兔眼冲击伤眼前节伤情变化及血—房水屏障通透性改变的初步研究

目的研究眼原发性冲击伤眼前节伤情变化及血—房水屏障通透性改变的过程。方法用ＢＳＴ－Ⅲ微型生物激波管，在２３０ｋＰａ和６００ｋＰａ的冲击波作用下造成兔眼冲击伤，进行伤后检查以及静脉注射荧光素后测定房水荧光素浓度。结果眼冲击伤的常见症状，如结膜充血水肿、房水混浊等在伤后２４至４８小时消失，而眼压和血—房水屏障的恢复需要更长的时间。结论虹膜睫状体血管功能的改变可能是眼冲击伤发生的病理学基础。     

眼内铜异物对血—房水屏障影响的实验研究

纯铜片植入兔眼玻璃体内，利用放射免疫的方法＾１３１Ｉ静脉注射后观察１周、３周时前房水放射性物质的脉冲数，并进行定量分析及统计学处理，同时观察超微结构的变化，证实了损伤部位，进五步证明了铜对眼组织的损伤与血－房水屏障的开放有直接关系。     

气相色谱法测定β-榄香烯在兔眼内的分布

目的测定正常兔眼球后注射榄香烯后药物在眼内的分布。方法采用气相色谱法测定正常兔眼单次及连续１周球后注射榄香烯后房水、玻璃体、视网膜和脉络膜中β－榄香烯的浓度。结果单次球后注射榄香烯后１ｈ，房水、玻璃体、视网膜和脉络膜中均检测到β－榄香烯。连续１周注射后，仅视网膜和脉络膜中检测到β－榄香烯，浓度与单次注射相比无明显增加。结论正常兔眼球后注射榄香烯可通过血－视网膜屏障进入眼内，连续用药后无明显蓄积作用。     

气相色谱法测定γ—榄香烯在兔眼内的分布

目的 测定正常兔眼球后注射榄香烯后药物在眼内的分布。方法 采用气相色谱法测定正常兔眼单次及连续１周球后注射榄香烯后房水、玻璃体、视网膜和脉络膜中β－榄香烯后１ｈ,房水、玻璃体、视网膜和脉络膜中均检测到β－榄香烯。连续１周注射后,仅视网膜和脉络膜中检测到β－榄香烯,浓度与单次注射相比无明显增加。结论 正常兔眼球后注射榄香烯可通过血－视网膜屏障进入眼内,连续用药后无明显蓄积作用。     

川芎嗪对环丙沙星在角膜穿孔伤兔眼眼内渗透性的影响

目的 研究兔角膜穿孔伤后血-眼屏障的改变及川芎嗪对环丙沙星在兔眼角膜穿孔伤眼内渗透性的影响.方法 18只新西兰兔,随机分为A、B、C 3组.A、B组各眼行角膜穿孔伤,1 h后A组静脉注射环丙沙星,B组静脉注射川芎嗪和环丙沙星;C组为对照组单纯静脉注射环丙沙星.用药后0.5 h,取房水及玻璃体,双缩脲法测定房水蛋白含量,反向高效液相色谱法测定房水及玻璃体环丙沙星浓度.结果 A、B和C组房水蛋白含量分别为(11.977±5.774)g·L-1、(14.767±5.814)g·L-1和(2.741±1.193)g·L-1,A、B组显著高于C组(P＜0.01);A、B和C组房水环丙沙星浓度分别是(1.390±0.284)mg·L-1、(1.390±0.284)mg·L-1和(0.655±0.291)mg·L-1,A、B组显著高于C组(P＜0.01);A、B 2组房水蛋白的含量与环丙沙星的浓度呈正相关(P＜0.01),但A、B 2组房水蛋白浓度及环丙沙星浓度比较差异无统计学意义(P＞0.05);3组玻璃体中环丙沙星浓度均很低,分别是(0.073±0.059)mg·L-1、(0.085±0.041)mg·L-1和(0.064±0.051)mg·L-1,3组比较差异无统计学意义(P＞0.05).结论 角膜穿孔伤增加血-房水屏障通透性,使房水中环丙沙星水平明显提高,浓度显著高于大部分眼内致病菌90%菌株最小抑菌浓度.川芎嗪不影响外伤眼血-房水屏障,不能增加环丙沙星在角膜穿孔伤兔眼眼内渗透性,可作为角膜穿孔伤后改善血循环用药.     

外伤性白内障摘除人工晶体植入术后房水炎细胞研究

目的动态观察兔眼外伤性白内障囊外摘除及后房型人工晶体囊袋内植入术后早期炎症反应中房水细胞学动态变化．方法青紫兰兔27只，分为外伤性白内障晶体囊外摘除及后房型人工晶体囊内植入组，晶体囊外摘除组和正常对照组。术后d1、d3、d7和d14抽取房水计数白细胞总数及分类。采用SAS软件包，对统计资料作方差分析．结果外伤性白内障囊外摘除及后房型人工晶体囊袋内植入术组房水白细胞总数及各项分类计数明显高于单纯晶体囊外摘除组，差异有显著性．结论术后在d1房水白细胞总数、嗜中性粒细胞和嗜酸性粒细胞增加可能与手术所致的机械性创伤及血－房水屏障破坏有关，术后7～14d房水巨噬细胞增多可能是对人工晶体材料的一种免疫反应所致。     

人工晶状体植入术后瞳孔膜形成的观察与处理

目的 各类白内障人工晶状体植入术后瞳孔膜形成的机制及处理方法。方法 对１４５例术后瞳孔膜形成进行观察。Ⅰ级膜９６眼，采用地塞米松眶内注射联合散瞳治疗。Ⅱ级膜４９眼采用５－ＦＵ联合地塞米松眶内注射及散瞳，随访３～１２月。结果 瞳孔膜１周内大部分吸收，５例１５天吸收，除拒绝治疗的３例外，无１例复发。结论 瞳孔纤维膜的形成可能与血－房水屏障破坏和免疫反应有关。５－ＦＵ联合地塞米松眶内注射及散瞳治疗较严重     

轻度和重度眼球挫伤的血视网膜屏障改变

采用活体和离体3种示踪法，即眼底荧光血管造影、荧光素和镧示踪剂观察了轻型和重型兔眼顿挫伤后的血视网膜屏障改变。在轻型挫伤未见示踪剂的渗漏。在重型挫伤，视网膜色素上皮细胞严重损害，伴有血视网膜外屏障的明显破坏和示踪剂向视网膜内的渗漏。结果表明顿挫伤性视网膜水肿主要由外层视网膜的细胞破坏所早场，血视网膜外屏障的改变在水肿的形成中可能仅起部分作用。（中华眼底病杂志，1992，8：130-132）     

超声乳化人工晶状体植入术后膜形成的分析

目的：探讨白内障超声乳化吸出及人工晶状体植入后人工晶状体前膜形成的机制和处理方法。方法：对393例进行术后随访观察。结果：有21眼人工晶状体前膜形成，发生率5．0％，用皮质类固醇治疗有效，1周内大部分吸收，无1例复发，有2眼用YAG，1眼失败，不影响术后矫正视力，结论：人工晶状体前膜是超声乳化及人工晶状体植入后常见早期并发症，其形成可能与血－房水屏障破坏和免疫反应有关，大多数病例通过药物治疗可完全吸收，视力增进。     

缝线固定人工晶状体植入术后房水细胞学实验研究

目的研究兔眼缝线固定式后房型人工晶状体植入术后早期炎症反应中房水的细胞学动态变化。方法分为缝线固定人工晶状体植入术组；晶状体囊外摘出组；正常对照组。术后1、3、7和14天抽取房水计数白细胞总数及分类。结果缝线固定人工晶状体植入术组术后房水炎症细胞数明显高于单纯晶状体囊外摘出组。结论术后早期房水白细胞总数和嗜中性粒细胞增加可能与手术所致的机械性创伤及血房水屏障破坏有关；术后房水巨噬细胞增多可能是对人工晶状体材料的一种免疫反应。     

The effect of viscoelastic substances on postsurgical blood aqueous barrier

A postsurgical flare was evaluated with a flare-cell meter and the effect of residual viscoelastic substances on the blood aqueous barrier function was studied. The materials consisted of 100 eyes undergoing extracapsular cataract extraction and posterior chamber lens implantation using sodium hyaluronate products (Healon:Pharmacia and Opegan:Santen). The molecular weight is 1.9-3.6 million daltons in Healon and 0.9-1.2 million daltons in Opegan. According to the aqueous warm current on the 1st postoperative day, the eyes were divided into two groups; the poor current group and the normal current group. The poor current group consisted of 13 eyes had static aqueous current, probably due to residual viscoelastic substances from the clinical findings, namely a little pain, foggy general corneal edema and spontaneous recovery of the warm current without specific administrations of antibiotics. Eyes with poor current were recognized in 18% (11/62) among cases with Healon and 5% (2/38) in case with Opegan. Flare values of the poor current group were higher in 7 eyes than the highest of the normal current group on the 1st postoperative day. After the 2nd postoperative day, the median flare value of the poor current group was higher than that of the normal current group. The difference was statistically significant throughout the first week (p less than 0.02). The cell number was also higher in the poor current group on the 1st and 2nd postoperative day (p less than 0.02). These findings suggest that the residual viscoelastic materials may increase the breakdown of blood-aqueous barrier and/or interfere the barrier recovery.     

Changes in anterior chamber flare and cells following cataract surgery.

The laser flare cell meter allows rapid non-invasive quantification of aqueous flare and cells. In this prospective study laser photometry was used to document the recovery of the blood-aqueous barrier in 27 normal eyes following cataract surgery. Aqueous flare and cells were highest on the first postoperative day, declining rapidly in the first week and returning to preoperative levels by 3 months. In six eyes (22.2%) there was an increase in either flare and cells or flare alone during the first postoperative week which was associated with a delayed recovery of the blood-aqueous barrier for up to 1 month following surgery. A consensual flare response was found to occur in the fellow eye in five patients (18.5%).     

Effects of residual sodium hyaluronate on postsurgical blood-aqueous barrier.

The effects of residual sodium hyaluronate (HA) on the postsurgical blood-aqueous barrier (BAB) function were investigated in 79 posterior chamber lens (PCL)-implanted eyes after both extracapsular cataract extraction and PCL implantation using HA products. The amount of residual HA was classified according to the status of the aqueous warm current on the 1st postoperative day. The eyes with static warm current were classified into the static current group and the other eyes into the normal current group. Aqueous flare intensity and cell number were measured in all eyes daily from the 1st to the 7th postoperative day using the flare-cell meter. Of the 79 eyes, 11 eyes (14%) were classified into the static current group. Flare intensity showed the most marked difference between the two groups on the 1st postoperative day. The difference was statistically significant from the 1st to the 7th postoperative days (P less than 0.05). Cell count was also higher in the static current group throughout the observation period except for the 3rd and 4th postoperative days (P less than 0.05). These findings suggest that residual HA exacerbated the postoperative inflammation and that its effects on the BAB continued for at least a week.     

The time course of laser-induced disruption of the blood aqueous barrier in the rabbit

The response of the blood aqueous barrier to a defined laser trauma was investigated in a series of seven groups with three pigmented rabbits in each group. The peripheral iris of the left eye was treated with the Argon laser (ten spots of 50-m size with an energy of 100 mJ). The right eyes served as controls. The anterior chambers of both eyes were tapped at given time intervals after the laser coagulation to enable the analysis of the protein content of the aqueous humour and for the assay of the lactate dehydrogenase activity. Within 100 min after laser treatment a positive correlation between time and protein concentration in the anterior chambers of the treated eyes (r = 0.77) and in the untreated eyes (r = 0.79) was established. There was a significant response on the blood aqueous barrier in the untreated fellow eyes. The activity of the lactate dehydrogenase showed a significant increase 5, 70 and 100 min after laser trauma in the treated eyes only. The laser trauma induced a significant increase ( = 0.01) in the intraocular pressures of the treated eyes, which persisted up to 70 min after treatment. The clinical implications of these findings are discussed.     

前部PVR睫状体上皮损伤修复过程中Cx43表达变化及意义

目的研究Cx43在前部增生性玻璃体视网膜病变（PVR）睫状体上皮损伤修复过程中表达的变化并探讨其机制和意义。方法利用苏木精一伊红染色、荧光免疫组织化学、透射电镜和Westernblot技术对外伤性前部PVR模型不同时间点睫状体上皮组织病理学变化及Cx43蛋白表达分布和表达量变化分别进行观察和检测。结果伤后6h睫状突表面有纤维蛋白渗出，1周时纤维增生膜基本形成。24hCx43在睫状体色素上皮（PE）细胞间出现表达，且蛋白含量略增；造模1周时，无色素上皮（NPE）细胞间Cx43表达增加，蛋白含量检测显著增高；伤后24h之前和1周之后Cx43表达于NPE—PE交界，其表达部位和表达的量的变化也无显著性差异。结论外伤性前部PVR睫状体上皮损伤修复过程中Cx43表达变化活跃，表明Cx43缝隙连接通道蛋白参与了该病理状态下睫状体上皮的组织损伤修复与功能调节。     

COX-2 inhibitors prolong trauma-induced elevations of iris hyaluronan.

PURPOSE: To investigate whether and how treatment with COX-2 inhibitors influences hyaluronan responses to a standardized trauma, argon laser induced iritis, in rabbits. METHODS: Two different COX-2 inhibitors were used, SC-236 and rofecoxib. The drugs were administered orally, 6 mg/kg/day and 1.5 mg/kg/day respectively. Iris and aqueous humor hyaluronan concentrations were measured with a radiometric assay at different time points after laser irradiation. RESULTS: The hyaluronan concentration in the iris increased 3-4-fold with a peak concentration of 129.1 microg/g wet weight 2 days after laser irradiation. It then decreased to normal values after 1 week. In eyes treated with either of the COX-2 inhibitors, iris hyaluronan concentrations did not decrease as rapidly and were significantly higher at day 4 and 7 when compared to drug untreated eyes. CONCLUSION: Treatment with COX-2 inhibitors prolongs trauma induced elevation of iris content of endogenous hyaluronan. This may be, at least partly, due to an inhibition of interstitial fluid pressure regulation.     

准分子激光原位角膜磨镶术后泪膜的早期改变

目的 探讨准分子激光原位角膜磨镶术（laser in situ keratomileusis,LASIK)术后泪膜的早期改变。方法 对74例（148只眼）近视患者行LASIK,观察术前,术后1d、1周、1个月、3个月的干眼症状,包括干涩感、异物感、烧灼感,以及荧光素试验、孟加拉玫瑰红染色、泪膜破裂时间（breakup time of tear film,BUT)和泪液分泌量结果,并对数据进行统计学分析。结果 术后1周干燥感较术前加重（P＜0．0127）,其他时间与术前比较差异均无显著间谍（P＞0．0127）;术后1d和1周烧灼感较术前加重（P＜0．0127）,术后1个月、3个月与术前比较差异无显著意义（P＞0．0127）;术后1d、1周和1个月异物感染较术前明显加重（P＜0．0127）,3个月接近术前水平（P＞0．0127）。术后1d和1周角膜荧光素着色点较术前明显增多（P＜0．0127）,术后1个月和3个月与术前比较差异无显著意义（P＞0．0127）;术后1d和1周孟加拉玫瑰红着色点较术前明显增多,差异有显著意义（P＜0．0127）,术后1个月和3个月接近术前水平（P＞0．0127）;术后1周和3个月泪液分泌量较术前明显减少,差异有显著意义（P＜0．05）,术后1个月接近术前水平（P＞0．05）;术后1d、1周、1个月和3个月BUT均较术前缩短（P＜0．05）。结论 LASIK对泪膜具有一定程度不良影响,发生机制与多种因素有关;临床应积极采取预防措施,以使LASIK术后干眼症的发生率和严重程度降至最低。     

Short-term blood-aqueous barrier breakdown after implantation of the 1CU accommodative posterior chamber intraocular lens

PURPOSE: To quantify intraocular inflammation after phacoemulsification with implantation of an accommodative posterior chamber intraocular lens (IOL). SETTING: Department of Ophthalmology, University of Erlangen-Nürnberg, Erlangen, Germany. METHODS: Twenty cataractous eyes of 20 patients without preexisting blood-aqueous barrier (BAB) deficiencies or previous intraocular surgery were included in this study. The mean age of the patients was 64.6 years +/- 16.0 (SD). A single surgeon performed phacoemulsification through a superior sclerocorneal tunnel incision and implantation of a 1CU IOL (HumanOptics AG) though a 3.2 mm incision. The haptics of the single-piece acrylic 1CU lens are designed for anterior optic movement following ciliary muscle contraction. The postoperative treatment was standardized. Postoperative BAB breakdown was quantified by laser flare photometry (FC-1000, Kowa) at 1 day, 1 and 4 weeks, and 3 and 6 months. RESULTS: The mean aqueous flare was 6.3 photons/ms +/- 3.0 (SD) (range 4.0 to 12.2 photons/ms) 1 day postoperatively, with 64% of patients having normal aqueous flare values (<8.0 photons/ms). One week after surgery, the mean aqueous flare was 5.3 +/- 2.8 photons/ms (range 2.0 to 10.5 photons/ms). Four weeks postoperatively, aqueous flare was normal in all patients and remained stable below the normal limit for up to 6 months (mean 3.3 +/- 1.2 months; range 2.0 to 5.4 months). The number of aqueous cells did not increase at any follow-up and was normal in all eyes. No postoperative complications such as fibrin formation, synechias, macrophages on the IOL optic, or endophthalmitis were observed. CONCLUSIONS: Phacoemulsification with implantation of the 1CU accommodative IOL led to minimal and short-lasting BAB alteration. No signs of persistent inflammation or pigment dispersion were detected.     

Time course of changes in aqueous flare following intravitreous gas injection in rabbits

The quantitative changes of the aqueous flare following intravitreous gas injection were determined by laser flare-cell metry in rabbits. A volume of 0.4 ml of air, 100% sulfur hexafluoride (SF6), or 100% perfluoropropane (C3F8), was injected separately into the vitreous of pigmented rabbits. The normal range of the aqueous flare was 7.8 +/- 3.0 (photon counts/msec). Each model showed an increase of aqueous flare on the first day (air: 18.9 +/- 9.1, SF6: 19.5 +/- 11.5, C3F8: 40.8 +/- 22.8). Subsequently, the aqueous flare of air-injected eyes gradually decreased, while that of SF6-injected eyes increased on the 4th day, and then gradually decreased. Also that of C3F8-injected eyes increased on the 4th day, and the 7th day, then decreased on the 14th day, but it was still higher than normal. Cataracts developed in two of the five eyes injected with SF6 and all of the four eyes injected with C3F8. These findings revealed that following intravitreous gas injection, disruption of the blood-ocular barrier depended on the expansibility of the gas and the length of time it remained in the vitreous cavity.     

下泪小点烧灼治疗重度水液缺乏型干眼的临床疗效

目的： 评价高温烧灼封闭下泪小点治疗重度水液缺乏型干眼的临床疗效。 方法： 前瞻性非随机对照 研究。选择2019年6月至2020年10月在福建医科大学附属第二医院眼科就诊的使用人工泪液和局部 抗炎保守治疗后疗效不佳的重度水液缺乏型干眼患者29 例（ 58 眼）。根据是否患有干燥综合征分为 2组：干燥综合征干眼（ SS）组17例（ 34眼）和非干燥综合征干眼（非SS）组12例（ 24眼）。采用高温热 烧灼封闭双眼下泪点,记录泪小点烧灼前2 个月、 1 d及烧灼后2 周、 2 个月时患者的眼表疾病指数 （ OSDI）、泪膜破裂时间（ TBUT）、角膜荧光素染色（ FL）和泪液分泌试验（ SⅠT）结果。数据分析采用 独立样本t检验、配对样本t检验及单因素重复测量方差分析。 结果： 2 组烧灼前各项干眼相关指标差 异无统计学意义。烧灼后2周和2个月与烧灼前1 d比较, SS组OSDI评分、 TBUT及FL评分差异均有 统计学意义（ F=69.58, P<0.001; F=49.45, P<0.001; F=34.07, P<0.001）;非SS组OSDI评分、 BUT、 FL评分及SⅠT值差异均有统计学意义（ F=57.89, P<0.001; F=72.83, P<0.001; F=47.44, P<0.001; F=28.35; P<0.001）,但SS组SⅠT值差异无统计学意义。烧灼2 个月后,非SS组OSDI评分、 TBUT、 FL评分、 SIT值均较SS组改善更明显（ t=2.22, P=0.04; t=-3.32, P<0.001; t=2.90, P=0.01; t=-4.00, P<0.001）。 SS组和非SS组均未发生明显眼部并发症,最常见的并发症为泪道再通,再通率为5.2%。 结论： 下泪小点烧灼封闭治疗重度干眼可改善重度干眼的症状和体征,是一种简单、经济且安全有 效的方法,对非干燥综合征干眼患者效果更佳。