Objective To evaluate the clinical efficiency of fresh amniotic membrane transplantation in treatment of stenosis of conjunctival sac. MethodsThirty cases (30 eyes) of stenosis of conjunctival sac were treated with fresh amniotic membrane transplantation. Amniotic membrane was obtained under sterile conditions after elective cesarean delivery. The woman’s serum was negative for HBsAg, syphilis, and human immunodeficiency virus. The placenta was first washedfree of blood clots with sterile saline. Under sterile conditions, the inner amniotic membrane was separated from the chorion by blunt dissection, and was cleaned of blood with the sterile saline again. The membrane was then flattened onto a surgidrape adhesive paper with the epithelium surface up. The paper with the adherent amniotic membrane was then cut into 5 cm×8 cm pieces, and then rinsed in solution containing 4×106 U/L of gentamycin and stored at 4℃. It could bestored for 12 hours after preparation. The-adhesiotomy was performed firstly. The separation between the conjunctiva and scar tissue should be complete and wide enough to reach to the orbital margin. The adhesiectomy was taken secondly. The scar tissues were removed completely. The fresh amniotic membrane was flattened onto the conjunctival defect with epithelium side up. The fresh amniotic membranewas 10 mm more than the conjunctival defect by trimming off the excess portion.This fashioned membrane was then secured to surrounding conjunctival edge with continuous 7-0 nylon sutures. The necessary mattress suture of inferior conjunctival fornix via skin next to the inferior orbital margin was performed simultaneously. The retrobular implantation of the an artificial globe made of hydroxyapatite was performed on some patients with sunken eye. Correction of traumatic ptosis was performed on a few patients.Results The operation ofreconstruction of partial conjunctival sac for 30 cases was successful. All amniotic membrane grafts were alive. The cosmetic result was complete favorable. The infection and contracture of the graft, immunologic rejection and amniotic lysis were not observedin all cases during the follow-up period of 13-18 months.Conclusion Fresh amniotic membrane transplantation can be used in reconstruction of the partial conjunctival sac effectively and can be popularized in thelocal hospital in China because the amniotic membrane can be obtained easily.
PURPOSE:To evaluate the value of the apoptosis-suppressing oncogene bcl-2 protein expression in the development and progression of uveal and conjunctival melanomas. METHODS:Using flow cytometry and immunofluorescence methods to detect the bcl-2 protein expression in 40 cases of uveal malignant melanomas (UMM), 5 cases of conjunctival nevi (CN) and 7 cases of conjunctival malignant melanomas (CMM). RESULTS :The expression content of bcl-2 protein in CMM was significantly higher than that in CN (P＜0.05);the bcl-2 protein positive expression percentages in CMM and UMM were 85.71% and 72.50% respectively. The expression content of bcl-2 protein in UMM was not related to pathological classfication, scleral invasion,ciliary body involvement,and tumor dimensions (P＞0.05). CONCLUSIONS: The over-expression of bcl-2 protein and apoptosis suppressing might be related to the pathogenesis of CMM and UMM;bcl-2 protein expression might be helpful in discriminating CN from CMM, but unavailable in evaluating the patholgical malignancy of UMM. （Chin J Ocul Fundus Dis,1997,13: 73-74 ）
We compared the sensitivities of human embryo conjtmctival fihroblasts(HECF)and rabbit conjunctival fibroblasts(RCF)m five anlineoplasties in vitro.When the concentration of vincrismum and doxorubicin was 0.001~10mg/L.5-FU was 1~1000mg/L and cisplatin was 0.01~10mg/L,the sensitivities of HECF to tile drugs were lower than that of RCF (Plt;0.01).while the difference of the sensitivilics be;ween HECF and RCF to VP-16 was not significant (P＜0.05). The results suggested that the selection of therapeutic agents for intraocular proliferative disease wilh'hunmn conjunctiva fihroblasts may be more valuable than that with RCF. （Chin J Ocul Fundus Dis,1994,10:223-225）
【摘要】 目的 观察在表面麻醉下不作结膜瓣和传统的以穹窿为基底结膜切开的小切口白内障摘除联合5.5 mm直径人工晶状体植入术的临床效果。 方法 收集2007年1月－2010年12月资料较完整的老年性白内障160例，将160例320只眼随机分成两组，每组各80例160只眼。在表面麻醉下行小切口白内障手术。A组不做结膜瓣，行长5.5 mm角巩膜缘的平行切口； B组行以穹窿为基底的传统的结膜瓣，做长5.5 mm角巩膜平行切口；两组均行手法小切口白内障劈核摘除联合5.5 mm直径硬质人工晶状体植入。观察术后效果及术后并发症。 结果 术后1个月，患者眼部舒适者:A组154只眼（96.25%），B组141只眼（88.13%），两组差异有统计学意义（χ2=7.332，Plt;0.05）。术后结膜退缩、下垂、巨大瘢痕：A组7只眼（4.38%），B组29只眼（18.13%），两组差异有统计学意义（χ2=15.149，Plt;0.01），两组患者术后1 d、1周及1个月视力比较：1 d，A组120只眼（75.00%），B组128只眼（80.00%）（χ2=1.467，Pgt;0.05）；1周，A组130只眼（81.25%），B组132只眼（82.25%）（χ2=0.084，Pgt;0.05）；1个月，A组138只眼（86.25%），B组139只眼（86.86%）（χ2=0.027，Pgt;0.05）；角膜水肿于术后2周后均消退。 结论 在表面麻醉下不做结膜瓣较做结膜瓣小切口白内障劈核摘除术联合人工晶状体植入术省时、对眼表面破坏小，角巩膜切口较小且较为隐闭，术后恢复快。在基层医院是一种较好的白内障手术方法。【Abstract】 Objective To observe the clinical effect of non-conjunctival flaps and traditional conjunctival flaps choper extracapsular cataract extraction (ECCE) on patients with senile cataracts. Methods The clinical data of 160 patients with cataracts between January 2007 and December 2010 were collected. The patients were randomly divided into two groups with 80 patients (160 eyes) in each group. The patients in group A underwent the small-incision choper ECCE surgery with non-conjunctival flaps; while the patients in group B underwent the traditional conjunctival flaps. Then the total effective rate, incidence of complications, and satisfaction rate of the two groups were analyzed and compared. Results One month after the surgery, the comfort was found in 154 eyes (96.25%) in group A and in 141 eyes (88.13%) in group B; the difference was significant (χ2=7.332，Plt;0.05). The complications after the surgery including conjunctiva retraction, nutation, and huge scar were found in 7 eyes (4.38%) in group A and in 29 eyes (18.13%) in group B, and the difference was significant (χ2=15.149，Plt;0.01) . The visual acuity of the patients one day, one week and one month after the surgery in the two groups were: one day: 120 eyes (75.00%) in group A and 128 eyes (80.00%) in group B (χ2=1.467，Pgt;0.05); one week: 130 eyes (81.25%) in group A and 132 eyes (82.25%) in group B (χ2=0.084，Pgt;0.05); one month: 138 eyes (86.25%) in group A and 139 eyes (86.86%) in group B (χ2=0.027，Pgt;0.05). The cornea edema was alleviated half month after the surgery. Conclusion Compared with the traditional way, non-conjunctival flaps ECCE may save the surgical time, reduce the damage of the ocular surface, improve the visual acuity and received higher satisfaction rate and less conjunctive complication, which is a good surgical method in local hospital.
目的 分析眼表面肿块的发病情况及组织病理学特点。 方法 对2004年1月-2008年12月收治并经病理学证实的326例眼表面肿块患者的年龄、性别、眼别、肿块发生部位、肿块性质及病理类型进行回顾性分析。 结果 326例眼表面肿块中，良性肿块264例（81.0%），恶性肿块62例（19.0%）。良性肿块中，前5位分别为色素痣67例（25.4）%，迷芽瘤63例（23.9）%，乳头状瘤39例（占14.8）%，结膜囊肿25例（9.5）%，炎性肉芽肿20例（7.6）%。恶性肿块中，前4位分别为鳞状细胞癌25例（40.3）%，淋巴瘤13例（21.0）%，恶性黑色素瘤12例（19.4）%，原位癌10例（16.1）%。 结论 眼球表面的肿块有共同的组织细胞起源，肿块的亚型表现出不同的组织结构、良恶性和好发部位；而同部位的良性、交界性和恶性病变的衍变发展，从某种程度上体现了一个疾病的不同发展阶段，三者间的鉴别和明确的病理诊断能为临床选择手术时机及手术方式提供依据。
【摘要】 目的 探讨结膜恶性黑色素瘤的手术治疗方法。 方法 1997年1月-2007年1月收治结膜恶性黑色素瘤48例，均为单眼。肿瘤范围:lt;1/3眼睑长度及结膜14例，gt;1/3眼睑长度，部分穹隆结膜受累19例，上下眼睑及内外眦大部分结膜受累者15例。采用单纯肿瘤切除术、单纯肿瘤切除联合液氮冷冻治疗、眼眶内容物剜除术3种治疗方法。 结果 所有患者均经病理学证实为结膜恶性黑色素瘤 。术后48例进行9个月～5年随访，15例眶内容物剜除术，3例死于肺及颅脑转移；14例单纯扩大肿瘤切除联合液氮冷冻治疗，2例死于肝转移；19例单纯扩大肿瘤切除术，6例分别死于肝、肺及颅脑转移。 结论 早期诊断并选择积极有效的手术治疗是提高患者生存率，改善生存质量的重要手段。手术切除联合液氮冷冻法可有效降低肿瘤复发，避免影响患者视觉质量和外观，是治疗结膜恶性黑色素瘤的一种有效方法。【Abstract】 Objective To investigate the surgical therapeutics for malignant melanoma of eyelid conjunctiva. Methods A total of 48 patients with monocular malignant melanoma of eyelid conjunctiva from January 1997 to January 2007 were collected. The scope of the melanoma involved lt;1/3 eyelid length and conjunctiva in 14, gt;1/3 eyelid length and part of conjunctival formix in 19, and upper and lower eyelid and most of the conjunctiva of medial and lateral canthus in 15. Eye socket exenteration,tumor resection combine with eyelid reconstruction, tumor resection were used. Results All of the patients were diagnosed as malignant melanoma of eyelid conjunctiva by pathological examination. The follow-up period was 9 months-5 years. Among the 15 patients who had undergone eye socket exenteration,3 died. Among the 14 patients who had undergone expand tumor resection combine with liquid nitrogen frozen, 2 died. Among the 19 patients who had undergone tumor resection combine with eyelid reconstruction, 6 died. Conclusion Tumor resection combine with liquid nitrogen frozen is effective on malignant melanoma of eyelid conjunctiva.