简介：AIM:ToanalyzecasesofobstructionofthenasolacrimalductwhichcreatesafertileenvironmentforsecondarybacterialInfectionandcanresultindacryocystitis,whichisaconstantthreattocorneaandorbitalsofttissueandapotentialsourceofendophthalmitisfollowingintraocularsurgery.Themajorityofobstructionsofthelacrimalexcretoryoutflowsystemareacquiredonesoccurringinadulthoodandinvolvingthedistalpartsofthesystem.Acquiredobstructionmaybeprimary/idiopathicorsecondarytoawidevarietyofinfectious,inflammatory,traumatic,mechanical,toxicorneoplasticcausesmimickingidiopathicinflammation.Thesecasesaretreatedbydacryocystorhinostomy(DCR).METHODS:Thepresentstudywasconductedtodeterminethehistopathologic,immunohistochemicalandcurrentmicrobiologiccharacteristicsoflacrimalsacspecimensinpatientsundergoingexternaldacryocystorhinostomy.RESULTS:Non-specificlacrimalsacpathologywaspresentinall33casesand81.8%ofthecasesshowedmoderatechronicinflammationwithachronicinflammatoryscore(CIS)rangingbetween4and6,whereas12.12%showedsevereinflammatorychangeswithaCISof7.Milddegreeofinflammationwasseenin6.06%withaCISof3.Thetotalprevalenceofgrampositive,gram-negative,andculture-negativesampleswere59.4%,37.5%,and3%respectively.CONCLUSION:Non-specificchronicinflammationwithfibrosisisindeedthemostcommonlyreportedhistopathologicalfindinginlacrimalsacwallbiopsyspecimens.

简介：目的分析比较角膜地形图与散瞳检影两种方法所测得的散光及与近视度数的关系。方法采用角膜地形图对290只准备行LASIK手术的近视眼进行检查,同时采用散瞳检影法检查记录近视度数及散光并对两种方法所得数据进行比较分析。结果两种方法在散光轴向上无显著性差异(P＞0．5)；而在散光度数方面有非常显著差异(P＜0．01)。角膜地形图检查及检影法所测得的散光度数均与屈光度增高成正比。结论角膜地形图能快速而准确地提供角膜的屈光状态指标；全眼散光仍应以散瞳检影后患眼接受的度数和散光轴作为标准；散光度数均与屈光度增高成正比。

简介：AIM:Todescribethecharacteristicsofmodulationtransferfunction(MTF)ofanteriorcornealsurface,andobtainthethenormalreferencerangeofMTFatdifferentspatialfrequenciesandopticalzonesoftheanteriorcornealsurfaceinmyopes.·METHODS:Fourhundredeyesfrom200patientswereexaminedunderSIRIUScornealtopographysystem.PhoenisanalysissoftwarewasappliedtosimulatetheMTFcurvesofanteriorcornealsurfaceatverticalandhorizontalmeridiansatthe3,4,5,6,7mmopticalzonesofcornea.TheMTFvaluesatspatialfrequenciesof5,10,15,20,25,30,35,40,45,50,55and60cycles/degree(c/d)wereselected.·RESULTS:TheMTFcurveofanteriorcornealsurfacedecreasedrapidlyfromlowtointermediatefrequency(0-15cpd)atvariousopticalzonesofcornea,thevaluedecreasedto0slowlyathigherfrequency(>15cpd).Withtheincreaseoftheopticalzonesofcornea,MTFcurvedecreasedgradually.3)Intherangeof3mm-6mmopticalzonesofthecornea,theMTFvaluesmeasuredathorizontalmeridianweregreaterthanthecorrespondingvaluesathorizontalmeridianofeachspatialfrequency,thedifferencewasstatisticallysignificant(P<0.05).At7mmopticalzonesofcornea,theMTFvaluesmeasuredathorizontalmeridianwerelessthanthecorrespondingvaluesatverticalmeridianat10-60spatialfrequencies(cpd),andthedifferencewasstatisticallysignificantin25,30,35,40,45,50cpd(P<0.05).·CONCLUSION:MTFcanbeusedtodescribetheimagingqualityofopticalsystemsatanteriorcornealsurfaceobjectivelyindetail.

简介：目的评价小切口白内障囊外摘除联合人工晶体植入术对高度近视并发性白内障的临床疗效。方法对我院2006年4月～2010年5月期间实施小切口非超声乳化白内障囊外摘除术治疗的23例（28眼）高度近视（眼轴〉26mm）并发性白内障患者病案资料进行回顾性分析。结果所有患者均顺利完成手术,术中3眼晶状体后囊膜破裂,1眼术后发生视网膜脱离,术后3d最佳矫正视力达0.3以上者21眼（75%）,术后1个月最佳矫正视力达0.3以上者23眼（82%）。结论小切口白内障囊外摘除术治疗高度近视并发性白内障,术中及术后并发症少,术后视力恢复好,对手术设备要求不高,是基层医院治疗高度近视并发性白内障的理想术式。

简介：目的：分析玻璃体腔注射曲安奈德术后继发性青光眼的发生率和危险因素。方法：对连续收治的256例有玻璃体腔注射曲安奈德适应证的各类眼底病患者实施单次玻璃腔注射4mg/0.1mL曲安奈德手术,观察其术后眼压变化情况。主要适应证包括湿性年龄相关性黄斑变性,其它原因如糖尿病性视网膜病变、视网膜中央静脉阻塞、视网膜分支静脉阻塞,视网膜静脉周围炎等引起的黄斑水肿性疾病。结果：256例256眼经至少3mo的追踪观察随访中,56眼发生继发性青光眼,发病率为21.9%。结论：继发性青光眼与年龄、性别、血压、糖尿病、玻璃体腔注药术的不同适应证、术前是否行白内障手术、是否行光动力治疗、是否行玻璃体切除手术等因素没有相关性。注药前青光眼病史的存在和基础眼压高于19mmHg等情况为术后继发性青光眼的显著危险因素。

简介：AIM:Toassesstheeffectivenessofimmunosuppressantsintheprophylaxisofcornealallograftrejectionafterhigh-riskkeratoplastyandnormal-riskkeratoplasty.METHODS:WesearchedtheCochraneCentralRegisterofControlledTrials(CENTRAL),MEDLINE,EMBASE,CNKI,VIPandreferencelistsofarticles.Dateofmostrecentsearch:18June,2011.Allrandomisedcontrolledtrials(RCTs)assessingtheuseofimmunosupressantsinthepreventionofgraftrejection,irrespectiveofpublicationlanguage.Twoauthorsassessedtrialqualityandextracteddataindependently.Onlydichotomousoutcomes(cleargraftsurvival,ratioofimmunereactionsandsideeffects)wereavailableandwereexpressedasrelativerisk(RR)and95%confidenceintervals(CI).RESULTS:Sevenstudieswereincludedinthisreview.Inthecomparingofmycophenolatemofetil(MMF)withplacebo,theresultsshowedMMFcouldsignificantlyreduceimmunereactionscomparedwithplacebo(RR1.0895%Cl0.95to1.21),butnoeffectoncleargraftsurvival(RR1.1195%Cl0.90to1.35).Incleargraftsurvivalandimmunereactions,MMFandcyclosporineA(CsA)showedsimilareffect(RR1.1195%Cl0.90to1.35,andRR1.48,95%Cl0.56to3.93,respectively).Tacrolimus(FK506)andsteroidshowedsimilareffectsoncleargraftsurvivalandimmunereactions(RR0.32,95%CI0.02to6.21,andRR1.00,95%CI0.88to1.14,respectively).Nodrugrelativesideeffecthasbeenfound.CONCLUSION:MMFmayreduceimmunereactionsinbothnormal-riskandhigh-riskrejectionofpenetratingkeratoplasty.CsAandFK506showedsimilareffectsasMMF.However,duetothelackoflargeclinicaltrials,theevidenceremainweak,thequalityofevidenceswereratedasverylowtomoderate.Large,properlyrandomised,placebo-controlled,doublemaskedtrialsareneededtoevaluatetheeffectofimmunosuppressants.

简介：目的观察Ex-press青光眼引流器植入术治疗难治性青光眼患者的疗效及安全性。方法选取2015年月—520177月我院难治性青光眼患者74例（74眼）,依据治疗方案不同分组,各37例（37眼）。观察组行Ex-press青光眼引流器植入术,对照组行小梁切除术。统计对比两组手术成功率及并发症发生情况。结果观察组手术成功率.49%（32/较对8637）照组59.46%（22/37）高,且并发症发生率18.92%（7/37）较对照组40.54%（15/37）低,差异有统计学意义（P〈0.05）。结论Ex-press青光眼引流器植入术应用于难治性青光眼治疗中,可进一步提高治疗效果,且安全性较高。

简介：AIM:Toinvestigatetheaccuracyofintraocularpressure(IOP)asmeasuredbyaReichertOcularResponseAnalyzer(ORA),aswellastherelationshipbetweencentralcornealthickness(CCT)andIOPasmeasuredbyORA,Goldmannapplanationtonometry(GAT),anddynamiccontourtonometry(DCT).·METHODS:Atotalof158healthyindividuals(296eyes)werechosenrandomlyformeasurementofIOP.AfterCCTwasmeasuredusingA-ultrasound(A-US),IOPwasmeasuredbyORA,GAT,andDCTdevicesinarandomizedorder.TheIOPvaluesacquiredusingeachofthethreetonometrieswerecompared,andtherelationshipbetweenCCTandIOPvalueswereanalyzedseparately.TwoIOPvalues,Goldmann-correlatedIOPvalue(IOPg)andcorneal-compensatedintraocularpressure(IOPcc),weregotusingORA.ThreegroupsweredefinedaccordingtoCCT:1)thincornea(CCT<520μm);2)normal-thicknesscornea(CCT:520-580μm);and3)thickcornea(CCT>580μm)groups.·RESULTS:Innormalsubjects,IOPmeasurementswere14.95±2.99mmHgwithORA(IOPg),15.21±2.77mmHgwithORA(IOPcc),15.22±2.77mmHgwithGAT,and15.49±2.56mmHgwithDCT.Meandifferenceswere0.01±2.29mmHgbetweenIOPccandGAT(P>0.05)and0.28±2.20mmHgbetweenIOPccandDC(P>0.05).TherewasagreatercorrelationbetweenIOPccandDCT(r=0.946,P=0.000)thanthatbetweenIOPccandGAT(r=0.845,P=0.000).DCThadasignificantcorrelationwithGAT(r=0.854,P=0.000).GATwasmoderatelycorrelatedwithCCT(r=0.296,P<0.001),whileIOPccshowedaweakbutsignificantcorrelationwithCCT(r=0.155,P=0.007).TherewasastrongnegativecorrelationbetweenCCTandthedifferencebetweenIOPccandGAT(r=-0.803,P=0.000),withevery10increaseinCCTresultinginanincreaseinthisdifferenceof0.35mmHg.Thethickcorneagroup(CCT>580μm)showedtheleastsignificantcorrelationbetweenIOPccandGAT(r=0.859,P=0.000);whilethethincorneagroup(CCT<520μm)hadthemostsignificantcorrelationbetweenIOPccandGAT(r=0.926,P=0.000).ThecorrelateddifferencesbetweenIOPccan

简介：目的:通过测定糖尿病性白内障患者血清中糖代谢指标、胰岛素抵抗与房水和血清中炎症因子的水平,探讨其相关性。方法:随机选取我院2017-02/2018-01糖尿病性白内障患者69例(观察组)和白内障患者65例(对照组),检测两组患者血清中糖化血红蛋白(HbA1c)、空腹血糖(FPG)、空腹胰岛素(FINS)的水平,计算胰岛素抵抗指数(HOMA-IR);同时检测房水和血清中的胰岛素样生长因子-1(IGF-1)、白细胞介素-6(IL-6)含量,对HbA1c、HOMA-IR与房水和血清中IGF-1、IL-6含量进行相关性分析。结果:对照组血清中的FPG、HbA1c、HOMA-IR,以及房水和血清中IGF-1、IL-6含量显著低于观察组,差异有统计学意义(均P<0.05)。HbA1c与房水及血清中的IGF-1和IL-6均呈正相关(P<0.05)。HOMA-IR与房水及血清中的IGF-1和IL-6均呈正相关(P<0.05)。结论:糖尿病性白内障患者HbA1c、HOMA-IR与房水及血清中的IGF-1、IL-6含量具有相关性,通过对上述指标的测定可以辅助判断病情。

简介：目的：系统评价拉坦前列素（Latanoprost）滴眼液与噻吗心安（Timolol）滴眼液降眼压的有效性和安全性。方法：计算机检索PubMed，Medline，CNKI及中国生物医学文献数据库收录的，并辅以手工检索、因特网搜索的有关拉坦前列素与噻吗心安治疗原发性开角型青光眼和高眼压症的随机对照试验（RCT）。按照纳入和排除标准限定研究对象，通过Jadad评分量表进行文献质量评估后，针对眼压下降比例、药物不良反应2项内容，使用Cochrane协作网提供的RevMan5．0软件进行Meta分析。结果：共纳入9项RCT，合计555例患者。Meta分析结果显示：（1）拉坦前列素滴眼液与噻吗心安滴眼液降眼压效果，在2，6，12wk时差异均有统计学意义（P＜0．01），加权平均差（WMD）分别为：在2wk[WMD＝-0．76，95％CI（-1．32，-0．20）]，在6wk[WMD＝-1．15，95％CI（-1．68，0．63）]和12wk[WMD＝-1．01，95％CI（-1．42，-0．61）]。（2）随访结束时，结膜充血、异物感为拉坦前列素的两种较为常见的不良反应，但其发生率拉坦前列素组与噻吗心安组比较，结膜充血的发生率[OR＝2．25，95％CI（0．99，5．08）]，异物感的发生率[OR＝2．48，95％CI（1．02，6．03）]，显示二者差异均无统计学意义。结论：治疗原发性开角型青光眼和高眼压症，拉坦前列素降眼压效果在用药12wk内较噻吗心安好；两者在12wk内引起结膜充血、异物感、虹膜色素加深、视野损害等的不良反应方面，差异不明显。由于纳入研究的样本量偏小，且方法学质量中等，致使本系统评价结果论证强度不高，因此还需要开展更多的高质量的临床随机对照研究，以便更客观、准确、全面地评价其疗效和安全性。

简介：目的分析初发翼状胬肉术后患者应用于退翳明目汤治疗后的疗效。方法采用随机数字表法将我院例初103发翼状胬肉术后患者分组,对照组51例应用典必殊滴眼液治疗,观察组52例给予退翳明目汤治疗,对比两组患者治疗后临床疗效、泪膜稳定性及术后复发率。结果观察组水肿消退、角膜创面上皮修复时间及干眼症状计分均低于对照组,SchirmerBUT水平均高于对照组,复发率0%低于对照组13.89P〈0.05）-Ⅰ及%（。结论退翳明目汤能够有效提升初发翼状胬肉术后患者泪液分泌量,提升泪膜稳定性,消除干眼症状,促进创面上皮修复,降低复发率。