Volume 48 · Issue 08 · 2012

Compressive optic neuropathy and exposure keratopathy is classical indications of orbital decompression surgery for thyroid associated ophthalmopathy.Recently,its therapeutic value should extend to cosmetic requirement,the entity of congestive orbitopathy,ocular hypertension and hormonal resistance. In order to improve the safe and efficacy of orbital decompressions,we need the graded decompression plans and the modified areas of bone removal.The preferred area of bone removal is deep lateral wall.In serious patients,a combined medial,inferior and deep lateral wall decompression is recommended.There have also been technical advances in the cosmetic incisions such as transconjunctival,eyelid crease or endoscopic access.Removing periorbital fat is a supplement skill for bony decompression.The removed amount and indications should be regulated strictly.Individual operative project is the tendency of development of orbital decompressions.(Chin J Ophthalmol,2012,48:673-675 )

There are many different orbital diseases and the orbital surgery is almost complex.Some severe surgical complications resulted from various factors.With the growing popularity of orbital treatments,most clinical units can carry out orbital surgery with different qualities and the number of surgery is growing day by day,resulting in uneven surgical effects,which may also be the cause of medical dispute in the near future.There are many different causes for the occurrence of surgical complications,for example,the complicated anatomy,diverse nature of the lesions,deep location and the different skills of operators.The correct understanding of various orbital diseases, strict control of surgical indications and objective assessment of the surgical quality should all be regarded as controllable factors,which are effective in improving surgical effects and avoiding surgical risks.

Objective The purpose of this study was to show the clinical and imaging characteristics in patients with congenital orbital fibrosis.Methods A retrospective review of a series of 14 patients with congenital orbital fibrosis hospitalized in Institute of Orbital Disease during 2005 to 2009 have been characterized. Patients aged from 3 months to 18 years old,the median age was 7 years old,6 cases (43％) were male.Results Ocular changes were found at birth in all patients,symptoms at onset of the disease included dysfunction of eye movement ( 12 cases ),lagophthalmos (7 cases ),diplopia (5 cases),exophthalmos (4 cases),conjunctival congestion (4 cases ) and endophthalmos ( 2 cases).The results of medical examinations including visual acuity,exophthalmos or endophthalmos,diplopia with or without compensative head station,displacement of the eye, lagophthalmos, blephroptosis and ocular dyskinesia all have been record.In the 14 cases,13 patients have undertaken the CT imaging examination,soft tissue lesions have been found in the orbit with high density and irregular shape,accompanied with thickened ocular muscles and anatomical changes.Of the 9 cases which underwent MRI examination,all of the lesions showed medium signals in T1 WI,with medium to low signals in T2WI.Local excision has been performed in 2 patients,we found that the orbital lesions packaged with hard fibrous tissues around,and the ocular muscles were thick and stark. Pathological examination showed fibrosis and degeneration in the lesions,lacrimal gland and ocular muscles. Some lymphocyte infiltration also has been observed.Conclusions Congenital orbital fibrosis is an orbital disease occurs at birth and is characterized with series of signs such as endophthalmos or exophthalmos,ocular dyskinesia and diplopia.Imaging examinations often find abnormal mass with irregular shape and soft tissue density in orbit.Till now,no efficient therapy has been established.

Objective To study the characteristic of the clinical and image features of distensible orbital venous malformations ( DOVM ).Methods It was a retrospective case series study.Clinical features and imaging findings,including B ultrasonography,CDFI,MRI,CT imaging of 43 patients with DOVM were reviewed in Shanghai Changzheng Hospital affiliated to Secondary Military Medical University.Results Forty-three patients (24 women and 19 men),whose ages range from 5 to 71 years old,showed clinical or radiological evidence of distensiblity.The mean age was 32 years.Location of the lesion within the orbit was variable,9 patients with superficial lesions,and 19 patients with deep lesions. Twelve patients were classified as combined lesions.3 patients with extraorbital venous malformations were classified as complex lesions.Twenty of 43 patients with DOVM were initially seen with proptosis or pain increasing with the head in a dependent position. Eight patients presented with a sudden onset of proptosis and pain secondary to thrombosis or hemorrhage.B ultrasonography showed an intermittently anechoic lesion that exhibits intrinsic flow during the Valsalva maneuver.Color Doppler imaging might demonstrate a reversal of flow toward the transducer during the Valsalva maneuver.Thirty-five of 43 cases with axial CT images showed a normal appearance or only mild enlargement of the involved veins,but coronal CT images could clearly demonstrate the lesion distensibility. Eight cases showed well defined tumor with homogeneous high density due to the thrombosis or hemorrhage within the orbit.MR imaging showed hypo- to hyperintense signal on T1-weighted images,had hyperintense signal on T2-weighted MR images. However, signal of lesions of orbital hemorrhage could be various according to the different hemorrhage time.Conclusion DOVM usually occurs in young patients.Clinical diagnosis can be established with the typical symptoms and one or more imaging examinations.

Objective To explore the classification of medial orbital blowout fractures (OBF) and the applications of reconstruction materials, to evaluate the efficacy and safety of surgical orbital reconstruction.Methods A retrospective review of 176 cases with medial OBF between January 2008 and January 2011 was conducted,they were classified to group Ⅰ ( pure medial wall fracture,85 cases ) and group Ⅱ (combined medial and inferior walls fractures,91 cases ). Group Ⅰ was classified into 3 subgroups,Ⅰ a, Ⅰ b,and Ⅰ c,according to the fractured appearances on CT scans. Group Ⅱ was classified into 2 subgroups,Ⅱ a and Ⅱb,according to the maxillo-ethmoidal bone buttress involved in or not. The operative designs and the choice of reconstruction materials were based on the fractured classification and diplopia.Materials used for repairing included artificial bone plates,titanium meshes and wedge implants. The surgical repairs were undergone via a trans-caruncular approach when necessarily combined with an inferior fornix or lower limbus palpebralis incision.Clinical outcomes and complications were recorded including visual acuity,exophthalmometry,diplopia,hypoglobus and CT scans before and follow-up period. Results Group Ⅱ showed more significant enophthalmos than group Ⅰ ( - 5.1± 0.8 mm vs - 2.7 ± 0.7 mm,P =0.000 ). Both groups improved after operations ( group Ⅱ: - 5.1 ± 0.8 mm vs. -0.7 ±1.2 mm,P=0.000; group Ⅰ:-2.7 ±0.7 mm vs.0.1 ±0.8 mm,P=0.000).Ocular displacement was more common in group Ⅱ than in group Ⅰ ( 62％ vs.0％,P =0.000).The hypoglobus was more common in subgroup Ⅱ b than in Ⅱ a ( 71％ vs.38％,x2 =8.19,P =0.004) and significantly improved after operations in subgroup Ⅱ b ( 71％ vs. 17％,x2 =38.27,P =0.000).Diplopia was more commonly noted in group Ⅱ than in group Ⅰ ( 100％ vs.83％,P =0.000),and was significantly relieved in both groups (group Ⅰ:Z =4.475,P =0.000; group Ⅱ:Z =-9.751,P =0.000).Postoperative CT displayed orbital walls reconstructed satisfyingly in 92％. No one was recorded with impaired vision after operation. The important complications were aggravated or new-onset diplopia,under- or over-correction of enophthalmos and ocular superior displacement.Conclusions A reconstructive operation of medial OBF with proper materials and surgical skills could be helptul for improving diplopia,enophthalmos and hypoglobus. The operations for repairing of medial OBF is efficient and safe.

Objective To describe the clinical features of blepharochalasis and the effect of surgical treatment of associated deformities.Methods A retrospective study reviewed 54 patients ( 98 eyes ) with blepharochalasis.The main features analyzed included sex,age of onset,duration and clinical signs.Surgical treatment for the correction of deformities includes blepharoplasty; resuspension of the prolapsed lacrimal gland,ptosis repair,surgical correction of lower eyelid retraction and lateral canthoplasty. Followup ranged from 6 to 60 months. Results The average age of onset was 9.3 years. The duration in all 54 patients (32 females and 22 males ) lasted for 2 - 16 years and different periorbital deformities were presented.After surgical repair,all patients were satisfied with their bilateral symmetrical creases in upper eyelids and the contour of upper eyelids.The appearance of floppy eyelids has been improved distinctly.The lateral canthus moved to the normal position. No patients complained epiphora or dry eye symptoms.Prolapse of the lacrimal gland recurred in two patients ( three eyes).They underwent reoperation with no further recurrence.Overcorrection in blepharoptosis surgery of five patients was fixed with suture adjustment of the levator aponeurosis. Conclusions Blepharochalasis onset often occurs around age 10 years and stabilizes till adolescence.Since it involves bilateral or unilateral,local eye tissues or periorbital tissues,elinical manifestations may vary in blepharochalasis. Ophthalmic plastic surgery to correct blepharochalasis and its associated deformities in the quiescent stage is usually safe and with satisfactory cosmetic effects.

Objective To describe the clinical features and surgical outcomes in a series of patients with perforating injuries and foreign bodies located at the exit wound in posterior global wall. Methods Retrospective case series of 17 eyes of 17 patients were included in the study,each patient who received treatments between January 2006 and December 2010 had perforating injuries with foreign bodies located at posterior global wall.The exit wounds of perforating injuries were in the area of optic disc and macula in 8 eyes. Seventeen eyes had vitreous hemorrhage,11 eyes had traumatic cataract,8 eyes had retinal detachment and one eye had endophthalmitis.According to different therapeutic regimen,cases were divided into two groups.Group A (7 cases) underwent vitrectomy combined with extraction of foreign body as an emergency operation.Group B (10 cases) underwent extraction of foreign body as an emergency operation and secondary vitrectomy were performed 1 - 2 weeks later.The mean follow-up time was 18 months ( ranged from 9 -47 months). The functional and anatomical results were compared between Group A and B.Fisher's exact test were used to analyze the data. Results The foreign bodies were extracted in 17 cases.Poor final best corrected visual acuity (BCVA) ( worse than or equal to O.1 ) was presented in all 8 cases with the exit wound being in the area of optic disc and macula,but only in 4 of 9 cases with the exit wound locatod in other sites,the difference between these two groups was statistically significant ( P =0.029 ).At final follow-up,vision was improved in 5 cases from Group A and 7 cases from Group B ( P =1.000 ) ;BCVA were better than or equal to 0.1 in 4 cases from Group A and 3 cases from Group B ( P =0.350) the differences were statistically nonsignificant.Intraoperative leakage at the exit wound occurred in 4 cases from Group A and one from Group B,the difference was statistically significant ( P =0.015 ).Intraoperative retinal detachment and postoperative silicone oil leakage occurred in 2 cases from Group A and none from Group B (P =0.154). Postoperative retinal detachment occurred in 1 case from Group A and 3 cases from Group B ( P =0.603).Silicone oil-dependent eye occurred in 1 case from Group A and 2 cases from Group B ( P =1.000) ;the differences were statistically nonsignificant.Conclusions The visual prognosis is worse in cases with the exit wound being in the area of optic disc and macula. Both therapeutic regimens were effective,but each has their pros and cons. Appropriate therapeutic regimen should be selected in term of situations.To avoid leakage at the exit wound in vitrectomy,we recommend therapeutic regimen B be selected first.

Objective To analyze the long-term safety of implantation of iris-fixed phakic intraocular lens (IOL) Verisyse for the treatment of high myopia.Methods One hundred and eighteen eyes of 59 cases implanted Verisyse for high myopia in Eye Center of Tongren Hospital from Jan.2005 to Jan.2007 were followed up for 48 to 72 months,mean time period was( 56.2 ± 16.9 ) months.There were 32 male cases ( 64 eyes) and 27 female cases ( 54 eyes ).Age ranged from 22 to 39 years old,mean ( 26.6 ± 7.5) years.The uncorrected vision acuity was 0.02 - 0.08,and the best corrected vision acuity was 0.3 -1.0.The visual acuity,refraction,intraocular pressure,corneal endothelium and the distance between Verisyse to corneal and lens was measured separately,and the complications were also observed.The results were treated with analysis of paired-samples t test and Fisher exact probability test.A difference at P ＜0.05was considered to be statistically significant. Results The complications included the dislocation of Verisyse into anterior chamber in 8 cases (8 eyes,6.78％ ),retina detachment in 2 cases (2 eyes,1.69％ ),corneal endothelium lost more than 1000/mm2 in 6 cases (7 eyes,5.93％ ),corneal edema in 1 case (1 eye,0.84％ ).Pre-operative mean corneal endothelium density was (2821 ± 117)/mm2,and it was ( 2249 ± 654 )/mm2 after surgery.There was no significant difference( t =1.112,P =0.09 ) between preand post-operative data.Post-operative uncorrected vision improved 5 to 8 lines than that of pre-operation.Post-operative corrected vision improved 1 to 3 lines than that of pre-operation except 1 ease ( 1 eye ) developed corneal decompensation and 2 cases (2 eyes ) developed retina detachment. SE showed no significant difference in long-term after operation compared with 3 months after surgery ( t =0.641,P =0.21 ).The mean intraocular pressure was( 16.4 ± 3.4) mm Hg( 1 mm Hg =0.133 kPa).The distance between anterior surface of IOL.and endothelium was ( 2.468 ± 0.342 ) mm,distance between posterior surface of IOL and lens was ( 0.652 ± 0.176 ) mm,and distance between edge of IOL and peripheral endothelium was (1.728 ± 0.213 )mm except eyes occurred Verisyse dislocation. Verisyse dislocation occurred more commonly when the iris was not perfectly crapped in the loop,and the difference was significant ( P =0.000). No glaucoma occurred.Conclusions Implantation of Verisyse can correct high myopia effectively.But it damages corneal endothelium in some cases.This complication may be related to the unstable position of Verisyse in the anterior chamber. So we should pay more attention to the safety of this kind of phakic IOL clinically.

Objective To map and to identify the causal gene of autosomal dominant congenital coralliform cataract ( ADCC ) in a Chinese family. Methods Case series study.Clinical features of all affected members in this family were examined. Blood samples were collected from nine family members for genetic linkage analysis.Polymorphic microsatellite markers were selected from the regions which harbor all known loci linked with ADCC. Direct genomic sequencing was used to evaluate the candidate gene.Results The affected members in this family showed classic phenotype of ADCC. The maximum two-point LOD score of 1.51 was obtained for marker D2S325 (θ =0).The LOD score of 1.20 was obtained for marker D11S925.The CRYGC/CRYGD gene located on 2q33-q35 and the CRYAB gene located on 11q22-q22.3.Therefore,the CRYGC/CRYGD and CRYAB gene may be the candidate gene in this family.Sequencing of the coding regions of the CRYGD gene showed the presence of a heterozygous C→A transversion at nucleotide 70 in exon 2 of CRYGD that is associated with cataracts in this family.This mutation resulted in a proline to threonine substitution at amino acid 23 of the protein in the first of the four Greek key motifs that characterized this protein. No mutation in all exons of CRYGC and CRYAB gene were found in the family.Conclusion Direct DNA sequence analysis revealed a C-to-A transition at nucleotide 70 of the CRYGD gene in this ADCC family

Objective To assess the inner caliber of large retinal vessel quantitatively using spectral domain optical coherence tomography (SD-OCT) and to reveal the association between changes in the inner caliber of large retinal vessel and the primay hypertension.Methods A retrospective case-control study was carried out including 215 cases (with primary hypertension) and 210 controls (without primary hypertension ) admitted to our hospital since 2009 and all the cases and controls were grouped according to age. SD-OCT was performed to assess the inner caliber of large retinal vessel quantitatively including retinal artery inner caliber( RAIG),retinal vein inner caliber(RVIC) and retinal arterio-venous inner caliber ratio (RAVICR).The differences in the inner caliber of large retinal vessel between the cases anti the controls in each age groups were analyzed by t test.In all cases,multiple comparisons were performed according to their blood pressure level by SNK test of one way ANOVA.The RAVICR was also correlated with the following relevant determinants via multiple stepwise regression analysis:age,diastolic and systolic blood pressure.Results In each age group of cases ( ＜40,40 to 49,50 to 59,60 to 69,≥70 years),the values of RAIC were (93.0±6.3),(86.2±6.1),(84.5±5.1),(84.0±5.5),and (81.7±5.4) μm respectively,and the values of RVIC were (129.4±5.8),(130.7 ±6.5),(129.6 ±5.4),(132.2 ±6.4),and (131.6±5.1) μm respectively,and the values of RAVICR were (0.720 ±0.07),(0.661 ±0.06),(0.653 ±0.04),(0.637 ±0.06),and (0.621 ±0.05 ) μm respectively.Compared with controls,RAIC (t =-4.813,- 10.893,- 15.689,-8.811,and - 10.151 respectively;P ＜0.05) and RAVICR (t =-3.276, -8.654, -13.470, -7.801,and -9.210 respectively; P＜0.05) were significantly decreased in each age group of cases. Multiple comparisons were made among each systolic and diastolic pressure groups in all cases.In systolic groups,difference of RAIC or RAVICR were significant( SNK test) between 140 to 149 mm Hg(1 mm Hg=0.133 kPa) and 170 to 179 mm Hg group ( q =9.46,10.61;P＜ 0.05 ),140 to 149 mm Hg and ≥ 180 mm Hg group ( q =11.03,13.98 ; P ＜ 0.05 ),150 to 159 mm Hg and 170 to 179 mm Hg group (q=8.13,8.82;P＜0.05),150 to 159 mm Hg group and ≥180 mm Hg group ( q =9.01,9.97;P ＜0.05 ). In diastolic groups,difference of RAIC or RAVICR were significant ( SNK test) between 90 to 99 mm Hg and 100 to 109 mm Hg group ( q =6.79,5.95 ;P ＜0.05 ),90 to 99 mm Hg and ≥110 mm Hg group ( q =9.72,10.21 ;P＜0.05),100 to 109 mm Hgand ≥110 mm Hg group ( q=5.93,6.07 ;P ＜0.05 ).RAVICR was associated with the diastolic and systolic blood pressure revealed by the multiple stepwise regression analysis ( ANOVA:F =11.231 ; Standardized regression coefficient:β =-0.024,-0.019,respectively; P ＜0.05).Conclusions Quantitative assessment for the inner caliber of large retinal vessel can be done by SD-OCT.The value of RAI and RAVICR were correlated with diastolic and systolic blood pressure in primary hypertension.

Objective To investigate the prevalence and anatomy features of iridociliary body cysts in patients with narrow anterior chamber angle.Methods Retrospective case series study.The prevalence and anatomy features of iridociliarybody cysts in 223 patients (402 eyes) were analyzed retrospectively with ultrasound biomicroscopy ( UBM ).All of the patients were examined for susceptive narrow anterior chamber angle without complaint. The age of the patients,the site,diameter and number of cysts,the anterior chamber angle and the central anterior chamber depth were measured.Results Iridociliary body cysts were found in 19 patients (23 eyes) out of 223 patients (402 eyes),the prevalence is 5.7％.Fifteen patients were unilateral and four patients bilateral.Two eases originated from the ciliary process,eighteen cases from the iris root,and three from both the root and posterior surface of the iris.Twenty one cases were single cysts while two cases were multiple cysts. The diameter of the cysts ranged from 0.5 to 3.1 mm,averaged (0.71 ± 0.53 ) mm.The average age and the central anterior chamber depth of the eyes with iridociliary body cysts were( 55.32 ± 10.74 ) years and( 2.25 ± 0.39 ) mm,with no significant difference ( t =0.534,0.783 ;P＞0.05 )as compared to that of patients without cysts,which were (57.46 ± 10.52 )years and (2.14 ±0.34) mm.The anterior chamber angle in iridociliary body cysts group was 8.2° ( 21.0°,0.0° ),with no significant difference ( Z =- 0.062,P ＞ 0.05 ) as compared to that of patients without cysts,which was 8.9°(21.4°,0.0° ).Conclusions The prevalence rate of iridociliary body cysts in this study is 5.7％,central anterior chamber depth and anterior chamber angle in patients with cysts do not differ form patients without cysts.

Objective To study the disease-causing gene mutation in a Chinese family with ectopia lentis.Methods The phenotype of each family member in a Chinese family with ectopia lentis was identified by detailed clinical examination. The inheritance mode in this family was ascertained by the pedigree analysis.Linkage analysis was performed by microsatellite markers on chromosome 15 and LOD Score was calculated by Mlink program. Gene mutations were detected by sequence analysis to the whole coding region and exon-intron boundaries of the candidate gene. Results A significant LOD score of 3.01 was obtained at D15S978 on chromosome 15q21.1,where FBNI gene was located. A C3519G change in exon 29 of FBNI gene,resulting in asparagine change to lysine at codon 1173,was detected by direct sequence analysis. This mutation was absent in the normal family members and 100 normal controls.Conclusions Our results indicate that c.C3519G (p.N1173K) mutation in FBN1 gene is the underlying molecular pathogenesis of this family with ectopia lentis.(Chin J Ophthalmol,2012,48:

The patient was a 23-year-old male who went to the Department of Ophthalmology of Beijing Tiantan Hospital on April 20, 2011 due to sudden painless loss of vision in his left eye for 19 h and weakness in his right limb for 15 h. After the onset of the disease, the patient was diagnosed with "central retinal artery occlusion in his left eye" and "cerebral infarction" in another hospital, and was given rescue drug treatment. The patient was in good health before, and had no symptoms such as dizziness, headache, nausea and vomiting since the onset of the disease when he got up in the morning. Physical examination: blood pressure 135/80 mm Hg (1mm Hg =0.133 kPa), clear mind, fluent speech, drooping right mouth corner, left deviation of teeth, muscle strength of right upper and lower limbs grade V, tendon reflex slightly active than that of left side, and pathological signs negative. Skull CT examination: showed left lateral paraventricular ischemic infarction.

combined hamartoma of the retina and retinal pigment epithetium (CHRRPE) is a rare benign tumor, mostly monocular, located in the optic head or posterior pole retina, characterized by mild bulge on the retinal surface, varying degrees of pigmentation, vascular tortuosity and epiretinal membrane formation [1]. Because this disease is rare in clinical practice, clinical ophthalmologists are prone to misdiagnose and misdiagnose it. At the same time, because its lesion area may have varying degrees of pigmentation, it is easy to be confused with some malignant fundus lesions, such as choroidal malignant melanoma and retinoblastoma, which leads to wrong eyeball removal.

The 8-year-old female child came to the Department of Ophthalmology of Peking Union Medical College Hospital because of poor vision in both eyes since childhood. The left eye had undergone lens extraction and vitrectomy respectively because of "congenital cataract and persistent primitive vitreous hyperplasia". The child was the first child and delivered naturally at full term; The parents were not close relatives, and there was no history of similar diseases in the family. The mother had no history of drug use and other diseases during pregnancy.

Achromatopsia is an early onset retinal dystrophy that causes severe visual impairment.To date,four genes have been found to be implicated in achromatopsia-associated mutations:guanine nucleotide-binding protein ( GNAT2 ), cyclic nucleotide-gated channel alpha-3 ( CNGA3 ), cyclic nucleotide-gated channel beta-3 (CNGB3) and phosphodiesterase 6C (PDE6C).Even with early onset,the slow progress and the good responses to gene therapy in animal models render achromatopsia a very attractive candidate for human gene therapy after the successful of the Phase Ⅰ clinical trials of Leber's congenital amaurosis.With the development of molecular genetics and the therapeutic gene replacement technology,the adeno-associated viral ( AAV ) vector-mediated gene therapy for achromatopsia in the preclinical animal experiments achieved encouraging progress in the past years.This article briefly reviews the recent research achievements of achromatopsia with gene therapy.

The first academic conference on ophthalmoplasty and orbitopathy of the Ophthalmology Branch of Chinese Medical Association was held in the Friendship Hall of Shanghai Exhibition Center from May 11 to 13, 2012. The conference invited Professor Zhao Kanxing, Chairman, Professor Qu Jia and Professor Sun Xinghuai, Vice Chairman of the Ophthalmology Branch of Chinese Medical Association, as well as experts from the United States, Singapore, Philippines, South Korea, India and other countries to participate and give special speeches.

Endoplasmic reticulum is the organelle where proteins get folded and assembled,and all kinds of damage factors can lead to the accumulation of unfolded proteins,therefore initiate endoplasmic reticulum stress(ERS) by activating the intracellular signal transduction pathways-cumulatively called the unfolded protein response,either to protect cells or to induce cell apoptosis,PERK pathway has been considered as a main signal transduction pathway of ERS,and a lot of eye diseases are correlated with PERK pathway mediated ERS.This article mainly summarize the progress of the eye diseases associated with PERK pathway mediated ERS.

Blepharoplasty is a common eyelid abnormality in Orientals, especially in children. It is manifested as the horizontal skin folds of the upper and/or lower eyelids crossing the eyelid margin, and the eyelashes tilt backward to rub against the conjunctiva and cornea. Most children have no symptoms and tend to heal themselves with age, but some children have repeated corneal erosion, which may affect the visual function in severe cases. There is no unified standard for the treatment, operation indications and operation timing of blepharoplasty in China at present, and it is often misdiagnosed as entropion in clinic.

On September 21, 1982, ORBIS flying eye hospital visited China for the first time (Figure 1, 2). It flew to Guangzhou, China, and stayed there for 18 days. In the next 30 years, ORBIS flying eye hospital visited China 22 times, and visited 23 provinces and cities to carry out the work of visiting and treating blindness.

Sponsored by the Department of Ophthalmology of Beijing Children's Hospital affiliated to Capital Medical University, the "Study Class on New Progress in Children's Ophthalmology and Lacrimal Duct Diseases" (a national continuing education project) will be held in Beijing from September 14 to 16, 2012. The class will invite well-known domestic ophthalmologists such as Fan Xianqun, Sun Fengyuan, Lu Hai, Jiao Yonghong, Yu Gang, Xiang Nan, Zhao Junyang, Li Xiaoqing, Wu Qian, Wu Wencan, Fan Jinlu, Jin Tao and Tian Yanjie to teach. The special lectures cover special lacrimal duct diseases, children's blepharoplasty, children's eye tumors,

The Chinese Medical Association is scheduled to hold the 17th National Ophthalmology Academic Conference of the Chinese Medical Association in Nanjing, Jiangsu Province from August 21 to 25, 2012. This is another large-scale ophthalmology event held in China after the 16th National Ophthalmology Academic Conference of Chinese Medical Association and the 4th Global Chinese Ophthalmology Academic Conference in 2011. It is expected that 5,000 delegates will participate in the event, and more than 1,000 famous international and domestic ophthalmologists will give special reports on new technologies, new knowledge and new experiences in ophthalmology development. Ophthalmologists from all over the country will gather at this grand event to exchange and share the latest research results in ophthalmology and visual science with domestic colleagues. The conference will also hold a large-scale exhibition of ophthalmic medical devices and drugs. The organizing committee of the conference welcomes ophthalmologists from all over the country to contribute to the conference.

In order to cultivate more ophthalmology talents and jointly develop ophthalmology, Sun Yat-sen Ophthalmology Center of Sun Yat-sen University and Alcon Company jointly established Sun Yat-sen Ophthalmology Center of Sun Yat-sen University and Alcon Ophthalmology Skill Training Center. The skills training center is equipped with eight sets of teaching equipment such as Alcon Infiniti phacoemulsification surgery instrument, surgical microscope and video teaching system, which will not only be used for the teaching of phacoemulsification cataract surgery training course carried out by Zhongshan Eye Center in cooperation with Alcon, but also for the study of ophthalmic microsurgery for residents, graduate students and advanced physicians in Zhongshan Eye Center. This is the fifth ophthalmic surgery skills training center established by Alcon in cooperation with well-known ophthalmic teaching hospitals in China.

On June 9th, 2012, the 10th anniversary of the founding of the Eye Hospital of the First Affiliated Hospital of Harbin Medical University and the 2012 Harbin International Academic Symposium on Ophthalmology were successfully held. Leaders of relevant provincial and municipal departments and Professor Wang Ningli, chairman-designate of Ophthalmology Branch of Chinese Medical Association, attended the opening ceremony and delivered congratulations. Professor Zhao Kanxing, chairman of Ophthalmology Branch, sent a congratulatory letter. At the opening ceremony, Professor Liu Ping signed an agreement with the Ophthalmology Center of the University of Melbourne, Australia, on behalf of the First Affiliated Hospital of Harbin Medical University. On the basis of the early joint cooperation, he will carry out further and more effective cooperation in scientific research, teaching cooperation and exchange of visiting scholars.

The book "Laser Treatment of Fundus Diseases" edited by Professor Zhang Huirong of Ophthalmology Center of Peking University Third Hospital has been published by People's Medical Publishing House. The book consists of 12 chapters: overview, indications of laser, contraindications of laser, laser treatment of retinal vein occlusion, diabetic retinopathy, retinal vascular inflammation, other retinal vascular diseases, macular and related diseases, peripheral degeneration and hiatus of the retina, benign and malignant tumors of the eye fundus, complications of laser, and methods and effects of photodynamic therapy.

In order to improve the printing quality of the journal, this journal has been changed to CTP plate making since 2011. In order to guarantee the printing quality of the pictures after CTP plate-making, this journal makes the following requirements for the published pictures.

According to international practice and the actual situation in China, for papers that meet the following conditions, the Chinese Medical Association series journals allow and accept the republication of relevant papers of the same research in different languages.

In order to promote international exchanges in the field of ophthalmology and enable domestic doctors to read excellent overseas monographs on ophthalmology, the editorial department of the Overseas Excellent Medical Monographs Introduction Project of China International Medical Exchange Foundation organized and published the book "Pathogenesis and Treatment of Ophthalmic Diseases" in August 2012.