Objective To evaluate the effect of releasable sutures on shallow anterior chamber, filtering bleb and long-term intraocular pressure (IOP). Methods We searched MEDLINE (1971 to 2007), OVID (1971 to 2007) and National Science and Technology Library (1971 to 2007). Randomized controlled trials (RCTs) of the effect of releasable sutures on trabeculectomy were collected. Study selection and assessment, data collection and analyses were undertaken and cross-checked by two reviewers. Meta-analyses were performed with The Cochrane Collaboration’s RevMan 4.2.10 software. Results Six RCTs involving 341 eyes were included. Significant differences were observed in the reduction of postoperative shallow anterior chamber (RD –0.23, 95%CI –0.31 to –0.14, Plt;0.000 01) and functional filtering blebs (RD –0.15, 95%CI –0.27 to –0.02, P=0.02). But, no differences were observed for the control of long-term IOP (SMD –0.13, 95%CI –0.37 to 0.10, P=0.27). Conclusion The evidence currently available showed that releasable sutures could reduce the incidence of shallow anterior chamber and has no beneficial effect in controlling long-term IOP. The current evidence is insufficient to define the efficacy of maintaining functional filtering blebs. Further large-scale, high-quality randomized controlled trials are needed.
摘要:目的:总结儿童眼球钝挫伤致前房积血的原因、临床表现以及最佳治疗方法。方法: 回顾分析四川大学华西医院2007年9月~2008年9月收治的眼球钝挫伤致前房积血23例的治疗:(1)半卧位休息;(2)双眼包扎或不包扎;(3)止血;(4)手术治疗。 结果: Ⅰ、Ⅱ级前房积血吸收快,出现继发性出血者常需要采取手术治疗,视功能恢复缓慢。结论: 早期积极恰当治疗,可减少继发性青光眼、角膜血染等并发症。Abstract: Objective: To summarize the reasons of children hyphema caused by blunt, clinical manifestations, as well as the best method of treatment. Methods: analysing the 23 cases history of eye hyphema from September 2007 to September 2008 in West China Hospital of Sichuan University caused by blunt. The treatments were: (1) semisupine rest; (2) eyes bandaged; (3) to use hemostatic medicine; (4) surgery. Results: Hyphema in Ⅰand Ⅱ class could be absorbed fastly.Secondary hemorrhage often need to be taken for surgical treatment, depending on the slow recovery of vision. Conclusion: Early appropriate and positive treatment can reduce secondary glaucoma, corneal complications such as blood.
A three-dimensional (3D) model of human anterior chamber is reconstructed to explore the effect of different corneal temperatures on the heat transfer in the chamber. Based on the optical coherence tomography imaging of the volunteers with normal anterior chamber, a 3D anterior chamber model was reconstructed by the method of UG parametric design. Numerical simulation of heat transfer and aqueous humor flow in the whole anterior chamber were analyzed by the finite volume methods at different corneal temperatures. The results showed that different corneal temperatures had obvious influence on the temperature distribution and the aqueous flow in the anterior chamber. The temperature distribution is linear and axial symmetrical around the pupillary axis. As the temperature difference increases, the symmetry becomes poorer. Aqueous floated along the warm side and sank along the cool side which forms a vortexing flow. Its velocity increased with the addition of temperature difference. Heat fluxes of cornea, lens andiris were mainly affected by the aqueous velocity. The higher the velocity, the bigger more absolute value of the above-mentioned heat fluxes became. It is practicable to perform the numerical simulation of anterior chamber by the optical coherence tomography imaging. The results are useful for studying the important effect of corneal temperature on the heat transfer and aqueous humor dynamics in the anterior chamber.
目的：观察前房冲洗术联合尿激酶治疗严重外伤性前房积血的临床疗效。方法：选择近3年来我科收治的严重外伤性前房积血患者57例(56眼)，随机分为Ａ组29例(29)眼)、Ｂ组28例(28眼)，Ａ组采用先前房注入尿激酶再行前房冲洗的方法，Ｂ组行单纯前房冲洗术。观察术中及术后并发症；术后视力、眼压情况。结果：Ａ组术中干净清除血凝块29眼(100％)，术中出血5眼(17.24％)，无虹膜损伤，术后第一天矫正视力≥0.5有24眼，眼压≥21 mm Hg者4眼(13.79％)；Ｂ组术中仍有少量血凝块4眼(14.29％)，术中出血4眼(14.29％)，虹膜损伤1眼(3.57％)，术后第一天矫正视力≥0.5有16眼，眼压≥21 mm Hg者8眼(28.57％)。Ｂ组术后仍有少量血凝块者加用药物治疗后吸收，两组病例中高眼压均加用药物控制正常，一周时视力无明显差异(P＞0.05)。结论：前房冲洗术前先使用尿激酶治疗严重外伤性前房积血是一种操作更安全，更有效的手术方法。
目的 通过比较白内障患者与正常人用两种方法测量的前房深度和眼轴长度值，观察IOL Master和接触式A型超声测量是否存在差别及其关联程度。 方法 选取2010年12月－2011年2月期间行白内障摘除加人工晶状体植入术的年龄相关性白内障患者及除屈光不正外没有其他眼部病变的志愿者共89例。分别用IOL Maste和A型超声测量54例（96只眼）白内障患者和35例（70只眼）正常者的前房深度（ACD）和眼轴长度（AL），应用配对t检验对每组两种方法测得的ACD及AL值进行比较，并应用Pearson相关分析比较两种方法的相关性。应用独立样本t检验比较白内障组和正常者组间两种方法测得的差值是否不同。 结果 白内障组A型超声和IOL Master测得的ACD值分别是（2.83 ± 0.34）、（3.05 ± 0.39） mm，AL值分别是（23.93 ± 2.46）、（24.27 ± 2.57） mm，差异均有统计学意义（P＜0.05）；正常者组A型超声和IOL Master测得的ACD值分别是（3.16 ± 0.36）、（3.43 ± 0.46） mm，AL值分别是（24.16 ± 1.61）、（24.49 ± 1.62） mm，差异均有统计学意义（P＜0.05）。两种测量方法的相关系数分别是rACD=0.823（P＜0.05）和rAL= 0.995（P＜0.05）。白内障组和正常者组两种方法测得的ACD差值分别是（0.23 ± 0.23）、（0.28 ± 0.30） mm；AL差值分别是（0.34 ± 0.27）、（0.33 ± 0.15） mm；两组间ACD和AL差值的比较，差异均无统计学意义（P=0.243，0.742）。 结论 不论是白内障组还是正常者组，用IOL Master测得的ACD及AL值均比A型超声测得的相应值高，但是两种方法测得的值高度相关。白内障组和正常者组用两种方法测得的差值相比无差别；在可测到ACD及AL值的情况下，两种测量方法的差值均不受晶状体密度的影响。