隧道巩膜切口与透明角膜切口超声乳化白内障手术的临床效果分析

目的探讨老年性白内障摘除人工晶状体植入术两种不同术式的临床疗效;评价隧道巩膜切口与透明角膜切口的疗效差异。方法对年龄60～80岁,平均(68.4±9.1)岁的老年性白内障患者按前后阶段分成两组,A组98例(109只眼),行隧道巩膜切口白内障超声乳化摘除联合人工晶状体植入术;B组216例(258只眼)行透明角膜切口白内障超声乳化摘除联合折叠式人工晶状体植入术。分析两种不同切口及相应不同类型人工晶状体植入方式的优缺点。结果术后视力：两组术后1周、1个月、3个月的裸眼视力及最佳矫正视力存在显著性差异。术后并发症有轻度角膜内皮水肿、重度角膜内皮水肿、重度前段葡萄膜反应、人工晶状体夹持等。结论角膜透明切口白内障超声乳化摘除联合折叠式人工晶状体植入术术后散光小,并发症少,视力恢复好。     

青光眼术后白内障晶状体超声乳化人工晶状体植入

目的 探讨青光眼术后白内障透明角膜切口晶状体超声乳化吸出术的方法及疗效评价.方法 对42例(44眼)青光眼术后白内障施行透明角膜切口晶状体超声乳化人工晶状体植入术,术后随访3～6个月,观察视力、眼压及并发症情况.结果 44眼术后视力明显提高,术后所有患者跟压控制在正常范围.结论 行透明角膜切口晶状体超声乳化吸出及人工晶状体植入术是治疗青光眼术后复杂白内障有效方法.     

小切口非超声乳化联合推注式折叠型人工晶状体植入术

目的　研究小切口非超声乳化联合推注式折叠型人工晶状体植入术治疗白内障的疗效。方法　对34例38 眼不同类型的白内障施行3 mm巩膜隧道切口非超声乳化白内障摘出联合推注式折叠型人工晶状体植入术。结果　38 眼全部囊袋内植入人工晶状体,术后1 d视力≥0.8 者12 眼,0.4~0.6者22眼,视力≤0.3者4眼,术后2周视力≥0 8 者15眼,0.4~0.6者21眼,视力≤0.3者2眼。术前、术后角膜散光差异无显著性(P>0.05)。结论　小切口非超声乳化联合推注式折叠型人工晶状体植入术实现了真正意义上的小切口手术,具有许多优点,是治疗白内障的一种好方法。     

隧道式蝶形切口白内障摘出人工晶状体植入术

目的 探讨非超声乳化非碎核隧道式娩出硬核联合人工晶状体植入术的效果。方法 将75例(75眼)随机分为2组:观察组采用隧道式蝶形切口娩出硬核施行白内障术36例(39眼);对照组采用超声乳化术联合人工晶状体植入术39例(39眼)。结果 观察组术后裸眼视力>0.5者占66.3％,矫正视力>0.5者占96.9％,对照组术后裸眼视力>0.5者占67.6％,矫正视力>0.5者占97.2％。结论 隧道式蝶形切口白内障摘出联合人工晶状体植入术视力恢复快,术中角膜内皮细胞的损伤以及术后角膜散光同超声乳化联合人工晶状体植入术相比较差异均无显著意义(P>0.05)。     

透明角膜切口晶状体超声乳化治疗原发性闭角型青光眼合并白内障

目的评价透明角膜切口白内障晶状体超声乳化吸出后房人工晶状体植入术治疗原发性闭角型青光眼合并白内障的疗效。方法回顾性分析闭角型青光眼伴白内障14例(27眼)。单纯行透明角膜切口白内障晶状体超声乳化吸出联合后房型人工晶状体植入术,术后随访8~20个月。结果所有患者术中术后无严重并发症,术后视力较术前明显提高,术后平均眼压(12.64±3.37)mmHg与术前用药后平均眼压(16.72±4.26)mmHg相比差异有统计学意义(配对t检验,P<0.01),周边前房较术前明显加深,前房角均重新开放或部分开放增宽。结论单纯透明角膜切口白内障晶状体超声乳化吸出后房型折叠人工晶状体植入术,可有效治疗合并白内障的闭角型青光眼。     

透明角膜切口超声乳化白内障吸除折叠式人工晶状体植入术临床分析

目的探讨透明角膜切口超声乳化白内障吸除可折叠人工晶状体植入术后的临床效果。方法采用上方3.2mm阶梯状透明角膜切口,对101例123眼白内障行超声乳化白内障吸除折叠人工晶体植人。术后观察手术反应,角膜散光,视力和并发症。结果术后第一天裸眼或球镜矫正视力≥0.5者占79.68%;术后1周,1个月和3个月裸眼或球镜矫正视力≥0.5者分别占87.00%,91.87%和95.12%。术后3个月平均角膜散光与术前两者相比较差异无统计学意义(>0.05)。术后常见的炎症反应主要与核的硬度,超声乳化的时间及能量的大小有关。结论透明角膜切口的超声乳化白内障吸除折叠式人工晶状体植入术具有角膜散光小、术后视力恢复快、术后反应轻、无严重并发症发生的优点。     

白内障超声乳化两种透明角膜切口比较

目的:比较白内障超声乳化大小两种透明角膜切口术后视力及散光度数的差异。方法:选择老年性白内障160例160眼分别行白内障超声乳化5.5mm透明角膜切口(A组)与3.2mm透明角膜切口(B组)植入术后1wk;1,3,6mo进行视力及散光度数比较。结果:术后1wk裸眼视力A组明显低于B组,术后1,3,6mo裸眼视力A组与B组比较无明显差异;术后1wk;1mo角膜散光度数比较A组明显高于B组,术后3,6mo角膜散光度数A组与B组比较无明显差异。结论:基层医院面向经济欠发达的农村地区开展5.5mm透明角膜切口硬质人工晶状体植入术是行之有效的。     

透明角膜切口超声乳化折叠人工晶状体术后角膜散光的临床观察

目的:探讨透明角膜切口白内障超声乳化吸除联合折叠人工晶状体植入术后角膜散光的变化情况。方法:收集年龄相关性白内障患者58例79眼,全部实施透明角膜小切口超声乳化吸除联合折叠人工晶状体植入术。观察术前,术后3d;1wk;1mo视力及角膜散光情况。结果:术后1mo视力提高明显且趋于稳定。平均角膜散光度,术后1mo较1wk明显减少,二者比较差异有显著性。结论:3.2mm透明角膜切口白内障超声乳化吸除联合折叠人工晶状体植入术,术后角膜散光小,视力恢复快,稳定时间短,是理想的白内障手术切口方法。     

超乳治疗慢性闭角型青光眼临床观察

目的观察透明角膜切口晶状体超声乳化吸出联合人工晶状体植入治疗慢性闭角型青光眼合并白内障的疗效。方法原发性慢性闭角型青光眼20例(22眼),视力<0.1,晶状体不同程度浑浊,行晶状体超声乳化吸出联合人工晶状体植入术。结果术前用药后眼压(28.63±13.27)mmHg,术后为(15.42±3.86)mmHg(t=4.243,P<0.05);术后房角不同程度开放。结论透明角膜切口晶状体超声乳化吸出联合人工晶状体植入术可有效地治疗因晶状体阻滞合并白内障的慢性闭角型青光眼。     

两种透明角膜切口白内障超声乳化术后角膜散光比较

目的 评价2.6mm与3.0mm两种透明角膜小切口超声乳化白内障吸除联合折叠式人工晶状体植入术对角膜散光的影响.方法 将69例(69只眼)白内障患者,按照2.6mm与3.0mm两种不同大小透明角膜切口随机分为A、B两组,行透明角膜小切口超声乳化白内障吸除联合折叠式人工晶状体植入术,比较两组手术性角膜散光的情况.结果 A组(3.0mm组)术后1周、术后1个月、术后3个月平均手术性角膜散光度分别为(0.6347±0.57773)D、(0.6029±0.52986)D和(0.6471±0.51902)D;B组(2.6mm组)术后1周、术后1个月、术后3个月平均手术性角膜散光度分别为(0.7286±0.62241)D、(0.6286±0.45927)D和(0.5714±0.49472)D;差异无统计学意义(P>0.05).结论 在同轴白内障超声乳化吸除联合折叠式人工晶状体植入术中,2.6mm透明角膜切口是一种安全有效的手术切口.     

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.