019冠状病毒病期间眼科诊疗的风险,并提出防护建议供参考。关键词:COVID-19;眼科;保护
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引用次数: 0
The effect of phacoemulsification on ocular surface of cataract with Meibomian gland dysfunction 超声乳化术对睑板腺功能障碍白内障眼表的影响
Pub Date : 2020-02-25 DOI: 10.3760/CMA.J.ISSN.2095-1477.2020.02.011
X. Tao, Jin Zhong, Linyong Chen
Objective To observe the effect of phacoemulsification on ocular surface function in cataract patients with Meibomian gland dysfunction (MGD). Methods A prospective cohort study. Total of 81 eyes of 78 cases of cataract with MGD in Wenrong Hospital of Jinhua from Mar.2016 to Feb.2018 were enrolled in this study.All patients underwent phacoemulsification and intraocular lens implantation.The ocular surface function was observed and all cases were followed up for 3 months. Results The Schirmer test (SIt) and break up time (BUT) at 3 days after operation were higher than those at 1 day before operation (P 0.05), and no significant difference between 3 days after operation and 3 months after operation (P>0.05), and the difference was significant between 1 day before operation and 3 months after operation (P<0.05). Conclusion After phacoemulsification, ocular dysfunction still occurs in patients with cataract and MGD.No significant recovery occurrs after 3 months of follow-up. Key words: Cataract; Disorder, function, Meibomian gland; Phacoemulsification; Function, ocular surface
目的观察超声乳化术对伴有睑板腺功能障碍(MGD)的白内障患者眼表功能的影响。方法前瞻性队列研究。选取金华市文荣医院2016年3月至2018年2月收治的78例白内障合并MGD患者的81只眼作为研究对象。所有患者均行超声乳化术和人工晶状体植入术。观察眼表功能,随访3个月。结果术后3 d的Schirmer试验(SIt)、破裂时间(BUT)均高于术前1 d (P<0.05),术后3 d与术后3个月差异无统计学意义(P<0.05),术后1 d与术后3个月差异有统计学意义(P<0.05)。结论白内障合并MGD患者行超声乳化术后仍存在眼功能障碍。随访3个月无明显恢复。关键词:白内障;紊乱,功能,睑板腺;超声乳化;功能、眼表
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引用次数: 0
Posterior sub-tenon’s injection of triamcinolone acetonide in the treatment of optic disc vasculitis 曲安奈德后关节下注射治疗视盘血管炎
Pub Date : 2020-02-25 DOI: 10.3760/CMA.J.ISSN.2095-1477.2020.02.008
Yi Liu, Decheng Liu
Objective To evaluate the efficacy of posterior sub-tenon’s injection of triamcinolone acetonide in the treatment of optic disc vasculitis. Methods The clinical data of 60 eyes of 60 patients with optic disc vasculitis from May 2016 to May 2019 in the Seventh People’s Hospital of Zhengzhou were retrospectively analyzed. Triamcinolone acetonide 40 mg/0.5 ml was injected into Tenon’s capsule with a self-made gauge 6 lacrimal irrigation needle, and compound Xueshuantong and energy mixture were infused intravenously, compound anisodine injection was injected subcutaneously beside superficial temporal artery, methylcobalamin, citicoline and compound vitamin B were taken orally. All patients were followed up for 6-18 months. Results All 60 cases were cured within 6 to 18 months after treatment. The visual acuity were improved and the shape of macular fovea were restored, macular edema were alleviated. Conclusion Posterior sub-tenon’s injection of triamcinolone acetonide in the treatment of optic disc vasculitis is safe, effective, simple and inexpensive. Key words: Vasculitis, optic disc; Triamcinolone acetonide, injection, sub-tenon’s posterior; Efficacy, clinical
目的探讨曲安奈德在视盘血管炎治疗中的应用价值。方法回顾性分析郑州市第七人民医院2016年5月至2019年5月收治的60例视盘血管炎患者60只眼的临床资料。用自制6号泪道冲洗针将曲安奈德40 mg/0.5 ml注射到Tenon胶囊中,静脉滴注复方血栓通、能量合剂,颞浅动脉旁皮下注射复方山莨菪碱注射液,口服甲钴胺素、胞胆碱、复方维生素B。所有患者随访6 ~ 18个月。结果60例患者均在治疗后6 ~ 18个月内痊愈。改善了视力,恢复了黄斑中央凹形状,减轻了黄斑水肿。结论后路静脉注射曲安奈德治疗视盘血管炎安全、有效、简便、经济。关键词:血管炎;视盘;曲安奈德,注射,关节后;功效、临床
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引用次数: 0
The efficacy among different dose of intravitreal conbercept injection for the treatment of retinopathy of prematurity 不同剂量玻璃体内注射孕酮治疗早产儿视网膜病变的疗效观察
Pub Date : 2020-02-25 DOI: 10.3760/CMA.J.ISSN.2095-1477.2020.02.006
Shuang Sun, Xiantao Sun, Yuebing Lu
Objective To evaluate the efficacy of intravitreal injection of different dose of conbercept for the treatment of retinopathy of prematurity (ROP). Methods Prospective randomized controlled study. The clinical data of 120 eyes of 60 children of prethreshold type 1 ROP diagnosed in Children’s Hospital Affiliated to Zhengzhou University from Oct. 2017 to Oct. 2018 were analyzed. All cases were randomly divided into two groups, including low-dose group (0.15 mg/0.015 ml) and high-dose group (0.25 mg/0.025 ml). The main outcome measure was the total success rate of treatment, and the secondary outcome measures were the success rate of single treatment and adverse reactions. Results The total success rate of treatment was 94.17% (113/120). In 52 eyes of 26 cases in the low-dose group, 49 eyes received one or more injections to control the disease, with a success rate of 94.23%. In 68 eyes of 34 children in the high-dose group, 64 eyes received one or more injections to control their condition, with a success rate of 94.12%. The difference was not statistically significant between the two groups (χ2=0.026, P=0.979). The success rate of single injection in low-dose group was 76.92% (40/52) and 61.76%(42/68) in the high-dose group. There is no statistically significant difference between the two groups (χ2=1.762, P=0.078). Conclusion The low-dose of conbercept is effective in the treatment of ROP, the care rate is the same as the high dose of that. Key words: Conbercept, injection, intravitreal, different doses; Retinopathy, premature; Success rate, treatment
目的探讨不同剂量的康贝莱玻璃体内注射治疗早产儿视网膜病变(ROP)的疗效。方法前瞻性随机对照研究。分析2017年10月至2018年10月郑州大学附属儿童医院诊断的阈前1型ROP患儿60例120眼的临床资料。所有病例随机分为低剂量组(0.15 mg/0.015 ml)和高剂量组(0.25 mg/0.025 ml)。主要观察指标为总治疗成功率,次要观察指标为单次治疗成功率和不良反应。结果总治疗成功率为94.17%(113/120)。低剂量组26例52眼,49眼接受一次或多次注射以控制病情,成功率为94.23%。高剂量组34例患儿68只眼,64只眼接受一次或多次注射以控制病情,成功率为94.12%。两组间差异无统计学意义(χ2=0.026, P=0.979)。低剂量组单次注射成功率为76.92%(40/52),高剂量组为61.76%(42/68)。两组间差异无统计学意义(χ2=1.762, P=0.078)。结论低剂量康宁治疗ROP疗效显著,其护理率与高剂量康宁相同。关键词:conberconcept;注射剂;玻璃体内;视网膜病变,过早;治疗成功率
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引用次数: 0
Observation on the early efficacy of trabeculectomy combined with incision of outer wall of Schlemm’s canal for the treatment of juvenile glaucoma 小梁切除术联合施莱姆管外壁切口治疗青光眼的早期疗效观察
Pub Date : 2020-01-25 DOI: 10.3760/CMA.J.ISSN.2095-1477.2020.01.003
Yuanyuan Zhang
Objective To observe the early efficacy of trabeculectomy combined with incision of outer wall of Schlemm’s canal in the treatment of juvenile glaucoma. Methods The clinical data of 34 eyes of 22 cases with juvenile glaucoma from Sep.2016 to Feb.2019 in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed.All patients underwent trabeculectomy combined with incision of outer wall of Schlemm’s canal.The followed-up times was 6 months. Results There was no significant difference in visual acuity (logMAR) between before and after operation (t=-0.544, P=0.590). The average IOP decreased at each time point postoperatively, and the difference was statistically significant between before and after operation (P<0.05). Functional filtration blebs were formed in 21 eyes (61.76%) postoperatively.The complete success was in 27 eyes (79.41%) at 6 months postoperatively, and the partial success was in 4 eyes (11.76%). The success rate was 91.17%(31/34). At 1 day postoperatively, the intraocular pressure was ≤21 mmHg in 34 eyes (1 mmHg=0.133 kPa). The intraocular pressure increased at 1 month postoperatively in 3 eyes.After treatment with ocular hypotensive drugs, IOP of them decreased to normal level.At 6 months postoperatively, the IOP increased in 7 eyes and decreased after treatment with ocular hypotensive drugs.There were 3 eyes with further visual field impairment and cup-to-disk ratio damage among 7 eyes.No serious complication during or after surgery occurred. Conclusion Trabeculectomy combined with incision of outer wall of Schlemm’s canal for the treatment of juvenile glaucoma can effectively control the IOP and protect visual function. Key words: Glaucoma, juvenile; Trabeculectomy; Incision, outer wall, Schlemm’s canal
目的观察小梁切除术联合施莱姆管外壁切口治疗青光眼的早期疗效。方法回顾性分析2016年9月至2019年2月郑州大学附属第一医院收治的22例青少年青光眼患者34只眼的临床资料。所有患者均行小梁切除术联合施勒姆管外壁切口。随访时间为6个月。结果手术前后两组患者的视力(logMAR)差异无统计学意义(t=-0.544, P=0.590)。术后各时间点平均IOP下降,术前与术后比较差异有统计学意义(P<0.05)。术后形成功能性滤过泡21眼(61.76%)。术后6个月完全成功27眼(79.41%),部分成功4眼(11.76%)。成功率为91.17%(31/34)。术后1 d, 34眼眼压≤21 mmHg (1 mmHg=0.133 kPa)。术后1个月有3眼眼压升高。经降眼压药物治疗后,眼压降至正常水平。术后6个月,7只眼的IOP升高,经降压药物治疗后IOP降低。7眼中有3眼视野进一步受损,杯盘比受损。术中及术后均无严重并发症发生。结论小梁切除术联合施莱姆管外壁切口治疗青光眼能有效控制眼压,保护视力。关键词:青光眼;青少年;小梁切除术;切口,外壁,施莱姆氏管
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引用次数: 0
The change of corneal microstructural of patients with ocular surface squamous neoplasia after treatment with topical interferon alfa-2b and 5-fluorouracil 外用干扰素α -2b和5-氟尿嘧啶治疗眼表鳞状瘤变患者角膜显微结构的变化
Pub Date : 2020-01-25 DOI: 10.3760/CMA.J.ISSN.2095-1477.2020.01.012
Yunjuan Su
Objective To observe the change of corneal microstructural of patients with ocular surface squamous neoplasia (OSSN) after treatment with topical interferon alfa-2b (IFNα-2b) and 5-fluorouracil(5-FU). Methods A retrospective case series study.Total of 16 eyes of 16 patients with OSSN were treated with topical IFNα-2b (1 million IU/mL) and 1% 5-FU four times a day.The inneoplastic lesion and the cornea under involved areas were observed with in vivo confocal microscopy (IVCM) before and after treatment. Results Main features of OSSN at 4 months after treatment showed reduction reflectivity of epithelial cells, loss of cellular pleomorphism and demarcation line between normal and neoplastic tissue. Basal cell layers containing bright dots were found to diminish or disappear gradually. Other change was the reappearance of distinctsubbasal nerves. A few dendritic cells appeared as bright cellular particles with small dendritic processes that transformed into large and highly reflective arborizing cells were found. Conclusion The reduced reflectivity and polymorphhism of epithelial cells, and the increasing density of limbal dendritic cells after topical IFNα-2b and 5-FU therapy are observed with IVCM. Key words: Neoplasia, squamous, ocular surface; Cell, dendritic; Microscopy, in vivo, confocal
目的观察外用干扰素α-2b (IFNα-2b)联合5-氟尿嘧啶(5-FU)治疗眼表鳞状瘤变(OSSN)患者角膜显微结构的变化。方法回顾性病例系列研究。16例OSSN患者共16只眼,局部应用IFNα-2b(100万IU/mL)和1% 5-FU,每日4次。采用体内共聚焦显微镜(IVCM)观察治疗前后肿瘤内病变及受累区域下角膜的变化。结果治疗后4个月,OSSN主要表现为上皮细胞反射率降低,细胞多形性丧失,正常组织与肿瘤组织的分界线消失。发现含有亮点的基底细胞层逐渐减少或消失。其他变化是明显的基底下神经的再现。少数树突状细胞呈明亮的细胞颗粒,具有小的树突状突起,转化为大的、高反射的树突状细胞。结论IVCM观察到外用IFNα-2b和5-FU治疗后角膜缘树突状细胞的密度增加,上皮细胞的反射率降低,多形性降低。关键词:肿瘤,鳞状,眼表;树突状细胞;显微术,活体,共聚焦
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引用次数: 0
期刊
中华眼外伤职业眼病杂志
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