结膜入路整形术治疗下眼袋

自１９９３年以来，对５２岁以下较为严重下眼袋患者施术２２例，共计４４只眼，应用结膜入路下眼袋整形术，这一手术方法既克服了皮肤入路手术皮肤遗留痕迹的缺点，且有手术过程操作简单，出血少，不损伤重要组织及血管等特点，满意率达９７．７３％，取得了满意的临床效果。作者阐述了手术适应证、手术设计、方法以及注意事项，同时认为严格手术适应证和精湛外科技术是手术成功的关键。     

转化生长因子-β抑制剂Decorin抗眼结膜滤过泡瘢痕形成的实验研究

目的　探讨Decorin抑制结膜下瘢痕形成的作用机制并为临床应用提供理论依据。方法　新西兰大白兔分为Decorin组、磷酸盐缓冲液 (PBS)组、正常对照组。在滤过术后第 7,14,3 0天 ,应用链酶亲和素免疫组织化学法 (SABC法 )检测各组在结膜滤过泡中转化生长因子 - β1(TGF- β1)和转化生长因子 - βⅠ型受体 (TGF - βRⅠ )的含量 ;应用天狼星玫瑰红 -偏振光法检测各组Ⅰ、Ⅲ型胶原的含量。　结果　PBS组结膜滤过泡中TGF - β1、TGF - βRⅠ免疫组化染色和Ⅰ、Ⅲ型胶原染色呈强阳性表达 ,第 3 0天明显比第 7天增强 (P <0 .0 5 ) ;Decorin组结膜滤过泡中TGF - β1、TGF - βRⅠ免疫组化染色和Ⅰ、Ⅲ型胶原染色呈弱阳性表达 ,相同时相点比较 ,Decorin组比PBS组明显呈弱表达 (P <0 .0 1)。Decorin可使滤过泡瘢痕中TGF - β1和TGF - βRⅠ活性降低 ,Ⅰ、Ⅲ型胶原的含量减少。　结论　Decorin可作为抑制滤过泡瘢痕形成的辅助药物     

应用结膜后退法矫治睑球粘连

目的：为眼部热力及化学性烧伤导致的睑球粘连寻找一种新的治疗方法。方法：用残留的结膜行1次或多次后退重建结膜囊。结果：1998年以来用此法为38例（40只眼）睑球粘连者进行了治疗，其中13例（13只眼）行2次，19例（21只眼）行3次，仅6例（6只眼）行1次结膜后退成功，其中1例失败。结论：结膜后退法是矫治睑球粘连的一些种有效的方法。     

带蒂球结膜瓣转移术治疗翼状胬肉

目的 :探讨带蒂结膜瓣转位移植术治疗翼状胬肉的临床效果。方法 :施行带蒂结膜瓣转位移植术治疗翼状胬伙肉 2 4 0例 ,2 5 2只眼 ,手术在手术显微镜下进行 ,干净彻底切除胬肉组织 ,在上方球结膜制作 4 mm× 10 mm大小 ,外眦端游离 ,内眦端带蒂的菲薄结膜瓣游离端向下须超过胬肉宽度 2 mm,以起拦截作用。移植片与结膜创缘对合 ,缝合 7针～ 10针。结果 :本组翼状胬肉 2 4 0例 ,2 5 2只眼 ,术后随访 6个月～ 5 a,复发 9例 ,占 3.6 % ,取得了较好效果。结论 :本手术取材容易 ,操作简便 ,效果可靠 ,即使在肉眼下亦可施行 ,适合在基层医院开展。     

细胞间粘附分子在翼状胬肉中的表达及意义

目的　研究翼状胬肉组织中细胞间粘附分子1(ICAM-1)的表达水平,探讨ICAM-1在翼状胬肉病理过程中的作用。方法　采用酶联免疫吸附试验法(ELISA)检测28例翼状胬肉患者组织匀浆中的ICAM-1含量,并与正常人结膜组织进行对照。结果　翼状胬肉组织匀浆中ICAM-1含量明显高于正常对照组(P<0.01),进行期组的ICAM-1含量明显高于静止期组(P<0.05)。结论　在翼状胬肉组织中存在ICAM-1异常表达,可能是翼状胬肉发病的重要原因之一。     

雌激素α和β受体在大鼠结膜上皮和Henle腺上的分布

目的阐明雌激素α、β受体在大鼠结膜上皮和Henle腺的分布。方法选择22例青春期SD雌性大鼠上眼睑标本,采用免疫组织化学方法对结膜上皮和Henle腺雌激素α、β受体进行检测;同时采用放射免疫分析技术检测大鼠血清雌二醇的浓度。结果22例大鼠中,19例大鼠的结膜上皮雌激素α受体呈阳性表达,17例大鼠的结膜上皮雌激素β受体呈阳性表达。18例大鼠Henle腺深部的基底细胞雌激素α受体呈阳性表达,17例大鼠的Henle腺深部的基底细胞雌激素β受体呈阳性表达。在所有的大鼠中,Henle腺的杯状细胞雌激素α、β受体均呈阴性表达。雌激素α、β受体在结膜上皮阳性表达率间比较,差异无显著性(P>0.05);雌激素α、β受体在Henle腺深部的基底细胞阳性表达率间比较,差异亦无显著性(P>0.05)。正常大鼠血清雌二醇水平经检测含量为(22.13±3.54)ng/L。结论雌激素及其受体对大鼠结膜上皮、Henle腺深部的基底细胞具有重要的调控作用,但对Henle腺的杯状细胞分泌黏液功能无直接调节作用。     

Cellular dynamics of corneal wound re-epithelialization in the rat. I. Fate of ocular surface epithelial cells synthesizing DNA prior to wounding

The fate of ocular surface epithelial cells in response to injury of the cornea was examined. Corneal epithelial cells were labeled during DNA synthesis with [3H]thymidine 1 h prior to wounding. A 3-mm diameter epithelial defect was made in the center of the rat cornea, with the basement membrane remaining intact. Within 12 h of abrasion, labeled cells were detected in the regenerating surface. At 18 h, there was a 2.7- and 17-fold increase of labeled basal and suprabasal cells, respectively, in the epithelium adjacent to the wound, and at 24 and 30 h there was an excessive number of cell layers (up to 7) at the margin of the abrasion. Re-epithelialization progressed as a gradient of cell layers that became diminished towards the center of the wound. Completion of layers 1, 2, 3, and 4 were recorded at 24, 30, 36, and 72 h, respectively. No changes in the labeling index of the limbus or conjunctiva were noted. These results suggest that processes of centripetal and vertical migration, as well as events related to cell division, in the uninjured corneal surface are not impeded by wounding of the corneal epithelium. However, wound healing appears to require cells with a basal phenotype, presumably because of this cell type's migratory capability.     

Tumors of the ocular surface: A review

Tumors of the Ocular Surface clinically manifest with a very wide spectrum and include several forms of epithelial, stromal, caruncular, and secondary tumors. As a group, these tumors are seen commonly in the clinical practice of a comprehensive ophthalmologist, cornea specialist, and an ocular oncologist. This review is aimed to discuss the common tumors of the ocular surface and emphasize on their clinical diagnosis and appropriate management.     

Epibulbar schwannoma in a 12-year-old boy: A case report and review of literature

Schwannomas are benign, encapsulated, primary neurilemmal tumors composed of proliferating Schwann cells. Schwannomas are commonly seen in the orbit, but are rare on the epibulbar surface. Herein, we report a case of a 12-year-old boy who presented to us with a slow-growing painless subconjunctival mass in the left eye. There was no intraocular extension of the mass and intra-operatively, the mass could be clearly delineated and was excised off the underlying sclera. Histopathological examination of the mass showed typical features of schwannoma and immunohistochemistry helped to confirm the diagnosis. There was no recurrence of the lesion observed at follow-up 26 months after surgery. Here, we describe this uncommon tumor and review the available literature. Although rare, an epibulbar schwannoma should be considered in the differential diagnosis of an amelanotic, painless subconjunctival nodular mass. Excision of the lesion is the recommended treatment.     

Ocular surface evaluation in patients treated with a fixed combination of prostaglandin analogues with 0.5% timolol maleate topical monotherapy: a randomized clinical trial

OBJECTIVES:

To compare ocular surface changes induced via glaucoma treatment in patients using fixed combinations of prostaglandin analogues (travoprost, latanoprost and bimatoprost) with 0.5% timolol maleate

METHODS:

A prospective, multicenter, randomized, parallel group, single-blind clinical trial was performed in 33 patients with ocular hypertension or open angle glaucoma who had not been previously treated. The ocular surface was evaluated prior to and three months after treatment, with a daily drop instillation of one of the three medications. The main outcome measurements included the tear film break-up time, Schirmer''s test, Lissamine green staining, the Ocular Surface Disease Index questionnaire, impression cytology using HE and PAS and immunocytochemistry for interleukin-6 and HLA-DR. Ensaiosclinicos.gov.br: UTN - U1111-1129-2872

RESULTS:

All of the drugs induced a significant reduction in intraocular pressure. Decreases in the Schirmer''s test results were observed with all of the drugs. Decreases in tear-film break-up time were noted with travoprost/timolol and latanoprost/timolol. An increase in the Lissamine green score was noted with travoprost/timolol and bimatoprost/timolol. The Ocular Surface Disease Index score increased after treatment in the travoprost/timolol group. Impression cytology revealed a significant difference in cell-to-cell contact in the same group, an increase in cellularity in all of the groups and an increase in the number of goblet cells in all of the groups. The fixed combinations induced an increase in IL-6 expression in the travoprost/timolol group, in which there was also an increase in HLA-DR expression.

CONCLUSIONS:

All of the fixed combinations induced a significant reduction in intraocular pressure, and the travoprost/timolol group showed increased expression of the inflammatory markers HLA-DR and interleukin-6. All three tested medications resulted in some degree of deterioration in the ocular surface after three months of glaucoma treatment.