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玻璃体

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Methods The medical records of 142 patients with complex retinal detachments who underwent vitrectomy were reviewed. Hypotony was defined as a persistent intraocular pressure of 5 mmHg or less for 6 months in the follow-up.

方法对142例复杂性视网膜脱离行玻璃体视网膜手术的临床资料进行回顾性分析,低眼压的诊断标准为眼压≤5 mm Hg (1 mm Hg=0.133 kPa),并持续6个月。

RESULTS: A total of 45 eyes from 45 patients were treated with the Ahmed glaucoma valve implant and its combination surgery. At a mean follow up of 9.7 months (range3~18months), the mean intraocular pressure was reduced from 36.8±12.3mmHg before the implant surgery to 18.0±4.5mmHg at the last follow up after surgery. The success rate was 87%.The best postoperative corrected visual acuity improved 16 eyes(35%).Transient postoperative hypotony and shallow anterior chamber occurred in 20% of cases. The common postoperative complication in later was the formation of encapsulated bleb(13%).

结果:难治性青光眼45例(45眼)实行了Ahmed青光眼阀植入术或联合晶状体摘除、玻璃体切割、人工晶状体植入术等;术后平均观察(3~18)9.7mo;患者术前的平均眼压36.8±12.3mmHg,术后平均眼压18.0±4.5mmHg;手术成功率87%;术后最佳矫正视力提高16眼(35%),视力无变化21眼(47%),视力降低8眼(18%);术后早期最常见的并发症是一过性浅前房及低眼压,发生率为20%,晚期最常见的并发症是滤过泡包裹,发生率是13%。

RESULTS: A total of 45 eyes from 45 patients were treated with the Ahmed glaucoma valve implant and its combination surgery. At a mean follow up of 9.7 months (range3~18months), the mean intraocular pressure was reduced from 36.8±12.3mmHg before the implant surgery to 18.0±4.5mmHg at the last follow up after surgery. The success rate was 87%.The best postoperative corrected visual acuity improved 16 eyes(35%).Transient postoperative hypotony and shallow anterior chamber occurred in 20% of cases.

结果:难治性青光眼45例(45眼)实行了Ahmed青光眼阀植入术或联合晶状体摘除、玻璃体切割、人工晶状体植入术等;术后平均观察(3~18)9.7mo;患者术前的平均眼压36.8±12.3mmHg,术后平均眼压18.0±4.5mmHg;手术成功率87%;术后最佳矫正视力提高16眼(35%),视力无变化21眼(47%),视力降低8眼(18%);术后早期最常见的并发症是一过性浅前房及低眼压,发生率为20%,晚期最常见的并发症是滤过泡包裹,发生率是13%。

The ocular pressure of part traumatic chronic ocular hypotony can attain normal level using eye endoscope assisted vitrectomy.The main effective elements may be ocular pressure, pathology of ciliary body and the course of ocular hypotony before surgery.

眼内窥镜辅助的玻璃体切除术能够恢复部分眼外伤性长期低眼压患者的眼压,手术前眼压、睫状体病变情况和尽快行眼内窥镜下睫状体探察手术可能是恢复部分长期低眼压的关键。

We introduced improved primary mixed glial culture and different-attachment method to isolate and purify the OPCs, the cells were proliferated in serum-free medium, flow cytometry and immunohischemistry methods were employed to estimate the purity of cultured OPCs. Their abilities of differentiation and expression of trophic factors were identified by RT-PCR and immunostaining. Several methods including TUNEL and MTT were adopted to estimate the protective effects of conditioned culture medium from oligodendrocyte lineage cells on the primary cultured cerebellar granule neurons. Intravitreal transplant of OPCs, combined with retrograde fluorescent labeling the superior colliculus and intraorbital optic nerve transection, were used to investigate the protective effects of OPCs on the axotomized RGCs in vivo. Intravitreal transplantof OPCs or NSCs on the newborn rats, and retinal transplant of OPCs on the young rats were performed, to observe the myelin formation in the retina at different stages after cellular transplantation. Optic nerve transection was carried out on some rats with myelinated retinae, to study the influence of myelination on the injuried RGCs.

为此,本研究采用改良的胶质细胞混合培养与差速贴壁方法获得大鼠OPCs,使用无血清培养基进行扩增、培养,用免疫组织化学和流式细胞技术对培养细胞的纯度进行鉴定,对少突胶质系细胞表达部分营养因子的情况进行检测;采用TUNEL、MTT等方法对少突胶质系细胞条件培养基对原代培养小脑颗粒神经元的保护作用进行检测;将OPCs移植入成年SD大鼠玻璃体内,利用上丘逆行荧光标记技术,观察眼内移植的OPCs对眶内视神经切断时的视网膜神经节细胞的保护作用及其持续时间;将OPCs或NSCs移植入新生和幼年SD大鼠玻璃体或视网膜内,观察不同时期视网膜内髓鞘形成与分布特点,分析髓鞘的超微结构,并观察眼内髓鞘形成对损伤神经节细胞的保护作用。

Several clinical investigations demonstrated that intravitreous injection of plasmin before vitrectomy could reduce the risk of retinal bleeding or detachment.

不少临床研究表明:手术前,以少量纤溶酶降解玻璃体与视网膜连接处蛋白质,可明显减少手术引起的视网膜出血、脱离等并发症。

Eleven, 22 and 21 cases subject to re-operation respectively received intravitreous pneumatic retinopexy, scleral buckling procedure and vitrectomy, and the successful rate was 72.7%, 90.9% and 85.7% respectively.

再次手术11只眼行玻璃体腔注气术,22只眼行巩膜扣带术,21只眼行玻璃体切除术,其成功率分别为72.7%、90.9%和85.7%。

All cases were presented with cyclodialysis combined with other ocular injuries, the characteristics and surgical management were analyzed Results The major signs include vitreoretinal disorders(67.6%), lenticular injury(55.9%), obital fracture(10.8%), iridodialysis(9.0%), hyphema(5.4%).

回顾分析了2001年4月—2007年1月在本中心就诊的复杂性睫状体断离病例111例,结果在全部患者中,除睫状体断离外,伴有其他主要眼部病变包括玻璃体视网膜病变(67.6%),晶状体病变(55.9%),眶壁骨折(10.8%),虹膜根部断离(9.0%),前房积血(5.4%)。

The postoperative complication was membrana vitreous anterior opacification and retinal detachment opacification.

发生术中、术后并发症,如后囊膜破裂、悬韧带断裂、玻璃体溢出、角膜水肿和后发障等共40 眼。

The combination of 2-D ultrasonography and Color Doppler flow imaging has great value in diagnosing vitreous membranaceous pathological changes.

2D和CDFI的联合运用,对玻璃体内膜样病变的诊断具有重要价值。

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