FITC-BSA示踪法测定兔眼葡萄膜巩膜途径房水流出量

用异硫氰酸荧光素牛血清白蛋白（Fluorescein－isothiocvanatebovineserumalbumin，FITC－BSA）示踪法测定兔眼葡萄膜巩膜途径房水流出量。造健康白色家兔6只12眼，测量双眼眼压。用0．1mmol／LFITC－BSA持续前房灌注30min，灌注毕处死家兔，摘除双眼球，并将组织分离为前葡萄膜、后葡萄膜、前巩膜、后巩膜、视网膜和残余液体等6种组织。测定每种组织的荧光强度，计算每眼葡萄膜巩膜房水流出量（uveoscleraloutflow，Fu）为（0．178±0．029）μl／min。证明FITC－BSA示踪法是一种测定葡萄膜巩膜途径房水流出量的有效方法。     

莫索尼定滴眼对家兔葡萄膜巩膜途径房水外流的作用及机制

目的观察I1受体激动剂莫索尼定滴眼对葡萄膜巩膜途径各部位荧光强度的变化,研究莫索尼定对葡萄膜巩膜途径房水外流的作用机制。方法莫索尼定单侧滴眼,示踪剂FITC-BSA双眼前房注入,2-10 h不同时点冰冻切片,荧光显微镜下观察葡萄膜巩膜途径各部位的荧光强度;prazosin(α1受体拮抗剂)、yohimbine(α2受体拮抗剂)和efaroxan(I1受体拮抗剂)前处理30 min,莫索尼定滴眼,观察葡萄膜巩膜途径荧光变化。结果莫索尼定滴眼荧光显微镜观察,双侧葡萄膜巩膜途径荧光强度明显增强,以睫状体和脉络膜上腔较强。prazosin前处理组各部位与莫索尼定比较荧光强度无显著性差异,yohimbine和efaroxan前处理组双侧荧光强度各部位均较莫索尼定组减弱,差异有统计学意义(P<0.01),yohimbine较efaroxan前处理组荧光更弱。结论莫索尼定可增加房水经葡萄膜巩膜途径外流,与prazosin产生协同作用,yohimbine和efaroxan均可抑制双侧葡萄膜巩膜途径房水外流的增加,yohimbine的抑制作用更显著,说明葡萄膜巩膜途径房水外流主要由α2受体介导,I1受体也产生作用。     

兔眼硅胶膜植入滤过术的实验研究

目的 建立兔眼硅胶膜植入引流术模型,通过眼压、滤过泡及光镜下形态学的观察,探讨硅胶膜植入引流术的可行性、安全性。方法 将40只家兔随机分为4组,每组10只。每只家兔随机选择一眼植入硅胶膜,对侧眼行滤过术作为对照,术后观察眼压和滤过泡,并行病理组织学检查。结果 硅胶膜植入眼眼压下降维持时间和滤过泡的持续时间均长于对照眼。光镜显示硅胶膜植入眼可见开放的滤过道和咬切口。植入眼与对照眼的成纤维细胞增殖活性及规律相似。结论 硅胶膜引流术是一种安全、有效、操作简单的引流性手术。     

匹罗卡品家兔点眼对葡萄膜巩膜途径房水流出量的影响

为探讨匹罗卡品家兔点眼对葡萄膜巩膜途径房水流出色的影响，用1％匹罗卡品（Pilocarpine，PC）对家免单侧点眼。并用0.1mmol／L异硫氰酸荧光素牛血清白蛋白（Fluoreceinisothlocyanate－bovineserumalbumin，FITC－BSA）持续前房灌注30min。测定前、后葡萄膜等6种组织的FITC－BSA含量，计算每眼的葡萄膜巩膜层水流出量（Uveosderdoutflow，Fu）。分别比较点眼前后眼压和点眼后双眼的Fu。结果示：PC点眼后1h处理眼眼压为（0．70±0．08）kPa，下降率为25％（P＜0．01），对照眼眼压无显著变化（P＞0．05）；点眼后2h处理眼Fu值为（0．123±0．026）μl／min，对照眼Fu值为0．177±0．032）μl／min，双眼比较差异有显著性（P＜0．05）。说明1％PC单侧点眼可降低正常家兔眼压，PC可阻断家兔葡萄膜巩膜途径房水外流，兔眼的眼压下降主要为前路排出增加所致。     

莫索尼定点眼对家兔葡萄膜巩膜途径房水流量的影响

目的　测定莫索尼定 (Moxonidine ,MOX)局部应用后对家兔葡萄膜巩膜途径 (Uveoscle raloutflow ,Fu)房水流出量的影响 ,探讨MOX局部应用的房水动力学机制。方法　正常家兔2 0只 ,随机分为 2组 ,分别采用生理盐水及莫索尼定点眼 ,点眼前及点眼后 3 0min ,测量双眼眼压。点眼后 1 .5h用 0 .1mmol/L异硫氰酸荧光素牛血清白蛋白 (Fluorescein isothiocyanatebovinealbumi,FITC BSA)行前房灌注 ,测定Fu各组织的荧光强度 ,采用改良Suguro法计算各组Fu房水再现量。结果　MOX单侧点眼后 ,点眼侧兔眼Fu房水再现量为 (7.2 1± 0 .988)×1 0 - 1 μL·3 0min- 1 ,对侧眼Fu房水再现量为 (7.5 3± 0 .2 1 4)× 1 0 - 1 μL·3 0min- 1 ,与对照组相比具有显著性差异。结论　局部点用MOX可通过增加后路房水流量降低眼压     

T-PA辅助兔青光眼滤过手术的实验研究(Ⅰ)

目的　探讨组织型纤溶酶原激活剂 (t -PA)在兔眼青光眼滤过术毕前房小剂量 (2 5μg)注射的有效性。方法　采用前瞻性、盲法对照研究 ,2 0只健康白色家兔双眼行全厚巩膜咬切滤过手术 ,术毕随机选一眼为t-PA治疗眼 ,另一眼为等量生理盐水对照眼 ,术后临床观察结合光电镜检查。结果　生理盐水对照组术后 1日和 3日滤过道及滤泡腔内有纤维蛋白凝块及红细胞栓子阻塞 ,而t-PA治疗组滤过道完全开放 ,炎性细胞及成纤维细胞的数量明显减少 ;术后 7日和 1 4日t-PA治疗组手术区肉芽组织和瘢痕组织的量亦明显少于对照组。与组织学检查相一致 ,术后 1周内治疗组滤过泡比对照组明显增大。两组均未见明显毒副作用。结论　t-PA可有效溶解滤过道及滤泡腔内的纤维蛋白凝块 ,提高青光眼滤过手术的成功率     

小梁切除与调节缝线在青光眼滤过术中的应用

小梁切除术自 196 8年Ｃａｒｎｓ首先描述以来 ,经过不断改进 ,滤过手术后的并发症明显减少。至今仍为青光眼滤过手术的主要术式。小梁切除较常见的并发症为滤过过盛引起的浅前房和低眼压 ,其不仅加重术眼的炎性反应 ,还可加速白内障的形成 ,引起角膜内皮失代偿 ,这种并发症在技术的处理上颇为棘手 ,我院自 1999年开展小梁切除与调节缝线的方法以求减小术后浅前房的发生获得良好的临床效果 ,现报道如下。1　资料与方法1 1　一般资料　　随机抽取我院 1999年 2月～ 1999年12月行小梁切除联合调节缝线的患者 2 6例 (34只眼 ) ,为联合手术组 ,…     

糖尿病性白内障超声乳化术后泪膜稳定性的动态变化

目的观察糖尿病性白内障术后泪膜稳定性的变化规律,了解糖尿病患者术后泪膜功能的改变及其影响因素。方法设计自身配对研究。选2型糖尿病性白内障患者(随机检查48例48只眼),无糖尿病者设为对照组(随机检查80例90只眼)。采取透明角膜切口超声乳化白内障吸除及折叠式后房型人工晶体植入术,术前、术后1 d、7 d、1月、3月依次行Schirmer试验(Sit)、泪膜破裂时间(BUT)、角膜荧光素染色并对其泪膜稳定性的变化进行分析。结果术前两组SIt、BUT有明显差异(P<0.001),其中糖尿病组的患者泪膜稳定性较差。与术前相比,术后1 d两组BUT均明显缩短,Schirmer-I值明显增加,角膜荧光素染色为(+);与对照组相比,糖尿病组下降明显(BUT:P<0.05;Schirmer-1P<0.001)。两组Schirmer-I值术后7d恢复至术前水平,两组恢复有显著性差异(P<0.001)。对照组BUT术后1个月恢复至术前水平(P>0.001),糖尿病组BUT术后3个月恢复至术前水平(P<0.05),两组恢复程度有明显差异(P<0.05)。术前两组的角膜荧光素染色为阴性~+,无显著性差异;术后1 d两组亦无显著性差异。与对照组相比,糖尿病组角膜荧光素染色术后1个月恢复至术前水平。结论糖尿病患者泪膜稳定性较差,术后其泪膜稳定性较对照组下降明显,恢复较慢,部分患者术后出现眼干涩、畏光、视力波动等。术前应常规检查SIt、BUT、角膜荧光素染色,有助于早期发现、及时治疗。     

MMP-2/TIMP-2系统与原发性开角型青光眼的相关性分析

目的 探讨基质金属蛋白酶-2/金属蛋白酶组织抑制因子-2(MMP-2/TIMP-2)系统在原发性开角型青光眼中的可能发病机制.方法 正常人尸眼20只,中期原发性开角型青光眼患者20只眼,晚期原发性开角型青光眼22只眼,均行常规小梁切除术,采用RT-PCR法检测小梁网组织中MMP-2 mRNA和TIMP-2 mRNA的表达.结果 正常人和中、晚期原发性开角型青光眼小梁网均有MMP-2 mRNA和TIMP-2 mRNA的表达;MMP-2 mRNA在正常人小梁网呈高表达,在原发性开角型青光眼中表达明显下调,且随病程发展其表达逐步降低;TIMP-2 mRNA在正常人小梁网呈低表达,在原发性开角型青光眼中表达明显上调,且随病程发展其表达逐步升高;原发性开角型青光眼小梁网MMP-2 mRNA/TIMP-2 mRNA比值明显低于正常人,且随病程发展比值逐步减小.结论 小梁网细胞外基质TIMP对MMP的异常抑制,造成MMP-2/TIMP-2系统的失衡,可能是原发性开角型青光眼的发病机制之一.     

小梁切除术后晚期发生双侧眼内炎

晚期发生的眼内炎是眼内手术意外引起的滤过泡,或青光眼环钻术有计划做的滤过泡的常见并发症。小梁切除术后眼内炎曾有三例报告,本例行双眼小梁切除术,在患一般的结膜炎后发生双眼眼内炎,随后完全失明。小梁切除后的眼内炎需要对合并有任何型的滤过泡的结膜炎进行有力的药物处理。     

A HISTOPATHOLOGIC IMMUNOHISTOCHEMICAL AND ULTRASTRUCTURAL STUDY OF RABBIT CORNEA AFTER EXCIMER LASER PHOTOREFRACTIVE KERATECTOMY

In excimer laser photorefractive keratectomy(PRK), the central part of the Bowman's mem-brane and superficial stroma is ablated after re-moval of the corneal epithelium. Clinical studiesshowed that the results of PRK for myopia of up to--6 diopters are satisfactory[' 'J. However, deeperresearch is needed, especially the healing processfollowing PRK,which is different from the woundhealing mechanism after conventional occularsurgery['.'J. Corneal haze and myopic regression arethe 2 main co…     

AN EXPERIMENTAL STUDY ON UVEOSCLERAL OUTFLOW WITH FITC-BSA AS A TRACER IN RABBIT EYE

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EFFECT OF FUNDUS PIGMENT ON RESPONSE OF RABBIT RETINA TO TRANSPUPILLARY THERMOTHERAPY

Objective To study the effect of fundus pigment on the response of the retina to transpupillary thermotherapy (TTT). Methods The retina were irradiated with 810 nm diode laser in 16 eyes of 8 pigmented rabbits and 12 eyes of 6 albino rabbits. The spot size was 1.2 mm; the duration was 60 s; and powers were 50, 80, 150 and 300 mW for pigmented rabbits and 800, 1 200 and 1 500mW for albino rabbits. All of the eyes were followed up with ophthalmolscope. The fundus was photographed and examined histologically with optic microscope immediately and 1 month after TTT respectively. Results The changes of the fundus and the histological examination were not significant immediately and 1 month after TTT in 50 mW group of pigmented rabbit and 800 mW of albino rabbit. Grey spot on the retina was observed on the fundus in 80 mW group of pigmented rabbit and 1 200 mW of albino rabbit immediately after TTT. The structure of the retina remained intact and subretinal fluid was observed histologically. Grey spot was still visible on the fundus, though the fluid was absorbed after 1 month. As the power of diode laser was increased to 150 mW for pigmented rabbits and 1500 mW for albino rabbit, fundus white spots were observed and the outer retina was destroyed while photoreceptors existed immediately after TTT. Pigmentation was found in white lesions and the fibrous proliferation was found in choroid 1 month after TTT. Prominent white spot was seen on the fundus immediately after laser irradiation of 300 mW in pigmented rabbits and the structure of the retina was obscured. One month after TTT, dense pigmentation appeared at laser lesions. The retina was thinner. There was prominent fibrous proliferation in the choroid. Conclusion The fundus pigment seems to play an important role in the response of the retina to TTT. The reaction of the retina is in proportion to the intensity of laser.     

Experimental study on cyclosporine A drug delivery system in prevention of posterior capsule opacification after intraocular lens implantation in rabbits

Objective To study the effect of cyclosporine A drug delivery system (CsA-DDS) on the prevention of posterior capsule opacification (PCO) after experimental intraocular lens implantation in rabbit eyes. Methods Twenty healthy New Zealand white rabbits, whose left eyes and right eyes were used respectively as experiment eyes and controls, were subjected to extracapsular lens extraction and artificial lens implantation. During the operation, CsA-DDS with poly (lactideco-glycolide) as carriers or empty DDS was implanted in the capsular bag for the experimental eyes and controls respectively. After the operation, anterior chamber reaction, intraocular pressure (IOP) and CsA concentration were monitored and twelve weeks after the operation, the eyes were extracted for histopathological and morphological examinations. Results There were no differences between the two groups in conjunctival congestion,IOP change and anterior chamber reaction. PCO was less severe in the experimental eyes than in the controls. Light microscopy revealed that posterior capsular membrane in the experimental eyes was slick, with no obvious proliferation,whereas in the controls, there were lens epithelial cell proliferation and cortex regeneration of different degrees.Morphological examination with electron microscope showed that in the experimental eyes, lens epithelial cells did not function actively and apoptosis occurred, whereas in the controls, epithelial cells presented active function. No marked ultrastructural changes were found in either group. Conclusion Cs-DDS can inhibit PCO after intraocular lens implantation in rabbit eyes and does not have toxic effects on the surrounding ocular tissues. Therefore, it has a good potential for clinical use in prevention of PCO.     

PRK术后家兔角膜透射电镜、扫描电镜的实验研究

应用 SVS APEX PLUS型准分子激光治疗系统对 6只家兔双眼进行 PRK术 ,设定右眼- 4.0 0 D,左眼 - 8.0 0 D。分别于术后 3天、30天、1 0 0天两组随机选取 1只家兔 ,使其猝死摘除双眼球 ,取其角膜。每只角膜分为两半 ,一半角膜电镜下观察其超微结构 (1 /4行 SEM,1 /4行TEM)。透射电镜观察手术后 1 0 0天 ,角膜上皮细胞基本恢复正常。扫描电镜观察则上皮细胞界限分明 ,上皮明亮细胞较多 ,但微绒毛、微皱褶相对减少。提示 PRK术后 1 0 0天角膜组织结构基本正常 ,但仍有组织薄弱处和特殊性改变。其角膜上皮微绒毛、微皱褶相对减少 ,可能是临床上PRK术后部分患者近期角膜干燥的原因之一     

前列腺素F2α和E2降低眼压及与房水cAMP含量变化关系的初探

目的 探讨小剂量前列腺素F２α和E２（PGF２α、PGE２)对正常兔眼压的作用及与环磷酸腺苷(cAMP)的房水动力学介导作用的相关性。方法 采用随机盲法对照研究,30只兔60只眼随机分成三组,每组分别点用PGF２α10μg或PGE２ １０μg或等量生理盐水。每组选10眼,用药后不同时间测量眼压。另外10眼滴药后2h抽取房水检测cAMP含量变化。结果 PGF２α治疗组用药后0..5h、PGE２组用药后1h眼压开始下降,持续至用药后5h,其中2h时眼压下降幅度最大,平均分别为0..50kPa和0..45kPa。用药2h后PGE２组房水中cAMP含量由用药前(17..50±3..80)pmol/ml增高至(37..21±4.34)pmol/ml,而PGF２α组房水cAMP含量变化不明显。结论 小剂量PGF２α及PGE２可以降低正常兔眼内压。PGE２降眼压机理与房水中第二信使cAMP的动力学介导作用相关,而PGF２α可能另有一套不同的第二信使系统。