Lisch nodules of the iris in neurofibromatosis type 1

Neurofibromatosis type 1 (NF1) is a common autosomal dominant disease. The Lisch nodule represents one of the most common NF1 ocular manifestations. Several studies have reported that the Lisch nodule is a melanocytic hamartoma but its pathogenesis is still debated. We have studied the histopathological and ultrastructural features of a Lisch nodule of a 50-year-old woman biopsied during an intracapsular cataract extraction. Our researches revealed that it was composed of three main cytotypes: pigmented cells, fibroblast-like cells and mast cells, showing a pattern similar to a neurofibroma. Furthermore, we hypothesize that Lisch nodules are compatible with neurofibromas.     

Fuchs' heterochromic cyclitis: an immunological disease or an immunological response?

Over a 10 year period, a large number of immunological investigations were performed on the peripheral blood, iris and aqueous humour of patients with Fuchs' heterochromic cyclitis (FHC). Many immunological aberrations were detected, but it was felt these may indicate a response to a variety of initiating or unrelated factors rather than reflecting a disease of true immunological origin.     

兔虹膜和视网膜色素上皮细胞的体外培养比较

目的 观察比较有色素兔虹膜色素上皮(IPE)及视网膜色素上皮(RPE)细胞的体外生长状况。方法 采用酶消化法及酶辅助机械分离法分别分离IPE和RPE细胞。观察培养的两种细胞的生长状况，并对其进行免疫组化鉴定。结果 原代IPE及RPE细胞大多呈圆形或六边形，细胞内充满了黑色素颗粒。随着传代的增加，呈梭形或纤维细胞样生长的细胞增多，细胞中的色素颗粒也逐渐减少。细胞角蛋白免疫组化染色显示IPE及RPE细胞绝大多数呈棕黄色阳性反应。Desmin兔疫组化染色显示IPE细胞中阳性细胞约占5％。结论 分离培养的IPE和RPE细胞纯度很高。IPE细胞中绝大多数为后层IPE细胞。IPE和RPE细胞的形态及体外生长特点类似。     

外翻肠囊法研究丹参水提物在大鼠肠内的吸收

研究丹参水提物在大鼠肠内的吸收特征,采用大鼠肠外翻模型,选择丹参水提物中具有代表性的原儿茶醛(protocatechuic aldehyde,PAL)、迷迭香酸(rosmarinic acid,RA)和丹酚酸B(salvianolic acid B,SAB)3种成分为考察对象,建立其超高效液相(UPLC)测定方法并测量其累积吸收量,阐明各成分在不同肠段的吸收特征。实验结果显示,RA,SAB在回肠内为被动吸收,符合一级速度过程;RA,SAB在空肠内低、中剂量时为零级速度过程,高剂量时为一级速度过程,是一种主、被动同时存在的吸收方式;PAL在空肠、回肠内均为被动吸收。小肠不同部位的吸收实验表明,空肠可能为RA和SAB的主要吸收部位,回肠可能为PAL的主要吸收部位。丹参水提物中PAL,RA,SAB 3种成分在小肠均有吸收,但各成分的吸收速率及其机制不尽相同,提示小肠对丹参水提物各成分的吸收具有选择性,并不是简单地半透膜渗透过程。     

Phakic anterior chamber lenses in very high myopia: an 18-month follow up

Background: To evaluate the efficacy and tolerance of two different foldable anterior chamber phakic intraocular lenses for high myopia. Design: A prospective interventional case series at the Eye Clinic, Kartal Training and Research Hospital, Istanbul, Turkey. Participants: Sixty‐two eyes of 31 patients received iris‐claw lens (group 1) (Artiflex AC 401, Ophtec), and 43 eyes of 22 patients received angle‐supported lens (group 2) (I‐Care, Corneal). Methods: The mean preoperative spherical equivalents for group 1 and group 2 were ?12.13 D and ?18.95 D, respectively. Endothelial cell density was measured at day 1 and at 1, 3, 6, 12 and 18 months for follow ups. Main Outcome Measures: Percentage change in endothelial cell density and improvement in visual acuity. Results: At the 18‐months follow up, uncorrected visual acuity improved to logMAR 0.37 ± 0.23 from 1.60 ± 0.10 in group 1, and logMAR 0.47 ± 0.14 from 0.70 ± 0.20 in group 2; best spectacle corrected visual acuity improved to logMAR 0.23 ± 0.22 from logMAR 0.36 ± 0.14) in group 1, and logMAR 0.29 ± 0.18 from logMAR 0.50 ± 0.20) in group 2 (P < 0.001, in both groups). Mean decreased endothelial cell density was 241 cells/mm² (8.61%) and 223 cells/mm² (8.42%) at 18 months follow up in group 1 and 2, respectively (P = 0.17) but significant in comparison to preoperative values for both groups (P < 0.001). Conclusions: Although both iris‐claw and angle‐supported lenses offer good refractive outcomes significant endothelial cell density was observed at 18 months follow up.     

结膜瓣遮盖联合虹膜嵌顿术治疗全层感染真菌性角膜炎

目的：观察结膜瓣遮盖联合虹膜嵌顿术治疗全层感染真菌性角膜炎的疗效。 方法：分析2005-03/2011-04在邢台眼科医院行结膜瓣遮盖+虹膜嵌顿术的深部真菌性角膜炎患者26例26眼,全部的病灶的范围均<(5×5)mm²,角膜刮片检查真菌菌丝全部为阳性;前房积脓（+）,病灶均较致密,术前不能确定病灶累及深度;在术中,当病灶剖切至接近后弹力层深度时,根据临床特点,对于病灶累及角膜全层,但直径≤1mm的患者,人为在残余病灶的近周边处刺透角膜,造成角膜穿孔,自角膜穿孔或破溃处注吸前房积脓和抛光内皮斑后,将相邻近的虹膜嵌顿在角膜穿孔处,并用缝线固定1～2针,最后行结膜瓣遮盖术,尽量保持水密,术后继续给予抗真菌治疗并密切观察。 结果：患者26例中有5例在病灶剖切中自行破溃,3例在病灶剖切中不慎切透,18例角膜基质床在剖切过程中完整;结膜上皮恢复时间为13.44±2.21d;24例感染得到控制,成功率为92%;2例因感染未控制而改为角膜移植术,最终控制感染。 结论：结膜瓣遮盖联合虹膜嵌顿术是治疗小范围的全层真菌性角膜炎的有效方法,它可以控制感染,为以后的增视手术创造条件,适合在基层医院开展。     

实时虹膜识别联合波前引导LASIK治疗中高度近视性散光

目的:评价实时虹膜识别技术应用在波前引导准分子激光原位角膜磨镶术（laser in situkeratomileusis, LASIK）治疗中高度近视性散光中的准确性、稳定性。方法:采用随机对照研究,接受实时虹膜识别联合波前引导LASIK手术的近视性散光患者57例104眼作为试验组,接受常规波前引导LASIK手术的近视性散光患者58例107眼作为对照组,对两组患者术后1,3,6mo的裸眼视力、最佳矫正视力、散光度、散光轴向、波前像差等进行比较。结果:静态虹膜识别检测出眼球旋转偏移角度为2.61°±2.08°,动态虹膜识别检测眼球旋转变化范围为0°～5°。术后6mo时,试验组裸眼视力≥术前最佳矫正视力的患者（96眼,92.3%）多于对照组（78眼,72.9%）,差异有统计学意义(P＜0.01);试验组的平均散光（-0.28±0.26D）低于对照组(-0.44±0.35D),差异有统计学意义(P＜0.05)。术后6mo,试验组无散光眼（49眼,47.1%）多于对照组（31眼,29.0%）, 差异有统计学意义(P＜0.01)。当瞳孔直径为6mm时,试验组彗差的增加少于对照组,差异有统计学意义(P＜0.01)。结论:实时虹膜识别技术能够有效校正LASIK术前和术中的眼球旋转偏差及瞳孔中心移位,使散光度数和轴向的治疗更加精确,同时提高视觉质量。     

Waardenburg综合征Ⅱ型1例

Waardenburg综合征(WS)是一种罕见的常染色体显性遗传病,其主要临床特点包括色素分布异常以及先天性耳聋。WS共分为四型,临床上需同其他疾病仔细鉴别。     

Impact of iris pigment and pupil size in ultraviolet radiation cataract in rat

Purpose: To investigate the effect of iris pigment and pupil size in ultraviolet radiation (UVR)‐induced cataract. Methods: Brown‐Norway rats (pigmented) and Fischer‐344 rats (non‐pigmented) were unilaterally exposed in vivo to 5 kJ/m² UVR. Each strain was split into two groups, each receiving either mydriatic (tropicamide) or miotic (pilocarpine) eye‐drops. One week after exposure, the degree of ocular inflammation and damage in the anterior segment was determined. The lenses were extracted, photographed and the degree of forward light scattering (cataract) was quantified. Results: The cataract types differed between the two strains. All Fischer rats developed macroscopically identifiable UVR cataract while only 41% of Brown‐Norway rats did so. All groups except the miotic Brown‐Norway developed significant light scattering. The Fischer rats developed 3–4‐fold more lens light scattering than the Brown‐Norway rats. The miotic Fischer group exhibited significantly more light scattering than the mydriatic Fischer group. There was no significant difference in light scattering between the two Brown‐Norway groups. There was a correlation between ocular inflammation and degree of light scattering, with Brown‐Norway rats exhibiting less inflammation and lens light scattering. Conclusions: Pigmented rats develop less UVR cataract and less ocular inflammation than non‐pigmented rats. Pupil size plays a smaller role in UVR cataract development in pigmented rats than in non‐pigmented. The role of UVR‐induced ocular inflammation in cataract development is still ambiguous.     

先天性白内障合并先天性虹膜发育异常的临床表型

背景 先天性白内障临床类型与遗传基因位点存在一定的相关性,而不同致病基因的先天性白内障可伴发相同的眼部合并症,同时不同的眼部合并症可由同一致病基因引起,它们之间是否存在对应关系尚未明确.目的 观察先天性白内障合并先天性虹膜发育异常的表现类型,总结其发病规律.方法 对云南省第二人民医院眼科诊治的先天性白内障合并先天性虹膜发育异常患者15例进行眼科形态学观察,分析不同类型的先天性白内障伴发虹膜发育异常的特点.结果 15例患者均为双眼发病,7例核性白内障并发完全性虹膜缺损,2例全白内障并发部分完全性虹膜缺损,5例全白内障并发无虹膜,1例缝性白内障并发无虹膜.结论 不同类型白内障合并的虹膜发育不全有一定的规律性,为进一步研究其致病原因和发病机制提供依据.