巩膜环扎术后超声乳化白内障吸除人工晶状体植入术的疗效观察

目的　探讨视网膜脱离巩膜环扎术后超声乳化白内障吸除人工晶状体植入术的疗效和并发症。方法　对 33例 ( 33只眼 )视网膜脱离巩膜环扎术后患者行超声乳化白内障吸除人工晶状体植入术 ,观察手术前、后视力的变化情况和手术并发症的发生情况。结果　 2 8只眼 ( 84 8% )术后最佳矫正视力≥ 0 1,其中 12只眼 ( 36 4% )≥ 0 4,与术前比较差异有非常显著性意义 (P <0 0 1)。 2只眼发生后发性白内障行激光晶状体后囊膜切开术。平均随访时间 ( 1 9± 1 0 )年 ,未发现视网膜再脱离者。结论　视网膜脱离巩膜环扎术后行超声乳化白内障吸除人工晶状体植入术 ,可使患者恢复较好的视功能 ,手术并发症少 ,视网膜脱离的复发率低 ,具有较高的安全性。     

巩膜环扎术后白内障摘除人工晶状体植入术

目的探讨视网膜脱离行巩膜环扎术后白内障摘除联合人工晶状体植入术的效果和并发症。方法对30例（30只眼）视网膜脱离行巩膜环扎术后的白内障进行白内障囊外摘除或超声乳化吸除联合人工晶状体植入术,观察术后最佳矫正视力及并发症。结果巩膜环扎术至白内障手术的平均时间间隔为（41.7±6.99）个月。白内障术后平均随防（17.07±2.53）个月,30只眼中20只眼（66.67％）的最佳矫正视力≥0.5,仅1只眼于术后3个月复发视网膜脱离。结论视网膜脱离行巩膜环扎术后,再施行白内障囊外摘除或超声乳化吸除联合人工晶状体植入术是安全的,大多数眼可获得较好的视力效果,很少引起视网膜脱离复发。     

白内障超声乳化联合巩膜扣带术治疗白内障合并孔源性视网膜脱离

目的:观察白内障超声乳化、人工晶状体植入联合巩膜扣带术治疗白内障合并有视网膜脱离的疗效。方法:对7例视网膜脱离1wk内合并有白内障患者采用白内障超声乳化、人工晶状体植入联合巩膜扣带术,观察视网膜平复情况及术后3mo矫正视力。结果:7例患者视网膜平复,术后3mo矫正视力均显著提高。结论:对部分白内障合并视网膜脱离患者采用白内障超声乳化、人工晶状体植入联合巩膜扣带术,既解除了白内障对视网膜脱离手术的妨碍,又顺利完成了视网膜脱离复位手术,术后视力显著提高。     

视网膜脱离巩膜外垫压术后白内障超声乳化人工晶状体植入术的疗效

目的 评价视网膜脱离巩膜外垫压术后施行白内障超声乳化和人工晶状体植入术的术中、术后并发症和最佳矫正视力结果。方法 回顾性观察1997年11月～2002年11月施行视网膜巩膜垫压术后施行白内障超声乳化和人工晶状体植入术的患者。记录术前、术后的最佳矫正视力，术中、术后并发症。并对其临床特点进行分析和讨论。结果 48例49眼。从视网膜脱离手术到超声乳化手术之间的时间为6月～43年，平均13．5年；超声乳化手术平均随访24．6个月。术后最佳矫正视力≥0．1者43眼(87．76％)，≥1．0者25眼(51．02％)。6眼矫正视力低于0．1的患者中，5眼黄斑区有增殖条索改变，1眼存在视网膜前膜。3眼发生后发性白内障行激光晶状体后囊膜切开术。随访期内未发现视网膜再脱离者。结论 视网膜脱离巩膜外垫压术后行白内障超声乳化联合人工晶状体植入术，可使大部分患者恢复较好的视功能，手术并发症少，无视网膜脱离再复发，具有较高安全性。     

白内障超声乳化吸除人工晶状体植人联合巩膜扣带术治疗孔源性视网膜脱离疗效观察

目的评价自内障超声乳化吸除与巩膜扣带联合手术视网膜复位后即刻植入人工晶状体治疗白内障合并孔源性视网膜脱离的疗效和可行性。方法对13例（13只眼）白内障合并视网膜脱离的病例,采用超声乳化白内障吸除联合间接眼底镜直视下巩膜外冷凝裂孔联合巩膜扣带术,并根据情况进行环扎、放液,术后3d内即刻植入人工晶状体。结果全部13只眼均一次性成功去除白内障,其中12只眼脱离的视网膜复位后植入人工晶状体视力短期内提高,并发症少。结论自内障超声乳化吸除与巩膜扣带联合术后即刻植入人工晶状体是治疗自内障合并孔源性视网膜脱离的理想手术方法。     

高度近视白内障超声乳化人工晶状体植入术27例

目的:探讨高度近视眼合并白内障行超声乳化白内障吸除人工晶状体植入术治疗的临床疗效。方法:27例(37眼)因白内障合并高度近视行超声乳化白内障吸除+人工晶状体植入术。记录术前眼轴长度和术后视力,屈光度数,观察手术并发症术后眼部情况。术后随访时间为6～24mo。结果:术前平均眼轴长度为28.3mm。术后最佳矫正视力≥0.2共35眼(95%),≥0.5者共33眼(89%)。术中无后囊膜破裂;术后角膜水肿2眼,术后一过性高眼压1眼,后发性白内障2眼;术后发现黄斑变性和眼底出血共4例,无视网膜和脉络膜脱离者。结论:超声乳化白内障吸除低度数折叠式人工晶状体植入术是治疗白内障合并高度近视眼安全、有效的方法。     

屈光度大于-12.00D透明晶状体超声乳化术的临床研究

目的:探讨屈光度大于-12.00D透明晶状体超声乳化吸除联合人工晶状体植入术治疗高度近视的有效性和安全性。方法:对78例(100眼)高度近视患者行巩膜隧道切口超声乳化透明晶状体吸除联合人工晶状体植入术。平均年龄39.2岁,术前矫正视力0.12～0.6,平均近视度数(-14.41±4.33)D。结果:术后所有患者裸眼视力均有提高;82眼(82.0%)裸眼视力≥0.5;96眼(96.0%)矫正视力≥0.5。术后屈光度数为-0.60～-3.48D,平均散光度数(0.58±0.92)D。术后平均随访时间19.5mo。术后发生晶状体后囊膜混浊14眼(14.0%),未见视网膜裂孔、视网膜脱离及黄斑囊样水肿。结论:超声乳化吸除屈光度大于-12.00D透明晶状体联合人工晶状体植入术,术后视力好、并发症少,是矫治高度近视安全、有效的方法,但是手术者及患者的选择应当是有条件的。     

白内障超声乳化折叠人工晶状体植入250例临床分析

目的:观察超声乳化白内障吸除折叠人工晶状体植入术的临床疗效及并发症。方法:对250例(254眼)进行超声乳化晶状体吸除一期折叠人工晶状体植入术。结果:术后1wk;1,3mo裸眼或矫正视力≥0.5者分别为82.4%、84.6%、89.2%。结论:超声乳化白内障吸除折叠人工晶状体植入术疗效满意、安全、快捷。手术成功关键取决于术者技术熟练程度。     

青光眼术后白内障小瞳孔下超声乳化术的临床研究

目的：探讨青光眼术后白内障在小瞳孔下超声乳化联合人工晶状体植入术的临床疗效及手术技巧。
　　方法：采用超声乳化白内障摘出联合人工晶状体植入术治疗小瞳孔青光眼术后白内障36例36眼,均采用透明角膜切口植入折叠人工晶状体,观察比较手术前后视力、眼压滤过泡及并发症情况,术后随访3 mo。
　　结果：术前裸眼视力或最佳矫正视力均≤0.3,术后1wk最佳矫正视力≥0.3者23眼(63.89%),术后3mo随访视力≥0.3者34眼(94.44%),视力<0.3者2眼(5.56%),其中1眼为青光眼术后视神经萎缩,1眼合并糖尿病视网膜病变;眼压控制正常,滤过泡完整,未见严重并发症。
　　结论：青光眼术后白内障在小瞳孔下行白内障超声乳化联合人工晶状体植入术手术复杂,手术技巧合理应用仍能取得较好临床效果,影响视力的主要因素是原先存在的视网膜视神经病变。     

超声乳化透明晶状体摘除联合人工晶状体植入治疗高度近视的临床疗效

目的:探讨超声乳化透明晶状体摘除联合人工晶状体植入治疗高度近视的临床疗效。方法:对30例49眼高度近视眼患者,经透明角膜切口行超声乳化透明晶状体吸除联合后房型折叠人工晶状体植入术,对比患眼手术前后视力,观察术后并发症,术后随访6～12(平均8.5)mo。结果:术后49眼矫正视力均超过术前最佳矫正视力,其中术后裸眼视力≥0.5者28眼(57%),术后最佳矫正视力≥0.5者41眼(84%);术后发生后囊混浊5眼(10%),均行YAG激光治疗;1例发生视网膜脱离(2%)。随访期内未发现黄斑囊样水肿、眼底出血、青光眼、人工晶状体偏位等并发症。结论:超声乳化透明晶状体摘除联合折叠式人工晶状体植入术,作为一种屈光手术治疗高度近视是安全有效的方法。     

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.