Table of Content

16 October 2008 Volume 22 Issue 5

  

Articles

Morphological changes of the upper airway in OSAHS patients with UPPP


HE Shou-huan,CHEN Bin,YIN Shan-kai,SU Kai-ming,JIANG Xiao

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(5):  385-388 . 

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To explore the morphological changes of the upper airway in OSAHS patients with UPPP. Methods32 patients with OSAHS were enrolled in this study, and their pharynxes were scanned by CT before and after UPPP for analysis. The patients were divided into four groups according to the therapeutic efficacy, and comparison was done among the four groups. Results2-3 years after UPPP, the OSAHS patients′ upper airway morphology changed. The cross-section areas and transverse diameters of the velo-pharyngeal were enlarged during normal respiration; at the end of deep inspiration, the cross-section areas and transverse diameters of the velo-pharyngeal and retro-pharyngeal were both enlarged, and the pharyngeal collapsibility was relieved. There were significant differences in the cross-section areas′ changes of the velo-pharyngeal among the four groups. ConclusionIt is better for OSAHS patient to accept UPPP only if their main constrictive cross-section is located at the velo-pharyngeal level. CT imaging of the upper airway can be one reference standard for choosing UPPP.

Post-operative ICU monitoring and nursing for patients with OSAHS

SONG Xi-cheng,ZHANG Qing-quan,XIA Yong-hong,LIU Lu-yi, YU Lu-xin,WANG Gao,JIANG Xiu-liang

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(5):  389-392 . 

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To study the clinical sense of post-operative ICU monitoring and nursing for patients with OSAHS. Methods348 patients with OSAHS were included in the present study. Of all patients, 199 underwent uvolopalatopharyngoplasty (UPPP), 109 underwent modified hyoid suspension in combination with UPPP, 28 underwent nasal surgery in combination with UPPP, 4 underwent 3-planar operations and 8 underwent cervical pathway tongue root and body surgery. All patients were transferred to ICU wards right after the operations, and continuously sedated and subjected to controlled hypotension. All vital signs were monitored. ResultsDuring the course of ICU monitoring, the Ramsay score was increased to 6 or the SAS score was 1. Patients were transferred back to general wards after analepsia and extubation. The time span of tracheal intubation varied from 16 to 62 hours, with an average of 19.3 hours. After being observed for 2 hours following extubation, patients would be transferred to general wards if no adverse events occurred. 19 patients suffered from mild pharyngeal bleeding and healed after expectant treatment and cold compress; 5 suffered from bleeding because of restlessness and had an elevated blood pressure, and were controlled after sedation and antihypertensive therapy; none had hemostasis or secondary hemostasis operations. 3 cases (1 had 3 planar surgeries and 2 had 2 planar surgeries) suffered a dyspnea after extubation and were subjected to emergency tracheotomies. ConclusionsOSAHS patients should be treated by post-operative ICU monitoring, retaining tracheal canulas and delayed extubation as well as sedating and analgesic drugs, so as to lower the rate of serious complications such as bleeding and airway tract obstruction.

Complications following hyoid suspension

SUN Yan,ZHANG Qing-quan,SONG Xi-cheng,ZHANG Hua,CHEN Xiu-mei,WANG Xi-wen,WANG Yan

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(5):  393-394 . 

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To explore the complications that happened after uvulopalatopharyngoplasty (UPPP) combined with hyoid suspension for obstructive sleep apnea hyperventilate syndrome (OSAHS) patients. MethodsFrom January 2003 to June 2008, 109 (98 males and 11 females) cases of severe OSAHS were treated with UPPP. All patients were checked with a fiber optic laryngoscope of Muller and X-ray or CT for upper air flue when they were in a waking state to locate the collapse level (oropharyngeal and palatopharyngeal level, most of them had an obstruction on the oropharyngeal level). After the UPPP, they were sent to the ICU and monitored with trachea cannula for 1 to 2days. ResultsThe lower perforated edge of the inferior maxilla mangled by the thread for the hole was too low in 1 case. Incisions on the neck were fat liquoring in 6 cases. 3 cases had repeated inflammation, which was probably because the incision was irritated by the suture. 2 cases had bleeding from the incision. All had discomfort sensation on the pharyngeal and glossal portion, and movement of the tongue was constrained for 2-4 days and became normal after 5-7days. ConclusionHyoid suspension has few complications and is simple, safe and effective for OSAHS with an oropharyngeal level collapse.

Hard palate shortening in combination with lateral pharyngoplasty in treatment of recrudescent OSAHS patients following uvulopalatopharyngoplasty

YUAN Ying, YANG Shu-juan,WANG Ling-tai,LIU Fu-xing,SUN Xin-zhong

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(5):  395-397 . 

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To investigate the feasibility and clinical value of hard palate shortening in combination with lateral pharyngoplasty(HPS-LPP) in treatment of OSAHS with recurrence after uvulopalatopharyngoplasty(UPPP). MethodsHPS-LPP was performed on 8 patients. The pre-and post-operative scores of polysomnography(PSG), Muller test and cephalometric data were compared. ResultsNo apparent complications occurred, and the clinical symptoms were alleviated. Both the apnea hyponea index(AHI) and the lowest SaO2 (LSaO2) were improved in 7 cases. ConclusionThe volopharyngeal cavity can be effectively enlarged by HPS-LPP, which may be a revision surgery for recrudescent cases after UPPP.

Expression of the Ras-GTPase-activiting protein SH 3 domain binding protein
in laryngeal squamous cell carcinoma and it clinical significance

XU Zhi-jian ,PENG Jie-ren,HUANG Xiao-ming,GUAN Zhong,ZHU Xiao-fen,LIAO Yan-ping

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(5):  401-404 . 

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To investigate the expression of the Ras-GTPase-activiting protein SH 3 domain binding protein(G3BP) in laryngeal squamous cell carcinoma(LSCC) and to explore its correlation with biological behavior. MethodsThe expressions of G3BP in 91 cases of LSCC were determined by immunohistochemistry. The relationships between protein expression and tumor size, differentiation degree, TNM stage, lymph node metastasis and prognosis of LSCC were explored. ResultsThe positive expression rate of G3BP in LSCC was 84.7％. The G3BP expression level was correlated with the degree of differentiation of tumors（P=0.008）, clinical stage（P=0.005）, lymphatic metastasis（P=0.000）,　and tumor recurrence or distant metastasis（P=0.000）, and also the expression of G3BP was significantly related to survival in a negative time-dependent manner in LSCC patients（P=0.000）. ConclusionsThe expression of G3BP is related to the degree of differentiation of tumors， clinical stage, tumor recurrence or distant metastasis, lymphatic metastasis and survival in LSCC patients. Over-expression of G3BP may be used as a prognostic marker for overall survival of LSCC patients.

Expression and mutation analysis of tumor suppressor PTEN in nasopharyngeal carcinoma

CHENG Jin-mei,XIE Zhen-yu,LIN Qin,ZHANG Peng-fei,LIN Ying,YI Zi-xiang,TIAN Wei-zhong

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(5):  405-407 . 

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To detect the expression and mutation of tumor suppressor PTEN in nasopharyngeal carcinoma（NPC）， and to　investigate the relationship of the PTEN gene to pathogenesis and development of NPC． MethodsExpression levels of PTEN in 52 cases of NPC were determined by an immunohistochemistry method， and polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP), while silver staining and DNA sequencing were used to detect the mutation in exon 5 and 8 of the PTEN gene in NPC. ResultsDifferences of the PTEN expression were significant between NPC and nasopharyngitis (P＜0.05)． Expressions of PTEN were closely related to lymph node metastasis and clinical TNM stage(P＜0.05). None of 52 cases showed mutation in exon5 and 8 of the PTEN gene in NPC． ConclusionPTEN may have some effects on the pathogenesis and development of NPC, and mutation in exon 5 and 8 of PTEN may not play a main role in the genesis and development of NPC.

Apoptotic effect of human maligant melanoma cell line A375 induced by tumor-specific recombinant TRAIL gene

ZHU Chun-sheng,CHEN Jian-qiu

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(5):  408-411 . 

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To explore the targeted gene therapy of tumors by using the TRAIL gene in combination with the telomerase promoter. MethodsTotal RNA was extracted from peripheral blood lymphocytes (PBL) whose proliferation had been stimulated. The TRAIL gene with an IL-2 signal peptide gene was amplified by RT-PCR and cloned into the vector pGL3-181hTERT downstream of the hTERT promoter to form a eukaryotic expressing vector. A375 cells were transfected by the recombinant vector and apoptosis of the transfected cells was evaluated by rypan-blue exclusion and transmission electron microscopy (TEM). ResultsWe successfully constructed a recombinant eukaryotic expression vector for the TRAIL gene. The expressed product significantly induced the apoptosis of the A375 cells. ConclusionThe recombinant eukaryotic expression vector pGL3-IL-181hTERT/TRAIL was successfully constructed, which provides the possibility for gene therapy of tumors.

Clinical guidelines for usage of 226- and 1,000-Hz tympanometry in
normal neonates

YANG Kun,LIU Zhi-qi,HUANG Zhi-wu

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(5):  420-423 . 

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To evaluate the clinical characteristics of tympanograms using 226- and 1,000-Hz probe frequencies and to provide a clinical guideline. MethodsHearing of all subjects was screened by means of transient-evoked otoacoustic emissions. Tympanograms, recorded with probe-tone frequencies of 226- and 1,000-Hz, were classified based on the Liden/Jerger model of shapes. Furthermore, equivalent ear canal volume, tympanometric peak pressure and other important tympanometric parameters were calculated for each tympanogram. ResultsBoth ears of the 100 neonates passed the TEOAE Screening. Most tympanograms obtained from the 226 Hz tympanometric data were double-peaked (96.0%). The 1000Hz tympanometric data obtained showed a single - peaked tympangram in 180 ears (90.0%). 174 (87.0%) ears were either double-peaked in 226Hz tympanogram or single-peaked in 1000Hz. 6 ears had a single peak both in 226Hz and in 1,000Hz tympanogram. ConclusionThese results have led to the successful implementation of 1,000-Hz tympanometry in neonatal hearing assessment.

He-Ne Laser， O₂ inhalation and de-proteinized calf blood extracts applied to tympanic membrane perforation induced by trauma

LIU Ji-rong, LI Da-you,LI Dong-mei

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(5):  424-426 . 

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To assess the effect of He-Ne laser， O2 inhalation in combination with de-proteinized calf blood extracts in treatment of tympanic membrane perforation induced by trauma. Methods112 cases of tympanic membrane trauma perforations were randomly divided into the experimental group and the control group A and the control group B. 42 patients (43 ears) in the experimental group were treated with He-Ne laser, O2 inhalation and medicines. 40 patients(40 ears) in control group A mended by themselves. 30 patients(30 ears) in control group B were treated by the tympanic membrane patching method. Also the three groups were routinely treated with antibiotics. Tympanic membrane trauma perforations were observed after 2 and 4 weeks of treatments and followed up for 3 months. ResultsCurative rates at 2 and 4 weeks in the experimental group were 71.43% and 95.24%, which were significantly higher than those(17.5% and 45%)in the control group A (both P＜0.01, χ2 test). There were no statistical significances(χ2＝3.429 and χ2＝1.683, both P＞0.05) between the experimental group and the control group B. ConclusionsHe-Ne laser，　O2 inhalation and medicines can increase the therapeutic effectiveness of tympanic membrane trauma perforation, shorten the period of healing and improve the curative rate.

Surgical management for stenosis or atresia after operations for congenital external atresia in 10 cases

XU Yao-dong, LIU Xiang, OU Yong-kang, ZHENG Yi-qing,CHEN Sui-jun,JI Shu-fang, GUO Xiao-juan

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(5):  427-428 . 

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To explore the surgical management for stenosis or atresia following operations for congenital external atresia and its effect. Methods10 cases of stenosis or atresia which had received operations for congenital external atresia were enrolled in this study. In the second operations, an endaural incision was done and scar tissues were cut away to extend the external canal, skin grafting was transplanted to the new canal, and also tympanopalsty was simultaneously done in 7 ears. Results2 cases had re-stenosis and were alleviated after local rejection of hormones and local packing. PTA of 7 cases decreased 15dBHL and of the other 3 cases had no improvement. ConclusionRe-operation for stenosis or atresia after operations for congenital external atresia is effective and tympanoplasty can be simultaneously done.

Effect of functional endoscopic sinus surgery on symptoms and
quality of life in chronic rhinosinusitis

LIU Li-ting,LIU Dan,SHEN Bin,MA Lian-shan,YAN Li-ping,HAN Zai-wen

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(5):  434-438 . 

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To evaluate the effect of functional endoscopic sinus surgery and the modus operandi on symptoms and quality of life of patients with chronic rhinosinusitis. Methods Sixty patients with chronic rhinosinusitis and nasal polyps were enrolled by random and their QOL scores were assessed by using QOL instruments including existing SF-36 questionnaires (Chinese version) and SNOT-20 questionnaires, and of them patients of different groups were given different scope surgeries to appraise the impact of the modus operandi on patient′s symptoms and the quality of life. ResultsIn the 1 month follow-up settings, such domains as role physical， mental health, role emotional and general health of SF-36, scores of the total 20 items and the most important 5-item scores of SNOT-20 were markedly improved (P＜0．05)； in the 2-6 month follow-up settings， the above indexes stayed fixed(P＞0．05)； and in the 6month follow-up settings， indexes of symptoms and QOL status entirely improved from the baseline，and different scope surgeries had no statistical significance on symptoms and QO L. ConclusionsOn the whole patients undergoing endoscopic sinus surgery have their symptoms relieved and QOL status will be normal on postoperative 6 months. Improved and traditional endoscopic sinus surgery are basically identical on the improvement of the symptoms and QOL.

Imaging anatomy of the apertura of the sphenoidal sinus


JIANG Shao-hong,LIU Feng-chun,ZHANG Qing-quan,L Yong-bin ,WANG Qiang

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(5):  439-441 . 

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To measure the imaging anatomical data of the apertura of sphenoidal sinuses and their surrounding structure and to provide clinical guidance for surgeons. Methods30 adults with a normal sphenoidal sinus were subjected to lamella CT scanning of rhino-sinuses. Axial and frontal reconstructions were performed. The apertura of sphenoidal sinuses and their surrounding structures were measured. ResultsThe maximal vertical longitude of sphenoidal sinuses was (2.28±0.52)mm and the maximal horizontal longitude was (2.06±0.32)mm. Distance between the apertura of the sphenoidal sinus and the anterior naris was (72.34±3.67)mm， the maximal distances between the apertura and hanging wall, posterior wall, inferior wall and lateral wall of the sphenoidal sinus were (10.64±3.99), (17.68±2.78), (13.25±3.50) and (8.76±3.79)mm, respectively. ConclusionsThe apertura of the sphenoidal sinus is the vital anatomic landmark for per-sphenoidal operations, and it should be intero-inferiorly oriented not exceeding 10.64±3.99mm upwards and 8.76±3.79mm laterally.

Correlation between aquaporin-5 expression and curative results of nasal polyp operations

CAO Ying-chun,SHI Xue-yan,LI Jian-dong,WANG Zong-feng,LI Xin-gong

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(5):  442-444 . 

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To observe the distribution and expression of aquaporin-5(AQP5) in recurrent nasal polyps and cured ones and to explore the relationship between AQP5 in nasal polyps and the curative results of nasal polyp operations. MethodsEndoscopic sinus surgery was performed on 63 patients with nasal polyps who were followed up for 6 months. After the operations, nasal padding materials were removed at 48 hours, hormones were used for 1 to 2 months, saline was used for flushing the nostrils once daily for 1 to 3 months and the nasal cavity was cleaned up under nasal endoscopy once a week for 1 month, and then once every two weeks for 3 to 6months. AQP5 expression was determined by immunohistochemistry in the recurrent nasal polyp group and the cured group. ResultsThe expression of AQP-5 positive cells was statistically significantly decreased in the recurrent nasal polyp group compared with the cured group(P＜0.05). ConclusionsOverexpression of AQP5 may influence the recurrence of nasal polyps and it might be used as an index for prognosis of nasal polyps after the operations.

correlation between E-selectin expression and the curative results of nasal polyp operations

GE Hong-zhou,LIN Yong-chen,DONG Xiu-li,LIN Jie-fa,LIU Yu-xian

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(5):  445-448 . 

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To study the relationship between expression of E-selectin and the curative results of nasal polyp operations by immunohistochemistry. MethodsBased on the Haikou standard in 1997, 40 patients with nasal polyps were subjected to endoscopic examination and sinus CT scanning before surgery, during endoscopic surgeries, and pathologic examination after the operations. Followed up for one year, the surgical effect were determined. ResultsThe higher the E-selectin, the poorer the prognosis. ConclusionIn the present experiment, E-selctin expression is related to prognosis in nasal polyps.

Growth features of human embryonic lens epithelial cells cultured in vitro

ZOU Jun,LU Yi,CHU Ren-yuan

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(5):  453-456 . 

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To investigate the biological characteristics of human embryonic lens epithelial cells cultured in vitro. MethodsHuman embryonic lens epithelial cells were cultured by the explanting culture methods. An inverted phase contrast microscope, electron microscope and immunocytochemistry were used to study the growth specialties of the human embryonic lens epithelial cells. ResultsHuman embryonic lens epithelial cells of primary culture in vitro grew out of the edge of tissue pieces after incubation for 48-72 hours. The primary cultured cells maintained typical morphology of the epithelial cells and reached a confluence in 10 days. Growth curves of cultured human embryonic lens epithelial cells in passage 2 showed an S-shape. After a 1-2 day latent period, the cultured cells logarithmically grew and reached a confluence in 10 days. The shape of human embryonic lens epithelial cells in passage 2 was hexagon or oval with normal ultra-structure. Positive staining of α-crystalline was shown in passage 2 cultured human embryonic lens epithelial cells by immunocytochemistry. ConclusionHuman embryonic lens epithelial cells have proliferative capacity and are suitable for related study of cataracts.

Acute retinal necrosis syndrome in 42 eyes

DONG Wei-hong,ZHOU Fang,BI Hong-sheng,WANG Xing-rong,
DU Xiu-juan,MA Xian-zhen,YU Chao

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(5):  457-459 . 

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To explore the therapeutic methods for acute retinal necrosis syndrome and to evaluate the therapeutic effects of anti-virus drugs, photocoagulation and vitreous-retinal surgery. MethodsThirty-six cases (42 eyes) of acute retinal necrosis syndromes were studied. All were treated with acyclovir （ACV） and corticoid hormones. Those with severe vitreous inflammation or retinal detachment were treated with drugs, and photocoagulation in combination with surgery. Followed up from 6 to 24 months, the retinas and eyesight were observed. ResultsThe retinas of 40 eyes were all successfully reattached, and the visual acuity of 37 eyes was improved, in which the acuity of 23 eyes was better than 0.1 and the best acuity was 0.8. ConclusionRetinal detachment is the most severe complication of acute retinal necrosis syndrome, and it can lead to visual loss and often is easily misdiagnosed. If it is diagnosed early and treated in time with proper methods such as effective drugs including acyclovir and corticoid hormones, photocoagulation and vitreous-retinal surgery, good results can be produced.

Comparison of laser in situ keratomileusis and laser epithelial
keratomileusis in treatment of hyperopia


LI Yan,WU Yu-wei,ZHANG Zuo-hong,LI Jing-hai

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(5):  460-463 . 

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To compare the difference between laser in situ keratomileusis (LASIK) and laser epithelial keratomileusis (LASEK) for correction of hyperopia. MethodsA randomized prospective study of 65 cases (121 eyes) which had surgeries from January 2005 to May 2007 was conducted. All patients were randomly assigned to receive LASIK or LASEK. The postoperative stimulated symptoms, uncorrected visual acuity (UCVA), refractive power, time of epithelial healing and corneal hazes were observed and analyzed. ResultsMost patients of the LASEK group got more obviously stimulated symptoms such as tears and foreign body sensations than the LASIK group. All the patients got obvious improvements on visual acuity. The spherical powers of patients who were given LASEK were obviously dropped (P>0.05). Compared with the spherical powers on half and one month post-operation, there was a obvious regression in patients of the LASIK group at postoperative 3 and 6 months (P<0.01). There were no syndromes during or after the operations. ConclusionBoth LASEK and LASIK are predictable, safe and available in treating hyperopia. Neither produces serious syndromes.

Imaging sectional anatomy of the optic canal

JIANG Peng-fei,LIU Feng-chun,L Yong-bin

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(5):  464-466 . 

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To explore the normal imaging anatomy of the optic canal by spiral CT so as to supply data for clinical application. MethodsThe optic canals of 30 normal subjects were examined by MS CT，and the anatomic structures were determined by means of multi-planar reconstruction. ResultThe axial, frontal and oblique frontal CT scanning had respective advantages. ConclusionAnatomic measurement of the optic canal could be accurately and easily performed by means of multi-planar reconstruction of MS CT.

Manual nucleus fragmentation in senile cataracts

XIA Wen-qing,ZHENG Min,MAN Xiao-fei,LI Jian-ping

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(5):  467-469 . 

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To observe the clinical effectiveness of manual nucleus fragmentation in senile cataracts. MethodsManual nucleus fragmentation and rigid intraocular lens implantation were performed on 98 patients (107 eyes) suffering from senile cataracts. The visual acuity, corneal astigmatism and complications were observed for 3 months postoperatively. Results Visual acuity of 76 (71.03%) eyes was up to 0.5, of 20 (22.47%) eyes between 0.8 and 1.0 at the 1st week postoperatively. Mean corneal astigmatism was not significantly different before surgery and at the 3rd month after surgeries(P＞0.05). Posterior capsule rupture occurred in 4 cases (3.74%). ConclusionManual nucleus fragmentation for senile cataracts is effective and safe with satisfactory visual acuity after the operations.

Surgeries for 27 cases of ocular trauma complicated with ciliary body detachment

WEN Ying,ZHANG Jian-hua,BI Hong-sheng

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(5):  470-472 . 

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To evaluate the clinical effect of vitrectomy and cyclodialysis cleft repair for ocular trauma complicated with ciliary body detachment. Methods27 cases of complicated ocular trauma were subjected to ultrasound bio-microscopy (UBM) for determining ciliary body detachment, which was 360 degrees associated with the cyclodialysis of 3 to 5 o′clock. Pre-operative visual acuity (VA) ranged from light perception (LP) to hand movement (HM). The average intraocular pressures(IOP) was 6.03±3.25mmHg before surgeries. Also blood staining of cornea, mydriasis, hyphema, detachment of the iris root, luxation or semiluxation of the lens, traumatic cataract, vitreous opacity and detachment of the retina or choroids were found. Repair of the cyclodialysis cleft combined with vitrectomy was performed on all patients, and also cataract removal, iris root suture, retina re-attachment and sclera tapping were performed. ResultsAfter surgeries, the ciliary body reattached in all cases. Post-operative VA was significantly improved. The mean IOP was 19.33±5.05 mmHg at 1 month. During the follow-up, no detachment of the retina was found and the refracting media of 24 eyes(88.89%)remained clear. ConclusionFor ocular trauma with the cyclodialysis above 2 o′clock, combined vitrectomy and repair of the cyclodialysis cleft are effective to recover the anatomic structure and preserve the available visual function.

Significance of measurement of the corneal deep in the LASIK operation

LI Jing,ZHAO Hua,XU Shen,SHEN Wen-jing,XU Peng

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(5):  473-475 . 

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To explore the significance of the sub-keratoderma valve matrix deep in laser in situ keratomileusis (LASIK). MethodsThe deep of sub-keratoderma flap stroma was measured by A ultrasonometry in 89 cases (177 eyes) after general LASIK. We planned to retain 300μm corneal stroma and adjusted the laser cutting area. ResultThe mean deep of the flap was（118.01±18.03）μm，the mean deep of the suction was（77.62±22.65）μm，and the mean deep of the remaining stroma was（321.28±13.28）μm. The mean vision was respectively 1.02±0.23, 1.0±0.22, 1.04±0.20 and 1.18±0.24 at day 1, week 1, month 1 and 3 after LASIK, also the vision of 117 eyes increased more than one row, only 5 eyes' decreased more than one row than that before surgery. The remaining diopter was +0.75D～-1.25D, meanly -0.06±0.37D after 3 months. 111 eyes (62.71%) were cut 6.5mm and 8.0mm in the stroma, 59 eyes (33.5%) 6.0?mm and 8.0?mm, and 4 eyes (2.26%) 6.0?mm; the remaining 3 eyes (1.69%) were given a zonational cut. ConclusionsInstantaneously registering of the deep of the stroma subkeratoderma flap in LASIK is helpful in decreasing the keratoconus risks.

Operative approach and skill for desic and biological amniotic membrane grafting in treating ocular surface diseases

LIANG Ling,ZHANG Ji-ping

JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2008, 22(5):  476-477 . 

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To approach the operative methods and skills of desic and biological amniotic membrane grafting in different ocular surface diseases. Methods79 patients (100 eyes) with eye burn，pterygium and conjunctiva tumor，who accepted different types of desic and biological amniotic membrane grafting were followed up. ResultsCorneal perforation occurred only in 1 eye of the eye burn group (1/26)； recurrence happened in 2 eyes of the pterygium group (2/59)； 15 eyes in the conjunctiva tumor and other groups had good recuperation after the operations. ConclusionDifferent types of amniotic membrane grafting should be selected for different ocular surface diseases. Noninvasive, non-tweezers and mosaic sutures should be adopted to speed up wound healing and reduce recurrence. Biological amniotic membrane grafting is the choice of operation for patients with a history of conjunctiva trauma.