Retrospective analysis of 30 cases of penetrating keratoplasty in children followed- up 3 months to 3 years found that 46.7% of the grafts were clear and 53.3% were failures.The younger the children,the higher was the risk of failure,especially amo- ng cases of combined operations.

The manifestations of rheumatic disease on ocular surface include dry eye, marginal nonbacterial corneal ulcer (corneal melting) and necrotizing scleritis. The pathogenesis involves with immune complex response. We use artificial tears to relief symptom in associated dry eye patients. For the superficial corneal ulcer we administer 0.5% heparin and 1% cyclosporin A or 0.05% FK506 topically to the eye, while for the deep corneal ulcer or tending to perforation or perforated, we employ lamellar keratoplasty or penetrating keratoplasty or sclera transplantation. (Ophthalmol CHN, 2006, 15:159-160 )

Corneal graft melting after keratoplasty is rare to happen.However,once corneal graft melting had happened,it is difficult to manage.It would be precluded effectively by confirming the risk factors and pathogenesis for corneal graft melting.Progression of graft melting also can be well controlled using immune depressant,heparin,or collagenase inhibitor at the early stage.Those patients with melted graft can be treated with repeat keratoplasty

An experimental study was made on the preser- vation of donor corneas with a Dexsol medium prepared,a total of 40 animal corneas(rabbit and monkey,20 each)and 5 human corneas were used.The corneas were preserved separately at 4℃ for 2 weeks and at 34℃ for 5 weeks.The corneas preserved at different temperatures for different lengths of time were doubly stained with trypan-blue and alizarin red,which revealed that the endothelial cells remained fully active.Transmisscon and scanning election microscopy showed that neither the corneas preserved at 4℃ for 2 weeks nor those preserved at 34℃ for 5 weeks had any pathological changes in the ultrastructure of their endothelial cells.The rabbit cornea preserved with the Dexsol medium was used in homoplastic perforating keratoplasty,which resulted in a transparent transplant 2 months after the opera- tion.In 20 patients who received donor corneas preserved in the Dexsol medium for keratoplasty, the grafts remained clear 3 months after operation, and had an average endothelial cellular density of 1915/m~2 in the central region.

Objective To prove the existence of dry eye in children and to learn the clinical characteristics of them. Design Prospective observational case series. Participants 38 cases(76 eyes) of suspected children of dry eye diagnosed by adult standard and 38 normal children subjects. Methods 38 suspected child patients were studied who were diagnosed clinically with dry eye by adult standard, and were followed up 6 months. The control group consisted of 38 normal children with no significant difference in age. Dry eye examinations including Schirmer test, break-up time(BUT) and fluorescein staining were performed on these two groups. Following items were recorded in 38 suspected children of dry eye, including symptoms and causations. Main Outcome Measures Symptoms, Schirmer test, BUT and fluorescein staining. Results In the 38 suspected patients, frequent blinking was the most common symptom in 21 cases(55.26%), followed by dryness (15 cases, 39.47%), redness (14 cases, 36.84%) and photosensitivity (14 cases, 36.84%). The Schirmer test and BUT were decreased remarkably in the suspected patients compared to those of normal subjects (P=0.0000). In both groups, right eyes were correlated with left eyes in both Schirmer test and BUT. Between these two groups, Schirmer test was nol correlated with BUT. In the suspected patients, the results of BUT and fluorescein staining were improved (P

Objectives To investigate the clinical feature, diagnosis and surgical treatment for macular corneal dystrophy. Design Retrospective case series. Participants 18 patients(36 eyes)with macular corneal dystrophy. Methods The clinical data of patients were studied, including history, visual acuity, slit lamp microscopy, surgical method and follow-up. Main Outcome Measures Slit-lamp microscopic images of corneal dystrophy and graft. Results The patients with macular corneal dystrophy experienced progressive loss of vision. With slit lamp microscope, opacities were observed in the entire thickness of the stroma. Irregular grey-white nodules were noted in the central superficial stroma and peripherial deep stroma. Penetrating keratoplasties were performed in 14 cases (18 eyes). The follow-up was 6-112 months. At the last follow-up, all the grafts were clear. Conclusion Macular corneal dystrophy has typical clinical features. The diagnosis is mainly based on typical clinical manifestations. Penetrating keratoplasty is an effective approach for the treatment of patients with severe macular corneal dystrophy. (Ophthalmol CHN, 2006, 15:169-172 )

OBJECTIVETo summarize operation key points, prevention and management of complications in vascularized autotransplantation of submandibular gland for treatment of severe keratoconjunctivitis sicca.

METHODS23 patients with severe keratoconjunctivitis sicca were treated by this procedure. Postoperative (99m)Tc images, follow-up studies, and management of complications were performed.

RESULTSThe transplantations were successful in 19 cases, whose symptoms of xerophthalmia disappeared. The patients could stop applying artificial tears. In 4 patients the transplanted glands did not survive. Epiphora occurred in 5 cases. They were successfully treated by reducing the size of the graft. Obstruction of the Wharton's duct took place in one case and was treated by reconstructing the duct. When the superficial temporal vein was too small, venous bridging was applied. To select a relevant vein for anastomosis, blood oozing from the three veins was carefully inspected prior cutting off the gland when the external maxillary artery was preserved and was infused with heparin after the gland had been freed.

CONCLUSIONSIf every point has been properly managed, the successful rate of operation could be warranted.

Adolescent ; Adult ; Child ; Female ; Humans ; Keratoconjunctivitis Sicca ; surgery ; Male ; Middle Aged ; Postoperative Complications ; prevention & control ; Submandibular Gland ; blood supply ; transplantation ; Transplantation, Autologous ; Treatment Outcome