目的：研究M22优化脉冲光技术治疗睑板腺功能障碍(meibomian gland dysfunction，MGD)所致干眼的疗效，并用keratograph 5M干眼分析仪分析评估患者治疗前后病情变化。方法：收集汕头博德眼科医院门诊患者46例，年龄31~85(55.39±14.02)岁，行M22优化脉冲光治疗1个疗程(每月1次，共3次)，治疗前后均采用keratograph 5M干眼分析仪分析评估患者泪河高度情况、泪膜破裂时间(break-up time，BUT)、脂质层、睑板腺情况的变化，采用t检验分析对比治疗前后 变化情况。结果：患者治疗后泪河高度较强脉冲光治疗前明显增高，由(0.20±0.11) mm增加到(0.35±0.11) mm，BUT时间延长，由(4.98±2.13) s延长到(10.12±1.86) s，脂质层异常情况好转，有效率达93.48%，睑板腺阻塞情况减轻，有效率达84.78%以上，治疗后与治疗前差异有统计学意义(P<0.01)。结论：M22优化脉冲光技术在治疗MGD导致的干眼有较好的效果，没有出现并发症，是较安全有效地治疗方法，且keratograph 5M干眼分析仪可以较全面的对该病进行评估。

Objective: To study the efficacy of M22 Optimal Pulsed Technology in the treatment of dry eye caused by meibomian gland dysfunction and to evaluate the changes of patients affer treatment with keratograph 5M dry eye analyzer. Methods: Forty-six patients collected from Shantou Balder Eye Hospital receiving M22 Optimal Pulsed Technology treatment for three times, once a month, then using keratograph 5M dry eye analyzer to assess the height of tears river, break-up time (BUT), lipid layer, and meibomian gland. The results before and affer laser treatment were compared using t-test in this study. Results: Affer treatment, there was signiffcant effect than those of before treatment, the BUT time was prolonged from (0.20±0.11) mm to (0.35±0.11) mm, the abnormalities of the lipid layer were alleviated, the cure rate exceeded 93.48%, and the obstruction of the meibomian gland was reduced, the cure rate was higher than 84.78%. TTe difference before and affer corresponding treatment was statistically signiffcant (P<0.01). Conclusion: M22 Optimal Pulsed Technology has a good effect in the treatment of MGD-induced dry eye without complications. So M22 Optimal Pulsed Technology is a safe and effective treatment method. And keratograph 5M dry eye analyzer can deliver comprehensive assessment of dry eye. 

教学查房是手把手教学的重要手段和具体表现，是让同学们把书本知识应用到医疗诊疗中的重要桥梁。眼科学具有形象生动、结构复杂、直观性和操作性强等特点。外眼疾病的特征更是显而易见，针对外眼疾病诊疗中的一些不规范的操作也更易暴露出来。本文以上睑下垂为例，旨在阐明教学查房在外眼疾病教学中的重要性。

Teaching rounds are an important means and concrete manifestation of hands-on teaching, and an important bridge for students to apply book knowledge to medical diagnosis and treatment. Ophthalmology has the characteristics of vivid image, complex structure, intuition and strong operability. The characteristics of external eye diseases are more obvious, and some non-standard operations in the diagnosis and treatment of external eye diseases are easier to expose. This article takes blepharoptosis as an example to illustrate the importance of teaching rounds in the teaching of external eye diseases.

目的：探讨眼睑基底细胞癌在控制性切除联合眼睑一期修复的疗效。方法：通过对 47 例经病理诊断为眼睑基底细胞癌患者行控制性切除联合眼睑一期修复手术治疗，对其疗效进行回顾性分析。结果：术后修复皮瓣均成活，眼睑功能良好，随访 4 个月~10 年，期间无复发及转移病例。结论：对于眼睑部的基底细胞癌，采用显微控制下切除肿瘤联合一期修复的手术方法提高了患者的治愈率，同时最大限度地保留了眼睑的正常组织，达到了保持眼睑功能和美容的双重目的。

Objective: To evaluate the clinical efficacy of controlled excision combined with eyelid reconstruction in the treatment of basal cell carcinoma of eyelids. Methods: Clinical data of 47 patients pathologicall diagnosed with eyelid basal cell carcinoma were treated by controlled excision combined with eyelid reconstruction were retrospectively analyzed. Results: All skin flaps survived after operation, and the eyelid function was excellent. No recurrence or metastasis occurred during the follow-up. Conclusion: For basal cell carcinoma of the eyelids, controlled excision combined with eyelid reconstruction can improve the cure rate, and retain the normal tissues of the eyelid as much as possible, which both maintains eyelid function and improves cosmetic appearance.

目的：探讨推广新生儿眼病筛查以及婴儿期定期眼保健的必要性。方法：回顾分析 2014 年 1 月至 2016 年 12 月 20800 例惠州市妇幼保健计划生育服务中心门诊收集的婴儿眼保健资料。结果：共检出致盲性眼病 7 种 158 例，其中满 42 d 内检出 147 例，3 个月内检出 8 例，6 个月内检出 2 例，12 个月内检出 1 例。检出时已合并眼位、眼前节异常、影响视功能者 8 例。不同出生胎龄致盲性眼病检出率：≤ 34 周为 11.64％，34～37 周为 1.24％，≥ 37 周为 1.29％。相对于纸质宣传材料，开展家长学校讲课，利用 PPT 结合实际病例讲解，更有助于普及眼保健。相对于眼底检查，眼前节的方式更容易被接受、被推广。结论：致盲性眼病婴儿期发病在临床中并不少见，并且部分是可以早期筛查、早期治疗以避免视功能损害的。临床中需要大力普及眼保健知识，并可以在具备条件的医院，适当利用新生儿广域成像系统推广新生儿眼病普筛。

Objective: To discuss the necessity of screening for neonatal eye disease and regular eye care in infancy. Methods: A retrospective analysis of 20 800 infants in our hospital from January 2014 to December 2016 was conducted. From January 2014 to December 2016. Results: Seven types of blindness eye diseases were detected in 158 cases, including 147 cases at 42 days, 8 cases at 3 months, 2 cases at 6 months and 1 case at 12 months after birth. Eight cases were supervened with abnormal eye position, anterior segment abnormality and poor visual function. The detection rate of blindness-inducing diseases was 11.64% for infants aged ≤ 34 weeks, 1.24% for 34–37 weeks and 1.29% for ≥ 37 weeks. Compared with the paper propaganda materials, the introduction of parental school lectures and PPT combined with explanation of actual cases was more conducive to popularize eye care. Compared with fundus examination, anterior segment examination was more likely to be accepted and popularized. Conclusion: Eye disease inducing blindness in infancy are commonly encountered in clinical practice, which can be screened and treated early to avoid visual impairment. It is necessary to popularize the knowledge of eye care, and promote the screening of newborn eye disease in qualified hospitals.

Background: The aim of this study was to assess the health literacy of adult Vietnamese population in relation to common eye conditions and identify factors associated with respondents never having had an eye examination.

Methods: Four hundred households from two districts of Ba Ria-Vung Tau (BRVT) province were selected by multistage cluster random sampling. One adult from each household was administered a pre-tested knowledge, attitude and practices toward eye health questionnaire. Chi-square test and logistic regression were used for statistical analysis.

Results: Of the 400 subjects interviewed (mean age: 51.5±14.5 years; range, 30–90 years), 53.5% reported never having had an eye examination and 38.0% had spectacles. Awareness of eye conditions ranged from 7.0% for glaucoma to 52.8% for red eye. Low awareness of these conditions was significantly associated with rural habitation (odds ratio ranged from 1.65 to 2.78), lower educational attainment (odds ratio ranged from 1.78 to 2.59) and non-spectacle wear (odds ratio ranged from 1.88 to 4.55). Significant barriers to eye examination included lower educational attainment, reported absence of eye problems, non-spectacle wear, lack of affordability, and lack of health insurance.

Conclusions: Knowledge of and attitude or practices to eye health is low within the general public in Vietnam, especially among those who have never had an eye examination, are less educated and live in rural areas. Eye health promotion activities are warranted for the population and speciff c factors that influence eye examination visits should be addressed.

Background: The aim of this study was to assess the health literacy of adult Vietnamese population in relation to common eye conditions and identify factors associated with respondents never having had an eye examination.

Methods: Four hundred households from two districts of Ba Ria-Vung Tau (BRVT) province were selected by multistage cluster random sampling. One adult from each household was administered a pre-tested knowledge, attitude and practices toward eye health questionnaire. Chi-square test and logistic regression were used for statistical analysis.

Results: Of the 400 subjects interviewed (mean age: 51.5±14.5 years; range, 30–90 years), 53.5% reported never having had an eye examination and 38.0% had spectacles. Awareness of eye conditions ranged from 7.0% for glaucoma to 52.8% for red eye. Low awareness of these conditions was significantly associated with rural habitation (odds ratio ranged from 1.65 to 2.78), lower educational attainment (odds ratio ranged from 1.78 to 2.59) and non-spectacle wear (odds ratio ranged from 1.88 to 4.55). Significant barriers to eye examination included lower educational attainment, reported absence of eye problems, non-spectacle wear, lack of affordability, and lack of health insurance.

Conclusions: Knowledge of and attitude or practices to eye health is low within the general public in Vietnam, especially among those who have never had an eye examination, are less educated and live in rural areas. Eye health promotion activities are warranted for the population and speciff c factors that influence eye examination visits should be addressed.

Background: Evaluation of corneal biomechanical properties 3 months after using rigid gas permeable (RGP) contact lenses in keratoconus.

Methods: In this prospective trial study, cases were 32 keratoconic eyes with no history of RGP lens wear. All eyes were examined with the Ocular Response Analyzer (ORA) and the Corneal Visualization Scheimpflug Technology (CORVIS-ST) to measure corneal hysteresis (CH), corneal resistance factor (CRF), deformation amplitude (DA), applanation velocity (AV) 1 and 2, applanation length (AL) 1 and 2, and peak distance before and 3 months after fitting aspheric RGP lenses. The effect of the correlation between contralateral eyes and maximum keratometry were controlled for in the analysis. Results were compared using repeated measures analysis of covariance.

Results: At 3 months, neither the increases in mean CH (0.14±2.77 mmHg, P=0.789), CRF (0.41±4.35 mmHg, P=0.612), AV1 (0.03±0.17 m/s, P=0.301), AV2 (0.11±0.59 m/s, P=0.299), AL1 (0.44±1.56 m/s, P=0.118), AL2 (1.16±5.06 m/s, P=0.211), and peak distance (0.19±1.29 m/s, P=0.409), nor the decrease in mean DA (0.03±0.17 mm, P=0.402) was statistically significant.

Conclusions: Results in our series of patients indicated that 3 months of RGP lens wear had no significant impact on corneal biomechanics, and perhaps non progression of keratoconus. Therefore, RGP lenses can be regarded safe and appropriate in keratoconic patients.

Background: Evaluation of corneal biomechanical properties 3 months after using rigid gas permeable (RGP) contact lenses in keratoconus.

Methods: In this prospective trial study, cases were 32 keratoconic eyes with no history of RGP lens wear. All eyes were examined with the Ocular Response Analyzer (ORA) and the Corneal Visualization Scheimpflug Technology (CORVIS-ST) to measure corneal hysteresis (CH), corneal resistance factor (CRF), deformation amplitude (DA), applanation velocity (AV) 1 and 2, applanation length (AL) 1 and 2, and peak distance before and 3 months after fitting aspheric RGP lenses. The effect of the correlation between contralateral eyes and maximum keratometry were controlled for in the analysis. Results were compared using repeated measures analysis of covariance.

Results: At 3 months, neither the increases in mean CH (0.14±2.77 mmHg, P=0.789), CRF (0.41±4.35 mmHg, P=0.612), AV1 (0.03±0.17 m/s, P=0.301), AV2 (0.11±0.59 m/s, P=0.299), AL1 (0.44±1.56 m/s, P=0.118), AL2 (1.16±5.06 m/s, P=0.211), and peak distance (0.19±1.29 m/s, P=0.409), nor the decrease in mean DA (0.03±0.17 mm, P=0.402) was statistically significant.

Conclusions: Results in our series of patients indicated that 3 months of RGP lens wear had no significant impact on corneal biomechanics, and perhaps non progression of keratoconus. Therefore, RGP lenses can be regarded safe and appropriate in keratoconic patients.

大部分眼科手术/操作具有创伤小、疼痛刺激轻等特点，因此，选择眼表面麻醉即可满足手术的镇痛的需要，促进了眼科日间手术的广泛开展。其中，盐酸奥布卡因滴眼液是常用的眼科表面麻醉剂，具有麻醉起效迅速、镇痛作用强、持续时间久(约13 min)等特点，已经广泛应用在眼内手术中，在使用过程中，盐酸奥布卡因滴眼液对瞳孔及血管无影响，保证了眼内手术的安全。盐酸奥布卡因滴眼液能提供良好的眼表环境，对角膜厚度及角膜上皮厚度影响轻微，从而满足屈光手术的需要。此外，盐酸奥布卡因滴眼液能提供良好的术后镇痛，减少术后镇痛药物的使用，降低斜视术后患儿的躁动发生率。不含防腐剂的表面麻醉剂不影响麻醉剂的起效时间及镇痛效果，对眼表的影响轻微，从而创造良好的手术操作环境，提高手术效果，降低并发症和手术风险，是眼科手术中较为理想的表面麻醉药物。文章就盐酸奥布卡因滴眼液的作用机制及麻醉效果、药代动力学、临床疗效、安全性等进行综述。

Most ophthalmic surgeries are characterized by small incisions and mild pain, therein, the choice of topical anesthesia can meet the needs of surgeries and accelerate ophthalmic surgeries to be conducted in day surgery model. 0.4% oxybuprocaine hydrochloride eye drops is one of commonly used topical anesthetics for ophthalmic surgery, which has the characteristics of rapid onset and sufficient analgesia with long duration (about 13 minutes). Oxybuprocaine hydrochloride eye drops has been widely and safely used in intraocular surgery without affecting the pupil and blood vessels. Meanwhile, oxybuprocaine hydrochloride eye drops has negligible effects on corneal thickness and corneal epithelial thickness to meet the needs of refractive surgery. In addition, oxybuprocaine hydrochloride eye drops can provide sufficient postoperative analgesia, reduce the use of postoperative analgesics and the incidence of emergence agitation in children after strabismus surgery. The preservative-free topical anesthetic would be one of ideal topical anesthetics as it can provide a good surgical condition and reduce complications and risks of post-operative infections without changing the onset time and analgesia effects. This article provides a review of the mechanism, analgesia, pharmacokinetics, clinical efficacy, and safety profiles of 0.4% oxybuprocaine hydrochloride eye drops.

目的: 分析高度近视眼行白内障摘除及后房型人工晶状体植入术后并发裂孔源性视网膜脱离的发生率、相关危险因素及临床特点。

方法 : 回顾性分析高度近视眼行白内障摘除及后房型人工晶状体植入术患者 146 例(232 只眼) 。裂孔源性视网膜脱离在术后随访的3年时间发生。所有眼均进行了详细的眼科检查, 包括: 最佳矫正视力、眼底检查、A 超眼轴长度测量。

结果: 15 只眼发生裂孔源性视网膜脱离(6.4%) , 均需行玻璃体视网膜手术进行视网膜复位。从白内障手术到发生视网膜脱离的平均时间为10 ± 9 个月(0.5～32 个月) 。视网膜脱离经手术治疗后视力为手动 /10 cm～0.06, 12 只眼(80%) 最终视力低于白内障术前。术中后囊膜破裂与术后视网膜脱离的发生显著相关 (P < 0.01) , 60%(9/15) 的视网膜脱离患者术中发生了后囊膜破裂。

结论: 高度近视眼白内障术后并发裂孔源性视网膜脱离的发生率为 6.4%, 其预后差。术中发生后囊膜破裂患者术后发生视网膜脱离的危险性更高, 对术中后囊膜破裂患者需密切随访。

Aim: To analyze the clinical characteristics, incidence and risk of retinal detachment (RD) after cataract surgery and posterior chamber intraocular lens implantation in high myopic patients.

Methods:The medical records of 146 high myopic patients (232 eyes) who underwent cataract surgery and posterior chamber intraocular lens implantation were studied retrospectively. The development of RD was followed up over a 3-year period, and its characteristics were determined. All of the eyes received a comprehensive ophthal-mological examination, including best-corrected visual acuity measurements, a dilated fundus examination and axial length measured by A-scan ultrasonography.

Results: RD developed in 15 eyes of 15 patients. All the 15 eyes needed vitreo-retinal surgery. The mean interval between cataract surgery and the development of RD was 10 ± 9 months (range 0.5～32 months) . The visual results of the eyes after anatomical successful vitreo-retinal surgery ranged from finger count /10 cm to 0.06. 80% (12/15) of the eyes had a worse vision after the surgery than that before cataract surgery. Posterior capsular tear were associated significantly with RD (P < 0.01). Approximately 60%( 9/15) of retinal detachment was attributable to posterior capsule tear during cataract surgery.

Conclusion: Incidence of RD in high myopic patients after cataract surgery was 6.4%. RD was the potentially serious complication and tended to develop more frequently in eyes with posterior capsular rupture during cataract surgery. It is crucial to examine retinal status after cataract surgery and to have a close follow-up to prevent retinal complications, especially for patients with posterior capsular disruption.