Diplopia ; etiology ; Enophthalmos ; etiology ; Exophthalmos ; etiology ; Facial Nerve Injuries ; etiology ; Hemorrhage ; etiology ; Humans ; Intraoperative Complications ; etiology ; prevention & control ; Orbit ; blood supply ; surgery ; Orbital Fractures ; surgery ; Postoperative Complications ; etiology ; prevention & control ; Reconstructive Surgical Procedures ; adverse effects ; Reflex, Trigeminocardiac ; Vision, Low ; etiology

Ophthalmic plastic and reconstructive surgery is an interdisciplinary speciality,it includes cosmetic surgery,oculo- plastic surgery and orbital surgery.The current mainly problems and strategies will be discussed in this paper,the status and progresses of cosmetic surgery,including cosmetic eyelid surgery,anesthetic injection methods,and laser facial rejuvenation.Present existing prob- lems and their countermeasures in ocnloplastic surgery,including eyelid malignant tumor,eyelid defects,blepharospasm and anoph- thalmic socket disorders.Problems and management of orbital surgery,ineluding thyroid-associated orbitopathy,orbital fractures,and orbital deformities.At last,the mainly problems and corresponding measures of development of ophthalmic plastic and reconstructive surgery will be discussed.(Ophthalmol CHN,2007,16:365-367)

Objective To investigate the indications and surgical approaches of full-thickness eyelid reconstruction with superficial temporal artery island flap and oral mucosa free grafting,and evaluate the safety and efficacy.Methods A total of 13 eyes of 13 patients with wide full-thickness eyelid defect were treated by the eyelid reconstruction with superficial temporal artery island flap and oral mucosa free grafting.The defect area was(33.67?8.35) mm?(16.44?4.45) mm and the size of island flap was(38.56?8.99)mm?(18.44?4.00)mm.Eight cases were treated with oral lip mucosa grafting,while the other 5 with hard plate muco-periosteal free grafting.Follow up was conducted for 6 to 24 months. Results The flaps were clinically viable in 10 cases and partially viable in 2.One was inviable for venous circumfluence failure,and a successful free skin grafting was conducted 3 months postoperation.All the grafted oral mucosa survived.Five cases underwent the second surgery to thin the island flap,among whom 3 were performed eyelid suspension with the frontal muscle.The survived flaps were similar to skin in colour,soft in nature,and could effectively protect the eyeballs. Conclusion The superficial temporal artery island flap along with oral mucosa free grafting works well in wide full-thickness eyelid reconstruction.

Objective To investigate the eyelid and orbital development of congenital microphthalmia. Design Prospective case se- ties. Participants 23 eyes of 23 patients with congenital microphthalmia aged from 6 months to 78 months. Methods The parameters of palpebral fissure length (PFL), palpebral fissure height(PFH) were measured in all patients. Also, combining the computer tomography (CT) imaging with the computer-aided design system, the anteroposterior axis of eyeball and orbital volumn were calculated automatically. To e- valuate the influence factor of eyelid and orbital growth, correlations between age, anteroposterior axis of eyeball and PFL, PFH, orbital volumn were analyzed. Main Outcome Measures PFL, PFH, anteroposterior axis of eyeball and orbital volumn. Results The PFL, PFH, anteroposterior axis of eyeball and orbital volumn in micro-side were (16.44?3.24) mm, (2.47?1.48) mm, (11.99?3.33) mm, (14.19?2.37) ml respectively. These parameters above were all significantly smaller than the unaffected side (all P=0.000). Moreover, orbital volume showed a strong linear correlation with the anteroposterior axis of eyeball and age(r=0.62, 0.63;p=0.037, 0.035). Both PFL and PFH were corelated with the anteroposterior axis of eyeball (r=0.54, 0.53; P=0.030,0.034), while showing no significant difference with age. According to the an- teroposterior axis of eyeball, two groups, including group less than or equal to 12 mm (10 cases) and group more than 12 mm (13cases), whose PFL,PFH and orbital volumn were (13.50?1.97) mm, (1.08?0.66) mm; (12.73?0.95) ml, (18.20?2.49) mm; (3.30?1.16) mm, (15.05?2.57) ml, respectively. They had statistically significant difference in PFL, PFH and orbital volumn (P=0.001, 0.003,0.024). Conclusion The development of eyelid and orbit with congenital microphthalmia is obviously retarded. The smaller the eyeball is, the much worse in- fluence in eyelid and orbital growth is. The intervention therapy in early stage as far as possible is fundamental approach in simulating the eyelid and orbital development, or preventing and reducing the incidence of orbital deformity.

Objective To observe the postoperative changes of diplopia and eyeball movement disorder in patients with orbital fracture. Methods The clinical data of 62 patients with reconstructive surgeries for orbital fracture were retrorespectively analyzed.The position,range of fracture and incarceration of extraocular muscles were determined by CT scanning.The eyeball movement and diplopia were examined and recorded pre-operation,3,6 and 12 months after operation,respectively. Results Among the 62 cases,23 were simple orbital wall fracture and the other 39 were complex orbital fracture.Eighteen of the patients with simple orbital wall fracture had diplopia and 19 had eyeball movement disorder of Ⅰ degree or Ⅱ degree before operation.Twelve months after operation,5 had diplopia ofⅠ degree or Ⅱ degree,and 5 had eyeball movement disorder of Ⅰ degree.For those with complex orbital fracture,36 had diplopia and 38 had eyeball movement disorder.Twelve months after operation,29 had diplopia(III degree diplopia in 6) and 22 had eye movement disorder.Among the 12 patients with complex orbital fracture who received operation within 3 weeks after trauma, only one had III degree diplopia,while 5 of the 23 with complex orbital fractures repaired 3 months after trauma had III degree diplopia. Conclusion Surgical management can effectively improve diplopia and eyeball movement disorder resulted from orbital fracture.Earlier treatment is superior to later treatment in regard with the effect of surgical intervention.

Objective To explore the clinical effect of modified frontalis muscle suspension for severe blepharoptosis correction. Design Retrospective case series. Participants Fifty-six cases (101 eyes) with severe blepharoptosis. Methods Modified frontalis mus- cle suspension was adopted. The technique included single blepharoplasty-type incision, dissecting the posterior gaps of frontalis muscu- lar fasciae ahead,then euthyphoria isolating anterior gaps of rontalis muscular fasciae, using frontalis muscle transfer without vertical incision. Main Outcome Measure The positon chang of the upper eyelid in the primary position gaze. Results The follow-up period ranged from 8 to 20 months (mean, 13.6 months). All the patients were deemed to have a good surgical outcome. Complications such as ectropion and corneal exposure were avoided. But ten eyes required reoperation for undercorrection, six eyes for overcorrection and two eyes for entropion. Conclusion This surgical technique is a useful procedure that results in substantial cosmetic and functional im- provement with few complications.

Objective To develop a multiplex PCR-based reverse line blot(mPCR/RLB) hybridization assay to detect,simultaneously,seven genes encoding AR-erm(A/TR),erm(B),mef(A/ E),tet(M),tet(O),aphA-3,aad-6 and two AR-related genes,int-Tn and mreA in group B streptococcus.Methods Nine pairs of specific primers and Oligonucleotide probes targeting erm(A/TR), erm(B),mef(A/E),tet(M),tet(O),aphA-3,aad-6 int-Tn and mreA respectively were modified according to former studies or designed in this study.The primers and probes were labeled with biotin and amino,respectively.The nine genes were amplified simultaneously in the same tube.PCR product hybridized with the probes labeled in the BiodyneC nylon membrane to detect the nine genes.To detect the sensitivity and specificity of the method developed,PCR with single pair of primer targeting each gene were tested in 318 isolates tested and the results were compared with the one abtained by RLB.Results The nine resistance-related genes could be successfully detected by mPCR/RLB assay developed in this study.Based on sequencing,21 of 22 isolates with mef had mef(E)and eight of 353 with int-Tn had an atypical sequence.Except for the above 29 genes,all the others corresponded well with the results obtained by single pair primer PCR.Conclusion The mPCR/RLB assay developed in this study is simple,rapid and suitable for surveillance of antibiotic resistance in GBS.

Retinoblastoma (RB) is the most common intraocular malignant tumor in early childhood, which has an adverse effect not only on the eyesight, but also on patients’ life. Uveal melanoma (UM) is an another common intraocular malignant tumor in adults, nearly half of the patients will have metastasis of tumor with a low survival rate. The long non-coding RNAs (lncRNAs) are non-coding RNA with a length greater than 200 nt. More and more studies have confirmed that lncRNAs are involved in the proliferation, migration and invasion of tumors by regulating the gene expression at various levels, which makes lncRNAs become the novel target in the therapy of intraocular malignant tumors. This article reviewed studies of the roles and mechanisms of lncRNAs in RB and UM.

OBJECTIVETo study the clinical manifestations and surgical treatment of Type II orbital neurofibromatosis.

METHODSFrom Jan, 2001, to Oct, 2006, clinical data of 16 cases with type II orbital neurofibromatosis were retrospectively analyzed in the Department of Ophthalmology, Ninth People's Hospital, Medical School of Shanghai Jiao Tong University.

RESULTSAll patients had orbito-temporal or intra-orbital neurofibromatosis, combined with periorbital deformities. After partial tumor resection, the orbital reconstruction and blepharoplasty were performed in the same stage. The patients were followed up for 6-12 months with no relapse. The vision was improved in 6 cases and kept the same in 10 cases. The cosmetic results were satisfactory in all cases. 5 cases were re-operated because of relapse of blepharoptosis.

CONCLUSIONSThe function and appearance can be markedly improved after one-stage partial tumor resection, orbital reconstruction and blepharoplasty in patients with type II orbital neurofibromatosis.

Adolescent ; Adult ; Female ; Follow-Up Studies ; Humans ; Male ; Neurofibromatosis 2 ; surgery ; Orbital Neoplasms ; surgery ; Reconstructive Surgical Procedures ; methods ; Retrospective Studies ; Young Adult

UNLABELLEDOBJECTIVE To compare anti-oxidative effects of acupuncture at different Shichen (traditional twelve two-hour periods) accordin-17:00), You (17:00-19:00), Xu (19:00-21:00), Hui (21:00-23:00) periods according to the eight methods of the intelligent turtle, once each day, for 7 consecutive days. Changes of malondialdehyde (MDA) content and superoxide dismutase (SOD) activity after treatment were observed.

RESULTSSOD activities and MDA contents at the 12 periods were different in the healthy guinea pigs, SOD activity at Wu period was the highest and the lowest at Zi period; MDA content was the highest at Zi period and the lowest at Wu period. The needling method according to eight methods of the intelligent turtle could increase SOD activity in the guinea pigs. The increasing amplitude of SOD activity was the largest at Mao period and the smallest at the Wu period; it also could decreased MDA content, the decreasing amplitude of MDA was the largest at Wu period and the smallest at Hai period.

CONCLUSIONAcupuncture at different periods according to eight methods of intelligent turtle has different effects on serum SOD and MDA, which can increase SOD activity and decrease MDA content in the healthy guinea pig.

Acupuncture Therapy ; Animals ; Female ; Guinea Pigs ; Male ; Malondialdehyde ; blood ; Superoxide Dismutase ; blood ; Time Factors