目的：观察使用计算机辅助双目间接检眼镜成像技术对早产儿视网膜病变（retinopathy of prematurity,ROP）进行表面麻醉下光凝手术的效果,探讨计算机辅助双目间接检眼镜成像技术条件下进行ROP光凝手术模式的应用价值。方法：回顾性研究...目的：观察使用计算机辅助双目间接检眼镜成像技术对早产儿视网膜病变（retinopathy of prematurity,ROP）进行表面麻醉下光凝手术的效果,探讨计算机辅助双目间接检眼镜成像技术条件下进行ROP光凝手术模式的应用价值。方法：回顾性研究,阈值前1期及阈值期ROP患儿58例116眼在术前、术中、术后分别使用计算机辅助的双目间接检眼镜成像技术对患儿视网膜进行检查,术前检查用于设计手术方案,术中检查用于检测病变区激光治疗的遗漏区,手术结束时用于记录手术效果。手术在实施心电监护后的表面麻醉下进行。随访312mo。结果：本组病例中术中使用计算机辅助双目间接检眼镜成像技术检查可及时发现36眼（31.0%）存在遗漏区,立即补充激光治疗。所有116眼一次激光治疗后ROP病变得到控制。随访结束时所有术眼均未出现视网膜不良结构。结论：表面麻醉条件下的早产儿视网膜光凝手术过程中,使用计算机辅助双目间接检眼镜成像技术进行眼底检查,可及时发现激光遗漏区,立即补充激光治疗后能够有效避免二次手术。展开更多
Objective. To report the outcomes following treatment of retinal tears with argon laser photocoagulation by trainee doctors as an emergency procedure. Methods. Retrospective, case note analysis of 100 consecutive pati...Objective. To report the outcomes following treatment of retinal tears with argon laser photocoagulation by trainee doctors as an emergency procedure. Methods. Retrospective, case note analysis of 100 consecutive patients treated between August 2000 and December 2002 at a tertiary referral hospital. Result. The case notes of 100 consecutive patients (41 male,59 female)-with a mean age of 57.5 years were reviewed. Out of these 90 were symptomatic. The follow-up period ranged from 1 week to 8 months. All patients had argon laser retinopexy in the Emergency department. The on-call Registrar performed the procedure on 94 patients, and Senior House Officers performed the other six. A total of 98 procedures were performed on the slit lamp and two by laser indirect ophthalmoscope. In all, 24 patients needed further treatment with either indirect laser, cryotherapy, or surgery. At the last follow-up, all the patients had anatomically attached retinas. Conclusion. A significant proportion of patients (24% ) undergoing laser retinopexy in the emergency department needed further treatment. The relative inexperience in using the indirect laser, together with its unavailability in the Emergency department, may be the contributory factors. There seems to be scope for supervised training in using the laser indirect ophthalmoscope for the trainees in the Ophthalmic Emergency department.展开更多
Background: Perforating injuries continue to have a poor prognosis with less t han two-thirds of eyes having at least ambulatory final vision, due to prolifer ation originating from the exit wound. Materials and Metho...Background: Perforating injuries continue to have a poor prognosis with less t han two-thirds of eyes having at least ambulatory final vision, due to prolifer ation originating from the exit wound. Materials and Methods: We developed a new , proactive treatment method, which is applicable in most eyes with perforating trauma. The strategy involves limited, indirect ophthalmoscopic vitrectomy durin g the primary repair; heavy topical corticosteroid therapy postoperatively; and complete vitrectomyon day 3, including prophylactic retinectomy around the exit wound, evacuation of subretinal blood, laser retinopexy, and silicone oil implan tation. Results: In the five consecutive eyes in which the proactive treatment a pproach was used, no"enscarceration" of the retina into the exit wound, prolife rative vitreoretinopathy, retinal detachment, or retinal folding has occurred. T he median visual acuity improved from count fingers to 0.6 in the three eyes wit hout macular involvement. Conclusions: Far-reaching conclusions must not be mad e based on such a small series, but the proactive treatment approach appears pro mising in preventing proliferation-related complications such as fractional ret inal detachment or retinal fold development. A similar approach should be consid ered for eyes with deep impact trauma from intraocular foreign bodies and in eye s with incarcerated retina in the rupture wound.展开更多
文摘目的：观察使用计算机辅助双目间接检眼镜成像技术对早产儿视网膜病变（retinopathy of prematurity,ROP）进行表面麻醉下光凝手术的效果,探讨计算机辅助双目间接检眼镜成像技术条件下进行ROP光凝手术模式的应用价值。方法：回顾性研究,阈值前1期及阈值期ROP患儿58例116眼在术前、术中、术后分别使用计算机辅助的双目间接检眼镜成像技术对患儿视网膜进行检查,术前检查用于设计手术方案,术中检查用于检测病变区激光治疗的遗漏区,手术结束时用于记录手术效果。手术在实施心电监护后的表面麻醉下进行。随访312mo。结果：本组病例中术中使用计算机辅助双目间接检眼镜成像技术检查可及时发现36眼（31.0%）存在遗漏区,立即补充激光治疗。所有116眼一次激光治疗后ROP病变得到控制。随访结束时所有术眼均未出现视网膜不良结构。结论：表面麻醉条件下的早产儿视网膜光凝手术过程中,使用计算机辅助双目间接检眼镜成像技术进行眼底检查,可及时发现激光遗漏区,立即补充激光治疗后能够有效避免二次手术。
文摘Objective. To report the outcomes following treatment of retinal tears with argon laser photocoagulation by trainee doctors as an emergency procedure. Methods. Retrospective, case note analysis of 100 consecutive patients treated between August 2000 and December 2002 at a tertiary referral hospital. Result. The case notes of 100 consecutive patients (41 male,59 female)-with a mean age of 57.5 years were reviewed. Out of these 90 were symptomatic. The follow-up period ranged from 1 week to 8 months. All patients had argon laser retinopexy in the Emergency department. The on-call Registrar performed the procedure on 94 patients, and Senior House Officers performed the other six. A total of 98 procedures were performed on the slit lamp and two by laser indirect ophthalmoscope. In all, 24 patients needed further treatment with either indirect laser, cryotherapy, or surgery. At the last follow-up, all the patients had anatomically attached retinas. Conclusion. A significant proportion of patients (24% ) undergoing laser retinopexy in the emergency department needed further treatment. The relative inexperience in using the indirect laser, together with its unavailability in the Emergency department, may be the contributory factors. There seems to be scope for supervised training in using the laser indirect ophthalmoscope for the trainees in the Ophthalmic Emergency department.
文摘Background: Perforating injuries continue to have a poor prognosis with less t han two-thirds of eyes having at least ambulatory final vision, due to prolifer ation originating from the exit wound. Materials and Methods: We developed a new , proactive treatment method, which is applicable in most eyes with perforating trauma. The strategy involves limited, indirect ophthalmoscopic vitrectomy durin g the primary repair; heavy topical corticosteroid therapy postoperatively; and complete vitrectomyon day 3, including prophylactic retinectomy around the exit wound, evacuation of subretinal blood, laser retinopexy, and silicone oil implan tation. Results: In the five consecutive eyes in which the proactive treatment a pproach was used, no"enscarceration" of the retina into the exit wound, prolife rative vitreoretinopathy, retinal detachment, or retinal folding has occurred. T he median visual acuity improved from count fingers to 0.6 in the three eyes wit hout macular involvement. Conclusions: Far-reaching conclusions must not be mad e based on such a small series, but the proactive treatment approach appears pro mising in preventing proliferation-related complications such as fractional ret inal detachment or retinal fold development. A similar approach should be consid ered for eyes with deep impact trauma from intraocular foreign bodies and in eye s with incarcerated retina in the rupture wound.
