2023年 · 第59卷第12期

Surgeon introduction Tian Bei, MD, chief physician, associate professor. Member of the Standing Committee of China Sports Rehabilitation Education College of Chinese Medical Association, Member of Sports Medicine Branch of Chinese Medical Association, Member of the Optometry Group of Ophthalmologist Branch of Chinese Medical Doctors Association, Member of the Standing Committee of Diabetes Professional Committee of China Geriatric Health Care Association, Member of Ophthalmology Professional Committee of China Medical Equipment Association, Member of Diabetic Ophthalmology Group of Diabetes Professional Committee of China Research Hospital Association. Vice Chairman of the 13th Health and Wellness Committee of China Democratic League, corresponding editorial board of Chinese Journal of Ophthalmology. Honorary Institute, Senior Visiting Scholar, Royal Murphy Eye Hospital, UK, and Member of Vitreoretinal Surgery Association, UK and Ireland. He has been engaged in the first-line clinical work of ophthalmology in Beijing Tongren Eye Center, Beijing Tongren Hospital affiliated to Capital Medical University for more than 20 years. He is good at vitreoretinal surgery, phacoemulsification cataract aspiration, fundus laser surgery, etc. So far, he has more than 10,000 surgical experiences.

The patient was a 32-year-old female. He went to Jinan Mingshui Eye Hospital because the vision under his right eye was occluded for 1 week. The patient had poor visual acuity in both eyes since childhood and was diagnosed with Marfon's syndrome in an external hospital 10 years ago, which was not treated. History of ocular trauma and surgery was denied, and other systemic medical history was denied. The patient's mother suffered from Marfon's syndrome and died of heart disease (details unknown). Full body examination: height 1.75 m, tall and lean body type, spider-like fingers (toes); Cardiac ultrasound Doppler examination revealed mitral valve prolapse with mild-moderate regurgitation, aortic widening with moderate regurgitation, and mild tricuspid valve regurgitation. Eye examination: both eyes were 0.1 for naked eyes and 0.3 for corrected eyes (right eye: -13.50 DS-5.50 DC x 135°; Left eye: -5.50 DS-3.50 DC x 10°); IOP was 14 mmHg (1 mmHg =0.133 kPa) in the right eye and 11 mmHg in the left eye; The conjunctiva of the right eye is not congested, the cornea is transparent, the anterior chamber is moderately deep, the aqueous humor is clear, the lens is displaced to the nasal side (12: 00 to 5: 30), the temporal lens is incomplete, the suspensory ligament of the lens is visible (A in the essence picture 1), the vitreous body is flocculous and opaque, the optic disc boundary is visible in the fundus, the color is normal, there are no obvious abnormalities in the arteries and venous large blood vessels, the retina is bulged from 10: 00 to 2: 00, the retinal hole is visible at about 12: 00, and the fovea is unclear; The conjunctiva of the left eye is not congested, the cornea is transparent, the anterior chamber is moderately deep, the aqueous humor is clear, the lens is displaced to the nasal side (6: 00 to 3: 00 orientation), the temporal lens is incomplete, the suspensory ligament of the lens is visible (B in the essence picture 1), the vitreous body is slightly opaque, the optic disc is visible in the fundus with clear boundaries and normal colors, there are no obvious abnormalities in the arteries and venous large blood vessels, and the fovea is unclear. Clinical diagnosis: Marfon's syndrome; Binocular lens subluxation with incomplete formation; Rhegmatogenous retinal detachment in right eye; Refractive error (anisometropia) in both eyes.

The patient was a 70-year-old male. Because of blurred vision in his left eye for more than 1 year, he went to the Department of Ophthalmology, Affiliated Hospital of Jining Medical College. Has a history of chronic bronchitis. Eye examination: left eye naked visual acuity of 0.04 (uncorrectable), accurate light localization, intraocular pressure of 21 mmHg (1 mmHg =0.133 kPa); The conjunctiva is not congested, the cornea is transparent, the central depth of the anterior chamber is acceptable, the peripheral depth is greater than 1 corneal thickness, the iris is clear in texture, the pupil is round, about 3 mm in diameter, the light response is normal, and the annular gray-white debris-like substance deposits can be seen on the pupil margin; Nuclear opacity of the lens, the nucleus is dark yellow, gray-white debris-like substance deposits can be seen on the anterior surface of the lens, an intermediate disk approximately consistent with the diameter of the pupil can be seen after dilatation of the pupil, and frost-white granular substance deposits can be seen on the anterior surface of the temporal and nasal peripheral lens (Quintessential Picture 1); The optic disc of the left eye is clearly bounded and pale in color. The diameter ratio of the optic cup to the optic disc is about 1.0. The retina is flat, and the macular area is scattered with drusen. Clinical diagnosis: Left eye pseudolens capsule exfoliation syndrome; Secondary glaucoma in left eye; Cataract in the left eye.

The patient was a 50-year-old female. Because the visual acuity of his left eye decreased for more than half a month, he went to Yichang Huaxia Eye Hospital. In 2008, he was injured by a stone in his left eye without surgery; In 2009, the left eye underwent lens dislocation and lens excision without intraocular lens implantation; In 2010, intraocular lens suspension with iris septum was performed in the left eye. Eye examination: visual acuity was 0.4 in the right eye and 30 cm manual in the left eye, which could not be corrected; The cornea of the left eye is transparent, the anterior chamber is medium-deep, the iris is atrophied, the pupil is dilated, the diameter is about 9.0 mm, the intraocular lens is disengaged into the vitreous cavity below the nose, the suspension line above the temporal is disengaged, and the vitreous body is mildly opaque; The optic disc is vaguely visible in the fundus, with clear boundaries and reddish color, flat retina, depigmentation of the peripheral retina, and occlusion of the inferior branch veins (essence pictures 1 and 2); The right eye examination showed no obvious abnormalities. Clinical diagnosis: dislocation of intraocular lens in left eye.