表麻下小切口非超声乳化白内障手术并发症探讨

目的 观察表麻下小切口非超声乳化白内障手术术中、术后并发症，对其进行分析并提出处理意见。方法 102例(102只眼)白内障，术中表面麻醉后，采用圈垫式劈核技术，手法碎核，进行小切口非超声乳化白内障摘除并人工晶状体植人术。结果 术中：虹膜脱出12只眼，虹膜根部离断1只眼，晶状体后囊破裂7只眼。术后：角膜内皮条样浑浊30只眼，片状浑浊10只眼，前房纤维素样渗出10只眼，继发青光眼1只眼。结论 表麻下小切口非超声乳化白内障手术避免了球周、球后麻醉带来的一系列并发症。对晶状体核的处理较关键，亦是易产生并发症的步骤。     

表面麻醉下白内障摘除人工晶状体植入术

目的进一步探讨表面麻醉下小切口非超声乳化白内障摘除人工晶状体植入术的安全性及有效忡。方法随机抽取220例(256眼)行小切口非超声乳化白内障摘除及人工晶状体植入术患者分为2组。表面麻醉组110例(126 眼),球后麻醉组110例(130眼),比较2组的手术效果及并发症。结果表向麻醉组手术时间明显短于球后麻醉组(P<0.01),而且并发症更少,术后1d及1周视力对比无显著性差异(P>0.05)。结论表面麻醉下小切口非超声乳化白内障摘除人工晶状体植入术是安全有效的,而且并发症少,简便易行。     

表面麻醉在白内障非乳化手术中的应用

目的：探讨表面麻醉在白内障非超声乳化囊外摘出及人工晶状体植入术中应用的效果。方法：观察115例（129眼）白内障在表面麻醉下进行的小切口非超声乳化囊外摘出及人工晶状体植入术，对术中术后并发症进行分析。结果：9例术中轻微痛感不影响手术；有7例冲吸皮质时后囊破裂，经过处理也植入人工晶状体；术中术后无角膜水肿及上皮脱落现象；均无其他麻醉式的并发症发生。结论：表麻下行非超声乳化白内障人工晶状体手术是可行的和安全有效的，手术时间短，痛苦小，术后反应轻，恢复快，无重要的麻醉并发症。     

表面麻醉下小切口非超声乳化白内障摘除及人工晶状体植入术

目的：探讨表面麻醉下行小切口非超声乳化白内障摘除人工晶状体植入术的安全性及有效性。方法：对90例（102只眼）白内障患者在表面麻醉下行小切口非超声乳化白内障摘除及人工晶状体植入术并观察其麻醉效果及术后视力。结果：所有患者在表麻下均能很好地配合手术顺利完成。无一例改用其它麻醉方法。平均手术时间为20.04分钟。术后1天及1周视力≥0.5者，分别占67.65％和77.27％。结论：表面麻醉小切口非超声乳化白内障摘除及人工晶状体植入术是安全有效的。     

门诊白内障患者表面麻醉下行超声乳化摘出术

目的 分析和探讨表面麻醉下行人障超声乳化摘出及人工昌状体植入术的可行性及其效果。方法 门诊非选择性地对１３２例１５７眼各种类型白内障在表面麻醉下进行了超声乳化摘出并人工晶状体植入术。结果 １５２眼（９６．８％）。麻醉满意,５眼（３．２％）增加球后麻醉后完成手术,术后视力及并发症与本科以往球后麻醉下所行白内障超声乳化术的效果相似。结论 表面麻醉下做巩膜隧道切口可满意地完成白内障超声乳化摘出及人工晶状体植入术,为门诊开展本手术提供了便利。     

表面麻醉下小切口白内障囊外摘出并发症及处理

目的探讨表麻下小切口非超乳白内障摘出术的并发症预防和处理。方法对458例(512眼)白内障表麻下行小切口非超乳白内障摘出人工品状体植入术,并对并发症进行分析。结果术中并发症:角膜后弹力层脱离2例(2眼),虹膜脱出10例(10眼),虹膜根部断离2例(2眼),瞳孔括约肌断裂5例(5眼),前房积血5例(5眼),后囊破裂、玻璃体脱出1例(1眼),晶状体坠入玻璃体腔2例(2眼),术后并发症:角膜水肿15例(15眼),术后高眼压继发青光眼2例(2眼),前房纤维渗出5例(5眼),人工晶状体前膜形成2例(2眼),无张力瞳孔3例(3眼),人工晶状体偏心5例(5眼),脱位1例(1眼),瞳孔夹持2例(2眼),晶状体后囊浑浊20例(20眼),化脓性眼内炎1例(1眼)。结论表麻下小切口非超乳白内障手术并发症少,切口小,安全可靠。并发症与术者熟练程度,规范的切口,充足的黏弹剂相关。     

倍诺喜表面麻醉下小切口非超声乳化白内障术

目的：探讨倍诺喜表面麻醉下行小切口非超声乳化白内障摘除及人工晶状体植入术的安全性及有效性。方法：对364例(402只眼)白内障患者在倍诺喜表面麻醉下行小切口非超声乳化白内障摘除及人工晶状体植入术并观察其麻醉效果及术后视力。结果： 所有患者在表麻下均能很好地配合手术顺利完成，无一例改用其它麻醉方法。平均手术时间为12．35分钟。术后1天及1周视力≥0．5者，分别占62．44％和78．11％。结论：倍诺喜表面麻醉小切口非超声乳化白内障摘除及人工晶状体植入术是安全有效的。     

表面麻醉及球周麻醉下超声乳化白内障吸除联合人工晶状体植入术的比较

目的：评价表面麻醉下超声乳化白内障吸除及人工晶状体植入术的安全性和效果。方法：两组共375例（400只眼）白内障分别在表麻下及球周麻醉下施行超声乳化吸除及人工晶状体植入术,对术后视力,术中及术后并发症进行分析。结果：两组术后1天、1周、3个月视力无显著差异;关发症：后囊破裂及角膜水肿发生率,两组间相差不显著;球周麻醉组发生眶内出血2只眼,暂时性上睑下垂26只眼,暂时性复视9只眼。结论：表面麻醉下超声乳化术是安全有效的。在熟练掌握超声乳化手术的基础上,表面麻醉下手术较球周麻醉下更安全、快捷。     

合并全身病的白内障表面麻醉超声乳化术分析

目的 探讨合并全身病的白内障表麻下超声乳化吸出人工晶状体植入术的可行性及安全性。方法 对197例(199眼)合并全身病的白内障均在表麻下完成巩膜隧道切口超声乳化吸出，植入人工晶状体。手术时间13-25分钟，平均20分钟。观察麻醉效果、并发症及术前术后视力等。结果 全部病例未加球后、球周麻醉或结膜下麻醉，手术成功率97．49％，表麻成功率100％，术后视力恢复快、反应轻、结膜充血不明显。结论 表麻对合并全身病的白内障患者是安全可行的。     

小切口非超声乳化白内障手术并发症分析

目的：分析小切口非超声乳化白内障摘出手术的并发症原因,总结防治经验。 方法：对485例（549眼）白内障患者行小切口非超声乳化白内障摘出人工晶状体植入术,对发生的并发症进行分析。 结果：术中后囊膜破裂18眼,虹膜根部离断2眼,前房出血6眼术后角膜水肿37眼,前房积血4眼,切口虹膜嵌顿9眼。 结论：小切口非超声乳化白内障手术安全,并发症的发生主要与术者熟练程度有关。     

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.