息肉状脉络膜血管病变(polypoidal choroidal vasculopathy,PCV)是亚洲人群中常见的致盲性眼病，发生大出血并发症后严重危害视力且预后差。PCV大出血包括视网膜下出血(subretinal hemorrhage,SRH)和玻璃体积血(vitreous hemorrhage,VH)。SRH的危险因素包括较长病程、簇型PCV、息肉状病灶不消退、合并视网膜色素上皮脱离；其治疗方式包括抗血管内皮生长因子药物、光动力疗法、激光、玻璃体腔注气、眼内注射组织纤溶酶原激活剂、玻璃体切割术或联合治疗等方式，其中，黄斑中心凹是否受累和出血时间是影响治疗方式选择的主要因素。发病年龄较大、白细胞计数较高、天门氨酸转移酶和丙氨酸转氨酶的比值较高、活化部分凝血活酶时间较长、曾行光动力疗法、有玻璃体腔注药治疗史、SRH面积大、出现视网膜色素上皮脱离的PCV患者发生VH的风险高。浓厚的VH通常需行玻璃体切割术，其手术时机和手术方式的选择是临床关注的焦点。鉴于目前PCV大出血的危险因素尚不完全明确、治疗方面也尚未形成共识，需要开展相关临床研究，提供更多依据。
Polypoidal choroidal vasculopathy (PCV) is a common blinding disease in Asian populations. Massive hemorrhage complications secondary to PCV include subretinal hemorrhage (SRH) and vitreous hemorrhage (VH). The risk factors for SRH include a long duration, clustered PCV, non-regression of polyp lesions and presented with retinal pigment epithelial detachment. The treatments for SRH include anti-vascular endothelial growth factor drugs, photodynamic therapy, laser, vitreous pneumatic displacement, intravenously injected tissue plasminogen activator, vitrectomy and combination therapy. Whether macular fovea is involved and the time since bleeding onset are the main factors afecting the choice of treatment for SRH. Older age of onset, higher white blood cell count, higher aspartate amino transferase and alanine amino transferase ratio, longer activated partial thromboplastin time retinal pigment epithelium detachment, photodynamic therapy history, intravitreal injection history larger SRH area and presented with retinal pigment epithelial detachment were associated with higher risk of VH. PCV patients with massive VH should be treated with vitrectomy, while the timing and technique of operation should be paid atention to. At present, the risk factors of PCV massive bleeding are not completely clear, and its treatment methods are diverse, which requires a large number of studies to prove its effectiveness and establish expert diagnosis and treatment consensus.
目的：探讨运用Barrett Universal Ⅱ公式(BUⅡ公式)计算人工晶状体(intraocular lens,IOL)屈光力时，可选参数角膜横径，又称白到白(white-to-white,W T W)与晶状体厚度(lens thickness,LT)的实际应用价值。方法：采用单中心、前瞻性临床研究，连续纳入同一术者顺利进行白内障超声乳化吸除术联合MX60(IOL植入术患眼279眼，术前使用OA-2000非接触式光学生物测量仪测量眼部数据并计算IOL植入度数，代入B UⅡ公式保留或去掉可选参数WTW、LT计算预测结果，进一步根据患者眼轴长度(axial length,AL)分亚组分析。主要结局指标：随访患者至术后1个月以上，比较使用和未使用WTW和LT两个参数、BUⅡ公式预测误差(prediction error,PE)、绝对预测误差(absolute error,AE)、AE小于0.5 D所占比例。结果：总体1上，忽略W T W + LT，PE为-0.05 D(-0.26, 0.18)(P=0.011)，其他参数组合的PE与0比较差异无统计学意义(P>0.05)。各参数组合的AE比较差异无统计学意义(0.22~0.23 D，P= 0.404)。同时忽略WTW + LT时AE出现最大值(+1.5 D)。应用WTW + LT、忽略WTW + LT、忽略WTW和忽略LT时纳入患者AE ≤ 0.50 D的比例分别为80.65%、79.57%、80.65%和81.36%。在各眼轴亚组中，忽略LT时，AE ≤ 0.50 D的百分比在短眼轴亚组(80.00% vs.66.67%~73.33%)与长眼轴亚组(77.78% vs. 73.33%~75.56%)中较高。在中等眼轴亚组中，AE ≤ 0.50 D百分比代入全部参数时略高(83.11% vs. 80.82%~82.19%)，忽略WTW + LT计算时稍低(80.82%)。结论：使用BU Ⅱ计算IOL屈光力时，可选参数WTW和LT无论是否代入公式中，皆可得到相近的平均预测水平；但是，同时忽略WTW和LT可能出现较大预测误差。对于22 mm ≤ AL<26 mm眼，推荐代入全部参数计算；当AL≤ 22 mm或AL ≥ 26 mm，仅输入WTW的计算方法累积精确度更高，可优先采用。
Objective: To investigate the practical application value of the optional parameters of corneal horizontal diameter or white to white (WTW) and lens thickness (LT) a using Barrett Universal II formula. Methods: Single-center, prospective clinical study. Eligible 279 eyes who underwent uneventful phacoemulsification and enVista MX60 implantation by the same surgeon were consecutively enrolled. OA-2000 (Tomey, Japan) non-contact optical biometry was used to measure the ocular data and calculate the IOL implantation power preoperatively. The BU II network formula was used to retain or remove optional parameters WTW and LT, and the predicted results were calculated. Further subgroup analysis was conducted based on the patient's axial length. Main outcome measures: Follow up patients for more than 1 month after surgery, compare the proportion of using and not using WTW and LT parameters, BU II formula prediction error (PE), absolute prediction error (AE), and AE less than 0.5 D. Results: Overall, ignoring WTW + LT, the median PE was -0.05 D (-0.26, 0.18) (P = 0.011) , and there is no statistically significant difference in PE compared 0 for the other parameter combinations (P > 0.05). There was no significant difference in the median AE of each parameter combination (0.22~0.23 D, P = 0.404). While ignoring both WTW and LT, the maximum AE value (+1.5 D) was found. The proportion of patients with AE ≤ 0.50 D included in the application of WTW+LT, neglect of WTW+LT, neglect of WTW, and neglect of LT were 80.65%, 79.57%, 80.65%, and 81.36%, respectively in each axial subgroup, when LT was ignored, the percentage of AE ≤ 0.50 D was higher in the short axial subgroup (80% vs. 66.67%~73.33%) and the long axial subgroup (77.78% vs. 73.33%~75.56%). In the subgroup of moderate eye axis, the percentage of AE ≤ 0.50 D was slightly higher when all parameters were substituted (83.11% vs. 80.82%~82.19%), and slightly lower when WTW+LT calculation was ignored (80.82%). Conclusions: When applying Barrett Universal II to calculate the refractive power of artificial lenses, the optional parameters WTW and LT can obtain similar average prediction levels regardless of whether they are substituted into the formula; However, ignoring both WTW and LT may result in significant prediction errors. For eyes with a diameter of 22 mm ≤ AL<26 mm, it is recommended to use all parameters for calculation; When AL ≤ 22 mm or AL ≥ 26 mm, the calculation method that only inputs WTW has higher cumulative accuracy, and it is suggested to be prioritized.
目的：初步评价折叠顶压球囊(foldable capsule buckle,FCB)治疗孔源性视网膜脱离(rhegmatogenous retinaldetachment,RRD)的有效性、安全性以及手术可操作性。方法：裂孔位置距角膜缘后≥15 mm的采用前瞻性临床病例研究。选择2020年3月至2021年9月在济南明水眼科医院院行FCB植入术治疗裂孔位置距角膜缘后≥15 mm的10例RRD患者(10眼)。应用眼部B型超声、眼底照相评价手术效果。根据术后有无FCB是否暴露、复视情况、排斥反应、眼球运动障碍等术后并发症的发生情况评价手术的疗效和安全性。结果：随访6个月~2年。10例RRD患者在术后通过眼部B超、眼底照相及光学相干断层扫描(opticalcoherence tomography,OCT)评估视网膜均复位。1例合并黄斑区视网膜脱离的患者视力提高。9例患者术后出现复视，术后1~3个月复视消失，1例在术后4个月仍存在复视，行FCB取出，术后视网膜未出现再脱离，复视症状消失。结论：初步研究可确定折叠顶压球囊植入治疗裂孔位置比较靠后(距角膜缘后≥15 mm)且传统巩膜扣带术操作难度大的孔源性视网膜脱离安全、有效，对眼球损伤小，易于操作。
Objective: To preliminarily evaluate the effectiveness, safety and surgical operability of foldable capsule buckle (FCB) in the treatment of rhegmatogenous retinal detachment (RRD). Methods: It is a prospective clinical case study. Ten patients (10 eyes), with a distance of ≥ 15 mm from the posterior margin of the angular membrane at the location of the fissure, who underwent FCB implantation surgery for RRD at Jinan Mingshui Ophthalmology Hospital from March 2020 to September 2021 were enrolled. The surgical outcome was evaluated by B-ultrasound, fundus photography and optical coherence tomography (OCT). The surgical efficay and safety were evaluated by the postoperative complications, such as FCB exposure, diplopia, rejection, and eye movement limitation. Results: The mean follow-up time was 1 year (6 months to 2 years). Retinal reattachment was evaluated by B-ultrasound, fundus photography and OCT after operation in 10 patients. One patient with macular retinal detachment had improved visual acuity. 9 patients developed diplopia after operation, but diplopia disappears 1-3 months after operation. One patient still had diplopia 4 months after operation, and FCB was removed 4 months after operation. No retinal detachment occurred after operation, and the symptoms of diplopia disappeared.Conclusion: It is confirmed by this preliminary research that the implantation of the foldable capsule buckle is safe and effective to treat rhegmatogenous retinal detachment with a relatively posterior position (≥15 mm from the back of the corneal limbus) with little damage to the ocular and easy to operate, compared with the difficulty and complexity in traditional scleral buckling surgery.
随着人口老龄化、生活方式的改变，眼科疾病患病人数的增加、国家眼病诊疗相关政策的持续推动、居民健康意识的逐渐提升，眼科门急诊患者数量持续增长，亟需构建科学的眼科急诊预检分诊标准，合理配置医疗资源，确保患者得到及时、恰当的治疗。国外已有医院依据患者症状或体征的严重程度对患者进行等级划分，建立起相对成熟的眼科急诊预检分诊模式，我国目前尚没有统一的、权威的眼科急诊预检分诊标准，国内外现行的眼科急诊预检分诊模式的分诊精准度及临床适用性有待进一步探索。该文通过综述国内外眼科急诊分诊标准及应用评价、眼科远程急诊预检分诊方式研究进展，以期为构建符合我国国情的、科学有效的眼科急诊预检分诊标准、提高眼科急诊分诊质量提供参考。
With the aging of population, the changing of lifestyle and the increasing number of ophthalmic emergency patients,Chinese national policies related to ophthalmic diagnosis and treatment are continually promoted, and residents' health awareness are gradually improved, the volume of ophthalmic outpatients and emergency patients continues to increase. It is urgent needed to establish scientific ophthalmic emergency pre-examination and triage criteria, to reasonably allocate medical resources, and to ensure that patients receive timely and appropriate treatment. The relatively mature ophthalmic emergency pre-examination and triage models with the severity of patients' symptoms or physical signs,have been established in foreign hospitals. Currently, there is no unified and authoritative ophthalmic emergency triage criteria in China. The accuracy and clinical applicability of the existing ophthalmic emergency triage models at home and abroad need to be further explored. This article reviewed the ophthalmic emergency triage criteria and application evaluation at home and abroad, and remote emergency triage in ophthalmology, in order to provide a reference for establishing a scientific and effective ophthalmic emergency triage criteria comformed Chinese national conditions, and improving the quality of ophthalmic emergency triage.
Background and Objective: Corneal neurotization is a novel surgical technique used to restore corneal sensation in patients with neurotrophic keratopathy. Neurotrophic keratopathy is a disorder characterized by dysfunction of the ophthalmic division of the trigeminal nerve, which provides sensory innervation to the cornea. Without sensation, the cornea is at risk of infection, ulceration, perforation, and ultimately, vision loss. Corneal neurotization has emerged as an innovative technique to reinnervate anesthetized corneas by transferring a healthy donor nerve to the affected eye around the corneoscleral limbus. As the field of corneal neurotization rapidly grows, there is a need to synthesize the existing body of literature on corneal neurotization and identify important areas for further research. In this review, we will discuss neurotrophic keratopathy and its current management strategies, followed by an overview of corneal neurotization techniques, outcomes, surgical considerations, and future directions. Methods: PubMed and Google Scholar searches were conducted to retrieve and analyze relevant original papers and reviews on neurotrophic keratopathy and corneal neurotization up until April 2022.Key Content and Findings: Currently, numerous techniques for corneal neurotization exist, including direct nerve transfers, as well as indirect neurotization via interposition nerve grafts. So far, corneal neurotization has been shown to be highly successful in restoring corneal sensation, improving visual acuity,and improving corneal epithelial health. To date, there have been no significant differences in outcomes between direct versus indirect neurotization techniques, different donor nerves, or autologous versus allogeneic interposition grafts. However, there is some evidence that corneal neurotization procedures may be more successful in pediatric patients.Conclusions: Corneal neurotization shows great promise in treating neurotrophic corneas and represents the first management option to date that addresses the underlying pathophysiological mechanism of neurotrophic keratopathy by restoring corneal sensation. As the use of corneal neurotization continues to broaden, additional studies will become important to compare techniques in a systematic manner, with larger sample sizes, as well as standardized outcome measures and follow-up time.
Background and Objective: Corneal neurotization is a novel surgical technique used to restore corneal sensation in patients with neurotrophic keratopathy. Neurotrophic keratopathy is a disorder characterized by dysfunction of the ophthalmic division of the trigeminal nerve, which provides sensory innervation to the cornea. Without sensation, the cornea is at risk of infection, ulceration, perforation, and ultimately, vision loss. Corneal neurotization has emerged as an innovative technique to reinnervate anesthetized corneas by transferring a healthy donor nerve to the affected eye around the corneoscleral limbus. As the field of corneal neurotization rapidly grows, there is a need to synthesize the existing body of literature on corneal neurotization and identify important areas for further research. In this review, we will discuss neurotrophic keratopathy and its current management strategies, followed by an overview of corneal neurotization techniques, outcomes, surgical considerations, and future directions. Methods: PubMed and Google Scholar searches were conducted to retrieve and analyze relevant original papers and reviews on neurotrophic keratopathy and corneal neurotization up until April 2022.Key Content and Findings: Currently, numerous techniques for corneal neurotization exist, including direct nerve transfers, as well as indirect neurotization via interposition nerve grafts. So far, corneal neurotization has been shown to be highly successful in restoring corneal sensation, improving visual acuity,and improving corneal epithelial health. To date, there have been no significant differences in outcomes between direct versus indirect neurotization techniques, different donor nerves, or autologous versus allogeneic interposition grafts. However, there is some evidence that corneal neurotization procedures may be more successful in pediatric patients.Conclusions: Corneal neurotization shows great promise in treating neurotrophic corneas and represents the first management option to date that addresses the underlying pathophysiological mechanism of neurotrophic keratopathy by restoring corneal sensation. As the use of corneal neurotization continues to broaden, additional studies will become important to compare techniques in a systematic manner, with larger sample sizes, as well as standardized outcome measures and follow-up time.
角膜移植手术是治疗角膜病变重要且有效的手段。但对眼表功能完全失代偿、多次角膜移植排斥等类型的患者，常规同种异体角膜移植手术成功率却非常低。对于这类患者，人工角膜植入术成为复明的新希望。随着人工角膜的设计和植入方式的不断改进，人工角膜的功效及优点已渐渐突显。目前，波士顿I型(领扣型)人工角膜在全球范围内应用最为广泛。现就波士顿I型人工角膜的基本特征、临床应用及未来发展等方面进行阐述。
The corneal transplantation is an effective option for visually impaired patients with keratopathy to restore vision function. However, the success rate of allograft keratoplasty is still very low for those patients with end-stage ocular surface or repeated corneal graft rejection. For those patients, artificial keratoplasty might be a promising alternative option. The efficacy and advantages of artificial keratoplasty have been gradually highlighted, after consistent improvement of the product design and implantation procedure. Nowadays, the Boston type I (collar button) corneal prosthesis is the most widely used product around the world. In this review, the history, indications, postoperative complications and future prospect of Boston type I corneal prosthesis will be summarized.
目的：分析单中心神经眼科疾病谱及流行病学特点，为指导神经眼科疾病诊断和治疗提供基础。方法：纳入2010年1月1日—2021年12月31日中国人民解放军总医院神经眼科病区收治的神经眼科疾病患者，从电子病例系统检索和记录所有纳入病例的年龄、性别、地区分布及病种亚型分析。结果：共计7245例神经眼科患者纳入统计，其中男性3331例(46.0%)、女性3914例(54.0%)，男女比例1∶1.2；年龄(38.2±17.5)岁。83.25%(6031/7245)为传入神经系统疾病，9.92%(719/7245)为传出神经系统疾病和眼眶疾病，6.83%(495/7245)未归类。病种分析显示，占比最高的是脱髓鞘性视神经炎(demyelinating optic neuritis,DON)，为40.17%(2910/7245)；占比第二的是非动脉炎性前部缺血性视神经病变(nonarteritic anterior ischemic optic neuropathy,NAION)，为11.37%(824/7245)；占比第三的是外伤性视神经病变5.15%(373/7245)，其中7.85%(569/7245)表现为不明原因视神经萎缩。从年龄分布来看，DON和外伤性视神经病变患者中18~40岁者占比最高(分别为48.63%和44.24%)，NAION患者中41~60岁者占比最高(66.14%)，小于18岁的未成年患者在遗传性视神经病变中占比最高，比例为48.58%。在2226例DON患者中，视神经脊髓炎(neuromyelitis optica,NMO)/视神经脊髓炎谱系疾病(neuromyelitis optica spectrum disorder,NMOSD)比例最高，为60.02%；髓鞘少突胶质细胞糖蛋白抗体(myelinoligodendrocyte glycoprotein antibody,MOG-IgG)阳性视神经炎比例为11.68%；多发性硬化(multiple sclerosis,MS)和MS相关性视神经炎和慢性复发性炎性视神经病变(chronic recurrent inflammatory optic neuropathy,CRION)占比较低，分别是1.8%和2.25%。DON整体患者中，男女比例为1∶3.08；在NMO/NMOSD患者中男女比例为1∶8；MOG阳性视神经炎患者中，男女比例为4∶5；在非典型视神经炎患者中，男性比例高于女性，为1.28∶1；DON患者中，81.79%患者为中青年，MOG阳性视神经炎未成年患者可达41.15%。结论：DON和NAION是神经眼科传入系统疾病最常见两大病种。
Objective: To analyze the spectrum and epidemiological characteristics of neuro-ophthalmic diseases from single center, and to provide basis for guiding the diagnosis and treatment of neuro-ophthalmic diseases. Methods: Patients with neuro-ophthalmic diseases admitted to the neuro-ophthalmology ward of Chinese PLA General Hospital from January 1, 2010 to December 31, 2021 were enrolled. The age, gender, regional distribution and disease subtypes of all included patients were retrieved and recorded from the electronic case system. Results: A total of 7245 patients with neuro-ophthalmic diseases were enrolled, including 3331 males(46.0%)and 3914 females(54.0%), with a male to female ratio of 1:1.2. The average age was 38.2±17.5 years. 83.25%(6031/7245)were afferent nervous system diseases, 9.92% (719/7245)were efferent nervous system diseases and orbital diseases, and 6.83%(495/7245)were not classified. The ratio of demyelinating optic neuritis(DON)was the highest(40.17%,2910/7245), followed by nonarteritic anterior ischemic optic neuropathy(NAION)(11.37%,824/7245)and traumatic optic neuropathy(TON) (5.15%,373/7245). The ratio of optic nerve atrophy with unknown causes was 7.85%(569/7245). Characteristics of age distribution, the DON and TON were more common in 18-40 age group(the proportion were 48.63% and 44.24%,respectively), the NAION was common in 41-60 age group(66.14%), and the hereditary optic neuropathy was common in younger 18 age group (48.58%). In 2226 DON patients, the proportion of neuromyelitis optica(NMO)/neuromyelitis optica spectrum disorder(NMOSD)-optic neuritis(ON)was the highest(60.02%)and myelinoligodendrocyte glycoprotein antibody(MOG-IgG)ON was 11.68%, while multiple sclerosis(MS)-ON and chronic recurrent inflammatory optic neuropathy(CRION)were relatively low(1.8% and 2.25%,respectively). In DON patients, the male to female ratio was 1:3.08. In NMO/NMOSD-ON patients, the ratio of male to female was 1:8, and that of MOG-ON was 4:5. In atypical ON, the ratio of male to female was higher than that of female(1.28:1). In DON patients, 81.79% of patients were young and middle-aged, and the proportion of children with MOG-ON(less than 18 years old)was 41.15%.Conclusions: DON and NAION are the two most common diseases of neuro-ophthalmic afferent system.
视网膜神经纤维层是视网膜的最内层，主要由来自视网膜神经节细胞的无髓鞘轴突组成，此外还有神经胶质细胞与视网膜血管，其厚度与年龄、眼球增长、眼底结构改变等因素相关。光学相干断层扫描可以清晰展示角膜、视网膜、脉络膜、视神经等高分辨率断层图像，可以在活体上显示生物学组织的细微结构，在临床与科研中已获得广泛应用。在青光眼视神经病变中，光学相干断层扫描可以发现视野异常前的视网膜神经纤维层损害，已成为青光眼早期诊断与视神经损伤程度检测的重要手段。除视神经病外，越来越多的研究表明许多视网膜血管疾病、神经元变性疾病等视网膜疾病也有视网膜神经纤维层的损伤。探讨视网膜疾病与神经纤维层的关系，将有利于进一步推进对视网膜疾病发病机制及病理改变的认识。本文就视网膜神经纤维层的定量评估与多种视网膜疾病的关系展开综述，为其在视网膜疾病中的应用提供参考。
The retinal nerve fiber layer, the innermost layer of the retina, consists mainly of unmyelinated axons from retinal ganglion cells, as well as glial cells and retinal blood vessels , the thickness of which is related to factors such as age, ocular growth and fundus structure changes. Optical coherence tomography (OCT) can clearly display the cornea, retina, choroid, optic nerve and other high-resolution tomography images. It can show the fine structure of biological tissues in vivo, which has been widely used in clinical and scientific research. In glaucomatous optic neuropathy, OCT can detect the damage of retinal nerve fiber layer before abnormal visual field, which has become an important means of early diagnosis of glaucoma and detection of the degree of optic ner ve damage. In addition to optic neuropathy, more studies have shown that many retinal diseases such as retinal vascular diseases and neurodegenerative diseases also have retinal nerve fiber layer injury. Exploring the relationship between retinal diseases and nerve fiber layer will be beneficial to further promote the understanding of the pathogenesis and pathological changes of retinal diseases. This paper reviews the relationship between the quantitative evaluation of retinal nerve fiber layer and various retinal diseases, and provides reference for its application in retinal diseases.
后视路病变是视交叉以后的视觉通路其本身或毗邻结构发生病变，引起视觉功能改变的一类疾病。神经眼科医生比较熟悉枕叶病变引起的对称性同侧偏盲，但枕极(纹状皮质的最后部分)的病变产生中心性对称性同向盲点，此类视野改变容易被忽略或误诊。该文报道一例老年男性患者，因双眼视觉清晰度下降、视物变形就诊。眼科检查：最佳矫正视力：右眼0.8，左眼1.0，FM-100检查提示重度色觉异常，颅脑磁共振成像(magnetic resonance imaging,MRI)提示双侧枕叶脑梗死(右侧枕极部，左侧纹状皮质前部)，24-2 Humphrey视野检查可见双眼同向暗点趋势(不典型)，10-2 Humphrey视野检查可见双眼中心视野同向偏盲(暗点)，故而确诊。后视路病变可引起多种特征性的视野改变，可伴有高级视功能异常及其他神经系统症状和体征，是神经眼科的重要组成部分。该例枕极脑梗死病变产生对称性同向性盲点伴色觉改变患者的诊治过程，提示需关注后视路病变视野改变的多样性及其他视觉功能异常，提高早期诊断率，改善患者预后。
The disease of the posterior visual pathway is a kind of lesion in which the visual pathway itselfor its adjacent structure changes after optic chiasma causes pathological changes, resulting in changes in visual function. Neuro-ophthalmologists are familiar with symmetrical ipsilateral hemianopia caused by occipital lobe lesions, but occipital tip (the last part of the striatal cortex) lesions produce central symmetrical homonymous scotomas, which can easily be overlooked or misdiagnosed. This article reported a case of an olderly male patient treated with decreased binocular visual clarity and distortion. Ophthalmology examination: best corrected visual acuity: 0.8 in the right eye, 1.0 in the left eye; FM-100 examination indicated severe dyschromatopsia; cranial magnetic resonance imaging: infarction of bilateral occipital lobe (right portion of the occipital tip and left anterior portion of striate cortex); 24-2 Humphrey field examination showed a tendency of homonymous scotoma in bilateral eyes (atypical); 10-2 Humphrey field examination showed homonymous hemianopia (scotoma) in the central visual field. These results confirm a diagnosis of the disease of the posterior visual pathway. As an important part of neuro-ophthalmology, the posterior visual pathway can cause various characteristic visual field defects, which can be accompanied by advanced visual dysfunction and other neurological symptoms and signs. The diagnosis and treatment process of this case of occipital tip cerebral infarction with symmetrical homonymous blind spot accompanied by color vision changes suggests that attention should be paid to the diversity of visual field changes and other visual functional abnormalities in the posterior visual pathway lesions, so as to improve the early diagnosis rate and prognosis of the patient s.
YAMANE式后房型人工晶状体巩膜层间固定术是近年出现的一种人工晶状体悬吊术式。该文介绍了笔者结合实际条件对其改良后的手术步骤，手术关键点及使用经验。在缺乏足够囊膜支撑的条件下，此手术方式微创、安全、有效，术后恢复快。在随访期间(最长5年)，视力稳定，未出现人工晶状体脱位、移位、倾斜，人工晶状体夹持及人工晶状体襻暴露等并发症，值得临床推广应用。
The YAMANE intrascleral fixation of posterior chamber intraocular lens (IOL) is a new technique in recent five years for IOL suspension. This article introduces a modified YAMANE technique including surgical procedure, key points and using experience. In the absence of adequate capsular support, this procedure is minimally invasive, safe, effective and has a fast postoperative recovery. During the follow-up period (up to 5 years), the visual acuity was stable, and there were no complications such as luxation of lens, displacement, tilt of intraocular lens, intraocular lens clamping and IOL haptic exposure.
