睫状神经节烧灼加视神经剪断术治疗绝对期青光眼

目的观察睫状神经节烧灼及视神经剪断术治疗伴有剧烈疼痛的绝对期青光眼的疗效。方法对15例(15眼)确诊为绝对期青光眼并伴有剧烈疼痛者,采用睫状神经节烧灼加视神经剪断术进行治疗。术中先行外直肌剪断。然后剪断视神经,翻转眼球暴露睫状神经节用烧灼器行睫状神经节烧灼。结果15例(15眼)术后1周内所有症状全部消失。出院后3a内定期追踪观察,无1例复发,保留眼球有效率为100％。结论睫状神经节烧灼加视神经剪断术方法简单,易于开展,在绝对期青光眼的治疗中有较好的疗效。     

氯丙嗪球后注射联合角膜层间灼烙治疗绝对期青光眼

目的:探讨氯丙嗪球后注射联合角膜层间灼烙治疗绝对期青光眼的临床效果,以解除绝对期青光眼疼痛问题。方法:对29例(30眼)绝对期青光眼采用球后注射氯丙嗪,对伴发大泡性角膜病变者加用角膜层间灼烙术。结果:29例中14例仅采用球后注射氯丙嗪一种方法就达到止疼目的,15例(16眼)伴发大泡性角膜病变者,因球后注射未完全解除疼痛而加用角膜层间灼烙术后疼痛消失。结论:球后注射氯丙嗪治疗绝对期青光眼引起的疼痛是简单有效的方法,对合并大泡性角膜病变者,于第1次注射氯丙嗪后即需加用角膜层间灼烙术。     

先天性无虹膜患者的临床分析

目的探讨先天性无虹膜患者的l临床表现及其治疗。方法为回顾性系列病例研究。选择1984年1月至2007年1月于我科就诊的8例（16只眼）先天性无虹膜患者,均为双眼患病,矫正视力均低于1．0。8例患者均伴不同程度白内障;其中5只眼伴青光眼,均为难治性青光眼;4只眼伴弱视;8只眼伴眼球水平震颤。根据病情不同分别行囊外白内障摘除术和人工晶状体植人术、小梁切除术、睫状突激光光凝术、戴镜行弱视训练、配戴角膜接触镜等治疗。结果6只晶状体明显混浊眼行白内障手术后视力有不同程度提高,无手术并发症。5只青光眼中,1只眼行小梁切除术,但术后眼压仍然不能控制于正常范围内,又行睫状突光凝术;3只眼仅行睫状突光凝术;1只眼局部使用降眼压药物治疗。此5只青光眼中,3只眼眼压得到控制,另2只眼仍不能控制于正常范围内。4只弱视眼经配镜、弱视训练后视力均有一定提高,2只眼配戴角膜接触镜后畏光症状得到缓解。结论先天性无虹膜患者眼部表现多种多样,虽治疗棘手,但经适当的治疗后可改善视力和临床症状。（中华眼科杂志．2008,44：46-49）     

睫状环阻滞性青光眼的超声生物显微镜检查

目的 应用超声生物显微镜结合Ａ超检查睫状环阻滞性青光眼,以了解急性发作时睫状环阻滞的状况。方法 对２７例（３１只眼）抗青光眼术后发生的睫状环阻滞性青光眼进行实时超声生物显微镜检查,与同一眼术前的超声生物显微镜影像进行对比观察;并以５４只正常眼和７２只原发性闭角型青光眼作为对照研究。结果 睫状环阻滞性青光眼发作时,１８只眼（５８．１％）睫状体和晶体完全相贴,１３只眼（４１．９％）睫状体和晶体间有一间     

新生血管性青光眼睫状体冷凝术联合球后无水酒精注射疗效观察

目的 观察睫状体冷凝术联合球后无水酒精注射治疗新生血管性青光眼患者眼痛等临床症状的疗效.方法 对视力光感或光感消失伴药物不能控制眼压、且不宜施行滤过性手术的新生血管性青光眼32例（32只眼）,施行睫状体冷凝联合球后无水酒精注射术,并辅助降眼压药物治疗.结果 所有患者眼压均得到控制,症状缓解,虹膜新生血管消失.结论 睫状体冷凝术联合球后无水酒精注射对缓解视功能丧失的新生血管性青光眼患者的眼痛等临床症状是一种有效的治疗方法.     

布比卡因、利多卡因球后注射致暂时失明八例报告

布比卡因、利多卡因球后注射致暂时失明八例报告瑞安市人民医院眼科金晓峰球后麻醉是在眼球肌锥内注入麻醉药阻滞睫状神经节及睫状神经，可使结膜、角膜及前葡萄膜得到麻醉，同时可以降低眼肌张力，并使眼眶内血管收缩，有降低眼压的作用，是眼部手术的主要麻醉手段。我院...     

球后注射氯丙嗪治疗绝对期青光眼

我院于 1995年至 2 0 0 0年对 12例绝对期青光眼伴顽固性眼痛行氯丙嗪球后注射 ,取得了显著的止痛效果 ,现总结如下。本组共 12例 12眼 ,男 6眼 ,女 6眼 ,年龄 17～ 84岁 ,平均年龄 5 8岁。病程短者 1个月 ,长者 1年余。 12眼中 11眼为新生血管性青光眼 ,其中一眼为Ｃｏａｔｓ病所继发 ,一眼为闭角型青光照绝对期 ,眼压在 43 38ｍｍＨｇ～ 81 78ｍｍＨｇ。平均眼压 65ｍｍＨｇ。其中伴有前房积血 2例。仅 1眼入院视力为眼前手动 ,其余均为无光感。所有患眼均有角膜混浊水肿 ,虹膜萎缩 ,有新生血管 ,瞳孔强直散大 ,伴有眼痛、偏头痛。治疗方…     

睫状体冷凝联合睫状前动脉结扎及广泛视网膜光凝治疗新生血管性青光眼

目的睫状体冷凝联合睫状前动脉结扎及广泛视网膜光凝治疗新生血管性青光眼的临床效果。方法新生血管性青光眼20例,在球后麻醉下行睫状体冷凝联合睫状前动脉结扎术及广泛视网膜光凝,观察术后眼压、视力变化及虹膜新生血管消退情况。结果手术前后眼压变化有统计学意义（P〈0．05）、虹膜新生血管明显消退。结论该术式治疗新生血管性青光眼是一种安全,有效的方法。能有效地消退虹膜新生血管,控制眼压,消除眼痛症状。     

角膜层间烧灼联合错位神经根切断及羊膜覆盖术治疗大泡性角膜病变

目的 观察角膜层间烧灼联合错位角膜神经根切断及羊膜覆盖术治疗大泡性角膜病变的临床疗效。方法 选取有明显眼痛且视功能差的大泡性角膜病变患者28人（28只眼）,其中白内障摘除联合人工晶体植入术后16只眼,单纯白内障摘除术后2只眼,白内障针拨术后1只眼,青光眼白内障联合术后3只眼,青光眼滤过术后2只眼,闭角型青光眼绝对期1只眼,眼外伤2只眼,玻璃体切割术后1只眼。对28只眼均行角膜板层切开,层间烧灼,错位角膜神经根切断及羊膜覆盖术。术后随诊观察6～ 32个月,平均18月。结果 术后28只眼中25只眼(89.3％)术后疼痛感消失,3只眼(10.7％)疼痛明显缓解。术后1月8只眼(28.6％)视力提高,20只眼(71.4％)视力同术前。羊膜于术后5 ～45天脱落或溶解,平均28.8天。 术后26只眼(92.9％)角膜上皮在1月内愈合,角膜大泡完全消失,2只眼(7.1％)角膜大泡范围明显缩小。28只眼角膜基质水肿均减轻。随访6～ 32个月均未发现症状复发,角膜大泡复发或其他并发症出现,患者原有残存视力保留或提高。结论 角膜层间烧灼联合角膜错位神经根切断及羊膜覆盖术是缓解视功能差的大泡性角膜病变患者疼痛症状的有效的手术方法。     

睫状环阻塞性青光眼的治疗方法的临床报道

目的探讨睫状环阻塞性青光眼的治疗方法及疗效。方法在本院行青光眼术后发生的睫状环阻塞性青光眼25例（27眼）,进行早期综合药物治疗,包括散瞳、皮质类固醇滴眼、碳酸酐酶抑制剂滴眼和口服,甘露醇静脉滴注等,疗程结束后所有患者均进行结果评定,并对其临床资料进行总结分析。结果术后早期均有轻度的角膜水肿,前房变浅或消失,眼压正常或升高。7眼青光眼联合白内障手术伴不同程度的前房渗出,2眼人工晶状体前膜形成,经皮质类固醇及散瞳局部治疗1周后角膜透明：渗出及膜均吸收,前房反应消失,前房深度恢复正常。此外,治疗后的平均眼压（17．3±2．3）mmHg,与治疗前平均眼压（25．0±2．0）mmHg比较,差异显著。结论早期综合药物治疗青光眼术后发生的睫状环阻塞性青光眼,眼压均得到有效的控制,治疗成功后部分患者继续长期滴用睫状肌麻痹剂的措施有一定效果。     

小梁切除联合巩膜瓣下甘油保存羊膜植入治疗难治性青光眼

目的:探讨小梁切除联合巩膜瓣下甘油保存羊膜植入治疗难治性青光眼的临床疗效.方法:对完成随访观察的12例(17眼)难治性青光眼患者施行小梁切除联合巩膜瓣下甘油保存羊膜植入.结果:术后随访6～24mo,88%的患者眼压得到良好控制,功能性滤过泡形成率为88%,无明显严重并发症发生;2例新生血管性青光眼分别于术后2,3mo眼压复升,手术失败.结论:小梁切除联合巩膜瓣下甘油保存羊膜植入手术,功能性滤过泡形成良好,眼压控制满意,可作为治疗难治性青光眼一种新的、有效的尝试术式.     

彩色多普勒超声对中晚期青光眼患者眼动脉血流速度的测定

目的了解中、晚期青光眼患者眼动脉血流情况及血管因素在中、晚期青光眼患者视功能损害机制中的作用。方法采用彩色多普勒超声检查仪测定１５６例中、晚期青光眼患者的眼动脉血流速度，并与正常组７５例的有关参数值进行比较。结果正常组：平均最大收缩期血流速度（ｐｅａｋｓｙｓ－ｔｏｌｉｃｖｅｌｏｃｉｔｙ，ＰＳＶ）为３５．９８±９．１３ｃｍ／ｓ，舒张期眼动脉血流速度（ｅｎｄｄｉａｓｔｏｌｉｃｖｅｌｏｃｉｔｙ，ＥＤＶ）为１１．９８±３．９０ｃｍ／ｓ。开角型青光眼（ｐｒｉｍａｒｙｏｐｅｎａｎｇｌｅｇｌａｕｃｏｍａ，ＰＯＡＧ）组：ＰＳＶ为２４．１３±４．６５ｃｍ／ｓ，ＥＤＶ为７．１０±１．８５ｃｍ／ｓ，闭角型青光眼（ｐｒｉｍａｒｙｃｌｏｓｅａｎｇｌｅｇｌａｕｃｏｍａ，ＰＣＡＧ）组：ＰＳＶ为２２．８９±５．４３ｃｍ／ｓ，ＥＤＶ为７．０６±１．９２ｃｍ／ｓ。各组间ＰＳＶ与ＥＤＶ比较：ＰＯＡＧ组与ＰＣＡＧ组间差异无显著性（Ｐ＞０．０５），青光眼组与正常组间差异有非常显著性（Ｐ＜０．０１）。结论中、晚期青光眼患者因眼动脉血流速度下降明显，导致局部血液循环障碍。青光眼患者的视功能损害与视神经的血供不足关系密切。     

Comparison of efficacy and tolerability between two gel-forming timolol maleate ophthalmic solutions in patients with glaucoma or ocular hypertension

PURPOSE: To compare two gel-forming timolol maleate ophthalmic solutions, Timoptol XE and Lizmon TG, in regard to efficacy and tolerability in patients with glaucoma or ocular hypertension by means of a patient-masked prospective randomized crossover study. SUBJECTS AND METHODS: A total of 37 patients with glaucoma or ocular hypertension under treatment with antiglaucoma ophthalmic solutions including 0.5% twice-daily timolol maleate participated in this study. Only timolol maleate was withdrawn and either Timoptol XE or Lizmon TG was randomly allocated. After instillation for 1 month, the other ophthalmic solution was subsequently instilled for another month. Routine ophthalmic examination including slit-lamp examination and intraocular pressure (IOP) monitoring was conducted before instillation of gel-forming ophthalmic solutions and just after completing the instillation of each ophthalmic solution. Patient questionnaire surveys were also performed just after completing the instillation of each ophthalmic solution. RESULTS: Mean IOP, just before the withdrawal of timolol ophthalmic solution, was 16.4 +/- 2.9 mm Hg. At the end of Timoptol XE or Lizmon TG instillation, mean IOPs were 16.3 +/- 2.5 or 16.3 +/- 3.0 mm Hg, respectively. The results of the questionnaire survey showed no significant difference between Timoptol XE and Lizmon TG in regard to all survey items. Twenty-nine patients (78.4%) preferred to use gel-forming timolol solutions rather than twice-daily timolol ophthalmic solution. The presence of concurrently used ophthalmic solutions did not effect the incidences of subjective symptoms. The incidences of objective adverse effects were not significantly different between two gel-forming timolol ophthalmic solutions. CONCLUSION: Both gel-forming timolol ophthalmic solutions could be good choices for glaucoma treatment.     

The use of YAG cyclophotocoagulation to lower pressure in advanced glaucoma

YAG cyclophotocoagulation is a non-invasive cyclodestructive procedure which may be used in a graduated dosage as an outpatient procedure in cases of refractory glaucoma. In a group of 60 patients treated there were 37 patients with absolute glaucoma and 23 patients with advanced glaucoma in most of whom drainage operation had failed to control the intraocular pressure (IOP). Following treatment IOP fell in all but one case with absolute glaucoma. In 21 cases with absolute glaucoma it fell to 22 mmHg or less, while in 21 cases with advanced glaucoma it was 22 mmHg or less. Treatment was graduated as mild, moderate or maximal. Reactions were more severe with maximal treatment. In advanced glaucoma mild treatment only was used and this was repeated if necessary. Hypotony only occurred with maximal therapy.     

The use of YAG cyclophotocoagulation to lower pressure in advanced glaucoma

YAG cyclophotocoagulation is a non-invasive cyclodestructive procedure which may be used in a graduated dosage as an outpatient procedure in cases of refractory glaucoma. In a group of 60 patients treated there were 37 patients with absolute glaucoma and 23 patients with advanced glaucoma in most of whom drainage operation had failed to control the intraocular pressure (IOP). Following treatment IOP fell in all but one case with absolute glaucoma. In 21 cases with absolute glaucoma it fell to 22 mmHg or less, while in 21 cases with advanced glaucoma it was 22 mmHg or less. Treatment was graduated as mild, moderate or maximal. Reactions were more severe with maximal treatment. In advanced glaucoma mild treatment only was used and this was repeated if necessary. Hypotony only occurred with maximal therapy.     

小梁切除联合睫状体平坦部造瘘治疗绝对期青光眼研究

目的：研究绝对期青光眼消除症状，保留眼球的治疗方法。方法：对20例20眼绝对期青光眼患者采用小梁切除联合睫状体平坦部造瘘置硅胶管手术。结果：绝大多数患者症状消除，眼压下降。结论：本文设计的方法效果良好。对术后硅胶管裸露的预防值得进一步深入研究。     

Prevalence of glaucoma types and legal blindness from glaucoma in the western region of Saudi Arabia: a hospital-based study

To determine prevalence of glaucoma subtypes and legal blindness in patients on their first visit to an ophthalmic center in the western region of Saudi Arabia a chart review analysis was carried out of new patients in 2006 with glaucoma diagnosis in our Glaucoma Unit. Diagnosis was confirmed clinically and by glaucoma workup. The main outcome was prevalence of glaucoma types and legal blindness from glaucoma. Of 2,354 new patients in 2006, 417 were glaucomatous. Mean age was 56.4 years and mean intraocular pressure (IOP) was 26.5 mmHg; 54.4% had prior glaucoma diagnosis. Prevalence of primary open-angle glaucoma was 30.5%, primary angle-closure 24.7%, neovascular 7.6%, surgically induced 6.5%, and exfoliative 5.2%. One-third of patients were unilaterally legally blind, whereas 11.3% were bilateral. Primary glaucoma represents two-thirds of glaucoma cases in Saudi Arabia. Approximately one-half of patients were legally blind in at least one eye at time of presentation.     

儿童Marfan综合征的临床表现和眼部并发症的防治

目的 分析马凡综合征的临床表现和眼部并发症的防治情况。方法 对儿童16例马凡综合征的临床资料进行回顾性分析。结果 16例患者中晶状体脱位占100％，视网膜脱离占12．5％。心血管异常占43．75％。体形高瘦、蛛状指占50％，有家族史占31％。行晶状体摘除和人工晶状体植入术后。患儿视力均得到不同程度的提高。结论 对可疑马凡综合征的儿童。应及时全身检查，对相关项目综合分析。脱位品状体的早期摘除和人工晶状体植入可有效防止患儿青光眼、色素膜炎和弱视并发症的发生。     

The causes of a decrease in eye function in open-angle glaucoma

On the grounds of the analysis of 123 case histories of patients with open-angle glaucoma, for the period of 5-20 years, as well as clinical and sectional observations, the authors make a conclusion that in a part of patients the cause of progression of glaucomatous process in normalized intraocular pressure is a descending atrophy of the optic nerve. It is connected with sclerotic changes in the internal carotid and ophthalmic arteries exerting pulsating pressure on intracranial portions of the optic tract (a "basal factor" of glaucoma).     

恶性青光眼发病机制及临床分型的研究

目的 研究恶性青光眼的发病机制,为它的临床分类提供依据。方法 采用眼科超声生物显微镜、眼科Ａ,Ｂ型超声以及眼科临床检查方法及诊断性手术对１２例恶性青光眼病例进行了活体眼部解剖结构的定性及定量观察,并采用对照研究的方法和对侧眼进行了比较研究,按照观察结果结合临床表现对恶性青光眼的分类提出了新的建议。结果 在１２例病例中有４例（３３．３％）经超声生物是微镜证实存有睫状环阻滞的特征,且对侧眼存在眼前段侠