高度近视白内障人工晶状体植入术的临床观察

目的　观察超声晶状体乳化吸出联合折叠式人工晶状体植入术治疗白内障合并高度近视的临床效果。方法　对70例 (12 5眼 )白内障合并高度近视行超声乳化吸出低度数或负度数丙烯酸酯折叠式人工晶状体植入术 ,观察术中术后并发症、术后视力和屈光状态。术后随访时间≥ 3月。结果　术中和术后并发症有后囊破裂 3眼 ,角膜水肿 12眼。术后 3月最佳矫正视力 <0 1者 4眼 ,0 1～ 0 4者 2 5眼 ,0 5～ 0 9者 86眼 ,1 0～ 1 5者 10眼。 4眼 (3 2 % )晶状体后囊浑浊 ,无视网膜脱离者。结论　超声乳化吸出低度数或负度数丙烯酸酯折叠式人工晶状体植入术治疗白内障合并高度近视 ,是安全有效的。     

低度数或负度数折叠式人工晶状体植入术治疗白内障合并高度近视的临床观察

目的观察白内障摘除联合低度数或负度数丙烯酸酯(Acrysof)折叠式人工晶状体植入术治疗白内障合并高度近视的临床疗效.方法对40例(56只眼)白内障合并高度近视患者行超声乳化白内障吸除低度数或负度数Acrysof折叠式人工晶状体植入术,观察术中和术后并发症、术后视力和屈光度数.术后随访时间≥3个月.结果术中无并发症发生.术后3个月最佳矫正视力＜0.1者2只眼,0.1～0.4者12只眼,0.5～0.9者36只眼,1.0～1.5者6只眼;4只眼(7.2%)晶状体后囊膜混浊,1只眼(1.8%)发生晶状体囊袋阻滞综合征,无视网膜脱离者.结论超声乳化白内障吸除低度数或负度数Acrysof折叠式人工晶状体植入术,是治疗白内障合并高度近视患者安全、有效的手术方法.     

高度近视白内障Bigbag人工晶状体植入术的临床观察

目的观察超声乳化晶体吸出联合Bigbag折叠式人工晶状植入后囊术治疗白内障合并高度近视的临床效果。方法对54例93眼白内障合并高度近视行超声乳化吸出低度数或负度数bigbag丙稀酸酯折叠式人工晶状体植入术,观察术中术后并发症、术后视力和屈光状态,角膜内皮细胞损失,后束皱褶。术后随访时间3m-6m。结果术中无后囊膜破裂,见晶体与整膜紧密相贴,后囊膜未见皱褶,人工晶体固定良好。术后3眼角膜水肿。6m最佳矫正视力<0.1者4眼,0.1～1.4者28眼,0.5～0.9者55眼,1.0～1.5者6眼;后囊膜混浊2眼;无视网膜脱离和黄斑囊样水肿。结论超声乳化吸出低度数或负度数bigbag丙烯酸折叠式人工晶状体植入术治疗白内障合并高度近视是安全有效理想术式,不仅降低了后束膜皱褶的发生率,同时也减少了视网膜脱离的发生。     

高度近视白内障超声乳化及人工晶状体植入术

目的　分析高度近视白内障超声乳化吸出及后房人工晶状体植入术的疗效。方法　对 5 0例 ( 5 8眼 )高度近视白内障行巩膜隧道切口晶状体超声乳化吸出及后房人工晶状体植入。眼轴长 2 7～ 3 3 5 6mm ,平均 2 9 3 5mm。其中眼轴长≤ 3 0mm者 40眼 ,眼轴长 >3 0mm者 18眼。植入折叠式人工晶状体 ,观察术中术后并发症及术后视力。结果　眼轴长≤ 3 0mm的40眼中术后视力≥ 0 4者 3 5眼 ( 87 5 %) ;眼轴长 >3 0mm的 18眼中术后视力≥ 0 4者 9眼 ( 5 0 0 %)。术中后囊破裂 1例 ,行前部玻璃体切除及人工晶状体睫状沟植入术。结论　高度近视白内障超声乳化及人工晶状体植入能改善视力 ,但眼轴长 >3 0mm者术后视力恢复较差     

透明晶状体置换术治疗高度近视的临床研究

目的 探讨透明晶状体超声乳化吸出术联合人工晶状体植入术矫治高度近视的有效性及安全性。方法 对48例（60眼）高度近视行透明晶状体超声乳化术联合低度数或负度数后房人工晶状体植入术。观察术后视力,术中和术后并发症。结果 所有病例术后裸眼视力均优于或等于术前最好矫正视力,术前最好矫正视力≥0.5者28眼（46.67%）;术后裸眼视力≥0.5者40眼（66.67%）。术中除1例发生后囊破裂,人工晶状体植入睫状沟外,其余均植入囊袋内。术后观察6-18月无角膜水肿失代偿、视网膜脱离等严重的远期并发症。结论 透明晶状体超声乳化吸出联合后房人工晶状体植入术矫治高度近视,是1种安全、有效的手术方法。具有术后视力恢复好,屈光状态稳定,并发症少,远期疗效可靠的优点。     

超高度轴性近视白内障的晶状体超声乳化吸出术

目的观察超声乳化吸出及人工晶状体植入术治疗超高度轴性近视白内障的效果。方法对105例（105眼）超高度近视白内障行品状体超声乳化吸出术，植入低度数人工品状体，随访3月。结果术中无并发症发生。术后8眼晶状体后囊轻度浑浊，无视网膜脱离者。结论超声乳化白内障吸出术对于超高度轴性近视白内障是一种较好的手术方式，尤其同时植入负、低度数后房型人工晶状体既可为增加眼内组织的稳定性。防止发生视网膜脱离，又可同时进行屈光矫正。     

高度近视白内障超声乳化摘出人工晶状体植入术

目的评价高度近视眼白内障超声乳化摘出术及人工晶状体植入术的疗效.方法对眼轴＞26mm(平均27.46mm)的94例(104眼)高度近视合并白内障患者行超声乳化摘出及人工晶状体植入术.结果术后1月裸眼或矫正视力≥0.5者84眼(80.76%),视力≥1.0者34眼(32.69%).结论高度近视白内障超声乳化及人工晶状体植入术具有术后视力恢复快屈光状态稳定等优点,但眼轴＞30mm以上者视力差.     

超声乳化术治疗高度近视合并白内障12例

目的 观察高度近视合并白内障患者行超声乳化吸出联合折叠式人工晶状体植入术的临床手术效果.方法 对12例(18眼)高度近视合并白内障的患者行透明角膜切口的超声乳化术,术前人工晶状体的计算公式根据眼轴的长度的不同选用不同的计算公式:眼轴长度<26.00 mm者,人工晶状体计算公式采用SRK-Ⅱ,眼轴长度>26.00 mm者,采用SRK-T公式(为保证手术后的裸眼视力效果,眼轴长度>26.00 mm的患者实际植入人工晶状体度数采用SRK-T公式的计算结果,与SRK-Ⅱ公式仅作术前理论预测对照),同期植入疏水性丙烯酸酯折叠式人工晶状体.结果 18眼术后最佳矫正视力>0.25者占94.4%,SRK-Ⅱ和SRK-T公式预测屈光度和术后实际屈光度的误差值分别为(1.48±0.67)D和(0.78±0.56)D,二者比较差异有统计学意义(P<0.05),术中无一例患者发生后囊膜破裂,术后第1天8眼患者眼压轻度升高,经降眼压后1～2 d恢复正常,术后无一例患者发生角膜内皮失代偿,随访期内(6～12个月)未发现影响视力的后囊增生及视网膜脱离的发生.结论 超声乳化联合折叠式人工晶状体植入术是治疗高度近视合并白内障安全而有效的方法,对于眼轴长度>26.00 mm的高度近视患者的人工晶状体的计算公式选择SRK-T对保证手术效果是有益的.     

高度近视透明晶状体乳化吸出人工晶状体植入

目的 观察高度近视透明晶状体及合并白内障超声乳化吸出后房型硬性人工晶状体植入的效果。方法 42例(58眼)。透明晶状体12例(22眼)，合并白内障30例(36眼)。均行晶状体超声乳化吸出，5．5mm自闭式巩膜隧道切口植入PMMA硬性人工晶状体，随访3月～1年，观察术后视力及并发症。结果 透明晶状体组：术后1周及3月～1年，视力≥0．3者分别为100％、95．5％；白内障组视力≥0．3者分别为66．7％，72．2％。并发症：透明晶状体组无特殊并发症；白内障组，1眼后囊破裂，2眼角膜中度水肿，6眼后发障(1眼激光治疗)。结论 高度近视晶状体超声乳化吸出及人工晶状体植入安全有效。     

高度近视白内障超声乳化人工晶状体植入术的效果

目的 评价高度近视合并白内障行超声乳化吸出及折叠人工晶状体植术的临床效果.方法 对36例（48眼）高度近视合并白内障行透明角膜切口超声乳化吸出及折叠人工晶状体植入术.眼轴长度（26.78～34.56）mm,平均（27.43±2.80） mm,其中眼轴≤30 nm者36眼;眼轴＞30mm者12眼.观察术后视力及术中术后并发症.结果 术中悬韧带离断1眼,后囊破裂2眼,经处理均植入折叠人工晶状体于囊袋内.眼轴≤30 mm的36跟中术后视力≥0.3者30眼（83.3％）;眼轴＞30 mm的12眼中术后视力≥0.3者5眼（41.7％）.结论 透明角膜切口超声乳化吸出及折叠人工晶状体植入术,适合于高度近视合并白内障.但眼轴＞ 30 mm者术后视力恢复较差,与眼轴长度及黄斑功能有关.     

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.