巩膜扣带术联合氪多波长激光治疗单纯孔源性视网膜脱离

目的：探讨巩膜扣带术联合氪多波长激光治疗单纯孔源性视网膜脱离的疗效、适应证及其临床意义。方法：巩膜扣带术治疗47例（47只眼）单纯孔源性网脱，术中不用冷凝而待术后视网膜下液吸收后用氪多波长激光封闭裂孔，观察其疗效，对结果进行评价。结果：术后随访2-30个月，47例中视网膜完全复位的45例（95.74%），术后矫正视力≥0.05者41例（87.23%），最佳矫正视力为1.0。结果：巩膜扣带术联合氪多波长激光治疗单纯孔源性视网膜脱离，术中不用冷凝，简化了手术操作，无冷凝的相关并发症，术后采用氪多波长激光封闭裂孔，可以根据裂孔的部位及屈光介质混浊的程度选用不同波长的激光进行封孔，是治疗单纯孔源性网脱的有效方法之一。     

巩膜扣带术联合氪多波长激光光凝治疗视网膜脱离

目的 评价巩膜扣带术后限期应用双目间接眼底镜激光光凝封闭裂孔治疗视网膜脱离的疗效。方法 回顾性分析在我院行巩膜扣带术后接受氪激光光凝治疗的孔源性视网膜脱离患者39例(39只眼)的临床资料。结果 术后随访3～6个月，39只眼中，视网膜一次性复位36只眼(92．3％)。结论 巩膜扣带术后限期经光导双目间接眼底镜激光光凝治疗孔源性视网膜脱离，简便快捷、安全可靠，减少了术后并发症，是治疗孔源性视网膜脱离的有效方法之一。应用宽环扎，能更好的缓解玻璃体牵引；采用光导间接眼底镜进行光凝，可以减轻患者不适、对创口无污染、不压迫眼球。     

氪多波长激光治疗和预防视网膜脱离临床分析

目的 分析氪多波长激光治疗和预防视网膜脱离的效果。方法 用氪多波长激光治疗和预防视网膜脱离患者188例（193眼）。结果 视网膜周边干性裂孔和视网膜周边变性单纯用氪多波长激光治疗15眼，成功100％；局限性孔源性视网膜浅脱离10眼，先使用脱水剂、卧床休息、单眼加压包扎等措施，而后行激光治疗，成功率80％，2眼因玻璃体有牵引结合局部垫压术后成功；巩膜外扣带术后激光封孔141眼，成功率96．5％。5眼因玻璃体有牵引行玻璃体手术后眼内激光封闭裂孔成功；复杂性视网膜脱离经玻璃体切割手术，术中及术后激光封闭裂孔27眼，成功100％。结论 氪多波长激光治疗和预防视网膜脱离成功率高，创伤小，对于周边视网膜干性裂孔和变性激光治疗可以预防视网膜脱离的发生。激光可根据病情在术中术后选择，作为常规视网膜脱离手术和玻璃体手术的补充治疗。     

巩膜扣带术治疗孔源性视网膜脱离

目的 观察巩膜扣带术治疗孔源性视网膜脱离的疗效。方法 160例（168眼）行巩膜扣带术，术中均在双目间接检眼镜直视下定位裂孔、冷凝封闭裂孔。术后随访，观察视网膜复位情况。结果 本组病例初次手术视网膜解剖复位率94．0％。二次巩膜扣带术后视网膜解剖复位率为97．6％。结论 巩膜扣带术是治疗孔源性视网膜脱离的有效方法。合理联合视网膜下液引流、玻璃体气体填充及眼底激光光凝可提高手术成功率。     

视网膜脱离巩膜扣带术后激光光凝封闭裂孔

目的 评价巩膜扣带术后激光光凝封闭裂孔治疗视网膜脱离的效果.方法 回顾性分析2003年1月至2005年5月我科在巩膜扣带术后采用532nm激光经瞳孔光凝封闭裂孔治疗的原发性（孔源性）视网膜脱离35例（35眼）的临床资料,术后随访3～6月.结果 经一次治疗视网膜复位者33眼（94.29%）.结论 巩膜扣带术后激光光凝裂孔治疗原发性（孔源性）视网膜脱离,安全可靠,术后并发症少,是治疗视网膜脱离的一种有效方法.     

光凝和冷凝治疗孔源性视网膜脱离的临床研究

目的：分析二极管激光光凝和冷凝在巩膜扣带术中治疗视网膜脱离的临床应用。方法：回顾分析1998年1月－1998年12月我科在巩膜扣带术中利用二级管激光封闭视网膜裂孔的光凝组30眼与冷凝封闭裂孔的冷凝组37眼的孔源性视网膜脱离患者的临床效果。结果：光凝组一次复位率100％。冷凝组一次复位率97．3％。术后视力改善光凝组25眼（83．83％）,凝凝组26眼（70．27％）。冷凝组术后出现5例黄斑部视网膜前膜。结论：二极管激光在巩膜扣带术中,治疗孔源性视网膜脱离和冷冻一样简单、有效。     

简易气囊扣带术治疗孔源性视网膜脱离

目的 介绍一种治疗视网膜脱离的简易气囊扣带术.方法 选择5例患者实施气囊扣带术.气囊经球结膜切口插入视网膜裂孔相应部位的球结膜下.扩张气囊,产生顶压效果,促使视网膜下液吸收.术后1～2d在视网膜裂孔周围行眼底激光光凝封闭裂孔.5～7d后取出气囊导管.结果 4例患者一次手术成功,1例因新发生的视网膜裂孔再次脱离,施行传统的巩膜扣带术成功复位.所有病例随访一年以上未发生视网膜的再次脱离.结论 对于特定的孔源性视网膜脱离,气囊扣带术相对于传统的巩膜扣带术而言是简易有效地治疗手段,值得尝试推广.     

手术显微镜下巩膜外加压术治疗单纯孔源性视网膜脱离

也源性视网膜脱离是常见致盲眼病，治疗原则是封闭裂孔。巩膜扣带术作为常规视网膜脱离的手术方式，对于大多数早期的裂孔源性视网膜脱离有较高的手术成功率。随着显微手术的不断发展，为达到最小的手术量引、最少的手术操作及最佳的手术效果，手术显微镜下巩膜扣带术逐渐发展起来，在手术显微镜下进行手术操作，更加直观、精细与微创，我院在2009年6月至2010年6月在手术显微镜下巩膜外加压术治疗单纯孔源性视网膜脱离，效果良好，现报告如下。     

巩膜扣带术治疗陈旧性孔源性视网膜脱离

目的:观察巩膜扣带术治疗陈旧性孔源性视网膜脱离的疗效。方法:陈旧性孔源性视网膜脱离患者12例12眼,术前均在裂隙灯下用三面镜进行裂孔定位,术中均在显微镜下行巩膜扣带术,按术前裂孔的定位预置巩膜缝线,放出黏稠视网膜下液,冷凝封闭裂孔,预置缝线下植入硅胶,根据病情,部分患者植入环扎带,结扎缝线固定。术后随访,观察视网膜复位情况。结果:本组病例初次手术视网膜解剖复位率100%。结论:巩膜扣带术对于部分陈旧性孔源性视网膜脱离可以取得较好的效果。     

光凝和冷凝封闭裂孔治疗原发性视网膜脱离的临床观察

目的评价激光光凝和冷凝封闭裂孔治疗原发性(孔源性)视网膜脱离的临床效果。方法回顾性分析2001年1月至2005年10月我科在巩膜扣带术后采用532nm激光经瞳孔光凝封闭裂孔的光凝组38例(38只眼)和冷凝封闭裂孔的冷凝组40例(40只眼)的原发性视网膜脱离的临床资料,随访6~12个月。结果出院时光凝组和冷凝组视网膜复位率无明显差异(P>0.05);随访期光凝组视网膜复位率、视力改善情况、PVR逆转率明显优于冷凝组(P<0.01)。结论巩膜扣带术后激光光凝封闭裂孔可减轻视网膜色素上皮的释放和血-视网膜屏障的破坏,逆转PVR的进程,减少术后复发率,是治疗原发性视网膜脱离的一种有效方法。     

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.