新鲜与干燥胎儿角巩膜板层移植术远期疗效的比较

４５例（４６眼）采用新鲜与干燥的胎儿角膜、巩膜作板层移植术，其中新鲜组１９例（２０眼），存活１９眼，脱落１眼；干燥组２６例（２６眼），存活２６眼，总有效率９８％。术后２～３年随访比较，两者均具有良好的透明性，视力有不同程度提高，在相同病种其免疫排斥反应程度无显著差异，在治疗效果上具有同等价值。     

87例巩膜加压环扎术治疗孔源性视网膜脱离

本文报告了８７例（８７眼）巩膜加压环扎术治疗孔源性视网膜脱离，经３～６个月随访，其中治愈率为８２．８％，并对环扎的作用、适应症、并发症及术中应注意的问题等进行了简要的讨论。     

后巩膜加固术后巩膜生物力学性能的研究

研究后巩膜加固术后巩膜生物力学性能的变化,为该手术在临床的推广使用提供参考。在Instron5544材料性能试验机上,采用单向拉伸及球面致压两种方法对术后不同区域获取的兔眼巩膜进行预拉伸、松弛及蠕变实验。结果显示,加固条带区巩膜试件与其它各组试件相比,在线性阶段单位宽度上的刚度系数显著增大,在松弛阶段抗变形能力偏高,在蠕变阶段蠕变率明显偏低。说明后巩膜加固术能起到加强后巩膜薄弱部分抵抗变形的能力,同时降低巩膜蠕变率,从而控制进行性近视的发展。     

The presence and distribution of elastin in the posterior and retrobulbar regions of the mouse eye

The Presence and distribution of elastin in the posterior and retrobulbar regions of the mouse eye was investigated. Mice of two strains (C57/BL6 and DBA/2J) were studied at 2 months and 8-12 months of age. Light, confocal, and transmission electron microscopy were used to identify elastin, using immunohistochemical techniques and ultrastructural evaluation. Elastin was found in the following ocular structures: conjunctiva, muscle tendons, sclera, choroid, and meninges. The elastin in the sclera was most dense in a ring surrounding the peripapillary optic nerve head, with its presence in the inner sclera declining with greater distance from the nerve head. Elastin fibers were oriented in the sclera along what would be expected to be the principal stress directions generated from the intraocular pressure, though actual biomechanical measurements have not yet been made in the mouse sclera. Elastin comprises a portion of the mouse sclera and its distribution in the peripapillary area is similar to that in human eyes.     

改良后巩膜切除术治疗恶性青光眼38只眼观察

目的 观察改良的后巩膜切除术对恶性青光眼治疗的临床效果.方法 对2006年5月至2010年6月在邢台眼科医院收治的恶性青光眼并行改良后巩膜切除术患者34例38只眼.观察手术前后视力、眼压、前房深度及并发症情况,并进行统计学处理.术后随访6～24个月.结果 手术前后0.02以上视力比较,差异有统计学意义(P＜0.05),手术后0.02以上视力者增加13例.治疗前眼压(34.15±8.5) mm Hg降低为治疗后平均眼压(17.8±4.7) mm Hg,经统计学处理术前、术后眼压差异具有统计学意义(t=P＜0.01)前房深度由术前(0.956±0.37) mm加深为(1.83±0.41) mm,经统计学处理术前、术后前房深度差异具有统计学意义,(t =P ＜0.05).结论 改良的后巩膜切除术能够有效地加深前房,破坏玻璃体腔水囊,并有外引流作用,可以有效的降低眼压,提高患者的视功能,并具有手术安全性高、并发症少、易普及等优点,是治疗恶性青光眼患者的一种安全有效的手术方法.     

Rituximab Induction and Maintenance Treatment in Patients with Scleritis and Granulomatosis with Polyangiitis (Wegener’s)

Aims: To evaluate the efficacy and safety of rituximab (RTX) induction and maintenance treatment for patients with scleritis and granulomatosis with polyangiitis (GPA), Wegener’s.

Methods: Nine patients (12 eyes) with scleritis with GPA who did not respond to corticosteroids and more than one immunosuppressive agent who received ongoing maintenance RTX treatment were identified. Demographics and outcome measures were recorded.

Results: Median follow-up time of 30 months (range, 15 to 87 months). All 12 eyes achieved remission during the RTX maintenance period with a median time in remission of 14 months (range, 5–76 months), and median interval between RTX initiation and inactive disease of 5 months (range, 2–8 months). Two eyes in two patients relapsed. One received steroid eye drops, and the other received a short-term increased dose of intravenous corticosteroids.

Conclusions: RTX was effective as an induction and maintenance treatment in our small cohort of patients with GPA-associated scleritis.     

眼内容摘除羟基磷灰石义眼座植入术96例疗效观察

目的 探讨Ⅰ期或Ⅱ期眼内容摘除羟基磷灰石义跟座植入术的手术效果.方法 对96例(96眼)Ⅰ期或Ⅱ期行眼内容摘除、经眼球内视神经断离、自体巩膜成形、羟基磷灰石义眼座植入术,跟踪观察10-24月.结果 术后眼睑轻度肿胀,球结膜水肿,眼眶区胀痛,仅2例球结膜切口裂开,经保守治疗愈合.无义眼座暴露、脱出及感染,交感性眼炎等并发症.结论 此术式符合眼球及眼肌生理解剖,手术方便易行,并发症少,术后义眼座球体稳定,眼眶饱满,活动度好,外观逼真.     

单眼形觉剥夺对豚鼠后极部巩膜整合素β1表达的影响

目的探讨豚鼠形觉剥夺性近视模型中巩膜整合素β1的表达及其与形觉剥夺的关系。方法40只出生后1周花色豚鼠,右眼遮盖作为形觉剥夺组,左眼不作处理作为对照组。遮盖2、4、8周和遮盖8周去遮盖1周后测量屈光度,眼科A超测定眼轴长度;对两组4个时间点眼球后壁行SP法免疫组织化学染色和RT-PCR检测巩膜整合素β1蛋白和mRNA水平的动态变化。结果与对照组相比,形觉剥夺组4个时间点眼球后壁巩膜整合素β1表达明显减少,差异有统计学意义（P〈0.05）,去遮盖1周后,表达上调,但仍低于对照组（P〈0.05）;而对照组间相比较,差异无统计学意义（P〉0.05）;形觉剥夺组和对照组屈光度、眼轴长度比较,差异有显著的统计学意义（P〈0.05）。结论豚鼠形觉剥夺时,后极部巩膜整合素β1表达减少,去遮盖后表达上调,提示整合素β1可能参与了形觉剥夺性近视的发生,其影响巩膜重塑的机制有待进一步研究。