综合手术方法治疗挫伤性重度前房积血

目的:观察采用综合手术方法治疗挫伤性重度前房积血的手术效果,并探讨其手术技巧。方法:对23例23眼重度前房积血患者采用了透明角膜切口、超声乳化灌注抽吸或手动抽吸、前房注入黏弹剂分离取出凝血块,对于术中再次前房出血的,则前房注入并保留少许黏弹剂等综合手术方法。术后注意观察前房、视力和眼压情况。结果:术后23例23眼中21眼一次手术成功,2眼术后再次前房出血;术后视力<0.05者5眼(22%),0.05～0.3者11眼(48%),>0.3者7眼(30%)。结论:针对不同情况的前房积血,采用不同的手术方法,可达到较好的手术效果。     

挫伤性前房积血行前房冲洗术中尿激酶的应用

目的观察尿激酶治疗挫伤性前房积血的疗效。方法16例（16眼）Ⅱ级以上挫伤性前房积血病例经保守治疗,血液无明显吸收、持续高眼压或角膜有血染倾向者,及时行前房穿刺冲洗,术中结合使用尿激酶。结果16例挫伤性前房积血病例术后视力均明显提高,积血在2—11d内完全吸收。结论挫伤性前房积血适时应用前房冲洗结合使用尿激酶,可明显缩短前房积血吸收时间及减少并发症的发生。     

挫伤性前房积血与眼压

目的 探讨挫伤性前房积血与眼压之间的关系。方法 对１５６例进行回顾性研究。结果与结论 挫伤性前房积血多发生于青年男性,前房积血伴有低眼压和眼后段损伤者视力预后差。     

煤矿井下高压乳化液冲击性眼外伤特点及治疗

目的分析煤矿井下高压乳化液冲击性眼外伤的临床特征及治疗方法。方法仔细检仔细检查结膜、角膜挫伤排除眼球破裂伤；对严重的前房积血，早期双眼遮盖，半卧位，药物的联合应用，必要时实行手术治疗，防止角膜血染和继发性青光眼的发生，使积血尽快吸收露出瞳孔，为眼后段的损伤能得到及时的诊断治疗创造条件。结果本组42例（42眼）入院时视力〈0．05者21眼，0．05～0．1者15眼，0．12～0．25者6眼。治疗后视力〈0．05者6眼，0．05—0．1者4眼，0．12—0．5者13眼，0．6—1．0者19眼。前房积血吸收时间为7d左右，无角膜血染出现，8例眼压〉21mmHg，34例眼压≤21mmHg（1mmHg=0．133kPa）。眼后段损伤均未因前房积血而延误治疗。结论煤矿井下高压乳化液冲击性眼外伤，临床表现多为眼球不同程度的挫伤，其中前房积血发生率最高，不但影响视力，而且影响对眼后段损伤的诊断与治疗。全面评估，抓住重点，合理治疗，是提高视功能的关键。     

前房改良冲洗术治疗挫伤性重度前房出血106例

目的:观察前房改良冲洗术治疗挫伤性重度前房出血的疗效。方法:对106例重度前房出血患者行颞侧角膜隧道切口联合使用黏弹剂、尿激酶冲洗前房积血。结果:患者2例术后2d出现前房积血,余患者前房积血清除干净无再出血,在视力、眼压及并发症等方面明显优于常规术式。结论:前房改良冲洗术治疗挫伤性重度前房出血是一种简单、安全、有效的术式,在临床中值得推广。     

挫伤性前房积血致继发性青光眼临床分析

目的 探讨挫伤性前房积血所致继发性青光眼的治疗方法及其临床疗效.方法 回顾性分析58例（58眼）挫伤性前房积血所致继发性青光眼采用非手术或手术治疗及其效果.结果 非手术治疗49例,前房积血在2～13d吸收,眼压降至正常,视力提高.9例手术治疗后眼压均恢复正常,积血吸收.结论 对挫伤性前房积血所致继发性青光眼应尽早发现和合理治疗,对眼压持续不降或积血无改善者均应及时行手术治疗.     

手术治疗挫伤性前房积血所致继发性青光眼的疗效及安全性分析

目的：探讨手术治疗挫伤性前房积血所致继发性青光眼的疗效及安全性分析。方法：选取2014－11／2015－11我院收治的挫伤性前房积血继发性青光眼患者70例70眼，所有患者均行手术治疗，对比患者手术前后的视力、前房深度、平均眼压及术后并发症情况。结果：与治疗前相比，挫伤性前房积血所致继发性青光眼患者治疗后视力明显改善，差异有统计学意义（t＝42.471，P＜0．001）。与治疗前相比，挫伤性前房积血所致继发性青光眼患者治疗后前房深度较深，平均眼压较低，差异有统计学意义（ t＝9．726、26．041， P＜0．001）。2例继发性青光眼患者手术治疗后出现前房积血，经治疗后症状缓解，未出现角膜血染、眼球肿胀疼痛等并发症。结论：手术治疗挫伤性前房积血所致继发性青光眼患者的疗效佳，安全性高，能提高患者的视力、加深前房角深度以及降低眼压。     

挫伤性玻璃体积血的手术时机与效果

目的　探讨挫伤性玻璃体积血的手术时机与效果。方法　对 116例 (116只眼 )挫伤性玻璃体积血患者分别采用药物治疗 46例 (46只眼 )和玻璃体手术治疗 70例 (70只眼 ) ,并对结果进行比较性研究和随诊观察。结果　玻璃体手术组患者术后 1个月 ,视力≥ 0 1者为 71 4 %;而非手术组患者药物治疗后 1个月 ,视力≥ 0 1者仅为 2 1 7%,两者差异有显著意义 (P <0 0 5 )。非手术组患者治疗后视力 >0 1者 10只眼 ,其中 7只眼是于受伤后 2周内恢复视力。手术组患者中 ,仅有 2 7 1%的患眼做单纯玻璃体切除术 ,70 9%的患眼行玻璃体切除联合其他术式 ;术后有 3只眼发生视网膜脱离 ,经再手术治愈。非手术组患者治疗过程中 ,有 14只眼发生视网膜脱离 ,11只眼接受手术治疗 ,8只眼治愈。结论　挫伤性玻璃体积血药物治疗观察的时间为伤后 2～ 3周 ,若无明显好转应及时选择玻璃体手术治疗。     

双切口联合手术治疗青光眼合并白内障临床疗效观察

目的观察分析双切口白内障超声乳化吸出人工晶状体植入联合小梁切除术治疗青光眼合并白内障的效果。方法选取我院2010年6月至12月青光眼合并白内障患者60例(60眼),均接受双切口白内障超声乳化吸出人工晶状体植入联合小梁切除术,观察术前、术后的视力、眼压及并发症情况。结果 60例患者术前视力<0.1者30眼,0.1～0.3者18眼,0.3～0.5者12眼;术后视力均有提高,其中<0.1者9眼,0.1～0.3者16眼,0.3～0.5者20眼,0.5及以上者15眼;术前、术后视力比较,差异有统计学意义(P<0.05)。术后眼压为(14.58±2.32)mmHg(1kPa=7.5mmHg),与术前(29.08±7.59)mmHg相比,差异有显著统计学意义(P<0.01)。3例患者术中对其进行周边虹膜切除时发生出血,术后5例患者出现少量前房积血,2例患者出现前房纤维素性渗出,3例患者出现角膜上皮轻度水肿。结论双切口超声乳化吸出人工晶状体植入联合小梁切除术治疗青光眼合并白内障可明显改善患者视力,有效控制眼压。     

复方血栓通胶囊治疗挫伤性前房积血106例临床分析

目的 探讨口服复方血栓通胶囊治疗挫伤性前房积血的疗效。方法 对1994年10月至2004年9月门诊及收住院治疗的106例(106只眼)挫伤性前房积血患者,给予口服复方血栓通胶囊为主的药物治疗,并对伴有不同并发症的患者分别辅之以地塞米松、甘露醇静脉滴注或皮质类固醇口服。结果 前房积血Ⅰ级患者,积血吸收平均时间为4天,Ⅰ级患者积血吸收平均时间为6天,Ⅰ级患者积血吸收平均时间为12天。前房积血吸收后视力0.04以下4只眼,0.04～0.1者9只眼,0.2～0.3者9只眼,0.4～0.6者11只眼,0.8者23只眼,1.0以上50例。结论口服复方血栓通胶囊治疗挫伤性前房积血疗效可靠,较静脉给药方便,患者较易接受。     

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.