透明晶状体超声乳化吸除术治疗高度近视

目的 研究透明晶状体超声乳化吸除治疗高度近视的安全性、有效性。方法 对18例对侧眼已行白内降超声乳化吸除及人工晶状体植入术，另1只眼为高度近视的患者，行透明晶状体超声乳化吸除联合人工晶状体植入术。结果 术中未发生前囊撕裂和后囊破裂等并发症；术后未发现黄斑囊样水肿及视网膜脱离等并发症，随访6—26月，3只眼出现轻度后囊混浊。结论 在具备熟练的超声乳化技术的前提下，通过摘除透明晶状体联合人工晶状体植入术治疗高度近视，是安全有效的方法。     

透明晶状体超声乳化人工晶状体植入术治疗高度和超高度近视

目的探讨透明晶状体超声乳化人工晶状体植入治疗高度进行性近视、超高度近视的临床效果。方法对32例(58眼)高度、超高度近视患者施行透明晶状体超声乳化联合低度数或负度数人工晶状体植入术,观察术中、术后并发症及术后视力。结果术后3月视力≥0.5者45眼(76％),术后6月视力≥0.5者46眼(79％),≥1.0者11眼(19％),影响术后视力恢复的主要原因为高度进行性近视眼底病变。术中后囊破裂1例,术后角膜水肿7眼,后囊混浊6眼,随访中未发现视网膜脱离、黄斑囊样水肿等并发症。结论 透明晶状体超声乳化联合人工晶状体植入术与角膜屈光手术相比较,更适合治疗高度进行性近视及超高度近视。     

透明晶状体置换术治疗高度近视的临床研究

目的 探讨透明晶状体超声乳化吸出术联合人工晶状体植入术矫治高度近视的有效性及安全性。方法 对48例（60眼）高度近视行透明晶状体超声乳化术联合低度数或负度数后房人工晶状体植入术。观察术后视力,术中和术后并发症。结果 所有病例术后裸眼视力均优于或等于术前最好矫正视力,术前最好矫正视力≥0.5者28眼（46.67%）;术后裸眼视力≥0.5者40眼（66.67%）。术中除1例发生后囊破裂,人工晶状体植入睫状沟外,其余均植入囊袋内。术后观察6-18月无角膜水肿失代偿、视网膜脱离等严重的远期并发症。结论 透明晶状体超声乳化吸出联合后房人工晶状体植入术矫治高度近视,是1种安全、有效的手术方法。具有术后视力恢复好,屈光状态稳定,并发症少,远期疗效可靠的优点。     

小切口超声乳化吸出术联合低及负度数人工晶状体植入术治疗轴性高度近视白内障

目的　探讨小切口超声乳化吸出术联合低、负度数人工晶状体植入术治疗轴性高度近视白内障的临床效果。方法　对86例111眼轴性高度近视患者进行超声乳化吸出术联合低、负度数人工晶状体植入术。观察患者术后视力、屈光度数和手术并发症。随访1 a。结果　术后3 个月,85 眼最佳矫正视力≥0.5;屈光度数为-0 26~-3.50 D,平均(-1.32±0.65)D,无过矫现象发生。术中发生后囊破裂1 眼;术后角膜水肿14眼,3~7 d消退;后囊混浊9眼;术后6个月内无视网膜脱离者。结论　小切口超声乳化吸出术联合低、负度数人工晶状体植入术提高了轴性高度近视患者的视力,有效的预防了视网膜脱离,获得了预期的屈光状态。     

屈光度大于-12.00D透明晶状体超声乳化术的临床研究

目的:探讨屈光度大于-12.00D透明晶状体超声乳化吸除联合人工晶状体植入术治疗高度近视的有效性和安全性。方法:对78例(100眼)高度近视患者行巩膜隧道切口超声乳化透明晶状体吸除联合人工晶状体植入术。平均年龄39.2岁,术前矫正视力0.12～0.6,平均近视度数(-14.41±4.33)D。结果:术后所有患者裸眼视力均有提高;82眼(82.0%)裸眼视力≥0.5;96眼(96.0%)矫正视力≥0.5。术后屈光度数为-0.60～-3.48D,平均散光度数(0.58±0.92)D。术后平均随访时间19.5mo。术后发生晶状体后囊膜混浊14眼(14.0%),未见视网膜裂孔、视网膜脱离及黄斑囊样水肿。结论:超声乳化吸除屈光度大于-12.00D透明晶状体联合人工晶状体植入术,术后视力好、并发症少,是矫治高度近视安全、有效的方法,但是手术者及患者的选择应当是有条件的。     

"冷"超声乳化行透明晶状体摘出及折叠式人工晶状体植入术治疗超高度近视

目的观察“冷”超声乳化行透明晶状体摘出联合低或负度数后房型人工晶状体植入术治疗超高度近视的效果。方法对36例(68眼)超高度近视患者施行透明晶状体“冷”超声乳化联合低或负度数折叠式后房型人工晶状体植入术,随访3~6个月,观察术后效果和屈光状态及并发症。结果术后裸眼视力均大于或等于术前矫正视力,术后裸眼视力>0.5者42眼,术后矫正视力>0.5者54眼;术前角膜内皮细胞计数为(1640~2600)·m-2,平均为(1890±210)·m-2;术后为(1540~2480)·m-2,平均为(1820±180)·m-2;与术前比较差异均无显著意义(P>0.05,χ2=1.578)。随访中无视网膜脱离及黄斑囊样水肿等并发症发生。结论“冷”超声乳化行透明晶状体摘出及折叠式低或负度数人工晶状体植入术,对超高度近视是一种安全、有效的增视手术。     

负度数折叠式人工晶状体植入术治疗白内障合并轴性高度近视

目的:探讨超声乳化白内障吸除联合负度数人工晶状体植入术治疗白内障合并高度近视的临床疗效。方法:对30例41眼白内障合并高度近视患者行超声乳化白内障吸除联合负度数折叠式人工晶状体植入术,随访6mo,观察术中和术后并发症、术后视力、眼底情况。结果:术前平均眼轴长度为32.11mm。术后视力<0.1者3眼,0.1～0.5者26眼,>0.5者12眼。术中2眼晶状体后囊膜破裂;1眼角膜水肿,未见视网膜脱离。24眼眼底有明显的高度近视眼底病变。结论:超声乳化白内障吸除联合负度数人工晶状体植入术是治疗白内障合并高度近视眼安全、有效的方法。     

超声乳化摘除透明晶状体治疗高度近视的疗效观察

目的探讨超声乳化透明晶状体吸除联合人工晶体植入术治疗高度近视的有效性和安全性。方法对59例103只眼高度近视患者行巩膜隧道切口超声乳化透明晶状体吸除联合人工晶体植入术。术中将切口选在陡子午线上可以矫正术前存在的部分散光.平均年龄35.37±4.32岁,术前矫正视力0.15～1.0,平均近视度数-13.10±3.15D,平均散光度数-1.36±0.83D,平均眼轴长度27.82±2.13mm,平均植入人工晶状体屈光度数＋7.22±3.71D。结果术后88只眼裸眼视力≥0.5,其中19只眼视力≥0.8;14只眼视力〈0.5,但较术前最佳矫正视力有所提高;1只眼术后视力无提高,查眼底见黄斑变性。术后平均近视度数-2.13±0.31D;平均散光度数-1.21±0.26D。术后发生晶状体后囊膜混浊3只眼,视网膜脱离1只眼,黄斑囊样水肿1只眼。结论超声乳化透明晶状体吸除联合人工晶状体植入术是矫治高度近视安全、有效的方法,具有术后视力好、并发症少,预测屈光状态准确性高及稳定性好,可通过切口的选择减少散光等优点。可用于高度近视眼的屈光手术治疗,特别是对于准分子激光无法治疗的超高度近视尤为适用。     

超声乳化透明晶状体摘除联合人工晶状体植入治疗高度近视的临床疗效

目的:探讨超声乳化透明晶状体摘除联合人工晶状体植入治疗高度近视的临床疗效。方法:对30例49眼高度近视眼患者,经透明角膜切口行超声乳化透明晶状体吸除联合后房型折叠人工晶状体植入术,对比患眼手术前后视力,观察术后并发症,术后随访6～12(平均8.5)mo。结果:术后49眼矫正视力均超过术前最佳矫正视力,其中术后裸眼视力≥0.5者28眼(57%),术后最佳矫正视力≥0.5者41眼(84%);术后发生后囊混浊5眼(10%),均行YAG激光治疗;1例发生视网膜脱离(2%)。随访期内未发现黄斑囊样水肿、眼底出血、青光眼、人工晶状体偏位等并发症。结论:超声乳化透明晶状体摘除联合折叠式人工晶状体植入术,作为一种屈光手术治疗高度近视是安全有效的方法。     

高度近视眼透明晶状体摘除联合人工晶状体植入术的临床观察

目的　探讨高度近视眼透明晶状体超声乳化吸除或囊外摘除联合人工晶状体植入术的安全性和有效性。方法　 33例 (4 7只眼 )高度近视眼 ,行超声乳化吸除联合折叠式人工晶状体植入术 2 8只眼 ,透明晶状体囊外摘除联合硬性人工晶状体植入术 1 9只眼。平均年龄 (4 8.3± 1 2 .6 )岁。术前矫正视力 0 .1 5～ 1 .0 ,平均近视度数 (-1 4 .2 2± 3.6 5 ) D,平均散光度数 (0 .97± 0 .82 ) D。随访半年以上。结果　术中 1只眼后囊膜破裂。术后半年 ,所有患者裸眼视力均提高 ,37只眼 (78.7% )裸眼视力≥ 0 .5 ,4 0只眼 (85 .1 % )矫正视力≥ 0 .5 ,平均近视度数 (- 1 .34± 0 .6 2 ) D,平均散光度数 (0 .84± 0 .87) D。术后晶状体后囊膜混浊 6只眼 (1 2 .8% ) ,视网膜脱离 1只眼。囊外摘除术者并发症多。结论　超声乳化透明晶状体摘除联合低度、负度数人工晶状体植入术是矫治高度近视眼安全、有效的手术方法 ,适应于不宜行角膜屈光手术的高度近视眼患者     

Strabisme Alternant - Etude clinique - traitement

The author defines motor and sensory alternation: the term alternation should not be used in isolation, it should always be accompanied by the name of the parameter concerned. Sensory alternation is always found together with motor alternation but the reverse is not true.The examining criteria for a diagnosis of sensory alternation are given, sensory alternation must not be confused with alternating inhibition. Working from clinical observations of cases of motor alternating strabismus, the author selects 2 types of binocular sensory relations which allow one to differentiate between:- cases of primary alternating strabismus- cases of secondary alternating strabismusThese forms will develop in different ways; in both cases a cure is possible providing that the right treatment is prescribed and once prescribed carefully followed, etc. It is always a case of serious forms of strabismus whose developmental period is spread over several years.According to the authors, the frequency of cases of true primary strabismus is from 1–3%, the frequency of cases of secondary alternating strabismus varies according to the type of therapy practised on cases of monocular strabismus with amblyopia. These latter will become cases of alternating strabismus under the influence of certain types of therapy carried out over several years (penalization, rocking, alternated occlusion, etc...).Experimental data on kittens confirm clinical data; kittens placed in abnormal environments during the sensitive period will show modification in the distribution of cortical cells and the absence of binocular cells (either because the excitation of the two eyes was not simultaneous, or not identical: artificial strabismus, occlusion, opaque glasses). This disturbances become irreversible after a certain period of exposure (a function of age, length of exposure, etc...).It is thus necessary to bear in mind: 1) the iatrogenic risks of certain orthoptic treatments, 2) the necessity for a binocular form of treatment as soon as possible, as once a certain stage is passed, cortical plasticity diminishes and the elaboration of normal binocular relations becomes impossible.

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Effects of Adenosine Agonists on Intraocular Pressure and Aqueous Humor Dynamics in Cynomolgus Monkeys

The effects of single or multiple topical doses of the relatively selective A₁adenosine receptor agonists (R)-phenylisopropyladenosine (R-PIA) and N⁶-cyclohexyladenosine (CHA) on intraocular pressure (IOP), aqueous humor flow (AHF) and outflow facility were investigated in ocular normotensive cynomolgus monkeys. IOP and AHF were determined, under ketamine anesthesia, by Goldmann applanation tonometry and fluorophotometry, respectively. Total outflow facility was determined by anterior chamber perfusion under pentobarbital anesthesia. A single unilateral topical application of R-PIA (20–250 μg) or CHA (20–500 μg) produced ocular hypertension (maximum rise=4.9 or 3.5 mmHg) within 30 min, followed by ocular hypotension (maximum fall=2.1 or 3.6 mmHg) from 2–6 hr. The relatively selective adenosine A₂antagonist 3,7-dimethyl-1-propargylxanthine (DMPX, 320 μg) inhibited the early hypertension, without influencing the hypotension. Neither 100 μg R-PIA nor 500 μg CHA clearly altered AHF. Total outflow facility was increased by 71% 3 hr after 100 μg R-PIA. In conclusion, the early ocular hypertension produced by topical adenosine agonists in cynomolgus monkeys is associated with the activation of adenosine A₂receptors, while the subsequent hypotension appears to be mediated by adenosine A₁receptors and results primarily from increased outflow facility.