New two-point scleral-fixation technique for foldable intraocular lenses with four hollow haptics

The study was to report a new two-point scleral-fixation technique for foldable intraocular lenses with four haptics. Lenses were slid into the anterior chamber from a 2.8 mm corneal incision and fixed under two sclera flaps at two opposite points. The postoperative best-corrected visual acuities (BCVAs) of all patients were significantly better than their preoperative BCVA. The results demonstrate that two-point, scleral fixations of foldable, intraocular lenses might be practicable and effective.     

Heat shock proteins in the retina: Focus on HSP70 and alpha crystallins in ganglion cell survival

Heat shock proteins (HSPs) belong to a superfamily of stress proteins that are critical constituents of a complex defense mechanism that enhances cell survival under adverse environmental conditions. Cell protective roles of HSPs are related to their chaperone functions, antiapoptotic and antinecrotic effects. HSPs' anti-apoptotic and cytoprotective characteristics, their ability to protect cells from a variety of stressful stimuli, and the possibility of their pharmacological induction in cells under pathological stress make these proteins an attractive therapeutic target for various neurodegenerative diseases; these include Alzheimer's, Parkinson's, Huntington's, prion disease, and others. This review discusses the possible roles of HSPs, particularly HSP70 and small HSPs (alpha A and alpha B crystallins) in enhancing the survival of retinal ganglion cells (RGCs) in optic neuropathies such as glaucoma, which is characterized by progressive loss of vision caused by degeneration of RGCs and their axons in the optic nerve. Studies in animal models of RGC degeneration induced by ocular hypertension, optic nerve crush and axotomy show that upregulation of HSP70 expression by hyperthermia, zinc, geranyl–geranyl acetone, 17-AAG (a HSP90 inhibitor), or through transfection of retinal cells with AAV2-HSP70 effectively supports the survival of injured RGCs. RGCs survival was also stimulated by overexpression of alpha A and alpha B crystallins. These findings provide support for translating the HSP70- and alpha crystallin-based cell survival strategy into therapy to protect and rescue injured RGCs from degeneration associated with glaucomatous and other optic neuropathies.     

雷珠单抗注射联合Ex-PRESS引流器对新生血管性青光眼的疗效

目的：研究雷珠单抗注射联合Ex－PRESS引流器治疗新生血管性青光眼的近期和远期疗效。方法：选取2012－01／2014－12我院眼科收治的51例62眼新生血管性青光眼患者为研究对象,在统一入组条件、统一测量方法的前提下,按目前实际诊疗状况并结合医生的判断进行分组,对照组23例28眼,观察组28例34眼。观察组患者接受雷珠单抗注射联合Ex－PRESS引流器植入术,对照组患者单纯给予Ex－PRESS引流器植入术。比较两组患者治疗前后视力水平及眼压,同时比较两组治疗有效率及不良反应发生率。结果：治疗前,两组患者眼压比较,差异无统计学意义（P＞0．05）。治疗后,两组患者眼压均显著降低,组内比较差异有统计学意义（P＜0．05）,且观察组治疗后1、4wk时眼压显著低于对照组,组间比较差异有统计学意义（P＜0．05）。治疗前,两组视力分布比较,差异无统计学意义（P＞0．05）。治疗后,对照组视力升高2例3眼,维持平稳18例22眼,下降3例3眼;观察组视力提高12例12眼,维持平稳15例21眼,下降1例1眼,两组视力分布比较差异有统计学意义（ P＜0．05）。观察组治疗有效率为85．3％,对照组为60．7％,观察组高于对照组,两组比较差异有统计学意义（ P＜0．05）。观察组前房出血4例4眼,角膜内皮功能失代偿2例2眼,术后并发症发生率为18％;对照组角膜水肿3例3眼,术后并发症发生率为11％,两组比较差异无统计学意义（ P＞0．05）。结论：对于新生血管性青光眼患者,采用雷珠单抗注射联合Ex－PRESS引流器植入术能够有效降低眼压、改善视功能或者延缓患者视功能衰退,具有疗效确切、安全性高等特点,值得临床上推广应用。     

眼外伤后继发性青光眼的常见临床分型及治疗对策

外伤性青光眼是继发性青光眼的一种,可导致视力严重下降。外伤性青光眼的临床表现及发病机制复杂,主要分为眼内积血型、房角挫伤型、晶状体相关型、粘连增殖型。每种类型的治疗方法不同,对具体病例采取针对性治疗措施对保护患者视力具有重要意义。     

有晶状体眼后房型人工晶状体植入术后人工晶状体位置异常原因的分析

目前近视发病率逐年上升。一直以来眼科医生通过准分子激光手术来矫正低、中度近视,然而此种手术对于角膜偏薄、圆锥角膜以及高度近视等部分患者的治疗存在局限性。1993年,瑞士STAAR公司生产了一种可植入式接触镜( ilplantable collaler lens, ICL),植入到后房睫状沟中,用来矫正屈光不正。经过设计的不断改进,ICL已经逐渐成为目前治疗中、高度近视的有效手术方式。虽然其安全性已被证实,但仍有文献报道, ICL植入术后人工晶状体的位置会发生偏位及旋转,导致视力下降,严重者产生继发性青光眼,前囊下白内障等并发症。我们针对ICL术后位置异常进行综述。     

原发性开角型青光眼与24h眼压及眼灌注压的研究进展

原发性开角型青光眼是一类早期无明显临床症状,但随病情进展将导致不可逆的视神经损害及视野缺损的致盲性眼病。眼压是原发性开角型青光眼诊断及评定治疗效果的简单而又重要的指标。临床上,一些治疗中的原发性开角型青光眼患者白天就诊时间所测眼压已达靶眼压,但视神经损害却仍在进展,研究表明可能与夜间眼压的升高、24 h较大的眼压波动及夜间眼灌注压的降低有关。因此,我们对原发性开角型青光眼与眼压及眼灌注压波动的相关文献予以综述,以更好的理解三者之间的关系。