超声乳化白内障吸除联合折叠式人工晶状体植入治疗急性闭角型青光眼22例

目的:观察透明角膜切口超声乳化白内障吸除联合折叠式人工晶状体植入治疗急性闭角型青光眼的临床疗效。方法:回顾分析2001-12/2004-07我院眼科住院22例25眼急性闭角型青光眼并不同程度的晶状体混浊,其中11眼为原发性急性闭角型青光眼,14眼为继发性急性闭角型青光眼。患者入院后均行透明角膜切口超声乳化联合折叠式后房型人工晶状体植入手术。随访时间7～36(平均16.50±9.80)mo。结果:术后随访眼压为(10.55±5.08)mmHg(1mmHg=0.133kPa),比术前用药后的眼压(28.35±15.70)mmHg明显降低,差异有显著性(t=4.732,P<0.001)。中央前房深度由术前的(1.08±0.75)mm增加到术后的(2.37±0.48)mm,两者比较差异有显著性(t=6.632,P<0.001)。术后所有25眼最佳矫正视力均有提高。结论:透明角膜切口超声乳化白内障摘除联合折叠式人工晶状体植入,是治疗急性闭角型青光眼并白内障的一种有效的方法。     

超乳治疗慢性闭角型青光眼临床观察

目的观察透明角膜切口晶状体超声乳化吸出联合人工晶状体植入治疗慢性闭角型青光眼合并白内障的疗效。方法原发性慢性闭角型青光眼20例(22眼),视力<0.1,晶状体不同程度浑浊,行晶状体超声乳化吸出联合人工晶状体植入术。结果术前用药后眼压(28.63±13.27)mmHg,术后为(15.42±3.86)mmHg(t=4.243,P<0.05);术后房角不同程度开放。结论透明角膜切口晶状体超声乳化吸出联合人工晶状体植入术可有效地治疗因晶状体阻滞合并白内障的慢性闭角型青光眼。     

超声乳化白内障吸除人工晶状体植入术治疗原发性闭角型青光眼

目的探讨晶状体超声乳化吸除联合后房型人工晶状体植入术治疗白内障合并原发性闭角型青光眼的疗效。方法2002年2月～2004年3月本院收治白内障合并原发性闭角型青光眼34例（36只眼）。术前控制眼压,经视力检查、前房角镜和裂隙灯显微镜等检查后,均单独采用晶状体超声乳化吸除联合后房型人工晶状体植入术。术后随访1—12个月。结果32只眼视力较术前提高,视力〉0．5者占69．5％;33只眼术后眼压〈21mmHg（1mmHg=0．133kPa）,另3只眼用一种降眼压药物眼压控制在21mmHg以下;全部治疗眼前房加深,房角粘连范围减轻。结论超声乳化白内障吸除联合后房型人工晶状体植入术可有效地治疗合并白内障的原发性闭角型青光眼。     

透明角膜切口晶状体超声乳化治疗原发性闭角型青光眼合并白内障

目的评价透明角膜切口白内障晶状体超声乳化吸出后房人工晶状体植入术治疗原发性闭角型青光眼合并白内障的疗效。方法回顾性分析闭角型青光眼伴白内障14例(27眼)。单纯行透明角膜切口白内障晶状体超声乳化吸出联合后房型人工晶状体植入术,术后随访8~20个月。结果所有患者术中术后无严重并发症,术后视力较术前明显提高,术后平均眼压(12.64±3.37)mmHg与术前用药后平均眼压(16.72±4.26)mmHg相比差异有统计学意义(配对t检验,P<0.01),周边前房较术前明显加深,前房角均重新开放或部分开放增宽。结论单纯透明角膜切口白内障晶状体超声乳化吸出后房型折叠人工晶状体植入术,可有效治疗合并白内障的闭角型青光眼。     

晶状体超声乳化术治疗急性闭角型青光眼合并白内障的临床观察

目的 观察超声乳化白内障吸出术联合后房型人工晶状体植入术治疗急性闭角型青光眼合并白内障的临床疗效.方法 回顾性分析2003年1月至2007年5月收治的急性闭角型青光眼合并白内障患者21例(22只眼),行透明角膜切口晶状体超声乳化吸除联合后房型人工晶状体植入术.随访1个月至1年,对比术前、术后视力,观察术后角膜内皮细胞数量、前房深度、前房角宽度和眼压变化.结果 20只眼眼压控制正常,2只眼需滴降眼压药物,22只眼最佳矫正视力均有不同程度提高.结论 超声乳化术治疗急性闭角型青光眼合并白内障手术安全、疗效可靠.     

超声乳化白内障吸除术联合人工晶状体植入术治疗闭角型青光眼的临床观察

目的:观察超声乳化白内障吸除术联合后房型折叠式人工晶状体植入术治疗急性闭角型青光眼合并白内障患者的临床疗效。方法:42例(42眼)急性闭角型青光眼合并白内障患者入院后均行超声乳化白内障吸除术联合后房型折叠式人工晶状体植入术,术后随访3mo。结果:术后最佳校正视力,较术前显著提高(P<0.05);患者术后3mo眼压平均为(13.5±3.2)mmHg,较术前用药前后眼压相比均明显下降(P<0.05);前房角镜检查发现术后前房角均有增宽,房角关闭及周边虹膜前粘连范围减小;中央前房深度为(3.12±0.46)mm,手术前后相比,差异有统计学意义(P<0.05)。结论:超声乳化白内障吸除术联合后房型折叠式人工晶状体植入术可有效降低眼压、提高视力,为急性闭角型青光眼同时合并白内障患者安全有效的治疗途径之一。     

白内障超声乳化治疗闭角型青光眼的临床观察

目的评价白内障超声乳化吸出后房人工晶状体植入术治疗合并白内障的闭角型青光眼的疗效。方法回顾分析2003年4月至2004年11月收住院的闭角型青光眼25例(26眼),其中14眼为原发性急性闭角型青光眼,7眼为原发性慢性闭角型青光眼,5眼为继发性急性闭角型青光眼。均有不同程度的晶状体浑浊,行透明角膜切口超声乳化吸出后房硬性人工晶状体植入术。随访6月～1年(平均9.40月)。结果术后随访平均眼压(10.28±2.48)mmHg(1mmHg=0.133kPa),比术前用药后眼压(18.36±3.23)mmHg明显降低,差异有统计学意义(P<0.05),中央前房深度由术前的(1.56±0.45)mm,增加到术后的(2.23±0.34)mm,两者比较差异有统计学意义(P<0.05)。术后22眼(84.60%)最佳矫正视力有不同程度提高。结论透明角膜切口超声乳化白内障吸出联合后房型硬性人工晶状体植入术,可有效治疗合并白内障的闭角型青光眼。     

白内障超声乳化术治疗闭角型青光眼的临床体会

目的：观察白内障超声乳化联合后房型折叠式人工晶状体植入术治疗合并白内障的不同房角关闭状态的闭角型青光眼的疗效。方法：白内障超声乳化联合后房型折叠式人工晶状体植入术治疗闭角型青光眼48例64眼,术前及术后常规行视力、裂隙灯、Goldmann前房角镜检查、前房深度、眼压检查。结果：术后随访3～12mo,52眼视力较前有明显提高。59眼术后眼压〈21mmHg。64眼前房深度均加深,术前前房深度平均1.803mm,术后前房深度平均3.143mm。术前关闭的前房角有不同程度的开放,虹膜平坦,虹膜周边前粘连的范围明显缩小。64眼均未发生后囊膜破裂及角膜失代偿。结论：合并白内障的闭角型青光眼患者行超声乳化白内障吸除联合折叠式人工晶状体植入术,不但能够有效降低眼压、加深前房、开放房角,还可恢复视功能,并能减少小梁切除术的常见并发症,是治疗闭角型青光眼的一种安全有效的方法。     

晶状体超声乳化吸除及人工晶状体植入术对闭角型青光眼眼压及前房深度的影响

目的评价品状体超声乳化吸除及后房型折叠式人工晶状体植入术或联合小梁切除术，治疗合并有自内障的闭角型青光眼，观察其术后眼压、前房深度及视力等的变化。方法回顾分析27例（30只眼）闭角型青光眼合并白内障患者。经综合降眼压治疗3～4d，眼压低于25mmHg者21只眼，即行巩膜隧道切口晶状体超声乳化吸除及后房型折叠式人工晶状体植入术，眼压高于25mmHg者9只眼，即行巩膜隧道切口晶状体超声乳化吸除及后房型折叠式人工晶状体植入联合抗代谢药物及小梁切除术。随访3—6个月。结果所有患者术中、术后没有出现严重的并发症，术后视力均有提高，术后眼压都得到控制。平均眼压由术前的20．28mmHg降至11．07mmHg；中央前房深度由术前的2．14mm加深到3．43mm。术后眼压、中央前房深度与术前相比均有显著性差异。术后前房角开放均≥180°。结论晶状体超声乳化吸除及后房型折叠式人工晶状体植入术或联合小梁切除术，是治疗合并有白内障的闭角型青光眼的有效方法。     

晶状体超声乳化治疗闭角型青光眼

目的 探讨晶状体超声乳化白内障摘出治疗闭角型青光眼合并白内障的临床疗效.方法 本组临床观察对象为闭角型青光眼29例(37眼).均有不同程度的晶状体浑浊.行巩膜隧道切口晶状体超声乳化白内障摘出折叠式人工晶状体植入术.随访1-21个月(平均13.9月).结果 术后平均眼压(11.25±2.50)mmHg,比术前用药后平均眼压(19.50±10.26)mmHg明显降低,差异有统计学意义(P＜0.05),中央前房深度由术前的(1.47±0.32)mm增加到术后(2.35±0.34)mm,两者比较差异有统计学意义(P＜0.05).术后视力均有不同程度提高.结论 闭角型青光眼并白内障行晶状体超声乳化联合后房型折叠式人工晶状体植入术,在一定程度上可得到有效的治疗.     

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.