晶状体病学PDF格式文档图书下载

第一章　晶状体的胚胎发育和组织解剖　CHAPTER 1 DEVELOPMENT AND ANATOMY OF THE LENS 1

一、晶状体的胚胎发育DEVELOPMENT GROWTH OF THE LENS 1

目录 1

二、晶状体发育的基因调控THE GENE REGULATION ON THE LENS DEVELOPMENT 2

（三）酶分布及其活性ENZYME DISTRIBUTION AND ITS ACTIVITY 1 3

三、胚胎期晶状体对眼球发育及其眼前段形成的调控THE LENS REGULATES ON EYE DEVELOPMENT AND FORMATION OF THE ANTERIOR SEGMENT IN THE EMBRYO 3

四、晶状体的解剖ANATOMY OF THE LENS 3

（一）晶状体的大小和位置THE SIZE AND POSITION OF THE LENS 3

（二）晶状体的结构THE STRUCTURE OF THE LENS 4

第二章 晶状体的生理、生化及白内障形成机制概述 CHAPTER 2 INTRODUCTION OF THE LENS PHYSIOLOGY,BIOCHEMISTRY AND MECHANISMS OF CATARACT FORMATION 9

一、晶状体的生理功能PHYSIOLOGY OF THE LENS 9

二、晶状体的生化与代谢BIOCHEMISTRY AND METABOLISM OF THE LENS 10

（一）晶状体蛋白质THE LENS PROTEIN 10

（二）晶状体的非蛋白成分NON-PROTEIN COMPONENTS OF THE LENS 12

（四）糖代谢GLUCOSE METABOLISM 13

三、抗氧化防护系统PROTECTION SYSTEM AGAINST OXIDATIVE 14

四、白内障形成机制概述THE INTRODUCTION OF MECHANISMS OF CATARACT FORMATION 14

第三章 晶状体位置异常和畸形 CHAPTER 3 ECTOPIA LENTIS（SUBLUXATION/DISLOCATION）AND LENS MALFORMATION 17

一、晶状体异位和脱位原因CAUSES OF ECTOPIA LENTIS 17

二、晶状体半脱位和全脱位SUBLUXATION AND DISLOCATION OF THE LENS 17

（一）晶状体半脱位SUBLUXATION OF THE LENS 17

（二）晶状体全脱位DISLOCATION OF THE LENS 18

（一）先天性晶状体脱位CONGENITAL ECTOPIA LENTIS 20

三、各种类型的晶状体异位和脱位TYPES OF ECTOPIA LENTIS 20

（二）外伤性晶状体异位或脱位TRAUMATIC ECTOPIA LENTIS 21

（三）自发性晶状体异位或脱位SPONTANEOUS ECTOPIA LENTIS 21

四、晶状体脱位的治疗原则THE MANAGEMENT PRINCIPLE OF ECTOPIA LENTIS 21

五、晶状体畸形LENS MALFORMATIONS 22

第四章 年龄相关性白内障的流行病学 CHAPTER 4 THE EPIDEMIOLOGY OF AGE-RELATED CATARACT 23

一、白内障的流行病学观察的常用指标THE USUAL INDEX IN EPIDEMIOLOGICAL STUDY OF CATARACT 23

二、白内障社会群体与环境危险因素SOCIAL COLONY FACTORS OF CATARACT 24

三、相关个体危险因素THE ASSOCIATED INDIVIDUAL FACTORS 25

四、防治策略STRATEGIES OF CATARACT PREVENTION AND TREATMENT 26

五、未来展望THE FUTURE 27

（一）核混浊NUCLEAR OPACITIES 29

一、晶状体混浊性缺陷OPAQUE LENS DEFECT 29

第五章　白内障的形态学　CHAPTER 5 FORMS OF CATARACT 29

（二）皮质混浊CORTICAL OPACITIES 33

（三）囊膜混浊CAPSULAR OPACITIES 34

二、晶状体非混浊性缺陷NON-OPAQUE LENS DEFECT 36

第六章　白内障的分类及临床表现　CHAPTER 6 CLASSIFICATION AND MANIFESTATION OF CATARACT 37

一、白内障分类CLASSIFICATION OF CATARACT 37

二、白内障的临床表现MANIFESTATIONS OF CATARACT 37

（一）症状SYMPTOMS 37

（二）体征SIGNS 39

三、临床白内障的分类和分级CLINICAL CLASSIFICATION OF CATARACT 40

第七章　先天性白内障　CHAPTER 7 CONGENITAL CATARACT 41

一、病因与基因异常CAUSES AND GENE MUTATION 41

（一）手术步骤STEPS 1 42

二、婴幼儿白内障类型TYPES OF INFANTILE CATARACT 43

三、先天性白内障合并其他眼部异常CONGENITAL CATARACT ASSOCIATE WITH OTHER OCULAR DISODERS 47

第八章　年龄相关性白内障　CHAPTER 8 AGE-RELATED CATARACT 49

一、分类与临床过程THE CLASSIFICATION AND CLINICAL PRESENTATION 49

二、临床表现MANIFESTATIONS 51

三、病理机制PATHOLOGICAL MECHANISM 51

四、治疗原则PRINCIPLES OF TREATMENT 52

第九章　其他类型的白内障　CHAPTER 9 MISCELLANEOUS CATARACTS 53

一、并发性白内障COMPLICATED CATARACT 53

（一）眼后段疾病POSTERIOR SEGMENT DISEASES 53

（二）眼前段疾病ANTERIOR SEGMENT DISEASES 54

二、外伤性白内障TRAUMATIC CATARACT 55

（一）糖尿病性白内障DIABETIC CATARACT 57

三、代谢性白内障 METABOLIC CATARACT 57

（三）手足搐搦性白内障TENANIC CATARACT 58

（四）低血糖性白内障HYPOGLYCEMIC CATARACT 58

四、药物及中毒性白内障DRUG-INDUCED AND TOXIC CATARACT 58

（二）半乳糖血症性白内障GALACTOSE CATARACT 58

五、后发性白内障AFTER-CATARACT 59

第十章　全身疾病和白内障　CHAPTER 10 SYSTEMIC DISEASES AND CATARACT 61

一、染色体异常CHROMOSOMAL DISORDERS 61

二、代谢紊乱METABOLIC DISORDERS 62

三、系统性疾病综合征SYSTEMIC DISEASE AND SYNDROMES 63

（一）抗醌体制剂ANTI-CHINONE DRUGS 65

（二）抗氧化损伤类药物ANTI-OXIDATE INJURY DRUGS 65

一、药物治疗MEDICAL TREATMENT 65

第十一章 白内障的药物治疗与疗效评价 CHAPTER 11 DRUG THERAPYAND ITS EVALUATION 65

（四）营养类制剂NUTRITION DRUGS 66

（五）中草药制剂TRADITIONAL CHINESE HERBS AND THEIR COMPLEX 66

（三）醛糖还原酶抑制剂ALDOSE REDUCTASE INHIBITORS 66

（六）其他抗白内障药物THE OTHERS 67

二、药物疗效评价EVALUATION OF DRUG 67

三、展望EXPECTATION 68

第十二章　手术时机和术前评估　CHAPTER 12 INDICATIONS AND PREOPERATIVE EVALUATION 69

一、手术时机TIMING OF SURGERY 69

（一）生活质量QUALITY OF LIFE 69

（二）视力VISUAL ACUITY 69

二、手术难度的评估EVALUATION OF THE OPERATIVE DIFFICULTY 70

（一）眼部情况评估 EVALUATION OF THE OCULAR CONDITION 70

（三）对比敏感度和眩光CONTRAST SENSITIVITY AND GLARE 70

（二）全身情况评估EVALUATION OF THE GENERAL CONDITION 71

三、术后视功能恢复的评估EVALUATION OF POSTOPERATIVE RETURN OF VISUAL FUNCTION 71

（一）病史询问HISTORY OVERVIEW 71

（二）眼部一般常规检查ROUTINE EXAMINATIONS OF THE EYES 71

（三）眼部特殊检查SPECIAL EXAMINATIONS OF THE EYES 73

第十三章　人工晶体屈光度计算　CHAPTER 13 INTRAOCULAR LENS POWER CALCULATIONS 79

一、人工晶体计算公式的历史和发展HISTORIC OVERVIEW AND DEVELOPMENT OF INTRAOCULAR LENS POWER CALCULATIONS 79

（一）第一代公式FIRST-GENERATION FORMULAS 79

（二）第二代公式SECOND-GENERATION FORMULAS 80

（三）第三代公式THIRD-GENERATION FORMULAS 80

（一）A型超声波生物测量仪A-ULTRASOUND BIOMETRY 81

二、人工晶体测量法IOL MEASUREMENT METHODS 81

（四）第四代公式FOURTH-GENERATION FORMULAS 81

（二）角膜曲率计KERATOMETRY 82

三、正常眼的人工晶体计算INTRAOCULAR LENS POWER CALCULATIONS IN NORMAL EYES 83

四、特殊情况的人工晶体测量和计算INTRAOCULAR LENS POWER CALCULATIONS IN UNUSUAL EYES 83

（一）成熟期白内障MATURE STAGE CATARACT 83

（二）无晶体眼APHAKIC EYE 83

（三）人工晶体眼PSEUDOPHAKIC EYE 83

（四）硅油填充眼THE EYES WITH SILI CON-FILLED VITREOUS 83

（三）角膜地形图CORNEAL TOPOGRAPHY 83

（五）联合角膜切开手术的角膜曲率计算CALCULATION OF THE CORNEAL POWER FOR CONCURRENT KERATOTOMY 84

（六）驮背（双）人工晶体植入计算PIGGY-BACK IOLS POWER CALCULATION 84

（七）角膜屈光性手术后角膜曲率的测量MEASURING OF THE CORNEAL POWER AFTER CORNEAL REFRACTIVE SURGERY 84

五、光学相干生物测量仪OPTICAL COHERENCE BIOMETRY（IOL Master） 85

（一）眼轴的测量THE MEASUREMENT OF EYE AXIS 85

（二）角膜曲率的测量THE MEASUREMENT OF CORNEAL CURVATURE 86

（三）前房深度测量THE MEASUREMENT OF ANTERIOR CHAMBER DEPTH 87

（四）水平角膜直径的测量THE MEASUREMENT OF WHITE TO WHITEW-W 87

（五）IOL Master人工晶体度数的计算IOL CALCULATION BASED ON IOL Master 87

第十四章　超声乳化仪及其主要工作原理　CHAPTER 14 PHACOEMULSIFICATION SYSTEM AND ITS PHYSICAL PRINCIPLES 89

一、流体动力学FLUID DYNAMICS 89

（一）流体动力系统的组成THE COMPONENTS OF FLUID DYNAMI CS SYSTEM 89

（二）流体动力系统的特点THE CHARACTERS OF FLUID DYNAMICS SYSTEM 89

二、与超声乳化术有关的流体动力学概念THE CONCEPTS OF FLUID DYNAMICS IN PHACOEMULSIFICATION 90

三、超声乳化仪泵的类型及功能特点TYPES OF PUMP AND THEIR FUNCTIONS 91

（一）抽吸泵ASPIRATION PUMP 91

（二）真空泵VACUUM PUMP 92

四、超声功率产生的基本原理及其有关特性BASIC PRINCIPLES OF THE ULTRASONIC ENGERGY GENERATION 92

五、超声乳化仪PHACOEMULSIFICATION SYSTEM 93

六、各种超声乳化仪简介BRIEF INTRODUCTION OF THE MACHINES 95

（一）Alcon系列超声乳化仪ALCON SERIES PHACO MACHINES 95

（二）AMO公司系列超声乳化仪AMO MACHINES 98

（三）博士伦Millennium超声乳化仪BAUSCII LOMB MILLENNIUM MACHINE 99

（四）歌德MEGATRON S3超乳化手术系统GEUDER MEGATRON S3 SYSTEM 100

（五）Mentor公司Mentor超声乳化仪MENTOR MACHINE 101

（六）ASSISTANT MINIMAL STRESS超声乳化仪ASSISTANT MINIMAL STRESS MACHINES 101

（七）CATATHEX CMP超声乳化仪CATATHEX CMP MACHINES 102

第十五章　手术室与术前准备　CHAPTER 15 PREPARATION OF OPERATION ROOMS AND PATIENTS 103

一、手术间OPERATION ROOM 103

二、手术床OPERATION BED 103

三、手术椅OPERATION CHAIR 104

四、手术显微镜OPERATION MICROSCOPE 104

五、白内障手术器械OPERATION INSTRUMENTS OF CATARACT SURGERY 105

六、患者的准备PREPARATION OF THE PATIENTS 106

第十六章　麻醉　CHAPTER 16 ANESTHESIA 109

一、全身麻醉GENERAL ANESTHESIA 109

二、局部浸润麻醉LOCAL INFILTRATION ANESTHESIA 109

三、表面麻醉TOPICAL ANESTHESIA 110

（一）表面麻醉的历史演变与发展HISTORICAL EVOLVEMENT AND DEVELOPMENT OF TOPICAL ANESTHESIA 110

（二）适应证与禁忌证INDICATIONS AND CONTRAINDICATIONS 110

（三）表面麻醉的临床应用TOPICAL ANESTHESIA AND THEIR APPLICATIONS 111

四、合并症及其处理COMPLICATIONS AND THEIR MANAGEMENTS 113

（四）注意事项TIPS 113

（五）如何过渡到表面麻醉手术HOW TO TRANSFER TO TOPICAL ANESTHESIA SURGERY 113

三、切口的分类TYPE OF INCISIONS 115

第十七章 切口 CHAPTER 17 INCISIONS 115

一、角膜缘解剖概述INTRODUCTION OF ANATOMY OF LIMBUS 115

二、切口的发展与演变THE EVOLUTION OF INCISIONS 115

四、切口的构筑ARCHITECTURE OF THE INCISIONS 116

（一）巩膜隧道切口SCLEROCORNEAL INCSIONS 117

（二）角膜隧道切口CORNEAL TUNNEL INCISIONS 118

（三）蓝线切口的构筑BLUE LINE CONSTRUCTION 119

（四）切口构筑的器械INSTRUMENTS AND BLADES FOR CONSTRUCTION OF THE INCISIONS 120

二、撕囊术的2个力学因素-剪切力和牵拉力TEARING BY SHEARING AND TEARING BY STRETCHING 121

一、晶状体囊膜THE LENS CAPSULE 121

第十八章 连续环形撕囊术 CHAPTER 18 CAPSULORHEXIS 121

三、撕囊的要求TECHNIQUES OF CAPSULORHEXIS 122

（二）器械INSTRUMENTS 122

（三）囊膜撕开的基本原则PRINCIPLES OF CAPSULORHEXIS 122

（一）基本要求BASIC TECHNIQUES 122

四、撕囊方法TECHNIQUES 124

（一）撕囊针头撕囊CAPSULORHEXIS BY NEEDLE 124

（二）撕囊镊撕囊CAPSULORHEXIS BY FORCEPS 124

五、染色剂的使用USE OF THE STAINING 125

六、高频电针头撕囊CAPSULORHEXIS BY HIGHFREQUENCY NEEDLE 126

七、撕囊术中的问题及对策PROBLEMS AND SOLUTIONS IN CAPSULORHEXIS 127

八、后囊膜撕囊术POSTERIOR CAPSULORHEXIS 129

一、水分离HYDRODISSECTION 131

第十九章　水分离和水分层　CHAPTER 19 HYDRODISSECTION AND HYDRODELINEATION 131

二、水分层HYDRODELINEATION 133

第二十章 白内障超声乳化吸除术的基本理论及技术发展　CHAPTER 20 PRINCIPLES AND TECHNIQUES OF PHACOEMULSIFICATION 135

一、超声乳化技术发展与演变THE EVOLUTION OF PHACOEMULSIFICATION 135

二、单手与双手技术ONE-HANDED VERSUS TWO-HANDED TECHNIQUES 136

三、囊内超声乳化与核翻转囊上有关技术ENDOCAPSULAR AND SUPRACAPSULAR PHACOEMULSIFICATION 136

四、单通道与双通道超声乳化术ONE-CHANNEL VERSUS BIMANUAL PHACOEMULSIFICATION 137

五、超声乳化白内障吸除术的学习曲线THE LEARNING CURVE OF PHACOEMULSIFICATION 137

六、参数设置PARAMETERS SETTING 138

第二十一章 “分而治之”及其演变方法 CHAPTER 21 DIVIDE AND CONQUER-NUCLEOFRACTIS VARIANTS 139

一、刻槽分而治之碎核技术TRENCH DIVIDE AND CONQUER NUCLEOFRACTIS 139

三、下坡式雕刻与碎核法DOWNSLOPE SCULPTING AND NUCLEOFRACTIS 141

二、火山口分而治之碎核方法CRATER DIVIDE AND CONQUER 141

四、原位超声乳化四分法碎核技术THE IN SITU PHACO-FOUR QUADRANT FRACTURE TECHNIQUE 142

（二）注意事项TIPS 144

第二十二章　超声乳化劈核技术　CHAPTER 22 PHACO CHOPTECHNIQUES 145

一、拦截劈核术Koch's STOP AND CHOP 145

二、水平劈核技术-Nagahara方法HORIZONTAL PHACO CHOP-Nagahara's TECHNIQUE 146

三、垂直劈核技术VERTICAL PHACO CHOP 147

四、乳化针头斜面向下的超声乳化劈核术BEVEL-DOWN PHACO CHOP（PHACO DRILL） 148

五、囊膜上超声乳化术SUPRACAPSULAR PHACOEMULSIFICATION 150

六、特殊情况及合并症处理SPECIAL CASES AND COMPLICATION MANAGEMENT 150

第二十三章　灌注抽吸与后囊膜抛光　CHAPTER 23 IRRIGATION/ASPIRATION AND POSTERIOR CAPSULE POLISHING 153

一、基本原则GENERAL PRINCIPLES 153

三、特殊情况下的皮质抽吸ASPIRATION OF THE CORTEX UNDER SPECIAL CONDITIONS 154

二、双手灌注抽吸系统TWO-HANDED INFUSION/ASPIRATION SYSTEM 154

四、后囊膜抛光POSTERIOR CAPSULE POLISHING 155

第二十四章　人工晶体植入与切口关闭　CHAPTER 24 INTRAOCULAR LENS IMPLANTATIONAND WOUND CLOSURE 157

一、折叠人工晶体植入法FOLDABLE IOL IMPLANTATION 157

（一）镊子折叠法人工晶体植入FOLDABLE IOLIMPLANTATION WITH FORCEPS 157

（二）推进器系统折叠人工晶体植入FOLDABLE IOL IMPLANTATION WITH INJECTOR SYSTEMS 159

二、PMMA一片式硬性人工晶体植入THE RIGID PMMA IOL IMPLANTATION 161

三、粘弹剂抽吸与切口检查REMOVAL OF OVD AND INCISION CHECK 162

第二十五章　安全超声乳化技术　CHAPTER 25 SAFETY PHACOEMULSIFICATION 163

一、麻醉ANESTHESIA 163

二、切口INCISION 163

三、截囊术CAPSULOTOMY 164

四、水分层HYDRODE LINEAT ION 165

五、在前房中预先填充Healon5 PREFILLING THE ANTERIOR CHAMBER WITH Healon5 165

六、超声乳化技术PHACOEMULSIFICATION TECHNIQUE 165

七、皮质抽吸CORTICAL ASPIRATION 166

八、后囊膜抛光POSTERIOR CAPSULAR POLISHING 167

九、植入人工晶体IOL IMPLANTATION 167

十、粘弹剂抽吸和切口检查THE REMOVAL OF OVD AND INCISION CHECK 168

第二十六章　预劈核超声乳化术　CHAPTER 26 PHACO PRECHOP 169

一、手术步骤GENERAL SURGICAL PROCEDURE 169

二、预劈核方法PHACO PRECHOP METHOD 170

三、空手道预劈核技术KARATE PRECHOP 171

四、对抗预劈核技术COUNTER PRECHOP 174

五、超声乳化PHACOEMULS IFICATION 175

六、预劈核技术的并发症及处理COMPLICATIONS OF PHACO PRECHOP AND THEIR MANAGEMENT 176

第二十七章　超声模式与热效应　CHAPTER 27 ULTRASONIC MODEAND THERMALEFFECT 177

一、热能产生的因素FACTORS OF THERMAL EFFECT 177

二、如何控制热能的产生HOW TO REDUCE THE THERMAL EFFECT 178

三、临床意义CLINICAL SIGNIFICANCE 179

四、测量方法及相关仪器METHODS OF MEASUREMENT AND RELATED DEVICES 180

第二十八章 “冷超声”的概念及其技术发展　CHAPTER 28 CONCEPT OF“COLD PHACO”AND ITS TECHNIQUES 183

一、声波技术SONIC WAVE TECHNOLOGY 183

二、ADVANTEC包件（NEOSONIX软件系统）ADVANTEC PACKAGE 183

三、涡流技术VORTEX TECHNOLOGY 184

一、激光乳化技术PHOTOLYSIS TECHNOLOGY 185

第二十九章　激光乳化白内障吸除联合超小切口人工晶体植入术　CHAPTER 29 PHOTOLYSIS CATARACT REMOVAL TECHNOLOGY WITH ULTRASMALL INCI-SION IOL IMPLANTATION 185

二、手术步骤SURGERY PROCEDURES 187

三、超小切口人工晶体INTROCULAR LENS FOR ULTRASMALL INCISION 189

四、临床结果CLINCIAL OUTCOMES 190

第三十章　白星技术白内障手术技术　CHAPTER 30 WHITESTAR CATARACT SURGICAL TECHNOLOGY 191

一、基本原理BASIC PRINCIPLE 191

二、临床研究CLINICAL STUDY 192

三、白星技术的优点ADVANTAGES OF WHITESTAR 193

第三十一章　射流溶解白内障乳化吸除技术　CHAPTER 31 AQUALASE LIQUEFACTION TECHNOLOGY 195

一、射流溶解技术工作原理AQUALASE LIQUEFACTION TECHNOLOGY 195

二、射流溶解白内障吸除术临床特点CLINICAL CHARACTERS OF AQUALASE CATARACT REMOVAL 196

第三十二章　手法碎核小切口白内障摘除术　CHAPTER 32 THE MANUAL SMALL INCISION CATARACT SURGERY 199

一、手术方法SURGICAL PROCEDURES 199

二、并发症及其处理COMPLICATIONS AND MANAGEMENT 201

三、手法碎核小切口白内障手术的临床研究进展THE CLINICAL STUDY OF MANUAL SMALL INCISION CATARACT SURGERY 202

第三十三章　白内障囊外摘除术　CHAPTER 33 EXTRACAPSULAR CATARACT EXTRACTION 205

一、手术步骤SURGICAL PROCEDURES 205

二、术中合并症COMPLICATIONS DURING THE OPERATION 210

第三十四章　先天性晶状体不全脱位及其手术治疗　CHAPTER 34 CONGENITAL LENS SUBLUXATION AND ITS SURGICAL MANAGEMENT 211

一、先天性晶状体不全脱位的原因CAUSES OF LENS CONGENITAL SUBLUXATION 211

二、术前评估PREOPERATIVE EVALUATION 211

三、囊膜张力环CAPSULAR TENSION RINGS 212

四、手术适应证SURGICAL INDICATIONS 213

五、手术方法SURGICAL TECHNIQUES 213

六、临床结果CLINICAL OUTCOME 215

二、类型TYPES 217

第三十五章　后极性白内障超声乳化手术　CHAPTER 35 PHACOEMULSIFICATION OF POSTERIOR POLAR CATARACT 217

一、发病率INCIDENCE 217

三、手术治疗SURGICAL MANAGEMENT 218

四、后囊膜破裂的处理MANAGEMENT OF POSTERIOR CAPSULE RUPTURE 220

第三十六章　儿童白内障手术　CHAPTER 36 PEDIATRIC CATARACT SURGERY 223

一、婴幼儿眼球发育特点THE CHARACTERISTICS OF INFANT'S EYES 223

二、儿童白内障手术的复杂性THE COMPLEXITY OF PEDIATRIC CATARACT SURGERY 224

三、手术时机TIMING OF SURGERY 224

四、术前检查PRE-OPERATIVE EXAMINATION 224

五、手术治疗SURGICAL PROCEDURE 225

六、有关儿童白内障手术的问题探讨THE CONTROVERSY OVER PEDIATRIC CATARACT SURGERY 227

八、术后合并症POSTOPERATIVE COMPLICATIONS 229

七、术后处理POSTOPERATIVE MANAGEMENT 229

第三十七章　高度近视眼白内障超声乳化术　CHAPTER 37 PHACOEMULSIFICATION IN HIGH MYOPIA 231

一、高度近视眼的解剖特点ANATOMICAL CHARACTERISTICS OF HIGH MYOPIA 231

二、术前检查与术后屈光状态的选择PREOPERATIVE EVALUATION AND CHOICE OF THE POSTOPERATIVE REFRACTION 232

三、人工晶体的选择与计算IOL CALCULATION AND ITS CHOICE 232

四、手术原则SURGICAL PRINCIPLES 233

五、透明晶状体摘除治疗高度近视CLEAR LENS EXTRACTION FOR THE CORRECTION OF HIGH MYOPIA 235

第三十八章 高度远视眼白内障超声乳化术　CHAPTER 38 PHACOEMULSIFICATION IN HIGH HYPEROPIA 237

一、高度远视眼部特点ANATOMICAL CHARACTERISTICS OF HIGH HYPEROPIA EYES 237

二、人工晶体计算IOL CALCULATION 238

三、人工晶体的选择CHOICE OF IOL 238

四、手术治疗SURGICAL PROCEDURES 239

五、手术并发症SURGICAL COMPLICATIONS 242

第三十九章 白内障超声乳化联合角膜散光矫正术　CHAPTER 39 CORRECTION OF THE PREOPERATIVE ASTIGMATISM IN PATIENT WITH PHACOEMULSIFICATION 243

一、小切口超声乳化术与手术源性角膜散光SMALL INCISION PHACO AND SURGICALLY INDUCED ASTIGMATISM 243

二、白内障超声乳化术中矫正角膜散光常用方法METHODS OF CORRECTION OF PREOPERATIVE ASTIGMATISM IN PHACOEMULSIFICATION 244

（一）最陡角膜散光轴向行透明角膜切口法CLEAR-CORNEAL INCISION ALONG STEEP MERIDIAN 244

（二）对侧透明角膜切口OPPOSITE CLEAR-CORNEAL INCISION 244

（三）角膜缘松解切口或周边角膜松解切口LIMBAL RELAXING INCISION（LRI）OR PERIPHERAL CORNEAL RELAXING INCISION（PCRI） 244

（四）Osher's散光性角膜切开术Osher's ASTIGMATIC KERATOTOMY 247

（五）Toric人工晶体植入术TORIC IOL IMPLANTATION 249

第四十章　硬核白内障超声乳化术　CHAPTER 40 PHACOEMULSIFICATION OF ROCK HARD CATARACT 253

一、临床特征CLINICAL CHARACTERISTICS OF ROCK HARD CATARACT 253

二、手术策略SURGICAL STRATEGIES 253

三、手术注意事项SURGICAL TIPS 256

一、临床经过CLINICAL PRESENTATION 257

二、临床特点CLINICAL CHARACTERISTICS 257

第四十一章　皮质液化性白内障超声乳化术　CHAPTER 41 PHACOEMULSIFICATION OF LIQUEFIED CATARACT 257

三、手术策略SURGICAL STRATEGIES 258

第四十二章　葡萄膜炎并发性白内障的手术治疗　CHAPTER 42 CATARACT SURGERY IN PATIENT WITH UVEITIS 261

一、术前准备PREOPERATIVE PREPARATION 261

二、手术原则THE PRINCIPLES OF SURGERY 261

三、小瞳孔手术处理措施THE MANAGEMENT OF MIOTIC PUPILS 263

四、术后处理及随访POSTOPERATIVE TREATMENT AND FOLLOW-UP 264

第四十三章 白内障合并青光眼的超声乳化手术　CHAPTER 43 PHACOEMULSIFICATION IN CATARACT AND GLAUCOMATOUS EYES 265

一、术前准备和手术方式的选择PREOPERATIVE PREPARATION AND CHOICE OF SURGERY 265

二、单纯超声乳化白内障手术SIMPLE PHACOEMULSIFICATION 266

三、超声乳化白内障摘除联合非穿透性小梁切除术PHACOEMULSIFICATION AND NON-PENETRATIVE TRABECULECTOMY 268

四、超声乳化白内障摘除联合小梁切除手术PHACOEMULSIFICATION AND TRABECULECTOMY 269

五、超声乳化白内障摘除联合前段玻璃体切除术PHACOEMULSIFICATION COMBINED WITH ANTERIOR VITRECTOMY 271

六、术后的观察与处理POSTOPERATIVE FOLLOW-UP 272

第四十四章　角膜移植、白内障摘除及人工晶体植入三联手术 273

CHAPTER 44 COMBINED CATARACT SURGERY AND KERATOPLASTY—THE TRIPLE PROCEDURE 273

一、手术适应证与手术方法INDICATIONS AND SURGICAL PROCEDURES 273

二、手术并发症COMPLICATIONS 275

三、手术技巧及其注意事项SURGICAL TECHNIQUES AND TIPS 275

第四十五章　玻璃体切除术后白内障超声乳化术　CHAPTER 45 PHACOEMULSIFICATION IN VITRECTOMIZED EYES 277

一、玻璃体切除术后白内障发生率及其原因RATE AND CAUSES OF CATARACT IN VITRECTOMIZED EYES 277

（二）人工晶体度数的计算IOL CALCULATION 278

四、术前评估PREOPERATIVE EVALUATION 278

（一）术后视力的预测EVALUATION OF VISUAL ACUITY 278

三、玻璃体切除术后眼的特点CHARACTERISTICS OF VITRECTOMIZED EYES 278

二、玻璃体切除术后白内障的手术时机TIMING OF SURGERY 278

五、手术原则PRINCIPLES OF SURGERY 279

六、术中及术后常见并发症INTRAOPERATIVE AND POSTOPERATIVE COMPLICATIONS 281

第四十六章　外伤性白内障的手术治疗　CHAPTER 46 SURGICAL TREATMENT OF TRAUMATIC CATARACT 283

一、一般处理原则PRINCIPLES OF GENERAL MANAGEMENT 283

二、手术基本原则GENERAL PRINCIPLES OF SURGERY 284

三、手术步骤SURGICAL PROCEDURES 284

第四十七章　无后囊膜支撑的二期人工晶体植入术　CHAPTER 47 SECONDARY INTRAOCULAR LENS IMPLANTATION IN EYES WITH NO CAPSU-LAR SUPPORT 289

一、适应证INDICATIONS 289

二、禁忌证或相对禁忌证CONTRAINDICATIONS 289

四、手术方式SURGICAL TECHNIQUES 290

三、术前准备PREOPERATIVE EXAMINATION 290

五、术后处理POSTOPERATIVE MANAGEMENT 296

六、并发症COMPLICATIONS 296

第四十八章　小切口折叠人工晶体置换术　CHAPTER 48 FOLDABLE IOL EXCHANGE THROUGH SMALL INCISION 299

一、原因CAUSES 299

二、人工晶体置换手术方法PROCEDURE OF IOL EXCHANGE 301

三、并发症COMPLICATIONS 304

四、人工晶体混浊的实验室研究LABORATORY STUDY OF OPACIFICATED IOLS 304

第四十九章　超声乳化术中常见并发症　CHAPTER 49 INTRAOPERATIVE COMPLICATIONS OF PHACOEMULSIFICATION SURGERY 307

一、概述INTRODUCTION 307

二、关键手术操作步骤相关合并症THE COMPLICATIONS ASSOCIATED WITH THE KEY SURGICAL PROCEDURES 308

（一）与切口有关的并发症COMPLICATIONS DURING INCISION CREATION 308

（二）与撕囊有关的并发症COMPL ICATIONS OF CAPSULORHEXIS 308

（四）与灌注抽吸有关的并发症COMPLICATIONS DURING IRRIGATION/ASPIRATION 309

（五）与人工晶体植入有关的并发症COMPLICATIONS DURING INTRAOCULAR LENS IMPLANTATION 309

（三）与碎核和超声乳化有关的并发症COMPLICATIONS DURING PHACOEMULSIFICATION 309

三、后囊膜破裂和玻璃体脱出POSTERIOR CAPSULE RUPTURE AND VITREOUS LOSS 310

（一）原因CAUSES 310

（二）并发症COMPLICATIONS 311

（三）处理MANAGEMENT 312

四、后弹力膜脱离DESCEMET MEMBERANE DETACHMENT 313

五、术中浅前房INTRAOPERATIVE SHALLOWING OF THE ANTERIOR CHAMBER 313

第五十章 白内障手术合并爆发性脉络膜上腔出血 CHAPTER 50 EXPULSIVE SUPRACHOROIDAL HEMORRHAGE DURING CATARACT SURGERY 315

一、发生率INCIDENCE 315

二、发病机制MECHANISM OF EXPULSIVE SUPRACHOROIDAL HEMORRHAGE 315

四、处理MANAGEMENT 316

三、临床表现CLINICAL MANIFESTATION 316

第五十一章 超声乳化术后眼内炎 CHAPTER 51 ENDOPHTHALMITIS AFTER PHACOEMULSIFICATION 317

一、临床表现CLINICAL MANIFESTATIONS 317

（一）感染性眼内炎INFECTIVE ENDOPHTHALMITIS 317

（二）晶状体相关性葡萄膜炎LENS-RELATED UVEITIS 317

二、诊断DIAGNOSIS 318

三、发病原因、预防与治疗THE ETIOLOGY，PREVENTION AND TREATMENT 318

（一）发病原因ETIOLOGY 318

（二）预防PROPHYLAXIS 318

（三）治疗MANAGEMENT 319

第五十二章 超声乳化白内障吸除术后慢性角膜水肿的防治 CHAPTER 52 THE PREVENTION AND TREATMENT OF CHRONIC CORNEAL EDEMA AFTER PHACOEMULSIFICATION 321

一、角膜内皮细胞的生理特性及其功能PHYSIOLOGY AND FUNCTION OF ENDOTHELIUM 321

二、角膜内皮的愈合机制HEALING MECHANISM OF ENDOTHELIUM 321

四、临床表现CLINICAL MANIFESTATIONS 322

三、内皮损伤的机制MECHANISM OF ENDOTHELIUM DAMAGE 322

五、术后慢性角膜水肿的预防PREVENTION OF CHRONIC CORNEAL EDEMA 323

六、术后慢性角膜水肿的治疗TREATMENT OF CHRONIC CORNEAL EDEMA 325

第五十三章 如何通过手术途径降低后囊膜混浊的发生率 CHAPTER 53 HOW TO REDUCE THE RATE OF POSTERIOR CAPSULAR OPACIFICATION 327

一、研究意义SIGNIFICANCE OF STUDY 327

二、病理机制PATHOGENESIS 327

三、防治的有效手术途径SURGICAL METHODS FOR PREVENTION 328

四、Nd:YAG激光切开术Nd:YAG CAPSULOTOMY 331

第五十四章 超声乳化白内障吸除术中灌注液及相关药物 CHAPTER 54 INTRAOCULAR IRRIGATING SOLUTIONS AND DRUGS USED FOR PHACOEMULSIFICATION 335

一、相关实验室研究LABORATORY STUDIES 335

二、灌注液INTRAOCULAR IRRIGATING SOLUTIONS 336

三、术中相关用药DRUGS USED INTRAOPERATIVELY 337

一、粘弹剂的物理学及流变学特性PHYSICAL AND RHEOLOGICAL CHARACTERISTICS OF OVD 339

第五十五章 眼科粘弹性物质 CHAPTER 55 OPHTHALMIC VISCOELASTIC DEVICES 339

（一）粘滞性VISCOSITY 340

（二）假可塑性PSEUDOPLASTICITY 340

（三）弹性ELASTICITY 340

（四）内聚性COHESIVENESS 340

（五）涂敷性COATABILITY 340

二、粘弹剂的分类CLASSIFICATION OF OVD 341

三、成分简介INGREDIENTS 341

（一）透明质酸钠SODIUM HYALURONATE，NAHA 341

（二）硫酸软骨素CHONDROITIN SULFATE，CDS 342

（三）羟丙甲基纤维素HYDROXYPROPYL METHYLCELLULOSE，HPMC 342

（四）其他OTHERS 342

四、常见OVDs产品简介PRODUCTIONS 342

附录 超声乳化仪参数设置 APPENDIX PARAMETERS SETTING OF PHACOEMULSIFICATION SYSTEM 345

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