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Vitreous surgery for severe ocular trauma

Objective To summarize the visual outcome of patients with severe ocular trauma treated with vitreous surgery. Methods Clinical data of 188(191 eyes) with severe ocular trauma treated with vitreous surgery in a period from November 1996 to April 1998 were analysed retrospectively. Results The study included penetrating injury in 56 eyes, foreign bodies in the posterior segment in 70 eyes, blunt injury in 41 eyes , and globe rupture in 24 eyes. Main complications included endophthalmitis in 35 eyes, choroidal bleeding in 20 eyes, retinal detachment in 60 eyes, and vitreous hemorrhage in 97 eyes. Post-opera-tively, out of 188 eyes, except for 3 of patients too young to examine, visual acuity improved in 133(70.7%), including 85(45.2%) with visal acuity 0.02-1.0, 46(24.5%) remained unchanged; and 9(4.8%) had worse vision. Among 34 with no-light-perception, 12 had light-perception or over. Conclusion A majority of severe trauma eyes can be salvaged with considerable visual recovery after adequate and timely vitreous surgery. (Chin J Ocul Fundus Dis,1999,15:4-6)

帶狀皰疹性葡萄膜炎并前房積血二例

新型血小板聚集功能缺陷癥并眼底出血二例

報告2例新型血小板聚集功能缺陷癥所致的眼底出血，用AP方案治療有效。討論了出血的機制，認為本病眼底出血同全身出血傾向一樣，與血小板膜糖蛋白Ⅲa位點上刺參酸性粘多糖受體被某種輔因子遮蔽有關。 （中華眼底病雜志，1994，10：176-177）

The Relationship among Neonatal Hypoxicischemic Encephalopathy Graduation and Intracranial Hemorrhage and Evaluation the Prognosis by Computer Tomography

目的:通過CT影像資料評價新生兒缺氧缺血性腦病與顱內出血量的關系及其預后。方法:收集1998~2006年臨床診斷為缺氧缺血性腦病70例新生兒患者的CT資料,觀察CT圖像顯示的腦出血量,分析不同程度的缺氧缺血性腦病和出血部位與顱內出血量和預后的關系。結果:新生兒缺氧后輕、中度出血在1~2周內均可完全吸收,發生在基底節或大腦白質區域的重度出血預后較差。結論:顱內出血量與窒息缺氧程度呈正相關;發生在不同部位的出血,其預后不同。

Analysis of Micro-trauma Technique Cooperated with Liquefaction Drainage Treating 120 Patients with Hypertensive Putamen Hemorrhage

目的:應用微創液化引流術治療高血壓殼核出血的療效。方法:對120例高血壓殼核出血患者,在CT引導下,依據血腫大小、形態及患者病情,選擇適宜的穿刺點、方向,行CT平面導向下微創液化引流術,清除血腫。結果:120例患者出院94例,死亡26例,病死率為21.6%。對存活65例患者隨訪6個月至2年,以日常生活能力(ADL)評估患者神經功能,ADL128例(43％),ADL220例(30.7%)、ADL310例(15.3％)、ADL45例(7.6％)、ADL52例(3.0%)。結論:應用微創液化引流治療殼核出血,能最大限度地清除血腫,避免或減輕并發癥,具有較大優越性。

特發性血小板減少性紫癜以眼科癥狀為首診一例

原發性血小板增多癥致眼底出血及視網膜靜脈阻塞一例

Microsurgical Treatment of Hypertension Brainstem Hemorrhage

目的:探討高血壓腦干出血的顯微外科治療的手術指征、手術技巧、效果和預后。方法: 回顧性分析21例高血壓腦干出血患者的臨床資料、手術方式、治療效果及隨訪資料。結果:21例患者均于顯微鏡下清除血腫,無手術死亡,術中運用神經電生理監測。11例患者術后神經功能障礙得到改善,5例癥狀加重持續昏迷。5例術后死亡,術后隨訪6～18個月,9例生活基本能夠自理,7例長期臥床。結論: 采用顯微外科技術治療高血壓腦干出血,效果良好。

Efficacy of vitrectomy for vitreous hemorrhage in patients with polypoidal choroidal vasculopathy

Objective To observe the efficacy of vitrectomy for vitreous hemorrhage in patients with polypoidal choroidal vasculopathy (PCV). Methods Fourteen patients (14 eyes) of PCV with vitreous hemorrhage diagnosed by routine ophthalmologic examination, A and/or B mode ultrasound, fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) were enrolled in this study. The patients included eight males (eight eyes) and six females (six eyes), with the mean age of (58.7plusmn;6.0) years. All patients received vitrectomy with silicone oil and C3F8 gas tamponade. There were eight eyes received photodynamic therapy (PDT) after surgery. The retinal reattachment, visual acuity, pathological lesion degree and complications were comparatively analyzed. Results Among 14 eyes, six eyes (42.9%) recovered, seven eyes (50.0%) improved, and one eye (7.1%) aggravated. Ten eyes achieved retinal reattachment after surgery, while four eyes developed retinal detachment after the first surgery. The retina remained attached in these three eyes after silicon oil tamponade, C3F8 gas tamponade and scleral buckling, respectively; but one eye maintained silicon oil without special treatment. Thirteen eyes (92.9%) achieved retinal reattachment finally. Five eyes of them occurred hyphema one to seven days after surgery, but hyphema was absorbed and intraocular pressure was stable after douche of anterior chamber and pharmacotherapy. The vision improved with more than two lines in one eyes, improved with one to two lines in one eye, unchanged in 10 eyes, and decreased in two eyes. Of eight eyes who underwent PDT, abnormal vessels regressed in five eyes, abnormal vessels remained in three eyes. Conclusions Vitrectomy can remove cloudy refracting media for PCV with vitreous hemorrhage. The combined treatment of vitrectomy and PDT can improve or stabilize visual function,is an effective therapy for the PCV with vitreous hemorrhage.

Effects of vitrectomy on neovascular glaucoma combined with vitreous hemorrhage

ObjectiveTo explore the effects of vitrectomy on neovascular glaucoma combined with vitreous hemorrhage.MethodsSeven eyes of 7 patients with neovascular glaucoma combined with vitreous hemorrhage underwent vitrectomy combined with phacoemulsification, panretinal photocoagulation, and trabeculectomy. The preoperative visual acuity ranged from light perception to 0.2, and the mean preoperative intraocular pressure was 54 mm Hg (38-64 mm Hg)(1 mm Hg=0.133 kPa). The mean follow-up was 8 months (6-15 months).ResultsThe postoperative visual acuity ranged from light perception to 0.4, and the mean postoperative intraocular pressure was 17 mm Hg (10-30 mm Hg) which was significantly lower than preoperative one (Plt;0.05). The postoperative complications mainly included fibrosis exudates in anterior chamber (7 eyes), intraocular pressure elevation 1-2 weeks after the operation (2 eyes), and postoperative suprachoroidcavity hemorrhage (2 eyes).ConclusionVitrectomy combined with phacoemulsification, panretinal photocoagulation, and trabeculectomy may be effective procedures for some cases of neovascular glaucoma combined with vitreous hemorrhage.(Chin J Ocul Fundus Dis, 2005,21:148-149)