前列腺素类药物治疗青光眼的临床评估

前列腺素(PG)类药物,尤其是前列腺素F2α(PGF2α)是目前认为最具潜力和最有效的局用抗青光眼药物,其降眼压(IOP)作用主要通过提高葡萄膜-巩膜途径而非经典的小梁网途径的房水引流来实现,同时其具有良好的夜间降IOP作用,能减少IOP的昼夜波动,减轻IOP波动对视野和视神经的损害。本文就其代表药物的特点加以综述,以期为临床应用提供参考。     

青光眼治疗药物评价

在现有降眼压(IOP)药物中,单一药物治疗青光眼,只有25%～50%的病例IOP可达标.对于IOP不能达标者目前的选择有:换药、加药、激光或手术治疗.本文从降IOP药物的选择、联用及用药原则,以及其他视神经保护药、细胞骨架干扰剂等辅助药物治疗青光眼作一评价.     

青光眼治疗药物的研究进展

青光眼造成的失明通常是不可逆的,眼压升高被认为是青光眼的最重要危险因素。降眼压治疗可以延缓青光眼的发生和进展,是目前临床治疗青光眼的主要策略。视神经保护可能是青光眼治疗的新方向。从传统降眼压药物、新型降眼压药物、视神经保护药物3个方面对青光眼治疗药物进行综述和探讨。     

青光眼的药物治疗

早期治疗青光眼的药物是由局部的β受体（β－R）阻滞剂、肾上腺素能药、缩瞳药和口服碳酸酐酶抑制剂（CAIs)组成。近期治疗青光眼的药物又增加有：降低眼内压（IOP）药（如前列腺素）、局部应用的CAIs和α2－肾上腺素能促进剂。β－R阻滞剂仍为治疗青光眼的一线药物。但β－R阻滞剂进行单一药物治疗时对降低IOP无效，且有不良反应。建议选用前列腺素，局部的CAIs和α2－肾上腺素能促进剂。     

高尿酸血症药物治疗进展

高尿酸血症(HUA)是一种以血尿酸水平升高为主要表现的代谢性疾病,长期高尿酸血症会导致尿酸盐沉积于关节、肾脏而出现痛风、肾脏损害等。药物降尿酸是目前主要的治疗方法。本文介绍了依照发病机制降尿酸药物的4个类别,分别为抑制尿酸生成、促进尿酸排泄、同时抑制尿酸生成促进排泄及促进尿酸溶解药物,并对传统及新型降尿酸药物进行了比较及探讨,以期为该类药物的进一步研发提供参考。     

比马前列素滴眼液的药理和临床应用

比马前列素是合成的前列酰胺F2α衍生物，通过增加小梁网通道和葡萄膜巩膜通道的房水流出而降低眼内压（IOP），被认为是目前降眼压作用最强的局部抗青光眼药物。主要用于开角型青光眼（POAG）或高眼压症（OHT）的患者，全身不良反应较少。现主要综述该药的药理作用、药动学及临床应用。     

青光眼治疗药多唑胺盐酸盐:一种具有局部活性的碳酸酐酶抑制剂

据估计到2000年世界上将有0．668亿青光眼病人，多数为原发性开角型。青光眼病的危险因素包括年龄、种族、高限内压（IOP）、全身性高血压、糖尿病、严重的远视和家族史，其中主要的是年龄和高IOP。目前临床应用的所有治疗药物都是降低眼内压的。早期认为IOP升高和青光眼是同义语，但现在发现约1／6病人IOP正常（＜2．93hP旬。IOP正常的青光眼病人有出现血管痉挛的倾向，如头痛、偏头痛、手脚冰凉较常见，血管功能异常可影响视神经乳头，因此青光眼病人眼内血流量是引起人们极大观注的课题。碳酸吁酶（CA）在房水分泌过程中起重要作…     

复合式小梁切除术治疗原发性青光眼的疗效观察

目的 探讨复合式小梁切除术(trabeculectomy)在治疗原发性青光眼(primary glaucoma,PG)中的临床效果.方法 将188例(208眼)已确诊的原发性闭角型青光眼(primary ange-closureglaucoma,PACG)及开角型青光眼(rimary open angle glaucoma,POAG)分为两组.对照组85例(95眼)采用常规小梁切除术治疗,观察组103例(113眼)采用复合式小梁切除术治疗.比较两组的临床效果.结果 观察组术后24周浅前房发生率、眼压控制率、功能性滤过泡及手术成功率与对照组比较,差异均有统计学意义(P＜0.05).结论 复合式小梁切除术治疗原发性青光眼,具有术中创伤小、降眼压作用明显、并发症少、安全性高等优点,前房和功能性滤过泡形成理想,眼压控制好,视力满意,有效提高了患者的生活质量.     

小梁切除术联合玻璃体内注射Bevacizumab治疗新生血管性青光眼的临床研究

<正>新生血管性青光眼(neovascular glaucoma,NVG)常由广泛累及眼后节的缺氧或局部性眼前节缺氧引起,以视网膜中央静脉阻塞、分支静脉阻塞或增生性糖尿病视网膜病变引起为多见,是一种较难治疗的致盲性血管疾病相关性青光眼,用一般抗青光眼药物和手术治疗效果欠佳。在近年来较多的研究证实,玻璃体内注射Bevacizumab对消退虹膜新生血管     

干燥羊膜移植联合复合式小梁切除术治疗难治性青光眼临床观察

Objective To explore the effect and security of dry amniotic membrane transplantation com-bined with trabeculectomy on refractory glaucoma. Methods Dry amniotic membrane transplantation combined with trabeculectomy was performed on 32 cases (39 eyes) with refractory glaucoma. All the patients were followed-up for 6-24 months. The acuity of visual, filtering bleb, anterior chamber depth, IOP and the complications of operation were studied. Results The IOP was descended 59.9 % (P<0.001) from (41.3±5.1)mmHg pre-operation to(17.2±5.3) mmHg post-operation. The total success rate was 93.4 %. After operation, 34 eyes (87.2 %) were kept functional filtering bleb. 27 eyes (69.2 %) had improved visual acuity. The complications included shallow anterior chamber (5 eyes) and early postoperative hypotony (9 eyes). Conclusions Amniotie membrane transplantation combined with trabeculectomy for refractory glaucoma can effectively inhibit the sear formation, decrease the IOP and increase the success rate considerably. The method is safe and effective in the treatment of refractory glaucoma.     

干燥羊膜移植联合复合式小梁切除术治疗难治性青光眼临床观察

Objective To explore the effect and security of dry amniotic membrane transplantation com-bined with trabeculectomy on refractory glaucoma. Methods Dry amniotic membrane transplantation combined with trabeculectomy was performed on 32 cases (39 eyes) with refractory glaucoma. All the patients were followed-up for 6-24 months. The acuity of visual, filtering bleb, anterior chamber depth, IOP and the complications of operation were studied. Results The IOP was descended 59.9 % (P<0.001) from (41.3±5.1)mmHg pre-operation to(17.2±5.3) mmHg post-operation. The total success rate was 93.4 %. After operation, 34 eyes (87.2 %) were kept functional filtering bleb. 27 eyes (69.2 %) had improved visual acuity. The complications included shallow anterior chamber (5 eyes) and early postoperative hypotony (9 eyes). Conclusions Amniotie membrane transplantation combined with trabeculectomy for refractory glaucoma can effectively inhibit the sear formation, decrease the IOP and increase the success rate considerably. The method is safe and effective in the treatment of refractory glaucoma.     

干燥羊膜移植联合复合式小梁切除术治疗难治性青光眼临床观察

Objective To explore the effect and security of dry amniotic membrane transplantation com-bined with trabeculectomy on refractory glaucoma. Methods Dry amniotic membrane transplantation combined with trabeculectomy was performed on 32 cases (39 eyes) with refractory glaucoma. All the patients were followed-up for 6-24 months. The acuity of visual, filtering bleb, anterior chamber depth, IOP and the complications of operation were studied. Results The IOP was descended 59.9 % (P<0.001) from (41.3±5.1)mmHg pre-operation to(17.2±5.3) mmHg post-operation. The total success rate was 93.4 %. After operation, 34 eyes (87.2 %) were kept functional filtering bleb. 27 eyes (69.2 %) had improved visual acuity. The complications included shallow anterior chamber (5 eyes) and early postoperative hypotony (9 eyes). Conclusions Amniotie membrane transplantation combined with trabeculectomy for refractory glaucoma can effectively inhibit the sear formation, decrease the IOP and increase the success rate considerably. The method is safe and effective in the treatment of refractory glaucoma.     

干燥羊膜移植联合复合式小梁切除术治疗难治性青光眼临床观察

Objective To explore the effect and security of dry amniotic membrane transplantation com-bined with trabeculectomy on refractory glaucoma. Methods Dry amniotic membrane transplantation combined with trabeculectomy was performed on 32 cases (39 eyes) with refractory glaucoma. All the patients were followed-up for 6-24 months. The acuity of visual, filtering bleb, anterior chamber depth, IOP and the complications of operation were studied. Results The IOP was descended 59.9 % (P<0.001) from (41.3±5.1)mmHg pre-operation to(17.2±5.3) mmHg post-operation. The total success rate was 93.4 %. After operation, 34 eyes (87.2 %) were kept functional filtering bleb. 27 eyes (69.2 %) had improved visual acuity. The complications included shallow anterior chamber (5 eyes) and early postoperative hypotony (9 eyes). Conclusions Amniotie membrane transplantation combined with trabeculectomy for refractory glaucoma can effectively inhibit the sear formation, decrease the IOP and increase the success rate considerably. The method is safe and effective in the treatment of refractory glaucoma.     

干燥羊膜移植联合复合式小梁切除术治疗难治性青光眼临床观察

Objective To explore the effect and security of dry amniotic membrane transplantation com-bined with trabeculectomy on refractory glaucoma. Methods Dry amniotic membrane transplantation combined with trabeculectomy was performed on 32 cases (39 eyes) with refractory glaucoma. All the patients were followed-up for 6-24 months. The acuity of visual, filtering bleb, anterior chamber depth, IOP and the complications of operation were studied. Results The IOP was descended 59.9 % (P<0.001) from (41.3±5.1)mmHg pre-operation to(17.2±5.3) mmHg post-operation. The total success rate was 93.4 %. After operation, 34 eyes (87.2 %) were kept functional filtering bleb. 27 eyes (69.2 %) had improved visual acuity. The complications included shallow anterior chamber (5 eyes) and early postoperative hypotony (9 eyes). Conclusions Amniotie membrane transplantation combined with trabeculectomy for refractory glaucoma can effectively inhibit the sear formation, decrease the IOP and increase the success rate considerably. The method is safe and effective in the treatment of refractory glaucoma.     

干燥羊膜移植联合复合式小梁切除术治疗难治性青光眼临床观察

Objective To explore the effect and security of dry amniotic membrane transplantation com-bined with trabeculectomy on refractory glaucoma. Methods Dry amniotic membrane transplantation combined with trabeculectomy was performed on 32 cases (39 eyes) with refractory glaucoma. All the patients were followed-up for 6-24 months. The acuity of visual, filtering bleb, anterior chamber depth, IOP and the complications of operation were studied. Results The IOP was descended 59.9 % (P<0.001) from (41.3±5.1)mmHg pre-operation to(17.2±5.3) mmHg post-operation. The total success rate was 93.4 %. After operation, 34 eyes (87.2 %) were kept functional filtering bleb. 27 eyes (69.2 %) had improved visual acuity. The complications included shallow anterior chamber (5 eyes) and early postoperative hypotony (9 eyes). Conclusions Amniotie membrane transplantation combined with trabeculectomy for refractory glaucoma can effectively inhibit the sear formation, decrease the IOP and increase the success rate considerably. The method is safe and effective in the treatment of refractory glaucoma.     

干燥羊膜移植联合复合式小梁切除术治疗难治性青光眼临床观察

Objective To explore the effect and security of dry amniotic membrane transplantation com-bined with trabeculectomy on refractory glaucoma. Methods Dry amniotic membrane transplantation combined with trabeculectomy was performed on 32 cases (39 eyes) with refractory glaucoma. All the patients were followed-up for 6-24 months. The acuity of visual, filtering bleb, anterior chamber depth, IOP and the complications of operation were studied. Results The IOP was descended 59.9 % (P<0.001) from (41.3±5.1)mmHg pre-operation to(17.2±5.3) mmHg post-operation. The total success rate was 93.4 %. After operation, 34 eyes (87.2 %) were kept functional filtering bleb. 27 eyes (69.2 %) had improved visual acuity. The complications included shallow anterior chamber (5 eyes) and early postoperative hypotony (9 eyes). Conclusions Amniotie membrane transplantation combined with trabeculectomy for refractory glaucoma can effectively inhibit the sear formation, decrease the IOP and increase the success rate considerably. The method is safe and effective in the treatment of refractory glaucoma.     

0.03%卢美根和0.5%噻吗心胺在治疗开角型青光眼和高眼压症中的比较

<正>青光眼治疗的主要目的是降低眼压,防止高眼压导致视神经萎缩以致视力丧失。目前降眼压的药物大多数是通过针对房水循环的不同环节来抑制房水的生成以达到降眼压的目的。近年来出现了一类具有独特的药理学特性的降眼压药物——前列腺素类药物,卢美根(bimatoprost)是其中的新成员[1,2],它是前列腺素的合成拟似物,通过对前列腺素F(PGF)     

干燥羊膜移植联合复合式小梁切除术治疗难治性青光眼临床观察

Objective To explore the effect and security of dry amniotic membrane transplantation com-bined with trabeculectomy on refractory glaucoma. Methods Dry amniotic membrane transplantation combined with trabeculectomy was performed on 32 cases (39 eyes) with refractory glaucoma. All the patients were followed-up for 6-24 months. The acuity of visual, filtering bleb, anterior chamber depth, IOP and the complications of operation were studied. Results The IOP was descended 59.9 % (P<0.001) from (41.3±5.1)mmHg pre-operation to(17.2±5.3) mmHg post-operation. The total success rate was 93.4 %. After operation, 34 eyes (87.2 %) were kept functional filtering bleb. 27 eyes (69.2 %) had improved visual acuity. The complications included shallow anterior chamber (5 eyes) and early postoperative hypotony (9 eyes). Conclusions Amniotie membrane transplantation combined with trabeculectomy for refractory glaucoma can effectively inhibit the sear formation, decrease the IOP and increase the success rate considerably. The method is safe and effective in the treatment of refractory glaucoma.     

干燥羊膜移植联合复合式小梁切除术治疗难治性青光眼临床观察

Objective To explore the effect and security of dry amniotic membrane transplantation com-bined with trabeculectomy on refractory glaucoma. Methods Dry amniotic membrane transplantation combined with trabeculectomy was performed on 32 cases (39 eyes) with refractory glaucoma. All the patients were followed-up for 6-24 months. The acuity of visual, filtering bleb, anterior chamber depth, IOP and the complications of operation were studied. Results The IOP was descended 59.9 % (P<0.001) from (41.3±5.1)mmHg pre-operation to(17.2±5.3) mmHg post-operation. The total success rate was 93.4 %. After operation, 34 eyes (87.2 %) were kept functional filtering bleb. 27 eyes (69.2 %) had improved visual acuity. The complications included shallow anterior chamber (5 eyes) and early postoperative hypotony (9 eyes). Conclusions Amniotie membrane transplantation combined with trabeculectomy for refractory glaucoma can effectively inhibit the sear formation, decrease the IOP and increase the success rate considerably. The method is safe and effective in the treatment of refractory glaucoma.     

药物缓释系统在青光眼治疗中的应用

青光眼是当前第一位不可逆性致盲性眼病,眼内压间断或持续升高是重要的危险因素,也是唯一可控的因素。青光眼引起的视功能损伤是不可逆的,目前唯一被证实有效的治疗方法是降眼压,采取的主要手段是药物、激光和手术。药物治疗主要是滴眼液局部给药,这种传统滴眼液给药存在一定的局限性;药物的生物利用度也受角膜上皮细胞渗透性特点以及血-房水和血-视网膜屏障的影响;另外,多数青光眼患者需要联合使用数种降眼压药物,每天多次使用,才能达到理想的眼压水平,因此患者的依从性非常重要。必须最大限度减少给药次数、延长给药间隔,从而降低对患者用药依从性的依赖,同时增加眼部给药的生物利用度提高疗效。近年来,药物缓释系统的开发和临床应用为解决上述问题提供了可能。本文就药物缓释系统在青光眼药物的研究进展进行归纳和总结,希望能为其临床应用提供参考。