全国眼眶病及眼整形专题讲座及研讨会将在海口市召开

由中华医学会中华眼科杂志编委会主办的“全国眼眶病及眼整形专题讲座及研讨会”定于 2 0 0 3年 1 2月 6～ 1 2日在海南省海口市召开 ,届时将邀请我国从事眼眶病、眼整形基础及临床研究的知名专家和学科带头人进行专题讲座 ,欢迎全国眼科医师踊跃报名参加。讲座内容 :(1 )眼眶病的影像学诊断方法 ;(2 )眼眶肿瘤的病理学诊断 ;(3)眼眶肿瘤的临床特点 ;(4)眼眶肿瘤手术技术 ;(5)眼眶血管瘤畸形诊断及治疗 ;(6)甲状腺相关眼病的诊断及治疗 ;(7)眼整形的手术原则和手术方法 ;(8)眼部美容手术原则及方法 ;(9)眼部皮片和皮瓣移植术 ;(1 0 )活动性…     

全国眼眶病及眼整形专题讲座及研讨会将在海口市召开

由中华医学会中华眼科杂志编委会主办的“全国眼眶病及眼整形专题讲座及研讨会”定于 2 0 0 3年 12月 6目～ 10日在海南省海口市召开 ,届时将邀请我国从事眼眶病、眼整形基础及临床研究的知名专家和学科带头人进行专题讲座 ,欢迎全国眼科医师踊跃报名参加。讲座内容 :(1)眼眶病的影像学诊断方法 ;(2 )眼眶肿瘤的病理学诊断 ;(3)眼眶肿瘤的临床特点 ;(4)眼眶肿瘤手术技术 ;(5 )眼眶血管瘤畸形诊断及治疗 ;(6 )甲状腺相关眼病的诊断及治疗 ;(7)眼整形的手术原则和手术方法 ;(8)眼部美容手术原则及方法 ;(9)眼部皮片和皮瓣移植术 ;(10 )活动性…     

全国眼眶病及眼整形专题讲座及研讨会将在成都召开

由中华医学会中华眼科杂志编委会主办的“全果眼眶病及眼整形专题讲座及研讨会”定于 2 0 0 3年 10月在四川省成都市召开 ,届时将邀请我国从事眼眶病、眼整形基础及临床研究的知名专家和学科带头人进行专题讲座 ,欢迎全国眼科医师踊跃报名参加。讲座内容 :(1)眼眶病的影像学诊断方法 ;(2 )眼眶肿瘤的病理学诊断 ;(3)眼眶肿瘤的临床特点 ;(4)眼眶肿瘤手术技术 ;(5 )眼眶血管瘤畸形诊断及治疗 ;(6 )甲状腺相关眼病的诊断及治疗 ;(7)眼整形的手术原则和手术方法 ;(8)眼部美容手术原则及方法 ;(9)眼部皮片和皮瓣移植术 ;(10 )活动性义眼座和钛钉…     

眼整形外科存在的问题及对策

眼整形外科是眼科和整形外科学科交叉产生的一门新兴专业,包括眼部美容、眼部整形和眼眶外科三部分。本文主要对三部分的关键问题进行述评:眼部美容(包括眼睑美容手术、药物注射美容和激光美容)的现状和发展;眼睑恶性肿瘤、眼睑缺损、眼睑痉挛及眼窝凹陷等眼部整形手术中存在的问题和解决措施;眼眶外科中甲状腺相关眼眶病、眼眶骨折和眼眶畸形等方面亟待解决的问题及对策,并对我国眼整形外科发展中存在的问题逐一提出解决策略。(眼科,2007,16:365-367)     

本期导读

本期以眼外伤、眼整形为重点报道内容，特邀范先群撰写了专家述评《眼眶整复手术存在问题及对策》。眼眶整复手术是对外伤、炎症、肿瘤和先天异常等所致的眼眶畸形进行整形、修复和重建，以期矫正外形、改善容貌、恢复功能。近些年来，由于临床需要、技术进步和眼整形知识的传播，促进了眼眶整复手术的发展和普及。     

无眼球患儿眶内植入物手术时机的选择

正常儿童颅面部发育依赖于眼眶的生长发育,而骨性眶腔的增大与眼球发育相关。目前国内众多学者围绕发育期眼球摘除或无眼球患儿眶内植入物手术时机的选择有不少争论。有些学者认为植入物手术越早越好,而另一些学者则认为一个固定大小的眶内植入物并不能刺激眼眶发育达到正常水平,而且随着患儿的发育必将面临二次或三次手术的可能。根据儿童眼眶、眼球发育及其眶容积缺失对眶发育的影响,来论述发育期患儿眶内植入物手术时机的选择问题。     

儿童先天性上睑下垂的治疗策略

先天性上睑下垂是儿童时期常见的眼部疾病,其对儿童的影响不仅包括外观,更重要的是对视觉及心理发育。目前在对儿童先天性上睑下垂诊治方面国内外存在很多争议及误区。视力发育状态的评估,手术时机的确定,手术方式及悬吊材料的选择,手术前后视力及视功能的提高是临床中需要密切关注的问题。（眼科, 2012, 21: 292-296）     

眼眶骨折的临床治疗分析

目的:研究不同类型的眼眶区骨折的治疗方案,探讨不同类型眼眶骨折的最佳治疗方法。方法:回顾性总结2001/2006眼眶区骨折患者共80例;按复位—眼眶—分类法分为Ⅰ～Ⅵ型,采用保守治疗和手术治疗的方法。将保守治疗无效且拒绝手术患者和接受手术的患者疗效进行比较性研究。结果:开放性骨折2例行1期手术,术后无明显复视和眼球凹陷。78例早期均先采用保守治疗,保守治疗包括使用大剂量皮质类固醇激素,高渗脱水剂、神经营养药物等,有41例复视消失或减轻,眼球内陷小于2mm,保守治疗的总有效率为52%。有37例复视、眼球内陷、眼面部畸形仍明显的患者被告知手术的必要性,其中有17例患者接受手术治疗,眼部畸形改善、复视显著改善或消失16例。20例未接受手术,眼部畸形改善、复视显著改善或消失3例。经Fisher精确率检验将两组患者疗效比较,有效率的差异有显著性。结论:对于全身情况允许的开放性骨折患者1期手术内固定可以得到良好效果;保守治疗是Ⅰ型眶区骨折的首选方法;手术内固定眶壁重建术是Ⅱ～Ⅵ型眶区骨折的较好方法。     

儿童共同性斜视手术应注意的问题

儿童共同性斜视除少部分通过配戴眼镜矫正外,大部分仍需手术治疗,早期实行手术纠正眼位不仅是为解决外观,而是使双眼视功能沿正常生理途径发展的重要手段之一,下面就儿童共同性斜视的手术应注意的问题阐述如下。一、手术时机的选定儿童时期正处于视功能和双眼视觉发育的阶段,因此对于儿童共同性斜视患者经保     

眼眶发育异常的影响因素及相关治疗

眼眶发育与眼球的发育直接相关,发育期各种原因引起的眼球发育迟滞及眼球缺如都会导致眼眶发育延迟,从而影响颅面骨的发育,最终导致患者面部畸形。因此在积极治疗患眼的同时,如何能兼顾患儿的眼眶发育,一直以来都是眼科学界研究的难点。传统的治疗包括不断增大的义眼片放置、固定大小的义眼台植入、真皮脂肪片移植和气球样注水扩张器包埋,这些治疗均难以取得满意的效果。近来,组织渗透压依赖性自行膨胀扩张器的出现,为患者和医师提供了新的选择。全文就眼球异常等对眼眶发育的影响,以及促进眼眶发育的各种方法和最新进展作一综述。     

Biomaterials in ophthalmic plastic and reconstructive surgery.

Over the past several years, new biomaterials have been developed or modified for use in ophthalmic plastic and reconstructive surgery. Hydroxyapatite and high-density porous polyethylene are extensively utilized in enucleation and evisceration surgery as well as in orbit reconstruction. Absorbable plates and screws as well as cyanoacrylate glue are at the forefront of fracture repair. Silicone and polytetrafluoroethylene eyelid implants are important adjuncts for adult and congenital ptosis repair. As technology advances, new materials will be developed and new applications identified. An understanding of biomaterials and their use is essential for every oculoplastic surgeon.     

重视我国眼整形眼眶病专业的发展

眼整形眼眶病是一门年轻而发展迅猛的眼科学分支专业,包括眼整形、眼美容和眼眶外科.近年来,眼整形眼眶病领域的新技术和新手术不断涌现,技术创新和学科交叉使其对眼睑和眼眶等疾病的治疗力求达到功能重建及形态修复的完美结合.我国眼整形眼眶病专业起步较晚,但立足于创新性研究,积极开展学科交叉、医工合作和国际学术交流,取得了快速发展.针对目前我国眼整形眼眶外科发展中存在的问题,必须规范专业化人才培养、加强国内外多渠道交流、重视基础与临床转化研究,进一步促进眼整形眼眶病专业的发展.

Abstract：

Ophthalmic plastics and orbital diseases have developed rapidly as a young branch of ophthalmology in recent years. The current situation and development of ophthalmic aesthetics,plastics and orbital surgery are discussed in this paper. The functional reconstruction and appearance rehabilitation are both important to the ophthalmic plastic surgery. Although the ophthalmic plastics and orbital surgery started late in China,it developmented rapidly. The development of this branch is based on innovative research,active interdisciplinary,medical-engineering cooperation and academic exchange. However,there are still some problems about ophthalmic plastics and orbital surgery in China. To promote the development of ophthalmic plastic and orbital surgery,we should regulate the training of ophthalmic plastic surgeons,and pay attention to the clinical translational research.     

Ophthalmic plastic surgical skills assessment tool

PURPOSE: To present a structured tool to assess ophthalmic plastic surgical skill and to determine its face and content validity. METHODS: A 1-page structured subjective evaluation form was developed to evaluate a resident's oculoplastic surgical skill while performing lateral tarsal strip surgery. The tool consisted of generic task components and global indices evaluated using a 5-point Likert scale. A survey was conducted among a panel of highly experienced oculoplastic surgeons to establish face and content validity of the tool. All feedback was considered and, if feasible, was used to amend the tool. RESULTS: There was more than 90% agreement among the highly experienced oculoplastic surgeons regarding the content and weighting of each assessment component. The final format of the tool is divided in 9 task-specific indices, based on the lateral tarsal strip procedure, and 9 global indices which, after assessment, appraisal, and amendment by our expert panel, demonstrates face and content validity. CONCLUSIONS: The Ophthalmic Plastic Surgical Skills Assessment Tool is a structured, quantitative instrument designed to aid in the oculoplastic surgical evaluation and training of residents.     

Oculoplastic publication trends in general ophthalmology journals

AIM: To examine the publication trend of oculoplastic articles throughout the last decade in general ophthalmology journals. METHODS: A review of all abstracts published between January 2010 to December 2019 in general, clinical ophthalmic journals was conducted. Articles that were categorized as original articles in general and clinical journals were included in the study. RESULTS: Totally 10 281 abstracts were included. Of them 465 (4.5%) were oculoplastic publications. The mean number of annual-publications was 46.5 and the mean annual-rate of oculoplastic publications was 4.51%. A significant decreasing trend in the number of oculoplastic publication in the last decade was found (P<0.01, R2=0.770). However, there was no significant change in the annual-rate of oculoplastic publications during the last decade (P=0.191, R2=0.203). From the 465 oculoplastic articles: 179 (38.5%) were articles about eyelid diseases, 160 (34.40%) were about orbit diseases, 92 (19.80%) were about lacrimal diseases and 34 (7.30%) were about thyroid eye disease (TED). A significant decreasing trends in the number of orbital and eyelids publications were found (P<0.01, P<0.01). However, there were no significant changes in the annual-rate of orbital, eyelids, TED and lacrimal-diseases publications throughout the last decade. CONCLUSION: Oculoplastic subspecialty deals with a wide range of pathologies in different ages. However, less than 5% of the articles in general, clinical, high impact factor ophthalmology journals are about oculoplastic diseases. One of the best way for ophthalmologists from different subspecilties, nowadays, to be updated, is to read high-impact-factor, general ophthalmology journals. Therefore, it is important that those journals will include articles about breakthroughs in oculoplastic.     

Teratoma orbitario maduro congénito: reporte de un caso

Teratomas are gonadal or extragonadal neoplasms, derived from the three embryonic tissues, composed of germ cells of the neuroectoderm, mesoderm and ectoderm. Congenital orbital teratoma (OCT) commonly affects the left orbit, primarily affecting women over men at a ratio of 2:1. We present the case of a female patient of 9 days of extrauterine life with a left mature congenital orbital teratoma. The orbit and oculoplastic service performed an orbital exenteration and total resection of the tumor mass.     

Major orbital complications of endoscopic sinus surgery

BACKGROUND: The paranasal sinuses are intimately related to the orbit and consequently sinus disease or surgery may cause severe orbital complications. Complications are rare but can result in serious morbidity, the most devastating of which is severe visual loss. METHODS: A retrospective review was undertaken of four cases of severe orbital trauma during endoscopic sinus surgery. RESULTS: All the cases suffered medial rectus damage, one had additional injury to the inferior rectus and oblique, and two patients were blinded as a result of direct damage to the optic nerve or its blood supply. CONCLUSION: Some ophthalmic complications of endoscopic sinus surgery are highlighted, the mechanisms responsible are discussed, and recommendations for prevention, early recognition, and management are proposed.     

Complications of fine needle aspiration biopsy of the orbit

When properly used in well-indicated patients, fine needle aspiration biopsy of orbital lesions is an invaluable adjunct diagnostic technique. In experienced hands, the success rates have been high and the complications rare and minor. If the protocols are not followed or the surgeon is inexperienced, serious complications may result. A recent survey among 202 oculoplastic and orbital surgeons, with a total of 152 patients, confirmed this. In 138 patients, the biopsy was performed by an oculoplastic or orbital surgeon, and 10 minor complications were reported. Eleven out of the 14 remaining patients were seen by an oculoplastic or orbital surgeon in consultation for complications arising from a fine needle aspiration biopsy of the orbit performed by someone else. Complications in this group of patients included orbital hemorrhage requiring orbital decompression, motility disturbance, ptosis, and blindness. There were three deaths.     

Orbital development after enucleation without orbital implant in early childhood]

PURPOSE: To evaluate the development of orbital volume in five adults who underwent enucleation without orbital implant during early childhood, using reconstructed computed tomography(CT) images. MATERIALS AND METHODS: The orbital volume of 5 adults who underwent enucleation without orbital implants during early childhood was measured using CT images, and the results were compared between the anophthalmic orbit and the unaffected orbit in each case. The shape of maldevelopmental orbit and the relationship between orbital development and replacement of the prosthesis were also investigated. RESULTS: Orbital development in patients who underwent enucleation without orbital implant during early childhood was delayed in comparison with the unaffected orbit, and the delayed development was especially remarkable at the part of orbit corresponding to the equator of the eyeball. Maldevelopment of the orbit was severer in cases without replacement of the prosthesis than with it. CONCLUSION: For the development of orbital volume in anophthalmos after enucleation, orbital volume in place of the eyeball is required. Therefore, orbital implantation at the time of enucleation and replacement of the prosthesis with larger ones as the body grows are important.     

Basic research in orbital and oculoplastic surgery

This review summarizes basic research in orbital and oculoplastic surgery during the past year. Innovative and exciting projects have been undertaken elucidating microscopic anatomy of the orbital septum, orbital lymphatics, and levator elastic fiber network. Eyelid anatomy as assessed by magnetic resonance imaging has been beautifully demonstrated. In the realm of orbital disease, several studies have provided potential alternative therapeutic modalities in the management of the anophthalmic socket. These particular studies range from the use of demineralized bone in the rabbit anophthalmic socket, to the use of bone graft to reconstruct the monkey orbital floor. Further elegant studies outline the velocity of ophthalmic artery flow, and potential applications of ocular thermography.