Objective: To explore the possibility of LPD with transanal specimen extraction for periampullary tumors. Background: Natural orifice specimen extraction has been widely performed in colorectal surgery. But so far there is no report regarding natural orifice specimen extraction in LPD. Methods: Data of 3 patients who underwent LPD with transanal specimen extraction by the same surgeon between July 2018 and March 2019 due to periampullary tumors were evaluated retrospectively. Results: All patients underwent LPD with no conversion to open surgery. Specimens were all extracted transanally. No complications occurred except for delayed gastric emptying in 1 patient. The patients’ anorectal function was intact and no opioids were required postoperatively. After a follow-up of 17–25 months, all patients were alive with no tumor recurrence. Conclusion: Treatment of periampullary tumors by LPD with transanal specimen extraction is feasible and safe.

目的 研究青少年轻中度近视患者配戴夜戴型角膜塑形镜后的疗效及安全性.方法 根据随机数字表法将2017年1月2日至2018年1月30日期间某院接收的青少年轻中度近视患者100例200眼分为对照组和观察组,每组50例,对照组、观察组分别配戴框架眼镜、夜戴型角膜塑形镜.将2组青少年轻中度近视患者的裸眼视力、眼轴增长率、角膜曲率、屈光度以及并发症发生率进行比对.结果 观察组青少年轻中度近视患者配镜1周内、1个月后、3个月后、6个月后、12个月后的裸眼视力水平均高于对照组,差异具有统计学意义;观察组患者的眼轴增长量低于对照组,差异具有统计学意义;观察组患者配镜后的角膜水平曲率、垂直曲率和屈光度均显著低于对照组,差异具有统计学意义;观察组的并发症发生率为6.00％,与对照组12.00％比较,差异无统计学意义.结论 配戴夜戴型角膜塑形镜可对青少年轻中度近视进行较好地控制,有助于裸眼视力的提高,矫正角膜曲率和屈光度,安全性与戴框架眼镜相当.

目的:比较双眼外直肌后徙术与常规疗法治疗斜视的临床疗效.方法:选取2016年6月-2017年6月笔者医院收治的128例斜视患者,按治疗方式不同分成对照组和研究组,每组各64例.其中对照组患者行常规单眼外直肌后徙联合内直肌缩短术(R&R),研究组患者行双眼外直肌后徙术(BLR-rec).术后对患者随访1年,观察术后眼位正位率、欠矫率、过矫率,视觉功能恢复情况以及并发症发生率.结果:研究组患者正位率为89.06％高于对照组的68.75％,差异有统计学意义(P<0.05).术前,对照组和研究组患者视近度、视远度和平均斜视度比较,两组患者融合功能和立体视功能占比比较,差异均无统计学意义(P>0.05).术后,两组患者的斜视度较治疗前均出现了明显下降(P<0.05),且研究组治疗后斜视度下降幅度明显大于对照组(P<0.05);两组患者视觉功能恢复率均明显增加(P<0.05),且研究组恢复率明显大于对照组(P<0.05).研究组并发症发生率明显低于对照组(P<0.05).结论:双眼外直肌后徙术较单眼外直肌后徙联合内直肌缩短术有更好地临床效果,且安全性更高,值得临床推广.

1.斜视的具体症状有哪些? 斜视常常被人们称为“斜眼” “对眼”,顾名思义就是眼球的位置不正.用医学术语描述,就是:眼的视轴发生了偏斜,并且不能被双眼的融合机能克服.常见的表现形式为内斜视、外斜视、上斜视、下斜视等. 斜视时时刻刻都存在的称为恒定性斜视;时而正位,时而斜视,或仅在疲劳、患病、精力不集中时表现出来的称为间歇性斜视;当正位和斜视有规律地、交替隔一天出现的就称为周期性斜视,最常见的是48小时周期.

目的:比较额肌瓣悬吊术与提上睑肌缩短术治疗重度上睑下垂患儿的临床疗效.方法:选取2015年5月-2018年5月笔者医院收治的重度上睑下垂患儿104例(157眼),根据手术方式的不同将所有患儿分为额肌瓣悬吊组(n=52例,73眼,采用额肌瓣悬吊术)和提上睑肌缩短组(n=52例,84眼,采用提上睑肌缩短术),比较两组患者临床疗效,泪膜破裂时间(Breakup time of tear film,BUT)、泪液分泌试验(Schirmer test,SIt)、角膜荧光染色(Fluorescent staining,FL)检查结果,观察两组患者术后并发症发生情况.结果:提上睑肌缩短组患者术后临床总有效率为92.86％(78/84)显著高于额肌瓣悬吊组的82.19％(60/73),差异有统计学意义(P<0.05).两组患者术后7d、术后1个月FL高于术前(P<0.05),两组患者术后3个月FL与术前比较差异无统计学意义(P>0.05);提上睑肌缩短组术后7d、术后1个月、术后3个月SIt、FL与额肌瓣悬吊组比较差异无统计学意义(P>0.05);提上睑肌缩短组术后7d BUT低于额肌瓣悬吊组(P<0.05),而提上睑肌缩短组术后1个月、术后3个月BUT与额肌瓣悬吊组比较差异无统计学意义(P>0.05).额肌瓣悬吊组并发症发生率为8.22％(6/73),提上睑肌缩短组为3.57％(3/84),差异无统计学意义(P>0.05).结论:与额肌瓣悬吊术相比,提上睑肌缩短术治疗重度上睑下垂患儿的疗效更为确切,且安全性与其相当,临床可考虑将提上睑肌缩短术作为治疗重度上睑下垂患儿的首选术式.

Abstract Background: So far, there has been a controversy surrounding repositioning difficulty and recurrence rate between traumatic benign paroxysmal positional vertigo (t-BPPV) and idiopathic BPPV (i-BPPV). Objectives: This meta-analysis was aimed to explore whether or not the differences between t-BPPV and i-BPPV in the repositioning difficulty and recurrence rate existed. Material and methods: A literature search was performed in the databases including Pubmed, Embase, CENTRAL, which completed in 21 January 2019, with no restriction of publication language. Relative risk (RR) of number of repositioning maneuvers and the recurrence rate was calculated with its 95% confidence interval. Sensitive analysis was performed simultaneously. Results: Six retrospective cohort studies were included in our meta-analysis, including 865 t-BPPV patients and 3027 i-BPPV patients. All studies were high quality according to Newcastle-Ottawa Scale (NOS) assessment. Patients with t-BPPV required more repositioning maneuvers for resolution than those with i-BPPV (RR = 3.27, 95% CI = 1.88–5.69, p < .0001), and the recurrence rate of t-BPPV was higher than that of i-BPPV (RR = 2.91, 95% CI = 2.04–4.14, p < .00001). Conclusions and significance: Compared with i-BPPV, patients with t-BPPV require more repositioning maneuvers to resolve, and the recurrence of t-BPPV was more frequent.

Objective: The objective of our study was to investigate the potential association between the occurrence of benign paroxysmal positional vertigo (BPPV) and saccular dysfunction using cervical vestibular evoked myogenic potentials (cVEMP) testing. Methods: The databases including Pubmed, Embase, and CENTRAL were systemically searched for case-control literatures investigating saccular dysfunction using cVEMP testing in BPPV patients compared with healthy controls. The literatures were published up to 16 April 2019 and were limited to the English language. All statistical processes were carried out using software Review Manager, version 5.3. Subgroup analysis and sensitive analysis were performed simultaneously. Results: Of the 12 case-control studies confirmed for meta-analysis, p13 latency of cVEMP was assessed in 8 studies, n23 latency in 6 studies, amplitude in 5 studies, asymmetry ratio (AR) in 3 studies, proportion of absent response in 9 studies, and abnormal cVEMP in 8 studies. Compared with healthy controls, the p13 mean latency of cVEMP was longer (MD = 0.88, 95% CI = 0.64-1.12, p < 0.00001), the mean amplitude was lower (SMD = -0.60, 95% CI = -0.80 to -0.41, p < 0.00001), and the proportions of absent response (OR = 8.76, 95% CI = 2.28-33.61, p = 0.002), and abnormal cVEMP (OR = 7.47, 95% CI = 4.65-12.01, p < 0.00001) were higher in BPPV patients. But there was no significant difference in the n23 mean latency (MD = 0.37, 95% CI = -0.23-0.98, p = 0.22) and the AR of cVEMP (MD = 3.95, 95% CI = -4.75-12.65, p = 0.37) between BPPV patients and healthy controls. In the sub-group analysis based on age, only the result of the proportion of absent response of cVEMP indicated a significant difference existed (p = 0.002) between the studies with age-matched controls (OR = 2.78, 95% CI = 1.09-7.10, p = 0.03) and the studies without age-matched controls (OR = 53.85, 95% CI = 10.09-287.13, p < 0.00001). In the sub-group analysis of the proportion of abnormal cVEMP according to the diagnostic criteria of abnormal cVEMP, the result indicated no significant difference existed between the four groups (p = 0.61, I 2 = 0%). In the sensitivity analysis, we obtained the consistent results after removing each study sequentially. Conclusion: The meta-analysis reveals that saccular dysfunction may be associated with BPPV occurrence, and neural degeneration in the saccular macula may be a potential pathogenesis for BPPV.

Background: To investigate the therapeutic effectiveness and safety of endoscopic dacryocystorhinostomy (EN-DCR) to treat congenital nasolacrimal canal dysplasia (CNCD). Methods: Forty children (50 eyes) with congenital nasolacrimal duct obstruction (CNLDO) and lacrimal bony dysplasia, including 8 children with bony atresia (10 eyes) and 32 with bony stenosis (40 eyes), were recruited in this retrospective study. Standardized EN-DCR was performed in all cases. The postoperative observations included relief of symptoms, fluorescein dye disappearance test (FDDT), syringing of lacrimal passages and anastomotic patency under nasal endoscopy. Patients were followed up for 8-18 months. Results: Standardized EN-DCR surgery had a success (cure and improvement) rate of 100%, including a cure rate of 82% and an improvement rate of 18%. The cure rate among 40 cases of bony nasolacrimal duct stenosis was 82.5%, while that of 10 cases of bony nasolacrimal duct atresia was 80%. Statistical analysis showed that nether the receipt of other treatments before surgery nor the type of bony nasolacrimal duct dysplasia affected the cure rate. No significant complications were observed during postoperative follow-up except for four cases (4 eyes) that suffered middle turbinate and nasal mucosal adhesion and two cases with sinusitis. Conclusions: CNCD is a type of CNLDO that does not respond to conservative and conventional treatment. EN-DCR represents a safe and effective treatment for children with CNCD. In addition, the combination of EN-DCR with lacrimal CT scanning provides advantages over traditional lacrimal surgery in that it has a high success rate with a low incidence of complications. Key words: nasal endoscopy; endoscopic dacryocystorhinostomy (EN-DCR); children; congenital nasolacrimal duct obstruction (CNLDO); nasolacrimal canal dysplasia

Background: This study was performed to compare the efficacy of marsupialization under nasal endoscopy versus lacrimal probing for the treatment of congenital dacryocystocele. Methods: A prospective randomized controlled study. Forty neonates (43 eyes) diagnosed with congenital dacryocystoceles were divided into Group A (nasal endoscopic marsupialization) and Group B (lacrimal probing). The patients were followed up for 1 year after surgery. The efficacy, incidence of complications, and reoperation rate were compared between the two groups. Results: The male:female ratio was 25:15 patients (27:16 eyes). In Group A, the success rate was 100%, the incidence of complications was 5%, and the reoperation rate was 0%. In Group B, the success rate was 90%, the incidence of complications was 20%, and the reoperation rate was 30%. There was no significant difference in the success rate between the two groups, but the incidence of complications and the reoperation rate in the lacrimal probing group(Group B) were significantly higher than those in the nasal endoscopic marsupialization group(Group A). Conclusion: In the treatment of congenital dacryocystoceles, nasal endoscope marsupialization has the same success rate as lacrimal duct probing, but the former is more effective and safer in clinical practice.

BACKGROUND:The pathogenesis of recurrence of traumatic benign paroxysmal positional vertigo (BPPV) is poorly understood by far.OBJECTIVES:To evaluate the value of secondary otolith dysfunction using vestibular evoked myogenic potential (VEMP) test in the pathogenesis of recurrence of BPPV after mild traumatic brain injury (mTBI).MATERIAL AND METHODS:We reviewed 42 patients with BPPV after mTBI. According to recurrence, patients were divided into two groups. Both cervical VEMP (cVEMP) and ocular VEMP (oVEMP) tests were performed on all of them.RESULTS:We detected abnormal cVEMP responses in four (26.7%) patients in the recurrent BPPV group after mTBI and five (18.5%) patients in the non-recurrent BPPV group after mTBI, and there was no significant difference between both groups. We detected abnormal oVMEP responses in nine (60.0%) patients in the recurrent BPPV group after mTBI and six (22.2%) patients in the non-recurrent BPPV group after mTBI, and there was a significant difference between both groups.CONCLUSIONS AND SIGNIFICANCE:Our study shows that oVEMP abnormalities in recurrent BPPV group after mTBI are significantly higher than those in non-recurrent BPPV group after mTBI. Therefore, we can conclude that secondary utricular dysfunction may be a potential pathogenesis of recurrence of traumatic BPPV.

Purpose: To investigate the difference in the optic canal diameter between children with autosomal recessive malignant infantile osteopetrosis and normal children, and to assess the influence of hematopoietic stem cell transplantation on the optic canal diameter. Methods: Twenty pediatric patients with malignant infantile osteopetrosis and 22 normal control children were included in this study. Eleven patients with malignant infantile osteopetrosis underwent hematopoietic stem cell transplantation. The measurements included optical canal diameter and flash visual evoked potential. Comparisons of these measurements between patients with malignant infantile osteopetrosis and normal controls as well as before and after hematopoietic stem cell transplantation were performed. The correlation between age and optic canal diameter was analyzed using Pearson correlation analysis. Results: The mean optic canal diameter before hematopoietic stem cell transplantation was 1.65 ± 0.54 mm in patients with malignant infantile osteopetrosis and 3.38 ± 0.60 mm in the control group ( P < .001). The mean optic canal diameter after hematopoietic stem cell transplantation was 2.72 ± 0.66 mm, which was significantly different from the pre-transplantation measurement ( P < .001). The P2 latency for the flash visual evoked potential after hematopoietic stem cell transplantation (152.3 ± 36.4 ms) was significantly less than that before transplantation (165.5 ± 27.7 ms; P = .051). Pearson correlation analysis revealed a significant correlation between age and optic canal diameter ( r = 0.722, P < .001). Conclusions: The optic canal was narrower in pediatric patients with malignant infantile osteopetrosis than in age-matched normal controls. This condition can be relieved through hematopoietic stem cell transplantation and the impaired conductibility of the optic nerve can be improved in some cases. [ J Pediatr Ophthalmol Strabismus. 2019;56(1):35–42.]

Infantile malignant osteopetrosis (IMO) is a rare congenital disease that is characterized by an impaired function or differentiation of osteoclasts. IMO is the most severe type of osteopetrosis. Patients usually present various fatal manifestations soon after birth and die in infancy or childhood. Clinical features include bone marrow failure resulting in pancytopenia, hepatosplenomegaly, blindness secondary to optic nerve compression, hydrocephalus, and other neurological complications.[1] T-cell immune regulator 1 (TCIRG1, Gene ID: 10312) is one of the main genes that are responsible for the majority of IMO cases. Mutations in TCIRG1 associated with general clinical features have been reported in some studies.[2] In this study, we reported the ocular manifestations and genetic findings of an IMO patient. A male infant, whose eyes were unable to follow the light at birth, had a tilted mouth at 4 months of the age. His parents were no consanguineous couple. At the age of 5 months, he was referred to the Department of Hematology, Beijing Children's Hospital, and was diagnosed IMO with general examination and gene mutation detection. Mutation analysis of the TCIRG1 gene was performed using direct DNA sequencing of polymerase chain reaction-amplified exons. Prediction of the protein domains was based on the potential topological domains reported in UniProt database (Q13488; http//www.uniprot.org). After 6 months, he received successful hematopoietic stem cell transplantation (HSCT). We performed detailed eye examination before and after HSCT, including orbital three-dimensional computer tomography (CT) scan to measure the optic canal diameters, RetCam III fundus examination, flash visual evoked potential (FVEP), and flash electroretinogram (FERG) using the standard FVEP protocols recommended by the International Standard EEG 10–20 System (ISCEV) (Roland Inc., German). The principles outlined in the Declaration of Helsinki were followed. The Ethics Committees for Human Studies of Beijing Children's Hospital had approved this study. Informed consent was obtained from his parents. We identified a possible novel frameshift mutation c.1007_1013del (p.L336pfs*8) [Figure 1a] and a reported missense mutation c.1213G>A (p.G405R) [Figure 1b] in the patient. MutationTaster predicted the effect of the c.1007_1013del mutation as "disease causing," which caused by deletions of a number of 1007_1013 nucleotides in a DNA sequence that is not divisible by there. The c.1007_1013del mutation was predicted to disrupt the ninth exon, change the reading frame (the grouping of the codons), resulting in a completely different translation from the original. This mutation was not reported in HGMD professional database and ExAC database. c.1213G>A was a missense mutation, a previously reported osteopetrosis-causing mutation (Pangrazio, et al. Osteoporos Int., 23, 2713, 2012), which was deemed to "disease causing" by MutationTaster, causing guanine to become adenine in the coding area of 1213. The mutation was predicted to disrupt the eleventh exon, leading to the change of amino acids (glycine to arginine). This mutation was reported in HGMD professional database.[2]Figure 1: Partial nucleotide sequences of the T-cell immune regulator 1 gene. Arrows point to a possible novel frameshift mutation c.1007_1013del (p.L336pfs*8), and a reported missense mutation c.1213G>A (p.G405R). The patient (a) and his mother (c) carry the c.1007_1013del (p.L336pfs*8) mutation. The patient (b) and his father (d) have the c.1213G>A (p.G405R) mutation.Analysis of the parental DNA showed that the patient's mother carries the c.1007_1013del mutation [Figure 1c], and his father has the c.1213 G>A mutation [Figure 1d]. Thus, it followed that this patient's pathogenic genetic mutation was inherited from both of his parents, and the mutation was complex heterozygous mutation in the TCIRG1 gene. Before HSCT, the patient was in poor growth, with square skull, forehead protruding, and facial palsy. After transplantation, all reduced peripheral blood cells gradually turned to be stable, the bone mineral density decreased, and the hepatosplenomegaly was getting better. The eyes were dull to light, with nystagmus showing pendulum-like movement; for 1 month after transplantation, the eyes have been responded to light, nystagmus seemed mitigated. The preoperative fundus examination indicated the pale papilla of optic nerve, gloomy center of the macula, and thin retinal arteries, some of which were occluded like white line [Figure 2a]; postoperative photograph showed no change yet. Orbital CT scan showed that the diameter of bilateral narrow visual neural tubes was 1.5–1.7 mm [Figure 2b]; after 3 months of HSCT, they seemed slightly wider (1.7–1.9 mm). Before HSCT, the waveform of FVEP P2 was not elicited; Photopic 3.0 ERG displayed blanking type in the light adaptive stimulation; Scotopic 3.0 ERG in the dark adaptation state showed that latency period of the right/left eye in a/b wave was 27.0/24.4 ms and 76.9/78.4 ms and the amplitude was 0.83/1.62 μV and 67.5/102 μV, respectively. These outcomes indicated that the function of the binocular rods and cones was badly damaged. After HSCT, FVEP P2 latency period was 187.1/174.3 ms and the amplitude increased (5.23/2.89 μV); the corresponding values of Scotopic 3.0 ERG were 17.0/18.5 ms and 41.4/40.8 ms and 77.9/45.7 μV and 229/174 μV.Figure 2: (a) Fundus examination indicated the pale papilla of optic nerve, thin retinal artery – even some occlusion like white line – and gloomy center of the macula. (b) Orbital computed tomography scan showed the bone density of the orbital bone increased thickening, the density of the medullary cavity increased, the bilateral orbital volume was small, the bilateral visual neural tubes were very thin, and the narrowest diameter was 1.5–1.7 mm.Osteopetrosis is a sort of very heterogeneous disease. The heterogeneity depends on the causal genes, modes of inheritance, and disease severity/phenotypes. To date, more than 10 osteopetrosis-causing genes have been identified.[3] The inheritance patterns contain autosomal dominant, autosomal intermediate, and autosomal recessive. The disease severity also varies from malignant, intermediate, to mild manifestations. This patient's disease is TCIRG1-related disease, which occurs due to the loss of function of both alleles on the homologous chromosomes. It is generally recessive and malignant. It is proved that the pathogenesis of osteopetrosis is due to the insufficient acidification of the microenvironment of osteoclasts, which requires an acidic environment for reabsorption and remodeling of bones. During acidification, H+ is transported into secondary lysosomes by vacuolar type H+ adenosine triphosphatase (V-ATPase), and TCIRG1 encodes its a3 subunit.[1] In this patient, the inheritance pattern is obviously recessive, as the parents are both healthy heterozygous mutation carriers. The disease severity in our patient is also consistent with the recessive pattern. The paternally inherited known missense mutation, c.1213G>A, combined with possible unknown mutated genes, c.1007_1013del, maternally inherited on the other chromosome, resulted in the severe phenotypes in our patient. Frameshift mutation and missense mutation have been regarded as "loss of function mutations." The guidelines of the American College of Medical Genetics and Genomics have also been classified these types of mutation as "pathogenic mutations."[4] Approximately 10% of children with IMO in the TCIRG1 gene have extensive and severe neurological damage, including optic atrophy, VEP loss, nystagmus, and blind. These children with severe visual impairment within 1 year of age are up to 75%. At present, most scholars hold that the neurological symptoms are due to the thickening of the bone plate at the bottom of the skull and stenosis or occlusion of channels in which cranial nerves, spinal cord, and major blood vessels run, including the optic nerve compression caused by the optic canal stenosis.[5] The mechanism of optic nerve damage is still not fully understood. The FVEP and FERG test indicated that this infant's vision had been severely impaired. Although we fully informed the parents of the risk of transplantation, they persisted with HSCT for their baby. The infant has been still in the early stage of recovery; however, we saw an exciting and unexpected result that FVEP and FERG outcomes indicated a probably improved visual function. Due to the insignificantly widen optic nerve tube, we look forward to the patient's long-term observations. Financial support and sponsorship This study was supported by the grants from the National Natural Science Foundation of China (No. 81570891); the National Natural Science Foundation of China (No. 81272981); the Beijing Municipal Administration of Hospitals' Ascent Plan (No. DFL20150201); the Science and Technology Project of Beijing Municipal Science and Technology Commission (No. Z151100001615052); the Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support (No. ZYLX201307); the Beijing Natural Science Foundation (No. 7151003); and the Advanced Health Care Professionals Development Project of Beijing Municipal Health Bureau (No. 2014-2-003). Conflicts of interest There are no conflicts of interest.

BackgroundTo investigate auditory and vestibular functions, estrogen levels, and its clinical correlation in postmenopausal females with Meniere's disease (MD).MethodsWe retrospectively analyzed the serum estradiol (E2) levels and the auditory and vestibular functions measured by auditory brainstem response (ABR) to high click rate, pure‐tone audiometry (PTA), and caloric test on postmenopausal women who suffered from MD or not at the Specialist Clinic of Vertigo, Shandong Provincial Hospital, during September 2010 to October 2014.ResultsA total of 76 postmenopausal patients with MD and 50 healthy postmenopausal controls were included. The patients with MD had lower estrogen levels (22.50 ± 16.66 pg/mL vs 30.69 ± 18.59 pg/mL, P = 0.011), longer I‐V interpeak latency of ABR (left 0.22 ± 0.16 mseconds vs 0.18 ± 0.10 mseconds, P = 0.118; right 0.24 ± 0.13 mseconds vs 0.17 ± 0.09 mseconds, P = 0.001), and higher unilateral weakness (UW) value (P < 0.001) in comparison with the controls. The mean pure‐tone thresholds of at the speech frequency (500 Hz, 1 kHz, 2 kHz, and 3 kHz) were significantly elevated in patients with MD than those in the controls (left P < 0.001, right P < 0.01). The estradiol level of patients with MD was correlated with ABR latency (left r = −0.229, P < 0.05; right r = −0.220, P < 0.05) and UW value (r = −0.328, P < 0.05), but not with mean pure‐tone threshold.ConclusionsEstrogen levels correlated with auditory and vestibular function in postmenopausal patients with MD. Low estrogen may be involved in the microcirculatory disturbance of the inner ear, affecting the occurrence and development of MD.

目的 观察分析曾行泪囊脓肿切开的先天性鼻泪管阻塞患儿泪道阻塞的病例特点及手术疗效.方法 回顾分析22例(24眼)曾行泪囊脓肿切开的先天性鼻泪管阻塞患儿病史及病例特点,行CT检查了解骨性泪道发育情况,采用Ritleng泪道插管术或鼻内窥镜下鼻腔泪囊吻合术进行手术治疗,对治疗效果及并发症进行总结.结果 24眼中,合并骨性鼻泪管发育异常14眼(58.3％),其中骨性狭窄12眼,骨性闭锁2眼,所有患儿遗留泪囊区皮肤瘢痕.不合并骨性泪道发育异常者10眼,其中泪囊突出2眼,复杂性鼻泪管阻塞8眼.不合并骨性泪道发育异常者采用Ritleng泪道插管术治疗,合并骨性泪道发育异常者采用鼻内窥镜下鼻腔泪囊吻合术,共治愈21眼(21/24,87.5％),好转2眼,无效1眼.结论 泪囊脓肿反复发作的先天性鼻泪管阻塞患儿泪道发育情况较为复杂,不应盲目行泪囊脓肿切开,不合并骨性泪道发育异常的患儿可行泪道插管术,对于合并骨性鼻泪管发育异常患儿需行鼻窦内窥镜下鼻腔泪囊吻合术.

目的 探讨先天性泪囊突出的CT影像特征及其对治疗方式选择的指导作用.设计 回顾性病例系列.研究对象 2008年6月至2015年6月北京儿童医院眼科先天性泪囊突出患儿24例(38眼).方法 分析患儿的CT影像特征,总结其手术方式及术后效果.主要指标 CT影像特征、治疗方式、术后效果.结果 所有患者CT显示患侧泪囊区呈类圆形囊性低密度肿物影像,骨性鼻泪管扩大,伴有或不伴有下鼻道肿物.5例(5眼,13.2％)行保守治疗2周后肿物消失.19例(33眼,86.8％)伴发急性泪囊炎、呼吸窘迫或经保守治疗2周后无效而手术治疗.其中,无下鼻道肿物的5例(8眼,21.1％),局麻下泪道探通术后内眦肿物消失.存在下鼻道肿物的14例(25眼,65.8％),全麻下鼻窦内窥镜下造口术,术后内眦及下鼻道肿物全部消失.结论 CT检查不仅可清晰显示先天性泪囊突出的解剖特征,也为手术治疗方式选择提供影像学支持.

小 毛的父母都是近视眼,所以父母一直担心已经 3 岁的小毛是否会近视,带孩子去医院检查,查出的结果是 3岁的小毛的眼睛现在既不近视也不远视.

Objective To evaluate the role of Computed Tomography(CT)in the diagnosis of congenital dacry-ocystocele. Methods CT results of 12 cases(19 eyes)with congenital dacryocystocele from June 2014 to June 2016 in Beijing Children's Hospital were analysed. Results The common features of congenital dacryocystocele on CT is a round cystic image with low density at inner canthus,ipsilateral nasolacrimal canal enlargement and with or with-out the inferior nasal passage mass. Conclusions Computed Tomography can show the prominent anatomical features of congenital dacryocystocele definitely. So it plays an important role in the auxiliary diagnosis of congenital dacry-ocystocele.

Objective The research of amblyopia had developed to the level of psychophysics and neurobiology.This review covered the perceptual learning theory including noise theory,spatial integration theory,lateral interaction theory,spatial distortions theory and binocular interaction theory.We also review the theoretical model of visual impairment mechanism.

社会对视光产业的需求日益增加,国家对视光产业发展积极规划与布署.视光的刚性需求,首先带来了视光人才专业布局的改变.眼病和视光,"眼科学+视光学"组合成了最好的眼科全程医疗保健体系. 从事眼科工作36年,从事小儿眼科和眼视光工作34年的于刚院长用自己多年从事视光工作的经历,在全国视光产业大会上和与会专家就如何打造OD+的新构思和新设想进行了分享.

不少家长发现孩子一到春天总是喜欢揉眼睛,由于孩子年龄小,还不太会表达自己的感受,家长常常会特别纳闷:到底是什么原因让孩子喜欢揉眼睛呢? 最常见的原因是过敏性结膜炎.春天花粉等过敏原增多,加上孩子的抵抗力较低,很容易诱发过敏性炎症.除揉眼外,过敏性结膜炎的孩子还会有眼睛流泪、红肿的现象,严重的还会感到灼烧感.而且当孩子脱离过敏原后数小时内症状就会消失,再次接触过敏原,上述症状立即再次出现.有的孩子除眼睛不适外,还同时伴有过敏性鼻炎,哮喘等.遇到这种情况,家长要让孩子尽量远离花粉等过敏原,如果症状较重,要到医院就诊,使用抗过敏类药物治疗.