人工晶状体眼视网膜脱离临床分析

目的 探讨白内障术后人工晶状体眼视网膜脱离的临床特点、发病机理及手术方法。方法 对我院1998年～2004年收治的18例(18只眼)白内障术后人工晶状体眼视网膜脱离进行回顾性分析。结果 一次手术视网膜复位14只眼(77.8％);术后视力提高12只眼,视力不变者4只眼,视力下降2只眼。结论 人工晶状体眼视网膜脱离具有视网膜脱离发展快、病情重、裂孔寻找困难的特点;一旦出现网脱症状,应仔细检查,尽早采取合适的手术方式．提高视网膜复位率以保存视功能。     

人工晶状体眼视网膜脱离的治疗分析

目的 回顾分析人工晶状体植入术后视网膜脱离的临床特点及手术治疗效果.方法 对24例(24只眼)人工晶状体植入术后视网膜脱离的患者,19只眼采用冷凝、环扎外加压及放液术,5只眼联合采用玻璃体切割、眼内光凝及注入硅油术.结果 所有术眼视网膜均解剖复位.术后平均随访12个月,有明显视力提高9只眼,视力0.1～0.15(37.5%);10只眼视力0.08～0.1(41.66%);5只眼视力0.05～0.08(20.83%).结论 尽早合理的选择手术方式,可提高人工晶状体眼视网膜脱离的视网膜复位率.     

巩膜扣带术联合超声乳化治疗孔源性视网膜脱离合并白内障

目的 探讨巩膜扣带术联合晶状体超声乳化治疗孔源性视网膜脱离合并白内障的手术操作技巧及其效果.方法 回顾性分析巩膜扣带术联合晶状体超声乳化治疗的孔源性视网膜脱离合并白内障29例(29眼)其中同期后房型人工晶状体植入25眼.术中联合玻璃体腔注入六氟乙烷(C2F6)8眼,注入滤过空气1眼.手术后随访3～24个月.对视力、人工晶状体位置、视网膜复位情况及手术并发症等进行了临床观察.结果 所有病例术中眼底检查满意,均发现裂孔.随访期末视力提高者22眼,占75.86％(其中提高2行以上者16眼占55.17％);视力不变者7眼,占24.14％.随访期内28眼视网膜完全复位(96.55％),1眼视网膜未完全复位(3.45％).所有病例人工晶状体无明显偏位,术中术后无严重并发症发生.结论 巩膜扣带术联合晶状体超声乳化治疗孔源性视网膜脱离合并白内障既可免除患者二次手术的痛苦,又可使视网膜脱离及时复位,有助于恢复较好的视功能.     

人工晶状体植入术后视网膜脱离的手术治疗

目的探讨人工晶状体植入术后视网膜脱离的手术方法并评价其疗效。方法2000年1月～2002年6月经玻璃体视网膜联合术治疗人工晶状体植入术后视网膜脱离31例(31眼)的临床资料作回顾分析。手术采取玻璃体切除、剥离视网膜前膜、激光封闭视网膜裂孔及眼内长效气体或硅油填充等方式。结果随访期为12～39月，平均22月。随访时视网膜复位29眼，占93．55％。有27眼(占87．11％)视力提高，其中≥0．1者22眼，最好视力为0．8。结论人工晶状体植入术后视网膜脱离使眼内病变复杂，易致严重PVR。应用玻璃体视网膜联合术，可使视网膜得以有效复位。     

人工晶体植入术后视网膜脱离

目的 探讨后房型人工晶体植入术后视网膜脱离的发病机制和相应的预防及处理方法。方法：分析39例39眼人工晶体植入术后继发视网膜脱离的特征及手术治疗方法,ECCE IOL25眼,PHACO IOL14眼。结果：术后随访3～36个月,最终视网膜复位35眼（89.7%）,26眼视力提高（66.7%）,12眼视力不变（30.8%）,1眼视力下降（2.5%）。结论：提高白内障手术成功率和精确使用Nd：YAG激光。加强术后随访观察可减少或避免视网膜脱离的发生;一旦人工晶体植入后继发视网膜脱离,尽早手术,可保存患者视功能。     

玻璃体切除术后无晶状体眼Ⅱ期人工晶状体植入术式的临床观察

目的探讨复杂性眼外伤或视网膜脱离行玻璃体切除术后无晶状体眼Ⅱ期不同类型人工晶状体植入术式临床疗效,评估手术的可行性。方法对41例(41眼)因复杂性眼外伤或视网膜脱离行玻璃体切除术后无晶状体眼,分别行前房型人工晶状体植入术18眼、后房型人工晶状体缝线固定术17眼、带虹膜人工晶状体植入术后6眼,术后平均随访10月。结果41例患者术后裸眼视力均达到或接近术前矫正视力。其中前房型人工晶状体植入术18眼中最好视力≥0.5者(44％),后房型人工晶状体缝线固定术17眼中最好视力≥0.5者9眼(53％),带虹膜人工晶状体植入术6眼中最好视力≥0.5者2眼(33％)。结论晶状体、玻璃体切除术后人工晶状体植入术式的选择,主要应根据患者的瞳孔大小、眼压、房角结构及患者全身情况选择术式,2种不同类型人工晶状体植入术式临床疗效,经过统计学处理无显著性差异P>0.05,术后的视力与角膜及眼损伤程度及术后散光密切相关。     

人工晶状体术后视网膜脱离48例临床分析

目的 分析人工晶状体术后视网膜脱离的原因，探讨治疗方法，提高治愈率。方法 分析48例(48只眼)人工晶状体术后视网膜脱离原因及治疗方法，对术后成功率进行统计。结果 48例(48只眼)人工晶状体视网膜既离术后随访半年至1年。单纯视网膜复位术(环扎 外垫压术)18只眼，14只眼复位(77．8％)；视网膜复位术 玻璃体切割术 注气6只眼，5只眼复位(83．3％)；视网膜复位术 玻切术 取出人工晶状体 注油或注气7只眼，7只眼复位(100％)；视网膜复位术 玻切术 注油17只眼，15只眼复位(88．2％)。所有末复位眼中，除2例因年龄及经济原因放弃治疗外，其余均行二次玻璃体手术获得成功。结论 人工晶状体术后视网膜脱离术前检查对手术方式的选择至关重要，玻璃体切割手术是治疗人工晶状体术后视网膜脱离的主要方法。     

白内障术后人工晶状体眼视网膜脱离临床分析

目的 探讨白内障术后人工晶状体眼视网膜脱离的临床特点及治疗方法。方法 对我院1998年～2002年4年间经行常规视网膜脱离复位术及玻璃体视网膜联合术治疗的16例(16只眼)白内障术后人工晶状体眼视网膜脱离的临床资料作回顾性分析。结果 行常规视网膜脱离复位术(巩膜外加压 冷凝 放液术)12只眼；玻璃体切除、眼内填充联合巩膜环扎术4只眼。随访3月～1年，视网膜复位12只眼(占75％)，术后视力提高10只眼，不变4只眼，下降2只眼。16只眼均未行人工晶状体取出。结论 人工晶状体眼视网膜脱离具有发展迅速、眼内病情复杂、眼底周边部检查困难、裂孔发现率低，易致严重PVR，诊断及治疗难度加大等特点。白内障术后人工晶状体眼视网膜脱离，应根据不同的病情选择相应的手术方式进行治疗，仍可取得较好的疗效。     

玻璃体切除术治疗人工晶状体眼视网膜脱离

目的探讨以玻璃体切除术治疗人工晶状体眼视网膜脱离的临床效果。方法对50例（50眼）人工晶状体眼视网膜脱离施用玻璃体切除术。其中16眼行硅油填充术，34眼行C3F8眼内填充。术后随访6～24月。结果术后视网膜最终完全复位49眼（98．00％）。15眼（30．00％）术中新发现裂孔。术后视力均有不同程度的提高。结论玻璃体切除术治疗人工晶状体眼视网膜脱离具有术野清晰、易于寻找隐匿性裂孔、提高视网膜复位率及复发率低的优点。     

硅油填充眼的白内障超声乳化联合人工晶状体植入术

目的:探讨玻璃体视网膜手术联合硅油眼内填充术后并发性白内障行白内障超声乳化人工晶状体植入的临床效果、临床特点及特殊手术方法。方法:回顾性分析了我科2005-01/2008-06视网膜脱离硅油注入术后并发白内障病例共47例47眼。硅油注入术后6～35(平均16.2)mo。采用超声乳化白内障摘除+人工晶状体植入术。结果:经过随访,视力提高41眼(87%);视力达到视网膜脱离术后白内障发生前的最佳视力的有32眼(68%)。最高矫正视力0.4;脱盲率为62%。结论:白内障超声乳化手术是提高硅油注入术后并发白内障患者视力的较好方法。     

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.