家兔眼前段碱烧伤治疗的实验研究

本文用4％氢氧化钠溶液制成20只家兔(20只眼)眼前段碱烧伤模型,进行临床治疗观察和组织病理学检查。结果表明:在减轻症状、减少角膜新生血管,缩短病程方面,常规治疗加滴新福林组疗效较常规治疗组好。认为这种方法具有临床推广价值。     

实验性眼冲击伤视网膜电图的改变

实验性兔眼冲击伤后，视网膜电图（ERG）a、b波振幅明显降低，分别约为伤前35%及54%，并于伤后14d，21d才恢复至伤前水平。地塞米松合并蝮蛇抗栓酶治疗组ERG a、b波振幅恢复早于对照组及地塞米松合并妥拉苏林或单纯用地塞米松的两个治疗组。表现一定能量的冲击波可造成明显的视网膜功能损害，ERG可作为检测损伤程度，客观评价疗效的重要指标。 （中华眼底病杂志，1995，11：169-171）     

眼冲击伤早期视网膜电图的变化

本文探讨了眼冲击伤早期视网膜电图（ERG）的变化。实验动物为成年家兔，用BST－Ⅲ型生物激波管造成轻度和重度的眼冲击伤，冲击波超压峰值分别为429±38．8kPa和834±16．47kPa。于伤前和伤后0．5h，3h，6h和24h；临床观察并检测伤眼和对侧健眼的ERG变化。结果提示：伤后轻、重伤两组伤眼的a波和b波波幅值均明显下降，a波峰潜时延长；2组健服的a、b波幅值也有下降。表明眼冲击伤后早期，伤眼的伤情不论轻重，视功能的障碍均是严重的，并影响对侧眼。     

家兔眼前段碱烧后自由基清除酶动态变化的实验研究

家兔眼前段烧伤后４、２４和７２小时房水中自由基清除酶ＳＯＤ、ＣＡＴ和ＧＳＨ－Ｐｘ活力的下降，提示眼前段碱烧伤存在着自由反应的紊乱，自由基清除酶活性降低，引起角膜组织严重损伤，溃疡难以愈合。     

眼冲击伤的特点和临床分型的实验研究

为建立眼冲击伤的动物模型和观察伤情特点，作者们采用BST－Ⅲ型生物激波管进行了实验研究。实验中进行了临床、病理、电镜、荧光眼底血管造影及视诱发电位等项的检测。结果对3种实验动物模型，证明冲击了波能造成严重的眼损伤：如瞳孔缩小、眼压升高、眼睑、结膜、角膜、巩膜、葡萄膜，晶状体、视网膜和眼眶的损伤。其中以晶状体和视网膜的损伤严重。另外有二只眼球被击出眶外。按照眼损伤的严重性，将眼冲击伤分成：轻、重、极重3型。并探讨不同伤情特点。     

自由基清除剂治疗眼前段碱烧伤的实验研究

本文对照组角膜溃疡和角膜穿孔的发生率分别是70%和55%。联合治疗组降低了眼前碱烧伤时角膜溃疡(32%,P<0.05)和角膜穿孔(0%,P<0.01)的发生率。单独应用SOD没有达到治疗目的,本文结论,自由基清除剂可能成为治疗碱烧伤的一种新的药物。     

室内爆炸犬眼冲击伤后早期眼组织病理结构改变

目的:观察犬眼室内爆炸冲击波损伤后早期眼组织结构的病理学改变。方法:爆轰塔内B炸药爆炸致眼冲击伤,根据对眼球的不同爆炸强度随机分组:A组549mmHg;B组1089mmHg;C组2128mmHg;D组无致伤对照组。均分别于伤后0.5h和6h处死动物,取眼组织标本于40g/L中性甲醛溶液固定,行常规石蜡包埋,切片,HE染色,光镜观察,拍照。结果:眼部冲击伤后即刻出现球结膜充血、水肿,脉络膜出血,有明显的视网膜血管改变,组织水肿、渗出、出血等改变。结论:爆轰塔内B炸药爆炸致眼冲击波可造成视网膜、脉络膜、视神经的直接损伤。     

冲击波所致兔视神经损伤的超微结构改变

冲击波眼损伤是目前备受关注的一种眼外伤，其伤后视力损害尤为明显。迄今为止，冲击波眼损伤的机制仍不清楚，许多实验研究集中于伤后脉络膜改变，然而脉络膜的变化似乎并不足以解释伤后严重的视功能障碍，对此我们进行此实验研究，报告如下。     

Penetrating Ocular Injuries from Fish-hooks

Purpose: To report four cases of penetrating ocular injuries from fish-hooks. Methods: The case records of four patients who attended the ophthalmology department with ocular fish-hook injuries were reviewed. Results: Individuals were male, between the ages of 9 and 67. All cases had anterior segment involvement and the hooks were extracted by backing them out through the primary incision. Final visual outcomes were 6/12 or better. Conclusions: These results suggest that a good visual outcome can be achieved with the less published back-out method of fish-hook extraction. Obviously the technique of choice used for removal of the hook will vary depending on the case and perhaps more important than the method of hook extraction is the need for prompt surgical repair. None of the authors have a proprietary interest in this study.     

Potential Mechanisms of Intraocular Pressure Reduction by Micropulse Transscleral Cyclophotocoagulation in Rabbit Eyes

PurposeTo evaluate the histological changes associated with, and the potential mechanisms of, intraocular pressure (IOP) reduction by micropulse cyclophotocoagulation (MP-CPC) in rabbit eyes.MethodsMP-CPC was performed on the right eyes of Dutch belted rabbits, whereas the left eyes served as controls. The laser power settings were 250, 500, 750, 1000, 1500, and 2000 mW, 10 seconds per sweep, 100 seconds in total. IOP, outflow facility, and uveoscleral outflow tract imaging, using a fluorescent tracer, were examined at one week after MP-CPC. Changes of morphology and protein expressions in the outflow tissues, conjunctiva, and sclera were also evaluated.ResultsSignificant reductions in IOP after MP-CPC were observed at 500 to 1000 mW (P = 0.036 and P = 0.014, respectively). The pre-MP-CPC IOP was 11.35 ± 0.41 mm Hg. At one week after surgery, the respective IOP values in the eyes treated at 500 mW and 1000 mW were 9.45 ± 0.49 mm Hg and 7.4 ± 0.27 mm Hg, respectively. Severe ciliary body damage was observed at 1500 to 2000 mW. MMP1–3 and fibronectin expression levels in the outflow tract and ciliary body were upregulated after MP-CPC. The α-smooth muscle actin (α-SMA) was upregulated at higher power levels. MP-CPC significantly increased uveoscleral outflow, whereas the outflow facility did not change. The α-SMA, collagen, and fibronectin were significantly upregulated in the subconjunctiva and sclera.ConclusionsReactive fibrotic responses were observed in the outflow tract, conjunctiva, and sclera after MP-CPC. A potential mechanism of IOP reduction by MP-CPC in pigmented rabbit eyes may involve increased uveoscleral outflow related to MMP upregulation.     

超声生物显微镜在眼前段微小异物诊断的应用

目的探讨超声生物显微镜（UBM）在眼前段微小异物诊断中的应用。方法应用UBM对7例眼前段异物诊断和定位并经手术摘出证实。结果7例异物均经UBM定位后手术顺利取出。结论相对于其他影像学检查，UBM在眼前段异物诊断和定位中具有明显的优越性。     

Comparison of intraocular pressure readings with Perkins, Tonopen, iCare 200, and iCare Home to manometry in cadaveric eyes

AIM: To compare intraocular pressure (IOP) readings obtained with Perkins tonometry, iCare Home, iCare 200, and Tonopen to IOP readings obtained with the manometer of a perfusion system to assess the accuracy and reproducibility of each method of tonometry at set pressures.METHODS: The IOP of human cadaveric eyes (n=2) was measured using a manometer inserted into the eye through the optic nerve. IOP measurements were obtained using a Perkins tonometer, iCare Home, iCare 200, and Tonopen. These measurements were compared to set point IOP measurements of a manometer to determine accuracy and reproducibility of each device.RESULTS: Mean IOP readings obtained with the Perkins tonometer compared to manometer readings demonstrated a difference of -1.0±5.0 mm Hg (P=0.45), indicating a lower reading on average than manometery although not significant. Mean IOP difference between iCare 200 and manometer was 5.3±2.2 mm Hg (P<0.0001). Mean difference in IOP between iCare Home and manometer was 3.5±2.4 mm Hg (P=0.0004). Mean IOP difference compared to manometer was 4.6±4.0 mm Hg for the Tonopen (P<0.0001). IOP measurements obtained with the Perkins tonometer demonstrated a standard deviation of 5.0 mm Hg while the Tonopen measurements demonstrated a 4.0 mm Hg standard deviation. In comparison, iCare 200 and iCare Home demonstrated 2.2 and 2.4 mm Hg standard deviation, respectively.CONCLUSION: Applanation tonometry produces more accurate IOP readings than rebound tonometry or Tonopen, however it demonstrates greater variability than the other forms of tonometry. Rebound tonometry is more reproducible but tends to over-estimate IOP.     

实验性急性高眼压对兔视网膜电图的影响

目的：检测家兔实验性急性高眼压不同压力状态下视网膜电图的变化。方法：采用视电生理检测仪测定家兔实验前,30mmHg(1mmHg=0.133kPa),60mmHg,90mmHg和120mmHg前房高压灌注45min及恢复正常眼压4h的视网膜电图（Flash Electroretinogram FERG)和振荡电位（Oscillatory Potentials,OPs)。结果：对照组和30mmHg组视电生理检测在实验前后无差异。60mmHg组在高压持续45min后,b波和OPs波振幅下降,4h后恢复正常。90mmHg和120mmHg组在高压45min后,FERG波形消失。4h后有不同程度恢复。结论：随着实验性高眼压压力的升高,家兔视网膜功能损伤加重,恢复能力减弱。     

Effect of Topical Phenylephrine 2.5% on Episcleral Venous Pressure in Normal Human Eyes

PurposePhenylephrine has been shown to affect intraocular pressure (IOP) but the mechanism of action is poorly understood. However, its action as a vasoconstrictor suggests possible effects on episcleral venous pressure (EVP). In this study, we evaluated the effect of phenylephrine on EVP and IOP in healthy subjects.MethodsForty eyes of 20 subjects were included. Each subject received 3 drops of phenylephrine 2.5% in one eye at 1-minute intervals. The fellow eye served as control. Blood pressure, heart rate, and IOP and EVP of both eyes were measured at baseline, 15 minutes, and 60 minutes after instillation of phenylephrine. IOP was measured by pneumatonometry. EVP was assessed by using a computer-controlled episcleral venomanometer. Changes in IOP, EVP, blood pressure, and heart rate at 15 and 60 minutes were analyzed by paired t-tests.ResultsIOP increased 15 minutes after instillation of phenylephrine in both treated (P = 0.001) and control eyes (P = 0.01) and returned to baseline at 60 minutes. The change in IOP at 15 minutes was not significantly different between the 2 groups. EVP in treated eyes was unchanged at 15 minutes (P = 0.8) but decreased significantly at 60 minutes (P < 0.001). In control eyes, there was no change in EVP at any time (P > 0.6). There were no significant changes from baseline in systolic and diastolic blood pressure and heart rate after instillation of phenylephrine.ConclusionsIOP elevation associated with topical phenylephrine is not caused by an increase in EVP in healthy subjects. Instead, EVP decreases with phenylephrine, but the mechanism remains to be determined.     

人眼轴长度与眼内压的相关性研究

观察眼轴长度与非接触眼压测量值之间的关系。 方法:选择在我院眼科门诊就诊的患者及行准分子激光角膜手术术前常规检查的近视患者共508例1010眼,年龄17～53(平均26.65±6.55)岁,分别测量眼轴长度及非接触眼压值,并按眼轴长度分为＜24mm,24～25.99mm,≥26mm三组,应用相关直线回归分析方法分析眼轴长度与眼内压之间的关系,方差分析比较3组眼压的差别。 结果：眼轴长度与眼内压值之间呈正相关性（r=0.138,P＜0.01,Y=7.331+0.296X),≥26mm组的眼内压升高幅度最大。 结论：眼轴长度与眼内压之间存在一定的内在联系,这种联系随着眼轴长度的增加而更为密切,提示临床应重视对高度近视眼的眼内压监测。     

原发性眼部淋巴瘤研究进展

原发性眼部淋巴瘤根据累及部位分为原发性眼内淋巴瘤（PIOL）和眼附属器淋巴瘤（POAL）。原发性玻璃体视网膜淋巴瘤（PVRL）是PIOL最常见的形式,是一种侵袭性B细胞恶性肿瘤,被认为是原发性中枢神经系统淋巴瘤（PCNSL）的一种亚型。因其眼部症状的非特异性而经常导致误诊。恶性细胞的细胞病理学/组织病理学鉴定是诊断PVRL的金标准。其他辅助检查,如光学相干断层扫描和眼底自发荧光已被应用于PVRL的诊断。细胞因子测量和B细胞克隆性以及突变分子的测定进一步提高了诊断的准确性。目前PVRL的治疗包括局部放疗,玻璃体内化疗（甲氨蝶呤和利妥昔单抗）,根据是否累及非眼部组织进行全身化疗。眼眶淋巴瘤是POAL的主要形式,绝大多数起源于B细胞。 组织病理学亚型和疾病的临床分期是预测预后及选择治疗的最佳指标。在治疗孤立性低级别淋巴瘤时,放射治疗是首选治疗方法。对于播散性和高度恶性淋巴瘤,应选择化疗或放疗联合化疗。     

高眼压症患者32例随访观察

目的:探讨高眼压症的致病因素、随访指标、病情变化等。方法:对32例高眼压症患者进行2～10(平均5)a的随访,随访包括对眼压、视野、视盘及视神经纤维层等方面的检查。结果:随访过程中29例患者眼压无明显变化,眼压呈下降趋势2例,眼压增高1例,视野出现改变5例。结论:高眼压症与多种致病因素有关,应密切随访观察,如出现可疑青光眼改变,应积极进行抗青光眼治疗。     

眼后段异物早期和晚期玻璃体切除异物摘出效果的分析

目的探讨眼球穿孔伤合并眼后段异物早期和晚期玻璃体切除异物摘出的效果。方法眼球穿孔伤合并眼后段异物采用玻璃体切除异物摘出手术26例（26眼）。其中早期手术组12例,伤后6d以内（3.75±1.55）d手术;晚期手术组14例,伤后7～12d（9±1.96）d手术。比较两组病例术后1周眼内组织反应渗出情况及术后3～7个月视网膜脱离和增生情况。结果早期手术组术后瞳孔区渗出膜形成7例,前房积血1例,晚期手术组术后瞳孔区渗出膜形成4例,（P〉0.05）。早期手术组视网膜增生膜形成1例,复发视网膜脱离2例;晚期手术组复发视网膜脱离1例（P〉0.05）。结论眼球穿孔伤合并眼后段异物早期行玻璃体切除异物摘出治疗能及时控制病情发展,治疗效果好。