5—氟尿嘧啶不同用药方式辅助青光眼滤过手术的实验研究

术后结膜下注射５－氟尿嘧啶能提高难治性青光眼滤过手术的成功率。为降低结角膜毒性，减少频繁用药，用随机盲法对照实验对５－Ｆｕ不同用药方式进行了比较研究。术中在滤过部位使用高浓度５－Ｆｕ比术后用药能提高手术成功率，临床上未见明显的眼毒副作用。光镜检查术中５－Ｆｕ用药组可见潜在的滤腔。电镜检查两组５－Ｆｕ用药组均可见减少变细、紊乱排列的胶原纤维。     

抗代谢药物与包裹性囊状滤过泡

为了探讨抗代谢药物对青光眼小梁切除术后包裹性囊状滤过泡形成的影响，本文分别对５０眼术中应用丝裂霉素Ｃ（ＭＭＣ）和４０眼术后结膜下注射５—氟尿嘧啶（５－Ｆｕ）的难治性青光眼进行分析。术后６个月，ＭＭＣ组手术成功率８６％；５－Ｆｕ组成功率８２．５％。包裹性囊状滤过泡的发生率，ＭＭＣ组１６％；５－Ｆｕ组１０％。结果表明，上述药物能明显减少滤过泡的瘢痕化，但不能减少包裹性囊状滤过泡的发生。男性、青少年性青光眼和以角膜缘为基底的结膜瓣发生率较高。     

5—氟尿嘧啶高分子缓释剂在兔眼滤过术后抗瘢痕形成的研究

目的研究５－氟尿嘧啶（５－ｆｌｕｏｒｏｕｒａｃｉｌ，５－Ｆｕ）缓释剂在兔眼滤过术后抗瘢痕形成的疗效及毒性。方法对２３只家兔双眼行巩膜后唇咬切术，术后次日第１组结膜下注射２．５％５－Ｆｕ缓释剂１０ｍｇ，第２组结膜下注射２．５％５－Ｆｕ注射液１０ｍｇ。术后第１周隔日用药１次，连续３次；第２周隔２日用药１次，连续３次。第３组用同法注射等体积的空白缓释剂。结果空白缓释剂组的滤过泡在术后７天内失败，５－Ｆｕ注射液组的滤过泡在术后２０～３０天失败，５－Ｆｕ缓释剂组的滤过泡持续至实验全程。术后７～３０天，５－Ｆｕ缓释剂组巩膜瘘道的阻塞率为６．７％，５－Ｆｕ注射液组为４１．７％，空白缓释剂组为１００．０％。５－Ｆｕ缓释剂组３只眼，５－Ｆｕ注射液组８只眼及空白缓释剂组２只眼出现角膜上皮缺损。结论本研究结果显示，５－Ｆｕ缓释剂可有效防止滤过泡瘢痕化及巩膜瘘道阻塞，提高兔眼滤过术的成功率，并降低５－Ｆｕ注射液的毒性，有临床应用价值。     

5—氟尿嘧啶多相脂质体对实验性青光眼滤过术瘢痕形成的影响

目的 为研究５－氟尿嘧啶（５－Ｆｌｕｏｒｏｕｒａｃｉｌ，５－Ｆｕ）多相脂质体和５－Ｆｕ预防滤过术瘢痕形成的作用。方法 对２０只新西兰长耳兔双眼行小梁切除术。术后将兔分为２组，每组１０只，每组按随机规定一眼为用药眼，对侧眼为对照眼。第１组：用药眼术后每日结膜下注射５－Ｆｕ（水针剂）０．２ｍｌ（５ｍｇ），对照眼结膜下注射等量生理盐水。第２组：用药眼术后每隔３日结膜下注射５－Ｆｕ多相脂质体０．２ｍｌ（５     

滤过手术联合干扰素治疗青光眼临床观察

为观察滤过手术联合ａ干扰素，治疗难治性青光眼的疗效，将３４例（４２只眼）难治性青光眼随机分为ａＩＦ治疗组２２只眼与５ＦＵ对照组２０只眼。治疗组术中、术后，采用ａＩＦ球内（玻璃体内）或结膜下注射，对照组术后采用５ＦＵ结膜下注射。术后随访５～１４个月。结果ａＩＦ治疗组手术成功率为８１８％（１８／２２）５ＦＵ对照组为８５％（１７／２０），Ｐ＞００５。功能性滤过泡眼数，ａＩＦ治疗组为１７／２２，５ＦＵ对照组为１６／２０。治疗组未见明显全身和局部副作用。结论：ａＩＦ能促进滤过泡的形成，提高青光眼滤过手术的成功率，效果同５ＦＵ。     

难治性青光眼滤过术中一次性应用MMC和5—Fu的疗效观察

近几年来国内外已开始应用ＭＭＣ和５Ｆｕ于抗青光眼滤过术中抗瘢痕形成，且二者均能提高手术成功率。为了进一步观察ＭＭＣ和５Ｆｕ对复杂难治性青光眼的临床疗效，我们分别采用术中一次应用ＭＭＣ和５Ｆｕ的方法对４０例（４８眼）难治性青光眼患者进行了临床观察...     

青光眼术后5－FU结膜下注射致后期全眼球炎

青光眼术后５－ＦＵ结膜下注射致后期全眼球炎合肥市第一人民医院眼科赵军民青光眼术后结膜下注射５氟尿嘧啶（简称５－ＦＵ）可以促进结膜滤过泡的形成，从而大大提高了手术成功率，但在后期会给眼组织带来哪些不利影响，国内还少有报导。笔者曾遇一例青光眼术后用５－Ｆ...     

滤过手术联合干扰素治疗难治性青光眼

青光眼滤过手术失败的关键原因是滤过道瘢痕化。一些难治性青光眼，如葡萄膜炎性青光眼、新生血管性青光眼等，术后特别易发生滤过道瘢痕化，常规手术成功率低。青光眼滤过手术联合ａ－干扰素（ａ－ｉｎｔｅｒｆｅｒｏｎ，ａ－ＩＦ）治疗难治性青光眼，经我们临床观察效果良好，现报告如下。１资料与方法１．１一般资料选择我院１９９３年１０月～１９９７年３月间住院的难治性青光眼患者３６例（４４眼），随机分为ａ－ＩＦ治疗组２３眼和５－ＦＵ对照组２１眼。男２０例（２６眼），女１６例（１８眼）。两组患者年龄分别为３７．２３±１…     

结膜下注射5-氟尿嘧啶防止青光眼滤过术后瘢痕形成

１９８４年Ｈｅｕｅｒ等首次将５－Ｆｕ应用于青光眼滤过手术后抗滤过泡瘢痕形成获得了成功。１９９１年以来,我院采用青光眼滤过术后结膜下注射５－Ｆｕ,对１０１例闭角型青光眼患者进行了临床观察,现报告如下。本组１０１例（１１４眼）中急性闭角型青光眼４３例（４...     

滤过手术联合干扰素治疗青光眼的临床观察

目的为观察滤过手术联合a-干扰素治疗难治性青光眼的疗效。方法将34例（42只眼）难治性青光眼随机分为a－IF治疗组22只眼与5－Fu对照20只眼。治疗组术中、术后，采用a－IF球内（玻璃体内）或结膜下注射，对照组术后采用5－Fu结膜下注射。术后随访5～14个月。结果a－IF治疗组手术成功率为81．8％（18/22），5－Fu对照组为85％（17/20）。P＞0．05。功能性滤过泡眼数，a－IF治疗组为17/22，5－Fu对照组为16/20，治疗组未见明显全身和局部副作用。结论a－IF能促进滤过泡的形成。提高青光眼读过手术的成功率，效果同5－FU。     

防盲治盲可行途径的探索

目的:通过实践探讨防盲治盲可行途径,为基层农村开展防盲治盲工作提供借鉴。方法:通过多种途径的尝试,如:在基层县市建立眼专科医院和眼科研究所;与公立医院资源整合建立合作体;以股份制的形式参与其他专科医院的建设和经营;收购经营不善眼科医院;利用眼科流动手术车的形式深入各乡镇开展防盲治盲等。结果:在新会区建立眼科医院及研究所,在此基础上,与广东多家基层医院眼科合作,不同程度地提升了当地的眼科诊疗水平,但因相关政策改变而解除合作关系;以股份制的形式将普宁市杨庆寿眼科诊所转变成医院;收购海南眼科医院后,对医院的技术和管理都有很大的提高,转亏为盈,培养了一批眼科骨干,为防盲治盲工作配备了硬件和软件;以"江可伯"眼科流动手术车的形式深入山区和基层农村开展防盲治盲。结论:加强与社会各机构团体的合作,整合利用各种防盲资源,利用眼科流动手术车进行规模化的复明手术,降低运营成本,通过"结构脱盲""项目脱盲"和"监管脱盲"三管齐下,走出一条农村眼科事业发展的新道路。     

Download shareware for simulation of Listing's Law for teaching purposes

Explaining Listing's Law to students or orthoptists is a time-consuming business. We have therefore developed shareware to demonstrate Listing's Law in a more direct way for teaching purposes. This realistic three-dimensional simulation helps to understand ocular motility. It shows that computer-aided simulations have advantages over printed media in explaining Listing's Law.     

Clinical prediction of the need for interventions for the control of myopia

The prevalence of myopia is increasing in Western populations but in East Asian countries, it is increasing to epidemic levels, where there are also markedly increased rates of progression to pathological myopia. Measures to more effectively control the development and progression of myopia are urgently needed. Notwithstanding a large volume of research, especially regarding the different mechanisms for the development of myopia and the efficacy of particular methods of intervention, there is still a great need and scope for improvements in clinical efforts to prevent and/or control myopic progression. Too often clinical efforts may involve only one method of intervention; however, the heterogenous nature of myopia suggests that clinical intervention may be more successful when interventions are employed in combination. The decision to prescribe interventions for the control of myopia in children, especially prior to onset, may be better framed by a comprehensive estimation of the degree of risk for the development and/or progression of myopia. For example, rather than ascribing equal weight to any degree of parental myopia, more accurate estimates may be obtained, if risk is judged to increase with the degree of parental myopia and the extent of any associated degenerative pathology. Risk estimates may be limited to broad mild, moderate and severe classifications due to lack of accurate weighting of risk factors. Nevertheless, comprehensive assessment of risk factors appears likely to better inform a prognosis and discussions with parents. Consideration of numerous environmental influences, for example, such as continuity and intensity of near work and time spent outdoors, may contribute to better risk estimation. Family‐based practice appears to be ideally suited for risk estimation and the clinical application of approaches to control myopia. A proactive approach to estimating risk of developing myopia prior to its onset may be beneficial. Earlier implementation of interventions to control myopia could significantly reduce the chance of progression to pathological myopia.     

Stereothresholds for moving line stimuli for a range of velocities

This study examined the influence of lateral target motion on the stereothresholds for bright vertical lines at a range of velocities. Stimuli were presented for 200 ms with horizontal velocities from 0 to 12 deg/s. Observers' horizontal eye movements were recorded on additional trials, and confirmed that the velocity of retinal image motion closely matched the velocity of the stimulus. In three auxiliary experiments, stereothresholds were measured (1) after equating the detectability of targets that moved at different velocities, (2) for moving and stationary stimuli with durations between 20 and 200 ms, and (3) for stationary stimuli presented at eccentricities of 0.6 and 1.2 deg. The results indicate that stereothresholds are unaffected by velocities up to approximately 2 deg/s, but worsen in proportion to the velocity at higher speeds. The results of our auxiliary experiments demonstrate that the increase in stereothresholds during image motion cannot be attributed primarily to a reduction in the detectability of the stimulus, a decrease in the effective exposure duration, or non-foveal viewing. We conclude that the elevation of stereo thresholds during lateral motion is consistent with a shift in the sensitivity of the visual system toward lower spatial frequencies as a result of motion blur.     

人工角膜植入术的临床研究

评价复杂性角膜混浊患者行人工角膜植入术的临床效果和并发症等。方法选择15例双眼盲目患者的单侧眼15只,术前视力均为光感,角膜混浊病变无法用常规角膜移植手术达到复明目的。其中严重碱烧伤6只眼,严重酸烧伤3只眼,铝水烧伤2只眼,爆炸伤1只眼,严重实质性眼干燥症1只眼,多次穿透性角膜移植失败角膜严重血管化2只眼。人工角膜(MICOF)由俄罗斯费德洛夫眼外科中心制造。手术分两期：一期手术将人工角膜支架植入角膜层问,选择病例行角膜表面或层问加固性手术。约3个月后行二期手术,植入带螺纹的人工角膜光学部。常规行晶状体、部分虹膜及前部玻璃体切除术,将外1／3上、下睑缘做永久性缝合。对完全睑球粘连者,用上、下睑皮肤覆盖角膜表面,仅暴露人工角膜光学部。结果二期术后观察4～26个月,平均9．5个月,除1只眼视力光感外,其余眼裸眼视力0．12～1．0。手术并发症包括分离角膜板层时穿入前房,晶状体皮质残留,柱镜前表面结膜上皮遮盖,柱镜前表面纤维增生组织遮盖,柱镜后壁沉着物,角膜溶解。结论人工角膜特别适合于穿透性角膜移植难于成功的双眼盲目者,而且是对目前严重角膜瘢痕血管化、严重眼睑或泪液功能不良患者有效的复明手段。该术式结合自体结膜遮盖、骨膜层问移植及睑裂部分缝合等,有利于人工角膜的长期存留。