Although amniotic membrane transplantation (AMT) has long been used as an essential surgical technique for ocular surface reconstruction, its role continues to evolve and expand. In the management of numerous ocular surface disorders, ranging from inflammatory to infectious, traumatic to neoplastic, the ability to perform AMT is a valuable addition to the skillset of any ophthalmologist. The purpose of this paper is to provide ophthalmologists with an updated, evidence-based review of the clinical indications for AMT in corneal and conjunctival reconstruction, reviewing its common and even experimental applications known to date. The methods of amniotic membrane preservation, the available commercial amniotic membrane products to date, and future directions for amniotic membrane use, including amniotic membrane extract eye drops (AMEED), are also discussed. It is paramount for ophthalmologists to stay up-to-date on the applications of AMT so as to effectively incorporate this versatile treatment modality into their practice,both in the operating room and in the clinic. By familiarizing the general ophthalmologist with its diverse applications, we hope to motivate general ophthalmologists to incorporate the use of AMT into their clinical practice, or provide guidance on how to recognize when referral to a corneal specialist for amniotic membrane application is prudent.
Abstract: The goal of ophthalmology residency training is to produce competent ophthalmologists. Appropriate assessments must be employed to ensure this goal is met. Valid and reliable workplace-based assessments are designed to assess competence in the many domains required of a good ophthalmologist. These assessments increase standardization and objectivity as compared to simple observational feedback. When used appropriately, workplace based assessments not only provide measures of competence but also facilitate effective formative feedback and enhance learning.
Background: The purpose of this study is to summarize the application of day surgery combined with fast track program in strabismus operation under general anesthesia.
Methods: The clinical data of 2,000 cases of strabismus patients who had underwent surgery in day surgery or traditional hospitalization in the duration from 2015 to 2016 was retrospectively analyzed. The safety and efficacy were assessed by comparing the average length of stay in hospitals, anesthesia recovery time, patient satisfaction and number of adverse events.
Results: Compared with the traditional group, the average length of stay in hospital and recovery time in day surgery group were significantly lower (P<0.001) and the satisfaction of patient was improved (P<0.05), which were statistically significant difference. Moreover, no adverse events occurred among these patients.
Conclusions: The application of day surgery in strabismus operation under general anesthesia is feasible, which can reduce the recovery time and shorten the hospital stay of patients safely and effectively, and their satisfaction was improved at the same time.
Abstract: Myasthenia gravis (MG) is an autoimmune antibody-mediated disorder which causes fluctuating weakness in ocular, bulbar and limb skeletal muscles. There are two major clinical types of MG. Ocular MG (OMG) affects extra ocular muscles associated with eye movement and eyelid function and generalized MG results in muscle weakness throughout the body. Patients with OMG have painless fluctuating extra ocular muscles weakness, diplopia and ptosis accompanied by normal visual acuity and pupillary function. Frequently, patients with OMG develop generalized MG over 24 months. Pure OMG is more often earlier in onset (<45 years) than generalized MG. It can also occur as part of an immune-genetic disorder or paraneoplastic syndrome related to thymus tumors. Diagnosis is based on clinical manifestations, laboratory findings, electrophysiological evaluation and pharmacologic tests. Therapeutic strategies for MG consist of symptom relieving medications (e.g., acetylcholine esterase inhibitors), immunosuppressive agents, and surgical intervention (e.g., thymectomy).
Background: To record the corneal, and anterior chamber depth changes after performing recession versus resection of horizontal recti muscles.
Methods: Consecutive patients who underwent isolated lateral rectus muscle recession or resection February 2014 to January 2015 were prospectively studied. Refractive error (spherical equivalent); K1, K2, and mean k reading, anterior and posterior corneal elevation; and anterior chamber depth were measured (Pentacam) before, 1 month, and 3 months after surgery. Patients who could not maintain reliable fixation and those with a history of eye surgery were excluded. Pre- and postoperative measurements were compared by analysis of variance.
Results: A total of 36 eyes of 23 patients (average age, 16 years) were included. Rectus muscle recession was performed in 24 eyes; and resection was performed in 12 eyes. Statistically significant changes in mean keratometry of recession group only. Central anterior elevation, and central anterior chamber depth were significant when both groups are compared at first month after surgery. Changes became regressive at the end of the third month. Although a significant change of central anterior elevation persisted.
Conclusions: In recession group, the mean K was the only statistically significant variable by the first postoperative month. Comparing the both groups, the anterior corneal elevation, and central anterior chamber depth revealed a significant difference by the end of the first postoperative month. After 3 months, all parameters showed a statistical insignificant difference between the recession and resection groups except the anterior corneal elevation.
