目的 探讨准分子激光上皮瓣下角膜磨镶术（LASEK）后角膜上皮下雾状混浊（Haze）的形成原因及防治措施。 方法 2004年2月－2011年12月期间采用LASEK治疗近视患者345 例669 只眼，屈光度?3.50～?13.5 D，平均（?6.87 ± 2.92）D；散光?0.50～?4.00 D，平均（?1.83 ± 1.32）D 。根据患者术前屈光等效球镜度数分为：中度近视组（?3.50～?5.75 D）120只眼，高度近视组（?6.00～?8.75 D）288只眼，超高度近视组（?9.00～?13.50 D） 261只眼。应用综合措施防治Haze，术中用日夜配戴的高亲水性绷带型角膜接触镜覆盖保护角膜上皮瓣，术毕频点激素眼液4次，术后使用激素类联合非甾体类抗炎眼液及降眼压药、抗生素眼液；随访6～12个月，观察术后Haze的发生率，并按Fantes（1990）标准分级，分析相关原因。 结果 LASEK术后6个月时0.5级Haze发生率14.65%（98只眼），无1级Haze。各组0.5级Haze发生率分别为中度近视组2.5%（3只眼），高度近视组11.11%（32只眼），超高度近视组24.14%（63只眼）。 结论 LASEK术后Haze的发生与术眼的屈光度呈正比，与角膜上皮瓣的活性和完整性，术后紫外线照射等有关。术后采用激素类联合非甾体类抗炎眼液及降眼压药等综合防治措施，可减少、减轻Haze的发生，使LASEK技术更安全有效。
Objective To evaluate glaucoma and anterior chamber angle changes after intravitreal silicone oil injection(SOI). Methods The intraocular pressure(IOP) and anterior chamber angles of 34 e yes(33 patients)undergone pars plana vitrectomy and SOI were observed. Results Glaucoma occurred in 9 eyes(26%),in which silicone oil glaucoma(SOG) accounted for 77%(7/9).The changes of the superior part of anterior chamber angle were peripheral anterior synechiae in 11 eye(32%) and SO emulsification droplets in 22 eyes(64%) in 1～4.5 months after surgeries.Glaucoma occurred in 6 eyes of 7 eyes undergone peripheral iridectomy at the inferio r part of the iris after the closure of iridectomy holes (plt;0.05). Conclusion High incidence of glaucoma was found in this series of patients after intravitreal silicone oil injection,and the main causes of SOG were closure of the inferior iridecomy hole and silicone emulsification. (Chin J Ocul Fundus Dis, 2001,17:105-107)
Objective To review research progress of corneal tissueengineering.Methods The recent articles on corneal tissue engineering focus on source and selection of corneal cells, the effects of growth factors on culture of corneal cells in vitro. The preparation and selection of three-dimensional biomaterial scaffolds and their b and weak points were discussed. Results The corneal tissue engineering cells come from normal human corneal cells. The embryo corneal cell was excellent. Several kinds of growth factors play important roles in culture, growth and proliferation of corneal cell, and incroporated into matrix.Growth factors including basic fibroblast growth factor, keratinocyte growth factor, transforming growth factor β1 and epidermal growth factor was favor to corneal cell. Collagen, chitosan and glycosaninoglycans were chosen as biomaterial scaffolds. Conclusion Human tissue engineering cornea can be reconstructed and transplanted. It has good tissue compatibility and can be used as human corneal equivalents.
Objective To observe the biocompatibility of the acellular corneal stroma materials prepared by three different methods. Methods Three different serial digestion methods were used to produce the acellular corneal stroma materials. The biocompatibility of the materials was investigated by the cell seeding and the materials were implanted into the rabbit corneal stroma layer. Results The cells in the materials 1 and 2 were not decellularized completely. The rabbit corneal fibroblasts died on the materials 1 and 2 after the cell seeding for 3-4 days. An obvious rejection could be observed after the implantation. The cells in material 3 were decellularized completely and the collagen fibers or elastic fibers were reserved integrally，showing a typical three-dimensional net work. The rabbit corneal fibroblasts could expand on the materials in vitro. No obvious rejection could be observed and the materials were gradually absorbed. Conclusion The acellular porcine cornea stroma materials prepared by trypsin-Dnase-Rnase are suitable for reconstruction of the tissue engineered cornea.
目的 探讨聚乙二醇滴眼液对准分子激光上皮下角膜磨镶术（LASEK）后角膜雾状混浊（haze）影响的临床研究。 方法 回顾性分析2009年3月－2010年3月行LASEK的患者45例90只眼的临床资料。患者屈光度（?4.68 ± 2.30）D（?1.75～?6.50 D），随机分为聚乙二醇滴眼液组（试验组）和对照组，术后定期随访观察两组角膜haze形成、角膜上皮愈合时间、视力恢复情况及屈光度。 结果 术后1、3、6个月，两组haze形成差异无统计学意义（P＞0.05），试验组术后第1、3、5天角膜刺激症状明显轻于对照组（P＜0.05），上皮愈合速度较对照组更快（P＜0.05）。 结论 LASEK术后应用聚乙二醇滴眼液虽然能减轻术后患者角膜刺激症状,能促进角膜上皮更快愈合，但是不能减轻haze的形成。
目的:通过应用护理程序于准分子激光原位角膜磨镶术,使护理行为标准化,程序化,系统化,减少由于护理问题引发的手术并发症。方法:将100例患者随机分为常规组和程序组,分别对其实施单纯性健康宣教法和模拟训练,实地参观为一体的护理程序法,从评估,诊断,计划,实施,评价,五个方面科学实施,最终从焦虑指数,术中配合,术后满意率三个方面对两组效果进行评估。结果:常规组焦虑指数的SAS评分为42.49±1.63,程序组为32.78±1.56,两者之间有显著差异(t=9.89,Plt;0.01);术中常规组头位改变率13.27%(13/98),眼位变化率16.33%(16/98),程序组分别为3.06%(3/98)、2.04%(2/98),两者之间有显著差异(χ2=15.18,Plt;0.01);常规组术后7天裸眼视力大于或等于最佳矫正视力的常规组75眼(76.53%),程序组95眼(96.94%),两者之间有显著差异(X2=14.65,Plt;0.01)。结论:护理程序的实施规范了护士对准分子激光原位角膜磨镶术的全程护理,取得了较好的临床效果。
Objective To observe the efficacy of photodynamic therapy for vitelliform macular dystrophy(VMD) with choroidal neovascularization(CNV). Methods The clinical data of 7 patients (7 eyes) of VMD with CNV who had undergone photodynamic therapy (PDT) were retrospectively analyzed. The patients were 4 males and 3 females, aged from 20 to 54 years. The patients received the examinations of best corrected visual acuity (BCVA), slitlamp microscopy, fundus photography, fluorescein angiography (FFA), indocyanine green angiography (ICGA), spectral domain OCT(SD-OCT), electrooculogram（EOG）and electroretinogram (ERG)before and after PDT. The BCVA ranged from finger counting to 0.6. Retinal edema and the subretinal fluid were observed. The mean thickness of central retina was (506.00plusmn;30.71) mu;m. PDT was performed according to the standard treatment. The follow-up period ranged from 2 to 11 months with the mean of 6.3 months. The changes of BCVA, CNV and side effects were observed after treatment. Results BCVA improved in all patients ranging from 0.12 to 1.0. The regression of the CNV and resolution of the subretinal fluid were observed by FFA, ICGA and SD-OCT after PDT. The mean thickness of central retina was reduced to (401.00plusmn;52.22) mu;m. There was no PDTassociated ocular or systemic side effect. Conclusions PDT is an effective and safe treatment for VMD with CNV. It may improve or stabilize the visual acuity.
Objective To evaluate the effects of surgical treatment for severe ocular rupture with blood staining of cornea and non-light perception , and analyze the relative factors. Methods Seven severely rup tured eyes of 7 patients with blood staining of cornea and non-light perception underwent second-stage penetrating keratoplasty combined with vitrectomy using temporary keratoprosthesis. All injured eyes had blood staining of cornea, hemorrhage in anterior chamber and vitreous, and choroidal and retinal detachment before the second-stage surgery. The average interval of the two surgical stages was 18 days (12-21 days). The preoperative visual acuity was non-light percept ion in all injured eyes with the mean intraocular pressure of 3 mm Hg (1 mm Hg =0.133 kPa) (2-5 mm Hg).The mean follow-up period was 12 months (6-30 months). Results The postoperative visual acuity was better than light perception in 5 eyes with the best corrected visual acuity of light perception to 0.06. The retina was attached in 5 eyes (5/7). The mean postoperative intraocular pressure was 12 mm Hg(5-15 mm Hg)which was significantly higher than the preoperative one (Plt;0.05). Postoperative complications mainly included temporary intraocular hypertension (1 eye), corneal neovasculariza tion (4 eyes), cornea rejection (4 eyes), and ocular atrophy (2 eyes). Conclusion Penetrating keratoplasty combined with vitrectomy using temporary keratoprosthesis is a safe and effective method in treating severe ocular rupture with blood staining of cornea and non-light perception. (Chin J Ocul Fundus Dis，2004，20：212-214)