简介:目的:研究板层角膜切除术联合那他霉素治疗真菌性角膜溃疡的临床疗效及组织病理学基础。方法:选取2009-12/2011-11真菌性角膜溃疡患者32例32眼,角膜病变未累及内皮层,行角膜板层切除联合那他霉素滴眼治疗,观察记录治疗前后视力、角膜情况、病程、并发症及致病菌种类,对切除组织行组织病理学检查。结果:治疗前视力≤0.05者20眼,~0.3者11眼,〉0.3者1眼。板层切除术后联合那他霉素治疗痊愈28例(87.5%),治愈时间7~32(平均13.2±8.5)d,痊愈时视力≤0.05者5眼,~0.3者8眼,〉0.3者15眼。病情控制不良改行角膜移植术者4例。31例真菌培养阳性(96.9%),其中镰刀菌18例,曲霉菌属8例,链格孢霉3例,未知菌属2例。病理学检查显示溃疡灶中有多量中性粒细胞浸润,过碘酸-希夫(PAS)染色显示角膜组织中菌丝多数位于角膜浅层,并呈与板层胶原纤维平行方向生长,但也有少数呈斜形或垂直生长方式,侵及切除组织全层。不同菌属之间菌丝在角膜中生长方式无明显差异。结论:对于病变未累及全层的真菌性角膜溃疡患者,及时行板层角膜切除术可大大提高那他霉素药物治疗有效性,缩短病程,恢复视力。
简介:目的探讨白内障超声乳化摘除及人工晶体植入联合房角分离术治疗闭角型青光眼合并白内障的临床效果方法回顾性分析2009年10月至2011年6月我院收治的闭角型青光眼合并白内障共112例(120眼),应用白内障超声乳化摘除及人工晶体植入联合房角分离术,对房角关闭区域用粘弹剂和手指按压进行钝性分离。观察手术前后的房角及前房变化、视力、眼压及并发症情况,随访6月。结果均经统计学处理。结果120眼手术顺利,术后追踪6月,全部患者术后视力提高,房角开放,中央前房加深,眼压控制良好,手术前后比较差异具有统计学意义。结论超声乳化白内障摘除联合房角分离术是治疗闭角型青光眼合并白内障的有效方法之一,但具体适应证尚待进一步探讨。
简介:目的:分析玻璃体切割术治疗复杂性视网膜脱离的效果。方法:对45例45眼复杂性视网膜脱离眼行闭合式玻璃体切割术,术毕玻璃体腔行C3F8气体或硅油填充。结果:玻璃体切割联合玻璃体腔注气术15眼,1次手术视网膜复位13眼(87%);玻璃体切割联合玻璃体腔内硅油填充术30眼,1次手术完全复位27眼(90%)。统计学检验两组1次手术视网膜复位率的差异无显著意义。术后视力:数指/眼前者2眼,0.02~0.05者3眼,0.06~0.1者10眼,0.12~0.25者19眼,≥0.3者11眼。术中常见的并发症有医源性视网膜裂孔,术后并发症最多见是继发性青光眼和白内障。结论:玻璃体切割联合眼内填充能有效地治疗复杂性视网膜脱离,术后大部分患者视力能得到改善。
简介:AIM:Toexploretheeffectofsaturatedhydrogensalineonbluelight-inducedretinaldamageinrats.·METHODS:Theretinaldamageofratswasinducedbybluelightexposurefor6hoursandexamined8hours,16hoursand24hoursaftertheexposure.OnehundredfemaleSprague-Dawleyratswererandomlydividedintofourgroups.Group1included30ratsreceivedlightexposurewithoutanyothertreatment.Group2included30ratsreceivedlightexposurewithintraperitonealinjectionofnormalsaline.Group3included30ratsreceivedlightexposurewithintraperitonealinjectionofsaturatedhydrogensaline.AndGroup4includedtheother10ratswhichdidnotreceiveanytreatment.Theamountofintraperitonealinjectionofsaturatedhydrogensalineandnormalsalinewascalculatedintheratioof1ml/100gofratweight.SpecimenswerecollectedandprocessedbyH-Estaining,ultrastructureobservation,biochemicalmeasurement.Morphologicalchangeswereobservedbylightmicroscopeandtransmissionelectronmicroscope(TEM)andtheretinalouternuclearlayer(ONL)thicknesswasmeasuredbyIPP6.0,whilethemalondialdehyde(MDA)wasmeasuredbycolorimetricdeterminationat532nm.·RESULTS:AlthoughthestructureofretinainGroup1andGroup2wasinjuredheavily,theinjuryinGroup3wasmild.ThedifferencesbetweenGroup1andGroup2werenotsignificant.ComparedwiththeratsinGroup1andGroup2,theonesinGroup3hadmoreclearlydemarcatedretinastructureandmoreorderedcellsbylightmicroscopeandTEMobservation.TheONLthicknesses(400times)offourgroupsateachtimepointexceptbetweenGroup1andGroup2weresignificantlydifferent(P<0.05).ThethicknessesoftheONLinGroup1atthreetimepointswere30.41±4.04μm,26.11±2.82μmand20.63±1.06μm,inGroup2were31.62±4.54μm,25.08±3.63μmand19.07±3.86μm,inGroup3were29.75±3.62μm,28.83±1.97μmand27.61±1.83μm.InGroup4themeanofthethicknesswas37.35±1.37μm.Astimewentby,thedamageg
简介:AIM:Anaerobicbacteriacancauseocularinfections.WetestedtheOxyPlateTMAnaerobicSystem(OXY)toisolatepertinentanaerobicbacteriathatcancauseoculardisease.METHODS:OXY,whichdoesnotrequiredirectanaerobicconditions(i.e.bags,jars),wascomparedtoconventionalisolationofincubatingculturemediainanaerobicbags.Standardcoloniescountswereperformedonanaerobicocularbacterialisolatesunderaerobicandanaerobicconditions(anaerobicbags)usingagarmedia:1)OXY(aerobiconly),2)5%sheepblood(SB),3)Chocolate,and4)Schaedler.Thebacteriatestedwerede-identifiedocularisolatesculturedfromendophthalmitisanddacryocystitisthatinclude10Propionibacteriumacnesand3Actinomycesspecies.Thecolonycountsforeachbacteriaisolate,oneachculturingcondition,wererankedfromlargesttosmallest,andnon-parametricallycomparedtodeterminethebestculturingcondition.RESULTS:Allanaerobicconditionswerepositiveforalloftheanaerobicisolates.SBandSchaedler’sagarunderaerobicconditionsdidnotsupportthegrowthofanaerobicbacteria.SparsegrowthwasnotedonchocolateagarwithPropionibacteriumacnes.Asananaerobicsystem,SBinananaerobicbagisolatedhighercolonycountsthanOXY(P=0.0028)andchocolateagar(P=0.0028).CONCLUSION:AlthoughOXYdidnottesttobemoreefficientthanotheranaerobicsystems,itappearstobeareasonablealternativeforisolatinganaerobicbacteriafromocularsites.Theuseofanagarmediuminaspeciallydesignedplate,withouttherequirementofananaerobicbag,renderedOXYasanadvantageoverotheranaerobicsystems.
简介:AIM:TopresenttheresultsofimplantationofIakymenkokeratoprosthesisinfivepatientswithvascularizedcornealleukomacausedbysevereocularinjury.·METHODS:Iakymenkokeratoprosthesiswasimplantedinto5eyesof5patients:4patientsweresufferedfromchemicalburnsand1patientfromexplosiveinjury.Thepreoperativevisualacuityrangedfromlightperceptiontohandmotion.Theimplantationsurgerywascomposedoftwo-stageprocedures.Thefollow-upperiodwasfrom9monthsto11years.Theoutcomemeasureswerevisualacuity,retention,andcomplicationsofthekeratoprosthesis.·RESULTS:Visionimprovementswereachievedinmostpatients.Allkeratoprosthesiswereretainedwithinthefollow-upperiod.Cornealmeltingoccurredinonepatientandfibrousclosureinanotherpatient,bothofwhichweresuccessfullytreated.Retinaldetachmentoccurredinonepatientaftersurgery.·CONCLUSION:Iakymenkokeratoprosthesisseemstobeapromisingalternativeforthepatientswithseverecornealinjury,butfurtherinvestigationisneededtoevaluatetheroleofIakymenkokeratoprosthesis.
简介:AIM:Toevaluatechangesintheanteriorchamberdepth(ACD),crystallinelensthickness(LT)anditsrefractivepowerafterlaserinsitukeratomileusis(LASIK).·METHODS:Inallcases,thepreoperativeandpostoperativecentralACDwhichweremeasuredwithPentacam,Orbscan,IOL-MasterandA-scanultrasonography,centralcornealtruenetpowerwhichwasmeasuredwiththePentacam,OrbscanandIOL-Master,axiallength(AL)whichwasmeasuredwithIOL-MasterandLTwhichwasmeasuredwiththeA-scanultrasonographywerecomparedusingthepairedsamplettest.OcularrefractiveerrorsandlensrefractivepoweratcornealplanewerecalculatedandtheircorrelationswerealsoevaluatedbeforeandafterLASIK.RESULTS:At1weekafterLASIK,LTandcrystallinelensrefractivepoweratcornealplane(Dlens)whichwereassociatedwiththeIOL-MasterandPentacamincreasedsignificantly(P≤0.005),ACDdecreasedsignificantly(P≤0.001),butnosignificantincreasewasobservedintheDlenswhichwasassociatedwiththeOrbscan(P=0.261).SignificantcorrelationsbetweenthechangesintheocularrefractiveerrorsandDlenswhichwereassociatedwiththePentacamwereobservedat1weekand6monthsafterLASIK(P=0.028;P=0.001).CONCLUSION:LTincreasedsignificantlyafterLASIK,andthismightpartiallyleadtoACDdecrease,Dlensincreaseandasmallquantityofmyopicregression.
简介:AIM:Toinvestigatetheefficacyofnon-buckledvitrectomywithclassicalendotamponadeagentsinthetreatmentofprimaryretinaldetachment(RD)complicatedbyinferiorbreaksandproliferativevitreoretinophathy(PVR).METHODS:Aretrospective,consecutiveandcaseseriesstudyof40patientswithinferiorbreakRDandPVR≥C1wasconducted.Allpatientsunderwentastandard3-port20-gaugeparsplanavitrectomy(PPV)withgasorsiliconeoiltamponadewithoutsupplementaryscleralbuckling.Thevitreousandallproliferativemembranewerecompletelyremoved,andretinectomywasperformedwhennecessary.Themeanfollow-upwas12.5months.Theprimaryandfinalanatomicsuccessrate,visualacuityandcomplicationswererecordedandanalyzed.RESULTS:Primaryanatomicsuccessratewasachievedin35of40eyes(87.5%)andthefinalanatomicsuccessratewas100%.ThemostcommoncauseofredetachmentwasrecurrentPVR.Thebest-correctedvisualacuity(BCVA)atfinalfollow-upwasimprovedin34eyes(85%),remainedstablein1eye(2.5%),andworsenedin5eyes(12.5%).Themeanvisualacuityatfinalfollow-upwasimprovedsignificantly(P=0.000).CONCLUSION:ThisretrospectivestudyprovidesevidencethatvitrectomywithoutscleralbucklingseemedtobeaneffectivetreatmentforinferiorbreakRDwithPVR.Withcompleteremovalofvitreousandproliferativemembranesandtimingofretinectomy,theinferiorbreakswhichcomplicatedwithPVRcouldbeclosedsuccessfullywithoutadditionalscleralbuckling.
简介:<正>DearSir,IamDr.Jing-WenGong,fromtheDepartmentofOphthalmology,ZhejiangProvincialPeople’sHospital,Hangzhou,China.Iwritetopresentapeculiarcasereportofjerkysee-sawnystagmusininternuclear
简介:AIM:Toevaluatethelong-termresultsandcomplicationsofahmedglaucomavalve(AGV)implantationinrefractoryglaucoma.·METHODS:Aretrospectivereviewof13patients(13eyes)withrefractoryglaucomawhounderwentAGVimplantationandhadaminimumfollow-upof18monthswasperformed.Allpatientsunderwentacompleteophthalmologicexaminationandintraocularpressure(IOP)measurementbeforesurgeryandat1month,3months,6months,1yearaftersurgeryandyearlyafterwards.Complicationsandthenumberofantiglaucomamedicationsneededwererecorded.·RESULTS:Meanagewas27.3±16.0years.Alleyes(100%)hadatleastonepriorincisionalsurgery.Meanfollow-upwas61.3±30.8months.IOPwasreducedfromameanof35.0±7.0mmHgto18.2±7.9mmHgat12monthsandto17.0±4.1mmHgat96months(P<0.05)withalowernumberofmedicationsfrombaseline,76.9%patientsrequiredadditionalprocedurestoachievethesuccesscriteriasetbypreviouslypublishedseries.Themostcommoncomplicationswereencapculatedcystformationineighteyes(61.5%)andtubeexposureinfoureyes(30.8%).·CONCLUSION:EncapsulatedcystformationwasthemostcommoncomplicationwhichhinderedsuccesfulIOPcontrolafterAGVimplantinsertionforrefractoryglaucoma.Despitecystexcisionwithanti-fibroticagents,successfulIOPreductionwasnotachievedin76.9%ofthepatientswithoutantiglaucomamedication.
简介:AIM:TotrainTibetanmonkey(Macacathibetana)forintraocularpressure(IOP)measurementinconsciousstateandobtainnormalIOPinconsciousTibetanMacaque.·METHODS:Thetrainingwasbasedonaward-conditionedbehavior.Foodstimulationandhuman-animalinteractionwereusedinthistraining.·RESULTS:TrainedTibetanmonkeyscalmlyacceptedIOPmeasurementbytheTonoVet?誖reboundtonometerwithoutsedationoranesthesiaandtheirIOPvaluesweresimilartootherprimates.·CONCLUSION:Human-cultivatedThibetanmonkeysaretamable,andcanbeusedforbiomedicalresearchsuchasophthalmicresearchwithoutanesthesia.
简介:AIM:ToevaluatetheeffectofCollagencross-linkingonthepreventionofmeltinginrabbitcorneasafteralkaliburn.·METHODS:TwentyNewZealandwhiterabbitswererandomlydividedintomodelcontrolgroupandcollagencross-linkingtreatmentgroup.Thesecondgroupofrabbitsreceivedcollagencrosslinkedtreatment.Bothgroupswereappliedwithantibioticeyedropstopreventinfection.Thecorneaswereevaluatedformelting,opacity,pathologicalandimmunohistochemistry,recordthechangeswhen28daysaftertheanimalswerekilled.·RESULTS:Inthecontrolgroup,6outof8rabbitsshowedcornealmeltingafterinjury(14±4)days,whiletwocornealperforated.Incollagencross-linkingtreatmentgroup,onerabbitshowedcornealmeltingafterinjury23days,withoutcornealperforation;cornealdissolutionratebetweenthetwogroupswassignificantlydifferent(P<0.05).Pathologicalexaminationsuggestedthatinthetreatmentgroup,mildcornealedema,milddamagetocollagenfibers,inflammatorycellinfiltrationwassignificantlylessthanthecontrolgroup.Immunohistochemistryshowedthatcornealcollagenfibersarrangedinneatrowsinthecontrolgroup.·CONCLUSION:Collagencross-linkingtreatmentnotonlycanpreventanddelaythecornealmeltingafteralkaliburn,butalsocanreducethedestructionofcornealcollagenfibersandinfiltrationofinflammatorycellsinthecornealtissue.
简介:AIM:Tostudythedistributionofocularhigher-orderaberrations(HOAs)andmesopicpupilsizeinindividualsscreenedforrefractivesurgery.·METHODS:OcularHOAsandmesopicpupilsizewerestudiedin2458eyesof1240patientswithmyopia,myopicastigmatismandcompoundmyopicastigmatismand215eyesof110patientswithhyperopia,hyperopicastigmatismandcompoundhyperopicastigmatismusingtheZywaveaberrometer(Busch&Lomb).Allpatientshadcorrectablerefractiveerrorswithoutahistoryofrefractivesurgeryorunderlyingdiseases.Root-mean-squarevaluesofHOAs,totalsphericalaberration,totalcomaandmesopicpupilsizewereanalyzed.OcularHOAsweremeasuredacrossa≥6.0mmpupil,andpupilsizemeasurementswereperformedunderthemesopiccondition.·RESULTS:ThemeanvaluesofHOAs,totalsphericalaberrationandtotalcomainthemyopicgroupwere0.369μm,±0.233,0.133±0.112μmand0.330±0.188μm,respectively.InthehyperopicgroupthemeanvaluesofHOAs,totalsphericalaberrationandtotalcomawere0.418μm±0.214,0.202±0.209μmand0.343±0.201μm,respectively.HyperopesshowedgreatertotalHOAs(P<0.01)andtotalsphericalaberration(P<0.01)comparedtomyopes.Inage-matchedanalysis,onlytheamountoftotalsphericalaberrationwashigherinthehyperopicgroup(P=0.05).Mesopicpupilsizeinthemyopicgroupwaslarger(P≤0.05).·CONCLUSION:TheresultssuggestedthatsignificantlevelsofHOAswerefoundinbothgroupswhichareimportantforplanningrefractivesurgeriesonIranians.Thereweresignificantlyhigherlevelsoftotalsphericalaberrationinhyperopescomparedtomyopes.Mesopicpupilsizewaslargerinmyopicgroup.
简介:AIM:Toexaminetheα-Galgeneexpressionanddistributioninthedifferentspecies/genusanddevelopingphaseanimalocularsurfacetissue.METHODS:α-Galbindingassaywerecarriedoutonvariousanimaleyesections.Photograph,slit-lampobservationonvariouseyeshowednormalcornealtransparence.RESULTS:Astrongα-Galexpressionininvertebratesandsomevertebratesoculartissue,butnoα-Galbindinginbirds,fishandmammal.α-Galexpressionchangeinthedevelopmentofmiceocularsurfacetissue(exceptsclera)anddisplaygenusdependencyinthedifferentmurineocularsurfacetissue.CONCLUSION:Thisstudyidentifiedspecificα-Galepitopesbindingareaintheocularsurfaceofseveralspeciesandmaysolvetheproblemthatnaiveocularsurfacemaybeusedasnaturalα-Galgeneknockoutmodel/highriskimmunologicrejectionmodelorocularsurfacescaffoldmaterial.
简介:·AIM:Toreportvariousocularinjuriescausedbydurianfruit.·METHODS:Threecasesofocularinjuriesweredescribedinyoungpatients,duetoaccidentalfallofdurianfruitontheforeheadandface,whiletheyweretakingrest/sleeping/playingundertheduriantree.·RESULTS:Theocularinjuriesobservedwerelaceratinginjuryofcorneawithirisincarceration,hyphema,superficialpenetratinginjuryofscleraandanglerecessionglaucomaintherighteyeoffirstpatient;laceratinginjuryofcorneawithirisprolapseinthelefteyeofsecondpatient;subconjunctivalhaemorrhage,traumaticmydriasisandsuperficialpenetratinginjuryofsclera,commotionretinopathyandmacularedemainthelefteyeofthirdpatient.Visionimprovedtonormalinalltheeyesfollowingsurgical/medical/opticaltreatment.·CONCLUSION:Evidenceofpenetratinginjury(becauseofthorns)andbluntinjury(becauseofweight)canbeseenintheeyeswhendurianfruitfallsontheface.Visioncanberecoveredfullywithimmediateandappropriatetreatmentinthesecases.Theocularinjuriescanbepreventedbyeducatingthepublictowearprotectivemetalframewidegogglesandnottosleep/takerestundertheduriantree.