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Yamane 式后房型人工晶状体植入术后眼内炎一例

Preoperative Routine Testings versus Selective Routine Testings in the Safty of Cataract Surgery: A Systematic Review

Objectives　To systematic review the safety of routine preoperative testings versus selectivepreoperative testings for cataract surgery. Methods　We searched the Cochrane Central Register of Controlled Trials-Central (which contains the Cochrane Eyes and Vision Group Trials Register) in the Cochrane Library (Issue 3, 2008), MEDLINE (1966 to Oct. 2008), EMBASE (1980 to Oct. 2008), CMB-disk (1979 to Oct. 2008). We also hand-searched related journals. All the search was restricted in English and Chinese. Methodological quality of randomized controlled trials (RCTs) was evaluated by simple evaluate method that recommended by the Cochrane Collaboration. Data extracted by two reviewers with designed extraction form. RevMan 5.0 software was used for data management and analysis. Obtained evidence the safety of routine preoperative testings versus selective preoperative testings.Result　Four RCTs involving 20 490 participants required cataract surgery were included by total retrieve and riddling. The result of metaanalysis showed that there was no significant difference between the two groups in the rates of intraoperative systemic events [RR=1.05, 95%CI (0.89, 1.24), P=0.59], postoperative systemic events [RR=0.97, 95%CI (0.80, 1.18), P=0.77], intraoperative ocular events [RR=0.99, 95%CI (0.74, 1.33), P=0.97] and postoperative ocular events [RR=1.11, 95%CI (0.76, 1.60), P=0.59]. Conclusion　To compare routine preoperative testings group with selective preoperative testings group, there was no significant difference in the rates of intraoperative systemic events, postoperative systemic events, intraoperative ocular events and postoperative ocular events. However the application of the results to the patients with incapacitating systemic diseases needs further study.

EXPERIMENTAL STUDY OF PREVENTIVE EFFECT ON FORMATION OF CATARACT IN DIABETIC RATS

We assayed the levels of free radical and scavenger in the blood and lens of streptozotocin-in-duced diabetic SD rats, and found that the levels of lipoperoxide(LPO),MDA were higher than that of normal SD rats, and the total superoxygen dismutase (T-SOD), Cu-Zn-SOD) were lower that that of normal rats ( P lt;0.01 ). Simultaneous injection of streptozotocin and large dose of SOD could no avoid the occurence of diabetes mllitus, but did improve the metabolism of free radical in blood and lens. Hence, we think that large dose of SOD might be effective in preventing to development of diabetic cataract which is related to deterioration of free radical metabolism. （Chin J Ocul Fundus Dis,1994,10:25-27）

多发性骨髓瘤患者白内障术后眼内炎一例

直观教学法在白内障术前宣传教育中的应用

目的为更好地开展白内障的术前宣传教育（宣教）、普及相关知识等提供一定的思路、方法和依据。 方法选取 2014 年 1 月—12 月行超声乳化吸除术+人工晶状体植入术的 123 例白内障患者，按入院时间的先后分为观察组（62 例）和对照组（61 例），分别采用直观教学法和零散宣教两种形式进行宣教，比较两种宣教形式对患者在手术相关知识的掌握、实际操作完成情况和术中配合程度的影响。 结果观察组患者掌握术前相关知识的成绩为良好的比例（58.07%）显著高于对照组（24.59%），掌握术前相关知识的得分 [（78.65±11.26）分] 明显高于对照组 [（70.33±12.06）分]，各项操作完成合格率（91.94%）高于对照组（78.69%），术中配合程度好的比例（90.30%）明显高于对照组（72.10%），手术时间 [（6.10±1.00）min] 短于对照组 [（6.74±1.11）min]，差异均有统计学意义（P<0.05）。 结论直观教学法有助于患者掌握手术相关知识，提高实际操作水平，并促进手术顺利进行，且该方法简单、易行、患者易于接受，适宜在临床推广应用。

硅橡胶免缝线角膜环和常规缝合金属角膜环在玻璃体切割联合白内障手术中的应用比较

牵牛花综合征伴先天性白内障一例

Role of Intraocular Lens Degree Measure before the Cataract Surgery in Tibetan Area

【摘要】 目的 探讨在藏区白内障术前人工晶体度数的测定的必要性。方法 回顾性分析2009年8月—12月在拉萨光明眼科康复诊疗院进行白内障手术的170例患者,其中85例术前行人工晶体度数的测定,85例未行晶体度数的测定,比较两组术后3 d的视力。结果 测定组:术后视力≥0.3为51例,占60％；0.1lt;视力lt;0.3为24例,占28.24%;视力lt;0.1为10例,占11.76％。未测定组:术后视力≥0.3为48例,占56.47％；0.1lt;视力lt;0.3为17例,占20%;视力lt;0.1为20例,占23.53％。两组术后3 d最佳视力的比较有统计学意义(P＜0.05)。结论 术前测定人工晶体度数有助于改善白内障患者术后视力,在藏区有必要行白内障术前人工晶体度数的测定。

Safety of intravitreal injection of triamcinolone acetonide combined with partial anterior vitrectomy for cataract with severe vitreous hemorrhage

ObjectiveTo observe the safety of intravitreal injection of triamcinolone acetonide (TA) combined with partial anterior pars plana vitrectomy (PPV) for cataract with severe vitreous hemorrhage.MethodsA retrospective case-control study. A total of 60 patients (60 eyes) with cataract and severe vitreous hemorrhage were included from June 2017 to June 2019 in Xi’an People’s Hospital (Xi’an Fourth Hospital). There were 32 males (32 eyes) and 28 females (28 eyes), with a mean age of 64.8 years. The eyes were randomly divided into intravitreal injection TA group (TA group) and non-TA injection group (control group), with 30 eyes in each group. Before phacoemulsification, 0.05-0.10 ml TA was injected into the vitreous cavity in the TA group and the vitreous besides the vitrectomy channel was removed. The eyes of the control group underwent conventional cataract phacoemulsification combined with PPV. The follow-up time after surgery was ≥6 months. The rate of success continuous circular capsulorhexis, posterior capsule rupture, and intraocular lens (IOL) implantation in the capsular bag were compared between the two groups. The statistical data were compared with χ2 test. ResultsFor all eyes in the TA group, after intravitreal injection of TA combined with partial anterior PPV, the white reflection of the fundus can clearly show the anterior and posterior capsule of the lens. Continuous circular capsulorhexis was completed, the posterior capsule was not broken, and the IOL was successfully implanted inside the capsular bag. Among the 30 eyes of the control group, 4 eyes did not complete continuous circular capsulorhexis. Radial tear occurred during capsulorhexis, and capsulorhexis was used to complete capsulorhexis. In 5 eyes with posterior capsule rupture, the posterior capsule occurred in 3 eyes during phacoemulsification, and injecting the lens cortex caused posterior capsule repture in 2 eyes; the IOL was implanted in the ciliary sulcus and the capsular bag in 4 and 1 eyes, respectively. Whether the consecutive capsulorhexis was successful (χ2=4.286), whether the posterior capsule was ruptured (χ2=5.455), whether the IOL was implanted in the capsular bag (χ2=4.286), the differences in the number of eyes between the two groups were statistically significant (P= 0.038, 0.020, 0.038). At the last follow-up, no special complications occurred.ConclusionsIntravitreal injection of TA combined with partial anterior PPV can improve the visibility of the anterior and posterior lens capsule and lens nucleus during phacoemulsification in patients with cataract and severe vitreous hemorrhage. The surgical success rate is high, the complications are few, and the safety is good.

Clinical characteristics and therapeutic effect of retinal detachment in aphakic and pseudophakic eyes in 805 patients

Objective　To observe the clinical characteristics and therapeutic effect of aphakic retinal detachment (ARD) eyes and pseudophakic retinal detachment (PPRD) eyes.Methods 　The clinical data of 805 patients,including 321 ARD and 484 PPRD eyes were retrospectively analyzed.The patientsprime;visiual acuity, refraction, intraocular pressure were examined, and the patients also underwent slit lamp microscopy and direct and (or) indirect ophthalmoscopy.The preoperative bestcorrected visual acuity (BCVA) was between light perception (LP) and 0.6.Mainly according to the PVR grade and retinal holes position to take the scleral buckling or vitrectomy combined with scleral buckling. The 805 eyes were divided into 1995-1999 group (243 eyes) and 20002007 group (562 eyes) according to operative time.The follow-up ranged from 3 to 25 months, with an average of 12.3 months.The success standard of surgery was set as anatomic retinal reattachment and the last follow-up time was considered as the judgment time.The surgical complications were recorded at each followup time points. The composition of PPRD,the visual acuity,ocular lesions, surgical methods and results before operation and visual acuity after operation in two groups were analyzed and compared by MantelHaenszel chisquare test. Results　The average interval from lens extraction to RD occurrence was 15.4 months in PPRD eyes and 39.1 months in ARD eyes. The final total anatomic success rate was 95.9%, and was 93.5% in the scleral buckle eyes and 97.2% in vitrectomy eyes.The BCVA was better than 0.3 after operation only in 11.9% of the 805 patiens,and the visual acuity increased more than 2 lines in 67.3%. Compared with the ARD eyes,early onset, high proportion of total posterior vitreous detachment,severe PVR,wide RD range,low detection rate of retinal hole and low antomic success rate were found in PPRD eyes.Compared with the 1995-1999 group,the proportion of vitreous surgery,anatomic success rate and better visual acuity were found in 2000-2007 group.Conclusions 　The ocular lesions of ARD and PPRD is more complicated,the therapeutic effect are improving in recent years.