佩戴角膜绷带镜对轻度MGD患者白内障术后干眼防治的安全性及有效性

目的评价角膜绷带镜防治轻度睑板腺功能障碍(MGD)患者白内障术后干眼的有效性和安全性。方法采用非随机对照临床研究方法, 纳入2020年6月至2021年2月于烟台毓璜顶医院眼科行超声乳化白内障摘出联合人工晶状体(IOL)植入手术的白内障合并轻度MGD患者60例60眼, 根据患者意愿将其分为绷带镜佩戴组和对照组, 每组30眼, 其中绷带镜佩戴组术眼术后连续佩戴角膜绷带镜14 d, 第14天复查时取出;对照组术眼术毕未佩戴角膜绷带镜, 2个组术眼术后用药均一致。术前及术后第1、7、14天, 采用裂隙灯显微镜观察眼前节结构及炎症表现;采用标准对数视力表获得最佳矫正视力(BCVA);采用眼表疾病指数(OSDI)问卷对术眼眼表症状进行评分;采用眼表综合分析仪评估术眼睑板腺情况并记录非侵入性首次泪膜破裂时间(NIFBUT);采用角膜荧光素钠染色(CFS)观察术眼角膜上皮有无缺损并对角膜着色情况进行评分。结果术后第1、7、14天, 2个组术眼均未出现炎症反应及并发症;术后不同时间点BCVA总体比较差异有统计学意义(F时间=3.610, P=0.016), 其中各组术后第7天BCVA较术后第1天提高, ...     

白内障术后弥漫性角膜上皮糜烂治疗效果

目的:评估白内障术后弥漫性角膜上皮糜烂不同治疗方法的效果。方法:回顾性分析山西省眼科医院2012年1月至2019年12月白内障术后出现弥漫性角膜上皮糜烂17例(17眼)的临床资料。患者按治疗方式分为3组：A组4例(4眼),进行单纯的药物治疗;B组9例(9眼),进行角膜绷带镜联合药物治疗;C组4例(4眼),进行自体血清滴...     

羊膜移植治疗反复性角膜上皮糜烂

目的 探讨羊膜移植治疗反复性角膜上皮糜烂的临床疗效.方法 回顾性分析保存生物羊膜移植治疗的20例（21眼）反复性角膜上皮糜烂住院患者,术后随访观察3～16个月,对术后角膜上皮完全修复时间、视力提高情况进行分析评价.结果 21眼中19眼单纯羊膜移植术,术后角膜上皮完全修复时间最短3d,最长28 d;1眼于术后第8天羊膜融解,角膜上皮未愈合,经再次手术并联合佩戴角膜接触镜治疗后角膜上皮完全修复;1眼首次手术及联合佩戴角膜接触镜治疗,术后7d角膜上皮完全修复.术后视力提高（t=2.613,P=0.02）.结论 羊膜移植是治疗反复性角膜上皮糜烂的有效方法.     

佩戴角膜绷带镜对轻度MGD患者白内障术后干眼防治的安全性及有效性

目的:评价角膜绷带镜防治轻度睑板腺功能障碍(MGD)患者白内障术后干眼的有效性和安全性。方法:采用非随机对照临床研究方法,纳入2020年6月至2021年2月于烟台毓璜顶医院眼科行超声乳化白内障摘出联合人工晶状体(IOL)植入手术的白内障合并轻度MGD患者60例60眼,根据患者意愿将其分为绷带镜佩戴组和对照组,每组30眼...     

绷带型角膜接触镜在角膜深层异物取出术后的应用

目的:观察绷带型角膜接触镜在角膜深层异物取出术后的临床疗效.方法:对角膜深层异物取出术后患者46例46眼,随机分成戴镜组和对照组各23例23眼,两组均实施角膜深层异物取出术,比较两组患者术后1、3、7d的眼部疼痛程度及术后7d角膜上皮愈合情况.结果:术后1、3、7d两组患者眼部疼痛程度评分:戴镜组分别为0.44±0.26、0.26±0.14、0.12±0.08分,对照组分别为1.26±0.44、1.02±0.38、0.68±0.26分,两组同一时段的眼部疼痛程度差异有统计学意义(P<0.05);术后7d两组患者角膜上皮缺损情况:戴镜组角膜上皮完全修复21眼(91%),对照组上皮完全修复14眼(61%),差异有统计学意义(P<0.05).结论:配戴绷带型角膜接触镜能有效缓解角膜深层异物取出术后患者的眼部刺激症状,能加速术后角膜创面的修复.     

白内障行晶状体超声乳化术后干眼症的干预治疗

目的观察我院对白内障施行晶状体超声乳化术者在术后予以干眼症的干预措施的临床疗效。方法对258例（258眼）白内障患者随机分观察组和对照组两组,对观察组术后采用针对干眼症的干预治疗,对所有术后病例发生干眼症状、角膜荧光染色、BUT进行评分,观察对比两组术后1周、1个月和3个月时各项评分结果。结果观察组同对照组比术后1周、1个月和3个月发生干眼症状及角膜荧光染色评分均明显低于对照组,而BUT则明显长于对照组,均有显著性差异。结论对白内障施行晶状体超声乳化手术者在术后予以干眼症的干预治疗有确切疗效。     

全麻术后角膜上皮剥脱一例

1病例 患者,女,3岁,因右眼眼球穿孔伤,外伤性白内障入院。于2010年9月28日全麻下行右眼角膜裂伤缝合术,手术历时40min。术后左眼角膜上皮正常。又于2010年10月7日全麻下行白内障摘出联合前部玻璃体切除加人工晶状体植入术,手术历时60min。患儿苏醒后即出现左眼畏光、流泪。眼部检查发现左眼角膜中央部上皮糜烂剥脱。处理：贝复舒滴眼液滴眼4次／d,托百士眼膏涂眼3次／d。术后2d角膜恢复正常。     

老年白内障患者两种手术方式术后干眼的临床分析

目的了解老年白内障患者两种手术方式术后干眼的发病情况。方法对392例（392只眼）单眼老年白内障患者进行分组：A组206例（206只眼）行巩膜隧道切口白内障囊外摘除联合人工晶状体植入术;B组186例（186只眼）行透明角膜切口白内障超声乳化摘除联合人工晶状体植入术。术后观察3个月,比较两组手术方式术后干眼的发病情况。结果术后1d至3个月,小切口囊外摘除术组有20只眼（9．71％）出现了干眼症状,超声乳化组有29只眼（15．59％）出现了干眼症状。结论透明角膜切口的白内障超声乳化术比巩膜隧道的小切口自内障囊外摘除术术后千眼的发病率高。     

超声乳化术对伴有糖尿病的白内障患者眼表及角膜内皮细胞的影响

目的:探究超声乳化术对伴有糖尿病的白内障患者眼表及角膜内皮细胞的影响.方法:本研究为病历资料回顾性分析.选取2016-01/12于我校附属医院接受超声乳化术治疗的白内障患者98例98眼,根据是否合并糖尿病分为观察组和对照组.观察组为伴有糖尿病的白内障患者50例50眼,对照组为单纯白内障患者48例48眼.两组患者均行白内障超声乳化术,透明角膜切口,均由同一位医师完成,术前均无干眼症.术前糖尿病患者血糖控制正常,无眼底改变.观察两组患者术后1、3、7d,1mo的眼表情况.比较手术前后干眼症状评分、泪膜破裂时间(BUT)、角膜荧光素染色(FL)评分、泪液分泌试验(SchirmerⅠtest,SⅠt)结果以及角膜内皮细胞密度.结果:两组手术前后干眼症状评分差异显著,术后7d,1 mo观察组均显著高于对照组,差异均有统计学意义(P<0.05),术后1、3d差异均无统计学意义(P>0.05).两组手术前后BUT差异显著,术后7d,1mo观察组显著低于对照组,差异均有统计学意义(P<0.05),术后1、3d差异均无统计学意义(P>0.05).两组手术前后FL评分差异显著,术后3、7d,1mo观察组均显著高于对照组,差异均有统计学意义(P<0.05),术后1d差异无统计学意义(P>0.05).两组手术前后泪液分泌量差异显著,术后1、3、7d,1mo观察组均显著高于对照组,差异均有统计学意义(P<0.05).两组手术前后角膜内皮细胞密度差异显著,术后1、3、7d,1mo观察组均显著低于对照组,差异均有统计学意义(P<0.05).结论:超声乳化术对伴有糖尿病的白内障患者泪膜破裂时间、泪液分泌量、干眼症症状等具有显著影响,可能与糖尿病患者对损伤的修复能力降低有关.     

干眼症患者白内障手术后的观察

目的：探讨干眼症患者白内障手术后应进行的观察及治疗。方法：22例干眼症患者中4例伴口腔干燥及类风湿因子阳性的患者为A组，18例单纯角结膜干燥的患者为B组。所有术眼均进行白内障囊外摘除联合人工晶状体植入。术后给予典必殊目水（Tobredex,0.3%妥布霉素＋0.1%地塞米松）及泪然目水（Tears Naturale Ⅱ,0.3%羟丙基甲基纤维素，Alcon公司）。结果：两组术眼术后都出现了角膜上皮缺损，A组较B组上皮缺损严重且持续时间长，恢复慢。结论：干眼症患者白内障手术后易出现角膜上皮缺损，尤其是伴类风湿因子阳性的患者。因此术后应密切观察角膜情况及伤口恢复情况，并及时给予积极治疗。     

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.