Volume 40 ·  Issue 09 ·  2004

Modern medicine is still in the stage of understanding myopia. In recent years, with the application of high-tech, optical correction of myopia has made great progress, especially eye refractive surgery. The correction of myopia in China has distinct characteristics, but there are many lessons. Through wearing glasses, the far vision of millions of myopic patients has been improved, and some people who undergo surgery have indeed benefited from meeting their special needs. However, people (especially myopic students) want to cure myopia radically and bid farewell to glasses. Therefore, it is necessary to analyze many problems existing in the understanding and correction of myopia, especially how to strive for reasonable correction of myopia, and put forward some suggestions for reference.

Objective to study the similarities and differences between excimer laser keratomileusis (LASEK) and excimer laser photorefractive keratectomy (PRK) in the treatment of myopia below-8.00 d. Methods 46 patients with myopia degree ranging from-1.75 to-8.00 d were treated simultaneously in both eyes. One eye was treated with PRK and the other with LASEK. The epithelial healing time was observed, the degree of pain was recorded, and the visual acuity, refractive state and the degree of Haze under the corneal epithelium were compared within 6 months after operation. Results The average epithelial healing time was 3.49 d in LASEK group and 2.87 d in PRK group, and the difference between the two was significant (P<0.05); The mean pain index was 2.04 in LASEK group and 2.45 in PRK group, with significant difference (P<0.05); There was no significant difference in visual acuity and diopter recovery between the two groups within 6 months after operation (P>0.05), and there was no difference in the occurrence of complications. The degree of postoperative Haze in LASEK group was significantly lower than that in PRK group (P<Conclusion LASEK can treat myopia below-8.00 D as safely and effectively as PRK, and can reduce the early pain level and the occurrence of Haze complications compared with PRK. (Chinese Journal of Ophthalmology, 2004, 40: 579-583)

Objective to explore the role of the relationship between regulation and convergence in the occurrence and development of myopia. Methods The subjects of this study included 31 adult emmetropia and 46 adult myopia. The myopia was divided into high myopia (>-6.00 D), moderate myopia (-6.00~ -3.25 D) and mild myopia (-3.00~ -0.50 D). The measurement of binocular synergistic parameters included distant occultation, near occultation and positive and negative relative adjustment. The calculated adjustment (AC/A) of different diopter arrays was analyzed and compared. Results the calculated AC/A of myopia group was higher than that of emmetropia group, and the calculated AC/A increased with the deepening of myopia. There was no significant difference between distant occultation and negative relative adjustment between myopia group and emmetropia group (P>0.05), but the absolute value of positive relative adjustment in myopia group was significantly lower than that in emmetropia group (P<0.05), and the proximal occultation in myopia group had a tendency to esophobia compared with the proximal occultation in emmetropia group (P<0.05). Conclusion The synergistic parameters of adjustment, vergence and their interactions were significantly different among myopia patients, and AC/A was the key parameter of the difference, and showed an upward trend due to the increase of myopia degree. The increase of AC/A indicated that there was a tendency of retinal defocus in myopia patients when working at close range.

Objective to investigate the therapeutic effect of excimer laser therapeutic resection (PTK) combined with photorefractive resection (PRK) in the treatment of myopia with corneal opacity. Methods the corneal epithelium was removed by laser plus curettage, and the corneal opacity was removed by PTK with a diameter of 7.0 mm. RESULTS 54 cases (79 eyes) with corneal opacity were followed up for more than 1 year. The preoperative mean diopter was (-6.73±4.17) D, and the mean best corrected visual acuity was 0.63. The causes of corneal opacity included infection, mechanical trauma, chemical burn, thermal burn, postoperative scar and other reasons. The mean cutting depth of PTK combined with PRK was (124.63±53.31) μ m. After operation, 50 eyes (63.3%) had Haze under corneal epithelium ≤ Ⅰ, and 69 eyes (89.9%) had visual acuity equal to or exceeding the preoperative best corrected visual acuity, with an average of 0.74. The corneal surface is smoother than that before operation, and astigmatism is reduced. Conclusion PTK combined with PRK is a safe and effective method for the treatment of corneal opacity

Objective to investigate the dynamic changes of ciliary body shape and position in spontaneous hyperopia and near adjustment in healthy living eyes. Methods the dynamic observation and statistical analysis of the changes of ciliary body shape and position in 68 normal eyes were carried out by using 50 MHz high frequency transducer of ultrasonic biomicroscope (UBM). Results (1) The thickness of the anterior ciliary body, the length of the ciliary process, the total area of the ciliary body and the area of the annular muscle increased, the width and angle of the ciliary process, the distance between the ciliary process and the trabecular, iris and sclera process, and the angle between the ciliary process and the iris and sclera decreased, and the degree of opening of the anterior chamber angle decreased. However, the difference of the posterior ciliary body thickness, the longitudinal muscle area, the angle between the sclera and iris and the angle between the trabecular and iris was not significant. (2) The changes of the morphological parameters were complementary and highly consistent, and the positional parameters were also the same, but the relationship between the morphological and positional parameters was not significant. Conclusion During human eye near adjustment, the muscle fibers of each part of the ciliary body contract coordinately, especially the annular muscle contraction, which makes the ciliary process become sharp and slender, the ciliary body moves forward and inward, relaxing the suspensory ligament, supporting Helmholtz's theory of accommodation relaxation.

Objective to study the image characteristics of pathological myopia by coherence optical tomography (OCT). Methods OCT examination was performed in 100 patients (195 eyes) with high myopia. Results 7 eyes (3.6%) had normal OCT examination, 161 eyes (82.6%) had uneven and thin light band of retinal pigment epithelium and choroidal capillary, 21 eyes (10.8%) had full thickness macular hole, 10 eyes (5.1%) had retinal detachment, 24 eyes (12.3%) had localized superficial retinal detachment, 7 eyes (3.6%) had retinoschisis, 19 eyes (9.7%) had macular choroidal neovascular membrane, 9 eyes (4.6%) had Fuchs plaque, 3 eyes had thick macular hemorrhage, 18 eyes (9.2%) had macular epiretinal membrane, and often had retinal edema, 5 eyes (2.6%) had thin macular epithelium, and 3 eyes (1.5%) had lacquer crack. Conclusion Compared with slit lamp panretinal microscopy, OCT is superior in observing the changes of retinal pigment epithelium and choroidal capillary, confirming macular hole, finding small neuroepithelial detachment and cleavage, diagnosing macular epiretinal membrane and neuroepithelial thinning

Objective to investigate the effect of scintillation light on the development of eyeball and myopia in guinea pigs. Methods Thirty 4-week-old guinea pigs were randomly divided into three groups. Group I was kept in the scintillating light environment, and the scintillating mode was bright for 2 s and dark for 2 s; Group Ⅱ and group Ⅲ were kept in daily illumination environment as controls. The illumination time of group Ⅱ was 12 h a day, and the illumination time of group Ⅲ was 24 h a day. The illumination of the 3 groups was 200 lumens. After 6 weeks of experiment, the eye diopter was measured by retinoscopy and the eye axial length was measured by A ultrasound. The eyeball was removed and the weight of the eyeball was measured with an electronic balance. The histological changes of sclera, choroid and retina at the posterior pole of the eyeball were observed under light microscope and transmission electron microscope. Results Compared with the control group, the animals raised in the scintillation illumination environment developed myopia of-7.00 D. The axial growth of the eye was 0.56 mm, the weight of the eyeball was 68 mg, the number and activity of sclera cells at the posterior pole increased, the gap between collagen fibers enlarged, the choroidal layer narrowed, and the extracellular disc of retinal photoreceptor cells became shorter and irregular. (Chinese Journal of Ophthalmology, 2004, 40:601-604)

Objective to evaluate the efficacy of intraocular lens implantation with iris septum in the treatment of cataract complicated with iris defect, and to explore the mechanism of postoperative complications.Methods 25 patients (27 eyes) who underwent intraocular lens implantation with iris septum were collected, and the curative effect and complications were analyzed.At the same time, the angular structure and intraocular lens haptic position of patients with secondary glaucoma were observed by gonioscope and ultrasound biomicroscope (UBM). Postoperative visual acuity increased ≥2 lines in 20 eyes (74.1%) compared with that before operation, the change was<1 line in 5 eyes (18.5%), and the decrease was>2 lines in 2 eyes (7.4%). Postoperative complications included secondary glaucoma in 10 eyes (37.0%), astigmatism degree ≥2.00 D in 17 eyes (63.0%), corneal decompensation in 2 eyes (7.4%), anterior chamber hemorrhage in 2 eyes (7.4%), vitreous hemorrhage in 3 eyes (11.1%), and retinal detachment in 1 eye (3.7%). Among 20 intraocular lens haptics in 10 eyes with secondary glaucoma, 9 haptics were accurately fixed in the ciliary sulcus, and other positions included anterior chamber angle, ciliary process and posterior ciliary process. Postoperative secondary glaucoma is mainly related to chamber angle injury, and abnormal position of intraocular lens haptics, intraocular hemorrhage and persistent inflammatory reaction are also involved in its occurrence. (Chinese Journal of Ophthalmology, 2004, 40: 605-608)

Objective to investigate the level of clinical efficacy research in ophthalmology in China and provide reliable evidence for the research of evidence-based medicine (EBM). Methods According to the EBM standard, all the papers published in Chinese Journal of Ophthalmology from 1983 to 2002 about clinical efficacy were retrieved and analyzed. Results There were 152 clinical efficacy research papers; Among them, 35 were randomized controlled trials and 8 were clinical controlled trials, accounting for 28.1% of the clinical efficacy research papers, and there were many problems in randomization, control setting, blinding, baseline data, follow-up, loss to follow-up, complication report and statistical analysis, etc. Among the papers belonging to controlled experiments, 10 papers (23.3%) described the specific methods of randomized or semi-randomized grouping; Placebo-controlled and open-controlled articles were 3 (7.0%) and 9 (20.9%), respectively; 7 blinded research papers (16.3%); 25 papers (58.1%) had follow-up results and provided more detailed follow-up data; There were no papers analyzing the factors such as confusion, bias, interference and contamination that affected the quality of clinical efficacy research; There is no paper that estimates the sample content at the time of project design; Some or all of the data in 15 papers (34.9%) did not indicate the significance test method, only P value. Conclusion Some clinical research design methods in the field of ophthalmology in China are not rigorous enough, which affects the authenticity and reliability of the research results. It is very important to pay attention to the training of ophthalmologists in clinical research design methods and strictly control the research quality to improve the clinical efficacy research level in China. (Chinese Journal of Ophthalmology, 2004, 40:609-613)

Objective to investigate the effects of endothelial leukocyte adhesion molecule-1 (ELAM-1) on the morphology and actin cytoskeleton of porcine trabecular cells, and to explore the pathogenesis of glaucoma.Methods Primary cultured porcine trabecular cells were activated by interleukin-1 (IL-1) stimulation, and further crosslinked with ELAM-1 antibody or IgG to observe the dynamic changes of cell morphology, intercellular junction, actin and cell thickness. Results No ELAM-1 was expressed in porcine trabecular cells without IL-1 treatment, but ELAM-1 was expressed in porcine trabecular cells after IL-1 treatment. After IL-1 activated porcine trabecular cells were further crosslinked with ELAM-1 antibody or IgG, the intercellular space was enlarged, the cells became rounded and thicker, and the stereosensitivity of cells was enhanced. Conclusion ELAM-1 can be expressed in porcine trabecular cells, and the expressed ELAM-1 can affect actin cytoskeleton and change cell morphology by binding to antibody or cross-linking by IgG. (Chinese Journal of Ophthalmology, 2004,40:614-619)

The "9th National Academic Conference on Ophthalmology Pathology and Basic and Clinical Diagnosis and Treatment" sponsored by the Ophthalmology Group of Ophthalmology Branch of Chinese Medical Association and the Editorial Board of Chinese Journal of Ophthalmology is scheduled to be held in Dayong City, Hunan Province in late May 2005. At that time, well-known ophthalmologists and academic leaders in China will be invited to give special academic lectures and popular lectures on ocular pathology knowledge on clinical and basic research progress in ocular pathology, ocular tumors and related fields. Lecture contents: (1) Relationship between origin and multidirectional differentiation of ocular surface tumors and ocular surface stem cells

Sympathetic nerve fibers can regulate the integrity of corneal epithelium, the proliferation of corneal epithelium and wound healing, etc. Previously, corneal nerve was studied in vitro, and confocal microscope, as a new type of optical microscope, can scan the cornea in real time from four dimensions (three dimensions, space and time) in vivo [1-4]. We conducted confocal microscopy in 37 normal subjects (42 eyes) to understand the morphology of normal corneal nerves, and provide reference for the study of corneal nerve morphology under various pathological conditions.

As the main structural protein of the lens, α-lens protein is an important substance for maintaining the structure and refractive characteristics of the lens, and its molecular bridesmaid function plays a decisive role in protecting the transparency of the lens. Glycosylation can modify α-lens protein, influence its molecular bridesmaid function, and participate in the formation of age-related cataract and diabetic cataract [1,2]. This study confirmed the mechanism of glycosylation in the formation of cataract by observing the modification and influence of fructose-6-phosphate (F6P) and ribose on α-lens protein.

The role of mitochondria in the process of apoptosis has been widely paid attention to. Apoptosis of lens epithelial cells is considered to be the cytological basis for the formation of various cataracts (except congenital cataracts). In this study, cyclosporine A (CsA) was used to block the mitochondrial permeability transition pole (MPTP) of mitochondrial membrane to observe the changes of mitochondrial function and the role of MPTP in the process of apoptosis in lens epithelial cells after oxidative damage.

The "National Glaucoma Standardized Diagnosis and Treatment Study Class" jointly organized by Chinese Medical Doctors Association and the Department of Ophthalmology of Peking Union Medical College Hospital will be held in Beijing in mid-November, 2004. The session will last for 5 days, and the conference fee will be 860 yuan. After the study period, 10 points of national Class I continuing education credits will be awarded. Contents: Clinical and progress of glaucoma, epidemiology of glaucoma, heredity of glaucoma, early diagnosis and treatment of primary angle closure glaucoma, early diagnosis and treatment of primary open angle glaucoma, surgical treatment and its progress, congenital

This book is edited by Professor Wu Lezheng of Zhongshan Ophthalmology Center in Guangzhou and published by Beijing Science and Technology Press. The book systematically introduces the generation and propagation of bioelectricity in retina and visual path, the measurement principle, method, influencing factors and result analysis of multifocal electrophysiological technology, and the application of this technology in macular degeneration, retinopathy and visual path degeneration. This book is supported by the National Science and Technology Academic Works Publishing Fund, and is the first academic monograph in this field in the world.

Shandong Institute of Ophthalmology and Eye Hospital was founded in January 1991. It is a social welfare institution approved by the State Science and Technology Commission, which integrates scientific research, teaching and medical treatment. It is affiliated to Shandong Academy of Medical Sciences, and jointly trains ophthalmology doctoral students with Peking University and Qingdao University. The director and dean is Professor Xie Lixin, the only academician of Chinese Academy of Engineering in China's ophthalmology community. At present, our institute has 150 open hospital beds and has assets of 130 million yuan, of which more than 200 sets of scientific research and medical equipment with international advanced level of more than 10,000 yuan.

This book is written by Professor Ingrid Kreissig of Germany, translated by Professor Hui Yannian of Xijing Hospital of the Fourth Military Medical University, and published by Beijing Science and Technology Press. This book analyzes diagnostic methods, differential diagnosis, and approaches to minimal extraocular surgery in the treatment of retinal detachment, using a conversational narrative to encourage original thinking. Comes with 409 illustrations to provide hands-on instruction in manual form. Volume 1: Diagnosis, interrupted external pad pressure without drainage, and case reports; Volume 2: Temporary top pressure with balloon and gas and no drain, external cushion pressure or gas or vitreous surgery, reoperation and case reports.

Practical Ocular Surface Diseases edited by Professor Zhu Zhizhong has been published by Beijing Science and Technology Press. This book aims at serving the clinical practice of ocular surface diseases, with detailed content, comprehensively discussing the basic theory and clinical practice of ocular surface diseases, including the latest progress in theory and technology in the field of ocular surface at home and abroad. This book focuses on the mastery and application of diagnosis and treatment technology, and has reference value for medical treatment, scientific research and teaching of medical staff at all levels of ophthalmology.

In order to reflect the innovative scientific research achievements and clinical experience of ophthalmology in China as soon as possible, this journal has opened up a "fast track" to publish excellent academic papers in 2002, simplifying the procedure from review to official publication of papers, and shortening the publication cycle. In view of the increasing number of authors applying for the "fast track" at present, the editorial board of this journal has supplemented and improved the specific conditions for applying for the "fast track" on the basis of the operation of some time ago, and reiterated the relevant regulations of the "fast track" once again, so that academic papers with innovative content can be published as soon as possible.

The Chinese Journal of Ophthalmology was founded on October 1, 1950. It was sponsored by the Chinese Medical Association and edited by the Editorial Committee of the Chinese Journal of Ophthalmology. The editorial committee is composed of 61 well-known ophthalmologists in China. The current editor-in-chief Zhao Jialiang and the editorial director Zhao Hongmei. The main readers of this journal are ophthalmologists across the country, and it is publicly distributed at home and abroad. China Standard Issue Number: ISSN 0412-4081, CN11-2142/R; Postal Code: 2450; National map code: BM93. "Chinese Journal of Ophthalmology" has always implemented the Party and the State

The "National Fundus Disease Basic and Clinical Technology Study Class" jointly organized by Chinese Medical Doctors Association and Peking Union Medical College Hospital Ophthalmology Department will be held in Beijing in mid-November, 2004. The session will last for 5 days, and the conference fee will be 860 yuan. After the study period, 10 points of national Class I continuing education credits will be awarded. Teaching contents: General introduction of fundus diseases, progress of retinal transplantation, progress of stem cell transplantation, research progress of artificial eye, diagnosis and treatment of fundus degenerative diseases, surgical treatment of submacular neovascular membrane, epiretinal membrane and surgical treatment, age-related macular degeneration

With the development and popularization of corneal transplantation, more and more hospitals are facing the problem of corneal shortage. Although Beijing Tongren Eye Bank has carried out publicity and registration of eyeball donation since its establishment in 1992, at present, about 32 000 people are willing to donate eyeballs after death, but the actual eyeball donation occurring every year still can't meet the clinical needs. Therefore, we made statistics and investigated the basic situation of some registrants in Beijing Tongren Eye Bank, in order to determine whether the method of registering eyeball donors is effective and possible improvement measures.

The National Symposium on Optometry sponsored by the editorial department of Chinese Journal of Ophthalmology was held in Qingdao, Shandong Province from June 30 to July 2, 2004. Chairman of Ophthalmology Branch of Chinese Medical Association Editor-in-Chief Zhao Jialiang, Executive Deputy Editor-in-Chief He Shouzhi, Deputy Editor-in-Chief Xie Lixin (Academician of Chinese Academy of Engineering) and Chu Renyuan, Chairman of Shandong Ophthalmology Branch Li Jinghai, Leader of Optometry Group of Chinese Medical Association Ophthalmology Branch Qu Jia and experts in optometry and related specialties such as Wang Qinmei, Niu Lanjun, Wang Zheng, Du Zhiyu, Lu Wenxiu, Li Ying, Lu Fan and Zhou Xingtao attended the conference and gave wonderful special reports.

There are many kinds of orbital tumors, but granulosa cell tumors are rare in clinical practice. One case admitted to our hospital is reported as follows. The patient was a 41-year-old female who was admitted to the hospital with "right intraorbital tumor" due to swelling and pain in the right orbit and right face for more than two years and exophthalmos for more than one year. Ocular examination showed that the visual acuity of the right eye was 0.4, the corrected visual acuity was 3.00 DC ×95° =1.2, and the visual acuity of the left eye was 0.7. The right exophthalmos, the lower eyelid was slightly depressed, and a soybean-sized mass could be palpable along the deep part of the inferior orbital margin, with medium quality, smooth surface, immobile, and obvious tenderness. No abnormalities were found in the anterior and posterior segments of both eyes.

An 11-year-old woman was admitted to hospital on July 19, 2002 because she found a tumor in both eyes for more than 10 years. The child's parents were not close relatives, and her mother had a stable pregnancy and a full-term natural delivery. After birth, she found a tumor in both eyes. Due to poor economic conditions, she was not diagnosed and treated. The tumor grew slightly with the child's age. In 2002, she came to our hospital for treatment because of the influence on her appearance. No abnormalities were found in general physical examination.

The most important function of the visual system is form perception, that is, it can not only see objects, but also distinguish their shapes. At present, the main means of clinical evaluation of form perception is eye chart, but simply using eye chart to check the angle of view can only reflect the ability of macula to distinguish small targets with high contrast (that is, the contrast of graphics is very obvious). For example, if the eye chart with black and white characters is used to check the eyesight chart, the eyesight of two people is equal, but if the eye chart with black and gray characters is used to check the eyesight chart, the eyesight of two people is not necessarily equal.