Infectious scleritis: Report of four cases

While systemic autoimmune diseases are the main possibilities in the differential diagnosis of scleritis, other less common etiologies such as infections must also be considered. The authors report four cases of infectious scleritis to review predisposing factors, clinical characteristics, methods of diagnostic approach, and response to therapy. Two patients had primary scleritis and two patients had secondary scleritis following extension of primary corneal infection (corneoscleritis). Diagnoses included three local infections (one each withStaphylococcus. Acanthamoeba, and herpes simplex) and one systemic infection (Lyme disease). Stains, cultures, or immunologic studies from scleral, conjunctival, and/or corneal tissues, and serologic tests were used to make the diagnosis. Medical therapy, including antimicrobial agents, was instituted in all patients, and surgical procedures were additionally required in two patients (scleral grafting in one and two penetrating keratoplasties in another); the patient who required two penetrating keratoplasties had corneoscleritis and underwent eventual enucleation. Infectious agents should be considered in the differential diagnosis of scleritis.     

环扎加压术治疗大裂孔视网膜脱离

目的：探讨环扎加压术对大裂孔视网膜脱离的疗效。方法：回顾分析1998年12月至2001年12月进行环扎加压术的大裂孔视网膜脱离病例33例33眼。结果：环扎加压术1次手术成功率78．79％，未愈7例中3例再行环扎加压术治愈，总治愈率达87．88％。结论：环扎加压术对于单纯型大裂孔视网膜脱离实为一种有效的治疗方法。眼内气体填充是治疗有翻转后瓣的大裂孔网脱的有效手段。     

Intravitreal injection of 0.3 ml of SF6 gas for persistent subfoveal fluid after scleral buckling for rhegmatogenous retinal detachment

Purpose  To determine the efficacy of intravitreal injection of sulphur hexafluoride (SF6) gas for reducing persistent subfoveal fluid after scleral buckling surgery for macula-off rhegmatogenous retinal detachments. Methods  We injected 0.3 ml of SF6 gas into the vitreous cavity of two eyes of two patients with persistent macular retinal detachment 3 and 5 months after successful scleral buckling. Optical coherence tomography was performed before and after surgery. Results  Subfoveal fluid was displaced peripheral to the fovea immediately after gas injection and the fluid was absorbed gradually in both eyes. Conclusions  Persistent subfoveal fluid after scleral buckling may be treated with intravitreal SF6 gas injection. The authors have no proprietary interest in any aspect of this report     

青光眼双滤过手术的临床报告

目的　观察双滤过手术治疗青光眼的疗效。方法　选择 130只眼晚期、绝对期原发性青光眼随机分为两组 ,每组 6 5只眼。 组行双滤过手术 , 组行小梁切除术。结果　术后随访观察 5～ 2 1月 ,平均 (14 .34±4 .35 )个月。 组眼压≤ 2 1m m Hg(1m m Hg=0 .133k Pa) 6 2只眼 (95 .4 % ) ,其中需局部用药 6只眼 (9.2 % ) ,术后平均眼压为 (19.37± 2 .92 ) m m Hg,较术前下降 (33.2 6± 12 .33) m m Hg; 组眼压≤ 2 1mm Hg5 5只眼 (84 .6 % ) ,其中需局部用药 12只眼 (18.5 % ) ,术后平均眼压 (2 2 .6 2± 5 .6 8) m m Hg,较术前下降 (2 7.83± 8.81) m m Hg。两组手术成功率差异有显著性 (P <0 .0 5 )。并发症 : 组 9只眼 (13.8% ) ,其中浅前房 6只眼 (9.2 % ) ,前房积血 3只眼 (4 .6 % ) ; 组 2 2只眼 (33.8% ) ,其中浅前房 15只眼 (2 3.1% ) ,恶性青光眼 2只眼 (3.1% ) ,脉络膜脱离 2只眼 (3.1% ) ,前房积血 3只眼 (4 .6 % )。两组并发症的发生率差异有显著性 (P <0 .0 5 )。结论　青光眼双滤过手术效果好 ,并发症少 ,是治疗青光眼安全有效的手术方法     

Scleral show

Scleral show is an anatomical condition in which the sclera area is visibly exaggerated due to constitutional, evolutive, or endocrine etiology. It can also occur because of iatrogenies, and is considered one of the most complex blepharoplasty complications. Its evolution and poor response to treatment are questionable. The defect is not always linked to an ectropion, and the basic differences between the two are explained. During blepharoplasties, in order to avoid iatrogenic scleral show, among other complications, one should take special precautions with the quantity and the exact location of the tarsal portion of orbicularis oculi muscle to be resected.     

Human ocular counterroll: assessment of static and dynamic properties from electromagnetic scleral coil recordings

Summary Static and dynamic components of ocular counterroll as well as cyclorotatory optokinetic nystagmus were measured with a scleral search coil technique. Static counterroll compensated for about 10% of head roll when the head was tilted to steady positions up to 20 deg from the upright position. The dynamic component of counterroll, which occurs only while the head is moving, is much larger. It consists of smooth compensatory cyclorotation opposite to the head rotation, interrupted frequently by saccades moving in the same direction as the head. During voluntary sinusoidal head roll, cyclorotation compensated from 40% to more than 70% of the head motion. In the range 0.16 to 1.33 Hz, gain increased with frequency and with the amount of visual information. The lowest values were found in darkness. The gain increased in the presence of a visual fixation point and a further rise was induced by a structured visual pattern. Resetting saccades were made more frequently in the dark than in the light. These saccades were somewhat slower than typical horizontal saccades. Cyclorotatory optokinetic nystagmus could be induced by a patterned disk rotating around the visual axis. It was highly variable even within a same subject and had in general a very low gain (mean value about 0.03 for stimulus velocities up to 30 deg/s). It is concluded that cyclorotational slip velocity on the retina is considerably reduced by counterroll during roll of the head, although the residual cyclorotation after the head has reached a steady position is very small.     

视网膜脱离巩膜环扎术后眼前节结构的初步观察

目的 观察巩膜环扎术后眼前节结构的变化,探讨术后继发性闭角型青光眼的发病机制。方法 应用超声生物显微镜检查３０例（３３只眼）孔源视网膜脱离患者术前、后３－７天的活体奶前节形态结构,并分别进行定量测定,检查结果经统计学分析两组间配对ｔｓｗｃｗ,以Ｐ〈０．０５作为差异有显著性标准。结果 术前１只眼存在裂隙样睫状体脱离。术后１１只眼（３３．３％）发生睫状体脱离,睫状体增厚水肿;术前睫状体厚度为（８２１．     

双层逆向返转式巩膜瓣小梁切除术的临床观察

目的 为防止小梁切除术后巩膜瓣粘连,保持滤道通畅.方法60例青光眼术中采用双层逆向返转式巩膜瓣,相当于瓣下加一个支撑垫.结果 术后随访1～4年,平均1年10月,视力稳定或有不同程度的提高.术后平均眼压16.72±3.82mmHg,C值0.25±0.008.结论 该术式对青光眼术后眼压控制,C值改善效果显著.     

两种不同放液方法在环扎加压术中使用的比较

目的 比较2种不同的放液方法在环扎加压术中使用后对于手术成功率以及手术并发症的影响。方法 回顾性分析同一手术者在2002年1月至2003年3月间所进行的80眼环扎加压手术，其中38眼为使用巩膜切开法冷针放液(2002年1月～10月)，42眼为冷针直接穿刺放液(2002年11月～2003年3月)，比较不同的放液方法对于手术成功率和手术中并发症出现的比率的影响。结果 两种不同的手术方法，手术成功率和并发症出现率差异无显著性。结论 冷针直接穿刺放液法是一种安全有效的放出视网膜下液(SRF)的方法。     

巩膜扣带手术后视物变形的原因分析

目的 探讨巩膜扣带手术后视网膜复位患者视物变形的原因。 方法 对巩膜扣带手术后视网膜成功复位的79例79只眼行临床观察，手术后2周、2、6个月及1年时行Amsler表检查，分为视物变形组和无视物变形组；同时行检眼镜、荧光素眼底血管造影（FFA）和光相干断层扫描（OCT）检查。并对手术后2周视物变形10只眼和正常人10只眼行视盘-中心凹角测量。 结果 79只眼手术后2周51只眼（64.56%）视物变形，视物变形眼和正常眼的视盘-中心凹角无明显差异(P=0.880)。79只眼中44只眼(视物变形组35只眼，无视物变形组9只眼) 手术后2周时检查OCT和FFA ，视物变形组OCT发现黄斑结构异常31只眼(88.57%)，有7种类型，主要为神经上皮层脱离（74.29%）；FFA发现黄斑结构异常6只眼(17.14%)，也主要为神经上皮层脱离(66.67%)。无视物变形组OCT发现神经上皮层脱离和色素上皮层脱离各1只眼，FFA未见异常。手术后2、6个月、1年时随访，各有18只眼（18/28）、5只眼(5/9)和3只眼(3/7)异常黄斑结构好转，视物变形减轻或消失；而黄斑前膜形成后未见明显变化，视物变形严重而持续。 结论 巩膜扣带手术后视物变形的主要原因是黄斑结构异常，手术后早期和晚期视物变形的主要原因分别是神经上皮层脱离和黄斑前膜。（中华眼底病杂志，2004，20：94-97）