冻存羊膜移植治疗早期中度及重度眼表烧伤的临床研究

目的探讨冻存羊膜移植在治疗早期中、重度眼表烧伤中的疗效。方法对28例（33眼）中、重度眼表烧伤施行羊膜移植术。随访6～12月,观察临床疗效。结果术后大部分患者保存了眼球,1眼发生角膜穿孔。角膜恢复透明12眼,角膜斑翳7眼,角膜白斑3眼,角膜新生血管9眼,睑球粘连1眼。13眼视力提高〉3行。无急性排斥反应和继发感染发生。结论羊膜移植是治疗早期中、重度眼表烧伤的一种较安全有效的方法。     

早期多次新鲜羊膜移植治疗重度眼表烧伤的疗效

目的:探讨早期多次新鲜羊膜移植治疗重度眼表烧伤的治疗效果。方法:回顾性分析我院2007-01/2011-12收治的25例25眼重度眼表烧伤患者早期采用两次及以上羊膜移植的治疗效果。术后对眼表稳定情况、角膜上皮愈合情况及新生血管、视力等进行观察随访。结果:患者25例25眼中,20眼在行2次羊膜移植术后6～14d羊膜开始溶解,拆线后羊膜脱落。眼表炎症控制,荧光素钠染色角膜上皮完整;角膜缘缺血改善。4眼2次羊膜移植术后,羊膜溶解脱落后表现为角膜上皮未愈合,直径大于2mm以上,角膜缘缺血大于1/4象限,再行第3次移植。最终眼球保存完整,眼表稳定。1眼2次术后3d出院,未能继续跟踪观察。结论:重度眼表烧伤采取早期多次新鲜羊膜移植治疗,对稳定眼表十分有效。     

羊膜移植治疗急性眼表烧伤的疗效

目的:讨论羊膜移植术对治疗急性眼表烧伤的疗效。方法:用新鲜的人羊膜移植术来治疗眼部早期烧伤10例12眼。结果:患者12眼均于术后3wk内眼表重新再次上皮化;恢复透明角膜3眼,薄翳5眼,遗留角膜斑翳2眼,角膜白斑者2眼;角膜血管新生3眼,其中限于角膜周边部仅2眼,1眼进入角膜瞳孔区;睑球轻度粘连2眼。结论:羊膜移植治疗早期眼部烧伤可获得稳定的眼表,是一种有效的方法,且为日后行角膜移植术治疗创造了条件。     

新鲜羊膜移植在治疗早期重度眼烧伤中的临床观察

目的研究新鲜羊膜移植术对治疗早期重度眼烧伤的临床效果.方法采用新鲜羊膜治疗碱烧伤5例(5眼),酸烧伤3例(3眼),热烧伤8例(8眼).烧伤部位包括角膜、结膜.受伤到手术时间1～14 d,平均7 d.结果16眼均无羊膜移植排斥反应和继发感染,眼表稳定.术后3～7 d眼部炎症均可控制,无角巩膜溶解穿孔、虹膜萎缩,视力较前有不同程度提高,其中7眼角膜恢复透明,8眼角膜无新生血管,合并角膜不同程度斑翳,1眼全角膜浑浊.结论运用羊膜移植重建眼表烧伤,可有效促进上皮细胞分化移行,抑制局部炎症,阻止新生血管和瘢痕形成,预防或修复睑球粘连.早期新鲜羊膜移植可用作重度眼烧伤后重建眼表的第一步.     

羊膜移植治疗眼表烧伤的临床应用分析

目的:评价羊膜移植治疗眼表化学烧伤及热烧伤的临床疗效。方法:收集我院眼部化学及热烧伤24例28眼,行新鲜羊膜移植术治疗,随访6～24mo。术后观察视力,羊膜移植片情况,角膜恢复情况及角膜上皮修复时间,并发症。结果:术后视力提高者22眼(79%),不变者6眼(21%),无视力下降者,术前术后视力差别无统计学意义。羊膜移植片情况:28眼中羊膜覆盖成活24眼,成活率达86%。角膜恢复情况:28眼中角膜最终恢复透明8眼,角膜云翳12眼,角膜斑翳5眼,角膜白斑3眼。角膜上皮愈合时间:22眼角膜上皮1～3wk全部愈合。术前4眼睑球粘连患者,睑球粘连情况均得到改善,3眼完全分离。结论:新鲜羊膜移植术是治疗眼表化学及热烧伤的有效方法。     

生物羊膜覆盖联合角膜绷带镜治疗眼表化学性烧伤

目的：探讨生物羊膜覆盖联合角膜绷带镜治疗眼表化学性烧伤患者的临床效果及生物羊膜的稳定性。

方法：回顾性研究。选取2018-12/2021-08在我院治疗的眼表化学性烧伤患者49例49眼的临床资料,按照手术方式分为单纯羊膜覆盖组25眼和羊膜覆盖术后配戴角膜绷带镜组24眼。比较两组患者的羊膜脱落时间、术后疼痛评分、眼表修复率及修复时间、术后视力和并发症情况。

结果：单纯羊膜覆盖组和羊膜覆盖术后配戴角膜绷带镜组患者术后1d眼部疼痛评分为2.208±0.758和2.063±0.800分(P>0.05),术后3d为1.844±0.762和1.150±0.582分,术后7d为1.684±0.820和0.750±0.514分(均P<0.05)。羊膜覆盖术后配戴角膜绷带镜组羊膜脱落时间为10.75±2.63d,比单纯羊膜覆盖组(7.60±2.22d)更长(P<0.05),且角膜修复效果较单纯羊膜覆盖组更好。术后6mo,两组患者视力分别为0.30(0.10,0.55)和0.30(0.20,0.58)(P>0.05),两组患者并发症发生情况无差异(P>0.05)。

结论：生物羊膜覆盖可以有效地治疗眼表化学性烧伤,联合角膜绷带镜治疗可以延缓其脱落时间,提高角膜修复率,降低患者术后不适程度。     

羊膜移植联合亲水性软性角膜接触镜治疗早期眼烧伤

目的 观察羊膜移植联合亲水角膜接触镜治疗早期眼烧伤的临床疗效.方法 21例（21眼）早期眼烧伤患者,采用羊膜移植并佩戴亲水性软性角膜接触镜治疗,术后随访3月.结果 所有患眼术后症状均有不同程度缓解;20例眼表基本稳定,视力不同程度提高;2例角膜云翳;l例眼结膜表层重建,但发生角膜斑翳.无严重眼部并发症发生.结论 羊膜移植联合亲水性角膜接触镜治疗各种早期眼烧伤安全、有效,值得在临床上广泛推广使用.     

重度眼表碱烧伤早期羊膜移植治疗的研究

目的 探讨新鲜羊膜早期移植在重度眼表碱烧伤的治疗效果.方法 采用新鲜羊膜早期移植治疗重度眼表碱烧伤35例38眼.结果 术后所有患眼眼表迅速稳定,20眼角膜恢复透明,10眼形成角膜白斑,4眼全角膜浑浊,3个月后24眼脱盲,视力≥0.2者11眼.结论 重度眼表碱烧伤早期进行新鲜羊膜移植可促进角膜上皮修复、抑制角膜新生血管侵入,防止睑球粘连.     

羊膜移植治疗早期眼表碱性化学伤的临床观察

目的:探讨新鲜人羊膜移植术对中重度早期眼表碱烧伤的临床效果。方法:对32例41眼中重度早期眼表碱烧伤进行单层或多层羊膜移植术,联合局部给予典必殊眼液及眼膏点眼,术后随访6～18(平均12)mo。结果:Ⅱ～Ⅲ度眼表碱烧伤29眼,角膜上皮愈合良好。Ⅳ度烧伤12眼,6眼角膜上皮愈合良好,5眼发生持续性上皮糜烂,1眼角膜溶解穿孔,所有病例均无排斥反应及睑球粘连。结论:单纯羊膜移植术是Ⅱ～Ⅲ度早期眼表碱烧伤简单有效的治疗方法,但对Ⅳ度烧伤者疗效欠佳。     

羊膜移植治疗早期眼表碱性化学伤的临床观察

目的 探讨新鲜人羊膜移植术对中重度早期眼表碱烧伤的临床治疗效果。方法 对32例41眼中重度早期眼表碱烧伤进行单层或多层羊膜移植术，联合局部给予典必殊眼液及眼膏点眼，术后随访6～18个月，平均12个月。结果 Ⅱ度～Ⅲ度眼表碱烧伤29眼，角膜上皮愈合良好。Ⅳ度烧伤12眼，6眼角膜上皮愈合良好，5眼发生持续性上皮糜烂，1眼角膜溶解穿孔，所有病例均无排斥反应及睑球粘连。结论 单纯羊膜移植术是Ⅱ度～Ⅲ度早期眼表碱烧伤简单有效的治疗方法，但对Ⅳ度烧伤者疗效欠佳。     

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.