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·AIM: To investigate the ocular surface and refractive change after the surgery of levator resection and frontalis suspension. ·METHODS:One hundred and twenty-one patients (146 eyes) for corrective surgery of congenital ptosis were selected in our department from July 2014 to June 2016. According to the severity of congenital ptosis, all the children divided into mild group (47 eyes), moderate group (68 eyes) and severe group(31 eyes). All the children were divided into group of less than 5 years old (104 eyes) and group of more than or equal to 5 years old (42 eyes) according to the age. According to the surgical approach, all the children divided into group of levator resection (62 eyes) and group of frontalis suspension(84 eyes). The effects of the two surgeries on the ocular surface and refractive were compared. The relationship between age, severity of postoperative ptosis and postoperative ocular surface, refractive of children were analyzed. ·RESULTS: There were no significant differences in break-up time (BUT), keratometry (Km) and corneal astigmatism (Ast) in the levator resection group and frontalis suspension group (P > 0. 05). There was significant difference between the mild, moderate and severe group on the proportion of excellent corrected to uncorrected (Z=-2.936, P=0.003). The proportion of excellent correction in mild group was higher than that of moderate and severe group(93.6%, 83.8% and 67.7%). The indexes of BUT (F=9.793, P=0.041) and Km (F=11.657,P=0.037) in the three groups decreased with the increase of severity. While the Ast (F=28.417, P<0.01) showed an increasing trend, the difference was significant. In addition, the proportion of excellent correction in <5 year old group was significantly more than≥5 years old group(x2=4.082,P=0.043). The index of Km (t= 2.813, P= 0.006) was higher and Ast (t=-7.741, P<0.01) was lower in the <5 year old group. There was no significant difference in the index of BUT between the two groups after surgery (P>0.05). · CONCLUSION: The corneal refractive power and astigmatism can be improved similarly after treated with levator resection and frontalis suspension surgery. And there is some damage of corneal epithelial in the initial postoperation, but the function of ocular surface can return to normal after a period of time. The less severity of ptosis before surgery,the better improvement of ocular surface and refractive after sugery. There is no correlation between the age and postoperative ocular surface, but earlier surgical treatment may improve the children's refractive power and astigmatism and achieve greater benefits.
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@#AIM: To investigate the effect of anterior transposition of inferior oblique muscle on the treatment of dissociated vertical deviation(DVD)in children with inferior oblique overaction(IOOA)and unequal inferior oblique transposition of the treatment of IOOA with the eyes of the asymmetry of DVD efficacy, associated with the lower oblique hyperfunction DVD patients to provide more effective treatment. <p>METHODS: Eighty patients with hyperfunction who were treated in our hospital from January 2014 to December 2015 were randomly selected and treated with anterior transposition of inferior oblique muscle. Patients were followed up for 1 to 30mo. We compared the vertical incline at the original incline from far(5m), near(33cm)distance and IOOA degree before and after operations, and the correlation between the two. We also compared the vertical incline at the original incline from far(5m), near(33cm)distance and IOOA degree before and after operations in 30 eyes(20 patients)with bilateral asymmetry DVD and IOOA who received unequal inferior oblique transposition. The incidence of antielevation syndrome(AES)was observed after operations. <p>RESULTS: The mean prism diopters(PD)at 5m before operations was 19.5±0.15, the average PD after operations was 3.5±0.18, at 5m the original incline was 16±0.21PD. The mean PD at 33cm was 18.6±0.20 before operation, 4.5±0.26 after operations, and 14.1±0.16 at 33cm the original incline, the difference was statistically significant(<i>P</i><0.05). Preoperatively, inferior oblique muscle hyperfunction +2 and +3 was 50 eyes, + 1 was 20 eyes, and 12 eyes still showed inferior oblique muscle hyperfunction after operation, but the degree of hyperactivity was +1. There was a significant positive correlation between the degree of IOOA and the vertical inclination(33cm: <i>r</i>=0.554, <i>P</i><0.01; 5m: <i>r</i>=0.454, <i>P</i> <0.01). There were significant differences(<i>P</i><0.05)in the vertical incline in 20 patients(30 eyes)with bilateral asymmetry DVD and IOOA and the degree of IOOA was significantly lower. In contrast, 18 patients(24 eyes)underwent anterior transposition of the inferior oblique muscle had AES in different degrees, which had statistically significant difference(<i>P</i><0.05)compared with patients(30 eyes)with IOOA treated with unequal inferior oblique transposition. <p>CONCLUSION: Anterior transposition of the inferior oblique muscle has a good therapeutic effect on isolated vertical strabismus patients with inferior oblique hyperfunction. While the incidence of postoperative AES is low in patients received unequal inferior oblique muscle transposition.
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AIM: To screen TIGR/myocilin gene (MYOC) mutation in high myopic Chinese children with family history.METHODS: Gene sequencing was performed in exon 3 of the TIGR gene in high myopic Chinese Children. The coding sequence of TIGR exon 3 was screened by capillary electrophoresis sequencing. The sequence alterations were analyzed by bioinformatics.RESULTS: TIGR gene mutation was not found in high myopic patients and normal controls group.CONCLUSION: No identified gene mutation is found in TIGR gene in high myopic Chinese children.