Application of ultrasound biomicro-scopy in the planning of cataract surgery in anterior megalophthalmos.

Anterior megalophthalmos, a rare hereditary disorder, is macrocornea (horizontal corneal diameter more than 13 mm) in association with enlarged lens-iris diaphragm and ciliary ring. One of the major challenging issues in the cataract surgery of these patients is preventing intraocular lens (IOL) malposition, because of probable large capsular bag. Several approaches have been selected by previous surgeons, such as, custom-made anterior chamber IOLs. In this study, we show a normal capsular bag diameter despite ciliary ring enlargement, with application of ultrasound biomicroscopy (UMB). We suggest that in cases of anterior megalophthalmos without phacodonesis, UBM could measure the actual size of the capsular bag and obviate the need for further procedures.

Assessing amblyogenic factors in 100 patients with congenital ptosis / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To study the frequency of amblyogenic factors in patients with congenital ptosis.congenital ptosis more than 1 year old were included. Amblyopia was defined as best-corrected visual acuity (BCVA) less than 10/10 or a difference between the two eyes of at least 2/10. In patients too young to be measured by the linear Snellen E test, fixation behavior was observed. Different types of amblyopia were assessed for each patient as: 1) anisometropic amblyopia: astigmatic anisometropia≥ 1dpt, hyperopic spherical anisometropia≥ 1dpt, myopic spherical anisometropia≥ -3dpt (with cycloplegia);2) strabismic amblyopia, and 3) stimulus deprivation amblyopia (SDA). Then the total incidence of amblyopia and each type of it were obtained. Patients with uni-and bi-lateral ptosis were also compared. Each specific cause was refractive amblyopia in 29.8%, SDA in 10.5%, strabismic amblyopia in 4.3%. Amblyopia was more frequent in severe ptosis, 76% in patients with covered optical axes (OA), compared to non-covered OA (22.5%). In unilateral ptosis with covered OA, astigmatic anisometropic amblyopia was more frequent, and in bilateral ptosis with at least one eye covered OA, spherical anisometropic amblyopia was more frequent. In both unilateral and bilateral ptosis, SDA was more common if the OA was covered. Paying attention to all causes of amblyopia may be important in preventing amblyopia in a child with a ptotic eye.

Recombinant tissue plasminogen activator for treatment of fibrinous membranes after cataract surgery / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the efficacy of recombinant tissue plasminogen activator (TPA) for treatment of fibrinous membranes following cataract surgery.METHODS: 25μg of TPA was injected into the anterior chamber of 15 pseudophakic eyes with moderate to severe fibrinous membranes that developed after cataract surgery.Simultaneously, topical corticosteroid and cycloplegic therapy was continued. Routine follow-up included slit lamp examination and intraocular pressure measurement.RESULTS: Injection of the solution of tissue plasminogen activator into anterior chamber of 15 eyes resulted in complete dissolution of the fibrinous membranes in 9 (60.0%)eyes after 2 hours, and 11 (73.3%) eyes within 1 day. In 3eyes, within a few days after injection, fibrinous membrane recurred. Increased anterior chamber reaction (P=0.54) and corneal edema (P =0.083) were seen after 24hours. No evidence of toxicity was observed as measured by slit-lamp biomicroscopy and intraocular pressure. Finally, expectable stable result was obtained in all of the eyes.CONCLUSION: Safety and high efficacy of TPA in the treatment of fibrinous membranes after cataract surgery are confirmed.