Table of Content

    25 July 2014, Volume 23 Issue 4
    Some issues of diagnosis based on ocular fundus image reading in teleophthalmology
    LI Jian-jun, ZHANG Li, PENG Xiao-yan.
    2014, 23(4):  217-220.  doi:10.13281/j.cnki.issn.1004-4469.2014.04.001
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     It is important to sort out the understanding of teleophthalmolgy fundus photography diagnosis  to improve the quality of distance ophthalmic medical service. The quality of fundus photos determines the quality of the diagnosis. The basic requirements of fundus photos are correct position and accurate focusing and clear image. Single fundus photo plays an important role in the screening and diagnosis of common blinding diseases, such as glaucoma, diabetic retinopathy, age related macular degeneration. However, it can't find peripheral fundus lesion, also cannot determine the stereospecificity of the lesion. In the absence of other clinical data, there is a risk of misdiagnosis and missed diagnosis. The remote consultation on fundus diseases based on fundus photos is facing the challenges, so it is significant to set classification standard of remote consultation on fundus diseases, and evaluate it objectively and comprehensively. When writing the report of image reading, it is important to pay attention to the medical history and complaint, emphatically describe fundus signs with differential diagnosis significance, make a diagnosis carefully and provide treatment suggestion more. (Ophthalmol CHN, 2014, 23: 217-220)
    Clarify some problems of pan-retinal photocoagulation for diabetic retinopathy
    TIAN Bei
    2014, 23(4):  222-225.  doi:10.13281/j.cnki.issn.1004-4469.2014.04.002
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    Panretinal photocoagulation (PRP) is the only well tested and best working treatment method for diabetic retinopathy(DR). Since the number of DR patients has greatly inclined, mainland China has promoted universal standardization of PRP technology and has actively engaged in technology improvement through academic forums. This article provides opinions and suggestions on the following topics: standardization of rules, method, and timing of PRP in primary ophthalmic units, improvement of PRP technique, and full understanding the relationship between PRP and macular edema. (Ophthalmol CHN, 2014, 23: 222-225)
    The concept and meaning of lacrimal system
    ZHANG Jing-xian, DENG Hong-wei.
    2014, 23(4):  226-229.  doi:10.13281/j.cnki.issn.1004-4469.2014.04.003
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     Emotional tears, stimulated tears and basic tears have with their own origin, mechanism, function and excluded paths. We focus on the controversial points in basic tear secretion mechanism, and according to our clinical observation results we put forward the hypothesis that "periodic blink is the power source of secrete basal tear”. We describe in this paper that the periodic blink movement starting basal tear secretion of tear function mechanism and operation. The eyelid movement promotes two tear rivers become one again divides into two, which periodically updates the front tear film, and at the same time blink movement squeezing and relaxing extrusion lacrimal sac, pulling the canalicular wall produces lacrimal pump action. The front tear film is evaporated out and at the same time drives the tear rivers and orderly migrating to the tear lake, which is the lacrimal non-tube section part. Lacrimal pump acts to take tears from the tears lake into the lacrimal duct to exclude. There is mucous membrane between the junction of lacrimal sac, lacrimal canaliculus and nasolacrimal duct. The directional swing of the nasolacrimal duct cilium makes basic tear transitional to the nasolacrimal duct outlet, and tear degasification enters the respiratory airflow, discharge or inhalation. This article explains the necessity of lacrimal system including the conjunctiva, eyelids and conjunctival sac, eyelid blinking. We firstly propose some new concepts, such as the ordinary tear, vaporization of lacrimal duct and lacrimal non-tube section part, tube section part and the connection point of the two section parts. (Ophthalmol CHN, 2014, 23: 226-229)
    Retinal nerve fiber layer thickness in the patients with mild cognitive impairment or Alzheimer’s disease 
    ZHU Li-ping1, REN Xiao-lei2,WANG Ya-xing2, XU Liang2, ZHANG Xiao-jun1.
    2014, 23(4):  231-234.  doi:10.13281/j.cnki.issn.1004-4469.2014.04.004
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     Objective To investigate the variation of retinal nerve fiber layer (RNFL) thickness in patients with the mild cognitive impairment (MCI) and Alzheimer's disease (AD). Design Case-control study. Participants 3122 residents over 50 years old(including 50 years old) who came from four communities of Haidian District and three natrual villages of Yufa town in Daxing District were investigated, 2511 subjects who had complete data were include into the study and the subjects with glaucoma were removed. 47 subjects were diagnosed as MCI, 10 cases were AD and 2454 cases were normal cognition; 167 cases were randomly selected as normal control group from cognitively normal subjects according to distribution characteristics of the case group,whose sex and age were matched with the case group. Methods Initially, MMSE scales was used to test subjects’ cognitive function; then, the subjects who were abnormal on MMSE with ADL, CDR and Hachinski ischemia index were evaluated according to the standard of illiterate group ≤19 scores, primary-school group ≤22 scores, middle school graduated above group ≤26 scores; eventually, the patients with MCI and AD were screened out according to medical history and cognitive function scores. The temporal, nasal, upper pole and lower pole RNFL thickness of all subjects were detected and measured with Heidelberg OCT instrument. The RNFL thickness between MCI group, AD group and normal control group were compared. Main Outcome Measures RNFL thickness. Results Compared with the normal control group, the RNFL thickness in the temporal side, upper pole and the average in MCI group and AD group was significantly thinner(all P<0.05). The RNFL thickness of every quadrant in AD group were thinning trend compared with MCI group, but there was significant difference only in temporal (P<0.05). Conclusion Compared with normal cognitive functions individuals,RNFL thickness in the temporal and upper pole was significant thinner in MCI and AD patients; RNFL thickness of the temporal quadrant in AD patients was thinner than MCI patients. So the RNFL thickness, especially in the temporal quadrant, might be used as early objective indicators for monitoring cognitive dysfunction. (Ophthalmol CHN, 2014, 23: 231-234)
    Meta analysis of optic disc morphology in nonarteritic anterior ischemic optic neuropathy
    MA Jin1, CHEN Ting1, SHAN Guang-liang2, ZHONG Yong1
    2014, 23(4):  235-239.  doi:10.13281/j.cnki.issn.1004-4469.2014.04.005
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    Objective To investigate the feature of optic disc morphology in nonarteritic anterior ischemic neuropathy (NAION). Design Systemic review. Participants A comprehensive literature research was conducted for published studies reporting both optic disc morphology and NAION from CNKI, EMBASE and Pubmed database. Methods Based on inclusion and exclusion criteria, the study included data extraction and meta-analysis. Pooled WMD, heterogeneity and sensitivity analysis were calculated with Stata software. Main Outcome Measures Parameters of optic disc morphology. Results Between unaffected fellow eyes of NAION patients group and control group, the disc area (WMD=-0.20, 95%CI:-0.37~-0.03), cup area (WMD=-0.36, 95%CI:-0.58~-0.14), cup/disc area ratio (WMD=-0.15,  95%CI:-0.23~-0.06), cup volume (WMD=-0.08, 95%CI:-0.12~-0.05), mean cup depth (WMD=-0.10, 95%CI:-0.13~-0.06) and cup shape measure (WMD=-0.03, 95%CI:-0.05~-0.02) were smaller in the unaffected eyes, whereas there were no significant differences in rim area (WMD=0.05, 95%CI:-0.15~0.25) and rim volume (WMD=0.05, 95%CI:-0.07~0. 16). When the same parameters were compared between the affected and unaffected eyes of the patients with unilateral NAION, smaller rim volume (WMD=-0.08, 95%CI:-0.14~- 0. 02) and greater cup shape measure (WMD=0.03, 95%CI: 0.00~0.06) were in eyes after NAION, while the other optic disc parameters showed no correlations. Conclusion Small disc and small cup is the characteristic feature in the NAION, and after NAION there is a trend toward cupping compared with the fellow eye. (Ophthalmol CHN, 2014, 23: 235-239) 
    Changes in subfoveal choroidal thickness after interferon therapy in chronic hepatitis C patients
    MAO Fei-fei, YOU Qi-sheng, LI Dan, SUN Hui-yu, LIU Yue-hong, LIU Bin-bin, XU Xue-jing, DONG Yu.
    2014, 23(4):  240-243.  doi:10.13281/j.cnki.issn.1004-4469.2014.04.006
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    Objective To evaluate changes in choroidal thickness as measured by enhanced depth imaging spectral -domain optical coherence tomography (EDI-OCT) after interferon therapy in chronic hepatitis C patients. Design Retrospective case series. Participants  11 cases (22 eyes) of chronic hepatitis C patients (43.7±10.5 year-old) with interferon therapy from Beijing Ditan Hospital. Methods All the patients underwent detailed ocular examinations including corrected visual acuity, intraocular pressure, slit lamp microscope, indirect ophthalmoscope and color fundus photography. The subfoveal choroidal thickness (SFCT) was measured using EDI -OCT at baseline and 3 months after the treatment with interferon. Main Outcome Measures SFCT. Results Among 11 patients, 9 eyes (5.7%) of 6 cases developed interferon-related retinopathy.13 patients had bilateral retinopathy and 11 patients had unilateral retinopathy. SFCT of patients was (317.6±78.8) μm at the baseline and decreased to (280.1±77.1) μm after interferon therapy (P=0.000). There was no difference in SFCT between with retinopathy group (320.5±82.4) μm and without retinopathy group (252.1±61.7) μm (P=0.053). Conclusion There is an overall thinning of the SFCT on EDI OCT after interferon treatment in chronic hepatitis C patients. (Ophthalmol CHN, 2014, 23: 240-243) 
    Orbital exenteration for benign disease: 37 case series
    SU Fan, XIAO Li-hua.
    2014, 23(4):  243-246.  doi:DOI:10.13281/j.cnki.issn.1004-4469.2014.04.007
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    Objective  To analyze the indications of orbital exenteration for benign disease. Design  Retrospective case series. Participants Thirty-seven patients who had undergone orbital exenteration from November 1999 to August 2010 inclusive at Armed Police General Hospital. Methods Medical records of all patients were reviewed. Main Outcome Measures Type of orbital exenteration, pathologic diagnosis and reasons for orbital exenteration. Results The surgery types include total orbital exenteration(94.6%), subtotal orbital exenteration(5.4%), and total orbital exenteration with radioactive seeds(2.7%). Pathologic diagnosis were as the following: 11 cases (29.7%) of inflammatory pseudotumor, 8 cases (21.6%) of pleomorphic adenoma, 6 cases (16.2%)of meningioma, 4 cases (10.8%) of Wegener granuloma, 2 cases (5.4%) of hemangiopericytoma, and 1 case(2.7%) of paraganglioma, hemangioma, neurofibroma, fibrolipoangioma, baby pigmentosa tumors of neuroectoderm, and orbital osteoclasia, respectively. Reasons for orbital exenteration were as the following: recurrence or repeatedly recurrence (86.5%), no light perception of surgical eye( 54.1%), uncontrolled pain (43.2%), large or wide-spread tumor(40.5%), still advanced tumor with long time steroid therapy(27.0%). Conclusion The indications for orbital exenteration in management of benign orbital disease are recurrence or repeatedly recurrence of diseases with blindness, uncontrolled pain, large or wide-spread tumor. Orbital exenteration could be used to clear focal lesions completely and lower recurrence of orbital benign diseases significantly. (Ophthalmol CHN, 2014, 23: 243-246)
    The short-term evaluation on orbital floor reconstruction with resorbable plate
    CHEN Zhi-yuan1, LI Wen-hao1, LIU Jing-ming1, HAN Song2, WU Xiao-xia1, WANG Xuan1.
    2014, 23(4):  247-250.  doi:10.13281/j.cnki.issn.1004-4469.2014.04.008
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    Objective To assess the short-term effect of resorbale implants in the treatment of orbital floor fractures. Design Retrospective case series. Participants 12 cases of orbital floor fractures with less than 2.6 cm2 of floor defect. Methods All the patients underwent orbital floor reconstruction via subciliary approach. The resorbale implants were placed on the surface of orbital floor defect. The orbital axial CT and coronal CT scans have been used and compared in all the cases preoperatively and postoperatively. The mean follow-up was 6.4±1.8 months. Main Outcome Measures Ocular symptom, radiological evaluation and complications. Results The diplopia and the restricted globe movement were resolved in 5/12 cases, improved in 7/12 cases. The infection and the extrusion of the implants did not occur after surgery. The paresthesia of the infraorbital distribution with different extent were observed in all cases and could be resolved within 3 to 6 months after operation. CT scans show that the orbital floor was reconstructed and the orbital implants did not dislocate. Conclusion The resorbable implant is an acceptable material for orbital floor reconstruction less than 2.6 cm2 in the short term. (Ophthalmol CHN, 2014, 23: 247-250)
    Magnetic resonance imaging of human extraocular muscles during sustained convergence
    2014, 23(4):  251-255.  doi:10.13281/j.cnki.issn.1004-4469.2014.04.009
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    Objective To analyze magnetic resonance imaging data of the extraocular muscles in convergence. Design Experimental study. Participants Eight normal subjects aged (27.4±3.1) years. Methods Eight normal subjects, non-convergence state, asymmetrical convergence: a total amount of 20△ base-out prism was placement in front of the right eye or the left eye; symmetrical convergence: 10△ base-out prism was placement in front of both eyes. Extraocular muscles (EOMs) paths were evaluated by axial, coronal and sagittal MRI scans during the subject focus to a target at a distance of 5 m from the eye. Main Outcome Measures In convergence, the contractile changes of the EOMs and the converging eye rotated degrees. Results In asymmetrical convergence, the converging eye lateral rectus (LR) muscles exhibited significant relaxational thinning compared with the non-convergence eye (cross-sectional area were 0.4710±0.1077 and 0.5155±0.1168 cm2,P=0.037), while the other EOMs did not showed significant contractile changes. The converging eye rotated nasally 11.03±1.44°, the aligned eye rotated nasally 1.40±0.46°, and the converging eye showed 1.0° intorsion of the rectus pulley array. In symmetrical convergence, the eye rotated nasally 5.26±1.15°; there were no significant contractile changes in the cross sections of the EOMs. Conclusion The converging eye LR muscles exhibited large contractile cross-section changes. The significant changes of the eye rotation associated with the asymmetrical convergence and symmetrical convergence. (Ophthalmol CHN, 2014, 23: 251-255)
    Ex-PRESS miniature glaucoma device implantation combined with anti-VEGF for neurovascular glaucoma  
    WANG Huai-zhou, HONG Jie, ZHAO Bo-wen, SANG Jing-hong, WANG Ning-li.
    2014, 23(4):  256-260.  doi:10.13281/j.cnki.issn.1004-4469.2014.04.010
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    Objective To evaluate the efficacy and safety of Ex-PRESS miniature glaucoma device implantation combined with anti-VEGF for neurovascular glaucoma. Design Prospective interventional case series. Participants 16 eyes of 16 patients with neurovascular glaucoma who underwent Ex-PRESS miniature glaucoma device implantation in Tongren Hospital from March 2012 to October 2013. Methods All patients underwent Ex-PRESS miniature glaucoma device implantation on 5-10 days after intravitreous injection 0.5 mg ranibizumab. Followed up was performed at day 1, day 2, day 3, week 1, week 2, week 3, month 1, month 3, month 6, and month 12 after surgery. Main Outcome Measures Intraocular pressure (IOP), numbers of anti-glaucoma medication and postoperative complications. Results Pre-operation mean IOP was 44.6±17.8 mmHg in 16 patients. IOP after Ex-PRESS surgery was (12.6±3.5), (13.8±7.5), (17.5±6.5), and (22.6±9.5) mmHg respectively at month 1, month 3, month 6, and month 12 after surgery. The number of anti-glaucoma medication was (3.2±1.4) before operation and (0.6±0.2) after operation. At the last following up, the complete success rate was 81.3%, and qualified success rate was 87.5%. The postoperative complications included shallow anterior chamber (3 eyes), hyphema (2 eyes), choroidal effusion (2 eyes) and IOP elevation (>30 mmHg) (2 eyes). Conclusions Implantation of Ex-PRESS miniature glaucoma device combined with anti-VEGF treatment can stable lowering IOP and has fewer complications for neurovascular glaucoma. It can be considered as alternative method for management of neurovascular glaucoma. (Ophthalmol CHN, 2014, 23: 256-260)
    Nd∶YAG laser click membrane for secondary glaucoma associated with pupillary occlusion 
    DONG He, XU Shao-kai, ZHANG Fan-you.
    2014, 23(4):  260-263.  doi:10.13281/j.cnki.issn.1004-4469.2014.04.011
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     Objective To assess the clinical effect of Nd∶YAG laser click membrane in the treatment of secondary glaucoma associated with pupillary occlusion. Design Retrospective case series. Participants 15 cases (15 eyes) of secondary glaucoma associated with pupillary occlusion and pupillary membrane from 2008 to 2012 in Third People’s Hospital of Dalian. Method In all patients Nd∶YAG laser was used to click pupil membrane with 0.4-1.0 mJ of single pulse for relieving the occlusion of pupil. All patients were followed up for 6 months. Main Outcome Measures Intraocular pressure (IOP), corneal endothelial count and vision before and after operation. Results  Average pre-operative IOP was (43.2±13.7) mmHg which was significantly different from the last follow-up IOP (15.6±5.2) mmHg(t=8.76, P=0.000). After laser therapy, 1 eye was treated with combined medication therapy, 2 eyes with trabeculectomy. Corneal endothelial cell count at pre-operation was (2272.0±431.8) /mm2, and (2226.9±422.9) /mm2 at post-operation. Pre-operative visual acuity was from hand motion to 0.12, and post-operative visual acuity was from 0.1 to 0.6. There was no significant injury of cornea endothelial cells and lens. Conclusions  Nd∶YAG laser for secondary glaucoma associated with pupillary occlusion and a gap between the lens and pupil is safe and effective. (Ophthalmol CHN, 2014, 23: 260-263)  
    Treatment of in-the-bag intraocular lens subluxation
    SHI Xiang-yu, LU Hai, QI Meng, WANG Shao-li, YU Jie, ZHENG Peng-fei, HE Lei.
    2014, 23(4):  264-267.  doi:10.13281/j.cnki.issn.1004-4469.2014.04.012
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     Objective To study the surgical methods and their safety of in-the-bag IOL subluxation. Design Retrospective case series. Participants 19 cases (19 eyes) were enrolled with the diagnosis as in-the-bag IOL subluxation in Beijing Tongren Eye Center from Feb 2009 to Feb 2013. Methods Review the above cases. IOL exchange with suture fixation surgery or transcapsule IOL suture fixation reposition surgery was performed according to the IOL type and the severity of the IOL subluxation. Main Outcome Measures Surgical method, visual acuity, postoperative complications. Results All 19 cases went through surgical treatment smoothly: 5 cases (26.3%) by IOL exchange with suture fixation surgery in which the dislocated IOL was removed and replaced with transscleral sutured posterior chamber IOL; other 14 cases (73.7%) by transcapsule IOL suture fixation reposition surgery in which the dislocated haptics were sutured to the sclera. The postoperative follow-up lasted for 5 to 41 months. At the last visit, postoperative visual acuity ≥0.3 in all 19 cases, ≥0.8 in 8 cases (42.1%). Mild hyphema or vitreous hemorrhage occurred in 7 cases (36.8%) in the first day after surgery. Hypertension occurred in 3 cases (15.8%) during the first week after surgery. IOP all went back to normal after eye drop treatment. Slight decentration of IOL occurred in 3 cases (15.8%). Slight tilt of IOL occurred in 4 cases (21.1%). These 7 cases were remained untreated with observation. Conclusion IOL exchange with suture fixation surgery and transcapsule IOL suture fixation reposition surgery are effective and safe surgical solutions to postoperative in-the-bag IOL subluxation. (Ophthalmol CHN, 2014, 23: 264-267)
    The influence of capsular tension ring on post-operation refraction in lens subluxation patients combined with high myopia 
    WANG Hong-tao, DING Ning, SONG Xu-dong.
    2014, 23(4):  267-271.  doi:10.13281/j.cnki.issn.1004-4469.2014.04.013
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    Objective To research the influence of capsular tension ring (CTR) on post-operation refraction in lens subluxation patients combined with high myopia.  Design Retrospective case series. Participants 20 patients (20 eyes) with high myopia were performed phacoemulcificatioan and IOL implantation as control group. 20 patients (20 eyes) with high myopia were performed phacoemulcification, IOL and CTR implantation as observed group. All patients came from Beijing Tongren Hospital in Jan. 2013 to Dec. 2013. Method The visual acuity, intraocular pressure, corneal endothelium, and refraction before and after surgery in both groups were reviewed and compared. Main Outcome Measures Visual acuity, intraocular pressure, coneal endothelium, and refrection predication error. Results Predicative refractive degree in observed group and control group was (-1.29±0.34) D, (-1.16±0.39) D (P=0.31). Refractive prediction error in observed group and control group in 3 months after phacoemulcification was (1.38±0.43) D, (1.71±0.32) D, respectively (P=0.06). There was no hyperopia error in two groups after phacoemulcification. Conclusion Capsular tension ring implantation had no significant effect on refractive error in lens subluxation patients combined with high myopia. There is no necessity to additional adjusting IOL calculating formula in these patients.  (Ophthalmol CHN, 2014, 23: 267-271)
    Application of trypan blue lens capsule staining for cataract surgery in Vision Recovery Project 
    SONG Wan-qing, WEI Xiu-juan, LUAN Li-li.
    2014, 23(4):  271-273.  doi:10.13281/j.cnki.issn.1004-4469.2014.04.014
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     Objective To explore the application value of trypan blue lens capsule staining in cataract surgery in Vision Recovery Project. Design Retrospective comparative case series. Participants 84 patients (84 eyes) with severe cataract in “Vision Recovery Project of Millions of Poor Cataract Patients” in 2012-2013 were recruited. Methods  Patients were randomly divided into observation group(42 patients, 42 eyes)  and control group(42 patients, 42 eyes). Observation group received 0.1 ml trypan blue capsule staining before continuous curvilinear capsulorhexis during phacoemulsification, but control group were not stained. Main Outcome Measures State of intraoperative lens capsule staining, success rate of continuous curvilinear capsulorhexis, visual acuity, intraocular pressure, degree of anterior chamber inflammation, corneal edema and posterior capsular opacification. Results The lens anterior capsule of all patients in observation group was stained as light blue after the trypan blue staining. The success rate of continuous curvilinear capsularhexis was 97.6% in observation group and 78.6% in control group (P=0.003). The difference of visual acuity, intraocular pressure, anterior chamber inflammation, corneal edema after surgery were no statistically significant (all P>0.05). 3 months after surgery, significant posterior capsular opacification appeared in one case in observation group and six cases in control group (P=0.027). Conclusion The continuous circular capsulorhexis and phacoemulsification in Vision Recovery Project could become easier to perform after anterior capsule staining with trypan blue. (Ophthalmol CHN, 2014, 23: 271-273) 
    Clinical efficacy of sodium hyaluronate and bFGF eye drops in dry eye and eyes after LASIK
    2014, 23(4):  274-279.  doi:10.13281/j.cnki.issn.1004-4469.2014.04.015
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    Objective To observe the efficiency and safety of 0.1% sodium hyaluronate (SH) eye drops and basic fibroblast growth factor (bFGF) eye drops in simplex dry eye and dry eye after LASIK. Design Randomized controlled study.  Participants 70 cases with simplex dry eye (group Ⅰ) and 40 post-LASIK cases (group II) from January 2012 to August 2012. Method There were two subgroups in group I and group II respectively. 0.1% SH (A) and bFGF (B) eye drops were used randomly, four times a day for 14 days in group I and 30 days in group II. Changes of symptoms and signs were observed at different times. Dry eye symptoms including asthenopia, foreign body sensation, eye dry, burning sensation, swelling sensation, ophthalmodynia, conjunctiva congestion and photophobia were scored using questionnaire survey. Main Outcome Measures Score of dry eye symptoms, tear break-up time (BUT), Schirmer TestⅠ, corneal fluorescein staining (FL), symptoms changes of self-evaluation. Results Ocular symptoms and signs improved significantly after treatment in both subgroups of group Ⅰ (P<0.05). 0.1% SH eye drops was better than bFGF eye drops in improving asthenopia (P=0.006) and ophthalmodynia (P=0.040) at 14 days after treatment (P<0.05). SH was better to improve BUT (P=0.055) and Schirmer TestⅠ (P=0.573), and bFGF was better to reduce corneal fluorescein staining (P=0.375), but the different was not significant. Significant change of symptoms in patients using SH eye drops and bFGF eye drops were 94.3% and 78.6%, respectively. In group II, there were symptoms in 1 and 3 days after LASIK, and improved in 10 and 30 days post-operation. SH eye drops was better than bFGF eye drops in improving foreign body sensation (P=0.004), burning sensation (P<0.001), swelling sensation (P=0.005) and conjunctiva congestion (P=0.007). BUT and Schirmer TestⅠdecreased in 10 days after LASIK, but increased in 30 days, than that of 10 days after operation (groupIIA BUT: P=0.142, Schirmer TestⅠ: P=0.053; groupIIB BUT: P=0.006, Schirmer TestⅠ: P=0.010). Corneal fluorescein staining aggravated in 10 day after LASIK, and improved in 30 days, with significant differences (groupIIA P=0.005, groupIIB P=0.079). There was no significant difference between groupIIA and groupIIB in changes of dry eye signs. No side-effect was found during observation. Conclusion SH and bFGF eye drops can facilitate corneal epithelial repair, improve tear film stability, and alleviate various symptoms in simplex dry eye and post-LASIK patients. SH eye drops is better than bFGF eye drops in improving certain symptoms including asthenopia, foreign body sensation, burning sensation, swelling sensation, conjunctiva congestion and ophthalmodynia. (Ophthalmol CHN, 2014, 23: 274-279)
    Clinical cases guiding training pattern for graduate students of ophthalmology
    LI Shu-ning
    2014, 23(4):  280-281.  doi:10.13281/j.cnki.issn.1004-4469.2014.04.016
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    Clinical analysis ability is important for graduate students training of ophthalmology. Clinical cases showing during training course would attract the interest of students, providing opportunity for teachers and students communication, activating discussion around the cases, which would improve the clinical analysis ability of graduate students of ophthalmology. (Ophthalmol CHN, 2014, 23: 280-281)
    Pay attention to the continuing clinical and scientific research education for ophthalmic nurses
    DUAN An-li, HUANG Wei-lin.
    2014, 23(4):  282-283.  doi:10.13281/j.cnki.issn.1004-4469.2014.04.017
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    It is important to conduct clinical and scientific continuous education for nurses. In clinical practice, clinical education can improve the nurse professionalism and be advantageous to the doctor-nurse collaboration. In the scientific research work, the training nurses to assist scientific research can provide the thought for scientific research and increase over-all quality of nurses for clinical participation. (Ophthalmol CHN, 2014, 23: 282-283)
    Pros and cons of glaucoma surgery
    DUAN Xuan-chu, LUO Hao-min.
    2014, 23(4):  288-288.  doi:10.13281/j.cnki.issn.1004-4469.2014.04.023
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    Glaucoma is a lifelong disease and irreversible ocular disease causing blindness, which is still not possible to restore the normal visual function even after appropriate treatment. The disease can’t be cured, just being slowed progression. Nowadays, there are three kinds of treatment of glaucoma, such as drugs, laser, or surgery, to reduce the intraocular pressure (IOP) to vary as much as possible for each patient to achieve the "target IOP." The commonly used anti-glaucoma surgery is trabeculectomy, which can significantly reduce IOP peak and fluctuation, with high success rate, but there are still some risks and complications. Doctors and patients should make a decision cautiously. Many factors affect the surgical outcome, so doctors should pay more attention to deal with the glaucoma, especially refractory glaucoma. (Ophthalmol CHN, 2014, 23: 288-Post II)