月经周期与眼压升高2例

例１女，４０岁，双眼胀痛伴视力模糊，恶心欲吐２天。于１９９０年５月２０日来本院就诊。患者既往每于月经来潮即出现上述症状，经期终止症状消失。眼部检查：视力，右５．０ＪＩ．０，左５．０ＪＩ．０；眼压，右３．２４ｋＰａ，左２．９８ｋＰａ，双上睑消肿，球结膜轻度充血。其它未见异常。每日给予０．２５％喷吗心胺滴眼二次，次日复诊，自觉症状消失。眼压．右２．７３ｋＰａ．左２．２２ｋＰａ。观察一周，眼压波动在３．３ｋＰａ～１．９４ｋＰａ，未见其它异常。停用药物，月经终止两周后测量眼压。右：２．５１ｋＰａ，左：２…     

Nd：YAG激光经巩膜睫状体光凝的实验研究

用一种廉价的激光聚焦头和连续波Ｎｄ：ＹＡＧ激光机连接，在一组有色家兔眼实施了接触式经巩膜睫状体光凝。实验观察了激光聚集头的位置和能量水平对睫状体的破坏，以及光凝后眼压的变化。结果表明：聚焦头位于角巩缘后１．０ｍｍ，５Ｊ的能量可使睫状体产生明显的破坏，而巩膜没有损害。每只眼实施１２个光凝点可使眼压持续显著地下降。实践证明这种廉价的聚焦头可以替代昂贵的蓝宝石聚焦头进行经巩膜睫状体光凝。     

不同能量二极管激光睫状体光凝的实验研究

目的：比较不同能量二极管激光睫状体光凝对家兔眼压的影响。方法：采用Ｖｉｓｕｌａｒｓ ＤｉｏｄｅⅡ二极管激光对两组有色素兔和一组无色素兔进行接触式经巩膜睫状体光凝术。激光击射部位在角巩膜缘后１～１．２ｍｍ,聚焦于睫状体,沿角巩膜缘共击射２４点,第一组有色素兔使用能产生爆破声的临界能量。第二组有色素兔用较低的能量,第三组无色素兔用相当高的能量。随访并记录２月的眼压及不良反应。结果：二极和激光睫状体光凝术可显著降低眼压,其中使用较高能量的有色素兔组具有最好的降眼压效果。结论：睫状体光凝的降眼压效果与激光能量、击射点数和术眼所含色素的多少有关。     

砝码式压迫器的临床应用及机理探讨

本文报告用砝码式压迫器控制眶压眼压后施行白内障摘出手术１７０眼，玻璃体脱出率为４．７％（８／１７０）。对４０只眼在压迫前及压迫１５分钟后测量眼压，平均眼压分别为２．２５±０．６３ｋＰａ（１６．９±４．７）及１．０１±０．６５ｋＰａ（７．６５±４．８６ｍｍＨｇ）；平均下降１．２５ｋＰａ（９．３４ｍｍＨｇ），下降率为４４．７％。     

阿普可乐定防止Nd：YAG激光虹膜切除术后眼压升高

目的 了解阿普可乐定是否有效降低棕色虹膜人种激光肛膜切除术后眼压急性升高。方法 ４８只原发性闭角型青光眼,按年龄、性别进行匹配,分为治疗组和对照组。治疗组术前１小时和术后即刻滴用１％阿普可乐定,对照组滴用安慰剂。术后０．５、１．０、１．５、２．０、３．５小时观察眼压和其他情况。结果 激光治疗后,治疗组和对照组眼压最大升高值分别为０．６２±０．６７ｋＰａ（１ｋＰａ＝７．５ｍｍＨｇ）和１．１３±０．８     

现代白内障囊外摘除术后早期眼压的观察

目的探讨白内障囊外摘除术后早期眼压的变化情况。方法将５８只眼随机分为三组，对术后早期不同时间的眼压进行观察和对照。结果术后１小时眼压均低者不能测出；３小时平均眼压高于术前水平；６～１２小时达高峰，３１只眼（５３．４５％）眼压＞２．８０ｋＰａ（１ｋＰａ＝７．５ｍｍＨｇ），４只眼（６．９０％）眼压≥４．００ｋＰａ，最高眼压为４．４０ｋＰａ；２４小时后眼压自然下降；术后７２小时内，５只眼（８．６２％）眼压低于正常水平（＜１．３３ｋＰａ）。术前应用醋氮酰胺组，术后平均眼压低于应用甘露醇组和未用降眼压药组（Ｐ＜０．０５），且术后正常眼压者所占比例较高。结论术前预防性服用醋氮酰胺，对降低白内障摘除术后早期的眼压有一定作用。     

倍频Nd：YAG激光小梁成形术疗效分析

为评价倍频Ｎｄ：ＹＡＧ激光小梁成形术的临床疗效。对２２例３８只临床用药物不能控制病情发展的原发性开角型青光眼，采用倍频Ｎｄ：ＹＡＧ激光实施小梁成形术，所有病例均治疗下半部１８０°小梁，５０个光凝点，局部组织产生苍白反应。结果：随访期内眼压平均下降０．７５ｋＰａ（５ｍｍＨｇ），眼压降幅与术前眼压水平成正相关。结论：倍频Ｎｄ：ＹＡＧ激光是行小梁成形术的有效激光，治疗参数为：光斑直径５０μｍ，功率０．７～１．２Ｗ，曝光时间０．１ｓ。     

国产手持式压平眼压计与非接触眼压计测量结果比较

为了解国产手持压平眼压计与非接触眼压计的眼压测值间有否差异，用两种眼压计对２５人５０眼进行了双盲法测量眼压，结果：前者为２．７０±１．３１ｋＰａ，后者为２．６６±１．３０ｋＰａ，两者间差异无显著意义（Ｐ〉０．０５），经相关分析相关性极好（ｒ＝０．９９８５，Ｐ〈０．０１），表明国产手持压平眼压计的测值是准确可靠的，且具有价格低廉，携带方程等优点。     

半导体激光治疗重症青光眼--睫状体光凝和睫状体冷冻的对比研究

６０例（６０只眼）重症青光眼患者，随机分成半导体激光经巩膜睫状体光凝组和睫状体冷冻组。半导体激光功率１．５～２．０Ｗ、脉冲时间２ｓ、治疗范围２７０°，发射１２～２０个激光点。所有病例均完成３个月的随访观察，结果与冷冻组比较，光凝组治疗成功率为７３．３％，疼痛解除率为９６．７％，Ｐ＞０．０５；光凝组治疗后１天及１周的眼压分别为２２．１０±９．３４ｍｍＨｇ和１８．１３±６．４０ｍｍＨｇ，Ｐ＜０．０１；末次随访时光凝组眼压２０．５４±７．９６ｍｍＨｇ，Ｐ＞０．０５。光凝组早期并发症少，Ｐ＜０．０１。半导体激光经巩膜睫状体光凝与传统的睫状体冷冻比较，具有简便、安全、降压快、副作用小、疗效可靠等优点，是治疗难治性青光眼的有效手段之一。     

双氯灭痛滴眼剂的抗炎作用研究

０．１％双氯灭痛滴眼对兔眼前房穿刺后继发房水蛋白升高的抑制率为７３．７％，穿刺后５、１５、３０、６０、９０分钟缩瞳反应抑制率分别为６５．２±１７．１％、５０．４±２０．７％、５０．４±２０．７％、５０．８±１４．９％、５８．５±１６．８％、４９．０±１２．６％。对５％和２０％花生四烯酸（ＡＡ）点眼致房水蛋白升高的抑制率分别为８１％和４３．２％。对５％ＡＡ点眼后所致眼压升高在不同时间均有抑制作用，给     

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.