t—PA结膜下注射治疗术后眼内纤维蛋白渗出

为观察ｔ－ＰＡ（组织型纤溶酶原激活剂）结膜下注射对术后眼内纤维蛋白渗出的治疗效果，对２０例（２０眼）术后眼内纤维蛋白渗出患者用ｔ－ＰＡ结膜下注射。ｔ－ＰＡ治疗浓度为５０μｇ／ｍｌ，每次注射剂量为０．５ｍｌ，一次注射不能使纤维蛋白渗出完全溶解者间隔４８～７２小时重复给药，直至吸收。并与同期１９例（１９眼）用地塞米松治疗眼内纤维蛋白渗出的病人作对照。结果表明ｔ－ＰＡ组眼内纤维蛋白渗出完全吸收时间为注药后１～１４天，平均５．２０±３．４９天。对照组纤维蛋白渗出完全吸收时间为１～２１天，平均１０．３２±５．９６天，二者相比，有显著差异（Ｐ＜０．０１）。在ｔ－ＰＡ组治疗中未发现出血倾向、眼内压升高等并发症。全组病人随访一个月，未见眼内纤维蛋白渗出复发。认为ｔ－ＰＡ结膜下注射治疗眼内纤维蛋白渗出为一种安全有效的治疗方法。     

t—PA对人工晶体植入后瞳孔膜的治疗

白内障人工晶体植入术后可产生纤维蛋白渗出膜，作者采用前房注射ｔ－ＰＡ（１０μｇ）治疗瞳孔膜，观察ｔ－ＰＡ的疗效和毒性，７例中，５例平均在１．３小时溶解（０．５～３小时），２例大部分溶解，其中２例前房有絮状渗出瞳孔膜，注射后全部溶解，术后第一天复发。注药后２例出现眶周及患侧头痛，无角膜内皮毒性反应。     

t—PA治疗内眼术后眼内纤维蛋白渗出的临床观察

眼内纤维蛋白渗出是内眼手术失败并危及视力的严重的并发症之一，本文采用组织型纤溶酶原激活剂（ｔｉｓｕｅｐｌａｓｍｉｎｏｇｅｎａｃｔｉｖａｔｏｒ，ｔＰＡ）治疗２３例（２６眼）内眼术后纤维蛋白渗出患者，现报告如下。１对象与方法经常规治疗未迅速溶解的２３例...     

t—PA治疗玻璃体切割术后眼内纤维蛋白渗出

眼内纤维蛋白渗出是导致玻璃体切割术失败并危及视力的主要并发症之一。目前，动物实验和临床研究证实，玻璃体切割术联合眼部应用组织型纤维蛋白溶酶原激活剂（ｔ－ＰＡ），可有效地预防和治疗眼内纤维蛋白渗出及纤维增殖膜形成。本就这一疗法的研究现状作一总结，认为：眼部应用ｔ－ＰＡ治疗玻璃体切割术后眼内纤维蛋白渗出具有效果可靠、安全、毒性低、副作用小、适应证广泛等优点，在预防和治疗各种原因引起的增殖性玻璃体视网     

t—PA前房注射治疗人工晶体植入术后纤维蛋白性膜

目的探讨组织型纤溶酶原激活剂（ｔｉｓｕｅｐｌａｓｍｉｎｏｇｅｎａｃｔｉｖａｔｏｒ,ｔＰＡ）治疗人工晶体植入术后晶体前机化膜的合理方法,并评价其临床效果。方法将４３例（５８只眼）各类白内障术后眼分为３组,分别于人工晶体植入术后不同时间,前房内注射ｔＰＡ,或联合ＹＡＧ激光治疗,对比观察各组疗效。第１组２６只眼,在手术结束时立即前房内注入４μｇｔＰＡ。第２组２２只眼,在术后５～７天前房内形成纤维蛋白膜时,于前房内注射４μｇｔＰＡ。第３组１０只眼,术后形成较厚的纤维蛋白膜,在术后５～９天时先用ＹＡＧ激光切开纤维膜,再向前房内注射４μｇｔＰＡ。结果第１组患者中,４只眼发生前房内出血,８只眼形成瞳孔区纤维蛋白膜,于术后３～５天时再次前房内注射ｔＰＡ后全部溶解。第２组患者中,２０只眼内的纤维蛋白膜２４小时内全部溶解,无前房出血。第３组患者,４～２４小时内瞳孔区的纤维蛋白膜全部吸收,无前房内出血。结论在术后约１周时,前房炎症稳定的情况下,小剂量ｔＰＡ前房内注射治疗晶体前纤维蛋白性机化膜十分有效,ＹＡＧ激光联合治疗的作用更加明显。     

t－PA治疗内眼术后纤维蛋白性渗出

ｔ－ＰＡ是纤维蛋白特异性的血栓溶解因子，国外ＤＮＡ重组技术的发展使ｔ－ＰＡ得以大量合成并应用于眼科。本文复习有关文献，就ｔ－ＰＡ的特性及其在内眼术后纤维蛋白性渗出的治疗作用进行综述。     

t—PA治疗内眼术后纤维蛋白性渗出

ｔ－ＰＡ是纤维蛋白特异性的血栓溶解因子，国外ＤＮＡ重组技术的发展使ｔ－ＰＡ得以大量合成并应用眼科。本复习有关献。就ｔ－ＰＡ的特性及其在内眼术后纤维蛋白性渗出的治疗作用进行综述。     

t－PA对实验性玻璃体渗出的治疗作用

１８只兔眼玻璃体腔内注射自体血浆０．２ｍｌ制成的玻璃体渗出模型，随机接受玻璃体内注射组织型纤溶酶原激活酶（ｔ－ｐＡ）或生理盐水，其中１０眼玻璃体内注入ｔ－ＰＡｌ２．５μｇ，结果６眼的纤维蛋白在６ｈ内清除，另４眼在ｌｄ内彻底清除。注入生理盐水的７眼需７ｄ才完全清除。两组从时间上比较，差别有显著性（Ｐ＜０．０５）．经裂隙灯、ＥＲＧ、光镜及电镜检查未见毒性作用。另１只注入１００μｇｔ－ＰＡ的兔眼虽然６ｈ内见纤维蛋白凝块溶解，但眼底镜和光镜下已显示视网膜的毒性变化。     

t－PA治疗玻璃体切割术后眼内纤维蛋白渗出

眼内纤维蛋白渗出是导致玻璃体切割术失败并危及视力的主要并发症之一。目前，动物实验和临床研究证实，玻璃体切割术联合眼部应用组织型纤维蛋白溶酶原激活剂（ｔ－ＰＡ），可有效地预防和治疗眼内纤维蛋白渗出及纤维增殖膜形成。本文就这一疗法的研究现状作一总结，认为：眼部应用ｔ－ＰＡ治疗玻璃体切割术后限内纤维蛋白渗出具有效果可靠、安全、毒性低、副作用小、适应证广泛等优点，在预防和治疗各种原因引起的增殖性玻璃体视网膜病变（ＰＶＲ）中有广阔的应用前景。     

T—PA治疗内眼术后纤维蛋白性渗出

ｔ—ＰＡ是纤维蛋白特异性的血块溶解因子，国外ＤＮＡ重组技术的发展使ｔ—ＰＡ大量合成并应用于眼科。本文复习有关文献，就ｔ—ＰＡ的特性及其在内眼术后纤维蛋白性渗出的治疗作用、最佳剂量进行综述。     

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.