简介：目的：观察结膜松弛症松弛结膜组织和泪液中黏蛋白的表达变化，探讨结膜松弛症的发病机制。方法：收集结膜松弛症组38例38眼和正常对照组36例36眼的结膜组织和泪液标本，分别行免疫组织化学染色检测结膜组织中黏蛋白（MUC2、MUC4、MUC5AC、MUC16）表达情况，ELISA检测泪液中黏蛋白（MUC2、MUC4、MUC5AC、MUC16）A值，结果行统计学分析，比较两组之间的差异。结果：结膜松弛症组的结膜上皮细胞中MUC2、MUC4与正常对照组表达无统计学差异（P=0.315、0.156）；结膜松弛症组的结膜上皮细胞中MUC5AC、MUC16阳性表达细胞较正常对照组明显减少，差异有统计学意义（P=0.016、〈0.01）。结膜松弛症组泪液中MUC2的A值与正常对照组无统计学差异（P=0.651），结膜松弛症组中MUC4、MUC5AC的A值较正常对照组明显降低，有显著的统计学差异（均P〈0.01），结膜松弛症组中MUC16的A值较正常对照组下降，差异有统计学意义（P=0.022）。结论：结膜松弛症患者结膜组织和泪液中MUC5AC和MUC16均下降，对其进一步研究可能揭示结膜松弛症的发病机制。

简介：目的探讨当前基层医院沙眼防治工作中出现的若干问题。方法对门诊记录的14600例沙眼患者依据年龄、生活习惯、卫生习惯、是否接受正规有效治疗以及复诊等情况进行调查和追踪随访。结果沙眼检出率高达22.86%,这与社会因素、个人的生活卫生习惯、不能接受正规有效的治疗和复诊率低密切相关。结论大力推广WHO的SAFE策略,开展＂防沙＂健康教育工作,规范治疗,降低沙眼患病率,提高沙眼疗效。

简介：目的比较24h眼压监测中夜间即刻坐位眼压值和坐起休息10min后测得的眼压值，探讨夜间眼压的不同测量方法对青光眼24h眼压昼夜波动的影响。方法对已确诊且未用药、未做过手术的48例正常眼压性青光眼及17例原发性开角型青光眼患者进行24h眼压监测，每2h1次，其中测量夜间0：00、2：00、4．00眼压时，逐个唤起患者后立即测，后嘱患者坐起休息10min再测，采用SPSS软件以配对t检验分析比较测量结果。结果夜间即刻坐位眼压值和坐起休息10rain后测得的眼压值差异有统计学意义（P〈0．001），正常眼压性青光眼与原发性开角型青光眼间眼压差值差异有统计学意义（P〈0．05）。结论即刻坐位眼压值能更准确反映夜间眼压，对24h眼压测量及青光眼诊断及治疗更有价值，值得临床应用。

简介：病例介绍患者男38岁,因＂右眼义眼台1期植入术后5年暴露1年＂入院。病程中在外院三次行右眼义眼台暴露结膜切口对位缝合术、羊膜修补术及唇黏膜修补术,结果均失败。体检：右眼睑无红肿,右眼义眼台暴露约6mm×8mm,周围球结膜轻度充血,表面少量粘性物覆盖,眼台运动基本正常,余未见明显异常。完善各项检查后拟局麻下行义眼台暴露自体中薄皮瓣移植修复术。

简介：Choroidalneovascularization(CNV)isanuncommoncomplicationassociatedwithamacularhole.Inthiscasereportofararecondition,wepresentapathologicmyopiapatientwithaco-existentmacularholeandchoroidalneovascularmembrane.ThepatientwastreatedwithphotodynamictherapyforCNV,andthenvitreoussurgeryfortheretinaldetachmentandmacularhole.Attheendof4yearsfollow-up,hervisualacuitywasimprovedto0.1whilethemacularholeremainedopen.OpticalcoherencetomographyisausefulinspectionmethodofthediagnosisofCNVandmacularhole.

简介：AIM:Tocomparethetrabecularmeshwork(TM)andirisapoptosisoftreatedanduntreatedprimaryopenangleglaucoma(POAG)patients.METHODS:Eighttreatment-naive,newlydiagnosed(group1)and11medlcaiytreated(group2)patientswithPOAGwereincludedinthestudy.Eachpatientunderwentalimbus-basedtrabeculectomy.TheTMandperipheralirisspecimensweredissectedoutandweresnap-frozeninliquidnitrogenandstoredat-80tuntiltheywereassayed.ApoptosisineachgroupwasassesedbyTUNELmethod.RESULTS:Themeanpatientagewas60.6±5.8years(53-68years)vs58.9±8.9years(47-70years)ingroup1andgroup2(P=0.859).Themeantreatmenttimeingroup2was22.2±7.3months(12-34months).ApoptoticindexesinTMandirisweresignificantlyhigherinPOAGpatientsusingmedication(group2)comparedtotreatment-naivePOAGpatients(group1)(P=0.004,0.015;respectively).CONCLUSION:LongtermadministrationoftopicalantiglaucomamedicationscausesadditionaltoxiceffectsonTM.

简介：AIM:Toinvestigatetheaccuracyofintraocularpressure(IOP)asmeasuredbyaReichertOcularResponseAnalyzer(ORA),aswellastherelationshipbetweencentralcornealthickness(CCT)andIOPasmeasuredbyORA,Goldmannapplanationtonometry(GAT),anddynamiccontourtonometry(DCT).·METHODS:Atotalof158healthyindividuals(296eyes)werechosenrandomlyformeasurementofIOP.AfterCCTwasmeasuredusingA-ultrasound(A-US),IOPwasmeasuredbyORA,GAT,andDCTdevicesinarandomizedorder.TheIOPvaluesacquiredusingeachofthethreetonometrieswerecompared,andtherelationshipbetweenCCTandIOPvalueswereanalyzedseparately.TwoIOPvalues,Goldmann-correlatedIOPvalue(IOPg)andcorneal-compensatedintraocularpressure(IOPcc),weregotusingORA.ThreegroupsweredefinedaccordingtoCCT:1)thincornea(CCT<520μm);2)normal-thicknesscornea(CCT:520-580μm);and3)thickcornea(CCT>580μm)groups.·RESULTS:Innormalsubjects,IOPmeasurementswere14.95±2.99mmHgwithORA(IOPg),15.21±2.77mmHgwithORA(IOPcc),15.22±2.77mmHgwithGAT,and15.49±2.56mmHgwithDCT.Meandifferenceswere0.01±2.29mmHgbetweenIOPccandGAT(P>0.05)and0.28±2.20mmHgbetweenIOPccandDC(P>0.05).TherewasagreatercorrelationbetweenIOPccandDCT(r=0.946,P=0.000)thanthatbetweenIOPccandGAT(r=0.845,P=0.000).DCThadasignificantcorrelationwithGAT(r=0.854,P=0.000).GATwasmoderatelycorrelatedwithCCT(r=0.296,P<0.001),whileIOPccshowedaweakbutsignificantcorrelationwithCCT(r=0.155,P=0.007).TherewasastrongnegativecorrelationbetweenCCTandthedifferencebetweenIOPccandGAT(r=-0.803,P=0.000),withevery10increaseinCCTresultinginanincreaseinthisdifferenceof0.35mmHg.Thethickcorneagroup(CCT>580μm)showedtheleastsignificantcorrelationbetweenIOPccandGAT(r=0.859,P=0.000);whilethethincorneagroup(CCT<520μm)hadthemostsignificantcorrelationbetweenIOPccandGAT(r=0.926,P=0.000).ThecorrelateddifferencesbetweenIOPccan

简介：AIM:Tostudytheimpactofscleralflapposition,underwhichtheposteriorchamberintraocularlenses(PC-IOL)weresulcus-fixedbytrans-scleralsuture,oncorneaastigmatism.METHODS:Twenty-sixaphakicorcataracteyeswerecomprisedinthisprospectivenoncomparativecaseseriesstudy.Eleveneyeshadtraumaticcataractremovedwithoutsufficientcapsularsupport,3hadblunttraumawithsubluxatedtraumaticcataract,8hadundergonevitreoretinalsurgeryand4hadcongenitalcataractremoved.Theaverageagewas54years(range21-74years),with17menand7women.ThefoldablePC-IOLwasfixedinsulcusbytrans-scleralsuture.TheincisionforIOLimplantationwasmade1mmposteriortolimbusalongthesteepestmeridianofcornea,whilescleralflapstoburytheknotsoftrans-scleralsutureweremadealongtheflattestmeridian.Allthesurgerieswereperformedbyasingledoctor(MaL),andthefollowupwasatleast13months(range13-28months).Thepreoperative,3monthsand1yearpostoperativecornealcurvaturealongthesteepestandflattestcorneameridianandoverallcorneaastigmatismwerecompared.RESULTS:Thecurvaturealongthesteepestmeridianchangedfrom44.25±2.22Dpreoperativelyto44.08±2.16Dat3monthspostoperatively,and43.65±5.23Dat1yearpostoperatively(P>0.05);thecurvaturealongtheflattestmeridianchangedfrom41.24±2.21Dpreoperativelyto43.15±3.94Dat3monthspostoperatively,and42.85±5.17Dat1yearpostoperatively(P<0.05);andthesurgeryinducedastigmatism(SIA)oncorneawascalculatedbyvectoranalysis,whichwas2.42±2.13Dat3monthspostoperatively,and2.18±3.42Dat1yearpostoperatively,thedifferencewasstatisticallysignificant(P<0.05).CONCLUSION:Thescleralflapmadealongtheflattestmeridian,underwhichtheposteriorchamberintraocularlenses(PCIOL)weresulcus-fixedbytrans-scleralsuture,cansteepenthecorneainvaryingdegrees,thusreducingpreexistingcornealastigmatism.

简介：在眼外伤司法鉴定中,医学影像学检查技术可为法医学鉴定人提供客观的鉴定资料并作为主要的鉴定依据。本文对医学影像学检查技术在眼外伤司法鉴定中的应用及法医学意义进行分析及探讨。

简介：目的探讨手法小切口白内障囊外摘除联合人工晶体植入术在民生工程中的应用及体会。方法在濉溪县残联组织的民生工程中,共对300例（300眼）患者实施手法小切口白内障囊外摘除联合人工晶体植入术。结果术后第一天视力：在0.05以上者296例,脱盲率为98.67%;0.3以上者275例,脱残率91.67%。结论手法小切口白内障囊外摘除联合人工晶体植入术尤其适用于基层医院开展规模化的白内障复明手术。

简介：年龄相关性黄斑变性（age-relatedmaculardegeneration,AMD）是由多种因素诱发的、与年龄相关的一组黄斑疾病。AMD以黄斑部视网膜及其下的视网膜色素上皮（retinalpigmentepithelium,RPE）和脉络膜发生病变,并导致患者视功能障碍和中心视力下降为特点,已成为我国老年人群不可逆视力损伤的主要原因[1]。

简介：目的采用隧道式切口制作巩膜瓣.方法对90例120只眼青光眼进行治疗.取得了很好的疗效.结果120只眼在术后1-2天前房形成97只眼,经过按摩后使前房形成的10只眼,经加压包扎等处理后恢复前房的13只眼.随访8个月～3年,弥散扁平型滤过泡113只眼;包囊性过滤泡5只眼;滤枕扁平无滤过功能2只眼.眼压控制:111只眼眼压在12～18mmHg之间,9只眼眼压高于25mmHg.结论巩膜瓣制作切面光滑及厚度均匀与否对于巩膜瓣的粘连有一定的关系.采用白内障隧道刀制作巩膜瓣具有取材方便,制作简便,滤过效果好等优点.

简介：目的探讨健康体检中青光眼筛查方法及结果分析。方法采用同顾分析方法对我院健康体检数据库资料进行分析。结果在121697人健康体检中，发现青光眼1381例，患病率为1.14％，原发性闭角型青光眼（PACG）810例，患病率为0.67％，原发性开角型青光眼（POAG）476例，患病率为0.39％，正常眼压性青光眼（NTG）44例，患病率为0.04％，继发性青光眼（SG）51例、患病率为0。04％。正常大陷门者112例，术发现先天性青光眼。结论青光眼筛查方法应简易、快捷、价廉及有效的。对健康体检作青光眼筛查足必要的并且足可行的，而且在健康体检数据中为所有受检建立健康档案，这对青光眼患者诊断、治疗及评估有十分重要意义，特别对可疑青光眼受检者有一个长期跟踪观察及对比机会。

简介：AIM:Toaddressissuesininteroperabilitybetweendifferentfundusimagesystems,weproposedawebeyepicturearchivingandcommunicationsystem(PACS)frameworkinconformancewithdigitalimagingandcommunicationinmedicine(DICOM)andhealthlevel7(HL7)protocoltorealizefundusimagesandreportssharingandcommunicationthroughinternet.METHODS:Firstly,atelemedicine-basedeyecareworkflowwasestablishedbasedonintegratingthehealthcareenterprise(IHE)EyeCaretechnicalframework.Then,abrowser/serverarchitectureeye-PACSsystemwasestablishedinconformancewiththewebaccesstoDICOMpersistentobject(WADO)protocol,whichcontainsthreetiers.RESULTS:Inanyclientsysteminstalledwithwebbrowser,clinicianscouldlogintheeye-PACStoobservefundusimagesandreports.Multipurposeinternetmailextensions(MIME)typeofastructuredreportissavedaspdf/htmlwithreferencelinktorelevantfundusimageusingtheWADOsyntaxcouldprovideenoughinformationforclinicians.Somefunctionsprovidedbyopen-sourceOviyamcouldbeusedtoquery,zoom,move,measure,viewOICOMfundusimages.CONCLUSION:Suchwebeye-PACSincompliancetoWADOprotocolcouldbeusedtostoreandcommunicatefundusimagesandreports,thereforeisofgreatsignificanceforteleophthalmology.

简介：随着研究生招生观念的转变，招收的医学临床专业学位研究生的比重越来越大，对专业型研究生的培养也越来越注重实用。我们在眼科专业型研究生临床培养中，增加病房临床实践时间，特别注重典型病例的示范作用，每一个专业组都会结合自己专业的特点，将典型病例的特点从各个角度展示给广大研究生们，培养其临床诊治思辨能力，培训其显微手术技巧，从临床病历书写到记录总结，结合文献复习，拓展知识结构，锻炼专业型研究生论文书写能力，并以典型病例为基础，扩展知识覆盖面，引申注意事项及特殊病例的诊治。这套严格的培养体系，使专业型研究生能举一反三，从典型病例、重点病例中获取对该种病情的最直观的全景了解与熟悉，以最少的时间掌握最多的临床知识，丰富临床经验，为将来工作岗位中的考核打下基础。

简介：目的探讨隧道式小切口白内障囊外摘除后房型人工晶体植入联合小梁切除术（即小切口三联术）的临床效果。方法不同类型的青光眼伴白内障患者38例42眼,行隧道式小切口白内障囊外摘除后房型人工晶体植入联合小梁切除术,术后随访6-24月,平均12.5月,对视力,眼压,滤过泡及并发症进行临床观察。结果术后随访视力≥0.5者26眼,占61.9%;0.2-0.4者9眼,占21.4%,视力〈0.2者7眼,占16.7%。眼压控制在正常范围（〈21mmHg）38眼,占90.5%,4眼术后眼压在21-24.38mmHg,用噻吗洛尔眼水滴眼,眼压可控制正常。功能性滤过泡占80.9%,无严重并发症。结论隧道式小切口白内障摘除及后房型人工晶体植入联合小梁切除是既有效,又经济的治疗方法,值得推广。

简介：<正>晶体核坠入玻璃体内是白内障超声乳化术中的并发症之一。我们眼科中心自1993年12月到1997年3月期间共施行了白内障超声乳化术3058例,术中发生晶体核脱位于玻璃体内二例,发生率为0.065%,现报告如下。病例报告例一,女,70岁,左眼老年性白内障(核心性)伴高度近视眼,术前矫正视力0.05。于1993年12月行白内障超声乳化术,术中晶体核掉入玻璃体内,

简介：AIM:Toassesstheawarenessofeyecomplicationsandtheprevalenceofretinopathy,inthefirstvisittoeyeclinic,amongtype2diabeticpatientsattendingatertiarymedicalcentreinKualaLumpur,Malaysia.METHODS:Aninvestigator-administeredquestionnairewasgivento137patientswithdiabetesundergoingfirsttimeeyescreeningintheeyeclinic.Thiswasfollowedbyadetailedfundusexaminationbyaseniorophthalmologisttoassessforpresenceofretinopathy.RESULTS:Almost86%ofrespondentswereawareofdiabeticeyecomplications,especiallyinpatientswhohadachievedtertiaryeducationallevel(96.3%).Themajorityofthepatients(78.8%)werereferredbytheirphysiciansandonly20.4%cameontheirowninitiative.Manyofthepatients(43.8%)didnotknowhowfrequenttheyshouldgoforaneyecheck-upand72.3%didnotknowwhattreatmentswereavailable.Lackofunderstandingondiabeticeyediseases(68.6%)wasthemainbarrierformostpatientsfornotcomingforeyescreeningearlier.Despiteahighlevelofawareness,only21.9%hadrecordedHbA1clevelof<6.5%while31.4%wereundertheerroneousassumptionofhavingagoodbloodsugarcontrol.Atotalof29.2%haddiabeticretinopathyintheirfirstvisiteyetesting.CONCLUSION:Inthepresentstudy,29.2%oftype2diabeticpatientshadretinopathyintheirfirsttimeeyetesting.Althoughtheawarenessofdiabeticeyecomplicationswashighamongfirsttimeeyescreeningpatients,theappropriateeyecare-seekingbehaviorwascomparativelylessandshouldberectifiedtopreventtheriseofthissightthreateningeyedisease.

简介：AIM:Todemonstratethemorphologyandstructureofinvitroreconstructedtissue-engineeredhumancornealepithelium(TE-HCEP)withseedercellsfromanuntransfectedHCEPcellline.·METHODS:TheTE-HCEPswerereconstructedinvitrowithseedercellsfromanuntransfectedHCEPcellline,andscaffoldcarriersofdenudedamnioticmembrane(dAM)inair-liquidinterfaceculturefor3,5,7and9days,respectively.Thespecimenswereexaminedwithhematoxylin-eosin(HE)stainingofparaffin-section,immunocytochemicalstaining,scanningandtransmissionelectronmicroscopy.·RESULTS:DuringinvitroreconstructionofTE-HCEP,HCEPcellsformeda3-4,6-7and8-10layersofanHCEP-likestructureondAMsinair-liquidinterfaceculturefor3,5and7days,respectively.Butthecellsdeceasedto5-6layersandthestructureofstraifiedepitheliumbecamelooseatday9.Andthecellsmaintainedpositiveexpressionofmarkerproteins(keratin3andkeratin12),cell-junctionproteins(zonulaoccludens-1,E-cadherin,connexin43andintegrinβ1)andmembranetransportproteinofNa+-K+ATPase.TheHCEPcellsinTE-HCEPwererichinmicrovillionapicalsurfaceandestablishednumerouscell-cellandcell-dAMjunctionsatday5.·CONCLUSION:ThemorphologyandstructureofthereconstructedTE-HCEPweresimilartothoseofHCEPinvivo.TheHCEPcellsinthereconstructedTE-HCEPmaintainedthepropertiesofHCEPcells,includingabilitiesofformingintercellularandcell-extracellularmatrixjunctionsandabilitiesofperformingmembranetransportation.TheuntransfectedHCEPcellsanddAMscouldpromisinglybeusedinreconstructionHCEPequivalentforclinicalcornealepitheliumtransplantation.

简介：应用准分子激光原位角膜磨镶术（laserinsitukeratomileusis，LASIK）和交叉柱镜法治疗中、高度散光68例（110眼），比较两种方法的疗效，现报告如下。