玻璃体切除手术治疗儿童外伤性眼内炎疗效观察

目的:探讨玻璃体切除手术治疗儿童外伤性眼内炎的疗效。方法:回顾分析12例(12眼)儿童外伤性眼内炎经玻璃体切除术治疗的疗效。结果:玻璃体切除后12眼中10眼的炎症控制,另2眼二次手术玻璃体切除后炎症控制。1眼术后视网膜脱离行二次手术。随访2～21(平均8.7)mo。视力提高者9眼(75%),≥0.1者5眼(42%)。结论:玻璃体切除术联合敏感抗生素应用是治疗儿童外伤性眼内炎的有效手段。     

儿童外伤性眼内炎的手术治疗

目的 探讨玻璃体切除术治疗儿童外伤性眼内炎的疗效.方法 回顾性研究,17例(17眼)儿童外伤性眼内炎治疗方法及疗效.结果 单纯玻璃体腔注药控制4眼;玻璃体切除13眼,其中玻璃体、晶状体切除联合硅油填充10眼,玻璃体切除联合硅油填充2眼,眼内注气1眼;17眼中共保留晶状体5眼.9眼视力提高(52.94％),视力不变者3眼(17.65％),视力下降5眼(29.41％)(其中3眼眼球萎缩).结论 儿童外伤性眼内炎手术效果与眼内炎程度、就诊时间、致病菌毒力有关,无外伤性白内障的眼内炎玻璃体切除是否保留晶状体要考虑年龄及眼内炎的严重程度.     

外伤性眼内炎玻璃体手术的预后因素分析

目的:探讨外伤性眼内炎玻璃体切除术治疗视力预后的相关因素。方法:回顾性分析62例62眼行玻璃体切除术治疗的外伤性眼内炎患者的临床资料,即对患眼的自然因素(性别、年龄、眼别、视力、眼压、眼内异物、致伤情况、外伤性白内障、血管炎性改变、视网膜脱离、病原学检查/培养结果)、围手术因素(术前玻璃体注药史、手术方式、术中眼内充填气体/硅油、术中及术后并发症)等因素与随访0.5a后视力及患眼预后情况进行多因素分析。结果:62眼预后:矫正视力>0.02者53眼(85%),其中13眼矫正视力>0.3者13眼(21%),眼球摘除者2眼(3%)。多元分析结果显示:患眼自然因素中视网膜血管炎性改变、视网膜脱离的发生对视力预后影响具有显著性意义;围手术因素中,眼内炎症加重,手术复杂程度增加,手术失败的危险性亦增加,术后并发症的发生亦对不良视力预后的相关性增加。结论:合并视网膜脱离、血管炎性改变,手术复杂程度及术后并发症发生等因素是与外伤性眼内炎患者视力远期预后密切相关的因素。对于诊断明确的外伤性眼内炎应尽早行玻璃体手术。     

儿童外伤性眼内炎玻璃体切割手术的治疗效果及影响因素分析

目的　分析儿童外伤性眼内炎玻璃体切割手术后的治疗效果及影响因素。方法　对 1 7例(1 7眼 )儿童外伤性眼内炎的致伤原因、致伤物、性别、年龄、就诊时间、临床表现、治疗方式及效果进行回顾性分析。结果　 1 7例患儿中因延迟就诊 ,病情进展为全眼球炎而行眼内容物剜除术 3例 ,1 4例急诊行玻璃体切割术。术后随访 3～ 6月 ,视力 0 3与 0 7各 1例 ,0 0 2～ 0 0 5者 3例 ,光感～0 0 2者 9例 ;玻璃体切割术后发生低眼压 4例 ,占 2 8 5 %。结论　儿童外伤性眼内炎玻璃体切割手术后治疗效果与眼内炎的程度、就诊是否及时、致病菌毒力大小有关。术后发生低眼压的原因可能与炎症形成睫状体膜、前部增生性玻璃体视网膜病变及硅油填充有关。     

儿童外伤性眼内炎的临床分析

本文报道了２５例儿童外伤性眼内炎的致伤原因、临床表现、治疗和结果。致伤原因主要是一次性注射针头，占５６％。治疗后２４％的病例视力在０．０５以上。我们认为对儿童外伤性眼内炎应早期施行玻璃体切割术     

玻璃体切除术治疗外伤性眼内炎

目的　探讨玻璃体切除术治疗外伤性眼内炎的效果。方法　回顾我院 1997年 1月～ 2 0 0 1年 12月外伤性眼内炎49例 (4 9眼 )的临床资料 ,采用玻璃体切除的方法进行治疗 ,术后随访 1～ 6月。结果　术后视力提高 3 4眼 (69.3 9%) ,不变 9眼 (18.3 8%) ,下降 3眼 (6.12 %) ,3眼行眼球摘除 (6.12 %)。其中有效 3 2眼 (65 .3 1%) ,显效 2 3眼 (4 6.94%)。结论　外伤性眼内炎一旦确诊应及时施行玻璃体切除术 ,才能有效控制炎症。     

玻璃体切割术治疗外伤性眼内炎

目的:评价玻璃体切割联合眼内药物灌注治疗严重的外伤性眼内炎的临床效果.方法:回顾性分析30例(30眼)因外伤性眼内炎行玻璃体切除术,术中联合药物玻璃体腔灌注的患者.结果:术后 3mo 29 眼炎症得到控制,眼球得以保留,28眼视力有不同程度提高.眼内异物是最常见的受伤原因,金黄色葡萄球菌是最常见的细菌.结论:及时行玻璃体切割术联合眼内药物灌注是治疗外伤性眼内炎的有效方法.     

儿童眼外伤227例相关因素分析

目的:通过对儿童眼外伤患者各相关因素分析,探讨儿童眼外伤防治措施。方法:对227例(242眼)住院儿童眼外伤患者的年龄、性别、受伤环境、外伤性质、致伤原因、并发症及视力改变等因素进行统计分析。结果:统计结果显示,男:女≈4.28:1,多发年龄段为5～6岁年龄组,受伤环境多见于公共场所,致伤物多为锐器和肢体击打,外伤性质以眼球穿通伤为多见,并发症主要为眼球破裂、眼内容脱出、外伤性白内障、玻璃体出血和眼内炎等,致盲率为42.15%,眼球摘除共12眼(4.96%)。结论:眼外伤为儿童主要的致盲原因之一,儿童眼外伤的预防及眼外伤发生后的正确处理具有重要的意义。     

外伤性眼内炎手术治疗

目的　探讨外伤性眼内炎玻璃体切除手术治疗效果 ,并分析相关因素。方法　因外伤性眼内炎接受玻璃体切除手术治疗 2 1例 ( 2 1眼 ) ,其中硅油填充 18眼 ,C3 F8填充 2眼 ,无填充物 1眼。术前视力光感至 0 1。眼压平均为 7mmHg( 5～ 2 5mmHg) ( 1mmHg =0 13 3kPa)。平均随访 18月 ( 3～ 43月 )。结果　术后视力无光感至 0 8,视力提高 15眼 ( 71 43 % ) ,不变 4眼( 19 95 % ) ,视力下降 2眼 ( 9 42 % )。眼压平均为 18mmHg( 10～ 2 2mmHg) ,显著高于术前眼压 (P <0 0 5 )。并发症主要包括前房炎性渗出 ( 19眼 ) ,术后短暂高眼压 ( 4眼 ) ,视网膜脱离 ( 3眼 ) ,眼球萎缩 ( 2眼 )。结论　玻璃体切除手术是治疗外伤性眼内炎的安全有效的方法。     

学龄前儿童外伤性眼内炎68例分析

目的 探讨学龄前儿童外伤性眼内炎的特点及治疗方法。方法 回顾性分析68例(68眼)3～7岁外伤性眼内炎的临床资料。结果 68例眼内感染最终全部得到控制，56眼视力有不同程度的提高，33眼矫正视力在0．1以上，其中ll眼在0．5以上，经弱视治疗和视功能训练，有20例获立体视觉。结论 学龄前儿童眼内炎预后较差，早期进行玻璃体切除是有效的治疗方法。弱视治疗有利于视力进一步提高，建立立体视觉。     

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.