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[通过在前房注射荧光素溶液显示正常和青光眼患者人眼的房水流出模式(作者译)]

[Demonstration of aqueous outflow patterns of normal and glaucomatous human eyes through the injection of fluorescein solution in the anterior chamber (author's transl)].

作者信息

Benedikt O

出版信息

Albrecht Von Graefes Arch Klin Exp Ophthalmol. 1976 Apr 1;199(1):45-67. doi: 10.1007/BF00660815.

Abstract

After partially injecting the anterior chamber with a 0.2% fluorescein-Ringer solution we examined using a blue filter slitlamp normal eyes, eyes with open-angle glaucoma, and eyes following iridectomy, iridencleisis, Elliot's trephination, and trabeculectomy. In normal eyes at physiological intraocular pressure, 1--9 aqueous veins were found with a mean of 4.6. The distribution of these veins was usually irregular, being more numerous and of largest caliber in the lower nasal quadrant. With only a few exceptions the aqueous veins originated 1--2 1/2 mm peripheral from the limbus and joined the episcleral veins after a short course. The venae recipientes were characterized by a straight and deep course. In eyes with an open-angle glaucoma the average number of aqueous veins was found to be increased compared to the number found in healthy eyes. However, the caliber of these veins was smaller and distribution mor uniform. Eyes having undergone iridectomy do not differ from normal eyes in the mechanism of aqueous humor outflow. After iridencleisis and after trephination the transport of aqueous humor from the anterior chamber is achieved through a filtration bleb: (1) transconjunctival, (2) by bulk-flow through lymphatic vessels, (3) diffusely through lymphatic vessels or veins. In most cases the different transport mechanisms were combined and pure types were seldom found. There was a very definite relationship found between the size of the filtration bleb and the development of draining lymphatic vessels. After trabeculectomy the following drainage mechanisms of the aqueous humor were observed: 1. Subconjunctival outflow of aqueous humor. The further drainage in this case was achieved as in the old types of fistula building operations i.e., primarily through the lymphatic vessels. 2. Direct transport of aqueous humor into the surgical area through newly incorporated veins and lymphatic vessels. 3. Drainage of aqueous humor through still functioning aqueous veins.

摘要

用0.2%荧光素 - 林格溶液部分注入前房后,我们使用蓝色滤光片裂隙灯检查了正常眼、开角型青光眼眼以及接受虹膜切除术、虹膜嵌顿术、埃利奥特环钻术和小梁切除术的眼睛。在生理眼压下的正常眼中,发现1 - 9条房水静脉,平均为4.6条。这些静脉的分布通常不规则,在下鼻象限数量更多且管径最大。除少数例外,房水静脉起源于角膜缘周边1 - 2.5毫米处,走行一段短距离后汇入巩膜表层静脉。房水静脉的特点是走行笔直且深。在开角型青光眼眼中,发现房水静脉的平均数量比健康眼中的数量增加。然而,这些静脉的管径较小且分布更均匀。接受虹膜切除术的眼睛在房水流出机制上与正常眼睛没有差异。虹膜嵌顿术后和环钻术后,房水从前房的运输是通过滤过泡实现的:(1)经结膜,(2)通过淋巴管的大量流动,(3)通过淋巴管或静脉的弥散。在大多数情况下,不同的运输机制是结合的,很少发现纯粹的类型。发现滤过泡的大小与引流淋巴管的发育之间存在非常明确的关系。小梁切除术后观察到以下房水引流机制:1. 房水的结膜下流出。在这种情况下,进一步的引流与旧的造瘘手术类型一样,即主要通过淋巴管。2. 房水通过新并入的静脉和淋巴管直接运输到手术区域。3. 房水通过仍在发挥作用的房水静脉引流。

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