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A simple, safe bimanual technique for subincisional cortex aspiration. 一种简单、安全的切口下皮质抽吸的双手技术。
Pub Date : 2002-07-01 DOI: 10.3928/1542-8877-20020701-18
T. Sakamoto, K. Shiraki, Kohji Inoue, N. Yanagihara, S. Ataka, Kaori Kurita
We developed a bimanual manipulation technique to facilitate the removal of the subincisional lens cortex in small-incision phacoemulsification cataract surgery. A separate aspiration handpiece, not connected to an aspiration tube, is passed into the anterior chamber through a side-port corneal incision. Under irrigation with a standard infusion/aspiration (I/A) handpiece through a tunnel incision, the cortex is stripped off with the separate handpiece and removed with the I/A handpiece. In 227 eyes, subincisional cortex removal and subsequent capsule polishing was performed safely with the separate handpiece. Rupture of the posterior lens capsule occurred in 3 high-risk eyes.
在小切口白内障超声乳化手术中,我们发展了一种双手操作技术,以方便切除切口下晶状体皮层。一个独立的抽吸机头,不连接抽吸管,通过侧口角膜切口进入前房。在标准输注/抽吸(I/ a)机头通过隧道切口冲洗下,用单独的机头剥离皮层,并用I/ a机头切除。在227只眼睛中,我们使用单独的手机具安全地进行了切口下皮层切除和随后的囊抛光。3例高危眼发生晶状体后囊破裂。
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引用次数: 6
Subconjunctival dislocation of an anterior chamber intraocular lens. 前房人工晶状体结膜下脱位。
Pub Date : 2002-07-01 DOI: 10.3928/1542-8877-20020701-12
Atul Kumar, S. Nainiwal, T. Dada, M. Ray
Post-traumatic dislocation of an intraocular lens (IOL) is a serious complication, especially after a blunt trauma because the posterior chamber lenses can potentially dislocate subconjunctively. We report a case of subconjunctival dislocation of a Kelman multiflex AC IOL. Such cases require immediate wound repair with IOL explantation to prevent endophthalmitis.
外伤后人工晶状体脱位是一种严重的并发症,特别是在钝性外伤后,因为后房型晶状体可能会在结膜下脱位。我们报告一例Kelman多功能AC人工晶状体的结膜下脱位。这种情况需要立即修复伤口并植入人工晶状体以防止眼内炎。
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引用次数: 18
INTRAOCULAR LENSES IN CATARACT AND REFRACTIVE SURGERY 人工晶体在白内障和屈光手术中的应用
Pub Date : 2002-07-01 DOI: 10.3928/1542-8877-20020701-22
J. Weyne
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引用次数: 4
Simultaneous choroidal and brain metastasis as initial manifestations of lung cancer. 同时发生脉络膜和脑转移是肺癌的初始表现。
Pub Date : 2002-07-01 DOI: 10.3928/1542-8877-20020701-14
J. Shields, Noel Perez, C. Shields, S. Foxman, B. Foxman
A previously healthy 75-year-old woman developed blurred vision in her left eye and was found to have an amelanotic choroidal metastasis. Cranial magnetic resonance imaging disclosed 2 brain lesions compatible with metastasis. Subsequent evaluation revealed a primary cancer in the lung. Simultaneous metastasis to the choroid and the brain from an occult primary lung cancer is rare. This case underscores the need for a detailed systemic evaluation in a patient with an amelanotic choroidal mass in which a metastasis is a diagnostic consideration.
一名健康的75岁妇女在她的左眼视力模糊,并被发现有无色素脉络膜转移。颅脑磁共振成像发现2例脑病变伴转移。随后的检查显示为原发性肺癌。隐匿的原发性肺癌同时转移到脉络膜和脑部是罕见的。本病例强调了对无黑色素样脉络膜肿块患者进行详细系统评估的必要性,其中转移是诊断考虑因素。
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引用次数: 12
Usage and cost of laser trabeculoplasty in the United States. 激光小梁成形术在美国的使用和成本。
Pub Date : 2002-07-01 DOI: 10.3928/1542-8877-20020701-17
Chad D Albright, Stefanie G. Schuman, P. Netland
To determine annual usage and costs of laser trabeculoplasty (LTP) in the United States, we reviewed data from the Health Care Financing Administration from 1986 to 2000, using the Part B Extract and Summary System (BESS). The annual number of LTP procedures performed increased to a peak number of 176,670 in 1992 and has declined since that time, with a 57% reduction in the number of procedures performed in 2000 (75,838) compared with the peak number. The total allowed charges declined from a peak of $137,127,436 in 1991 to $27,622,073 in 2000 (80% reduction). The average allowed charge per procedure was highest in 1989 ($893), and by 2000 the average charge ($359) was reduced by 60% compared with the peak charge. The total number of LTP procedures performed in Medicare beneficiaries has decreased in recent years compared with the peak number in 1992. In recent years, there also has been a marked reduction in the total allowed charges and the average charge per procedure for LTP.
为了确定美国激光小梁成形术(LTP)的年使用量和成本,我们使用B部分提取和汇总系统(BESS)回顾了1986年至2000年卫生保健融资管理局的数据。每年LTP手术的数量在1992年达到176670例的峰值,此后有所下降,2000年的手术数量与峰值相比减少了57%(75838例)。许可收费总额由1991年的137,127,436元的峰值下降至2000年的27,622,073元(减少80%)。每宗手术的平均收费在1989年达到最高(893元),到2000年,平均收费(359元)较高峰收费减少了60%。与1992年的高峰相比,近年来在医疗保险受益人中进行的LTP手术总数有所下降。近年来,LTP的总允许收费和每个程序的平均收费也有明显的减少。
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引用次数: 14
Capillary hemangioma of the retina. 视网膜毛细血管瘤。
Pub Date : 2002-07-01 DOI: 10.3928/1542-8877-20020701-21
S. Mitra, A. Ganesh
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引用次数: 2
Management of pseudophakic retinal detachment with undetectable retinal breaks. 假晶状体视网膜脱离伴视网膜破裂的治疗。
Pub Date : 2002-07-01 DOI: 10.3928/1542-8877-20020701-11
Wen-Chuan Wu, Ming-Tsong Chen, S. Hsu, Chi-Wu Chang
BACKGROUND AND OBJECTIVEDifficulties encountered during the repair of pseudophakic retinal detachment are related to difficulties in peripheral retinal visualization and identification of retinal breaks. The implication of nonvisualized breaks in patients with pseudophakic retinal detachment is associated with lower rates of surgical success. This report decribes the results of a prospective trial to evaluate the efficacy of both scleral buckling surgery in the treatment of pseudophakic retinal detachment with undetected retinal breaks and pars plana vitrectomy techniques in the management of the cases that redetected after primary buckling surgery.PATIENTS AND METHODSThis study represents 25 cases of pseudophakic retinal detachment with undiagnosed retinal breaks. In each case, we performed a scleral buckling that extended over the circumference of the retinal detachment. Pars plana vitrectomy with internal subretinal fluid drainage and long-term tamponade were performed on 7 patients with uncomplicated recurrent retinal detachments after primary buckling surgery. The mean duration of follow up was 32 months.RESULTSThere were 25 eyes (24.5%) of pseudophakic retinal detachment with undiagnosed retinal breaks represented in our pseudophakic retinal detachment cases. Anatomic success was achieved after the initial scleral buckling surgery in 18 eyes (72%). The overall success rate was 92%. The visual acuity was 20/40 or better in 8 patients (32%), 20/80 to 20/40 in 6 patients (24%), 5/200 to 20/80 in 7 patients (28%), and light perception to hand movement in 4 patients (16%). Complications included vitreous hemorrhage, macular pucker, cystoid macular edema, and hypotony with proliferative vitreoretinopathy.CONCLUSIONScleral buckling surgery in conjunction with cryotherapy is effective in the initial treatment of pseudophakic retinal detachment with undetectable retinal breaks. Pars plana vitrectomy with internal fluid-gas exchange and long-term tamponade can be used to treat these patients with recurrent retinal detachment after primary buckling surgery to get a higher overall success rate.
背景与目的在假晶状体视网膜脱离的修复过程中遇到的困难与周围视网膜的可视化和视网膜断裂的识别困难有关。假性视网膜脱离患者的非可视性断裂与较低的手术成功率相关。本报告描述了一项前瞻性试验的结果,该试验评估了巩膜屈曲手术治疗未发现视网膜断裂的假性视网膜脱离的疗效,以及在初次屈曲手术后再次发现视网膜断裂的病例中,玻璃体切割技术的治疗效果。患者和方法本研究报告了25例假性晶状体视网膜脱离伴未确诊的视网膜破裂。在每个病例中,我们都进行了巩膜屈曲,延伸到视网膜脱离的周围。本文对7例初次屈曲术后复发性视网膜脱离的患者行玻璃体切割合并视网膜下积液引流和长期填塞。平均随访时间32个月。结果假性晶状体视网膜脱离25眼(24.5%)有未确诊的视网膜破裂。18眼(72%)初次巩膜扣带手术解剖成功。总成功率为92%。视力20/40及以上者8例(32%),20/80 ~ 20/40者6例(24%),5/200 ~ 20/80者7例(28%),手部运动光觉者4例(16%)。并发症包括玻璃体出血、黄斑皱、囊样黄斑水肿和低眼压伴增生性玻璃体视网膜病变。结论巩膜扣带术联合冷冻疗法是治疗伴有视网膜破裂的假晶状体视网膜脱离的有效方法。玻璃体平面体切除联合内液气交换和长期填塞可用于治疗初次屈曲术后复发性视网膜脱离的患者,总体成功率较高。
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引用次数: 24
Local methotrexate and dexamethasone phosphate for the treatment of recurrent primary intraocular lymphoma. 局部甲氨蝶呤联合磷酸地塞米松治疗复发性原发性眼内淋巴瘤。
Pub Date : 2002-07-01 DOI: 10.3928/1542-8877-20020701-16
G. Velez, H. Boldt, S. Whitcup, R. Nussenblatt, M. Robinson
A 70-year-old patient with recurrent bilateral primary intraocular lymphoma (PIOL) was treated with local injections of methotrexate and periocular dexamethasone phosphate to both eyes over the course of 5 months. Local therapy consisted of a cycle to each eye of 3 intravitreal injections of methotrexate (200 microg in a total volume of 0.1 cc) administered on days 1, 5, and 8, followed by a subtenon injection of dexamethasone phosphate (7.5 mg in a total volume of 0.3 cc) on day 9. This treatment cycle was administered 4 times for the right eye and 3 times for the left eye, at 4 to 6 week intervals. Electroretinography was used to assess retinal function prior to and during each treatment regimen. Complete regression of the lymphomatous infiltrates and resolution of the vitritis was observed with preservation of visual acuity and no changes on electroretinography. The effect was sustained for 24 months after termination of treatment in the absence of systemic chemotherapy, radiation treatments, or maintenance intravitreal injections. Local combined chemotherapy can be used to treat recurrent PIOL, and can serve as successful palliative therapy in patients for whom further treatment with systemic chemotherapy or radiation is contraindicated.
一例70岁的复发性双侧原发性眼内淋巴瘤(PIOL)患者采用甲氨蝶呤和眼周磷酸地塞米松局部注射治疗5个月。局部治疗包括在第1天、第5天和第8天对每只眼睛进行3次甲氨蝶呤(200微克,总容积为0.1毫升)的玻璃体内注射,然后在第9天注射磷酸地塞米松(7.5毫克,总容积为0.3毫升)。治疗周期为右眼4次,左眼3次,间隔4 ~ 6周。在每个治疗方案之前和期间使用视网膜电图评估视网膜功能。观察到淋巴瘤浸润完全消退,玻璃体炎消退,视力保留,视网膜电图无变化。在没有全身化疗、放射治疗或维持玻璃体内注射的情况下,这种效果在治疗结束后持续了24个月。局部联合化疗可用于治疗复发性PIOL,并可作为成功的姑息治疗,为患者进一步接受全身化疗或放疗的禁忌。
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引用次数: 29
A clinical evaluation of an aspheric multifocal intraocular lens and its implications for the developing world. 非球面多焦人工晶状体的临床评价及其对发展中国家的意义。
Pub Date : 2002-07-01 DOI: 10.3928/1542-8877-20020701-08
S. Kaushik, Kamlesh
BACKGROUND AND OBJECTIVESTo evaluate the clinical performance of a new aspheric multifocal intraocular lens (IOL), and to compare the results with a corresponding monofocal IOL.PATIENTS AND METHODSTwo groups of 20 patients each were implanted with a multifocal and monofocal IOL and prospectively studied. Distance and near vision, contrast sensitivity, depth of focus, and quality of vision were assessed in both groups.RESULTSIn 85% of multifocal cases and 100% of monofocal cases, the corrected distance vision was 6/9 or better. With distance correction, 80% of multifocal cases had near vision of N9 or better against 10% of monofocal cases. The mean addition required for near vision N6 was +0.8 diopters (D) and +2.6 D in the multifocal and monofocal groups, respectively. Multifocal cases showed significantly decreased contrast sensitivity and increased depth of focus.CONCLUSIONSMultifocal IOLs are a good option for those with nonexacting visual requirements. The loss in contrast sensitivity seems to be an acceptable trade-off for satisfactory unaided near vision.
背景与目的评价新型非球面多焦点人工晶状体(IOL)的临床效果,并与相应的单焦点人工晶状体进行比较。患者与方法采用多焦点和单焦点人工晶体植入术,每组各20例,进行前瞻性研究。对两组患者的远近视力、对比敏感度、聚焦深度和视力质量进行评估。结果85%的多焦病例和100%的单焦病例矫正视力达到6/9及以上。经过距离矫正后,80%的多焦点病例的近视力达到N9级或更好,而10%的单焦点病例的近视力达到N9级或更好。在多焦点组和单焦点组中,近视力N6所需的平均增加值分别为+0.8屈光度(D)和+2.6 D。多焦病例的对比敏感度明显降低,焦深明显增加。结论多焦点人工晶状体是视力要求不严格的患者较好的选择。对比敏感度的下降似乎是获得满意的无辅助近视力的一个可接受的代价。
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引用次数: 13
Surgical treatment of hereditary lens subluxations. 遗传性晶状体半脱位的手术治疗
Pub Date : 2002-07-01 DOI: 10.3928/1542-8877-20020701-10
S. Ozdek, Ayça Sarı, K. Bilgihan, F. Akata, B. Hasanreisoǧlu
BACKGROUND AND OBJECTIVETo evaluate the effectiveness and results of pars plana vitreolensectomy approach with transscleral fixation of intraocular lens in hereditary lens subluxations.METHODSFifteen eyes of 9 consecutive patients with a mean age of 12.8+/-6.2 years (6-26 years) with hereditary lens subluxation were operated on and the results were evaluated in a prospective study. Surgery was considered if best spectacle corrected visual acuity (BSCVA) was less than 20/70. All eyes underwent a 2-port pars plana vitreolensectomy and transscleral fixation of an intraocular lens (IOL).RESULTSThe mean follow-up period was 12.6+/-7.5 months (6-22 months). There was no major intraoperative complication. Preoperatively, 8 eyes (53.3%) had a BSCVA of counting fingers (CF) and 7 eyes (46.6%) had a BSCVA of 20/200 to 20/70. Postoperatively, 14 eyes (93.3%) had a BSCVA of 20/50 or better. None of the patients had IOL decentration or intraocular pressure (IOP) increase during the follow-up period. There was a macular hole formation in 1 eye postoperatively.CONCLUSIONSThe early results of pars plana vitreolensectomy with IOL implantation using scleral fixation technique had shown that it not only promises a rapid visual rehabilitation but it is also a relatively safe method. More serious complications, however, may occur in the long term.
背景与目的评价经巩膜人工晶状体固定治疗遗传性晶状体半脱位的疗效。方法对9例平均年龄12.8+/-6.2岁(6-26岁)的遗传性晶状体半脱位患者15只眼进行手术治疗,并对手术结果进行前瞻性评价。如果最佳眼镜矫正视力(BSCVA)低于20/70,则考虑手术。所有的眼睛都接受了2孔玻璃体切除术和经巩膜固定人工晶状体(IOL)。结果平均随访时间为12.6±7.5个月(6 ~ 22个月)。术中无重大并发症。术前计数指BSCVA 8眼(53.3%),BSCVA 20/200 ~ 20/70 7眼(46.6%)。术后14只眼(93.3%)BSCVA在20/50以上。随访期间无一例人工晶状体脱位或眼压升高。术后1眼出现黄斑孔形成。结论采用巩膜固定技术行玻璃体睫状体切除联合人工晶状体植入术的早期结果表明,该方法不仅能快速恢复视力,而且是一种相对安全的方法。然而,长期来看,可能会出现更严重的并发症。
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引用次数: 16
期刊
Ophthalmic surgery and lasers
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