Conjunctiva Sac Research Articles

Clinical value of endoscopic lacrimal duct probing in neonates with acute dacryocystitis

ObjectiveTo observe the clinical of endoscopic-assisted lacrimal duct probing in neonates with acute dacryocystitis. MethodsThe prospective treatment of 148 eyes of 103 cases of neonatal acute dacryocystitis was studied. In the observation group, 58 cases (76 eyes) underwent endoscopic exploration of lacrimal passage under topical anesthesia. Make the child lie on the bed, after the surface anesthesia of hydroxybucaine hydrochloride, dot dilator is not easy to expose the dilatable lower point. With the assistance of nasal endoscope, the probe of the No. 6 lateral foramina lacrimal duct entered the lacrimal duct and dacryocyst successively. After entering the dacryocyst, the pus was sucked out with a syringe and rinsed repeatedly with normal saline until no obvious suppurative secretions were discharged. Postoperative topical anti-inflammatory eye drops and oral antibiotics were used. In the control group, 45 patients (72 eyes) were treated with hospitalized systemic antibiotics and conservative treatment with local antibiotic eye drops. ResultsIn the observation group, 58 cases (76 eyes) underwent superficial anesthesia and nasal endoscopy assisted lacrimal duct exploration and achieved satisfactory results. Stenosis of the lower nasal passage was found in one eye. In all cases, there were no serious complications during and after surgery, and no recurrence was observed for 3 months to 1 year after surgery. In the control group, 45 cases (72 eyes) of neonates with acute dacryocystitis, 10 cases with conjunctival sac secretion disappeared after conservative treatment. Redness and swelling in the dacryocystitis were improved in 31 cases, of which 2 cases had facial scars due to drainage of pus from the conjunctiva sac through a percutaneous laceration incision. Four patients were discharged automatically due to the aggravation of symptoms. After 6 months of follow-up, about 50% of the children received exploratory treatment of lacrimal passage and completely healed. ConclusionNasal endoscope-assisted dacryocystitis is a method for the treatment of neonatal acute dacryocystitis, which is worthy of clinical promotion.

Conjunctival sac flora and drug susceptibility analysis in normal children in East China

PurposeTo investigate the distribution characteristics of conjunctival sac flora and assess the susceptibility of commonly used topical antimicrobial agents in normal children under the age of 18 in East China.MethodsIn 2019, a study was conducted at Qingdao Eye Hospital of Shandong First Medical University to analyze the microorganism cultures of conjunctival sac in 1258 normal children (2516 eyes; average age, 6.21 ± 3.78 years) in East China. Exclusion criteria included children with ocular surface diseases and those who had used any topical antimicrobial agents recently. The microorganism species in the conjunctival sac were analyzed using the M-38A protocol (microdilution method; investigators read the minimum inhibitory concentration [MIC] values) by the Clinical and Laboratory Standards Institute to determine drug susceptibility.ResultsThe incidence of conjunctival sac microorganism in children was 32.87% (827/2516), a total of 541 cases (male 293, female 248). Children with conjunctival sac flora in a single eye were 255 and in both eyes were 286 (no statistical difference, P > 0.05). The concordance rate of children with binocular conjunctival sac flora was 32.16% (174/541; male 84, female 90). A total of 42 species of bacteria were detected. Children with Gram-positive cocci accounted for the highest proportion, 91.54% (757/827). The top three bacteria with the highest detection rates were Staphylococcus epidermidis (S. epidermidis; 52.12%), Streptococcus (12.09%), and Staphylococcus aureus (S. aureus; 10.76%). Streptococcus mitis (5.20%) accounted for the highest proportion of Streptococcus.S. epidermidis had the highest proportion in all age groups and was positively correlated with age (r = 0.89, P = 0.03). Before six years of age, the streptococcal proportion(mainly S. mitis) was greater than that of Staphylococcus aureus. The drug susceptibility analysis showed that S. epidermidis was most sensitive to gatifloxacin (98.61%), while it had the highest resistance rate to erythrocin (87.94%). S. aureus had the highest susceptibility to moxifloxacin (100%). Streptococcus was most sensitive to moxifloxacin (96.97%) and had the highest resistance rate to tobramycin (92.93%).ConclusionsConjunctival sac flora in children was dominated by Gram-positive cocci, mainly S. epidermidis, S. aureus, and Streptococcus. S. epidermidis increased with age; the proportion of Streptococcus was higher than S. aureus among children aged 0–6 years. The typical conjunctiva sac flora was generally sensitive to quinolones, such as moxifloxacin and gatifloxacin; Streptococcus displayed high resistance to tobramycin antibiotics; and the female children had higher resistance to tobramycin than the male children.

Formulation And Evaluation of Controlled Release Bromfenac Sodium Ocular Insert

According to the World Health Organization, cataract operations are performed on one million people per year [1]. After cataract surgery, however, most patients still experience physiologically severe postoperative ocular inflammation. Uncontrolled intraocular inflammation causes discomfort, delayed recovery, poor visual results, and even more severe problems such as cystoid macular oedema and synechiae due to inflammatory cells and cytokines entering the aqueous humour. Topical non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used to treat non-infectious ocular inflammation after ophthalmic surgery. As a result, NSAIDs appear to be potentially useful drugs for cataract surgery. [2] The U.S Food and Drug Administration has approved four ophthalmic NSAIDs to treat postoperative ocular inflammation followed by cataract surgery: bromfenac sodium, diclofenac sodium, Ketorolac tromethamine, and nepafenac.[3] The first approved NSAID for treating anterior chamber inflammation during cataract surgical treatment is bromfenac ophthalmic solution. Bromfenac is a more potent drug than other drugs for treating ocular inflammation. [4] The drug-loaded eye drop is easy to use. However, it has the inherent disadvantage that most medication is almost immediately diluted away in the tear film when the eye drops are introduced into the cul-de-sac and quickly exhausted from the precorneal cavity's constant tear flow. This process occurs more intensively in swollen eyes than in normal eyes and lachrymal-nasal drainage. [5,6] To avoid the previously stated side effects and increase the drug's effectiveness, a novel approach of an ocular insert that increases the drug's contact time in the eye should be chosen, thus improving patient compliance by increasing bioavailability and reducing frequent administration. [7] Ophthalmic inserts are skinny discs of polymeric substances that fit into the upper or lower conjunctiva sac. They have compensations over the conventional dosage forms and possess amplified ocular residence, discharge the drugs at a slow and consistent momentum, are capable of delivering precise dosing, lack preservatives, have augmented shelf life, and reduced systemic incorporation. [8] Our research intended to fabricate bromfenac sodium ocular inserts to amplify the contact time and offer a controlled release model that could advance patient compliance, cut dosing frequency, and attain superior curative usefulness.

Etiology and clinical signs of thoracic cancer

The article discusses the main causes of keratoconucleotide in dogs, as well as the clinical signs of the disease. As a result of anamnesis data collection and clinical examination, the type and nature of the peripheral and eye lesions have been identified, most of which are associated with purulent era to co nucleotide. Dogs were noted for palpation of the infected eyes with severe pain and increased local temperatures. Dog's eye as an eye organ is of great importance in the animal body, since the eye is an external analyzer, which helps the animals to freely understand the environment, to find food, to move and to protect themselves from damaging factors. Therefore, pathology of the organs affects the condition of the dog's body. The results of the research show that the main etiological factors in the development of ophthalmology are, in most cases, environmental degradation, high levels of dust, solar radiation, environmental pollution and dense animal conservation, and timely and poor quality preventive measures. Studies have shown that the purulentkera to contusing dogs also develops as a complication of infectious, non-communicable diseases. By the third day of treatment, sick dogs treated by traditional methods had little to no clinical signs on the first day. By the fifth day of treatment, palpation of the mucous serous fluid from the conjunctiva sac when the palpation of the eyelid did not decrease, the upper and lower conjunctivitis was red and the mucous membrane was not diminished.

Stimulating effects of conjunctival sac implants after eye enucleation on orbital bone tissue in rabbits

Objective To investigate the stimulating effects of conjunctival sac implants following eye enucleation on orbital bone tissue in rabbits model. Methods Eighty 1-month-old New Zealand rabbits were randomly divided into normal control group, only eyeball enucleation group, 2-week interval group and 4-week interval group.The right eyeballs were enucleated in the rabbits in the only eyeball enucleation group, 2-week interval group and 4-week interval group, and conjunctival sac implants were placed intraoperatively.Then a larger implant was replaced in a 2-week interval or 4-week interval in different groups, respectively.Spiral CT scan was used to evaluate the orbital bone development with aging.The peripheral blood of 3 ml was collected in the rabbits for the detection of osteocalcin and alkaline phosphatase using osteocalcin test kit (N-MID Osteocalcin) and alkaline phosphatase assay kit (NPP substrate-AMP buffer method), respectively.The animals were sacrificed at 3 months after operation for the histopathological examination of orbital bone tissue. Results The operation was successful in all the rabbits and no infection occurred after operation.The variance of orbital bone CT value was obvious in all the rabbits.The intercalated osteocalcin concentration was (48.55±7.99), (59.80±2.96), (57.94±5.20) and (55.96±3.22) μg/L and the alkaline phosphatase concentration was (284.66±132.69), (232.96±54.39), (232.40±118.23), (284.20±130.41)μg/L in the normal control group, only eyeball enucleation group, 2-week interval group and 4-week interval group, respectively, showing insignificant differences among the four groups (F=2.710, 0.281, both at P>0.05). Similar pathological findings were in the 2-week interval group and 4-week interval group, such as no obvious orbital bone malformations, weak bone absorption and few bone osteoclasts under the optical microscope.Varying degrees of orbital deformities and bone tissue absorption were found in the only eyeball enucleation group.No orbital bone developing abnormality was seen in the normal control group and the left eyes in various groups under the optical microscope. Conclusions Compared with the only eyeball enucleated eyes, the orbital bone tissue has a well developed process in conjunctiva sac implant eyes following eyeball enucleation.Conjunctiva sac implant is an effective method to stimulate orbital growth and orbital volume increasing. Key words: Eye enucleation; Bone tissue; Orbital malformation; Osteoclast

Conjunctival flora and their antibiotic susceptibility in patients undergoing penetrating intraocular surgeries

Objective To determine the spectrum of conjunctival flora and the antibiotic susceptibility profiles of patients scheduled for penetrating intraocular surgeries. Methods A prospective case control study was performed.A total of 192 patients (192 eyes) scheduled for penetrating intraocular surgeries at the Fourth People's Hospital of Shenyang from February to August 2015 were enrolled.Samples from the conjunctival sac were collected before instillation of any ophthalmic solutions for both aerobic and anaerobic culture.The positive rate and bacterial spectrum were observed.Bacterial isolates were tested for antibiotic susceptibility to 7 commonly used ophthalmic antibiotics using automated drug resistance analyzing system.The research was approved by the Ethics Committee of the Fourth People's Hospital of Shenyang. Results Totally 91 strains were collected from 81 conjunctival samples during aerobic culture, the positive rate was 42.19%.Staphylococcus epidermidis was the most common microorganism (64.84%), followed by Staphylococcus lentus (7.69%) and Staphylococcus aureus (3.30%). Coagulatase negtive Staphylococcus (CNS) accounted for 80.22% of the positively cultured aerobes.For anaerobic culture, a total of 28 strains were isolated from 28 conjunctival samples, the positive rate was 14.58% Propionibacterium acnes was the predominant species (71.43%), followed by Finegoldia magna (10.71%). Majority of the CNS were sensitive to gentamycin and vancomycin, with resistance rates lower than 10%, but their resistance rate to erythromycin and ceftazidime was 87.67% and 63.01%, respectively.Resistance rate of these CNS to levofloxacin, ciprofloxacin, and moxifloxacin was 42.47%, 39.73% and 17.81%, respectively.Multidrug resistance to at least 3 antibiotic classes was present in 38.36% of the CNS. Conclusions Bacteria in the conjunctiva sac of preoperative patients are resistant to various ophthalmic antibiotics.To follow-up the bacterial distribution and antibiotic resistance is great meaningful in the prophylactic and treatment in ocular surgery-related infections. Key words: Penetrating ocular surgery; Conjunctiva; Bacteria; Antibiotic resistance

FIRST OCCURENCE OF Thelazia callipaeda IN FOXES (Vulpes vulpes L.) IN SERBIA

Thelazia callipaeda is a vector-borne zoonotic eyeworm, parasitizing at the conjunctiva sac of domestic and wild carnivores (dogs, cats, foxes, and wolves), and humans. Over the last decade, infection with that spirudida is increasingly occurring in dogs and cats in the numerous European countries including the Balkans area. In Serbia we also established infection with this parasites in foxes during 2014. Adult nematodes were retrieved from the conjunctival sacs of 3 animals (2 from Belgrade area and 1 from Branicevo district) hunted during control effect of oral vaccination of foxes against rabies. In total we extracted 23 parasites, 10 males and 13 females. This is the first report of autochthonous cases of T. callipaeda infection in red foxes in Serbia.

Prevalence and Risk Factors for Bovine Thelaziasis at Mersa Town of South Wollo Zone, Amhara Regional State, Ethiopia

A cross sectional study was conducted from April 2014 to June 2014 in Mersa Town of South Wollo Zone, Amhara Regional Stat to determine the prevalence of thelaziasis of the disease in cattle associated risk factors responsible for the occurrence of the disease. A total of 384 cattle of both ages (98 young and 286 adult) sexes (203 male and 181 females) were examined using visual observation of the eyes by flushing the conjunctiva sac and lachrymal duct with sterile saline solution. The overall prevalence for thelaziasis was 18.23% (70 cases). Age, sex, body condition scores and management systems did not show any statistical significant difference (P>0.05) in the prevalence for thelaziasis. The prevalence was higher in male (24.12%) than female (11.6%), age groups of young (26.53%) were higher than adult (18.38%) in animals kept in extensive (20.69%) than those kept in semi-intensive system (13.01%). The prevalence of bovine thelaziasis was recorded highest it in poor (30.19%) than medium (17.79%) and lowest in good (14.48%) body conditioned score cattle. The results of the present study showed that bovine thelaziasis requires special attention considering its impact on cattle production and productivity.

Microbiology of conjunctiva sac in intravitreal injections

PurposeTo evaluate the conjunctival sac flora before and after intravitreal injection (IVI) in eyes with no prophylactic antibiotic use.Methods37 eyes of 37 patients not using systemic or local antibiotics for at least 30 days were included. Microbiological culture from conjunctiva sac to nutrient media was taken twice: before IVI and before any topical medications were given and 30 minutes after anty‐VEGF IVI. Topical antibiotics were not used neither before, nor after IVI. Shortly before IVI conjunctival sac was rinsed with 5% povidone‐iodine (PVI). Control group constituted eyes not treated with IVI of the same patients.ResultsNegative microbiological cultures before and after IVI were noted in the studied group in 15 patients (40.5%) and in 9 control eyes (24.3%). Coagulase‐negative Staphylococci (CNS) were cultured in 13 eyes (35.1%) before IVI and in 8 eyes (21.6%) after IVI. In 3 eyes (8.1%) Staphylococcus aureus was shown before IVI, with subsequent negative cultures. In the control group CNS was shown in 14 eyes (37.8%) before IVI and in 7% (18.9%) after IVI. Microbiological flora was identical in studied and control groups in 14 cases (37.8%). There was no case of post‐IVI endophthalmitis.ConclusionsAbout 50% of cultures were negative, in 35% ‐ CNS, and in 15% ‐ other bacteria were cultured, including Staphylococcus aureus in 8%. The number of negative cultures after IVI (the use of PVI) was higher than before IVI, and all Staphylococcus aureus were eliminated. The eye antisepsis based on PVI in IVI is an effective and efficient prophylaxis method.

Microbiology of conjunctiva sac in intravitreal injections

PurposeTo evaluate the conjunctival sac flora before and after intravitreal injection (IVI) in eyes with no prophylactic antibiotic use.Methods37 eyes of 37 patients not using systemic or local antibiotics for at least 30 days were included. Microbiological culture from conjunctiva sac to nutrient media was taken twice: before IVI and before any topical medications were given and 30 minutes after anty‐VEGF IVI. Topical antibiotics were not used neither before, nor after IVI. Shortly before IVI conjunctival sac was rinsed with 5% povidone‐iodine (PVI). Control group constituted eyes not treated with IVI of the same patients.ResultsNegative microbiological cultures before and after IVI were noted in the studied group in 15 patients (40.5%) and in 9 control eyes (24.3%). Coagulase‐negative Staphylococci (CNS) were cultured in 13 eyes (35.1%) before IVI and in 8 eyes (21.6%) after IVI. In 3 eyes (8.1%) Staphylococcus aureus was shown before IVI, with subsequent negative cultures. In the control group CNS was shown in 14 eyes (37.8%) before IVI and in 7% (18.9%) after IVI. Microbiological flora was identical in studied and control groups in 14 cases (37.8%). There was no case of post‐IVI endophthalmitis.ConclusionsAbout 50% of cultures were negative, in 35% – CNS, and in 15% – other bacteria were cultured, including Staphylococcus aureus in 8%. The number of negative cultures after IVI (the use of PVI) was higher than before IVI, and all Staphylococcus aureus were eliminated. The eye antisepsis based on PVI in IVI is an effective and efficient prophylaxis method.

Stimulating test of bear bile eye drops on rabbit eyes

Objective To explore the stimulating effect of bear bile eye drops on rabbit eyes frequently in order to provide experimental basis for drug use. Methods Bear bile eye drops dripped into the right eye of rabbit conjunctival sac as experimental group (different frequency as 1, 5, 10 min) while normal saline was used in the left eye of rabbit as the control group (one drop once and 10 times continually). We observed the stimulation of rabbit eyes at 0, 6, 12, 24, 48 hours after the last dripping. Results At the observation of 5 and 10 min interval set, the right eyes of rabbit had no hyperemia, no edema, no secretion, no maculae corneae, and normal iris that was 1 score according to eye stimulation response scale belonging no irritation. After 1 min interval set observation of right eyes, they presented light conjunctiva hyperemia, light edema, increased secretion of conjunctiva sac with 5 score belonging to light stimulation; but it decreased to 3 scores at 6 h interval set belonging to no stimulation; the average score declined underneath 1 score at the observation of 12 h interval set. Conclusions Bear bile eye drops can arouse reversible light stimulation when used in high frequency, so the safety is high, but we should avoid the high frequency of use. Key words: Animal experiment; Rabbit; Bear bile eye drop; Chinese patent drug; Stimulating test

Incidence of postoperative endophthalmitis from 1990 to 2009 using povidone–iodine but no intracameral antibiotics at a single academic institution

To correlate the incidence of postoperative endophthalmitis with changes in the preoperative prophylaxis over a 20-year period. Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany. Retrospective chart review. Patients diagnosed with postoperative endophthalmitis from 1990 to 2009 after intraocular surgery performed at the same institution were included. Because of changes in the preoperative prophylaxis during the study period, 3 groups were formed for data analysis: Period 1 (1990 to 1992), no standardized prophylaxis regimen; period 2 (1993 to 1998), preoperative topical medication, povidone-iodine 10.0% periorbitally, and 1 drop of povidone-iodine 1.0% in the conjunctiva sac; and period 3 (1999 to 2009), similar to period 2 except with irrigation of the conjunctival sac with 10 mL of povidone-iodine 1.0%. The overall rate of postoperative endophthalmitis was 0.113% (77/68,323) for all intraocular surgeries. It decreased significantly from 0.291% (16/5505) in period 1 to 0.170% (33/19,413) in period 2 to 0.065% (28/43,405) in period 3 (P < .001). In cataract surgery, the overall rate of postoperative endophthalmitis was 0.125% (30/24,034). It decreased in each subsequent period, from 0.338% (9/2662) in period 1 to 0.224% (15/6696) in period 2 to 0.041% (6/14,676) in period 3 (P < .001). Coagulase-negative Staphylococcus was the most commonly isolated organism (47.4%). The rate of postoperative endophthalmitis decreased over a 20-year period at a single academic institution. Although multiple factors might have contributed to this decline, implementation of a preoperative prophylaxis protocol using copious povidone-iodine might have been the most important contributor. No author has a financial or proprietary interest in any material or method mentioned.

Effects of povidone-iodine solution with different concentration on the conjunctival sac washing before intraocular operation

Objective To investigate the effect of different concentration of povidone-iodine solution on preoperative irrigation of the conjunctival sac .Methods A total of 150 patients were randomly divided into Group A, B and C, each group had 50 cases.All patients were performed with conventional intraocular surgery＇s preparation.First, 0.5%iodine solution was used to disinfect all patients＇eyelid, surrounding skin and limbi palpebralis after entering operation room .Second, irrigation of the conjunctival sac was performed （ three different concentration separately ） before operation.1 minute later, bacterial culture of conjunctiva sac and immediately corneal fluorescein staining was done .The degree of conjunctival hyperemia and corneal epithelial damage under slit lamp were compared among groups .Results The negative rate of bacterial culture of conjunctiva sac of the groups using 0.025% iodine solution and 0.05% iodine solution were 92.0% and 94.0%.The effects were better than 78.0%of 0.01%iodine solution group.There were significant differences between groups （χ2 =7.197,P〈0.05）.0.05% iodine solution had a more serious effects and worse corneal epithelial damage compared with the other groups .There were significant differences between groups （χ2 =20.257,18.656, respectively;P〈0.05）.Conclusions 0.025% iodine solution has better bactericidal effect and higher efficiency , and has little damage to the cornea and conjunctiva , so it is more suitable to preoperative disinfection of conjunctival sac in operation in ophthalmology . Key words: Povidone-iodine; Concentration; Irrigation of conjunctival sac; Ophthalmological operation

External ocular surface bacterial isolates and their antimicrobial susceptibility patterns among pre-operative cataract patients at Mulago National Hospital in Kampala, Uganda

BackgroundEndophthalmitis is a severe complication of cataract surgery which leads to high ocular morbidity and visual loss even with antibiotic treatment. Bacterial ocular floras are the implicated causative agents. This study was undertaken to evaluate the external ocular surface bacterial isolates and their antimicrobial susceptibility patterns among pre-operative cataract patients at Mulago National Hospital.MethodsThis cross sectional study enrolled consecutively 131 patients scheduled for routine cataract surgery in the Department of Ophthalmology at Mulago National Hospital in Kampala, Uganda. Eyelid margin and conjunctival swabs were collected and processed using standard microbiological procedures to identify bacterial isolates and their respective antimicrobial susceptibility patterns.ResultsOf 131 patients involved (mean age 63.3 ± 14.5 years), 54.2% (71/131) were females. The eyelid margin and conjunctival samples were culture positive in 59.5% (78/138) and 45.8% (60/138) respectively. The most common organisms identified were Coagulase-negative Staphylococci (CoNS) [65.9% (91/138)] and Staphylococcus aureus [21.0% (29/138)]. CoNS showed the highest resistance to tetracycline (58.2%, 53/91) and erythromycin (38.5%, 35/91), whereas in S. aureus the resistance to tetracycline and erythromycin were 55.2% (16/29) and 31.0% (9/29) respectively. Methicillin resistant CoNS (MRS) and Methicillin resistance S. aureus (MRSA) were 31.9% (29/91) and 27.6% (8/29) respectively. There were low resistance rates for CoNS, S. aureus and other bacterial isolates to ciprofloxacin (11.1%-24.2%), gentamicin (5.6-31.0%), tobramycin (17.2% -25.3%) and vancomycin (0.0%).ConclusionCoNS and S. aureus are the most common bacterial isolates found on the external ocular surface of the pre-operative cataract patients. Ciprofloxacin, gentamicin, tobramycin and vancomycin showed the lowest resistance rates to all bacterial isolates, therefore may be used to reduce bacteria load in the conjunctiva sac among cataract patients prior to surgery.

Meta analysis of the bacteria culture results after conjunctiva sac irrigation by two common disinfectant

Objective To provide strong evidence for sterilization standardization by comparing the results of bacteria culture after conjunctiva sac irrigation by gentamicin and povidone-iodine (PVI) and analyzing the sterilization effect of these two common disinfectant. Methods Six randomized control trials comparing the sterilization effect between gentamicin and PVI in conjunctiva sac irrigation were retrieved through the following databases: Pubmed,Embase,Cochrane Library,WANFANG DATA,CNKI and VIP database.Relative Risk (RR) was set as the effect indexes to evaluating the conjunctiva sac bacterial-culture results before and after irritation.The data of these articles were processed with Meta analysis by random model.The side effects of both dilutions were also compared using the descriptive analysis. Results Before irrigation,bacteria in the sac were mostly gram-positive coccus,among which Staphylococcus epidermidis and Staphylococcus aureus were most common.The detection rate of these two bacteria were 30.5% (226/740) and 2.4% (18/740),and the constituent ratio were 65.5% and 5.2% respectively.After irrigation,the number of the bacteria was decreased dramatically,but could not be totally eliminated.There was no significant difference in sterilization effect between gentamicin and PVI after conjunctiva sac irrigation.The weighted average value of RR was 0.51 with 95% confidence interval (CI) in (0.25,1.06),P=0.07.Comparing to gentamicin,PVI was less comfortable after conjunctiva sac irrigation,but when the concentration was regulated,it would be acceptable by patients and didn′t affect surgeries. Conclusions There was no significant difference in sterilization effect between gentamicin and PVIin conjunctiva sac irrigation.The side effect of PVI was minor in low concentration.PVI is more specific to the bacteria species than gentamicin.Using PVI was recommended in preoperation sterilization.(Chin J Lab Med,2013,36:625-629) Key words: Povidone-iodine; Gentamicins; Conjunctiva; Irrigation; Premedication; Meta-analysis

Comparative study on bacterial species in conjunctival sac between Qiang minority and Han nationality

Background Qiang minority is minority groups of China with the special habits and customs and living condition. So whether the spectrum of disease and bacteria spectrum in conjunctiva are similar with Han nationality is worth paying attention. Objective Present survey was to obtain the data about bacterial species in conjunctival sac in Qiang minority population with the age 40 years old and more and the compare with matched Han nationality population. Methods This survey study was performed as the standardized training and protocol. A total of 212 eyes of 106 individuals from Qiang minority in Beichuan county and 640 eyes of 320 subjects from Han nationality in Mianyang city received questionnaire survey and ophthalmological examination. The secretion of the inferior palpebral conjunctival sac was embrocated and inoculated on blood plate for 48-72 hours. The bacteria was separated and identified. This study was approved by the Ethic Committee of Sichuan Provicial People' s Hospital. Orally informed consent was obtained before the medical procedure. Results All the examinee finished the survey and examination with a good compliance. No significant difference was found in the demography between these two groups of population. The multiple bacterial positive rate in conjunctival sac was 59. 4% in Qiang minority and that of Han people was 66. 3% with a considerably difference between them (χ2 = 2. 27,P = 0. 13). The multiple bacterial species were simultaneously detected in 26.2% in Qiang minority population and 11.88% Han people, showing evidently difference (χ2 = 106. 40, P = 0. 00 ) . The positive rate of corynbaccterium in conjunctival sac of Qiang minority was statistically lower than that of Han people (20. 7% versus 45. 0% ,χ2 =31. 75 ,P = 0. 00) ,but there was no statistical difference in the positive rate of staphylococcus epidemics between two groups (χ2 = 1. 89 ,P = 0. 17). Conclusion The bacteria positive rate in conjunctiva sac is resemble in the population over 40 years in both the Qiang minority and Han nationality. The simple bacterial species is found in majority people in two groups of subjects. The positive rate of multiple bacterial strains coexistence is more in the Qiang minority. The bacterial strains is different between Qiang minority and Han nationality. Key words: bacteria; conjunctival sac; Qiang minority; Han nationality

Conjunctival Marginal Zone B-Cell Lymphoma in a 13-Year-Old Child

Ocular adnexal lymphoma is a hematopoietic tumor that arises in the conjunctiva, orbit, eyelid, lacrimal gland, or lacrimal sac. The treatment options in children have not been addressed in the literature. The authors describe a 13-year-old child with ocular adnexal lymphoma and discuss the treatment options.

Treatment of splitting of conjunctiva sac after hydroxyl apatite implanting

目的 探讨眼球摘除术羟基磷灰石(HA)Ⅰ期植入后结膜囊裂开的治疗方法.方法 采用中两医结合方法治疗眼球摘除术HA Ⅰ期植入后结膜囊裂开,先充分清除创面分泌物,再用3%双氧水清洗创面后于结膜囊创口涂锡类散及滴贝复舒滴眼液,每日3次.结果 轻度创口裂开经3～5 d换药后创口迅速愈合;中度及重度创口开裂尚需清创后再用锡类散得到治愈.结论 锡类散是中成药粉,有去腐生肌的功效;贝复舒为碱性成纤维细胞生长因子,两药交替频繁点用以促进创面愈合,可起到互补作用。

Polymethyl methacrylate as an ocular implant in muscle cone

目的 探讨聚甲基丙烯酸甲酯义眼台肌圆锥内植入的可行性及其美容效果.方法用化学固化型义齿基托材料制做义眼台.52例行眼内容物摘除术.术中将巩膜壳剪成两半并剪断视神经,义眼台放于肌圆锥内.5-0线间断缝合巩膜壳的两部分,并在巩膜壁上剪2个2 mm×3 mm大小的小孔做引流用.间断缝合眼球筋膜,连续缝合球结膜.结膜囊填油纱条,加压包扎.3 d后选配仿真义眼片植入结膜囊,5 d拆除结膜缝线.随访观察最少半年.结果 义眼台植入后,眼部外观良好,义眼有一定的活动度.无义眼台脱出、外露等并发症.结论 聚甲基丙烯酸甲酯义眼台肌锥内植入能够达到良好的美容效果,并且费用低、操作方便、并发症少。

Clinical study and use of allograft acellular dermal matrix in the treatment of conjunctival sac narrow

Objective To study the clinical effect of allograft acellular dermal matrix（ADM） in the treatment of conjunctival sac narrow. Methods 26 cases（26 eyes） with conjunctival sac narrow after operation of hydroxyapatite （HA） implantation were treated with allograft acellular dermal matrix. Follow-up ranged from 6 to 18 months（averaged 11 months）. Results All of the 26 cases got satisfied clinieal effect. ADM emerged the normal colour and outward appearance of eonjunctiva 6 months postperation. No infection, necrosis or exclusion took place and good cosmetic effect were got after artificial eyes used. Conclusion It was suggested that ADM was convenient and safe on the conjunctiva sac rebuild in the eases of conjunctival sac narrow. Key words: allograft acellular dermal matrix; conjunctival sac narrow; plastic surgery