Objective: To demonstrate the clinical characteristics and surgical effects of glaucoma in Hallermann-Streiff syndrome (HSS). Methods: Observational case series and literature review. The results of ophthalmic examinations of three patients diagnosed as glaucoma with HSS were recorded, including visual acuity, intraocular pressure (IOP), slit-lamp microscopy, ultrasound biomicroscopy, optical coherence tomography, corneal topography, A-scan and B-scan ultrasonography, and orbital size measurement by X-ray. Peripheral iridectomy, glaucoma drainage device implantation or trabeculectomy, were performed in these patients. Results: Three HSS patients were 9, 29 and 47 years old, respectively, including 2 females and 1 male. The best corrected visual acuity was 6/150 to 6/12. The mean spherical equivalent refraction was +12.1 DS. The average IOP was 37.7 mm Hg, and the average corneal diameter was 9.1 mm. The average central anterior chamber depth was 2.43mm. The average axial length was 18.13mm. Keratometry showed average K1 of 56.97 degrees, and K2 of 60.65 degrees. Two younger patients were aphakic bilaterally with uveitis, pupillary fibrous membrane and peripapillary choroidal atrophy. The older patient showed blue sclera, cataract, and anterior chamber angle closure. The horizontal orbital diameter was 28.76-31.40 mm, and vertical orbital diameter was 30.16-32.90 mm. All patients were proportionate nanism, with an average height of 143 cm. Craniofacial manifestations included dyscephalia and “bird-like” face, hypotrichosis, dental anomalies, and mandibular hypoplasia. They were followed up for 47.7 (11-84) months after surgery. The IOPs were all controlled, and the visual acuities remained unchanged. No treatment-related complications occurred. Conclusions: HSS patients with glaucoma may present as small orbit, microphthalmia, microcornea, blue sclera, aphakia, pupillary fibrous membrane, uveitis, with atrophic chorioretinal changes. For these patients, personalized treatment may help to achieve better therapeutic effects.
Macular edema refers to the formation of edema in the macular area, the most sensitive part of the retina to light, and fluid infiltration, resulting in serious visual impairment. Macular edema is basically not present after intraocular lens surgery, but it is not immune to this situation. We report a case of rapid, severe, and rare macular edema after ICL surgery. Now combined with the literature reports as follows.
OBJECTIVE:To explore the influencing factors of ophthalmology surgery time under general anesthesia relying on previous surgery information, and to construct a machine learning model to predict the surgery time for better scheduling of next day surgery. METHODS: A total of 4859 general anesthesia surgery cases in the Ophthalmology Center of the Second Affiliated Hospital of Zhejiang University School of Medicine from June 2019 to June 2021 were extracted and included in this study to establish a database. Prediction with machine learning modeling: decision tree analysis and plain Bayesian analytic classifier were used to do classification model prediction; linear regression, random forest, neural network, and support vector machine were used to do regression model prediction. Prediction accuracy, Mean Square Error (MSE), and Root Mean Squared Error (RMSE) were used to evaluate the model prediction effectiveness. RESULTS: The Random Forest model had the smallest RMSE and MSE; the Linear Regression model was the largest of the four models and relatively less effective. CONCLUSION: Age, gender, body mass index, ASA classification, eye type, type of surgery, and surgeon are predictors of ophthalmic surgery time. Machine learning for predicting surgical time can probably predict the start and end time of surgery, which contributes to the efficiency of surgery, increases patient turnover, and plays an important role in social benefits and economic improvement of hospitals.
A 16-year-old girl presented to the hospital because of recurrent transient visual loss on the left eye for nearly a month. The corrected visual acuity of both eyes is 1.0 for the right eye and 1.2 for the left eye. Color fundus photographs, Fundus fluorescence angiography(FFA) and optical coherence tomography(OCT) showed left eye optic disc edema. No abnormality was found in brain magnetic resonance imaging and magnetic resonance angiography. Contrast-enhanced transcranial doppler ultrasound(cTCD) indicates positive foaming test, supporting right to left shunt. Cardiac ultrasound indicates patent foramen ovale(PFO). Combined with the medical history and examination results, the diagnosis was PFO and left eye optic disc edema. Transient visual loss of the left eye disappears after catheter-based patent foramen ovale closure, but there was still optic disc edema in the left eye.
Optical coherence Tomography (OCT) is a type of tomography that measures the light reflection of biological tissue to reflect the deep structure, which mainly uses low-coherence light interference. The damage of retinal ganglion cells (RGCs) can be reflected by changes in parameters such as the macular ganglion cell complex (GCC), to a certain extent, reflecting the damage of the optic nerve. OCT is evaluated by non-invasive and repeatable characteristics, which is regarded as a "window" for the discovery of central nervous system diseases in neuroophthalmology. OCT is widely used to study neurodegenerative diseases such as multiple sclerosis, Alzheimer's disease and Parkinson's disease. In this paper, the application of OCT to detect the thickness changes of ganglion cell complex in macular area in different neuroophthalmic diseases is aimed at providing clinical ideas for diagnosis, differentiation and prognosis assessment of neuroophthalmic diseases.
Sterile marginal corneal infiltrates is a relatively rare postoperative complication after corneal refractive surgery. The key is to differentiate between infectious and non-infectious corneal infiltrates. This article reports 3 cases of sterile marginal corneal infiltrates after femtosecond laser-assisted in situ keratomileusis (FS-LASIK). Topical tobramycin and dexamethasone eye drops and eye ointment were used for treatment. After treatment, the patient's pain, foreign body sensation, and tearing symptoms were significantly relieved. Most of the peripheral corneal infiltrates lesions improved in 1 week, and gradually healed to form interlaminar scars in 2 weeks. Observation after treatment found no significant impact on visual acuity. No glucocorticoid-induced intraocular hypertension occurred.
Objective To investigate the safety and efficacy of "double lacrimal tubular catheterization and absorbable lacrimal duct anastomosis" in the treatment of lacrimal duct rupture surgery. Methods A retrospective analysis was performed on the treatment effect of 24 patients (24 cases) with primary lacrimal tubule rupture who applied "double lacrimal tubular catheterization with absorbable lacrimal anastomosis".According to the location of the tear duct rupture and the degree of medial canthus and lower eyelid laceration, different surgical plans were adopted, and the silicone tube was removed after 3~6 months after surgery. Results The lacrimal canalicular laceration and anastomosed in 100.00% during operation.There were 16 cases of 24 patients with silicone catheter removed at 3 months after surgery, and 8 cases with silicone catheter removed at 6 months after surgery.The follow-up period after extubation was 3 to 6 months. At 3-6 months after surgery, 22 (91.67%) were cured, 2 (8.33%) were improved, and 0 (0.00%) were ineffective. During the follow-up period, one patient had a small lower tear spot, and one case had poor healing at the broken end of the tear duct to form a fistula. There were 9 cases of nasal allergy in the early stage, all patients had no serious epistaxis, and all patients did not have eyelids, medial canthus, and lacrimal punctal deformities after surgery.The complication rate was 8.33%. Conclusion "Double lacrimal tubular catheterization with absorbable lacrimal anastomosis" is safe and effective in the treatment of lacrimal duct rupture.
In the early 2020's, the COVID-19 spread all over the world,impacted societies and healthcare systems，affecting various professional fields. Pediatric ophthalmology was no exception.People generally reduce going out and gathering， with a decrease in the number of patients and an increase in the risk of infection . At the same time, the epidemic also affected pediatric ophthalmic diseases，Long term home quarantine and online learning have led to a significant increase in children's use of electronic devices. Long term screen gaze and lack of outdoor activities make myopia prevention and control more difficult. long-term use of electronic screens has led to a dramatic increase in the incidence of visual display terminal syndrome, dry eye disease, acute acquired combatant isotropy, accommodation abnormalities, which has brought new challenges to pediatric ophthalmologists. This article summarized the impact of COVID-19 epidemic on pediatric ophthalmology and provided countermeasures for similar public health events in the future and better protect children's eye health.
In the early 2020's, the COVID-19 spread all over the world,impacted societies and healthcare systems，affecting various professional fields. Pediatric ophthalmology was no exception.People generally reduce going out and gathering， with a decrease in the number of patients and an increase in the risk of infection . At the same time, the epidemic also affected pediatric ophthalmic diseases，Long term home quarantine and online learning have led to a significant increase in children's use of electronic devices. Long term screen gaze and lack of outdoor activities make myopia prevention and control more difficult. long-term use of electronic screens has led to a dramatic increase in the incidence of visual display terminal syndrome, dry eye disease, acute acquired combatant isotropy, accommodation abnormalities, which has brought new challenges to pediatric ophthalmologists. This article summarized the impact of COVID-19 epidemic on pediatric ophthalmology and provided countermeasures for similar public health events in the future and better protect children's eye health.
