改良式羟基磷灰石义眼座植入的临床观察

目的观察改良式羟基磷灰石义眼座植入的临床效果。方法21例眼内容摘除后行一期植入羟基磷灰石义眼座，巩膜花瓣样成形，义眼座植入巩膜壳内，前有双层巩膜壳包裹。结果术后所有病例随访6月～1年，术后上眶区饱满，与对侧眼相比无明显差异，切口一期愈合，义眼活动良好，矫正外形良好，未发现其他并发症。结论改良式羟基磷灰石义眼座植入术并发症少，疗效良好。     

改良式羟基磷灰石义眼座植入的临床观察

目的 观察改良式羟基磷灰石义眼座植入的临床效果。方法 26例眼内容剜除后患者一期植入羟基磷灰石义眼座．义眼座置于四条眼外肌之间肌锥内，前有双层巩膜壳包裹。结果 术后所有病例随诊6个月～2年，术后上眶区均饱满，与对侧眼相比外观无明显差异，切口一期愈合，义眼活动良好，矫正外形满意，未发现其他并发症。结论 改良式羟基磷灰义眼座植入术并发症少，疗效满意，是较为理想的眼眶美容术式。     

羟基磷灰石义眼座植入12例的临床体会

目的观察羟基磷灰石义眼座术后的临床疗效．方法行眼球内容物剜除术，剪断视神经，于4条直肌间剪开巩膜，一期植入羟基磷灰石义眼座于巩膜腔及肌锥内．结果随访6-24个月，12例均植入成功，无义眼座排斥，暴露，感染等并发症．获得满意的外观康复效果．结论羟基磷灰石义眼座是理想的眼眶内填充物，眼内容物剜除术后植入义眼座，明显改善术后眼窝塌陷畸形刑于义眼安装，无严重并发症，是一种眼眶美容术中的理想方法．     

改良式肌锥内羟基磷灰石义眼座植入术30例的临床观察

目的:观察改良式肌锥内羟基磷灰石义眼座植入术的临床效果。方法:眼内容物剜出术后,剪断外直肌和视神经,一期植入羟基磷灰石义眼座于肌锥内。结果:追踪观察6mo,所有义眼矫正的外形满意,活动度良好,无1例义眼暴露。结论:改良式肌锥内羟基磷灰石义眼座植入术并发症少,疗效满意,是一种理想的眼眶美容术。     

眼内容剜出肌锥内羟基磷灰石植入术的改进

羟基磷灰石义眼座植入术具有活动度佳，美容效果好的特点。以往都采用眼内容物剜出羟基磷灰石植入巩膜壳内术式。我院自2001年以来，采用在原术式的基础上作了改进，即术中仅断离外直肌及视神经后行眼内容物剜出，双层巩膜后肌锥内羟基磷灰石(HA)植入术，取得了较满意效果，现报道如下。     

不同术式羟基磷灰石义眼座植入的临床观察

目的观察不同术式的羟基磷灰石义眼座植入的效果及并发症。方法35例病例随机分为无包裹组19例和自体巩膜包裹组16例,通过不同手术方法植入羟基磷灰石义眼座。随访3m～18m。结果术后眼窝饱满度、义眼座活动度良好。主要并发症为结膜囊裂开,义眼座暴露,无包裹组暴露原因与全身营养不良有关,自体巩膜包裹组暴露原因与巩膜自溶有关。结论不同术式羟基磷灰石义眼座植入术后的并发症原因各不相同,提倡直接植入无包裹义眼座。     

巩膜瓣下肌锥内羟基磷灰石义眼座一期植入

目的观察巩膜瓣下肌锥内羟基磷灰石义眼座一期植入的临床效果。方法眼内容摘除50例,剪断视神经,剪开巩膜壳,制作巩膜瓣,植入羟基磷灰石义眼座于肌锥内,缝合巩膜瓣及结膜筋膜组织。结果追踪观察1年,观察眼外形,眼球运动,结膜愈合及义眼座位置。所有义眼矫正的外形美观,活动度良好,无结膜愈合不良或巩膜瓣暴露者。义眼座无移位、固定或感染。结论巩膜瓣下肌锥内羟基磷灰石义眼座一期植入术并发症少,眼球运动、眼部外观与健眼基本相同,可达到美容效果。     

自体巩膜包盖义眼座的临床观察

目的 探讨眼内容物剜除术自体巩膜包盖羟基磷灰石(HA)义眼座的临床效果.方法 对15例行眼内容物剜除术的患者同时剪断视神经、保留自体巩膜植入(HA)义眼座.结果 15例患者术后均I期愈合,义眼活动度及眼外观形态满意.结论 (HA)材料制作义眼座具有较好的生物相容性,排斥反应低,保留的自体巩膜使HA得以双层巩膜加固,提高手术成功率.     

羟基磷灰石义眼台植入89例

目的 观察羟基磷灰石眼座植入的临床效果。方法 75例羟基磷灰石义眼座Ⅰ期植入，14例Ⅱ期植入。随访3月一2年。结果89例眼睑及结膜均有不同程度水肿，1例羟基磷灰石义眼座暴露，不影响效果，没有处理。Ⅱ期植入2例出现下穹隆狭窄，经成形后恢复，89例义眼活动良好，配戴仿真义眼片后眼外观满意。结论 羟基磷灰石义眼座植入术式操作简单，美容效果佳。Ⅰ期较Ⅱ期植入义眼活动度及外观好，尽量行Ⅰ期植入。     

外伤后重度眼球萎缩羟基磷灰石义眼座植入术

目的 探讨外伤后重度眼球萎缩患者羟基磷灰石义眼座植入的一种新方法。方法 对12例自体巩膜腔仅能包裹义眼座l／4～l／2的重度眼球萎缩患者，采用沿自体巩膜缘交叉褥式缝合，形成网式捆绑义眼座植入肌锥内，自体巩膜呈帽状覆盖义眼座，眼外肌较常规位置靠前缝合。结果 12例中除l例先天性小眼球患儿结膜裂开5mm，2月自愈外，其余11例均无并发症，义眼安装满意。结论 “网式捆绑法”羟基磷灰石义眼座植入术解决了因患者重度眼球萎缩，自体巩膜无法牢固包裹义眼座，又无异体巩膜时的眼眶美容难题。     

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.