简介:目的观察生物羊膜与丝裂霉素C(MMC),应用于青光眼小梁切除术中治疗青光眼的临床疗效。方法随机选择39例(48只眼),分为羊膜组(22只眼)和丝裂霉素组(26只眼)。羊膜组施行小梁切除术联合巩膜瓣下生物羊膜植入术,丝裂霉素组施行小梁切除术联合巩膜瓣下放置丝裂霉素C,浓度为0.25mg/ml,时间2分钟,术后随访3-9月,比较两种手术方式的临床疗效。结果术后与术前相比:两组眼压均明显降低。术后并发症:羊膜组副反应小,引起的并发症主要有术后浅前房;丝裂霉素组引起的并发症主要有滤过泡渗漏、低眼压等。结论小梁切除联合生物羊膜植入术可有效地减少瘢痕组织形成,且并发症较丝裂霉素少,是治疗青光眼安全、有效的手术方法。
简介:目的:通过对视网膜脱离患者术前、术后的血流动力学研究及视网膜功能的了解,判断视网膜脱离患者的术后恢复情况,并探讨两种检测方法的临床价值。方法:对我院62例孔源性视网膜脱离患者,通过彩色多普勒(CDI)检测视网膜中央动脉(CRA)的收缩期峰值流速(Vmax)、舒张末期流速(Vmin)、阻力指数(RI);多焦视网膜电图(mfERG)分别对视网膜脱离患者的术前、术后进行检测,并以对侧正常眼作对照组。结果:CDI术前患眼与对照眼的CRA各项指标比较,差异无统计学意义。术后2wk视网膜脱离眼CRA的Vmax,Vmin均较术前降低,RI增高,差异有统计学意义(P〈0.05)。视网膜脱离术后患者脱离区mfERG的a波、b波振幅密度均明显高于术前,潜伏期比手术前明显缩短,有统计学意义(P〈0.05)。结论:通过mfERG,CDI的联合检测能及时了解视网膜脱离术后的视网膜复位情况及硅胶海绵垫压后CRA的血流情况,从而避免视网膜脱离术后视网膜部分复位不良,巩膜因缺血引起局部坏死等情况发生。
简介:目的:研究板层角膜切除术联合那他霉素治疗真菌性角膜溃疡的临床疗效及组织病理学基础。方法:选取2009-12/2011-11真菌性角膜溃疡患者32例32眼,角膜病变未累及内皮层,行角膜板层切除联合那他霉素滴眼治疗,观察记录治疗前后视力、角膜情况、病程、并发症及致病菌种类,对切除组织行组织病理学检查。结果:治疗前视力≤0.05者20眼,~0.3者11眼,〉0.3者1眼。板层切除术后联合那他霉素治疗痊愈28例(87.5%),治愈时间7~32(平均13.2±8.5)d,痊愈时视力≤0.05者5眼,~0.3者8眼,〉0.3者15眼。病情控制不良改行角膜移植术者4例。31例真菌培养阳性(96.9%),其中镰刀菌18例,曲霉菌属8例,链格孢霉3例,未知菌属2例。病理学检查显示溃疡灶中有多量中性粒细胞浸润,过碘酸-希夫(PAS)染色显示角膜组织中菌丝多数位于角膜浅层,并呈与板层胶原纤维平行方向生长,但也有少数呈斜形或垂直生长方式,侵及切除组织全层。不同菌属之间菌丝在角膜中生长方式无明显差异。结论:对于病变未累及全层的真菌性角膜溃疡患者,及时行板层角膜切除术可大大提高那他霉素药物治疗有效性,缩短病程,恢复视力。
简介:目的:探讨眼附属器B细胞非霍杰金淋巴瘤(B—cellnon-Hodgkinlymphoma,NHL)中Skp2,p27和PTEN的表达。方法:收集1995年到2011年青岛大学附属医院眼科石蜡包埋标本,用免疫组化法分别检测眼附属器B细胞NHL(n=30)标本中Skp2,p27和PTEN的表达,以眼部反应性淋巴组织增生(n=10)作为对照组。以患者的年龄、性别、发病部位,病理类型作为眼附属器B细胞NHL的的分类标准。结果:Skp2,p27和PTEN的表达与患者的年龄、性别、发病部位无关,而与病例类型有关。眼附属器B细胞NHLSkp2表达率与眼部反应性淋巴组织增生相比显著增高。p27,PTEN表达率与反应性淋巴组织增生相比显著降低。随眼附属器B细胞NHL病理分级的提高,Skp2的表达显著增高,p27和PTEN的表达显著降低。在黏膜相关淋巴组织结(mucosa—associatedlymphoidtissue,MALT)外边缘区B细胞淋巴瘤(diffuselargeB—celllymphoma,DLBCL)中,Skp2分别与p27,VFEN成负相关,p27和PTEN成正相关。结论:Skp2的表达升高,p27,PTEN蛋白的缺失以及可能与眼附属器B细胞NHL的发生有关;其中在MALT外边缘区DLBCL中,三种蛋白存在相关性。联合三种蛋白的检测眼附属器B细胞NHL的不同病理类型有重要意义。
简介:AIM:ToinvestigatetheinterferingeffectofY-27632,aROCK-Iselectiveinhibitor,onthesignaltransductionpathwayoftransforminggrowthfactor-β1(TGF-β1)inocularTenoncapsulefibroblasts(OTFS)invitro.METHODS:AfterOTFSfrompassages4to6invitrowereinducedbyTGF-β1andthentreatedbyY-27632,thechangesoftheOTFScellcycleswereanalyzedviaflowcytometry,andtheproteinsexpressionoftheα-smoothmuscularactin(α-SMA),connectivetissuegrowthfactor(CTGF),collagenIwerecalculatedbyWesternblot.AfterOTFStreatedbythedifferentconcentrationsofY-27632,theexpressionlevelsoftheα-SMA,CTGFandcollagenImRNAwereassayedbyRT-PCR.RESULTS:Y-27632hadnomarkedlyeffectontheOTFScellcycles.AftertreatedbyTGF-β1,OTFSinG1periodsignificantlyincreased.ThecellcyclesdistributionbybothTGF-β1andY-27632hadnoremarkabledifferencefromthatincontrolgroup.Y-27632significantlyinhibitedtheproteinsexpressionsofbothα-SMAandCTGF,whiletosomeextentinhibitedthatofcollagenI.TGF-β1significantlypromotedtheproteinsexpressionsofα-SMA,CTGFandcollagenI.AfterOTFStreatedbybothTGF-β1andY-27632,ofα-SMA,theproteinexpressionwassimilarwiththatincontrolgroup(P=0.066>0.05),buttheproteinexpressionofCTGForcollagenI,respectively,wassignificantlydifferentfromthatincontrolgroup(P=0.000<0.01).Thedifferencesofexpressionsoftheα-SMA,CTGFandcollagenImRNAin30,150,750μmol/LY-27632groupwerestatisticallysignificant,comparedwiththoseincontrolgroup,respectively(α-SMA,P=0.002,0.000,0.000;CTGF,P=0.014,0.002,0.001;collagenI,P=0.003,0.002,0.000).CONCLUSION:BlockingtheRho/ROCKsignalingpathwaybyusingofY-27632couldinhibitthecellularproliferationandtheexpressionofbothCTGFandα-SMAwhateverOTFSinducedbyTGF-β1ornot.Y-27632suppressedtheexpressionofcollagenImRNAwithoutinduction.
简介:目的探讨白内障超声乳化摘除及人工晶体植入联合房角分离术治疗闭角型青光眼合并白内障的临床效果方法回顾性分析2009年10月至2011年6月我院收治的闭角型青光眼合并白内障共112例(120眼),应用白内障超声乳化摘除及人工晶体植入联合房角分离术,对房角关闭区域用粘弹剂和手指按压进行钝性分离。观察手术前后的房角及前房变化、视力、眼压及并发症情况,随访6月。结果均经统计学处理。结果120眼手术顺利,术后追踪6月,全部患者术后视力提高,房角开放,中央前房加深,眼压控制良好,手术前后比较差异具有统计学意义。结论超声乳化白内障摘除联合房角分离术是治疗闭角型青光眼合并白内障的有效方法之一,但具体适应证尚待进一步探讨。
简介:AIM:Toinvestigatetheaccuracyofintraocularpressure(IOP)asmeasuredbyaReichertOcularResponseAnalyzer(ORA),aswellastherelationshipbetweencentralcornealthickness(CCT)andIOPasmeasuredbyORA,Goldmannapplanationtonometry(GAT),anddynamiccontourtonometry(DCT).·METHODS:Atotalof158healthyindividuals(296eyes)werechosenrandomlyformeasurementofIOP.AfterCCTwasmeasuredusingA-ultrasound(A-US),IOPwasmeasuredbyORA,GAT,andDCTdevicesinarandomizedorder.TheIOPvaluesacquiredusingeachofthethreetonometrieswerecompared,andtherelationshipbetweenCCTandIOPvalueswereanalyzedseparately.TwoIOPvalues,Goldmann-correlatedIOPvalue(IOPg)andcorneal-compensatedintraocularpressure(IOPcc),weregotusingORA.ThreegroupsweredefinedaccordingtoCCT:1)thincornea(CCT<520μm);2)normal-thicknesscornea(CCT:520-580μm);and3)thickcornea(CCT>580μm)groups.·RESULTS:Innormalsubjects,IOPmeasurementswere14.95±2.99mmHgwithORA(IOPg),15.21±2.77mmHgwithORA(IOPcc),15.22±2.77mmHgwithGAT,and15.49±2.56mmHgwithDCT.Meandifferenceswere0.01±2.29mmHgbetweenIOPccandGAT(P>0.05)and0.28±2.20mmHgbetweenIOPccandDC(P>0.05).TherewasagreatercorrelationbetweenIOPccandDCT(r=0.946,P=0.000)thanthatbetweenIOPccandGAT(r=0.845,P=0.000).DCThadasignificantcorrelationwithGAT(r=0.854,P=0.000).GATwasmoderatelycorrelatedwithCCT(r=0.296,P<0.001),whileIOPccshowedaweakbutsignificantcorrelationwithCCT(r=0.155,P=0.007).TherewasastrongnegativecorrelationbetweenCCTandthedifferencebetweenIOPccandGAT(r=-0.803,P=0.000),withevery10increaseinCCTresultinginanincreaseinthisdifferenceof0.35mmHg.Thethickcorneagroup(CCT>580μm)showedtheleastsignificantcorrelationbetweenIOPccandGAT(r=0.859,P=0.000);whilethethincorneagroup(CCT<520μm)hadthemostsignificantcorrelationbetweenIOPccandGAT(r=0.926,P=0.000).ThecorrelateddifferencesbetweenIOPccan
简介:AIM:Tofindouttheoutcomeoflaserphotocoagulationinclinicallysignificantmacularedema(CSME)byopticalcoherencetomography(OCT).·METHODS:Itwasaprospective,non-controlled,caseseriesstudyenrolling81eyesof64patientswithCSMEbetweenAugust2008andJanuary2010.AllpatientsreceivedmodifiedgridphotocoagulationwithfrequencydoubledNd:YAGlaser.Eachpatientwasevaluatedintermsofbest-correctedvisualacuity(BCVA)andregressionorprogressionofmaculopathyafterlasertherapyat1,3and6months.Spearman’scorrelationtestwasusedtoshowthecorrelationbetweenBCVAandtotalmacularvolume(TMV).Analysisofvariance(ANOVA)wasusedtocompareamonggroupsandindependentt-testwasusedtocompareineachgroup.·RESULTS:ThereishighcorrelationbetweenBCVAandTMV(P≤0.001).BCVAimprovedin50.6%,remainedstaticin39.5%anddeterioratedin9.9%patientsafter6monthoftreatment.TheBaselineTMV(meanandSD)were9.26±1.83,10.4±2.38,11.5±3.05,8.89±0.75and9.47±1.98mm3fordifferentOCTpatterns,ST(spongelikethickening),CMO(cystoidmacularedema),SFD(subfovealdetachment),VMIA(Vitreomacularinterfaceabnormality)andaverageTMVrespectively(P=0.04).After6monthsoflasertreatment,themeanTMVdecreasedfrom9.47±1.98mm3to8.77±1.31mm3(P=0.01).InSTtherewassignificantdecreaseinTMV,P=0.01,Furtherwithinthesegroupsat6months,theyweresignificantlydifferent,P=0.01.·CONCLUSION:OCTshowedthedifferentmorphologicalvariantofCSMEwhiletheresponseoftreatmentisdifferent.TMVdecreasedthemostandhenceshowedtheimprovementinvisionafter6monthsoflasertreatment.IntheeraofAntivascularendothelialgrowthfactors(VEGFs),efficacyoflaserseemstobeinshadowbutitisstillfirstlineoftreatmentindevelopingnationlikeNepalwhereantiVEGFsmaynotbeeasilyavailableandaffordable.