Therapeutic and protective properties of the corneal collagen shield

Following completion of radial keratotomy (RK) corneal incisions, 16 rabbits had a collagen shield placed on the operated cornea. Sixteen additional rabbits did not receive a collagen shield and were studied as a control group. The operated eyes of each group were enucleated at specified intervals. Fifty patients between 18 and 30 years of age with myopia greater than -6.5 diopters (D) had RK surgery: 25 patients (31 eyes) were chosen as a control group and 25 patients (30 eyes) had a collagen shield placed on the operated cornea at the end of surgery. Each patient was followed clinically at specified intervals. Histological and clinical findings included decreased postoperative corneal edema and inflammatory reaction and accelerated epithelial and stromal healing time and corneal stability. Patients who received collagen shields noted less glare and discomfort and obtained an average of nearly 1 D greater effect than the control group.     

前房接种角膜抗原和角膜移植物诱导的前房相关免疫偏离

目的 观察角膜抗原和角膜移植片诱导前房相关免疫偏离的可能性。方法 分别将角膜抗原和带有完善内皮层的角膜移植片接种于新西兰兔眼结膜下和前房。７天后,使用添加完全弗氏佐剂的角膜抗原或植片供体脾细胞免疫动物。１周后,评估抗原特异性迟发型超敏反应的诱导情况。     

Quantitative determination of fluorescein in the anterior chamber and vitreous body

The blood-retinal barrier plays an important role in the physiology of the retina, the vitreous body and the aqueous humour. Many intra-ocular processes cause a breakdown of this barrier and this results in an increase in the concentration of fluorescein in the vitreous and the aqueous after it has been injected intravenously (Cunha-Vaz et al., 1975).In our clinic we have built an apparatus for the quantitative determination of the concentration of this fluorescein in both healthy and pathological eyes (Brubaker and Coakes, 1978).The goal of the present communication is to invite other workers with similar interests to compare their results with ours.     

国产牛腱角膜胶原膜缓释妥布霉素的实验研究

目的探讨应用牛腱胶原研制的国产牛腱角膜胶原膜制作缓释妥布霉素及其效果.设计随机对照实验研究.研究对象新西兰家兔36只.方法将36只新西兰家兔(72眼)随机分为3组局部频繁点眼组、角膜胶原膜载药组、结膜下注射组,对3组兔眼分别用0.3%妥布霉素眼液频繁点眼、载药的角膜胶原膜贴覆于角膜表面和结膜下注射20mg硫酸妥布霉素,用免疫比浊法分别测定每组中3只兔(6眼)用药后0.5、1、3及6小时房水中妥布霉素的药物浓度.主要指标兔眼房水中妥布霉素的药物浓度.结果0.5、1、3和6小时频繁点眼组兔眼房水中妥布霉素的药物浓度分别为(0.23±0.18)μg/ml、(0.30±0.13)μg/ml、(0.21±0.04)μg/ml、(0.23±0.12)μg/ml;角膜胶原膜组房水中妥布霉素浓度分别为(4.15±0.85)μg/ml、(12.31±2.75)μg/ml、(9.03±1.47)μg/ml、(1.40±0.72)μg/ml;结膜下注射组分别为(3.55±2.82)μg/ml、(17.65±2.67)μg/ml、(7.64±4.39)μg/ml、(2.44±1.74)μg/ml.房水中妥布霉素的浓度在四个时点角膜胶原膜组和结膜下注射组都显著高于局部频繁点眼组,结膜下注射组除在1小时显著高于角膜胶原膜组外,其余时点与角膜胶原膜组无显著性差异.结论自制国产牛腱角膜胶原膜能够提高妥布霉素的角膜穿透力和其滴眼液的生物利用度,是良好的药物载体.     

角膜胶原膜的研制及临床应用

研究角膜胶原膜的制做方法及其在单纯疱疹病毒性角膜炎（ＨＳＫ）治疗中的应用。从猪巩膜中提取胶原采用离心干燥成膜法制成角膜胶原膜，在无环鸟苷药液内浸泡后用于治疗单纯疱疹病毒性角膜炎。结果应用浸泡无环鸟苷（ＡＣＶ）药液的胶原膜治疗组病灶平均愈合时间为９．４５天，局部滴无环鸟苷药液组病灶愈合平均时间为１４．３６天，两组治愈率和有效率分别为９０．６３％、６５．６３％和９６．８８％，８１．２５％差异显著（ｐ＜０．０５）。可见浸泡无环鸟苷药液后的胶原膜在单纯疱疹病毒性角膜炎的治疗中将具有较好的应用前景。     

Iris fluorescein angiography and fluorescein gonioscopic photography after implantation of Choyce Mk IX anterior chamber lenses

Patients underwent intracapsular cataract extraction and implantation of a Choyce Mk IX anterior chamber intraocular lens. At fluorescein angiography (FAG) at a mean of 8 months post-operatively, 9 showed leaking from the iridal vessels, and 3 were normal: Three cases were excluded because of factors affecting the iris FAG. At a mean of 37 months 5 still had a slight degree of leakage. No primarily negative iris FAG changed to positive later. Fluorescein gonioscopic photography (FGP) revealed leakage in 29.5% of the tips of the foot plates at a mean of 37 months. No correlation was observable between FGP and gonioscopy. The pupillary deformation quotient DQ (greatest: smallest pupillary diameter) was significantly greater at a mean of 8 months in the eyes with leakage in iris FAG than in eyes without leakage (P = 0.0145). Individually a change both in direction against normalisation and in elongation was recorded during the observation time.     

近视眼角膜横径和前房深度及前房体积相关因素分析

目的: 分析近视患者角膜横径和前房深度的相关影响因素,进一步探讨前房体积的影响因素。方法: 随机收集241例482眼6～47岁近视患者,男124例248眼,女117例234眼。采用OrbscanⅡZ角膜地形图测量角膜横径和前房深度并应用SPSS17.0统计软件对其相关影响因素进行分析,建立数学模型探讨前房体积影响因素。结果: 角膜横径和前房深度平均值为11.69±0.51,3.04±0.30mm,男性、女性角膜横径和前房深度平均值分别为11.74±0.49,11.64±0.53,3.07±0.30,3.02±0.29mm,性别差异具有统计学意义(t=-2.265,-1.971;P=0.024,0.048),男性角膜横径和前房深度均大于女性。角膜横径和前房深度分别与年龄呈负相关(r=-0.260,-0.246;P=0.00,0.00),与等效球镜度无相关性(r=-0.057,0.067;P=0.210,0.142),角膜横径与前房深度呈正相关(r=0.297;P=0.00),回归方程Y=1.025+0.173X(Y代表前房深度,X代表角膜横径,F=46.440,P=0,R2=0.088)。结论: 近视眼患者的角膜横径和前房深度二者之间呈正相关。角膜横径、前房深度及前房体积男性大于女性,均与年龄呈负相关,与近视等效球镜度数无关。     

Human corneal endothelial permeability to fluorescein and fluorescein glucuronide

The corneal endothelial permeability coefficient (Pac) for fluorescein and fluorescein glucuronide was determined in ten normal young volunteers. After oral administration of fluorescein, the apparent concentrations of both dyes in the corneal stroma and the anterior chamber were measured by differential fluorometry. The apparent dye levels calculated directly from the in vivo fluorometric measurements were converted to the true ones, based on the result of a normalization experiment performed in rabbit eyes. The value of Pac averaged 5.44 +/- 1.77 X 10(-4) cm/min for fluorescein and 3.77 +/- 1.10 X 10(-4) cm/min for fluorescein glucuronide (mean +/- SD, N = 20); the former was significantly greater than the latter (paired t-test, P less than 0.001). The aqueous-cornea distribution ratio was 0.50 +/- 0.14 for fluorescein and 0.66 +/- 0.16 for fluorescein glucuronide; the latter was significantly greater than the former (paired t-test, P less than 0.001). It was suggested that the previously reported values of Pac for fluorescein in the human eye were underestimates.     

Effect of a collagen shield on cat corneal epithelial wound healing

We have previously demonstrated that a corneal bandage lens made from porcine scleral collagen may be useful in treating various ocular surface problems. In order to determine whether the collagen shield would accelerate epithelial healing, a 7 mm diameter circular area in the center of the left cornea of ten domestic cats was mechanically deepithelialized. In five of the cats, a 14.5 mm non-cross-linked collagen shield was then placed on the cornea covering the wound. Another shield was applied 24 hr after surgery. The wound size was determined immediately after surgery and at 8-hr intervals until wound closure. Using analysis of variance for experiments with repeated observations, there was a significantly greater healing response in the treated group than in the control group. There was, however, no significant difference in slope between the two groups, suggesting that the shield did not increase the speed of epithelial cell migration. Rather, the effect of the shield was most pronounced during the first 8 hr after wounding. In contrast to that of the treated group, the mean defect radius of the control group was larger at t = 8 hr than at t = 0 hr. The earlier wound closure exhibited by the treated group, which may be due to protection and lubrication of the epithelial cells at the margins of the fresh wound, suggests that the collagen shield may be useful in treating corneal surface conditions of which deepithelialization is a component.     

Late dislocation of intrastromal corneal ring segment into the anterior chamber

We describe the case of a 53-year-old woman with keratoconus who presented with a dislocated intrastromal corneal ring segment (ICRS) (Intacs) in the anterior chamber 3 weeks after surgery. To our knowledge, this is the first report of a late occurrence of postoperative anterior chamber dislocation of an ICRS and illustrates the need to consider the potential for such a complication.     

SMILE术矫正高度与低度散光前后表面曲率和前房深度的变化

目的:对微小切口基质透镜切除术(SMILE术)矫正高度散光与低度散光前后表面曲率、前房深度变化进行观察比较.方法:选取2013-04/2017-01在我院行SMILE术治疗的复合性近视散光的患者共63例88眼,等效球镜为-4.00~-9.00D,根据散光情况分为两组,其中A组柱镜度数为-2.00~-4.00D,B组柱镜度数为-0.25~-1.00 D.常规围手术期检查.所有病例按照SMILE术式常规操作流程完成手术,术后常规抗炎、抗菌药物治疗.随访视力、眼压、屈光度及角膜地形图(Pentacam)至术后3 mo.观察对比A、B组前后表面曲率、前房深度变化.A、B组数据之间的比较采用独立样本t检验,A、B组各时间段之间的数据进行重复测量数据的方差分析后再进行两两比较.结果:患者88例手术均顺利完成,边缘Ⅰ级愈合.A、B两组在术前、术后1wk,1、3mo时,后表面曲率及前房深度差异无统计学意义(P>0.05).A、B两组前表面曲率术后1wk时较术前均有明显变化(P<0.05),术后1wk,1、3 mo时两两相比差异无统计学意义(P>0.05).结论:无论是SMILE术矫正高度散光还是低度散光,角膜后表面的曲率及前房深度均无明显变化,前表面曲率在术后1 wk稳定.     

Persistent corneal edema secondary to presumed dead adult filarial worm in the anterior chamber

We present three cases of persistent corneal edema secondary to presumed dead adult filarial worms lying in the anterior chamber with their attachment to the endothelium. Two of them were initially diagnosed as descemet's fold with corneal edema. Two patients underwent penetrating keratoplasty and in one case, surgical removal was partly possible with clearing of cornea.