结膜下注射法治疗重症电光性眼炎

电光性眼炎是眼科最常见的一种辐射伤 ,我科 1999年用结膜下注射法治疗重症电光性眼炎 ,疗效确切 ,现介绍如下 :门诊收治电光性眼炎患者 2 2例 ,44眼。其中男性 2 0例 ,女性 2例。年龄 15～ 47岁 ,平均年龄 2 9岁。患者均有长时间紫外线接触史。初次发病 ,眼剧痛 ,结膜充血 ,伴不同程度的角膜上皮剥脱。治疗 :1%地卡因局麻患眼 ,结膜下注射 1%普鲁卡因 0 .4ml 盐酸肾上腺素 0 .1ml,涂抗生素眼膏后包扎患眼。结果 :2 2例患者剧痛症状全部消失 ,且结膜充血消退明显。随诊观察无反复 ,第二天角膜上皮愈合良好。无视力障碍 ,未发现并发症 ,治愈…     

电光性眼炎80例临床分析

目的 观察电光性眼炎的临床表现、治疗及效果。方法 对80例电光性眼炎患者进行综合分析。结果 43．75％24小时内症状消失。46．25％72小时痊愈；8例转变为慢性睑缘炎和结角膜炎。结论 从事焊接工作对眼睛的保护极其重要。     

电光性眼炎38例临床报告

目的 分析电光性眼炎的常见病因,探讨眼科急诊对于电光性眼炎的诊治.方法 搜集我院眼科夜间急诊电光性眼炎38例,对其发病诱因和发病时限等指标进行分析,并对治疗措施进行总结.结果 38例电光性眼炎中男32例（84.21%）,女6例（15.79%）.平均（37.00±4.31）岁.发病时限为3～10（7.00±2.12）h,主要致病因素为电焊光照射32例（84.21%）,家庭紫外灯消毒4例（10.53%）,医院紫外灯消毒1例（2.63%）,观看日食1例（2.63%）,主要症状及体征是畏光、流泪、视物模糊、眼痛、混合充血或伴有结膜水肿、角膜上皮粗糙或部分剥脱.经过0.40%盐酸奥布卡因（倍诺喜,benoxil）紧急滴眼后（10.00±3.54）min症状明显缓解,再给予重组牛碱性成纤维细胞生长因子（贝复舒）、氧氟沙星眼膏（迪可罗）等对症治疗并预防感染.结论 电光性眼炎的患者中男性居多,主要致病因素为电焊光照射,其主要临床表现为角膜刺激症状,治疗上积极采取对症治疗缓解症状、促进角膜上皮恢复,同时预防感染.     

电光性眼炎127例临床分析

目的探讨电光性眼炎的临床治疗及预防。方法对127例电光性眼炎进行临床分析，并用利多卡因、贝复够及润舒滴眼液综合治疗。结果全部病例均在较短时间内治愈。结论用此综合疗法对电光性眼炎有较好的疗效，预防是关键。     

电光性眼炎频滴地卡因致角膜上皮脱落糜烂3例诊治

在电焊作业时因未戴防护面罩而致电光性眼炎是常见的职业性眼病。门诊常用 0 5 %地卡因眼液滴眼以缓解症状 ,但若使用不当则可造成不良后果。最近 4月内我院门诊收治 3例因地卡因眼液滴眼不当而致角膜上皮脱落糜烂患者 ,报告如下。一般资料 :3例男 ,2 5～ 3 5岁 ,均为非正式电焊工 ,电焊作业时均未戴防护面罩 ,作业时间 2 0分钟至 3小时不等 ,作业后 3～ 6小时出现电光性眼炎症状 ,表现为双眼刺痛、畏光、流泪等。均自购“电光眼水”(含 0 5 %地卡因 ,以下同 )滴眼 10～ 2 0次 ,症状曾有缓解 ,但 1天后症状加重。症状体征 :眼异物感加重 ,…     

润舒利多卡因治疗电光性眼炎

电光性眼炎足眼科较常见的急症，是一种职业性眼病。过去的治疗方法主要是用1％的卡因止痛，由于该药副作用较大，不宜过多重复使用，自1996年以来我们用润舒利多卡因治疗电光性眼炎36例，效果满意，报告如下：     

利多卡因球结膜下注射治疗重症电光性眼炎

电光性眼炎是眼科临床最常见的一种辐射伤。我科于2000年以来采用利多卡因球结膜下注射治疗重症电光性眼炎48例96眼，治疗效果令人满意，现介绍如下。     

电光性眼炎频滴地卡因致角膜上皮剥脱伤

我院地处城市工业区,电光性眼炎发病较多。作者现将10余年来所遇到因电光性眼炎频繁滴地卡因液所致角膜上皮剥脱伤(简称剥脱伤)28例(52眼)临床结果报告如下。     

蜂蜜眼膏治疗电光性眼炎1000例疗效观察

我院用蜂蜜眼膏治疗电光性眼炎,作用快、疗效好,现将1000例总结于后,供同道参考。一、配方:蜂蜜100克,盐酸麻黄素2克,盐酸普普卡因2克,按眼科技术操作常规配制。二、使用方法:1、用消毒玻璃棒或滴管(醋酸考地松眼药水滴管)将蜂蜜眼膏搅拌均匀后,滴于结膜囊内1—2滴。2、滴此眼膏之前向患者说明,此药滴入眼内有短暂性疼痛,顿时泪水较多,约5—15分钟,自觉症状即可消失。3、如果较重的患者相隔数分钟后,可重复滴药一次,可加速自觉症状的消失。4、遇冬天需加温(间接)后,再用玻璃棒搅拌均勾使用。     

非典型肺炎期间紫外线眼损伤的治疗与护理

目的 探讨非典型肺炎期间暴发电光性眼炎的病因，临床表现，治疗及护理。方法 对52例紫外线灯照射所致的电光性眼炎的临床表现、治疗、护理进行回顾分析。结果 46例24小时内痊愈，6例48小时内痊愈。结论 加强有关部门对紫外线灯的管理，普及紫外线消毒的防护知识是预防电光性眼炎的关键。     

不同眼用营养剂对电光性眼炎的疗效

目的 比较不同的眼用营养剂对电光性眼炎患者角膜上皮愈合时间、痛觉和泪膜稳定性的影响。方法 将12例24眼随机分成3组,分别加用含碱性成纤维细胞生长因子、10g/L羧甲基纤维素钠、多种氨基酸的滴眼液作为辅助治疗。结果 加用碱性成纤维细胞生长因子滴眼液组角膜愈合时间较其它两组缩短,加用10g/L羧甲基纤维素钠滴眼液组泪膜稳定性较其它两组增高。结论 碱性成纤维细胞生长因子有利于电光性眼炎角膜上皮的愈合,羧甲基纤维素钠有利于患者泪膜的稳定。     

Subconjunctival bevacizumab injection for corneal neovascularization

PURPOSE: To report on the clinical use of subconjunctival bevacizumab in patients with corneal neovascularization. METHODS: The charts of 10 consecutive patients with corneal neovascularization who received subconjunctival injections of bevacizumab (2.5 mg/0.1 mL) were reviewed. Digital photographs of the cornea were graded by 2 masked observers for density, extent, and centricity of corneal vascularization. Image analysis was used to determine the area of cornea covered by neovascularization as a percentage of the total corneal area. RESULTS: No significant ocular or systemic adverse events were observed during 3.5 +/- 1.1 months of follow-up. Seven patients showed partial regression of vessels. The extent decreased from 6.0 +/- 1.2 (SD) clock hours before the injection to 4.6 +/- 1.0 clock hours after bevacizumab injection (P = 0.008). Density decreased from 2.7 +/- 0.2 to 1.9 +/- 0.3, respectively. (P = 0.007). No change was noticed in the centricity of corneal vessels. Corneal neovascularization covered, on average, 14.8% +/- 2.5% (SD) of the corneal surface before the injections, compared with 10.5% +/- 2.8% (P = 0.36, t test) after bevacizumab injection. Therefore, bevacizumab decreased corneal neovascularization by 29%. CONCLUSIONS: Short-term results suggest that subconjunctival bevacizumab is well tolerated and associated with a partial regression of corneal neovascularization.     

Bupivacaine and lidocaine retrobulbar anesthesia. A double-blind clinical study

Bupivacaine 0.75% with epinephrine and/or hyaluronidase and lidocaine 2% with epinephrine and hyaluronidase were compared as to onset and duration of surgical anesthesia and akinesia in a prospective, randomized, double-blind study in 111 patients undergoing 128 elective intraocular surgical procedures. There was no significant difference in onset time to adequate surgical anesthesia among any of the drug groups at 15 minutes following retrobulbar injection, but the bupivacaine with epinephrine group lagged for akinesia. Mean duration of akinesia was 11 hours for the bupivacaine groups compared to four hours for lidocaine. During the eight hours following surgery, 70-90% of the patients receiving bupivacaine required no postoperative analgesia compared to less than 40% of the lidocaine group. There were no drug-related complications.     

Effect of amniotic membrane transplantation on the healing of bacterial keratitis

PURPOSE: To study, with the use of an animal model, the efficacy of amniotic membrane (AM) transplantation as adjunctive treatment in corneal healing after bacterial keratitis. METHODS: Staphylococcus aureus keratitis was induced in 47 rats by injection of bacteria into the corneal stroma. Treatment was started 48 hours later with one of three randomly assigned protocols: cefazolin drops (50 mg/mL) and AM transplantation (n = 16); nonpreserved 0.9% saline drops and AM transplantation (n = 15); or cefazolin without AM transplantation (n = 16). Cefazolin and saline drops were administered every 30 minutes for 6 hours, then hourly for 6 hours. AM was transplanted 24 hours after termination of cefazolin or saline treatment. Results were clinically assessed 7 days after AM transplantation or at the corresponding time in the nontransplanted animals. The rats were then killed, and their corneas were removed for bacterial counts or histopathologic examination. RESULTS: The best clinical results were observed in the group treated with cefazolin and AM transplantation, manifested by the least corneal haze and neovascularization (P = 0.007 and P = 0.014, respectively) and minimal bacterial counts (28 colony-forming units [CFU]/mL compared with 160 CFU/mL and 240 CFU/mL, respectively). Histopathologic examination showed that the central corneal vessels from rats treated with cefazolin and AM were smaller and less congested than those from the other two groups. CONCLUSIONS: AM transplantation is a useful adjunctive treatment after bacterial keratitis in this rat model. The transplanted AM improved the healing process, resulting in decreased corneal haze and less neovascularization.     

P-选择素对角膜上皮创伤修复及其中性粒细胞迁移的影响

目的观察P-选择素对角膜上皮创伤修复及其中性粒细胞迁移的影响。方法选用P-选择素基因敲除小鼠与野生型小鼠进行对比,观察角膜上皮创伤修复过程,同时用免疫组织化学方法观察中性粒细胞在角膜的迁移,并用酶联免疫吸附测定方法检测角膜中细胞因子和趋化因子的变化。结果与野生型小鼠相比,P-选择素基因敲除小鼠的角膜创伤修复延迟,向角膜迁移的中性粒细胞数量减少;中性粒细胞的迁移与趋化因子和细胞因子有密切的关系。结论P-选择素表达缺陷可导致角膜上皮创伤修复的延迟。这种延迟可能与创伤后中性粒细胞向创伤区迁移数量减少有关。     

Effect of topical steroids on corneal epithelial healing after vitreoretinal surgery

PURPOSE: Topical steroid use is usually avoided in cases of corneal epithelial defect. We evaluated the effect of topical steroid treatment on corneal epithelial healing after epithelial debridement in vitreoretinal surgery. METHODS: Our study population included 85 eyes undergoing vitreoretinal surgeries in our clinic. We prospectively compared the duration of corneal epithelial wound healing in 43 eyes in which topical dexamethasone was used with that in 42 eyes in which topical dexamethasone was not used in the early postoperative period after epithelial debridement. Factors that may retard corneal epithelial healing, including pre- and intraoperative topical solutions, median operative time, the presence of diabetes mellitus, prior ocular surgeries, pseudophakia, aphakia and the presence of intraocular gas or silicone oil in aphakic patients, were not significantly different between the two groups. RESULTS: The mean corneal epithelial defect closure time was 59.7 +/- 2.6 hours (mean +/- SEM) in the group receiving topical steroid treatment, and 61.9 +/- 2.6 hours in the group that did not receive steroids. CONCLUSION: Topical dexamethasone administered five times/day did not significantly retard corneal epithelial healing in subjects undergoing vitreoretinal surgery with postoperative topical steroid treatment, compared with subjects who did not receive steroid treatment.     

Effects of morphine on corneal sensitivity and epithelial wound healing: implications for topical ophthalmic analgesia.

Studies were conducted to examine the analgesic and toxic effects of topical morphine on corneal abrasion. For the toxicity study, rabbits were anaesthetized and epithelial cells were removed from the cornea and limbus. Animals were randomised and treated topically as follows: (1) saline (control); (2) morphine sulphate (MS, 0.5%); and (3) proxymetacaine hydrochloride (proparacaine) (PH, 0.5%). Two drops of the solution were instilled in the eyes at 4 hour intervals for 6 consecutive days and the progression of corneal wound healing was assessed. Results showed that repeated topical MS had no adverse effects on corneal wound closure. The rates of wound healing were similar in both saline and MS treated groups. Eyes treated with MS showed wound closure in a symmetrical fashion starting on day 2 following abrasion. The progression of epithelial wound healing was completed by day 4 in one eye, by day 5 in three eyes, and by day 7 in five eyes. In contrast, repeated topical PH application delayed corneal wound closure. Eyes treated with PH showed signs of corneal wound closure on the third day, but only two eyes out of six had completed wound closure by the eighth day after corneal abrasion. In a subsequent masked study, the analgesic efficacy of topical MS was assessed in seven patients with unilateral corneal abrasion. In all cases, a baseline response was first established. Subsequently, saline was instilled in both eyes and the patient's corneal response to pain pressure was determined 10 and 20 minutes later. Finally, MS was applied and the analgesic effect on the cornea was assessed. Results showed that saline had no effect compared with the baseline response. In contrast, MS showed an analgesic effect as early as 10 minutes after application in the eye with corneal abrasion. MS showed an analgesic efficacy of 4.3-fold and 5.5-fold greater than the baseline or saline on the eye with corneal abrasion. However, MS had no analgesic effect on the intact corneal. Collectively, these data indicate that opioids do have a desirable analgesic property with out irritating or causing any adverse effect on ocular structures.     

Wound healing of the corneal posterior surface in animal experiments

Autoradiographic studies using tritiated thymidine as a precursor of DNA synthesis show that the process of wound healing of the corneal endothelium in both rhesus monkeys and rabbits following scarification and cryocoagulation takes place for the most part by means of cell proliferation. After injection of tritiated thymidine into the anterior chamber immediately prior to sacrifice, autoradiographically labeled flat mounts and cross-section preparations of the corneas of 7 rhesus monkeys and 14 rabbits were examined at lesion ages ranging from 4 hours to 10 days. In the monkeys scarcely 10% of the endothelial cells in the areas of the corneal lesions or at their borders were in the S-phase in the autoradiographically labeled flat mounts 24 hours to 3 days after injury, whereas up to 39% of those in the rabbits were seen to be so after 18 hours. In the monkeys one could discern mitoses between the 2nd and 5th days, and amitoses (binuclear cells) were found in 1-day and 3-day animals. In rabbits numerous mitoses could be discerned between the 1st and 5st days, but no multinuclear cells were seen. Healing of the corneal endothelium in the monkeys occurred some-what later and was less pronounced than in the rabbits.     

Comparison of the effects of fourth-generation fluoroquinolones on corneal re-epithelialization in rabbit eyes

BACKGROUND: Gatifloxacin and moxifloxacin ophthalmic solutions are frequently prescribed for antimicrobial prophylaxis following cataract and corneal refractive surgeries, although the use of topical antibiotics is likely to interfere with wound healing in the immediate postoperative period. A potential factor that may influence rates of wound healing or corneal re-epithelialization is how the solutions are preserved. Gatifloxacin is preserved with 0.005% benzalkonium chloride, whereas moxifloxacin is unpreserved. The purpose of this study was to evaluate the effects of commercially prepared topical gatifloxacin and moxifloxacin on corneal re-epithelialization in rabbit eyes. METHODS: In this randomized, prospective, controlled study, 17 New Zealand white rabbits underwent bilateral corneal de-epithelialization procedures using 20% alcohol contained within a 6 mm trephine. Postoperatively, eyes were randomly assigned to receive either gatifloxacin 0.3%, moxifloxacin 0.5%, or balanced salt solution (BSS) four times daily. Each 6 hours during the first 2 days, and every 12 hours thereafter slit-lamp measurements and corneal photography were performed, enabling de-epithelialized surface areas to be calculated via EPCO 2000 computer analysis. RESULTS: Gatifloxacin (n = 12) and moxifloxacin (n = 13) treated eyes had a statistically significant (p = 0.036) delay in epithelial healing relative to controls (BSS, n = 8). Healing rates of gatifloxacin and moxifloxacin treated eyes were not significantly different (p = 0.545). CONCLUSIONS: We found no significant difference in re-epithelialization rates following topical application of gatifloxacin 0.3% and moxifloxacin 0.5%. Both antibiotic solutions delayed healing compared to BSS. Our analysis suggests that there was no apparent added epithelial toxicity due to the presence of BAK in the gatifloxacin preparation.     

Intraoperative mydriasis by intracameral injection of mydriatic eye drops: in vivo efficacy and in vitro safety studies

Background: This study investigated the efficacy and safety of intracameral injection of commercially available eye drops containing 0.5% tropicamide and 0.5% phenylephrine hydrochloride (Mydrin‐P, Santen Pharmaceutical, Osaka, Japan). Design: In vitro experiment and prospective clinical study at a private hospital. Participants and Samples: Mydrin‐P was applied to confluent cultured human corneal endothelial cells, and the cellular morphology was examined. Clinical study subjects were 65 eyes of 65 patients that underwent phaco‐emulsification and aspiration with intraocular lens implantation and received intracameral injection of Mydrin‐P for poor mydriasis after preoperative topical instillation of mydriatics (intraocular mydriasis group; with five subgroups based on cause: diabetes, pseudo‐exfoliation, post‐surgery, uveitis, unknown). Controls, comprising 39 eyes of 39 patients, were not injected with Mydrin‐P. Methods: The ratio of pupillary diameter to corneal diameter was determined before and after injection of Mydrin‐P. Corneal endothelial density was measured preoperatively and 3 months and 1 year postoperatively. Main Outcome Measures: Pupillary diameter and corneal endothelial density. Results: Human corneal endothelial cell morphology was unaltered after Mydrin‐P injection. The mean ratio of the pupillary diameter to corneal diameter increased in the intraocular mydriasis group (before: 54.2 ± 4.8%, after: 58.4 ± 6.6%; P < 0.001) and in the diabetes and unknown subgroups. The corneal endothelial cell density reduction rate 3 months and 1 year after surgery was not significantly different between the intraocular mydriasis group and controls. Conclusion: Intracameral injection of Mydrin‐P appears to be effective and safe for dilating the pupil in cases with poor mydriasis after preoperative instillation of mydriatics.