正常眼压性青光眼与原发性开角型青光眼24小时眼压曲线的比较

目的 通过24 h眼压的测量来深入分析比较正常眼压性青光眼(NTG)与原发性开角型青光眼(POAG)的眼压曲线特征.方法 前瞻性病例对照研究.收集2006年4月至2009年4月在上海市闸北区北站医院和复旦大学附属眼耳鼻喉科医院门诊就诊的NTG患者131例及POAG患者102例,测量24 h眼压,用非接触性眼压计从8 am起每隔2 h测一次眼压,0 am至6 am之间测得的为唤醒后即刻坐位眼压.主要观察指标为眼压波动曲线、平均眼压、峰值时间及眼压、谷值时间及眼压和眼压波动值.采用独立样本t检验和卡方检验比较各指标在两组之间的差异.结果 NTG组双眼平均眼压为(14.2±2.1)mmHg,低于POAG组[(19.9±3.5)mmHg];NTG组双眼峰值眼压为(17.0±2.4)mmHg,低于POAG组[(24.7±4.3)mmHg];NTG组双眼谷值眼压为(11.8±2.2)mmHg,低于POAG组[(16.5±3.1)mmHg];NTG组双眼眼压波动值为(5.2±1.8)mmHg低于POAG组(8.2±3.1)mmHg];两组的平均眼压、峰值、谷值及眼压波动值的差异均有统计学意义(t=-14.52、-16.44、-13.16、-8.90,P均＜0.01).NTG组63.3%患者、POAG组73.5%患者的峰值眼压位于门诊工作时间以外;尤其是NTG组有51.5%患者、POAG组有64.7%患者的峰值位于0 am至6 am时间段,两组差异有统计学意义(X2=8.150,P=0.017).结论 NTG及POAG患者24 h眼压曲线的变化规律具有相似性,是诊断和个体化治疗方案制订的依据,并可用作治疗随访中评价疗效和调整方案的重要参考指标.     

原发性开角型青光眼患者及正常人的眼压日内波动趋势

目的研究原发性开角型青光眼（POAG）、正常眼压性青光眼（NTG）患者及正常人双眼眼压昼夜波动趋势及其眼压峰值出现的规律，比较双眼眼压波动趋势是否一致。设计前瞻性病例系列。研究对象POAG、NTG患者及正常对照各30例。方法用Goldmann压平眼压计测量眼压日曲线，比较双眼的日眼压波动模式及眼压峰值分布。主要指标眼压测量值。结果眼压峰值出现于非办公时段的正常人为右眼6．7％、左眼10．0％；NTG患者为右眼20．0％、左眼23．3％；POAG患者为右眼23．3％、左眼20.0％。结论POAG、NTG患者和正常人有着不同的眼压昼夜波动模式，且双眼的波动趋势不尽相同，不能完全将双眼等同看待；部分观察对象的峰值眼压分布于非办公时段，办公时段多次眼压测量不能完全代替一日眼压监测。（眼科，2007,16：33．36）     

正常眼压性青光眼中眼压与视野间的关系

目的 :探讨正常眼压性青光眼 (normalpressureglaucoma ,NPG)的眼压、视野和相互关系。方法 :分析 98例新诊断NPG患者的眼压曲线和视野状态。结果 :眼压曲线呈单峰式波动 ,双眼对称 ,总体平均水平位于 16mmHg上下 ,波动幅度 <2mmHg。患者男性眼压均值右眼为15 70± 2 5 7mmHg、左眼为 15 46± 2 %41mmHg ,女性右眼为 16 5 2± 1 97mmHg、左眼为 16 45± 2 0 1mmHg ,眼压与年龄相关不显著 (P >0 0 5 )。患者各相应年龄组的眼压均高于正常老年人 (分别P <0 0 2 ,P <0 0 1,P <0 0 0 1)。在 98例患者 196眼的视野中 ,5 2例患者为单眼损害 ,14 4眼的视野损害在损害形态和部位上与眼压升高的原发性开角型青光眼 (hp -POAG)相符合 ,但旁中心损害侵入中心固视区者约占 2 2 2 2 %。在两眼视野损害相对轻重的划分中 ,视野损害不同分级状态下眼压的平均值、最高值和波动差二者间差异不显著 (P >0 0 2 ) ,单侧视野损害患者患眼与对侧眼眼压差异不显著 (P >0 0 5 ) ,但同侧视野损害较重且眼压较高眼数的构成比最大 ,约占 5 5 1%(P <0 0 1)。结论 :NPG患者的眼压状态在单值水平、波动幅度和双眼对称性上均与一般群体生理眼压相一致 ,但平均眼压高于年龄可比的正常老年人。视野损害特征与hp -POAG相符合 ,     

24小时眼压监测中夜间眼压测量方法的探讨

目的比较24h眼压监测中夜间即刻坐位眼压值和坐起休息10min后测得的眼压值,探讨夜间眼压的不同测量方法对青光眼24h眼压昼夜波动的影响。方法对已确诊且未用药、未做过手术的48例正常眼压性青光眼及17例原发性开角型青光眼患者进行24h眼压监测,每2h1次,其中测量夜间0:00、2:00、4:00眼压时,逐个唤起患者后立即测,后嘱患者坐起休息10min再测,采用SPSS软件以配对t检验分析比较测量结果。结果夜间即刻坐位眼压值和坐起休息10min后测得的眼压值差异有统计学意义(P<0.001),正常眼压性青光眼与原发性开角型青光眼间眼压差值差异有统计学意义(P<0.05)。结论即刻坐位眼压值能更准确反映夜间眼压,对24h眼压测量及青光眼诊断及治疗更有价值,值得临床应用。     

高眼压症中央角膜厚度与眼压关系的临床观察

目的 评价高眼压症患者中央角膜厚度(CCT)与眼压(IOP)的关系,并探讨CCT在判断高眼压症患者是否给予降眼压药物干预治疗中的临床意义.方法 对54例(108只眼)高眼压症患者进行非接触眼压计检测和超声角膜厚度测量,并对校正眼压＜21 mmHg的患者31例62只眼(占57.4%)不予降眼压治疗,追踪观察其眼压、视野、视乳头以及视网膜神经纤维层的情况.结果 IOP随CCT增加而增高,并呈正相关(CCT每增加100μm,IOP将随之增加2.1mmHg).对校正眼压＜21mmHg的患者不予降眼压治疗,随访24～36个月,平均30个月,其中1例2只眼出现视野改变,发生率为1.85%.结论 中央角膜厚度测量可以作为高眼压症与青光眼进行鉴别诊断,以及判断高眼压症能否发展为青光眼的重要依据,常规测量高眼压症患者的CCT并校正其眼压,对高眼压症患者的合理处置非常重要,对校正眼压＜21mmHg的患者可以不需降压药物干预治疗,仅需密切随访.     

角膜中央厚度对高眼压症和开角型青光眼眼内压测量值的影响

目的研究角膜中央厚度对高眼压症和原发性开角型青光眼病人的眼内压测量值的影响.方法对44例(88眼)临床诊断为高眼压症的患者,31例(61眼)原发性开角型青光眼患者及52例(104眼)与高眼压症患者屈光状态相近的正常人的角膜中央厚度及眼内压进行检测,用统计学方法比较3组的角膜中央厚度的差异及高眼压症患者的眼内压值与角膜中央厚度的相关关系.结果①高眼压症组的角膜中央厚度的平均值585.6±35.7μm明显高于原发性开角型青光眼(54.1±38.7μm)(P＜0.01)及正常对照组(535.5±29.4μm)(P＜0.01),而原发性开角型青光眼的角膜中央厚度与正常对照组相比无显著性差异(P＜0.05).②将高眼压症患者的角膜中央厚度与眼内压测量值进行简单线性相关分析,可见角膜中央厚度与眼内压测量值呈明显正相关,相关系数为0.636(P＜0.01).角膜中央厚度每增加50μm可使眼内压测量值升高约2mmHg.结论①高眼压症患者的角膜中央厚度明显大于原发性开角型青光眼和正常眼,高眼压症患者的角膜中央厚度与眼内压呈明显的正相关,提示高眼压症患者是由于角膜中央厚度高于正常范围而造成眼内压测量值的升高.②角膜中央厚度值可作为高眼压症及原发性开角型青光眼的诊断与鉴别诊断的重要依据.提示临床工作中,可将角膜中央厚度检测作为排除青光眼的常规检查手段.③当角膜中央厚度在520±50μm的范围内,眼压读数相对准确,如果角膜中央厚度超过570μm,眼压读数相应增高,这可能是高眼压症患者眼压测量值高于正常范围的重要原因之一.     

高眼压症及原发性开角型青光眼患者的24 h眼压波动规律

目的 通过24 h眼压测量来深入分析对比高眼压症与原发性开角型青光眼(POAG)患者的眼压曲线特征。方法 收集2016年1月~2019年3月在我科门诊诊断为高眼压症的患者52例(104眼)及POAG尚未接受降眼压治疗的患者38例(76眼)。入院后行24 h眼压检查,用非接触性眼压计从早9时起每隔2 h测量眼压1次,至次日7时结束。分析2组患者的平均眼压,峰值眼压及时间点,谷值眼压及时间点,昼夜眼压波动及双眼眼压压差值及其分布情况,比较2组眼压波动的异同点。结果 104眼高眼压症患者的平均眼压为(18.73±1.71)mmHg(1 mmHg=0.133 kPa),平均峰值眼压为(22.36±2.40) mmHg,平均谷值眼压为(15.63±2.09) mmHg,平均昼夜眼压波动为(6.72±2.24) mmHg。76眼POAG患者的平均眼压为(20.65±2.53) mmHg,平均峰值眼压为(25.78±2.81) mmHg,平均谷值眼压为(17.45±2.54) mmHg,平均昼夜眼压波动为(8.34±2.37) mmHg。2组的峰值及谷值眼压值分布最多的时间点均为凌晨3时及夜晚21时,大部分患者的峰值眼压时间点在门诊时间之外。高眼压症组中昼夜眼压波动位于5~8 mmHg的占比最大,为54.81%(57/104),POAG组中昼夜眼压波动>8 mmHg的占比最大,为53.95%(41/76)。高眼压症组中,16例患者经24 h眼压检查后监测到眼压波动异常,占比为30.77%(16/52);POAG组中经24 h眼压检查后有29例患者可以监测到眼压波动异常,占比为76.32%(29/38)。结论 24 h眼压监测中,POAG患者较高眼压症患者的平均眼压、峰值眼压、谷值眼压、昼夜眼压波动及双眼压差均有增加。对于24 h眼压发现眼压波动较大的高眼压症患者应在后续加强密切随访,而对于POAG患者24 h眼压监测可在治疗前提供眼压的基线水平,为后续治疗提供参考及评估依据,因此建议将24 h眼压作为高眼压症及POAG的常规检查手段。     

Circadian changes of intraocular pressure and ocular perfusion pressure after timolol or latanoprost in Caucasians with normal-tension glaucoma

Purpose To evaluate the circadian effects on intraocular pressure (IOP) and ocular perfusion pressure (OPP) of 0.5% timolol or 0.005% latanoprost in Caucasian patients affected by normal-tension glaucoma (NTG). Patients and methods In this crossover trial, 30 consecutive NTG subjects underwent three 24-hour assessments of IOP, blood pressure (BP), heart rate (HR), and OPP [calculated according to the formula OPP = (1/3 systolic BP + 2/3 diastolic BP) x 2/3 – IOP]: at baseline, and after 1-month treatment with timolol or latanoprost. These parameters were recorded at 4 a.m., 8 a.m., noon, 4 p.m., 8 p.m., and midnight. Results Both timolol and latanoprost reduced IOP (p < 0.001), with a difference in favour of latanoprost of 1.3 mmHg (95% CI 0.9, 1.6; p < 0.001). After timolol, BP and HR decreased with respect to baseline (p < 0.001). Latanoprost increased mean OPP (3.6 mmHg, 95% CI 2.9, 4.3; p < 0.001), whereas timolol did not improve it. Conclusions Latanoprost induces an IOP reduction greater than timolol, also achieving a better circadian flattening of the IOP curve. Only latanoprost significantly increased mean 24-hour OPP. The management of Caucasian NTG patients should be critically realized, considering the 24-hour influence of each IOP-lowering drug on the ocular blood perfusion.     

青光眼昼夜眼压波动

病理性高眼压和较大的昼夜眼压波动是青光眼视神经损害进展的重要危险因素.眼压具有波动性,正常人眼压波动的峰值多出现于凌晨,这种波动与体位、眼灌注压、眼轴等有关.正常眼压性青光眼患者眼压波动是视野进展的重要危险因素,且经24小时眼压监测发现大部分眼压是存在异常的,因此需根据其昼夜眼压曲线明确诊断和针对性治疗;原发性开角型青光眼患者昼夜眼压波动规律与正常人相似,眼压高峰多在夜间,但波动范围可能比正常人大,且双眼的波动呈明显的一致性;激光周边虹膜切开术后的慢性闭角型青光眼患者的昼夜眼压波动较大,其眼压波动与基线眼压和房角粘连程度呈正相关.与激光和药物相比,小梁切除术更有利于控制长期和昼夜的眼压波动.抗青光眼药物中前列腺素类药物是控制昼夜眼压波动效果最好的滴眼剂.     

Central and paracentral corneal pachymetry in patients with normal tension glaucoma and ocular hypertension

Purpose The difference in central corneal thickness among subgroups of glaucoma patients, as well as its influence on Goldmann applanation tonometry, has been well documented in several clinical trials. In the present study, possible similarities and differences between central corneal thickness and corneal thickness of paracentral quadrants in patients with normal tension glaucoma (NTG) and ocular hypertension (OHT) were investigated. Methods Central and paracentral corneal thickness was measured by optical slit scan pachymetry (Orbscan II). Fourteen patients (28 eyes) with NTG and 11 patients (22 eyes) with OHT were included in this study. t-Test was performed for statistical analysis. To evaluate overall corneal topography, the mean and SD values of the differences between the central corneal thickness and each peripheral quadrant were analysed. Results The following data was obtained (μm): (central, upper, temporal, nasal, inferior paracentral quadrant): OHT group 617–695–663–687–660. NTG group 568–629–593–612–616. Corneal thickness of all four paracentral quadrants differed significantly between the OHT and NTG groups. There was a more heterogeneous intraindividual pattern of overall corneal topography in the OHT group, and a more heterogeneous pattern of corneal topography among the individuals of the NTG group (interindividual heterogeneity). Conclusions A comparison of central corneal thickness and paracentral corneal thickness revealed clinically relevant differences between the OHT and NTG groups. The presented data underlines the importance of correlating the site of applanation with the corresponding corneal thickness, especially in OHT patients. It further substantiates the necessity to obtain individual pachymetric data for each NTG patient.     

选择性激光小梁成形术对开角型青光眼小梁切除术后高眼压的疗效

目的观察选择性激光小梁成形术对降低开角型青光眼小梁切除术后患者眼压的疗效。方法22例患者22眼,使用倍频Q-开关Nd:YAG激光照射鼻侧180°小梁网,光斑400μm,脉宽3ns,能量设置0.4~1.0mJ,光斑点数50~55。术后测1h、1d、1周及1、3、6月眼压。结果术后6月成功率为16/22(72.7%)。术前、术后1h、1d、1周及1、3、6月眼压分别为(23.5±3.4)mmHg、(24.1±4.3)mmHg、(16.8±4.6)mmHg、(19.3±3.8)mmHg、(18.5±4.1)mmHg、(19.7±4.5)mmHg、(19.4±4.7)mmHg。结论SLT对开角型青光眼术后高眼压具有良好的降压效果。     

高度近視患者白内障術後的眼壓燮化觀察

目的觀察高度近視患者白内障術後的眼壓變化,評價手術方式對其的影響.方法高度近視白内障患者190例,分爲ECCE和PHACO兩組,分别觀察.結果術後随訪中,ECCE組眼壓升高25例,占21.93%,開角型青光眼3例,占2.63%;PHACO組眼壓升高3例,占3.94%,可疑開角型青光眼1例.結論高度近視白内障患者術後眼壓升高存在一過性升高和青光眼發作兩種情况,超聲乳化術後眼壓升高較少.     

Diurnal variation in central corneal thickness and intraocular pressure in eyes with pseudoexfoliation syndrome without glaucoma

Aim:

The aim was to ascertain if any differences exist in diurnal central corneal thickness (CCT) and intra-ocular pressure (IOP) between eyes with pseudoexfoliation (PXF) syndrome without glaucoma and eyes with no ocular pathology. A secondary aim was to determine whether there was a significant relationship between CCT and IOP.

Settings and Design:

This study was a prospective design conducted within a hospital setting.

Materials and Methods:

The experimental group consisted of seven participants with bilateral PXF (14 eyes) and the control group comprised of 15 participants (30 eyes). Testing included CCT and IOP measured at four different times on one given day (8.00 a.m.; 11 a.m.; 2 p.m. and 5 p.m.).

Statistical Analysis:

The data were analyzed with the generalized linear latent mixed model.

Results:

PXF eyes displayed a significantly thinner overall mean CCT (520 μm) compared to controls (530 μm). Furthermore, a significant reduction in CCT and IOP occurred in the PXF group from 8 a.m. to 5 p.m. The mean overall IOP in PXF eyes was significantly lower than the control group. A significant association between IOP and CCT was also found in PXF eyes.

Conclusions:

Displaying a significantly thinner mean CCT highlights the importance of measuring CCT in an ophthalmic clinical setting as to avoid falsely underestimated IOP measurements in such a high-risk glaucoma population. Furthermore, a statistically significant correlation between IOP and CCT in PXF eyes suggests that the reduction in CCT that occurred in PXF eyes between 8 a.m. and 5 p.m. may be partly responsible for the reduction in IOP measurements.     

曲伏前列素滴眼液(速为坦)治疗原发性开角型青光眼和高眼压症的临床研究

目的观察曲伏前列素滴眼液(速为坦)降眼压效果及安全性。方法采用随机、单盲、平行对照试验,选取原发性开角型青光眼和高眼压症患者,试验组入选24例(24只眼)滴用曲伏前列素滴眼液,对照组入选23例(23只眼)滴用拉坦前列素滴眼液(适利达),均为每日1次,共观察4周。观察的指标包括眼压、视力、血压、脉搏、眼部症状和体征以及不良反应。结果1试验组平均日间眼压从(2483±297)mmHg(1mmHg=0133kPa)降至(1613±292)mmHg,最大下降幅度为352%;对照组从(2396±362)mmHg降至(1614±297)mmHg,最大下降幅度为326%。2用药后试验组和对照组结膜充血均有明显增加,试验组的眼痒明显重于对照组,但都不妨碍继续用药。未发现其他眼部改变和全身副作用。结论曲伏前列素滴眼液对控制原发性开角型青光眼和高眼压症的眼压是有效和安全的,可望成为理想的一线抗青光眼药物。     

不同间隔时间测量青光眼患者24h眼压的比较研究

目的比较每隔2h与每隔3h测量24h眼压的差异,从而制订出对患者更方便、更行之有效的24h昼夜眼压监测方法。方法选择青光眼患者27例（54眼）,相同条件下,使用非接触眼压计,分别进行每隔2h与每隔3h的24h眼压测量。比较2h测量组与3h测量组的峰值出现的时间,并比较2h组与3h组的全天时间段和睡眠时间段的峰值眼压、谷值眼压、波动值、平均值眼压。结果2h组中,有59．26％的患者眼压峰值出现在睡眠时间;3h组中,有61．11％的患者眼压峰值出现在睡眠时间,2h组和3h组达峰值的频数差异无统计学意义。全天时段2h组和3h组的眼压峰值、谷值、平均值及眼压波动值比较,差异无统计学意义（P〉0．01）。睡眠时间段2h组和3h组的眼压峰值、谷值及平均值比较,差异无统计学意义（P〉0．01）,2h组眼压波动值大于3h组（P〈0．01）。结论24h眼压监测能更好地发现青光眼的高眼压和昼夜眼压波动异常。使用非接触眼压计每隔3h昼夜眼压监测可以代替2h发现高眼压和眼压波动异常,是既行之有效,又更为简单的方法。     

白内障超声乳化人工晶状体植入术对早期原发性青光眼眼压控制效果分析

目的 观察早期原发性青光眼行超声乳化联合人工晶状体植入术后眼内压(IOP)控制情况,分析与术后IOP控制效果相关的影响因素.方法 回顾性选择原发性闭角型青光眼(PACG)43例(43只眼)和原发性开角型青光眼(POAG)早期患者32例(32只眼),均行标准3.2mm透明角膜切口白内障超声乳化联合折叠人工晶状体植入术,术后2年定期随访.手术成功标准为:术后IOP保持在6～21mmHg,青光眼神经病变及相应视野缺损无明显进展,无需再行抗青光眼手术治疗.结果 白内障超声乳化联合人工晶状体植入术后,PACG组有28例(65.1%)、POAG组有12例(37.5%)术后IOP控制良好,2年累计生存率之间存在差异(P＜0.05).PACG组成功与失败病例在术前IOP(33.0±5.3)mmHg vs(40.1±3.6)mmHg,P＜0.01、抗青光眼药物数量(2.9±0.9vs4.1±0.4,P＜0.01)、房角粘连范围(2.9±0.5)钟点vs(4.2±0.8)钟点,P＜0.01)之间的差异具有统计学意义,而POAG组成功与失败病例在术前IOP(25.3±3.4)mmHgvs(35.4±3.6)mmHg,P＜0.01、抗青光眼药物数量(1.2±0.4vs2.8±0.9,P＜0.01)之间的差异具有统计学意义.Cox逐步回归分析发现,在PACG组中术前IOP(P＜0.05,RR=1.17)、PAS(P＜0.01,RR=3.971),在POAG组中术前IOP(P＜0.01,RR=1.284),与相应两组术后生存时间具有相关性.结论 在术前PACG患者考虑到IOP和房角粘连范围、POAG患者考虑到IOP的条件下,超声乳化联合人工晶状体植入术对于伴有白内障的早期原发性青光眼,是一种可供选择的有效的控制眼内压的治疗方法.

Abstract：

Objective To assess and find associated factors for favorable postoperative intraocular pressure (IOP) after cataract phacoemulsification with intraocular lens implantation in patients with primary glaucoma on early stage.Methods Forty-five patients (43 eyes) with primary angle closure glaucoma (PACG) and 32 patients with primary open angle glaucoma (POAG) were retrospectively selected.All patients had undergone standard 3.2mm limbal incision phacoemulsification,and 2 years of routine follow-up after cataract surgery.Success was defined as an IOP between 6-21mmHg,with fewer antiglaucoma medications needed than those during pre-operation,no obvious progressions of glaucomatous neuropathy and its coincident visual field loss,and no need of additional glaucoma surgery.Results After phacoemulsification with intraocular lens implantation,there were 28 cases (65.1%) in PACG group and 12 cases (37.5%) in POAG group with well controlled postoperative IOP,and the different of 2-year survival rate was statistically significant (P ＜0.05).There were significant different in the pre-IOP (33.0± 5.3mmHg vs 40.1 ± 3.6mmHg,P ＜0.01),the number ofantiglaucoma medications (2.9± 0.9 vs 4.1± 0.4,P＜0.01) and the extent of peripheral anterior synechiae (PAS) (2.9±0.5 clock hours vs 4.2± 0.8 clock hours,P ＜0.01) between success and failure cases in PACG group.The pre-IOP (25.3±3.4 mmHg vs 35.4±3.6 mmHg,P＜0.01),the number of antiglaucoma medications (1.2± 0.4 vs 2.8± 0.9,P ＜0.01) were significant different between the success and failure cases in POAG group.Cox stepwise regression analysis found that pre-IOP (P ＜0.05,RR=1.17) and the extent of PAS (P ＜0.01,RR=3.971) in PACG group and the pre-IOP (P＜0.01,RR=1.284) in the POAG group was significant associated with the corresponding survival time after cataract surgery.Conclusions Phacoemulsification with intraocular lens implantation may be an alternative procedure for effective IOP control of the patients with primary glaucoma on early stage coexisting with cataract on considering pre-IOP and the extent of PAS in PACG and pre-IOP in POAG.     

真空小梁成形术治疗原发性开角型青光眼及高眼压症的临床分析

目的观察真空小梁成形术（PNT）治疗原发性开角型青光眼（POAG）和高眼压症患者的疗效和安全性。方法 21例（30只眼）患者进行视力、屈光度、中央角膜厚度、眼压、裂隙灯、前房角镜、眼底、视盘相干光断层扫描（OCT）及Humphrey自动视野计等全面眼科检查,并行PNT1000型治疗仪（Ophthalmic International公司产）治疗,首次治疗后第7天重复治疗1次,首次治疗后1 h、1 d、1周、2周、1个月、2个月、3个月复查,主要观察指标为眼压。结果 30只眼患者治疗前眼压（23.3±1.7）mm Hg,治疗后1 d、1周、2周、1个月、2个月、3个月各时间点眼压分别为（19.7±4.0）mm Hg、（19.7±2.8）mm Hg、（19.4±4.1）mm Hg、（19.0±2.4）mm Hg、（18.6±3.3）mmHg、（18.4±3.0）mm Hg,各时间点较治疗前基线眼压差异有统计学意义（P均〈0.001）,25只眼（83.3%）治疗后眼压下降幅度超过15%。结论本研究的短期小样本证实PNT是一种治疗POAG和高眼压症的安全有效的方法。     

76例急性闭角型青光眼持续高眼压下行抗青光眼手术的临床效果评价

目的 探讨在持续高眼压下行抗青光眼手术的临床疗效.方法 对76例(76只眼)经常规降眼压处理后眼压仍大于40 mmHg的急性闭角型青光眼患者行抗青光眼手术,观察术后视力、眼压及滤过泡等情况.结果 行小梁切除术38只眼,行超声乳化白内障摘除联合房角分离术26只眼,行超声乳化白内障摘除联合小梁切除术12只眼,术后66例视力较术前有明显提高,术后眼压符合完全成功67只眼(78.1％),符合条件成功4只眼(12.5％),平均眼压(15.88±6.32)mmHg,5只眼(9.4％)失败,27只眼滤过泡为功能性滤过泡,5只眼为非功能性滤过泡.结论 对持续高眼压性青光眼行抗青光眼手术,需依据病情采取不同治疗举措,可取得降低眼压,提高视力,保护视功能的效果.     

七氟烷吸入麻醉对大鼠青光眼造模眼眼压的影响

目的研究吸入麻醉药七氟烷对磁性微球前房注射诱导实验性大鼠青光眼造模眼和正常眼眼压(IOP)的影响。方法雄性8～10周挪威褐鼠6只,进行2周清醒状态下IOP测量训练后,采用磁性微球前房注射方法诱导实验性青光眼,右眼为青光眼造模眼,左眼为自身对照眼,研究吸入麻醉药七氟烷麻醉对造模眼和对照眼IOP的影响。结果七氟烷可明显降低造模眼和对照眼的IOP,麻醉平稳后造模眼IOP最大降低幅度为52.6%(t=20.61),对照眼最大降低幅度为37.5%(t=4.98),造模眼降低的程度明显大于对照眼。造模眼IOP在大鼠苏醒后仍低于基础值,差异有统计学意义,而对照眼IOP在苏醒后即恢复至接近基础值。结论七氟烷吸入麻醉可以显著降低大鼠IOP,其中青光眼造模眼的下降幅度更为显著,持续时间更长。该结果提示在对先天性青光眼患儿使用七氟烷全身麻醉下检查时,应充分考虑到该药物降低IOP的作用。     

一氧化氮与青光眼患者眼压升高关系的研究

目的探讨一氧化氮(nitricoxide,NO)在青光眼患者眼压升高中的作用.方法对急性闭角型青光眼患者16例,老年性白内障患者29例,正常志愿者30例,应用高效液相色谱分析仪检测其血浆和房水中NO的含量,并以NO2和NO3之和表示.结果正常对照组血浆中NO的平均含量为(2969.37±862.85)ng/L;青光眼组血浆中NO的平均含量为(1390.78±302.95)ng/L,较对照组明显降低(t=2.853,P<0.01);白内障组血浆中NO的平均含量为(4234.89±1495.23)ng/L,较对照组明显升高.对照组房水中NO平均含量为(1405.83±602.70)ng/L;青光眼组房水中NO的平均含量为(2052.03±694.74)ng/L,与对照组比较差异无显著性(t=1.862,P＞0.05);白内障组房水中NO的平均含量为(2454.67±655.13)ng/L,较对照组明显升高.房水/血浆NO含量比值对照组为47.3%,白内障组为58.0%,二者的比值差异无显著性;而青光眼组为144.0%.结论血浆、房水中NO含量与急性闭角型青光眼眼压升高有关.