白内障超声乳化吸除联合人工晶状体植入Ⅰ期后囊膜连续环形撕除的临床观察

目的探讨白内障超声乳化吸除联合人工晶状体植入术中Ⅰ期后囊膜连续环形撕除的临床疗效。方法对53例(60只眼)先天性白内障和后囊混浊的老年性白内障,施行白内障超声乳化吸除联合人工晶状体植入,同时行Ⅰ期后囊膜连续环形撕除,术后观察眼压、人工晶状体位置、视轴区后发障等情况。结果术中人工晶状体均顺利植入囊袋;54只眼术后视力较术前提高,术后24小时后眼压正常;术后随访3个月~2年,无发生玻璃体疝入前房,未发现人工晶状体异位或夹持,无一例出现后发障、视网膜脱离。结论白内障超声乳化吸除联合人工晶状体植入Ⅰ期后囊膜连续环形撕除是可行、安全的,能有效地治疗后囊膜混浊,预防后发障。     

先天性白内障手术中预防后发障的方法

目的　探讨小儿先天性白内障手术中预防后发障的方法。方法　对 46例 ( 4 6眼 )先天性白内障 ,以白内障超声乳化仪的注吸I/A系统吸净晶状体植入人工晶状体后 ,进行后囊连续环形撕囊及前段玻璃体切除联合手术 (A组 ) ,同期施行的3 2例 ( 3 2眼 )先天性白内障 ,以同样的方法行白内障摘出人工晶状体植入后 ,进行单纯后囊连续环形撕囊术 ,不做前段玻璃体切除 ,作为对照组 (B组 )。术后随访 2年以上。结果　后发障发生的情况 ,A组 2眼 ( 4 4% ) ,B组 7眼 ( 2 1 9% ) ,两组对比差异具有显著性意义 (P <0 0 5 )。两组均未发现眼底并发症。结论　先天性白内障术中行后囊连续环形撕囊联合前段玻璃体切除术 ,是预防后发性白内障的有效方法。     

青少年白内障术中晶状体后囊浑浊的手术处理

目的：探讨青少年白内障手术中同期晶状体后囊浑浊的手术处理方法，方法：对白内障超声乳化术（phacoemulcification)，非超乳的小切口白内障囊外除术（small incision ECCE)联合后房人工晶体植入术手术当中囊抛光不干净或白内障术后后发性白内障63例65眼于后房型人工晶体植入后一期采用后囊截开或撕囊术，对照组选用同期类似患31例31眼行白内障术中常规后囊抛光术，术后视力和并发症两组进行 对比，统计结果进行组间／检验。结果：截囊组术后 力最佳1．5，最差0．3，术后2月平均视力0．6，与对照组相比有显差异（t检验，P＜0．05），术后随访6－22月对照组继发后发性白内障21只眼（并发率67．3％），撕后囊组无后发性白内障和眼后节并发症发生。后发障发生率与对照组有显性差异。结论：青少年白内障后房型人工晶体植入术后同期采用后囊截开或撕囊术对眼内组织损伤小，术后反应轻，人工晶体在眼内稳定性好，后发性白内障及眼后节并发症少。     

儿童先天性白内障不同术式的后发障发生率

目的探讨减少儿童白内障术后后发障的手术方法。方法15岁以下的先天性白内障117例(158眼)。分为3组:A组进行超声乳化吸出术及后囊抛光术,共79眼;B组进行超声乳化及后囊连续环形撕囊术,共32眼;C组进行超声乳化、后囊连续环形撕囊及前部玻璃体切除术,共47眼。≥3岁者一期囊袋内植入人工晶状体。观察术后后发障的发生情况。结果A组有71眼在术后25天～3年期间出现后发障,占89.87%,平均出现时间为11月。B组有24眼在术后45天～2年半期间出现后发障,占75.00%,平均出现时间为1年5月。C组有6眼在术后50天～2年期间出现后发障,占12.77%,平均出现时间为1年3月。结论3岁以下婴幼儿进行白内障吸出、后囊环形撕囊术并行前部玻璃体切除术,二期植入人工晶状体。3～15岁的患儿进行白内障吸出、后囊环形撕囊术并行前部玻璃体切除术,〗并囊袋内植入人工晶状体可有效预防后发障的发生。     

儿童先天性白内障不同手术方式的临床效果观察

目的 探讨减少儿童白内障术后后发障的手术方法.方法 15岁以下先天性白内障54例(88眼).分为3组:A组进行超声乳化吸出术后囊抛光术,共35眼;B组进行超声乳化及后囊连续环形撕囊术,共31眼;C组进行超声乳化、后囊连续环形撕囊及前部玻璃体切除术,共22眼.≥3岁者一期囊袋内植入人工晶状体.观察术后后发障的发生情况.结果 A组有31眼在术后25d～3a出现后发障,占88.57%,平均出现时间为11月.B组有23眼在术后45d～2.5a期间出现后发障,占74.19%,平均出现时间为1年5月.C组有3眼在术后50d～2a期间出现后发障,占13.64%,平均出现时间为1年3月.结论 3岁以下婴幼儿进行白内障吸出、后囊环形撕囊术并行前部玻璃体切除术,二期植入人工晶状体.3～15岁的患儿进行白内障吸出、后囊环形撕囊术并行前部玻璃体切除术,并囊袋内植入人工晶状体可有效预防后发障的发生.     

儿童白内障三种术式后发障形成的临床探讨

目的 探讨预防儿童后发性白内障的手术方式。方法 48例(57眼)儿童白内障，其中先天性白内障41眼，外伤性白内障16眼，年龄3—14岁。57眼随机分为3组，每组都行小切口、前囊连续环形撕囊，白内障吸出及折叠式人工晶状体植入。Ⅰ组行后囊抛光，保留完整后囊；Ⅱ组行后囊连续环形撕囊；Ⅲ组行后囊连续环形撕囊及前部玻璃体切除术。术后随访3—18月，平均12月，观察并记录各组后发性白内障发生情况及其它并发症。结果 后发障≥3级者发生率Ⅰ组为42％，Ⅱ组为21％，Ⅲ组为0。各组均无玻璃体癌、视网膜脱离或囊样黄斑水肿等并发症发生。术后矫正视力≥0．5者40眼(70％)，0．1—0．4者11眼(19％)。结论 白内障吸出及折叠式人工品状体植入术中，行后囊连续环形撕囊联合前部玻璃体切除术可有效地预防儿童后发性白内障的发生，远期效果需进一步观察。     

后囊环形撕囊在幼儿先天性白内障术中的应用

目的探讨在幼儿先天性白内障手术中行一期后囊连续环形撕囊的临床意义。方法对18例(30眼)幼儿先天性白内障采用一期后囊环形撕囊。结果术后术眼均达到视轴区透明。结论一期后囊环形撕囊可有效地预防幼儿先天性白内障术后后发障的发生。     

前部玻璃体切除在先天性白内障手术中的作用

目的探讨存先天性白内障手术中前部玻璃体切除对术后视轴区后囊浑浊的预防作用。方法对61例（122眼）2～8岁的儿童双眼先天性白内障施行晶状体超声乳化联合人工晶状体植入。右眼为对照组（61眼）联合后囊连续环形撕囊;左眼为研究组（61眼）联合后囊连续环形撕囊及前部玻璃体切除。随访6～66月,平均31．6月观察记录两组视轴区浑浊情况和其它并发症.结果视轴区浑浊发生率,对照组为36．07％,研究组为8．20％,研究组明显低于对照组（P〈0．01）。在能够进行视力检查的48例（96眼）中,术后最佳矫正视力≥0．3者,对照组为30只眼（62．50％）;研究组为39只眼（81．25％）,研究组高于对照组,差异有统计学意义（P〈0．05）。结论对于（2～8岁）儿童先天性白内障,在施行晶状体超声乳化联合人工晶状体植入的同时,联合后囊连续环形撕囊及前部玻璃体切除,可安全有效的减低术后视轴区浑浊的发生率。     

先天性白内障囊外摘除联合后囊连续环形撕囊疗效分析

目的观察先天性白内障摘除术中行后囊连续环形撕囊(PCCC)防治后发性白内障的疗效及可能出现的并发症。方法采用小切口先天性白内障单纯囊外摘除或联合人工晶体植入术,对58例97眼先天性白内障患者进行后囊连续环形撕囊,使晶体后囊中央形成约3～5mm的囊膜缺损区,行前部玻璃切除术,以避免后发障的发生。结果Ⅰ期植入人工晶体50眼。能合作检查视力者中,术后1个月矫正视力≥0.6者18眼,0.5以下42眼;术后3个月矫正视力≥0.6者20眼,0.5以下46眼;术后6～12个月矫正视力≥0.6者21眼,0.5以下50眼。术后一个月第1次复查,无1眼发生后发障,3个月周边部后囊膜混浊40例,撕囊区清亮。6～12个月16眼发生新生膜,10眼少量玻璃体脱出于前房,玻璃体轻度混浊,瞳孔不圆18眼,人工晶体偏位10眼,无1眼发生视网膜脱离。结论后囊连续环形撕囊是一种经济、安全、高效的防止先天性白内障术后后发障的手术方式,适用于不能配合激光治疗的儿童,但存在一定的复发率。     

儿童白内障Ⅰ期后囊连续环形撕囊临床观察

目的：探讨Ⅰ期后囊连续环形撕囊对儿童后发障的预防作用。方法：对42例（48只眼）在植入人工晶状体前施行Ⅰ期后囊连续环形撕囊，术后随访2个月至2年。结果：术后矫正视力≥0．5者有21只眼，占48．3％，随访期间有40只眼（83．3％）保持中央视轴区透明或基本透明。术后未发现严重并发症。结论：儿童白内障摘除联合人工晶状体植入术中施行Ⅰ期后囊连续环形撕囊，安全有效，在一定程度上可减少后囊混浊的发生。     

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.