脐带在高度近视眼后巩膜加固术中的应用

目的 观察用胎儿脐带行后巩膜加固术的短期疗效,探讨其安全性及应用价值。方法 将用酒精脱水固定处理后的胎儿脐带复水后,对121例(187眼)行后巩膜加固术,观察其术后视力及并发症。结果 术后3d视力提高(P<.01);术后1周以后视力与术前无差异(P>0.05),术后排斥反应小,并发症少。结论 胎儿脐带作为后巩膜加固术的加固材料是比较安全的,而且较易获得,其远期效果还待进一步观察。     

Melatonin receptor expression in the cornea and sclera

The scornea and sclera have been shown to exhibit circadian rhythms in cellular proliferation, wound healing and extracellular matrix synthesis. The distribution of melatonin Mel1a and Mel1c receptors was examined in the cornea and sclera of the Xenopus laevis eye in order to determine whether melatonin may potentially influence the growth and/or development of these ocular tissues. Sections of adult X. laevis eyes were analyzed by immunocytochemistry and confocal microscopy, using antibodies prepared against specific peptide sequences of the Xenopus Mel1a and Mel1c receptor proteins. Antibodies were pre- incubated with their appropriate antigenic peptides to control for non-specific labelling. Analysis of the distribution of Mel1a and Mel1c receptor immunoreactivity in the Xenopus eye revealed that both the Mel1a and Mel1c receptors were located in the outer fibrous layer (OFL) of the sclera, with Mel1c labelling being the most prominent. Similarly, Mel1a and Mel1c (Mel1c mostly) were also located in cells of the inner fibrous layer (IFL) with Mel1c being most abundant. The chondrocytes of the cartilaginous layer also appeared to express Mel1a, Mel1c, or both receptors. Both Mel1a and Mel1c receptor immunoreactivity were observed in the corneal epithelium and endothelium. Whereas the Mel1a antibody labelled the entire corneal epithelial layer, the Mel1c antibody labelled only the most superficial layer of epithelial cells. Cell processes of fibroblasts of the corneal stroma were immunoreactive for either Mel1a or Mel1c receptors. The identification of Mel1a and Mel1c receptors in restricted distributions in the cornea and sclera suggests that melatonin may play a role in the cellular physiology of these ocular tissues.     

角巩膜栗刺异物伤诊治分析

目的探讨角巩膜栗刺异物伤的临床特点,治疗方法及其临床效果。方法对71眼角巩膜栗刺异物伤采取剔出或巩膜切开摘出异物。结果巩膜异物1次摘出32眼,2次摘出16眼,3次摘出9眼,11眼经4次摘出,3眼经5次全部摘出。无眼内炎及视力改变。结论栗刺所致巩膜异物多而隐匿,采取恰当方法彻底清除异物是治疗成功的关键。     

带和不带巩膜壳羟基磷灰石义眼台植入临床观察

目的比较不带巩膜壳和带巩膜壳羟基磷灰石义眼台植入术的疗效。方法30例不带巩膜壳羟基磷灰石义眼台植入者、30例带自体巩膜壳义眼台植入者、10例改良带自体巩膜壳义跟台植入者,术后随访1～10 a,对其疗效进行比较,以评价手术效果。结果30例带自体巩膜壳义眼台植入者,术后有5例发生肉芽肿形成,其中4例行义眼台取出术,1例经保守治疗痊愈。30例不带巩膜壳义眼台植入者有1例出现义眼台暴露。10例改良带自体巩膜壳义眼台植入者,无一例出现并发症。结论肉芽肿形成是带自体巩膜壳义眼台植入术后常见并发症,包裹的巩膜壳会影响义眼台血管纤维化,并发生融解和异物反应。改良带自体巩膜壳义眼台植入术可避免这一并发症,又可获得较好的美容效果。     

两种不同羟基磷灰石义眼台植入术的临床观察

目的：比较眼球摘除+义眼台植入+异体巩膜移植术与眼内容物摘除+义眼台巩膜壳内植入术两种手术方式,探讨异体巩膜作为羟基磷灰石义眼台覆盖材料的优点。

方法：临床观察60例60眼,眼球摘除+HA植入覆盖同种异体巩膜者为异体巩膜组30眼,眼内容物摘除+HA自体巩膜壳内植入为自体巩膜组30眼。两组在术后1,3d; 1wk; 1,6mo进行随诊,观察结膜伤口愈合情况以及有无HA眼台的暴露。

结果：异体巩膜组中有6眼结膜伤口裂开,1眼HA眼台暴露。自体巩膜组中有7眼结膜伤口裂开,5眼HA眼台暴露,2例义眼台暴露后取出。

结论：眼球摘除+义眼台植入+异体巩膜移植术用于临床有较多优越性,术后并发症少。     

针刺对形觉剥夺性近视豚鼠巩膜形态及组织中HIF-1α、SOD、MDA水平的影响

目的 探究针刺对形觉剥夺性近视(FDM)豚鼠巩膜组织形态特点及巩膜组织中缺氧诱导因子1α(HIF-1α)、超氧化物歧化酶(SOD)、丙二醛(MDA)水平的影响。方法 选取普通级3周龄健康三色豚鼠72只,随机分为空白组、模型组和针刺组(各24只)。用半透明气球作为眼罩分别固定于模型组和针刺组豚鼠右眼及头面部建立FDM模型,左眼充分暴露作自身对照;针刺组在豚鼠模型建立当天起,于每日相同时间对豚鼠进行针刺和电针干预治疗,空白组豚鼠不做任何干预。记录每组豚鼠造模前、造模后2周及4周的眼轴长度和屈光度。造模后4周处死豚鼠,光学显微镜下观察巩膜形态变化,Western blot检测各组豚鼠巩膜中HIF-1α蛋白表达,比色法测定各组豚鼠巩膜中SOD活力和MDA含量。结果 造模后2周和4周,与空白组比较,模型组及针刺组豚鼠遮盖眼近视屈光度及眼轴长度均明显增加(均为P<0.05);与模型组比较,针刺组豚鼠遮盖眼近视屈光度减小,眼轴增长明显减缓(均为P<0.05)。造模后4周,与空白组比较,模型组豚鼠巩膜厚度明显变薄,胶原纤维分布稀疏,有明显纤维空隙且排列不规则;与模型组相比,针刺组豚鼠巩膜层...     

鸡眼形觉剥夺性近视的实验研究

目的建立鸡形觉剥夺近视模型,观察形觉剥夺眼屈光、巩膜形态学改变。方法将孵出后一天的家鸡25只,以右眼为形觉剥夺眼,左眼为开放对照眼,2周后进行检影验光,并摘出眼球,测量眼轴长和赤道径。观察巩膜软骨层中细胞密度、增殖细胞率,并测量角巩膜的干湿重。结果剥夺眼的屈光度平均为-11.9±4.6D,对照眼平均为+3.0±1.2D,两者差异有显著性意义,轴长较对照眼明显延长（P<0.01）,剥夺眼的巩膜干湿重均明显重于对照眼（P<0.01）,并且巩膜软骨中增殖细胞率明显高于对照眼（P<0.05）,但细胞密度则低于对照眼（P<0.05）。结论鸡眼形觉剥夺可产生一定程度的近视和眼轴延长,并伴随着巩膜的病理形态改变。     

虾青素胶囊治疗膝关节骨性关节炎疗效观察

目的观察虾青素胶囊治疗膝关节骨性关节炎的疗效。方法将60例膝关节骨性关节炎患者随机分为治疗组(30例)和对照组(30例)。治疗组给予虾青素胶囊治疗,对照组给予芬必得治疗。比较两组治疗前后膝关节功能评分,观察主要症状缓解情况和治疗效果。结果 (1)治疗组的疼痛缓解持续时间较对照组缩短,而疼痛缓解时间较对照组延长(P均0.01);(2)两组治疗后关节功能较治疗前均有提高(P均0.01),而治疗组比对照组更优(P0.05);(3)总有效率治疗组为66.67%,对照组为83.33%,两组疗效比较差异无统计学意义(P0.05)。结论虾青素胶囊治疗骨性关节炎有一定的疗效。     

Dimensions of the human sclera: Thickness measurement and regional changes with axial length

Scleral thickness, especially near the region of the optic nerve head (ONH), is a potential factor of interest in the development of glaucomatous optic neuropathy. Our goal was to characterize the scleral thickness distribution and other geometric features of human eyes. Eleven enucleated human globes (7 normal and 4 ostensibly glaucomatous) were imaged using high-field microMRI, providing 80 μm isotropic resolution over the whole eye. The MRI scans were segmented to produce 3-D corneoscleral shells. Each shell was divided into 15 slices along the anterior-posterior axis of the eye, and each slice was further subdivided into the anatomical quadrants. Average thickness was measured in each region, producing 60 thickness measurements per eye. Hierarchical clustering was used to identify trends in the thickness distribution, and scleral geometric features were correlated with globe axial length. Thickness over the whole sclera was 670 ± 80 μm (mean ± SD; range: 564 μm-832 μm) over the 11 eyes. Maximum thickness occurred at the posterior pole of the eye, with mean thickness of 996 ± 181 μm. Thickness decreased to a minimum at the equator, where a mean thickness of 491 ± 91 μm was measured. Eyes with a reported history of glaucoma were found to have longer axial length, smaller ONH canal dimensions and thinner posterior sclera. Several geometrical parameters of the eye, including posterior scleral thickness, axial length, and ONH canal diameter, appear linked. Significant intra-individual and inter-individual variation in scleral thickness was evident. This may be indicative of inter-individual differences in ocular biomechanics.     

异体巩膜矫正甲状腺相关眼病上睑退缩并内翻

目的 评估异体巩膜移植延长上睑提肌矫正甲状腺相关眼病上睑退缩并内翻的疗效.方法 对17例（21眼）上睑退缩并内翻的静止期甲状腺相关眼病患者行异体巩膜移植延长上睑提肌矫正上睑退缩并内翻,观察其临床效果.结果 术后所有患者睑裂宽度均较术前缩小,差异有统计学意义（t=2.94,P=0.028）,患者自觉症状不同程度减轻或消失,随访6个月和1年无上睑退缩或内翻复发.结论 异体巩膜移植延长上睑提肌能有效矫正甲状腺相关眼病上睑退缩并内翻.