Scleral explant removal: the last decade

PURPOSE: To examine the reasons for and outcomes of the scleral explant removal over the last decade. METHODS: A case note review of patients undergoing scleral explant removal in the operating theatre over a period of 10 years from January 1990 to December 1999. The following information was retrieved: age, sex, reason for explant removal, duration of explant (ie interval between primary surgery and explant removal), type of explant, symptomatic relief, preoperative and postoperative retinal status including redetachment, causes for redetachment, and follow-up. Mann-Whitney U-test and Fisher's exact test were used for statistical analysis. RESULTS: A total of 72 patients were eligible for the study. The average age was 54.1+/-17.0 years (range, 17-84 years). The mean duration of explant was 50.1 years (range, 1-282 months) and mean follow-up was 18.3 months (range, 4-120 months). In all, 51 (70.8%) patients had a sponge silicone explant, 13 (18%) patients had a solid silicone explant, whereas eight (11.1%) patients had a combination of the two. The commonest reason for the explant removal was extrusion (n=34, 47.2%) closely followed by pain (n=29, 40.2%). Symptomatic relief was achieved in 88% of patients. Six patients (8.3%) suffered retinal redetachment post explant removal. There was no statistically significant correlation between the reason for the removal or the duration of the explant and retinal redetachment. The majority (N=5) of redetachment occurred within 6 months of the explant removal (P<0.01). CONCLUSION The Scleral explant removal provides symptomatic relief to the majority of patients, but is associated with a small risk of redetachment especially within 6 months postoperatively.     

Survey of dry eye symptoms in Australian pilots

In 1996, a questionnaire was distributed to 4000 Australian commercial pilots for the quantification of symptoms of dry eye. The 1246 respondents ranged in age from 18-71 years (mean age 40.4 years), and 98.2% were men. Symptoms of dry eye during flight were reported by 901 (72.3%, 95% CI = 69.7 74.8) while only 67 (5.4%, 95% CI = 4.2-6.8) reported dry eye independent of flight. In univariate analyses, the following factors were associated with dry eye in flight: age, use of distance glasses, smoking, average weekly number of flight hours, type of aircraft usually flown, and normal cruising altitude. In a multiple logistic regression model, only the class of aeroplane (large jets vs. propeller-driven planes) (OR = 1.75, 95% CI = 1.34-2.28) and estimated number of flight hours per week (OR = 1.58, 95% CI = 1.34-1.86) were related to dry eye symptoms. In conclusion, self-reported symptoms of dry eye are common in Australian pilots and are associated with aeroplane class and flying time.     

Japan's share of published research in ophthalmology

PURPOSE: This study was conducted to determine Japan's share of published research in ophthalmology during the last decade. METHODS: Ophthalmology journals with higher impact factors were accessed through the Medline database to elicit the number of articles published in 1991-2000 that originated in various countries, including Japan. The proportion of articles with a higher grade of evidence (randomized controlled trials/clinical trials, cohort studies, and case-control studies) was determined for Japan and compared with the average values of the total articles published in these journals. In addition, the percentage of published research from the 20 top-ranking countries was calculated, showing the trend over time. RESULTS: Of the total articles (21,327), Japan's share in the selected ophthalmology journals was 6.5% (1,387 articles), ranking third in the world, following the USA (51.5%) and the UK (11.3%). The recent increase in the share was statistically significant for Japan (P =.01). However, the proportionate value of clinical research evidence was lower for Japan-originated articles than the average value for the total clinical research articles in these journals. CONCLUSIONS: Appropriate measures should be taken in the ophthalmology field in Japan to increase the number of clinical research papers with a higher grade of evidence.     

血小板反应蛋白在眼部的研究进展

血小板反应蛋白（TSP）由5个具有同源性的成员组成,其在全身不同组织细胞中的表达广泛,且具有复杂的生物学功能.TSP在眼组织中的分布也较为广泛,主要分布于视网膜色素上皮（RPE）细胞、角膜内皮细胞和晶状体上皮细胞等,也可由小梁网细胞所分泌,从而发挥不同作用.作为细胞因子,TSP在眼的病理生理过程中具有重要的调节作用,参与年龄相关性黄斑变性的发生、角膜疾病的修复、白内障的形成、开角型青光眼的发病与进展、眼部肿瘤的病理过程、增生性玻璃体视网膜病变和糖尿病视网膜病变等的病理过程.对TSP功能的研究有助于揭示眼科多种疾病的发病机制,并为相关病变的防治提供新的思路.就TSP在眼部的分布、眼部合成细胞及其在眼科相关疾病中作用的研究进展进行综述.     

上海市社区卫生服务中心眼病防治资源现况调查及策略研究

目的：了解上海市社区卫生服务中心眼科资源和眼科服务的分布状况,以及目前上海市防盲治盲工作中存在的主要问题,为加强防盲治盲工作,提高初级眼保健水平提供依据。方法利用普查的方法,对上海市所有社区卫生服务中心的眼病防治资源进行调查,获得上海市社区卫生服务中心眼病防治服务资源资料。采用统计描述方法,描述不同地区中社区眼病防治资源的分布情况。结果上海市17个区县共有244个社区,其中有236个（96.72%）社区参加调查并交回问卷。上海市236个社区中,其中有49个（20.8%）社区具有独立的眼科门诊,有96个(40.7%)社区眼科设置在五官科,有33个(14.0%)社区有二、三级医疗机构坐诊,有87个(36.9%)社区无眼科门诊。社区中眼科医师共82人,从事眼科的全科及五官科医师共129人,社区中眼科护士共9人,视光师1人。专职公共卫生眼防人员36人,兼职公共卫生眼防人员201人。社区中所有眼科设备共941件,使用率为90.33%。结论上海市社区卫生服务中心眼科资源和眼保健服务能力参差不齐,专业眼科技术人员缺乏,公共卫生眼防人员结构层次偏低且流动性较大,眼病筛查设备落后,公共卫生眼病防治经费投入不足,需要争取政府和其他部门对社区眼病防治的支持,不断完善“社区-区县-市级”的三级防盲网络体系建设和网络信息化建设。（Chin J Ophthalmol,2015,51：493-498）