热融金属双眼结膜囊铸型2例

1　临床资料例 1:患者 ,男 ,34a,系个体经营者。因双眼被融化的铅液溅入 ,视物不见 0 .5 h来诊。患者在制做爆米花锅的封盖时 ,不慎将加热融化的铅液溅入双眼 ,立即感剧烈灼痛、流泪、双眼视物不见 ,即来院急诊。查体 :双眼视力光感 ,双眼睑近睑缘皮肤红肿 ,睫毛不齐 ,易拔除。双眼结膜囊均见有葡萄酒杯状银灰色的铅铸型 ,眼球转动时略有活动 ,类似驳壳义眼。滴 10 g· L- 1 地卡因 2次后 ,取出该铸型。见角膜上皮焦痂状 ,角膜深层混浊。双眼结膜囊涂用玻璃酸钠液 ,后点素高捷疗眼膏及抗菌素、皮质类固醇类药物 ,以减少炎性反应 ,避免睑球…     

原发性结膜肿瘤728例临床病理分析

目的 了解眼部原发性结膜肿瘤的组织病理学特征及发病率.方法 收集第三军医大学附属西南眼科医院2003年1月至2009年12月期间门诊及住院治疗的728例原发性结膜肿瘤的临床病理资料进行回顾性分析.结果 良性结膜肿瘤570例(78.3%),其构成位于前10位的依次为:色素痣、结膜囊肿、乳头状瘤、血管瘤、迷芽瘤(皮样瘤、皮样脂肪瘤、畸胎样瘤)、脂肪瘤及纤维脂肪瘤、反应性淋巴增生、黑变病、非典型性增生、皮脂腺瘤.恶性结膜肿瘤158例(21.7%),其构成位于前5位的分别是:鳞状细胞癌(含黏液表皮样癌)、恶性淋巴瘤、恶性黑色素瘤、浆细胞瘤、原位癌.对结膜鳞状细胞性肿物及黑色素性病变的临床、病理特征及鉴别诊断进行了总结分析.结论 结膜肿瘤临床及病理分类繁多,对病变进行临床及病理分析有助于正确的诊断及治疗.

Abstract：

Objective To investigate the histopathologic features and incidence of primary conjunctival neoplasms. Methods The histopathologic data of 728 primary conjunctival neoplasms in Southwest Eye Hospital from January of 2003 to December of 2009 were collected and analyzed retrospectively. Results Benign conjunctival neoplasms were 570(78.3%), the top ten in the ranking in turn were pigmented nevus, conjunctival cyst, papilloma, hemangioma, Choristoma, lipoma and lipofibroma, Reactive Lymphoid Hyperplasia,melanosis, atypical hyperplasia, sebaceous adenoma. Malignant conjunctival neoplasms were 158(21.7%), the top five in the ranking in turn were squamous cell carcinoma, malignant lymphoma, plasmocytoma, carcinoma in situ. The clinical, pathological and differential diagnosis of conjunctival squamous cell neoplasms and melanin lesions were summarized. Conclusions The classification of conjunctival neoplasms are various, the clinical and pathological analysis of primary conjunctival neoplasms is helpful to the diagnosis and therapy.     

原发性结膜肿瘤728例临床病理分析

目的 了解眼部原发性结膜肿瘤的组织病理学特征及发病率.方法 收集第三军医大学附属西南眼科医院2003年1月至2009年12月期间门诊及住院治疗的728例原发性结膜肿瘤的临床病理资料进行回顾性分析.结果 良性结膜肿瘤570例(78.3%),其构成位于前10位的依次为:色素痣、结膜囊肿、乳头状瘤、血管瘤、迷芽瘤(皮样瘤、皮样脂肪瘤、畸胎样瘤)、脂肪瘤及纤维脂肪瘤、反应性淋巴增生、黑变病、非典型性增生、皮脂腺瘤.恶性结膜肿瘤158例(21.7%),其构成位于前5位的分别是:鳞状细胞癌(含黏液表皮样癌)、恶性淋巴瘤、恶性黑色素瘤、浆细胞瘤、原位癌.对结膜鳞状细胞性肿物及黑色素性病变的临床、病理特征及鉴别诊断进行了总结分析.结论 结膜肿瘤临床及病理分类繁多,对病变进行临床及病理分析有助于正确的诊断及治疗.     

眼结膜乳头状瘤一例

1　病例介绍　　患者 ,男 5 8岁 ,因右眼内眦部乳头状赘生物 10天 ,于2 0 0 2年 6月就诊眼科。患者 10天前右眼不明原因出现痒、干涩 ,伴异物感 ,并见内眦部有一粉红色赘生物 ,且逐渐增大。全身体检 :口腔内右颊侧粘膜及舌腹可见多个溃疡 ,余组织未见异常。眼部检查 :双眼视力 1 0 ,右眼下睑内眦部结膜面可见一粉红色带蒂乳头状瘤体 ,质软 ,直径约 4mm ,遮挡泪小点 ,余未见异常。初步诊断 :右眼下睑结膜乳头状瘤 (conjunctivapapilloma ,CP)。采用超脉冲二氧化碳激光行瘤体切除术 ,切除范围大于瘤体根部 ,并局部冷冻 ,术后滴宁眼液治疗。病…     

结膜恶性淋巴瘤2例

例1，男，12岁。于1981年4月入院。双眼痒异物感3月就医，无发热等其他病史，曾在外院行活俭诊为恶性淋巴＄。检查：血压12／8kPa，心肺听诊无异常．肝脾未触及，左颈部及腋下皆可触及数个绿豆大小淋巴结，质硬，可活动。服部检查：双眼内眦部结膜充血、增厚，结膜下楼红包浸润     

435例原发性眶内肿瘤的病理类型

本文分析435例眼眶内原发性肿瘤的病理类型.共分8种组织类型:囊性病变83例(19.1%);血管性病变64例(14.7%);间叶组织肿瘤50例(11.5%);泪腺上皮性病变73例(16.8%);神经组织性肿瘤54例(12.4%);淋巴细胞性病变55例(12.6%);组织细胞性病变16例(3.7%);特发性眶内假瘤40例(9.2%).并讨论眶内常见肿瘤的临床病理特点.眼科学报 1993;9:66-69.     

人眼结膜吸吮线虫病一例

结膜吸吮线虫病是人畜共患的一种眼寄生虫病，最近我院门诊诊治了一位患者。现报告如下：     

角结膜缘上皮性肿瘤DNA含量测定对于病理诊断的意义

应用真彩色图象分析法，采用定量病理技术，测定了５２例角膜结膜上皮性新生物（上皮良性增生，上皮非典型性增生，原位癌和鳞状细胞癌）细胞核内的ＤＮＡ含量，发现，上皮良性增生病变中，二倍体～四倍体（２Ｃ－４Ｃ）细胞占８８．５９％，≥五倍体（≥５Ｃ）细胞仅占１１．４１％，上皮非典型性增生中，２Ｃ－４Ｃ细胞占５８．６２％，≥５Ｃ细胞占４１．３８，原位癌、鳞状细胞癌中，２Ｃ－４Ｃ细胞分别为２１．１１％和２１．６     

Treatment of Conjunctival Lymphomas

Due to their indolent nature, conjunctival lymphomas have different treatment options compared to other adnexal lymphomas. Therapeutic options directed towards conjunctival lymphomas include radiotherapy (external beam radiation), brachytherapy, cryotherapy, intralesional interferon injections, systemic rituximab, and observation. Radiotherapy that has been demonstrated to be highly effective for both low and high-grade tumors, however, can be associated with a high percentage of short-term side effects and long-term complications. Brachytherapy can provide local tumor control, but can also cause many complications. Cryotherapy may be used for certain tumor locations, but has a high recurrence rate. Both interferon and rituximab show promising results for treating low-grade tumors while avoiding the complications associated with radiotherapy. Finally, reports of spontaneous regression of low-grade conjunctival lymphomas have led some investigators to advocate a course of careful observation following biopsy.     

Conjunctival involvement with mycosis fungoides in a patient receiving PUVA therapy

A 40-year-old woman had documented mycosis fungoides of the skin. Over a period of five years, she had undergone intermittent treatment with psoralen long-wave ultraviolet light (PUVA) therapy. Despite regression of the skin lesions, tumor plaques developed in her eyelid and conjunctiva within the area shielded by dark glasses. Light and electron microscopic examination of a biopsy from the conjunctival plaque confirmed that the lesion was a deposit of mycosis fungoides. Local radiotherapy resulted in complete regression of these ocular lesions. The conjunctiva may well be an iatrogenic "sanctuary site" when this disease is treated with PUVA therapy.     

结膜肿物72例临床分析

目的:探讨结膜肿物的临床、病理学分类及治疗方法。方法:回顾性分析72例结膜肿物患者年龄分布、病理分类、治疗及外观等情况。结果:结膜恶性肿瘤中居前两位者为结膜黑色素瘤、淋巴瘤,良性肿瘤中居前两位者为乳头状瘤和皮样瘤。72例全部手术切除,其中恶性的辅以放、化疗。结论:对结膜肿物进行分析有利于指导临床诊断及其治疗。     

结膜固定术治疗结膜松弛症的疗效评价

目的 评价结膜巩膜缝线固定术与下穹窿结膜固定术治疗结膜松弛症的疗效.方法 对24例双眼结膜松弛症患者,双眼交替行下穹窿结膜固定术、结膜巩膜缝线固定术进行治疗.术后随访观察并进行填表式自觉症状主观评估;裂隙灯形态学、泪河宽度测量、泪膜破裂时间、基础泪液分泌试验、眼表荧光素染色、第一荧光素染色客观评价.结果 术后随访1月下穹窿结膜固定术有效率91.7%,结膜巩膜缝线固定术有效率41.7%.两组间有效率P<0.01,差异有统计学意义.术后随访6月下穹窿结膜固定术有效率为79.2%,结膜巩膜缝线固定术有效率为75.0%.两组间有效率P>0.05,差异无统计学意义.结论 下穹窿结膜固定术术后刺激症状轻,操作简单、安全,为治疗结膜松弛症的一种好手术方法.     

Conjunctival Biopsy as an Aid in the Evaluation of the Patient with Suspected Sarcoidosis

Conjunctival biopsy is an underused but simple technique in the evaluation of the patient with sarcoidosis and occasionally other systemic diseases. In 55% of patients with biopsy-proven sarcoidosis from other sites, a blind conjunctival biopsy was positive. Bilateral conjunctival biopsies and the examination of multiple sections of each biopsy were essential to obtain this high of a yield. There was no relationship between an anterior uveitis and a positive conjunctival biopsy.     

Conjunctival Cysts of the Orbit Following Enucleation

Four patients developed orbital conjunctival cysts following enucleation. The cysts were demonstrated by ultrasonography and computerized tomography and confirmed by histopathology. They were lined by a non-keratinizing stratified squamous epithelium without goblet cells and contained fluid with mucinous strands. They were excised at eight, seven, seven, and 25 years post-enucleation, respectively, the latter being the longest interval yet recorded. A simple classification of conjunctival cysts of the orbit is proposed and the mechanisms of the development of cysts in anophthalmic sockets are discussed. The effects of secretory rate and cyst growth are reviewed and surgical management in prevention and treatment of these lesions is outlined.     

Melanocytic Tumors of Interest to the Ophthalmologist

The principal malignant melanocytic tumors of interest to ophthalmologists are those originating in the skin of the lids, the conjunctiva, and the uveal tract. Metastasis rarely, if ever, develops from melanocytomas of the optic nerve head, tumors of the pigmented epithelia, or primary melanomas of the orbit. Malignant melanomas of the lids and conjunctiva have many more features in common with those of the skin than with the more prevalent uveal melanomas. The most important of these are the tendency to metastasize via lymphatic channels to the regional lymph nodes and the frequent occurrence of metastatic disease at the time of initial presentation. In general, melanomas of all tissues carry a worse prognosis when they are large and/or thick, they exhibit deep invasion, they are of the epithelioid cell type, mitotic activity is marked, metastatic disease is evident, and the patient is older. Histogenetic classification of uveal melanomas has not been shown to be a useful guide to prognosis of patients with such lesions.     

原发性眼睑肿瘤291例临床病理分析

目的:了解原发性眼睑肿瘤的组织病理学特征及发病率。方法:收集第三军医大学附属西南眼科医院2003-01/2009-12门诊及住院治疗的291例原发性眼睑肿瘤患者的临床病理资料进行回顾性分析。结果:良性眼睑肿瘤172例(59.1%),其构成位于前10位的依次为:乳头状瘤、色素痣、炎性肉芽肿、皮样囊肿或表皮样囊肿、淀粉样变性、疣、血管瘤、黄色瘤、浆细胞肉芽肿、毛发上皮瘤。恶性眼睑肿瘤119例(40.9%),其构成位于前5位的肿瘤依次为:基底细胞癌、鳞状细胞癌(含梭形细胞癌)、皮脂腺癌、恶性淋巴瘤、恶性黑色素瘤。对眼睑三大恶性肿瘤的临床流行病学资料进行了总结分析,讨论了眼睑肿瘤切除术后的眼睑修复方法。结论:眼睑肿瘤临床病理分类繁多,对病变进行临床病理分析有助于正确的诊断及治疗。     

结膜囊成形术矫治无眼球性结膜囊狭窄

目的 评价几种结膜囊成形手术的疗效。方法 各种原因引起的结膜囊狭窄及闭锁87例分别用羊膜、皮肤、自体结膜岛状移植做结膜囊成形术行回顾性研究。结果 随访6-52月,无继发感染,75例治愈,能放置正常大小义眼片,外观满意,9例好转,能放置较小眼片,3例无效,重新手术。结论 对Ⅰ°、Ⅱ°结膜囊狭窄结膜缺损可用羊膜移植或自体结膜岛状移植,对Ⅲ°和结膜囊闭锁可用游离皮片移植,埋线法穹隆加深术能抵抗术后结膜囊收缩,眼座植入与结膜囊成形术可同期进行。     

108例干眼症之结膜囊细菌菌落

连续选取我院角膜病门诊１０８例（２１６只眼）确诊为干眼症患者、２１６例（４３２只眼）正常人分别结膜囊细菌培养，结果说明结膜囊作细菌培养阳性率干眼症患者明显高于正常人（Ｐ〈０．００１），且以致病力较强的绿脓力及金黄色葡萄球菌最多。建议干眼症患者除了给予人工泪液外还应给予预防性抗生素治疗。