Anterior lamellar recession for management of upper eyelid cicatricial entropion and associated eyelid abnormalities

AIM：To evaluate the functional and aesthetic outcomes of upper eyelid cicatricial entropion（UCE） correction using anterior lamellar recession（ALR） with addressing the associated conditions including dermatochalasis,brow ptosis,blepharoptosis,and lid retraction.METHODS：Chart review of patients with upper lid cicatricial entropion who had undergone ALR from 2013 to 2016 was reviewed.Success was defi ned as the lack of any lash in contact with the globe,no need for a second procedure,and acceptable cosmesis at the fi nal follow up.RESULTS：Sixty eight patients（97 eyelids） were operated by ALR with simultaneous correction of associated lid problems in each case when necessary.The mean followup time was 17.8 mo（range,6.0-24.0 mo）.Concomitantly,levator tucking was performed in 19 eyelids（19.6%）,upper lid retractor recession in 18 eyelids（18.6%）,and internal browpexy in 31 eyelids（32.0%）.In 95.8% of patients（95%CI：0.85-0.96）,satisfactory functional and cosmetic outcome was achieved with a single surgical procedure.CONCLUSION：Based on the principles of lamellar recession and concurrently addressing the associated lid problems,this approach is an effective and safe treatment of UCE.

Treatment of Complex Proximal Tibial Fractures (Types V &VI of Schautzker Classification) by Double Plate Fixation with Single Anterior Incision

Background: complex proximal tibial fractures (Types V & VI of Schautzker classification) are the major problems in orthopedic surgery and associated with high complication rates. There are many alternatives in treatment of these fractures. Aim: to evaluate the results of double plating with single anterior incision in complex proximal tibial fractures (Types V& VI of Schautzker classification).Methods and Materials: 22 patients (16 males and 6 females) with Types V and VI of Schautzker classification of proximal tibial fractures (14 cases were Type V and 8 cases were Type VI) were treated by double plating with single anterior incision method between May 2006 and May 2011. The bony and functional outcome was evaluated according to Knee Society Score. Results: According to Knee Society Score, the results were as follows: excellent in 19 patients (86.4%), good in 2 patients (9.1%), fair in 1 patient (4/5%), and poor in no patient (0%).Conclusion: the double plate fixation with single anterior incision is the best, effective and simple procedure in treatment of complex proximal tibial fractures (Types V and VI of Schautzker classification).

Therapeutic effect of two methods on avulsion fracture of tibial insertion of anterior cruciate ligament

BACKGROUND The tibial stop of anterior cruciate ligament(ACL) is fan-shaped and attached to the medial groove in front of the intercondylar spine,which is located between the anterior horn of the medial and lateral meniscus.The incidence of this fracture is low previously reported,which is common in children and adolescents.With the increase of sports injury and traffic injury and the deepening of understanding,it is found that the incidence of the disease is high at present.AIM To explore the difference between open reduction and internal fixation with small incision and high-intensity non-absorbable suture under arthroscopy in the treatment of tibial avulsion fracture of ACL.METHODS Seventy-six patients with tibial avulsion fracture of anterior cruciate ligament diagnosed and treated in Guanyun County People’s Hospital from April 2018 to June 2020 were retrospectively analyzed.According to the surgical methods,they were divided into group A(40 cases) and group B(36 cases).Patients in group A were treated with arthroscopic high-strength non-absorbable suture,and patients in group B were treated with small incision open reduction and internal fixation.The operation time,fracture healing time,knee joint activity and functional score before and after operation,and surgical complications of the two groups were compared.RESULTS The operation time of group A was higher than that of group B,and the difference was statistically significant(P < 0.05);the fracture healing time of group A was compared with that of group B,and the difference was not statistically significant(P > 0.05);The knee joint function activity was compared between two groups before operation,3 mo and 6 mo after operation,and the difference was not statistically significant(P > 0.05);the knee joint function activity of group A and group B at 3 mo and 6 mo after operation was significantly higher than that before operation(P < 0.05);the limp,support,lock,instability,swelling,upstairs,squatting,pain and Lysholm score were compared between the two groups before and 6 mo after operation,and the difference was not statistically significant(P > 0.05);the scores of limp,support,lock,instability,swelling,upstairs,squatting,pain and Lysholm in group A and group B at 6 mo after operation were significantly higher than those before operation(P > 0.05);the surgical complication rate of group A was 2.63%,which was lower than 18.42% of group B,and the difference was statistically significant(P > 0.05).CONCLUSION Both small incision open reduction and internal fixation and arthroscopic high-strength nonabsorbable sutures can achieve good results in the treatment of anterior cruciate ligament tibial avulsion fractures.The operation time of arthroscopic high-strength non-absorbable sutures is slightly longer,but the complication rate is lower.

Simple method of measuring ocular rotation in supine position during small incision lenticule extraction

AIM:To introduce a novel measurement method of static cyclotorsion in small incision lenticule extraction(SMILE)and to investigate the effect of preoperative parameters on cyclotorsion and the effect of cyclotorsion on postoperative outcomes.METHODS:The medical records of 242 patients and 484 eyes who under went SMILE surger y were retrospectively reviewed.Preoperative intraocular pressure,refractive error,and corneal thickness were investigated.Refractive values and visual acuity were measured at 1d,1,3,and 6mo.Ocular cyclotorsion in the supine position was measured by calculating the location and angle of the incision site of the cornea in the anterior slit photograph taken after surgery.RESULTS:Of the total 484 eyes in 242 patients,preopera tive means phericale quivalent(SE)was-4.10±1.64 D,and the mean astigmatism was-0.82±0.74 D.Uncorrected distance visual acuity(UCVA)and SE improved significantly after the surgery.Moreover,219(45.2%)eyes had excyclotorsion,235(48.6%)eyes had incyclotorsion,and 30(6.2%)eyes had no torsion.The right eyes tended to be excyclotorted,and the left eyes tended to be incyclotorted(P<0.01).The mean cyclotorsion was 1.18°±3.69°,and the mean absolute value of cyclotorsion was 3.14°±2.26°.The range of cyclotorsion was 0.5°–11.4°.It was found that the smaller the preoperative sphere,the higher the amount of cyclotorsion(r=0.11,P=0.016).There was no significant association between the amount of cyclotorsion and preoperative astigmatism.There was no correlation between sex,preoperative corneal thickness,preoperative intraocular pressure,amount of cyclotorsion,and direction of cyclotorsion.The ratio of right eye excyclotorsion and left eye incyclotorsion on 1d was higher than that at 1,3,and 6mo(all P<0.01).There was no difference between the 1,3,and 6mo results in the right and left eyes(P=0.15,P=0.16,respectively).CONCLUSION:The newly devised ocular cyclotorsion measurement method can be used to evaluate ocular cyclotorsion after SMILE.Preoperative SE is associated with the amount of cyclotorsion,however,cyclotorsion doesn't have a significant effect on the results of SMILE surgery.

Observation of Clinical Treatment Effect of Plastic Surgery of Asymmetric Double Eyelids

Objective:To explore the clinical efficacy of plastic surgery of asymmetric double eyelid.Methods:The clinical data of 70 patients with asymmetrical double eyelid who underwent plastic surgery in our hospital from April 2018 to December 2019 were retrospectively analyzed.The patients were divided into different groups based on different plastic surgery procedures.The control group(n=35 cases)were the patients who underwent double eyelid incision method,and the patients who used embedding double eyelid method were included in the observation group(n=35 cases).The operation time,intraoperative blood loss,incision size,healing time of incision,satisfaction of p1astic surgery and occurrence of complications were compared between the two groups.Results:The operation time and incision healing time of the observation group were shorter than those of the control group.The intraoperative blood 1oss and incision were less than those of the control group,and the satisfaction was higher than that of the control group.The difference was statistically significant(P<0.05).The incidence of complications in the observation group was slightly lower than the control group,but the difference was not statistically significant(P>0.05).Conclusion:For asymmetric double eyelid,it should undergo embedding double eyelid plastic surgery,because the operation time and incision healing time are shorter.And intraoperative blood 1oss and incision size are smal1er,which can improve patient satisfaction and reduce the incidence of complications.

Relationship between early structural changes at cornea incision sites and surgical outcomes after phacoemulsification

AIM: To assess the early structural changes at clear corneal cataract incision sites and surgical outcomes using anterior segment optical coherence tomography(AS-OCT).METHODS: We evaluated 80 eyes of 59 patients who underwent phacoemulsification with a clear corneal incision. All incisions were evaluated 1 wk, 1, and 3 mo postoperatively using AS-OCT and analyzed regarding angle, length of the incision, maximal corneal thickness at the incision, and if present, corneal endothelial gap length and incision gap area. The patients were divided into two groups according to whether or not an endothelial gap was present at 1 wk postoperatively(endothelial gap, group 1;no endothelial gap, group 2). We analyzed the difference in patient and surgical factors between the two groups, and compared the surgical outcome and the refractive outcome.RESULTS: An endothelial gap was observed in 56(70.0%) of 80 eyes at 1 wk postoperatively but not at 3 mo postoperatively. The mean patient age was significantly higher in group 1 than in group 2. The longer the length of the corneal incision and the steeper the incision angle, the greater the length and area of the endothelial gap. In group 1, the mean change in mean keratometry of the anterior cornea was significantly greater than in group 2, and the spherical equivalent(SE) and mean numerical error indicated significant myopic changes at 1 wk postoperatively. CONCLUSION: The risk of an endothelial gap increases with patient age and a long corneal incision and steep incision angle. The presence of an endothelial gap aftersurgery may affect the early postoperative corneal curvature and SE.

梯形透明角膜切口在晶状体超声乳化术患者治疗中的临床效果

目的探讨梯形透明角膜切口在晶状体超声乳化术患者治疗中的临床效果。方法选取行晶状体超声乳化术的患者57例(68眼)作为研究对象,采用随机数字表法将患者分为常规切口组和梯形切口组。常规切口组28例(34眼),男15眼,女19眼,年龄41~82(65.0±10.1)岁;梯形切口组29例(34眼),男21眼,女13眼,年龄46~87(66.0±11.1)岁。两组患者均接受白内障超声乳化吸出联合人工晶状体植入术,常规切口组采用3.0 mm透明角膜切口,梯形切口组为改进的梯形透明角膜切口。比较两组患者术后裸眼视力、眼压及角膜散光度以及术中及术后并发症发生情况。结果术后1周及3个月梯形切口组患者裸眼视力均优于常规切口组,差异均有统计学意义(均为P<0.05);术后1周、1个月及3个月两组患者眼压及角膜散光度差异均无统计学意义(均为P>0.05)。术中常规切口组患者出现前房塌陷的眼数以及需要水密切口的眼数均大于梯形切口组,差异均有统计学意义(均为P<0.05);术后常规切口组患者出现切口水肿、切口哆开的眼数均大于梯形切口组,差异均有统计学意义(均为P<0.05)。术中常规切口组因前房变浅出现人工晶状体移位18眼,水密切口前房形成后人工晶状体位置正常;水密时2眼发生虹膜脱出切口嵌顿、3眼发生人工晶状体囊袋内旋转或囊口嵌顿。术中梯形切口组患者术毕3眼发生前房变浅,使用水密切口形成前房;无人工晶状体前囊口嵌顿、移位或虹膜脱出等情况。结论改良的梯形透明角膜切口可以在保证白内障患者术中前房稳定性的同时有效防止因术中前房塌陷而导致的人工晶状体移位,也能减少冲洗针头水密切口引起的相关并发症,使患者尽早恢复视力。

颈侧方入路手术在治疗原发性甲状旁腺功能亢进症中的临床研究

目的探讨颈侧方切口经胸锁乳突肌肌间入路手术(SMIA)在治疗原发性甲状旁腺功能亢进症中的可行性及其临床效果。方法回顾性分析2019年1月-2022年6月浙江大学医学院附属第一医院行单侧甲状旁腺手术的64例原发性甲状旁腺功能亢进症患者的临床资料,根据手术切口及入路分为颈侧方切口SMIA组及正中切口颈白线入路组(LACA组)。比较两组间临床特征、手术相关结果及术后颈前区功能的差异。采用EQ-5D-5L量表评估术后颈部不适主观感受,Hollander伤口评估量表评定切口愈合情况。结果两组患者在年龄、性别、术中出血、手术前后甲状旁腺激素及血钙水平等方面均无统计学差异(P>0.05)。SMIA组平均手术时间[(39.77±5.69)min]明显少于LACA组[(54.41±4.66)min]。术后1月及12月,两组在颈前区功能保护方面有统计学差异(1月:84.67±3.74 vs.79.47±5.38,P<0.001;12月:93.80±2.52 vs.89.94±2.39,P<0.001),且SMIA组均优于LACA组;SMIA组术后6月及12月的Hollander切口评估量表得分优于LACA组,差异有统计学意义(6月:1.93±0.58 vs.2.41±0.66,P=0.003;12月:1.03±0.67 vs.1.74±0.62,P<0.001)。结论颈侧方切口经胸锁乳突肌肌间入路行甲状旁腺切除是简便、安全及有效的手术方式,较于传统切口更易寻找甲状旁腺病变,缩短手术时间,且对颈前区功能保护的作用优势明显。

切口设计及修复情况对上前牙美学区显微根尖手术术后牙龈退缩影响的回顾性研究

目的:研究切口类型及修复体对上前牙美学区显微根管外科手术(endodontic microsurgery,EMS)后牙龈退缩的影响。方法:纳入53例上前牙美学区需行EMS患者,术后随访1年以上,分析性别、切口类型(沟内切口;龈乳头基部切口)、修复体情况(无修复体;有修复体)对上前牙美学区根尖手术后牙龈退缩的影响。结果:按纳入标准,共采集53例患牙临床冠及78例龈乳头数据,统计分析表明,术前及术后1年患牙临床冠高度(H1)、龈乳头高度(H2)及切缘龈乳头距离(H3)存在统计学差异(P <0.05)。性别和切口类型对术后牙龈退缩无显著影响。按修复体有无进行分析,临床冠高度变化(ΔH1)及切缘龈乳头距离变化(ΔH3)均有统计学意义(P <0.05)。结论:上前牙美学区患牙显微根尖手术术后存在一定程度牙龈退缩,修复体的存在会使牙龈退缩加重,影响前牙区美学效果。

膝前正中入路与内外侧双切口入路治疗SchatzkerⅤ型、Ⅵ型胫骨平台骨折的疗效比较

目的比较膝前正中入路与内外侧双切口入路治疗SchatzkerⅤ型、Ⅵ型胫骨平台骨折的疗效。方法回顾性分析2020年9月至2022年9月于商水县人民医院行手术治疗的106例胫骨平台骨折(SchatzkerⅤ型、Ⅵ型)患者资料,根据其手术方式将患者分为前正中切口组(n=62)和内外侧切口组(n=44),比较两组患者的手术情况、下肢关节功能恢复情况、术后疗效和术后并发症的发生情况。结果前正中切口组手术时间、术中出血量和引流量均低于对照组;骨折愈合时间长于内外侧切口组;前正中切口组日常生活功能、膝关节稳定程度等Merchant评分高于内外侧切口组,疼痛评分及活动范围等Merchant评分低于内外侧切口组,差异有统计学意义(P<0.05)。结论相较于膝内外侧切口入路治疗,膝前正中切口入路治疗SchatzkerⅤ型、Ⅵ型胫骨平台骨能有效缩短手术时间、减少术中出血量,而患者术后关节功能恢复情况及并发症发生风险与膝内外侧切口入路无明显差异,但患者骨折愈合时间略长于膝内外侧切口入路治疗。

上前牙种植单冠修复体切导的数字化设计正确度

目的:通过虚拟数字模型实验比较动态咬合记录法(patient-specific motion,PSM)和平均值数字牙合架法设计前牙种植单冠修复体切导的正确度。方法:招募12名牙列完整、有稳定切导的健康受试者,口内扫描获得受试者牙列模型,并采集两种动态咬合记录:(1)仅包括前伸运动;(2)包括前伸运动及侧前伸运动。加高原始模型上中切牙参与前伸引导的部分舌面作为参考模型;虚拟拔除单个上中切牙,虚拟种植获得上颌工作模型。在修复体设计软件中使用复制功能进行种植单冠形态设计,使用不同数字化方法设计切导:对照组为平均值数字牙合架法,试验组为仅包括前伸运动的动态咬合记录法(PSM1)和包括前伸运动和侧前伸运动的动态咬合记录法(PSM2)。通过逆向工程软件分析比较修复体切导形态与原始切导形态的三维偏差,评价指标包括代表高牙合程度的正值平均值、正面积比、最大值,代表低牙合程度的负值平均值、负面积比、最小值,以及代表整体偏差程度的均方根。结果:数据采用中位数(四分位距)表示。PSM2组的正值平均值、正面积比、负值平均值小于对照组[8.0(18.8)μm vs.37.5(47.5)μm;0 vs.7.2%(38.1%);-109.0(63.8)μm vs.-66.5(64.5)μm],负面积比大于对照组[52.9%(47.8%)vs.17.3%(45.3%)],差异均具有统计学意义(P<0.05);PSM1组的正面积比[0.1%(7.0%)]和负值平均值[-97.0(61.5)μm]均小于对照组,负面积比[40.7%(39.2%)]大于对照组,差异具有统计学意义(P<0.05);PSM1组的正值平均值[20.0(42.0)μm]和正面积比均大于PSM2组,差异具有统计学意义(P<0.05)。结论:设计前牙种植单冠修复体切导时,相较于平均值数字牙合架法和仅包括前伸运动的动态咬合记录法,包括前伸运动和侧前伸运动的动态咬合记录法更有利于减少修复体的咬合干扰,提高咬合适合性。

眉下缘切口提升术联合重睑成形治疗中重度上睑皮肤松弛的美学效果观察

目的:观察眉下缘切口提升术联合重睑成形治疗中重度上睑皮肤松弛的美学效果。方法:回顾性分析2020年10月-2022年10月在笔者医院治疗的62例上睑皮肤松弛患者临床资料,根据治疗方法不同分为联合治疗组(n=32)和眉下切口组(n=30),联合治疗组行眉下缘切口提升术联合重睑术,眉下切口组行眉下缘切口提升术,术后对患者进行随访,比较两组术后矫治效果,上睑缘至眉距离(The distance between the upper eyelid margin and the eyebrow,DEE)、睑裂宽度(The height of the palpebral fissure,HPF)、瞳孔中点睑缘与重睑距离(Middle pupil margin-fold distance,MPMFD)、角膜内侧睑缘与重睑距离(Medial corneal margin-fold distance,MCMFD)以及外眦处睑缘与重睑距离(Lateral canthus margin-fold distance,LCMFD)、上睑皱纹改善效果(Lemperle评分)、术后外观满意度、术后并发症发生率。结果:治疗后,联合治疗组DEE、HPF、MPMFD、MCMFD、LCMFD均高于对照组(P<0.05);治疗后,两组患者Lemperle评分均有所降低,但联合治疗组低于眉下切口组(P<0.05);治疗后,联合治疗组术后外观满意度96.88%高于眉下切口组76.67%(P<0.05);治疗后,联合治疗组与眉下切口组并发症发生率比较,差异无统计学意义(P>0.05)。结论:眉下缘切口提升术联合重睑成形治疗中重度上睑皮肤松弛,能够有效改善上睑松弛情况,减少上睑皱纹,且患者外观满意度较高。

保留眼轮匝肌的小切口重睑成形术在临床的应用

目的探讨一种恢复期短,损伤轻,维持时间稳定,形态自然的重睑手术方法;方法自2021年12月至2022年12月收集76例重睑就医者,按不同的手术方法,将上睑皮肤组织较薄,松弛不明显的分为观察组38例,另将上睑皮肤松弛较明显的分为对照组38例。观察组采用保留眼轮匝肌的小切口重睑成形术,对照组采用传统的切开重睑成形术。结果观察组重睑切口长度、重睑手术时间、重睑切口愈合时间均明显低于对照组,差异对比有统计学意义(P<0.05)。观察组术后重睑形态评分、皮肤感觉评分和皮肤完整度及颜色评分均高于对照组,并发症低于对照组,差异对比有统计学意义(P<0.05)。结论保留眼轮匝肌的小切口重睑成形术因组织损伤少,血液循环及淋巴循环建立快,因此恢复期短,效果稳定,自然度高,满意率也较高,值得临床推广。

改良眉下联合切口上睑提升术在上睑皮肤松弛中的应用效果

目的探究改良眉下联合切口上睑提升术在上睑皮肤松弛中的临床效果。方法选取2021年3月至2024年3月郑州欧华医疗美容医院收治的86例上睑皮肤松弛患者,按治疗方法不同分为研究组和对照组,每组43例。观察组患者采用改良眉下联合切口上睑提升术,对照组患者采用重睑成形术;术后随访3个月。结果观察组患者术后消肿及恢复时间均短于对照组患者,差异有统计学意义(P<0.05);治疗3个月后,2组患者睑裂高度经瞳孔上下睑缘间距离增加,眉毛至发际线距离减少,组间比较差异有统计学意义(P<0.05);两组患者Lemperle皮肤弹评分、全球美学改善量表评分均降低,组间比较差异有统计学意义(P<0.05);两组患者睑缘反光点距离、角膜内侧睑缘与重睑褶皱距离、中瞳孔边缘与重睑褶皱距离、外眦边缘与重睑褶皱距离均升高,组间比较差异有统计学意义(P<0.05)。结论改良眉下联合切口上睑提升术能提高上睑皮肤松弛患者上睑松弛的矫正效果,提升面部美学效果,减少皱纹,改善皮肤松弛状态和眼眶形态,缩短恢复时间。

连续埋线重睑成形术联合微创切口抽脂对不对称重睑患者外观改善情况及并发症的影响

目的 探究不对称重睑患者应用连续埋线重睑成形术与微创切口抽脂术治疗对其外观改善情况及并发症的影响。方法回顾性分析2021年1月至2023年1月在安徽医科大学第二附属医院就诊的84例不对称重睑患者资料,根据手术方式不同分为两组,对照组42例采用常规切开重睑成形术,观察组42例采用连续埋线重睑成形术与微创切口抽脂术治疗。对两组围手术期相关指标、外观改善情况及并发症进行比较。结果 观察组手术时间(31.07±4.14) min、切口长度(2.43±0.32) cm及切口愈合时间(5.35±1.24) d短于对照组,术中出血量(24.58±3.07) mL少于对照组;并发症发生率4.76%,低于对照组19.05%),外观改善情况优于对照组,差异有统计学意义(P<0.05)。结论 不对称重睑患者应用连续埋线重睑成形术与微创切口抽脂术治疗,可有效改善外观,减少并发症,促进术后恢复。

颈侧方切口手术治疗甲状腺良性肿瘤的效果分析

目的分析颈侧方切口手术治疗单侧甲状腺良性肿瘤的疗效。方法收集2019年8月至2022年8月衢州市人民医院收治的120例甲状腺良性肿瘤患者的临床资料。依据不同手术切口采用非随机同期对照法分为观察组和对照组,每组60例。观察组取颈侧方切口,对照组取颈前低位弧形切口。比较2组患者手术时间、切口长度、术中出血量、术后第1天引流量、住院时间、术后12 h视觉模拟疼痛量表评分、术后24 h皮下积液发生率等。结果2组患者手术时间比较,差异无统计学意义(P>0.05)。观察组患者切口长度、术中出血量、术后第1天引流量、住院时间、术后12 h视觉模拟疼痛量表评分、术后24 h皮下积液发生率均明显优于对照组,差异均有统计学意义(P<0.05)。结论颈侧方切口手术治疗单侧甲状腺良性肿瘤效果好,切口美观,颈部功能恢复快。

睑缘切口重睑术的临床应用效果分析

目的:对比睑缘切口重睑术和传统切口重睑术的临床效果。方法:回顾性选取2020年1月-2023年1月在笔者医院进行睑缘切口重睑术治疗的185例就医者为研究组,另选取接受传统切口重睑术治疗的100例就医者为对照组。观察两组治疗后的美学效果满意率、手术情况、治疗3个月后瘢痕程度[温哥华瘢痕量表(Vancouver scar scale,VSS)、就医者与观察者瘢痕评估量表(Patient and observer scar assessment scale,POSAS)评分]和并发症的发生情况。结果:治疗后,研究组美学效果满意率明显高于对照组(P<0.05);研究组手术时间长于对照组,且消肿时间和自然恢复时间明显短于对照组(P<0.05)。治疗3个月后,研究组VSS、观察者评价得分(Observer scar assessment scale,OSAS)和就医者评价得分(Patient scar assessment scale,PSAS)均明显低于对照组(P<0.05);研究组并发症总发生率明显低于对照组(P<0.05)。结论:睑缘切口重睑术的美学效果良好,就医者术后恢复较快,瘢痕程度较低,且安全性良好。

小牛血去蛋白提取物眼用凝胶在老年性硬核性白内障小切口摘除手术中的应用效果

目的:研究小牛血去蛋白提取物眼用凝胶在老年性硬核性白内障小切口摘除手术中的应用效果。方法:选取我院2021年6月至2022年12月诊治的老年性硬核性白内障患者152例(152眼)作为研究对象。随机将患者分为对照组和观察组,各76例。对照组采取小切口摘除术,观察组在对照组基础上加用小牛血去蛋白提取物眼用凝胶治疗。分析对比两组术前及术后1、8 w的视力、前房炎性反应、角膜内皮细胞相关参数,其中视力采用标准视力量表测定,角膜内皮细胞相关参数采用SP-1P非接触型的角膜内皮细胞仪测量。结果:观察组术后1 w、8 w的矫正视力均较对照组显著提高(P<0.05);术后1 w前房炎性反应较对照组减轻(P<0.05)。两组术后1 w中央角膜厚度高于术前,而六边形细胞的比例、角膜内皮细胞的密度均显著低于术前;术后8 w中央角膜厚度显著低于术后1 w,六边形细胞的比例、角膜内皮细胞的密度均显著高于术后1 w;且观察组患者的术后1 w中央角膜厚度显著低于对照组,而六边形细胞的比例、角膜内皮细胞的密度显著高于对照组(P<0.05)。结论:小牛血去蛋白提取物眼用凝胶在老年性硬核性白内障小切口摘除手术中,能改善角膜内皮细胞相关参数。

微创全瓷贴面配合DSD技术修复前牙切缘切角缺损美学效果观察

目的:探讨微创全瓷贴面配合数字化微笑设计(Digital smile design,DSD)技术修复前牙切缘切角缺损的美学效果。方法:选取2019年1月-2022年1月笔者医院接诊的78例前牙切缘切角缺损患者为研究对象,采用区组随机化法分为观察组(116颗患牙)和对照组(120颗患牙),每组39例。对照组采用微创全瓷贴面修复,观察组给予微创全瓷贴面联合DSD技术进行修复。比较两组患者治疗6个月后的满意度、美学效果[美国公共卫生署评估标准(United states public health service,USPHS)],对比治疗前后两组患者的红色美学指数、牙周健康指数[牙龈指数(Gingival index,GI)、牙菌斑指数(Plaque index,PLI)、龈沟出血指数(Sulcus bleeding index,SBI)]的变化。结果:治疗6个月后,两组美学效果各维度评级有显著差异,观察组治疗满意率、红色美学指数评分均显著高于对照组(P<0.05);治疗6个月后,两组GI、PLI、SBI均明显降低,且观察组显著低于对照组(P<0.05)。结论:微创全瓷贴面联合DSD技术修复前牙切缘切角缺损可有效改善牙齿美学效果,提高患者治疗满意度,适合临床推广。

一针法小切口重睑术的临床应用效果评价

目的 探讨一针法小切口重睑术的临床应用。方法 选取2023年1月至2024年1月于蚌埠医科大学第一附属医院接受重睑术的60例(120眼)患者行回顾性分析。其中30例接受一针法小切口重睑术,30例接受全切重睑术。比较两组患者的手术时间、患者满意度和并发症。结果 观察组患者手术时间(22.07±2.92)min,低于对照组(63.40±5.90)min,差异有统计学学意义(P<0.001)。观察组患者非常满意90.0%(27/30),满意6.7%(2/30),不满意3.3%(1/30);对照组患者非常满意93.3%(28/30),满意6.7%(2/30)。两组患者满意度比较差异无统计学意义(P>0.05)。观察组患者术后并发症发生率为10.0%(3/30),低于对照组20.0%(6/30),但差异无统计学意义(P>0.05)。结论 一针法小切口重睑术手术时间短、创伤小、瘢痕不明显,满意度高,适合手术初学者,值得在临床推广。