先天性瞳孔残膜2例

1临床资料病例1,男性,11岁。因2个月前体检时发现视力差,于1999年7月5日以“先天性瞳孔残膜”收入院。既往无特殊病史。父母非近亲婚配。全身体检无异常。专科检查:VOD5.1,VOS4.3,矫正视力不增加,双眼外眼无异常,右眼瞳孔10点、1点处有色素膜残留,呈网状,与晶状体前囊黏连,瞳孔     

瞳孔残膜的治疗

瞳孔残膜又称永存瞳孔膜，严重者影响视力。本文采用广东威达医疗器械公司生产的DI92型染料激光机治疗严重瞳孔残膜2例，4眼。效果良好，无并发症，现报告如下。病例报告：冽1；何XX，男，7岁。家长发现多个瞳孔7年。无家族史。全身及其它脏器检查无异常。视力：右眼0．4，左眼0．3o双眼指测眼压正常，外眼光光无异常。双眼虹膜纹理清晰，瞳孔直径4Inln，薄片状残膜位于瞳孔中央，并由多条色素条带与瞳孔相连，瞳孔光反射灵敏。散瞳后由瞳孔间隙见到晶状体透明。眼底无法窥见。例2：李x，男、ste。视物不清3年。无家族史。全身其它""-""'"…     

手术治疗膜状先天性瞳孔残膜

报告了６例１１眼膜状先天性瞳孔残膜的临床特征及手术方法。阐述了膜状瞳孔残膜的手术指征。并首先提出膜状先天性瞳孔残膜中的屈光不正是形成弱视的重要因素。     

先天性瞳孔残膜误诊为无瞳孔1例

患者，男，9岁。因双眼视力不好9年余于2004年8月11日入院。其父母代诉患儿自出生后视力不好，注意力差，曾到昆明等地就诊。近年来视力下降加重，于当日到本院就诊，以“双眼先天性瞳孔闭锁”住院。入院查体温37．5，心率84次／min，呼吸20次／min，体重22妇，一般情况可，神清，查体合作，心肺阴性，肝脾未及。眼科情况：右眼视力4．1，左眼视力指数／眼前，双眼球水平震颤，     

瞳孔成形术治疗双眼先天性瞳孔残膜一例

6岁女性,双眼视力差。双眼瞳孔区丝状及膜状虹膜残留,覆盖大部分瞳孔区及视轴,周边丝状膜与虹膜相连。诊断双眼先天性瞳孔残膜。行双眼瞳孔成形术,术后瞳孔圆,晶状体前囊可见少许虹膜色素沉着。(眼科,2022,31:452-453)     

双眼先天性膜状瞳孔残膜

0引言瞳孔残膜又称永存瞳孔膜,系胎儿期瞳孔膜的残留。在新生婴儿中常可观察到不同程度的瞳孔残膜,但随年龄增长,大部分婴儿眼内残膜逐渐消失。     

Nd：YAG激光切除术治疗影响视力的先天性瞳孔残膜

用Ｎｄ：ＹＡＧ激光节除影响视力的先天性瞳孔残膜８５例。残膜被成功地切除后，除１３眼仍有废用性弱视外，视力均有明显提高，其中矫正视力为０．８－０．９者占３５．０％，＞１．０者占６５．０％。弱视眼视力为０．１－０．２，经过０．５－１．０年的弱视训练治疗，视力均优于０．６。无明显并发症。     

瞳孔残膜的治疗

瞳孔残膜的治疗河北廊坊石油管道局医院眼科陈茜和最近作者遇到两例（４只眼）致密瞳孔残膜，严重影响视力，经手术治疗效果尚好，现报告如下。例１女９岁家长发现患儿视物障碍６年。于１９９３年７月２４日来我院。门诊行氟离子及ＹＡＧ激光治疗未成功，于１９９３年８月...     

双眼典型先天性瞳孔残膜1例

瞳孔残膜,与虹膜基质前层增殖不同,是一种先天性的发育异常,笔者临床发现1例,现报告如下。1　临床资料患者,男,15a,学生,自发现双眼“虹膜增生”后就诊,双眼1a前出现“近视”,配镜至今,不伴其它全身不适,查体裸眼视力OD:1.0,OS:0.8,矫正OS-0.50DS1.0,双外眼未见异常,角膜?..     

永存瞳孔膜激光切开术

目的 评价严重的永存瞳孔膜Nd∶YAG激光切开术的效果.方法 永存瞳孔膜26例（31眼）,表麻下置角膜接触镜,在裂隙灯显微镜引导下.Nd∶YAG激光准确聚焦于瞳孔缘处的瞳孔膜进行发射.单脉冲切开能量为0.4～0.8 mJ,每次治疗总量为5～10 mJ,平均（2±0.18）mJ.结果 永存瞳孔膜激光切开术1次切开者5眼,占16.13％;2～3次切开者12眼,占38.71％;4～5次切开者14眼,占45.16％.矫正视力;0.1 ～0.25者5眼,占16.13％;0.3～0.5者7眼,占22.58％;0.6～0.8者8眼,占25.81％;≥1.0者,11眼占35.48％.术后未发生晶状体浑浊、视网膜损伤或眼压持续增高等并发症.结论 Nd∶YAG激光切开术治疗严重的永存瞳孔膜可增进视力,不需要专门的手术设备,表面麻醉下就可在门诊施行手术,是一种简便、安全、有效的治疗方法.     

先天性蹼状永存瞳孔膜显微切除术

目的 探讨先天性大范围永存瞳孔膜的手术方法。方法 在显微镜下，作角膜缘3mm切口，用晶状体囊剪沿瞳孔残膜始部剪断，用囊镊夹住取出，晶状体前囊所剩的残膜用注吸针头吸出，切口不必缝合。结果 手术5例9眼，瞳孔残膜全部取出。无晶状体浑浊或前房积血等并发症发生，视力有不同程度增进，效果满意。结论 大范围的先天性瞳孔残膜应用显微手术治疗效果满意。     

Surgical treatment of hyperplastic persistent pupillary membrane]

Clinical findings of two patients with persisting pupillary membranes are described and therapy is discussed. The indication for excision of the pupillary membrane was constituted in one patient (age 6 weeks) by complete occlusion of the optic axis, in the second (age 4 months) by absence of any recordable fixation. In both cases the pupillary membrane could be separated from the anterior lens capsule without lens damage. No strabismus or lens opacification were detected postoperatively. Surgery was undertaken with the intention of avoiding primary lentectomy, since pupillary membranes can usually be separated easily from the anterior lens capsule with viscoelastic substances.     

永存瞳孔膜治疗方法的选择

目的：探讨不同形态的永存瞳孔膜的治疗方法。

方法：选取永存瞳孔膜患者36例67眼。对于单条丝状永存瞳孔膜激光切除。单条粗大、网状或栅栏状瞳孔膜,在散瞳下应用激光脉冲击断残膜两端,然后采用透明角膜切口,注吸取出。膜状瞳孔膜行透明角膜切口,注入黏弹剂于残膜与晶状体前表面之间使其游离,用显微囊膜剪自瞳孔膜与虹膜连接处根部分别剪断,用囊膜镊取出。

结果：共治疗67眼,平均随访时间3.8a。54眼瞳孔区透明,无残膜遗迹,瞳孔圆形居中,对光反应灵敏。晶状体前囊色素残留者8眼,瞳孔欠圆者5眼。术后33眼眼压不同程度升高,治疗前后均差1.04kPa(4mmHg),经降眼压治疗后恢复正常。无前房出血、误伤晶状体等其他并发症。

结论：对于单条丝状或条状不影响视功能的永存瞳孔膜,可采用激光治疗; 对于膜状或网状瞳孔膜,且影响患者的视功能发育者,手术是治疗该类瞳孔膜的有效方法。早期发现、早期治疗有利于患者获得有用视力,为部分弱视患者的视功能训练或合并眼底病患者的治疗提供有利条件。     

Double silicone intubation as treatment for persistent congenital nasolacrimal duct obstruction

PURPOSE: The great majority of children with nasolacrimal duct (NLD) obstruction are successfully treated with probing or conventional silicone tube intubation. A small percentage of patients fail to have their NLD obstruction resolved with these procedures and require dacryocystorhinostomy (DCR). This study was conducted to assess the effectiveness of double bicanalicular silicone intubation with placement of two loops of silicone tubing through the NLD for treatment of persistent NLD obstruction in children as an alternative to DCR. METHODS: Ten eyes of 9 patients with nasolacrimal duct obstruction who had failed conventional therapies and were to otherwise undergo DCR were instead treated with double bicanalicular silicone tube intubation. Resolution of preoperative symptoms and signs of NLD obstruction were assessed. RESULTS: At an average follow-up of 40 +/- 5.6 months, all patients had improvement in symptoms and signs. The mean patient age was 31 +/- 3.2 months. The average duration of intubation was 15 +/- 0.73 months. Eight of 10 eyes had complete resolution of NLD obstruction symptoms. Two of 10 treated eyes had occasional symptoms of mattering with upper respiratory infection and exposure to wind or cold but required no further treatment. Nine of 10 eyes were treated for congenital NLD obstruction. The remaining patient had failed conventional bicanalicular intubation after repair of a traumatic common canalicular avulsion. CONCLUSIONS: Double bicanalicular silicone tube intubation is an effective alternative to DCR in selected children who have failed conventional therapies for NLD obstruction. This treatment obviated DCR in all patients in this study.     

永存原始玻璃体增生症与先天性纤维血管瞳孔膜临床特征的比较

目的：分析永存原始玻璃体增生症(PHPV)和先天性纤维血管瞳孔膜(CFPM)的临床特征异同。

方法：回顾性分析2006-03/2021-12在空军军医大学西京医院眼科接受手术治疗的PHPV(PHPV组)和CFPM患儿(CFPM组)的眼部生物测量参数、临床表现、病变的形态学特点。

结果：纳入PHPV患儿56例61眼,CFPM患儿24例25眼; PHPV和CFPM的发病年龄相似、无性别差异,均以单眼患病为主,其占比分别为91%和96%。PHPV合并白内障患眼可有多种并发症和眼发育异常,CFPM主要为不同程度的瞳孔区堵塞及形态异常。PHPV组和CFPM组单眼患病患儿患眼前房深度(ACD)均小于对侧眼,手术年龄≤24月龄患儿患眼眼轴长度(AL)均小于对侧眼(P<0.05); PHPV组单眼患病患儿患眼角膜直径(CD)小于对侧眼、眼压高于对侧眼(均P<0.05); CFPM组单眼患病患儿患眼与对侧眼CD、IOP比较均无显著差异(P>0.05)。PHPV组患儿患眼ACD小于CFPM组患眼(P<0.05)。术中发现PHPV纤维血管膜组织位于晶状体后、玻璃体腔内,而CFPM纤维血管膜位于虹膜与晶状体前囊膜之间,很少累及晶状体。

结论：PHPV和CFPM有非常相似的临床特点,提示PHPV和CFPM可能是永存胚胎血管(PFV)的不同表现形式,但PHPV病变范围更广、病情更复杂。