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| 1 | 超声乳化联合小梁切除术及术中应用5-氟尿嘧啶治疗青光眼合并白内障的长期疗效观察显示文摘目的探讨超声乳化联合小梁切除术及术中应用5氟尿嘧啶(5fluorouracil,5Fu)治疗青光眼合并白内障的疗效。方法对1996年1月至1998年12月,在新加坡国立眼科中心行超声乳化联合小梁切除术及术中应用5Fu治疗的71例(71只眼)原发性开角型青光眼(POAG)和原发性闭角型青光眼(PACG)患者的临床资料进行回顾性分析。除外随访时间<6个月的患者。结果术后患者平均眼压和平均用药种数均较术前明显降低,差异有统计学意义(P<001)。术后随访1~5年的患者眼压与术前比较均明显下降,差异有统计学意义(P<001)。手术完全成功率1、3及5年分别为842%、627%及553%。在手术完全成功的条件下,POAG与PACG(P=0281)、同一切口与不同切口(P=0487)手术疗效比较(采用Cox模型进行多因素生存分析),手术成功率差异无统计学意义(P>005)。但POAG与PACG术后平均眼压比较,差异有统计学意义(P=002)。术后较术前平均视力提高差异有统计学意义(P<001)。术后与术前平均视野缺损(MD)值(P=055)和模式标准差(PSD)值(P=064)比较,差异无统计学意义,表明患者术后视野保持稳定。术后4d发生眼内炎1例,术后晚期由于脉络膜渗漏和伤口漏引起低眼压2例。结论超声乳化联合小梁切除术及术中应用5Fu治疗POAG和PACG的成功率高,手术安全,长期观察疗效稳定。 | 才瑜 Zena LIM Boon Ang LIM Francis OEN 晏晓明 李美玉 Steve SEAH | 2005 | 中华眼科杂志2005，41，2： | 22 |
| 2 | 内窥镜下睫状体光凝术:概述和亚洲视角(英文)显示文摘青光眼手术治疗方法已被分为睫状体破坏性(减少流入)或滤过性(增加流出)两大类。睫状体破坏性手术传统上用于视力预后差的青光眼以及难治性青光眼如外伤后、无晶状体眼、先天性青光眼和发育性青光眼。自从1992年Uram首次使用内窥镜下睫状体光凝术(endoscopic cyclo-photocoagulation,ECP)以来,短期和长期的转归已经表明ECP的应用前景广阔。本文在PubMed查询、复习有关ECP的英文文献,并与新加坡一所眼科三级医院的有限结果进行比较。文献报告显示出ECP及联合白内障超声乳化术的ECP在治疗小儿及成人严重的、各种病因所致的青光眼方面的安全性和有效性。这在新加坡某眼科三级医院未发表的短期结果中也有报告,与那些已经发表的结果是一致的。已发表的报告和当前的经验证明,可直视目标组织的ECP,通过内窥镜直视将合适的红外波长激光能量应用于目标组织睫状上皮细胞,避免了'盲目'状态下经巩膜睫状体光凝术所引起的并发症。但是引进这项技术存在着显著的经费困难。ECP在控制眼压和减少抗青光眼药物的依赖性方面是安全有效的。广泛接受和使用这一技术仍有待于大规模的随机对照研究。 | E-Shawn Goh Boon Ang Lim Leonard Yip | 2008 | 国际眼科杂志2008，8，9： | 4 |
| 3 | 超声乳化联合小梁切除术中使用丝裂霉素C临床观察显示文摘目的 评价超声乳化联合小梁切除术中使用丝裂霉素C(MMC)的效果和安全性。方法 回顾性随访联合手术65例 73眼 ,术中使用MMC组 3 4例 3 7眼 ,未用MMC的对照组 3 1例 3 6眼。对比两组手术前后的眼压、视力及术后并发症。结果 术后 1年 ,MMC组眼压从术前 (17 87± 5 41)mmHg降至 (11 61± 5 12 )mmHg ,对照组从术前 (18 82± 2 82 )mmHg降至(14 86± 2 91)mmHg ,MMC组与对照组相比眼压下降差异具有显著意义 (P =0 0 2 8)。术后 2组平均视力都显著提高 (P <0 0 1) ,但提高程度的差异无显著意义 (P =0 876)。结论 白内障超声乳化联合小梁切除术中使用MMC(0 4mg/ml ,5mins) | 杨瑾 LIM Boon Ang Paul TK CHEW | 2003 | 眼外伤职业眼病杂志2003，25，8： | 2 |
| 4 | 应用AccuMap多焦视觉诱发电位客观视野检测法观察晶状体混浊对青光眼视野检测结果的影响显示文摘目的探讨AccuMap多焦视觉诱发电位客观视野检测法观察晶状体混浊对青光眼视野检测结果的影响及与Humphrey自动视野检测结果之间的相关性。方法观察和比较原发性青光眼伴有中等程度晶状体混浊患者白内障术前后AccuMap与Humphrey视野计检测结果。术前由同一位有经验的眼科医师观察并记录(采用LOCSⅢ标准)患者晶状体的混浊程度。结果符合入选标准并完成观察者共22例。(1)AccuMap视野检测平均振幅术前为(308.0±96.6)nV,术后为(382.6±146.7)nV,术前与术后平均振幅差异有统计学意义(P=0.01)。平均视野损害严重程度指数(accumapseverityindex,ASI)术前为90.0±54.8,术后为48.6±42.4,术后比术前ASI显著下降(P<0.001)。潜伏期术前后无明显变化,术前平均为(1207.5±67.7)ms,术后为(1191.2±61.9)ms(P=0.289)。(2)晶状体混浊程度与AccuMap振幅的变化AccuMap振幅的变化与晶状体混浊程度无明显相关性(Spearman秩相关分析,P=0.09)。(3)Humphrey视野计检测结果术前平均偏差(meandeviation,MD)为-12.2±7.8,术后为-9.6±8.8,术后与术前MD差异有统计学意义(P<0.001);而模式标准差(patternstandarddeviation,PSD)术前为6.5±3.2,术后为6.3±4.0,差异无统计学意义(P=0.748)。(4)ASI与MD比较术前、术后ASI分别与MD具有相关性(Pearson相关分析,术前P=0.013,术后P<0.001);且术后与术前ASI的变化与MD的变化也具有相关性(Pearson相关分析,P=0.017)。结论AccuMap视野检测法显示晶状体混浊影响青光眼患者的视野检测结果,其中振幅受影响更明显。与Humphrey视野检测结果比较,AccuMap检测的ASI与MD具有相关性。(中华眼科杂志,2006,42972-976) | 才瑜 LIM Boon Ang CHI Luu POR Yongming OEN Francis 晏晓明 CHEW Paul SEAH Steve | 2006 | 中华眼科杂志2006，42，11： | 2 |
| 5 | Agreement of angle closure assessments between gonioscopy, anterior segment optical coherence tomography and spectral domain optical coherence tomography显示文摘AIM: To determine angle closure agreements between gonioscopy and anterior segment optical coherence tomography(AS-OCT), as well as gonioscopy and spectral domain OCT(SD-OCT). A secondary objective was to quantify inter-observer agreements of AS-OCT and SD-OCT assessments.METHODS: Seventeen consecutive subjects(33 eyes)were recruited from the study hospital's Glaucoma clinic.Gonioscopy was performed by a glaucomatologist masked to OCT results. OCT images were read independently by 2 other glaucomatologists masked to gonioscopy findings as well as each other's analyses of OCT images.RESULTS: Totally 84.8% and 45.5% of scleral spurs were visualized in AS-OCT and SD-OCT images respectively(P <0.01). The agreement for angle closure between AS-OCT and gonioscopy was fair at k =0.31(95% confidence interval, CI: 0.03-0.59) and k =0.35(95%CI: 0.07-0.63) for reader 1 and 2 respectively. The agreement for angle closure between SD-OCT and gonioscopy was fair at k =0.21(95% CI: 0.07-0.49) and slight at k =0.17(95% CI: 0.08-0.42) for reader 1 and 2 respectively. The inter-reader agreement for angle closure in AS-OCT images was moderate at 0.51(95% CI: 0.13-0.88). The inter-reader agreement for angle closure in SD-OCT images was slight at 0.18(95% CI: 0.08-0.45).CONCLUSION: Significant proportion of scleral spurs were not visualised with SD-OCT imaging resulting in weaker inter-reader agreements. Identifying other angle landmarks in SD-OCT images will allow more consistent angle closure assessments. Gonioscopy and OCT imaging do not always agree in angle closure assessments but have their own advantages, and should be used together and not exclusively. | Elton Lik Tong Tay Vernon Khet Yau Yong Boon Ang Lim Stelson Sia Elizabeth Poh Ying Wong Leonard Wei Leon Yip | 2015 | International Journal of Ophthalmology(English edition)2015，8，2： | 0 |
| 6 | Effects of primary glaucoma on sleep quality and daytime sleepiness of patients residing at an equatorial latitude显示文摘AIM:To investigate the impact of primary glaucoma on sleep quality and daytime sleepiness of patients.METHODS:Prospective cross-sectional study with consecutive sampling in South-East Asian population was performed.Validated questionnaires:the Pittsburg Sleep Quality Index(PSQI)and Epworth Sleepiness Scale(ESS)were administered prospectively.Subjects with nonglaucomatous optic neuropathy or concomitant retinal pathology were excluded.Glaucoma severity was based on HVF 24-2 perimetry.Binocular single vision was represented based on the better eye.Frequency of and predictive factors for poor sleep quality and excessive daytime sleepiness were compared.RESULTS:A total of 79 primary open angle glaucoma(POAG),27 primary angle-closure glaucoma(PACG)patients,and 89 controls were recruited.PACG patients had higher median PSQI scores(P=0.004)and poorer sleep quality(P<0.001).Compared to controls,PACG patients were 3.34 times more likely to have poor sleep quality(P=0.008),which remained significant after adjustment for demographics(P=0.016)and predictive variables(P=0.013).PACG patients have poorer sleep quality when visual acuity(VA)was 6/15 or worse(P=0.009).Univariate and multivariate analysis of predictive variables for poor sleep quality and daytime sleepiness did not find statistical significance.CONCLUSION:PACG patients have poorer sleep quality but not daytime sleepiness.This is important in South-East Asian population with heavy disease burden.Evaluations on sleep disturbances can be considered to provide more ho istic care. | Jacob YH Chin Zhi Hong Toh Ying Tai Lo Hannah TY Wang Elizabeth YW Poh Chun Hau Chua Owen Kim Hee Boon Ang Lim Vernon KY Yong Augustinus Laude Hon Tym Wong Leonard WL Yip | 2020 | International Journal of Ophthalmology(English edition)2020，13，9： | 0 |
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