AIM:To analyze and summarize the clinical and pathological features of ciliary body medulloepithelioma.METHODS:The clinical and pathological data of 11 patients(11 eyes) who were diagnosed with ciliary body medulloepi...AIM:To analyze and summarize the clinical and pathological features of ciliary body medulloepithelioma.METHODS:The clinical and pathological data of 11 patients(11 eyes) who were diagnosed with ciliary body medulloepithelioma at Beijing Tongren Hospital,Capital Medical University,from 2007 to 2021 were retrospectively analyzed.RESULTS:The initial symptoms of 11 patients included vision loss(6 eyes),atrophia bulbi(1 eye),proptosis(2 eyes),and leukocoria(2 eyes).Most patients suffered with corneal opacity,anterior chamber flare and hyphema.Iris neovascularization and synechia,complicated cataract,and secondar y glaucoma occurred in several cases.Three patients even had lens subluxation and retinal detachment.B-scan ultrasonography showed vitreous opacity and a medium-high uneven echo mass in the eyeball.Ultrasound biomicroscopy examination showed a spherical or hemispherical ciliary body mass with uneven internal echoes and irregular cystic spaces.All of the 11 patients were diagnosed with malignant ciliary body medulloepithelioma by pathological evidence.In this study,6 patients had enucleation(2 patients had systemic chemotherapy after surgery),and the other 5 patients had local tumor resection(1 patient had plaque radiotherapy after surgery).CONCLUSION:Ciliary body medulloepithelioma is a rare intraocular tumor and may be easily confused with retinoblastoma.Analyzing the clinical and pathological features of ciliary body medulloepithelioma is useful to further understand ciliary body medulloepithelioma,and can make an accurate diagnosis and better treatment.展开更多
AIM:To explore the clinical and pathological characteristics of thirteen patients with orbital liposarcoma.METHODS:The clinical history data of thirteen patients diagnosed as orbital liposarcoma at Beijing Tongren Hos...AIM:To explore the clinical and pathological characteristics of thirteen patients with orbital liposarcoma.METHODS:The clinical history data of thirteen patients diagnosed as orbital liposarcoma at Beijing Tongren Hospital,from 2006 to 2021 were collected and analyzed.The data includes age,gender,affected orbital side,course of disease,status of disease(primary or recurrent),clinical manifestations,preoperative visual acuity,operative treatment,the relations between liposarcoma and surrounding tissue,longest diameter of liposarcoma,histological subtype,immunohistochemical indicators,follow-up treatment and prognosis.RESULTS:The initial symptoms are diverse.Proptosis is the most frequent chief complaint and the others included vision loss,epiphora,diplopia,and eyelid palpable mass.Results of imaging examination[computed tomography(CT)or magnetic resonance imaging(MRI)]showed orbital mass.In terms of treatment,10 patients received tumor resection,and the mean longest diameter of the tumor was 3.39±1.36 cm.The other 3 patients had optic nerve invaded,so they received orbital exenteration.Pathological examination results confirmed the diagnose of liposarcoma for 13 patients.Six patients displayed as myxoid type,and three patients in each type of dedifferentiated and welldifferentiated type.One patient was verified as pleomorphic,which was a rare type of liposarcoma.All of the patients showed Vimentin positive,and most showed CD34 and S-100 positive.Besides,four patients showed smooth muscle actin positive.All thirteen patients were alive.CONCLUSION:Orbital liposarcoma is a rare disease and it has no specific clinical manifestation.The diagnosis of liposarcoma should be considered when proptosis and orbital mass occurred in orbit.It is recommended to perform pathological examination to achieve early detection and early treatment.展开更多
Dear Editor,We present an exceptionally rare case about bilateral medulloepithelioma of the ciliary body.This case was approved by Ethics Committee of Capital Medical University.Written informed consent was obtained f...Dear Editor,We present an exceptionally rare case about bilateral medulloepithelioma of the ciliary body.This case was approved by Ethics Committee of Capital Medical University.Written informed consent was obtained from the patients.Discovering leukocoria in both eyes and proptosis in right eye for 2mo by parents in a 4.5-month-old boy.He had undergone no treatment elsewhere except magnetic resonance imaging examination before coming to Beijing Tongren Hospital.展开更多
目的:评价改良折叠式人工晶状体(IOL)悬吊治疗外伤性晶状体脱位的手术技术。方法:前瞻性随机对照研究。共15例患者接受了改良折叠式IOL悬吊手术。其中,9例患者选择了Akreos AO IOL,使用聚丙烯缝线穿过IOL的环状襻,经巩膜引导穿刺后,缝...目的:评价改良折叠式人工晶状体(IOL)悬吊治疗外伤性晶状体脱位的手术技术。方法:前瞻性随机对照研究。共15例患者接受了改良折叠式IOL悬吊手术。其中,9例患者选择了Akreos AO IOL,使用聚丙烯缝线穿过IOL的环状襻,经巩膜引导穿刺后,缝合线末端热膨胀固定在巩膜。6例患者选择了Tecnis ZA9003 IOL,未使用缝合线,巩膜穿刺引导IOL襻穿出巩膜后,直接将IOL襻末端热膨胀固定在巩膜内。观察所有患者的最佳矫正视力(BCVA,LogMAR)及术后并发症。结果:研究共纳入15例患者,其中男7例,女8例,平均年龄64.00±9.85岁,平均病程5.80±3.17wk。人口统计学和基线临床特征之间没有显著差异。接受改良折叠式IOL悬吊手术后,所有患者视力均有明显改善。术后3mo,患者的BCVA(LogMAR)从1.28±0.56改善至0.52±0.30。其中,选择Akreos AO IOL患者的BCVA(LogMAR)从1.39±0.62改善至0.59±0.25,选择Tecnis ZA9003 IOL患者的BCVA(LogMAR)从1.12±0.45改善至0.42±0.35。此外,在我们的研究中没有观察到严重的术后并发症。仅1例患者IOL脱位,IOL光学面轻度倾斜。结论:改良折叠式IOL悬吊手术具有良好的视觉效果和预后,无严重并发症,是IOL悬吊手术的有效选择。展开更多
AIM: To analyze whether wet-lab training(WLT) or surgical-simulator training(SST) is better for ophthalmology residents to master the chopping technique.METHODS: Sixty ophthalmology residents(in their second year) and...AIM: To analyze whether wet-lab training(WLT) or surgical-simulator training(SST) is better for ophthalmology residents to master the chopping technique.METHODS: Sixty ophthalmology residents(in their second year) and three cataract surgeons participated in the study. The residents were randomly separated into two groups, WLT group and SST group. The residents in WLT group were asked to perform 10 trials of chopping using pig eyes and scored by the surgeons, and then they performed and scored using simulator for one time. The residents in SST group underwent 10 trials of chopping using simulator, and the simulator scored each trail. Then, this group were asked to perform the chopping using pig eyes and scored by the surgeons. At last, we investigated the residents’ satisfaction about the training.RESULTS: The demographic characteristics had no significant differences between the two groups. Recorded by the simulator, the residents in SST group got significantly higher overall score(83.90±1.31) than WLT group(78.73±1.92, P=0.03). And the residents in SST group got less corner area injured, and they spend less time than WLT group(P<0.05). Moreover, the residents in WLT group used more ultrasonic energy value than SST group(P=0.03). However, scored by the surgeons, the residents in two groups got nearly the same overall score. The residents in WLT group performed better on the frequencies of posterior capsule torn and incisional stress(P=0.03, 0.008, respectively). In the survey, the residents in two groups held the same opinion that the training was helpful and they strongly recommended this training. And all of them enjoyed the training, and enjoyed being randomized in their own group. However, with respect to the realistic character, the residents thought that WLT was better than SST(P<0.001).CONCLUSION: Both of the Eyesi surgical-stimulator and the wet-lab improve the residents’ chopping ability and each has its own advantages. The combination of the two training ways could be considered to be a part of the training curriculum for new residents.展开更多
AIM:To observe the efficacy and safety of pars plana vitrectomy(PPV)with eye position guided fluid-air exchange(FAX)and air to mponade in the treatment of rhegmatogenous retinal detachment(RRD).METHODS:RRD patients wi...AIM:To observe the efficacy and safety of pars plana vitrectomy(PPV)with eye position guided fluid-air exchange(FAX)and air to mponade in the treatment of rhegmatogenous retinal detachment(RRD).METHODS:RRD patients without severe proliferative vitreoretinopathy(PVR)C1 or more were enrolled.All patients underwent PPV combining with air tamponade.During operation,the primary retinal break(s)were placed at lower site and subretinal fluid was aspirated through the break(s)at the same time when eye position guided FAX was proceeding.Sufficient laser spots were made to seal the retinal break(s)after FAX,and filtered air was left in vitreous cavity as to mponade agent finally.The main outcomes were primary and final success rates,best corrected visual acuity(BCVA),and the secondary outcomes were rate of postoperative cataract surgery and high intraocular pressure.RESULTS:A total of 37 eyes(20 males and 17 females)with a follow-up time of≥6 mo were included.The range of RRD was 5.6±1.8 h,and the number of retinal breaks was 1.9±1.2.The breaks located at inferior quadrants(between 3:00 and 9:00)in 5 cases(13.5%),and both superior and inferior breaks were found in 3 cases(8.1%).A total of 25 cases(67.6%)with macular detached involvement,9 cases(24.3%)with intraocular lens,and 8 patients(21.6%)were treated with phacoemulsification and intraocular lens implantation together.The success rate of primary retinal reattachment was 100%(37/37).At 6 mo postoperatively,BCVA(logMAR)was increased from 1.13±1.07 to 0.23±0.15(P<0.001).Phacoemulsification combined with intraocular lens implantation was performed in 2 patients(5.4%),and one of them underwent macular epiretinal membrane peeling in addition(2.7%).Furthermore,high intraocular pressure was found in 4 cases(10.8%).CONCLUSION:PPV with air tamponade by eye position guided FAX can achieve a high reattachment success rate in the management of patients with RRD,and it has the advantages of short postoperative prone time and fewer operative complications.展开更多
AIM:To investigate the effects of on ocular surface microbiota in patients who received intravitreal injections.METHODS:Samples of ocular surface microbiota were obtained from 41 eyes of 41 patients who visited the De...AIM:To investigate the effects of on ocular surface microbiota in patients who received intravitreal injections.METHODS:Samples of ocular surface microbiota were obtained from 41 eyes of 41 patients who visited the Department of Ophthalmology.Patients were separated for three groups.Group A did not receive perioperative managements or intravitreal injection.Group B1 received only once and B2 received more than twice.In operating room,the samples were collected on the ocular surface.Operating taxonomic units(OTUs) clustering and alpha/beta diversity analysis was performed.The microbial 16S rRNA from samples were analyzed using the Hi Seq 2500 platform.RESULTS:Alpha diversity did not differ in each group,and beta diversity differed in the B2 group.Beta diversity showed a significant difference between Group A and B2(P=0.048).With the perioperative managements before intravitreal injection,the composition and relative abundance were altered.Top 10 microbiota on phylum and genus level,and then microbiota notably changed at genus level were listed.Gram-negative bacteria were varied more.Furthermore,Proteus was not found in Groups A and B1,but it was appeared after the patients received perioperative management and intravitreal injections in Group B2.CONCLUSION:With the perioperative managements,the balance of microbiota on the ocular surface is destroyed,and relative composition and abundance of microbiota on the ocular surface is obviously altered.The clinical doctors should pay more attention on the consequence of perioperative managements before intravitreal injection.展开更多
文摘AIM:To analyze and summarize the clinical and pathological features of ciliary body medulloepithelioma.METHODS:The clinical and pathological data of 11 patients(11 eyes) who were diagnosed with ciliary body medulloepithelioma at Beijing Tongren Hospital,Capital Medical University,from 2007 to 2021 were retrospectively analyzed.RESULTS:The initial symptoms of 11 patients included vision loss(6 eyes),atrophia bulbi(1 eye),proptosis(2 eyes),and leukocoria(2 eyes).Most patients suffered with corneal opacity,anterior chamber flare and hyphema.Iris neovascularization and synechia,complicated cataract,and secondar y glaucoma occurred in several cases.Three patients even had lens subluxation and retinal detachment.B-scan ultrasonography showed vitreous opacity and a medium-high uneven echo mass in the eyeball.Ultrasound biomicroscopy examination showed a spherical or hemispherical ciliary body mass with uneven internal echoes and irregular cystic spaces.All of the 11 patients were diagnosed with malignant ciliary body medulloepithelioma by pathological evidence.In this study,6 patients had enucleation(2 patients had systemic chemotherapy after surgery),and the other 5 patients had local tumor resection(1 patient had plaque radiotherapy after surgery).CONCLUSION:Ciliary body medulloepithelioma is a rare intraocular tumor and may be easily confused with retinoblastoma.Analyzing the clinical and pathological features of ciliary body medulloepithelioma is useful to further understand ciliary body medulloepithelioma,and can make an accurate diagnosis and better treatment.
基金Supported by National Natural Science Foundation of China(No.82000862,No.82201214)Shaanxi Key Research and Development Program(No.2021SF-156).
文摘AIM:To explore the clinical and pathological characteristics of thirteen patients with orbital liposarcoma.METHODS:The clinical history data of thirteen patients diagnosed as orbital liposarcoma at Beijing Tongren Hospital,from 2006 to 2021 were collected and analyzed.The data includes age,gender,affected orbital side,course of disease,status of disease(primary or recurrent),clinical manifestations,preoperative visual acuity,operative treatment,the relations between liposarcoma and surrounding tissue,longest diameter of liposarcoma,histological subtype,immunohistochemical indicators,follow-up treatment and prognosis.RESULTS:The initial symptoms are diverse.Proptosis is the most frequent chief complaint and the others included vision loss,epiphora,diplopia,and eyelid palpable mass.Results of imaging examination[computed tomography(CT)or magnetic resonance imaging(MRI)]showed orbital mass.In terms of treatment,10 patients received tumor resection,and the mean longest diameter of the tumor was 3.39±1.36 cm.The other 3 patients had optic nerve invaded,so they received orbital exenteration.Pathological examination results confirmed the diagnose of liposarcoma for 13 patients.Six patients displayed as myxoid type,and three patients in each type of dedifferentiated and welldifferentiated type.One patient was verified as pleomorphic,which was a rare type of liposarcoma.All of the patients showed Vimentin positive,and most showed CD34 and S-100 positive.Besides,four patients showed smooth muscle actin positive.All thirteen patients were alive.CONCLUSION:Orbital liposarcoma is a rare disease and it has no specific clinical manifestation.The diagnosis of liposarcoma should be considered when proptosis and orbital mass occurred in orbit.It is recommended to perform pathological examination to achieve early detection and early treatment.
文摘Dear Editor,We present an exceptionally rare case about bilateral medulloepithelioma of the ciliary body.This case was approved by Ethics Committee of Capital Medical University.Written informed consent was obtained from the patients.Discovering leukocoria in both eyes and proptosis in right eye for 2mo by parents in a 4.5-month-old boy.He had undergone no treatment elsewhere except magnetic resonance imaging examination before coming to Beijing Tongren Hospital.
文摘目的:评价改良折叠式人工晶状体(IOL)悬吊治疗外伤性晶状体脱位的手术技术。方法:前瞻性随机对照研究。共15例患者接受了改良折叠式IOL悬吊手术。其中,9例患者选择了Akreos AO IOL,使用聚丙烯缝线穿过IOL的环状襻,经巩膜引导穿刺后,缝合线末端热膨胀固定在巩膜。6例患者选择了Tecnis ZA9003 IOL,未使用缝合线,巩膜穿刺引导IOL襻穿出巩膜后,直接将IOL襻末端热膨胀固定在巩膜内。观察所有患者的最佳矫正视力(BCVA,LogMAR)及术后并发症。结果:研究共纳入15例患者,其中男7例,女8例,平均年龄64.00±9.85岁,平均病程5.80±3.17wk。人口统计学和基线临床特征之间没有显著差异。接受改良折叠式IOL悬吊手术后,所有患者视力均有明显改善。术后3mo,患者的BCVA(LogMAR)从1.28±0.56改善至0.52±0.30。其中,选择Akreos AO IOL患者的BCVA(LogMAR)从1.39±0.62改善至0.59±0.25,选择Tecnis ZA9003 IOL患者的BCVA(LogMAR)从1.12±0.45改善至0.42±0.35。此外,在我们的研究中没有观察到严重的术后并发症。仅1例患者IOL脱位,IOL光学面轻度倾斜。结论:改良折叠式IOL悬吊手术具有良好的视觉效果和预后,无严重并发症,是IOL悬吊手术的有效选择。
基金Supported by Natural Science Foundation Grant from Jiangxi Science and Technology Department (No.20192BAB205049)Young Talent Scholar Grant (No.2016KJXX-12)from Shaanxi Science and Technology Department, Teaching Reform Grant (No.JC2020-0309,No.JG20190330)。
文摘AIM: To analyze whether wet-lab training(WLT) or surgical-simulator training(SST) is better for ophthalmology residents to master the chopping technique.METHODS: Sixty ophthalmology residents(in their second year) and three cataract surgeons participated in the study. The residents were randomly separated into two groups, WLT group and SST group. The residents in WLT group were asked to perform 10 trials of chopping using pig eyes and scored by the surgeons, and then they performed and scored using simulator for one time. The residents in SST group underwent 10 trials of chopping using simulator, and the simulator scored each trail. Then, this group were asked to perform the chopping using pig eyes and scored by the surgeons. At last, we investigated the residents’ satisfaction about the training.RESULTS: The demographic characteristics had no significant differences between the two groups. Recorded by the simulator, the residents in SST group got significantly higher overall score(83.90±1.31) than WLT group(78.73±1.92, P=0.03). And the residents in SST group got less corner area injured, and they spend less time than WLT group(P<0.05). Moreover, the residents in WLT group used more ultrasonic energy value than SST group(P=0.03). However, scored by the surgeons, the residents in two groups got nearly the same overall score. The residents in WLT group performed better on the frequencies of posterior capsule torn and incisional stress(P=0.03, 0.008, respectively). In the survey, the residents in two groups held the same opinion that the training was helpful and they strongly recommended this training. And all of them enjoyed the training, and enjoyed being randomized in their own group. However, with respect to the realistic character, the residents thought that WLT was better than SST(P<0.001).CONCLUSION: Both of the Eyesi surgical-stimulator and the wet-lab improve the residents’ chopping ability and each has its own advantages. The combination of the two training ways could be considered to be a part of the training curriculum for new residents.
基金Supported by the Natural Science Basic Research Project of Shaanxi Province(No.2019JM-578)。
文摘AIM:To observe the efficacy and safety of pars plana vitrectomy(PPV)with eye position guided fluid-air exchange(FAX)and air to mponade in the treatment of rhegmatogenous retinal detachment(RRD).METHODS:RRD patients without severe proliferative vitreoretinopathy(PVR)C1 or more were enrolled.All patients underwent PPV combining with air tamponade.During operation,the primary retinal break(s)were placed at lower site and subretinal fluid was aspirated through the break(s)at the same time when eye position guided FAX was proceeding.Sufficient laser spots were made to seal the retinal break(s)after FAX,and filtered air was left in vitreous cavity as to mponade agent finally.The main outcomes were primary and final success rates,best corrected visual acuity(BCVA),and the secondary outcomes were rate of postoperative cataract surgery and high intraocular pressure.RESULTS:A total of 37 eyes(20 males and 17 females)with a follow-up time of≥6 mo were included.The range of RRD was 5.6±1.8 h,and the number of retinal breaks was 1.9±1.2.The breaks located at inferior quadrants(between 3:00 and 9:00)in 5 cases(13.5%),and both superior and inferior breaks were found in 3 cases(8.1%).A total of 25 cases(67.6%)with macular detached involvement,9 cases(24.3%)with intraocular lens,and 8 patients(21.6%)were treated with phacoemulsification and intraocular lens implantation together.The success rate of primary retinal reattachment was 100%(37/37).At 6 mo postoperatively,BCVA(logMAR)was increased from 1.13±1.07 to 0.23±0.15(P<0.001).Phacoemulsification combined with intraocular lens implantation was performed in 2 patients(5.4%),and one of them underwent macular epiretinal membrane peeling in addition(2.7%).Furthermore,high intraocular pressure was found in 4 cases(10.8%).CONCLUSION:PPV with air tamponade by eye position guided FAX can achieve a high reattachment success rate in the management of patients with RRD,and it has the advantages of short postoperative prone time and fewer operative complications.
基金Supported by Key Research and Development Program of Shaanxi Province in China (No.2017SF-028)the Natural Science Foundation of Shaanxi Province (No.2019JQ-953)the Fundamental Research Funds for the Central Universities sponsored by Xi’an Jiaotong University (No.11913291000038/11913200000213)。
文摘AIM:To investigate the effects of on ocular surface microbiota in patients who received intravitreal injections.METHODS:Samples of ocular surface microbiota were obtained from 41 eyes of 41 patients who visited the Department of Ophthalmology.Patients were separated for three groups.Group A did not receive perioperative managements or intravitreal injection.Group B1 received only once and B2 received more than twice.In operating room,the samples were collected on the ocular surface.Operating taxonomic units(OTUs) clustering and alpha/beta diversity analysis was performed.The microbial 16S rRNA from samples were analyzed using the Hi Seq 2500 platform.RESULTS:Alpha diversity did not differ in each group,and beta diversity differed in the B2 group.Beta diversity showed a significant difference between Group A and B2(P=0.048).With the perioperative managements before intravitreal injection,the composition and relative abundance were altered.Top 10 microbiota on phylum and genus level,and then microbiota notably changed at genus level were listed.Gram-negative bacteria were varied more.Furthermore,Proteus was not found in Groups A and B1,but it was appeared after the patients received perioperative management and intravitreal injections in Group B2.CONCLUSION:With the perioperative managements,the balance of microbiota on the ocular surface is destroyed,and relative composition and abundance of microbiota on the ocular surface is obviously altered.The clinical doctors should pay more attention on the consequence of perioperative managements before intravitreal injection.