Congenital cataract is a serious disease seriously affecting the visual function of infants and young children. With the development of technologies of cataract surgery and intraocular lens implantation, high-quality visual rehabilitation can be obtained after congenital cataract surgery. However, how to better prevent and treat the adverse events and complications related to surgery, the treatment of other eye dysplasia and form deprivation amblyopia that may be associated with surgery are still the clinical problems that need to be paid attention to after congenital cataract surgery. In this article it summaries the occurrence, risk factors, treatment and prevention of high intraocular pressure and secondary glaucoma after congenital cataract and intraocular lens implantation, in order to further improve the understanding of the prevention and treatment of high intraocular pressure and glaucoma after congenital cataract surgery, and prevent further damage to visual function caused by postoperative complications.
Objective: To explore the effectiveness of visual function training in the prevention and control of myopia among preclinical myopic children. Methods: Children and adolescents who visited the Third Affiliated Hospital of Jinzhou Medical University for ophthalmic specialty in August 2022 were selected for the study. After cycloplegic refraction, children and adolescents aged 7-8 years with a refractive error of ≤+0.75D and >-0.50D in the preclinical stage of myopia were chosen. A total of 25 individuals were initially selected; however, after excluding 3 with incomplete follow-up results, 21 preclinical myopic children and adolescents were statistically analyzed. The observed indicators included equivalent sphere power, axial length, corneal curvature, NRA、 PRA、 accommodation amplitude、accommodation sensitivity, and convergence and divergence flexibility. Follow-up evaluations were conducted 2, 4, and 6 months after baseline data collection. The training frequency was twice a week, lasting 30 minutes each time. Results: 1. Changes in accommodation amplitude and sensitivity: Overall, accommodation amplitude showed an increasing trend and differences were statistically significant at each time point. Further pairwise comparisons showed significant differences 2, 4, and 6 months after treatment compared to baseline (t=-2.37, -2.98, -3.40; P<0.05). Accommodation flexibility initially increased and then decreased, with significant differences at all time points. Significant differences were found when comparing 2 and 4 months after treatment to baseline (t=-4.11, -2.66; P<0.05), and when comparing 2 and 4 months after treatment to 6 months after treatment (t=-3.78, 2.40; P<0.05). 2. Changes in binocular NRA、PRA accommodation flexibility、convergence and divergence flexibility: Overall, PRA gradually decreased over time and showed statistically significant differences at all time points. Further pairwise comparisons indicated significant differences 2, 4, and 6 months after treatment compared to baseline (t=2.74, 3.66, 4.96; P<0.05), and significant differences between 2 months after treatment and 6 months after treatment (t=2.33;P<0.05). Accommodation flexibility initially increased and then decreased, with significant differences at all time points. Statistically significant differences were found when comparing 2 and 4 months after treatment to baseline (t=-3.49, -2.55; P<0.05), and when comparing 2 and 4 months after treatment to 6 months after treatment (t=3.24, 2.34; P<0.05). Conclusion: Visual function training is effective in the prevention and control of myopia in children during the preclinical stage. Early proactive intervention in children and adolescents with related high-risk factors can effectively reduce the prevalence of myopia, providing a scientific basis for developing targeted strategies and measures for the prevention of myopia among students.
Smile surgery has been widely promoted in China due to its small incision, no need for corneal flap fabrication, good postoperative predictability, and biomechanical stability. Its safety and effectiveness have been widely recognized by refractive surgeons both domestically and internationally. The common postoperative complications include diffuse lamellar keratitis (DLK), corneal epithelial defect, haze under the corneal epithelium, corneal epithelial implantation, foreign body under the corneal cap, and occasional corneal interlayer infection. Complication of marginal keratitis after Smile surgery is relatively rare. This article reports a case of eye redness and foreign body sensation 3 days after Smile surgery. Slit lamp examination revealed conjunctival ciliary congestion, and an inflammatory infiltration area parallel to the corneal edge was visible in the cornea. There was a 1-2mm transparent corneal area between the infiltration area and the corneal edge, and keratitis was limited to the edge of the Smile surgical incision above the nose. Activated dendritic cells were observed under confocal microscopy, and no obvious pathogens were found. The diagnosis was marginal keratitis. Local corticosteroids and immunosuppressive agents were administered to the eyes, and the condition rapidly improved. Follow up for 1 year showed stable vision and no other adverse reactions in the patient.
Mammalian target protein of rapamycin (mTOR) is a protein kinase that primarily involves in the regulation of nutrient levels andgrowth metabolism in vivo. mTOR serves as a crucial target for cancer, aging, and other metabolic related pathological diseases, participating in various biological processes such as proliferation, transdifferentiation, and autophagy. Te eye is considered an area with immune privilege, as the vascular system afects vision and is located outside the central light path. Many areas of the eye have mechanisms for transporting immune cells to the afected areas related to developmental, damaged, or aging. Although the immune response is primarily aimed at reparing or protecting itself, immune cells may secrete some cytokines, leading to infammation or fbrosis, which in turn can damage vision. Results from studies have confirmed that mTOR is closely related to pterygium, age-related macular degeneration (AMD), glaucoma, cataract, diabetic retinopathy (DR), eye tumors and other eye diseases. Currently, mTOR inhibitors are widely used as immunosuppressants and approved for cancer treatment; however, there are few reports on the use of mTOR inhibitors for eye diseases. Therefore, in the article it provides a brief overview of the role, regulatory mechanisms, and drug treatment of the mTOR signaling pathway in related ophthalmic diseases, providing ideas for the pathological mechanisms and treatment of related ophthalmic diseases, in order to carry out more in-depth research in the future.
A 40-year-old male patient, pain in the left eye was found with difficulty in raising the upper eyelid and vision loss for 1 day .Blindness in the left eye,intraocular pressure T+,scar can be seen from the left eyebrow arch to the temporal side,blepharoptosis completely covers the pupil with a diameter of about 4.0mm,direct and indirect response to light(-),eyeball protrusion and fixation .Auscultation:The upper eyelidof the left eye is heard with a wind murmur consistent with the pulse.Ocular CT examination showed multiple fractures of orbit ,optic nerve thickening,tortuous and dilated superior ocular vein,and enlarged cavernous sinus region.Previous:Patient had severe closed craniocerebral injury 40 days ago.
The whole lacrimal passage intubation is widely used in lacrimal surgery. However, one of the most typical complications is the prolapse of the silicone tube from the medial canthus. In case, the bicanalicular silicone tube after whole lacrimal duct intubation has completely prolapsed from the medial canthus before extubation, then cannot be found in the opening of the nasolacrimal duct, and it would be a challenge to reposition or removal. A novel approach to employ a modified suture-probe and silk thread traction technique has been developed, and it is not only safe and effective, but also cost-effective.
Objective: To compare the changes in corneal densitometry (CD) in patients following TransPRK, SMILE, and FS-LASIK surgeries in the early postoperative period. Methods: A retrospective controlled study was conducted to collect data from the right eyes of 205 patients who underwent refractive laser surgery from January 2020 to June 2023, including 76 eyes for TransPRK, 66 eyes for SMILE, and 63 eyes for FS-LASIK. Pentacam was used to measure corneal densitometry (CD) preoperatively, one month postoperatively, and three months postoperatively. Repeated measures analysis of variance was applied to compare the differences in CD values across three different layers (anterior, middle, and posterior) and three diameter ranges (0-2mm, 2-6mm, and 6-10mm). Results: In the TransPRK group, there was a significant increase in CD values in the anterior layer (2-6mm) and middle layer (0-2mm) one month postoperatively compared to preoperative values (both p < 0.001). Additionally, the CD in the middle layer (0-2mm) was higher than that in the FS-LASIK group (p = 0.012). At three months postoperatively, the CD values in the middle and posterior layers (0-2mm and 2-6mm) were significantly increased compared to preoperative values (both p < 0.01). Notably, the CD in the middle layer (0-2mm) was higher than that in the other two surgical groups (both p < 0.01), and the CD in the posterior layer (0-2mm) was higher than that in the FS-LASIK group (p = 0.025). In the SMILE group, there was an increase in CD values in the anterior layer (2-6mm) and middle layer (0-2mm and 2-6mm) one month postoperatively compared to preoperative values (all p < 0.05). In the FS-LASIK group, there was a significant increase in CD values in the full range of the anterior layer and the middle layer (2-6mm) three months postoperatively (all p < 0.05). Conclusion: TransPRK has a significant impact on the CD in the middle layer (0-2mm) of the cornea, necessitating enhanced management in the early postoperative period. The CD value in the middle layer (0-2mm) can serve as a sensitive indicator for observing changes in corneal transparency following surgery.
Degenerative entropion is a common and frequent ocular disease, which is mainly related to the horizontal and vertical relaxation of the eyelids after aging and the riding of the orbicularis oculi muscle in front of the orbital diaphragm. According to its pathogenesis, the surgical method of degenerative entropion is mainly designed based on orbicularis oculi, tarsus and lower palpebral retractor muscle. In order to provide reference for the rational selection of surgical methods, this paper reviews the various surgical treatment methods of involutional entropion in recent years in monographs and literatures.
Objective:Clinical analysis of endophthalmitis after 23G/25G minimally invasive vitrectomy. Methods: Retrospectively analyzed the clinical characteristics of patients with endophthalmitis (except patients with open eye trauma) after minimally invasive vitreous surgery in our hospital from June 2014 to May 2023.Results: 8955 patients in this study, and 11 cases of endophthalmitis occurred in the eyes after minimally invasive vitrectomy, the incidence rate was 0.12%. The average age was 60.8±7.6 years, and 5 patients (45.4%) were complicated with diabetes ; the composition of primary eye diseases: 7 cases (63.6%) of macular disease, 3 cases (27.3%) of vitreous hemorrhage, 1 case (9.1%) of retinal detachment; During the operation, 3 cases (27.3%) underwent cataract surgery; After the operation ,the vitreous cavity of 8 cases (72.7%) were filled with sterule air,the other 3patients (27.3%) filled with equilibrium liquid,and sclera puncture incision was not sutured in all patients; 3 cases (27.3%) had low intraocular pressure after operation. The time for endophthalmitis after operation was 2.8±1.1day. Eleven patients had poor inflammation control after local and systemic anti-inflammatory treatments. They all underwent vitrectomy combined with intraoperative injection of vancomycin solution. Among the 9 patients,the vitreous cavity was filled with silicone oil after the operation. After the operation, the endophthalmitis was controlled and final correctd visual acuity of 10 patients improved. Conclusion: Minimally invasive vitrectomy and suture-free scleral incision may be a potential way for pathogenic microorganisms to invade the eye and cause endophthalmitis. Particular attention should be paid to the "wick effect" at the scleral incision caused by vitrectomy in macular surgery, which may be one of the risk factors for postoperative endophthalmitis.
