兔眼局部应用两性霉素B缓释制剂的研究

目的探索兔眼局部应用两性霉素B脂质体（AmBL）和两性霉素B卡波姆（AmBC）滴眼液后，房水中的药代动力学状况。方法用32只新西兰白兔，在角膜上皮完整和刮除时，分别应用0．5％AmBL或0．5％AmBC滴一眼，并用0．5％两性霉素B滴眼液（AmBS）滴对侧眼作对照，分别在用药后0．25、0．5、1、2、3、4h6个时点，抽取兔眼房水，用HPLC方法测定房水中两性霉素B的质量浓度。结果AmBL滴眼后，房水中AmB的有效抑菌浓度可维持2h，AmBC和AmBS滴眼1h后即近全部消除。角膜上皮完整时，AmBL的药效曲线下面积（AUC）和药物半衰期（T1/2）是AmBS的3．6倍和5倍；角膜上皮刮除后，AmBL的AUC和T1/2是AmBS的3．9倍和3．2倍。AmBC的AUC和T1/2与AmBS相似。结论AmBL具有较好的缓释作用和生物利用度，是较有前途的局部治疗真菌性角膜炎的新型缓释制剂。     

玻璃酸钠滴眼液联合软性角膜接触镜在翼状胬肉切除术后的早期应用

目的:探讨3g/L玻璃酸钠滴眼液联合软性角膜接触镜对翼状胬肉术后早期角膜上皮愈合及局部舒适度的影响.方法:选取90例90眼原发性单眼翼状胬肉患者,行翼状胬肉切除联合自体角膜缘干细胞移植术,术毕随机将患者分为3组,A组(研究组)术毕立即戴软性角膜接触镜,次日给予3g/L玻璃酸钠滴眼液及左氧氟沙星滴眼液点眼(4次/d),妥布霉素地塞米松眼膏涂眼(1次/晚),术后7d取下角膜接触镜;B组(常规用药组)常规予左氧氟沙星滴眼液点眼(4次/d),妥布霉素地塞米松眼膏涂眼(1次/晚);C组在B组的基础上加用3g/L玻璃酸钠滴眼液(4次/d).观察并比较各组术后角膜上皮愈合时间及不同时间点的眼部疼痛评分情况.结果:A组术后6h,1、3d疼痛评分均低于其余两组,差异有统计学意义(P<0.05);术后5、7d,三组疼痛评分无明显差异(P>0.05).术后第1d,三组均无完全愈合者;术后2d,A组的角膜上皮愈合率显著高于B组(P=0.015),而A组和C组及B组和C组比较,差异均无统计学意义(P>0.05);术后3d,A组的角膜上皮完全愈合率均高于其余两组,差异有统计学意义(P<0.05).结论:翼状胬肉术后早期应用3g/L玻璃酸钠滴眼液联合佩戴软性角膜接触镜可以加快角膜上皮缺损修复,减轻局部疼痛,显著改善患眼局部舒适度.     

普拉洛芬滴眼液治疗干眼症疗效观察

目的：观察1g/L普拉洛芬滴眼液治疗干眼症的疗效。方法：选择我院2011-01/12门诊诊断为干眼症的患者100例,随机分成A、B两组,A组：1g/L普拉洛芬滴眼液及1g/L玻璃酸钠滴眼液联合应用,4次/d点眼,1滴/次。B组：1g/L玻璃酸钠滴眼液单独应用,4次/d点眼,1滴/次。试验疗程为14d。所有的患者符合入选标准,用药前及用药后14d观察患者的问卷评分、SchirmerI试验、角膜荧光素染色评分。比较两组的结果,进行统计分析。结果：1g/L普拉洛芬滴眼液及1g/L玻璃酸钠滴眼液联合应用治疗干眼症患者的效果明显优于单纯使用1g/L玻璃酸钠滴眼液治疗组,两组结果差异有统计学意义。结论：1g/L普拉洛芬滴眼液治疗干眼症,对于缓解症状,改善角膜情况效果良好。     

鱼腥草滴眼液治疗流行性角膜结膜炎的临床观察

目的:观察鱼腥草滴眼液治疗流行性角膜结膜炎的临床效果。方法:收集2005-07/2005-09同仁医院门诊急诊就诊的临床确诊为流行性角膜结膜炎的患者40例,随机分为观察组和对照组,分别给予鱼腥草滴眼液和1g/L阿昔洛韦滴眼液点眼,观察6项眼部症状及体征的变化并评分,进行统计学分析。结果:在总的显效率上,两组间差异有统计学意义(P<0.01),观察组优于对照组。用药后第7d,在结膜充血的改善上观察组和对照组间差异有统计学意义(P<0.05);用药后14d,在畏光、异物感、流泪以及结膜充血的改善上两组差异均有统计学意义(P<0.05〉。结论:鱼腥草滴眼液对于治疗流行性角膜结膜炎有明显效果,其疗效优于1g/L阿昔洛韦滴眼液。     

两性霉素B经三种途径给药后在角膜和房水中药物浓度的实验研究

背景角膜基质内注射或前房内注射两性霉素B治疗顽固的真菌性角膜炎取得较好疗效，但通过这2种途径给药后，药物在角膜和房水的浓度变化尚不清楚。目的探讨质量分数0．25％两性霉素B滴眼液点眼、1％两性霉素B注射液角膜基质内注射及1％两性霉素B注射液前房内注射3种途径给药后兔眼角膜和房水中的药物质量浓度变化。方法健康家兔45只按随机数字表法分为A、B、C3组，每组15只。A组、B组分别在角膜基质内和前房内单次注射10¨g两性霉素B注射液，C组兔眼机械法去除角膜上皮后用0．25％两性霉素B滴眼液点眼，每次50仙l，共6次，每次间隔5rain。分别于用药后30min、6h、1d、3d、7d各处死3只实验兔，获取房水和角膜组织，采用高效液相色谱法进行两性霉素B质量浓度的定量检测。结果在质量浓度0．10～100．00mtg／L范围内，两性霉素B的峰面积与吸收度之间具有良好的线性关系；0．10mg／L为其定量限质量浓度；药物在房水的回收率为89．1％～95．7％，在角膜中为81．4％～83．6％。用药后30rain、6h、1dA组角膜中的药物质量分数高于B组及C组，差异均有统计学意义（P〈0．05），高药物质量浓度可持续7d，超出绝大多数敏感真菌的MIC。。。用药后30min、6h、1dB组兔眼房水中的药物质量浓度高于A组及C组，差异均有统计学意义（P〈0．05）。C组1d内角膜和房水中均检测到明显药物浓度。结论兔眼角膜基质内注射及前房内注射两性霉素B可以提高药物在角膜及房水中的质量浓度，清除角膜上皮可以提高两性霉素B的角膜穿透力。     

环孢霉素A滴眼液治疗单疱病毒性角膜基质炎疗效观察

目的:观察10g/L环孢霉素A滴眼液治疗单疱病毒性角膜基质炎临床疗效。方法:我院2011-01/2012-01治疗单疱病毒性角膜基质炎患者91例91眼,随机分为两组,A组应用10g/L环孢霉素A滴眼液和更昔洛韦凝胶,B组应用5g/L氯替泼诺滴眼液和更昔洛韦凝胶,其余均为对症治疗,随诊观察6～12(平均10)mo。结果:两组治疗单疱病毒性角膜基质炎疗效无显著性差异,但A组治愈时间平均5.1±2.4d,B组治愈时间平均6.2±2.8d,A组较B组平均治愈时间短。两组治愈率及复发率无统计学差异。结论:对于单疱病毒性角膜基质炎患者应用10g/L环孢霉素A滴眼液能够安全有效治愈,且治愈时间短。     

小牛血清去蛋白眼用凝胶对兔角膜碱烧伤的治疗作用

背景角膜化学烧伤,特别是碱烧伤对眼组织造成了严重危害,目前临床上多采用抗炎、抑制免疫反应、角膜移植术等方法进行治疗,但针对角膜碱烧伤微环境下的组织修复研究也十分必要。目的观察角膜修复剂小牛血清去蛋白眼用凝胶对兔角膜碱烧伤的治疗作用。方法采用浸有0．5mol／LNaOH溶液的滤纸贴附于角膜中央的方法制备兔眼角膜碱烧伤模型共24只兔24只眼,采用随机数字表法将模型眼随机分为生理盐水对照组、小牛血清去蛋白眼用凝胶组、空白凝胶基质组、碱性成纤维细胞生长因子（bFGF）阳性对照组4个组,分别采用生理盐水、小牛血清去蛋白眼用凝胶、凝胶空白基质和重组牛bFGF眼用凝胶点眼,每日4次。连续2周。分别于给药前及给药后3、5、7、10、14d于裂隙灯下观察各组眼的角膜溃疡和炎症反应,参照Ando等的评分标准对角膜炎症进行评分,进行角膜上皮荧光素钠染色,记录眼角膜溃疡面积的大小,并参照Trousdale评分标准对角膜溃疡进行评分。于造模后14d用过量麻醉法处死动物并摘除实验眼眼球,对角膜组织行常规组织病理学检查。结果造模后兔眼角膜混浊、水肿、灰白,造模成功率为100％。不同药物点眼后7d,裂隙灯下检查发现生理盐水对照组角膜呈瓷白色混浊,可见前房积脓;小牛血清去蛋白眼用凝胶组角膜溃疡愈合;空白凝胶基质组角膜上皮完整,但眼内结构窥不清;而bFGF阳性对照组角膜溃疡愈合,但可见新生血管。点眼后3、5、7、10、14d,小牛血清去蛋白眼用凝胶组及bFGF阳性对照组眼前节炎症评分均明显低于生理盐水对照组,差异均有统计学意义（P〈O．01）;小牛血清去蛋白眼用凝胶组眼前节炎症评分虽然稍低于bFGF阳性对照组,但二者的差异无统计学意义（P〉0．05）;与空白凝胶基质组相比,小牛血清去蛋白眼用凝胶组各时间点兔眼炎症评分值明显下降,差异均有统计学意义（P〈0．05）。小牛血清去蛋白眼用凝胶组点眼后,角膜溃疡评分均明显下降,与生理盐水对照组相比,角膜溃疡评分的差异有统计学意义（P〈0．01）,与bFGF阳性对照组比较,角膜溃疡评分有所下降,但差异无统计学意义（P〉0．05）,与空白凝胶基质组比较,角膜溃疡评分明显下降,差异有统计学意义（P〈0．05）。结论小牛血清去蛋白眼用凝胶可减轻家龟角膜碱焙伤的眼前节炎症反应,促进角膜上皮愈合,其疗效优于bFGF。     

互隔交链孢霉菌性角膜炎的临床与病原学研究

目的探讨互隔交链孢霉菌性角膜溃疡的临床和实验室特征。方法对真菌性角膜溃疡患者,裂隙灯显微镜下观察临床表现后,角膜刮片作10％KOH湿片、Giemsa染色显微镜检查,真菌菌丝阳性者作真菌培养鉴定,并根据美国国家临床实验室标准化委员会（NCCLS）M38-A方案进行体外药敏试验,同时对患者给予两性霉素B、酮康唑、氟康唑滴眼液治疗,并观察抗真菌药物的疗效。以分离的互隔交链孢霉菌株制作兔真菌性角膜溃疡模型,5d和14d后处死兔,取角膜行真菌培养和组织学检查。结果互隔交链孢霉菌性角膜炎患者均为单眼患病,患者和兔模型的角膜溃疡灶均较浅薄,呈淡灰色,边界模糊。显微镜下角膜刮片可见直且粗大的无色隔膜菌丝,并有大量球形厚垣孢子位于菌丝顶端或相连。分离培养基中该种真菌菌丝为棕色,壁砖墙分隔的深棕色孢子链生于棕色分生孢子梗顶端。体外药物敏感试验显示该种真菌对两性霉素B、酮康唑、氟康唑、伏立康唑、咪康唑、益康唑和特比萘芬敏感,对克霉唑、氟胞嘧啶及伊曲康唑耐药。23例患者除1例手术治愈外,其余22例用两性霉素B、酮康唑、氟康唑联合频繁滴眼治愈,平均治愈时间34d。结论互隔交链孢霉菌性角膜溃疡具有独特的临床和实验室特征,对角膜毒力较低,抗真菌药物联合滴眼可完全治愈。     

锰离子滴眼液局部应用对眼前节组织的毒性作用

背景 锰离子滴眼液用于活体视觉传导通路的示踪观察方法已有研究,但锰离子局部点眼对眼前节组织的毒性作用尚无深入研究. 目的 研究不同质量浓度锰离子滴眼液对兔眼眼前节组织的毒性作用.方法 选取32只清洁级新西兰白兔,按照随机数字表法随机分为1.00 mol/L MnCl2组、0.50 mol/LMnCl2组、0.25 mol/L MnCl2组以及对照组,每组8只.采用抽签法随机选择动物一侧眼为实验眼,按照分组情况分别用1.00、0.50、0.25 mol/L锰离子滴眼液及生理盐水各1滴点于结膜囊中,分别于点眼后2h及1、3、7、14、21和28 d时在裂隙灯显微镜下观察眼局部刺激反应;用角膜荧光素染色法观察角膜上皮损伤情况并进行评分;采用角膜内皮镜观察角膜内皮细胞密度(ECD)和角膜厚度,并于点眼后3、7、14、28 d行苏木精-伊红染色,检查结膜、角膜、小梁网及睫状体的组织病理学变化.结果 1.00 mol/L MnCl2组和0.50 mol/L MnCl2组兔眼均出现睑结膜充血、水肿及大量分泌物等刺激症状,1.00 mol/L MnCl2组兔眼于点眼后1d刺激反应最强,点眼后7d反应消失;0.50 mol/L MnCl2组兔眼眼表刺激反应程度轻于1.00 mol/L MnCl2组,持续到点眼后3 d;0.25 mol/L MnCl2组兔眼点眼后未见明显的眼表刺激反应.点眼后2h、1d、3d及7d,各组兔眼角膜上皮荧光素染色评分总体比较差异均有统计学意义(x2=17.350、19.200、12.200、10.140,均P＜0.05).各组兔眼点眼后不同时间点ECD总体比较差异无统计学意义(F分组=0.38,P＞0.05;F时间=1.79,P＞0.05).各组兔眼点眼后不同时间点角膜厚度总体比较差异有统计学意义(F分组=18.22,P＜0.05;F时间=116.75,P＜0.05)点眼后2h～3d,1.00 mol/L MnCl2组兔眼角膜厚度值明显增加,但点眼后7～28 d,各组兔眼角膜厚度值接近,点眼后2h～14d角膜厚度值均明显高于点眼后28 d,0.50 mol/L MnCl2组兔点眼后2h～1d角膜厚度值明显高于点眼后28 d,差异均有统计学意义(均P＜0.05).组织病理学检查结果显示,1.00 mol/L MnCl2组兔眼于点眼后3d和7d可见结膜、小梁网和睫状体的炎性细胞浸润及角膜基质水肿,0.50 mol/L MnCl2组于点眼后3d可见结膜炎性细胞浸润,但角膜、小梁网和睫状体组织未见明显异常,而0.25 mol/L MnCl2组兔眼点眼后结膜、角膜、小梁网和睫状体均未见明显异常.结论 1.00 mol/L锰离子滴眼液对兔眼眼前节有明显毒性作用,0.50 mol/L锰离子滴眼液的毒性则明显降低,0.25 mol/L锰离子滴眼液对兔眼眼前节无明显的毒性作用.     

蒙脱石滴眼液对小鼠泪膜功能和角膜上皮厚度的影响

目的　研究蒙脱石滴眼液对小鼠泪膜功能和角膜上皮厚度的影响。方法　将24只BALB/C小鼠随机分成A组和B组,每组12只。A组用15 g·L^-1蒙脱石混悬液滴眼,B组用等量PBS滴眼,每天3次。分别在滴眼前和滴眼后1 d、4 d、7 d对2组小鼠进行泪液分泌试验、泪膜破裂时间（break up time,BUT）检测和角膜荧光素（fluorescein,FL）染色评估,滴眼后7 d利用光学相干断层扫描血管造影（optical coherence tomography angiograph,OCTA）进行角膜分区,分别测量2组小鼠不同区域角膜上皮厚度。结果　A组与B组泪液分泌量有差别（F=19.731,P=0.009）,A组较B组泪液分泌量低,泪液分泌破坏显著,且2组泪液分泌量的差别有随着处理时间延长逐渐变大的趋势;滴眼后4 d和7 d,两组泪液分泌量比较,差异均有统计学意义（t=3.847、5.695,P=0.026、0.009）。A组较B组BUT缩短（F=22.432,P=0.001）,泪膜破坏明显,且2组泪膜破坏程度的差别随着处理时间延长而有变大的趋势,滴眼后4 d和7 d,两组BUT比较,差异均有统计学意义（t=5.753、5.695,P=0.024、0.009）。A组较B组角膜FL染色评分增加（F=14.753,P=0.003）,角膜上皮细胞损伤明显,且2组角膜FL染色的差别有随着处理时间延长逐渐变大的趋势,滴眼后4 d和7 d,两组FL评分比较,差异均有统计学意义（t=7.536、9.864,P=0.031、0.012）。滴眼后7 d,与B组相比,A组各区域角膜上皮厚度均变厚,差异均有统计学意义（均为P＜0.05）。结论　蒙脱石滴眼液会破坏小鼠的泪液分泌功能和泪膜稳定性,并损伤小鼠角膜上皮细胞,使角膜上皮变薄。     

Use of collagen shields containing amphotericin B in the treatment of experimental Candida albicans-induced keratomycosis in rabbits.

We evaluated the effect of collagen shields presoaked with amphotericin B on the treatment of experimental Candida albicans-induced keratitis. Treatment results were compared to those of amphotericin B eyedrops instilled hourly. Forty-eight albino rabbits received intrastromal injections of 10(8) C. albicans organisms. Twenty-four hours later, eyes were treated for eight hours each day with hourly instillation of 0.15% amphotericin B drops, hourly instillation of saline drops, or application of a collagen shield presoaked in 0.5% amphotericin B for one hour. The rabbits were killed after one, three, or five days of treatment. Quantitation of fungi in the cornea was achieved by culturing homogenates and counting colony-forming units. Treatment with amphotericin B applied either as hourly instilled drops or absorbed in collagen shields significantly (P less than .05) reduced corneal fungal counts at all time points when compared to saline-treated control eyes. Rabbit eyes treated with amphotericin B-soaked collagen shields had significantly lower fungal counts compared with hourly instilled amphotericin B drops at Days 1 (P = .02) and 3 (P = .04), but not at Day 5. The collagen shields were as effective in reducing the number of colony-forming units as were amphotericin B drops at Day 5. These data suggest that collagen shields soaked in amphotericin B could be a useful and convenient treatment device in keratomycosis such as that caused by C. albicans.     

Neuroprotective effect of Erigeron Breviscapus (vant) Hand -Mazz on NMDA -induced retinal neuron injury in rats

To investigate whether Erigeron Breviscapus (vant) Hand-Mazz (EBHM) has neuroprotective effect against N-methyl-D-aspartate (NMDA)-induced neuron death in retinal ganglion cell layer (RGCL). · METHODS: Sixty healthy SD rats were randomly divided into four groups. 6 animals were normal control group (group A). The others were divided as group B (EBHM group), group C (normal saline+NMDA group) and group D(EBHM + NMDA group), each group had 18 rats. 10nmol NMDA was intravitreally injected to induce partial damage of the neurons in RGCL in the right eyes of Groups C and D. Same volume PBS was intravitreally injected into the left eyes as self-control. Groups B and D were pretreated intraperitoneally with 6g/L EBHM solution at a dose of 150mg/kg body weight/day seven days before and after NMDA treatment. Group C were administrated intraperitoneally with 9g/L normal saline at the same time of EBHM injection. Rats were sacrificed at 4,7,14 day after NMDA treatment. Flat whole retinas were stained with 5g/L cresyl violet and neuron counting in RGCL from both eyes were observed. Each subgroup had 6 rats. · RESULTS: There was no significant difference of neuron counting in RGCL between the right eye and the left eye in group A. There was no significant difference between normal control group and EBHM group either in the right eyes or in the left eyes at 4, 7 and 14 day respectively after intravitreal injection of 10nmol NMDA in group C and group D. (P = 0.636, P =0.193). Neuron counting of RGCL in group C and D was significantly decreased in the NMDA- treated eyes 4, 7 and 14 days after intravitreal injection (P < 0.001). There was no significant difference between self-control eyes group and normal control group. However, neuron counting was significantly higher in the EBHM+NMDA group than normal saline +NMDA group 14 days after intravitreal injection (P = 0.044), but lower than normal control group (P <0.05). · CONCLUSION: EBHM has no effect on neuron counting of RGCL when administered alone in normal rats. The results indicate that EBHM plays a partial protective role in NMDA-induced neuron loss in RGCL in rats.     

Inhibitory effect of tetrandrine eye drops on corneal allograft rejection in rats

To observe the effect of tetrandrine (Tet) eye drops of different concentrations on corneal graft and on allograft rejection in rats. · METHODS: Models of allograft rejection were set up in 64 SD rats and they were then randomly divided into 3, 5, 10g/L tetrandrine eye drops-treated and control groups. At different times postoperatively, neovascularization and inflammation of corneal graft were observed using slit-lamp microscopy, HE staining, light microscopy and microphoto-analysis. · RESULTS: The graft was infiltrated mainly with lymphocytes and mononuclear-macrophages. Corneal neovascularization and inflammation were significantly inhibited in the 5g/L Tet-treated group (P <0.05), compared with control group on day 7, 14, 21, 28 postoperatively. · CONCLUSION: Corneal edema and corneal epithelial bubble appear when the graft is treated with tetrandrine of higher concentration (10g/L), but 5g/L Tet eye drops significantly inhibit corneal allograft rejection in rats without serious side-effects.     

Research on mouse model of grade II corneal alkali burn

AIM: To choose appropriate concentration of sodium hydroxide (NaOH) solution to establish a stable and consistent corneal alkali burn mouse model in grade II. METHODS: The mice (n=60) were randomly divided into four groups and 15 mice each group. Corneal alkali burns were induced by placing circle filter paper soaked with NaOH solutions on the right central cornea for 30s. The concentrations of NaOH solutions of groups A, B, C, and D were 0.1 mol/L, 0.15 mol/L , 0.2 mol/L, and 1.0 mol/L respectively. Then these corneas were irrigated with 20 mL physiological saline (0.9% NaCl). On day 7 postburn, slit lamp microscope was used to observe corneal opacity, corneal epithelial sodium fluorescein staining positive rate, incidence of corneal ulcer and corneal neovascularization, meanwhile pictures of the anterior eyes were taken. Cirrus spectral domain optical coherence tomography was used to scan cornea to observe corneal epithelial defect and corneal ulcer. RESULTS: Corneal opacity scores (
) were not significantly different between the group A and group B (P=0.097). Incidence of corneal ulcer in group B was significantly higher than that in group A (P=0.035). Incidence of corneal ulcer and perforation rate in group B was lower than that in group C. Group C and D had corneal neovascularization, and incidence of corneal neovascularization in group D was significantly higher than that in group C (P=0.000). CONCLUSION: Using 0.15 mol/L NaOH can establish grade II mouse model of corneal alkali burns.     

汉防己甲素滴眼液治疗大鼠角膜移植排斥反应及植片变化

目的:探讨汉防己甲素(Tet)滴眼液治疗实验性角膜移植排斥反应效果及植片变化。方法:建立大鼠角膜移植排斥反应模型,随机分4组:A、B、C、D组为SD-Wistar大鼠行同种异体角膜移植术,SD鼠为受体,Wistar鼠为供体,其中A组为空白对照组,B～D组分别为3,5,10g/L汉防己甲素滴眼液治疗组。术后不同时间裂隙灯显微镜记录及比较各组角膜植片新生血管情况,并观察植片病理学改变。结果:植片内主要为淋巴细胞及巨噬细胞浸润。B、C、D组术后7,14,21,28d时角膜植片水肿、淋巴细胞及巨噬细胞浸润及新生血管明显少于A组(P<0.05)。不同Tet浓度组间比较C组排斥指数最低(P<0.05)。结论:高浓度(10g/L)Tet治疗角膜移植排斥反应时可出现角膜基质水肿及角膜大泡,但5g/L浓度Tet滴眼液可有效抑制角膜移植排斥反应,且无明显毒副作用。     

准分子激光角膜上皮下磨镶术中应用丝裂霉素C预防Haze的早期临床观察

目的:探讨准分子激光角膜上皮下磨镶术中联合应用丝裂霉素C预防术后上皮下浑浊(Haze)的发生。方法:患者42例(84眼)分为A、B两组,A组右眼进行常规LASEK手术,不用丝裂霉素C;B组左眼常规LASEK手术 0.2g/L丝裂霉素C棉片于激光治疗区12～15s,术后随访6mo。结果:A组出现1级Haze18例,2级或以上Haze5例,Haze发生率55%;B组出现1级Haze7例,2级或以上Haze2例,Haze发生率21%,两组Haze发生率差异有统计学意义(P<0.001)。结论:LASEK手术中联合应用0.2g/L丝裂霉素C可降低Haze的发生率同时减轻Haze的程度,但是其更远期的疗效及副反应有待于进一步的观察。     

维生素D3联合rhG-CSF对糖尿病小鼠眼部结构的保护作用

目的:探讨维生素D3(VD3)联合rhG-CSF对实验性糖尿病(diabetes mellitus,DM)小鼠眼部结构损伤的作用。方法:健康C57BL/6小鼠22只,体质量20~25g,随机分为联合治疗实验组、DM对照组,并设健康对照。用20g/L链脲佐菌素(streptozotocin,STZ)ip,制备实验性DM模型,实验组小鼠制模后14d行VD35mg/kg ip,1次/wk;制模后28d行20μg/kg rhG-CSF sc,1次/d,连续注射5d。两组每周进行血糖监测和眼底镜观察。每周各组随机摘取3只眼球,常规病理制片后镜下观察眼球各部分结构,利用病理图像分析系统测量中央角膜、视乳头旁1PD处脉络膜厚度和视网膜神经上皮层的厚度。结果:DM小鼠7d角膜中央出现明显水肿,21d达高峰后逐渐减轻,经联合治疗后小鼠角膜厚度一直呈现减少趋势,水肿情况比DM对照组有明显缓解,接近健康小鼠平均值。DM小鼠7d角膜上皮厚度明显增加,21d达高峰后逐渐下降,到35d后DM对照组角膜上皮厚度持续下降,萎缩明显,联合治疗组的角膜上皮厚度接近正常(P>0.05)。DM小鼠7d脉络膜厚度降低,开始萎缩,逐渐加剧,联合治疗组在28d后脉络膜厚度明显增加,到49d时与正常小鼠无差异,两组DM小鼠的视网膜神经上皮层厚度均呈逐渐下降趋势,联合治疗组的下降趋势略缓和。结论:VD3联合rhG-CSF治疗能有效缓解小鼠DM角膜水肿,改善角膜上皮萎缩,有效缓解并改善脉络膜萎缩,对视网膜神经上皮层萎缩也有一定的保护作用。     

维生素A治疗苯扎氯铵诱导的小鼠干眼的实验研究

目的通过随机对照实验探讨维生素A对苯扎氯铵诱导的小鼠干眼的治疗作用。方法实验研究。选用BALB＆小鼠50只,使用0．25％的苯扎氯铵溶液局部点眼以诱导干眼。在第21天时根据泪膜破裂时间（BUT）、角膜荧光素钠染色、炎症指数等参数选择干眼表现程度相近的小鼠30只（60眼）并随机分为A、B、C三组,每组10只（20眼）。A、B组分别使用5000IU／（g·mD维生素A微乳剂和空白微乳剂滴眼,C组为空白对照组。在治疗的第0、1、3、5、7天检测BUT和角膜上皮荧光素钠染色、眼表炎症程度及基础泪液分泌量。7d治疗结束后取出小鼠眼球,进行HE及过碘酸．希夫（PAS）染色,角蛋白10（K10）免疫荧光标记,以及WesternBlot检测角膜组织中K10表达水平。对数据采用单因素方差分析。结果在药物治疗的第0、1、3、5天各项临床指标差异无统计学意义。治疗第7天时,A、B、C组BUT值分别为（4．20±0．89）s、（3．32±1．01）s和（3．28±0．74）s;其中A组的BUT值较B组和C组长,差异有统计学意义（F=6．825,P=-0．002）。A、B、C组角膜荧光素钠染色评分分别为3．74±1．31、5．47±1．81和5．83±1．54,其中维生素A微乳组较空白微乳组和空白对照组角膜荧光素钠染色分级轻．差异具有统计学意义（F=8．853,P〈0．01）。各组间的角膜炎症指数评分、基础泪液分泌量差异均无统计学意义。组织病理检查示维生素A组与空白微乳组和空白对照组比较,其角膜上皮形态较规整;PAS染色示维生素A组杯状细胞数量更接近正常小鼠。维生素A组的角膜上皮层几乎均不表达K10．而空白微乳组及空白对照组呈阳性表达。Westem Blot检测示维生素A组角膜中的K10水平低于空白微乳组和空白对照组。结论维生素A可以延长苯扎氯铵诱导的干眼小鼠的BUT,降低角膜上皮染色程度,抑制角膜上皮鳞状化生,并能增加结膜杯状细胞数量,有望用于干眼治疗。     

Intracameral amphotericin B injection in the management of deep keratomycosis

PURPOSE: To report the use of intracameral amphotericin B in the management of deep keratomycosis. METHODS: Four patients with deep keratomycosis unresponsive to conventional medical treatment underwent repeated intracameral injections of 5 microg amphotericin B in 0.1 mL 5% dextrose through a paracentesis. Three to 13 intracameral injections were given to each patient over 6 to 36 days. RESULTS: Three of the four patients had complete resolution of the ulcer. The fourth patient perforated and required evisceration. CONCLUSION: Preliminary experience suggests that intracameral injections of amphotericin B may have a role in the management of deep keratomycosis.