房水引流植入物手术治疗顽固性青光眼

目的 :探讨房水机械引流手术在顽固性青光眼治疗中的应用价值。方法 :采用国产房水引流植入物 ,共治疗 11例(11眼 )顽固性青光眼 ,其中新生血管性青光眼 6眼 ,原发性绝对期青光眼 3眼 ,滤过性手术失败者 2眼。结果 :术后随访 3个月～9个月 ,平均 6 .5个月 ,眼压由术前 38mm Hg～ 6 7m m Hg降至术后 7mm Hg～ 33m m Hg。术后常见并发症浅前房 ,前房积血等。结论 :房水引流植入物手术为顽固性青光眼的治疗提供了新的途径。     

压力对体外培养牛眼小梁细胞的影响

目的 观察压力对小梁细胞的影响。方法 对体外培养牛眼小梁细胞施以不同程度的压力,用倒置相差显微镜、光镜、电镜观察细胞形态结构及吞噬功能的变化。结果 细胞承受２．００ｋｐａ（１ｋｐａ＝７．５ｍｍＨｇ）、２．６７ｋｐａ压力４８小时,各项指标与对照组比较,差异无显著性。４．００ｋｐａ２４小时,细胞形态结构有轻度的损伤,吞噬功能有轻度下降。当压力进一步增加,时间更加延长后,细胞的损伤也更重。结论小梁细胞只     

Whole-blood pharmacokinetics and metabolic effects of the topical carbonic anhydrase inhibitor dorzolamide

Following a single-dose, open-label, pilot pharmacokinetic study in six subjects, the systemic pharmacokinetics and metabolic effects of dorzolamide after topical ocular administration were investigated in a double-blind, randomised, placebo-controlled study in 12 healthy volunteers. The subjects received a controlled diet on the 5 days before treatment initiation and throughout the study. For 14 days, a bilateral q.i.d. regimen of 3% dorzolamide, consisting of approximately 7.7 g per day (21.3 mol) dorzolamide hydrochloride, or placebo was given. Blood and urine electrolytes and acid-base profiles were measured 1 day prior to treatment and on days 1, 7 and 14 of treatment, and 24-h urine samples were collected daily.Topically applied dorzolamide was slowly taken up in erythrocytes and eliminated with a half life of approximately 120 days. Compared to the pre-study values, no significant treatment effect was observed in either the daily profiles or the 14-day cumulative sodium, potassium and citrate excretions. Two other volunteers given acetazolamide (125 mg q.i.d.) and assessed with the identical set of observations demonstrated marked metabolic changes.In spite of the prolonged and marked inhibition of carbonic anhydrase in red blood cells by dorzolamide, clinically significant metabolic and renal effects were not observed. The ocular tolerability profile was acceptable to all subjects.     

闭角型青光眼凝血指标的变化

目的:探讨闭角型青光眼患者凝血指标变化与临床的关系。方法:对50例闭角型青光眼患者及43例正常对照组进行了凝血指标(PT、TT、Fbg、APTT)检测。结果:闭角型青光眼患者与对照组比较PT、TT无显著变化(P<0.05),Fbg含量升高有极显著性差异(P<0.01),APTT时间缩短有极显著性差异(P<0.01)。结论:闭角型青年眼患者体内血液是高凝状态,而这种高凝状态在闭角青光眼病的发生、发展中起着重要的作用。     

Differential diagnosis of anterior segment cysts by ultrasound biomicroscopy

BACKGROUND: To describe the ultrasound biomicroscopic (UBM) features of anterior segment cysts. DESIGN: A retrospective case series. PARTICIPANTS: One hundred eighteen eyes with anterior segment cysts examined by UBM at The New York Eye and Ear Infirmary between August 1992 and November 1997 were included in this study. INTERVENTION: The authors reviewed demographic and diagnostic data from the medical record including ocular and medical history, age, race, gender, and intraocular pressure. Ultrasound data concerning the type, number, position, and acoustic characteristics of cysts were recorded. The authors then correlated the written, clinical, and UBM characteristics. RESULTS: One hundred eyes (92.6%) had neuroepithelial cysts. Ninety (83.3%) of these had primary neuroepithelial cysts, 10 (9.3%) had cysts associated with uveitis, 7 (6.5%) had implantation cysts, and 1 (0.9%) had a cavitated ciliary body tumor. Neuroepithelial cysts typically were round or ovoid, thin-walled, and echolucent. Of the 90 eyes with primary neuroepithelial cysts, 56 (62.2%) had 3 or fewer cysts; multiple cysts (>3 per eye) were found in 34 eyes (37.8%). The multiple cysts occupied more than 180 degrees in 12 patients (13.3%). Primary neuroepithelial cysts were located at the iridociliary junction (74.2%), pars plicata (14.0%), pars plana (6.8%), and iris (5.0%). Implantation cysts (seven eyes) tended to have thicker walls and two contained a copious, echogenic material. CONCLUSION: The UBM results provide important information regarding location and extent of anterior segment cystic lesions. Ultrasound characteristics may help differentiate between neuroepithelial, implantation, and neoplastic cysts.     

视网膜脱离巩膜环扎术后眼前节结构的初步观察

目的 观察巩膜环扎术后眼前节结构的变化,探讨术后继发性闭角型青光眼的发病机制。方法 应用超声生物显微镜检查３０例（３３只眼）孔源视网膜脱离患者术前、后３－７天的活体奶前节形态结构,并分别进行定量测定,检查结果经统计学分析两组间配对ｔｓｗｃｗ,以Ｐ〈０．０５作为差异有显著性标准。结果 术前１只眼存在裂隙样睫状体脱离。术后１１只眼（３３．３％）发生睫状体脱离,睫状体增厚水肿;术前睫状体厚度为（８２１．     

白内障囊外摘出及人工晶状体植入术后继发性青光眼

目的探讨白内障囊外摘出及人工晶状体植入术后继发性青光眼的原因。方法对11例术后继发性青光眼进行详细的观察分析。结果发现其主要原因为房角阻塞,瞳孔阻滞,手术创伤及血—房水屏障破坏等。结论术后继发性青光眼原因多种多样,大部分可以预防及药物治愈。     

外伤性晶状体脱位继发性青光眼的治疗分析

目的 探讨外伤性晶状本脱位继发性青光眼的治疗方法。方法 药物保守治疗１８例,单纯小梁切除７例,单纯晶状体摘出１４例,晶状体摘出联合小梁切除７例。结果 ４６例中２例在局部滴用噻吗心安后,眼压控制在２１ｍｍＨｇ以下。治疗后矫正视力和前相比差异有显著性。结论 外伤性晶状体脱位继发性青光眼的治疗关键是尽早地用药物或手术方法缓解瞳孔阻滞,房角损伤≥２个象限者加用滤过性手术。     

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     

羊膜移植联合小梁切除治疗难治性青光眼

目的探讨羊腰移植联合小梁切除治疗难治性青光眼的疗效。方法对24例25眼难治性青光眼进行羊膜移植联合小梁切除术后对眼压、滤泡、前房、视力进行3～7个月观察随访。结果术后3个月93．8％的眼压控制在8～20mmHg、6个月85．8％的眼压控制在8～20mmHg，5例5眼需局部加用降眼压药物。术后3个月23眼形成功能性滤泡，有效率为92％，6个月21眼形成功能性滤泡，有效率为91％，视力均有不同程度的改善，前房稳定。结论羊膜移植能有效防止滤过泡疤痕纤维化，是治疗难治性青光眼的简单、安全、有效方法。