白内障不同手术方式对人工晶体眼高阶像差影响的临床观察

目的观察白内障超声乳化和小切口囊外摘除术两种手术方式术后人工晶状体眼的高阶像差的变化,评价不同手术方式对人工晶状体眼高阶像差的影响。方法连续选取年龄相关性白内障44例(44眼),随机分为两组,A组22例(22眼)实施巩膜隧道切口(5.5mm)白内障囊外摘除联合人工晶体植入术;B组22例(22眼)实施巩膜隧道切口(3.0mm)白内障超声乳化摘除联合人工晶体植入术;并设同龄正常晶状体眼22例(22眼)为对照组。分别采集术后1周、1个月、3个月及对照组波前像差值并进行统计学分析,比较实验组间、实验组与正常对照组间高阶像差的差异。结果术后1周、1个月、3个月A组和B组之间高阶像差的差异无统计学意义(P>0.05),A、B两组分别与正常对照组比较,高阶像差的差异均有统计学意义(P<0.05)。结论人工晶状体眼的高阶像差较正常晶状体眼增大,白内障超声乳化和小切口囊外摘除两种手术方式对高阶像差的影响无明显差异。     

3. 0 mm 透明角膜切口白内障超声乳化术后角膜散光的临床观察

目的 观察3.0 mm透明角膜切口白内障超声乳化术后角膜散光及角膜形态变化特点.方法 收集年龄相关性白内障患者53例（77眼）,实施3.0 mm透明角膜切口白内障超声乳化联合折叠人工晶体植入术.检查术前,术后3 d、1周、1个月、3个月的裸眼视力及行角膜地形图检查观察散光变化.结果 平均角膜散光度术后1个月较1周明显减少,两者比较有显著性差异,3个月与1个月比较无显著性差异,即1个月时视力明显提高且趋于稳定.结论 角膜地形图可准确全面反映白内障术后角膜形态变化.3.0 mm透明角膜切口白内障超声乳化联合折叠人工晶体植入术具有术后角膜散光小,视力恢复快等优点,是较理想的白内障手术切口方法.     

超声乳化白内障吸除术对青光眼合并白内障患者术后角膜水肿的影响分析

目的 :观察青光眼合并白内障患者行超声乳化白内障吸除术后角膜水肿的发生情况,并分析术后角膜水肿发生的影响因素。方法 :选取2011年2月-2013年12月在我院行超声乳化白内障吸除术治疗的青光眼合并白内障患者50例(60眼),观察术后1~3 d角膜水肿的发生情况。结果 :患者60眼中共发生角膜水肿13眼,发生率为21.67%;单因素分析显示,超声乳化白内障吸除术后角膜水肿的发生与患者年龄、晶状体核硬度、糖尿病史、眼部手术史相关(P<0.05);多因素分析显示,超声乳化白内障吸除术后角膜水肿的发生与晶状体核硬度、抗青光眼手术史相关(P<0.05)。结论 :高龄、晶状体核硬度程度高、合并糖尿病、抗青光眼手术史患者是超声乳化白内障吸除术后角膜水肿发生的高危人群。     

双灌注超声乳化法治疗青光眼术后浅前房白内障的效果

目的探讨双灌注超声乳化方法治疗青光眼术后浅前房白内障的效果。方法选取笔者所在医院2015年6月—2017年7月治疗的青光眼术后高危浅前房老年性白内障患者120例(120眼),其中男63例(63眼),女57例(57眼);年龄53～80岁(平均68.3岁)。随机分为两组:A组(双灌注组)患眼行双灌注技术辅助下白内障超声乳化吸除人工晶体植入术;B组(对照组)患眼行常规白内障超声乳化吸除人工晶体植入术。观察两组患者术中后囊膜破裂情况、术后第1天角膜水肿情况、测量术后第1天眼压。结果 A组无一眼术中发生后囊膜破裂;B组术中有6眼发生后囊膜破裂,前段玻璃体切割后人工晶体植入于睫状沟内;两组比较差异有统计学意义(P<0.05)。A组患者术后第1天角膜清亮,无一眼发生角膜水肿;B组有9眼术后发生角膜水肿,其中1级角膜水肿4眼,2级角膜水肿5眼;两组比较差异有统计学意义(P<0.05)。A组术后第1天无一眼眼压>21.0 mmHg;B组有7眼术后第1天眼压>21.0 mmHg,其中3眼眼压>30.0 mmHg,应用前房穿刺放液后眼压均恢复正常,两组比较差异有统计学意义(P<0.05)。结论合并青光眼术后高危浅前房的白内障患者在超声乳化手术中应用双灌注技术,可以动态维持术中前房深度稳定,后囊膜扩张,囊袋饱满,提供安全的操作空间,降低了损伤眼部其他邻近组织的风险,减少术中并发症,增加了手术的安全性。     

比较糖尿病病人白内障超声乳化术不同隧道长度切口对角膜生物力学的影响

目的比较糖尿病合并白内障病人行白内障超声乳化手术采用不同隧道长度切口角膜生物力学的差异。方法收集 2020年 10月至 2021年 11月于贵州医科大学附属医院拟行白内障超声乳化手术的 2型糖尿病病人 67例 67眼，行颞侧三平面透明角膜切口，按切口隧道长度分为两组:长隧道组(长度 ≥1.75 mm，<2.40 mm)共 33例( 33眼)。短隧道组(长度 >1.20 mm，<1.75 mm)共 34例( 34眼)。应用可视化角膜生物力学分析仪测量两组病人术术后 1d、术后 1周和术后 1个月的角膜生物前、力学参数，透，明角膜切口隧道长度通过眼前节光学相干断层扫描在病人术后 1d进行测量。结果术前及术后 1d、术后 1周、术后 1个月两组眼压、中央角膜厚度、最大形变幅度、第一压平时间、第二压平时间、峰距、矫正眼压、第一压平时角膜硬度参数(stiffness parameter at applanation 1，SP-A1)及角膜生物力学指数( corneal biomechanical index，CBI)的总体相比，差异有统计学意义(均 P<0.05)；其中术后 1d中央角膜厚度、 CBI［(长隧道组( 647.21±96.07)μm、0.58(0.10，0.82)，短隧道组( 674.34±115.59) μm、0.50(0.23，0.80)］较术前［长隧道组:(564.03±29.45)μm、0.06(0，0.24)，短隧道组:(553.19±29.54)μm、0.13(0，0.43)］均显著增大(均 P<0.05)术后 1个月两组中央角膜厚度及 CBI恢复至术前水平(均 P>0.05)。 l两组术后 1d第二压平时间及峰距较术前减少(均 P<0.05)、，在术后 1周及术后 1个月均比术后 1d增大(均 P<0.05)。两组术后 1个月及术后 1周最大形变幅度较术后 1d增大( P<0.05)，SP-A1在术后 1个月及术后 1周较术后 1d及术前明显减小( P<0.05)。长隧道组与短隧道组术后 1d眼压［1.83(0.08，4.17)mmHg比 0.33(?0.50，1.83)mmHg］、第一压平时间［ 0.22(0.01，0.57)ms比 0.04(?0.09，0.23)ms］、第二压平时间［?0.47(?0.68，?0.21)ms比?0.22(?0.48，0.01)ms］及矫正眼压［ 0.6(?0.99，1.72)mmHg比?1.53(?3.80，?0.36)mmHg］的变化量比较，差异有统计学意义( P<0.05)，术后 1周第二压平时间、峰距及矫正眼压的变化量比较，差异有统计学意义( P<0.05)。结论对于行白内障超声乳化术透明角膜三平面切口的糖尿病病人，长隧道切口组比短隧道切口组角膜生物力学在早期变化更明显、角膜生物力学改变更大，角膜修复愈合更慢。同正常白内障病人一样，对于糖尿病合并白内障病人而言，两组病人白内障超声乳化术后 1个月角膜硬度也较术前降低。     

低于常温灌注液对超乳术中角膜内皮细胞保护的研究

目的：研究通过降低超乳术中灌注液的温度来保护角膜内皮细胞功能的可行性。方法选取2012_2014年医院30例 IV 级核年龄相关性白内障患者行左右眼对照实验,术后1d、1周、3个月使用裂隙灯显微镜观察角膜水肿程度,记录水肿消退时间,进行角膜中央厚度测量及角膜中央部位的角膜内皮细胞计数。超乳手术中试验组采用低于常温灌注液,对照组采用常温灌注液,手术方式及过程均保持一致。双眼手术时间间隔≤1周。结果试验组术后角膜水肿程度、角膜内皮细胞丢失率均低于对照组,差异有统计学意义（p ＜0,05）。结论采用低于常温灌注液有助于超乳术中角膜内皮细胞的保护。     

不同方位角膜切口对高龄白内障术后泪膜和眼表的影响

目的：探讨不同方位角膜切口对高龄白内障术后泪膜和眼表的影响。方法选取2010年7月~2014年6月本院高龄(≥80岁)白内障超声乳化患者120例(120眼),随机分成2组院A组采用颞侧角膜切口行白内障超声乳化手术58例(58眼);B组采用上方角膜切口行白内障超声乳化手术62例(62眼)。分别于术前3 d和术后3、7、30、90凿观察比较两组患者角膜荧光素染色(FL)评分、泪膜破裂时间(BUT)、基础泪液分泌试验(S玉t)检查。结果 A组患者FL评分在术后3、7、30 d明显增高,BUT、S玉t检查术后3、7、30 d明显缩短,差异均有统计学意义(P<0.05);A组患者90凿的FL评分、BUT、S玉t检查与B组比较,差异均无统计学意义(孕>0.05)。结论高龄白内障超声乳化手术中早期颞侧角膜切口较上方角膜切口患者的泪膜稳定性和眼表情况均有明显的影响,晚期则无明显影响。     

糖尿病性白内障超声乳化术后角膜水肿36例临床分析

目的 观察糖尿病性白内障超声乳化术后角膜水肿情况,为临床评估术后角膜受损提供参考.方法 选取行白内障超声乳化术的患者80例(119眼),根据患者是否为糖尿病性白内障将其分为观察组(糖尿病性白内障)36例(54眼)和对照组(非糖尿病性白内障)44例(65眼),行白内障超声乳化术后,对比手术前后的角膜中央厚度、角膜中央内皮细胞计数.结果 两组术前角膜中央厚度差异无统计学意义(P＞ 0.05);观察组术后1天、术后1个月以及术后3个月的角膜中央厚度均显著厚于对照组(A超法:=4.538,6.832,5.038,均P＜0.05;Orbscan Ⅱ法:t=5.392,6.910,4.052,均P＜0.05);术后3个月,观察组角膜中央厚度显著厚于术前(=8.692,P＜0.05),而对照组和术前的对比差异无统计学意义(P＞0.05).两组患者术前和术后1天的角膜中央内皮细胞计数对比,差异无统计学意义(P＞0.05);而术后1个月和术后3个月,观察组的角膜中央内皮细胞计数显著少于对照组(t =5.248,4.892,均P＜0.05).结论 糖尿病性白内障超声乳化术后角膜内皮细胞的损伤更明显,且恢复速度慢,测量术后第1天的角膜中央厚度对评估其角膜内皮细胞损伤情况有重要参考.     

超声乳化爆破模式在白内障手术中的应用

目的 探讨超声乳化爆破模式在白内障术中应用及对角膜内皮细胞影响.方法 选取2018年8月至2020年1月合肥市第二人民医院年龄相关性白内障79例(83眼),其中42眼采用爆破模式行白内障超声乳化术(爆破组).另41眼作为对照组采用连续模式行白内障超声乳化术(连续组).术中连续组最大能量50％,最大负压240 mmHg,流量26 mL/min;爆破组最大能量50％,最大负压300 mmHg,流量30 mL/min.观察术中有效超声乳化时间(EPT)、平均超声乳化功率(AVE),比较两组术前、术后1 d、1周、1个月角膜内皮细胞密度、六角形细胞比例、变异系数及中央角膜厚度等.结果 爆破组EPT(12.31±8.30)s、AVE(10.00±6.81)％均低于连续组EPT(18.51±9.30)s、AVE(15.01±7.90)％,差异有统计学意义(P<0.05).术后1天、1周爆破组角膜内皮细胞密度、六角形细胞比例均高于连续组、变异系数低于连续组,差异有统计学意义(P<0.05).结论 超声乳化爆破模式能提高超声乳化效率,减轻角膜内皮细胞损伤.     

表麻下白内障超声乳化术后角膜水肿98例分析

目的 探讨表麻下白内障超声乳化摘除及人工晶体植入术后发生角膜水肿的原因。方法 全部病例来源于我院1190例1281眼白内障超声乳化手术及后房型人工晶体术后引起的角膜水肿的病例。结果 本组1190例1281眼中共发生角膜水肿及失代偿98眼，其中角膜水肿97眼，角膜失代偿1眼。结论 白内障超声乳化术后发生角膜水肿及角膜失代偿与下面因素有关：晶体核硬化程度；术者手术熟练程度、手术时间；术中消毒液的种类；角膜内皮细胞总数：术后高眼压是否及时处理。以上诸多因素应该是临床眼科医师必须重点考虑的关键所在。     

Enriched environment and acceleration of visual system development

Rearing mice from birth in an enriched environment leads to a conspicuous acceleration of visual system development appreciable at behavioral, electrophysiological and molecular level. Little is known about the possible mechanisms of action through which enriched environment affects visual system development. It has been suggested that differences in maternal behavior between enriched and non-enriched conditions could contribute to the earliest effects of enriched environment on visual development and that neurotrophins, BDNF in particular, might be involved. Here, we examined Brain Derived Neurotrophic Factor (BDNF) levels in the visual cortex during development and showed that an increase occurs in the first week of life in enriched pups compared to standard reared pups; BDNF levels at birth were equal in the two groups. This suggests a postnatal rather than a prenatal effect of environment on BDNF. A detailed analysis of maternal care behavior showed that pups raised in a condition of social and physical enrichment experienced higher levels of licking behavior and physical contact compared to standard reared pups and that enhanced levels of licking were also provided to pups in an enriched environment where no adult females other than the mother were present. Thus, different levels of maternal care in different environmental conditions could act as indirect mediator for the earliest effects of enrichment on visual system development. Some of the effects of different levels of maternal care on the offspring behavior are long lasting. We measured the visual acuity of differentially reared mice at the end of the period of visual acuity development (postnatal day 45) and at 12 months of age, using a behavioral discrimination task. We found better learning abilities and higher visual acuity in enriched compared to standard reared mice at both ages.     

Effects of diazepam and picrotoxin on the visual system

The effects of diazepam (1 mg/kg i.v.) followed by picrotoxin (0.1 mg/kg i.v.) on the temporal alterations of shock-evoked cortical potentials after a flash of light were investigated in the pretrigeminal cat. In the dark-adapted state, a light flash produced a facilitation of more than 1500 sec, followed by a slight depression of the evoked cortical potential obtained by optic tract stimulation.     

Kinetic modelling of in vitro cell-based assays to characterize non-specific bindings and ADME processes in a static and a perfused fluidic system

Recently, physiologically based perfusion in vitro systems have been developed to provide cell culture environment close to in vivo cell environment (e.g., fluidic conditions, organ interactions). In this work, we model and compare the fate of a chemical, benzo[a]pyrene (B[a]P), in a perfusion and a standard (static well-plate) system. These in vitro systems are composed of Caco-2 and HepG2 cells so as to mimic absorption across the small intestine and intestinal and hepatic metabolism. Compartmental models were developed and calibrated with B[a]P kinetics data in the culture medium to estimate the apparent permeability of Caco-2 cells, the in vitro biotransformation of B[a]P, as well as the different routes of loss by non-specific adsorption. Our results show that non-specific binding is the main process responsible for the depletion of B[a]P in the culture media: at steady state, only 40% and 24% of the total concentration of B[a]P are bioavailable in the static and perfused systems, respectively. We also showed that Caco-2 permeability in the perfused culture system is closer to in vivo conditions than the one obtained in the static system and that higher cellular metabolic activities are observed in static conditions. Perfused in vitro systems combined with kinetic modelling are promising tools for studying in vitro the different processes involved in the toxicokinetics of xenobiotics.     

Histaminergic mechanisms in the vertebrate visual system

This paper presents and summarizes our recent results on histamine (HI) in vertebrate visual system. The data include: 1. HI distribution, localization, synthesis, uptake and metabolism in retina, optic nerve, choroid and brain of carp, hen, rabbit, cow, 2. distribution of HI in human eyes, 3. 3H-mepyramine binding in the bovine retina, and HI dependent cAMP generating system in the rabbit eye, 4. effect of light stimulation on HI content in the rabbit retina, optic nerve and brain, 5. diurnal variations of histidine decarboxylase and histamine-methyltransferase activity in the rabbit ocular and brain structures. These results are discussed in terms of possible function(s) of HI in the visual system.     

Impairment of visual system of beagles orally ingesting clioquinol

Visual system was examined in 3 beagles given clioquinol for a long period and in 2 control beagles. Ophthalmoscopic examination revealed the decreased diameter of the optic disks of the treated dogs except for one dog. There were degenerative changes of the optic nerves in all of the treated dogs. The changes included disruption of the axons and the myelin sheaths. It was difficult to observe the morphological change of the retinae of the treated dogs. The findings demonstrate that the changes in the visual system after clioquinol administration are severe in the optic nerves rather than in the retinae.     

A visual representation system for drug abuse counselors

Node-link mapping is a technique that consists of drawing spatial-verbal displays to visually represent interrelationships between ideas, feelings, facts, and experiences. These multirelational maps are drawn during ongoing counseling sessions to represent a variety of personal and nonpersonal topics. This article provides an overview of this technique, including rationale, related and supporting research, and an example of its use during counseling. In addition, this article describes the potential impacts of mapping and comments on practical considerations related to the effective use of this tool in drug abuse counseling.     

Teratogenic effects of ethanol exposure on zebrafish visual system development

Ethanol intake during pregnancy can produce a wide range of adverse effects on nervous system development including fetal alcohol syndrome (FAS). The most severe congenital malformation observed in newborns with FAS is cyclopia. In this study, we have exposed zebrafish embryos to different ethanol concentrations (2.4%, 1.5% or 1.0%) during eye morphogenesis in four zebrafish strains (AB, EK, GL and TL). In addition, we have studied the survival rate of the cyclopic animals to the end of larval development. The zebrafish strains GL and AB generated the higher percentage of cyclopic animals after exposure to 2.4% ethanol, while EK showed the higher percent cyclopic animals using 1.5% and 1.0% ethanol. The EK strain showed the higher percent survival during the larval period at all ethanol concentrations (2.4%, 1.5% and 1.0%). Moreover, we have investigated cytoarchitectural alterations in the main components of the visual pathway-retina and optic tectum-and ethanol treatment affects both the retina and the optic tectum. The lamination of neural retina is clearly delayed in treated larvae 3 days postfertilization and the thickness of the pigmented epithelium is considerably reduced. With regard to the optic tectum, treatment with ethanol alters the normal pattern of tectal lamination. The use of zebrafish EK strain is a suitable in vivo vertebrate model system for analyzing the teratogenic effect of ethanol during vertebrate visual system morphogenesis as it relates to both cyclopia and FAS.