白内障超声乳化吸出隧道巩膜瓣下小梁切除术

目的　探讨白内障超声乳化吸出人工晶状体植入联合隧道巩膜瓣下小梁切除术的效果及安全性。方法　对青光眼合并白内障 46例行超声乳化吸出人工晶状体植入联合隧道巩膜瓣下小梁切除术 ,术后观察眼压、视力、滤过泡等情况。结果　术后随访 3月～ 12月 ,平均眼压为 (14 3 7± 5 3 8)mmHg ,较术前降低 10 82mmHg(1mmHg =0 13 3kPa)。术后矫正视力≥ 0 5者 2 5眼 ,占 54 3 %。术后功能型滤过滤占 80 4% ,非功能滤过泡占 19 6%。结论　超声乳化白内障摘出人工晶状体植入联合隧道巩膜瓣下小梁切除术安全有效 ,视力恢复快 ,降压效果好 ,适用于青光眼合并白内障     

白内障超声乳化联合小梁切除手术疗效分析

目的　评价白内障超声乳化、小梁切除联合手术 3种不同术式的疗效。方法　以 3种不同的术式对 34例青光眼合并白内障患者行联合手术。A组 ,自巩膜隧道切口进行超声乳化 ,切口处做巩膜瓣 ,瓣下小梁切除。B组 ,隧道切口旁做巩膜瓣。C组 ,透明角膜隧道 ,其它部位行小梁切除。比较 3组术后眼压、视力、滤过泡通畅及并发症情况。结果　术后 3组眼压分别降低 (9 47± 2 44)mmHg、(1 0 2 5± 2 83)mmHg、(1 0 54± 3 0 9)mmHg较术前眼压差异具有显著性 (P <0 0 5)。3组间差异无显著性 (P >0 0 5)。结论　白内障超声乳化联合小梁切除手术 3种术式在控制眼压恢复视力方面作用基本相同 ,具有视力恢复快、控制眼压稳定及并发症少的效果     

超声乳化吸出与小梁切除双切口联合手术的临床观察

目的探讨晶状体超声乳化吸出人工晶状体植入与小梁切除双切口联合手术的临床效果。方法原发性开角型及闭角型青光眼合并白内障30例(35眼),行双切口联合手术,即分别做颞侧透明角膜的白内障切口及上方巩膜的小梁切除术的巩膜切口。分析手术前后的视力、眼压控制以及术后滤泡形成情况。结果术后矫正视力≥0.3者28眼(80.00%),比术前视力≥0.3的眼数(2眼)明显增多。术后平均眼压(13.35±2.03)mmHg。术后功能型滤过泡32眼(91.43%)。无严重并发症发生。结论超声乳化吸出人工晶状体植入与小梁切除双切口联合手术是一种安全、有效、便捷的治疗青光眼合并白内障的手术方式。     

青光眼合并白内障超声乳化人工晶状体植入联合小梁切除术的效果

目的探讨青光眼合并白内障行超声乳化吸出、人工晶状体植入联合小梁切除术的效果。方法青光眼合并白内障44例（47眼）,行超声乳化吸出及折叠式人工晶体植入联合全巩膜隧道内小梁切除术,术后观察眼压、视力、滤过情况等,随访1～36个月。结果47眼术后眼压均可控制在正常范围,长期随访眼压未升高,术后矫正视力：数指2眼（4．26％）,0．1～0．633眼（70．21％）,0．8-1．212眼（25．53％）,术后并发症主要是虹膜反应、角膜水肿及瞳孔散大。结论白内障行超声乳化及折叠式人工晶状体植入联合巩膜隧道内小梁切除术可有效控制眼压,提高视力。     

白内障超声乳化人工晶状体植入联合小梁切除术

目的评价白内障超声乳化摘出、折叠式人工晶状体植入联合隧道内小梁切除术(三联手术)治疗青光眼合并白内障的疗效.方法采用隧道式巩膜瓣切口对24例(28眼)青光眼合并白内障施行三联手术.结果术后随访末期,最终矫正视力为0.1～1.0,其中0.1～0.5者15眼(53.6%),0.6～0.8者10眼(35.7%),1.0者3眼(10.7%).术后眼压全部降至正常范围,平均眼压(14.3±6.5)mmHg(1mmHg=0.133kPa).术后有角膜水肿8眼(28.6%),浅前房2眼(7.1%),后发性白内障2眼(7.1%).结论白内障超声乳化吸出折叠人工晶状体植入联合隧道内小梁切除术治疗青光眼合并白内障是一种安全、有效的手术方法.     

晶状体超声乳化吸出人工晶状体植入联合隧道巩膜瓣下小梁切除术治疗青光眼合并白内障

目的 探讨晶状体超声乳化吸出人工晶状体植入联合隧道巩膜瓣下小梁切除术治疗青光眼合并白内障的效果及安全性.方法 对青光眼合并白内障52例(52眼)患者行超声乳化吸出人工晶状体植入联合隧道巩膜瓣下小梁切除术,术后随访3个月,观察眼压、视力、滤过泡及并发症情况.结果 术后3个月,平均眼压为(14.38±4.37)mmHg(1kPa=7.5mmHg),较术前平均下降10.75mmHg;矫正视力≥0.5者28眼;功能性滤过泡41眼,非功能性滤过泡11眼.术中2眼后囊膜破裂,术后早期11眼角膜水肿、5眼浅前房,术后晚期4眼发生后发性白内障.结论 超声乳化白内障吸出人工晶状体植入联合隧道巩膜瓣下小梁切除术安全有效,视力恢复快,降压效果好,适用于青光眼合并白内障.     

青光眼白内障超乳三联手术中两种切口方式的疗效分析

目的 分析白内障超声乳化加人工晶体植入联合小梁切除术中单切口术式和双切口术式对手术效果的影响.方法 28例（31眼）青光眼合并白内障病例分为A、B两组.A组（单切口组）：15例（17眼）,巩膜隧道切口行白内障超乳＋ IOL植入＋小梁切除术;B组（双切口组）：13例（14眼）,透明角膜切口行白内障超乳＋IOL植入,上方做传统小梁切除术.分析比较两组术后眼压、视力及并发症情况,随访3-6月.结果 术后随访3-6月,两组视力均有提高.眼压：A组术前平均眼压33.21 mmHg,术后16.24 mmHg;B组：术前平均眼压34.25mmHg,术后15.74 mmHg.术后眼压与术前相比,两组均有明显差异性;术后平均眼压两组之间无明显差异性.术后并发症无明显差异,功能性滤过泡数量两组之间无明显差异.结论 超乳青光眼白内障联合手术,单切口和双切口术式均有良好的降低眼压、提高视力的作用,是治疗闭角型青光眼合并白内障安全、有效的方法.     

青光眼术后白内障超声乳化吸出术的临床观察

目的　探讨抗青光眼滤过手术后白内障超声乳化吸出及人工晶状体植入术的手术技巧及效果。方法　对行小梁切除术后白内障患者 82眼 ,采用经颞侧透明角膜切口行超声乳化吸出及折叠式人工晶状体植入术 ,术后随访 1～ 6月 ,平均 3月。结果　术后随访所有患者视力均较术前有所提高 ,其中视力≥ 0 5者 68眼占 82 93 % ,术后平均眼压为 (14 2 2± 2 5 1)mmHg(1mmHg =0 13 3kPa)。滤过泡无瘢痕化改变。结论　把握手术时机和适应证 ,具备娴熟的晶状体超声乳化手术技巧 ,经颞侧透明角膜切口行超声乳化吸出联合人工晶状体植入术 ,在抗青光眼滤过手术后白内障的治疗上能取得良好的效果。     

抗青光眼滤过术后患者白内障超声乳化吸除及人工晶状体植入术

目的：探讨抗青光眼滤过术后白内障患者进行白内障超声乳化吸除及人工晶状体植入术的手术切口选择和临床效果。方法：32例（41只眼）青光眼滤过术后的白内障患者,采用上方透明角膜隧道切口和避开滤过泡的巩膜隧道切口行白内障超声乳化吸除,植入折叠式人工晶状体24只眼,硬性人工晶状体17只眼。结果：全部白内障术后病例视力有不同程度的提高,视力≥0．5者达75．6％。采用透明角膜隧道切口和巩膜隧道切口术后患者的眼压和滤过泡改变无差异性,术后随访平均5个月,平均眼压较术前增加1．59mmHg(1mmHg=0.133kPa),差异无显著性。结论：对抗青光眼滤过术后白内障患者,采用透明角膜和巩膜隧道切口行白内障超声乳化吸除及人工晶状体植入术,可提高视力,同时可保持原有的滤过功能。     

超声乳化术治疗闭角型青光眼合并白内障临床观察

目的 探讨白内障超声乳化折叠式人工晶状体植入术治疗闭角型青光眼的安全性和有效性。方法 38例(38眼)青光眼合并白内障患者，房角关闭小于1／2者单纯施行白内障超声乳化摘出及折叠式人工晶状体植入术，房角关闭大于1／2者施行角巩膜分开切口白内障超声乳化摘出及折叠式人工晶状体植入联合小梁切除术。结果 38例术后3个月眼压均控制在正常范围内，平均眼压为14．2mmHg，全部病例视力较术前提高，视力≥0．5者20眼(52．6％)．未发生严重并发症。结论 白内障超声乳化术在闭角型青光眼患者治疗中具有安全、视力恢复较好较快、降眼压效果确实、并发症少的优点。     

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.