塑料密闭式输液盐水代替医用洗眼壶

眼科门诊处置中,结膜囊冲洗是最常见处置之一,结膜囊冲洗适用于结膜囊内异物及脓性分泌物多时,结、角膜酸碱化学烧伤时,手术前及角膜染色检查时,结膜囊冲洗即洗眼液,常用洗眼溶液是生理盐水,盛溶液用具自然离不开洗眼壶,本院眼科医用洗眼壶为玻璃制品,玻璃易清洗、耐热、     

眼结膜囊冲洗新型受水器的研制及临床应用

目的研制新型受水器使结膜囊冲洗不弄湿衣服、头发,使洗眼舒适度提高,洗眼耗时缩短。方法选取2015年1月~5月本科室患者200例(200眼)按手术日单双号分为对照组100例和观察组100例,进行改进前后舒适度和洗眼耗时的对比。结果两组结膜囊冲洗耗时对比,对照组平均每例眼睛洗眼耗时5.34分,舒适度60.8分,观察组平均每例眼睛耗时4.69 min,舒适度评分91.5分,平均每只眼节约0.65分,经比较,差异高度显著(P<0.01)。结论研制的新型受水器使用于临床,洗眼舒适度提高,省时省力,护理工作效率提高,值得全国推广应用。     

小儿伪膜性结膜炎的治疗体会

目的：探讨小儿伪膜性结膜炎的治疗方法。方法将我科门诊2012年2月-11月诊治的63例出现伪膜改变的结膜炎患儿采取剥膜、结膜囊冲洗及抗生素、抗病毒眼液点眼等综合治疗，部分患者加用糖皮质激素眼液及全身用药。结果所有患儿均在15 d内达到治愈标准，无角膜斑翳等并发症发生。结论伪膜剥除联合结膜囊冲洗及眼药水点眼等综合治疗效果显著。     

利多卡因氯霉素复合液持续冲洗治疗眼烧伤的临床观察

目的观察利多卡因氯霉素复合液持续结膜囊冲洗治疗眼烧伤的疗效.方法对56例共105只眼,致伤因素分别为电弧伤、化学伤、火焰伤、热水(油)烫伤,给予利多卡因氯霉素复合液持续结膜囊冲洗治疗.结果总有效率为92.3%,仅有4例6只眼发生角膜穿孔、真菌性角膜炎等严重并发症,1例出现视网膜部分剥落.结论利多卡因氯霉素复合液持续结膜囊冲洗治疗眼烧伤是一种简单易行、效果满意的方法,值得临床推广应用.     

小儿急性结膜炎应用冲洗结膜囊结合氯霉素(润舒)点眼治疗的观察

目的:对小儿急性结膜炎应用冲洗结膜囊结合氯霉素(润舒)点眼治疗的效果进行观察.方法:选取在我院接受治疗的急性结膜炎患儿200例,根据入院的编号平均分组,单号为实验组,双号为对照组,各100例,对照组给予氯霉素(润舒)点眼治疗,实验组给予冲洗结膜囊结合氯霉素(润舒)点眼治疗.结果:实验组治疗总有效率为96.00%,对照组治疗总有效率为84.00%,P<0.05;实验组总不良反应发生率为2.00%,对照组总不良反应发生率为4.00%,P>0.05.结论:小儿急性结膜炎应用冲洗结膜囊结合氯霉素(润舒)点眼治疗效果确切,值得推广.     

聚维酮碘在白内障患者术前结膜囊冲洗中的应用

目的 探讨聚维酮碘在白内障患者术前结膜囊冲洗中的应用方法和临床效果.方法 选择100例白内障手术患者,随机分为实验组和对照组.术前实验组用0.25%聚维酮碘消毒液冲洗结膜囊;对照组用0.08%庆大霉素注射液冲洗结膜囊;然后两组分别取样进行结膜囊细菌培养,比较两组洗眼效果.结果 术前用0.25%聚维酮碘消毒液、庆大霉素注射液洗眼后细菌培养阳性率分别为2.0%、20.0%.两组自觉症状和眼内炎发病率无明显差别（P＆gt;0.05）.结论 术前用0.25%聚维酮碘消毒液冲洗结膜囊可以降低术炎细菌培养阳性率, 使白内障术后眼内炎发病率明显下降,且无严重角膜并发症,是一种有效、安全的预防白内障术后眼内炎的措施之一.     

基于BioOcularTM角膜上皮模型EIT法对眼用制剂包装材料眼刺激性的再研究

目的：探讨用BioOcularTM 角膜上皮模型EIT法评价眼用制剂包装材料眼刺激性的可行性。方法：在眼用制剂包装材料的浸提液中加入不同浓度的阳性物质,同时进行BioOcularTM 角膜上皮模型EIT试验和Draize试验,比较两种方法所得结果的一致性。 结果：与Draize法比较,BioOcularTM 角膜上皮模型EIT法对含不同浓度阳性物质浸提液的眼刺激性分级与体内试验的一致程度为100%。 结论：BioOcularTM 角膜上皮模型EIT法有潜力作为眼用制剂包装材料眼刺激性试验的替代方法。     

洛度沙胺滴眼液联合生理盐水冲洗结膜囊治疗过敏性结膜炎的疗效观察

目的评价洛度沙胺滴眼液联合生理盐水冲洗结膜囊治疗过敏性结膜炎的临床疗效。方法收集我院门诊诊治的84例过敏性结膜炎患者,随机分成3组。对照组28例,采用洛度沙胺滴眼液治疗;试验组28例,采用洛度沙胺滴眼液联合生理盐水冲洗结膜囊治疗;另有阴性对照组28例,采用生理盐水冲洗结膜囊。治疗2周后,比较2组的临床疗效与眼痒、结膜充血、眼睑滤泡改善的时间。结果试验组总有效率为92.9%,高于对照组的78.6%,两组比较差异具有统计学意义(P<0.05);并且试验组与对照组的症状体征改善时间比较有统计学差异(P<0.05)。结论洛度沙胺滴眼液联合生理盐水冲洗结膜囊是治疗过敏性结膜炎的一种新的快速有效的方法。     

一次性输液器和输液加温器在结膜囊冲洗中的应用

目的：探索解决传统洗眼壶常温冲洗液结膜囊冲洗中的缺陷，从而减少手术前护理操作的副作用，减轻手术后眼部反应．降低手术后并发症发生率，提高手术后患者视觉效果。方法：选择80例白内障手术患者，将其随机分成两组，观察组40例，其中26例为左眼白内障手术患者，14例为右眼白内障手术患者，用生理盐水，一次性输液器和输液加温器加热冲洗结膜囊。对照组40例，其中22例为左眼白内障手术患者，18例为右眼白内障手术患者，用生理盐水和洗眼壶常温冲洗结膜囊。观察结膜囊冲洗后眼部刺激症状、结膜充血、泪脂等情况。结果：观察组眼部刺激症状．结膜充血及滔脂情况等明显好于对照组。结论：用一次性输液器和输液加温器进行冲洗，操作简便，不仅可以调节控制水速、水量、冲洗的力度，且冲洗液的温度接近体温，刺激小，更舒适，结膜反应轻，泪脂冲洗充分，患者术后反应轻，相关并发症减少，同时也减轻了护理工作量，值得推广应用。     

46例角膜穿孔伤合并外伤性白内障的治疗体会

目的探讨角膜穿孔伤合并外伤性白内障患者,人工晶体植入术手术时机及效果。方法对46例（46眼）角膜穿孔伤合并外伤性白内障患者根据病情分期行角膜修补术、白内障囊外摘除术、人工晶体植入术。第一种术式10眼,采用一期修补角膜,二期行白内障囊外摘除术＋人工晶体植入术;第二种术式24眼一期采用角膜修补术＋白内障囊外摘除术,二期行人工晶体植入术;第三种术式12眼一期行角膜修补术＋白内障囊外摘除术＋人工晶体植入联合手术。结果术后随访3～6个月,视力〉1.0者4例,占8.69%,0.5～0.9者24例占52.17%,0.1～0.4者13例占28.2%,〈0.1以下者5例,占10.87%。结论角膜穿孔伤合并外伤性白内障患者,白内障囊外摘除术及人工晶体植入术手术时机及术式选择非常重要。     

Povidone iodine in the treatment of adenoviral conjunctivitis in infants

Context: Adenoviral conjunctivitis.

Objective: To examine the effects of conjunctival irrigation with povidone iodine in infants with adenoviral conjunctivitis.

Material and methods: An outbreak of adenovirus conjunctivitis occurred between September and December 2012 at the neonatal intensive care unit of our hospital. Forty-three infants with adenoviral conjunctivitis were examined in this study. Thirty-five eyes of 35 infants who had detailed ophthalmological examination and clinical scoring were included. The conjunctiva of 15 infants (Group 1) were irrigated with povidone iodine 2.5% solution and then treated with preservative-free artificial tears and preservative-free antibiotic drops. Twenty infants (Group 2) were treated only with the same drops with the same posology, without conjunctival irrigation with povidone iodine. Patients were examined two times a week until the complete recovery. Lid edema, conjunctival chemosis, fragility of conjunctival vasculature, pseudomembrane formation, and corneal involvement were scored clinically.

Results: Twenty patients (57%) were female and 15 patients (43%) were male and mean age was 3.1 months (ranged from 1 to 4 months). No relation was found between gender and clinical scores. Statistically significant lower clinical scores were obtained from Group 1. The median recovery time was earlier in Group 1 (7?d) than Group 2 (12?d) (p?=?0.001).

Conclusion: Conjunctival irrigation with 2.5% povidone iodine is effective in the treatment of adenoviral conjunctivitis in infants.     

百草枯致兔眼损伤的病理观察

目的探讨百草枯致[损伤的病理]变,为构建相应动物模型奠定基础。方法将20只普通级健康成年白色新西兰家兔按照随机数字表法分为5组,每组4只。每只家兔左眼结膜囊内滴入百草枯原液100μl后立即将其眼睑轻轻闭合,使药液分别保留30 s(30 s组)、1 h(1 h组)、4 h(4 h组)、8 h(8 h组)和24 h(24 h组);右眼结膜囊内滴入生理盐水100μl作为对照。接触百草枯原液达规定时间后,以生理盐水分别冲洗双眼5 min。应用裂隙灯和角膜荧光素染色技术观察眼结膜、虹膜和角膜的损伤情况并进行评分,记录眼损伤累加最高积分和损伤完全恢复时间。实验第21天处死动物,取角膜组织进行组织病理学观察。结果 30 s组家兔出现轻至中度结膜刺激症状,未见角膜、虹膜损伤,实验第2天眼损伤累加最高积分达峰,为(14.0±2.3)分,眼损伤完全恢复时间为(9.5±0.6)d,角膜组织切片未见明显病理改变。1 h组家兔出现中至重度结膜刺激症状,虹膜无损伤,角膜有局灶性损伤,染毒后(5.5±1.9)d眼损伤累加最高积分达峰,为(47.5±8.5)分,高于30 s组(P<0.05),眼损伤完全恢复时间为(13.5±2.4)d,组织切片见角膜受损部位上皮扁平细胞层缺失。4 h组、8 h组和24 h组家兔除了出现重度结膜刺激症状外,均出现角膜和虹膜损伤,损伤程度随着接触百草枯原液时间的延长而加重,眼损伤累加最高积分分别在染毒后(6.2±1.0)、(7.7±1.0)和(7.2±2.1)d达峰,分别为(67.5±10.5)、(79.5±9.7)和(80.0±9.5)分,均高于30 s组和1 h组(均P<0.05),3组之间差异无统计学意义(P>0.05)。4 h组中有2只家兔分别在实验第12、19天眼损伤完全恢复,另2只和8 h组、24 h组的全部家兔至实验第21天眼损伤未完全恢复。组织病理学观察显示4 h组家兔角膜上皮细胞部分脱落,呈虫蚀样改变;8 h组角膜上皮扁平细胞和棘状细胞脱落,仅存柱状基底细胞,部分深达角膜基质层,角膜基质纤维板层结构紊乱,可见肉芽组织和角膜新生血管;24 h组角膜上皮完全剥脱,仅存基质层、内弹力层和内皮细胞层。结论眼接触百草枯原液30 s即可导致结膜损伤,接触1 h可致角膜损伤,接触时间≥4 h可造成角膜混浊、角膜损伤瘢痕愈合等难以恢复的眼损伤。家兔眼接触百草枯原液≥4 h出现的眼损伤可作为百草枯致眼损伤的动物模型。     

腹腔镜次全子宫切除术前应用安乐阴阴道冲洗的消毒效果

目的观察腹腔镜次全子宫切除术前应用安乐阴阴道冲洗的消毒效果。方法选取2018年1-11月福建中医药大学附属人民医院妇行腹腔镜次全子宫切除术的患者200例,按随机数字法分为观察组和对照组,每组100例。术前3 d对照组采用1∶5000高锰酸钾溶液进行阴道冲洗,观察组采用安乐阴中药洗剂进行阴道冲洗。比较2组阴道pH值、阴道不适症状(发热、外阴瘙痒、尿路刺激症状等)、阴道细菌菌落数、阴道分泌物清洁度。结果阴道冲洗后,观察组阴道pH值低于对照组,差异有统计学意义(P<0.01);2组阴道不适症状发生率比较差异无统计学意义(P>0.05);冲洗后,2组细菌菌落数均低于治疗前,且观察组优于对照组(P<0.01);2组阴道分泌物清洁度比较差异无统计学意义(P>0.05)。结论行腹腔镜全子宫切除术前,采用安乐阴中药洗剂冲洗阴道可预防感染,不会改变阴道微生态环境,且患者无不适症状,值得临床推广应用。     

剪除睫毛对白内障手术野细菌分布的影响

摘要：目的 探讨剪除睫毛对白内障手术野细菌分布的影响,为白内障围手术期感染控制措施制定提供依据。 方法 选取2017年3月—5月于我院行白内障手术的患者280例（280只眼）。根据患者手术意愿分为剪睫毛组（128 例）和不剪睫毛组（152例）,均行白内障超声乳化吸除术并人工晶体植入术。术毕采集医用手术薄膜睑缘粘贴面及 下穹窿部结膜囊拭子标本进行细菌培养,观察2组细菌培养结果。比较2组患者术后眼部刺激及充血情况。结果 与剪睫毛组相比,不剪睫毛组手术薄膜睑缘粘贴面细菌培养阳性率［13.16%（20/152）vs. 29.69%（38/128）］、结膜囊拭 子和医用薄膜检出同种细菌比例［2.63%（4/152）vs. 7.81%（10/128）］均明显降低（均P＜0.05）。术毕结膜囊中检出细 菌与手术薄膜上检出细菌同种,均为表皮葡萄球菌。术后第1、7天,不剪睫毛组患者眼部刺激症状及充血程度均较 剪睫毛组明显改善。结论 白内障患者手术前剪除睫毛可增加医用薄膜结膜粘贴面及术毕结膜囊拭子细菌阳性检 出率,且术后眼部刺激症状及充血程度较不剪除睫毛者严重,眼内炎感染的菌株来源于术眼睑缘周围可能性极大。     

Evaluation of the toxicity of graphene oxide exposure to the eye

Graphene and its derivatives are the new carbon nanomaterials with the prospect for great applications in electronics, energy storage, biosensors and medicine. However, little is known about the toxicity of graphene or its derivatives in the case of occasional or repeated ocular exposure. We performed in vitro and in vivo studies to evaluate the toxicity of graphene oxide (GO) exposure to the eye. Primary human corneal epithelium cells (hCorECs) and human conjunctiva epithelium cells (hConECs) were exposed to GO (12.5–100?μg/mL). Acute GO exposure (2?h) did not induce cytotoxicity to hCorECs. However, short-term GO exposure (24?h) exerted significant cytotoxicity to hCorECs and hConECs with increased intracellular reactive oxygen species (ROS). Glutathione (GSH) reduced the GO-induced cytotoxicity. We further performed acute eye irritation tests in albino rabbits according to the Organization for Economic Cooperation and Development (OECD) guidelines, and the rabbits did not exhibit corneal opacity, conjunctival redness, abnormality of the iris, or chemosis at any time point after the instillation of 100?μg/mL of GO. However, 5-day repeated GO exposure (50 and 100?μg/mL) caused reversible mild corneal opacity, conjunctival redness and corneal epithelium damage to Sprague-Dawley rats, which was also alleviated by GSH. Therefore, our study suggests that GO-induced time- and dose-dependent cytotoxicity to hCorECs and hConECs via oxidative stress. Occasional GO exposure did not cause acute eye irritation; short-term repeated GO exposure generally resulted in reversible damage to the eye via oxidative stress, which may be alleviated by the antioxidant GSH.     

Ecbalium elaterium (squirting cucumber)--remedy or poison?

BACKGROUND: Ecbalium elaterium is a plant endemic to the Mediterranean basin. Its roots and cucumber-shaped fruit have been used in folk medicine since antiquity. The alleged uses of the fruit juice are as a potent cathartic, analgesic, and antiinflammatory agent. Cucurbitacin B, a triterpene derivative is the active antiinflammatory principal. PATIENTS: We present a series of 13 patients who were exposed to the juice of Ecbalium elaterium in its natural form. In 3 patients, exposure was intranasal for the treatment of sinusitis or liver cirrhosis. In 3 other cases, children ingested the fruit unwittingly. In 6 patients, exposure was ocular and, in one, dermal. Within minutes of exposure, the patients exhibited irritation of mucous membranes at various degrees of severity manifested as edema of pharynx, dyspnea, drooling, dysphagia, vomiting, conjunctivitis, corneal edema, and erosion, depending on the route of the exposure. Recovery began within several to 24 hours after administration of oxygen, steroids, antihistamines, and beta-2-agonists. Ocular exposures responded to topical steroid and antibiotic eyedrops within a few days. The toddler with the dermal exposure remained asymptomatic. CONCLUSION: Exposure to the juice of Ecbalium elaterium, mainly in its undiluted form, may cause irritation of mucous membranes, supposedly of inflammatory nature. Patients exposed orally or intranasally should be closely followed for upper airway obstruction. Patients exposed ocularly should have their eyes promptly irrigated to prevent corneal and conjunctival injury.     

Toxicity of adipic acid

Adipic acid has very low acute toxicity in rats with an LD50 > 5000 mg/kg. Adipic acid produced mild to no skin irritation on intact guinea pig skin as a 50% concentration in propylene glycol; it was not a skin sensitizer. Adipic acid caused mild conjunctival irritation in washed rabbit eyes; in unwashed rabbit eyes, there was mild conjunctival irritation, minimal iritis, but no corneal effects. Adipic acid dust may irritate the mucous membranes of the lungs and nose. In a 2-year feeding study, rats fed adipic acid at concentrations up to 5% in the diet exhibited only weight loss. Adipic acid is not genetically active in a wide variety of assay systems. Adipic acid caused no developmental toxicity in mice, rats, rabbits, or hamsters when administered orally. Adipic acid is partially metabolized in humans; the balance is eliminated unchanged in the urine. Adipic acid is slightly to moderately toxic to fish, daphnia, and algae in acute tests.     

Chloramphenicol/sulfobutyl ether-β-cyclodextrin complexes in an ophthalmic delivery system: prolonged residence time and enhanced bioavailability in the conjunctival sac

Objective: Conventional chloramphenicol (CHL) eye drops are widely used anti-infection formulations for acute bacterial conjunctivitis. However, the therapeutic effects are limited by insufficient concentration in the conjunctival sac. Hence, the objective of this study is to formulate and develop novel CHL eye drops with improved topical concentrations by increasing the solubility and decreasing the transcorneal penetration.

Research design and methods: CHL was included in the sulfobutyl ether-β-cyclodextrin (SBE-β-CD) using the freeze-drying method. Eye drops containing CHL/SBE-β-CD complexes were prepared and evaluated for in vitro and in vivo studies.

Results: The formation of CHL/SBE-β-CD inclusion was confirmed by DSC, XRD, NMR, and SEM. The aqueous solubility of CHL was significantly enhanced, and the drug transcorneal penetration was inhibited after inclusion. The CHL/SBE-β-CD displayed sustained release profiles. The tear fluid elimination kinetic study showed that the CHL/SBE-β-CD eye drops had better ability to prolong the residence time, and significantly increase CHL concentration in the conjunctival sac. Besides, it was shown that CHL/SBE-β-CD eye drops were nonirritating to rabbits’ eyes.

Conclusions: The SBE-β-CD inclusions offer a potential alternative strategy for ocular administration of poorly water-soluble drugs in the conjunctival sac.     

Evaluation of ocular irritation in the rabbit: Objective versus subjective assessment

There are several methods for assessing ocular irritation in laboratory animals. The most common method is that of Draize, but an objective evaluation of tissue changes, such as corneal and conjunctival edema, and conjunctival and ciliary body capillary disruption may also be used. The present investigation compares the subjective Draize score to several objective procedures, namely, corneal thickness measurement, evaluation of corneal and conjunctival water content, and conjunctival and aqueous humor concentrations of a dye bound to plasma proteins after intravenous injection. The following seven organic solvents were tested: tetrahydrofurfuryl alcohol, N-methylformamide, Solketal, Carbitol, dimethyl sulfoxide, propylene glycol, and triacetin. After a single instillation of 100 μl of undiluted compound in the rabbit eye, evaluation of the above parameters was made at 2 and 24 hr. Draize score and corneal thickness were further determined daily for 10 additional days. A linear correlation was found between Draize total score and tissue changes. This was due mainly to the highly significant correlation between conjunctival Draize score and conjunctival edema and capillary permeability. There was a significant correlation between Draize corneal score and corneal edema or thickness only on Day 1. No relationships were shown between iris hyperemia and Evans blue dye diffusion into the aqueous humor following iv injection. Minor corneal damage was difficult to assess with the Draize system, and corneal thickness determination appeared to be helpful to this purpose. Therefore, it is proposed that in addition to the standard Draize method, corneal thickness measurements should be performed. Both subjective and objective procedures ranked the compounds' irritant potential in the same order.