目的观察大鼠角膜碱烧伤使用羊膜匀浆提取液(extraction of amniotic membrane,EAM)后角膜瘢痕的变化,探讨羊膜匀浆提取液应用于角膜碱烧伤的临床价值及作氉用机理。方法取SD大鼠40只随机分为EAM组(20只)和对照组(20只),所有大鼠通过1 m...目的观察大鼠角膜碱烧伤使用羊膜匀浆提取液(extraction of amniotic membrane,EAM)后角膜瘢痕的变化,探讨羊膜匀浆提取液应用于角膜碱烧伤的临床价值及作氉用机理。方法取SD大鼠40只随机分为EAM组(20只)和对照组(20只),所有大鼠通过1 mol·L-1的NaOH溶液建立右眼角膜碱烧伤模型。EAM组行EAM滴眼,每天4次,对照组用PBS缓冲液滴眼。通过裂隙灯显微镜下观察大鼠角膜透明性,角膜共聚焦显微镜动态观察大鼠角膜超微结构的变化,计算肌成纤维细胞的数量。结果碱烧伤后28 d,EAM组的角膜透明度评分明显好于对照组,两组分别为2.36±0.81和3.36±1.12(P<0.01)。碱烧伤后第9天、第11天、第14天EAM组肌成纤维细胞密度均小于对照组,各时间点EAM组、对照组分别为(201±39)个·mm-2、(291±48)个·mm-2,(248±84)个·mm-2、(349±105)个·mm-2,(108±57)个·mm-2、(175±62)个·mm-2,两组之间差异均有统计学意义(均为P<0.01)。结论新鲜EAM可以有效抑制碱烧伤后肌成纤维细胞的激活和增殖,减少角膜瘢痕的形成。展开更多
Purpose To determine the frequency o f ocular manifesta-tions in inherited epidermolysis bullosa(EB)within the continental United States and to define the estimated cu-mulative risks of developing nonscarring(blisters...Purpose To determine the frequency o f ocular manifesta-tions in inherited epidermolysis bullosa(EB)within the continental United States and to define the estimated cu-mulative risks of developing nonscarring(blisters or ero-sions)and scarring corneal manifestation s within each major EB subtype over time.Design Observational(cross-sectional and longitudinal).Methods Up to 16years of longitudinal follow-up was conducted on 3,280consec-utively enrolled patients in the National EB Registry,an epidemiologic study funded by the Na tional Institutes of Health.Data were stratified by majo r EB type and subtype.Frequencies of occurrence were dete rmined for eight vari-ables(corneal erosions or blistering;corneal scarring;symblepharons;blepharitis;ectro pions;lacrimal duct ob-struction;impaired vision;blindn ess)by contingency ta-bles,and cumulative risks were generated by life table analysis technique.Results The most common ocular manifestations were corneal erosio ns and blisters.Fre-quencies mirrored relative severity of skin disease,with74.10%of all patients with recessiv e dystrophic EB,Hallopeau-Siemens(RDEB-HS )and 47.50%of all pa-tients with junctional EB,Herlitz(JEB-H)experiencing at least one episode.Lower frequencie s were noted for corneal scarring.Symblepharons and ectrop ions were most com-monly seen in inversa RDEB and JEB-H,respectively.Blindness was reported in 6.47%of RD EB-HS patients.The cumulative risks of nonscarring and scarring corneal lesions in JEB-H at age 5are 83.18%an d 27.08%and at age 25are 83.18%and 72.22%.With tim e,the cumu-lative risk of each in RDEB-HS approached that reported in JEB-H patients.Conclusion Ocular d isease activity,par-ticularly corneal,is common in some EB subtypes.Careful ophthalmologic examination should become an integral part of the management of all patients wit h inherited EB.展开更多
Purpose. To report three cases of adenoviral keratoconjunctivitis in patients who have undergone photorefractive keratectomy and that just developed subepithe lial infiltrates. Methods. Description of patients that de...Purpose. To report three cases of adenoviral keratoconjunctivitis in patients who have undergone photorefractive keratectomy and that just developed subepithe lial infiltrates. Methods. Description of patients that developed postoperative adenoviral keratoconjunctivitis after photorefractive keratectomy without influe nce in the final visual outcome. Results. All patients presented adenoviral kera toconjunctivitis 2-3 months after refractive surgery. They developed multiple p inpoint subepithelial infiltrates in six eyes, without haze development. The final uncorrected visual acuity was better or equal to 20/30. Conclusion. Although patients undergoing photorefractive ker atectomy might develop severe corneal scarring following ocular infections, such events may follow their natural evolution.展开更多
Introduction: Visual rehabilitation after open globe injury may be a challengi ng process because of ametropia following aphakia, corneal scarring with high or irregular corneal astigmatism or loss of contrast sensiti...Introduction: Visual rehabilitation after open globe injury may be a challengi ng process because of ametropia following aphakia, corneal scarring with high or irregular corneal astigmatism or loss of contrast sensitivity due to traumatic aniridia. We report on contact lens fitting for visual rehabilitation in patient s after open globe injury. Patients: From 2000 to 2003, contact lenses were fitt ed unilaterally for the visual rehabilitation in 13 patients after open globe in jury. In three patients we found unilateral aphakia, in 8 patients a high or irr egular astigmatism after penetrating or autorotation keratoplasty and in two pat ients a traumatic aniridia, in one case combined with aphakia. Results: 11 rigid contact lenses were fitted with different designs of the front and back surface as well as two iris-print lenses. In 11 patients (86%) a good visual rehabili tation was achieved with an increase of visual acuity up to 9 lines while obtain ing a good contact lens tolerance. One patient wearing an iris-print contact le ns was unable to tolerate the contact lens due to its thickness and its weight. In another patient fitting of a contact lens was not possible because of the com plicated corneal condition. We did not observed severe contact lens complication s at any time. Conclusions: In addition to operative procedures for visual rehab ilitation after open globe injuries, the use of contact lenses is another possib le procedure for refractive correction. Different problems such as ametropia fol lowing aphakia, irregular or high astigmatism or aniridia can be solved with goo d visual results, good tolerance and less complications.展开更多
文摘Purpose To determine the frequency o f ocular manifesta-tions in inherited epidermolysis bullosa(EB)within the continental United States and to define the estimated cu-mulative risks of developing nonscarring(blisters or ero-sions)and scarring corneal manifestation s within each major EB subtype over time.Design Observational(cross-sectional and longitudinal).Methods Up to 16years of longitudinal follow-up was conducted on 3,280consec-utively enrolled patients in the National EB Registry,an epidemiologic study funded by the Na tional Institutes of Health.Data were stratified by majo r EB type and subtype.Frequencies of occurrence were dete rmined for eight vari-ables(corneal erosions or blistering;corneal scarring;symblepharons;blepharitis;ectro pions;lacrimal duct ob-struction;impaired vision;blindn ess)by contingency ta-bles,and cumulative risks were generated by life table analysis technique.Results The most common ocular manifestations were corneal erosio ns and blisters.Fre-quencies mirrored relative severity of skin disease,with74.10%of all patients with recessiv e dystrophic EB,Hallopeau-Siemens(RDEB-HS )and 47.50%of all pa-tients with junctional EB,Herlitz(JEB-H)experiencing at least one episode.Lower frequencie s were noted for corneal scarring.Symblepharons and ectrop ions were most com-monly seen in inversa RDEB and JEB-H,respectively.Blindness was reported in 6.47%of RD EB-HS patients.The cumulative risks of nonscarring and scarring corneal lesions in JEB-H at age 5are 83.18%an d 27.08%and at age 25are 83.18%and 72.22%.With tim e,the cumu-lative risk of each in RDEB-HS approached that reported in JEB-H patients.Conclusion Ocular d isease activity,par-ticularly corneal,is common in some EB subtypes.Careful ophthalmologic examination should become an integral part of the management of all patients wit h inherited EB.
文摘Purpose. To report three cases of adenoviral keratoconjunctivitis in patients who have undergone photorefractive keratectomy and that just developed subepithe lial infiltrates. Methods. Description of patients that developed postoperative adenoviral keratoconjunctivitis after photorefractive keratectomy without influe nce in the final visual outcome. Results. All patients presented adenoviral kera toconjunctivitis 2-3 months after refractive surgery. They developed multiple p inpoint subepithelial infiltrates in six eyes, without haze development. The final uncorrected visual acuity was better or equal to 20/30. Conclusion. Although patients undergoing photorefractive ker atectomy might develop severe corneal scarring following ocular infections, such events may follow their natural evolution.
文摘Introduction: Visual rehabilitation after open globe injury may be a challengi ng process because of ametropia following aphakia, corneal scarring with high or irregular corneal astigmatism or loss of contrast sensitivity due to traumatic aniridia. We report on contact lens fitting for visual rehabilitation in patient s after open globe injury. Patients: From 2000 to 2003, contact lenses were fitt ed unilaterally for the visual rehabilitation in 13 patients after open globe in jury. In three patients we found unilateral aphakia, in 8 patients a high or irr egular astigmatism after penetrating or autorotation keratoplasty and in two pat ients a traumatic aniridia, in one case combined with aphakia. Results: 11 rigid contact lenses were fitted with different designs of the front and back surface as well as two iris-print lenses. In 11 patients (86%) a good visual rehabili tation was achieved with an increase of visual acuity up to 9 lines while obtain ing a good contact lens tolerance. One patient wearing an iris-print contact le ns was unable to tolerate the contact lens due to its thickness and its weight. In another patient fitting of a contact lens was not possible because of the com plicated corneal condition. We did not observed severe contact lens complication s at any time. Conclusions: In addition to operative procedures for visual rehab ilitation after open globe injuries, the use of contact lenses is another possib le procedure for refractive correction. Different problems such as ametropia fol lowing aphakia, irregular or high astigmatism or aniridia can be solved with goo d visual results, good tolerance and less complications.
