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Objective To investigate the related factors and the preventive measures of choroidal detachment after glaucoma filtering surgery. Methods The clinical data of 8 patients (10 eyes) with choroidal detachment out of 337 patients (378 eyes) undergoing glaucoma filtering surgery were analyzed retrospectively. Results Of the 8 patients (10 eyes) with choroidal detachment, acute angle closure glaucoma was found in 3 patients (3 eyes), chronic angle closure glaucoma in 4 patients (6 eyes), and neovascular glaucoma in 1 patient (1 eye). The youngest was 51 years old and the oldest was 73 years old with an average age of (65.25?5.58) years old. Of the 8 patients, primary hypertension was found in 1 patient, type Ⅱ diabetes in 4 patients (diabetes patients combined with hypertension in 3 out of the 4 patients). Intraocular pressure of 3 patients (4 eyes) was regulated to the normal level [(22.38-24.38) mmHg] by medicine before operation. The remaining 5 patients (6 eyes) underwent operation at high intraocular pressure [(35.76-50.10) mmHg]. Choroidal detachment occurred at 1-11 d, (5.25?2.2) d in average. Shallow anterior chambers of 6 eyes treated by medicine therapy recovered within 5-10 d, (7.5?1.04) d in average. Shallow anterior chamber of 4 eyes treated by surgery recovered within 1-6 d, (3.65?1.45) d in average. Conclusion Occurrence of the choroidal detachment after glaucoma filtering surgery is associated with many factors, such as high intraocular pressure before operation, diabetes, hypertension, and arteriosclerosis. The preventive measures of choroidal detachment after glaucoma filtering surgery include: controlling intraocular pressure as low as possible before operation, avoiding sudden reduced intraoculer pressure during operation, forming anterior chamber at the end of operation, using releasable scleral flap sutures, adopting corticosteroid and ciliary muscle anaesthetics after operation, and avoiding mental stress.
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Objective To explore the clinical therapeutic methods for secondary glaucoma induced by the migration of silicone oil into the anterior chamber.Methods Totally 26 cases of such secondary glaucoma,including 22 aphakic eyes and 4 phakic eyes were subjected.Silicone oil was directly taken out for the patients whose retina was reposited well after silicone oil injection for over 3 months.The aphakic patients underwent 6 o'clock position peripheral iridectomy with laser or operation on prone position,then silicon oil was reinjected,and trabeculectomy was carried out through inferior cornea.The phakic patients received silicone oil aspiration with Healon from the anterior chamber.When silicone oil remigrated into the anterior chamber,the crystal was resected,silicone oil was reinjected,and 6 o'clock position peripheral iridectomy were performed.The patients were followed up for 3 months after the intraocular pressure(IOP) reaching normal range.Results Except one patient gave up treatment,all the patients had stable and normal IOP after 3 months of follow-up.IOP was controlled through different methods in 21 aphakic eyes:5 with prone position,5 with 6'clock position peripheral iridectomy through laser or operation,4 with silicon oil reinjecting,2 with direct aspiration of silicone oil,and 3 with trabeculectomy under cornea.IOP was controled in all of phakic eyes:3 with Healon aspiration of silicone oil,1 with crystal resection and reinjection of silicone oil.Conclusion Secondary glaucoma induced by migration of silicone oil into the anterior chamber can be satisfactorily treated by many ways.
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Objective To observe the early ultrastructural changes of the optic nerves after the brain impact injury. Methods Eighteen 15-week-old Wistar rats were used in the air-pressure brain impact injury examination. All of the rats underwent the procedures of right-parietal-bone fenestration after abdominal cavity anesthesia with 1% sodium pentolbarbital (45 mg/kg), and then they were divided randomly into 3 groups, i.e., mild injury group (8 rats) underwent with 7 kg of air pressure in distance of 11 cm; severe injury group (8 rats) with 7 kg of airpressure in distance of 8 cm; and control group (2 rats) underwent with the parietal-bone fenestration but without impact injury.The ultrastructural changes of the optic nerves were observed 1, 6, 24, and 72 hours after the injury by electron microscopy. Results The difference of ultrastructural changes of optic nerve was not obvious in wild injury group and the control group, and the lanthanum nitrate was only found in the blood vessels in optic nerve. The lanthanum nitrate entered the nerve stroma 1 hour after severe and increased as time goes on. Simultaneously, displayed dilatation of endoplasmic reticulum, cavitation and tumefaction of mitochondrion, vacuolation of nerve stroma, and vacuolation of some axis-cylinder were seen in the glial cells. Conclusion The brain impact injury may cause ultrastructural changes of the optic nerve and increase of permeability of blood vessels.
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Objective To compare the changes of retinal sensitivity of central 30? visual field after correction with spectacles with those before correction in juveniles and to provide data for the necessity of correction with spectacles in the measurement of juvenile central visual field. Methods The changes of the retinal sensitivity of central 30? visual field after correction with spectacles in 122 eyes of juveniles were measured using Humphrev 750 Ⅱ perimeter, and were compared with those before correction. Results All the myopic eyes of 122 juveniles passed the reliability of parameters. Among the detected eyes, 110 eyes showed degree dependent changes of the retinal sensitivity of central visual field. Conclusion Correction with spectacles should be used for the measurement of central visual field in juveniles. Otherwise, the results might be unreliable, especially in the cases with moderate and high myopia.
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Objective To study the characteristics of ocular trauma inside of the tank after being bit by the antitank bombs to provide experimental evidences for defense- and-treatment of ocular trauma. Methods A total of 48 health sheep were divided into 3 groups and put into a tank separately. The three different caliber antitank bombs were used to shot the tank forearmor: large high-energy bomb for Group I, intermediate armor-piercing explosive fire bomb for Group Ⅱ, small armor-piercing fire bomb for Group Ⅲ. After the hit, the harmful gases, temperature, blast overpressure within the cabin and the injury situations of eyes were checked. Results After fire, harmful gases and blast overpressure were increased, but the temperature was not obviously changed. Each bomb explosion caused obvious reaction in blood vessel of uvea and retina, edema and degeneration as well as the changes of ultrastructure in retina. Conclusion The ocular trauma inside of the tank are complex and serious and related to the weapon calibre, class, and wounding effect. Closed ocular trauma has the characteristics of slight wound outside and serious wound inside as well as obvious reaction in blood vessels of uvea and retina.