Background: Few prevalence studies on intermittent exotropia (IXT) based on Chinese populations. Furthermore, longitudinal change in this pattern within a local setting has not been reported in the past. This study aims to determine the pro?le of children with IXT in China.Methods: A total of 7,537 subjects from nine multi-layer primary and secondary schools participated in this investigation. The position of eyes was examined by using Hirschberg test and alternate cover test. The obtained results were classi?ed according to respective features and analyzed statistically.Results: The prevalence of IXT among the participants was 7.98%, accounting for 73.04% of all types of strabismus. Junior high school students had a lower prevalence of IXT than elementary and senior high school counterparts. Logistic regression analysis showed that IXT was mainly found in male pupils at high grades in rural areas and in male secondary students at high grade in urban regions.Conclusions: IXT was shown to be more prevalent than other types of strabismus in Chinese children. Furthermore, the distribution and characteristics of IXT greatly varied among participants.
Background: Few prevalence studies on intermittent exotropia (IXT) based on Chinese populations. Furthermore, longitudinal change in this pattern within a local setting has not been reported in the past. This study aims to determine the pro?le of children with IXT in China.Methods: A total of 7,537 subjects from nine multi-layer primary and secondary schools participated in this investigation. The position of eyes was examined by using Hirschberg test and alternate cover test. The obtained results were classi?ed according to respective features and analyzed statistically.Results: The prevalence of IXT among the participants was 7.98%, accounting for 73.04% of all types of strabismus. Junior high school students had a lower prevalence of IXT than elementary and senior high school counterparts. Logistic regression analysis showed that IXT was mainly found in male pupils at high grades in rural areas and in male secondary students at high grade in urban regions.Conclusions: IXT was shown to be more prevalent than other types of strabismus in Chinese children. Furthermore, the distribution and characteristics of IXT greatly varied among participants.
Background: Corneal ectasia is a serious complication after laser in situ keratomileusis (LASIK). Ideally, patients at risk of ectasia should be identified prior to laser as unsuitable for LASIK, however, at present, there is no absolute test, system, or marker that can unequivocally identify patients at risk of developing ectasia. It has been suggested that changes in the forward protrusion of the posterior cornea or posterior corneal elevation (PCE) may be a key to the early detection of ectasia after LASIK. The purpose of this study was to examine the long term changes of the PCE after myopic LASIK using the ORBSCAN® IIz (Bausch & Lomb, Rochester, USA) and to evaluate the contributory preoperative factors to PCE changes.Methods: This was a retrospective longitudinal case series. Forty-two eyes of 23 consecutive myopic patients who underwent uneventful LASIK surgery 6 years ago were recalled for a postoperative follow-up examination using the ORBSCAN® IIz to determine the elevation changes to the posterior corneal surface from the preoperative measurements. A forward shift of the posterior surface was given a negative value. Correlation analyses and forward stepwise regression analyses were performed to evaluate the effect of each of the preoperative parameters on the changes in PCE. Statistical and graphical analyses were performed.Results: There was no statistical difference between the mean best-fit sphere (BFS) pre-LASIK and 6 years postop (P=0.25). Forty-two post-LASIK eyes had a mean posterior displacement of -9.38±9.84 μm (range, 12 to -31 μm) 6 years after LASIK. Forward stepwise multiple linear regression analysis indicated that the ablation spherical equivalent (ASE) was the only indicator of the forward shift of the posterior cornea after LASIK.Conclusions: The present study identified a significant forward shift of the posterior cornea 6 years after LASIK. The ASE was the most significant prognostic determinant for forward protrusion of the posterior cornea after LASIK.
Background: Corneal ectasia is a serious complication after laser in situ keratomileusis (LASIK). Ideally, patients at risk of ectasia should be identified prior to laser as unsuitable for LASIK, however, at present, there is no absolute test, system, or marker that can unequivocally identify patients at risk of developing ectasia. It has been suggested that changes in the forward protrusion of the posterior cornea or posterior corneal elevation (PCE) may be a key to the early detection of ectasia after LASIK. The purpose of this study was to examine the long term changes of the PCE after myopic LASIK using the ORBSCAN® IIz (Bausch & Lomb, Rochester, USA) and to evaluate the contributory preoperative factors to PCE changes.Methods: This was a retrospective longitudinal case series. Forty-two eyes of 23 consecutive myopic patients who underwent uneventful LASIK surgery 6 years ago were recalled for a postoperative follow-up examination using the ORBSCAN® IIz to determine the elevation changes to the posterior corneal surface from the preoperative measurements. A forward shift of the posterior surface was given a negative value. Correlation analyses and forward stepwise regression analyses were performed to evaluate the effect of each of the preoperative parameters on the changes in PCE. Statistical and graphical analyses were performed.Results: There was no statistical difference between the mean best-fit sphere (BFS) pre-LASIK and 6 years postop (P=0.25). Forty-two post-LASIK eyes had a mean posterior displacement of -9.38±9.84 μm (range, 12 to -31 μm) 6 years after LASIK. Forward stepwise multiple linear regression analysis indicated that the ablation spherical equivalent (ASE) was the only indicator of the forward shift of the posterior cornea after LASIK.Conclusions: The present study identified a significant forward shift of the posterior cornea 6 years after LASIK. The ASE was the most significant prognostic determinant for forward protrusion of the posterior cornea after LASIK.
目的：比较翼状胬肉两种不同手术方式后巩膜溶解的发生概率，探讨产生巩膜溶解的原因，选择合理手术方式。方法：对本院两年来263例翼状胬肉采用两种不同的手术方式，观察术后发生巩膜溶解的情况，并通过局部药物进行治疗。结果：263例翼状胬肉患者，130例采用胬肉切除+结膜瓣转位术，裸露角膜缘3 mm巩膜，术后局部滴0.02%丝裂霉素C(mitomycin C, MMC)，胬肉复发26 例，发生巩膜溶解6例；133例采用胬肉切除+角膜缘干细胞移植术，术后滴0.02% MMC，胬肉复发5例，无1例发生巩膜溶解。结论：翼状胬肉术后发生巩膜溶解，是一种严重的手术并发症，可能与术中过度烧灼巩膜面，巩膜板层暴露于MMC有关。采用胬肉切除+角膜缘干细胞移植术，植片覆盖裸露巩膜，促进巩膜表层愈合，术后避免MMC直接浸润巩膜板层故未见此并发症发生。与传统手术方式相比，复发率低，并发症少，是一种安全、有效的翼状胬肉手术方式。
Objective: To compare the occurrence probability of posterior scleral dissolution in two different surgical methods, and to explore the reasons for the dissolution of the scleral. Methods: Using two different surgical methods on 263 cases of pterygium submitted in our hospital in 2 years, observed the occurrence of scleral at postoperative, and treated with topical drugs. Results: Two hundred and sixty three cases of patients with pterygium, 130 cases of pterygium resection and conjunctival flap transposition, bare 3 mm limbus sclera, postoperative topical mitomycin C (MMC). The recurrence of pterygium in 26 cases, scleral melting in 6 cases; 133 cases of pterygium excision and limbal stem cell transplantation, MMC (0.02% MMC drip after operation, 5 cases of recurrent pterygium, no scleral melting occurred in 1 case. Conclusion: The scleral dissolution occurred after pterygium surgery is a serious complication, which may be related to the excessive burning of the scleral surface, and the lamellar exposure to MMC. Excision of pterygium and corneal limbal stem cell transplantation were used to cover the exposed scleral, promote the surface healing of the wound, and avoid the MMC direct infiltration of the lamina. Compared with the traditional operation mode, the recurrence rate is low, and the complication is little. It is a safe and effective surgical method.
目的：探讨口服25%葡萄糖减轻早产极低出生体重儿在第一次早产儿视网膜病眼底检查时的疼痛 的效果。方法：选取2014年9月至2015年8月在广东省妇幼保健院NICU住院的早产极低出生体重儿，随机分为观察组和对照组，观察组在进行第一次早产儿视网膜病眼底检查前2 min，给予25% 葡萄糖溶液1mL口服；对照组未用任何安慰剂。两组患儿眼底检查后分别进行新生儿疼痛量表的 评估。结果：观察组患儿眼底检查后疼痛评分低于对照组(P<0.001)。结论：眼底检查前2 min口服25%葡萄糖溶液1 mL是缓解早产儿视网膜病检查引起的疼痛的有效措施。
Objective: To explore the analgesic effect of oral glucose 25% on preterm and very low birth weight infants for the first time of fundus examination for retinopathy screening. Methods: Cases of preterm and very low birth weight infants in Guangdong Women and Children’s Hospital NICU from February 2014 to January 2015 were randomly divided into observation group and control group. The observation group was given 1 mL of 25% glucose solution by oral 2 min before the first time of retinopathy screening. The control group was given nothing. Pain was evaluated using the Neonatal Infant Pain Scale immediately after the fundus examination in both groups. Results: The NIPS of the observation group was lower than that of the control group (P<0.001). Conclusion: 1 mL of 25% glucose solution given 2 min before fundus examination for retinopathy of prematurity by oral was an effective measure for pain relief.
青光眼(glaucoma)是一组具有特征性视神经损害和视野缺损的眼病,在临床上常常表现为视力减退、眼部胀痛伴头痛等症状，是一种致盲率居第二位的不可逆性眼病。青光眼视神经损伤有一定 的遗传倾向，造成视神经凹陷性萎缩及视野不同程度缺损这两种结局的危险因素有多种,其中致盲的主要原因包括进行性视神经节损害、病理性眼压升高等。所以在青光眼的治疗中一方面要考虑降低眼压，另一方面还要保护好视神经。本文将从视神经损害的机制、影响因素、分级方法、视神经相关检测指标及其在临床上相关仪器应用、治疗等方面进行综述。
Glaucoma is an irreversible eye disease with the characteristic of optic nerve damage and visual ?eld defect, the clinical manifestation is behaved for vision loss, eye pain with symptoms such as headache, which rate of blindness ranks second place. The optic nerve injury of glaucoma has a certain genetic predisposition. There are many risk factors result in optic nerve atrophy and visual ?eld defect, one of the major causes of blindness including optic ganglion damage, pathological elevation of intraocular pressure. So on the one hand in the treatment of glaucoma should be considered to reduce intraocular pressure, on the other hand, to protect the optic nerve. This article will reviews the mechanism, influencing factors, classification methods, optic nerve related detection indexes and clinical application and treatment of optic nerve injury.
目的：研究玻璃体腔注射曲安奈德(triamcinolone acetonide,TA)和雷珠单抗(Lucentis)治疗视网 膜中央静脉阻塞(central retinal vein occlusion,CRVO)的黄斑水肿的疗效。方法：配对病例对照研究。将2013年1月至2015年6月，在我院因CRVO并发黄斑水肿而接受玻璃体腔注射TA或Lucentis 的患者，根据患者基线水平的最佳矫正视力(best-corrected visual acuity,BCVA)(logMAR视力)和黄斑中心厚度(central macular thickness,CMT)将两组患者进行配对，选出12对患者，主要的观察 指标为随访1年时两组患者的BCVA和CMT。结果：TA组患者的BCVA由基线时的0.78±0.12提高到 0.55±0.24(P=0.005),CMT由基线时的(598.92±192.67) μm减少到(258.28±75.38) μm (P=0.002)。Lucentis组患者的BCVA由基线时的0.78±0.11提高到0.48±0.21(P=0.002), CMT由基线时的 (591.75±181.68) μm减少到(281.17±63.08) μm (P=0.002)。TA组和Lucentis组患者基线及最终的 BCVA和CMT直接均无显著差异。TA组的平均注药次数为(2.4±0.9)次，Lucentis组为(4.0±1.6)次， 两组有统计学差异(P=0.012)。结论：玻璃体腔注射TA或Lucentis均能减轻CRVO所致的黄斑水肿并提高视力，两者的疗效并无显著差异。TA的平均注射次数比Lucentis组少，但是TA更容易引起眼压升高。应该根据患者的综合情况制定个性化的治疗方案。
Objective: To compare the efficacy of intravitreal injections of triamcinolone acetonide (TA) and that of ranibizumab for macular edema secondary to central retinal vein occlusion (CRVO). Methods: In a retrospective assessment 12 TA-treated patients and 12 ranibizumab-treated ones with macular edema after CRVO were pairmatched according to initial best-corrected visual acuity (BCVA) and central macular thickness (CMT). BCVA and CMT were the main endpoints. Results: The initial BCVA of 0.78±0.12 increased significantly to 0.55±0.24 in the TA-treated patients (P=0.005). And the initial CMT of (598.92±192.67) μm decreased significantly to (258.28±75.38) μm (P=0.002). In the ranibizumab-treated patients, the initial BCVA of 0.78±0.11 increased significantly to 0.48±0.21 (P=0.002) and the initial CMT of (591.75±181.68) μm decreased significantly to (281.17±63.08) μm (P=0.002). There was no significance between the initial and final BCVA and CMT of TAtreated patients and ranibizumab-treated patients. Conclusion: Both treatments decreased the CMT and induced an improvement in BCVA from baseline.
A 45-year-old female presented with typical features of posterior scleritis in her left eye with visual acuity of 20/252. After treatment with oral steroids and immunosuppressive drugs, at 2 months follow-up, posterior scleritis resolved and visual acuity improved to 20/50. Five months later she presented with vision loss (20/160) associated with active choroidal neovascular membrane (CNVM) close to scar. Significant choroidal thinning (subfoveal choroidal thickness =137 microns), compared to fellow eye (subfoveal choroidal thickness =247 microns) was noted. Two doses of intravitreal bevacizumab (IVB) were given at 1 month interval. At 9 months follow-up, her visual acuity was maintained at 20/160 with scarred CNVM. In conclusion, IVB is safe and efficacious in treatment of inflammatory CNVM secondary to posterior scleritis. Choroidal changes after posterior scleritis could be contributory factor for formation of CNVM.
A 45-year-old female presented with typical features of posterior scleritis in her left eye with visual acuity of 20/252. After treatment with oral steroids and immunosuppressive drugs, at 2 months follow-up, posterior scleritis resolved and visual acuity improved to 20/50. Five months later she presented with vision loss (20/160) associated with active choroidal neovascular membrane (CNVM) close to scar. Significant choroidal thinning (subfoveal choroidal thickness =137 microns), compared to fellow eye (subfoveal choroidal thickness =247 microns) was noted. Two doses of intravitreal bevacizumab (IVB) were given at 1 month interval. At 9 months follow-up, her visual acuity was maintained at 20/160 with scarred CNVM. In conclusion, IVB is safe and efficacious in treatment of inflammatory CNVM secondary to posterior scleritis. Choroidal changes after posterior scleritis could be contributory factor for formation of CNVM.
目的：探讨改良的外路泪囊鼻腔吻合术式联合泪道置管治疗泪囊黏液囊肿的临床疗效。
方法：对23例（23眼）泪囊黏液囊肿行改良式泪囊鼻腔吻合术，并联合泪道置管，术后行泪道冲洗，并观察泪溢情况。结果：23例患者，1例术中改为泪囊摘除术，20例完成12个月的追踪观察治疗，1例术后6个月失访，1例12个月时失访。随访1个月，22例患者术后泪囊肿均消失，外观明显改善；随访12个月，20例患者中18例溢泪症状完全消失，所有患者泪道冲洗通畅，仅1例患者因泪溢症状对手术疗效不满意。
结论：改良式外路泪囊鼻腔吻合术联合泪道置管治疗泪囊黏液囊肿，具有良好的临床效果值得推广。
Purpose: To investigate the eficacy of modified external dacrocystorhinostomy (DCR) with intubation in the treatment of lacrimal sac cys.
Methods: Twenty-three lacrimal sac cyst cases (23 eyes) were enrolled and treated with DCR technique and tube intubation. The success was assessed based on lacrimalirrigation and symptomatic relief of epiphora.
Results: Among 23 patients, surgery was intenupted and converted to dacryocystectomy in l case, thus surgery was successfully performed in 22 cases. Among them, 1 case lost follow up at 6 month, 1 case lost follow up at 12 month. At 1 month visit, lacrimal sac cyst disappeared in 22 cases. At 12 month visit, epiphora was completed relieved in 18 out of 20 cases, irrigation indicated no obstruction in all 20 cases.
Conclusions :The modified DCR technique with intubation has satisfactory outcome for lacrimal sac cyst.
目的：分析非散瞳状态下的小学生眼屈光状态。方法：采用横断面调查设计，对城区小学生2046人 (4092眼) 进行电脑自动验光，数据采用 SPSS10.0 软件行统计分析。结果：在4092眼中 ,正视眼1309眼 (32.0%)，远视眼170眼 (4.2%)，近视眼2613眼 (63.8%)。 其中低度近视2102眼 (51.4%)，中度近视464眼 (11.3%)，高度近视47眼 (1.1%)。 其中，男生1348眼近视 (61.2%)，女生1265眼近视 (67%)。6个年级中正视眼比例逐渐下降 , 1年级正视眼占 45.5%、6年级正视眼占19.2%。平均屈光度 (-1.32±1.60) D，小学六个年级屈光度比较差异有统计学意义 (P < 0.01)，其中女生的平均近视程度较男生重，男女屈光度比较差异有统计学意义 (P < 0.01)。小学6年间近视的进展为 -1.0 D，平均 -0.2 D/y。结论：我国小学生近视情况严重 ，应予以重视 ，加强早期干预 。
Purpose: To observe the eyes' refractive status without cycloplegia in 2046 pupils.Methods: The cross-sectional study was conducted in 2046 pupils of 4092 eyes in Xi‘an city primary schools. The objective ophthalmic examinations were done on all participants, which included non-cycloplegic objective refraction, visual acuity, ocular pressure, fundus evaluation by special trained ophthalmologists and nurses. The special designed inventory scale was filled in and input special computer program, then the data were statistically analyzed with SPSS10.0.Results: In the primary school of 2046 pupils of 4092 eyes, the detective rate of emmetropia was 32.0% of 1309 eyes, hypermetropia was 4.2% of 170 eyes, myopia was 63.8% of 2613 eyes, low myopia was 51.4% of 2102 eyes, moderate myopia was 11.3% of 464 eyes, and high myopia was 1.1% of 47 eyes in total. In both eyes, the detective rate was 61.2% of 1348 eyes in 2204 boys, 67% of 1265 in 1888 girls. Among 6 grades , the constituent ratio of moderate and high myopia groups were significantly increased with the age,s growing, including emmetropia 45.5% of 343 eyes out of 754 in 1st grade and 19.2% of 122 eyes out of 634 in 6th grade. The average refractive error of spherical equivalent refraction was (-1.32±1.60) D. Among 6 grades, the 1st grade, was (0.82±1.42) D , and the 6th grade’s was (-1.82±1.68) D, there were significant differences among 6 grades (P < 0.01). There was a significant difference between girls and boys (P < 0.01). The average myopizing rate was -0.2 D per year, -1.0 D in the total of the progression in 6 years.Conclusion: Poor condition of myopizing was showed in Chinese pupils. It should be taking seriously and making early intervention.
