进行性睑皮肤松弛症伴泪腺脱垂的手术治疗

目的 探讨眼睑皮肤松弛合并泪腺脱垂症手术治疗效果.方法 采用切开法重睑成形术设计手术切口.按拟定的重睑高度嘶出第一条切口线,再于第一条重睑线处用平镊夹起松弛皮肤,以睫毛微翘无睑裂闭合不全为度,画出第二条切口线与第一条线相连,两线间的距离即为拟切除的皮肤量.术中去除部分松弛皮肤、部分眼轮匝肌及疝出之眶隔脂肪,同时将脱垂的泪腺一并固定于泪腺窝内.皮肤缝合同美容性重睑术.结果 9例患者术后眼睑重新塑造,泪腺复位,随访6～12个月,眼睑形态良好,泪腺脱垂无复发,外观显著改善.结论 经双重睑切口联合脱垂泪腺复位手术效果良好,实现患者美观与功能的双重恢复.     

眼睑皮肤松弛症及其伴发畸形的手术整复

目的 评价眼睑皮肤松弛症及其伴发畸形的手术整复效果.设计 回顾性病例系列.研究对象 35例(52眼)眼睑皮肤松弛症稳定期患者.方法 所有患者实施上睑畸形矫正术,做上睑重睑切口,切除多余松弛皮肤及眶脂肪,18例(36眼)联合行泪腺脱垂复位术;10例(16眼)联合上睑下垂矫正术.4例(6眼)行下睑缩矫正术.7例(14眼)行外眦畸形矫正术,联合或二期行眼睑皮肤松弛矫正或上睑下垂矫正术.主要指标 双眼重睑形态,眼睑位置,眼睑运动功能,泪腺的位置,有无泪液分泌异常.结果 随访6～60个月,所有患者双眼上睑重睑基本对称,双上睑形态良好,眦角位置接近正常,无溢泪及干眼症状.2例(3眼)患者于术后29及36个月复诊时发现泪腺脱垂复发,再次行泪腺脱垂复位术,术后分别随访18、24个月,未发现泪腺再脱垂.结论 采用眼部整复手术矫正眼睑皮肤松弛症及伴发畸形安全有效,术后复发率较低.     

眼睑松弛症的手术治疗分析

目的:探讨眼睑松弛症的手术治疗方法及效果。方法:对15例26眼眼睑松弛症患者均在停止发作并静止6mo以上手术。对于上睑皮肤松弛、上睑下垂、泪腺脱垂和睑裂横径缩短均采用重睑切口,上睑下垂视提上睑肌腱膜有无断裂采取提上睑肌腱膜修复或折叠术。泪腺脱垂全层缝合泪腺组织固定于眶泪腺窝处的骨膜上。睑裂横径缩短将外眦韧带缝合固定于外侧眶缘骨膜,下睑内翻做平行于睑缘的皮肤切口,去除多余皮肤及部分眼轮匝肌。结果:15例患者皮肤松弛得到明显改善,其中上睑下垂、睑裂横径缩短和下睑内翻,也均得到满意矫正,泪腺脱垂1例明显改善,余复位良好。随访6mo～2a,无复发。结论:手术治疗安全,效果确切。     

眼睑松弛症伴泪腺脱垂的手术治疗

目的探讨眼睑松弛症伴泪腺脱垂的手术矫正方法及效果，方法按照切开法重睑成形术设计手术切口，将脱垂的泪腺复位于眶外上方的泪腺窝内，然后去除上睑松弛的皮肤及疝出的脂肪，形成弧度自然、流畅的重睑。结果28例（56眼）上睑皮肤松弛得到充分矫正，恢复皮肤弹性，3例（4眼）术后6个月时在颞上方触到泪腺，目前仍处于观察中。结论治疗眼睑松弛症的重点是通过手术将汨腺复位下泪腺窝内，可达到美容与功能治疗的目的，手术效果稳定易于掌握。     

上睑成形术治疗青年睑皮肤松弛症

目的:观察上睑成形术治疗青年睑皮肤松弛症的临床效果.方法:青年睑皮肤松弛症患者15例,均为双眼,女性,年龄17～28岁,5例合并泪腺脱垂,无其他异常;均行上睑成形术,术中切除多余的皮肤和眶脂,3例病例复位脱垂的泪腺.结果:随访1 wk至2 a,所有病例外观均较术前有明显改善.1例泪腺脱垂患者在术后1.5 a时发现泪腺脱垂稍微加重,该患者术中未予泪腺复位术,但其上睑重睑的形态保持完好.所有患者均无出血、感染、重睑形态差等并发症.结论:上睑成形术治疗青年睑皮肤松弛症可获得满意的美容效果.     

上睑成形术治疗泪腺脱垂并眼睑松弛症

目的 探讨泪腺脱垂并眼睑松弛症的手术矫正方法及效果。方法 28例（56眼），年龄17－43岁。采用上睑成形术治疗泪腺脱垂并眼睑松弛症：距睑缘6－8mm画出满意弧度的重睑线，切除多余皮肤，切除眶隔处脱出的眶脂肪，通过眶隔缩短加固使脱垂泪腺复于原位。结果 56眼术后均泪腺复位，重睑线美观，睑松弛症消失，随访6月至3年无复发。结论 此法操作简单，疗效满意。     

泪腺脱垂复位并重睑成形治疗泪腺脱垂

目的 探讨泪腺脱垂复位并重睑成形治疗泪腺脱垂的临床效果.方法 对18例(36眼)泪腺脱垂按照重睑成形术设计手术切口,根据上睑皮肤松弛和眼睑饱满程度决定皮肤及脂肪的去除量,用4-0线褥式缝合泪腺前缘及泪腺筋膜将脱垂的眶部或睑部泪腺分别固定于眶上缘内及眶外侧壁的骨膜上,并将切开的眶隔拉紧加固间断缝合,上睑皮肤以重睑成形方式缝合,外侧皮肤间断缝合.术后随访6个月～3年.结果 17例34眼(94.44％)术后泪腺复位良好,无复发.1例2眼(5.56％)在术后2年轻度复发,但症状较术前明显改善.18例36眼全部双眼睑裂对称,重睑形态良好自然.结论 泪腺脱垂复位、眶隔加固并重睑成形术治疗泪腺脱垂效果良好,实现了功能治愈与美容效果的双重目的.     

睑松弛症的手术治疗

目的：探讨睑松弛症的发病机理和手术治疗方法。方法：对30例睑松弛症患者采用手术方法分别治疗上睑皮肤松弛、泪腺脱垂、上睑下垂和睑裂横径缩短，取上睑组织作组织学检查。结果：随访6月～5年，30例患者的上睑皮肤松弛均得到明显改善，3例4眼残留部分泪腺脱垂，上睑下垂和睑裂横径缩短均得到满意矫正。组织学检查显示病变区皮下灶性淋巴细胞浸润，弹力纤维断裂崩解。结论：睑松弛症的发生与慢性炎症有关，手术治疗可有效改善症状。     

不同病因所致泪腺脱垂的治疗方法

目的:探讨不同病因所致泪腺脱垂的治疗方法.方法:根据病因将病例分为外伤型,眼睑松弛型,眼睑皮肤松弛型3种类型.泪腺脱垂患者共54例(88眼),除部分外伤性泪腺脱垂可采用手法复位外,其余病例分别采用泪腺复位术或切除术,并于术前术后进行泪液分泌试验及泪膜破裂时间的测定.结果:在3组病例中无论手术或手法复位泪腺均保持了泪液分泌功能及泪膜功能,而手术切除泪腺患者出现了眼球干涩,异物感明显等症状.结论:对不同病因所致泪腺脱垂应采取积极的手法及手术复位治疗,不仅保证泪腺功能的完整,防止干眼症的发生,同时也使患者外观得到改善.     

泪腺脱垂及眼睑松弛症与双重睑一次成形术

本文报告了52例泪腺脱垂并眼睑松弛症与双重睑一次成形术，均经手术证实，其好发于青年女性。临床特征，上睑皮肤松弛，肿胀，颞侧下垂。以手术治疗为主。     

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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Current Thoughts on the Aetiology of Ocular Changes during Contact Lens Wear

ABSTRACT: Contact lenses are known to produce changes to the ocular tissues, and this review attempts to give a comprehensive assemblage of the knowledge on the aetiology of such changes. To achieve this result, the changes are categorized by structure and function, and discussed according to the temporal nature of occurrence where appropriate. Although assessment of the importance of a particular tissue change is difficult, this overview enables some degree of judgement to be made on the aetiology of the major side-effects of contact lens wear. This gives a basis on which to modify aspects of contact lens wear to ultimately increase the success rate.     

The detection of motion in chromatic stimuli: first-order and second-order spatial structure

This study provides evidence for the existence of a low-level chromatic motion mechanism and further elucidates the conditions under which its operation becomes measurable in an experimental stimulus. Observers discriminated the direction of motion of amplitude modulated (AM) gratings that were defined by luminance or chromatic variation and masked with spatiotemporally broadband luminance or chromatic noise. The size and retinal location of the stimuli were varied and the effects of broadband noise and grating masks were both compared with the cohort of stimuli. Some significant disparities in the published literature were well explained by the results. In conclusion, evidence for a chromatically sensitive motion mechanism that evades the, detrimental effects of a luminance mask was found only at the fovea and only when the stimulus was small and centrally placed.