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基于小梁网-Schlemm管途径的微创青光眼手术治疗开角型青光眼的研究进展
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作者 孟素坤 刘建荣 《国际眼科杂志》 2025年第4期583-588,共6页
青光眼是全球首位不可逆性致盲性眼病,通过手术降低眼压是治疗开角型青光眼(OAG)的重要手段。近年来微创青光眼手术(MIGS)逐渐兴起,为青光眼的治疗提供了更多选择。基于小梁网-Schlemm管途径的MIGS作用于房水流出的主要途径,对眼部正常... 青光眼是全球首位不可逆性致盲性眼病,通过手术降低眼压是治疗开角型青光眼(OAG)的重要手段。近年来微创青光眼手术(MIGS)逐渐兴起,为青光眼的治疗提供了更多选择。基于小梁网-Schlemm管途径的MIGS作用于房水流出的主要途径,对眼部正常解剖结构的损伤较小,逐渐成为主流手术。根据作用机制主要分为小梁网切开类、小梁网旁路类和Schlemm管扩张类三种类型,代表术式和装置有内路房角镜下微导管/缝线辅助的全周小梁切开术(GATT)、微导管/缝线辅助下360°外路小梁切开术(MAT)、小梁消融术、双刃刀(KDB)、谷户钩(TMH)、准分子激光小梁切开术(ELT)、iStent系列、Hydrus微支架植入术、内路Schlemm管成形术(ABiC)、穿透性Schlemm管成形术(PCP)、新型微创内路三联(3T)手术。文章回顾了目前基于小梁网-Schlemm管途径的MIGS在OAG中应用的文献,旨在对此类MIGS治疗OAG的作用原理、有效性和安全性进行综述,并对各术式的优缺点进行总结,以期为OAG手术治疗的选择和临床研究提供参考。 展开更多
关键词 微创青光眼手术 小梁网 房水流出通路 开角型青光眼
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Research progress on the correlation between aqueous humor components and pathogenesis and postoperative complications in patients with different types of cataracts
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作者 Liang Chen Yan Hong 《国际眼科杂志》 CAS 2024年第11期1681-1694,共14页
Aqueous humor provides the necessary nutrition for the lens and transports the metabolites in the eye.It was a liquid that can directly reflect the microenvironment in the eye'and it can be easily obtained during ... Aqueous humor provides the necessary nutrition for the lens and transports the metabolites in the eye.It was a liquid that can directly reflect the microenvironment in the eye'and it can be easily obtained during the operation.This review intended to analyze the components of aqueous humor in patients with different types of cataracts'so as to reflect the pathogenesis and development of the disease'evaluate the incidence of postoperative complications and provide reference value for the surgical design of sequential cataract surgery.The aqueous humor components of different types of cataracts showed different degrees of inflammation'oxidative stress and extracellular matrix remodeling.The biomarker of early neuropathy in diabetic cataract was neural cell adhesion molecule-1(NCAM1).Transforming growth factor-β(TGF-β)was the evaluation factor of disease development in patients with pseudoexfoliation syndrome.The relationships between postoperative complications of different types of cataracts and aqueous humor components were as follows:Macular edema after diabetic cataract surgery was associated with tumor necrosis factor-alpha;capsular contraction after high myopic cataract surgery was related to monocyte chemoattractant protein-1(MCP-1)and TGF-β2;Klotho and glutathione S-transferase P 1(GSTP1)were associated with high intraocular pressure after primary open-angle glaucoma complicated by cataract surgery;capsular contraction after retinitis pigmentosa complicated by cataract surgery was associated with matrix metalloproteinases;pro-inflammatory cytokines and fibroblast growth factor 4 in the aqueous humor of congenital cataracts were associated with posterior capsular opacification after surgery.Granulocyte colony stimulating factor 3 and MCP-1 were the main cytokines mediating the pain of the second eye in the binocular sequential cataract surgery short interval(1 wk)'while MCP-1 mediated pain in the long interval(6 wk).The second eye after binocular sequential cataract surgery had a higher level of proinflammatory factors.The components of aqueous humor in patients with different types of cataracts were related to the pathogenesis and postoperative complications of the disease.Monitoring the components of the aqueous humor could help better understand the intraocular microenvironment of different types of cataracts and provide a reference for predicting the development of the disease and implementing relevant targeted therapy. 展开更多
关键词 aqueous humor CATARACT SURGERY COMPLICATIONS CYTOKINE
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玻璃体切除术联合地塞米松玻璃体内植入剂治疗特发性黄斑前膜
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作者 王爽 白淑玮 +1 位作者 雷春灵 李凤至 《国际眼科杂志》 CAS 2024年第10期1624-1628,共5页
目的:研究玻璃体切除术联合地塞米松玻璃体内植入剂治疗特发性黄斑前膜(IMEM)的疗效。方法:回顾性分析2019-01/2023-01在西安市人民医院诊断为IMEM患者72例72眼,按照不同治疗方式分为A组和B组,A组36眼接受玻璃体切除、黄斑前膜(ERM)剥... 目的:研究玻璃体切除术联合地塞米松玻璃体内植入剂治疗特发性黄斑前膜(IMEM)的疗效。方法:回顾性分析2019-01/2023-01在西安市人民医院诊断为IMEM患者72例72眼,按照不同治疗方式分为A组和B组,A组36眼接受玻璃体切除、黄斑前膜(ERM)剥除术联合地塞米松玻璃体内植入剂治疗;B组36眼仅接受玻璃体切除、ERM剥除术治疗。随访12 mo。比较术前及术后1、3、6、12 mo最佳矫正视力(BCVA)、眼压、黄斑中心凹视网膜厚度(CMT)、黄斑视网膜结构变化。结果:术后1、3、6 mo两组间BCVA比较有差异(均P<0.05),A组视力提高较明显;术后12 mo两组间BCVA比较无差异(P=0.056)。术后1、3、6 mo两组间CMT比较有差异(均P<0.05),A组患者术后CMT降低较B组明显;术后12 mo两组间CMT比较无差异(P=0.165)。两组手术前后各时间眼压比较有差异(F时间=2.763,P时间<0.05;F组间=26.800,P组间<0.05;F交互=5.091,P交互<0.05)。A组术后黄斑视网膜结构变化明显。结论:玻璃体手术联合地塞米松玻璃体内植入剂治疗晚期IMEM,能够在术后6 mo内迅速改善黄斑形态并帮助视功能恢复。 展开更多
关键词 特发性黄斑前膜 黄斑水肿 玻璃体内注射 地塞米松 玻璃体切除术
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蜡样芽孢杆菌性眼内炎的临床治疗观察 被引量:2
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作者 朱娟 陈涛 +1 位作者 常花蕾 冯茂飞 《国际眼科杂志》 CAS 北大核心 2023年第7期1230-1234,共5页
目的:分析外伤性蜡样芽孢杆菌性眼内炎的临床特征及抗生素敏感性,探讨早期诊治措施。方法:收集2019-01/2021-12陕西省眼科医院眼外伤中心收治的蜡样芽孢杆菌性眼内炎患者15例15眼的临床资料。记录受伤时间、受伤情况、术前视力、末次随... 目的:分析外伤性蜡样芽孢杆菌性眼内炎的临床特征及抗生素敏感性,探讨早期诊治措施。方法:收集2019-01/2021-12陕西省眼科医院眼外伤中心收治的蜡样芽孢杆菌性眼内炎患者15例15眼的临床资料。记录受伤时间、受伤情况、术前视力、末次随访矫正视力、手术方式、细菌培养及药敏试验检测结果。结果:纳入患者15例15眼中,5眼单纯角膜穿通伤行伤口清创缝合联合眼内抗生素注射;10眼眼球穿通伤合并外伤性白内障及眼内异物行清创、白内障切除、眼内异物取出、玻璃体切除联合硅油填充及眼内抗生素注射。末次随访时,11眼(73%)治疗有效,眼球保留;4眼(27%)治疗无效,行眼内容物剜除。眼球保留的11眼中,视力下降1眼(9%),视力不变1眼(9%),视力提高1级4眼(36%),视力提高2级5眼(45%),治疗后视力较治疗前明显改善。相关性分析显示,病程与最终矫正视力呈负相关(r_(s)=-0.762,P=0.001)。纳入患者玻璃体液及房水样本培养均为蜡样芽孢杆菌生长,药敏试验检测均对万古霉素敏感。结论:万古霉素是治疗蜡样芽胞杆菌性眼内炎的有效药物,尽早进行玻璃体切除联合硅油填充、万古霉素玻璃体内注射是治疗蜡样芽孢杆菌眼内炎的有效方法。 展开更多
关键词 眼外伤 蜡样芽胞杆菌 眼内炎 玻璃体切除术 万古霉素
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