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。     

后巩膜加固术治疗进行性近视的临床研究

目的：研究后巩膜加固术(PSRD)治疗进行性近视的疗效及机理。方法：对20例(36眼)进行性近视行改良的Snyder—Thompson式PSRO，手术前后观察裸眼视力、矫正视力、眼底、屈光度、眼轴、闪光视网膜电图(F—ERG)，振荡电位(Ops)。术后随访1年者36眼，5年以上13眼。结果：(1)术后90％以上的高度近视患者视力稳定，部分患者视力有不同程度的提高。(2)术后眼轴及屈光度稳定(P＞0．05)。(3)F—ERG的a波b波波幅术后较术前有提高(P＜0．05)，Ops振幅有非常显著性提高(P＜0．002)，且均随时间的延长，提高更加明显。结论：后巩膜加固术治疗进行性近视，的确起到稳定眼轴及屈光度，改善黄斑病变及视网膜血液循环，从而提高视功能的作用。     

后巩膜加固术的组织学观察

目的：为进一步了解巩膜加固术后的组织学改变。方法：选用白色家兔为实验对象，采用人体巩膜施行巩膜加固术，于术后不同时期分批处死动物，并对手术区巩膜进行组织学检查结果：术后1－2周，为炎症浸润期：术后1－2个月为肉芽肿及新生血管增殖期，植片与巩膜粘连；术后3－6月，纤维母细胞形成，植片与巩膜完全愈合，形成“新巩膜”。实验结果为后巩膜加固术提供了理论根据。     

负透镜诱导豚鼠离焦性近视眼巩膜胶原密度及形态学改变

目的探讨新生豚鼠负透镜诱导离焦性近视发生时巩膜胶原密度和形态的变化。方法30只新生有色豚鼠随机分成透镜诱导组（单眼-10.00D透镜诱导）和正常对照组（无处理组）,第28天测量屈光度,眼球冰冻切片行VanGieson胶原染色,以锯齿缘为界分别分析前后部巩膜胶原密度;并进行电镜扫描观察巩膜胶原纤维直径。结果新生豚鼠28d透镜诱导组诱导眼的平均球镜等值屈光度低于对侧眼（P〈0.01）;诱导眼后部巩膜胶原染色光密度值低于对侧眼（P〈0.01）;诱导眼和对侧眼屈光度差值与后部巩膜胶原染色光密度差值呈正相关（r=0.84,P〈0.01）;诱导眼后部巩膜胶原纤维直径小于对侧眼（P〈0.01）;诱导眼前部巩膜胶原密度和胶原直径与对侧眼相比,差异无统计学意义（P〉0.05）;新生豚鼠28d诱导组对侧眼各项指标与对照组相比,差异无统计学意义（P〉0.05）。结论新生豚鼠负透镜诱导离焦性近视时后部巩膜胶原密度减少,伴胶原直径的减小,影响胶原代谢的机制尚需进一步研究。     

异种巩膜作加压材料治疗视网膜脱离

采用异种（猪）巩膜作加压材料治疗35例（35只眼）视网膜脱离，术后近期全部视网膜复位。随访中有5例复发，其中4例第2次手术，再复位2例，治愈率91.4%.经3年以上随访，术后均无明显免疫排斥反应、加压物排出、暴露及感染发生。猪巩膜具有人巩膜相似的优良特性，可代替异体（人）巩膜应用于眼科临床。 （中华眼底病杂志，1994，10：207-209）     

巩膜上腔麻醉行白内障摘出人工晶状体植入术效果观察

目的 探讨巩膜上腔麻醉行白内障摘出人工晶状体植入术的安全性及有效性。方法 观察242例270眼巩膜上腔麻醉施行现代白内障囊外摘出人工晶状体植入术的麻醉效果和并发症。结果 所有患者都能很好配合手术，无一例改行球后或球周麻醉。巩膜上腔麻醉的并发症为球结膜水肿、球结膜下出血。无一例发生球后麻醉的并发症。结论 巩膜上腔麻醉对于白内障摘出人工晶状体植入术是一种安全、有效的麻醉方法。     

输尿管结石急性梗阻伴肾包膜下积液的声像表现及其临床意义

目的:探讨输尿管结石急性梗阻伴肾包膜下积液的声像表现及其临床意义.材料和方法:对30例声像图表现为输尿管结石急性梗阻伴肾包膜下积液的病例进行回顾性分析.结果:肾包膜下积液多发生于肾的上、下两极,上极4例,下极28例(其中包括上、下两极均发生积液的病例2例).积液以积液的最大切线宽度估测为2～30mm,呈带状、三角形或梭形,同时伴有肾轻度积水.结石梗阻部位多位于输尿管下段,结石的最长径<10mm.结论:输尿管结石急性梗阻伴肾包膜下积液有其特征性声像表现,超声检查可以及时明确诊断,有效的指导临床治疗.     

Experience with scleral covered orbital implants

The scleral covered implant provides excellent and lasting volume replacement and is retained well as a secondary implant. It should be avoided if the fornices are shallow and as a primary implant after recent ocular trauma.     

Peculiar Findings in a Case of Bilateral Uveal Pigmented Lesions

Purpose: To describe a probable case of bilateral diffuse uveal melanocytic proliferation (BDUMP) with unusual manifestations and prognosis.

Design: Case report.

Methods: Clinical follow-up of the patient lasting 50 months with recurrent fundus examination using color photographs, angiography, ultrasound, and optical coherence tomography. Serological and radiological investigations were performed to assess possible extraocular alterations.

Results: In both eyes patch-shaped pigmented alterations of the fundus were revealed. Fluorescein and indocyanine angiography evidenced corresponding areas of hyperfluorescent pinpoints and subtle serous detachment of the neurosensory retina, respectively. Ten months after the initial evaluation, flat pigmentary lesions appeared in the superior scleral surface of the right eye and underwent histological examination. After an initial decrease in visual acuity, the patient experienced a spontaneous recovery. He did not develop cataracts or any systemic malignancies.

Conclusions: Although not all the criteria for the diagnosis were fulfilled, clinical findings were compatible with BDUMP. The presence of scleral pigmented lesions and the good visual prognosis may widen the spectrum of this rare disease.     

Keratoglobus: An experience at a tertiary eye care center in India

Context:

This study was carried out as a part of an internal audit and is the largest series of patients having keratoglobus, published in the literature. Poor visual acuity of the patients indicates the blinding nature of the disease.

Aims:

We report our experience with patients having keratoglobus at a tertiary eye care center in India.

Settings and Design:

Retrospective study.

Materials and Methods:

We analyzed adults and pediatric patients (<16 years) with keratoglobus, seen during 2008–2012. The age, gender, consanguinity, presenting ocular signs, ocular and systemic associations, visual acuity, corneal topography, and surgeries were documented.

Results:

Forty-eight patients (mean age 22 ± 15 years, 31 males) having keratoglobus were analyzed. 21 patients (42 eyes) were <16 years. Twelve eyes (16 events) had positive history of trauma. The presenting clinical signs were corneal scars/scars of tear repair (15 eyes), hydrops, healed and acute (14 eyes) and corneal or globe rupture (9 eyes). Best-corrected visual acuity was >20/40 in 6/42 (14.3%) pediatric eyes and 15/53 (28.30%) adults. Visual acuity ranging from counting of fingers to no light perception was noted in 20/53 (37.74%) adults and 21/42 (50%) pediatric patients; 13/20 (65%) with blue sclera and 8/22 eyes (36.37%) without blue sclera. Vernal keratoconjunctivitis was present in one pediatric patient. Choroidal osteoma, retinitis pigmentosa, and retinal detachment were present in adults. Surgeries performed were corneal tear repair (5 eyes), tissue adhesive application (2 eyes), descematopexy (4 eyes) and penetrating keratoplasty (PK - 8 eyes: Three had post-PK glaucoma, graft failure-one eye, 4 patients wore scleral lens - prosthetic replacement of the ocular surface ecosystem).

Conclusions:

About 50% of pediatric eyes (65% having blue sclera) had no functional vision. Trivial trauma was responsible for corneal rupture indicating need for protective glasses. About 50% patients had post-PK glaucoma though grafts were clear.