目的:探讨白内障超声乳化术后角膜后弹力层脱离(Descemet’s membrane detachment, DMD)患者接受前房注气术的解剖复位和视功能恢复情况。方法:本研究回顾性分析了2014年10月至2019年10月期间在汕头国际眼科中心诊断白内障术后角膜后弹...目的:探讨白内障超声乳化术后角膜后弹力层脱离(Descemet’s membrane detachment, DMD)患者接受前房注气术的解剖复位和视功能恢复情况。方法:本研究回顾性分析了2014年10月至2019年10月期间在汕头国际眼科中心诊断白内障术后角膜后弹力层脱离并接受了前房注气术治疗患者的临床资料。主要观察指标为角膜后弹力层是否重新附着以及术后最佳矫正视力。结果:患者平均年龄为70.16 ± 9.99岁,男女比例为9:16。在首次前房注气术后,25例患者中有18例(72%)角膜后弹力层成功复位。常见并发症包括持续性DMD (24%)、气体相关性瞳孔阻滞(8%)、接触式房角关闭(4%)、角膜内皮失代偿(4%)和葡萄膜炎(4%)。复位成功率与患者年龄、性别和干预时间无显著相关性。6例患者因持续性DMD接受了二次的前房注气术,6名(100%)均成功重新附着。在解剖上成功复位的患者,72%在术后一个月的最佳矫正视力优于0.5。结论:前房注气术是治疗角膜后弹力层脱离的一种安全有效方法,即便面对脱离时间长的病例。Purpose: To evaluate the anatomical reattachment and visual recovery outcomes of Descemet’s membrane detachment (DMD) after phacoemulsification cataract surgery treated with anterior chamber air injection. Methods: This retrospective study analyzed the clinical data of patients diagnosed with post-cataract surgery DMD who underwent anterior chamber air injection at Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong from October 2014 to October 2019. The primary outcomes included the rate of anatomical reattachment of Descemet’s membrane and the postoperative best-corrected visual acuity (BCVA). Results: The mean age of patients was 70.16 ± 9.99 years, with a male-to-female ratio of 9:16. After the first anterior chamber air injection, 18 of 25 patients (72%) achieved successful Descemet’s membrane reattachment. Common complications included persistent DMD (24%), gas-induced pupillary block (8%), acute angle-closure glaucoma (4%), corneal endothelial decompensation (4%), and uveitis (4%). The success rate of reattachment was not significantly correlated with age, gender, or timing of intervention. Six patients underwent a second anterior chamber air injection for persistent DMD and all of them (100%) achieved successful reattachment. Among patients with successful anatomical reattachment, 72% achieved BCVA better than 0.5 one month postoperatively. Conclusion: Anterior chamber air injection is a safe and effective treatment for DMD, even in cases with prolonged detachment.展开更多
真性囊膜剥脱综合征(True Exfoliation Syndrome, TEX)是一种罕见的全身性细胞外基质疾病,在眼部则累及眼前节组织,当疾病发展到一定程度,其典型表现为晶状体前囊膜发生板层剥离,游离端在前房水中飘动,常合并晶状体混浊,部分合并晶状体...真性囊膜剥脱综合征(True Exfoliation Syndrome, TEX)是一种罕见的全身性细胞外基质疾病,在眼部则累及眼前节组织,当疾病发展到一定程度,其典型表现为晶状体前囊膜发生板层剥离,游离端在前房水中飘动,常合并晶状体混浊,部分合并晶状体前悬韧带的断裂。由于眼部表现有相似性,常易于与假性囊膜剥脱综合征混淆。TEX确切的发病机制未明,可能与长期高温环境下工作、暴露于热辐射、红外线、眼外伤、年龄相关性退行性变化、炎症等因素有关,也有相当一部分为特发性。文章报道一例真性囊膜剥脱综合征合并老年性白内障的病例,旨在提高对本病诊断和治疗的认知。True Exfoliation Syndrome (TEX) is a rare systemic extracellular matrix disorder that primarily affects anterior segment structures in the eye. As the disease progresses, it is characterized by lamellar delamination of the anterior lens capsule, with free-floating edges visible in the aqueous humor. TEX often coexists with lens opacities and, in some cases, is accompanied by a break of the anterior zonular fibers. Due to similar ocular presentations, TEX is frequently mistaken for Pseudo-Exfoliation Syndrome. The exact pathogenesis of TEX remains unclear but is believed to be associated with long-term occupational exposure to high temperatures, thermal radiation, infrared light, ocular trauma, age-related degenerative changes, and inflammation, while a significant number of cases are idiopathic. This report presents a case of True Exfoliation Syndrome associated with age-related cataracts, aiming to improve awareness of the diagnosis and treatment of this rare condition.展开更多
目的:利用光相干断层扫描(OCT)研究不同区域视网膜神经纤维层(RNFL)厚度与光反射信号值在青光眼中的变化情况。方法:病例对照研究。纳入49名健康受试者的49只眼及47名青光眼患者的47只眼进行以视盘为中心的三维OCT扫描。在半径为1.7 mm...目的:利用光相干断层扫描(OCT)研究不同区域视网膜神经纤维层(RNFL)厚度与光反射信号值在青光眼中的变化情况。方法:病例对照研究。纳入49名健康受试者的49只眼及47名青光眼患者的47只眼进行以视盘为中心的三维OCT扫描。在半径为1.7 mm、1.95 mm和2.2 mm的3个分析环下,导出视盘周围环形截面图像,然后通过Image J软件进行分析。对比两组间不同半径,分析环下不同象限RNFL厚度及光反射信号的改变。结果:青光眼组RNFL在不同分析半径不同象限下的厚度值及光反射信号值基本较对照组低(p t检验),其中在下方象限中两组厚度差别最大;在颞侧象限中光反射信号值差别最大。大部分区域RNFL厚度与视野MD呈中至高度正相关(p p p均 p均 Objective: To investigate the changes in the thickness of the retinal nerve fiber layer (RNFL) and light reflectivity in different regions in eyes with glaucoma using optical coherence tomography (OCT). Methods: A case-control study was conducted, including 49 eyes from 49 healthy subjects and 47 eyes from 47 glaucoma patients for three-dimensional OCT scans centered on the optic disc. Circular peripapillary sections were extracted at radii of 1.7 mm, 1.95 mm, and 2.2 mm and then analyzed using Image J software. The changes in RNFL thickness and light reflectivity in different quadrants under different radii of analysis rings were compared between the two groups. Results: The thickness and light reflectivity of the RNFL in the glaucoma group were generally lower than those in the control group at different analysis radii and in different quadrants (p t-test), with the greatest difference in thickness in the inferior quadrant and the greatest difference in light reflectivity in the temporal quadrant. The RNFL thickness in most areas showed a moderate to high positive correlation with visual field mean deviation (MD) (p p p p < 0.05). Conclusion: The light reflectivity of the RNFL in different regions reflects the degree and regional changes of RNFL damage in glaucoma to some extent and can be used as one of the auxiliary diagnostic indicators for glaucoma diagnosis.展开更多
文摘目的:探讨白内障超声乳化术后角膜后弹力层脱离(Descemet’s membrane detachment, DMD)患者接受前房注气术的解剖复位和视功能恢复情况。方法:本研究回顾性分析了2014年10月至2019年10月期间在汕头国际眼科中心诊断白内障术后角膜后弹力层脱离并接受了前房注气术治疗患者的临床资料。主要观察指标为角膜后弹力层是否重新附着以及术后最佳矫正视力。结果:患者平均年龄为70.16 ± 9.99岁,男女比例为9:16。在首次前房注气术后,25例患者中有18例(72%)角膜后弹力层成功复位。常见并发症包括持续性DMD (24%)、气体相关性瞳孔阻滞(8%)、接触式房角关闭(4%)、角膜内皮失代偿(4%)和葡萄膜炎(4%)。复位成功率与患者年龄、性别和干预时间无显著相关性。6例患者因持续性DMD接受了二次的前房注气术,6名(100%)均成功重新附着。在解剖上成功复位的患者,72%在术后一个月的最佳矫正视力优于0.5。结论:前房注气术是治疗角膜后弹力层脱离的一种安全有效方法,即便面对脱离时间长的病例。Purpose: To evaluate the anatomical reattachment and visual recovery outcomes of Descemet’s membrane detachment (DMD) after phacoemulsification cataract surgery treated with anterior chamber air injection. Methods: This retrospective study analyzed the clinical data of patients diagnosed with post-cataract surgery DMD who underwent anterior chamber air injection at Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong from October 2014 to October 2019. The primary outcomes included the rate of anatomical reattachment of Descemet’s membrane and the postoperative best-corrected visual acuity (BCVA). Results: The mean age of patients was 70.16 ± 9.99 years, with a male-to-female ratio of 9:16. After the first anterior chamber air injection, 18 of 25 patients (72%) achieved successful Descemet’s membrane reattachment. Common complications included persistent DMD (24%), gas-induced pupillary block (8%), acute angle-closure glaucoma (4%), corneal endothelial decompensation (4%), and uveitis (4%). The success rate of reattachment was not significantly correlated with age, gender, or timing of intervention. Six patients underwent a second anterior chamber air injection for persistent DMD and all of them (100%) achieved successful reattachment. Among patients with successful anatomical reattachment, 72% achieved BCVA better than 0.5 one month postoperatively. Conclusion: Anterior chamber air injection is a safe and effective treatment for DMD, even in cases with prolonged detachment.
文摘真性囊膜剥脱综合征(True Exfoliation Syndrome, TEX)是一种罕见的全身性细胞外基质疾病,在眼部则累及眼前节组织,当疾病发展到一定程度,其典型表现为晶状体前囊膜发生板层剥离,游离端在前房水中飘动,常合并晶状体混浊,部分合并晶状体前悬韧带的断裂。由于眼部表现有相似性,常易于与假性囊膜剥脱综合征混淆。TEX确切的发病机制未明,可能与长期高温环境下工作、暴露于热辐射、红外线、眼外伤、年龄相关性退行性变化、炎症等因素有关,也有相当一部分为特发性。文章报道一例真性囊膜剥脱综合征合并老年性白内障的病例,旨在提高对本病诊断和治疗的认知。True Exfoliation Syndrome (TEX) is a rare systemic extracellular matrix disorder that primarily affects anterior segment structures in the eye. As the disease progresses, it is characterized by lamellar delamination of the anterior lens capsule, with free-floating edges visible in the aqueous humor. TEX often coexists with lens opacities and, in some cases, is accompanied by a break of the anterior zonular fibers. Due to similar ocular presentations, TEX is frequently mistaken for Pseudo-Exfoliation Syndrome. The exact pathogenesis of TEX remains unclear but is believed to be associated with long-term occupational exposure to high temperatures, thermal radiation, infrared light, ocular trauma, age-related degenerative changes, and inflammation, while a significant number of cases are idiopathic. This report presents a case of True Exfoliation Syndrome associated with age-related cataracts, aiming to improve awareness of the diagnosis and treatment of this rare condition.
文摘目的:利用光相干断层扫描(OCT)研究不同区域视网膜神经纤维层(RNFL)厚度与光反射信号值在青光眼中的变化情况。方法:病例对照研究。纳入49名健康受试者的49只眼及47名青光眼患者的47只眼进行以视盘为中心的三维OCT扫描。在半径为1.7 mm、1.95 mm和2.2 mm的3个分析环下,导出视盘周围环形截面图像,然后通过Image J软件进行分析。对比两组间不同半径,分析环下不同象限RNFL厚度及光反射信号的改变。结果:青光眼组RNFL在不同分析半径不同象限下的厚度值及光反射信号值基本较对照组低(p t检验),其中在下方象限中两组厚度差别最大;在颞侧象限中光反射信号值差别最大。大部分区域RNFL厚度与视野MD呈中至高度正相关(p p p均 p均 Objective: To investigate the changes in the thickness of the retinal nerve fiber layer (RNFL) and light reflectivity in different regions in eyes with glaucoma using optical coherence tomography (OCT). Methods: A case-control study was conducted, including 49 eyes from 49 healthy subjects and 47 eyes from 47 glaucoma patients for three-dimensional OCT scans centered on the optic disc. Circular peripapillary sections were extracted at radii of 1.7 mm, 1.95 mm, and 2.2 mm and then analyzed using Image J software. The changes in RNFL thickness and light reflectivity in different quadrants under different radii of analysis rings were compared between the two groups. Results: The thickness and light reflectivity of the RNFL in the glaucoma group were generally lower than those in the control group at different analysis radii and in different quadrants (p t-test), with the greatest difference in thickness in the inferior quadrant and the greatest difference in light reflectivity in the temporal quadrant. The RNFL thickness in most areas showed a moderate to high positive correlation with visual field mean deviation (MD) (p p p p < 0.05). Conclusion: The light reflectivity of the RNFL in different regions reflects the degree and regional changes of RNFL damage in glaucoma to some extent and can be used as one of the auxiliary diagnostic indicators for glaucoma diagnosis.
