Volume 43 ·  Issue 01 ·  2007

On behalf of the editorial board of Chinese Journal of Ophthalmology, I would like to extend my warm congratulations to our fellow ophthalmologists in China. I would like to express my sincere gratitude to the authors, readers, editors who have worked hard for this journal, as well as to all people and groups at home and abroad who support and care about this journal.

flip open<The first issue of Chinese Journal of Ophthalmology, with its traditional font and yellowing paper, can not help arouse our reverence for this journal, which is almost the same age as New China and has witnessed the development of ophthalmology in China for nearly 60 years.

The application basic research of ocular surface diseases in our country mainly focuses on the localization, cell markers and in vitro culture of limbal stem cells, followed by the histobiological characteristics and biological functions of amniotic membrane and the screening of stem cells and goblet cell culture carriers. However, there are many clinical studies, especially in ocular surface reconstruction surgery, which has achieved good curative effect and has been widely used in clinical practice. However, at present, the application basic research in our country is still mainly follow-up research, lacking the research results with strong original and deep academic influence at international level. However, clinical surgery lacks perfect and relatively unified standards, the evaluation of ocular surface damage degree and curative effect is not scientific and complete, the clinical application of amniotic membrane lacks strict control of indications, and there is no uniform technical standard for the sampling of amniotic membrane. In addition, the diagnosis and treatment of dry eye syndrome in our country also faces many serious problems. In view of the analysis of the above existing problems, this paper puts forward a series of suggestions and strategies in the future.

The prevalence of glaucoma is about 1% ~2%, and the prevalence of glaucoma in myopic patients is 2~3 times that of normal people. It is estimated that in the next 20 years, hundreds of thousands of patients will develop glaucoma after excimer laser corneal refractive surgery worldwide. Most studies have shown that the thinning of central cornea and interlaminar cystoid syndrome after corneal refractive surgery reduce the measured value of intraocular pressure, and it is easy to miss the diagnosis of glaucoma. The application of glucocorticoid increases intraocular pressure in patients susceptible to hormone after operation. Therefore, refractive surgeons should pay attention to the long-term follow-up and monitoring of patients after excimer laser refractive corneal surgery.

Objective to investigate the incidence of dry eye syndrome in cataract patients after surgery. Methods 37 cases (50 eyes) of cataract patients were examined 3 days before surgery, 1 week, 1 and 3 months after surgery. The examination items included: ocular surface observation with slit lamp microscope, fluorescein staining of cornea and conjunctiva, tear film rupture time (BUT), Schirmer Ⅰ test (ST Ⅰ) and conjunctival imprint cytology (IC). The effect of dry eye syndrome on quality of life was evaluated by ocular surface disease index questionnaire, and 25 modified National Institute of Ophthalmology visual function questionnaires were used to understand the ocular condition, daily life and overall visual function of patients. Results the visual function of cataract patients was good after cataract surgery, BUT some patients had intractable dry eye symptoms after surgery. After cataract surgery, the tear river line was narrowed, BUT was shortened, ST Ⅰ decreased, and fluorescein staining of cornea and conjunctiva was aggravated. This phenomenon could appear 1 week after surgery, and reached the most obvious state at 1 month after surgery. Some patients' symptoms can recover to a certain extent at 3 months after surgery. IC examination showed that the density of goblet cells in conjunctiva was significantly lower after surgery than before surgery. Conclusion Patients may have obvious symptoms and signs of dry eye after cataract surgery, so timely intervention and treatment should be given.

Objective to investigate the clinical effect of upper palpebral papillectomy, cryoplasty combined with amniotic membrane transplantation in the treatment of vernal keratoconjunctivitis with huge papillas.Methods Eight patients (16 eyes) with vernal keratoconjunctivitis characterized by huge upper palpebral conjunctival papillas were treated with the method of upper palpebral conjunctival papillectomy, freezing the upper palpebral conjunctival surface at-70℃, and transplanting a single layer of amniotic membrane on the upper palpebral surface.The patients were followed up for 3~22 months, and the changes of symptoms, signs and complications were observed. Results Within 1 week after operation, the shield corneal ulcer and patchy coloration of corneal epithelial spots all healed, and there was no recurrence during the follow-up.Fourteen eyes were cured, and the symptoms of eye irritation basically disappeared 1 month after surgery. The huge papilla did not recurrence, no complications such as entropion or trichiasis appeared, but the vascular texture of the upper palpebral conjunctiva was unclear, and there were a few scars. One eye improved after drug treatment; Amniotic membrane transplantation with 5-fluorouracil cotton pad infiltrated the upper eyelid in the other eye was performed again. After 9 months follow-up, there was no recurrence. Conclusion Excision and cryotransplantation combined with amniotic membrane transplantation may be a safe and effective method for the treatment of refractory spring keratoconjunctivitis with huge nipple, but the indication should be strictly selected.

Objective to establish an animal model of dry eye disease with main lacrimal gland removal, and to investigate the relationship between the expression of apoptosis-related genes in ocular surface tissue and ocular surface dry degeneration and tissue damage.Methods Twenty healthy adult Wistar rats were randomly divided into experimental group and normal control group, 10 rats in each group, and 10 animal model rats with main lacrimal gland removal (experimental group) were made. Schirmer Ⅰ test, tear film rupture time and corneal epithelial fluorescein staining were performed before and at 3 days, 1, 2, 4 and 8 weeks after operation; The expression of Bax and Bcl-2 in corneal, conjunctival epithelial cells and meibomian gland acinar cells of 10 model mice and 10 normal control mice was detected by immunohistochemistry.Results the Schirmer Ⅰ test and tear film rupture time in the experimental group were significantly shorter than that before operation from 1 to 2 weeks after operation, and shorter with the prolongation of observation time (P<0.05). The corneal epithelial fluorescein staining experiment showed positive results. The number of Bax positive expression cells in corneal, conjunctival epithelial and meibomian gland acinar cells in the experimental group [503.47±343.73], (586.36±296.47) and (436.61±246.96) per 1000 cells] were significantly higher than those in the control group [241.71±130.12), (311.03±142.33) and (202.16±109.29) per 1000 cells] (P<0.05); The number of Bcl-2 positive cells (237.32±87.07), (236.07±81.24), (251.79±89.93) per 1000 cells) was significantly lower than that of the control group (474.24±167.62), (342.81±114.57), (320.42±153.32) per 1000 cells) (all P<0.05). Conclusion Apoptosis occurred in the acinar cells of cornea, conjunctiva epithelium and meibomian gland in dry eye rats with main lacrimal gland removed. Apoptosis may be one of the causes of ocular surface damage in dry eye rats.

Objective to investigate the curative effect of excimer laser subepithelial keratomileusis (LASEK) with 5% hypertonic saline in the treatment of moderate and low myopia. Methods 48 patients (96 eyes) with moderate and low myopia who underwent LASEK in our ophthalmology department from January to November 2005 were collected and divided into two groups. The first group was 22 cases (44 eyes). Epithelial flaps were made with 20% ethanol (A-LASEK) during operation; In the second group of 26 patients (52 eyes), epithelial flaps were made with 5% hypertonic saline (HS-LASEK) during operation. The repair time of corneal epithelium, visual acuity, diopter and nebulous opacity under corneal epithelium were observed after operation. The follow-up time was 6 months. Results There were no serious complications in all patients during and after operation. The mean epithelial repair time was (4.52±0.21) d in patients with A-LASEK and (3.84±0.39) d in patients with HS-LASEK, and the difference between the two groups was statistically significant (P<0.05). After removing contact lens, the visual acuity of the two groups was significantly improved compared with that before operation. The visual acuity reached 0.8 in 12 eyes (27.3%) in A-LASEK group and 25 eyes (48.1%) in HS-LASEK group at 3 days after operation, and the difference was statistically significant (P<0.05). After 1 month after operation, 13 eyes (29.5%) in patients with A-LASEK and 15 eyes (28.8%) in patients with HS-LASEK showed nebulous opacity under corneal epithelium, but all of them were lower than 0.5, which did not affect the visual acuity of patients. Only 6 eyes (11.5%) of HS-LASEK patients had obvious pain, and the difference between the two groups was statistically significant (P<0.05). Conclusion LASEK with hypertonic saline is safe and effective in the treatment of moderate and low myopia, and is superior to LASEK with ethanol in relieving postoperative pain and nebulous opacity under corneal epithelium.

Objective to investigate the clinical characteristics, diagnosis and treatment of bilateral occult binocular superior oblique muscle paralytic strabismus. Methods The clinical data of 7 patients with bilateral occult binocular superior oblique muscle paralytic strabismus who underwent surgical treatment from January 1999 to December 2003 were retrospectively analyzed. The changes of compensatory head position, vertical deviation degree in original position, function of superior and inferior oblique muscles before and after surgery were observed. Results All the patients were diagnosed with unilateral superior oblique paralytic strabismus with their heads tilted towards the healthy shoulder at the first visit △ (6 △ ～30 △ ), the degree of hyperfunction of inferior oblique muscle was +2~ +4, the degree of insufficiency of superior oblique muscle was-1 or-2, and there was no obvious abnormality in the function of contralateral superior and inferior oblique muscle. In the first operation, 2 patients selected simple inferior oblique muscle attenuation, 5 patients selected anterior transposition of inferior oblique muscle combined with ipsilateral superior rectus muscle recession, The postoperative mean in-situ upper strabismus was 12.0 △ (0 △ ～20 △ All patients had different degrees of superior oblique paralysis in the contralateral eye from 1 week to 4 years after surgery. The degree of inferior oblique hyperfunction was +2 or +3, and the degree of superior oblique insufficiency was 0 or-1. All patients underwent the second surgery within 4 months to 4 years after the first surgery, and the average degree of superior strabismus was 2.3 △ (0 △ ～7 △ Conclusion Bilateral occult binocular superior oblique paralytic strabismus is difficult to diagnose before the first operation. For patients with unilateral superior oblique paralytic strabismus, the possibility of superior oblique paralysis in the contralateral eye should be considered before operation. Inferior oblique muscle weakening surgery and vertical muscle recession surgery should be performed in stages. When the occult paralytic symptom of contralateral eye is obvious after the first operation, the second corrective surgery should be considered.

Objective to investigate the clinical and laboratory characteristics of fungal corneal ulcer of Alternaria mutilata. Methods the clinical manifestations of fungal corneal ulcer were observed under slit lamp microscope, and the corneal scraping was examined with 10% KOH wet sheet and Giemsa staining microscope. The fungal hyphae positive were cultured and identified, and in vitro drug susceptibility test was performed according to the M38-A protocol of National Committee for Standardization of Clinical Laboratories (NCCLS). At the same time, the patients were treated with amphotericin B, ketoconazole and fluconazole eye drops, and the curative effect of antifungal drugs was observed. The rabbit fungal corneal ulcer model was made from the isolated Alternaria mutilata strain, and the rabbits were sacrificed after 5 days and 14 days, and the corneas were taken for fungal culture and histological examination. Results All patients with Alternaria mutilata keratitis were monocular, and the corneal ulcer foci of both patients and rabbit models were shallow, pale gray, with blurred borders. Straight and thick colorless septal hyphae were seen on the corneal scraping under microscope, A large number of spherical chlamydospores were located at the apex of the hypha.In the isolation medium, the mycelium of this fungus was brown,and the dark brown spore chains separated by brick walls were born at the apex of the brown conidial stalk.In vitro drug sensitivity test showed that this fungus was sensitive to amphotericin B, ketoconazole, fluconazole, voriconazole, miconazole, econazole and terbinafine,and resistant to clotrimazole,flucytosine and itraconazole.Except one case was cured by surgery, the other 22 cases were cured by amphotericin B, ketoconazole and fluconazole combined with frequent eye drops, with an average cure time of 34 days.Conclusion Alternaria interstitialis fungal corneal ulcer has unique clinical and laboratory characteristics, low virulence to cornea, and can be completely cured by combination of antifungal drugs with eye drops.

Objective to investigate the significance of ultrasound, CT and MRI in the diagnosis of carotid cavernous sinus fistula. Methods 58 cases of carotid cavernous sinus fistula with complete clinical data from 1997 to 2004 were retrospectively analyzed. The results of B-ultrasound, color Doppler ultrasound, CT and MRI were observed in detail, and the imaging manifestations of carotid cavernous sinus fistula were summarized for diagnosis. Results The imaging manifestations of carotid cavernous sinus fistula mainly included superior ophthalmic vein dilatation, cavernous sinus enlargement, exophthalmos and extraocular muscle thickening. Superior ophthalmic vein dilatation was the most specific imaging sign of carotid cavernous sinus fistula. Color Doppler findings in 49 cases showed that the superior ophthalmic vein was filled with arterialized blood flow in reverse direction; CT examination revealed 58 cases, which showed that the dilated superior ophthalmic vein showed a fusiform shadow from the anterior inner to the posterior outer; MRI examination revealed 58 cases of superior ophthalmic vein dilatation, and the signal characteristic was empty vessel shadow without signal at both T1WI and T2WI, and cavernous sinus enlargement was another specific sign, respectively: CT examination revealed 41 cases of enlarged cavernous sinus showed high density shadow; 37 cases of cavernous sinus enlargement were found by MRI, showing empty and no signal shadows on both T1WI and T2WI. Conclusion Carotid cavernous fistula has unique imaging features, which can be clearly demonstrated by B-ultrasound, color Doppler, CT and MRI, and it is important for the clinical diagnosis and differential diagnosis of carotid cavernous fistula.

Objective to investigate the expression of glucocorticoid receptor (GR) α and β mRNA in orbital tissue of patients with thyroid-related ophthalmopathy (TAO). Methods Extraocular muscle and/or orbital adipose tissue samples were taken from 17 patients with severe TAO who underwent surgical treatment in our department and 10 healthy adults who died unexpectedly as controls. Total RNA was extracted from extraocular muscle and orbital adipose tissue, and RNA was reverse transcribed into cDNA. The whole PCR amplification process of GR α and GR β was detected by fluorescence quantitative polymerase chain reaction (PCR) method in real time, and the expression levels of GR α and GR β mRNA were calculated in each sample. Results GR α and GR β mRNA were expressed in extraocular muscle and orbital adipose tissue. The expression level of GR α mRNA was (40.15±11.37) copies/μ L in TAO patients and (20.64±7.07) copies/μ L in normal controls. The ratio of GR α mRNA expression to GR β mRNA expression (GR α/GR β ratio) was 77.76±18.77 in TAO patients and 148.34±23.86 in normal controls, and the difference was statistically significant (P<0.05). There was no statistically significant difference in the expression level of GR α mRNA and the ratio of GR α/GR β between extraocular muscle and orbital adipose tissue, between patients with normal, hyperthyroid and hypothyroid function, and between patients treated with glucocorticoids and those without glucocorticoids (P>0.05). Conclusion The expression of GR α mRNA in orbital tissue of TAO patients was enhanced; The decrease of GR α/GR β ratio may play a role in the pathogenesis of TAO and the therapeutic response of glucocorticoids.

Objective to investigate the transcription and expression of erythropoietin (EPO) in human retinal pigment epithelium (RPE) cells induced by different concentrations of hydrogen peroxide and to explore the mechanisms of its occurrence.Methods Human embryonic RPE cells were cultured in primary culture.After identifying, hydrogen peroxide at concentrations of 0, 200, 400, 600 and 800 μ mol/L for 6 h, respectively, caused different degrees of oxidative stress in RPE cells. Semi-quantitative RT-PCR was used to detect the expression of EPO at the transcriptional level in RPE cells during oxidative stress. The expression sites and changes of EPO in RPE cells were detected by immunohistochemistry. Results the content of SOD decreased and the content of MDA increased by hydrogen peroxide. The results of semi-quantitative RT-PCR showed that the expression of EPO mRNA increased by hydrogen peroxide and increased with the increase of hydrogen peroxide concentration in a certain range. The expression of EPO mRNA reached the highest value in the 600 μ mol/L hydrogen peroxide group, and then decreased with the increase of the concentration. The results of immunohistochemical staining showed that hydrogen peroxide could induce the expression of EPO in human RPE cells, and it increased with the increase of hydrogen peroxide concentration in a certain range, and the expression of EPO reached the peak in the 600 μ mol/L hydrogen peroxide group. Conclusion The oxidative stress induced by hydrogen peroxide can induce the transcription and expression of EPO in human RPE cells, and the expression of EPO is related to the survival and tolerance of RPE.

Objective to investigate whether nuclear factor kappa B (NF-κ B) is involved in the regulation of the expression of platelet-derived growth factor A (PDGF-A) and PDGF-B in the retina of rats induced by interleukin-1 β. Methods 128 SD rats were randomly divided into 4 groups, the right eye was the experimental eye and the left eye was the normal control eye. The intravitreal inflammatory reaction was observed and scored by slit lamp microscopy 4 and 24 hours after injection, and the expression and changes of NF-κ B, PDGF-A and PDGF-B in the retina were detected by histopathology, immunohistochemistry and RT-PCR. Results The expression and changes of NF-κ B, PDGF-A and PDGF-B in the retina were detected by histopathology, immunohistochemistry and RT-PCR The expression of inflammatory cells and NF-κ B activation in group D were significantly lower than those in group B, and the expression of PDGF-A, PDGF-B protein and mRNA were also significantly lower than those in group B (P<0.05). The expression of PDGF-A in group B and group D was significantly higher than that of PDGF-B (P<0.05). Conclusion NF-κ B is involved in regulating the expression of PDGF-A and PDGF-B in rat retina induced by IL-1 β. Different isomers of PDGF-A and PDGF-B have different expressions in intraocular inflammatory response.

Mucin is a kind of highly glycosylated macromolecular glycoproteins.Ocular surface mucin is an important component in tear film and plays an important role in maintaining normal physiological function of ocular surface.The changes of structure and distribution of mucin run through the pathophysiology of various ocular surface lesions.The study of ocular surface mucin is of great significance in exploring the pathogenesis of ocular surface diseases,guiding the diagnosis and treatment of diseases.

congenital cranial dysinnervation disorders (CCDDs) are congenital, non-progressive sporadic or familial cranial neuromuscular diseases, which are caused by abnormal or complete absence of one or more cranial nerves, resulting in primary or secondary abnormal innervation of muscles. They can be manifested as abnormal vertical ocular movement, abnormal horizontal ocular movement and facial paralysis. In the past, these diseases are often called congenital fibrosis syndrome. Recent neuropathological, neuroimaging and molecular genetic studies have shown that these diseases are caused by abnormal development of cranial nerve nucleus and/or cranial nerve in brainstem.

At the beginning of 2007, this journal conducted statistics and analysis on the submissions and published articles in 2006. Now, the ranking of the top ten units in the number of submissions received and the number of published articles in Chinese Journal of Ophthalmology in 2006 is published separately, which not only encourages and commends the achievements made by these units in 2006, but also hopes that new units will emerge in the top ten ranking in 2007.

The book "Testing Methods and Clinical Application Atlas of Roland Visual Electrophysiology Instrument", edited by Professor Wu Dezheng, a visual electrophysiology expert at Sun Yat-sen Ophthalmology Center of Sun Yat-sen University, and Dr. Liu Yan of Beijing Tongren Ophthalmology Center, has been published by Beijing Science and Technology Press. The book elaborates on the clinical application of visual electrophysiology through electrophysiological graphics, fundus pictures, etc., and covers many diseases related to visual electrophysiology in clinic; The selection of stimulation parameters, recording conditions, result analysis and printing methods of various test items (including full-field electroretinogram, multifocal electroretinogram, visual evoked potential and electrooculogram, etc.) of Roland visual electrophysiology instrument were introduced.

In order to improve the writing level of medical papers, especially English medical papers, the Chinese Medical Journal (English version) will hold a "National Medical Paper Writing Seminar" in Beijing in May 2007. The seminar will invite well-known epidemiologists and statisticians in China to teach scientific research topic selection, scientific research design and statistics related knowledge. The president, editor-in-chief and editorial director of Chinese Medical Association magazine will teach the writing skills of various parts of medical papers, ethical issues in paper writing, copyright knowledge, problems of multiple submissions, repeated publications and secondary publications, application of charts, matters for attention in submitting to English journals, writing English abstracts and matters for attention in writing English medical papers, etc. The latest details of the workshop are available at www.cmj.org.

In order to promote the sci-tech journals sponsored by China Association for Science and Technology and its affiliated national societies to better serve the independent innovation of science and technology, strengthen the academic exchange function, promote the implementation of the strategy of high-quality sci-tech journals, improve the core competitiveness of sci-tech journals, and improve the ability of national societies to serve the strategy of rejuvenating the country through science and education and strengthening the country through talents, China Association for Science and Technology organized the application and evaluation of the project funded by high-quality sci-tech journals in 2006. According to the preliminary and final results of the expert evaluation committee of the project, it was decided to grant project funding to 106 kinds of sci-tech journals. The number and amount of funded projects are: 5 items in Category A, each of which is 250,000 yuan; 40 category B projects, each with a subsidy of 150,000 yuan; 61 category C projects, each with a subsidy of 50,000 yuan.

Approved by China Association for Science and Technology and the Ministry of Science and Technology, the "7th International (Shanghai) Academic Conference on Ophthalmology and Optometry", co-sponsored by Ophthalmology Branch of Chinese Medical Association in six provinces and one city in East China, and co-sponsored by Eye, Ear, Nose and Throat Hospital affiliated to Fudan University, School of Optometry of Wenzhou Medical College and China International Science and Technology Conference Center, will be held at Shanghai Everbright Convention and Exhibition Center International Hotel (No.66 Caobao Road, Xuhui District, Shanghai) from April 12 to 15, 2007. Experts, scholars and well-known manufacturers in the fields of ophthalmology and optometry from the United States, European countries, South Korea, Japan, India and other countries in China will be invited to attend this conference.

Jointly sponsored by Beijing Tongren Ophthalmology Center of Capital Medical University and Chinese Journal of Ophthalmology, and co-organized by Department of Ophthalmology of Mianyang Central Hospital of Sichuan Province, the National Symposium and Study Class on the Progress of Ophthalmoplastic Surgery will be held in Mianyang, Sichuan Province from April 25 to 29, 2007. This class will give special lectures by well-known experts with rich clinical experience in eye plastic surgery, including congenital deformities and defects, such as ptosis, small palpebral fissure, no eyeball, orbital bone development deformity, etc. Ocular tissue defects and morphological deformities caused by trauma, such as orbital fracture, canthal angle displacement, orbital depression, symblepharon, etc.; Eyelid defect repair and eye cosmetics after ocular tumor resection, such as double eyelid, eyelid bag, eyelid skin laxity correction, eyebrow ptosis correction, etc. 80% of the seminar and study classes have surgical video demonstrations and surgical observations. The content learned is easy to learn and use. All trainees receive CME credits at the national level.

Professor Yan Shaoming, an expert in stereoscopic vision examination in China and the Department of Ophthalmology of Naval General Hospital, newly developed "Digital Stereoscopic Vision Examination Chart" by applying random points and high-tech image processing technology has been published by People's Medical Publishing House. After the upgrading of image processing technology, the book significantly improves the fidelity, accuracy, clarity and color degree of image quality, and is more advanced and innovative; At the same time, due to the adoption of the drawing board mode, the special base for placing the drawing board, and the synchronous upgrade of the matching red and blue glasses, the inspection method is more standardized and more operable. The examination chart consists of six kinds of charts, which can accurately measure stereoscopic acuity, crossover vision and non-crossover vision, diagnose stereoscopic blindness and check the overall stereoscopic function. It plays an important role in strengthening the clinical application of ophthalmology, spreading new knowledge and theory of stereoscopic vision, and promoting the standardization of stereoscopic vision examination methods.

In order to implement the policy of combining popularization and improvement, Chinese Journal of Ophthalmology will open a column of "Test Questions Analysis" in 2007 while reporting major clinical and basic achievements and progress at home and abroad, caring for the actual needs of the majority of ophthalmologists and strengthening the practicality of the journal. This column will invite authoritative ophthalmologists in China to make an accurate and in-depth analysis of all kinds of ophthalmology test questions. Readers are welcome to pay attention to this column, actively read, and put forward suggestions and opinions.

With the development and improvement of clinical diagnosis technology, the role of all kinds of ophthalmology clinical pictures in disease diagnosis has been paid more and more attention. In order to encourage clinical accumulation of relevant data, promote experience exchange, improve clinical diagnosis and treatment technology, provide a new platform for academic exchange for readers, and at the same time enrich the content and form of this journal to better serve the majority of ophthalmologists, Chinese Journal of Ophthalmology launched the "Picture Essence" column in 2007. The submitted pictures can be arranged according to the types of cases or diagnostic techniques, and related instructions can be attached to clarify the arrangement method of the pictures, the purpose, environment, method, technique and significance of shooting, etc. Pictures should highlight the characteristics of essence, and each picture should have a detailed text description.

Beijing Yingzhi Eye Hospital is an earlier private specialist hospital in China, bringing together a group of skilled ophthalmologists who have returned from study abroad; It has international advanced large-scale ophthalmological equipment and a diagnosis and treatment area of 4,000 square meters; It is one of the few private eye hospitals in Beijing that can perform various microsurgeries such as retinal detachment reduction surgery, vitrectomy surgery, phacoemulsification for cataract surgery, excimer laser for myopia and astigmatism, corneal transplantation surgery and anti-glaucoma surgery. The hospital has a rigorous medical style and a very humanized service concept. In January 2002, the institute passed ISO9001: 2000 version of international quality management system certification. Now it is a designated hospital of basic medical insurance in Beijing and a designated cooperative eye hospital of international emergency rescue company. Dozens of foreigners from embassies and trading companies in Beijing seek medical treatment in this hospital.

Recurrent cicatricial entropion is caused by cicatricial contraction of palpebral conjunctiva and meibomian plate, which is commonly seen in the clinical scar stage of trachoma, after chemical injury, after thermal burn and after various eyelid maloperations. On the one hand, recurrent cicatricial entropion seriously affects the appearance of patients, on the other hand, the friction of entropion trichiasis on the corneal surface can cause mechanical keratopathy, which needs surgical treatment [1]. If it is not corrected in time or improperly treated, it will lead to serious complications such as corneal neovascularization, corneal ulcer perforation, and even loss of vision [2]. From 2001 to 2004, we used allogeneic sclera to treat patients with recurrent cicatricial entropion caused by various causes, and the clinical follow-up observation results are good.

From March 2004 to January 2006, 38 cases (38 eyes) were treated with modified posterior chamber suture intraocular lens implantation. This surgical method not only avoided the disadvantages of the traditional internal approach needle holder into the eye, but also avoided many disadvantages of the external approach using long needle, so that the steps of leading, loops and suture embedding became simple and reliable. Those who needed primary implantation did not have to worry about not preparing the corresponding needle and thread in advance, and those who needed secondary implantation did not have to worry about the inconvenience caused by scar tissue on the sclera. Because it is especially suitable for implanting folded intraocular lens through corneal incision, even for patients whose intraocular lens was displaced repeatedly, it could be fixed to the ciliary sulcus without taking out the lens. This method is simple in operation, less invasive, reliable in fixation and good in effect.

Citrobacter fraudii is an opportunistic pathogenic bacterium, which exists in human and animal intestines. The infectious endophthalmitis caused by it is rare and the prognosis is extremely poor [1]. In June 2005, we treated a case of suppurative endophthalmitis caused by this bacterium, and the prognosis of the patient was good.

mucopolys accharidosis (MPS) is a hereditary disorder of mucopolys metabolism. Due to the congenital defects of mucopolys metabolizing enzymes in the body, the decomposition of mucopolys is impaired, resulting in a large amount of mucopolys accumulated in the connective tissue of the whole body. A child with MPS was diagnosed and treated in our hospital, and the report is as follows.

The patient was a 56-year-old female who came to our hospital on August 25, 2006 because she was found to have a non-pigmented mass in the conjunctiva of her left eye for 8 months, and felt mild redness, photophobia and lacrimation. The patient underwent pigmented nevus resection in the local hospital in 1997 because of conjunctival pigmented nevus. The specific treatment process and pathological results are unknown. The right eye failed to undergo surgical treatment due to retinal detachment, and had been blind for 20 years. The whole body examination: chest radiograph, blood routine, liver and kidney function, liver and kidney B-ultrasound and bone scan were all normal; Ocular examination showed that the right eye had no light sensation, the naked eye visual acuity of the left eye was 0.08, and the corrected visual acuity of the left eye was 0.3. A 6 mm ×10 mm fleshy red mass was seen at the marginal sclera of the inferior temporal angle of the left eye, with an irregular surface, uneven and lobulated, without pigment. The blood vessels were obviously dilated on the surface and around the mass (Figure 1), and there was no mass in the fornix and palpebral conjunctiva. The cornea was transparent, the anterior chamber, iris and lens were not abnormal, and the fundus was highly myopic.

The patient was a 76-year-old female who came to our hospital on May 25, 2005 due to the sudden decrease of visual acuity in her left eye for 5 days. The patient had a history of hypertension for more than ten years, and her blood pressure was stable under drug control. Ophthalmological examination showed that the visual acuity was 0.9 in the right eye and 0.06 in the left eye; Mild opacity of the peripheral cortex of both eyes; Fundus retinal arteries in both eyes were thin, with enhanced reflection, and arteriovenous cross impression was visible. Sub-circular preretinal hemorrhage about 6 PD in size was visible below the macular area of the left eye (Quintessence Picture 1). Fluorescein fundus angiography showed large preretinal hemorrhage in the macular area masking fluorescence (Quintessence Picture 2). Indocyanine green angiography showed low fluorescence through hemorrhage, and high fluorescence on the retinal artery wall in the bleeding area was visible (Quintessence Picture 3). Diagnosis: large retinal aneurysm in left eye; Retinal arteriosclerosis in both eyes.

allergic conjunctivitis is a group of conjunctival allergic diseases caused by external allergens, including seasonal allergic conjunctivitis (SAC), perennial allergic conjunctivitis (PAC), vernal catarrh keratoconjunctivitis (VKC), giant papillary conjunctivitis (GPC) and atopic keratoconjunctivitis (AKC).

Multiple-choice questions include single-choice questions and multiple-choice questions. Single-choice questions have only one standard answer, mainly including A-type questions and B-type questions. Multiple-choice questions, namely X-type questions, have two or more answers. This issue introduces the most common form of A-type questions, namely single-sentence best-choice questions (A1-type questions). In single-sentence best-choice questions, each question consists of one question stem and five alternative answers to choose from. Only one of the alternative answers is the best choice, and the rest are interference options. Some questions have one special standard negative word (no, no, can't, except, except, wrong, irrelevant, etc.) in the question stem, and it is required to find one answer that meets the requirements of the question stem among the five alternative answers.

The 4th Academic Symposium on Excimer Laser Refractive Keratophysical Surgery of the Chinese Medical Association, sponsored by the Department of Continuing Education of the Chinese Medical Association, was held in Xiamen, Fujian Province from October 26 to 30, 2006. More than 300 refractive experts, scholars and doctors from home and abroad attended the conference. During the conference, 30 experts and scholars gave special lectures, covering related research in the field of eye refraction, involving the current cutting-edge academic progress. The meeting also awarded honorary awards to the top five doctors and technicians who achieved the employment certificate examination of excimer laser users in 2005. The conference adheres to the academic spirit of rigorous and realistic, and strives to be lively in content and form. The conference ended successfully in a warm and harmonious atmosphere.