粘弹剂在青光眼小梁切除术中的应用观察

目的观察在青光眼小梁切除术中使用粘弹剂的效果。方法将我院开展的40例(40只眼)青光眼小梁切除术中20只眼为试验组,另外20只眼为对照组,试验组在术中使用1%Healon,对照组不用,术后观察眼压、前房形成、功能性滤过泡形成等情况。结果试验组在术后浅前房的防治、术后眼压控制及远期功能滤过泡形成中、手术成功率方面优于对照组。结论在青光眼小梁切除术中使用粘弹剂能有效防止术后浅前房,有利于功能滤过泡的形成。     

前房注BSS和粘弹剂预防青光眼小梁切除术后浅前房比较

目的：探讨前房注BSS和粘弹剂预防青光眼小梁切除术后浅前房的临床效果。方法：观察组28例（31只眼）急性闭角型青光眼,在小梁切除手术结束时前房注BSS形成正常前房。对照组28例（34只眼）急性闭角型青光眼,在手术结束时前房注粘弹剂形成正常前房。结果：观察组术后浅前房3只眼,占9．7％;对照组术后浅前房3只眼,占8．8％。卡方检验,P＞0．05,两组无显著性差异。观察组术后无高眼压,对照组术后5只眼高眼压,卡方检验,P＜0．05,两组有显著性差异。结论：青光眼小梁切除结束时,前房注BSS和粘弹剂,均能预防术后浅前房发生,效果相近;但前房注BSS方法安全,不需特殊材料。     

激光虹膜光凝术联合粘弹剂在新生血管性青光眼治疗中的应用

目的:探讨532 nm激光行虹膜新生血管光凝术联合粘弹剂在小梁切除术中治疗新生血管性青光眼的作用.方法:对18例新生血管性青光眼先用532 nm激光封闭虹膜表面血管,1 wk后行小梁切除术,术中应用粘弹剂,观察降眼压效果,观察前房和滤过泡,随诊10 mo.结果:术中18例前房均无大量出血,术后滤泡均呈弥散隆起.眼压:第1 wk内1～5 mmHg.2～4 wk 2～10 mmHg,随诊期间眼压为6～12 mmHg.结论:采用532 nm激光直接封闭虹膜新生血管后再行小梁切除术,同时术中应用粘弹剂能避免发生前房大量出血,避免出血阻塞滤过口.提高了新生血管性青光眼手术治疗的成功率.为新生血管性青光眼治疗提供了一种经济有效的综合治疗方法.     

复合式与常规小梁切除术后浅前房的临床对比

目的 比较复合式小梁切除术及常规小梁切除术术后浅前房的发生情况.方法 青光眼124例(148眼)分为2组.复合式手术组(A组)62例(76眼)行复合式小梁切除术,即增加可拆除的调节缝线及术中应用丝裂霉素C及黏弹剂;对照组(B组)62例(72眼)行常规小梁切除术;观察两组术后前房形成的情况,并作统计学分析.结果 A组术后浅前房发生率为17.1﹪(13眼),B组为40.3﹪(29眼),两者差异有统计学意义(χ2=4,P=0.002).结论 复合式小梁切除术较传统的小梁切除术能较迅速恢复和维持术后前房深度,有效减少术后浅前房发生,提高手术成功率.     

青光眼小梁切除术后浅前房的原因和治疗效果分析

目的 分析青光眼术后浅前房发生的原因和治疗效果.方法 回顾性分析我院青光眼小梁切除术后浅前房146例157眼的原因及治疗效果.结果 2001年7月～2005年6月我院进行的青光眼小梁切除术643眼巾,发生术后浅前房157眼,发生率为24.42%.157眼术后浅前房的原因主要为滤过过强65眼(41.40%),结膜瓣渗漏53眼(33.76%),脉络膜脱离20眼(12.74%),睫状环阻塞性青光眼14眼(8.92%),其它原因5眼(3.18%).采用约物:睫状肌麻痹剂、高渗剂,皮质类同醇等和/或手术:结膜瓣或巩膜瓣修补术、玻璃体抽液 前房注气术等治疗,157眼浅前房中140眼(89.17%)经过药物治疗前房形成,17眼(10.83%)药物治疗无效通过手术治疗后形成前房.结论 157眼青光眼小梁切除术后浅前房发生的原因主要为房水引流过畅、结膜瓣渗漏、脉络膜脱离及睫状环阻塞性青光眼.89.17%的浅前房可以通过药物治疗形成前房,只有10.86%的浅前房需要手术治疗.     

消毒空气泡在青光眼小梁切除术中的应用

目的:探讨空气泡在青光眼小梁切除术中的应用效果。方法:对30眼青光眼小梁切除术患者术中前房注入消毒空气泡维持前房、术毕前利用消毒空气泡形成前房,观察术中前房深度、前房出血影响情况、术后浅前房的发生率,并与对照组相比较。结果:所有患者均能在前房不完全消失的情况下完成手术,前房出血不累及瞳孔区,术后浅前房发生率较低。结论:在青光眼小梁切除术中使用消毒空气泡的方法简便易行,降低了术中术后并发症的发生和危害,有效地提高了手术的安全性和成功率。     

粘弹剂在小梁切除术中的应用

目的 为控制小梁切除术后滤过强引发的低眼压及浅前房等并发症的方法。方法在小梁切除榱辅助应用粘弹剂。结果 发生率下降至１４％。结论此方法可有效地控制小梁切除术后早期超滤过、浅前房及相关并发症的发生。     

两种小梁切除术的临床效果分析

目的:单纯应用可调整缝线的小梁切除术与复合式小梁切除术的术后疗效及并发症的比较。方法:原发性开角型青光眼(POAG)或原发性闭角型青光眼(PACG)182例(226眼),其中实验组98例(130眼),对照组84例(96眼),实验组单纯应用可调整缝线的小梁切除术,对照组复合式小梁切除术(采用丝裂霉素C联合可调整缝线的小梁切除术),并对手术疗效,手术并发症进行对照分析。结果:两组术后眼压控制理想,但术后浅前房、低眼压、前房出血的发生率实验组明显低于对照组,差异具有统计学意义(P<0.05)。结论:复合式小梁切除术疗效确切,但术后浅前房、低眼压与前房出血的发生率较高,而单纯应用可调整缝线的小梁切除术不仅疗效确切,且术后浅前房、低眼压与前房出血的发生率明显降低。     

青光眼小梁切除术后浅前房的预防体会

青光眼小梁切除术后浅前房是最常见的术后近期并发症.作者自1999年1月以来,针对青光眼小梁切除术后浅前房的最主要原因,特别注意手术中的几个步骤及术后密切观察、处理,其青光眼小梁切除术后浅前房发生率较既往明显降低,无一例出现严重并发症,取得较满意效果,现报告如下.     

小梁切除术终前房重建疗效分析

目的　探讨青光眼小梁切除术终出现浅前房时重建前房的方法及疗效。方法　对 1 999年 4月～2 0 0 0年 1 2月住院的 1 2 0例 (1 51眼 )青光眼小梁切除术 ,术终前出现浅前房者 43例 (48眼 )随机分为前房重建组2 4例 (2 6眼 ) ,对照组 1 9例 (2 2眼 ) ,治疗组术终重建前房。分析两组术后效果。结果　治疗组术后浅前房发生率为 7 69% ;对照组则为 45 45 % ,浅前房程度按Spaeth分级法进行分级 ,重建组Ⅰ级 1眼 ,Ⅲ级 1眼形成恶性青光眼 ;对照组Ⅰ级 8眼 ,Ⅱ级 2眼 (P <0 0 0 5)。结论　青光眼小梁切除术终浅前房者进行重建前房 ,方法简单 ,可有效防止术后浅前房及低眼压的发生     

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.