丝裂霉素C抑制实验性兔角膜新生血管形态学改变的研究

采用角膜缝线方法,诱导8只家兔16只眼角膜新生血管形成。缝线后的第3d,将丝裂霉素C和生理盐水分别注射于家兔眼结膜下,观察每眼角膜新生血管生长情况及组织病理学改变,以探讨丝裂霉素C抑制角膜新生血管的作用机制、结果：丝裂霉素组新生血管的长度明显短于对照组,差异有极显著意义（P＜0．01）;光镜下见浆细胞少;电镜下见新生血管内皮细胞变性。结果表明,丝裂霉素C结膜下注射抑制角膜新生血管的作用,可能是通过控制炎症增生和破坏新生血管内皮细胞来实现的。     

滤过性手术中联合应用丝裂霉素C效果观察

目的：评价顽固性青光眼滤过性手术中联合应用丝裂霉素Ｃ（ＭＭＣ）的近期眼压和视功能结果。方法：５１例６１眼顽固性青光眼,全部采用小梁切除术,术中联合应用ＭＭＣ,ＭＭＣ浓度为０．２ｍｇ／ｍｌ￣０．４ｍｇ／ｍｌ局部接触时间２￣５分钟。     

国产房水引流物置入术治疗难治性青光眼远期疗效观察

１９９３年７月～１９９８年１月为１０３例（１０６只眼）难治性青光眼患者施行国产房水引流物（ＨＡＤ）置入术。术后平均随访３２８月。术后１年时平均眼压２２±１．４ｋＰａ。术后１～５年的手术成功率分别为８３８％,８０４％,７７１％,７１０％及６４３％。术中联合应用丝裂霉素Ｃ的病例,其术后１年时的成功率为８９５％。术后常见的并发症有持续性浅前房,局限性脉络膜脱离及眼压升高等。认为ＨＡＤ可用于治疗难治性青光眼。     

闭角型青光眼小梁切除术后前房延缓形成探讨

目的：本文探讨原发性闭角型青光眼小梁切除术后前房延缓形成的病因及治疗。方法：对原发性闭角型青光眼小梁切除术后发生浅前房者于术后第３ ｄ 给予处理,观察前房延缓形成的情况。结果：本文１５０ 例２０８ 例眼小梁切除术后发生浅前房 １１４ 眼（５４．８％ ）,发生前房延缓形成４０ 眼（１９．２３％ ）。结论：小梁切除术后浅前房适时恰当的处理,可明显减少前房延缓形成的发生。     

Changes in optic nerve head blood flow and retrobular hemodynamics following calcium-channel blocker treatment of normal-tension glaucoma

Background: Because calcium channel blockers reduce vascularresistance, they may have a clinical application in the treatment ofnormal-tension glaucoma (NTG). This study investigates changes inboth the optic disc blood flow and the hemodynamics of retrobulbarvessels in NTG patients after the systemic administration of a calcium channel blocker. Methods: Twelve eyes of 12 NTG patients (meanage 57 6 ± 15.3 years) were examined before and after a 4-weektreatment with 2 mg b.i.d. oral nilvadipine, an L-typc calcium channel blocker. By scanning laser-Doppler flowmetry (SLDF), we obtained the velocity, flow, and volume from within a 10 × 10 pixel windowplaced on the temporal rim region of the optic disc perfusion map. Byultrasound color Doppler imaging (CDI), we measured the peak systolicvelocity (PSV) and the end diastolic velocity (EDV) of the ophthalmicartery (OA), central retinal artery (CRA), nasal posterior ciliary artery (NPCA), and temporal posterior ciliary artery (TPCA). We then calculated a resistance index (RI) for each vessel. Results: After treatment, the flow and velocity of the optic disc blood flow significantly increased (P < 0.05).Nilvadipine also significantly reduced RIs of the CRA, NPCA, and TPCA(P <0 .05), and increased both the PSV of the NPCA and the EDVs of the CRA, NPCA, and TPCA. The percent change in velocity correlated significantly with the percent changes of the CRA RI and NPCA RI. Conclusions: Oral nilvadipine appears to reduce orbital vascular resistance, which consequentlyincreases the optic disc blood flow. Abbreviations.BP – blood pressure;CRA – central retinal artery;CDI – ultrasound color Doppler imaging;EDV – end diastolic velocity;NPCA – short posterior ciliary arteries located nasal to optic nerve;NTG – normal-tension glaucoma;OA – ophthalmic artery;PP – perfusion pressure;PSV – peak systolic velocity;RI – resistance index;SLDF scanning laser-Doppler flowmetry;TPCA – short posterior ciliary arteries locatedtemporal to optic nerve.     

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