严重眼外伤的玻璃体视网膜手术方法探讨

目的 探讨玻璃体视网膜手术治疗严重眼外伤的效果.方法 玻璃体切除联合白内障人工晶状体植入术、服内异物摘出术、视网膜脱离复位术等治疗严重眼外伤34例(34眼).结果 术后视力较术前提高者26眼(76.47%),术后视力不变者6眼(17.64%),术后视力下降者2眼(5.89%);眼内异物14眼(41.17%)均一次成功摘出,视网膜脱离者13眼(38.23%),手术后成功复位11眼(84.62%).结论 严格选择手术适应证及手术时机,掌握熟练的手术操作技巧,则玻璃体视网膜手术可以挽救大多数严重外伤眼,并能获得一定的视功能.     

玻璃体切除手术治疗复杂眼外伤

目的:探讨玻璃体切除术在治疗复杂眼外伤中的应用价值。方法:对75例77眼复杂眼外伤的玻璃体切除手术进行临床分析。结果:眼内非磁性异物18眼,摘出率100%。玻璃体积血26眼,复杂视网膜脱离23眼,复位率85%,化脓性眼内炎5眼,炎症均控制。继发性青光眼5眼,眼压均控制在正常范围内。77眼中术后视力提高者63眼(85%),视力不变或下降者14眼(15%)。结论:玻璃体切除手术是目前最理想的治疗复杂眼外伤的方法。     

复杂性眼外伤玻璃体切除手术时机的选择

目的探讨玻璃体切除术治疗复杂性眼外伤手术时机和治疗效果。方法应用玻璃体切除术治疗复杂性眼外伤94例(95眼),总结临床资料,对手术时机和治疗效果进行分析、评价。结果94例(95眼)术后视力提高78眼(82.11%),视力不变15眼(15.79%),视力下降2眼(2.11%)。外伤后11~20天行玻璃体切除手术治疗的55眼,功能治愈48眼(87.27%),解剖治愈7眼(12.73%),没有未愈眼。无感染和交感性眼炎的发生。结论眼外伤后14天是选择玻璃体切除手术的最佳时机。     

早期玻璃体切除联合硅油填充术治疗开放性眼外伤合并视网膜脱离的疗效观察

目的探讨早期玻璃体切除联合硅油填充术治疗开放性眼外伤合并视网膜脱离的临床疗效。方法回顾性分析我科治疗的26例(26只眼)开放性眼外伤合并视网膜脱离的临床资料,所有患者均于伤后72 h内行常规三通道玻璃体切除联合硅油填充术,根据病情联合其它术式。观察术后视网膜状态、视功能及并发症。结果术后随访末次最佳矫正视力0.12～0.3者3例(11.54%),指数～0.1者16例(61.54%),光感～手动者5例(19.23%),无光感者2例(7.69%)。所有患者第1次玻璃体切除术后随访复发性视网膜脱离4例(15.38%),再次手术治疗后视网膜复位。眼球萎缩1例(3.85%)。术后无眼内炎及严重增生性玻璃体视网膜病变(PVR)并发症发生。结论早期玻璃体切除联合硅油填充术治疗开放性眼外伤合并视网膜脱离可有效的控制眼球萎缩,复位视网膜,挽救一定的视力,且术后并发症少。     

玻璃体切割治疗玻璃体积血的临床疗效观察

目的:探讨玻璃体切割治疗玻璃体积血的临床疗效。方法:对72例75眼玻璃体积血患者采用玻璃体切割手术治疗,术中根据具体病情联合单纯白内障摘除或白内障摘除联合人工晶状体植入术、眼内异物取出、膜剥离、水下透热、眼内光凝或/和巩膜外冷凝及眼内注气或硅油充填。结果:选取75眼中外伤性玻璃体积血(穿孔性眼外伤19眼,眼球钝挫伤8眼)27眼,视网膜静脉阻塞15眼,增殖期糖尿病视网膜病变12眼,Eales病9眼,视网膜裂孔合并玻璃体积血9眼,年龄相关性黄斑病变3眼。术后随访6～48(平均18±5.6)mo,75眼中72眼视力有不同程度的提高,>0.05者65眼(87%),>0.2者54眼(72%),>0.5者23眼(31%),术后视力没有提高3眼(4%),术后视力与术前相比差异具有统计学意义(P<0.05)。结论:严重的眼外伤合并玻璃体积血、大量玻璃体积血药物治疗不吸收,反复发生的玻璃体积血和B超检查发现视网膜脱离者应及时行玻璃体切割术以改善和保护视功能。     

严重眼外伤的玻璃体手术治疗

目的探讨玻璃体手术治疗严重眼外伤的效果。方法严重眼外伤35例(35眼),行玻璃体切除术和眼内异物摘出术,联合角巩膜缝合、晶状体切除、眼内激光光凝、巩膜外冷凝以及C3F8或硅油填充术,并根据年龄、眼部外伤情况及术前炎症反应,行人工晶状体Ⅰ期植入或Ⅱ期植入术。随访3～6月。结果术中16例眼内异物均成功摘出,视网膜脱离22眼,其中19眼复位。术后视力提高22眼,视力不变10眼,视力下降3眼。结论玻璃体切除术能有效治疗严重眼外伤,能最大限度挽救患者的视力和眼球。     

前玻璃体切除手术治疗严重开放性眼外伤

目的观察前玻璃体切除手术治疗严重开放性眼外伤的临床效果。方法对7例(7眼)严重的开放性眼球损伤者采用或联合前玻璃体切除术处理眼前段紊乱。结果术后视力明显提高6眼,脱盲3眼(0.6、1.0、0.4)脱残3眼(0.08、0.15、0.15)。3眼顺利植入后房型人工晶状体。结论采用前玻璃体切除术使严重开放性眼外伤者眼前段重建,恢复屈光间质透明性,以挽救视力及保存眼球。     

严重眼外伤一期玻璃体切除术的临床研究

目的 探讨严重眼外伤一期玻璃体切除术的疗效.方法 2009年6月至2011年6月,采用一期清创缝合联合玻璃体切除术治疗并随访的严重眼外伤23例(23眼),均单眼受伤,男17例,女6例,年龄在6 ～56岁,平均(37.26±5.65)岁.结果 术后随访3～36个月,平均(18.24±7.41)月,术前视力为无光感者3例(13.1％),光感～手动者20例(87.0％),术后末次随访无光感者1例(4.3％),光感～手动者6例(26.1％),指数～0.1者14例(60.9％),0.12～0.3者2例(8.7％).功能治愈11例(47.8％),解剖治愈8例(34.8％),未愈4例(17.4％).术后复发性视网膜脱离4例(17.4％),眼球摘除1例(4.3％).结论 严重眼外伤可采用一期清创缝合联合玻璃体切除术挽救视力,保全眼球.组织损伤严重,术后增生性玻璃体视网膜病变形成,是影响疗效的主要因素.     

累及后节开放性眼外伤二期微创玻璃体手术时机临床观察

目的探讨微创玻璃体手术治疗累及后节开放性眼外伤的疗效以及玻璃体手术的时机。方法采用随机对照研究,对经微创玻璃体手术治疗严重眼外伤进行回顾性分析。将36例(36只眼)复杂性开放性眼球伤患者分为早期手术组16例(16只眼)和晚期手术组20例(20只眼),所有的患者均采用一期眼球清创缝合术和二期玻璃体切除手术治疗。早期手术组玻璃体切除术在外伤1周内进行,晚期手术组玻璃体切除术在外伤10~14 d后施行,术后随访4~6个月,观察术后视力及术后并发症。结果手术成功29只眼(80.6%)其中脱盲17只眼(47.2%)(最佳矫正视力≥0.05),失败7只眼(19.4%)。早期手术组术中注入硅油者14只眼(87.5%),晚期手术组术中注入硅油者17只眼(85.0%),两组无统计学意义(χ~2=0.046,P>0.1)。随访期末早期手术组脱盲率68.8%(11只眼),晚期手术组脱盲率30.0%(6只眼),差异无统计学意义(χ~2=1.89,P>0.05)。结论微创玻璃体手术治疗复杂性开放性眼外伤,手术时间短,并发症少,大部分视网膜能解剖复位。为节约患者就医成本,缩短就医时间,对于累及后节开放性眼外伤患者,建议外伤后1周内采用二期微创玻璃体手术。     

玻璃体切除术治疗严重眼外伤

目的探讨玻璃体手术在治疗严重眼外伤中的应用。方法对52例（52眼）严重眼外伤施玻璃体手术进行治疗。结果术后视力较术前提高者37例。28例眼内异物均成功摘出。视网膜脱离25眼有21眼复位。结论玻璃体切除术有效治疗严重眼外伤，掌握手术适应症和时机，能最大限度挽救视力和眼球。     

Strabisme Alternant - Etude clinique - traitement

The author defines motor and sensory alternation: the term alternation should not be used in isolation, it should always be accompanied by the name of the parameter concerned. Sensory alternation is always found together with motor alternation but the reverse is not true.The examining criteria for a diagnosis of sensory alternation are given, sensory alternation must not be confused with alternating inhibition. Working from clinical observations of cases of motor alternating strabismus, the author selects 2 types of binocular sensory relations which allow one to differentiate between:- cases of primary alternating strabismus- cases of secondary alternating strabismusThese forms will develop in different ways; in both cases a cure is possible providing that the right treatment is prescribed and once prescribed carefully followed, etc. It is always a case of serious forms of strabismus whose developmental period is spread over several years.According to the authors, the frequency of cases of true primary strabismus is from 1–3%, the frequency of cases of secondary alternating strabismus varies according to the type of therapy practised on cases of monocular strabismus with amblyopia. These latter will become cases of alternating strabismus under the influence of certain types of therapy carried out over several years (penalization, rocking, alternated occlusion, etc...).Experimental data on kittens confirm clinical data; kittens placed in abnormal environments during the sensitive period will show modification in the distribution of cortical cells and the absence of binocular cells (either because the excitation of the two eyes was not simultaneous, or not identical: artificial strabismus, occlusion, opaque glasses). This disturbances become irreversible after a certain period of exposure (a function of age, length of exposure, etc...).It is thus necessary to bear in mind: 1) the iatrogenic risks of certain orthoptic treatments, 2) the necessity for a binocular form of treatment as soon as possible, as once a certain stage is passed, cortical plasticity diminishes and the elaboration of normal binocular relations becomes impossible.

---

     

Current Thoughts on the Aetiology of Ocular Changes during Contact Lens Wear

ABSTRACT: Contact lenses are known to produce changes to the ocular tissues, and this review attempts to give a comprehensive assemblage of the knowledge on the aetiology of such changes. To achieve this result, the changes are categorized by structure and function, and discussed according to the temporal nature of occurrence where appropriate. Although assessment of the importance of a particular tissue change is difficult, this overview enables some degree of judgement to be made on the aetiology of the major side-effects of contact lens wear. This gives a basis on which to modify aspects of contact lens wear to ultimately increase the success rate.     

The detection of motion in chromatic stimuli: first-order and second-order spatial structure

This study provides evidence for the existence of a low-level chromatic motion mechanism and further elucidates the conditions under which its operation becomes measurable in an experimental stimulus. Observers discriminated the direction of motion of amplitude modulated (AM) gratings that were defined by luminance or chromatic variation and masked with spatiotemporally broadband luminance or chromatic noise. The size and retinal location of the stimuli were varied and the effects of broadband noise and grating masks were both compared with the cohort of stimuli. Some significant disparities in the published literature were well explained by the results. In conclusion, evidence for a chromatically sensitive motion mechanism that evades the, detrimental effects of a luminance mask was found only at the fovea and only when the stimulus was small and centrally placed.     

Local chemotherapeutic agents for the treatment of ocular malignancies

We critically analyze available peer-reviewed literature, including clinical trials and case reports, on local ocular cancer treatments. Recent innovations in many areas of ocular oncology have introduced promising new therapies, but, for the most part, the optimal treatment of ocular malignancies remains elusive.