玻璃体视网膜联合手术治疗复杂性眼外伤

目的探讨玻璃体视网膜联合手术治疗复杂性眼外伤的手术方法。方法2006年9月至2007年9月83例复杂性眼外伤,进行玻璃体视网膜联合手术。对合并白内障影响后段手术操作者,先行晶状体切除术或晶状体超声粉碎术;合并眼内异物者,用异物镊摘出之;合并前部增生性玻璃体视网膜病变者,行周边部视网膜切开,并取出视网膜下增生膜或增生条索,同时行巩膜环扎术。最后根据视网膜情况行长效气体或硅油等充填玻璃体腔;无晶状体眼则视视力恢复情况行二期人工晶状体植入术。术后随访12—24个月,观察视网膜复位及视力恢复情况。结果视网膜完全复位77眼,视网膜部分复位、硅油维持跟3跟,低眼压、硅油维持眼2眼,眼球萎缩者1眼。术后视力提高者68眼,不变13眼,下降2眼。其中矫正视力0．5以上者22眼,0．1～0．4者37眼,最佳矫正视力为1．0。结论玻璃体视网膜联合手术是治疗复杂性眼外伤的理想方法,可有效保留伤眼,挽救、改善患眼的视功能。     

Vitreo-retinal pediatric surgery: epidemiologic factors, etiology and prognosis

The features of pediatric vitreoretinal surgery are different from those of the adult population. In order to identify those differences, our retrospective study, dealing with a consecutive series of 2230 patients who underwent vitreoretinal surgery, analyzes several parameters for the 43 young patients (under 19 years old) (2%). Two main results can be withdrawn from the study. First, trauma is a major cause of vitreoretinal surgery in children (30% of the cases), proportionally much more frequent than in adults. Second, patient's age is the only factor that significantly influences the surgical prognosis, with a success rate of 35% under the age of 10 years, and 73% above this age (p < 0.05). We conclude that pediatric vitreoretinal surgery has a more guarded prognosis compared to the one performed in the adult population.     

A Distinct Vitreo-retinal Dystrophy with Early-onset Cataract from Recessive KCNJ13 Mutations

Purpose: To document a distinct vitreo-retinal dystrophy with early-onset cataract as related to recessive KCNJ13 mutations.

Methods: A retrospective case series (two patients from two families)

Results: A 12-year-old Saudi Arabian girl with nystagmus since birth was referred because of recent decreased vision. Parents were first cousins and a younger sister had been diagnosed with retinal dystrophy. Examination revealed total white cataract in the right eye. In the left eye, there were posterior cortical lenticular opacities and an unusual retina fundus dystrophic appearance notable for fibrosis over the optic disc and clumped pigmentation. After right eye cataract surgery, the posterior pole of the left eye was seen as similar to that of the right eye and electroretinography revealed severe cone-rod dysfunction, with only subnormal scotopic tracings recordable in both eyes. Next-generation sequencing of retinal dystrophy genes revealed homozygosity for a novel missense mutation in KCNJ13 (c.359T?>?C; p.Ile120Thr [NM_002242.4]), which co-segregated with the disease. Direct KCNJ13 sequencing for an unrelated 33-year-old Saudi Arabian male with similar clinical findings but early-adult-onset rather than juvenile cataract revealed the same homozygous mutation.

Conclusions: Juvenile or early-adult-onset cataract in the setting of a congenital vitreo-retinal dystrophy notable for fibrosis over the disc and clumped pigmentation in the posterior pole is a unique phenotype that suggests recessive KCNJ13 mutations.     

Latanoprost: A Review

Latanoprost is a new topical ocular prostaglandin that decreases intraocular pressure (IOP) by increasing uveoscleral outflow. Its efficacy is comparable with that of timolol and it shows almost complete additivity with timolol. Once daily dosing of 0.005% latanoprost yields a maximal effect with no significant circadian fluctuation in IOP. Local side effects include increased iris pigmentation, conjunctival hyperemia, and punctate epithelial erosions. No significant systemic side effects have been reported. The effect of latanoprost on eyes with compromised blood-aqueous barriers and its additivity to other ocular medications are areas that will require further evaluation.     

眼眶减压术20眼临床分析

目的：探讨眼眶减压术对经保守治疗无效的甲状腺相关性眼病的临床疗效与合并症。方法：对12例20眼的术前临床表现、术后的疗效与并发症进行随访并统计。结果：三壁减压使眼球后退6－8mm,外下壁减压后退4－6mm,内下壁减压后退3－5mm。14／16眼（87．5％）角膜损害痊愈,2／16眼（12．5％）好转。17／20眼（85％）视力提高,3／20眼（15％）无改善。并发症包括2眼复视,5眼眶下神经损害,1眼眶继发出血。结论：眼眶减压术对保守治疗无效的甲状腺相关眼病是一种有效、安全、并发症少的治疗手段。可用于继发角膜损害,压迫视神经与要求美容 的病例。     

屈光手术的回顾和展望

屈光手术和眼前节成像系统的发展大大提高了手术的安全性、有效性、可预测性和稳定性。飞秒激光可用于制作角膜瓣,进行角膜基质内切割,制作角膜基质环植入隧道等。与传统激光切削模式相比,波前像差引导等个性化切削模式能提高患者术后的视觉质量。角膜胶原交联术是一种治疗圆锥角膜的全新方法。有晶状体眼人工晶状体植入术和屈光性人工晶状体置换术对于高度近视和远视的治疗有着重要的临床应用价值。现有的老视手术有助于提高患者的生活质量。本文对各种屈光手术新技术及相关的眼前节成像系统进行了评述,并展望了屈光手术未来的发展趋势,强调了解屈光手术新技术和新设备的重要性,提出应该积极稳妥地推进屈光手术新技术在临床上的应用。     

Vitreo-retinal biomicroscopy using bilaterally aspherical Volk lenses (+78 D, +90 D)]

Aspherical+ Volk lenses allow a full realization of El Bayadi conception of use of a great power a positive lens for the indirect ophthalmoscopy by means of a biomicroscope. The authors compared the techniques of ophthalmoscopy with utilization of a biomicroscope pointing to following advantages of the Volk lens: the lack of contact with the patient's eye (avoidance of eventual transmission of infection), possibility of examination of the entire area of the fundus, a detailed evaluation of the vitreous, possibility of examination even by narrow pupil, a high comfort of examination for the patient. These advantages were confirmed during the examination of 51 eyes with retinal detachment, pathological changes of the macula and the optic disc and with intraocular tumors.     

Endoscopic vitreoretinal surgery: Review of current applications and future trends

Endoscopy provides unique optical properties to circumvent anterior segment opacities and visualize difficult-to-access anatomical regions, including retroirideal, retrolental, ciliary body, and anterior retinal structures. We summarize the basic principles and utilization of endoscopic vitreoretinal surgery, along with recent technological advances in the field base on a structured literature search in Pubmed, Embase, and Google Scholar database up to February, 2020. Endoscopy has been used in the management of retinal detachment, ischemic retinopathies with neovascular glaucoma, severe ocular trauma, endophthalmitis, lens-related disorders in the posterior segment, pediatric vitreoretinal diseases, and implantation of retinal prostheses. Ongoing development of endoscopic technology aims to provide higher resolution images with endoscopes of smaller diameter. New surgical techniques supported by the adoption of endoscopy are available to manage challenging surgical scenarios. Endoscopy can be a useful adjunct to microscope wide-angle viewing systems in the management of complex vitreoretinal diseases.     

Review of complications in double eyelid surgery

Double eyelid surgery is popular worldwide, especially in East Asia. Although double eyelid surgery seems simple, it comes with numerous complications. These complications can be divided into disordered complications and esthetic complications. Plastic surgeons pay more attention to the esthetic aspect. In our long-term clinical work, we have repeatedly observed that many patients with overactive facial muscles (frontalis muscle or corrugator supercilii muscle) often develop esthetic complications after surgery. These patients present with an appearance of a double eyelid fold that is either too high, too low, or absent. However, some plastic surgeons have not realized this, and most of them believe that esthetic complications are caused by improper techniques during surgery. Therefore, it is necessary for us to share our experience in this field with our peers.