In search of a rapid method for vascular anastomosis with high quality,a compatative study was carried out to observe the results of laser welding of the saphenous artery of rabbit(0.45-0.85 indiameter)with the use of a degradable intraluninal bionterial support and the traditional method of suture anastomosis. The results showed that there was no significant difference observed between the two groups in the immediate and long patency rated and the occurrence of stenosis,However,the time ...
【摘要】 目的 总结80 W绿激光汽化术治疗大体积良性前列腺增生症的技术及临床疗效。 方法 回顾性分析2007年9月-2009年11月完成经尿道80 W绿激光汽化术治疗体积gt;100 mL良性前列腺增生症患者围手术期及随访资料，包括术前前列腺体积、血红蛋白、国际前列腺症状评分（IPSS）、生活质量（QOL）评分，手术时间、汽化激光能量及术后血清钠、血红蛋白、术后留置尿管时间、IPSS、QOL评分、3个月后残余前列腺体积等。 结果 45例体积gt;100 mL的良性前列腺增生症患者均在持续硬膜外麻醉下完成手术，无中转开放手术。术前前列腺体积（128.82±24.82） mL，血红蛋白（138.5±6.85） g/mL，IPSS评分27.10±2.88，QOL 4.26±0.87，术前最大尿流率（6.53±3.76） mL/s，手术时间（141.00±30.19） min，汽化能量（36.14±11.64） MJ，术后3 d血红蛋白（124.33±7.64） g/mL，术后留置尿管时间（101.55±20.55） h，术前与术后血清钠无明显变化，血红蛋白轻度下降，无需输血。3个月后残余前列腺体积（44.63±10.31） mL，IPSS评分11.58±2.52，QOL 2.74±1.10。无尿道狭窄发生。 结论 经尿道80 W 绿激光汽化术治疗体积gt;100 mL的良性前列腺增生症，具有良好的安全性和临床疗效，可作为此类患者的首选治疗之一。【Abstract】 Objective To investigate the efficacy and safety of 80 Watt high-power potassium-titanyl-phosphate (KTP) photoselective laser vaporization of the prostate (PVP) in patients with large-volume benign prostate hyperplasia (gt;100 mL). Methods Retrospective analysis was performed in patients with large-volume benign prostatic hyperplasia (gt;100 mL), who were treated with the 80 Watt KTP transurethral photoselective laser vaporization of the prostate from September 2007 to November 2009. The preoperative evaluation included prostate volume by transrectal ultrasonic scanning, serum sodium and serum hemoglobin, international prostate symptom score (IPSS) and quality of life (QOL) score. The operative time and vaporization energy and average indwelling catheterization time were recorded. The postoperative serum sodium, serum hemoglobin after the operation were compared with those before the operation. After 3 months, the IPSS, QOL and residual prostate volume were evaluated. Results Forty-five patients of totally 219 patients with gt;100 mL prostate in volume were successfully operated under continuous epidural anesthesia. None was changed to open operation. The mean preoperative prostate volume was (128.82±24.82) mL, the mean IPSS was (27.10±2.88) and QOL were (4.26±0.87). The mean operative time was (141.00±30.19) minutes. The mean indwelling catheterization was (102.17±19.50) hours. The serum sodium did not change, while the serum hemoglobin level reduced mildly but without transfusion. After 3 month, the mean IPSS was (11.58±2.52) and QOL were (2.74±1.10) with residual prostate volume was (44.63±10.31) mL. No stricture was observed in 〖LM〗this group. Conclusion The transurethral photoselective vaporization of the prostate with 80 Watt KTP laser is a safe and effective therapy for patients with gt;100 mL prostate in volume in experienced PVP center.
ObjectiveTo investigate the efficacy and safety of intravitreal ranibizumab and (or) triamcinolone combined with laser photocoagulation for macular edema secondary to branch retinal vein occlusion (BRVO) during one year period. MethodsThe data of 31 eyes from 31 consecutive patients with macular edema secondary to BRVO during one year follow-up visit were retrospectively analyzed. Mean best corrected visual acuity (BCVA) logMAR was (0.74±0.36) and mean central retinal thickness (CRT) was (484.48±164.81)μm at baseline. All patients received standardized clinical comprehensive examinations including vision, intraocular pressure and optical coherence tomography for diagnosis before treatment. All patients received intravitreal injections of 0.5 mg ranibizumab (0.05 ml) at first visit. The continue PRN treatment were based on the visual acuity changes and the optical coherence tomography findings. Eyes received combined triamcinolone acetonide 0.05 ml (40 mg/ml) and ranibizumab for macular edema recurrence after two injections of ranibizumab and received laser photocoagulation during 10-14 days after third injections of ranibizumab. Mean injection of ranibizumab was 3.52±2.01, 15 eyes with triamcinolone acetonide (0.84±1.21), 21 eyes with laser photocoagulation (0.97±0.95) and 12 eyes with three treatment. Compared the visual acuities and CRTs of the first and the last visits by statistical analysis. ResultsMean visual acuity improved significantly to 0.42±0.33 logMAR (t=6.611, P=0.000). Mean improvement of visual acuity was 2.90±3.07 lines. A gain of three or more logarithmic lines was evaluated in 20/31 eyes (64.52%) at the last visit. Mean CRT was (326.19±117.80)μm (t=4.514, P=0.000).Mean reduction of CRT was (333.58±134.17)μm. A decrease of 100μm of CRT was evaluated in 17/31 eyes (54.84%). No severe ocular and systematic side effect was found. ConclusionThe efficacy and safety of intravitreal ranibizumab and (or) triamcinolone combined with laser photocoagulation for macular edema secondary to BRVO were assured.
Objective To observe the short-term effect of changing the sequence of PRP and MLP on the pre-proliferative or proliferative diabetic retinopathy patients with clinical significant macular edema (CSEM). Methods Sixty-three consecutive pre-proliferative or proliferative diabetic retinopathy outpatients (103 eyes) with clinical significant macular edema were selected and divided into two groups: 54 eyes in patients of group A accepted MLP one month prior to PRP and 49 eyes in patients of group B accepted the photocoagulative therapies in a contrary sequence. All the patients were followed up for 3 to 13 months and visual acuity. Light sensitivity of 5deg;macular threshold, and FFA were performed pre- and post-photocoagution. Results The improvement of visual acuity was found to be better in group A than that of group B (Plt;0.01) 2 months after the therapy, since then, there was no significant defference (Pgt;0.05) in both groups. Three and 4 months after the treatment, there was no significant difference in change of light sensitivity of 5deg;macular threshold in both groups. The macular leakages of 59 eyes, 32 ingroup A and 27 in group B, were well controlled. Conclusion Among the pre-proliferative or proliferative diabetic retinopathy patients with CSEM, visual acuity of those who accept MLP prior to PRP more rapidly than those who accept contrary sequence of photocoagulation, but the changing of therapeutic sequence might have no dramatic influence on light sensilivity of 5deg;macular threshold. (Chin J Ocul Fundus Dis,2000,16:150-152)
ObjectiveTo preliminarily evaluate the feasibility of ultra-wide-angle fundus imaging (UWFI) to observe the Weiss ring (vitreous floats) and the effectiveness and safety of neodymium-doped yttrium aluminum garnet (Nd: YAG) laser ablation in the treatment of symptomatic Weiss ring. MethodsA retrospective clinical study. From March 2016 to December 2019, 80 eyes of 68 patients with symptomatic Weiss ring who were diagnosed and treated at Guangzhou Aier Eye Hospital were included in the study. Among them, there were 39 eyes in 32 males and 41 eyes in 36 females; the average age was 53.7±10.8 years old. All the affected eyes were examined by slit lamp microscope combined with 90 D front lens and UWFI. The position and shape of the vitreous floating objects by drawing pictures were recorded. All the affected eyes underwent Nd: YAG laser ablation treatment. Three months after treatment, a questionnaire survey was conducted on the patients to assess the improvement of subjective symptoms. Those with a total score of 10, 7-9, 3-6, and ≤2 points were defined as cured, significant improvement, partial improvement, and no improvement, respectively. The measurement software Gauge 1.0 was used to manually measure the long diameter, circumference and area of the vitreous float on the UWFI image. The diameter of the optic disc to 1 Unit (U) was set as a standardized reference value. Those who did not show UWFI and no floating objects were found on the front mirror were recorded as 0. The changes of vitreous floats before and after treatment were compared by Wilcoxon rank sum test; the changes in their size before and after treatment and the patients' subjective symptom improvement scores after treatment were analyzed by Spearman rank correlation. ResultsAfter treatment, in 80 eyes, there were no vitreous floats in 59 eyes (73.8%, 59/80) on UWFI. Before treatment, the circumference of the vitreous float was 1.84 (1.07, 2.64) U, the long diameter was 1.17 (0.84, 1.66) U, and the area was 0.18 (0.08, 0.30) U2; after treatment, the circumference was 0.00 (0.00, 0.23) U, The long diameter is 0.00 (0.00, 0.23) U, and the area was 0.00 (0.00, 0.01) U2. There were statistically significant differences in the perimeter, diameter, and area of floating objects before and after treatment (Z=−7.722, −7.560, −7.655; P＜0.001). The results of the questionnaire survey showed that the patient's subjective symptoms were cured, significantly improved, and partially improved in 49 (61.3%, 49/80), 25 (31.2%, 25/80), and 6 (7.5%, 6/80) eyes, respectively. The results of correlation analysis showed that the degree of improvement of the patient's subjective symptoms was related to the circumference (r=0.812), long diameter (r=0.796), and area (r=0.791) of the vitreous float on UWFI before and after treatment (P＜0.01). During the follow-up period, no complications such as increased intraocular pressure or decreased vision occurred. ConclusionsUWFI can objectively image the Weiss ring, and its size can be quantified relatively to the measurement software. Nd: YAG laser ablation treatment of symptomatic Weiss ring is safe and effective.