原发性干燥综合征 (primary Sjogren' s syndrome，SS) 是一种主要累及外分泌腺体的自身免疫性疾病，患者通常因为严重的干眼症状首先就诊于眼科，大多数临床医师对原发性干燥综合征相关性干眼 (Sjogren' s syndrome dry eye disease，SS-DED) 认识不足，可能导致漏诊和误诊。侵入性极小的客观检查及生物标志物的发展，将有助于发现 SS-DED 的真面目，并可能从新的角度阐释其发病机制，为其诊断、分类及治疗提供新的思路。SS-DED 的治疗没有特效的药物，大多数患者需接受多种方法的治疗，以了解哪些方法最有效。

Primary Sjogren' s syndrome is an autoimmune disease that mainly affects exocrine glands. Patients usually refer to ophthalmologists because of severe dry eye symptoms. Most clinicians have insufficient knowledge with dry eye disease associated with primary Sjogren' s syndrome probably leading to misdiagnosis or missing the diagnosis. The diagnosis of Sjogren' s syndrome dry eye disease (SS-DED) is difficult, but the extremely invasive objective examination and the development of biomarkers will help to understand this disease and explain its pathogenesis from a new perspective. There is no specific treatment for the SS-DED, and most patients should receive multiple treatments to select the optimal treatment. 

目的：研究M22优化脉冲光技术治疗睑板腺功能障碍(meibomian gland dysfunction，MGD)所致干眼的疗效，并用keratograph 5M干眼分析仪分析评估患者治疗前后病情变化。方法：收集汕头博德眼科医院门诊患者46例，年龄31~85(55.39±14.02)岁，行M22优化脉冲光治疗1个疗程(每月1次，共3次)，治疗前后均采用keratograph 5M干眼分析仪分析评估患者泪河高度情况、泪膜破裂时间(break-up time，BUT)、脂质层、睑板腺情况的变化，采用t检验分析对比治疗前后 变化情况。结果：患者治疗后泪河高度较强脉冲光治疗前明显增高，由(0.20±0.11) mm增加到(0.35±0.11) mm，BUT时间延长，由(4.98±2.13) s延长到(10.12±1.86) s，脂质层异常情况好转，有效率达93.48%，睑板腺阻塞情况减轻，有效率达84.78%以上，治疗后与治疗前差异有统计学意义(P<0.01)。结论：M22优化脉冲光技术在治疗MGD导致的干眼有较好的效果，没有出现并发症，是较安全有效地治疗方法，且keratograph 5M干眼分析仪可以较全面的对该病进行评估。

Objective: To study the efficacy of M22 Optimal Pulsed Technology in the treatment of dry eye caused by meibomian gland dysfunction and to evaluate the changes of patients affer treatment with keratograph 5M dry eye analyzer. Methods: Forty-six patients collected from Shantou Balder Eye Hospital receiving M22 Optimal Pulsed Technology treatment for three times, once a month, then using keratograph 5M dry eye analyzer to assess the height of tears river, break-up time (BUT), lipid layer, and meibomian gland. The results before and affer laser treatment were compared using t-test in this study. Results: Affer treatment, there was signiffcant effect than those of before treatment, the BUT time was prolonged from (0.20±0.11) mm to (0.35±0.11) mm, the abnormalities of the lipid layer were alleviated, the cure rate exceeded 93.48%, and the obstruction of the meibomian gland was reduced, the cure rate was higher than 84.78%. TTe difference before and affer corresponding treatment was statistically signiffcant (P<0.01). Conclusion: M22 Optimal Pulsed Technology has a good effect in the treatment of MGD-induced dry eye without complications. So M22 Optimal Pulsed Technology is a safe and effective treatment method. And keratograph 5M dry eye analyzer can deliver comprehensive assessment of dry eye. 

目的：探讨眼睑基底细胞癌在控制性切除联合眼睑一期修复的疗效。方法：通过对 47 例经病理诊断为眼睑基底细胞癌患者行控制性切除联合眼睑一期修复手术治疗，对其疗效进行回顾性分析。结果：术后修复皮瓣均成活，眼睑功能良好，随访 4 个月~10 年，期间无复发及转移病例。结论：对于眼睑部的基底细胞癌，采用显微控制下切除肿瘤联合一期修复的手术方法提高了患者的治愈率，同时最大限度地保留了眼睑的正常组织，达到了保持眼睑功能和美容的双重目的。

Objective: To evaluate the clinical efficacy of controlled excision combined with eyelid reconstruction in the treatment of basal cell carcinoma of eyelids. Methods: Clinical data of 47 patients pathologicall diagnosed with eyelid basal cell carcinoma were treated by controlled excision combined with eyelid reconstruction were retrospectively analyzed. Results: All skin flaps survived after operation, and the eyelid function was excellent. No recurrence or metastasis occurred during the follow-up. Conclusion: For basal cell carcinoma of the eyelids, controlled excision combined with eyelid reconstruction can improve the cure rate, and retain the normal tissues of the eyelid as much as possible, which both maintains eyelid function and improves cosmetic appearance.

目的：探讨全视网膜光凝及术后应用羟苯磺酸钙治疗糖尿病视网膜病变的疗效。方法：选取96例患者，共175只眼，随机分为对照组(48例，86只眼)和研究组(48例，89只眼)。两组均予全视网膜激光光凝治疗，其中研究组术后再予羟苯磺酸钙继续12周治疗。12周后，观察两组患者治疗前后视力、血液流变学的变化。结果：治疗后研究组在视力>1.0范围的患者明显多于对照组(χ²=6.779，P=0.009)， 而2组在视力≤0.4，0.4~0.6，0.7~1.0范围患者视力差异比较分别为( χ²=0.003，P=0.955)，(χ²=1.640，P=0.200)，(χ²=2.148，P=0.143)。治疗后研究组患者的血浆粘度、红细胞压积、红细胞变形指数、纤维蛋白原改善均优于对照组(P<0.05)。研究组总有效率89.9%，对照组75.6%，两组差异比较(χ² =6.302，P=0.012)。结论：全视网膜激光光凝及术后应用羟苯磺酸钙治疗糖尿病性视网膜病，能有效提高视力及临床疗效，可能与改善患者血液流变相关。

Objective: To investigate the curative effect of the postoperative retinal laser photocoagulation and calcium dobesilate in the treatment of diabetic retinopathy. Methods: Selected 96 patients, 175 eyes, randomly divided into control group (48 cases, 86 eyes) and study group (48 cases, 89 eyes). Two groups were all given retinal laser photocoagulation treatment, while the study group continued to receive calcium dobesilate for 12 weeks after treatment. After 12 weeks, observed the eyesight, change of blood rheology of the two groups. Results: After the treatment, the patients with vision >1.0 in the study group were significantly more than the control group (χ² =6.779, P=0.009), in the vision range of ≤0.4, 0.4~0.6, 0.7~1.0, the difference between the two groups was (χ² =0.003, P=0.955), (χ² =1.640, P=0.200), (χ²=2.148, P=0.143), respectively. After treatment, plasma viscosity, erythrocyte deposited, erythrocyte deformation index, fibrinogen in the study group were better than those in the control group (P<0.05). The total effectiveness in the study group was 89.9%, in the control group was 75.6%, the difference was statistically significant (χ²=6.302, P=0.012). Conclusion: The whole retinal laser photocoagulation and postoperative application of calcium dobesilate in treating the diabetic retinopathy can effectively improve eyesight and clinical curative effect, which may be associated with improving blood rheology.

Background: To date, compliance to atropine penalization in amblyopic children has only been assessed through self-report. The goal of this pilot study is to measure compliance to atropine penalization objectively.

Methods: Seven amblyopic children (3–8 years; 20/40–20/125 in the amblyopic eye) were enrolled. None had been treated with atropine previously. Children were prescribed either a twice per week or daily atropine regimen by their physicians. Compliance was defined as the percentage of days in which the atropine eye drop was taken compared to the number of doses prescribed. We used medication event monitoring system (MEMS) caps to objectively measure compliance. The MEMS caps are designed to electronically record the time and date when the bottle is opened. The parents of the children were provided a calendar log to subjectively report compliance. Participants were scheduled for return visits at 4 and 12 weeks. Weekly compliance was analyzed.

Results: At 4 weeks, objective compliance averaged 88% (range, 57–100%), while subjective compliance was 98% (range, 90–100%). The actual dose in grams and visual acuity (VA) response relationship (r=0.79, P=0.03) was signiff cantly better than the relationship between regimen and response (r=0.41, P>0.05), or the relationship between actual dose in drops and response (r=0.52, P>0.05).

Conclusions: Objective compliance to atropine penalization instructions can be monitored with MEMS, which may facilitate our understanding of the dose-response relationship. Objective compliance with atropine penalization decreases over time and varies with regimen. On average, subjective parental reporting of compliance is overestimated.  

Background: To date, compliance to atropine penalization in amblyopic children has only been assessed through self-report. The goal of this pilot study is to measure compliance to atropine penalization objectively.

Methods: Seven amblyopic children (3–8 years; 20/40–20/125 in the amblyopic eye) were enrolled. None had been treated with atropine previously. Children were prescribed either a twice per week or daily atropine regimen by their physicians. Compliance was defined as the percentage of days in which the atropine eye drop was taken compared to the number of doses prescribed. We used medication event monitoring system (MEMS) caps to objectively measure compliance. The MEMS caps are designed to electronically record the time and date when the bottle is opened. The parents of the children were provided a calendar log to subjectively report compliance. Participants were scheduled for return visits at 4 and 12 weeks. Weekly compliance was analyzed.

Results: At 4 weeks, objective compliance averaged 88% (range, 57–100%), while subjective compliance was 98% (range, 90–100%). The actual dose in grams and visual acuity (VA) response relationship (r=0.79, P=0.03) was signiff cantly better than the relationship between regimen and response (r=0.41, P>0.05), or the relationship between actual dose in drops and response (r=0.52, P>0.05).

Conclusions: Objective compliance to atropine penalization instructions can be monitored with MEMS, which may facilitate our understanding of the dose-response relationship. Objective compliance with atropine penalization decreases over time and varies with regimen. On average, subjective parental reporting of compliance is overestimated.  

Background: To compare the structural outcome of intravitreal bevacizumab (IVB) and laser treatment for type 1 retinopathy of prematurity (ROP).

Methods: This is a retrospective comparative study. From December 2002 to April 2009, patients with type 1 ROP according to criteria of Early Treatment of Retinopathy of Prematurity (ETROP) study were treated by peripheral retinal diode laser photocoagulation in nearly confluent pattern. From May 2009 to January 2015, we performed IVB for patients with type 1 ROP. The patients were closely followed until disappearance of retinal neovascularization in the laser group and regression of avascular zone in the bevacizumab group. The demographical data, postmenstrual age (PMA) for treatment, and fundus findings were recorded by chart review. The difference between laser and bevacizumab groups was compared by Student t-test and Fisher exact test.

Results: We collected 43 patients (86 eyes) with type 1 ROP, including 30 male and 13 female infants. Their mean gestation age and birth body weight (BBW) were 27.5 weeks and 1,034 gm. Zone I and zone II disease were found in 8 and 35 patients. The mean PMA for treatment was 37.3 weeks. The mean follow-up period was 54.4 months. Laser treatment was administered in 26 patients, and bevacizumab injection for 17 infants. Single session of laser was performed in all patients of laser group without recurrence of retinal neovascularization. Complete regression of ROP was found in 15 infants of bevacizumab group following the first IVB. Four eyes in two patients (2/17, 11.7%) had recurrence of ROP and received additional injections and adjuvant laser treatment. There was no unfavorable anatomical results such as retinal detachment or macular ectopia or complications such as cataract or endophthalmitis in either bevacizumab or laser management.

Conclusions: Laser therapy and IVB were both effective treatments for type 1 ROP to cause favorable anatomical outcomes. Single session of laser ablation in nearly confluent pattern was sufficient for complete regression of ROP in laser group. Single IVB was appropriate for managing most of cases with ROP in bevacizumab group, but a small proportion (nearly one tenth) of them had recurrent episodes requiring adjuvant therapies.

Background: To compare the structural outcome of intravitreal bevacizumab (IVB) and laser treatment for type 1 retinopathy of prematurity (ROP).

Methods: This is a retrospective comparative study. From December 2002 to April 2009, patients with type 1 ROP according to criteria of Early Treatment of Retinopathy of Prematurity (ETROP) study were treated by peripheral retinal diode laser photocoagulation in nearly confluent pattern. From May 2009 to January 2015, we performed IVB for patients with type 1 ROP. The patients were closely followed until disappearance of retinal neovascularization in the laser group and regression of avascular zone in the bevacizumab group. The demographical data, postmenstrual age (PMA) for treatment, and fundus findings were recorded by chart review. The difference between laser and bevacizumab groups was compared by Student t-test and Fisher exact test.

Results: We collected 43 patients (86 eyes) with type 1 ROP, including 30 male and 13 female infants. Their mean gestation age and birth body weight (BBW) were 27.5 weeks and 1,034 gm. Zone I and zone II disease were found in 8 and 35 patients. The mean PMA for treatment was 37.3 weeks. The mean follow-up period was 54.4 months. Laser treatment was administered in 26 patients, and bevacizumab injection for 17 infants. Single session of laser was performed in all patients of laser group without recurrence of retinal neovascularization. Complete regression of ROP was found in 15 infants of bevacizumab group following the first IVB. Four eyes in two patients (2/17, 11.7%) had recurrence of ROP and received additional injections and adjuvant laser treatment. There was no unfavorable anatomical results such as retinal detachment or macular ectopia or complications such as cataract or endophthalmitis in either bevacizumab or laser management.

Conclusions: Laser therapy and IVB were both effective treatments for type 1 ROP to cause favorable anatomical outcomes. Single session of laser ablation in nearly confluent pattern was sufficient for complete regression of ROP in laser group. Single IVB was appropriate for managing most of cases with ROP in bevacizumab group, but a small proportion (nearly one tenth) of them had recurrent episodes requiring adjuvant therapies.

目的：通过光学相干断层扫描技术(optical coherence tomography，OCT)观察不同临床类型原发性闭角型青光眼(primary angle-closure glaucoma, PACG)行激光周边虹膜切开术(laser peripheral iris, LPI)前、后前房角开放距离变化，评价治疗效果。方法：选择明确诊断为PACG患者46例50眼，其中 急性闭角型青光眼临床前期及缓解期眼26例27眼，慢性闭角型青光眼20例23眼，行LPI治疗，通过OCT分别检查术前、术后2周距巩膜突500及750 μm处前房角开放距离，采用配对t检验。结果：急性闭角型青光眼LPI术前、术后2周前房角开放距离差异有统计学意义(P<0.05)；慢性闭角型青光眼术 前、术后2周前房角开放距离差异无统计学意义(P>0.05)。结论：急性闭角型青光眼LPI术后前房角开放距离增加，治疗效果较好；慢性闭角型青光眼LPI术后前房角开放距离增加不明显，术后仍存在前房角闭塞趋向。

Objective: To observe the anterior chamber angle opening distance before and after laser peripheral iris (LPI) in patients with different clinical types of primary angle closure glaucoma (PACG) by using optical coherence tomography (OCT), and evaluate the effect of the treatment. Methods: Selected 46 cases (50 eyes) of patients with PACG, including 26 cases (27 eyes) of acute angle closure glaucoma at the preclinical stage and remission phase of ocular and 20 cases (23 eyes) of chronic angle closure glaucoma, implemented LPI, examined the anterior chamber angle opening distance at the point of 500 and 750 μm from posterior to the scleral before and after surgery for 2 weeks by OCT, using a paired t-test. Results: Compared the anterior chamber angle opening distance before and after surgery for 2 weeks, the difference in patients with acute angle closure glaucoma was statistically significant (P<0.05), but not statistically significant in patients with chronic angle closure glaucoma (P>0.05). Conclusion: The opening distance of the anterior chamber angle of the patients with acute angle  closure glaucoma after LPI was increased, and the treatment effect was better; but of the patients with chronic angle closure glaucoma after LPI, the distance was not obviously increased, the tendency of anterior chamber angle occlusion still existed after LPI.