简介:目的观察初学者学习0.7毫米微创白内障手术改良法的临床效果。方法随机选取门诊和住院白内障患者50人,由初学者在老师指导下应用0.7毫米微创白内障手术改良法施行手术。研究内容包括手术时间,术中灌注液应用量,术中并发症等。结果手术时间随着学习的进程总体呈下降趋势,从开始10例平均时间61分22秒下降到第5个10例的18分54秒。特别是30例后下降明显。共7例9次并发症发生。第4例出现后囊破裂,未行玻璃体切割的情况下成功植入人工晶状体于睫状沟内。前10例中共有2例,第2和4个10例中各1例术中角膜上皮水肿。另外还有1例发生后弹力层撕裂,两例切口撕裂,1例结膜水肿。结论经过短期的0.7毫米微创白内障手术改良法训练,初学者可从传统同轴超声乳化安全转换至0.7毫米微创白内障手术。
简介:目的观察泪道探通后氟尿嘧啶应用联合鼻泪管中逆行植入球头硅胶管术治疗慢性泪囊炎的临床疗效。方法从门诊就诊的泪道阻塞患者中,选取泪点泪小管均通畅的慢性泪囊炎患者42例(56只眼),随机分为实验组与对照组,治疗组采用先泪道探通扩张,并将氟尿嘧啶溶液浸入阻塞创面,后经鼻腔逆行植入球头硅胶管术治疗,对手术疗效进行分析。对照组则不采用氟尿嘧啶干预措施,其余治疗与对照组相同。两组患者均于术后3个月拔管。结果拔管后随访3~12个月,治疗组21例(29只眼)中有效25只眼,泪道冲洗通畅无分泌物,2只眼冲洗欠通畅无分泌物,2眼泪道冲洗仍阻塞,治愈率86.2%。对照组21例(27只眼)中有效17只眼,泪道冲洗通畅无分泌物,4只眼冲洗欠通畅无分泌物,6眼泪道冲洗仍阻2塞,治愈率63.0%。经χ检验治疗组治愈率高于对照组(P〈0.05)。结论泪道探通联合球头硅胶管逆行植入术治疗慢性泪囊炎具有操作简便、不切皮肤、不损伤组织结构等优点,临床疗效肯定。氟尿嘧啶对于预防泪道阻塞部位创面再次粘连,提高远期疗效有确切作用。
简介:AIM:Toevaluatetheaccuracyofsphericalequivalent(SE)estimatesofadouble-passsystemandtocompareitwithretinoscopy,subjectiverefractionandatablemountedautorefractor.METHODS:Non-cycloplegicrefractionwasperformedon125eyesof65healthyadults(age23.5±3.0years)fromOctober2010toJanuary2011usingretinoscopy,subjectiverefraction,autorefraction(AutokeratorefractometerTOPCONKR-8100,Japan)andadoublepasssystem(OpticalQualityAnalysisSystem,OQAS,VisiometricsS.L.,Spain).Nineconsecutivemeasurementswiththedouble-passsystemwereperformedonasubgroupof22eyestoassessrepeatability.ToevaluatethetruenessoftheOQASinstrument,theSElaboratorybiasbetweenthedoublepasssystemandtheothertechniqueswascalculated.RESULTS:TheSEmeancoefficientofrepeatabilityobtainedwas0.22D.SignificantcorrelationscouldbeestablishedbetweentheOQASandtheSEobtainedwithretinoscopy(r=0.956,P<0.001),subjectiverefraction(r=0.955,P<0.001)andautorefraction(r=0.957,P<0.001).ThedifferencesinSEbetweenthedouble-passsystemandtheothertechniquesweresignificant(P<0.001),butlackedclinicalrelevanceexceptforretinoscopy;Retinoscopygavemorehyperopicvaluesthanthedouble-passsystem-0.51±0.50Daswellasthesubjectiverefraction-0.23±0.50D;Moremyopicvalueswereachievedbymeansofautorefraction0.24±0.49D.CONCLUSION:Thedouble-passsystemprovidesaccurateandreliableestimatesoftheSEthatcanbeusedforclinicalstudies.Thistechniquecandeterminethecorrectfocuspositiontoassesstheocularopticalquality.However,ithasarelativelysmallmeasuringrangeincomparisonwithautorefractors(-8.00to+5.00D),andrequirespriorinformationontherefractivestateofthepatient.