角膜缘上皮移植治疗翼状胬肉疗效观察

目的　观察角膜缘上皮移植治疗翼状胬肉的疗效。方法　将 82例 (90眼 )翼状胬肉 ,随机分成A、B两组。A组 42例 (4 6眼 ) ,行翼状胬肉切除联合角膜缘上皮移植术 ;B组 40例 (4 4眼 ) ,行单纯翼状胬肉切除术。术后随访 6～ 2 4月。结果　A组 2例 (2眼 )复发 ,复发率 4 3 5 % ;B组 17例 (19眼 )复发 ,复发率 43 18%。两组比较 ,差异有非常显著意义 (P <0 0 1)。供体角膜缘区无并发症发生。结论　角膜缘上皮移植术能有效预防翼状胬肉的复发。     

现代白内障囊外摘除术中角膜缘切口的探讨

本文为探讨角膜缘切口类型对现代白内障囊外摘除手术的影响。将行白内障摘除人工晶体植入手术中角膜缘切口随意分成二组，梯形切口35眼；斜形切口39眼，并观察术后的情况。发现现代白内障囊外摘除术中角膜缘梯形切口组较斜形切口组为好，术中截囊针易于进入前房，组织损伤少，便于缝合，而且术后切口的愈合也较牢固，角膜平均散光较轻。由此可见，角膜缘梯形切口是初学现代白内障囊外摘除人工晶体植入术者值得提倡使用的。     

The blood vessels of the limbus spiralis

Summary The capillaries of the spiral limbus in the cochlea of the laboratory rat were investigated under light and electron microscopy. A stereological examination of the capillary volumes of specimens injected with horseradish peroxidase was performed. The volume of capillaries amounted to 2.87%, and, as such, is very high. The ultrastructure of the capillaries showed continuous endothelial cells and basal laminae, discontinuous pericytes and varying relations towards the surrounding tissue. Morphological criteria, such as microvilli and plasmalemmal vesicles, suggest a significant transendothelial transport. The causes for the abundance of vessels in the spiral limbus are discussed: the transport of oxygen to the perilymph and the need of substances for the formation of the tectorial membrane seem to be important factors. The transport processes are obviously controlled by the endothelial cells as well as by the spiral limbus cells.     

深低温保存兔角膜缘干细胞的体外培养

目的 探寻深低温保存兔角膜缘干细胞的体外培养方法。方法 将2mm宽的兔角巩膜组织通过程序降温仪降温后置于-196℃液氮中深低温保存。1年后复温，应用消化培养法分别对冻存及新鲜的兔角膜缘干细胞进行体外培养，观察并记录细胞生长情况，HE染色观察培养细胞的形态特征。结果 经过深低温保存的兔角膜缘干细胞可以在体外被成功培养并传代，其在原代培养48h后开始贴壁生长，5d后生长较旺盛，但可见部分破裂和死亡细胞，约12d基本形成单层；传代培养时次日贴壁，7d形成单层。新鲜兔角膜缘干细胞原代培养时细胞形态相似，但破碎死亡细胞少见，且于7d左右即基本形成单层，传代时两者无明显差别。结论 深低温保存的角膜缘干细胞能被成功地进行体外培养，培养后细胞具有与培养的新鲜角膜缘干细胞基本相似的特性，为深低温保存的角膜缘干细胞培养后移植治疗临床眼表疾病提供了实验依据，并为眼库技术的发挥开辟了新的应用途径。     

1262例透明角膜缘切口行白内障超声乳化手术的临床观察

目的：探讨我院透明角膜缘切口行白内障超声乳化术的安全性和有效性。方法回顾性分析我院2011年1月至2013年8月行白内障超声乳化吸除联合折叠人工晶状体植入1262例（1739只眼）术后视力、人工晶状体植入率及并发症处理等情况。结果术中植入人工晶状体1731只眼（99．5％）,8只眼因后囊膜破裂未植入人工晶状体;术后1周矫正视力≥0．5者1268只眼,0．1～0．4者332只眼,＜0．1者139只眼。13只眼术后出现一过性高眼压,后囊破裂35只眼,角膜水肿中度357只眼,重度59只眼,角膜内皮失代偿1只眼,术后眼内炎3只眼。结论透明角膜缘切口行白内障超声乳化术具有麻醉简单、术后反应轻、视力恢复快的优点,只要规范操作,正确处理术后并发症,手术效果满意,是一种比较理想的手术方式。     

Transforming ocular surface stem cell research into successful clinical practice

It has only been a quarter of a century since the discovery of adult stem cells at the human corneo-scleral limbus. These limbal stem cells are responsible for generating a constant and unending supply of corneal epithelial cells throughout life, thus maintaining a stable and uniformly refractive corneal surface. Establishing this hitherto unknown association between ocular surface disease and limbal dysfunction helped usher in therapeutic approaches that successfully addressed blinding conditions such as ocular burns, which were previously considered incurable. Subsequent advances in ocular surface biology through basic science research have translated into innovations that have made the surgical technique of limbal stem cell transplantation simpler and more predictable. This review recapitulates the basic biology of the limbus and the rationale and principles of limbal stem cell transplantation in ocular surface disease. An evidence-based algorithm is presented, which is tailored to clinical considerations such as laterality of affliction, severity of limbal damage and concurrent need for other procedures. Additionally, novel findings in the form of factors influencing the survival and function of limbal stem cells after transplantation and the possibility of substituting limbal cells with epithelial stem cells of other lineages is also discussed. Finally this review focuses on the future directions in which both basic science and clinical research in this field is headed.     

角膜缘干细胞移植治疗翼状胬肉切除联合羊膜移植术后羊膜溶解

目的：观察角膜缘干细胞移植术治疗翼状胬肉切除联合羊膜移植术后羊膜溶解的临床效果。方法：翼状胬肉切除术联合羊膜移植术后出现羊膜溶解的患者124例135眼随机分成A、B、C三组,A组36例38眼采取保守治疗, B组42例45眼再次行羊膜移植术, C组46例52眼行自体角膜缘干细胞移植术。术后随访6～18mo比较各组胬肉复发情况。结果：A组38眼中24眼复发,复发率63．2％。 B组45眼中术后7眼胬肉复发,复发率15．6％。 C组52眼2眼复发,复发率3．8％,A组与B组比较,B组与C组比较差异均有统计学意义（P＜0．05）。结论：自体角膜缘干细胞移植术是治疗翼状胬肉切除联合羊膜移植术后羊膜溶解的有效方法。     

In vivo confocal microscopy of congenital aniridia-associated keratopathy

Purpose

To explore the in vivo morphological changes of cornea and limbus in aniridia-associated keratopathy (AAK).

Methods

Three cases of AAK were examined with the application of in vivo confocal microscopy (IVCM).

Results

Abnormal structure of wing and basal layer of epithelium, the loss of subbasal nerves, and the presence of goblet cells at central cornea could be identified in the most severe case, along with the absence of Vogt palisades. The less extent of abnormalities in corneal epithelial cells, subbasal nerve, and Vogt palisades were visible in the moderate or mild cases.

Conclusions

The morphological changes of cornea and limbus vary in AAK, and IVCM is a promising tool to determine the degree of limbal stem cell deficiency in patients with AAK.