Falsely elevated intraocular pressure due to increased central corneal thickness

· Purpose: To evaluate whether ocular hypertensive subjects have a higher central corneal thickness than other individuals. · Methods: In this prospective study, 48 subjects with ocular hypertension, 63 patients with open-angle glaucoma, 56 nonglaucomatous patients with diabetes mellitus, and 106 control subjects were evaluated. Corneal thickness was measured by ultrasound pachymetry, and intraocular pressure was determined by Goldmann applanation tonometry. · Results: Central corneal thickness was significantly higher in the ocular hypertensive subjects, mean ±S.D., 592±39 μm, than in the patients with glaucoma (536±34 μm), the nonglaucomatous patients with diabetes mellitus (550±31 μm), and the normal subjects (545±33 μm), P<0.001. The three latter groups did not vary significantly in central corneal thickness, P>0.05. · Conclusion: In some individuals with increased transcorneal measurements of intraocular pressure, the cornea is thicker than in subjects with normal intraocular pressure readings or patients with glaucoma. It suggests that in ocular hypertensive subjects, corneal pachymetry should be performed to rule out an abnormally thick cornea as a reason for falsely high measurements of intraocular pressure. Received: 14 April 1998 Revised version received: 10 July 1998 Accepted: 23 July 1998     

Filtration procedures supplemented with mitomycin C in the management of childhood glaucoma

AIMS: To evaluate the outcome of filtering procedures supplemented with mitomycin C in children with glaucoma. METHODS: All patients aged 17 or younger with glaucoma who underwent filtering surgery supplemented with mitomycin C at a tertiary care centre (n = 21) during a 5 year interval (1992 and 1996) were included. One eye for each patient was entered into the analysis. The postoperative intraocular pressure (IOP), use of antiglaucoma medications, clinical stability of glaucoma, complications, and visual acuity were retrospectively evaluated. Kaplan-Meier survival curves were used to estimate the probability of success. RESULTS: At the time of surgery mean age was 5.7 (SD 5.0) years. The most common diagnoses were trabeculodysgenesis (n = 6) and aphakic glaucoma (n = 8). Mean IOP before surgery was 35.7 (10.5) mm Hg. Average length of follow up was 18.6 (14.7) months. The probability of having IOP less than 21 mm Hg with no antiglaucoma medications and with clinically stable glaucoma 1 year after surgery was 76.9% in phakic eyes (n = 13) and 0% in aphakic eyes (n = 8). A phakic patient with Sturge-Weber's syndrome had choroidal effusion after surgery that resolved spontaneously. In the aphakic group one patient had retinal detachment and another developed an encapsulated bleb. Visual acuity deteriorated in one patient. CONCLUSION: A guarded filtration procedure with mitomycin C is relatively successful in phakic children with glaucoma, but unsuccessful in aphakic ones.     

硅油继发青光眼的发病相关因素及治疗的初步探讨

探讨硅油继发青光眼的发病相关因素及治疗。方法对行玻璃体切割,硅油注入术的２７５例患者术后随访结果进行回顾性研究。结果硅油继发青光眼的发病率为１１．３％,随着硅油在眼内存留时间的延长,其发病率增高。     

An Experimental Study on Homoharringtonine Liposome and Glaucoma Filtration Surgery

Purpose: To observe the inhibitory action of homoharringtonine liposome during the healing process of wounds in the filtering sitesMethods: posterior sclerectomies were performed in 14 rabbits. Postoperatively one eye of each rabbit received subconjunctival injections of HH liposome and fellow eye received saline injection in a randomized masked fashion.Results; Fourteen days after operation the IOP of experimental eyes reduced significantly (P < 0.01) as compared with the controlled eyes, and the number of remaining filtering blebs increased noticeably (P< 0.05). Pathohistological examination revealed that the number of fibroblasts per square micron in the filtering sites and the thickness of the scars in the center of the filtering sites of the experimental eyes were less than those of the controlled eyes. No serious ocular toxic and side effects were found.Conclusion : This experiment suggests that homoharringtonine liposome can markedly inhibit the scar formation of filtering sites after glaucoma fi     

抗心磷脂抗体检测在青光眼中的初步应用

目的探讨抗心磷脂抗体（ＡＣＡ）与青光眼疾患的临床相关意义。方法对２６例青光眼患者及１１例非青光眼患者,采用抗心磷脂抗体酶免疫（ＥＬＩＳＡ）测定法,进行抗心磷脂抗体检测。结果青光眼组ＩｇＧＡＣＡ与ＩｇＭＡＣＡ值均比对照组高,有显著差异（Ｐ＜０．０５）;其中开角型青光眼ＩｇＧＡＣＡ与对照组之ＩｇＧＡＣＡ值比较无显著差异（Ｐ＞０．０５）;开角型青光眼ＩｇＭＡＣＡ与对照组之ＩｇＭＡＣＡ值比较有显著差异（Ｐ＜０．０５）。闭角型青光眼与对照组比较：ＩｇＧＡＣＡ与ＩｇＭ之ＡＣＡ值比较均有显著差异（Ｐ＜０．０５）。结论青光眼病人的抗心磷脂抗体较高,预测可能产生视网膜静脉阻塞,需进一步追踪随访     

睫状体冷冻术联合巩膜穿刺术治疗绝对期青光眼

目的评价睫状体冷冻术联合巩膜穿刺术在治疗绝对期青光眼中的应用。方法对绝对期青光眼４７眼施行睫状体冷冻术联合巩膜穿刺术,观察术后３ａ内眼压变化。结果全部病例术后高眼压症都获缓解,对术后早期眼压反弹,本术较单纯施行睫状体冷冻术者控制眼压疗效好（Ｐ＜０．０１）,且无副作用和并发症。结论睫状体冷冻术联合巩膜穿刺术是治疗绝对期青光眼更简便、安全、有效的手术选择。     

减压阀引流术治疗新生血管性青光眼

为评价青光眼减压阀引流术治疗新生血管性青光眼,在视网膜血管性疾病、糖尿病、眼外伤所致的新生血管性青光眼２９例２９眼施行青光眼减压阀引流术,植入Ａｈｍｅｄ减压阀２０眼,Ｋｒｕｐｉｎ减压阀９眼。青光眼控制标准为６ｍｍＨｇ≤眼压≤２１ｍｍＨｇ,视功能保持或有所改善。结果：手术总成功率７５．８６％,眼压从术前平均５２．５６±１４．５１ｍｍＨｇ下降到２０．１５±１３．２６ｍｍＨｇ,平均随访１７．８３个月。有７眼在眼压正常后虹膜新生血管完全消退。术后３个月成功率７９．３１％,６个月成功率７６．１９％,１年成功率６６．６７％。主要手术并发症有前房导管口阻塞１３．７９％,浅前房１０．３４％,前房出血３．４５％。结论：青光眼减压阀引流术治疗新生血管性青光眼获得较为满意的疗效,是目前值得推荐的治疗选择。     

抗青光眼术在无晶体眼和人工晶体眼的疗效

探讨发生于无晶体眼和人工晶体眼的青光眼的有效的手术治疗方法。方法：回顾分析１９９２年１１月～１９９７年６月我院４５例４５眼发生于无晶体眼和人工晶体眼的青光眼的住院病例的临床资料。手术方法包括小梁切除术、睫状体冷冻术、青光眼减压阀植入引流术以及其他手术。结果：青光眼减压阀植入引流术控制眼内压优于睫状体冷冻术和小梁切除术,术后合并使用降眼压药物少于睫状体冷冻术后。结论：发生于无晶体眼和人工晶体眼的青光眼的治疗需根据临床情况考虑,青光眼减压阀植入引流术有较好的疗效     

青光眼减压阀植入治疗无晶体眼和人工晶体眼青光眼的疗效

目的 :评价青光眼减压阀植入术治疗无晶体眼和人工晶体眼青光眼的疗效 ,探讨术后并发症和预防措施。方法 :回顾性分析19例 ( 2 0眼 )无晶体眼和人工晶体眼青光眼患者行青光眼减压阀植入术。其中 13眼行 Ahmed减压阀植入 ,7眼行 Krupin减压阀。结果 :术后一周平均眼压 1.93± 0 .69k Pa,95 %术眼眼压控制正常。平均随访 18.9± 6.9月的 14只术眼平均眼压 2 .4 0± 0 .4 7k Pa,64 .3 %术眼眼压控制正常。术后常见并发症有前房导管口阻塞、导管接触角膜、前房积血、低眼压等。结论 :青光眼减压阀植入术是治疗无晶体眼和人工晶体眼青光眼的较为有效的方法 ,但仍存在一定的并发症     

Genetic markers in primary open-angle glaucoma

Purpose: To investigate possible associations between genetic markers and Primary Open-Angle Glaucoma (POAG). Methods: A number of genetic markers were typed in 84 unrelated patients with POAG and compared with a random sample of healthy individuals. The markers were Transferrin, Group Specific Component, G1m (1), G1m (2) and G3m (5) Allotypes, Adenylate Kinase, Adenosin Deaminase, Glyoxalase I and Acid Phosphatase and PCR-based markers HLA-DQA1 and D1S80. Results: No significant differences were found except the strong association between the group of POAG patients and Acid Phosphatase ACP^*C allele (² = 32.86; p < 0.0001). Conclusions: Since Acid Phosphatase gene is localized to chromosome 2p23, this result could be a first comprehensive step in the localization of POAG genes.