Expressions of TGF-β2, bFGF and ICAM-1 in lens epithelial cells of complicated cataract with silicone oil tamponade

AIM： To investigate the expression differences of transforming growth factor-β2（TGF-β2）, basic fibroblast growth factor（b FGF） and intercellular cell-adhesion molecule-1（ICAM-1） in lens epithelial cells（LECs） of complicated cataract with silicone oil tamponade and agerelated cataract. METHODS： Totally 150 eyes of 150 patients（aged 35 to 77y） were investigated, including 75 patients with complicated cataract after silicone oil tamponade and 75 patients with age-related cataract. The central piece of anterior capsules was collected during cataract surgery. TGF-β2, b FGF and ICAM-1 were detected in the 60 specimens of the two groups by immunohistochemistry. The expression levels of the three kinds of messenger ribonucleic acid（m RNA） were determined by real-time quantitative reverse transcriptionpolymerase chain reaction in the 90 specimens of the two groups.RESULTS： TGF-β2 was detected in the cytomembrane and cytoplasm of the LECs and b FGF was detected in the nucleus. ICAM-1 was positive in the cytomembrane of the LECs and the distribution of positive cells was uneven. The m RNA genes expression of the TGF-β2, b FGF and ICAM-1 was significant differences between the two groups and markedly increased in complicated cataract group（P〈0.05）.CONCLUSION： The up-regulated TGF-β2, b FGF and ICAM-1 maybe associate with the occurrence and development of complicated cataract with silicone oil tamponade.

Long-term follow-up of cataract surgery in eyes filled with silicone oil

AIM:To evaluate the refractive and long-term outcome of eyes filled with silicone oil(SO)undergoing phacoemulsification cataract surgery(PCS).METHODS:This retrospective study evaluated patients with SO tamponade who were scheduled for PCS.RESULTS:Subjects(n=26)were followed for 29.5±13.9 mo after cataract surgery.The median spherical equivalent refraction(SER)was+5.3 D[interquartile range(IQR)+2.9 to+6.7]before PCS,and+3.4 D(IQR+2.0 to+4.4)after PCS.Within the follow-up period retinal reattachment after SO removal was achieved in 15 out of 26 eyes(57.7%).In 13 eyes assessment of refraction after SO-removal was possible,and showed a myopic shift of-4.6 D(IQR-2.9 to-7.3)in the SER.After SO removal,5 of the 13 eyes(38.5%)were within±1.0 D of the target refraction,while 9 out of the 13 eyes(69.2%)were within±2.0 D.CONCLUSION:In our study,the refraction after PCS for eyes filled with SO manifested low predictability,as did the myopic shift following SO removal.A significant percentage of the eyes that underwent SO administration required a long-term tamponade.

Axial length,vitreoretinal pathology,and anterior chamber depth can predict postoperative refractive outcomes in phacovitrectomy/silicone oil removal

AIM:To evaluate the postoperative refractive prediction error(PE)and determine the factors that af fect the refractive outcomes of combined pars plana vitrectomy(PPV)or silicone oil removal(SOR)with cataract surgery.METHODS:The study is a retrospective,case-series study.Totally 301 eyes of 301 patients undergoing combined PPV/SOR with cataract surgery were enrolled.Eligible individuals were separated into four groups according to their preoperative diagnoses:silicone oil-filled eyes after PPV(group 1),epiretinal membrane(group 2),macular hole(group 3),and primary retinal detachment(RD;group 4).The variables af fecting postoperative refractive outcomes were analyzed,including age,gender,preoperative best-corrected visual acuity(BCVA),axial length(AL),keratometry average,anterior chamber depth(ACD),intraocular tamponade,and vitreoretinal pathology.The outcome measurements include the mean refractive PE and the proportions of eyes with a PE within±0.50 diopter(D)and±1.00 D.RESULTS:For all patients,the mean PE was-0.04±1.17 D,and 50.17%of patients(eyes)had a PE within±0.50 D.There was a significant difference in refractive outcomes among the four groups(P=0.028),with RD(group 4)showing the least favorable refractive outcome.In multivariate regression analysis,only AL,vitreoretinal pathology,and ACD were strongly associated with PE(all P<0.01).Univariate analysis revealed that longer eyes(AL>26 mm)and a deeper ACD were correlated with hyperopic PE,and shorter eyes(AL<26 mm)and a shallower ACD were correlated with myopic PE.CONCLUSION:RD patients have the least favorable refractive outcome.AL,vitreoretinal pathology,and ACD are strongly associated with PE in the combined surgery.These three factors affect refractive outcomes and thus can be used to predict a better postoperative refractive outcome in clinical practice.

Timely vitrectomy without intraocular lens removal for acute endophthalmitis after cataract surgery

AIM:To investigate the clinical features,causative organisms and effects of timely vitrectomy and silicone oil tamponade without intraocular lens(IOL)removal in the treatment of acute-onset endophthalmitis after cataract surgery(APCE).METHODS:We retrospectively analyzed the clinical features and microbiological factors in 10 eyes of 10 patients with APCE at Tianjin Medical University General Hospital from January 2010 to December 2018.Data on the clinical features,causative organisms,visual acuity,intraocular pressure(IOP)and complications were collected.The mean follow-up period was 25.5 mo.RESULTS:The mean age of the patients was 71.4 y.The mean time between cataract surgery and the onset of endophthalmitis was 2.0 d.Preoperative visual acuity ranged from no light perception to hand motion.After vitrectomy,the visual acuity increased in nine eyes(90%),and was unchanged in one eye(10%).A significant difference was observed between the mean preoperative(36.3±7.1 mm Hg)and postoperative IOP(14.9±4.3 mm Hg,P<0.05).Staphylococcus epidermidis was isolated in 5 eyes,S.aureus in 2 eyes,and Enterococcus in 1 eye.Postoperative complications mainly included fibrin exudates in the anterior chamber at the early stages in all eyes and temporary IOP elevation in one eye.No retinal detachment or ocular atrophy was observed during the follow-up period.CONCLUSION:Under systemic antibiotic treatment and timely diagnosis,vitrectomy and silicone oil tamponade without IOL removal is a safe and effective method for APCE.

白内障超声乳化人工晶状体植入联合硅油取出术临床疗效观察

目的探讨玻璃体切割术后硅油充填眼行白内障超声乳化人工晶状体植入联合硅油取出术的临床疗效。方法 2010年8月—2011年6月对35例(36眼)玻璃体切割术后硅油充填眼白内障患者行白内障超声乳化人工晶状体植入联合硅油取出术,观察患者术后1个月最佳矫正视力以及术后并发症发生情况。结果术后1个月,3眼(8.33%)最佳矫正视力<0.01,5眼(13.89%)为0.01～0.04,10眼(27.78%)为0.05～0.09,15眼(41.67%)为0.1～0.25,3眼(8.33%)≥0.3。所有患者均无持续性角膜内皮失代偿、硅油泡残留、人工晶状体移位和玻璃体出血等并发症发生。结论玻璃体切割术后硅油充填眼行白内障超声乳化人工晶状体植入联合硅油取出术安全、有效。

微切口超声乳化术联合硅油取出术治疗玻切术后硅油填充眼合并白内障

目的:观察玻璃体切割术后硅油填充眼行微切口白内障超声乳化联合睫状体平坦部硅油取出术的临床疗效。方法:2013-02/11对43例43眼玻璃体切割术后硅油填充眼合并白内障患者行微切口白内障超声乳化联合睫状体平坦部硅油取出术,术中均Ⅰ期植入人工晶状体,观察患者术后3mo最佳矫正视力和手术并发症发生情况等。结果:术后3mo,最佳矫正视力较术前提高者共39例(91%),最高矫正视力达0.6,视力无提高者4例(9%)。所有患者均未发生后囊膜破裂、硅油残留、角膜内皮失代偿、前房积血、玻璃体积血、人工晶状体移位、继发性青光眼、锯齿缘离断等并发症。结论:微切口超声乳化人工晶状体植入术联合睫状体平坦部硅油取出术是一种有效、安全的手术方式。

不同材料的人工晶状体植入术后的临床疗效观察

目的 评价超声乳化白内障吸出联合不同材料制成的人工晶状体植入术治疗白内障的疗效。方法 将 14 5例(14 8眼 )行超声乳化白内障吸出联合人工晶状体植入术的患者分为 3组 ,术中随机植入PMMA人工晶状体、新型疏水性丙烯酸酯类、硅凝胶类折叠式人工晶状体。比较术前和术后视力、散光情况。统计术后晶状体后囊膜混浊情况及行Nd :YAG激光后囊膜切除术的情况。结果 术后早期视力、3个月后散光度数、晶状体后囊膜混浊发生率及行Nd :YAG激光后囊膜切除术的情况 ,植入折叠式人工晶状体者均优于植入非折叠式人工晶状体者。植入Canonstaar硅凝胶类折叠式人工晶状体组术后散光最小。植入AcrysofTM新型疏水性丙烯酸酯类折叠式人工晶状体组术后晶状体后囊膜混浊发生率及行Nd :YAG激光后囊膜切除术的比例最低。结论 超声乳化白内障吸出联合折叠式人工晶状体植入的临床应用效果满意。

非超声乳化小切口白内障人工晶体植入治疗老年性白内障的观察

目的探讨非超声乳化小切口白内障摘出联合人工晶状体植入术治疗老年性白内障的临床效果。方法对46例51眼老年性白内障患者施行非超声乳化小切口白内障摘出联合后房型人工晶状体植入术,观察术后视力恢复、散光及并发症。结果术后1周、1个月、3个月裸眼或矫正视力≥0.5者分别占84.4%、92.2%、94.2%;≥1.0者分别占49.0%、54.9%、56.9%。术前、术后1周、1个月和3个月平均散光分别为(0.92±0.79)D、(1.38±0.58)D、(0.98±0.63)D和(0.97±0.59)D,术后1周与术前比较有显著差异(P<0.001),术后1个月和3个月与术前比较无显著差异(P>0.05)。无娩核困难、后囊膜破裂、玻璃体脱出、人工晶状体偏位和虹膜损伤等并发症。结论非超声乳化小切口白内障摘出联合人工晶状体植入术治疗老年性白内障具有创伤小、角膜散光小、术后视力恢复良好、并发症少等优点。

前葡萄膜炎小瞳孔并发白内障超声乳化术的临床观察

目的 探讨前葡萄膜炎小瞳孔并发白内障行超声乳化吸出术的临床效果。方法 对 41例 43眼前葡萄膜炎小瞳孔并发白内障患者行超声乳化白内障摘除联合人工晶体植入术。采用三种方法扩大瞳孔 :① 19眼行机化膜剪除联合放射状瞳孔松解术 ;② 11眼行直接牵拉扩张瞳孔 ;③ 13眼单纯分离粘连 ,用粘弹剂扩张瞳孔。结果 术后瞳孔均保持 3～ 3 5mm圆形 ,无粘连 ,具有一定活动度。术后视力 :术后 1周≥ 0 5占 62 8% ,术后 1个月≥ 0 5占 69 9%。并发症 :后囊破裂 2眼 (4 7% ) ,角膜水肿 6眼 (13 9% ) ,3～ 5d水肿消失 ,虹膜睫状体炎 1眼 (2 3 % )。结论 超声乳化术治疗葡萄膜炎小瞳孔并发白内障是安全有效的 ,可获得良好的术后视力 ,且瞳孔圆形 。

硅油取出联合白内障摘除并人工晶状体植入术的临床分析

目的:对硅油填充术后白内障手术结果进行总结分析。方法:行白内障囊外摘除联合人工晶状体植人及取出硅油。结果:经4～24mo随访,22例(22眼),视力2眼(9%)光感～指数;12眼(54%)≥0.1;6眼(27%)达到≥0.3;1眼(5%)最佳矫正视力达1.0;其中1眼(5%)出现视网膜脱离复发,经再次硅油充填后视网膜复位。结论:硅油填充术后的白内障囊外摘除联合人工晶状体植入术与同时取出硅油是一种较理想的方法。

硅油眼的硅油取出联合白内障超声乳化术的疗效观察

目的观察玻璃体切除术后硅油填充眼患者硅油取出联合超声乳化人工晶状体植入术的术后视力、屈光度变化和术中及术后并发症情况。方法收集17例(17眼)玻璃体切除术后硅油填充眼的白内障患者,行硅油取出联合超声乳化人工晶状体植入术,观察术前及术后最佳矫正视力(BCVA)、眼压,术中及术后并发症情况,并对术后实际屈光度和术前目标屈光度进行比较。结果随访时间为3～14.5个月,平均(4.00±2.81)个月。6眼术后BCVA为0.05～0.1,6眼为0.12～0.3,4眼为0.4～0.7,1眼>0.8。术后眼压为(13.61±3.67)mm Hg(1mm Hg=0.133kPa),与术前(16.31±6.95)mm Hg相比,差异无统计学意义(Z=1.1043,P=0.2933)。术后实际测得屈光度为(-1.09±3.91)D,与术前目标屈光度(-1.46±1.29)D相比,差异无统计学意义(Z=3.7504,P=0.0527)。术中1眼出现灌注偏离综合征,9眼行中央部后囊膜切除,所有患者术中未出现晶状体坠入玻璃体腔等并发症。术后早期5眼出现轻度角膜水肿,1眼行掺钕钇铝石榴石(Nd:YAG)激光后囊膜切开,2眼发生视网膜再次脱离。结论玻璃体切除硅油填充患者行硅油取出联合超声乳化人工晶状体植入术可有效提高视力,术后实际屈光度与术前目标屈光度较为一致,手术并发症少,手术方法安全、有效。

硅油取出联合白内障超声乳化及人工晶状体植入术

目的:探讨硅油充填眼并发性白内障行硅油取出联合白内障超声乳化及人工晶状体植入术的临床效果。方法:对25例25眼硅油填充术后并发性白内障患者进行经睫状体扁平部切口取硅油联合白内障超声乳化及人工晶状体植入术。结果:术后随访3～12(平均7)mo。手术后最佳矫正视力:光感～指数/眼数者3眼,0.02～0.1者4眼,0.1～0.2者10眼,>0.2者8眼。所有患者均无持续性角膜内皮失代偿、硅油泡残留、人工晶状体移位、玻璃体出血等并发症。结论:硅油取出联合白内障超声乳化及人工晶状体植入术是安全、有效的。

人工晶状体植入治疗先天性白内障56例

目的 :观察人工晶体植入手术联合视功能训练对先天性白内障患儿视功能恢复的影响 ,探讨先天性白内障的治疗方法。方法 :对 5 6例 ( 72眼 )先天性白内障人工晶状体植入术后视功能恢复情况进行回顾性分析 ,采用白内障超声乳化术或双腔注吸术 ,掌握手术和人工晶状体植入时机、选择适宜的人工晶状体度数、术中一期后囊膜撕开 ,术后及时进行双眼视功能训练。术后随访 2年以上。结果 :术后 2年 ,矫正视力≥ 0 .3者 5 5眼 ( 76.4% ) ,具有融合功能者 2 4例 ( 4 2 .9% ) ,具有立体视觉者 2 2例 ( 39.3% )。中央视轴区透明者 65眼( 90 .3% ) ,后囊及玻璃体前界膜增殖膜形成者 7眼 ( 9.7% )。结论 :先天性白内障人工晶状体植入手术时机、术式选择恰当 。

玻璃体切割硅油充填术后白内障手术

白内障是硅油充填术后常见并发症,常以后囊下及核性混浊为主。其形成有很多因素引起.有关并发性白内障的手术方法有多种,国外有学者提出单一角膜切口行超生乳化及硅油取出术。亲水性丙烯酸酯材料的人工晶状体被认为适用于硅油眼。但有关人工晶状体的选择还需进一步论证。

271例后房型人工晶体植入术的远期随访

本文报道271例(300只限)白内障囊外摘出后房型人工晶体植入术,随访24～112月,并就其手术方法、术后视力恢复情况、并发症的产生原因及预防处理方法,以及手术要点,均作了较为详细的讨论。

超声乳化白内障摘除人工晶体植入术1560例临床观察

对1999年10月至2004年12月开展超声乳化白内障手术以来,年龄40岁以上的白内障患者1 560例1 620眼进行分析总结.结果显示:术后1周视力>0.3者1 474眼,占91%,>0.5者1 377眼,占85%,>1.0者243眼,占15%.并发症为后囊膜破裂者占1.91%,前囊膜撕裂者占1.1%,化脓性眼内炎2眼.超声乳化白内障手术效果显著.

白内障并硅油眼的人工晶状体测量

目的:探讨利用矫正眼球长度来测量计算白内障并硅油眼人工晶状体度数方法的有效性。方法:选取因玻璃体切除术后白内障并硅油眼患者28例28眼,年龄25～72岁。患者均采取坐位方式来测量角膜曲率及眼球长度,测量过程中将玻璃体腔内超声传播速度由1532m/s修改为990m/s,再按SKR-Ⅱ公式来计算人工晶状体度数。患者在同一次手术中行白内障超声乳化摘除、人工晶状体植入及硅油取出。结果:患者28例均顺利植入人工晶状体,取出眼内硅油。术后无严重并发症,患者术后1mo的屈光度在-2.00～2.50DS。结论:利用改良方式来测量白内障并硅油眼的眼轴长度及计算人工晶状体度数是一项可行的临床测量方法。

同一切口完成硅油取出和白内障摘出术临床观察

目的观察硅油存留眼同一角巩膜切口完成硅油取出和白内障摘出术的有效性与安全性。方法对23例(23眼)原硅油充填眼行超声乳化或小切口白内障摘出联合硅油取出术。后囊撕开,使硅油经瞳孔和巩膜隧道排出。结果全部病例硅油完全取出,17眼顺利植入后房型人工晶状体,术后视力均保持视网膜脱离术后水平或有所提高。所有病例未发现玻璃体出血、持续性角膜变性、后发白内障和与手术相关的黄斑囊样水肿。术后3个月复查3例视网膜再脱离,发生率为13%。结论同一切口取出硅油和白内障手术安全有效,手术时间短,并发症少。

硅油填充术后白内障摘除及人工晶体植入术

目的对硅油填充术后白内障手术结果进行回顾性总结。方法行白内障囊外摘除联合人工晶体植入及取出硅油。结果经６－２０个月随访，２３例（２３只眼），术后视力≥ ０．１者１４眼（６０． ８７％），≥０．３者９眼（３９． １３％）。术中后囊破裂８只眼。结论硅油填充术后的白内障囊外摘除联合人工晶体植入术与同时取出硅油是一种较理想的方法。

超声乳化人工晶体植入联合23G/25G微创硅油取出术治疗视网膜脱离玻璃体切割术后硅油填充眼并发白内障的临床观察

目的:探讨超声乳化人工晶体植入联合23G/25G微创硅油取出术治疗视网膜脱离玻璃体切割术后硅油填充眼并发白内障的疗效。方法:回顾性分析超声乳化人工晶体植入联合23G/25G微创硅油取出术治疗的视网膜脱离玻璃体切割术后硅油填充眼并发白内障患者52例的临床资料。结果:术后3个月,患者视力均有不同程度的提高。所有患者无角膜损害,人工晶状体无移位,眼压正常。结论:超声乳化人工晶体植入联合23G/25G微创硅油取出术治疗视网膜脱离玻璃体切割术后硅油填充眼并发白内障的疗效显著。