Medpor Titan外科种植体在眼眶爆裂性骨折修复术中的应用

目的评价镶嵌钛网高密度多孔聚乙烯（Medpor Titan）外科种植体在眼眶爆裂性骨折修复术中的作用。方法回顾性分析采用Medpor Titan修复眼眶爆裂性骨折的患者11例（11只眼）。术前存在眼球内陷、眼球运动障碍及复视,眼眶CT证实为眼眶爆裂性骨折。术后观察眼球突出度、眼球运动及复视等变化,并复查眼眶CT。结果术前9例合并眼球内陷有8例完全矫正,1例欠矫3 mm。术后眼球内陷1~3 mm,平均（-0.89±1.17）mm,与术前比较差异有统计学意义（P〈0.01）;术前10例眼球运动障碍的患者9例恢复正常,1例好转;合并复视的6例患者中5例复视消失,1例改善。复查眼眶CT见眶壁骨折复位良好,Medpor Titan无移位、脱出,无肌肉及软组织嵌顿。结论 Medpor Titan不仅能较好的用于眼眶骨折修复,且能在影像学上很好地显影,是较理想的眼眶骨折修复材料。     

眼眶内、下壁爆裂性骨折的眼球缺失一期整复的探讨

随着羟基磷灰石义眼座眼窝填充术的广泛开展，术后上睑区凹陷复发报道明显增多，有文献报道其主要原因，多伴有眶骨骨折，一期未处理，眶腔扩大，眶内容物相对不足。我科2005年3月-2007年11月对12例伴爆裂性眶内、下壁骨折的眼球缺失患者，行眶内、下壁骨折羟基磷灰石骨片整体修复，联合羟基磷灰石眼座植入术，取得良好效果，报告如下。     

Effects of penetrating cornea injury combined with seawater immersion on the levels of aqueous humor TNF-α in rabbits

Objective To observe effects of penetrating cornea injury combined with seawater immersion on the levels of aqueous humor TNF-α in rabbits. Methods 10 adult healthy grey rabbits were used for the experiment. The rabbit eye model of comea blast injury was developed by using a single firecracker. For each rabbit, the right eye was the experimental eye (seawater was injected into the anterior chamber through the cornea incision, simulating seawater immersion) and the left eye was the control (treated with 0.9% sodium chloride). Levels of aqueous humor TNF-α were detected by using double-antibody sandwich ELISA on the 1st, 2nd, yrd, 4th, 5th, and 7th days following seawater immersion or 0.9% sodium chloride injection. Results Following development of the model, levels of aqueous humor TNF-α in the experimental eye on the 1st, 2nd, 3rd days were 190.338, 156. 107,117.018 ng/L respectively, and significant differences could be seen when comparisous were made between the experimental and control eyes. The level of aqueous humor TNF-α on the 1st day was the highest and obviously reached the peak. Conclusions Level of aqueous humor TNF-α in the experimental eye with penetrating cornea injury combined with seawater immersion was significantly higher than that of the control eye, indicating that TNF-α was clearly involved in the pathological change and it played an important role in the process.     

超选择眼动脉溶栓联合机械碎栓治疗急性视网膜中央动脉阻塞

采用Seldinger技术,对11例(11眼)在6 h内发病的急性视网膜中央动脉阻塞(CRAO)患者实施超选择眼动脉灌注尿激酶溶栓联合机械碎栓治疗.溶栓后第2、14天11例患眼视力均恢复至4.6,6个月后7例患眼视力为4.6～4.8,4例4.8.与治疗前比较,治疗后视觉功能改善明显(P<0.05).认为超选择眼动脉溶栓联合机械碎栓治疗发病在6 h以内的急性CRAO,是一种安全有效的介入方法 .     

充气性视网膜固定术治疗巩膜扣带术后残留视网膜脱离

目的 观察充气性视网膜固定术治疗巩膜扣带术后残留视网膜脱离的疗效.方法 回顾分析我科经充气性视网膜固定术治疗巩膜扣带术后残留视网膜脱离13例(13眼)孔源性视网膜脱离或合并增生性玻璃体视网膜病变(PVR),其中PVR A级3眼,B级6眼,C1级3眼,C2级1眼;黄斑部脱离4眼.眼轴长度21.45-28.47 mm.前次手术采用单纯巩膜外加压8眼,环扎联合加压3眼,环扎联合加压、注气2眼.患眼于本次术中玻璃体腔内注入纯全氟丙烷(C3F8)气体0.5-1.0ml,术后严密观察,保持适当体位,确保气泡封闭裂孔.结果 手术后随访2-13月,12眼视网膜完全复位.1眼因PVR进展视网膜下液增多,视网膜未复位,后行玻璃体手术.手术后9眼视力提高,3眼视力不变,1眼视力下降.结论 巩膜扣带术后残留视网膜脱离可以通过充气性视网膜固定术获得视网膜解剖复位,视力改善.     

白内障超声乳化摘出及人工晶状体植入术在高度近视白内障患者中的应用

目的：观察高度近视患白内障超声乳化出及人工晶状体植入术的疗效。方法：本组高度近视白内障患（眼轴26．05－33．87mm)62例（65只眼），采用巩膜隧道切口及原位超声乳化（分而治之或拦甓裂法）吸出，囊袋内植入硬质人工晶状体。结果：术后3天矫正视力≥0．529只眼（44＝62％），0．2－0．431只眼（47．69％），≤0．15只眼（7．60％）。术后1个月矫正视力≥0．541只眼（63．08％），0．2－0．420只眼（30．77％），≤0．14只眼（6．15％），并发症为虹膜损伤（1．54％），后囊破裂（3．07％），及角膜水肿（30．76％），结论：白内障超声乳化联合后房人工晶状体植入术适合高度近视白内障，并能获得良好的手术效果。     

大鼠细菌性角膜炎角膜组织ICAM—1的表达

为探讨细胞间粘附分子－１（ＩＣＡＭ－１）在细菌性角膜炎发病机制中的作用，将ＳＤ大鼠２２只随机分为细菌性角膜炎组和对照组，研究ＩＣＡＭ－１在角膜组织的表达及分布。应用抗ＩＣＡＭ－１单克隆抗体及免疫组化染色技术角膜上皮细胞、基质层角膜细胞及内皮特异性染色。结果表明，对照组角膜上皮细胞染色程度为－＋，基持层角膜细胞染色为＋均呈低度表达。角膜炎组角膜上皮细胞、基质层角膜细胞及内皮细胞垃强型强烈表达ＩＣＡＭ     

Effects of penetrating cornea injury combined with seawater immersion on the levels of aqueous humor TNF-α in rabbits

Objective To observe effects of penetrating cornea injury combined with seawater immersion on the levels of aqueous humor TNF-α in rabbits. Methods 10 adult healthy grey rabbits were used for the experiment. The rabbit eye model of comea blast injury was developed by using a single firecracker. For each rabbit, the right eye was the experimental eye (seawater was injected into the anterior chamber through the cornea incision, simulating seawater immersion) and the left eye was the control (treated with 0.9% sodium chloride). Levels of aqueous humor TNF-α were detected by using double-antibody sandwich ELISA on the 1st, 2nd, yrd, 4th, 5th, and 7th days following seawater immersion or 0.9% sodium chloride injection. Results Following development of the model, levels of aqueous humor TNF-α in the experimental eye on the 1st, 2nd, 3rd days were 190.338, 156. 107,117.018 ng/L respectively, and significant differences could be seen when comparisous were made between the experimental and control eyes. The level of aqueous humor TNF-α on the 1st day was the highest and obviously reached the peak. Conclusions Level of aqueous humor TNF-α in the experimental eye with penetrating cornea injury combined with seawater immersion was significantly higher than that of the control eye, indicating that TNF-α was clearly involved in the pathological change and it played an important role in the process.     

以眼球突出为首诊的原发性肝细胞肝癌1例

眼眶转移癌大多数发生在已知原发肿瘤的患者，以眼部症状为首诊的病例很少见，我们在临床工作中遇到1例以眼球突出为首诊的眼眶转移性肝细胞肝癌，现报告如下。