尿激酶联合透明质酸酶诱导兔眼玻璃体后脱离的实验研究

目的：研究尿激酶联合透明质酸酶玻璃体腔内注射诱导兔眼玻璃体后脱离（PVD）的效果，并评价其安全性。 方法：20只兔40眼随机分为A，B，C3组，分别为6，6，8只，均以右眼为实验眼，左眼对照。3组动物实验眼玻璃体腔内注射药物分别为：尿激酶1000U，透明质酸酶20U，尿激酶1000U＋透明质酸酶20U，对照眼内均注入BBS0．ImL。术后7d内行裂隙灯、检眼镜、光镜及扫描电镜等检查。 结果：术后7dA组部分性PVD发生率100％，B组为16．7％，两组均无完全性PVD发生；C组完全性PVD发生率100％，对照眼无PVD。病理学检查未发现视网膜毒性。 结论：尿激酶1000U联合透明质酸酶20U兔眼玻璃体腔内注射能诱导完全性PVD，且无眼内毒性。     

用任氏液或透明质酸钠作部分玻璃体置换

自Gonin以来已于视网膜脱离手术引流视网膜下积液后,用置换物重新填入玻璃体腔,使眼球的低压状态恢复正常,且由于置换物的填塞作用而使视网膜复位。生理盐水或任氏液、硅油、新鲜或冷冻的玻璃体、透明质酸钠以及气体物质如空气、氩、氪、八氟丁烷或六氟化硫都曾作为玻璃体置换物质。在液体置换物中,主要以透明质酸钠和任氏液作生理性玻璃体置换物,对动物实验最为恰当。本文作者用眼球正常的兔24只共48眼作玻璃     

玻璃体切除玻璃体腔注药治疗感染性眼内炎

目的评价玻璃体切除联合玻璃体腔注药治疗严重眼内炎的临床应用价值。方法对43例（43眼）感染性眼内炎进行玻璃体切除联合玻璃体腔注药、眼内异物摘出，或联合晶状体切除、视网膜脱离复位及硅油或惰性气体填充术，配合全身及局部应用抗生素（或抗真菌药）、皮质类固醇药物治疗。随访4月～4年。结果41眼（95．35％）眼内炎控制，保存了眼球；35眼（81．40％）视力不同程度的提高；视力无变化者3眼（6．98％）；视力降低3眼（6．98％）；1眼（2．33％）作眼内容摘除；1例术后自动出院，失随访。结论玻璃体切除联合玻璃体腔注药是治疗严重眼内炎的有效方法。     

透明质酸酶对外伤性玻璃体积血转归的影响

目的探讨透明质酸酶对兔眼外伤性玻璃体积血转归的影响。方法28只新西兰白兔,右眼为外伤性玻璃体积血模型,左眼为空白对照眼。1d后随机分为实验组和阳性对照组,每组14只兔（14只眼）。实验组玻璃体腔注射透明质酸酶0．002umol／（min·L）,阳性对照组玻璃体腔注射0．1mL BSS。分别于给药后1、3、7、14、21、28d测量眼压,行裂隙灯及眼底检查。每组抽取2只实验兔行眼球摘除,抽取玻璃体液测定碱性成纤维细胞生长因子（bFGF）的质量浓度,取眼球壁行组织病理学检查。结果给药14d后,实验组的玻璃体混浊程度明显低于阳性对照组,各组间比较差异有统计学意义（P〈0．05）。给药后1d、3d,实验组眼压和空白对照组眼压比较差异均有统计学意义（P〈0．05）,与阳性对照组比较差异均有统计学意义（P〈0．05）。随着时间推移,玻璃体中bFGF的质量浓度均增高,阳性对照组增高更明显。组织病理学检查见实验组和阳性对照组视网膜均出现了水肿和神经节细胞空泡样变、内界膜增厚等改变,但实验组较阳性对照组形成增生膜少。结论透明质酸酶20IU于兔眼玻璃体腔内注射对视网膜无毒性作用,可加速外伤性玻璃体积血的消散,造成眼压一过性降低。     

复合式小梁切除术应用透明质酸钠的临床观察

目的观察在复合式小梁切除术中应用透明质酸钠保持前房深度的手术效果。方法78例（87眼）原发性闭角型青光眼分为2组：透明质酸钠组33例（4l眼）行前房注入透明质酸钠后再行复合式小梁切除术;对照组45例（46眼）行复合式小梁切除术。结果浅前房发生率透明质酸钠组12．20％（5／41）,对照组32．61％（15／46）,两组比较P〈0．05。手术成功率透明质酸钠组97．56％（40／41）,对照组91．30％（42／46）,两组比较P〉0．05。结论维持正常前房深度下行复合式小梁切除术可降低浅前房发生率。     

几丁糖填充玻璃体腔对兔眼内组织结构影响的研究

目的探讨几丁糖玻璃体腔填充对视网膜、睫状体、晶状体、角膜等眼内组织结构和眼压的影响。方法选择健康青紫蓝兔12只,右眼为实验组,左眼为对照组,行玻璃体切除术后,玻璃体腔内注入医用几丁糖（实验组）和透明质酸钠（对照组）,手术前后定期行裂隙灯显微镜及检眼镜检查并测量眼压,术后行组织学和透射电镜检查。结果术后玻璃体腔内的填充物始终保持透明。视网膜平伏,未见视网膜脱离及增生。实验组与对照组在各时间点眼压比较,差异无统计学意义（P〉0．05）。光镜及透射电镜检查结果发现,实验组及对照组镜下表现无明显差异,角膜、睫状体、晶状体及视网膜均无异常。结论几丁糖填充玻璃体腔内对眼组织结构无明显影响,也不引起眼压波动。（中华眼科杂志,2005,41：892-895）     

玻璃体腔内注气治疗高度近视黄斑裂孔性视网膜脱离

目的：总结玻璃体腔内注气治疗高度近视黄斑裂孔性视网膜脱离的疗效。探讨该方法的适应证及相关因素。方法：２８例高度近视黄斑裂孔性视网膜脱离患者,经三种玻璃体腔内注气术,观察复位率、术前后视力变化及并发症情况。结果：２８例患眼,一次注气复位成功２１例（７５％）,复位眼视力７６．２％进步,２３．８％不变,无减退者,未出现严重并发症。结论：玻璃体腔内注气治疗高度近视黄斑裂孔性视网膜脱离。安全简便,可重复,不损伤残存视力,可作为该疾患的首选治疗方案。     

非眼球摘除术治疗严重眼球破裂伤后无光感眼

目的探讨严重眼球破裂伤后无光感眼的治疗方法，采取非眼球摘除术的保守和手术的综合治疗，以达到挽救部分病人眼球及视力的目的；方法21例严重眼球破裂后无光感眼的病人，男18例，女3例。采取一期清创缝合，取异物，严密巩膜伤口缝合，结膜下或球旁或玻璃体腔内注射抗生素，及必要的二期玻璃体切割术而保留眼球的综合治疗。观察术后1周、2周、3个月、6个月的视力，眼球形态，是否发生交感性眼炎。结果视力≥0．1者6眼（占28．6％）；光感以上〈0．1者8眼（占38．1％）；无光感视力，眼球保住4眼（占19．O％）；无光感视力，最终眼球摘除术3眼（占14．3％）。治愈率达85．7％。结论严重眼球破裂伤后无光感眼可以不需要眼球摘除术，伤口处理得好，仍可使部分病人获得视力，保住眼球。     

晶状体或人工晶状体脱入玻璃体腔伴视网膜脱离手术疗效

目的探讨玻璃体切除术治疗晶状体或人工晶状体脱入玻璃体腔伴视网膜脱离的临床疗效和并发症。方法对在我院进行标准睫状体平坦部三切口闭合式玻璃体切除术的26例（26只眼）晶状体或人工晶状体脱入玻璃体腔伴视网膜脱离者行回顾性分析。其中眼挫伤后晶状体脱位7只眼,白内障术中晶状体脱位和术后人工晶状体脱位19只眼。对人工晶状体脱人玻璃体腔者术中经角膜缘摘出人工晶状体,对晶状体脱入玻璃体腔者直接在玻璃体腔内行晶状体核超声乳化吸出。其中14只眼行硅油填充,12只眼行C3F8填充,16只眼联合巩膜外加压。术后随访6-18个月,平均（11．50±2．67）月。结果26只眼均顺利摘出人工晶状体或超声乳化吸出玻璃体腔内晶状体核,视网膜最终完全复位23只眼（88．46％）,部分复位2只眼（7．69％）,失败1只眼（3．85％）,后者系由病程长,增生性玻璃体视网膜病变（PVR）严重所致,术后大部分患者视力有不同程度的提高。结论玻璃体切除术治疗晶状体或人工晶状体脱入玻璃体腔伴视网膜脱离可获得较好解剖效果,但功能恢复较差。     

玻璃体腔注射阿霉素和万古霉素治疗眼球穿孔伤并发症的实验研究

目的观察玻璃体腔注射阿霉素和万古霉素对感染性眼内炎及外伤性增生性玻璃体视网膜病变（PVR）的抑制效果。方法40只新西兰白兔随机分为4组,每组10只。右眼建立外伤性出血性眼球穿孔伤模型,左眼为空白对照眼。4个组中生理盐水组,玻璃体腔注射生理盐水0．1mL;阿霉素组,注射阿霉素2．5μg（0．1mL）;万古霉素组,注射万古霉素1．0mg（0．1mL）;联合用药,注射阿霉素2．5μg（0．1mL）及万古霉素1．0mg（0．1mL）。以裂隙灯显微镜观察眼前段炎症情况,炎症持续超过2周者行玻璃体微生物学培养;直接检眼镜观察外伤性PVR情况。结果联合用药组PVR程度低于生理盐水组（P=0．023）及万古霉素组（P=0．034）;生理盐水组、阿霉素组各发生细菌性眼内炎2例（20．0％）;万古霉素组、联合用药组未见细菌性眼内炎发生。结论在外伤性出血性眼球穿孔伤动物模型中,玻璃体腔注射阿霉素可能降低外伤性PVR程度;而玻璃体腔注射万古霉素可能降低感染性眼内炎症发生率。     

A defect in the blood-retina barrier in the optic nerve head region in the rabbit and the monkey

The permeability properties of the tissues in the optic nerve head region have been investigated in monkey and rabbit using horseradish peroxidase as an histochemical tracer. Following intravenous administration, the tracer diffused from the peripapillary choroid into the different parts of the optic nerve head region, and also into the receptor layer of the sensory retina adjacent of Kuhnt intermediary tissue. This observation demonstrates a defect in the blood-retina barrier in this region. The defect in the permeability barrier is most likely located either to the retinal pigment epithelium near the optic nerve head, to the Kuhnt intermediary tissue, or to the junction between these tissues.     

Role of low and high spatial frequencies in the face-selective responses of neurons in the cortex in the superior temporal sulcus in the monkey

There are neurons in the cortex in the anterior part of the superior temporal sulcus of the macaque monkey with visual responses selective for faces. One aim of the present study was to analyze further the information which leads them to respond, by measuring their responses to parametrically filtered stimuli. The responses of 32 such single neurons were measured to faces which were digitized, lowpass filtered at spatial frequencies of 2, 4, 8,...128 cycles/face, highpass filtered at frequencies of 4, 8,...64 cycles/face, and presented in random sequence using a video framestore. It was found that many of the neurons could respond to blurred images of faces, with a mean frequency at half-maximum amplitude of the neuronal response to the series of lowpass filtered images of faces of 3.3 cycles/face. Almost all the neurons had lowpass cutoff frequencies defined in this way below 8 cycles/face. Many of the neurons could also respond to images of faces in which the only information remaining was a limited amount of high spatial frequency edge information. The mean frequency at half-maximum amplitude of the neuronal response to the series of highpass filtered images of faces was 29.7 cycles/face. Almost all the neurons had highpass cutoff frequencies above 8 cycles/face. Thus, many of the neurons could respond to a lowpass and a highpass filtered image of a face even when these had no spatial frequencies in common. The mean separation between the lowpass and highpass cutoff frequencies was 3.2 octaves. For comparison, face recognition in man can be performed with images which contain only information up to 8 cycles/face, or with highpass filtered images which contain only information down to 8 cycles/face. The response of the neurons was not always a smooth function of frequency, but could decrease as higher frequencies were included in the lowpass filtered images of faces, or as low frequencies were included in the highpass filtered images of faces. This indicates that information in certain frequency bands was able to inhibit these neurons. This was particularly likely to occur for the non-optimal face stimulus for a given neuron, indicating that the selectivity of these neurons to different faces was a combination of the excitation produced by some information in faces and inhibition produced by other.     

Ophthalmology in Europe in the days of the French Revolution

The authors highlight the political and scientific landmarks in 18th century France; the Revolution of 1789 had positive effects, in that it marked the accession of the French middle-class to political power and enabled the promotion of young scientists without consideration of social class or fortune; it had negative effects, in that France lost the scientific edge it had gained when all existing chairs in ophthalmology were abolished. The status of ophthalmology and of physiological optics in the 18th century are discussed, with a brief mention of the most important innovators in the field.     

The decrease in the threshold on the dark side of the luminance edge in the after-flash effect

Foveal thresholds were measured for a small, briefly presented test slit as a function of the distance from the edge of a luminance-step pattern. A luminance-step pattern was briefly presented after the test slit. By this experiment, the edge threshold effect (i.e. the rise in threshold at the luminance edge) and the fall in threshold on the dark side of the edge were found. On the other hand, the fall in threshold was never obtained at a steadily presented luminance edge. This fall in threshold found here was briefly discussed.     

Investigations of the enzymes involved in the fructose breakdown in the cattle lens

By introducing fructose into the glycolysis, it is possible to stimulate ATP formation. As is the case in animal experiments, in human lenses, too, the first step in the phosphorylation to fructose-1-phosphate via the enzyme ketohexokinase. The present investigation deals with the question whether enzymes present in the lens are responsible for the further steps in fructose degradation. Particularly the aldolase isoenzyme C splits fructose-1-phosphate into glyceraldehyde and dihydroxyacetone phosphate in the same way as in glucose catabolism. Dihydroxyacetone phosphate can further be directly degraded and thus utilized to ATP formation. From glyceraldehyde, glycerol (aldose reductase) or glycerate (aldehyde dehydrogenase) can be formed. The presence of triosekinase, which phosphorylates glyceraldehyde directly to glyceraldehyde-3-phosphate, could only be determined in the lens tissue of young animals. The presence of glycerokinase (glycerol leads to glycerophosphate) could not be verified. Thus, in the lens tissue 1 ATP molecule net per fructose molecule can be formed. In older age, the glucose breakdown is limited by hexokinase and phosphofructokinase, so that the glucose, after transformation via the sorbitol pathway to fructose, can also be utilized for the energy metabolism.