Volume 40 ·  Issue 02 ·  2004

The rapid development of medical science and technology has promoted the progress of glaucoma detection technology, but because of the complexity of glaucoma disease itself, even the latest detection technology is inevitably deficient [1].

evidence-based medicine (EBM) takes detailed scientific evidence as the best clinical research basis, thus responsibly, clearly and wisely using the best available evidence to determine the treatment of each patient. based on the results of large-scale clinical trials, it also emphasizes the combination of physicians' personal professional knowledge and clinical experience, and the ultimate goal is to better solve the practical clinical problems.

Objective to investigate the stereoscopic vision of children with congenital nystagmus before and after Parks intermediate zone displacement. Methods The stereoscopic acuity of 21 children with congenital nystagmus was measured qualitatively and quantitatively by Yan's random point simultaneous vision machine and stereoscopic view book. After Parks intermediate zone displacement, the stereoscopic acuity of distant and near was also measured, and the grading comparison was carried out. Results All cases had no tremor or obvious reduction, visual acuity improved by 2~5 lines, and compensatory head position was basically eliminated or improved. Stereoscopic vision increased from scratch, visual acuity increased gradually from 800″ to 60″, and changed from peripheral stereoscopy to macular stereoscopy and even foveal stereoscopy. Conclusion the stereoscopic vision of children with congenital nystagmus can be partially developed before surgery, and the direction of the median zone is better than that of the non-median zone. After Parks median zone displacement, the problems of nystagmus, compensatory head position and vision can not only be solved, but also the stereoscopic vision can be improved to varying degrees.

Objective to investigate the feasibility of cultivating melanocytes of yellow human choroid and iris in vitro, and to observe whether melanocytes can synthesize pigment in vitro. Methods the chromatic tissues of choroid and iris were digested with trypsin and collagenase. The isolated cells were cultured in F12 medium supplemented with fetal bovine serum, basic fibroblast growth factor, isobutyl methyl xanthine and cholera toxin. The cells were stained by immunohistochemistry with keratin antibody and S-100 antibody. The content of melanin in the cells was determined by spectrophotometer and the amount of melanin was calculated. Results Uveal melanocytes were successfully cultured in vitro; The mean pigment content in each melanocyte was (79.83±36.20) pg during the growth phase, and each cell synthesized melanin (11.44±5.77) pg per day. The expression of S-100 was positive in uveal melanocytes cultured in vitro, but the expression of keratin was negative. Conclusion the yellow human uveal melanocytes cultured in vitro can synthesize pigment in vitro, and the pigment content and production amount in yellow human uveal melanocytes are between white human and black human.

Objective to investigate the biocompatibility of cyclosporine A sustained-release system (CsA DDS) implanted in the anterior chamber and the changes of drug concentration in aqueous humor. Methods Thirty-six New Zealand white rabbits were randomly divided into four groups: A, B, C and D, which corresponded to different CsA DDS types A, B, C and D respectively. EM DDS was implanted in the anterior chamber of one eye of rabbits 4 to 6, and keratotomy and suture were performed in the other eye as control; CsA DDS was implanted in the anterior chamber of one eye of rabbits 7~9, and keratotomy and suture were performed in the other eye as the control. The observation was made for 12 weeks after operation. Results No obvious intraocular toxicity was observed in the four types of CsA DDS; Conclusion the biocompatibility of CsA DDS implanted in the anterior chamber is good for rabbit eyes. Among the 4 types of CsA DDS, types A and B are more suitable for the treatment of rejection, while types C and D are more suitable for the prevention of rejection.

Objective to investigate the value of two-dimensional electrophoresis and mass spectrometry in the study of lens proteome characteristics and provide a new and effective way for the prevention and treatment of cataract.Methods Solid phase pH gradient (IPG) isoelectric focusing two-dimensional gel electrophoresis was used to separate the proteins of clear lens of New Zealand rabbits aged 3 months. The electrophoresis images were analyzed by ImageMaster 2D Elite 3.01 image analysis software, and the main high-abundance lens proteins were identified by matrix-assisted laser desorption time-of-flight mass spectrometer. Results Two-dimensional electrophoretic spectrum showed that the protein distribution in the 250 μ g rabbit lens was in the region with the isoelectric point (PI) of pH 5-9 and the relative molecular mass of 14 000-94 000; The relative molecular mass of high-abundance lens proteins is 14 000~40 000. The approximate PI, relative molecular mass and relative protein content of 180 protein spots were quantitatively detected by image analysis software, and 16 types of high-abundance lens proteins were identified by mass spectrometry.Conclusion Two-dimensional electrophoresis and mass spectrometry can effectively separate and analyze the characteristics of lens proteome, which provides a new method and approach for analyzing the protein expression changes during cataract formation, and brings a new prospect for the prevention and treatment of cataract.

Objective to investigate the apoptotic mechanism and inducing causes of retinal injury in contusion retinopathy. Methods the rabbit eye contusion retinopathy model was made by 3 J energy free fall. The retinopathy and apoptosis were observed by light, electron microscope and TUNEL staining. The changes of MDA content and SOD activity in retinal homogenate were measured, and statistically analyzed. Results Apoptosis of photoreceptor cells occurred in retinopathy after contusion with 3 J energy, and the content of MDA in retina increased gradually with contusion time (P<0.01), SOD activity increased reflexively in the early stage after contusion (P<0.01), significantly decreased at 3 d (P<Conclusion Apoptosis is an important mechanism of contusion retinopathy, and ROS is an important inducer of photoreceptor apoptosis in contusion retinopathy.

Objective to investigate the clinical effect of non-penetrating trabecular surgery (NPTS) combined with amniotic membrane implant in the treatment of juvenile glaucoma. Methods Twenty-six patients (32 eyes) with juvenile glaucoma aged 12-28 were treated with non-penetrating trabecular surgery combined with amniotic membrane implant. The intraocular pressure, intraocular reaction and filtering bleb were observed after operation, and the anterior chamber gonioscopy was performed. The average postoperative follow-up time was (8.3±4.2) months. Results There was no significant change in postoperative visual acuity compared with preoperative visual acuity. The mean intraocular pressure (28.6±7.3) mm Hg (1 mm Hg =0.133 kPa) before operation and (15.7±3.7) mm Hg after operation were significantly different (t =4.82, P<0.01). 2~5 kinds of drugs were used before operation, with an average of 3.2 kinds; There were 0~2 kinds of postoperative drugs, with an average of 0.8 kinds, and the difference was significant (rank sum test, t =128, P<During the follow-up period, 30 eyes (93.8%) had intraocular pressure ≤21 mm Hg, 18 eyes (56.3%) had normal intraocular pressure without medication, and 12 eyes (37.5%) had normal intraocular pressure after medication. Six eyes had slight anterior chamber hemorrhage after operation; There were no complications such as shallow anterior chamber, ocular inflammatory reaction, choroidal detachment, etc. Postoperative gonioscopy showed that the posterior elastic membrane and residual trabecular meshwork were thinned, and 5 eyes showed microperforation in trabecula.Conclusion NPTS combined with amniotic membrane implantation can effectively reduce intraocular pressure, reduce the application of anti-glaucoma drugs, and have less postoperative complications, which is one of the effective methods for the treatment of juvenile glaucoma.

Objective to investigate the histopathological changes of trabeculectomy after perfluoropropane (C3F8) was supplemented.Methods Twenty New Zealand rabbits were subjected to trabeculectomy and randomly divided into two groups, 10 rabbits (20 eyes) in each group.Group 1: One eye was randomly selected for trabeculectomy alone, and the other eye was subjected to trabeculectomy with C3F8 gas supplemented; Group 2: One eye was randomly selected to undergo trabeculectomy combined with mitomycin C (MMC), and the other eye underwent trabeculectomy with C3F8 gas. By histopathological and immunohistochemical techniques, the filtering vesicle tissues of rabbits were examined at different periods of 3 days, 1, 2, 3 and 4 weeks after operation, and the changes of fibroblasts, new collagen fibers, new blood vessels and inflammatory cells were observed. Results There were significant differences in the amount of new collagen fibers and fibroblasts in the filtering tract between the C3F8 gas group and the simple trabeculectomy group (P<0.05); There were significant differences in the amount of new collagen fibers and fibroblasts in the filtering tract between MMC group and trabeculectomy group (P<0.05); There was no significant difference in the amount of neovascularized collagen fibers and fibroblasts in the filtration tract between the C3F8 gas group and the MMC group (P>0.05). There was no significant difference between the amount of neovascularized blood in the filtration tract of rabbits with three different surgical procedures and the amount of inflammatory cells in the filtration tract at five different postoperative periods (P>0.05). Conclusion The adjuvant application of C3F8 gas during trabeculectomy can inhibit the proliferation of fibroblasts and the synthesis of neovascularized collagen fibers, inhibit or reduce the scarring of the filtration tract after surgery, and thus improve the success rate of surgery.

Objective to investigate the pharmacokinetic characteristics of 0.5% pilocarpine sodium hyaluronate sustained-release eye drops after eye drops and evaluate its relative bioavailability. Methods 100 healthy white rabbits were randomly divided into 10 experimental groups and 10 control groups, 5 rabbits (10 eyes) in each group. 50 μ l of 0.5% pilocarpine sodium hyaluronate sustained-release eye drops was dripped into the conjunctival sac of both eyes of each experimental group, and 50 μ l of 1% pilocarpine eye drops was dripped into both eyes of each control group. Aqueous humor was extracted and quantitatively analyzed at 5, 10, 20, 30, 40, 60, 90, 120, 150 and 180 min after administration. Dichloromethane was used to extract the drug in aqueous humor, and the drug concentration in aqueous humor was determined by reverse phase high performance liquid chromatography (HPLC). The pharmacokinetic parameters were obtained by computer fitting with 3p87 pharmacokinetic calculation software. The results showed that pilocarpine could be well separated from other impurities by reverse phase HPLC, and the lowest concentration was 0.025 μ g/ml. The average recovery rate of pilocarpine in aqueous humor was 98.2%. After administration, the peak time of aqueous humor was 10 min and 20 min, the peak concentration was 4.46 μ g/ml and 2.25 μ g/ml, respectively, and the drug elimination half-life was 31.83 min and 22.98 min, respectively. The area under the concentration-time curve (AUC0~180) of aqueous humor in the experimental group was 1.75 times that of the control group. The peak concentration of aqueous humor in the experimental group was 1.98 times that of the control group (P<Conclusion Compared with 1% pilocarpine eye drops, 0.5% pilocarpine sodium hyaluronate sustained-release eye drops reached earlier peak time, increased peak concentration and prolonged elimination half-life, suggesting that its relative bioavailability was improved and its action time was prolonged.

Objective to investigate the characteristics of corneal endothelial cell injury and repair after phacoemulsification cataract aspiration and the clinical grading criteria of corneal edema. Methods 105 cases (105 eyes) of senile cataract patients underwent phacoemulsification cataract aspiration. The degree of corneal edema was observed by slit lamp microscope after operation, and the time of edema resolution was recorded. The density of endothelial cells in upper, middle and lower cornea was observed by contact endothelial microscope before and 3 months after surgery respectively. Results the loss rates of corneal endothelial cells were 4.6%, 14.9%, 40.8%, 67.0% and 84.4% in patients with corneal edema of grade 0~4, respectively; The time of regression of corneal edema was (2.1±0.7), (5.6±1.9) and (21.8±7.1) d, respectively, and the mean density of upper, middle and lower corneal endothelial cells were (2006±546), (1979±545) and (1754±543) /mm2 at 3 months postoperatively, respectively; the difference was significant between upper and lower, middle and lower (P =0.025, 0.030); The mean decreases of endothelial cell density in upper, middle and lower cornea were (627±496), (656±492), (1026±509) /mm2, respectively, and there were significant differences between upper and lower cornea, middle and lower cornea (P =0.017, 0.027). Conclusion the degree of corneal edema after phacoemulsification cataract aspiration is divided into 0~4 grades, which can clearly indicate the degree of corneal endothelial cells injury, and provide important reference for clinical evaluation of prognosis. The damage site of corneal endothelial cells after phacoemulsification cataract aspiration is mainly in the lower part of cornea, and the density of corneal endothelial cells cannot recover to normal level after 3 months.

Objective to investigate the changes of anterior chamber angle structure after phacoemulsification and folding intraocular lens implantation. Methods 46 cases (50 eyes) of senile cataract were treated with small incision phacoemulsification and folding intraocular lens implantation. The anterior chamber depth and anterior chamber angle width were measured by ultrasound biomicroscopy before and 1 month after surgery. Results the anterior chamber depth increased significantly in all patients 1 month after surgery (P<0.01); The trabecular iris angle at 500 μ m (TIA500) and the open distance of the anterior chamber angle at 250 μ m and 500 μ m (AOD250, AOD500) were significantly increased compared with those before operation (all P<0.01), the mean ratio of TIA500 (postoperative TIA500/preoperative TIA500) was 1.65 (1.12~4.91), the mean ratio of AOD250 (postoperative AOD250/preoperative AOD250) was 1.81 (1.06~2.67), and the mean ratio of AOD500 (postoperative AOD500/preoperative AOD500) was 1.65 (1.01~2.76), all of which showed significant negative correlation with the preoperative values (all P<Conclusion Phacoemulsification and folding intraocular lens implantation can significantly increase the width of anterior chamber angle in senile cataract patients; The narrower the anterior chamber angle before operation, the greater the change degree of the anterior chamber angle after operation.

drug-induced keratopathy is a keratopathy caused by systemic and ocular local medication, also called toxic keratopathy, with various clinical manifestations and easy to be confused with other corneal diseases. If not diagnosed and treated in time, it will seriously threaten vision.

In June 1997, we performed phacoemulsification cataract aspiration under the guidance of corneal topography to correct corneal astigmatism while removing cataract. The results are reported as follows.

continuous curvilinear capsulorhexis (CCC) makes phacoemulsification cataract aspiration safer and more convenient, and becomes the key technique in this surgery. However, improper CCC operation can lead to corresponding complications, such as capsular block syndrome (CBS).

posterior capsular opacification (PCO) is a common complication that affects long-term visual acuity after cataract extraction.

aquaporin (AQP) exists in the cell membranes of animals, plants and microorganisms. The pores are formed by a series of homologous membrane protein family members, which mediate the transmembrane water transport of different types of cell membranes. At present, eight kinds of aquaporins have been identified from mammalian tissues [1], which are widely distributed in various tissues and organs. They play an important role in maintaining the water balance of the body, and are closely related to some diseases caused by water balance disorders. Among them, AQP 1 is the most widely distributed and has the most role.

The Beijing International Glaucoma Conference in 2004 (BIGC2004) will be held in Beijing from April 8 to 11, 2004. This conference was jointly organized by Ophthalmology Branch of Chinese Medical Association, World Association of Ophthalmic Surgeons and Chinese Medical Association. It is one of the key academic conferences of Chinese Medical Association in 2004.

Chronic nasolacrimal duct obstruction or accompanied by chronic dacryocystitis is the common cause of lacrimal duct obstruction.At present, balloon catheter lacrimal duct dilatation is used abroad [1], but the balloon is not easy to implant into the lacrimal duct, and the amount of gas injected into the balloon is not easy to control, and the structure is complicated.

When laser in situ keratomileusis (LASIK) is applied to treat myopia, the corneal flap should be performed routinely. Because the corneal flap and the stromal bed cannot completely heal for a long time after operation, the corneal flap can be displaced under the action of strong external force.

In early 1990s, iris-type intraocular lens implantation became an effective method for treating congenital or traumatic aphakia and aphakia. However, due to many factors such as the complexity of these patients and the characteristics of intraocular lens itself, there are many postoperative complications.

The author applied mannitol to treat glaucoma from 1998 to 1999 to reduce intraocular pressure in patients, but it caused acute renal failure and died in 2 cases secondary to multiple organ failure. The diagnosis and treatment are reported as follows.

cicatricial pemphigoid (CP) is a rare systemic autoimmune disease, which is characterized by vesicular ulcers and scar formation of the skin and mucosa. The main manifestation of the eye is chronic keratoconjunctivitis, accompanied by subepithelial scar formation of the conjunctiva, which leads to shortening of the fornix, symblepharon, adhesion of the eyelid margin, entropion, trichiasis, dry eye, corneal neovascularization and scar formation, and the prognosis is poor [1-5].