简介：干眼症是十分常见的眼表疾病,其发病机制至今尚未明确.近年来的研究表明基于免疫的炎症反应可能是各种类型干眼症发病的共同机制.泪腺及眼表面的炎症可导致泪腺及眼表上皮细胞损伤及凋亡、泪液中水样液及黏液的分泌减少,而性激素水平的异常可能是导致此炎症反应发生的重要因素,本文复习了以上热点问题的相关文献作一综述.

简介：过敏性眼表疾病是眼科门诊常见的眼部炎症。由于眼表暴露在各种各样的过敏原下,使眼部易导致过敏性反应。过敏性眼部疾病最特征的表现是眼部的瘙痒感,表现为双侧性,临床表现因人而异。

简介：Endogenousaspergillusendophthalmitis(EAE)afterkidneytransplantisararebutimportantclinicalproblemduetopotentiallydevastatingconsequences.EarlydiagnosisofEAE,timelyremovalofaffectedvitreousbyvitrectomy,properanti-fungaltreatment,allcontributedtothesuccessfulcontrolofthedisease.TherapeuticsuccessofEAEinpost-transplantpatientsdependslargelyonpromptdiagnosis.DefinitediagnosisofEAEisbasedonpositivecultureresultsofvitreousspecimen,whilefundoscopyandBscanultrasoundmayaidearlydiagnosis.Intermsofanti-fungalmedicine,amphotericinBhaslongbeenthefirstchoice,butitssystemicapplicaitonhassevereadversereactions,especiallyforpatientswithimpairedrenalfunction.Herein,wereportthetreatmentmodalityofEAEafterkidneytransplantwithvitrectomy,systemicadministrationofmicafunginplusvoriconazole,topicalapplicationoffluconazolandamphotercinB.

简介：AIM:Todescribethedesignandpreliminaryresultsofthehospitalbasedepidemiologicalstudyfordiabeticretinopathy(HBESDR),anongoingepidemiologicalstudytoestimatetheprevalenceofdiabeticretinopathy(DR)andtoelucidatetheclinical,anthropometric,biochemicalandanyotherriskfactorsassociatedwithdiabeticretinopathy.METHODS:Totally2000diabeteswillberecruitedfromtheDiabeteseyeclinicintheFirstAffiliatedHospitalofChinaMedicalUniversity.AllsubjectsunderwentbloodsugarestimationandOralGlucoseToleranceTesttodiagnosediabetes.Alldiabeteswouldundergocompletequestionnaire,acomprehensiveeyeexamination.Bloodandurinewouldbecollectedforbiochemicalinvestigations.AllfundusphotographsforanyDRwillbegraded.Participantswhoneedtreatmentwillbesenttotheophthalmicclinicandfollow-upintervalprogramforallsubjectswillbesuggested.Acomputerizeddatabaseiscreatedfortherecords.RESULTS:Todate,1174diabeteshavebeenrecruited,therewere350(29.81%)DRinalldiabetes,mostofthemwerewithmildnon-proliferativediabeticretinopathy(NPDR)(139,39.71%);71(20.29%)moderateNPDR,66(18.86%)severeNPDR,74(21.14%)proliferativediabeticretinopathy(PDR).Females,longerdurationofdiabetes,familyhistoryofdiabetesandhypertensionhadastatisticallysignificantincreaseinriskofanyDR.CONCLUSION:ThestudyisexpectedtoprovideanestimateoftheoverallprevalenceofDRandtheprevalencewithdifferentdurationofdiabetesandalsoabetterunderstandingoftheriskfactorsassociatedwithDR.

简介：AIM:Todescribethecharacteristicsofmodulationtransferfunction(MTF)ofanteriorcornealsurface,andobtainthethenormalreferencerangeofMTFatdifferentspatialfrequenciesandopticalzonesoftheanteriorcornealsurfaceinmyopes.·METHODS:Fourhundredeyesfrom200patientswereexaminedunderSIRIUScornealtopographysystem.PhoenisanalysissoftwarewasappliedtosimulatetheMTFcurvesofanteriorcornealsurfaceatverticalandhorizontalmeridiansatthe3,4,5,6,7mmopticalzonesofcornea.TheMTFvaluesatspatialfrequenciesof5,10,15,20,25,30,35,40,45,50,55and60cycles/degree(c/d)wereselected.·RESULTS:TheMTFcurveofanteriorcornealsurfacedecreasedrapidlyfromlowtointermediatefrequency(0-15cpd)atvariousopticalzonesofcornea,thevaluedecreasedto0slowlyathigherfrequency(>15cpd).Withtheincreaseoftheopticalzonesofcornea,MTFcurvedecreasedgradually.3)Intherangeof3mm-6mmopticalzonesofthecornea,theMTFvaluesmeasuredathorizontalmeridianweregreaterthanthecorrespondingvaluesathorizontalmeridianofeachspatialfrequency,thedifferencewasstatisticallysignificant(P<0.05).At7mmopticalzonesofcornea,theMTFvaluesmeasuredathorizontalmeridianwerelessthanthecorrespondingvaluesatverticalmeridianat10-60spatialfrequencies(cpd),andthedifferencewasstatisticallysignificantin25,30,35,40,45,50cpd(P<0.05).·CONCLUSION:MTFcanbeusedtodescribetheimagingqualityofopticalsystemsatanteriorcornealsurfaceobjectivelyindetail.

简介：AIM:Todefinetheultrasonographicstructureofnormallowereyelidanatomiccompartmentsandtheirspacialrelationshipindynamicmotion.METHODS:Highresolutionultrasound(15MHz)wasperformedonthelowereyelidsof7normalsubjects.Movementsofthelowereyelidanditscompartmentswerevisualizedwithultrasound.Inaddition,themaximalexcursionareaofthelowereyelidfatcompartmentsandretractormotionswasmeasuredbeforeandaftermotion.RESULTS:Theorbicularismusclecouldbeseenasanecholucentstructurebetweenthedermisandtheechodencefatpads.Lowereyelidfatpadseemstobedividedinto2compartmentsasrangeofmotionanddirectionofmovementofeachofthemvaries.Itseemsthatthesecompartmentshavealsodifferentbehavior.Themeasuredprofileareaofthevisiblenormallowereyelidfatpadsduringmovementofglobefromup-gazetodown-gazedecreasedby50%.Orderofmovementoflowereyelidstructuresseemstobeasfollows:afterglobemovementfistweseeretractormovement,anteriororbitalfatpad,thenskinandseptum,andfinallymovementofinferiorfatpad.CONCLUSION:Ultrasoundrepresentsanoninvasivetoolforthevisualizationoflowereyelidmorphology.Expandingitsapplicationcouldhelpusunderstandthecompartmentalchangesinphysiologicaleyelidmovement,inaginganddiseasedstudypopulations,aswellasassessoperativeoutcomes.

简介：后囊膜混浊是白内障囊外摘除术后最主要的并发症之一.后囊膜混浊的发生是多因素参与的结果,手术方式的改进、人工晶状体的改良、术后炎症反应的控制都可以减少后囊膜混浊的发生.本文就人工晶状体的设计对后囊膜混浊的影响作一综述.

简介：AIM:Toevaluatetheefficacyandsafetyoftrabeculectomy,phacotrabeculectomyplusintraocularlensimplantation(phacotrab+IOLgroup)andphacoemulsificationwithIOL(phaco+IOL)inprimaryangle-closureglaucoma(PACG).METHODS:Itwasasystematicreviewandmeta-analysis,randomizedcontrolledtrials(RCT)andclinicalcontrolledtrials(CCT)werecollectedthroughelectronicsearchesoftheCochraneLibrary,PubMed,EMbase,WanfangDatabaseonline,ChinesejournalFull-textDatabase,ChineseScientificJournalsFull-textDatabase(fromthedateofbuildingthedatabasetoOctober2010)Wealsocheckedthebibliographiesofretrievedarticles.Alltherelateddatathatmatchedourstandardswereabstracted.ThequalityofincludedtrialswasevaluatedaccordingtotheDutchCochraneCentre.RevMan5.0softwarewasusedforMeta-analysis.RESULTS:Atotalof5RCTand11CCTinvolving1495eyeswereincluded.Theresultsofmeta-analysisshowedthatphacotrab+IOLgroupwassuperiorthantrabeculectomy(trabgroup)(MD-3.93,95%CI[-7.31,-0.54])whichwasalsosuperiorthanphaco+IOLgroup(MD0.52,95%CI[0.10,0.95])indecreasingIntraocularPressure(IOP).Phacotrabgroup(MD-1.45,95%CI[-1.68,-1.22])andphacogroup(MD-1.12,95%CI[-1.87,-0.37])arebothdeeperthantrabgroupintheanteriorchamberdepth.Inincreasingthecoefficientofoutflowfacilityofaqueoushumor(Cvalues)therewasnostatisticaldifferenceinthethreegroups.Andtherewasnostatisticaldifferencebetweenphacotrabgroupsandphacogroupsinvisualacuitybutphacotrabgroupwassuperiorthanphacogroup(MD1.07,95%CI[0.73,1.40])intheuseofIOP-loweringdrugs.Therewasnostatisticaldifferenceamongthreegroups.CONCLUSION:Currentevidencesuggeststhatphacotrab+IOLgroupwassuperiorthantrabgroupwhichwasalsosuperiorthanphaco+IOLgroupindecreasingIOP.Phacotrabgroupandphacogrouparebothdeeperthantrabgroupintheanteriorchamberdepth.PhacotrabgroupwassuperiorthanphacogroupintheuseofIOP-loweringdrugs.

简介：眩光是很常见的现象,也是引起车祸以及视觉疲劳一个重要因素.偏振照明系统可以过滤对面的偏振光,增加会车时司机的视力范围以及分辨力,完美解决夜间会车的失能性眩光.而对于日常生活中常见的反射性眩光,偏振眼镜可以过滤反射形成的平面偏振光,得到清晰的视觉.

简介：AIM:Toreporttheeffectivenessandsafetyofprimary23-Gauge(G)vitreoretinalsurgeryforrhegmatogenousretinaldetachment(RRD).·METHODS:Inthisretrospectivestudy,49eyesof49consecutivepatientswhounderwentprimary23-Gtransconjunctivalsuturelessvitrectomy(TSV)forRRDbetweenJanuary2007andJuly2009atourinstitutionwereevaluated.·RESULTS:Meanfollow-uptimewas8.9±7.7months(1-28months).Retinalreattachmentwasachievedwithasingleoperationin47(95.9%)of49eyes.Intwoeyes(4.1%),retinalredetachmentduetonewbreakswassuccessfullytreatedwithreoperationusingthe23-GTSVsystem.MeanlogMARvisualacuitywas2.01±0.47preoperativelyand1.3±0.5postoperatively(P<0.001,Pairedt-test).Meanpreoperativeintraocularpressure(IOP)was14.1±2.8mmHg.MeanpostoperativeIOPwas12.3±3.6mmHgat1day,13.1±2.1mmHgat1week,14.3±2.2mmHgat1month.Iatrogenicperipheralretinalbreakwasobservedin1eye(2.0%)intraoperatively.Nosutureswererequiredtoclosethescleralorconjunctivalopenings,andnoeyesrequiredconvertionofsurgeryto20-Gvitrectomy.·CONCLUSION:Primary23-GTSVsystemwasobservedtobeeffectiveandsafeinthetreatmentofRRD.

简介：<正>作者就21例(40侧)鼻窦内窥镜手术所取得初步经验总结如下。临床资料和手术方法21例中男15例,女6例。年龄21～76岁。筛窦(包括窦口鼻道复合体)息肉16例,上颌窦息肉5例。有1～3次鼻手术史5例。有不同程度嗅觉减退、脓涕多者8例。全部病例均有头胀痛、鼻塞症状。21例中行前组筛窦开放上颌窦根治17例(32侧)。全组筛窦开放+上颌窦根治4例(8侧)。术后1、3、6个月行鼻窦内窥镜复查,并清除残留或复发病变组织、分解粘连。

简介：黄斑水肿是眼底疾病的常见并发症，可发生在糖尿病视网膜病变、视网膜静脉阻塞、葡萄膜炎以及白内障等多种眼前后段疾病和内眼手术后。因其损害中心视功能造成严重视力障碍，且尚无好的治疗方法而备受关注。黄斑水肿的病因各异，其治疗首先应治疗原发病；此外，针对黄斑水肿，除了传统的激光光凝等方法外，

简介：泪道阻塞是眼科的常见病，有先天性和后天性两大类，易发展为急，慢性泪囊炎，以手术治疗为主，目的是重建或恢复泪液的引流通路，传统手术方面报道较多的是泪囊鼻腔吻合术（EXT-DCR）虽然成功率可达85％，但在颜面部残留永久性疤痕，影响美容，非手术方法主要有：探通，置线，置管等，但只是简单的解决问题，而且易致周围组织刺激，更容易形成粘连和疤痕使管腔再度阻塞。目前，虽然报道使用激光泪道成形术收到较好的效果，泪道能够冲洗通畅，但部分仍有溢泪症状。近年来，随着内窥镜技术不断成熟，既微创又美观的手术要求越来越高，因此，诸如鼻内窥镜下泪囊鼻腔吻合术（IECR）得以开展和创新。另外高分子材料及其它医疗器械的不断更新和完善，其治疗手段有了长足的进步。

简介：目的了解胚胎小鼠内耳发育早期的形态学特征及规律.方法利用光镜观察胚胎第8d(embryonicday,E8)到15d的C57BL/6小鼠内耳发育过程中的形态变化.结果C57BL/6小鼠E8出现耳的始基(听板),随后形成听凹、听泡,E10前庭、耳蜗才开始发育,E14内耳感觉上皮才初步分化为支持细胞和毛细胞.结论C57BL/6小鼠的前庭部先开始发育,耳蜗形成较迟;在E11至E15期间形态变化明显,到E15内耳初具成熟形态.

简介：人工耳蜗是重度耳聋患者重建听力的惟一有效装置.虚拟通道是利用电流定向技术产生比已有电极数目更多的可感知的音调信息,不仅能提高噪声环境下的言语分辨率、音乐欣赏力,还可以提高汉语音调的识别率.

简介：目的探讨带虹膜隔张力环植入手术治疗虹膜缺损的护理措施。方法回顾分析我院所诊治的虹膜缺损患者24例,24例患者均行带虹膜隔张力环植入的手术,针对性的对该手术不同类型的患者加强心理护理、术前准备、术后护理及预防并发症的发生。结果所有患者均根据虹膜缺损的范围和程度选择并放置合适型号的带虹膜隔张力环,术后随访3个月,均未发现张力环、人工晶状体偏位、移位,晶状体囊袋损伤及瞳孔阻滞等现象。结论囊袋内植入带人工虹膜的张力环治疗部分或完全虹膜缺损,取得了较好的治疗效果,开辟了该类疾病治疗的新思路,手术期间应加强患者的心理护理及术后的密切观察,及时采取相应的护理措施,从而减少并发症,提高疗效。

简介：·AIM:Toinvestigatetheantifibroticeffectoffreeze-driedbilayeredfibrin-bindingamnioticmembraneontrabeculectomyinarabbitmodel.·METHODS:Twenty-fourJapanesewhiterabbitswererandomizedintothreegroups:theexperimentalgroup(oculartrabeculectomyincombinationwithfreeze-driedbilayeredfibrin-bindingamnioticmembranetransplantation),thecontrolgroup(oculartrabeculectomyincombinationwithnaturalbilayeredfibrin-bindingamnioticmembrane)andtheblankgroup(singletrabeculectomy).Clinicalobservation,hematoxylin-eosinstaining,Massionstaining,real-timePCRandimmunohistochemistryforα-SMAwereperformedondays7,14,21and30followingsurgery.·RESULTS:Statisticaldifferenceswerenotedinsurvivalanalysisandintraocularpressure(IOP)amonggroupsondays7,14,21and30followingsurgery.Histology,immunoh-istochemistryandreal-timePCRfurtherdemonstratedthattrabeculectomyincombinationwithfreeze-driedbilayeredfibrin-bindingamnioticmembraneresultedingoodwoundhealingandnoscarformation.·CONCLUSION:Self-madefreeze-driedbilayeredfibrin-bindingamnioticmembranemayinhibittheformationofscarringinglaucomaaftertrabeculectomy.·

简介：目的探讨不同手术方式治疗复发性翼状胬肉的疗效。方法选取复发性翼状胬肉患者60例（60只眼）随机分成两组：A组30个病人（30只眼）翼状胬肉切除联合冻干羊膜移植术;B组30个病人（30只眼）翼状胬肉切除联合带自体角膜缘干细胞结膜瓣移植术。结果两组病人术后随访6个月至2年,翼状胬肉切除联合冻干羊膜移植术组与翼状胬肉切除联合带自体角膜缘干细胞结膜瓣移植术组术后复发率分别为：36.7%和10%,差异具有统计学意义（P〈0.05）.结论复发性翼状胬肉的治疗中翼状胬肉切除联合带自体角膜缘干细胞结膜瓣移植术相对于翼状胬肉切除联合冻干羊膜移植术疗效更明确。

简介：目的通过安徽省某县09年度与11年度分别开展的贫困白内障复明手术各300例（300眼），手术结果的比较，探讨防盲手术培训的重要性。方法手术均由通过培训与再培训并获得资格认证的两位医生完成。术前视力〈0．1，排除其他眼病及严重全身疾病。手术方式统一为小切口非超声乳化白内障摘除及人工晶状体植入术，植入的人工晶状体均为Alton晶状体，粘弹剂为玻璃酸钠（其胜，上海产）。术前、术后处理按照安徽省防盲手术要求执行。结果比较两年度病人的早期术后视力，术中及术后早期并发症，09年度与11年度比较，术后第一天裸眼视力≥0．3比率由49．5％上升至60．4％；术中玻璃体脱出由7％降至4％；角膜水肿发生率由16％降至11％；其他并发症同样明显减少。而每例白内障手术时间也由40分钟减少至22分钟。结论11年度手术质量明显好于09年。并且09年手术是在省防盲中心派一名教师现场指导下完成，而11年度则是完全是独立完成。这些结果均提示通过有效的防盲手术培训，能以明显的提高白内障手术质量；同时也充分证实了防盲手术培训是非常重要的。

简介：AIM:Topresentretinalmicrostructure,metabolismandfunctionabnormalitiesinthecourseofmultipleevanescentwhitedotsyndrome(MEWDS)byHeidelbergspectralismodalityimagingplatformandobserveitsoutcomebyEDI-SD-OCTandtwowavelengthautofluorescence.METHODS:Acaseofmultipleevanescentwhitedotsyndromeina23-year-oldfemalepresentedinitiallywitha15-dayhistoryoffloatersandacentralscotomaintherighteye.Toestablishthediagnosis,multimodalityimagingwasperformed,namely,bluelight-fundusautofluorescence(BL-FAF,excitation488nm,emission>500nm),near-infraredfundusautofluorescence(NIR-FAF,excitation787nm,emission>800nm)usingaconfocalscanninglaserophthalmoscope,fundusfluoresceinangiography(FFA),indocyaninegreenangiography(ICGA),spectrum-domainenhancedepthimagingopticalcoherencetomography(SD-EDI-OCT),multifocalelectroretinography(mf-ERG)andfundusphotograghwereperformedandfollowedupattheeighthmonthafterinitiallyvisiting.RESULTS:Opticalcoherencetomography(OCT)showedatransientdisruptionofthefovealphotoreceptoroutersegmentsincorrespondencetofovealgranularity.NIR-FAFshowedhypoautofluorescentareas,≤40μminsize,mostlyconcentratedaroundtheposteriorpoleanditstemporalsidelessthanthatinBL-FAF.Mf-ERGshowpinnacledisappearedinfoveaandmaculaandresponsesdecreasedmarkedlycomparedwiththefolloweye.Attheeighthmonthfollowup,hyperfluorescenceinBL-FAFweredisappear,while,NIR-FAFHypofluorescentspotsinearlystageofsuchlesionwerereduced.ButOCTdemonstratedthestructurewasrecoveredinresidualHypofluorescentareainNIR-FAF.Thesubfovealchoroidalthicknesswasdecreasedfrom372μmto307μmslightlyandcostlinewasrecovered.CONCLUSION:MEWDSisabenignself-healingdiseaseandthereisnopathologicalevidencetoinvestigatethenaturalcourseofsuchdisease.SD-OCTallowshighlydetailedimagesapproachinghistopathologytocertifythemicrostructura