Objective: To compare the efficacy of bicanalicular silicone intubation assisted with epidural catheters and traditional bicanalicular silicone intubation in the anastomosis of lacrimal canaliculus rupture. Methods: Fifty-two patients (52 eyes) were randomly divided into two groups. Patients in group A (30 cases) were treated by bicanalicular silicone intubation assisted with epidural catheters, while patients in group B (22 cases) were treated with conventional operation (bicanalicular silicone intubation). The intubation time, average operation time, nasal bleeding rate, intraoperative pain score and one-time success rate were compared between the 2 groups. Results: Intubation time in group A was (11.20±3.80) min and that in group B was (21.50±12.60) min (P<0.05). The mean operation time of group A was (42.70±5.50) min and that of group B was (62.20±15.20) min (P<0.05). Intraoperative pain score was 3.10±0.80 in group A and 4.60±1.25 in group B (P<0.05). The rate of nasal hemorrhage was 3.33% (1/30) in group A and 18.2% (4/22) in group B (P<0.05). With respect to one-time anastomosis success rate assessment, the effective rate was 93.3% (28/30) in group A, and 86.4% (19/22) in group B (P>0.05). Conclusion: During lacrimal canalicular anastomosis, bicanalicular silicone intubation assisted with epidural catheters is superior to bicanalicular silicone intubation in intubation time, average operation time, nasal bleeding rate and pain degree. There is no significant difference between the two methods in one-time success rate. Bicanalicular silicone intubation assisted with epidural catheters is safe, reliable, and worthy of promotion.

Objective: To evaluate the efficacy and safety of surgical resection of conjunctival papillae combined with autologous conjunctival graft in the treatment of vernal keratoconjunctivitis (VKC). Methods: All 11 cases (22 eyes) with VKC were treated with surgical resection of conjunctival papillae in combination with autologous conjunctival graft. Clinical efficacy and safety were evaluated. Results: After 36 to 48 months of follow-up, 19 eyes were cured (86.36%), 2 eyes were improved (9.09%), and 1 eye was ineffective (4.55%). The total effective rate was 95.45%. Conclusion: Surgical resection of conjunctival papillae combined with autologous conjunctival graft is efficacious and safe in the treatment of VKC.

Background: To analyze the morphological changes of meibomian glands in patients with recurrent and primary meibomian gland cyst under in vivo confocal microscope (IVCM). Methods: A cross-sectional study was performed in Shantou International Eye Center from September 2018 to April 2019. Ten patients with recurrent meibomian cyst, 10 patients with primary meibomian cyst and 10 control subjects were selected in this clinical trial. All subjects received routine ophthalmologic examination and IVCM examination. IVCM examination parameters included open area of meibomian gland, and the maximum and minimum diameter of meibomian gland opening. Relevant parameters were analyzed and statistically compared among different groups. Results: The average minimum diameter of meibomian glands opening in the recurrent meibomian gland cyst group was (109.08±49.96) μm, the average maximum diameter of meibomian glands opening was (144.95±68.10) μm, and the median open area of meibomian gland was 11 621.62 (3 976.49–24 828.82) μm2. In the primary meibomian gland cyst group, the average minimum diameter of meibomian glands opening was (101.53±29.55) μm, the average maximum diameter of meibomian glands opening was (130.08±45.21) μm, and the median open area of meibomian gland was 10 615.07 (5 813.29–18 275.44) μm2. The opening of meibomian glands in both the recurrent and primary meibomian gland cyst groups was enlarged, which significantly differed from that in the control group (both P<0.05). No statistical significance was noted between the recurrent and primary meibomian gland cyst groups (P>0.05). The acinus structure around the gland tube was manifested with serious hypertrophic scar complicated with inflammatory cell infiltration. Conclusion: IVCM can detect the morphological changes of meibomian glands in meibomian gland cyst patients. The IVCM findings of recurrent and primary meibomian gland cyst are different.

Objective: To investigate and analyze the effect of He-Ne laser, recombinant human interferon α-2b ointment and gabapentin on skin lesion healing, sleep, pain and disease course in acute herpes zoster ophthalmicus. Methods: Sixty patients with acute herpes zoster ophthalmicus were collected from January 2017 to January 2020 in our hospital. According to the different treatment, they were divided into an experimental group (32 cases) and a control group (28 cases). The patients in the control group received routine basic treatment including antiviral, neurotrophic therapy, interferon α-2b ointment and gabapentin, and the experimental group was treated with He-Ne laser on the basis of control group treatment. The time of detumescence, blister stopping, scab formation, scab removal and pain relief, Visual Analogue Scale (VAS) score, sleep time, adverse reactions, and postherpetic neuralgia were collected and analyzed. Results: Before treatment, there was no significant difference in the observation indexes between the two groups (P>0.05); after treatment, the observation indexes of skin rash (detumescence, blister stopping, scab formation, scab removal) and pain relief time in the experimental group were significantly less than those in the control group, and the scab removal rate on the 4th and 7th days post-treatment in the experimental group was significantly higher than that in the control group; after treatment, the sleep duration was prolonged, and the VAS score was decreased. For pain relief and prolonging sleep time, the experimental group was better than the control group, and the difference was statistically significant P<0.05). There was no significant difference in scab removal rate on 2, 14 and 28 days post-treatment (P>0.05). The effective rate in the experimental group (93.75%) was significantly higher than that in the control group (75%), and the difference was statistically significant (P=0.047); there was no significant difference in PHN and adverse reactions between the two groups (P>0.05). Conclusion: He-Ne laser combined with interferon α-2b ointment and gabapentin is safe and effective in the treatment of acute herpes zoster ophthalmicus. It can significantly relieve the acute pain, promote the recovery of rash, improve sleep quality, shorten the disease course, and can be actively promoted in clinical usage.

Objective: To observe and evaluate the feasibility and clinical effect of modified combined fascial sheath (CFS) suspension on the treatment of recurrent severe blepharoptosis. Methods: A total of 26 patients (32 eyes) with recurrent severe ptosis treated in Hebei Eye Hospital from March 2017 to March 2020 were included. All patients were corrected by modified CFS suspension. The patients were followed up for 1 year, and returned to the hospital at 1 month, 3 months, 6 months and 1 year respectively. The marginal reflex distance-1 (MRD1), eyelid crease depth, length, radian, and complications were recorded as the main observation indexes and the effect was evaluated. Results: In the 32 eyes of 26 patients, 27 eyes (84.4%) were completely corrected, 4 eyes (12.5%) were improved, while 1 eye (3.1%) had no improvement, the invalid eye was adjusted again 6 months after operation, and reached the effective standard after adjustment. Conjunctival prolapse occurred in 1 case, and the symptoms of conjunctival prolapse disappeared after the treatment with drugs and pressure dressing, and no case of exposure keratitis or other complications occurred. Conclusion: Modified combined fascial sheath suspension is an effective method on the treatment of recurrent severe blepharoptosis with the advantages of simple operation, less trauma, definite therapeutic effect, and fewer complications, which is worthy of clinical promotion and application.

Objective: To observe the clinical efficacy of ultrasonic atomization fumigation of traditional Chinese medicine combined with acupuncture in the treatment of meibomian gland dysfunction (MGD). Methods: A total of 77 MGD patients (154 eyes) in Xinhua Hospital were selected and randomly divided into a control group (27 cases, 54 eyes), a ultrasonic atomization of traditional Chinese medicine group (atomization group; 25 cases, 50 eyes), and a ultrasonic atomization of traditional Chinese medicine combined with acupuncture group (combined treatment group; 25 cases, 50 eyes). The control group received meibomian gland massage, the atomization group received meibomian gland massage and ultrasonic atomization of traditional Chinese medicine, and the combined treatment group received additional acupuncture treatment. The treatment period was 4 weeks. Tear breakup time (BUT), basal tear secretion test data (Schirmer I Test, SIT), corneal fluorescein staining score (FL), and Meibomian Gland Yielding Secretion Score (MGYSS), Eyelid Margin Abnormality Score (EMAS), Subjective Symptom Score (SSS) were collected and conduct clinical efficacy were evaluated. Results: There were no significant differences in BUT, SIT, FL, MGYSS, EMAS and SSS among the three groups (all P>0.05). After treatment of 4 weeks, the BUT, SIT, FL, MGYSS, EMAS and SSS in each group were improved significantly compared to baseline (P<0.05). The above indicators in combined treatment group were significantly different from atomization group (P<0.05) and control group (P<0.05). The total effective rates after treatment were 51.85% (28/54) in control group, 84% (42/50) in atomization group, and 96% (48/50) in combined treatment group. The difference in total effective rate between combined treatment group and atomization group was significant (P<0.05). Conclusion: Ultrasonic atomization of traditional Chinese medicine combined with acupuncture presents good clinical effects in improving the meibomian gland function of patients with MGD and alleviating the dry eye symptoms.

Ocular myasthenia gravis (OMG) is an autoimmune disease involving the postsynaptic membrane of the neuromuscular junction. The fluctuation of OMG and the clinical characteristics of fatigue easily lead to a high rate of missed diagnosis and misdiagnosis, which seriously affects the quality of life of patients. Therefore, detection methods play an important role in the early diagnosis of OMG. In this paper, OMG detection methods were reviewed in clinical examination, neostigmine test, autoantibody detection, electrophysiological detection, and other aspects, in order to provide useful guidance for the early diagnosis of OMG.

Meibomian gland dysfunction (MGD) is a common ophthalmic disease, which is the main cause of evaporative dry eye. Population-based studies have suggested that the prevalence of MGD is high in Asia, with a reported incidence of 46.2% to 69.3%. Current modalities of MGD treatment include lid hygiene, warm compresses, massage, artificial lubricants, systemic and topical antibiotics, etc., among which warm compress is a common at-home treatment. Due to different eyelid warming methods, temperature, durations of heat application, frequency and compliance, there is no uniform standard for the application of warm compress to the treatment of MGD. In addition, adverse events of warm compress, such as blurred vision and thermal damage, have not attracted enough attention in clinical practice. Therefore, in order to improve the clinical efficacy of warm compress and reduce its adverse events, it is necessary to conduct standardized guidance or treatment of warm compress in the future. Based on the above considerations, this article will briefly review the application of warm compress to the treatment of MGD.

Primary acquired nasolacrimal duct obstruction (PANDO), which mainly occurs in the middle-aged and elderly women, is the most common type of obstructive diseases of the lacrimal duct, and it is also a common and frequently-occurring disease in ophthalmology. It constantly occurs secondary to various symptoms and signs of acute or chronic dacryocystitis, which seriously affects the daily work and life of patients. This article summarizes the research progress on the possible pathogenesis of PANDO in recent years, the urgent problems to be solved and the hot research directions in the future, aiming to further deepen the understanding of the occurrence and development of lacrimal obstructive diseases.

2. Department of Ophthalmology, First Affiliated Hospital of Jinan University, Guangzhou 510630, China)