儿童白内障术后远期结果的研究进展

本文对近几年一些学者对儿童白内障远期随访结果进行了综述和评价。手术时机选择、儿童特殊的屈光变化以及如何精确测定儿童植入人工晶状体性能及屈光度都对儿童白内障术后远期视功能产生影响。慢性青光眼是儿童白内障术后远期丧失视力的主要原因。长期弱视治疗是获得手术成功的保证之一。因此，要真正获得有用的视功能，应重视儿童白内障手术后的后续治疗，并提议应建立完善的白内障术后追踪随访和弱视治疗机构。     

虹膜夹型有晶状体眼人工晶状体植入术对高度近视眼对比敏感度的影响

目的 研究虹膜夹型有晶状体眼人工晶状体（iris-claw phakic intraocular lens，ICPIOL）植人术后对比敏感度（contrastsensitivity，CS）的变化。方法 2005年5月至12月于温州医学院附属眼视光医院和中山大学中山眼科中心接受ICPIOL（Verisyse，美国AMO公司）植入术的高度近视眼患者12例（23只眼），分别在术前、术后1、3、6个月采用CS测试灯箱（CSV-1000型，美国Vector Vision公司）检查暗视状态下无／有眩光时的对比敏感度函数（contrast sensitivity function，CSF）。结果 术后1、3、6个月等效球镜度数分别为（-0．60±0．77）D，（-0．48±0．77）D，（-0．34±0．53）D，与术前（-15．53D±3．65D）差异均有显著统计学意义（P均〈0．001），最佳矫正视力（IogMAR）分别为0．064-0．12，0．02±0．09，-0．003±0．08，与术前（0．21±0．12）差异均有显著统计学意义（P均〈0．001）。术后各空间频率的CS与术前比较有增高趋势。术后3个月6、12、18周／度的CS在无眩光时和有眩光时均明显提高（P均〈0．01），开始接近正常范围。术后3、6个月在各空间频率上CS差异均无统计学意义（P均〉0．05）。结论 ICPIOL植入术矫治高度近视眼可以使CSF恢复到接近正常范围，显著改善视功能，是一种适用于高度乃至超高度近视眼的可供选择的屈光手术。     

Specular microscopy of hard contact lens wearers

Wide-field specular microscopy, slit-lamp examination, and pachometry were performed on 22 successful hard contact lens wearers and 22 controls matched for age, race, sex, and refractive error. A minimum of 600 cells per control and 1200 per contact lens wearer were manually digitized from the specular photomicrographs. Frequency distributions of cell areas were compared between the two groups using the parameters of mean, median, standard deviation, coefficient of variation, skewness and kurtosis. Slit-lamp examination was normal and there was no significant difference in corneal thickness between the patient group and the control group. Comparison of mean, median, and standard deviation also revealed no significant difference, but skewness (P less than .001), kurtosis (P less than .001) and coefficient of variation (P less than .004) were greater in the hard contact lens wear group. Hard contact lens wearing time correlated with increasing pleomorphism (P less than .05). Specular microscopy also revealed morphologic changes including deep stromal striae, intra- and extracellular "blackout" areas, and clustering of extremely small and large cells. The possible relationship between endothelial hypoxia and structural stromal changes are discussed.     

Expression of P53 during lens epithelial cell apoptosis induced by ultraviolet

Cataract is a disease induced by multi- factorsand its pathologic mechanism isstill unknown.Ithasbeen accepted that ultraviolet irradiation ( UVR) isone of the most important pathogenesis.Li etal hasreported that UVR could induce the apoptosis of lensepithelial cells( LECs) and resulted in lens opacities.In order to study the pathologic mechanism of UVR-induced cataract at molecular and cellular levels,weinvestigated the apoptosisof LECs and the expressionof P5 3.1　 MATERIALSAND M…     

Congenital lens coloboma and associated pathologies

Coloboma of the lens is characterized by notching of the equator of the lens. The cause of the condition is faulty development of the zonule. The lens deprived of its normal pull in the defective region is thicker and more spherical as if there were no loss of its substance. We report five cases of lens coloboma and localized zonular defect without any associated systemic anomalies. One case included retinal detachment; another included an iris coloboma; and a third included iris, choroid and optic disk colobomas and retinal detachment with lens coloboma. The remaining two cases were without associated ocular anomalies. The pathogenic mechanisms and relationship of this defect with the differentiation of the tertiary vitreous and development of the zonule is discussed. The defect most likely occurs in the third to fourth months of gestation during differentiation of the tertiary vitreous in response to toxic, inflammatory or genetic factors.     

外伤性白内障人工晶状体植入术临床观察

目的 评价外伤性白内障人工晶体植入的疗效及问题。方法 对56例外伤性白内障人工晶体植入术后进行回顾性研究。结果 术后矫正视力≥0.5者48眼,占85.7%;0.1-0.4者6眼,占10.7%;0.1以下者2眼,占3.6%。结论 利用显微手术方法,使用粘弹剂,控制眼内炎症,选择好手术时机,可使手术效果满意。     

Experimental observation of living cells on the surface of intraocular lenses

目的 :对比观察后房型人工晶状体植入术后晶状体表面细胞染色前后的数量、形态。方法 :2 0只兔行后房型人工晶状体植入术。分别于术后 1 ,3,7,1 4和 2 8d分组取出人工晶状体放入1 640细胞培养液于倒置显微镜下观察。结果 :术后 1～ 2 8d人工晶状体表面有细胞粘附 ,染色后细胞形态失去立体外观 ,体积小 ,细胞数量较染色前明显减少。结论 :人工晶状体表面细胞在染色过程中有部分脱落。脱落的细胞数量可以计数比较 ,但细胞类型无法确定。因此需寻找更精确可靠的仪器及方法 ,以免造成实验误差。     

外伤性白内障术前B超检查的临床意义

目的 探讨外伤性白内障术前采用Ｂ超检查后囊破损情况的临床意义。方法 外伤性白内障３０只眼,术前采用Ｂ超检查评估后囊情况,显微镜下白内障摘除术中直接观察后囊情况并记录。结果 １４只眼术前Ｂ超检查后囊完整,手术证实１２只眼后囊完整,２只眼后囊小破坏。１６只眼术前Ｂ超检查后囊破损,手术证实１４只眼后囊存在大小不等的破损,２只眼后囊完整。结论 外伤性白内障术前Ｂ超检查为非侵入性、无痛性检查方法,操作简便,