Volume 49 · Issue 10 · 2013

In the past twenty years,with the rapid development of dry eye research in China,significant progresses have been achieved and there has been a remarkable improvement in diagnostic rate and clinical outcomes.Publication and popularization of the clinical diagnosis and treatment recommendations for dry eye from consensus of expert advice provides criteria for clinical work of dry eye.There has still been a significant gap between our research and world's advanced level in dry eye,therefore clinical investigations of high level will be intensively promoted to reveal the epidemiologic and clinical characteristics of dry eye populations in China,and establish the diagnostic criteria for Chinese patients,develop the clinical research on dry eye drugs and home-made clinical devices.Based on evidence-based research evidences,criteria for diagnosis and treatment of dry eye will be established and the clinical investigation of dry eye will be developed to reach the world's advanced level. (Chin J Ophthalmol,2013,49:865-868)

Mitomycin C (MMC),as it could reduce tissue adhesions and scar formation,has been widely adopted in pterygium surgery to lower the recurrence rate.Upon a certain therapeutic effect obtained,a variety of ocular complications was combined and always occupies a quite long time after MMC application.once occurred,it was tough to cure.Compared to autologous limbalconjunctival grafts,MMC has no apparent advantage to reduce reoccurrence of pterygium.Therefore,it is advised to abandon the use of MMC in pterygium surgery. (Chin J Ophthalmol,2013,49:869-872)

To investigate the relationship between glaucoma and Moscow Eye Microsurgery Complex (Moroz) keratoprosthesis.

Analysis and retrospective review of consecutive clinical case series.A total of 90 patients had a Moroz keratoprosthesis implantation between Apr,2000 and Jun,2011 at our hospital.Fifteen eyes of 15 patients were included in this research.Twelve eyes were identified glaucoma before Moroz keratoprosthesis surgery,and 3 eyes developed glaucoma afterward.Intraocular pressure (IOP),best-corrected visual acuity (BCVA),and treatment of glaucoma were recorded at 1 to 3 months after the Moroz keratoprosthesis implantation.

Moroz keratoprosthesis surgery improved vision dramatically in the majority of patients in our study.The most common preoperative corneal diagnosis was alkali burn (8 eyes,53.3%),which maybe the risk factor of secondary glaucoma after keratoprosthesis surgery.Five of these 15 patients received cyclocryotherapy after the surgery to control elevated IOP.BCVA decreased from 0.8 to 0.2,0.25 to light perception,0.3 to 0.1,0.2 to hand movement,and 0.25 to counting fingers,respectively.

Moroz keratoprosthesis caused glaucoma in only a small number of patients.Visual field,optic nerve appearance and IOP were the main diagnostic modalities after Moroz keratoprosthesis implantation. (Chin J Ophthalmol,2013,49:873-877)

To summarize the clinical characteristics and the therapy effect of blepharitis patients in clinic.

Retrospective case series study.Four hundred and thirty-eight patients were diagnosed clinically as blepharitis in Beijing Tongren Hospital from Jan 2009 to Jul 2012.Analyzed the general states of health,case history,and the clinical manifestation,to summarize the clinical characteristics of blepharitis.The patients were clinically degree indexing and treated appropriately.After 1-2 courses of the treatment,the effect was analyzed.main outcome measures: manifestation of lid margin,corneal,conjunctiva,and the results of tear tests.

Four hundred and thirty-eight patients were recorded,from 3 to 84 years old,and the average was 40±18 years old.435 (99.3%) cases were suffered with double eyes.159 (26.3%) cases were males,and 279 (63.7%) cases were females.Children group had 41 cases (9.4%),which from 0 to 16 years old.Adult group (17-59 years) included 331cases,which were 75.6% in the study.66 cases were in aged group (≥60 years),being 15.0% in all cases.176 cases (40.2%) were on mild stage,174 cases (39.7%) on middle stage,and 88 cases (20.1%) were on serious stage.Aged group were significantly more than children group (χ²=34.575,P<0.05).No significant difference between male

To evaluate the clinical results of deep anterior lamellar keratoplasty (DALK) assisted by big bubble techniquein the treatment of deep infectious purulent keratitis.

Seventeen patients (17 eyes) with deep infectious purulent keratitis received DALK surgery in Shandong Eye Hospital from January 2011 to March 2012.Case selection:Patients with purulent keratitis,the infection or infiltrate depth was more than four fifth corneal thickness; Surgical technique:Use DALK assisted by big bubble technique to cut off the lesions and expose the Descemet' s membrane.The prepared donor which stored in D-X medium or in glycerine preoperatively was oversized by 0.25 mm,and after stripping of Descemet's membrane,the donor button was interrupted sutured with 10-0 nylon suture.The perioperative complications,recurrence,graft status and visual recovery were evaluated.

The mean follow up time were 9 months.17 patients with average age of (46±13) year old received DALK surgery,including 14 cases of fungal keratitis and 3 cases of bacteria keratitis.Perioperative complications: Two cases suffered micro perforation and were continuing performed DALK surgery after injecting air bubble in the anterior chamber.Three cases suffered double anterior chamber,one was resolved after graft resuture,and the other two were absorbed automatically.One patient suffered fungal recurrence and cured with secondary penetrating keratoplasty.Graft status: All grafts attached closely to the recipients,slit lamp and AS-OCT examinations were difficult to distinguish the interface.All of grafts were transparent.Visual acuity: before the operation best corrected visual acuity (BCVA) in patients with HM/20 cm to 3.7,after the

To investigate the feasibility and clinical efficacy of corneal collagen crosslinking (CXL) for the treatment of infectious keratitis.

Noncomparative interventional case series.19 patients with infectious keratitis admitted to our hospital between November 2011 and January 2012 were recruited into this study,CXL was performed when medications combined proved poor therapeuticeffects.Postoperatively,the graft status,graft clarity,the visual prognosis and postoperative complications were recorded.

In 15 cases,there was improvement in symptoms one week after operation.3 cases remained stable,while 1 case reported deteriorated function at the same time.One month after operation,Corneal melting was arrested and complete epithelialization was achieved in 13 cases,5 cases experienced significant improvement and 1 patient experienced corneal ulcer perforation.2 month after surgery,patients with healed corneal ulcer increased to 17cases,and 2 cases experienced corneal ulcer perforation.Those 17 cases with healed corneal ulcer were followed up for 6 months,15 cases had significant improvement in best-corrected visual acuity,2 cases had no significant change,and no relapse was observed in those 17 cases.

Our experience based on the above and other cases suggest that CXL could be an effective tool in battling difficult cases of infectious keratitis.This treatment could present many advantages but will need further investigation both by in vitro and in vivo studies. (Chin J Ophthalmol,2013,49:890-895)

To evaluate the efficacy and safety of riboflavin-ultraviolet-A (UV-A) -induced corneal collagen cross-linking (CXL) in the management of progressive keratoconus.

It was a retrospective case series study.Twenty-three eyes of 13 patients with progressive keratoconus were included.Corneal collagen crosslinking was performed under topical anesthesia including corneal deepithelization (8 mm diameter) and instillation of 0.1% riboflavin (in 20% dextran T500 solution) every 3 minutes for a total of 30 minutes.The irradiation is performed for another 30 min using a solid-state UV-A illuminator at 370 nm and an irradiance of 3 mW/cm².Average follow-up was 15.23±3.39 months (range:12 to 22 months).Visual acuity,corneal topography,in vivo confocal microscopy,and endothelial cell count were evaluated at baseline and at 1,3,6,and 12 months follow-up.

Mean uncorrected visual acuity (UCVA) and best spectacle-corrected visual acuity (BSCVA) increased 0.115±0.158 LogMAR (t=3.418,P=0.0026) and 0.114±0.218 LogMAR (t=2.441,P=0.0236) 12 months postoperatively respectively.Interim analysis of treated eyes showed a flattening of the steepest simulated keratometry value (K-max) and astigmatism by an average of (1.893±3.713) diopters (D) (t=2.391,P=0.0262) and (0.117±1.488) D (t=0.370,P=0.715) respectively at 12 months.Central corneal thickness decreased by (27.5±26.8) μm (t=4.812,P=0.000) and (1.54±19.4) μm (t=0.147,P=0.885) at one month and 12 months postoperatively respectively.Intraocular pressure,endothelial cell count,lens and fundus didn't change significantly at 12 months follow-up.

CXL stabilised and improved the UCVA and BSCVA as well as the maximum k-readings at 1 year postoperatively in our cohort.It seems to be a safe and promising procedure to stop the progression of keratoconus. (Chin J Ophthalmol,2013,49:896-901)

To explore a method of primary culturing human adenoid cystic carcinoma cells of lacrimal gland.

Experiment research.Tumor tissue was obtained from the surgical material of a patient diagnosed as lacrimal adenoid cystic carcinoma in Tianjin Medical University Eye Hospital during May 16th to June 1st.We gained primary cells via tissue culture techniques.Mixed cells were removed through several ways.Observed cell morphological characteristics by phase contrast microscope,scanning electron microscope and transmission electron microscope.Cyto-immunochemical staining was applied to detect the expressions of vimentin,desmin,S-100,cytokeratin,pan and CD34.Their expressions were also detected in the tumor tissue except CD34.Made cell growth curve and calculated cell doubling time.

The outgrowth of cells was observed by day 5 after seeding tissues,and then cells generated slowly.The first passage proceeded by day 32,and the classical epithelioid cell colonies was observed by day 69 after inoculation.Purified cells of human lacrimal adenoid cystic carcinoma were obtained after the removal of mixed cells through several ways,which have been successfully subcultured for more than 100 passages.The 25th passage LACC cells appeared to be typically epithelioid cells,they showed contact inhibition as the density high enough.SEM and TEM showed the 25th passage LACC cells were malignant tumor cells poorly differentiated.They showed positive reaction with vimentin、cytokeratin (pan) as well as S-100,but negative reaction with desmin and CD34,which were consistent with the tumor tissue.The cell growth curve turned like a sigmoid one,and the cell doubling time was 37.1 h.

We gained

This study was to evaluate clinical results of two types soft one-piece keratoprosthesis (KPros) made of PHEMA implanted to alkali burned rabbit corneas.

Experimental study.Twelve pieces KPros were implanted alkali burned rabbit corneas (typeⅠandⅡ,6 pieces respectively).The examinations including slit-lamp,fundus photography,B-ultrasound and ultrasound biomicroscope (UBM) were carried out.

All Kpros were stable and no complications happened including conjunctiva flap dehiscence,aqueous leak and infection.IOP were normal by finger touch.B-ultrasound show no retina detachment and UBM show synechia in most animals (10 case).Retroprosthetic membrane happened in typeⅠ (3 case).Visible conjunctiva hyperplasia covering the optical region happened in all KPros.

(1) The same material,integrated design,maybe eliminating the material interface problem. (2) Simple surgical skills. (3) IOP measurement is possible because of soft material. (4) KPro I do not need removal of the lens and vitrectomy.The projecting portion of KProⅡmay reduce the incidence of proliferative membrane.Long term effects need more cases and further observation. (Chin J Ophthalmol,2013,49:909-913)

To investigate the role of B7-H3 in the immune reaction of corneal transplantation in mice

Experimental study.Thirty Corneas of C57BL/6 mice were orthotopically transplanted into the eyes of BALB/c mice,and graft survival was assessed on the basis of Sonoda's standard.When the RI grade was≥2,rejection was acknowledged and brought into the rejected group (R),and the others into the accepted group (A) ;8 BALB/c Corneas into their own eyes belonged to isografts (I) ; In addition,8 normal BALB/c mice were the control group (C).At last,three eyes in each group (C,I,A,R groups) were used for HE staining and IHC of B7-H3,and there were five eyes in each group for qPCR to detect B7-H3 mRNA expression.Repeated-measures analysis of variance (factorial analysis) followed by LSD test were used for post hoc analysis for expression differences of B7-H3 mRNA between groups.

There were 9 accepted grafts and 21

To investigate the preventive and therapeutic effects of agent calcium dobesilate (CDO) with different doses on the galactose cataract of rats.

We chose fifty Wistar rats at 20-day old.Then,they were divided into 3 groups at random.Choose 10 rats as the control group and gave normal diet;10 rats as the model group and fed with Gal solution ( drink

Bacteria adherent on the active or inactive surface can form biofilms in which they are encased in a hydrated matrix of extracellular polymeric substances,which is so called bacterial biofilm (BBF).BBF has greater virulence and drug resistance,they can also evade the host immune system and lead to immune injury compared with planktonic bacteria.Many common medical infections involving ophthalmic infection are biofilm-associated.In this paper,the concept and biological characteristics of BBF and BBF-related ophthalmic infection were reviewed. (Chin J Ophthalmol,2013,49:947-950)

Infectious keratitis remains a severe ocular condition that can lead to irreversible complications and even blindness.An early diagnosis of an infective microorganism leading to effective treatment may improve the outcome of infectious keratitis.However,the accurate and rapid identification of the infectious agent remains a challenge for the ophthalmologist.In vivo confocal microscopy (IVCM) is a noninvasive imaging technique that provides high-resolution images of ocular surface structures at a cellular level and infectious keratitis represents one of its most important clinical uses.The value of IVCM has been demonstrated in the diagnosis of acanthamoeba and filamentous fungal keratitis.The follow-up of such corneal infections may also be improved by this noninvasive imaging technique.However,the current resolution of IVCM limits its use in cases of bacterial and viral keratitis. (Chin J Ophthalmol,2013,49:951-955)

Optic neuritis is an inflammatory disease of the optic nerve with an abrupt loss of vision.The mechanism of the disease is not completely clear.Autophagy is an important metabolic pathway of eukaryotic cells involved degrading and recycling damaged organelles and proteins to maintain intracellular homeostasis.It is involved in the pathogenesis of various diseases.In this article,the probable effects of autophagy in the mechanism of optic neuritis is reviewed. (Chin J Ophthalmol,2013,49:956-959)