染色羊膜及其在眼外科移植手术中的应用

目的 我们用4种活体染料染色羊膜,观察染色情况并评价其染色性质.方法 新鲜羊膜、脱细胞羊膜分别用不同浓度的荧光素钠(10.0 g·L-1、2.5 g·L-1、1.0 g·L-1)、虎红(5 g·L-1、1 g·L-1)、丽丝胺绿(5 g·L-1、1 g·L-1)、台盼蓝(5g·L-1、1 g·L-1)进行染色,用10倍光学显微镜观察并记录染色情况;然后用2.5 mL平衡盐溶液洗脱,每隔30 min换一次洗脱液并记录洗脱情况.连续洗脱4 h;最后再用2.5 mL平衡盐溶液浸泡洗脱24 h,并记录结果.结果 4种染料均染色羊膜,新鲜羊膜和脱细胞羊膜染色和脱色效果差别不大.经过洗脱120 min后,1.0 g·L-1荧光素钠、5 g·L-1和1 g·L-1的丽丝胺绿染色褪去,2.5 g·L-1荧光素钠洗脱180 min染色基本褪去,5 g·L-1丽丝胺绿洗脱24 h后染色基本褪去,5 g·L-1和1 g·L-1虎红、台盼蓝染色洗脱24 h后,染色仍未褪去.结论 所用4种染料均可染色新鲜羊膜、脱细胞羊膜,荧光素钠、丽丝胺绿染色、脱色效果优于其他染料.染色羊膜简单、有效,有助于眼科医师在羊膜移植手术中适当地处理羊膜.     

活体染色在眼表疾病的临床应用

活体染料如荧光素钠、虎红、丽丝胺绿是眼表疾病临床诊断的重要工具,目前已广泛用于眼表疾病的诊断、评估疾病的严重性及治愈情况等.每种染料具有独特的化学结构和性质,了解这些活体染料的功能和用途对眼科临床十分必要的、.本文对活体染料的历史及其在眼表疾病的应用近况进行概述.     

眼睑刷上皮病变与干眼相关的研究进展

眼睑刷上皮病变(LWE)指睑缘皮肤黏膜交界处区域之后的边缘处睑结膜出现相应的病理改变,在使用荧光素钠或丽丝胺绿等染色剂后出现染色。目前研究认为LWE形成主要是由于眼睑刷区域与眼面之间的摩擦增加所致,但具体机制尚不明确。LWE常见病因包括配戴角膜接触镜、泪膜异常、瞬目异常、炎症。临床研究发现,LWE可在常规干眼指标阴性时出现,所以LWE的诊断对干眼的早诊早治具有重要作用。然而,临床上关于LWE与干眼等指标相关的研究较少,本文结合国内外现有研究,对LWE的病因、发病机制、临床表现及治疗进行介绍,并总结LWE与干眼相关的研究进展,以期为深入研究LWE的病因及LWE在临床的应用提供参考。     

白内障超声乳化手术对眼表的影响

目的 探讨超声乳化白内障吸除术对眼表的影响。方法 对68例80眼行超声乳化白内障吸除合并人工晶状体植入术的患者，观察术前、术后1天、1周、1个月、3个月、6个月的干眼症状（干涩感、异物感、烧灼感），泪膜破裂时间（BUT）、基础泪液分泌试验（Schinner’Ⅰ试验）、角膜荧光素染色及眼表虎红染色，并对数据进行统计学分析。结果 白内障超声乳化术后1周内患者有明显的干眼症状，术后1天和1周虎红染色和荧光素试验较术前明显增多（P〈0．05）；而且泪液分泌量术后1周较术前明显减少（P〈0．05）；术后（1～6）个月接近术前水平（P〉0．05）。术后1天、1周和1个且BUT均较术前明显缩短（P〈0．05）；3～6个月后接近术前水平（P〉0．05）。结论 超声乳化白内障吸除术对眼表具有一定程度的影响，发生机制与多种因素有关；临床应积极采取预防措施。     

荧光素钠与吲哚菁绿混合应用对血压脉搏的影响

为了眼底荧光血管造影、吲哚菁绿血管造影（ＦＦＡ．ＩＣＧＡ）同步激光扫描的需要,我们观察了国产荧光素钠与吲哚菁绿造影剂混合应用对血压、脉搏的影响。方法：对１００例需要做ＦＦＡ与ＩＣＧＡ同时检查的眼底病患者,并分两个年龄组：老龄组（５９～７６岁）,中低龄组（１８～５８岁）。所有患者给予两种血管造影剂混合后注射,在不同时间（注射前与注射后即刻,注射后１０分钟、３０分钟）进行了血压和脉搏的比较。结果：经统计学处理,１００例患者中及两个不同年龄组注射后即刻的收缩压、舒张压（老龄组除外）均比注射前升高（Ｐ＜０．０１）,老龄组舒张压差异无显著性（Ｐ＞０．０５）。脉搏均比注射前减慢（Ｐ＜０．０１）。注射后１０分钟、３０分钟的收缩压、舒张压与注射前相比差异不显著（Ｐ＞０．０５）,而脉搏减慢仍有显著差异（Ｐ＜０．０５）,但仍在正常生理范围。结论：两种造影剂混合应用,对血压的影响只是一过性升高,很快可以恢复。对老年人的舒张压影响不大。脉搏较注射前减慢,持续时间较长,但在正常范围。所以,两种国产造影剂混合使用是安全的     

翼状胬肉切除联合角膜干细胞移植术后配戴绷带镜的效果评价

目的：评价翼状胬肉切除联合角膜干细胞移植术后配戴绷带镜的临床效果。

方法：本研究为前瞻性分析,选择2015-08/2018-02入我院行翼状胬肉切除联合角膜干细胞移植术患者110例110眼,随机数字表法将其分为对照组和观察组各55例55眼,对照组术后常规观察,观察组术后配戴绷带镜; 采用视觉模拟评分(VAS)比较术后1、3d,1wk的疼痛情况,采用荧光素钠染色法(FL)评估角膜上皮愈合情况及并发症发生率。

结果：观察组术后1、3d,1wk VAS评分和角膜上皮愈合评分均明显低于对照组,差异均有统计学意义(P<0.05)。两组并发症发生率比较,差异无统计学意义(P>0.05)。

结论：翼状胬肉切除联合角膜干细胞移植术后配戴绷带镜有较好的应用安全性和有效性,可减轻胬肉手术后疼痛,促进上皮愈合。     

白内障摘出联合睫状体光凝或小梁切除术治疗原发性闭角型青光眼效果及对眼表的影响

目的 比较晶状体超声乳化术联合睫状体光凝术(CPC)或晶状体超声乳化术联合小梁切除术(CPT)治疗原发性闭角型青光眼(PACG)的效果及对眼表的影响.方法 纳入合并白内障行手术治疗的PACG患者101例(101眼),并根据接受手术方式的不同分为两组:CPC组患者接受CPC,共46例(46眼);CPT组接受CPT,共55...     

Non-fluorescent dye staining of primate blue cones

The intravitreal injection in macaque retina of the fluorescent dye Procion yellow can selectively label a specific cone population whose eccentricity distribution and angular separation are consistent with those of the blue-sensitive cones of human and non-human primate retinas. Because at the concentrations used the dye is poorly visible in conventional light microscopy, fluorescence microscopy is required for the observation of the stained cones. In this paper we describe several alternative methods for the staining of blue cones in primate retina, staining that can be visualized in conventional light microscopy and, with some methods, electron microscopy.     

Clinical staining of the ocular surface: Mechanisms and interpretations

In this article we review the mechanism of ocular surface staining. Water-soluble dyes are excluded from the normal epithelium by tight junctions, the plasma membranes and the surface glycocalyx. Shed cells can take up dye. A proportion of normal corneas show sparse, scattered time-dependent, punctate fluorescein uptake, which, we hypothesise, is due to a graded loss of the glycocalyx barrier, permitting transcellular entry into pre-shed cells. In pathological staining, there is little evidence of ‘micropooling’ at sites of shedding and the term ‘punctate erosion’ may be a misnomer. It is more likely that the initial event involves transcellular dye entry and, in addition, diffusion across defective tight junctions. Different dye-staining characteristics probably reflect differences in molecular size and other physical properties of each dye, coupled with differences in visibility under the conditions of illumination used. This is most relevant to the rapid epithelial spread of fluorescein from sites of punctate staining, compared to the apparent confinement of dyes to staining cells with dyes such as lissamine green and rose bengal. We assume that fluorescein, with its lower molecular weight, spreads initially by a paracellular route and then by transcellular diffusion. Solution-Induced Corneal Staining (SICS), related to the use of certain contact lens care solutions, may have a different basis, involving the non-pathological uptake of cationic preservatives, such as biguanides, into epithelial membranes and secondary binding of the fluorescein anion. It is transient and may not imply corneal toxicity. Understanding the mechanism of staining is relevant to the standardisation of grading, to monitoring disease and to the conduct of clinical trials.     

Application of Prussian blue staining in the diagnosis of ocular siderosis

AIM:To explore the value of Prussian blue staining in the diagnosis of ocular siderosis.METHODS: Between January 2012 and January 2013, the Prussian blue stain used in anterior lens capsule and vitreous liquid after centrifugation from patients with definitive diagnosis and suspicious diagnosed of ocular siderosis. At the same time, give a negative control.RESULTS: Anterior lens capsule membrane and liquid of vitreous cavity from patients with definitive diagnosis and suspicious diagnosed of ocular siderosis revealed ferric ions that stained positively with Prussian blue. In the control group, there is no positive reaction.CONCLUSION: Prussian blue staining in the diagnosis of ocular siderosis has a very significant worth, suspected cases can be definitive diagnosed.     

Quantitative rose bengal staining technique for external ocular diseases

A new technique for quantitative assessment of rose bengal staining in ocular surface disorders is described. The globe is divided into 16 quadrants which represent clinically important regions of the eye. Each quadrant is graded numerically for intensity and area of rose bengal staining. This simple grading system facilitates mathematical study and computer analysis of ocular surface disease.     

Optimizing evaluation of Lissamine Green parameters for ocular surface staining

Purpose

The recently published seminal dry eye workshop proceedings defined Lissamine Green (LG), an organic dye, as a gold standard for demonstrating ocular surface staining. The purpose of the current study was to determine the optimal parameters of 1% LG instillation for the ocular surface examination in dry eye patients.

Design

Prospective and observational quality improvement study.

Methods

A quality improvement study evaluated 16 eyes from eight dry eye patients with different levels of severity. LG (1%), in three volumes (5, 10, and 20 μl) was instilled into the conjunctival cul-de-sac, and four masked observers with different levels of clinical expertise examined the patients with and without red filter. The staining pattern of the conjunctiva and cornea was documented with the Oxford scale within 4 min of LG instillation. Optimal volume and inter-observer reliability were assessed.

Results

All dye volumes were tolerated well by all patients. Experienced observers preferred 10 μl volume because of the ease of examination and accuracy. Although instillation of 20 μl yielded similar scores as 10 μl, it resulted in overflow of the lid and facial skin staining. The use of red filter significantly improved reading scores (P<0.01). Inter-observer reliability was higher for conjunctival scores than for corneal scores for all patients. The highest reliability was demonstrated with 10 μl volume and increased with greater experience of the observer.

Conclusions

Ocular surface examination with instillation of 10 μl 1% LG has good inter-observer reliability and is well tolerated. Observation through a red filter facilitates the examination.     

A potential method for local drug and dye delivery in the ocular vasculature

We propose a new drug and dye delivery system that would allow repeated release of substances in the ocular vasculature by an externally controlled mechanism. The substances are encapsulated in heat-sensitive liposomes, which are lysed by locally applying a heat pulse produced by an argon laser. The system was tested by investigating the release of carboxyfluorescein encapsulated in the liposomes. The liposome suspension was incubated at 37 degrees or 38.5 degrees C and irradiated at different powers and pulse durations. The amount of dye released was monitored by fluorophotometry and compared with the concentration obtained when the liposomes were lysed at their transition temperature of 41 degrees C. The results showed that 85% of the encapsulated substance can be released. Moreover, a dramatic contrast was observed between the fluorescence before and after the lysis. Presently the energy density is higher than but close to the maximal permissible exposure for humans. The release mechanism with the short laser pulse appeared to be similar to that present when liposomes were heated slowly.