·AIM:To determine the value of Schirmer Ⅰtest (SⅠt) without anesthesia and with topical anesthesia for diagnosing dry eye (DE). ·METHODS:Totally 220 eyes in 110 patients, male (44) and female (66), (39.56&...·AIM:To determine the value of Schirmer Ⅰtest (SⅠt) without anesthesia and with topical anesthesia for diagnosing dry eye (DE). ·METHODS:Totally 220 eyes in 110 patients, male (44) and female (66), (39.56±12.67) years old diagnosed with DE were examined. SⅠt without anesthesia was performed firstly, and 15 minutes later, it was applied again in the same person after topical anesthesia with 0.5% proparacaine hydrochloride eye drops. The wetting strips counted <10mm per 5 minutes were defined positive, while ≤5mm per 5 minutes were defined strong positive. ·RESULTS:The wetting length in SⅠt after topical anesthesia was significantly lower than that in SⅠt without anesthesia(P < 0.001). The positive rate and strong positive rate of SⅠt after topical anesthesia were significantly higher than that of SⅠt without anesthesia (P <0.001). The positive rate and strong positive rate of SⅠt without anesthesia and the strong positive rate of SⅠt after topical anesthesia in patients with aqueous-deficiency dry eye (ADDE) were significantly higher than those in total patients whereas those in patients with evaporative dry eye (EDE) were significantly lower than those in total patients (P <0.001). ·CONCLUSION:SⅠt after topical anesthesia with 0.5% proparacaine hydrochloride eye drops is more objective and reliable than that without anesthesia in reflecting the status of DE, and its diagnostic value in patients with ADDE was even higher, making itself a meaningful evidence for the diagnosis and treatment of DE.展开更多
Introduction: To report by using topical anesthesia for standing phacoemulsification and intraocular lens implantation for two patients who need cataract extraction but unable to lie flat with marked cervical kyphosis...Introduction: To report by using topical anesthesia for standing phacoemulsification and intraocular lens implantation for two patients who need cataract extraction but unable to lie flat with marked cervical kyphosis due to long-standing ankylosing spondylitis and chronic uveitis. Methods: Two patients are unable to lie flat respectively during phacoemulsification underwent this technique in Jingdong and Tonghai county Hospital of Yunnan province in China. Each patient was positioned erect or semirecumbent in a standard reclining cataract surgical chair. The ceiling-mounted microscope was rotated 60 degrees from the vertical to point toward the patient. Results: The intraoperative and postoperative periods were uneventful in two patients, with good visual outcomes after surgery. Conclusion: This technique is valuable for situations where the patient requires upright positioning because of the inability to recline flat, and should be considered for cases where standard surgical positioning is not possible.展开更多
Purpose: To evaluate the feasibility, reliability and analgesia effect of topical anesthesia combined with subconjunctival anesthesia in anti-glaucomatous surgery.Methods: Two hundred and four cases (357 eyes) underwe...Purpose: To evaluate the feasibility, reliability and analgesia effect of topical anesthesia combined with subconjunctival anesthesia in anti-glaucomatous surgery.Methods: Two hundred and four cases (357 eyes) underwent anti-glaucomatous surgeries under topical anesthesia with 0.5% Alcaine eye drops combined with subconjunctival anesthesia with 2% Lidocaine. The analgesic effect was analysed with visual analogue pain scale.Results: Among all of 357 eyes, 62 eyes underwent peripheral iridectomy, 67 eyes underwent simple trabeculectomy, 167 eyes underwent compound brabeculectomy and 12 eyes nonpenetrating trabecular surgery. The effects of anesthesia were as follows: 304 eyes(85.2%) were painless (Grade I ), 50 eyes (14.0%) were slight painful (Grade Ⅱ ), and 3 eyes (0.8%) were more painful (Grade Ⅲ ) during surgery. And no severe complications were observed in all the cases during surgery and postoperatively. Amaurosis fugax was not observed in the glaucoma patients at the late stage with narrow visual fields and poor visual ability.Conclusion: Topical anesthesia combined with subconjunctival anesthesia is effective,safe and simple anesthesia alternative in routine anti-glaucomatous surgery, especially for the glaucoma patients at the late stage with narrow visual fields and poor visual ability. It is worthy of being applied widely.展开更多
Purpose: To determine whether 2% Lidocaine injection is an effective topical anesthetic agent for non-phaco small incision cataract surgery.Setting: Charity eye clinic supported by Hellen Keller International.Methods:...Purpose: To determine whether 2% Lidocaine injection is an effective topical anesthetic agent for non-phaco small incision cataract surgery.Setting: Charity eye clinic supported by Hellen Keller International.Methods:One hundred and twenty-five consecutive cataract surgery patients received topical anesthesia with 2% Lidocaine injection solution just 1 and 0.5 minutes prior to non-phaco small incision cataract extraction and intraocular lens implantation. Each patient was asked about pain or piessure sensation during the operation.Results: The surgeon felt ease in the operations. Many patients (93/125) were comfort during the whole surgery. Only 9 patients′ score was above level 3,mostly complained during the nucleus extraction; Among those whose score was level 1～2, 82.6%(19/23)claimed discomfort at middle of the operation (nucleus extraction) or the beginning (creating the conjunctival flap).Conclusion: Lidocaine injection solution(2%) was an effective topical anesthesia agent in cataract surgery.展开更多
目的观察两种不同的表面麻醉剂对基础泪液分泌试验(Schirmer I test,SIT)的影响。方法选取我院准分子门诊就诊患者84例(168眼),其中男51例(102眼),女33例(66眼),同一患者左右眼随机分别以5 g·L-1盐酸丙美卡因滴眼液和4g·L-1...目的观察两种不同的表面麻醉剂对基础泪液分泌试验(Schirmer I test,SIT)的影响。方法选取我院准分子门诊就诊患者84例(168眼),其中男51例(102眼),女33例(66眼),同一患者左右眼随机分别以5 g·L-1盐酸丙美卡因滴眼液和4g·L-1盐酸奥布卡因滴眼液1滴单次滴眼,观察滴眼后的眼部刺激症状及结膜充血情况,测量其SIT值,并对结果进行比较分析。结果盐酸丙美卡因组有15眼出现一过性眼部刺激症状,盐酸奥布卡因组有33眼,两组比较差异有统计学意义(P<0.05);盐酸丙美卡因组轻度结膜充血的眼数为54眼,明显多于盐酸奥布卡因组的39眼(P<0.05);盐酸丙美卡因组SIT值为(7.50±5.15)mm,盐酸奥布卡因组为(9.71±5.46)mm,两组间比较差异有统计学意义(P<0.05);盐酸丙美卡因组48眼SIT值小于10 mm,盐酸奥布卡因组为33眼,两者间差异有统计学意义(P<0.05);盐酸丙美卡因组30眼SIT值小于5 mm,盐酸奥布卡因组为21眼,两者间差异无统计学意义(P>0.05)。结论盐酸丙美卡因较盐酸奥布卡因有更好的眼部耐受性,且测量的SIT值短于盐酸奥布卡因组,说明盐酸丙美卡因眼表麻醉效果可能要强于盐酸奥布卡因。展开更多
文摘·AIM:To determine the value of Schirmer Ⅰtest (SⅠt) without anesthesia and with topical anesthesia for diagnosing dry eye (DE). ·METHODS:Totally 220 eyes in 110 patients, male (44) and female (66), (39.56±12.67) years old diagnosed with DE were examined. SⅠt without anesthesia was performed firstly, and 15 minutes later, it was applied again in the same person after topical anesthesia with 0.5% proparacaine hydrochloride eye drops. The wetting strips counted <10mm per 5 minutes were defined positive, while ≤5mm per 5 minutes were defined strong positive. ·RESULTS:The wetting length in SⅠt after topical anesthesia was significantly lower than that in SⅠt without anesthesia(P < 0.001). The positive rate and strong positive rate of SⅠt after topical anesthesia were significantly higher than that of SⅠt without anesthesia (P <0.001). The positive rate and strong positive rate of SⅠt without anesthesia and the strong positive rate of SⅠt after topical anesthesia in patients with aqueous-deficiency dry eye (ADDE) were significantly higher than those in total patients whereas those in patients with evaporative dry eye (EDE) were significantly lower than those in total patients (P <0.001). ·CONCLUSION:SⅠt after topical anesthesia with 0.5% proparacaine hydrochloride eye drops is more objective and reliable than that without anesthesia in reflecting the status of DE, and its diagnostic value in patients with ADDE was even higher, making itself a meaningful evidence for the diagnosis and treatment of DE.
文摘Introduction: To report by using topical anesthesia for standing phacoemulsification and intraocular lens implantation for two patients who need cataract extraction but unable to lie flat with marked cervical kyphosis due to long-standing ankylosing spondylitis and chronic uveitis. Methods: Two patients are unable to lie flat respectively during phacoemulsification underwent this technique in Jingdong and Tonghai county Hospital of Yunnan province in China. Each patient was positioned erect or semirecumbent in a standard reclining cataract surgical chair. The ceiling-mounted microscope was rotated 60 degrees from the vertical to point toward the patient. Results: The intraoperative and postoperative periods were uneventful in two patients, with good visual outcomes after surgery. Conclusion: This technique is valuable for situations where the patient requires upright positioning because of the inability to recline flat, and should be considered for cases where standard surgical positioning is not possible.
文摘Purpose: To evaluate the feasibility, reliability and analgesia effect of topical anesthesia combined with subconjunctival anesthesia in anti-glaucomatous surgery.Methods: Two hundred and four cases (357 eyes) underwent anti-glaucomatous surgeries under topical anesthesia with 0.5% Alcaine eye drops combined with subconjunctival anesthesia with 2% Lidocaine. The analgesic effect was analysed with visual analogue pain scale.Results: Among all of 357 eyes, 62 eyes underwent peripheral iridectomy, 67 eyes underwent simple trabeculectomy, 167 eyes underwent compound brabeculectomy and 12 eyes nonpenetrating trabecular surgery. The effects of anesthesia were as follows: 304 eyes(85.2%) were painless (Grade I ), 50 eyes (14.0%) were slight painful (Grade Ⅱ ), and 3 eyes (0.8%) were more painful (Grade Ⅲ ) during surgery. And no severe complications were observed in all the cases during surgery and postoperatively. Amaurosis fugax was not observed in the glaucoma patients at the late stage with narrow visual fields and poor visual ability.Conclusion: Topical anesthesia combined with subconjunctival anesthesia is effective,safe and simple anesthesia alternative in routine anti-glaucomatous surgery, especially for the glaucoma patients at the late stage with narrow visual fields and poor visual ability. It is worthy of being applied widely.
文摘Purpose: To determine whether 2% Lidocaine injection is an effective topical anesthetic agent for non-phaco small incision cataract surgery.Setting: Charity eye clinic supported by Hellen Keller International.Methods:One hundred and twenty-five consecutive cataract surgery patients received topical anesthesia with 2% Lidocaine injection solution just 1 and 0.5 minutes prior to non-phaco small incision cataract extraction and intraocular lens implantation. Each patient was asked about pain or piessure sensation during the operation.Results: The surgeon felt ease in the operations. Many patients (93/125) were comfort during the whole surgery. Only 9 patients′ score was above level 3,mostly complained during the nucleus extraction; Among those whose score was level 1～2, 82.6%(19/23)claimed discomfort at middle of the operation (nucleus extraction) or the beginning (creating the conjunctival flap).Conclusion: Lidocaine injection solution(2%) was an effective topical anesthesia agent in cataract surgery.
