Search

Objective: To investigate the anatomical region, histopathological classification and histogensis distribution of ocular mass lesions in South China. Methods: Retrospective cases study. The clinical and pathological data of 7 910 samples with ocular (adnexal) tumors or proliferative lesions which were examined from January 2000 to May 2018 were retrospectively retrieved. The constituent ratios of ocular mass lesions in different anatomical regions and histogenesis have been analyzed. Results: There were 3 445 males and 4 465 females aged from 3 months to 106 years. Classification by anatomical region. Eyelid 4 976 cases (62.9%): benign-pigmented nevus (31.7%, 1 342/4 235), squamous cell papilloma (12.3%, 519/4 235), seborrheic keratosis (9.4%, 396/4 235); malignant-basal cell carcinoma (48.5%, 359/741), sebaceous gland carcinoma (34.4%, 255/741), squamous cell carcinoma (12.3%, 91/741). Ocular surface 1 449 cases (18.3%): benign-pigmented nevus (26.6%, 359/1 348), squamous cell papilloma (12.8%, 173/1 348); malignant-lymphoma (34.7%, 35/101), squamous cell carcinoma (30.7%, 31/101).Orbit 1 485 cases (18.8%): benign-hemangioma (28.5%, 332/1 167), lacrimal gland (duct) cyst(13.2%, 154/1 167); malignant-lymphoma (44.7%, 142/318), adenoid cystic carcinoma (10.1%, 32/318). Classification by histogenesis: epithelial 2 145 cases (27.1%), cutaneous appendages 378 cases (4.8%), cystoid 1 068 cases (13.5%), mesenchymal 748 cases (9.5%), lymph-hematopoietic 225 cases (2.8%), neurogenic 31 cases (0.4%), melanocytic 1 765 cases (22.3%), others 1 550 cases (19.6%). Conclusions: Over the past 18 years, the ocular tumors identified at the Second Affiliated Hospital, Zhejiang University School of Medicine most frequently occur in eyelid and originate from epithelium. The most common types are as followings. Benign lesions: pigmented nevus, squamous cell papilloma are the most common types for eyelid and ocular surface, whereas hemangioma, lacrimal gland (duct) cyst and epidermoid cyst are the most common types for orbit. Malignant cancers: basal cell carcinoma is the most prevalent disease in eyelid, whereas lymphoma occurs more frequently in ocular surface and orbit. ( Chin J Ophthalmol, 2019, 55: 847-853 ).

Objective: To investigate the etiology and management of secondary glaucoma after penetrating keratoplasty (PKP)., Methods: Eighty cases (80 eyes) with secondary glaucoma occurring in 1,450 cases (1,500 eyes) of PKP, its causes, time of onset and the relationship with the primary disease were analyzed. According to different causes, they were treated with different therapies., Results: The intraocular pressure (IOP) of 63 cases (63 eyes) became normal after drug treatment for 2 - 3 weeks. In 17 cases (17 eyes) who had received antiglaucomatous operations, 13 cases' (13 eyes) IOPs were normal and 4 cases' (4 eyes) still high., Conclusions: Accurate perioperative management can decrease the incidence of secondary glaucoma after PKP. The majority of secondary glaucoma can be controlled by different therapies according to different causes.

Objective: To study the choice of diopter and size of optical portion of intraocular lens (IOL) before cataract extraction for cases with high myopia., Methods: Extracapsular cataract extraction (ECCE) or phacoemulsification with IOL implantation was performed on 60 cases (94 eyes) with high myopia (axial length > 26mm). The posterior chamber IOL selected and inserted was the one with the diopter and size of the optical portion suitable for the recipient to have a postoperative low myopia and easy to be examined with an ophthalmoscope., Results: The postoperative eyes were of low myopia, -2.07 +/- 1.95 D. The larger size of optical portion was more suitable for ocular fundus examination. Great care was taken for phacoemulsification for cataractous nucleus below III grade., Conclusions: For patients with axial myopia, the IOL implanted should create low myopia postoperatively. Larger optic size is better for fundus examination. Phacoemulsification can produce less astigmatism and damage, but the indication must be controlled strictly.

Objective: To investigate the method of treatment of intraocular fibrinous membrane by tissue plasminogen activator (t-PA) after intraocular lens (IOL) implantation and evaluate its clinical results., Methods: 58 eyes of 43 patients after cataract surgery were divided into three groups, and received t-PA anterior chamber (AC) injection or combined with YAG laser therapy at different times after the operation. Group 1 included 26 eyes which received 4 microg t-PA AC injection at the end of operation. In group 2, 22 eyes whose fibrinous membrane was formed 5 - 7 days after the operation were injected with 4 microg t-PA at that time. In group 3, 10 eyes with thicker membrane were given YAG laser treatment at postoperative 5 - 9 days and then 4 microg t-PA was injected into the AC., Results: In group 1, hyphema occurred in 4 eyes, in 8 eyes at the pupillary region the fibrinous membrane was formed which was completely lysed after t-PA AC injection at postoperative 3 - 5 days. In group 2, the membrane was lysed within 24 hours in 20 of 22 eyes and no hyphema was found. In group 3, the membrane was lysed within 4 - 24 hours after t-PA injection in all cases, and no hyphema occurred., Conclusion: It is very effective to treat fibrinous membrane formation after IOL implantation by t-PA AC injection at postoperative 1 week when the AC inflammation is well controlled. The combined use of YAG laser with t-PA AC injection is much more effective for the treatment of such a membrane.

Objective: To evaluate the results of cataract extraction with intraocular lens (IOL) implantation in children., Methods: Cataract extracapsular extraction with anterior vitrectomy and IOL implantation was performed on 104 eyes of 64 children with congenital cataract aged 1.5 - 14 years old. The visual acuity and possible complications were followed up for a mean period of 22 months., Results: After operation 86.4% patients were relieved from blindness, 62.7% obtained corrected vision >or= 0.3, binocular vision and stereopsis were restored in 41.8% and 30.6% respectively. In 3 eyes secondary cataract developed and in 5 eyes slight iris capture occurred., Conclusions: Cataract extraction with anterior vitrectomy and IOL implantation is effective in pediatric cataract treatment. Most patients get remarkable improvement in visual acuity and visual function with minimal complications after surgery. The influence factors on the postoperative visual function need further study.

Objective: The results of phacoemulsification (phaco) operations which were performed with 3.2 mm incision and foldable intraocular lens (IOL) implantation were reviewed., Methods: On forty-nine eyes with cataract of forty-two cases phaco and foldable IOL implantation was randomly performed. The results of the postoperative vision, the refraction and the loss rate of corneal endothelial cell were analyzed., Results: By the 7th postoperative day, the uncorrected vision in 32 eyes (65.31%) was 1.0 or better. The visual acuity in forty-one eyes (83.67%) was 1.0 or better after 3 months of operation. The loss rate of endothelial cells was 11.72%. In the comparison between the postoperative and preoperative corneal astigmatism, the mean former one became against the rule for 0.10 DC., Conclusions: The small incision operations not only can provide a satisfactory early postoperative visual acuity with a slight corneal astigmatism, but also can reduce the time for suturing and avoid the harmful effects of stitches.

Objective: To explore the modulation of cell proliferation induced by growth factors in cultured human retinal pigment epithelial (RPE) cells., Methods: A well-cultured system of human fetal RPE cells was established to determine the effects of several growth factors, such as epidermal growth factor (EGF), basic-fibroblast growth factor (b-FGF), insulin-like growth factor (IGF-I), on the cultured human RPE cells by using 3H-thymidine incorporation and cell count., Results: (1) EGF, b-FGF, IGF-I significantly increased the DNA 6.6-12.2 times in human RPE cells in comparison with the control, the rank order of potency of the factors being EGF > b-FGF > IGF-I. (2) When the factors were used in combination, the above factors caused a significant enhancement of 3H-Tdr incorporation by times., Conclusion: It is suggested that the synergetic effects of growth factors and their complex interactions play a role in the development of proliferative retinopathy.

Objective: To evaluate the characteristics of cellular proliferation in different retinal diseases., Methods: Three specific antibodies [to cytokeratin (CK), glial fibrillary acidic protein (GFAP) and actin, respectively] were used. Vitrectomy specimens from 28 cases with different proliferative retinal diseases were studied immunohistochemically., Results: In the vitreous with proliferative vetreoretinopathy (PVR), most of the proliferative cells were derived from glial and retinal pigment epithelial (RPE) cells. In the vitreous of proliferative diabetic retinopathy (PDR), RPE cells might enhance the contraction of proliferative membranes. Increase in actin in firovascular membranes with PDR may play a positive role on the pericytes dropping out from microvessels., Conclusion: The cell proliferation in the vitreous associated with the increase of levels of growth factors in pathological vitreous, possibly, is one of the mechanisms for the deterioration of proliferative retinal diseases.

Objective: We reported the clinical results of the extracapsular cataract extraction (ECCE) with intraocular lens (IOL) implantation through a corneal incision., Methods: The ECCE with IOL implantation was performed through a stepped corneal incision within limbus 1.0-1.5 mm. The changes of intraocular pressure (IOP), endothelia and astigmatism were observed., Results: The IOP has no significant changes, and the rate of endothelial cells loss (12.55%) also has no significant differences compared with routine cataract extraction. The corneal astigmatism became 0.96 DC with the rule after operation., Conclusion: For complicated cataract after trabeculectomy, uveitis with pupillary block, and serious diabetic cataract, the intraocular surgery through a corneal incision is effective and safe.

Objective: The study was designed to approach the operative techniques of penetrating keratoplasty (PKP) in children and the influential factors on the rate of graft clarity., Methods: PKP was performed on 33 eyes of 30 children whose corneal opacities resulted from various causes and they were followed for 6 months to 3 years., Results: The rate of graft clarity was 66.7% and 44.8% of these eyes were relieved from blindness. The poorest results achieved were in cases with congenital corneal opacity and the main cause of graft failure is endothelial immune rejection., Conclusion: Although the surgical results in children are poorer than that in adults, from the concern of prevention of amblyopia and cosmetic problem, it is necessary to perform the operation earlier.

The results of 34 cases with cataract extracted by phacoemulsification were preliminarily reported. Postoperatively, they achieved corrected visual acuities > 1.0 in 24 eyes (70.59%) in one week and in 25 eyes (73.53%) after 3 months. The post-operative astigmatism showed a tendency of change from with-the-rule shifting to against-the-rule. The rate of the corneal endothelial cell loss was 13.28%. No severe intra- and post-operative complications were found. It is concluded that the small incision, slight post-operative reaction and fast visual rehabilitation inherent in phacoemulsification procedures are more beneficial to patients than the conventional extracapsular cataract extraction.

We used well-cultured human embryo retinal pigment epithelial (RPE) cells to establish a light-damaged RPE cell model. There was no onco-gene c-fos expression in RPE cells cultured under normal condition. Immediately after 30 minutes of light exposure, onco-gene c-fos expression occurred in the RPE cells. The expression reached the highest level 1.5 hours after light exposure and disappeared 4 hours later. Taurine and gamma-interferon in different concentrations could restrain onco-gene c-fos expression in light damaged RPE cells. The restraint effects were of concentration dependence.

The insulin-like growth factor I (IGF-I) levels in 67 vitreous samples taken from 57 patients with various proliferative retinal diseases and 10 normal subjects were detected by radioimmunoassay (RIA). The acid-ethanol-extracted (AEE) method was used to remove the IFG-binding protein before the detection. Our results revealed that IGF-I levels were increased to varying extents in these patients' vitreous. The IGF-I levels in the vitreous with proliferative diabetic retinopathy (PDR) and central retinal vein occlusion (CRVO) were significantly higher than those of the controls. In the PDR group, the increased IGF-I level in the vitreous was positively correlated with the level in serum. The increased IGF-I level in vitreous may play an important role in the development and pathogenesis of proliferative retinal diseases. Great differences were found between the native and the AEE treated vitreous, suggesting that the binding protein posed an obvious interference on the detection of IGF-I by RIA.