Mechanical detachment of the anterior hyaloid membrane from the posterior lens capsule1

Objective

To investigate the incidence of spontaneous detachment of the anterior hyaloid membrane from the posterior lens capsule and to explore the possibility of surgical separation of the anterior hyaloid membrane.

Evaluation of photorefractive keratectomy retreatments after regressed myopic laser in situ keratomileusis

PURPOSE: To evaluate the results of photorefractive keratectomy (PRK) enhancements in eyes previously treated by myopic laser in situ keratomileusis (LASIK) showing an undercorrection due to either a refractive regression or a primary undercorrection, when an in-the-bed enhancement was not advisable because of residual stromal thickness limitations. DESIGN: Noncomparative, prospective, interventional case series. PARTICIPANTS: Seventeen eyes of 17 patients previously treated by LASIK for a spherical equivalent (SE) correction of -8.125 to -12.50 diopters (D; mean, -9.45 +/- 1.01 D), that after a follow-up of 6 to 14 months ended up with a refraction of -1.50 to -3.75 D (SE; mean, -2.48 +/- 0.74 D). Intended flap thickness was 160 microm for all eyes. In all cases, the residual stromal bed under the flap was considered too thin (255-305 microm) to allow an in-the-bed enhancement without exceeding an assumed safety thickness limit (250 microm). INTERVENTION: Eyes were treated by PRK at least 6 months after LASIK. The PRK ablation parameters (diameter, attempted correction) were selected to avoid theoretical flap perforation. The deepest ablation was 60 microm, for a -3.75-D correction. We used a Bausch & Lomb 217 C excimer laser (Bausch & Lomb, Rochester, New York). MAIN OUTCOME MEASURES: Refraction, uncorrected and best-corrected visual acuity (BCVA), slit-lamp evidence of corneal opacity or other visible complications, and corneal topography. RESULTS: Although the initial postoperative period was characterized by very satisfactory refractive results (mean SE error at 1 month, -0.04 +/- 0.37 D; range, +0.75 to -0.625 D), during follow-up, a dense haze (grade 3 and 4) developed in 14 eyes (82.3%) that induced a further myopic regression (SE, -1.725 to -5.50 D; mean, -3.11 D) and BCVA loss (two to six lines). These 14 eyes underwent a further surgical treatment to remove the severe haze at 3 to 10 months after PRK. CONCLUSIONS: Based on these results, we strongly advise against PRK as a possible option to correct eyes previously treated by myopic LASIK that resulted in an undercorrection.     

Treatment of persistent corneal epithelial defect by autologous serum application.

OBJECTIVE: To evaluate the efficacy of autologous serum application for the treatment of persistent epithelial defect. DESIGN: Prospective, clinical, noncomparative case series. PARTICIPANTS: A total of 16 eyes were studied. INTERVENTION: Autologous serum was prepared from the patients and diluted to 20% by saline. The patients were instructed to use the autologous serum six to ten times a day. The concentration of vitamin A, epidermal growth factor (EGF), and transforming growth factor-beta (TGF-beta) was measured at 1 week and 1 month stored in the refrigerator and 1 month and 3 months in the freezer. MAIN OUTCOME MEASURES: Time to closure of epithelial defect. RESULTS: Vitamin A, EGF, and TGF-beta were stable during the 1 month in the refrigerator and 3 months in the freezer. Among 16 persistent epithelial defects, 7 (43.8%) healed within 2 weeks, 3 (18.8%) healed within 1 month, and the remaining 6 (37.5%) did not respond within 1 month. No apparent side effect of autologous serum application was observed. CONCLUSIONS: Autologous serum application healed 43.8% of persistent defect within 2 weeks and 62.5% within 1 month.     

Treatment of corneal chemical alkali burns with a crosslinked thiolated hyaluronic acid film

Purpose

The study objective was to test the utilization of a crosslinked, thiolated hyaluronic acid (CMHA-S) film for treating corneal chemical burns.

综合教学方法应用于临床医学专业留学生眼科学见习教学初探

临床医学专业留学生与国内学生之间存在较多差异,传统的教学方法并不适合临床医学专业留学生的临床学科教学.在临床医学专业留学生的眼科学见习教学中,根据他们的具体情况和眼科学本身的特点,综合运用兴趣激发教学方法、情景教学方法、以问题为基础学习教学方法和集中教学与分散教学结合教学方法,营造活泼的教学氛围,提高留学生在教学过程中主动参与和积极思考的意识,取得了良好的教学效果.     

"三明治"教学方法在眼科学临床教学中的应用

目的探索“三明治”教学方法在眼科学临床教学中应用的可行性。方法在华中科技大学同济医学院附属协和医院2003级五年制临床医学专业120名学生的眼科学临床教学阶段,随机选取60名学生作为实验组,实施“三明治”教学方法;60名学生作为对照组,实施传统教学方法。学生以作业形式记录学习体会,并于教学结束后接受问卷调查。教师盲法对两组学生进行理论考试和操作考试。结果实验组学生平均理论考试成绩为41.950±4.533分,操作考试成绩为39.200±0.988分,均高于对照组学生的38.025±6.752分和36.225±6.929分,P〈0.01,差异均具有统计学意义。问卷调查结果显示,有75.0％的学生对“三明治”教学方法感到适应,有25.0％的学生能够逐渐适应,没有学生表示不适应;有93.3％的学生认为“三明治”教学方法可以提高学习兴趣和积极性;有90.0％的学生认为“三明治”教学方法对理论与实践的结合有所帮助;有95.0％的学生赞同推广“三明治”教学方法。结论在眼科学临床教学中应用“三明治”教学方法是可行的。     

The relationship between glaucoma and myopia: the Blue Mountains Eye Study.

OBJECTIVE: To quantify the relationship between myopia and open-angle glaucoma, ocular hypertension (OH), and intraocular pressure (IOP) in a representative older population. DESIGN: Cross-sectional population-based study of 3654 Australians 49 to 97 years of age. METHODS: Subjects with any myopia (> or =-1.0 diopter [D]) were identified by a standardized subjective refraction and categorized into low myopia (> or =-1.0 D to <-3.0 D) or moderate-to-high myopia (> or =-3.0 D). Glaucoma was diagnosed from characteristic visual field loss, combined with optic disc cupping and rim thinning, without reference to IOP. Ocular hypertension was diagnosed when applanation IOP was greater than 21 mmHg in either eye in the absence of glaucomatous visual field and optic disc changes. MAIN OUTCOME MEASURE: General estimating equation models were used to assess associations between eyes with myopia and either glaucoma or OH. RESULTS: Glaucoma was present in 4.2% of eyes with low myopia and 4.4% of eyes with moderate-to-high myopia compared to 1.5% of eyes without myopia. The relationship between glaucoma and myopia was maintained after adjusting for known glaucoma risk factors, odds ratio (OR) of 2.3, and 95% confidence intervals (CI) of 1.3 to 4.1 for low myopia. It was stronger for eyes with moderate-to-high myopia (OR, 3.3; CI, 1.7-6.4). Only a borderline relationship was found with OH, OR of 1.8 (CI, 1.2-2.9) for low myopia, and OR of 0.9 (CI, 0.4-2.0) for moderate-to-high myopia. Mean IOP was approximately 0.5 mmHg higher in myopic eyes compared to nonmyopic eyes. CONCLUSIONS: This study has confirmed a strong relationship between myopia and glaucoma. Myopic subjects had a twofold to threefold increased risk of glaucoma compared with that of nonmyopic subjects. The risk was independent of other glaucoma risk factors and IOP.