特发性眼睑痉挛的手术治疗

目的探讨手术治疗特发性眼睑痉挛的疗效。方法采用Anderson手术治疗22例(44眼)严重的特发性眼睑痉挛。结果手术能够明显减轻眼睑痉挛的程度,并能完全矫正眉下垂、上睑下垂、睑皮松弛及睑裂横径缩小等临床症状。结论对于严重的持续性的特发性眼睑痉挛手术治疗是一种效果显著的方法。     

特发性眼睑痉挛的手术治疗

目的 探讨手术治疗特发性眼睑痉挛的疗效.方法 手术切除睑板前、眶隔前及上、下眼睑的眶部轮匝肌、皱眉肌及降眉间肌治疗严重的特发性眼睑痉挛.结果 本组病例共7例,均不同程度明显减轻睑痉挛的程度,所有病例睑皮松弛、上睑下垂、眉下垂、睑裂横径缩小等现象均消失.功能性视力障碍消失.结论 手术切除眼轮匝肌、皱眉肌及降眉间肌是治疗眼睑特发性痉挛的有效方法.     

12例严重特发性眼睑痉挛的手术治疗

采用Ａｎｄｅｒｓｏｎ法手术治疗了１２例严重的特发性眼睑痉挛患者。结果：手术能够明显减轻眼睑痉挛的程度,并能完全矫正眉下垂、上睑下垂、睑皮松弛、睑裂横径缩小等临床症状。结论：对于严重的持续性的特发性眼睑痉挛患者手术治疗是一种疗效显著的方法。     

A型肉毒毒素治疗眼睑痉挛的临床研究

目的：探讨 A 型肉毒毒素治疗中重度眼睑痉挛的临床疗效。 方法：选取本院眼科门诊诊断明确的眼睑痉挛的患者113例,采用A型肉毒毒素局部注射治疗,并对治疗疗效进行评估。 结果：患者59例（52.2%）症状完全缓解,49例（43.4%）明显改善,4例（3.5%）部分改善,1例无效（0.9%）,总有效率达到99.1%。起效时间1~14d,大多于14d内达到最佳效果,疗效持续1~9 mo。不良反应可出现轻度眼睑闭合不全、上睑下垂、局部皮下瘀血等共23例,均在2~4 wk内恢复。 结论：局部注射A型肉毒毒素治疗中重度眼睑痉挛安全、有效。     

次全闭睑肌切除手术治疗眼睑痉挛的疗效及常见并发症

目的观察次全闭睑肌切除手术治疗眼睑痉挛的疗效及常见并发症。方法回顾性分析不能通过肉毒杆菌毒素A注射得到治疗的10例（20眼）眼睑痉挛次全闭睑肌切除手术的临床疗效及常见并发症。结果90％病人解除了手术前开睑不能的临床症状，可以维持日常生活；同时眉下垂、上睑下垂、外呲韧带松弛、眼睑皮肤松弛得以解除。     

睑松弛症的手术治疗

目的：探讨睑松弛症的发病机理和手术治疗方法。方法：对30例睑松弛症患者采用手术方法分别治疗上睑皮肤松弛、泪腺脱垂、上睑下垂和睑裂横径缩短，取上睑组织作组织学检查。结果：随访6月～5年，30例患者的上睑皮肤松弛均得到明显改善，3例4眼残留部分泪腺脱垂，上睑下垂和睑裂横径缩短均得到满意矫正。组织学检查显示病变区皮下灶性淋巴细胞浸润，弹力纤维断裂崩解。结论：睑松弛症的发生与慢性炎症有关，手术治疗可有效改善症状。     

甲状腺相关眼病上睑退缩的治疗

目的：探讨甲状腺相关眼病上睑退缩的治疗方法。方法：回顾分析临床资料完整的90例123眼甲状腺相关眼病上睑退缩的治疗效果。治疗方法包括保守观察、全身和局部糖皮质激素治疗、局部肉毒杆菌毒素注射和手术治疗等。治疗后平均随访1．4年。结果：用全身和局部糖皮质激素治疗34例49眼中，上睑退缩完全消失4例6眼，明显改善13例20眼，无效17例23眼；局部肉毒杆菌毒素注射20例26眼中，上睑退缩完全消失8例9眼，明显改善9例11眼，无效3例6眼，持续时间6w至2年，注射后并发上睑下垂4例5眼；提上睑肌延长术11例15眼中，术后上睑退缩完全消失7例10眼，明显改善2例3眼，复发1例1眼，轻度过矫1例1眼；上睑退缩伴患眼下斜视15例15眼，行患眼下直肌后退术，其中术后上睑退缩完全消失14例14眼，明显改善1例1眼；10例18眼未作任何治疗，经平均2年随访观察发现2例4眼上睑退缩完全消失，1例2眼有明显改善。结论：甲状腺相关眼病上睑退缩宜采用综合治疗措施。发病初期或活动期病例用全身和局部糖皮质激素和局部注射肉毒杆菌毒素治疗效果好，静止期或保守治疗效果不好的患者宜行提上睑肌延长术治疗，伴有下斜视的患者行斜视矫正术可同时矫正斜视与上睑退缩。     

三联术治疗先天性睑裂狭小综合征

目的探讨先天性睑裂狭小综合征的手术方法。方法13例行内眦成形、外眦成形和上睑下垂矫正三联手术。结果术后全部13例(26眼)睑裂宽度≥6mm，重睑线美观自然，眼睑闭合良好。结论三联术治疗先天性睑裂狭小综合征术式简便，效果确切。     

眼睑痉挛手术疗法

笔者对保守治疗无效的眼睑痉挛患者,采用眼轮匝肌、眉部肌肉手术切除方法共治5例8眼,均获得较好效果,报告如下。5例8眼,男性2例,女性3例,年龄均在55岁以上,双眼3例,单眼2例。手术方法局部浸润麻醉后,距离上睑缘3mm,下睑缘2mm处作与睑缘平行的皮肤切口,同时切除部分松弛皮肤。睑痉挛患者从睑缘3mm开始,先在皮肤与眼轮匝肌之间分离,然后分离眼轮匝肌与眶隔,游     

A型肉毒毒素治疗特发性眼睑痉挛的临床报告

特发性眼睑痉挛（idiopathic blophawvopaiwn）是一种进行性慢性神经肌肉性疾病，表现为眼睑非随意频繁的痉挛性抽动，睁眼困难，甚至引起功能性视力障碍；以往常采用口服药物、针灸疗法或手术治疗，但疗效不确定，并发症多。1984年Frueh等首先应用A型肉毒毒素（BTA）治疗特发性眼睑痉挛，因疗效高和副反应少已成为当前首选疗法。我科自1999年以来，采用眼睑局部注射BTA治疗特发性眼睑痉挛，效果满意，现报告如下。     

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.