晶体穿孔辅酶A治疗房水pH总蛋白前列腺素动态超微实验（二）

兔房水正常ｐＨ７．８６，晶体穿孔，直径１ｍｍ，深３ｍｍ，对照组房水ｐＨ最低６．９，辅酶Ａ治疗组最低７．７。兔房水总蛋白正常值３５．６７ｍｇ／１００ｍｌ，对照组最高值是正常值的８０倍，辅酶Ａ治疗组仅为正常值的３倍。兔房水前列腺素正常值２．２１６ｎｇ／ｍｌ，对照组最高值是正常值的３倍，辅酶Ａ治疗组最高值仅１．６倍，所有数据显示：辅酶Ａ对１ｍｍ直径的晶体伤孔，具有肯定的疗效。     

晶体穿孔辅酶A治疗临床疗效观察

在广泛性动物实验基础上,凡来医院的晶体前囊穿孔,不论伤孔直径大小,伤后多长时间,一律采用辅酶A每公斤体重10u,溶于5%葡萄糖中,每天静滴加球结膜下注射,有效者连治2周,其中晶体前囊伤口直径≤1mm,>0.1mm,伤后24小时内接受辅酶A治疗的116例,168眼晶体前囊伤口愈合、恢复一定程度的透明、保留一定的调节力与视力.随访3～25年,远期疗效稳定,为临床治疗晶体小伤口探明一种方法.     

外伤性晶体脱位（附27例报告）

晶体脱位大多数为外伤引起,孙信孚等报告23例晶体脱位,其中外伤引起者18例,约占75％。现将我院1980～1987年收治的外伤性晶体脱位27例报告如下:     

眼前段碱性化学伤的后期治疗（二）

(四)手术原则的选择和预后判定1.对后期碱性伤轻度病例的手术选择:(1)对仅有部分结膜纤维化的病人,可以切除部分异常的结膜及切除和灼烙局部肥厚增生的Tenon 囊组织,如有少量的角膜血管膜性组织一并切除,同时取健眼1/4～1/2象限的角膜缘干细胞,单纯移植到球结膜缺损的角膜缘部位.     

眼球破裂伤（附10例报告）

本文提出了眼球破裂伤的定义及分类分级方法,讨论了眼球破裂伤的处理方法及预后。对10例眼球破裂伤患者的临床资料进行了分析。     

69例（75眼）眼球穿孔伤治疗总结

我院自1990年4月至1995年3月共收治眼球穿孔伤69例（75眼），采取显微清创缝合。玻璃体切除等治疗，获得较满意的效果。现总结报告如下。临床资料一般情况：本组69例（75眼），占同期住院眼外伤患者411例的16．7％。其中，严重眼球破裂伤27例。男58例（84％），女11例（16％）。年龄1岁2月一63岁（平均28．30岁），21一50岁44例（64％）。右眼34例，左眼29例，双眼6眼。工人29例，农民20例，士兵13例，儿童7例。2．眼部损伤：角膜穿孔伤28眼（37．33%），巩膜穿孔伤4眼（5．33％），角巩膜穿孔伤29眼（38．67％），隐匿性巩膜裂伤6眼（8．0…     

松弛性视网膜切开治疗穿孔伤性视网膜脱离

目的 探讨松弛性视网膜切开对穿孔性牵引性视网膜脱离(perforating traction retinal detachment,PTRD)的治疗价值和效果。 方法 对1998～2001年本院住院行松弛性视网膜切开的21例PTRD患者作回顾性分析。 结果 出院时视网膜解剖均复位，数指(counting finger,CF)以上视力12例占57%，最好视力为0.05。18例患者随访时间6～24个月，解剖复位14例占77.8%。 结论 为了提高PTRD的解剖复位率，松弛性视网膜切开是有效方法之一。尤其适用于伴有视网膜嵌顿、前部增生性玻璃体视网膜病(anterior prolif erative vitreoretinopathy, aPVR)、机化条索的PTRD患者。 （中华眼底病杂志，2003，19：5-7）     

Clinic study on silicone hydrogel contact lenses used as bandage contact lenses after LASEK surgery

AIM: To compare the clinical performance of two types of silicon hydrogel contact lenses used as bandage lenses after LASEK surgery. METHODS: A prospective, double-masked study was conducted on 42 eyes of 21 patients who received binocular LASEK surgeries. The interocular difference in spherical equivalent power was less than -1.50D. Patients were randomly assigned to wear Galyfilcon A (Lens A) bandage contact lens in one eye and Balafilcon A (Lens B) in the fellow eye after the surgery. The responses to a subjective questionnaire on comfort of wearing, corneal epithelial status, conjunctival hyperemia, limbal neovascularization, lens fitting and contact lens debris were assessed 1 and 5 days postoperatively. Corneal endothelium was assessed before and 5 days after the surgery upon bandage lens removal. RESULTS: There was no difference between the two groups in terms of conjunctival hyperemia, limbal neovascularization, contact lens fitting, corneal epithelial status, corneal endothelium cell density (CD) and endothelium cell size (CS) at any postoperative visit. Complaints of discomfort, including foreign body sensation, pain and intolerance were statistically more among Lens B wearers at any postoperative visit (P<0.05). Lens B appeared to attract much more debris than Lens A at the 5-day post-operative follow-up visit (P<0.01). CONCLUSION: The two types of silicon hydrogel lenses investigated in this study demonstrated similar clinical performance in terms of corneal responses and lens fitting. However, Lens A showed a better performance in terms of comfort of wearing and deposit resistance.     

The critical initial comfort of soft contact lenses

Background : The initial comfort of soft lenses is not as important when prospective patients are highly motivated to be fitted with contact lenses but can be critical in the case of apprehensive patients, especially in the case of proactive demonstration/diagnostic fittings. Failure to eliminate initial discomfort may cause apprehensive prospective contact lens wearers to decide not to proceed with a fitting. However, in all cases of clinical and research fittings, initial comfort is critical to fit evaluation, when abnormal lid tonus and lacrimation can invalidate assessment. Method : A panel of experienced contact lens practitioners evaluated three methods of lens settling that could be employed to improve soft lens comfort immediately after lens insertion. Results : A total of 1,234 lens insertion experiences were examined by the panel and it was found that soft lens settling procedures were indicated in 46 per cent of cases. The settling procedure was found to be successful in 86 per cent of cases. The temporal lens displacement method of soft lens settling was found to be easier to use (p < 0.001) and the lens displacement away from the perceived location of irritation method was found to be the most successful (p < 0.05). Conclusion : In cases of mild to moderate discomfort, the displacement away from irritation method had a better chance of establishing comfort and was the most appropriate method to teach patients to use when inserting lenses for themselves. This study also indicates that, under certain conditions, the location of corneal sensation may be much better than previously found.     

Tecnis非球面折叠人工晶状体植入术的临床应用研究

目的:探讨老年性白内障超声乳化联合Tecnis非球面折叠人工晶状体植入的临床效果。方法:回顾性分析了205例289眼Tecnis非球面折叠人工晶状体在超声乳化白内障吸除加人工晶状体植入术中的应用。检查患者术后的视力、人工晶状体的位置及手术并发症的发生情况。随访时间3～9mo。结果:术后3mo,平均裸眼远视力为4.58±0.12,最佳矫正远视力为5.12±0.16。术后晶状体后囊膜混浊22眼。结论:Tecnis折叠人工晶状体植入术可使患者恢复良好的裸眼远视力,并且减少眩光,提高夜间视力,改善人工晶状体眼的视觉质量。     

Acri．Smart非球面人工晶状体与球面人工晶状体临床应用的对比研究

目的比较白内障超声乳化吸除植入前表面光学改良的非球面人工晶状体与传统球面人工晶状体对植入眼对比敏感度和视觉质量的影响。方法选择我院2006年4月至2007年8月年龄相关性白内障患者117例（117只眼），随机分为2组，行白内障超声乳化摘除术后，分别植入非球面人工晶状体（Acri．smart 36A）和球面人工晶状体（Aeri．smart 46S）。术后3个月分别检测最佳矫正视力、眩光和无眩光条件下的对比敏感度以及不同瞳孔直径条件下的全眼球像差。结果两组的最佳矫正视力比较，差异无统计学意义（P〉0．05）。植入Acri．smart 36A型人工晶状体眼的对比敏感度在空间频率3、6、12、18c／d时无眩光、有眩光条件下均明显大于植入Acri．smart 46S型人工晶状体眼（P〈0．01）。在全眼球像差方面植入Acri．smart 36A型人工晶状体眼在不同瞳孔直径条件下均明显低于植入Acri．smart 46S型人工晶状体眼（P〈0．01）。结论与球面人工晶状体比较，非球面人工晶状体可降低像差，提高视觉对比敏感度，改善白内障患者术后的视觉质量。     

6种人工晶状体调制传递函数的研究

目的：研究人工晶状体的最佳光学结构，为人工晶状体的设计提供理论依据。方法：以Gullstrand Ⅰ号模型眼为基础，计算6种不同光学结构人工晶状体植入后的调制传递函数(MTF)。结果：6种不同光学结构人工晶状体植入后的MTF有明显差异。结论：一些特定结构的人工晶状体具有较好的成像质量，其中以双凸结构为最佳。     

The alpha and gamma crystallin content in aqueous humor of eyes with clear lenses and with cataracts.

Specific radioimmunoassays were used to measure the concentration of α- and γ-crystallins in human aqueous humor. It was demonstrated that these crystallins are normally present in aqueous humor from healthy eyes. The crystallin concentration did not seem to increase with age. The normal upper limit for the α-crystallin concentration was found to be 10 ng/ml and for the γ-crystallin concentration 60 ng/ml. In the aqueous humor of eyes with cortical cataract the concentration of both crystallins was increased. With nuclear cataracts the α-crystallin concentration was increased while the γ-crystallin concentration was decreased. Experiments in rabbits showed that the crystallins in the aqueous humor left the anterior chamber at the same rate as the aqueous bulk flow. The demonstration of lens crystallins in the aqueous humor is compatible with the hypothesis that they leak from the lens.     

Protein-bound and free UV filters in cataract lenses. The concentration of UV filters is much lower than in normal lenses

In human cataract lenses the UV filters, 3-hydroxykynurenine glucoside (3OHKG) and kynurenine (Kyn) were found to be covalently bound to proteins and the levels in the nucleus were much higher than in the cortex. The levels of the bound UV filters in cataract nuclei were much lower than those in age-matched normal lenses. 3-Hydroxykynurenine could not be detected in cataract lenses. As with normal lenses, protein-bound 3OHKG in cataract lenses was found at the highest levels followed by Kyn. Free UV filter concentrations were also markedly reduced in cataract lenses. This feature may well contribute to the lower protein-bound levels; however, there was no clear relationship between free and bound UV filter contents when individual lenses were examined. We propose that since cysteine is a major site for UV filter binding, the well-documented oxidation of protein sulfhydryl groups during the progression of nuclear cataract may account, in part, for the pronounced decrease in bound UV filters in cataract lenses.     

双眼多焦点人工晶状体植入术后远期视功能的研究

目的探讨双眼植入多焦点人工晶状体（multifocal immocular lenses，MIOL）后的远期视功能的变化规律。方法对16例32眼植入MIOL的白内障患者和13例26眼双眼植入单焦点人工晶状体（mondoeal intraocular lens，SIOL）的白内障患者，在手术后〉6个月时进行视力、对比敏感度及焦点深度的检查，同时进行统计学分析。结果MIOL眼远期近视力和矫正远视度数下的近视力≥4．7的眼数为28眼，明显好于SIOL眼（4眼）；两组的对比敏感度值均位于正常值范围；MIOL眼的焦点深度为（4．93±1．10）D，明显大于SIOL眼[（3．62±1．13）D]。结论双眼植入MIOL在术后远期可以获得满意的非矫正近视力和矫正远视力下的近视力以及中间距离视力，对比敏感度恢复到正常值范围。     

透气硬性角膜接触镜矫治先天性小眼球屈光不正

目的 分析先天性小眼球的屈光参数特点,观察透气硬性角膜接触镜(rigid gas-permeable contactlens,RGP)矫治先天性小眼球的屈光不正的效果,并探讨验配注意事项.方法 对视光门诊确诊先天性小眼球的患者7例14只眼,测量眼轴长度、前房深度和角膜曲率,检影验光和主觉验光,并记录裸眼视力(uncorrected visual acuity,UCVA)和框架眼镜的最佳矫正视力(best spectacle corrected visual acuity,SP-VA),配戴特殊设计的试戴镜,荧光素染色评价配适状态,片上验光追加度数,订制RGP,检查戴RGP的最佳矫正视力(best RGP-corrected visual acuity,RGP-VA)、配适情况,并随访观察.结果 14只先天性小眼球的平均角膜曲率半径(6.93±0.27)mm,前房深度(2.46±0.23)mm,眼轴长度(15.67±0.59)mm,验光度数(+17.29±3.52)D,RGP的平均基弧(6.92±0.19)mm,屈光度(+21.91±4.66)D.全部患者的RGP-VA比UCVA都有显著提高.RGP-VA与SP-VA相当.平均随访时间为20个月(7～29月),镜片配适良好,患者均能坚持全天配戴,未发生与角膜接触镜相关的并发症.结论 先天性小眼球的屈光参数显著不同于正常眼球,角膜异常弯曲、前房浅、眼轴短.屈光呈超高度远视,均伴有弱视.RGP是有效的光学矫正手段.为确保订制的RGP参数准确,需要专用的RGP试戴镜.