开角型与闭角型青光眼色觉异常的对比研究

采用FM100－色彩有试验，对开角型与闭角型青光眼色觉损害的情况进行了对比观察，结果发现，两类青光眼色彩分辨力的损害，无论在波长区域或程度上，均无明显差异，认为眼压升高是引起色觉异常的始发因素，据此可以对两类青光眼色觉损害的相似性作出较为满意的解释。     

External Trabeculotomy for Developmental Glaucoma

We have used external trabeculotomy in the treatment of developmental glaucoma for the past ten years. There were 57 operations involving 47 eyes in 29 individuals. The procedure was more successful in congenital than in adolescent glaucoma, and although late failure does occur with the latter, it appears to be uncommon with the former.     

眼球加压试验对青光眼的诊断价值

Blaxter于1955年做眼球加压试验(压出率),认为对诊断青光眼有一定的价值。作者为证实本试验的临床价值,对正常人50例100眼,青光眼127例173眼,除做压出率外并加做容积差和代偿值。结果正常眼中仅2眼可疑阳性,青光眼绝对期阳性率最高,单性青光眼次之,青光眼术后阳性率最低。本法简便易行,阳性率高,并可提示青光眼是否需要手术及术后房水流畅情况。对单性青光眼早期诊断及预示治疗是否稳定有一定的价值。     

原发性青光眼病人的眼A超测量

用美国ＪＥＤＭＥＤ公司生产的ＤＧＨ４０００型眼用Ａ超测量仪对１０２例原发性青光眼患者及４４例正常人的眼轴长度、前房中央深度、晶体厚度进行了测量。急性闭角型青光眼（急闭青）患者以上测量值（ｘ）分别为２２．２５ｍｍ，２．４２ｍｍ，５．０３ｍｍ；慢性闭角型青光眼（慢闭青）患者分别为２２．２８ｍｍ，２．５７ｍｍ，４．８７ｍｍ；慢性单纯型青光眼（慢单青）患者分别为２３．５９ｍｍ，３．４６ｍｍ，４．１０ｍｍ；正常人分别为２３．２２ｍｍ，３．４０ｍｍ，３．９８ｍｍ。同时计算了前房中央深度与眼轴长度比、晶体厚度与眼轴长度比、前房中央深度与晶体厚度比。发现急闭青与慢闭青患者的以上测量数值及相应比值与正常人之间差异有显著性（ｒ＜０．０１），而慢性单纯型青光眼患者与正常人比差异无显著性（Ｐ＞０．０５）。提示解剖因素在闭角型青光眼的发病原因中起主要作用，可建立自己实验的正常人和青光眼病人眼Ａ超测量的标准值，对提高青光眼的诊断水平有重要价值。     

Endothelial damage from retrocorneal mode-locked neodymium:YAG laser pulses in monkeys

Laser pulses were focused 0.85 to 1.60 mm from the rhesus monkey corneal endothelium using a mode-locked laser at 3.3 and 4.5 mJ. Sixteen slightly off-axis pulses were applied with no contact lens on the eye. Corneal damage was studied clinically and by scanning electron microscopy. The retrocorneal distance for a 50% incidence of endothelial damage (LD 50 = lesion distance, 50%) for 3.3 mJ mode-locked pulses was found to be 1.60 mm. All mode-locked pulses of 4.5 mJ focused 0.85 to 1.60 mJ from the endothelium caused damage. In comparison, Q-switched pulses of 12 mJ or less are not likely to damage the cornea if focused more than 0.75 mm from the endothelium. The severe, early effect of mode-locked pulses is edema of endothelial cells in a 0.2- to 0.3-mm diameter circular zone surrounding a 0.1-mm diameter denuded zone with a small central break of Descemet's membrane. By two months, mild and moderate lesions heal with little or no distortion of the endothelial mosaic. Irregular enlargement of endothelial cells surrounding and covering the previously denuded area of severe lesions is caused by both mode-locked and Q-switched treatment. In no case was there clinically significant, persistent damage in the healed monkey corneas.     

A method for measuring neuroretinal rim area

A practical method for measuring the neuroretinal rim area (NRA) of the optic nervehead is described. Sequential stereo photographs are taken on 35 mm colour transparencies using a Zeiss fundus camera with Allen stereoseparator. While examining a stereo pair with a pocket viewer the disc and cup margins are traced against the stereo image with a Rotring pen (0.1 mm tip) on a clear transparency overlying one of the photographs. This tracing is digitised and analysed by an 'edge detection' algorithm which measures the area between the traced lines, i.e. NRA. The intraobserver intraphotograph coefficient of variation (standard deviation/mean) was calculated for measurements of disc area, cup area and NRA made on 10 stereo photographs of discs with various topographies. Coefficients for NRA ranged from 3.2% to 3.9% for discs with easily discernible cup margins and from 1.6% to 7.2% for discs with less obvious cups.     

Cyclocryotherapy in the treatment of advanced glaucoma

Cyclocryotherapy in the treatment of aphakic open-angle glaucoma (AO), aphakic angle-closure glaucoma (ACL), and neovascular glaucoma (NVG) was evaluated in 96 eyes of 96 patients. All patients had follow-up of greater than 12 months, with a mean of 29.0 +/- 2.1 months (+/- SEM). Intraocular pressure (IOP) was lowered to less than 21 mmHg in 76% of eyes with AO, 68% of eyes with ACL, and 55% of eyes with NVG. Patients with NVG lost vision more frequently (70%) than patients with AO (41%) or ACL (41%). Patients with NVG had a higher incidence of loss of light perception and phthisis bulbi than patients with ACL (P less than 0.015). In patients having visual field examinations (76/96), glaucomatous field loss was arrested in 71% of patients with AO and 65% of patients with ACL, compared to 29% of patients with NVG (P less than 0.025). There was a significant correlation between postoperative IOP less than 21 mmHg and preservation of visual field. Patients receiving initial 360 degrees cryosurgical treatment required fewer repeat treatments than patients receiving initial 180 degrees treatment (P = 0.004); complications were slightly more common in the 360 degrees group.     

Intraocular pressure in diabetic persons

Intraocular pressure measurements were taken in 2366 diabetic persons and 381 nondiabetic persons who lived in southern Wisconsin. Diabetic persons tended to have higher mean intraocular pressure than the nondiabetic persons. Higher blood pressure, earlier time of day of IOP measurement, absence of cataract and, in some comparisons, female gender, were significantly associated with higher intraocular pressure. In this study rates of a positive history of glaucoma were higher in diabetic persons than in nondiabetic persons and the population participating in the Health Interview Survey. These findings suggest that ophthalmologists must be aware of the increased risk of glaucoma when evaluating diabetic patients.     

青光眼小梁切除术中局部应用丝裂霉素的临床疗效观察

为改善青光眼小梁切除术后滤过泡的功能，随机将４４例（６０眼）各型中晚期患者，分为丝裂霉素（ＭＭＣ）组及生理盐水组（各３０眼）。ＭＭＣ组小梁切除术中局部应用０．２ｍｇｍｌ－１ＭＭＣ５ｍｉｎ。术后追踪１～１２月。结果示：ＭＭＣ组中为功能性滤过泡的眼显著多于对照组；ＭＭＣ组术后眼压下降率明显大于对照组，且一年时ＭＭＣ组手术成功率显著高于对照组。提示ＭＭＣ是安全、效好的抗瘢痕形成药物。     

Long-term diabetic vitrectomy results. Report of 10 year follow-up

Ten year follow-up examinations were obtained on 72 cases having pars plana vitrectomies for diabetic retinopathy complications from 1970 to 1973. Forty-two percent of the cases maintained 6/60 or better visual acuities through the tenth year. The visual results were quite stable, with 53% of the cases having the same or better visual acuities at ten years compared with six months. Neovascular glaucoma developed in 11 eyes, usually during the first six months, and open-angle glaucoma developed in 16 eyes, usually after the five-year follow-up examination. Both types of glaucoma occurred almost exclusively in aphakic eyes. Cataracts developed in 75% of retained clear lenses. The vitreous cavities remained clear in 67% of the eyes, and the maculas were attached in 65% of the eyes 10 years following vitrectomy. Fundus neovascularization did not recur.