目的观察小切口白内障囊外摘除人工晶状体(IOL)植入联合房角分离术治疗原发性闭角型青光眼(PACG)合并白内障的患者临床疗效及手术适应证的探讨。方法已确诊为PACG患者92例(92眼),均合并有程度不同的晶状体混浊。所有患者行小切口...目的观察小切口白内障囊外摘除人工晶状体(IOL)植入联合房角分离术治疗原发性闭角型青光眼(PACG)合并白内障的患者临床疗效及手术适应证的探讨。方法已确诊为PACG患者92例(92眼),均合并有程度不同的晶状体混浊。所有患者行小切口白内障囊外摘除IOL植入联合房角分离术,术后随访9~24个月。随访观察手术前后眼压、视力、中央前房深度、房角形态、房水流畅系数与压畅比和降眼压用药数量等的变化情况。结果术后随访最终平均眼压明显低于术前平均眼压(P〈0.01),术后最佳矫正视力好于术前(P〈0.01)。前房深度加深(P〈0.01)。房角全部开放72眼(78.26%)。术后房水流畅系数与压畅比有明显改善(P〈0.01)。术后平均使用降眼压药数量明显减少(P〈0.01)。另14眼(15.22%)虽经联合降眼压,术后眼压仍大于25 mm Hg(1 mm Hg=0.133 k Pa),遂加行小梁切除术。结论小切口白内障摘除IOL植入联合房角分离术,能有效降低眼压、加深前房、开放房角、改善视功能,对合并白内障的闭角型青光眼,是安全经济有效的手术方法,对于无超声乳化设备的基层医院值得推广应用。但对于术前房角粘连关闭大于270°的患者,联合采用小梁切除术,对于挽救患者的视功能,是必要和稳妥的。展开更多
Objective To evaluate topical interferon alfa 2b (IFNα2b) as a single therape utic agent in the treatment of presumed recurrent corneal and conjunctival intra epithelial neoplasia. Design Noncomparative, retrospectiv...Objective To evaluate topical interferon alfa 2b (IFNα2b) as a single therape utic agent in the treatment of presumed recurrent corneal and conjunctival intra epithelial neoplasia. Design Noncomparative, retrospective case series. Particip ants Seven consecutive patients with recurrent corneal and conjunctival intraepi thelial neoplasia diagnosed at the University of Minnesota from July 2000 to Nov ember 2003 were studied retrospectively. All patients had a history of histologi cally proven primary corneal and conjunctival intraepithelial neoplasia and were treated by surgery, cryotherapy, radiation, and/or topical mitomycin C before r ecurrence. Intervention Patients with a clinical diagnosis of recurrent corneal and conjunctival intraepithelial neoplasia were treated with recombinant topical IFNα2b drops (1 million IU/ml) 4 times daily until lesion resolution was noted. Main outcome measures A review of medical records was performed to asse ss the duration of and response to treatment with topical IFNα2b, defined by cl inical resolution of corneal and conjunctival intraepithelial neoplasia. Results The average age of the 7 patients at the initiation of topical IFNα2b treatmen t for presumed recurrent corneal and conjunctival intraepithelial neoplasia was 68.7 years (range, 54-88). Six of 7 patients had successful treatment of recurr ent corneal and conjunctival intraepithelial neoplasia lesions with topical IFN α2b treatment. The average length of IFNα2b treatment to resolution of recurre nt corneal and conjunctival intraepithelial neoplasia was 14.5 weeks (range, 5- 24). After treatment with topical IFNα2b for recurrent corneal and conjunctival intraepithelial neoplasia, 2 patients had another recurrence of corneal and con junctival intraepithelial neoplasia, noted at 1 year and 2 months, respectively. The average post treatment follow-up was 11.7 months (range, 8-17) after the resolution of recurrent corneal and conjunctival intraepithelial neoplasia. No s ide effects of treatment were noted in any patient. Conclusions Topical IFNα2b as a single therapeutic agent is an effective treatment of presumed recurrent co rneal and conjunctival intraepithelial neoplasia. It offers the benefits of topi cal therapy and avoids the risks of surgical or other interventions specifically , ocular surface toxicity, cicatricial conjunctival changes, and limbal stem cel l deficiency. Larger controlled studies with longer follow-up periods are recom mended to confirm the longterm efficacy and safety of this topical treatment.展开更多
文摘目的观察小切口白内障囊外摘除人工晶状体(IOL)植入联合房角分离术治疗原发性闭角型青光眼(PACG)合并白内障的患者临床疗效及手术适应证的探讨。方法已确诊为PACG患者92例(92眼),均合并有程度不同的晶状体混浊。所有患者行小切口白内障囊外摘除IOL植入联合房角分离术,术后随访9~24个月。随访观察手术前后眼压、视力、中央前房深度、房角形态、房水流畅系数与压畅比和降眼压用药数量等的变化情况。结果术后随访最终平均眼压明显低于术前平均眼压(P〈0.01),术后最佳矫正视力好于术前(P〈0.01)。前房深度加深(P〈0.01)。房角全部开放72眼(78.26%)。术后房水流畅系数与压畅比有明显改善(P〈0.01)。术后平均使用降眼压药数量明显减少(P〈0.01)。另14眼(15.22%)虽经联合降眼压,术后眼压仍大于25 mm Hg(1 mm Hg=0.133 k Pa),遂加行小梁切除术。结论小切口白内障摘除IOL植入联合房角分离术,能有效降低眼压、加深前房、开放房角、改善视功能,对合并白内障的闭角型青光眼,是安全经济有效的手术方法,对于无超声乳化设备的基层医院值得推广应用。但对于术前房角粘连关闭大于270°的患者,联合采用小梁切除术,对于挽救患者的视功能,是必要和稳妥的。
文摘Objective To evaluate topical interferon alfa 2b (IFNα2b) as a single therape utic agent in the treatment of presumed recurrent corneal and conjunctival intra epithelial neoplasia. Design Noncomparative, retrospective case series. Particip ants Seven consecutive patients with recurrent corneal and conjunctival intraepi thelial neoplasia diagnosed at the University of Minnesota from July 2000 to Nov ember 2003 were studied retrospectively. All patients had a history of histologi cally proven primary corneal and conjunctival intraepithelial neoplasia and were treated by surgery, cryotherapy, radiation, and/or topical mitomycin C before r ecurrence. Intervention Patients with a clinical diagnosis of recurrent corneal and conjunctival intraepithelial neoplasia were treated with recombinant topical IFNα2b drops (1 million IU/ml) 4 times daily until lesion resolution was noted. Main outcome measures A review of medical records was performed to asse ss the duration of and response to treatment with topical IFNα2b, defined by cl inical resolution of corneal and conjunctival intraepithelial neoplasia. Results The average age of the 7 patients at the initiation of topical IFNα2b treatmen t for presumed recurrent corneal and conjunctival intraepithelial neoplasia was 68.7 years (range, 54-88). Six of 7 patients had successful treatment of recurr ent corneal and conjunctival intraepithelial neoplasia lesions with topical IFN α2b treatment. The average length of IFNα2b treatment to resolution of recurre nt corneal and conjunctival intraepithelial neoplasia was 14.5 weeks (range, 5- 24). After treatment with topical IFNα2b for recurrent corneal and conjunctival intraepithelial neoplasia, 2 patients had another recurrence of corneal and con junctival intraepithelial neoplasia, noted at 1 year and 2 months, respectively. The average post treatment follow-up was 11.7 months (range, 8-17) after the resolution of recurrent corneal and conjunctival intraepithelial neoplasia. No s ide effects of treatment were noted in any patient. Conclusions Topical IFNα2b as a single therapeutic agent is an effective treatment of presumed recurrent co rneal and conjunctival intraepithelial neoplasia. It offers the benefits of topi cal therapy and avoids the risks of surgical or other interventions specifically , ocular surface toxicity, cicatricial conjunctival changes, and limbal stem cel l deficiency. Larger controlled studies with longer follow-up periods are recom mended to confirm the longterm efficacy and safety of this topical treatment.