白内障膨胀期继发青光眼的手术疗效观察

目的观察白内障膨胀期继发青光眼的手术效果.方法对42例(42眼)白内障膨胀期继发青光眼行手术治疗.其中5眼行单纯小切口白内障囊外摘出人工晶状体植入术;34眼行小切口白内障囊外摘出人工晶状体植入联合小梁切除术,另3眼行小切口白内障囊外摘出联合小梁切除术.结果术后眼压正常40眼(95.24%),术后视力均较术前明显提高,术后视力≥0.3者29眼(69.05%).结论白内障膨胀期继发青光眼选择恰当的手术方式,可以控制眼压及提高视力,及时手术是预防白内障膨胀期继发青光眼的有效措施.     

超声乳化联合IOL植入治疗晶状体溶解性青光眼的临床研究

目的:研究超声乳化联合人工晶状体植入治疗晶状体溶解性青光眼的治疗效果。方法:对32例32眼过熟期白内障继发晶状体溶解性青光眼患者,采用超声乳化联合人工晶状体植入给予治疗,对视力及眼压情况进行观察和研究。结果:术后随访0.5a,眼压均控制到正常范围内,视力有不同程度提高。结论:通过临床观察证明单纯超声乳化联合人工晶状体植入治疗晶状体溶解性青光眼安全有效,且手术切口小,组织损伤小,术后反应较轻,可有效控制眼压,恢复视功能。     

晚期青光眼合并老年性过熟期白内障的术后观察

目的探讨晚期青光眼合并老年性过熟期白内障的手术治疗效果。方法对进行传统青白联合术的16例病人18眼（其中10例为独眼）;抗青光眼术后合并白内障19例22眼,进行巩膜隧道切口白内障超声乳化摘除并植入折叠式人工晶体。术前观察视力、眼压。结果术后术眼眼压均较术前明显降低,视力较术前提高。结论对晚期青光眼合并过熟期老年性白内障,手术治疗仍为较好方法,且能明显降低眼压和改善视力。     

硅油乳化继发青光眼及白内障的手术探究

目的:探讨硅油乳化继发青光眼及白内障的手术方式。方法:选取硅油乳化继发青光眼及白内障患者30例30眼,行硅油取出联合晶状体超声乳化人工晶状体植入及小梁切割术,观察患者术后7d～6mo术眼的视力、眼压,以及术后并发症发生的情况。结果:所有术眼均有不同程度的乳化硅油小滴残留,术后视力上升者18眼(60%),下降者7眼(23.3%),不提高者5眼(16.7%);眼压1wk内正常者25眼(83.3%),高于正常者5眼(16.7%);6mo后眼压正常者28眼(93.3%),高于正常者2眼(6.7%);无角膜失代偿、人工晶状体移位或玻璃体积血发生。结论:硅油取出术联合晶状体超声乳化人工晶状体植入及小梁切割术可有效控制硅油乳化继发青光眼及白内障患者的眼压,并提高视力,是一种治疗硅油乳化继发青光眼及白内障安全、有效的术式之一。     

小切口手法白内障囊外摘除联合房角分离术的临床分析

目的:探讨小切口手法白内障囊外摘除人工晶状体植入联合房角分离术治疗继发性闭角型青光眼临床效果。方法:在22例27眼年龄相关性白内障继发闭角型青光眼中,术前及术后常规行视力、前房深度、前房角镜、眼压检查,统计学分析处理。结果:所有患者术后末次随访平均眼压(14.57±4.78mmHg)较术前用降眼压药后平均眼压(25.81±2.90mmHg)明显下降,术后视力均有不同程度提高,中央前房深度由术前的1.22±0.35mm增加到术后2.35±0.26mm,房角均较术前增宽,术前关闭房角有不同程度地开放。结论:小切口手法白内障囊外摘除人工晶状体植入联合房角分离术治疗年龄相关性白内障继发闭角型青光眼能良好地控制眼压和提高视力。     

不同手术方式治疗膨胀期白内障继发青光眼的临床观察

目的:探讨膨胀期白内障继发青光眼的治疗方法。方法:对36例36眼老年性白内障膨胀期引起的继发性急性闭角型青光眼患者,根据前房角检查结果选择手术方式:房角开放1/2以上实施小切口白内障囊外摘除联合人工晶状体植入术(两联术),反之采用小切口白内障囊外摘除联合人工晶状体植入加小梁切除术(三联术)。其中16例行两联手术,20例行三联手术。结果:两联手术患者16例,视力0.05～0.2者5例(31%);0.3～0.4者9例(56%);≥0.5者2例(13%)。16眼术后眼压12.23～20.55(平均16.46)mmHg。20例三联手术患者视力0.05～0.2者9例(45%);0.3～0.4者8例(40%);≥0.5者3例(15%)。其中18眼术后眼压13.35～20.55(平均16.48)mmHg。2眼术后眼压高于正常达32.9～25.81mmHg,5g/L噻吗心安眼液点眼1次/d,眼压控制正常,平均眼压14.57mmHg。结论:膨胀期白内障继发青光眼患者房角开放1/2以上实施小切口白内障囊外摘除联合人工晶状体植入术(两联术);反之采用小切口白内障囊外摘除联合人工晶状体植入加小梁切除术(三联术)远期疗效良好。     

超声乳化联合人工晶状体植入治疗过熟期白内障376例观察

目的 探讨超声乳化联合人工晶状体植入术治疗过熟期白内障的疗效.方法 对376例过熟期白内障施行超声乳化联合人工晶状体植入术,观察其撕囊成功率、人工晶状体囊袋内植入率、术中的并发症、术后视力、眼压等指标.结果 376眼中撕囊成功361眼(占96.01%),人工晶状体囊袋内植入367眼(占97.60%).术中后囊膜破裂4眼,部分悬韧带断裂3眼,乳化头损伤虹膜2眼.术后轻度角膜水肿36眼,虹膜部分后粘连2眼.术后第1天视力均有明显的提高,视力0.3以上有264眼(占70.21%),眼压正常.结论 超声乳化联合人工晶状体植入术治疗过熟期白内障的疗效良好(中国眼耳鼻喉科杂志,2007,7:99-100)     

青光眼白内障联合手术治疗白内障继发青光眼

目的探讨白内障继发青光眼进行白内障青光眼联合手术的效果。方法28例（28只眼）白内障继发青光眼完成了超声乳化吸出及人工晶状体植入联合巩膜瓣下小梁切除术。结果术前视力〈0．1者22只眼,0．1～0．3者6只眼。术后视力〈0．1者13只眼,0．1～1．0者15只眼。术前平均眼压（34．30±9．32）mmHg,术后平均眼压（16．42±5．36）mmHg（1mmHg=0．133kPa）。25眼眼压降至正常范围,3眼经药物治疗达到正常范围。并发症主要是角膜水肿和浅前房。术后随访3～6个月。结论超声乳化吸出及人工晶状体植入联合巩膜瓣下小梁切除术对于白内障继发青光眼是安全和有效的。     

Fuchs综合征并发白内障青光眼手术治疗的临床体会

目的: 探讨Fuchs综合征并发白内障青光眼的手术治疗效果。方法: 对Fuchs综合征患者16例16眼合并白内障行超声乳化联合人工晶状体植入术,2例2眼合并白内障及青光眼行超声乳化人工晶状体植入术联合小梁切除术,观察术前和术后视力、眼压以及治疗效果。结果: 患者18例18眼术后视力均有明显提高,术后3mo视力(含矫正)≥0.5者16眼(88.89%),10眼后囊混浊行YAG激光后囊切开术后视力均≥0.5。2眼合并青光眼者术后眼压降至正常范围。结论: 超声乳化联合人工晶状体植入术以及联合小梁切除术治疗Fuchs综合征并发白内障青光眼效果良好,安全可靠,术后反应轻,并发症少,是可行的手术方法。     

晶状体超声乳化人工晶状体植入术治疗闭角型青光眼

目的观察分析晶状体超声乳化吸出术联合后房人工晶状体植入术治疗合并白内障的急性闭角型青光眼的疗效。方法对我院治疗的合并白内障的闭角型青光眼48例(48眼),术前查前房角,前房角关闭粘连小于180°范围者行晶状体超声乳化吸出术联合后房型人工晶状体植入术。术前、术后分析比较眼压、视功能及前房深度,随访6～12个月。结果术后48眼眼压全部控制在21.0 mmHg以下,无严重并发症。46眼视力均有不同程度的提高,2眼视力无变化。术前术后视力及眼压差异有统计学意义。结论对于合并有白内障的前房角关闭粘连小于180°的急性闭角型青光眼可行单纯晶状体超声乳化人工晶状体植入术治疗。     

Strabisme Alternant - Etude clinique - traitement

The author defines motor and sensory alternation: the term alternation should not be used in isolation, it should always be accompanied by the name of the parameter concerned. Sensory alternation is always found together with motor alternation but the reverse is not true.The examining criteria for a diagnosis of sensory alternation are given, sensory alternation must not be confused with alternating inhibition. Working from clinical observations of cases of motor alternating strabismus, the author selects 2 types of binocular sensory relations which allow one to differentiate between:- cases of primary alternating strabismus- cases of secondary alternating strabismusThese forms will develop in different ways; in both cases a cure is possible providing that the right treatment is prescribed and once prescribed carefully followed, etc. It is always a case of serious forms of strabismus whose developmental period is spread over several years.According to the authors, the frequency of cases of true primary strabismus is from 1–3%, the frequency of cases of secondary alternating strabismus varies according to the type of therapy practised on cases of monocular strabismus with amblyopia. These latter will become cases of alternating strabismus under the influence of certain types of therapy carried out over several years (penalization, rocking, alternated occlusion, etc...).Experimental data on kittens confirm clinical data; kittens placed in abnormal environments during the sensitive period will show modification in the distribution of cortical cells and the absence of binocular cells (either because the excitation of the two eyes was not simultaneous, or not identical: artificial strabismus, occlusion, opaque glasses). This disturbances become irreversible after a certain period of exposure (a function of age, length of exposure, etc...).It is thus necessary to bear in mind: 1) the iatrogenic risks of certain orthoptic treatments, 2) the necessity for a binocular form of treatment as soon as possible, as once a certain stage is passed, cortical plasticity diminishes and the elaboration of normal binocular relations becomes impossible.

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Effects of Adenosine Agonists on Intraocular Pressure and Aqueous Humor Dynamics in Cynomolgus Monkeys

The effects of single or multiple topical doses of the relatively selective A₁adenosine receptor agonists (R)-phenylisopropyladenosine (R-PIA) and N⁶-cyclohexyladenosine (CHA) on intraocular pressure (IOP), aqueous humor flow (AHF) and outflow facility were investigated in ocular normotensive cynomolgus monkeys. IOP and AHF were determined, under ketamine anesthesia, by Goldmann applanation tonometry and fluorophotometry, respectively. Total outflow facility was determined by anterior chamber perfusion under pentobarbital anesthesia. A single unilateral topical application of R-PIA (20–250 μg) or CHA (20–500 μg) produced ocular hypertension (maximum rise=4.9 or 3.5 mmHg) within 30 min, followed by ocular hypotension (maximum fall=2.1 or 3.6 mmHg) from 2–6 hr. The relatively selective adenosine A₂antagonist 3,7-dimethyl-1-propargylxanthine (DMPX, 320 μg) inhibited the early hypertension, without influencing the hypotension. Neither 100 μg R-PIA nor 500 μg CHA clearly altered AHF. Total outflow facility was increased by 71% 3 hr after 100 μg R-PIA. In conclusion, the early ocular hypertension produced by topical adenosine agonists in cynomolgus monkeys is associated with the activation of adenosine A₂receptors, while the subsequent hypotension appears to be mediated by adenosine A₁receptors and results primarily from increased outflow facility.