羟基磷灰石义眼座植入Ⅰ期钻孔的初步效果

目的 评价羟基磷灰石义眼座植入Ⅰ期钻孔放置钛钉的疗效。方法 对31例眼球摘除患者行Ⅰ期或Ⅱ期羟基磷灰石义眼座植入同时行钻孔,钻入钛钉的螺纹套子,中间放置平头钉,3～7个月后剪开,更换为球头钉,定制义眼片。结果 随访3．0～11．0个月(平均6．9个月),所有患者对义眼外观及活动度满意,无义眼座暴露、继发感染、栓钉脱出、栓钉偏斜等并发症。结论 羟基磷灰石义眼座植入Ⅰ期钻孔手术效果好,无明显增加并发症的发生机会,是一种可供选择的手术方法。     

钛钉Ⅰ、Ⅱ期置入羟基磷灰石义眼座的临床研究

目的 比较钛钉Ⅰ、Ⅱ期置入羟基磷灰石义眼座的疗效。方法20例眼球摘除患者行Ⅰ期放置平头钉，3～6个月更换为球头钉，定制义眼片。20例眼球摘除患者置入羟基磷灰石义眼座后6个月放置球头钉，定制义眼片。结果随访3个月～3年两组患者并发症的发生无显著差别。结论钛钉Ⅰ期置入羟基磷灰石义眼座无明显增加并发症的发生机会。     

羟基磷灰石眼座植入后钻孔的临床研究

目的评价羟基磷灰石眼座植入后钻孔手术的疗效。方法146例HA植入6个月后行钻孔手术。用弧形视野计测量术前、术后义眼的活动度。结果义眼的活动幅度从术前的18.7±3.8度提高到42.3±3.7度。随访1～40个月无继发感染等并发症。结论钻孔手术放置栓钉后不仅义眼的活动幅度增加，而且大大提高其活动灵敏度，改善患者外观。     

羟基磷灰石眶内植入术中Ⅰ期钻孔的效果

目的：探讨Ⅰ期和Ⅱ期羟基磷灰石(hydroxyapatite HA)眶内植入术中Ⅰ期钻孔的效果。方法：对73眼分3组行HA植入术Ⅰ期钻孔，其中①组：眼球除Ⅰ期HA植入20眼；②组：眼内容剜除Ⅰ期HA植入38眼；③组：Ⅱ期HA植入15眼。结果：随访3～9mo，所有患无义眼座暴露，继发感染，钛钉脱出等并发症。①组：有5例(25%)钛钉偏斜。②组：所有患在暴露钛钉时，无钛钉偏斜。③组：13眼(87％)出现钛钉偏斜。结论：羟基磷灰石眼座植入Ⅰ期钻孔用于HAⅠ期植入手术效果好，无明显增加并发症的发生机会，而HAⅡ期植入患选择Ⅱ期钻孔。     

视网膜母细胞瘤摘除术后羟基磷灰石义眼座Ⅰ期和Ⅱ期植入临床观察

目的 比较视网膜母细胞瘤摘除术后羟基磷灰石义眼座Ⅰ期植入和Ⅱ期植入的临床效果。方法 对11例视网膜母细胞瘤患者进行观察．6例行羟基磷灰石义眼座Ⅰ期植入．5例行Ⅱ期植入和颜面部整复术。结果 术后随访3～36个月，6例Ⅰ期植入者，术后结膜无裂开、感染、结膜囊狭窄等并发症；5例Ⅱ期植入者，HA活动度较Ⅰ期差．1例见结膜创口裂开，羟基磷灰石义眼座暴露。结论 视网膜母细胞瘤摘除术后Ⅰ期植入羟基磷灰石义眼座．在治疗和美容效果上明显优于Ⅱ期植入者，视网膜母细胞瘤摘除术后尽可能Ⅰ期植入眼座是可行的。     

眼外伤后Ⅰ期与Ⅱ期植入羟基磷灰石义眼座效果比较

目的 比较眼外伤后羟基磷灰石义眼座Ⅰ期植入与Ⅱ期植入的手术效果.方法 将108例单眼眼外伤患者分为2组,48例患者行Ⅰ期眼内容物摘除术+自体双层巩膜覆盖羟基磷灰石(hydroxyapatite,HA)义眼座植入术,60例患者行Ⅱ期眼内容物摘除术+自体双层巩膜覆盖HA义眼座植入术.对所有患者的义眼座活动度、术后并发症、外观的满意率进行回顾性对比分析.结果 Ⅰ期与Ⅱ期植入患者对其外观及活动度均满意,无义眼座暴露、继发感染或脱出等并发症.Ⅰ期植入48例,活动度优41例(85.42%),良7例(14.58%);其外观非常满意42例(87.50%),基本满意5例(10.42%),满意率为97.92%.Ⅱ期植入60例,活动幅度优50例(83.33%),良10例(16.67%);对其外观非常满意51例(85.00%),基本满意6例(10.00%),满意率95.00%.结论 Ⅰ期或Ⅱ期羟基磷灰石义眼座植入术效果和并发症上无明显差别.根据患眼伤情,选择合适的手术方法可减轻术后反应,增加患者的满意率.     

儿童羟基磷灰石眼窝植入的临床研究

目的 评价儿童眼球摘除术后羟基磷灰石眼座眼窝植入的疗效。方法 采用自体巩膜或异体硬脑膜包裹羟基磷灰石作为眼窝植入物，观察56例的疗效，其中36例眼球摘除后Ⅰ期植入，20例Ⅱ期植入，6例钻孔放置栓钉。结果 随访1-78月，无眼座暴露、眶内感染或植入物排异、移位等并发症，外观满意。钻孔后放置栓钉者活动佳，未钻孔者活动稍差。结论 儿童羟基磷灰石眼座眼窝植入并发症少，能促进眼眶的正常发育，有助于儿童的身心健康成长。     

改良的羟基磷灰石义眼座植入术的初步效果

目的:评价羟基磷灰石义眼座植入术的疗效.方法:对49例(49眼)眼内容物剜除术患者行Ⅰ期或Ⅱ期羟基磷灰石义眼座植入手术.结果:随5mo～4a的所有患者对外观及义眼活动度满意,无感染、结膜裂开和义眼座暴露等并发症.结论:改良的羟基磷灰石义眼座植入术具有操作简单,对组织损伤小,并发症少等优点,是一种可供选择的手术方式.     

羟基磷灰石义眼台植入89例

目的 观察羟基磷灰石眼座植入的临床效果。方法 75例羟基磷灰石义眼座Ⅰ期植入，14例Ⅱ期植入。随访3月一2年。结果89例眼睑及结膜均有不同程度水肿，1例羟基磷灰石义眼座暴露，不影响效果，没有处理。Ⅱ期植入2例出现下穹隆狭窄，经成形后恢复，89例义眼活动良好，配戴仿真义眼片后眼外观满意。结论 羟基磷灰石义眼座植入术式操作简单，美容效果佳。Ⅰ期较Ⅱ期植入义眼活动度及外观好，尽量行Ⅰ期植入。     

简易Ⅰ期羟基磷灰石义眼座植入

目的介绍一种简单的Ⅰ期羟基磷灰石义眼座植入手术方法。方法26例眼内容物剜出术后,从鼻上方内直肌与上直肌之间将义眼座植入肌锥腔,巩膜壳平铺于义眼座上,分层缝合巩膜、筋膜、结膜。结果随访12～24个月,26例眼窝饱满,无塌陷,装上义眼片后活动度良好,1例义眼座暴露,经手术修复。结论该手术方法简单,易行,义眼座植入并发症少,义眼片活动度好,是值得推广的手术。     

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.