小梁切开术治疗先天性青光眼的临床观察

目的：观察小梁切开术治疗先天性青光眼的疗效。     

小梁切除联合羊膜移植治疗原发性青光眼临床研究

目的：观察小梁切除联合新鲜羊膜移植治疗原发性青光眼疗效评价。方法：34例48眼原发性闭角型青光眼：18例26眼原发性开角型青光眼施行小梁切除联合结膜瓣下及巩膜瓣下新鲜羊膜移植术,术后随访8－21个月,平均15．7个月。结果：49例71眼术后眼压均控制在正常范围内,眼压控制成功率95．95％,术后所有病例视力均有不同程度提高,视野损害均未见加深。结论：新鲜羊膜可有效防止滤过泡的疤痕组织形成,保持滤过通畅,并能长期有地保留功能性滤过泡。     

半导体红外线激光经巩膜行睫状体光凝术治疗难治性青光眼临 …

目的：观察８１０ｎｍ半导体红外线激光经巩膜睫状体光凝术（ｔｒａｎｓｃｈｅｒａ ｃｉｌｉａｒｙ ｐｈｏｔｏｃｏａｇｎｌａｔｉｏｎ ＴＳＣＰＣ）治疗难治性青光眼的临床效果。方法：应用法国ＢＩＶ公司生产的８１０ｎｍ半导体红外线激光仪,经光纤将能量传输到激光头,在距角膜缘后１．２～１．５ｍｍ,紧贴眼球壁,使激光头与视轴平行,设置激光能量１．８～２．２Ｗ,时间２～３ｓ,发射激光后听到眼内“爆破声”作为治疗能     

三种波长的激光小梁成形术临床疗效比较

目的　对氩激光、倍频Nd：YAG激光、半导体激光小梁成形术的疗效作一前瞻性的评价和比较。方法　随机地将原发性开角型青光眼病人50例84眼分为三个激光组,分别用氩激光、倍频Nd：YAG激光、半导体激光进行小梁成形术,随访三组的有效率。结果　三组各随访期的眼压下降有统计学意义。三组之间的眼压下降数和成功率无差别。结论　三种波长激光都能有效地进行小梁成形术。     

MIR204 n.37C>T variant as a cause of chorioretinal dystrophy variably associated with iris coloboma,early-onset cataracts and congenital glaucoma

Four members of a three-generation Czech family with early-onset chorioretinal dystrophy were shown to be heterozygous carriers of the n.37C>T in MIR204. The identification of this previously reported pathogenic variant confirms the existence of a distinct clinical entity caused by a sequence change in MIR204. Chorioretinal dystrophy was variably associated with iris coloboma, congenital glaucoma, and premature cataracts extending the phenotypic range of the condition. In silico analysis of the n.37C>T variant revealed 713 novel targets. Additionally, four family members were shown to be affected by albinism resulting from biallelic pathogenic OCA2 variants. Haplotype analysis excluded relatedness with the original family reported to harbour the n.37C>T variant in MIR204. Identification of a second independent family confirms the existence of a distinct MIR204-associated clinical entity and suggests that the phenotype may also involve congenital glaucoma.     

滤过性手术中联合应用丝裂霉素C效果观察

目的：评价顽固性青光眼滤过性手术中联合应用丝裂霉素Ｃ（ＭＭＣ）的近期眼压和视功能结果。方法：５１例６１眼顽固性青光眼,全部采用小梁切除术,术中联合应用ＭＭＣ,ＭＭＣ浓度为０．２ｍｇ／ｍｌ￣０．４ｍｇ／ｍｌ局部接触时间２￣５分钟。     

国产房水引流物置入术治疗难治性青光眼远期疗效观察

１９９３年７月～１９９８年１月为１０３例（１０６只眼）难治性青光眼患者施行国产房水引流物（ＨＡＤ）置入术。术后平均随访３２８月。术后１年时平均眼压２２±１．４ｋＰａ。术后１～５年的手术成功率分别为８３８％,８０４％,７７１％,７１０％及６４３％。术中联合应用丝裂霉素Ｃ的病例,其术后１年时的成功率为８９５％。术后常见的并发症有持续性浅前房,局限性脉络膜脱离及眼压升高等。认为ＨＡＤ可用于治疗难治性青光眼。     

Changes in optic nerve head blood flow and retrobular hemodynamics following calcium-channel blocker treatment of normal-tension glaucoma

Background: Because calcium channel blockers reduce vascularresistance, they may have a clinical application in the treatment ofnormal-tension glaucoma (NTG). This study investigates changes inboth the optic disc blood flow and the hemodynamics of retrobulbarvessels in NTG patients after the systemic administration of a calcium channel blocker. Methods: Twelve eyes of 12 NTG patients (meanage 57 6 ± 15.3 years) were examined before and after a 4-weektreatment with 2 mg b.i.d. oral nilvadipine, an L-typc calcium channel blocker. By scanning laser-Doppler flowmetry (SLDF), we obtained the velocity, flow, and volume from within a 10 × 10 pixel windowplaced on the temporal rim region of the optic disc perfusion map. Byultrasound color Doppler imaging (CDI), we measured the peak systolicvelocity (PSV) and the end diastolic velocity (EDV) of the ophthalmicartery (OA), central retinal artery (CRA), nasal posterior ciliary artery (NPCA), and temporal posterior ciliary artery (TPCA). We then calculated a resistance index (RI) for each vessel. Results: After treatment, the flow and velocity of the optic disc blood flow significantly increased (P < 0.05).Nilvadipine also significantly reduced RIs of the CRA, NPCA, and TPCA(P <0 .05), and increased both the PSV of the NPCA and the EDVs of the CRA, NPCA, and TPCA. The percent change in velocity correlated significantly with the percent changes of the CRA RI and NPCA RI. Conclusions: Oral nilvadipine appears to reduce orbital vascular resistance, which consequentlyincreases the optic disc blood flow. Abbreviations.BP – blood pressure;CRA – central retinal artery;CDI – ultrasound color Doppler imaging;EDV – end diastolic velocity;NPCA – short posterior ciliary arteries located nasal to optic nerve;NTG – normal-tension glaucoma;OA – ophthalmic artery;PP – perfusion pressure;PSV – peak systolic velocity;RI – resistance index;SLDF scanning laser-Doppler flowmetry;TPCA – short posterior ciliary arteries locatedtemporal to optic nerve.     

Filtration procedures supplemented with mitomycin C in the management of childhood glaucoma

AIMS: To evaluate the outcome of filtering procedures supplemented with mitomycin C in children with glaucoma. METHODS: All patients aged 17 or younger with glaucoma who underwent filtering surgery supplemented with mitomycin C at a tertiary care centre (n = 21) during a 5 year interval (1992 and 1996) were included. One eye for each patient was entered into the analysis. The postoperative intraocular pressure (IOP), use of antiglaucoma medications, clinical stability of glaucoma, complications, and visual acuity were retrospectively evaluated. Kaplan-Meier survival curves were used to estimate the probability of success. RESULTS: At the time of surgery mean age was 5.7 (SD 5.0) years. The most common diagnoses were trabeculodysgenesis (n = 6) and aphakic glaucoma (n = 8). Mean IOP before surgery was 35.7 (10.5) mm Hg. Average length of follow up was 18.6 (14.7) months. The probability of having IOP less than 21 mm Hg with no antiglaucoma medications and with clinically stable glaucoma 1 year after surgery was 76.9% in phakic eyes (n = 13) and 0% in aphakic eyes (n = 8). A phakic patient with Sturge-Weber's syndrome had choroidal effusion after surgery that resolved spontaneously. In the aphakic group one patient had retinal detachment and another developed an encapsulated bleb. Visual acuity deteriorated in one patient. CONCLUSION: A guarded filtration procedure with mitomycin C is relatively successful in phakic children with glaucoma, but unsuccessful in aphakic ones.     

硅油继发青光眼的发病相关因素及治疗的初步探讨

探讨硅油继发青光眼的发病相关因素及治疗。方法对行玻璃体切割,硅油注入术的２７５例患者术后随访结果进行回顾性研究。结果硅油继发青光眼的发病率为１１．３％,随着硅油在眼内存留时间的延长,其发病率增高。