Table of Content

25 March 2014, Volume 23 Issue 2

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Prevention of infection of peri-cataract surgery

WANG Jun

2014, 23(2):  73-75.  doi:10.13281/j.cnki.issn.1004-4469.2014.02.001

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Endophthalmitis is the most serious postoperative complication of the phacoemulsification. Using antibiotics rationally during perioperative period and disinfecting correctly and standardly during operative period play the important roles in preventing the endophthalmitis. This review discusses several relative issues, including the careful systemic prophylactic application of antibiotics, the necessity of topical antibiotic eye drops, the effectiveness of adding the antibiotics into the perfusion solution or the injection of antibiotics into anterior chamber, and the unified standard and method of the disinfection. (Ophthalmol CHN, 2014, 23: 73-75)

Prevention of posterior capsular opacification after cataract surgery

WAN Xiu-Hua, LI Xiao-Xia

2014, 23(2):  76-79.  doi:10.13281/j.cnki.issn.1004-4469.2014.02.002

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 Posterior capsular opacification (PCO) is the most common complication after cataract operation. Recently, there are many researches interested in how to prevent PCO, such as the developments in the intraocular lens materials and designs, surgical methods such as anterior capsule polishing, posterior capsulorhexis with anterior vitrectomy, implanting capsular tension ring (CTR) or capsular adhesion-preventing ring (CAPR). However, the most of these preventing methods are controversial, the most action mechanisms are still unclear, and the long time effects are still uncertain.  （Ophthalmol CHN, 2014, 23: 76-79)

Refraction and its changes after intraocular lens implantation in congenital cataract

YANG Shuang, SONG Xu-Dong

2014, 23(2):  80-85.  doi:10.13281/j.cnki.issn.1004-4469.2014.02.003

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 Objective To investigate the myopic shift and axial length growth after cataract extraction and intraocular lens (IOL)implantation in children with congenital cataract. Design Retrospective case series. Participants Thrirty-one children (53 eyes) with congenital cataract accepted primary or secondary IOL implantation. Methods The clinic information of the participants were retrospectively reviewed. The time interval of cataract extraction with primary or secondary IOL implantation was（3.21±1.56）years. The follow-up period was 28.74±11.67 months postoperatively. The participants were divided into 2 groups according to the age at surgery, groupⅠ: ＜3 years old（16 cases, 27 eyes）, groupⅡ: ≥ 3 years old（15 cases, 26 eyes）. The participants were also divided into 3 groups according to the age at follow-up period, group A: ＜4 years old（11 cases, 18 eyes）, group B: 4~6 years old（17 cases, 30 eyes）, group C: ＞6 years old（9 cases, 15 eyes）. During the regular follow-up period, the changes of refractive status and axial length were recorded. Main Outcome Measures The changes of refractive status and axial length. Results The mean myopic shift power of group A, B and C  was 1.18±0.98 D/y, 0.80±0.81 D/y, and 0.71±0.82 D/y respectively (F=3.532，P=0.032), but the difference between group B and C was no statistics significant (P=0.605). The mean axial length growth of  group Ⅰ and Ⅱ was 1.22±0.76 mm and 0.82±0.46 mm respectively (P=0.030). The mean prediction error for the two groups was 1.64±1.32 D and 0.55±1.16 D respectively (P=0.009). During the same follow-up period, the changes of refractive status and axial length showed a moderate correlation (r=0.596，P<0.001). Conclusion The myopic shift power decrease with the age increasing after IOL implantation in children with congenital cataract, the myopic shift power and axial length growth of younger patients are more rapid than older patients. To some degree, the increasing of axial length will effect the myopic shift power. (Ophthalmol CHN, 2014, 23: 80-85)

Clinical application of double choppers pre-chop technique in phacoemulsification

YAO Tao, HE Wei

2014, 23(2):  86-90.  doi:10.13281/j.cnki.issn.1004-4469.2014.02.004

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 Objective To evaluate the effect of pre-chopping technique with double choppers on phacoemulsification. Design Prospective comparative case seires. Participants 80 patients (80 eyes) with senile cataract from 2013 March to 2013 May in Shenyang He Eye Hospital. Methods 80 cataract patients (80 eyes) with nucleus density at grade II~IV were randomly divided into the pre-chopping group and the control group (stopping and chopping method ) according to random number table. The effective phaco time (EPT), best corrected visual acuity (BCVA) and cornea edema at 1, 3, 7, 30 days after operation, and operative complications were compared between two groups. Main Outcome Measures EPT, BCVA, cornea edema, and operative complications. Results Compare with the control group (19.32±6.12 s), the EPT of the pre-chopping group (13.56±5.21 s) was lower (P=0.000). BCVA was better in the early stages (3 days) after operation (postoperative 3 days, 1 eye < 0.5, 19 eyes 0.5~0.8, 18 eyes > 0.8 in pre-chopping group, and 9 eyes < 0.5, 21 eyes 0.5~0.8, 12 eyes >0.8 in the control group, P=0.023). Corneal edema was minorer in the early stages (3 days) after operation (postoperative 3 days, score 0, 18 eyes; score 1, 11 eyes; score 2, 8 eyes; score 3, 1 eye in pre-chopping group, and score 0, 12 eyes; score 1, 10 eyes; score 2, 11 eyes; score 3, 9 eyes in the control group, P=0.047). There was no significant difference of BCVA and corneal edema between two groups in 1 month after surgery. Postoperative 1 month, BCVA< 0.5, 0 eyes; 0.5~0.8, 9 eyes; > 0.8, 29 eyes in pre-chopping group, and BCVA< 0.5, 1 eye; 0.5~0.8, 10 eyes; >0.8, 31 eyes in the control group, P=0.879. Postoperative 1 month, score 0, 37 eyes; score 1, 1 eye; score 2, 0 eye; score 3, 0 eye in pre-chopping group, and score 0, 38 eyes; score 1, 4 eyes; score 2, 0 eye; score 3, 0 eye in the control group(P=0.653). There were no obvious complications occurred in pre-chopping group and there was 1 case of posterior capsular rupture in the control group. Conclusion The pre-chopping technique with double choppers technique can effectively reduce the EPT in phacoemulsification, diminish injury to corneal endothelium, and improve the quality of operation. (Ophthalmol CHN, 2014, 23: 86-90)

Comparing the postoperative incidence of posterior capsular opacification in patients with different types of cataract

LIU Jie, ZHAO Xian, ZHANG Heng-Li, SHAO Li-Jing, TANG Guang-Xian, WANG Min, ZUO Jian-Xia, WANG Shu-Rui

2014, 23(2):  91-93.  doi:10.13281/j.cnki.issn.1004-4469.2014.02.005

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Objective To compare the incidence of posterior capsule opacification (PCO) after surgery in the patients with different types of cataract. Design Retrospective case series. Participants 2069 eyes that accepted phacoemulsification and intraocular lens implantation by the same ophthalmologist from 2007 to 2008 in the First Hospital of Shijiazhuang. In which, 1574 eyes with simply senile cataract, 305 eyes with diabetic cataract, 165 eyes with cataract combined with high myopia, and 25 eyes with uveitis complicated cataract. Method The incidences of PCO in the patients with various types of cataract were recorded through observing visual acuity, split lamp and ocular fundus for 2 years after operation. The PCO was classified according to Hayashi's method. Main Outcome Measures The incidence of PCO in patients with various types of cataract. Results In simply senile cataract group, diabetic cataract group, uveitis combined cataract group and high myopia combined cataract group, the incidence of PCO was 8.13% (128 eyes), 12.79% (39 eyes), 16.00% (4 eyes) and 21.82% (36 eyes), respectively (χ2=35.377, P=0.000). The incidence of 1 level PCO among 4 groups was similar, 60 eyes/3.81% in simply senile cataract group, 6 eyes/1.97% in diabetic cataract group, 1 eye/4.00% in uveitis combined cataract group, and 5 eyes/3.03% in high myopia combined cataract group. The incidence of 2 level PCO in diabetic cataract group was higher (20 eyes/6.56%) and the incidence of 3 level PCO in high myopia combined cataract group was higher (24 eyes/14.55%) than in the other groups. Conclusion The incidence of PCO postopteratively in simply senile cataract group was significantly lower than other groups, but in high myopia combined cataract group was higher and the PCO was denser. (Ophthalmol CHN, 2014, 23: 91-93)

No relationship between filtration amount in trabeculectomy and intraoperative and early postoperative intraocular pressure

HUANG Yao, RONG Shi-Song, MENG Hai-Lin, FAN Su-Jie, LI Si-Zhen, LIANG Yuan-Bo, WANG Ning-Li

2014, 23(2):  94-98.  doi:10.13281/j.cnki.issn.1004-4469.2014.02.006

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 Objective To study the amount of filtration in primary trabeculectomy and the association of filtration amount with intraoperative and early postoperative intraocular pressure (IOP). Design Prospective observational study. Participants 82 cases of glaucoma patients underwent primary trabeculectomy between December 2009 and August 2010 were included. Methods 1. Add different volume of normal saline on the specified location of sterilized filter papers for Schirmer’s test, then observe the correlation of volume of fluid with the wet length. 2. Prospectively enrolled consecutive patients with primary open-angle or angle-closure glaucoma who underwent primary trabeculectomy. Use Tonopen to measure the intraoperative IOP after closure of the scleral flap. Use sterilized filter papers to measure the amount filtration 60 s after injecting BSS through the paracentesis. Wait for 80 s to get the readings. Analysis the relationship between filtration amount and intraoperative IOP, postoperative IOP at 1 and 7 days after surgery. Observe the height and range of filtering bleb and complications. Main Outcome Measures Wet length of the filter paper, intraoperative IOP, early postoperative IOP and the height, range and complications of filtering bleb. Results The wet length of the filter paper was significantly associated with the liquid volume. The liquid volume can be calculated by the following equation: Volume (μl) = 1.0434 × Length (mm) + 2.4086 (R2 = 0.97). In Eighty-two consecutive eligible patients (82 eyes) who underwent primary trabeculectomy, mean preoperative IOP was 32.3±9.0 mmHg. According to the intraoperative wet length of the filter paper, the patients were divided into three groups: group 1(≤5 mm, n=46), 2 (6~10 mm, n=18), and 3 (≥11 mm, n=18). The intraoperative IOP of the three group was 13.9±8.3 mmHg, 12.1±5.4 mmHg,12.1±6.5 mmHg, respectively (P=0.543). At 1d postoperatively, the IOP was 13.3±7.9 mmHg, 12.7±7.3 mmHg, 15.9±9.0 mmHg, respectively. At 7d postoperatively, the IOP was 12.2±6.9 mmHg, 10.7±5.6 mmHg, 13.1±8.1 mmHg, respectively. The postoperative IOP among these three groups had no significant differences (all P>0.05). There were no shallow anterior chamber postoperatively. Conclusion The wet length of the filter paper is significantly associated with the liquid volume. In trabeculectomy, the filtration amount can be measured by the filter papers for Schirmer’s test. Filtration amount during trabeculectomy can not be independently used to determine the intraoperative IOP and predict the early postoperative IOP. (Ophthalmol CHN, 2014, 23: 94-98)

Refraction state of patients with exudative age-related macular degeneration

LI Xue, SHE Zhong-Yang, REN Xue-Tao, HAN Xu, WU Pei-Bei, JIAO Xuan, ZHANG Yong-Peng, MA Kai

2014, 23(2):  99-102.  doi:10.13281/j.cnki.issn.1004-4469.2014.02.007

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 Objective To investigate the difference of the refraction between patients with exudative age-related macular degeneration (AMD) and non-AMD populations. Design Case-control study. Participants A total of 247 eyes with refraction information from 136 exduative AMD patients were recruited. 154 eyes with AMD as exduative AMD group, in which 67 eyes were from 34 biocular AMD patients, 87 eyes were from 102 monocular AMD patients. A number of 242 non-AMD eyes (136 non-AMD subjects who were age and sex matched with the AMD group) were recuited from Beijing Desheng Region as control group. Methods Refractions were measured by auto refractor and non mydriatic optometry. Hyperopia standard defined as more than +0.5 D. The refractions were compared between the two groups. Main Outcome Measures Refraction state and degree. Results The frequencies of hyperopia in AMD group were 46.7% (72 eyes), the refractions of interquartile range was +0.50（-0.38，+1.25）D. The frequencies of hyperopia were 30.6% (74 eyes) in control group, meanwhile the refractions of interquartile range was +0.13（-1.13，+0.84）D. The refractions of AMD group were inclined to higher hyperopia than control group（P<0.001）. Also, there were higher hyperopia frequencies of AMD group than control group（P<0.001）. Conclusion Compared with non-AMD populations, exudative AMD patients may be inclined to be a higher hyperopia. (Ophthalmol CHN, 2014, 23: 99-102)

The differential diagnosis of submacular hemorrhage with or without choroidal neovascularization in highly myopia eyes by OCT

YUE Yan-Kun, ZHANG 恩Kui, WANG Hai-Wei, ZHAO Xiao-Ling, TIAN Mo

2014, 23(2):  103-106.  doi:10.13281/j.cnki.issn.1004-4469.2014.02.008

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Objective To evaluate and analysis the optical imaging characteristics of submacular hemorrhage in highly myopia with or without choroidal neovascularization by optical coherence tomography (OCT). Design Retrospective case series. Participants Forty-seven highly myopia patients (47 eyes) with submacular hemorrhage. Methods Fluorescence fundus angiography (FFA), fundus autofluorescence (FAF), OCT and best corrected visual acuity (BCVA) were performed on 47 highly myopia eyes with submacular hemorrhage. Main Outcome Measures Imaging of OCT and FAF, BCVA. Results  In the 47 eyes, 27 eyes with choroidal neovascularization (CNV) (CNV group), 20 eyes without choroidal neovascularization (simple hemorrhage group) according to FFA and ICGA.  The characteristics of OCT images in CNV group were spindle shape with strong or medium reflection, sticking out upwards from retinal pigment epithelial （RPE） layers. Simple submacular bleeding without CNV showed protruded medium reflection area under the neuroepithelial layer without disruption of RPE layer. In CNV group, the inner segment/ outer segment (IS/OS) line of photoreceptors was intact in OCT only in 3/27 eyes and destroyed in 24/27 eyes; However, in the simple hemorrhage group, the IS/OS line of photoreceptors was intact in 13/20 eyes and destroyed in 7/20 eyes (χ2=14.86，P=0.000). In the CNV group, hypoautofluorescence was present at the area of the bleeding combined with the hyperautofluorescence around it; in the simple hemorrhage group, hypoautofluorescence was present at the area of the bleeding. Conclusion Submacular hemorrhage in highly myopia eye could be divided into two forms: submacular hemorrhage with choroidal neovascularization and simple submacular bleeding, which can be differentiated by OCT and FAF. (Ophthalmol CHN, 2014, 23: 103-106)

Neuroprotective effects of saturated hydrogen water on retinal ganglion cells in rat optic nerve crush model

YOU Yu-Xia, LI Jian-Jun, LI Yu-Jie, MA Ke

2014, 23(2):  107-110.  doi:10.13281/j.cnki.issn.2014.02.009

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Objective To investigate the protective effect of saturated hydrogen water on the retinal ganglion cells (RGC) of the rat optic nerve crush model. Design Experimental study. Participants Eighteen healthy adult male SD rats. Methods Eighteen SD rats were randomly divided into the A, B and C group. There were 6 rats in each group. All the right eyes were selected as the experimental eyes, the left eyes served as controls. And the optic nerve crush model was established by using a micro optic nerve forceps with the clipping pressure of 40 g to crush the exposed optic nerve for 60 s at 2 mm from the optic disc. The rats of group A were given saturated hydrogen water by intraperitoneal injection with a dose of 5 ml/kg/d； those of group B were given saturated hydrogen water by dropping three times a day; and those of group C were given saline by dropping three times a day for consecutive two weeks. At the 9th days after injury, 3% fluorogold injection to both superior colliculus for labeling RGC under anesthesia. At the 14th days after injury, the rats were sacrificed, and RGCs were photographed and counted with mask method. Main Outcome Measures Survival percentages of RGCs. Results The average survival percentage of RGCs in A, B and C group was 40.35%±13.04%, 58.34%±14.00%, and 43.07%±7.80%, respectively（F=3.965, P=0.041）. A significant difference was found between group B and A（P=0.020）, between group B and C（P=0.042）. The difference between group A and C was no significant（P=0.698）. Conclusion Dropping saturated hydrogen water into eyes for 14 days may play a protective role for RGCs in rat optic nerve crush model. (Ophthalmol CHN, 2014, 23: 107-110)

The long-term effects of different administration of 1% atropine on the myopia progression in adolescents with low myopia

ZHOU Lei, SHEN Jiang

2014, 23(2):  111-114.  doi:10.13281/j.cnki.issn.1004-4469.2014.02.010

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Objective To investigate the efficacy of different administration of 1% atropine gel on the myopia progression in adolescents with low myipia. Design Prospective comparative case series. Participants 150 cases (300 eyes) myopic children between 9 to 12 years old, who visited to optometry clinic in Ningbo Eye Hospital between January 2011 and April 2011, whose diopters were -0.50 to -1.50 DS. Methods 150 cases were divided randomly into three groups (50 cases in each group). Control group: used 1% atropine gel one time every night. Group B: twice a week. Group C: one time every week. All the participants were followed up for two years with return visiting every three months. Main Outcome Measures Visual acuity, refraction, intraocular pressure, the axial length of the eyes. Results 133 children completed the two-year follow-up, in which 38 cases in the group A, 47 cases in the group B, and 48 cases in the group C. The dropout rate was 11.3%. After treatment, the myopia diopter progression in the group A, B, and C was (-0.33±0.11) D, (-0.36 ± 0.13) D, and (-0.62 ± 0.30) D, respectively. The axial growth was (0.32 ± 0.08) mm, (0.33 ± 0.10) mm, and (0.48 ± 0.17) mm, respectively. The changes of the spherical diopter and axis length between group A and group B were not different significantly (all P>0.05). Compared with group A and B, the visual acuity was declined, the diopter was increased, and the axis length got longer in the group C (all P<0.05). Conclusion Persistent use of 1% atropine eye gel can control effectively the myopia progression in adolescents with low myopia. There is no significant difference between the administration of every day and twice every week. Two times a week medication is more tolerance, which is more suitable for administration. (Ophthalmol CHN, 2014, 23: 111-114)

The short-term effects of surgery for congenital nystagmus with vertical head posture

WANG Yuan, YU Gang, CAO Wen-Hong, BAI Da-Yong, HU Shou-Long, LIU Wen, FAN Yun-Wei, WU Qian

2014, 23(2):  115-120.  doi:10.13281/j.cnki.issn.1004-4469.2014.01.011

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 Objective  To evaluate the surgery efficacy for congenital nystagmus with vertical head posture. Design Retrospective case series. Participants Seventeen congenital nystagmus patients with vertical head posture, who were diagnosed between July. 2010 and Mar. 2012 in Beijing Children's Hospital were enrolled. The ages ranged from 4 to 12 years, average 7.8±2.3 years. Methods Seven cases with a chin-up posture were accepted the operation of bilateral superior oblique tenectomy + bilateral inferior rectus recession. Ten patients with a chin-down posture were accepted the operation of bilateral superior rectus recession + inferior oblique tenectomy or myectomy. In which, four cases with horizontal strabismus were accepted bilateral lateral rectus, and two cases with convergence damping were accepted medial rectus recession as well. Degrees of head posture, null zone best corrected visual acuity(BCVA), the frequency, amplitude and intensity of nystagmus waveform were observed and recorded before and after the surgery. All the participants were followed up 6 to 23 months, averaged 11.2±2.9 months. Main Outcome Measures Degrees of head posture, null zone BCVA, and the frequency, amplitude and intensity of nystagmus waveform before and after the surgery. Results The degree of head posture was less than 15°in 4 cases, between 15°and 30°in 7 cases, and more than 30 °in 6 cases preoperatively; and less than 15°in 13 cases, between 15°and 30°in 3 cases, more than 30 °1 cases at the end of follow up（χ2=9.936, P=0.007）. Null zone BCVA increased from 0.22±0.12 preoperatively to 0.26±0.13 postoperatively (t=-2.66, P=0.017) , and the frequency（3.19 Hz preoperatively to 2.27 Hz postoperatively, t=6.77, P=0.000）, amplitude （22.9 degrees preoperatively to 16.6 degrees postoperatively, t=4.132, P=0.001）and intensity（75.1 Hz*degree preoperatively to 37.1 Hz*degree postoperatively, t=6.275, P=0.000）of nystagmus waveforms were significantly improved. Conclusion Surgery treatment for congenital nystagmus with vertical head posture can provide the expectations of ocular motor and visual results. The surgery should be designed according to different situation of different patients. (Ophthalmol CHN, 2014, 23: 115-120)

Clinical characteristics and treatment effect in patients with facial rosacea combined ocular damage

CHEN Ying-Xin, GAO Ming-Hong

2014, 23(2):  121-125.  doi:10.13281/j.cnki.issn.2014.02.012

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Objective To investigate the clinical characteristics and treatment of facial rosacea with ocular damage. Design Retrospective case series. Participants Sixteen cases of facial rosacea with ocular damagewere enrolled from January 2010 to December 2012. The age range at presentation was between 16 and 56 years. Methods 16 cases of medical records were followed up for 12 months. In addition to gross inspecting rosacea lesions of the eyes and face, slitlamp and microscope were used to detect the subtle changes in the face and eyes, particular vascular abnormalities. Tests of tear production and tear breakup time (BUT) were performed in 12 patients with ocular dry sensation. Mites were checked on face and nasal skin, and microbiological examination and culture were performed on the palpebrals. Minocycline hydrochloride was used orally 50 mg, twice one day for 3 to 6 months. Topical corticosteroids (loteprednol suspension eye drop) and antibiotic (levofloxacin) were used 3 times one day until two weeks after ocular changes were negative. Main Outcome Measures Skin changes, ocular changes， Schirmer test and tear film BUT. Results Clinical features: common signs of facial skin showed erythema vasodilation hyperplasia in 16 patients (100%), conjunctival hyperemia and conjunctival vasodilation deformation or hyperplasia in 16 patients(100%), 14 cases (87.5%) of blepharoconjunctivitis and 12 cases (75%) of dry eye. Less common signs were including 4 cases (25%) of inferior corneal tongue and tree-like pannus, 6 cases (37.5%) of facial rhinophyma, 4 cases (25%) of corneal ulcers, 4 cases (25%) of episcleritis and two cases (12.5%) of iridocyclitis. After the medication treatment, skin and eye lesions of all the participants were significantly improved (100%). It showed that erythema of facial and nasal skin, and corneal pannus was subsided, corneal infiltrates and conjunctival hyperemia disappeared. Conclusion Atypical ocular clinical manifestations were often difficult to identify, vascular changes was the basis sign, facial vascular changes were often combined for diagnosis. And it was very effective to use minocycline hydrochloride combined with corticosteroid for facial rosacea with ocular damage. (Ophthalmol CHN, 2014, 23： 121-125)

The effects of recessive placement of spherical headed silicone tube for chronic dacryocystitis

LU Jun-Hua, PAN Xue-Fei, ZHAO Mao-Zhu

2014, 23(2):  126-129.  doi:10.13281/j.cnki.issn.1004-4469.2014.02.013

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Objective To observe the clinical effects of the recessive placement of spherical headed silicone tube on treatment of chronic dacryocystitis. Design Retrospective case series. Participants 65 patients ( 67 eyes) with chronic dacryocystitis. Methods All the participants were accepted the operations of the recessive placement of spherical headed silicone tube. Using the method of probing of lacrimal passage, the traction line was sent into the inferior nasal meatus using the 8-pin, after the expansion of nasal tube using the expansion rope, the ball head silicone tube was tracted retrogradely guaided by the traction line and implanted. Then the lacrimal passages were washed with plus gentamicin and dexamethasone mixture and saline irrigation after the operation once a day in one week, after 1 week once a week, for 3 months, and the tube was removed three to six months after placing. The lacrimal passages were washed with antibiotic and hormone (about 4 times), the tube was injected with TobraDex after the tube was removed. The symptoms were observed in the following 3 months to 2 years.  Main Outcome Measures The symptom of epiphora and pus, the situation of lacrimal duct. Results After the tube planting,  the lacrimal duct system of totally 65 patients (67 eyes) were able to be irrigated successfully. 49 eyes（73.13%） were cured after the removal of silicone tube during the follow-up period, and the symptom of epiphora and pus disappeared, there were no serious intra- and post-operative complications. Conclusion Recessive placement of spherical headed silicone tube is an effective method for the most chronic dacryocystitis. (Ophthalmol CHN, 2014, 23: 126-129)

Pathological changes of intraorbital tissues of thyroid associated ophthalmopathy

HU Yi-Bo, AI Li-Kun, WU Yi, XU Xiao-Lin, CHEN Xue

2014, 23(2):  130-134.  doi:10.13281/j.cnki.issn.1004-4469.2014.02.014

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 Objective To study pathological changes of conjunctiva, extraocular muscle and pulley of thyroid associated ophthalmopathy (TAO). Design Experiment study. Participants The TAO group consisted of 16 TAO patients who need surgical correction of strabismus. There were 8 males and 8 females with an age range of 32 to 65 years (mean 50.3±6.7 years); the control group consisted of 12 non-TAO patients with concomitant strabismus. There were 6 males and 6 females with an age range of 6 to 52 years (mean 28.8±7.4 years). Methods The samples of conjunctivas, extraocular muscles and pulleys were collected from those TAO patients who need surgical correction, including 16 conjunctivas, 12 extraocular muscles, and 9 pulleys. And 12 conjunctivas, 8 extraocular muscles, and 8 pulleys were obtained from the control group. Operation findings，HE staining, special staining and immunohistochemical staining were used to observe the pathologic changes of the samples from the two groups. Main Outcome Measures Pathological changes of conjunctiva, extraocular muscle and pulley. Results Comparing with the control group, 14 conjunctival epitheliums were thickened, 2 conjunctival epitheliums were atrophy, 16 conjunctival samples showed substantia proprias fibrosis, tissues disturbanced, inflammatory cellular infiltration around the vascular walls in the TAO group；10 extraocular muscle fibers were thickened, 2 extraocular muscle fibers were atrophied，and all 12 extraocular muscles fibers showed various degrees of ruptured fibrosis, significant collagen fibers proliferation, vacuolization in the TAO group; 9 pulley muscle fibers were ruptured, tissues disturbanced, elastic fibers ruptured, collagen fibers proliferation significantly, vacuolization in the TAO group. Conclusion In TAO group, not only the extraocular muscles, but the connective tissue, as well as conjunctivas, probably experienced similar process from the degenerative inflammatory response to fibrosis, which result into various clinical manifestations of the eye. (Ophthalmol CHN, 2014, 23: 130-134)

Pros and cons of the electronic medical record in the clinic teaching processes of ophthalmology

LUO Fei, XU Qing, PAN Zhi-Qiang

2014, 23(2):  137-139.  doi:10.13281/j.cnki.issn.2014.02.016

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 Electronic medical record (EMR) has many superiorities such as convenient writing, long-term of preservation, resource-saving, integrity of data, efficient retrieval and sharability. It has improved the interns’ work efficiency in ophthalmologic clinical teaching and provided more clinical teaching resources. But at the same time it also has limitations such as the decreasing quality of medical records, limiting students’ thinking, and weakening clinicians’ teaching consciousness. Aimed at these pros and cons, we should take advantages of it and overcome the deficiencies to improve the quality of ophthalmologic clinical teaching. (Ophthalmol CHN, 2014, 23: 137-139)

How to enhance patients adherence to topical glaucoma medication

WU Ling-Ling, LI Jian-Jun

2014, 23(2):  141-144.  doi:10.13281/j.cnki.issn.1004-4469.2014.02.021

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To emphases and enhance medication adherence in patients with primary glaucoma can directly be related to the therapeutic effect and prognosis of glaucoma. In this paper, the understanding of necessity and significance to improve long-term treatment of glaucoma patients, selection of eye-drops with the less frequency, fully consideration of the side effects, costs, and supply convenience factors, emphasis on the communication between doctors and patients for improving patient’s satisfaction to the treatment were elaborated. (Ophthalmol CHN, 2014, 23: 141-144)