翼状胬肉保留球结膜根治性切除联合应用丝裂霉素的疗效探讨

目的 :探讨防止初发性翼状胬肉术后复发的最佳手术方法。方法 :A组 5 2例 5 3眼初发性翼状胬肉 ,根据翼状胬肉临床形态学分级 ,本组中间型翼状胬肉 3 2眼 ,肥大型翼状胬肉 2 1眼 ,采用显微镜下保留翼状胬肉表面的球结膜 ,在自然解剖状态下彻底分离切除结膜下增生的筋膜血管、包括周围 1mm正常的筋膜组织 ,术中注意保护角膜缘组织 ,结合应用丝裂霉素 ,保留球结膜与巩膜紧密缝合 ,术后合理用药的方法。B组 2 2例 2 2眼 ,中间型翼状胬肉 16眼 ,肥大型翼状胬肉 6眼 ,采用单纯性翼状胬肉切除。术后观察随访 6～ 18个月 ,平均 9个月。结果 :A组 5 2例 5 3眼均获得根治性治愈 ,1眼术后有纤维血管增生 ,但未超过角膜缘。 3眼术后 2～ 3周结膜鼻侧缘出现肉芽增殖 ,经局部处理后均无真性翼状胬肉复发。术后无明显并发症发生。B组真性翼状胬肉复发 5眼占 2 2 7% ,4眼术后有纤维血管增生占 18 2 %。以术区是否又重新出现成纤维细胞增生作为评价复发和根治性治愈的标推 ,两组间比较 (χ检验 ,χ值为12 2 46,P <0 0 0 1) ,具有非常显著统计学意义。结论 :显微镜下保留球结膜根治性翼状胬肉切除结合应用丝裂霉素是治疗初发性翼状胬肉的有效方法 ,与翼状胬肉切除联合自体结膜移植术比较还具有手术损伤小、术后复发率     

翼状胬肉切除联合自体球结膜瓣移植术的临床分析

目的：探讨显微镜下施行翼状胬肉切除联合下方游离自体球结膜瓣移植术的疗效。方法：对93例97眼翼状胬肉施行翼状胬肉切除联合下方游离自体球结膜瓣移植术,观察术后恢复情况。结果：术后随访6～18mo,3眼复发（3%）,1眼并发炎性息肉（1%）,无其他并发症。结论：显微镜下翼状胬肉切除联合下方游离自体球结膜瓣移植术是治疗翼状胬肉的有效方法,具有术后复发率低且不影响白内障、青光眼手术切口选择的优点。     

进展期翼状胬肉切除联合术中及术后应用丝裂霉素C的疗效观察

目的探讨原发性进展期翼状胬肉切除联合术中及术后应用丝裂霉索C的疗效性及安全性。方法对54例(58眼)原发性进展期翼状胬肉患者施干行翼状胬肉保留球结膜根治性切除术,术中予浓度为0.02%的MMC棉片呈"C"形浸泡胬肉残端5分钟,术后一周予新配制的浓度为0.01%的MMC滴眼液点眼,每天3次,连用7天。结果 54例(58眼)原发性进展期翼状胬肉患者随访一年至两年,术后1眼复发,复发率为1.72%。结论原发性进展期翼状胬肉保留球结膜根治性切除联合术中及术后应用丝裂霉素C不仅可明显降低复发率,而且手术操作简单.损伤小,比较安全,无严重并发症,值得推广。     

翼状胬肉切除联合球结膜下生物羊膜移植的初步研究

目的:探讨翼状胬肉切除联合球结膜下生物羊膜移植的临床效果和安全性。方法:52例52眼初发性翼状胬肉,在手术显微镜下进行手术,保留翼状胬肉表面的球结膜。在自然解剖状态下彻底分离切除球结膜下的翼状胬肉组织,同时进行结膜下生物羊膜移植。术后随访6～15(平均10.24±2.45)mo。结果:48例48眼治愈,4例4眼复发。复发率7.69%;术中术后未见并发症。结论:手术显微镜下行翼状胬肉切除联合球结膜下生物羊膜移植具有手术损伤小,最大限度保留了正常眼表面的解剖结构,术后复发率低,是治疗初发性翼状胬肉的一种新的有效方法。     

两种术式治疗翼状胬肉的疗效观察

目的:分析两种不同的手术方式治疗翼状胬肉的临床效果。方法:第1组33例35眼,有2例2眼为复发病例,采用翼状胬肉切除联合游离球结膜瓣移植术。第2组32例35眼,有2例2眼为复发病例,采用翼状胬肉切除联合游离球结膜瓣移植加丝裂霉素棉片术。结果:术后1a内随访,第1组复发1例(1眼),复发率3.03%(2.85%)。第2组复发1例(1眼),复发率3.12%(2.85%),有1例发生球结膜瓣愈合不良,于术后20d拆除结膜瓣缝线。无巩膜溶解等严重并发症。结论:翼状胬肉切除联合游离球结膜瓣移植术与翼状胬肉切除联合游离球结膜瓣移植加丝裂霉素棉片术,复发率均较低,两组间没有差异。     

新鲜羊膜球结膜下移植治疗翼状胬肉

目的　探讨防止初发性翼状胬肉术后复发的最佳手术方法。方法　 3 4例 (3 6眼 )初发性翼状胬肉 ,在手术显微镜下进行手术 ,保留翼状胬肉表面的球结膜 ,在自然解剖状态下彻底分离切除翼状胬肉组织 ,同时行新鲜羊膜移植。术后随访 9～ 2 0月 ,平均 11 2月。结果　 3 4例 (3 6眼 )均治愈 ,均无复发。术后未见并发症。结论　手术显微镜下行翼状胬肉切除联合新鲜羊膜球结膜下移植是治疗初发性翼状胬肉的有效方法。     

改良自体结膜瓣移植治疗翼状胬肉的临床初步报告

目的探讨一种治疗初发性翼状胬肉的新的手术方法,寻求防止初发性翼状胬肉术后复发的最佳手术方法。方法18例（18眼）初发性翼状胬肉,在手术显微镜下进行手术,彻底切除翼状胬肉组织,保留巩膜表面的眼球筋膜囊,同时从上方或下方取条状球结膜转位行改良的自体球结膜移植。术后随访12—20个月,平均（16．09±3．56）月。结果18例（18眼）均治愈,未见胬肉复发。术中术后未见并发症。结论手术显微镜下行保留眼球筋膜囊的翼状胬肉切除联合改良自体球结膜移植手术,术后复发率低,是治疗初发性翼状胬肉的一种新的安全有效的方法。     

自体结膜瓣移植治疗翼状胬肉的临床观察

探讨一种治疗初发性翼状胬肉的新手术方法,寻求防止初发性翼状胬肉术后复发的最佳手术方法。 方法：初发性翼状胬肉15例15眼,在手术显微镜下进行手术,彻底切除翼状胬肉组织,同时从上方取半圆形球结膜行自体球结膜移植。术后随访3～12mo。 结果：患者15例15眼均治愈,未见胬肉复发。术中术后未见并发症。 结论：手术显微镜下行翼状胬肉切除联合自体球结膜移植手术,术后复发率低,是治疗初发性翼状胬肉的一种新的安全有效的方法     

翼状胬肉三种手术方法的临床效果观察

目的对比3种手术方法治疗翼状胬肉的临床效果。方法翼状胬肉63例(63眼)随机分为3组:第1组,胬肉单纯切除;第2组,自体角膜缘上皮联合球结膜移植;第3组,翼状胬肉切除球结膜移植术中应用丝裂霉素C。每组均为21例。观察术后角膜愈合情况、角膜缘新生血管及球结膜是否有结膜翼状胬肉样组织增生。结果随访6~24月。第1组中有7例复发(33.33%);第2组及第3组均无复发者。结论单纯手术切除不能从根本上阻止翼状胬肉复发,自体角膜缘上皮联合球结膜移植术及翼状胬肉切除球结膜移植术中应用丝裂霉素C均可有效地阻止胬肉复发。     

翼状胬肉术后角巩膜溶解6眼

0引言翼状胬肉是眼科常见病和多发病,治疗以手术为主。但是单纯胬肉切除术后复发率高达20%~70%[1]。近年来国内外眼科学者为了预防翼状胬肉术后复发,不断改进手术方式,同时术中术后联合应用抗代谢药物等方法极大地降低了手术后复发率,但同时也出现了新的术后并发症的发生,有的并发症可严重影响视功能,甚至丧失眼球[2]。现将我院近年来翼状胬肉切除联合丝裂霉素C(MMC)术后角巩膜溶解6眼,报告如下。1临床资料总结我院2003-12/2008-08门诊及住院翼状胬肉切除联合MMC术后角巩膜溶解6眼,其中女5眼,男1眼,年龄50~73岁,2眼为复发性胬肉。显微镜下行胬肉切除术。切除胬肉体部,保留胬肉头部不     

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.