房水铁离子含量测定与眼铁质沉着病相关性的研究

目的：测定眼我质沉着症房水中铁离子含量,探讨其对手术预后及相关影响。方法：对１７只铁质沉着症眼,在摘取眼内异物手术前,取０．２ｍｌ房水标本,对照组取１０只正常尸体眼房水,采用铁试剂盒,亚铁嗪法测定铁质子含量。结果：１７例房水铁离子含量平均为２．９８９μｇ／ｍｌ。对照组平均含量为０．６３１μｇ／ｍｌ。术后视力０．５以上者４例,０．１￣０．４者４例,０．０１￣０．０９者２例,手动以下者７例,其中眼球萎     

眼铁质沉着症（附21例报告）

目的：探讨眼铁质沉着症的临床特点及手术效果。方法：对21例21眼科铁质沉着症行X线眼内异物定位检查,其中18眼手术摘出异物,4例行后房型人工晶状体植入。结果:2例术后视力≥0.5,2例≥0.1,其余14眼视力均无明显改善。结论：眼铁质沉着症对视功能损害严重,术后视力改善不理想。为避免眼铁质沉着症的发生,一旦发现眼内铁质异物,应 尽快取出。     

超声生物显微镜在眼铁质沉着症检查中的应用

目的:探讨眼铁质沉着症的超声生物显微镜(UltrasoundBiomicroscopy,UBM)图像特征及异物的检出率。方法:应用UBM对16例眼铁质沉着症患者进行检查,分析UBM图像,同时与X线眼眶照片检查结果及手术结果进行对照。结果:16例眼铁质沉着症患者UBM检查均显示不同组织的铁锈沉着。X线眼眶照片显示异物残留者10例中,UBM检查显示异物残留者4例,X线检查未见异物残留者6例中,UBM检查显示异物残留者1例,手术取出异物11例。UBM显示异物图像为高强反射声影,有超声伪影,铁质沉着症的UBM图像特征为多发性点状、斑片状或线状高强回声、无超声伪影。结论:UBM能准确显示眼内异物位置及铁锈沉着部位,但异物的检出率较X线照片低。     

眼铁质沉着症临床分析

目的 探讨眼铁质沉着症的临床表现和发病机制。方法 对因眼内异物引起的10例（10眼）眼铁质沉着症进行X线眼内异物定位检查，2例采用巩膜外磁性试验后牵引至睫状体平坦部吸出；2例晶状体异物行白内障囊外摘出合并后房型人工晶状体植入；6例行平坦部三通道闭合式玻璃体手术摘出异物，其中2例视网膜脱离行视网膜复位手术并注入硅油。结果 2例晶状体异物的术后视力恢复到0．5和0．6；其余8例视力未见明显提高。2例玻璃体视网膜手术，分别于术后6、9月取出硅油，视网膜复位。结论 眼内铁质异物存留所致的眼铁质沉着症后果严重，造成视功能的严重障碍，且异物摘出较困难，术后视力改善不理想。因此在临床上对有异物伤病史的患者，一定要排除眼内异物的存在，一旦发现眼内铁质异物，应尽快摘出，避免铁质沉着症的发生。     

眼铁锈症

眼铁锈症是指眼球穿孔伤,铁质异物进入眼内,存留数日至数月,可发生临床上的铁沉着,铁离子由异物周围扩散和传播到眼内组织,呈现棕黄色的细微颗粒样沉着Bunge(1860年)首先报道了眼部铁锈沉着症。发病机制：铁锈沉着的机制尚不明确,据Bunge(1891)认为铁被组织中的二氧化碳所溶解,变为碳酸氧化亚铁。它一方面向周围组织渗透溶解,变为碳酸氧化亚铁,并向周围组织渗透扩散;另一方面则借助于由后向前移动的电子,将铁离子带到眼球前段的组织内。以后碳酸氧化亚铁氧氯化铁氧化铁（Fe2O3）,氧化铁为一般的铁锈,其溶入组织内或被电子带…     

眼铁质沉着症诊治分析

目的：探讨眼铁质沉着症发生的相关因素,找出铁沉着症可靠体。方法：对我院12年铁沉着症51例进行回顾性分析。结果：①异物最大长径≤2.0mm,铁沉着症发生率84.31％;82.50％位于睫状体锯齿缘附近;②95.24％位于眼内下半部;③≤1.0mm异物,96％是医、患漏诊和疏忽;④2.1－3.0mm异物共6例,5例是医、患疏忽,均为巩膜穿孔伤;⑤手术前后视力比较差异无显著性（P＞0.05）;⑥手术成功率93.18％,失败6.82％;⑦51眼均见晶状体铁质沉着。结论：眼内科小异物动能小,穿 透力弱,易停留在眼内前部,因重力下沉于睫状体平担部4－8点范围,该区域隐蔽,不充分扩瞳,医师易漏诊,需作X线摄片;小异物入眼损伤小,视期视力无影响,易被患者疏忽;较大异物巩膜穿孔,易引起医、患疏忽。晶状体囊下上皮内花圈状铁质沉着斑点是铁沉着症临床诊断可靠体征。     

包裹性眼内异物的治疗体会(附9例报告)

我院自1993－1994年共收治磁性和非磁性异物132例，异物取出成功率94％，其中9倒包裹性异物未取，现将追踪观察情况报告如下：本文9例9眼，其中铁质异物5眼，铜质异物4眼，受伤至就诊时间8天一2年，术后视力0．4－1．2，追踪时间平均9个月。异物包裹时间为4周一25年。铁和钢进入眼内早期可能发生急性或亚急性化脓性炎症，晚期可能发生铁锈或铜锈沉着症，其中尤以纯铜的危害最大，严重的化脓性炎症可丧失视力致眼球萎缩。铁锈和铜锈的发生与异物的大小、位置，在眼内滞留时间以及是否包裹等因素有关，异物越大，铁离子和铜离于发生扩散的机会…     

眼铁锈沉着症的闪光视网膜电图变化

眼球穿孔伤常合并眼球内异物,较小异物常不能及时明确诊断。在眼内异物中铁最常见,铁在眼内可引起铁锈沉着症而损害视功能。为了探讨其对视网膜功能的影响,我们对29例29眼铁锈沉着症患者行闪光视网膜电图(F—ERC)测定。现将其结果分析如下。一、对象与方法 1、对象:确诊眼内铁异物29人,男15人,女14人,年龄20～69岁,平均年龄39.3岁,病程1个月到3年不等。术前X线检查阳性22人,阴性7人。手术22例取出磁性异物,7例取不出异物,其中6人X线阴性,但晶体有较明显铁锈沉着。21例同时行内障手术,术前或术后发现有明显玻璃体积血者除外,外伤前视力差者除外。以对     

铁质沉着症合并白内障行人工晶体植入术探讨

眼球铁质沉着症是眼内铁异物存留所发生的严重并发症,对眼各组织造成不同程度的损害.铁质沉着症合并白内障行Ⅰ期人工晶体植入术国内未见报告.我院近2年,收治5例铁锈沉着症合并白内障病例,行眼内异物摘出术、白内障囊外摘除术及I期人工晶体植入术,术后视力得到不同程度恢复,报告如下.     

眼内微小金属异物的定位与摘除(摘要)

本文对1978～1988年我院收治的位于晶状体虹膜隔以后,且长、宽、厚均1mm的眼内微小金属异物105例(109眼)进行统计分析,结果表明:(1)左右眼异物伤机会均等(右57左52);男女有显著差异(男93女12,P<0.001);年齡最大60岁,最小11岁,20～40岁占80.1%。(2)诊断依据:有外伤史、角巩膜伤痕者100眼占91.74%(其中有铁或铜锈沉着症者23眼占21.1%);否认外伤史、视力无明显下降,检查外眼无阳性体征者9眼占8.25%;在外伤史,眼前段伤痕、铁、铜绣沉着症及视力下降4项中有1～2项阳性者应高度怀疑眼内异物。(3) 定位方法:采用罗氏法,角膜缘缝金属环、薄骨或无骨X线摄片定位106眼占97.2%,对少数极微小的金属异物,即使病史与体征阳性、一般X线也不能显影,应用薄骨,无骨影定位。(4) 摘出方法:术中磁性试验阳性,异物取出者70眼占64.2%;阴性的39眼占35.8%,则采用巩膜标记重新定位,异物摘出者34眼,5眼未摘出的原因有①异物太微小;②被组织包裹;③磁性微弱;④被机化或分解。⑤手术后视力:等于或高于术前视力者81眼占74.3%,其中11眼视力在1.0以上(10眼为异物存留眼内1月以內;仅有光感的13眼中,10眼为异物存留眼内一年以上,表明微小金属异物在眼内时间越长,予后越差。1例长达15年者已渐失明。笔者认为根据铁离子在眼内7天损害眼组织的情况,金属异物最好在一周内摘除。 (本文在中山眼科中心钟国庆、文旭导师指导下完成,谨致谢忱)     

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.