直肌离断对虹膜睫状体的脂质过氧化损伤

实验测定了犬眼不同组合的２条和３条直肌离断后虹膜眼下状体组织脂质过氧化反应产物丙二醛含量和超氧化物岐化酶活性，并观察了睫状体非色素上皮细胞的超微结构，发现２条直肌离断术后１、３、７天，ＭＤＡ和ＳＯＤ变化不显著。３条直肌离断术后１、３天ＭＤＡ含量明显升高，ＳＯＤ活性显著降低，术后７天变化不显著，超微结构示细胞内膜性结构受损，提示３条直肌同时离断眼前节缺血早期，超氧自由基大量产生引发的脂质过氧化损伤，     

眼直肌离断后血循环恢复的动态实验研究

手术或外伤时可能同时损伤３条以上直肌而造成严重的局部血流量下降。本实验利用５１Ｃｒ同位素示踪技术及参考血样法对４５只成年杂种犬不同组合眼直肌离断０、２、４、６、８周时的局部血流量进行了检测，结果如下：①Ａ组（上、下直肌＋外直肌离断组），Ｂ组（上、下直肌＋内直肌离断组）和Ｃ组（上、下直肌离断组）瞬时血流量分别下降了２４９％、２４９％和２３５％。４周时局部血流量开始恢复，８周时恢复分别达到正常值的８４８％、８５８％和８７４％。②实验中共发生眼前节缺血综合征（ＡＳＩＳ）７例（占总数的１５５％），Ａ、Ｂ、Ｃ３组无统计学差异；ＡＳＩＳ组和未发生ＡＳＩＳ组在０～４周时局部血流量无明显差异，在６～８周时有明显差异（Ｐ＜００５）。结果表明：同时离断３条直肌或同时离断２条垂直肌就会影响眼前节血循环，并导致ＡＳＩＳ的发生。ＡＳＩＳ的发生不完全取决于局部血流量的早期变化，而与其晚期组织对缺血代偿反应差异有关。     

实验性眼前节缺血及其病理学观察

观察３４只犬眼直肌离断术后眼前段的大体、光镜和电镜变化，其中１６只各种组合的２条直肌离断眼，术后均无明显缺血变化；１８只各种组合的３条直肌离断眼，术后５只眼出现了典型的眼前节缺血综合征。离断肌肉组织合均为上、下和外直肌，占此种组合的５５．６％。ＡＳＩＳ的光镜表现为缺血所致的眼前节组织变性、坏死、上皮脱落及炎性反应。睫状体非色素上皮细胞的电镜表现为细胞的膜性结构受损。讨论了其发生机理，提示上、下和外     

不同大小透明角膜切口对白内障超声乳化术后泪膜的影响

目的　采用光学相干断层扫描（ｏｐｔｉｃａｌｃｏｈｅｒｅｎｃｅｔｏｍｏｇｒａｐｈｙ,ＯＣＴ）和其他泪膜检测指标评估不同大小的角膜切口对白内障超声乳化术后泪膜的影响。方法　随机将年龄相关性白内障患者７９例９８眼分为２．２ｍｍ组（４６眼）和３．０ｍｍ组（５２眼）,均行超声乳化白内障吸出联合人工晶状体植入术,于术前、术后１ｄ、７ｄ、１个月及３个月检测基础泪液分泌（ｓｃｈｉｒｍｅｒＩｔｅｓｔ,ＳⅠＴ）、泪膜破裂时间（ｂｒｅａｋ-ｕｐｔｉｍｅ,ＢＵＴ）、干眼症状（ｄｒｙｅｙｅｓｙｍｐｔｏｍｓ,Ｓｘ）评分,并采用ＲＴＶｕｅＯＣＴ检测泪河面积（ｔｅａｒｍｅｎｉｓ-ｃｕｓａｒｅａ,ＴＭＡ）、泪河高度（ｔｅａｒｍｅｎｉｓｃｕｓｈｅｉｇｈｔ,ＴＭＨ）及泪河深度（ｔｅａｒｍｅｎｉｓｃｕｓａｒｅａｄｅｐｔｈ,ＴＭＤ）,对两组各项检测结果进行比较。结果　与术前相比,术后１ｄ、７ｄ、１个月时２．２ｍｍ组及３．０ｍｍ组的Ｓｘ评分均升高（均为Ｐ＜０．０５）,术后３个月时与术前差异均无统计学意义（均为Ｐ＞０．０５）;术后７ｄ时２．２ｍｍ组及３．０ｍｍ组的ＢＵＴ、ＳⅠＴ均不同程度降低（均为Ｐ＜０．０５）,至术后１个月时２．２ｍｍ组的ＳⅠＴ仍较低（Ｐ＜０．０５）,而ＢＵＴ与术前差异无统计学意义（Ｐ＞０．０５）,３．０ｍｍ组的ＢＵＴ、ＳⅠＴ仍不同程度降低（均为Ｐ＜０．０５）;术后１ｄ、７ｄ时２．２ｍｍ组及３．０ｍｍ组的ＴＭＡ、ＴＭＨ及ＴＭＤ均比术前明显减小（均为Ｐ＜０．０５）,术后１个月时２．２ｍｍ组的ＴＭＡ、ＴＭＨ及ＴＭＤ与术前差异均无统计学意义（均为Ｐ＞０．０５）,而３．０ｍｍ组的ＴＭＡ及ＴＭＤ仍比术前明显减小（均为Ｐ＜０．０５）,ＴＭＨ与术前差异无统计学意义（Ｐ＞０．０５）。两组之间相比,２．２ｍｍ组的Ｓｘ评分在术后１ｄ、７ｄ时均比３．０ｍｍ组低,差异均有统计学意义（均为Ｐ＜０．０５）,术后１个月及３个月时两组的Ｓｘ评分差异均无统计学意义（均为Ｐ＞０．０５）;２．２ｍｍ组的ＢＵＴ、ＳⅠＴ在术后７ｄ时均明显高于３．０ｍｍ组（均为Ｐ＜０．０５）,术后１个月及３个月时两组差异均无统计学意义（均为Ｐ＞０．０５）;术后１ｄ、７ｄ时,２．２ｍｍ组的ＴＭＡ、ＴＭＨ及ＴＭＤ均显著高于３．０ｍｍ组（均为Ｐ＜０．０５）,术后１个月及３个月时两组差异均无统计学意义（均为Ｐ＞０．０５）。结论　与３．０ｍｍ透明角膜切口相比,２．２ｍｍ透明角膜切口对眼表泪膜的影响更小,恢复更快。     

复合式小梁切除术联合康柏西普治疗新生血管性青光眼

目的　观察复合式小梁切除术联合康柏西普对新生血管性青光眼的疗效。方法　５６例（５６眼）新生血管性青光眼患者根据治疗方法不同分为Ａ组和Ｂ组,Ａ组给予康柏西普玻璃体内注射后行复合式小梁切除术,Ｂ组给予睫状体冷凝术治疗。对两组患者术后视力、眼压、手术成功率和并发症情况进行观察,并进行统计学分析。结果　术后１个月,Ａ组视力提高者１０眼（３５．７％）,不变者１６眼（５７．１％）,下降者２眼（７．２％）;Ｂ组视力提高者３眼（１０．７％）,不变者１７眼（６０．７％）,下降者８眼（２８．６％）;两组视力提高率间差异有统计学意义（Ｐ＜０．０５）,Ａ组视力提高率较Ｂ组高。Ａ组手术成功率为９２．９％,显著高于Ｂ组（７８．６％）,差异有统计学意义（Ｐ＜０．０５）。两组术后１ｄ、２周、３个月眼压与术前相比均显著下降,差异均有统计学意义（均为Ｐ＜０．０５）;术前两组眼压差异无统计学意义（Ｐ＞０．０５）,术后各时间点两组眼压比较差异均有统计学意义（均为Ｐ＜０．０５）,Ａ组均显著低于Ｂ组。Ａ组并发症发生率为２１．４％,显著低于Ｂ组（７５．０％）,差异有统计学意义（Ｐ＜０．０５）。结论　复合式小梁切除术联合康柏西普治疗新生血管性青光眼疗效好、并发症少、安全性高。     

应用Pentacam三维眼前节分析诊断系统对白内障超声乳化术后眼前节变化与屈光飘移的相关性分析

目的　使用Ｐｅｎｔａｃａｍ三维眼前节分析诊断系统记录白内障超声乳化术后患者前房容积（ａｎｔｅｒｉｏｒｃｈａｍｂｅｒｖｏｌｕｍｅ,ＡＣＶ）、前房深度（ａｎｔｅｒｉｏｒｃｈａｍｂｅｒｄｅｐｔｈ,ＡＣＤ）及人工晶状体位置,探讨它们的变化和屈光漂移的关系。方法　在术前,术后第１天、１周、２周、１个月,使用Ｐｅｎｔａｃａｍ系统测量４０例（４０眼）白内障患者的ＡＣＶ、ＡＣＤ等,同时使用自动验光仪记录它们的角膜地形图及屈光状态。使用非参数检验方法,对收集的数据进行统计分析。结果　验光显示患者白内障术后２周屈光度为（－１．１３±１．００）Ｄ、术后１个月为（－１．３４±１．２０）Ｄ、术后３个月为（－１．２３±１．１０）Ｄ,近视度均比术后第１天显著增加（均为Ｐ＜０．０５）。Ｐｅｎｔａｃａｍ系统检查显示,白内障术后２周患者ＡＣＤ为（３．１２±０．２３）ｍｍ、ＡＣＶ为（１３１．００±４５．５７）ｍｍ３,术后１个月ＡＣＤ为（２．３７±０．２２）ｍｍ、ＡＣＶ为（１２９．００±４１．３３）ｍｍ３,术后３个月ＡＣＤ为（２．７０±０．３３）ｍｍ、ＡＣＶ为（１３１．００±４３．２７）ｍｍ３,均比术后第１天显著减少（均为Ｐ＜０．０５）。患者术后屈光度变化和ＡＣＤ变化呈正相关（ｒ１周＝０．７６,ｒ２周＝０．７８,ｒ１个月＝０．７９,ｒ３个月＝０．７５,均为Ｐ＜０．０５）。但是,患者术后屈光度变化、ＡＣＤ变化和术前ＡＣＤ的相关性均无统计学意义（（ｒ＝－０．４２、－０．５６,均为Ｐ＞０．０５）。结论白内障手术患者,术后存在屈光飘移的可能,影响术后视功能。人工晶状体植入术后早期的屈光飘移与ＡＣＤ的变化密切相关。     

肝素处理人工晶体在糖尿病性白内障的应用

为观察肝素表面处理人工晶体在糖尿病性白内障手术后的作用。对４５例糖尿病白内障患者行现代囊外白内障摘除，分别植入ＨＳＭ－ＩＯＬ２２眼和ＰＭＭＡ－ＩＯＬ２３眼，对二组术后视力及眼前节反应等进行了回顾性对比分析。结果：二组比较，矫正视力大于０．５者，在术后２周及３个月时差异最显著（Ｐ＜０．０５）；晶体表面纤维蛋白样渗出和色素沉着均在术后２周时差异最显著（Ｐ＜０．０５）；虹膜后粘连在６个月后差异最显著（Ｐ＜０．０５）。结论：ＨＳＭ—ＩＯＬ在术后能减轻糖尿病白内障术后眼前节炎性反应，提高术后视力。     

不同人工晶状体行后囊后嵌顿术的实验研究

目的　对比３种不同人工晶状体植入术后对幼兔眼前节炎症反应、人工晶状体位置及后囊膜混浊的影响,为儿童后囊后人工晶状体嵌顿术选择合适的人工晶状体。方法　１月龄新西兰白兔３６只,随机分成Ａ、Ｂ、Ｃ３组,均行右眼晶状体吸出＋后囊膜连续环形撕囊联合人工晶状体后囊后嵌顿术,其中Ａ组植入硬片式人工晶状体;Ｂ组植入三片式软性人工晶状体;Ｃ组植入单片式软性人工晶状体。术后１ｄ、１周、１个月、３个月分别行术眼的裂隙灯、ＵＢＭ及眼前节照相检查。结果　术后１周时Ａ组的眼前节炎症反应较Ｂ组、Ｃ组重,差异均有统计学意义（Ｐ＝０. ０３、０．０３）。术后３个月时Ａ组有２眼人工晶状体夹持,１０眼正位;Ｂ组１１眼正位,１眼偏位;Ｃ组２眼正位,８眼偏位,２眼夹持;人工晶状体正位率Ａ组、Ｂ组之间差异无统计学意义（Ｐ＞０. ０５）,但与Ｃ组间差异均有统计学意义（Ｐ＝０．０３、０．０１）。术后３个月时,Ａ组、Ｃ组均有２眼出现后囊膜混浊,余术眼后囊膜均保持清亮,后囊膜混浊发生率３组间差异无统计学意义。结论　襻为聚丙烯材料、光学部为丙烯酸酯（Ａｃｒｙｌｉｃ）的三片式人工晶状体更适合儿童后囊后嵌顿术,对维持人工晶状体正位有积极作用。     

超声乳化白内障吸出人工晶状体植入术联合房角分离术治疗闭角型青光眼合并年龄相关性白内障的疗效观察

目的　对比观察超声乳化白内障吸出人工晶状体植入术联合及不联合房角分离术治疗闭角型青光眼合并年龄相关性白内障的疗效。方法　选取８９例（９８眼）闭角型青光眼合并年龄相关性白内障患眼分为两组,Ａ组４９眼采用超声乳化白内障吸出人工晶状体植入术联合房角分离术治疗,Ｂ组４９眼行超声乳化白内障吸出人工晶状体植入术,对比观察两组患者手术前后的眼压、中央前房深度、房角结构等。结果　Ａ组术后１ａ眼压为（１４．３４±３．６４）ｍｍＨｇ（１ｋＰａ＝７．５ｍｍＨｇ）,比术前眼压（３４．６５±６．５３）ｍｍＨｇ明显降低,差异有统计学意义（ｔ＝１９．２８,Ｐ＜０．０５）。Ｂ组术后１ａ眼压为（１６．２６±４．９１）ｍｍＨｇ,比术前（３５．１５±６．２７）ｍｍＨｇ亦明显降低,差异有统计学意义（ｔ＝１６．５５,Ｐ＜０．０５）。术后１ａ两组间眼压对比差异有统计学意义（ｔ＝２．１９,Ｐ＜０．０５）。Ａ组绝对成功３０眼（６１．２２％）,相对成功９眼（１８．３７％）,总成功率７９．５９％。Ｂ组绝对成功２７眼（５５．１０％）,相对成功７眼（１４．２９％）,总成功率６９．３９％。两组间的总成功率差异无统计学意义（Ｚ＝０．８８６,Ｐ＞０．０５）。Ａ组术后１个月中央前房深度（３．２４±０．３８）ｍｍ较术前（２．０４±０．３１）ｍｍ加深,差异有统计学意义（ｔ＝３．１４１,Ｐ＜０．０５）。Ｂ组术后１个月中央前房深度（３．０５±０．３６）ｍｍ较术前（２．０１±０．２９）ｍｍ亦加深,差异有统计学意义（ｔ＝３．０７８,Ｐ＜０．０５）。术后１个月两组比较差异无统计学意义（ｔ＝０．１７５,Ｐ＞０．０５）。术后１个月行房角检查:Ａ组４０眼前房角全部开放,９眼残留小于４５°的锥状或堤坝状粘连。Ｂ组１０眼３个象限残留房角粘连,１９眼２个象限残留房角粘连,２０眼有小于１个象限的房角粘连。两组视力改善率及术后并发症发生率差异均无统计学意义（均为Ｐ＞０．０５）。结论　超声乳化白内障吸出人工晶状体植入术联合房角分离术是治疗闭角型青光眼合并白内障的安全、有效的方法,对眼压、中央前房深度和房角结构都有明显改善。     

同轴微切口白内障超声乳化术后泪膜及角膜规则性的研究

目的　比较１．８ｍｍ和３．０ｍｍ两种白内障手术切口术后泪膜及角膜规则性的变化。方法　选取２０１４年１１月至２０１５年１０月行白内障超声乳化吸出术的年龄相关性白内障患者４８例（６２眼）,根据患者对人工晶状体的选择分为:Ａ组２４例（３０眼）行１．８ｍｍ透明角膜微切口白内障超声乳化术,Ｂ组２４例（３２眼）行３．０ｍｍ透明角膜切口白内障超声乳化术。比较术前及术后１ｄ、７ｄ、１个月、３个月的泪膜破裂时间（ｂｒｅａｋ-ｕｐｔｉｍｅ,ＢＵＴ）、基础泪液分泌（ＳｃｈｉｒｍｅｒⅠ ｔｅｓｔ,ＳⅠｔ）、角膜荧光素染色评分（ｃｏｒｎｅａｆｌｕｏｒｅｓｃｅｉｎｓｔａｉｎｉｎｇ,ＦＬＳ）、干眼主观症状评分、角膜表面规则性指数（ｓｕｒｆａｃｅｒｅｇｕｌａｒｉｔｙｉｎｄｅｘ,ＳＲＩ）及角膜表面非对称性指数（ｓｕｒｆａｃｅａｓｙｍｍｅｔｒｙｉｎｄｅｘ,ＳＡＩ）。结果　术后１ｄ、７ｄＢ组ＢＵＴ均短于Ａ组（均为Ｐ＜０．０５）。术后１ｄＢ组ＳⅠｔ低于Ａ组（Ｐ＜０．０５）。术后１ｄ、７ｄ、１个月Ｂ组ＦＬＳ均高于Ａ组（均为Ｐ＜０．０５）。术后１ｄ、７ｄＢ组干眼主观症状评分均高于Ａ组（均为Ｐ＜０．０５）。术后１ｄ、７ｄ、１个月Ｂ组ＳＡＩ、ＳＲＩ均高于Ａ组（均为Ｐ＜０．０５）。Ａ组ＢＵＴ、ＦＬＳ、干眼主观症状评分、ＳＡＩ于术后１个月恢复至术前状态,ＳⅠｔ和ＳＲＩ于术后７ｄ恢复至术前状态;Ｂ组各项结果均于术后３个月恢复至术前状态。结论　１．８ｍｍ切口较３．０ｍｍ切口白内障超声乳化术后干眼症状更轻,泪膜功能及角膜规则性恢复更快。     

Experimental Study on the Prevention of Anterior Segment Ischemia by Preservation of Anterior Ciliary Vessels

Purpose: To observe the effect of preserving anterior ciliary vessels (ACVs) on anterior segments of rabbit eyes undergoing tenotomy of extraocular muscles. Methods: Thirty-two adult New Zealand white rabbits were divided into four groups. Same procedures were done in both eyes in each group except that left eyes underwent preservation of ACVs. In the first group medial and lateral recti, in the second group, superior and inferior recti, in the third group, medial, lateral and superior or inferior recti and in the fourth group, all four recti, underwent tenotomy. Slit-lamp examination, intraocular pressure (IOP) measurement, total protein and lactic acid quantification in aqueous humor were done in all eyes pre- and post-operatively. By four weeks after operation, the eyes were enucleated for histological examination and electron microscopy. All data were analyzed using SPSS version 10.Results: In the left eyes of both group 1 and group 2, no inflammatory response was observed. In the left eyes of group     

Anterior segment ischemia after recession of various recti. An experimental study

In 40 normal adult cynomolgus monkey eyes, recession of various recti in different combinations was done to evaluate their effects on the anterior segment. These procedures were done as primary, secondary, tertiary, and fourth procedures (each separated by several weeks or months), ultimately involving all four recti in the eyes. In 11 eyes, posterior ciliary arteries (PCAs) were occluded to determine its effects on the anterior segment. All eyes were examined by slit lamp, color photography, and fluorescein angiography of the anterior segment, and tonometry, before surgery and serially thereafter during the follow-up period. These studies showed that recession of two or three recti simultaneously in different combinations produced no serious permanent anterior segment changes, although initially in some of the eyes there was transient mild-to-moderate anterior segment ischemia. Recession of four recti simultaneously as a primary procedure produced serious permanent ocular and anterior segment changes; however, when this was done as a secondary or tertiary procedure after previous recessions of three or four recti, anterior segment changes were much fewer and milder than when it was a primary procedure. Occlusion of all the posterior ciliary arteries in itself produced no important changes in the anterior segment, but when combined with simultaneous recession of both the horizontal recti, it produced serious anterior segment changes. In the light of these findings, the pattern of arterial blood supply of the anterior segment is discussed.     

离断眼直肌与房水氧含量变化的关系

采用血气分析仪法观察30只狗眼离断直肌后房水氧分压的变化情况,并根据Henry's 定律计算氧含量,发现2～4条直肌离断后,房水氧含量较对照眼分别下降4.42%(P>0.05),20.17%和28.61%(P<0.001)。证实低氧房水环境是眼前节缺血综合征时相应组织病理损伤过程的重要原因之一,提示在斜视矫正等手术中不宜同时离断3条以上直肌。     

Microvascular change of the anterior eye segment after tenotomy in the rabbit

Background: The microvascular changes secondary to anterior segment ischemia following tenotomy of the extraocular muscles have not been studied in the rabbit. Methods: Using scanning electron microscopy of methylmethacrylate ocular microvascular luminal castings, the anterior eye segment vasculature after tenotomy was documented and compared to that after occlusion of the bilateral long posterior ciliary arteries and that in the eyes that were not subjected to any surgical intervention. Results: Five days and 1 week after the surgical intervention with tenotomy, microvascular change secondary to the anterior segment ischemia was not apparent, but 2 weeks after the tenotomy subtle evidence of ischemia such as new vessels in the iris was observed. Seven weeks after tenotomy, marked microvascular change was observed where corneal new vessels arose from the superior perilimbal arteries. In contrast, we found prominent microvascular changes 2 weeks after the occlusion of the long posterior ciliary arteries. Conclusions: Tenotomy of the rabbit eye causes microvascular change similar to that in occlusion of the long posterior ciliary arteries. This result suggests that the anterior ciliary artery of the rabbit contributes blood flow to the anterior eye segment and also has a stronger connection with the long posterior ciliary artery than previously reported.     

直肌睫状前血管的分离和保留对兔眼前段缺血综合征的预防作用

目的　观察兔眼眼外直肌手术中直肌睫状前血管 (ACVs)的分离和保留对预防眼前段缺血综合征 (ASI)的作用。方法　将 32只健康新西兰白兔随机分为 4组 ,每组右眼分离和保留ACVs,左眼去除ACVs。A组 :切断 2条水平直肌 ;B组 :切断 2条垂直直肌 ;C组 :切断内、外直肌和 1条垂直直肌 ;D组 :切断 4条直肌。术前和术后裂隙灯显微镜下观察眼前段的体征 ,测量眼压、房水中总蛋白和乳酸的浓度。术后 4周处死动物 ,光镜和电镜下检查虹膜和睫状体的超微结构。结果 4组中右眼术后均未发生缺血性改变。A组左眼无明显缺血改变 ,B组左眼仅出现轻度缺血的病理学改变。C、D组左眼出现明显甚至严重的ASI体征 ,眼压出现下降趋势 ,C组眼压术前为 (17 2 1± 3 76 )mmHg(1mmHg =0 133kPa) ,术后最低降至 (14 4 8± 3 36 )mmHg(P <0 0 5 ) ,D组眼压术前为 (16 6 8± 2 33)mmHg,术后最低降至 (3 17± 0 92 )mmHg(P <0 0 5 ) ;房水中总蛋白和乳酸的浓度明显增高 ,C组术前分别为(5 0 5 3± 5 0 )mg/L和 (7 5 4± 0 4 7)g/L ,术后分别最高升至 (811 9± 4 4 4 )mg/L和 (11 0 0± 3 5 9)g/L(P<0 0 5 ) ;D组术前分别为 (5 0 4 6± 4 1)mg/L和 (7 17± 1 4 4 )g/L ,术后分别最高升至 (10 2 5 8± 78 3)mg/L和 (8 2 3± 1     

血管内皮生长因子在兔眼前段缺血模型中的表达

目的通过直肌断腱术制备兔眼前段缺血（ASI）模型,观察血管内皮生长因子（VGEF）在兔眼前段缺血模型中的表达,探索ASI的发病机制。方法新西兰白兔16只,左眼对照;右眼造模：切断右眼上、下、内、外四条直肌;于术后第1、3、7、14天,分别随机处死4只兔,并迅速摘取眼球;做免疫组织化学检查,并采用计算机图像分析。结果 （1）裂隙灯观察：各组左眼未发生明显变化。右眼：自术后第1天,眼前段均发生了不同程度的缺血表现。（2）免疫组织化学方法：左眼出现个别眼睫状体、视网膜弱阳性。右眼虹膜、睫状体色素上皮、晶状体前囊、视网膜多层VGEF阳性表达。图像分析睫状体色素上皮VGEF表达情况：术后第1天即有表达,第7天达到高峰,第14天表达衰减。结论 VEGF在兔ASI模型中的表达上调,并随时间而衰减,提示其可能为该病的发病机制之一。     

直肌内血管显微分离术方法的实验研究

目的探讨眼直肌内睫状前动脉(ACAs)显微分离术的方法和技巧及应用此方法在一眼同时行4条直肌手术的安全可行性.方法对健康成年杂种犬10只16只眼行直肌内睫状前血管显微分离术.其中8只眼行直肌联结术(Jensen术式),8只眼行肌肉转位术(Hummelsheim术式),术后观察眼前段反应三个月.结果垂直肌的血管较水平肌粗,易分离.ACAs在直肌内的数目存在变异.每例手术均成功分离并保留了大多数ACAs,两种术式术后均未发现眼前节缺血(ASI).结论直肌内血管显微分离术是一种安全可行的显微手术方法,可使累及多条直肌的复杂斜视手术一次完成,避免或减少了ASI的风险.     

Arterial vascularization and ischemia of the anterior eye segment. Experimental radio-anatomical study of human cadavers

Ischemia of the anterior segment of the eye is rare but may be in relation with some strabismic procedures. The physiopathology is unclear. This experimental data on human cadaver studied the arterial vascularization of the major circle of iris with injection and opacification of an aqueous suspension of barium. The respective participation of anterior ciliary arteries and long posterior ciliary arteries, respectively were analysed. Some recti muscles were cut with various combinations and before injection. The breaks of the major arterial circle which resulted were noticed. They were large when both vertical recti were cut and minimal or absent when both horizontal recti were cut. The anterior ciliary arteries coming from interior and superior rectus are very important. The long posterior ciliary arteries seem to be more important than the anterior ciliary arteries coming from both horizontal recti muscles and especially the medial long posterior ciliary artery. Our study provides an explanation of classical iatrogenic iridociliary ischemia following Hummelsheim or O'Connors strabismus procedure.