正常眼压老年人眼前段超声生物显微镜的研究

目的对比窄前房角和宽前房角老年人眼前段结构的形态特征。方法选取59-73岁正常眼压老年人41名(62眼)作为观察对象。根据房角镜检查分为窄房角组(32只眼)和宽房角组(30只眼),分别用A超及超声生物显微镜(UBM)检测前房深度、晶体厚度、眼轴长度、晶体相对位置测量,睫状体厚度、房角开放距离、小梁虹膜角、虹膜厚度、虹膜晶体接触距离,并且对比点1%匹罗卡品滴眼液前后眼前段结构的变化。结果与宽角眼相比,窄角眼前房浅、晶体厚度较大、相对晶体位置前移、睫状体薄、小梁虹膜角窄,房角开放距离小、虹膜厚度小、虹膜晶体接触距离较大;睫状体厚度与晶体厚度呈负相关(r1=-0.53,p<0.01;r2=-0.40,p<0.05),与前房深度成正相关(r1=-0.83,p<0.01;r2=-0.79,p<0.01);窄角眼点匹罗卡品后使小梁虹膜角增加,房角开放距离增加,睫状体厚度增加,虹膜晶体接触距离增加,虹膜厚度变小,前房深度减小。宽角眼点匹罗卡品后小梁虹膜角减小,前房深度减小,房角开放距离减小,虹膜厚度变小,睫状体厚度增加,虹膜晶体接触距离增加。点1%匹罗卡品滴眼液前后,两组的前房深度差值、小梁虹膜角差值、房角开放距离差值均有显著性差异(p<0.01),睫状体厚度差值、平均虹膜厚度差值、以及虹膜晶体接触距离差值均无显著性差异(p>0.05)。结论老年人窄前房角的眼前段结构预示,他们可能是发生闭角青光眼的高危人群。     

匹罗卡品对兔眼葡萄膜巩膜途径作用的形态学研究

目的：从形态学方面探讨匹罗卡品对兔眼葡萄膜巩膜途径的作用。方法：通过前房内注入微量示踪剂异硫氰酸荧光素牛血清白蛋白（Fluorescein isothiiocyanate-bovine serum albumin,FITC-BSA),匹罗卡品点眼后2,4,6,8,10和12h各处死家兔2只,摘除眼球作冰冻切片,于荧光显微镜下观察并确定睫状体、脉张膜上腔、前、后巩膜和脉络膜的荧光强度等级,并于光镜下观察其组织结构改变。结果：匹罗卡品点眼后眼压下降,点眼后睫状体、脉络膜上腔和前巩膜荧光强度均显著减弱,后巩膜、脉络膜无明显变化。光镜观察见睫状肌细胞间隙缩小。结论：匹罗卡品通过收缩睫状肌而减少房水从葡萄膜巩膜途径排出。     

1%匹罗卡品眼液对LASIK术后早期远视现象的治疗分析

准分子激光角膜原位磨镶术治疗近视由于其安全、快捷、有效及手术设计的相对合理 ,被认为是眼科屈光手术最有前途的手术之一。本门诊在近 1年半的时间内完成的近 15 0 0例的L ASIK手术患者中绝大多数均在短期内就可以恢复到较理想的视力 ,但也有极少部分患者在早期内存在较明显的远视现象 ,尤其是近距离的工作很难完成 ,严重影响了他们的正常工作和学习。如何才能使他们尽快地恢复远近视力 ,笔者曾翻阅了大量的国内期刊杂志 ,发现对此现象还未曾有专门的治疗报道。我们在尝试使用 1%匹罗卡品眼液滴眼治疗后 ,发现治疗结果非常满意。现报告…     

匹罗卡品对近视眼瞳孔中心位置的影响

目的：探讨缩瞳剂对瞳孔中心位置的影响及其在PRK和LASIK术中与激光切削中心偏移的关系。方法：对46例（92眼）拟行PRK和LASIK手术的近视眼患以1％及2％硝酸匹卡品眼液点眼,在解膜地形图上自动测量缩瞳前后的角膜直径,瞳孔中心偏离角膜光学中心的方向和距离。结果：自然状态成年近视眼瞳孔直径为：水平径3．86（0．93mm,垂直径3．96（02mm,73.91%的瞳孔中心位于角膜光学中心的鼻上方,平均偏离0．22（0．10mm,1％或2％硝酸匹罗卡品眼液缩瞳后,瞳孔中心平均偏离0．16（0．05mm和0．20（0．10mm。瞳孔中心的象限分布比例与缩瞳前无明显差异。结论：缩瞳使瞳孔中心相对于角膜光学中心的偏离减少,有利于减少PRK和LASIK术中激光切削中心大多向鼻上方的偏移。缩瞳的实际意义在于便于手术中心的定位。     

超声生物显微镜有眼前段钝挫伤中初步应用

为探讨超声生物显微镜在眼前段钝挫伤中的应用价值。对７只眼前段钝挫伤眼进行上有科常规检查，传统眼科Ｂ超少超声生物显微镜检查。结果显示超声生物显微镜显示房角后退、虹膜根部离断、睫状体分离、晶体悬韧带断裂不全脱位和玻璃体疝，并能显示出传统Ｂ超所不能显示的睫状体和脉络膜浅脱离。表明超声生物显微镜在眼前段外伤中有极好的应用价值。尤其在屈光介质混浊（角膜混浊、前房积血），睫状体分离低眼压和隐藏在虹膜后的病变时     

闭角型青光眼局部使用匹罗卡品对球结膜组织的影响

目的 观察闭角型青光眼术前滴用1%匹罗卡品不同时间对球结膜组织的影响。方法 使用光学显微镜和透射电镜对88例施行小梁切除术的原发性闭角型青光眼患者的球结膜活检组织进行病理学检查和细胞定量分析。根据患者术前曾局部用药的不同时间分为1年以内（I组，40例）、1～3年（Ⅱ组，23例）和3年以上（Ⅱ组，23例）和3年以上（Ⅲ组，25例）共3组。结果I组对球结膜组织无明显影响；Ⅱ组显示球结膜下纤维母细胞和炎性细胞的数量轻度增多和淋巴细胞活化；Ⅲ组显示球结膜下纤维母细胞和炎性细胞数目明显增多，有些病例显示球结膜上皮增生，球结膜下纤维化或亚临床性炎症改变。结论 长期滴用1%匹罗卡品可对球结膜组织产生不同程度炎性反应和纤维增生，尤其用药3年以上组最明显。     

4%匹罗卡品—体位试验对闭角性青光眼的诊断价值

原发性闭角性青光眼(PACG),具有浅前房、窄房角、虹膜膨隆、晶体相对大、位置靠前、眼轴较短的解剖特点,但具有这种特点的眼,PACG的发生率究竟多高,什么时候发病,至今还不能作出确切的回答,也不能依据解剖特点,进行治疗和预防。即使一眼已确诊为(PACG)时,其对侧眼是否千篇一律的作预防性虹膜切除术,意见也不完全一致。有的作者     

小梁切除术中应用匹罗卡品的临床观察

目的：观察小梁切除术中应用匹罗卡品的临床效果。方法：观察组（I组）72例80眼小梁切除术术中前房内注射低浓度匹罗卡品；对照组（Ⅱ组）90例104例未应用匹罗卡品，比较两组间虹膜根部切口大小适中率及瞳孔正圆率的差异。结果：I组虹膜根部切口大小适中率为96．25％，Ⅱ组为87．50％，I组瞳孔正圆率为93．75％，Ⅱ组为79．81％，两组间差异具有非常显著性（P＜0．01）。结论：小梁切除术中应用匹罗卡品缩瞳，可准确地控制虹膜根部切口的大小和位置,提高手术的质量。     

闭角型青光眼术前滴用匹罗卡品对小梁切除术结果的影响

目的 探讨闭角型青光眼术前长期滴用1％匹罗卡品与小梁切除术效果的关系。方法 随机选择88例原发性闭角型青光眼病例，按局部滴用1％匹罗卡品滴眼液累计时间不同发为3组，均行小梁切除术，术后对眼压、视野、滤过泡、滤过瘘口及虹膜粘连进行临床观察。结果 术后3组间统计比较，眼压（P＜0．05）、视野（P＜0．01）、滤过泡（P＜0．05）、滤过瘘口（P＜01）、虹膜粘连（P＜0．01）均有显著性差异。用药3年以上对小梁切除术效果有明显影响。结论 术前长期滴用1％匹罗卡品与小梁切除术效果密切相关。闭角型青光眼应缩短术前用药时间，早期手术，提高手术疗效。     

外伤性前房积血眼前段损伤的超声生物显微镜诊断分析

目的 探讨眼球闭合性损伤后前房积血时眼前段的超声生物显微镜(UBM)表现,分析外伤后前房积血产生的原因.方法 对闭合性损伤后的前房积血患者而行UBM检查的79例(79眼)进行回顾性分析,观察其合并眼前段损伤的形态学变化情况.结果 79例前房积血中合并有虹膜根部断离12眼(13.58％),房角后退46眼(58.23％),睫状体脱离38眼(48.10％),睫状体分离房角漏7眼(8.86％).结论 前房角和睫状体的损伤是外伤性前房积血的主要原因.UBM对外伤性前房积血者眼前段损伤的诊断具有较高的参考价值.     

Effect of pilocarpine on intraocular pressure in ocular hypertensive subjects

In normal subjects, ocular administration of pilocarpine results in initial elevation of IOP succeeded by a fall. We have now examined the effect of pilocarpine on IOP in nontreated ocular hypertension. Our results demonstrate that the initial hypertensive phase is absent in these patients and that the subsequent hypotensive phase is more marked than in normotensive eyes. It is suggested that in normal eyes IOP is regulated by two opposing cholinergic effects, and imbalance the two may lead to ocular hypertension (or hypotension).     

Transient changes of intraocular pressure and anterior segment configuration after diagnostic mydriasis with 1% tropicamide in children

Background: This study investigated the association of transient changes in intraocular pressure (IOP) with changes in the anterior chamber configuration in children after diagnostic mydriasis with 1% tropicamide. Methods: In this prospective case‐control study, 163 hospital clinic‐based samples of unrelated children with or without myopia were enrolled. Complete ophthalmological examinations, including visual acuities, cycloplegic refraction, slitlamp examination, fundus examination, IOP, axial length measurement and Pentacam examination were performed. Results: Lens thickness in emmetropic children was significantly greater than in myopic children of both genders, both before and after mydriasis. In a comparison of the biometric differences before and after mydriasis, IOP was not different, but the lens thickness after mydriasis was significantly less in myopic and emmetropic children of both genders. The mean anterior chamber angle, anterior chamber depth and anterior chamber volume significantly increased after mydriasis in myopic and emmetropic children of both genders. These parameters were not related to the changes of IOP under multiple regression analysis. There were no statistically significant differences between groups in either biometric parameters or anterior chamber configurations. Conclusion: While the present findings do not show a significant change in IOP following mydriasis, there was wide inter‐individual variation, with some children showing an increase in IOP of up to 8.0 mmHg and some showing a decrease of a similar amount. This variation suggests that IOP should be monitored when mydriatics or cycloplegics are used in children.     

Ciliary body melanocytoma with anterior segment pigment dispersion and elevated intraocular pressure

PURPOSE: To discuss a case in which melanocytoma of the ciliary body presented with widespread pigment dispersion and elevated intraocular pressure (IOP). METHODS: A 64-year old woman presented with increased IOP and persistent anterior segment inflammation in her right eye. She had undergone a trabeculectomy for uncontrolled IOP before presentation. Slit-lamp examination, gonioscopy, and ultrasound biomicroscopy revealed a ciliary body mass with extension into the subconjunctiva in addition to widespread pigmentary dispersion in the anterior segment. Enucleation of the right eye was performed for histopathologic evaluation, as a diagnosis of ciliary body melanoma was made on clinical examination. RESULTS: Histopathologic findings were diagnostic of a melanocytoma of the ciliary body with necrosis and focal malignant transformation with extension of melanocytoma cells and melanophages into the subconjunctival space, trabecular meshwork, and anterior chamber angle. CONCLUSION: Melanocytoma of the ciliary body is a rare intraocular tumor that may present with pigment dispersion and secondary elevated IOP. Careful examination of the anterior segment is imperative in such cases.     

Ultrasound biomicroscopic morphometry of the anterior eye segment before and after one drop of pilocarpine

Purpose: To measure anterior eye segment morphometric data using ultrasound biomicroscopy. This is a new high-frequency, high-resolution ultrasound method enabling the visualisation of the anterior segment of the living eye with magnification similar to a light microscope. Methods: Thirteen morphometric parameters of the anterior eye segment were measured before and after the application of one drop of pilocarpine in 10 eyes of 5 persons, using a Zeiss-Humphrey Ultrasound Biomicroscope at a frequency of 50 MHz. In each session, 3 morphometric parameters in the central images (corneal thickness, anterior chamber depth, pupillary diameter) were measured 4 times, and 10 parameters in the radial images (scleral thickness, angle-opening distance, trabecular-iris angle, trabecular-ciliary process distance [TCPD], iris thickness 1, 2 and 3, iris-ciliary process distance, iris-lens contact distance [ILCD], iris elevation) were measured on the 3, 6 and 9 o'clock meridians three times each. Results: Statistically significant changes were noted in the following parameters: pupillary diameter, iris thickness 1 and 2, and TCPD were decreased, while ILCD was increased after pilocarpine. Wide chamber angles showed a tendency to become narrower and narrow ones to become wider after pilocarpine. Conclusion: One drop of pilocarpine caused significant changes in the anterior eye segment morphology. Not only the pupillary diameter decreased but iris thickness and trabecular-ciliary process distance were also decreased simultaneously. At the same time the contact surface between the lens and iris increased significantly. Ultrasound biomicroscopy gives new morphometric image information about the anterior eye segment which is not available using conventional gonioscopy or ophthalmic echography.Abbreviations ACD anterior chamber depth - AOD500 angle-opening distance - CD corneal thickness - Fi1 trabecular-iris angle - ICPD iris-ciliary process distance - ID1, ID2 and ID3 iris thickness 1, 2 and 3 - IE iris elevation - ILCD iris-lens contact distance - PD pupillary diameter - SD scleral thickness - TCPD trabecular-ciliary process distance     

The state of anterior eye segment after posterior chamber intraocular lens implantation with transscleral fixation

PURPOSE: The aim of the study was to evaluate the state of anterior eye segment in postoperative period after PC-IOL transscleral fixation. MATERIAL AND METHODS: The material comprised 31 eyes in 31 patients, (11 women and 20 men), aged 20-80 years (average 61 years), who underwent the primary or secondary PC-IOL implantation with transscleral fixation. The examination was performed 10 to 14 months (average 12 months) after surgery. The clinical state of the corneas was evaluated using endothelial and confocal microscopy. The position of the IOL, its location and symmetry were evaluated with ultrasound biomicroscopy. RESULTS: The visual acuity ranged from 0.1 to 1.0. In 20 eyes (64%) the position of PC-IOL was correct. In the rest of cases the inappropriate position of implants was observed. The decrease of endothelial cells density was 13% in eyes with primary implantation and 7% in cases with secondary implantation of IOL. In the corneal endothelium, there were features of pleomorfism and polymegatism; in a few cases some deposits were observed. CONCLUSION: The implantation of posterior chamber intraocular lenses with transscleral fixation is recommended for some cases of primary or secondary problems with capsule support. The PC-IOL implantation with transscleral fixation can be the alternative method for the anterior IOL implantation.