过熟期白内障囊外摘除联合人工晶状体植入术

目的：探讨过熟期白内障囊外摘除和人工晶状体植入的手术方法及术中、术后并发症发生的原因和治疗措施。方法：对202例（202只眼）过熟期白内障患者施行白内障囊外摘除和后房型人工晶状体植入术。结果：开罐式截囊106只眼，信封式截囊81只眼，连续环形撕囊15只眼。123只眼采用双手压迫式娩核，其余患眼采用晶状体套圈娩核。除12只眼因术中玻璃体脱出未植入人工晶状体外，其余患者均植入后房型人工晶状体。59.9%患者术后视力≥0.5。信封式截囊及套圈娩核造成晶状体悬韧带断裂及玻璃体脱出等并发症更少。结论：对于皮质完全液化的过熟期白内障宜采用信封式截囊，伴晶状体悬韧带松驰的过熟期白内障套圈娩核较双手压迫式娩核有效及安全 。     

小儿白内障后囊破裂人工晶状体植入术探讨

目的　探讨小儿白内障后囊不完整时Ⅰ期后房型人工晶状体植入术和Ⅱ期人工晶状体植入术两种术式的效果。方法　小儿白内障术前或术中后囊破裂2 7例(3 9眼)。分为两组:A组18例(2 6眼) ,行Ⅰ期后房型人工晶状体植入术,B组9例(13眼) ,未行人工晶状体植入或行Ⅱ期植入术,术后随访1年,比较两组的视力。结果　两组视力差异有显著意义(P <0. 0 5 ) ,B组的并发症多。结论　应重视小儿白内障手术的质量,以避免术中并发症的发生或尽量实行Ⅰ期人工晶状体植入。     

线状与开罐式晶状体前囊截囊的临床效果比较

目的 了解线状晶状体前囊截囊在人工晶状体植入术应用中,术后早期视力恢复及并发症情况。方法 对１３２例１６８眼白内障用线状截囊法行白内障囊外摘除及囊袋内人工晶状体植入,同时对１３０例１５６眼开罐式截囊作为对照。结果 线状组术后早期矫正视力０．５以上者１３２眼（７８．９％）。术后早期并发症角膜内皮水肿５６眼（３３．３％）,房水混浊１１６眼（６９．０％）,葡萄膜色素脱落３６眼（２１．４％）。结论 线状组     

后囊破裂型外伤性白内障人工晶状体二期植入

目的探讨人工晶状体二期睫状沟植入在眼球穿孔伤所致后囊破裂型外伤性白内障手术中的应用。方法我院2011年1月至2013年1月收治眼球穿孔伤所致后囊破裂型外伤性白内障82例（82眼）,在一期眼球清创缝合白内障摘出联合前段玻璃体切除手术时尽量保留残余囊袋。3～6个月后行二期人工晶状体植入术。根据囊袋残留情况分为两组：A组：残留囊袋足够支撑后房型人工晶状体者（48例）,进行后房型人工晶状体睫状沟植入。B组：囊袋无残留或残留囊袋无法支撑后房型人工晶状体者（34例）,进行缝线固定晶状体襻于巩膜壁的后房型人工晶状体睫状沟植入。结果两组患者术后视力均有提高。B组BCVA明显低于A组。A组2例（4．17％）人工晶状体光学中心轻度偏移,4例（8．33％）体部轻度倾斜;B组6例（17．65％）人工晶状体光学中心轻度偏移,6例（17．65％）体部倾斜,其中3例（8．82％）眼球转动时有不适感。结论对于眼球穿孔伤所致后囊破裂型外伤性白内障,于一期行眼球清创缝合、白内障摘出联合前段玻璃体切除手术时尽量保留残余囊袋组织,可为二期植入人工晶状体创造良好条件。二期手术时选择后房型人工晶状体睫状沟植入术,符合人体解剖结构,稳定性好。     

超声乳化术中人工晶状体前囊夹持植入的临床观察

目的:观察超声乳化术中人工晶状体前囊夹持植入法的临床效果。方法:对白内障超声乳化术中撕囊口过小21例21眼、后囊破裂6例6眼、囊袋宽松1例2眼采用前囊夹持法植入后房型人工晶状体,术后观察视力、人工晶状体位置及后发性白内障情况,术后随访6～24mo。结果:术后3mo视力0.3以上6眼,0.5以上13眼,0.8以上10眼,人工晶状体位置稳定,后发性白内障发生率与囊袋内植入相近,未发现其它与固定有关的并发症。结论:白内障超声乳化术中采用前囊夹持法植入后房型人工晶状体效果良好,是超声乳化术中出现撕囊口过小、后囊膜破裂等并发症的一种有效补充手段。     

白内障摘出人工晶体植入不同截囊方法对比分析

目的 评价白内障囊外摘出人工晶体植入术中两种不同截囊方法对术后视力的影响。方法 对３０２例白内障患者进行圆形开罐式截囊、改良信封式截囊，两组进行对比观察，对两组术后病人随访１￣１８个月，影响视力的因素进行分析。结果 改良信封式截囊，水力分离，环形撕囊对角膜内皮损伤小，残留的皮质及上皮细胞少，囊袋内植入的机率大，减少并减轻术后并发症的发生。结论 术后并发症，开罐式截囊组明显多于改良信封式截囊组。     

白内障摘出人工晶体植入术不同截囊方法对比分析

目的评价白内障囊外摘出人工晶体植入术中两种不同截囊方法对术后视力的影响。方法对302例白内障患者进行圆形开罐式截囊、改良信封式截囊，两组进行对比观察，对两组术后病人随访1～18个月，影响视力的因素进行分析。结果改良信封式截翼，水力分离，环形撕囊对角膜内皮损伤小，残留的皮质及上皮细胞少，囊袋内植入的机率大，减少并减轻术后并发症的发生。结论术后并发症，开罐式截囊组明显多于改良信封式截襄组。     

三种截囊法在老年性白内障囊袋内人工晶状体植入术中效果观察

对132眼老年性白内障施行白内障囊外搞出及囊袋内人工晶状体植入术，按前囊截开方式不同分为3组：（1）开罐式截囊；（2）线状截囊；（3）连续环形撕囊。观察人工晶状体排在囊袋内固定形式并与开罐组相比，线状组和撕囊组与其差异有显著性（P＜0.05）。后囊浑浊发生率分别为：开罐组22％；撕囊组9.4％；线状组4％。提示：选用一种既能有效地清除晶体上皮细胞又能确保人工晶状体并完全植入囊袋内的截囊方式，对防止后囊浑浊提高视力是一种有效而实用的方法。     

外伤眼晶状体玻璃体切除术后人工晶状体Ⅱ期植入的临床观察

目的探讨外伤眼晶状体玻璃体切除术后人工晶状体Ⅱ期植入的术式选择及临床效果。方法回顾2002年6月～2008年6月我院收治的Ⅱ期人工晶状体植入术62例（62眼）,根据病情不同分别行保留前后囊者的后房型人工晶状体睫状沟植入术;部分残留晶状体囊可支撑后房型人工晶状体一侧襻者,行另一襻睫状沟单线缝合;无晶状体囊者行双线睫状沟缝合固定人工晶状体术。结果患眼术后视力均有不同程度提高。视力均达0．05或以上。0．05．0．1者6眼,0．2～0．3者37眼,0．4～0．6者11眼,〉0．6者8眼。术后随诊观察1—3月。结论Ⅱ期人工晶状体植入对无晶状体眼视力恢复起重要作用。根据晶状体囊情况采用不同术式行人工晶状体Ⅱ期植入。     

外路法行后房型人工晶状体缝线固定术

目的探讨白内障术后晶状体后囊不完整和缺如眼的后房型人工晶积体植入术。方法对12例13眼采用外路法行经睫状沟后房型人工晶状体二点缝线固定植入术。结果术后视力最佳1．5，最差0．2，平均0．6。术后随访6－24月，无并发症。结论此法植入后房型人工晶状体，眼内操作少，限内组织损伤小，术后反应轻。人工晶状体眼内稳定性好、无偏位、并发症少。     

Electrophysiological determination of the refractive state of the eye of the opossum

The refractive state of the eye of the South American opossum Didelphis marsupialis aurita was investigated with electrophysiological techniques. Using adult specimens, trapped from the wild, averaged cortical evoked responses were recorded from the region of projection of the central visual field. Stimuli consisted of a phase reversal of a square wave grating generated on a CRO screen, with luminance of 2.4 cd/m2 and contrast 0.84. The refractive state of the eye was altered by means of trial lenses and the amplitude of the cortical responses thus obtained compared to those obtained with no lens (control values). Refraction "tuning curves" were determined for each animal. The average refractive state was found to be -2.27 D indicating that this species when raised in its habitat shows, at low ambient luminosity, some degree of myopia. Determination of the Contrast Sensitivity Function indicate that induced ametropias lead to a reduction of the cut-off value of the spatial frequency and a loss of contrast sensitivity.     

Influence of exercise on the structure of the anterior chamber of the eye

Purpose

To measure changes in anterior chamber structure before and after exercise in healthy individuals using anterior segment optical coherence tomography (ASOCT).

Methods

Thirty‐two healthy young individuals performed jogging for 20 min. Eye blinking rate was recorded during rest and exercise. The anterior chamber angle (ACA), angle opening distance at 500 μm from the scleral spur (AOD500), trabecular‐iris space area at 500 μm from the scleral spur (TISA500), iris concavity (IC), iris concavity ratio (CR), iris thickness at 750 μm from the scleral spur (IT750), anterior chamber depth (ACD), anterior chamber width (ACW), pupil diameter (PD), intraocular pressure (IOP), blood pressure (BP) and heart rate (HR) were recorded before and after exercise. Anterior chamber angle (ACA), AOD500, TISA500, IC, IT750, ACD, ACW and PD were measured with ASOCT.

Results

Compared with rest, the blinking rate during exercise did not change significantly (13.04 ± 5.80 versus 13.52 ± 5.87 blinks/min, p = 0.645). The average IOP (15.4 ± 2.4 versus 12.4 ± 2.1 mmHg), ACA (35.96 ± 11.35 versus 40.25 ± 12.64 degrees), AOD500 (0.800 ± 0.348 versus 0.942 ± 0.387 mm), TISA500 (0.308 ± 0.155 versus 0.374 ± 0.193 mm²), IC (?0.078 ± 0.148 versus ?0.153 ± 0.159 mm) and CR (?0.027 ± 0.050 versus ?0.054 ± 0.056) changed significantly (all p < 0.001), while the average IT750 (0.463 ± 0.084 versus 0.465 ± 0.086 mm; p = 0.492), ACD (3.171 ± 0.229 versus 3.175 ± 0.238 mm; p = 0.543) and ACW (11.768 ± 0.377 versus 11.755 ± 0.378 mm; p = 0.122) showed no significant change after exercise.

Conclusion

The blinking rate did not change significantly during exercise, while ACA, AOD500 and TISA500 increased after exercise. Exercise also induced or increased IC. These changes in anterior chamber structure were only associated with exercise, but not with the postexercise change in PD or IOP.