目的探讨弥可保(甲基维生素B12对儿童外伤性上睑下垂的治疗作用并与普通维生素B12的疗效比较.方法将58位患儿分为A,B两组.分别用弥可保和维生素B12肌肉注射及口服治疗外伤性上睑下垂,并比较它们的疗效.结果弥可保组治愈率为94.29%,有效率为100%;维生素B12组治愈率为60.87%,有效率为86.96%,完全随机两样本率比较,u值=3.1126,P＜0.05.弥可保组疗效优于维生素B12组.结论弥可保促进周围神经再生作用明显优于维生素B12,并具治疗疗程短和疗效佳的优势,可初步认为是治疗外伤性上睑下垂的一个行之有效的方法.但由于病例较少,而且未设空白对照组,故尚待继续进行研究.

目的探讨儿童眼外伤的超声影像特征及其在临床诊断中的价值.方法对经临床证实的231例237眼眼外伤眼球的声像图特征进行回顾性分析.结果发现球内异物101眼、玻璃体积血165眼、视网膜脱离的76眼、脉络膜脱离13眼及其他病变32眼.对上述各种病变的影像进行描述.结论超声检查对指导儿童眼外伤的诊断具有重要临床价值.

Objective It is to observe the effect of argon green laser combined with Shuxuetong on central retinal vein occlusion (CRVO). Methods Eighty-six patients (eighty-six eyes) with CRVO were randomly divided into treatment group and control group. The treatment group was treated with argon green laser combined with Shuxuetong, while the control group was treated with laser only. Followed up six to fifteen months, the changes of vision, fundus and fundus fluorescein angiography before and after treatment in the two groups were compared.Results The vision advancement, absorb velocity of pathological changes and improvement of macular edema in treatment group were better than that in control group. The difference was marked.Conclusion Laser combined with Shuxuetong has better effect on CRVO. The therapeutics can significantly improve illness state, rise vision and shorten disease course. The therapeutics is worth to extend.

Objective:To investigate the relationship among inflammatory reaction and cytokine levels,nitric oxide(NO) content in aqueous humor after alkali burn.Methods:12 adult New Zealand rabbits were divided into two groups(6 rabbits each):normal control group and alkali burn experimental group.Aqueous humor samples were aspirated on the alkali burn 1,3,7,14 and 30 days,and the total number of white blood cells in the aqueous humor and their subset distribution as well as tumor necrosis factor-α (TNF-α) and NO~-_2/NO~-_3 were counted.The data were analyzed using analysis of variance of SPSS software.Results:There was a higher number of inflammatory cells and a higher level of TNF-α and NO~-_2/NO~-_3 in alkali burn eyes than that in the normal control eyes.The number of mononuclear phagocyte and the levels of TNF-α,the content of NO~-_2/NO~-_3 in aqueous humor were the highest in alkali burn group in 7～14 days.The change of TNF-α,NO~-_2/NO~-_3 and inflammatory reaction were basically similar,that is ,the more serious the reaction,the higher the levels of the content.Conclusion:The intraocular inflammation after alkali burn is closely related to the change in cytokine levels and NO content in aqueous humor.

目的探讨Nd:YAG激光治疗儿童后发性白内障的临床效果,重点分析激光治疗中出现的并发症及其处理对策.方法对儿童后发性白内障40例(52只眼)行Nd:YAG激光后囊切开术,术后随访3～12月,观察并分析术后视力变化和并发症情况.结果激光截囊成功率为100%,术后视力有不同程度提高.并发症包括人工晶状体损伤(3.8%)、玻璃体前界膜破裂(15.4%)、葡萄膜炎反应(11.5%)、高眼压(9.6%)等.结论Nd:YAG激光治疗儿童后发性白内障简便有效,能明显提高视力,只要操作得当,聚焦准确,掌握好击射能量等,就能有效避免并发症的发生.

目的:研究儿童外伤性白内障后囊连续环形撕囊人工晶状体植入术对提高视力,预防弱视及后发性白内障发生的意义.方法:观察42例(42眼)儿童外伤性白内障施行现代囊外摘除、后囊连续环形撕囊及人工晶状体植入术的疗效和并发症,随访1～24月,平均12月.结果:术后葡萄膜炎反应较成人严重,矫正视力较满意,＞0.3共27眼.术后后发性白内障发生率明显下降.结论:儿童外伤性白内障后囊连续环形撕囊人工晶状体植入术是目前恢复视力、预防弱视及后发性白内障发生的有效方法.

弱视为一种儿童常见眼病之一,它严重影响儿童视功能发育.当前治疗弱视的方法很多,各种疗法都有一定的效果.但根据弱视的年龄、程度、注视性质及类型不同,采用多种方法联合治疗,更能取得较好的疗效.现将我院从1980年以来用综合疗法治疗各种弱视儿童,并追踪观察了3～15年(平均5.5年),以上资料完整的813例治疗结果报告如下.

Objective:To investigate the long-term effect of cryotherapy with liquid nitrogen on children benign ocular tumors and tumor-like lesions of 247 cases.Methods:Using liquid nitrogen as freezing source to treat benign tumors and tumor-like lesions, cotton bud method was used for tumor with it diameter less than 3mm; cryo-head was used for tumor with diameter ranging from 3mm to 5mm;decantmethod was used for tumor diameters 5mm. Results: In all 247 cases,194 cases were benign tumors,187 cases were recovered completely(97.39%),7cases were improved(3.61%).The effective rate was 100%.There were 53 cases with tumor-like lesion,52 cases were completely recovered(98.11%),1 case was improved (1.89%)the effective rate was 100%.Conclusion: Cryotherapy with liquid nitrogen is a simple,low expense and safe method of treatment, which is especially suitable for treating pediatric benign ocular tumors and tumor like lesions.It has no harmful effects to patient's appearance.

目的:观察新生儿缺氧缺血性脑病(HypoxicIschemic Encephalopthy,HIE)患儿的眼底改变,以了解两者之间的关系.方法:对231例(462眼)HIE患儿用托品酰胺散瞳后,用直接检眼镜检查眼底.结果:231例中,148例(296眼)眼底有改变,占总眼数64.07%.眼底改变主要表现为:视乳头、视网膜水肿,视网膜缺血,视网膜出血,视网膜血管病变和黄斑出血.结论:在轻、中、重度特别是中、重度HIE患儿常有眼底改变.

目的本文观察282例眼钝位对房角损伤所致房角后退的各种状态,并探讨房角后退与前房出血及青光眼的关系.方法应用Goldmann前房角镜,检查282例眼钝伤的双眼前房角,观察房角后退的各种形态,根据Howard等的分类法将房角后退分成浅(Ⅰ度),中(Ⅱ度),深(Ⅲ度)三度,并以圆周0～360°范围作记录.结果各种原因所致282例钝伤眼中,267眼有房角后退占94.68%,其中Ⅰ度房角后退119眼(44.57%),Ⅱ度95眼(35.58%),Ⅲ度53眼(19.85%).有前房出血记录者198眼(70.21%),全部有房角后退.在房角后退的267眼中,41眼有眼压升高,其中17眼房角后退为唯一原因,眼压升高均发生在1年内,大部分在1周内.其中16眼经药物治疗后1年内眼压恢复正常,1眼手术治疗.结论眼钝伤做房角镜检查,有利于发现房角损伤,并综合各种损伤分析病情,指导临床治疗.若发现房角后退＞180°时,有可能发生青光眼,应定期随诊.

目的:分析儿童眼部肿瘤的发病特点.方法:对341例儿童眼部肿瘤患者的年龄、性别、肿瘤发生部位及病理类型进行回顾性分析.结果:患儿平均发病年龄4.2岁,341例儿童眼部肿瘤中,良性肿瘤12种233例(68.33%),恶性肿瘤3种108例(31.67%).结论:视网膜母细胞瘤105例(97.33%),在恶性肿瘤中发病率最高.从发现症状到就医的早迟,视网膜母细胞瘤不同时期的平均发生时间有显著性差异(P＜0.05).定期对5岁以内儿童进行眼部检查,对提高视网膜母细胞瘤的存活率至关重要.

目的:观察睫状体冷冻治疗各种类型晚期青光眼的远期效果.方法:对我科1989～1999年冷冻睫状体治疗晚期青光眼137眼进行回顾性分析.结果:治疗后平均眼压下降2.9kPa(P＜0.01).以最终眼压低于2.8kPa为标准,新生血管性青光眼眼压控制率为78.95%,继发性青光眼控制率为75%.原发闭角与开角青光眼控制率为67.31%.疼痛控制率为96 64%.并对冷冻的温度、范围、次数、时间及术后并发症及其机理作了探讨.结论:睫状体冷冻治疗对于难以控制的青光眼是一种有效的治疗措施.