简介：日益增长的白内障盲表明目前白内障手术数量还远远低于清除白内障积存数及服务新发病人的要求。经济状况越好,文化程度越高,对视力的要求也会越强烈,病人也会更早地要求实施白内障手术。老年人口的增加也会使得白内障手术的需求成倍增加。即使在印度,白内障手术率(CSR)高达每百万人口3250例,白内障手术率仍然需要提高2-3倍,才能有效地解决白内障盲的问题。在很多国家,白内障手术率甚至要提高10倍才能解决问题。增加白内障手术服务本身就是一个极大的挑战。同样具有挑战的是保证服务的质量。这需要不断增加的资源(扩充容量)及最大限度地使用现有资源(提高效率)。本文中讨论在现有服务制度下,如何扩充容量,提高效率,这正是很多地方所需要的。

简介：<正>眼型重症肌无力是一种少见的眼病,而累及诸眼外肌引致眼球固定者则未见报道。我们发现一例,现报告如下。患者,女性,24岁,未婚。因双眼球固定、上睑下垂于1997年4月3日来诊。患者于21年前(约3岁时),在无明显诱因下出现眼球各向运动困难,双上

简介：目前，由于眼外伤的增加，广谱抗生素和糖皮质激素的广泛应用，真菌性角膜炎正以每年增加的发病率成为我吲主要的致肓性眼病之一。在基层医院，由于缺乏高效低毒、廉价的抗真菌药物，真菌性角膜炎已成为眼科医生的棘手问题。对于有些药物治疗效果差，而经济条件困难的重症的患者，我们采取传统的球膜遮盖术，取得较好的效果，现报告如下。

简介：AIM:TopresenttheresultsofimplantationofIakymenkokeratoprosthesisinfivepatientswithvascularizedcornealleukomacausedbysevereocularinjury.·METHODS:Iakymenkokeratoprosthesiswasimplantedinto5eyesof5patients:4patientsweresufferedfromchemicalburnsand1patientfromexplosiveinjury.Thepreoperativevisualacuityrangedfromlightperceptiontohandmotion.Theimplantationsurgerywascomposedoftwo-stageprocedures.Thefollow-upperiodwasfrom9monthsto11years.Theoutcomemeasureswerevisualacuity,retention,andcomplicationsofthekeratoprosthesis.·RESULTS:Visionimprovementswereachievedinmostpatients.Allkeratoprosthesiswereretainedwithinthefollow-upperiod.Cornealmeltingoccurredinonepatientandfibrousclosureinanotherpatient,bothofwhichweresuccessfullytreated.Retinaldetachmentoccurredinonepatientaftersurgery.·CONCLUSION:Iakymenkokeratoprosthesisseemstobeapromisingalternativeforthepatientswithseverecornealinjury,butfurtherinvestigationisneededtoevaluatetheroleofIakymenkokeratoprosthesis.

简介：目的了解眼科住院病人的内部构成比,为眼科的发展提供理论依据。方法收集2002-2004年眼科住院病人2,165例。运用Stata8．0软件进行统计分析。结果眼科住院病人前四位的疾病是：白内障、眼外伤、青光眼、视网膜脱离；在年龄、性别上有明显差异,以30-40岁(14．48-16．08％)、50-60岁(14．99-18．38％)、60-70岁(18．38-21．22％)为主要病源；性别上,男性为60．31-64．17％,女性为35．84-39．69％。结论白内障、眼外伤、青光眼、视网膜脱离是眼科住院主要病种。

简介：AIM:Toinvestigatethefrequencyofidiopathicphacodonesis(IP)insenilecataractsubjectsandtheshort-termclinicaloutcomesfollowingcataractsurgery.METHODS:Thisinstitutionalcase-controlstudyincluded1301consecutivelow-incomecataractsubjectsfromJunetoNovember2009.Anteriorsegmentwerecarefullyevaluatedwithdilatedpupilunderslit-lamp.IPwerescreenedandgradedbyacriteriasetbytheauthors.Riskfactors,surgicaloutcomes,andoperativecomplicationswereanalyzed.RESULTS:Atotalof42subjects(3.2%)withIPwerediagnosedandclassifiedasgrade1(36subjects),grade2(5subjects)andgrade3(1subject).HarderlensesandintumescentcataractswereobservedintheIPgroupthanthecontrolgroup(P<0.05).Logisticsregressiontestalsoindicatedthemainriskfactorwasthehardnessofthelens.Theincidenceofzonulardialysisduringsurgerywas23.8%(10eyes),whichwassignificantlyhigherthanthecontrols(0.7%,P<0.001).Visualoutcomesofthetwogroupswerenotstatisticallyorclinicallysignificant.CONCLUSION:HardnucleusandintumescentcataractarerelatedtoIPinsenilecataractsubjectsinQinghai,China.Withmorecarebeingtaken,grade1andsomeofthegrade2IPsubjectsachievedsimilarsurgicaloutcomesascomparedtocontrols.

简介：目的研究不典型眼肌型重症肌无力（OMG）患者的临床表现。方法回顾性分析了自2003年6月-2009年12月到我院就诊的36例不典型眼肌型重症肌无力患者的临床特点。结果年龄10-68岁,上睑下垂9例,内直肌麻痹8例,外直肌麻痹6例,上斜肌麻痹2例,4例有复视,2例仅有眼睛不适和视物模糊感,2例辐辏麻痹,1例眼轮匝肌麻痹,1例患者先后出现内直肌麻痹,外直肌麻痹及上斜肌麻痹,1例全眼外肌麻痹。全组中症状有晨轻暮重及波动性表现且疲劳试验阳性的有24例,占66.7%;新斯的明试验阳性者32例,占88.9%。低频重复神经电刺激：全组10例,阳性率27.8%。SFEMG额肌异常29例,阳性率80.6%。结论一些临床表现不典型,疲劳试验阴性的眼肌型重症肌无力患者,应常规给予新斯的明试验。不典型OMG重复低频电刺激阳性率低,SFEMG仍可作为一项不可或缺的重要辅助检查手段,提高眼肌型重症肌无力的检出率,减少漏诊误诊。

简介：目的：研究左氧氟沙星治疗重症细菌性角膜炎和结膜炎的疗效以及耐药性。方法：将我院收治的195例重症细菌性角膜炎和结膜炎患者作为观察对象,随机均分为A组、B组和C组,分别给予左氧氟沙星、氧氟沙星和氯霉素进行治疗,统计治疗数据,评价不同治疗方法治疗的效果和耐药性。结果：采用左氧氟沙星治疗的A组患者痊愈54例（83.1%）,显效7例（10.8%）,有效3例（4.6%）,无效1例（1.5%）;采用氧氟沙星治疗的B组患者痊愈25例（38.5%）,显效6例（9.2%）,有效23例（35.4%）,无效11例（16.9%）;采用氯霉素治疗的C组患者痊愈4例（6.2%）,显效3例（4.6%）,有效36例（55.4%）,无效22例（33.8%）,组间治疗效果和耐药性存在显著差异（P〈0.05）。结论：左氧氟沙星治疗重症细菌性结膜炎和角膜炎起效快,效果好,不易产生抗药性,值得推广借鉴。

简介：AIM:Tofindasimplemathematicalcorrelationbetweenthelensbasecurve(BC)andkeratometryfindings(krf).METHODS:Thisretrospectivestudyincluded400keratoconiceyes(350patients)previouslyfitwithrigidcontactlensesatanacademiceyecenteroverafiveyearperiod.Thepatientswereclassifiedintofivegroupsbasedonthekeratometryfindings(krf<7,krf:7-8,krf>8,krf-krs(differencebetweentwokeratometry;flatandsteep)=0.3-0.6,krf-krs>0.6mmasgroups1to5,respectively.MultivariatelinearregressionandMunro’scorrelationcoefficientwereemployedtodefertheformulas.RESULTS:Alinearcorrelationcouldbefoundinallgroupsexceptforpatientsingroup3.Forgroup1,BC=0.211×krf+5.904.Forgroup2,BC=0.456×krf+4.160.Forgroup4,BC=0.321×krf+5.219.Forgroup5,BC=0.337×krf+5.090.CONCLUSION:ThedevelopmentofnewformulasforRGPfittingenablesophthalmologiststoworkwithconfidenceandpreventsunnecessaryandfrequentlenstrials.Thecustomarylensfittingmethodsareneededtobereplacedbynewformulas,whichhelptosavetimeandcosts.

简介：目的观察自制全结膜囊羊膜固定器在重症眼表烧伤行羊膜遮盖手术中应用效果。方法在11例（13眼）眼部重症烫伤患者治疗中采用自制全结膜囊羊膜固定器将羊膜固定于眼表及眼睑皮肤面。根据病情需要更换羊膜，随访3月至3年。结果患者平均手术时间为（8．0±3．0）分钟；眼表组织上皮化时间（13．2±11．3）天。重复手术次数3．5次，患者手术依从性良好，观察病例无角膜穿孔，无睑球粘连。结膜囊狭窄5例，角膜斑翳5例，角膜血管化2例。结论采用自制全结膜囊羊膜固定器手术，缩短手术时间，无创伤，重症烧伤患者可多次重复手术，特别适合重症眼表烧伤早期治疗，减少晚期严重并发症的发生。

简介：AIM:Toevaluatetheeffectsandsafetyofphacoemu-lsification(Phaco)orsmall-incisionextracapsularcataractsurgery(SICS)andintraocularlens(IOL)implantationforagedpatients.METHODS:Totally137agedpatients(149eyes)underwentcataractoperationinthecaseofstablesystemiccondition,thebloodpressurelessthan160/95mmHg,bloodglucoselessthan8mmol/L,andunderthehelpofelectrocardiogramsurveillancebyanesthesiologistsduringtheoperation.106agedpatients(114eyes)underwentPhacowhile31agedpatients(35eyes)underwentSICS.Thepostoperativevisualacuity,cornealendothelialcellloss,surgerytimeandmajorcomplicationswereobservedandanalyzedretrospectively.RESULTS:Thebest-correctedvisualacuity(BCVA)of≥0.6wasachievedin135eyes(92.6%)at1monthpostoperatively(χ2=259.730,P<0.001).Foragedpatients,bothPhacoandSICScouldsignificantlyimprovevisualacuitywithnosignificantdifference(χ2=4.535,P>0.05).Postoperativecornealendothelialcelllosswas18.6%,inPHACOgroup,theratewas18.5%;inSICSgroup,theratewas19.0%,thedifferenceofwhichwasnosignificant(χ2=0.102,P>0.05).Thesurgerytimewasdifferentintwogroups.Noseverecomplicationsoccurred.CONCLUSION:BothPhacoandSICScombinedwithIOLimplantationforagedpatientsareeffectiveandsafe.Beforesurgery,detailedphysicalexaminationshouldbeperformed.Whenthesystemicconditionisstable,cataractsurgeryforagedpatientsissafe.

简介：AIM:ToevaluatethecornealendothelialcelldensityandmorphologyinChinesepatientswithpseudoexfoliationsyndrome(PEX).·METHODS:Medicalrecordsof16patients(20eyes)withPEXwhopresentedtoourinstitutionbetweenJuly2008andJune2010wereretrospectivelyreviewed.Thirteeneyeshadcombinedglaucoma.Theinformationoffiveapparentlynormalfelloweyesinthesepatientswasalsorecorded.Lefteyesof20patientswithbilateralsenilecataractsbutnoothereyediseasewereincludedascontrols.Specularmicroscopywasperformedinalleyestoanalyzeforcornealendothelialcelldensityandmorphology.Celldensity,coefficientofvariationincellsize,andpercentageofhexagonalcellsincornealendotheliumwereevaluated.·RESULTS:ThemeancornealendothelialcelldensityinthePEXeyeswas2298±239cells/mm2,significantlylowerthanthatinthecataracteyes(2652±18cells/mm2,P=0.026),buttherewerenosignificantdifferencesincoefficientofvariationofcellsizeandfrequencyofhexagonalitybetweenthesetwogroups.NosignificantdifferencesinthethreeparameterswerefoundbetweentheapparentlynormalfelloweyesandthePEXeyesorthecataracteyes,orbetweenthePEXeyeswithandwithoutglaucoma.·CONCLUSION:CornealendothelialcelldensitymaydecreaseinChinesepatientswithPEX.ThedevelopmentofglaucomainPEXeyesdoesnotseemtoberelatedwiththechangeincornealendothelialcelldensityormorphology.

简介：AIM:ToidentifythefunctionofST2andexploretheroleofIL-33/ST2signalinginregulatingthepro-allergiccytokineproductioninhumancornealepithelialcells(HCECs).METHODS:HumancornealtissuesandculturedprimaryHCECsweretreatedwithIL-33indifferentconcentrationswithoutorwithdifferentinhibitorstoevaluatetheexpression,locationandsignalingpathwaysofST2inregulatingproductionofpro-allergiccytokineandchemokine.TheexpressionofmRNAwasdeterminedbyreversetranscriptionandrealtimePCR,andproteinproductionwasmeasuredbyenzyme-linkedimmunosorbentassay(ELISA),immunohistochemicalandimmunofluorescentstaining.ST2proteinwasdetectedindonorcornealepithelium,andST2signalwasenhancedbyexposuretoIL-33.·RESULTS:IL-33significantlystimulatedproductionofpro-allergiccytokinesthymicstromallymphopoietin(TSLP)andchemokine(CCL2,CCL20,CCL22)inHCECsatbothmRNAandproteinlevels.Thesestimulatedproductionsofpro-allergicmediatorsbyIL-33wereblockedbyST2antibodyorsolubleST2protein(P<0.05).Interestingly,theIκB-αinhibitorBAY11-7082orNF-κBactivationinhibitorquinazolineblockedNF-κBp65proteinnucleartranslocation,andalsosuppressedtheproductionsofthesepro-allergiccytokinesandchemokineinducedbyIL-33.CONCLUSION:ThesefindingsdemonstratethatIL-33/ST2signalingplaysanimportantroleinregulatingIL-33inducedpro-allergicresponses.IL-33andST2couldbecomenovelmoleculartargetsfortheinterventionofallergicdiseasesinocularsurface.

简介：<正>DearSir,IamDr.Sheng-LiMi,fromtheBiomanufacturingengineeringlaboratory,GraduateSchoolatShenzhen,TsinghuaUniversity,Shenzhen,China.Iwritetopresentacasereportofnocardiabrasiliensisinapatientwithdiabetes.Nocardiaispartofagroupofaerobicactinomycetes,widelydistributedinsoil.Nocardiaasteroidsandnocardiabrasiliensisarethemostcommonhumanpathogens.Humansinfectedbynocardiaasteroidsthroughtherespiratorytractmainlysufferfromprimarysuppurativepulmonaryconditions.Infectionofnocardiabrasiliensisoftenoccursintheadvancedstagesofaprogressivediseaseorimmunedisorder,especiallyCushingsyndrome,diabetes,orinpatientsusingcorticosteroids,immunosuppressiveagentsandbroad-spectrumantibioticsforlongtime[1].Toourknowledge,thereportsofnocardiakeratitiswasveryrare

简介：AIM:ToanalyzecasesofobstructionofthenasolacrimalductwhichcreatesafertileenvironmentforsecondarybacterialInfectionandcanresultindacryocystitis,whichisaconstantthreattocorneaandorbitalsofttissueandapotentialsourceofendophthalmitisfollowingintraocularsurgery.Themajorityofobstructionsofthelacrimalexcretoryoutflowsystemareacquiredonesoccurringinadulthoodandinvolvingthedistalpartsofthesystem.Acquiredobstructionmaybeprimary/idiopathicorsecondarytoawidevarietyofinfectious,inflammatory,traumatic,mechanical,toxicorneoplasticcausesmimickingidiopathicinflammation.Thesecasesaretreatedbydacryocystorhinostomy(DCR).METHODS:Thepresentstudywasconductedtodeterminethehistopathologic,immunohistochemicalandcurrentmicrobiologiccharacteristicsoflacrimalsacspecimensinpatientsundergoingexternaldacryocystorhinostomy.RESULTS:Non-specificlacrimalsacpathologywaspresentinall33casesand81.8%ofthecasesshowedmoderatechronicinflammationwithachronicinflammatoryscore(CIS)rangingbetween4and6,whereas12.12%showedsevereinflammatorychangeswithaCISof7.Milddegreeofinflammationwasseenin6.06%withaCISof3.Thetotalprevalenceofgrampositive,gram-negative,andculture-negativesampleswere59.4%,37.5%,and3%respectively.CONCLUSION:Non-specificchronicinflammationwithfibrosisisindeedthemostcommonlyreportedhistopathologicalfindinginlacrimalsacwallbiopsyspecimens.

简介：AIM:Tocharacterizetheclinicalfeatures,diagnosis,treatmentandprognosisofuveitisassociatedwithankylosingspondylitis(AS)inChinesepatients.·METHODS:TwohundredandthreepatientswithuveitisassociatedwithASfollowed-upintheThirdMilitaryMedicalUniversityDapingHospitalbetween2005and2010wereretrospectivelyevaluatedinthisstudy.Completeophthalmologicalexaminationswereevaluatedatbaselineandduringthefollow-upperiod.Thegender,age,follow-uptime,meanfrequencyofuveitisonset,andaccompanyingeyeexaminationfindings,history,demographicalparameterswerereviewed.Allthepatientspresentedcompleteclinicalandradiologic(sacroiliac,lumbar,dorsalandcervicalspine,knee,ankle,shoulder,hip,elbow)evaluation.HLA-B27typingwasalsosearched.·RESULTS:Therewere203patientsdiagnosedwithASassociateduveitis.AllshowedsacroiliacX-raychangesindicativeofAS.Therewere184maleand19femalepatients.Theaverageageofpatientswas35±12(range18-50).Meanfollow-upperiodwas2.4years(1-5years).Acuteanterioruveitiswasthemostcommontypeofuveitisinbothgenders.121eyespresentedunilateralinvolvement(55.2%),and92eyespresentedbilateralinvolvement(45.3%)withonsetalternately.22eyesoccurredhypopyon,16eyeswerefoundanteriorvitreouscells,7eyeswerenotedreactivemacularedemaorexudation,29eyespresentedposteriorsynechiaeofiris,and14eyespresentedcataract,9eyespresentedsecondaryglaucoma,2eyespresentedbendcornealdegenerationand1eyespresentedatrophyofeyeball.Atthefinalvisit,uveitiswaswellcontrolledinmostpatients.·CONCLUSION:ASassociatedwithuveitisinChinesepatientsmainlymanifestsasacuteanterioruveitis.AcombinationofcorticosteroidswithothermydriasisagentsiseffectiveformostASassociatedwithuveitispatients.Ingeneral,theprognosisisgoodinthesecases.

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: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:Toinvestigatethelevelsofserumsolubleintercellularadhesionmolecules-1(sICAM-1)andneutrophilicexpressionofCD18inpatientswithvariousstagesofdiabeticretinopathyandtodeterminetheirdifferentexpressionpatterninthedevelopmentofdiabeticretinopathy(DR).·METHODS:LevelsofserumsICAM-1andCD18onthesurfaceofneutrophileweremeasuredin41DRpatients,theywereclassifiedinthreesubgroupsaccordingtothestageofretinopathyasdeterminedbyfund’sophthalmoscopy;10controlsubjectswerealsostudied.sICAM-1weremeasuredbyenzyme-linkedimmunosorbentassayandCD18byflowcytometry.·RESULTS:TheneutrophilicCD18expressionandserumsICAM-1levelwereallsignificantlyelevatedinalldiabeticsubgroupscomparedtocontrolsubjects(P<0.01).ThedifferencesofCD18andsICAM-1amongthediabeticsubgroupsweresignificantinCD18butnotinsICAM-1.TheprogressionofretinopathywasassociatedwithanincreasebothinCD18andinsICAM-1levelsbysimplecorrelationanalysis(β=0.74,P<0.001;β=0.38,P<0.01,respectively).ButstepwisemultipleregressionanalysisrevealedthatonlyCD18wasindependentdeterminantofretinopathy(β=1.04,P<0.01).·CONCLUSION:OurresultsconfirmthecontributionofendothelialandneutrophilicactivationinthedevelopmentofDRasindicatedbyincreasedlevelsofCD18andsICAM-1.However,adirectimplicationofCD18andICAM-1intheprogressionofDRcanbesupportedonlyintheCD18butnotICAM-1.CD18andICAM-1mayplaydifferentroleinthedevelopmentofdiabeticretinopathy.

简介：AIM:Toinvestigatethetreatmentstatusandprognosisofspace-occupyinglacrimalglandlesionsatonetertiaryeyecenterinChina.·METHODS:Aretrospectiveclinicalstudywasperformedon95patientswithspace-occupyinglesionsofthelacrimalglandsurgicallytreatedattheEye&ENTHospitalofFudanUniversityfrom2003to2007.Thereviewedclinicaldataincludedage,gender,sideofthelesion,durationofsignsandsymptoms,histopathologicaldiagnosis,treatmentmodality,recurrence(local,regional,anddistantmetastasis)andsurvival.·RESULTS:Ofthe95cases(99eyes),pleomorphicadenomaswerethemostcommonlesions(43cases),followedbylymphoiddisorders(14),inflammatorypseudotumors(11),carcinomaex-pleomorphicadenomas(11),andadenoidcysticcarcinomas(ACC,6).Therewere8patientswithrelapsedpleomorphicadenomas.Fiveofthese8caseshadmalignantpathologicalchanges.AllpatientswithACChadmetastasisandthreeofthemdiedduringtheirfollow-up.·CONCLUSION:Ourstudyindicatedthatthemostcommonlacrimalglandlesionswerepleomorphicadenomas.Multiplerecurrenceandsurgicalproceduresmayincreasetheriskoftumorprogression.ACChadahighincidenceoftumormetastasisandapoorprognosis.