International Journal of Ophthalmology Press -->Clinical research

Influence of surgery intervention on the prognosis of fungal corneal ulcer

Gui-Gang Li,Hong Zhang and Cai-Ni Ji

AIM:To investigate the influence of surgery interven-tion on the prognosis of fungal corneal ulcer,and to discuss the importance of surgery for the treatment of serious corneal ulcer. ·METHODS:Altogether 39 patients with fungal corneal ulcer underwent focus of infection cleaning,focus of infection cleaning with amniotic membrane grafting or focus of infection cleaning with conjunctival flap covering surgery separately,followed with standard medical treatment. The outcome of the treatment was recorded and evaluated through follow-up visit of more than six months. ·RESULTS:Thirty-four patients were cured through one time surgery,two patients were cured through two time surgery,while the other three eyeballs were eviscerated due to corneal perforation and secondary endophthal-mitis. ·CONCLUSION:Surgery may play an important role in the rescue of the anatomy and function of eyeballs infected with fungus.

Clinical observation of treatment of fungal keratitis with local debridement combined with 50g/L anerdian type 3 disinfectant dilution used in conjunctival sac

Zhi-Wei Luo,Jian-Nan Li,De-Yong Jiang,Yong Cai and Xiang-Yang Peng

AIM:To observe the effect of treatment of fungal keratitis with local debridement combined with 50g/L anerdian type 3 disinfectant dilution used in conjunctival sac and medication. ·METHODS:Sixty-one patients 61 eyes were treated with local debridement combined with 50g/L anerdian type 3 disinfectant dilution used in conjunctival sac and medication and the effects were observed. ·RESULTS:The cure rate was as the follows:of the mild 100%,of the moderate 78%,of the serious 27%. ·CONCLUSION:The treatment result of local debride-ment combined with 50g/L anerdian type 3 disinfectant dilution used in conjunctival sac and medication is better for the mild and the moderate,yet not effective for the serious cases.

Reliability analysis of the measurement of corneal thickness in myopic eyes with the Pentacam Scheimpflug system

Xiu-Hua Zheng,Yuan-Zhi Chen,Jin-Ling Ge,Chuan-Jing Gao and Jing-Jing Liu

AIM:To assess the accuracy and variability of corneal thickness in myopic eyes obtained by ultrasound pachy-meter,OrbscanⅡ system and Pentacam Scheimpflug imaging system. ·METHODS:First,Pentacam system,OrbscanⅡ system and A-scan ultrasonic pachymeter were used to measure the corneal thickness on 56 myopic cases(56 right eyes)undergoing laser in situ keratomileusis(LASIK);Then,the results were compared. ·RESULTS:The value of corneal thickness measured by Pentacam,OrbscanⅡ and A-scan ultrasonic pachymetry was 547.04±3.65μm,535.41±32.93μm and 539.46±29.15μm respectively; there was no significant difference between the results with one-way ANOVA; these three kinds of instruments of measuring corneal thickness had a good linear correlation; Pentacam system had good repeatability in the measurement of corneal thickness. ·CONCLUSIONS:The Pentacam system offers an accep-table method for evaluating corneal thickness,which is useful in corneal refractive surgery.

Clinical analysis of 312 cases small incision cataract extraction and intraocular lens implantation

Gui-Lian Jing,Yue-Li Li and Jun Yue

AIM:To investigate the clinical effect of small incision extracapsular cataract extraction and intraocular lens implantation. ·METHODS:From the April 2007 to December 2008,312 cases who underwent the small incision extracapsular cataract extraction and intraocular lens implantation analyzed retrospectively. ·RESULTS:Postoperative visual acuity increased signifi-cantly,≥ 0.05 were in 307 cases,off blindness rate accounted for 98.4%; ≥ 0.3 were in 285 cases,and off disability rate accounted for 91.3%. Intraoperative and postoperative complications:posterior capsule rupture 4 eyes accounted for 1.3%; corneal edema 75 eyes account-ed for 24.0%; iris damage 2 eyes accounted for 0.6%; temporary high intraocular pressure 5 eyes accounted for 1.6%; pupil mild deformity 6 eyes accounted for 1.9%; intraocular lens gripping 2 eyes accounted for 0.6%; postoperative uveitis 12 eyes accounted for 3.8%; withnot artificial lens implanted 5 eyes accounted for 1.6%; The average corneal astigmatism was 1.53±1.32 in the posto-perative day 7,and no serious complications occurred. ·CONCLUSION:Small incision cataract extraction and intraocular lens implantation has a significant effect and fewer complications,and it is safety and easy surgery,especially in primary hospital for the prevention of blindness.

Preliminary result of ReSTOR +3D apodized diffractive multifocal IOL implantation

Ying-Jie Lin,Xian-Jun Liang,Jin-Xian He,Jing Ye and Min-Zhuo Huo

AIM:To evaluate the visual performance of the Acrysof ReSTOR +3D intraocular lens (IOL) (SN6AD1,Alcon) implantation. ·METHODS:Totally 32 patients 48 eyes were implanted with the Alcon ReSTOR +3D apodized diffractive multifocal IOL. The mean follow-up was 4±1.5 months(range form 3 to 6 months). Distant uncorrected ,best-corrected visual acuity; near uncorrected,best-corrected visual acuity; intermediate visual acuity,best-corrected visual acuity,spectacle independency and the position of the IOLs were observed. ·RESULTS:Distance uncorrected visual acuity was 0.85±0.17 and distant best-corrected visual acuity was 0.96±0.14. Near uncorrected visual acuity was 0.64±0.13 and near best-corrected visual acuity was 0.77±0.15. Inter-mediate uncorrected visual acuity was 0.65±0.15 and intermediate best-corrected visual acuity was 0.69±0.17. Spectacle independency was 84%. No tilt or decentration of the IOL were observed. Posterior capsular opacification was not found in the follow-up. ·CONCLUSION:The Acrysof ReSTOR +3D IOL provides a satisfactory full range of vision.

Small incision non-phacoemulsification cataract extraction and IOL implantation under topical anesthesia

Zhi-Min Han

AIM:To investigate the safety and efficaty of topical anesthesia in non-phacoemutsification cataract extraction and introcular lens (IOL) implantation using small incision. ·METHODS:Under topical anesthesia,small incision non-phacoemulsification cataract extraction and IOL implantation were done in 79 patients 86 eyes,and the effectiveness of topical anesthesia and postoperative visual acuity were surveyed. ·RESULTS:Sixty-four patients 71 eyes complained no pain. 15 patients 15 eyes complained distending pain,and another topical anesthetic was given during operation.The mean duration of the operation was about 18 minutes. The vision ≥0.5 was 83% (at first postoperative day)and 92%(at 1 week postoperatively) respectively. ·CONCLUSION:Small incision non-phacoemulsification cataract extraction and IOL implantation under topical anesthesia is simple and spends little time. The recovery of eyesight is quick and stable. The cost of operation is very cheap. This operation has many advantages in our country.

Clinical effects of sodium hyalurantae in complex trabeculectomy

Ya Li and Wei-Xiao Luo

AIM:To explore the effects of sodium hyalurantae in complex trabeculectomy. ·METHODS:Case-control studies. 56 eyes with primary glaucoma who need complex trabeculectomy were randomly divided into observation group and control group with 28 eyes in each group. Patients in the observation group were applied the sodium hyalurantae,and the control group were not applied during the operation. The changes in anterior chamber,bleb,IOP and corneal endothelial cells in two groups were observed. ·RESULTS:The anterior chambers of 28 eyes in observation group formed early postoperatively. The shapes of filter blebs in observation group were better than control group at three months after operation. Functional filtering bleb appeared in 27 eyes(96%) in observation group and functional filtering bleb appeared in 26 eyes (93%) in control group. IOP of observation group is slightly higher than that of control group early postoperatively,and three months after operation,IOP of observation group was somewhat lower than that of control group. There was no statistical difference between the corneal endothelial cells of preoperation and postoperation in two groups. ·CONCLUSION:It can make the anterior chamber form better by using sodium hyalurantae in complex trabeculectomy,and it can support filtration path to inhibit scar formation and increase the successful rate of complex trabeculectomy.

Diode laser transseleral cyclophotocoagulation for treatment of refractory glaucoma

Ying Yang,Yi-Lian Cheng and Qian Luo

AIM:To investigate the outcome and treatment parameter of transscleral diode laser cyclophotocoagula-tion in refractory glaucoma. ·METHODS:Fifty patients 50 eyes of refractory glaucoma were treated with the transscleral diode laser cyclo-photocoagulation,the power,area,points of photocoa-gulation,points of blast were recorded,intraocutar pressure(IOP),symptom,visual acuity,the representa-tion of anterior segment before and after treatment and the complication were observed. ·RESULTS:The average of IOP was 18.50±2.50mmHg after treatment,obviously decreased after treatment (P<0.01). The pain decreased in 46 eyes,the decreasing amount of IOP was not obviously correlated with power,but had relativity with area and points of cyclo-photocoagulation,and had obvious positive relativity with points of blast. ·CONCLUSION:It is a safe and effective method to treat the refractory glaucoma with transscleral diode laser cyclophotocoagulation; and it is important to design the treatment parameter acording to the IOP before treatment and different type glaucoma.

Application of optical coherence tomography and standard automatic permetry in the early glaucoma

Fang-Fang Wu,Hong-Qiang Jia and Zi-Liang Zhao

AIM:To investigate the diagnonsis effect of optical coherence tomography (OCT),standard automatic permetry (SAP) in the early glaucoma. ·METHODS:Forty-two patients 68 eyes with glaucoma (binoculus/ ocellanae:25/18,male/female:29/13,left/right:32/36,open/close:18/50) aged 36-82 years old,the average age was 60.8±0.92. Visual disks C/D and retinal nerve fibers layer thickness were inspected by automatic vision inspection and OCT scanners. ·RESULTS:The positive rate of diagnonsis of automatic vision inspection and OCT was 84.37% and 93.75%,respectively. The positive rate of inspection in OCT was higher than that of automatic vision inspection for early glaucoma patients. ·CONCLUSION:For glaucoma patient,the loss of retinal nerve fibers is earlier than the change in field of vision defects. Combined of visual field and OCT method can qualitatively and quantitatively get an objective assessment for vision defects of glaucoma.

Removal dislocated lenses in vitreous cavity by intravitreal phacoemulsification

Da-Ling Xu,Yan Chen and Ming Huo

AIM:To evaluate the effect of treating the glaucoma with phacoemulsification replacing phacofragmentation without perfluorocarbon liquid to remove the dislocated lens in vitreous cavity. ·METHODS:Between November 2007 and March 2010,a series glaucomatous cases of 16 patients 16 eyes with posterior dislocation lens because of ocular trauma or cataract surgery were studied retrospectively. The total vitrectomy combined with intravitreal phacoemulsification devoid of the silicone sleeve was used to remove dislo-cation of the lens. The main outcome measures were visual acuity,intraocular pressure,retina and sclera heal-ing postoperatively. ·RESULTS:All dislocated lenses were successfully removed. There was no retinal detachment,retinal hemorrh-age and sclera burning. No complications occurred during phacoemulsification. After operation,Visual acuity was counting fingers in 2 eyes,0.1-0.3 in 7 eyes,more than 0.3 in 5 eyes and was unchanged in 2 eyes. The postoperative intraoclar pressure was located between 15-20mmHg in 14 eyes and lowered to mormal range in another two eyes using anti-glaucoma medical drops. ·CONCLUSION:The conventional phacoemulsification probe devoid of the silicone sleeve can be used to remove the dislocaed lens of vitreous cavity in vitrectomy surgery. This technique has minor injury,convenience and short time and doesn’t need the perfluorocarbon injection. It is preferred to treat the glaucoma due to the dislocation of lens.

Optical coherence tomography and fundus fluorescein angiography for macular hemo-rrhage in pathological myopia

Jie Zhao,Xiao-Dong Sun,Hao Lu,Liang Yan and Jie Qin

AIM:To evaluate the characterization of macular hemorrhage in pathological myopia (PM) with optical coherence tomography (OCT) and fundus fluorescein angiography (FFA). ·METHODS:A series of retrospective cases study was designed. OCT,FFA and color photography were perform-ed on 42 patients 43 eyes of PM with macular hemorrhages. ·RESULTS:The causes and symptoms of PM with macular hemorrhage could be divided into two forms:new veins:macular hemorrhage with choroidal neovascularization (CNV) of 24 patients 24 eyes. The fundus characteristics were macular hemorrhage demonstrated oval,less than 1 disk diameter (PD),with rare edema and exudation around. And new membrana vasculosa can be seen partially. The FFA characterisitics were classic CNV of 17 eyes (71%) and occult CNV of 7 eyes (29%). The characteristics of OCT were 21 eyes (87.5%),spindle shape or circular conglomerate,strong or medium reflection,sticking out upwards from retinal pigment epithelial layers,under the epithelial layers of retinal neuroepithelial; 3 eyes (12.5%) CNV were irre-gular reflection signal which may aggregate disorder,and located on the level of retinal pigment epithelial layers. Simplex:macular hemorrhage without CNV of 18 patients 19 eyes. The fundus characteristics were flat hemorrhagic focus with different sizes and less-orderly boundary,without any exudation or edemas around. The FFA characterisitics were fluorescence blocked by hemorrh-age,without CNV high fluorescence pheno-menon. Lacquer cracks sometimes appeared at the sites of macular hemorrhage or around the hemorrhage. The characteristics of OCT were the protruded low reflection area under the retinal pigment epithelial. Choriocapillary layer with consistent photonic band. ·CONCLUSION:Most of macular hemorrhage in patho-logical myopia with new veins is caused by typical CNV. Typical figures of OCT are fusiform shape in pigment epithelium layers or quasicircular strong reflection mass,with clear boundary. Retinal protruded upwards,and choroids under it can be a shield. Simplex macular hemorrhage demonstrates as limited retinal pigment epithelial hemorrhagic detachment. OCT exami-nations were favorable for identifying the characteristics and reasons of macular hemorrhage in pathological myopia,and were helpful for diagnosis,prevention,guide and treatment.

Clinical study on the treatment of long-standing retinal detachment by scleral buckling surgery

Shao-Yang Shi,Xue-Mei Feng,Cun-Wen Pei,Na Hu,Xun Li and Xiao-Long Chen

AIM:To discuss the therapeutic effect and surgical indication with scleral buckling for long-standing retinal detachment. ·METHODS:The major surgery was as follows:retinal breaks locating,cryotherapy,scleral buckling or encircl-ing scleral buckling. Thirty-eight patients 38 eyes with long-standing retinal detachment accepted surgery,including thirty-six eyes in scleral buckling among which nineteen eyes encircling scleral buckling and silicone encircling,and two eyes underwent encircling scleral buckling merely. Among these cases twenty-six eyes underwent subretinal fluid drainage and seven eyes combined with 532 nm laser photocoagulation. ·RESULTS:The rate of retinal reattachment after one surgical procedure was 87% and after two procedures was 92%. And there were no serious complications occurred in operation and postoperation. ·CONCLUSION:Scleral encircling and buckling proce-dures can be used effectively to treat selected cases of long-standing retinal detachment,and the choice of operation should be individualized for each patient.

Primary 23-gauge pars plana vitrectomy for rhegmatogenous retinal detachment

Zhi-Xiong Liu,Guo-Ji Wu,Ke-Ming Kang,Xiao-Bo Wang and Hui-Chan Chen

AIM:To investigate the outcome of primary 23-gauge(23G) pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD). ·METHODS:In this prospective case series,20 eyes of 20 consecutive patients with RRD underwent primary 23G PP with intraocular gas tamponade and sclerotomy suturing. Postoperative mean follow-up was 6 months. Main outcome measures included post-operative anatomical status,visual acuity,intraocular pressure,and operative complications. ·RESULTS:The primary anatomical success rate was 100%. The mean postoperative visual acuity at postopera-tive month 3 improved from 0.02-0.5(logMAR was 1.187±0.616) to 0.3-0.8 (logMAR was 0.276±0.114) (t=5.756,P<0.001) and from 0.8-1.0 (logMAR was 0.218±0.276) to 0.6-1.0 (logMAR was 0.312±0.285) (t=-1.0,P=0.374) in macular-off and macular-on cases,respectively. No patients had hypotony or developed choroidal detach-ments,endophthalmitis,and PVR. Postoperative cataract progression occurred in 4 eyes(20%). Early ocular hyper-tension in 5 eyes was controlled with 1-2 kinds of anti-glaucoma drops. ·CONCLUSION:23G PPV is an effective surgical technique in the management of RRD. Complications are rare with sclerotomy suturing.

Efficacy of phacoemulsification combined with vitrectomy in the treatment of proliferative diabetic retinopathy

Yan-Qing Gao,Xin Wang,Xiao-Hui Guo,Kun-Peng Xie and Xiao-Ping Sun

AIM:To investigate the efficacy and complications of phacoemulsification combined with vitrectomy in the treatment of proliferative diabetic retinopathy and cataract. ·METHODS:Retrospectively analyzed the information of 55 patients 68 eyes with cataract and proliferative diabetic retinopathy,which were treated with vitrectomy com-bined lens phacoemulsification and intraocular lens im-plantation,the postoperative visual acuity and compli-cations in and after operation were observeed. ·RESULTS:The follow-up period was 3-24 months with the average of 8.5 months. Postoperative visual acuity improved or remained unchanged in 51 eyes (75% ); and decreased in 17 eyes (25% ). Complication in operation is iatrogenic retinal tear in 15 eyes (22%). Postoperation complications consisted of anterior chamber fibrin exudation in 30 eyes (44% ); vitreous hemorrhage in 11 eyes (16%); retinal detachment in 3 eyes (4%); rubeosis of iris in 5 eyes (7%); neovascular glaucoma in 2 eyes (3%). Retinal photocoagulation was performed in 31(46%) eyes after surgery. ·CONCLUSION:Vitrectomy combined lens phacoemul-sification and intraocular lens implantation to treat cataract proliferative diabetic retinopathy is safe and efficient,which can improve the visual acuity of majority of patients. The key point is to select suitable patients and the key influencing factor of postoperative visual acuity is the degree of retinal damage.

Verteporfin photodynamic therapy combined with Bevacizumab therapy in neovascular secondary to central exuda-tive chorioretinopthy

Yun Xiao,Yin-Bo Fan,Lan Qu,Xiao-Wei Gao and Yan Zhang

AIM:To investigate the therapeutic effect of photo-dynamic therapy (PDT) combined with bevacizumab on central exudative chorioretinopthy(CEC). ·METHODS:Clinical data of 40 patients who had undergone PDT combined with bevacizumab because of choroidal neovascularisation caused by CEC,diagnosed by examination of best-corrected visual acuity (BCVA),ocular fundus fluorescein angiography (FFA),and optical coherence tomography (OCT),were retrospectively an-alyzed. The changes of the BCVA,ocular fundus charac-teristics,and the results of FFA and OCT before and after combined therapy were observed and analyzed. The numeration of the times of retreatment and the safety of the combination therapy were analyzed. ·RESULTS:At the end of the follow-up period after combination therapy,the BCVA improved more than 2 lines in 34 eyes,stabled in 5 eyes,lost more than 2 lines in 1 eye. ·CONCLUSION:PDT combined with bevacizumab the-rapy is an effective and safety therapy for most patients with CEC.

Research on the hemodynamics behind the eyeball by color Doppler imaging after scleral buckling

Jun-Qi Lu,Jiong Lu and Jin-Yu Wang

AIM:To observe the ocular hemodynamic changes in the eyes of patients with rhematigenous retinal detachment before and after the scleral encircling procedure with the encircling band shorten in a certain range. ·METHODS:Central retinal arteries (CRA)were studied with color Doppler imaging (CDI) in 28 patients with unilateral rhematogenous retinal detachment,the fellow eyes served as control.The measured parameters included peak systolic velocity(Vmax),end diastolic velocity(Vmin),mean velocity(V),resistance index(RI) and pulsatility index(PI). ·RESULTS:A comparison of the indexes of CRA in both the sick eyes before the operations and the eyes in the control group found the differences among them no statistical significance. The Vmax,Vmin,RI and PI of the CRA of the sick eyes all increased 14 days after the operations,but not reached statistical significant difference,and showed no statistical significance as compared with those in the control group. ·CONCLUSION:Scleral buckling procedure with the encircling band shorten in a certain range can not change blood flow in retinal tissue for a short time after surgery. Color Doppler imaging is a useful tool for the studies of ocular hemodynamics changes.

Vitrectomy combined with intravitreal antibiotics injection for endophthalmitis

Yu Di,Yi-Ou Zhang,Yang Yang,Hong-Wei Yang,Yan Lu and Xiao-Long Chen

AIM:To observe the clinical effects of vitrectomy combined with intravitreal injection of vancomycin for endophthalmitis. ·METHODS:We carried out retrospective analysis of endophthalmitis in 30 cases 30 eyes. We observed the culture results of vitreous bacteria and fungi. All cases were injected vancomycin into vacuum vitreous after vitrectomy.We further observed the situation in the eyes,including the best-corrected visual acuity and complications. ·RESULTS:During the follow-up time,the endophthalmictis in 29 eyes (97%) were controlled without retinal complication. One case of 1 eye (3%) was panophthalmitis and removal of eye ball. Visual acuities of 19 eyes (63%) were improved,of 7 eyes(23%)were same,of 4 eyes(13%) were decreased. ·CONCLUSION:Vitrectomy combined with intravitreal injection of vancomycin is effective in treating endo-phthalmitis.

Clinical application effect analysis of amniotic membrane grafting for ocular surface burn

Qiu-Jin Ren,Shu-Yan Gu and Hui Yue

AIM:To evaluate the clinical curative effect of amniotic membrane grafting for ocular chemical burn and thermal burn. ·MEHTODS:We collected 24 patients 28 eyes with ocular chemical and thermal burn,which had been treated with amniotic membrane grafting in our hospital. The follow-up time ranged from 6-24 months. The posto-perative visual acuity,the condition of amniotic mem-brane transplant,renovation of cornea,healing time of corneal epithelium and complication were observed. ·RESULTS:Postoperative corrected visual acuity:visual acuity was improved in 22 eyes(79%)and was not changed in 6 eyes(21%)after amniotic membrane grafting,no visual acuity appearances declined,and there was no statistical significance between preoperative visual acuity and postoperative visual acuity. Status of amniotic membrane implant:amniotic membrane survived in 24 eyes and the survival rate was up to 86%.Conditions of cornea:8 eyes recovered to transparent; nebula emerged in 12 eyes eventually,corneal macula emerged in 5 eyes and 3 eye ended up with leukoma. Time of corneal epi-thelium healing:corneal epithelium of 28 eyes recovered entirely,22 eyes of which recovered within 3 weeks. Symblepharon condition improved in all 4 patients who suffered from preoperative atretoblepharia,including three cases completely separate. ·CONCLUTION:Amniotic membrane grafting is an effective method to deal with ocular surface burn.

Effects of two surgical techniques for excision of pterygium on different eyes of homobody

Jun-Hua Fan,Xue-Xi Li and Dong-Ping Pan

AIM:To compare the effects of excision of pterygium with gliding the corneal limbal stem cells beside pterygium-neck(A operation) and classical pterygium excision combined with corneal limbal stem cells trans-plantation(B operation) on different eyes of homobody. ·METHODS:There were 105 patients 210 eyes with initial pterygium in two eyes,one eye got A operation and the other got B operation. The postoperative follow-up period was 12 months. The duration of complaint symptoms,the time of corneal epithelium healing and recurrence of pterygium were observed after operation. ·RESULTS:Eight eyes of 105 eyes that got A operation were recurred,the rate of recurred was 7.8%. 6 eyes of 105 eyes that got B operation were recurred,the rate of recurred was 5.9%. The difference was not significantly different(P>0.05). 87.6% patients complained that the eyes got B operation were more uncomfortable.The duration of complaint symptoms after operation was significantly different between two operation(P<0.01). The time of corneal epithelium healing was also signifi-cantly different(P<0.05). ·CONCLUSION:The excision of pterygium with gliding the corneal limbal stem cells beside pterygium-neck is a convenient,micro-injury and light compliant symptoms surgery. The rate of recurred is not significantly different between this operation and classical pterygium excision combined with corneal limbal stem cells transplantation.

Influence of head down tilt simulated weightlessness on electrophysiology of vision

Jun Zhao,Lian-Na Hu,Hui-Ze Liang,Hong-Xin Yan,Chang-Yu Qiu and Fu-Lin Gao

AIM:To observe the influence of head down tilt simulated weightlessness on electrophysiology of vision. ·METHODS:Head-down tilt for -6° was adopted in 6 healthy volunteers. Pattern visual evoked potential (P-VEP) under different space frequency,flash electroretino-graphy (ERG),including rod response,maximal res-ponse,cone response,oscillatory potentials (OPs) and 30Hz flicker were recorded,and the latency and amplitude from each wave were analyzed before,two days and five days after trial. The record procedure followed the ISCEV standard for full-field clinical ERG (2008 update). ·RESULTS:No significant difference was detected in the latencies of P100 under different space frequency. The amplitude of P100 had significant change under high space frequency between pre-test and 2,5 days after test (P<0.05). But not the same happened in middle and low space frequency. No significant differences were detected in the latencies and amplitudes of cone response and 30 Hz flicker among various time points(P>0.05). The latencies were significantly prolonged in rod and maximal responses between pre-test and 2 days after test (P<0.05),but no obvious change was found in amplitudes(P>0.05). There were no significant differences detected in the ∑OPs (P>0.05). ·CONCLUSION:Head-down tilt simulated weightlessness induce the abnormality of VEP and ERG which influence the visual function of healthy people.

Clinical observation on the application of 5g/L loteprednol etabonate ophthalmic suspension after LASIK

Wei-Tao Li,Hu Li and Jing Wei

AIM:To compare the visual refractive outcome and complication of laser in situ keratomileusis (LASIK) treated with 5g/L loteprednol etabonate and 1g/L fluorometholone ophthalmic suspension after operation. ·METHODS:Totally 160 consecutive eyes that received 5g/L loteprednol etabonate ophthalmic suspension(group A) and 1g/L fluorometholone ophthalmic suspension (group B) after LASIK were reviewed. Manifest refrac-tion,uncorrected visual acuity(UCVA),best spectacle-corrected visual acuity (BSCVA),and intraocular pres-sure (IOP) were recorded before and 1 day,1 week,1 month,3 months after treatment.Diffuse lamellar keratitis (DLK),postoperative complications,and frequency of retreatments were observed. ·RESULTS:There was no difference in manifest refraction,UCVA,BSCVA and DLK after operation between two groups. Preoperatively IOP didn’t differ significantly between two groups. IOP in group A and B were 13.3±3.5mmHg and 16.4±4.9mmHg respectively 3 months after operation. IOP in group A was lower significantly than the later. ·CONCLUSION:Loteprednol etabonate ophthalmic suspension 5g/L can suppress the inflammation response caused by LASIK effectively. Compared with traditional steroid suspension,5g/L Etabonate ophthalmic suspen-sion can obviously reduce occurrence of high IOP.

Clinical analysis of the recovery of stereovision in far and near after operation in patients with partially accommodative esotropia

Si-Ming Zeng and Yu-Mei Yan

AIM:To evaluate the effect of recovery of stereovision in far and near after operation in patients with partially accommodative esotropia. ·METHODS:Eighty-three cases of stereovision in far and near with partially accommodative esotropia after operation were observed. ·RESULTS:In 83 cases,56 cases had obtained stereovi-sion in far,35 cases had obtained stereovision in fovea centralis. The difference in stereovision between pre-and post-operation was significant(P<0.01);the younger the age of onset,the poorer the recovery of stereovision after operation. The early age of operation,the higher recovery of stereovision after operation and the older age of operation,the poorer recovery of stereovision after operation(P<0.01). ·CONCLUSION:The partially accommodative esotropia has an important influence in the development of stereovi-sion.The early correction of eye position will benefit the recovery of stereovision in far and near.

Influence of correcting the corneal astigmatism on intraocular lens power formulas

Ya-Qin Ru,Jian-Ming Chen,Deng-Ting Wang and Lan-Ping Su

· AIM:To analyse the influence of correcting corneal astigmatism on the accuracy of intraocular lens power prediction after cataract surgery.· METHODS:Thirty-five cases of age-related cataract 35 eyes were selected,the corneal astigmatism was reduced after phacoemulsification with superior incision and PMMA intraocular lens implantation.The keratometry was measured before operation and three months postoperatively,then the absolute forecast error of SRK Ⅱ,SRK/T,Holladay Ⅰ formula with preoperative and postoperative corneal curvature were compared.·RESULTS:The average corneal curvature was increased by 0.30±0.81D(t=-2.205,P<0.05),the corneal astigmatism was decreased by 0.70±0.71D after operation(t=5.846,P<0.01),there was correlation between them(r=-0.554,P<0.01).The absolute predict errors of SRKⅡ,SRK/T and Holladay Ⅰ formulas using preoperative curvature was respectively 0.85D,0.73D and 0.78D,there was no significant difference(χ2=4.474,P>0.05).The absolute predict error using postoperative curvature was respectively 0.72D,0.54D and 0.46D,SRKⅡ indicated statistical difference from other formulas(χ2=7.758,P<0.05).The third theoretical formula had statistical difference from using preoperative and postoperative curvature(Z=-2.208,-2.273,P<0.05).· CONCLUSION:Correcting the corneal astigmatism may cause the changes in corneal refraction,which leads to the error of the intraocular lens prediction increase,especially the accuracy of the third generation formula decrease,so it is necessary to adjust and optimize the formula accordingly.·

Efficacy and proper application of glucocorticoid in treatment of keratouveitis

Hui-Min Yuan

·AIM:To investigate the treatment method of glucocorticoid for keratouveitis.·METHODS:Totally 27 patients 27 eyes with keratouveitis underwent small doses corticosteroids combined with anti-infective.Therapeutic effect and safety were evaluated.·RESULTS:All patients were cured,and no drug complications appeared.·CONCLUSION:Small dose of glucocorticoid is an effective,safe and practical way for keratouveitis.·

Local eye drops after cataract surgery-induced drug-induced corneal lesion

Gui-Lian Jing,Yue-Li Li,Jun Yue and Cong-Hui Xiao

·AIM:To analyze the drug toxicity of tobramycin dexamethasone eye drops in ocular surface and to investigate the clinical features,treatment effect of dexamethasone-induced drug-induced corneal lesions.·METHODS:The clinical findings in 14 cases 18 eyes with tobramycin dexamethasone-induced drug-induced corneal lesions after cataract surgery were retrospectively analyzed.·RESULTS:Tobramycin dexamethasone eye drops were used in 14 patients 18 eyes for more than 1 week;clinical manifestations:eye irritation:eye wear,tearing,photophobia,decreased vision.Signs:ocular ciliary hyperemia and punctate corneal erosion in 11 eyes,diffuse corneal opacity in 6 eyes,corneal stromal infiltration in 1 eye.Patients with a history of diabetes mellitus in 5 eyes,anti-glaucoma surgery in 6 eyes,2 eyes after vitrectomy,the body in good condition in 5 eyes,after drug withdrawl,eye symptoms relieved,disappeared.·CONCLUSION:Clinicians should pay attention to the toxity of tobramycin dexamethasone eye drops on cornea,and prevention and treatment,standard medication should be performed.·

Manual small incision cataract surgery under small pupil

Jian Zhang,Lei Zhang and Ming-Zhen Bei

·AIM:To discuss the manual small incision cataract surgery under small pupil.·METHODS:Totally 30 patients 38 eyes with cataracts underwent the manual small incision cataract surgery and intraocular lens implantation.Different ways were performed to dilate the small pupils during the surgery and the cataract was extracted smoothly.·RESULTS:The visual acuity of 16 eyes(42%)was better than 0.5.The visual acuity of 19 eyes(50%)was between 0.5 and 0.3.The visual acuity of 3 eyes(8%)was lower than 0.3.No complication was found in all cases.·CONCLUSION:Manual small incision cataract surgery is a safe and effective way to solve cataract in small pupils.·

Analysis of small-incision glaucoma and cataract surgery in 17 cases

Wu-Ping Xu and Hui-Ying Chen

·AIM:To investigate the clinical effect of small-incision extracapsular cataract extraction with posterior chamber intraocular lens implantation and trabeculectomy for glaucoma and cataract.·METHODS:Totally 17 patients with glaucoma and cataract underwent the extracapsular cataract extraction with posterior chamber intraocular lens implantation and trabeculectomy,postoperative visual acuity,intraocular pressure and complications were observed.·RESULTS:All the patients were returned to normal intraocular pressure range.Visual acuity was improved in different degrees.Early shallow anterior chamber occurred in 1 eye,and transient corneal edema occurred in 2 eyes.·CONCLUSION:The small-incision glaucoma and cataract surgery is a safe and effective way.·

Clinical observation of carbamycholine in glaucoma and cataract surgery

Chun-Li Xu,Lin Li,Xiao-Wei Gao,Xia Li,Yong-Li Yang and Xiao-Yun Dong

· AIM:To observe the clinical application of carbamycholine in the trabeculectomy combined with cataract phacoemulsification and intraocular lens implantation.· METHODS:Ninety-seven patients 120 eyes with chronic angle-closure glaucoma with age-related cataract from January 2007 to January 2008 were randomly divided into three groups:the observation group(group A,conjunctival sac carbamycholine dropping after phacoemulsification),the replacement group(group B,the anterior chamber carbamycholine replacement after phacoemulsification)and the retention group(group C,the anterior chamber carbamycholine detain after phacoemulsification).Intraocular pressure(IOP)vision,anterior chamber exudation,iris weeks incision and complications in each group(40 eyes,aged 60-80 years old,followed-up for 12 months)were observed.· RESULTS:Early IOP control of A,B group was significantly better than that of C group;and the difference was statistically significant(P<0.05),but later IOP control among the three groups showed no significant difference;early visual acuity of A,B group was significantly better than that of C group,the difference was statistically significant(P<0.05),but later visual acuity showed no significant difference;the moderate rate of iris incision size among the three groups showed no significant difference;the anterior chamber exudation of group A was lower than that of B,C group,the difference among the three groups was significant(P<0.05).· CONCLUSION:Carbamycholine application in glaucoma with cataract surgery can increase postoperative response,while reasonable application can significantly reduce its side effects.·

Follow-up study for immediate argon laser peripheral iridoplasty as treatment of acute attack of primary angle-closure glaucoma

Ke-Hao Zhao and Ping Chen

· AIM:To study the efficacy and persistency of argon laser peripheral iridoplasty(ALPI)as a first-line treatment of acute primary angle-closure glaucoma(PACG).· METHODS:Twenty-three patients with acute PACG were recruited into the study.Each patient received topical pilocarpine(10g/L),timolol(5g/L),and immediate ALPI as primary treatment.The intraocular pressures(IOPs)2 hours,1 month,6,12,24,36 months after ALPI were documented.The angle of anterior chamber were documented at each follow-up time.Dark room,prone provocative tests were done in the follow-up.· RESULTS:The mean IOP of this group patients was reduced from 69.43±8.22mmHg before ALPI to 15.74±3.09mmHg 2 hours after ALPI.Some patients had ocular hypertension in the follow-up.The anterior chamber angle was widened on goniscope and the trabecular meshwork could be visualized widely in static state after ALPI,but the anterior chamber angle was narrowed on goniscope in some other patients in the follow-up.Dark room,prone provocative tests were positive in part of patients in the follow-up.·CONCLUSION:ALPI,without adjunctive systemic carbonic anhydrase inhibitors and hyperosmotic agents,appeared to be effective and safe in controlling the IOP in acute PACG;part of patients developed chronic angle-closure glaucoma in the 3 years follow-up.·

Therapeutic effect observation on cyclophotocoagulation for refractory glaucoma

Wen-Sheng Lu and Guang-Xian Tang

·AIM:To evaluate the efficiency of transscleral cyclophotocoagulation(TSCPC)for refractory glaucoma.·METHODS:Retrospective analysis was made in 36 eyes with refractory glaucoma treated by TSCPC with lower energy power(1.5-2.1W)and more laser spots(10-32).Intraocular pressure(IOP),visual acuity,ocular symptoms and complications were observed after TSCPC.Patients were followed up for 3 months.·RESULTS:The mean preoperative IOP was 62.89±17.36mmHg which was significantly different from the final follow-up mean IOP,21.13±7.06mmHg(P<0.05).The success rate was 83%(30/36).Postoperative visual acuity remained unchanged in 6 eyes;improved in 4 eyes.The cyclocryotherapy were performed in 6 eyes whose IOP was not controlled.The pain sense disappeared or remarkably relieved.The main complications included mild uveitis and hyphemae.Atrophy of eyeball occurred in no eye.·CONCLUSION:TSCPC is a simple,safe and effective method for eyes with refractory glaucoma.·

Changes of tear film functions in trabeculectomy with human amniotic membrane or mitomycin C

Jin-Ying Wang,Qi Zhang and Ming Lu

·AIM:To observe the changes of tear film functions in trabeculectomy by using human amniotic membrane(HAM)or mitomycin C(MMC).·METHODS:In a randomized control clinical trial,44 eyes 36 patients were divided randomly into two groups,and each group had 22 eyes.The former was underwent trabeculectomy with HAM transplanted and adjustable suture line,and the later was administrated intra-operatively with MMC and adjustable suture line.Slit-lamp microscope examination,cornea fluorescence integral(FI)staining,tear break-up time(BUT)and Schirmer Ⅰ test(SⅠt)were carried out 1 day before,1 month and 3 months after operation in the 44 eyes.·RESULTS:Compared with the data before operation,all of the cornea FI scores,SⅠt and BUT were statistically significant 1 month after operation(P<0.05),but there was no statistical significance between the two groups.3 months after operation,all of the data returned to their preoperative values in HAM group,but the tear film functions were significantly decreased in MMC group,there was statistical significance between the two groups(P<0.05).·CONCLUSION:The changes of tear film functions in the combined trabeculectomy with HAM and adjustable suture line are smaller than those in the MMC group.It is a safe and effective method for treatment of glaucoma.·

Laser photocoagulation versus cryopexy in the treatment of rhegmatogenous retinal detachment

Xue-Xia Gao,Chun-Yan Kang and Rui-Feng Wang

·AIM:To compare the clinical results of laser photocoagulation and cryopexy in the scleral buckling of rhegmatogenous retinal detachment.·METHODS:The results of 42 eyes treated with laser photocoagulation and 39 eyes treated with cryopexy from February 2007 to August 2009 were analysed.·RESULTS:Retinal detachment in photocoagulation group had an anatomic success rate of 100% with one surgical procedure.Retinal detachment eyes with retinal cryopexy had a success rate of 94.9% with one operation.The postoperative visual acuity of 37 eyes(88%)in photocoagulation group was impoved.The postopertive visual acuity of 29 eyes(74%)in cryopexy group was impoved,there was no difference between them(P>0.05).·CONCLUSION:Treating the rhegmatogenous retinal detachment by laser photocoagulation in scleral buckling is as simple and effective as cryopexy.·

Choroid revascularizaton surgery associated with medicine treatment for primary pigmentary degeneration of retina

Xue-Fang Liu,Xiao-Ying Hui and Sai-Lin Zhu

·AIM:To investigate an effective treatment for primary pigmentary degeneration of retina.·METHODS:Totally 60 cases 120 eyes enrolled by standard diagnosis underwent choroids revascularization surgery associated with medicine treatment.After 24-36 months,we observed visual acuity,visual field,electroretinogram(ERG).·RESULTS:There was decrease of vision acuity in 2 eyes(1.6%),no improvement in 15 eyes(12.5%),improvement ranged from 0.02 to 0.20 in 80 eyes(66.7%),over 0.20 in 23 eyes(19.2%).The examination of peripheral fields(60°)and central visual field(30°)was performed on 56 cases 112 eyes.The sensitivity of peripheral fields could be detected in 56 eyes after the treatment(50%),whereas only in 45 eyes,and no changes in 47 eyes before the treatment.The detection rate was 83.9%.ERG was done in 59 cases 110 eyes.Wave a and wave b could not be recorded in 100 eyes before or after the treatment;wave shape could be recorded in 100 eyes after the treatment with a detection rate of 90.9%.·CONCLUSION:Choroid revascularization surgery associated with medicine treatment can control the development of primary pigmentary degeneration of retina and improve visual acuity and visual function.·

Analysis on psychological problems of patients with acute idiopathic optic neuritis

Wen-Juan Qin,Jun-Feng Mao,Fu-Feng Zhang and Shi-Hui Wei

·AIM:To study the mental and psychological problems of patients with acute idiopathic optic neuritis.·METHODS:Totally 239 cases of patients with acute idiopathic optic neuritis diagnosed and treated in Department of Ophthalmology and Department of Neurology of Xiangya Hospital of Central South University from May 2007 to October 2009 were collected.The psychological health of these patients was investigated and analyzed through symptom check list 90(SCL-90).·RESULTS:Total symptom index of the 239 cases of patients with acute idiopathic optic neuritis was 1.25±0.48,wherein,the total symptom index of the patient with acute idiopathic optic neuritis in both eyes was higher than that of the patient with acute idiopathic optic neuritis in one eye;the patients with best-corrected visual acuity below 0.3 were more than the patients with best-corrected visual acuity above 0.3.The positive items of the patients in this group were 19.In 9 subscales,the factor scores of interpersonal sensitivity,depression,anxiety and hostility were higher than normal value,wherein,the most common problems were depression and anxiety.·CONCLUSION:Patients with acute idiopathic optic neuritis have certain mental and psychological problems,wherein,the most common problems are depression and anxiety.Medical staffs should pay attention to the psychological intervention treatment of these patients.·

External route microsurgery for secondary giant retinal tear during or after vitrectomy

Da-Ling Xu,Yan Chen,Ming Huo,Kun Jin and Tong Luo

· AIM:To study the effect of external route microsurgery for giant retinal tear(GRT)caused by vitreous incarceration in the inner aspect of sclerotomy sites during or after vitrectomy.· METHODS:From June 2008 to February 2010,12 cases of patients with GRT related to vitreous incarceration of sclerotomy were treated using external route microsurgery and analyzed retrospectively.The encircling,silicone buckle,transscleral cryopexy and perfluorapropane tamponade were performed under a surgical microscope.Among them,4 cases of GRT were treated intraoperatively and 8 cases were occurred and treated postoperatively.· RESULTS:The following up time ranged from 2 to 15 months(mean 6 months).The retinas were reattached in eleven eyes after one operation.The retina was redetached in one eye one month later and another microsurgery was performed.At last,retinal reattachment was achieved in all patients.The postoperative best-corrected visual acuity was lower than 0.1 in 4 eyes(33%),0.1-0.3 in 5 eyes(42%)and higher than or equal to 0.4 in 3 eyes(25%).· CONCLUSION:The GRT related to vitreous incarceration of sclerotomy is a serous surgical complication.It is a secure and effective technique that the encircling,silicone buckle,tranascleral cryopexy and perfluorapropane tamponadd are used to treat the complication under the surgical microscope.·

Increase of intraocular pressure after Nd∶YAG laser iridectomy interruped by pilocarpine

Chun-Yan Wang,Yu-De Ai and Ge-Tu Tao

·AIM:To investigate if pilocarpine can effectively prevent the acute increase of intraocular pressure(IOP)in brown eyes after Nd∶YAG laser iridectomy.·METHODS:Totally 48 cases 58 eyes with primary angle-closure glaucoma were divided into treatment and control groups,which were matched by age and sex.One drop of pilocarpine was applied into the conjunctival sac at one hour before laser iridectomy and immediately after laser iridectomy in treatment group,whereas one drop of antibiotic as placebo was applied in control group at the same time.IOP,pupil diameter were measured at 0.5,1.0,1.5,2.0,3.5 hours after laser iridectomy.·RESULTS:The maximum increase of IOP after laser iridectomy was 0.62±0.67kPa and 1.13±0.87kPa in treatment and control group respectively,there was a significant difference(P=0.03).The obvious decrease of IOP occurred at 0.5,1.0 and 1.5 hours after laser iridectomy in treatment group.No ocular and systemic side effects were found in treatment group,except pupil diameter was obviously larger in treatment group than that in control group.·CONCLUSION:20g/L pilocarpine can effectively prevent the acute increase of IOP in brown eyes after Nd∶YAG laser iridectomy.·

Reconstruction of full-thickness eyelid defects with hard palate mucosa grafting combined with periorbital superficial muscle aponeurosis system flap transfer

Xiao-Hua Li

·AIM:To discuss the use of auto extricated hard palate mucosa grafting plates to substitute posterior layer eyelid tissue combined with periorbital superficial muscle aponeurosis system(SMAS)flap transfer for repairing defected anterior layer eyelid skin,and the clinical curative effects for full-thickness eyelid defects caused by reconstruction of injured eyes and eyelid malignant tumor.·METHODS:For all 16 patients 16 eyes with medium to heavily full-thickness eyelid defects larger than or equal to the full length of eyelid,oral hard palate mucosa grafting plates were used to substitute tarsal plates and conjunctivas,and reconstruct posterior layer eyelids;periorbital flood-abundant SMAS flaps were transferred to cover the hard palate mucosa and substitute the defected eyelid skin and muscle layer and reconstruct anterior layer eyelids.Among them,10 cases adopted musculus orbicularis oculi single flaps,3 cases superficial temporal artery flaps,2 cases upper eyelid skin orbicular muscle double flaps,1 case on-eyebrow inversion belt flaps.During the surgery,hard palate mucosa grafting was firstly performed,then periorbital SMAS transfer flaps was designed in accordance with part and range of the eyelid anterior defects,palpebral margins was sutured upon completion,and incised after 3-6 months.·RESULTS:For all patients who were followed up for over 12-36 months,the hard palate mucosa grafting plates and their transfer flaps survived without untoward effects of contraction,dislocation,infection or necrosis.Appearance of eyelids and functional improvements were satisfactory.·CONCLUSION:Hard palate mucosa grafting plates have a similar hardness with that of tarsal plates,good supporting effect,soft mucosa surface,no after-surgery contraction,easy availability,and high survival rate.Periorbital SMAS flaps have similar thickness and color with that of eyelids,abundant flood supply,high viability,simple operation,and minor injuries.Reconstruction of full-thickness eyelid defect with hard palate mucosa grafting combined with periorbital SMAS flap transfer can repair defected skin,tarsal plates and conjunctivas with positive curative effect and highly clinical values.·

Application of anterior chamber puncture and pH measurement in the treatment of moderate ocular alkali burns

Qing-Tao Li

· AIM:To evaluate the clinical effect of anterior chamber puncture and pH determination in the treatment of moderate ocular alkali burns.· METHODS:Totally 78 patients of moderate ocular alkali burns were included in this study.The patients were randomly divided into two groups.The experimental group had 39 cases,who underwent the application of anterior chamber puncture and pH value measurement combined with routine treatment.Control group had 39 cases who were treated only with conventional combined therapy.Corneal edema duration time,visual acuity,the corneal neovascularization and other complications were observed.· RESULTS:Corneal edema duration time,visual acuity,the corneal neovascularization and other complications were compared between the experimental group and control group,and the difference had statistical significance(P<0.05).· CONCLUSION:The anterior chamber puncture and the pH measurement play an active role in the treatment of moderate ocular alkali burns.·

Application of mitomycin C in nasal endoscopic dacryocystorhinostomy

Zhi-Yong Qin,Zhang-Min Lu and Zhi-Jian Liang

·AIM:To discuss the clinical effect of mitomycin C in nasal endoscopic dacryocystorhinostomy for curing chronic dacryocystitis.·METHODS:Totally 65 patients with chronic dacryocystitis were divided into treatment group and control group;the patients in treatment group received 0.4mg/mL of mitomycin C when undergoing nasal endoscopic dacryocystorhinostomy,while the patients in control group received no medicine when undergoing traditional dacryocystorhinostomy.After 12 months follow-up the patency of lacrimal passage was observed,and the area of ostomy with nasal endoscope and mycteric recovery was examined.·RESULTS:Of all 39 eyes 35 patients in treatment group,38 eyes were cured,the cure rate was 97%;of all 34 eyes 30 patients in control group,26 eyes were cured,the cure rate was 76%;a significant difference was found in cure rate between two groups(P<0.05).·CONCLUSION:The application of mitomycin C in nasal endoscopic dacryocystorhinostomy is a simple,safe and effective way to treat the chronic dacryocystitis,because it possesses the advantages of small injuries of tissue,few scar of face,small atresia of ostomy and high successful rate.·

Clinical analysis on treatment of nasolacrimal duct obstruction by recessive placement of spherical headed silicone tube

Cheng-Pu Zhang and Xiao-Hui Guo

· AIM:To analyze and investigate the clinical effects of recessive placement of spherical headed silicone tube through lacrimal passage in treatment of nasolacrimal duct obstruction.· METHODS:Totally 101 cases 122 eyes with nasolacrimal duct obstruction were treated by recessive placement of spherical headed silicone tube through lacrimal passage and followed up for 6-24 months.The effects were observed.· RESULTS:After surgery,105 eyes(86.1%)were cured,12 eyes(9.8%)showed progress and 5 eyes(4.1%)were ineffective.The total effective rate was 95.9%.· CONCLUSION:This operation is simple,safe,time-saving,without incision,less bleeding and has high successful rate,it does not change the original anatomical structure.·

Application of conjunctival blotting cytological examination in diagnosis of dry eye

Yan Liu

·AIM:To evaluate the effect of conjunctival blotting cytological examination in dry eye diagnosis.·METHODS:Totally 36 patients 72 eyes with dry eye syndrome from April 2008 to September 2008 and 10 normal volunteers 20 eyes were analyzed.Conjunctival blotting cytology combined PAS staining were applied.Conjunctival epithelial cells and the number,morphology and changes of goblet cells were observed.·RESULTS:Morphologically,97% of the normal volunteer presented the Nelson grade 0,84% of mild dry eye patients presented the Nelson grade 1,79% of moderate dry eye patients presented the Nelson grade 2,98% of severe dry eye patients presented the Nelson grade 3;The number of goblet cells was calculated using five visual fields randomly under high magnification.There was significantas decrease in dry eye group(mild:101.67±15.64,moderate:40.77±5.39,severe:6.36±3.61)compared with normal group(196.10±22.53,P<0.01);There was significant decreased in severe dry eye group than in mild or moderate dry eye group and the difference was statistically significant(P<0.01).·CONCLUSION:Conjunctival blotting cytological examination is asimple,accurate and objective method,when combined with other examination methods,it has good prospects for diagnosis of dry eye.·

Clinical application study of insulin pump in eye diseases in type 2 diabetes mellitus patients during the perioperation period

Jing-Xu Yang,Xiao-Yi Dun,Yu-Jie Yang,Hong Yuan and Hai-Yan Wang

·AIM:To compare the effect of continuous subcutaneous insulin injection(CSII)by using insulin pump and multiple subcutaneous insulin injection(MSII)in treatment of eye diseases in type 2 diabetes mellitus(T2DM)patients during the perioperation period.·METHODS:The study included 320 T2DM patients with eye diseases,who were divided into two groups randomly:CSII group and MSII group.The changes of some clinical indexes were compared between the two groups before and after treatment,including the plasma glucose levels,the duration to achieve the target for plasma glucose,insulin dosage,the incidence of hypoglycemia and complication,the length and expense of hospitalization.·RESULTS:The plasma glucose levels in both groups decreased evidently after the therapy(P<0.01).The plasma glucose 2 hours after meal in CSII group was lower than that in MSII group(P<0.01)with less insulin dosage(P<0.01).The duration to achieve the target for plasma glucose and the length of hospitalization in CSII group was shorter than those in MSII group(P<0.01).The incidence of hypoglycemia and complication was lower than those in MSII group(P<0.01).However,the expense of hospitalization in CSII group was higher than that in MSII group(P<0.01).·CONCLUSION:The insulin pump was safe and effective for T2DM patients with eye diseases during the peri-operation period.·

Quantitative analysis between the astigmatism of anterior corneal surface and overall astigmatism in myopia

·AIM:To research the relationship between the astigmatism of anterior corneal surface and overall astigmatism,and provide the reference for the refractive surgery design.·METHODS:Totally 358 eyes were enrolled.The astigmatic degree and axis of anterior corneal surface were obtained by the corneal surface topography examination with an topographer(TMS-4,TOMEY company,Japan);the degree and axis of the overall astigmatism were from cycloplegic refraction by an automatic refractor(RM8 000,TOPCON company,Japan).·RESULTS:The ratio of the overall astigmatism and the astigmatism of anterior corneal surface was 0.811±0.665.In 150 eyes with overall astigmatism less than 0.50D,the differences of astigmatic degree and axis between two astigmatisms were significant respectively;there was positive correlation in astigmatic degree and axis.In 122 eyes with overall astigmatism between 0.50D and 1.00D,significant difference was found in astigmatic degree but not in axis between two astigmatisms.There was no correlation in astigmatic degree and positive correlation in astigmatic axis.86 eyes with overall astigmatism more than 1.00D,significant difference was found in astigmatic axis but not in degree;There were positive correlation in astigmatic degree and axis.·CONCLUSION:The posterior corneal surface and crystalline compensate for the astigmatim of anterior corneal surface.The astigmatism of anterior corneal surface is positively correlated with the overall astigmatism.The higher the astigmatic degree,the higher the correlation.Corneal refractive surgery may be designed better according to the overall astigmatism.The incision location in refractive lens exchange and cataract surgery is determined by the astigmatism of anterior corneal surface.·

Clinical observation and complications analysis of orthokeratology lens for myopia

Yue-Jing Wang,Du-Ya Chen,Wei Cheng and Chuan-Wei Zhang

·AIM:To observe the clinical effects and complications of orthokeratology lens for myopia,and to analyze the relevant factors.·METHODS:The medical records of orthokeratology lens wearer 302 cases 601 eyes from three eye centers were analyed and the uncorrected visual acuity,refractive status,Orbscan examination,fluorescein staining 1 week;1 month,3 months after wearing glasses were observed.The condition of all patients before treatment was regarded as control group.·RESULTS:There was significant difference 1 week;1 month,3 months after wearing glasses compared with before wearing glasses in uncorrected visual acuity(t=-95.920,-77.710,-65.362;P<0.01,<0.01,<0.01),the anterior corneal surface horizontal curvature(t=26.020,20.143,17.476;P<0.01,<0.01,<0.01)and there was significant difference 1 week,1 month,3,6 months after wearing glasses compared with before wearing glasses in the anterior corneal surface perpendicular curvature(t=22.505,20.626,21.667,25.397;P<0.01,<0.01,<0.01,<0.01);However,There were no significant difference in uncorrected visual acuity 1 week;1 month,3 months after wearing glasses compared with the corrected visual acuity before wearing glasses.(t=-1.364,0.599,0.581;P=0.174,0.550,0.562);The punctate loss of corneal epithelium and indentation of center cornea appeared in 1 week was 7.5%,1 month 6%,3 months 9.8%,of which recurrence ratio was 2.5%.·CONCLUSION:Orthokeratology has the quick,effective,safe,and reversible advantages for myopia,whereas it has certain applicability for correction of myopia.·

Effects of super-thin corneal contact lens on LASEK

You-Tian Han,Ji-Hong Chen and Jia-Yi Zhao

·AIM:To evaluate the effects of super-thin corneal contact lens on LASEK.·METHODS:Thirty cases 57 eyes were divided into 2 groups randomly.The super-thin contact lens(NEW VISION,Korea)with 0.03mm central thinness was used in the experimental group,while the common contact lens(Bausch lomb,USA)with 0.14mm central thinness was used in the control group.The irritation,healing of corneal epithelium in 5 days postoperatively,haze and uncorrected visual acuity in 6 months postoperatively were compared.·RESULTS:Less irritation was found in the experimental group in 1 day and 5 days postoperatively,and better recovery of corneal epithelium was made in the experimental group in 5 days postoperatively.However,there was no difference in haze formation and uncorrected visual acuity in 6 months postoperatively.·CONCLUSION:Super-thin corneal contact lens can significantly reduce the early post-operative symptoms and promote healing of corneal epithelium.·

Clinical observation of perioperative intervention treatment for dry eye in LASIK

Jun Wang and Hui-Ying Chen

·AIM:To observe the clinical effect of perioperative intervention treatment for dry eye in LASIK.·METHODS:Totally 568 patients 1124 eyes with myopia and astigmatism in LASIK surgery underwent preoperative screening and perioperative intervention.Dry eye symptoms were observed before and 1 week;1 month,3 months after operation.Tear secretion test,tear film break-up time and corneal fluorescein staining were performed.·RESULTS:Mild dry eye was found in 158 eyes(14.57%)1 week,136 eyes(12.10%)1 month,58 eyes(5.16%)3 months after operation.·CONCLUSION:The screening before surgery and reasonable perioperative intervention play on important role in reducing the occurrence of dry eye.·

Clinical treatment of diffuse lamellar keratitis after laser in situ keratomileusis

Wen-Xuan Pei,Hong Yi and Hai-Bo Xiong

·AIM:To evaluate the clinical classification treatment of diffuse lamellar keratitis(DLK)after LASIK.·METHODS:Nineteen patients 21 eyes of DLK after LASIK from April 2008 to September 2009 in our hospital were collected.They were given clinical classification treatment according to corneal layer inflammatory extent.The clinical symptoms,corneal infiltration and scope of vision,refractive and intraocular pressure were observed before and after treatment 1 day,3,5,7,10 days and 1 month.·RESULTS:Most of patients presented mild symptom,including degrees Ⅰ:18 eyes,degree Ⅱ:2 eyes,degree Ⅲ:1 eye.Through the appropriate classification of glucocorticoid treatment,corneal flap lesions of inflammatory cell infiltration mostly subsided within 1 week.1 month after treatment,uncorrected visual acuity was significantly increased,reaching preoperative best-corrected visual acuity.Corneal signs,visual acuity and refractive error recovery levels among the various DLK gradings and also among the different treatments in the cases.Were not significantly differenct.There was no glucocorticoid-induced high intraocular pressure.·CONCLUSION:Clinical classification has a guiding role in glucocorticoid classification treatment of DLK.·

Investigation of the phacoemulsification and implantation of a foldable IOL associated with trabeculectomy

Sheng Wang,Yin-Xia Wang,Xiao-Jin Chen,Min Wang,Juan-Juan Zhang and Chun-Xia Xiao

AIM:To investigate the therapeutic effect and method of phacoemulsification and foldable intraocular lens (IOL) implantation associated with trabeculectomy in angle-closure glaucoma with cataract.METHODS:Phacoemulsification with implantation of foldable IOL associated with trabeculectomy was per-formed on 43 patients 43 eyes with cataract and angle-closure glaucoma through a 3.2mm hyaline corneal incision and another sclera incision.RESULTS:The post-operation vision >0.5 was in 26 cases (60%),between 0.1 to 0.5 in 17 cases(40%).The vision was improved in all cases.The average intraocular pressure 1 week after operation was 15.4±3.8mmHg,which was 10-30mmHg,lower than that before operation(P<0.01).42 eyes (98%) formed functional filtering bleb.CONCLUSION:Phacoemulsification and foldable IOL implantation associated with trabeculectomy in angle-closure glaucoma with cataract offers a safe and effective method to treat cataract with angle-closure glaucoma,and have a quicker visual recovery and good effect.

Clinical obervation of small incision nonphacoemulsification cataract extraction and intraocular lens implantation

Sheng-Wei Wu,Fan-Hong Kong and Jian-Hua Liu

AIM:To investigate the clinical curative effect of small incision nonphacoemulsification cataract extraction and intraocular lens implantion in the base hospital.METHODS:A total of 323 patients 362 eyes with cataracts admitted to our hospital underwent the small incision nonphacoemulsification cataract extraction and the phacoemulsification cataract extraction.The rupture of posterior capsule,prolapse of vitreous,visual acuity,corneal edema,fibrocculent reaction of anterior chamber and the occurrence of after-cataract in two groups were compared and analyzed.RESULTS:The rupture of posterior capsule,prolapse of vitreous,comeal edema,fibrocculent reaction of anterior chamber and the occurrence of after-cataract,the visual acuity one week and three months after operation in two groups were not significantly different.The price of operation was significantly lower in the small incision non-phacoemulsification cataract extraction group compared with that of the phacoemulsification cataract extraction group.CONCLUSION:The small incision nonphacoemulsifica-tion cataract extraction has advantages of small injury,quick recovery of visual acuity,low price and being operated easily in the base hospital.

Combined surgery of the Ahmed glaucoma valve implant for glaucoma secondary to traumatic lens subluxation

Xiao-Bing Wang

AIM:To explore the clinical effect of Ahmed glaucoma valve implant combined with lensectomy and vitrectomy for glaucoma secondary to traumatic lens subluxation.METHODS:Nine eyes which performed Ahmed glau-coma valve implant combined with lensectomy and vitrectomy and ciliary sulcus fixation of intraocular lenses for glaucoma secondary to lens subluxation were retros-pectively analyzed.RESULTS:The visual acuity was improved in 8 eyes after surgery.The intraocular pressure decreased from 44.11±8.85mmHg pre-operation to 14.78±5.52mmHg.The complications concluded transient hypotony,tube block-age,and drainage disk encapsulation,and they all recovered well after treatment.CONCLUSION:Ahmed glaucoma valve implant combined with lensectomy and vitrectomy and ciliary sulcus fixation of intraocular lenses is a safe and effective way to treat glaucoma secondary to traumatic lens subluxation.

Effect observation of small incision non-phacoemulsification cataract extraction and IOL implantation and trabeculectomy

Min Xiao

AIM:To evaluate the therapeutic effects of small incision non-phacoemulsification cataract extraction and IOL implantation and trabeculectomy (triple operation).METHODS:Triple operation on 43 cases 46 eyes with glaucoma and cataract was analyzed retrospectively.Visual acuity,intraocular pressure(IOP),filtration state and postoperative complication were observed.RESULTS:Postoperative visual acuities were improved.Postoperative IOP:11.04-19.08mmHg,the mean postopera-tive IOP:14.05±3.24mmHg.3 cases 3 eyes IOP were about 25mmHg postoperatively and could be controled in normal range by 5g/L timolol.38 eyes had the functional filtering bleb (including Ⅰand Ⅱ type).All cases had no severe complications.CONCLUSION:The triple operation with small incision non-phacoemulsification cataract extraction and IOL im-plantation and trabeculectomy may effectively control IOP and improve visual acuity.Triple operation is an effective and safe method for cataract patients with glaucoma.

Clinical observation of different sewing method of scleral flap in trabeculectomy of acute angle-closure glaucoma

Heng Li and Xue Mi

AIM:To compare the clinical effect of improved sewing method and traditional sewing method of scleral flap in trabeculectomy for acute angle-closure glaucoma.METHODS:Forty-two eyes 68 cases with acute angle-closure glaucoma underwent trabeculectomy and peripheral iridectomy,A group 16 cases 28 eyes:improved sewing method of scleral flap was adopted during operation;B group 26 cases 40 eyes:traditional sewing method of scleral flap was used during operation.RESULTS:All cases were followed-up for 6-12 months,averaged 6.7 months.A group:the suture was pulled out 3-17 days after operation,averaged 8.33 days.The shallow anterior chamber was 2 cases(7%) in A group and 12 cases(30%) in B group,there was significant difference between 2 groups(P<0.05).The intraocular tension was 10-19mmHg (averaged 13.31mmHg) in A and 6-42mmHg (averaged 14.64mmHg) in B after 2 weeks,there was no significant difference between 2 groups.The intrao-cular tension was 10-17.30mmHg (averaged 11.96mmHg) in A and 7-44mmHg(averaged 15.17mmHg) in B after 6 months,there was no significant difference between 2 groups.The functional filterbubble was 28 cases(100%) in A and 36 cases(90%) in B,there was no significant difference between 2 groups.CONCLUSION:It is safe and effetive that the improved sewing method of scleral flap for trabeculectomy of acute angle-closure glaucoma,and it is a better method to avoid the occurrance of shallow anterior chamber than the traditional sewing method in the forepart after operation.

Analysis of relative factors and characteristics about anxiety in the patients with primary open angle glaucoma

Li Zhang,Ping Yun,Xian-Qian Sun and Song-Nian Fu

AIM:To investigate the relative factors contributing to anxiety in the patients with primary open angle glaucoma (POAG).METHODS:The degrees of depression and anxiety in 82 patients with POAG and 82 non-POAG individuals were assessed using Hamilton pression scale(HAMD),then the incidence of anxiety in two group and the factors contributing to anxiety in POAG group were analyzed.The all collected data were then subjected to χ2 test.RESULTS:The incidence of anxiety in the patients with POAG was 13 cases (16%),significantly higher than that of the non-POAG individuals (5 cases,6%),(P=0.046),and the risk factors contributing to anxiety were sex,age,education,course,visual field.CONCLUSION:The incidence of anxiety in patients with POAG is high,especialy in those female patients with long-course,old,worse education and worse visual function,so,they should be given psychology intervention at the time of the disease’s treatment.

Intravitreal injection of triamcinolone acetonide combined with retinal photocoagulation for cystoid macular edema associated with nonischemic central retinal vein occlusion

Jin-Wei Feng

AIM:To investigate the efficacy of intravitreal triamcino-lone acetonide (IVTA) combined with retinal laser photo-coagulation for the treatment of cystoid macular edema (CME) associated with nonischemic central retinal vein occlusion (CRVO).METHODS:Fifty-six eyes of CME associated with noni-schemic CRVO were divided into two groups randomly.IVTA combined with retinal laser photocoagulation group(treat-ment group):30 eyes.Laser photocoagulation group(control group):26 eyes.Best-corrected visual acuity (BCVA),intraocular pressure (IOP),fluorescein fundus angiography(FFA) and optic coherent tomography(OCT) before treatment and at 3 month after treatment in these eyes were examined.40mg/mL IVTA with were performed after 2 weeks of grid pattern retinal laser photocoagulation for CME associated with nonischemic CRVO.RESULTS:Three months after treatment,23 eyes (77%) had improved BCVA,7 eyes (23%)remained the same.Fluorescence leakage relieved had been found by FFA.The average retinal thickness of macular area was (170±32)μm in treatment group.15 eyes(58%) had improved BCVA,11 eyes (42%) remained the same.Relief of fluorescence leakage was found by FFA.The average retinal thickness of macular area was(223±57)μm,in control group.There was statistical significant diffe-rence between treatment group and control group (χ2=4.20,χ2=5.13,P<0.01).CONCLUSION:IVTA combinated with retinal laser photocoagulation for the treatment of CME associated with nonischemic CRVO has better efficacy than retinal laser photocoagulation.

Acute symptoms of PVD induced retinal tear with vitreous hemorrhage

Hui-Li Li and Sheng-Yan Xiao

AIM:To observe the clinical characteristics and treat-ment effects of retinal tears with vitreous hemorrhage induced by acute symptomatic posterior vitreous detach-ment.METHODS:Retrospective analysis of 8 cases of patients concerning retinal tears with vitreous hemorrhage caused by acute symptomatic posterior vitreous detachment and clinical data was performed.RESULTS:The covered eyes,semi-supine and applica-tion of hemostatic agent symptomatic treatment led to the increased visibility of fundus.With timely laser photocoa-gulation treatment,retinal tears closed without retinal detachment.CONCLUSION:Full understanding of clinical features about retinal tears with vitreous hemorrhage caused by acute symptomatic posterior vitreous detachment,careful check in finding the hole,and timely tears sealing by laser photocoagulation treatment are key factors to better prognosis.

Vitrectomy for severe ocular injury with no light perception

Ze-Jun Xu,Yi-Min Xu,Hui-Ru Lin,Shan Lin and Bin Qin

AIM:To investigate the effect of vitrectomy for severe ocular injury with no light perception.METHODS:We retrospectively analyzed 10 patients 10 eyes with severe ocular injury.All affected eyes were performed by one surgeon with standard 3-port pars plana vitrectomy.The mean postoperative follow-up time was 12 months (6-24 months).During the follow-up,we surveyed their visual acuity,the corrected vision,intrao-cular pressure and fundus examination.Some patients were performed with B-ultrasound,UBM,ERG,OCT and fundus photograph.RESULTS:Five eyes had visual acuity of light percep-tion or above.5 eyes had visual acuity of no light percep-tion after operation.In these 5 eyes,2 eyes,because of atrophia bulbi,were performed second surgery with eyeball removal and hydroxyapatite implantation.CONCLUSION:The severe injured eyes with no light perception should not be removed blindly.Vitrectomy may save the visual function of some patients.

Clinical application of fourier-domain optical coherence tomography in central serous choroiretinopathy

Chun-Yang Feng

AIM:To explore the clinical application of fourier-domain optical coherence tomography (FD OCT) in central serous choroiretinopathy(CSC).METHODS:Fourty patients 40 eyes diagnosed with CSC by fluorescein fundus angiography (FFA) underwent FD OCT to observe the changes of macula,then they were treated with 532 laser,and FD OCT was traced.RESULTS:Neurosensory retina or combined with retinal pigment epithelium(RPE) detachment and RPE fracture were observed.The recovery of visual acuity post-laser therapy was consistent with the loss of macular volume.CONCLUSION:FD OCT could replenish and improve FFA in CSC diagnosis and display a clinical significance for estimated prognosis in CSC post-laser therapy.

Therapeutic effect of kudiezi on anterior ischmic optic neuropathy

Chun Shi and Jian Ying

AIM:To observe the therapeutic effect of kudiezi on anterior ischmic optic neuropathy(AION).METHODS:In 32 patients 32 eyes who were diagnosed as with AION,16 patients 16 eyes underwent intravenous drip with kudiezi 20mL (treatment group),and the other 16 patients 16 eyes underwent intravenous drip with dansen 20mL (control group) with the period of treatment of 15 days.The changes of visual acuity and ocular fundus of the patients after injection were recorded,and the visual field was checked before and after the treatment.RESULTS:The visual acuity was better in treatment group than that in control group with significant difference (P<0.01).At the 3rd,7th and 15th day after treatment,the visual acuity was better in treatment group than that in control group with significant difference(P<0.01;P<0.05;P<0.01).In treatment group,the visual field improved in 14 eyes (87.50%)and of remained unchanged in 2 eyes (12.50%).In control group,the visual field improved in 7 eyes(43.75%)and remained unchanged in 9 eyes (56.25%).There was significant difference between the two groups (P<0.01).CONCLUSION:Kudiezi is efficacious in treatment of AION.

Clinical analysis of 85 cases of oil workers with contusion hyphema

Feng-Hai Sun,Hong-Mei Ma,Jian Jia and Mei-Ling Xu

AIM:To analyze traumatic hyphema occurrance chara-cteristics in oil workers,and propose the treatment and prevention measures.METHODS:Eighty-five patients with traumatic hyphema were analyzed to explore different effective treatment of hyphema.RESULTS:Eighty-five patients with traumatic hyphema underwent the treatment,the vision had significant improvement:56 cases recovered to 1.0,19 cases up to 0.5-0.8,7 cases 0.1-0.4,3 cases≤ 0.1.CONCLUSION:Early medical or surgical treatment play the key effect on the hyphema,which can achieve satis-factory results.Positive prevention is important to avoiding injury.

Treatment of children severe congenital blepharoptosis with the frontalis suspen-sion using dacron mesh sling

Guang-Rui Chai,Shu-Guo Yin and Xiao-Long Chen

AIM:To study the surgical effects of frontalis suspen-sion with dacron mesh sling for children severe congenital blepharoptosis.METHODS:Frontal muscle suspensions were performed on 55 cases 74 eyes of children severe congenital blepharoptosis with dacron mesh sling.The follow-up periods were 1 month to 24 months (average 6.5 months).The photos were compared before and after the operation.RESULTS:After the operation,the excellently-corrected eyes were 69 (93%);under-corrected eyes were 5 (7%);no over-corrected eyes.CONCLUSION:Frontal muscle suspension using dacron mesh sling is an effective and safe operation method to treat children severe congenital blepharoptosis.

Levator aponeurosis plication combined with upper eyelid blepharoplasty

Xu-Xia Zhang

AIM:To explore the surgery effect of the upper eyelid blepharoplasty combined with the levator aponeurosis plication in mild blepharoptosis.METHODS:We performed upper eyelid blepharoplasty in 326 patients 652 eyes and combined with the levator aponeurosis plication in 36 patients 65 eyes.RESULTS:Followed up for 1-6 months,the double eyelid was symmetry and showed good shape.The palpebral fissure was enlarged 1.5mm in average.The mild notch deformity of margin was in 2 eyes,and disappered after 3 months by massaging upper eyelid.Under-corrected was in 1 eye.There was lagohthalmus 1-3mm early after operation,average 2.1mm,1 month later lagohthalmus disappered and no exposure keratitis occurred.CONCLUSION:The upper eyelid blepharoplasty combined with the levator aponeurosis plication in mild blepharoptosis patient can achieve a high success rate and high satisfactory rate.

Successful eradication of xanthelasma palpebrarum using XL-radiofrequency ablation skin apparatus

Xing-Lin Wang,Wei Suo,Tian-Yu Jiang,Qing-Hua He and Hong-Yu Xiao

AIM:Therapeutic methods of XL-radiofrequency abla-tion skin apparatus (invented by department of Phy-siotherapy,Chinese PLA General Hospital) in eradicating xanthelasma palpebrarum are studied and their clinical effects are investigated.METHODS:XL-radiofrequency ablation skin apparatus was performed on 40 cases 73 lesions of xanthelasma palpebrarum with the length of 3-15mm and width of 3-10mm in an area of 6-150 (average 44±34)mm2 by separat-ing layer and ablation removing methods.The postopera-tive follow-up durations ranged from 1 to 3 years.RESULTS:In 40 patients with 73 lesions,35 cases 67 lesions were cured successfully by once and 4 cases 6 lesions by twice with well healing,no-scarring with cure in 39 cases and marked result in 1 case.1 case 2 lesions had a recurrence in postoperation of 7 months,2 cases 2 lesions had a slight hypopigmentation.The protective crust over lesion was formed next day and fall off half month postoperation.Local erythemia in several cases occurred after the crust fall off and disappeared during 6 to 10 months.XL-radiofrequency ablation skin apparatus offered several advantages,such as easy operation,high accuracy,clear visible field under the operative magnifier,no bleeding,shorter operation time,no smog,little pain,one-off ablation electrode during the procedure,slight inflammation reaction,no infection,no antibiotics follow-ing operation,no visible scarring and lower recurrence after healing.CONCLUSION:The efficacy of XL-radiofrequency abla-tion skin apparatus is significantly more evident and safe in eradicating xanthelasma palpebrarum.

Clinical analysis of nasal endoscopic dacryocystorhinostomy in treating chronic dacryocystitis

Ru-Shan Ye,Xin Lu and Hong Zhang

AIM:To explore the therapeutic method of treating chronic dacryocystisis with nasal endoscopic dacryocy-storhinostomy.METHODS:A total of 30 patients(32 eyes)of chronic dacryocystitis were submitted to nasal endoseopic dacryocystorhinostomy.They underwent the irrigation of lacrimal passage after the surgery,and were followed up by endoscopy for aperiod range from 1-3 years.RESULTS:Twenty-six eyes(81%)were cured,4 eyes (13%)were improved,and the total effective rate reached to 94%.CONCLUSION:Nasal endoscopic dacryocystorhino-stomy for the chronic dacryoeystitis is an ideal way to treat the chronic dacryocystitis,because it possesses the advantages of small tissue injuries,simple and quick operation,fewer complications.

Clinical study of methylprednisolone pulse therapy with triamcinolone acetonide and dexamethasone peri-orbital injection on thyroid associated ophthalmopathy

Xiao-Jun Shen and Chao Peng

AIM:To evaluate the effect of methylprednisolone pulse therapy with triamcinolone acetonide and dexamethasone peri-orbital injection on thyroid associated ophthalmo-pathy.METHODS:Thirty-six cases 53 eyes of Graves ophthal-mopathy were treated with methylprednisolone(500mg) every day,three days later peri-orbital injection of triamcinolone acetonide(40mg)and dexamethasone(2.5mg) once one month and three months in one course.Symptoms and signs of the patients were observed before and after one course of treatment.RESULTS:The mean value of exophthalmus of the patients was significantly decreased after the treatment by(3.4±1.2)mm.The thickness of the extraocular muscles was significantly decreased by(1.1±0.3)mm.CONCLUSION:Methylprednisolone pulse therapy with triamcinolone acetonide and dexamethasone peri-orbital injection can improve symptoms and signs of the patients with thyroid associated ophthalmopathy with less side effect and high safety.

Therapeutic effect of Zyoptix individualized LASIK of cornea saving for myopia

Rui-Bo Zhao,Yong-Hong Guo and Yong-An Meng

AIM:To observe the Bausch & Lomb Zyoptix individualized LASIK of cornea saving treatment for myopia,and analyze postoperative changes in higher-order aberrations.METHODS:Thirty-two patients 64 eyes with thin cornea myopia unsuitable for conventional LASIK surgery under-went the Zyoptix LASIK surgery.The degree of the cornea saved,the recovery of vision at 1 year and 6mm pupil diameters changes in higher-order aberrations were analyzed.RESULTS:The average saved corneal tissue was 29.27μm (21.36%);1 year after operation,uncorrected visual acuity was 0.93±0.24,visual acuity was signifi-cantly improved compared with that of preoperative (P<0.01),and similar to the preoperative best-corrected visual acuity (0.96±0.09);81% of cases have the better postoperative visual acuity than the preoperative best-corrected visual acuity,visual acuity was improved in all cases.At 6mm pupil diameter,the overall higher-order aberrations,third order coma and the fourth order spherical aberration were increased 1.76 times,2.10 times,3.90 times compared with that of the preoperative,similar to conventional LASIK surgery.CONCLUSION:Zyoptix individualized LASIK of cornea saving can save 20%-25% of the corneal tissue,expand the treatment scope of myopia,and have a good safety,efficacy and predictability in clinic.

Relationship between corneal topography before LASIK analyzed by Pentacam system and the postoperative vision improvement

Yu-Xia Zhang,Yi-Hua Chen and Qi Zhao

AIM:To analyse the corneal topography with Pentacam system before LASIK,and to explore the relationship between the corneal topography and the vision improve-ment.METHODS:The Pentacam system was used to analyse the corneal topography shapes before LASIK,and then the uncorrected eye vision,best-corrected vision and astigmatism degree were observed before and 3,6 months after LASIK.RESULTS:Before operation,the rate of symmetrical bow tie and asymmetrical bow tie patterns was 76.13%,the rate of round and ellipse patterns was 19.03%,and the rate of irregular patterns was 4.84%.The different among the three groups had statistical significance(P<0.05).After LASIK,the uncorrected eye vision and astigmatism degree improved with statistical significance after opera-tion(P<0.05).In the three groups,round and ellipse patterns showed the best results,symmetrical bow tie and asymmetrical bow tie patterns ranked the second,and irregular patterns the third.There was significant difference in each shape when compared in the 3rd and the 6th month after operation(P<0.05).CONCLUSION:Using Pentacam system to analyse the corneal topography,we find that there is a relationship between the corneal topography and the vision improvement.

Clinical research of DCT in LASEK surgery

Ye-Shuang Tan,Xia Zhou,Ling Xu and Ling-Li Wang

AIM:To evaluate the performance of dynamic contour tonometer(DCT)before and after LASEK surgery by applying mitomycin C.METHODS:Three hundred eyes of 150 myopic patients admitted in our hospital were included in this study.The left and right of eyes of 150 patients was randomly divided into two groups,0.2g/L MMC sponge was put onto the cornea ablation area in 2 minutes during the operation in 150 eyes of MMC group;BSS sponge was put onto the cornea ablation area in 2 minutes during the operation in 150 eyes of the control group.The IOP was measured with DCT before operation and 1 week and 4,12 weeks after operation.RESULTS:The IOP in MMC group and control group was 17.17±2.35mmHg,18.12±2.41mmHg before opera-tion respectively.The IOP in MMC group and control group was 17.09±2.72mmHg,17.24±2.39mmHg,17.12±2.67mmHg,17.52±2.47mmHg,18.01±2.69mmHg,17.66±2.54mmHg 1 week and 4,12 weeks after the operation respectively.There was no difference of DCT in the control group and MMC group at various time point after the operation respectively.CONCLUSION:DCT may be suitable for monitoring IOP in eyes that have had corneal refractive surgery.The application of MMC in LASEK has no effect on the IOP.

Clinical efficacy of pressing triple prism treatment in acquired strabismus

AIM:To investigate the efficacy and safety in patients with diplopia caused by paralytic strabismus treated with pressing triple prism.METHODS:Fourteen patients with paralytic strabismus were included in this study.All patients were given eye examination,optometry and weared frame spectacles;the patients complicated with blephroptosis were weared stent frame glasses.Pressed the corresponding degree of membranous triple prism to correct diplopia after mea-suring the degree of strabismus repeatedly.Then syno-ptophore was used to test the level Ⅰ function in patients.RESULTS:Among 14 cases,9 suffered from diplopia were completely disappeared,5 were obviously improved;and after the treatment,the compensatory head posture of 6 patients were gone,8 had level Ⅰ function by syno-ptophore test.CONCLUSION:Pressing triple prism is effective to relieve diplopia and compensatory head posture of the patient not suitable for the surgery,and it can improve the quality of life and not affect the treatment of primary disease.

Etiology analysis of non-strabismic diplopia with first symptom of diplopia

Li-Hong Wang and Li-Jie Hou

AIM:To explore the etiology distribution of non-strabismic diplopia with first symptom of diplopia.METHODS:Non-strabismic diplopia patients (69 cases) with first symptom of diplopia underwent routine examination,uncorrected visual acuity,corrected visual acuity,refractive status,anterior segment and fundus examination.After that,according to the movement examination of monocular and binocular,the binocular visual function,the convergence function by synoptophore,Maddox Rod Test were applied.According to illness history,eye specialist examination,systemic examination and consultations advice,etiology distribution of the disease was analysed.RESULTS:Patients(32 cases) with convergence insuffi-ciency was the most common reason.Corneal astig-matism from pterygium surgery( 8 cases),early cataract(8 cases),lens or artificial lens subluxation (4 cases),after cataract (3 cases),glaucoma (2 cases),macular epiretinal membrane(2 cases),retinal detachment (2 cases),vitreous liquefaction (1 case),posterior vitreous detachment (1 case),double pupils caused by trauma (1 case),postoperative pathologic high myopia (1 case),and unknown reasons (4 cases) were all the causes of this disease.CONCLUSION:In the non-strabismic diplopia with first symptom of diplopia,the convergence insufficiency is the most common etiology.There is similar proportion in the patients of monocular/binocular diplopia and young/age.

Comparison of master eye operation and slave eye operation on patients with concomitant exotropia

Yong-Jian Huang and Wei Feng

AIM:To search for an excellent therapy for patients with concomitant exotropia.METHODS:In 120 patients patients with concomitant exotropia,60 patients underwent the strabismus operation in master eye,and the other 60 patients underwent strabismus operation in slave eye.The changes of visual acuity,surgical amount and stereopsis vision of the patients after operation were recorded.RESULTS:Compared with slave eye operation,the surgical results were better in the master eye operation in surgical amount (P<0.01),post-operation visual acuity(P<0.05) and stereopsis vision(P<0.05).CONCLUSION:Master eye operation on patients with concomitant exotropia have better effect than slave eye operation.

Treatment of amblyopia by using VEP visual exam and therapeutic system

Hui Qiu,Xin-Yao Li,Hong-Yang Li,Xin-Ling Wang and Jin-Song Zhang

AIM:To investigate clinical effect of DV-100 VEP visual exam and therapeutic system in treating amblyopia.METHODS:DV-100 VEP visual exam and therapeutic system were used to test PVEP of amblyopia of 210 cases 346 eyes,the most suitable visual stimulating signal of amblyopia eyes was measured,and vision training software was made by which amblyopia vision therapy was done at home.RESULTS:All of cases were followed up for 24-26 months,efficient rate of treatment was 90.5%.With the improvement of visual acuity,PVEP P100 time was shorter and amplitude value was increased.Treating result of young age groups was better than that of older age group.CONCLUSION:Personal amblyopia vision training software can be made by using VEP visual exam and therapeutic system,and the outcome of therapy can be monitored by PVEP.

Analysis of the morphology of corneal endotheliitis by confocal microscope

Jun Zhao,Hua Zhao,Jun Qiang,Min Liu and Li Liu

AIM:To observe the morphology of corneal endotheliitis by confocal microscope.METHODS: Confoscan 4.0 (made in Japan) was used to scan the 24 cases 24 eyes suffered from corneal endotheliitis and the image of every corneal sheet was recorded.RESULTS: Opacitas were found in anterior stroma.In deeper stroma, stroma cell was disorder and high glisten structure and DM reductus were found. High glisten structure were found before corneal endothelium which suggested that pleomorphism transform in corneal endothelium. There were corneal epithelium cell degeneration in 4 eyes.CONCLUSION: By confocal microscope we can observe the morphology of every corneal sheet as well as histopathologic slide. The morphological characteristic of corneal endotheliitis is that the deeper stroma and endothelium are damaged. Confocal microscope has certain reference value for cormeal endothelitis.

Penetrating keratoplasty in the treatment of stromal corneal dystrophy

Nan Zhang,Ping Liu and Xin Wang

AIM:To investigate the clinical effects of penetrating keratoplasty in the treatment of stromal corneal dystrophy. METHODS: Fifteen cases 17 eyes with stromal corneal dystrophy were enrolled in this study and followed up for 6-36 months, with on average of 18 months. RESULTS: Visual acuity was increased significantly after keratoplasty. Corrected vision >0.1 was in 16 eyes(94%).Correct vision >0.3 was is 9 eyes(52%).Rejection occurred in 2 eyes and no corneal lesion recurred in all patients.CONCLUSION: Penetrating keratoplasty is an effective method in treatment of stromal corneal dystrophy.

Clinical effect of tobramycin-dexamethasone combined with aciclovir in the treatment of herpes simplex keratitis

Qiu-Ping Xue

AIM:To discuss the effects of tobramycin-dexamethasone(TobraDex) eye drops combined with aciclovir eye drops (ACV) to treat herpes simplex keratitis (HSK) .METHODS: Forty-three cases 46 eyes with HSK were divided into two groups randomly, one group of TobraDex eye drops was with 23 cases 25 eyes,another group of recombinant bovine fibroblast growth factor eye drops was with 20 case 21 eyes, clinical effect was analyzed.RESULTS: The shallow layer was cured completely, the effectiveness of in-depth TobraDex was 87.5%, and that of the group of recombinant bovine fibroblast growth factor was 60.0%, the average cure time of the TobraDex group was 12 days,and recombinant bovine fibroblast growth factor group was 17 days. CONCLUSION: The TobraDex eye drops combined with ACV eye drops to treat HSK can enhance the curative effect, shorten the course and the recrudescence,especially in in-depth HSK.

Research on the developing operation method of cataract in the primary hospital

Hong-Wei Lü and Zuo-Shu Gao

AIM:To summarize and analyze the effect and characteristic of the phacoemulsification extraction and the small incision non-phacoemulsification extraction and intraocular lens(IOL), and evaluate a more suitable operation method in primary hospital. METHODS: A total of 387 cases 405 eyes was chosen and the cataract patients medical record material treated by the small incision non-phacoemulsification extraction and IOL was selected, and 256 cases 278 eyes were chosen and the cataract patients medical record material treated by the phacoemulsification extraction and IOL was selected, then the complications in the operation, after the operation, and the visual acuity restores situation were summarized. RESULTS: There was no significant difference between the phacoemulsification extraction and the small incision non-phacoemulsification extraction in complications,during operation and after operation. CONCLUSION: The small incision non-phacoemulsification extraction and IOL is safe and effective, the operation is simple, the investment and expense are few, so it is more suitable in primary hospital.

Risk factors of cataract formation

Xue-Qin Huang and Li-Hua Song

AIM:To investigate the various risk factors of cataract formation and find the intervention measures for reduce its incidence. METHODS: Two hundred and six cases of cataract from outpatients and inpatients in our hospital were collected from December 2006 to October 2009. The relationship between the physical health and cataract formation were investigated.RESULTS: Alcohol, excessive smoking, diabetes, hypertension, cardiovascular diseases, glaucoma, the concentrations of blood glucose, urea nitrogen, creatinine, blood cholesterol C, triglyceride Gu were positively correlated with the occurrence of cataract; but blood carbon dioxide combining power, calcium, phosphorus, serum total blank, albumin binding capacity were negatively correlated with the occurrence of cataract. CONCLUSION: Active treatment of primary diseases and good habits is an important factor in reducing and delaying cataract.

Upper peribulbar anesthesia and topical anesthesia in ECCE and IOL implantation

Ren-Zheng Deng,Deng-Feng Xu,Li-Jun Tang,Deng-Qi Jiang and Juan Cheng

AIM:To estimate the safety and advantage of upper peribulbar anesthesia and topical anesthesia in extra capsular cataract extraction(ECCE) and intraocular lens(IOL) implantation. METHODS: All the 286 patients(301 eyes) with cataract from June 2005 to December 2008 were randomly assigned to three groups: group A(126 eyes) under upper peribulbar anesthesia and topical anesthesia; group B(89 eyes) under infra-conjunctival anesthesia;group C(86 eyes) under retrobulbar anesthesia. All the surgeries were under the microscope. The time of follow-up was 3 days. The effectiveness of anesthesia in operation, postoperative visual acuity and conjunctival reaction 3 days after operation were surveyed. RESULTS: The effectiveness of anesthesia in operation was good, these in group A and C were better than that in group B;postoperative visual acuities in group A and B were better than that in group C;conjunctival reaction in group A and group C were better than that in group B. CONCLUSION: ECCE and IOL implantation with upper peribulbar anesthesia and topical anesthesia is safe and superior to the infra-conjunctival anesthesia, topical anesthesia and retrobulbar anesthesia.

Measurement of intraocular lens diopter on patients with cataract and silicon oil tamponaded eyes

Hui Yang and Pei-Feng Li

AIM:To evaluate the feasibility of the measure method of intraocular lens(IOL) diopter in cataract with silicon oil-filled eye by using corrected eye’s axiel. METHODS: Twenty-eight cases of silicon oil tamponaded eyes with cataract were taken in the study. Their ages were from 25 to 72. They received silicon oil extraction and cataract phacoemulsification and IOL implantation in one operation. Before the operation, they received keratometry measure and eyeball length measure at seated. During the measurement ,the speed of the supersonic wave in vitreous was corrected from 1532m/s to 990m/s. Their IOL power were calculated by SKR-Ⅱformula with corrected eyeball length. RESULTS: All the cases had silicon oil extraction and cataract phacoemulsification and IOL implantation in one operation. There were no complications. Their diopter were from -2.0D to 2.5D one month after the operation. CONCLUSION: Measurement of IOL diopter by axial length on patients with cataract and silicon oil tamponaded eyes is a feasible clinical method.

Clinical observation of triple surgery in the treatment of glaucoma with cataract

Mao-Ju Zhang,Jia-Zhang Li,Hong-Yan Li and Tuo Li

AIM:To observe the therapeutic effect of phacoemulsification, posterior chamber intraocular lens implantation and trabeculectomy (triple surgery) in the treatment of glaucoma with cataract.METHODS: Triple surgery was performed in 62 patients 68 eyes with glaucoma and cataract, visual acuity, intraocular pressure, bleb and complications were observed.RESULTS: Follow-up was 6-50 (mean 16.8)months. The postoperative vision was improved in varying degrees. The postoperative intraocular pressure was controlled in normal range.CONCLUSION: Triple surgery in the treatment of glaucoma with cataract can better control the intraocular pressure, and can quickly obtain good vision with fewer complications.

Therapeutic effects of surgery correction on 41 cases of aphakia

Wen Yang,Xiao-Zhao Tang and Jun-Feng Yang

AIM:To evaluate the effects and safety of surgery correction on 41 cases of aphakia.METHODS: Forty-one cases of aphakia selected from 2004 to 2009 in our hospital were corrected by posterior chamber secondary intraocular lens implantation. The effects and safety were observed (in 6 months’ follow-up).RESULTS: Good correction effect was achieved in all cases after operation. CONCLUSION: Posterior chamber secondary intraocular lens implantation is an effective, safe and feasible method for aphakia without serious complications.

Correlation of disc damage likelihood scale with the structural and functional change in optic nerve with primary open-angle glaucoma

Min Cui,Xiao-Ming Chen and Yong-Zhi Huang

AIM:To evaluate whether the disc damage likelihood scale(DDLS)graded by the map of heidelberg retina tomography(HRT) is correlated with the structural and functional change in optic nerve with primary open angle glaucoma(POAG).METHODS: Consecutive observational case series of 60 eyes 60 patients with POAG were enrolled in the study. HRT-Ⅲ examination was performed by an examiner masked to the clinical examination findings. While all eyes were detected by OCTOPUS -900 visual field perimetry (G2-TOP). Rim area(RA) and mean defect(MD)were recorded. The DDLS score were graded by topographic and reflective map of HRT-Ⅲ. Findings were assessed by the Pearsons.RESULTS: Eleven eyes with optic discs of 3.09 to 3.43mm2,36 eyes with optic discs of 2.41 to 2.67mm2 and 13 eyes with optic discs of 1.64 to 1.81 mm2 were analyzed. The results showed that DDLS was strongly correlated with RA and MD,and the correlation between DDLS and MD did not change obviously along with magnification of optic disc area.CONCLUSION: The DDLS graded by the map of HRT is a good method to grade the change of structural and function in optic nerve with POAG.

Clinical analysis of peseudo exfoliation glaucoma

Jing Su,Hong Li and Juan Guo

AIM:To observe and evaluate the clinical features, manifestations and management of peseudo exfoliative glaucoma.METHODS: The clinical records of 13 cases 17 eyes with PEG were analyzed retrospectively.RESULTS: Intraocultar pressure(IOP) was well controlled in 3 eyes with drug ,IOP of 1 eye was normal by trabeculectomy but the vision was no light. IOP and visual field of 3 eyes was normal.The IOP of 7 eyes on which phacoemulsification was performed was reduced significantly, phacoemulsification and trabeculectomy were performed on 2 eyes, IOP of 1 eye reduced significantly but vision was no light, malignant glaucoma was the postoperative compliation of 1 eye.CONCLUSION: Early recognition and treatment is very important to delay the process of glaucoma and reduce occurrence of surgical compliations.

Clinical analysis of 221 cases of traumatic glaucoma

Gui-Ping Yang

AIM:To analyze the etiopathogenisis and therapeutic conditions of traumatic glaucoma, and provide epidemiologic data for traumatic glaucoma.METHODS: Retrospective analysis of 221 cases 223 eyes of traumatic glaucoma from June 2004 to May 2009 in our hospital was performed. RESULTS: According its etiopathogenisis, it concluded 95 cases 98 eyes(43.0%) of hyphema, 50 cases 53 eyes(22.6%) of dislocation of the lens, 39 cases 43 eyes(17.6%) of angle recession, 20 cases 20 eyes(9.1%) of lens cortex release, 8 cases 8 eyes(3.6%) of corneal perforation, 6 cases 6 eyes(2.7%) of intraocular foreign body, 3 cases 5 eyes(1.4%) of chemical burns. The majority of traumatic glaucoma was caused by hyphema after blunt trauma.CONCLUSION: The pathogenesis and etiopathogenisis of traumatic glaucoma are complex and visual function damage is serious. Prevention and rational treatment of traumatic glaucoma are the key factors to save the patients’ visual acuity.

Clinical observation of the application of mitomycin C in glaucoma filtration surgery

Wen-Qin Fu and Xin Wang

AIM:To explore the effect of mitomycin C(MMC) in glaucoma filtration surgery.METHODS: The effect of MMC in the glaucoma filtration surgeries in 35 eyes of 32 patients was observed.RESULTS: In the average two years’ follow-up, visual acuity was improved in 21 eyes, remained unchanged in 14 eyes, type Ⅰfiltration bleb occurred in 18 eyes, type Ⅱ in 15 eyes and type Ⅲ in 1 eye. One eye had normal intraocular pressure without filtration bleb.CONCLUSION: The application of MMC in glaucoma filtration surgery is an effective method for glaucoma.

Combined therapy for the neovascular glaucoma

Dong-Zhen Yu,Zi-Bin Zhang,Zhen Liu,Ning Gao and Mei Zhao

AIM:To explore the efficacy of neovascular glaucoma treated by pan retinal photocoagulation or pan retinal cryotherapy combined with trabeculectomy. METHODS: Sixty-four patients 64 eyes with neovascular glaucoma were first treated by retinal photocoagulation or pan retinal cryotherapy and then trabeculectomy.Postoperative visual acuity, intraocular pressure,iris neovascularization,filtering bleb ,and complications of the surgery were studied.RESULTS: Follow-up visits during the period of 6 to 12 months after the treatment showed that visual acuity did not manifest improvement but mean intraocular pressure dropped from 47.89±6.74mmHg to 18.41±2.16mmHg. The intraocular pressure of 53 eyes was controlled normal,and the success rate was 73%. CONCLUSION: Trabeculectomy combined with pan retinal photocoagulation or pan retinal cryotherapy has better long-term therapeutic efficacy in treating neovascular glaucoma.

Four joint surgery in the treatment of neovascular glaucoma

Jia Guo Cao,Qing Hui Yan,Yan Li Bao and Yan Li

AIM:To evaluate effects of trabeculectomy with mitomycin C (MMC), intravitreous injection of triamcinolone acetonide ( TA) and cyclocryotherapy in patients with neovascular glaucoma(NVG).METHODS: Trabeculectomy with MMC was performed on 16 eyes of 16 patients with NVG. Intravitreous injection of TA(4mg/0.1mL), cyclocryotherapy at 4 to 6 points about half circle of the eye. Each point was frozen for 60 seconds.RESULTS: The postoperative normal IOP was in 14 eyes (88%) and the IOP above 21mmHg was in 2 eyes. The stimulative symptoms were reduced or relieved and iris new vessels were reduced. There was no atrophy of eyeball in all patients.CONCLUSION: Trabeculectomy with MMC, intravitreous injection of TA and cyclocryotherapy is an effective method for patients with NVG.

Clinical observetion of pan retinal photocoagulation for diabetic retinopathy

Wei Wang,Yu-Sheng Yang,Zhi-Jian Liao and Ming Li

AIM:To explore the effect of pan retinal photocoag-ulation(PRP) on treating diabetic retinopathy(DR).METHODS:A total of 408 cases (795 eyes) of DR was chosen, 532nm semiconductor laser was used to have PRP, spot diameter was 300-500μm, time was 0.2-0.3 seconds,spot space was 1-1.5 spot. Slap shot 300-500 points per time to reach tertiary light spot; the amount of laser was 1 000-1 500 points, retreated for 3-4 times. The fundus fluorescein angiography (FFA) was performed 3-6 months after the treatment.RESULTS: Patients with obvious effect were 289 eyes (36.3%); with effect were 418 eyes(52.6%); with no effect were 88 eyes (11.1%), and the total effective rate was 88.9%. 234 eyes (29.4% ) had improved visual acuity, and 453 eyes had invalid treatment(57.0%).CONCLUSION: PRP is the most effective way for DR,and an important method to control the illness and protect the eyesight of the patient.

Research on the fundus fluorescein angiography in congenital hypertrophy of the retinal pigment epithelium in patients with familial adenomatous polyposis

Yan Ding,Yu Xu and Xiao-Dong Xu

AIM:In order to investigate the features of fundus fluorescein angiography(FFA) in congenital hypertrophy of the retinal pigment epithelium (CHRPE) in patients with familial adenomatous polyposis(FAP). METHODS: Prospective FFA and ophthalmoscopy were carried out in 22 patients with 65 CHPRE lesions.RESULTS: A total of 86% were over half the optic disc diameter in size. About 74% of CHRPE lesions were close to retinal vessels. The retinal vascular changes were: with capillary non-perfusion area (46%), partly block of retinal vessels (8%), chorioretinal anastomoses (6%), capillary microaneurysms (3%), choriocapillary vessels can be observed (5%) and in the depigmented marginal halo (20%). About 10% of the lesions were not seen on ophthalmoscope and could only be detected by angiography.CONCLUSION: Even though the diagnosis of CHRPE is clinical, FFA may be useful in confirming the diagnosis, as well as detecting additional lesions not seen by means of ophthalmoscopic examination.

Clinical analysis of 23 cases with rhegmatogenous retinal vitreous hemorrhage

Li-Bo Ma,Ju Wen,Zhi Zhang and Jian-Dong Zhang

AIM:To investigate the pathogenesis, clinical features and treatment of retinal vitreous hemorrhage . METHODS: Twenty-three eyes of spontaneous vitreous hemorrhage were collected, the reason of vitreous hemorrhage was the horse shoe-shaped retinal hole associated with vessel breaks 2 eyes were with the simple concurrent vitreous hemorrhage, 21 eyes were with rhegmatogenous retinal detachment complicated with vitreous hemorrhage; 3 eyes were performed only with laser treatment, 20 eyes underwent extra-retinal detachment surgery or vitrectomy.RESULTS: After laser or surgical treatment, there was no bleeding recurrence in the 23 eyes, hole was closed, the visual acuity of 22 eyes was better than or equal to that of preoperative, 1 eye of recurrent retinal detachment was the traction retinal detachment. CONCLUSION: Rhegmatogenous vitreous hemorrhage is a major reason for vitreous hemorrhage, early diagnosis and timely treatment can achieve a satisfactory effect and avoid serious complications.

Triamcinolone acetonide in vitreous surgery

Hua-Peng Yang,Rui Cui and Zhi-Min Zhang

AIM:To research triamcinolone acetonide(TA) assisted vitrectomy marked residual vitreous cortex, posterior vitreous cortex and epiretinal membrane, and whether there is statistical significance in visual acuity and intraocular pressure when compared with the control group. METHODS: From January 2004 to January 2008, 52 patients 53 eyes with vitrectomy, including treatment group 28 eyes with intravitreal injection of TA in the control group, 25 eyes did not use TA. The mean follow-up was 6 months, visual acuity and intraocular pressure changes were observed, and analyzed the statistical significance. RESULTS: The intraocular pressure in treatment group and control group after two months greater than 21mmHg were 11% and 9%, no statistical significance existed; There were no significant changes in visual acuity between the two groups before and after surgery.CONCLUSION: TA can clearly mark the residual vitreous, posterior vitreous cortex and epiretinal membranes, improve operation efficiency, no side effects are found related with TA.

Study on measurement of neurosensory retinal thickness in different macular sections of high myopia

Qiao-Ya Lin,Xue-Xi Li and Xue-Li Huang

AIM:To research characters of neurosensory retinal thickness in different macular sections of high myopia and analyze the correlation between neurosensory retinal thickness and gender, age, diopter as well as axial length.METHODS: One hundred and two patients with high myopia(102 eyes) were included.The neurosensory retinal thickness in different macular sections was measured by optical coherence tomography (OCT).The difference among neurosensory retinal thickness in every macular sections and the corelation between neurosensory retinal thickness and gender, age, diopter as well as axial length were analyzed.RESULTS:The minimum retinal thickness of fovea centralis was 175.34±29.01μm.OCT assessment revealed a significant difference of neurosensory retinal thickness in every macular sections.The inner regions were thicker than the outer regions, the nasal, superior and inferior side were thicker than the temporal side, the mean retinal thickness of central region and the minimum retinal thickness of fovea centralis was the thinnest. With the increase of the axial length, the mean retinal thickness of central region was increased while the superior side of the outer region was decreased.CONCLUSION:Perhapes the change of neurosensory retinal thickness in every macular sections caused by the increase of the axial length is the pathological basis before the macular degeneration of high myopia.

Curative effect observation on lysis of posterior synechia by 532 laser combined with Nd∶YAG laser

Xing-Hua Jiang,Ping Chen and Yu-Wei Song

AIM:To evaluate the feasibility and efficacy in lysis of posterior synechia by 532 laser combined with Nd∶YAG laser.METHODS: Ninety-seven patients 116 eyes of posterior synechia were divided into three groups: Nd∶YAG laser group, 532 laser group and combined both group. Three kinds of method in order to loosen posterior synechia.RESULTS: Synechia in 116 eyes were dissolved by laser,the pupil diameter ≥ 6mm (n=92 ) accounted for 79.3%; 5-6mm (n=24) accounted for 20.7%. All the pupil adhesions were dissolved accounting for 74.1% (n=86); most of the pupil adhesions were dissolved in 30 eyes accounting for 25.9%. Nd∶YAG laser group (n=18): pupl diameter ≥6mm in postoperation was in 12 eyes accounted for 66.7%, 5-6mm was in 6 eyes accounted for 33.3%; 532 laser group(n= 61): the pupil diameter ≥6mm in postoperation was in 52 eyes accounted for 85.2%, 5-6mm was in 9 eyes accounted for 14.8%; 532 laser combined with Nd∶YAG laser group (n=37) : pupil diameter ≥6mm in postoperation was in 33 eyes accounted for 89.2%, 5-6mm was in 4 eyes accounted for 10.8%.CONCLUSION: Laser lysis is a safe and effective method for posterior synechia.

Clinical observation on qingkailing eye drops for treatment of chronic uveitis

Xiao-Feng Xie,Jun-Guo Guo,Hong-Sheng Bi and Li-Li Li

AIM:To observe the clinical effect of qingkailing eye drops in treatment of chronic uveitis. METHODS: Clinical chronic uveitis selected were randomly divided into two groups, 40 cases in the control group received hormones and dilation, 40 cases in the treatment group received hormones,dilation and qingkailing eye drops.RESULTS: The treatment group had a quick effect, less hormone use, short duration, low relapse rate, which confirmed that qingkailing eye drops had an important role in the treatment of chronic uveitis.CONCLUSION: Qingkailing eye drops on chronic uveitis has a significant effect.

Sclera and amniotic membrane preserved by long-term cryopreservation with glycerol for treating the exposure of hydroxyapatite artificial eye stock

Jun-Hua Fan,Xue-Xi Li and Dong-Ping Pan

AIM:To evaluate the effect of sclera and amniotic membrane preserved by long-term cryopreservation with glycerol for treating the exposure of hydroxyapatite artificial eye stock. METHODS:Thirteen patients 13 eyes with exposure of hydroxyapatite artificial eye stock were treated by debridement and transplantation with sclera and amniotic membrane preserved by long-term cryopreservation with glycerol. The follow-up was 6 months to 1 year to observe the time of vascularization of sclera and epithelization of amniotic membrane.RESULTS: Thirteen patients 13 eyes were healed well, the time of vasculariztion of sclera was 10 days after operation and the time of epithelization of amniotic membrane was 7 days after operation. No conjunatival sac stenosis or re-exposure of artificial eye stock was observed. CONCLUSION: Sclera and amniotic membrane preserved by long-term cryopreservation with glycerol can be used to patch up the exposure of hydroxyapatite artificial eye stock. It is an effective method with high successful rate.

Comparison of transplantation of autologous corneal limbal stem cell and the conventional surgical resection for pterygium

Ji-Hua Liu and Tian-He Huang

AIM: To investigate the effect of transplantation of autologous corneal limbal stem cell for pterygium under microscope． METHODS: Fiftythree eyes 46 cases with pterygium were treated by transplantation of autologous corneal limbal stem cell．The simple resection of pterygium of 39 cases 46 eyes as the control group were analyzed． RESULTS: After followup of 6 to 12 months，no recurrence and no subepithelial fibrovascular proliferation were found and all achieved a radical cure．Compared with the control group,there were significant differences in therapy effects (P<0.01)． CONCLUSION: The excision of pterygium combined with autologous corneal limbal stem cell transplantation seems to be an effective treatment for pterygium with low recurrence rate and better vision.

Vitrectomy for severe ocular trauma

Hong-Yan Huang,Xiao-Gong Ma and Jian-Jun Niu

AIM:To investigate the effect of vitrectomy in treat-ment of severe ocular trauma. METHODS: Seventy-five cases 77 eyes with severe ocular trauma were treated with vitrectomy in combination of IOL implantation,intraocular foreign body extraction,retinal reposition.RESULTS:After treatment,vision was improved in 63 eyes (85% );remained unchanged or worsened in 14 eyes(15%); foreign bodies in 18 eyes were extracted in one operation, the extraction rate was 100%;23 eyes had retinal detachment, the reposition rate after operation was 85%. Vitreous hematocde was occurred in 26 eyes, suppurative endophthalmitis was controlled. Secondary glaucoma was occurred in 5 eyes, the intraocular pressure was in normal range. CONCLUSION: Vitrectomy is an ideal method for severe ocular trauma.

Influences of correction with spectacles in middle-aged and aged patient with ametropic asthenopia on xerophthalmia

Hong Wei and Hui-Bo Wang

AIM:To investigate the influences of correction with spectacles in middle-aged and aged patient with ametropic asthenopia on xerophthalmia. METHODS: Eighty-six xerophthalmia patients combined with ametropic asthenopia aged 40-58 years old were randomly divided into drug treated group and drug-spectacles treated group, clinical symptoms and physical signs before and after treatment were observed. RESULTS: Clinical symptoms and physical signs were improved after treatment in both groups, there were statistical differences between the two groups(P<0.05), and the curative effect in drug-spectacles group was better than that in drug treated group. CONCLUSION: Drug-spectacles treatment has better effect on improving symptoms and physical signs.

Clinical analysis of 50 cases of dry eye

An-Tai Zhu and Chun-Yan Li

AIM:To investigate the dry eye’s onset, clinical manifestations and diagnosis. METHODS: The 50 patients with suspected dry eye in our hospital from October 2008 to October 2009 were collected, medical history and symptoms were collected, regular and special eye’s examinations were performed. RESULTS: The clinical diagnosis of dry eye was in 41 cases 72 eyes, of which, aged ≥ 55 years old in 32 cases, including mixed-type dry eye in 28 cases, over evaporation in 3 cases, aqueous tear deficiency (ATD) in 1 case; aged <55 in years old in 9 cases, including mixed-type dry eye in 1 case, over evaporation in 6 cases, water liquid type in 2 cases. CONCLUSION: The symptoms are one of the most important indicators in the dry eye patients. While, there are a number of dry eye diagnostic methods, it is better to take variety of clinical measurements together in diagnosis of dry eye.

Changes of corneal higher-order aberrations and aspherical coefficient Q value after LASIK surgery

Yong-Hong Guo and Rui-Bo Zhao

AIM:To observe the changes of ocular higher-order aberrations and corneal aspherical coefficient Q value and high aberration under different pupil diameter after conventional LASIK surgery using laser machine with small scanning spot 2mm active eye tracking system.METHODS: Thirty-three patients 60 eyes with myopia were received conventional LASIK surgery. The preoperative and postoperative 3 months records of total order aberrations, third order cornea, the fourth-order spherical aberration and corneal aspheric surface coefficient Q value in pupil diameter of 5mm and 6mm were examined and statistically analyzed. RESULTS: After LASIK surgery, 5mm and 6mm pupil diameters,higher order aberrations were increased significantly, especially in the fourth-order spherical aberration. There was significant increase in horizon coma than the vertical coma. Compared with under 5mm diameter higher order aberrations, those under 6mm were significantly increased before and after surgery. Corneal aspheric coefficient Q value significantly changed to the positive direction and there was significant difference after LASIK sugery.CONCLUSION: After conventional LASIK surgery with myopia, higher-order aberrations are increased significantly, especially in the fourth-order spherical aberration. After surgery, there is significant increase in the higher-order aberrations under 6mm pupil diameter than under 5mm pupil diameter. Corneal surface aspherical coefficient Q value is changed from negative to positive and there is significantly statistical difference.

Analysis of the consistency between the dominant eye and the non-dominant eye after LASIK

Huan Huang,Li Wang,Chao Peng and Xiao-Jun Shen

AIM:To evaluate the consistency change between the dominant eye and non-dominant eye after LASIK.METHODS: A retrospective study of 74 eyes of 37 cases who had underwent myopic LASIK were divided into 3 groups:group one, the vision of the dominant eye was equal the other eye’s; group two, the vision of the dominant was better than the other eye’s; group three, the vision of the dominant was worse than the other eye’s. All the cases were the best-corrected visual acuity before the operation and the follow-up period was after the operation 1 day, 1 month, 3 months and 6 months. The results were compared and analysed.RESULTS: The consistency of the preoperation were not statistically different from that of other postoperation except the one after the surgery 1 day.CONCLUSION: LASIK does not change the consistency of the balance among the dominant eye and the non-dominant eye.

Analysis on the clinical therapeutic effect of amblyopia with primary microtpia

Yun Tao,Xiao-Bo Wan and Ting-Li Sun

AIM:To evaluate the feasibility of the clinical therapy in amblyopia with primary microtpia METHODS: The therapia was observed for 1-3 years in 37 patients,and the retrospective study was performed to analyze the therapeutic effect in different amblyopia degree,or in different age group,or in different fixationism, their impact on therapeutic effect was analyzed by statistical analysis. RESULTS: The total effective rate was 76% in their therapia,the cure rate was 22%,31% recovered the stereopsis, the therapeutic effect was uniformity in different amblyopia degree,or in different age group,the therapeutic effect was different in different fixationism (P<0.05).CONCLUSION: Treatment of amblyopia with primary microtpia is feasible in different amblyopia degree,or in different age group .Further theory, clinical research and effective therapeutic regimen are necessary to improve the cure rate.

Biological amniotic membrane transplantation combined with remedial contact lens in corneal ulcer

Min-Jie Wan and Ming Huo

·AIM:To observe the clinical effect and feasibility of biological amniotic membrane transplantation combined with remedial contact lens in corneal ulcer.·METHODS:Thirty-five eyes of 33 patients with corneal ulcer were cut the ulcer lesions firstly,then the biological amniotic membrane was applied to the ulcer area.The amniotic membrane was interruptedly sutured to the healthy cornea.On the second day of post-operation the patients wore remedial contact lens,and therapeutic eyedrops were used.·RESULTS:The anterior chamber of all the patients recovered in 1-2 days,and the local irritation improved obviously.The mean healing time was 30-45 days.5 cases occurred corneal neovascularization and cicatrization.The anterior chamber in 2 patients disappeared repeatedly and penetrated corneal transplantation was performed finally.The visual acuity of all patients improved after treatment.·CONCLUSION:Biological amniotic membrane trans-plantation combined with remedial contact lens are effective for corneal ulcer,and creat favourable local condition for later corneal transplantation.·

Corneal astigmatism correction with the AcrySof Toric intraocular lens in cataract surgery

Yong Zhang,Guang Qiao and Hao Zhang

·AIM:To evaluate astigmatism correction of the AcrySof Toric intraocular lens(IOL)in cataract patients.·METHODS:Thirty-nine patients 45 eyes were implanted with the AcrySof Toric IOL by the same surgeon between June 2008 and January 2009.Three Toric models were evaluated in cylinder powers of 1.50 diopters(D)(SN60-T3;T3 group,n=11),2.25D(SN60-T4;T4 group,n=17),and 3.00 D(SN60-T5;T5 group,n=17)at the IOL plane.The patients were followed up for 6 months with pre-and postoperatively refractive assessments performed.·RESULTS:Six months postoperatively,the mean un-corrected visual acuity(UCVA)was 0.73±0.20 in the T3 group,0.92±0.16 in the T4 group,0.85±0.23 in the T5 group,respectively.Residual astigmatism was-0.52±0.22D.The mean IOL rotation was 3.5±2.1degrees,2.8±2.0 in the T3 group,3.0±2.2 in the T4 group,3.9±1.8 in the T5 group,respectively.·CONCLUSION:Implantation of the AcrySof Toric IOL proved to be successful in correcting corneal astigmatism in cataract patients.·

Treatment of after cataract with Nd∶YAG laser

Li Li,Ke Yang and Shan Zhong

·AIM:To evaluate the effect of Nd∶YAG laser for after cataract.·METHODS:A total of 723 cases 770 eyes of after cataract were treated by Nd∶YAG laser.Different patients were treated according to different conditions.·RESULTS:The success rate was 99.1%.The follow-up time was 4-12 months.The average visual acuity of all cases was improved from 0.22 to 0.50.The complications included the damage of lens in 86 eyes(11.2%),transient high intraocular pressure in 7 eyes(0.9%)and vitreous hernia in 2 eyes(0.3%).·CONCLUSION:Nd∶YAG laser is a safe and effective method for posterior capsulotomy.Different treatment according to different patients can improve effect and safety.·

Application of soft-shell technique in phacoemulsification in cases with posterior polar cataract

Dong-Ping Pan,Xue-Xi Li,Ji-Ting Chen and Jia-Na Chen

·AIM:To search for an effective technique to control the complications in phacoemulsification in eyes with posteri-or polar cataract.·METHODS:Twenty-seven cases(thirty-three eyes)with posterior polar cataract underwent phacoemulsifica-tion.Soft-shell technique was introduced to protect corneas and posterior capsule in the surgical procedure.Visual acuity(VA)and complications after operation were observed.Then the data were analyzed.·RESULTS:Twenty-eight eyes revealed intact posterior capsule,six of which revealed posterior capsule opacifi-cation.Five eyes developed posterior capsule rupture,however no vitreous prolapse.All eyes were implanted foldable intraocular lens in the capsular bags.The postoperative VA in all cases were improved without obvious complications.·CONCLUSION:The application of soft-shell technique in phacoemulsification is effective for improving VA,reduc-ing complications,and controlling surgical quality in cases with posterior polar cataract.·

Clinical application of ciliary sulcus fixation of intraocular lens in capsular bag

Wen-Bin Gu,Xin Yang,Hong-Yun Bi,Bao-Yu Gu and Nan Ye

·AIM:To investigate the clinic result of ciliary sulcus fixation of intraocular lens in capsular bag.·METHODS:Nineteen patients 19 eyes with partially dislocated lens and 4 patients 4 eyes with inadvertent damage and zonular mutilation to the posterior capsule during extracapsular cataract extraction or phacoemulsifi-cation underwent ciliary sulcus fixation of intraocular lens in capsular bag.·RESULTS:At both the 6-and 36-month follow-up visits,there was no increased risk of progression in the evalua-tion group.17 eyes had normal position,all cases were without suture brisement,ablating or postoperative capsular bag shrinkage.·CONCLUSION:The treatment of subluxation of lens,abnormal zonular and defective cataract by ciliary sulcus fixation of intraocular lens in capsular bag can ensure the success outcomes,with good clinical result and low expense,it can replace capsule tension ring.·

Study on the morphology of corneal endothelial cells after phacoemulsification

Zhi-Wei Meng,Li-Xia Yang and Ya-Nan Xu

·AIM:To observe the corneal endothelial cells morpho-logy after phacoemulsification,and find out the regularity of corneal endothelial cells morphologic change and some related influencing factors.·METHODS:Seventy-nine cases 91 eyes with age-related cataract were chosen in this research.The phacoemul-sification was performed through the clear cornea combined with the foldable intraocular lens implantation.The cell density(CD),coefficient of variation(CV)of the endothelial cells in the central and incision cornea were examined preoperatively and 3 days postoperatively.·RESULTS:The level of postoperative CD decreased gradually,and the level of CV increased.Morphology of endothelial cells in the incision cornea showed a significant lower CD,higher CV than those in the central cornea at 3 days postoperatively.·CONCLUSION:In phacoemulsification through the clear cornea,the endothelial cells suffer from energy and mechanic injury.The corneal endothelial cells in incision are easier to be damaged than that in the central part during this surgery,We should pay more attention to the mechanic injury in elder patient,because it lead to more corneal endothelial cell loss.·

Clinical research on small incision non-phacoemulsification cataract extraction combined with IOL implantation under topical anesthesia

Ming-Hua Li,Zeng-Qin Zhu,Jun-Hua Zhao and Jian-Chao Liang

·AIM:To investigate the effect and safty of small incision non-phacoemulsification cataract extraction combined with intraocular lens(IOL)implantation under topical anesthesia.·METHODS:The cases with cataract in our hospital from January 2007 to January 2008 received small incision non-phacoemulsification cataract extraction combined with IOL implantation under topical anesthesia,and the clinical effect was observed.·RESULTS:The effect of anesthesia was obvious in operation,the excellence rate was 94.7% and good rate was 5.3% and the total effective rate was 100.0%.There was no case who received anesthesia of behind the eyeball and around the eyeball because of pain.There were 65 eyes(57.5%)with naked vision 0.5 or above and 22 eyes(19.5%)with naked vision more than 0.8 in one day after operation.There were 85 eyes(75.2%)with naked vision 0.5 or above and 17 eyes(15.0%)with naked vision more than 0.8 in one day after operation.All of them were followed up for one month and no case was with decressed vision.There was one case(0.9%)with naked vision less than 0.5 because of diabetic retinopathy.There were 7 eyes(6.2%)with corneal endothelium edema,4 eyes(3.5%)with bulbi hypertonia,and all of symptom disappeared after dealing.·CONCLUSION:The effect of small incision non-phacoe-mulsification cataract extraction combined with IOL implantation under topical anesthesia is obvious and safe,so it is worth being used widely.·

Investigation of small incision non-phacoemulsification cataract extraction combined with trabeculectomy

Hai-Ying Cai,Lei Zhang and Ming-Zhen Bei

·AIM:To evaluate the effect of small incision non-phacoemulsification cataract intraocular lens implantation combined with trabeculectomy in treatment of glaucoma with cataract.·METHODS:Retrospective study was conducted in 32 cases 32 eyes of chronic angle-closure glaucoma with cataract.All the patients underwent small incision non-phacoemulsification cataract extraction combined with trabeculectomy.·RESULTS:Mean follow-up was 7.3 months(6-9 months),27 eyes(84%)had the best-corrected visual acuity at or above 0.3.All the IOP was controlled in normal range.The mean IOP was reduced to 13.50±5.30mmHg,functional filtering bleb in 28 eyes(88%).No serious complica-tions occurred in or after operation.·CONCLUSION:Small incision non-phacoemulsification cataract extraction combined with trabeculectomy is a safe,effective and economic method in the treatment of chronic angle-closure glaucoma with cataract.·

Relationship between cataract incision closed form and occurrence of endophthalmitis

Jian-Guo Li and Ming-Lei Wang

·AIM:To analyze the cataract incision closed form and endophthalmitis occurrence relationship.·METHODS:Cataract surgery in 5139 eyes in 2001-01/2007-12,were extracted by comparing the surgical incision(scleral tunnel)size(3.5-7.0mm)and closed form(self-closed,a needle stitching,double needle stitching)and the incidence of endophthalmitis.·RESULTS:Of cataract surgery in 5139 eyes,endophthal-mitis occurred in 10 eyes,the rate was 0.54%-0,mean 0.28%.·CONCLUSION:Cataract surgery incision closed form and the incidence of endophthalmitis was significantly related.To effectively close the incision can reduce or avoid the occurrence of endophthalmitis.·

Analysis on shallow anterior chamber formed after trabeculectomy in patients with glaucoma

Xiu-Jun Shan and Wen-Shuang Xu

·AIM:To analyze the causes for the formation of shallow anterior chamber after traheculectomy in patients with glaucoma and its treatment.·METHODS:Studies on the causes of shallow anterior chamber formed after trabeculectomy and its treatment were carried out in 1556 cases 1556 eyes with glaucoma during recent 7 years.·RESULTS:Shallow anterior chamber had been occurred in 148 eyes(9.51%)of 1556 eyes after the operation.The excessive drainage through filtration track,the loosening of suture,the leakage of chamber fluid and malignant glaucoma were the main causes for the formation of shallow anterior chamber formed after the operation.Under the corresponding treatment of complications after the operation,the shallow chamber in 147 eyes recovered to normal.·CONCLUSION:The effective control of intraocular pressure before and after the operation,keeping suitable depth of anterior chamber during the operation,master-ing the degree of tightness of suture at incision,careful observation on changes of intraocular pressure and anteri-or chamber and treatment of complications on time are key points for the prevention of shallow anterior chamber occurred in patients with glaucoma after trabeculectomy.·

Relationship between the thickness change of retinal nerve fiber layer and visual field damage in the primary open angle glaucoma for the syndrome differentiation of TCM

Qing Chen,Hong-Bo Cheng,Ping Zeng,Jun Liu,Chong Wen and Ying-Ying Zheng

·AIM:To investigate the relationship between the thickness change of retinal nerve fiber layer and visual field damage in the primary open angle glaucoma(bluish glaucoma)for the syndrome differentiation of TCM.·METHODS:Seventy-two patients(144 eyes)of primary open angle glaucoma underwent optical coherence tomo-graphy for a 3.4mm ring around the optic disc.Each quadrant retinal nerve fiber layer thickness was recorded,and imported Humphry vision analyzer was used for quantification in the whole field of vision 30° test checks.Traditional Chinese medicine was applied on the patients with TCM theory.The relationship between the two was observed.·RESULTS:TCM syndrome and retinal nerve fiber layer thickness changes had statistical significance,TCM syndro-me type and the type of visual field damage was statistically significant(P<0.05).·CONCLUSION:The optic nerve damage is more common in the deficiency within the blue wind,optic nerve damage were seen in the early period.Therefore,the extent of optic nerve damage to a certain extent gives a certain degree of guidance in TCM treatment.·

Value of optic disc formation analysis in early diagnosis of primary open angle glaucoma in basic hospital

Hong Wei and Hui-Bo Wang

·AIM:To investigate the value of optic disc formation analysis in early diagnosis of primary open angle glaucoma.·METHODS:Seventy-two examinees whose cup-disc ratio were 0.5-0.8 underwent ophthalmic routine examina-tions,gonioscopy,perimetry and optical coherence tomography(OCT),and the results were analyzed.·RESULTS:The intraocular pressure of only 10 exami-nees with normal optic disc formation fell on the "suspicious" range.All the examinees with normal optic disc formation got normal results in perimetry and OCT.A big proportion of examinees with abnormal optic disc formation got abnormal results in intraocular pressure measurement,perimetry and OCT.·CONCLUSION:The optic disc formation is a sensitive factor in early diagnosis of primary open angle glaucoma.·

Effect of phacoemulsification with foldable intraocular lens implantation in eyes with acute angle-closure glaucoma

Lu-Xin Zhao and Hong Zhai

·AIM:To evaluate the clinicaI effects of phacoemulsification(phaco)with foldable intraocular lens(IOL)implantation in the treatment of acute angle-closure glaucoma.·METHODS:Twenty consecutive patients 23 eyes were included in this study with acute angle-closure glaucoma and cataract,and phacoemulsification with foldable IOL implantation were performed.Visual acuity and intraocular pressure(IOP)were recorded pre-and postoperatively.The pre-and postoperative changes about the anterior chamber depth(ACD)and angle opening distance(AOD500)were detected by ultrasound biomicroscopy(UBM).·RESULTS:The mean visual acuity was increased from 4.16±0.38 of preoperative to 4.75±0.10 of postoperative,and IOP was reduced from 48.65±7.34mmHg to 16.65±1.97mmHg.ACD of pre-and postoperation were 1.35±0.04mm and 3.51±0.07mm,AOD500 of pre-and posto-peration were 225.09±12.43μm and 511.18±12.20μm respectively,there was significant difference(P<0.01).·CONCLUSION:Phacoemulsification with foldable IOL implantation is a safe and effective method to treat acute angle-closure glaucoma.·

Application of modified anterior chamber penetration in acute angle-closure glaucoma with continuous high IOP

Jian-Qi Zheng,Wei Cui and Yi Lu

·AIM:To evaluate the clinical effects of the modified anterior chamber penetration on treating the acute angle-closure glaucoma with continuous high intraocular pressure(IOP).·METHODS:The modified anterior chamber penetration was performed on 33 patients 33 eyes with the sudden attack of angle-closure glaucoma after topical anaesthetic.·RESULTS:All patients with the modified anterior chamber penetration rapidly reduced IOP,eye pain,eased headache,improved eyesight in various degrees,after treatment IOP was an average of 15 mmHg.No complications occurred.·CONCLUSION:The modified anterior chamber pene-tration is an effective,safe and simple method of treating the acute angle-closure glaucoma with continuous high IOP.It can avoid side effects caused by long-term IOP-decreasing drug and can quickly reduce IOP to alleviate the suffering of patients,reduce the damage to visual function caused by the high IOP.·

Analysis on fundus fluorescein angiography in patients with age related macular degeneration

Min Xiao

·AIM:To evaluate the fundus fluorescein angiography(FFA)for the diagnosis of age related macular degene-ration(AMD).·METHODS:AMD patients were examined by FFA using Topocon TRC-NW7SF fundus camera and analysed in combination with other clinical examinations.·RESULTS:In total of 62 eyes in 40 AMD patients,49 eyes(79%)were diagnosed as atrophic type,13 eyes(21%)exudative type.The atrophic type showed spots or mottled shape in fluorescence transmission,and no fluorescein leakage was found.In the early stage of exudative type,choroidal neovascularization(CNV)could be seen,and in the later stage,there was a lot of fluorescein leakage;the blocked fluorescence was observed if hemorrhage formed around.·CONCLUSION:The application of FFA helps the early diagnosis of AMD and points out the area and location of CNV.·

Trimacinolone combined with surgery for rhegmatogenous retinal detachment associated with choroidal detachment

Bin Li and Qi Li

·AIM:To investigate the effects of posterior Tenon capsule injection of trimacinolone combined with surgery on retinal detachment associated with choriodal detachment.·METHODS:Eighteen patients were studied.The clinical data,preoperative management,operative methods,therapeutic effects and follow records were analyzed.·RESULTS:Fifteen cases were completely succeeded,1 case failed,2 cases redetached after the follow-up of 3-12 months.The total successful rate was 83%.IOP and vision were significantly improved.·CONCLUSION:The successful rate of retinal detach-ment associated with choriodal detachment is lower than that of the general retinal detachment.Posterior Tenon capsule injection of trimacinolone is an effective and safe method for rhegmatogenous retinal detachment associated with choroidal detachment,it can improve the success rate.·

Clinical application of Traditional Chinese Medicine nourishing yin and promoting blood circulation in recurrent uveitis

Dan Zhou,Hong-Sheng Bi,Li-Juan Wei and Xiao-Feng Xie

·AIM:To observe clinical curative effect of nourishing yin and promoting blood circulation in recurrent uveitis with the conventional medicine treatment.·METHODS:Forty cases of uveitis were randomly divided into experimental group 20 cases 20 eyes and control group 20 cases 20 eyes,nourishing yin and promoting blood circulation on the basis of conventional medicine treatment group and conventional medicine treatment group.·RESULTS:The effective rate was 75%(15 eyes)and the cure rate was 45%(9 eyes)in experimental group,while it was 60%(12 eyes)and 25%(5 eyes)respectively in the control group.There was statistically significant difference between the experimental group and control group(P<0.01).·CONCLUSION:Application of nourishing yin and promoting blood circulation in the recurrent uveitis,with conventional western medicine,can effectively control the inflammatory process and reduce the recurrence.·

Therapeutic effect of photodynamic therapy and injection of triamcinolone acetonide via posterior sub-tenon combination therapy on choroidal neovascularization combined with multifocal choroiditis

Hai-Quan Yin,Li Xu and Liang Yin

·AIM:To investigate the efficacy of photodynamic therapy(PDT)and injection of triamcinolone acetonide(TA)via posterior sub-tenon combination therapy on choroidal neovascularization(CNV)combined with multifocal choroiditis(MC).·METHODS:Eight patients(8 eyes)who were diagnosed as MC combined with CNV were retrospectively analyzed.The changes in the best-corrected visual acuity(BCVA),FFA/ICGA and OCT were analyzed before and after combination therapy.·RESULTS:During 6-month follow-up the BCVA was improved after combination therapy(P<0.05).FFA/ICGA showed decrease and stoppage of inflammation on preocular and fundus in 8 eyes(100%),no leakage or reduced leakage in 7 eyes(88%)1 month after combina-tion therapy.In 1 eye(12%),the fundus remained leaky.At the 6-month follow-up,no inflammation relapse was obtained,FFA /ICGA showed no leakage or slight leakage in 8 eyes(100%).·CONCLUSION:Combination therapy of PDT and injec-tion of TA via posterior sub-tenon is safe and effective to CNV combined with MC.·

Study of treating iridocyclitis with pubescent coccineus colquhounia flower tablet combined with glucocorticoid

Zong-Yin Gao,Min Jin and Yun-Xi Zhu

·AIM:To discuss the curative effect of pubescent coccineus colquhounia flower tablet on iridocyclitis.·METHODS:Eighty-nine patients with iridocyclitis referred to our hospital from Jan.2006 to Dec.2007 were divided into two groups,treatment group 45 cases(pubescent coccineus colquhounia flower and glucocorti-coids)and control group 44 cases(glucocorticoids and placebo).·RESULTS:Cure rate in 14 days of treatment group and control group was 88%,60% respectively,there was significant difference between them(P<0.05).Following up of 12 months,we found that the recurrent rate of control group was 17%,recurrent rate of treatment group was 8%,there was significant difference between them(P<0.05).·CONCLUSION:Pubescent coccineus colquhounia flower can treat iridocyclitis.And its cure rate and recurrent rate are better than those of glucocorticoids only.·

Clinical analysis of steroids induced high intraocular pressure after excimer laser cornea refractive surgery

Yan Gao,Yan-Xia Liu and Zhi-Qiang Wei

·AIM:To analyse and explore the incidence,clinical characteristics and correlated factors of steroids induced high intraocular pressure(IOP)after excimer laser cornea refractive surgery,then make a help for clinic.·METHODS:Retrospective study of high IOP of 1580 patients(3160 eyes)after laser in situ keratomileusis(LASIK)or laser subepithelial keratomileusis(LASEK)from 2005 to 2009 was performed in our hospital.·RESULTS:Sixty-eight eyes in 38 cases of steroids induced high IOP were recognized.The incidence rate was 2.2%.There were 20 male cases and 18 female cases.The age of the patients ranged from 18-33 years old.The spherical equivalent refraction were-4.00--12.00D.It occurred from 14-30 days after excimer laser cornea refractive surgery.There were 16 cases(30 eyes)and 22 cases 38 eyes occurred steroids induced high IOP after LASIK and LASEK,respectively.Fluorometholone or prednisolone acetate eye drops were topically used on 68 eyes.The time with eyedrops was from 20 days to 90 days.The eyesight of 38 patients 68 eyes decreased with different degree and intraocular pressure increased,and some patients had corneal epithelium edema.The eyesight of all patients recovered to normal and the symptoms of them disappeared after stoping the steroids,and giving topical or systemic antiglaucoma agents according to patients’ intraocular pressure.·CONCLUSION:There were special features in steroids induced high IOP after excimer laser cornea refractive surgery.The clinician should pay more attention to these cases to avoid misdiagnosis.·

Comparison of the clinical effect between lecithin-bound iodine and fufangxueshuantong capsule in the treatment of vitreousopacities

Yun-Feng Shi,Qing-Hui Yan,Yan-Li Bao,Shuang Zhang and Cui-Ling Fei

·AIM:To evaluate the clinical effect of lecithin-bound iodine and fufangxueshuantong capsule in the treatment of vitreous opacities.·METHODS:Vitreous opacity patients which had different disease time were randomly divided into two groups,the lecithin-bound iodine(LBI)group and the fufangxue-shuantong capsule group.The vitreous body turbidity situation,change of eyesight were observed under the direct ophthalmoscope and slit-lamp before the treatment and 30 days,60 days after oral drug treatment.At the same time,the vitreous body turbidity grade was evaluated.·RESULTS:After 30 days’ treatment,the effective rate of fufangxueshuantong was significantly lower than that of LBI in the fresh and short-term groups(P<0.05).After 60 days’ treatment,in the old group,there was a much higher effective rate in patients who had taken fufangxueshuantong than those who had taken LBI(P<0.05).Moreover,the total effective rate in each group were significantly higher than the efficiency of the 30 days’ treatment(P<0.05).Compared with the fresh group,the total effective rates of the long-term group and old group were significantly decreased after two drugs’ treatment(P<0.01).·CONCLUSION:LBI is more effective to the fresh and short-term vitreous opacities than fufangxueshuantong capsule,and fufangxueshuantong capsule is an ideal treatment for chronic old vitreous opacities.To extend the treatment time of vitreous opacities and offer early treatment will contribute to the improvement of treatment effectiveness.·

CT diagnosis of benign tumors in the lacrimal gland

Dong-Shun Cai and Xue-Peng Gong

·AIM:To discuss the value of CT in diagnosing benign tumor of the lacrimal gland.·METHODS:The clinical data and imaging manifesta-tions of 30 cases with pathologically confirmed benign lacrimal gland tumor were analyzed retrospectively.·RESULTS:The lesions originated in the orbital lobe of the lacrimal gland in 26 cases and the palpebral lobe in 4 cases.The tumors showed oval shape in 18 cases,irregular shape in 4 cases,irregular margin shape in 8 cases.Most cases showed average density on CT.Orbital bone compression or defect was seen in 18 cases,bone destruction with hyperostosis bone sclerosis in 12 cases.·CONCLUSION:Benign tumos in the lacrimal gland have some imaging features.·

Color Doppler ultrasonography examination in orbital rhabdomyosarcoma

Jie Zhang,Hong Zhang and Guo-Xiang Song

·AIM:To analyse the clinical and color Doppler ultrasonography imageological characters of orbital rhabdomyosarcoma for the sake of clinical diagnosis and management.·METHODS:Sixteen cases of orbital rhabdomyosarcoma from Jan.1996 to Dec.2009 were reviewed as a retrospective study.The tumor location,shape,internal echo,distribution,shape and kinetic parameter of blood flow were summed up accordingly,rhabdomyosarcoma in color doppler ultrasonography was summarized.·RESULTS:Multiple lesions were in the upper part of the orbit,showing round or irregular in shape,internal echo was medium or low and most was not uniform,sound attenuation was not obvious.Blood flow showed more signal,star or dot in shape,and arterial spectrum.·CONCLUSION:Color Doppler ultrasonography is simple,non-invasive with dynamic observation,indicating lesions in blood flow distribution and characteristics of the spectrum for us to understand the blood supply.Color Doppler ultrasonography is extraordinarily helpful in the diagnosis and management of orbital rhabdomyosar-coma.·

Effects of different operation methods on the prognosis of senile entropion

Qun Zhou and Zhong Zheng

·AIM:To investigate the effects of different operation methods on senile entropion.·METHODS:One hundred and eighty-five cases 286 eyes were selected,and eyelid skin resection,orbicularis muscle resection,palpebral margin incision and plication of the orbicularis muscle were performed respectively.Recurrent rate was observed during a long-term following period(the mean postoperative follow-up period was 2 years;ranged from 9 months to 43 months).·RESULTS:The long effect of plication of the orbicularis muscle was the best while the eyelid skin resection was the worst.·CONCLUSION:Plication of the orbicularis muscle is a simple method with reliable effect for treatment of senile entropion.·

Clinical analysis of reverse implantation of spherical headed silicon tube in nasolacrimal duct for the treatment of chronic dacryocystitis

Xin-Fa Wang and Jin-Xin Wei

·AIM:To observe and analyse the clinical effect and promotive value in grass-roots hospitals of reverse implantation of spherical headed silicon tube in naso-lacrimal duct for the treatment of chronic dacryocystitis.·METHODS:Thirty-seven eyes of 35 cases with chronic dacryocystitis were treated with reverse implantation of spherical headed silicon tube in naso-lacrimal duct.·RESULTS:Thirty-seven eyes of 35 cases were followed up for 1 year,of which 34 eyes were cured with no epiphora and the secretions disappeared.3 eyes were ineffective and the cure rate was 92%.·CONCLUSION:Reverse implantation of spherical headed silicon tube in naso-lacrimal duct for the treatment of chronic dacryocystitis has a definite effect.It should be promoted in grass-roots hospitals because of its simplicity and low-cost.·

Study on the relationship between astigmatism and deviation food habit of Uighur children

Mutallip Obulkasim,Munire Mijit and Xue-Yi Chen

·AIM:To find out the astigmatic distribution of Uighur children between the age of 6 and 13,and to observe the relationship between astigmatism and deviation food habit at the same time.·METHODS:The distribution rules of the main types of astigmatism and the distribution rules of deviation food habit on the astigmatism of the 262 children 485 eyes aged 6 to 13 were investigated.·RESULTS:The astigmatism degrees were in low grade of both myopic and hypermetropic astigmatism,the myopic astigmatism accounted for 64.9% of total astigmatic eyes,hypermetropic astigmatism accounted for 35.1% of total astigmatic eyes.In the myopic astigmatism,there were 71.4% children didn’t like meat,and 48.2% children didn’t like vegetable;and in the hypermetropic astigmatism,there were 40.6% children didn’t like meat,and 68.8% children didn’t like vegetable.·CONCLUSION:There are more myopic astigmatism than hypermetropic astigmatism,and low grade than middle or high grade astigmatism,in school age children.Most of the children with myopic astigmatism don’t like meat,and hypermetropic astigmatism ones don’t like vegetable.To prevent myopic astigmatism,the children have to learn a good eating habit to balance diet.Children must be treated for apositia syndrome early if founded.·

Analysis of optic disc parameters in Zhuang nationality by Heidelberg retina tomograph

Ke Yang,Li Li and Hai-Qin Bai

AIM: To study the optic nerve head parameters and topograph features of normal subjects in Zhuang nationality in Guangxi for establishing database. METHODS: One hundred and twenty blood-unrelated nomoral volunteers living in Longlin county of Guangxi were involved in the study.Heidelberg retina tomograph-Ⅱ(HRT-Ⅱ)was used to obtain the optic nerve head parameters. RESULTS:The parameters included optic disc area 2.26±0.47mm2,cup area 0.51±0.35mm2, CUP/disk area ratio 0.21±0.12, rim/disk area ratio 0.80±0.12, cup volume 0.12mm3,rim area 1.75±0.34mm2,rim volume 0.53±0.14mm3, height variation contour 0.45±0.10mm, cup shape measure - 0.20±0.07mm, mean cup depth 0.21±0.10mm,maximum cup depth 0.60±0.22mm,mean retinal nerve fiber layer thickness 0.30±0.07mm and cross-section area 1.57±0.43mm2. A negative correlation was found between mRNFLT,RNFLA and age. There was no significant difference between right and left eyes and between different genders in all parameters. The binocular difference value of C/DAR was 0.00- 0.16 in Zhuang nationality. CONCLUSION: HRT-Ⅱ can be used to measure optic disc parameters of normal person in Zhuang nationality.There were differences in age.

Corneal transplantation combined with FK506 for herpes simplex keratitis

Wei Peng,Ju-Tian Huang,Xiao-Ling Luo and Qiong Xiao

AIM: To observe the therapeutic effects of corneal transplantation combined with FK506 for herpes simplex keratitis(HSK). METHODS: Lamellar keratoplasty and penetrating keratqdasty were applied according to the different range and depth of cornea affected by HSK in 15 cases 15 eyes diagnosed with HSK, for whom anti-virus drugs had no effect. Clinical effects and complications of corneal transplantation combined with FK506 for HSK were studied postoperatively, and cases were followed up for 6-24 months. RESULTS:Visual acuity of 14 cases improved in various degrees, ranging from 0.05 to 0.6. 12 cases were of transparent grafts, 2 cases of mild turbidity grafts;1 case of apparent rejection and failure. Secondary glaucoma was in 7% (1 case)and complicated cataract 7% (1 case). CONCLUSION: It’s effective and safe that corneal transplantation combined with FK506 for treatment of HSK.

Observation of therapeutical effect of natamyc in fungal corneal ulcer

Dong-Mei Wang,Guang-Sheng Chen and Ming-Han Huang

AIM: To evaluate the efficacy of natamyc in curing fungal corneal ulcer by a case-control study of natamyc and fluconazole. METHODS: Eighty-four cases with fungal corneal ulcer were divided into two groups with 42 cases in each group. Natamyc and fluconazole were used for each group respectively. RESULTS: Twenty-one cases were cured, 34 cases were effectively and 8 cases were ineffective, the effective rate was 81% in natamyc group.In fluconazole group, the corresponding number of cases was 11,29,13 respectively, and the effectively and ineffectively,effective rate was 69%. There was no significant difference between the two groups in effective rate (χ2=1.587,P>0.05);there was a significant difference between the two groups in cure rate (χ2=5.048,P<0.05),and also a significant difference between the two groups in average period of therapy which was 16.7±7.68 days in natamyc group and 28.6±7.3 days in fluconazole group (t=7.94, P<0.01). CONCLUSION: Natamyc is more effective than fluconazole in treatment of fungal corneal ulcer, which can be generalized in clinic.

Small incision non-phacoemulsification on cataract patients of hyper old under topical anesthesia

Gang Du,He-Zheng Zhou,Xu-Qing Sun and Feng-Nian Luo

AIM: To explore the clinical efficacy and safety of small incision non-phacoemulsification under topical anesthesia on cataract patients over the age of 90. METHODS: Twenty-four cases (25 eyes)of hyper old cataract patients were selected and they underwent small incision non-phacoemulsification and intraocular lens implantation. RRSULTS: All patients were performed smoothly operation by physicians. 17 eyes (68%) got a visual acuity of 0.6 or more 3 months after operation, of which 12 eyes (48%) got a visual acuity of 0.8 or more. No serious complications occurred and the effects were satisfactory. CONCLUSION: The careful examinations of the body and eyes before operation, especially the conditions of corneal endothelium and nuclear hardness, were the guarantee of success of the small incision non-phacoemulsification under topical anesthesia.

Combined surgery for the treatment of cataract and proliferative diabetic retinopathy

Bin Li,Qi Li and Lin Li

AIM:To investigate the clinical efficacy of the pars plana vitrectomy combined with phacoemulsification in the treatment of cataract and proliferative diabetic retinopathy(PDR). METHODS: A retrospective review clinical data consisted of 39 eyes of 34 patients with cataract and PDR, 39 eyes were treated with the techniques of phacoemulsification and pars plana vitrectomy, intraocular lens was inserted in 32 eyes. Triamcinolone acetonide was injected in 11 eyes. RESULTS: Of 39 eyes after follow-up of 3 months to 2 years, vision <0.1 was in 12 eyes ,0.1- 0.2 in 14 eyes, 0.2- 0.5 in 9 eyes,>0.5 in 4 eyes. Postoperatively FFA indicated that fluorescein leakage disappeared and new vascularization withered in 27 eyes, there were macular edema in 16 eyes. CONCLUSION: The pars plana vitrectomy combined with phacoemulsification is effective and safe in treatment of PDR and cataract, without serious complications.

Small incision cataract extraction and intraocular lens implantation through a small pupil

Yan-Li Wan

AIM:To explore the surgical techniques and the techniques of the small pupil cataract surgery. METHODS: Small scleral tunnel incision 42 cases(46 eyes) of small pupil cataract patients. We use viscoelastic solution after blunt separation of posterior synechia, or pupillary margin of radial cut to expand the pupil, extracapsular cataract extraction, and then plant intraocular lens(IOL). RESULTS: Following up 6 to 18 months,Visual acuity improved in all cases. Postoperative best corrected visual acuity was 0.04- 0.1 in 8 eyes(17%) , 0.2- 0.5 in 18 eyes (39%),0.6-1.0 in 20 eyes (44%) . Visual acuities less than 0.1 were attributed to posterior segment abnormalities. No serious complications were found. CONCLUSION: When we select the right indications and surgical techniques properly, cataract extraction and IOL implantation through small pupils with small incision of scleral tunnel can obtain good clinical effects.

Small incision non-phacoemulsification cataract extraction and intraocular lens implantation in high degree axial myopia

Guang-Yi Bao,Guang-Hua Zhao and Li Wang

AIM:To observe the clinical efficacy of small incision non-phacoemulsification and intraocular lens(IOL) implantation in high degree axial myopia cataract, and analyse related factors to postoperative visual acuity. METHODS: One hundred and eighty-six eyes of 158 patients with axial length ≥26mm of high myopia underwent small incision non-phacoemulsification and IOL implantation. The postoperative visual acuity and intraoperative and postoperative complications were observed in the postoperative follow-up of 6 months. RESULTS: Three months later,uncorrected visual acuity ≥0.5 was in 145 eyes(78%), 0.1- 0.4 in 33 eyes(18%), <0.1 in 8 eyes (4%); complications included posterior capsule rupture in 11 eyes, endothelial edema in 19 eyes, retinal detachment in 3 eyes, posterior capsular opacification in 13 eyes in varying degrees. CONCLUSION: The efficacy of small incision non-phacoemulsification and IOL implantation for high axial myopia cataract, is very good. It is an ideal surgical method with high saftety.

Application of superficial anesthesia in combined trabeculectomy on glaucoma

Jin-Ming Xiang,You-Zhi Wang,Wei An and Ken Lin

AIM: To investigate the feasibility and saftety of superficial anesthesia in combined trabculectomy on glaucoma. METHODS: Combined trabeculectomy on glaucoma with superficial anesthesia was conducted in 81 eyes of 58 patients. Its anesthesic effect and complications in and post operations were observed. RESULTS: The operations were successfully completed with satisfactory analgesic effect in the group of patients. There were no serious complications in the operations. CONCLUSION: Superficial anesthesia have significant anesthesic effects for combined trabeculectomy on glaucoma. It is a simple, safe, and convenient choice of anesthesia.

Retrobulbar injection of triamcinolone acetonide combined with laser photocoagulation for chronic cystoid macular edema after cataract operation

Yan Qin,Ming Xu,Jian-Jun Tao and Jin Yu Wang

AIM: To investigate the effect of retrobulbar injection of triamcinolone acetonide(TA) combined with laser photocoagulation for chronic cystoid macular edema after cataract operation. METHODS: Thirty-seven patients 37 eyes with chronic cystoid macular edema after cataract operation were included. Seventeen eyes were treated with retrobulbar injection of TA combined with laser photocoagulation and twenty eyes only received laser photocoagulation. The follow-up time was 6 months. Visual acuity, fundus fluorescein angiography(FFA) and complications were observed and compared after treatment. RESULTS: All eyes had improved visual acuity after one month. At the end of the follow-up of 6 months, among the patients with retrobulbar injection of TA combined with laser photocoagulation, visual acuity was improved by 2 lines or more in 11 eyes (65%), improved within 1line or remained the same in 4 eyes (23%), decreased in 2 eyes (12%). Edema in 14 eyes (82%) was relieved after treatment. Among patients with laser photocoagulation, visual acuity was improved by 2 lines or more in 3 eyes (15%), improved within 1line or remained the same in 11 eyes (55%), edema in 9 eyes (40%) was relieved after treatment. The difference between the two groups was statistically significant (P<0.05). CONCLUSION: Retrobulbar injection of TA combined with laser photocoagulation for chronic cystoid macular edema after cataract operation is better than the operation only using laser photocoagulation

RetCam Ⅱ image analysis of anterior chamber angle in congenital glaucoma

Li-Na Huang,Ning Fan,Hong-Bo Cheng,Ming-Ying Lai,Guo-Ming Zhang and Song Tang

AIM: To evaluate the role of RetCam Ⅱ in examining the anterior chamber angle in congenital glaucoma. METHODS: Eighteen infants with suspect congenital glaucoma were examined the anterior chamber angle with RetCam Ⅱ under general anesthesia. RESULTS: Among the 18 infants, 13 cases (26 eyes) were diagnosed of primary infantile glaucoma, 3 cases (6 eyes)of Axenfeld-Rieger syndrome,1 case(2 eyes) of aniridia glaucoma, and 1 case (2 eyes) of large congenital cornea. CONCLUSION: RetCam Ⅱ provides objective images of anterior chamber angle, it is useful and effective in the diagnosis of congenital glaucoma.

Half-dose verteporfin photodynamic therapy for acute central serous chorioretinopathy

Yi Xuan,Pei-Quan Zhao and Qing Peng

AIM: To evaluate the efficacy of photodynamic therapy (PDT) with half-dose verteporfin for treating acute central serous chorioretinopathy (CSC). METHODS: Twelve eyes of 12 patients diagnosed with acute CSC from Apr.2009 to Sep.2009 received one single session of PDT using half-dose (3mg/m2) verteporfin. All eyes were imaged by three-dimensional optical coherence tomography (3D-OCT) before and 1 week, 4,12 weeks and 3 months after PDT to observe the resolution of subretinal fluid(SRF). fundus fluorenscense angiography(FFA), indocyanine green angiography(ICG), and fundus autofluorescence(FAF) were applied to measure the visual acuity(VA) and angiographic changes before and 4, 12 weeks after PDT to evaluate the reliability and effectiveness of PDT. RESULTS: Before PDT, 12 eyes presented serous neuroepithelial detachment in 3D-OCT image, showed indbot diffusion or smokestack phenomenon in FFA,and revealed dilated and tortuous choroidal vessels with diffuse hyperpermeability in ICG pictures.After one week, 3D-OCT showed that SRF was absorbed in 6 eyes. Four weeks after PDT, 9 eyes had complete resolution of SRF; 7 eyes showed a complete absence, and 3 eyes reduction of fluorescein leakage in FFA; the calibers of originally dilated and tortuous choroidal vessels appeared normal in 9 eyes and narrower in 3 eyes as shown in ICG; abnormal autofluorescence had almost resolved in all eyes. Twelve weeks after PDT, 11 eyes had complete resolution of SRF, only one eye unchanged; all eyes showed absence of fluorescein leakage in angiographic graphs and dots of hypoautofluorescence with uniform size and fluorescent intensity in the leak site. The mean VA improved from 0.43 to 0.8, with 2 eyes unchanged. None of the patients developed any systemic adverse event associated with the operation in the follow-up period. CONCLUSION: PDT with half-dose verteporfin is effective and safe in treating acute CSC.

Effects of the ginkgo biloba injection on plasma endothelin in diabetic retinopathy

Shi-Gang Yan,Hui-Jun Huang,Ze-Feng Xiao,Xiu-Ni Zhang,Peng Su and Jian-Hua Jiang

AIM: To discuss the antagonistic role of traditional Chinese medicine leaf of xingding extract-the ginkgo biloba injection on endothelin(ET) in diabetic retinopathy(DR) patients. METHODS: A total of 58 DR patients were enrolled in the study, DR patients were administered with 25mL ginkgo-dipyridamolum injection which was dissolved in 250mL normal saline, once a day for 15 days. The ET in their peripheral blood was measured before and after treatment. RESULTS: The mean value of plasma ET before treatment was 78.32pg/mL (reference value: 37.91-68.37pg/mL) and the highest value was 105.68pg/mL. The mean plasma ET level after treatment was 59.57pg/mL, which averagely decreased 18.75pg/mL as compared with that before the treatment. There was a significant difference between them(P<0.05). CONCLUSION: The ginkgo biloba injection can effectively decrease the plasma ET level of DR patients, which has a therapeutic effect on DR.

Triamcinolone acetonide-assisted pars plana vitrectomy surgery for proliferate diabetic retinopathy

Hong-Fei Liu

AIM: To discuss the role of the triamcinolone acetonide(TA)injection applied in the pars plana vitrectomy(PPV) surgery for proliferate diabetic retinopathy(PDR). METHODS: A prospective controlled clinical study was carried out on 107 eyes from 107 patients with PDR,with 53 patients undergoing TA-assisted PPV and 54 patients in control group undergoing conventional PPV.The retinal break,retinal detachment,vitreous hemorrhage were obeserved and recorded during operation.After treatment, the changes in best-corrected visual acuity (BCVA), intraocular pressure (IOP), macular edema were recorded. RESULTS:Total 104 patients(97.2%) were followed-up for 6-12 months,51 patients(96.2%) in TA-assisted PPV, 53 patients(98.1%) in conventional PPV. The incidence of retinal breaks was significantly lower in TA-assisted PPV than in conventional PPV(P<0.05). Retinal breaks were seen in 3 eyes(5.7%)undergoing TA-assisted PPV compared with 11 eyes (20.4%) undergoing conventional PPV.Retinal detachment,vitreous hemorrhage during operation,and the BCVA,IOP, macular edema after treatment all had no significiant difference. CONCLUSION: TA-assisted PPV offers improved visu- alization, and allows surgeons to excise the epiretinal membrane(ERM) safely and effectively,reduces the incidence of retinal breaks during the surgical management of PVR for PDR. There were no serious adverse events related to the intraoperative use of TA.

Nd∶YAG laser photocoagulation in the treatment of retinal vein occlusion

Ang Li,Dong-Ju Liu and Zhong-Yi Fan

AIM: To evaluate the curative effect of Nd∶YAG laser photocoagulation in the treatment of retinal vein occlusion(RVO). METHODS: Forty-two eyes of 42 patients diagnosed as RVO by fundus fluorescein angiography(FFA) were photocoagulated by frequency-doubled Nd∶YAG laser. Different methods were applied for different types, the visual acuity were compared and fundus changes were observed by FFA after photocoagulation. RESULTS: The visual acuity of 4 eyes (10%) improved after treatment;30 eyes (71%) remained the same;8 eyes’(19%) visual acuity decreased. It was effective in 38 eyes of the patients treated with Nd∶YAG laser photoco- agulation showed by FFA, the efficiency rate was 90%. CONCLUSION: Frequency-doubled Nd∶YAG laser photo- coagulation is effective in the treatment of RVO. It not only helps the absorption of retinal edema, hemorrhage and exudation, but also prevents the occurrence of proliferative vitreoretinopathy or neovascular glaucoma.

Analysis of efficacy of vitrectomy for ocular trauma

Cai-Xia Keng,Yan-Ping Xu,Shao-Li Wang and Jian Zhang

AIM:To investigate the relevant factors and clinical efficacy of vitreous surgery on ocular trauma. METHODS:A retrospective review was carried out in 70 cases (72 eyes) of ocular trauma received vitrectomy. RESULTS:The retina was reattached in 27 eyes (90%) postoperatively.Visual acuity after operation improved in 58 eyes(80%),not changed in 12 eyes(17%)and decreased in 2 eyes(3%). CONCLUSION:Vitrectomy is an effective method for complicated ocular trauma.Injured degree of eyeball and retina,the procedure of operation are the important factors of the visual outcome.

Vitrectomy for treating Terson syndrome

Jing-Jin Zhang,Li-Xia Yang,Jian Lin and Xiang-Rong Zheng

AIM : To analyse the operation time and curative effect of vitrectomy for treatment of Terson syndrome. METHODS: Five patients (6 eyes) with Terson syndrome underwent vitrectomy,accompanied with exchanging the gas for the liquid or argonion laser in some cases. RESULTS: Postoperatively, the visual acuity of 6 eyes was better than before; the vitreous cavities were all clear;retinal detachments were completely reattached. CONCLUSION: Vitrectomy is a safe and effective treatment for vitreous hemorrhage in Terson syndrome. Early surgery can not only recover the patients’ visual acuity but also decrease the complications.

Imaging of extraocular muscle and surgical treatment in congenital double elevator paralysis

Xue-Han Qian,Hui-Zhi Ma,Yue-Ping Li,Zhen-Hai Yang and Kan-Xing Zhao

AIM: To investigate the characteristics of the imaging of extraocular muscles in congenital double elevator paralysis(CDEP) and to evaluate different surgical outcomes based on imaging and clinical findings. METHODS: Sixteen patients were included in this retrospective study, from April 2006 to July 2009. Pre-operation ophthalmologic examination and orbit CT scan were performed. The choice of surgical procedure was based on the result of clinical evaluation and CT imaging. RESULTS: It showed that 81.3%(13/16) patients showed significant changes in extraocular muscles. In 68.7%(11/16) patients coronal images, the maximum cross-sectional area of superior rectus complex in affected eye became thinner than that of contralateral eye (9.95±2.82mm2 vs 24.52±5.42mm2,P<0.01),while no significant difference was found in inferior rectus(21.20±3.82mm2 vs 23.41±4.73mm2, P>0.05). In two patients, the maximum cross-sectional area of inferior rectus in affected eye became thicker than that of contralateral eye. The vertical misalignment was completely corrected in 14 patients and partially corrected in 1 patient. Psuedoptosis totally disappeared in 8 patients and partially improved in 7 patients. CONCLUSION: Either congenital hypoplasia or paresis of superior rectus muscle in affected eye may be one of the main reasons of CDEP. Surgical procedures for CDEP must be individualized according to clinical evaluation and imaging. Extraocular muscle CT imaging may give clinically valuable information for appropriate surgical planning.

Combined pranoprofen and artificial tears on the treatment of dry eye syndrome

Guo-Dong Cui,Jin-Liang Su,Hong Qiu,Lei Li and Ke-Xin Su

AIM:To investigate the clinical significance of anti-inflammatory therapy for dry eye syndrome. METHODS: Eighty patients with dry eye syndrome were analyzed retrospectively and divided into the artificial tears group(group A) and combined artificial tears with pranoprofen group(group B). Break-up(BUT) and corneal staining were analyzed two weeks later. RESULTS:There were significant differences in BUT and corneal staining between the two groups after treatment. The combined treatment was better than artificial tears alone in lengthening the BUT of tear film and improving corneal staining. CONCLUSION: The combined therapy of pranoprofen and artificial tears possesses important clinical application value for the patients with dry eye syndrome accompanying irritation.

Soft shell technique with Sodium Tvlose and sodium hyaluronate

Yi Lin Tang

AIM: To evaluate the efficacy of soft shell technique with Sodium Tvlose and sodium hyaluronate during cataract phacoemulsification with intraocular lens(IOL) implantation. METHODS: Eighty two eyes of 76 patients with mature cataract underwent phacoemulsification with IOL implantation, including 41 eyes using the soft shell technique with Sodium Tvlose and sodium hyaluronate(study group). RESULTS:The average naked vision was 0.50±0.22, 0 51±0.27 respectively the first day after operation, the difference between the study group and control group was not statistically significant, The average naked vision was 0.61±0.17, 0.63±0.18 respectively seven days after operation, there was no statistically significant difference between the two groups. The loss rate of corneal endothelial cells 1 month after surgery was 7.1% in the study group, 6.9% in the control group. There was no statistically significant difference between the two groups. CONCLUSION: The soft shell technique with Sodium Tvlose and sodium hyaluronate is the same safe and effective in protecting corneal endothelial cells during cataract surgery in patients with mature cataract as the import material.

Strabismus diorthosis under microscope

Xiao-Ran Yang

AIM: To investigate the feasibility of strabismus diorthosis under microscope using general micro equipments. METHODS: Divided the cases with strabismus into two groups: 36 cases underwent strabismus diorthosis under microscope using general micro equipments; and 45 cases underwent traditional strabismus diorthosis directly. RESULTS: The follow-up lasted for 2 weeks to 6 months. The post operation reaction in the group under microscope was light, conjunctival edema and congestion disappeared quickly, wound healed well, no complication occurred. In the other group, muscle slippage occurred in 2 cases, bulbar conjunctiva hyperemia, subconjunctival hemorrhage and edema occurred in 40 cases, conjunctival scar occurred in 10 cases, conjunctiva cyst 2 cases and conjunctival polypus 3 cases. CONCLUSION: Strabismus diorthosis under microscope has clear advantages compared with traditional strabismus diorthosis (without microscope). The muscle, blood tube and the move of needle in sclera as well as the depth can be seen clearly during the operation which make the operation easy to control, so we can properly and correctly perform the operation, shorten the operation time and avoid complications like blooding, penetrate sclera which often occur during the traditional operation. The strabismus diorthosis under microscope using general micro equipments can also separate structure correctly with fewer operation steps, light reaction after operation, sooner recovery after operation, which is suit to patient who needs strabismus diorthosis.

Transpupillary thermotherapy in the treatment of retinal arterial macroaneurysms

Xue-Mei Pan,Xing-Rong Wang,Li Liu and Hai-Yan Li

AIM: To evaluate the clinical effect of transpupillary thermotherapy(TTT) in the treatment of retinal arterial macroaneurysms. METHODS: The clinical data of 24 patients 24 eyes with retinal arterial macroaneurysms treated with TTT were retrospectively analyzed. According to the size of neoplasia showed by fundus fluorescein angiography(FFA), diffenent laser spot (0.8-1.2mm) and power (22.4-36.8mJ) were selected. The visual acuity,neoplasia and tube wall instauration were observed. RESULTS: All the neoplasias were atrophied after TTT, and the wall instauration returned to normal. Central vision was increased in 17 eyes. CONCLUSION: TTT is an effective method to treat retinal arterial macroaneurysms, particularly to patients with bleeding and edema.

Clinical research of puncta lacrimalis

Jing-Xian Zhang,Hong-Wei Deng,Yi-Tao Huang,Yuan Yang,Lin Ye and Hai Liang

AIM:To identify the causes of puncta lacrimalis inflammation, and to research its clinical development and prognosis as an independent disease. METHODS: The lacrimal puncta and ocular surface of patients with puncta lacrimalis were observed by slit-lamp, and lacrimal duct was washed and then examed. The changes of puncta in those study eyes were recorded by microphoto detector. Twenty-four eyes underwent tissue resection of lacrimal puncta and pathological examination. RESULTS: The rate of lacrimal punctum obstruction which needed surgical treatment was 11.95% in the patients with puncta lacrimalis. The clinical features of puncta lacrimalis were as following: the majority happened separately, minority combined with the inflammatory lacrimal duct obstruction. The diseases have acute and chronic divisions: Acute puncta lacrimalis is less common with the symptoms of warm tears overflow, local lacrimal puncta swelling, the fitting point wall. Chronic puncta lacrimalis is common with the symptoms of cold tears overflow, lacrimal puncta wall swelling or with proliferative membrane at the mouth of the lacrimal puncta, and then gradually the lacrimal puncta becoming close and flat surrounded by the conjunctive. The surgery of opening the lacrimal puncta was helpful in that case. CONCLUSION:Puncta lacrimalis is a common disease in the lacrimal disease, and needs to be treated as an independent disease, which is very important to make the diagnosis and treatment.

Clinical analysis of jolethin tablets as adjunctive treatment for vitreous hemorrhage

Yu-Ru Li,Wei-Yan Yan and Li Wang

AIM: To investigate the clinical efficacy of jolethin tablets as the adjunctive treatment for vitreous hemorrhage. METHODS: Thirty-two cases 32 eyes with vitreous hemorrhage caused by oculopathy were randomly divided into two groups with 16 cases in jolethin adjunctive treatment group received not only conventional treatment of haemostasis, promoting blood flow, and expanding blood vessel, but also received lecithin complexation iodine(jolethin) tablet which was taken orally, 1.5mg(100μg iodine included in it)every time, tid. totally for 60 days, the other 16 cases were in control group only received conventional treatment of haemostasis, promoting blood flow and expanding blood vessel. The observation course was 3 months in both two groups. Visual acuity, slit-lamp microscope examination, preset lens fundus examination and the grade of vitreous hemorrhage were performed on each patient pretreatment and 2, 4,8 and 12 weeks after the treatment. RESULTS: The degree of vitreous hemorrhage in therapy group at 4 weeks after treatment was equal to the degree of vitreous hemorrhage in control group at 8 weeks after treatment. 12 weeks after treatment, the vision distribution of therapy group was as follows: none of patients was light perception - 0.1, three patients were 0.15- 0.3 and thirteen patients were over 0.3. But in control group 12 weeks after treatment, the vision distribution was as follows: two patients were light perception - 0.1, seven patients were 0.15- 0.3 and seven patients were over 0.3. The difference between the two groups had statistical significance(P<0.05). CONCLUSION: Lecithin complexation iodine(jolethin) can improve the absorption of bleeding and effusion, assistantly cure vitreous hemorrhage, decurtate recovery time of vitreous hemorrhage, and recover the better visual function.

Investigation about the risk factors of the graft rejection after penetrating keratoplasty

Fu-Jun Gao

·AIM:To investigate the risk factors of corneal graft rejection after penetrating keratoplasty.·METHODS:The rejection cases of penetrating kerato-plasty in our hospital from 2001-01 to 2008-01 were retros-pectively analyzed,the ratio of various factors in the graft rejection patients and the incidence of graft rejection in all kinds of cases were analyzed.·RESULTS:The total rejection rate was 31.0%,25.5% in normal group,59.4% in high-risk group(P<0.05),48.1% in chemical eye burn group(P<0.05).Rejection of high-risk group was early and serious.·CONCLUSION:Of the factors of corneal graft rejection,the rejection rate is different in different original diseases,the graft rejectim has a close relationship with the preoperative symptoms,planting beds,surgical operation design and the prevention after surgery.Planting beds neovascularization is a high risk factor of graft rejection.·

Ciliary sulcus sutured intraocular lens and anterior chamber intraocular lens implan-tation for cataract surgery type of posterior capsule rupture

Jian-Jun Li,Rui-Bo Zhao and Hong Lin

·AIM:To compare the effect of ciliary sulcus sutured intraocular lens surgery and anterior chamber intraocular lens implantation for posterior capsule rupture of cataract.·METHODS:The retrospective analysis involved the ciliary sulcus sutured intraocular lens surgery,anterior chamber intraocular lens implantation for cataract posterior capsule rupture of 45 cases of 45 eyes.The efficacy of surgery was compared with the two groups.·RESULTS:Ciliary sulcus sutured intraocular lens surgery group and the anterior chamber intraocular lens implantation group can effectively cure capsular rupture after cataract treatment.But the latter had two cases of postoperative iridocyclitis and the elevation of intraocular pressure after six months and visual acuity improvement of the rest.The former had all visual acuity improved,and no obvious complications.·CONCLUSION:Ciliary sulcus sutured intraocular lens surgery and anterior chamber intraocular lens implan-tation in cataract surgery can be effective in the treatment of posterior capsule rupture and improve eyesight,but the former is closer to physical location with fewer postoperative complications.·

Application of Nd∶YAG in different types of after cataract

Li-Ping Liu,Ying Luo and Hui Song

·AIM:To evaluate the effect of the Nd∶YAG on the after cataract.·METHODS:A total of 652 cases 830 eyes including Elsching pearl after cataract,reductus after cataract and fibrosis after cataract were treated by YAG.According to the different type,different laser parameter was chosen.The Elsching pearl after cataract and reductus after cataract were treated by cruciform incision.And fibrosis after cataract was treated by cruciform incision or can-openning incision depends on the serious of the fibrosis.The intraocular pressure and visual acuity were observed 1 week,1 month and 3-6 months after therapy,respec-tively.The average follow-up was 2.72 months.·RESULTS:Among the 390 eyes of Elsching pearl after cataract,the intraocular pressure of 385 eyes was normal,the visual acuity of 386 eyes(99.0%)was improved.Among the 320 eyes of reductus after cataract,the intraocular pressure of 320 eyes was normal;the visual acuity of 318 eyes(99.3%)was improved.Among the120 eyes of fibrosis after cataract,the intraocular pressure of 113 eyes was normal,the visual acuity of 118 eyes(98.3%)was improved.·CONCLUSION:We should choose the laser parameter flexibly in order to ensure effective high proportion pulse energy,which is vital in the treatment of after cataract by YAG laser.·

Intravitreal injection of Bevacizumab in treatment of AMD

刘文杰,高磊,东长霞,于华军,姜凯,林旭明

·AIM:To evaluate the safety and efficacy of intravitreal bevacizumab(Avastin)injection in patients with exudative age-related macular degeneration(AMD).·METHODS:The records of patients treated with intravitreal injection of 2.5mg bevacizumab for AMD were retrospectively reviewed.All patients were evaluated by complete ophthalmic examination,optical coherence tomography and fluorescein and/or indocyanine green angiography.Repeated treatment with intravitreous bevacizumab occurred if there were signs of persistent or recurrent exudation.Changes in best-corrected visual acuity(BCVA),central foveal thickness(CFT)and total macular volume(TMV)over at least 6 months were the main outcome measures.·RESULTS:Thirty eyes of 30 patients(21 males and 9 females)with the average of 72 years old were included.The mean baseline of BCVA,CFT and TMV were 1.03±0.55(logMAR),364.97±151.83μm and 8.36±1.84mm3,respectively.Although there was no significant decrease in mean CFT and TMV one week after the injection,the mean BCVA had significant improvement(logMAR,0.79±0.33;P=0.02).At the last visit of 9.7 months follow-up(data available for 30 eyes),BCVA(logMAR,0.70±0.40;P=0.004),CRT(272.93±81.06;P=0.05)and TMV(7.20±0.98;P=0.004)showed significant improve-ments over baseline values.BCVA was improved by at least two lines in 18 eyes(60%),remained stable in 8 eyes(27%)at the last visit.A total of 58 injections were performed and the average number of injections was 1.93 in the group.About 50% of re-injections gained at least two lines of vision improvement one week following the re-treatment.No serious ocular or systemic adverse events were observed.·CONCLUSION:Intravitreal injection of bevacizumab for exudative AMD was well tolerated with an improvement in BCVA,CFT and TMV over the mean 9.7 months follow-up period.Re-injection of intravitreal bevacizumab should be administered if needed.·

Study of relationship between plasma homocysteine level and age-related macular degeneration TCM syndrome

冯春阳,陈丽,吕长香

·AIM:To study the changes and significance of the serum plasma homocysteine(Hcy),superoxide dismutase(SOD),malondialdehyde(MDA)and serum lipid levels within age-related macular degeneration(AMD)TCM syndrome types,and to observe if Hcy level is a risk factor in AMD among Chinese population.·METHODS:Fifty-two AMD patients’ blood samples were collected with 19 healthy samples as control.The fasting Hcy levels were measured by euzyme-linked immunosorbent assay.SOD,MDA,and blood fat concentration were also measured.And different AMD TCM syndrome types and all these indexes were analyzed to find the influence on Hcy from the related factors and the independent factor of AMD.·RESULTS:The Hcy levels in phlegm-blood stasis syndrome group and liver-kidney deficiency syndrome group were higher than those of the control(P<0.05),yet no differences were detected among three case groups.Results demonstrated negative correlation between Hcy and SOD level.SOD levels in phlegm-blood stasis syndrome group and liver-kidney deficiency syndrome group were higher than controls and phlegm syndrome group(P<0.05),while TC level was higher than controls(P<0.05);MDA,TC and LDL-C levels in all groups were elevated to different degrees(P<0.05).No difference of HDL-C level among four groups was found.·CONCLUSION:Hyperhomocysteine may play roles in phlegm-blood stasis syndrome and liver-kidney deficiency syndrome AMD by various pathogenic mechanisms,but was not a risk factor of AMD in this survey.Increased TC and LDL-C levels may be indexes of stage increasing in phlegm syndrome group.Increased TC,TG and LDL-C may be some of the useful markers of phlegm-blood stasis syndrome and liver-kidney deficiency syndrome.Decreased SOD and increased MDA may be regarded as pathological basis in AMD.·

Retinometer examination in predicting the value of visual acuity after cataract surgery

Ying-Hong Lin,Peng Zhuang,Cai-Hui Zheng,Ya-Ling Han and Xiao-Kun Hu

·AIM:To evaluate a retinal visual acuity meter(retino-meter)in predicting the value of visual acuity after cataract surgery.·METHODS:Ninety-three patients(106 eyes)with various types of cataract were randomly selected,preoperative visual acuity tested by LAMBDA 100 retinometer in patients was compared with postoperative 3 months corrected visual acuity.·RESULTS:Of 106 eyes,12(11.3%)had equal preo-perative predicted and postoperative visual acuity,69(65.1%)had better visual acuity than predicted visual acuity(false-negative),25(23.6%)had postoperative visual acuity lower than predicted(false-positive).·CONCLUSION:LAMBDA 100 clinical detection of retinal visual acuity meter has an excellent result in determining the non-dense non-mature cataract with high accuracy.The existence of false-negative and false-positive cases in different eyes provides a basis for intrao-perative implantation of different intraocular lens.·

Phacoemulsification combined with silicone oil removal from pars plana in silicone oil-tamponaded eyes

Xiao Sun,Yu Wang,Liang Wen,Gang Zhai and Cong Xie

·AIM:To observe the clinical effect of phacoemulsification combined with silicone oil removal from pars plana in eyes with silicone oil tamponade.·METHODS:Twenty-four eyes of cataract with silicone oil tamponade were performed with phacoemulsification combined with silicone oil removal from pars plana.The visual acuities and complications were observed.·RESULTS:Three cases presented retinal detachment in the operation.Three months after operation the visual acuity in 1 eyes were >0.3,16 eyes were from 0.12 to 0.3 and 7 eyes were ≤0.1.21 eyes were implanted PC-IOL,3 eyes were not.·CONCLUSION:Phacoemulsification combined with silicone oil removal from pars plana is an effective and safe mothed for the cataract after silicone oil tamponade.·

Minimal outside scleral surgery for rhegmatogenous retinal detachment concomitant myopia

Fu-Sheng Li,Yan-Ping Xu and Jian-Hua Wang

·AIM:To analyze minimal outside scleral surgery for primary rhegmatogenous retinal detachment(RRD)concomitant myopia below PVR C2.·METHODS:The medical records of 32 patients(32 eyes)with RRD were retrospectively reviewed.Firstly,they were treated by body therapy and wearing pin-hole glasses in one week,then the retinal break were treated by laser.Minimal outside scleral surgery was used in the end.The intraoperative and postoperative best-corrected visual acuity and the intraocular pressure were recorded.And complications were evaluated.·RESULTS:After 2 to 6 months follow-up,postoperative best-corrected visual acuity and the intraocular pressure improved than that of preoperative.Total retinal anatomical attachment was achieved in 32 patients(32 eyes).No serious postoperative complications took place.·CONCLUSION:Minimal outside scleral surgery is effective for primary RRD concomitant myopia below PVR C2.·

Krypton laser photocoagulation treatment of branch retinal vein occlusion with complications

Yin-Fang Meng,Shu-yan Ye,Li-Hua Wu,Jin-Wei Mu,Yan Tian and Yan Zan

·AIM:To investigate the effect of krypton laser photocoagulation on branch retinal vein occlusion(BRVO)with comptications.·METHODS:All of 46 patients 46 eyes with complications of BRVO were photocoagulated by krypton laser ;26 cases with macular edema were performed grid laser photocoagulation;20 cases with neovascularization were performed diffuse laser photo-coagulation.The patients were followed up by fundus examination and fundus fluorescein angiography(FFA)for 3 months.Patients who still had macular edema or neovascularization after the first photocoagulation at the end of 3 months were performed second photocoa-gulation.·RESULTS:Macular edema disappeared and visual acuity improved by 2 lines in 28 eyes,visual acuity of 16 cases were the same as before photocoagulation,and 2 cases were decreased.In the 20 patients with neovas-cularization,neovascularization disappeared in 16 patients after the first photocoagulation,4 patients after the second photocoagulation disappeared.·CONCLUSION:Krypton laser photocoagulation is obviously effective in treatment of BRVO with cimplications.·

Sub-bleb injection of Bevacizumab in treatment of liltering bleb neovasculariza-tion

Mei-Yan Feng

·AIM:To evaluate the safety and efficacy of sub-bleb bevacizumab injection in treatment of filtering bleb neovascularization.·METHODS:A group of treament cases of filtering bleb by injecting bevacizumab 1mg(0.04mL,25mg/mL)were retrospectively analyzed.All the cases,8 cases of 8 eyes,were followed-up for 2-6 months.·RESULTS:Two weeks after the injection,intraocular pressure dropped to normal in 87.5%,neovascularization of bleb disappeared in 87.5%.All the cases had not such symptoms as high intraocular pressure,uveitis,adverse reaction of inner eyes or the whole body.·CONCLUSION:The sub-bleb injection of bevacizumab is an ideal choice to inhibit the neovascularization.It is easy to operate with fewer complications.It can be more effective if used earlier.However,it still needs further large sample multicentre clinical research.·

Clinical comparison of two kinds of orbital implants and discussion of surgical technique

Hong-Yang Li,Qing-Cai Yang,Qi-Chang Yan,Hui Qiu,Yu Zhao and Jin-Song Zhang

·AIM:To compare the clinical effect of intraorbital implantation of bioceramic spheres and hydroxyapatite spheres after evisceration.·METHODS:Seventy-three eyes of 73 patients were included in this study.Patients were randomly assigned to A,B groups.Thirty-five eyes were included in A group and 38 eyes in B group,respectively.After evisceration,patients in A group received the bioceramic implant and patients in B group received the hydroxyapatite implant.·RESULTS:Patients were followed-up for 6-15 months.There were no complications of implant extrusion,exposure,infection,or migration for patients in both groups.All patients in both groups had a good cosmetic result after final prosthetic fitting.Prosthetic motility was good in all patients.·CONCLUSION:Bioceramic is a safe and effective material of orbital implant for correction of anophthalmos after evisceration.The bioceramic implant is an alternative to the hydroxyapatite implant.·

Analysis of clinical results of four kinds of ptosis surgery

Fang Fu

·AIM:To observe the clinical effects of four kinds of ptosis surgery.·METHODS:The operative procedure was improved continuously to explore the effective treatment of ptosis surgery.·RESULTS:The result of each operation had its advan-tages and complications.Levator plication was an ideal surgical method for the current.·CONCLUSION:Clinical practice of levator plication differs with previous theory which considered that with each 3-5mm skin shortening by moderate ligament of levator,drooping amount of 1mm was corrected.Upper eyelid can be lifted by collapsing levator tendon membrane on the superior margin of moderate ligament and the upper palpebral margin located 2mm above corneal limbus and recovered to the corneal limbus after surgery.·

Head dilaceration combined with amniotic membrane transplantation in the treatment of pterygium

Ming-Gui Li

·AIM:To observe surgery results of the head dilaceration combined with amniotic membrane transplantation in the treatment of pterygium,and evaluate the best primary pterygium surgical method and surgical technique to reduce the relapse rate.·METHODS:Primary pterygium in 30 eyes of 20 cases were treated from January 2008 to August 2009.The surgery was to tear the head of pterygium with amniotic membrane transplantation.Postoperative corneal wound healing time and recurrence rate were observed.·RESULTS:Of postoperative follow-up 2 months to 18 months,mean follow-up time was 6 months,28 eyes were cured,the cure rate was 93%;2 eyes recurred,the recurrence rate was 7%.The average repair time of corneal wound was 2-3 days.22 of the 30 eyes had visual acuity improved in different degrees.Cosmetic effect:The patient was difficult to find signs of pterygium surgery under a slit lamp microscope.·CONCLUSION:Head dilaceration combined with amniotic mem-brane transplantation in the treatment of primary pterygium has quick recovery,low relapse rate and good cosmetic effect.·

Curative effect review of 33 eyes of recurrent pterygium surgery

Jing Lu and Fu-Rong Liu

·AIM:To observe the recurrence rate and complications of different methods of recurrent pterygium surgery.·METHODS:Between November 2006 and February 2009,31 cases(33 eyes)of recurrent pterygium(12 eyes of which were accompanied by symblepharon and limitation of ocular motility)were treated with pterygium excision,intraoperative mitomycin C application,conjunctival autografting(pedicle or free)or amnion membrane transplantation.The surgical method was to excise pterygium thoroughly,cover the bare sclera with a sponge containing 0.2g/L mitomycin C for 3 minutes,then irrigate the area with saline solution.The methods of covering the bare sclera included pedicle flap transposition of upper or lower conjunctiva(26 eyes),dissociative upper and lateral conjunctiva transplantation(2 eyes),and amnion membrane transplantation(5 eyes).·RESULTS:All cases were followed up for 9 months to 3 years with no pterygium recurrence in 28 eyes and slightly recurrence(fibrovasclar tissue did not enter the limbus of cornea or the entry size was no more than 2mm)in 5 eyes,the recurrence rate was 15%,4 of which had been performed with pedicle flap transposition,and 1 of which had been performed with amnion membrane transplanta-tion.Slightly recurrences of symblepharon were observed in 3 eyes;conjunctival granuloma in 1 eye,uncomfortable symptoms such as dry,red and foreign body sensation in 5 eyes,and no corneal and sclera resolving occurrence in any eye.·CONCLUSION:The surgical method of pterygium excision combined with conjunctival autograf-ting or amnion membrane transplantation,intraoperative mitomycin C application can obviously decrease the recurrence rate of recurrent pterygium.·

Clinical study of lacrimal duct flush with an improved method in treating neonatal dacryocystitis

Fen-Qin Wang,Nuo Dong,Ya-Ling Wang,Xiao-Yan Lu and Dong-Kan Li

·AIM:To evaluate the clinical effect of lacrimal duct flush with an improved method in treating neonatal dacryocystitis.·METHODS:Two hundred and eighty cases(340 eyes)with neonatal dacryocystitis were treated with lacrimal duct flush between 2006 and 2009,the cases were grouped in two categories:140 cases 164 eyes in A(lacrimal duct flush)group,and 140 cases 176 eyes in B(lacrimal duct flush with an improved method)group.·RESULTS:After follow-up for 3-18 months,141 eyes 86.0% of 164 eyes were not cured by lacrimal duct flush in A group.However,there were only 17 eyes 9.7% of 176 eyes need probing in B group.·CONCLUSION:Lacrimal duct flush with an improved method is an effective method in treating neonatal dacryocystitis.·

Clinic analysis of convergence weakness by Sheard’ s criterion

Fang-Fang Lan,Wei-Min Liu,Hong-Ting Liu and Lu Gan

·AIM:To evaluate and analyze binocular symptoms on convergence weakness patients by Sheard’s criteria.·METHODS:Eighteen patients were selected.For each subject,their oculomotor function included refraction,distance and near disassociated phoria,distance and near fusional convergence,vergence facility,near point of convergence,relative accommodation,accommodation facility and amplitude.Data were analyzed in light of Morgan normal values and Sheard criteria.·RESULTS:There were 14 cases(78%)who weren’t fit to Sheard criterion and they were demand to average(3.47±2.83)△ BO prisms on their nearly work.·CONCLUSION:Sheard criteria is effective diagnostic aids or guides to predict convergence weakness patients.·

Analysis of data of AIDS’ complication of eyes

Nan Su

·AIM:To find out the clinical situation,treatment and prognosis of AIDS’ complication of eyes by investigating material.·METHODS:The patients from Aug.2008 to Aug.2009 in Kabwe General Hospital of Zambia were collected.·RESULTS:Symptom was serious,course of disease was long and the rate of growing blind was high in AIDS’ complication of eyes.·CONCLUSION:We should thoroughly understand and grasp the clinical manifestation of AIDS’ complication of eyes,increase the detection rate of AIDS,discover earlier,treated early to improve the life’s quality of AIDS’ patients,meanwhile prevention is an important thing to reduce the incidence rate of AIDS.·

Clinical study of posterior chamber phakic intraocular lens implantation for moderate to high myopia

Yong-Xiang Gong,Cheng Xiong and Min Gong

·AIM:To observe the clinical outcomes and complications of posterior chamber phakic intraocular lens(IOL)implantation for high myopia.·METHODS:Forty-five eyes of 23 patients with high myopia went through ophthalmologic examination and underwent IOL implantation after ensured without contraindication.Descriptive study was done on the clinical outcomes and complications.·RESULTS:The postoperation uncorrected vision was as good as the best spectacle-corrected vision of pre-operation in all 45 eyes.3 eyes underwent transient high intraocular pressure and all the 45 IOL showed various degrees of pigmentation.·CONCLUSION:The short-term clinical outcome of phakic IOL for high myopia is effective and reliable and no complications occurred during the observation period.The long-term clinical outcomes need to observe.·

Application of mitomycin C in surgical treatment of epithelial ingrowth after LASIK

·AIM:To observe the clinical effect of using mitomycin C(MMC)during surgical treatment of epithelial ingrowth after laser in situ keratomileusis(LASIK).·METHODS:MMC 0.2g/L was applied in surgical treatment of epithelial ingrowth after LASIK on 31 patients(31 eyes).The uncorrected visual acuity and the recovery of corneal flap were observed after surgery.·RESULTS:The uncorrected visual acuity increased after surgery(P<0.05)and was 0.82±0.19 6 months posto-peratively.Majority of corneal flaps recovered well.Fringe of the flap melted in 4 eyes,but central visual acuity had no effect.·CONCLUSION:Excellent outcome was found in the surgical treatment of epithelial ingrowth after LASIK by using 0.2g/L MMC.·

Features of OCT in Vogt-Koyanagi-Harada disease

Ying Zhu,Fan-You Zhang,Shao-Kai Xu and Dan Zhao

·AIM:To observe the features of optical coherence tomography(OCT)in multilobular retinal detachment in acute Vogt-Koyanagi-Harada(VKH)disease.·METHODS:Twenty-four eyes of 12 patients with VKH disease were examined with OCT and(fundus fluorescein angiography,FFA).·RESULTS:OCT revealed serous detachment of retinal neuroepithelia in 24 eyes of 12 patients,and subretinal septa that divided the subretinal space into several compartments.After steroid therapy,the serous detachment and subretinal septa resolved completely.·CONCLUSION:Before therapy,subretinal septa caused multilobular retinal detachment in acute VKH disease.·

Clinical analysis of timolol eye drops treatment on 54 cases of refractive regression after LASIK

Li-Juan Yang,Shi-Hui Yu and Qing-Sheng Zhang

·AIM:To analyze and sum up therapeutic effect of 2.5g/L timolol maleate eye drops on the refractive regression after excimer laser in situ keratomileusis(LASIK).·METHODS:Fifty-three cases(66 eyes)with refractive regres-sion from 1 400 cases(2 650 eyes)of excimer LASIK surgery in our hospital centers 2007-08/2008-08 after follow-up of more than 0.5 year were randomly divided into two groups according to operation time.The test group was treated with 2.5g/L timolol maleate eye drops.The control group was treated with 1g/L sodium hyaluronate eye drops.Treatment time of both groups was 2 weeks.At the end of treatment,the test group and the control group were analyzed comparatively(visual acuity increased by the number of lines).·RESULTS:The test group visual acuity was improved-1-4 lines(average 1.45±1.09 lines),the control group visual acuity was improved-2-2 lines(average 0.61±0.86 lines),Group t tests showed differences between the two groups was statistically significant(t=3.500,P<0.05).·CONCLUSION:Timolol maleate eye drops 2.5g/L have significant effect on postoperative refractive regression after LASIK.·

Comparative study of clinical efficacy between amniotic membrane transplantation and conjunctival flap covering surgery in the treatment of corneal ulcers

Pei-Jian Miao,Jian-Ping Cui,Ling Yang and Zheng-Pei Zhang

AIM:To provide evidence for Evidence-Based Medicine on clinical treatment of corneal ulcers by analyzing the clinical efficacy between amniotic membrane transplantation and conjunctival flap covering surgery,in addition,to explore the different surgical adaptabilities for each treatment of corneal ulcers.·METHODS:This retrospective review comprised 46 cases of hospitalized corneal ulcers patients (47eyes) who had amniotic membrane transplantation or conjunctival flap covering surgery from October 2004 to July 2009,including 13 cases 14 eyes with viral corneal ulcer,19 cases 19 eyes with fungal corneal ulcer,7 cases 7 eyes with bacterial corneal ulcer,3 cases 3 eyes with erosion and marginal corneal ulcer,2 cases 2 eyes with sterile inflammatory corneal ulcer,2 cases 2 eyes with corneal epithelial bullae and ulcers for corneal endothelial decompensation caused by optical surgery,9 cases 9 eyes with perforation.All the patients were treated with removal of the necrotic corneal tissue combined with amniotic membrane transplantation or conjunctival flap covering surgery and then were treated with drugs based on primary disease.·RESULTS:We found 17 cases 18 eyes treated with amniotic membrane transplantation,29 cases 29 eyes treated with conjunctival flap covering surgery in which 2 cases 2 eyes had corneal transplantation there after.13 cases 14 eyes treated with amniotic membrane transplantation were cured,the cure rate was 78% (14/18);23 cases 23 eyes treated with conjunctival flap covering surgery were cured,the cure rate was 79% (23/29);the clinical cure rates between them were of no significant difference(P>0.05).·CONCLUSION:Amniotic membrane transplantation and conjunctival flap covering surgery in the treatment of corneal ulcers can achieve better surgical treatment if appropriate surgical method is selected according to different types and different ulcer process.

Eye axis measurement with A-ultrasonic scan and the calculation of the power of intraocular lens in silicone oil-filled eyes

Xu-Kang Cheng,Yan Luo and Jie Feng

AIM:To evaluate the accuracy of modified sound speed for the measurement of eye axis and the power of intraocular lens(IOL) in silicone oil-filled eye.·METHODS:Twenty-four cases with cataract after silicone oil tamponade from 2003 to 2008 in our hospital were included.The eye axis length were measured with A-ultrasonic scan and calculated by the sound speed modified formula.The power of IOL were then calculated through SRK II formula.All cases underwent the operation of silicone oil removal combined with phacoemulsification and IOL implantation.3 months after surgery all eyes were reexamined and the actual axial length were again measured.The eye axis length and the refraction state were compared before and after the operation.·RESULTS:The eye axis length was 25.25±0.65mm before silicone oil tamponade and 24.80±0.67mm after the operation.And the postoperative eye axis length measurements showed no statistical significance compared with the preoperative measurement.The mean difference of the refraction state before and after the operation was 1.50±0.40D,and the difference was not significant.·CONCLUSION:Eye axis lens measurement with A-ultrasonic scan by modified sound speed shows better clinical practicability in silicone oil-filled eyes than traditional manual counting method.

Clinical study on phacoemulsification combined with Tecnis foldable lenses

AIM:To evaluate the clinical effect of phacoemulsification combined with Tecnis foldable lenses.·METHODS:All 205 patients (289 eyes)who had been implanted Tecnis foldable lenses were included in this study and their visual acuity,position of lenses and complications after operation were observed.·RESULTS:Three months after surgery,the average visual acuity was 4.58±0.12,and the best corrected visual acuity was 5.12±0.16.There were 22 eyes with posterior capsular blur.·CONCLUSIONS:Tecnis foldable lenses can reduce spherical aberration and improve ocular quality of pseudophakic patients.

Visual function of multifocal intraocular lens after early surgery

Hong-Chao Xu and Qing-Lan Kong

AIM:To evaluate the effectiveness and safety of implantation of ReSTOR multifocal intraocular lens(IOL).·METHODS:The study included 41 cases (60 eyes)of patients with cataract who received phacoemulsification with ReSTOR multifocal IOL implantation.Visual acuity,corneal astigmatism,contrast sensitivity,operative complications,spectacles independence,patient satisfaction and untoward visual symptoms were observed.The follow-up period was 3 to 6 months.·RESULTS:At 3 months after implantation,the average uncorrected distant visual acuity was 0.80±0.25 while the average near visual acuity was 0.86±0.20.There was no statistically significant difference between the preoperative corneal astigmatism and corneal astigmatism at 3 months after the operation.Contrast sensitivity in low and middle space frequency were all in the normal range,slightly declined in 2 eyes.The rate of off-glasses was 86% (33 cases).·CONCLUSION:ReSTOR diffractive multifocal IOL can offer a better near and far eyesight.And 86% of the patients can take off their glasses.

Capsulotomic locus of continuous curvilinear capsulorrhexis in cataract surgery

AIM:To determine capsulotomic locus of continuous curvilinear capsulorrhexis in cataract surgery.·METHODS:Various types of 40 age-related cataract eyes were performed continuous curvilinear capsulorrhexis and the capsulotomic locus was obtained.·RESULTS:Thirty-seven eyes of 40 eyes(92.5%) were implemented continuous curvilinear capsulotomy successfully.The other 3 eyes were performed the operation with can opener capsulectomy because crystalline lens dilation and diffluence in 1 eye and crystalline lens peplos fibrous degeneration in 2 eyes.·CONCLUSION:Capsulotomic locus of continuous curvilinear capsulorrhexis in cataract surgery can be found.

Perioperative treatment of patients with both glaucoma and cataract

Zi Wang and Yi-Zhuang Li

AIM:To investigate the effects of comprehensive perioperative treatment on patients with both glaucoma and cataract.·METHODS:Small-incision manual nuclear fragmentation cataract extraction with implantation of posterior chamber intraocular lens (IOL) combined with trabeculectomy was performed on 79 eyes of 65 cases under topical anesthesia.The anesthesia effect was evaluated.The data of the postoperative vision,the intraocular pressure(IOP) and the count of the corneal endothelial cells were analyzed.·RESULTS:There were 97.5% patients satisfied with the anesthesia effect.All patients got improved vision and had steady IOP.The average loss of the count of corneal endothelial cells was 6.9%.·CONCLUSION:It was effective and safe to perform small-incision manual nuclear fragmentation cataract extraction with implantation of posterior chamber IOL combined with trabeculectomy on patients with both glaucoma and cataract under topical anesthesia.

Analysis of operative efficacy on glaucoma complicated with cataract

Shi-Gang Xia,Hui-Can Peng and Zhi Wang

AIM:To evaluate the surgical selection and its effect on glaucoma complicated with cataract.·METHODS:Seventy-two eyes with coexisting glaucoma and cataract underwent trabeculectomy,phacoemulsification and intraocular lens (IOL) implantation.Visual acuity,intraocular pressure(IOP),filtration state and postoperative complications were observed.·RESULTS:The visual acuity of 72 eyes improved quickly and remarkably.The postoperative IOP was normal.3 months and 18 months after surgery,the mean IOP was 15.30±2.64mmHg and 16.72±2.30mmHg respectively.72 eyes didn’t occur with serious complications.·CONCLUSION:Trabeculectomy combined with phacoemulsification and IOL implantation could control IOP effectively and improve visual acuity quickly and remarkably.

Therapeutic effect of phacoemulsification on uveitis-complicated cataract

Jie-Han Chen,Yu Pei,Guo-Sheng Dai and Qin Zhang

AIM:To evaluate the therapeutic effect of phacoemulsification on uveitis-complicated cataract.·METHODS:Clinical data from forty-eight eyes of 40 cases with uveitis-complicated cataract were retrospectively analyzed.·RESULTS:The visual acuity of 44 eyes (92%) improved two weeks after surgery.The posterior capsule ruptured in 5 eyes (10%) and tridemia occurred in 6 eyes (13%) during surgery.Corneal edema occurred in 38 eyes (79%) the second day after surgery.Fibrous exudates in anterior chamber were found in 43 eyes (90%) after surgery.Intraocular pressure elevated in 5 eyes (10%) postoperatively.Twelve eyes (25%) had irregular-shape pupil.·CONCLUSION:Although there are more complications during and after the surgery,phacoemulsification is still a safe and effective way to treat uveitis-complicated cataract.

Clinical Study of Cataract Phacoemulsifi-cation in the management of acute-closure glaucoma with continuous high intraocular pressure

Xue-Feng Lü,Xian-Zhi Bai,Ya-Jun Shen and Qun Ma

AIM:To investigate the clinical results of phacoemulsifi-cation in the management of acute-closure glaucoma with continuous high intraocular pressure.·METHODS:The phacoemulsification operations were performed in 31 case 31 eyes of acuteangle-closure glau-coma and cataract under higher intraocular pressure.The postoperative follow up was 6months to 2 years,and the vision and complications were observed.·RESULTS:The visual acuity of all cases was improved,the corrected visual acuity in 2 eyes(6%) was under 0.1,8 eyes (26%) between 0.1 and 0.2,15 eyes(48%) between 0.3 and 0.6,6 eyes(19%) between 0.8 and 1.0.The postoperative intraocular pressure remained normal in all eyes after one week.No serious complications such as choroidal hemorrhage,intraocular hemorrhage and malignant glaucoma were found.·CONCLUSION:The phacoemulsification with posterior chamber intraocular lens implantation in the management of acuteangle-closure glaucoma under higher intraocular pressure is safe and efficient.

Application of capsular tension ring in high myopia phacoemulsification and intraocular lens implantation

Hua-Cong Peng,Yuan Yuan and Bao-Song Liu

AIM:To evaluate the application value of a capsular tension ring (CTR) in high myopia cataract surgery associated with low diopter intraocular lens (IOL) implantation.·METHODS:Five hundred and forty-nine eyes of 427 patients with high myopia cataract had an implantation of a CTR during phacoemulsification associated with IOL implantation surgery.During 3-18 months’ follow-up,visual acuity,intraocular pressure (IOP) and the anterior segment of eyes were measured by slit-lamp microscope.·RESULTS:No IOL decentration was found.Postoperative visual acuity with correction greater than 0.8 in 43 eyes,0.6-0.8 in 118 eyes,0.5 in 89 eyes,0.4 in 101 eyes,0.3 in 66 eyes,0.2 in 80 eyes,less than 0.2 in 52 eyes at 3 months postoperatively.IOP of 549 eyes was 3-47mmHg at first day postoperatively,increase of IOP was found at 179 eyes only for a short time.CTR was removed from intraocular in 1 cases due to IOP increase beyond control.Retinal detachment was found in 2 cases at 18 months postoperatively.YAG laser posterior capsulotomy in 5 cases was performed due to posterior capsular opacity.·CONCLUSION:In eyes with either zonular dehiscence or weakness,application of CTR in high myopia cataract surgery associated with low diopter IOL implantation operation can prevent zonular dehiscence and IOL decentration and tilt,and may lead to prevent posterior capsular opacity and retinal detachment.

Application of MMC and adjustable suture line on the trabeculectomy

Dan-Ping Guo

AIM:To analyze the effects of application of mitomycin C(MMC) and adjustable suture line on the trabeculectomy.·METHODS:Analysis of 65 eyes of 65 glaucoma cases was conducted.MMC and adjustable suture line were used in the trabeculectomy.The patients were visited for 3 months to 1 year and the eye pressure before and after operation,incisal opening anastomosis,anterior chamber formation,filtering bleb and complication after operation were observed.·RESULTS:Anterior chamber formed in 63 eye (96.9%) one day after operation,with grade Ⅰ shallow anterior chamber in 1 eye (1.5%),grade Ⅱshallow anterior chamber in 1 eye (1.5%).During the 7th day to 10th day after operation,the average eye pressure was 13.6mmHg,14.9mmHg after 6 months and 16.7mmHg after one year.All the eyesight of the patients kept unchanged before and after the operation or improved slightly,and the filtering bleb formed.The adjustable suture line could be taken out of the wound according to the eye pressure,anterior chamber and its filtering within one to two weeks after operation.It is necessary to massage the eye balls to help to form the filtering.In this case the eye pressure could be dropped to 2-8mmHg.·CONCLUSION:The adjustable suture line and MMC on trabeculectomy could be safely applied and the complication obviously is decreased.It can be applied in the grass-roots level hospitals because of its remarkable curative effect and simple operation.

Optical imaging features of elderly central serous chorioretinopathy

Cai-Xi Zhou,Sheng-Juan Zhang,Zhi-Feng Yuan,Rong Yang and Rui-Feng Li

AIM:To observe the optical imaging features of the elderly central serous chorioretinopathy (CSC).·METHODS:The clinical data of 17 cases (18 eyes) of elderly patients with CSC diagnosed by fundus fluorescein angiography (FFA),indocyanine green angiography (ICGA) and optical coherence tomography (OCT) were analyzed retrospectively during Jan.2008-Jun.2009.·RESULTS:The elderly patients had the same FFA,ICGA and OCT changes with the middle-aged patients with CSC,but also had some of its own characteristic changes.(1)The FFA found the rate of the typical RPE leakage form such as "smoke "or" ink stain " was seldom,only 39%.The other 11 eyes(61%) showed diffuse retinal pigment epithelial lesion;(2)The ICGA found there were some other changes which differentiated from the CSC,such as the serous pigment epithelium detachment (PED),polyp-like choriodal vessel dilation,and choriocapillaris atrophy;(3) The (Fourier Domain) FD-OCT also found some other changes besides the CSC lesions,including nodular eminence of the RPE layer corresponding to drusen,multifocal retinal atrophy,and the (inner and outer segment) IS/OS layer atrophy partly.·CONCLUSION:The elderly patients with CSC has complex changes in optical imaging,and it can be easily confused with age-related macular degeneration.The FFA and ICGA combined with OCT examination are helpful for diagnosis.

Clinical observation of vitrectomy on acute retinal necrosis syndrome

AIM:To investigate the diagnosis and treatment of acute retinal necrosis syndrome (ARNS).·METHODS:The manifestation,diagnosis,treatment and prognosis of 64 eyes in 56 cases of ARNS from Jan.2003 to Jan.2009 were retrospectively analyzed.·RESULTS:After treatment,visual acuity improved in 37 eyes (58%).Final visual acuity was lower than 0.05 in 23 eyes (36%).Signs were controlled in 58 eyes (91%).·CONCLUSION:The diagnosis of ARNS should be mainly based on clinical manifestation,fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA).Early and sufficient treatment with antiviral agents,corticosteroid and prophylactic laser photocoagulation,sometimes vitrectomy are necessary to control the disease.

Analysis of fundus fluorescein angiography combined with visual electrophysiology of 42 eyes in 32 cases of ocular contusion

Chen Xu,Yu Song,Ying-Guang Xu and Hong-Juan Fan

AIM:To observe the characteristics and clinical significance of fundus fluorescein angiography (FFA) with visual evoked potential (VEP) and electroretinogram (ERG) after ocular contusion.·METHODS:Forty-two eyes were examined with the FFA,VEP and ERG methods.·RESULTS:In FFA examination,retinal concussion was found in 16 eyes(38.0%),retinal contusion in 9 eyes(21.4%),optic nerve injury in 22 eyes(52.3%),macular hole in 2 eyes (4.7%),choroidal rupture in 7 eyes (9.7%).In Visual electrophysiological examination,32 eyes (76.1%) had contusion-caused a,b-wave amplitude decrease in flash ERG examination,the P wave latency delayed and amplitude decreased evidently in flash VEP examination of 26 eyes (61.9%) of the vision below 0.1.·CONCLUSION:FFA combined with electrophysiological analysis of visual eye can evaluate the optic nerve and whole retinal function reliably and objectively.

Strabismus surgery combined with ptosis surgery for efficacy of oculomotor nerve palsy

周凤,刘桂琴,刘春明,欧阳明

AIM:To observe the results of different surgical methods in treatment of 11 patients with oculomotor nerve palsy.·METHODS:Eleven patients were carefully examined before surgery.The operative method was selected according to the individual condition of the patient.The effects of surgery were evaluated by the primary position of eye and the motility of eyeball after operation.·RESULTS:Eleven patients underwent external strabismus surgery,including 9 patients underwent strabismus surgery combined with ptosis surgery,all patients achieved satisfactory results.·CONCLUSION:The careful and complete examination before surgery is important for treatment of ocular nerve palsy.·

Treatment for the congenital malformations of small eyeball and small palpebral fissure

Hong Zhang,Juan-Juan Li,Zhi-Kun Zheng and Zhong-Kun Yang

AIM:To investigate the treatment of the congenital malformations of small eyeball and small palpebral fissure.·METHODS:Eleven eyes(11 cases) of congenital malformation who accepted the surgical treatment including conjunctival flap covering the entire cornea,outer canthal expanding,and conjunctival sac forming were retrospective analyzed.·RESULTS:In 11 cases,9 cases were able to successfully wear the pre-selected artificial eyes after 4 weeks,the conjunctival flap failed to heal in 2 cases,but after 6 weeks of treatment,they healed to wear artificial eyes.During the follow-up of 2-21 months,4 cases were replaced with larger models of artificial eyes.All cases could easily wear artificial eyes without palpebral fissure retraction,the corneal coverage was intact,no kenspeckle irritation with artificial eyes,and the appearance were obviously improved.·CONCLUSION:The surgical method of covering cornea,expanding outer canthus,and conjunctival sac forming,has the advantages of satisfactory appearance,minor trauma,fewer complications,less pain and low cost,and is worthy promotion.

Surgical treatment of mechanical eyelid kaceration

Yin-Bo Lu,Xiang-Yong Xie and Li-Jiao Wei

AIM:To analyze that appropriate primary suture is the best way to reduce the late complications of eyelid kaceration.·METHODS:Two hundred and thirty-six cases of mechanical eyelid kaceration.·RESULTS:All of the 236 cases are primary healing.After the surgery,4 patients have mild reclinatio palpebrarum,1 patient has mild trichoma.·CONCLUSION:Recovering the functions of eyelid is to thoroughly understand the eyelid anatomy,operate the eyelid carefully about the anatomic compartments,possibly keep the original tissue,reduce the tissue defect,deal with the details carefully,stitch laminated meticulously,decrease forming scars,refound the normal anatomic relation.Those are the key of successful primary treatment.

Analysis of the effects of progressive addition lenses on VDT operators visual fatigue

Qiang Guo and Qing Han

AIM:To investigate the effects of progressive addition lenses(PAL) on visual display terminal (VDT) operators visual fatigue.·METHODS:Nienty-eight VDT operators who had ametropia and visual fatigue were collected between Aug.2008 and Aug.2009 and divided voluntarily into two groups,single vision lenses (SVL) group with 52 patients and PAL group with 46 patients,the refraction condition and treatment effect of the two groups were analyzed in one year’s follow-up.·RESULTS:Of the 98 patients,44 patients couldn’t have their refraction errors corrected.Significant difference was found between SVL and PAL group in the symptoms like blur and swell (P<0.01),however,no difference was found between SVL and PAL groups in the symptoms like eye pain,dryness,eyelid heaviness.·CONCLUSION:Compared with SVL,PAL had an active clinical effect on relieving visual fatigue for lower and middle myopes.

Clinical analysis on the refractive condition of 472 eyes in elderly people over 70 years of age

Qing-Hua Yang,Wei Wang,Bing-Jian Yang,Bing Chen and Hai-Peng Zhao

AIM:To evaluate the visual acuity and refractive condition of some elderly people over 70 years of age.·METHODS:An examination was done under standard lighting for the distance visual activity and a complete ocular examination was performed in 472 eyes.Then refractive condition was examined and the vision was checked.·RESULTS:There were 468 ametropic eyes in the whole group(99.2%).Most of them were myopia and the proportion of myopia increased with age.There were 415 (87.9%)astigmatism eyes and there were a total of 172(36.4%) myopic astigmatism eyes which had the largest proportion of the whole group.Hyperopia astigmatism were more in the 70-80 age group while myopic astigmatism while more over 80 years old.The degree of the hyperopia astigmatism eye were mainly between 0.50D to 1.00D when it was mainly between 1.25D to 2.00D in the myopic astigmatism eyes.The rectification of vision in various age had a satisfactory improvement.·CONCLUSION:Because of the age-related changes of eyelid and cataract the eyes have a trend to be myopic astigmatism,which is the most common cause that affects the vision of the elderly people.Regular check on the condition of refraction of the eyes of aged people should be one part of the regular examination and refractive error correction can improve the quality of daily life for elderly people.

Study of refraction state and visual acuity of the preterm infants

Wen-Juan Hua,Li-Li Qiang,Qing-Qun Guo,Yong-Hui Gu,Xi-Ting Lu and Zhen Wang

AIM:To observe and analyse the visual acuity and refraction state of the preterm infants.·METHODS:To observe the visual acuity and static refraction of the 156 preterm infants(312 eyes) 4 to 6 years old and record the results.·RESULTS:The clinical data of 156 preterm infants(312 eyes)were observed,76.3% is hypermetropia(238 eyes),4.8% is myopia(15 eyes),9.0% is astigmatism(28 eyes),9.9% is emmetropia(31 eyes),physiological hypermetropia is the largest type.With the increasing of age,the percentage of hypermetropia goes down,the percentage of emmetropia and myopia goes up,and the percentage of emmetropia increases obviously.·CONCLUSION:The refraction state and visual acuity growth of preterm infants is close to that of normal infants,with the increasing of age,it shows the trend that the refraction state develops from hypermetropia to emmetropia or myopia.

Clinical observation of posterior scleral implantation surgery to treat pathologic myopia with the fibers of artificial pericardium

AIM:To evaluate the effect of posterior scleral implantation surgery to treat pathologic myopia with the fibers of artificial pericardium.·METHODS:Fifty-six patients (102 eyes)with pathologic myopia were treated with posterior scleral implantation surgery with the fibers of artificial pericardium and were followed up for 1 year after the operation.·RESULTS:The preoperative mean axial length was 28.83±3.12mm.The postoperative axial length was 28.71±3.14mm at 1 day,28.76±3.22mm at 1 month,28.84±3.17mm at 6 months,and 28.88±3.31mm at 1 year.There were no statistically significant differences between preoperative and postoperative axial length (P>0.05).The preoperative mean refraction(spherical equivalent,SE)was-17.42±6.71 diopters (D).The postoperative SE was-17.31±6.51D at 1 day,-17.43±6.42D at 1 month,-17.35±6.62D at 6months,and-17.34±6.72D at 1 year.There were no statistically significant differences between preoperative and postoperative diopters (P>0.05).Differences between best corrected visual acuity(BCVA)before and after surgery were not statistically significant.The postoperative BCVA were improved in 97 eye (95.1%),stable in 4 eyes(3.9%),and only 1 eye’s visual acuity(1.0%) was impaired.6 eyes’ intraocular pressure was heightened,and then quickly controlled with medicine.No other serious complications were observed.·CONCLUSION:This study indicates that posterior scleral implantation surgery with the fibers of artificial pericardium as the strengthened materials can effectively control eye’s axial length of pathologic myopia,stabilize the progression of diopters and improve eyesight.Meantime,there are not serious complications.

Multifocal electroretinogram in myopia

Zhong-Fei Chen,Yun-Dong Yang and Shen Xu

AIM:To measure and compare the difference of multifocal electroretinogram between normal subjects and patients with myopia.·METHODS:Twenty-two cases(44 eyes) of normal subjects and twenty-four cases (48 eyes) with myopia were tested with VERIS Science 4.2 made by EDI company of America.All trace grouping waveform and six ring average response were determined.We studied the differences of response densities and latencies between normal and myopic groups.·RESULTS:The response densities of all trace grouping waveform and six ring average response in myopia were decreased while the latencies were not changed.·CONCLUSION:The response densities of multifocal electroretinogram in myopic eyes were reduced and resulted predominantly from retinal receptors function loss.

Observation of the clinical effect of wavefront aberration and iris location guided EPI-LASIK for high myopia

Peng Li,Li Wang,Jian-Min Gao and Dan-Yu Gao

AIM:To observe the clinical effect of wavefront aberration and iris location guided epipolis laser in situ keratomileusis( EPI-LASIK )for high myopia.·METHODS:Fifty-four patients(108 eyes)with corneal high myopia were randomly divided into wavefront aberration and iris location guided EPI-LASIK group of twenty-nine patients (58 eyes)and conventional EPI-LASIK group of twenty-five patients (50 eyes).The uncorrected visual acuity(UCVA),refractions,vision quality and high-order aberration value were analyzed during the postoperative follow-up.·RESULTS:At 6th month postoperatively,there was no significant diference of the UCVA (P>0.05)between two groups;The postoperative UCVA of all eyes was satisfied,gained over 2 line of best-corrected visual acuity(BCVA) in wavefront guided group and gained over 2 line of BCVA in conventional group,there was significant diference between the two group(P<0.01);The postoperative refractions,vision quality was statistically different between the conventional group and wavefront guided group(P<0.05);there was significant difference in the postoperative high-order aberration between the two groups(P<0.01).·CONCLUSION:The wavefront aberration and iris location guided EPI-LASIK in some field is better than conventional EPI-LASIK for the treatment of high myopia.·

Clinical observation of treatment of pterygium with excimer laser phototherapeutic keratectomy

Yan-Jun Ren,Lan-Ping Sun,Gui-Fen Liu,Ya-Juan Zhang,Ji Li and Jun-Hua Hao

AIM:To evaluate excimer laser phototherapeutic keratectomy (PTK) treatment of pterygium.·METHODS:Thirteen eyes of pterygium from 12 cases underwent excimer laser cutting combined with pterygium excision.Wound healing and relapse rate were observed during the postoperative follow-up of 6 months.·RESULTS:There was no recurrence in the 12 cases of pterygium.·CONCLUSION:Excimer laser PTK for the treatment of pterygium is an effective surgical method.·

Treatment of traumatic corneal flap dislpacemeat after LASIK

Li Liu,Han-Bin Zhang and Mei Tang

AIM:To discuss the treatment of traumatic corneal flap dislpacemeat after laser in situ keratomileusis(LASIK).·METHODS:All the 11 patients with taumatic corneal flap dislpacemeat were re-positioned.Irrigation was applied on stromal bed and sub-flap.·RESULTS:Nine eyes regained vision of 0.6-1.0 after 1 week,1 eye regained vision of 0.8 after 8 months for traumatic hypema,secondary glaucoma,and commotio retinae.1 eye regained vision of 0.6 after 1 month for burn from lime.No epithelial ingrowth or corneal melting etc occurred.·CONCLUSION:Proper and prompt re-position of traumatic corneal flap can regain vision.·

Prophylactic retinal laser photocoagulation for medium and high myopia before LASEK

Jun Xu,Gang Xu and Dun-Chuan Zha

AIM:To appraise the curative effect of prophylactic retinal laser photocoagulation before laser epithelial keratomileusis (LASEK) for medium and high myopia.·METHODS:Mydrin eye-liquid was used to disperse pupils in 279 patients (551 eyes) with medium and high myopia before LASEK.Eyeground was examined carefully with 90D slit-light preset lens or three-mirror lens.It’s found that there’s obvious retinal degeneration in 18 cases of 26 eyes with grid style degeneration,snail style degeneration,bursa style degeneration and so on,or dry retinal hole at the same time.Double Nd∶YAG 532nm was used to perform laser treatment,and LASEK to correct myopia.·RESULTS:Preventive double Nd∶YAG 532nm was used to cure 18 cases of 26 eyes,after laser photocoagulation,the retinal degeneration and dry hole area have well-closed situation,the pigment patch formed obviously.6-18 months after LASEK surgery,there is no retinal detachment with random visits.·CONCLUSION:As for the eyes with obvious retinal degeneration or (with) dry retinal hole,prophylactic double Nd∶YAG 532nm laser photocoagulation surgery and choice of LASEK surgery to correct myopia are very important measures to prevent the occurrence of rhegmatogenous retinal detachment after excimer laser correction of myopia.

Analysis of curative effect of comprehensive therapy on children amblyopia

Jing Xie,Lin-Ying Xie and Ying Luo

AIM:To search the effect of synthesis treatment for children amblyopia of different ages.·METHODS:A total of 347 eyes of 196 children were conducted the comprehensive therapy.Retinoscopy optometry was conducted after mydriasis by 10g/L Atropine on amblyopia children aged 3 to 11 years,retinoscopy optometry was conducted after mydriasis by compound tropicamide on amblyopia children aged over 11 years,and then the comprehensive amblyopia therapy was conducted to those who fitted for eyeglasses after re-examined.·RESULTS:The basic amblyopia cure rate was 70.0% by the comparison between amblyopia degree and curative effect in this group.The basic amblyopia cure rate was 75.5% by the comparison between the age of amblyopia children and curative effect.The basic amblyopia cure rate was 78.4% by the comparison between refractive status and curative effect.The basic amblyopia cure rate was 61.4% by the comparison between adherence to treatment time and curative effect.·CONCLUSION:The curative effect of the synthesis treatment has a close relationship with the amblyopia type,degree,age and adherence to treatment time.The earlier it begins,the lighter the amblyopia degree is,the longer the adherence to treatment time is,the better the curative effect would be.

The ultrastructure of corneas preserved by long-term cryopreservation with improved glycerol and lamellar keratoplasty

Jun-Hua Fan,Xue-Xi Li and Dong-Ping Pan

AIM:To study the ultrastructure of comeas preserved by long-term cryopreservation with improved glycerol and to study the lamellar keratoplasty.METHODS:The corneas coated with sodium hyaluro-nate were long-term preserved in -45 ℃ glycerol. After 1 year,15 cases accepted lamellar keratoplasty with the long-term preserved cornea,and the cornea taken trans-mission electron microscopy(TEM) examination. RESULTS:All surgeries were successful,and patients were followed up for 6 to 24 months. 13 grafts were transparent,1 graft was translucent,and 1 graft was neovascularization. TEM examination showed that the ultrastructure of cornea was well-preserved. CONCLUSION:The improved long-term cryopreserva-tion with glycerol could preserve some viability of cornea. It is a proper way of preservation that could be used for lamellar keratoplasty in clinic when there is no fresh corneas.

Clinical observation of corneal astigmatism after phacoemulsification and foldable intraocular lens implantation by clear corneal incision

Xiu-Ling Ye and Zhong-Chen Zhang

AIM:To explore the change of corneal astigmatism after phacoemulsification associated with fold artiphakia lens embedded with hyaline corneal incision.METHODS:Seventy-nine eyes of 58 cases were enrolled. All cases underwent similar phacoemulsifica-tion combined with fold artiphakia lens implantation.The changes of corneal astigmatism before and 3 days,1 week,1 month after operation were compared as well as visual acuity.RESULTS:One month after operation,visual acuity elevated and became stabilization. Average corneal astigmatism were decreased obviously 1 month compared with 1 week after operation. There was significant difference.CONCLUSION:Phacoemulsification combined with fold artiphakia lens implantation with 3.2mm hyaline corneal incision may be a safe and effective method to treat cataract for smaller corneal astigmatism,quicker visual recovery and shortter stable time.

Clinical observation of 40 cases of small incision non-phacoemulsification and intraocular lens implantation in senile cataract

Shan-Hou Dai

AIM:To explore clinical effects of the non-phacoemulsification small incision extracapsular cataract extraction and intraocular lens implantation in the treatment of senile cataract.METHODS:Forty eyes of 40 cases with senile cataract were treated with scleral tunnel incision extracapsular cataract extraction,and posterior chamber intraocular lens implantation. Postoperative visual acuity,astigmatism and complications were observed.RESULTS:With follow-up of 1-36 months,naked eye,or corrected vision was ﹤0.5 in 1 case (2.5%),0.6-1.0 in 18 cases (45.0%),1.2-1.5 in 21 cases (52.5%). 1 month and 3 months before and after operation,mean astigmatism was (0.90±0.81) D,(0.95±0.65) D and (0.93±0.60) D respectively and compared with the preoperative data,mean astigmatism 1 month and 3 months after operation had no significant difference (P>0.05). The major complications are corneal edema,anterior chamber inflammation. No nuclear expulsion difficulties,posterior capsule rupture,vitreous prolapse,intraocular lens implantation failure or complications such as iris damage occurred.CONCLUSION:Small incision non-phacoemulsification extracapsular cataract extraction and intraocular lens implantation need simple equipment and operation is easy to master.With small incision,less trauma,good restored visual acuity,small corneal astigmatism and few complications,it’s effective,safe,reliable,affordable and suitable for primary hospital.

Manual small incision extracapsular cataract extraction combined with intraocular lens implantation for the treatment of hypermature cataract

Hong-Yu Yang

AIM:To explore the methods of manual small incision extracapsular cataract extraction(ECCE) combined with intraocular lens(IOL) implantation in treating hyperma-ture cataract and their clinical effects.METHODS:The manual small incision ECCE combined with IOL implantation was performed in 94 cases(97 eyes). After the surgery,these patients were observed and followed up.RESULTS:The postoperative vision of all patients was markedly improved. The naked(or corrected) visual acuity of 73% patients(71 eyes) reached 0.5 or above at the first day after the operation,and 85% of patients(82 eyes) reached 0.5 or above and 98%(95 eyes) reached 0.3 or above at the second day after the operation.CONCLUSION:The manual small incision ECCE combined with IOL implantation in treating hyperma-ture cataract seems to be a safe,effective and practical surgery.

Clinical application of interlaced non-phacoemulsification cataract extraction,keratoplasty and intraocular lens implantation

Yi Wu,Zhao-Xia Xia,Hua Li and Ting Huang

AIM:To treat the patients with cararact and ceratonosus that need to be cured simultaneously with interlaced non-phacoemulsification cataract extraction,intraocular lens implantation and keratoplasty(triple procedure)and to observe and analyze the clinical effects of the triple procedure.METHODS:Twenty-one cases 21 eyes with cararact and ceratonosus were performed the triple procedure,and visual acuity,corneal grafts were observed. Follow-up period lasted for 4 months to 9 months postoperatively.RESULTS:The naked vision of 92% eyes were improved compared with that of the preoperative. In 9 cases (43%) visual acuity was over 0.5 after 2 weeks,and 10 cases (48%) over 0.3,2 cases (10%) were 0.1. All the corneal grafts were completely transparent 7 to 14 days after operation. Corneal grafts of 17 cases were completely transparent 4 to 9 months after operation,and corneal grafts of 3 cases were semitransparent. There was 1 case whose corneal graft was moderately turbid with neovessels.CONCLUSION:Interlaced non-phacoemulsification cataract extraction,keratoplasty and intraocular lens implantation can cure the patients’ refracting media turbidity of forepart eye and help them to get perception function at one time. Compared to the traditional thipe procedure,the interlaced tripe procedure can decrease trauma and post-operative complications with high safety.

Clinical analysis of early fresh amniotic membrane transplantation for ocular severe alkali burns

Jian-Ying Qin,Shen Xu and Hua Zhao

AIM:To evaluate the early stage of fresh amniotic membrane transplantation for treatment of severe ocular alkali burn. METHODS:Forty-eight cases of 67 eyes with severe alkali burns were divided into A,B groups according to visiting time,26 cases of 38 eyes burned for 0.5 hours -7 days (including 7 days) were treated for the A group; 22 cases of 29 eyes burned for 7-20 days (not including 7 days) were treated for the B group,both groups were transplanted with fresh amniotic membrane and wore soft contact lenses after operation. The ocular surface conditions and visual acuity were observated after 3 months. RESULTS:There were 28 eyes of full transparent cornea,5 eyes of semi-transparent,3 eyes of all muddy and 2 eyes of corneal leukoplakia,and 2 eyes of symblepharon,and 2 eyes of new blood vessels,and the visual acuity of 28 eyes was ≥0.4,10 eyes <0.4 in A group. There were 12 eyes of full transparent cornea,7 eyes of semi-transparent,6 eyes of all muddy and 4 eyes of corneal leukoplakia,and 7 eyes of symblepharon,and 15 eyes of new blood vessels,and the visual acuity of 11 eyes was ≥0.4,18 eyes <0.4 in B group. Comparison of the two groups were statistically significant (P<0.05).CONCLUSION:Early fresh amniotic membrane transplantation could be better for reconstruction of ocular surface and improving vision,it is the best therapeutic approach for the severe ocular alkali burns. 

Effect of different size of conjunctival flap on trabeculectomy

Fen Wei and Jian-Ping Liu

AIM:To investigate the antihypertensive effect and the impact of postoperative complications of different conjunctival flap size in the routine glaucoma trabeculec-tomy. METHODS:The eyes of 10 cases with chronic angle-closure glaucoma underwent conventional trabeculectomy + peripheral iris excision procedure,and the conjunctival fornix flap for the basement,without intraoperative antimetabolites. Equilateral triangle conjunctival flap with the bottom edge of 10mm long and 6mm high was performed in one eye,and the other eye was performed a long-10mm,high-6mm rectangular conjunctival flap (the actual size of the equivalent twice of the former),and the remaining operation steps were the same. From the second day after the operation,the daily measurement of intraocular pressure (IOP) (non-contact tonometer),slit-lamp examination of anterior chamber were performed for seven days until suture removal.RESULTS:The eyes with expanded conjunctival flap in 10 cases all had the occurrence of postoperative shallow anterior chamber of which there were 5 cases with one-stage shallow anterior chamber,4 cases with two-stage shallow anterior chamber,1 case with three-stage shallow anterior chamber. Dyeing:one case of two-stage shallow anterior chamber eyes with conjunctival flap wound leakage; filtration bulb of conjunctival sac intumesce in the bottom of the three-stage shallow anterior chamber eyes. No cilio-choroidal detachment occurred. IOP mea-surement:all IOPs were lower than 4-8mmHg,and the difference between binoculus was less than 2mmHg. One stage and two stage shallow anterior chamber eyes underwent filtering pillow compression and bandaging,and three stage shallow anterior chamber eyes were dilated with Mydrin-P daily,pressuring with filtering pillow and bandaging,without using ocular hypotensive agents orally or intravenously. When removing the suture 7 days after operation,the anterior chambers were normal; binocular IOPs were 14 mmHg in 1 case,less than 10mmHg in 9 cases,the binocular difference was less than 2mmHg,and the sizes of binocular filter bleb were the same. There was no difference in binocular filter bleb and IOP during the half month,one month,and three month review.CONCLUSION:The expansion of the conjunctival flap can not reduce IOP and increase the volume of the filtering bleb effectively,but can increase the occurrence of complications caused by strong filtering,low eye pressure,and large filter bleb. 

Analysis of misdiagnosis of acute angle-closure glaucoma in acute episode time in 28 cases

Qi Lu,Bing Hu and Hong-Sheng Bi

AIM:To analyze the reason of misdiagnosis and differential diagnosis of acute angle-closure glaucoma in acute episode time in 28 cases.METHODS:Three typical misdiagnosis examples were analyzed.RESULTS:Fifteen cases were misdiagnozed as hyperpie-sia,9 as intracranial hypertension,4 as acute gastroen-teritis,and counteract glaucoma operation was performed in 22 cases after final diagnosis,drug expectant treatment was performed in 6 cases. Vision exceeded 0.5 in 15 cases,hand movement in 2 cases.CONCLUSION:Deficient physician’s cognition to acute angle-closure glaucoma is the main reason for misdia-gnosis. The strengthening of diagnosis consciousness and attaching importance to examination of eyes are the key for avoiding misdiagnosis.

Clinical analysis of 66 cases with silicone oil temponade

Yu Zhou,Zhu Yuan and Yi-Zhuan Zhang

AIM:To investigate the relationship between duration silicone oil temponade and complication and the cause of silicone oil temponade.METHODS:Retrospective survey was done in 66 cases (70 eyes) of silicone oil temponade.RESULTS:The primary cause of silicone oil temponade was regular hole retinal detachment,the second was retinal detachment with macula hole,the third was proliferative diabetic retinopathy. The average time of silicone oil temponade was 10.5 months,the incident rate of silicone oil emulsification was 28.6%,the incident rate of ocular hypertension was 15.7%,corneal degeneration was 2.9%,severely cataract was 46%. The main complica-tion of silicone oil removal was recurrence retinal detach-ment.CONCLUSION:In the follow-up on a regular basis,we can appropriately extent the remaining time of intraocular silicone oil. When silicone oil is removed,to maintain the vitreous cavity infusion,and according to the retinal situation to choose retinal laser,intraocular gas filling or silicone oil tamponade can reduce the occurrence of postoperative complications.

Relation of the prognosis and hemodynamics change in indirect optic nerve injury

Yao-Feng Li and Xia Sun

AIM:To explore the relation of the prognosis and hemodynamics change in indirect optic nerve injury. METHODS:The PSV,EDV,TAMX and RI in central retinal artery,posterior ciliary artery and ophthalmic artery were measured with CDFI in 102 patients with indirect optic nerve injury,the relation of eyesight,bloodstream change and prognosis were observed.RESULTS:The PSV of posterior ciliary artery and ophthalmic artery of 95 patients in 102 patients were significantly higher(P<0.05),the EDV of them were significantly lower(P<0.05),the TAMX of them were lower(P<0.05) and the RI of them were clearly highter (P<0.01),The blood flow parameters of central retinal artery in 102 patients showed no significant difference (P>0.05). The lower eyesight was,the clearer bloodstream change was and the worse prognosis was.CONCLUSION:The patients with indirect optic nerve injury have the high speed and high obstruction blood-stream changes of posterior ciliary artery and ophthalmic artery. The clearer bloodstream change was,the worse prognosis was.

Multi-surgery for the treatment of severe traumatic hyphema

Xue-Tao Shi,Xian-Zhong Ye and Jia-Ying Zhang

AIM:To observe the effect of multi-surgery for the treatment of severe traumatic hyphema and investigate surgical techniques.METHODS:Twenty-three cases (23 eyes) with severe traumatic hyphema underwent corneal incision and irriga-tionaspiration with ultrasound emulsification equipment or bimanual system to draw-off anterior chamber hyphema. During the operation,the viscoelastics was used to separate the blood clots and to stop bleeding. Anterior chamber,intraocular pressure and visual acuity were observed postoperatively.RESULTS:Twenty-one eyes succeeded in the first surgery,and the other 2 eyes failed. Visions less than 0.05 were in 5 eyes(22%),0.05~0.3 in 11 eyes(48%),and more than 0.3 in 7 eyes(30%).CONCLUSION:Multi-surgery in different hyphema may achieve better outcome.

Application of GX-Ⅲ-type multi-functional ion therapeutic machine under microscope for the treatment of lacrimal point stenosis

Fu-Lin Gao,Lian-Na Hu and Feng-Hua Bai

AIM:To investigate the effect of GX-Ⅲ-type multi-functional ion therapeutic machine under microscope for the treatment of lacrimal point stenosis or occlusion.METHODS:Twenty-six patients (28 eyes) with puncta stenosis or occlusion underwent puncta plasty,and the treatment effectiveness was evaluated.RESULTS:One day after operation,the drainage of lacrimal ductule was unobstructed in 28 eyes. All patients were followed up for 3 to 6 months,and the recovery rate was 93%.CONCLUSION:Puncta plasty performed by GX-Ⅲ-type multifunctional ion therapeutic machine under microscope is an effective and simple therapy for the treatment of lacrimal point stenosis or occlusion,with less damage and pains.

Application of self-nasal septal cartilage with mucosa in eyelid reconstruction

AIM:To study the clinical effect of self-nasal septal cartilage with mucosa for the treatment of large coloboma of eyelid after resection of eyelid malignant tumor. METHODS:After upper eyelid malignant tumors were resected,eyelids were restored by self-nasal septal cartilage with mucosa on 7 eyes of 7 cases. RESULTS:Seven cases were followed up for 0.5 to 2 years,and the self-nasal setpal cartilage with mucosa grew well. The morphology and function of the recon-struction of eyelids were well. CONCLUSION:The self-nasal septal cartilage with mucosa for restoring blepharocoloboma after eyelid malignant tumor resection is a convenient and less lesion reconstruction operation of eyelid.

Observation of the operation of epiphora caused by plica semilunaris laxation

Ye-Xiang Liu,Xing-Ru Zhang,Qing-Song Li and Yi-Jie Li

AIM:To investigate the operative effect of epiphora caused by plica semilunaris laxation.METHODS:Thirteen cases (18 eyes) underwent the chalasia plica semilunaris resection from June of 2007 to June of 2009. Postoperative symptoms were evaluated; the conjunctiva was observated by slit-lamp,so was tasting of chloramphenicol test. RESULTS:Symptoms disappeared or were improved in 15 eyes (83%) among 18 eyes 4 weeks after operation,and disappeared or were improved in 11 eyes among 13 eyes 12 weeks after operation,During the post-operative slitl-amp examination 4 weeks after operation,plica semil-unaris laxation was completely eliminated in 16 eyes (89%) with blockage of puncta relieved among 18 eyes,and 12 weeks after operation,plica semilunaris laxation was completely eliminated and the blockage of puncta were relieved in 12 eyes among 13 eyes (92%); chloramphenicol tasting tests returned to normal in 14 eyes (78%) of 18 eyes 4 weeks after operation,and 10 eyes (77%) of 13 eyes returned to normal 12 weeks after operation.CONCLUSION:The operation of plica semilunaris laxation resection is easy,safe and effective.

Application of bFGF in endoscopic dacryocystorhinostomy

Hai-Yun Lei and Peng Wei

AIM:To discuss the application of bFGF in endoscopic dacryocystorhinostomy for the treatment of chronic dacryocystitis and for the prevention of long-term cicatri-cial adhesion of pore-forming rim after operation.METHODS:Thirty-seven cases (37 eyes) with chronic dacryocy-stitis were treated by endoscopic dacryocystor-hinostomy. The wound was coated with bFGF eye gel; the secretion,blood callus and granulation around the nasal lacrimal sac stoma were cleared during each follow-up; lacrimal passage was irrigated; after the epithelization of mucous membrane of the nasal lacrimal sac stoma,the tube was pulled out. RESULTS:After 6 months to 1 year,32 eyes were cured,4 eyes were improved and 1 eye was invalid. The effective rate was 97.3%,and there were no compli-cations. Invalid in 1 case was caused by proliferation and adhesions of granulation tissue around the nasal lacrimal sac stoma or nasal septum adhesion. After occlusion stoma was cleared under nasal endoscope and the patient was re-catheterized and got a better recovery.CONCLUSION:Endoscopic nasal surgery dacryocystor-hinotomy with application of bFGF has a good long-term effect,low recurrence rate,and seems to be a better method for the treatment of chronic suppurative dacryocystitis.

Cataract surgery after corneal laser refrac-tive surgery

Xu-Kang Cheng,Yan Luo and Ming Lu

AIM:To discuss the characteristic of cataract surgery with intraocular lens(IOL) implantation after corneal laser refractive surgery. METHODS:This retrospective study included 4 eyes of 4 cases who had previously undergone myopic corneal laser refractive surgery and subsequently phacoemulsifi-cation with implantation of IOL. Based on the data cases provided,clinical history method(CHM) or adjusted keratometry method were used to calculate the kerato-metry and IOL power. Corneal conditions,surgical com-plications,uncorrected visual acuity,best corrected visual acuity,postoperative refractive status,etc were observed during the follow-up.RESULTS:The best corrected visual acuity postopera-tively increased obviously. The error between postopera-tive refraction and predicted refraction preoperatively ranged from -1.00D to +1.25D. CONCLUSION:Cataract surgery with IOL implantation after corneal laser refractive surgery is feasible. The characteristics and calculation methods of IOL must be mastered.

Effect of cyclopentolate hydrochloride on cycloplegia in children

姚润莲,艾育德,阿拉腾其木格

AIM:To investigate the effect of cyclopentolate hydrochloride on cycloplegia in children.METHODS:Sixty children (120 eyes) with refractive error ,aged from 6 to 12,were divided randomly into 3 groups:A,cyclopentolate hydrochloride eyedrop group;B,compound tropicamide group;C,10g/L atropine group. Before and after administration of these eyedrops,pupil size and objective refraction were checked on auto refractor,subjective refraction was checked in phoropter,and phoropter was used to check the accommodation response and residual accommodation respectively by "push-up"method. RESULTS:The time of maximum cycloplegia of cyclo-pentolate hydrochloride was 60 minutes. Under the ma-ximun cycloplegia,the residual accommodation in cyclopentolate hydrochloride eyedrop group and 10g/L atropine group had no significant difference. The residual accommodation in compound tropicamide eyedrop group was stronger than that of the other two goups (P<0.05).CONCLUSION:Cyclopentolate hydrochloride eyedrop is as effective as atropine for the measurement of refractive error in most healthy nonstrabismic children aged from 6 to 12.

Clinical analysis of checking 1000 cases before the LASIK or LASEK

Li-Xia Xue

AIM:To explore the importance of preoperative exa-mination of LASIK or LASEK for preventing and reducing the surgery complications and improving the success rate. METHODS:Data of 1000 cases (2000 eyes) treated by excimer laser were analyzed retrospectively.RESULTS:Posterior corneal surface Diff≥ 50μm were in 25 cases,pathological changes of optical fundus were in 46 cases,the average central corneal refractive more than 47.50D was in 17 cases. Thin cornea (central thickness <450μm) was in 13 cases,and there were 4 cases with glaucoma and 2 cases with keratitis.CONCLUSION:Detailed and thorough preoperative examina-tion is an important guarantee for success of the operation.

Clinical study of mitomycin C for the prevention of haze in LASEK surgery of high myopia

Huan Huang,Li Wang,Chao Peng and Xiu-Yun Wu

AIM:To evaluate the feasibility of mitomycin C (MMC) in preventing haze in LASEK surgery of high myopia.METHODS:Twenty-four high myopia patients(48 eyes) were randomly divided into two groups,one group included 11 patients(22 eyes) which operated LASEK surgery as usual and the other group(26 eyes) received 0.2g/L MMC sponge in the operation,and the time lasted for 12 seconds. After operation and the cornea was covered with gas-permeable soft contact lens. All of the patients were followed up,including vision and haze etc. for half a year. RESULTS:There was no difference of the haze between the two groups 6 weeks after the operation. 3 months,6 months after operation the haze in MMC group was lighter than that of the control group (P<0.05). CONCLUSION:MMC seems to be effective to prevent the haze in the surgery of LASEK of high myopia.

Exploration of operative methods in V-pattern exotropia

Shi-Chun Liu,Hua Li,Sheng-Fang Song and Yu-Fei Wu

AIM:To explore the operative methods and post-operative effects of V-pattern exotropia. METHODS:The operative methods and postoperative effects of 27 cases with V-pattern exotropia treated in our department during January 2004 to December 2008 were analyzed. Operative methods were chosen on the basis of their cause. 18 cases with inferior oblique hyperfunction were treated with inferior oblique reduction and exotropia correction. 9 cases without inferior oblique hyperfunction were treated with inferior oblique reduction and horizontal rectus vertical transporting. Follow-up time after surgey was two months to forty-one months.RESULTS:Twenty-five cases got V sign corrected,24 cases returned to the normal at primary position of eye,2 cases had undercorrection,1 case had overcorrection. 15 cases got different degrees of binocular vision,2 cases got stereoscopic vision. CONCLUSION:Inferior oblique hyperfunction is the main cause of V-pattern exotropia. Inferior oblique reduction and exotropia correction are effective methods. Patients without inferior oblique hyperfunction can be treated effectively with inferior oblique reduction and horizontal rectus vertical transporting.

Prevention and treatment of amblyopia in preschool children

Xiao-Wen Guo,Xiang-Qin Liu and Ling-Zhi Wang

AIM:To investigate the key for the prevention and treatment of preschool children with low vision. METHODS:A total of 6500 preschool eye health screenings were conducted,and the individuals of amblyopia were given a systematic treatment. RESULTS:Amblyopia prevalence was 4.38%; ametropia amblyopia 356 eyes(76.1%),strabismus amblyopia 47 eyes (10.0%),anisometropic amblyopia 65 eyes(13.9%). Amblyopia total cure rate was 98.1%,of which mild amblyopia efficiency was 100%,moderate amblyopia efficiency 96.6%,severe amblyopia efficiency 80.8%. CONCLUSION:Amblyopia in preschool children is mainly mild or moderate. The lighter the amblyopia and the earlier the treatment are,the better the therapeutic effect is.

Study of anterior chamber angle and depth,corneal thickness after implantation by ultrasound biomicroscopy

Qi Gong,Zhi-Lan Yuan,Qing-Huai Liu and Xiao-Yi Liu

AIM:To study the changes anterior chamber angle(ACA),corneal thickness and depth of anterior chamber after phacoemulsification and foldable intraocular lens(IOL) implantation by ultrasound biomicroscopy. ·METHODS:Small-incision phacoemulsification and foldable IOL implantation were performed in 20 eyes of 20 senior patients,and the changes of corneal thickness,ACA and anterior chamber depth were determined quantitatively by ultrasound biomicroscopy before and one week after the surgery. ·RESULTS:In all patients,the anterior chamber angle was widened significantly at one week after surgery.The measurements of AOD500(angle-opening distance at 500μm from the scleral spur) and ACA increased significantly after the operation.The mean post/operative corneal thickness was significant increased. A significant negative correlation existed between preoperative and postoperative data(P<0.01). ·CONCLUSION:Small-incision cataract surgery increases the thickness of corneal,deepens the anterior chamber and widens the ACA in senior patients.

Clinical observarion of Ahmed glaucoma valve implantation in the treatment of refractory glaucoma

Lei Li,Yang-Zong Daiji,Ling Li,Xue-Ying Ma and Rong Zhang

AIM:To explore the clinical effect of the Ahmed glaucoma valve implantation for treetment of refractory glaucoma. ·METHODS:Totally 18 patients with refractory glaucoma underwent glaucoma surgery using Ahmed glaucoma valve.The changes of intraocular pressure,the vision and postoperative complications were observed. Follow-up time was from 3 to 12 months.·RESULTS:At the postoperative month 1,the intraocular pressure was changed from 51.53±6.57mmHg to 16.82±5.63mmHg,and the successful rate was 95%; at the postoperative month 3,the intraocular pressure was changed from 51.53±6.57mmHg to 17.14±6.38mmHg,and the successful rate was 89%; for those eyes with the follow-up ≥12 months(n=15),the intraocular pressure was changed from 50.36±7.92mmHg to 18.35±7.24mmHg,and the successful rate was 73%.·CONCLUSION:The glaucoma surgery using Ahmed glaucoma valve is an effective method for refractory glaucoma,and this is a simple operation,rapid recovery,fewer complications,better intraocular pressure and vision.

Clinical analysis of reoperation for encapsulated blebs after Ahmed glaucoma valve implantation

Jian-Ming Tang and Nai-Chuan Wu

AIM:To evaluate the efficacy of reoperation for encapsulated cystic blebs after Ahmed glaucoma valve implantation. ·METHODS:The series cases of 7 eyes 7 patients with elevated intraocular pressure (IOP) induced by proliferation around Ahmed value were retrospectively studied. The IOP increased at 1 month to half a year,2 months in average. Secondary surgery preoperative examination:the elevation could not be controled by medicine,the plate and valve tube position was normal,the orifice was smooth without stemming,localized encapsulated cystic blebs were found in the equator of eyeball in which the plate was located. All patients underwent encapsulated cysts resection combined with mitomycin-C under conjunctival flaps. The changes of IOP and the outcome of the diseases were observed. ·RESULTS:At 1 month after surgery,all patient’s IOP were in the normal range,and the surgery success ratio was 100%;at 6 months after the surgery,2 patient’s IOP kept the normal level (15.00mmHg) without any anti-glaucoma medications.The normal IOP level were in 3 cases by using 2 or 3 different kinds of anti-glaucoma medications,and surgery success rate was 71% (5/7). IOP beyond control were in 2 cases,and further surgical treatment was necessary.·CONCLUSION:It is considered an effective method of surgical treatment for encapsulated cystic blebs around Ahmed value.

Clinical study of vitrectomy combined with silicone oil injection for retinal detachment with macular hole

Rong Zhang,Xue-Ying Ma and Ling Li

AIM:To observe the clinical efficacy of modern closed vitrectomy combined with C3F8 mixed gas or silicone oil injection for retinal detachment with macular hole from the January 2007 to October 2009. ·METHODS:Patients with retinal detachment with macular hole underwent modern closed vitrectomy combined with silicone oil injection.The visual acuity,intraocular pressure and closure situation of macular hole were observed postoperatively. ·RESULTS:The closure situation of macular hole:all cases of macular hole were closed with the fine retinal reattachment; After following-up for 4 months,none of cases required reoperation. After follow-up of 4 to 12 months,patient with progression of cataract was not found. Visual acuity and intraocular pressure:postoperatively the improvement of visual acuity (above 2 lines) were in 6 eyes (32%),unchanged in 13 eyes (68%),descent (above 2 lines) in 0 eye. At 1 month after operation,only 1 case (5%) presented the rising of intraocular pressure,while topical intraocular pressure reduced to normal after treatment. ·CONCLUSION:The modern closed vitrectomy combined with C3F8 mixed gas or silicone oil injection has a good therapeutic effect for retinal detachment with macular hole.

Clinical observation of vitrectomy combined triamcinolone acetonide for proliferative diabetic retinopathy

Li-Shuai Xu,Dong-Jing Liu,Chang-Jun Lan,Le Dai,Xu-Hong He and Jing Zhang

AIM:To explore the clinical effect of pars plana vitrectomy(PPV)combined triamcinolone acetonide (TA) intravitreal injection for proliferative diabetic retinopathy (PDR).·METHODS:The study included 90 patients with PDR was who underwent PPV:TA group included 50 eyes,control group included 48 eyes. The visual acuity,inflammation,intraocular pressure and fundus were evaluated after surgery.·RESULTS:In the postoperative month 6,the inflammation reaction of anterior chamber and macular edema in TA group was less than that in control group (P<0.05).But the corrected visual acuity and intraocular pressure showed no shown statistical significance.·CONCLUSION:PPV combined TA intravitreal injection for PDR is useful to reduce postoperative intraocular inflammation and macular edema.

Clinical application of improved 23-gauge vitrectomy system

Qian-Qian Shi,Yu-Jun Li and Yan-Qing Gao

AIM:To investigate the clinical application of improved 23-gauge vitrectomy system in the treatment of vitreoretinopathy disease and evaluate its efficacy and safety.·METHODS:A retrospective study of 112 cases(112 eyes) who received improved 23-gauge vitrectomy from August 2009 to February 2010 was retrospectively studied. The diseases included rhegmatogenous retinal detachment(53 cases),tractional retinal detachment(59 cases).The main observation were the surgical effects and complications.The follow-up time was from 1 month to 12 months.·RESULTS:All cases were successfully completed without significant complications.The best-corrected visual acuity was improved in different degree.·CONCLUSION:Improved 23-gauge vitrectomy system with better curative effect,faster postoperative recovery and few complications is an effective and safe surgical technique for all vitreoretinopathy diseases.

Comparative analysis the change trends of the related factor to suppurative endophthalmitis

Xing-Li Wang,Yi Wang,Rui Wang,Shao-Jun Chen,Yong Liu,Xiao-Yong Huang and Nan Wu

AIM:To analyze the change trends of the factor related to the patients with suppurative endophthalmitis in our hospital in recent 10 years and to provide useful information and basis to the prevention and treatment of suppurative endophthalmitis in future. ·METHODS:Totally 357 cases 357 eyes were retrospectively analyed from January 1999 to January 2009 in our hospital. We comparatively analyed the related factor of age,occupation and cause of disease of 357 cases 357 eyes with suppurative endophthalmitis in forward 5 years (January 1999-January 2004)and backward 5 years (February 2004-January 2009)of the recent 10 years. ·RESULTS:Children and middle-aged people constituted the main disease population in recent 10 years,the proportion was 43.7%,34.1% and 35.1%,42.8%,but the proportion of children(43.7%,35.1%)and young people (19.8%,10.8%) were declined markedly(P<0.05),while the proportion of old people(2.4%,11.3%) was increased markedly(P<0.05). Occupational structure that mainly comprehended farmers and students were not changed. The proportion was 41.3%,39.7% and 44.6%,35.5%;the cause of disease had no significant changes,the proportion of the ocular trauma that was the main cause of disease was 88.9% and 87.5%,and in the ocular trauma the proportion of syringe injuries (16.7%,9.1%) was significantly decreased (P<0.05),while the proportion of wire and scissors injuries(21.4%,31.6%) was significantly increased (P<0.05).·CONCLUSION:The children and middle-aged constitute the main disease population in recent 10 years,the proportion of children and young people is on a downward trend,while that of old people is on an upward trend; occupational structure that mainly comprehended farmers and students are not changed; the ocular trauma is the main cause of disease,in which the proportion of syringe injuries is on a downward trend,while the proportion of wire,scissors injuries on an upward trend.

Therapeutic effect of the two surgical methods for pterygium

Xiao-Shuang Ma and Bing Li

AIM:To observe therapeutic effects of excision of pterygium with the amniotic membrane transplantation and the auto-corneal limbus stem cell transplantation.·METHODS:A total of 82 patients 85 eyes which underwent excision of pterygium were randomly divided into 2 groups:Group A (40 eyes),amniotic membrane transplantation group; Group B (45 eyes),auto-corneal limbus stem cell transplantation group.·RESULTS:Followed up for 9 to 32 months after operation,2 cases recurred in group A and the recurrence rate was 5%,while the cure rate was 100% in group B. recurrence rate was not statistically different between the two groups.·CONCLUSION:Both methods have achieved good effect for pterygium,and pterygium excision with auto-corneal limbal stem cell transplantation has a better effect.

Clinical observation of autologus conjunctival transplantation combined with mitomycin C in the recurrent pterygium

Su-Xia Peng,Xiang-Dong Chen and Ji-Pu Bu

AIM:To observe the clinical effect of autologus limbal stem cell transplantation combined with mitomycin C in the recurrent pterygium.·METHODS:Totally 68 cases 79 eyes of recurrent pterygium were performed autologus limbal stem cell transplantation combined with mitomycin C.Following up time was 6 months.·RESULTS:The pterygium recurred in 1 case.Other cases had the stable ocular surface and no new vessels formation.·CONCLUSION:The recurrent pterygium excision with limbal stem cell transplantation combined with mitomycin C is very effective.

Clinical efficacy of three methods for eyelid xanthelasma

Yu-Hong Chen,Chu-Xian Chen and Hao Lin

AIM:To evaluate the clinical efficacy and safety of three methods for eyelid xanthelasma.·METHODS:Totally 66 cases 132 eyes of eyelid xanthelasma were equally divided into 3 groups by different treatment methods:group A (n=22) was treated with heparin sodium; group B (n=22) was treated with conventional surgery; group C (n=22) was treated with comprehensive therapy (invasive drug and lipid-lowering).·RESULTS:The total effective rate was significantly better in group C than that in group A and group B. There was no significant difference in adverse effect among the three groups.·CONCLUSION:The comprehensive therapy including invasive drugs and oral lipid-lowering drugs is a safe and effective,convenient and low recurrence rate method for eyelid xanthelasma,which is worth promoting.

Clinical analysis of the fundus changes of 350 cases with pregnancy induced hypertension syndrome

Bin-Jiang Luo,Xiao-Dong Liu,Lan Liu,Sui-Mei Zheng and Yong-Hong Wang

AIM:To investigate the relationship among blood pressure,proteinuria,edema and fundus changes of the patients with pregnancy hypertension syndrome(PIHS).·METHODS:We carried a retrospective analysis of the relationship among blood pressure,proteinuria,edema and fundus changes.The fundus was examined by the direct ophthalmoscope.·RESULTS:Fundus was normal in 112 patients (32.0% )and retinopathy was in 238 patients(68.0%).In the four degrees of PIHS patieints (gestational hypertension group,slight pre-eclampsia group,severe pre-eclampsia group and eclampsia group),the incident rates of fundus changes were 52.5%,60.0%,70.3% and 100% respectively,and there was great significant difference among four groups.·CONCLUSION:Fundus change is related to the elevation of blood pressure.Fundus changes are more serious,incidence of proteinuria and edema become more higher.So fundus change is an important sign to reflect lesion of organs.

Contrast study of drug therapy for dry eye

Hong-Yan Du,Lan-Gen Li,Peng-Cheng Du,Zhi-Min Qian and Zhong-Ying Wang

AIM:To evaluate the effects of basic fibroblast growth factor(bFGF) combined with nature tears II in the treatment of dry eye. ·METHODS:Totally 134 patients with dry eye were randomly divided into experiment group(69 eyes) treated by basic fibroblast growth factor combined with nature tears II and control group(65 eyes)treated by nature tears II with four times every day. The Schimer Ⅰ test(SⅠt),tear film break up time(BUT)were compared with before and one month later in both groups. The results were analysed statistically. ·RESULTS:There were significant difference in SⅠt and BUT one month after treatment in both groups (P<0.01) whereas no difference before the treatment(P>0.05).There were significant difference in SⅠt and BUT in experiment group before and one month later (P<0.01).·CONCLUSION:bFGF combined with nature tears II is an effective method for dry eye.

Change of corneal astigmatism induced by manual small incision cataract surgery

Lei Zhang,Ming-Zhen Bei and Xiao-Bin Cao

AIM:To study the change of corneal astigmatism induced by a superior incision in manual small incision cataract surgery (MSICS). ·METHODS:Totally 57 patients 86 eyes were randomly divided into two groups depending on preexisting astigmatism. 42 eyes in group A underwent MSICS and 44 eyes in group B underwent phacoemulsification(Phaco). The surgically induced astigmatism(SIA) were measured by corneal topography preoperatively and 1 month,3 months postoperatively. ·RESULTS:The mean SIA was higher in the MSICS group than that in the Phaco group 1 month after surgery and there were statistical differences between these two groups(P<0.05). The mean SIA was still a little higher in the MSICS group than that in the Phaco group 3 months after surgery but the differences were not statistically significant (P>0.05). ·CONCLUSION:The MSICS induced a slightly higher degree of SIA than Phaco,however there is no significant difference in the mean SIA at postoperative month 3. Both groups tend to stabilization of refraction 3 months after surgery.

Clinical analysis of comprehensive treatment for children’s anisometropic amblyopia

Fen Peng and Wan-Hong Liu

AIM:To evaluate the clinical curative effect of compreherisive treatment for children’s anisometropic amblyopia.·METHODS:Totally 48 children of anisometropic amblyopia from January 2005 to January 2010 were included in this study. The patients were randomly divided into two groups. The experimental group had 24 cases,which were treated with compreherisive therapy. The control group had 24 cases,which were treated with correction of refractive errors and occlusion therapy. The recovery of the vision and the stereoscopic vision were observed.·RESULTS:The curative effect were compared between the experimental group and the control group,and the difference had statistical significance(P=0.007);compared with the control group,the effect aprearance time was significant reduced in the experimental group (P=0.005);the recovery situation of the stereoscopic vision was compared between these both groups,and the difference had statistical significance(P=0.022).·CONCLUSION:The clinical curative effect of comprehensive treatment on anisometropic amblyopia of children is affirmative,and the curative effect appearance is short with better recovery of the stereoscopic vision.

The role of binocular single vision training in consolidating treatment of amblyopia

Xiu-Juan Zhang,Ji-Wen Yang,Yi Wang and Yun Chen

AIM:To evaluate the role of binocular single vision training in consolidating treatment of amblyopia. ·METHODS:The children with refractive amblyopia were collected in Optical Center of Shenyang Aier Hospital. All the patients were cured by the combined therapy and they entered a consolidation of basic stage for amblyopia. The children of amblyopia were randomly divided into 2 groups:50 children received conventional consolidation treatment of amblyopia (control group); the treatment group underwent conventional treatment combined with the consolidation of binocular vision training (including simultaneous perception,fusion,three-dimensional function) (n=50). The following up time was three-year in all children.·RESULTS:Nine children in the control group showed reduced visual acuity,the other 41 children had stable vision.The children in the treatment group had stable vision without regression.·CONCLUSION:Binocular single vision training plays an important role in the consolidating treatment of amblyopia.

Autos lamellar corneal translocation for treatment of bullous keratopathy

Yan Ju,Xiao-Wei Gao,Bao-Jiang Li,Bing Ren,Yu-Kun Hu,Rui-Fu Wang and Xiu-Xiang Ji

·AIM:To evaluate the clinical efficiency of autos lamellar corneal translocation in treating bullous keratopathy(BK).·METHODS:A total of 15 cases(15 eyes),including 8 cases after cataract surgery,4 cases after cataract surgery followed with glaucoma surgery,3 cases after glaucoma surgery complicated with cararact,were treated by autos lamellar corneal translocation.·RESULTS:After operation,all the patients were relieved from the distress of irration and corneal epithelium was integrity;After following up for 3 to 24 months,there was no recurrence of bullous keratopathy and complications.·CONCLUSION:Autos lamellar corneal translocation is an effective method to relieve clinical symptoms of bullous keratopathy,especically for those with poor visual function.·

Clinical analysis of cutting thickness on TOSCA treatment of complex refractive errors

Xue-Yan Liu,Shi-Yang Li,Ai-Hong Zhao,Hong-Li Ma and Xiao-Nan Jiang

·AIM:To analyze cutting thickness on TOSCA treatment of complex refractive errors.·METHODS:Totally 42 eyes 23 patients who received TOSCA were selected in our hospital,they were complex refractive errors.The spherical equivalent degree was-2.50--13.50D with an average of-7.51±2.23D.Then the cutting thickness in TOSCA and LASIK/LASEK mode was compared.·RESULTS:The preoperative average UCVA was 0.11±0.19 and BCVA was 0.98±0.16,and at 6 months postoperatively the average UCVA was 1.03±0.30,it was significantly improved and statisticaly different compared with the preoperative UCVA(P<0.05),and it was not significantly different compared with the preoperative BSCVA(P>0.05).The preoperative average spherical equivalent was-7.51±2.23D,and at 6 months postoperatively the average spherical equivalent was-0.42± 0.67D,controlled within±0.50D to achieve the purpose of correction of myopia.The preoperative average cutting thickness and the remaining thickness respectively were 92.43±21.28μm and 409.17±25.47μm in TOSCA mode,and 123.26±28.73μm,378.69±32.65μm in LASIK/LASEK,it was statistically different(P<0.05).·CONCLUSION:TOSCA can save corneal thickness significantly on treatment of complex refractive compared with LASIK,and improve the safety of operation theoretically.·

Two-hand micro-incision phacoemulsification and intraocular lens implantation for age-related cataract

Ling-Fei Huang,Li-Sha Xia,Fang-Qiong Liu and Wei Chi

·AIM:To observe the clinical effectiveness of two-hand phacoemulsification cataract surgery for age-related cataract.·METHODS:Totally 42 patients 42 eyes with age-related cataract underwent two-hand phacoemulsification cataract surgery using the Legacy 20000(Alcon Inc.U.S.)by the same surgeon.Vision before and after surgery,intraocular pressure(IOP),corneal astigmatism and the change of corneal endothelial cell,and postoperative complications were observed.·RESULTS:The best-corrected visual acuity was 0.67±0.11,0.81±0.14,0.83±0.12 in postoperative day 1,week 1,month 3,respectively,and they were significantly increased compared with baseline(P<0.01);The average IOP were 12.44±4.70mmHg,13.56±3.20mmHg,12.90±2.00mmHg in postoperative day 1,week 1,month 3,and there were no statistical differences compared with preoperative(P>0.05);The average corneal astigmatism were 1.23±0.62D,0.97±0.53D,(P<0.01,P<0.05)in postoperative day 1 and week 1 and they were significantly increased compared with baseline(P<0.01),whereas there were no statistically differences in postoperative month 3(0.65±0.47D,P=0.24).In postoperative month 3 corneal endothelial density was 2235.06±418.43/mm2,and the loss rate of corneal endothelial cell was(11.90±7.32)%.All patients were without serious complications postoperatively.·CONCLUSION:Two-hand micro-incision for age-related cataract is a safe and effective method.·

Effect of phacoemulification on unique eye cataract

Li-Lian Xie,Jun-Dong Zhu and Zheng Li

·AIM:To investigate the effect of phacoemulification on unique eye cataract.·METHODS:Forty-four patients with unique eye cataract underwent phacoemulsification.The preoperative visual acuity(VA)and postoperative VA were recorded.Intraoperative and postoperative complications were observed.Following up time was form 3 to 12 months.·RESULTS:Postoperative VA raised at different degrees:corrected VA<0.1 in 2 eye(4.5%),0.1-0.25 in 8 eyes(18.2%),0.3-0.5 in 18 eyes(40.9%)and 0.6-1.0 in 16 eyes(36.4%).The best-corrected VA better than 0.3 accounted for 77.3%,and the rate of VA larger than 0.05 was 95.5%.After operation,corneal endothelial edema were in 5 eyes(11.4%),and after cataract in 2 eyes(4.5%)·CONCLUSION:Eye condition of unique eye cataract patients is changeable.Individual operation plan should be settled according to specific circumstance.Phacoemulsification and intraocular lens implantation is safe and effective for unique eye cataract.·

Health economic evaluation of the small incision phacoemulsification cataract surgery by the clinical pathway in the primary hospital

Shu-Juan Wu and Zhi-Cheng Zeng

·AIM:To evaluate the surgical results and indicators of health economics(including length of stay,hospital costs)in patients with small incision phacoemulsification cataract surgery by clinical pathway,and to develop the system management and methods of cataract surgery project for primary hospital.·METHODS:The clinical pathway table of of senile cataract were developed and implemented,after that,96 patients with senile cataract were randomly divided into two groups:without small incision phacoemulsification cataract surgery(group A)and with phacoemulsification than surgery(group B),and the vision,complications,hospitalization days and total cost in the postoperative day 1 of the both groups were observed.·RESULTS:Both groups were significantly improved in visual acuity in the postoperative day 1(P <0.01),but there were no significant differences(P> 0.05)compared both groups;group A had the lower incidence of corneal edema than B group,the difference was statistically significant(P <0.05),but there were no significant difference in the incidence of complications and hospitalization days(P> 0.05);but,the average cost of hospitalization of the A group was lower than that of B group(P <0.01).·CONCLUSION:The small incision phacoemulsification cataract surgery by the clinical pathway have the better visual acuity,fewer complications,shorter hospitalization days,fewer financial burden,and in line with the fundamental purpose of health economics,which is worth promoting in the primary hospital.·

Application of DEG,CPF and FFA in diagnosing diabetic macular edema

Qiao-Sheng Yang,De-Yan Rong,Liu-Song Tang,Shi-Ping Xu and Xiao-Sheng Huang

·AIM:To discuss the applied value of the methods of the direct examination of the glass(DEG),the colored photograph of the fundus(CPF)and the fundus fluorescein angiography(FFA)in diagnosing the diabetic macular edema(DME).·METHODS:After distributing pupils,50 cases 100 eyes were checked with the methods of DEG,CPF and FFA.FFA was taken as the golden standard,and the results of DEG and CPF were compared with that of FFA.·RESULTS:Totally 45 eyes(45%)of 100 eyes(50 cases)were found with DME by FFA.However,10 eyes(10%)were found by DEG and 35 eyes(35%)found by CPF.The result of DEG was quite different from that of FFA(kappa=0.239,P=0.00),while the result of CPF was similar to that of FFA(kappa=0.794,P=0.00)and had significantly statistical difference.·CONCLUSION:These three methods can be used in diagnosing diabetic macular edema in some extent.CPF and FFA have the higher similarity.Therefore,the method of CPF is more suitable for those hospitals without FFA examination.·

Clinical observation of intravitreous injections of Bevacizumab (Avastin) for exudative age-related macular degeneration

Hao Hong and Qing-Huai Liu

·AIM:To evaluate the safety and efficacy of the exudative age-related macular degeneration(ARMD)treated with intravitreal injections of bevacizumab(avastin).·METHODS:Totally 22 patients(22 eyes)with exudative ARMD were treated with intravitreal injections of bevacizumab(1.25mg),and reinjected at 6-week intervals.The patients who had macular edema or leakage(according to the results of the examination on the 12th week)were given another injection.After 6-month-follow-up,the changes of the average visual acuity and central macular thickness(CMT)were analyzed through the results of the optical coherence tomography(OCT)(1st week,1st month,3rd month and 6th month after the operation)and fundus fluorescence angiography(FFA)(3rd month and 6th month after the operation).·RESULTS:After 6-month-follow-up,the average visual acuity was improved,the average CMT was reduced by 92.59μm,and both data were significant to the treatment efficacy,macular edema and leakage were disappeared or obviously alleviated through FFA.No other adverse effects were observed except four cases of subconjunctival hemorrhage.·CONCLUSION:Intravitreal injections of bevacizumab can improve the visual acuity of exudative ARMD patients and alleviate macular edema.Repeating injection can improve the efficacy and reduce the rate of recurrence.Long-term efficacy and safety of this treatment need to be evaluated with more cases and further follow-up.·

Clinical observation of treating retinal holes with 532nm frequency-doubled laser

Hai Tao Jiang,Xue Wang and Yue Tao

·AIM:To evaluate the effect of 532nm frequency-doubled laser in treating retinal holes.·METHODS:Totally 52 patients 62 eyes with retinal holes were treated with 532nm frequency-doubled laser.Whether retinal holes be sealed were observed.·RESULTS:After 6-24 months,50 patients 60 eyes with retinal holes were sealed(96%),2 patients 2 eyes occurred retinal detached and were treated with cryoretinopexy and sclera buckling.·CONCLUSION:Sealing retinal holes with 532nm frequency-doubled laser is an effective,safe,convenient and economical way.·

Laser treatment for retinal degeneration of the contralateral eye after retinal detachment operation

Ya-Ling Han,Ming-Yu Liu and Xiao-Kun Hu

·AIM:To evaluate the effect of the preventive retinal laser photocoagulation on the following eye in patients with peripheral retinal degeneration or associated with dry holes after retinal detachment operation.·METHODS:Patients who met the above conditions were evaluated for the presence of vitreoretinal changes using Goldman three-mirror contact len or indirect ophthalmoscopy.192 cases in contralateral eyes with peripheral retinal degeneration(lattice degeneration,snail track degeneration,cystic degeneration,etc.)or associated with dry holes received the preventive retinal laser photocoagulation.·RESULTS:The areas of peripheral retinal degeneration or dry holes in the following eyes of 192 patients who received the preventive retinal laser photocoagulation were closed well,and the pigment spots were sharp.All cases who had been treated by laser photocoagulation were followed up for 6-18 months.No retinal detachment was found.·CONCLUSION:The preventive retinal laser photocoagulation on peripheral retinal degeneration or associated with dry holes is effective to prevent the occurrence of retinal detachment.·

The inferior orbital wall fracture prothesis by three-dimensional computer guide

Fei Long,Xiao-Feng Zhang,Li-Ping Wang and Xiao-Ming Yu

·AIM:To investigate the surgical method of inferior orbital wall fracture by three-dimensional CT image,and to reproduct the virtual anatomical structure,design and pre-operative surgical simulation by computer imaging technology and data for orbital wall reconstruction.·METHODS:After sieving,computer navigation and three-dimensional reconstruction,the diagnosis and surgical planning in 30 patients with orbital wall fracture were analyzed.·RESULTS:By the computer navigation,all patients of inferior orbital wall fracture had a satisfactory operative outcome.·CONCLUSION:The inferior orbital wall fracture prothesis with the three-dimensional reconstruction by computer navigation have good effects.·

Epi-LASIK without flap for correction of high myopia

Yue Yang,Hua Liu and Hai-Bin Li

·AIM:To investigate the clinical effect of epipolis laser in situ keratomileusis(Epi-LASIK)without flap by mechanical method for correction of high myopia.·METHODS:Totally 86 patients 169 eyes with high myopia were performed Epi-LASIK without flap.Patients were followed up for 6 months.Postoperative irritation,corneal epithelial healing time,visual acuity,refraction,degree of corneal haze were observed.·RESULTS:All patients presented only with a mild to moderate foreign body sensation,photophobia,tearing.Corneal epithelial healing time was 3-4 days.After 6 months,postoperative spherical equivalent in all patients were within 1.00D,and no decline in best-corrected visual acuity,Best-corrected visual acuity improved 1 line or more in 23 eyes(13.6%).Corneal haze grade 0 in 142 eyes(84.0%),corneal haze 0.5 in 27 eyes(16.0%)1 month after surgery;after 3 months,corneal haze grade 3 in 2 cases 4 eyes with unknown causes;6 months after surgery,all corneal haze present 0.·CONCLUSION:Epi-LASIK flap for high myopia is a safe and effective method,with good predictability and stability.The further study should continue on the unexplained postoperative haze of individual patients.·

Ameliorate visual fatigue by fusion function training after LASIK surgery

Ling-Fang Du,Zheng-Qing Wu,Fang He,Guo-Qiao Li and Juan Li

·AIM:To analyze the relationship between visual fatigue and range of fusion after laser in situ keratomileusis(LASIK)in myopia patients,and with fusion function training by synoptophore to improve visual fatigue after LASIK surgery.·METHODS:Totally 60 myopia cases 120 eyes,whose diopters were from-1.50D to-8.00D,were determined the fusion range by synoptophore and visual fatigue questionnaire survey was conducted before LASIK.After LASIK patients were divided randomly into two groups:Group A with 30 days fusion function training by synoptophore;group B with out fusion function training,respectively,after 1 week and 1 month the fusion range was determined and visual fatigue questionnaire survey was conducted,statistical analysis was performed.·RESULTS:Group A and group B were with reduced scopes of fusion range postoperatively,which were statistically significant.1 week after operation,the scopes of fusion range in the two groups were 18.58±8.91 and 13.45±8.87,which were statistically significant(P < 0.05),1 month after operation,the scopes of fusion in the two groups were 20.55±7.23 and 18.12±6.10,which weren’t statistically significant.1 week postoperatively,visual fatigue of group A scored 3.92±1.65,group B scored 5.16±2.34 the difference of which was statistically significant(P<0.05),1month postoperatively,the scores were 1.28±0.96 and 1.45±0.99,the difference wasn’t statistically significant.·CONCLUSION:Decreased fusion function after LASIK surgery is an important factor of visual fatigue.Early postoperative functional training of fusion can effectively improve visual fatigue symptoms.·

Clinical effects of Augentropfen Stulln Mono eye-drops for asthenopia after laser in situ keratomileusis

Fang He,Wei-Qiong Song,Guo-Qiao Li,Zheng-Wu Peng and Shi-Lu Yin

·AIM:To observe the clinical effects of Augentropfen Stulln Mono eye-drops for asthenopia after laser in situ keratomileusis(LASIK).·METHODS:Totally 200 patients 400 eyes with earlier period asthenopia after LASIK were divided into treatment and control groups,in addition to conventional postoperative medication:the treatment group were added with Augentropfen Stulln Mono eye-drops(n=100),the control groups were added with Celluvisc eye-drops(n=100).On postoperative week 1,2,4,signs and symptoms of asthenopia were evaluated and drug adverse reaction were observed.·RESULTS:Asthenopia of all the patients were released gradually with the extension of operative time.One week and two weeks after surgery,the treatment groups’ asthenopia score was lower than the control groups’,and there were significant differences(P<0.05);four week after surgery the asthenopia score of two groups were 1.06±0.65 and 1.21±0.83,the difference was not significant(P>0.05).·CONCLUSION:Augentropfen Stulln Mono eye-drops are effective and safe for earlier period asthenopia after LASIK.·

Clinical observation of lamellar corneal cauterization for bullous keratopathy

Ya-Qiong Chen and Yuan Yuan

AIM:To study the clinical effects of lamellar corneal cauterization in treating bullous keratopathy(BK). METHODS:Totally 20 cases with BK were analyzed, including 15 cases after cataract extraction and intraocular lens implantation,5 cases after vitreous resection,the average age was 72.5 years.Visual acuity with 0.02-0.04 were in 9 cases,counting fingers in 5 cases,light perception in 3 cases and hand motions in 3 cases.All patients were treated by lamellar corneal cauterization. RESULTS:Eye symptoms disappeared in all cases and visual acuity was not obviously different before and after operation. CONCLUSION:Treating BK by lamellar corneal cauterization can effectively alleviate the symptom and prevent recurrence.

Cause and management for dislocation of nucleus in phacoemulsification

Jie-Mei Liu and Liang Zhang

AIM:To discover the cause of dislocation of nucleus into vitreous vacuum in phacoemulsification and proper management for these conditions. METHODS:Totally 7526 cases with dislocation of nucleus in phacoemulsification were reviewed in 5 years. RESULTS:Seven patients had severe dislocation of nucleus.2 cases suffered pars plana vitreoctomy(PPV) and 5 cases had mature or over mature cataract.When dislocation happened,3 patients was immediately performed PPV combined with intraocular lens(IOL) implantation,1 patient was implanted PMMA IOL without taking out of nucleus,1 patient suffered retinal detachment after 2 weeks,and 2 patients could not be further proceed for poor condition. CONCLUSION:The vitreous state(high fluidity) is the most common cause for dislocation of nucleus in phacoemulsification.PPV is a proper method for these patients.

Phacoemulsification technique for cataracts in eyes with posterior capsule defect

Feng Fan,Shao-Xin Pan,Xiao-Hong Wang and Jing Tian

AIM:To investigate the safety and outcome of phacoemulsification and extracapsular cataract extraction (ECCE) technique for cataracts extraction in eyes with posterior capsule defect. METHODS:Totally 33 cataract cases(40 eyes) with posterior capsule defect were analyzed retrospectively. ECCE was performed in 12 eyes and phacoemulsification in 28 eyes. RESULTS:Posterior capsular rupture and vitreous prolapse:3 eyes(25%)in ECCE group and 3 eyes(11%)in phaco group(P<0.05).Postoperative visual acuities improved more than two lines:83%in ECCE group and 93%in Phaco group(P<0.05). CONCLUSION:Phacoemulsification technique is safe and has a better outcome than ECCE for cataracts in eyes with posterior polar cataract.Keeping a stable anterior chamber,no water separation and correct handling of the posterior pole cortex and posterior capsule are the key factors for successful operation during this phaco technique.

Clinical effect of cool phacoemulsification combined with vitrectomy for cataract and the oculi posterior segment lesions

AIM:To explore the clinical effect of cool phacoemulsification combined with vitrectomy for cataract and the oculi posterior segment lesions. METHODS:Totally 98 patients 108 eyes with cataract and oculi posterior segment lesions underwent the cool phacoemulsification combined with vitrectomy.The visual acuity,the rate of intraocular lens implantation and surgical complications were observed. RESULTS:On postoperative week 1 and months 3,the visual acuity of most of the patients were improved in varying degrees;there were some complications including secondary glaucoma,after-cataract,uveitis,secondary vitreous hemorrhage,secondary retinal detachment and so on. CONCLUSION:It is an effective therapeutic tool to treat cataract and the oculi posterior segment lesions by cool phacoemulsification combined with vitrectomy,which is worth promoting;And can replace sonicate technology for lens extraction.

Effect of angle surgery in children with aphakic glaucoma

Jing-Ni Yu and Jian-Hui Xiao

AIM:To investigate the outcome of trabeculotomy and/ or goniotomy for pediatric aphakic glaucoma. METHODS:Retrospective chart review of consecutive children who had congenital cataract surgery between 1997 and 2010 and required goniotomy and/or trabeculotomy for aphakic glaucoma.Treatment success was defined as postoperative intraocular pressure≤24mmHg despite topical medication use,avoidance of trabeculectomy or shunt placement,and no visually significant complications in the follow-up period. Exclusion criteria included a diagnosis of anterior segment dysgenesis,microcornea,and glaucoma at the time of cataract surgery,and follow-up less than 1 year. RESULTS:Totally 10 patients 12 eyes met inclusion criteria.Of theses,2 eyes had goniotomy alone,2 eyes had goniotomy followed by trabeculotomy,and 8 eyes had trabeculotomy alone.Mean IOP before angle surgery was 35±10mmHg.Mean IOP at the last recorded visit was 22±4mmHg(P=0.0005).Treatment success was observed in 7 of the 12 eyes(58%):5 eyes(42%) were successful after a single angle surgery,each involving an initial trabeculotomy;2 eyes(17%) underwent subsequent shunt placement after initial goniotomy at 6 months and 1.3 years after the last angle surgery. CONCLUSION:When intraocular surgery is indicated to control IOP in pediatric aphakic glaucoma,trabeculotomy and/or goniotomy can be successful in the majority of eyes and may decrease the need for filtering and shunting procedures.

Transscleral cyclodiode laser photocoagulation in the treatment of ciliary block glaucoma

Guo-Fan Cao and Qin Jiang

AIM:To investigate the effect,safety and postoperation complications in the treatment of ciliary block glaucoma by transscleral cyclodiode laser photocoagulation. METHODS:It is a prospective study.Seven patients diagnosed ciliary block g’aucoma were given maximal dose anti-glaucoma medicines.But their intraocular pressure were still more than 30mmHg.Then they were treated by transscleral cyclodiode laser photocoagulation. RESULTS:Intraocular pressure and best-corrected visual acuity were compared between preoperation and postoperation after 1 intervention week Mean±SD intraocular pressure was reduced from 33.63±4.50mmHg pre-operatively to 15.88±3.21mmHg post-operatively; Mean±SD best-corrected visual acuity was increased from 0.16±0.11 preoperatively to 0.42±0.20 postoperatively. These two indexes were significantly different. All the patients’ anterior chamber were formed during 36 hours and one patient who had a small hyphema healed well. CONCLUSION:Transscleral cyclodiode laser photocoagulation appears to be an effective and safe treatment for ciliary block glaucoma.

Clinical effect of intravitreal triamcinolone acetonide combined with laser photocoagulation on macular edema with retinal vein occlusion

Yin-Bo Fan,Yun Xiao,Lan Qu,Xiao-Wei Gao and Yan Zhang

AIM:To determine the efficacy and safety of intravitreal triamcinolone acetonide(TA) combined with laser photocoagulation in macular edema caused by retinal vein occlusion. METHODS:Thirty-eight macular edema eyes of 38 patients with retinal vein occlusion were diagnosed by ophthalmoscopy,FFA and OCT.All patients received an intravitreal injection of 4mg of TA(0.1mL) and photocoagulation after 1-2 month(s).The changes of vision,ocular tension,ocular fundus and retinal thickness were observed for 3-9months. RESULTS:Visual acuity was improved in 36 eyes, remained stable in 2 eyes.Visual acuity less than 0.1 were in 3 eyes,0.1-0.3 in 11 eyes,0.3-0.5 in 17 eyes,more than 0.5 in 7eyes.Ocular tension increased in 4 cases in different extent and put back in 2-5 months after given ocular hypotensive agents.No one occurred retinal toxic reaction. CONCLUSION:Intravitreal TA combined with laser photocoagulation is an efficient and safe treatment in macular edema caused by retinal vein occlusion,it can improve the visual acuity remarkablely.

Clinical study on the treatment of old retinal detachment by scleral buckling procedure

Zhi Zhang and Li-Bo Ma

AIM:To observe the therapeutic effect of scleral buckling procedure for old retinal detachment. METHODS:Totally 12 patients 12 eyes with old retinal detachment preoperatively were under slit-lamp,using three mirrors to locate the retinal breaks,performed scleral buckling under the microscope.According to the preoperative position of the breaks pre-scleral suture was set,viscous subretinal fluid was drained,retinal breaks closed by croytherapy,silicone implanted under prescleral suture,and some patients combined with encircling band,ligated scleral suture to fixation.Patients were followed up to observe the retinal reattachment. RESULTS:The initial surgical retinal reattachment rate was 100%in all patients. CONCLUSION:Reattachment of retina can be achieved in some patients with old retinal detachment who undergo simple scleral buckling procedure.

Analysis of treatment on non-proliferative diabetic retinopathy

Shan-Shuang Du,Qiong Duan,Zhong-Qiao Zhu and Bei Liu

AIM:To investigate the result of the local retinal photocoagulation in combination with phamacological treatment for patients with non-proliferative diabetic retinopathy(NPDR). METHODS:Partial photocoagulation with 532 semiconductor green laser has been used on patients with stageⅢdiabetic retinopathy(DR),combined with the administation of drugs to control blood glucose,blood pressure,blood lipid and hemorheology. RESULTS:Among 185 treated eyes,visual acuity of 168 eyes(90.8%) was improved and stabilized after treatment, decreased visual acuity and complications happened in 17 eyes(9.2%),there was significant difference between the pre-treatment and post treatment. CONCLUSION:Local retinal photocoagulation combined with drug treatment for patients with NPDR are safe and effective.

Clinical observation of laser photocoagulation before laser in situ keratomileusis on the retinal degeneration

Yong Gu and Qiu-Xu Wang

AIM:To study the necessity of laser photocoagulation before laser in situ keratomileusis(LASIK) on the retinal degeneration. METHODS:Totally 49 eyes(49/1631) showed serious peripheral fundus degeneration after routine preoperative examination of 831 cases.Retinal tears were found in 17 eyes,lattice retinal degeneration in 15 eyes and cystoid retinal degeneration in 26 eyes.All of them have been treated with laser photocoagulation by 532nm solid laser. RESULTS:One month after laser photocoagulation, LASIK surgery was performed in laser region which has good pigmentation.There were no complications of retinal detachment during the follow-up period of 3-36 months. CONCLUSION:Detailed examination of fundus before LASIK is necessary.The preventative laser photocoagulation in serious peripheral fundus degeneration is safe and effective.

Clinical study on the effect of two surgery methods for pterygium on corneal curvature

Zhen-Liang Wang,Shi-Ming Wang and Yu-Jing Shi

AIM:To study the changes of corneal curvature after simple pterygium excision and pterygium excision with limbal stem cell transplantation. METHODS:Totally 38 patients 54 eyes with pterygium were selected.They were divided into 2 groups in random:simple pterygium excision was performed in group A(16 cases and 21 eyes),pterygium excision with limbal stem cell transplantation was performed in group B (22 cases and 33 eyes).The results of visual acuity, astigmatism and corneal curvature were tested between pre-surgery and post-surgery 10 day,pre-surgery and post-surgery 1 month,post-surgery 10 day and post- surgery 1 month in both groups. RESULTS:Naked visual acuity of post-surgery was better than that of pre-surgery.Corneal horizontal curvature on post-surgery was better than that of presurgery. Corneal vertical curvature;In group A,the corneal vertical curvature of post-surgery was higher than that of pre-surgery(P<0.05).In group B,the vertical curvature on post-surgery 10 day had no statistical difference than that of pre-surgery(P>0.05),on post-surgery 1 month which was higher than that of presurgery and post-surgery 10 days(P<0.05).Corneal mean curvature on post-surgery was better than that of pre-surgery.Astigmatism:the with-the-rule keratic astigmatism on post-surgery 10 day and on post-surgery 1 month was less than that of pre-surgery. CONCLUSION:The corneal horizontal curvature in the surgeries for pterygium can be ascended which can reduce pterygium induced refractive astigmatism.In short time after surgery,the effect of simple pterygium excision is similar to the effect of pterygium excision with limbal stem cell transplantation on corneal curvature.

Curative effect of multimodality treatment for the recurrent pterygium

Lan Liu,Xiao-Jun Cai,Hai-Tao Wang,Yin-Wei Song,Yun-Hua Wang and Yang Liu

AIM:To observe the recurrence rate and complications of amniotic membrane transplantation combined with subconjunctival injection of pingyangmycin hydrochloride in treating the recurrent pterygium. METHODS:Between 2008 and 2010,80 cases(105 eyes)of recurrent pterygium were treated with pterygium excision combined with amnion membrane transplantation and pingyangmycin hydrochloride injection.Mitomycin was used during the surgery and eye drops of rb-FGF after surgery. RESULTS:All cases were followed up for 6-18 months, pterygium recurrence occurred in 2 eyes.The recurrence rate was 1.9%.Uncomfortable symptoms such as dry,red and foreign body sensation were in 4 eyes,and no corneal and sclera resolving occurrrence in any eye. CONCLUSION:The surgical method of pterygium excision combined with amniotic membrane transplantation and pingyangmycin hydrochloride injection can obviously decrease the recurrence rate of recurrent pterygium.

Surgery therapy for prolapse of the lacrimal gland

Gui-Qin Yu,De-Fen Yang and Yan Li

AIM:To observe the clinical effect of reposition for prolapse of the lacrimal gland. METHODS:After diagnosing prolapse of the lacrimal gland,we made designs for skin incision before local anesthesia,marked the boundaries of the skin to be removed,then ablated the internal organization,fixed prolapsed lacrimal gland,and sutured double eyelid intactly. RESULTS:Among all the 33 cases,lacrimal gland was partially removed in 10 cases,and the lacrimal gland secretion in these cases was normal preoperatively,and slightly decreased after operation.Lacrimal gland was excised alone in 6 cases,without other treatment,bags under the eyes in those cases was not corrected satisfactorily.For the remaining patients,we made skin incision,removed the excessive skin and subcutaneous tissue,relocated the lacrimal gland,reduced the orbital septum,and the appearance was satisfying. CONCLUSION:The surgical anatomy can both restore the anatomical location and neurologic recovery of the lacrimal gland,and also improve the appearance of the bags under the eyes.

Cost-effectiveness analysis of laser plastic operation of lacrimal duct combined with inversely planting silicone tube end for lacrimal duct obstruction

Nan Chen,Lin Zhang,Chen Luo and Shen-Zhi Liu

AIM:To evaluate the economic practicality of laser plastic operation of lacrimal duct combined with inversely planting silicone tube end treating lacrimal duct obstruction. METHODS:The patients of lacrimal duct obstruction were treated with traditional external dacryocystorhinostomy and laser plastic operation of lacrimal duct combined with inversely planting silicone tube end.The resluts were evaluated with the cost-effectiveness analysis of clinical economics. RESULTS:There was no significant difference between the effect of the 2 groups(P>0.05).The cost-effectiveness ratio of laser plastic operation of lacrimal duct combined with inversely planting silicone tube end is better,which is a better treatment. CONCLUSION:Laser plastic operation of lacrimal duct combined with inversely planting silicone tube end is an operative method which should be promoted.

Research of early diagnosis and treatment on Vogt-Koyanagi-Harada syndrome

Lei Qin,Ping Zeng,Jun Liu and Xun-Qing Gu

AIM:To analyse the problems in the early diagnosis and treatment of clinical cases with Vogt-Koyanagi-Harada (VKH) syndrome. METHODS:Twenty-five cases 50 eyes with VKH syndrome were collected and analysed,routine examination of FFA and OCT were performed,its reason and differential diagnosis method were analyzed,most of them were diagnosed correctly,some of them were diagnosed as central serous chorioretinopathy(4 cases),glaucoma(2 cases),optic neurve-retinitis(5 cases).All the cases were given high dose corticosteroise treatment,and examined with OCT after two weeks. RESULTS:After one week,all the patients’ visions recovered to better than 0.5 in 78%of eyes. CONCLUSION:FFA and OCT are the useful methods on early differential diagnosis of the VKH syndrome.Early correct diagnosis for VKH syndrome and high dose corticosteroise treatment are the important factors for the better prognosis.

Implantation of iris-claw anterior chamber intraocular lens for the correction of high myopia

Gang Chen,Xiao-Hua Zhao and Yu-Ran Wang

AIM:To evaluate the efficiency,security after implantation of iris-clawed anterior chamber intraocular lens(IOL) for the correction of high myopia. METHODS:Iris-clawed anterior chamber IOL were implanted for seven cases of patients with high myopia (13 eyes).After the following up for 12 months,visual acuity,intraocular pressure,corneal endothelial cells counting,the activity of the pupil,the position of IOL and complications were observed. RESULTS:The implantation was successfully performed in all of 13 eyes.After the following up for 7 days,the postoperative uncorrected visual acuity of 10 eyes(77%) was better than the preoperative best-corrected visual acuity.After the following up for 12 months,postoperative average uncorrected visual acuity(0.6±0.2) was better than the preoperative average best-corrected visual acuity (0.4±0.1),there was significant difference between preand post-operation(P<0.05).There was no significant difference between preoperative and postoperative corneal endothelial cells counting,intraocular pressure (all P>0.05).The position of IOL retained center well,the react to light of the patient’s pupils was normal,and complications such as cataract and corneal endothelial decompensation was not found,but two eyes occurred corticosteroid-induced glaucoma after 3-4 weeks,and the simple eye of one case occurred retinal detachment after six months. CONCLUSION:Iris-clawed anterior chamber IOL is an effective,safe operative technique for the correction of high myopia.Follow-up study is still required for the evaluation of long-term results.

Fundus examination and therapy before LASIK operation

Yuan-Yuan Li,Dong-Mei Zhu,Xin Wang,Chun-Li Xue and Xin-Ai Ma

AIM:To investigate the therapeutic effects of preventive laser photocoagulation for myopia patients with peripheral retinal degeneration or holes before LASIK operation. METHODS:Before operation,the fundus was examined with direct and indirect ophthalmoscope and three-mirror contact lens.The 532nm laser photocoagulation was performed in order to strengthen the retina with severe peripheral degeneration. RESULTS:Peripheral fundus abnormalities and holes both increased with increased refraction diopter.The abnormalities were usually in the temporal fundus. Patients were followed up for 10 months,and no rhegmatogenous retinal detachment was found. CONCLUSION:It is necessary to know the retinopathy before operation.Preventive 532nm laser photocoagulation for moderate and high myopia patients,who were confirmed to have peripheral retinal degeneration or retinal holes before LASIK operation,is very necessary.

Influence of wearing glasses for myopia on exophoria and accommodation

Jun Luo,Li-Juan Tao,Jin-Mei Zhang,Mi Tian and Rong He

AIM:To explore the effect of wearing glasses for myopia on exophoria and accommodation of children and adolescents. METHODS:They were divided into three groups of continued wearing glasses,no wearing and interrupted wearing glasses.Exophoria was measured with heterophorometer.The AC/A ratio was measured with a synoptophore. RESULTS:The mean near exophoria of continued wearing group had significant difference with that of no wearing and interrupted wearing groups.The mean distant exophoria of three groups had no significant difference.The average value of AC/A ratio in continued wearing group has significant difference with that of no wearing and interrupted wearing groups. CONCLUSION:Myopia of adolescents and children was prone to exophoria.Exophoria myopia with continued wearing of glasses can decrease AC/A ratio and exophoria.relieve asthenopia,and reduce myopia at certain level.

Wearing RGP to treat anisometropic amblyopia

Wei Chen,Qiang Sun and Cong Zhang

AIM:To compare the clinical effects of amblyopia combined training with rigid gas permeable contact lens (RGP)and frame glasses. METHODS:A total of 106 patients(including 189 eyes) were enrolled in this study.They were randomly divided into Group A(53 cases 99 eyes) wearing RGP and group B(53 cases 90 eyes) wearing frame glasses.Then the two groups received the same combined training to treat amblyopia 1 month after wearing glasses and the conditions of sight were observed 3,6 months and 1 year after wearing glasses. RESULTS:It was safe and effective to wear RGP, without occurrence of such severe complications as acute conjunctivitis or keratitis.The recovery rate of amblyopia in group A was significantly higher than that of group B, especially in treating patients with high anisometropia. There existed significant difference in Ridit test(P<0.05).After wearing RGP for 1 month in group A,5 patients 7 eyes had the corrected vision>0.8 without amblyopia training. CONCLUSION:Wearing RGP is better than wearing frame glasses in visual quality,and is a safe and effective tool to treat anisometropic amblyopia,which is worth to generalizing.

Application of Methylrosanilinium Chloride in fungal keratitis diagnosis

Mao-Song Xie,Yong-Zheng Zheng,Yu-Lan Lin and Guo-Xing Xu

AIM:To investigate the application of Methylrosanilinium Chloride in the diagnosis of fungal keratitis.METHODS:Seventy fungal keratitis cases were collected from January 2009 to December 2010.The corneal scraping specimens were performed Methylrosanilinium Chloride staining and 100g/L KOH wet mount before microscopic observation,fungal culture and strain identification.The cultivation results were regarded as the "gold standard" of fungal keratitis diagnosis.RESULTS:The cultivation results of 58 cases were positive among 70 samples of fungal keratitis,the positive rate was 82.9%.Methylrosanilinium Chloride staining showed the positive rate was 61.4%,sensitivity 67.2%,specificity 29.6%,false positive rate 33.3%,false negative rate 32.8%,the correct index-3.1%,positive predictive value 90.7%,negative predictive value 29.6%.10% KOH wat mount showed the positive rate was 44.3%,sensitivity 44.8%,specificity 17.9%,false positive rate 41.7%,false negative rate 55.2%,the correct index-37.2%,positive predictive value 83.9%,negative predictive value 17.9%.CONCLUSION:Methylrosanilinium Chloride staining is a fast,effective way for the early diagnosis of fungal keratitis.

Contrastive study of deep lamellar keratoplasty and penetrating keratoplasty in treating keratoconus

Xiu Jiang and Jing Hong

AIM:To observe the changes of visual acuity,keratometry values and corneal endothelial cells after deep lamellar keratoplasty or penetrating keratoplasty in keratoconus patients.METHODS:The keratoconus patients who accepted operations from January 2003 to July 2009 were divided into two groups:one group accepted deep lamellar keratoplasty(27 eyes),the other group accepted penetrating keratoplasy(20 eyes).Postoperative uncorrected visual acuity,best corrected visual acuity,corneal topography changes and corneal endothelial cells were observed.RESULTS:In deep lamellar keratoplasty group,postoperatively the patients saw 4 lines more with no correction,7 lines more with best correction and there was no rejection.In penetrating keratoplasty group,postoperatively the patients saw 5 lines more with no correction,8 lines more with best correction and there were five patients had rejection.There were no difference in astigmatism degree after keratoplasty between the two groups.The speed of decline of corneal endothelial cells in deep lamellar keratoplasty group was lower than that of penetrating keratoplasty group.CONCLUSION:For unacute keratoconus,deep lamellar keratoplasty is better than penetrating keratoplasty.

Clinical effect of ciliary groove suture of posterior chamber intraocular lens in primary level hospital

Zhi-Zhuang Wei,Qiao Huang,Dong-Dong Li and Liu-Pei Wei

AIM:To assess the clinical effect of ciliary groove suture of posterior chamber intraocular lens(IOL) in primary level hospital.METHODS:From January 2001 to January 2011,68 cases(68 eyes)underwent ciliary groove suture with posterior chamber IOL,all acquired satisfying result.One edge of the lens was sutured to the ciliary groove in 7 cases(7 eyes),which was called "single-haptic fixation".The other 61 cases(61 eyes) were sutured the lens to ciliary groove in two sites,which was called "double-haptic fixation." RESULTS:Followed-up for 3-36(average 12) months,the best-corrected visual acuity(BCVA)was from 0.2 to 1.2 and 61 eyes(90%) were more than 0.3.The corneal scar and fundus oculi diseases resulted in poor vision.The intraocular pressure(IOP) in all eyes was normal.CONCLUSION:IOL suturing to the ciliary groove is an effective and safe method for correction of aphakia in eyes with inadequate posterior capsular support,the further observation is needed for long-term outcome.

Endoscope-assisted transscleral secondary sulcus fixation of sutured posterior chamber intraocular lens

Han Chen and Xiao-Guang Dong

AIM:To evaluate the surgical results of secondary sutured posterior chamber intraocular lens(IOL) assisted with endoscope for non-vitreous and aphakic eyes.METHODS:Eight cases were performed suture fixation of IOL with the assistant of endoscope,6 cases of routine patients were performed as control.The postoperative visual acuity,astigmatism,position of IOL and complications were observed.RESULTS:There were no complications with the 8 cases after the operation.And the position of IOL were all in ciliary sulcus.CONCLUSION:Endoscope could provide the direct view in the surgeries of transscleral sulcus fixation of sutured posterior chamber intraocular lens.

Different technique of manual small incision cataract surgery according to the nucleus’ hardness

Lei Zhang,Jian Zhang,Feng Shen and Zhen Li

AIM:To investigate different technique of manual small incision cataract surgery(MSICS) and its effects with soft and hard nucleus.METHODS:Totally 162 cases with 180 eyes were divided into three groups depending on the nucleus’hardness.Group A:57 eyes with gradeⅡnucleus.Group B:62 eyes with grade Ⅲ nucleus.Group C:61 eyes with grade Ⅳ-Ⅴ nucleus.They underwent MSICS with different technique respectively.RESULTS:The visual acuity after surgery and the complications between these groups had no statistically significant difference.CONCLUSION:The sugery effects and safety in MSICS can be improved if we use different technique to deal with hard and soft nucleus.

Clinical observation of small incision suture-fixation of foldable intraocular lens

Fang Huang,Hua Qi,Feng Shen and Lei Zhang

AIM:To investigate the clinical effect of small incision suture-fixation of foldable intraocular lens for aphakia correction.METHODS:Eleven cases with non-posterior capsular or disintegrated-posterior capsular eyes were included in this study.RAYNER(570C) foldable intraocular lens was selected.Main outcome measures were visual acuity and complications.RESULTS:On the first day postoperatively,the uncorrected visual acuity of 5 eyes(46%)was better than 0.5.The uncorrected visual acuity of 4 eyes(36%)was between 0.5 and 0.3.The uncorrected visual acuity of 2 eyes(18%)was 0.2.The best-corrected visual acuity were the same as or better than the preoperative at the 1-month,3-month and 6-month follow-up respectively.No complication was found in all cases.CONCLUSION:Small incision suture-fixation of foldable intraocular lens is a safe and effective way for non-posterior capsular aphakia eyes.

Clinical observation of 24 cases on suture fixation of intraocular lens implantaion in posterior chamber

Hui-Ying Chen and Qi-Hua Xu

AIM:To investigate the application of suture fixation of intraocular lens(IOL)implantion in posterior chamber in the following cases:posterior capsule broken in extracapsular cataract extration,injury cataract,lens dislocation and post eperative vitrectomy.METHODS:From April 2010 to April 2011,24 cases(24 eyes) used ciliary groove suture with posterior chamber type of intraocular lens and all cases acquired satisfied result.In 7 cases with two remaining quadrants posterior capsule due to lens posterior capsule damage,relying on the remaining posterior capsule,one side of the IOL loop was placed on it,the other side of the loop were implemented ciliary groove suture fixation,which was "one point fixation".Severe post-traumatic 17 cases without lens posterior capsule were implemented the ciliary groove suture fixation of both sides loops,which was "two-point fixation".RESULTS:Following up for 4-12 months(average 6 months),the BCVA was from 0.01 to 1.2 and 15 eyes’ vision were more than 0.6(62.5%).Poor vision was because of the corneal scar and injury fundal diseases.Transplanting the IOL secondarily made the vision better than pre-operation best-corrected visual acuity(BCVA).The intraocular pressure(IOP) in all eyes were normal and all had no complication.CONCLUSION:The method of suture fixation of intraocular lens implantion in posterior chamber is the best select to the lens with the posterior capsule broken or disappearance and large range ligaments loose.

Application of anesthesia under tenon capsule in temporal scleral small incision cataract surgery after trabeculectomy

Hong-Jie Zhang and Qing-Ming Chen

AIM:To observe the practical effect of anesthesia under tenon capsule in the temporal scleral manual small incision cataract surgery after trabeculectomy.METHODS:Twenty-nine patients(32 eyes) were treated by anesthesia under tenon capsule in the temporal scleral manual small incision cataract surgery after trabeculectomy,the anesthesia effect in operation,postoperative vision,postoperative intraocular pressure(IOP) and complications after the operation were observed.RESULTS:Twenty-nine eyes(90.6%) were complete and pain free,3 eyes(9.4%) had mild pain.All patients got improved vision and maintained functional filtering bleb effectively.In 3-12months’ follow-up after the operation,IOP were under control well.The main complications were corneal edema,anterior chamber exudates and quickly increasing IOP after operation.CONCLUSION:Using anesthesia under tenon capsule in the temporal scleral manual small incision cataract surgery after trabeculectomy is safe,effective and economic.It can improve the vision,meanwhile,maintain the functional filtering bleb.

Small incision somersault method cataract surgery under small pupil

Jian-Li Guo,Jin Cao,Guo-Xin Luo,Fang-Fang Yao and Jian-Cheng Zhang

AIM:To evaluate the curative effect of the small incision somersault method cataract surgery under small pupil and intraocular lens(IOL) implantation.METHODS:Totally 41 patients(46 eyes)with cataracts underwent the small incision somersault method cataract surgery under small pupil and IOL implantation,the clinical effect and at the same time complications were observed.RESULTS:Three days after operation the uncorrected visual acuity of 20 eyes(43%) was better than 0.5.The uncorrected visual acuity of 22 eyes(48%) was between 0.5 and 0.3.The uncorrected visual acuity of 4 eyes(9%) was lower than 0.3.No obvious complication was found in all cases.CONCLUSION:The small incision somersault method cataract surgery under small pupil and IOL implantation both are safe and worth popularizing.

Clinical analysis of operation on unique eye glaucoma in 68 cases

Jun-Dong Zhu,Li-Lian Xie,Wen-Fang Chen,Min-Wen Zhou and Zheng Li

AIM:To investigate the safety and efficacy of operation for unique eye glaucoma.METHODS:Sixty-eight cases of unique eye glaucoma were retrospectively analyzed,which underwent operation.The intraocular pressure(IOP),visual acuity,complications and surgery outcome of the groups were analyzed.The postoperative follow-up lasted for 3 to 24 months.RESULTS:The mean IOP after the operation was 14.2mmHg.No severe complications such as choroidal hemorrhage and malignant glaucoma were observed in all cases during surgery and postoperatively.The rate of flat anterior chamber was low.CONCLUSION:Eye condition of unique eye glaucoma patients is changeable.Individual operation plan should be settled according to specific circumstance.Operation used to treat unique eye glaucoma is safe and effective.

Application of paracentesis of anterior chamber in treatment of consistent high introcular pressure of acute angle-closure glaucoma

Kang-Sheng Luo

AIM:To evaluate the necessity,feasibility and effects of paracentesis of anterior chamber for acute angle-closure glaucoma with consistent high intraocular pressure(IOP).METHODS:The patients whose high IOP>40mmHg couldn’t be effectively reduced by drug treatment were randomly divided into 2 groups(group A and group B).Paracentesis of anterior chamber was performed on group A(treatment group) before operation,then performed tarbeculectomy after IOP returned to normal.And trabeculectomy was performed on group B(control group) under high IOP.The IOP,functional filter blebs,visual acuity,success rate of operation and complications of both groups were compared.RESULTS:No serious complications were found in group A.The IOP was decreased after paracentesis of anterior chamber.The eyes number and level of anterior chamber inflammation after operation in group A was slighter than that in group B(P<0.01).The rate of functional filter blebs formed,the success rate of operation,and the rate of visual recovery in group A were better than those in group B.The difference was significant(P<0.05,P<0.05,P<0.05,P<0.05).CONCLUSION:Paracentesis of anterior chamber as the auxiliary treatment of acute anger-closure glaucoma could shorten the time of reducing IOP,lessen visual function damage by high IOP,improve the success rate of operation,and reduce surgical complications.

Effect of topical NSAIDs in preventing macular edema after phacoemulsification in diabetes

Min-Chao Li,Xiao-Ran Yang,Fei Liu,Dong-Ping Shao and Yuan-Biao Li

AIM:To evaluate the efficacy of diclofenac sodium ophthalmic solution and a steroidal ophthalmic solution administered prophylactically against macular edema after phacoemulsificaition and intraocular lens implantation and to assess macular thickness changes using optical coherence tomography(OCT).METHODS:In this prospective study,patients with diabetes mellitus but without diabetic retinopathy were randomized to either the A group(n=104) or the B group(n=113).Patients in the A group received either tobramycin and dexamethasone ophthalmic suspension 4 times daily(qid) for approximately one day preoperatively and four weeks postoperatively plus diclofenac 1% qid for four weeks postoperatively.Patients in the B group received topical tobramycin and dexamethasone qid for approximately four weeks postoperatively alone.Outcome measures included macular edema incidence,central field retinal thickness as measured by OCT,and best-corrected visual acuity.RESULTS:Four eyes in A group and ten eyes in B group had clinically apparent macular edema.Based on OCT,six eyes in A group had macular edema,twelve eyes in B group.The central subfield retinal thickness values were significantly lower in the A group at four weeks than those in the B group.CONCLUSION:This study suggests that adding preoperative diclofenac sodium ophthalmic solution to postoperative topical dexamethasone significantly reduces the incidences of macular edema and suppresses increasing retinal thickening after cataract surgery in patients with diabetes mellitus.

Causes and treatment of secondary intraocular hypertension after silicone oil tamponade

Ru-Long Li,Ping-An Mao,Yang Xie and Guo-Hua Lu

AIM:To study the causes and treatment of secondary glaucoma after silicone oil tamponade.METHODS:Retrospective analysis was done in 97 eyes which underwent silicone oil tamponade.RESULTS:Secondary intraocular hypertension occurred in 39 eyes(40%),and 12 eyes(12%) occurred in two weeks,8 eyes(8%) occurred in the second to eighth week,19 eyes(20%) over eight weeks;Most eyes recoverred well through medicine or operation.CONCLUSION:Secondary intraocular hypertension is one of the common complications after silicone oil tamponade.Inflammatory reaction,over silicon oil,silicon oil going into the anterior chamber,and silicon oil emulsifying are the main causes of intraocular hypertension.Intraocular hypertension is more often in introcular lens or aphakic eyes.Medicine and operation are effective treatments.

Clinical curative effect of vitrectomy combined removal of intraocular foreign body of small diameter

Bei Liu,Li-Li Wang,Zhong-Qiao Zhu and Shan-Shuang Du

AIM:To observe the clinical curative effect of vitrectomy combined removal of intraocular foreign body(the diameter of foreign body ≤3mm).METHODS:From January 2006 to January 2010,25 patients(25 eyes) with ocular injury in our hospital underwent vitrectomy combined removal of intraocular foreign body.Thirteen patients(13 eyes) preserved part or all anterior lens capsule.In the follow-up of 6 months,implanting or suturing artifical lens was carried out in 18 cases(18 eyes).The surgical indications,related complications and clinical curative effect were summarized.RESULTS:Intraocular foreign bodys were dislodged successfully in 25 cases(25 eyes).One case with ablatio corporis ciliaris recovered by drug treatment.Vitrectomy and silicone oil filling were performed in the cases with retinal detachment.In the follow-up of 6 months,the corrected visual acuity increased in 23 cases and remained unchanged in 2 cases.CONCLUSION:Vitrectomy combined removal of intraocular foreign body is an effective method in definited ocular trauma patients(the diameter of foreign body ≤3mm).

Clinical observation on a modified method for epicanthal folds combining double-eyelid blepharoplasty in 96 cases

Zhong-Qun Li,Chun-Yan Xue and Hong-Ji Yan

AIM:To investigate the clinical effect of a simple and effective epi-canthoplasty combined with the double-eyelid blepharoplasty.METHODS:According to the serious degree and direction of epicanthal folds,a modified method designed to correct epicanthal folds and create double eyelid was operated asymmetrically at medial canthal area.The appearance of large opened eyes was produced by lengthening the palpebral fissure.RESULTS:All 96 eyes(58 cases) were operated and satisfactory aesthetic results were obtained.The results were good after 3-36 months follow-up.CONCLUSION:This is a simple and effective operative procedure with good results that can be widely used.

Clininal observation of microscopic operation shortening levator palpebrae superioris for treatment of moderate and severe congenital ptosis

Yong Wang

AIM:To discuss clininal effect of microscopic operation shortening levator palpebrae superioris for treatment of moderate and severe congenital ptosis.METHODS:Part of the levator palpebrae superioris of 53 paients(68eyes)who had moderate and severe congenital ptosis was resected in the microscope.RESULTS:Observed for 3 months to 1 year,cure was in 41 eyes and basic cure in 27 eyes of the 68 eyes operated.The satisfactory rate was 100%.All the patiens was satisfied with the microscopic operation.They were good looking and there were no complications.CONCLUSION:The microscopic operation for treatment of moderate and severe congenital ptosis is considered effective with high success rate.

Clinical analysis of high risk factors for promoting endophthalmitis after open ocular injuries

Ying-Xu Zhang,Run-Cai Ye and Shu-Yan Li

AIM:To research high risk factors for promoting endophthalmitis after open ocular injuries.METHODS:Totally 312 cases(315 eyes) with open ocular injuries were recalled and analyzed.The different factors working in promoting endophthalmitis after open ocular injuries were analyzed.RESULTS:Vitreum foreign body,rupture of post-capsule membrane and stab by slightness object significantly increased the risk of endophthalmitis,and it was statistically significant.Delay in primary repair more than 24 hours also increased the risk of endophthalmitis after open ocular injuries,but was not statistically significant.The length of the wound increased didn’t increase the risk of endophthalmitis after open ocular injuries.CONCLUSION:Vitreum foreign body,rupture of post-capsule membrane and stab by slightness object are the high risk factors for promoting endophthalmitis after open ocular injuries.Based on the wound repaired in time,the length of the wound increased didn’t increase the risk of endophthalmitis after open ocular injuries.

Clinical analysis of ocular contusion with ciliary detachment of 23 cases

Xiao-Tao Wang

AIM:To investigate the causes,clinical manifestations,treatment,prognosis of ocular contusion with ciliary detachment.METHODS:Twenty-three cases(23 eyes) of ocular contusion with ciliary detachment were retrospectively studied and the causes,clinical manifestations,therapeutic procedual,prognosis and follow-up records were analysed.RESULTS:Impacting with objects was the most common reason for ocular contusion with ciliary detachment which was followed by trauma by the fist and blast.15 eyes were damaged only in anterior segment,the other 8 eyes were injured in both anterior and posterior segment.Before treatment,best corrected visual acuity(BCVA) of 14 eyes was less than 0.1,accounting for 60.9%.However,the visual acuity of 16 eyes(69.6%) acquired BCVA of 0.5 or better after treatment by medicine or surgery.UBM scan displayed that ciliary detachment disappeared in 21 eyes,IOP remained normal in 21 eyes.CONCLUSION:Integrating UBM,by effective and timely treatment,visual acuity can improve and ciliary detachment disappear in most contused eyes.The visual acuity prognosis is usually poor when the posterior segment complications happen after contusion.

Efficacy comparison of mecobalamin on acquired ophthalmoplegia via varied administration routes

Xiao-Hui Zhang,Feng Wang and Lei Xiong

AIM:To investigate the effect of mecobalamin via different medication method on acquired ophthalmoplegia.METHODS:Twenty-four cases(24 eyes),clinically diagnosed as ophthalmoplegia,aged from 42 to 70 years,average 58,with 13 female and 8 male were analyzed.Patients were randomly divided into group A(ion transmission),B(peribulbar injection),C(muscular injection of 0.5mg mecobalamin),D(muscular injection of 10mg vitamin B1 and 500μg vitamin B12),with 6 eyes in each group.Extravenous ocular muscle function,diplopia and oblique angles were daily monitored.RESULTS:In terms of extravenous ocular muscle function,diplopia and oblique angles,significant differences existed as comparing group A or B with group C or D respectively.Neither significant differences showed between group A and B nor between group C and D.CONCLUSION:Ion transmission of mecobalamin was confirmed as an effective,safe and convenient medication scheme.As for non-traumatic paralysis of extravenous ocular muscle,peribulbar injection can also be an option.The mecobalamin effect by local medication was found better than that by systemic one.

Effect of hyaluronic acid sodium combined with rhEGF eye drops on dry eye after cataract extraction

Jie Li,Di Huang and Xi-Bin Zhou

AIM:To evaluate the effects of hyaluronic acid sodium eye drops combined with recombined human epidermal growth factor(rhEGF) eye drops on dry eye after extracapsular cataract extraction METHODS:All 42 cases(60 eyes) with dry eye symptom after the excision of extracapsular cataract were chosen and randomly divided into two groups,the treatment group and control group.In the treatment group,the patients were treated by hyaluronic acid sodium eye drops and rhEGF eye drops.In the control group,the patients were treated by hyaluronic acid sodium eye drops.The subjective dry eye symptoms,fluorescein staining(FL),the time of tear secretion(SchirmerⅠtest,SⅠt) and tear break-up time(BUT) were observed by the slit lamp before treatment,the second and the fourth week after treatment.RESULTS:There was no statistical difference between groups before treatment(P>0.05).After treatment,the subjective dry eye symptoms,FL,S Ⅰt and BUT were significantly different(P<0.01).CONCLUSION:Hyaluronic acid sodium eye drops combined with rhEGF eye drops can be effective to relieve the dry eye symptoms after extracapsular cataract excision.

Difference and correlation between IOLMaster and A ultrasound in clinic

Bao-Hua Li,Ping Liu and Xin Wang

AIM:To explore the difference and correlation between different axial length and Anterior Chamber Depth(ACD) by means of IOLMaster and A ultrasound in the clinical cataract patients.METHODS:Cataract patients were collected for 8 months and examined respectively preoperatively by IOLMaster and A ultrasound.The results of both examinations were checked.Every patients were examined by the same skilled doctor.The axial length and ACD were examined by IOLMaster in first step,and then by A ultrasound in second step.RESULTS:There was some significant difference in the axial length <22mm,and no difference in the axial length >26mm and between 22mm and 26mm.A ultrasound and IOLMaster axial length relationship were 0.998,0.991 and 0.783.The correlationship about their ACD were 0.851,0.628,0.673.CONCLUSION:It was found that the IOLMaster’s axial length was longer than A ultrasound.There have good relationship among three groups about their axial length and A ultrasound,though there are some difference.

Study of the effection of EDTA on lens epithelial cells removal

Zhi-Qiang Li,Ru-Yin Tian,Xin-Hua Liu and Xun-Qing Gu

AIM:To study the effection of EDTA on lens epithelial cells removal.METHODS:Thirty-two anterior lens capsules were collected in phacoemulsification,then randomly divided into 4 groups.Anterior lens capsules were digested with 5mmol/L,10mmol/L,20mmol/L EDTA and saline.Clearance situation of lens epithelial cells were observed.RESULTS:Epithelial cells could be completely detached from the anterior lens capsule by 20mmol/L EDTA solution treatment,some epithelial cells shed by the 5mmol/L and 10mmol/L EDTA solution treatment.In the control group only a small amount of epithelial cells shed.CONCLUSION:EDTA can remove the epithelial cells of anterior lens capsule.It can afford experimental and theoretical basis for clinical application of EDTA to remove the lens epithelial cells and prevent posterior capsular opacification(PCO).

Phacoemulsification and foldable intraocular lens implantation in microcoria cataract

Qiang Ma,Hu-Qin Lu,Hou-Cheng Liang,Ting Ma,Yue-Mei Zhang and Hong-Na Zhu

AIM:To explore the surgical techniques and the clinical effects of continuous pupillary collar cutting of phacoemulsification in microcoria cataract.METHODS:Twenty-three cases(34 eyes) of microcoria cataract were operated using manual pupilloplasty first,then were performed by continuous pupillary collar cutting,phacoemulsification and foldable intraocular lens implantation.RESULTS:During the follow-up of 6 months,all the cases got better visual acuity,the corrected visual acuity was less than 0.1 in 3 eyes,being 0.1-0.3 in 3 eyes,0.3-0.6 in 12 eyes and above 0.6 in 16 eyes.CONCLUSION:By using continuous pupillary collar cutting of phacoemulsification in microcoria cataract,this technique ensures the safety during surgery as well as improves the visual acuity with few complications.

Therapeutic effects study of phacoemulsification and manual sutureless small-incision extracapsular cataract surgery

Zhen-Fang Zhao,Xiang-Xing Duan,Ya-Ling Song and Li-Na Mo

AIM:To compare the operation methods and therapeutic effects of phacoemulsification and manual sutureless small-incision extracapsular cataract surgery.METHODS:One hundred and twenty-five cases(158 eyes) of cataract patients between 2009-01/2009-12 were divided into two groups,A group(80 eyes) performed phacoemulsification and B group(78 eyes) performed manual sutureless small-incision extracapsular cataract surgery,the two operations were compared in the postoperative visual acuity,astigmatism,operative and postoperative complications at 1 day,7 days,1 month and 3 months.RESULTS:There was no significant difference between two groups in postoperative visual acuity,astigmatism,operative and postoperative complications at each time points.CONCLUSION:The therapeutic effects of two kinds of operation are similar,and suitable operation should be choosed with clinical condition.

Clinical analysis of phacoemulsification and IOL implantation for the patients with lens protein glaucoma

Jian-Ying Du,Xiao-Rong Guan,Ji-Fei Zhao,Li Huang,Ling-Li Qin and Yan-Zhang Liu

AIM:To study the effect of phacoemulsification and lens implantation in treating lens protein glaucoma.METHODS:Thirty-two cases(32 eyes) with lens protein glaucoma were selected and performed phacoemulsifiction and intraocular lens implantation.RESULTS:After a week of operation,the intraocular pressure of most of the cases were controlled within normal level,the same as 6 months after operation,the visual acuity of patients had the improvement at different degrce in 6 months after operation.CONCLUSION:The lens protein glaucoma can be cured through the phacoemulsification and IOL implantation,with no need to combine with trabeculectomy.It is proved to be effective and safe.The patients with lens protein glaucoma could rehabilitate quickly after surgery.

Surgery treatment of uveitis complicated cataract

Wen-Li Li and Li-Bo Li

AIM:To evaluate clinical effect of phacoemulsification with intraocular lens on uveitis complicated cataract.METHODS:Nineteen cases(21 eyes) with uveitis complicated cataract were treated by phacoemulsification with implantation of intraocular lens.According to level and scope of synechia of iris in operation,different ways were used to treat synechia of iris and microcoria.RESULTS:Nineteen eyes(90%) visual acuity were improved.The postoperative visual acuity was ≥0.1 in 17 eyes(81%),≥0.3 in 15 eyes(71%).There were no serious complications and no aggravation of old uveitis.CONCLUSION:The method of phacoemulsification with intraocular lens implantation is obviously effective in the treatment of uveitis complicated cataract.Preoperative control of uveitis for 3 months and dealing with synechia of iris and microcoria during operation can help reduce complications and improve visual acuity.

Clinical observation of the effect of combined trabeculectomy for glaucoma

Hong-Min Chen

AIM:To investigate the effect of combined trabeculectomy for the patients with glaucoma and its complications.METHODS:From January 2008 to December 2008,122 patients(132 eyes) were performed combined trabeculectomy in our hospital.The postoperative intraocular pressure,filtration follicles,vision and complications of the patients were reviewed and they were followed up for one year.RESULTS:Postoperative shallow anterior chamber took place in 7 eyes,the incidence rate of shallow anterior chamber was 5.3% after combined trabeculectomy in early period,the average intraocular pressure were 16.7mmHg after one year,the success rate of operation was 98.5%,and 118 eyes(89.4%)had formed the functional filtration follicles.CONCLUSION:Combined trabeculectomy has less complications,high success rate and safety.

Application of binocular indirect ophthalmo-microscope in vitreoretinal surgery

Fei Liu,Jie Li,Dong-Ping Shao and Yuan-Biao Li

AIM:To discuss the effectiveness and techniques of vitrectomy using binocular indirect ophthalmomicroscope(BIOM3).METHODS:A retrospective study was carried on 126 patients(126 eyes) which were performed vitrectomy under BIOM3.The operation time,techniques of equipment using,intraoperative complication,postoperative visual acuity(VA) and complication were observed.RESULTS:Operation time was 44-92(mean 55) minutes.The postoperative follow-up time ranged from 3 to 10(mean 4.5) months.The postoperative visual acuity improved in varying degrees:VA≥0.3 in 12 eyes,0.3>VA≥0.1 in 36 eyes,0.1>VA≥0.01 in 45 eyes,VA<0.01 in 33 eyes.There was no severe complication during operation.5 retinal re-detachment cases,7 anterior chamber haemorrhage cases,5 secondary glaucoma cases and 2 proliferative vitreoretinopathy(PVR) cases were observed in follow-up after operation.BIOM3 application skills were introduced.CONCLUSION:We can get a good visualization and a wide field of retina in aphakia,gas-filled or silicone-filled eyes,small pupil and corneal diseases under BIOM3.BIOM3 is an excellent vitreoretinal surgical equipment with wild-angle viewing field and assistant-friendly advantages.

Correlated risk factors of diabetic retinopathy in type 2 diabetes mellitus in community

Xiu-Juan Li,Cheng-Yi Zhu and Hai-Juan Ma

AIM:To analyze the correlated risk factors of diabetic retinopathy(DR) in type 2 diabetes mellitus.METHODS:Three hundred cases with type 2 diabetes mellitus were divided into three groups:nondiabetic retinopathy group(NDR group),nonproliferative diabetic retinopathy group(NPDR group)and proliferative diabetic retinopathy group(PDR group)to analyze its correlated risk factors.RESULTS:Compared with NDR group,course of disease,systolic blood pressure(SBP),diastolic blood pressure(DBP),fasting plasma glucose(FPG),2h plasma glucose(2h PG),HbA1c and 24 hour urinary protein excretion in NPDR group and PDR group were significantly higher(P<0.05);the result of logistic regression showed that diabetic duration and SBP were independent risk factors of DR.CONCLUSION:Diabetic duration and SBP are independent risk factors of DR.

Experience on Laser treatment of 42 cases of central retinal vein occlusion

Zong-Ping Su

AIM:To discuss the experience on Laser treatment of central retinal vein occlusion(CRVO).METHODS:Forty-two 42 cases(42 eyes) of CRVO Laser treatment adopted different methods of photocoagulation treatment to explore its effects,according to the fundus fluorescein angiography(FFA) results.RESULTS:Visual acuity of 5 eyes(12%) of the 42 eyes improved 2 lines or more;28 eyes(67%) had no significant changes in vision;visual acuity of 9 eyes(21%) decreased by 2 lines or more;FFA examination showed tortuosity and expansion of retinal vein,retinal hemorrhage,edema and exudate subsided,treatment was effective in 37 eyes(88%).CONCLUSION:Laser treatment is effective for CRVO and is an important means to control the progression of the disease.

Study of optic disc parameters of normal people in Han nationality of Guangxi area

Ke Yang,Li Li and Hai-Qin Bai

AIM:To study the optic disc parameters of normal people in Han nationality in Guangxi.METHODS:One hundred and twenty blood-unrelated nomoral volunteers living in Lonlin region of Guangxi were involved in the study and divided into 4 groups according to their ages.Heidelberg retina tomograph-Ⅱ(HRT-Ⅱ)was used to obtain the optic disc parameters.The parameters included optic disc area(DA),cup area(CA),cup volume(CV),rim area(RA),rim volume(RV),height variation contour(HVC),cup shape measure(CSM),mean cup depth(MCD),maximum cup depth(MxCD),cup/disc area ratio(C/DAR),rim/disc area tatio(R/DAR),mean retinal nerve fiber layer thickness(mRNFLT) and cross-section area(RNFLA).RESULTS:The parameters of optic nerve head(ONH) in normal eyes were as follows:DA(2.2165±0.4266)mm2,CA(0.4816±0.2979)mm2,RA(1.7311±0.3217)mm2,C/DAR(0.2074±0.1092),R/DAR(0.7923±0.1091),CV(0.1076)mm3,RV(0.5196±0.1519)mm3,MCD(0.2055±0.0798)mm,MxCD(0.6039±0.1949)mm,HVC(0.4513±0.1639)mm,CSM(-0.2155±0.0617)mm,mRNFLT(0.3059±0.0845)mm,RNFLA(1.5785±0.3830)mm2.The normal volunteers were divided into 4 groups according to their age and a negative correlation was found between mRNFLT,RNFLA and age.CONCLUSION:HRT-Ⅱ can be used to measure optic disc parameters of normal people in Han nationality.The age influence should be paid attention to in measuring.

Study of intraocular pressure for long stage after LASIK of myopia

Jie Qin and Han-Qiang Liu

AIM:To investigate the change of intraocular pressure(IOP) for long stage after excimer laser in situ keratomo-leusis(LASIK) of myopia.METHODS:Thirty eyes of 15 patients(16 eyes of 8 patients in 6 months) who underwent myopia LASIK 5 years ago were selected randomly.IOP was measured preoperatively,2 weeks,1 month,6 months and 5 years after LASIK,respectively.RESULTS:The preoperative IOP was(17.48±3.06)m mHg,and the IOP of 2 weeks,1 month,6 months and 5 years after LASIK were(12.27±2.55)mmHg,(11.80±2.55)mmHg,(12.00±2.06)mmHg and(12.07±2.07)mmHg,respectively.There was no significant difference between IOP of 5 years after LASIK and IOP of 2 weeks,1 month and 6 months after LASIK(Z=-0.386,P>0.05;Z=-0.830,P>0.05;Z=-1.184,P>0.05).There was no significant difference among IOP of 2 weeks,1 month and 6 months after LASIK(H=1.444,P>0.05).The IOP of 2 weeks,1 month,6 months and 5 years after LASIK was lower than IOP before LASIK and there was significant difference among them(Z=-4.617,P<0.05;Z=-4.591,P<0.05;Z=-3.526,P<0.05;Z=-4.638,P<0.05).CONCLUSION:There is no significant difference between the IOP of long stage and short stage after LASIK.

Clinical study of complex anisodine Ⅱ combined with ixeris sonchifolia in treating anterior ischemic optic neuropathy

Du-You Yi,Hai-Tao Huang,Yong-Wang Zhao,Wen-Sheng Gao and Qin-Qi Yu

AIM:To explore the clinical application of complex anisodine Ⅱ combined with ixeris sonchifolia in treating anterior ischemic optic neuropathy(AION)(non-temporal arteritis type).METHODS:Thirty-eight patients(38 eyes) who were clinically diagnosed as AION(non-temporal arteritis type) were randomized into two groups.Group A used routine treatment,including hyperbaric oxygen;orally taken acetazolamide,vitamin B1,vitamin B12,compound salvia miltiorrhiza tablet;intravenous taken salvia miltiorrhiza injection 20mL.Group B used the routine treatment plus complex anisodine II subcutaneous injection beside the affected side arteriae temporalis superficialis combined with intravenous ixeris sonchifoila 20mL.The period of treatment was 10 days for the both groups.Visual acuity and fundus oculi were examined every day.Preoperative and postoperative visual field and FFA were compared.RESULTS:Compared with group A,group B had quick and better improvement of visual acuity(P<0.05).And the group B had better results of visual field and FFA test,when compared with group A(P<0.05).CONCLUSION:The use of complex anisodine II combined with ixeris sonchifolia in treating AION(non-temporal arteritis type) is safe and efficient.

Analysis of image-drifting in intraoperative image-guidance in endoscopic nasocular operation

Jiang Guo,Yong-Tian Lu,Xiao-Yan Dou and Jing Sima

AIM:To analyse the cause of image-drifting and to resolve it during image-guidance endoscopic nasocular operation.METHODS:The pre-operative plan and intra-operative navigation were rigorously processed according to the criteria of endoscopic nasocular operation.The occurrence of image-drifting was recorded,analyzed and resolved.RESULTS:The image-guidance system in endoscopic nasocular operation was used in 13 cases from August 2008 to December 2010,and image-drifting happened in 4 cases(31%).Among them,2 cases were systemic image-drifting,2 cases were structural image-drifting.Systemic image-drifting were resolved,while structural image-drifting were not resolved.But the operation was completed smoothly.CONCLUSION:The systemic image-drifting can be prevented through rigorous neuronavigative procedure,and it could be resolved by selecting a better landmark and adding more landmarks.The best way to prevent structural image-drifting is careful operation.

Application of basal anesthesia in infant chalazion surgery

Li Huang,Yong-Hua Li,Dian-Yi Wang,Qing-Wen Xu and Dong-Li Nie

AIM:To study the curative effect of basal anesthesia in infant chalazion surgery,providing the clinical treatment of infant chalazion with a reference.METHODS:A retrospective analysis of 56 cases’ data in our hospital afflicted with infant chalazion,surgery was conducted under basal anesthesia,and made postoperative follow-up.RESULTS:All cases of infants chalazion patients were cured,no anesthetic accident.All were cured in one-stage operation,local induration disappeared.All patients were followed up for more than six months,no recurrences.CONCLUSION:Basal anesthesia is a safe and effective method in infant chalazion surgery,it’s worthy of spreading.

Study on parameters of binocular vision in asthenopia patients

Rui Guo,De-Jian Hong and Shu-Hua Ding

AIM:To investigate the asthenopia patients’ discrepancy of distance phoria,near phoria and accommodation convergence/accommodation(AC/A) caused by different factors.METHODS:Eighty-four asthenopia patients from outpatient department of Jiangsu Province Hospital of TCM were selected consecutively.The sample was divided into two groups:A group(wrong corrected) and B group(corrected well).Standard 6m,40cm,40cm+1D phoria examinations were operated,and AC/A was calculated,gradient AC/A were computed.All results were compared with Morgan value,and results of group A were also compared with those of group B.RESULTS:The 6m phoria of both group A and B were higher than the Morgan value(P<0.05).Likely,the 40cm phoria of both group A and B were also higher than the Morgan value(P<0.05).However,the results of gradient AC/A of both group A and B were lower than 4/1(P<0.05).There was no significant difference between group A and B in all parameters above(P>0.05).CONCLUSION:The asthenopia patients have higher exophoria in both distance and near phoria than normal,while they have lower gradient AC/A.Stimulated AC/A can not be regarded as a factor to classify different asthenopia types.

Clinical comparative study between Epi-LASEK and traditional Epi-LASIK

Hong Yi,Yu-Long Wang and Wen-Xuan Pei

AIM:To compare safety,effectiveness and superiority for the correction of myopia and myopic astigmatism between epipolis laser-assisted in situ keratomileusis(Epi-LASIK)and laser-assisted subepithelial keratomileusis(Epi-LASEK) with an epikeratome.METHODS:A prospective study was performed on 21 myopia patients(42 eyes) to compare Epi-LASIK with Epi-LASIK plus alcohol(which we call Epi-LASEK).Alcohol(200mL/L) was used for 20 seconds before making the flap in the Epi-LASEK treatment group.In each patient,right eye was operated on with Epi-LASEK and the left with Epi-LASIK.Mean spheroequivalent was-5.60±2.90D,mean astigmatism was 1.40±1.20D before the operation.This study focused on flap quality and pain with and without alcohol.Refraction,haze and UCVA were checked preoperatively,and on the 2 weeks,1 month,3 months postoperatively.The result were statistically compared and analyzed.RESULTS:The Epi-LASEK treatment group had less postoperative astigmatism and haze than the Epi-LASIK group.Alcohol addition in the Epi-LASEK treatment group contributed to better flap.Pain did not increase in the Epi-LASEK treatment group(P>0.05).CONCLUSION:Epi-LASEK is a safe and effective treatment for the correction of myopia and myopic astigmatism.

Clinical observation on orthokeratology treatment of juvenile myopia

Xiang-Yong Xie,Yin-Bo Lu,Bi-Hua He and Zi-Ang Cheng

AIM:To observe treatment efficacy of wearing orthokeratology lens for juvenile myopia.METHODS:Seventy-six cases(152 eyes) of myopia,with age of 8-15 years old and the average spherical equivalent degree-3.92±1.13D,wore orthokeratology lens,according to the fitting program of orthokeratology,at night for 8-10 hours.They were followed up at 1 week,1 month,3,6 months,1 year,2 years after wearing glasses and observed with uncorrected visual acuity(UCVA),refraction,corneal curvature,axial length,slit-lamp examination with or without complications.RESULTS:One week,1 month,3,6 months,1 year,2 years after wearing glasses,UCVA increased from 0.15±0.12 before wearing glasses to 0.60±0.12,0.80±0.10,0.90±0.18,0.88±0.16,0.90±0.15,0.89±0.18,the differences were statistically significant(P<0.01);Corneal curvature flattened and decreased by 2.31±0.82,2.41±0.91,2.12±0.75,2.21±1.01,2.51±1.12,2.46±0.98D,differences were statistically significant(all P<0.001);1 year after wearing glasses,axial length increased by 0.13±0.11mm than that before wearing glasses,2 years after wearing glasses,the axial length increased by 0.25±0.17mm than that before wearing glasses,and there was no statistically significant difference;Compared myopia degree after full 2 years of wearing glasses and 1 week of stopped wearing with that before wearing glasses,myopia degree increased less with average annual 0.25±0.11D.After wearing glasses,a small number of patients with punctate corneal epithelial exfoliation,ghosting,conjunctivitis,etc.,could be restored after treatment.CONCLUSION:Orthokeratology treatment of juvenile myopia is effective and safe,which can control the development of myopia.

Clinical application of combined therapy of P-VEP respective spatial frequency stimulating therapy for amblyopia

Guo-Qiao Li,Wei-Qiong Song,Zheng-Qing Wu,Fang He,Jin-Feng Duan and Yan-Li Zhang

AIM:To evaluate the effect of combined therapy for amblyopia in children by making use of pattern visual evoked potential(P-VEP) respective spatial frequency stimulating therapy that can exercise hands,eyes and brain,together with after-image test,red-light flicker pleoptics and so on.METHODS:These children were divided into two groups:control group and experimental group.The control group:occlusive therapy with precision work,red flare.The experimental group:conventional methods mentioned above with DV-100 PVEP analysis system to do respective spatial frequency stimulating therapy.RESULTS:The total effective rate and cure rate of respective spatial frequency stimulating therapy in 24 months were higher than those of occlusive therapy with precision work.There was a statistically significant difference between them(P<0.05).CONCLUSION:Respective spatial frequency stimulating therapy can make a high level of compliance and curative effects for amblyopia.It is individualized,recreational and good for mental attitudes,and it is also a new way for amblyopia.

Clinical curative effect of irrigating the anterior chamber with solution of amphotericin B to treat the fungal keratitis

Qing-Tao Li

AIM:To evaluate the clinical curative effect of irrigating the anterior chamber with solution of amphotericin B to treat the fungal keratitis. METHODS:Forty-two patients(42 eyes) were included in this study.The patients were randomly divided into two groups. One was experimental group:the treatment included local and systemic application of fluconazole and combination of irrigating the anterior chamber with solution of amphotericin B.The other was control group:local and systemic fluconazole was used,irrigating the anterior chamber with 9g/L sodium chloride injection. Ulcer healing,hypopyon absorption, vision and other complications were observed. RESULTS:The data of ulcer healing of experimental group and control group were compared, the result was P=0.001. The data of hypopyon absorption of experimental group and control group were compared, the result was P=0.003. They had statistical significance.The data of vision of the patients before and after the treatment were compared, the result was P=0.300, the difference had no statistical significance. CONCLUSION:Irrigating the anterior chamber with solution of amphotericin B to treat the fungal keratitis reduces fungal keratitis ulcer healing and hypopyon absorption time and the complications.

Clinical observation on blue light-filtering photochromics IOL Matrix Aurium

Li-Li Liu,Yan-Ping Xu,Yu-Ying Shi and Cai-Xia Keng

AIM:To evaluate the result of the blue light-filtering photochromics IOL Matrix Aurium and compare patient-reported vision-related function between the blue light-filtering photochromic intraocular lens and a similar clear one that does not filter blue light. METHODS:Consecutively 57 eyes selected from 49 senile cataract patients who came from Beijing Prison Administration Bureau Central Hospital in 2007- 09/2010-10 were divided into two groups by their type of IOL according to their ideal:blue light-filtering photochromics IOL Matrix Aurium groups (Matrix 400) and a clear ultraviolet-filtering IOL (Matrix 401). The patients lived in Beijing or vicinity, which can be followed up in time. All patients performed phacoemulsification and IOL implantation,complications in operation or after operation were observed, and 3 months after operation several tests were done by the same technicians.The parameters included best corrective visual acuity (BCVA) under photopic(1000lux)and mesopic(40lux) and of the same time in sunlight outdoors, subjective visual quality was assessed with the National Eye Institute Visual Functioning Questionnaire-25 (NEI VFQ-25). Patients were investigated whether they had to wear sunglasses in sunlight outdoors. RESULTS:There were no other complications in or after operation except several mild corneal edema. We could observe that the blue light-filtering photochromics IOL Matrix Aurium could turn yellow in sunlight outdoors, about 6.5% patients needed a sunglass in Matrix 400 group, which was significantly lower than 30.8% in Matrix 401 group(P=0.032).There were no significant difference in BCVA under photopic(1000lux) or mesopic(40lux) or outdoors between two groups (P>0.05). There were no significant difference in mean NEI VFQ-25 scores. CONCLUSION:Blue light-filtering photochromics IOL Matrix Aurium has fuction of turning yellow in human’s eyes,povides good vision, and reduce the rate wearing sunglass in sunlight outdoors.Its retinal protective effects are needed for further study.

Influence of two different direction scleral tunnel incisions on nucleus delivery difficulty and complications

Li-Chuan Han and Yu Bai

AIM:To compare the difficulty of nucleus delivery about "straight line shape" and "anti-eyebrow shape" scleral tunnel incisions and analyse the correlated complications. And to observe clinical curative effects of endothelial repair time and the refractive state. METHODS:A total of 82 cases (82 eyes) cataract patients were accepted small-incision non-phacoemulsification cataract extraction and posterior chamber type intraocular lens implantation surgery. All patients were divided into two groups,one group was accepted 6mm "straight line shape" scleral incision in 2mm after corneoscleral limbus, the other group was accepted 7mm arc length of "anti-eyebrow shape"incision.Lens nucleus were pulled out through a 4mm×5mm pear-shaped lens loop after the hydrodissection,during the time,aspiring the small part of cortex,using Healon twice in front of and behind the lens nucleus and infusing sodium hyaluronate up and down the lens nucleus according to the 12 o’clock nuclear equator whice was upturned direction and the elasticity of incision. RESULTS:The "straight line shape" groups were superior to the "anti-eyebrow shape" groups, lens loop was easier to extend to the behind of lens nucleus and the time of pulling nucleus was shorter, pressure of lens capsule was lower, the risk of posterior capsule damage was decreased, corneal endothelial edema lessened.For anti-eyebrow incision group, the resistance increased when dragging lens nucleus, corneal edema was more serious than the straight line shape incision. Because the friction was increased and nucleus drag time was relatively longer when the top of the nucleus contacted with the corneal endothelium,therefore, probability of the posterior capsule and corneal endothelial damage was also relatively higher,endothelial repair time prolonged. CONCLUSION:The "straight line shape" scleral incision groups were easier to drag out lens nucleus, the time was shorter, capsule pressure and resistance were lower, which could effectively reduce the risk of posterior capsule damage and corneal endothelial edema.

Clinical study on SN6AD1 multifocal intra-ocular lens

Dong-Jian Zheng,Na Liang,Sheng-Sheng Ma and Yong-Gang Yuan

AIM:To evaluate the clinical efficacy after the implantation of SN6AD1 multifocal intraocular lens(MIOL). METHODS:After the phacoemulsification, SN6AD1 MIOL was inserted into 65 eyes of 44 patients. The mean follow-up duration was 3 to 6 months. The visual acuity, corneal astigmatism, defocus testing, rate of off-glasses and patient satisfaction were observed. RESULTS:At 3 months after the implantation, the average distant, intermedia and near visual acuity were satisfying. There was no statistically significant difference between the preoperative corneal astigmatism and corneal astigmatism at 3 months after the operation(P>0.05). The defocus curve showed double-peak shape,of which one peak was at the point of 0D and the other peak was on the plateau of -2.00--2.50D. Thirty-nine (89%) patients took off their glasses, who could engage in various distance work. CONCLUSION:SN6AD1 MIOL can offer a better whole range of vision and increase the rate of off-glasses.

Analysis of operative efficacy of one incision phacoemulsification and IOL implantation combined with trabeculectomy

Qin Yang,Ping Tang,Xin-Hua Cui,Xing-Xing Cai and Pei-Fei Chen

AIM:To evaluate the therapeutic effects of one incision phacoemulsification and intraocular lens(IOL) implantation combined with trabeculectomy (triple surgery) in the treatment of glaucoma combined with cataract. METHODS:A total of 30 cases (34 eyes ) with coexisting glaucoma and cataract, who were performed triple surgery from January 2008 to February 2009 in our hospital, were retrospectively analyzed. Preoperative and postoperative visual acuity intraocular pressure (IOP) and complications were observed, and all cases were followed up for 24 to 36 months. RESULTS:Preoperative mean visual acuity was 4.21±0.42. Postoperative mean visual acuity was 4.67±0.22. There was significant difference between before and after operation (t=-5.794,P<0.01).The postoperative IOP of 34 eyes were normal without any other treatments, the mean IOP decreased from preoperative 23.67±9.12mmHg to postoperative 15.90±2.74mmHg .There was significant difference between before and after operation (t=5.162, P<0.01). 34 eyes didn’t occur serious complications. CONCLUSION:One incision triple surgery could control IOP effectively and improve visual acuity quickly and remarkably.

Curative effect observation on modified trabeculectomy combined with interscleral drainage pond forming for acute angle-closure glaucoma

Shi-Gang Xia,Qi-Guo Xiao and Hui-Can Peng

AIM:To evaluate the clinical curative effect of modified trabeculectomy combined with interscleral drainage pond forming for the treatment of over 60 years old patients with acute angle-closure glaucoma(AACG). METHODS:A total of 73 patients 73 eyes aged over 60 of AACG underwent modified trabeculectomy combined with interscleral drainage pond forming. Anterior chamber depth, intraocular pressure, bleb shape and so on were observed after operation. RESULTS:About 3 to 36 months after surgery mean IOP was 12.5±4.8mmHg, significantly lower than that before surgery. Postoperative 75% (55/73) affected eyes had visual acuity improved. 96% (70/73)blebs were type Ⅰ, Ⅱ functional filtering bleb. Main complications were early shallow anterior chamber and hypotony in(18%, 13/73) affected eyes. CONCLUSION:Modified trabeculectomy combined with interscleral drainage pond forming is an effective way for the treatment of over 60 years old patients with AACG.

Changes of retinal nerve fiber layer after an episode of primary acute angle-closure glaucoma

Ge-Wei Wu and Ping Chen

AIM:To investigate retinal nerve fiber layer (RNFL) thickness changes after primary acute angle-closure glaucoma (PAACG). METHODS:Totally 36 patients were recruited, 26 Female (72.2%) and 10 male (27.8%). All the PAACG attacks were resolved after treatment by anti-glaucoma drug followed by laser peripheral iridotomy or surgery. Patients completed RNFL thickness measurement including mean,superior, temporal,inferior and nasal RNFL thickness at 2,4,8,12weeks after resolved using FD-OCT. Analysis of repeated measures and independent-sample t test analysis was carried out to analyze the difference of RNFL thickness (SPSS 15.0). RESULTS:There was no significant difference in RNFL thickness between the attacked eyes and the controled eyes at 2 weeks and 4 weeks. RNFL thickness of all quandrants in the attacked eyes thinned gradually with follow-up, among which there was significant difference between 2 weeks and 4,8,12weeks and there was no significant differences between other weeks. CONCLUSION:After an episode of PAACG, the RNFL thickness is thinning continually mainly in inferior quadrant during the first 8 weeks after primary acute angle-closure glaucoma.

The change of the function of macular area after intravitreal injection of triamcinolone acetonide for treatment of trauma induced persistent macular edema

Yong-Jun Huo,Song-Tao Li,Zhan-Yu Zhou and Hong-Ge Zhang

AIM:To evaluate the change of the function of macular area after intravitreal injection of triamicinolone acetonide for treatment of trauma induced persistent macular edema. METHODS:Twenty eyes with persistent macular edema induced by trauma were injected 0.1 milliliter triamicinolone acetonide into vitreous.Their visual acuity, thickness of nerve fibers layer of macular,incubation period and response densities of N1,P1 waves of the multifocal electroretinography were studied. RESULTS:After 3months’ treatment , their average visual acuity and thickness of nerve fibers layer of macular were 0.78±0.11 and 158.00±13.73μm;before treatment they were 0.21±0.09 and 321.67±42.24μm, incubation period and response densities of the N1,P1 waves of multifocal electroretinography’ s 1 and 2 rings decreased. Compared with those before treatment, there were significant statistical difference(P<0.01). CONCLUSION:Intravitreal injection of triamcinolone acetonide is a safe and effective way to treat the persistent macular edema induced by trauma, the function of macular area improve after edema dismissing of macular area.

Electrocardiogram changes in diabetic retinopathy patients and its clinical analysis

Yu Xin,Hong-Wei Yang and Xiao-Long Chen

AIM:To investigate the clinical value and law of electrocardiogram(ECG) changes in type 2 diabetes mellitus patients with diabetic retinopathy(DR). METHODS:The study was based on 113 patients with type 2 diabetes mellitus in the ophthalmology department of our hospital between June 2009 and March 2011, who were diagnosed with DR. A retrospective analysis were made on the clinical data of ECG, triglyceride, cholesterol and glycosylated hemoglobin. RESULTS:ST segment and T-wave abnormalities in ECGs were the major abnormalities. 25 cases (61.0%) in non-proliferative DR and 59 cases (81.9%) in proliferative DR had ECG abnormality. The difference was significant. Cases percentage in proliferation stage of DR patients with abnormal ECG was significantly higher than those of normal ECG group. Compared with normal ECG group, abnormal ECG group is also associated with higher average glycosylated hemoglobin. The difference was statistically significant (P<0.01). The difference of triglyceride and cholesterol levels between abnormal and normal ECG groups was not significant. CONCLUSION:As a severe complication in eyes, DR is associated with cardiovascular system diseases and the poor glycemia control.

Intravitreal injection of Bevacizumab (Avastin)for treatment of idiopathic choroidal neovascularization

Chun-Yan Lü,Lei Gao,Wen-Jie Liu,Kai Jiang and Xu-Ming Lin

AIM:To evaluate the safety and efficacy of intravitreal Bevacizumab(Avastin)in patients with idiopathic choroidal neovascularization (ICNV). METHODS:The records of patients treated with intravitreal injection of 2.5mg Bevacizumab for ICNV were retrospectively reviewed. All patients were evaluated by complete ophthalmic examination, optical coherence tomography (OCT) and fluorescein and/or indocyanine green angiography. Repeated treatment with intravitreous bevacizumab occurred if there were signs of persistent or recurrent exudation. Changes in best corrected visual acuity (BCVA), central foveal thickness (CFT) over at least 6 months were the main outcome measures. RESULTS:Forty eyes of 40 patients (19 males and 21 females) with the average age of 33.0±6.8 were included. The mean baseline of BCVA and CFT were 0.66±0.35(logMAR) and 275.39±107.59μm, respectively. One month after injection, the mean BCVA (logMAR 0.30±0.29,P=0.000) and CFT (185.39±45.77μm, P=0.000) were significantly improved. At the last visit of 9.2 months follow up, both BCVA (logMAR 0.31±0.38,P=0.000) and CFT (192.38±55.52μm,P=0.000) showed significant improvements over baseline values. BCVA was improved by at least two lines in 27 eyes (67.5%), remained stable in 8 eyes(20.0%)at the last visit. A total of 52 injections were performed and the average number of injections was 1.30/eye in the group. About 63.6% of re-injections gained at least two lines of vision improvement one month following the re-treatment. No serious ocular or systemic adverse events were observed. CONCLUSION:Intravitreal injection of bevacizumab for ICNV was well tolerated with an improvement in BCVA, CFT over the mean 9.2 months follow-up period. Re-injection of intravitreal bevacizumab should be administered when needed.

Comparison of once daily morning vs evening dosing of fixed combinations latanoprost/timolol

Jun-Mei Zhao

AIM:To evaluate the effect and safety of morning vs evening once daily of fixed combinations latanoprost/timolol maleate therapy in primary open angle glaucoma or in ocular hypertensive patients. METHODS:This study was prospective, observational clinial research. All ophthalmology examinations and 24 hours IOP testing were performed at the beginning of the study of latanoprost /timolol maleate.At 1 month follow-up, 24 hours IOP was tested and recorded the results and side effects. One week after stopping treatment, this was then changed to evening dosing once daily with fixed combinations of latanoprost/timolol maleate. After 1 month follow-up, 24 hours IOP was tested, the results and side effects were recorded. The IOP and side effects in two groups were then compared. RESULTS:Thirty-two patients completed this study. There was a significant reduction at each time point in the 24-hour diurnal curve of both morning (17.3±3.1mmHg) and evening (17.1±2.7mmHg) dosed patients, compared to the baseline IOP (21.1±3.3mmHg) (P<0.01). When the morning and evening dosing groups were compared directly, the 6∶00 time point was statistically lower with evening dosing (16.4±2.3mmHg) vs morning dosing (17.9±2.8mmHg) (P<0.05). A trend was observed, which indicated greater daytime reduction with night-time dosing, whereas morning dosing tended to give lower night-time pressure. There was a significantly lower mean range of diurnal pressure with evening (3.6±1.6mmHg) vs morning (4.4±1.6mmHg) dosing (P<0.05). There was no significant difference between two groups of side effects (P>0.05). CONCLUSION:This study suggests that fixed combinations latanoprost/timolol maleate both given once daily in the morning and evening can effectively reduce the IOP for the 24-hour diurnal curve and are well tolerated with few side effects. There is a significantly stable 24 hour IOP lowering in evening dosed fixed combinations of latanoprost /timolol maleate..

Analysis of clinical complications of Densiron68 as an intraocular tamponade in the vitreoretinal surgery

Xin-Dan Wang

AIM:To evaluate the clinical complications of Densiron68 as an intraocular tamponade in the vitreoretinal surgery. METHODS:Nineteen eyes of 18 patients aged 19 years to 78 years with complex retinal detachment were included.Initial evaluation included present ophthalmologic and general medical history, determination of the best corrected visual acuity, intraocular pressure (IOP) measureed by non-contact tonometer, detailed slit lamp and fundus examination. Surgery was performed as a standard three-port, pars plana vitrectomy. At removal surgery,15 eyes of the posterior peplos discission was performed. Mean duration of the Densiron68 endotamponade was 76.00±23.84 days,mean follow-up time after removal was 95.74±44.58 days. RESULTS:After Densiron68 removal, 16 eyes (84.21%) showed a stable reattached retinal without further interventions , while, in 1 eye (5.26%), recurrent retinal redetachment appeared during endotamponade. Two eyes (10.53%) developed redetachment after Densiron68 removal. Visual acuity was improved in 14 eyes (73.68%).Side effects included temporary inflammatory reaction, silicon oil emulsification, posterior capsular opacification, temporary high intraocular pressure and pupillary block glaucoma. CONCLUSION:The results showed that Densiron68 as an endotamponade was effective and security ,however, incidence of complications was higher shortly after tamponade.

Clinical analysis on vitrectomy for treating Terson syndrome

Jian-Jun Niu,Xiao-Gong Ma,Shi-Ying Sun,Lan Cui,Hong-Yan Huang and Shun-Li Li

AIM:To study the characteristic of vitreoretinal pathology and evaluate the effectiveness of vitrectomy for Terson syndrome. METHODS:Nine patients ( 12 eyes ) with Terson syndrome underwent vitrectomy. The clinical characteristic and the effectiveness of those cases after vitrectomy were analysed. RESULTS:Postoperatively,most vitreous cavities of 12 eyes were clear; the visual acuity of all patients increased more than two lines than before. All cases had no serious complication when followed up. CONCLUSION:Vitrectomy is a safe and effective method for treating Terson syndrome, which can rapidly improve vision of patients.

Analysis of the clinical and image feature of orbital hematoma

Li-Min Liu

AIM:To study the clinical and image feature of orbital hematoma, and provide evidence for diagnosis and treatment. METHODS :The patient who were treated in our department in last 4 years were collected, the etiology, clinical feature, image were analyzed. RESULTS:A total of 10 cases of hematoma, 1 case had a clear history of trauma, all patients showed exophthalmos, with different degrees of visual acuity decrease, eye movement disorders. Hematoma within the muscle cone in the cone CT showed high density, and the performance of the front showed quasi-circle. B-ultrasound within 4 days appeared as intense echoes of solid lesions, more than 4 days showed hypoechoic areas, individual had echoes interval inside, CDFI had no blood flow signals within the tumor, a routine MRI was consistent with subacute hemorrhage. Bleeding within 7 days of surgery were seen hematoma blood clot. CONCLUSION:Orbital hematoma took onset suddenly, most of which has no inducement, combined with clinical history, symptom, sign, CT, B ultrasound and MRI, we can obtain correct diagnosis. Operation is an efficient way to those who has no obvious improvement with conservative treatment , and obtains good prognosis.

Clinical analysis of periorbital and orbital cellulitis in Children

Xiao-Yu Zheng,Ji Jin and Hua-Ying Xie

AIM:To analyze clinical characteristics of periorbital and orbital cellulitis in pediatrics. METHODS:Fifty-four medical records of pediatrics admitted to the Department of Ophthalmology with a diagnosis of periorbital and orbital cellulitis during the year 2010 were retrospectively studied. RESULTS:Thirty-four cases of periorbital cellulitis and 20 cases of orbital cellulitis were included, with no significant differences in gender, eye involvement and age between the two. Male∶female ratio was 2.6∶1, The highest incidence occurred in the 0-3 year old group(71%). Seasonal distribution appeared to peak in November and January, the predisposing factors were diverse. White blood cell count, neutrophil count and percentage of elevated C-reactive protein in periorbital cellulitic patients were lower than those in orbital cellulitic patients(P<0.01).57% periorbital and 88% orbital cellulitic children were found sinusitis by orbital and sinus CT scans. The isolated pathogens found in pediatric orbital abscess fluid included Staphylococcus aureus, Staphylococcus simulans and Streptococcus pneumoniae.Periorbital cellulitic children were treated with single or two antibiotics, while orbital cellulitis usually required combined antibiotics, and surgical interventions when necessary. CONCLUSION:Children with periorbital or orbital cellulitis are commonly under three years old, seasonal incidence peaks in autumn and winter, upper respiratory infection and sinusitis are the most important predisposing factors. Orbital cellulitis has a more severe infection than periorbital cellulitis, CT scan is useful to differential diagnosis.Antibiotic therapy should have coverage against staphylococcal and streptococcal species, and adjust to different predisposing diseases and microbiology. A timely performed surgery can shorten the course of infection and decrease recurrence.

Clinical effect of suspension of frontal aponeurosis in patients with severe congenital blepharoptosis

Zhi-Yong Qin,Zhang-Min Lu and Zhi-Jian Liang

AIM:To investigate the clinical effect of suspension of frontal aponeurosis in patients with severe congenital blepharoptosis and surgical complication. METHODS:Eighteen patients (25 eyes)with severe congenital blepharoptosis were treated with suspension of frontal aponeurosis and the operative effect was analyzed retrospectively. RESULTS:The follow-up periods of the patients ranged from 3 months to 12 months. The blepharoptosis was corrected in all cases .At 3 months postoperative, the satisfactory rate was 76%(19/25 eyes),the basically satisfactory rate was 24%(6/25 eyes),no inefficient case .The complications were various degrees of lagophthalmus and recovered in 6 months. There were no severe complication such as ectropion, entropion,malformed upper lid margins,or exposure keratitis and so on. CONCLUSION:Suspension of frontal aponeurosis is an ideal method to treat severe congenital blepharoptosis in patients .

One-stage repair of congenital blepharophimosis syndrome with the frontalis suspension using dacron mesh sling

Long-Quan Xue and Shu-Guo Yin

AIM:To explore the one-stage repair effect of congenital blepharophimosis syndrome by combining Y-V medial canthoplasty with the frontalis suspension using dacron mesh sling . METHODS:From 2004 to 2009, an one-stage procedure combining blepharoptosis correction with medial canthoplasty was adopted in 14 patients with congenital blepharophimosis syndrome (5 male, 9 female; aged from 4 to 14). Bilateral severe blepharoptosis and epicanthus inversus were found in all the patients, 12 (86%)patients had flat dorsum nasi. The vertical length of the palpebral fissure was 1 to 5mm, horizontal length 18 to 25mm, and the intercanthal distance was 38 to 43mm. RESULTS:In the follow-up periods ranged from 1 to 24 mo, in all 14 cases, the vertical length of the palpebral fissure was 5 to 9 mm, horizontal length was 25 to 30mm, and the intercanthal distance was 30 to 35mm. The appearance of their bilateral eyelids was satisfying. CONCLUSION:The modified one-stage procedure combining Y-V medial canthoplasty with the frontalis suspension using dacron mesh sling can achieve favorable outcomes for patients with congenital blepharophimosis syndrome.

Clinical analysis of scleral complications after different pterygium surgery

Ying-Fang Zhu and Yu-Jun Liu

AIM:To analyze the clinical manifestations, causes and treatment of scleral complications after different pterygium surgery. METHODS:By retrospective study, the 577 cases (857 eyes) with primary pterygium were divided into 4 groups according to different surgical procedures. The clinical manifestations, causes and treatment were observed. RESULTS:A total of 39 eyes appeared different degree scleral complications. There were more stimulating symptoms and scleral complications in the group Ⅱof pterygium resection combined with mitomycin than those in other groups (P<0.01), followed by group Ⅰof pterygium resection. 34 eyes were cured after eyedrops of hydroxymethyl propyl and Basic Fibroblast Growth Factor(BFGF) in about 2 weeks. 5 eyes with scleral necrosis were gradually healing after the debridement and fresh amniotic membrane transplantation. CONCLUSION:Early detection and effective treatment, preoperative prevention are very important in the scleral complications,correct pterygium surgery and eyedrops can effectively reduce scleral complications.

Effect of inferior oblique weakening procedures on the status of ocular torsion

Hui Qiu,Xin-Yao Li,Ming-Yu Shi,Hong-Yang Li and Jin-Song Zhang

AIM:To analyse the effect of weakening inferior oblique muscles on the status of ocular torsion by measuring disc-fovea angle (DFA). METHODS:A total of 30 eyes of 23 cases with inferior oblique muscle overaction underwent inferior oblique weakening procedures,images of fundus including fovea and disc were photoed by OCT before and one week after surgery. DFA was measured by using PhotoShop software, and statistical analysis was done with SPSS software. RESULTS:DFA was 17.200°±6.624°and 7.735°±6.545°respectively before and one week after surgery. There was significant difference for DFA before and one week after surgery (P<0.01). CONCLUSION:DFA can be changed significantly through inferior oblique weakening procedures. Measurement of DFA is useful in surgery design before surgery and surgical result evaluation after surgery.

Clinical analysis of laser lacrimal point plasty therapy combined with lacrimal intubation for lacrimal point stenosis

Jin-Jin Tian,Hui Kong and Fu-Ling Liu

AIM:To analyse the feasibility,indications and efficacy of lacrimol point incision combined with lacrimal intubation in our clinic for the treatment of lacrmal point stenosis or occlusion. METHODS:A total of 37 patients (41 eyes) were with lacrmal point stenosis or occlusion.20 patients(22 eyes)underwent Nd:YAG laser combined with lacrimal intubation,17 patients(19 eyes) underwent lacrimol point incision combined with lacrimal intubation.All the cases had an extubation according to recovery.All patients then continued to be followed up for 3 months to 12 months.All patients’ situation of epiphora,the form and function recovery of lacrimal point, and surgical complications were observed and recorded. RESULTS:Until the last following up time,all cases had 100% effective rate.Nd:YAG laser combined with lacrimal intubation had a cure rate of 82% ,the other was 79%.There were no obvious difference between the two types.All the congenital atresia of lacrimal point cases had a 100% cure rate.After surgery,2 cases were with swelling tissue around lacrimal point and itching,1 case with split lacrimal point,1 case with lacrimal passages granulation. No other complications were found.No self-detachment of lacrimal drainage tube was found. CONCLUSION:Combination with lacrimal intubation to treat lacrmal point stenosis is unique and effective.Nd:YAG laser combined with lacrimal intubation is simple for lacrmal point stenosis or congenital atresia ,it deserved to be applied.Congenital closure of lacrimal point may be a surgical indications of lacrimal point incision combined with lacrimal intubation.

Study on the correlation between symptom and sign of patients with dry eye

Chuan-Wei Zhang,Kai Li and Yu-Liang Wang

AM:To discuss the correlation between symptom and sign of patients with dry eye. METHODS:The patients were analysed including ages, symptoms,tear break-up time(BUT)test, SchirmerⅠtest and the fluorescent stain test(FL).The clinical data was quantitated and analysed with correlation analysis. RESULTS:Age was negatively correlated with SchirmerⅠtest(r=- 0.219,P<0.05), dryness of eye was positively correlated with SchirmerⅠtest(r=0.156,P<0.05),dryness of eye was negatively correlated with BUT(r=- 0.254,P<0.01), eye dry was positively correlated with asthenopia(r=0.313,P<0.01),photophobia was negatively correlated with SchirmerⅠtest(r=- 0.231,P<0.01), photophobia was negatively correlated with the fluorescent stain test(FL)(r=- 0.165,P<0.05),the fluorescent stain test(FL) was negatively correlated with asthenopia(r=- 0.220,P<0.01). CONCLUSION:The incidence of dry eye was higher for the elderly.There are some correlation between subjective symptoms and objective signs of dry eye.

Effect of ciliary body shape and position on spatial structure in anterior segment of normal eyes

Wu-Feng Zhang and Xing-Hui Xu

AIM:To evaluate effect of ciliary body shape and position on spatial structure in anterior segment of normal eyes. METHODS:Totally 186 eyes of 186 normal subjects were examined by ultrasound biomicroscopy(UBM), A scan and Pentacam scheimpflug system, including ciliary body thickness(CBT), ciliary process length(CPL) , scleral ciliary process angle(θ) ,anterior chamber volume(ACV), anterior chamber depth(ACD), lens thickness(LT) and relative lens position(RLP), angle opening distance 500μm from the scleral spur(AOD500). The correlations of CBT, CPL, θ and ACV, ACD, LT, RLP, AOD500 were analysed using linear correlation and regression analysis. RESULTS:Normal CBT, CPL, θ and ACV, ACD, LT, RLP, AOD500 were 0.740±0.099mm, 1.228±0.166mm, 45.81°± 5.11°, 171.15±44.23mm3, 2.822±0.314mm, 4.29±0.48mm, 0.231 ± 0.013,0.373±0.069mm, respectively.CBT was positive correlation with ACV, ACD and RLP, negative correlation with LT and no correlation with AOD500. CPL was negative correlation with ACV, ACD, RLP and AOD500, positive correlation with LT. θ was positive correlation with ACV, ACD,RLP and AOD500 and no correlation with LT. CONCLUSION:Ciliary body shape and position are influence factors of differences in spatial structure of ocular anterior segment.

Comparison of presbyopic refraction between conventional refractive procedure and medical refractive procedure in pseudophakic eye

Jian He,Shao-Jian Tan,Hao Liang and Xia Li

AIM:To compare the difference between conventional refractive procedure and medical refractive procedure in pseudophakic eye, exploring the scientific and standardized procedure of presbyopic refraction for pseudophakic eye. METHODS:Totally 30 age-related cataract patients(60 eyes) were with binocular phacoemulsification and monofocal intraocular lens inter-capsular implantation. All the patients were measured with conventional refractive procedure firstly and then medical refractive procedure after about a week. Presbyopic ADD, accommodative amplitude, negative relative accommodation(NRA) and positive relative accommodation(PRA) with best corrected near visual acuity(BCNVA) and length of comfortable reading time were measured 3 months after surgery. RESULTS:ADD acquired from two refractive procedure was significantly different(P<0.05), ADD acquired from conventional refractive procedure was 1.50±0.42D, which existed positive correlation with age(P<0.05);ADD acquired from medical refractive procedure was 1.28±0.19D, which had no correlation with age(P>0.05). Length of comfortable reading time acquired from medical refractive procedure were 30.13±5.10minutes, which was significantly longer than the length of comfortable reading time acquired from conventional refractive procedure (P<0.05). CONCLUSION:The exact presbyopic refraction for pseudophakic eye should be based on the parameter acquired from medical refractive procedure, in order to achieve longer time and more comfort on reading.

Study of reading visual acuity in myopic anisometropes

Feng-Wei Song,Wei-Lin Lu,Chen-Xiao Wang and Dan Xu

AIM:To study the characteristics of reading visual acuity in myopic anisometropes and myopes without anisometropia by E Standard Logarithm Near Visual Acuity Chart and Chinese Characters Near Visual Acuity Chart. METHODS:Eighteen myopic anisometropes(experimental group, EG)and seventeen myopes without anisometropia(control group, CG)were recruited for this study. All subjects were fully corrected based on subjective refraction using frame glasses and then were measured reading visual acuity by E Standard Logarithm Near Visual Acuity Chart and Chinese Characters Near Visual Acuity Chart. RESULTS:There was no significant difference in binocular reading visual acuity between EG and CG at contrast level 100% or 10%(P>0.05). The reading visual acuity measured at contrast level 100% was significant different from that measured under 10% in both EG and CG (P<0.01).The reading visual acuity measured by Chinese Characters Near Visual Acuity Chart was obviously worse than that measured by E Standard Logarithm Near Visual Acuity Chart at both two contrast levels (100%, 10%). There was no significant difference in reading visual acuity between medium myopia group and low myopia group(P>0.05). CONCLUSION:There was no significant difference in binocular reading visual acuity between myopic anisometropes and myopes without anisometropia. The contrast had great effect on reading visual acuity. When the contrast was lower, the reading visual acuity measured was worse. There was no significant correlation between reading visual acuity and myopic diopter. The reading visual acuity measured by Chinese Characters Near Visual Acuity Chart was obviously worse than that measured by E Standard Logarithm Near Visual Acuity Chart. The reason might be that Chinese Characters Near Visual Acuity Chart only took the visual angle as standard design parameter according to the character’s height, while ignored the complex configuration and stroke of characters. So the Chinese Characters Near Visual Acuity Chart used at present should perfect its design and conversion mechanism.

Analysis of reason for refractive regression after LASIK

Yuan-Yuan Yan

AIM:To discuss the reason for refractive regression after laser in situ keratomileusis (LASIK). METHODS:There were 152 cases (287 eyes), men 62 cases, women 90 cases, aged 17 to 50 years old. Preoperative LASIK refraction with all patients was - 6.00 ~ -15.00 D.According to refraction ,they were divided into A group of 142 eyes (- 6.00 ~-9.00D), B group of 101 eyes (-9.25~-12.00D) and C group of 44 eyes (-12.25~-15.00D).They were recorded with different gender, age, refraction, corneal thickness, corneal refractive power and corneal laser ablation zone diameter, and analyzed statistically after LASIK. The mean follow-up time was 1 year. RESULTS:A group:refractive regression rate of surgery eye was 3.1%, the average number of refraction was -1.01±0.56D, 1 year after surgery the average corneal bed thickness of normal surgery eye was 457.1±30.1μm, regressive surgery eye was 396.2±32.0μm, the intraoperative mean diameter of ablation zone for the normal surgery eye was 6.22±0.37mm, regressive surgery eye was 5.73±0.38mm, all of the differences were significant (P<0.05). B group:refractive regression rate of surgery eye was 10.2%, the average refraction was -1.69±0.81D,1 year after surgery the average corneal thickness of normal surgery eye was 443.1±32.9μm, regressive surgery eye was 303.4±29.0μm,the intraoperative mean diameter of ablation zone for the normal surgery eye was 6.02±0.16mm, regressive surgery eye was 5.66±0.21mm, all of the differences were significant (P<0.05). C group:refractive regression rate of surgery eye was 11.3%, the average refraction was -1.96±1.76D, 1 year after surgery the average corneal thickness of normal surgery eye was 439.1±30.1μm, regressive surgery eye was 279.0±28.0μm,the intraoperative mean diameter of ablation zone for the normal surgery eye was 5.87±0.21mm, regressive surgery eye was 5.51±0.15mm, all of the differences were significant (P<0.05). CONCLUSION:LASIK can treat myopia of - 6.00~ -15.00D effectively. Patients of high myopia with preoperative thin corneal thickness and patients with a small intraoperative laser ablation zone diameter are prone to postoperative refractive regression.

Discussion of treatment for persistent corneal epithelium defect after vitrectomy

Yu-Zhao Sun,Feng Gu,Peng Sun,Han Zhang and Zhe-Li Liu

AIM:To summarize and discuss the treatment experience in persistent corneal epithelium defect after vitrectomy.METHODS: The repairment of cornea by tri- or quad-kinds treatments for 10 cases 11 eyes with the persistent corneal epithelial defect after vitrectomy were evaluated. Original postoperative anti-inflammatory eyedrop was halted, instead of dropping serum eyedrop to promote corneal repair. Moderate hormone was applied by retrobulbar injection and temporary eyelid saturation. The ratio of persistent corneal epithelium defect after vitrectomy was analyzed.RESULTS: The rate of persistent corneal epithelium defect after vitrectomy was 2.2% (11/509), the rate of diabetic retinopathy case was 4.8% (8/165). The curative rate was 100%. The rate of corneal nebula was 45.5% (5/11). CONCLUSION: The reason for persistent corneal epithelium defect is complex. It’s worth paying attention to diabetes cases. To terminate drug toxicity, strengthen the nutrition of cornea and suture the eyelid temporarily are the effective treatments.

Changes of axial length after second term intraocular lens implantation in children after congenital cataract extraction

Wei Xiao,Sen Miao,Dai-Xin Zhao and Kun Zheng

AIM:To observe the changes of axial length after second term intraocular lens(IOL) implantation in infants after congenital cataract extraction.METHODS: A consecutive case series of total 13 aphakic infants (22 eyes including 4 unilateral eyes), who had undergone IOL implantation surgeries at 2.5 years of age, were included. Patients were divided into 3 groups based on their ages at follow-ups: 3-year group, 4-year group and 5-year group. The axial lengths in each follow-up were measured. The changes of axial length were analyzed and compared with those of normal age-gender-matched children.RESULTS: The mean axial lengths from 3-year group to 5-year group were 22.41±1.75mm, 23.16±1.42mm and 23.73±1.37mm respectively.There was statistically significant difference compared with those of normal age-gender-matched children (P<0.05) .CONCLUSION: The axial length of young children, following second term IOL implantation at 2.5 years of age, was longer than normal children in the period of 5 years of age. 

Observation of ocular pulse amplitude variations after the laser peripheraliridectomy in acute angle-closure glaucoma

Pei-Feng Li,Xu-Kang Cheng,Yi Jin and Dan Chen

AIM:To study the variations of the intraocular pressure (IOP) and the ocular pulse amplitude (OPA) in the acute angle-closure glaucoma after laser peripheraliridectomy. METHODS: Totally 19 patients (19 eyes) were taken into the study. They were measured by the dynamic contour tonometry (DCT) before and 30 minutes after instillating 10g/L pilocarpine, 30 minutes and 1 week after the laser peripheraliridectomy. RESULTS: The mean IOP was 17.61±4.23mmHg, 17.35±3.52mmHg before and 30 minutes and 1 week after the 10g/L pilocarpine instillation, and 19.33±4.24mmHg, 16.08±2.13mmHg 30 minutes and 1 week after the laser peripher- aliridectomy. The mean OPA was 2.69±0.89mmHg, 2.72±0.93mmHg,3.03±0.89mmHg,2.51±0.69mmHg before and 30minuts after the pilocarpine instillation, 30 minutes and 1 week after the laser peripheraliridectomy.The IOP and OPA significantly increased 30 minutes after the laser peripheraliridectomy(P<0.05).The OPA was positive correlated with the IOP. CONCLUSION: The IOP and OPA will significantly increase 30minuts after the laser peripheraliridectomy in acute angle-closure glaucoma. The OPA is positive correlated with the IOP.

Application of anterior chamber penetration in acute angle-closure glaucoma with continuous high intraocular pressure

Xin Zhou,Liu Cao and Lin-Nong Wang

AIM:To investigate clinical effects of anterior chamber penetration on treating the glaucoma with continuous high intraocular pressure (IOP). METHODS: Eighty cases (80 eyes) of primary acute angle-closure glaucoma were divided into two groups by the different methods of treatment, anterior chamber penetration group: 40 cases (40 eyes) and control group: 40 cases (40 eyes). All the cases had IOP≥50mmHg before treatment. Before and after the treatment, routine examinations such as best spectacle corrected visual acuity(BSCVA),IOP were performed, the changes in anterior chamber angle and the complications of the surgery were observed and analyzed by SPSS statistically.RESULTS: Most cases gained a better vision after the treatment. The IOP of both groups were reduced, and the anterior chamber penetration group was lower than the control group. In gonioscopy examination, the higher ratio of the anterior chamber angle reopening was found in the anterior chamber penetration group. After the filtrating surgery, there were no complications in the anterior chamber penetration group. In the control group, malignant glaucoma were observed in 1 case, cyclodialysis was observed in 3 cases and shallow of anterior chamber was observed in 4 cases.CONCLUSION: Anterior chamber penetration is one kind of safe, effective and simple method of treating the glaucoma with continuous high IOP. It can reduce the damage to visual function caused by the high IOP and provide the good condition before the surgery. 

Analysis of grid photo-coagulation in treatment of macular vesicular edema caused by central retinal vein occlusion

Bo Zheng,Yong Wang and Li-Li Wang

AIM:To analyze curative effect of grid photo-coagulation in treatment of macular vesicular edema caused by central retinal vein occlusion.METHODS:One hundred thirty-seven patients (137 eyes) with macular vesicular edema caused by central retinal vein occlusion were detected with visual acuity,optical coherence tomography(OCT) and fundus fluorescein angiography(FFA) 1 week, 1 month, 3 months after grid photo-coagulation. RESULTS:Totally 119 eyes(86.9%) showed visual improvement and 18 eyes(13.1%)showed visual stability 1 month after treatment; 124 eyes(90.5%) showed visual improvement and 13 eyes(9.5%)showed visual stability 3 months after treatment. The visual acuity improved significantly 1 month and 3 months after treatment. CONCLUSION: The curative effect of grid photo-coagulation in treatment of macular vesicular edema caused by central retinal vein occlusion is affirmative. It is necessary that there should be sufficient effective photo-coagulation spot and correct photo-coagulation modality based on fundus condition in treatment.

Scleral buckling without drainage for old retinal detachment

Qi-Chang Wang,Han-Sheng Liu,Zeng-Chao Zhou and Juan Chen

AIM:To explore the results of scleral buckling procedure without subretinal fluid drainage for old retinal detachment.METHODS: Clinical data of 32 patients (32 eyes) with old retinal detachment who underwent scleral buckling procedure without subretinal fluid drainage were retrospectively analyzed. Best-corrected visual acuity(BCVA),intraocular pressure(IOP),surgery complications and retinal redetachment were examined . RESULTS: The follow-up duration was 6 months to 12 months postoperatively,mean 9.2 months. BCVA of 17 eyes was more than 0.1. IOP of 2 eyes increased in short time after surgery. Retina was completely reattached in 30 eyes (94%).Subretinal proliferative membrane in 2 eyes which continued to worsen after scleral buckling were achieved by vitrectomy.CONCLUSION:Scleral buckling procedure without subretinal fluid drainage is a simple and efficient surgery for the treatment of old retinal detachment without seriously subretinal proliferative membrane.

Autofluorescence observation of acute Vogt-Koyanagi-Harada disease

Lan-Ping Su,Xi-Jia Peng,Ji-Qi Zheng and Ya-Dong Wang

AIM:To investigate the characteristics of fundus autofluorescence (FAF) in acute Vogt-Koyanagi-Harada (VKH) disease. METHODS: A total of 9 patients 18 eyes with acute VKH were undertaken FAF by a confocal scanning laser ophthalmoscope (Heidelberg Retina Angiograph 2, HRA2). Characteristics of FAF images were compared with fundus fluorescein angiography (FFA) images. RESULTS:Early phase of FFA showed multiple areas of hyperfluorescence at the level of the retinal pigment epithelium (RPE)and late phase of FFA revealed multiple pooling of dye in the areas of serous detachment. In FAF imaging, the serous detached retinal areas were observed as hypoautofluorescence due to the blockage. In these hypoautofluorescence areas, hyperautofluorescent ring or semiring could still been seen. The site of these hyperautofluorescent ring corresponded with the leakage point in FFA. After resolution of serous detachment, the autofluorescence distribution returned to normal, while some hyperautofluorescent dots were observed scattered in macula.CONCLUSION:FAF imaging non-invasively visualised sequential metabolism and functional changes in RPE in acute VKH disease. The value of FAF in VKH needs further research.

Clinical analysis of intraoperative floppy-iris syndrome in cataract surgery

Jiao Liu,Lin-Bin Wu,Jia-Cheng Zhou,Dai-Li Xu and Yong-Hui Liu

AIM:To discuss the pathogen, clinical manifestation and the treatment of the intraoperative floppy-iris syndrome(IFIS)which occurs in the process of cataract surgery.METHODS: Totally 489 operation inpatients (558 eyes) with extracapsular cataract extraction (ECCE) and phacoemulsification in our hospital in 2008-2009 were reviewed. We analyzed the holistic and local drug-use state of patients preoperatively and surveyed the changes in the iris and the pupil of these operation on inpatients of IFIS when we injected adrenalin hydrochloride and viscoat in anterior chamber or used iris hooks and iris dilator rings in operations.RESULTS: In 2008, 9 cases attacked by IFIS in 236 operation inpatients of cataract surgery (279 eyes), and in 2009, 2 cases in 2009 in 253 operation inpatients of cataract surgery (279 eyes). The incidence rate difference(IRD) of IFIS in two years had clinical significance (P<0.05).CONCLUSION: The incidence of IFIS in cataract surgery is related to the using of α1 antitrypsin deficiency. Taking preventive action can reduce the morbidity for related cases before the operation. In operations, for the case of prolapse of iris and the contraction of pupil, injecting diluted adrenalin hydrochloride and viscoat in anterior chamber or using iris hooks and iris dilator rings when performed can prevent the tendency of prolapse of the iris through the incision basically, ameliorate the level of the contraction of pupil to a certain extent and reduce the incidence of the complication.

Influence of soft contact lenses on intraocular pressure measurement

Ling-Juan Xu,Zhi-Qi Chen,Yan Xiang,Gui-Gang Li and Hong Zhang

AIM:To evaluate the influence of soft contact lenses with -0.50D lens power on the measured value of the intraocular pressure (IOP) with the non-contact tonometer and Tono-pen tonometer.METHODS: Totally 30 healthy volunteers were included in this study. The right eyes were examined with slit-lamp microscope and there were no scars, edema, ulcers and other pathological changes in the corneas. IOP of the right eyes was measured after topical anesthesia with the non-contact tonometer and Tono-pen tonometer for each of them. After wearing a piece of soft contact lenses with -0.50D power, the IOP values were measured again, and then the IOP values were statistically evaluated. 21 eyes with corneal diseases or ocular hypertension whose IOP could not be measured by the non-contact tonometer were also included in this study. RESULTS: There was no statistical significance between naked eyes and eyes wearing soft contact lenses. The average IOP values measured with non-contact tonometer were 15.25±2.83mmHg in naked eyes and 15.20±2.89mmHg in eyes wearing soft contact lenses (P=0.825). The average IOP values measured with Tono-pen tonometer were 15.93±2.43mmHg in naked eyes and 16.60±3.09mmHg in eyes with soft contact lenses (P=0.146). Fifteen of the 21 eyes got IOP values by the non-contact tonometer after wearing soft contact lenses. The difference was not statistically significant between eyes with or without soft contact lenses.CONCLUSION: Soft contact lenses with -0.50D lens power has no influence on the measurement of IOP with non-contact tonometer and Tono-pen tonometer, indicating that relatively reasonable IOP may be gotten from corneas with scars and ulcers by wearing soft contact lenses. Moreover, it is possible that devices based on contact lens sensor may be used for IOP measurement in the future.

Discussion on the causes and treatment of postoperative complications in congenital ptosis

Ya-Ni Mao,Hong-Juan Jia and Dao-Man Xiang

AIM:To investigate the causes and treatment methods of postoperative complications in congenital ptosis. METHODS: A total of 20 children(21 eyes) who requested reoperation after the correction of congenital ptosis from 2005 to 2010 were surveyed and treated,to observe the effect of surgical treatment.RESULTS: The causes of reoperation were entropion trichiasis (9 eyes),under-corrected ptosis(14 eyes),under-corrected ptosis and eyelid defect companion fistula formation (1 eye),unsatisfied shape of double eyelids (19 eyes).14 eyes were operated with frontal muscle flap’s suture adjustable. 1 eye was operated with frontal muscle flap suspention and fistula resection combined reconstruction of eyelid defect. 4 eyes were operated with frontal muscle flap suspention. 2 eyes were performed with frontal muscle flap reinforcement. Through the observation after operation for 0.5-1 year,the postoperative effects of all patients were satisfactory except lid lag more or less. CONCLUSION: The postoperative complications of ptosis are varied. There are never fixed pattern to treat complications. We should modify our surgical methods in accordance with specific conditions. The adequate preoperative examination and the choice of correct operation technique,improving surgical skills are the key points to reduce the postoperative complications. 

Causes and curative effects analysis of 26 patients with recurrent congenital ptosis

Dong Jiang,Nai-Jiang Xu and Yan-Li Ding

AIM:To analyze the causes of recurrence congenital ptosis and guide the choice of surgical procedure again.METHODS:Previous surgical procedures before surgery was understood, reasons for failure was analyzed, and according to levator muscle strength of upper eyelid combined with medical history, surgical method was re-established. Based on the levator muscle strength, considering the previous surgical operations, for the levator muscle strength ≤4mm, frontalis flap suspension was introduced; for the levator muscle strength ≥6mm, levator shortening was introduced; for the levator muscle strength between 4-6mm, if they used frontalis in previous surgery, levator shortening and fromtal muscle flap suspension might be introduced. We have used fromtal muscle flap suspension.RESULTS:A total of 26 cases 30 eyes patients had no eyelid margin arc deformity,natural double eyelid,the upper palpebral margin located 1-2mm down upper corneal margin, or symmetric with the health eye.CONCLUSION: Recurrent congenital ptosis resurgery was re-established with surgical method according to levator muscle strength combined with medical history.

Limbal stem cell transplantation with fibrin sealant for the treatment of recurrent pterygium

Bing-Yu Tian and Hua Zhang

AIM:To analyze the therapeutic effectiveness of the fibrin sealant with limbal stem cell transplantation in the treatment of recurrent pterygium.METHODS: Totally 88 eyes with recurrent pterygium were randomly divided into two groups: observer group of limbal stem cell transplantation with fibrin sealant and control group of string with limbal stem cell transplantation in the treatment of recurrent pterygium.RESULTS:The recurrence rate was 2.2% in observer group and 14.3% in control group, respectively(P<0.05). Postoperatively, the foreign bodies sensation and the rate of transplant edema in observer group were less than that in control group.CONCLUSION:Fibrin sealant with limbal stem cell transplantation for treating recurrent pterygium has the advantage of slight trauma, mild pain, short operative time,early recovery.It is a more effective and satisfactory surgery way. 

Expression of form deprivation in children myopia

Ping Lin,Su-Wen Lai and Li-Ling Zhang

AIM:To investigate whether form deprivation due to various reasons in the children of growth and development stage will result in inconsistent occurrence and development of myopia in both eyes,and confirm form deprivation myopia from the clinical level, and to reveal the environmental factors and mechanisms of myopia to take effective measures of prevetion.METHODS:Totally 114 myopic children were selected for regular visual acuity, eye position, dominant eye, fundus, slit lamp, and standardized mydriatic retinoscopy and other tests, and understanding their family history and whether there was deprivation factors.Binocular vision and refraction were compared, and statistical analysis was done according to the form deprivation eye and diopter.RESULTS: Binocular visual acuity (P=0.000) and refraction (P=0.006) were significantly different, and form deprivation eye was correlated with binocular high refraction (P=0.005).CONCLUSION: Monocular form deprivation due to various reasons in the children of growth and development stage can cause inconsistent myopia of both eyes. The earlier the deprived eyes developed myopia, the higher the refractive error. We should pay attention and take effective measures for early intervention.

Application of botulinum toxin A injection guided by high-frequency ultrasound in the treatment of restrictive strabismus in thyroid associated ophthalmopathy

Xin-Hua Liu,Chong-Gang Pei,Yi Shao,Chao-Ying Miao and Xiao-Bo Huang

AIM:To observe the clinical effects of botulinum toxin A(BTXA) injection guided by high-frequency ultrasound in the treatment of restrictive strabismus in thyroid associated ophthalmopathy.METHODS: Thirty-two patients with restrictive strabismus in thyroid associated ophthalmopathy were recruited in clinical study.Under the guide of high-frequency B ultrasound diagnostic apparatus, BTXA was injected into the extra-ocular muscles.The changes of the degree of and strabismus diplopia were observed after therapy.RESULTS: In all eyes of 32 patients,the strabismus and diplopia were lessened in different degrees after repeated injection with botulinum toxin A in the affected extra-ocular muscles for 2 to 4 times. The total apparent rate was 47%,effective rate was 44%, ineffective rate was 9%.CONCLUSION: BTXA injection guided by high-frequency ultrasound technique is accurate positioning method in the treatment of restrictive strabismus in thyroid associated ophthalmopathy. It is an effective therapy to lighten the contraction of extra-ocular muscles remission of diplopia symptom and strabismus degree.

Long-term observation on the eye position after treatment of congenital esotropia with operation

Ai-Jun Han

AIM:To observe the clinical features and therapeutic efficacy of congenital esotropia and to follow-up the strabismus changes after surgery and the significance of the early treatment. METHODS: This study added up clinical data of 40 cases with congenital esotropia and made a retrospective analysis for their long-term eye position observation results.RESULTS: In congenital esotropia, postoperatively, the rate of achieving alignment within±10△at the last follow-up was significantly low and binocular vision in the group of surgery before 4 years old was significantly higher than that of after 4 years old.CONCLUSION: When cases with congenital esotropia obtain operation in sensitive period of vision development, the functional recovery is good.

Related issue of corneal injury after suspension of frontal muscle flap in preschool children

Meng-Xiang Guo,Dao-Man Xiang,Wen Liu and Lan-Xiang Hu

·AIM:To investigate the clinical factors inducing corneal injury after suspension of frontal muscle flap for congenital blepharoptosis in preschool children and to establish preventive measures.·METHORDS:Totally 94 preschool children(108 eyes)with congenital blepharoptosis were treated with suspension of frontal muscle flap.Bell phenomenon,angle eyelash,winking frequency,eyelid closure,fluorescent staining of the cornea and tear film break-up time(BUT)were observed pre-and post-operation.All the results were analyzed with statistical soft.·RESULTS:One week postoperatively,the rate of corneal injury was 10.2%,after 2 weeks all patients were cured.Early postoperative fluorescent staining of the cornea,blinking frequency and BUT compared with preoperation had statistically significant difference.There was no significant difference between preoperation and 2-week postoperation.·CONCLUSION:Suspension of frontal muscle flap is a kind of effective and safe measurement.The occurrence of corneal injury is mainly related with blepharophimosis,trichiasis,reduced blinking,Bell’s phenomenon disappearance and the tear film instability.·

Clinical observation of therapeutic effect of phacoemulsification with small corneal incision and IOL implantation for uveitis coexisting with cataract

Hong Zhang

·AIM:To estimate the therapeutic effect and safety of small incision phacoemulsification and IOL implantation on uveitis coexisting with cataract.·METHODS:Phacoemulsification with small incision and IOL implantation were performed in 40 eyes of 32 patients through a small corneal incision,and the small pupil and posterior synechia were carefully handled,then the postoperative visual acuity and complications were retrospectively analyzed.·RESULTS:Follow-up 1-13 months(7.6 months in average),all cases were achieved round pupil and visual acuity was improved.Posterior capsule ruptured was in 3 eyes and tridemia occurred in 2 eyes during surgery.Corneal edema,fibrous exudates in anterior chamber,posterior synechia and uveitis recurrence were the main postoperative complications ·CONCLUSION:This method with a small corneal incision can protect iris from injury.It is a safe and effective method for management of uveitis coexisting with cataract,there is little inflammatory reaction,and visual acuity is satisfactory.·

Retrospective analysis of systemic diseases and perioperative treatment in 141 elderly cataract patients

Xiu-Rong Huang,Wei Zhang,Hong-Yi Wang,Rong Yu and Wu-Bo Cheng

·AIM:To analyze the systemic diseases and perioperative treatment in elderly cataract patients,in order to improve the safety of the surgery.·METHODS:The clinical data of the 141 cases 161 eyes in cataract patients with age≥75 years old who underwent cataract surgery-related in Sichuan TCM hospital in the 4 years from January 2005 to December 2008 were observed.·RESULTS:Totally 31 cases with systemic disease patients temporarily gave up surgery after first assessment,accounting for 22.0% of the total number of patients.Six cases in 31 patients were discharged due to serious systemic diseases after treatment.ECG monitoring and continuous low flow oxygen were performed in 45 cases during operation.13 cases with high blood pressure.7 cases with OCR(Oculo-Cardiac reflex).2 cases with cough.Postoperative corrected visual acuity:light perception to <0.05 in 5 eyes,accounting for 3.4%;0.05 to <0.3 in 7 eyes,accounting for 4.7%;≥0.3 in 137 eyes,accounting for 91.9%.·CONCLUSION:The patients with the systemic diseases should be strengthened to assess the preoperative factors before cataract surgery.The systemic diseases should be treated and strictly mastered operative indication and surgical contraindication.ECG monitoring and continuous low-flow oxygen are applied to minimize the risk of surgery.Gentle surgery action is taken to avoid the Oculo-Cardiac reflex.Cataract patients with systemic diseases are appropriate to relax the visual requirements,be operated as soon as possible.·

Clinical observations on applying xinhuang tablet before and after cataract surgery

Wen Feng,Yi Chen and Xiao-Hong Wu

·AIM:To observe the effect of xinhuang tablet which were applied on the patients with age-related cataract who underwent cataract surgery on preventing postsurgical inflammatory reaction.·METHODS:Totally 121 eyes with age-related cataract who underwent phacoemulsification and intraocular lens(IOL)implantation were recruited.A group included 40 cases who took xinhuang tablet one day before the surgery,B group with 41 cases took xinhuang tablet after surgery,C group had 40 cases as a comparative group.All the groups used corticosteroid after the surgery routinely,and all the other medicines used on these groups were the same.Symptoms,signs and anterior chamber flare were respectively observed 1 day,3,7,14 and 28 days after surgery.·RESULTS:The integrated scores of symptoms,signs and anterior chamber flare in A group on the 1st day,3rd day and 7th day were lower than group B and group C,significant difference could be found(P<0.05);the integrated scores in B group were lower than comparative group C,significant difference could also be found between the two groups(P<0.05).·CONCLUSION:Xinhuang tablet are effective for restraining the early inflammatory reaction after cataract surgery,and the effect can be better when using them one day before surgery.·

Trabeculectomy combined with small incision extracapsular cataract extraction and intraocular lens implantation for primary open angle glaucoma coexisting with cataract

Mei-Xian Cheng,Tian-Chang Luo and Min-Yi Ruan

·AIM:To assess the outcome of trabeculectomy combined with small incision extracapsular cataract extraction and intraocular lens(IOL)implantation for the treatment of primary open angle glaucoma coexisting with cataract.·METHODS:A retrospective analysis of postoperative intraocular pressure(IOP)in 32 patients 56 eyes with primary open angle glaucoma between January 2004 and June 2010 were undertook.All patients had undergone simultaneous trabeculectomy,cataract extraction and posterior chamber IOL implantation.According to the age,the amount of glaucoma damage,and the target pressure,mitomycin C(MMC)was applied in 29 eyes,however 27 eyes were not applied.The mean follow-up duration was 14.2±6.7 months.·RESULTS:The mean IOP was reduced from preoperatively(39.2±10.6)mmHg to postoperatively(13.2±5.5)mmHg in the MMC group,the mean IOP was reduced from preoperatively(30.1±9.2)mmHg to postoperatively(17.5±8.1)mmHg in the cataract extraction and trabeculectomy alone group.Most subjects(88%)were able to discontinue all glaucoma medications.The best-corrected visual acuity was improved in 47 of 56 eyes(84%).·CONCLUSION:Trabeculectomy combined with small incision extracapsular cataract extraction and IOL implantation are effective as an initial surgical treatment for open angle glaucoma in glaucoma patients coexisting with cataract.·

Vitreous aspiration in the treatment of acute angle-closure glaucoma hard-controlled by drug

Jun-Hong Zhao,Hai-Tao Hu,Pei-Lin Lü and Ping Zhao

·AIM:To investigate the effect of vitreous aspiration on the treatment of acute angle-closure glaucoma hard-controlled by drug.·METHODS:Totally 60 cases(60 eyes,male 28,female 32)with acute angle-closure glaucoma enrolled in our hospital,24 hours after drug treatment,intraocular pressure(IOP)were still higher than 21mmHg.IOP was 21-35mmHg in 26 eyes(43%),<35-50mmHg in 18 eyes(30%),more than 50mmHg in 16 eyes(27%).Range of vision was light perception to 0.3.All eyes were treated by pars plana vitreous aspiration treatment(aspiration of vitreous fluid 0.4-1.0mL).·RESULTS:IOP was measured at 3 days after surgery,IOP was≤21mmHg in 14 eyes(23%),<21-35mmHg in 29 eyes(48%),<35-50mmHg in 13 eyes(22%),more than 50 mmHg in 4 eyes(7%);increase of visual acuity was two lines in 28 eyes(47%),increase of visual acuity was1 line in 24 eyes(40%),no increase in visual acuity was 8 eyes(13%);anterior chamber depth deepened in 58 eyes(97%);postoperative hyphema in 16 eyes(27%).After IOP were stable,patients were treated with simple anti-glaucoma surgery in 14 eyes,glaucoma,cataract and intraocular lens(IOL)exchange surgery in 28 eyes,cataract extraction and IOL implantation in 18 eyes.During the postoperative follow-up of 6-12 months,IOP was≤17mmHg in 54 eyes,IOP≤21mmHg in 4 eyes,IOP was <21-35mmHg in 2 eyes.Retinal detachment,cystoid macular edema,etc,were not found.·CONCLUSION:The vitreous aspiration in acute angle-closure glaucoma which is difficult to control by drug has a significant effect of lowering IOP.This method provide safe and reliable conditions for the implementation of a variety of glaucoma surgery and help protect and restore visual function.·

Observation on treatment of acute attack of primary angle-closure glaucoma

Xue-Yun Feng and Shi-Lai Zhao

·AIM:To explore the effect of paracentesis of anterior chamber combined laser peripheral iridectomy(LPI)in treatment of acute attack of primary angle-closure glaucoma.·METHODS:Totally 36 cases 40 eyes of acute attack of primary angle-closure glaucoma were divided into two groups.The combined therapy group was treated by paracentesis of anterior chamber combined LPI,the control group was treated by medicine that could decrease IOP,then intraocular pressure(IOP),anterior chamber angle and the percentage of acute attack stopping and trabeculectomy were observed.·RESULTS:The rate of acute attack stopping was 89% in paracentesis of anterior chamber combined LPI group,and 38%(P <0.05)in control group;In therapy group the rate of trabeculectomy was 32%,in control group it was 76%(P <0.05).·CONCLUSION:The paracentesis of anterior chamber combined LPI have show it’s better efficacy in patients of acute attack of primary angle-closure glaucoma.It can quickly open the closed angle,control IOP.So it can increase the percentage of acute attack stopping and decrease the rate of trabeculectomy.·

Clinical experience of Ahmed valve implantation for refractory glaucoma

Guo-Ying Liu,Fei Liu and Yuan-Biao Li

·AIM:To investigate the surgical skills and prevention of complications of Ahmed valve implantation for refractory glaucoma.·METHODS:This retrospective study reviewed the visual acurity,intraocular pressure(IOP)and complications in 5 refractory glaucoma patients with Ahmed valve implantation from 1999 to 2009.·RESULTS:In the follow-up examination of 6 to 24 months,the IOP was reduced from 43.00±14.71 to 22.60±12.72mmHg.Visual acurity improved in 1 case,continued in 3 cases and decreased in 1 case.The tubes were placed right in 4 cases,the other case touch to cornea.Iris neovascularization reduced in different degrees in 3 NVG.Complications included anterior chamber hemorrhage in 3 cases,anterior chamber fibrous exudation in 4 cases,tube blockage in 2 cases,shallow anterior chamber in 2 cases,anterior chamber disappearance and high IOP in 1 case in final,tube explosure in 1 case.·CONCLUSION:Ahmed glaucoma valve implant is an effective method for treating refractory glaucoma,and the surgical skills will reduce the incidence of early complicaions.·

Clinical analysis of 12 cases in treatment of malignant glaucoma

Yi-Qun Zeng and Zhen Wu

·AIM:To investigate the efficacy and safety of two methods in treatment of malignant glaucoma.·METHODS:A total of 12 cases 16 eyes with malignant glaucoma after trabeculectomy were operated by two styles.A style:lens nuclear hardness≤2 class,visual acuity≥0.1 undertook sucking corporis vitre hyponome+restitution with anterior chamber infusion gas.B style:lens nuclear hardness≥3 class,visual acuity<0.1 undertook sucking corporis vitre hyponome+cataract removal out of capsule+ intraocular lens implantation+crystalline lens post-membrane and corporis vitre frontal membrane cutdown.·RESULTS:All eyes were treated with drugs for 4~5 days at first.Five cases 7 eyes were operated with A style,7 cases 9 eyes were operated with B style,all had successful outcomes.·CONCLUSION:The operation for malignant glaucoma with A and B styles can control intraocular pressure and protect visual function.·

Optical coherence tomography of macula area after cataract phacoemulsification

Ge-Wei Wu and Ping Chen

·AIM:To observe macula changes in patients after cataract phacoemulsification by optical coherence tomography(OCT).·METHODS:Fifty-six patients were included in this study.The uncomplicated phacoemulsification was performed.OCT was examined preoperatively,1 month and 3 months after surgery.Preoperative visual acuity,the retinal thickness were compared with those after surgery.·RESULTS:Preoperative and 1 month after surgery,the mean foveal thickness was(241.3±9.9)μm and(260.7±16.8)μm,with significant difference(P=0.000).The mean foveal thickness was(245.6±17.6)μm 3 months after surgery without significant difference compared with preoperative(P=0.137).two eyes displayed cystoid macular edema at 1 month after surgery and 1 eye of them was resolved 3 months after surgery.·CONCLUSION:The retinal thickening and macular edema can be found 1 month after uncomplicated cataract phacoemulsification.Three months Postoperatively,macular edema disappears and does not show significant difference compared with preoperative.·

Argon laser combined with retrobulbar injection of triamcinolone acetonide for macular edema

Qiu-Li Song,Shu-Yun Xu and Zhong-Cheng Li

·AIM:To investigate retrobulbar injection of triamcinolone acetonide for macular edema.·METHODS:Totally 48 eyes of 48 cases of macular edema were selected,26 cases as experimental group and 22 cases as control group.Both groups were undertook argon green laser grid pattern photocoagulation for macular edema,the experimental group followed by retrobulbar injection of triamcinolone acetonide 20mg/0.5mL,the control group were not injected.·RESULTS:Visual acuity were improved after treatment in two groups,during treatment 7 days visual acuity in the experimental group improved in 6 cases.After treatment 1 month,3 months visual acuity improved in two groups,compared the same period,which had a significant difference(P<0.05).Macular retinal thickness measurement:after treatment 7 days,1 month,central macular thickness of both groups measured by OTC were significantly thinner than before,macular edema absorption was obvious in 3 months by FFA.·CONCLUSION:For macular edema,argon green laser combined with retrobulbar injection of triamcinolone acetonide is effective with rapid recovery.·

Clinical observation of hexuemingmu tablets for retinal hemorrhage caused by retinal vein occlusion

Xiao-Lin Hao,Wei-Zhi Dai,Hua Liu and Hai-Xia Wei

·AIM:To evaluate the effects of hexuemingmu tablets for retinal hemorrhage caused by retinal vein occlusion.·METHODS:A randomized controlled study was performed on 72 patients(72 eyes).Patients were divided into 2 groups randomly:38 patients in I group(hexuemingmu,38 eyes);34 patients in Ⅱgroup(fufangxueshuantong,34 eyes).The standard of effectiveness:Cure:best-corrected visual acuity(BCVA)recovered to the statements before the hemorrhage the case recorded or the level patients expressed,retinal hemorrhage,edema completely absorbed;Markedly:BCVA improved more than three rows compared to the one the case recorded when registered.Effective:BCVA only improved more than one row;Invalid:BCVA is not improved or gets worse.·RESULTS:After six months,BCVA of 68 eyes was improved,the total effective rate was 94%,marked improvement rate was 31%(22 eyes).Cure rate was 10%(7 eyes).In I group:the total effective rate was 97%(37 eyes),marked improvement rate was 39%(15 eyes).Cure rate was 13%(5 eyes).In Ⅱ group:the total effective rate was 91%(31 eyes),marked improvement rate was 21%(7 eyes),cure rate was 7%(2 eyes),the rate of effectiveness of two groups didn’t show statistical difference(P=0.341),while the rate of marked improvement of two groups showed statistical difference(P<0.05)。·CONCLUSION:Hexuemingmu tablets is an effective drug for retinal hemorrhage caused by retinal vein occlusion.It’s helpful in eliminating the hemorrhage and improving the patient’s BCVA.·

Prophylactic chorioretinectomy for traumatic retinal incarceration

Min-Chao Li,Xiao-Ran Yang,Fei Liu,Dong-Ping Shao and Yuan-Biao Li

·AIM:To evaluate the effectiveness of prophylactic chorioretinectomy for traumatic retinal incarceration.·METHODS:Retrospective,consecutive interventional case series of 69 eyes with traumatic retinal incarceration were treated with a 20 gauge three-port pars plana vitrectomy.The operative technique included prophylactic chorioretinectomy,endophotocoagulation,intraocular tamponade and scleral buckling procedure.·RESULTS:Sixty-nine eyes of 69 patients were followed for median of 11±6(range from 4 to 27)months.The rate of retinal reattachment was 91%(63/69).The rate of proliferative vitreoretinopathy was 14%(10/69).Best-corrected visual acuity(BCVA)≥0.1 occurred in 31 patients(45%).Globe survival rate was 99%(68/69).·CONCLUSION:Prophylactic chorioretinectomy is a surgical option that may increase the rate of final retinal reattachment and decrease the rate of proliferative vitreoretinopathy for traumatic retinal incarceration.·

Therapeutic effects and application of Ando hole in vitrectomy for diabetic retinopathy

Chao Wan,Ning Zhao,Yi-Zhou Sun,Hao Feng,Na Cai and Lei Chen

·AIM:To observe the comparision of postoperative complications between with and without Ando hole in vitrectomy for diabetic retinopathy.·METHODS:The patients who were treated with vitrectomy surgery combined with PEA and intraocular lens(IOL)implantation were retrospectively analyzed,including 90 cases(95 eyes)with Ando hole and 92 cases(98 eyes)without Ando hole in department of ophthalmology of the first hospital of China Medical University.The incidences of postoperative complications-posterior synechia of the iris,IOP rising caused by atretopsia were observed.·RESULTS:There were 15 eyes with atretopsia and 12 eyes with IOP raising in control group.There were 14 eyes with atretopsia and none with IOP rising in control group.There were no significant differences in the incidences of atretopsia and posterior synechia of the iris between the two groups,but the incidences of IOP rising were significantly different between the two groups.·CONCLUSION:Ando hole can avoid IOP rising caused by atretopsia in vitrectomy for diabetic retinopathy.·

Clinical research on the effect of vitrectomy for endogenous Klebsiella endophthalmitis

Xun Li,He-Nan Liu,Wei Pu and Xiao-Long Chen

·AIM:To investigate,evaluate and analyze clinical effect of vitrectomy for endogenous Klebsiella endophthalmitis.·METHODS:A total of 11 patients(12 eyes)with endogenous Klebsiella endophthalmitis underwent vitrectomy.According to the condition of retina,they were accompanied with membrane peeling and silicone oil tamponade during vitrectomy.·RESULTS:Postoperatively,vitreous cavities of 12 eyes were all clear,visual acuity was better than before.3 eyes(25%)achieved final visual of 0.1-0.3.The follow-up time was 3 months,and only 2 eyes developed lens opacity.·CONCLUSION:Vitrectomy is an effective method for endogenous Klebsiella endophthalmitis.·

Analysis of 89 cases for enucleation of eyeball and evisceration

Xian Chen and Mei-Zhu Chen

·AIM:To explore the risk factors and the method for improving the prognosis in enucleation of eyeball and evisceration.·METHODS:A retrospective analysis of 89 cases(89 eyes)in Fuzhou General Hospital of Nanjing Military Region was made through distribution of age,medical reasons,the selection of operations.·RESULTS:In recent years the main risk factors of enucleation of eyeball and evisceration were ocular trauma and its complications.·CONCLUSION:The good self-protection and the timely and effective treatment after ocular trauma are the key points to retain eyeball.Appropriate process and timing of hydroxyapatite(HA)implanting will be good for the prognosis.·

Clinical features and early surgery for ocular torticollis in infants

Dao-Man Xiang,Xiao-He Lu,Ya-Ni Mao,Jian-Xun Wang,Hong-Mei Zhou and Zheng Guo

·AIM:To observe clinical features and effects of early surgery for ocular torticollis in infants.·METHODS:Clinical data of 70 infants with ocular torticollis were retrospectively analyzed.Preoperative exam of the Bielschowsky’s head tilt test,nine cardinal field of gaze and fundus photography,the ocular muscle anomaly was analyzed,then the reason of ocular torticollis was diagnosed.The angle horizontal strabismus was calculated by the computer-aided strabismus diagnosis technology.The patients with superior oblique palsy and overacting inferior oblique muscle,were treated with inferior oblique myectomy,The different ways of surgery were designed for other patients with different type of the strabismus.The quantity of horizontal strabismus surgery was decided by the computer-aided strabismus diagnosis technology for patients with horizontal strabismus.·RESULTS:All the patients can be found to be connected with the primary affection.The most common cause was simple unilateral superior oblique palsy,54 patients(77%).All patients were treated by surgery.After primary surgery,64 patiennts(91%)with head tilt were completely curd or improved in half a year,6 patients were failed.The three of 6 patients were treated with secondary surgery,all the three patients had their head tilt a complete cure or improved.All the horizontal strabismus was cured in primary surgery for 11 patients(16%)with horizontal strabismus.·CONCLUSION:There are different causes of ocular torticollis in infants,early surgery can obtain satisfactory results.·

Clinical efficacy of oral fuming tablet combined with sodium hyaluronate eye drops for dry eye syndrome of deficiency of liver-yin and kidney-yin type

Xiao-Li Song,Yan-Fei Xing and Zhao-Ying Wang

·AIM:To observe the clinical efficacy of oral fuming tablet,sodium hyaluronate eye drops for dry eye syndrome of deficiency of liver-yin and kidney-yin type.·METHODS:The randomly selected 60 patients(120 eyes)with dry eye syndrome of deficiency of liver-yin and kidney-yin type were randomly divided into treatment group and control group,each of 30 patients(60 eyes),Treatment group were treated with oral fuming tablet plus sodium hyaluronate eye drops;control group were treated with sodium hyaluronate eye drops only.Treatment and observation lasted for two months.It was based on clinical symptoms and Schirmer I test(SⅠt),break-up time(BUT),corneal fluorescein staining and other tests to score.·RESULTS:Compared with before treatment,the differences of test results of BUT,SⅠt,corneal fluorescein staining of two groups after treatment were statistically significant(P<0.05 or P<0.01).The total effective rate was 93.3% in the treatment group,it was 75.0% in the control group.The treatment group was superior to the control group(P<0.01),with statistical significance.·CONCLUSION:The clinical efficacy of oral fuming tablet combined with sodium hyaluronate eye drops for dry eye syndrome of deficiency of liver-yin and kidney-yin type is superior to that of the simple use of sodium hyaluronate eye drops.·

Longitudinal observation of the preschool children’s refraction

Jing-Jing Feng,Ya-Ping Li,Xiao-Hui Li and Wei Chen

·AIM:To research the refractive changes in preschool children,to provide information for the prevention and treatment of the ametropia.·METHODS:Totally 466 children aged 3 years old were examined with Suresight hand-held refractometer and followed up for 4 years.·RESULTS:Hypermetropia and the complex hypermetropic astigmatism decreased with the age increase.Emmetropia and spherical myopia increased with the age increase.The axis of astigmatism was quite stable.The spherical diaopter and the cylinder diopter decreased with the age increase.The referent value of all aged groups were gained.·CONCLUSION:It is necessary to investigate the development of refraction in children.Refraction are very important in children’s eye care and the criteria of abnormal refraction in preschool children identified by the age should be paid more attention.·

Analysis of laser in situ keratomileusis for adult myopic anisometropia

Yan Lu,Zhe-Yao Cao and Li-Kun Xia

·AIM:To explore the causes and clinical effects of laser in situ keratomileusis(LASIK)for adult myopic anisometropia.·METHODS:Bilateral eyes of 104 patients with myopic anisometropia more than 2.50 diopters were divided into the high diopter group and the low diopter group,then 186 eyes were treated with LASIK.The mean refraction,the difference of binocular anisometropia,ocular axis,uncorrected visual acuity(UCVA)and best-corrected visual acuity(BCVA)were statistically analyzed before and after LASIK.·RESULTS:Six months after LASIK,UCVA was improved significantly,the difference of binocular anisometropia was significantly decreased,and BCVA was kept at the level of pre-operation or improved much better than the level of pre-operation in all cases.The high diopter group and the low diopter group had about the same corneal curvature and the significantly different ocular axis before operation.Six months after LASIK,the corneal curvature was significantly decreased and ocular axis was kept at the level of pre-operation in all cases.·CONCLUSION:The main cause of myopic anisometropia more than 2.50 diopters in adult is the difference of ocular axis between bilateral eyes.LASIK for myopic anisometropia is an effective,safe and predictable procedure.·

Conjunctiva flap covering in treatment of serious fungus corneal ulcer

Li Zhang,Ying-Xiang Qin,Wei-Hui Yang and Lian Bai

AIM:To study the clinical curative effect of conjunctival flap covering surgery in treatment of serious fungus corneal ulcer.METHODS:Thirteen patients(13 eyes)with serious fungus corneal ulcer who underwent conjunctival flap covering surgery were retrospectively analyzed,including 10 cases with traumatic corneal ulcer,3 cases of unknown causes.All the patients were treated with removal of the necrotic corneal tissue combined with conjunctival flap covering surgery.RESULTS:Postoperatively,the corneal ulcer in 12 eyes was cured after one surgery.1 case cured after treated again by conjunctival flap covering surgery after the conjunctival flap desquamated.The corneal ulcer was cured and the eyeballs were saved in 13 eyes by conjunctival flap covering surgery.CONCLUSION:Conjunctival flap covering surgery is effective and practical in treatment of serious fungus corneal ulcer which is not responded to medical therapy,and it is an effective method to control the fungus inflammation and save the eyeballs,which provide the further condition for corneal transplantation.

Clinical management of the complications of phacoemulsification combined with intraocular lens implantation in age-related cataract

Juan Guo,Jing Su and Lin Fu

AIM:To discuss the cause and management of the complications of phacoemulsification combined with intraocular lens(IOL)implantation in age-related cataract.METHODS:Totally 578 cases(603 eyes)of postoperative complications were clinically analyzed.RESULTS:Corneal endothelial edema was in 42 eyes(7.0%),ruptured posterior lens capsule 19 eyes(3.2%),temporary ocular hypertension 29 eyes(4.8%),toxic anterior segment syndrome 2 eyes(0.3%),cystoid macular edema 2 eyes(0.3%),IOL dislocation 1 eye(0.2%).CONCLUSION:Complications are related to the latent factors of phacoemulsification,surgical technique and experience of surgeons.Through understanding the reasons and symptoms of complications before the operation,the complications can be prevented and managed.

Manipulation of chopping nucleus with knife in small incision cataract surgery combined with intraocular lens implantation

Bing Wu and Jian Yang

AIM:To explore the efficacy,skill,complication and its treatment in small incision cataract surgery combined with intraocular lens(IOL)implantation.METHODS:A total of 173 cases 199 eyes treated by small incision cataract surgery combined with IOL implantation were retrospectively analyzed within 1 year.RESULTS:The uncorrected visual acuity was 0.5 or better in 70 eyes(35.2%),93 eyes(46.7%),134 eyes(67.3%),158 eyes(79.4%)at 1 day,1 week,1 month and 1 year postoperatively,while the corrected visual acuity was 0.6 or better in 78 eyes(39.2%),101 eyes(50.8%),145 eyes(72.9%),164 eyes(82.4%).CONCLUSION:Manipulation of chopping nucleus in small incision cataract surgery with few complications for visual rehabilitation is effective,safe and economic.It is worth to be popularized.

Therapy of after cataract by needling through corneoscleral limbus tunnel incision with topical anesthesia

Yuan-Gui Wang,Zhong-Min Lang and Jing Li

AIM:To compare the therapeutic method of posterior capsulorhexis with topical anesthesia by needling through corneoscleral limbus tunnel incision with that of YAG laser posterior capsulotomy on posterior capsular opacification.To evaluate the efficacy,safety and stability of posterior capsulorhexis.METHODS:An 1mm tunnel incisoon was stuck into by a diamond cutter from the cornescleral limbns atfer topical anesthesia was performed Postorior of intraoular lens was pricked into by a curved needle for dividing the thichened postorior capsiles.The efficacy and complication were observed.RESULTS:In 29 patients(32 eyes),whoes visual acuity was 1.0 account for 69.9% postoperatively,compared with preoperatively the visual acuitiy 0.06-0.1 without any discomfort and complication for the patients.CONCLUSION:Use of imported diamond cutter from Swizorland to discissio through tunnel incision is convenient and easy without any discomfort and complication for the patients.This method can be substituted by YAG laser posterior capsulotomy.

Clinical observation of compound trabeculectomy for glaucoma

Gui-Guo Yu and Yuan-Yuan Chen

AIM:To investigate the clinical effect of compound trabeculectomy for glaucoma.METHODS:A total of 39 cases 42 eyes undertook compound trabeculectomy with MMC and adjustable suture line.Intraoculer pressure,the filtering bleb and the depth of anterior chamber were observed.The follow-up period was 3-24 months.RESULTS:The adjustable suture lines of 42 eyes were removed 3-14 days after the surgery.The shallow anterior chamber after operation were observed in 2 eyes.After proper management,shallow anterior chamber returned to normal depth in all cases.CONCLUSION:Compound trabeculectomy can increase the success ratio of the surgery and reduce the incidence of complications.

Clinical analysis of neovascular glaucoma after vitrectomy and lens removal for proliferative diabetic retinopathy

Chun-Liu Gai,Xiao-Long Chen,Xue-Mei Feng and Lei Shi

AIM:To study the factors and treatments of neovascular glaucoma(NVG)after vitrectomy and lens removal for proliferative diabetic retinopathy(PDR)patients.METHODS:The postoperative NVG was analyzed in 7 PDR patients(7 eyes)after vitrectomy and phacoemulsification.Then they underwent the implantation of glaucoma valve combined with retinal photocoagulation.The visual acuity and intraocular pressure(IOP)were observed.RESULTS:NVG that occurred in 3-6 months after operation was the most(71.4%),all eyes had not been treated by further panretinal photocoagulation(PRP)and fundus fluorescein angiography(FFA)before occurring NVG.After treatment,the IOP was controlled in 5 eyes(71.4%),without declining eyesight,the new vessels decreased or regressed.CONCLUSION:The factors like the degree of disease,the stability of blood glucose,the skill and PRP in operation,the postoperative follow-up and further PRP,etc,all can influence the occurrence of NVG.Glaucoma valve combined with PRP can not only decrease IOP but also decrease or regress the new vessels.It is a safe and effective approach to those NVG patients.

Causes and treatment of shallow anterior chamber after trabeculectomy on glaucoma

Jin-Ming Xiang,Qi Zheng,Yan-Hong Xu,Gen-Zhu Zheng and Ken Lin

AIM:To analyze the causes and treatment of shallow anterior chamber after trabeculectomy on glaucoma.METHODS:A total of 96 case 128 eyes with glaucoma were treated with trabeculectomy and postoperatively shallow anterior chamber was found.All cases were analyzed retrospectively.RESULTS:Shallow anterior chamber was found in 26 eyes(20.3%)after trabeculectomy in 128 eyes.The causes included :excessive aqueous humor run off(19/26,73.1%),leakage of filter bulb(4/26,15.4%),detachment of choroid(2/26,7.7%),malignant glaucoma(1/26,3.8%).After proper management,shallow anterior chamber returned to normal depth in all cases.CONCLUSION:Shallow anterior chamber is usually found after trabeculectomy.It is necessary to adopt corresponding treatment according to its causes for avoiding the shallow anterior chamber.

Clinical analysis of shallow anterior chamber after glaucoma filtering surgery

Xiao-Li Duan and Yi-Fei Huang

AIM:To study the causes and managements of shallow anterior chamber after glaucoma filtering surgery.METHODS;A total of 358 consecutive patients(501 eyes)with glaucoma in the department of Ophthalmology,Qingyang People’s Hosptial from Jan.1990 to Jul.2009 were retrospectively reviewed on the survey,cause and management of postoperative shallow anterior chamber were discussed.RESULTS:The incidence of postoperative shallow anterior chamber in all the subjects and in the patients who underwent filtering operation of trabeculectomy,trabeculectomy with mitomycin C,antiglaucoma combined with cataract surgery was respectively 23.6%(118/501 eyes),21.2%(68/321 eyes),35.2%(44/125 eyes)and 10.9%(6/55 eyes).Shallow anterior chamber occurred in 1-7 days after operation and causes were excessive aqueous over-filtration(39.8%,47 eyes),choroidal detachment(28.0%,33 eyes),filter bleb leaks(22.9%,27 eyes),malignant glaucoma(6.8%,8 eyes),choroidal detachment and malignant glaucoma(0.8%,1 eye),and choroidal hemorrhage(1.7%,2 eyes).81 eyes needed surgical procedure for the reformation of shallow anterior chamber.Anterior chamber reformed in other 37 eyes without any surgical procedure.CONCLUSION:The incidence(23.6%)of shallow anterior chamber is high after filtering surgery,especially in trabeculectomy with mitomycin C(35.2%),it often appears at 1-2 days postoperatively.Most of the shallow anterior chamber can be reformed through conservative management.

Pars plana vitrectomy combined with phacoemulsification and intraocular lens implantation for proliferative diabetic retinopathy

Yuan-Biao Li,Fei Liu and Guo-Ying Liu

AIM:To evaluate the effectiveness of combined pars plana vitrectomy(PPV)and phacoemulsification(PEA)with intraocular lens(IOL)implantation in patients with concomitant cataract and proliferative diabetic retinopathy(PDR).METHODS:This retrospective study consisted of 36 patients 36 eyes with PDR and cataract.PPV was combined with PEA and IOL implantation.Gas tamponade was employed in 6 eyes;silicone oil tamponade was employed in 4 eyes;postoperative visual acuity,complications were analyzed.RESULTS:The postoperative follow-up interval ranged from 1 to 12 months(an average of 4.5 months).The postoperative visual acuity was improved in different degrees:≥0.1 in 6 eyes(17%),0.02-0.1 in 24 eyes(67%),light perception to counting fingers in 6 eyes(17%).During operation,no severe complications occurred.After operation,there was early ocular hypertension in 5 eyes(14%),posterior synechia in 3 eyes(8%),posterior capsular opacity(PCO)in 12 eyes performed Nd:YAG capsulotomy(33%),and neovascular glaucoma in 1 eye(3%),but there was no retinal detachment,no vitreous hemorrhage or corneal edema.CONCLUSION:This study suggests that the combined operation of PPV,PEA and IOL implantation is safe and effective for PDR coexisting with cataract.

Clinical study of the incidence of ciliary body cysts in angle-closure glaucoma

Yan-Zhu Ren,Hong-Mei Mu,Dong-Mei Zhang and Wan-Ting Zhang

AIM:To observe the incidence of iris and ciliary body cysts in angle-closure glaucoma,and its relationship between anterior chamber depth and anterior chamber angle.METHODS:Ultrasound biomicroscopy(UBM)was used in 740 cases 1057 eyes with angle-closure glaucoma for anterior segment examination.RESULTS:Ciliary body cysts were detected in 42 cases 60 eyes among 740 cases 1057 eyes,accounting for 5.68% in the number of examined eyes.Among the iris and ciliary body cysts of 60 eyes,iris ciliary sulcus cysts were in 56 eyes(93.33%),ciliary crown cyst was in 4 eyes(6.67%);one single cyst was in 33 eyes(55.00%),multiple cysts were in 27 eyes(45.00%).Anterior chamber axis depth in patients with no associated ciliary body cysts was 1.16-2.37mm,an average of 1.843mm;anterior chamber axis depth in patients with iris and ciliary body cyst was 1.67-2.78mm,an average of 2.297mm.Angle adhesion rate of more than two quadrants in patients with angle-closure glaucoma associated with and not associated with ciliary body cysts were 66.67% and 44.59% respectively.CONCLUSION:The ciliary body cysts in angle-closure glaucoma have a higher prevalence,mostly iris cyst in the ciliary sulcus,and have little effect on anterior chamber axis depth,but can increase the adhesion angle range,cause angle-closure glaucoma.

Effects of calcium dobesilate and laser therapy on diabetic macular edema

Hui-Jun Huang,Shi-Gang Yan and Jian-Ming Chen

AIM:To study effects of calcium dobesilate and laser therapy on diabetic macular edema.METHODS:Sixty diabetic retinopathy(DR)patients were divided into two groups.Patients in one group were treated by laser photocoagulation and orally taking calcium dobesilate capsules,while those in the other group were treated only by laser photocoagulation.DR patients’ eyesight,macular thickness and reactive density of mfERG in two groups after treatment of one to three months were detected.RESULTS:The effective rate of improving patients eyesight was 73% in the united treatment group,while it was 57% in the group treated singly.The united treatment group can reduce the macular thickness obviously than the group treated singly.The united treatment group can rise the rective density obviously than the group treated singly.CONCLUSION:Two groups treatment can lighten diabetic macular edema in various degree.The united treatment group is superior to the group treated singly.

The formation of retinal hole manifested as acute and dense vitreous hemorrhage

Hai-Yan Qi and Yan-Nian Hui

AIM:To report 4 cases of acute and fundus obscuring,dense vitreous hemorrhage due to the formation of retinal hole.METHODS:Retrospective case study.The medical records of all patients were reviewed.RESULTS:Four patients included 2 male and 2 female with ages of 38 to 69 years old.The involved eye was the right eye(also high myopia)in one case and the left eye(myopia 1 case,emmetropia 2 cases)in 3 cases.The history of disease course was 1 day-3 weeks.The visual acuity was hand mouement-0.04 at initiate visit and improved in all cases following treatment of retinal hole by means of pars plana vitrectomy in 3 cases and laser photocoagulation alone in one case.The final vision was 0.04,0.2,0.6 and 0.8,respectively.CONCLUSION:We should be aware that acute vitreous hemorrhage can be induced by the formation of retinal hole.Early diagnosis and seal of the retinal hole can avoid retinal detachment and achieve better visual recovery.

Laser photocoagulation treatment model by computer-aided imaging technology of indirect ophthalmoscopy for retinopathy of prematurity

Dao-Man Xiang,Feng Chen,Wei Zhou,Guo-Qiang Zhang,Ya-Ni Mao and Zheng Guo

AIM:To observe and discuss the value of using computer-aided imaging technology of binocular indirect ophthalmoscopy in laser photocoagulation treatment for retinopathy of prematurity(ROP).METHODS:The clinical data of 58 patients 116 eyes with threshold ROP or prethreshold type I ROP were retrospectively analyzed.Ocular fundus was examined by computer-aided imaging technology of binocular indirect ophthalmoscopy before and after in every operation.Before operation results were used to design the surgery;in operation results were used to detect the missed area after laser photocoagulation,after operation results were for the operation effect recording.The surgery was implemented under surface anesthesia with electrocardio monitoring.The follow-up duration was 3-12 months.RESULTS:Missed area was found in thirty-six eyes(31.0%)by computer-aided imaging technology of binocular indirect ophthalmoscopy of laser photocoagulation.The missed area was at once supplemented during surgery.All the eyes which had undergone one time laser photocoagulation had good result after surgery and the disease was controlled.At the end of follow-up duration,there was no unfavorable retinal structural outcome.CONCLUSION:Computer-aided imaging technology of binocular indirect ophthalmoscopy of laser photocoagula-tion for ROP can find missed area effectively during the operation.Second-time surgery was avoided by supplement laser photocoagulation in time.

Clinical analysis of abnormal intraocular pressure with ocular contusion

Xue-Yun Feng and Heng Yin

AIM:To analyze the change of intraocular pressure(IOP)with ocular contusion.METHODS:A total of 181 cases were diagnosed with ocular contusion,the IOP >24mmHg was regarded as ocular hypertension and the IOP <10mmHg was regarded as ocular hypotension;the causes of abnormal IOP were classified and analyzed.RESULTS:Totally 120 cases(66.3%)in 181 cases of ocular contusion were of abnormal IOP:98 cases(81.7%)of 120 cases were of ocular hypertension,22 cases(18.3%)were of ocular hypotension.Clinical findings:the IOP after ocular contusion was associated with many complications,including hyphema,vitreous hemorrhage,mydriasis,iridodialysis,recession of anterior chamber angle,lens dislocation,vitreous body rush into anterior chamber,retinal concussion,detachment of ciliary body,etc.CONCLUSION:Ocular contusion can cause abnormal intraocular pressure,therefore ophthalmologist should think highly of it.

Efficacy analysis of 12 cases with transcranial optic nerve decompression for traumatic optic nerve neuropathy

Tie Wu and Pu Yang

AIM:To explore the therapeutic effects of microsurgical decompression of traumatic optic nerve neuropathy via transcranial approach,in comparison of extracranial approach.METHODS:A total of 12 cases with optic nerve neuropathy which underwent microsurgical decompression via transcranial approach were retrospectively analyzed,and the clinical characteristics and methods of the therapy were concluded.The recent literatures on surgical decompression of optic nerve neuropathy via extracranial approach were reviewed and the therapeutic effects of such an extracranial approach were compared with our transcranial approach.RESULTS:All patients were followed up for 3 to 12 months postoperatively,with an average rate of efficacy being 83 percent.No patient experienced cerebrospinal fluid leakage after surgery.CONCLUSION:The efficacy of decompression of optic nerve neuropathy through the optic canal is concluded and the surgery should be performed as early as possible.Because of the better therapeutic effects,decompression of optic nerve neuropathy via transcranial approach is superior to that via extracranial approach.

Effectiveness of modulated medium frequency electrotherapy and peribulbar injection of mecobalamin in the treatment of neurogenic extraocular muscles paralysis

Jun Wang,Wan-Zhang Yang,Fang Wu,Bi-Yu Ye and Hui-Xiang Xiao

AIM:To observe the therapeutic effects of modulated medium frequency electrotherapy(MMFE)and peribulbar injection of mecobalamin for neurogenic extraocular muscles paralysis.METHODS:Ten patients(9 male and 1 female;average age:43.40±7.68 years;the median duration:43.50 days)were treated with MMFE for 20 minutes once a day and peribulbar injection of mecobalamin 500μg every other day,10 days as a course,for 2-4 courses based on patient’s condition;the changes of the position of eye,diplopia and ocular movement recover status were observed.RESULTS:Totally 3 patients were cured with traumatic brain injury,5 patients were improved with brainstem infarction,1 case showed efficacy with traumatic brain injury,1 case was of inefficacy with traumatic brain injury.CONCLUSION:MMFE and peribulbar injection of mecobalamin may improve the neurogenic extraocular muscles paralysis in patients.

Observation of extraocular muscle with B-mode ultrasound

Ming-Yu Shi,Xin-Yao Li,Hong-Yang Li and Hui Qiu

AIM:To understand extraocular muscles image features in B-mode ultrasound.METHODS:The extraocular muscles on normal persons and different extraocular muscle diseases were observed using B-mode ultrasound from Oct.2007 to Oct.2010.RESULTS:Symmetric extraocular muscle thickness had no significant difference in normal eyes,the medial rectus was the thickest muscle among four rectus;before the age of 20,four extraocular muscles thickness increased with age.Different extraocular muscle diseases had different performance in B-mode ultrasound.CONCLUSION:B-mode ultrasound can show good form of four extraocular muscles and it is benefit for follow-up observation of extraocular muscle disease.B-mode ultrasound is an effective means of checking extraocular muscles.

Clinical effect of probing of lacrimal passage for treatment of neonatal dacryocystitis at different ages

Ke-Wei Wang,Xi-Lang Wang and Li-Juan Tao

AIM:To observe clinical effect of probing of lacrimal passage for treatment of neonatal dacryocystitis with different age.METHODS:Probing of lacrimal passage in surface anesthesia was performed in 532 infants 590 eyes from November 2009 to September 2010 in our department of ophthalmology,including male 321(358 eyes),female 211(232 eyes),aged from 3 months to 48 months.RESULTS:Totally 456 eyes received the operation in group 1(aged from 3 months to 6 months)and 442 eyes were cured(96.9%);95 eyes received the operation in group 2(aged from 2 months to 12 months)and 83 eyes were cured(87.4%);39 eyes were in 3 group(age≥13 months)and success rate of the operation was 82.1%.There was significant difference between group 1 and group 2,group 1 and group 3(P<0.05,χ2=15.986,χ2=19.578 respectively)while there was no significant difference between group 2 and group 3(χ2=0.642,P>0.05).CONCLUSION:Probing of lacrimal passage is an effective treatment for neonatal dacryocystitis and the best time for probing of the lacrimal passage is 3-6 months after birth.

Efficacy of laser probing combined with artificial nasolacrimal duct stent implants for chronic nasolacrimal duct obstruction

Wei-Hai Xu

AIM:To observe the effect of nasolacrimal duct laser probing surgery and artificial nasolacrimal stent retrograde implantation in treatment of nasolacrimal duct obstraction.METHODS:A total of 54 patients 69 eyes with nasolacrimal duct obstruction were screened,and those who met the surgical indication,suffering severe epiphora with or without pus overflow were treated with laser nasolacrimal duct probing combined retrograde stent implant and followed up for 3-12 months.RESULTS:All patients were successfully implanted artificial nasolacrimal duct stent,mean operative time was 15.48 minutes.Epiphora symptoms were improved immediately after surgery,lacrimal duct were patent.The time of observing for 3,6 and 12 months,cure rates were 100% and 97% and 91%.CONCLUSION:Laser probing of nasolacrimal duct combined with nasolacrimal duct stent retrograde implantation is a simple,safe and effective treatment method for nasolacrimal duct obstruction,without skin scars,changing of the physical anatomy and so on.

Effect of hyaluronate eye drops combined with houttuynia cordata eye drops on the treatment of dry eye

AIM:To observe the effect of hyaluronate(HA)eye drops and HA eye drops combined with houttuynia cordata(HC)eye drops on the treatment of dry eye.METHODS:A total of 125 patients 198 eyes with dry eyes were randomly divided into group HA eye drops(group A)(63 cases,100 eyes)and group HA eye drops combined with HC eye drops(group B)(62 cases,98 eyes).The patients were treated with 1g/L HA eye drops in group A and 1g/L HA eye drops combined with HC eye drops in group B.After 2 months’ treatment,clinic symptom,Shirmer I test(S Ⅰ t),break-up time of tear film(BUT),and fluorescence staining(FL)were measured respectively.RESULTS:Both of the two methods could improve the clinic symptom,SⅠ t,BUT,and FL in group B were obviously better than those in group A.CONCLUSION:HA eye drops combined with HC eye drops can improve clinic symptoms of dry eye and heighten the effect of treatment.

Evaluation of amniotic membrane transplantation for treatment of severe vernal conjunctivitis

Ping Guo,Wei-Wei Zhou,Lei Qin,Qiang Li and Fang-Wei Ying

AIM:To investigate the therapeutic effect of amniotic membrance transplantation in treament of severe vernal conjunctivitis.METHODS:A total of 9 cases 12 eyes which were vernal conjunctivitis with macropapillary in palpebral conjunctiva and corneal ulcer received amniotic membrane transplantation.Their visual acuity,recurrence in upper palpebral conjunctiva and recovery of corneal ulcer were followed up.RESULTS:Totally 3 cases 5 eyes recurred and were well controlled by local treatment.Visual acuity were increased in all cases during follow-up period.The papilla had not been found in upper lid conjunctiva and cornea was transparent.CONCLUSION:Amniotic membrane transplantation is effective in treatment of severe vernal conjunctivitis with macropapillary in palpebral conjunctiva.

Clinical observation of risk factors affecting visual recovery after scleral buckling surgery

Xiao-Jun Shen and Chao Peng

AIM:To discuss the relative risk factors affecting visual recovery after scleral buckling surgery in rhegmatogenous retinal detachment.METHODS:A total of 102 cases(102 eyes)with rhegmatogenous retinal detachment treated by scleral buckling surgery in our hospital were retrospectively analyzed.Patients were followed up for 3 to 6 months,and the best-corrected visual acuity(BCVA)was observed.The Chi-square test was used to analyze the relative factors affecting the visual recovery.RESULTS:Macular detachment status,preoperative BCVA,quadrants of retinal detachment,as well as subretinal fluid drainage affected visual recovery significantly(P<0.01).Eyes with macula-off ≤7 days had a significantly lower BCVA compared to eyes with macula-off>7 days(P<0.05).CONCLUSION:Macular detachment status and time,preoperative visual acuity,quadrants of retinal detachment,as well as subretinal fluid drainage affect visual recovery significantly.Subretinal fluid drainage should be avoided as far as possible.

Effects of peri-orbital injection of triamcinolone acetomide on Graves’ ophthalmopathy

Huan-Jun Kang and Jin-Chen Jia

AIM:To evaluate the Clinical effect of triamcinolone acetomide on Graves’ ophthalmopathy.METHODS:Triamcinolone acetomide(40mg)was peri-orbitally injected in all patients.Every 30 days 1 times,4 times were a course of treatment.Visual acuity,eye symptom,exophthalmos,palpebral fissure height and eye position were measured at each visit,the thickness of extraocular muscles was measured by B-mode ultrasonography before treatment and after 6 months.RESULTS:The fifty-six eyes of 30 patients were treated.The average of exophthalmos before and after treatment were 18.2±2.2mm and 14.6±1.8mm(P<0.01),the improved rate of exophthalmia was 84%(47/56);the average height of palpebral fissure were 11.6±1.7mm,8.4±1.1mm(P<0.01),the improved rate was 80%(45/56).The thickness of extraocular muscles:inferior rectus,superior rectus,medial rectus,lateral rectus were 6.25±1.93,4.21±1.25,6.34±1.46,4.17±1.38,5.67±1.64,3.87±1.04,4.57±1.37,3.35±0.81mm respectively,the thickness of the extraocular muscles was significantly reduced.The visual acuity of 28 eyes was improved in the 35 visual acuity decreased eyes.The strabismus and diplopia of 17 patients(74%)disappeared,and 6 patients(26%)were improved in the 23 patients with strabismus and diplopia.No complication was found.CONCLUSION:Triamcinolone acetomide peri-orbital injection can improve the symptom,physical sign and the edema of the extraocular muscles,and side effects are few.

Clinical observation of SBK for treatment of myopia

Jin-Ke Li,Chao Zhang,Sheng-Jian Mi,Yu-Hui Duan,Sheng Zhou and Meng Chen

AIM:To investigate the clinical efficacy of sub-Bowman’s keratomileusis(SBK)for treatment of myopia.METHODS:From December 2009 to June 2010,71 patients 142 eyes underwent the treatment of myopia by SBK.Their visual acuity,refraction,anterior and posterior corneal surface height changes before and 6 months after operation were reviewed.RESULTS:The uncorrected visual acuity(UCVA)of patients 6 months after operation were 0.8-1.5,average 1.14±0.17,UCVA of all patients were≥0.8,UCVA were≥1.0 in 136 eyes,accounting for 95.8%,UCVA were≥1.2 in 64 eyes,accounting for 45.1%;Except for 3 eyes of 2 cases with 1 line down,the best-corrected visual acuity(BCVA)of the others 6 months after operation were the same with or better than preoperative,all BCVA were≥0.8,BCVA were≥1.0 in 136 eyes(95.8%)BCVA≥1.2 in 70 eyes(49.3%),64 eyes(45.1%)with UCVA≥preoperative BCVA 6 months after operation.Diopter:spherical equivalent(SE)were(-0.65-+0.97)D,average(0.15±0.41)D.All SE were ≤±1.0D,92.8%≤±0.5D 6 months after operation.Anterior and posterior corneal surface height changes were roughly the same 6 months after operation.CONCLUSION:SBK treatment of myopia has good predictability,accuracy and safety.

Clinical effects of pudilan oral liquid on epidemic keratoconjunctivitis

Li-Kun Xia,Zhe-Yao Cao,Lei Wang,Yuan Hu and Sheng-Nan Zhang

·AIM:To observe the efficacy and safety of oral anti-inflammatory drug pudilan for epidemic keratoconjunctivitis.METHODS:A total of 120 cases 226 eyes with epidemic keratoconjunctivitis were randomly divided into test group and control group,60 cases in each group.The test group was treated with pudilan oral liquid and diclofenac sodium eye drops;the control group received diclofenac sodium eye drops,for 14 days as a total course of treatment.Clinical efficacy and safety were observed after treatment.RESULTS:In the test group and control group,the total clinical effective rates were 90.0% and 75.0%,the cure rates were 85.0% and 68.3% respectively,the difference was statistically significant(P<0.05).The test group and control group had no significant adverse reactions.CONCLUSION:Compared with simple use of diclofenac sodium eye drops,pudilan oral liquid combined with diclofenac sodium eye drops has exact clinical curative effect and no adverse reaction in treatment of epidemic keratoconjunctivitis.

Comparison of corneal topography between keratoconus and astigmatism with high myopia in children

Zhi-Gang Xiao,Mi Tian,Li-Juan Tao,Zheng-Yan Qi and Li-Jun Zhou

·AIM:To evaluate the role of corneal topography in distinguishing children keratoconus from high myopic astigmatism.METHODS:This study analyzed the corneal index of twenty patients diagnosed with kerotoconus and twenty patiens diagnosed with high myopic astigmatism using TMS-4 corneal topography.RESULTS:Keratoconus group was compared with high myopic astigmatism group,the former was significantly higher than the latter in central corneal refractive power,surface asymmetry index,surface irregularity index,difference in central corneal refractive power of two eyes in same patient,and I-S(P<0.01).And statistically significiant difference was found in SimK’s Astig(P<0.05),espically differences in central corneal refractive power of two eyes and I-S were sensitive to identify.CONCLUSION:It is useful for identifying children kerotoconus and high myopic astigmatism using corneal topography to analyse index,thus we can avoid misdiagnosis of amblyopia and unnecessary training.

Clinical observation of manifestation and treatment of infusion misdirection syndrome during phacoemulsification

Lei Yu,Xing-Yu Li and Cong-Yi Wang

·AIM:To summarise the clinical manifestation and treatment of infusion misdirection syndrome during phacoemulisification.METHODS:There were 8 cases with infusion misdirection syndrome from September 2002 to December 2009.The clinical manifestations of these patients were suddenly heightened intraocular pressure,shallow anterior chamber,iris prolapse,and unsustainable anterior chamber depth through injection of viscoelastic material or heightened perfusion pressure.During that time,all patients had no significant pain,irritability or other symptoms.There was no intraocular hemorrhage by indirect ophthalmoscope examination during and after surgery.One of these 8 patients did not recieve any special handling,others were treated with the main incision suture,packet of eyes to rest and 200g/L mannitol injection rapidly.RESULTS:The one case,without special treatment,was performed anterior vitrectomy and intraocular lens suspension because of posterior capsular rupture during operation.After treatment of other 7 patients,1 patient was still unable to form anterior chamber,so pars plana vitreous cavity puncture was carried out;others formed anterior chamber,one of 7 cases had intraocular pressure heightened once again,so residual viscoelastic was not replaced.All the patients were sutured main incision after surgery.CONCLUSION:Infusion misdirection syndrome during phacoemulisification is one kind of rare complication.If it is treated properly,the physical signs originated by high intraocular pressure can be solved,and phacoemulsification can be finished successfully.

Clinical analysis of the small incision non-phacoemulsification and intraocular lens implantation for hemodialysis in uremic patient

Xin Cai,Jie Yuan,Ze-Jiang Ji,Zhuo-Jian Hao and Kai-Yu Liu

·AIM:To observe the clinical effects of the small incision non-phacoemulsification and intraocular lens(IOL)implantation for hemodialysis in uremic patient.METHODS:Forty eyes of 32 hemodialysis patients received small incision cataract non-phacoemulsification and IOL implantation,the complications and postoperative visual acuity were observed.RESULTS:Postoperatively,uncorrected visual acuity was<0.3 in 5 eyes(12.5%),>0.3 in 35 eyes(87.5%),including 0.5-0.9 in 27 eyes,0.3-0.5 in 8 eyes.The incidence of complications was very low during and after operation.CONCLUSION:After the small incision non-phaco-emulsification and IOL implantation,the visual acuity is easy to recover and the corneal astigmatism is small.The surgery is safe,convenient and economical,which is a minimally invasive treatment method for complicated cataract for hemodialysis in uremic patient.

Clinical observation of overall visual acuity after the implantation of ReSTOR multifocal intraocular lens

Hui-Ya Fan,Zi-Lin Chen and Qing-Shan Song

·AIM:To compare overall visual acuity and the rate of spectacle independence after implantation of ReSTOR multifocal intraocular lens(IOL)and Natural single-focal IOL in patients with age-related cataract.METHODS:A total of 27 patients with age-related cataract were divided into two groups at random.One group of 12 patients(15 eyes)received ReSTOR multifocal IOL,another group of 15 patients(18 eyes)received Natural single-focal IOL.3 months after surgery,we observed patient’s best-corrected distance visual acuity(BCDVA),distance-corrected near visual acuity(DCNVA),independence on spectacles and the distance-corrected visual acuity in distance of 40cm,63cm and 100cm.RESULTS:BCDVA in the multifocal group were not statistically different from the single-focal group.DCNVA,independence on spectacles and the distance-corrected visual acuity in distance of 40cm,63cm and 100cm were statistically better in the multifocal group compared with the single-focal group(P<0.05).CONCLUSION:The ReSTOR multifocal IOL may obtain excellent overall visual acuity.

Clinical research of complex trabeculectomy combined with human umbilical vein transplantation for refractory glaucoma

Xun Li,He-Nan Liu and Dian-Wen Gao

·AIM:To compare clinical outcomes of complex trabeculectomy combined with or without human umbilical vein(HUV)transplantation in refractory glaucoma.METHODS:This clinical trials included 28 eyes with refractory glaucoma at high risks as vascularization,uveitis,aphakia,pseudophakic and young ages.Complex trabeculectomy with HUV transplantation under the scleral flap was performed in 15 eyes and complex trabeculectomy without HUV transplantation in 13 eyes.The outcome measured including surgical success rate,postoperative intraocular pressure(IOP),the number of antiglaucoma medications and complications.All patients were followed for 12 months.RESULTS:Complete success was seen in 12/15(80.0%)study eyes and 8/13(61.5%)control eyes at 6 months postoperatively,and in 11/15(73.3%)and 6/13(46.2%)at 12 months after surgery,respectively.IOP decreased from 50.9±12.2mmHg and 49.7±11.7mmHg preoperatively in study and control groups to 17.3±1.1mmHg and 20.9±2.2mmHg,respectively at 12 months(P=0.00).Early postoperative hypotony developed in 2 control eyes owing to excessive filtration but none of study eyes.Encapsulated bleb occurred in 4 control eyes but in 1 study eye.CONCLUSION:In refractory glaucoma,complex trabeculectomy combined with HUV transplantation compared to without HUV transplantation has higher success rate,lower postoperatively mean IOP,and lower complication rate.

Analysis of Ahmed glaucoma valve implantation for silicone oil-induced secondary glaucoma

Wu-Qin Gao and Bo Ye

·AIM:To analyze the therapeutic effect of Ahmed glaucoma valve(AGV)implantation for silicone oil-induced secondary glaucoma.METHODS:Eleven patients with secondary glaucoma caused by silicone oil received AGV implantation,and were followed up over 1 year.RESULTS:The mean preoperative intraocular pressure(IOP)was 45.35±13.96mmHg.After 1 week,2,3,4 weeks,3,6,12 months IOP was respectively 16.11±4.82,15.98±4.78,15.91±4.78,16.51±4.94,16.66±5.01,16.37±4.90,16.79±5.06mmHg.There were significantly differences between preoperative IOP and each period postoperatively(P<0.05).CONCLUSION:AGV implantation for silicone oil-induced secondary glaucoma is a feasible and effective treatment.

Manifestation of high order wavefront aberrations in patients with subclinical keratoconus

Yong Liu,Wen-Fang Zhang and Zhou-Xing Yu

·AIM:To investigate the manifestation of high order wavefront aberrations(HOAs)in patients with subclinical keratoconus(SKC).METHODS:It was a case-control study.In this study 20 patients(32 eyes)with SKC was in SKC group and 20 patients(40 eyes)with myopia were selected in the same period as control group.Wavefront aberrations in each eye was measured by OPD Scan ARK-10000(NIDEK,Japan).Statistical analysis was performed to compare the root mean square(RMS)of total ocular HOAs,spherical aberration and coma between 2 groups respectively by Student’s t-test.RESULTS:The RMS of total ocular HOAs,spherical aberration and coma were 0.637±0.488μm,0.276±0.135μm,0.364±0.205μm respectively in SKC group,while that in control group were 0.394±0.282μm,0.113±0.084μm,0.148±0.079μm respectively,the differences were statistically significant(t=2.160,2.341,3.679;P<0.05).Negative spherical aberration was found in 19 eyes in SKC group and 9 eyes in control group,the differences were statistically significant(χ2=10.17;P=0.001).CONCLUSION:The HOAs is significantly higher in eyes with SKC than in myopic eyes.It may be helpful for detecting SKC to measure wavefront aberrations.

Research on intravitreal Bevacizumab combined with retinal photocoagulation for iris and retinal neovascularization

Rong Hu,Ling Gong and De-Yong Jiang

·AIM:To evaluate the efficacy and safety of intravitreal Bevacizumab(IVB)combined with retinal photoco-agulation for iris and retinal neovascularization.METHODS:The clinical data of 13 patients 13 eyes with iris or retinal neovascularization treated with IVB associated with retinal photocoagulation were retrospectively analyzed.Among these patients,retinal neovascularization was secondary to branch retinal vein occlusion(BRVO)in 2 eyes,to proliferative diabetic retinopathy(PDR)in 6 eyes and to Eales disease in 1 eye.4 eyes with iris and retinal neovascularization were secondary to central retinal vein occlusion.All of patients underwent IVB(1.25mg/0.05mL)combined with retinal photocoagulation.The follow-up period ranged from 3 to 18 months.Additional IVB and retinal photocoagulation were administered if recurrence was observed in follow-up period.The changes of best-corrected visual acuity(BCVA),intraocular pressure(IOP),fundus fluorescein angiography(FFA)were observed and analyzed before and after the treatment.RESULTS:At the end of the follow-up period,BCVA was improved obviously(>1 lines)in 8 eyes(61.5%),kept stable(changed within 1 line)in 4 eyes(30.8%)and decreased(>1 lines)in one eye(7.7%).The regression of iris and retinal neovascularization in all 13 eyes were observed by FFA image.There were 2 eyes with additional IVB and retinal photocoagulation during follow-up period.Among neovascular glaucoma,decreased IOP was noticed in 2 eyes(50.0%).The only complication was subconjunctival hemorrhage in one eye.CONCLUSION:The preliminary result in our observation shows that IVB combined with retinal photocoagulation is effective and safe in treating iris and retinal neovascularization.This should be comfirmed by a multicenter,randomized,controlled clinical trial.

Image characteristics of infrared ray and autofluorescence in central serous chorioretinopathy

Shu-Hua Zhang

·AIM:To observe the image characteristics of infrared ray(IR)and autofluorescence(AF)in central serous chorioretinopathy(CSC).METHODS:Totally 80 eyes of 76 CSC patients were examined the infrared photography of ocular fundus,autofluorescence photography of ocular fundus,fundus fluorescein angiography(FFA)using IR imaging mode and FA imaging mode of Heidelberg Spectralis HRA.RESULTS:In 80 eyes,the IR image of CSC focus contained dark macular edema area,clear periphery in the macula layer detachment area,white spot-like focus existed specifically in the leaking area.The AF image of CSC focus showed patterns characterized as weak plate-like AF in the macular edema area(18 eyes of 18 patients,22.50%),weak AF with strong spot-like AF in the macular edema area(13 eyes of 13 patients,16.25%),weak AF with strong lamellar AF in the macular edema area(11 eyes of 11 patients,13.75%),strong AF circle in the periphery of macula layer detachment area(3 eyes of 3 patients,3.75%),weak AF combined with strong spot-like AF(21 eyes of 19 patients,26.25%),local densed strong AF and weak AF at the posterior pole(3 eyes of 3 patients,3.75%),weak AF in the macular edema area with weak or strong spot-like or plate-like AF scattered(11 eyes,13.75%).FFA fluorescein leaking point or abnormal fluorescence were in accordance with abnormal AF in 47 eyes of 45 patients(58.75%),not in accordance in 33 eyes of 31 patients(41.25%).The IR image of ocular fundus was in accordance with FFA fluorescein leaking point in 68 eyes of 65 patients(85.00%),not in accordance in 12 eyes of 11 patients(15.00%).CONCLUSION:IR and AF provide a novel,fast and non-surgical method for the diagnosis of CSC.IR and AF as complement are combined with FFA for the diagnosis of CSC.

Characteristics of indocyanine green angiography in central exudative chorioretinopathy

Bao-An Hao and Xi-Jia Peng

·AIM:To analyze the characteristics of indocyanine green angiography(ICGA)in central exudative chorioretinopathy(CEC).METHODS:A total of 24 cases(24 eyes)with CEC were examined with fundus fluorescein angiography(FFA)and ICGA using Heidelberg retina angiography 2(HRA2).The images of ICGA and FFA were analyzed.RESULTS:The choroidal neovascularization(CNV)of CEC was classic CNV confirmed by FFA.In early phase of ICGA,24 CEC eyes showed a well-defined CNV and 5 eyes showed local dilatation of choroidal vessels around lesion.In the late phase of ICGA,CNV showed dye leakage or staining.In the early phase of ICGA,20 eyes showed a dark rim around CNV and the other 4 eyes without the dark rim.In the late phase of ICGA,all CEC eyes showed a dark rim around CNV.The repeated ICGA images of a patient with CEC treated by photodynamic therapy(PDT)2 months ago showed retinal-choroidal anastomosis(RCA).CONCLUSION:The structure,border,changes of local choroidal vessels and RCA of CNV were more clearly displayed on ICGA performed by HRA2 than on FFA in patients with CEC.

Etiological analysis of extraocular causes of ophthalmoparalysis

Ai-Ping Huang,Jian-Liang Zhang,Xiao Li,Zhu-Yuan Tang,Wei Liu and Jiao Huang

·AIM:To explore relevant extraocular causes of ophthalmoparalysis.METHODS:Routine ophthalmologic and ocular muscle examination were performed in 157 patients of ophthalmoparalysis to use prism,synoptophore and red glass test,etc.Biochemical examination of blood and imaging diagnosis(CT,MRI,DSA)were also included.RESULTS:For the 157 cases,the extraocular causes were mainly diabetes(23.6%),intracranial vascular diseases(18.5%),craniocerebral trauma(15.9%),viral infection(10.8%),thyroid associated ophthalmopathy(7.0%),encephalic tumor(4.5%),myasthenia gravis(1.9%),nasopharyngeal carcinoma(1.9%),etc.CONCLUSION:The causes of ophthalmoparalysis are complicated.For patients with binocular diplopia cannot be explained by ocuar diseases,the patients should be examined carefully with a complete body and eyes to determine the causes.

Clinical research on surgery of inferior orbital wall fracture caused by gun or ammunition explosion

Yi Li,Yu-Feng Zhang,Xiao-Yong Cao and Yu Zhu

·AIM:To investigate an effective treatment of craniofacial fracture patients in modern warfare for rapid recovery in normal face and physiological function.METHODS:Different parts of different pathological fractures were submitted to different treatment options:minimally invasive surgery,cosmetic incision and fixing method such as titanium mesh and plate were taken to different parts of the craniofacial fracture under the guidance of nasal endoscope;medical Earbrain cements(EC)was applied for reposition and fixation of craniofacial bone fragments.RESULTS:The patients could quickly return to normal face and physiological function after craniofacial fracture surgery.CONCLUSION:Different minimally invasive surgery,cosmetic incision and fixing method such as titanium mesh and plate endoscope-guidedly is a very effective method;application of EC for fracture reduction and fixation of craniofacial bone fragments can accelerate healing.

Clinical analysis of the implantation of lead-type silicone tube combined with or without laser for lacrimal duct obstruction

Jing Zhang,Guang-Li Sun and Yu Zhu

·AIM:To compare the clinical efficacy of implantation of lead-type silicone tubes combined with or without laser treatment for lacrimal duct obstruction.METHODS:The patients were randomly divided into two groups,one group were implanted with lead-type silicone tube only(A group);another group underwent the laser treatment combined with implantation of lead-type silicone tube(B group).RESULTS:The cure rate of lead-type silicone tube implantation for lacrimal duct obstruction was 77.6%,the cure rate of laser treatment combined with lead-type silicone tube implantation for lacrimal duct obstruction was 87.5%.CONCLUSION:The laser treatment combined with lead-type silicone tube implantation has a higher cure rate of lacrimal duct obstruction,and more obvious advantages.

Research on tear secretion and tear film stability in patients with chronic renal failure

Xiao-Hui Jiang,Ya-Xin Yang and Lan Yu

·AIM:To investigate the changes of tear secretion and tear film stability in patients with chronic renal failure(CRF).METHODS:The Results of Schirmer Ⅰ tests(SⅠt),tear film break-up time(BUT)and fluorescein sodium staining on the cornea performed in 48 patients 96 eyes with CRF were compared with those in the control group.RESULTS:Both SⅠt and BUT were significantly lower in the CRF group compared with the control group.Rate of fluorescein sodium staining on the cornea in the CRF group was significantly higher compared with that of the control group(t=-11.103,P<0.01;t=-10.807,P<0.01).CONCLUSION:The CRF patients are found with decreased tear secretion and poor tear film stability,so they are susceptible persons of dry eye.

Research on related factors of dominant eye in myopic children

Jun-Fang Yang,Li-Juan Tao,Zheng-Yan Qi,Zhi-Gang Xiao,Li-Jun Zhou and Yi-Lan Tan

·AIM:To explore the relationship of myopic children’s dominant eye,diopter,classes of eye and uncorrected visual acuity.METHODS:Totally 99 cases of children with their pupil back to normal after glasses were randomly selected after cycloplegic retinoscopy.The dominant eye was checked with hole-in-the-card test,classified and statistically analyzed.RESULTS:In 99 cases of myopic children,the right eye as the dominant eye,namely right type(R type)accounted for 66.7%(66/99),the difference was statistically significant(P=0.0001);when eye refraction was not equal,the eye of a relatively low refraction acted as the dominant eye in 42 cases(52.5%),there was no significant difference between the two types(P=0.527);when the eye refractive power was equal,the right eye as the dominant eye accounted for 68.4%,the difference was statistically significant(P= 0.0231);in 64 patients with different uncorrected visual acuity in both eyes,the eye of low visual acuity acted as the dominant eye in 34 eyes(53.1%),no significant difference between the two types(P=0.4795);in 35 cases of equal visual acuity in both eyes,right eye acted as dominant eye in 29 cases(82.9%),it was of highly statistically significant difference(χ2 = 30.2286,P<0.01).CONCLUSION:The R type dominant eye is common in the eyes of myopic children.For the relevance of dominant eye refraction,and also uncorrected visual acuity level,the difference was not statistically significant.

Examination and evaluation on binocular vision in anisometropic amblyopia before and after treatment

Qing-Hui Zhang,Rui Wang and Jun-Shuang Ren

·AIM:To study the binocular vision in anisometropic amblyopia before and after treatment.METHODS:The stereoacuity and synoptophore III of 56 cases(103 eyes)with anisometropic amblyopia were examined before and after treatment.RESULTS:There was no significant difference in simultaneous vision;there were significant differences on stereopsis and fusion function before and after treatment.CONCLUSION:Anisometropic amblyopia may simultaneously affect the binocular vision development as well as the visual development,and the binocular vision may improve when the visual acuity increase,so improvement of the binocular vision should be regarded during the treatment of amblypia.

Clinical significance of treatment of amblyopia in older children and adolescents

Li Peng,Man-Ping Zhang and Qing Xie

·AIM:To observe and discuss the therapeutic efficacy of combining therapy for amblyopia in adolescents and older children.METHODS:A total of 90 cases(148 eyes)were randomly selected from the patients,which were treated with occlusion therapy,red light glitter,photogene,haidinger,meticulous homework,laser therapy and mind-cure in our hospital from August 2005 to January 2009.The 8-10 age group was of 114 eyes,11-13 age group of 24 eyes,and 14-16 age group of 10 eyes.The course of treatment was 30-750 days,the mean was 163 days.The data were analyzed retrospectively.RESULTS:Vision had raised 2 lines or more after the treatment,the effective rate was 93.3%.98 eyes’ corrected visual acuity arrived at 0.9,The recovery rate was 66.2%,the therapeutic efficacy of 8-10 age group was significantly different with that of 11-13 age group and 14-16 age group.CONCLUSION:The therapeutic efficacy of combining therapy for amblyopia in hobbledehoy and older children is affirmed,especially on establishing good visual function after treatment for central fixation amblyopia with ametropia.

Analysis of curative effect of monocular amblyopia in school-age children

Xiu-Yun Qiu,Lin-Ying Wang and Li-Mei Zhang

·AIM:To investigate the treatment effect of monocular amblyopia of school-age children in Beijing Miyun country.METHODS:Seventy-one cases of monocular amblyopia from outpatient in 6-18 years old received comprehensive treatment.The treatment effectiveness observation and correlative analysis of age,type and extent of amblyopia were analyzed.RESULTS:In 71 cases,the recovery rate of monocular amblyopia in school-age children was 63%,and 24% for the progressive,and 13% for the invalid.CONCLUSION:The treatment effect of monocular amblyopia in school age children is better,and should be given active treatment.The treatment effect has the close relationship among age,type,extent and fixation in amblyopia.For 6-12 years old cases,anisometropia,mild and central fixation have favorably effect.

Influence of compliance on the curative effect of amblyopia in children

Zheng-Yan Qi,Yan Guo,Jun-Fang Yang,Jun Luo and Rong He

·AIM:To study the influence of compliance on curative effect of amblyopia in children.METHODS:With 10g/L atropine optometry,and in accordance with the national uniform diagnostic criteria for amblyopia,178 eyes of 101 children with amblyopia who were admitted in eye clinic of our hospital were retrospectively analyzed,including age,amblyopia type,degree of amblyopia and their relationship with compliance,and the relationship between curative effect and compliance were analyzed.RESULTS:The compliance of different age groups were significantly different(P<0.05),the compliance of the different types of amblyopia were significantly different(P<0.05),different degrees of amblyopia had no significant difference in compliance;of children with good compliance,the cure rate was significantly higher than that of poor compliance,with the statistical analysis of curative effect between the treatment groups of different compliance,the difference was statistically significant(P<0.01).CONCLUSION:The curative effect is positively correlated with compliance,and attention should be paid.

Clinical effect comparison of ganciclovir ophthalmic gel and ganciclovir eye drops in the treatment of herpes zoster keratitis

Jia-Sheng Zhang

AIM:To compare the clinical effect of ganciclovir ophthalmic gel and ganciclovir eye drops in the treatment of herpes zoster keratitis.METHODS:A total of 68 patients 68 eyes of herpes zoster keratitis were selected and divided into two groups randomly,there were 36 patients 36 eyes in ganciclovir ophthalmic gel group(observation group),32 patients 32 eyes in ganciclovir eye drops group(control group).All patients were used ganciclovir ophthalmic gel or ganciclovir eye drops six times per day,and they underwent systemic anti-viral treatment.RESULTS:The therapeutic efficiency between the observation group and the control group had no statistical difference(P>0.05).But the time of recovery in the observation group was less than that in the control group.The difference was statistically significant(P<0.05).CONCLUSION:The application of ganciclovir ophthalmic gel and ganciclovir dye drops in the treatment of herpes zoster keratitis has the same efficiency,but ganciclovir ophthalmic gel can shorten the time of recovery.

Application of confocal microscopy in fungal keratitis

Xue-Yong Wang and Xu-Mei Wang

AIM:To investigate the application of confocal microscopy in fungal keratitis.METHODS:A total of 42 patients 42 eyes diagnosed with suspected fungal keratitis were performed the confocal microscopy and corneal lesions stained tissue smear examination simultaneously and the results were analysed retrospectively.RESULTS:In 42 patients 42 eyes with fungal keratitis,fungal hyphae was observed in 39 eyes(93%) by the confocal microscopy,however in 30 eyes(71%) by corneal lesions stained tissue smear examination.Statistical analysis showed that the difference was statistically significant(χ 2=6.574,P<0.05).CONCLUSION:Confocal microscopy is a noninvasive,efficient,intuitive inspection equipment,which has important clinical value in the initial diagnosis of fungal keratitis.

Comparison of comfortable degree between wearing glasses and no wearing glasses after phacoemulsification combined with IOL implantation

Feng-Zhen Sun and Hai-Ning Yu

AIM:To investigate the comfortable degree between wearing glasses and no wearing glasses after phacoe-mlsification combined with intraocular lens(IOL) implantation.METHODS:Sixty-two patients who were treated with phacoemulsification combined with IOL implantation were randomly divided into two groups.Group 1:34 patients 68 eyes weared glasses,group 2:28 patients 56 eyes did not wear glasses.RESULTS:Group 1 was more comfortable than the group 2,the difference was significant(P<0.05).CONCLUSION:Wearing suiltable glasses can reduce the uncomfortable symptom after phacoemlsification combined with IOL implantation.

Analysis of small incision cataract extraction in 287 black cataract patients during aiding Africa

Wen-Xing Xiao

AIM:To investigate the clinical effect of small incision cataract extraction and intraocular lens implantation in 287 black cataract patients during the China-aided project in Africa.METHODS:Totally 287 eyes of 287 cases with senile cataract were treated with scleral tunnel incision extracapsular cataract extraction,and posterior chamber intraocular lens implantation.Postoperative visual acuity and complications were observed.RESULTS:Intraocular lens was implanted in 275 eyes under quite limited medical facilities in Africa.Postoperative vision increased significantly after a week.The postoperative vision was ≥0.3 in 240 eyes(83.6%),≥0.5 in 166 eyes(57.8%),corneal edema was in 53 eyes(18.5%);posterior capsule rupture was in 5 eyes(1.7%);anterior chamber inflammation was in 38 eyes(13.2%).CONCLUSION:Small incision cataract extraction combined with intraocular lens plantation has significant effect in a large scale of black cataract patients in Africa.

Therapeutic effect of phacoemulsification on diabetics with cataract

Jian-Hua Yin,Xiao-Hua Si,Jia-Ning Pu and Li-Juan Qin

AIM:To observe and evaluate the clinical therapeutic effect of phacoemulsification and intraocular lens implantation for diabetics with cataract.METHODS:One hundred and forty-eight diabetics 164 eyes were treated with phacoemulsification and intraocular lens implantation to observe postoperative complications.RESULTS:Postoperative complications in diabetics with cataract underwent cataract surgery were more than those in non-diabetics.CONCLUSION:There are many postoperative complications in diabetics with cataract.Careful preoperative preparation and postoperative treatment are necessary.Stable blood sugar before and after operation is important.

Investigation of cataract surgery tendency in Shenzhen during last three years

Min Fang,Heng Luo,Xin-Hua Liu,Qi-Gao Feng and Bing Du

AIM:To investigate cataract surgery tendency in Shenzhen during last three years.METHODS:The cataract categories and surgery types were retrospectively analyzed for the inpatients with cataract.RESULTS:Cataract surgery was performed in 10058 cases,4284 cases were male(42.59%)and 5774 cases(57.41%)were female,the average age was 67.03±15.37 years old,the youngest was 3 months old and the eldest was 99 years old.Cataract categories:senile cataract 9000 cases(89.48%),complicated cataract 565 cases(5.62%),traumatic cataract 265 cases(2.63%),congenital cataract 178 cases(1.77%),metabolic cataract 14 cases(0.14%),aphakia 36 cases(0.36%).Surgery types:phacoemulsification with posterior intraocular lens 9499 cases(94.44%),extracapsular cataract extraction with posterior intraocular lens 220 cases(2.19%),extracapsular cataract extraction 100 cases(1.00%),second stage intraocular lens 228 cases(2.27%),patients without surgery for other reasons 11 cases(0.1%).CONCLUSION:Cataract inpatient cases increase during the last 3 years,senile cataract is the main cataract category,phacoemulsification with posterior chamber IOL is the predisposing cataract surgery.

Deep sclerectomy augmented with human umbilical vein or reticulated hyaluronic acid for primary open angle glaucoma

Xun Li,He-Nan Liu and Dian-Wen Gao

AIM:To investigate clinical outcomes of the deep sclerectomy(DS) and human umbilical vein(HUV) transplantation for primary open angle glaucoma(POAG).METHODS:Thirty-nine patients 39 eyes with POAG were involved in this prospective and random trial.DS with HUV transplantation group was performed in 19 patients and DS with reticulated hyaluronic acid implant(SKGEL) transplantation group in 20 patients.The postoperative indexes included postoperative intraocular pressure(IOP),the number of antiglaucoma medications,and postoperative complications.All patients were followed up for 12 months.RESULTS:The postoperative complete success rate was 79% in HUV group and 80% in SKGEL group at 12 months.IOP decreased from 39.9±9.3mmHg and 38.4±7.7mmHg preoperatively in HUV and SKGEL groups to 17.5±0.4mmHg and 17.7±0.6mmHg at 12 months respectively(P=0.55).Early postoperative hypotony occurred in 3 HUV and 3 SKGEL patients.Encapsulated bleb was observed 2 in HUV group and 3 in SKGEL group.CONCLUSION:DS with HUV transplantation and DS with SKGEL transplantation are similarly effective in lowering IOP and reducing the need for antiglaucoma medications over a 12-month follow-up period.

Clinical observation of the phacoemulsification and trabeculectomy for glaucoma combined with cataract

Qing-Jian Kong

AIM:To evaluate the clinical efficacy of the phacoemulsification and trabeculectomy for glaucoma combined with cataract.METHODS:The postoperative vision,intraocular pressure(IOP) and anterior chamber were retrospectively summarized in 36 cases with glaucoma combined with cataract after the phacoemulsification and trabeculectomy.RESULTS:The visual acuity postoperatively was improved in 26 cases(72.2%),the IOP postoperatively was under 21mmHg in 31 cases(86.1%),the rate of functional filtering blebs was 91.7%(33/36),there was few complication after phacoemulsification and trabeculectomy for glaucoma combined with cataract.CONCLUSION:Phacoemulsification and trabeculectomy with better visual recovery and fewer complications is an effective method of surgical treatment for glaucoma combined with cataract.

Research on phacoemulsification combined with goniosychialysis for acute angle-closure glaucoma

Rui Shi,Qian Zheng,Hai-Yan Zhang and Chang-Xu Yu

AIM:To investigate the clinical results of phacoem-ulsification and intraocular lens(IOL) implantation combined with goniosychialysis for acute angle-closure glaucoma.METHODS:Phacoemulsification and IOL implantation combined with goniosychialysis was performed in 80 cases 80 eyes diagnosed with acute angle-closure glaucoma and cataract under high intraocular pressure(IOP).Followed-up for 6 months to 2 years postoperatively,the vision and complications were observed.RESULTS:The visual acuity of all cases was improved.The IOP remained normal in all eyes in 1 week postoperatively.CONCLUSION:The phacoemulsification and IOL implantation combined with goniosychialysis in the management of acute angle-closure glaucoma is safe and efficient.

Diagnosis and preventive photocoagulation for retinoschisis before laser surgery for myopia

Xin Sun,Yan Chen and Jing-Cai Lian

AIM:To discuss the characteristic of retinoschisis in patients with myopia and the significance of preventive photocoagulation before laser surgery for myopia.METHODS:A total of 22 eyes in 12 patients suffering from myopia combined with retinoschisis were included.The mean best-corrected visual acuity was 0.82±0.13 and the mean preoperative spherical equivalent of the subjective refraction was 6.50±3.98D.The patients underwent preventive photocoagulation 1 month before the laser surgery for myopia.RESULTS:All the eyes that received preventive photocoagulation for retinoschisis had no retinal detachment after laser surgery for myopia.CONCLUSION:A thorough fundus examination is necessary before the surgery for myopia.The retinoschisis should be recognized and treated with preventive photocoagulation.The laser surgery for myopia is safe after preventive photocoagulation for these indicated patients.

Study in krypton laser combined with compound anisodine for central serous chorioretinopathy

Fei Long,Shu-Jie Cao,Li-Ping Wang,Feng Qi and Wei-Wei Xiu

AIM:To evaluate curative effect of laser combined with compound anisodine for central serous chorioretinopathy(CSC).METHODS:All of 156 cases 158 eyes diagnosed with CSC were divided into two groups.Laser combined with compound anisodine was performed in 86 cases 86 eyes as treatment group;the control group,70 cases 72 eyes,were treated by krypton laser combined with danshen and inosine.The curative effect and recurrent rate were compared in two groups.RESULTS:The cure rate was 94.2% in treatment group,75.0% in control group;in treatment group the average cure time was 34.8±8.6 days,5 cases 5 eyes recurred,however in control group the average cure time was 68.4±16.8 days,18 cases 18 eyes recurred.There was statistically significant difference in the average cure time(P<0.01) and recurrent rate(P<0.05) between two groups.There was significant difference in cure rate in two groups(P<0.01).CONCLUSION:Krypton laser combined with compound anisodine for CSC is effective and safe.The effect which can shorten the course of disease,prevent the progress of photic injure in the macular area and repair the retinal non-treament area,improve the function of retina and reduce the recurrent rate is obvious.

Therapeutic effect of photodynamic therapy on choroidal neovascularization of pathologic myopia

Li-Hong Cui,Cong Zhang,Hui Wang and Li Xu

AIM:To investigate the efficacy of photodynamic therapy(PDT) on macular choroidal neovascularization(CNV) of pathologic myopia(PM).METHODS:Twenty patients 21 eyes who were diagnosed with PM were analyzed retrospectively.The changes in the best-corrected visual acuity(BCVA),fixation nature,fundus examination,FFA/ICGA and OCT were analyzed before and after PDT treatment.RESULTS:During 6 months follow-up,only 1 case was performed vitrectomy because of vitreous hemorrhage 3 months after PDT.Compared with pre-treatment of PDT,the BCVA of other patients was improved(P<0.05).Before PDT treatment,3 eyes were central fixation and 18 eyes were paracentral fixation.The fixation characteristic was not changed after PDT.3 months after PDT,FFA/ICGA showed no leakage or reduced leakage in 18 eyes(86%).In 2 eyes,the fundus remained leaky,1 eye was not followed because of vitreous hemorrhage and performing vitrectomy.In the six-month follow-up,FFA/ICGA showed no leakage or slight leakage in 19 eyes(90%) and continous leakage in 1 eye(5%).CONCLUSION:PDT can block CNV of PM completely or partly,and reduce the danger of vision loss.

Efficacy of recurrent pterygium excision combined with corneal limbal stem cell transplantation or amniotic membrane trans-plantation

Lu-Lu Qiu,Yan-Hai Ren and Bao-Wen Zhao

AIM:To compare the curative effect of corneal limbal stem cell transplantation and amniotic membrane transpl-antation under the microscope for recurrent pterygium.METHODS:Ninety patients 96 eyes with recurrent pterygium were randomly divided into A,B groups.A group 40 patients 42 eyes underwent pterygium excision combined with autologous corneal limbal stem cell transplantation.B group,50 patients 54 eyes,underwent pterygium excision with amniotic membrane transplantation.Postoperative symptoms,corneal healing,conjunctival tissue healing,neovascularization and pterygial proliferation in 2 years were observed.RESULTS:In A group 39 eyes(93%) were cured,3 eyes(7%) recurred;of B group 48 eyes(89%) cured,6 eyes(11%) recurred in 96 eyes,the difference was not significant(χ 2=0.0456,P>0.05).The average time of corneal healing was that A group was(4.12±1.08) days,B group(7.38±1.12) days respectively.There were significant differences in two groups(t=4.307,P<0.05).CONCLUSION:There are good curative effect and low recurrence rate in both groups,but A group is worthy of clinical generalization with faster corneal epithelial healing and discomfortableness disappearance.

Clinical analysis of modern vitrectomy combined with heavy silicone oil tamponade in treatment of 21 cases with severe ocular injury

Li-Bo Xiao,Yun-Qin Li,Shou-Guang Mu,Jian-Shu Kang,Yu-Ling Ren and Li-Ping Xue

AIM:To explore the therapeutic effect of modern vitrectomy combined with heavy silicone oil tamponade on severe ocular injury.METHODS:The clinical data of 21 patients suffering from severe ocular injury admitted to our hospital from 2009 to 2010 were performed the modern vitrectomy combined with heavy silicone oil tamponade.Of 21 cases,7 cases were sutured combined with vitrectomy in the first stage.14 cases were sutured in the first stage and performed by vitrectomy in the second stage.All the 21 patients were followed up for a mean of 7.5(3-12)months and the therapeutic effect was observed.RESULTS:The eyeballs of 17 patients were reserved after operation.The eyeballs of 4 patients were atrophic.The visual acuity of 10 patients was improved in different degree compared with that before operation.CONCLUSION:Application of the modern vitrectomy combined with heavy silicone oil tamponade in treatment of the severe ocular injury can not only reserve the intact eyeball but also partially improve the visual acuity.

Comparative study on the three surgical procedures for severe congenital ptosis

Gang Liu,Lin-Han Guo and Hui Liu

AIM:To investigate the superiority and disadvantage of three operations for severe congenital blepharoptosis.METHODS:Forty-two severe congenital ptosis cases 47 eyes undergoing therapy were divided into three groups.25 cases 28 eyes were treated by shortening levator muscle of upper eyelid,10 cases 12 eyes by frontalis muscle flap suspension operation,and 7 cases 7 eyes by frontal muscle suspension using fascia lata.The clinical data were recorded and analyzed,and the effect was evaluated.RESULTS:The cases which were conducted shortening levator muscle of upper eyelid had natural appearance and satisfactory results.And the others had obvious dermatolysis of upper eyelid,blepharal dysraphism and insufficient correction.CONCLUSION:Shortening levator muscle of upper eyelid is more suitable for physiology status and has the best effects and fewer complications.

Clinical research on correction of low to moderate myopia by iris location combined with wavefront aberrations guided Epi-LASIK

Peng Li,Li Wang,Dan-Yu Gao,Xin-Xin Wang and Yan-Qun Deng

AIM:To observe the effect of iris location combined with wavefront aberrations guided Epi-LASIK surgery for low to moderate myopia.METHODS:All of 100 patients 179 eyes with low to moderate myopia were randomly divided into two groups,one group of 50 patients 90 eyes received wavefront-guided joint iris location of Epi-LASIK(wavefront group) surgery;the other group of 50 patients 89 eyes received routine Epi-LASIK(control group);postoperative uncorrected visual acuity(UCVA),refraction,aberration,higher order aberrations and the satisfaction of visual quality were analyzed and correlation analysis was carried out during follow-up period.RESULTS:After 6 months,there were statistical differences(P<0.05)between wavefront group and control group patients with UCVA after surgery,preoperative best-corrected visual acuity(BCVA) and postoperative UCVA in wavefront group,preoperative BCVA and postoperative UCVA in control group;postoperative aberrations increased compared with the preoperative aberrations.Postoperative wavefront aberrations and high level aberration of wavefront group were smaller than the control group,the difference was statistically significant(P<0.05);the overall satisfaction of visual quality in wavefront group was better than control group,there were significant differences(P<0.05).CONCLUSION:The iris location combined with wavefront guided Epi-LASIK is better than the conventional Epi-LASIK in some aspects of correction of high myopia.

Evaluate the position of implantable collamer lens implantation for high myopia by Pentacam anterior segment system

Ying-Jie Lin,Xian-Jun Liang,Jin-Xian He,Hai Zhu and Sheng Zeng

AIM:To observe the changes of anterior segment after implantation of the implantable collamer lens(ICL)for high myopia by Pentacam anterior segment system.METHODS:Eight patients 12 eyes with myopia were implanted ICL in our hospital from October 2009 to February 2010.The mean follow-up was 3.8 months.UCVA,BCVA,intraocular pressure,spherical equivalent(SE) were measured.ICL position was observed by Pentacam.Anterior chamber depth was observed.RESULTS:The postoperative UCVA was better than the BCVA of preoperative(t=2.237,P=0.047).Following up 3 months,the vault was 0.34-0.74mm(average 0.52±0.11mm),the average depth of anterior chamber was 2.39±0.18(2.01-2.67)mm was less than that of preoperative which was 3.24±0.11(3.01-3.46) mm.There were no serious complications.CONCLUSION:ICL implantation is a safe,efficacy,predictable and stable method in correcting high myopia.

Clinical results of LASIK for myopia combined with medium and high astigmatism

Yue-Xiu Wang,Yan-Lu Chen,Fan-Xue Kong,Fang-Lei Yu and Zhi-Li Lu

AIM:To investigate the clinical efficacy of laser in situ keratomileusis(LASIK)for myopia combined with medium and high astigmatism.METHODS:Sixty-two myopia patients 83 eyes combined with medium and high astigmatism(≥-2.00D) were treated with LASIK by the excimer laser treatment system of Wavelight company of Germany.Preoperative and postoperative tests included vision,dioptre,astigmatism and the axis of astigmatism.RESULTS:After 6 months’ follow-up,the results showed that vision was over 0.8 in 78% and 1.0 in 47% respectively.The postoperative uncorrected visual acuity better than preoperative best-corrected visual acurity was in 57 eyes(69%).64 eyes(77%) were within ±1.00D of astigmatism.The average residual astigmatism was-0.80D,and 37eyes(45%) residual astigmatism were within ±0.50D.CONCLUSION:The LASIK is an effective treatment for myopia combined with medium and high astigmatism,patients have a high level of satisfaction.

Pathological classification of 1082 eyes with corneal disease

Wei-Ya Zhou,Wei-Min He,Lin Wang and Ying-Ping Deng

AIM:To evaluate the corneal surgical indications and histopathological classification of corneal specimens in West China Hospital.METHODS:Retrospective analysis was performed on 1082 eyes suffering from corneal disease diagnosed from January 1990 to December 2009 at pathological department in West China Hospital.RESULTS:A total of 1082 corneal specimens were identified,the constituent ratio of which was as follows:corneal scar 31.42%(340/1082),keratitis 14.51%(157/1082),keratoconus 12.38%(134/1082),choristoma 12.29%(133/1082),bullous keratopathy 5.64%(61/1082),corneal scar associated with keratitis 5.45%(59/1082),epicorneal fibrotic proliferation and neovascularization with or without inflammatory cells infiltration 3.97%(43/1082),corneal degeneration 2.59%(28/1082),squamous cell carcinoma 2.13%(23/1082),corneal dystrophy 1.94%(21/1082),atypical hyperplasia 1.66%(18/1082),corneal perforation 1.39%(15/1082),papilloma 1.02%(11/1082),nevus 0.92%(10/1082),pseudo-epitheliomatous hyperplasia 0.65%(7/1082),ICE syndrome 0.46%(5/1082),intraepithelial epithelioma 0.46%(5/1082),malignant melanoma 0.46%(5/1082),keratinization or dyskeratosis 0.46%(5/1082),calcifying epithelioma 0.09%(1/1082),amyloid degeneration 0.09%(1/1082).There was an obvious increase in the number of operation from 2000 to 2009 compared with that from 1990 to 1999(912/170).211 eyes was from childen,in which congenital choristoma and corneal scar accounted for 44.55% and 36.49% respectively.CONCLUSION:The leading reasons for keratoplasty in West China Hospital are corneal scar,keratitis,keratoconus and choristoma.

Contrastive analysis of corneal thickness measurement difference between OCT and corneal pachymeter

Yang-Li Huang,Chi Feng and Li-Li Sun

AIM:To investigate the clinical significance of corneal thickness measurement difference between optical coherence tomography(OCT)and corneal pachymeter.METHODS:The clinical data of corneal thickness in 102 cases 199 eyes measured by ultrasonic corneal hymeter and OCT were analyzed by statistical test.RESULTS:The thicknesses were 532.478±29.49μm and 541.47±29.00μm from OCT and ultrasonic corneal pachymeter respectively,there was statistical significance by paired t-test.It was divided into 4 groups by corneal thickness standardized on ultrasonic thickness measuring,paired t-test showed that when the corneal thickness≤500μm,500μm 600μm,no comparison was done for little cases.CONCLUSION:Traditional ultrasonic corneal pachymeter and OCT showe some differences and better clinical conformance on measuring corneal thickness and can be used as reference before excimer laser surgery.

Clinical effect of ciliary groove suture of posterior chamber intraocular lens

Yan Cheng and Fei Feng

AIM:To assess the clinical effect of ciliary groove suture of posterior chamber intraocular lens(IOL).METHODS:From November 2003 to August 2008,52 cases 53 eyes underwent ciliary groove suture with posterior chamber IOL all acquired satisfying result.We sutured one edge of the lens to the ciliary groove in 7 cases,which was called "single-haptic fixation".The other 45 cases 46 eyes were sutured the lens to ciliary groove in two sites,which was called "double-haptic fixation".RESULTS:Followed up for 3-48(average 18)months,the best-corrected visual acuity(BCVA)was from 0.2 to 1.2 and 28 eyes(53%)were more than 0.6.The corneal scar and fundus oculi diseases resulted in poor vision.The intraocular pressure(IOP)in all eyes was normal.CONCLUSION:IOL suturing to the ciliary groove is an effective and safe method for correction of aphakia in eyes with inadequate posterior capsular support.

Phacoemulsification and negative power intraocular lens implantation in axial high myopic eyes

Wei Dai and Shi-Hong Zhao

AIM:To evaluate the clinical effect of phacoemulsification and negative power intraocular lens implantation in patients with axial high myopia and cataract.METHODS:Thirty cases 41 eyes received phacoemulsification and negative power intraocular lens implantation.Preoperative axial length,postoperative visual acuity and the fundus examination were recorded.Intraoperative and postoperative complications were observed.The follow-up time was 6 months.RESULTS:The mean preoperative axial length was 32.11mm.Postoperative visual acuity achieved 0.1 or better in 38 eyes,and 0.5 or better in 12 eyes.Only 2 eyes had posterior lens capsule rupture,and 1 eye had corneal edema.No retinal detachment was observed during the follow-up time.24 eyes had obvious high myopia retinopathy.CONCLUSION:Phacoemulsification and negative power intraocular lens implantation is safe and effective for axial high myopic eyes.

Clinical value of optical coherence tomography in age-related cataract before phacoemulsification

Xiao-Yuan Zhang and Ting-Yan Chen

AIM:To evaluate the clinical value of optical coherence tomography(OCT)in age-related cataract before phacoemulsification.METHODS:Four hundred cases 400 eyes of age-related cataract with normal fundus or only loss of foveal reflex under direct and indirect funduscopes were selected for study,including 100 cases with diabetic history,60 cases with high myopia.Besides traditional detailed ophthalmology examinations,all the subjects underwent macular exam with OCT before surgery.The omission diagnose rate of funduscopes and the risk ratio of general risk factors were calculated.RESULTS:Twenty-eight cases of maculopathy were found by OCT before cataract surgery,including 12 cases of macular edema,10 cases of age-related macular degeneration,2 cases of vitreomacular traction,1 case of macular hemorrhage,2 cases of macular hole and one case of macular atrophy.Diabetic history,high myopia and age above 60 years old were risk factors,and risk ratio with 95% confidence interval were 4(1.837,8.087),2.27(1.050,4.9),2.5(1.14,5.53)respectively.CONCLUSION:OCT is highly sensible in suspection of maculopathy before cataract surgery,especially for patients with diabetes,high myopia and old age,it can be recommended as preoperational routine examination.

Clinical evaluation of phacoemulsification and intraocular lens implantation for cataract after trabeculectomy

Wan-Jiang Dong,Gang Tan,Hua Liu,Su-Ying Yu and Shao-Zhu Hu

AIM:To evaluate the results of phacoemulsification combined with soft intraocular lens implantation in the treatment of cataract after trabeculectomy.METHODS:In total of 132 patients 148 eyes with cataract after trabeculectomy were treated by phacoemulsification and intraocular lens implantation in nasal or superior temporal quadrant incisions.Visual acuity,intraocular pressure(IOP)and complications were assessed in the postoperation.The follow-up time was from 3 to 39 months.RESULTS:All 148 eyes of 132 patients acquired satisfied visual acuity.One week postoperatively,the corrected visual acuity(CVA)showed that 8 eyes(5.4%)were<0.05,26 eyes(17.6%)were≥0.05-0.3,72 eyes(48.6%)were>0.3-0.6,40 eyes(27.0%)were>0.6-1.0,2 eyes(1.4%)were>1.0.The intraocular pressure(IOP)was all stable after the operation(15.23±3.42mmHg,1mmHg=0.133kPa).The main complications were early postoperative corneal edema and iris reaction which were mild and faded away in 2-5 days.CONCLUSION:The small incision phacoemulsification combined with intraocular lens implantation is convenient and effective for the treatment of cataract after trabeculectomy.It has achieved rapid postoperative recovery,less complication,lower astigmatism and stable IOP.The operation is better than extracapsular cataract extraction(ECCE)method in the treatment of cataract after trabeculectomy.

Treatment of neovascular glaucoma by anterior retina condensation in combination with pars plana vitrectomy

Li-Bo Xiao,Li-Ping Xue,Yun-Qin Li and Chun-Ling Wei

AIM:To evaluate the effect of the treatment of neovascular glaucoma(NVG)by anterior retina condensation in combination with pars plana vitrectomy.METHODS:Tirty-one cases 31 eyes with diagnosed NVG were treated by anterior retina condensation in combination with pars plana vitrectomy,and whole-retina photocoagulation was applied as well.RESULTS:Preoperative intraocular pressure(IOP)was 41.1±6.2mmHg,after 3-25 months’ follow-up(average 9.8 months),the average of IOP was 22.6±6.9mmHg.There was statistical difference between IOP before and after operation.25 eyes IOP was controlled to be normal(19.8±2.4mmHg);3 eyes needed topical anti-glaucoma drops,and 2 eyes were carried out glaucoma valve implantation.1 eye was applied evisceration because of no light perception and eye-pain after operation.20 cases got a better visual acuity,5 cases remained the same level,5 cases decreased,and 1 case became no light perception.Neovascular on the surface of iris almost or completely disappeared in 30 cases,maintaining corneal transparency and non hematocele anterior chamber.Most follow-up cases eye-pain disappeared or obviously reliever.CONCLUSION:Treatment of anterior retina condensation in combination with pars plana virrectomy is effective in neovascular glaucoma.It can lead to better visual acuity,disappearance of iris neovessels,and decrease of IOP.

Ahmed glaucoma valve implantation for neovascular glaucoma

Qi Zhao and Hui-Zhu Wang

AIM:To study the effect of Ahmed glaucoma valve(AGV)implantation for neovascular glaucoma and prevention of its complications.METHODS:Eighteen patients underwent AGV implantation were summarized retrospectively.The visual acuity,intraocular pressure,postoperative complications and the effective rate were observed,the mean period of follow-up was 6-18 months.RESULTS:The postoperative best corrected visual acuities were stable in 11 eyes,improved in 5 eyes and dropped in 2 eyes.The success rate for intraocular pressure was 89% after the operation.The common postoperative complications included transient flat anterior chamber,high intraocular pressure and hyphema in early stage,fibrination in late stage.CONCLUSION:AGV implantation is one of the effective methods for neovascular glaucoma.

Sodium hyaluronate combined with Ahmed glaucoma valve for refractory glaucoma

Jin-Ying Wang and Yuan Gao

AIM:To investigate the the long-term efficacy of combination of sodium hyaluronate and Ahmed glaucoma valve for refractory glaucoma and the prevention and treatment for surgical complications.METHODS:Twenty-seven patients 27 eyes with refractory glaucoma were treated with sodium hyaluronate and Ahmed glaucoma valve and followed up from 6 to 22 months.RESULTS:Postoperative intraocular pressure(IOP)declined from 46.70±9.31mmHg preoperatively to 18.7±6.85mmHg.Visual acuity was improved to some extent.Displacement of glaucoma valve was found in 1 case and improved with adjustment.Hyphema was found in 2 cases and absorbed with medication.CONCLUSION:Sodium hyaluronate combined with Ahmed glaucoma valve can effectively reduce the IOP in patients with refractory glaucoma and decrease the postoperative complications.

Effect of Ahmed glaucoma valve implantation with mitomycin C combined with retinal photocoagulation for neovascular glaucoma

Lei Li,Rui Yang,Hong Qiu,Chun-Yan Liu and Ke-Xin Su

AIM:To investigate the therapeutic effect of Ahmed glaucoma valve implantation with mitomycin C combined with retinal photocoagulation in treatment of neovascular glaucoma.METHODS:Twenty-six eyes with neovascular glaucoma were underwent the implantation of glaucoma valve combined with panretinal photocoagulation.RESULTS:Follow-up 12 months,the success rate was 61.54%.the average intraocular pressure decreased from 49.78±14.17mmHg preoperatively to 18.45±8.91mmHg postoperatively.In the postoperative ultimate check-up,visual acuity of 14 cases were improved(53.85%),12 cases had no change,No case was decreased and impairmented.The new vessels of the iris disappeared in 21 eyes.The important complications such as shallow anterior chamber was 6 in eyes(23.08%),hyphema 3 eyes(11.54%),tube occlusion 2 eyes(7.69%),fibrosis around Ahmed valve 1 eye(3.85%).CONCLUSION:Ahmed glaucoma valve implantation combined with panretinal photocoagulation in treatment of neovascular glaucoma can not only decreased intraocular pressure timely but also increased visual acuity.It is a safe and effective approach to those patients with neovascular glaucoma.

Clinical observation of hexuemingmu tablet combined with krypton laser on the retinal vein occlusion

Qing Yu,Zhi-Min Li,Xian Wang and Bing-Min Feng

AIM:To investigate the effect of hexuemingmu tablet combined with krypton laser on the retinal vein occlusion(RVO).METHODS:Fifty-seven patients with 60 eyes diagnosed as RVO with FFA and OCT were divided into two groups randomly.One group including 29 patients 30 eyes were treated by hexuemingmu tablet combined with krypton laser,the other group includ 28 patients 30 eyes were treated by krypton laser.The visual acuity,fundus and FFA were evaluated before and after treatment in the 6 months follow-up.RESULTS:The vision acuity was improved significantly in the group treated by hexuemingmu tablet combined with krypton laser,and the hemorrhage in this group was absorbed much more quickly(P<0.05).CONCLUSION:Hexuemingmu tablet combined with krypton laser can accelerate hemorrhage absorbing and improve visual acuity in the RVO treatment.

Clinical study on the treatment of rhegmatogenous retinal detachment by scleral buckling

Xue-Ying Ma,Rong Zhang and Ling Li

AIM:To discuss the therapeutic effect,surgical indication of scleral buckling for rhegmatogenous retinal detachment(RRD).METHODS:The major surgeries were as follows:retinal breaks locating,cryotherapy,scleral buckling or encircling scleral buckling.192 cases 195 eyes with RRD accepted surgery,including 131 eyes in segmental scleral buckling and 64 eyes in encircling scleral buckling.Among these cases 145 eyes underwent subretinal fluid drainage and 16 eyes with gas filing into vitreous space.RESULTS:The rate of retinal reattachment after one surgical procedure was 94.9%.The postoperative visual acuity increased significantly,which had statistical difference compared with that of the preoperative(P<0.05)And there were no serious complications in operation and postoperation.CONCLUSION:Scleral buckling appears to be safe and effective in patients with RRD.

Therapy of vitreous hemorrhage in branch retinal vein occlusion by vitrectomy

Pei-Feng Li

AIM:To study the clinical curative effect of vitrectomy for vitreous hemorrhage in branch retinal vein occlusion.METHODS:Twenty-eight cases 28 eyes of vitreous hemorrhage caused by branch retinal vein occlusion were taken into investigation.All the patients accepted routine three-way joint vitrectomy combined with membrane peeling,diathermy,retinal photocoagulation and silicon or gas or fluid tamponade.RESULTS:The branch retinal vein occlusion seemed to be vascular sheathing in 28 eyes.The occlusion areas were supertemporal quadrant in 20 eyes,infratemporal quadrant in 8 eyes.2 eyes had disc neovascularization,18 eyes had retinal neovascularization in the areas of retinal vein occlusion.Retinal detachment was found in 7 eyes.The postoperative visual acuity was better than that of preoperative.CONCLUSION:Vitrectomy is an effective way for branch retinal vein occlusion with vitreous hemorrhage.The proliferation should be carefully removed.

Clinical observation of YAG laser for diabetic retinopathy

Chang Liu,Guo-Jun Lü and Hong Ren

AIM:To evaluate the therapeutic effect of YAG laser for diabetic retinopathy(DR).METHODS:A total of 142 cases 247 eyes with DR were treated with photocoagulation by YAG 532nm laser.RESULTS:Visual acuity was improved in 198 eyes after the treatment of panretinal photocoagulation,and neovascularization disappeared completely or partially,favorable response rate was 80.2%.The effective rate of preproliferative diabetic retinopathy(PPDR)and early proliferative diabetic retinopathy(PDR)was totally 92.0%,showing significantly higher favorable response rate than that of the eyes with high-risk PDR(41.7%).CONCLUSION:YAG 532nm laser is effective for DR,and better clinical outcome can be expected from early intervention.

Application of panretinal mirror-assisted vitrectomy for removing foreign body from posterior segment

Yi-Qiao Xing,Yin Li,Tuo Li and Hong-Yan Li

AIM:To evaluate the effects of panretinal mirror-assisted vitrectomy for removing foreign body from posterior segment.METHODS:We retrospectively analyzed 28 patients 30 eyes with posterior segment foreign bodies from January 2008 to January 2010,performed vitrectomy,removed foreign body under direct vision with panretinal mirror assisted,retinal detachments or breaks were treated with heavy water replacement,intraocular photocoagulation,scleral condensation,silicone oil or C3F8 filling,vancomycin injection for endophthalmitis postoperatively.RESULTS:All of 30 eyes,the foreign body of each eye was extracted for one time;the success rate was 100%(not including intraorbital foreign body).Best-corrected visual acuity increased in 22 eyes(73%);unchanged in 5 eyes(17%);decreased in 3 eyes(10%).Visual acuity >0.02 or finger count/1 meter in 18 eyes(literacy rate of 60%).During the operation,we found 11 eyes with retinal detachment,9 eyes were restorated one time(restoration rate 82%).CONCLUSION:With the assistance of panretinal mirror,vitrectomy for removing foreign body from posterior segment is an effective method,which can provide a wider and clearer vision to increase the improvement rate of visual acuity.

Measuring central corneal thickness and anterior chamber depth in myopia with Pentacam Scheimpflug imaging system

Li Jia,Jin-Ke Li,Chao Zhang,Sheng-Jian Mi and Yu-Hui Duan

AIM:To assess the accuracy of Pentacam Scheimpflug imaging system in the measurement of central corneal thickness and anterior chamber depth in myopia.METHODS:Pentacam Scheimpflug imaging system and A-scan ultrasonic pachymetry were used to measure the central corneal thickness and anterior chamber depth in 82 patients 164 eyes with myopia.The results of two methods were compared.The results were analyzed with SPSS 16.0.Correlation analysis was performed in intraocular pressure and axial length.RESULTS:The value of central corneal thickness measured by the Pentacam Scheimpflug imaging system was 524±0.037μm,and by A-scan ultrasonic pachymetry was 521±0.036μm.There was significant difference between the results of these two methods(P<0.01).The value of anterior chamber depth measured by the Pentacam Scheimpflug imaging system was 3.26±0.25mm,and by A-scan ultrasonic pachymetry was 3.36±0.53mm.There was significant difference(P<0.05),and significant linear correlation between the two methods(P<0.01).The average central corneal thickness was 3μm by optics;average anterior chamber depth was 0.1mm by ultrasound.The two methods for measuring the central corneal thickness and intraocular pressure and the anterior chamber depth and axial length were positively related(P<0.01).CONCLUSION:There exists certain difference in the central corneal thickness and the anterior chamber depth for ametropia measured by Pentacam,a three-dimensional anterior segment analyzer and A-scan ultrasonic pachymetry.

Analysis of 824 myopia cases not suitable for LASIK

Jin-Ke Li,Li Jia,Chao Zhang,Sheng-Jian Mi,Yu-Hui Duan and Sheng Zhou

AIM:To identify the reasons for myopia patients not suitable for laser in situ keratomileusis(LASIK)after preoperative assessment.METHODS:Two thousand eight hundred ninety-one myopia patients were examined.824 cases of them did not undergo LASIK,the reasons were analyzedRESULTS:A total of 297 patients(36.0%)were insufficient of the corneal thickness ;194 patients(23.5%)had some apprehension about the surgery ;96 patients(11.6%)had a larger pupil ;50 patients(6.1%)had a larger height of the corneal anterior and posterior surface;the corneal curvature of 46 patients(5.6%)was higher;43 patients(5.2%)had no ideal best-corrected visual acuity;31 patients(3.8%)had the fundus disease,31 patients(3.8%)had dry eye and 36 patients(4.4%)had the other reasons.CONCLUSION:LASIK is an alternative surgery.We must perform preoperative assessment carefully,evaluate the test results comprehensively and scientifically,enhance communication between doctors and patients and strictly master surgical indications and contraindications.

Effects of total and corneal astigmatism on LASIK correction of myopic astigmatism

Li Liu,Zi-Xin Chen,Ying-Pei Chen,Xiao-Yao Li and Qian Hu

AIM:To evaluate the effects of total and corneal of astigmatism on laser in situ keratomileusis(LASIK)correction of myopic astigmatism.METHODS:Totally 162 eyes of 84 patients who underwent primary LASIK for myopic astigmatism were reviewed retrospectively.Based on the differences between total and corneal axis of astigmatism and degrees,the patients were divided into two groups:A group(112 eyes)with difference of astigmatism<15° or degrees of total astigmatism

Genetic diagnosis of VMD2 gene in Best vitelliform macular dystrophy pedigree

Chun-Xia Wang,Zi-Yan Yu,Qi Sun,Wen-Kai Zhou,Di Wu and Jin-Song Zhang

AIM:To definitively diagnose a Best vitelliform macular dystrophy(BVMD) pedigree by molecular genetic examination of vitelliform macular dystophy 2(VMD2) gene,and to provide the basis for gene diagnosis of Best disease·METHODS: Ophthalmological examinations were performed.Mutations in the coding regions of VMD2 gene was analyzed by polymerase chain reaction(PCR) and direct DNA sequencing.VMD2 mutation screening was performed in 100 normal controls·RESULTS: Funduscopic examination of the proband revealed vitelliform lesions in the maculae of both eyes.Fundus angiography didn’t show choroidal neovascularization.Mutation analyses found a heterozygous mutation c.886A>G(Asn296Asp) in exon 8 of VMD2 gene·CONCLUSION: A novel disease-causing mutation in VMD2 gene(Asn296Asp) is found in a Best disease family.Mutation screening of VMD2 gene can be used for definite diagnosis and genetic consultation of Best disease.The possibility of Best disease should not be neglected when a case has macular abnormality.

Effect of corneal ulcer debridement combined with antimycotic drug for fungal keratitis

Yu-Zhao Sun,Yue-Dong Hu,Lei Chen and Hui Zhang

AIM:To analyze the effect of corneal ulcer debridement combined with antimycotic drug for fungal keratitis·METHODS:Collecting 2010-09/ 2011-09 fungal keratitis 30 cases in our hospital,all patients were treated with corneal scraping,followed with corneal ulcer debridement,and fluconazole or natamycin eyedrop according to the severity of keratitis,ineffective treatment cases resorted to the self conjunctiva cover or lamellar kemtoplasty.The therapetic results were observed with following up·RESULTS:Totally 27 cases corneal blade and fungi culture were positive,positive rate were 90%.Among these cases,6 mild keratitis cases all recovered after corneal ulcer debridement combined with fluconazole eyedrop,course 2-3weeks.The moderate keratitis were 17 cases,12 cases recovered after corneal ulcer debridement combined with natamycin eyedrop,course 4-10weeks.7 cases became serious,among which 3 cases underwent self conjunctiva cover,1 cases underwent the lamellar kemtoplasty.The total effective rate of corneal ulcer debridement combining with antimycotic drug for fungal keratitis was 70%·CONCLUSION:Corneal ulceration debridement combined with antimycotic drug is simple,economic,effective and feasible treatment for fungal keratitis.

Species of bacteria on conjunctiva sac of the middle age and the elder of Han nationality in Ganzi district

Danba Jiachu,Ji Duo,Hong Zheng,Gema Zewang,Zhi-Rong Liu and Yue Zhang

AIM:To evaluate the species of bacteria on the conjunctiva sac of the middle age and the elder of Han nationality in Ganzi district·METHODS:A total of 173 cases(346 eyes) of the middle age and the elder of Han nationality in Ganzi Tibetan Autonomous Prefecture were examined.The professional person embrocated the inferior palpebral conjunctiva.Then the secretion was inoculated on blood plate for 48hours,the bacteria was seperated and identified·RESULTS: The positive rate of the bacteria cultivation was 60.4.%(209/346).Totel 232 strains were cultivated.The most dominant was Staphylococcus epidermidis(115 strains,49.6%),the next was Corynebacterium(60 strains,25.9%).The positive rate of bacteria in the conjunctival sac of the elder in Guzan and Lucheng town of Kangding County were 69.2% and 65.8%,the difference was not statistically significant(χ2=0.1709,P>0.05).The positive rate of the elder in Gar town of Jiulong County was 44.3%,compared with the ones in Guzan and Lucheng town was lower.The difference was statistically significant(Guzan vs Gar:χ2=13.2002,P<0.05;Lucheng vs Gar:χ2= 9.6869,P<0.05)·CONCLUSION:Bacteria could be found in most people’s conjunctiva of Han nationality,Staphylococcus epidermidis and Corynebacterium were the dominant strain on the conjunctiva of the middle age and the elder.Different district has different positive rate of the bacteria cultivation.

Clinical observation on phacoemulsification combined with goniosynechialysis for treatment of PACG with cataract

Yong-Min Liu,Yong-Hong Liu,Xiang-Xia Luo and Li Su

AIM:To observe the influence of phacoemulsification combined with goniosynechialysis(Phaco-GSL) on anterior chamber and intraocular pressure(IOP) for primary angle-closure glaucoma(PACG) with cataract patients·METHODS:Totally 36 patients(36 eyes) with PACG and cataract were randomly divided into observation group of 18 patients and control group of 18 patients,the observation group underwent Phaco-GSL treatment,the control group was treated with simple Phaco surgery,changes in anterior chamber structure,IOP and visual acuity were recorded before and after the surgery·RESULTS:The patients with postoperative anterior chamber angle opening greater than 270° were 18 cases(100%) in the observation group,10 cases(56%) in the control group,the comparison between two groups was statistically significant(P <0.01);Postoperative anterior chamber deepened 1.208±0.181mm in the observation group,0.883±0.074 mm in the control group,the comparison between two groups was statistically significant(P<0.01);The patients with postoperative IOP decreased to the normal range in the case of no drug treatment were 15 cases(83%)in the observation group,9 cases(50%)in the control group,the comparison between two groups was statistically significant(P<0.01);All the postoperative visual acuity had improved,but the comparison between two groups was not statistically significant(P>0.05)·CONCLUSION:Phaco-GSL can significantly improve anterior chamber structure with effective lowering IOP to achieve the desired therapeutic effect for the patients of PACG with cataract.

Modified operation for the treatment of glaucoma combined with cataract

AIM:To investigate the clinical effects of modified and general cataract extraction united with trabeculectomy for the treatment of glaucoma combined with cataract·METHODS:All the data of the operations of 64 eyes from January 2004 to June 2010 in our hospital were collected and analyzed.Postoperative intraocular pressure,visual acuity and functional filtering bleb were compared between the two surgical methods.The data were analyzed by SPSS 11.0 statistical software·RESULTS: There were no significant difference in intraocular pressure and functional filtering bleb between the two groups,but the difference was significant in visual acuity·CONCLUSION:As it has advantages of recovering quickly visual acuity and controlling intraocular pressure well,modified operation is an ideal method in treating glaucoma combined with cataract.

Clinical study of no scleral suture trabeculectomy for glaucoma

Qiu-Li Yu and Wen-Bin Liu

AIM:To evaluate the clinical effect of no scleral suture trabeculectomy for glaucoma·METHODS:Totally 45 cases(57 eyes) of glaucoma were included from December 2007 to June 2010.57 eyes were randomly divided into two groups(Group A and B).24 cases(29 eyes) were treated with no scleral suture trabeculectomy(Group A) and 21 cases(28 eyes) were treated with traditional trabeculectomy(Group B).Intraocular pressure(IOP),anterior chamber,filtering bleb and complications were compared·RESULTS:No scleral suture trabeculectomy appeared more effective in IOP control and functional bleb formation whereas a lower complication rate compared with traditional surgery·CONCLUSION:No scleral suture trabeculectomy is an effective method for glaucoma.

Evaluation of the efficacy and safety of intravitreal Avastin for diabetic macular edema

Quan-Liang Zhao,Chun-Xiang Zhang and Ru-La Sa

AIM:To evaluate the efficacy and safety of intravitreal avastin for diabetic macular edema(DME)(diabetic retinopathy Ⅳ period and macular edema above metaphase)·METHODS:Totally 60 patients who were diagnosed by fundus fluorescein angiography(FFA) from January 2009 to December 2010 with declining eyesight and diabetes of clinical treatment significance FFA showed diabetic retinopathy in Ⅳ period,optical coherence tomography(OCT) examination showed moderate or above macular edema,macular edema history did not exceed 3 months were selected.All eyes received a baseline eye examination before treatment,which included intraocular pressure,slit-lamp,best-corrected visual acuity,mydriatic fundus examination,and color retinal photography,FFA,OCT were performed.An intravitreal injection of avastin(1.25mg) was given at baseline and followed by two additional injections of four weeks intervals.Recording the first day,the second day,the third day,the third week,the third month,the sixth month of best-corrected visual acuity,intraocular pressure,the change of lens and vitreous,status of retinal leakage and observing postoperative central retinal thickness by OCT to compare·RESULTS:The intravitreous injection of avastin could improve vision function and decrease central macular thickness(CMT) obviously.The central macular thickness was(395.933±119.784)μm in preinjection and(314.200±60.528)μm in postinjection,showing a statistically significant difference between them.During the follow-up,no significant changes in intraocular pressure and cataract were observed.The retina toxicity reaction relevant to avastin and local or systemic adverse reactions were nothing·CONCLUSION:The intravitreous injection of avastin can relieve macular edema and improve visual acuity stably for diabetic retinopathy patients.However,its long-term treatment effect requires a large sample of experiments to further confirm.

Curative effect observation of treatment of inferior rhegmatogenous retinal detachment by pneumatic retinopexy

Yi Zhang

AIM:To evaluate the effectiveness of pneumatic retinopexy(PR) with cryopexy in the therapy of inferior rhegmatogenous retinal detachment(RRD)·METHODS:Twenty-two patients(22 eyes) were included in this study.The RRD diagnosis was confirmed by best-corrected visual acuity(BCVA),slit-lamp microscope,indirect ophthalmoscope and Goldman three-mirror contact lens.All patients had undergone PR with cryopexy,and the post-operative follow-up was 6 to 24 months with an average of 12 months.Post-operative BCVA and final anatomical outcome was analyzed·RESULTS:The reattachment rate of single PR was 77%(17/22 eyes),and 2 eyes required additional intravitreal injection of the gas.The total reattachment rate of PR was 86%(19/22 eyes).Three eyes needed additional scleral buckling.Final retinal reattachment was achieved in all 22 subjects(100%).Postoperative BCVA was significantly improved(P<0.01)·CONCLUSION:PR is an effective surgery for inferior RRD·

Characteristics and management of retinopathies in myopic eyes before LASIK

Shan-Xiang Li,Gang-Ping Zhao,Guo-Pei Li,Yan-Hua Wang,Zhui Li and Ling-Jiang Zhao

AIM:To analyse the characteristics of retinal lesions in myopic patients scheduled for laser in situ keratomileusis(LASIK),then to assess the efficacy and safety of prophylactic laser coagulation for retinal lesions in these myopic eyes·METHODS:Retrorespective clinical research.LASIK were performed in 1100 continuous patients(2190 eyes).Before operation,the fundus was examined with direct and indirect ophthalmoscope and three mirror contact lens.The laser photocoagulation was performed in order to strengthen the retina with severe peripheral degeneration·RESULTS:Peripheral fundus abnormalities and holes both increased while refraction diopter increased,and there were statistically significant differences among groups(P<0.05).And the abnormalities were usually in the temporal fundus.A total of 2190 eyes were examined.Among them,132 eyes(6.07%) were found to have peripheral retinal degeneration:64 eyes(48.48%) had lattice degeneration,37 eyes(28.03%) had cystoid degeneration,54 eyes(40.91%) had snail track degeneration,34 eyes(25.76%) had white non-pressure change,12 eyes(9.09%) had cobblestone degeneration,14 eyes(10.61%) had retinal dry holes,4 eyes(3.03%) had hole and localized shallow detachment.The pathological changes in 43 cases(78 eyes) were treated effectively by laser photocoagulation for more than three weeks,and eventually the holes were firmly closed and the lattice degeneration,the cystoid degeneration were photocoagulated reliably.No new holes and retinal detachment occurred·CONCLUSION: It’s necessary to examine the fundus of the two eyes with the three-mirror contact lens before LASIK.To prevent retinal detachment effectively,laser photocoagulation should be performed in time on the peripheral retinal degeneration of myopia.

Ultrasound biomicroscopy observation on traumatic cyclodialysis cleft

Qiao Li,Yu-Liang Wang,Jing Xing and Xin Zhou

AIM:To analyze the features of traumatic cyclodialysis cleft by ultrasound biomicroscopy(UBM) and summarize the results of ciliary body suture with UBM in traumatic cyclodialysis cleft·METHODS:Totally 30 eyes of 30 patients with post-traumatic ciliary body detachment were diagnosed by UBM examination,with the localization and range of cyclodialysis cleft.Among them,5 eyes of 5 patients were treated with ciliary body suture according to the results of UBM examination.Patients were examined postoperatively on visual acuity,intraocular pressure(IOP),and UBM and ultrasonography re-examination·RESULTS:All patients had cyclodialysis detachment,90%(27/30)had full cyclodialysis detachment,and 87%(26/30)had cyclodialysis cleft,the mean ACD was(1.830±0.575)mm.5 patients of them had been treated by ciliary body suture with UBM.The IOP of 4 patients was normal after the first surgery,the IOP of 1 patient was normal after the fourth surgery.Ciliary body of all patients after surgery was adhered to sclera,anterior chamber was deepened,and visual acuity was improved·CONCLUSION:UBM is a useful method for appropriate diagnosis of traumatic cyclodialysis cleft.Ciliary body suture with UBM is an effective surgery for treatment of traumatic cyclodialysis cleft.UBM can be of great value in the diagnosis,management and follow-up of patients with traumatic cyclodialysis cleft.

Transconjunctival sutureless repair of orbital fracture

Ming Chen,Guang-Rui Chai,Zhi-Cai Su,Lu Liu and Meng Wang

AIM:To report the surgical outcomes of patients undergoing orbital fracture repair without periosteal closure·METHODS:All patients data were reviewed in a retrospective manner.Seventy-two patients(73 eyes) who underwent transconjunctival repair of isolated orbital fractures(n=51) or complex orbital fractures(n=21) without periosteal closure were included.A transconjunctival incision below the tarsus provided preseptal access to the inferior orbital rim,and transcaruncular incision provided access to the internal orbital fracture,after which the periosteum was incised for exploration and repair of orbital fracture.Forced ductions were performed after release of entrapped tissue and placement of orbital implants,and the periosteum was sutureless,conjunctiva was reapproximated with forceps and interruptedly sutured.Incidence of postoperative complications,including orbital implant exposure,infection,and migration was measured·RESULTS:All patients were followed up for 4-18(average 11) months postoperatively.One patient experienced lower lid retraction with entropion.Other complications included lateral canthal dystopia(n=3) or pyogenic granuloma at the lateral canthotomy site(n=1).There were no cases of postoperative implant exposure,infection,or migration·CONCLUSION:Forgoing closure of the periorbita after transconjunctival orbital fracture repair is associated with a low incidence of postoperative complications.This technique is applicable in the repair of both isolated orbital fracture and complex orbital fracture.

Comparison between the effect of LASIK and LASEK on the choroidal blood flow

Jian Zhao and Jue-Tian Meng

AIM:To evaluate the effect of laser in situ keratomileusis(LASIK) and laser subepithelial keratomileusis(LASEK) on the choroidal blood flow by comparing and analyzing the ocular pulse amplitude(OPA) values before and after LASIK and LASEK·METHODS:After routine check all patients were devided into two groups and each group had 20 patients(39 eyes).After measured central corneal thickness(CCT) and corneal curvature(CCV) by Pentacam system,the two group patients which would be treated by LASIK or LASEK operation were measured intraocular pressure(IOP) and OPA by the dynamic contour tonometry(DCT) before operation and one month after operation.Finally the statistical analysis were adopted to evaluate the measurement results·RESULTS:There was no statistical difference between the OPA values of the LASIK patients or the LASEK patients before and after operation(P>0.05),and the OPA values had no statistical difference between the LASIK patients and the LASEK patients before and one month after operation(P>0.05)·CONCLUSION: LASIK and LASEK operation don’t affect the choroidal blood flow.

Refractive changes in the eye after scleral encircling and buckling surgery

Yong Wang,Mei Ren,Li-Li Wang and Zhong-Qiao Zhu

AIM:To investigate changes in refractive state after scleral encircling and buckling surgery·METHODS:Twenty-three cases(23 eyes) that were successfully treated for rhegmatogenous retinal detachment with scleral encircling and buckling were measured with A-scan ultrasonography and given rtinoscopy optometry 1 day before surgery,as well as 1 week,4 weeks and 12 weeks after surgery.Refractive factors,axial length,chamber depth,lens thickness,refractive power of cornea and diopter status of the eyes were measured and compared pre-and post-operatively·RESULTS:When compared to the data obtained before surgery,significant increases in both axial length and lens thickness of the eyes were observed on the 1st,4th and 12th week after surgery(P<0.01 for both factors,but P<0.05 for diopter strength and anterior chamber shallowing refractive power increase.Diopter strength had a tendency to shift to a negative value·CONCLUSION:Axial length and diopter strength increased after surgery.This suggests that the myopic shift after scleral encircling and buckling surgery may be primarily caused by the increase of axial length.

Analysis of retinal nerve fiber layer thickness in patients with unilateral anisometropic amblyopia

Xiu-Li Bao and Yu-De Ai

AIM:To compare the peripapillary retinal nerve fiber layer(RNFL) thickness of amblyopic and sound eyes in patients with unilateral anisometropic amblyopia·METHODS:Totally 38 patients with unilateral anisometropic amblyopia and without strabismus were selected.The peripapillary RNFL thickness in amblyopic and sound eyes was detected by optical coherence tomography(OCT)·RESULTS:For 38 patients with amblyopia,the mean age was 10.73 years,the average RNFL thickenss in amblyopic eyes was 106.38±12.05μm.The RNFL was thickest in the inferior quadrant 133.67±19.44μm,followed by superior 123.31±13.95μm,nasal 89.96±17.71μm and temporal 70.06±10.18μm.The RNFL thickenss in amblyopic eyes was thicker than that in sound eyes,showing statistical difference in averge and nasal RNFL thickenss(P=0.016;P=0.01)·CONCLUSION: The RNFL thickness,specially nasal and average RNFL thickness in amblyopic eyes is thicker than that in sound eyes in unilateral anisometropic amblyopia.

Comparison study on the effectiveness of topical Pranoprofen for the inflammation after laser surgery of anterior segment

Li Huang and Feng-Ju Zhang

AIM:To evaluate the efficacy and safety of Pranoprofen eye drops in relieving reactions of postoperative inflammation of Nd:YAG laser to treat the disease of the anterior segment of the eye·METHODS:Totally 60 cases(60 eyes) with angle-closed glaucoma were performed laser peripheral iridotomy(LPI) and laser capsulotomy,then were randomly divided into two groups,experimental group and control group,30 cases(30 eyes) of each group.Pranoprofen and TobraDex eye drops,four times each day,were administered in experimental and control group respectively.All patients had been observed for 7 days.Ocular pain,photophobia,epiphora,conjunctival congestion,keratitis,aqueous humor flare were observed and recorded to calculate a comprehensive score to assess the curative effects·RESULTS:There was no significant difference in comprehensive score between the two groups at 1 day,3,7 days postoperatively(P>0.05)·CONCLUSION:Pranoprofen eye drops have excellent efficacy and safety to control the inflammation after laser peripheral iridotomy and laser capsulotomy,it can decrease the danger of high intraocular pressure due to corticosteroid.

Analysis of clinical features and the first study of responsible genes for the two Usher syndrome families

Xin Jin,Tie-Cheng Liu and Hui-Jun Yuan

AIM:To analyze the clinical features of the two Usher Syndrome families USH-001 and USH-002,and screening for possible relevant USH gene map locus·METHODS:The clinical and pedigree features of USH-001,USH-002 families were analysed.The short tandem repeat markers around the 12 known USH gene map locus were screened to choose the possible relevant genes by use of the principles and methods of linkage analysis·RESULTS: The phenotypes of the family USH-001 were similar to USH-002,night blindness occurred in 10-13 years old and gradually got worse with age,visual field gradually narrowed to tubular vision,while the decline of visual acuity were not obvious,bone cell-like retinal pigmentation was found in the peripheral retina.Hearing loss in both ears occurred in childhood,it was non-progressive sensorineural hearing loss,with mainly high-frequency hearing loss and normal vestibular function.Their clinical manifestations were consistent with the diagnosis of USH-002.The phenotype did not consecutively transmit.In USH-001 family all the patients shared the same Allele of D11S902 and D17S785 short tandem repeat markers,and all the patients in USH-002 family shared the same Allele of D1S425and D9S1776 markers·CONCLUSION: USH-001 and USH-002 are USH2 families and their genetic forms are autosomal recessive.USH1C and USH1G are likely pathogenic genes for USH-001 family,USH2A and USH2D are likely pathogenic genes for USH-002 family.

Content determination and analysis of chromium in serum and aqueous humor of diabetic cataract patients

Min Zhang,Zhong-Chen Zhang and Hui-Ling Li

AIM:To evaluate the aqueous humor and serum levels of chromium(Cr) in cataract patients with and without 2 type diabetes mellitus·METHODS:Levels of Cr were measured using atomic absorption spectrometry in the serum from 40 patients and aqueous humor aspirates taken during anterior segment surgery from 19 eyes of 19 patients who had diabetic cataracts(diabetic group)and from 21 eyes of 21 patients who had senile cataract only(control group)·RESULTS:The mean aqueous humor Cr concentration in eyes with diabetes cataract was significantly lower than that from eyes with senile cataract(P<0.05).There was also a statistically significant difference between the serum Cr concentrations of the diabetic group and the control group(P<0.05).Serum and aqueous humor chromium content in both groups showed no significant correlation(r=-0.142,P>0.05)·CONCLUSION:The aqueous humor and serum Cr levels are decreased in eyes with diabetic cataract.Cr has an important role in the development process of cataract in patients with diabetes.

Comparison of corneal flap thickness created by two different microkeratomes

Ri-Ping Zhang,Ming-Zhi Zhang,Li-Xia Sun and Jin-Yu Li

AIM:To analyze corneal flap thickness of laser in situ keratomileusis(LASIK) by Hansatome microkeratome and Amadeus II microkeratome.METHODS:Totally 50 patients(100 eyes) were divided into two groups randomly.The LASIK procedures were performed with Hansatome microkeratome using a 160μm head in group 1 and Amadeus II microkeratome using a 140μm head in group 2.The preoperative central corneal thickness and the stromal bed thickness after the flap was lifted were measured by ultrasound pachymetry.All patients were performed LASIK on right eye firstly and then left eye.The actual corneal flap thickness created by two different microkeratomes and the difference between the left and right eye of patients by the same microderatome were compared.RESULTS:The mean actual corneal flap thickness created by Hansatome and Amadeus II were 98.70±18.04μm(range from 67 to 158μm) and 110.60±16.47μm(range from 69 to 171μm),respectively.The difference between these two kinds of microkeratomes was statistically significant(P= 0.001).In the Hansatome group,the flap thickness in the right eye and left eye were 104.40±18.78μm and 93.00±15.61μm(P=0.01),while in the Amadeus II group,the flap thickness in the right eye and left eye were 115.12±18.74μm and 105.20±12.29μm(P=0.024).The corneal flap thickness of left eye was thinner than the right eye in each groups and the difference between two groups was statistically significant.CONCLUSION:The corneal flap thickness created by microkeratome was different from the expected value.Intraoperative measurement of corneal flap thickness was important for LASIK surgery.

Comparison in measurements of central corneal thickness using Pentacam system and A-scan ultrasound pachymetry after laser in situ keratomileusis

Juan Wang,Xue-Fei Li,Jun-Zhu Zhang,Hong-Jiang Jia and Jin-Rong Zhao

AIM:To compare the difference in central corneal thickness(CCT) measurements after laser in situ keratomileusis(LASIK) using Pentacam system and A-scan ultrasound pachymetry.METHODS:Pentacam system and A-scan ultrasonic pachymeter were used to measure the corneal thickness on 267 myopic cases(267 eyes)undergoing LASIK 1 month,3 months and 6 months after the operation.Then the results were compared.RESULTS:The differences between the instruments were evaluated with paired t-test.The correlation between the measurements was evaluated using Pearson correlation coefficients.Of the 267 eyes,the CCT values of the two methods were positively related by linear correlation analysis(r=0.985,P<0.01),and the CCT of the two methods 1 month,3 months and 6 months after LASIK had no statistically significant difference(P>0.05).CONCLUSION:Pentacam system can measure the CCT easily,accurately and without any invasion.It is more fit for people after LASIK to monitor the corneal changes with time and for people to do more deep research.

Iris-clip intraocular lens(verisyse) implanting for aphakic eye after trauma operation

Quan-Yong Yi,Ai-Min Wei,He-Ding Zhou,Yun Wang and Hong-Jian Zhou

AIM:To investigate the visual function and complications of iris-clip intraocular lens(verisyse) implanting to cure aphakic eye after trauma operation,to offer some clinical basis for the selection of surgical procedure and the ways of operation for aphakic eye after trauma operation.METHODS:A retrospective review was conducted for consecutive patients that received suture iris-clip intraocular lens(experimental group)and intraocular lens suspension(control group)for aphakic eye after trauma operation in our hospital from Aug.2006 to July.2008,and to compare the visual acuity,corneal endothelium and complications after operation.RESULTS:All cases in experimental group were fixed successfully one time,postoperative uncorrected visual acuity improved compared with before operation,the best corrected visual acuity(BCVA) came at or near the preoperative BCVA.No complications such as vitreous hemorrhage or choroidal detachment occurred.There was no significant statistical difference between two groups in visual acuity,corneal endothelium and complications after operation.CONCLUSION:The advantage of iris-clip intraocular lens(verisyse) implanting is simple to manipulate and safe and suitable for cases of lack of posterior capsule,normal depth of anterior chamber and normal corneal endothelium cells.

Comparison of three anesthesia methods in phacoemulsification and intraocular lens implantation combined with trabeculectomy

Xian-Jin Cui and Feng-Hua Li

AIM:To evaluate the reliability and effectiveness of topical anesthesia,topical combined with subconjunctival anesthesia and retrobulbar anesthesia in phacoemulsifi-cation and intraocular lens implantation combined with trabeculectomy.METHODS:Ninety patients(120 eyes) according to admission time were divided into three groups,and underwent the combined surgery of phacoemulsification and intraocular lens implantation combined with trabeculectomy by using topical anesthesia,topical combined with subconjunctival anesthesia and retrobulbar anesthesia respectively.The anesthetic effect and complications intaroperation and postoperation were observed.RESULTS:In topical anesthesia group,3 eyes were given additional subconjuncival anesthesia due to lack of intraoperative anesthesia and 11 cases were not successfully completed due to unsuccessfully satisfactory analgesic effect.All the 30 eyes were successfully completed with satisfactory analgesic effect and without any intraoperative and postoperative potential risk in topical combined with subconjunctival anesthesia group.And in retrobulbar anesthesia group,one eye had transient amaurosis,3 eyes were retrobulbar hemorrhage after operation and one eye’s eyelid was bruising after surgery,with the affective methods of intaroperation and postoperation,these operations all successfully completed.CONCLUSION:Topical combined with subconjunctival anesthesia is the most safe and effective way in these three anesthesia methods,which has an advantage over topical or retrobulbar anesthesia.

Clinical study on the treatment of angle-closure glaucoma with cataract by small incision non-phacoemulsification cataract extraction combined with IOL implantation and trabeculectomy

Wen-Jiu Zhang,Tao-Yang Chen and Zhui Dai

AIM:To evaluate the clinical effect of small incision non-phacoemulsification cataract extraction combined with IOL implantation and trabeculectomy in the treatment of angle-closure glaucoma with cataract.METHODS:Small incision non-phacoemulsification cataract extraction combined with IOL implantation and trabeculectomy was performed on 20 cases(20 eyes) of angle-closureglaucoma with cataract,The follow-up was 3 months.RESULTS:Vision of most patients were improved after operation,the occurrence rate was 90%.All intraocular pressure were normal after 1 week.No serious complications were found.CONCLUSION:Small incision non-phacoemulsification cataract extraction combined with IOL implantation and trabeculectomy can be a good alternatives in treatment of angle-closure glaucoma with cataract.

Efficacy and safety of domestic Latanoprost in treating with open angle glaucoma and ocular hypertension

Lu Zhao,Yan-Ling Wang,Zhao-Yang Meng and Hui Hong

AIM:To observe the efficacy and safety of domestic latanoprost in treating with open-angle glaucoma and ocular hypertension.METHODS:By using randomized,single blind control trial,90 patients with open angle glaucoma or ocular hypertension were divided into 3 groups randomly,30 patients in each group.They were treated by 0.05g/L domestic latanoprost,0.05g/L imported latanoprost and 0.04g/L travoprost respectively for 4 weeks,one drop,once daily evening.RESULTS:After two weeks,there was no statistical significance in terms of post-treatment intraocular pressure(IOP) difference among three group(P=0.673).After four weeks,there was no statistical significance in terms of IOP reduction difference among three groups at each time point.Four patients(13%)with conjunctival hyperemia were in experiment group,three(10%)in control group 1 and eight(27%)in control group 2.CONCLUSION:Domestic latanoprost is safe and can effectively lower IOP of patients with open angle glaucoma and ocular hypertension,which may provide new choice for treatment.

Phacoemulsification and intraocular lens implantation combined with trabeculectomy on the management of glaucoma and coexisting cataract under topical anesthesia

Da-Wei Zhao

AIM:To evaluate the clinical efficacy of phacoemulsifi-cation and intraocular lens implantation combined with trabeculectomy for glaucoma and coexisting cataract under topical anesthesia.METHODS:Under topical anaesthesia,phacoemulsification and intraocular lens implantation combined with trabeculectomy were done in 45 cases 45 eyes of glaucoma and coexisting cataract,and the clinical effect was observed.RESULTS:Postoperative best-corrected visual acuity was 0.1-0.3 in 12 eyes(27%),0.4-0.6 in 23 eyes(51%),0.7-1.0 in 10 eyes(22%).The postoperative intraocular pressure(IOP) was normal in 43 cases,only IOP of two cases were higher than normal recovered to normal after local dropping of drug.The main postoperative complications included corneal edema,shallow anterior chamber and iritis.The follow-up after surgery was from 6 to 18 months,all the complications were normal after drug treatment.CONCLUSION:Under topical anesthesia,phacoemulsification and intraocular lens implantation combined with trabeculectomy is an effective method to restore vision and control IOP in treating glaucoma and coexisting cataract.

Clinical comparison observation of the Q-switching Nd:YAG laser and operation peripheral iridotomy

Xue-Mei Zhuang,Yan-Jiao Yao and Lin Zhang

AIM:To compare the efficacy of Q-switching Nd:YAG laser and operation peripheral iridotomy.METHODS:The retrospective analysis involved 108 eyes of laser group and 78 eyes of surgery group,the intraocular pressure,vision,anterior chamber depth,operative complications were observed after operation.RESULTS:Six months after operation,the intraocular pressure control rate of two groups had no difference.The improvement of visual acuity of two groups had significant difference.The laser group are superior to surgery group(P<0.05).CONCLUSION:Q-switching Nd:YAG laser peripheral iridotomy can be handled easily,which is a safe and effective method for treatment of glaucoma,but cannot completely substitute the surgery of peripheral iridotomy.

Clinical observation of early stage of Posner-Schlossman syndrome

Wen-Xue Hu and Xiao-Hua Huang

AIM:To observe the clinic characters of early stage of the Posner-Schlossman syndrome to aid the diagnosis.METHODS:Select 31 patients 31 eyes from 2004-06 to 2011-02 with Posner-Schlossman syndrome whose signs and symptoms can be observed in early stage in our hospital.Having got records within the first 24 hours and succedent two days,which include vision,hyperemia of the eyeball,corneal edema,keratic precipitates(KP),Dyndall’s sign,pupillary light reflex,intraocular pressure.Main symptoms and diagnosis of the day were recorded as well.RESULTS:Although all 31 patients could be diagnosed as Posne-Schlossman syndrome eventually,in the first 24 hours only 15 patients’(48%)diagnosis were Posner-Schlossman syndrome,in the succedent two days 23(74%) and 29 patients’(93%) diagnosis were Posner-Schlossman syndrome in sequence.CONCLUSION:Posner-Schlossman syndrome can be divided into three types clinically:typical Posner-Schlossman syndrome,KP type and high-intraocular-pressure type.The last two types are more difficult to diagnose in early stage.KP and distending feeling of the eyeball are important signs and symptoms.

Dosage study of intravitreous injection with triamcinolone acetonide for DME

Li Zhou,Xue-Wen Huang and Hai Huang

AIM:To look for the minimum effective dosage of intravitreal injection with triamcinolone acetonide(TA) for diabetic macular edema(DME).METHODS:A total of 45 eyes in 38 DME patients who were diagnosed by FFA were collected.They were divided into two groups:22 eyes in group A and the other 23 eyes in group B.Different dosage of 40g/L TA(2mg or 4mg) were respectively used for intravitreal injection for the two groups.Before the treatment,the average best-corrected visual acuity(BCVA) was 0.06±0.06 and 0.06±0.05 in the two groups respectively(t=0.076,P=0.94),and all the intraocular pressure(IOP) was below 21mmHg.The average follow-up duration was 6 months after treatment.The BCVA,IOP,changes of lens and ocular fundus and FFA before and after treatment were observed.RESULTS:The average BCVA after treatment was 0.13±0.05 and 0.12±0.04 in the two groups respectively.The differences caused by treatment for each group were statistically significant(t=-4.39,P=0.00;t=-5.75,P=0.00).The hypertension rate was 9%(2 eyes) in group A and 39%(9 eyes) in group B(χ2=3.99,P=0.04).For 19 eyes in group A and 22 eyes in group B,the treatment showed effective by FFA(χ2=0.32,P=0.56).The recurrence rate was 23% and 13% respectively,the difference was not statistically significant(χ2=0.21,P=0.64).No refractory glaucoma and cataract development eye occurred.Intravitreous injection with TA again was effective if macular edema recurred.CONCLUSION:No matter the dosage is 2mg or 4mg,intravitreous injection with TA is a promising therapeutic method for DME,its short-term recurrence rate is not obviously different.But 2mg TA injection may cause less increased IOP than 4mg TA injection.

Clinical analysis of anteroposterior surgery combined with silicone oil implantation for proliferative diabetic retinopathy

Xiao-He Xu,Xiao-Long Chen,Kun Zheng and Fang Zhao

AIM:To investigate the outcome of the anteroposterior surgery combined with silicone oil implantation for proliferative diabetic retinopathy(PDR).METHODS:Totally 51 eyes of 43 PDR patients underwent anteroposterior surgery combined with silicone oil implantation from March 2008 to June 2011,whose postoperative best-corrected visual activity,reattachment of retina and complications were retrospectively analyzed.RESULTS:Totally 39 eyes(76%) showed improved visual acuity postoperatively.9 eyes(18%) showed unimproved.3 eyes(6%) showed vision impaired.All eyes(100%) showed anatomic repair of retinal detachment after the surgery.4 eyes occurred retinal detachment after silicon oil dislodgment,anatomically repaired after second surgery.CONCLUSION:Anteroposterior surgery combined with silicone oil implantation,which can improve visual acuity postoperatively,to avoid the complications of cataract surgery and decrease the incidence rate of rehaemorrhagia and retinal detachment after vitrectomy,is safe and effective in treating patients with PDR.

Effects of vitrectomy for vitreous hemorrhage

Jian-Hong Yu,Gang-Ping Zhao,Min Zhu,Zhi Huang,Xiao-Yun Wu,Yu Lei and Dan Hu

AIM:To evaluate the therapeutic effects of vitrectomy for vitreous hemorrhage.METHODS:Seventy-five eyes of seventy-two patients with vitreous hemorrhage due to varied etiology underwent pars plana vitrectomy combined with cataract removal and/or IOL implantation,extraction of intraocular foreign bodies,membrane peeling,endodiathermy,endophotocoagulation,transscleral cryotherapy and long-acting tamponades according to particular situation respectively.RESULTS:Diagnosis included:traumatic vitreous hemorrhage(27 eyes),retinal branch/central vein obstruction(15 eyes),proliferative diabetic retinopathy(12 eyes),Eales’ disease(9 eyes),rhegmatogenous vitreous hemorrhage(9 eyes),age-related macular degeneration(3 eyes).Postoperative follow-up ranged from 6 to 48 months(mean,18.6 months).The final visual acuity improved in 72 eyes(96%).Of the 75 eyes,65 eyes(87%) had a best postoperative visual acuity of 0.05 or better,54 eyes(72%) had visual acuity of 0.2 or better,23 eyes(30.66%) had visual acuity of 0.5 or better,only 3 eyes visual acuity didn’t improved(4%).There was significant difference between preoperative and postoperative vision(P<0.05).CONCLUSION:Vitreous hemorrhage with serious ocular trauma,massive and unresolved vitreous hemorrhage,repeat vitreous hemorrhage or retinal detachment found with B-ultrasonic examination should timely undergo vitrectomy to improve and protect their visual acuity.

Therapeutic effect of methylprednisolone systemic and local application for uveitis

Chao Wan,Li-Min Liu,Hao Feng,Yi-Zhou Sun,Na Cai and Lei Chen

AIM:To observe the clinical effects of methylprednisolone systemic and local application for uveitis.METHODS:Eighty-six 86 cases(157 eyes) of uveitis patients were analysed retrospectively and treated at the Ophthalmology Department of the First Hospital of China Medical University.Methylprednisolone 500-1 000 mg was transfused per day for stoss during the first 3-5 days,and then changed to prednisone 1mg/kg·d orally,and decrement gradually.Methylprednisolone 40mg was locally applicated by injection behind the eyeball during the first 3-5 days,and then decrement gradually,adjusting the medication according to patient’s condition.The best-corrected visual acuity(BCVA),the recovery of uveitis and exudative detachment of retina by ophthalmoscope,the fluorescence leakage of FFA and macular retinal thickness by OCT were observed before and after the treatment.RESULTS:At the end of the follow-up period,the BCVA improved in 128 eyes(81.5%),remained unchanged in 16 eyes(10.2%),and degraded in 13 eyes(8.3%);the uveitis and retina detachment were recovery in 149 eyes(94.9%);the leakage of FFA were no or little in 131 eyes(83.4%);the macular retinal thickness by OCT examination were lower in 134 eyes(85.4%),14 eyes(8.9%) were unchanged and 9 eyes(5.7%) were aggravated.CONCLUSION:The systemic and local application of methylprednisolone for uveitis is effective,which can effectively control the uveitis and improve visual function.

Clinical evaluation of corneal limbal stem cell autograft transplantation with bulbar conjunctival flap in the treatment of pterygium

Xian-Meng Zhao,Er-Ying Han and Chao-Guang Guo

AIM:To investigate the clininal effect of limbal stem cell autograft transplantation with bulbar conjunctival flap in the pterygium.METHODS:Totally 96 patients 112 eyes with pterygium were treated by limbal stem cell autograft transplantation with bulbar conjunctival flap.Postoperative reaction,graft vitality and recurrence of pterygium were observed.RESULTS:All cases were found with transient reaction,the grafts grew well without serious complication and no recurrence was found during the follow-up of 6-12 months.CONCLUSION:Limbal stem cell autograft transplantion with bulbar conjunctival flap is effective and safe for treatment of pterygium.It is good-looking on the ocular surface and recurence rate is lower,which is a method worth popularizing.

Clinical observation of Methycobal combined with Fufang Xueshuantong capsule and Vitaminum B1 in treatment of diabetic ophthalmoplegia

Ya Li and Wei-Xiao Luo

AIM:To observe clinical effect of Methycobal combined with Fufang Xueshuantong capsule and Vitaminum B1 in treatment on diabetic ophthalmoplegia.METHODS:In recent four years,64 cases were asked to take orally Methycobal combined with Fufang Xueshuantong capsule and VitaminumB1 in treatment of diabetic ophthalmoplegia on foundation of treatment on diabetes.Fufang Xueshuantong capsule and VitaminumB1 treatment were established as control group.RESULTS:After 2-16 weeks of treatment,symptoms of two groups disappeared or relieved inordinately.After 3 months of treatment,the efficacies of treatment with Methycobal combined with Fufang Xueshuantong capsule and VitaminumB1 were superior to the control group.CONCLUSION:Methycobal combined with Fufang Xueshuantong capsule and VitaminumB1 is effective and safe in the treatment for acute diabetic ophthalmoplegia.

Retrospective analysis of CT findings of orbital trauma in 950 cases

Yu-Lin Zhang,Li-Qun Dong and Zhong Zheng

AIM:To explore the CT findings of orbital trauma and the application value of CT in orbital trauma.METHODS:The CT findings of 950 patients with orbital trauma from February 2008 to June 2011 were retrospectively analyzed.RESULTS:Among them,846 patients were found with orbit fractures or periorbital fractures by CT scan,103 patients were detected with intra-orbital soft tissue injury.CONCLUSION:The CT scan can sensitively detect the sign of orbital injury,should be a valuable method in clinical diagnosis and treatment.

Thickness measurement of central fovea of macula and retinal nerve fiber layer in children with ametropic amblyopia

Qing-Qiang Wang,Yan-Jun Zhai,Jing Zhang,Xin-Guo Jia and Jun-En Wang

AIM:To assess and compare the thicknesses of central fovea of macula and retinal nerve fiber layer in normal children and children with ametropic amblyopia.METHODS:Optical Coherence Tomography(OCT) was performed on 20 children(40 eyes) with ametropic amblyopia,the mean age was 6.15±1.64 years old,spherical equivalent was 1.50-7.00D,axis oculi was 22.07±0.97mm;OCT was also performed on 25 normal children(50 eyes),the mean age was 8.62±2.42 years old,spherical equivalent was 0.57±1.07D,axis oculi was 22.81±0.72mm.Thicknesses of central fovea of macula and retinal nerve fiber layer were measured.In this study,t-test and Pearson test with SPSS 13.0 software were used to assess and compare the thicknesses of central fovea of macula and retinal nerve fiber layer in normal children and children with ametropic amblyopia.RESULTS:The average thickness of the fovea was 136.60±13.82μm in normal eyes and 132.98±14.99μm in amblyopic eyes.The difference between the two groups was not statistically significant(P>0.05).The average thicknesses of the retinal nerve fiber layer was 110.40±7.63μm in normal eyes and 116.95±9.59μm in amblyopic eyes.The difference between the two groups was statistically significant(P<0.01).There was negative correlation between average thicknesses of the retinal nerve fiber layer and axis in normal eyes(r=-0.31,P<0.05),but there was no significantly correlation in amblyopic eyes(r=0.12,P>0.05).CONCLUSION:Retinal nerve fiber layer thickness may be affected by ametropic amblyopia,but further histopathologic confirmation is needed.

Clinical application of the photorefraction in vision screening by the device refitted from pocket-sized digital camera

Bin Wang,Li Mu,Jia-Rong Zhang,Jun-Gui Hu,Ming Wei and Run-Hao Song

AIM:To evaluate the feasibility and reliability of the digital photorefraction device refitted from the pocket-sized digital camera in the vision screening of infants.METHODS:One hunderd infants aged from 6 months to 72 months were screened by the digital photorefraction device.The results were compared with clinical examination and retinoscopy.RESULTS:The specificities of the simple device in hyperopia,myopia,astigmatism,anisometropia,strabismus were:96.46%,95.29%,96.75%,98.97%,100%,and the sensitivities were:82.76%,93.33%,84.78%,75.00%,100%.CONCLUSION:The simple device is characterized by high sensitivity,good reliability,high specificity,simple operation,low price,easy popularization.It could be used for vision screeing of children.It is applicable to establish and popularize the family mode of vision screening.

Efficacy observation of deep lamellar keratoplasty for the treatment of keratoconus

Li Xiao,Yan-Chao Wu,Dong Wang and Xin Wang

AIM:To evaluate the effect of deep lamellar keratoplasty for the treatment of keratoconus.METHODS:Deep lamellar keratoplasty was applied for treatment of 132 cases (140 eyes) with keratoconus.The effectiveness of operation was clinically observed and evaluated.Postoperative follow-up were 6- 48 months.RESULTS:The postoperative corrected vision was 0.2- 0.4 in 13 cases (14 eyes),>0.4- 0.8 in 92 cases (96 eyes),>0.8 in 27 cases (30 eyes).Rejection occurred in 5 eyes,clear graft in 131 cases (139 eyes),semitransparent in 1 cases (1 eye),8 eyes appeared Descemet’s layer folds.CONCLUSION:Deep lamellar keratoplasty with fewer complications,can reduce the incidence of endothelial rejection.Postoperative visual acuity is good,and there is less demanding on the donor material,etc.It provides a safe and effective choice for the treatment of keratoconus.

Effect of phacoemulsification with selective transparent corneal incisions on corneal astigmatism

AIM:To investigate the surgically induced refractive change after phacoemulsification with selective maximum astigmatic axis clear corneal incision.METHODS:All 96 cases (112 eyes) with cataract were randomly divided into three groups,group A received temporal transparent corneal incision (34 cases,39 eyes);group B received transparent corneal incision at 11 O’clock(26 cases,31 eyes);group C received highly selective transparent corneal incision at steepest corneal meridian guided by corneal curvature (36 cases,42 eyes).RESULTS:There was no statistically significant difference in visual acuity in three groups before and 1 week after operation (P>0.05).The visual acuity in group C was much better than that in group A and B before and 1 month,3 months after operation (P<0.05),but there was no statistically significant difference between group A and B(P>0.05).The corneal astigmatism degree of group C was much lower than that of group A and B 1 month and 3 months after operation (P<0.05).CONCLUSION:The incision at the steepest corneal meridian guided by corneal curvature has the least effect on corneal astigmatism and can improve visual acuity rapidly.The surgically induced astigmatism can be controlled effectively and patients can gain better visual acuity.

Value of applied reverse transcription-polymerase chain reaction in detecting fungal corneal ulcer

Lin Zhao and Fan-You Zhang

AIM:To establish a method for rapid detection of clinical suspect fungal corneal ulcer by reverse transcription-polymerase chain reaction(RT-PCR).METHODS:A pair of oligonucleotide sequences,which was based on the conserved region of 18srRNA shared by medically important conditioned fungi,was used as the general primers to amplify the DNAs from clinical suspect fungal corneal ulcer in a RT-PCR assay,and the result was compared with culture.RESULTS:A 400bp specific DNA product was successfully amplified.The positive rate of fungi culture among 26 clinical specimens was 61.9%,while that of RT-PCR amplification was 73.8%.In addition,the accuracy of PCR method in this study was 83.8%,the sensitivity was 100.0%,and the specialty was 33.3%.CONCLUSION:PCR with the general primers is suitable for rapid detection of fungal corneal ulcer because of quickness and high positive rate.

Clinical study of compound trabeculectomy in the second filtration surgery

Shao-Xin Pan and Gui-Qiu Zhao

AIM:To study the clinical effects of compound trabeculectomy in the second filtration surgery and compare the safety and effectiveness between traditional trabeculectomy and compound trabeculectomy.METHODS:Totally 24 cases(24 eyes)of glaucoma for the second filtration surgery were randomly divided into two groups,14 cases (14 eyes) who underwent compound trabeculectomy(traditional trabeculectomy combined with mitomycin and adjustable sutured scleral flap) were observation group and 10 cases (10 eyes) underwent trabeculectomy(traditional trabeculectomy combined with mitomycin) as control to compare the postoperative intraocular pressure(IOP),filtration,the depth of anterior chamber and postoperative complications between the two groups.RESULTS:Twenty-four eyes were successful.In the follow-up of 12 months,on the first day of postoperation,the incidence rate of shallow anterior chamber in observation group and control group were 7% and 30% respectively(P<0.05).12 months later,the rate of IOP from 6-21 mmHg in observation group and control group were 86% and 40% respectively (P<0.05).Functional filtering bubbles were 86% and 40% respectively (P<0.05).CONCLUSION:Compound trabeculectomy is effective and safe in the second filtration surgery and superior to the traditional trabeculectomy.The key of successful operation lies in using mitomycin and adjustable sutured scleral flap.

Effect of mitomycin C in the surgery of trabeculectomy combined with extracapsular cataract extraction

Hong-Gang Wang,Hou-Cheng Liang,Ting Ma and Tan Long

AIM:To investigate the effect of mitomycin C in the surgery of trabeculectomy combined with extracapsular cataract extraction and IOL implantation.METHODS:Thirty-two patients with glaucoma and cataract were chosen and randomized to two groups,mitomycin group and control group.Both of the two groups were performed trabeculectomy combined with extracapsular cataract extraction and IOL implantation.0.2g/L mitomycin C was used for 3minutes in the mitomycin group.The complications,operative effect and postoperative visual acuity were compared 12 months after surgery.RESULTS:There were no significant differences in shallow anterior chamber,best corrected visual acuity and patients who needed Nd:YAG posterior capsulotomy in two groups,but the incidence of functional filter bleb in mitomycin group was significant more than that of control group,and the failure of the surgery in mitomycin group was significant less than that of control group.Both groups had no bleb leak,malignant glaucoma or endophthalmitis in follow-up.CONCLUSION:Mitomycin C can certainly increase the success of triple surgery without increasing the incidence of complications.

Clinical observation on the phaco-emulsification and intraocular lens implantation combined with trabecul-ectomy inside the tunnel for treatment of glaucoma with cataract

Hong-Wei Ma,Zhi-Hui Su and Nan-Nan Liu

AIM:To discuss the treating method and the clinical efficacy on combined surgery of glaucoma with cataract.METHODS:Phacoemulsification and intraocular lens implantation combined with trabeculectomy inside the tunnel was performed on 45 cases(45 eyes) of glaucoma with cataract.RESULTS:There were 32 eyes of which the preoperative visual acuity was﹤0.1,0.1- 0.3 in 13 eyes.There were 6 eyes (13%)of which the postoperative visual acuity was<0.1,0.1- 0.5 in 22 eyes (49%),>0.5 in 17 eyes(38%).The postoperative IOP was normal in 42 cases.The average value of IOP was 12.78±2.70mmHg.The main postoperative complications included corneal edema and iritis.The follow-up after surgery was 6-12 months.No case of IOP increased.Visual acuity declined in 3 cases.CONCLUSION:The phacoemulsification and intraocular lens implantation combined with trabeculectomy inside the tunnel is an ideal method in treating glaucoma with cataract.

Influence to dilated pupil’s diameter of cataract patients with NPDR by different cataract surgery

Shu-Lin Wang and Xin Wang

AIM:To investigate the influence to dilated pupil’s diameter of cataract patients with nonprohferative diabetic retinopathy (NPDR) by manual small incision cataract surgery (MSICS) and phacoemulsification(Phaco).METHODS:Pilot study.Sixty eyes of cataract patients with NPDR were divided into two groups,MSICS group of 30 eyes and Phaco group of 30 eyes.The pupil was dilated by Compound Tropicamide.The diameter of dilated pupil was compared before and after the cataract surgery.RESULTS:Before surgery,the dilated pupil’s diameter of MSICS group was 6.23±0.83mm,and Phaco group was 6.26±0.85mm.There was no significant difference between the two groups(P>0.05).Before and after the surgery,the difference of the dilated pupil’s diameter of MSICS group was 0.11±0.094mm,Phaco group was 0.17±0.119mm.The difference was significant(P<0.01).There was significant difference between the MSICS group and Phaco group in those above(P<0.05).CONCLUSION:Both MSICS and Phaco can reduce the diameter of dilated pupil of the cataract patients with NPDR.The phacoemulsification seems to reduce more.

Clinical observation of Becacizumab combined with grid photocoagulation for the treatment of cystoid macular edema associated with central retinal vein occlusion

Li-Li Wang,Li-Jie Li,Bo Zheng,Li-Ying Jin,Wen Zhang,Min Huo and Bin He

AIM:To evaluate the efficacy of intravitreaI Becacizumab (IVB)combined with grid photocoagulation for the treatment of cystoid macular edema(CME)associated with central retinaI vein occlusion(CRVO).METHODS:Tirty-two cases(32 eyes)of CME associated with CRVO made a definite diagnosis by FFA were divided into two groups randomly.IVB combined with grid photocoagulation group(A group):16 eyes.Grid photocoagulation group(B group):16 eyes.Best corrected visual acuity(BCVA),central macular thickness(CMT),intraocular pressure(IOP) and complications at 4 weeks,12 weeks,24 weeks after treatment in these eyes were examined and compared between the two groups.RESULTS:BCVA of A group had improved and CMT were 351.81±57.68μm,320.44±58.94μm,296.50±52.15μm respectively at 4,12,24 weeks after treatment.Both of them had statistical significant difference before and after treatment.CMT of B group were 526.56±88.92μm,441.06±94.06μm,374.31±106.07μm respectively at 4,12,24 weeks after treatment.There was statistical significant difference before and after treatment.IOP of the two groups had no statistical significant difference before and after treatment.The energy and laser spots of B group were much more than those of A group.CONCLUSION:IVB combined with grid photocoagulation for the treatment of CME associated with CRVO has better efficacy than grid photocoagulation alone.

Efficacy observation on treatment of vitreous hemorrhage by combining the injection of UK in vitreous cavity with TA

AIM:To observe the effectiveness and safety of the treatment on vitreous hemorrhage by combining the injection of urokinase (UK) in vitreous cavity with triamcinolone acetonide (TA).METHODS:Totally 52 cases (52 eyes) who were finally diagnosed as vitreous hemorrhage during April,2009 to February,2011 in the ophthalmology department of our hospital were analyzed retrospectively.The patients with an average age of 54.2,who aged from 29 to 65,were given the treatment of injection of UK (10000U/0.1 mL) in vitreous cavity along with TA (4mg/0.1mL).The results showed that their vision,intraocular pressure(IOP) and ocular fundus have changed.All the patients involved were followed-up for more than 3 months,and 14 of them were followed-up for over 16 months.RESULTS:Before the treatment,the eyesight of every patient involved was hand movement to 0.02.After the treatment,the eyesight of the most effective case,who suffered from vitreous hemorrhage caused by retinal vein occlusion,was improved to 1.0.Of all the cases involved,37 (71%) were cured,26 (93%) of the 28 cases with the problem of blooding caused by retinal vein occlusion were cured,9 (45%) of the 20 cases with the problem of blooding caused by diabetic retinopathy were cured,and 2 (50%) of the 4 cases with the problem of blooding caused by retinal periphlebitis were cured.And other 15 cases were found having no difference in the eyesight after the treatment.Of the 37 effective cases,1 year later,2 cases got vitreous hemorrhage caused by retinal vein occlusion who recovered after the operation of vitrectomy,and 1 of the 37 cases,who was the patient of diabetic retinopathy,suffered from shallow retinal detachment,and he was given the retinal reattachment after the operation of vitrectomy combined with silicone oil tamponade,but his eyesight was not well recovered.None of the 52 cases suffered from the increase in IOP or endophthalmitis,etc.CONCLUSION:The treatment to vitreous hemorrhage by combining the injection of UK in vitreous cavity with TA is very effective,especially for the cure of vitreous hemorrhage caused by retinal vein occlusion,which is worth promoting.

Clinical research of the application of taking fluorescein sodium injection orally on vitrectomy

Yu-Qing Wang,Yong-Bin Yu and Zhen-Zhen Zhao

AIM:To evaluate the efficacy of fluorescein sodium on dyeing residual vitreous during the vitrectomy.To discuss the effect of fluorescein sodium which can demarcate the residue vitreous on vitrectomy and whether there are statistical significance on postoperative intraocular pressure(IOP) and visual acuity with comparison group and whether it can decrease the complications or not during vitrectomy.To investigate whether the fluorescein sodium can produce retinal toxicity or not through clinical study.METHODS:The study included 60 cases (60 eyes) who underwent vitrectomy in the first clinical hospital of Harbin medical university from September,2009 to September,2010.The 60 cases were proliferative vitreous retinopathy or detachment of retina,without operation experience of posterior segment in the past.There were not any condition affecting the ocular disease.All the patients could endure the vitrectomy,and they had had common body examination and ocular examination.All eyes were examined by slit-lamp biomicroscopy,binocular indirect ophthalmoscopy,B-scan and electroretinography before operation.The condition of cornea,anterior chamber,lens,vitreous body,retina,etc.were learned about.60 cases with vitrectomy were divided into study group and control group.Fluorescein sodium injection was taken orally in 30 eyes of study group before the surgery.Fluorescein sodium was not used in the 30 eyes of control group.All eyes were examined by slit-lamp biomicroscopy,binocular indirect ophthalmoscopy,B-scan after operation.The mean follow-up was 1 month after operation,visual acuity and IOP of the two groups were compared and analyzed.RESULTS:The location and coverage of the residual vitreous cortex were clearly shown by fluorescein sodium and the residual vitreous cortex was conveniently to be recognized and removed There was neither difference in visual acuity,IOP before and after operation nor obvious ocular complications related to fluorescein sodium,and no evident differences in comparison between the two groups.CONCLUSION:Location and coverage of the residual vitreous cortex were clearly shown by fluorescein sodium.It has the surgery safety,without obvious adverse reactions,and decreases the complicating diseases such as incidence of iatrogenic retinal break.It is profitable to protect and recover visual function without intraocular toxicity.

Clinical efficacy analysis of vitrectomy

Ying-Nan Zhang and Xiao-Long Chen

AIM:To observe the clinical efficacy of different types of fundus disease with vitrectomy.METHODS:Clinical data of different types of fundus disease in 91 cases(96 eyes) with vitrectomy were analyzed retrospectively,in which fundus disease combined with proliferative diabetic retinopathy were 54 cases (59 eyes),with high intraocular pressure were 21 cases;purely high intraocular pressure retinopathy,8 cases (8 eyes);purely retinal detachment,17 cases (17 eyes);other reasons such as trauma,proliferative vitreoretinopathy,12 cases(12 eyes),and the reasons for poor visual recovery after surgery were summed up.RESULTS:All patients were followed up for 1 month to 6 months,the postoperative vision of 71 eyes in 96 eyes which was compared with preoperative vision improved to varying degrees,accounting for 74% of the total number of eyes (71/96),including the postoperative vision of 18 eyes improved from light perception,hand movement and finger counting to over 0.1,accounting for 19% of the total number of eyes (18/96);the postoperative vision of 9 eyes increased to over 0.02 but below 0.1,accounting for 9% of the total number of eyes (9/96);the postoperative vision was not improved in 20 eyes,accounting for 21% of the total number of eyes (20/96);the postoperative vision decreased in 5 eyes,accounting for 5% of the total number of eyes (5/96).CONCLUSION:Vitrectomy which treats different types of fundus disease is obviously effective and safe,which can improve visual function in most eyes and has fewer complications.

Reasons and management of intractable high intraocular pressure after vitrectomy of proliferative diabetic retinopathy

Liang Zhang,Yun-Yun Zhao,Zhong-Ning Huang,Dong-Ming Yin and Qian-Li Meng

AIM:To seek the reasons and effective methods to treat the intractable high intraocular pressure (IOP) after vitrectomy of proliferative diabetic retinopathy (PDR).METHODS:Postoperative IOP of eyes with PDR after vitrectomy were retrospectively analyzed within 2 years in our hospital.RESULTS:Twenty-five eyes (21.0%) occurred intractable high IOP in 119 eyes.IOP in 18 (72.0%) of 25 eyes could be controlled by using medical treatment,while 7 eyes required surgery.19 (76.0%) of 25 eyes had high IOP within one week after surgery,the other 6 eyes had high IOP at 2 to 18 months after surgery.The reasons of postoperative high IOP happened in 3 months after surgery included pupil atresia in one eye and neovascular glaucoma in 4 eyes.These 4 eyes with neovascular glaucoma had received phacoemulsification cataract surgery.In 119 eyes,silicone oil injection was in 42 eyes (35.3%),C3F8 injection in 12 eyes (10.1%).In 25 eyes with postoperative high IOP,11 eyes had received vitrectomy combined with silicone oil injection (44%,P= 0.41).IOP had no statistically significant difference between the eyes with and without silicone oil.2 eyes were injected C3F8 (7.7%,P=0.83),IOP had no statistically significant difference between the eyes with and without C3F8.CONCLUSION:The intractable high IOP after vitrectomy treating PDR usually can be controlled by medication.Silicone oil as intraocular tamponade is not the primary factor for postoperative high IOP.As long-dated high IOP may be associated with neovascular glaucoma.Intraoperative or postoperative cataract extraction requires carefully consideration.

Comparative study of combining use of computer-assisted imaging system of indirect ophthalmoscope and wide-field digital retinal imaging system in retinopathy of premature screening

Feng Chen,Dao-Man Xiang,Tian Liu,Ya-Ni Mao and Jian-Xun Wang

AIM:To study the essentiality of combining use of computer-assisted imaging system of indirect ophthalmoscope and wide-field digital retinal imaging system and analyze the result of two methods in the retinopathy of premature (ROP) screening.METHODS:Using the computer-assisted imaging system of indirect ophthalmoscope and wide-field digital retinal imaging system,the ophthalmologist examined the premature infants regularly in the ophthalmologic clinic,neonate department and neonate intensive care department from the 1st October 2009 to the 31st October 2010.The examination would be finished till infants’ retinal vascularization completed in nasal and temple retina.The ROP infants’ information would be preserved and their eye disease process would be followed up timely.It would be chosen to be operated on for those patients whose disease process developed to the pre-threshold and threshold and be followed up regularly till their ROP were complete regression and stationary.Finally the data of ROP patients were statistically analysed.RESULTS:From the 1st October 2009 to the 31st October 2010,1431 premature infants who were the objects of ROP screening (gestational age :27-35 weeks;birth weight:0.8-2.5kg)were examined and followed up regularly and found 111 ROP cases(7.76%).53 ROP cases were examined only by RetCamⅡ,and 58 ROP cases who were borderline cases were examined with combining use of computer-assisted imaging system of indirect ophthalmoscope and wide-field digital retinal imaging system.67.57% of patients were found their disease regression after follow-up.19 cases’diseases developed to styleⅠ of the pre-threshold and 15 cases developed to or above the threshold,34 cases were done by laser photocoagulation and 31 cases had good outcomes after operation and 2 ROP 4A stage cases had bad outcome.CONCLUSION:The study was found when the premature infants were shorter in their gestational weeks and the lighter in birth weight,their incidence of ROP were higher and their disease extent were more serious,and they needed ROP screening timely and early intervention treatment.Combining use of computer-assisted imaging system of indirect ophthalmoscope and wide-field digital retinal imaging system is helpful to increase the rate of ROP diagnosis,to preserve the object data and to ROP screening training.

Clinical pathological analysis of 291 primary blepharal neoplasms

Yu-Li Yang,Yong Liu and Wei Qin

AIM:To investigate the histopathologic features and incidence of primary blepharal neoplasms.METHODS:The clinical pathological data of 291 primary blepharal neoplasms in Southwestern Eye Hospital from January 2003 to December 2009 were collected and analyzed retrospectively.RESULTS:Benign blepharal neoplasms were 172 cases(59.1%),the top ten in the ranking in turn were papilloma,pigmented nevus,inflammatory granuloma,dermoid cyst or epidermoid cyst,amyloid degeneration,warts,hemangioma,xanthoma,plasma cell granuloma,trichoepithelioma.Malignant blepharal neoplasms were 119 cases(40.9%),the top five in the ranking in turn were basal cell carcinoma,squamous cell carcinoma(including spindle cell carcinoma),sebaceous gland carcinoma,malignant lymphoma,malignant melanoma.The clinical epidemiological data of the top three malignant blepharal neoplasms were summarized.The eyelid restoration after neoplasms ablation were discussed.CONCLUSION:The classification of blepharal neoplasms was various,the clinical pathological analysis of primary blepharal neoplasms was helpful to correct diagnosis and treatment.

Effect of artificial tears and recombinant bovine basic fibroblast growth factor eyedrops on dry eye after glaucoma filtering surgery

Shou-Quan Lu and Zhi-Cheng Zeng

AIM:To discuss the clinical effects of artificial tears and recombinant bovine basic fibroblast growth factor (rb-bFGF) eyedrops on dry eye after glaucoma filtering surgery.METHODS:All 60 cases(60 eyes)with dry eye symptom after glaucoma filtering surgery were chosen and randomly divided into two groups,treatment group and control group.In treatment group,the patients were treated by artificial tears and rb-bFGF eyedrops.In control group,the patients were treated by artificial tears.The subjective dry eye symptoms,fluorescein staining(FL),the time of tear secretion (Schirmer Ⅰ test,SⅠ t)and tear break-up time(BUT)were observed by slit lamp before treatment,2 weeks and 4 weeks after treatment.RESULTS:There was no statistical difference between the two groups before treatment (P>0.05).After treatment,the subjective dry eye symptoms,FL,S I t and BUT were significantly different (P<0.01).CONCLUSION:Artificial tears combined with rb-bFGF eyedrops can be effective to relieve the dry eye symptoms after glaucoma filtering surgery.

Clinical study of ultra-thin-flap and thick-flap LASIK in treatment of low and moderate myopia

Ying-Fang Zhu and Yu-Jun Liu

AIM:To observe ultra-thin-flap and thick-flap LASIK in treatment of low and moderate myopia before and after operation and to analyze the advantage or limitation in ultra-thin-flap LASIK.METHODS:A total of 154 cases of low and moderate myopia were chosen,81 cases(159 eyes) underwent the Moria 110 thick-flap LASIK in group 1,the other 73 cases(145 eyes) underwent the Moria 90 ultra-thin-flap LASIK in group 2.The actual corneal flap thickness and the corneal flap shape in the surgery,the complication between two groups before and after surgery,the cornea thickness,corneal flap thickness,surplus corneal stroma thickness,postoperative vision and intraocular pressure were observed.RESULTS:The actual corneal flap thickness of group 1 was 134.0±2.5μm;and that of group 2 was 93.5±5.9μm.There was significant difference between two groups (P< 0.05).There was no significant difference between two groups (P>0.05) in corneal flap shape,the complication,vision and intraocular pressure postoperative.There was fewer complication and thicker surplus corneal stroma thickness in group2 (P< 0.05).CONCLUSION:Ultra-thin-flap LASIK can produce the same good effect as the thick-flap LASIK.But the former can retain thicker corneal stroma bed,it can do wider diopter treatment with better security and wider adaptation scope,and will be the best choice for myopia people.

Clinical observation on Acrysof ReSTOR multi-focal intraocular lens implantation for treatment of high myopia in middle-and old-aged patients

Xiao-Lin Hao,Wei-Zhi Dai,Hai-Xia Wei,Lian-Rong Su and Qi Li

AIM:To observe the effectiveness and safety of clear lens extraction and Acrysof ReSTOR multi-focal intraocular lens(IOL) implantation to correct high myopia in middle-and old-aged patients.METHODS:Phacoemulsification and implantation of Acrysof ReSTOR multi-focal IOL were performed on 44 eyes of 26 high myopic patients with clear crystalline lens.Preoperative and postoperative visual acuity,refractive error,corneal curvature,IOP,endothelial cell counting,stereoscopic vision,spectacles independent rate,vision habit,and satisfaction,of the patients were observed.RESULTS:No complications occurred intraoperatively.Postoperative uncorrected and best-corrected distant and near visual acuity,corneal curvature,and stereoscopic vision all improved than before surgery about 95.5% patients never wore spectacles,and 97.7% patients were satisfied with the refractive results.After operation,except for a transient increased intraocular pressure,no posterior capsular opacification,cystoid macular edema and retinal detachment were found during the follow-up period.CONCLUSION:Clear lens phacoemulsification and Acrysof ReSTOR multi-focal IOL implantation to correct high myopia in middle-and old-aged patients is a safe,effective procedure serving as a refractive surgery.Further follow-up over a longer period is needed to fully assess the effectiveness and complications of this operation.

Analysis of related factors and treatment of epithelial ingrowth after laser in situ keratomileusis

Li-Mei Zheng,Rong-Zhao Hong,Mei-Cong Wu and Yong-Jiang Wang

AIM:To investigate the treatments of epithelial ingrowth(EI)after laser in situ keratomileusis (LASIK),analyse the related factors,and evaluate efficacy of the treatment.METHODS:Ten patients (16 eyes) with EI were analyzed from 2666 paients(5212 eyes) who underwent LASIK from September 2006 to November 2011 in our hospital.The reason for occurrence of EI aftere LASIK was analyzed,the different treatment methods were used,and their efficacy was evaluated.RESULTS:The incidence rate of EI was 0.31% in 2666 paients(5212 eyes);According to the occurrence reasons,the occurrence time,the range and position,the different treatment methods were used.Four paients(5 eyes)were treated with 10g/L Prednisolone Acetate Ophthalmic Solution (Pred Forte)and intraocular pressure-lowering ophthalmic solution,EI disappeared;other six paients (11 eyes)were treated with pharmaceutical and surgery.The EI were cleaned up,and the corneal flap was dried in the open air for 1minute after repositioning the flap,and contact lens were used for 1-2 days after surgery.They were treated with Pred Forte and intraocular pressure-lowering ophthalmic solution after surgery.All paients had good visual acuity and no recurrence occured in the six months to four years follow-up.CONCLUSION:EI after LASIK is an special complication.Excluding contraindication preoperatively,operating normatively,early diagnosis and active treatment are effective treatment methods for EI.

Impact of ultrasonic atomization of methylcobalamin on corneal nerve recovery after LASIK

Jiu-Feng Tang,Xiao-Fu Sun and Zhi-Yu Liu

AIM:To evaluate the impact of ultrasonic atomization of methylcobalamin on corneal nerve recovery after LASIK.METHODS:Seventy-two patients in our hospital underwent LASIK,refraction degree -1.50-- 4.50D were randomly divided into A,B,C three groups,each group 24 cases.After LASIK surgery,all patients were treated as following:group A (control group) without anti-dry eye treatment;group B using artificial tears after surgery;group C(ultrasonic atomization methylcobalamin group) using ultrasonic spray methylcobalamin treatment after surgery.We observed tear film break up time (BUT),tear secretion amount and corneal anterior stromal layer of nerve fiber density in three groups preoperative and postoperative 1 week,1 month and 3 months.RESULTS:Compared with the group A,BUT in group B after 1 month significantly increased,and it significantly increased in group C postoperative 1 week,1 month and 3 months(P<0.05).Compared with group A,tear secretion amount in group B and C during different periods increased significantly(P<0.05).Compared with group B,tear secretion amount in group C after 1 month and 3 months increased significantly(P<0.05).Nerve fibers in the central district area of newborn increased significantly in group C compared with group A and B after LASIK corneal surgery(P<0.05).CONCLUSION:Ultrasonic atomization of methylcobalamin on patients after LASIK corneal surgery can reduce the occurrence of dry eye and repair the damaged corneal sensory nerves.

Investigation of thickness of corneal flap with different flap preparation style in excimer laser surgery

Yong-Liang Lou,Shan Liu,Miao Wang,Mei-Lin Chen and Jia-Ni Lin

AIM:To observe the safety and predictability of excimer laser surgery by measuring the thickness of corneal flap,and to provide help for clinic.METHODS:The operative eyes were divided into 4 groups according to the preparation types of corneal flap.Fifty-five eyes were treated with laser in situ keratomileusis with 90μm femtosecond laser flap preparation (group A).Sixty-one eyes were treated with laser in situ keratomileusis with Moria-Ⅱ 90 microkeratomy flap preparation (group B).Thirty eyes were treated with laser in situ keratomileusis with Moria-Ⅱ110 microkeratomy flap preparation (group C).One hundred and five eyes were treated with laser assisted subepithelial keratectomy (group D).Ultrasonic pachymetry was employed to measure the flap thickness of these four groups.The results were analyzed with t-test or linear-regression by SPSS software.RESULTS:The average thickness of these 4 groups were 90.95±10.82μm (group A),133.61±11.97μm (group B),147.70±16.16μm (group C),66.35±11.95μm (group D).They were compared with t-test and showed statistical difference.Correlations between the thickness and the preoperative parameters were analyzed.Group A showed a weak correlation with the spherical equivalent diopter.Group B revealed a moderate correlation with the spherical equivalent diopter and weak correlation with the preoperative intraocular pressure,the average curvature of the cornea,the stall of the microkeratomy of Moria-Ⅱ.Group D showed moderate correlation with flap preparation,weak correlation with spherical equivalent diopter.There was no statistical difference between the thickness of the flap and the used times of the cone in group A,as well as the used times of the blade in Moria-Ⅱ in group B and C and the eyes either right or left in group D.CONCLUSION:Although the thickness was stable in every group,there was difference in the average thickness of these 4 groups.Spherical equivalent diopter may be one reason for the influence of the corneal thickness.It is more predictable and flexible in the thickness of the corneal flap with femtosecond than with the microkeratomy of Moria-Ⅱ.With the thinnest flap thickness,LASEK is the safest operation

Clinical observation on LASEK for treatment of high and super-high myopia

He Cheng and Yue-Lan Zou

AIM:To evaluate the clinical results of laser subepithelial keratomileusis (LASEK) in the correction of high and super-high myopia.METHODS:LASEK was performed on 271 cases(493 eyes) with myopia who were divided into a high myopia group(6.00-10.00D) and a super-high myopia group(≥10.00D) on the basis of the preoperative spherical equivalent refraction.The high myopia group was 311 eyes and the other group was 182 eyes.The follow-up time was 1 year.The postoperative uncorrected visual acuity(UCVA),haze and other complications were compared between the two groups.RESULTS:The postoperative UCVA raised in all eyes.At the end of 1 year,there were 255 eyes (82.0%) in high myopia group and 110 eyes (60.4%) in the other one of which the postoperative UCVA was better than the preoperative best-corrected visual acuity (BCVA).The differences were statistically significant between the two groups (P<0.01).The all hazes were within 2 grade.There weren’t apparent cornea irritation and severe complications.CONCLUSION:LASEK was a safe,effective method for high myopia,but not effective for super-high myopia.

Clinical observation of phacoemulsification in management of primary angle-closure glucoma complicated cataract

Li-Jiang Xu and Guo-Xing Xu

AIM:To investigate the surgery effect of phacoemulsification for primary angle-closure glaucoma(PACG) complicated with cataract surgery.METHODS:PACG complicated with cataract were 32 eyes, of which the acute phase of 28 eyes performed phacoemulsification, chronic phase of 4 eyes performed phacoemulsification combined with trabeculectomy.RESULTS:At postoperative 1 day, 9 eyes appeared corneal endothelial linear ruffled, 5 eyes occurred corneal stromal layer mild edema, turbidity cornea, which regressed at postoperative 2-4 days. Corneal restored transparent, causing inflammation cell + to + +. After the anti-inflammatory treatment for 1 week, inflammatory cells in the anterior disappeared. After 1 week follow-up, the acute phase of 28 eyes, intraocular pressure were 10-20mmHg, chronic phase of 4 eyes, intraocular pressure were 7-9mmHg. At postoperative two weeks of follow-up, all patients'' intraocular pressure were 10-20mmHg. Visual acuity of all the patients improved to varying degrees. CONCLUSION:Phacoemulsification combined with IOL implantation for the treatment of PACG complicated with cataract is a safe, effective, change numerous for brief choice, which avoids to re-performing the cataract surgery after pure glaucoma surgery. 

Protective effects of DuoVisc viscoelastic materials on low density corneal endothelium during phacoemulsification and intraocular lens implantation

Yao Xu,Bin-Chuan Chen,Yan-Wu Wang,Hong-Yan Tie,Yong-Cheng Wang and Xing Wei

AIM:To observe the protective effects of DuoVisc viscoelastic materials on low density corneal endothelium during cataract phacoemulsification and intraocular lens(IOL) implantation.METHODS:Twenty eyes of cataract with corneal endothelial cell density of 652.9-930.3/mm² were observed. Before the surgery, the corneal endothelium density and central corneal thickness were recorded, then the patients underwent cataract phacoemulsification and IOL implantation in the capsular, the changes were observed during 7days postoperatively.RESULTS:In the early days after the surgery, 4 of these corneas were with mild edema, after medical treatment, they returned transparent. During postoperative 7days, the corneal endothelium cell densities after the surgery(735.6±92.6/mm² )were not statistically less than before(798.2±113.1/mm², P=0.145), the thickness of the central corneas were normal(0.53±0.02mm), which had no statistical significance compared with preoperatively(0.51±0.014mm, P=0.144).CONCLUSION:In the condition of mastering the technique of phacoemulsification, it is feasible to use DuoVisc viscoelastic materials in the surgery of cataract phacoemulsification and IOL implantation with low density corneal endothelium.

Clinical observation of secondary operation of intraocular lens suture fixation after lensectomy-vitrectomy

Zhen Li and Jin-Chen Jia

AIM:To discuss the methods and skills of secondary operation of intraocular lens(IOL) suture fixation after lensectomy-vitrectomy. METHODS:IOLs were implanted into 26 cases(26 eyes) after lensectomy-vitrectomy fixed in the ciliary grooves. The suture line was fixed on the sclera. The clinical curative effect and the complications were observed 3 to 24 months after operation. RESULTS:Seven cases had postoperative best-corrected visual acuity of＞0.5, 11 eyes were between 03 and 0.5, 8 eyes were between 0.1 and 0.3. Light IOL tilt was happened in 2 eyes, and 1 eye was corrected by operation. Intraocular hemorrhage was happened in 3 cases, hemorrhage was absorbed during 20 days. The intraocular hypertension was happened in 5 cases, 3 cases were controlled simply by corresponding treatment, 1 case was controlled by long-term drugs,1 case was controlled by implanting drain valve. Intraocular hypotension was happened in 4 cases, but all were controlled by corresponding treatment within 1 week.CONCLUSION:IOL implantation after lensectomy-vitrectomy was effective and responsible, the complications are fewer, which is an ideal method towards this kind of disease.

Analysis of phacoemulsification cataract excise combined with intraocular lens implantation after trabeculectomy

Yi Wu,Ai-Ping Gu,Pei-Yi Long,Yan-Fang Zhong and Yan-Fang Liu

AIM:To discuss the surgical technique and therapeutic effects of phacoemulsification cataract excise combined with intraocular lens(IOL) implantation after anti-glaucoma trabeculectomy.METHODS:We retrospectively reviewed 87 cases(87 eyes) with phacoemulsification cataract excise combined with IOL implantation after anti-glaucoma trabeculectomy during January 2007 to December 2010. Followed up for 6 months. The postoperative visual acuity, intraocular pressure(IOP) and complications were analyzed.RESULTS:Followed up for 6 months after surgery, the visual acuity of these cases all improved,≥0.3 in 78 cases (90%). The postoperative IOP were all decreased compared with preoperative IOP. The complications were corneal edema (15 eyes, 17%), iris reaction (11 eyes, 13%), hyphema (5 eyes, 6%) and posterior capsule opacification (10 eyes, 11%).CONCLUSION:The phacoemulsification cataract excise combined with IOL implantation after anti-glaucoma trabeculectomy can significantly improve the visual acuity, maintain the stabilization of filtering bleb and IOP, and recover the structure of anterior segment.

Vitrectomy combined with sodium hyaluronate implantation for the treatment of open angle glaucoma

Jing-Ze Wang

AIM:To survey the effects of of vitrectomy combined with sodium hyaluronate implantation for the treatment of open angle glaucoma and to provide a reference for the reasonable choice of surgical methods.METHODS:Totally 600 cases (600 eyes) with open angle glaucoma were equally divided into two groups based on order of hospitalization. The treatment group were given vitrectomy combined with sodium hyaluronate implantation, the control group used vitrectomy combined with trabeculectomy.RESULTS:After treatment, uncorrected visual acuity of the two groups improved significantly, and the changes of the treatment group was better (P＜0.05). Intraocular pressure (IOP) of the two groups after treatment were decreased. IOP of the treatment group in each time point were better than the control group after surgery (P＜0.05). The incidence of postoperative anterior chamber Tyndall syndrome, hyphema and the hypotony-related macular degeneration compared had no significant difference (P＞0.05).CONCLUSION:Vitrectomy combined with sodium hyaluronate implantation for the treatment of open angle glaucoma can decrease postoperative IOP, has good visual recovery and fewer complications which should be widely applied.

YAG laser peripheral iridectomy for the treatment of difficult drug controlled acute angle-closure glaucoma

Ming Lu,Yuan Gao and Jin-Ying Wang

AIM: To investigate the effect of YAG laser peripheral iridectomy in difficult drug controlled acute angle-closure glaucoma. METHODS: Retrospectively analyzed 124 cases ( 124 eyes) of admission patients, among which males were 51 cases, females were 73 cases. Their admission diagnosis accorded with the clinical features of acute angle- closure glaucoma. After 24 hours'drug treatment, the intraocular pressure(IOP) of acute angle- closure glaucoma patients were still > 21mmHg, 51 eyes ( 41. 1% ) between 21 -35mmHg, 37 eyes(29. 8% ) between 36-50mmHg, 36 eyes (29. 1% ) >50mmHg. The range of visual acuity were light perception to 0. 3. All the cases accepted YAG laser peripheral iridectomy under topical anesthesia. The IOP, visual acuity, anterior chamber depth were observed postoperatively. After IOP was steady, trabeculectomy, glaucoma cataract combined with intraocular lens ( IOL) implantation, or single phacoemulsification combined with IOL implantation were performed respectively. RESULTS: Two days after YAG laser peripheral iridectomy, IOP was≤21mmHg in 28 eyes (22. 6% ), 22-35mmHg in 60 eyes (48. 4% ), 36 - 50 mmHg in 25 eyes(20.2% ), > 50mmHg in 11 eyes ( 8. 9% ). After laser surgery, visual acuity increased 3 lines in 33 eyes (26.6% ), 2 lines in 31 eyes (25. 0% ), 1 line in 44 eyes (35.5% ), no change in 16 eyes (12. 9% ), and the anterior chamber depth increased in 119 eyes ( 96. 0% ), postoperative hyphema in 98 eyes ( 79. 0% ). After IOP was steady, 37 eyes accepted trabeculectomy, 43 eyes accepted glaucoma cataract combined with IOL implantation, 44 eyes accepted phacoemulsification combined with IOL implantation. Followed up for 3 - 9 months, IOP ≤18mmHg were in 95 eyes, ≤25mmHg in 24 eyes, 26 - 35mmHg in 5 eyes, no hyphema, cystoid macular edema and other complications. CONCLUSION: YAG laser peripheral iridectomy can significantly reduce the IOP in difficult drug controlled acute angle - closure glaucoma, which provides safe and reliable condition for treatment of different glaucoma and is helpful to the protection and restoration of visual function, as well as increase the efficacy.

Integrated traditional Chinese and western medicine for the treatment of neovascular glaucoma

Xi-Dong Yan,Peng Li and Xia Qi

AIM:To analyze the clinical effect ofintegrated traditional Chinese and western medicine for the treatment of neovascular glaucoma(NVG).METHODS:Totally 251 cases(284 eyes)with NVG in glaucoma wards in eye center during January 2004 to January 2010 were collected, among which 150 cases(162 eyes) were treated with traditional Chinese medicine, 101 cases(122 eyes) were treated by single western medicine. Traditional Chinese medicine based on the principle of syndrome differentiation and treatment, taking traditional Chinese herbs according to the plus and minus of “Buyang Huanwu Decoction ”. Western medicine mainly treated with surgery. Panretinal photocoagulation(PRP) combined with vitreous injection of triamcinolone acetonide were performed in NVG stage 1. Compound trebeculectomy combined with amniotic membrane transplantation were performed in NVG stage 2. Ahmed valve implantation combined with anterior vitrectomy and vitreous injection of triamcinolone acetonide were performed in NVG stage 3A. While Ahmed valve implantation combined with vitrectomy and vitreous injection of triamcinolone acetonide were performed in NVG stage 3B and 3C. The intraocular pressure, visual acuity and iris neovascularization were observed 6 months after surgery.RESULTS:Compared with single western medicine, combined traditional Chinese medicine could improve the visual acuity of NVG in stage 1 and 2（Z_C=2.872,P<0.05；Z_C=8.017,P<0.05）, effectively control the intraocular pressure in stage 2 and 3（Z_C=4.557,P<0.05；Z_C=2.171,P<0.05）, promote iris neovascular regression in stage 2（Z_C=5.330,P<0.05）.CONCLUSION:The outcome of integrated traditional Chinese and western medicine is better than single western medicine for NVG.

Comparison of central corneal thickness measured using Lenstar LS900 and SIRIUS anterior segment analysis system

Cheng-Shu Sun,Yong-Zhi Huang,Xiao-Lan Zhang and Lin Wang

AIM:To compare the central corneal thickness(CCT) measured by Lenstar LS900 and SIRIUS anterior segment analysis system.METHODS:The CCT was measured on 29 patients (58 eyes), aged 18 to 40 years old, using Lenstar LS900 and SIRIUS eye anterior segment analysis system respectively before the refractive operation. A paired t-test comparison has been taken. The linear regression analysis was used to analyze the correlation of the two measurement results. Bland-Altman has been taken to analyze the correlation of the two methods.RESULTS:The average value of CCT with Lenstar LS900 was 532.89±46.65μm, and that of SIRIUS measurement was 532.10±47.21μm. Two kinds of measurements showed no significant difference (P＞0.05). Correlation coefficient analysis showed high correlation. The correlation coefficient was 0.994 (P＜0.05). Two kinds of the measurements of CCT were consistent.CONCLUSION:The measurement results of Lenstar LS900 and SIRIUS eye anterior segment analysis system show high uniformity. Two measuring instruments are precise and can be used to measure CCT.

Argon green laser combined with traditional Chinese medicine for the treatment of diabetic macular edema

Xiu-Mei Yu,Zhi Chen and Lan-Lan Wu

AIM:To investigate the use of argon green laser photocoagulation combined with traditional Chinese medicine treatment of diabetic macular edema (diabetic macular edema, DME) efficacy.METHODS:Totally 68 cases (132 eyes) with diabetic edema during August 2010 to June 2011 were colected. All the cases were randomly divided into two groups:treatment group of 35 cases (68 eyes), control group of 33 cases (64 eyes). Treatment group used argon green laser combined with traditional Chinese medicine for the treatment of DEM, control group was treated with argon green laser only. After 6 months, visual acuity, fundus fluorescein angiography(FFA), optic coherence tomography(OCT) were exmanied and statistical analysis were performed.RESULTS:Six months after treatment, visual acuity of treatment group improved or stabilized in 62 eyes (91.2%), decreased in 6 eyes (8.8%). Visual acuity of control group improved or stabilized in 49 eyes (76.6%), decreased in 15 eyes (23.4%). There was statistical significance between two groups (P＜0.05). FFA showed that macular edema partial or complete regressed in 63 eyes (92.7%), did not disappear in 5 eyes (7.3%) in treatment group. Macular edema partial or complete regressed in 50 eyes (78.1%),did not disappear in 14 eyes（21.9%）in control group. There was statistical significance between two groups (P＜0.05). OCT showed that macular edema in treatment groupalleviated or stabilized in 61 eyes (89.8%), unchanged or aggravated in 7 eyes (10.2%). Macular edema in control group alleviated or stabilized in 44 eyes (68.8%), unchanged or increased in 20 eyes (31.2%). Comparison of the two groups was statistically significant (P＜0.05 ).CONCLUSION:Argon green laser photocoagulation combined with traditional Chinese medicine for treatment of DEM is safe and effective.

Clinical observation of the treatment of macular edema after vitrectomy in patients with proliferative diabetic retinopathy

Ding-Ding Wang,Qing-Shan Song,Hui-Lan Zhou and Zi-Lin Chen

AIM:To study the efficacy of retrobulbar injection of triamcinolone acetonide(TA) combined with macular laser photocoagulation after vitrectomy in patients with proliferative diabetic retinopathy(PDR) for the treatment of diabetic macular edema.METHODS:PPV combined with full panretinal photocoagulation were performed in 43 cases with PDR, 40mg/mL TA after operation were injected retrobulbarly, 32 cases with macular edema diagnosed 1 week later were treated with macular laser photocoagulation(532nm) 2 weeks postoperatively. The best-corrected visual acuity(BCVA), CMT and complications were analyzed after postoperative 1 week, 1 month, 3 and 6 months. RESULTS:Twenty-eight cases'BCVA(88%) increased after 1 month, 4 cases(12%) were not changed. The difference of BCVA after 1 month compared with after 1 week was statistically significant(P<0.05), the difference of BCVA after 3 and 6 months compared with after 1 month was not statistically significant(P>0.05). The CMT was thickening after 1 week, and decreased after 1 month compared with after 1 week, the difference was statistically significant(P<0.05). The difference of CMT after 3 and 6 months compared with after 1 month was not statistically significant(P>0.05). The serious, irreversible complications had not been found in all patients during follow-up. CONCLUSION:Retrobulbar injection of TA combined with macular laser photocoagulation for the treatment of PDR, postoperative DEM gained satisfactory and long lasting clinical effect.

Clinical research of operation time for vitreous hemorrhage resulted from ocular contusion

Yu-Qing Wang,Yan-Ping Song,Zhao-De Zhang and Han-Feng Tang

AIM:To investigate the best time of surgery for vitreous hemorrhage resulted from ocular contusion and to evaluate the therapeutic effect.METHODS:Retrospectively analyze the 56 cases(56 eyes) of vitreous hemorrhage resulted from ocular contusion which registered in our hospital from January 2010 to December 2011. According to vitreous hemorrhage time, all the cases were divided into three groups:14 eyes of groupⅠfor 15-30 days, 22 eyes of group Ⅱ for 31-60days and 20 eyes of group Ⅲ for over 60 days. The operation used pars plana vitrectomy, and the postoperative follow-up was 6-24 mouths. The data was analyzed by SPSS 10.0.RESULTS:The final visual acuity of all cases is respectively 0.37±0.223 for the groupⅠ, 0.18±0.216 for the group Ⅱ and 0.12±0.128 for the group Ⅲ. Visual acuity of groupⅠcompared with group Ⅱ,there was statistical significant difference（χ²=13.383,P<0.01）.Visual acuity of groupⅠcompared with group Ⅲ, there was statistical significant difference （χ²=13.217, P<0.01）. Visual acuity of groupⅡcompared with group Ⅲ, there was statistical significant difference （χ²=0.045,P>0.05）. All result suggested that the final visual acuity of performing surgery within 15-30 days was better than that after 30 days, and the final visual acuity decreased with the time of vitreous hemorrhage.CONCLUSION:The final visual acuity decreased with the prolonged time of vitreous hemorrhage. Within 15-30 days, the final visual acuity can gain good outcome by surgery.

Long-term effect after large range retinotomy and silicone oil tamponade for the treatment of complex ocular trauma

Ze-Jun Xu,Shan Lin and Hui-Ru Lin

AIM: To study the long-term clinical efficacy of large range retinotomy and silicone oil tamponade for the treatment of complex ocular trauma, and to investige the influence of silicone oil choice to eye ball, intraocular pressure(IOP) and visual function.METHODS:Retrospectively analyzed the clinical data of 28 cases (28 eyes)with complex open ocular trauma with retinal incarceration treated by large range retinotomy combined with silicone oil tamponade. There were male 27 cases, female 1 case, aged 19-57 years old. The 180 degrees -360 degrees retinotomy and partial excision, laser photocoagulation and silicone oil tamponade were performed intraoperatively. Ten cases performed 360 degrees retinotomy to ambitus, 18 cases performed 180 degrees retinotomy and partial retinectomy. Silicone oil removal conditions:silicone oil tamponade for more than 6 months, the IOP>10mmHg, retinal reattachment well, retinotomy edges closed well. Postoperative follow-up was 2-5 years.RESULTS:Afterretinotomy, retinectomy and silicone oil tamponade, the early retina all reset. In 10 cases of 360 degrees retinotomy, 8 eyes ( 80%) removed silicone oil, 2 eyes ( 20%) became silicone support eyes due to the IOP<5mmHg. In 8 eyes of silicone oil removal, 2 eyes with IOP in the normal range, vision as counting fingers. In other 6 eyes, the IOP was in 3-7mmHg with corneal edema turbidity, choroidal edema, in which 3 eyes associated with vitreous hemorrhage and 5 eyes appeared eyeball atrophy, eye fetal implanted in second stage. In 18 eyes of 180 degrees retinectomy, open line after removal of silicone oil, 17 eyes' corrected visual acuity was from counting fingers- 0.3, the IOP in the normal range, 1 eye (5.5%) occurred eyeball atrophy.CONCLUSION:Complex severe ocular trauma retinal incarceration treated by large rangeretinotomy, retinectomy combined with silicone oil tamponade, although early retinal reattachment rate is high, but the long-term rate of low IOP and eyeball atrophy is also high. We should strictly control the operation pointer.

Clinical analysis of argon laser photocoagulation in the treatment of retinal vein occlusion

Qiu-Xia Wang and Xiao-Yuan Zhang

AIM:To analyze the effects of the argon laser photocoagulation in the treatment of retinal vein occlusion(RVO).METHODS:Fifty-seven cases who were diagnosed as RVO and treated by argon laser photocoagulation were followed up. Observed the patients'' visual acuity, fundus changes and complications, evaluated the clinical value of argon laser photocoagulation for RVO. Argon laser photocoagulation were divided into macularl attice photocoagulation, local retinal photocoagulation and panretinal photocoagulation.RESULTS:The 57 cases 3-6 months after argon laser photocoagulation were reexamined. The last visual acuity improved in 23 eyes, no change in 25 eyes, and decreased in 9 eyes. Fundus fluorescein angiography(FFA) was reexamined after laser photocoagulation(observing the area changes of retinal capillary non-perfusion area and the regression condition of new vessels), the outcome was effective in 54 eyes, developed to NVG in 3 eyes. However, laser photocoagulation had no significant effect on macular late complications. CONCLUSION:Laser photocoagulation treatment can improve central visual acuity, promote the absorption of retinal edema, hemorrhage and exudation, at the same time reduce the new vessels caused by NVG, also have remarkable effect in preventing or delaying the proliferative vitreoretinopathy and secondary neovascular glaucoma.

Clinical analysis of ocular trauma and intraocular foreign bodies in 74 cases

Hai-Lin Hu and Jun-Fang Wang

AIM:To evaluate the effect of surgery in cases of ocular trauma and intraocular foreign bodies.METHODS:Clinical data of 74 cases with foreign bodies were retrospectively analyzed.RESULTS:Successful operation was achieved in 71 eyes(96%), 3 eyes (4%) with failed operation. In 71 cases, all foreign bodies were removed successfully. Among them the complications included traumatic cataract in 42 cases (42/74, 57%), vitreous hemorrhage in 18 cases(18/74, 24%), retinal detachment in 2 cases (2/74, 3%) and secondary glaucoma in 9 cases(9/74, 12%). 44 eyes underwent electromagnet epispastic foreign body by external-route surgery,and 30 eyes underwent vitrectomy extraction. Ophthalmectomy was carried out in 3 cases(3/74, 4%) for the fungal intraocular inflammation after the incomplete extraction of foreign bodies. CONCLUSION:Vitrectomy is more favorable for the extraction of intraocular foreign bodies and the posterior polar ones with lens turbidity and vitreous opacity. Electromagnet epispastic foreign body by external-route surgery is suitable for the accurate positioning magnetic foreign body before the equator. Ultimately the possibility whether the eye can reconstruct has certain relevance with the integrity of the foreign body''s removal.

Expression and meaning of Bcl-2 and MMP-9 in pterygium

Dan-Na Zhang,Gui-Fang Yang and Zhao-Chen Liu

ATM:To study the expression and the relationship of B-cell lymphoma/leukemia-2 (Bcl-2 )and matrix metalloproteinases-9(MMP-9) in pterygium, and to provide the theory basis for the treatment of pterygium.METHODS:The expression of Bcl-2 and MMP-9 were detected in 76 cases with pterygium by immunohistochemical method and were compared with the normal conjunctiva epithelium in other 9 cases.RESULTS:The expression of Bcl-2 and MMP-9 was higher in pterygium than in normal conjunctiva epithelium(P<0.05).The expression of Bcl-2 was related to that of MMP-9.CONCLUSION:The increase of Bcl-2 and MMP-9 are presented in pterygium, which may play an important role in the origin and development of pterygium .

Application of suturing contusion cyclodialysis cleft under ultrasound biomicroscopic

Ning Zhao,Rui-Jun Zhang,Hao Feng,Jin-Song Zhang,Hong Ren and Chang Liu

AIM:To evaluate the effect of suturing contusion cyclodialysis cleft under ultrasound biomicroscopic (UBM)．METHODS:To analyze the clinical data of 57 cases with contusion cyclodialysis cleft sutured under UBM and evaluate its effects.RESULTS:In our study of 57 eyes with contusion cyclodialysis cleft sutured under UBM, the intraocular tension recovered to normal shortly after the operation in 53 eyes,the intraocular tension recovered to normal after second operation in 4 eyes. In our cases, we found the site and size of cyclodialysis in 42 eyes (74%) by UBM check before the operation, which were successfully sutured. In the 15 cases who were not found the site and size of cyclodialysis,the operation proved success by first suture in 11 cases, by second suture in 4 cases. Visual acuity improved in 48 cases.CONCLUSION:Suturing of the attachment of the ciliary body under UBM is an effective method to treat contusion cyclodialysis cleft .

Imaging features analysis of congenital fibrosis of extraocular muscles in a family

Ying Xu and Xiao-Juan Jing

AIM:To study the imaging features of extraocular muscles (EOMs) and ocular motor nerves of a Chinese family with congenital fibrosis of extraocular muscles (CFEOM) by magnetic resonance imaging (MRI), and approach the etiopathogenisis of CFEOM to provide theory basis for the treatment of it.METHODS:In a autosomal dominant inheritance of CFEOM family, 2 cases of three generations were scanned by high resolution MRI, and 12 healthy people were selected as control group. Scanning method:orbital region were performed 3mm, T1-weighted imaging(T1WI); intracranial region were performed 1mm, 3D FIESTA imaging. The changes of EOMs and ocular motor nerves of two groups were compared.RESULTS:Compared to healthy people, the volumes of patients'' 5 EOMs were smaller than those of control group, especially the superior rectus (P＜0.05) . And diameters of ocular motor nerves(oculomotor nerve, abducent nerve) were smaller, too (P＜0.05) .CONCLUSION:The EOMs of patients with CFEOM are atrophied compared with that of healthy people, intracranial ocular motor nerves are dysplasia, which indicates that this disease can be caused by dysplasia of ocular motor nerves.

Observation of KTP laser fusion of lacrimal passage obstruction after different indwelling things comparison

Tian-Lan Zhan

AIM:To observe the difference of different intubation to obstruction of lacrimal passage after laser recanalisation and analyze it.METHODS:Totally there were 179 cases (299 eyes) with canalicular obstruction caused by various reasons. According to causes, cases were divided into three groups, among which 43 cases(74 eyes)were lacrimal canalicular obstruction group, 82 cases (134 eyes) were nasolacrimal duct obstruction group,54 cases(91 eyes) were lacrimal canalicular combined with nasolacrimal duct obstruction group. Lacrimal canalicular obstruction group was divided into two groups randomly:silicone intubation group 37 eyes, silk group 37 eyes. Nasolacrimal duct obstruction group was divided into three groups randomly:silicone intubation group 44 eyes, silk group 44 eyes, T-silicone intubation group 46 eyes. Lacrimal canalicular combined with nasolacrimal duct obstruction group was divided into two groups randomly:silk combined with T-silicone intubation group 45 eyes, silicone intubation with canalicular expansion tube group 46 eyes. The mean follow-up was 3-6 months, recovery of lacrimal passage drainaging tears function was observed and the therapeutic effect was compared among the groups.RESULTS:The curative and effective rates of the seven groups (lacrimal canalicular obstruction:silk group, silicone intubation group; nasolacrimal duct obstruction:silk group, silicone intubation group, T-silicone intubation group; lacrimal canalicular combined with nasolacrimal duct obstruction:silk combined with T-silicone intubation group, silicone intubation with canalicular expansion tube group) were 89.2% and 8.1%, 62.2% and 21.3%, 52.3% and 34.1%, 59.1% and 34.1%, 80.4% and 8.7%, 82.2% and 6.67%, 60.9% and 19.6% respectively.CONCLUSION:Clinical results show that the selection of indwelling things should based on the position, severity, course of disease, treatment conditions and compliance of the patient. In order to achieve the best curative effect, the indwelling things should be chosen personally according to specific condition of each patient.

Wide-angle laser scanning ophthalmoscope in the peripheralfundus examination of patients with high myopia before refractive surgery

Duan-Xiao Wu and Jia Lin

AIM:To evaluate the effect of dilated-free wide-angle laser scanning ophthalmoscope (OPTOS200) in screening the retinal peripheral lesions in patients with high myopia before refractive surgery. METHODS:Before refractive surgery, 72 cases 118 eyes with dioptor >-6.00D were examined with dilated-free wide-angle laser scanning ophthalmoscope and after pupil dilation three-mirror contact lens by two experienced physicians, and the peripheral retinopathy (with or without degeneration area, dry retinal tears, retinal detachment, etc.) were observed. Statistics of examination time of the two methods, number of eyes with lesions and total number of lesions were collected and comparatively analyzed.RESULTS:The average time of dilated-free wide-angle laser scanning ophthalmoscope examination was 4.16±1.22 minutes per eye, and that of post dilation three-mirror contact lens examination was 21.64±5.32 minutes, which was statistically different (P<0.01). Wide-angle laser scanning ophthalmoscope examination founded that 60 eyes (51%) were with peripheral retinal lesions, missed diagnosis in 4 eyes (founded by three-mirror contact lens), 6 eyes were with dry retinal tears, and total number of lesion was 87, 1 case with mild retinal detachment in the edge of tear. Three-mirror contact lens examination founded that 65 eyes (55%) were with peripheral retinal lesions, missed diagnosis in 1 eye(founded by wide-angle laser scanning ophthalmoscope), 8 eyes were with dry retinal tears, total number of lesion was 128, 3 cases with mild retinal detachment in the edge of tear. The number of eyes with lesions founded by the two methods had no significant difference (P>0.05), but the number of lesions per eye was statistically significant (P<0.05). The retinal degeneration areas undiscovered by wide-angle laser scanning ophthalmoscope were mainly located below, and covered by the upper eyelid in patients with small palpebral fissure. CONCLUSION:Wide-angle laser scanning ophthalmoscope (OPTOS200) has the same effect as three-mirror contact lens in peripheral fundus examination of patients with high myopia before refractive surgery. It is a convenient, non-invasive method, while its details and comprehensiveness are not as good as three-mirror contact lens, so we should recheck the lesions by three-mirror contact lens. 

Effect of Toric intraocular lens implantation for the correction of regular corneal astigmatism during cataract surgery

Xu-Kang Cheng,Yan Luo,Ming Lu and Jie Feng

AIM:To evaluate toric intraocular lens (IOL) implantation as a treatment of regular corneal astigmatism during phacoemulsification.METHODS:Totally 41 cases(47 eyes) with cataract and corneal astigmatism had toric IOL(22 eyes) or spherical IOL(25 eyes) implantation during phacoemulsification, followed up for 6 months. Uncorrected distance visual acuity (UDVA), postoperative residual astigmatism, complications were analyzed, and effect of two IOLs were compared. Toric IOL axis rotational stability was observedRESULTS:Six months postoperatively, the mean UDVA was 0.73±0.37 in the toric IOL group and 0.47±0.18 in the spherical IOL group, there was statistical significant difference. The postoperative residual astigmatism was 0.53±0.40D in the Toric IOL group and 2.13±0.76D in the spherical IOL group, there was statistical significant difference. The visual acuity and the IOL location of Toric IOL group were both steady. The mean IOL misalignment was 4.22±1.46 degrees.CONCLUSION:Phacoemulsification combined with Toric IOL implantation for cataract and corneal astigmatism patients is effective, predictable and safe in correcting corneal astigmatism.

Observation of laser subepithelial keratomileusis for the treatment of ametropia after cataract extraction and intraocular lens implantation

Xin-Yu Li,Lei Liu,Dong-Ping Li,Gui-Gang Li and Jun Hu

AIM:To evaluate the efficacy and safety of laser subepithelial keratomileusis (LASEK) treating ametropia after cataract extraction and intraocular lens implantation .METHODS:After cataract extraction and intraocular lens implantation, the ametropia in 42 cases (49 eyes) was treated with LASEK. Postoperative follow-up was 6 months, corneal topography, visual acuity, refractive diopter, corneal haze and any other conditions were recorded.RESULTS:The uncorrected visual acuity was over 1. 0 in 32 eyes (65.3%) ,and over 0. 8 in 42 eyes (85.7%) . 45 eyes (91.8%) were within ±1.0 sphere diopter, 34 eyes (69.4%) were within ±0.5 sphere diopter. 43 eyes (87.8%) were within ±1.0 cylinder diopter, within ±0.5D 31 eyes (63.3%) . Corneal haze was at 0.5 grade in 4 eyes and 0 grade in others at postoperative 6 months. There were no complications such as secondary keratoconus, secondary glaucoma, ablation decentration, etc.CONCLUSION:LASEK for ametropia after cataract extraction and intraocular lens implantation is an effective and safe surgery.

Observation on efficacy of mitomycin C in laser subepithelial keratomileusis

Xiang-Ming Liu,An-Zhen Mao and Xian-Hua Xie

AIM:To observe the effect of mitomycin C(MMC) in middle and high myopic laser subepithelial keratomileusis(LASEK).METHODS:Totally 166 cases (332 eyes) with myopia were randomly divided into observation group with the use of 0.2g/L MMC and control group without the use of MMC ,83 cases (166 eyes) in each group. All patients were followed-up 12 months and the corneal epithelial healing time, the uncorrected visual acuity as well as the occurrence of corneal haze after surgery were observed.RESULTS:The corneal epithelial healing timewas 4.05±0.30 days in the observation group and 4.22±0.37 days in the control group, there was no significant difference between the two groups (P＞0.05). In postoperative 12 months, there were 17 eyes whose uncorrected visual acuity were ＜0.8, 42 eyes were 0.8-1.0 and 107 eyes were ≥1.0, the percent in each section of the two groups had no significant difference between groups (P＞0.05). The incidence of haze ≤1 or 2 grade was 1.8% (3/166 eyes) in observation group and 2.4% (4/166 eyes) in control group with the preoperation diopter was≤-6.00DS, there was no significant difference between the two groups (P＞0.05). While the preoperative diopter was -6.00--8.00DS, the haze rate was 3.0% (5/166 eyes) in observation group and 10.2% (17/166 eyes) in control group, there was significant difference between groups (P＜0.05). When the preoperative diopter was ≥-8.00DS, the haze rate was 6.0% (10/166 eyes) in observation group and 17.5% (29/166 eyes) in control group, there was significant difference between groups (P＜0.05). CONCLUSION:Application of MMC in LASEK can reduce the incidence of postoperative haze effectively with high safety.

Correlated study of axial length, diopter, keratometric power and central corneal thickness in high myopia

Min Zhang,Yang Jiang,Ying Li,Yan Luo,Feng-Rong Ai and Yu-Mei Jin

AIM:To study the correlation of the axial length(AL), diopter(D), keratometric power (K₁,K₂) and central corneal thickness(CCT) of high myopia.METHODS :Eighty cases(158 eyes ) were divided into 3 groups depending on their diopters: 26 cases(46 eyes) with diopters arranged from -6.00D--9.00D in group A (myopia group); 57 cases(97 eyes) with diopters arranged from -9.25D--20.00D in group B (high myopia group); 9 cases(15 eyes) with diopters over 20.25D in group C (super high myopia group). AL, diopter, keratometric power and CCT of three groups were measured. RESULTS: There were significant difference(P<0.05) among AL values of three groups (group A: 26.75±015mm; group B: 29.25±0.19 mm; group C: 32.27±0.84mm). Positive correlations existed between AL values and diopters of three groups （r=0.352,0.715,0.622;P<0.05）,while negative correlations between AL values and K₁、K ₂（r₁=-0.630,-0.494,-0.750, r₂=-0.609,-0.465,-0.782;P<0.05）. Positive correlations existed between diopters and K₁,K₂ in group A, while did not exist in group B and C. No correlation existed between CCT and diopters of three groups.CONCLUSION: Axial growth was the main influence factor of high myopia, keratometric power was the second factor, and CCT has no influence.

Density and morphological study of corneal endothelial cell in acute episode of anterior uveitis

AIM:To observe themorphological features of corneal endothelial cells in acute episode of anterior uveitis, and to explore the damage mechanism of corneal endothelial by fresh keratic precipitates (KP). METHODS:Fifty cases(50 eyes) with acute anterior uveitis of first time onset were selected in this study. Inflammation lasted for 3 days or more, KP≥(+++) as acute attack group (group A). Inflammation receded completely, KP(-) as group B. The opposite eye with no onset of acute anterior uveitis as group C. All people were measured by non-contact corneal specular microscopy, which included cell density(CD), hexagonality(HG), average size(AVG), standard deviation of the average cell area(SD), the variation coefficient of the cells in the area(CV), and the central corneal thickness(CCT) was measured. Then the data were compared and analyzed.RESULTS:Compared with group C, CD and HG of group A reduced, AVG, SD, CV, CCT of group A increased, the difference were statistically significant(P<0.05). Compared with group C, HG of group B reduced, CV increased, the difference was statistically significant(P<0.05). Compared with group B, HG of group A reduced, CCT and CV increased, which had statistical significance(P<0.05). Comparison among three groups showed that CV and HG had statistical significane（P＜0.05）.CONCLUSION:Fresh KP of acute anterior uveitis can increase the corneal thickness, change the form of endothelial cells and also reduce their function. After the alleviation of inflammation, corneal thickness tends to normal, but changing patterns of cells persisted.

Clinical analysis of phacoemulsification and intraocular lens implantation for cataract with high myopia

Bao-Wen Zhao,Tian-Hua Jia,Li Zhang and Tian-Hua Piao

AIM:To investigate the effect of phacoemulsification and intraocular lens ( IOL) implantation in treatment of high myopia.METHODS:Phacoemulsification and IOL implantation was performed in 45 cases (52 eyes) with high myopia cataract.RESULTS:The postoperative visual acuity of 43 eyes(83%) improved differently, the visual acuities were>0.4 in 12 eyes(23% ),0.1-0.4 in 33 eyes (63% ),<0.1 in 7 eyes (13% ). The visual acuities have no change in 9 eyes (17% ).CONCLUSION: Phacoemulsification and IOL implantation is a safe and effective method for treating high myopia and correcting refractive error.

Clinical effect of combined surgery in complicated cataract induced by silicone oil-filled eye

Xian-Meng Zhao,Er-Ying Han,Shi-Hui Yu and Chao-Guang Guo

AIM:To investigate the clinical effect of silicone oil removal combined with manual small incision extracapsular cataract extraction and intraocular lens (IOL) implantation. METHODS:Fifty-six cases (56 eyes) of complicated cataract induced by silicone oil-filled eye underwent silicone oil removal combined with manual small incision extracapsular cataract extraction and intraocular lens implantation. Postoperative follow-up ranged from 3 to 12 months with medium 7.26±1.38 months. Data were collected on corrected visual acuity, intraocular pressure (IOP), reaction of anterior chamber, location of IOL, opacity of posterior capsular, vitreous hemorrhage and reattachment of retina. RESULTS:Postoperative visual acuities of 53 eyes (95%) increased, ≥0.05 in 47 eyes（84%）, ≥0.3 in 27 eyes（48%）, there was significant difference between preoperative and postoperative vision (P＜0.05). Four eyes (7%) had temporary ocular hypertension and recovered by local drugs. Posterior capsulectomy was performed with the Neodymiun: YAG laser in 15 eyes (27%), retinal detachment happened in 2 eyes (4%). None of the cases had complications, such as bullous keratopathy,silicone oil residues, IOL displacement and vitreous hemorrhage. CONCLUSION:Silicone oil removal combined with manual small incision extracapsular cataract extraction and intraocular lens (IOL) implantation is a safe and effective method for complicated cataract induced by silicone oil-filled eye, it can improve vision, shorten period of surgery and reduce times of surgery.

Compound trabeculectomy in treatment of intraocular pressure elevation after non-penetrating trabeculectomy

Lei Qiao,Ping Jiang,Ning Guo,Peng Li,Yan-Ming Tian and Xi-Dong Yan

AIM:To research the long-term curative effectiveness and safety of compound trabeculectomy for primary open angle glaucoma(POAG) with intraocular pressure elevation after non-penetrating trabeculectomy. METHODS:Thirteen cases (25 eyes) who underwent compound trabeculectomy for (POAG) with intraocular pressure(IOP) elevation after non-penetrating trabeculectomy treated in our hospital during March 2006 to July 2011 were retrospectively analyzed. Glaucoma with high IOP after operation belonged to refractory glaucoma. Compound trabeculectomy was used to treat glaucoma eyes with central island and tubular vision under topical anesthesia combined tenon anesthesia. Those factors were taken into account such as IOP, visual acuity, cornea, filtering bleb, anterior chamber depth and complications.RESULTS:All patients were followed up for 3 months to 5 years. The IOP was 28-52mmHg before the operation, and 11.7-18mmHg postoperatively. At the last visit 3 months after operation the IOP was 14.5mmHg. We set the IOP ≤21mmHg for success criteria. Three months later, vision was improved in 3 eyes (12%) , unchanged in 17 eyes (68%), declined in 5 eyes (20%), and in 25 eyes (100%) , cornea became transparent .There were 22 eyes (80%) with functional filtering blebs. The other 3 eyes with IOP elevation and non-function filtering blebs were also cured by compound trabeculectomy. The incidence of shallow anterior chamber, hyphema, and aqueous flare was 60%, 40%, 20%, and those signs disappeared after treatment. There was no occurring of complication such as endophthalmitis.CONCLUSION:Compound trabeculectomy is the further development of trabeculectomy, which is the most classic and effective way for glaucoma. Compound trabeculectomy for the treatment of POAG with ocular hypertension was found to have a long term curative effectiveness and safety. Compound trabeculectomy, as a supplementary means of ocular hypertension after non-penetrating trabecular operation, effectively protect the remaining vision. But advanced POAG is not suitable for non-penetrating trabeculectomy. 

Clinical analysis of argon laser photocoagulation for the treatment of retinal vein occlusion in 57 cases

Qiu-Xia Wang and Xiao-Yuan Zhang

AIM:To analyze the clinical effects of the argon laser photocoagulation for the treatment of retinal vein occlusion(RVO) .METHODS:Totally 57 cases with RVO treated by argon laser photocoagulation were followed up. Observe patients'' visual acuity, fundus change, complications and evaluate the clinical value of argon laser photocoagulation in treating RVO. Laser therapy were divided into macular grid photocoagulation, local and pan-retinal photocoagulation according to the fundus fluorescein angiography(FFA).RESULTS:After laser treatment, visual acuity of 23 eyes improved, 25 eyes had no change, 9 eyes declined. FFA was checked after laser treatment(observing the area changes of retinal capillary in non-perfusion area, as well as the regression of neovascularization), 54 eyes were effective, 3 eyes occurred neovascular glaucoma(NVG). Laser photocoagulation had no significant effect to late complications in macular area.CONCLUSION:Laser photocoagulation can improve central visual acuity, promote the absorption of retinal edema, hemorrhage and exudation, reduce neo vessels caused by RVO, which has significant effect on preventing and delaying proliferative vitreoretinopathy(PVR) and secondary NVG.

Changes and correlation of serum stromal cell-derived factor-1β, leptin in patients with type 2 diabetes mellitus

Mei-Xia An,Han-Chun Xu,Yan Li,Ya-Ling Xuan,Li-Li Wang and Yi Cao

AIM:To study the levels of serum stromal cell-derived factor-1β(SDF-1β) and leptin in patients with type 2 diabetes mellitus (T2DM).METHODS:Twenty-eight cases with T2DM were divided into two groups, diabetic retinopathy (DR, 14 cases), and no diabetic retinopathy (NDR, 14 cases). A total of 14 healthy subjects were enrolled as normal control group(NC). The levels of serum SDF-1β and leptin were measured by Enzyme-linked Immune sorbent Assay(ELISA). RESULTS:The levels of serum SDF-1β and leptin were decreased by degrees from NC to NDR, DR groups. Compared with NC group, level of SDF-1β was lower (P=0.011). There was positive correlation between the level of SDF-1β and leptin (r=0.524, P<0.001).CONCLUSION:The levels of serum SDF-1β in T2DM patients with DR are decreased and they likely contribute to diabetic complications such as diabetic retinopathy by passing into peripheral organization. Further studye is necessary to the role of Leptin.

Research of expression and correlation of Survivin and Fas in primary pterygium

Ling Jin,Xiang-Qian Xu,Qing-Xiu Yang,Hong Zhang,Duan-Rong Cao and Bai-Jun Li

AIM：To investigate the expression and relationship of Survivin and Fas in primary pterygium. METHODS:SP immunohistochemistry was used to detect the expression of Survivin protein and Fas protein in primary pterygium of 40 cases and nomal conjunctiva of 20 cases. All data were analyzed by SPSS 11.5.RESULTS:The positive expression of Survivin in pterygium (37.5％) was higher than that in normal conjunctiva tissues(10.0％, P＜0.05). The positive expression of Fas in primary pterygium was significantly higher (75.0％)than that in normal conjunctiva tissues (15.0％, P＜0.05). There was a positive correlation between the expression rate of Survivin and Fas in primary pterygium(P＜0.01) and there was consistency between the expression strength of Survivin and Fas in primary pterygium（P＞0.05）. CONCLUSION：It indicated that Survivin may play an important role in the pathway of development of primary pterygium. There was a close correlation between the expression of Survivin and Fas in primary pterygium. It also indicated that Survivin and Fas may commonly participate in the occurrence and development of primary pterygium. 

Clinical features of congenital nasolacrimal duct obstruction and affecting factors of the outcome of lacrimal probing

Wang Fang,Li Zhang,Ling-Yan Chen,Li He and Xi-Hua Liu

AIM: To investigate the clinical features of congenital nasolacrimal duct obstruction and affecting factors of the outcome of lacrimal probing.METHODS:We retrospectively analyzed 616 infants (687 eyes) with congenital nasolacrimal duct obstruction who underwent lacrimal probing in the Department of Ophthalmology of Shenzhen Children's Hospital between June 2010 and May 2011. The main study items include the following: age at the initial consulting, age at the time of lacrimal probing, gender, mode of delivery, purulent secretion, past history of lacrimal rinsing, past history of lacrimal probing. We sumed up the clinical features and investigated the possible relationship between the above clinical parameters and success rate of lacrimal probing. The criterion for success of lacrimal probing is defined as: disappearance of epiphora and purulent secretion, and patency confirmed by lacrimal rinsing.RESULTS:There was no significant difference on the success rate of lacrimal probing between natural birth and Cesarean birth (P=0.376). The success rate of lacrimal probing between male and female infants also showed no significant difference (P=0.498). The success rate of lacrimal probing is negatively associated with the age at the time of lacrimal probing (P=0.001). The success rate of lacrimal probing at 3, 6, 9, 12 and 15 months was 100%,97.8%,90.8%,83.3% and 76.5% respectively (P=0.018). The success rate of lacrimal probing in infants with purulent secretion was significantly decreased (P=0.013). Past history of lacrimal rinsing did not influence the success rate of lacrimal probing (P=0.561). However, infants with past history of lacrimal probing showed significantly reduced success rate of lacrimal probing as compared with those without past history of lacrimal probing (P=0.042).CONCLUSION:The success rate of lacrimal probing for congenital nasolacrimal duct obstruction decreased significantly with the increasing age. Purulent secretion was also risk factor for the failure of lacrimal probing. It is important to effectively control local inflammation and perform lacrimal probing as earlier in order to increase the success rate of lacrimal probing for infants with congenital nasolacrimal duct obstruction.

Treatment of congenital nasolacrimal duct obstruction in different stages

Bo Jiang,Li-Li Gong and Shu-Qin Chen

AIM:To discuss the clinical effects of congenital nasolacrimal duct obstruction(CNLDO) in different stages with conservative treatment and lacrimal passage probing. METHODS:Thirty-seven infants (41 eyes), aged 20 days to 2 months, diagnosed with CNLDO were followed in the study between 2008 and 2011. Conservative dacryocyst massage was performed on infants ＜6 months. Lacrimal passage probing was performed on infants ＞6 months when conservative treatment had no effect. RESULTS:All infants finished follow-up,25 eyes(61.0%) were cured within six months after birth. The rest of 16 eyes(39.0%) received lacrimal passage probing after six months, of which 14 eyes resolved after the first probing and 2 eyes resolved after the second probing. CONCLUSION:Conservative treatment before 6 months in CNLDO was recommended. After 6 months, lacrimal passage probing could help promote the effect. 

Correlation analysis of intraocular pressure, central corneal thickness, refraction dioptres and corneal curvature before LASIK

Yan Zhang,Yan-Zhen Zheng,Wen-Li Dong and Yan Qiu

AIM:To explore the relationship of intraocular pressure (IOP), central corneal thickness(CCT),refraction dioptres and corneal curvature before LASIK.METHODS: Totally 220 cases (440 eyes) with refractive errors were enrolled and the data were measured by non-contact tonometer, ultrasound pachymetry and computer refractor. Various measurements were compared and analyzed statistically.RESULTS: There was a positive correlation between IOP and CCT in patients with refractive errors（ r=0.568,0.534, 0.413, 0.412；P<0.001）. There was no statistically significant correlation between refraction dioptres and CCT, IOP, corneal curvature in refractive errors（r=-0.078,0.068,-0.077; P=0.052, 0.073, 0.058）. There was no statistically significant correlation between corneal curvature, IOP and CCT in refractive error（r=0.004,-0.058; P=0.917, 0.157）.CONCLUSION: There is a positive correlation between IOP and CCT in patients with refractive errors.

Clinical manifestation of double depressor paralysis and its surgical treatment

Jin-Mao Chen,Li-Ping Lai,Chong-Fei Tao and Yu Liu

AIM:To discuss the clinical manifestation of double depressor paralysis(DDP) and evaluate its surgical method and therapeutic effect.METHODS: Six cases of DDP were retrospectively reviewed from July 2009 to September 2011．To examine the eye position, eye movement, compensatory head posture and forced duction test. All patients were operated on the paretic eye. The superior rectus muscle (SR) was weakened and inferior oblique muscle (IO) transferred. The horizontal muscles operation can be executed at the same time or the next time. Clinical characteristics and surgical procedure and the results were summarized.RESULTS: The clinical characteristics of patients were hypertropia of the peratic eye (≥25△). Significant limitation of lateral-in-fraduction and medial-infraduction was observed. Horizontal deviation can be accompanied. The non-paretic eye is often the fixation eye. Some patients show pseudo-blepharoptosis in the primary position when fixed with the paretic eye. After 6 to 24 months follow-up, 5 patients were cured in one operation and the rest one was greatly improved by the second operation.CONCLUSION: Ocular movement examination is efficient and direct method for DDP diagnosis. The operation project lies on the deviation degree and result of forced duction test. Most patients with DDP gain good results. The operation principles include SR slack, IO transfer, accompanied or unaccompanied with horizontal muscles operation.

Effect comparison of two fixed esotropia operation method

Yan-Li Wei,Xiao-Ju An,Qiang Sun and Jian Ye

AIM:To compare the effects of two fixedesotropia operation method.METHODS:Retrospectively analyzed the operation courses of 26 cases(45 eyes) with fixed esotropia in the last 11 years. During January 2000 to December 2006, surgeries were done for 17 eyes to cut off tendon of medial rectus and shorten lateral rectus for an excessive amount (Surgery I). During January 2007 to December 2010, surgeries were taken for 28 eyes to cut off tendon of medial rectus, overlap lateral rectus and fix it to orbital periosteum on the side of temporal bone (Surgery II). RESULTS:Among the 17 eyes on which Surgery I was performed, it was found that 4 eyes turned inward for more than 15 degrees 1 day after the surgery. Then surgeries were taken immediately to fix lateral rectus on orbital periosteum so that the eyes could be over corrected for 5-10 degrees. During follow-up about 1 year after surgery, the eyes were over corrected for about 5-10 degrees. During follow-up of the other 13 eyes in 6-18 months after surgery, esotropia of 10-30 degree occurred on 7 eyes. Surgeries were practiced in all of them to fix lateral rectus on orbital periosteum and over correct the eyes for 5-10 degrees. During their visits in 1 year after surgery, the eyes were over corrected for about 5 degrees. Of the 28 eyes on which Surgery II were performed, it was found that all of the eyes were over corrected, and were similar to the surgical designs. During their visits in 1-2 years after surgery, the eyes were over corrected for about 5 degrees. Patients of 2 cases visited us for 3-4 years, and their eyes were slightly over corrected for within 5 degrees.CONCLUSION:Regular surgical treatment for fixed esotropia could not achieve better effect, and the surgical effect will regress in time. The surgery to cut off tendon of medial rectus and shorten lateral rectus for an excessive amount has achieved better effect. It is safer and less difficult. The rate of success is high. And, the rate of regression is low according to statistics of patient visits after the surgery for a long time. It is the one that should be applied in wider scope. 

Study of the norvancomycin integrity treatment in bacterial endophthalmitis

Juan Peng,Xiang-Yin Sha and Rui-Ming Yang

AIM:To analyze the outcome and complication of the norvancomycin integrity treatment in bacterial endophthalmitis. METHODS: Twenty-seven patients 27 eyes were observed from July, 2009 to August, 2011. All the patients underwent corpus vitreum bacterial culture and suspecptibility. The vitreous injections of norvancomycin were performed. The treatment also included intravenous injection of norvancomycin and levofloxacin. The patients without improvement underwent vitrectomy with norvancomycin perfusion fluid after two to four days. The best-correct visual acuity, intraocular pressure, anterior chamber and vitreum changes were observed before and after operation. The data were evaluated by statistical analysis. RESULTS:Twenty-seven patients were healing well with increase of visual acuity. 56% specimens were found positive by 67% for gram-positive bacteria. Most gram-positive bacteria were susceptible to norvancomycin while the gram-negative to levofloxacin. 8 patients healed by vitreous injections and 18 patients by vitrectomy. The best correct visual acuity and symptoms were increased. CONCLUSION: The bacterial culture of vitreous could guide the clinical treatment. The norvancomycin integrated treatment is effective for bacterial endophthalmitis.

Compare the Pseudophakic accommodation of three type monofocal intraocular lens implantation eyes

Hua-Ming Wen1,Li-Chuan Han,Ri-Chang Cong and Hai-Xiang Li

AIM: To compare the Pseudophakic accommodation of three monofocal intraocular lens implantation eye after phacoemulsification. METHODS: A total of 78 eyes from 78 patients under going phacoemulsification received intraocular lens based on the principle of voluntary. Twenty-three eyes from 23 patients who had implantation of AcrySof Natural intraocular lens were randomized into groupⅠ. Twenty-four eyes from 24 patients who had implantation of Canon staa intraocular lens were randomized into groupⅡ. Thirty-one eyes from 31 patients who had implantation of Canon staa intraocular lens were randomized into group Ⅲ. Main outcome measures included best-corrected distance visual acuity, distance corrected near vision, and the Pseudophakic accommodation amplitude. All the clinical data were obtained at 3 months postoperatively. RESULTS:At 3 months postoperatively, best-corrected distance visual acuity were similar among the 3 groups(F=0.317, P=0.729). Near vision on the basis of best corrected distance vision were statistically significant (F=3.377, P=0.039), added value on the basis of best-corrected near and the accommodation amplitude were statistically significant (F=10.094, P=0.000; F=16.806, P=0000) the among three groups. CONCLUSION: Three monofocal intraocular lens after cataract surgery implanted all could gain better distance visual acuity, near vision of the Acrysof Natural and the Canon staa intraocular lens implantation were more satisfactory, Acrysof Natural intraocular lens eyes had a better Pseudophakic accommodation.

Clinical effects of the ReSTOR+3D multifocal intraocular lens

Dong-Ping Pan,Xue-Xi Li,Wei-Na Li and Jia-Na Chen

AIM:To observe the clinical effect of the ReSTOR+3D multifocal intraocular lens (MIOL). METHODS:Fouty cases (80 eyes) with age-related cataract were divided into two groups with the same standard. 20 cases were bilaterally implanted with the Alcon ReSTOR+3D MIOL and another 20 cases with Alcon Nature blue-filter monofocal intraocular lens(SIOL) in different time. Both groups were performed clear corneal incision phacoemulsification combined with intraocular lens(IOL) implantation. Distance visual acuity and near visual acuity were observed at postoperatively l day. At postoperative 30 days, distance/near visual acuity, corrected distance/near visual acuity, best-corrected near visual acuity and contrast sensitivity(CS) were also observed. Visual quality, postoperative satisfactory and spectacle independence rate of each visual functional area were evaluated by questionaires. RESULTS:Allcases had good distance visual acuity postoperatively. The MIOL group was better than the SIOL group in uncorrected near and middle visual acuity. CS in the MIOL group was lower than that in the SIOL group, but there was no functional significance. In the MIOL group, 85% of the cases achieved total spectacle independence. CONCLUSION:The ReSTOR+3D multifocal IOL provides a satisfactory full range of vision, which is safe, effective and has high satisfactory.

Clinical effect of cataract surgery with higher power toric intraocular lens implantation in patients with high corneal astigmatism

Xian-Yi Bao,Yong Wang,Ying-Jia Ye and Ting-Ting Peng

AIM:To evaluate the visual and refractive outcomes after higher power toric intraocular lens(IOL) implantation in patients with high amounts of corneal astigmatism. METHODS:This study comprised 21 cases 24 eyes with cataract and more than 2.5 diopters (D) of corneal astigmatism who had toric AcrySof SN60T6, SN60T7, SN60T8 or SN60T9 IOL implantation. The preoperative and postoperative 3 months uncorrected distance visual acuity (UCDVA) and best-corrected distance visual acuity (BCDVA), preoperative corneal astigmatism, residual refractive cylinder and IOL axis and position in postoperative 1 week and 3 months were evaluated. RESULTS:Three months postoperatively, 75％ of eyes showed the 0.5 or better in UCDVA. The preoperative corneal astigmatism was 3.45±0.63D. The postoperative 3 months residual refractive cylinder was 0.72±0.23D(P＜001). The anticipated correction was 3.12±0.54D. The achieved correction was 3.05±0.66D (P＞0.05). The mean Toric IOL misalignment was 3.2°±2.1°. CONCLUSION:Implantation of higher power toric IOL during cataract surgery is a safe, effective and predictable method in correcting high amounts of corneal astigmatism.

Clinical analysis of trabeculectomy for primary acute angle-closure glaucoma with high intraocular pressure

Wen-Xuan Pei

AIM:To evaluate the therapeutic efficacy and safety of trabeculectomy for primary acute angle-closure glaucoma(PACG) with high intraocular pressure (IOP)． METHODS:Fourty-eight cases (50 eyes) of PACG were retrospectively analyzed，which underwent trabeculectomy. These cases were divided into 2 groups by the preoperative IOP： the operation group (12 eyes，IOP≥40mmHg)，and the control group (38 eyes，IOP＜40mmHg)．The IOP，visual acuity，complications and surgery outcome of both groups were compared． RESULTS: No severe complications such as choroidal hemorrhage，malignant glaucoma were observed in both groups during surgery and postoperation．The success rate of operation in the control group was much higher than that in the operation group shortly after the operation with significant difference (P=0.0332）．But the success rate of both groups had no significant difference（P＞0.05）in return visit． CONCLUSION:Trabeculectomy for PACG with persistent high IOP should be performed actively to avoid further damage to the visual function．

Intravitreal Avastin injection for the treatment of neovascular glaucoma

Xiao-Yan Gao,Jun-Xia Zhang,Hai-Ning He and Rui-Li Cao

AIM:To evaluate the clinical curative effect of intravitreal Avastin injection for the treatment of neovascular glaucoma. METHODS:There were 23 neovascular glaucoma patients(23 eyes) whose visual acuity was higher than counting fingers treated in our hospital from January 2007 to October 2011. After intravitreal Avastin injection, the change of iris neovessels was observed. When the neovessels subsided in 3-7 days, the anti-glaucoma operation was performed. The intraocular pressure, visual acuity, change of neovessels, inflammatory reaction, complications were observed and followed up 12-24months. RESULTS:In the 23 eyes, there were 21 eyes that iris neovessels subsided in 3-5 days after injection, the effective rate was 91.30%. There were 2 eyes that iris neovessels thinned in 5 days, atrophied in 7 days, and subsided in 2 weeks. The difference of intraocular pressure was less than 2mmHg before and after the Avastin injection. There were no complications and adverse reaction after Avastin injected in 23 eyes, then performed compound trabeculectomy. In the following up days of 12-24 months, there were 18 eyes intraocular pressure in normal range without anti-glaucoma medicine; there were 3 eyes intraocular pressure below 21mmHg adding 2 kinds of anti-glaucoma medicine and 2 eyes intraocular pressure below 21mmHg adding 3 kinds of anti-glaucoma medicine. CONCLUSION:Intravitreal Avastin injection can subside or atrophy the neovessels of neovascular glaucoma, then filtered operation were performed on patients, which avoids intra- or postoperative hemorrhage, destructive operation and preserves better visual acuity and controls intraocular pressure. The complications were treated postoperatively and visual function was protected.

Analysis on the outcome of clinical pathways for patients with primary acute angle-closure glaucoma

Jian-Quan Li,Jian Zeng,Min Yu,Gang Qiao and Xiao-Li Wang

AIM:To analyze the outcome of clinical pathways for patients with primary acute angle-closure glaucoma in our hospital for two years and evaluate the value of this way. METHODS:Eighty-three eyes of 82 patients who suffered primary acute angle-closure glaucoma from January 2010 to December 2011 were cured with filtering operation (trabeculectomy or composite trabeculectomy) by managing with clinical path, they are divided path group. The control group was another 67 patients from January 2008 to December 2009, who suffered the same disease and cured with the same operation not by managing with clinical path. The working days before surgery, days in hospital, cost for cure, curative effect, and degree of satisfaction of patients were all recorded for analysis. RESULTS:The path group had an average of 2.6 working days before surgery, 7.0 days in hospital, cost of 2158 yuan for cure, degree of satisfaction of patients(974%). The control group had an average of 4.2 working days before surgery, 11.2 days in hospital, cost of 2630 yuan for cure, degree of satisfaction of patients(90.2%). They were all statistically different(P＜0.05), but there was no difference in curative effect(P>0.05). CONCLUSION: The clinical path for patients with primary acute angle-closure glaucoma can not only shorten working days before surgery and days in hospital, but also save cost for cure and improve the degree of satisfaction of patients.

Efficacy of the Ahmed glaucoma valve implantation for the treatment of refractory glaucoma

Jian-Quan Sun,Jian-Hua Yang and Yu Zhang

AIM: To explore the clinical efficacy of the Ahmed glaucoma valve implantation for refractory glaucoma. METHODS: The clinic outcomes of 21 cases (21 eyes) with refractory glaucoma were reviewed,all patients underwent the placement of Ahmed glaucoma valve implant. RESULTS:The mean preoperative intraocular pressure(IOP) was 44.6±7.2mmHg. Postoperative 6 months at the last follow-up mean IOP was 15.4±5.3mmHg; Comparing than the preoperative visual acuity, 4 eyes increased, 14 eyes had no changes and 3 eyes decreased. The main postoperative complications included postoperative shallow anterior chamber (2 eyes), retained high IOP (1 eye), tube blockage (1 eye), corneal decompensation (1 eye) and fiber wrap of drainage tray (3 eyes). The procedural success rate at 6 months was 86%. CONCLUSION: Ahmed glaucoma valve implantation may be an effective procedure for refractory glaucoma.

Report Series No.2 Early changes of choriodal neovascularization after photodynamic therapy

Yan Zhang,Chen-Jin Jin,Zhen Tian and Xiao-Jing Zhong

AIM: To study the early changes of choriodal neovascularization(CNV) one week after photodynamic therapy(PDT). Compare the differences between standard PDT and fast infusion reduced light dose PDT. METHODS: Sixteen cases（19 eyes） with subfoval CNV suffered PDT with visudyne. Of the 19 eyes included, 13 eyes suffered standard PDT (6mg/m² visudyne, injection speed is 3mL/min, the interval time between the injection and exposure to the light is 15 minutes, the wave length of light is 689nm, fluency of the light is 600mW/cm², duration of the light is 83 seconds, dose of light is 50J/cm²), 6 eyes suffered fast infusion reduced light dose PDT (6mg/m² visudyne, injection speed is 6ml/min, the interval time between the injection and exposure to the light is 15 minutes, the wave length of light is 689nm, fluency of the light is 600mW/cm², duration of the light is 42 seconds, dose of light is 25J/cm²).The changes of best-corrected visual acuity (BCVA), letters of early treatment for diabetic retinopathy study (ETDRS). Optical coherence tomography(OCT) before and one week after PDT were compared. Using the software of OCT, the bilaminar foveal thickness (Tf), neuroretinal foveal thickness (Nf), outer high reflectivity band thickness (T) and subretinal fluid thickness (SF) were measured. Compare the changes of every observation indexes pre- and postoperatively as well as their differeces. RESULTS: No significant changes had found in OCT images or visual acuity one week after PDT(P>0.05). All the indexes had no significant differences after PDT or between the groups（P>0.05）. CONCLUSION: There were no changes before and one week after PDT.Compared to standard PDT, fast infusion reduced light dose PDT had no differences.

Operation timing of vitrectomy for treatment of proliferating diabetic retinopathy with macular hemorrhage

Yan Zhang,Wen-Li Dong and Dong-Yu Li

AIM:To investigate the operation timing of vitrectomy for proliferative diabetic retinopathy(PDR) with macular hemorrhage. METHODS:In this retrospective analysis study, 62 PDR patients (62 eyes) with macular hemorrhage were enrolled from March 2009 to December 2010. 38 cases (38 eyes) were treated with panretinal photocoagulation firstly, then underwent vitrectomy after 2 months. 24 cases (24 eyes) were treated with vitrectomy directly, and retinal photocoagulation was made at the same time. The patient were treated with BSS or silicone oil tamponade in vitrectomy surgery according to whether the merger of rubeosis iridis, optic disc neovascularization and lens intraocular, so the retina get a good reset. RESULTS:There were 16 (67%) eyes with course of disease <2 months and postoperative visual acuity ≥ 01. There were 9 (24%) eyes with course of disease≥ 2 months and postoperative visual acuity ≥ 0.1. The two groups difference was statistically significant (χ²=11293,P=0.001). The difference of filler material was statistically significant (χ² =14.078,P＜0.05), comparing the course of disease <2 months group and ≥ 2 months group. CONCLUSION: PDR with macular hemorrhage patients should use silicone oil limiting hemorrhage to those whose course of disease ≥ 2 months, the retinal was reseted good. The patients who were treated in two months after the changes can get a good visual function.

Analysis of central serous chorioretinopathy FFA and synchronous spectral domain OCT

Yang Yang,Yong-Jun Qi,Gui-Fang Li,Jian-Hua Deng,Xiao-Yan Xie and Wan-Jun Liu

AIM:To discuss the fundus angiography of central serous chorioretinopathy (CSC), including fundus fluorescein angiography (FFA),indocyanine green angiography(ICGA),and synchronous spectral domain optical coherence tomography(SDOCT) in order to investigate the pathogenesis of CSC. METHODS: Fifty-four cases with CSC in our hospital during June 2009 to October 2011 were checked by using Spectralis HRA-OCT. PatientsFFA,ICGA and synchronous SDOCT were analyzed and explained. RESULTS:FFA of 54 cases with CSC appeared retinal pigment epithelial(RPE)fluorescein leakage,ICGA appeared choroidal vascular abnormal in lesions and SDOCT appeared neuroepithelial serous detachment. Comparing FFA with SDOCT of 38 cases（70.4%）, FFA appeared fluorescein leakage where ICGA was small pieces RPE detachment. CONCLUSION:CSC patients disorder location can be diagnosed accurately by checking FFA,ICGA and synchronous SDOCT, which provides clinical data for CSC pathogenesis in order to better guide clinical treatment.

Comparison of the intraocular pressure of non-contact tonometry and Schiotz tonometer in different corneal thickness

Xiao-Ju An and Kai-Jian Chen

AIM:To compare the difference of intraocular pressure of non-contact tonometry and Schiotz tonometer in different corneal thickness. METHODS:Totally 314 cases (627 eyes) were recruited. Corneal thickness was measured by corneal pachymeter and intraocular pressure was measured by non-contact tonometry and Schiotz tonometer. Eyes were divided into 3 groups based on corneal thickness: thin group: corneal thickness＜530μm, normal group: 530μm＜corneal thickness ≤570μm and thick group: corneal thickness＞570μm. The statistical significance of differences was evaluated by paired t-test and the agreement was assessed by Bland-Altman analysis. RESULTS:The eyes of thin, normal and thick group were: 170, 301 and 156 eyes, respectively.The intraocular pressure of non-contact tonometry and Schiotz tonometer in 3 groups were 12.82±2.67 mmHg，12.84±2.37mmHg；1367±2.66mmHg，13.58±2.41mmHg；15.45±2.91mmHg，14.76±2.39mmHg, respectively. There was significant difference in thick group and no significant difference in other groups. CONCLUSION: It is suggested that either non-contact tonometry or Schiotz tonometer could measure intraocular pressure in eyes with corneal thickness≤570μm, and consult the intraocular pressure of the two measurements in eyes with corneal thickness ＞570μm.

Clinical research of different types of vitreous hemorrhage with vitrectomy

Ming-Min Gao,Yan-Lin Zheng,Ling Zhang,Qun Sun and Yi-Qian Mao

AIM: To observe the clinical efficacy ofvitrectomy on different causes of vitreous hemorrhage, and the effect of correlative factor on vitrectomy. METHODS: Clinical data of different types offundus disease in 76 cases 76 eyes with vitrectomy were analyzed retrospectively. The multiple factors related with clinical efficacy of vitrectomy including the causes, age and the time were analyzed. RESULTS: In cause groups, diabetic retinopathy(proliferative) was in 31 cases (41%), rhegmatogenous retinal detachment 24 cases (32%), branch retinal vein occlusion 10 cases (13%), central retinal vein occlusion 3 cases (4%), retinal vasculitis 2 cases (3%), blunt trauma 2 cases (3%), simple vitreous hemorrhage 2 cases (3%), proliferative vitreoretinopathy 1 case (1%), polypoidal choroidal vasculopathy 1 case (1%). In age groups, there was statistical difference between each group(χ²=21.89, P<0.01); in youth group(<45), there were 26 cases, rhegmatogenous retinal detachment was in 11 cases (42%); in middle-aged group (45-59), there were 19 cases, rhegmatogenous retinal detachment was in 9 cases (47%); in old group(>60), there were 31 cases, diabetic retinopathy was in 24 cases(77%). In time groups, there was statistical difference between each group(χ²=20.37, P<0.01); in one month group, there were 26 cases, the postoperative vision of 13 cases (50%) increased over 03; in two month group, there were 24 cases, the postoperative vision of 10 cases (42%) increased over 0.1 but below 0.3, in three month group, there were 11 cases, the postoperative vision of 5 cases (45%) increased over 0.01 but below 0.09; in over three month group, there were 15 cases, the postoperative vision of 6 cases(40%) increased over 0.01 but below 0.09 and 6 cases (40%) increased over 0.1 but below 0.3. CONCLUSION: The diabetic retinopathy(ptoliferative), rhegmatogenous retinal detachment and branch retinal vein occlusion are the main causes of the vitreous hemorrhage. Vitrectomy used to treat different causes of vitreous hemorrhage is obviously effective (especially caused by rhegmatogenous retinal detachment), which can improve visual function. The vitrectomy has better clinical efficacy on vitreous hemorrhage in one to two months.

Effect observation of pars plana vitrectomy for the treatment of vitreous hemorrhage complicated retinal hole or detachment

Wen-Xing Xiao and Yue-Lin Zhang

AIM: To discuss the effect and necessity of pars plana vitrectomy(PPV) for the treatment of vitreous hemorrhage complicated retinal hole or detachment. METHODS: Totally 28 cases(28 eyes) with vitreous hemorrhage complicated retinal hole or detachment were treated by PPV. The change of visual acuity was observed pre- and postoperatively and the relationship between vitreous hemorrhage and detachment was analyzed. RESULTS: In 28 cases with vitreous hemorrhage caused by various reasons, 7 cases occurred no retinal detachment from preoperative B ultrasound, 3 cases found retinal hole in intraoperation, 4 cases accompanied peri-hole shallow detachment. Postoperative visual acuity of 28 cases (including postoperative follow-up best-corrected visual acuity) improved in various degree, better than counting finger or before eye in 27 cases(96%),≥0.05 in 20 cases(71%),≥0.3 in 5 cases(18%).There was statistical significant difference between pre- and postoperation(P＜0.05). CONCLUSION: It is safe and effective for vitreous hemorrhage complicated retinal hole or detachment treated by PPV, and can find retinal hole and shallow detachment as soon as possible so as to avoid further enlargement of retinal detachment.

Clinical efficacy observation of treatment for orbital cellulites

Li-Mei Wang,Shao-Yang Shi,Xue-Mei Feng,Na Hu and Cun-Wen Pei

AIM:To observe the etiological factor and clinical efficacy of comprehensive treatment for orbital cellulitis, and to improve its diagnostic method and provide its theoretical basis. METHODS:Totally 63 patients with orbital cellulitis form January 2009 to January 2012 in our hospital were analyzed. RESULTS:All patients were successfully healed within 2 weeks to 1 month without severe complication. CONCLUSION: The comprehensive treatment for orbital cellulitis with the advantages of definite effect is worth of promotion.

Comparative observation of silicone reverse-intubation and dacryocystorhinostomy

Yue Bai and Guo-Xing Xu

AIM:To evaluate the clinic value and the curative effects of silicone reverse-intubation in treating chronic dacryocystitis and nasolacrimal duct obstruction. METHODS:Totally 67 cases were studied retrospectively about postoperative curative effect from 3 months to 12 months, including 35 cases on silicone reverse-intubation and 32 cases on dacryocystorhinostomy. RESULTS：The cure rate of the group of the silicone reverse-intubation was 94%, of the dacryocystorhinostomy was 94%. The difference of two groups was not significant(P>0.05)，while the operative time of silicone reverse-intubation was significantly less than that of dacryocystorhinostomy(P<0.001). And there were no severe complications in silicone reverse-intubation group. CONCLUSION：The silicone reverse-intubation is a simple, convenient, economical and effective surgery which is suitable to popularize for treating chronic dacryocystitis and nasolacrimal duct obstruction.

Implantation of Verisyse phakic iris-fixated intraocular lens for the correction of severe myopia

Li-Feng Yan,Jian-Ting Liu,Lin Jiang,Dao-Man Xiang and Su-Hua Zhang

AIM：To evaluate the efficacy, safety, and predictability of the implantation of Verisyse phakic iris-fixated intraocular lens(IOL) for the correction of severe myopia. METHODS：In this prospective study, 10 cases (13 eyes) with myopia at -15.00～-24.50 dioperts (D) were implanted with Verisyse phakic iris-fixated intraocular lens. Visual acuity, refraction, intraocular pressure, the Verisyse IOL position, contrast sensitivity, glare sensitivity, operative complications and poor visual symptoms were observed. RESULTS: The postoperative uncorrected visual acuity and best-corrected visual acuity(BCVA) significantly improved. The BCVA≥ 0.5 or better was presented in 100% eyes and ≥ 0.8 accounted for 85% at 3 months after surgery. There was no significant increase in mean intraocular pressure at each time point in one year after surgery. The Verisyse IOL appeared to be correctly positioned in the anterior chamber in all eyes. Contrast sensitivity and glare sensitivity in all eyes increased at 3 months postoperatively as compared with those of preoperative values (best spectacle corrected). Postoperative complications included as light inflammatory deposits on the PAC IOL surface at 3 months in 2 eyes; oval pupil in 1 eye. CONCLUSION：Verisyse IOL implantation for the correction of severe myopia is effective, safe and predictable. It can be a supplement for corneal refractive surgery, but follow up is still required for the evaluation of long term results.

Relationship between the corneal curvature, axial length, height, weight, bone age and the degree of myopia in students aged 6-14

Yi Xiong,Jie Zhao,Hui-Juan Zhao,Qiang-Qiang Li,Yong-Shun Gu and Li Wang

AIM：To explore the relationship between the corneal curvature, axial length, height, weight, bone age and the degree of myopia in students aged 6-14. METHODS：The height, weight, visual acuity were examined in children aged 6-14 in Baoshan district of Shanghai. There were 621 poor vision students were enrolled refractive examination, including the optometry after cycloplegia, corneal curvature and axial length.They were also taken the imaging examination of carpal bone to define their bone age. The relationship of examination results was analyzed. RESULTS: Statistics showed that the spherical equivalent had negative correlation with axial length and had no correlation with corneal curvature. The spherical equivalent had negative correlation with age, the axial length, height, weight, bone age had positive correlation with age, while the corneal curvature and the difference of axial length between measurement and emmetropia had no correlation with age. The height, weight, age, bone age and bone age difference had negative correlation with spherical equivalent, had positive correlation with axial length, had no correlation with corneal curvature. The height, weight, age, bone age had no correlation with the difference of axial length, and the bone age difference had weak positive correlation with the difference of axial length. CONCLUSION: The myopia of adolescent has some relationship with the rhythm of body growth and development.

Clinical observation of P-VEP before and after treatment in amblyopia children by different cover methods

Zheng-Mei Jiang,Wei-Zhong Ge and Xiao-Dong Li

AIM:To evaluate the effect of different cover methods in treatment of amblyopia with pattern visual evoked potential (P-VEP). METHODS:A prospective study was conducted with 136 monocularamblyopia children, aged 3-6 years old, selected from children optometry specialist out-patient. They were divided into covered group(69 cases) and partially covered group(67 cases), respectively. On the basis of accurate refractive correction, the healthy eye from each group was covered for 10, 5 hours per day, and at the same time, the same amount of fine eyesight training was conducted, respectively. P-VEP (P100 amplitude and potential) test results and visual acuity improvement were analyzed. RESULTS:One month after treatment, compared with before treatment, P100 amplitude increased and latency was shortened in full cover group, and the difference was statistically significant (P<0.05), while those differences in the partially covered group were not statistically significant (P>0.05), while the difference between the two groups was statistically significant; 6 months after treatment, the visual acuity increment: cure rate, progress rate and total efficiency rate between the two groups was statistically significant(P<0.05), the difference of the P100 amplitude, latency shortening in covered group was statistically significant compared with before treatment (P <0.05), and the differences between the two groups were not statistically significant(P >0.05); the visual acuity increment: cure rate, progress rate and total efficiency rate between the two groups was not statistically significant(P >0.05). CONCLUSION:The P100 amplitude and latency were improved in cover group after amblyopia treatment in early period, partially covered group had no obvious changes than before treatment, there were significant changes in visual acuity increment in the two groups, indicating that cover group has better efficacy than the partially covered group. In the long term, no significant difference was found between the P100 amplitude, latency and visual acuity, which further indicate that the long-term efficacy of the two methods is the same and regular PVEP test can evaluate the therapeutic effect and provide guide for further treatment.

The effect of digital multimedia visual training applied after intermittent exotropia

Xiao-Dong Hu,Jing Chen,Xiu-Jun Peng,Shao-Ming Yan and Ming-Di Yang

AIM:To evaluate the effect of digital multimedia visual training in stereoacuity rebuilding of the postoperative intermittent exotropia. METHODS:Eighty-three patients with intermittent exotropia were randomly divided into 2 groups including treatment group and control group. In the treatment group, 41 patients were trained with digital multimedia system including antisuppression and fusion function training. In the control group, 42 patients received no any training. The differences of binocular visual and fusion range and final deviation were compared between the two groups before and after treatment. RESULTS:When compared with control group, the stereoscopic vision had significantly rebuilded (P<0.05), the fusion function was greatly enhanced (P<0.05), treatment group got better efficacy in final deviation (P<0.05). CONCLUSION:The digital multimedia visual training can promote binocular function and increase the final orthotropia ratio .The new treatment provides a new feasible way for intermittent exotropia clinical therapy.

Clinical effects of phacoemulsification combined with intraocular lens implantation in patients of cataract with idiopathic macular epiretinal membrane

Kang-Yi Luo,Bing Du,Xun-Qing Gu and Sheng Chen

AIM:To explore the clinical effects of phacoemulsification and intraocular lens implantation in patients of cataract with idiopathic macular epiretinal membrane. METHODS: Totally 112 patients (118 eyes) with coexisting cataract and idiopathic macular epiretinal membrane underwent phaco and intraocular lens implantation were analyzed retrospectively covering a period from 2008 to 2011.The patients were divided into three types according to their characteristics and OCT features: the early stage, the proliferative stage, and the traction stage respectively.The visual acuity, the best-corrected visual acuity (BCVA), the central macular thickness and the membrane shape were observed and analyzed before the surgery and at 1 week and 6 months after the surgery. RESULTS:The visual acuity and the BCVA of all the patients were improved more or less 6 months after the surgery . 100% and 73% of the eyes had a BCVA of ≥0.5 in the early stage and the proliferative stage respectively,with 53% of the eyes had a BCVA of ≥0.1 in the traction stage, whereas the central macular thickness had no significant difference. Vitrectomy and internal limiting membrane removal were performed in two patients in the traction group. CONCLUSION:Phacoemulsification and intraocular lens implantation is an effective and safe method for the management of cataract with idiopathic macular epiretinal membrane. The visual quality can be improved,whereas the retinopathy does not worsened.To the patients with cataract and idiopathic macular epiretinal membrane in the traction stage, combined surgery (vitrectomy, internal limiting membrane removal, phaco and intraocular lens implantation) should be performed.

Clinical observation of phacoemulsification combined with intraocular lens implantation on diabetic cataract patients

Ling Zhao,Yang-Yang Jin,Yan-Xia Zhang,Dong Li,Ying-Li Wang and Rong Fan

AIM:To discuss clinical therapeutic effectiveness of phacoemulsification and intraocular lens(IOL) implantation on diabetic cataract patients． METHODS:Totally 80 cases (106 eyes) of diabetic cataract patients underwent phacoemulsification and foldable IOL implantation through temporal transparent cornea incision．The postoperative complications, visual acuity and incision healing were observed. RESULTS:All operations were finished successfully with primary IOL implantation in capsule.3 months after operation the naked eyesvision≤0．1 were in 6 eyes(5.7％)，0．2-0．5 in 28 eyes (26．4％ )， 0．6-1．0 in 72 eyes (67．9％)．There was no bleeding during operation and no infection after operation. CONCLUSION: It is safe and efficient to treat diabetic cataracts with phacoemulsification combined with foldable IOL implantation．

Clinical analysis of small incision extracapsular enucleation combined with intraocular lens implantation for the treatment of cataract in primary level hospital

Zhi-Zhuang Wei,Han-Lin Qin,Dong-Dong Li,Qiao Huang and Liu-Pei Wei

AIM：To investigate the clinical effect and comprehension of the small incision extracapsular enucleation combined with intraocular lens implantation for the treatment of cataract in primary level hospital. METHODS：From January 2001 to December 2011, 2713 cases (3029 eyes) underwent small incision extracapsular enucleation combined with intraocular lens implantation, and the suitability of the surgery and treatment effects were analyzed. RESULTS: Postoperative vision was improved significantly, one day after operation, 2963 eyes(97.82%)whose visual acuity was better than 0.05 could obtain bright light. 2671 eyes (88.18%) whose visual acuity was better than 0.3 could get rid of disability. Seven day after operation, 3011 eyes (99.41%) whose visual acuity was better than 0.05 could obtain bright light. 2787 eyes (92.01%) whose visual acuity was better than 0.3 could get rid of disability. 3023 eyes (99.80%) implanted intraocular lens, main postoperative complications included 180 eyes of iritis,195 eyes of corneal edema, 138 eyes of post-capsular rupture, 30 eyes of iris damage（15 eyes of iridodialysis）, 23 eyes of intraocular hypertension, 25 eyes of hyphema and 24 eyes of crystalline lens residual.All complications could be cured by active treatment. The operation was simple and had less complications. CONCLUSION: The technique of small incision possesses satisfactory result, simple operation and cheap equipment, suitable for patients with cataract from poor areas in primary level hospital.

Clinical analysis of pre- and post-silicone oil removal combined with phacoemulsification

Yi-Xia Zhang,Wei Yang,Ming-Lei Qiu and Cai-Yun Li

AIM:To compare the effects of pre- and post- silicone oil removal combined phacoemulsification in silicone oil-filled eyes. METHODS: The clinical data of 36 patients (36 eyes) were analyzed. The 36 cataracts after silicone oil tamponade with pars plana vitrectomy were randomly divided into two groups. The two groups underwent combined phacoemulsification pre- and post-silicone oil removal respectively. The intraoperative and postoperative complications and postoperative anterior chamber reaction, intraocular pressure and corneal endothelium were observed. RESULTS:All patients operations were completed smoothly with silicone oil removal and IOL implantation, complications got effectively clinical control.The corneal endothelium cells densities and ratios of hexagonal cells were differently decreased.The ratios of hexagonal cells were significant difference between two groups of one week postoperatively. The corneal endothelial cell density and proportion of hexagonal cell were significant difference between two groups of one month postoperatively (P<0.05). CONCLUSION:The complications, anterior chamber reaction, and corneal endothelial lesion were less in group of pre-silicone oil removal combined phacoemulsification.

Alteration of major parameters of optic disk after compound trabeculectomy in primary open angle glaucoma patients with HRT-Ⅱ

Xu Huang,Yin Tang and Zhong-Ning Xuan

AIM:To evaluate the feasibility of application with HRT-Ⅱ to detect morphological alteration of optic disc in primary open angle glaucomatous patients after complex trabeculetomy. METHODS: Totally 20 eyes of 20 cases with different stages of primary open angle glaucoma （POAG）were performed with complex trabeculectomy. All patients IOP were controlled without medicines. The follow-up period was 24 months. HRT-Ⅱscanning was differently undergone in postoperation 3,6,12 and 24 months. RESULTS: There was significant difference (P<0.05) between preoperation and postoperation in cup/disk area ratio (C/D), rim area (RA), mean and superior /inferior retinal nerve fibre layer (mRNFL) in all patients with different stages. CONCLUSION:HRT-Ⅱ can be applied to detect the post-operative morphological alteration of optic disc in POAG patients with high objectivity and repeatability.

Clinical analysis of autologous serum eye drops in ocular surface disorders

Zhi-Rong Liu,Yue Zhang,Zheng-Zheng Wu,Hui Chen,Jin-Biao Zhang and Fang Li

AIM: To evaluate the effectiveness of treating ocular surface disorders using 100% autologous serum eye drops. METHODS: Totally 35 cases (35 eyes) who had persistent corneal epithelial defects or ulcer that were nonresponsive to conventional medical treatment or amniotic membrane transplantation or lamellar keratoplasty were reviewed.These patients were treated with 100% autologous serum eye drops for 2-6 weeks. Its symptoms and corneal epithelial repair were observed. RESULTS:In 35 eyes ,12 eyes (34.3%) healed within 2 weeks,14 eyes (40.0%) healed within 4weeks.But the corneal epithelium of 9 eyes (25.7%)did not recover within 4 weeks. In herpetic keratitis and neurotrophic keratopathy the cure rate and improvement rate were 47.6% respectively, 95.2% healed within 4 weeks by using 100% autologous serum eye drops.No side effects and secondary infections were detected. CONCLUSION: The use of 100% autologous serum eye drops appears to be an effective and safe medical therapy in the treatment of persistent corneal epithelial defects or ulcer especially caused by the herpetic keratitis and neurotrophic keratopathy.

Effect of Cyclogyl and compound tropicamide on cycloplegia

Ying Zhang and Yu Liu

AIM:To investigate the effect of Cyclogyl and compound tropicamide on cycloplegia with objective assessment to guide their clinical work. METHODS: Totally 60 cases(120 eyes) of myopia and hyperopia(each of 50%) aged 12 to 40 years from 2010/12 to 2011/03 were randomly selected.They were conducted mydriasis with domestic compound tropicamide eye drops 4 times, and retinoscopy 45 minutes later, and measured the amount of residual accommodation with integrated refractor.They were reinspected with Cyclogyl on the second day. RESULTS: In the hyperopia group, there were significant differences in refraction results between Cyclogyl and compound tropicamide (P<0.01); there were less differences in the myopia group (P<0.05), but still statistically significant. CONCLUSION:Clinically for refraction of patients with refractive error, compound tropicamide eye drops is an effective cycloplegic, but because of its limited cycloplegia and relaxation of accommodation, especially in hyperopic patients, it should be integrated with other relaxation methods, such as Cyclogyl, to get the final glasses prescription.

Clinical observation of silicone intubation combined with laser by endoscopy for lacrimal duct obstruction

Yong Chen,Li-Xin Chen,Yan-Ju Yue,Su-Yu Gan,Hua Wu and Xu-Qin Yi

AIM:To evaluate the effects of silicone intubation combined with laser by endoscopy for lacrimal duct obstruction. METHODS: Totally 186 patients (238 eyes) with obstruction of lacrimal passage were treated with the above method from May 2008 to June 2010. Tears recovery and fluorescein excretion test were used to determine the lacrimal duct patency. RESULTS: After the mean follow-up for 5.6 months, 214 of the 238 troubled eyes(89.9%) got cured, 20 eyes (84%) turned for better,4 eyes (1.7%) showed no effect. The total effective rate was 98.3%. CONCLUSION:Combination of laser and silicone intubation by endoscopy is a useful, economical and feasible method to treat the obstruction of lacrimal passage.

Nd:YAG laser combined with novel lacrimal duct stent treatment for nasolacrimal duct obstruction

Xue-Ping Wang and Zi-Qiu Wu

AIM:To evaluate the clinical effects of Nd:YAG laser combined with novel lacrimal duct stent implantation treatment for nasolacrimal duct obstruction． METHODS:Totally 26 cases (29 eyes)with nasolacrimal duct obstruction were implanted with lacrimal duct stents after Nd:YAG laser surgery, and irrigated lacrimal duct regularly after surgery. RESULTS:All cases were followed up for 9-12 months.22 eyes were cured， 5 eyes improved，and 2 eyes(7%) treated ineffectively．The total efficiency was 93％. CONCLUSION:The novel lacrimal duct stent and the operation procedure are safe and simple,with less tissue hurt.It is an effective method for treating lacrimal duct obstruction and chronic dacryocystitis.

Investigation of the clinical characters of subconjunctival hemorrhage

Jun Zhang,Sen-Yu Liu,Pu Wang and Zi-Cheng Zhu

AIM:To investigate the clinical characters and causes of subconjunctival hemorrhage(SCH). METHODS: A total of 103 patients with SCH aged 0-83 years were studied. The conjunctiva was divided into 10 equal areas. The age, gender, medical history, ocular disease history and site of subconjunctival hemorrhage were determined for all subjects. RESULTS:The number of patients involved by SCH showed an age-related increase. The number of patients with SCH increased markedly in 41-50 years of age and 61-70 years of age(0-10 years:5 patients,11-20 years:5 patients,21-30 years:10 patients, 31-40 years:15 patients, 41-50 years:24 patients, 51-60 years:14 patients, 61-70 years:24 patients, 71-80 years:5 patients, and over 80 years:1patient). The number of patients with traumatic SCH was 18 patients(54.1%) in less than 40 years of age, the number of patients with SCH by hypertension was 17 patients(56.7%) after the age of 60 years. Overall SCH was significantly more common in the temporal areas than other areas (45.6%). However the temporal areas were affected more often in traumatic SCH (50.0%). Summer subconjunctival hemorrhage was in 43 patients (41.7%). CONCLUSION: SCH showed an age-related increase in extent and was predominant in the temporal areas. However traumatic SCH was usually detected as localized hemorrhage in the temporal areas. The peak season for SCH was summer in all age groups. The trauma is the main reason in the younger group(≤40 years), but hypertension was the major risk factor in the older group(＞60 years ).

Clinical curative effect of lifting flaps for LASIK enhancement

Hong-Jun Wang and Chun-Jian Mo

AIM：To discuss the efficacy and safety of lifting flaps for laser in situ keratomileusis (LASIK) enhancement. METHODS：Totally 25 cases (36 eyes) of post-LASIK with residual refractive error were performed enhancement using lifting flaps, then ablated corneal stroma by excimer laser procedure. Postoperative follow-up survey included visual acuity, refractive error and complications for 1 year. RESULTS：The average uncorrected visual acuity improved from preoperative 0.39±0.16 to postoperative 092±0.17, 1.01±0.16, 1.03±0.16, 1.04±0.18 at 1 month, 3, 6, 12 months. The pre-operative mean spherical equivalent changed from -1.87±0.64D to 0.21±0.43D at post-enhancement 12 months. There was significant difference between them (P<0.01). CONCLUSION：Ｌifting flaps for LASIK enhancement is safe and effective to treat LASIK postoperative undercorrection and reftactive regression treatment.

Pars plana vitrectomy evaluating vision prognosis in eye injuries with non-light perception

Xue-Jing Li,Shou-Kang Zhang and You-Zhi Tang

AIM:To select suitable surgery by pars plana vitrectomy(PPV) evaluating severity of the ocular trauma and vision prognosis in eye injuries with non-light perception. METHODS: Eight cases(8 eyes)with non-light perception in complicated ocular trauma were treated with vitrectomy surgery. RESULTS:After the surgery, non-light perception was in 5 eyes, finger counting in 1 eye, hand motion in 1 eye, 0.05 in 1 eye. In the operation, the author altered the way of performing operation to evisceration and orbital implant of hydroxyapatite in 2 eyes, eyeball enucleating in 1 eye 4 months after vitrectomy surgery, silicone oil tamponade in the other 3 eyes. CONCLUSION: PPV can evaluate severity of the ocular trauma and select the suitable operation method.

Eye position influence on far and near stereoscopic vision of intermittent exotropia patients

Hui Qiu,Ming-Yu Shi,Hong-Yang Li and Jin-Song Zhang

AIM:To analyze the eye position influence on far and near stereo vision of intermittent exotropia patients. METHODS:Far stereo vision was tested by Clement Clarke International synoptophore, using random-dot picture card.Near stereo vision was tested with three-dimensional map. Far and near stereo vision of 40 intermittent exotropia patients were measured preoperative and postoperative a week respectively, and the results were analyzed. RESULTS:Preoperative existence ratio of near stereo vision was higher than the rate of far stereo vision. Preoperative visual acuity distribution of near stereo vision was different from normal. Postoperative far and near stereo vision were improved in varying degrees. The difference was statistically significant. CONCLUSION:Intermittent exotropia patients have different degree far and near stereo vision. The stereo vision damage in intermittent patients shows the loss of far stereo vision and the decline of near stereoacuity.Most patients with intermittent exotropia have near stereo vision, but the stereoacuity is lower than normal. The operation of eye position correction is important for near stereoacuity improvement and far stereo vision reconstruction. Surgery timing for patients with intermittent exotropia should be referred to the distance and near stereoscopic vision test results.

Analysis of refraction error of high myopia patients with cataract after phacoemulsification

Qin Yang,Ping Tang,Xin-Hua Cui,Xing-Xing Cai and Pei-Fei Chen

AIM:To study the factors influencing the refraction of high myopia patients with cataract after phacoemulsification and intraocular lens implantation. METHODS:Phacoemulsification and intraocular lens implantation were performed on 30 patients (38 eyes) with axial high myopia and cataract. Three months after operation, postoperation refractions were measured and compared with predictive refractions. RESULTS: The average predictive refraction of 38 eyes was -1.39±0.47D.The average postoperative refraction was -0.87±0.93D.The average refraction error was -0.67±0.74D.There was significant statistical difference (t=3.375,P=0.002). There was low correlation between absolute refraction error and k-reading (r=0.443), and there was high positive correlation between refraction error and axial length (r=0.909). The absolute refraction error increased with the axial length growth. The average refraction error in eyes with axial length of 26-29mm was 0.61±0.39D, and with axial length ≥29mm was 1.37±0.84D.The difference was statistically significant (t=2.8601,P=0.005). The absolute refraction errors in eyes with axial length of 26-29mm were all less than 2.00D, and the refraction errors of six eyes with axial length of ≥ 29mm were ≥ 2.00D, accounting for 32%. CONCLUSION: The axial length is one of the most important factors which influence the postoperative refractive error of high myopia with cataract surgery.

SIRIUS 3D topography in the diagnosis of keratoconus

Yan Qiu,Yan-Zhen Zheng,Guo-Guang Zhai,Yu-Lan Di and Yao-Yu Li

AIM:To discuss the characteristics of corneal topography for keratoconus patients and provide objective and feasible basis for diagnosis of keratoconus. And to conduct strict screening on corneal refractive surgery patients using corneal topography to increase the predictability of the operation. METHODS:Eleven cases of keratoconus patients and 11 eyes of suspected keratoconus patients used the SIRIUS 3D corneal topography instrument to check. The morphology of corneal anterior and posterior surface topography, central corneal refractive power, inferior and superior central corneal difference of average refractive power (I-S) and surface asymmetric index (SAI)were obtained. RESULTS: Keratoconus corneal thinnest point was not in the central cornea,but located to the top of the cone of the third quadrant, and surrounded by the concentric circles with refractive power gradually reduced.The difference in central corneal refractive power between keratoconus and suspected keratoconus had statistical significance. Keratoconus and suspected keratoconus corneal thickness difference was statistically significant difference.The highest points on corneal anterior and posterior surface and corneal thinnest point of keratoconus and suspected keratoconus were generally identical in SIRIUS 3D corneal topography, which accorded with the trend of the development of keratoconus. Its vectogram has a certain significance in the judgement of keratoconus. CONCLUSION: The SIRIUS 3D corneal topography is an effective method of early diagnosis of keratoconus, providing a reliable basis for the patients screening before corneal refractive surgery.

Choice of parameters about Moria M2 microkeratome suitable for the Central Plains people

Yan-Dong Liu,Hua Shen,Yin-Bo Zhang,Jun Li and Ji-Ling Zhang

AIM:To study the choice of parameters about Moria M2 microkeratome suitable for the Central Plains people,and to produce the desired corneal flap. METHODS:Totally 300 cases (594 eyes) with myopia from November 2009 to February 2012 in Xingtai Eye Hospital excimer laser treatment of myopia department were collected,which were conducted LASIK and came from the Central Plains region. 154 cases (305 eyes) were male (51.35%); 146 cases (289 eyes) were female (48.65%). The mean preoperative corneal curvature ranged from 40D to 47D. Corneal flap were made with Moria M2 in different curvature of the cornea, suction ring and stop position ,and corneal diameter, diameter of the corneal flap and pedicle width were measured to compare. The data were analyzed with SPSS 13.0 statistical software, two-sample mean comparison t test. RESULTS: Patient’s distribution: Hebei Xingtai 101 cases（33.67%）, Hebei Handan 56 cases（18.67%）, Shandong Liaocheng 31 cases（10.33%）, Shanxi Changzhi 23 cases （7.67%）, Henan Anyang 48 cases（16.00%）, Henan Puyang 16 cases（5.33%）, Henan Hebi, 25 cases（8.33%）. Corneal diameter on average was 11.35±0.25mm,corneal flap diameter on average was 8.83±0.47mm, corneal flap pedicle width on average was 4.28±0.82mm. Pedicle width and diameter of the corneal flap showed a positive correlation. In the case of the same curvature and stop position of blade, corneal flap diameter was positively correlated with width of the pedicle, and was negatively correlated with suction ring (P <0.05). In the case of the same suction ring and stop position of blade, corneal flap diameter and pedicle width with curvature were positively correlated (P<0.05). In the case of the same curvature and the suction ring, pedicle width and stop position of blade were negatively correlated (P<0.05). CONCLUSION:The cornea diameter of Central Plains people is generally smaller than the foreigners, we could reference to data table suitable for the Central Plains people when we conduct LASIK with Moria M2 microkeratome.

Application of multifocal electroretinogram and colour Doppler imaging in retinal detachment patients

Hai-Xia Zhang,Chang-Sheng Feng,Guang Zeng and Dong-Yan Hu

AIM:To determine the prognosis by evaluating the retinal function and hemodynamic changes pre-and postoperation in retinal detachment patients, and investigate the clinical value of the techniques. METHODS: Central retinal arteries（CRA）were studied with color Doppler imaging （CDI）in 62 cases with unilateral rhegmatogenous retinal detachment, the fellow eyes served as control. The measured parameters included peak systolic velocity (Vmax), end diastolic velocity (Vmin) and resistance index(RI).The preoperative and postoperative retinas of retinal detachment were detected with multifocal electroretinogram (mfERG). RESULTS：There were no significant differences between the sick eyes and control eyes in the CDI parameters of CRA preoperatively. RI was significantly elevated (P<0.05), Vmax and Vmin were significantly declined (P<0.05) 2 weeks postoperation. The amplitude of a wave and b wave of mfERG were both significantly elevated in the detached area after retinal detachment operation(P<0.05). Compared with preoperation, the latent period decreased (P<0.05). CONCLUSION: Retinal reattachment and CRA hemodynamics are evaluated with combined mfERG and CDI examination, to avoid impaired reattachment and scleral ischemia after local silicone sponge implant.

Stochastic comparison research of Knife 90 and 110 of Moria M2 application in LASIK

Zhi-Cheng Shi,Li Wang,Huan Huang,Min Mo,Xiu-Yun Wu and Xiao-Liu Luo

AIM:To study the curative effect,complications, safety and merit of Knife 90 and 110 of Moria M2 in excimer laser in situ keratomileusis(LASIK) for myopia. METHODS:The selected 105 cases (202 eyes) of LASIK surgery patient were divided into two groups according to the stochastic tables. Knife 90 of Moria M2 was used in 51 cases (98 eyes) of LASIK patients, Knife 110 in 54 cases (104 eyes) of LASIK patients as control.After operation, optical coherence tomography (OCT) was used to detect two groups of corneal flap thickness.Two groups of techniques were observed 1 day, 1 week, 1 month, and 3 months postoperatively with uncorrected visual acuity (UCVA), corrected visual acuity(CVA) and corneal flap shape, involution situation, complications. RESULTS:Corneal flap thickness of Knife 90 group was 118.3±15.2μm, corneal flap thickness of Knife 110 group was 130.5±17.1μm, having significant difference. Knife 90 group had not discovered interlaminar punctiform metal detritus, Kinfe 110 group had interlaminar punctiform metal detritus case (12 cases), having significant difference.The two groups were similar in form of the corneal flap, involution situation, postoperative reaction and postoperative UCVA. CONCLUSION: The LASIK efficacy and complications of Knife 90 are similar with Kinfe 110, however, Knife 90 can retain a relative thicker cornea stroma, correct higher diopter, howe less interlaminar punctiform metal detritus and complications, therefore it has better safety and adaptation range．

Effect of vitrectomy and internal limiting membrane peeling for macular hole with retinal detachment

Juan Peng,Xiang-Yin Sha and Rui-Ming Yang

AIM:To analyse the outcome and complication of vitrectomy and internal limiting membrane peeling for macular hole with retinal detachment. METHODS:Twenty-two cases (22 eyes) were observed from September 2009 to December 2011.All the cases underwent vitrectomy and internal limiting membrane peeling. The best-corrected visual acuity and intraocular pressure were observed before and after operation.The data of first three days, a week and a month after operation were evaluated by statistical analysis. RESULTS:Thirteen cases underwent vitrectomy with C³F⁸ while the other 9 cases with silicon oil. The rate of anatomical closure was 100%.The best-corrected visual acuity was elevated gradually after operation. The intraocular pressure raised in first three days and went down after a week.The outcome was better in group with the course of the disease less than 6 months.There was no correlation between the best-corrected visual acuity of postoperative 1 month and patients age. CONCLUSION:Vitrectomy and internal limiting membrane peeling is effective for macular hole with retinal detachment.It can improve vision.

Clinical investigation of foscarnet sodium eye drops for the treatment of epithelial herpes simplex keratitis

Jing Yu1 and Ming-Chang Zhang

AIM: To investigate clinical effect of epithelial herpes simplex keratitis (HSK) treated by foscarnet sodium eye drops in the early and middle term.  METHODS:Totally 60 cases (60 eyes) with HSK at Zhongxiang Peoples Hospital from March 2008 to December 2009 were enrolled. All the patients were divided into control group and experimental group randomly. Control group patients were treated by ganciclovir eye drops, 8 times per day, while experimental group patients were treated by foscarnet sodium eye drops, 6 times per day. All patients were treated for 14 days and were followed up for 2 years. The medication outcome and recurrence rate were investigated.  RESULTS:There were no significant differences between control and experimental group in clinical characteristics of patients including age, gender, mean score of symptoms and signs before treatment (P>0.05). After therapy, both the corneal ulcer area and the score of symptoms and signs in control group patients and experimental group patients decreased significantly than those before treatment(P<0.05). But between two groups after treatment, the differences were not remarkable (P >0.05). In the 2 years follow-up, the recurrence rate in experimental group was significantly reduced compared with that in control group (P <0.05). CONCLUSION: Foscarnet sodium eye drops play a similar role in therapy of HSK with ganciclovir eyedrops in early stage, while may decrease the recurrence rate of HSK in the middle term."

Effect of thin-flap LASIK on corneal sensitivity of different positions

Hui-Na Li,Yi-Zhuang Li and Tao Qian

AIM:To evaluate changes in corneal sensitivity of different positions following thin-flap laser in situ keratomileusis (LASIK).  METHODS:Corneal sensitivity was measured in 43 cases (84 eyes) before and 1 month, 3 months after correction of myopia by thin-flap LASIK. Sensitivity measurements were made with an esthesiometer at the central,temporal,inferior,nasal and superior points on the corneal flap.The data were statistically analysed. RESULTS:The corneal sensitivities after thin-flap LASIK were reduced during the first month after surgery at any points on the corneal flap. Corneal sensitivity was significantly decreased at the central point. The corneal sensitivities of all the positions except the central point were recovered to preoperative levels at postoperative 3 months.Compared with postoperative 1 month, the central corneal sensitivity significanthy recovered, which has statistical significance. However, compared with preoperation, it decreased, which also has statistical significance. CONCLUSION: The corneal sensitivity is significantly reduced following thin-flap LASIK during the first month, with a return to preoperative levels at postoperative 3 months. The recovery of central corneal sensitivity needs more time.

Clinical curative effect of improved pouch-shaped conjunctival flaps in treatment of refractory corneal ulceration

Dan-Dan Xu,Hai-Jun Liu and Zi-Bin Liu

AIM:To study the clinical curative effect of improved pouch-shaped conjunctival flaps in treatment of refractory corneal ulceration. METHODS:Totally 36 cases (36 eyes) with refractory corneal ulceration that was not cured with routine medical therapy were performed with removal of the necrotic corneal tissue combined with improved pouch-shaped conjunctival flaps covering surgery. Original diseases were further taken medical treatment postoperatively. Follow-up lasted 3-6 months. RESULTS:Corneal ulcer of 35 eyes were healed.Only 1 eye with corneal ulceration perforation lost solution in the middle which was not close to the cornea after conjunctival flap, which was operated again and combined with amniotic membrane transplantation and eventually corneal ulcer healed. All of the 36 eyes were healed. CONCLUSION: Improved pouch-shaped conjunctival flaps surgery is a distinct efficative method in the treatment of refractory corneal ulcer which can not be cured with routine medical therapy.It can effectively inhibit the inflammatory reaction and better protect the eyeball.

Clinical analysis of corneal edema after cataract phacoemulsification surgery

Chao Zhang,Hong Tang,Ping Qin and Li Jia

AIM:To analyze the correlative factors of the corneal edema after cataract phacoemulsification. METHODS:The relations between the corneal edema and age,rigidity of lens nucleus,glaucoma, diabetes in 532 cases (564 eyes) after cataract phacoemulsification were studied. RESULTS:There were 118 eyes of corneal edema in 564 eyes, the rate of corneal edema was 20.9%. The incidence of patients older than 70 was 24.0%,Ⅳ level of lens nucleus was 36.9%,Ⅴ level of lens nucleus was 100%, patients with operation for glaucoma was 68.1%, and patients with diabetes was 48.6%. CONCLUSION:Corneal edema after cataract phacoemulsification surgery has parallel correlation with age and rigidity of lens nucleus. Its easy to occur in patients with diabetes or operation for glaucoma.While, patients with no ocular operation, diabetes mellitus have a lower rate of corneal edema and lighter reaction.

Clinical observation on the curative effect of double fresh amniotic membrane covering in the treatment of fungal corneal ulcers

Rong-Hua Fu,Yuan-Yuan Li and Ping Liu

AIM:To observe the curative effect of double fresh amniotic membrane covering in the treatment of fungal corneal ulcers. METHODS:Totally 35 cases (35 eyes) in patients with corneal ulcers were completely removed necrotic tissue, with double fresh amniotic membrane to cover the cornea and fixed with suture.Drugs were applied to inhibit inflammation, and they were followed up for 6 to 12 months. RESULTS:Corneal ulcers in 33 cases were cured, 2 cases failed.Overall vision was markedly improved. CONCLUSION:Double fresh amniotic membrane covering is an effective method for treatment of corneal ulcers.

Conjunctival flap covering combined with iris incarcerating surgery for the treatment of full-thickness fungal keratitis

Yan-Dong Liu

AIM: To observe efficacy of conjunctival flap covering combined with iris incarcerating surgery for the treatment of full-thickness fungal keratitis. METHODS:Totally 26 cases(26 eyes) with fungal keratitis which were conducted conjunctival flap covering combined with iris incarcerating surgery from March 2005 to April 2011 in Xingtai Ophthalmology Hospital were analysed. All the range of lesions <5×5mm², all fungal hyphae were positive in corneal scraping examination: hypopyon (+), lesions relatively dense. The depth of lesions could not be determined before surgery. During surgery, when the lesion was cutted close to descemet, based on clinical features, according to the lesions ≤ 1mm in diameter, artificially pierced the cornea residual disease near surrounding, and resulted in corneal perforation. After aspirated hypopyon and polished smooth endothelial plaque, the nearby iris was incarcerated among the corneal perforation, and fixated by suturing 1 or 2 needles, and conducted conjunctival flap covering surgery at last, tried to maintain water density. Anti-fungal treatment and closed observation should also maintain after surgery. RESULTS:Five of 26 cases self-ruptured during the lesion cutting, 3 cases accidentally cutted through,18 cases of corneal stromal bed were complete in cutting process, recovery time of conjunctival epithelial was 13.44±2.21days. 24 cases of infection were controlled, the success rate was 92%. Due to uncontrolled infection, two cases were performed keratoplasty, and finally the infection was under control. CONCLUSION:Conjunctival flap covering combined with iris incarcerating surgery is effective for the treatment of small-scale and full-thickness fungal keratitis, which could control infection, and create conditions for future improving vision surgery, and suitable for carrying out in the primary hospital.

Security analysis on patients with eld or concomitant systemic disease in scale cataract surgery

Jian Wang,Ming-Chang Jin,Shao-Jun Duan,Zheng-Fang Zhang and Feng Jin

AIM:To discuss the security on patients with eld or concomitant systemic disease in scale cataract surgery. METHODS:The clinical data of 235 patients above 75 years or with systemic disease in “love and light” activity were retrospectively analysed. RESULTS:There were 213 cases (257 eyes) with systemic disease(90.6%). The ratios of circulation system disease, metabolic disease, and respiratory system disease were 65.1%, 13.6% and 11.1%, respectively. There were 25 cases (10.6%) deferring surgery because of the first preoperative evaluation of systemic disease and the surgery was done after effective treatment. The surgery off-disability and off-blindness rates were 95.4% and 84.2%, respectively. 12 cases with vision <0.1 had different degree of fundus disease. CONCLUSION:Strengthening preoperative comprehensive assessment, treating systemic disease fully, mastering operation indication strictly, monitoring in operation, operating legerity and 10-15 minutes surgery time were the effective measures to guarantee the security of patient with eld or concomitant systemic disease in scale cataract surgery.

Application of anterior lens capsule in combined glaucoma and cataract surgery

Jian Yang,Hai-Yan Qin,Bing Wu and Feng Sun

AIM:To explore application results of anterior lens capsule in combined glaucoma and cataract surgery . METHODS:Twenty-three cases（25 eyes）of glaucoma complicated cataract underwent trabeculectomy, phacoemulsification and foldable intraocular lens implantation surgery. The curvilinear autologous anterior capsule was placed under the scleral flap after repeated washing with BSS liquid intraoperatively. Intraocular pressure and visual acuity were mainly observed in patients 1 day, 1 week, 3 weeks, 1 month and 6 months after operation and field of vision, filtering bleb and complications were recorded. RESULTS: The average IOPs of 1 day, 1 week, 3 weeks, 1 month and 6 months after operation were 18.3±1.5,1732±0.82,15.71±0.71,16.17±0.52,16.87±0.71mmHg (1kPa=7.5mmHg) respectively, compared with the preoperative (4516±4.41) mmHg, the differences were statistically significant (allP<0.05). The mean preoperative visual acuity was 0.12±0.08, 2 months after operation ,the visual acuity was below 0.1 in 2 eyes (8%), 0.1 to 0.2 in 3 eyes (12%), 0.3-0.6 in 13 eyes (52%), 0.8 to 1.2 in 7 eyes (28%), postoperative visual acuity improved significantly, the differences were statistically significant (allP<0.05). Preoperative and postoperative mean visual field defect value and the average standard value of the difference were not statistically significant (allP>0.05). After operation, functional bleb formed in 23 eyes, accounting for 92%，non-functional bleb in 2 eyes, accounting for 8%. Intraoperative posterior capsular rupture occurred in 1 eye, no vitreous prolapse and other complications occurred. CONCLUSION:Anterior lens capsule used in combined glaucoma and cataract surgery can effectively reduce intraocular pressure with long-term and effective retention of functional bleb to improve vision, the success rate is high with no significant complications, and patients with combined surgery can reduce the economic burden.

Effect of vision improvement on physical and cognitive function of adults with age-related cataract

Cheng Lei,Xiao-Liang Luo and Xiao-Jie He

AIM:To evaluate the effect of vision improvement induced by phacoemulsification on physical and cognitive function in aged adults. METHODS:A total of 64 cases with age-related cataract were enrolled in this study.Phacoemulsification combined with intraocular lens implantation was performed on 40 cases and the others who were eligible for but declined cataract surgery were allocated to a control group. Physical function was assessed using functional independence measure (FIM), survey of activities and fear of falling (SAFE) measure at baseline and 6 months after surgery. The mini mental state exam (MMSE) was also administered for cognitive function assessment. RESULTS:Significant difference existed within or between groups from baseline to follow-up on either of the measures of physical function. MMSE scores declined in both groups postoperatively.Significant difference was observed in the control group but not in the cataract surgery group. CONCLUSION:Vision enhancement induced by phacoemulsification leads to improvement in physical function but not in cognitive function.

Clinical observation on phacoemulsification in patients with cataract and angle-closure glaucoma

Xiu-Jun Peng,Gui-Qin Wang and Na Li

AIM:To observe the effectiveness and safety of phacoemulsification with intraocular lens (IOL) implantation or combined with trabeculectomy in patients with cataract and angle-closure glaucoma. METHODS:In 251 cases （279 eyes）with cataract and angle-closure glaucoma，208 eyes in which the wideness of the anterior chamber angle was NⅠ-NⅡ had been performed phacoemulsification and IOL implantation ；71 eyes in which the wideness of the anterior chamber angle was NⅢ-NⅣ had been performed phacoemulsification and IOL implantation combined with trabeculectomy. RESULTS: Followed up for 3 months，intraocular pressure kept normal in all 208 eyes in the group of phacoemulsification and IOL implantation；intraocular pressure kept normal in 68 eyes in the group of phacoemulsification and IOL implantation combined with trabeculectomy，intraocular pressure in 3 eyes was 20-25mmHg for 1 week after operation，and then was controlled to normal with 50g/L Betoptic. CONCLUSION:Phacoemulsification and intraocular lens implantation or combined with trabeculectomy is an effective and safe surgical technique with less complications for the cataract and angle-closure glaucoma.

Surgery in early primary angle-closure glaucoma with cataract

Min Fang,Yi-Qun Hu,Cong-Ling Chen and Hong-Bo Cheng

AIM:To study the safety and efficacy of phacoemulsification and intraocular lens implantation in early primary angle-closure glaucoma with cataract. METHODS:Early primary angle-closure glaucoma patients with cataract were divided into two groups randomly, one group was treated with laser peripheral iridotomy, the other group was treated with phacoemulsification and intraocular lens implantation. Intraocular pressure and eye sight were compared after surgery, the follow-up was 3 months. RESULTS:Both groups could have results of deeper peripheral anterior chamber and wider anterior chamber angle in different extend, however, patients in laser group didnt have their eyesight improved, patients in phaco group had obvious eye sight improvement, and anterior chamber angle widened in all the patients, some peripheral angle synechia reopened after surgery. CONCLUSION: Phacoemulsification and intraocular lens implantation is safe in early primary angle-closure glaucoma with cataract, is equally effective in plateau iris configuration, and can improve eyesight at the same time.

Modified trabeculectomy combined with amniotic membrane implantation for treatment of refractory glaucoma

Jiang-Shan Cai,Fa-Zhong Li,Yan-Jiao Liao and Zhi-Hao Gu

AIM:To explore the clinical efficacy of modified trabeculectomy combined with amniotic membrane implantation on refractory glaucoma treatment.  METHODS: A total of 40 cases (48 eyes) were treated with modified trabeculectomy combined with amniotic membrane implantation and routine trabeculectomy respectively. Comparison of two groups was carried out on the aspects of intraocular pressure (IOP), filtering bleb, visual acuity and complication of operation.  RESULTS:One year after the surgery, no shallow anterior chamber occurred, with normal IOP, functional filtering bleb, improved visual acuity and less complications were in combined treatment group, showing significantly increased benefit when compared to those in routine trabeculectomy.  CONCLUSION:Combined modified trabeculectomy and amniotic membrane implantation is an easy, safe and effective method for treatment of refractory glaucoma, which is suitable for universal promotion."

Clinical study of trabeculectomy combined with sclera flap invagination in the treatment of neovascular glaucoma

Zhong Yue,Sen Song,Li Feng,Shi-Qiang Li,Qian Yang and Yi-Xuan Sun

AIM:To evaluate the clinical effect of trabeculectomy combined with sclera flap invagination in the treatment of neovascular glaucoma(NVG). METHODS:Forty-eight cases (48 eyes) with neovascularization were performed trabeculectomy combined with sclera flap invagination .The visual acuity, intraocular pressure (IOP), anterior chamber (angle of anterior chamber), hyphema, iris neovascularization and filtering bleb after operation were observed. All patients were followed up for 6-12 months. RESULTS:About 6-12 months after operation, IOP were controlled in less than 21mmHg in 40 cases.Symptoms of 6 cases were alleviated, and the IOP were controlled in less than 21mmHg with treatment of carteolol hydrochloride eye drops. CONCLUSION:Trabeculectomy combined with sclera flap invagination is an ideal treatment for NVG.

Amniotic membrane implantation and mitomycinc in non-penetrating trabecular surgery for the treatment of primary open angle glaucoma

Xiao-Bo Yang,Li-Juan Chen and Juan Li

AIM:To probe into the effect of amniotic membrane implantation and mitomycinc in non-penetrating trabecular surgery (NPTS) for the treatment of primary open angle glaucoma(POAG). METHODS:Forty-two eyes of 30 POAG patients were treated with amniotic membrane implantation and mitomycinc in NPTS. RESULTS:Intraocular pressure: (35.76±6.34)mmHg before the operation, (13.82±4.22) mmHg after the operation. Visual acuity：12 eyes higher than before the operation, 26 eyes remained the same ,4 eyes worse than before. Visual field:34 eyes expanded relatively, 8 eyes remained the same. Follicle：flat bleb in 38 eyes, cyst bleb in 3 eyes, scar organized bleb in 1 eye. Anterior chamber: No shallow anterior chamber observed in all cases. CONCLUSION:Amniotic membrane implantation and mitomycin in NPTS for the treatment of POAG seems a simple, safe and effective procedure of anti-glaucoma operation.

Multi-factor analysis of the effects on visual acuity prognosis of intravitreal Avastin and macular grid photocoagulation for diabetic macular edema

Yi-Qun Hu,Qing-Shan Chen,Min Fang,Jie-Ting She and Xu Yang

AlM：To investigate the related factors of effects on best-corrected visual acuity (BCVA) after intravitreal Avastin combined with macular grid photocoagulation(MGP) for diabetic macular edema(DME). METHODS：A retrospective review of a consecutive series of 41 DME patients(41 eyes) who received intravitreal Avastin combined with MGP. Gender, disease course, the changes of central macular thickness (CMT), type of DEM, changes of postoperative CMT, massive subfoveal hard exudates and visual acuity 1 month after treatment were recorded. Multi-factor regression analysis of BCVA after the combined treatment was performed with SPSS statistics software. P<0.05 was considered statistically significant.  RESULTS: The postoperative BCVA was related to the preoperative BCVA, disease course, the changes of CMT and massive subfoveal hard exudates (P<0.05). CONCLUSlON: The better preoperative BCVA is, the better postoperative BCVA would be. Early treatment for the patients with DME would get better postoperative BCVA. Postoperative BCVA is relatively improved in patients with obvious regression of macular edema. Patients with massive submacular hard exudates could hardly be improved in postoperative BCVA.

Relationship of macular area thickness and related biochemical indicators in patients with early diabetes

He-Peng Zhang and Bing Li

AIM: To study the relationship of retinal thickness at macular area and related biochemical indicators in early diabetic patients. METHODS:Diabetes group had 40 cases (40 eyes), male and female 20 cases of each).The control group had 40 cases (40 eyes, male and female 20 cases of each), optical coherence tomography (OCT) was applied to measuring the retinal thickness at macular area. Related biochemical analyzer was used to test microalbuminuria (mAIb), glycated hemoglobin (HbA1c),c-peptide (C-PR),total cholesterol (TC),triglycerides (TG),low density lipoprotein (LDL),and high-density lipoprotein (HDL) values in the diabetes group. Two groups of retinal thickness at macular area were compared and the relationship of macular area thickness and related biochemical indicators in the diabetes group was analysed. RESULTS: Macular area in the selected diabetes group patients was thicker than that in normal group, which was positively correlated with mAIb, TC, TG, and LDL(P＜0.05) , negatively with HDL(P＜0.05) and uncorrelated with HbA1c and C-PR(P＞0.05). CONCLUSION:For patients with early diabetes, detecting the macular area thickness and mAIb, TC, TG, LDL, HDL changes is conductive to the early prediction of complications of diabetes.

Research of wavefront aberrations in myopia

Chun Zhang,Zong-Hui Yan,Ming Li,Hui-Li Jia,Bao-Wen Gu and Xu Yang

AIM:To investigate the related factors in the ocular aberrations induced by myopia. METHODS:The ocular aberrations of 115 cases ( 218 eyes ) were measured before laer in situ keratomileusis (LASIK) refractive surgery in our hospital by Zywave. Preoperative examinations included contrast sensitivity and wavefront aberrations for both eyes by Zywave (Hartmann-Shack wavefront aberrometer). RESULTS:About 89% of all in ametropia people was low order wavefront aberration (defocus and regular astigmatism),and 3^rd order and above were only about 11%, Individual difference was large in high order aberrations from 1.86 to 0.03.RMS was increased with the larger pupil zone. The correlations between the components of wavefront and contrast sensitivity were weak negative.There were no correlations between the RMS of high order aberration and diopter in eyes with myopic spherical errors below -6.00D, whereas in eyes with errors between -6.00D and -14.00D,the correlations were stronger.The RMS of 3^rd and 4^th order aberration were positively correlated with astigmatism. There was no obvious difference between female and male. CONCLUSION:Wavefront aberration of the myopia patients is affected by specific conditions, personalized surgical removal of the wavefront aberration should be thoughtful."

23-gauge sutureless vitrectomy for rhegmatogenous retinal detachment

Yan Zhang

AIM:To evaluate the safety and efficacy of 23-gauge transconjunctival sutureless pars plana vitrectomy for rhegmatogenous retinal detachment( RRD). METHODS:Totally 26 consecutive cases(26 eyes) were recruited between March 2010 and June 2011. All surgeries were performed with the 23-gauge technique. Main outcome measures included visual acuity, intraocular pressure, operative complications．Postoperative mean follow-up were 3 months． RESULTS:Anatomical success was achieved in 81% of 21 cases with single surgery and rose to 96% of 25 cases with additional surgery. Mean visual acuity improved in 21 cases （80%），unchanged in 3 cases（12%），declined in 2 cases（8%）. The differences of intraocular pressure at postoperative 1 day was significant（P<0.01）.Two cases with ocular hypotony (intraocular pressure ≤6mmHg), sustained for 2 weeks and did not occur choroidal detachment. CONCLUSION:Acceptable anatomical and functional success rates can be achieved with 23-gauge transconjunctival sutureless vitrectomy for RRD. The main advantages of this technique are lost in RRD surgery and had to faced higher failure rate.

Clinical application of continuous subcutaneous insulin infusion in vitrectomy perioperation in diabetic patients

Jun-Feng Zhang,Jun Li and Lin Li

AIM:To observe the value of clinical application of continuous subcutaneous insulin infusion(CSII) with the insulin pump in diabetic patients before and after surgery. METHODS: Fifty diabetic patients (50 eyes) needed to treat with vitrectomy were randomized.27 cases were treated with insulin pump of CSII and 23 cases were treated with daily multi-subcutaneous insulin injection( MSII). The dosage was adjusted according to the blood glucose test results. The differences with the two treatments in blood glucose control level and the time when blood glucose was controlled were compared. RESULTS: Before and after surgical treatment, the two methods were effective in controlling blood sugar to normal or basically normal level, the differences were significant (P<0.05);But the two treatment groups, in the time of blood glucose down to normal, insulin dose and systemic complications,also had significant differences (P<0.01). CONCLUSION: For perioperative diabetes, the clinical application of insulin pump treatment method is better than that of the conventional way of insulin injection.It is a fast, safe and effective treatment method fit for humans physiological function.

MRI of trochlear nerve in patients with congenital superior oblique palsy

Yu Gong and Hu Liu

AIM:To assess the relationship of trochlear nerve and congenital superior oblique palsy and find out the etiologies of congenital superior oblique palsy，to provide theoritical basis for the clinical dignosis and treatment of congenital superior oblique palsy. METHODS:In 16 patients with congenital superior oblique palsy and 11 normal people, the trochlear nerve was depicted with three-dimensional (3D) Fourier transformation constructive interference in steady state (CISS) 3.0T magnetic resonance imaging (MRI), whereas the adjacent vessels were detected with 3D time-of-flight (TOF) MRI.The identification rates of the two groups were studied to find if there was any abnormal with the trochlear nerve of patients with congenital superior oblique palsy. RESULTS: 3D-CISS MRI depicted the proximal cisternal segment of trochlear nerve in the patient group and normal group with identification rates of 27.2% and 812%.The difference between the two groups was statistically significant(P<0.05). CONCLUSION: The abnormal of trochlear nerve is one of the etiologies of congenital superior oblique palsy.

Efficacy of different treatments of neonatal dacryocystitis

Jie Yin and Zhu-Lin Hu

AIM：To explore the clinical efficacy of different approaches to the treatment of neonatal dacryocystitis.  METHODS：Totally 386 cases (412 eyes) of neonatal dacryocystitis in outpatient service of our hospital from July 2010 to December 2011 were treated with lacrimal sac massage, irrigation of lacrimal passage and probing combined with drug injection of lacrimal passage to observe the effect of three kinds of therapy and the results were statistically analysed between groups.  RESULTS：Of 412 eyes, lacrimal sac massage cured 97 eyes, the cure rate was 23.5%; lacrimal passage pressure washing cured 98 eyes, the cure rate was 31.1%.Compared with lacrimal sac massage, the difference was statistically significant (P<0.05); Probing combined with drug injection of lacrimal passage cured 213 eyes , the cure rate was 98.2%.Compared with lacrimal sac massage and irrigation of lacrimal passage, the difference was statistically significant (P<0.01). CONCLUSION：Eye lacrimal sac massage therapy in neonatal dacryocystitis is simple, easy, suitable for early treatment; Pressure washing and probing of lacrimal passage can be used in invalid children; Probing combined with tobradex eye ointment injection of lacrimal passage can significantly improve the cure rate of neonatal dacryocystitis ,which can be used as an effective treatment method.

Clinical observation of small incision non-phacoemulsification cataract extraction and intraocular lens implantation

Hong Sun

To analyze the safety and efficacy of small incision non-phacoemulsification cataract extraction and intraoclar les (IOL) implantation. METHODS:Totally 300 cases (360 eyes) of cataract had been operated with small incision non-phacoemulsification cataract extraction and IOL implantation in our hospital. The vision and complications of the patients were observed-after 1 week and 3 months. RESULTS:After 1 week,postoperative vision was ≥0.05 in 356 eye (98.9%), 0.1-0.2 in 13 eyes, 0.3-1.0 in 315 eyes (87.5%).After 3 months, postoperative vision was ≥0.05 in 356 eyes (98.9%), 0.1-0.2 in 6 eyes, 0.3-1.0 in 322 eyes (89.4%).During surgery, 26 eyes (7.2%) had posterior capsule rupture, 19 eyes(5.3%) had repetitive prolapse of upper iris, 28 eyes (7.8%) had cornea edema, 8 eyes (2.2%) had mutilation of iris root, 5 eyes (1.4%) had anterior chamber hemorrhage and 10 eyes (2.8%) had upper incision leakage.10 eyes(2.8%) had cystoid macular edema; 12 eyes(3.3%) had posterior capsule opacification. There was no case with lens nucleus falling into vitreous cavity or epichoroidal explosive hemorrhage.CONCLUSION:Taking account of the advantages of the small incision non-phacoemulsification cataract extraction and IOL implantation,such as good efficacy, high safety and less complications, it is a good way for cataract surgery.

Therapeutic effect of suture-fixation of intraocular lens for non-normal lens eye

Wei-Feng Shen

To observe the clinical therapeutic effect of suture-fixation of intraocular lens (IOL) for non-normal lens eye of non-posterior capsule because of all kinds of reasons . METHODS:Alcon CZ70BD IOL was selected. 8 cases (9 eyes) of non-normal lens (including 3 eyes of hypermature cataract, 4 eyes of traumatic cataract with subluxation, 2 eyes of Marfans syndrome ) were treated with suture-fixation of IOL because of non-posterior capsule or disintegrated-posterior capsule; 8 cases (8 eyes) of non-normal lens that had been treated with cataract surgery (including 7 aphakic eyes with pupillary complications, 1 eye of dislocated IOL) were treated with secondary suture-fixation of IOL. Main outcome measures were visual acuity and complications. All the patients were followedup for 1-6 months. RESULTS: Mild anterior chamber or vitreous hemorrhage occurred in 5 eyes（29%） intraoperatively or postoperatively and cured in 10 days. Choroidal detachment was observed in 1 eye （6%） and cured in 1 month. Ocular hypotension because of mild incision leakage occurred in 2 eyes（12%） postoperatively and cured by hypertension bandaging in 5 days. Uncorrected visual acuity ＞0.1 was achieved in 13 eyes (76%) at the first day and 17 eyes (100%) at the 10^th day; Uncorrected visual acuity ＞0.3 was achieved in 11 eyes (65%) and 12 eyes (71%) at the 10^th day and 1st month. CONCLUSION:Suture-fixation of IOL is a good choice for non-normal lens eye of non-posterior capsule.

Surgery efficacy of complicated cataract after vitrectomy combined with silicone oil tamponade

Fulati·Abudoureyimu and Xing Chen

To investigate the phacoemulsification treatment after vitrectomy combined with silicone oil tamponade. METHODS:Totally 102 cases (102 eyes) of cataract after vitrectomy combined with silicone oil tamponade during 2007-11/2011-11 were retrospectively analysed, 3 to 9 (mean 6.1) months after the vitreous surgery. Vitreous cavity infusion was used. The patients were first treated with phacoemulsification, anterior chamber injection of viscoat and silicone oil replacement, and then with intraocular lens implantation and circular posterior capsulotomy.Intraoperative and postoperative complications, postoperative vision and so on were observed. RESULTS:Four weeks after operation, visual acuity had varying degrees of improvement in 97 eyes and no improvement in 5 eyes among the 102 eyes of 102 cases; posterior capsular rupture occurred in 2 cases, no lens nucleus falling into vitreous body or choroidal detachment occurred. CONCLUSION: Phacoemulsification,silicone oil removal, intraocular lens implantation and circular posterior capsulotomy for complicated cataract after vitrectomy combined with silicone oil tamponade can effectively reduce intraoperative and postoperative complications, and meanwhile avoid the risks arising from the secondary operation.

Ahmed glaucoma valve implantation and intravitreal Avastin for neovascular glaucoma

To demonstrate the effect of Ahmed glaucoma valve implantation and intravitreal avastin in the treatment of neovascular glaucoma(NVG). METHODS:A retrospective random case series study was performed. Twenty eyes of-twenty cases who presented with NVG were first treated with intravitreal bevacizumab 2.5 mg in 0.1 mL,then with Ahmed glaucoma valve implantation after regression of iris neovessels. Cases were followed up for 6-36(mean 24) months with observation on visual acuity, IOP control, regression of iris neovessels, and complications during or after surgery. RESULTS:All cases regressed iris neovessels at different degree within 1 week after injection. At final follow-up, the IOP of 16 eyes were all less than 21mmHg without any drugs and of 3 eyes with 1-3 kinds of anti-glaucoma drugs after combined Ahmed glaucoma valve implantation. The IOP of one eye was controlled after cryotherapy. The mean IOP dropped from 44.17±1617mmHg preoperatively to 13.62±3.81mmHg postoperatively. IOP reduction was statistically different between preoperative and postoperative (t=11.028,P=0000) at final follow-up.Visual acuity was improved in 8 cases （40％） and was no changed in 12 cases.No serious complications were observed during or after intravitreous injection and Ahmed glaucoma valve implantation. CONCLUSION:Ahmed glaucoma valve implantation and intravitreal avastin in the treatment of NVG is useful and safe. On one hand, it improves the success rate of surgery and preserves visual function,furthermore its complications are less. However, its chronic effect needs to further follow-up. At the same time, we should take some treatment to the protopathy of this disease.

Clinical analysis of postoperative complications of trabeculectomy

Rui Zhu,Zhi-He Zhao,Yan Li and Rui Dai

To evaluate the reasons and the dealing ways of postoperative complications of trabeculectomy in the management of primary angle-closure glaucoma-shallow anterior chamber and descemet membrane detachment. METHODS:Totally 160 cases(187 eyes) of primary angle-closure glaucoma underwent trabeculectomy, postoperative complications-shallow anterior chamber and descemet memberane detachment were observed. RESULTS:There were 33 eyes(17.65%) that incurred shallow anterior chamber, in which 1 occurred choroidal detachment and finally cured after conservative treatment. 5 cases (6 eyes) performed anterior chamber injection of sodium hyaluronate,after operation in which 1 occurred both eyes descemet membrane detachment,finally right eye which detached widely cured after 3 times injections of gas in the anterior chamber,as detached less than one-third,left eye was untreated. CONCLUSION:Trabeculectomy in the management of primary angle-closure glaucoma must be performed lightly and accurately in order to reduce and avoid the occurrence of serious complications.

Observation of vitrectomy and Nd:YAG 532nm laser on treatment of retinal vasculitis

Heng Li and Xue Mi

To report the effects of the vitrectomy combined with Nd:YAG 532nm laser on treatment of retinal vasculitis. METHODS:Data of 36 cases(36 eyes)with retinal vasculitis undergoing vitrectomy and Nd:YAG 532nm laser treatment were analyzed retrospectively. RESULTS:Two cases were retinal arteritis,4 cases were retinal phlebitis and 30 cases damnification were on both artery and vein of retina in 36 cases.The damnification of lens was in 1 case, iatrogenic retinal hole was in 6 cases and dialysis of ora serrata was in 3 cases in operation. 2 cases were of retina detachment again，2 cases of hyphema and 9 cases of ocular hypertension after operation.The best visual acuity of 36 cases were improved, which was 0.02 to 0.1 in 2 cases（6%）, 0.12 to 0.4 in 22 cases（61%）and 0.5 to 1.0 in 12 cases（33%）. CONCLUSION:Vitrectomy combined with Nd:YAG 532nm laser is an effective treatment for retinal vasculitis

Efficacy of photodynamic therapy with 1/3 dose verteporfin for treating acute central serous chorioretinopathy

Dong-Ning Liu,Li Xu and Gui-Jun Gao

To evaluate the efficacy of photodynamic therapy (PDT) after 1/3 dose verteporfin injection to treat acute central serous chorioretinopathy (CSC). METHODS: Twenty-six eyes of 26 cases diagnosed with acute CSC by fundus fluorescein angiography(FFA) and optical coherence tomography (OCT) examination received one single session of PDT using 1/3 dose (2mg/m2) verteporfin. Best-corrected visual acuity (BCVA) was measured before, 1 week, 4 weeks, and 12 weeks after PDT with 1/3 dose. OCT, FFA and indocyanine green(ICG) examination were performed before, 4 weeks, and 12 weeks after PDT with 1/3 dose. RESULTS:Twenty of 26 eyes (77%) had complete resolution of subretinal fluid (SRF) 1 week after 1/3 dose PDT treatment. After 4 weeks, SRF in 26 eyes was completely absorbed, fluorescein leakage of 22 eyes reduced in FFA and the tortuous choroidal vessels appeared normal in ICG; Twelve weeks after PDT, there was no recurrence of CSC in 26 eyes. The mean BCVA was improved from 0.41 to 0.80 1 week after PDT treatment. CONCLUSION: PDT with 1/3 dose verteporfin injection is effective and safe in treating acute CSC

Clinical effect of silicone oil in traumatic vitreoretinal surgery

Hong-Wei Hu,Li-Li Huang and Yu Song

To observe clinical effect of silicone oil in traumatic vitreoretinal surgery. METHODS:The vitrectomy was performed on 36 cases (36 eyes) with ocular trauma from October 2009 to January 2011.Triamcinolone acetonide and laser were used during surgery and the eyes were filled with silicone oil . Silicone oil removal time was about 8 months after surgery. RESULTS: The observation period was 10 months. Laser treatment was added. In observation period, there were no retinal detachment, no intraocular hemorrhage and severe proliferative response, and no infectious endophthalmitis. CONCLUSION: Silicone oil in traumatic vitreoretinal surgery can support the retina for a long time, control inflammation, inhibit proliferation and play the role of infection prevention,and provide favorable conditions for timely added laser treatment.

Clinical analysis of optic nerve tumor in 36 cases

Yang Liu,Hong Zhang,Lin Liu and Guo-Xiang Song

To analyse the history, clinical manifestation，imaging study, and treatment of optic nerve tumor for the diagnosis and treatment. METHODS:The clinical data for 36 cases with optic nerve glioma and optic nerve sheath meningioma treated during 2000 to 2009 were analyzed retrospectively. RESULTS:6 cases in all 15 cases of optic nerve gliomas found exophthalmos and 5 cases found vision loss for the chief complaint, and exophthalmos complicated with vision loss was in 2 cases. In optic nerve sheath meningioma group, 13 cases had the chief complaint of exophthalmos, and vision loss was in 5 cases, exophthalmos complicated with vision loss was in 3 cases. Ultrasound, CT and MRI all had typical performance.30 cases were treated with surgery, 6 cases with Gamma knife. CONCLUSION:The examination and imaging performance of optic nerve tumour have certain characteristic performance,which has important value for auxiliary diagnosis.Therapeutic schedule should be synthetically formulated with patients specific conditions,it is mainly surgery and radiation therapy at present.

Preliminary clinical research on the viral optic neuritis in a comprehensive therapy of anti-viral drug combined methylprednisolone

Ying-Chun Li,Ying-Chuan Fan,Jian-Bin Hu,Yu-Chuan Chen,Ya-Li Liu and Mei Jiang

-To compare the effect of the treatment on viral optic neuritis in a comprehensive therapy of Ganciclovir combined methylprednisolone and comprehensive therapy of methylprednisolone. METHODS:Fourty-one cases 41 patients (60 eyes) with viral optic neuritis were randomly divided into a control group with 20 cases (30 eyes) and a treatment group with 21 cases (30 eyes). Visual acuity and visual evoked potential (VEP)were observed on patients before treatment and on 3^rd, 7^th, 14^th,30^th,90^th,180^th day after treatment . RESULTS:Visual acuity and LP₁₀₀ in two groups were improved over time (P<0.01). Visual recovery had begun on 3^rd day after treatment, visual acuity in the treatment group was better than that in the control group after 1 month (P=0.009), no difference was between the two groups in improved visual acuity after 6 months (P>0.05); the trend that LP₁₀₀ in both groups was improved with time (P<0.01)was showed, a fast recovery rate was showed for LP₁₀₀ in both groups in treatment early (within 2 weeks)stage, the difference was significant compared with pretreatment (P<0.01). However, the recent recovery effect on LP₁₀₀ in the treatment group was better than that in the control group and a little difference was showed in the late treatment stage. CONCLUSION:Visual acuity and LP₁₀₀ can be more quickly improved and the optic nerve electrical activity be strengthened in the comprehensive therapy of Ganciclovir combined methylprednisolone to treat viral optic neuritis compared with the comprehensive therapy of methylprednisolone so as to improve the visual quality of patients.

Clinical analysis for the treatment of post-traumatic infectious endophthalmitis with vitrectomy and intravitreal drugs

Lu Lu and Zhe-Li Liu

Application of 20MHz high frequency B mode ultrasound in extraocular muscle

Ming-Yu Shi,Hui Qiu,Shang Gao and Jin-Song Zhang

To define the value of 20MHz high frequency B mode ultrasound in extraocular muscles disease. METHODS:10MHz and 20MHz B-mode ultrasound were used to observe the extraocular muscles on normal persons and different extraocular muscle diseases from Jan 2011 to Dec 2011. RESULTS:In the normal eyes and strabismus patients, 20MHz high frequency ultrasound could clearly show the morphological characteristics of the extraocular muscles. Symmetric extraocular muscle thickness was not significantly different in normal eyes. Compared with 10MHz ultrasound, its measured value was significantly increased. Different extraocular muscle diseases had different performance. CONCLUSION:20MHz high frequency ultrasound is suitable for observing extraocular muscles of the normal eyes and strabismus patients. The display is better than 10MHz ultrasound. But there are certain limitations in the types of extraocular muscle disease with extraocular muscle thickness increase.

Clinical observation of dissociated vertical deviation surgery

Er-Ying Han,Shi-Hui Yu and Yue-Li Li

To discuss the effective surgical measures of dissociated vertical deviation (DVD) METHODS: The effectiveness of the surgical treatment of 38 cases (61 eyes) with DVD with large recession of superior rectus muscle or combined with anterior transposition of the inferior oblique muscle to the patients with inferior oblique muscle overaction was retrospectively analysed. The curative effect was observed. RESULTS:The treatment results of 46 eyes were qualified in appearance after surgery, satisfactory ratio was 75%， and 14 eyes showed improvement after treatment, improvement ratio was 23%, one eye ineffectively. CONCLUSION:It is an effective method for DVD to treat with large recession of superior rectus muscle and anterior transposition of the inferior oblique muscle. When DVD combines with inferior oblique muscle overaction, anterior transposition of the inferior oblique muscle is preferred as the initial procedure, if it does not, the large recession of superior rectus muscle should be the first choice.

Analysis of postoperative complications of artificial nasolacrimal duct implantation

Jian-Wei Yang,Yan Li,Qun-Ying Wu,Li Xiao and Ping Bai

To investigate the postoperative complications of artificial nasolacrimal duct implantation, and to look for effective treatment method. METHODS:Totally 146 cases (160 eyes) of dacryocystitis and nasolacrimal duct obstruction with more than 3 months of artificial nasolacrimal duct implantation in our hospital during 2009-2010 were analyzed retrospectively.The causes of complications were summarized and analyzed, treatment method and its effect on complication were observed. RESULTS:Complications occurred in 37 eyes of the 160 eyes.3 eyes (8.1%) were due to eyebrow was too high and lacrimal sac-nasolacrimal duct angle was too big.3 eyes (8.1%) with traumatic dacryocystitis and nasolacrimal duct stenosis changed to operation treatment because the dilator could not enter the nasolacrimal duct; 5 eyes（13.5%） underwent reimplantation due to artificial nasolacrimal duct down shift at one month later; Proliferation of granulation tissue and obstruction occurred in 20 eyes (54.1%) 6 months after the surgery, and 6 eyes （16.2%） 12 months after the surgery;5 eyes restored unobstructed with dilatation and injection of mitomycin C and tobramycin dexamethasone ointment, the failed cases underwent dacryocystorhinostomy or nasal endoscopic dacryocystorhinostomy. CONCLUSION:Obstruction caused by granulation tissue hyperplasia of artificial nasolacrimal duct mushroom head is the most common complication of artificial nasolacrimal duct implantation, incidence is proportional to implantation time. It is needed to strictly grasp the indications of artificial nasolacrimal duct implantation.Chronic dacryocystitis should be treated with operation therapy as the preferred method.

Clinical research of improved dacryocystorhinostomy with nasal endoscope

To investigate the surgical approach, techniques and clinical efficacy ofdacryocystorhinostomy under nasal endoscope in treating chronic dacryocystitis. METHODS:Thirty-eight cases (40 eyes)with chronic dacryocystitis were treated with endoscopic transnasal dacryocystorhinostomy and were rinsed the lacrimal passage and nasal cavity routinely under nasal endoscope after operation. RESULTS:After 5-14 months follow-up, the stoma inside nasal cavity of 35 patients (37 eyes)were unobstructed, the symptoms of pyorrhea and epiphora disappeared; the symptoms of pyorrhea and epiphora occured in 2 eyes 3 months after operation, the stoma inside nasal cavity were obstructed, and the stoma was expanded again under nasal endoscope, 1 case was cured, 1 case was invalid;1 eye was obstructed with rinses overflowing and needed pressurizing. The total effective rate was 95% (38/40). CONCLUSION:Endoscopic transnasal dacryocystorhinostomy has advantanges of less damage,no facial scar,easy to operate and so on.Intraoperative fine operation and strengthening follow-up after surgery are the important conditions for therapeutic effect. Endoscopic transnasal dacryocystorhinostomy is effective in the treatment of chronic dacryocystitis and worthy of clinical promotion and application.

Clinical effect of blockage of inferior lacrimal point for the treatment of moderate or severe dry eye syndrome

Cong Ma,Wen-Jia Zhang and Zhu-Lin Hu

To investigate the clinical effect of blockage of inferior lacrimal point for the treatment of moderate or severe dry eye syndrome. METHODS: Surgical treatment in blockage of inferior lacrimal point have been used in 19 cases(38 eyes) with moderate or sever dry eye syndrome who have less effect with artifitial tears in our department from January 2010 to January 2011,The height of lacrimal rivus,corneal fluorescein stain,tear film break-up time(BUT),SchirmerⅠtest(SⅠt) were checked by slit-lamp microscope at preoperative 3 days and postoperative 1 week,3 months,6 months. RESULTS:Preoperative dry eye patients complained of dryness, foreign body sensation, visual fatigue. Postoperative patients with these symptoms significantly reduced or even disappeared. Compared with preoperative, 15 cases (30 eyes) with fluorescein staining of corneal epithelial punctate coloring disappeared, and the lower eyelid formed tears River line. Compared with preoperation, BUT and SⅠt significantly increased and the extension. CONCLUSION:Sugery of blockage of inferior lacrimal point can significantly improve the clinical manifestations of dry eye syndrome, increase the tear volume of ocular surface, break the vicious circle of tear secretion, which is an effective and simple method for moderate or severe dry eye patients who can not receive good outcome from medication therapy.

Clinical research on the implantation of posterior chamber phakic intraocular lens for correction of high myopia

Li Jia,Chao Zhang,Hong Tang,Yu Zhang,Jing Wang and Ping Qin

To observe and investigate the efficacy and safety of the implantation of posterior chamber phakic intraocular lens for high myopia. METHODS: In the research,17 cases(33 eyes) with high myopia were treated with posterior chamber phakic intraocular lens implantation, among them 22 eyes were implanted with implantable contact lens(ICL) and 11 eyes with toric implantable contact lens(TICL).The preoperative refraction was -8.00-24.00 dioper （mean-15.46 ±6.26D）and eyeball length was 25.33-3377mm(mean 30.22±2.55mm). The visual acuity, refraction, intraocular pressure and position of the intraocular lens were examined after operation. RESULTS:All of 33 eyes were implanted successfully.The uncorrected visual acuity of every eye was the same or even better than preoperative best-corrective visual acuity, the intraocular pressures were normal and the refraction remained stable after postoperative follow-up of 6 months. CONCLUSION:The implantation of posterior chamber phakic intraocular lens was efficacious and safe.It provides much more potential choices for patients with refractive errors.The patients can gain better visual acuity and maintain it after operation.

Application of corneal topography on cycloplegic dioptoscopy in astigmatic children

Yi-Lan Tan,Li-Juan Tao,Jun-Fang Yang,Zheng-Yan Qi and Rong He

To analyze the correlation of astigmatism by corneal topography and cycloplegic retinoscopy in children with non-mixed astigmatism and study the value of corneal topography. METHODS:Both corneal topography and cycloplegic retinoscopy-were used in 88 cases (171 eyes) with non-mixed astigmatism and their results were compared. RESULTS:The difference was not significant in examining astigmatism axis and astigmatism degree (t=1.838，P>0. 05；t=1.009，P>0.05),but the actual best-corrected visual acuity was significantly different from high prediction visual acuity(PVA) and low PVA（t=3566，P<0.01；t=3.445，P<0.01）. CONCLUSION: The degree and axis of astigmatism by corneal topography can provide important reference for cycloplegic retinoscopy. Corneal topography can play an important role in increasing the speed and accuracy of cycloplegic retinoscopy.

Management of rigid gas permeable contact lens in controlling the difficult refractive errors in teenagers

Zhi Wang,Qi-Guo Xiao,Zhi-Gang Fei,Man-Hong Yuan and Shi-Gang Xia

To study the management of rigid gas permeable contact lens (RGP) in controlling the difficult refractive errors in teenagers. METHODS:Fifty-one cases (90 eyes) ranging from 10 to 20 years old with difficult refractive errors were fitted with RGP. The corrected visual acuity and complications were observed. RESULTS:The difference of corrected visual acuity between RGP (0.95±0.17) and spectacles (0.39±0.11) was significant (P<0.05). No serious complications occurred in all cases. CONCLUSION:RGP could effectively improve the visual acuity of teenagers with difficult refractive errors and promote functional development of vision.

Relationship between ocular axis and intraocular pressure

Yan-Ting Tao

To observe association between the degree of ocular axis and non-contact intraocular pressure(IOP). METHODS:One thousand and ten eyes of 508 cases aged 17 to 53(mean 26.65±6.55) years old were selected. IOP and degree of ocular axis were examined. They were divided into three groups by ocular axis: ＜24mm，24-2599mm，≥26mm.The correlation between degree of ocular axis and IOP was analyzed by rectilinear correlation and differences of IOP of the three groups were compared by analysis of variance. RESULTS:The IOP was positively correlated with the ocular axis（r=0.138,P＜0.01，Y=7.331+0.296X）. The IOP of the cases whose length of ocular axis were longer than 26mm in the largest increased. CONCLUSION:There is certain relationship among length of ocular axis and IOP, the relationship tends to become closer when length of ocular axis and IOP increase.We must pay more attention to the monitoring of IOP in high myopia.

Comparative study of the clinical effects between two modes of incision of extracapsular cataract extraction and intraocular lens implantation

Li-Lun Wang,Qing-Wei Du and Zhao Huo

AIM:To compare clinical effect between two modes of incision of extracapsular cataract extraction and intraocular lens implantation. METHODS:In the retrospective analysis,143 cases (164 eyes) with cataract (February 2008-October 2011)were divided into group A (scleral tunnel incision) 72 cases 80 eyes and group B (clear corneal incision) 71 cases 84 eyes, all patients were checked visual acuity before and 1 week after surgery, astigmatism, operation time, complications and analyzed statistically. RESULTS:There was significant statistical difference of visual acuity 1 week after surgery, astigmatism, operative time between the two groups(P<0.05),but no statistical difference of complications such as vitreous loss, corneal edema, iris damage and so on (P>0.05). CONCLUSION:There was more obvious advantages of clinical effect of the corneal incision than scleral tunnel incision in extracapsular cataract extraction and intraocular lens implantation, and also it is simple, easy, economical, safe, more suitable for primary hospital.

Clinical observation on surgery treatment of complicated cataract in silicone oil-filled eyes

Zi-Jun Wang and Jing-Bo Li

AIM:To observe the safety and efficacy of phacoemulsification combined with silicone oil removal and intraocular lens implantation on the cataractous eyes filled with silicone oil after vitrectomy. METHODS: Totally 32 patients (32 eyes)with complication of cataract when filled with silicone oil after vitrectomy were selected and operated by phacoemulsification combined with removal of silicone oil through pars plana incision and foldable intraocular lens implantation. And then, they were followed up for 3-18 months (average 9 months). RESULTS:The best-corrected visual acuity after surgery were as follows: 3 eyes were light perception to the counting fingers, 10 eyes were 0.02 to 0.1, 12 eyes were between 0.1 and 0.2, and 7 eyes were above or equal to 0.3. And no complications such as retinal detachment, corneal endothelial decompensation, intraocular lens shifted, silicone oil left and so on were observed. CONCLUSION: The operations of phacoemulsification combined with removal of silicone oil through pars plana incision and foldable intraocular lens implantation, treating complication of cataract in eyes filled with silicone oil after vitrectomy, are safe and effective.

Manual small incision cataract extraction through temporal scleral incision after glaucoma surgery

Shu-Lan Ren,Rui Zhang and Fan-Hong Kong

AIM:To evaluate the efficacy of a method of small incision cataract extraction after glaucoma filtering surgery. METHODS:50 eyes of 50 patients with cataract after glaucoma surgery underwent manual small incision catarat extraction through a temporal scleral tunnel incision.The postoperative visual acuity,IOP, corneal curvature and filtering bleb were observed. RESULTS:Followed up for 3-12 months,the visual acuity of all the eyes were improved after surgery.There were no changes in IOP and filtering bleb.Postoperative changes in corneal curvature(0.75-1.25D) returned to preoperative levels 3 months after operation. CONCLUSION:The manual small incision cataract extraction through a temporal scleral tunnel incision is convenient and effective in treating cataract after glaucoma surgery.

Study on the positions of different PC-IOL implantations by ultrasonic biomicroscope

Shi-Yi Wang and Qian Tan

AIM:To evaluate the stability using ultrasonic biomicroscope(UBM) in eyes having phacoemulsification with implantation of 2 types posterior chamber intraocular lens (PC-IOL). METHODS:The degree of PC-IOL decentration,tilt and anterior chamber depth(ACD) were measured by UBM，while locating the haptics and observing the relationships of haptics on uveal tissue. RESULTS:There was no significant change during the 1 month follow-up period in decentration or tilt in each group (P>0.05).There was no significant difference among the groups in IOL decentration or tilt at any time point (P>0.05).There was no significant change during the 1 month follow-up period in ACD in each group (P>005). There was significant difference among the groups in ACD at 1 week,1 month after surgery (P<0.05). CONCLUSION:The stability of 1-piece IOL in eyes was better than that of 3-piece IOL;UBM can locate the haptics and observe the relationships of haptics on uveal tissues better.

Efficiency of extracapsular cataract extraction plus implantation of artificial lens for the treatment of patients with diabetes mellitus and cataract

Jian-Gang Dong and Kou-Hong Jiang

AIM:To evaluate the clinical efficiency of extracapsular cataract extraction plus implantation of artificial lens for the treatment of patients with diabetes mellitus (DM) and cataract. METHODS:Eighty-seven (104 eyes) DM patients received phacoemulsification (Phaco) and small-incision cataract surgery (SICS) plus implantation of artificial lens. Best-corrected visual acuity and complications were observed. RESULTS:No posterior capsule rupture, intraocular hemorrhage and endophthalmitis were noted. Six patients were observed with severe corneal edema, and recovered after drug administration. CONCLUSION:Phaco and SICS plus implantation of artificial lens are efficient for the treatment of DM patients with cataract.

Clinical application analysis of phacoemulsification for diabetic cataract

Yuan Wang,Rui Wang,Chun-Chao Bi and Wei Li

AIM:To investigate the visual acuity change and its influencing factors of diabetic cataract after phacoemulsification and intraocular lens implantation. METHODS:Phacoemulsification and intraocular lens implantation was done in 42 patients (48 eyes) with diabetic cataract and 48 senile cataract patients (48 eyes).Visual acuity and postoperative complications were observed. RESULTS：Compared with the control group, diabetic group postoperative visual acuity was poor, but the two groups was no significant difference. In the diabetic group, postoperative corneal endothelial edema, fibrinous exudation and posterior synechiae of iris increased significantly. CONCLUSION：The visual acuity after the operation was related to the diabetic retinopathy level, diabetic duration and postoperative complications.

Secondary glaucoma from herpes simplex keratitis

Jin-Tao Li,Bin Wang and Chun-Jun Xu

AIM:To investigate clinical feature,pathogenesis and treatment methods of herpes simplex keratitis(HSK)with glaucoma． METHODS:Diagnostic standard was intraocular pressure ≥24mmHg.Standard clinical cure was corneal lesions still and intraocular pressure ≤21mmHg after stopping ocular hypotensive drugs for one week．30 cases with secondary glaucoma were given combined antiviral, anti-inflammatory and intraocular pressure reduction treatment. RESULTS:Clinical cure of 30 cases were obtained by antiviral，anti-inflammatary and ocular hypotensive drugs． CONCLUSION:The inflammation and intraocular pressure could be controlled through active antiviral，anti-inflammatary and ocular hypotensive drugs treatment．Individualized survey of intraocular pressure is necessary for HSK secondary glaucoma.

Clinical analysis of secondary glaucoma after ocular trauma in 87 cases

Yu Yuan

AIM:To analyse the main causes of glaucoma after ocular trauma and treatment methods. METHODS:A retrospective analysis was conducted on 87 cases (87 eyes) with secondary glaucoma after ocular trauma in our hospital from June 2008 to June 2010, with clinical data and treatment methods. RESULTS:Secondary glaucoma after ocular trauma can be caused by a variety of reasons, the main reasons included intraocular hemorrhage in 40 eyes (46%), lens source in 27 eyes (31%), anterior chamber angle contusion in 14 eyes (16%), and intraocular inflammation in 6 eyes (7%).According to the different ocular trauma causes,different treatment regimens were made.The drugs and operation treatment were followed up for 3-12 months, 79 eyes were with intraocular pressure control in the normal level, the control rate was 91%; visual acuity improved in 91%. CONCLUSION:Secondary glaucoma after ocular trauma in the pathogenesis and the mechanism is complex. Timely treatment according to the different etiologies is needed for control of intraocular pressure and improvement of visual acuity.

Changes of intraocular pressure after posterior sub-Tenons capsule injection with triamcinolone acetonide for macular edema

Liang-Yu Wang,Zhan-Yu Zhou,Shan-Yao Zhao and Yun-Xiao Wang

AIM:To investigate the changes of intraocular pressure (IOP) and associated factors of IOP elevation after posterior sub-Tenon’s capsule (PST) injection with triamcinolone acetonide (TA) for macular edema. METHODS:The study included 46 cases(46 eyes) who received PST injections of 20mg TA to treat macular edema with diabetic retinopathy (n=16),age-related macular degeneration (n=13), retinal vein occlusion (n=11),and posterior uveitis (n=6). IOP measurements were performed on the day of injection, and 2 weeks，1 month，2, 3, 4, 5 and 6 months later. RESULTS:The mean IOP of all eyes showed a gradual increase after the injection, peaked at 3 months (19.22±6.86mmHg), and then decreased gradually until reaching a minimum at 6 months. Of the 46 eyes, 17(37%) showed an IOP above 21 mmHg at 3 months post-injection. Compared with the pre-injection, the mean IOP increased significantly at 2 weeks，1 month，2，3，4，5 months（t value were 3.747, 5.836, 5.982, 5.866, 4.202, 3.246 respectively, all P<0.05）, however, there was no significant difference between the pre-injection and the 6 months post-injection (t=1.446,P>0.05) . And IOP elevation significantly correlated with younger age（χ²=5599，P<005）and higher baseline IOP（χ²=10.323，P<005）, but not with gender（χ2=0.022，P>0.05）or disease（χ^{2^{=0.050，P>0.05）.
CONCLUSION:E1evation of IOP after PST injection with TA is not rare and the peak level usually occurs at 3 months post-injection, and then the IOP decreases gradually to approach the baseline level until 6 months post-injection. Younger age and higher baseline IOP are identified as risk factors. Our findings indicate that careful assessment of IOP during a follow-up at least 6 months is necessary，especially in those who are younger or with higher baseline IOP.}}

Timing and efficacy of laser for diabetic retinopathy after cataract surgery

Yan Cheng,Fei Feng and Pei-Quan Zhao

AIM:To observe photocoagulation treatment effect on diabetic retinopathy (DR) after phacoemulsification or non-phacoemulsification small incision cataract extraction and intraocular lens implantation, to further explore the timing and influencing factors of photocoagulation treatment. METHODS:Totally 60 cases (108 eyes) with DR after phacoemulsification or non-phacoemulsification small incision cataract extraction and intraocular lens implantation underwent local retinal photocoagulation, grid photocoagulation or standard panretinal photocoagulation treatment at early stage according to DR staging under the guidance of fundus fluorescein angiography (FFA). RESULTS:After 1 year follow-up, visual acuity improved in 30 cases of all patients (27.8%), unchanged in 71 eyes(65.7%), decreased in 7 eyes(6.5%).FFA follow-up examination showed retinal edema vanished, most neovascularization shrinked, bleeding and exudation partly absorbed,the complicated macular edema in 18 cases completely vanished after photocoagulation. CONCLUSION: Reasonable and timely conduct of argon laser retinal photocoagulation therapy after cataract surgery can effectively control the progress of DR,and plays an important role in the improvement of visual function and stabilization of vision.

Clinical analysis of modern vitrectomy in treatment of 45 cases with complex retinal detachment

Zhi-Gang Liu

AIM:To assess the effectiveness of modern vitrectomy on complex retinal detachment. METHODS:Totally 45 cases (45 eyes) of complex retinal detachment underwent modern vitrectomy combined with 15% C₃F₈-gas or silicone-oil tamponade. RESULTS:Fifteen eyes underwent vitrectomy with C₃F₈-gas tamponade,13(87%) eyes achieved retinal reattachment primarily.30 eyes underwent vitrectomy with silicon-oil tamponade,27(90%) eyes achieved retinal reattachment primarily.The comparison between two groups has no significant difference.The visual acuity after operation was counting fingers in 2 eyes; 0.02-0.05 in 3 eyes，0.06-0.1 in 10 eyes；0.12-0.25 in 19 eyes，greater than or equal to 0.3 in 11 eyes. The main complication in operation was iatrogenic slit pore. The main complications after operation were secondary glaucoma and complicated cataract. CONCLUSION:Modern vitrectomy combined with C_{3_{F₈-gas or silicone-oil tamponade is a useful procedure for complex retinal detachment.The visual acuity of most patients after operation could improve.}}

Curative effect of early panretinal photo-coagulation and compound anisodine para-temporal-superficial artery injection for radiation retinopathy

Ru Liu,Li-Lian Xie,Tao Tian and Qiao-Ying Luo

AIM:To observe the combined curative effect of early panretinal photocoagulation (PRP) and compound anisodine para-temporal-superficial artery injection for radiation retinopathy（RR）. METHODS:Twenty-one patients (41 eyes ) with RR in our hospital received early PRP and compound anisodine para-temporal-superficial artery injection. The visual acuity, capillary nonperfusion, retina-neovascularization, and complications at 3 months after treatment were observed. RESULTS:Three months after the treatment, visual acuity were increased in 6 eyes (14.6%) , steady in 31 eyes (75.7%) , decreased in 4 eyes (9.7%) . Iridal neovascularization regressed in 2 eyes, while the other one received the cyclophotocoagulation. Primary retinal neovascularization regressed in 9 eyes (75%), and primary retinal nonperfusion disappeared in 22 eyes (687%), primary retinal nonperfusion shrinked more than five disc area in 7 eyes (21.8%), the total effective rate was 90. 5%. Only one eye developed vitreous hemorrhage,however, no optic disc and iridal neovascularization, and neovascular glaucoma were observed; no complication related with the treatment appeared in all patients. CONCLUSION:Early PRP and compound anisodine para-temporal-superficial artery injection is effective and reasonable integrated traditional and western medicine treatment for radiation retinopathy.

Clinical and pathological study of lamellar keratectomy combined with natamycin medication for the treatment of fungal corneal ulcer

Qing-Yan Zeng,Hua Jiang,Shang-Cao Wu,Xiao-Li Jin and Jiao Qin

AIM:To study the clinical outcome and pathological base of lamellar keratectomy combined with natamycin medication for the treatment of fungal corneal ulcer. METHODS:Thirty-two eyes of 32 cases suffered from fungal corneal ulcer in which the endothelium was not infected were included in this study. All patients received lamellar keratectomy combined with natamycin medication. Visual acuity, corneal infiltration, clinical outcome, complications and fungal species were recorded. Pathological examinations were conducted with the corneal lamellar tissues. RESULTS:Twenty cases had a preoperative visual acuity below 0.05，11 cases between 0.05 and 0.3，and 1 case between 0.3 and 1.0. Twenty-eight cases were healed by lamellar keratectomy combined with natamycin medication. The heal course ranged from 7 to 32 days, with an average time of 13.2±8.5 days. Postoperative evaluation showed that 5 cases had a visual acuity below 0.05，8 cases between 0.05 and 0.3，15 cases between 0.3 and 1.0. Four cases converted to keratoplasty due to uncontrolled infection. Positive cultures were found in 31 cases with 18 Fusarium species, 8 Aspergillus species, 3 Alternaria species and 2 uncertain species. Pathological examination showed dense infiltration of polymorphonuclears(PMNs), and periodic acid-schiff(PAS) staining demonstrated most hyphae lay in superior corneal lamellae and parallel to it, while little hyphae traversed the cornea in a plane perpendicular or inclined to the stromal lamellae. There was no significant difference in growth patterns in cornea between different pathogenic fungi. CONCLUSION: Timely lamellar keratectomy can significantly improve the efficiency of natamycin medication in fungal corneal ulcer and restore visual acuity.

Efficacy of deproteinized calf blood extract eye gel for corneal incision repair after recurrent pterygium surgery

Qing-Xia Liu,Lai-Jun Xu and Jian-Jun Zhang

AIM:To observe the application efficacy of deproteinized calf blood extract eye gel for postoperative recurrent pterygium corneal incision repair. METHODS:Totally 68 cases(68 eyes) of postoperative recurrent pterygium corneal incision edema were randomly divided into 2 groups with 34 cases(34 eyes) in each group. The control group used routine diclofenac sodium eye drops plus antibiotics eye drops and simultaneous bFGF eye drops alternately, four times a day. The treatment group used deproteinized calf blood extract eye gel 4 times a day in addition to the daily alternate application of diclofenac sodium eye drops plus antibiotics eye drops. The course of treatment was 1 month. Contrast analysis was conducted on the subjective symptoms, signs, and repair of corneal incision in patients before and 3, 7, 14days, 1 month after treatment respectively. RESULTS:About 3, 7, 14days after recurrent pterygium surgery, corneal incision edema weakened more significantly, incision repaired faster, and subjective symptoms subsided in a shorter time in treatment group than in control group. 1 month after operation, there was no significant difference between the two groups. CONCLUSION:Deproteinized calf blood extract eye gel has a shorter onset time, better comfort and safety for the early repair of postoperative recurrent pterygium corneal incision, and can reduce the incidence of postoperative infectious keratopathy and postoperative corneal astigmatism with good effect.

Clinical and pathological characteristics of ocular melanoma

Hong Zhou,Wen-Rong Xu and Jing Tang

AIM:To analyse ocular melanomas clinical and pathological specifics for earlier diagnosis and treatment. METHODS:Twenty-four cases with ocular melanoma were retrospectively collected during July 2002 to July 2011 and patients clinical and pathological history were reviewed. All samples had routine paraffin section, HE dying and some difficult diagnosed samples plus S-100 protein and HMB-45 s-p immunohistochemical method. Excel was used for establishment of a database and software SPSS 17.0 applied for statistical analysis. RESULTS:All 24 cases were ocellus, with 13 males and 11 females; 14 left eyes and 10 right eyes; 3 cases of eyelid malignant melanoma, 6 cases of primary malignant melanoma of conjunctiva and 15 cases of uveal melanoma respectively. CONCLUSION:Diversity of melanoma histopathology exists. Most cases can be confirmed by routine pathological method. Immunity histochemistry is of high value for diagnosis or differential diagnosis of melanoma.

Upper eyelid retraction surgery and its effect

Yan Li,Qun-Ying Wu,Li Xiao,Jian-Wei Yang,Ping Bai and Nan Li

AIM:Through the clinical case discussion and study of upper eyelid retraction in indexing, choosing different operation scheme and observing the therapeutic effect of operation, to provide more effective treatment options for different patients. METHODS:Retrospective summary was conducted on 98 patients (146 eyes) with upper eyelid retraction during November 2000 to December 2010. Indexing was conducted on the patients condition and according to the indexing, different operation treatment was selected and curative effect of the operation was observed. RESULTS:According to the different indexing to choose a suitable operation method can be effective in correction of eyelid retraction. CONCLUSION: Eyelid retraction indexing due to the cause and degree of eyelid retraction,implementation of personalized operation in different types of patients, and normative clinical treatment path have filled the domestic gaps in diagnosis and treatment method of the same disease.

Ametropic asthenopia and dry eye syndrome in middle-aged and aged patients

Xiao-Bo Huang,Yu Song and Ying Wu

AIM：To investigate the relationship between ametropic asthenopia and dry eye syndrome, and the influences of correction with spectacles in middle-aged and aged patients with ametropic asthenopia on xerophthalmia． METHODS：A random survey was conducted according to unified standard in middle-aged and aged patients with asthenopia at out-patient department. The incidence of ametropic asthenopia and that of dry eye syndrome in patients with asthenopia were analysed. The relationship between ametropic asthenopia and dry eye syndrome was investigated. Patients of dry eye syndrome combined with ametropic asthenopia aged 40-65 years old were randomly divided into spectacles treated group, drug treated group and matched control group, and treated for 3 months. The treatment effect of dry eye syndrome were observed． RESULTS：The incidence of asthenopia induced by ametropia was 42.0%. There was a strong relationship between ametropic asthenopia and dry eye syndrome. After 3 months follow-up, the dry eye syndrome of spectacles treated group was obviously better than drug treated group (P<0.05). CONCLUSION：There is a strong relationship between ametropic asthenopia and dry eye syndrome.Spectacles treatment has better effect on improving symptoms and physical signs.

Clinical research of HA petal-like scleral shell implantation

Jun Yuan,Yan-Xian Li,Jiao Zhang,Chao Xu and Ting-Ting Bai

AIM： To investigate the hydroxyapatite(HA) orbital, Ⅰ implant surgery within the petal-shaped scleral shell effects. METHODS：On the cases of enucleation of eyeballs contents indications, we implement the surgery of enucleation of the eye contents. Based on the b-ultrasound and steel balls, we can check out the required model of the HA orbital. After the implantation of hydroxyapatite artificial eye Ⅰ petal-shaped scleral shell, its surface is double layer sclera covered. In the following 6 to 15 months, the postoperative outcome was observed. RESULTS：The 48 cases(48 eyes) were all successfully implanted in HA orbital and achieved more satisfactory appearance of the cosmetic results. CONCLUSION：The Ⅰ implantation of hydroxyapatite artificial eye Taiwan petal-shaped scleral shell keeps eye on six subsidiary muscle and its function, orbital autologous sclera double front coverage prevent eye exposure, improve enucleation of the eye sockets after collapse deformities and achieve ideal eye plastic effect.

Low vision patients with mental health and social support related research

Yu-Hua Xue and Li Zhang

AIM:To study the effect of mental health status and social support of low vision patients. METHODS:Totally 105 patients with low vision were tested as random samples taken from the First Affiliated Hospital of the General Hospital of PLA, Beijing Tongren Hospital and China Academy of Traditional Chinese Medicine Eye Hospital. General information inventory, Symptom Check List-90 (SCL-90) and Social Support Rate Scale (SSRS) were adopted. RESULTS：(1) Compared with normal model, average scores of nine factors in SCL-90 were significantly different except for interpersonal relationship (P<0.01 or P<005). (2) Scores of interpersonal relationship, anxieties, hostility, crankiness, and mental disease among various age groups were different. And there was statistical difference (P<0.05). (3) A negative correlation was found between social support dimension and subjective support dimension through the correlation studies. CONCLUSION ：Mental health problems exist in patients with low vision and inadequate social support could be felt subjectively. Mental nursing should be attached importance to patients with low vision.

Comparison between emmetropia and high myopia eyes in central anterior chamber depth and anterior chamber angle with Pentacam

Hai-Yan Dai,Tian-Hua Piao,Yu-Hua Lin and Bao-Wen Zhao

AIM:To compare the differences in the central anterior chamber depth (CACD) and anterior chamber angle (ACA) measurements between emmetropia and high myopia eyes with Pentacam Scheimpflug. METHODS:In this prospective study, 82 healthy patients and 68 patients with myopia in the Affiliated Hospital of Mudanjiang Medical University were evaluated. Pentacam measurements were performed three times of one patient. A paired t-test was used to compare measurements of CACD and ACA width. The two groups were compared with SPSS 13.0. RESULTS:The differences in ACD and ACA values taken between the two groups were statistically significant (P<0.05). The ACD was deeper and the ACA was wider in patients with myopia. CONCLUSION:Patients with myopia have deeper ACD and wider ACA.

Clinical analysis of gradient AC/A radio for ametropia correction on teenagers

Fang-Fang Lan,Lu Gan and Wu-Xiao Zhao

AIM:To investigate the influence of wearing glasses for teenagers myopia by determining the gradient AC/A radio,and to assess the role of the gradient AC/A radio made in myopia development and progression. METHODS:The study comprised 33 cases (66 eyes) of myopia. Refraction was measured with MPMVA, the gradient AC/A radio measured with risely prism on Phoropter. The main statistic soft ware SPSS 16.0 was used. RESULTS:After wearing glasses,the gradient AC/A ratios were higher than before, and went down after 3 months, there was statistic difference between them (P＜0.05). CONCLUSION:After teenagers of myopia wear suitable glasses,their accommodative and convergent parameters such as the gradient AC/A radio will be normalized gradually. Thus it is beneficial for recovering the function balance of accommodation and convergence.

Clinical studies of excimer laser in situ keratomileusis correction of myopia in patients with keloids

Hong-Su Jiang and Wei-Hua Wu

AIM:To observe and research safety, effectiveness and predictability of excimer laser in situ keratomileusis surgery (LASIK) treatments of myopic patients with keloids. METHODS:Prospective consecutive study. Under the consent of Ethics Committee,16 myopic patients (32 eyes) with keloids underwent LASIK treatment. Their age ranged from 19 to 29 years (mean 23.6 years). Uncorrected distance visual acuity was 0.05-0.2, best-corrected visual acuity(BCVA) was 0.8-1.2. Routine slit-lamp microscope, Orbscan Ⅱ anterior segment analysis system, intraocular pressure, corneal thickness, computer optometry, cycloplegic retinoscopy, subjective refraction, contrast sensitivity and glare as well as other tests were performed. Operation was performed on one eye first in all patients, then on the contralateral eye when no abnormal responses occurred 3 months later.Postoperative follow-up lasted for 2-6 years, average 5820±4.6 months. RESULTS: Postoperative 2-6 years, visual acuity was equal to or greater than 1.0 in 30 eyes (94%), 0.8 in 2 eyes (6%). Postoperative BCVA was greater than or equal to the preoperative in 31 eyes (97%), 1 eye had -0.75D refractive regression. The average difference between postoperative refraction and target refraction was -0.25±0.35 (-0.75~0.75) DS. The corneas were clear, no haze formation or scar healing and no corneal ectasia or corneal thickening occurred. CONCLUSION:LASIK treatment of myopia with keloids is safe and effective. It also shows that the corneal flap and stromal layer are non-scar healing, but a large sample of long-term follow-up is needed for further certification.

Comparison of central corneal thickness measurement with Pentacam, Sirius and an ultrasonic pachymeter

Hui Guo,Bao-Wen Gu,Xu Yang,Chun Zhang and Hai-Hua Xiao

AIM:To determine the agreement among Sirius pachymetric readings and the measurements made with Pentacam and ultrasonic pachymetry. METHODS:In this prospective study, 51 patients（102 eyes）with refractive surgery were enrolled and performed Pentacam and Sirius acquisitions followed by ultrasonic pachymetry. Pachymetric readings on central corneal thickness were recorded with Sirius, Pentacam and the ultrasonic system. Data were compared using t-tests, and the Pearson correlations and Bland-Altman analysis of all pairs were determined. RESULTS:Overall, ultrasonic measurements were significantly lower than all readings from the Sirius and the Pentacam，the Sirius was closest to the ultrasonic measurements values.In those Bland-Altman plots,3.92% of Sirius-Pentacam differences falled outside the 95% confidence limits for the mean difference.Within the limits of agreement,the maximum Sirius-Pentacam absolute difference was 19.5μm. 2.94% of Sirius-ultrasonic pachymetry differences falled outside the 95% confidence limits for the mean difference.Within the limits of agreement, the maximum Sirius-ultrasonic pachymetry absolute difference was 18.667μm. 5.82% of Pentacam-ultrasonic pachymetry differences falled outside the 95% confidence limits for the mean difference.Within the limits of agreement, the maximum Pentacam-ultrasonic pachymetry absolute difference was 25.33μm. CONCLUSION:Sirius system and Pentacam system have a good agreement , and the Sirius system is closer to ultrasound readings than Pentacam system over the results of corneal thickness.

Causes and management of posterior capsule rupture in manual small incision cataract surgery

Shu-Lan Ren,Rui Zhang and Fan-Hong Kong

AIM:To study the causes and management of posterior capsule rupture(PCR) in manual small incision cataract surgery(MSICS). METHODS:The clinical datas of 360 eyes undergoing MSICS in our hospital from 2008 to 2010 year was reviewed,and the causes and management of PCR in 26 eyes were analysed. RESULTS:These 26 eyes all got intraocular lens implantation, and the number of eyes which achieved a best-corrected visual acuity of 0.3 or more was 22(84.6%).No serious complications occurred. CONCLUSION:Posterior capsule rupture which occurrs in diferent stages of the operation was the commonest intraoperative complication in MSICS. The incidence of PCR can be decreased by careful operation,and suitable management leads to satisfactory outcome.

Safety analysis of cataract surgery on senile patients with cardiovascular disease in the peri-operation period

Fei Chen and Li-Qun Dong

AIM:To evaluate safety and reliability of cataract surgery on the patients with cardiovascular disease in the peri-operation period METHODS:A retrospective study was performed in 74 senile cataract patients with cardiovascular disease which were treated by cataract surgery in the past 2 years. RESULTS:Four cases(4 eyes) did not have cataract surgery due to surgical contraindication;70 cases(70 eyes) with cardiovascular disease were treated with cataract surgery monitored by electrocardiography (ECG) and supplied by constant inhalation of low dose oxygen to minimize the surgical risk.5 cases(5 eyes) were treated by extracapsular cataract extraltion (ECCE)+intraocular lens(IOL) implantation and 65 cases(65 eyes) were treated by phacoemulsification with IOL implantation. 3 patients were installed temporary pacemakers before cataract surgery. After follow up for 1 month,65 cases (65 eyes ) had a best corrected visual acuity (BCVA) equal to or more than 0.3 (92.9% ); 4 cases (4 eyes ) had BCVA of 0.05 or less than 0.3 (5.7%); and 1 cases (1 eye) had BCVA less than 0.05 (1.4%). There were no severe complications during the operation. CONCLUSION:Senile cataract patients with cardiovascular disease must be evaluated before surgery. Surgical indications and contraindication must be controlled strictly.The electrocardiographic monitor is a necessary method to the senile cataract patients with cardiovascular disease in the operation.

Clinical observation of phacoemulsification in management of primary angle-closure glucoma

Zhen Li,Dong-Mei Li,Feng-Qi Yu,Liang Yue,Mei Zhang and Hai-Feng Ge

AIM:To observe the changes of the intraocular pressure (IOP) and the central anterior chamber depth (ACD) after phacoemulsification in eyes with primary angle-closure glucoma, and to analyze the therapeutic efficacy. METHODS:In this prospective clinical self control study, 37 cases (49 eyes) of primary angle-closure glucoma were performed phacoemulsification and IOL implantation, of which 23 eyes underwent combined trabeculectomy. All eyes with an attack history of glaucoma underwent combined goniosychialysis.The visual acuity,IOP,ACD and anterior chamber angle were observed postoperatively. All cases were followed up for 3 months to 2 years. RESULTS: Their visual acuity improved in 47 eyes postoperatively, the best-corrected visual acuity was 0.5 or better in 35 eyes (71%).The mean IOP was significantly decreased (P＜0.01), the mean ACD was significantly increased (P＜0.01), and the anterior chamber angles were wider postoperatively. In 47 eyes the long-term IOP were controlled.The IOP increased again in 2 eyes postoperative 1 month, They were patients with chronic angle-closure glucome at the late stage who accepted surgory under high IOP. CONCLUSION:Phacoemulsification and folding IOL implantation is effective and safe in patients with primary angle-closure glucoma.It could decrease the IOP, increase ACD and widen anterior chamber angles significantly. However, patients with angle closure and synechia range ≥ 180° should also undergo trabeculectomy.

Clinical study of modified viscocanalostomy for juvenile glaucoma

Yuan Zong,Qin Chen,Ya Liang and Zhi-Lan Yuan

AIM:To report the surgical results of modified viscocanalostomy for patients with primary juvenile open angle glaucoma (JOAG). METHODS:The medical records of 27 patients (totally 43 eyes) with JOAG were reviewed to learn the results of modified viscocanalostomy for their glaucoma. Gender, age at initial modified viscocanalostomy, family history, corrected visual acuity, glaucoma medication used, surgical outcome duration of postoperative observation, preoperative and postoperative intraocular pressures (IOP) were reviewed. Complete success was defined as an IOP≤21mmHg, qualified success as IOP≤21mmHg with use of glaucoma medications, and failure as IOP >21mmHg despite medical therapy. The surgical technique used to perform the modified viscocanalostomy procedures was reviewed and the absence of significant complications noted. RESULTS:Complete success was achieved in 74% of the eyes over the two years follow-up period .Mean initial measures of IOP were 35.38±7.15mmHg. On the 24 months follow-up visit, the IOP was 16.50±2.52mmHg.The reduction of IOP was 18.88mmHg (P<0.01). No significant surgical complications occurred intraoperatively and posteperatively. CONCLUSION:Modified viscocanalostomy is a potentially effective initial surgical treatment of JOAG with a higher long-term success rate and fewer risks of postoperative complications.

Observation of fourier-domain optical coherence tomography in traumatic macular hole

Li-Li Liu,Ran-Yang Guo,Wen-Li Fu,Xue-Jun Li,Mei Wang and Fang Jin

AIM:To observe the characteristic of the images of fourier-domain optical coherence tomography (FD-OCT) in patients with traumatic macular hole (TMH ) and to detect the clinical significance of FD-OCT. METHODS:Consecutive 29 patients (29 eyes) diagnosed with TMH by examinations of visual acuity, slit-lamp and direct or indirect ophthalmoscopy underwent FD-OCT. The characteristic of the images of FD-OCT in patients with TMH were retrospectively analyzed. RESULTS:Of the 29 patients (29 eyes) with TMH, lamellar macular hole was in 3 cases of 3 eyes(10%), OCT showed macular neurosensory partial deletion; full-thickness macular hole was in 26 cases of 26 eyes(90%), OCT images were seen macular neurosensory full-thickness loss. In the 26 patients with full-thickness macular hole, macular hole with full-thickness defect of neurosensory retina without edema or detachment at the margin was in 3 cases 3 eyes; full-thickness macular hole with edema of neurosensory retina at the margin in 6 cases 6 eyes; macular hole with localized detachment of the neurosensory retina at the margin in 5 cases 5 eyes; macular hole with choroidal rupture at the margin in 7 cases 7 eyes; macular hole with thinning neurosensory retina at the margin in 3 cases 3 eyes and macular hole with epiretinal membrane in 2 cases 2 eyes. CONCLUSION:FD-OCT can clearly observe the form of traumatic macular hole and display the surrounding tissue damage.FD-OCT is useful for disease evaluation and clinical diagnosis of TMH.

Analysis report for retinopathy of prematurity screening in 383 cases

Fan Lü,Song-Yi Wu,Xiao-Xia Li and Min-Ling Lin

AIM:To analyse the incidence and risk factors of retinopathy of prematurity (ROP) in Quanzhou region. METHODS:The fundus of 383 premature infants were reviewed,who were examined in Ophthalmology clinic and NICU from October 2010 to September 2011, and a meta-analysis was performed. RESULTS:In all the 383 premature infant cases, ROP was found in 53 cases, accounted for 13.8%, all binocular. Pre-threshold typeⅠROP in 22 cases, accounted for 5.7%, which were treated with photocoagulation therapy. The 5 period ROP was in 1 case, accounted for 0.3%. Aggressive posterior ROP was in 2 cases, accounted for 0.5%. Data also showed that the incidence and severity of ROP had a negative corrlation with birth weight and gestational age, especially birth weight. CONCLUSION:Low birth weight and gestational age are the fundamental risk factors of ROP. We should develop standard ROP screening for those high risk premature infants.

Characteristics of multifocal electroretinogram in proliferative diabetic retinopathy

Ya-Li Zhou,Hong-Wei Yang,Yang Yang,Yong Yu and Xiao-Long Chen

AIM:To observe the characteristics of the images of multifocal electroretinogram (mf-ERG)performed on the patients with severe proliferative diabetic retinopathy（PDR)and its clinical significance. METHODS:Forty PDR patients(44 eyes) and forty normal control subjects (40 eyes) were tested with mf-ERG. The data were processed with software SPSS 13.0. RESULTS:mf-ERG showed the response densities of ring 1-ring 5 areas in PDR were significantly decreased while the latencies of ring 4 of N1 wave and the latencies of ring 2,ring 3,ring 4 and ring 5 of P1 wave were significantly prolonged with normal control group. CONCLUSION:mf-ERG can provide more information to evaluate the retina function effectively in PDR.

Clinical research on application of compound anisodine in adolescent patients with acute optic neuritis

Zhong-You Yang,Fu-Bin Pei,Ji-Jun Yang,Bo-Wen Lu,Chun-Ping Ming and Xiao-Yu Zhang

AIM:To observe the application of compound anisodine injection,hormone impact and supplemental energy comprehensive treatment of adolescents with acute optic neuritis. METHODS:Sixty-five cases (82 eyes) adolescent patients with acute optic neuritis were randomly divided into 2 groups:a treatment group of 33 cases (41 eyes) and a control group of 32 cases (41 eyes). At the same time, as the treatment group and control group were treated with the same systemic medication, the affected eyes in the treatment group were injected with compound anisodine around superficial temporal artery, 1 time a day, 2mL each time, In 14, 30, 60 days,the changes in course time, visual acuity, visual evoked potentials and fundus fluorescein angiography were observed before and after treatment in 2 groups. RESULTS: In 14, 30, 60 days, the efficacy observed in treatment group was higher than that in the control group,the difference was statistically significant (P<0.05). CONCLUSION:Combination with compound anisodine injection beside the superficial temporal artery for adolescents with acute optic neuritis can shorten the disease course, reduce the amount of hormone, and increase the patient’s visual acuity more than traditional hormone impact and supplemental energy comprehensive treatment.

Intraocular pressure change after different treatments for thyroid-associated ophthalmopathy

Jiang Yu and Jin Xu

AIM:To study the effect of methylprednisolone pulse therapy and extraocular muscle surgery on intraocular pressure (IOP) in patients with thyroid-associated ophthalmopathy (TAO) . METHODS:Twenty-six patients（42 eyes） with TAO who visited our department were given methylprednisolone pulse therapy or extraocular muscle surgery between Jan.2008 and Dec.2010 were analyzed retrospectively. Pre-operative and post-operative IOP in both primary gaze and up gaze were all studied. RESULTS:In the 16 patients treated with methylprednisolone pulse therapy, the mean pre-treatment IOP was 21.13±4.10mmHg in primary gaze and 23.75±5.67mmHg in upgaze. After treatment the mean IOP was 16.81±3.69mmHg（P＜0.05）and 18.5±4.03mmHg（P＜0.05）respectively. The mean pre-operative IOP in the 10 eyes who had extraocular muscle recession was 18.4±2.49 mmHg in primary gaze and 24.7±3.63mmHg in upgaze. The post-operative IOP was 17.3±1.55mmHg（P＞0.05）and 18.6±2.2mmHg（P＜0.01）respectively. In patients with a pre-operative IOP≥21mmHg were observed a greater reduction in IOP (P<0.05). CONCLUSION: We observed a significant reduction in IOP in the two groups of patients after treatment for TAO, however no significant difference was found in IOP in primary gaze after extraocular muscle surgery.

Clinical observation of blepharospasm treated with comprehensive therapy

AIM:To study the treatment and efficacy of comprehensive therapy for blepharospasm. METHODS:Several methods were as follows: therapy for primary external ophthalmopathies, psychological therapy, acupuncture therapy, systemic and local drug therapy.The above comprehensive therapies were used to treat blepharospasm. RESULTS:About 77.4 percent of the patients with blepharospasm symptoms disappeared after 6 times acupuncture therapy. 96.8 percent of the patients symptoms disappeared after 12 times acupuncture therapy.3.2 percent of the patients symptom did not disappear after acupuncture therapy. CONCLUSION:It is an effective and safe treatment of blepharospasm with comprehensive therapy.

Amniotic membrane and fascia lata transplantation for exposure of hydroxyapatite implantation in orbit

Hai-Shan Song and Xin Liu

AIM: To investigate the methods and treatments of the exposure of hydroxyapatite implantation in orbit. METHODS:Thirteen cases of hydroxyapatite exposure were included in this study. They were treated with amniotic membrane and fascia lata transplantation. Artificial eyes were implanted in 5 to 8 weeks. The patients were followed 6 to 18 months. RESULTS: No exposure appeared and the cosmetic effect was satisfactory. CONCLUSION: Amniotic membrane and fascia lata transplantation is an effective method to repair hydroxyapatite exposure.

Changes of central corneal thickness after thin-flap laser in situ keratomileusis

Ming-Hui Zhao,Jun Zou,Ping Hu and Qiang Wu

AIM:To analyze the changes of central corneal thickness (CCT) and refractive error in post thin-flap laser in situ keratomileusis (LASIK) eyes. METHODS:Totally 158 myopic patients (302 eyes) having thin-flap LASIK were prospectively evaluated. CCT and refractive error were measured before and 1 day, 1 week, 1 month, 3, 6 months after surgery. Age, predicted photoablation depth, optic zone ,postoperative predicted diopter and actual diopter changes were also recorded. RESULTS:Preoperatively, the mean CCT was 531.6±24.3μm. On the first day postoperatively, CCT rapidly decreased. At 1 month, it was 427.2±38.0μm. At 3 months, it was 434.4±38.2μm, and at 6 months, it was 435.6±38.0μm. The CCT difference before and 1 day after LASIK was highly correlated with predicted photoablation depth（r=0.916, P<0.01）. The increase of corneal thickness in post LASIK eyes in 6 months was negatively correlated with age, preoperative refractive error, and optical zone, respectively (r=-0.180, P=0.026; r=-0.187, P<0.01; r= -0.171, P=0.137, respectively). The spherical equivalent refraction at 6 months was close to the preoperative predicted values. All patients were followed up for six months, no case of refractive regression occurred.At 6 months, all the uncorrected visual acuity was≥0.8, the average visual acuity was 1.3±0.2. CONCLUSION:At 6 months after surgery, CCT and spherical equivalent refraction were relatively stable. The increase of CCT in post thin-flap LASIK eyes in 6 months was negatively correlated with age, preoperative refractive error, and optical zone, respectively. The spherical equivalent refraction at 6 months was close to the preoperational predicted values. The treatment of myopia in thin-flap LASIK has a good accuracy, and a long-term prediction.

Posterior chamber phakic intraocular lens implantation for moderate to high myopia

Shan-Xiang Li,Gang-Ping Zhao,Jian-Hong Yu,Guo-Pei Li,Yan-Hua Wang and Zhui Li

AIM:To assess the clinical outcomes of implantation of a lens consisting of a biocompatible collagen copolymer (Visian implantable Collamer lens \[ICL\]; STAAR Surgical, Nidau, Switzerland) for moderate to high myopia. METHODS:Totally 24 eyes of 15 patients with myopic refractive errors of -3.50 to -15.50 diopters (D) who underwent ICL implantation and routine postoperative examinations were evaluated. Before and 1day,1 month, 3, 6 and 12 months after surgery, the safety, efficacy, predictability, stability, and adverse events of the surgery were assessed. RESULTS:The uncorrected visual acuity was 0.90±0.29(0.5-1.5) after surgery, higher than the mean preoperative best-corrected visual acuity 0.84±0.24(0.4-1.2) with non-significance (P>0.05). The average values for spherical refractions were -0.20±0.68（1.00- -1.25）DS after surgery, lower than that of preoperative -10.19±3.37(-3.50--15.50)DS with remarkable significance (P<0.05). The average values for cylindrical refractions were -0.41±0.58DC after surgery, lower than that of preoperative -1.98±1.62DC with remarkable significance (P<0.05). The average anterior chamber depth were 225±0.32mm after surgery, lower than that of preoperative 3.08±0.21mm with remarkable significance (P<0.05).There was not significant difference between preoperative and postoperative intraocular pressure. The surgery was without serious complications. CONCLUSION: Implantation of ICL is safe and effective and provides predictable and stable refractive results in the treatment of moderate to high myopia during one-year observation, suggesting its viability as a surgical option for the treatment of such eyes.

Study of RGPCL and frame glasses on accommodative lag in student myopia

Zhong-Long Yang,Chun-Yan Zhang,Fang Chen and Zhi Chen

AIM:To discuss the differences between rigid gas permeable contact lens(RGPCL) and frame glasses in juvenile myopia accommodative lag. METHODS: Fifty-seven newly diagnosed,10 to 15 years old, moderate to low myopia patients(114 eyes)were examined with medical optometry, corneal curvature and corneal topography.According to the wishes of parents, 27 patients chose RGPCL, 30 patients chose frame glasses. Based on best-corrected visual acuity, accommodative lag was determined by low diopter neutralization dynamic retinoscopy method in two groups. The patients were reexamined one time every 3 months, accommodative lag was measured again using the same method for comparative analysis after 1 year. RESULTS:Eye accommodative lag had no significant difference between the two groups (F=1.961, P=0.121). After 1 year , 25 patients(50 eyes) adhered to wearing glasses in RGPCL group, the amount of accommodative lag was no significant difference (P>0.05); 27 patients(54 eyes) adhered to wearing glaeees in frame glasses group, the amount of accommodative lag was significantly different (F=4.658, P<0.05); comparing the two groups (F=6.134, P<0.01). CONCLUSION: Accommodative lag in RGPCL-wearing eye was significantly less than that in frame glasses-wearing eye, which may have a role in slowing progress of juvenile myopia and should be vigorously promoted.

Effects of central corneal thickness on 24-hour intraocular pressure fluctuation

Chang-Hua Ye,Jun Li,Ding Lin and You-Qin Jiang

AIM:To evaluate the effects of central corneal thickness (CCT) on 24-hour intraocular pressure (IOP) fluctuation. METHODS: Measurements of IOP were obtained by Goldmann applanation tonometer on 5am,7am,10am,2pm,6pm,and 10pm during a 24-hour period from 39 untreated glaucoma patients and 44 age-matched normal control subjects. CCT was measured in all subjects using ultrasound pachymetry. The association between IOP fluctuation (peak IOP-trough IOP) during the 24-hour period and the CCT was assessed in both glaucoma patients and healthy age-matched controls using Spearman correlation. RESULTS: The average 24-hour IOP, peak IOP, IOP fluctuation and CCT in glaucoma group and control group were 21.33±2.91mmHg and 16.19±2.33mmHg（t=12.615，P=0.000）, 24.67±2.72mmHg and 18.55±2.45mmHg（t=12.613，P=0.000）, 6.63±3.26 mmHg and 4.72±1.60mmHg（t=4.709，P=0.000）, 544.44±32.11μm and 537.16±27.66μm（t=1.569，P=0.119）, respectively. The average 24-hour IOP, peak IOP and IOP fluctuation were significantly different between normal and glaucomatous patients. The CCT, however, was not significantly different between the two groups. There was no statistically significant correlation between IOP fluctuation and CCT in glaucomatous (r=0.140，P=0.222) and normal subjects (r=0.050，P=0.642). There was no significant difference in average 24-hour IOP, peak IOP or IOP fluctuation between glaucomatous patients and normal subjects with thick(CCT≥545μm) and thin corneas(CCT＜545μm). CONCLUSION:Twenty-four-hour IOP fluctuations are not correlated with CCT measurements in glaucoma patients and normal subjects.

Corneal endothelial cell damage-related factors analysis in phacoemulsification

Lie Ma,Fang Liu,Li-Ping Gu and Wei-Li Li

AIM:To investigate the effect of various parameters on corneal endothelial cells in cataract surgery. METHODS:All 55 cases of cataract patients were randomly selected by lens nuclear grade. With cataract phacoemulsification and intraocular lens implantation, intraoperative ultrasound energy, time and the cumulative releases of energy (CDE) were recorded. Before and 1 week after surgery the central corneal endothelial cell density of the region, the proportion of hexagonal cells were measured. Stepwise regression analysis of the data using software SPSS 17.0 were processed. Affecting factors on the decline of corneal endothelial cell density and hexagonal cell proportion were analysed to identify factors that affect the corneal endothelial cell damage. RESULTS:Before and 1 week after surgery, corneal endothelial cell density was 2685.78±413.39/mm² and 2524.39±557.80/mm², hexagonal cells proportion was 53.04±9.68% and 49.82±9.39%. Compared with the preoperative,postoperative corneal endothelial cell density was significantly decreased and the proportion of hexagonal cells decreased. Statistics found that the strongest influence factor on the corneal endothelial cell was nuclear hardness (P=0.000), followed by the cumulative release of phaco-emulsification energy (P=0.041) and phacoemulsification time (P=0.046). According to statistical analysis they were statistically significant (P<0.05). CONCLUSION:The degree of lens nuclear grade, phacoemulsification ultrasound energy and the length of phacoemulsification time are major risk factors on the corneal endothelial cell damage. Therefore, improving surgical techniques, reducing intraoperative phaco-emulsification time, reducing the release of invalid ultrasonic energy can effectively reduce the corneal endothelial cell damage.

Effect of phacoemulsification and intraocular lens implantation on high myopia with cataract

Zhen Li,Feng-Qi Yu,Liang Yue and Mei Zhang

AIM:To evaluate the effect of phacoemulsification and intraocular lens implantation under topical anesthesia on high myopia with cataract. METHODS:In a retrospective study, 60 cases (88 eyes ) of high myopia with cataract underwent phacoemulsification and intraocular lens (IOL) implantation under topical anesthesia. Preoperatively, best-corrected visual acuity (BCVA) ranged from light perception to 0.04 in 40 eyes, from 0.05 to 0.25 in 39 eyes and from 0.3 to 0.4 in 9 eyes.The spherical equivalent ranged from -6.0D to -25D. The eye axial length ranged from 26.05 to 33.4 mm（<30mm，n=69； ≥30mm,n=19）. All cases were followed up for 1 to 3 months. RESULTS:All of the 88 eyes accepted folding IOL implantation，spherical IOL in 46 eyes,aspherical IOL in 39 eyes, and multifocal IOL in 3 eyes,their visual acuity improved in all cases. BCVA achieved 0.5 or better in 54 eyes（61%），0.3 or better in 73 eyes（83%）and 0.05 or better in 83 eyes（94%）. No severe complications were observed. CONCLUSION:Phacoemulsification and folding IOL implantation under topical anesthesia is effective and safe,it is an ideal proceduce for high myopia with cataract.

High intraocular pressure at the early stage after small incision non-phacoemulsification cataract surgery

Hong-Li Zhao,Guo-Cui Tao and Xiao-Qing Fei

AIM:To detect the incidence and mechanism of high intraocular pressure(IOP) at the early stage after small incision non-phacoemulsification cataract surgery. METHODS:Totally 116 patients (116 eyes) who had undergone small incision non-phacoemulsification cataract surgery in our hospital in the first half of 2011 were retrospectively analysed. RESULTS:Among the 116 eyes，postoperative IOP elevation occurred in 35 eyes (about 30.2%).The IOP reached the peak mostly 6 to 24 hours after the surgery, up to 56mmHg (1mmHg = 0.133kPa). 88.6% of high IOP occurred at the same time. And in this period the incidence of IOP elevation were significantly higher than in other periods (P<0.01). 62.9% of high IOP rose slightly, less than 30mmHg. CONCLUSION:The incidence of higy IOP at the early stage after small incision non-phacoemulsification cataract surgery is high, but most of the IOP rose slightly. The most common reason is that some substances blocked the trabecular meshwork. These substances were residual viscoelastic agent, residual cortex, denatured red blood cells, macrophages and pigment particle.These substances blocked the trabecular meshwork, and aqueous humor outflow was obstructed, and then the IOP rose. Other reasons also included IOL subluxation, endophthalmitis, etc.

Cultivation and identification of nanobacteria in aqueous humor of patients with age-related cataract

You-Ping Zheng,Xing-Rui Lan,Shao-Qiong Guo,Jie-Mei Liu and Gui-Fang Wang

AIM:To isolate, culture and identify the nanobacteria (NB) from aqueous humor of patients with age-related cataract in our department. METHODS:Sample nanobacteria in aqueous humor of 30 patients with age-related cataract were collected for NB culture in this study. Immunohistochemistry, transmission electron microscopy (TEM) were used to investigate the appearance and components of cultured NB. RESULTS:Twelve aqueous samples out of 30 (40%) showed growth of NB, 1 of 5 showed growth of NB in the saline control group, but none growth in the control group. TEM showed needle-like nanobacteria aggregates of different sizes. CONCLUSION:For the first time we isolated, cultured and identified nanobacteria in aqueous of patients with age-related cataract, indicating that nanobacteria infection is related with age-related cataract.

Clinical effect of trans-scleral diode laser cyclophotocoagulation and ibuprofen oral on neovascular glaucoma

Mei Yu,Lin Xu and Gang Li

AIM:To evaluate the main reason of the post operative pain of trans-scleral diode laser cyclophotocoagulation and the clinical effects of combined treatment of trans-scleral diode laser cyclophotocoagulation and ibuprofen oral on late neovascular glaucoma(NVG). METHODS:Totally 30 cases(30 eyes) of NVG accepted trans-scleral diode laser cyclophotocoagulation and ibuprofen oral.All cases were followed up for more than 6 months about intraocular pressure (IOP) and early postoperative pain. RESULTS:The average preoperative IOP was 56.23±21.62mmHg, and the average IOP within 24 hours after the manipulation was 31.36±10.01mmHg (t=8.009,P=0.001).The pain of all cases were relieved obviously. There was mild pain in 3 eyes, heavy pain in 18 eyes and severe pain in 9 eyes before operation. There was no pain in 14 eyes,mild pain 9 eyes,heavy pain in 7 eyes within 24 hours after operation. There was no pain in 21 eyes, mild pain in 8 eyes, heavy pain in 1 eye within 72 hours after operation. CONCLUSION:Trans-scleral diode laser cyclophoto-coagulation and ibuprofen oral can alleviate the post-operative pain and lower IOP for late NVG effectively.

Compared analysis of the efficacy of different treatment methods for neovascular glaucoma

Zhi Yang,Xin-Hua Wang and Ruo-Xi Li

AIM:To compare the efficacy of three different treatment methods for neovascular glaucoma (NVG). METHODS:Totally 51 NVG patients (54 eyes)were retrospectively observed and analyzed, according to the different surgical treatment the patients were divided into three groups.Group A, 27 patients (28 eyes)were treated with simple cyclophotocoagulation; Group B, 14 patients (14 eyes) with trabeculectomy and intraoperative mitomycin C (MMC) application 1 week after avastin intravitreal injection; Group C , 10 patients (12 eyes) with vitrectomy and drainage valve implantation 1 week after avastin intravitreal injection.In the treatment of both Group B and C, the whole course of panretinal photocoagulation (PRP) were completed as early as possible. RESULTS:The mean intraocular pressure(IOP) in patients discharged from hospital:Group A,25.75±1.44mmHg, surgical success rate was 21%;Group B was 12.86±1.37mmHg, surgical success rate was 86%;Group C was 16.58±1.85mmHg, surgical success rate was 83%. CONCLUSION:The three methods can all reduce IOP on different levels. But IOP in most patients within a week after cyclophotocoagulation is not in the normal range. Therefore, visualizable eye should not choose the simple cyclophotocoagulation.Anti-vascular endothelial growth factor (VEGF) drugs combined with anti-glaucoma surgery can effectively control the IOP within a week.For the preservation of visual function in patients,it was better than simple cyclophotocoagulation.

Study on operational timing choosing of primary angle-closure glaucoma in high intraocular pressure

Ai-Ping Gu,Yi Wu,Yan-Fang Zhong,Pei-Yi Long,Duo Tan and Yan-Fang Liu

AIM:To discuss the operational timing choosing and the technical details of primary angle-closure glaucoma (PACG) in high intraocular pressure. METHODS:The curative effects of 57 cases (57 eyes) with PACG of our hospital in two years ( January 2009 to December 2010) were retrospectively analyzed, these cases were treated with surgical therapy in high intraocular pressure (>40 mmHg). RESULTS:There was no complication in these cases. Followed up for six months, the vision of 53 eyes (93%) were improved and 4 eyes (7%) were not improved; intraocular pressure of 48 eyes (84%) treated with surgery and 9 eyes (16%) treated with combinations of surgery and drug administration were controlled under 21mmHg. CONCLUSION:If the intraocular pressure can not lowered to normal level through regular drug administration for the acute onset of PACG, there is an emergent need for surgical measure to protect and recover the vision of patients.

Macular edema and visual outcome following cataract surgery in patients with diabetic retinopathy

Ling-Yue Jiang and Zhao-Yang Chen

AIM:To compare the macular edema (ME) and visual outcome after cataract surgery in eyes with diabetic retinopathy with normal eyes. METHODS:Thirty-three patients with type-2 diabetes and 30 controls were enrolled. Visual acuity and fundus were examined preoperation, and at postoperative 7 days, 6 weeks and 6 months. Fluorescein fundus angiography(FFA) was performed preoperation and at postoperative 6 weeks. Postoperative ME and visual recovery in two groups were observed. RESULTS:There was no statistically significant difference in visual acuity between preoperative and postoperative 7 days or 6 months, but at 6 weeks there was a significant difference with lower VA in the diabetic group. 7% of control and 16% of diabetic eyes developed clinical cystoid macular edema (CME). Incidence of fluorescein angiography (FA) leakage was 21% in control and 75% in diabetic eyes. There was no significant difference in visual acuity at postoperative 6 months between two groups, and ME recovered. CONCLUSION:The final visual outcome in eyes with mild to moderate retinopathy is as good as in normal eyes, but an increased frequency of macular changes may protract recovery of full vision. For this kind of CME, generally no treatment is needed, they can recover by themselves.

Clinical observation of using nerve growth factor after retinal detachment surgery

Jian Wang,Zheng-Gao Xie,Fang Chen,Chao-Rong Zhuang and Dong-Sheng Ye

AIM:To observe the clinical effects of using nerve growth factor after retinal detachment surgery. METHODS:All 32 cases of retinal detachment surgery were randomly divided into treatment and control groups. The control group was given corticosteroids, Ginkgo biloba and methylcobalamin tablets, the treatment group was given intramuscular nerve growth factor on the above basis. The visual acuity, visual field and visual evoked potential of two groups were compared. RESULTS:The treatment groupˊs improvement of visual acuity, visual field and visual evoked potential were better than the control groupˊs. CONCLUSION:Nerve growth factor used after retinal detachment surgery improves visual function.

Observation of curative effect on allergic conjunctivitis with azelastine hydrochloride eye drops and emedastine difumarate eye drops

Bing Han,Chun-Min Liu,Yuan Wang and Jing Chen

AIM:To compare the curative effect on allergic conjunctivitis between azelastine hydrochloride eye drops and emedastine difumarate eye drops. METHODS:Two groups with allergic conjunctivitis were treated with azelastine hydrochloride eye drops and emedastine difumarate eye drops separately, twice a day, one drop per time,at interval of 12 hours, the treatment stopped after 14 days.The follow-up observations were done in 3 days, 7 days and 14 days during treatment as well as 7 days after finishing treatment. RESULTS:With 3 days treatment, the differences between these two groups on curative ratio(P<0.05) and effective ratio (P<0.01) were significant. But with 7 days and 14 days treatment as well as 7 days after treatment, the differences were not significant. CONCLUSION:On the treatment for allergic conjunctivitis, both of azelastine hydrochloride eye drops and emedastine difumarate eye drops have safe effect, but in the early stage, the effect of azelastine hydrochloride eye drops is better and more obvious.

Intravitreal triamcinolone acetonide assisted pars plana virectomy for the treatment of proliferative diabetic retinopathy

Xian-Zhen Ma,Hong-Sheng Bi,Xing-Rong Wang and Wei-Hong Dong

AIM:To study the advantages and complications of intravitreal triamcinolone acetonide(TA) assisted pars plana virectomy(PPV) for the treatment of proliferative diabetic retinopathy(PDR). METHODS: The study included 36 case (48 eyes) who underwent PPV for the treatment of PDR with vitreous hemorrhage.They received an intravitreal injection of 01mL triamcinolone acetonide 5 to 7 days before operation.During the surgery, 0.3 to 0.5mL of TA was injected into the vitreous cavity to visualize the posterior hyaloid. RESULTS:Inflammatory reaction degree: 4 eyes(8%) had little exudation membrane in pupil postoperatively and absorbed at postoperative 5-7 days; 15 eyes (31%) had aqueous flare which disappleared at about postoperative 3-5 days. Intraocular inflammation was light and no retinal toxicity was found in any eye. The postoperative visual acuity was improved in 39 eyes.The difference of the mean intraocular pressure was not statistically significant after intravitreal TA. During one week after operation, the difference was statistically significant between the mean preoperative and postoperative intraocular pressure.But the difference was not statistically significant after 3 months. CONCLUSION: Intravitreal TA assisted PPV for the treatment of PDR was useful with no serious complications.

Effect of ICGA in differential diagnosis between nonarteritic anterior ischemic optic neuropathy and optic neuritis

Pei-Lin Lü and Run-Sheng Wang

"AIM:To study the role of indocyanine green angiography(ICGA) in differential diagnosis between nonarteritic anterior ischemic optic neuropathy (NAION) and optic neuritis. METHODS:Twenty-seven cases 27 eyes with detailed clinical data which were not easily diagnosed by optic disc edema on fundus photography were enrolled. All eyes received examination using the retinal and choroidal angiography(FFA and ICGA). The gender and age matched 20 cases 20 normal control eyes received FFA and ICGA over the same period, and continuous images of each group were analyzed. RESULTS:In 20 cases of control eyes,ICGA examination showed early peripapillary choroidal vascular fluorescence filling in normotension. The performance characteristics of early continuous ICGA pictures from the other 27 eyes showed that the optic disc edema can be clearly divided into ischemic and non-ischemic; ischemic images demonstrated a temporary disc ischemia area and the corresponding choroidal regional hypo-fluorescence, from which the scope and extent of ischemia can be directly determined and the 16 eyes were considered to have NAION; 11 eyes with images demonstrating immediately vascular fluorescence filling in normotension in showed the same as normal control and they were considered to have optic neuritis. CONCLUSION:Some of the optic disc edema is difficult to diagnosis accurately. Choroidal angiography showed that there is a disc choroidal regional fluorescein filling defect for NAION with characteristic changes. These changes contribute to the differential diagnosis and are worthy of attention.

Effect of berberine on the morphology of orbital adipose tissue in thyroid associated ophthalmopathy

Gui-Qin Liu,Fang-Wei Ying,Feng Zhou,Ming Ouyang and Ning Fan

AIM:To investigate the effect of berberine on the morphology of orbital adipose tissue in thyroid associated ophthalmopathy(TAO). METHODS:Forty-eight patients with TAO were randomly assigned to no berberine therapy (group 1, TAO control) or berberine therapy for 4 weeks (group 2), 8 weeks (group 3), and 12 weeks (group 4) before undergoing orbital decompression. The orbital adipose tissue was obtained from the surgery, and undergone frozen section and HE staining. The morphology of adipocyte was investigated. RESULTS:The mean deviation sectional area of orbital adipocytes in normal control were 5909.4625±664.91 (pixel²), in group 1, 2, 3 and 4 were 46077.5357±11263.27, 19634.100±3512.43, 17529.69±4342.99, 27980.1304±6123.96 (pixel²) respectively. There were significantly difference in mean deviation sectional area of orbital adipocytes between normal control and TAO control, normal control and group 1. There were significantly difference in mean deviation sectional area of orbital adipocytes among TAO control and all experimental groups. The mean sectional area of orbital adipocytes in normal control were 13780.104±7542.28 (pixel²), in group 1, 2, 3 and 4 were 45210.250±25854.40, 45554.80±15544.69, 39163.94±12696.71, 27184.889±10703.85(pixel²) respectively. There were significant differences in mean sectional area of orbital adipocytes between normal control and all experimental groups, between group 1 and group 4. CONCLUSION: The mean sectional area of orbital adipocytes in patients with TAO was larger than that of normal control. The difference in sectional area of orbital adipocytes in TAO patients was larger than that of normal control. Taking berberine can decrease the difference of orbital adipocytes size in patients with TAO, and reduce the size of enlarged adipocytes to some extent.

Clinical analysis of deproteinized calfblood extract eye gel for treatment of dry eye

Xiao-Xia Ding,Tong-Juan Lu and Pin Li

AIM:To evaluate the efficacy of deproteinized calfblood extract eye gel for dry eye by observing changes in the patientˊs subjective symptoms and laboratory test results of dry eye before and after treatment. METHODS:Totally 22 selected cases of 43 dry eyes were treated with deproteinized calfblood extract eye gel 3 times/d.Patients were observed with subjective symptoms: dryness, foreign body sensation, burning sensation, visual fatigue, redness, pain, photophobia, lacrimation; and dry eye laboratory tests: fluorescein staining, tear film break-up time(BUT), SchirmerⅠtest (SⅠt) on the day of treatment and 1 week,2 weeks,1 month after medication. RESULTS:One month after medication, the patient’s subjective symptoms gradings were significantly different with those before treatment (P<0.01), the 8 subjective symptoms were visibly relieved; after treatment, the patientˊs fluorescein staining, BUT and SⅠt values were significantly different with those before treatment (P<0.01). CONCLUSION: Deproteinized calfblood extract eye gel is effective for treatment of dry eye.

Clinical observation on integration of traditional Chinese medicine and western medicine for Vogt-Koyanagi-Harada syndrome in 34 cases

Hao Chen and Xiang-Xia Luo

AIM:To discuss the clinical efficacy of integration of traditional Chinese medicine and western medicine for Vogt-Koyanagi-Harada syndrome. METHODS:All 34 cases (68 eyes) with Vogt-Koyanagi-Harada syndrome were treated with low-dose corticosteroids, immunosuppressive agents combined with treatment based on syndrome differentiation of traditional Chinese medicine. RESULTS:Totally 60 eyes cured, 4 eyes improved, the total effective rate was 94%. Visual acuity was better than 1.0 in 24 eyes, and better than 0.2 in 64 eyes. Visual acuity in 4 eyes was less than 0.2 because of cataract. CONCLUSION:Integration of traditional Chinese medicine and western medicine for Vogt-Koyanagi-Harada syndrome can effectively control inflammation and reduce the dosage of corticosteroids and immunosuppressive agents.

Clinical application report of orthokerato-logy in 423 cases

Jian-Zhuo Chen,Lu Chen,Yuan-Yuan Li,Run Wang and Bo Wang

AIM:To observe the effect and safety of orthokeratology rectifying myopia and controlling the development of myopia. METHODS:The myopia of 423 cases (789 eyes) were corrected by orthokeratology, and the changes of corneal condition, vision, dioptre were observed.At the same time, patients under the age of 15,who had worn orthoklenses for over one year were studied. RESULTS:All patients were satisfied with the effect and safety of orthokeratology. CONCLUSION:Orthokeratology as a non-traumatic way rectifying myopia can reduce dioptre and control the development of myopia effectively.

Research on the macular ganglion cell thickness in the congenital high myopic amblyopia patients

Hong-Wei Deng,Qing-Shan Chen,Chun-Min Liu and Hui-Li Jia

AIM:To detect the relationship of macular retinal ganglion cell thickness with the extent of amblyopia in the highly myopic amblyopia patients. METHODS:Totally 12 patients (20 eyes) with congenital high myopia and amblyopia were measured by the 10g/L atropine mydriasis. Patientsˊ age was 3.5 to 15 years old. Fourier-domain optical coherence tomography (FD-OCT) were used to measure the macular ganglion cell thickness and macular retinal thickness, and compare the correlation of the ganglion cell layer thickness ratio of the total retinal thickness with amblyopia and myopia degree of the patients. RESULTS:The study found that there was no significant correlation between myopia degree of the patients with high myopia and best-corrected visual acuity. There was a phenomenon that the higher the degree of myopia the thinner the thickness of the ganglion cell layer. CONCLUSION:Patients with congenital myopic amblyopia has the decreased proportion of ganglion cells layer in macular center thickness.

Related factors analysis and treatment of amblyopia in children

Ji-Jin Zhang and Feng Xu

AIM:To study the formation and treatment characteristics of amblyopia in children. METHODS:Retrospective analysis was done on the clinical data of treatment of 176 cases (291 eyes) of amblyopia in children. RESULTS:All 176 cases of amblyopia in children, mild amblyopia was in 19 cases, moderate 81 cases, severe 76 cases; refractive error accounted for 68.75%, strabismus accounted for 14.21%, anisometropia accounted for 11.93%, the form deprivation and congenital amblyopia accounted for 3.41% and 1.70%; total cure rate was 70.80%. CONCLUSION: Most amblyopia in children are functional, efficacy is closely related to children age, the type and degree of amblyopia.Comprehensive therapy focused on the gradual elimination of macular functional inhibition of amblyopia eye, which is the the best measurement for the treatment of amblyopia in children.

Long-term effect of intravitreal bevacizumab injection for chronic central serous chorioretinopathy

Xi Chen,Qing-Huai Liu and Xiao-Yi Liu

AIM: To evaluate the safety and long-term efficacy of intravitreal bevacizumab injection(IVB)as therapy for chronic central serous chorioretinopathy(CSC).

METHODS: Six patients(6 eyes)with CSC were treated with an intravitreal injection of bevacizumab(1.25mg/0.05mL). 5 patients received second intravitreal injection of bevacizumab 3 months after the first injection. Patients had follow-up on 1, 3, 6, 12, 24 months after the injections. Outcome measures included pre and post-treatment changes in best-corrected visual acuity, intraocular pressure(IOP), subretinal fluid(SRF)measurement with optical coherence tomography(OCT), changes in fluorescein angiography(FA).

RESULTS: After the first injection, 1 patient showed resolution of SRF completely, while his visual acuity showed no change; 1 patient whose visual acuity improved and SRF resolved completely on 1 month recurred; 3 patients showed no obvious changes in the SRF and in visual acuity; 1 patient showed decreased thickness of SRF while his visual acuity were stable. After the second injection, 1 patient showed resolution of SRF completely with improved his visual acuity; 2 patients showed resolution of SRF completely, while his visual acuity showed no change; the others showed no obvious change. The changes of SRF and visual acuity seemed to have no direct relation. The visual acuity showed no significant difference before and 12,24 months after the first injections. Pre and post-treatment the IOP of the 6 patients all belong to normal range. No cases of endophthalmitis were reported.

CONCLUSION:IVB have some effect in chronic CSC cases in improving subretinal fluid resolution. But IVB have no long-term effect on improving visual acuity.

Clinical efficacy of two medicines for cornea epithelial healing after Epi-LASIK

Yan Lu,Li-Kun Xia and Guang-Rui Chai

AIM:To observe the effect of protein-free calf blood extract eye gel and recombinant bovine basic fibroblast growth factor(bFGF)eye drops on cornea epithelial healing after epipolis laser in situ keratomileusis(Epi-LASIK), and to evaluate the efficacy and safety.

METHODS:One hundred and twenty cases 240 eyes performing Epi-LASIK were randomized into experimental and control group. Sixty cases(120 eyes)were treated as control group with bFGF eye drops for 7 days, four times a day conventionally. Sixty cases(120 eyes )were treated as experimental group with protein-free calf blood extract eye gel for 7 days, four times a day. All the patients of two groups started postmedicating just after the first check on the first day after Epi-LASIK. The postoperative symptoms and signs, time of corneal epithelial recovery, visual acuity, spherical equivalent and corneal subepithelial opacity(haze)were examined at special time in patients of two groups within 6 months.

RESULTS: There was no significant difference in grades of postoperative symptom and sign between experimental and control group before postmedicating on the first day after Epi-LASIK(t=1.2912,P>0.05). There was no significant difference in effective rate between two groups(P>0.05). The experimental group got a more significant decline of grades of postoperative symptom and sign than control group on the 3^rd day postoperatively(t=2.2366, P<0.05), which gave evidence of protein-free calf blood extract eye gel has faster onset of action than bFGF eye drops. There was no significant difference in time of corneal epithelial recovery between two groups(t=1.4586, P>0.05). There was no significant difference in the long-term results of visual acuity, spherical equivalent and haze between two groups(P>0.05). There was no adverse drug effect during treatment.

CONCLUSION: Short-term application of protein-free calf blood extract eye gel after Epi-LASIK has distinct stimulative effect on the healing of corneal epithelium, which can significantly improve the postoperative irritative symptoms. Its effect is faster than conventional treatment. Protein-free calf blood extract eye gel with good safety, can be used alone or in combination, and has better application prospect.

Clinical observation of povidone iodine combined with carbolic acid in the treatment of fungal corneal ulcer

Shao-Shuai Shuai,Hong-Zhu Ning,Fang Chen,Qing-Song Yu

AIM:To observe the clinical curative effect of povidone iodine combined with carbolic acid in the treatment of fungal corneal ulcer.

METHODS: A total of 110 eyes clinically diagnosed with fungous cornea ulcer were divided to two groups at random, each with 55 eyes. The observation group was firstly treated with povidone iodine eye drops, carbol cauterize corneal ulcer and then, Fluconazole eye ointment and recombinant bovine basic fibroblast growth factor gel enveloping eyes. The control group was firstly treated with iodine tincture cauterize corneal ulcer and then used Fluconazole eye ointment and recombinant bovine basic fibroblast growth factor gel enveloping eyes. The clinical feasibility of iodine tincture and povidone iodine combined with carbolic acid in the treatment of fungal corneal ulcer was observed and comparatively studied.

RESULTS: Fifty-five eyes in the observation group used povidone iodine combined with carbolic acid cauterize corneal ulcer wound surface, all ulcer healed up, and the course of disease was shortened, the effect was better than the control group(P<0.05).

CONCLUSION:Povidone iodine combined with carbolic cauterize in the treatment of fungal corneal ulcer can enhance the curative rate obviously. It is an effective and safe therapeutic method.

Clinical observation on pupil adhesion in operation on complicated cataract with uveitis by use of pupil flange ring excision method

Yong-Hong Liu,Yong-Min Liu and Li Su

AIM: To observe clinical results of pupil adhesion in operation on complicated cataract with uveitis by use of pupil flange ring excision method.

METHODS: Fifty patients 50 eyes with pupil adhesion due to complicated cataract with uveitis were selected and divided into observation group and control group, with 25 eyes in each group. Patients of two groups received phacoemulsification intraocular lens(IOL), in the observation group pupil flange ring excision method was adopted to treat pupil adhesion or seclusion, while in the control group blunt separation was used.

RESULTS: Patients' visual acuity of two groups both enhanced three months after operation. In observation group, there were 5 eyes with visual acuity less than 0.3(20%), 7 eyes between 0.3-0.6(28%), and 13 eyes greater than 0.6(52%). In control group, 6 eyes less than 0.3(24%), 8 eyes between 0.3-0.6(32%), and 11 eyes greater than 0.6(44%), the difference between the two groups was not statistically significant(P>0.05). However, there were 22 eyes(88%)with circular pupil and light reflex in observation group, while in control group it was 7 eyes(28%), the difference showed statistical significance. Of all patients, no apparent intraoperative and postoperative complications were recorded.

CONCLUSION: In the operation on complicated cataract with uveitis, application of pupil flange ring excision can effectively resolve the ‘small pupil' problem, ensure safe execution of phacoemulsification, achieve satisfactory postoperative vision and bring about sound pupil formation.

Reason analysis on complications of phacoemulsification in primary hospital

Ji-Lie Zhao,Dong-Mei Cai and Yuan-Mei Leng

AIM: To probe the reason of complications of phacoemulsification and intraocular lens implantation in primary hospital.

METHODS: Totally 200 clinical cases(250 eyes)from February in 2011 to February in 2012 were involved. The complications of the phacoemulsification and intraocular lens implantation were observed.

RESULTS: There were 6 eyes(2.4%)with rupture of posterior capsule, 15 eyes(6%)with rupture of anterior capsule, 3 eyes(1.2%)with dehiscence of the zonule, 5 eyes(2%)with iris injure, 5 eyes(2%)with incision injury.

CONCLUSION:Phacoemulsification and intraocular lens implantation is safe. But since the surgeons in primary hospital are not familiar with this operation, some complications have happened.

Compare the two method of improving spectacle independence in patients after operation on visual function

Jing Mu,Yi-Zhuang Li and Hui Chen

AIM: To compare visual function in patients with bilateral diffractive multifocal intraocular lenses(IOLs)and patients with monovision.

METHODS:This study comprised consecutive bilateral cataract patients 45 cases(90 eyes)between March 2011 and January 2012. All cases were divided into two groups: multifocal IOL group(23 patients)with implantation of AcrySof ReSTOR +3D(SN6AD1)multifocal IOLs, monovision group(22 patients)with implantation of AcrySof IQ(SN60WF)IOLs. Parameters analyzed 3 months postoperatively included binocular uncorrected distance, intermediate, and near visual acuities, stereo vision, photopic, mesopic contrast sensitivity function without glare; spectacle independence and subjective visual symptoms. The independent-samples t test was used to compare the measured data which met normal distribution. The Chi-square test was applied to compare categorical variables.

RESULTS: There were no significant differences between groups in bilateral uncorrected distance vision(t=2.001, P=0.052), intermediate(t=1.304, P=0.199)and near vision(t=1.642, P=0.108). Percentage of patients wearing spectacle for distance vision were less than 4% in all groups. On the questionnaire, patients in multifocal IOL group complained with double vision, trouble in night vision and halo.

CONCLUSION: Pseudophakic monovision and multifocal IOL achieved distance vision, intermediate vision and near vision.

Nd:YAG laser capsulotomy in advance to prevent posterior capsular opacification in youth

Peng Zhang,Dan Li,Jian Zhang,Zheng Zhang,Jin-Peng Chen and Hui-Yong Xu

AIM: To explore a simple method to prevent posterior capsular opacification(PCO)after phacoemulsification in youth.

METHODS:Phacoemulsification combined with intraocular lens(IOL)implantation was performed 1 months earlier than Nd:YAG laser posterior capsulotomy.

RESULTS: In the observation group of 21 eyes, there was no PCO in 18 eyes after 3 years. In the control group of 20, PCO occurred in 12 eyes after 3 years. In comparison to the control group and observation group after 3 years, Z=-3.04, P=0.002, the difference between the two groups was statistically significant.

CONCLUSION:Nd:YAG laser posterior capsulotomy can effectively prevent PCO after phacoemulsification in youth.

Analysis of intraocular lens implantation without a successful continuous circular capsulorhexis〓〓in〓〓 phacoemulsification surgery

Hong-Jun Bian,Hong Sun,Jian Cai,Xiu-Ming Wang and Feng Sheng

AIM: To analyze the feasibility of intraocular lens(IOL)implantation without a successful continuous circular capsulorhexis in phacoemulsification surgery, and to discuss the key points of each step, as well as the complications.

METHODS: IOL implantations after the failure of continuous circular capsulorhexis in 56 eyes were analyzed.

RESULTS:Phacoemulsification and IOL implantation were performed in all 56 eyes of the group, with intraoperative posterior capsular rupture in 4 eyes and IOL implantation in all eyes.

CONCLUSION: Timely remediation of the torn capsule membrane with serious analysis and cautious treatment of the following operation steps can still make phacoemulsification surgery finished smoothly.

Medium-term clinical outcome in cataract patients underwent Acrysof ReSTOR multifocal intraocular lens implantation after phacoemulsification

AIM:To evaluate the clinical effect of the Acrysof ReSTOR multifocal intraocular lens(IOL)by comparison of pseudoaccommodation and visual quality between Acrysof ReSTOR multifocal IOL and Acrysof SN60AT monofocal lens implantation at 3 years follow-up.

METHODS: A total of 68 patients 80 eyes with age-related cataract underwent phacoemulsification and IOL implantation were divided into two groups. One group of 32 patients 40 eyes received Acrysof ReSTOR multifocal IOL(group A), the other 36 patients 40 eyes received Acrysof SN60AT monofocal lens(group B). Pseudoaccommodation, the postoperative uncorrected distance and near visual acuity, the best-corrected distance and near visual acuity, distance-corrected near visual acuity and contrast sensitivity were statistically analyzed. Also, visual quality and satisfactory after the operation were evaluated by questionnaires.

RESULTS: All patients had similar uncorrected distance visual acuity, best-corrected distance and near visual acuity postoperatively(P>0.05). The multifocal eyes was better than the monofocal eyes in uncorrected near visual acuity, distance-corrected near visual acuity, pseudoaccommodation and independence on spectacles(P<0.01), and nearly all subjects were satisfied with the results of their surgery.

CONCLUSION: The Acrysof ReSTOR multifocal IOL implantation can provide a high level of uncorrected and corrected distance vision, improve uncorrected and distance-corrected near vision and reduce spectacle dependency with a high level of patients' satisfaction.

Observation on clinical practice of aspheric diffraction-type multifocal intraocular lens

Li Su,Yong-Min Liu,Yong-Hong Liu,Yi-Shan Wang and Xiang-Xia Luo

AIM: To make assessment of clinical operation effect of implanting Acrysof IQReSTORE+3D aspheric diffraction-type multifocal intraocular lens(IOL).

METHODS: Forty-four patients of senile cataract(55 eyes)were selected to perform phacoemulsification, and monofocal or multifocal IOL was implanted according to the willingness of the patients. For multifocal IOL group(“MIOL”), Acrysof IQReSTORE+3D were implanted for 21 patients 27 eyes in total; for monofocal IOL group(“MoIOL”), Abbott Sensar were implanted for 23 patients 28 eyes in total. All patients suffered no other oculopathy which may affect postoperative visual acuity. Three months after operation, observation was made on two groups of patients with respect to uncorrected distance visual acuity, uncorrected near visual acuity, best-corrected distance visual acuity, best-corrected near visual acuity, intraocular spectacles abandon rate, visual symptom, self assessment of comforts and satisfaction by patients.

RESULTS: In terms of uncorrected near visual acuity, spectacles abandon rate, visual symptom, self assessment of comforts and satisfaction by patients, MIOL group made a better assessment than MoIOL group. No evident difference related to intraocular variation between MIOL and MoIOL was discovered.

CONCLUSION: Comparing with implant of traditional monofocal IOL, performing phacoemulsification with implant of aspheric diffraction-type multifocal IOL could help patients achieve satisfactory distant, medium and near vision. With better vision quality, patients have higher satisfactory rate of operational effect. The postoperative results were even more obvious with patients who have received operation for two eyes.

Clinical study of AcrySof Toric intraocular lens implantation

Yu-Jie Yang,Lin Li,Yong-Li Yang,Xiao-Wei Gao,Ling Xie and Chun-Li Xu

AIM: To evaluate the clinical effect and the rotational stability of AcrySof Toric intraocular lens(IOL).

METHODS:Eighty-six eyes of 72 subjects were enrolled from No.474 Hospital of Chinese PLA, Center of Ophthalmology of Chinese PLA. The preoperative corneal astigmatism was more than 1.00 diopter(D)for all eyes.All patients underwent similar phacoemulsification combined with Toric IOLs implantation.The uncorrected visual acuity(UCVA), best-corrected visual acuity(BCVA), preoperative corneal astigmatism, anticipated residual astigmatism, postoperative residual astigmatism and Toric lens axis were detected and measured. The postoperative IOL position was assessed at 1 day, 1 week, 1 month and 3 months using a specially designed angle measuring eyepiece under the slit-lamp.

RESULTS: Three months following surgery, 92% of eyes showed 0.5 or better in UCVA.78% of eyes was 0.8 or better in UCVA and 95% of eyes achieved 0.8 or better in BCVA. The mean preoperative corneal astigmatism was 2.25±0.43D and the postoperative refractive cylinder was 0.42±0.32D, indicating a significant decrease in refractive cylinder after surgery(t=2.880, P<0.01). And there was no statistical significance(t=1.752, P>0.05)with anticipated residual cylinder 0.45±0.39D. The mean rotation of Toric IOLs was 3.15±1.05 degrees after operation 1 week, 3.3±1.5 degrees after 1 month, and 3.55±1.75 degrees after 3 months, there was no significant difference among three groups(F=2.26, P>0.05), and the mean rotation was within 5 degrees in 95.3% of eyes, 100% of eyes rotated less than 10 degrees.

CONCLUSION: The Toric IOL showed good rotational stability and predictability in the correction of corneal astigmatism. Implantation of AcrySof Toric IOL is an effective option for the correcting of preexisting corneal astigmatism in cataract surgery.

Compared analysis of the efficacy of two different treatment methods for neovascular glaucoma

Zheng Zhang,Peng Zhang,Jin-Peng Chen and Jian Zhang

AIM: To compare the efficacy of two different treatment methods for neovascular glaucoma(NVG).

METHODS: According to the different surgical treatments, divide 32 NVG patients(32 eyes)into two groups: Group A 14 patients(14 eyes)were treated with Ahmed glaucoma valve implantation and panretinal photocoagulation(PRP); Group B 18 patients(18 eyes)with trabeculectomy and amnion transplantation and panretinal photocoagulation(PRP).

RESULTS: The mean intraocular pressure(IOP)in patients discharged after six months: Group A, was 12.15±5.47mmHg, surgical success rate was 85.7%; Group B, was 14.32±4.75mmHg, surgical success rate was 83.3%.

CONCLUSION: The two methods can both reduce IOP on different levels. There is no obvious difference between their surgical success rates. But for NVG patients, it is more economic to be treated with trabeculectomy and amnion transplantation and panretinal photocoagulation(PRP).

Clinical observation of treating earlier dysfunction filtering bleb of refractory glaucoma

Fang Chen,Chao-Xiong Hu,Shao-Shuai Shuai and Qing-Song Yu

AIM: To observe the treatment method and efficacy to the earlier dysfunctional filtering blebs of refractory glaucoma, and investigate safer and more effective treatment method.

METHODS: Twenty eyes of 20 patients with refractory glaucoma were included in this study between January 2006 and January 2012, every eye had the failing filtering bleb(or failing tendency)after suffering trabeculectomy. The treatment methods included eyeball massage or after breaking suture of sclera, and bled needling with a blunt needle or 5-fluorouracil(5-FU)subconjunctival injection. All patients underwent the treatment of failing filtering blebs 3-8 days after trabeculectomy with mitomycin-C. All the patients were followed up for 6 months.

RESULTS: After massage and revision with bled needling and 5-FU subconjunctival injection, the failing filtering blebs turned to be functional blebs in 18 eyes(90%). The average intraocular pressures(IOPs)were 24.61±5.4mmHg(1mmHg=0.133KPa)before treatment and 15.20±4.8mmHg 6 months after treatment. There was significant difference in IOP between pre- and post treatment eyes(P<0.001). No any severe complications were found during and after surgery.

CONCLUSION: Refractory glaucoma was more complicated, and the failing filtering bleb(or failing tendency)was more readily available after suffering trabeculectomy. Eyeball massage or after breaking suture of sclera, and bled needling with a blunt needle or 5-FU subconjunctival injection are a safer and more effective method to treat early dysfunctional filtering bleb after glaucoma trabeculectomy, and it can improve the success rate of surgery.

Effect of Ahmed glaucoma valve implantation with mitomycin C for treatment of neovascular glaucoma

Yi Huang,Zhi-Gang Qian and Hui-Min Shi

AIM:To investigate the clinical efficacy of Ahmed glaucoma valve implantation with mitomycin C(MMC)combined with retinal photocoagulation for treatment of neovascular glaucoma(NVG).

METHODS:The medical records of 41 cases 41 eyes of NVG who underwent Ahmed glaucoma valve implantation with MMC combined with retinal photocoagulation were retrospectively analyzed, including intraocular pressure(IOP), visual acuity, the operative success rate and surgery complications.

RESULTS:The average IOP postoperatively all had statistical difference compared with preoperative IOP(all P<0.05). The operative successful rate was 93%, in which 36 eyes(88%)with complete success, 2 eyes(5%)with success at certain condition and 3 eyes(7%)with failure. The difference of visual acuity was not significant(P>0.05). The complication after the operation included early hypotony in 4 eyes(10%), postoperative shallow anterior chamber in 1 eye(2%), hyphema in 3 eyes(7%)and tube occlusion in 1 eye(2%).

CONCLUSION:Ahmed glaucoma valve implantation with MMC combined with retinal photocoagulation is a safe and effective therapy to decrease the IOP of NVG.

Association between photoreceptor integrity and visual acuity in diabetic macular edema with or without serous retinal detachment

Fang Rong,Bin Mo and Wu Liu

AIM: To observe the photoreceptor integrity by spectral-domain optical coherence tomography(SD-OCT)in diabetic macular edema(DME)with or without serous retinal detachment(SRD), and assess their association with visual acuity.

METHODS: In this prospective study, consecutive patients were observed by SD-OCT with central subfield mean thickness(CSMT)≥300μm and without definite macular traction or compact hard exudates in central 500μm. They were divided into two groups: with or without SRD. The integrity of photoreceptor was observed in the central 500μm. The integrity of external limiting membrane(ELM)in all eyes and the integrity of inner and outer segments(IS/OS)in eyes without SRD was classified as existent or completely absent. In SRD eyes, the integrity of IS/OS was classified into another two grades: preserved or atrophic. BCVA between different integrity of IS/OS or ELM were compared.

RESULTS: In all the 56 eyes of 41 patients, there were 32 eyes detected without SRD and 24 eyes with SRD. In eyes without SRD, BCVA was significantly poorer in eyes with completely absent IS/OS or ELM than those with existent IS/OS or ELM(t=-7.938, P=0.000; t= -7.347, P=0.000). In eyes with SRD, BCVA was also significantly poorer in eyes with atrophic IS/OS than those with preserved IS/OS(t=-4.354, P=0.000), but there was no significant difference in BCVA between eyes with or without completely absent ELM(t=-0.895, P=0.381).

CONCLUSION: In patients of diabetic macular edema, the integrity of subfoveal IS/OS was closely related to BCVA. But the associations between the integrity of ELM and BCVA might not consistent in eyes with or without SRD.

Observation on clinical effects of panretinal photocoagulation for vascular fundus diseases in highland area

Xue-Ying Ma,Rong Zhang,Ling Li,Ya-Qin Song and Lei Li

AIM: To observe clinical efficacy of argon laser photocoagulation or panretinal photocoagulation(PRP)therapy on plateau diabetic retinopathy(DR), retinal vein occlusion(RVO), and to evaluate security and effectiveness of argon laser treatment of fundus diseases.

METHODS: Totally 122 cases(227 eyes)of DR were selected, including 51 cases(90 eyes)of preproliferative diabetic retinopathy(PPDR), 71 cases(137 eyes)of proliferative diabetic retinopathy(PDR), 120 cases(124 eyes)of RVO, 27 cases(27 eyes)of central vein occlusion(CRVO), 93 cases(97 eyes)of branch retinal vein occlusion(BRVO). They were performed argon laser photocoagulation treatment. The fundus examination, visual acuity and fundus fluorescein angiography(FFA)examination of each patient were taken in the end after the last treatment 1 month, 3 months and 6 months postoperatively.

RESULTS: After the retinal photocoagulation on DR patients, operation were effective in 81 eyes(90.0%), ineffective in 9 eyes(10.0%)in PPDR cases; effective in 98 eyes(71.5%), ineffective in 39 eyes(28.5%)in PDR cases, and the total effective rate was 78.9%. After the retinal photocoagulation on RVO patients, operation was effective in 90 eyes(92.8%)in BRVO cases; effective in 22 eyes(81.5%)in CRVO cases. The total effective rate of argon laser(532nm)treatment on retinal vascular disease was 82.9%.

CONCLUSION: Fundus argon laser photocoagulation(532nm)for the vascular fundus diseases in highland area is a safe and effective method in the treatment of DR. The effective rate of laser therapy on PPDR was higher than the proliferative phase, timing of treatment selection can effectively prevent the progression of DR to prevent blindness in serious consequences; timing retinal laser photocoagulation therapeutic intervention on RVO can accelerate hemorrhage and absorption of edema, prevent forming neovascularization and reduce complications.

Efficacy of photodynamic therapy with 1/2 dose verteporfin for treating central serous chorioretinopathy

Xiao-Tong Zhuang and Wei Xiao

AIM:To evaluate the efficacy of photodynamic therapy(PDT)after 1/2 dose verteporfin injection in treating central serous chorioretinopathy(CSC).

METHODS:Thirty-six eyes of 36 patients diagnosed with CSC received one single session of PDT using 1/2 dose(3mg/m²)verteporfin. Best-corrected visual acuity(BCVA)and OCT were measured before, 1 week, 4, 12 and 24 weeks after PDT treatment with 1/2 dose. OCT, FFA and ICG examination were performed before, 4 and 24 weeks after PDT treatment with 1/2 dose.

RESULTS:Twenty-seven of 36 eyes(75%)had complete resolution of subretinal fluid(SRF)1 week after 1/2 dose PDT treatment. SRF was partly absorbed in 9 of 36 eyes(25%). After 4 weeks, SRF in 36 eyes was completely absorbed, fluorescein leakage of 36 eyes disappeared in FFA and the tortuous choroidal vessels appeared normal in ICG; Twelve to twenty-four weeks after PDT treatment, there was no recurrence of CSC in 36 eyes. The mean BCVA was improved from 0.52 to 0.80 four weeks after PDT treatment.

CONCLUSION:PDT with 1/2 dose verteporfin injection is effective and safe in treating CSC in short time follow-up. It can shorten the coursing of CSC and protect the macular visual function.

Application of primary 23-gauge vitrectomy for vitreoretinopathy

Yang Xie,Guo-Hua Lu,Ping-An Mao,Xin-Cheng Sun and Xing-Cen Ji

AIM: To investigate the clinical application of 23-gauge vitrectomy system in the treatment of vitreoretinopathy disease and evaluate its efficacy and safety.

METHODS: A retrospective study of 26 cases(26 eyes)who received 23-gauge vitrectomy from February 2012 to September 2012 was retrospectively studied. The diseases included vitreous hemorrhage(6 cases), rhegmatogenous retinal detachment(14 cases), proliferative diabetic retinopathy(5 cases)and macular epiretinal membrane(1 case). The main observation was the surgical effects and complications. The follow-up time was from 1 month to 6 months.

RESULTS: All cases were successfully completed without significant complications. The best-corrected visual acuity was improved in different degrees.

CONCLUSION: The 23-gauge vitrectomy system with better curative effect, faster postoperative recovery and few complications is an effective and safe surgical technique for all vitreoretinopathy diseases.

Alterations of the level of VEGF in the aqueous humor of PDR patients before and after vitrectomy

Shuang Li and Xun-An Fu

AIM: To evaluate aqueous humor level of vascular endothelial growth factor(VEGF)in proliferative diabetic retinopathy(PDR)patients before and after vitrectomy.

METHODS: Aqueous humor samples were collected from 30 PDR patients before and after vitrectomy. Thirty cases of cataract patients without diabetes mellitus were chosen as a normal control group. Aqueous humor concentrations of VEGF were determined by enzyme-linked immunosorbent assays(ELISA).

RESULTS: Aqueous humor concentrations of VEGF were significantly greater in PDR patients than in control(P<0.05). VEGF concentrations decreased significantly in postoperative samples than that in preoperative samples(P<0.05).

CONCLUSION: VEGF actively takes part in the occurrence and development of PDR, and has a close relationship with neovascularization in the late stage of PDR.

Clinical observation of surgical treatment of ptosis in 225 cases

Yin-Juan Nan and Hong-Zhuan Ouyang

AIM:To observe the advantages and disadvantages of different surgeries for the treatment of ptosis to provide theory and basis for clinical choice of reasonable operation method.

METHODS:A retrospective analysis of 225 cases 298 eyes performed ptosis operation in our hospital from January 2008-December 2011. According to the different operation modes patients were divided into two groups: borrow frontalis muscle power operation, as well as the levator palpebrae superioris complex operation. Patients were performed 3-6 months' follow-up observation, evaluation and analysis. The effects of two groups were compared.

RESULTS: All of the patients divided into two groups, borrowed from the frontal muscle power operation in 38 cases 44 eyes,2 eyes overcorrection, 1 case of recurrence, the cure rate was 93.2%; levator palpebrae superioris complex operation in 187 cases 254 eyes,6 eyes and 2 eyes overcorrection, undercorrection, the cure rate was 97.6%, significantly higher than the amount of muscle strength in use operation group 2 cases 2 eyes with ptosis after operation of short-term undercorrection, reopened incision and upregulated the levator palpebrae superioris muscle fixed position; 1 case 1 eye recurred after half year, the re-operation found suture exfoliated then repaired; 4 cases 6 eyes of overcorrection released upper eyelid muscle to adjust the margin position. All surgeries have improved the blepharoptosis symptoms and reached the appearance change.

CONCLUSION:Congenital ptosis in principle should be treated early, earlier operation can prevent children from amblyopia and mental disorders. Acquired ptosis due to a variety of causes, which should be treated according to the different causes first, then in stable condition 3-6 months after choose different operation methods. Correction of ptosis based on the severity, select the appropriate operation, improve the curative effect to reduce complications.

Clinical research of HAR-800 hand-held autorefractor on preschool children

Liang-Cheng Wu,Xiang-Ying Hu and Cheng-Hai Weng

AIM: To evaluate the accuracy of HAR-800 hand-held autorefractor on preschool children.

METHODS:Totally 173 preschool children were included in this study. They were performed HAR-800 hand-held autorefractor examination before using atropine ointments for cycloplegic refraction. The results from HAR-800 refractor were set as experimental group, and the cycloplegic refraction were controlled group. The refractions between the two groups were compared and analyzed.

RESULTS: The sphere was 1.59±0.61D in the experimental group, while 3.15±0.72D in the controlled group. The difference was significant(t=-82.89, P<0.001), however, there was a significant correlation(r=0.87, P<0.001, Pearsons correlation analysis). The cylinder difference was also significant(t=-6.97,P<0.001)and a significant correlation also existed between the two groups(r=0.76,P<0.001, Pearsons correlation analysis).

CONCLUSION: The HAR-800 hand-held autorefractor can not replace cyclopegic refraction using atropine, but the results can reflect the preschool children refraction.

Effect of comprehensive treatment for children and teenagers with aniso-metropia amblyopia

Shan Lin

AIM:To evaluate the effect of comprehensive treatment for children and teenagers with anisometropia amblyopia.

METHODS: Forty-five children and teenagers with anisometropia amblyopia, aged 8-15 years old, selected from our hospital between January 2007 and October 2010, were divided into two groups. Group A(22 patients)wore rigid gas permeable(RGP)lenses and group B wore eyeglass frames. Both groups received same amblyopia therapy with a patch, red light flashing, synoptophore disinhibition, and using of oral levodopa and depending on binocular vision and stereopsis comprehensive treatment method to carry on the treatment. Follow-up for 30 months observed in patients with visual acuity and stereopsis of near and far.

RESULTS: Comprehensive treatment of amblyopia after 30 months, two cases of corrected visual acuity were improved, Recovery rates were different for groups A and B:40.9%(9/22)and 17.4%(4/21), the curative effect of group A was significantly higher in B group, two groups had statistical significance(χ²=6.932, P<0.05). The rank sum test, group A of far and near stereopsis was clearly higher than group B(P<0.05).

CONCLUSION:Older children and teenagers with anisometropic amblyopia should take active treatment of amblyopia. For anisometropic amblyopia, patients should be recommended to wear RGP lens, which can improve the clinical cure rate,and maximize the possible recovery of binocular vision.

Long-term efficacy of implantation of AcrySof Toric intraocular lens on corneal astigmatism in cataract surgery

Wen Lan,Zhen-Ping Huang,Pei-Li Hou,Chun-Hong Wang,Qin-Rui Hu and Yan Wu

AIM: To evaluate the clinical outcome of correction of corneal astigmatism and rotational stability of implantation of the AcrySof Toric intraocular lens(IOL)in cataract surgery.

METHODS: Twenty-eight patients(thirty-two eyes)with more than 1.0 diopter(D)of preexisting astigmatism underwent similar phacoemulsification combined with AcrySof toric IOL implantation. The uncorrected visual acuity(UCVA), best-corrected visual acuity(BCVA), preoperative corneal astigmatism, anticipated residual astigmatism, postoperative residual astigmatism and toric lens axis were detected and compared.

RESULTS: At 1 year following surgery, 85% of eyes showed the 0.5 or better in UCVA; 86% of eyes was 0.8 or better in BCVA and 92% of eyes achieved 0.6 or better in BCVA. The mean preoperative corneal astigmatism was(2.20 ±0.65)D and the postoperative residual astigmatism was(0.54±0.13)D, indicating a significant decrease in refractive cylinder after surgery(t=10.134, P<0.01). Preoperative predictive astigmatism(0.52±0.14)D and postoperative residual astigmatism(0.54±0.13)D showed no significant difference(t=0.364, P>0.05). After postoperative 6 month, the mean rotation of toric IOLs was 3.4°±2.2°, and after postoperative 1 year it was 3.82°±1.27°.

CONCLUSION:AcrySof Toric IOL implantation is a viable and highly predictable method of correcting the corneal astigmatism, with no injury of the cornea. Careful selection of the patient, accurate keratometry and precise alignment of the cylindrical axes are some of the factors to be considered for a superior outcome.

Clinical study of the implantation of phakic posterior chamber Toric intraocular lens for high myopia with astigmatism

Wen-Ling He,Xin-Hua Liu and Liang-Nan Sun

AIM: To assess the clinical outcome of the implantation of phakic posterior chamber Toric intraocular lens(TICL)for high myopia with astigmatism.

METHODS: Totally 50 eyes of 30 patients with high myopia and astigmatism were treated with TICL implantation from October 2009 to November 2011. The preoperative mean spherical equivalent was -10.75±2.65D, the mean cylindrical equivalent was -2.85±0.75D. All of the patients were followed up for 3 months to 2 years. Uncorrected and best-corrected visual acuity, refraction, intraocular pressure and endothelial cell morphometry, as well as the complications were observed.

RESULTS: The range of uncorrected visual acuity after operation was 0.5-1.2, mean 0.75±0.34. The range of preoperative best-corrected visual acuity was 0.3-1.0, mean 0.58±0.35. The mean best-corrected visual acuity after operation was 0.78±0.35. The uncorrected visual acuity after operation of 20 eyes was same and of 30 eyes was better than the preoperative best-corrected visual acuity. The mean spherical equivalent after operation was -0.52±0.35D, the mean cylindrical equivalent was 0.52±0.25D. Corneal endothelium counting before and after the operation had no significant difference. No serious complication was detected during the follow-up.

CONCLUSION: The implantation of phakic posterior chamber TICL for high myopia with astigmatism is safe and effective. It is a suitable treatment method for high myopia.

Research of exudative age-related macular degeneration treated with iodized lecithin tablets

Qin Ye and Guo-Xing Xu

AIM: To discuss the clinical application value of the optical coherence tomography(OCT)in the treatment of exudative age-related macular degeneration(AMD)by iodized lecithin tablets.

METHODS: Totally 53 cases 60 eyes diagnosed with exudative AMD were divided into two groups: the treatment group(26 cases, 30 eyes)treated with iodized lecithin tablets and the control group(27 cases, 30 eyes)treated with vitamin E and vitamin C. OCT was used to check all the cases after 67 days. The curative effect was evaluated based on OCT outcome.

RESULTS: In treatment group, 16 eyes were cured, 9 eyes improved and 5 eyes had no effect after the treatment of iodized lecithin tablets, and the total effective rate was 83.3%. In control group,2 eyes were cured, 8 eyes improved and 20 eyes had no effect without the treatment of iodized lecithin tablets, and the total effective rate was 33.3%. The visual acuity of treatment group improved obviously, and the macular retina thickness decreased obviously. The curative effect of two groups had significant difference. The treatment group was superior to the control group.

CONCLUSION: Iodized lecithin tablets have significant curative effect in treating exudative AMD.

Study on higher order aberrations in moderate curvature myopia and axial myopia

Lu Yang,Yi Shao,Yong-Yan Liu,Li-Hua Zhang,Qiong Zhou and Ke-Zheng Liu

AIM: To investigate the difference of ocular higher order aberrations between curvature myopia and axial myopia in moderate myopic eyes, according to the analysis of higher order aberrations in different types of moderate myopia.

METHODS: It was a prospective study. Totally 39 moderate myopic subjects(56 eyes, myopia with no astigmatism)participated in this study and were divided into two groups: group A was moderate curvature myopia group(11 patients,16 eyes),with average age 22±2 years, mean axial length of 23.89±0.13mm, mean corneal curvature 45.56±0.95D and mean diopter -4.58±0.82D. Group B was moderate axial myopia group(53 patients, 79 eyes), with average age 22±3 years, mean axial length of 25.82±0.44mm, mean corneal curvature 41.93±0.85D and mean diopter -4.50±0.78D. The values of higher order aberrations were analyzed at different pupil diameters between the two groups.

RESULTS: The comparison on mean age between the two groups had nosignificant difference as well as that on mean diopter(P>0.05). The comparisons on both average curvature of cornea and mean axial length showed significant differences(P<0.05), respectively. The values of RMS3, RMS4, RMS6, RMSh and C12 of the two groups(Group A/Group B)were 0.165±0.064/0.098±0.045, 0.127±0.034/0.059±0.025, 0.040±0.014/0.028±0.010, 0.218±0.059/0.129±0.040 and 0.137±0.057/0.048±0.037, respectively, when pupil diameter was 6mm and the comparison of the two groups had significant differences(P<0.05). Meanwhile the comparisons of ocular higher order aberrations on group A and group B also presented significant differences(P<0.05), with the former higher than the latter.

CONCLUSION: Curvature myopia had more coma, spherical aberration, secondary spherical aberration and total higher order aberrations than axial myopia in moderate myopic eyes in normal and moderately dilated pupils.

Causes and treatment of descemet membrane detachment after compound trabeculectomy on glaucoma

Jian-En Li,Hong-Hong Zhang and Wei Shi

AIM: To explore the causes and treatment of descemet membrane detachment due to penetrating trabeculectomy.

METHODS: Totally 805 cases 956 eyes with glaucoma underwent compound trabeculectomy was observed clinically. Five cases 5 eyes with descemet membrane detachment were symptomatically treated.

RESULTS: Descemet membrane detachment occurred in 5 cases 5 eyes who were treated by injecting aseptic air or viscoelastic agent into the anterior chamber, all incisions were closed by suturing with satisfied effects.

CONCLUSION: Early diagnosis and treatment of descemet membrane detachment is important for postoperative visual acuity recovery.

Comparison of corneal ablation depth during individual and conventional LASIK

Xu-Yang Sun,Xue-Jun Fang and Han-Qiang Liu

AIM:To compare the difference of actual corneal ablation depth during individual and conventional laser in situ keratomileusis(LASIK).

METHODS: Prospective comparative study. 161 eyes of 87 low and moderate myopia patients accepted refractive surgery with the Technolas 217z100 excimer laser system. Two groups were divided according to the type of operation: conventional LASIK and individual LASIK. The corneal thickness was continuously assessed intraoperatively with online optical coherence pachymetry(OCP). The residual stromal thickness before and after laser ablation were recorded, and then the actual corneal ablation depth was calculated. The values of actual and theoretical ablation depth, and the difference in the two groups were compared.

RESULTS: In conventional-LASIK group, the actual corneal ablation depth and theoretical ablation depth were 94.37±22.76μm and 85.69±21.19μm respectively(P<0.05); In individual-LASIK group, the actual corneal ablation depth and theoretical ablation depth were 90.08±15.98μm and 76.30±13.65μm respectively,(P<0.05). In conventional-LASIK group, the actual corneal ablation depth was increased in 8.68±6.30μm than the theoretical ablation depth. In individual-LASIK group, the actual corneal ablation depth was increased in 13.78±7.63μm than the theoretical ablation depth(P<0.05). The difference in individual-LASIK group was about 5.10±1.10μm thicker than that in conventional-LASIK group.

CONCLUSION: Actual ablation depth was thicker than theoretical ablation depth in both conventional LASIK and individual LASIK. The difference of actual corneal ablation depth and theoretical ablated depth in individual LASIK is more than that in conventional LASIK.

Observation of the intraocular pressure elevation after sclera buckling surgery with ultrasound biomicroscopy

Yun Zeng and An-Huai Yang

AIM: To investigate the mechanism of intraocular pressure(IOP)elevation after scleral buckling surgery with ultrasound biomicroscopy(UBM).

METHODS: A totally of 156 patients 161 eyes who underwent scleral buckling surgery operated by professor An-Huai Yang during July, 2011 and February, 2012 were selected in this retrospective study. All the patients were grouped by high IOP and normal IOP(not suffering from glaucoma and without glaucoma family history). The structure ofocular anterior segment was observed with UBM in all patients following scleral buckling surgery. We analyzed the relationship between IOP and the structure parameter of ocular anterior segment to investigate the mechanism of high IOP after scleral buckling surgery.

RESULTS: By UBM, the main causes of high IOP after scleral buckling surgery wereadhesion of iris to trabecular meshwork and closure of anterior chamber angle. The high IOP group and normal IOP group had statistical differences in anterior chamber depth(ACD)(t=2.003, P=0.048), angle opening distance₅₀₀(AOD₅₀₀),(t=2.071, P=0.049)and ciliary body thickness(CBT)(t=1.932, P=0.038).

CONCLUSION: UBM is effective in observation of the structure of ocular anterior segment after scleral buckling surgery and intraocular hypertension is a common complication. ACD, AOD₅₀₀and CBT changes are related to IOP changes soon after operation(in 2 weeks). The edema and forward rotation of ciliary body, the narrow of anterior chamber angle are the mainly factors resulting in high IOP after scleral buckling surgery. The high IOP group has a tendency to appear to be a shallow anterior chamber and narrow anterior chamber angle.

Clinical observation on improvement of posterior chamber intraocular lens implantation with suture fixation

Fang-Ju Han,Jing-Jing Zhang and Wei Liu

AIM:To assess the clinical effect on improvement of posterior chamber intraocular lens(IOL)implantation with transscleral suture fixation.

METHODS: Totally 82 cases were divided into two groups, one group with non-sclera flap and the pars plana location for IOL transscleral fixation of suture ends were buried into the sclera, the other group with sclera flap and the ciliary sulcus location for IOL transscleral fixation. The operation time, visual acuity and postoperative complications were compared.

RESULTS: There was significant difference in operation time between two groups. There was no significant difference in visual acuity. No cases of suture erosion, postoperative endophthalmitis, retinal detachment. Pupillary capture of the IOL optic occurred more frequently in the ciliary sulcus group with sclera flap.

CONCLUSION: Improvement of posterior chamber IOL implantation with transscleral suture fixation is a safe and effective and simple method for correction of eyes in the absence of adequate posterior capsular support.

Application of ultrasound biomicroscopy to Nd:YAG laser in glaucoma

Jian-Ming Tang,Jie Zhao,Bei-Jing Zhu,Yi Xiong,Sen Yang and Hao Lu

AIM: To evaluate the therapeutic effects of Nd:YAG laser in primary angle-closure glaucoma(PACG)by domestic ultrasound biomicroscopy(UBM).

METHODS: PACG(including acute, chronic)patients, a total of 31 cases 43 eyes were included in this study. UBM measurement of intraoperative central anterior chamber distance(ACD), and the angle opening distance(AOD)in 12:00, 3:00, 6:00, and 9:00 four directions, angle opening in degrees(AA), and intraocular pressure(IOP)was performed before and after surgery, respectively.

RESULTS: The postoperative IOP and central ACD had no significant difference compared with that of preoperative. AOD and AA increased significantly preoperatively and postoperatively in four directions.

CONCLUSION: Angle changes and laser patency can be observed in vivo before and after surgery by UBM, which is a more effective method for diagnosis and treatment of PACG.

Effect of cyclocryotherapy and trabeculectomy for the treatment of late neovascular glaucoma

AIM: To evaluate the efficacy of cyclocryotherapy and trabeculectomy for the treatment of late neovascular glaucoma.

METHODS:Cyclocryotherapy and trabeculectomy were performed on 37 cases(37 eyes)with late neovascular glaucoma. All patients were followed up for 12 months. The intraocular pressure(IOP), anterior chamber reaction, pain intensity, and complications were observed.

RESULTS: Compared with preoperation, the mean IOP was significantly decreased at 1 day, 3 days, 1 week, 1 month, 3 and 12 months postoperation(P<0.05). The postoperative anterior chamber reaction was mild, pain was relieved, and no serious complications.

CONCLUSION:Cyclocryotherapy and trabeculectomy can effectively manage late neovascular glaucoma.

Comparison of anterior segment changes before and after laser peripheral iridotomy by anterior segment optical coherence tomography in eyes with primary angle-closure glaucoma

Xiao-Tong Zhuang,Feng-Min Wang and Wei Xiao

AIM: To evaluate the changes of anterior segment configuration after laser peripheral iridotomy(LPI)in patients with primary angle-closure glaucoma(PACG)by using anterior segment optical coherence tomography(AS-OCT).

METHODS: This retrospective self control study consisted of forty-two eyes of 30 patients with PACG whose open angles were more than 180 degree. Central anterior chamber depth(ACD), opening distance(AOD), trabecular iris area(TISA)were measured using AS-OCT before and four weeks after LPI.

RESULTS: The parameters of AS-OCT on baseline were AOD 0.172±0.078μm, TISA 0.066±0.025mm²at 500μm anterior to sclera spur, and AOD 0.268±0.133μm, TISA 0.122±0.045mm² at 750μm. After LPI, the parameters were AOD 0.277±0.105μm, TISA 0.113±0.041mm²at 500μm, and AOD 0.388±0.154μm, TISA 0.194±0.063mm² at 750μm, which were significantly increased compared with the baseline(P<0.05). There was no significant difference on ACD before and after LPI(P=0.108).

CONCLUSION: PACG can be controlled by LPI resulting in an increase of AOD, TISA but not ACD.

Effect of triamcinolone acetonide and laser photocoagulation for macular edema of retinal vein occlusion

Shao-Jun Chen,Zheng-Qin Yin,Hong Yang,Nan Wu,Shi-Ying Li and Xiao-Hong Meng

AIM: To observe and compare the effect of intravitreous injection of triamcinolone acetonide(TA)and laser photocoagulation for macular edema in branch retinal vein occlusion(BRVO), and to investigate the necessity and time point for combination of two therapies.

METHODS: The patients with macular edema of non-ischemia BRVO were divided randomly into TA group(46 eyes)and laser group(44 eyes), and were treated with double blind method. TA group underwent intravitreous injection TA(IVTA)4mg, laser group was with grid photocoagulation within blood vessels arch and spot photocoagulation in nonperfusion area. The patients' best-corrected visual acuity(BCVA)and central retinal thickness(CRT)by optic coherence tomography(OCT)in different time of pre-and post-therapy were examined and the data were analyzed by independent sample t test.

RESULTS: One week to one month after treatment, the improvement of BCVA and CRT in TA group were significant better than those in laser group in patients whose initial CRT were 300-500μm. One to three months after treatment, the improvement in TA group dropped down slowly, while the improvement in laser group increased gradually. Six months after treatment, there was no significant difference between TA group and laser group. A few patients in TA group needed re-injection due to recurred macular edema.

CONCLUSION: Both IVTA and laser photocoagulation could be used in BRVO whose CRT ranged 300 -500μm; The patients with CRT larger than 500μm could be treated by combined therapy of IVTA followed by laser grid photocoagulation 1 week-1 month later. Recurrence of macular edema after IVTA could be injected TA again six months after first injection.

Early postoperative intraocular pressure of transplantation of autologous retinal pigment epithelium-Bruch membrane complex

Gang An,You Wang,Xue Li and Lin Li

AIM: To observe the early postoperative intraocular pressure(IOP)of transplantation of autologous retinal pigment epithelium(RPE)-Bruch membrane complex after the removal of corneal neovascularization(CNV).

METHODS: A retrospective study was performed in 24 patients 25 eyes with age-related macular degeneration(ARMD)who underwent vitreoretinal surgery and related literatures were reviewed. The 24 patients 25 eyes were divided to group A(the macular subretinal hemorrhage and CNV removal surgery group, n=14)and group B(transplantation of autologous RPE-Bruch membrane complex after the removal of the CNV group, n=11). IOP was measured before surgery and then on day 1, 2, 3, 4, 5, 6 and 7 after surgery with Goldmann applanation tonometer. Two sets of IOP were counted and possible factors were analyzed for association with ocular hypertension.

RESULTS: The IOP was elevated on day 1 after surgery in 78.1% of all cases, and also elevated significantly on day 2 in 56.4% of group B, respectively. Besides, the mean postoperative IOP, the peak postoperative IOP and incidence of high IOP at week 1 was elevated significantly in group B, respectively.

CONCLUSION: Early postoperative IOP and incidence of high IOP in patients with hemorrhagic ARMD undergoing transplantation of autologous RPE-Bruch membrane complex after the removal of the CNV have significant elevation, and need for perioperative prevention of high IOP should be noted.

Clinical value of honghua injection acupoint iontophoresis on treatment of traumatic vitreous hemorrhage

Hai Yu,Hui-Li Li,Xiao-Dan Li,Xiao-Xi Liu and Xiang-Ge He

AIM: To observe the effects of honghua injection iontophoresis combined with acupoint stimulation in the treatment of traumatic vitreous hemorrhage.

METHODS: There were 100 cases 113 eyes with traumatic vitreous hemorrhage in our study. Sixty cases 71 eyes were treated with p-aminomethyl benzoic acid(PAMBA)0.2g+9g/L sodium chloride injection 10mL, after diluted it was used in muscle injection combined with oral taking Chinese medicine, at the same time honghua iontophoresis was performed through Jingming, Chengqi, Cuanzhu, Laogong acupoints in observed group. Forty cases 42 eyes were treated only with PAMBA 0.2g + 9g/L sodium chloride injection 10mL, after diluted it was used for muscle injection combined with oral taking Chinese medicine in control group. The changes of visual acuity and fundus were investigated before and after treatment.

RESULTS: Effective rate was 87.32% in the observed group, 59.52% in control group. The result showed a higher effective ratio in observed group than in control group. There was significant difference between two groups(P <0.01).

CONCLUSION: Chinese medicine honghua injection iontophoresis combined with acupoint stimulation is an effective and simple therapy for traumatic vitreous hemorrhage.

Clinical observation of severe ocular trauma treated with vitrectomy

Meng-Fei Hu,Shi-Yang Li and Hong-Li Ma

AIM: To investigate the clinical efficacy of vitrectomy combined with other surgical treatment of severe ocular trauma.

METHODS: A retrospective analysis of 30 cases 31 eyes with severe ocular trauma treated with vitrectomy from January 2011 was performed.

RESULTS: Of the 31 eyes, postoperative visual acuity improved in 24 eyes, and of the 12 eyes with preoperative visual acuity of no light perception(NLP), 10 eyes had improved visual acuity after surgery, included 2 eyes with light perception, 3 eyes with hand movement, 4 eyes with finger counting, and one had best-corrected visual acuity recovered at 0.1; intraocular foreign bodies in 6 eyes were successfully extracted, the extraction rate was 100%, endophthalmitis were well controlled; 18 eyes with complicated retinal detachment, 15 eyes obtained successfully reset, the retinal reattachment rate was 83%; 14 eyes with traumatic cataract or lens dislocation, after vitrectomy, 12 eyes underwent intraocular lens(IOL)implantation, and the IOL implantation rate was 86%.

CONCLUSION: Severe ocular trauma included preoperative eyes with NLP, appropriate vitrectomy combined with corresponding treatment measures can maximize the retention in patients with eye and save the patient's visual function.

Central aponeurosis disinsertion of the levator in correcting upper eyelid retraction in patients with thyroid associated ophthalmopathy

Hua-Li Zhu,Lin Yan,Wen Jiang,Ling Huang,Li Li and Xiao Zhang

AIM:To evaluate the clinical effect of central aponeurosis disinsertion of the levator in correcting upper eyelid retraction in patients with thyroid associated ophthalmopathy.

METHODS: Thirty-five patients 52 eyelids with inactive thyroid associated ophthalmopathy were recruited. All patients had a typical manifestation of upper eyelid retraction.

RESULTS: All patients had subjective improvement in appearance and symptom. All patients' upper eyelid retraction was obviously corrected.

CONCLUSION: Central aponeurosis disinsertion of the levator is effective in correcting upper eyelid retraction.

Prevalence factors analysis and treatment of dry eye syndrome in youth video terminals workers

Guo-Liang Li and Dong-Mei Liang

AIM: To analyze the prevalence factors of dry eye syndrome in youth video terminals workers, and to explore the efficacy of artificial tear for the treatment of dry eye syndrome.

METHODS: Totally 136 cases with dry eye syndrome due to long-term video terminal contacts were clinically investigated, including common symptoms(dry eye, visual fatigue, foreign body sensation etc.), breaking-up time(BUT), Schirmer test. Then 130 cases were selected and randomly divided into two groups. Treatment group 65 cases were treated by artificial tears, 3 times a day, one drop each time. Control group 65 cases were treated with oral tetracycline 250mg, twice a day, continuous for 3 months.

RESULTS: Common symptoms: dry eye and foreign body sensation(89.2% in the treatment group, control group 80.0%), burning sensation(33.9% in the treatment group, control group 30.8%), asthenopia(treatment group 72.3%, control group 67.7%), blurred vision(30.8% in the treatment group, control group 35.4%), eye pain(therapy group, 24.6% control group 21.5%); the two groups had no significant difference. Before and after the treatment, the two experiments of BUT and Schirmer had significantly statistical difference.

CONCLUSION: Video display terminals(VDT)is the main reason for youth dry eye syndrome. Local artificial tears using is significantly better than oral tetracycline.

Clinical research of the implantation of Toric implantable collamer lens for high myopia with astigmatism

Li Zhang,Hai-Xiang Jiang,Ying-Jia Ye,Cheng-Cheng Zhang,Man Xu and Lan Yang

AIM: To evaluate the efficacy and safety of Toric implantable collamer lens(TICL)for high myopia with astigmatism.

METHODS: This retrospective case series included 40 eyes of 22 patients from February 2010 to June 2011. A TICL was intraocularly implanted via a 3mm clear corneal incision after local anesthesia.Patients were examined preoperatively and followed-up 1 day, 1 week, 1 month, 3, 12 months postoperatively for uncorrected visual acuity. The examinations also included best-corrected visual acuity(BCVA)preoperatively, slit-lamp examination, refraction, intraocular pressure, endothelial cell morphometry, cylinder axis of the TICL, etc.

RESULTS: The uncorrected visual acuity in 40 eyes was equal or improved after 3 months of the operation in comparison with BCVA of preoperation. The spherical refraction after operation was within(-0.5- +0.5)D. The cylinder refraction was within(-0.75-0)D. The axial deviation of TICL after 1 month postoperatively within 10° was 95.0%(38/40). The axial deviation of TICL between 10 ° and 15° was 2.5%(1/40). The axial deviation of TICL above 30° was 2.5%(1/40)whose astigmatic axial rotation was changed after surgical intervention. As a result, the axial deviation of TICL was within 10 degrees. 7 eyes had increased intraocular pressure shortly after surgery and after treatment the intraocular pressure became normal in 1 week. No severe complications including secondary glaucoma and cataract and etc occurred.

CONCLUSION: TICL implantation appears to be an effective, safe method for high myopia with astigmatism.

Comparison of effect on intraocular pressure with laryngeal mask airway and endotracheal tube for ophthalmic surgery in paediatric patients

Jiang-Long Lai,Ji-Ting Chen and Sheng-Lu Zhang

AIM: To evaluate efficacy and safety of laryngeal mask anesthesia(LMA)and endotracheal intubation anesthesia and effect on intraocular lens(IOP)for paediatric ophthalmic surgery.

METHODS: Totally 90 patients under general anesthesia in paediatric ophthalmic surgery were equally randomly divided into LMA group(group L)and endotracheal intubation group(group T). Before induction of anesthesia(T₀), immediately after insert LMA / endotracheal tube(T₁), 3 minutes after insert LMA / endotracheal tube(T₂), immediately after extubation(T₃), 3 minutes after extubation(T₄), the systemic blood pressure(SBP), diastolic blood pressure(DBP), heart rate(HR)and IOP were recorded. The time of extubation, and the incidence of anesthetic complication were recorded.

RESULTS: SBP, HR, IOP during T₁, T₂, T₃, T₄were significantly higher in group T than T₀, and those in group L(P<0.05). SBP, HR, IOP were not significantly changed in group L during each time.

CONCLUSION: Compared with endotracheal intubation, LMA is an effective, safety anesthesia for ophthalmic surgery in children, with the advantages of hemodynamic stability, mild airway trauma, maintain IOP stability, fewer perioperative complications and anesthesia revive fast.

Clinical application of computed tomo-graphic dacryocystography and three-dimensional reconstruction

Jin Zhou,Shu-Lin Xia,Yi Xiao,Jiao Xie,Qing Yang and Xiang Ji

AIM:To study the application of computed tomographic dacryocystography and three-dimensional reconstruction in endoscopic transnasal dacryocystorhinostomy.

METHODS: Forty-six cases 65 eyes were performed computed tomographic dacryocystography and three-dimensional reconstruction before the endoscopic transnasal dacryocystorhinostomy in order to locate the opening of lacrimal sac accurately and guide the operation. The curative effect was observed.

RESULTS: All operations were successfully performed with the accurate location of lacrimal sac before the operation and the operation efficiency was 100%.

CONCLUSION: Computed tomographic dacryocysto-graphy and three-dimensional reconstruction should be a routine examination before endoscopic transnasal dacryocystorhinostomy.

Clinical effect of He-Ne laser combined with medicine therapy on herpes zoster keratitis

AIM:To invest the clinical effect of He-Ne laser on the therapeutic program of the herpes zoster keratitis(HZK).

METHODS: We have set the He-Ne laser and medicine combination therapy as observation while the medicine therapy as contrast according to clinic case-control method. We have calculated the quantity data from both ocular and whole body aspects.

RESULTS:The skin crusts generating rate was better in the observation group at 10^th day of therapeutic program. The pain relief rate was better in the observation at 5^th day of program(χ²=4.03, P<0.05). The difference of the patients' keratitis between both groups was significant(t=4.227, 8.208; P<0.01), the general results of observation group were better( χ²=4.49, P<0.05). We did not found any serious complications during the whole program.

CONCLUSION:The He-Ne laser improves the treatment efficiency of medicine to the HZK.

Clinical comparison between phaco-emulsification and small incision cataract surgery

Zhan-Mei Li,Hai Huang and Xue-Wen Huang

AIM:To investigate and compare the therapeutic effects of phacoemulsification and small-incision cataract surgery on senile cataract.

METHODS: Totally 355 cases(393 eyes)of senile cataract patients were divided into group A and group B by treatment modality. Group A with 180 cases(193 eyes)was treated with cataract surgery through a small-incision, and group B with 175 cases(200 eyes)was treated withphacoemulsification. Postoperative visual acuity, corneal astigmatism and the density of corneal endothelium were compared respectively.

RESULTS: One day postoperatively, the visual acuity inphacoemulsification group was much better than that in small-incision cataract surgery group, but there were no statistically significant differences at 7 and 30 days. The corneal astigmatism in patients with small-incision cataract surgery was higher than that of with phacoemulsification 7 days postoperatively, but there was no significant difference at 30 days. For those patients with Ⅳ-Ⅴ degree of nuclear hardness, the density of corneal endothelium in phacoemulsification group was less than that in small-incision cataract surgery group.

CONCLUSION: Suitable operative mode should be chosen according to the nuclear hardness of senile cataract patients.

Comparison of the effect ofincision suture and no suture in small incision non-phacoemulsification cataract surgery

Chu-Liang Huang,Ji-Lin Cai,Lin-Xiong Shen,Jing Guo and Jin-E Yuan

AIM: To compare the effectiveness of incision suture and no suture in small incision non-phacoemulsification cataract surgery.

METHODS: Totally 420 patients 477 eyes with cataract underwent small incision non-phacoemulsification cataract surgery through sclera tunnel incision(6-7mm)and implanted rigidly artificial crystal(The diameter was 5.5 mm), the incisions of 205 patients 230 eyes(group A)with cataract were symmetrically sutured two needles, the incisions of 215 patients 247 eyes(group B)with cataract were not sutured. Bare eye vision and corneal astigmatism were observed at postoperative 2 days and 3 months.

RESULTS: At postoperative 2 days, bare eye sight or the best-corrected visual acuity(BCVA)through spherical mirrors ≥0.5 was in193 eyes(83.9%)in group A and in 190 eyes(76.9%)in group B, at postoperative 3 months, bare eye sight or BCVA by spherical mirrors ≥0.5 was in 205 eyes(89.1%)in group A and in 198 eyes(80.2%)in group B, there was statistical difference in vision changes at postoperative 2 days and 3 months between two groups(P < 0.05); At postoperative 2 days, mean corneal astigmatism was 1.53±0.59D in group A and 1.85±0.97D in group B, at postoperative 3 months, mean corneal astigmatism was 1.05±0.43D in group A and 1.31±0.65D in group B, there was statistical difference in mean corneal astigmatism at postoperative 2 days and 3 months between two groups(P < 0.01); In group A there were no postoperative complications such as incision leakage, shallow anterior chamber, iris encephaloceles or iris embedded in sclera incision, etc; but in group B there were 3 eyes(1.21%)with incision leakage and shallow anterior chamber after operation and 4 eyes(1.62%)with iris encephaloceles and iris embedded in sclera incision at postoperative one day.

CONCLUSION: Incision suture in small incision non-phacoemulsification cataract surgery has better visual recovery, less corneal astigmatism and more safe than that no suture.

Analysis of phacoemulsification in treatment of special type of cataract

Lin Mou

AIM: To investigate the safety and efficacy of phacoemulsification in the treatment of special types of cataract.

METHODS:Clinical data were retrospective analyzed, and the surgery essentials of phacoemulsification and intraocular lens implantation in the treatment of special type of cataract, such as cataract after glaucoma surgery, small pupil cataract, uveitis complicated cataract, and post-traumatic cataractwere researched.

RESULTS:Of the 73 cases(84 eyes)for the treatment of special types of cataract, simple phacoemulsification in 27 cases 28 eyes; posterior chamber intraocular lens implantation in 52 eyes; anterior chamber intraocular lens implantation in 4 eyes; average intraocular pressure at postoperative 1 month was 12.72±2.63mmHg, the off-blind rate was 99%, off-disability rate was 96%; complication rate was 4%.

CONCLUSION: The surgery for special type of cataract is difficulty, small incision phacoemulsification and retained posterior capsule combined intraocular lens implantation is the ideal surgical removal for special type of cataract.

Application of small incision inside the tunnel sub-nuclear techniques in cataract

Jian-Ping Luo,Zhao Xie,Qi-Qiong He and Xiao-Wei Yan

AIM: To study the therapeutic effects of small incision inside the tunnel sub-nuclear techniques.

METHODS: Totally 400 cases with age-related cataract were randomly divided into experimental group(200 cases)and control group(200 cases). Small incision inside the tunnel sub-nuclear techniques was performed on the experimental group, and the control group using small incision inside the anterior chamber nuclear techniques division.

RESULTS: There were no significant differences between two groups in the postoperative visual acuityone day and one week after surgery; the incidence of complications in the experimental group was lower than that in the control group.

CONCLUSION: Small incision cataract extraction inside the tunnel sub-nuclear techniques is a safe and effective operation method, especially suitable in basic-level hospital.

Efficacy of phacoemulsification and intraocular lens implantation for diabetic cataract

Xiang-Ming Liu,An-Zhen Mao and Xian-Hua Xie

AIM: To observe the efficacy of phacoemulsification and intraocular lens(IOL)implantation for diabetic cataract.

METHODS: Totally 38 cases(41 eyes)with diabetic cataract(observation group)and 117 cases(127 eyes)with non-diabetic simple senile cataract(control group)in the same period all received phacoemulsification and IOL implantation and the efficacy and postoperative complications were observed and compared.

RESULTS: There were 32 eyes(78.0%)in the observation group and 110 eyes(86.6%)in the control group getting postoperative best-corrected visual acuity>0.4 respectively, the difference between two groups was not significant(P>0.05). The incidence rate of corneal edema and fibrin exudation in the observation group were 31.7% and 19.5% respectively which were significantly higher than the control group, the differences between groups were statistically significant(P<0.05); the incidence rate of posterior capsular opacification was 14.6% in the observation group and 11.0% in the control group, the difference between groups was not significant(P>0.05).

CONCLUSION: The treatment of phacoemulsification and IOL implantation for diabetic cataract is safe and feasible and has the same efficacy with the simple senile cataract.

Treatment of different types of after cataract with Nd:YAG laser

Ying-Yue Chen and Yong-He Chen

AIM: To investigate the methods, effect and complication of treating different types of after cataract withNd:YAG laser.

METHODS: A total of 360 patients 382 eyes with different types of after cataract were treated by Nd:YAG laser. The complication and visual acuity were observed. Laser parameters in three groups of one-level, two-lever, three-level membrane were recorded. Laser parameters in four groups of senile cataract, congenital cataract, complicated cataract and traumatic cataract were statistically analyzed.

RESULTS: The best-corrected visual acuity had significant difference after laser treatment(P<0.05). The average total laser energy and pulse had significant difference comparing with senile and traumatic group(P<0.05). The complications included high intraocular pressure in 7 eyes(1.8%)and the damage of lens in 26 eyes(7.7%).

CONCLUSION:Nd:YAG laser is a safe and effective method for after cataract. Three-level membrane in traumatic cataract is in majority. Single dose energy, total pulse and total laser energy are all big. Different therapic laser parameter according to different patients and timely treatment of complication can improve effect and safety.

Clinical evaluation of posterior chamber intraocular lens implantation without suture on posterior capsule rupture

Cheng Chen,Bai-Chao Ren and Jian-Mei Ma

AIM: To investigate the effect and skill of posterior chamber intraocular lens implantation withoutsuture for posterior capsule rupture of cataract.

METHODS: Totally 31 cases(31 eyes)of cataract patients underwent continuous curvilinear capsulorhexis(CCC). When finding the posterior capsule rupture in small incision cataract surgery, the surgeon prevented expansion of posterior capsule rupture. After vitrectomy, the surgeon implanted posterior chamber intraocular lens by residual posterior capsule or anterior capsule.

RESULTS: After 1 week, corrected visionin 80.6% eyes were more than 0.5. After 3 months follow-up, corrected vision in 83.9% eyes were more than 0.5. 31 eyes had no serious complication.

CONCLUSION: Posterior chamber intraocular lens implantation withoutsuture is effective and convenient in the treatment of posterior capsule rupture.

Analysis of phacoemulsification combined goniosychialysis for cataract extraction in treatment of angle-closure glaucoma

Yong Sun,Xin-Juan Wan,Gang Liu and Yan-Li Qin

AIM: To analyze the effect of phacoemulsification combined goniosychialysis for cataract extraction in the treatment of angle-closure glaucoma(ACG).

METHODS: Totally 46 cases(56 eyes)of ACG which had cataract and closed range of anterior chamber angle less than or equal 180° received phacoemulsification surgery with intraocular lens(IOL)implantation combined goniosychialysis. The intraocular pressure(IOP), vision, depth of anterior chamber, width of anterior chamber angle of preoperative and postoperative were observed.

RESULTS: The IOP of 56 eyes was all under the control of 21mmHg(1mmHg=0.133kPa)after operation and the anterior chamber angles became wilder than preoperative. Best-corrected visual acuity was improved. There was no serious operation complication. The preoperative and postoperative IOP, best-corrected visual acuity and anterior chamber depth had statistically significant differences.

CONCLUSION:We can receive satisfactory clinical effect of phacoemulsification surgery combined goniosychialysis for the proper patient who suffering from ACG and cataract.

Clinical analysis of the etiology of high intraocular pressure after trabeculectomy

Shu-Na Wang,Zi-Wen Wang and Mei-Zhen Yu

AIM: To study the etiology of high intraocular pressure(IOP)after trabeculectomy.

METHODS:Clinical data of 30 patients 34 eyes including the first time preoperative, intraoperative and postoperative situation were recorded, and when high IOP occurred, ophthalmic specialized examination(intraocular pressure, vision, angle of anterior chamber, etc)and UBM was perfoemed to analyze the cause of high IOP after trabeculectomy from September, 2009 to December, 2010.

RESULTS:The cause of high IOP after trabeculectomy included: filtering bleb flat scarring in 12 cases 15 eyes; malignant glaucoma tendency in 5 cases 6 eyes; postoperative bleeding anterior chamber 3 cases 3 eyes; sclera disc incision unobstructed 2 cases 2 eyes; Preoperative high IOP lasted for a long time in 2 cases 2 eyes; encapsulated filtering bleb in 2 cases 2 eyes; Other reasons such as preoperative uveitis in 1 case 1 eye; postoperative intumescent cataract in 1 case 1 eye; poor operation in 1 case 1 eye and surgery way not chosen wisely in 1 case 1 eye.

CONCLUSION: The main reason for high intraocular pressure after trabeculectomy is the postoperative filtering bleb flat scarring.

Observation on the efficacy of citicoline sodium on glaucoma visual field damage

Tian Xia,Jing Liu and Yu Zhang

AIM: To observe the efficacy of citicoline sodium on glaucoma visual field damage.

METHODS: Glaucoma patients with visual field defects and intraocular pressure(IOP)< 18mmHg were chosen, totally 29 patients 48 eyes were selected, of which 16 cases were male, 27 eyes, 13 cases were female, 21 eyes; in which 25 eyes were with primary open-angle glaucoma; 19 eyes with angle-closed glaucoma, and 4 eyes with normal IOP glaucoma. Citicoline sodium tablets were used orally, each 0.2g 3 times daily, continuously for three months. The visual field mean defect(MD), mean sensitivity(MS)and loss variance(LV), and other indicators were detected before and 1 month, 3 months after treatment.

RESULTS: One month after treatment, the MS of 48 eyes was significantly higher than that before treatment, the difference was statistically significant(P<0.01); MD value was significantly lower than that before treatment, the difference was statistically significant(P<0.05). Three months after treatment, the MS of patients was significantly higher than that before treatment, the difference was statistically significant(P<0.01); MD and LV value decreased, the difference was statistically significant(P<0.01).

CONCLUSION: Citicoline sodium has protective effect on visual function of primary glaucoma to some extent.

MP-1, SWAP/B-YP, standard W-WP examination in glaucoma

Xiao-Peng Cao,Rui-Fu Wang,Ying Lei,Xiao-Wei Gao,Peng Cao and Li-Ping Liu

AIM:To research the correlation between the physiological blind spot visual field variation and optic disc parameters detected by microperimetry-1(MP-1), short-wavelength automated perimtry/blue-on-yellow perimetry(SWAP/B-YP), standard white-on-white perimetry(W-WP)in the modern clinical comprehensive detection of glaucoma patients.

METHODS:The optic area visual field detection in 39 cases of 78 normal physical examinees(all soldiers), 59 cases 118 eyes with early stage of glaucoma, 25 cases 50 eyes with middle stage of glaucoma was detected using HUMPHREY Ⅱ-750 automated full field perimetry, SWAP/B-YP, MP-1, and precisely positioned by 45° non-mydriatic fundus camera and superimposed. The data obtained by the three perimeters were analyzed. Key indicators included cup/disc(C/D)ratio and mean deviation(MD).

RESULTS: There was obvious difference in the MP-1 and SWAP/B-YP. Compared with the normal physical examinees, C/D, MD enlarged in patients with early stage of glaucoma, and physiological blind spot was slightly enlarged, and there were obvious variations in blind spot, MS, MD observed in patients with middle stage glaucoma by the three perimeters. When glaucoma was detected by MP-1 combined SWAP/B-YP, with the guidance of Logistic regression analysis, the specificity, sensitivity, accuracy rate of MD was 92.0%,95.0%,93.9%, respectively, and after the comprehensive analysis of C/D, the rate could surpass 99%.

CONCLUSION: The sensitivity of MP-1 and SWAP/B-Y was higher in detection of early stage of glaucoma than standard W-WP, and they had good correlation, but for the advanced glaucoma, W-WP was fast, accurate, and time-saving, The above three perimeters can fully reflect that 45° non-mydriatic fundus camera combined with the visual field function comprehensive analysis, which combines morphology and fuctionial study to get the precise and quantitative materials of visual function, can improve the clinical diagnosis effect of glaucoma.

Risk factor analysis on recurrent retinal detachment after silicone oil removal

Jian-Qin Lei and An-Ming Xie

AIM: To find the risk factors for recurrent retinal detachment after silicone oil removal.

METHODS: We retrospectively reviewed all silicone oil removed surgeries performed between January 2008 and October 2011 in our vitreous-retinal group. All eyes had pars plana vitrectomy and silicone oil tamponade before in our center caused by retinal detachment. Binary logistic regression was used to find out the risk factors associated with recurrent retinal detachment. Factors analyzed included gender, age, primary diagnosis, lens state before silicone oil removal, duration of silicone oil, times of posterior segment surgeries, whether circling buckle was used, whether 20-gauge or 23-gauge vitrectomy was used, if combined with anterior segment surgeries during silicone oil removal, if combined with anterior segment or retinal operations during silicone oil removal.

RESULTS: Altogether, 128 eyes were collected, and 23 eyes(18.0%)had recurrent retinal detachment. Times of posterior segment surgeries before silicone oil removal and primary diagnosis were the independent risk factors associated with recurrent retinal detachment. The duration of silicone oil had a positive correlation with intraocular pressure elevation(IOP≥25mmHg).

CONCLUSION: Recurrent retinal detachment is a relatively frequent complication after silicone oil removal, especially for eyes with serious ocular trauma and multiple posterior segment surgeries.

Efficacy of mouse nerve growth factor in treating diabetic optic neuropathy

Jian-Li Ma,Xian-Yong Sun,Jie Zhang and Hua-Dong Lou

AIM: To investigate the efficacy and safety of the mouse nerve growth factor(M-NGF)in treating diabetic optic neuropathy(DON).

METHODS: All 67 cases(115 eyes)with DON were randomly divided into two groups according to the need of photocoagulation or not, and each group was randomly divided into normal treatment group and M-NGF treatment group. Patients in normal treatment group were treated by conventional way and those in M-NGF treatment group were treated with M-NGF plus conventional treatment for 3 weeks. Two months later, the vision and visual field of different groups were inspected and the safety was evaluated.

RESULTS: The effective rate was 71.4% in normal treatment group and 94.7% in M-NGF treatment group(P<0.05)in non-photocoagulation group, and 73.0% in normal treatment group and 93.3% in M-NGF treatment group(P<0.05)in photocoagulation group. The general effective rate of later was higher than the former(P<0.05), while the treatment effect had no significant statistical difference(P>0.05). Apart from local injection pain and swelling scleroma in several patients, other side effects were not found.

CONCLUSION: M-NGF is an effective and safe way to treat DON, which is worth widely applying in clinical practice.

Vitrectomy combined with intravitreal phacoemulsification to treat dislocated lens into the vitreous cavity

Ling Li,Xing-Ru Zhang,Min-Hong Xiang and Zhen-Yong Zhang

AIM: To investigate the clinical effects of vitrectomy combined with intravitreal phacoemulsification to treat dislocated lens into the vitreous cavity.

METHODS:Retrospective study of 23 cases patient's data, whose lens were dislocated into the vitreous cavity were treated by vitrectomy combined high-energy(80%-100%), high negative pressure(200-500mmHg)intravitreal phacoemulsification. We observed the best-corrected visual acuity preoperative and postoperative and complications.

RESULTS:Twenty-three cases of dislocated lens into the vitreous were removed successfully by this method, with no surgery-related complications. The mean follow-up period was 18 months. Preoperative best-corrected visual acuity ranged from 3.3 to 4.2, and postoperative best-corrected visual acuity ranged from 3.7 to 4.9. There was a significant difference(t=-11.244, P=0.000).

CONCLUSION:Pars plana vitrectomy combined with intravitreal phacoemulsification to treat dislocated lens into the vitreous cavity is an effective and safe method.

Retrospective analysis about the changes of corneal refraction that RGP made to early cone corneal patients

Li Sun,Yan Zhang,Chuan Lü,Man Xu and Yan-Chun Xu

AIM: To discuss the function of rigid gas permeable(RGP)oncone corneal refraction.

METHODS: Forty-six patients 73 eyes were diagnosed with early conical cornea. In statistical analyses, the vision correction of patients with spectacles framework are compared to that of other patients with RGP.

RESULTS: Vision correctionof patients with RGP is statistically different from that of patients who wear framework glasses(P<0.05). The difference values between the patients' two-times of optometry examination results on the condition of wearing RGP were statistically different from the difference values of examination results on condition that patients wear no glasses(P<0.05). In the condition of wearing RGP, vision correction among male patients was statistically better than that among female patients(P<0.05). Vision correction of the patients below 25 was not statistically different from that of the patients above 25(P>0.05). The patients' cornea were 490μm thick, which was statistically different from normal corneal thickness(P<0.05).

CONCLUSION: Corrected visual acuity of patients wearing RGP is better than that of patients with framework glasses. The optometry examination result of patients with RGP is more accurate. Corrected visual acuity of men is better than that of women, on the condition of wearing RGP. Vision correction extent has no difference among patients of different ages, when they wear RGP. The cornea of cone corneal patients is commonly thinner than that of normal persons.

Comparative analysis of combined therapy and clinical efficacy for myopic amblyopia

AIM: To observe and analyze the clinical effect of minimal occlusion + Haidinger brush + flicker red light + distance visual function training of red E standard logarithm visual acuity chart in treating children with myopic amblyopia.

METHODS: Totally 97 children(186 eyes)with myopic amblyopia were treated, 47 children(89 eyes)in group A aged 4-12(5.79±1.98)years old were treated by covering + flicker red light + near visual function training and 50 children(97 eyes)in group B aged 3-10(5.92±1.72)years old were treated by minimal covering + Haidinger brush + flicker red light + distance visual function training of red E standard logarithm visual acuity chart. The patients with mild myopia, moderate myopia and high myopia were 16, 52 and 21 eyes in group A and 18, 55 and 24 eyes in group B(χ²=0.004, P>0.05). The patients with low amblyopia, medium amblyopia and severe amblyopia were 23, 49 and 17 eyes in group A and 26, 55 and 16 eyes in group B(χ²=0.136, P>0.05). All patients were followed up for 24 months to comparatively analyze the efficacy of two different combined therapies.

RESULTS: The recovery rate, effective rate and inefficacy rate was 35.96%, 40.45% and 23.60%, respectively in group A, and 56.70%, 26.80% and 16.49%, respectively in group B(χ²=6.022, P<0.05). The patients whose myopic degree developed ≤1.0D, 1.0D-3.0D and ≥3.0D were 3, 49 and 37 eyes in group A and 4, 69 and 24 eyes in group B after therapy(χ²=5.074, P<0.05).

CONCLUSION:The efficacy is better of minimal covering+ Haidinger brush + flicker red light + distance visual function training by red E standard logarithm visual acuity chart for treating children with myopic amblyopia and the develop of myopic degree were mild after therapy.

Influence of Esculin and Digitalisglycosides Eye drops on the accommodation of juvenile myopia

Xiu-Mei Yu,Chun-Yan Zhang,Fang Chen and Zhi Chen

AIM: To observe the effect of Esculin and Digitalisglycosides Eye drops on the accommodation function of juvenile myopia.

METHODS: Totally 158 cases of myopia with an average age of 15.22±0.96 years old were selected between June 2011 and July 2011, including 66 males and 92 females, with mean refractive diopter -4.46±1.31D. Based on pupil dilation and medical optometry, the patients wore corrective glasses, and then they were divided into experimental group 72 patients, and control group 86 patients. The experimental group was used Esculin and Digitalisglycosides Eye drops 3 times a day for both eyes, 30 days a course, and reviewed every two weeks to evaluate the amplitude of accommodation, accommodative lag, accommodative sensitivity, positive and negative relative accommodation, and the data obtained were analyzed using ANOVA.

RESULTS: Theaccommodative sensitivity in the experimental group was obviously improved compared with that in control group, and the difference was statistically significant(left eye:F=6.342,P<0.05; right eye: F=7.966, P<0.05; both eyes: F=6.922,P<0.05). The negative relative accommodation in the experimental group was obviously improved compared with that in control group, and the difference was statistically significant(F=6.102,P<0.05). There was no significant difference in refractive diopter between the two groups(F=2.361,P>0.05).

CONCLUSION: Esculin and Digitalisglycosides Eye drops can effectively improve the accommodation function of juvenile myopia.

Postoperative efficacy of PRK correcting mild-to-moderate myopia with low dose mitomycin C administered intraoperatively

Yu-Kun Niu,Lin Li,Wei-Qun Wang,Yuan-Dong Li and Ze-Guang Xu

AIM: To evaluate the efficacy ofphotorefractive keratectomy(PRK)in correcting mild-to-moderate myopia with the low dose(0.02g/L)mitomycin C(LMMC)in eyes for 30 seconds.

METHODS: Fifty-seven eyes of 30 patients with mild-to-moderate myopia were treated with PRK, and theLMMC was administered topically for 30 seconds. Seventy-seven eyes of 39 patients with mild-to-moderate myopia were treated with LASIK. The follow-up was evaluated 6 months later. Independent samples t test, Chi-square test were used for statistical analysis. Significance level was set P<0.05.

RESULTS: In the PRK+LMMC group 6 months later, mean spherical equivalent refraction was 0.210±0.72D, spherical equivalent refraction within ±0.50D was obtained in 71.9% of eyes, uncorrected visual acuity≥1.0 was obtained in 77.2% of eyes, and mean best spectacle-corrected visual acuity was 1.19±0.18, and they were-0.017±0.81D, 70.1%, 72.7% and 1.16±0.19, respectively, in the LASIK group 6 months later. The differences between two groups were not statistically significant(t=1.76; χ²=0.051; χ²=0.805; t=0.984, all P>0.05). No eye presented more than grade 1 haze in PRK+LMMC group. 1 eye occurred epithelial ingrowth in LASIK group.

CONCLUSION:PRK correcting mild-to-moderate myopia with LMMC administered topically for 30 seconds intraoperatively is equally effective with LASIK, and avoids LASIK flaps complications. PRK is an effective alternative to LASIK.

Clinical analysis of ocular syphilis

Hui Zhang,Zhi-Jian Jiang and Jian-Hong Dong

AIM:To investigate the clinical features of ocular syphilis.

METHODS:The clinical data of 13 patients with active ocular syphilis were retrospectively reviewed. The diagnosis was made first in eye clinic. Twelve patients received systemic penicillin therapy and 1 patient was treated with ceftriaxone due to penicillin allergy.

RESULTS:The major ocular manifestations included chorioretinitis(9 cases, 17 eyes), neuroretinitis(2 cases, 3 eyes), optic neuritis(1 case, 1 eye), exudative retinal detachment(1 case, 2 eyes). The mean follow-up visual acuity was 0.56±0.23, and follow-up of(rapid plasma reagin)RPR titer was 1:16.6.

CONCLUSION:Ocular syphilis has different manifestations, which is easy to misdiagnosis and missed diagnosis. Oculist should be vigilant to detect and treat early.

Clinical effect analysis of different surgical excisions of primary pterygium

Chun-Yan An and Mei Sun

AIM: To compare the effect of primary pterygium excision using several surgeries.

METHODS: A total of 206 eyes of primary pterygium were selected and all underwent pterygium excision. They were divided into 4 groups. Group A with 50 eyes using simple pterygium excision. Group B with 47 eyes using simple pterygium excision and mitomycin C(MMC). Group C with 52 eyes using simple pterygium excision and amniotic membrane transplantation combined with MMC. Group D with 57 eyes using autologous corneal limbus stem cells transplantation. Postoperative follow-up was 2 years.

RESULTS: The recurrence rate was remarkably different between group A and the other three groups.The recurrence rate in group B was lower than that in group A, but higher than the other groups. The recurrence rates among the last two groups had no significant difference. Average surgery time was 13 minutes in the group A, which was greatly shorter than other groups. Average surgery time of the last two groups was a little longer. Most recurrences occurred within 12 months.

CONCLUSION: MMC can reduce the recurrence rate of simple pterygium excision. Pterygium surgeries including free autologous conjunctival grafting and amniotic membrane transplantation are associated with fewer recurrences.

Clinical features of paralytic strabismus

Xin-Ling Wang,Xue-Jiao Li and Qi-Chang Yan — 2013/8/26 15:29:06

AIM: To observe the clinical features of paralytic strabismus and analyze its etiology.

METHODS: Eighty-nine cases(97 eyes)were diagnosed with paralytic strabismus and recruited in this study in the Department of Ophthalmology, the Fourth Affiliated Hospital, China Medical University between July 2008 and February 2013. The clinical data were recorded including the general and ophthalmic history, symptom, visual acuity, fundus, pupil, eyelid, visual field, eye movement, synoptophore, acting countervail head, ultrasound of eyeball and ocular muscle, color Doppler ultrasonography of the carotid artery, orbital computed tomography(CT), brain magnetic resonance imaging(MRI), blood biochemistry and immunologic tests.

RESULTS: The medical history disclosed that among these cases, hypertension in 36 cases, diabetic mellitus in 28 cases, hyperlipidemia in 19 cases, heart diseases in 17 cases, ischemic cerebrovascular disease in 12 cases and hyperthyroidism in 3 cases. Symptoms included vertigo in 47 cases and binocular temporal amaurosis in 36 cases. The horizontal restriction was manifested in 38 cases 45 eyes, vertical restriction in 42 cases with 42 eyes, and horizontal-and-vertical restriction in 9 cases with 10 eyes.

CONCLUSION: Brain vascular ischemic disease is one of the top reasons causing paralytic strabismus. Systemic disease history was found in a high proportion of the cases. It is of great essence to detect the life-threatening ischemia of vertebrobasilar artery system and take priority for treatment.

Comparison of central corneal thickness measured by Lenstar LS900, OrbscanⅡ and ultrasonic pachmetry

Hong-Tao Zhang and Hua Jiang — 2013/8/26 15:29:06

AIM: To investigate the difference of central corneal thickness(CCT)measured by Lenstar LS900, OrbscahⅡ system and ultrasonic pachmetry, and to evaluate the correlation and consistency of the results for providing a theoretical basis for clinical application.

METHODS: The mean value of CCT in 70 eyes of 35 patients measured three times by Lenstar LS900, OrbscahⅡ system and ultrasonic pachmetry underwent statistical analysis. The difference of CCT was compared, and the correlation and consistency of three measurements were analyzed to provide theoretical basis for clinical application. CCT values measured by different methods were analyzed with randomized block variance analysis. LSD-t test was used for pairwise comparison between groups. The correlation of three measurement methods were analyzed by linear correlation analysis, and Bland-Altman was used to analyze the consistency.

RESULTS: The mean CCT values measured by Lenstar LS900, OrbscanⅡ and ultrasonic pachmetry were 542.75±40.06, 528.74±39.59, 538.54±40.93μm, respectively. The mean difference of CCT measurement was 4.21±8.78μm between Lenstar LS900 and ultrasonic pachmetry, 14.01±13.39μm between Lenstar LS900 and Orbscan Ⅱ, 9.8±10.57μm between ultrasonic pachmetry and Orbscan Ⅱ. The difference was statistically significant(P<0.05). Three measurements were highly correlated(P>0.05): There was positive correlation between CCT with Lenstar LS900 and ultrasonic pachmetry(r=0.977, 0.944; P<0.05). The analysis method of Bland-Altman: 95% consistent interval of upper and lower value was -13.0～21.4μm between Lenstar LS900 and ultrasonic pachmetry, 1.4% points outside the limits of agreement of 95%, 95% consistent interval of upper and lower value was -30.5～10.9μm between OrbscanⅡ and ultrasonic pachmetry, 7.1% points outside the limits of agreement of 95% consistent interval.

CONCLUSION: There are excellent correlation among Lenstar LS900, Orbscan Ⅱ and ultrasonic pachmetry. Lenstar LS900 can be used as CCT non-contact measurement tool.

Clinical observation of torsional phacoemulsification for a beginner

Qiong Lei,Hua-Cong Peng and Bao-Song Liu — 2013/8/26 15:29:06

AIM: To observe the clinical security of torsional phacoemulsification for a beginner.

METHODS: The clinical data of 200 eyes who accepted torsional phacoemulsification by a beginner from February 2012 to March 2013 were reviewed. The operation complications were analyzed and the postoperative effect was assessed.

RESULTS: There was no collapse of the anterior chamber during operation. When the last nuclear was removed the surge occurred mildly. Posterior capsular rupture happened in 8 eyes, 5 eyes' intraocular lens(IOL)implanted in sclera sulcus after anterior vitrectomy, 3 eyes' IOL in bag without vitreous outflow. One eye without continuous curvilinear capsulotomy was transferred to the superior doctor for extracapsular cataract extraction(ECCE). One eye with the loose zonular fiber was implanted a capsular tension ring by the superior doctor. Seven cases need suture because of short sclera tunnel incisions. Uncorrected visual acuity a week after operation: 2 eyes(1%)<0.05, 31 eyes(15.5%)0.05-<0.3, 64 eyes(32%)≥0.3, 103 eyes(51.5%)≥0.5. There was no grade 3 corneal edema. The high intraocular pressure can be controlled by anterior chamber penetration or drugs.

CONCLUSION: The technique of torsional phacoemulsification is safe and effective for a beginner.

Clinical observation of primary phacoemulsification plus intraocular lens implantation for primary angle-closure glaucoma

Qing-Hui Kong,Xiao-Yan Dou and Jiang Guo — 2013/8/26 15:29:06

AIM:To evaluate the effects and safety of primary phacoemulsification plus intraocular lens implantation for controlled chronic angle-closure glaucoma(CACG)and acute angle-closure glaucoma(AACG).

METHODS: Sixty-eyes of 45 cases with CACG or CACG were randomly divided into two groups. Thirty-four eyes in IOL group underwent phacoemulsification plus intraocular lens(IOL)implantation. Twenty-six eyes in laser iridotomy(LI)group included treatment by LI. Intraocular pressure(IOP), numbers of antiglaucoma medications, complications, and corneal endothelial cell counts were examined in each group.

RESULTS: In IOL group, IOP was significantly reduced from a preoperative mean of 14.82±4.23mmHg to a 6-month postoperative mean of 10.94±1.24mmHg. However, in LI group, mean preoperative IOP was 15.34±4.13mmHg, and the 6-month postoperative IOP was 14.68±4.77mmHg. There was statistical significance in preoperative and postoperative IOP between two groups(F=36.452, P<0.01). In IOL group, no patient used anti-glaucoma medications 6-month postoperatively, whereas in LI group, mean number of anti-glaucoma medications was 0.24±0.41(P<0.05). There were no significant differences in preoperative and postoperative corneal endothelial cell counts between IOL and LI groups(P>0.05).

CONCLUSION: Primary phacoemulsification plus intraocular lens implantation for controlled CACG or AACG seems to be a safe and effective method in reducing IOP. This procedure might become the first treatment of choice for controlled CACG or AACG with cataract.

Preliminary observation about anterior capsular changes in different patients after cataract phacoemulsification

Min Wang,Yu-Lan Wang,Yao-Hua Sheng,Jin-Hua Tao and Chao Song — 2013/8/26 15:29:06

AIM: To compare changes of anterior capsular opening size between complicated and simple cataract patients who underwent phacoemulsification and foldable IOL implantation.

METHODS:Patients complicated with high myopia, primary angle-closure glaucoma(PACG), diabetic cataract and simple cataract(control group)were selected, 25 case in each group. All patients accepted phacoemulsification by the doctor with operation experience of more than 5 000 cases, and the same 1-piece hydrophilic acrylic IOL was implanted without any complicated happened. The measured value about anterior capsular area by Image-pro plus 6.0 was greater than 23mm². Every patient was checked regularly through dilated pupil, take photos by slit-lamp camera and area was measured after operation 1 week, 1 month, 3 and 6 months, then to record the biological changes about anterior capsular in 4 groups.

RESULTS: The average anterior capsular area in 4 groups 1 week after operation had no difference(P>0.05); No difference was found between simple and complicated high myopia group 6 months after operation(P>0.05). Capsule contraction was observed in complicated POAG group 3 months after operation and in diabetes mellitus group 6 months postoperatively, the average anterior capsular area become smaller than 1 week postoperatively(P<0.05).

CONCLUSION: Cataract patients who complicated PACG or diabetes mellitus maybe the high-risk groups, capsule contraction will be happened 1 month after operation. For high-risk groups, we should prolong the follow-up time, enrich the observation data, and provide the clinical basis for reasonable and preventive intervention.

Surgery effect of endoscope-assisted transscleral suture fixation intraocular lens

Hai-Jun Yang,Jing-Lin Yi,Xing-Zhong Luo,Hui Xie,Yong-Quan Bai and Min Zhou — 2013/8/26 15:29:06

AIM: To research surgery effect and complications of transscleral suture fixation intraocular lens(IOL)assisted with endoscope or with the traditional method.

METHODS: Thirty cases need IOL implantation without sufficient posterior lens capsule membrane support were chosen. These patients were divided into two groups randomly and every group had 15 patients. Group A underwent surgery of transscleral suture fixation IOL with the traditional method. Group B had surgery of transscleral suture fixation IOL assisted with endoscope. The surgical complications and postoperative effect were regularly observed and analyzed.

RESULTS: All patients were successfully completed surgery. The mean naked visual acuity(NVA)of group A was 0.26±0.14(from 0.1 to 0.6)one month after operation. The mean NVA of group B was 0.37±0.16(from 0.15 to 0.8). The postoperative NVA of two group patients was improved different degree than preoperative NVA. The differences of postoperative NVA between the two groups had statistical significance(t=2.351, P<0.05). The mean best-corrected visual acuity(BCVA)of group A and group B were 0.45±0.13(from 0.3 to 0.6)and 0.47±0.14(from 0.3 to 0.8)one month after operation. The differences of postoperative BCVA between the two groups had statistical significance(t=1.327, P>0.05). Group A appeared more complications included 3 cases of corneal edema, 3 cases of uveitis, 4 cases of anterior chamber hemorrhage, 2 cases of vitreous hemorrhage, 3 cases of IOL deviation or tilted, 1 case of the peripheral iris anterior adhesion, 2 cases of elevated intraocular pressure. Group B appeared only a few minor complications including 5 cases of corneal edema, 2 cases of uveitis.

CONCLUSION: With the help of endoscope for transscleral suture fixation IOL can ensure sutures fixed position is located in the ciliary sulcus, surgery complications decrease significantly and surgical effect is better compared with the traditional method.

Efficacy and safety of Latanoprost/Timolol fixed combinations in treatment of refractory glaucoma following vitrectomy in short period

Ting Wang,Tao Liang,Wen-Qian Yu and Ke-Feng Liu — 2013/8/26 15:29:07

AIM: To evaluate the efficacy and safety of Latanoprost/Timolol fixed combinations(LTFC)in treatment of refractory glaucoma following vitrectomy in short period.

METHODS: In the present study, 42 eyes of 38 refractory glaucoma patients who had received vitrectomy were carried out. The patients were randomly divided into two groups after a 2-week washout period for previous antiglaucoma medication. Patients in group 1 underwent a 6-week treatment with LTFC and those in group 2 were treated with Latanoprost/Timolol unfixed combinations(LTuFC)for 6 weeks. The IOP, visual field, and mRNFL were measured after the washout period as the baseline, and after 6 weeks of therapy. Eye condition and adverse reactions were observed.

RESULTS: The mean baseline IOPs of groups 1 and 2 were respectively 37.90±3.74mmHg and 37.57±3.23mmHg. After 6 weeks, the mean IOPs were respectively 30.10±4.90mmHg and 30.62±4.62mmHg, indicating a significant reduction from the baseline(t=12.16, t=13.78, P<0.01). No difference was observed in the IOP reduction between LTFC and LTuFC(20.54%±7.88%, 18.23%±7.03%, t=0.75, P>0.05). IOP reduction was 24.87%(20 eyes), 17.46%(15 eyes), and 9.65%(7 eyes)respectively among those with open-angle glaucoma, with partially open-angle glaucoma, and with closed-angle glaucoma. The eye drops didn't have effects on the vision field and mRNFL(all P>0.05), and their main adverse reactions were eye irritation and mild hyperemia.

CONCLUSION: In refractory glaucoma, especially in open-angle or partially-open-angle glaucoma, LTFC, administered after vitrectomy, helps to reduce IOP with desirable safetly and tolerance.

Effect of Ahmed valve implantation on late neovascular glaucoma

Ping-An Mao,Yan-Wen Jia,Yang Xie and Guo-Hua Lu — 2013/8/26 15:29:07

AIM: To discuss the effect and safety of Ahmed valve implantation in late neovascular glaucoma.

METHODS: The Ahmed glaucoma valve were implanted in 41 eyes(41 cases)with late neovascular glaucoma, the follow-up was 12 months on average, intraocular pressure was recorded at 1 day, 1 week, 1 month, 3, 6, 12 months respectively after operation and compared with that before operation, at the same time, the complications and treatment were analyzed.

RESULTS: The mean intraocular pressure before operation, 1 day, 1 week, 1 month, 3, 6, 12 months after operation was 59.83±5.53, 19.27±8.19, 19.69±6.86, 20.67±6.73, 21.05±6.93, 21.49±7.42, 22.14±8.08mmHg, the mean intraocular pressure before operation was higher than that after operation and the difference was obvious in statistics. Major complications included hyphema, low intraocular pressure early postoperation, shallow anterior chamber, obstruction of the tube, the plate wrapped or exposed.

CONCLUSION: Ahmed valve implantation is an effective method to treatlate neovascular glaucoma.

Effects of traditional trabeculectomy, mitomycin C trabeculectomy and sclera pool trabeculectomy on post-surgical life quality in glaucoma patients

Zhuo-Lin Zhou,Qian-Li Ma,Xin-Guang Yang and Hong-Xia Fang — 2013/8/26 15:29:07

AIM: To explore and compare the effects of trabeculectomy, mitomycin C(MMC)trabeculectomy and sclera pool trabeculectomy on life quality of patients with glaucoma.

METHODS: Totally, 60 patients(60 eyes)with glaucoma were divided into group A, B and C equally and randomly. Twenty patients(20 eyes)in group A received treatment of traditional trabeculectomy; Twenty patients(20 eyes)in group B received MMC trabeculectomy; while twenty patients(20 eyes)in group C received sclera pool trabeculectomy. One-year follow study was proposed, Chinese version low vision quality of life questionnaire(CLVQOL)and self- assessment score were used to evaluate effects of surgeries on life quality of patients.

RESULTS: Compared with group A, scoring of CLVQOL increased significantly in group B and C, and more significantly in group C(distant vision, movement, sensitization and fine work)when compared with group B(P<0.05). Compared with group A, scoring of self assessment increased significantly in group B and C, more significantly in group C(vision self scoring and subjective brightness scoring)when compared with group B(P<0.05).

CONCLUSION: The improvement effect of sclera pool trabeculectomy on life quality of patient with glaucoma is better than traditional and MMC trabeculectomy.

Correlation between retinal thickness in macular sections and contrast sensitivity function in myopia after LASIK

Qiao-Ya Lin,Rui-Zhen Ye and Xue-Xi Li — 2013/8/26 15:29:07

AIM: To explore the relationship between retinal thickness changes in different macular sections and decrease of visual function in myopia after laser in situ keratomileusis(LASIK).

METHODS: The retinal thickness in different macular sections of patients after LASIK was measured by Cirrus high spectral domain optical coherence tomography(HD-OCT). The contrast sensitivity function(CSF)was measured by OPTEC 6500. The results were analyzed by correlation analysis.

RESULTS: The retinal thickness in different macular sections outside fovea was positively correlated with the CSF of different spatial frequencies.

CONCLUSION: The decreased CSF of different spatial frequencies results from the changes of retinal thickness at different macular regions outside fovea.

Clinical study on photocoagulation with 532nm laser for diabetic retinopathy

Guo-Ying Liu — 2013/8/26 15:29:07

AIM: To evaluate the efficiency of 532nm laser photocoagulation in treating diabetic retinopathy.

METHODS: Totally 96 eyes in 48 diabetic cases, including 54 eyes with preproliferative diabetic retinopathy(PPDR), 42 eyes with proliferative retinopathy(PDR)(20 eyes with high-risk PDR, 22 eyes with non-high-risk PDR), and 21 eyes with macular edema, were treated with 532nm laser photocoagulation. According to DR stage and severity, the patients had received the treatment of subpanretinal photocoagulation(Sub-PRP), standard panretinal photocoagulation(S-PRP), extra panretinal photocoagulation(E-PRP), local photocoagulation and grid pattern photocoagulation. All cases were followed-up for 3 months to 4 years, and visual acuity and retinopathy changes were observed. Further photocoagulation was performed when necessary.

RESULTS: Visual acuity was improved or maintained in 45 eyes(83%)in the group of PPDR, 18 eyes(82%)in the group of non-high-risk PDR, 12 eyes(60%)in the group of high-risk PDR. As to the retinopathy development, edema, exudation and bleeding absorption in the retina, as well as partial or entire vanishment to retinal neovascularization, were considered as effective outcome. The effective data were 50 eyes(93%)in the group of PPDR, 19 eyes(86%)in the group of non-high-risk PDR, 13 eyes(65%)in the group of high-risk PDR.

CONCLUSION: In treating diabetic retinopathy, 532nm laser photocoagulation is effective and safe. Better effect can be achieved in early stage. Early discovery and treatment, attention to photocoagulation methods and skills, regular follow-ups and timely supplement of photocoagulation, are the key points for improving the effect of retinal photocoagulation.

Clinical analysis of 532nm frequency-doubled laser in treating retinal holes of 78 eyes

Heng Li and Xue Mi — 2013/8/26 15:29:07

AIM: To evaluate the clinical effect of photocoagulation with 532nm frequency-doubled laser in patients with retinal hole.

METHODS: Seventy-two cases(78 eyes)with retinal holes were treated with 532nm frequency-doubled laser. All the eyes were divided according to the quadrants of location of retinal holes and the size of retinal hole and existence of local retinal detachment accompanying retinal holes. Statistical analysis was made on these data.

RESULTS: 1)The retinal holes were located in the upper quadrants of retina in 44 eyes and there were also retinal holes located in the lower quadrants of retina in 31 eyes(there were 3 eyes with retinal holes both located in the upper and lower quadrants of retina, which were not included in control group). The difference of photocoagulation effect between the two groups was statistically significant. 2)The retinal holes diameter ≤2 papilla diameter(PD)were present in 37 eyes, the holes diameter of retina >2PD were seen in 41 eyes, the difference of photocoagulation effect between the two groups was statistically significant. 3)Retinal holes without local retinal detachment were observed in 45 eyes, retinal holes with local retinal detachment were seen in 33 eyes, the difference of photocoagulation effect between the two groups was statistically significant.

CONCLUSION:Photocoagulation with 532nm frequency-doubled laser is effective and safe to treat retinal holes. The effect is better in patients with retinal holes in the upper quadrants and with the retinal holes diameter ≤2PD and without local retinal detachment.

Clinical curative effect analysis of double-frequency 532nm laser on retinal hole in high myopia

Yan He and Ya-Lin Zhang — 2013/8/26 15:29:07

AIM: To observe the clinical effect of double-frequency 532nm laser on retinal hole in 62 cases 68 eyes with high myopia >-6.00D.

METHODS: Totally 68 consecutive eyes diagnosed of retinal hole associated with high myopia >-6.00D accepted double-frequency 532nm laser therapies. The situation of retinal hole and the occurrence rate of retinal detachment were observed.

RESULTS: After the follow up of 6-24 mouths, 65 retinal holes were closed successfully among 68 cases(96%), and 3 cases(4%)got retinal detachment and undergone, underwent vitreous retinal surgery finally.

CONCLUSION: Double-frequency 532nm laser is a safe, effective tool in treatment of retinal hole associated with high myopia >-6.00D.

Observation and management of shallow anterior chamber after glaucoma surgery

Song-Ya Fan and Shu-Zhen Li — 2013/8/26 15:29:07

AIM: To analyze the cause and management of shallow anterior chamber after glaucoma surgery.

METHODS: The cause and management of shallow anterior chamber after glaucoma surgery on 298 cases(462 eyes)were analyzed retrospectively.

RESULTS: In 298 cases(462 eyes), 99 eyes(21.4%)had shallow anterior chamber. In 358 eyes treated with trabeculectomy, 77 eyes(21.5%)had shallow anterior chamber. In 85 eyes treated with trabeculectomy+MMC(mitomycin C), 20 eyes(23.5%)had shallow anterior chamber. In 19 eyes treated with trabeculectomy combined with cataract phacoemulsification and intraocular lens implantation, 2 eyes(10.53%)had shallow anterior chamber. Shallow anterior chamber appeared at 1 day to 5 days postoperatively. Forty-two eyes(42.4%)were with excessive filtering, 6 eyes(6.1%)with malignant glaucoma, 29 eyes(29.3%)with choroidal detachment, 2 eyes(2.0%)with malignant glaucoma complicated by choroidal detachment. Of 99 eyes with shallow anterior chamber, anterior chamber of 79 eyes recovered treated by nonsurgical methods, 20 eyes treated by operation.

CONCLUSION: The common cause of shallow anterior chamber after glaucoma surgery was preoperative high intraocular pressure, inflammation, excessive filtering, conjunctival flap flushing and choroidal detachment. Most cases can be managed with nonsurgical methods. Surgical interference should be taken if necessary.

Curative effect of early retinal photocoagulation and Xuefuzhuyu decoction for ischemic retinal vein occlusion

Juan-Yu Gao and Yuan Zhou — 2013/8/26 15:29:07

AIM: To observe the curative effect of early retinal photocoagulation combined with Xuefuzhuyu decoction in treatment of ischemic retinal vein occlusion(RVO).

METHODS: Fifty-five patients(55 eyes)with ischemic RVO received early retinal photocoagulation by Zeiss Lumenis 1000 laser machine combined with Xuefuzhuyu decoction. The visual acuity, capillary nonperfusion and neovascularization were detected at 3 months after treatment.

RESULTS: Three months after treatment, visual acuity were increased in 23 cases(42%), steady in 30 cases(55%), decreased in 2 cases(4%), the total effective rate was 96%. Retinal non-perfusion area(NPA)disappeared in 38 cases(69%), NPA was less than 5 disc area(DA)in 15 cases(27%)and ≥5DA in 2 cases(4%).

CONCLUSION: Early retinal photocoagulation and Xuefuzhuyu decoction is effective and reasonable treatment for ischemic RVO.

Clinical efficacy research of nerve growth factor combined with traditional medicine for the treatment of anterior ischemic optic neuropathy

Li-Hua Luo and Yan-Ling Wang — 2013/8/26 15:29:07

AIM: To evaluate the efficacy and safety of nerve growth factor(NGF)on optic nerve anterior ischemic optic neuropathy.

METHODS:A total of 343 eyes of 343 patients with anterior ischemic optic neuropathy were treated with mouse NGF by the dosage of 30μg qd and continuous injected for three weeks, at the same time given expanding vascular medicine and neurotrophic agent. Corrected LogMar visual acuity, visual field mean deviation(MD)values and pattern visual evoked potential(P-VEP)were recorded and analyzed. The adverse reactions in the course of treatment were analyzed in order to evaluate the safety of this method.

RESULTS: The patient's vision after treatment were significantly increased compared with that before treatment, MD of visual field and P-VEP display incubation period after treatment were significantly lowered compared with that before treatment, the difference were statistically significant(P<0.05). There were 18 cases of adverse events in laboratory indicators in this study, and the incidence rate was 5.25%.

CONCLUSION: Mouse nerve growth factor combined with vasodilators and neurotrophin for the treatment of anterior ischemic optic neuropathy had satisfaction efficacy and safety.

Clinical research on the development of posterior vitreous detachments after coaxial microincision phacoemulsification

Rong Xu,Yan-Li Zhou and Yong Wang — 2013/8/26 15:29:07

AIM: To explore the development process of when posterior vitreous detachments(PVDs)after coaxial micro-incision phacoemulsification and aspiration combined with foldable intraocular lens implantation.

METHODS: Clinical data of 917 patients with cataract were collected after coaxial microincision phacoemulsification and aspiration combined with foldable intraocular lens implantation. The 917 operating eyes forms observation group and the 917 corresponding normal eyes serve as control group. All patients underwent a comprehensive ocular examination before surgery. The vitreous and retinal condition was tested by B-scan ultrasonography and biomicroscope with a 90-diopter(D)preset lens after 1 week and 1, 3, 6, and 12 months postoperatively.

RESULTS: The incident rate of eyes in the observation group that developed PVD after operation were 8(0.9%), 31(3.4%), 53(5.8%), 78(8.5%), 129(14.1%)within 1 week and 1, 3, 6, 12 months, respectively. Ten(7.8%)of the 129 eyes in which PVD developed during the one year follow-up period had new retinal breaks with or without a retinal detachment; One(0.1%)of the 788 eyes in which a PVD did not developed during the follow-up period had new retinal tear with or without a retinal detachment; these percentages were statistically significant(P=0.009). Eight(14.8%)of 54 eyes with lattice degeneration and 2(2.7%)of 75 eyes without lattice degeneration had retinal tears associated with a PVD; the difference was statistically significant(P=0.004).

CONCLUSION: Development of PVDs seems to accelerate after coaxial microincision phacoemulsification and linearly accumulated for 1 year postoperatively. Approximately 7.8% of eyes with a PVD had retinal tears. Compared with patients having no lattice degeneration, Patients' eyes with lattice degeneration had a 5.5-fold higher risk of developing retinal breaks associated with a PVD. This indicates long-term follow-up is necessary after phacoemulsification is performed.

Expression of chemokine receptor CXCR3 in female patients with dry eye at perimenopause

Hong Zhang and Xue-Yi Chen — 2013/8/26 15:29:07

AIM: To explore the expression and clinical significance of chemotactic factor receptor-3(CXCR3)of female patients conjunctival with dry eye at perimenopause.

METHODS: Thirty dry eye case(60 eyes)in the patient at perimenopause of the First Affiliated Hospital of Xinjiang Medical University and thirty dry eye cases(60 eyes)in patient at non-perimenopause were selected. The conjunctival epithelial cells at perimenopause and non-perimenopause in dry eye cases were obtained by impression cytology methods, and then immersed into the centrifugal tube with corresponding number respectively and the expression of CXCR3 in conjunctival epithelium of at perimenopause and non-perimenopause in dry eye cases were detected by flow cytometry.

RESULTS: The break-up time(BUT)and Schirmer Ⅰ test result of perimenopause was significantly lower than those of non-perimenopause(F=4.076, 5.023; P<0.05). Positive expression rate of CXCR3 at non-perimenopause in dry eye cases was more obvious than that at perimenopause in dry eye syndrome cases(P<0.01). Expression rate of CXCR3 in dry eye cases was negatively correlated with BUT and Schirmer Ⅰ test(r=-0.753, r=-0.684; P<0.05). However, it was non-related with corneal fluorescence staining(P>0.05).

CONCLUSION: CXCR3 plays an inflammatory mediators role in dry eye mechanism and its expression level reflects the progress of dry eye at perimenopause.

Clinical analysis of high myopia in 320 cases in Ningxia Hui Autonomous Region

Jin-Yan Zhu,Wei-Ning Rong,Ya-Ni Liu and Xun-Lun Sheng — 2013/8/26 15:29:07

AIM: To analyze the clinical manifestations and etiological factors of high myopia in 320 cases.

METHODS:A total of 320 patients(640 eyes)with high myopia treated in Ningxia Eye Hospital from January 2011 to November 2012 were studied. All of them underwent thorough eye examination and relevant environmental factors were recorded. The following data were analyzed, including gender, ethnicity, age of onset, refractive error, axial length, best corrected visual acuity(BCVA), educational level and living environment.

RESULTS: Bilateral high myopia was present in 320 patients(130 men and 190 women; 250 being of Han nationality and 70 of Hui nationality)with a mean age of 42.65±16.51 years(range: 3-80 years); the male to female ratio was 1:1.5. The age of onset was lower than 20 years in 237 patients, higher than 21 yeas in 83 patients, the difference was statistically significant(P<0.001). There was no significant difference between diopter and educational level(P>0.05). The patients with BCVA higher than 0.3 increased with diopter increased, while BCVA lower than 0.8 and between 0.4～0.7 reduced. Refraction was significantly negatively correlated with BCVA(r=-0.196, P<0.05)and positive correlated with axial length(r=0.681, P<0.05).

CONCLUSION: In the study, patients with high myopia tend to have early onset, low educational level, and spacious living environment. Such results indicate that the genetic factors may be the main cause of high myopia in this group. The higher the degree of myopia was, the worse BCVA and the longer AL would be.

Clinical study of applying mitomycin C in LASEK surgery for treatment of middle and high myopia

Ying-Long Li and Xiao-Ning Peng — 2013/8/26 15:29:07

AIM: To study the effect and safety of applying mitomycin C(MMC)in laser subepithelion keratomileusis(LASEK)surgery of middle or high myopia to prevent the formation of haze under corneal epithelium.

METHODS: Totally 120 patients(240 eyes)for LASEK surgery were selected randomly, the right eyes were set as test group, and the left eyes as control group. The eyes in control group underwent general LASEK, while for the test group, a filter paper with 0.2g/L MMC solution was covered on the corneal stroma bed after the laser ablation. The postoperative symptom, epithelial flap, recorrected visual acuity, haze formation were investigated.

RESULTS: There was no statistical difference of ocular irritation symptom and corneal epithelium healing time between the two groups. For the test group the grade 0 haze was found in 105 eyes(87.5%)by 1 month, in 80 eyes(66.7%)by 3 months, in 96 eyes(80.0%)by 6 months, while for the control group in 62 eyes(51.7%)by 1 month, in 39 eyes(32.5%)by 3 months, in 68 eyes(56.7%)by 6 months, there was statistically significance. Uncorrected visions were more than 1.0 in 91 eyes(75.8%)for the test group, while in 51 eyes(42.5%)for the control group in 6 months after operation, there was statistically significance(P<0.05).

CONCLUSION: The application of 0.2g/L MMC during LASEK for treatment of middle or high myopia was a safe and effective treatment. It could reduce the formation of haze.

Clinical research on the correlation of visual functional status and diopter in high myopia

Shu-Sheng Han and Yi-Ning Shi — 2013/8/26 15:29:07

AIM: To observe the changes of visual functional status at different diopter degrees and to research the correlatively objective sensitive indications among diopter degrees, visual function and morphological damage at early stage in high myopia.

METHODS: Low vision course(LVC)in vision center, macular course(M2, C08, TG2), the index that can reflect the state of visual function in visual electrophysiology system were used to make qualitative and quantitative observation, including single cones-electroretinogram(ERG), 30Hz flicker ERG, P-VEP, 1, 2 rings at first kernel response of multifocal ERG

RESULTS: Vision light sensitivity was decreased with the increase of diopter. P-VEP in visual electrophysiology, single cones cells, b wave of 30Hz flicker ERG, amplitude density of 1 and 2 rings, b wave in 1 ring, and latencies of a, b wave in 2 ring were all decreased(P<0.05). The results of stepwise multiple regression analysis indicated that diopter value had negative correlation with axial and single cone b-wave latency, and had positive correlation with P-VEP amplitude.

CONCLUSION: Vision, visual electrophysiology amplitude can detect the effect of different diopter on retinal function at early stage.

Clinical effect of super quantity of medial rectus recession in treating large angle esotropia

Min Xia,Xiao-Hu Chen,Yan Dai and Yuan Zhao — 2013/8/26 15:29:08

AIM: To observe the clinical effect of super quantity of binocular medialrectus in treating large angle concomitant esotropia.

METHODS: Eighty-one patients with large angle concomitant esotropia were analyzed retrospectively. According to the operation method, they had been divided into observation group(large recession of rectus muscle)and control group(normal recession of rectus muscle). The number of muscle were evaluated, eye's position and involution function in a week and a year after operation were also evaluated.

RESULTS:Forty-three cases in observation group had binocular medial rectus treatment, while 5 cases had binocular medial rectus+monocular medial rectus muscle resection treatment. Six cases in control group had the surgical treatment of bilateral medial rectus recession, 21 cases had binocular medial rectus+monocular medial rectus muscle resection and 6 cases with binocular medial rectus+bilateral lateral rectus shortening. The difference of the muscles' numbers of two groups in operation had statistical significance(χ²=41.72, P<0.01). One week after the operation, eye position of observation group was -2^△～+12^△, the average was +6.52^△±3.23^△, while that of control group was -3^△～+10^△, the average was +5.38±2.46^△. The difference of two groups had no statistical significance(t=1.45, P=0.08). One year after operation, eye positions of observation group and control group were -5^△～+10^△(average: +4.57^△±2.71^△)and -5^△～+8^△(average: +3.92^△±2.15^△). The difference of two group had no statistical significance(t=1.23, P=0.10). One week after the operation, 14 cases of observation group and 6 cases of control group's involution function were limited. One year after operation, 5 cases of observation group and 2 cases of control group's involution function were limited. The differences of two group had no statistical significance(χ²=1.27, P>0.05; χ²=0.47, P>0.05).

CONCLUSION: Super quantity of medial rectus recession in treating large angle concomitant esotropia can reduce the muscle's number, but it has no obvious influence on eyeball's involution function.

Clinical analysis on 159 cases of mechanical ocular trauma

Zi-Yao Liu,Ya-Zhi Fan,Yu-Ping Zheng and Jian-Ming Wang — 2013/7/29 14:34:25

AIM: To provide the basis of security guidance and decreasing the incidence through a general investigation of the mechanical ocular trauma among all the common causes, occasions where getting hurt as well as the characteristics of the high-risk group, and by further analysis and monitoring of the clinical cases and follow-up visit, study the related key factors of influencing the prognosis statistically.

METHODS: The data of the 159 cases with mechanical ocular trauma were recorded.

RESULTS: We obtained the 159 subjects' ages, genders as well as mechanical ocular trauma characteristic data, such as ocular distributions, the seasons of the injuries occurring, the causes and the occasions of the injuries, the high-risks group and so on. The factors affecting the visual prognosis,univariate analysis showed that the difference between urban and rural areas was a related influencing factor while the consulting hours and the ages of the patients were irrelevant. In the multivariate Logistic regression model of complications that affected the visual prognosis, there were four main factors leading to poor eyesight: endophthalmitis, retinal detachment, luxation or subluxation of the lens, prolapse of vitreous. In the multivariate Logistic regression model of the visual prognosis of mechanical eye injury, there were three factors of concern that corresponded to poor eyesight: the ages less than 10, zonation Ⅲ, grade of injury more than 3.

CONCLUSION: The epidemiologic features of the mechanical ocular trauma in our hospital correspond to the reports from other areas. Appropriate medical care can improve the visual prognosis. Factors such as zonation Ⅲ, ages less than 10, grade of injury more than 3, endophthalmitis with the eye injury, prolapse of vitreous, luxation or subluxation of the lens and so on, indicate poor visual prognosis.

Corneal layer plate removal with Fluconazole injected corneal stroma and autologous conjunctival transplantation for keratomycosis

Li-Dong Yang,Yun-Dong Yang,Xin Zhang,Hong-Qiang Jia and Shen Xu — 2013/7/29 14:34:26

AIM: To investigate the clinical effect of corneal layer plate removal with Fluconazole injected corneal stroma and autologous conjunctival transplantation for keratomycosis.

METHODS: There were 168 cases suffered keratomycosis that the focus located shallow of the cornea and was not obvious to drug, who registered in our hospital from March 2005 to June 2010. In surgery we removed plate layer to cormea clear, the region was greater than focus for 0.5mm,then we injected fluconazole which is 2g/L density in corneal stroma to make the edema area greater than Removal of area for 0.5mm. At last we took pedicle conjunctival flap to cover the plant bed by continuous suture. Postoperative day use drug to drop eye and to observe that whether recurrent of the keratomycosis and how was the edema degrade, the blood supply of conjunctival graft pieces, how about the stimulating signs of the surgery eye, the vision.

RESULTS: The improvement rate was 96.2% after surgery for seven days and the cure rate was 95.5% after surgery for one months. We found in 157 eyes accepted trigeminy surgery there were 6 eyes recurrence and the recurrence rate was 3.8%. The mean time of corneal stromal edema faded away was 13.4 hours. After surgery for one month there were 39 eyes(24.8%)whose vision removed than preoperative, there were 91 eyes(58.0%)whose vision were same as preoperative and there were 27 eyes(17.2%)whose vision lower than preoperative. In these operations the loss ratio of corneal endothelium was from 0%-8%, the mean was 2.9%. The irritative symptoms postoperative were mild for 87%, moderate for 10% and severe for 3%. By this surgery the mean length of stay was 7.3 days so the mean hospitalization expenses only were 2160 RMB. Three months after surgery, 4 cases were slight corneal ectasia.

CONCLUSION: This operation combined corneal layer plate removal, Fluconazole injected corneal stroma and autologous conjunctival transplantation for keratomycosis which was in early-to-mid was affordable and curative effect. So which could be used in some district which shortage the cornea donor.

Surface anesthesia of the small incision cataract extraction and intraocular lens implantation

Zong-Hui Liao,Fang-Fang Wang and Yu-Ming Zhang — 2013/7/29 14:34:26

AIM: To observe the effect of cataract extraction and intraocular lens implantation with manual small incision cataract surgery under surface anesthesia in the Primary Hospitals.

METHODS: Totally, 372 eyes of 358 cataract cases, in our hospital from January 2010 to March 2013, underwent cataract extraction and intraocular lens implantation with manual small incision cataract surgery under surface anesthesia. Intraoperative pain, postoperative complications and visual acuity were observed.

RESULTS: In the process of surgery, patients without pain and being-cooperated were recorded in 342 eyes(91.9%), that occasionally felt slight pain, but within endure and the operation was completed successfully were recorded in 17 eyes(4.6%). There were 13 eyes quit, 8 eyes(2.2%)of them because of the intolerable pain, the other 5 eyes(1.3%)of the ceaseless movement of the eye. The best corrected visual acuity on the 3^rd day after operation of 4.0～4.5 were observed in 57 eyes(15.9%), 4.5～4.8 in 213 eyes(59.3%), above 4.8 in 89 eyes(24.8%).

CONCLUSION: The cataract extraction and intraocular lens implantation with manual small incision cataract surgery under surface anesthesia can avoid corresponding complications, reduce the operation time obviously and ensure better quality of operation. It's suitable to carry out the prevention and treatment of blindness at the Primary Hospitals.

Clinical significance of glycosylated hemoglobin determination on diabetic cataract surgery

Hong-Fen Zhu and Jin Zhang — 2013/7/29 14:34:26

AIM: To evaluate the efficacy and clinical significance ofglycosylated hemoglobin(HbAlc)determination on diabetic cataract surgery.

METHODS: Totally 105 patients with diabetes(120 monocular)undergone phacoemulsification in our hospital from March 2012 to March 2013 were enrolled into the observation group(glycosylated hemoglobin determination group, HbA1c <6.5%). One hundred and eleven patients received diabetic cataract phacoemulsification surgery(126 monocular)in our hospital from January 2011 to March 2012 were reviewed as control group(blood glucose group, blood glucose <6.4mmL/L). Both of the groups were performed phacoemulsification with IOL intraocular lens implantation. Postoperative anterior segment inflammatory response(TASS), visual acuity and intensity of use of antibiotics(DDD)of the two groups' were compared during the following-up.

RESULTS:Glycated hemoglobin determination group: the mean visual acuity recovery was 0.72, the incidence of TASS was 83.3%, and DDD was 45.5. Blood glucose group: those were 0.498, 93.7%, and 88.6. The difference of incidence, degree and occurrence time of TASS(SAS 15.0 software analysis)and the degree of visual recovery between the two groups were statistically significant(P<0.05). The values of DDD were significantly different(P<0.01).

CONCLUSION:Glycosylated hemoglobin determination is the gold standard to measure blood sugar preoperation and has important significance for choosing the right time for diabetic cataract surgery. TASS was significantly reduced in the patients with preoperative standard glycosylated hemoglobin, the visual acuity of them improved significantly, and DDD values were significantly lower.

Clinical study on the treatment of cataract with angle-closure glaucoma by phacoemulsification combined with gonio- synechialysis

Xiao-Ming Zhang — 2013/7/29 14:34:26

AIM:To observe the effect of phacoemulsification combined with goniosynechialysis for angle-closure glaucoma and cataract.

METHODS: Fifty-five patients(55 eyes)with angle-closure glaucoma combined with cataract were analyzed retrospectively, including male 25 cases(25 eyes)and female 30 cases(30 eyes), aging from 52 to 82 years old(mean age: 70.6±1.2 years). All patients were treated with phacoemulsification combined with goniosynechialysis. The intraocular pressure, visual acuity, central anterior chamber depth and the change of anterior chamber angle were observed and recorded. The time of following-up was 6 months.

RESULTS:After 6 months' follow-up, the mean postoperative intraocular pressure was 14.3±4.1mmHg, which significantly decreased compared with that of preoperative(22.4±3.1mmHg, P<0.05). The mean postoperative central anterior chamber depth was 3.04±0.34mm, which significantly increased compared with that of preoperative(1.49±0.31mm, P<0.05). Visual acuity was increased in all patients. The range of angle closure ≤180°in 36 patients preoperative were widened postoperative.

CONCLUSION: The treatment of cataract with primary angle-closure glaucoma by phacoemulsification combined with goniosynechialysis is safe and effective.

Common complications and management of small incision cataract extraction in primary hospitals

Shu-Xiang Chen,Juan Li,Jing Li,Yun Ha,Lin Yang and Lin Chen — 2013/7/29 14:34:26

AIM: To discuss the security of small incision cataract extraction and intraocular lens implantation in cataract treatment, and to analyze intraoperative and postoperative complications and promote corresponding management.

METHODS: The surgery,extracapsular cataract extraction with small incision and intraocular lens implantation, was performed on 1 232 eyes with cataract. And complications were reviewed.

RESULTS: In the surgery: there were 19 eyes(1.54%)with irisprolapse, 4 eyes(0.32%)with iridodialysis, 62 eyes(5.03%)with ruptured posterior lens capsule, 4 eyes(0.32%)with detachment of post elastic layer. After the surgery: there were 56 eyes(4.54%)with corneal endothelial edema, 62 eyes(5.03%)with temporary intraocular hypertension, 2 eyes(0.16%)with acute endophthalmitis, 42 eyes(3.41%)with uveitic reaction, 5 eyes(0.41%)with hyphema, 1 eye with retinal detachment, 28 eyes(2.27%)with residual cortex.

CONCLUSION:Extracapsular cataract extraction with small incision and intraocular lens implantation is a safe, simple, and effective operation. However, various complications may occur due to nonproficiency and inadequate experience. Consequently, in order to achieve approving surgical outcome, operative skills should be mastered proficiently, and complications should be managed appropriately.

Phacoemulsification with intraocular lens implantation in primary angle-closure suspect, primary angle-closure and primary angle-closure glaucoma with cataract

Kun Zeng,Qi-Gao Feng,Bao-Tao Lin,Yun Peng,Hui Guo and Yu-Jin Pan — 2013/7/29 14:34:26

AIM: To evaluate the features and clinical outcomes of cataract extraction by phacoemulsification with intraocular lens implantation in primary angle-closure suspect(PACS), primary angle-closure(PAC)and primary angle-closure glaucoma(PACG)with cataract.

METHODS:Phacoemulsification with intraocular lens implantation was performed on 86 cases(86 eyes)diagnosed as PACS, PAC and PACG co-existing cataract from January to December 2012. All cases were followed up for 3 months to 1 year. Pre-operative and post-operative visual acuity, intraocular pressure(IOP), gonioscopy, ultrasound biomicroscopy(UBM), visual field and usage of anti-glaucomaous eye drops were recorded.

RESULTS:Zonular dialysis existed in 19 eyes(22%). The post-operative visual acuity improved in 84 eyes(98%). The post-operative visual acuity was <0.1 in 7 eyes(8%), 0.1-0.5 in 32 eyes(37%), 0.6-1.0 in 47 eyes(55%). There were 83 eyes(97%)with IOP between 10-15mmHg without any drug at the end of the follow-up period. The central anterior chamber was deepened and the anterior angle opened postoperatively at different extent.

CONCLUSION: PACS, PAC and PACG co-existing zonular dialysis is common. Phacoemulsification with IOL implantation can reduce IOP, deepen anterior chamber and open angle.

Mesopic visual quality after three kinds of aspheric acrylic monofocal intraocular lenses

Hai-Lun Ji,Wei Xiao and Wei Pu — 2013/7/29 14:34:26

AIM:To evaluate best corrected visual acuity(BCVA)and contrast sensitivity(CS)under mesopic condition with no glare in patients following implantation of three different kinds of aspheric acrylic monofocal intraocular lens(IOLs).

METHODS: Seventy-seven cases(90 eyes)of age-related cataract patients were selected, who were undergone phacoemulsification and intraocular lens(IOL)implantation in our hospital during December 2011 to November 2012. Preoperatively, the patients were randomly divided into three groups: 30 eyes(25 cases)were implanted with hydrophobic yellow-tinted acrylic(HOYA)IOLs in group 1; 30 eyes(28 cases)with hydrophilic acrylic IOLs(Rayner)in group 2; 30 eyes(24 cases)with hydrophilic acrylic surface heparin processing IOLs(XO)in group 3. All eyes were evaluated at 1 month and 3 months postoperatively. The BCVA and CS under mesopic condition without glare were measured and underwent statistical analysis.

RESULTS: There was neither statistically significant difference in the BCVA(P>0.05), nor statistically significant difference in CS results(after standardization of contrast sensitivity value: lgCS)(P>0.05)between groups under mesopic condition, but the lgCS of the HOYA group decreased slightly.

CONCLUSION: There were not marked differences of BCVA and CS between groups of patients at the follow-up intervals of 1 month and 3 months under mesopic condition. The blue-filter type artificial lens may protect the retina, thus, it is advisable to implant yellow-tinted filter blue artificial lens, especially for patients who are children or young persons.

Intraocular lens implantation in the condition of vitreous cavity filled with gas

Dong-Lin Wang,Chun-Xia Zhang,Yan-Hui Han,Fan-Chao Meng and Xiao-Hua Yang — 2013/7/29 14:34:26

AIM: To evaluate the clinical significance and technique of intraocular lens implantation in the condition of vitreous cavity filled with gas.

METHODS: Clinical data of 36 patients(36 eyes)who received intraocular lens implantation in the condition of vitreous cavity filled with gas was retrospectively studied. The postoperative follow-up period was for 3-12 months, averaged in 5.6 months.

RESULTS: Postoperative visual activity improved 2-6 lines compared with preoperative best corrected visual activity in all eyes. No severe complication occurred.

CONCLUSION: Assisted with noncontact panoramic viewing systems, it is easier to observe peripheral retinal clearly for photocoagulation in aphakia with gas filled vitreous cavity. Intraocular lens implantation in the condition of vitreous cavity filled with gas is easier, without unnecessary duplication operation. The surgery is safe and effective without too much difficulty.

Prevention of after-cataract by application of heparin treatment of capsular tension ring in Marfan syndrome and subluxation of lens

Zhong-Qing Li,Chang-Tao Zhao,Wei Wang,Xia Xiang and Chun-Hui Ren — 2013/7/29 14:34:26

AIM: To investigate the effect of heparin treatment on capsular tension ring(CTR)in the prevention of after-cataract postoperative patients with Marfan syndrome and subluxation of lens.

METHODS: Totally 34 cases(56 eyes)were divided randomly into experimental and control groups. Preoperative heparin 12500 units was added to 500mL Ringer's infusion, and CTR was dealt with heparin stock solution soak for 20 minutes in experimental group; there was no any drugs in the control group's solution, and CTR was not dealt with heparin. Postoperative IOP, anterior chamber reaction, corneal edema, IOL position, posterior capsular opacification were observed.

RESULTS: There was statistically significant difference in the posterior capsular opacification between the heparin group(13.3%)and the contral group no-heparin(69.2%)(P<0.01). In addition, anterior chamber reaction of the experimental group was significantly lighter than the control group. However, no significant differences were found between the two groups in IOP and corneal edema.

CONCLUSION: The present results indicate that there is the preventive effect on posterior capsular opacification by CTR soaked in heparin in postoperative patients with Marfan syndrome and subluxation of lens, thus contributing to the recovery of visual function.

Genetic analysis of a Chinese family with autosomal dominant congenital cataract

Han Wang,Tian-Xiao Zhang,Di Wu and Jin-Song Zhang — 2013/7/29 14:34:26

AIM: To investigate a Chinese autosomal dominant congenital cataract(ADCC)family and to find the relationship between the candidate gene and this pedigree.

METHODS: The clinical data and blood samples of the ADCC family were collected.Microsatellite markers were chosen according to 24 known candidate genes of ADCC. Lod scores of microsatellite markers were calculated with Mlink package of linkage software.

RESULTS: The phenotype of this family was nuclear cataract. After linkage analyzing,Lod scores of 50 microsatellite markers were less than zero. There was no linkage between the microsatellite markers and this pedigree.

CONCLUSION: The related gene of this family is not among the known genes of ADCC maybe there is a new pathogenic gene in this pedigree.

Analysis of influence factors on anterior chamber volume by corneal horizontal diameter and anterior chamber depth

Ming-Hua Zhang and Ai-Cun Fu — 2013/7/29 14:34:26

AIM: To investigate the correlative factors of corneal horizontal diameter(CHD)and anterior chamber depth(ACD)and discuss the affecting factors of anterior chamber volume(ACV).

METHODS: A total of 241 cases(482 eyes)of myopia aged 6-47 years were collected on randomly. There were 124(248 eyes)male subjects and 117(234 eyes)female subjects. CHD and ACD were measured with the Orbscan ⅡZ system, and each measurement was repeated three times. SPSS 17.0 software was used to analyze the correlation data. Mathematical model was set up to research anterior chamber volume.

RESULTS: The average of CHD is(11.69±0.51)mm, with diameter of(11.74±0.49)mm in male and(11.64±0.53)mm in female.The average of ACD was(3.04±0.30)mm, with depth of(3.07±0.30)mm in male and(3.02±0.29)in female. Differences in gender of CHD and ACD were significant in the t-test for independent samples(t= -2.265, -1.971; P=0.024, 0.05), these size of male were both larger than that of female. Through person correlation analysis, a negative correlation was found between CHD and age, ACD and age(r= -0.260,

-0.246; P=0, 0); a positive correlation was found between CHD and ACD(r=0.297; P=0), the regression equation between CHD and ACD in myopia population was Y=1.025+0.173X(F=46.440,P=0, R²=0.088), where Y represents ACD and X represents CHD.

CONCLUSION: There are statistically significant difference between male and female in CHD, ACD and ACV. The size of these in male is larger than in female. The CHD is positively correlated with the ACD, and CHD, ACD and ACV are negatively correlated with age and are not associated with the degree of myopia.

Photodynamic therapy with one third-dose verteporfin for treating acute central serous chorioretinopathy

Bo Zheng and Xiao-Juan Fan — 2013/7/29 14:34:26

AIM: To evaluate the efficacy of photodynamic therapy(PDT)with one third-dose verteporfin for treating acute central serous chorioretinopathy(CSC).

METHODS: Twenty-two eyes of 22 patients diagnosed with acute CSC from May 2010 to May 2011 received single session of PDT with one third dose(2mg/m²)verteporfin. All eyes were imaged by optical coherence tomography(OCT)preoperative and 1 week, 2, 4 weeks and 3 months after PDT. The resolution of subretinal fluid(SRF)was observed. Fundus fluorescein angiography(FFA)and indocyanine green angiography(ICGA)were applied preoperative and 4 weeks after PDT to evaluate the reliability and effectiveness of PDT.

RESULTS: Twenty-two eyes presented serous neuroepitheial detachment in OCT image and showed fluorescence leakage or smokestack phenomenon in FFA, and revealed dilated and tortuous choroidal vessels with diffuse hyperpermeability in ICGA pictures. After one week, OCT showed that SRF was reduced in 7 eyes. The SRF was completely resolute in 11 eyes after 2 weeks. Four weeks after PDT, 22 eyes had complete resolution of SRF and disappear of fluorescein leakage in FFA. The dilated and tortuous choroidal vessels improved in 15 eyes and remained the same in 7 eyes by ICGA. The mean BCVA was 0.5 at baseline and 0.9 at 3 weeks. None of the patients developed any systemic adverse event associated with the operation in the follow-up period.

CONCLUSION: PDT with one third dose verteporfin is effective and safe in treating acute CSC.

Photodynamic therapy combined with the Sanqi Panax Notoginseng for patients with age-related macular degeneration and choroidal neovascularization

Mei-Xia Song,Shang Li,Li Wang,Feng Sun,Yong-Qiang Jiang and Hong Li — 2013/7/29 14:34:27

AIM: To investigate the clinical effect of photodynamic therapy(PDT)combined with Traditional Chinese medicine Sanqi Panax Notoginseng therapy for age-related macular degeneration(AMD)and choroidal neovascularization(CNV).

METHODS: Seventeen patients(17 eyes)with AMD and CNV were diagnosed by visual acuity, ocular pressure, fundus fluorescein angiography(FFA), idocyanine green angiography(ICGA)and optic coherence tomography(OCT), and male 7 cases, female 10 cases, age 53-72 years old. PDT was performed using the recommended standard procedure. The patients were treated with PDT for 5 days, and Sanqi Panax Notoginseng 500mg injection by intravenous drip for 10 days, once a day, 15 days as one course. One month, 3, 6 months of follow-up after treatment.

RESULTS: Of 17 patients after 6 months treatment, visual acuity improved in 8 cases(47%, 8/17), remained stable in 6 cases(35%), and decreased in 3 cases(18%); and 12 cases(71%)with CNV closure and leakage stopped completely, 5 cases(29%)with most of the CNV's closure, 1 patient experienced blurred vision.

CONCLUSION: The results show that PDT combined with traditional Chinese medicine Sanqi Panax Notoginseng in treatment of ADM-CNV is simple and has reliable effect, it can be used in clinical application.

Analysis on related factors of diabetic macular edema

Xiao-Chuan Wang,Yan Wang,Xiao-Dong Huang and Yang-Gui Yu — 2013/7/29 14:34:27

AIM: To explore the relationship between diabetic macular edema(DME)and diabetic duration with visual acuity.

METHODS:The clinical material examination results, diabetic duration and visual acuity on 40 DME patients diagnosed by fundus fluorescein angiography(FFA)and optical coherence tomography(OCT)method were analyzed in this retrospective study. The relationship between various types of DME and above mentioned factors was also analyzed.

RESULTS: Among 40 DME patients, 14 eyes(35%)were focal DME, diffuse DME in 20 eyes(50%)and cystoid macular edema in 6 eyes(15%). Significant correlations existed between the visual loss and the types of DME(r=-0.835, P=0.000). There was more damage to the visual acuity of patients with macular cystoid edema than those with focal DME. The diabetic duration was closely related to the types of DME(r=0.472, P=0.002).

CONCLUSION: The DME are closely related to diabetic duration and visual acuity.

Emergency management of retinal detachment with pneumatic retinopexy and laser photocoagulation

Yan-Jun Huang,Fei Liu,Yuan-Biao Li,Dong-Ping Shao and Yi-Xuan Jin — 2013/7/29 14:34:27

AIM: To evaluate the effects, surgical indications, complications and technique of pneumatic retinopexy(PR)combined with postoperative laser photocoagulation for the emergency treatment of retinal detachment.

METHODS: A review of 45 consecutive eyes of 45 patients who underwent PR for uncomplicated rhegmatogenous retinal detachment with superior retinal breaks at 6 o'clock and PVR stage lower than C from September 2011 to June 2012. Laser photocoagulation was performed at 24-48 hours after surgery. Primary and final anatomic outcomes, visual acuity, and adverse events were recorded.

RESULTS: The follow-up period was 3-15 months, with the mean of 10 months. The single-procedure reattachment rate was 40 eyes(88.9%). Postoperative subretinal bubble in 2 eyes(4.4%), subretinal fluid was absorded delay in 3 eyes(6.7%). New retinal hole in 5 eyes(11.1%), became tractional detachment of retina in 2 eyes(4.4%), cataract aggravated in 1 eye(2.2%).

CONCLUSION: PR with postoperative laser photocoagulation was applied to retinal detachment, which only with superior retinal hole and PVR stage be lower than C. Compared with vitreo-retinal surgery(V-R)and conventional scleral buckling(SB), PR closed retinal hole fleetly after found out rhegmatogenous retinal detachment. The requirements of therapeutic environment and armarium of PR are not so strict.The technique was simple. Treatment cost is cheap. But the single-procedure reattachment rate is low. It must be keep the posture with fidelity and follow up intimately.

Clinical features and surgical effect of vireoretinal diseases with contralateral blindness

Zhi-Xiong Liu,Guo-Ji Wu,Ke-Ming Kang,Xiao-Bo Wang and Hui-Chan Chen — 2013/7/29 14:34:27

AIM: To investigate the clinical characteristics and surgical results of vireoretinal diseases in 68 patients with contralateral blindness(solitary eye).

METHODS: A total of 68 patients(68 eyes)with contralateral blindness were enrolled in this retrospective consecutive study. The clinical characteristics, surgical procedures and temponade materials chosen, preoperative and postoperative visual acuity, complications and prognosis were analyzed. The follow-up ranged from 4 months to 5 years, with an average of(11.30±9.57)months. At the last follow-up, the surgical effects were evaluated.

RESULTS:After operation, visual acuity increased significantly. The number of eyes with vision of 0.05 or better increased from 22 eyes(32.4%)preoperative to 60 eyes(88.2%)postoperative, and that of 0.3 or better from 3 eyes(4.4%)to 37 eyes(54.4%). The best-corrected visual acuity before and after surgery also differed significantly(t=8.986, P<0.01).

CONCLUSION: With vitreoretinal surgery, visual impairment or loss due to vitreoretinal diseases can be avoided in most patients with contralateral blindness.

Observation of clinical efficacy of pattern scan laser photocoagulation on diabetic retinopathy

Zhi-Hua Peng,Gu-Meng Cheng and Lan Wu — 2013/7/29 14:34:27

AIM: To evaluate the clinical efficacy of pattern scan laser photocoagulation(Pascal)on proliferative diabetic retinopathy(PDR).

METHODS: A total of 93 patients with retinopathy(186 eyes)were randomly divided into treatment group(96 eyes of 48 patients)who treated with panretinal photocoagulation(PRP)using Pascal at one time and control group(90 eyes of 45 patients)who treated with PRP using multi-wavelength krypton laser in 4-5 times. The visual acuity, FFA, OCT, visual field will be evaluated of each patient before and after the treatment.

RESULTS: The visual acuity findings were stated as below: the overall effective rate of visual acuity in treatment group is 85.4% while it is 82.2% in control group. The overall effective rate in two groups has no significant difference. The retinal sensitivity has no significant decrease in the treatment group while which decreased significantly in the control group.

CONCLUSION: The clinical efficacy of Pascal on treating the PDR is better than which of the regular argon laser. The field of vision has no significant narrowed after the Pascal treatment which can efficiently shorten the length of treatment and reduce the pain sensation.

Prevention effect of travoprost on high intraocular pressure within 24 hours after diabetic retinopathy vitrectomy

Xue Li,Xiao-Guang Zhang,Lin Li and Gang An — 2013/7/29 14:34:27

AIM: To observe the clinical significance of travoprost for prevention of high intraocular pressure(IOP)within 24 hours after diabetic retinopathy(DR)vitrectomy.

METHODS: A total of 102 patients(102 eyes)with DR who underwent vitrectomy and related literatures were analyzed and compared. All patients were randomly assigned to group A(vitrectomy combined with intravitreal silicone oil, C₃F₈ or balanced salt solution tamponade group, 51 patients 51 eyes)or group B(surgical therapy is the same as the group A, while instilling one drop of 0.04g/L travoprost eyedrops in the inferior cul-de-sac about 60 minutes before the surgery, 51 patients 51 eyes). The changes of IOP, best-corrected visual acuity(BCVA)and ophthalmoscope observations within 24 hours respectively before and after the surgery were counted and analyzed.

RESULTS: The mean IOP of each group within 24 hours after the surgery was higher than the contralateral eyes(t=2.17 and 2.09, P<0.05)and the mean IOP within 24 hours before the surgery(t=2.41 and 2.28, P<0.05). The incidence of high IOP(the high IOP was defined as mean IOP≥25mmHg)and decreased BCVA in group A transcended group B(χ²=4.86 and 3.99,P<0.05). Meanwhile, the mean BCVA of group A within 24 hours after the surgery was slightly worse than that of group B(t=1.43, P>0.05).

CONCLUSION: The preliminary result in our scrutiny showed that the preoperative treatment of 0.04g/L travoprost eyedrops was well tolerated with the significant reduction in the incidence of high IOP and decrease in BCVA within 24 hours after DR vitrectomy. It has clinical significance about the prevention of visual impairment owing to high IOP within 24 hours after DR vitrectomy.

Effects of compound Xueshuantong on fundus morphology of patients with vein occlusion in retinal branches

Yong Shen — 2013/7/29 14:34:27

AIM:To observe the effects of compound Xueshuantong on fundus morphology of patients with vein occlusion in retinal branches.

METHODS: Eight-five patients(85 eyes)with vein occlusion in retinal branches were selected and divided into two groups. Forty-three patients in experimental group were treated with compound Xueshuantong capsules, while 42 cases in control group with salvia miltiorrhiza. The preoperative and postoperative fundus morphological variations of patients in two groups were compared.

RESULTS: The extinction rate of macular edema and effective rate of patients in experimental group were significantly higher than those in control group. Compared with the optimal corrected vision, relative diameter of retinal veins and square of retinal hemorrhage before treatment, there was no significant difference. However, after treatment, the optimal corrected vision of patients in two groups elevated remarkably, and the optimal vision in experimental group was notably higher than that in control group; the relative diameter of retinal veins and relative square of retinal hemorrhage of patients after treatment significantly decreased or lessened in two groups, and relative square of retinal hemorrhage of patients in experimental group was distinctly smaller than that in control group.

CONCLUSION: Compound Xueshuantong capsule can effectively promote the vision recovery of patients with vein occlusion in retinal branches, and lessen the square of retinal hemorrhage, with the therapeutic effect superior to salvia miltiorrhiza.

Retrospective analysis of surgical treatments in 128 patients with proliferative diabetic retinopathy combined with vitreous hemorrhage

Zhuo-Lin Zhou,Chun-Chao Bi and Rui Wang — 2013/7/29 14:34:27

AIM: To explore the surgical intervention time in treatment of proliferative diabetic retinopathy(PDR)combined with vitreous hemorrhage.

METHODS: Totally, 128 cases(177 eyes)with PDR combined with vitreous hemorrhage were investigated retrospectively. Patients with PDR were divided into Ⅳ group, Ⅴ group and Ⅵ group. Vitrectomy and laser treatment were applied. Surgical complications, anterior chamber inflammation, intraocular pressure 1 week after surgeries and restoration of vision 6 months after surgeries were observed and compared between groups.

RESULTS:Vision of all patients restored significantly after surgeries, but more significantly in Ⅳ group(P<0.05); there were no significant differences of surgical complications, anterior chamber inflammation and intraocular pressure 1 week after surgeries in 3 groups(P>0.05).

CONCLUSION: Clinical effects could be improved significantly by surgical intervention at Ⅳ stage of PDR without increasing any surgical risks.

Intravitreal injection of Bevacizumab combined retinal photocoagulation for diabetic macular edema

Quan-Liang Zhao and Chun-Xiang Zhang — 2013/7/29 14:34:27

AIM:To evaluate the clinical outcomes of macular laser photocoagulation after intravitreal injection of 1.25mg doses of Bevacizumab for diffuse diabetic macular edema(DME).

METHODS: Eighty-six eyes of 74 patients with diffuse DME were randomized into 2 groups. In laser group, 48 eyes were subjected to a macular Focal/grid laser photocoagulation 3 weeks after intravitreal injection of 1.25mg doses of Bevacizumab. In control group, 38 eyes underwent only intravitreal injection of 1.25mg doses of Bevacizumab. The changes of visual acuity and central macular thickness of all eyes in both groups preoperatively, 3 and 6 weeks, 3 months postoperatively were recorded.

RESULTS:There was no statistical significance on visual acuity before and 3 weeks after treatment, while the differences before and 6weeks and 3 months after treatment were significant. Central macular thicknesses were 395.933±119.784, 292.617±39.131, 302.350±55.272 and 314.200±60.528μm before, and 3,6 weeks, 3 months after injection, respectively in laser group. In control group, those were 398.734±111.764, 301.217±34.231, 312. 120±53.170 and 395.145±108.687μm, respectively. The 2-tailed T test revealed that visual acuity was not significantly different between two groups at baseline and 3 weeks after injection, but were significantly better in laser group at 6 weeks(P=0.02)and 3 months after treatment(P<0.001).

CONCLUSION: Intravitreal injection of Bevacizumab combined retinal photocoagulation is more effective to diffuse DME, benefits retinal photocoagulation and improves visual acuity of patients with diabetic macular edema.

Analysis on complications after intravitreal injection of bevacizumab

Cui-Wei Zhang,Jin-Song Mo,Xu-Yang Liu and Qing-Shan Chen — 2013/7/29 14:34:27

AIM: To observe and analyze on the incidence rate and causes of complications after anintravitreal injection of bevacizumab.

METHODS: Totally, 207 cases(207 eyes)with wet age-related macular degeneration were selected randomly. All cases were treated with intravitreal injections of bevacizumab(1.5mg/0.06mL)and asked for chief complaints at 1 day, 1 week, 4, 12 weeks after operation, and also examined for routine visual acuity(best corrected visual acuity, BCVA), non-contact tonometer, slit lamp microscope and indirect ophthalmoscope etc.

RESULTS: Among 207 cases(207 eyes), visual acuity improved efficiency was 90.8% 12 weeks after treatment, foreign body sensation was found in 7 cases(3.4%), eyelid skin pruritus in 1 case(0.5%), conjunctival congestion in 6 cases(2.9%), subconjunctival hemorrhage in 1 case(0.5%), post-operative intraocular pressure elevation in 2 cases(1.0%).

CONCLUSION: The intravitreal injection of bevacizumab is effective with fewer complications. We propose to carry out a further randomized multicenter and larger-sample clinical research and further draw up the clinical application criterion of bevacizumab.

Clinical profiles and related factors analysis on nonarteritic anterior ischemic optic neuropathy

Jing Hao,Guang-Wei Cui,Yue-Zhong Zheng and Ji-Chuan Shi — 2013/7/29 14:34:27

AIM:To investigate the clinical profiles, visual outcomes and related factors for the patients with nonarteritic anterior ischemic optic neuropathy(NAION).

METHODS: From January 2006 to December 2009 in our hospital, 116 consecutive patients(116 eyes)with NAION were retrospectively analyzed. The clinical and fundus fluoresecein angiographic profiles, visual outcomes and related factors of the patients were recorded. The routine managements included controlling systemic diseases, systemic vasodilators, neuroprotection agents or oral corticosteroids.

RESULTS: Of 116 cases, 65 were males and 51 were females. The average ages were 56.4±9.8 years. The unilateral onset were 98 cases(84.5%)and the bilateral onset were 18 cases(15.5%). The papillary edemas were seen in all patients and the peripapillary hemorrhages were seen in some patients. The visual field defects were seen in all patients, and the inferior altitudinal defects or nasal inferior defects were common(53.7%). The filling defect or delay was seen in all patients at the early stage of fluorescein fundus angiography and the optic disc staining or diffuse fluorescein leakage at the late stage. After the active treatment for 2-3 months, the papillary edemas were subsided, and the optic nerve were sectoral or diffuse atrophy. The visual fields defects of 87.3% eyes were improved or stable, and 12.7% eyes were residual partial visual defect. The average best-corrected vision of 116 eyes at the initial visit were 0.52±0.21, and the corrected vision at the final visit were 0.68±0.20, the vision were improved after the treatment(t=10.61, P=0.000). Among the 116 patients, 72 cases(62.1%)were with cardiovascular disorders, 52 cases(44.8%)with systemic hypertension and 27 cases(23.3%)with diabetes mellitus. After the logistic regression analysis, the related factors for the lower final visual acuity(0.5 or less)were related to the lower initial vision(0.5 or less), diabetes mellitus history and older ages(over 60 years), there were not related to the gender and systemic hypertension.

CONCLUSION: Elderly persons with systemic hypertension or diabetes mellitus were the major risk factors for the pathogenesis of NAION and poor visual prognosis. Corrected diagnosis and proper treatment would improve the optic nerve ischemia, and improve the visual acuity and visual field defects recovery.

Clinical characteristics and efficacy of intraocular foreign bodies in 78 cases

Li-Hua Wang,Ying-Jun Han and Tian-Wei Liang — 2013/7/29 14:34:27

AIM: To investigate epidemiologic and clinical characteristics, complications, and visual outcomes of post-traumatic intraocular foreign body(IOFB).

METHODS: Totally 78 patients with IOFB injury were retrospectively reviewed. Data on age, sex, activity at the time of injury, initial and final visual acuity, complications, surgical methods were recorded. Special attention was paid on risk factors for endophthalmitis.

RESULTS: Male adults were the major population affected by IOFBs. Hammering was the most common activities at the time of injury. Explosive injury and posterior segment IOFB had bad final visual outcome. All of anterior segment IOFB was extracted, 93% posterior segment IOFBs was removed. Seven cases of endophthalmitis(9%)were found. Inflammation was controlled by vitrectomy combined with intraocular injection.

CONCLUSION: When primary wounds were repaired appropriately and extensive antibiotics administered. Even though advancement in vitreoretinal surgery can reduce the frequency of blindness, further promotion and education on eye protection during work are needed.

Efficacy assessment of optical coherence tomography in high myopia macular hole after silicone oil tamponade

Xue-Feng Pan,Feng-Feng Tong,Yun-Fang Liu and Xiao-Feng Wang — 2013/7/29 14:34:28

AIM: To evaluate the efficacy of optical coherence tomography(OCT)in highly myopic macular hole after silicone oil tamponade.

METHODS: A retrospective analysis of 20 cases of high myopia macular hole with retinal detachment after vitrectomy with silicone oil tamponade was performed. The mean follow-up time was 7 months. OCT examination was given to assess the macular hole closure and retinal reset during the follow-up. Best corrected visual acuity(BCVA)was recorded.

RESULTS: There were three kinds of postoperative OCT performance: macular hole closure in 2 eyes(10%), macular hole was not closed but the retinal reattachment in 16 eyes(80%), macular hole was not closed with shallow retinal detachment in 2 eyes(10%). Postoperative BCVA improved compared with that of preoperative. The improvement of visual acuity was closely related to the anatomy reset of macular hole. No serious postoperative complications occurred.

CONCLUSION: OCT for macular hole in high myopia silicone oil tamponade postoperative follow-up can confirm the diagnosis of macular hole closure and retinal reset, providing the means of reference for the timing of silicone oil removal.

Application of RetCamⅡ in the screening of neonatal fundus disease

Zhi-Gang Xiao,Li-Juan Tao,Zhi-Xiang He,Jiu-Ju Wu and Jian-Bo Xiang — 2013/7/29 14:34:28

AIM: To investigate the safe and reliable examination method for neonatal fundus screening.

METHODS: Fundus information of 2 836 neonates performed by RetCamⅡ in our hospital from January 1, 2012 to December 31, 2012 were retrospectively analyzed, including 1 625 cases(57.30%)of premature infants which were first examined 1-4 weeks after birth and 1 211 cases(42.70%)of term infants which were first examined within 4 weeks after birth.

RESULTS: Totally 454 cases of abnormalfundus were found, including 207 cases(12.74%)of retinopathy of prematurity(ROP), ROPⅠ in 118 cases(57%), ROPⅡ in 58 cases(28.02%), ROPⅢ in 23 cases(11.11%), ROPⅣ in 8 cases(3.86%), no case of ROPV. A total of 247(20.40%)term infants had abnormal fundus, of which 68 cases(27.53%)were developmental or hereditary disease, retinoblastoma in 1 case(0.40%), retinal hemorrhage in 102 cases(41.30%), retinal exudative changes in 68 cases(27.53%), optic atrophy in 5 cases(2.02%)and optic disc edema in 3 cases(1.21%).

CONCLUSION: Neonatal fundus diseases were so various and harmful that early screening should be attended to. Premature infants and term infants with high risk are treated as focus group of fundus screening and RetCamII examination is safe and effective.

Optical coherence tomography examination of patients with hyperopic ametropic amblyopia

Hong-Chao Xu,Xue-Gang Guan and Wen-Jing Li — 2013/7/29 14:34:28

AIM: To investigate the changes of retina in amblyopic eye by measuring macular retinal thickness in hyperopicametropic amblyopic patients.

METHODS: Optical coherence tomography(OCT)was used to measure the macular retinal thickness value in 17 amblyopic patients(20 eyes)and 14 healthy controls(20 eyes). The result was processed as retinal thickness value and thickness map by computer. The data were analyzed by SPSS 13.0 software package.

RESULTS: The retinal thickness of central sector or region in amblyopic eyes were thicker than those in normal eyes(P<0.05), in the inner ring, the difference of nasal quadrant between amblyopic eyes and normal eyes was statistically significant(P<0.05), but there was no significant difference in other three quadrants of the inner ring and in any quadrant of the outer ring between amblyopic eyes and normal eyes(P>0.05).

CONCLUSION: The macular retina thickness of the central region is thicker in hyperopic ametropic amblyopic patient. OCT is a noninvasive, noncontact technique that visualizes the retinal structure in vivo, this technique may be used to find the potential initial neural site of the visual deficit in this condition.

Clinical research on high oxygen permeable contact lens used after photorefractive keratectomy surgery

Hao-Jiang Yang,Lin Li,Xiao-Yan Dou,Jing Sima,Xiu-Fang Lü and Yu-Li Wei — 2013/7/1 11:07:55

AIM: To evaluate the outcome of high oxygen permeable contact lens used after photorefractive keratectomy(PRK)surgery.

METHODS: Totally 95 patients(190 eyes)after PRK were included. Patients were randomly assigned to wear high oxygen permeable contact lens in one eye and normal lens in the fellow eye after surgery. The subjective symptoms and corneal epithelial status after PRK were evaluated. Uncorrected visual acuity(UCVA)and haze were assessed at 6 months after PRK.

RESULTS: Complaints of blurred vision, pain and photophobia were statistically more among the normal lens group than high oxygen permeable contact lens group(P<0.05). The time of corneal epithelium recovery was 3.11±2.12 days in the high oxygen permeable contact lens group and 4.02±2.21 days in the normal lens group respectively. There was statistically significant difference between two groups(P<0.05). The wholly healing of corneal epithelium happened in 46% and 36% eyes at 72 hours after surgery respectively. Seven days after surgery, 60 eyes(63%)and 48 eyes(51%)achieved UCVA better than 1.0 respectively(P=0.35). There was no difference in UCVA and haze 6 months after surgery(P=0.55).

CONCLUSION: High oxygen permeable contact lens can significantly produce less the corneal irritated symptoms, reduce the discomfort feeling and promote healing of corneal epithelium after PRK.

Clinical study of tectonic surgery for rheumatic diseases associated corneal melting

Xu Xu and Ming-Hong Gao — 2013/7/1 11:07:55

AIM: To explore the indications, efficacy, and complications of different types tectonic surgery for rheumatic diseases associated corneal melting.

METHODS: It was a retrospective case series study. Sixteen patients(19 eyes)with rheumatic diseases associated corneal melting underwent surgery for tectonic indications at the General Hospital of Shenyang Military Region between January 2008 and August 2012 were involved. The selection of surgical procedures was based on the preoperative corneal status(location, depth and area). These include penetrating keratoplasty(4 eyes), deep lamellar keratoplasty(8 eyes), corneal(scleral)patch grafts(5 eyes)and amniotic membrane transplantation(5 eyes). Concomitant systemic disease, indication for tectonic graft, preoperative visual acuity, postoperative visual acuity and postoperative complications were recorded and studied during the follow-up period of 1 year. Efficacy was evaluated by the outcomes of cured or improved or invalid.

RESULTS: Corneal melting were completely cured in 12 eyes, improved in 5 eyes and showed invalid in 2 eyes. Visual acuity in 7 eyes(36.8%)was improved after operation. Postoperative complications included graft melting in 3 eyes, persistent corneal epithelium defect in 3 eyes, secondary glaucoma in 1 eye, complicated cataract in 1 eye.

CONCLUSION: Designing the appropriate type of tectonic surgery based on the different preoperative corneal status allows the removal of the corneal lesion and spares the maximum amount of normal tissue. It is an effective approach for preservation of eyeballs and restoration of visual function.

The analysis of clinical effect of phacoemulsification on primary angle-closure glaucoma with cataract

Ling Zhao,Yang-Yang Jin,Dong Li and Rong Fan — 2013/7/1 11:07:55

AIM:To evaluate the clinical outcomes and affected factors of prognosis of cataract extraction by phacoemulsification with intraocular lens implantation in eyes with primary angle-closure glaucoma(PACG)and co-existing cataract.

METHODS: Totally 60 cases(70 eyes)of PACG with cataract, including 43 eyes with acute primary angle-closure glaucoma(APACG), 27 eyes of chronic primary angle-closure glaucoma(CPACG). The main outcome measures included: visual acuity, intraocular pressure, gonioscopy, depth of anterior chamber(ACD). Patients were examined 6 months after surgery.

RESULTS: After phacoemulsification, visual acuity was improved(P<0.05), postoperative mean IOP was decreased(P<0.01), part of anterior chamber was widened(P<0.01). The depth of anterior chamber(ACD)was deepen(P<0.01).

CONCLUSION:Phacoemulsification is more effective for acute APACG than for CPACG.

Manual small incision combined with negative power intraocular lens implantation for cataract with high myopia clinical observation

Chun-Ming Chen,Hong Zhong and Ping-Bo Wu — 2013/7/1 11:07:55

AIM: To evaluate the clinical effect of manual small incision combined with negative power intraocular lens implantation for cataract with high myopia.

METHODS: Totally 75 cases(98 eyes)with super high myopia and cataract which had underwent small incision combined with negative power intraocular lens implantation were studied retrospectively. Preoperative axial length and postoperative visual acuity, refractive diopter and expected deviation value(refractive deviation)were recorded. Eye conditions operation complications and postoperative were observed. The patients were followed-up for 6 to 12 months.

RESULTS: The mean preoperative axial length was 32.05±1.78mm. Best corrected visual acuity≥0.2 was in 66 eyes, accounting for 67.3%; ≥0.5 in 43 eyes, accounting for 43.9%; the postoperative refractive error <±1.00D was total 48 eyes, accounting for 49.0%; <±2.00D total 78 eyes, accounting for 79.6%. Intra-operative posterior capsular rupture occurred in 3 eyes. Intra-operative posterior elastic layer detachment occurred in 1 cases. The postoperative corneal edema was found in 21 eyes. Postoperative 6 months, posterior capsular opacification was found in 13 eyes, and the visual acuity recovered after Nd:YAG laser cut. No retinal detachment, secondary glaucoma, macular cystoid edema, intraocular lens shift and other complications were found. Two eyes had the symptom of binocular interference post-operation. Three months later, another eye was performed intraocular lens implantation. The symptoms were eliminated post-operation.

CONCLUSION: The manual small incision cataract extraction combined with negative power intraocular lens implantation for cataract with high myopia is safe, effective method.

Study of two surgical methods for the cataract of the gradeⅢ nuclear and above

Hai-Lun Ji and Wei Xiao — 2013/7/1 11:07:56

AIM: To study thetherapeutic effect of two surgical methods for the cataract of the grade Ⅲ nuclear and above.

METHODS:Totally 52 eyes were performed retrospective analysis with phacofragmentation technique(group A)and extracapsular extraction surgery for cataract with small incision(group B)differently, and the effects of surgical treatment were compared.

RESULTS:Postoperative best corrected visual acuity(BCVA)of group A lens was better improved than group B, the difference was statistically significant(P<0.05); the difference of corneal thickness was not statistically significant(P>0.05); the effect of group A on corneal endothelium was larger than group B, the difference was statistically significant(P <0.05); the surgical complications of group A were lower than group B, the difference was statistically significant(P <0.05).

CONCLUSION: The technology of sonicating lens can be considered for the cataract of the grade Ⅲ nuclear and above.

The comparison of higher-order aberration and contrast visual after the aspheric and spherical intraocular lens implantation

Qing-Shan Song,Zi-Lin Chen and Hui-Ya Fan — 2013/7/1 11:07:56

AIM: To compare the difference of wavefront aberration, uncorrected visual acuity(UCVA), best-corrected visual acuity(BCVA), contrast visual acuity between aspheric intraocular lens and spherical intraocular lens after implantation.

METHODS: Totally 46 patients(50 eyes)with age-related cataract were divided into 2 groups at random, one group of 23 patients(24 eyes)received ACR6D SE spherical intraocular lens(Group A), another group of 23 patients(26 eyes)received negative spherical aberration Acri.Smart 36A aspheric lens(Group B). Three months after surgery, we observed patient's UCVA, BCVA, the contrast vision of dark background(25cd/m²)and highlighted background(255cd/m²), the spherical aberration, coma and total high-order aberration RMS'(pupil's diameter was 6mm)differences between two groups.

RESULTS: The differences of UCVA and BCVA between the two groups were not significant. There was no significant difference in the contrast visual acuity of 100% and 25% between highlighted background and dark background, however, under dark background, the contrast visual acuity of 5% and 10% in Group B was better than Group A. When the pupil diameter was 6mm, root-mean-square(RMS)of higher-order aberration, spherical aberration and comatic aberration in Group A were significantly lower than Group A and difference was statistically significant.

CONCLUSION:Acri.Smart 36A aspheric intraocular lens can significantly reduce patients' wavefront aberration and improve contrast visual acuity under lower contrast of dark background when compared with ACR6D SE spherical intraocular lens.

Comparison of curative effect between 180 and 360 degrees of selective laser trabeculoplasty in treatment of primary open angle glaucoma

Yuan-Xiang Luo,Wei Yang,Ming-Lei Qiu and Yi-Xia Zhang — 2013/7/1 11:07:56

AIM: To evaluate and compare the clinical effect of 180 and 360 degrees of selective laser trabeculoplasty(SLT)in treatment of primary open angle glaucoma(POAG).

METHODS: Totally 60 cases(60 eyes)of POAG were treated by SLT with light spot diameter of 400μm, irradiation time of 3 nanosecond, and power of 0.3-1.2mJ. Patients were evaluated 1 hour, 1 day, 1 week, 1 month, 3 and 6 months after laser treatment.

RESULTS: Intraocular pressure(IOP)decreased significantly in two groups after laser treatment. The mean preoperative IOP was(25.6±2.0)mmHg(1kPa=7.5mmHg)in 180-degree SLT group, and(25.4±2.1)mmHg in 360-degree SLT group. The mean IOP at 1 hour, 1 day, 1 week, 1 months, 3 months and 6 months postoperatively were(27.1±2.1)mmHg,(16.5±1.9)mmHg,(19.6±1.9)mmHg,(18.5±1.8)mmHg,(19.9±1.9)mmHg,(20.3±1.8)mmHg, respectively, in 180-degree SLT group, and were(26.6±1.9)mmHg,(15.9±2.0)mmHg,(19.0±2.0)mmHg,(17.8±1.9)mmHg,(18.7±2.0)mmHg,(19.2±1.9)mmHg, respectively, in 360-degree SLT group. There were statistically significant decreases in IOP at 1 day, 1 week, 1 month, 3 months and 6 months postoperatively compared with preoperative IOP in the two groups(P<0.01). To compare the effect of two groups, the 360-degree SLT group showed significantly lower post-treatment IOP at each follow-up point relative to 360-degree SLT group, and its IOP reduction rate stayed statistically higher than the 180-degree group at 3 months and 6 months postoperatively(P<0.05).

CONCLUSION: This study suggests that 360-degree SLT is more effective than 180-degree SLT in treatment of POAG.

Angle observation of laser peripheral iridoplasty for the treatment of acute angle-closure glaucoma which could not be controlled by drugs

Wei Han,Li-Xia Guo and Su-Jie Fan — 2013/7/1 11:07:56

AIM: To evaluate the effect of laser peripheral iridoplasty(LPIP)to treat acute angle-closure glaucoma(AACG)which could not controlled by drugs and with persistent ocular hypertension.

METHODS: Totally 67 patients(69 eyes)with AACG were performed LPIP when intraocular pressure(IOP)was still over 30mmHg after the medicine therapy for 3-6 hours. Visual acuity and intraocular pressure were under detection before laser treatment and 30 minutes, 60 minutes and 2 hours after laser treatment. We measured the anterior chamber depth, width of angle, iris thickness with ultrasound biomicroscope(UBM). Dynamic gonioscopy was used to evaluate the degree of peripheral anterior synechia(PAS).

RESULTS: Angle open distance(AOD)after iridoplasty was increased(P<0.01). Trabecular-iris angle(TIA)was widen(P<0.01)and the extents of PAS were reduced in some cases. IOP reduced at different levels in different time after laser treatment. The mean IOP before acute attack was(53.81±10.22)mmHg. The mean IOP were(33.81±9.22)mmHg,(21.93±7.19)mmHg and(15.16±3.07)mmHg at 30 minutes, 60 minutes and 2 hours after laser treatment respectively(F=151.79, P<0.01). Visual acuity increased in all patients.

CONCLUSION: LPIP can deepen peripheral anterior chamber, increase the angle access and lower the IOP immediately. It is an important ongoing adjuvant treatment, which can reduce the patients suffering by lowering the IOP quickly, reduce the damage of visual function caused by long-term high intraocular pressure, avoid side effect of the drugs, and can improve the prognosis.

A retrospective study of different therapies of acute angle-closure glaucoma

Lei Zhu — 2013/7/1 11:07:56

AIM: To compare the effect of 2 different methods in treatment of acute angle-closure glaucoma.

METHODS: A retrospective study was done. Totally 115 cases(115 eyes)diagnosed with acute angle-closure glaucoma were divided into observation group and control group. The observation group(n=45, 45 eyes)was given trabeculectomy after anterior chamber paracentesis while control group(n=70, 70 eyes)was received trabeculectomy after drugs decompression. The clinical efficacy was compared between the two groups.

RESULTS: The postoperative vision recovery, anterior chamber angle and complications of observation group were better than that of control group, and the incidence of complications was less than that of control group, the difference was statistically significant(P<0.05).

CONCLUSION: Trabeculectomy combined with anterior chamberparacentesis is a simple therapy with fewer complications, which is worth to actively promoting in clinical.

Treating malfunction filtering bleb with repeated needling combined with adjunctive 5-FU after glaucoma filtration surgery

Yi Liu,Yan Cai and Xin-Hui Wang — 2013/7/1 11:07:56

AIM: To evaluate the therapeutic efficacy of a repeated bleb needling technique combined with subconjunctival injection of 5-FU in eyes with previous glaucoma surgery that had malfunctional filtering blebs.

METHODS: A retrospective review of 34 consecutive patients(34 eyes)of repeated bleb needling combined with subconjunctival injection of 5-FU in eyes, which had malfunctional filtering blebs after previous glaucoma surgery in our hospital from March 2009 to February 2013 was performed. The intraocular pressures(IOP), shapes of filtering blebs and complications after surgery were analyzed.

RESULTS: There was significant reduction of mean IOP from 35.51mmHg to 14.43mmHg(P<0.05). The overall success rate was 91%. The general complications included damage of corneal epithelium, conjunctiva torn, and choroidal detachment.

CONCLUSION: Repeated needling with adjunctive 5-FU proved a highly effective, safe alternative to treat malfunctional filtering blebs after previous glaucoma surgery.

Clinical effect of subthreshold photocoagulation for diabetic macular edema using 532 laser

Dong-Ping Shao,Ying Ding,Fei Liu,Min-Chao Li and Xiao-Ran Yang — 2013/7/1 11:07:56

AIM: To explore the clinical application effect of 532 laser subthreshold photocoagulation for diabetic macular edema(DEM).

METHODS: Fifty-seven eyes of 32 diabetes patients with diffuse macular edema of non-proliferative diabetic retinopathy were randomized to experimental group and control group. The subthreshold laser photocoagulation was performed in the experimental group, and the threshold laser photocoagulation in control group. The effect evaluation of photocoagulation included visual acuity, fundus examination, optical coherence tomography at pre-treatment and various times after treatment(1 week, 1 month, 3 months), and all patients underwent fluoreseein angiography at pre-treatment and the 3^rd month after treatment.

RESULTS: At the first month after photocoagulation, in the experimental group, the eye visual acuity improved accounted for 11.1%, unchanged accounted for 66.7%, vision loss accounted for 22.2%, and the eyes visual acuity improved accounted for 13.3%, unchanged accounted for 63.3%, vision loss accounted for 23.3% in the control group. There were no statistical differences in visual acuity improvement in two groups. At the first month after photocoagulation, in the experimental group, macular edema completely absorbed accounted for 0 cases, partial absorbed accounted for 40.7%, no absorbed accounted for 59.3%, and in the control group was 6.7%, 53.3%, and 40.0%. Macular edema was absorbed better in the control group than in the experimental group, but the difference was not statistically significant(P>0.05). At 3^rd month after laser treatment, the data of macular edema absorbed and visual acuity improved were similar in two groups, the difference was not statistically significant(P>0.05).

CONCLUSION: The subthreshold photocoagulation for DME is as effective as classical grid laser treatment, and this method is very safe.

Assessment of the change of retinal nerve fiber layer thickness after laser in situ keratomileusis by three dimensional frequency domain optical coherent tomography

Xue-Qiu Yang,Jing-Jing Zhao and Wen-Juan Zhuang — 2013/7/1 11:07:56

AIM: To evaluate the change of retinal nerve fiber layer thickness(RNFLT)after laser in situ keratomileusis(LASIK)by three dimensional frequency domain optical coherent tomography(3D-OCT).

METHODS:Eighty-three patients(83 right eyes)who underwent LASIK operation were recruited. RNFLT was performed by 3D-OCT preoperatively and 1 day, 1 week, 1 month and 3 months postoperatively. The data was analyzed with repeated measures ANOVA and paired t test.

RESULTS: After the comparisons of the RNFL thickness among different time points, we found no statistical differences excluding the RNFLT of superior, nasal and 12, 1-4 o'clock sectors through the repeated measures with ANOVA.Then using paired t test for further analysis, the difference was not remained in the follow-up observation. There was also a significant correlation between RNFLT and diopter(superior r=-0.316, P=0.004; nasal r=-0.456, P<0.001)and laser cutting time(superior r=0.341, P=0.002; nasal r=0.471, P<0.001), but no significant correlation between RNFLT and age and suction time.

CONCLUSION: There is no change of RNFLT after LASIK during the follow-up.

The clinical research of central serous chorioretinopathy by multifocal electro- retinography

Qin Ye and Jian Guo — 2013/7/1 11:07:56

AIM: To elevate the diagnostic accuracy and guide the clinical treatment of central serous chorioretinopathy(CSCR)by means of multifocal electroretinogram(mf-ERG)at presentation and after resolution of the acute phase.

METHODS: A comparative observational case series group and a normal sample group were set. Thirty-one eyes of 31 patients with unilateral CSCR were examined. Both eyes underwent complete ophthalmological examination, which included measurement of best-corrected visual acuity, fluorescein angiography, OCT and mf-ERG recording. The results were compared with the corresponding findings of 30 normal volunteers of the same age.

RESULTS: At presentation, the averaged mean retinal response density of the mf-ERG of the affected eyes in area 1 was 60.54±18.20 nV/degree², 45.43% lower compared to the normal controls(P<0.01), and in area 2 was 38.12±10.81 nV/degree², 37.42% lower compared to the normal controls(P<0.05). After regression of CSCR, the averaged mean retinal response density of the mf-ERG of the affected eyes in area 1 was 93.71±14.13nV/degree², 15.53% lower compared to normal controls(P<0.05), and in area 2 was 51.16±10.34 nV/degree², 16.01% lower compared to the normal controls(P<0.05). It was interesting that 8 of 31 fellow non-affected eyes showed abnormal values, with an averaged mean retinal response density of mf-ERG in area 1(62.41 nV /degree²). In the remaining 23 eyes, the mf-ERG values were within normal limits.

CONCLUSION: Multifocal electroretinography is favorable in the clinical treatment and the following observation of central serous chorioretinopathy. It may play an important role in the diagnosis, pathogenic condition evaluation and prognosis of CSC.

Clinical study of retinal detachment associated with choroidal detachment

Shu-Qiong Hu,Jia-Hua Fang,Xiang-Ping Huang and Yan-Hua Zhu — 2013/7/1 11:07:56

AIM: To analyze the clinical characteristics of retinal detachment associated with choroidal detachment and to evaluate the surgical techniques, the efficacy and operation time for treatment.

METHODS: We reviewed and analyzed the operative effects of vitreoretinal surgeries in 45 patients(45 eyes)with retinal and choroidal detachment in our hospital from January, 2010 to January, 2012. In these 45 patients, there were 38 patients of rhegmatogenous retinal detachment associated with choroidal detachment, 7 patients of retinal redetachment associated with choroidal detachment. The surgical techniques include scleral encircling operation, epichoroidal space drainage by sclerocentesis intraocular photocoagulation, gas-fluid exchange, perfluoropropane(C₃F₈)or silicone oil intraocular tamponade and vitreoretinal surgery.

RESULTS: The drainage of the suprachoroidal space liquid and blood was successful in 45 eyes. Silicone oil tamponade was performed for 39 eyes and C₃F₈ tamponade for 6 eyes. Retinas and choroids were all reattached and retinal holes were closed. Visual acuities were improved, ≥0.1 in 23 eyes.

CONCLUSION: The vitreoretinal surgery and external drainage by sclerocentesis and scleral encircling operation is an effective operating method for rhegmatogenous retinal detachment associated with choroidal detachment.

Macular edema owing to retinal vein occlusion treated by intravitreal triamcinolone acetonide

Wei Liu and Yang Cheng — 2013/7/1 11:07:56

AIM: To assess the long-term safety and efficacy of intravitreal triamcinolone acetonide(TA)injection in the management of macular edema caused by retinal vein occlusion(RVO).

METHODS: This prospective, interventional case series included 17 patients(17 eyes)with RVO and macular edema. They received an intravitreal injection of 2mg TA. Follow-up was for 1 year. Outcome measures were visual acuity and macular thickness measured using ocular coherence tomography(OCT).

RESULTS: In our group, visual acuity measurements showed that 15 eyes(88%)had improved visual acuity, and mean visual acuity increased from 0.114±0.068 preoperatively to a postoperative visual acuity of 0.184±0.094(P<0.05). The central macular thickness was reduced from 514.0±67.4μm to 442.0±61.5μm(P<0.05). Six patients in the study suffered a rise in intraocular pressure(IOP)(35%)temporarily. There was no case of visually significant cataract, vitreous haemorrhage, retinal detachment, or endophthalmitis.

CONCLUSION:Intravitreal injection of triamcinolone acetonide can effectively improve the macular edema caused by retinal vein occlusion.

Clinical observation of different periods of injection Avastin before proliferative diabetic retinopathy vitrectomy

Shen-Wen Liu,Bo Qin,Hui Guo,Bai-Jun Li,Sheng Chen and Yin Liu — 2013/7/1 11:07:56

AIM: To evaluate theeffect of preoperative injection of Avastin at different time points for pars plana vitrectomy(PPV)in proliferative diabetic retinopathy(PDR)through clinical research and study the best proper time point for injection.

METHODS: We studied 49 patients(51 eyes)(from March 2010 to August 2012)with severe PDR. Sixteen cases(17 eyes)were treated with Avastin 4 days before PPV(group 1); 15 cases(16 eyes)were treated with Avastin 10 days before PPV(group 2); and 18 cases(18 eyes)underwent direct PPV(group 3). Surgical time, the condition of neovascular membranes, the number of iatrogenic retinal tear, and silicone oil utilization intra-operative, and vision after 6 months of surgery were recorded.

RESULTS: Compared to group 1(treated withAvastin, 4 days before PPV), group 2(treated with Avastin, 10 days before PPV)and group 3(simple vitrectomy surgery group), there were significantly difference. In group 1 and group 2, operative time was shortened, and interruption neovascular membranes bleeding rate, iatrogenic retinal tear rate and silicone oil utilization rate intra-operative were lower than the group 3, and the visual acuity was significantly better than the group 3. There was no statistically significant difference between group 1 and group 2 in surgical time, the condition of neovascular membranes, the number of iatrogenic retinal tear, and silicone oil utilization intra-operative, and vision 6 months after surgery.

CONCLUSION:Avastin administered prior to PPV was well tolerated, thus facilitating PPV, and to maximize the recovery of patients with limited vision. The ideal injection time of Avastin using for PPV in PDR is 4 days before PPV.

The pathogenic factors and clinical relevance study of non-arteritic anterior ischemic optic neuropathy in the population of high altitude regions

Hai-Hui Qi,Ling Li,Ze-Feng Kang,Xue-Ying Ma and Rong Zhang — 2013/7/1 11:07:56

AIM: To explore the pathogenic factors and clinical relevance study of non-arteritic anterior ischemic optic neuropathy(NAION)in the population of high altitude regions.

METHODS: The patients who came to our ophthalmology clinic outpatient to see a doctor and diagnosed with NAION from March 2011 to September 2012 were included as case group. During the same period, persons who participated in medical examination in our outpatient department and whose age and gender matched with case group were regarded as the control group. 1)Registering personal information of each object included in detail. 2)Taking detailed ophthalmologic examinations to included objects. 3)For the included objects, blood pressure monitoring and laboratory tests including blood routine, serum lipid, blood glucose, hemorrheology and so on were taken. These observational indexes were detailed recorded.

RESULTS: 1)Between NAION group and control group, there were no significant differences among the total cholesterol, HDL lipoprotein and blood routine(P>0.05); however, as to the triglycerides, blood glucose, blood pressure had a significant difference(P<0.05), NAION group was higher than the control one. 2)To high shear viscosity of whole blood, plasma viscosity, shear between high and low reduction viscosity of whole blood, erythrocyte deformation index, ESR and KESR, there was no significant difference between two groups(P>0.05); low shear and shear between high and low viscosity of whole blood, HCT, high and low shear reduction viscosity of whole blood, erythrocyte aggregation index had a significant difference(P<0.05), NAION group was higher.

CONCLUSION: 1)The pathogenic factors of NAION in the population of high altitude regions are multiple factors instead of single one. 2)Under the environment conditions of high altitude, low atmospheric pressure and low oxygen, the onset of NAION is associated with a series of pathophysiologic changes in the microcirculation of human body. 3)It had statistical significances among triglycerides, blood pressure, blood glucose and the onset of NAION at high altitudes. 4)High blood viscosity is a risk factor of the onset of NAION at high altitudes. 5)It is time to strengthen health education of NAION among the population of high altitude regions and improve their awareness of prevention and cure of that.

The discussion of high risk factors on high intraocular pressure after phaco-emulsification and intraocular lens implantation

Chao Zhang,Hong Tang,Li Jia and Jing Wang — 2013/7/1 11:07:57

AIM: To analyze and study reasons of high intraocular pressure(IOP)after phacoemulsification and intraocular lens implantation and its therapeutic methods.

METHODS: Totally 1 258 cases(1 318 eyes)of cataract treated with phacoemulsification and intraocular lens implantation were retrospectively analyzed in our hospital from January 2006 to October 2012.

RESULTS: Among the 1 318 eyes, IOP occurred in 54 eyes(about 4.10%). The IOP reached the peak mostly 2 to 4 hours after the surgery, up to 22-60mmHg. One eye with congenital cataract; 2 eyes with traumatic cataract; 15 eyes with diabetes; 12 eyes with hypertension; 2 eyes with chronic pigment meningitis; 1 eye after vitrectomy; 11 eyes with high myopia; 10 eyes with unconsolidated systemic disease. Part of the cortical residual and the viscoelastic agent residue or crystal posterior capsular rupture vitreous overflowed into the anterior chamber or severe inflammatory reaction was observed through slit lamp in high IOP patients.

CONCLUSION: Viscoelastic agent residue and inflammation is the main reason of IOP. With diabetes, high myopia, chronic pigment meningitis, ocular trauma of disease such as cataract patients are more prone to IOP.

Clinical analysis of meibomian gland dysfunction in elderly patients

Qin-Tang,Xi-You Cao and Qiao-Mei Chu — 2013/7/1 11:07:57

AIM: To explore the clinical features, diagnosis and treatment of meibomian gland dysfunction(MGD)in elder patients.

METHODS: Through the questionnaire survey, tear break-up time, Shimmer I test, corneal fluorescein staining and meibomian gland secretion examination, 74 cases(145 eyes)of meibomian gland dysfunction were divided into mild, moderate, severe group. According to the disease degree, dredging, cleaning combined eyelid massage, artificial tears, or anti-inflammatory, anti-infection were performed, respectively.

RESULTS: Totally 74 patients were treated for meibomian gland dysfunction(MGD)with 145 eyes. After one month, the ocular surface disease index decreased, the meibomian gland secretion grade lowered, the time period of tear broken was extended, the ocular surface staining grade lowered. The ratio of total cure was 34.5%, and the ratio of efficiency was 98.6%.

CONCLUSION: Ophthalmology physicians should master the clinical characteristic of MGD for the elderly patients. Symptoms, illness history inquiry and MGD test were highly regarded to avoid misdiagnosis and error treatment.

Meta-analysis of clinical effectiveness of the treatment of limbal autograft stem cells transplantation with the use of mitomycin-C for pterygium

Lin Zhou,Tuo Li,Jia-Zhang Li,Xiu-Sheng Song,Han-Dong Dan and Qing-Song Wu — 2013/7/1 11:07:57

AIM: To evaluate effectiveness of the treatment of limbal autograft stem cells transplantation combined with the use of mitomycin C(MMC)for pterygium on the postoperative recurrence and repairing time of corneal epithelial.

METHODS: All the relevant reported studies were searched out through Cochrane Datebase, Pubmed, China BioMedical Literature Database(CBM), China National Knowledge Infrastructure(CNKI), VIP and Wanfang Database which published before December 2012. All the randomized controlled trials(RCT)which accessed the recurrence of pterygium by comparing the treatment of limbal autograft stem cells transplantation with the additional use of MMC during limbal autograft stem cells transplantation were included. The data were analyzed by RevMan 5.1 software provided by Cochrane Collaboration Network.

RESULTS: Totally 217 studies were included at first and 12 RCT were included at last. A total of 1 044 eyes were included. Twelve RCT were analyzed with Meta-analysis: the postoperative recurrence rate had statistical significance between limbal autograft stem cells transplantation and limbal autograft stem cells transplantation combined MMC,(OR=0.23,95% CI:0.15-0.36, Z=6.40, P<0.01). Six studies of RCT about repairing time of corneal epithelial showed that repairing time of corneal epithelial had no statistical significance between limbal autograft stem cells transplantation and limbal autograft stem cells transplantation combined MMC by Meta-analysis(MD=0.62, 95% CI: 0.62-1.85, Z=0.98, P=0.33).

CONCLUSION: The application of MMC with the treatment of limbal autograft stem cells transplantation can reduce the recurrence of pterygium, while it has no effect on the repairing time of limbal epithelium.

Effect of glaucoma drugs joint surgical treatment on patients with tear of MUC5AC and ocular surface

Rong-Zhong Zhou — 2013/7/1 11:07:57

AIM: To explore the effect of glaucoma drugs joint surgical treatment on patients with tear of MUC5AC and ocular surface.

METHODS: Totally 26 cases(29 eyes)underwent glaucoma and cataract surgery who with history of glaucoma drugs admitted to our hospital in March 2010 to September 2011 were included. The content of tear MUC5AC and the ocular surface function scores of patients and healthy people at different time point were measured and analyzed. The relativity between types and taking time of medication, and ocular surface function scores before and after surgery was analyzed. The change of ocular surface function score, and the content of tear MUC5AC before and after surgery was compared.

RESULTS: Content of tear MUC5AC of glaucoma patients at each period was significantly lower than that of healthy people. There was statistically significance at preoperative 1 day, postoperative 1 month, 3 months(P=0.0168,P=0.0001,P=0.0150), and there was no statistically significance postoperative 6 months(P=0.2230). The content of tear MUC5AC of glaucoma patients decreased significantly post-operation, then gradually increased. Comparing the content of tear MUC5AC 1 month post-operation with 1 day pre-operation, 3 months and 6 months post-operation, there was statistically significance(P=0.0365,P=0.0329,P=0.0004). There was a positive correlation between preoperative ocular surface function score and the taking time and types of medication(P=0.0427,P=0.0327), and there was no correlation 6 months post-operation(P=0.1788,P=0.9916). The ocular surface function score of glaucoma patients was significantly higher, then gradually reduced, there was statistically significance between 1 month post-operation and 1 day pre-operation, 3 months and 6 months post-operation(P=0.0012,P=0.0001,P=0.0000). Ocular surface function score was significantly lower 6 months post-operation, compared with the preoperative 1 day, there was statistically significance(P=0.0049).

CONCLUSION: Glaucoma medications combined with glaucoma and cataract surgery impaired tear MUC5AC and ocular surface, such kind of damage is more obvious with the increase of taking time and types of the drug and gradually improves with the post-operative time extending.

Consolidation effect of visual function training on children with different degrees of amblyopia

Run-Jing Wei,Jin-Tao Wu,Zheng-Wei Shen,He-Zheng Zhou and Feng Chang — 2013/7/1 11:07:57

AIM: To observe the consolidation effect of visual function training in amblyopic therapy on children with amblyopia of different degrees(mild, moderate and severe)which had been normalized.

METHODS: Totally 78 amblyopic children were divided into two groups: visual function training group(n=36, 70 eyes)and control group(n=42, 67 eyes). The rollback situation of the two groups in 6, 12, 24 and 36 months were observed after visual acuity reached 0.9 during treatment.

RESULTS: The rollback rates were both 0 in visual function training group and control group with different degrees of amblyopia after 6 months. There was no significant difference in rollback rate between the 2 groups with different degrees of amblyopia after 6 and 12 months. There was no significant difference in rollback rate between the two groups with mild amblyopia after 24 and 36 months(P=0.269, 0.269). However, the rollback rate in training group with moderate amblyopia was significantly different from in control group after 24 and 36 months(P=0.004, 0.002). There was no significant difference in rollback rate between the two groups with severe amblyopia after 24 and 36 months.

CONCLUSION: Visual function training can reduce the rollback rate and consolidate the effect of amblyopic treatment effectively for children with moderate amblyopia. However, the effect is not as good for children with mild and severe amblyopia.

Assessment of diagnostic value of age for meridional amblyopia with Logistic regression and receiver operating characteristic curve

Hui Li,Jiang-Tao Xu,Xiao-Ming Jiang and Ying Zhou — 2013/7/1 11:07:57

AIM: To assess the diagnostic value of age for meridional amblyopia by Logistic regression and receiver operating characteristic(ROC)curve.

METHODS: A total of 1 005 children(1 910 eyes)with unknown ocular abnormalities other than with-the-rule astigmatism(aged 4-8 years)were recruited. Astigmatism >or =1.00D and sphere < or = 3.00D were present in one or both eyes. The difference of sphere between both eyes was less 1.50D. The difference of astigmatism between both eyes was less 1.00D. All astigmatism was calculated by the absolute value. By analyzing age, sex, astigmatism type, diopter of cylinder and diopter of sphere with Logistic regression, two mathematical models were established. Then the diagnostic efficacy of the model was assessed using the ROC curve.

RESULTS: The model 1 included 4 parameters(sex, astigmatism type, diopter of cylinder and diopter of sphere). The model 2 included 5 parameters(the 4 parameters of the model 1 adding age). Using Logistic regression, the diopter of cylinder had an influence on the diagnosis of meridional amblyopia in two models. In model 2, age was another influencing factor on the diagnosis of meridional amblyopia. The model 1 area under ROC curve(AUC)was 0.64, and the model 2 was 0.74. The area of model 2 was greater than the model 1. There was statistical difference in the AUC of two models(P<0.05).

CONCLUSION: Age might be an influential factor on the diagnosis of meridional amblyopia using Logistic regression and ROC curve.

The main effect of dominant eye on phoria examination results of civil aviation cadet

Chang-Liang Meng,Xiao-Ming Zeng and Jing Xu — 2013/7/1 11:07:57

AIM:To explore impact of portable phoria meter placed whether in front of dominant or non-dominant eye on phoria results during phoria inspection in physical examination of cadet candidate.

METHODS:Totally 650 candidates had passed the first round of ophthalmology check of China Southern 2012 Annual civil aviation cadet in Guangdong province. We picked out their dominant eyes by card-hole method, then respectively placed in front of the dominant eye(the dominant eye group)and non-dominant eye(non-dominant eye group)to measure phoria value. Von Graefe measurement value was as a control, exophoria was negative, esophoria was positive, vertical phoria was absolute value. Chi-square test was applied to analyze the phoria values respectively in the phoria group between dominant eye group and non-dominant eye group, dominant eye and Von Graefe law group, non-dominant eye group and Von Graefe law group.

RESULTS: Von Graefe group: average exophoria value was -2.21±0.35^△, average esophoria value was +3.87±1.20^△, hyperphoria value was +0.44±0.12^△. Average exophoria value of dominant eye group was -2.68±0.55^△, average esophoria value was +6.22±2.55^△, average hyperphoria value was +0.46±0.15^△; average exophoria value of non-dominant eye group was -2.16±0.40^△, average esophoria value was +3.22±1.65^△, hyperphoria value was +0.45±0.14^△. As for horizontal heterophoria(exophoria and esophoria), there was significant difference between dominant eye group and non-dominant eye group(P<0.05), dominant eye group and Von Graefe group(P<0.05), and there was non-significant difference between non-dominant eye group and Von Graefe group(P>0.05); As for vertical heterophoria, there was non-significant difference among the Von Graefe group, the dominant eye group and non-dominant eye groups(P>0.05).

CONCLUSION:The results are more reliable when portable phoria meter placed in front of dominant eye during the phoria check for civil aviation cadet.

Microperimetery fixation in non-arteritic anterior ischemic optic neuropathy eyes

Xin-Ling Wang,Ming-Yu Shi,Li Feng and Qi-Chang Yan — 2013/6/3 10:33:27

AIM: To investigate the fixation features in non-anterior ischemic optic neuropathy(NAION)eyes with microperimetery.

METHODS: Twenty-three patients with 27 NAION eyes were enrolled in this study. The fixation features were measured by Nidek MP-1 microperimeter and direct ophthalmoscope, and the results were analyzed.

RESULTS: There were 18 eyes manifesting central fixation, 9 eyes with eccentric fixation by the direct ophthalmoscopy. There were 18 eyes manifesting predominantly central and stable fixation, 6 eyes with predominantly eccentric and relative unstable fixation, and 3 eyes with predominantly eccentric and unstable fixation. Best-corrected visual acuity(BCVA)of the central fixation eyes was better than the eccentric fixation ones(P<0.05).

CONCLUSION: The difference between central and eccentric fixation can be detected definitely by the direct ophthalmoscopy in the NAION eyes, while microperimetery can manifest fixation location and stability in details.

Compound Xueshuantong capsule joint laser treating central serous chorioretinopathy

Jing Ye,Xue-Yan Yang and Sheng Zeng — 2013/6/3 10:33:27

AIM: To study the clinical effects of Compound Xueshuantong capsule combined with laser in treating central serous chorioretinopathy(CSC).

METHODS: Totally 38 patients(40 eyes)who suffered CSC were divided into two groups randomly. Laser combined with Compound Xueshuantong capsule for treatment group(n=20)and laser was used in controlled group(n=20)respectively. The curative effect and recurrent rate were compared in two groups.

RESULTS: After 1 week treatment, the sight was increased significantly in treatment group(P<0.05). After 1 month treatment, the absorption of edema was significantly in treatment group(P<0.05).

CONCLUSION: Compound Xueshuantong capsule combined with laser can relieve symptoms quickly and reduce recurrence, which was a good method for CSC.

Clinical effect analysis of phacoemulsification on cataract patients with diabetes mellitus

Bin Wang,Jin-Xia Li,Ying-Li Wang,Bin-Ge Wu and Jian-Xin Huo — 2013/6/3 10:33:27

AIM: To observe the clinical outcome of Phacoemulsification(Phaco)and IOL implantation on cataract patients with diabetes mellitus(DM)and analyze factors influencing visual acuity after Phaco.

METHODS:Phacoemulsification and IOL implantation were applied to 40 cataract patients(62 eyes)with type II DM(research group)and 60 cataract patients(82 eyes, control group)between January 2010 and December 2010. Visual acuity was measured 1 day, 1 week, 1 month, 3 months and 6 months post-operation. Central corneal thickness and endothelial cells count were examined pre-operation and 1 day, 1 week, 1 month, 3 months and 6 months post-operation. Fundus was examined under pupil dilatation 3 months and 6 months post-operation. In research group, 41 eyes were observed with non-diabetic retinopathy(NDR)and 21 eyes with DR.

RESULTS: Best corrected visual acuity(BCVA): 1 day, 1 week and 1 month post-operation, significant difference was observed between research group and control group(P<0.05). No significant difference was observed 3 months post-operation between NDR group and control group(P>0.05). Significant difference was observed between NDR and DR as well as between DR and control(P<0.05). No significant difference was observed 6 months post-operation between NDR and DR as well as between NDR and control(P>0.05). Significant difference was observed between DR and control(P<0.05). Central corneal thickness: significant differences were observed between 2 groups 1 day, 1 week, 1 month and 3 months post-operation(P<0.05). No significant differences were observed between 2 groups 6 months post-operation(P>0.05). When measured 1 day, 1 week post-operation, both groups have significant differences compared to pre-operation result(P<0.05). One month and 3 month post-operation, significant difference was observed in research group compared to pre-operation data(P<0.05), while there was no significant difference for control group(P>0.05). Six months post-operation, there was no significant difference compared to pre-operation result between 2 groups(P>0.05). Corneal endothelial cells count: No significant difference was observed between 2 groups pre-operation(P>0.05). Significant differences were observed between 2 groups when measured 1 day, 1 week, 1 month, 3 months and 6 months post-operation(P<0.05). Both groups showed significant difference in 1 week, 1 month, 3 months and 6 months compared to pre-operation measurement(P<0.05).

CONCLUSION: For DM patients after Phaco, key incipient influencing factor of VA is transient cornea edema, while chief factor influencing VA in mid-term is concomitant DR. More severe endothelial damage and recovery retardation of corneal edema were observed in cataract patients with DM after Phaco.

Clinical effects of modified operation for treatment of cataract and glaucoma

Yan Wang,Ruo-Xi Li and Xin-Hua Wang — 2013/6/3 10:33:27

AIM: To discuss the clinical effects of cataract extraction with modified small incision non-phacoemulsification and intraocular lens implantation combined with trabeculectomy for the treatment of cataract combined with glaucoma.

METHODS: Totally 135 patients with cataract combined with glaucoma were selected as objects in our hospital from March 2008 to January 2011. They were randomly divided into observation group and control group, according to different treatment methods. Observation group(cataract extraction with modified small incision non-phacoemulsification and intraocular lens implantation combined with trabeculectomy group, n=68)and control group(conventional operation group, n=67). We made a retrospective analysis on the clinical effects of the patients in two groups.

RESULTS: In observation group, the postoperative good eyesight rates were 92.6% and 88.2% for 1 week and 3 months after the operation; the good intraocular pressure rates were 98.5% and 95.6%; the incidence of complications was 5.9% for corneal edema, iris injury and anterior chamber inflammation. Compared with the control group, P<0.05, there were significant differences after statistical analysis.

CONCLUSION: Cataract extraction with modified small incision non-phacoemulsification and intraocular lens implantation combined with trabeculectomy for the treatment of cataract combined with glaucoma can improve curative effect and operation security, it is a safe and secure surgery method for the treatment of cataract combined with glaucoma.

Effect of 3.0mm corneal incision guided by corneal topography on corneal astigmatism in cataract surgery

Shi-Heng Lu,Yi Zhang and Jiao Lü — 2013/6/3 10:33:27

AIM: To compare preoperative and postoperative corneal astigmatism using 3.0mm corneal incision guided by corneal topography system in phacoemulsification.

METHODS:Phacoemulsification was performed on 144 cases 156 eyes with 3.0mm corneal clear incision at the steepest corneal meridian. Preoperative corneal astigmatism and the data 3 months postoperatively were observed by the corneal topography system. Statistical analysis included sample Student's t-test, one way ANOVA test, Kruskal-Wallis test and Pearson correlation test.

RESULTS: According to analysis, the postoperative corneal astigmatism correlated negatively with the preoperative corneal astigmatism(r=-0.69, P<0.01). The corneal cylinder changed significantly in each grade after the surgery(P<0.05). When the preoperative corneal cylinder was between 0.12D and 0.25D, the postoperative corneal cylinder was higher than before. Whereas, the postoperative corneal cylinder became lower than before when the preoperative cylinder ranged from 0.37D to 1.0D.

CONCLUSION: The incision located at the steepest corneal meridian under the guidance of corneal topography changes the preoperative astigmatism. For astigmatic correction, 3.0mm on-axis clear corneal incision phacoemusification is recommended with preoperative corneal astigmatism between 0.37 and 1.0D.

The application of capsular tension ring combined with iris hook in treatment of cataract with dislocated lens

Dong-Bin Chen,Wen-Yong Liao and Wan-Jiang Dong — 2013/6/3 10:33:27

AIM: To discuss the application of capsular tension ring(CTR)combined with iris hook in treatment of cataract with dislocated lens.

METHODS: Twenty-seven patients with 27 cataract-infected eyes combined with lens subluxation were treated phacoemulsification cataract surgery. With iris hook fixing capsular hole, CTR was implanted. The operation methods, postoperative vision, intraocular pressure, anterior chamber and intraocular lens location were analyzed.

RESULTS: The operations were successfully completed for 25 patients with 25 cataract-infected eyes. The posterior capsule rupture and vitreous prolapse happened for the other 2 cases with 2 eyes. Between the 2 cases, 1 received ciliary sulcus implantation and the other anterior chamber intraocular lens implantation. The patients' vision was improved more or less. No serious complications happened.

CONCLUSION: The application of CTR combined with iris hook in the treatment of cataract with lens dislocation can improve the procedure's operability and security, and reduce operation complications.

Comparison of the efficacy of manual nuclear small incision cataract surgery and phacoemulsification cataract surgery in the treatment of hard nuclear cataract

Jian-Zhi Chen,Chun-Yan Fu,Ze-Yi Li and Kang-Keng Zheng — 2013/6/3 10:33:27

AIM: To compare the efficacy of broken nuclear small incision cataract surgery and phacoemulsification cataract surgery in the treatment of hard nuclear cataract.

METHODS: Totally 42 patients with hard nuclear cataract were divided into observation group and control group, the observation group patients chosen broken nuclear small incision cataract surgery, the control group chosen phacoemulsification cataract surgery. Vision correction, corneal astigmatism effect after 1 day, 1 week, 1 month and 3 months and postoperative complications of two groups were observed and compared.

RESULTS: After 1 day, 1 week, 1 month and 3 months, the difference of the proportion of patients corrected visual acuity 0.5-1.0 had no significant significance(P>0.05). Postoperative 1 day and 1 week, the observation group patients with corneal astigmatism higher than that in the control group, the difference was significant(P<0.05). After 1 month and 3 months, there were no significant difference between the two groups of patients with corneal astigmatism(P>0.05). Sac membrane rupture in the control group was significantly higher than the observation group, the ratio of postoperative corneal edema in the control group were significantly higher than the observation group, the differences were statistically significant(P<0.05).

CONCLUSION: Broken nuclear small incision cataract surgery has good effect and few complications.

Applied value of Toric implantation and multifocal IOL in cataract complicated with corneal astigmatism

Qing Guo — 2013/6/3 10:33:27

AIM: To study the applied value of Toric implantation and multifocal intraocular lens(IOL)in cataract complicated with corneal astigmatism.

METHODS: Patients with cataract and corneal astigmatism were collected and randomly divided into observation group given Toric IOL and control group given multifocal IOL. Then postoperative vision, astigmatism and operation index were observed.

RESULTS: Vision and astigmatism of observation group recovered from 1^st week and control group from 3^rd week. Systolic blood pressure, diastolic blood pressure, heart rate operation time and postoperative complications of observation group were significantly lower than control group.

CONCLUSION:Toric IOL implantation has positive therapeutic significance for its rapid, effective and safe recovery of vision and astigmatism.

Comparison of efficacy of procedures in the treatment of acute angle-closure glaucoma

Lian-Rong Su,Qi Li and Hai-Xia Wei — 2013/6/3 10:33:28

AIM: To observe the clinical effects of 3 different surgery treatments for acute angle-closure glaucoma.

METHODS: Totally 60 cases of acute angle-closure glaucoma were randomly divided into 3 groups. Iris root excision or laser iridotomy was applied to group A, cataract phacoemulsification with artificial lens implantation and goniosynechialysis for group B, crabeculectomy for group C. The changes of vision, intraocular pressure, chamber angle, anterior chamber depth before and after operation were observed, while the postoperative complications and following operations were analyzed. The period of follow-up was one week, one month, three months and six months.

RESULTS: No statistical significance was found for treatments of group A and C(P>0.05). For group C the treatment was statistically significant(P<0.01). Intraocular pressure: for all three groups intraocular pressure dropped with statistical significance(P<0.05)and group C was most effective. Chamber angle change: For group B 80% chamber angles were completely open and anterior chamber depth obviously increased(P<0.01); Postoperative complications: For group A 10% to 20% cases needed medical treatments or operations. Less complication were found for group B with better improvements of vision. For group C more complications were observed with some cases of severe and enduring cases which needed re-operation.

CONCLUSION: Cataract phacoemulsification with artificial lens implantation and goniosynechialysis is a safe and effective surgery for treatment of acute angle-closure glaucoma, which can effectively improve vision, decrease intraocular pressure, open anterior chamber angle.

The risk factors of phototoxic maculopathy caused by welding arc in occupational welders

Dong-Ping Shao,Ying Ding,Xiao-Ran Yang,Fei Liu and Min-Chao Li — 2013/6/3 10:33:28

AIM:To investigate the risk factors that cause phototoxic maculopathy in occupational welders.

METHODS: We examined a group of 68 male welders 136 eyes from some metal manufacturing enterprise from March 2012 to December 2012. Participants underwent thorough ophthalmologic examination including visual acuity, fundus photography, and high definition optical coherence tomography(OCT)scan. A specialist of occupational medicine examined all participants of this study prior to the OCT. The clinical history of all subjects was screened carefully before the study. All the subjects were divided into three groups according to age, length of service, protection habits. The incidences of phototoxic maculopathy were compared in 3 groups.

RESULTS: The incidences ofphototoxic maculopathy in less than or equal to 35 years old group, and more than 35 years old group were respectively 35.14%, 29.03%, and difference was not statistically significant. The incidences of phototoxic maculopathy in less than or equal to 10-years-seniority group, and more than 10-years-seniority group were respectively 11.76% and 33.33%, and the difference was statistically significant. The incidences of phototoxic maculopathy in strict protection group, protective random group and sunglasses protection group were respectively 21.88%, 36.96%, and 50.00%. The incidence in strict protection group was lower than the other two groups, the incidence was the highest in sunglasses protection group, and the difference was statistically significant.

CONCLUSION: The risk factors of phototoxic maculopathy in occupational welders are the length of service and protection habits. The longer the length of service, the macular lesions probability is high; protection more strict, macular lesions rate is low. The phototoxic maculopathy occurs regardless of age.

The clinical effect of 23G- minimally invasive vitrectomy for idiopathic macular epiretinal membrane

Li-Jing Hou,Dong-Bo Pang and Jia Li — 2013/6/3 10:33:28

AIM: To observe the clinical effect of 23G-minimally invasive vitrectomy for idiopathic macular epiretinal membrane.

METHODS: Totally 30 eyes of 30 cases of idiopathic macular epiretinal membrane were performed vitrectomy, membrane peeling and gas tamponade with 23-G minimally invasive vitrectomy from January 2010 to December 2012 years in our hospital. The follow-up time was 2 to 13 months. The operation effect was analyzed.

RESULTS: Thirty cases(30 eyes)of idiopathic macular epiretinal membrane were performed 23G-minimally invasive vitrectomy, 1 eye with macular epiretinal membrane reoccurred, 29 eyes macular epiretinal membrane disappeared, vision had different degrees of improvement than preoperative, metamorphopsia was disappeared or reduced, the macular epiretinal membrane was disappeared showed by OCT.

CONCLUSION: 23-G minimally invasive vitrectomy is a safe and effective method for the treatment of macular epiretinal membrane. It can improve the visual quality and the quality of life in patients prior to serious damage of visual function, and should be performed early.

Optical coherence tomography of central serous chorioretinopathy

Feng Yan,Kai Meng,Bao-Cheng Men and Dan Liu — 2013/6/3 10:33:28

AIM:To observe the imaging features of the foveal photoreceptor layer in eyes with central serous chorioretinopathy(CSC)using frequency-domain optical coherence tomography(FD-OCT)and to find the relationship between best-corrected visual acuity(BCVA)and the morphology of thickness of the outer nuclear layer.

METHODS: Totally 58 eyes from 54 CSC patients and 60 eyes from 30 healthy volunteers as the control group were selected. FD-OCT scan was performed on all the patients and volunteers. FD-OCT scan of 6mm horizontal line was performed, the scan depth was 1.9mm with a 5.8mm×5.8mm transverse area, the vertical and horizontal resolution was 5μm and 18μm respectively. The scan mode was 512×496. The morphological changes of FD-OCT on different stages of CSC were observed and the relationship between best-corrected visual acuity(BCVA)and the morphology of thickness of the outer nuclear layer were analyzed.

RESULTS: Simple serous neuroepithelial layer detachment and simple serous neuroepithelial layer detachment associated with pigment epithelial layer detachment at macula were about 84.5% of all the patients. Thickness of the outer nuclear layer was thinner from acute stage to chronic stage of CSC, and the relationship between thickness of the outer nuclear layer and BCVA was negative.

CONCLUSION: FD-OCT can detect the detailed morphologic changes and pathological morphology at the foveal photoreceptor layer in eyes with CSC patients.

Clinical study about pneumatic retinopexy used in unsuccessful scleral buckling surgeries

Gang Qiao,Yan Dai,Xiao-Li Wang,Jian Zeng and Min Yu — 2013/6/3 10:33:28

AIM: To analyze the effect of pneumatic retinopexy used in unsuccessful scleral buckling surgeries which failed because of missing holes, new breaks and so on.

METHODS: A case control study was done, 32 unsuccessful scleral buckling paients(32 eyes)in our hospital from 2010 to 2012, who match condition of pneumatic retinopexy were divided into two groups in random. The observation group were cured by pneumatic retinopexy, the control group were cured by vitrectomy combined with gas. The cure rate, corrected visual acuity, hospitalization costs and satisfaction rate were recorded to be contrasted.

RESULTS: The cure rate of both group were high, the observation group was 93.8%(15/16),the control group was 87.5%(14/16). The corrected visual acuity of the two groups respectively were 4.72±0.12, 4.75±0.14. They had no difference in statistic. But the observation group was far less than the control group in hospitalization costs, they were 4 543±126 yuan and 12 367±138 yuan respectively, and it got higher satisfaction rate than the control group, they were 93.8% and 62.5%. Both index had difference in statistic(P<0.05).

CONCLUSION: The pneumatic retinopexy used in unsuccessful scleral buckling surgeries can improve cure rate, satisfaction rate and it can bring down in hospitalization costs.

Clinical study of quantitative analysis of the anatomical structure after canalicular laceration

Min Wei,Shu-Sen Jiang,Hong-Qi Wu and Qiu-Feng Zong — 2013/6/3 10:33:28

AIM: To quantitatively analyse the anatomical structure after canalicular laceration, to provide a basis for finding nasal ends of the canalicular and to evaluate the feasibility of taking the lacrimal caruncle as anatomic landmarks for finding the nasal ends of the inferior canalicular.

METHODS: In this prospective case-control study, 100 cases(72 males and 28 females)of traumatic inferior canalicular laceration were chosen. They were completely random divided into the experimental group(n=50), finding the nasal ends of the inferior canalicular by applying the method of lacrimal caruncle anatomic landmarks; the control group(n=50), finding the nasal ends of the inferior canalicular by applying the direct vision method. The distance of the lacrimal punctum and the temporal side of the stump, the vertical distance and quadrant between nasal ends of the canalicular and lacrimal caruncle were measured. The success rate of the two groups to find the nasa lends of the canalicular were recorded. The data were compared using χ² test.

RESULTS: The nasal ends of the inferior canalicular in the semi-quadrant of the lacrimal caruncle was 94%. The canalicular nasal ends from the lacrimal caruncle of the vertical distance was 2.34±0.68 mm,in which lacrimal punctums pitch temporal side of the stump<4mm by nasal ends vertical distance of the lacrimal caruncle was 2.01±0.77mm. Lacrimal punctums pitch temporal side of the stump between 4-7mm was 0.57±0.19mm, lacrimal punctums pitch temporal side of the stump>7mm was 3.05±0.97mm. The success rate of surgery looking the inferior lacrimal duct nasal stump: experimental group: 49/50(98%), control group: 40/50(80%), the difference was statistically significant(P<0.05).

CONCLUSION: Nasal ends of the inferior canalicular locates below the parallel lines of the lacrimal caruncle. The canalicular nasal ends locates in the deep side of the lacrimal caruncle within 2-3mm. The lacrimal punctum and the length of the temporal side can be used to clear the radius around the lacrimal caruncle. The success rate of finding the nasal ends of the experimental group is faster than the control group. The lacrimal caruncle as anatomic landmarks to find the nasal ends of the inferior canalicular is feasible, especially for patients whose inferior canalicular bitamporal side of the stump from inferior lacrimal punctum was 4-7mm.

Clinical evaluation of Vitamin A palmitate eye ophthalmic gel combined Ellie eye drops for treatment of eye surface trauma

Dao-Yuan Jiang and Chun-Hong Wan — 2013/6/3 10:33:28

AIM: To observe and evaluate clinical effect of the combined use of vitamin A palmitate eye ophthalmic gel and Ellie eye drops for the treatment of various eye surface damage.

METHODS:Totally 167 cases of corneal disease were randomly divided into Ellie eye drops treatment group(n=45), vitamin A palmitate eye ophthalmic gel(n=55)in treatment group, the combined use group(n=67). Ellie eye drops were used to drop eye every 2 hours a day(daily 6 times). Vitamin A palmitate eye ophthalmic gel treatment group was used every 2 hours a day(daily 6 times), eye drops 1 time before sleeping in the evening. The combined use group was treated according to the above method of two medicines with 5 minutes interval.

RESULTS: Cure rate and the total effective rate of vitamin A palmitate eye ophthalmic gel treatment group were 56.4% and 83.6% respectively. Cure rate and the total effective rate of Ellie eye drops group were 66.7% and 88.9% respectively. Cure rate and the total effective rate of combined use group were 83.6% and 97.0% respectively. Alone use of Ellie eye drops in various eye surface damage was more efficient than vitamin A palmitate eye ophthalmic gel. The efficacy of combined use group for the treatment of various eye surface damages was obviously higher than that of the single application group(P<0.05). Local stimulation and systemic adverse reactions were not found during the observation.

CONCLUSION: Ellie eye drops is more effective than vitamin A palmitate eye ophthalmic gel for the treatment of all kinds of ocular surface damage, but the two medicine combined application treatment is much safer and more specific than the alone application.

The efficacy of hydrophilic soft contact lenses in the treatment of ocular surface diseases

Qi-Hong Hao,Zong-Yin Gao and Zhi-Bo Rao — 2013/6/3 10:33:28

AIM: To investigate patients who suffering bullous keratopathy, postoperative pterygium and filamentary keratopathy, by wearing hydrophilic soft corneal contact lens at the same time, and observe the treatment effect on alleviating corneal irritation symptoms and promoting corneal repair.

METHODS: Totally 79 hospitalized patients(90 eyes)were divided into treatment group and control group randomly. The control group was given routine treatment; the treatment group had routine treatment and still wore hydrophilic soft corneal contact lens. The alleviating corneal irritation symptoms and promoting corneal repair between two groups were compared.

RESULTS: Cornea irritation symptoms in the treatment group patients had significantly alleviated than control group, there were significant differences(H=26.801,P<0.001), it can be considered that the overall distribution of the symptoms was different between the two groups. In corneal wound healing, there were significant differences(H=7.347, P<0.05)between the two groups at one day post-operation. It can be considered that the overall distribution of the symptoms was different between the two groups at 1 day post-operation. There were significant differences(H=13.495, P<0.001)between the two groups in pterygium post-operation. There were no significant differences(H=0.006, P>0.05)between the two groups in bullous keratopathy postoperation. There were no significant differences(H=0.245, P>0.05)between the two groups in filamentous keratitis post-operation. In corneal wound healing, there were not significant differences(H=0.708, P>0.05)between the two groups at one week post-operation. It cannot be considered that the overall distribution of the symptoms was different between the two groups.

CONCLUSION: The using of therapeutic corneal contact lens not only reduces the suffering of patients with corneal diseases, but also shortens the repairing time of corneal epithelial, reduces the economic pressure of the patients, and is conducive to clinical treatment and nursing. However, for bullous keratopathy, the main cure is still penetrating corneal transplantation at present.

The clinical observation of Cachet phakic anterior chamber IOL implantation in the correction of high myopia

Zu-Hong Mao and Le Wang — 2013/6/3 10:33:28

AIM: To observe the safety and clinical effects of Cachet IOL implantation in the correction of high myopia.

METHODS: Twelve high myopia patients with Cachet anterior chamber IOL implantation from May 2011 to December 2011 were recruited in clinical study. The change of vision, IOP, corneal endothelium and the complication were observed after therapy. The follow up time was 3-6 months.

RESULTS: In all eyes of 12 patients, the uncorrected distance visual acuity(UDVA)and corrected distance visual acuity(CDVA)were obviously improved in different degrees after surgery compared with those of pre-therapy. The anterior chamber was clear at 2 days after therapy. The loss rate of corneal endothelium was low, the IOL of all patients had a good position and there were no obvious complication after therapy.

CONCLUSION: The Cachet IOL implantation is an accurate method in the correction of high myopia. It is an effective therapy to lighten the response of anterior chamber, and remission of complication and improve the vision. However, its safety needs long time observation.

Comparison of refractive error in eyes with vitrectomy, silicone oil tamponade finished phacoemulsification and intraocular lens implantation in different time point

Qian Shi,Xiu-Jun Peng,Bai-Chen Liu and Cheng-Rong Lu — 2013/6/3 10:33:28

AIM: To compare the refractive error in eyes with vitrectomy and silicone oil tamponade finished phacoemulsification and intraocular lens(IOL)implantation in different time point.

METHODS: Fifty-one patients(51 eyes)with vitrectomy and silicone oil tamponade performed phacoemulsification and IOL implantation were retrospectively analysed during 2009-01/2011-12 and divided into three groups by different time point of phacoemulsification and IOL implantation. There were 17 cases in A group performed silicone oil tamponade after vitrectomy combined with phacoemulsification and intraocular lens IOL implantation, silicone oil removal was performed after 3-6 months; 13 cases in B group performed silicone oil removal combined with phacoemulsification and IOL implantation; 21 cases in C group of scheduled phacoemulsification and IOL implantation after silicone oil removal, refractive error was compared 3months postoperatively.

RESULTS: The average absolute value of refractive error was 0.873±0.256D in A group, 0.828±0.134D in B group, 0.473±0.121D in C group. There was no statistical significant difference compared with A group and B group(P>0.05), but there was statistical significant difference compared with C group and A, B group(P<0.05).

CONCLUSION: Axial length was measured by A Scan ultrasonograph. The refractive error was small in group of phacoemulsification and IOL implantation after silicone oil removal relatively.

Anterior segment changes during accommodation in myopia with OCT

Shao-Bo Zhou,Hui Li,Juan Tan and Hai-Feng Hong — 2013/6/3 10:33:28

AIM: To evaluate anterior segment changes during accommodation in different degree of myopia with OCT.

METHODS: Sixty myopes with the age from 18 to 39 years were enrolled in this study and were divided into two groups: low to moderate myopia group(>-6.0D), and high myopia group(≤-6.0D). Anterior segment measurements were performed by anterior segment optic coherence tomography(OCT)under three different accommodative state of relax(0.0 D), 3.00D and 5.00D. The posterior corneal curvature(PCC), anterior chamber depth(ACD), lens thickness(LT), pupil diameter(PD)were compared at different accommodative state using repeated measures ANOVA.

RESULTS:Low to moderate myopia group comprised 32 myopes with the mean age 29.34±4.65 years, mean spherical equivalent -3.72±1.05D; High myopia group comprised 28 myopes with the mean age 29.57±5.89 years, mean spherical equivalent -7.05±0.85D; With the accommodation relaxed(0D), there was no difference between the low to moderate myopia group and high myopia group both in PCC and LT, ACD was 2.92±0.23mm in high myoia and 2.67±0.19mm in low to moderate myopia(t=-4.637, P=0.000). Pupil diameter was 6.21±0.56mm in low to moderate myopia and 5.95±0.42mm in high myopia(t=2.011, P=0.049). With the accommodation increased, ACD decreased significantly, LT increased significantly, and PD decreased significantly in both groups(all P<0.05). The PCC has no significant change during accommodation in both groups(all P>0.05).

CONCLUSION: Anterior segment OCT can find the alteration of ACD, LT and PD with accommodation. During accommodation, the cornea is stable. However, with the accommodation increased, ACD, greater changes happened in LT and PD using anterior segment OCT.

Clinical genetics and gene mapping studies on a family in the area of northeast with hereditary cataract

Tian-Xiao Zhang,Li-Wei Ma,Jiang-Yue Zhao,Xue Zhang and Jin-Song Zhang — 2013/6/3 10:33:28

AIM: To map the causal gene of congenital nuclear cataract in a family in the area of northeast.

METHODS: We investigated there generations of a Chinese family affected with hereditary cataract. Peripheral blood samples were collected from all of the family members, and genomic DNA was then extracted from the blood samples. Linkage analysis was performed using 62microsatellite markers. Two-point LOD scores(Z)were calculated using the LINKAGE programs(ver. 5.2). Haplotypes were constructed according to the allele information.

RESULTS: The affected members in this family showed classic phenotype of autosomal dominant congenital cataract. The maximum two-point LOD score of 2.71 was obtained for marker D22S689(θ = 0). Haplotype analysis traced the disease gene on chromosome 22q11.2-12.1, containing CRYBB1, CRYBB2, CRYBB3, CRYBA4 genes.

CONCLUSION: The occurrence of congenital nuclear cataract consistents with the autosomal dominant inherited regular, and the causal gene of congenital nuclear cataract localize at 22q11.2-12.1 in this family.

Analysis of relationship among visual evoked potential, oscillatory potential and visual acuity under stimulated weightlessness

Jun Zhao,Lian-Na Hu,Yong-Zhi Li,Xin Xu,Fu-Lin Gao and Yuan Wang — 2013/5/6 14:25:11

AIM: To observe the influence of head-down tilt simulated weightlessness on visual evoked potential(VEP), oscillatory potentials(OPs)and visual acuity, and analyse the relationship among them.

METHODS: Head-down tilt for -6° was adopted in 14 healthy volunteers. Distant visual acuity, near visual acuity, VEP and OPs were recorded before, two days and five days after trial. The record procedure of OPs followed the ISCEV standard for full-field clinical electroretinography(2008 update).

RESULTS: Significant differences were detected in the amplitude of P₁₀₀ waves and ∑OPs among various time points(P<0.05). But no relationship was observed among VEP, OPs and visual acuity.

CONCLUSION: Head-down tilt simulated weightlessness induce the rearrange of blood of the whole body including eyes, which can make the change of visual electrophysiology but not visual acuity.

Impact of incisions of cataract surgery on patients with corneal astigmatism

Jing Li,Yuan Yuan,Bao-Song Liu and Hua-Cong Peng — 2013/5/6 14:25:11

AIM: To research the impact of different 3.2mm incisions of cataract surgery on patients whose corneal astigmatism was within 25 degrees by Orbscan.

METHODS: We collected 40 cases of cataract patients whose corneal astigmatism was within 25 degrees detected by Orbscan and randomly divided them into groups A, B. Detected by Orbscan, 20 patients(20 eyes)in group A was conducted with 3.2mm corneal astigmatism axial incision and 20 patients(20 eyes)in group B was conducted with 3.2mm corneal incision on 90 degrees of the axis. All cataract operations were implemented by the same physician. We observed the postoperative changes of corneal astigmatism between two groups.

RESULTS: The comparisons of Polar K on each time preoperative and postoperative point were significant differences within each group. But the comparisons of Polar K on each time preoperative and postoperative point were not statistically significant between two groups. After 3 months, two kinds of incisions would both increase about 0.3D Polar K in the cornea.

CONCLUSION: 3.2mm corneal incision may cause Polar K 0.3D in corneal astigmatism.

The clinical application in high myopia with implantation of the iris-fixated phakic intraocular lens

Xiang-Hua Yuan,Bo-Lin Xie and Yun-Gao Xiao — 2013/5/6 14:25:11

AIM: To evaluate the safety, efficacy and predictability of the Verisyse/Artisan iris-fixated phakic intraocular lens for correction of high myopia.

METHODS:Totally 58 cases(112 eyes)of the Verisyse/Artisan iris-fixated phakic intraocular lens for correction of high myopia were collected, the preoperative and 3, 6 and 12 months postoperative examination such as uncorrected visual acuity(UCVA), best-corrected visual acuity(BCVA), refraction, endothelial cell, intraocular pressure were observed.

RESULTS: All of 112 eyes were implanted successfully and were followed-up for 1 year. UCVA of all patients were ≥0.5 three months after surgery, 72.3% of eyes with BCVA ≥0.8 six months after surgery, 98% of eyes residual refraction≤±1.00diopters(D)1 year after surgery. There were significant differences between preoperative and 3, 6 and 12 months postoperative spherical equivalent refraction and astigmatism(P<0.05). There were no significant differences between preoperative and 3 and 6 months postoperative intraocular pressure and counts of endothelial cell(P>0.05), but endothelial cell will be loss with the increase of observation time after surgery. Glaucoma, cataract, corneal endothelial decompensation and other serious complications were not found in our study.

CONCLUSION: Verisyse/Artisan iris-fixated phakic intraocular lens for correction of high myopia is effective, safe and predictable. All patients satisfied with the improvement of visual, no serious complications were found, but further clinical observed for a long period of time is necessary.

Comparison of the contrast vision after implanting photochromic, yellow or clear intraocular lenses

Chen Chen,Wei-Jing Du,Li-Tai Shen and Qiu-Hong Wei — 2013/5/6 14:25:11

AIM: To compare the contrast vision following implantation one of the following three intraocular lenses(IOLs): photochromic IOL, blue-light filtering IOL and conventional clear IOL.

METHODS: Totally 97 cases(102 eyes)were randomly divided into 3 groups according to the type of IOL. Group A were implanted photochromic IOL, group B were implanted blue-light filtering IOL, group C were implanted conventional clear IOL. The contrast vision was evaluated in photopic condition three months after operation.

RESULTS: In the scotopia condition, the contrast vision of the group A was lower than that in the photopic condition, but the contrast vision of the group A became statistically different until the contrast dropped to 10% contrast condition. The contrast vision of group B and group C were lower than that in the photopic condition and there had significant statistical difference. In the photopic condition: there was no significant statistical difference between group A and C in all the contrast level(P_100%=1, P_25%=1, P_10%=0.86); the contrast vision of the group A was higher than group B in all the contrast level(P_100%=0.010, P_25%=0.004, P_10%=0.041); In the 100%, 25% contrast condition, the contrast vision of the group B was lower than group C. Difference was statistically significant, but it became no statistically significant difference until the contrast dropped to 10% contrast condition(P_100%=0.014, P_25%=0.016, P_10%=0.457). In the scotopia condition: there was no statistical difference between group A and group C in 100%, 25% contrast level, but in the 10% contrast condition the contrast vision of the group A was higher than group C. Difference was statistically significant(P_100%=1, P_25%=0.111, P_10%=0.029). The contrast vision of the group A was higher than group B in all the contrast level. Difference was statistically significant(P_100%=0.000, P_25%=0.000, P_10%=0.001). The contrast vision of group B was lower than group C in the 100%, 25% contrast condition. Difference was statistically significant, but it became no statistically different until the contrast dropped to 10% contrast condition(P_100%=0.000, P_25%=0.039, P_10%=0.596).

CONCLUSION: To the senile cataract patients, the photochromic Matrix 400 has better visual quality in scotopia lighting condition than the blue-light filtering people.

Clinical evaluation on the coaxial microincision cataract surgery in hard nuclear cataracts

Qing-Cheng Shi,Yan-Wen Zhou,Ling Chu and Yu-Ning Feng — 2013/5/6 14:25:12

AIM: To assess and compare the results of 2.2mm microincision coaxial cataract surgery(MCCS)phacoemulsification with the conventional 3.0mm MCCS in hard nuclear cataracts.

METHODS: Totally 132 eyes with hard cataract(Ⅳ level and above)were randomized to two groups: 2.2mm MCCS(group 1:60 eyes)and 3.0mm MCCS(group 2:72 eyes). All patients underwent standard phacoemulsification and intraocular lens implantation surgery by one experienced surgeon. The average ultrasound power(AVE)was recorded during the operation. The incidences of capsule rupture and postoperative corneal edema were compared.Visual acuity, surgically induced astigmatism(SIA)and the descent rate of endothelial cell density were compared at intervals of 1 day, 1 month and 3 months after surgery. Statistic analysis was taken by Student's t test and Chi square test.

RESULTS: There was no significant difference on the incidences of capsule rupture, postoperative corneal edema and AVE(P> 0.05)between the two groups(3.3%, 10.0%, 65.09±20.15)and(4.2%, 11.1%, 69.13±15.44). One day after the surgery, the 2.2mm MCCS group showed better uncorrected visual acuity as compared to the 3.0mm MCCS group(P < 0.05). There were no significant differences on best-corrected visual acuity on 1 month and 3 months after the surgery. There was no significant difference on the descent rate of endothelial cell density(16.54%±10.20%, 17.69%±10.65%)3 months after the surgery. One day, 1 month and 3 months after the surgery, SIA was 0.77±0.31,0.66±0.29, 0.52±0.25D in the 2.2mm MCCS group, and 1.41±0.73,0.98±0.61D,0.82±0.35D in the 3.0mm MCCS group, respectively. The differences were statistically significant.

CONCLUSION: The operative safety of the 2.2mm MCCS group were the same as 3.0mm MCCS group with the hard nuclear cataracts. The 2.2mm MCCS phacoemulsification could significantly reduce SIA and get better earlier visual rehabilitation.

Therapeutic effect of phacoemulsification combined with accommodative intraocular lens implantation

Si-Wen Zhang,Zheng-Zai Hu,Hong-Zhuan Ouyang and Hui Zhang — 2013/5/6 14:25:12

AIM: To evaluate the safety and effectiveness of phacoemulsification and Tetraflex accommodative intraocular lens(IOL)in providing both enhanced distance visual acuity and near visual acuity.

METHODS: Thirty patients(30 eyes)with age-related cataract underwent phacoemulsification and were implanted with Tetraflex IOL, while other 30 patients(30 eyes)were implanted with Akreos Adapt IOL. Prospective data collection included both uncorrected distance visual acuity(UCDVA)and uncorrected near visual acuity(UCNVA)testing, manifest refraction, best-corrected distance visual acuity(BCDVA), distance corrected near visual acuity(DCNVA), and the amplitude of accommodation. Intraoperative and post operative complications also were reported.

RESULTS: Six months after surgery, the uncorrected distance, corrected distance, and corrected near visual acuity had no significant difference between two groups. The UCNVA, DCNVA and the amplitude of accommodation of Tetraflex group were better than Akreos Adapt group(t=2.427, 8.687, 15.158, P=0.023, 0.000, 0.000).

CONCLUSION: The Tetraflex accommodating IOL is safe and effective. It provides enhanced near vision with good distance vision 6 months after surgery.

The discussions about safety and stability of Crystal replacement after ICL

Xiu-Li Xie — 2013/5/6 14:25:12

AIM: To evaluate the efficacy, safety and stability of Crystal replacement after implantable contact lens(ICL).

METHODS: The research was based on the retrospective analysis of 9 patients(10 eyes)who underwent Crystal replacement after ICL surgery in Wuhan Aier Eye Hospital during March 2012 to August 2012, because of their vault had raised, including 2 males(2 eyes)and 7 females(8 eyes). All patients were followed-up for 3-6 months. The visual acuity, peripheral anterior chamber angle, anterior chamber volume, intraocular pressure, pupil size, vault, glare sensitivity, endothelial cell morphometry, as well as lens opacities were observed.

RESULTS: After operation, naked visions of the 10 eyes were better than or equal to preoperative corrected vision. Peripheral anterior chamber angle and anterior chamber volume was significantly increased. Vault returned to normal. The glare sensitivity was relieved obviously. Pupil size returned to the preoperative level at 6 months after surgery. The intraocular pressure and corneal endothelium counting before and after the operation had no significant difference. No case of lens opacities had happened. No serious complication was detected during the follow-up.

CONCLUSION: The choose of Crystal replacement after ICL had been shown to have the great efficacy, safety and stability, which can effectively solve the problem of spring height after ICL, and greatly improve the postoperative vision correction effect and patient satisfaction.

Clinical effect of manual small incision cataract extraction and goniosynechialysis for acute angle-closure glaucoma

Bin-Bin Li and Li-Qun Hu — 2013/5/6 14:25:12

AIM: To investigate the clinical effect of manual small incision cataract extraction with intraocular lens(IOL)implantation and goniosynechialysis for acute angle-closure glaucoma.

METHODS: Manual small incision cataract extraction with IOL implantation andgoniosynechialysis was performed on 48 cases(48)eyes diagnosed with acute angle closure glaucoma and cataract. The best-corrected visual acuity(BCVA), intraocular pressure(IOP), anterior chamber depth(ACD)and anterior chamber angle width were measured and recorded preoperatively, 1 day,1 week,1 month and 3 months postoperatively.

RESULTS: The BCVA was significantly better after surgery(P<0.001). The mean IOP decreased significantly after surgery(P<0.05), ACD and anterior chamber angle width increased significantly(P<0.05).

CONCLUSION: The method of manual small incision cataract extraction with IOL implantation and goniosynechialysis is a good alternative for treating acute angle-closure glaucoma with cataract.

Clinical observation of bio-amnion implantation used in combined trabeculectomy for refractory glaucoma

Xin-Huai Xue and Yang Gao — 2013/5/6 14:25:12

AIM: To observe the clinical effect of bio-amnion implantation used in combined trabeculectomy for refractory glaucoma

METHODS: Totally 86 eyes of 80 glaucoma patients were randomly divided into 2 groups. In experimental group, 43 eyes underwent trabeculectomy combined with bio-amnion implantation. In control group, 43 eyes only underwent trabeculectomy combined. The intraocular pressure(IOP), filtrative bleb and complications were observed.

RESULTS: Following-up for 12 months, IOP: there was significant difference between the average IOP(15.5±1.1mmHg)in experimental group and the average IOP(19.7±2.5mmHg)in control group(P<0.05). Filtrative bleb: the incidence of the functional filtering bleb(86%)in experimental group was more than the one in control group(67%), there was significant different between the two groups(P<0.05). The incidence of complications of post-operation(shallow anterior chamber, choroidal detachment and bleb leaking)was lower than the one of the control group obviously.

CONCLUSION: Combined trabeculectomy with bio-amnion implantation can increase the rate of success and reduce the incidence of complications.

Application of clinical pathway in cyclocryotherapy in treatment of refractory glaucoma

Lin Mou — 2013/5/6 14:25:12

AIM: To analyze the implementation value of clinical path in cyclocryotherapy for refractory glaucoma.

METHODS: Refractory glaucoma patients who underwent cyclocryotherapy treatment in the ophthalmology department from January 2011 to December 2011 were included, 24 eyes of 23 cases were treated with the clinical path, and 20 eyes of 20 cases as control group. An average length of stay, preoperative average length of stay, average cost of hospitalization, the cure rate, and patient satisfaction indicators were compared between two groups

RESULTS: There was no difference in the effective rate of surgery between two groups(83% vs 80%). The average length of stay and average hospital costs were less in path group than the control group(4.2d vs 8.3d, 2138 vs 2 787), but patient satisfaction was higher than the control group(96% vs 85%), and the difference was statistically significant(P <0.05).

CONCLUSION: The clinical pathway in the ciliary body frozen for refractory glaucoma contribute to standardize the surgical procedure to ensure that the operation is successful and improve work efficiency and the quality of medical services.

Investigation on the variation in macular retinal thickness of high myopia

Yan-Ming Zhang and Wei-Hong Zhang — 2013/5/6 14:25:12

AIM: To investigate the variation in macular retinal thickness of healthy Chinese myopic subjects by using optical coherence tomography(OCT).

METHODS: A total of 20 cases 20 eyes of normal subjects and 48 cases 48 eyes of high myopia(spherical equivalent\〖SE\〗 <-6.0D)were underwent examination of optical coherence tomography(Zeiss - Humphrey OCT3000). Fast macular thickness map OCT scans of 6 mm were done well on each eye. The minimum foveal and average foveal(1mm ring on the OCT retinal thickness map)thicknesses, the inner ring(1-3mm)macular thickness and the outer ring macular(3-6mm)thicknesses of superior, nasal, temporal and inferior parafovea retinal thickness were recorded.

RESULTS: The retina thickness at the superior was significantly thicker, and the inferior and nasal sides ofparafovea was thicker than the temporal one at the inner ring(1-3mm)macular. The retina thickness at the nasal sides was significantly thicker, and the inferior and superior of parafovea was thicker than the temporal one at the inner ring(3-6mm)macular. 2)The minimum foveal and average foveal(1mm ring on the OCT retinal thickness map)thicknesses were significantly greater than in the normal group. The inner ring(1-3mm)and all(except the superior)of the outer ring macular(3-6mm)thicknesses were significantly lower in the high myopic eyes than in the normal group. No significant difference was found in the superior of the outer ring macular(3-6mm)thicknesses between the high myopic group and the normal group(P<0.05).

CONCLUSION: Retinal thickness is related with regional variations in correlation within the 6-mm macular region. The attenuation was really existed in high myopia. It was inparafovea area but not fovea.

Clinical observation on pathologic myopia CNV treated with intravitreal bevacizumab

Zheng-Qun Liu,Xiao-Hua Zhu and Hui Yue — 2013/5/6 14:25:12

AIM: To evaluate the efficacy and safety of intravitreal bevacizumab(Avastin)for choroidal neovascularization(CNV)in pathologic myopia(PM)by including optical coherence tomography(OCT), fluorescein angiography(FFA)and best-corrected visual acuity(BCVA).

METHODS: Totally 42 eyes in 41 patients with PM CNV were divided into 2 groups randomly, experimental group(n=22)were assigned to receive intravitreal bevacizumab injections and take fufangxueshuantong capsule; control group(n=20)just took fufangxueshuantong capsule. Subjects were followed up every month after treatment. The efficacy and safety of two group were compared by ophthalmic evaluations including OCT, FFA, and BCVA.

RESULTS: BCVA: BCVA in two groups was improved after 12 months. The mean number of treatments per eye, experimental group was 4.23±2.02 and control group was 1.95±1.90. There was significant difference(P<0.005). OCT: Before and after 12 months central foveal thickness(CFD)for two groups were thin,and the mean value in experimental group was 43.41±40.39μm and in control group was 22.65±20.79μm, there was significant difference(P<0.05); FFA: In experimental group CNV was completely disappeared in 20 eyes(91%), persistent in 2 eyes(9%); the control group CNV was completely disappeared in 12 eyes(60%), persistent in 8 eyes(40%). There was significant difference(P<0.05).

CONCLUSION: Intravitreal bevacizumab are safe and effective treatment for most patients of CNV in PM.

Primary study of micropulse diode laser photocoagulation for central serous chorioretinopathy

Jian-Feng Xu,Rui-Zhen Ye and Gui-Zhou Li — 2013/5/6 14:25:12

AIM: To investigate the effect of micropulse diode laser photocoagulation on central serous choroidretinopathy(CSC).

METHODS: Twelve patients diagnosed with CSC by fluorescein angiography(FFA)and optic coherence tomography(OCT)examination were treated with micropulse diode laser photocoagulation. The data of visual acuity testing, ophthalmic examination, color photographs, FFA and OCT before photocoagulation and 1 week, 2 weeks, 1 month, 3 months after it were used to evaluate the effects of micropulse diode laser photocoagulation.

RESULTS: All patients' self-conscious symptom and visual acuity improved differently. Nine and eleven eyes leakage point disappeared after micropulse diode laser photocoagulation in 2 weeks and one month in FFA. Nine and eleven eyes of subretinal effusion in OCT were absorbed after laser photocoagulation in 2 weeks and one month. All cases' leakage point and subretinal effusion disappeared after 3 months. The window defect in FFA did not occur in all laser treated eyes.

CONCLUSION: The micropulse diode laser photocoagulation could shorten the course of CSC, improve the patient's visual acuity and reduce the complications.

Clinical study on effects of the combination of triamcinolone acetonide intravitreous injection with laser on diabetic macular edema

Jie Yang,Zhen-Yu Peng,Hui Huang and Nan-Xiang Peng — 2013/5/6 14:25:12

AIM: To evaluate the effectivity and safety of intravitreal injection of triamcinolone acetonide(TA)combined with retinal laser photocoagulation in the treatment of diabetic macular edema(DME).

METHODS: Thirty-seven cases(55 eyes)with DME were selected and treated by intravitreal TA injection first and laser photocoagulation after three weeks, best-corrected visual acuity(BCVA), fundus examination and intraocular pressure(IOP)were examined before TA injection and 1 month, 3 and 6 months after treatment, optical coherence tomography(OCT), fundus fluorescein angiography(FFA)were examined 3 months after treatment.

RESULTS: The average visual acuity was 0.1627±0.1016, 0.2743±0.1617, 0.2615±0.1833 at preoperative, 3 and 6 months after treatment. The visual acuity after treatment was significantly improved than preoperative(P<0.01). The average macular thickness was 467.5±150.9μm, 272.7±120.1μm, 308.1±136.2μm at preoperative, 3 and 6 months after treatment. The macular thickness after treatment was significantly lower than preoperative(P<0.01). The macular area and related vascular fluorescein leakage was significantly reduced after treatment.

CONCLUSION: The combination of triamcinolone acetonide intravitreous injection with retinal laser photocoagulation can be an effective method in the treatment of DME, visual acuity improved efficiency was best 3 months after treatment.

Intravitreal lucentis combined laser photocoagulation treatment on macular edema

Tan-Wei Wei,Chen Qiao and Ming Yan — 2013/5/6 14:25:12

AIM:To investigate the efficacy of intravitreal lucentis combined laser photocoagulation treatment on macular edema.

METHODS: Ninety –eight patients(136 eyes)with macular edema diagnosed by ocular-fundus examination, fundus fluorescein angiography(FFA). Sixty-eight eyes of them were treated with intravitreal lucentis combined laser photocoagulation and sixty-eight eyes only laser photocoagulation. The follow-up time was 1 month, 3, 6 months. Visual acuity and FFA were measured.

RESULTS: Among patients with intravitreal lucentis combined laser photocoagulation, visual acuity in 51 eyes(75.0%)was improved in 2 lines or more and 10 eyes(14.7%)remained no change, 7 eyes(10.3%)deceresed. Edema in 59 eyes(86.8%)reduced after treament. Among patients with laser photocoagulation, visual acuity in 12 eyes(17.6%)was improved in 2 lines or more and 42 eyes(61.8%)remained no change, 14 eyes(20.6%)deceresed. Edema in 21 eyes(30.9%)reduced after treatment.

CONCLUSION: The result of intravitreal lucentis acetonide combined laser photocoagulation treatment for macular edemae is better than those of only using laser photocoagulation.

Investigation on the mechanism of peripheral axonal injury in glaucoma

Jun-Hong Zhao,Hai-Tao Hu,Pei-Lin Lü,Ying Qiao and Hou-Cheng Liang — 2013/5/6 14:25:12

AIM: To compare the angles of longitudinal section of sclera around optic nerve heads and the never fiber layer changes in healthy adults and patients with glaucoma, and to investigate the mechanism of peripheral retinal axonal injury, with the combined knowledge of biomechanics.

METHODS: The optical nerves and their peripheral tissue specimen in the 12 eyes from health adult donators and 12 eyes from glaucoma patient donators were dyed by Glees' method to compare the angles of longitudinal section of sclera around optic nerve heads(through optic nerve center), and to observe the anatomical features of the peripheral retinal axons.

RESULTS: The mean angle of longitudinal section of sclera around optic nerve in healthy adults was 73.3°, while that in patients with absolute glaucoma was 75.6°. The difference showed no significance(t=1.44, P>0.05). There was a sharp bend in the course of peripheral optical fiber in healthy adults. However, the optic nerve fiber disappeared completely in patients with glaucoma end stage.

CONCLUSION: The angle between the medial edge and leading edge of sclera(around optic nerve heads)is an acute angle. The optical fiber in glaucoma end stage disappeared completely. The phenomenon may be related to high intraocular pressure, the sclera shape, the shear modulus of sclera and axons, and “axonal bending-injury” mechanism.

Analysis of contrast sensitivity on examination for pilots

Yuan Gao,Xiu-Jun Peng,Li-Jie Yang,Bei Cui,Li-Qun Cao and Li-Wei Qin — 2013/5/6 14:25:12

AIM: To study the influential factors of the contrast sensitivity function(CSF), we tested and investigated the CSF of navy pilots.

METHODS: Totally 58 pilots(116 eyes)were examined by CSF under the nighttime, nighttime & periglare, daytime, daytime & periglare conditions for 5 spacial frequencies with OPTEC6 500 Vision Tester.

RESULTS: From mean diagram of curves, the peak of CSF under the nighttime, nighttime & periglare conditions was at 3-6c/d, daytime, daytime & periglare conditions was at 6c/d.

CONCLUSION: The distant CSF is better than the near CSF in navy pilots,the binoculus CSF is better than that of the single eye. The spatial characteristics of CSF in navy pilots were reflected by present study.

Comparison of clinical effects of three adjuvant therapeutics to primary pterygium excision

Hao-Ying Tang,Hong Ma,Min Lu and Hong-Jin Ling — 2013/5/6 14:25:12

AIM: To compare clinical effects of three adjuvant therapeutics to primary pterygium excision.

METHODS: This is a prospective, randomized, one-blinded trial. One hundred and sixty adult patients with advanced pterygium were randomly divided into amniotic membrane transplantation(Group A, 68 eyes), amniotic membrane transplantation and mitomycin C application(Group B, 62 eyes)and autologous corneal limbal stem cell transplantation with conjunctival flap(Group C, 60 eyes). Patients were followed up until 12 months after operation. The corneal wound healing time and recurrence rate were analyzed.

RESULTS: The corneal wound healing time was 2.1±1.5 days in group A, 2.3±1.2 days in group B and 2.8±1.7 days in group C, respectively. The recurrence rate was 16% in group A, 11% in group B and 7% in group C, respectively. The recurrence rate was similar between group A and B.

CONCLUSION: Amniotic membrane transplantation and mitomycin C application is more preferable in improving corneal wound healing and reducing post-operative recurrence after primary pterygium excision.

The immediate reconstruction on the large areas eyelid defect after the operation of malignant tumors of eyelids

Li-Li Dong,Guo-Ping Cao and Xue-Qun Yu — 2013/5/6 14:25:12

AIM: To investigate the surgical approaches of immediate eyelid reconstruction after the operation of malignant tumors of eyelids, and evaluate the clinical effect.

METHODS: From January 2010 to October 2011, 11 cases of malignant tumor of eyelid underwent the eyelid reconstruction with local or free flap grafting and hard palate mucosa autotransplantation. Of 11 cases, there were 3 males and 8 females, aging from 38 to 77 years. The defect was caused by basal cell carcinoma of eyelid in 6 cases, by carcinoma of meibomian glands in 4 cases and by squamous cell carcinoma of eyelid in 1 case, including 4 cases of complete eyelid defect and 7 cases of 1/2-2/3 eyelid defect.

RESULTS: The appearance and function of the eyelid in all cases were satisfactory. No tumor recurrence was observed in all cases during the follow up period of 6 to 24 months.

CONCLUSION: The eyelid reconstruction with local or free flap grafting and hard palate mucosa autotransplantation is an easy and effective method after resection of malignant eyelid tumors.

Clinical research on toric implantable collamer lens for patients with high myopic astigmatism

Hao-Jiang Yang,Jing Sima,Lin Li,Xiao-Yan Dou,Xiu-Fang Lü and Yu-Li Wei — 2013/5/6 14:25:13

AIM: To evaluate the efficacy, safety and stability of toric implantable collamer lens(TICL)for patients with high myopic astigmatism.

METHODS: Totally 15 patients(30 eyes)undergoing TICL placement were included. The uncorrected visual acuity(UCVA), corrected distance visual acuity(CDVA), refraction,intraocular pressure, endothelial cell counts and complications were regularly observed on 1 month, 3, 6 and 12 months post-operation.

RESULTS: All eyes had a significant increase in UCVA. 12 months after surgery, 27 eyes(90%)achieved UCVA better than 1.0. 28 eyes(93%)had a spherical equivalent(SE)within ±0.5D. None lost one or more lines of CDVA. 30 eyes changed within ±0.5D when comparing 1 month and 12 months. Postoperative endothelial cell density did not show a significant difference from preoperative measurements(P=0.31). Complications were not found after surgery.

CONCLUSION: TICL appears to be safe and effective for correction of high myopic astigmatism.

Clinical observation of scleral buckling for the early retinal detachment eyes with silicon oil tamponaded

Rui Zhang and Jie Luan — 2013/4/7 15:27:39

AIM:To evaluate the clinical effects of scleral buckling for the early retinal detachment eyes with silicone oil tamponaded.

METHODS: This retrospective observation included 26 cases(26 eyes)who had the signs of early retinal detachment after the silicone oil tamponaded under 15 days. All the cases received scleral buckling and were observed with the change of retinal reattachment, visual acuity and intraocular pressure(IOP)for 6-18 months.

RESULTS: All 26 cases(26 eyes)had the retinal detachment at the inferior side. The retina of 22 cases(22 eyes)was anatomical attached(92%)after the operation and 4 cases(4 eyes)accepted another time of silicone oil tamponaded. The visual acuity improved in 22 cases(22 eyes), 3 cases(3 eyes)had no change and 1 case(1 eye)decreased. The IOP increased at early period after the operation and became normal after 3 months.

CONCLUSION: Scleral buckling is effective for the early retinal detachment eyes with silicone oil tamponaded.

Curative effect assessment of oral ganciclovir capsules on the treatment of cortical endotheliitis

Yu-Zhao Sun and Kang Chen — 2013/4/7 15:27:39

AIM: To evaluate the clinical values of oral ganciclovir on the treatment of corneal endotheliitis.

METHODS:The data of 14 eyes of 14 patients with corneal endotheliitis diagnosed in China Medical University Eye Center from October 2011 to October 2012 were retrospectively analyzed. Oral ganciclovir was orally administered 1.0g 3 times per day for 2-4 weeks, and then by 0.5g 3 times per day for 4 weeks; 1.5g/L ganciclovir ophthalmic gel and 10g/L prednisolone acetate eye drops were adopted in eyes. The symptoms and signs, together with effective rate and cure rate were evaluated before and after the therapy 1 ^st week, 2^nd week,4^th week and 8^th week respectively. The recurrence was followed up. The score before and after the treatment by Rank-sum test was compared.

RESULTS: One week after therapy of oral ganciclovir, the symptoms and signs bettered, the score changed from 19.14±4.57 to 11.43±3.86, then 6.93±2.59 for 2^nd week, and 0.29±0.87 for 4^th week. Till 8^th week, the symptoms and signs of all the patients disappeared completely. The effective rate was 71%, 100%, 100%, 100% after the therapy 1^st week, 2^nd week, 4^th week and 8^th week respectively. Compared with the vision of before, 10 cases fully recovered, 3 cases declined mildly, and 1 case significantly reduced. None of the cases recurred during the follow-up time.

CONCLUSION: Treating corneal endotheliitis by oral ganciclovir combined with eye drops is effective. Oral ganciclovir could prevent recurrence.

Influence of phacoemulsification on five sites of corneal endothelium of senile cataract after anti-glaucoma surgery

Yong-Hua Li,Yu-Jie Zhang,Dong-Li Nie and Guang-Hua Cao — 2013/4/7 15:27:39

AIM: To study the influence of phacoemulsification on five sites of corneal endothelium of senile cataract in patients after anti-glaucoma surgery.

METHODS: Patients with cataract after anti-glaucoma surgery were selected, and the surgery of phacoemulsification was performed by a same skilled surgeon, The superior, inferior, central, nasal, temporal endothelium cells were observed with a non-contact endothelium scope on pre-operation and seventh day, first month, third month and sixth month of post-operation.

RESULTS: After operation, there were obvious differences of corneal endothelium of every sites between two groups(P<0.01).

CONCLUSION: Endothelium cells of senile cataract in patients after anti-glaucoma surgery are easier to be damaged in the phacoemulsification, so preoperative evaluation, surgery manner and postoperative treatment are very important.

The effect of vitamin A palmitate eye gel on ocular surface recovery after LASIK

Yan Lu,Li-Kun Xia and Guang-Rui Chai — 2013/4/7 15:27:39

AIM: To study the effect of vitamin A palmitate eye gel on ocular surface reconstruction after laser in situ keratomileusis(LASIK), and to evaluate the efficacy and safety.

METHODS: One hundred and twenty patients(240 eyes)performing LASIK were enrolled in this study. The right and left eyes were randomly divided into experimental group and control group. The experimental group were treated with vitamin A palmitate eye gel for 1 month, four times a day after LASIK, and the same as control group in other treatments. The SchirmerⅠ test, break-up time(BUT)and corneal sensation were detect at preoperation and the postoperative 1^st day, 1^st month, 3^rd month in two groups.

RESULTS: There were significant difference in BUT and tear secretion quantity between the experimental group and the control group at the postoperative 1^st month and 3^rd month(P<0.05), which provided evidence that the postoperative BUT and tear secretion quantity of experimental group recover faster than that of the control group. Comparing with control group, the experimental group had no significant difference in corneal sensation at the postoperative 1^st day,1^st month and 3^rd month(P>0.05), which revealed that vitamin A palmitate eye gel had no obvious effect on recovery of corneal sensation after LASIK. During the treatment, there was no adverse drug event occurred.

CONCLUSION: Early use of vitamin A palmitate eye gel postoperatively is applicable for ocular surface reconstruction, but has no obvious effect on the regeneration of corneal sensation.

Clinical analysis and disposal of posterior capsule rupture of the lens in phacoemulsification for cataract

Ri-Xin Wang — 2013/4/7 15:27:39

AIM: To analyze the causes and disposal of posterior capsule rupture of the lens in phacoemulsification for cataract.

METHODS: A total of 326 cases(377 eyes)with cataract were selected and underwent phacoemulsification and intraocular lens implantation. The causes of 23 cases(23 eyes)who suffered posterior capsule rupture were analyzed.

RESULTS: Posterior capsule rupture occurred in 23 eyes(6.1%)during the operation; 17 cases with visual acuity≥0.3(73.9%).

CONCLUSION: It is necessary to know the dangerous factors of posterior capsule rupture and avoid the incidence. If noticed early, the complications can be reduced and the visual acuity can be improved as well.

Application of stratified emulsion splitting technology in highly hard nuclear cataract surgery

Hui Na,Da-Guang Bi and Yong Wang — 2013/4/7 15:27:39

AIM:To explore safety and effectiveness of stratified emulsion splitting technology in highly hard nuclear cataract ultrasonic emulsification.

METHODS: Totally 43 cases(47 eyes)of highly hard nuclear cataract was performed cataract extraction combined IOL implantation with stratified emulsion splitting cataract ultrasonic emulsification technology.

RESULTS:Postoperative visual acuity 1 day, 1 week and 1 month best-corrected visual acuity ≥0.5 was accounted for 70.21%, 87.23% and 89.36%. Intraoperative capsule rupture was found in 2 eyes. Corneal mild edema was found in 7 eyes(14.89%)after the first l day post-operation.

CONCLUSION:Stratified emulsion splitting technique has a practical application with little tissue damage, low capsular rupture rate and few complications for highly hard nuclear cataract patients and can bring a desirable outcome.

Burst mode of phacoemulsification for rural hard nucleus cataract

Zu-Guang Huang,De-Yong Deng and Tao Peng — 2013/4/7 15:27:39

AIM: To investigate the advantage of burst mode of phacoemulsification for rural hard nucleus cataract.

METHODS: Totally 162 eyes(162 cases)were randomly divided into small incision cataract extraction(SICE)group and burst group. Actual phaco-emulsification(Phaco)power, Phaco time, visual acuity, corneal edema and other complications were recorded.

RESULTS: Visual acuity was significant improved in both two groups postoperatively. But the difference between the two groups was statistically significant(P <0.05)and visual acuity recovery was faster in burst group than in SICE group. In comparison of the astigmatism between the burst group and SICE group, the difference was significant(P <0.05)in early stage. The actual Phaco power in burst group was(16.2±5.4)% and Phaco time was(42.8±6.1)s econds. Serious corneal edema occurred more frequently in SICE group(69 eyes)than that in the burst mode group(12 eyes), 6 eyes suffered posterior capsular rupture in SICE group.

CONCLUSION: Burst Phaco mode reduced Phaco time and actual Phaco power consumed during phacoemulsification and reduced corneal edema and surgery complications in hard nucleus cataract surgery. It is an effective measure for hard nucleus cataract for better postoperative visual acuity and shorten recovery time.

Application of ultra-long chopper in micro-incision phacoemulsification

Ping-Xi Wang,Dan-Yi Li,Xin-Xiu Zhang,Dan-Dan Li and Hui-Yun Jia — 2013/4/7 15:27:39

AIM: To observe the clinical effect of 2.5 mm-long hooker using improved pre-chop phacoemulsification method with ozil technique and to discuss the clinic characteristics of this improved surgery method.

METHODS: Retrospectively analyzed 247 patients(320 eyes)with ozil phacoemulsification and intraocular lens implantation surgery. The 247 patients were randomly divided into two groups. The two groups were given different chop method during the surgery: improved pre-chop and traditional stop and chop. The improved pre-chop group were canceled water separation steps, the ultra-long chopper were entered into the capsular bag under the rim of continuous circular capsulorhexis, by passed the intraocular lens equator then reversed the hooker upward against the posterior pole of lens and cracked the nuclear into half with the phacoemulsification hand pieces extruding the nuclear from above downward without using energy, then rotated the nuclear and repeated the chop step. The control group used the traditional stop and chop technique. Pre-surgery recording included the best-corrected visual acuity(BCVA)and corneal endothelial cell counting. Average power(AP), real ultrasound phacoemulsification time(U/Time), accumulated energy complex parameter(AECP), BSS perfusion amount and complications were recorded. And the corneal edema and corneal endothelial cell counting were observed at one week post the surgery.

RESULTS: Compared the sub-group of two groups with the same hardness of nuclear, the AP, U/Time, AECP and the BSS perfusion amount of the improved pre-phaco group were lower than the stop and chop group(P<0.05)with significant difference. Also the lose rate of corneal endothelial cell of the improved pre-phaco group was lower than the stop and chop group(P<0.05).

CONCLUSION: Using the improved pre-phaco method in the ozil phacoemulsification cataract surgery could raise the energy utilization efficiency, decrease the BBS perfusion amount during the surgery and further lower the injury to the corneal endothelial cell brought by the phacoemulsification surgery.

Research of refraction of eyes with multifocal intraocular lens implantation under the guidance of IOL master

Ling Wan,Bo Chen,Zheng-Zheng Wu and Fang Li — 2013/4/7 15:27:39

AIM: To research the refraction of eyes after phacoemulsification of cataract and diffractive aspheric multifocal intraocular lens(IOL)implantation under the guidance of IOL master.

METHODS: Totally 68 patients(84 eyes)with age-related cataract were selected. Routine preoperative examinations were completed, and IOLs were determined under the guidance of IOL master. All the patients underwent phacoemulsification of cataract and multifocal IOL(Tecnis AMO00)implantation. 3 months later, postoperative visual acuity and the refraction(according to the integrated refractometer)of patients were observed.

RESULTS: The refraction types of these 84 eyes included 36 myopia and 48 hyperopia, with spherical and cylindrical diopter between -0.5D to +0.5D. No significant refractive error was detected. There were 64 eyes(76%)with postoperative uncorrected distance visual acuity ≥0.8, 77 eyes(92%)with best-corrected distance visual acuity ≥0.8, 58 eyes(69%)with uncorrected near visual acuity ≥0.8, 74 eyes(88%)with best-corrected near visual acuity ≥0.8, 58 eyes(69%)with intermediate visual acuity ≥0.8.

CONCLUSION: Diffractive aspheric multifocal IOL provides a high level of full vision, and will be more accurately selected under the guidance of IOL master. No significant refractive error was detected after surgery, and patients were much satisfied.

Clinical study of the quality of life and influence factors in glaucoma patients after trabeculectomy

Wen-Bin Zhang,Yan-Yi Peng,Jian-Guo Sun,Xin-Sheng Zeng and Qiong-Fang Ke — 2013/4/7 15:27:39

AIM:To evaluate the quality of life and influence factors in glaucoma patients after trabeculectomy.

METHODS:The quality of life of 123 cases of glaucoma after trabeculectomy patients were evaluated with a scale of life quality for diseases with visual impairment.

RESULTS:The quality of life scores of glaucoma patients after trabeculectomy were low. The Visual status was the significant factor to the patient's quality of life; The analysis of multiple stepwise linear regression indicated the visual status(β=-10.139, P=0.000), health education(β=2.576, P=0.000), number of operations(β=-3.598, P=0.002)and gender(β=3.807, P=0.013)are the main influencing factors.

CONCLUSION: The scores of quality of life of glaucoma patients after trabeculectomy were low. Therefore, doctors should not only pay attention to the clinical treatment of patients with glaucoma, but also take care of the quality of life according to the patient's occupation, economic status when protecting visual function. It is necessary to give some health education and psychological treatment to improve their quality of life.

Analysis on effects of triple surgery for chronic angle-closure glaucoma

Jing-Jing Qin,Yu Song and Li-Li Huang — 2013/4/7 15:27:39

AIM: To investigate the clinical efficacy of trabeculectomy combined with phacoemulsification and intraocular lens implantation for the treatment of primary chronic angle-closure glaucoma.

METHODS: A retrospective analysis was performed on 65 patients(70 eyes)with chronic angle-closure glaucoma and varying degrees of lens opacity admitted to our hospital ophthalmology from February 2011 to February 2012. Patients underwent trabeculectomy combined phacoemulsification and intraocular lens implantation. And after that patients were followed-up for at least 6 months. Postoperative visual acuity, intraocular pressure(IOP), and bleb complications were compared and analyzed.

RESULTS: According to the international standard eye chart check, after 3 months follow-up, visual acuity improved 1 line accounted for 80%(56/70); After 6 months follow-up, after vision correction the vision acuity that improved 1 line accounted for 93%(65/70); after 6 months of follow-up, IOP<21mmHg, accounted for 89%(62/70); functional blebs accounted for 89%(62/70), fewer postoperative complications.

CONCLUSION:Trabeculectomy combined with phacoemulsification and intraocular lens implantation in the treatment of primary chronic angle-closure glaucoma is a safe and effective surgery method and it has a good visual recovery, IOP decrease, and fewer complications.

Anterior chamber paracentesis combined with trabeculectomy in treatment of high intraocular pressure continued state of acute angle-closure glaucoma

Xiao-Jing Zhao — 2013/4/7 15:27:39

AIM: To investigate the effect of anterior chamber puncture combined trabeculectomy in the treatment of high intraocular pressure continued state of acute angle-closure glaucoma.

METHODS: Totally 80 cases with angle-closure glaucoma from March 2011 to June 2012 in our hospital were retrospectively analyzed, and 40 cases were given trabeculectomy after anterior chamber decompression(observation group)while 40 cases were received trabeculectomy after drugs decompression(control group). The clinical efficacy was compared between the two groups.

RESULTS: The postoperative vision recovery, anterior chamber angle and pupil improvement were better than the control group, and the incidence of complications were less than the control group, the difference was statistically significant(P<0.05).

CONCLUSION: The efficacy of anterior chamber paracentesis combined with trabeculectomy in the treatment of high intraocular pressure continued state of acute angle-closure glaucoma is effective, and it is a simple surgery with fewer complications, which is worth to actively promote in clinic.

Phacoemulsification combined with goniosynechialysis in the management of chronic primary angle-closure glaucoma

Yan-Jun Huang,Fei Liu,Xiao-Ran Yang,Yuan-Biao Li,Dong-Ping Shao and Min-Chao Li — 2013/4/7 15:27:39

AIM: To investigate the clinical effects of phacoemulsification combined with goniosynechialysis in the management of chronic primary angle-closure glaucoma(CPACG).

METHODS:Totally 57 cases(57 eyes)with CPACG and cataract were treated with phacoemulsification combined with goniosynechialysis. Intraocular pressure(IOP), anterior chamber angle, best-corrected visual acuity and central anterior chamber depth were monitored during follow-up for 8-15 months in these eyes.

RESULTS: The IOPs of 52 eyes were normal without any medications. The IOPs of 4 eyes were normal with a single antiglaucomatous eye drops. The IOP of 1 eye was normal with two kinds of antiglaucomatous eye drops. The anterior chamber angles became wider and the synechial angle closure were reopened after surgery in all eyes. The best-corrected visual acuity were improved except 1eye with optic atrophy. The postoperative central anterior chamber depth became deep.

CONCLUSION: Phacoemulsification combined with goniosynechialysis is able to safely effectively control IOP and also improve the visual acuity of CPACG.

Argon laser treatment of central serous chorioretinopathy

Ting- Bing Fang,Hao Yan and Zhi-Rong Xu — 2013/4/7 15:27:39

AIM: To observe the efficacy of the argon laser photocoagulation treatment of central serous chorioretinopathy(CSC).

METHODS: The treatment groups: 18 patients(18 eyes), argon laser photocoagulation and oral jolethin, vitamin B1, inosine and venoruton tablets. Control group: 18 patients(18 eyes), oral lecithin complex iodine, vitamin B1, inosine, venoruton tablets. Foveal thickness and neuroepithelial layer detachment range were measured by optical coherence tomography(OCT)before treatment, after 1 month and 3 months post-operation to compare the decline in value of foveal thickness and neuroepithelial layer detachment range of the two groups.

RESULTS: After 1 month of treatment, the decline in value of the center foveal thickness: the value of treatment group was 256±72μm; the value of the control group was 82±57μm, and the difference of the two groups, P <0.05; the decline in value of neuroepithelial layer detachment range: the value of the treatment group was 3 548±168μm, the value of the control group was 1 520±143μm, And the difference of the two groups, P<0.05. After three months of treatment, the decline in value of the center foveal thickness: the value of treatment group was 383±75μm, the value of the control group was 312±67 μm, and the difference of the two groups, P<0.05; decline in value of neuroepithelial layer detachment range: the value of the treatment group was 4 908±172μm, the value of the control group was 4 211±153μm, and the difference of the two groups, P <0.05. The differences were statistically significant between the treatment and the control groups(two independent samples t-test).

CONCLUSION:Argon laser photocoagulation treatment of CSC is an effective treatment method and can significantly shorten the course.

Application of OCT in treatment of acute central serous chorioretinopathy

Zi-Yun Xiao,Hui Song,Xiu-Sheng Song and Tuo Li — 2013/4/7 15:27:40

AIM: To dynamically observe the subtle structure changes in the acute central serous chorioretinopathy(ACSC)by optical coherence tomography(OCT).Compare the efficacy of laser, drug and the combined treatment.

METHODS: Totally 96 cases(98 eyes)of ACSC were confirmed by FFA and OCT, the differences of subretinal fluid absorption and visual acuity by drug, laser and laser combined with drug therapy were compared. Follow-up time was 2 weeks, 4 weeks and 8 weeks.

RESULTS: Between the groups were no statistically significant in the range of retinal detachment before treatment. After 2, 4 and 8 weeks treatment, the range of retinal detachment and cure rates were not statistically significant between the laser group and drug group. Compared to aforementioned two groups, a smaller range of retinal detachment and higher cure rate was found in combined treatment group, the differences were statistically significant.

CONCLUSION: The combined treatment of drug and laser can shorten the course of ACSC, improve the cure rate; OCT is noninvasive, simple, intuitive, can sensitively track the healing process of ACSC.

Choroid thickness in central serous chorioretinopathy using enhanced depth imaging optical coherence tomography

Xiao-Long Yu,Er-Hua Liu and Gang Tan — 2013/4/7 15:27:40

AIM: To observe the choroidal thickness in the macular area in affected and unaffected fellow eyes with central serous chorio retinopathy(CSC)and in healthy controls.

METHODS: Twenty-six cases with unilateral CSC and controls were recruited in this study. All eyes were divided into three groups: 26 eyes in Group A(affected eyes with CSC), 26 eyes in group B(unaffected fellow eyes)and 26 eyes in group C(right eyes of age and sex matched control). Enhanced depth imaging was obtained by using spectral-domain optical coherence tomography. Subfoveal choroidal thickness and choroidal thickness at 1mm/3mm nasal, temporal, superior and inferior to the fovea were measured.

RESULTS: Choroidal thickness was significantly increased in affected eyes with CSC than unaffected fellow eyes(t=5.57, P<0.01).The mean subfoveal choroidal thickness(SFCT)was 528.31±91.24μm in group A, 413.71±79.35μm in group B, and 301.31±52.46 in group C. The subfoveal choroid was significantly thicker in group A than Group C(P<0.01). SFCT in unaffected fellow eyes were thicker than the controls(P<0.01).

CONCLUSION:Choroidal thickness is thicker in affected eyes with CSC and also in fellow unaffected eyes, indicating that the choroid blood vessels are high and perfusion state, may be one of the factors of the disease CSC.

Clinical research on anterior chamber injection of dexamethasone after cataract surgery with uveitis

Jun Zhang,Wei Yang,Yi-Xia Zhang,Xin-Rong Zhao and Xin-Gang Qi — 2013/4/7 15:27:40

AIM:To explore cataract surgery complication of the anterior chamber injection 0.1mL dexamethasone for uveitis complicated cataract patients.

METHODS: The experimental group was injected 0.1mL dexamethasone to anterior chamber at the end of phacoemulsification(Phaco)+intraocular lens(IOL)implantation, while the control group did not. And the different postoperative inflammation between them was observed.

RESULTS: The differences of visual acuity between the two groups on the first two days after operation were statistically significant(P<0.05). The postoperative corneal edema and anterior chamber flare between the two groups in the first day were different(P<0.05). And the percentage of the experimental group postoperative visual acuity improved was higher than that of the control group.

CONCLUSION: It can reduce short-term postoperative inflammation, improve visual acuity earlier and do not impact the short-term postoperative intraocular pressure that uveitis complicated cataract was injected 0.1mL dexamethasone to anterior chamber at the end of Phaco+IOL.

Clinical curative effect of scleral buckling surgery for the treatment of old retinal detachment

Hai-Dong Huang,Ying Guo,Li-Yang Li,Di Guan,Hong-Fu Li and Lu Yin — 2013/4/7 15:27:40

AIM: To observe the clinical curative effect of scleral buckling surgery for the treatment of old retinal detachment.

METHODS: We selected 134 cases old retinal detachment patients as the objects in our hospital in recent years, all the patients was monocular retinal detachment. 66 cases of them were less than six months, 68 cases of them were more than six months, they were given scleral buckling surgery and the vision rehabilitation was compared after surgery.

RESULTS: Totally 61 cases(45.5%)of the patients' postoperative visual acuity was above 0.1, it was significantly higher than before the surgery; for the patients with retinal detachment less than half a year, 90.9% visual acuity was increased, 86.4% of the surgeries was success, they were significantly higher than the patients with retinal detachment more than six months. These differences were statistically significant(P<0.05).

CONCLUSION: Scleral buckling is a simple and effective method for the treatment of old retinal detachment. It can achieve higher cure rates and given the treatment earlier, the curative effect would be better.

Related factors of high-risk newborn retinal hemorrhage

Pan Liu,Yu Tian and Yun-Zhao Wu — 2013/4/7 15:27:40

AIM: To study the cause of high-risk neonatal retinal hemorrhage risk and analyze its related factors.

METHODS: After the first 72 hours of the birth, the newborns in the pediatrics were examined for fundus used the wide area digital fundus imaging system(RetCam Ⅱ).

RESULTS: Among 123 newborns, 19 neonates had retinal hemorrhage, and the incidence of retinal hemorrhage in newborns was 12.2%. Among 49 newborns who were came through spontaneous delivery, 18(29.6%)neonates had retinal hemorrhage, while 1(0.7%)neonate from 74 who were born by caesarean section suffered from retinal hemorrhage. The difference was statistically significant.(χ²=34.763 P=0.000). Logistic regression equation analysis tip: The risk factors of retinal hemorrhage were eutocia, premature delivery and intracranial hemorrhage.

CONCLUSION: The important relevant factors of high-risk neonatal retinal hemorrhage are eutocia and associated with intracranial hemorrhage.

Evaluation of the functions of retina of diabetic patients receiving silicone oil influxing

Quan-Liang Zhao,Chun-Xiang Zhang and Ming-Bao Gou — 2013/4/7 15:27:40

AIM: To know the change of the retina and optic nerve for proliferative diabetic retinopathy(PDR)patients after silicone oil influxing, who have been performed with silicone oil influxing following vitrectomy, recover the functions of their retina and optic nerve, and to gain an insight into the safety of such operation.

METHODS: Totally 30 patients, who were confirmed as PDR and performed with vitrectomy operation and silicone oil influxing during June 2010 to December 2011, were chosen as treat group; and 30 cases, who were performed with vitrectomy and C₃F₈influxing due to suffering from PDR, were chosen as control group. The patients in the two groups were observed for their intraocular pressure(IOP), best-corrected visual acuity(BCVA), after surgery colored fundus photography, perimetry, etc. to examine and evaluate the retinal functions.

RESULTS: Among the 30 cases in observation group, 15 eyes were found pale optic nerve, 9 eyes were found with faint colored optic nerve, and 15 eyes were found with local blood vessel occlusion in the retina. Among the 30 cases in the control group, the gas was entirely absorbed after three months postoperation, 3 eyes were found with faint colored optic nerve, and no one was found with paint optic nerve and local blood vessel occlusion in the retina. Visual acuity: By comparing the visual acuity of the patients preoperation and postoperation in the latest follow-up visit, the visual acuity of the patient postoperation in the silicone oil influxing group is improved by 23 eyes than that preoperation, reduced by 8 eyes than that preoperation, while the visual acuity of 10 eyes keeps unchanged. postoperation in the C₃F₈group, the visual acuity is improved by 33 eyes, reduced by 3 eyes(8.33%, P<0.05), which is of statistical significance. Using Goldmann tenometer to compare the average of the cases seven days postoperation and in the follow-up visit, the pressure in the silicone oil influxing group was 15.07±0.85mmHg, and that in the C₃F₈group was 17.84±1.86 mmHg. The change postoperation was of significance difference(P<0.05). The pressure in one week's following visit was of no statistical significance. Visual field: among the 60 cases who were performed with vitrectomy due to suffering from PDR, the visual field examination of 26 cases three months after the operation was made. It was found that, their visual field was tubular change.

CONCLUSION:Diabetic patients with silicone oil filling 3 months after surgery to remove the silicone oil found in some patients, color fades or pale optic local vascular occlusion of the retina, the white sheath, proliferating like change, As a result, the visual acuity and visual field of the patients showed impairment to different extent. Therefore, after they are operated with vitrectomy due to suffering from PDR, the silicone oil should be released as early as possible, depending on retinal restore so as to avoid impairment of optic nerve and retina.

Clinical effect of perioperative interventions on breeding period diabetic retinopathy

Shi-Huai Jiang,Gang Qiao,Ke Wang,Xiao-Hong Zeng and Gui-Rong Li — 2013/4/7 15:27:40

AIM: To analyze the clinical effect of perioperative intervention in proliferative diabetic retinopathy(PDR)patients.

METHODS: Totally 52 cases of eye diabetic retinopathy with medical records and follow-up materials were retrospectively analyzed from May 2009 to December 2011, male 15 cases, female 25 cases, age 31 - 78 years old, all patients underwent preoperative visual acuity, intraocular pressure, slit lamp microscope, slit lamp microscope eye fundus examination, B ultrasonic, corneal endothelial mirror etc. After 1 week, 2 weeks, 1 month, 2, 3, 6 months follow-up, the patients were observed the vision, intraocular pressure, artificial crystal, fundus, perioperative observation of patients with blood glucose, blood pressure, systemic, adverse events, and so on. Implementation of all patients perioperative interventions. According to the patients with diabetes related systemic complications diagnosis rating, each complication was recorded as 1 point, no complication 0. Operation method for vitrectomy + full retinal photocoagulation, merger macular edema and macular front wall line macular inside boundary film stripping, who do the same period with cataract phacoemulsification, stage I or implant implantation of artificial crystal, according to the intraoperative situation intraocular filling long-term gas/oil/song amine Ned; During the operation, the conventional for ecg monitoring, appear obvious blood pressure fluctuation in anesthesia physician care descending controlled decompression.

RESULTS: Forty cases of 52 eyes of diabetic retinopathy in patients with type I 5 cases, eyes surgery of 12 patients(30%), each eye around 14 cases(35%), PDR stage IV 15 eyes(28.8%), V stage 16 eyes(30.7%), VI period 21 eyes(40.3%). Preoperative sight is lower than 0.02 and eyes(73.1%), 0.02 - 0.1 7(13.5%)eye, 0.1 - 0.3 5 eyes(9.6%), more than 0.3 2 eyes(3.8%). In the follow-up of sight is lower than 0.02 17 eyes(32.7%), 0.02 - 0.1 9 eyes(32.7%), 0.1 - 0.3 14 eyes(32.7%), 0.3 above 12 eyes(23.1%). One surgery cured 47 eyes(90.4%), reoperation five eyes(9.6%), early postoperative mild vitreous hemorrhage again five eyes(9.6%), late again vitreous hemorrhage along with neovascular glaucoma 1 eyes(1.9%), infectious endophthalmitis 1 eye(1.9%). The material in our hospital medicine diagnosed with complications of patients for 17 cases(42.5%), no complications of 23 cases(57.5%), the score of 0 points 23 cases, 1 points, nine cases(22.5%), 2 points, four(10%), 3 points in 3 patients(7.5%), 4 points 1 cases(2.5%). During the operation, the implementation of controlled decompression five eyes(9.6%). All patients perioperative blood glucose, blood pressure and body were stable, no adverse events.

CONCLUSION: The perioperative intervention can significantly reduce the diabetes patients with systemic complications and adverse events, but the cost of patient care increased; Stable blood sugar, blood pressure and appropriate drug therapy can reduce the incidence of early vitreous hemorrhage again. Vitreous surgery or joint operation treatment is an effective means of PDR, surgical indications and timely grasp the surgical treatment of the patients with visual function is the key to save the residual of visual function.

Advantages and disadvantages of combined surgery which consists of posterior segment diseases and anterior segment disease

He-Yi Li,Ming-Hong Gao and Jian-Guo Li — 2013/4/7 15:27:40

AIM: To discuss the advantages and disadvantages of combined surgery, which consists of posterior segment diseases and anterior segment diseases(cataract, glaucoma, keratonosus), and analyze the hazards that may affect surgery.

METHODS: Group A: proliferative diabetic retinopathy(PDR), group B: complicated retinal detachment(RD). For comparison, group A was divided to group A₁: vitrectomy; group A₂: vitrectomy + cataract extraction; group A₃: vitrectomy + cataract extraction + intraocular lens implantation. Group B was divided to group B₁: vitrectomy; group B₂: vitrectomy + cataract extraction; group B₃: vitrectomy + cataract extraction+ intraocular lens implantation.

RESULTS: Surgery complications were the main outcome measures: neovascularity secondary glaucoma in group A and surgery recurrence or proliferative vitroretinopathy in group B. The incidence of complication: group A₃>A₂>A₁, A₃ was significantly higher than A₂ and A₁, and it was statistically significant, A₂>A₁, but it was not statistically significant. The results of group B were the same as group A.

CONCLUSION: Combined surgery will not be chosen if it is possible, and intraocular lens should not be implanted at once if the operation was influenced.

Clinical observation on effect of polyethylene glycol eye drops combined with bFGF on dry eye

Zhi-Hong Zhang — 2013/4/7 15:27:40

AIM: To evaluate effect of polyethylene glycol eye drops combined with basic fiberoblast growth factor(bFGF)eye drops on dry eye.

METHODS: Fifty-one patients(102 eyes)with dry eye were divided into treating group and control group randomly. Both eyes of one were compared by each other. The eyes of treating group were treated by polyethylene glycol eye drops combined with bFGF eye drops 4 times each day for 1 month. The 2 drops were dropped 5 to 10 minutes apart each time. The eyes of control group were treated by polyethylene glycol eye drops 4 times each day for 1month. Schirmer Ⅰ test, break-up time(BUT), corneal fluorescein staining and improvement of symptoms were observed before treatment and after treatment in the two groups.

RESULTS: There was significant difference intear film break-up time(BUT), corneal fluorescein staining and symptoms between before and after the treatment of both groups(P<0.05). There was also significant difference in BUT, corneal fluorescein staining and symptoms between the two groups after the treatment(P<0.05). There was no significant difference in Schirmer Ⅰ test between all time-point of the two groups(P>0.05).

CONCLUSION: Polyethylene glycol eye drops combined with bFGF has obviously effect on dry eye.

Clinical observation of adaptation and the influencing factors after wearing Menicon-Z RGPCL

Wei Wei,Yan Zhao and Chang-Ning Zhang — 2013/4/7 15:27:40

AIM: To evaluate the effect of variety factors on the patient's adaptability and subjective evaluation after wearing Menicon-Z rigid gas permeable contact lens(RGPCL).

METHODS: Totally 39 patients were recruited in this study. The clinic data including age, gender, spherical, astigmatism, corneal thickness, corneal curvature, basic tear and living areas were analyzed for their impact. Patients evaluated comfort and visual stability after wearing Menicon-Z RGPCL for a month.

RESULTS: The average adaptation period after wearing RGPCL was 6.41 ± 4.64 days. The age factor had a significant influence of the adaptation period(F=4.07, P=0.025). Patient's discomfort caused by foreign body sensation(0.62±0.71)and eye dry sense(0.64±0.63)after wearing RGPCL for a month.

CONCLUSION: Patients adapted to Menicon-Z RGPCL in about a week. The younger the more easily adapted to the RGPCL. The main impact factor of patient's adaptation period is comfort. Detailed guidance and corresponding treatment is an important means to resolve their symptoms and long-lasting wearing.

The peripheral blood T-lymphocyte subsets and natural kill cell in patients with nonarteritic anterior ischemic optic neuropathy

Ming-Zhen Bei and Hai-Ying Cai — 2013/4/7 0:00:00

AIM: To study the peripheral blood T-lymphocyte and natural kill(NK)cell in patients with nonarteritic anterior ischemic optic neuropathy(NAION).

METHODS: The changes of CD₃⁺,CD₄⁺,CD₈⁺,CD₄⁺/CD₈⁺, NK in 30 NAION and 31 normal controls were measured by flow cytometry monoclonal immunofluorescence.

RESULTS: CD₃⁺, CD₄⁺/CD₈⁺ ratio in NAION patients had no significant difference from normal control, CD₄⁺, CD₈⁺ decreased significantly.

CONCLUSION: Serious immunological disturbances of T lymphocyte subsets exist in NAION patients.

Related research on strabismus situation during physical examination of cadet candidates

Chang-Liang Meng,Xiao-Ming Zeng and Jing Xu — 2013/4/7 15:27:40

AIM: To investigate the strabismus situation in Department of Ophthalmology during physical examination of cadet candidates, and to explore the factors that influence the properties of the short-term changes of strabismus.

METHODS:The exophoria and exotropia of 4 231 qualified students in China Southern Airlines were compared and analyzed with normal students vision and refractive degree distribution during 2008-2012.

RESULTS:The exophoria value, difference of binocular visual acuity and anisometropia was large, and visual fatigue easily lead to exophoria or external oblique.

CONCLUSION:During physical examination for students with the binocular visual acuity differences >0.4, exophoria anisometropia >2.00D and visual fatigue symptoms, we should check the three levels of visual function.

Analysis of the correlated factors to the therapy effect of the amblyopic children

Jiang-Shan Xu,Hong-Wei Wang and Kai Meng — 2013/4/7 15:27:40

AIM: To explore the correlated factors which may affect the therapeutic effect of amblyopic children.

METHODS:The therapeutic effect of 120 amblyopic children was retrospectively analyzed, then the relation between multivariate factors and the therapeutic effect with the logistic regression model was analysed.

RESULTS: The average curative time of the 120 amblyopic children were 22.15±6.20 months, 81 cases was basically cured, and 20 cases improved, after single element analysis there were 5 factors affecting the curative effect, multivariate logistic regression analysis showed that the independent risk factors were the older age of the child, parents lack of the knowledge of the amblyopia, the poor guidance of the teacher and the deficiency of the indoor illumination, OR=3.601, 3.366, 2.690, 2.563.

CONCLUSION: The independent risk factors which affect the curative effect are older age, parents lack of the knowledge of the amblyopia, the poor guidance of the teacher and the deficiency of the indoor illumination. For this we should take actions to enhance the level of the therapeutic effect.

Application of viscoelastic agents in the corneal laceration suturing technique

Yan Lu,Yin-Ping Ge,Yu Di,Xiao-Long Chen and He-Nan Liu

AIM: To investigate the effect of viscoelastic agents on the corneal laceration suturing.

METHODS:Totally 146 cases(146 eyes)of corneal laceration were randomly divided into experimental group and control group. Appropriate amount of viscoelastic agents were injected into anterior chamber during corneal laceration suturing for 73 cases of the experimental group. While, the stitching process without application of viscoelastic agent in 73 cases of the control group. Then observed the corneal astigmatism and the iris anterior synechia occurrence rate after operation in the two groups.

RESULTS:Iris anterior synechia occured in 2 cases(2.7%)of the experimental group, but in 26 cases(35.6%)of the control group, postoperatively.The difference of the iris anterior synechia occurrence rate between the two groups was significant(P<0.05). The postoperative average corneal astigmatism of the experimental group was(1.29 ± 0.25)D, of the control group was(2.43±0.39)D. The difference of the corneal astigmatism between the two groups was significant too(P<0.05), which means the experimental group was lower than the control group on postoperative corneal astigmatism.

CONCLUSION:Viscoelastic agents play a significant adjunct role during corneal laceration suturing,such as they can effectively separate the adhesions between intraocular tissue and wound, make the corneal suture more precisely and reduce postoperative corneal astigmatism and other complications, which is of benefit to visual function recovery.

The adhibition of injecting dexamethasone into the anterior chamber in anti-glaucoma with cataract surgery

Xiao-Yun Dong,Xiao-Wei Gao,Rui-Fu Wang,Dai-Kun Lei,Ying Liu and Chun-Li Xu

AIM: To observe the anti-inflammatory effectiveness of anterior chamber injection of dexamethasone for anterior uveitis following cataract extraction combined with anti-glaucoma surgery.

METHODS: Forty-six patients who received combination procedure of cataract extraction and anti-glaucoma from September 2008 to October 2010 were randomly divided into two groups: treatment group and control group. Each group had 23 patients. All patients were performed using combination procedure of cataract extraction and anti-glaucoma. During surgery, the treatment group received anterior chamber injection of dexamethasone(0.5mg). The control group was applied with anterior chamber injection of balanced salt solution(0.5mg). The myopia, aqueous flare,intraocular pressure(IOP)and corneal endothelium counter was measured 1 day, 3,7 days,1 month and 3 months after surgery.

RESULTS: At 1, 3 and 7 days after surgery, the aqueous flare in treatment group was significantly lower than control group(P<0.05). There was no aqueous flare at 1 month and 3 months after surgery. The intraocular pressure between two groups was not statistically different(P>0.05). Meanwhile, no significant difference was found between two groups when determined the corneal endothelium counter.

CONCLUSION: Dexamethasone can effectively inhibit the inflammatory reaction of anterior uveitis after cataract combination with anti-glaucoma surgery. No severe applications is found after anterior chamber injection of dexamethasone.In all, it was a safe and effective method.

Clinical observation of auxiliary equipment for phacoemulsification in treatment of hard nucleus cataract

Gang Tan,Zhe Song,Xue-Jie Qiu and Si-Yu Wang

AIM: To compare the effect of application of auxiliary equipment protection onphacoemulsification and conventional phacoemulsification in treatment of hard nucleus cataract.

METHODS: Totally 87 cases(115 eyes)Ⅳ-Ⅴ nuclear cataract were randomly divided into two groups. Forty-four cases(58 eyes)were in group A. In this group, auxiliary equipment(Chop hook)protection was used in ultrasonic emulsification. During the surgery, there was a slightly pause after the nuclear fragmentation was sucked by the phaco tip. Then the auxiliary equipment was placed between the nuclear fragmentation and the cornea, that was just located above the blocked nuclear. After that, the nuclear fragmentation was removed through phacoemulsification. Forty-three cases(57 eyes)were in Group B, which was treated with traditional phacoemulsification. Visual acuity, corneal edema, the loss rate of corneal endothelial cell, intraoperative ultrasound emulsification time, intraoperative and postoperative complications were compared between the two groups at 1 day, 3 days and 1 month after operation.

RESULTS: One and 3 days after operation, the rate of vision recovery in group A was faster than that in group B(P <0.05). One month later, there was no statistical difference between the two groups in vision. At 3 days and 1 month after operation, the corneal endothelial cell loss rate between the two groups was significantly different(P <0.05). The complications of intraoperative and postoperative had no significant difference between the two groups(P >0.05).

CONCLUSION: Application of auxiliary equipment during the process of phacoemulsification is safer than conventional phacoemulsification.

Effect observation of 810nm laser cyclophotocoagulation for refractory glaucoma

Yu Di,Dong-Hai Gui,Qing-Zhu Nie,Chun-Liu Gai,Hong-Wei Yang and Xiao-Long Chen

AIM: To investigate the therapeutic effects of transscleral cyclophotocoagulation procedures(TCP)with 810nm laser for refractory glaucoma.

METHODS: Totally 25 patients(30 eyes)with refractory glaucoma were treated with TCP. The follow-up time was 3 months, the patients' symptom, intraocular pressure(IOP), visual acuity and complications were analyzed.

RESULTS: During the follow-up period, all patients' ocular pain was reduced. The mean IOP before TCP and at the last follow-up time were(50.42±2.50)mmHg(1kPa=7.5mmHg)and(15. 95±4.19)mmHg, respectively, the IOP decreased after TCP, there was significant difference(P<0.001). After TCP, the visual acuity improved in 2 eyes(6.7%), had no change in 24 eyes(80.0%), decreased in 4 eyes(13.3%). After TCP, the exudation of anterior chamber appeared in 12 eyes(40.0%), hyphema of anterior chamber appeared in 3 eyes(10.0%), vitreous hemorrhage in 1 eye(3.3%), which were all cured after drug treatment.

CONCLUSION: TCP with 810nm laser in treatment of refractory glaucoma has curative effect, can degrade the IOP, lessen ocular pain and with few complications.

Clinical study on the management of chronic angle-closure glaucoma by phacoemulsification for cataract surgery combined with lysis of the synechiae

He Cheng and Yue-Lan Zou

AIM: To investigate the clinical effect and indication of phacoemulsification combined with lysis of the synechiae in the management of chronic angle-closure glaucoma with cataract.

METHODS: The 32 patients were treated by phacoemulsification combined with lysis of the synechiae. The preoperative and postoperative intraocular pressure, visual acuity, anterior chamber depth, configuration of anterior chamber were compared; the postoperative complications were observed.

RESULTS: The mean postoperative follow-up duration was 6 months to 2 years. The best-corrected visual acuity was improved in all eyes. The intraocular pressure was reduced from15.2±8.1mmHg to 11.2±5.0mmHg, the difference had statistical significance(t=3.126, P<0.01). The central anterior chamber deepened from 2.22±0.39mm preoperatively to 3.36±0.43mm postoperatively, the difference had statistical significance(t=-14.371, P<0.001). The chamber adhesion range reduced. The serious complications did not happened.

CONCLUSION: Phacoemulsification combined with goniosynechialysis is an effective and safe treatment for primary chronic angle-close glaucoma with cataract.

Treatment choice of different stages for neovascular glaucoma

Shao-Wu Tao,Hui Li,Jing Li,Xiao-Jing Liu,Zhi-Hong Zhang and Zhi-Lan Pang

AIM: To investigate the treatment choice of different stages for neovascular glaucoma(NVG).

METHODS: The case information of 123 eyes of 116 NVG patients were analyzed and summarized retrospectively, according to different stages of NVG.

RESULTS: At the first stage, of the 17 eyes performed panretinal photocoagulation, the new vessels of 16 eyes were disappeared. At the second stage of 57 eyes, the new vessels of 17 eyes disappeared after panretinal photocoagulation. Of 26 eyes performed panretinal photocoagulation and trabeculectomy, the IOP of 23 eyes were fully controlled. Of 9 eyes performed vitrectomy and panretinal photocoagulation and trabeculectomy, the IOP of 8 eyes were fully controlled. All 5 eyes performed glaucoma drainage implant placement appeared fully controlled. At the third stage of 49 eyes, of 3 eyes performed glaucoma drainage implant placement, the IOP of 2 eyes were controlled. Of 38 eyes performed pan-peripheral retinal cryotheraphy and cyclocryotherapy and trabeculectomy, the IOP of 29 eyes were controlled.

CONCLUSION: From the view of NVG different stages, the individual treatment should be performed according to various clinical characteristic.

Clinical features and PDT effect of patients with CCSC

Ya-Dong Wang and Andrew Chang

AIM: To review the clinical features and photodynamic therapeutic effect of patients with chronic central serouschorioretinopathy(CCSC).

METHODS: Fifteen eyes of eleven patients diagnosed as CCSC were treated with photodynamic therapy(PDT), whose clinical data were retrospectively reviewed. The best-corrected visual acuity(BCVA), fundus fluorescein angiography(FFA), indocyanine green angiography(ICGA), optic coherence tomography(OCT)and fundus autofluorescence(FAF)before and after PDT were compared to evaluate therapeutic efficiency and safety of PDT on CCSC. The mean follow-up time was 10 months.

RESULTS: Mean age of the patients was 46.72±8.10 years. Mean duration of CCSC before PDT was 21.1±16.65 months. The mean log MAR BCVA at baseline was 0.50±0.22. The area of activefluorescein leakage was 1.27±1.45mm². Five eyes had leakage points within or near the foveal area, and 8 eyes had diffuse retinal pigment epithelium(RPE)decompensation with multiple window defect and multifocal leakage. ICGA revealed dilated choroid- capillaries and choroid hyperpermeability near the active leakage sites. Serous detachments of neurosensory retina were observed in 15 eyes on OCT, of which 7 eyes associated with RPE detachments. The mean foveal thickness was 297.27±107.23μm. Abnormal FAF alterations were detected in the area of retinal detachments and decompensation of RPE. After PDT treatment, the mean log MAR BCVA was 0.73±0.30 with significant improvement compared with before treatment(P<0.05). The mean area of fluorescein leakage was 0.05±0.12 mm²with statistically significant less compared with before PDT(P<0.05). The central foveal thickness decreased from 297.267±107.228μm to 173.733±38.944μm(P<0.05). The average time for absorption of subretinal fluid was 4.60±3.906 months. No serious adverse events were observed in treatment process and during the follow-up period.

CONCLUSION: Clinical features of CCSC include older age at onset and longer duration. Persistent serous retinal detachment of macular and diffuse decompensation of RPE may lead to permanent photoreceptor damage, consequently resulting in severe and irreversible visual loss. PDT with verteporfin could influence choroid vascular hyper-perfusion or hyper-permeability and help RPE to recover its normal structure and function, and thus facilitate the absorption of subretinal fluid and increased mean BCVA in eyes with CCSC, which provided an effective and safe treatment option for patients with CCSC.

Therapy of the serous neurosensory detachment caused by CCSC by using subthreshold TTT

Jing Yan,Tao Yan and Li Yan

AIM: To report the effects of subthreshold transpupillary thermotherapy(TTT)on the subsequent serous neurosensory detachment of chronic central serous chorioretinopathy(CCSC).

METHODS: Thirteen eyes of 10 CCSC patients who have been suffered serous neurosensory detachment for at least six months were treated with subthreshold TTT by using 810nm diode laser. Lesion changes have been compared via ophthalmic examination, angiography and OCT. The comparative study of the best corrected visual acuity(BCVA)was conducted under self-control method.

RESULTS: The average treatment of each patient by TTT was(1.23±0.44). All patients were followed up for 6 months. Before treatment, visual acuity was 0.05-0.4(0.16±0.10), and after treatment the vision was 0.05-0.8(0.35±0.21). The difference of visual acuity was statistically significant(P<0.05). No leakage of fluorescent dyes of FFA after treatment. No obvious choroidal permeability increase was noticed. The treatment-related side effects were not found in the treatment area.

CONCLUSION: The subthreshold TTT has obvious therapeutic effect on sustained neural epithelium detachment CCSC while there is no significant complications.

Analysis on effects and prognostic factors of laser photocoagulation for retinopathy of prematurity

Wen-Li Dong,Zong-Hua Wang,Yan Zhang and Yao-Yu Li

AIM: To observe the clinical effects of laser photocoagulation for retinopathy of prematurity(ROP)and to identify the potential risk factors for the unfavorable outcomes.

METHODS: Forty-six ROP infants(89 eyes)underwent laser photocoagulation were analyzed retrospectively. Among the 89 eyes, 57 eyes were type I pre-threshold and 32 eyes were threshold disease. Laser photocoagulation with 810nm wavelength using binocular indirect ophthalmoscope was performed in all the infants. While changes of ROP and retinal structural outcome after laser treatment were to be followed up. The results were divided into regressed group and progressed group. The relationships between anatomical outcome changes and localization of lesions, occurring in course of ROP, number of laser spots, ventilation need, sepsis, pneumonia of newborn et al were analyzed.

RESULTS: In the 89 eyes, ROP regressed completely in 79(89%), unfavorable structural outcomes were observed in 10(11%). The difference in birth weight(P=0.495), gestational weeks(P=0.668), age at laser photocoagulation(P=0.143)were not statistically significant between the two groups. Zone I disease(P=0.035), threshold disease(P=0.017), aggressive posterior ROP(P=0.000)and number of laser spots(P=0.031)in progression group were more than regressed group, the difference were statistically significant. Logistic regressive analysis indicated that aggressive posterior ROP(OR=12.167, 95% CI: 2.733-54.154, P=0.001)emerged as primary risk factors for anatomical outcome after laser treatment.

CONCLUSION: Laser photocoagulation is an effective approach to treat type I pre-threshold and threshold ROP. Aggressive posterior ROP is closely related to prognosis after laser treatment, which is easier to reach retinal detachment than other ROP.

Significance of contrast sensitivity for diabetic retinopathy between the stage of pan retinal photocoagulation

Xiao-Dong Li,Wei-Hua Liu and Wei-Zhong Ge

AIM: To explore the significance of contrast sensitivity(CS)for diabetic retinopathy(DR)between the stage of pan retinal photocoagulation(PRP).

METHODS: A total of 49 case(87 eyes)of DR was divided into three stages by the fundus fluorescein angiography(FFA), the first group was the stage of non-proliferative diabetic retinopathy(NPDR)(25 eyes), the second group was the stage of pre-proliferative diabetic retinopathy(PPDR)(27 eyes), the third group was the stage proliferative diabetic retinopathy(PDR)(35 eyes). 532nm laser was used to have PRP for the PPDR and PDR groups, and retreated for 3-4 times, the CS and eye sight was performed around the stage of PRP.

RESULTS: After the laser, the eye sight was increased in 22 eyes, decreased in 6 eyes and unchanged in 34 eyes. There were significant differences around the stage of PRP in CS. The differences in middle and high frequency were significant(P<0.05)between the control group and the laser group before PRP. After PRP, low and middle frequency had no significant difference(P>0.05)between PPDR and control group, and each frequency had significant difference(P<0.05)between PDR and control group.

CONCLUSION: CS is an important method of evaluation of the changes the DR, and can become the guiding and proof of PRP in the treatment of DR.

Relationship between serum vitamin D levels and diabetes retinopathy in type 2 diabetes mellitus patients

Yan-Ni Zhu,Guo-Jin Zuo,Qi Wang and Yan-Hua Zhu

AIM: To evaluate the relationship between serum vitamin D levels and diabetes retinopathy(DR)in patients with type 2 diabetes mellitus(T2DM).

METHODS: Totally 360 T2DM patients were chosen. Serum 25-(OH)D₃and 1,25-(OH)₂D₃ were measured by radioimmunoassay. All patients were divided into 3 groups according to the serum 25-(OH)D₃ level quartile, group L(the lowest quartile, serum 25-(OH)D₃<14.3ng/mL, n=87), group M(the middle two quartiles, serum 25-(OH)D₃≥14.3ng/mL, and serum 25-(OH)D₃<19.4ng/mL, n=176)and group H(the highest quartile, serum 25-(OH)D₃≥19.4 ng/mL, n=89). Then the patients of group L were randomly divided into Group L1 which received routine drug treatment without VitD and Group L2 with VitD treatment. Serum and 25-(OH)D₃, 1,25-(OH)₂D₃, calcium(Ca), phosphorus(P), Parathyroid Hormone(PTH)were measured at the experiment onset and at the end of follow-up visit. The new DR morbidity was calculated, too.

RESULTS: At the end of follow-up visit, serum 25-(OH)D₃,1,25-(OH)₂D₃ and Ca levels in Group H, M, L1 were all decreased compared with their own levels at the experiment onset(P<0.05), and serum P and PTH levels were increased(P<0.05). The above indexes disorder get improved in Group L2 at the end of follow-up visit(P<0.05). The lower serum 25-(OH)D₃ level, the higher DR morbidity(Group H, M, L1 13.48%, 21.59%, 45.45% respectively, P<0.05), Once Vitamin D treatment, the DR morbidity get decreased(18.6% vs 45.45%, P<0.05).

CONCLUSION: Serum 25-(OH)D₃ level is an risk factor of T2DM morbidity, and vitamin D treatment can reduce the DR morbidity in type 2 diabetic patients.

Polypoidal choroidal vasculopathy

Xue-Wei Bai,Hui-Ping Li and Xun-Lun Sheng

AIM: To explore the clinical feature of polypoidal choroidal vasculopathy(PCV)which would provide the basis for treatment and prognosis of PCV, according to the classification of indocyanine green angiography(ICGA)image, combined with fundus and optical coherence tomography(OCT)examination.

METHODS: Retrospective analysis of 33 PCV patients, who were diagnosed in Ningxia Eye Hospital with OCT, fundus fluorescein angiography(FFA)and ICGA. Comprehensive analysis the classification of PCV which were based on the ICGA image, and take the feature of PCV lesion into consideration.

RESULTS: Thirty-three PCV patients(54 eyes)were collected, 12 patients(36%)had monocular disease and 21 patients(64%)had binocular lesion. There were 20 male(61%)and 13 female(39%)included in the study. The age was raged from 42-86 years old and the average age was 70.63±9.42 years old. Forty-five eyes(83%)PCV lesion was located in macular area. Three types of PCV were classified according to ICGA image: polyps expansion type(20 eyes, 37%), abnormal branching vascular network type(16 eyes, 30%)and classical type(18 eyes, 33%). Twenty-seven eyes(50%)were suffered from pigment epithelial detachment(PED). The abnormal branching vascular network type(11 eyes, 68.8%)and classical type are(12 eyes, 66.7%)was more likely to suffer from PED. Twenty-three eyes(43%)have retinal neuroepithelium layer detachment including 10 eyes(62.5%)of abnormal branching vascular network type and 9 eyes(50.0%)of classical type. Thirty-one eyes(57%)shows active status 81.3% of abnormal branching vascular network type and 72% of classical type shows active status. Ten eyes(19%)appear fibrous membrane totally, including 7 eyes(43.8%)of branching vascular network type and 2 eyes(11.1%)of classical type. Thirty-seven eyes(69%)have nourishing vessels totally. Eighty-one percent of abnormal branching vascular network type and 94% of classical type have nourishing vessels.

CONCLUSION: The subtype of PCV such as branching vascular network type and classical type is apt to be active, the PED, retinal neuroepithelium layer detachment and nourishing vessels are more likely to appear in this two subtype rather than in the polyps expansion type, which always tend to be motionless. The branching vascular network type is easily to have fibrous membrane.

Study of liangxue huayu in treatment of CNV in exudative age-related macular degeneration and expression of CCR3 on peripheral blood mononuclear cells

Yan-Hong Hu,Ming-Xin Qi and Sheng Chen

AIM: To compare the expressions of CCR3 on T lymphocytes and/or eosinophil peripheral blood cell surface before and after liangxue huayu in treatment of choroidal neovascularization(CNV)in exudative age-related macular degeneration(AMD)and explore the mechanism of the incidence of CNV on exudative AMD.

METHODS: Totally 32 cases of exudative AMD patients, 44 cases of atrophic AMD patients and 50 healthy subjects were observed. 32 cases of exudative AMD patients were treated by liangxue huayu decoction and the expressions of CCR3 on T lymphocytes and/or eosinophil peripheral blood cell surface were detected by flow cytometry.

RESULTS: The expressions of CCR3 on T lymphocytes and/or eosinophil peripheral blood cell surface of the patients with exudative AMD were higher than the control group of healthy people(P<0.01); The expressions of CCR3 on T lymphocytes and/or eosinophil peripheral blood cell surface were no significant difference between the patients with atrophic AMD and the control group of healthy people(P>0.05); The expressions of CCR3 on T lymphocytes and/or eosinophil peripheral blood cell surface were no significant difference after liangxue huayu on treatment of CNV on exudative AMD(P>0.05).

CONCLUSION: The CNV formation of exudative AMD may be related to the higher expressions of CCR3 on T lymphocytes and/or eosinophil cell surface. Liangxue huayu decoction is effective in treating exudative age-related macular degeneration CNV, but it is not related with the expression of CCR3.

Clinical observation on combination of two kinds of silicone tubes implantation for treatment of acute dacryocystitis

Shi-Hua Zhang,Na Li,Xiang-Zhou Xu and Shu-Hong Cai

AIM: To discuss the feasibility and clinical efficacy of combination of two kinds of silicone tubes implantation for treatment of acute dacryocystitis.

METHODS: Totally 63 eyes, suffering from acute dacryocystitis, were chosen from Huizhou First Hospital, and were randomly divided into two groups: group A(42 eyes)and group B(21 eyes). In group A, patients were implanted two kinds of silicone tubes to expand both superior and lower lacrimal passage after irrigation and anti-inflammatory therapy, and silicone tubes were removed 3-6 months later. Patients in group B were performed dacryocystorhinostomy after combination of surgical incision and drainage and anti-inflammatory therapy. All cases were then followed a clinical follow-up for 6-12 month, given irrigation of lacrimal passage regularly. We did statistical analysis to compare the effects and complications of two groups by way of Kruskal-Wallis Test or Chi-square test.

RESULTS: The effective standard was based on anatomical structure and function of lacrimal abscess. Results showed that complete remission rate in group A was significantly higher than that in group B, while failure rate in group A was significantly lower than that in group B, and complication rate in group A was significantly lower than that in group B, P<0.05.

CONCLUSION: Combination of irrigation of lacrimal passage and two kinds of silicone tubes implantation were effective to cure acute dacryocystitis, significantly better than traditional therapy, by which we can recover anatomical structure and function of lacrimal passage quickly, showing good long-term results.

Toric intraocular lens versus peripheral corneal relaxing incisions to correct astigmatism in eyes having cataract surgery

Wei-Min Tang,Qin-De Chen,Xuan-Wei Liang and Zhong-Hao Wang

AIM: To compare phacoemusification combined Toric intraocular lens implantation(Toric-IOL)with spherical intraocular lens implantation combined peripheral corneal relaxing incisions(PCRIs)for astigmatism correction in elderly patients before having cataract surgery.

METHODS: This randomized prospective clinical study comprised eyes with more than 0.75 diopter(D)of preexisting corneal astigmatism. Totally 54 patients(54 eyes), 27 males and 27 females, with mean age 70.04±9.08 years, were enrolled consecutively to group A(n=30)(0.75D-1.50D)and group B(n=24)(1.75D-2.50D)according to the corneal astigmatism. In each group patients were randomized to undergo Toric-IOL implantation or PCRLs in the steep axis with spherical IOL implantation. Uncorrected visual acuity(UCVA), best-corrected visual acuity(BCVA), error of vector(|EV|), surgery induced refraction correction(|SIRC|)and correction rat(CR)were measured 1 month and 6 months postoperatively.

RESULTS: Six months postoperatively, all 54 eyes got the BCVA≥0.6. Patients underwent PCRIs and Toric-IOL with BCVA≥0.8 were 86.7% vs 93.3%(P>0.05)in group A and 75% vs 91.7%(P=0.59)in group B respectively. UCVA, |EV|, |SIRC| and CR in patients underwent PCRIs and Toric-IOL were not significantly different by 0.70±0.21 vs 0.76±0.17(P=0.81), 0.48±0.22 vs 0.37±0.19(P=0.13), 0.87±0.30 vs 0.92±0.38(P=0.71),0.75±0.16 vs 0.78±0.19(P=0.56)respectively in group A; It were significantly different by 0.50±0.15 vs 0.78±0.11(P<0.01), 1.17±0.36 vs 0.54±0.33(P<0.01), 1.08±0.27 vs 1.68±0.32(P <0.01), 0.51±0.13 vs 0.81±0.14(P <0.01)respectively in group B. Difference of UCVA and |EV| between 1 month and 6 months were not significant in patients in group A, but were significant in group B, regardless of PCRIs or Toric-IOL surgery. In group A,UCVA and |EV| measured 1 month and 6 months post-operation were 0.77±0.23 vs 0.70±0.21(P=0.09),0.50±0.23 vs 0.48±0.22(P=0.58)respectively in PCRIs patients and 0.77±0.223 vs 0.76±0.17(P=0.81), 0.40±0.18 vs 0.37±0.19(P=0.55)respectively in Toric-IOL patients. In group B, UCVA and |EV| measured 1 month and 6 months post-operation were 0.63±0.17 vs 0.50±0.15(P<0.01), 0.81±0.34 vs 1.17±0.36(P<0.01)respectively in PCRIs patients and 0.81±0.12 vs 0.78±0.11(P=0.08), 0.48±0.31 vs 0.54±0.33(P<0.01)respectively in Toric-IOL patients.

CONCLUSION: Toric-IOL implantation and PCRIs were both safe and effective for astigmatism correction in elderly patients before having cataract surgery. The efficacy and stability of astigmatism correction were equal in low astigmatic patients. Toric-IOL implantation achieved an enhanced effect over PCRIs in higher astigmatic patients. Both of the surgeries had the refractive regression after 6 months and PCRIs regressed more obviously.

Clinical evaluation of bromfenac ophthalmic solution for postoperative pain after photorefractive keratectomy

Zheng-Jun Fan

AIM: To evaluate the effectiveness of bromfenac ophthalmic solution for easing postoperative pain after photorefractive keratectomy(PRK).

METHODS: In a prospective randomized clinical trial, 60 patients underwent PRK. In addition to a standard regimen of topical antibiotics and topical steroids, 30 patients(the trial group)were treated withbromfenac ophthalmic solution twice daily from 3 days before surgery through 5 days after surgery. The other 30 patients(the control group)were treated with profenac ophthalmic solution four times daily from 3 days before surgery through 5 days after surgery. Patients completed a maximum pain assessment survey during the 5 days after surgery using the following 0-4 pain scale: 0=no pain, 1=mild pain, 2=moderate pain, 3=severe pain, 4=severe pain requiring immediate treatment.

RESULTS: The Mann-Whitney test showed a statistically significant difference between the bromfenac group and the control group in maximum pain score(P<0.05). However, all patients reported a pain assessment score below 2, with the exception of 3 patients in the control group who reported a score of 3.

CONCLUSION:Bromfenac ophthalmic solution is a reasonable analgesia for postoperative pain after PRK.

Analysis of affecting factors for treatment outcome in fungal keratitis

Bin-Hui Li,Guang-Ming Jin,Xiao-Jing Zhao,Ai-Ming Chen,Xing-Mei Zhu and Qin Li

AIM: To investigate the affecting factors that can serve as prognostic indicators of treatment outcomes, providing the first hand information for decision-making in therapy of fungal keratitis.

METHODS: Totally 105 cases(105 eyes)with fungal keratitis were enrolled, characteristics at diagnosis, laboratory examinations and treatment responses were analyzed statistically to estimate the relative risk of the main prognostic variables.

RESULTS: Among the 105 cases analyzed in the study,49 eyes(46.7%)were successfully cured, 30 eyes(28.6%)had slow-healing ulcers and 26 eyes(24.8%)were refractory to primary treatment.

CONCLUSION: The predictors of treatment failure are antifungal therapy begin at more than 7 days after symptoms appeared, ulcers that exceeded 16 mm², the presence of hypopyon that more than 2 mm and identification of Fusarium.

Clinical observation of primary angle-closure glaucoma and cataract underwent phacoemulsification

Jia Yu,Lei Shi,He-Nan Liu and Qi-Meng Li

AIM: To study the clinical efficacy of phacoemulsification and intraocular lens implantation for cataract patients with different angle-closure degree of angle-closure glaucoma.

METHODS: There were 31 patients 35 eyes who were with angle-closure glaucoma and cataract. According to the degree of angle closure adhesions, they were divided into groups A, B. Group A(the angle closure adhesions ≤ 90 °)had 19 eyes, group B(the angle closure adhesions 90° -180°)had 16 eyes. Phacoemulsification and intraocular lens implantation were performed for both groups. The preoperative and postoperative visual acuity, intraocular pressure(IOP), anterior chamber depth, angle changes and the length of the axial length, lens thickness, vitreous length in the two groups were observed and statistically analyzed.

RESULTS: The angle-closure glaucoma with cataract patients' visual acuity was improved and the angle deepened. Gonioscopy: The number of fully open angle was 16 in the group A(84%). And in the group B, completely open angle was 13 eyes(81%). The difference of A and B was not statistically significant(P>0.05). IOP: preoperative IOP was 35.13± 4.18mmHg in A, and in B was 45.01±5.31mmHg. After 1 week, IOP in group A was controlled in 14.25 ± 3.22mmHg and group B was 14.30±3.19mmHg, there was no statistical significance(P>0.05).

CONCLUSION: Positive relationship exists between the proportion of axial length, lens thickness and vitreous length. For angle-closure glaucoma with cataract patients, a simple surgery of the phacoemulsification can effectively treat angle-closure adhesions ≤ 180 °, and for patients with angle-closure adhesions> 180 °, the joint treatment of glaucoma surgery can be considered.

Clinical observation of phacoemulsification in treatment of angle-closure glaucoma with cataract

Jing Chen,Feng-Nian Luo,Gang Du and Lei Zhang

AIM: To evaluate the effect of phacoemulsification with posterior chamber intraocular lens(PCIOL)implantation for primary angle-closure glaucoma with cataract.

METHODS: Totally 39 cases(45 eyes)of angle-closure glaucoma with cataract were performed on phacoemulsification with PCIOL implantation. The visual acuity, intraocular pressure(IOP), anterior chamber depth(ACD)and chamber angle were observed postoperatively. All cases were followed up for 3 to 24 months.

RESULTS: The best-corrected visual acuity improved in all patients and 33 eyes(73%)≥0.5. The mean IOP was significantly decreased(P<0.01), the mean ACD was significantly increased(P<0.01), and the anterior chamber angles were wider postoperatively.

CONCLUSION: Phacoemulsification with PCIOL implantation is effective and safe for primary angle-closure glaucoma with cataract. It can decrease the IOP, increase ACD and widen anterior chamber angles significantly.

Injector implantation of sutured intraocular lens in the absence of capsular support via small-incision surgery

Yan Lu,Yu Di,Xiao-Long Chen,He-Nan Liu and Hong-Wei Yang

AIM:To evaluate the safety and efficacy of a modified technique for transscleral fixation of a foldable posterior chamber intraocular lens(IOL)in the absence of capsule support.

METHODS: Scleral fixation of a foldable IOL was performed by using a new small incision technique with injector implantation system via 3.2mm clear corneal incisions in 52 eyes of 52 patients who can not be normally implanted posterior chamber IOL because of posterior capsule rupture or suspensory ligament fracture. Postoperative visual acuity, corneal astigmatism and complications were observed in 6 months follow-up.

RESULTS: Postoperative uncorrected visual acuity improved in all patients, of which more than 1.0 in 8 eyes, 0.6 to 0.8 in 18 eyes, 0.4 to 0.6 in 16 eyes, less 0.4 in 10 eyes. Postoperative uncorrected visual acuity was at least 0.5 in 33 eyes(63%), 39 eyes(75%), 41 eyes(79%)at postoperative 1 week, 1 month, 3 months respectively. There was no significant difference in corneal astigmatism guided by corneal topography between preoperative and postoperative(P>0.05). During follow-up, the IOL was correctly positioned in all cases. There were no major complications, such as endophthalmitis or suture erosion through the conjunctiva at the site of fixation. No patient required further surgical interventions.

CONCLUSION: This modified technique of transscleral fixation of foldable posterior chamber IOL offers the advantages of a small incision and rapid visual rehabilitation, and minimizes the risk of intraoperative and postoperative complications.

Efficacy of phacoemulsification and intraocular lens implantation in diabetic cataract

Mei Sun

AIM: To analyze the effect of phacoemulsification and intraocular lens implantation for the treatment of diabetic cataract.

METHODS:Totally 65 cases 98 eyes of diabetic patients with phacoemulsification and intraocular lens implantation were retrospectively observed. Statistics analysis including visual acuity of 1 day, 30 days after surgery, complications, and the correlation between visual acuity and the duration of diabetes.

RESULTS: On the 1^st day after surgery, uncorrected visual acuity> 0.5 in 69 eyes(70.4%), 0.3 to 0.5 in 18 eyes(18.4%), 0.1 to 0.25 in 8 eyes(8.2%), and <0.1 in 3 eyes(3.1%). While on the 30^th day after surgery, visual acuity> 0.5 in 80 eyes(81.6%), 0.3 to 0.5 in 12 eyes(12.2%), 0.1 to 0.25 in 4 eyes(4.1%), <0.1 in 2 eyes(2.0%). Complications included corneal edema, anterior chamber fibrin exudation, synechia and secondary glaucoma.

CONCLUSION: Phacoemulsification and intraocular lens implantation for the treatment of diabetic cataract is safe and effective. The recovery of visual acuity is relative to the duration of diabetes and diabetic retinopathy.

Analysis of surgical treatment of traumatic anterior chamber hemorrhage and secondary glaucoma

Hai-Jia Xu,Zhuo Chen and Bi-Hua Xie

AIM: To analyze the use of different surgical methods for traumatic hyphema with secondary glaucoma patients, depending on the condition.

METHODS: Out of 63 cases 63 eyes, 18 cases 18 eyes underwent the scleral tunnel incision + transparent cornea auxiliary incision cataract aspirating needle manually suction lavage; 32 cases and 32 underwent self-closed clear corneal incision phacoemulsification infusion pumping aspiration; 13 cases and 13 underwent trabeculectomy.

RESULTS: In the 63 cases 63 eyes, visual acuity of 9 cases 9 eyes was more than 1.0, accounting for 14.3%; of 13 cases 13 eyes was 0.6 to 0.8, accounting for 20.6%; of 11 cases 11 eyes was 0.4-0.5, accounting for 17.5%; of 8 cases 8 eyes was 0.3, accounting for 12.7%; of 7 cases 7 eyes 0.2, accounting for 11.1%; of 5 cases 5 eyes was 0.15, accounting for 7.9%; of 3 cases 3 eyes was 0.1, accounting for 4.8%; of 3 cases 3 eyes was 0.01-0.05, accounting for 4.8%; of 2 cases 2 eyes was finger counting, accounting for 3.2%; of 2 cases 2 eyes was hand motion, accounting for 3.2%.

CONCLUSION: Anterior chamber hemorrhage patients, according to how much of the plot of blood volume, blood clot, the size of the cohesion of the anterior chamber, intraocular tissue injury severity, complications, respectively, using different surgical methods can receive different surgical effect. In particular, rational application of intraoperative viscoelastic agents play a very important role in improving the success rate of surgery to reduce postoperative complications.

Long-term effect evaluation of the hormone shock therapy for idiopathic demyelinated optic neuropathy

Yuan Zhao,Xiao-Hu Chen,Xiao-Li Wang,Min Yu,Ran Zhang and Xiao-Juan Zhao

AIM: To determine the long-term effect of methylprednisolone's shock therapy in idiopathic demyelinated optic neuropathy.

METHODS: The data of 81 cases(104 eyes)diagnosed with idiopathic demyelinated optic neuropathy were retrospectively analyzed. The cases were divided into group A and group B. Group A were applied methylprednisolone to aid in trophic nerve and expansion blood vessels' drug therapy, group B were applied only trophic nerve and expansion blood vessels' drug therapy. The two group's eyesight, visual field and visual evoked potential's change and recurrence rate were observed after 1 year, 2, 5 years respectively.

RESULTS: There was no significant difference of eyesight improvement, vision improvement and visual evoked potential recovery between two groups at each observation time point(P>0.05). From the beginning of this disease till five years, group A's recurrence rate was been much lower than group B. There was statistical significant difference(P<0.05).

CONCLUSION: The methylprednisolone's shock therapy can reduce the recurrence of the patients.

A contrastive study of laser ablation and mechanicalepilation in treating trichiasis

Li-Hui Wen,Xu Chen,Jun Wang and Lei Zhan

AIM: To probe the effect and safety of laser ablation for minor trichiasis through the contrastive study on the effect of laser ablation and mechanical epilation in trichiasis.

METHODS: Totally 59 cases(80 eyes)of minor trichiasis(less than 10)patients were involved. The phalangosis was divided into two areas according to the patient's nasal side and bitamporal and then were practiced laser ablation and mechanical epilation to them. Post-operative stimulating sign of the two areas, eyelid fovea, skin depigmentation and trichiasis recurrence were recorded and observed. Traditional treatment was practiced to those trichiasis recurrences and they were observed for half a year.

RESULTS: The success rate of first-time laser ablation intrichiasis was 62.1% and second-time treatment was up to 88.9%, while for the mechanical epilation in trichiasis it was 5.3% and 8.2% respectively. Because of its high reoccurrence rate, after two times of mechanical epilation in trichiasis, the patients received laser ablation. After receiving laser ablation, there were no red and swollen sign, no eyelid fovea and no skin depigmentation.

CONCLUSION:Mechanical epilation has a high recurrence rate in trichiasis while laser ablation has a much lower recurrence rate and has much less complications. So laser ablation is an ideal treatment for the minor trichiasis.

Research on the improved fibrin adhesive in pterygium surgery

Xiao-Lan Lai,Hong-Wei Deng,Xiao-Ming Yao,Ming Li and Wen-Jing Tan

AIM: To observe the application of bioadhesive fibrin adhesive and epidermal growth factor( EGF)instead of the conventional sutures in the ocular pterygium surgery.

METHODS: Totally 78 eyes in 60 cases of pterygium patients were divided into 2 groups according to the limbal violations range. Group A for the range of less than 1/2, a total of 28 cases, 34 eyes; Group B was greater than or equal to the range of 1/2, with a total of 44 eyes in 32 cases; each group was randomly divided into two groups A1, A2, B1, B2, one using absorbable sutures, the other using the improved adhesive fibrin paste method. The operation time, post-operative pain sensation, recurrence rate, and the ocular surface epithelial healing time were compared between the four groups.

RESULTS: The operation time between the group A1 and A2, B1 and B2 had significant differences(P<0.05). There was significant difference of pain assessment between the suture group and the fibrin paste group, the paste group was less pain feeling(P<0.05). The corneal epithelial healing were observed after 4 days and 6 days operation time, there was significant difference(P<0.05)of epithelial healing area in the fibrin paste group compared with the suture group. The recurrence rate during 6 months after operation was reduced in fibrin paste group, but there was no significant difference(P>0.05).

CONCLUSION:Using fibrin sealant compound in the pterygium surgery can relieve pain in patients, reduce inflammation, shorten the operation time, avoid the trouble feeling of suture after surgery, accelerate corneal epithelial healing, and reduce the relapse rate.

Clinical observation on dry eye after small incision extracapsular cataract extraction and intraocular lens implantation in patients with both diabetes and cataract

Shu-Yan Qin and Yi-Zhuang Li

AIM:To observe the difference of dry eye after small incision extracapsular cataract extraction and intraocular lens(IOL)implantation between patients with age-related cataract and patients with both diabetes and cataract.

METHODS:Seventy-five patients(78 eyes)who received small incision extracapsular cataract extraction in our hospital from January to December 2011 were divided into two groups: 35 patients(38 eyes)with age-related cataract in group A and 40 patients(40 eyes)with both diabetes and cataract in group B. The subjective complains of dry eye, tear break-up time, corneal fluorescein staining, Schirmer I test and the height of tear meniscus were measured preoperatively and 1 day, 1 week, 1 month and 3 months postoperatively respectively.

RESULTS:There was no significant difference between the two groups preoperatively(P>0.05). Compared with data before operation, the group A's subjective complains of dry eye increased and the mean tear break-up time reduced greatly at 1 day, 1 week postoperatively(P<0.05). They returned to their preoperative levels at 1 month and 3 month postoperatively(P>0.05). Compared with data before operation, the group B's subjective complains of dry eye increased and the mean tear break-up time reduced greatly at 1 day, 1 week and 1 month postoperatively(P<0.05). They returned to their preoperative levels at 3 month postoperatively(P>0.05). In the different time points after operation, the degree of subjective complains of dry eye were significantly more severe in group B than in group A, and the corneal fluorescein staining scores were significantly higher in group B than in group A(P<0.05).

CONCLUSION:The tear film stability of patients with both diabetes and cataract reduced in early stage after small incision extracapsular cataract extraction and intraocular implantation. Compared with patients with age-related cataract, patients with both diabetes and cataract recovered much more slowly. The subjective complains of dry eye were more obvious in patients with both diabetes and cataract, but they would disappear with the passage of time.

Influence factors of early postoperative low vision in diabetics after phacoemulsification

Kai Meng,Dan Liu,Jiang-Shan Xu and Lin Li

AIM: To study the influence factors of early low vision in diabetics after phacoemulsification.

METHODS:Totally 600 eyes which were performed diabetic cataract phacoemulsification combined artificial lens implantation from 2008 to 2011 in our hospital were involved into retrospective analysis, with the best-corrected visual acuity less than 0.3 as the standard. According to the 2002 international clinical classification of diabetic retinopathy(DR), subjects were divided into: group A with 237 eyes(no retinopathy), group B( non-proliferative phase of diabetic retinopathy, NPDR)363 eyes, group B was divided into: the mild NPDR 177 eyes, moderate NPDR 150 eyes, severe NPDR 36 eyes. The related cause factors of low vision were analyzed retrospectively.

RESULTS:Seven days after the surgery, the best-corrected visual acuity <0.3 were in 41 eyes(17.3%)of group A; 103 eyes(28.4%)of group B. There was no statistical significance between 2 groups(P<0.05). According to epidemiological methods, 5 factors which affected the early postoperative visual were analyzed. Multi-factor logistic regression analysis was used. The results of the 5 factors were given out as following, crystal nucleus hardness(OR=4.065,95% CI: 2.289-7.312); HbA1c(OR=3.781,95% CI:2.256-6.439); DR stage(OR=3.987,95% CI: 2.678-6.894); postoperative corneal edema(OR=1.089, 95% CI:1.017-1.072); age(OR=1.687, 95% CI:1.171-2.416). Then the 4 factors of low vision including crystal nucleus hardness, HbA1c, DR stage and postoperative corneal edema were analyzed using analysis of variance(ANOVA)(P<0.05), and the differences were statistically significant.

CONCLUSION: Crystal nuclear hardness,glycosylated hemoglobin, DR stage, the corneal edema are the influencing factors of early postoperative low vision of diabetic cataract.

Changes in visual function before and after laser photocoagulation of central serous chorioretinapathy

Yu Di,Dong-Mei Gui,Hong-Wei Yang and Xiao-Long Chen

AIM: To observe the clinical effect and visual function of laser in treatment of central serous chorioretinopathy(CSC).

METHODS: Totally 60 cases clinically diagnosed with CSC were randomly divided into laser treatment group and drug treatment group, 30 cases in each group.Visual acuity and changes of mfERG in two groups were observed, and patients were followed up for 6 months.

RESULTS: The treatment of vision effective rate in laser treatment group was 92.35% and after one month with no patient recrudesced. The treatment of vision effective rate in drug treatment group was 49.58% and the recurrence rate was 13.33%. mfERG showed the response densities of ring 2, ring 3, ring 4 and ring 5 areas in laser treatment group were significantly increased while the latencies of ring 4 of N1 wave and the latencies of ring 3, ring 4 and ring 5 of P1 wave were significantly different with drug treatment group(P<0.05).

CONCLUSION:Early treatment of CSC with laser can significantly improve visual function and recovery rate, prevent disease progression, and decrease the recurrence rate, especially at early stage of the disease.

Study of peripheral refraction with single-vision spectacle lenses in myopic children

Yu-Sen Dai,Dan-Dan Lin,Ping Lü,Hao Chen and Jun Jiang

AIM: To study the impact of wearing single-vision spectacle lenses(SVLs)on the refractive errors at the periphery of the retina in myopic children.

METHODS: It was a self-control study. Totally 48 children aged 10 to 15 years old were involved. Cycloplegic autorefraction from right eyes was measured using Grand Seiko WAM5500 infrared refractometer and the value was at 0° at the retinal central fovea, at 10°, 20°, and 30° in the temporal and nasal visual fields. Measurements were taken on each subject both while uncorrected and while wearing SVLs.

RESULTS: The mean spherical equivalent refraction of myopia children was -3.99±1.22D. Relative peripheral hyperopia defocus was found in horizontal visual field and increased with the increase of eccentricity. Relative peripheral hyperopic defocus increased when wearing spectacle correction, comparing with the uncorrected state(P<0.05). There was no statistical significance for J₁₈₀ and J₄₅ when compared wearing spectacle and uncorrected state.

CONCLUSION: Relative peripheral hyperopic defocus increased when wearing spectacle correction, comparing with the uncorrected state in myopia children. To improve the design of the lens based on the focus state of the peripheral retina may become the new ideas of myopia correction.

Clinical analysis of 183 cases with paralytic strabismus

Ying Zhang,Qing-Lan Kong,Jie Chen and Xiao Shi

AIM: To investigate pathogeny of paralytic strabismus, the patterns of paralytic extraocular muscles and effects of paralytic strabismus on binocular vision.

METHODS: A retrospective study was done in 183 patients with paralytic strabismus who underwent squint correction in our hospital from March 2009 to March 2012.

RESULTS: Of the 183 patients reviewed, the incidence of congenital paralytic strabismus was 80.87%, acquired paralytic strabismus accounted for 19.13%. In 77.60% of the cases, the causes could not be identified, followed by trauma accounted for 14.21%. Among all vertical strabismus the ratio of superior oblique palsy, inferior rectus palsy, superior rectus palsy, double elevator palsy, inferior oblique palsy, double depression palsy accounted for 81.19%, 8.26%, 6.88%, 2.29%, 0.92%, 0.46%, respectively. Among all horizontal strabismus the rate of extra rectus palsy was 54.17%, internal rectus palsy 45.83%. 28.92% of patients who were examined with synoptophore had binocular function.

CONCLUSION: Paralytic strabismus had complex causes. The most common paralytic extraocular muscle was superior oblique muscle. It has important effects on binocular vision. Therefore, surgical treatment should be carried out as early as possible.

Assessment study on quality of life for thyroid associated ophthalmopathy patients with SQOL-DV1

Peng-Xiang Yao,Xue-Liang Xu,Hai-Bo Jiang,Qi Hou and Yan Liu

AIM:To evaluate the validity, reliability and responsiveness of the quality of life scale which measures the quality of life for Chinese patients with visual impairment(SQOL-DV1)when it was used to assess the quality of life(QOL)in thyroid associated ophthalmopathy(TAO)patients.

METHODS:SQOL-DV1 was used to evaluate the QOL of 39 cases with TAO and 31 healthy people as the control group, and then it was analyzed that if the scale can be accurately and effectively assess the quality of life of the TAO patients.

RESULTS:Validity analysis: 1. content validity test. The correlation coefficient between each sub-score was about 0.62 - 0.80(P= 0.00), the correlation coefficient between sub-score and total score was about 0.88-0.89(P= 0.00). 2. Discriminant validity test. The degree scores in patients with TAO were lower than the control group in symptoms and visual function, physical function, social activities, spiritual and psychological of the sub-item scores and scale's total scores(P<0.05). Quality of life scale scores were significantly increased by the treatment(P<0.05). Reliability analysis: 1.The test-retest reliability. The correlation coefficient of repeated measurements was about 0.913(P= 0.00). 2. The Cronbach coefficient was 0.944. Reaction analysis: Effect size statistics(ES)was 0.88.

CONCLUSION: SQOL-DV1 scale is an effective, credible tool to assess the quality of life of the TAO Patients. It can be used for the measurement of quality of life of the TAO Patients in the clinical and related research.

Preventions and treatment of the complications induced by the rigid gas permeable contact lens

Hui Xiao,Zhong-Yi Fan and De-Yan Zhang

AIM: To assess the complications induced by wearing rigid gas permeable contact lens(RGP), and to discuss the preventions and treatments of theses complications.

METHODS: Totally 54 patients 101 eyes who underwent RGP therapy were observed alone for 1 year. The patients complains were recorded, routine eye examinations were conducted(including vision, refraction, ocular pressure, slit-lamp findings and corneal topography), the abnormal findings and the treatments were analyzed.

RESULTS: The abnormal findings included dryness in 16 eyes(15.8%), foreign body sensation 8 eyes(7.9%), spotty staining 7 eyes(6.9%), allergic inflammation of conjunctiva 3 eyes(3.0%); corneal trauma 1 eye(1.0%); improper glasses care 15 eyes(14.9%), including the scratched lens 10 eyes, lens lost 3 eyes, fragmentation 2 eyes. Patients all got satisfied outcome with symptomatic treatment except 2 cases not wearing glasses due to eye discomfort. Appropriated treatments were performed.

CONCLUSION: The detail examination, the operation and strict following up are effective methods to preserve the complications according to the RGP.

Curative observation and surgical technique investigation of foldable intraocular lens ciliary sulcus suture fixation with small incision

Jian-Qin Shen and Yan-Dong Ni

AIM: To observe the curative effect of foldable intraocular lens(IOL)ciliary sulcus suture fixation with small incision and to investigate the surgical technique.

METHODS: We took a retrospective analysis of 19 eyes without intact posterior capsule or lacking of zonular support, which fail to take a phacoemulsification. 11 eyes had a single-piece IOL ciliary sulcus suture fixated with a scleral incision(group Ⅰ); 8 eyes had a foldable IOL ciliary sulcus suture fixated with a corneal incision(group Ⅱ); Postoperative follow-up observations included visual acuity, intraocular pressure, IOL position and complications.

RESULTS:The postoperative naked visual acuity was improved in 10 eyes(91%)in group Ⅰand in 8 eyes(100%)in group Ⅱ; The postoperative corrected distance visual acuity(CDVA)was improved in 4 eyes(36%)in group Ⅰ and in 6 eyes(75%)in group Ⅱ. The postoperative CDVA was ≥0.5 in 1 eye in group Ⅰ and in 5 eyes in group Ⅱ, the difference was statistically significant(P=0.041). Apparent IOL deviation was not observed in any eyes postoperatively in our study.

CONCLUSION: The foldable IOL ciliary sulcus suture fixation with small incision is an effective method for treatment of eyes without intact posterior capsule or lacking of zonular support. And it is worth popularizing widely.

Clinical analysis on complications of phaco- emulsification

Jun-Dong Zhu,Li-Lian Xie and Wen-Fang Chen

AIM: To analyze the clinical curative effect and operation complications in the process of extracapsular extraction of cataract by phacoemulsification.

METHODS: Totally 4 350 cases of cataract were treated by sclera tunnel incision phacoemulsification cataract extraction, and the reason of the operation complications was analyzed. The patients were followed-up for 3-24 months.

RESULTS:Phacoemulsification was performed successfully on 4 345 eyes(99.89%), and 5 eyes were changed to extracapsular cataract extraction combined with intraocular lens(ECCE+IOL)implantation. 10 eyes(0.23%)attained corrected vision under 0.1; 290 eyes(6.67%)attained corrected vision of 0.1 to 0.4; 4 050 eyes(93.10%)attained corrected vision of 0.5 or better 3 months after operation. During the operations there were capsular rupture in 26 eyes(0.60%), defeated capsulorhexis in 16 eyes(0.37%), corneal endothelial edema 350 eyes(8.05%), posterior capsular opacification 116 eyes(2.67%), intraocular hypertension 31 eyes, entophthalmia in 3 eyes.

CONCLUSION: The extraction of cataract by phacoemulsification and embedding of artificial crystal may have less tissue damage, and vision recovers quickly. Though it is an effective method, understanding the reasons for operation complication and reducing the operation complication can ensure the success of operation.

Operation timing of cataract surgery for severe non-proliferative diabetic retinopathy

Qi Zhang,Jie Feng,Xu-Kang Cheng and Jian-Bin Chen

AIM: To investigate the operation timing of cataract surgery for severe non-proliferative diabetic retinopathy(NPDR).

METHODS:Totally 120 eyes with severe NPDR were divided into 3 groups according to the timing of cataract surgery. Group A never treated with panretinal photocoagulation, and focal or grid macular laser. Group B was treated with panretinal photocoagulation and focal or grid macular laser for less than 3 months. Group C was treated with panretinal photocoagulation and focal or grid macular laser for more than 6 months. We examined the changes of macular thickness using OCT before cataract surgery and 1 month and 6-months after surgery. The central subfield mean thickness(CSMT)was used to evaluate macular edema which was defined as an increase of CSMT(ΔCSMT)> 30% from the baseline. We also analyzed the best-corrected visual acuity of the three groups.

RESULTS: Macular edema occurred in 4 eyes(10.3%), 11 eyes(30.6%)and 2 eyes(4.4%)from the three groups respectively. 6 months after operation, compared to the A, C groups, macular edema from the group B were significantly different(χ²=4.821, 10.120; P<0.05). The best-corrected visual acuity of the group B was lower than the other groups(χ²=9.924, 12.101; P<0.05).

CONCLUSION: After treated with panretinal photocoagulation within short-term, cataract surgery might improve the risk of postoperative macular edema.

Retrospective study on congenital cataract treatment in 21 eyes

Xin-Zhang Li,Li Zhao and Xiao-Rong Xin

AIM: To evaluate the technique of congenital cataract surgery and highlight the significance of optic rehabilitation postoperatively by a retrospective study with congenital cataract.

METHODS:Phacomulsification and intraocular lens(IOL)implantation combined the technique of anterior and posterior continuous curvilinear capsulorhexis and the anterior vitrectomy were performed on the 21 consecutive eyes of 11 children who had congenital cataract. The postoperative follow-up was 6 months to 1 year, and at the same time all patients accepted amblyopic treatment so as to rehabilitate the visual acuity.

RESULTS: The visual acuity of all patients with congenital cataract was improved with different degrees after treatment.Fibrinous exudative was seen in 9 eyes(42.9%)1 week after operations. Posterior capsular opacification was found in three eyes(14.3%); the percentage of patients who failed to follow-up 6 months after operations was 45.5%.

CONCLUSION: The surgical skill of congenital cataract has its own characteristic which is different from surgeries for other kinds of cataract, the technique of phacomulsification and IOL implantation combined the double continuous curvilinear capsulorhexis and the anterior vitrectomy is effective for prevention of the posterior capsule opacification, and provides more opportunities for patients to get optic rehabilitation. Therefore, successful management of congenital cataract surgery, the duration of postoperative supervision and the training of optical rehabilitation are essential for the treatment of congenital cataract, both doctors and parents should be aware of this point.

Clinical research of corneal astigmatism correction with the AcrySof Toric intraocular lens in cataract surgery

Ying-Xu Zhang,Min-Yu Chen and Lin-Yi Luo

AIM: To evaluate the corneal astigmatism correction effect and positional stability of AcrySof Toric intraocular lens(IOL)after cataract surgery.

METHODS: Totally 20 patients 23 eyes were implanted with the AcrySof Toric IOL between April 2010 and April 2012. All the patients were followed up for 6 months. The pre and post-operative uncorrected visual acuity(UCVA), preoperative corneal astigmatism, postoperative residual astigmatism, Toric lens axis, Toric lens decentration, Toric lens tilt and the capsule were detected and measured.

RESULTS: After 6 months, UCVA was ≥0.6 in 100% of eyes; ≥0.8 in 69.6% of eyes. The mean preoperative corneal astigmatism was 2.31±0.70D and the postoperative residual astigmatism was 0.45±0.30D, indicating a significant decrease in refractive cylinder after surgery(t=15.045, P=0.000). The mean rotation of Toric IOLs was 5.36°±0.32°. After 6 months, IOL centricity was in 12 eyes(52.2%)in which 8 eyes(34.8%)<0.5mm, 1mm>3 eyes(13.0%)≥ 0.5mm,1 eye(4.3%)>1mm. 20 eyes(87.0%)was untilt while 3 eyes(13.0%)was tilt and less than 5°,

CONCLUSION: Even in different orientation,AcrySof Toric IOL still has good position stability. It is an effective and predicted method for the correct of corneal astigmatism in cataract surgery.

Peach-shaped reverse rectangular trabecu-lectomy under scleral flap for treatment of glaucoma

Chun-Feng Zhong

AIM: To study the effect of peach-shaped reverse rectangular trabeculectomy for treatment of glaucoma.

METHODS:From January 1, 2004 to December 31, 2011, 96 cases 100 eyes with glaucoma were collected and grouped according to time. There were 48 cases 50 eyes in experimental group, who underwent the use of peach shaped reverse rectangular trabeculectomy, the rest 50 patients were assigned to the control group, with conventional treatment.

RESULTS:The effect of use of peach-shaped reverse rectangular trabeculectomy was better than the conventional surgical treatment.

CONCLUSION:Peach-shaped reverse rectangular trabeculectomy has obvious effect for the treatment of glaucoma, it is worth spreading.

Clinical observation of calcium dobesilate and hexuemingmu tablets in treatment of non-proliferative diabetic retinopathy

Xiang-Lei Chen and Li-Ming Tao

AIM: To observe the therapeutic effect of calcium dobesilate and hexuemingmu tablet on non-proliferative diabetic retinopathy(NPDR).

METHODS: Totally 67 diabetic patients 129 eyes were selected. Patients were divided into experimental group and control group. Nonage experimental group was named group A1(16 cases, 29 eyes), nonage control group was named group A2(14 eases, 26 eyes), metaphase experimental group was named group B1(19 cases, 38 eyes), and metaphase control group was named group B2(18 cases, 36 eyes). The patients in experimental group A1 and group B1 took domestic calcium dobesilate and hexuemingmu tablets for 12 weeks. The patients in control group A2 and B2 took rutin tablets, vitamin C and inosine tablets. Three months before and after treatment, the patients' vision, intraocular pressure, the condition of retina, FFA were observed and compared.

RESULTS: After treatment the number of patients with improvement of eye ground in group A1 was significantly more than that in group A2, so was the effective rate(P<0.05)in group B1 was significantly more than that in group B2, so was the effective rate(P<0.05)patients with improvement of eye ground in group A1 was significantly more than that in group B1, so was the effective rate(P<0.05)for early pathological changes.

CONCLUSION: Calcium dobesilate and hexuemingmu tablet is effective on NPDR, which is more obvious for early pathological changes.

Effect of calcitriol in patients with proliferative diabetic retinopathy

Yan-Ni Zhu,Juan Lu,Jing Chen and Yan-Hua Zhu

AIM: To investigate the effect of calcitriol in patients with proliferative diabetic retinopathy(PDR).

METHODS: Totally 96 patients with PDR were chosen. All patients were divided into two groups randomly. Patients in group T(29 males and 19 females)were given calcitriol(0.25μg/day)and routine drugs, while patients in group C(31 males and 17 females)received routine drugs only. Other twenty normal adults were selected as healthy group(group N)and took no drugs. The serum Ca, P, 25-(OH)D₃, 1,25-(OH)₂D₃ and parathyroid hormone(PTH)were measured at the experiment onset and 12 weeks later.

RESULTS: Compared to group N, the serum 25-(OH)D₃, 1,25-(OH)₂D₃ level was both obviously decreased, and serum PTH level was increased both in Group C and Group T(P<0.05). After calcitriol treatment for 12 weeks, the serum 25-(OH)D3, 1,25-(OH)₂D₃ level in group T was all obviously increased(P<0.05), and serum PTH level was obviously decreased(P<0.05). Simultaneously ocular fundus changes were improved, the efficiency ratio of group T was higher than that of group C(89.6% vs 60.4%, P<0.05). There was no significant difference in serum Ca, P among the three groups at any time.

CONCLUSION: There is lower serum 25-(OH)D₃, 1,25-(OH)₂D₃ level in the patients with PDR, and calcitriol can improve the disorder and is effective in treating PDR.

Clinical analysis on subretinal fluid delay absorption of rhegatogenous retinal detachment patients following scleral buckling surgery

Xi-Xiang Yi and Pei Fu

AIM: To analyze the causes of delayed subretinal fluid(SRF)absorption after the rhegatogenous retinal detachment(RRD)surgery, in order to shorten the SRF absorption time.

METHODS: The clinical and follow-up data from consecutive series of 93 eyes of 93 patients received scleral buckling surgery for RRD were retrospectively reviewed. The relationship of multiple factors, including age, duration of disease, location of retinal hole, number of retinal hole, area and height of retina detachment, scleral buckling surgery methods with SRF absorption were analyzed respectively by χ²test.The correlations among statistically significant factors with postoperative SRF absorption were analyzed by multivariate Logistic regression analysis.

RESULTS: Postoperative SRF delayed absorption was found with significant difference among location of retinal hole(P=0.031)and the height of scleral buckling surgery ridge(P=0.047), different age(P=0.043)and different duration(P<0.05). Multivariate Logistic regression analysis showed that the preoperative SRF absorption was found with no significant difference among patient's gender and refraction, and number of retinal hole, and height of retinal detachment,management of subretinal fluid and intravitreal gas injection(P>0.05).

CONCLUSION:The causes of SRF delayed absorption depend on many factors, including the height of scleral buckling surgery ridge, the degree and scope of scleral condensation, RD time, location of retinal hole, and patients' age and characters. Scleral condensation and scleral buckling surgery may increase the retinal choroid blood circulation obstacle.

Clinical effect observation on compound anisodine injection for the treatment of anterior ischemic optic neuropathy

Bin Chen

AIM: To observe the clinical effect of compound anisodine injection for the treatment of anterior ischemic optic neuropathy(ION).

METHODS: From December 2011 to June 2012, 82 patients with anterior ION were selected as objects in our hospital, they were all ill in single eye. They were randomly divided into observation group and control group. Observation group(compound anisodine injection group, n=42)and control group(salvia hormone injection group, n=40). We observed the curative effects.

RESULTS: In observation group, the total effective rate was 88.1% after 2 courses of treatment, it was significantly higher than the control group, after χ² test, P<0.05. The complication rate was 2.4%, the differences were not apparent when compared with the control group, after the χ² test, P>0.05.

CONCLUSION: The clinical effect of compound anisodine injection for the treatment of anterior ION was obvious, it does not increase the incidence of adverse reactions when combined with traditional methods, it has the characteristics of safety, simple, and easy to practice.

Ultrasound biomicroscopy of eye in the elderly with primary angle closure suspect

Bei-Jing Zhu,Jian-Ming Tang,Jie Zhao,Jun Hu and Hao Lu

AIM: To investigate the potential dissect element of elderly acute primary angle closure for early glaucoma prevention by measuring the parameters of anterior eye segment in the elderly with primary angle closure using ultrasound biomicroscopy(UBM)and A-scan ultrasonography.

METHODS: A retrospective study was performed based on the measured parameters with two samples. The first sample included 35 primary angle closure suspect eyes of 33 patients aging from 55 to 83 years old and the second sample included 25 healthy eyes of 25 randomly selected volunteers aging from 55 to 80 years old. The anterior chamber depth(ACD), angle opening distance(AOD500), iris-lens contract distance(ILCD),trabecular-ciliary process distance(TCPD), the ciliary processes around the scleral forward rotation angle(B angle),iris thickness(IT)were measured by UBM. Axial length(AL), lens thickness(LT), relative lens position(RLP)were measured by A-scan ultrasonography.

RESULTS: We compared the parameters measured for 35 primary angle closure suspect eyes and 25 healthy eyes. For Crystal related parameters, the RLP of angle closure suspect eyes decreased significantly(P<0.01)from that of healthy eyes, the LT of angle closure suspect eyes increased significantly(P<0.05)from that of healthy eyes, the ILCD of angle closure suspect eyes increased significantly(P<0.01)from that of healthy eyes; For ciliary body parameters, the TCPD, B angle of angle closure suspect eyes decreased significantly(P<0.01)from that of healthy eyes; For anterior chamber associated parameters, the ACD, AOD500 of angle closure suspect eyes decreased significantly(P<0.01)from that of healthy eyes. However, there was no difference in IT between the primary angle closure suspect eyes and the healthy eyes.

CONCLUSION: Lens forward positioning, lens thickness increase, and ciliary body position forward swing are high risk factors of elderly acute primary angle closure.

Effect of altitude change on train staffs' intraocular pressure on highland

AIM:To dynamically monitor staffs' intraocular pressure(IOP)on Beijing-Tibet trains at different altitude, and explore the effect and cause of altitude change on the population's IOP.

METHODS: The whole staffs in a set who travelled between Beijing and Lasa were selected randomly, with the height of T1(200m), T2(2500m)and T3(4500m)on approaching and R1(4500m), R2(2500m)on back tracking as monitoring sites for IOP test. Blood pressure, plasma oxygen saturation and heart rate were recorded. Variance analysis and Pearson correlation were applied for statistical analysis, with P<0.05 indicating statistically significant difference.

RESULTS: There was dramatically significant difference between IOP tested at the altitude above 2500m and the lower altitude(200m)(P<0.05), and significant difference between IOP tested at the altitude of 4500m and other monitoring sites(P<0.05). There was no dramatic correlation between IOP and plasma oxygen saturation, heart rate, systolic pressure and diastolic pressure(P>0.05).

CONCLUSION:IOP of train staffs on highland fluctuates as rise of altitude, and it could be increased by high latitude, as may be correlated with low air pressure, change of the biological parameter of eyeball and systemic reaction to high altitude anoxia.

Clinical study of optimizating surgical excision of pterygium and limbal conjunctival transplantation with stem cell

Qing-He Li,Chang-E Hu,Yue-Mei Li and Shao-Wen Qi

AIM: To study clinical effects of optimizating surgical excision of pterygium and limbal conjunctival transplantation with stem cell.

METHODS: Primary pterygium patients 59 eyes of 59 cases were selected and randomly divided into two groups. Optimizating surgical excision of pterygium and limbal conjunctival transplantation with stem cell was performed in the experimental group(32 eyes of 32 cases); surgical excision of pterygium and limbal conjunctival transplantation with stem cell was performed in the control group(27 eyes of 27 cases); respectively using the corresponding approach of surgical treatment. The healing time of postoperative corneal epithelial and the conjunctival flap, the time of operative course, the rate of recurrence and postoperative comfort were compared and statistically analyzed.

RESULTS: The experimental group and the control group of the healing time of corneal epithelial respectively were 2.16±0.37 and 2.87±0.31 days, the time of operative course were 30.03±1.98 minutes and 36.63±2.42 minutes, the healing time of conjunctival flap were 8.06±0.75 days and 10.02±1.01 days, the scores of postoperative discomfort were 0.91±0.69 and 1.63±0.74. The differences were statistically significant(P<0.01), both groups had no recurrence case.

CONCLUSION: Using the optimizating surgical excision of pterygium and limbal conjunctival transplantation with stem cell can shorten the healing time of postoperative corneal epithelial and the conjunctival flap and patient feel more comfort after surgery.

Clinical observation of the abnormality of superior oblique tendon in congenital superior oblique muscle paralytic patients

Yang Zhang,Dai-Xin Zhao,Wei Pu,Long-Quan Xue and Wei Xiao

AIM: To measure the abnormality of the superior oblique tendon in patients with congenital superior oblique muscle paralysis.

METHODS: This is a cross-sectional, self-control designed study. The width and the tensity of the superior oblique tendon of both the paralytic and nonparalytic eye were measured during the operations in 22 patients who were diagnosed with esotropia(including congenital esotropia, basic esotropia and partially accommodative esotropia)accompanied with single superior oblique muscle paralysis. The tensity of the tendon was measured as the maximal distance of which the superior oblique tendon could be lifted from the sclera.

RESULTS: There was significant difference(P<0.01)in the average width of the superior oblique tendon between the paralytic eyes(2.64±0.69mm)and the nonparalytic eyes(3.84±0.56mm). There was also significant difference(P<0.01)in the average tensity between the paralytic eyes(9.02±1.68mm)and the nonparalytic eyes(6.48±1.33mm).

CONCLUSION: The superior oblique tendon is narrower and more relaxant in the paralytic eyes.

Clinical experience in combined treatment of 120 cases of neonatal dacryocystitis

Hai-Long Xu and Yong Li

AIM: To analyze and investigate the clinical effects of the combined treatment of neonatal dacryocystitis.

METHODS: Totally 120 cases(145 eyes)of neonatal dacryocystitis received combined treatment, including using secretions culture and drug susceptibility testing, massage, drug pressure washing, and lacrimal probing.

RESULTS: In the 145 eyes, 24 eyes were cured by lacrimal massage, accounting for 16.6%; 39 eyes were cured by drug pressure washing, accounting for 32.2%; 77 eyes were cured by lacrimal probing, accounting for 93.9%; total cure rate of 96.6%.

CONCLUSION: Combined treatment is an effective and safe therapeutic approach on neonatal dacryocystitis.

Research of xerophthalmia after LASIK

Xiu-Li Xie

AIM: To study the incidence of xerophthalmia between people with high myopia and low myopia after laser in situ keratomileusis(LASIK), and find a way to prevent the xerophthalmia.

METHODS: The research was based on the retrospective analysis of 388 patients who underwent LASIK surgery in Wuhan Aier Eye Hospital during the 2010-2011. The Patients were divided into low and high myopia group. Assessment included xerophthalmia symptoms, tear fluid quantity, lacrimal secretion, tear film stability, corneal epithelial defect and corneal sensation, etc.

RESULTS: After the surgery, patients with high myopia were significantly higher than the incidence of low myopia groups. High myopia patients, who underwent the LASIK, would have lower tear volume, poorer tear film stability, and higher rate to suffer xerophthalmia symptoms than that of low myopia patients during the observation periods before or after the surgery.

CONCLUSION: Both low and high myopia groups, the rate of women suffering from dry eye was significantly higher than men. Patients with high myopia was significantly higher than the risk of suffering from dry eye syndrome in patients with low myopia, and high myopia than low myopia patients suffering from dry eye symptoms after LASIK is more severe and more lasting. For patients with high myopia, ICL or TICL surgery should be chosen as possible to for refractive correction.

Application observation of fetal umbilical cord in posterior sclera reinforce-ment surgery

Xiao-Niu Zhang,Shi-Yang Li and Hong-Li Ma

AIM: To investigate the safety and efficacy of fetal umbilical cord in posteriorscleral reinforcement surgery to treat pathologic myopia.

METHODS: Totally 100 cases(136 eyes)with pathologic myopia were performed surgery after the posterior scleral reinforcement method with single band of rewatered fetal umbilical cord which had dehydration of alcohol fixation treatment. Postoperative visual acuity, diopter, eye axis and complications were observed. And the follow-up time lasted for 1.5 years.

RESULTS: After surgery, visual acuity of myopia stable or decreased accounted for 91.2%; corrected visual acuity was stable or improved after 0.5,1,1.5 years, third year respectively in 125 eyes(91.9%), 127 eyes(93.4%)and 124 eyes(91.2%); preoperative axial length of patients was 29.81±1.87mm while postoperative axial length after the 0.5,1,1.5 years respectively were 29.82±1.90mm, 29.83±1.79mm, 29.79±2.06mm. Compared with the preoperative axial length, there was no significant difference(P>0.05). 3 cases had postoperative transient diplopia. No retinal detachment, vitrectomy hemorrhage, rejection and other serious complications occurred.

CONCLUSION: Posterior scleral reinforcement surgery with fetal umbilical cord is a safe and effective treatment method which can prevent the development of myopia while the long-term effects need further observation.

Clinical effect of ICL implantation for extreme high myopia

Dong-Qiang Luo,Hua Wang,Guo-Ping Duan,Shu-Xi He and Jiao Chen

AIM: To analyze the clinical effect of posterior chamber implantable contact lens(ICL)implantation on extreme high myopia.

METHODS: ICL or Toric ICL(TICL)implantation was performed in 40 eyes of 20 patients with extreme high myopia. Spherical refraction of these patients was -10.0--18.0D and cylinder refraction was -0.25--3.00D. All the patients' equivalent spherical refraction was -15.32D. Uncorrected visual acuity(UCVA), best-corrected visual acuity(BCVA)slit-lamp examination, intraocular pressure(IOP), topography examination, amount of corneal endothelial cells was examined in these patients and follow-up was 12 months.

RESULTS:Twelve months after surgery, 32 eyes(80.0%)received UCVA better than 0.8. One line increased in eye chart of BCVA was 12 eyes(30.0%)and two lines were 6 eyes(15.0%)postoperatively. Refraction between +0.5D and -0.5D was 28 eyes(70.0%)after surgery. There was no significant difference of IOP between preoperation and postoperation(t=0.518, P=0.776). There was no significant difference of average amount of corneal endothelial cells before surgery(2 823±243.6/mm²)and 6 months after surgery(2 709±273.2/mm²). No other complications occurred during and after surgery.

CONCLUSION: For extreme high myopia, ICL implantation is safe and effective.

Clinical study of binocular vision rebuilding after surgery in adult comitant strabismus

Li-Li Chen,Zi-Lin Chen,Ze-Bin Li,Hui-Lan Zhou and Lai-Wei Wu

AIM: To investigate the rebuilding of binocular vision in adult comitant strabismus patients.

METHODS: Twenty-one cases of adult comitant strabismus were examined before operation, 3 days, 6 weeks, 6 months after operation respectively. Three degree binocular vision was tested by Synoptophore and near stereoacuity, crossed disparity and uncrossed disparity were tested by Yan Shaoming stereogram.

RESULTS: Sixteen cases had uniocular suppression before operation, among them, 6 cases removed uniocular suppression 6 weeks postoperatively, the difference was significant(P<0.05); Five cases had synoptophore binocular vision before operation and it increased to 11 cases 6 weeks postoperatively, among them, 7 cases were improved, improved 36.8%, the difference was statistically significant(P<0.05); Three cases had near stereopsis before operation and it increased to 7 cases 6 weeks postoperatively, among them, 4 cases were improved, improved rate 22.2%, the difference was statistically significant(P<0.01); Three cases had normal crossed disparity before operation and it increased to 7 cases 6 weeks postoperatively, among them, 4 cases were improved, improved 22.2%, the difference was statistically significant(P<0.01); Four cases had normal uncrossed disparity before operation and it increased to 7 cases 6 weeks postoperatively, among them, 3 cases were improved, improved 17.6%, the difference was statistically significant(P<0.01).

CONCLUSION: Binocular vision has been improved in different degrees postoperatively for adult comitant strabismus, mainly in simultaneous perception and synoptophore fusion, but stereopsis is hard to be built, especially the distance stereopsis; it is not clever to neglect the reconstruction of binocular vision just because of missing right time of surgery.

Therapeutic effect analysis of esculin and digitalisglycosides eye drops on adolescent refractive asthenopia

Qing Zhang,Ming-Hua Shi,Wei Zhou and Shu-Xian Gong

AIM: To evaluate the curative effect of esculin and digitalisglycosides eye drops on adolescent refractive asthenopia.

METHODS: Objects of study were patients with refractive asthenopia during April 2011 to April 2012, age from 6 to 18, totally 200 patients 400 eyes with typical visual fatigue symptoms were included. The enrolled patients used esculin and digitalisglycosides eye drops made by Germany, 1 drop per time,t.i.d. duration of the treatment lasted for 1 month. The improvement of treatment including visual fatigue, vision, dioptric change and drug adverse reactions were determined by conducting questionnaires rating.

RESULTS: Visual fatigue grade increased from 3.67 to 1.89 after the treatment, which had statistical significance(P<0.05). The naked eyesight of the patients improved from 4.43±0.38 to 4.60±0.49. Comparison differences between groups had statistical significance(t=-3.87, P<0.05). Dioptry decreased from -2.54±3.00D to -2.25±2.98D, but the differences had no statistical significance. There's no report for adverse reactions.

CONCLUSION:Esculin and digitalisglycosides eye drops is safe and effective in treating adolescent refractive asthenopia.

Analysis of wearing orthokeratology lens for anisometropia

Jing Wang,Xin-Hua Che and Ying-Xia Gu

AIM: To observe and evaluate the efficacy of wearing orthokeratology lens for anisometropia.

METHODS: Totally 38 patients with anisometropia were fitted with orthokeratology lens. They were followed up 1 day, 1 week; 1 month,3, 6 months; 1 year, 2, 3 years after wearing glasses, and uncorrected visual acuity, corneal curvature, axial length, slit-lamp examination with or without complications were observed.

RESULTS: The uncorrected visual acuity was significantly improved, and it was stable after 1 week. Individual cases with conjunctivitis and punctate epithelial exfoliation could be restored after treatment. Corneal curvature flattened, the average corneal curvature was 43.42±1.17D before wearing glasses, and was 41.65±1.56D one week after wearing glasses, the differences were statistically significant(P<0.01). After wearing glasses for 1 month, 3, 6 months, 1 year, 2 3 years, there were no significant changes. There was no statistically significant difference(P>0.05). After wearing glasses for 1 year, 2, 3 years, the axial length increased by 0.18±0.13, 0.22±0.11, 0.25±0.10mm than before wearing glasses, and there was no statistically significant difference(P>0.05).

CONCLUSION: Orthokeratology appears to be a preferred treatment for juvenile anisometropia, it can correct anisometropia, achieve the balance between two eyes, and it also can effectively control the development of myopia, thereby reducing the gap the degree of anisometropia.

Clinical trial of anterior stromal puncture and bandage contact lens in treating patients with recurrent epithelial defects

Xiao-Jing Li and Jian-Nan Li — 2013/11/25 11:01:52

AIM: To assess the safety and efficacy of combination therapy using anterior stromal puncture(ASP)and bandage contact lens for recurrent epithelial defects.

METHODS: ASP was used as a treatment for 23 eyes of 22 outpatients with recurrent epithelial defects. At the mean time, they wore bandage contact lens and used eyedrops. All patients report foreign-body sensation, blepharospasm, tearing and photophobia in the morning or evening, some with visual impairment. ASP was performed on every patient with a self-made 41/2 needle under surface anesthesia. The patients worn contact lens after the surgery. We observed symptoms of foreign-body sensation, photophobia, vision,epithelial and stromal scar healing at 3d; 1,2,4,8,12wk. The average follow-up period was 3 months, range 4wk-10mo.

RESULTS: Twenty-two eyes became completely asymptomatic and 19 eyes(83%)were once cured.

CONCLUSION:ASP with bandage contact lens turns out to be an effective, convenient, economical and repeatable therapeutic option for patients with recurrent epithelial defects, which can control the severe foreign-body sensation quickly.

Analysis on the safety of phacoemulsification combined with IOL implantation in Ⅱ diabetes patients with cataract

Bai-Lei Zhu and Qiu Zhong — 2013/11/25 11:01:52

AIM: To explore vision effect and safety for implanting the ultrasonic emulsification gettering combined artificial lens in Ⅱ diabetes patients with cataract.

METHODS: Atotal of 103 cases(112 eyes)Ⅱ diabetes patients with cataract treated in our hospital were as observation object, and 100 cases(110 eyes)of elderly patients with pure without diabetes cataract were for comparison, with the same set for medical ultrasound emulsification gettering technique combined IOL implantation, two groups in the near future vision, long-term vision and complications were compared.

RESULTS: Vision in the observation group patients after 1d, 1 week and preoperative had obviously improved(Z=7.63, 8.59, P<0.05), Vision in the control group patients after 1d, 1 week and preoperative had obviously improved(Z=5.36, 4.38, P<0.05); observation group after 1d, 1 week vision had obviously improved compared with the control group(Z=5.48, 4.68, P<0.05), best corrected visual acuity in observation group was better than the control group, the difference was statistically significant(Z=8.987, P<0.05); observation group after 1 month, 3 months visual acuity were lower than the control group, the difference were statistically significant(Z=13.21, 11.48, P<0.05), and there was no significant difference between the two groups 6 months postoperatively(Z=3.141,P>0.05).

CONCLUSION: Using ultrasonic emulsification combined IOL implantation for Ⅱ diabetes patients with cataract in good glycemic control can significantly improve patients visual acuity and found no obvious complications, curative effect is reliable.

Trabeculectomy combined with small incision extracapsular cataract extraction and intraocular lens implantation for primary open angle glaucoma coexisting with cataract

Yun-Kai Xia,Rong-Qiang Tan,Dai-Li Xu,Lin-Bin Wu and Bao-Di Li — 2013/11/25 11:01:52

AIM: To study the clinical effectiveness of trabeculectomy combined with small incision extracapsular cataract extraction and intraocular lens(IOL)implantation for the treatment of primary open angle glaucoma coexisting with cataract.

METHODS: A total of 34 eyes of 34 patients with primary open angle glaucoma and cataract had trabeculectomy combined with small incision extracapsular cataract extraction and intraocular lens implantation from January 2011 to January 2013. The postoperative visual acuity, intraocular pressure(IOP), filtering bleb and complications were observed.

RESULTS: The follow up duration was 6-24 months. The best corrected visual acuity(BCVA)was 0.1～<0.3 in 4 eyes(12%)and 0.3～1.0 in 30 eyes(88%). The postoperative IOP was 14.7±0.8mmHg at postoperative month 6. The functional filtering blebs were presented in 34 eyes in the first week and 28 eyes after 6 weeks, the filtering blebs were not obvious in 4 eyes, and encapsulated filtering blebs were presented in 2 eyes. Postoperative complications included corneal edema in 12 eyes(35%), fibrous exudates in 5 eyes(15%), shallow anterior chamber in 6 eyes(18%)and after cataract in 6 eyes(18%).

CONCLUSION: Trabeculectomy combined with small incision extracapsular cataract extraction and IOL implantation are effective as an initial surgical treatment for open angle glaucoma patients coexisting with cataract.

Clinical study of phacoemulsification with complicated cataract after vitrectomy surgery

Jian Li,Kang Liang and Xiao-Jun Lin — 2013/11/25 11:01:53

AIM: To evaluate the characteristics, safety and effectiveness of phacoemulsification with complicated cataract after vitrectomy surgery.

METHODS:Thirty-nine patients(39 eyes)with complicated cataract after vitrectomy were operated by phacoemulsification, among which 23 eyes after silicon oil tamponade were combined with silicon oil removal. Preoperative and postoperative best corrected visual acuity(BCVA)and complications were recorded. The mean follow-up period was 10 months, with the range from 3 to 24 months.

RESULTS:There were no serious surgical complications. Postoperatively, BCVA improved in 37 eyes(95%), and did not change in 2 eyes(5%). No decreased visual acuity was observed on the patients. One case had recurrent retinal detachment at two weeks after silicon oil removal, and one case had vitreous hemorrhage at one month. Both eyes were treated with vitrectomy and silicon oil tamponade and were cured. Postoperative complications, such as choroidal hemorrhage, ocular hypotension and so on were not observed.

CONCLUSION: Cataract is complicated and surgery can be much more challenging after vitrectomy. Phacoemulsification is safe and effective for complicated cataract in vitrectomized eyes.

Effect and safety of intravitreous injection of bevacizumab combined with Ex-press miniature glaucoma device implant for neovascular glaucoma

Hua Zhong,Yuan-Sheng Yuan,Can Zhao,Qin Chen,Xiao Yang,Jiao Li and Yan Yu — 2013/11/25 11:01:53

AIM: To evaluate the effect and safety in the treatment of neovascular glaucoma(NVG)by using intravitreous injection of bevacizumab combined with Ex-press miniature glaucoma device implant with MMC.

METHODS: Nineteen eyes of 18 patients with angle-closure NVG were treated by intravitreous injection of bevacizumab combined with Ex-press miniature glaucoma device implant with MMC after atrophy of iris neovascularization. The regressions of iris neovascularization, changes of intraocular pressure, characters of filtering bleb and complications of intravitreous injection and surgery were observed in a 12 months follow-up period.

RESULTS: Iris neovascularization was completely regressed during 2-7d after injection in 16 eyes. There was no significant difference between before and after injection. The IOPs of 11 eyes were less than 21mmHg without any drugs and of 5 eyes with 1-2 kinds of anti-glaucoma drugs after combined Ex-press implant. No serious complications were observed after intravitreous injection and ex-press implant with MMC.

CONCLUSION: Intravitreous injection of bevacizumab could significantly reduce the regression of iris neovascularization, avoid haemorrhage during subsequently Ex-press implanting, relieve postoperative inflammation. It improves the successful rate of Ex-press implant with MMC and remains visual function. However, the treatment of the protopathy and potential medical treatment risk of intravitreal bevacizumab should be mentioned.

Evaluation of curative effect of macular edema in retinal vein occlusion

Chang-Jun Hou and Fang Liu — 2013/11/25 11:01:53

AIM: To compare the efficiency of intravitreal injection of triamcinolone acetonide(TA)or general treatment for the treatment of macular edema in retinal vein occlusion.

METHODS: Seventy-five eyes of 75 patients with macular edema of retinal vein occlusion were diagnosed by examination of regular inspection, fundus fluorescein angiography(FFA)and optic coherence tomography(OCT). There were 31 patients in general treatment group and 44 patients in TA group. There were no significant differences between the two groups with regards to patient's age, duration of disease, intraocular pressure(IOP), best-corrected visual acuity(BCVA), central macular thickness(CMT)at baseline. Comprehensive ophthalmic evaluation was performed at baseline and at week 4 and 12 after treatment. Main outcome measures included IOP, BCVA and CMT by OCT.

RESULTS: Separate within-group analysis of showed significant reduction in CMT from baseline in TA group at week 12. The results showed significant improvement in BCVA in TA group and general treatment group. But no significant interaction between groups were observed of BCVA at week 4 and 12. There was a significant increase in IOP(>5mmHg)in the TA group when compared with the general treatment group at week 4, but no significant interaction between groups at week 12.

CONCLUSION: The result shows that general approach and intravitreal injection of triamcinolone acetonide are well tolerated wiht a significant improvement in BCVA and decrease in macular edema in retinal vein occlusion. But we must be attention to the increased IOP after intravitreal injection of TA.

Experience on the treatment of rhegmatogenous retinal detachment

Yun-Huan Li — 2013/11/25 11:01:53

AIM: To investigate the effect and safety of combined surgery with scleral buckling and drainage operation in the treatment of rhegmatogenous retinal detachment.

METHODS: Totally 88 patients(88 eyes)with rhegmatogenous retinal detachment accepted in our hospital from January 2009 to January 2013 were selected as study objects. All patients were given scleral operation and divided into two groups according to the operation mode. Patients in group A(44 eyes of 44 cases)were treated with combined surgery with scleral buckling and nondrainage operation, while patients in group B(44 eyes of 44 cases)were given combined surgery with scleral buckling and drainage operation. The retinal reattachment rate, postoperative visual acuity and complications between groups were compared after treatment.

RESULTS:The anatomic reduction rates of eyes in group A and B were respectively 93% and 89%, with no significant differences between groups(P>0.05). There were 37 eyes(84%)improved in eyesight after operation in group A, only 34 eyes(77%)in group B. And visual acuity recovery rate of group A was evidently higher than that of group B, with significant differences between them(P<0.05). Furthermore, the postoperative complication rate of group A was significantly lower than that of group B(11% vs 32%, P<0.05).

CONCLUSION: It is efficient and secure for combined surgery with scleral buckling and drainage operation to treat patients with rhegmatogenous retinal detachment, which is worthy of clinical application.

Intravitreous injection with ranibizumab combined laser photocoagulation for the treatment of branch retinal vein occlusion

Xiao-Bo Wang,Guo-Ji Wu,Xue-Yan Zhang,Xiang-Dong Luo and Cong Liu — 2013/11/25 11:01:53

AIM: To compare the safety and efficacy of intravitreal injection with ranibizumab combined with grid laser photocoagulation for the treatment of macular edema secondary to branch retinal vein occlusion(BRVO).

METHODS: Thirty patients(30 eyes)with BRVO were randomized into two groups: Group 1(14 eyes)received grid laser photocoagulation(GLP)treatment alone, Group 2(16 eyes)received three loading doses 0.05mL/(0.5mg)of intravitreal injection with ranibizumab at monthly interval(i.e. 0, 1 month and 2 months)plus standard laser treatment 7d after the 1^st injection. During the 6 months of follow-up, observation was made on the changes of the best-corrected visual acuity(BCVA)and central macular thickness(CMT)by OCT.

RESULTS: After 6 months follow-up, the patients' BCVA in two groups were both improved with the combined treatment group better than the simple GLP group(P<0.05); OCT display that CMT of group 1 decreased by an average of 236.4±113.0μm, CMT of group 2 decreased by an average of 386.6±195.5μm with the combined treatment group better than the simple GLP group(P<0.05).

CONCLUSION: The effect of the combined treatment is better than that of the simple GLP treatment. Intravitreal injection with ranibizumab combined with grid laser photocoagulation for the treatment of macular edema secondary to branch retinal vein occlusion is effective and safe.

Clinical observation on vitreous surgery in treating idiopathic macular hole

Min Liu,Jian-Lian Guo and Hua Zhang — 2013/11/25 11:01:53

AIM: To observe the surgical effect and influential factors of idiopathic macular hole(IMH)treated with vitrectomy and internal limiting membrane peeling combined with intravitreal gas tamponade.

METHODS: The clinical data of 22 IMH patients(23 eyes)were retrospectively analyzed. All the patients were diagnosed with IMH by optical coherence tomography(OCT)and their macular hole patterns were measured before and after surgery by OCT in addition to the routine examinations. All patients were treated with vitrectomy, internal limiting membrane peeling combined with gas injection(air or inert gas). The postoperative visual acuity, macular hole closure rate and the incidence of surgical complications were observed. The correlation between the patients' age, course of disease, preoperative best corrected visual acuity(BCVA), macular hole diameter, the type of vitreous cavity filling gas, the postoperative BCVA, and the macular hole closure rate was analyzed with SPSS 13.0 statistical software.

RESULTS: Postoperative OCT examination results showed that the macular hole closure rate was 100%. The macular hole closure rate was 79%(11 eyes of 14 eyes)after the first intravitreal air injection and 100%(9 eyes)after fist intravitreal inert gas injection(100mL/L C₃F₈). There was no significant difference between the air injection and inert gas injection(χ²=2.1214, P>0.05). The mean preoperational BCVA was 0.11±0.05 and the mean postoperative BCVA 0.23±0.12; there was a statistically significant difference between them(t=4.023,P<0.05). Compared with the patients without visual acuity improvement after surgery, the diameters of the hole were smaller in the patients whose postoperative visual acuity got improved(t=3.92, P<0.05). There was a significant difference in the visual acuity before and after the surgery(P<0.05). The age of the patients(r=-0.415, P=0.256), duration of disease(r=0.193, P= 0.498), preoperative VA(r=0.152, P=0.673)had no significant influence on IMH visual outcomes.

CONCLUSION: The vitrectomy combined with internal limiting membrane peeling and intravitreal gas tamponade is an effective treatment for IMH; the macular hole diameter is the major influence factor in the postoperative closure and visual prognosis of IMH; while the preoperative visual acuity, age, duration and the type of gas filled in the visual cavity have no effects on the postoperative closure and visual prognosis in IMH.

Clinical study on the optic nerve protection of calcium dobesilate in treating glaucoma

Yan-Ni Zhu,Yan-Jie Bai,Yan-Hua Zhu,Jia-Hua Fang and Zu-Hai Zhang — 2013/11/25 11:01:53

AIM:To observe the protective effect of calcium dobesilate on optic nerve of glaucoma patients whose intraocular pressure has been under control through operation.

METHODS: A total of 78 inpatients(89 eyes)with glaucoma in this hospital from January, 2011 to February, 2012 were enrolled. All patients were randomly divided into treatment group and control group with 6 months in a course. The visual acuity, visual field(mean sensibility, MS), and intraocular pressure were measured at the experiment onset and 6 months later to evaluate the clinical effect.

RESULTS: There were no statistically significant differences in the visual acuity, intraocular pressure between the two groups neither at the experiment onset nor after 6 months(P>0.05). The mean sensibility(MS)of the treatment group was obviously improved(14.56±5.03 vs 18.9±5.77, P<0.05)with statistically significant differences before and after the treatment, while the MS remained unchanged in the control group(14.75±5.17 vs 13.48±4.69). There are statistically significant difference between the treatment group and the control group. Compared to the ratio of improvement, stability, and deterioration in the control group(10.3%, 48.7%, 41.0%), the indexes were changed obviously in the treatment group(64.1%, 28.2%, 7.7%,P<0.05)with statistically significant difference between the two groups.

CONCLUSION:Calcium dobesilate can improve mean retinal sensitivity and protect the optic nerve in glaucoma patients whose intraocular pressure has been controlled.

Clinical observation on bandage contact lens applied in pterygium excision combined with conjunctival transplantation

Yuan Yuan and Jian-Nan Li — 2013/11/25 11:01:53

AIM: To observe the clinical effect of bandage contact lens in pterygium excision combined with conjunctival transplantation.

METHODS: The retrospective study included 114 eyes of 101 patients who underwent the pterygium excision combined with conjunctival transplantation from June 2012 to June 2013 in our hospital. The patients were divided into three groups according to the postoperative treatment. In group A, 30 cases(38 eyes)wore bandage contact lens; In group B, compression bandage was used in all the 33 cases(38 eyes); In group C, 38 eyes(38 cases)were covered with normal eye pad. All patients were examined 1, 3, 5d after surgery.

RESULTS:No complications such as corneal ulcer, granuloma, etc. or recurrence occurred in 114 eyes. Eye irritations in group A were less severe than in the other two groups. Postoperative repair time of corneal epithelium was shorter in group A and B than in group C.

CONCLUSION: Bandage contact lens can significantly reduce the irritations after pterygium excision combined with conjunctival transplantation and promote corneal epithelium repair in the defected area. Compared with traditional treatment, it can obviously increase the postoperative comfort level in patients, it is easy to promote its application, and it has lesser risks. So it has extensive clinical value.

Clinical application of prosthodontics membrane in conjunctival sac plasty

Mao-Zhu Zhao,Wei Lin and Jun-Hua Lu — 2013/11/25 11:01:53

AIM: To observe the clinical effect of prosthodontics membrane and lip mucosa transplantation combined with hydroxy apatite(HA)orbital implantation in the treatment of severe stenosis of conjunctival sac.

METHODS: Nineteen patients with orbital socket and severe stenosis of conjunctival sac were treated with prosthodontics membrane and lip mucosa transplantation combined with HA orbital implantation in reconstruction of conjunctival sac, Survival condition of lip mucosa, HA stability and conjunctival sac depth, palpebral fissure highness and facial appearance were observed after transplantation.

RESULTS: After 3-6 months of follow-up, lip mucosal membrane grew up well and fused with eyeball conjunctiva in all patients. Depth of conjunctival sac was normal and binocular palpebral fissure elevated basically symmetry and satisfactory appearance in 18 patients. One patient was not satisfied with the improved appearance.

CONCLUSION:The method of prosthodontics membrane and lip mucosa transplantation combined with HA orbital implantation is effective and safety in conjunctival sac reconstriction, and also satisfy patients' esthetic need.

Effect of houttuynia cordata eye drops combined with pemirolast potassium eye drops on the treatment of allergic conjunctivitis

Li Hang — 2013/11/25 11:01:53

AIM: To investigate the clinical effectiveness of houttuynia cordata eye drops combined with pemirolast potassium eye drops on the patients with allergic conjunctivitis.

METHODS: Totally, 63 patients with allergic conjunctivitis were randomly divided into the control group(31 cases)and the observation group(32 cases). The patients in the control group were treated with pemirolast potassium eye drops alone while patients in the observation group were medicated with pemirolast potassium eye drops combined with houttuynia cordata eye drops. Symptoms such as nictation, eye itching, red eye, foreign body sensation and signs such as conjunctival edema and hyperemia, upper and lower palpebral conjunctiva nipple and filtering blebs were observed before and after treatment.

RESULTS: The pretreatment symptom evaluation scored 9.38±0.71 and 9.41±0.56 respectively in the observation group and the control group and their pretreatment sign evaluation scored respectively 10.21±1.03 and 10.68±0.99, with no significant difference between the two groups. After the treatment, symptom evaluation scored 1.22±0.61 and 4.25±0.84 for the observation group and control group respectively and their sign evaluation scored respectively 1.21±0.60 and 5.78±1.29, with statistical difference between the two groups. The effective rate of the observation group(78.12%)was significantly higher than that of the control group(32.25%), and with statistical difference.

CONCLUSION: The pemirolast potassium eye drops combined with houttuynia cordata eye drops can ameliorate the clinical symtoms and signs of the patients with allergic conjunctivitis and improve the treatment efficacy.

Analysis of optic disk structure tested by Heidelberg retinal tomography Ⅲ in patients with primary open angle glaucoma

Si-Ying Liang,Li-Na Huang,Ning Fan and Xiao-Li Shen — 2013/11/25 11:01:53

AIM: To evaluate the diagnostic capability of Heidelberg retinal tomography-Ⅲ(HRT-Ⅲ)for primary openangle glaucoma(POAG)at different stages.

METHODS: Sixty-five patients(116 eyes)with POAG and 60 normal persons(114 eyes)were tested by HRT-Ⅲ with optic disk tomography to observe their optic disk structure parameters. The optic disk parameters of normal persons, patients with POAG, and patients of POAG at different stages were compared and analyzed. The correlation between optic disk parameters and mean defect of the visual field of patients were analyzed.

RESULTS: There were statistical differences in cup area, rim area, cup volume, rim volume, cup/disk area ratio, rim/disk area ratio, linear cup/disk ratio, mean cup depth, maximun cup depth, mean retinal nerve fiber layer(RNFL)thickness between normal persons and patients and among patients of the three stages(early, developing and late). A positive correlation was found between cup area, cup volume, cup/disk area ratio, linear cup/disk ratio, mean cup depth and mean defect of the visual field in POAG patients, while, a negative correlation was found between rim area, rim volume, rim/disk area ratio, mean RNFL thickness and mean deviation in POAG patients.

CONCLUSION: HRT-Ⅲ can effectively reflect changes of optic disc in each stage of POAG. It shows a good correlation with visual field and provides basis for the diagnosis of POAG.

Study of repeatability of corneal epithelium thickness profiles automatically measured by ultra-high resolution OCT system

Su-Zhong Xu,Xin-Jie Ye,Zhe Xu,Chun Yang and Mei-Xiao Shen — 2013/11/25 11:01:53

AIM: To assess the repeatability of thickness profiles of corneal epithelium produced by aautomatic hierarchic algorithm that was applied to images obtained by a custom-built ultra-high resolution OCT( UHR-OCT)system.

METHODS: Eighteen left eyes of 18 subjects(23.2±0.9)years; mean age±standard deviation)were imaged twice on non-consecutive days by a custom-built ultra-high resolution OCT(UHR-OCT)system. A hierarchic algorithm based on the axial gradient information and a shortest path search was developed to measure the corneal epithelial thickness profiles from the SD-OCT images.

RESULTS: There was good correlation between theautomatic and manual hierarchy positions of the epithelium( p>0.05, paired t-test). The average epithelial thickness of the 6mm central corneal region determined by the automatic hierarchic algorithm was 52.1±2.1μm, ranging from 50.3±1.8μm to 53.2±2.4μm along the horizontal meridian. The epithelial thickness differences between automatic and manual hierarchy by the UHR-OCT systems were 0.4±0.3μm. The intraclass correlation coefficients(ICC)and coefficients of repeatability(CoR)with repeated UHR-OCT measurements for epithelial thickness were 0.90±0.05 and 1.44±0.01μm respectively.

CONCLUSION:Regarding UHR-OCT system, the custom-developed automatic hierarchy has good repeatability and accuracy for measuring the thickness of corneal epithelium.

Observation on the effect of 200mL/L alcohol pretreatment on the pterygium operation

Jin-Lan Wan and Bin Kang — 2013/11/25 11:01:54

AIM: To observe the effect and clinical significance of alcohol pretreatment during the pterygium surgery.

METHODS: Totally 300 eyes with pterygium were randomly divided into two groups. Control group: 142 eyes with pterygium were peeled under local anethesia and their degenerative organization of pterygium was cleaned up followed by a transplantation of corneal limbus with an autologous conjunctival flap. Experimental group: 158 eyes with pterygium were placed with a special metal ring used in LASEK on the head of pterygium to isolate the treatment area under local anesthesis, then, the treatment area within the ring was filled with the alcohol with a concentration of 200mL/L for 40-60s, followed by an adequate flushing with saline. Subsequent surgical procedure was the same as control group.

RESULTS: Follow-up for all patients ranged from 1 month to 3 years. Postoperatively, 158 eyes of experimental group had better operative effect than control group. Experimental group had better would healing, complete tissue construction, and improved visual quality. The break-up time of tear film for experimental group was significantly prolonged than that for control group. The average corneal astigmatism and total higher-order aberrations of experimental group were significantly lower than that of control group. The recurrence rate of experimental group was also significantly lower than control group. There's no significant difference in the incidence of complications.

CONCLUSION: Alcohol pretreatment during the pterygium surgery is a safe and effective method.

Correlation between single nucleotide polymorphism in 11q24.1 chromosome and high myopia hereditary susceptibility

Xin-Hua Wang,Xiao-Yu Zhang,Han-Si Bi,Chang Zhao and Ruo-Xi Li — 2013/11/25 11:01:54

AIM: To study the correlation between genetic susceptibility to high myopia and single nucleotide polymorphisms(SNPs)in 11q24. 1 chromosome among Chinese college students.

METHOD: A total of 254 blood samples were obtained from Chinese college students who were often engaged in near work. The students were divided into high myopia group(42 cases), low to moderate myopia group(61 cases)and non-myopic group(151 cases). Genotyping technology was utilized to analyze the frequency of mutation of the SNPs alleles of four mononucleotides in the 11q24.1 chromosome, including rs577948, rs11218544, rs10892819 and rs11218553. And the Chi-square test was performed to test the difference of such mutation with myopia.

RESULTS:The frequency of the SNP alleles mutation of the mononucleotide rs577948 site in the high myopia group was significantly different from that in the low-to-moderate myopia group and the non-myopic group(P=2.28×10^-7).

CONCLUSION: There is no significant correlation between genetic susceptibility and the four variations of SNPs between mild myopic population and normal population and there is no significant difference between the two populations, either. However, A - G mutation of Rs577948 site in 11q24.1 chromosome in university students with high myopia group is closely associated with high myopia hereditary susceptibility.

Visual acuity assessment after cataract surgery by pattern reversal visual evoked potential

2013/11/25 11:01:54

AIM: To discuss visual acuity assessment after cataract surgery by pattern reversal visual evoked potential.

METHODS:Data of 72 adult cataract patients received PRVEP before and after phaco and IOL in Department of Ophthalmology, Tongji Hospital from October 2012 to May 2013 was analyzed retrospectively. A total of 114 eyes were studied, including 76 eyes with senile cataract and 38 eyes with complicated cataract. According to the degree of lens opacity and the hardness of lens nucleus, these data were divided into two groups: Group 1(gradeⅠ, Ⅱ, Ⅲ )and Group 2(grade Ⅳ, Ⅴ )and was statistically studied with correlation analysis.

RESULTS: Group 1:(1)Preoperative: the average of visual acuity was 0.344, the incubation time of P₁₀₀ wave was 107ms and the amplitude of N₇₅- P₁₀₀ wave was 4.633μV; postoperative: the average of visual acuity was 0.672, the incubation time of P₁₀₀ wave was 104.37ms and the amplitude of N₇₅- P₁₀₀ wave was 4.400μV.(2)The visual acuity before and after operation were both significantly negatively correlated with the incubation time of P₁₀₀ wave(P<0.01)and significantly positively correlated with the amplitude of N₇₅- P₁₀₀ wave(preoperative: P<0.01,postoperative: P<0.05);(3)The improved rows of the visual acuity before and after operation showed no relationship with the change of the incubation time of P₁₀₀ wave. Group 2:(1)Preoperative: the average of visual acuity was 0.116,the incubation time of P₁₀₀ wave was 118.905ms and the amplitude of N₇₅-P₁₀₀ wave was 1.650μV; postoperative: the average of visual acuity was 0.576, the incubation time of P₁₀₀ wave was 108.429ms and the amplitude of N₇₅- P₁₀₀ wave was 5.132μV.(2)The visual acuity before operation was significantly negatively correlated with the incubation time of P₁₀₀ wave(P<0.05),while the visual acuity after operation showed no relationship with the incubation time of P₁₀₀ wave; the visual acuity before and after operation showed no relationship with the amplitude of N₇₅- P₁₀₀ wave.(3)The improved rows of the visual acuity before and after operation showed no relationship with the change of the incubation time of P₁₀₀ wave.

CONCLUSION:According to the correlation among the visual acuity, the incubation time of P₁₀₀ wave and the amplitude of N₇₅- P₁₀₀ wave, PRVEP is significantly affected by preoperative visual acuity(the degree of opacity in refractive media). PRVEP is not helpful as an indicator of visual prognosis after cataract surgery, and PRVEP before cataract surgery has no clinical significance.

Clinical observation of the refractive regression of latanoprost eye drops the prevention of excimer laser in situ keratomileusis

2013/11/25 11:01:54

AIM:To observe the clinical effect of excimer laser in situ keratomileusis after the early application of latanoprost eye drops in prevention of refractive regression.

METHODS:Patients were randomly divided into experimental group, positive control group and blank control group, each group of 50 cases(100 eyes). In experimental group, patients used latanoprost eye drops once from the first day after the operation, and the eye drops were discontinued after three months. The positive control group applied timolol eye drops in the morning and evening respectively, and the eye drops were discontinued after three months. Blank control group without any ocular hypotensive drugs. Effect of preoperative, postoperative 1 week,1 month,3,6,12,24 months, the uncorrected visual acuity(UCVA),subjective refraction, corneal posterior surface, intraocular pressure, BUT, Schirmer test and other aspects of the change were observed.

RESULTS:There was no retreatment cases in experimental group and positive control group. Forty-eight cases of experimental group were able to adhere to employ latanoprost ophthalmic solution once daily for three months, while the positive control group had only 41 cases adhering to use timolol eye drops twice daily for three months. There was significant difference. The blank control group of 4 retreatment cases were appeared, there were significant differences compared with experimental group. No significant differences in BUT, Schirmer test among three groups were found.

CONCLUSION:Latanoprost eye drops can effectively prevent excimer laser in situ keratomileusis retreatment, with less side effects and better patient compliance.

Meaning of the coagulative function in serum for eye malignant tumor diagnosis and evaluation

Ya-Zhi Fan,Zi-Yao Liu,Yu-Ping Zheng,Jian-Ming Wang and Hai-Xiao Feng — 2013/10/28 11:29:58

AIM: To explore the meaning of the level of D-dimer(D-D), fibrinogen(Fib)and fibrin degradation products(FDP)in serum for eye malignant tumor diagnosis and evaluation.

METHODS: Sixty-seven patients with eye malignant tumor(malignant tumor group)in our hospital were selected,among which, 44 as malignant tumor without metastasis group, 23 as malignant tumor with metastasis group; 46 patients were selected with eye benign tumor(benign tumor group)during the same time period; 30 healthy people visited our hospital for regular physical examination was elected simultaneously as the healthy control group. The level of D-D, Fib and FDP were detected in serum.

RESULTS: The D-D, Fib and FDP level in eye malignant tumor group was significantly higher than those in either the eye benign tumor group or the healthy control group(P<0.01), malignant tumor with metastasis group had the significant higher level of D-D, Fib and FDP than those of malignant tumor without metastasis group(P<0.05). There was no significant difference statistically between the eye benign tumor group and healthy control group of the serum level of D-D, Fib and FDP(P>0.05). There was significant difference of D-D level distribution among each group(P<0.05).

CONCLUSION: To detect the level of D-D, Fib and FDP in serum can help with differentiation the tumor from benign to malignancy, analysis the progression of tumor and prognosis.

Value of recombinant human epidermal growth factor in corneal wound repair after corneal foreign body elimination

Hong-Jie Han — 2013/10/28 11:29:59

AIM: To investigate the repair efficacy of recombinant human epidermal growth factor on corneal epithelium after corneal foreign body eliminating operation.

METHODS: There were 102 patients with corneal foreign body(188 affected eyes)chosen for the study. All patients were divided into treatment group and control group according to the random number table. Both groups received corneal foreign body elimination by slit lamp. Postoperatively, the treatment group was given eye drops containing epidermal growth factor(JinYinShu)combined with tobramycin while the control group was only administrated with tobramycin. Treatment effects were compared 3d after treatment.

RESULTS: Three days after treatment, the cure rate in the treatment group(93.7%), was significantly higher than that in the control group(76.6%)(P<0.05). In the treatment group, fluorescein staining was negative in 90.4% of the cases, significantly higher than that in the control group(46.8%)(P<0.01).

CONCLUSION: The recombinant human epidermal growth factor is capable of integrating with corneal epithelial cells and endothelial cell receptor, shortening healing time of corneal epithelial wound, thus making it an effective treatment of traumatic corneal epithelial defect.

Clinical effect observation of the sutureless suspension technique for foldable intraocular lens implantations

Yun-Kun Miao,Jia Ma,Yuan-Sheng Yuan,Ming Yang,Lu Lü and Hong-Fen Zhu — 2013/10/28 11:29:59

AIM: To observe the clinical effects of the sutureless intraocular suspended implantation of foldable three-piece acrylic aspheric posterior chamber lens(Tecnis)through clear corneal incision.

METHODS: A total of 21 patients(24 eyes)with non or unintact capsule that underwent the intraocular suspended implantation of foldable three-piece acrylic aspheric posterior chamber lens(Tecnis)through clear corneal incision were observed and compared clinically to evaluate the clinical effects of this operative method. The observation and comparison were made on the parameters including visual acuity, intraocular reaction and lens situation by ultrasound biomicrography(UBM)before and after the operation.

RESULTS:A 3-12 months(6.5 months on average)follow up shows significant improvement(P<0.01)of both the uncorrected and corrected visual acuity of 24 eyes. The corrected postoperative visual acuity were 1.0-1.5(8 eyes, 33.3%), 0.5-0.9(13 eyes, 54.2%)and 0.1-0.4(3 eyes, 12.5%), respectively. There was no statistical difference in the distance from the plane of artificial lens body to corneal endothelium, and the distance from ciliary process to corneal endothelia(P>0.05)in UBM photos after operations. All of 24 eyes were successfully conducted intraocular lens implantation without serious, intraocular infections or inflammations, no complications like cyclodialysis or retinal detachment. Only a few cases present temporary increase of intraocular pressure.

CONCLUSION: The sutureless intraocular suspended implantation of foldable three-piece acrylic aspheric posterior chamber lens(Tecnis)through 3.0-6.0mm clear corneal incision is an advisable remedy for capsule rupture failure during phaco-emulsification and an advisable operation for the dislocation of crystalline lens resulted from trauma or congenital cataract. The procedure can improve visual acuity safely and effectively without obvious complications. Its long-term effect needs long-term follow-up observation.

Clinical investigation on angle-closure glaucoma patients with cataract treated by phacoemulsification combined with trabeculectomy

Ling Hui,Zi-Feng Zhang and Yu-Sheng Wang — 2013/10/28 11:29:59

AIM: To investigate the effectiveness of phacoemulsification with intraocular lens(IOL)implantation combined with trabeculectomy in patients with cataract and angle-closure glaucoma.

METHODS: In 36 cases(46 eyes)of angle-closure glaucoma with cataract, phacoemulsification with foldable IOL implantation combined with trabeculectomy was performed. Data of pre- and post-operation, including visual acuity, intraocular pressure, filtering bleb, anterior chamber depth, chamber angle, and funds were all recorded and analyzed in detail.

RESULTS: During the follow-up of 3 months to 2 years,visual acuity of 43 eyes(93.5%)got improved, and intraocular pressure in 44 eyes(95.7%)were controlled in normal range(<21mmHg). Mean anterior chamber depth of 35 patients(46 eyes)got deeper from 2.1mm to 3.8mm(average 2.1±0.3mm to 3.8±0.4mm)after operation, with chamber angle opened to some extent. Six eyes(13.0%)got mild to moderate corneal edema, without corneal endothelial decompensation.

CONCLUSION: Phacoemulsification with IOL implantation combined with trabeculectomy is an effective and safe surgical technique for patients with angle-closure glaucoma and cataract, with satisfied control of intraocular pressure, deepening of anterior chamber, opening of anterior chamber angle, and improving visual function.

Correlation of operation age, axial length and lens thickness in cataract

Xiao-Yin Sun and Tang Xu — 2013/10/28 11:29:59

AIM: To study the correlation of operation age, axial length and lens thickness in cataract eyes.

METHODS: A total of 319 patients(393 eyes)were divided into non-high myopia cataract group(198 patients, 237 eyes)and high myopia cataract group(121 patients, 156 eyes)according to the axial length. Axial length and lens thickness were measured with A-mode ultrasound biometry.

RESULTS: There were statistical difference in operation age(t=3.614, P=0.000), lens thickness(t=-3.081, P=0.002)between the non-high myopia cataract group and high myopia cataract group. The operation age of high myopia cataract group was younger than that of non-high myopia cataract group. The lens thickness in high myopia cataract group was thicker than that in non-high myopia cataract group. There was no significant correlation between age and axial length in the non-high myopia cataract group(r=-0.081, P=0.214). Age and lens thickness had positive correlation in the non-high myopia cataract group(r=0.178, P=0.006). Axial length and lens thickness had no significant correlation in the non-high myopia cataract group(r=-0.050, P=0.442). There was a negative correlation between age and lens thickness in the high myopia cataract group(r=-0.211, P=0.008). Age and lens thickness had no significant correlation in the high myopia cataract group(r=0.078, P=0.332). Axial length and lens thickness had positive correlation in the high myopia cataract group(r=0.207, P=0.010).

CONCLUSION: For the non-high myopia cataract patients, the cataract aggravate as the age increase. The operation age will not change as the axial length change. For the high myopia cataract patients, the cataract will not aggravate as the age increase, and the longer of the axial length, the younger of the operation age.

Micro-incision phacoemulsification combined with Toric intraocular lenses to correct preexisting corneal astigmatism in cataract patients

Bo Lu and Yan-Li Zhou — 2013/10/28 11:29:59

AIM: To assess the clinical outcomes and safety of toric intraocular lenses(Toric IOL)for the correction of preexisting corneal astigmatism in cataract patients having micro-incision phacoemulsification.

METHODS:Fifty-eight patients(69 eyes)with age-related cataract and corneal astigmatism were included in this clinical case series study and had micro-incision phacoemulsification combined with of Acrysof Toric IOL implantation. Preoperative corneal astigmatism was more than 0.75 diopter(D)for all eyes. The postoperative data of visual acuity, corneal astigmatism,and anticipated residual astigmatism were recorded. Uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), postoperative residual astigmatism and toric lens axis were observed. The postoperative data was collected on the day 1, month 1, 3 and year 1 after operation.

RESULTS: At 1 year following surgery, the UCVA rise up to 0.70±0.11 from 0.15±0.06(χ²=86.67, P<0.05)on average, and BCVA from 0.21±0.01 to 0.73±0.20(χ²=82.23, P<0.05)indicating a statistical difference. Mean preoperative figure of corneal astigmatism and anticipated residual astigmatism was 2.25±0.73D and 0.34±0.09D, and corneal astigmatism was 0.51±0.21D one year after operation, indicating a statistical difference between preoperative and postoperative astigmatism(t=12.48, P<0.05). There was no statistical difference among postoperative corneal astigmatism and anticipated residual astigmatism(t=1.69, P>0.05). The D-value of IOL positioning and predict axis was 3.79°±1.21° one year postoperatively. Ninety-six percent of patients had less than 5.00° of rotation, and no operative complication was found. There was no statistical difference in various time quantum in terms of BCVA, residual astigmatism, IOL axial view rotation(P>0.05).

CONCLUSION:For cataract patients, micro-incision phacoemulsification combined with Toric IOL can effectively improve visual acuity, rectify preoperative corneal astigmatism with fair stability.

Influence of two types of cataract surgery on corneal endothelial cells

Lei Li,Zhen-You Zheng and Li-Ping Chen — 2013/10/28 11:29:59

AIM: To compare the effects of small incision extracapsular cataract extraction and phacoemulsification on corneal endothelial cells.

METHODS: Eighty-two age-related cataract cases(82 eyes)from March 2011 to October 2011, were randomly divided into two groups: phacoemulsification group(group A)and small incision extracapsular cataract extraction group(group B). Corneal edema after operation and changes in corneal endothelial cells in different stages before and after operation were observed.

RESULTS: In both groups,there was significant difference in the data of corneal endothelial cell density before and after operation(P<0.05). Although all the postoperative data of corneal endothelial cell density were lower than the preoperative ones, they had been slightly increasing over time. The mean density of corneal endothelial cell in group A was significantly higher than that in group B at 7d, 1 month and 3 months after operation(P<0.05). In both groups, the average proportion of corneal hexagonal cells at 7d, 1 month and 3 months after operation was obviously lower than that before surgery, with significant difference between the two groups. Postoperative corneal edema was less severe in group A than in group B(P<0.05).

CONCLUSION: Phacoemulsification causes less damage to corneal endothelial cells and less postoperative corneal edema than small incision extracapsular cataract extraction.

Clinical observation of two operation methods for neovascular glaucoma

Jin-Peng Chen,Rong Wang,Hui-Yong Xu,Peng Zhang and Jian Zhang — 2013/10/28 11:29:59

AIM: To evaluate the clinical effect of two different surgical treatments for neovascular glaucoma(NVG).

METHODS: A total of 30 NVG inpatients(30 eyes)at our hospital from April 2008 to December 2011 were reviewed. Patients were divided into two groups according to the different surgical treatments. In group A, 12 cases(12 eyes)were treated with Ahmed glaucoma valve(AGV)implantation and in group B, 18 cases(18 eyes)were treated with semiconductor diode laser photocoagulation transscleral cyclophotocoagulation(TSCPC). Intraocular pressure, visual acuity and complications were compared between two groups postoperatively.

RESULTS: The postoperative IOP was significantly lower in each group(P<0.01). There were statistically significant differences(P<0.05)between AGV implantation group and TSCPC group in IOP 1 week after surgery, but there were no statistically significant difference(P>0.05)in IOP 1 month after surgery. Visual acuity: in group A, the visual acuity was improved in 3 eyes, unchanged in 7 eyes and worsened in 2 eyes.; in group B, the visual acuity was improved in 3 eyes, unchanged in 12 eyes and worsened in 3 eyes. Postoperative complications: in group A, eyeball pain and corneal edema were found in 5 cases(41.7%), shallow anterior chamber in 3 cases(25%), anterior chamber fibroid exudation in 2 cases(16.7%), hyphema in 3 cases(25%); in group B, eyeball pain atearly stage after surgery were found in 10 cases(55.6% ), corneal edema in 11 cases(61.1%), anterior chamber fibroid exudation in 5 cases(27.8%), hyphema in 6 cases(33.3%).

CONCLUSION: AGV implantation and TSCPC are both effective surgical treatment methods for NVG. AGV implantation is a filtration surgery, which is relatively safe. TSCPC is more economical and suitable for glaucoma of advanced or absolute stage.

Analysis on relative factors of the incidence and development of diabetic retinopathy

Jian-Wen Zhang,Li Ma and Feng-Xian Ma — 2013/10/28 11:29:59

AIM: To investigate the relative factors of the incidence and development of diabetic retinopathy(DR).

METHODS: The retinopathy of the 631 patients with type 2 diabetes mellitus(T2DM)was examined by ophthalmoscopy and fundus fluorescein angiography(FFA), and the relative factors which possibly associate with the incidence and development of DR were collected.

RESULTS: There were 205 patients with DR, the morbidity rate of DR was 32.5%(95%CI:28.82%-36.15%), the nonproliferative diabetic retinopathy(NPDR)and proliferative diabetic retinopathy(PDR)were 134 cases occupying 21.2%(95%CI: 18.04%-24.44%)and 71 cases occupying 11.3%(95%CI: 8.78%-13.72%)of the patients with DR, respectively. Univariate analysis showed that income, living environment, whether treatment by insulin, combined with diabetic nephropathy(DN), combined with diabetic peripheral neuropathy(DPN), hold on exercise, course of diabetes, fasting plasma glucose(FPG), 2 hours' postprandial plasma glucose(2hPG), glycosylated hemoglobin A1c(HbA1c), systolic blood pressure(SBP), total cholesterol(TC), urinary albumin excretion rate(UAER), serum creatinine(SCr), and blood urea nitrogen(BUN)were significant different among the patients without DR, the patients with NPDR and the patients with PDR(P<0.05 or P<0.01). Multivariate ordinal Logistic regression analysis showed that the incidence and development of DR increased in patients with longer course of diabetes, high HbA1c, high UAER and without exercise, and decreased in patients without DN and DPN(P<0.05 or P<0.01).

CONCLUSION: There was a high morbidity rate of DR in patients with patients with type 2 diabetes. The longer course of diabetes, high HbA1c, and without exercise were the independent development factors of DR, whether combined with DN, combined with DPN and UAER were indices for the incidence and development of DR.

Clinical analysis of the application of non-mydriatic fundus photography for diabetic retinopathy screening

Wei Xia,Li Wang,Peng-Qiu Li,Xue-Jun Zhang,Yan Yang and Yi Yang — 2013/10/28 11:29:59

AIM: To screen diabetic retinopathy(DR)in diabetes mellitus(DM)patients by non-mydriatic fundus photography, and to investigate the risk factors in DM patients for DR.

METHODS:A total of 768 patients with DM type 2 treated in the department of endocrinology in our hospital from November 2010 to December 2011 were enrolled in this study. All patients underwent non-mydriatic fundus photography, and were divided into two groups: non-diabetic retinopathy group(NDR group)and DR group, in accordance with the international clinical staging standard of DR released in 2002. Weight, height, blood pressure and medical history were recorded. Serum levels of fasting plasma glucose(FPG), lipids, glycated hemoglobin(HbA1c)and uric acid(UA)were measured.

RESULTS: Totally 317 out of 768 DM patients(41.3%)were diagnosed with DR. The detection rate in women was significantly higher than that in men(45.2% vs 37.6%, P<0.05). Compared with NDR group, DR group had older age, longer course and higher systolic blood pressure(SBP), FPG, Triglycerides(TG), HbA1c and UA level(P<0.05). Dinary logistic regression analysis showed that duration, gender, SBP and HbA1c were independent risk factors of DR in DM patients.

CONCLUSION:DR in DM patients is quite common and closely associated with duration, gender, blood pressure and glucose. Non-mydriatic fundus photography is a quite useful method for screening DR.

Functional analysis of dendritic cells from peripheral blood in patients with diabetic retinopathy

Xin Jin,Tie-Cheng Liu and Mao-Nian Zhang — 2013/10/28 11:29:59

AIM: To analyze the functions of dendritic cells(DC)from peripheral blood in type 2 diabetes mellitus(T2DM)patients with diabetic retinopathy(DR), and investigate the role of DC in the pathogenesis of DR.

METHODS: The subjects were divided into simple T2DM group, T2DM with DR group and normal control group. Flow cytometry was used to analyze classification and number of DC in peripheral blood, and ELISA was used to detect the level of Interleukin -12(IL-12).

RESULTS: Compared with the simple T2DM and normal control groups, the number and percentage of myeloid dendritic cells(mDC)in peripheral blood increased significantly in T2DM with DR group(P<0.05). The contents of IL-12 in plasma also increased significantly in T2DM with DR group, while the contents of IL-12 in cultured mDC supernatant and the IL-12 secretion of single mDC reduced significantly(P<0.05). The number and percentage of plasmacytoid dendritic cells(pDC)had no significant difference among the three groups(P>0.05).

CONCLUSION: Drift of the mDC/pDC subtype causes Th1/Th2 immune function disorders and promotes the immune inflammatory reaction, which may play an important role in the occurrence and development of DR.

Clinical application of microperimetry before and after glucocorticoid pulse therapy for acute pan-uveitis

Xuan Li and Zhuo Liu — 2013/10/28 11:29:59

AIM:To evaluate microperimetry in treatment of acute pan-uveitis patients before and after glucocorticoid pulse therapy, and to provide evidence for the clinical application of microperimetry.

METHODS:Fifty-three patients(106 eyes)with acute pan-uveitis who came to hospital within 5 days of onset were enrolled. The data of visual acuity, best corrected visual acuity, microperimetry images, OCT and flare examination outcome were analyzed before glucocorticoid pulse therapy and 1, 3, 7d, 1 month and 3 months after the therapy. The changes in visual acuity, light sensitivity, cell value of aqueous humor and macular edema were observed.

RESULTS: In patients with acute pan-uveitis, inflammation subsided gradually after treatment. Compared with the data before corticosteroid pulse therapy, all the data after the therapy showed significant improvement(P<0.05). Patients' vision at various times after the treatment improved gradually. The thickness of neuroepithelial layer of macular retina improved from(281±61)μm before treatment to(149±43)μm after treatment with significant difference(P=0.000). Flare examination result changed from 213.9±13.8 before treatment to 18.2±2.2 after treatment with significant difference(P=0.000).

CONCLUSION:Microperimetry can reveal the changes in visual acuity and light sensitivity before and after the glucocorticoid pulse therapy in patients with acute pan-uveitis, which suggests that microperimetry can serve as an efficient way to observe the development of acute pan-uveitis and its therapeutic effects.

Clinical study of conjunctival papilla grinding technique in the treatment of severe vernal keratoconjunctivitis with huge conjunctival nipple

Zong-Duan Zhang,Qin-Tuo Pan,Hui-Xiang Ma and Bing-Bing Chen — 2013/10/28 11:30:00

AIM: To observe and assess the efficacy and safety of conjunctival papilla grinding technique in the treatment of severe vernal keratoconjunctivitis(VKC)with giant conjunctival papilla.

METHODS: The prospective and controlled study was performed in 17 patients(24 eyes)with VKC. Eight patients(12 eyes)with giant conjunctival papillae were treated with grinding technique and 9 patients(12 eyes)were performed with conjunctival papillectomy, respectively. A comparison was made on the changes of symptoms including itching, tearing, light sensitivity and grittiness and physical signs of conjunctival papilla and the corneal epithelium before and after surgery.

RESULTS:The symptoms and signs in the first week, the second week and the forth week after the operation were obviously improved in the two groups, and differences in these aspects before and after surgery were of statistical significance(P<0.01). However, by grading of the signs of huge conjunctival nipple in the first week, the second week and the forth week after the operation, and conditions of repair of corneal damage in the second postoperative week, the result showed that efficacy of the grinding group was better than that of the surgical removal group(P<0.05).

CONCLUSION:Conjunctival nipples grinding operation can make the rough conjunctival wound flat quickly, relieve symptoms, and promote the repair of keratoconjunctival epithelium. And it is an effective, safe, and simple method to treat the severe VKC with huge conjunctival nipples.

Efficacy observation of danshen injection iontophoresis treatment for vitreous hemorrhage

Jing Hao and Guang-Wei Cui — 2013/10/28 11:30:00

AIM: To probe into the clinical value of danshen injection iontophoresis in treatment of vitreous hemorrhage.

METHODS: Eighty-eight vitreous hemorrhage patients(88 eyes)were selected from June 2012 to June 2013 in our hospital. The patients were divided into observation group and control group randomly, with 44 cases(44 eyes)in each group. The patients in control group were treated with xueshuantong clinical drug treatment. The patients in observation group were treated with danshen injection iontophoresis clinical drug treatment. The clinical treatment and visual recovery situations of the patients in two groups were compared and analyzed.

RESULTS: The cure rate and total effective rate of observation group were 75% and 95%. The cure rate and total effective rate of control group were 59% and 77%. There were statistically significant differences(P<0.05). Compared with control group, the rate of patients in observation group with visual acuity between 0.6 to 0.9 was improved significantly, rate of visual acuity less 0.2 was reduced significantly, and the whole blood viscosity, plasma viscosity, hematocrit and fibrinogen were improved significantly, there were statistical significance(P<0.05).

CONCLUSION: Danshen injection iontophoresis therapy has positive role in improving clinical outcomes and promoting visual function for patients with vitreous hemorrhage.

Comparative study of the accommodative convergence/accommodation after refractive correction

Ling-Fang Du,Zheng-Qing Wu,Fang He,Wei-Qiong Song,Yan-Li Zhang and Peng-Fei Lin — 2013/10/28 11:30:00

AIM: To study the ortho-k lens and frame glasses in patients with juvenile myopia the influence of the accommodative convergence/accommodation(AC/A), further clear the effectiveness of controlling the myopia development and security.

METHODS: Randomly select 60 patients to our hospital check-up successfully with ortho-k lens of juvenile myopia patients as experimental group, and 60 cases were randomly selected given frame glasses as control group. we observed two groups of patients before and after refractive correction the changes of AC/A and spherical equivalent. Observation time was 1 month, 3 months, 6 months, 1 year.

RESULTS: The AC/A of experimental group worn glasses before and after 1 month, 3 months, 6 months, 1 year were 4.05±2.03, 3.05±1.85, 3.31±1.02, 3.14±1.64 and 3.20±1.55,respectively with statistically significant difference(P<0.05). That of control group, worn glasses before and after 1 month, 3 months, 6 months, 1 year were: 4.12±1.86, 4.09±1.38, 3.58±1.45, 3.84±1.41 and 4.23±2.01, respectivley. Worn glasses after 1 month,6 months, 1 years there were no statistically significant difference(P>0.05). Three months after worn glasses there was significant difference(P<0.05). The two groups had no significant difference before(P>0.05). Wearing glasses after 1 month, 6 months, 12 months, the two groups had significant difference(P<0.05); 3 months after worn glasses there was no statistically significant difference(P>0.05). Spherical equivalent, observation time was 1 year: experimental group spherical equivalent degrees increased by 0.38±0.35DS, the control group spherical equivalent degrees increased by 0.84±0.56DS, the two groups were statistically significant difference(P<0.05).

CONCLUSION: Both groups could reduce the AC/A value. The experimental group than the control group was better and faster to improve the relationship between the adjustment and collection. The AC/A value was on the high side after myopic degree growth. The ortho-k lens is an effective lens for the moderate myopia.It can more effectively control the growth of juvenile myopia than frame glasses, which is an effective way to control myopia. The mechanism of improving his visual function remains to be further studied.

Clinical effect observation of wavefront-guided femtosecond laser in situ keratomileusis for correcting high myopia

Min Cui and Qi-Zhi Zhou — 2013/10/28 11:30:00

AIM: To investigate the outcome of wavefront-guided laser in situ keratomileusis(LASIK)with femtosecond laser for correcting high myopia

METHODS: Thirty-two patients(58 eyes)with high myopia(myopia degree: -6.0～-10.0DS, astigmia degree ≤ -2.0DC)underwent wavefront-guided LASIK using femtosecond laser in Chongqing Aire Eye Hospital from October to December in 2012 were collected as wavefront group, and 28 patients(56 eyes)with high myopia(myopia degree: -6.0～-10.0DS, astigmia degree ≤ -2.0DC)receiving LASIK with femtosecond laser were chosen as control group. These patients were followed up for 6 months. Uncorrected visual acuity(UCVA), refraction, total high order aberrations(HOA), spherical values and coma values between two groups were compared.

RESULTS: Six months after the operation, UCVA of all eyes were higher than 0.8. UCVA achieved 1.0 or better, which account for 91.4% of eyes in wavefront group and 87.5% in control group, the difference was not statistically significant(P=0.360). UCVA achieved 1.2 or better in 60.3% of eyes in wavefront group and 57.1% in control group, the difference was not statistically significant(P=0.729). UCVA achieved 1.5 or better in 17.2% of eyes in wavefront group and 12.5% in control group, the difference was not statistically significant(P=0.477). The coma values were lower in wavefront group than that in control group, the difference was statistically significant(P=0.021). There was no statistically significant difference in postoperative UCVA, refractions, total HOA and spherical values between two groups(P>0.05).

CONCLUSION: Compared with conventional LASIK with femtosecond laser, although wavefront-guided LASIK with femtosecond laser canreduce the coma values of patients with high myopia, wavefront-guided LASIK with femtosecond laser has no adventage in improving UCVA,correcting refractions, reducing the total HOA, and. spherica values.

Comparative study of Epi-LASIK and LASIK for myopic astigmatism

Dong-Qiang Luo,Hua Wang,Shu-Xi He and Jiao Chen — 2013/10/28 11:30:00

AIM: To analyze the effects of epipolis laser in situ keratomileusis(Epi-LASIK)and laser in situ keratomileusis(LASIK)for treatment of myopic astigmatism.

METHODS: For treatment of myopic astigmatism, 32 patients(64 eyes)treated by Epi-LASIK and 63 patients(126 eyes)received LASIK. By their degree of astigmatism, the eyes were divided into Group Ⅰ(-0.25～-2.75)DC and Group Ⅱ(-3.0～-5.0)DC. During the 6-month follow-up, the early effects of the two operations were observed and compared in terms of uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), residual astigmatism, corneal healing, intraocular pressure(IOP), corneal topography.

RESULTS: In Group Ⅱ, UCVA better than 20/20 was achieved in 87.5% of the eyes subjected to Epi-LASIK and in 63.3% of the eyes subjected to LASIK, with significant difference between them(χ²=4.055, P<0.05); residual astigmatism was -0.41±0.30D for the Epi-LASIK eyes and -0.74±0.36D for the LASIK eyes, with significant difference between them(t=2.672, P<0.05); postoperative corneal astigmatism was 0.63±0.34D for the Epi-LASIK eyes and 0.81±0.52D for the LASIK eyes with significant difference between them(t=2.234, P<0.05).

CONCLUSION: For treatment of high astigmatism(≥-3.00D), Epi-LASIK is more effective and predictive than LASIK.

Influences of OCT image on the prognosis of visual outcomes among patients with idiopathic macular holes

Jian-Ping Gao and Xiao-Jian Guo — 2013/10/28 11:30:00

AIM:To observe the optical coherence tomography(OCT)images of idiopathic macular hole(IMH)on patients before and after vitrectomy and internal limiting membrane peeling(ILMP)surgery, and to analyze the relationship between the macular hole configuration and the postoperative best corrected visual acuity so as to offer a potential index to effectively predict visual outcome in eyes with idiopathic macular holes.

METHODS: A total of 32 consecutive patients of IMH(7 males, 25 females)receiving the operation of PPV and ILMP were performed with routine ophthalmologic and OCT examination before and after the operation. The best-corrected visual acuity(BCVA)in the follow-up period was recorded. The minimum diameter, the base diameter, the hole height before the operation, and the macular retinal thickness before and after the operation were measured respectively by the analytical model of OCT. The correlation between macular hole index(MHI)and BCVA post operation was analyzed using SPSS 13.0.

RESULTS: The negative correlation was observed between the post operative BCVA and the minimum diameter and the base diameter before the operation(r=-0.524, -0.610, P<0.01); There were no significant correlation between the post operative BCVA and the hole height and the macular retinal thickness(r=-0.064, 0.003, P>0.05). The positive correlation was observed between the postoperative BCVA and the MHI before operation(r=0.457, P<0.01); The cut-off value of MHI was defined as 0.5 by clinical observation. Postoperative BCVA in the MHI ≥0.5 group was much better than that in the MHI<0.5 group(Mann-Whitney Test, U=30.0, W=135, P<0.01). The postoperative BCVA of patients with IMH was much better than that before the operation.

CONCLUSION: The smaller the minimum diameter and the base diameter is, the better the post operative BCVA. The MHI is easy to calculate, and patients of MHI ≥0.5 have a better postoperative BCVA, MHI can be used as clinical evaluation-index for operation selection. The PPV combined with IMLP can effectively treat the IMH based on the OCT result.

Investigation on screening criteria and early intervention age for refractive error in infants

Xing-Xiang Wu,Guang-Qiang Wu,Ning Wei,Yu-Tong Wang and Mei-Ling Tong — 2013/10/28 11:30:00

AIM: To analyze the refractive development in infants, to screen for the high risk group for infant refractive error and to explore the best timing for early intervention of the condition.

METHODS:Noncycloplegic refraction data in 7 stages of age(6, 9, 12, 18, 24, 30, and 36 months)were collected with Suresight autorefractor from 2 447 healthy infants(4 894 eyes). The development and distribution of refraction were analyzed.

RESULTS:Most of the 4 894 eyes were found to be hyperopic and astigmatic. The mean and standard deviation of sphere, cylinder, and spherical equivalent for seven age groups from 1.5 years as well as reference ranges(P₂₅～P₇₅ and P₅～P₉₅)were obtained. Hypermetropic and astigmatic refractive error reduced rapidly with age until the age of 1.5 years old, after which they did not change significantly.

CONCLUSION: In infants, spherical lens deviating from P₂₅～P₇₅(D)and cylindrical lens exceeding P₇₅(D)amblyopia are the suspected signs of amblyopia, and spherical lens deviating from P₅～P₉₅(D)and cylindrical lens exceeding P₉₅(D)indicate high risk of amblyopia. Intervention of refractive error may start at the age of 1.5 years.

Analysis on epidemiologic feature of dry eye in ophthalmologic pediatric outpatients

Wen-Guang Li,Shan-Shan Tang and Gui-Gang Li — 2013/9/23 14:08:05

AIM: To study the incidence of dry eye among clinic pediatric patients, and to analyze the correlation between pediatric dry eye and age, video display terminals(VDT)and conjunctivitis.

METHODS: There were 128 cases of ophthalmology pediatric outpatients(7-13 years)enrolled in this study in an order-statistic manner. Modified ocular surface disease index(OSDI)questionnaire and the tear film breakup time(BUT)were used to evaluate the prevalence of dry eye and severity.

RESULTS: The overall prevalence of dry eye in this study was 19.5%, of which 64 cases(15.6%)of children belongs to 7-10 years old group; another 64 cases(23.4%)of children belongs to 11-13 years old group. OSDI averaged 2.15±0.83 in 11-13 years old group, which was higher than that of 7-10 years old group(1.55±0.61). The difference between the two groups was statistically significant(P<0.05). In contrast, BUT averaged 10.05±2.97s in 11-13 years old group, which was shorter than that of 7-10 years old group(12.05±3.25s). The difference between the two groups was statistically significant(P<0.05). Those children who used visual display terminals over 2h every day had dry eye prevalence higher than that of the control group(43.3% vs 12.2%). Similarly, those who suffered from conjunctivitis during the recently three months had dry eye prevalence higher than that of the control group(26.3% vs 8.3%). The differences of OSDI and BUT between groups of each case were statistically significant(P<0.05).

CONCLUSION: A considerable number of pediatric patients suffered from dry eye. Growing age, excessive use of visual display terminals and conjunctivitis are important risk factors.

Postoperative efficacy of partial accommodative esotropia in children

Jian-An Lu,Wei Yang and Dan Wen — 2013/9/23 14:08:05

AIM:To explore the operative opportunity and postoperative effects in patients with partially accommodative esotropia.

METHODS: Three stages of the binocular visual function and VEP were observed in different ages with 65 cases of partially accommodative esotropia in preoperatively and postoperatively.

RESULTS: The difference in binocular visual function between preoperatively and postoperatively was significant(Z=7.253, P=0.000). The difference in binocular visual function with the difference age of operation was significant(H=6.739, P=0.034). The postoperation latencies were shortened and amplitude values were higher than preoperation(P_latency=0.029, P_amplitude=0.037).

CONCLUSION: The binocular visual function was improved after surgery. The early correction of eye position will benefit to the binocular visual function.

Lamellar keratoplasty combined with anterior chamber injections in the treatment of fungal corneal ulcer

Jing Zhang,Wan-Peng Wang,Wen-Fang Zhang and Jian-Hua Lu — 2013/9/23 14:08:05

AIM: To evaluate the clinical efficacy of lamellar keratoplasty combined with anterior chamber injections in the treatment of fungal corneal ulcer.

METHODS:Patients who are diagnosed with fungal corneal ulcer and treated with layer corneal transplantation were in control group. Those with fungal corneal ulcer that treated with lamellar keratoplasty in experimental group, as well as they were injected with 0.1mL fluconazole(0.05mL 2g/L fluconazole +0.05mL normal saline)into the anterior chamber for three times during operation, at the 3^rd day and 10^th day after operations.

RESULTS: The recurrence rate was 11% in control group, while no recurrence for experimental group in a 3- to 6-month follow-up observation.

CONCLUSION: The combination of anterior chamber injection into lamellar keratoplasty is an efficient approach to cure fungal corneal ulcer, and shows low recurrence rate.

Etiology and drug resistance analysis on fungal keratitis

Jin-Tao Chen — 2013/9/23 14:08:05

AIM: To investigate and analyze corneal edge ulcer training results, pathogenic bacteria distribution and drug resistance status of fungal keratitis.

METHODS:Corneal edge ulcer of 68 fungal keratitis patients who were treated in our hospital from January 1, 2011 to December 31, 2012 was collected. They were sent to isolate culture, identification and drug sensitive test. The culture and drug sensitive test results, and pathological changes of corneal tissue were summarized.

RESULTS:Fifty strains of fungi strains were checked out from 68 corneal edge ulcer, most of them were sickle bacteria genus. The resistant rate of natamycin, fluconazole, amphotericin and itraconazole was 26%, 46%, 54% and 60%, respectively.

CONCLUSION: The most pathogenic bacteria were sickle bacteria genera, the resistance of amphotericin and itraconazole is higher, while that of itraconazole is lower.

Effects of phacoemulsification combined with intraocular lens implantation on ocular surface

Ming Li,Juan Liu and Wei Liu — 2013/9/23 14:08:05

AIM: To explore the changes of ocular surface after phacoemulsification combined with intraocular lens implantation.

METHODS: Totally 78 cases of 78 eyes with age-related cataract were collected from August 2011 to October 2012, and they underwent corneal incision phacoemulsification combined with intraocular lens implantation. The score of dry eye symptoms; tear breakup time(BUT); Schirmer Ⅰ test(SⅠt)and corneal fluorescein staining were observed and recorded in 3 days before, 1 day, 1 week, 1 month, 3 and 6 months after surgery respectively. The results were analyzed statistically.

RESULTS: All the subjects complained of dry eye within 1 week after surgery. Compared with 3 days before the surgery, the corneal fluorescein staining increased and the amount of tear secretion reduced statistically significant in 1 day, 1 week and 1 month(P<0.05). BUT was significantly shorten in 1 month after surgery(P<0.05). Three months after the operation, they were all recovered to the level of before(P>0.05), and lasted to 3 months later.

CONCLUSION: Phacoemulsification combined with intraocular lens implantation has obvious effect on the ocular surface to some extent. Preventions and treatment should be taken clinically.

Investigation of perioperative prophylactic utilization of antibiotics in phacoemulsification and intraocular lens implantation

Wei-Jiang Chen — 2013/9/23 14:08:05

AIM: To investigate the perioperative prophylactic utilization of antibiotics in phacoemulsification and intraocular lens implantation patients in ophthalmology department of our hospital.

METHODS: A total of 1 156 cases underwent phacoemulsification and intraocular lens implantation from November, 2009 to November, 2012 in our hospital was included. Category of antibiotics, administration time point, medication time, wound healing were analyzed statistically and the rationality of above indexes was evaluated.

RESULTS: All 1 156 cases received prophylactic antimicrobials by local application in the perioperative period(100%). The utilization rate of the antibacterials systematically of 1 156 patients was 166(14.36%); The utilization rate of the antibacterials systematically in patients with two systemic infection risk factors was 72.09%; The utilization rate of the antibacterials systematically in patients with three or more systemic infection risk factors was 100%. All incisions were healed well with no postoperative infections.

CONCLUSION: The perioperative prophylactic utilization of antibiotics in phacoemulsification and intraocular lens implantation patients was meeting the standard of the ministry of health. In addition, the ministry of health organization was advised to formulate the clinical guidelines on perioperative prophylactic utilization of antibiotics in eye operation.

Long-term clinical manifestations of multifocal intraocular lens implantation

Jian-Jun Tao,Qian Xing,Jiong Lu and Zheng Gu — 2013/9/23 14:08:05

AIM: To investigate the long-term clinical manifestations of Array multifocal intraocular lens implantation.

METHODS: Of 33 cases with phacoemulsification cataract operation, 19 cases(25 eyes)underwent implantation of multifocal intraocular lens(experimental group), 14 cases(20 eyes)implanted monofocal intraocular lens(control group). Postoperative far visual acuity, intermidiate visual acuity, near visual acuity, stereo vision, off glass rate under different distances was observed.

RESULTS: The near uncorrected visual acuity ≥0.5 in experimental group were 17 eyes(68%, 17/25), and that in control group were 6 eyes(30%, 6/20), there was significant difference between two groups(P<0.05). The far uncorrected visual acuity ≥0.5 in experimental group were 23 eyes(92%, 23/25), and that in control group were 20 eyes(100%, 20/20), there was significant difference between two groups(P>0.05). Intermediate visual acuity: 40cm: scores of experimental group were 54.64±10.80, scores of control group were 47.05±6.39, there was significant difference between two groups(P<0.05). 63cm: scores of experimental group were 50.36±10.32, scores of control group were 46.50±8.32, there was no significant differences between two groups(P>0.05). 100cm: scores were 43.44±8.08 and 42.05±6.63 in experimental group and control group, with no significant difference(P>0.05). Stereo vision: 6 cases of experimental group underwent bilateral operation, stereo acuity of 6 cases was ≤60″, 6 cases of control group underwent bilateral operation, 1 case stereoacuity was ≤60″, there was significant difference between two groups(P<0.05). Wear glasses rate when reading newspaper: 6 cases of the 19 cases in experimental group need glasses, 11 cases of the 14 cases in control group need glasses, there was significant difference between two groups(P<0.05).

CONCLUSION: Array multifocal intraocular lens offered good vision in postoperation, provided good stereo vision for operators, reduced the rely on glasses postoperation, improved the quality of life for patients.

Trabeculetomy combined with implantation of silicon rubber slice for refractory glaucoma

Ming-Hai Shen and Chuan-Kai Fang — 2013/9/23 14:08:06

AIM: To evaluate the effect of trabecular filtration surgery combined with scleral interlayer filled with silicon rubber for refractory glaucoma and its complications.

METHODS: A total of 32 cases(32 eyes)of refractory glaucoma underwent trabecular filtration surgery combined with sclera interlayer filled silicone piece, namely trabeculectomy combined silicon rubber filled in sclera between layers was as experimental group. Twenty-one cases(21 eyes)treated by simple trabecular filtration surgery were as control group. Reducing effect of intraocular pressure(IOP)and complications of two groups were observed after operation.

RESULTS: Postoperative follow-up was 6-24 months. The mean IOP was 14.36±5.2mmHg(1mmHg=0.133kPa)in experimental group and 23.36±9.3mmHg in control group after operation. IOP of three eyes(9.4%)in experimental group and 5 eyes(23.8%)in control group was over 30mmHg. There was no serious complications and rejection correlated with silicone piece during the follow-up period.

CONCLUSION:Silicone piece filled between sclera layer is an effective method for refractory glaucoma, and can effectively reduce IOP. Due to its economic, convenient, especially can replace expensive imported drainage plant figure treatment of refractory glaucoma in our country the grass-roots hospital, it should be widely applied.

Clinical analysis of modified trabeculectomy in glaucoma surgery with high elevated intraocular pressure

2013/9/23 14:08:06

AIM: To make a retrospective analysis of the clinical data of modified trabeculectomy in treating glaucoma surgery with high elevated intraocular pressure retrospectively and evaluate the effect of modified trabeculectomy.

METHODS:One hundred acute angle-closure glaucoma patients(100 eyes)with persistent high intraocular pressure were divided into treatment group(45 eyes)and control group(55 eyes). Patients in treatment group was treated with by trabeculectomy, while those in control group received modified trabeculectomy. The modified measures include stellate ganglion block preoperative, topical anesthesia and local anesthesia with 20g/L lidocaine cotton-piece, to make scleral flap with sclerotome, to release aqueous humor outflow slowly after paracentesis of anterior chamber, and using mydriatic and cycloplegic during and after surgery.

RESULTS: The incidence of operation complicationin control group was lower than that in treatment group. The differences were statistically significant(P<0.05). The intraocular pressure of control group was lower than that of treatment group after 3 months follow-up. The differences were statistically significant(t=9.1535, P<0.05). The average hospitalization days and the expenses in the hospital of the control group were lower than that of the treatment group. The differences were statistically significant(t=39.8010, P<0.01; t=11.3219, P<0.01).

CONCLUSION: The modified trabeculectomy applied in the treatment of glaucoma with persistent high intraocular pressure can not only save the visual function of connection part to a certain extent, but also reduce the incidence of serious complications. It can obtain better intraocular pressure, shorten the average hospitalization days, decrease the expenses and increase patients satisfaction.

Relevant risk factors analysis of diabetic retinopathy in patients with type 2 diabetes mellitus from community

2013/9/23 14:08:06

AIM: To investigate the related risk factors of diabetic retinopathy(DR)in patients with type 2 diabetes mellitus(DM)in residents of community in our local area and provide a clinical evidence for prevention and treatment for the complication of DM.

METHODS: The residents who lived in our local community with type 2 DM and hospitalized were studied. The stages of DR and duration of DM, blood pressure, level of blood glucose, blood lipids and other factors were analyzed statistically.

RESULTS: Fifty-three patients(30.1%)were found with DR in 176 cases. The risk factors included the diabetic duration and glycosylated hemoglobin(all P<0.05). Age, systolic blood pressure, diastolic blood pressure, fasting blood glucose, 2-hour postprandial blood glucose, serum cholesterol, triglycerides, high dense lipoprotein, low dense lipoprotein, alanine aminotransferase, aspartate aminotransferase, creatinine, blood urea nitrogen were not risk factors of DR(all P>0.05).

CONCLUSION: Diabetic duration and glycosylated hemoglobin are the risk factors of DR.

Clinical analysis of 28 cases with diabetic retinopathy during pregnancy

Min Zeng and Bin-Bin Li — 2013/9/23 14:08:06

AIM: To investigate the progress, prevention and cure effect of diabetic retinopathy(DR)during pregnancy.

METHODS: Eighty-four gravidas were enrolled in this prospective study. The patients were divided into three groups, group A consisting of 28 gravidas with gestational diabetic mellitus(GDM)with DR, group B consisting of 28 gravidas with GDM alone, and group C consisting of 28 normal gravidas. The best corrected visual acuity(BCVA)and glycosylated hemoglobin(HbA1c)were determined and fundus photography was performed at 6, 9 months of pregnancy and 6 months after parturition respectively.

RESULTS: During pregnancy, the morbidity of GDM and DR was respectively 5.6% and 16.7%; the progress rate of gestational DR was 39.3%. At 9 months of pregnancy, the mean BCVA of group A was significantly poorer than that of group B or C(P<0.05)while there was no significant difference in BCVA between group B and C(P>0.05). The BCVA of group A at 9 months of pregnancy was poorer than that at 6 months of pregnancy or 6 months after parturition. At all times, the mean level of HbAlc of group A were significantly higher than that of group B or C(P<0.05).

CONCLUSION: DR progressing during pregnancy may be related to the increased HbAlc level, so close monitoring and control of blood glucose may help to reduce the visual impairment among DM gravidas.

Prophylactic vitrectomy for acute retinal necrosis syndrome

Sheng-Guo Li,Guo-Ping Kuang and Shu-Yang Chen — 2013/9/23 14:08:06

AIM: To evaluate the efficacy of prophylactic vitrectomy for acute retinal necrosis syndrome(ARNS).

METHODS: Twenty-six patients(33 eyes)were retrospectively included in this study. The eyes were divided into 2 groups by treatment, including routine treatment, which consisted of antiviral medication and vitrectomy after retinal detachment(RD)(n=20), and prophylactic vitrectomy, which consisted of antiviral medication and vitrectomy for the prevention of RD performed during the active inflammatory phase(n=13). The follow-up period ranged from 6 to 48 months.

RESULTS: In the routine treatment group, retinal detachment occurred in 11 eyes(55%), 4 eyes(20%)developed ocular atrophy, 3 eyes(15%)achieved increased visual acuity. In the prophylactic vitrectomy group, RD occurred in 1 eyes(8%), 5 eyes(38%)achieved increased visual acuity. There was lower incident of retinal detachment in the prophylactic vitrectomy group than that in the routine treatment group(P<0.05).

CONCLUSION: Prophylactic vitrectomy can prevent RD and improve the prognosis of ARNS.

Efficacy of vitreoretinal surgery in the treatment of X-linked retinoschisis with serious complications

Chen Zhao,Qi Zhang and Pei-Quan Zhao — 2013/9/23 14:08:06

AIM: To evaluate the efficacy of vitreoretinal surgery in the treatment of X-linked retinoschisis(XLRS)and its complications.

METHODS: A retrospective study was made on all the XLRS patients with severe complications after operation in this hospital. All the 25 patients(31 eyes)present with macular abnormalities with/without peripheral retina split bypreoperative OCT examination. Among the 31 eyes, there were 7 eyes with vitreous hemorrhage, 8 eyes with retinal detachment and vitreous hemorrhage, and 16 eyes with rhegmatogenous retinal detachment. All the 31 eyes were divided into 2 groups: group A included 15 eyes which underwent photocoagulation before the surgery, while the other 16 eyes in group B didn't perform photocoagulation before the surgery. All the patients underwent a pars plana vitrectomy without lensectomy associated with internal limiting membrane peeling. Photocoagulation was done to the retinal holes and degeneration areas in group A. Gas or silicone oil was filled in group B after retinal photocoagulation treatment. Three years later, analysis was made on the results of the visual acuity, postoperative anatomical and functional outcome in these 2 groups. Statistical analysis was made on the results of average visual acuity before and after operation by SPSS software method, the difference was statistically significant(P<0.05). The differences of changes of visual acuity in two groups were statistically significant by one-way analysis of variance method.

RESULTS: Postoperative anatomical and functional outcome were satisfied at the last visit. A total of 23 eyes'(74.2%)visual acuity were improved with the mean visual acuity increasing from 0.13±0.08 to 0.24±0.16, the difference was statistically significant(t=-5.354,P=0.000). The average visual acuity in group A was improved from 0.11±0.08 to 0.22±0.15 after operation(t=-4.391, P=0.000). While the average visual acuity in group B increased from 0.14±0.08 to 0.26±0.15(t=-4.488, P=0.000). The visual changes in two groups were statistical significance. But when compared the average changes of visual acuity before and after operation between two groups, F=4.055, P=0.069, there was no statistical significance. During the following-up period, the complications were found in three eyes, among which two eyes presented with proliferative vitroretinopathy and traction retinal detachment 10 and 12 months after surgery, and one eye presented with cataract 3 months after surgery. Two eyes belonged to group A while the third eye pertain to group B. After reoperation, all the three eyes have good prognosis and retinoschisis didn't worsen.

CONCLUSION: Vitreoretinal surgery can be applied to the treatment of X-linked congenital retinoschisis and its complication, effectively preventing the deterioration of schisis cavity and contributing to the improvement and stabilization of visual acuity and resuming the anatomic structure of retina.

Effects of puerarin treatment on hemodynamics and blood rheology in diabetic retinopathy patients

Yi-Qun Zhang and Li-Min Zhang — 2013/9/23 14:08:06

AIM: To explore the treatment effect of puerarin on ophthalmic artery blood velocity and blood rheology in patients with diabetic retinopathy, and provide experience for clinical medication.

METHODS: Eighty-six patients with diabetic retinopathy were selected in our hospital from February 2010 to December 2012. They were randomly divided into study group and control group, each group of 43 cases. The two groups were taken blood glucose and symptomatic treatment, while study group were given to puerarin based on the therapy. Recording two groups of patients in hemodynamics and blood rheology in 1 month before and after the treatment, and make a contrast.

RESULTS: Before treatment, the two group in blood rheology indexes, was not statistically significant(P>0.05); after treatment, patients in the study group of the hematocrit, the whole blood viscosity at low shear rate, plasma viscosity, whole blood viscosity, erythrocyte aggregation index were lower than those in the control group, the differences were statistically significant(P<0.05). Two groups had no statistically significant differences in the hemodynamic parameters before treatment(P>0.05); after treatment, Peak systolic velocity(PSV)and end diastolic velocity(EDV)in study group were higher than those in the control group, but the resistance index(RI)was lower than that in control group, the difference was statistically significant(P<0.05).

CONCLUSION: Puerarin can improve hemodynamics and hemorheology in patients with diabetic retinopathy, and can protect the central retinal artery function.

Causes analysis of diagnostic errors of Vogt-koyanagi-harada syndrome

Yu-Qin Huang,Wei Wang and Su-Dong Zhu — 2013/9/23 14:08:06

AIM: To investigate the causes of diagnostic errors by analyzing the 15 cases of Vogt-koyanagi-harada(VKH)syndrome.

METHODS: Data of 15 cases with VKH syndrome, collected from our out-patient clinic from January 2005 to December 2010, were analyzed retrospectively to find out the causes of diagnostic errors.

RESULTS: The misdiagnosis rate was as high as 80% in 15 cases. The common misdiagnosis was conjunctivitis, papillovasculitis, maculopathy, posterior scleritis, glaucoma-iridocyclitis syndrome, serous retinitis, keratitis, and uveitis. Of 15 cases,visual acuity of 5 cases were lower than 0.3 due to not timely and accurate treatment.

CONCLUSION: The misdiagnosis of VKH syndrome are related mainly with having not acquired medical history in detail, having not recognized the clinical symptom's features and the general manifestation of the VKH syndrome. The diagnostic ability for the VKH syndrome should be improved urgently.

Analysis of the influence factor on the bacterial culture of conjunctival sac before cataract

Li-Ping Huang,Wei Wu,Zhi-Qian Xiao,Nan-Xia Hua,Mei-Jian Wu and Li Mo — 2013/9/23 14:08:06

AIM: To investigate the main factors that affecting the positive rate of bacterial culture before the intraocular lens implantation.

METHODS:Conjunctival sac specimen form senile patients, who received cataract crystal implantation from December 2010 to December 2012 in our hospital, were collected and cultivated at the following 3 time points: on admission day, after the eye-drops and after the surgical eye preparation. Afterwards, a comparative analysis was made in terms based on of the following factors: age, gender, dominant eye, occupation, days for eye-drops as well as the intervention techniques.

RESULTS: Factors such as age, gender, intervention technique were significantly related with the rate of bacterial culture, while factors such as occupation, dominant eye and days for pre-operative eye-drops had few effects on the final results.

CONCLUSION: There are both internal factors and external factors affecting the bacterial culture. Inconjunctival sac intervention techniques play a crucial role in the bacterial culture in conjunctival sac, which deserves more attention.

Clinical analysis and treatment of intraocular hypertension after vitrectomy combined with intraocular plombage

Sheng Li,Jian-Ping Xia and Yuan-Yuan Qi — 2013/9/23 14:08:06

AIM: To analyze the law and the therapeutic schedule of postoperative intraocular hypertension of posterior vitrectomy combined with intraocular plombage.

METHODS: The visual acuity of 198 eyes after posterior vitrectomy combined with intraocular plombagefrom January 2009 to January 2011 in our hospital was monitored. Cases with intraocular hypertension were observed and analyzed.

RESULTS: Among the 198 cases, there were 53 cases with early postoperative intraocular hypertension, showing that the incidence was 26.8%. The incidence was similar among DR, rentina vascular diseases, macular hole and rhegmatogenous retinal detachment, with no statistic significance(P>0.05). The incidence rates were also similar between the silicone oil plombage group and inert gas plombage group, with no statistic significance(P>0.05). But the incidence rates were different between the groups with and without cataract extraction and IOL implantation, showing statistic significance(P<0.05).

CONCLUSION: The incidence of intraocular hypertension after vitrectomy combined with intraocular plombage has little to do with the protopathy and the filler, but is related with the surgical method. Releasing partial gas or anterior chabeer aqueous humbor fluid is an effective mean to lower IOP.

Evaluation of visual evoked potentials in post-trauma eyes

Xin Zhou — 2013/9/23 14:08:06

AIM: To analyze the visual evoked potentials(VEP)of 189 eyes subjected to traumatic injury, and to explore the feasibility and method to applying VEP technology to the evaluation of visual acuity after eye trauma.

METHODS: All the objects were volunteers who were grouped according to a random examination with the international standard visual acuity chart. The study determined spatial frequency in stimulation mode, P₁₀₀ amplitude and latency. Then, the lowest spatial frequency(LSF)was analyzed and its relationship with visual acuity were studied. Finally this study discussed about the way to evaluate visual acuity with VEP and also compared the VEP evaluation results with the visual acuity chart.

RESULTS: The LSF of 22', 11', 5', and 3' corresponded respectively to vision of 0.1-0.2, 0.3-0.5, 0.6-1.0, 1.2-1.5. There was a significant difference in P₁₀₀ amplitude between eyes with different visual acuity, but there was no significant difference in P₁₀₀ latency between these eyes. The random evaluation results of VEP combined with LSF and P₁₀₀ amplitude were highly consistent with the results with international standard visual acuity chart.

CONCLUSION: It is practicable to evaluate these volunteers' visual acuity with the VEP technology.

Relationship between neonatal dacryocystitis and cesarean section and the treatment of neonatal dacryocystitis

Yun-Qi Ai,Xin-Yu Gao,Su-Jing Huang,Mei-Neng Hong and Hui-Fang Li — 2013/9/23 14:08:06

AIM: To explore the treatment of neonatal dacryocystitis of different ages and the relationship between caesarean section and neonatal dacryocystitis.

METHODS: A total of 260 cases(260 eyes)of children with neonatal dacryocystitis were divided into 1-3 months group, 4-6 months group, 7-12 months group and 13-24 months group, Each group was respectively given the lacrimal sac massage, lacrimal passage irrigation and probing of lacrimal passage method. Curative effect of each method was observed in different groups. Analysis was made to determine whether caesarean section was the cause of neonatal dacryocystitis.

RESULTS: The comparison between 1-3 months group and 4-6 months group showed significant difference(χ²=19.89, P<0.05). Lacrimal sac massage was effective for babies under 6 months, particularly in 1-3 months babies. The curative effect of lacrimal passage irrigation in four groups was compared, and there was statistical significance in the difference between the curative effect of each group(χ²=54.95, P<0.05). The difference between the 1-3 months group and 4-6 months group was χ²=0.00003, P>0.05, lacrimal passage irrigation of these two groups showed no significant difference in efficacy. The comparison result between the other two groups showed no significant difference(P<0.05), lacrimal passage irrigation effects are different from each group. The comparison result between 7-12 months group and 13-24 months group was χ²=10.29, P<0.05. Infants born by cesarean section accounted for 85% of all cases.

CONCLUSION:Lacrimal sac massage can exert very good therapeutic effects in infants less than 3 months. The curative effects of irrigation of lacrimal passage are quite good in babies under 12 months. Probing of lacrimal passage has a good curative effect in 7-12 months infants, but a poor curative effect in babies over 12 months. Caesarean section is an important cause for neonatal dacryocystitis.

Comparison of small incision lenticule extraction and femtosecond laser assisted LASIK for myopia

Yu-Kun Hu,Wen-Jing Li,Xiao-Wei Gao,Yun-Lin Guo and Jing Dong — 2013/9/23 14:08:07

AIM: To compare the postoperative visual outcomes of VisuMax small incision lenticule extraction(SMILE)and femtosecond laser assisted LASIK(FEMTO LASIK)for myopia.

METHODS:Eighty-tree eyes(42 patients)underwent VisuMax SMILE and 94 eyes(47 patients)received FEMTO LASIK to correct myopia were comprised. The safety, efficacy, predictability, stability and adverse events were assessed preoperatively and 1d, 1 week, 1 month, 3 months postoperatively.

RESULTS: At 3 months, the mean safety index was 1.10±0.16 in the SMILE group and 1.09±0.16 in the FEMTO LASIK group; the mean efficacy index was respectively 1.10±0.16 and 1.08±0.12; Spherical equivalent(SE)was respectively 0.11±0.23D and 0.08±0.25D within ±1.00D of the targeted SE correction in 82 eyes(98.8%)of the SMILE group and 91 eyes(96.8%)of the FEMTO LASIK group and SE within ±0.50D in 73 eyes(88.0%)of the SMILE group and 78 eyes(83.0%)of the FEMTO LASIK group. There were no significant complications in both groups.

CONCLUSION: SMILE and FEMTO LASIK have equal safety, efficacy, predictabilityand stability in the treatment of myopia.

Assessment of visual function based on IOL-Master comparing with traditional ultrasonic biometry for intraocular lens calculation in high myopia patients

Lu Zhang — 2013/9/23 14:08:07

AIM: To evaluate the clinical feasibility of using a new optical coherence interferometry(IOL-Master), comparing with traditional ultrasonic biometry and manual keratometry in the accuracy and characteristics for intraocular lens calculation of high myopia.

METHODS: The measurement of axial length was performed in 60 eyes(30 eyes for each group)with senile cataract of high myopia(≥-6.00D)using IOL-Master and ultrasonic biometry. The measurement of corneal power(K)was also performed in the patient using IOL-Master and manual keratometry preoperatively. Phacoemulsification and foldable lens implantation were done on the patients. IOL power calculation was carried out according to the SRK/T formula on the basis of the group-related data. Best corrected visual acuity, refraction, contrast sensitivity and wave front aberration root mean square(RMS)were re-tested after 3 months postoperatively.

RESULTS: Significant difference between the two methods in axial length measurement which was 29.81±1.53mm by ultrasound and 29.63±1.81mm by IOL-Master(P=0.001). And in corneal power measurement which was 43.22±1.67K by manual keratometry and 44.27±1.39K by IOL-Master(P=0.006). There was a significant difference between the two groups(P=0.001). 63.0% vs 31.2% had a mean absolute refractive error(MARE)within ±0.50 diopter for the IOL-Master and A-scan groups, respectively(χ²=3.1, P<0.05). The RMS values of 4^th order aberration, 4^th order spherical aberration and total high order aberration in the IOL-Master group were lower than those in the A-scan group at 6mm pupil diameter 3 months later.

CONCLUSION: IOL-Master is a non-contact, accurate, safe and reliable tool for calculating IOL power and it is more accurate on the design of the IOL in the cataract surgery on the high myopia patients.

Effects of combined therapy in 80 cases of accommodative esotropia

Qi Liu,Li-Ming Liu and Yan-Li Qin — 2013/9/23 14:08:07

AIM: To investigate a comprehensive treatment for accommodative esotropia.

METHODS: Eighty patients with accommodative esotropia were analyzed. All cases wore corrective glasses 7d after mydriasis by 10g/L atropine. The pupils were all comprehensively trained. If the position of the esotropic eyes could not be corrected by spectacles and both eyes had similar visual acuity in one year, surgical intervention was taken to correct the position. Refraction, visual acuity, visual function and strabismus degree change before and after treatment were evaluated.

RESULTS: One year after wearing glasses, 50 cases had corrected eye position through correction and 30 cases were partially accommodative esotropia. Ten cases of esotropia degree >+15^△ which could not be complete corrected by cure correction got surgical intervention. Seven cases of them got normal eye positions and 3 cases were over corrected 10^△-20^△. After comprehensive treatment of 3 years, the cure rate of amblyopia was 88.7%.

CONCLUSION: The treatment for accommodative esotropia is a comprehensive course. It is necessary to pay attention to eye position correction, but also for the treatment of amblyopia, while paying attention to establish binocular vision.

Clinical observation of corneal lamellar debridement combined with sutureless amniotic membrane transplantation for the treatment of superficial fungal keratitis

Huang Zhang and Ming Ai — 2014/8/19 14:40:39

AIM:To evaluate the clinical efficacy of corneal lamellar debridement combined with sutureless amniotic membrane transplantation for the treatment of superficial fungal keratitis.

METHODS:Totally 22 cases(22 eyes)with superficial fungal keratitis were referred to our hospital from April 2012 to October 2013. The patients with persistent cornea ulcer after treatment of local and systemic antifungal drugs underwent corneal lamellar debridement combined with sutureless amniotic membrane transplantation, and the recipient bed was covered with an amniotic membrane using fibrin sealant during the operation. All patients were still given topical antifungal therapy for 1-2mo after operation. The followed-up time was 3mo or above. We observed the corneal healing and amniotic membrane adhesion by split lamp microscope, and investigated the transformation of amniotic membrane and fungal infection recurrence with confocal microscope.

RESULTS: Corneal edema and anterior chamber reaction of 21 patients disappeared gradually, and no amniotic membrane graft dissolved and shed off within 1-2wk postoperatively. Two weeks after operation, the graft integrated into the corneal and the corneal wounds' thickness increased gradually, the corneal epithelium reconstructed and corneas became clear. Four weeks after operation, the corneal scarring developed gradually and fluorescence staining was negative. Nineteen cases' amniotic membranes that adhered with the cornea dissolved 4wk after operation. There were different degrees of corneal nebula or macula remained 3mo postoperatively. All patients' vision improved in varying degrees, except in 1 case with fungal keratitis who had been cured by lamellar keratoplasty.

CONCLUSION:Corneal lamellar debridement combined with sutureless amniotic membrane transplantation can effectively remove the foci of inflammation, improve the local efficacy, shorten the operation time, relieve the postoperative reaction, and promote cornea union, which is an effective way to treat superficial fungal keratitis.

Clinical study of AcrySof IQ Toric intraocular lens implantation to corneal correct astigmatism

Qian Wang,Jun-Ying Zhu,Yan Xiao and Peng Chen — 2014/8/19 14:40:39

AIM: To observe the clinical outcome of implanting AcrySof IQ Toric intraocular lens to correct corneal astigmatism in cataract surgery, and to evaluate the result and rotational stability of AcrySof IQ Toric after cataract surgery.

METHODS: A retrospective study of 26 eyes in 21 cataract patients with corneal astigmatism. All patients implanted AcrySof IQ Toric intraocular lens. The preoperative and postoperative uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), preoperative corneal astigmatism, anticipated residual astigmatism, total astigmatism, postoperative residual astigmatism and Toric lens axis were detected and measured.

RESULTS: All patients' visual acuity and best corrected visual acuity improved significantly. The mean refractive cylinder decreased significantly after surgery from(2.05±0.57)D to(0.55±0.33)D(t=13.574, P<0.05). There was no significant difference between preoperative(0.47±0.19)D and postoperative corneal astigmatism(t=1.149, P>0.05). Three months after surgery, there was no significant difference between preoperative(2.01±0.58)D and postoperative(-1.89±0.53)D corneal astigmatism(t=1.908, P>0.05). The rotation of intraocular lens were <20°, the mean rotation was 3.65°±2.86°.

CONCLUSION: The AcrySof IQ Toric lens make cataract patients enjoy the better UCVA including good rotational stability in the correct of corneal astigmatism. The AcrySof IQ Toric implantation is an effective option for the correct of preexisting corneal astigmatism in cataract surgery.

Clinical study of topography-guided off-flap Epi-LASIK in treating traumatic corneal astigmatism

Su-Fang Duan,Jing Liu,Xiu-Hong Li,Zhen-Hua Liu,Zi-Xuan Song and Xiang-Ling Liu — 2014/8/19 14:40:39

AIM: To evaluate the visual performance of the patients with traumatic corneal astigmatism, after the treatment of topography guided off-flap epipolis laser in situ keratomileusi(off-flap Epi-LASIK).

METHODS: This prospective clinical study was comprised of 21 eyes of 21 patients with irregular corneal astigmatism caused by trauma, they were treated by off-flap Epi-LASIK from July 2012 to December 2013. The data included uncorrected visual acuity(UCVA), best spectacle-corrected visual acuity(BSCVA), contrast sensitivity 1, 6mo before and after surgery; the healing area percentage of corneal epithelia, the healing time of corneal epithelia and pain score at 3d after surgery.

RESULTS: Postoperative 1mo both UCVA and BSCVA were improved significantly than that before surgery(t=15.703, 4.351, P<0.05); Compared with the 1mo after surgery, UCVA at 6mo after surgery raised significantly(t=6.867, P <0.05). There was no statistical significance between 6 and 1mo after surgery about BSCVA(t=1.497, P=0.140). After surgery, mean spherical equivalent(SE)was reduced from -2.43±3.02D to -0.23±0.49D(P<0.05), and the mean cylinder was reduced from -1.86±2.23D to -0.46±1.03D(P<0.05). Postoperative 1mo,4 kinds of spatial frequency and contrast sensitivity had no significant difference compared with the preoperative(P>0.05). Postoperative 6mo except the 3c/d spatial frequency, the remaining 3 spatial frequency contrast sensitivity compared with those before operation were significantly improved(P<0.05). The healing area percentage of corneal epithelia was 92.46%±8.24%(80%-100%)at 3d after surgery; The healing time of corneal epithelia was 3.50±1.56d; Pain scores at 3 and 7d after surgery was 1.54±1.32 and 0.04±0.64, respectively.

CONCLUSION: Topography-guided off-flap Epi-LASIK is safe and effective in treating the patients with traumatic corneal irregular astigmatism. The operation can improve both the contrast sensitivity and the visual performance.

Impact of incision position of phacoemulsification cataract exaction on corneal astigmatism

Ming-Yan Zhai — 2014/8/19 14:40:39

AIM: To compare the impact of different incision positions of phacoemulsification cataract exaction on corneal astigmatism.

METHODS:Totally 412 patients(456 eyes)who had undergone the phacoemulsification and IOL implantation from June 2006 to June 2013 were randomly divided into two groups(each 228 eyes): observation group(incision above the middle of the limbus for the rule astigmatism, at the temporal for against the rule astigmatism, at the top of the temporal regulation on the maximum curvature of the meridian of the cornea for oblique astigmatism, at the top of the temporal for patients without astigmatism); control group(incision at top and middle of limbus), using a 3mm cornea scleral tunnel incision without suture, 2mm from the limbus. Corneal refractive status of preoperative and postoperative at different times were detected by corneal refractive, comparing the impact of different surgical incision on postoperative corneal astigmatism.

RESULTS:The visual acuity of 1, 3mo postoperative of observation group was significantly better than the control group(P<0.05). The average astigmatism of 1, 3mo postoperative of observation group was significantly lower than the control group(P<0.05). Corneal astigmatism 3mo postoperative of observation group was significantly lower than preoperative(P<0.05). Corneal astigmatism 3mo postoperative of control group was significantly higher than preoperative(P<0.05).

CONCLUSION:Incision at the corneal curvature of the largest radial could correct preoperative astigmatism and improve visual acuity to a certain extent.

Clinical application of capsular tension ring on cataract surgery in patients with pseudoexfoliation syndrome after trabeculectomy

Yi Zhang,Fan Zhang,Tu'erhongjiang Maimaiti,Dilinu'er Kasimu and Yong-Xiang Jiang — 2014/8/19 14:40:39

AIM:To investigate the safety and efficacy of capsular tension ring(CTR)insertion combined with phacoemulsification and intraocular lens(IOL)implantation in patient with pseudoexfoliation syndrome after anti-glaucoma surgery.

METHODS: A retrospective study was conducted of 10 eyes from 10 cataract patients with pseudoexfoliation syndrome following trabeculectomy surgery, and who underwent CTR insertion combined with phacoemulsification and IOL implantation between January, 2012 and June, 2013. All cases had nuclear cataracts(nuclear hardness Ⅱ 1 eye, nuclear hardness Ⅲ 4 eyes, nuclear hardness Ⅳ 5 eyes). One case with Ⅳ nuclear hardness cataract had iridodonesis and lens subluxation. Postoperative visual acuity, intra- and post-operative complications, anterior capsular opening, IOL position, and postoperative intraocular pressure(IOP)were assessed. Follow-ups ranged from 3 to 14mo. The t test was used to analyze the variables studied.

RESULTS: All patients had a successful CTR insertion combined with phacoemulsification and IOL implantation. A modified CTR insertion was performed in one case, the others underwent a standard CTR insertion. The best corrected visual acuity(BCVA)was ≥0.5 in 3 eyes and 0.3-<0.5 in 2 eyes. However, BCVA was ≤0.1 in 5 eyes. No decentration and dislocation of IOL was found during follow-up. Optic atrophy of different level could be found in all cases. The mean IOP was 16.78±2.48mmHg before surgery. And the average IOP is 16.01±2.33mmHg at 3mo postoperative(t=1.9955, P>0.05). The most common intrao- and post-operative complications were corneal edema, small pupil, residual cortex, spontaneous zonular dialysis.

CONCLUSION: Suitable CTR insertion in appropriate occasion may be beneficial to patients with pseudoexfoliation syndrome after trabeculectomy during cataract surgery. It prevents the IOL decentration and decrease the surgical complication. Less complication occurs at the early stage.

Clinical observation of complicated cataract after glaucoma surgery

Xue-Yan Wang — 2014/8/19 14:40:39

AIM: To observe the complicated cataract after glaucoma surgery, analyze the causes and summarize the treatments, in order to provide the basis for clinical treatment.

METHODS: Forty-five patients(50 eyes)with complicated cataract after glaucoma surgery treated in our hospital from October 2012 to September 2013 were selected. All patients were treated by 3.2mm tunnel incision phacoemulsification cataract operation. The postoperative complications, intraocular pressure, and visual acuity were observed.

RESULTS: After treatment, visual acuity of all patients were improved, without obvious complications, the intraocular pressure was normal.

CONCLUSION: 3.2mm tunnel incision phacoemulsification cataract operation can effectively improve the intraocular pressure and promote the recovery of visual acuity.

Two surgical treatment methods for open angle glaucoma and cataract

Yun-Kai Xia,Rong-Qiang Tan,Dai-Li Xu and Cheng Zheng — 2014/8/19 14:40:39

AIM: To compare the curative effects of two surgical treatment methods for open angle glaucoma and cataract patients.

METHODS: Totally 69 patients with primary open angle glaucoma and cataract were divided into two groups: group A and group B. Thirty-four patients(34 eyes)in group A underwent small incision non-phacoemulsification cataract surgery combined with trabeculectomy, just combined operations, 35 patients(35 eyes)in group B underwent small incision non-phacoemulsification cataract surgery beyond 6mo after trabeculectomy, just two stage operations. Postoperative intraocular pressure at 1wk and 3mo, postoperative corrected visual acuity and filtering bleb at 3mo were observed, and intraoperative and postoperative complications were compared. All the patients were followed up for 3-6mo.

RESULTS: All the visual acuity were increased compared with that before surgery in two groups, the difference was not statistically significant. All the intraocular pressure was controlled in two groups, the difference was not statistically significant, and the difference about the filtering bleb was neither statistically significant(P>0.05). There were no serious intraoperative and postoperative complications in two groups.

CONCLUSION: The two stage operations and the combined operations both can control theintraocular pressure and improved visual acuity of open angle glaucoma and cataract. The two stage operations may prevent a second operation for post trabeculectomy cataract, allowing earlier visual rehabilitation.

Study on the change of serum,aqueous humor and tear IL-2,sIL-2,NO,TAC,and SOD of patients with cataract

Hui-Fang Shen and Xin Xie — 2014/8/19 14:40:39

AIM: To study and observe the changes of serum, aqueous humor and tear IL-2, sIL-2, NO, TAC, and SOD of patients with cataract.

METHODS: Totally 60 patients with cataract in our hospital from November 2011 to September 2013 were included as the observation group, and 60 patients with eye traumas were as the control group. The serum, aqueous humor and tear IL-2, sIL-2, NO, TAC, and SOD of two groups were detected and compared, and the detection levels of patients with different stages were compared.

RESULTS: The serum, aqueous humor and tear IL-2, TAC, and SOD of observation group were all lower than those of control group, the sIL-2 and NO were all higher than those of control group. The serum, aqueous humor and tear detection levels of patients at different stages had obvious differences, and the aqueous humor IL-2 were lower than those of serum and tear, the sIL-2 were higher than those of serum and tear, with statistically significant differences.

CONCLUSION: The change of serum, aqueous humor and tear IL-2, sIL-2, NO, TAC, and SOD of patients are all great, and the influence of the stages for those indexes are great too, the inflammatory response state of aqueous humor are more obvious.

Study on the efficacy between cyclocryotherapy combined trabeculectomy and single cyclocryotherapy for neovascular glaucoma

Qian Wang — 2014/8/19 14:40:40

AIM: To investigate the clinical efficacy of cyclocryotherapy combined trabeculectomy and single cyclocryotherapy for neovascular glaucoma(NVG).

METHODS:Totally 82 patients with NVG from February 2012 to June 2013 in our hospital were selected and randomly divided into observation group and control group, each 41 cases. Patients in control group were given single cyclocrytherapy, and patients in observation group were given cyclocryotherapy combined trabeculectomy. The visual acuity, intraocular pressure and postoperative complications of two groups were observed.

RESULTS: After postoperative six months, the improvement rate of visual acuity in observation group was 61.0%, which was significantly higher than that of control group(41.5%), the difference was statistically significant(χ²=3.843, P=0.018). Intraocular pressure of observation group was significantly lower than that of control group, the difference was statistically significant(P<0.05). The complication rates(eye pain, hyphema, and corneal edema)of observation group were 9.8%, 12.2%, and 9.8%, which were significantly lower than that of control group(51.2%, 60.9%, and 48.8%), the difference was statistically significant(χ²=7.594,P=0.007; χ²=9.276,P=0.000; χ²=6.835,P=0.013). The difference of two groups was not statistically significant on complications of conjunctival edema, anterior chamber exudation, shallow anterior chamber, and eyeball atrophy(P>0.05).

CONCLUSION: Compared with single cyclocryotherapy, cyclocryotherapy combined trabeculectomy has advantages of low intraocular pressure, less postoperative complications, and high success rate, so it is worthy of promotion.

Subfoveal choroidal thickness measured by Cirrus HD optical coherence tomography in myopia

Li-Li Chen,Zi-Lin Chen and Ze-Bin Li — 2014/8/19 14:40:40

ATM: To measure the subfoveal choroidal thickness(SFCT)in myopia using Cirrus HD optical coherence tomography(OCT), and to explore the relationship between the SFCT, axial length and myopic refractive spherical equivalent.

METHODS: One-hundred thirty-three eyes of 70 healthy volunteers were recruited, and were divided into emmetropia group, low-degree myopia, middle-degree myopia and high-degree myopia group. SFCT were measured by Cirrus HD OCT, and the relationship between the SFCT, axial length and myopic refractive spherical equivalent were evaluated.

RESULTS: 1)Average SFCT was(275.91±55.74)μm in normals, that in emmetropia group, low-degree myopia, middle-degree myopia and high-degree myopia group were(290.03±34.82)μm,(287.64±51.51)μm,(274.95±56.83)μm,(248.37±67.98)μm; 2)the SFCT of high-degree myopia group was significant thinner than that of emmetropia group(P<0.05); 3)There was a significant negatives correlation between the SFCT and axial length(P<0.01), a significant positive correlation between SFCT and myopic refractive spherical equivalent(P<0.01).

CONCLUSION: the SFCT is inversely correlated with increasing axial length and myopic refractive error.

Study of retrobulbar hemodynamics in diabetes via color doppler ultrasound

Wei Chen,Li Zhang and Ya Zhang — 2014/8/19 14:40:40

AIM: To explore the changes of retrobulbar hemodynamics in diabetes via color doppler ultrasound.

METHODS: Totally 80 patients(160 eyes)with eye diseases in type 2 diabetes from June 2010 to May 2013 in our hospital were enrolled as research group. By fundus photography and direct ophthalmoscopy, patients were assigned to diabetes without retinopathy group(DNR subgroup), non-proliferative diabetic retinopathy group(NPDR subgroup)and proliferative diabetic retinopathy group(PDR subgroup). Of 60 healthy patients(120 eyes)over the same period were chosen as control group. The doppler parameters of central retinal artery(CRA), posterior ciliary artery(PCA)and ophthalmic artery(OA)were measured.

RESULTS: There were significant differences on circulatory parameters of CRA, PCA and OA between both groups(P<0.05). Significant differences were also observed on peak systolic velocity(PSV), end diastolic velocity(EDV)and resistance index(RI)of CRA, PCA and OA among DNR subgroup, NPDR subgroup and PDR subgroup(P<0.05). The EDV, RI and PSV of control group differed from those of DNR subgroup, NPDR subgroup and PDR subgroup(P<0.05).

CONCLUSION: The monitoring of retinal blood flow and analysis of blood spectrum morphology via color doppler ultrasound can effectively evaluate the degree of diabetic retinopathy lesions, especially before DR vascular disease. Early detection can reveal the hemodynamic change pattern of DR, facilitating the prevention of diabetic eye complications and improvement of the quality of life.

Clinical observation on preoperative application of Bevacizumab in proliferative diabetic retinopathy

Qian-Fang Qi,Yao-Wu Shi and Tao Guo — 2014/8/19 14:40:40

AIM: To discuss the effects and security of the application of intravitreous bevacizumab(IVB)before pars plana vitrectomy(PPV)in proliferative diabetic retinopathy(PDR).

METHODS: Retrospective study of 74 patients(80 eyes)with PDR. These patients were randomly divided into two groups, some patients in PPV group and others patients in PPV+IVB group. The PPV+IVB group were treated with IVB 10d before operation. The operating time, postoperative eyesight, intraocular pressure(IOP), complications and bleeding during operation and postoperation between the two groups were observed and compared.

RESULTS: Operating time and postoperative visual acuity were significantly different between the two groups. Operating time: with an average of 108±20.6min of test group and 129±32.4min of comparison group. Postoperative visual acuity: with an average of 0.32±0.20 and 0.21±0.16, there was significantly different between the two groups(P<0.05). Three months after operation, IOP was no significantly different between the two groups with an average of 21.3±7.2mmHg and 20.6±6.7mmHg(P>0.05).

CONCLUSION:Bevacizumab can make active neovascular membranes fibrosis, reduce bleeding in the strip membranes process, so as to make the operation field clear, and can shorten the surgical time and get the better sight, no serious complications during postoperative period appeared.

Risk factors of early postoperative high intraocular pressure after improved 23-gauge vitrectomy

Xue-Mei Liang,Jing-Jing Li and Bin Qin — 2014/8/19 14:40:40

AIM: To observe the incidence of high intraocular pressure(IOP)and its risk factors in the early stage(within 7d)after 23-gauge sutureless microincisional vitrectomy.

METHODS: Retrospective case series study. Totally 98 patients(98 eyes)who had undergone 23-gauge sutureless microincisional vitrectomy were enrolled. IOP was measured by non-contact tonometry. High IOP was defined as an IOP >25mmHg at any time within 7d after surgery. The influence of age, sex, side of operation, course of disease, primary disease pre-operation, reoperation, surgical options, type of tamponade, status of lens, surgical time on postoperative high IOP were analyzed.

RESULTS:High IOP was found in 33 eyes(33.7%)within 7d after surgery. High IOP was found in 8 eyes on postoperative 1d, the incidence was 24.2%(8/33), and 25 eyes was found on postoperative 3d, the incidence was 75.8%(25/33). The incidence of high IOP of male and female were 32.8%(20/61)and 35.1%(13/37)respectively. The incidence of high IOP of right and left eye were 36.8%(21/57)and 29.3%(12/41)respectively. There were no significant differences comparing age(Z=-0.22), sex(χ²=0.057), side of operation(χ²=0.612), course of disease(Z=-0.079)and surgical time(Z=-0.553)between patients with high IOP and those without it(P>0.05). Similarly, no statistical significance was found between eyes with gas tamponade and silicone oil tamponade(χ²=1.04), traumatic eyes and non traumatic eyes(χ²=0.044), and retinal detachment eyes and without retinal detachment eyes(χ²=2.282,P>0.05). The incidence of high IOP in eyes with several operations was higher than that in eyes with the first operation(χ²=5.211,P<0.05), in eyes with combined operations eyes was significantly higher than that in eyes with pure vitrectomy(χ²=4.57,P<0.05), and in eyes with aphakic eye was higher than that in eyes with phakic eyes(χ²=4.224,P<0.05).

CONCLUSION:High IOP occurs commonly in 3d after 23-gauge sutureless microincisional vitrectomy. The risk factors of high IOP are reoperation, combined operations and aphakic eye.

Research of association between the primary progressive type of pterygium and the tear film

Jin-Kui Cheng and Yan-Ning Yang — 2014/8/19 14:40:40

AIM:To research the association between primary progressive pterygium and tear film.

METHODS: Totally 60 cases of primary progressive pterygium from September 2012 to June 2013 in our hospital were enrolled. The pterygium eye was for observation group and the contralateral eye as the control group. The differences of eye symptoms, tear film break-up time(BUT), SchirmerⅠ test(SⅠt), corneal fluorescein staining(FL), tear ferning test(TFT)and the conjunctival impression cytology(CIC)were compared between two groups.

RESULTS: The eyes in observation group had higher symptoms score, FL score, grades of conjunctival squamous metaplasia, percentage of abnormal tear ferning, but had lower BUT and density of goblet cell, the differences had statistically significance(P<0.05); Similar SⅠt results were presented in the two groups, the difference had no statistically significance(P>0.05).

CONCLUSION: Primary progressive pterygium can cause a decrease in tear film stability, which in turn lead to some dry eye symptoms such as dry feeling and burning sensation, and its mechanism may be caused by multi-factors, such as density change of goblet cell and the tear fluid dynamics.

Clinical study Carbomer eye gel and rhEGF in treating dry eye after cataract surgery in diabetics

Yong-Li Yang,Yu-Jie Yang,Peng Li,Qiu-Ping Sun and Lin Li — 2014/8/19 14:40:40

AIM: To investigate the effect of Carbomer eye gel and recombinant human epidermal growth factor(rhEGF)on dry eye after cataract surgery in diabetics.

METHODS:A total of 160 patients(160 eyes)with diabetes undergone phacoemulsification with a diagnosis of dry eyes were randomized divided into two groups, treatment group(80 cases, 80 eyes)and control group(80 cases, 80 eyes). In treatment group, the patients were treated by Carbomer eye gel and rhEGF. In control group, the patients were treated by Carbomer eye gel. The subjective dry eye symptoms, tear break-up time(BUT), Schirmer I test(SⅠt)and cornea fluorescein staining(FL)were observed before treatment, 1, 4wk after treatment.

RESULTS: There was no significant difference between groups before treatment(P>0.05). After treatment at 1, 4wk, the subjective dry eye symptoms and the results of three examination(BUT, SⅠt and FL)in two groups better than those before treatment(P<0.01). And there was significant difference between experimental group and control group(P<0.05; P<0.01), the results of BUT, SIt and FL were improved in treatment group better than that in control group(P<0.01). All patients showed good tolerance to Carbomer eye gel and recombinant human epidermal growth factor.

CONCLUSION: Carbomer eye gel can relieve the dry eye symptoms of diabetes after phacoemulsification effectively, and it can be more effective to combine Carbomer eye gel with rhEGF at early stage after phacoemulsification.

MRI demonstrates abnormalities of motor nerves and extraocular muscles in congenital fibrosis syndrome due to mutations in KIF21A

Yong-Hong Jiao,Shao-Qin Wu,Feng-Yuan Man,Hong-Yan Jia,Gang Liu and Nan Lin — 2014/7/22 8:27:35

AIM:To observe the structural basis of ocular motility abnormalities in patients with congenital fibrosis of the extraocular muscles type Ⅰ(CFEOM Ⅰ)due to missense mutations in the developmental kinesin KIF21A using high-resolution magnetic resonance imaging(MRI).

METHODS: Totally 11 affected individuals reported KIF21A mutations were correlated with MRI studies demonstrating extraocular muscles(EOMs)size, location, contractility, and innervation. EOMs and the motor nerve in the orbits were imaged with T1 weighted in a triplanar scan using a dual-phased coils with 2.0mm thick. Motor nerves were imaged at the brainstem using head coils and 3D-FIESTA with 0.6-mm thick.

RESULTS: Patients with CFEOM Ⅰ exhibited different degrees of hypoplasia of oculomotor nerve, the abducens nerve and the trochlear nerve were also affected, of which 8 cases of orbital section could see the signal of abnormal nerve dominated by oculomotor nerve to lateral rectus. The both sides of six EOMS in all patients exhibited variable atrophy and abnormal bright internal signal on T1 imaging, particularly severe for the superior rectus and levator muscles.

CONCLUSION: High-resolution MRI can directly demonstrate pathology of motor nerves,affected EOMs, and ‘Pulley' hypoplasia caused by CFEOM Ⅰ due to mutations in KIF21A,and these findings suggest that the neuronal hypoplasia is the etiological factor of CFEOM.

Use of indocyanine green staining technique for phacoemulsification in white cataract

2014/7/22 8:27:35

AIM:To observe the application efficiency of 5g/L indocyanine green(ICG)staining technique for continuous circular capsulorhexis(CCC)during phacoemulsification in white cataract.

METHODS:Ninety-eight patients(98 eyes)with white cataract were randomly divided into staining group(50 cases, 50 eyes)and control group(48 cases, 48 eyes). The control group didn't do anterior capsule staining. The staining group was injected to fill the anterior chamber, 5g/L ICG 0.1mL was applied on the central surface of the anterior capsule, using a 27G blunt needle through the side-port after 30s, and the redundant ICG was replaced by BSS, and continuous curvilinear capsulorhexis was accomplished using capsulorhexis forceps.

RESULTS: In staining group: after ICG staining, the capsule, which presented uniform light green and visualization of the anterior capsule was significantly improved. There are 48 eyes capsulorhexis success. The rate of success was 96%. Meanwhile, in control group, there was 29 eyes capsulorhexis success. The rate of success was 60%. The difference was statistically significant(P<0.05). During follow-up, no dye particle and the complications of iritis or high intraocular pressure were found in the eyes of staining group. Anterior chamber inflammation, corneal opacity compared with control group, the difference was not statistically significant.

CONCLUSION:Indocyanine green staining increases the visibility of anterior capsule in over mature cataract, and it should be an effective and helpful method which can increase the success rate of capsulorehxis. At the same time, it can reduce the incidence of intraoperative complications. This will help beginners quickly grasp continuous curvilinear capsulorhexis, and shorten the learning curve.

Comparison of 2.2mm micro incision and 3.0mm incision coaxial phacoemulsification

Jian-Gang Zhu,Ya Cao and Qi-Hua Xu — 2014/7/22 8:27:36

AIM:To compare the operation effect of 2.2mm micro incision and 3.0mm incision coaxial phacoemulsification.

METHODS: Patients with age-related cataract(90 cases, 90 eyes)were enrolled in the study from January 2012 to June 2013 in our hospital, and they were randomly divided into 2 groups: 2.2mm incision group(45 eyes of 45 cases), 3.0mm incision group(45 eyes of 45 cases). Corneal tunnel incision coaxial phacoemulsification was performed. At 1d, 1wk, 1, 3mo after operation, the visual acuity, corneal endothelial cell count, central corneal thickness, operation astigmatism were recorded.

RESULTS: One day after operation, the visual acuity of 2.2mm incision group were significantly improved, the difference was statistically significant(P<0.05), there were no differences in two groups at 1wk, 1, 3mo after operation. No significant differences between the two groups of corneal endothelial cell counting, central corneal thickness at 1wk, 1, 3mo after operation were observed(P>0.05). Operation source astigmatism had statistically significant difference at 1d, 1wk, 1, 3mo after operation(P<0.05), it decreased significantly in the 2.2mm incision group.

CONCLUSION: The 2.2mm small incision coaxial phacoemulsification with postoperative visual acuity improved more significantly, can significantly reduce the operation astigmatism.

Using corneal topography design personalized cataract surgery programs

Jin-Ou Huang,Jin-Bang Chen,Wei-Jiang Chen,Yi-Song Qiu and Xiao-Hong Wei — 2014/7/22 8:27:36

AIM:To investigate how to design personalized cataract surgery programs to achieve surgical correction of preoperative corneal astigmatism with surgical astigmatism under the guidance of corneal topography, improve postoperative visual quality and reduce the cost of treatment.

METHODS: Totally 202 cases(226 eyes)cataract patients were divided into randomized treatment group and individualized treatment group. According to the method and location of the incision, randomized treatment group were divided into 8 groups. Surgical astigmatism after different incision were calculated with the use of preoperative and postoperative corneal astigmatism through vector analysis method. Individualized treatment groups were designed personably for surgical method with reference of every surgically induced astigmatism, the surgical method chooses the type of surgical incision based on close link between preoperative corneal astigmatism and surgically induced astigmatism, and the incision was located in the steep meridian. The postoperative corneal astigmatism of individualized treatment group was observed.

RESULTS: Postoperative corneal astigmatism of individualized treatment group were lower than that of 3.0mm clear corneal tunnel incision in the randomized treatment group, there were statistically significance difference, while with 3.0mm sclera tunnel incision group there were no statistically significance difference. After 55.8% of patients with the use of individualized surgical plan could undergo the operation of extracapsular cataract extraction with relatively low cost and rigid intraocular lens implantation, the per capita cost of treatment could be reduced.

CONCLUSION: Personalized cataract surgery programs are designed to achieve surgical correction of preoperative corneal astigmatism under the use of corneal topography, improve postoperative visual quality and reduce the cost of treatment.

Comparison on eye biometry of Lenstar 900, A-scan ultrasound and keratometer in patients with cataract

Dan Hu,Gang-Ping Zhao,Jian-Hong Yu and Xiao Zheng — 2014/7/22 8:27:36

AIM: To investigate the differences among Lenstar 900, A-scan ultrasound and keratometer in measurement of axial length(AL), anterior chamber depth(ACD)and corneal curvature(K₁, K₂, Km), and evaluate the consistency of the instruments, with the purpose providing references for the clinical application of Lenstar 900.

METHODS: In this study we picked up 36 patients(50 eyes)underwent cataract surgery, and lens nucleus hardness were under level IV. Before the operation, AL, ACD and K₁, K₂, Km were measured by Lenstar 900, A-scan ultrasound and keratometer respectively. The differences between the results were compared by the paired t-test. The correlation of the results was analyzed by Pearson correlation analysis, and the consistency was measured by Bland-Ahamn method.

RESULTS: The mean AL and ACD values measured by Lenstar 900 and A-scan ultrasound had no significantly statistic differences(P>0.05). The K₁, K₂, Km measured by Lenstar 900 and keratometer were not significantly statistical different(P>0.05). The results measured by these three instruments had close linearity correlation(r>0.9, P<0.01). The consistency of the results was well in Bland-Ahamn analysis.

CONCLUSION:The preoperatively biometric result of Lenstar 900, A-scan ultrasound and keratometer in patients with cataract are all reliable, and they can be substituted by each other. However, Lenstar 900 can not only measure AL, ACD and corneal curvature at the same time, but also cornal thickness, lens thickness, white to white, pupil size, optical axis eccentricity, retinal thickness and so on. It has a number of advantages such as non-touching, convenient and efficient, and can be recommended to use widely.

Travoprost effect on IOP in POAG patients with phacoemulsification and intraoclular lens implantaion

Xiao-Fang Zhou and Xun-An Fu — 2014/7/22 8:27:36

AIM: To investigate the effect of lowering intraocular pressure(IOP)and side effect of travoprost(TA)on phacoemulsification and intraoclular lens(IOL)implantation in primary open-angle glaucoma(POAG).

METHODS: Patients with POAG already received surgery of phacoemulsification and IOL implantation were selected by randomized, single-blind, parallel group trial. TA was applied once a day in 43 patients(43 eyes)of treatment group and brinzolamide was used twice in 43 patients(43 eyes)of control group. All patients were observed for 12wk. IOP, ocular symptom and adverse reaction etc. were observed.

RESULTS: The daily average IOP(mean±standard deviation)in the treatment group decreased from(24.20±3.01)mmHg(1mmHg=0.133kPa)to(16.77±2.89)mmHg and that in the control group was from(23.87±3.47)mmHg to(18.81±3.07)mmHg. IOP pre- and pro-treatment within two groups had significant difference(P<0.01), IOP between the groups at each time point had statistical difference(P<0.05). Conjunetival congestion increased and itching in treatment group was obviously more serious than that in the control group, but the treatment could continue. No other ocular and systemic adverse events related to the drugs were found.

CONCLUSION: It is demonstrated that travoprost is highly effective and safe in reducing IOP in POAG already received surgery of phacoemulsification and IOL implantation.

Observation of curative effect of glaucoma valve implantation and intravitreal Bevacizumab for neovascular glaucoma

Bing-Jian Lü,Rui-Fu Wang,Xiao-Yun Dong,Xiu-Xiang Ji and Yi Liu — 2014/7/22 8:27:36

AIM: To observe the effect of Ahmed glaucoma valve implantation intravitreal bevacizumab in the treatment of neovascular glaucoma(NVG).

METHODS: Twenty-two cases(22 eyes)who presented with NVG were first treated with intravitreal bevacizumab 0.1mL(2.5mg), then with Ahmed glaucoma valve implantation after regression of iris neovessels. Cases were followed-up for 6-36(mean 24)mo with observation on visual acuity, IOP control, regression of iris neovessels, and complications during or after surgery.

RESULTS: Iris neovessels was regressed in different degree after injection within 1wk in 22 eyes. At final follow-up, the IOP of 18 eyes were all less than 21mmHg without any drugs and of 3 eyes with 1-3 kinds of anti-glaucoma drugs after combined Ahmed glaucoma valve implantation. The IOP of one eye was controlled after cryotherapy. The mean IOP dropped from 45.36±8.13mmHg preoperatively to 15.59±3.21mmHg postoperatively. IOP reduction was statistically significance between preoperative and postoperative(P<0.05)at final follow-up. Visual acuity was improved in 9 eyes(41%)and was no changed in 13 eyes. No serious complications were observed during or after intravitreous bevacizumab injection and Ahmed glaucoma valve implantation.

CONCLUSION: Ahmed glaucoma valve implantation and intravitreal bevacizumab in the treatment of NVG is useful and safe. It improves the success rate of surgery and preserves visual function, furthermore its complications are less.

Study on macular retinal thickness in young people by using 3D optical coherence tomography

Gui-Ling Zhao,Yan-Hua Pang,De-Mao Liang and Qiu-Rong Lü — 2014/7/22 8:27:36

AIM: To measure the macular thickness of normal young people by 3D 1000 optical coherence tomography(OCT)and study the repeatability of measuring results and the relationship between the thicknesses of macular and gender. At the same time, to compare our result with the data of other types of OCT, and to understand the consistency of the measuring results of macular thickness of different types of OCT.

METHODS: Totally 222 eyes in 111 young people were detected using 3D scan mode of Topcon 3D OCT 1 000(ver 2.4). Twelve cases(24 eyes)underwent repeatability check. We took transverse comparison between our measured results with other research's results.

RESULTS:There were 111 cases of young people, whose age were from 18-27 years old, all uncorrected and corrected visual acuity were ≥1.0, all intraocular pressure were <21mmHg. The average thickness of all macular region was 273.32±17.08μm. Retinal volume of macular area was 7.73±0.37mm³. Center thickness was 161-264μm, and the average thickness was 200.13±18.81μm. Central macular thickness were 188-273μm, and the average thickness was 229.00±18.20μm. The central macular thickness in men was significantly greater than that in women, and there was statistical difference. The results of repeated check of 12 cases(24 eyes)in the macular area were no statistical difference except the outer ring of nasal quadrant, and the repeatability of average thickness in central macular thickness was better than in center thickness.

CONCLUSION:The repeatability of macular examination is good. The central macular thickness can be better repeated than the center thickness. The central macular thickness is 229.00±18.20μm in young people, according to the 3D 1000 OCT measurements. There are statistical difference of central macular thickness between different genders.

Comparison between intravitreal Ranibizumab and Tramicinolone acetonide for macular edema secondary to central retinal vein occlusion

Miao Zeng,Zhong-Shan Chen and Yan-Ping Song — 2014/7/22 8:27:36

AIM:To compare the efficacy and safety of intravitreal ranibizumab to those of triamcinolone acetonide(TA)injection for the treatment of macular edema secondary to central retinal vein occlusion(CRVO).

METHODS:This retrospective study included 40 eyes of 40 patients with macular edema associated with CRVO. Twenty patients 20 eyes were treated with intravitreal injection of triamcinolone acetonide(1mg, 0.1mL), the other 20 patients 20 eyes accepted intravitreal ranibizumab(0.5mg, 0.05mL). The change of best corrected visual acuity(BCVA), central macular thickness(CMT), and intraocular pressure(IOP)before treatment and at 1, 2wk, 1, 2,3,6mo post-injection in the two groups were observed.

RESULTS:BCVA was improved at 1, 2wk, 1, 2,3,6mo post-injection in the TA group(P<0.05)and ranibizumab group(P<0.05). No significant difference was found between the two groups(P>0.05). CMT decreased significantly within each group(P<0.05), and no significant difference between groups was found(P>0.05). In the TA group, the IOP was significantly higher at 2wk and 4wk than before treatment(P<0.05). In the ranibizumab group, no elevated IOP was observed at 1, 2wk, 1, 2,3,6mo(P>0.05). However, the IOP at 1mo was significantly higher in the TA group than that in the ranibizumb group(P<0.05).

CONCLUSION:Intravitreal ranibizumab is an effective and safe treatment method for macular edema secondary to CRVO. It can effectively improve BCVA and reduce CMT without ocular and systemic complications compared with intravitreal TA.

Clinical research of tear film stability after pterygium excision with amniotic membrane transplantation

Guo-Ying Ming,Min Lu,Zhao-Rong Zeng,Hao-Ying Tang and Dong-Mei Hong — 2014/7/22 8:27:36

AIM: To assess changes of tear film function in patients after pterygium excision combined with amniotic membrane transplantation.

METHODS:Totally 126 patients with pterygium excision with amniotic membrane transplantation from January 2011 to November 2013 were entered in the study. The tear breakup time(BUT), the Schirmer I test(SⅠt)and tear ferning test(TFT)were elevated in the patients before and after pterygium excision combined with amniotic membrane transplantation. The examnation times were 1d before surgey, 1wk, 1, 2mo after surgery. Operation eyes were studied group, while opposite healthy eyes as control group.

RESULTS: Compared with the control group, BUT and TFT were significantly different in the eyes with pterygium(P<0.05); However, no obvious difference was detected in the results of SⅠt(P>0.05). The results of BUT and TFT at 1mo after surgery in study group were significantly better than 1wk(P<0.05), while no significant difference compared with 2mo(P>0.05); The tear film stability in the study group at 1wk after surgery was still inferior to the control group(P<0.05)and there was no significant difference at 1, 2mo after surgery(P all>0.05). SⅠt results did not differ between the different examination times(P>0.05).

CONCLUSION:Tear film stability was broken in the eyes with pterygium. Pterygium excision combined with amniotic membrane transplantation can obviously restore the tear film function into normal state, and the tear film function could reach steady-state 1mo after surgery.

Analysis the changes of tear film after LASIK with corneal flap created by femtosecond laser with the different gender

Yuan Zhang,Bing-Bing Jia,Yan Zhang,Dong-Mei Gao and Yu-Zhen Pang — 2014/7/22 8:27:36

AIM: To observe the changes of tear film on the patients after laser in situ keratomileusis(LASIK)with corneal flap created by femtosecond laser with the different gender.

METHODS: The 120 myopic patients(240 eyes)who underwent femtosecond laser surgery LASIK from August to September 2013 were collected, and these patients were followed up for 3mo. The patients were divided into two groups according to the gender, group A was male(110 eyes of 55 patients); group B was female(130 eyes of 65 patients). Dry eye symptom score, tear break-up time(BUT), Schirmer Ⅰ test, corneal fluorescein staining were recorded preoperatively and postoperatively in 1wk,1,2,3mo.

RESULTS: Dry eye symptom score: it was statistically significant between two groups after operation in the 1wk,1, 2mo(P=0.000,0.023, 0.030). It had no statistical significance between the two groups in 3mo(P=0.283). BUT: it was statistical significance between two groups after operation in the 1wk,1, 2, 3mo(P=0.000,0.017, 0.026, 0.032). SchirmerⅠ test: it was statistically significant between two groups after operation in the 1wk, 1, 2mo(P=0.012,0.024, 0.018). It had no statistical significance between the two groups in 3mo(P=0.206)Corneal fluorescein staining: it was statistically significant between two groups after operation in the 1wk, 1, 2, 3mo(P=0.022,0.015, 0.036, 0.041).

CONCLUSION: The influence of tear film after femtosecond laser surgery for men less than that for women.

Comparsion on therapeutic effect of hydroxyl-glucoside and sodium hyaluronate on dry eye after age-related cataract surgery

Nan Chen,Wei Xiao,Bo-Tao Liu,Dai-Xin Zhao and Wei Pu — 2014/7/22 8:27:36

AIM: To observe the tear film changes after phacoemulsification combined with intraocular lens implantation in age-related cataract patients and to compare the therapeutic effect of hydroxyl-glucoside and sodium hyaluronate on the postoperative dry eye.

METHODS: A total of 49 patients(70 eyes)with age-related cataract suffering from dry eye after phacoemulsification combined with IOL implantation were divided into treatment group 1(group A, 23 eyes with conventional therapy and hydroxyl-glucoside at 7d postoperatively), treatment group 2(group B, 22 eyes with conventional therapy and sodium hyaluronate at 7d postoperatively)and control group(group C, 25 eyes with conventional therapy only). Questionnaire score of dry eye symptoms, SchirmerⅠtest(SⅠt), tearfilm break up time(BUT)and corneal fluoresce in staining(CFS)were measured at 2d preoperatively and 7, 14, 30, 90d postoperatively.

RESULTS: No statistical differences existed among the three groups of preoperative 2d(P>0.05). At 2d preoperatively and 90d postoperatively, the results of questionnaire score of dry eye symptoms, SⅠt, BUT, and CFS displayed no statistical differences in the patients of three groups(P>0.05). While there was statistical significance among preoperatively and 7, 14, 30d postoperatively of the three groups(P<0.05). At 14, 30d postoperatively, the questionnaire score of dry eye symptoms, SⅠt, BUT, CFS in group A and B were better than in group C, which displayed statistical differences(P<0.05). At 30d postoperatively the questionnaire score of dry eye symptoms, SⅠt, BUT in group B were better than in group A, which displayed statistical differences(P<0.05).

CONCLUSION: At the early stage after phacoemulsification combined with IOL implantation, the tear film stability is decreased, which may promote eyesymptoms. Management with hydroxyl-glucoside or sodium hyaluronate plays a role in relief of the structure and stability of the tear film and improves dry eye symptoms, while sodium hyaluronate eye drops is more effective.

Clinical analysis of vitrectomy in treatment of 48 eyes with metallic foreign bodies

Dong Yuan,Tao Jiang,Wen-Ying Wang,Shan-Yao Zhao and Yun-Xiao Wang — 2014/7/22 8:27:37

AIM: To investigate the effect of vitrectomy in treatment of metal intraocular foreign bodies and the factors affecting visual prognosis.

METHODS:Fourty seven cases(48 eyes)with foreign bodies from January 2010 to June 2013 in our hospital underwent vitrectomy combined with intraocular foreign body removal were retrospectively analyzed. The changes of visual acuity, the size of foreign body, the complications of preoperative, and the relationship between treatment time and visual acuity were recorded.

RESULTS: Totally 46 eyes were successfully removed the complete foreign body, 2 eyes of orbital foreign bodies had not been removed. After 6mo of followed-up, the best corrected visual acuity were all improved in varying degrees(P<0.05), intraocular foreign body size combined with retinal detachment was the risk factor for visual impact(P<0.05).

CONCLUSION:Vitrectomy has obvious advantages in the treatment of metal intraocular foreign bodies. Timely and appropriate vitrectomy is very important to the recovery of visual function.

Relationship between refractive error and influencing factors in Children

Hai-Jun Shi,An-Li Hu and Hong Zhu — 2014/7/22 8:27:37

AIM: To evaluate the relationship between axial length(AL), corneal and lens refractive power, and the refractive error in children.

METHODS:Totally 44 children 88 eyes with refractive error who underwent retinoscopy with cycloplegia, to be measured spherical equivalent refractive error. Axial length was measured by a noncontact optical biometry(ZEISS IOL-Master), and corneal K and anterior chamber depth(ACD)were also measured by the same machine. The refractive power of the lens was calculated by using the SRK formula. The patients were divided into 3 groups, myopia(SE<0), hyperopia(SE>+0.50D)and emmetropia(0 to +0.50D). Linear Correlation and Regression were used to evaluate the correlation among the optical parameters.

RESULTS:Totally 44 subjects, 88 eyes, average 9.04±2.39 years, spherical equivalent(SE)-3.50D to +8.75D. Hyperopic AL was shorter than the other two groups(P<0.05), same trend in lens power. No significant differences among the 3 groups in corneal K and ACD. There was a negative correlation between age and SE, SE and AL, SE and lens refractive power, and there was a positive correlation between age and AL, age and lens power.

CONCLUSION:As the children's growing up, SE trends to myopia, and AL becomes longer, and lens power is stronger.

Comparison dominant eye and anisometropia by Worth 4 dot test and hole-in-the-card test

Nian Guan and Zhi-Guang Hu — 2014/7/22 8:27:37

ATM: To investigate the relationship between the oculus dominans and the eye with higher diopter among myopes, and to study the difference between the Worth 4 dot test and hole-in-the-card test.

METHODS: Totally 125 cases were divided into two groups as physiogenic anisometropic group and pathological anisomitropic group according to the degree of binoculus anisometropy. Worth 4 dot test and hole-in-the-card test were used to distinguish oculus dominans respectively based on medical optometry.

RESULTS: In physiogenic anisometropic group, the oculus dominans and the eye with higher diopter among myopes had significant relationship by hole-in-the-card test(Z = -4.057, P<0.01)and Worth 4 dot test(Z=-3.558, P<0.01). However, in pathological group, No statistical significance was between two tests(P>0.05); distinguish the oculus dominans had no statistically significant difference between the Worth 4 dot test and hole-in-the-card test(n=125, P>0.05).

CONCLUSION:The oculus dominans is determined by gene or formed during juvenile period, then myopia anisometropic may affect the choice of that. The Worth 4 dot test has some reference significance for observing oculus dominans.

Visual quality of Q-factor guided LASEK for myopia and astigmatism with positive Q-factor

Jiao-Jiao Wang,Li-Jun Zhang,Fan-You Zhang,Qian Han and Ya-Nan Mu — 2014/7/22 8:27:37

AIM: To explore the long-term efficacy of Q-factor guided laser epithelial keratomleusis(LASEK )for myopia and astigmatism with positive Q-factor.

METHODS: There were 158 eyes which were myopia and astigmatism with positive Q-factor taken in two groups randomly: 86 eyes accepted Q-factor guided LASEK as observation group and 72 eyes accepted routine LASEK as control group. The difference between the two groups about all data was similar. The uncorrected visual acuity(UCVA)and the best corrected visual acuity(BCVA)as well as diopter, ocular tension, corneal topography, Keratometry value K, aspherical factor Q, Higher-order aberrations(HOA), corneal thickness by ultrasound and, contrast sensitivity(CS), Haze were examined and compared before and after surgery. All the cased were followed up for 14d, 1, 3, 6, 12mo. And there were no statistical difference among the data before surgery.

RESULTS: After 12mo there were no statistical difference between the two groups about UCVA and BCVA. But the safety index of observation group was 1.10, that of control group was 1.07. The validity index of observation group was 1.06, that of control group was 0.99. The HOA of observation group was 0.45±0.17μm, and that of control group was 0.72±0.25μm, there was statistically significant difference(t=-8.193,P=0.000). Q factor of observation group was 0.41±0.17, that of control group was 0.77±0.22, there was significant difference(t=11.377,P = 0.028). The contrast sensitivity of 3mo post surgery of patients in the observation group returned to the level of before surgery. But in the control group the contrast sensitivity of the patients did not returned until 6mo.

CONCLUSION: Q-factor guided LASEK for myopia and astigmatism with positive Q-factor is stable, safe and effective. The operation allow for reducing the high order aberrations, maintaining the most asphericity of cornea, saving more in corneal tissue, which cause faster recovery of contrast sensitivity, less haze and better visual quality.

Clinical effect of AcrySof Toric intraocular lens implantation for corneal astigmatism correction

Cheng Jiang,Zhi-Yi Wei and Qin Yang — 2014/7/22 8:27:37

AIM: To evaluate the clinical effect and the rotational stability of AcrySof Toric intraocular lens(IOL)implantation to correct preexisting corneal astigmatism in cataract surgery.

METHODS: Twenty-three patients(28 eyes)were enrolled from the department of ophthalmology in the first Affiliated Hospital of Nanjing Medical University. All patients underwent similar phacoemulsification procedure combined with AcrySof Toric IOL implantation from June 2012 to December 2013. The uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), anticipated residual astigmatism, postoperative residual astigmatism, and Toric IOL axis were detected and measured.

RESULTS: Three months after operation, the UCVA of all eyes were 0.75±0.16 and the BCVA were 0.84±0.15, there was no significant difference between UCVA and BCVA(t=1.036, P>0.05). The anticipated residual astigmatism was(0.28±0.12)D. The actual residual astigmatism after 3mo of the operation was(0.42±0.17)D. There was no significant difference between anticipated and actual residual astigmatism(t=1.259, P>0.05). The mean axis rotation of Toric IOL was 3.02°±1.56°(0°-7°)after 1d of operation and 3.28°±1.85°(0°-7°)after 3mo. Among all the eyes, 25 eyes(89%)rotated <5°, in 3 eyes(11%)rotated 5°-7°.

CONCLUSION:The AcrySof Toric IOL implantation shows good effectiveness, predictability and stability in correcting pre-existing astigmatism in cataract patients.

Visual cortex activation range of color vision with BOLD-fMRI in anisometropia amblyopia children

Hui-Fang Zhang and Zhen-Guo Yan — 2014/7/22 8:27:37

AIM: To analyze the recovery of visual cortex activation range of color vision in anisometropia amblyopia children after treatment by using blood oxygen level dependence-functional magnetic resonance imaging(BOLD-fMRI)and SPM8 software.

METHODS: Self-control study. This fMRI study directly compared activity in visual cortex produced by color monocular stimulation in 13 monocular anisometropia amblyopia children. The project of study was blocked design. The data of functions and anatomical MRI was stimulated by three-primary colors and was preprocessed and analyzed by SPM8 that based on MATLAB software. According to the data, we compared the change of the central area of color vision when first visit and 1, 2,4wk after treatment.

RESULTS: The BA17, BA18, BA19 and BA37 of amblyopia children were different activated after they accepted the three-primary colors stimulation(P<0.01). After 4wk treatment, amblyopia children accepted red stimulation, the visual cortex activation range without expanding; after accepting green stimulus, on the left side of the visual cortex BA37, BA19, BA20, the average t value were 3.5210, 3.2716, 3.1534(P<0.01); after accepting blue stimulation, the scope of the right side of visual cortex at BA19, BA18 were expanded to different extent, the average t value were 3.7345, 3.2701(P<0.01).

CONCLUSION: After 4wk treatment, visual cortex activation of color vision of anisometropia amblyopic children is expanded, but with low extent, after the short-term treatment of amblyopia, visual cortex activation of color vision has a certain degree of recovery but not obvious.

P-VEP games aided combined treatment of amblyopia in children

Zheng Yin,Xiao-Ying Li,Ying-Qiao Kuang,Ting Li,Mu-Zhen Huang and Xu-Guang Xia — 2014/7/22 8:27:37

AIM: To evaluate the efficacy of combined therapy for amblyopia in children by making use of pattern visual evoked potential(P-VEP)game.

METHODS: This was a prospective case control study. These asthenopic children were divided into two groups. The control group(66 eyes of 49 patients): occlusive therapy with glasses, cover, precision work, red light treatment and so on, later the stereo vision training was added. The experimental group(72 eyes of 52 patients): conventional methods mentioned above with P-VEP games.

RESULTS: The total effective rate and cure rate of experimental group in 6mo were higher than those of control group. The overall effective rate was 94.4% in the experimental group and 83.3% in the control group. There was a statistically significant difference between them(P<0.05).

CONCLUSION: The comprehensive therapy by making use of P-VEP game is an individualized effective new way in treating amblyopia.

Comparison of tilt and decentration of two aspheric intraocular lens by ultrasonic biomicroscope

Xiao-Bao Zhang,Qian Tan,Hai-Bo Jiang,Dan Liu and Yan-Xiu Li — 2014/6/19 9:55:01

AIM: To compare the differences of tilt and decentration of two aspheric posterior chamber intraocular lens(PC-IOL)implantation by ultrasonic biomicroscope(UBM).

METHODS:Thirty-seven patients(45 eyes)underwent cataract surgery were distributed to two groups randomly. Group A was implanted with Akreos AO(Bausch & Lomb; four-haptic)while group B implanted with ZCB00(Abbott Medical Optics, Inc. AMO; two-haptic). All eyes underwent standard phacoemulsification with intraocular lens implantation. Diameter of capsulotomy was recorded. One month postoperatively, vision, best-corrected visual acuity(BCVA)assessment, slit lamp examination, and anterior chamber depth(ACD)measured by UBM were performed. Tilt and decentration were measured horizontally and vertically, and total tilt and decentration were calculated by geometry method.

RESULTS:No statistical difference was found in BCVA and diameter of capsulotomy between two groups(P>0.05). The mean ACD of group A and group B were 3.86mm±0.31mm and 4.14mm±0.31mm respectively, which showed it had statistically significant difference(P<0.05). Horizontal decentration, vertical decentration and total decentration of group A were 0.15mm±0.09mm, 0.15mm±0.12mm and 0.22mm±0.12mm respectively, while it were 0.22mm±0.21mm, 0.14mm±0.15mm, 0.29mm±0.22mm for group B. Horizontal tilt, vertical tilt and total tilt of group A were 0.63°±0.62°, 0.89°±0.85°and 1.22°±0.76°, while it were 1.36°±1.48°, 1.46°±1.62° and 2.21°±1.97° for group B. No statistically significance was found in tilt and decentration between group A and group B, no matter horizontally or vertically or totally(P>0.05).

CONCLUSION:Two-haptic IOL shows no difference in tilt and decentration with four-haptic IOL postoperatively.

Effect of arcuate keratomy on decreasing astigmatism in IOL implantation after intracapsular cataract extraction

Zhong-Yu Xu,Da-Si Liao and Jia Liu — 2014/6/19 9:55:01

AIM: To study an approach to visual acuity correction after intracapsular cataract extraction by phase-II intraocular lens implantation through the individualized arcuate keratotomy.

METHODS: For demonstration, 48 postoperative patients(50 eyes)receiving the intracapsular cataract extraction were gathered up. Each patient received a scleral tunnel major incision along the radial line of the maximum corneal refractive power determined by a cornea curvimeter, and a arcuate keratotomy was made opposite to the major one; through the major incision an iris-claw intraocular lens is implanted. Each patient was measured for their corneal astigmatism and uncorrected visual acuity before and after the surgery.

RESULTS: The results suggested the average corneal astigmatism before the surgery and that 3d, 1, 3, 6 and 12mo after the surgery as +3.18±0.68, -1.56±0.73, +0.87±0.51, +1.21±0.70, +1.33±0.68 and +1.48±0.48 respectively. The uncorrected visual acuities 3d, 1, 3, 6 and 12mo after the surgery are 0.5±0.38, 0.56±0.23, 0.55±0.24, 0.52±0.28 and 0.51±0.25 respectively.

CONCLUSION: Phase-II intraocular lens implantation witharcuate keratotomy is helpful to improve the postoperative visual acuity and reduce preoperative corneal astigmatism after the intracapsular cataract extraction aphakic eyes, It is also a low-cost surgery, and easy to perform, with minor surgical injuries, particularly available for surgical visual acuity correction of the aphakic eye receiving intracapsular cataract extraction.

Analysis of relationship between axial length and complications of phacoemulsification

Yi Liu,Xin-Hui Wang,Meng-Fei Wang and Xiu-Xiang Ji — 2014/6/19 9:55:01

AIM: To observe the relationship between axial length and complications of phacoemulsification with intraocular lens(IOL)implantation in high axial myopia eyes and normal axis eyes.

METHODS: A retrospective review of 843 consecutive patients(1 042 eyes)of cataract extraction with phacoemulsification and IOL implantation in our hospital from February 2012 to February 2013 was performed. The patients were divided into two groups according to the axial length: 853 eyes were in normal axis group(21-24mm)and 189 eyes were in high axial myopia group(≥26mm). The two groups were compared regarding surgical complications, such as vitreous loss, posterior capsular rupture, nucleolus drop, and abnormal location of IOL.

RESULTS: Age was a risk factor in both groups. There was positive correlation between age and surgical complications, and between axial length and surgical complications, especially for complications with posterior capsular rupture and vitreous loss.

CONCLUSION: As the results illustrate, in this survey, age and high axial lengthare statistically significant risk factors for incidence of complications of phacoemulsification. Anticipation of these complications and also preparation and prophylactic measures may decrease incidence of these complications.

Application of lift and squeeze technique in phacoemulsification of hypermature cataract

Geng-Ying Li,Ping-Li Zhu,Min Su,Li-Ling Du and Wei He — 2014/6/19 9:55:01

AIM: To evaluate the effectiveness and security of lift and squeeze technique in phacoemulsification of hypermature cataract.

METHODS: From June 2010 to June 2013, totally 156 eyes with hypermature cataract, which received phacoemulsification in our hospital, were enrolled. Lift and squeeze technique was used to chop the nucleus, and 1g/L Trypan blue was used for capsulorhexis. Average time of phaco complication, corneal edema and visual outcome were recorded.

RESULTS: The best-corrected visual acuity(BCVA )was 0.1-0.4 in 15 eyes(9.6%), 0.5-0.7 in 82(52.6%)eyes, and 0.8-1.0 in 59(37.8%)eyes at 3mo after surgery. The phaco time was 25-56s(average 42±10s), the maximum phaco power was 30%. Posterior capsular rupture and vitreous loss happened in 2 eyes(1.3%), and the IOLs were implanted in the sulcus. Corneal edema classified at grade Ⅰ were seen in 12 eyes(7.7%), and 5 eyes(3.2%)at gradeⅡ, no eye at grade Ⅲ and grade Ⅳ. The mean endothelial cell loss was 8.7% at 3mo.

CONCLUSION: Crystalline lens capsule staining with Trypan blue increase the success rate of intact continuous curvilinear capsulorhexis(CCC). The lift and squeeze technique reduces the stress on the zonules and capsule, and decreases the phaco time and phaco power.

Clinical observation of double incision combined surgery of single-stab trabeculectomy and phacoemulsification

Si-Wei Liu,Qun Wang and Qian-Yan Kang — 2014/6/19 9:55:02

AIM:To observe the effects of double incision combined surgery of single-stab trabeculectomy and phacoemulsification.

METHODS: Totally 28 cases(30 eyes)with glaucoma and cataract undertook the modified combined surgery of single-stab trabeculectomy and phacoemulsification. After traditional phacoemulsification, cut the bulbar conjunctiva and Tenons capsule from the 11 o'clock to 1 o'clock, then puncture into the anterior chamber in 2mm behind the corneal limbus with 3mm tunnel knife, shaping a 3mm wide, 1/3-1/4 thickness scleral tunnel. Getting into the trabecular tunnel, bite off 3 pieces of trabecular tissue about 1mm×1mm size. The changes in the imtraocular pressure(IOP)and the visual acuity before and after the surgery as well as filtering bleb(OCT confirmed)and complications were carefully observed in 3-6mo postoperatively.

RESULTS: The postoperative visual acuity in 1wk postoperatively less than 0.1 was found in 3 eyes, from 0.1 to 0.3 was found in 6 eyes,from 0.3 to 0.6 in 13 eyes,from 0.6 to 0.8 in 8 eyes.One eye had malignant glaucoma, and 8 eyes had cornea edema and slightly fibrin exudation in the pupil area; In all cases maintained function conjunctival blebs of filtering, OCT confirmed this.IOP remained normal in 28 eyes in 3-6mo follow up, IOP of 2 other eyes could be controlled by anti-glaucoma eye drops.

CONCLUSION:Double incision combined surgery of single-stab trabeculectomy and phacoemulsification is effective and safe,reduces the postoperative complications and is worthy of promotion.

Follow-up observation of three operative treatments for primary infantile glaucoma

Qi Peng and Xiao-Hong Xu — 2014/6/19 9:55:02

AIM: To compare the efficacy and complication of extra-trabeculotomy in combination with trabeculectomy and trabeculectomy and compound trabeculectomy in the treatment of primary infantile glaucoma.

METHODS: Patients with primary infantile glaucoma undergone one of the three procedures from Jan 2006 to Jan 2014 were selected. Among them, group A(20 patients, 31 eyes)underwent extra-trabeculotomy in combination with trabeculectomy, group B(20 patients, 32 eyes)underwent trabeculectomy, while group C(20 patients, 30 eyes)underwent compound trabeculectomy

RESULTS: The success rates in group A were 96.8% at the time of discharge and 90.3% during follow-up(mean 24mo); the rates in group B were 96.9% and 81.2%(mean 24mo)the rates in group C were 83.3% and 76.7%(mean 24mo)respectively, the differences being significant(P <0.05). In group A and group B, there was no severe complications, while in group C, one case had vitreous prolapse.

CONCLUSION: Extra-trabeculotomy in combination with trabeculectomy is more efficacious and safer than trabeculectomy and compound trabeculectomy in the treatment of primary infantile glaucoma. It should be the first choice for primary infantile glaucoma.

Comparison of anterior segment parameters with Lenstar 900 and Sirius system

Yan Zhao,Wei Wei and Chang-Ning Zhang — 2014/6/19 9:55:02

AIM: To compare the anterior segment measurements derived from optical low coherence reflectometer(Lenstar LS900)and combined Scheimpflug-Placido disk topographer(Sirius).

METHODS: In this study, we enrolled healthy myopic subjects 54(87 eyes). The central corneal thickness(CCT), anterior chamber depth(ACD), flat keratometry(FK)readings, steep keratometry(SK)readings and white to white(WTW)were measured by LS900 and Sirius. Evaluation and analysis were performed using paired t tests, the Pearson correlation, and Bland-Altman analyses.

RESULTS:The CCT and ACD measurements were significantly lower whereas FK, SK and WTW measurements were higher with LS900(P<0.001). Mean differences were -6.11±6.32μm,-0.09±0.07mm, 0.18±0.25D, 0.21±0.36D and 0.25±0.39mm with statistical significant(P<0.01). Pearson correlation analysis showed high correlation between the 2 devices for all measurements(P<0.001). On Bland-Altman analysis, 95% limits of agreement for all measurements were 6.26 to -18.49μm; 0.04 to 0.22mm; 0.68 to 0.32D; 0.92 to 0.50D and 1.00 to 0.5mm.

CONCLUSION: Anterior segment parameters evaluated with LS900 and Sirius systemare correlated well and achieve good agreement. However, there are significantly statistical differences which may be caused by the different measurement modes, so they may not be interchangeable use under certain clinical circumstances.

Efficacy of intravitreal ranibizumab injection combined with macular grid photocoagulation for diabetic macular edema

Hu-Lin Jiang,Xu-Wei Han,Sheng-Qi Zhang,Xiu-Ling Fang and Bo-Jun Zhao — 2014/6/19 9:55:02

AIM:To evaluate the clinical efficacy of intravitreal injection of ranibizumab combined with macular grid photocoagulation for diabetic macular edema(DME).

METHODS:Totally 60 eyes(60 patients)with DME were randomly divided into 2 groups: 30 eyes of simple injection group underwent intravitreal injection of ranibizumab, and 30 eyes of combined treatment group underwent intravitreal injection of ranibizumab and macular grid photocoagulation 1wk later. The best corrected visual acuity(BCVA), central macular thickness(CMT)measured by optical coherence tomography(OCT)and postoperative complications were observed.

RESULTS:In simple injection group, the BCVA after operation were separately 0.390±0.075(4wk), 0.367±0.088(8wk)and 0.319±0.064(12wk),the CMT after operation were separately 221.63±112.34μm(4wk), 337.73±99.56μm(8wk)and 432.92±100.46μm(12wk), which were much better than pre-operation. But during follow-up, the BCVA presented down trend and the CMT was on the rise slowly. In combined treatment group, the BCVA after operation were separately 0.385±0.036(4wk), 0.382±0.079(8wk)and 0.377±0.097(12wk),the CMT after operation were separately 249.77±106.55μm(4wk), 270.40±92.88μm(8wk)and 275.84±97.34μm(12wk), which were satisfactory and steady during follow-up, better than simple injection group(P<0.05).

CONCLUSION:Intravitreal injection of ranibizumab can effectively improve visual acuity and decrease central foveal thickness for patients with DME, combining with macular grid photocoagulation can ensure therapeutic effects steady and permanent.

Clinical effect of vitrectomy with intravitreal ranibizumab for diabetic retinopathy

Yun-Peng Wang,Mei-Zhu Chen,Guo-Cang Chen and Yan-Jin Chen — 2014/6/19 9:55:02

AIM: To observe clinical effect of vitrectomy with intravitreal ranibizumab for the treatment of diabetic retinopathy(DR).

METHODS: From February 2011 to February 2013, there were 90 cases in our hospital diabetic retinopathy patients withvitrectomy surgery. It was randomly divided into observation group(45 cases)and control group(45 cases). Two groups of patients were performed vitrectomy. Patients in observation group were injected intravitreal ranibizumab before surgery, then vitrectomy was underwent for diabetic retinopathy. Vitrectomy was only underwent in control group.

RESULTS: The patients in observation group with good effect accounting for 71%(32/45)and good rate was 89%(40/45), which were significantly higher than that in control group 51%(23/45), 71%(32/45). Differences were statistically significant(P<0.05). Amount of bleeding was 9.64±2.27mL, intraocular pressure was 13.64±3.27mmHg. It was significantly less than that in control group 10.21±3.14mL, 16.00±3.14mmHg. Differences were statistically significant(P<0.05).

CONCLUSION: The vitrectomy with intravitreal ranibizumab treatment of diabetic retinopathy can not only reduce blood loss, but also reduce edema and improve effectiveness and safety. It's worth recommending for clinical practice.

Efficacy observation on multiple wave length laser for diabetic retinopathy and central retinal vein occlusion

Tao Tian,Ru Liu,Jing-Li Peng,Li-Lian Xie and Guo-Ping Kuang — 2014/6/19 9:55:02

AIM:To observe the efficacy of the multiple wave length laser in treating diabetic retinopathy combined with central retinal vein occlusion.

METHODS:Totally 95 cases(100 eyes)with diabetic retinopathy combined with central retinal vein occlusion were treated by multiple wave length laser. Krypton yellow laser was used for macular edema in focal photocoagulation and diffuse photocoagulation. For peripheral retina, krypton green or krypton red laser were used. Visual acuity, slit-lamp biomicroscopy, ophthalmoscopy and fundus fluorescein angiography were performed preoperatively and postoperatively. The patients were followed up for 12 to 48wk. In this study, change in visual acuity and macular edema were observed in both groups, and statistical analysis was performed.

RESULTS:The effective rate was 61.2% in diffuse macular edema group and 86.3% in focal macular edema group. The general effective rate of later was higher than the former, while the treatment effect had significant statistical difference(P<0.05).

CONCLUSION: Multiple wave length laser is an effective and safe way to treat diabetic macular edema of diabetic retinopathy combined with central retinal vein occlusion,which is worth widely applying in clinical practice.

Analysis of 50 cases of traumatic retinal detachment diagnosed by color Doppler ultrasound and two-dimensional ultrasound

Guo-An Liu,Rui-Zhen Ye and Min Xu — 2014/6/19 9:55:02

AIM: To evaluate the value of color Doppler ultrasound in the diagnosis of traumatic retinal detachment.

METHODS:All 50 cases(56 eyes)of suspicious traumatic retinal detachment from January to June in 2013 were enrolled in this study. All first received the two-dimensional ultrasound, then the color Doppler ultrasound, finally, these results were compared with the results of surgery.

RESULTS:All 56 eyes were observed intravitreal abnormal spots by the two-dimensional ultrasound, and 39 eyes were observed color blood signal by the color Doppler ultrasound. Forty eyes were approved retinal detachment by surgery.

CONCLUSION: It is better to display the intravitreal abnormal spots and color blood signal by the color Doppler ultrasound than by the two-dimensional ultrasound, so there is important clinical significance of the color Doppler ultrasound in the diagnosis of traumatic retinal detachment.

Micro-incision phacoemulsification with silicone oil removal for eyes with silicone oil tamponade combined cataract after vitrectomy

Rui-Fan Zhang,San-Mei Liu and Jie Zhong — 2014/6/19 9:55:02

AIM: To observe the clinical effect of micro-incision phacoemulsification combined with silicone oil removal from pars plana in eyes with silicone oil tamponade after vitrectomy.

METHODS: Forty-three patients(43 eyes)with cataract and silicone oiltamponade after vitrectomy underwent micro-coaxial phacoemulsification combined with silicone oil removal from pars plana between February 2013 and November 2013. Intraocular lens was implanted at stage I in all cases. The best corrected visual acuity was observed at 3mo after operation, and the complications were recorded.

RESULTS: The best corrected visual acuity in 39 cases(91%)was improved at 3mo after operation, and the best outcome was 0.6. There were still 4 cases(9%)without improvement of visual acuity. There was no incidence of complications such as posterior capsular rupture, residual silicone oil, corneal endothelial decompensation, hyphema, vitreous hemorrhage, intraocular lens dislocation, secondary glaucoma and ora serrata mutilation after operation in all patients.

CONCLUSION:Micro-invision phacoemulsification combined with silicone oil removal from pars plana is an effective and safe method for eyes with cataract and silicone oil tamponade after vitrectomy.

Application of the microprobe dredging operation in the treatment of the meibomian gland dysfunction(MGD)

Qing-Qiang Wang,Xin-Guo Jia,Wen-Bo Zhang,Qing Fu and Qiang Ma — 2014/6/19 9:55:02

AIM: To evaluate the function of the microprobe dredging technology in the treatment of meibomian gland dysfunction(MGD)and to provide fast, efficient, economical and practical method of treatment for meibomian gland dysfunction(MGD).

METHODS:The 100μm diameter stainless steel wire was made as the microprobe with the total length of 3cm, which the needle was about 5mm and hand shank was about 2.5cm. Selected 140 cases with dry eyes of meibomian gland dysfunction(MGD), patients were divided into two groups and made them have comparability. Observation group(n=70)used microprobe to dredge meibomian gland pipe accompanied with drugs, hot compress and meibomian gland massage treatment. The control group(n=70)was given conventional drugs, hot compress and meibomian massage treatment. To compare the tear break-up time(BUT), efficient rate and the cure rate of the two groups after treatment of 1d, 1wk, 2wk, 1 mo, 2mo and 3mo.

RESULTS: BUT were significantly prolonged in observation group and control group after treatment, and the observation group improved more obviously; the efficient rate and cure rate of the observation group were significantly higher than that of the control group after 1d, 1wk, 2wk, 1mo, 2mo and 3mo treatment.

CONCLUSION:Using microprobe to unclog the meibomian gland tube can provide the fast and efficient, economical and practical treatment for meibomian gland dysfunction(MGD), which can be promoted in the clinical practice.

Analysis of the correlation between tear film changes of allergic conjunctivitis and dry eye

Yong Li,Rui Li and Zhao-Chen Liu — 2014/6/19 9:55:02

AIM: To analyze the correlation between tear film changes of allergic conjunctivitis and dry eye, then provide clinical references for better treatment.

METHODS: Fifty patients with allergic conjunctivitis were taken as the observation group, the control group was selected based on 1:1 case control theory, and we chose 50 health volunteers without ocular surface diseases, xerophthalmia and systematic diseases randomly, then fluorescein(FL)staining, break-up time(BUT), Schirner I test(SⅠt), tear meniscus high(TMH)and slit-lamp examinations were performed in the two groups.

RESULTS: In the observation group, FL, BUT, SIt, TMH of right eyes and left eyes were statistically significant correlated(P<0.05). FL and BUT were statistically significant between control group and observation group(P<0.05). TMH and SIt has positive correlation, while FL and BUT has negative correlation and the differences were statistically significant(P<0.05).

CONCLUSION: Due to inflammatory mediators participation, allergic conjunctivitis could lead to the stability changes of tear film which cause in dry eye. The stability changes of allergic conjunctivitis correlate to the damage degree of epithelium.

Clinical observation of ocular alkali burn by Breviscapinun

Yu-Lian Cai,Yang-Chun Xie,Rong Su,Dao-Wei Qian,Lan Wu and Jian-Jun Yue — 2014/6/19 9:55:02

AIM: To find better ways of treating ocular alkali burn, and to reduce the suffering of patients and social burden.

METHODS:Totally 100 patients were graded according to the degree of chemical burns to four major groups, each half were randomly divided into the control group and the treatment group. Control group underwent conventional treatment. In addition to conventional therapy, patients in each treatment group were also added a Breviscapine intravenous injection of 40mg daily. Corneal recovery time, changes in vision, degree of corneal opacity, number of corneal neovascularization and other complications were observed. Curative effects were analyzed statistically.

RESULTS: There was no significant difference in level Ⅰ group between control group and treatment group(P>0.05); There were significantly different in level Ⅱ, Ⅲ and Ⅳ group(P<0.05). Compared to the degree of corneal opacity and the number of corneal neovascularization, the treatment group was obviously better than the control group(P<0.05).

CONCLUSION: Breviscapine in the treatment of ocular alkali burns can shorten the course of treatment, reduce corneal scarring, and improve vision.

Correlative study of distant vision and diopter among civil aviators in China

Yi-Rong Wang,Jia-Yuan Li,Ya-Na Qi and Huan Liu — 2014/6/19 9:55:02

AIM: To research the reasonability of current criteria on distant vision anddiopter for recruiting civil aviators in China.

METHODS: The data about distant vision and diopter of 1901 aviators, including flight majors and aviators in active service participating in physical examination of Civil Aviation Flight University of China from 2006 to 2013, were collected. ANOVA and LSD were used to compare the differences between distant vision and diopter among different groups. The Spearman correlation coefficients of distant vision(≥0.1 vs ≥0.3)and diopter(0.00 to -3.00D)were calculated.

RESULTS: The diopter of civil aviators in China increased with distant vision decreased. The correlation between distant vision and diopter(0.00 to -3.00D)among distant vision ≥0.3's population(0.4<r<0.5)was worse than that among distant vision ≥0.1's population(0.6<r<0.7).

CONCLUSION: The current eye standard of recruiting civil aviators in China is reasonable to consider both distant vision and diopter, but the standard for distant vision is higher. Further research is proposed to explore the proper standard of distant vision that matches the diopter standard.

Analysis on biometric measurements of Lenstar 900 in difference degrees of axial myopia

Lin-Li Yu,Gang-Ping Zhao,Shan Liao,Ling-Jiang Zhao,Yan-Hua Wang and Zhui Li — 2014/6/19 9:55:03

AIM: To measure ocular biometric values with the degree of axial myopia and determine the relationship between the differences using the Lenstar 900.

METHODS:Totally 413 myopes(826 eyes)were enrolled in this study and were divided into 3 groups: low myopia(myopia <3.00 diopters, 104 eyes), moderate myopia(myopia =3.00-6.00 diopters, 500 eyes)and high myopia(myopia >6.00 diopters, 222 eyes). Central corneal thickness(CCT), aqueous depth(AD), lens thickness(LT), axial length(AL)were measured by Lenstar 900. The parameters were tested using analysis of variance and the relations among SE, AL, LT were analyzed.

RESULTS: There were significant difference both in AL(F=206.16, P<0.01)and AD(F=4.764, P<0.05)and no significant difference both in CCT and LT between these myopia groups. With analysis of Person, the Spherical equivalent(SE)shows a significantly positive correlation with AL(r=0.662, P<0.01)and AD(r=0.095, P<0.05), no correlation with CCT and LT. AL shows a significantly positive correlation with AD(r=0.347, P<0.01)and CCT(r=0.126, P<0.01), negative correlation with LT(r=-0.265, P<0.01). LT shows a significantly negative correlation with AD(r=-0.496, P<0.01).

CONCLUSION: Along with the diopters increasing in myopia, the axial length and aqueous depth continue to increase. Spherical equivalent(SE)shows a significantly positive correlation with AD. AL shows positive correlation with SE, AD and CCT and negative correlation with LT. LT shows a significantly negative correlation with AD.

Comparative analysis of binocular summation of pattern visual evoked potential before and after the surgery of concomitant strabismus

Miao-Yun Liao,Zhong-Hua Wen and Hai Huang — 2014/6/19 9:55:03

AIM: To investigate the opportunity of the concomitant strabismus operation and the function in the treatment of strabismic amblyopia through analyzing the changes of binocular summation of pattern visual evoked potential(P-VEP)before and after the surgery of concomitant strabismus.

METHODS: In this retrospective study we investigated 67 cases admitted in our hospital. All patients were less than 18a and the postoperation squint angle was less than ±10^△. Patients were divided into three groups according to the strabismus type, age, and amblyopia degree. P-VEP binocular summation response was recorded in all cases, to observe the changes of the binocular summation response of P-VEP before strabismus surgery and 1mo, 3mo after surgery. The P-VEP response of binocular /monocular(B/M)ratio was taken as an evaluation index.

RESULTS: B/M value of three groups all improved obviously 1mo after surgery, which the difference showed statistical significant(P<0.01). 1)After 3mo surgery, B/M value in esotropia group was higher than that in exotropia group(P<0.05). 2)After 3mo surgery, B/M value in ≤6a group was higher than that in >12a group(P<0.05). 3)After 1mo surgery, B/M value in severe amblyopia group was higher than that in mild group(P<0.05). After 3mo surgery, B/M value in severe amblyopia group was higher than that in mild group significantly(P<0.01).

CONCLUSION: Concomitant strabismus surgery is suggested to be performed before 6 years old when the patients are difficult to improve the vision after amblyopia treatment, especially with the severe amblyopia and esotropia(accommodative esotropia must be excluded). The early operation is better to amblyopia treatment and binocular vision recovery.

Analysis of central corneal thickness in different degrees of diabetic retinopathy

Shan Hua and Ji-Ya Wang — 2014/5/22 9:13:02

AIM: To study central corneal thickness(CCT)and correlation in different degrees of diabetic retinopathy(DR).

METHODS: A total of 65 cases(130 eyes)with different degrees of DR and 35 normal cases(70 eyes)as the age-and gender-matched control group were examined by corneal endothelial microscope, to measure CCT and statistics

RESULTS: Compared to control group, there were no significant difference of CCT both mild and medium nonproliferative diabetic retinopathy(NPDR)groups(P>0.05). While the CCT of severe NPDR group and proliferative diabetic retinopathy(PDR)group were thicker than control group, and the differences were statistically significant(P<0.05); Pairwise comparison in different degrees of DR groups: the CCT of severe NPDR and mild NPDR groups were thicker than PDR group, and the differences were statistically significant(P<0.05); compared to medium NPDR, the CCT of PDR was thicker(P<0.05); The thickness of CCT increases with severity of DR, there was positive linear correlation(r=0.173, P<0.05).

CONCLUSION: The CCT increases with severity of DR. Taking care of protecting corneal endothelium is very important in the time of therapeutic measure, especially intraocular operation, to decrease complication.

Clinical comparison of phacoemulsification and non-phacoemulsification for cataract

Chang-Jiang Li — 2014/5/22 9:13:02

AIM: To contrast the effect of small incision phacoemulsification and non-phacoemulsification to treat cataract.

METHODS: Totally 172 patients with cataract were divided into 2 groups(n=86)randomly. Patients in Group Phaco were treated with phacoemulsification and, while those in Group Siecs were treated with small incision extracapsular cataract surgery and intraocular lens implantation. They were all followed up for 1-3y. Functional examinations were made at 3d; 1,6mo and last follow-up. The visual acuity, intraocular pressure, anterior chamber depth, average corneal power(ACP), cylinder(CYL), surface asymmetry index(SAI)and complications were contrasted between groups.

RESULTS: At 3d after operation, the visual acuity of Group Phaco was better than that of Group Siecs(P<0.05), and CYL, SAI and intraocular pressure of Group Phaco were all significantly lower than those of Group Siecs(P<0.05). At 1mo after operation, the visual acuity of Group Phaco was better than that of Group Siecs(P<0.05), and CYL, SAI and intraocular pressure of Group Phaco were slightly lower than those of Group Siecs(P<0.05); there was no difference between the two group. At 6mo after operation, the visual acuity of Group Phaco was still better than that of Group Siecs(P<0.05), and CYL, SAI and intraocular pressure of Group Phaco were flat as those of Group Siecs(P<0.05); there was no difference between groups in those indexes above(P>0.05). Furthermore, the APC and anterior chamber depth of each point-in-time had no significant difference between groups(P>0.05). The incidences of complication were similar in two groups(P>0.05); but with individual differences, patients of GradeⅡ and Ⅲ in Group Phaco got lower complication rate(P<0.05), while those of Grade Ⅳ higher(P<0.05)than those of Group Siecs.

CONCLUSION: Our research shows that phacoemulsification has high effect in the treatment of patients with GradeⅡ and Ⅲ nuclear hardness, while small incision extracapsular cataract surgery has high effect in the treatment of patients with Grade Ⅳ nuclear hardness.

Analysis on complications of phacoemulification in primary angle-closure glaucoma after trabeculectomy

Wei-Jiang Chen — 2014/5/22 9:13:02

AIM: To discuss the complications and prevention of phacoemulification in primary angle-closure glaucoma after trabeculectomy.

METHODS: Retrospective analysis of 33 cases(37 eyes)phacoemulification in primary angle-closure glaucoma after trabeculectomy in our hospital between January 2008 and June 2012, followed up 12-33mo, intraoperative and postoperative complications were observed.

RESULTS: Compared with pre-operation, intraocular pressure hadn't increased in follow-up 6mo. Iris was injured in 5 eyes, corneal edema was in 14 eyes, anterior chamber inflammation was in 16 eyes, all symptoms were improved in 3-7d. And no case with posterior capsule rupture or vitreous loss.

CONCLUSION: Phacoemulification is an effective way for the treatment of cataract after angle-closure glaucoma trabeculectomy, careful preoperative examination, intraoperative prevention can reduce or avoid the occurrence of surgical complications.

Clinical observation of phacoemulsification and IOL implantation for cataract patients with glaucoma

Jian-Hong Lin — 2014/5/22 9:13:02

AIM: To observe the efficiency of phacoemulsification with intraocular lens implantation in the treatment of cataract and glaucoma.

METHODS:Totally 60 patients(70 eyes)with cataract and glaucoma were included between March 2010 and March 2012 in our hospital. The phacoemulsification with intraocular lens implantation was performed. The observation of surgical efficiency, including the patient's IOP, anterior chamber depth, vision and complications, were compared before and after surgery.

RESULTS:Compared with preoperation, the patients' vision and anterior chamber depth were increased and the IOP was reduced significantly(P<0.05).

CONCLUSION: Phacoemulsification with IOL implantation is a safe and effective treatment for cataract and glaucoma.

Comparison of two different nucleus delivery methods in small incision cataract surgery

Li-Jun Zhang and Man-Yi Xiao — 2014/5/22 9:13:02

AIM: To compare the effect of treating cataract by sodium hyaluronate injection and lens-loop nucleus extraction of small incision cataract excision and explore more suitable method to promote the use of surgery in primary hospital.

METHODS: All 146 cataract patients(166 eyes)were allocated to two groups in random: the control group 78 patients(84 eyes)received conventional lens loop for extracapsular cataract extraction; the experiment group 68 patients(82 eyes)underwent nucleus extraction in small incision with sodium hyaluronate injection for extracapsular cataract extraction. Postoperative visual acuity and intraoperative and postoperative complications were compared between two groups.

RESULTS: Incidence of posterior capsule rupture difference was statistically significant(P<0.05)in small incision nucleus extraction with sodium hyaluronate injection compared with conventional lens loop for extracapsular cataract extraction. And there was no significant difference(P> 0.05)in postoperative visual acuity, astigmatism degree and postoperative complications compared with those of pre-operation.

CONCLUSION: Compared with the lens loop nucleus extraction, sodium hyaluronate injection for extracapsular cataract extraction can effectively protect the posterior lens capsule and can be promoted in small incision cataract surgery.

Efficacy of adjunctive intravitreous injection with Lucentis for neovascular glaucoma

Rui-Dong Gu and Ruo-Xi Li — 2014/5/22 9:13:02

AIM: To observe the clinical efficacy of adjunctive intravitreous injection with Lucentis for the treatment of neovascular glaucoma(NVG).

METHODS: The retrospective case series study included 25 eyes of 25 patients who underwentintravitreous injection with Lucentis. Patients firstly received an intravitreous injection with Lucentis(0.5mg/0.05mL), after the regression of neovascularization of the iris, patients accepted different surgical treatments according to different etiopathogenesis condition. Iris, chamber angle neovascularization condition, intraocular pressure, and visual acuity were observed postoperatively. The follow-up duration was 3mo.

RESULTS: After 3-7d of intravitreous Lucentis injecting, iris and chamber angle neovascularization was totally faded in 20 cases(20 eyes)and was not completely faded in 5 cases(5 eyes). Additional treatments were compound trabeculectomy(14 cases, 14 eyes), vitrectomy(4 cases, 4 eyes). The patients' mean intraocular pressure was 43.42±10.99mmHg before treatment, which decreased rapidly when they came out of the hospital(14.26±7.64mmHg, P<0.05)and stabilized during the follow-up 3mo(18.76±5.96mmHg, P<0.05). Follow-up at 3mo, visual acuity improved or remained in 20 cases(20 eyes)and decreased in 5 cases(5 eyes). The complete success, qualified success and failure were 21 eyes, 3 eyes and 1 eye, respectively.

CONCLUSION:Intravitreous injection with Lucentis can be used as an assisted treatment of NVG. According to different etiopathogenesis condition, it is an effective treatment to combine with other treatment methods for NVG.

Laser peripheral iridoplasty combined with iridectomy for the unmanageable acute angle-closure glaucoma by medication

Guo-Ying Liu and Fei Liu — 2014/5/22 9:13:02

AIM: To investigate the effect and safety of laser peripheral iridoplasty combined with iridectomy in the unmanageable acute angle-closure glaucoma by medication.

METHODS: Totally 19 cases(21 eyes)with acute angle-closure glaucoma, including 15 cases(17 eyes)with primary glaucoma and 4 cases(4 eyes)with intumescent cataract-induced glaucoma, were recruited into the study. The intraocular pressure(IOP)of all cases were still >21mmHg after 24h drug treatment, and then were treated by laser peripheral iridoplasty combined with iridectomy. The visual accurity, IOP, cornea, peripheral anterior chamber depth, anterior chamber angle and complications were observed at 24h after the surgery.

RESULTS: The mean IOP of all cases was reduced from 53.09±11.01mmHg before the surgery to 14.98±4.21mmHg at 24h after the treatment, with significant statistical difference(P<0.01). The visual acurity of all cases increased in different degrees from handle move to 0.3 to 0.1-1.0 at 24h after the treatment. In all cases, cornea edema reduced or cleared up, peripheral anterior chamber depth increased, and anterior chamber angle reopened in different degrees. Complications included iris hemorrhage in 11 eyes(52.4%), mild iritis in 21 eyes(100%). No cornea burn was encountered.

CONCLUSION: Laser peripheral iridoplasty combined with iridectomy is an effective and safe method for the treatment of the unmanageable acute angle-closure glaucoma by medication.

Optical coherence tomography changes on age-related macular degeneration patients after photodynamic therapy

Xiu-Mei Li,Zong-Yin Gao,Liu Zhang,Yuan-Jun Zhu and Li-Hui Kuang — 2014/5/22 9:13:02

AIM: To better reveal the changing process of macula area after photodynamic therapy(PDT), the changes of tomographic imaging on macular fovea optical coherence tomography(OCT)scan at different follow-up time points after treating age-related macular degeneration(AMD)by PDT were investigated.

METHODS: This cohort study included 30 eyes of 26 patients diagnosed as AMD. The dosage of verteporfin was calculated according to manufacturer's instruction. All participants got FFA, ICG, OCT scan and best corrected visual acuity before and followed up for 2wk, 1, 2, 3mo after PDT. The standard five lines combined with 6 lines OCT scan covered key parts of lesion and the scan locations before and after were kept the same. The bilaminar foveal thickness(BFT), outer high reflectivity band thickness(OHRBT), and the total area of intraretinal fluid(IRF)and subretinal fluid(SRF)were measured at different time points. The relationship between the changes and follow up time was analyzed. Statistical analysis of the data was performed using SPSS for windows version 13.0.

RESULTS:There months after treatment, an improvement of 2 lines or better on the Snellen chart was achieved on 22 eyes, visual acuity of 3 eyes without significant change, 3 eyes got decreased, 2 cases lost follow up. The average macular thickness of improved 22 eyes before treatment was 722.5±55.6μm, 2wk after treatment, 708.3±45.3μm, 1mo, 584.4±49.3μm, 2mo, 430.7±50.2μm and 180.6 ±36.3μm at 3mo.The OHRBT before and after treatment respectively were 302.3±50.2μm, 277.5±42.3μm, 202.7±40.1μm, 180.6±35.7μm, 100.8±22.9μm. The total area of both IRF and SRF was estimated as 0.34±0.12mm², 0.25±0.07mm², 0.10±0.05mm², 0.08±0.04mm², 0.05±0.01mm².

CONCLUSION: SRF and retinal edema of patients with AMD were absorbed 1mo after PDT, and the BFT, OHRBT were significantly tend to be thin.

Clinical effect of 23G transconjunctival sutureless vitrectomy for idiopathic macular hole

Wei Cao,Mei-Ping Zhang and Hong-Ping Cui — 2014/5/22 9:13:02

AIM: To observe the clinical effects of 23-gauge(23G)transconjunctival sutureless vitrectomy for idiopathic macular hole.

METHODS: In this retrospective study, 28 eyes of 28 consecutive patients who underwent 23-gauge transconjunctival sutureless vitrectomy for idiopathic macular hole between January 2013 and October 2013 in our hospital were evaluated. The follow-up time was 3-12mo. The operation effects were analyzed.

RESULTS: The macular hole was closed in 27 eyes of 28 eyes which underwent 23G transconjunctival sutureless vitrectomy and not closed in 1 eye after surgery. Best-corrected visual acuity at postoperative 1, 3mo was significantly improved compared to pre-operation(χ²=8.65, P=0.003; χ²=10.33, P=0.001). The macular hole was closed as shown by OCT. Intraoperative incision was sutured in 5 cases(18%). There was no statistically significant difference in intraocular pressure between pre-operation and post-operation. No post-operative complications such as endophthalmitis, retinal detachment, vitreous hemorrhage came up.

CONCLUSION: 23G transconjunctival sutureless vitrectomy is observed to be safe and effective technique in the treatment of macular hole. It is therefore our preferred system for straightforward macular surgery.

Dynamic observation on children's anisometropic amblyopic macular at area A1 by OCT

Li Jia and Jian-Ying Wang — 2014/5/22 9:13:02

AIM:To analyze relevancy between the changes of the retinal thicknesses of children's anisometropic amblyopic macular at Area A1 before and at the end of amplyopia cure and amplyopia cure effect.

METHODS: Through randomly selecting 30 cases(60 eyes)of anisometropic amblyopic children as test group and 29 cases(58 eyes)of children with normal vision after the vision correction as control group, the changes of the retinal thicknesses of macular of the test group and the control group at Area A1 by OCT-3 was observed dynamically and analyzed.

RESULTS:Compared with first diagnosis, the comparative difference of retinal thicknesses of macular at Area A1 in control group at 3, 6mo has statistical significance. The test group was divided into amblyopia group and non-amblyopia group. There has statistical significance for the comparative difference between the retinal thicknesses of macular centre at 3, 6mo and the first diagnosis in the non-amblyopia group, the amblyopia group was divided into the invalid cure group, progress group and the cured group according to amblyopic cure effect. Compared with first diagnosis, there is no statistical significance of macular at Area A1 in invalid cure group and progress group at 3, 6mo, and in the cured group at 3mo, but in the cured group at 6mo has statistical significance.

CONCLUSION: There is a certain relationship between the changes of retinal thicknesses of macular of children with anisometropic amblyopic at Area A1 before and at the end of amblyopia treatment and amblyopia cure effect. OCT is a kind of objective auxiliary test method and provides new clues for amblyopia research.

Clinical observation on epidemic hemorrhagic conjunctivitis by optical coherence tomography

2014/5/22 9:13:03

AIM: To observe thickness and morphological changes of bulbar conjunctiva pre- and post epidemic hemorrhagic conjunctivitis(EHC)therapy by optical coherence tomography(OCT).

METHODS: Observed morphological changes and measured the bulbar conjunctiva thicknesses of 29 cases(36 eyes)of incipient(1-2d)EHC patients, who were received and treated by department of ophthalmology, the Putuo Affiliated Hospital of Shanghai University of Traditional Chinese Medicine from May 2013 to December 2013, by OCT. Then measured the thickness again on 7, 14d after the therapy.

RESULTS: Among 29 patients(36 eyes), 7d after the EHC therapy, in 27 cured eyes, the full-thickness(before 344.00±59.91μm, after 230.19±22.16μm, t=11.75, P<0.01); epithelial thickness(before 56.52±6.19μm, after 51.37±5.53μm, t=4.61, P<0.01); and stromal thickness(before 287.11±60.56μm, after 178.81±20.20μm, t=10.69, P<0.01)of patients' bulbar conjunctiva were thicker than values measured after therapy with significant difference. Significant difference was also found for full-thickness(before 361.39±65.56μm, after 233.44±22.57μm, the difference was statistically significant, t=14.45, P<0.01); epithelial thickness(before 55.50±6.72μm, after 46.67±5.24μm, t=10.06, P<0.01)and stromal thickness(before 305.61±66.02μm, after 186.78±21.82μm, t=13.11, P<0.01)of patients' bulbar conjunctiva between values measured before and 14d after therapy.

CONCLUSION: The OCT is able to measure the thickness of bulbar conjunctiva in EHC patients. An significant increase was found in full, epithelial and stromal thickness of EHC patients' bulbar conjunctiva. With recovery from the disease, subepithelial fluid, interlaminar fluid and edema of the bulbar conjunctival stroma faded away firstly, which provide references for clinical therapies of the EHC.

Diagnosis and treatment characteristics of radioactive optic neuropathy

Yan Zhang,Hong-Yang Li,Chun-Xia Peng,Nan-Nan Guo and Shi-Hui Wei — 2014/5/22 9:13:03

AIM: To explore the diagnosis and treatment methods of radioaction-induced optic neuritis(RION)through the clinical dates of 17 patients.

METHODS: It was a retrospective case series study. From August 2008 to October 2013, 17 cases(24 eyes)of Rion clinical dates from Chinese PLA General Hospital were studied. The diagnosis methods including visual acuity, pupil, fundus, visual field, fundus fluorescein angiography(FFA), visual electrophysiological testing, and head MRI. To analysis the clinical date of patients with diagnosis of RION by statistical description.

RESULTS: The deterioration degree of vision: 13 eyes were classified as Ⅳ, 9 eyes as Ⅲ, 2 eyes as Ⅱ. Ten eyes RAPD(+), visual electrophysiology is extinguished. The retina of 5 eyes showed flame hemorrhages and cotton wool spots exudation. Optic nerve head edema in one eye. T1-weighted MRI enhanced in 19 eyes which showed optic nerve of the intracranial and intratubal segments abnormal changed, optic chiasm and pituitary stalk signal abnormalities and enhancement of the optic nerve. Tortuous optic nerves and rough edges were observed in 5 eyes. Treatment effect: 4 eyes of visual acuity improved, 1 eye from blindness to light perception,1 eye from 0.08 to 0.2, 1 eye from 0.4 to 0.6,1 eye from 0.04 to 0.15, the rest of the cases did not see any improvement.

CONCLUSION: The unique clinical manifestation of RION can provide objective basis for clinical diagnosis in time, but there have not been proven any effective treatments.

Application on the thickness of nerve fiber layer of the optic disc in pathologic myopia eyes by OCT

Zhi-Cheng Shi,Xiao-Liu Luo and Yu-Ai Liu — 2014/5/22 9:13:03

AIM: To analyze the application on frequency domain optical coherence tomography(OCT)technology of pathologic myopia optic disc neurosensory retinal thickness changes and its relationship with axis oculi, sex and age, and help for the early diagnosis of pathological myopia and primary open angle glaucoma.

METHODS: Collected 96 eyes of normal eyes(axis oculi 23-24mm)and 153 eyes of pathologic myopia eyes(axis oculi 25-27mm 80 eyes, >27mm 73 eyes). We measured the thickness of nerve fiber layer of the optic disc by OCT and analyzed their relationship with axis oculi, sex and age with multiple linear regression analysis.

RESULTS: The observation group showed significant smaller average thickness of peripapillary, superior, inferior, nasal than the control group(P<0.05); the difference in the temporal quadrant between the groups were no statistically significant differences(P>0.05); The partial correlation coefficient of peripapillary average thickness of nerve fiber layer and axis oculi was -1.31, gender was 5.21, age was -0.12.

CONCLUSION: The thickness of nerve fiber layer of the optic disc in the pathologic myopia eyes are decreased than normal eyes, axis oculi, sex and age are influenced factors. The pathologic myopia patients should use different index combined with optic nerve fiber layer thickness decreased to help for the diagnosis of early primary open angle glaucoma.

Clinical and pathological analysis of 504 cases of elderly ocular tumors

Hai-Yan Li,Zhi-Gang Yuan,Peng-Xia Yang and Qian Yang — 2014/5/22 9:13:03

AIM:To analyze the composition, distribution and characteristics of the elderly primary ocular tumors.

METHODS: This was a retrospective study and all 504 cases with primary ocular tumors aged 60 years or older were collected in Shanxi Eye Hospital, during the year 2000-2012. The onset age, location and pathological pattern were analyzed.

RESULTS: There were 346 cases of benign ocular tumors(68.7%), and 158 cases of malignancy(31.3%).Papillomas was the most common type of the benign with 83 cases(16.5%), followed by a variety of inflammatory cysts and lesions with 69 cases(13.7%)and 64 cases(12.7%)respectively. Among malignant tumors cases, eyelid basal cell carcinoma originated from epithelial was the most common with 72 cases(14.3%), followed by skin appendages sources malignant tumors with 39 cases(7.7%). Concerning the location of ocular tumors, there were 282 cases of eyelid tumor(56.0%)occupied the first position followed by conjunctival tumor with 157 cases(31.2%).

CONCLUSION: The prevalence and type of primary ocular tumor in elderly people are significant differences from the general population and children's, and the proportion of malignant tumors tended to increase along with the increase of age.

Clinical study of adverse effects induced by Travoprost eyedrops on ocular surface

Ye-Shuang Tan,Xia Zhou,Ling Fan,Na-Na Wang and Juan He — 2014/5/22 9:13:03

AIM: To evaluate the effects induced by topical antiglaucomatous drugs, Travoprost eyedrops on tear film.

METHODS: Eighteen patients(32 eyes)with primary open-angle glaucoma or ocular hypertension were all treated with Travoprost eyedrops once every night. The symptom score, Schirmer's test(SⅠt), corneal fluorescein staining(FL), tear film break-up time(BUT), were observed before the treatment and 1, 2 and 3mo after the treatment.

RESULTS: The average symptom score, FL of all patients were 1.34±1.56 and 0.44±0.73 before the treatment, and 2.75±1.63, 1.08±0.84; 5.10±1.68, 1.53±0.67; 6.33±1.40, 1.98±0.50 respectively after 1, 2 and 3mo of the treatment. There was significant increase in symptom score and FL after the treatment for 1, 2 and 3mo(P=0.00). The average BUT, SⅠt of all patients were(7.76±0.92s),(8.47±2.73mm/5min)before the treatment, and(7.08±1.15s),(7.73±3.44mm/5min);(5.59±1.33s),(6.82±3.05mm/5min);(4.29±1.87s),(6.04±3.15mm/5min)respectively after 1, 2 and 3mo of the treatment. There was significant decrease in BUT and ST after the treatment for 1, 2 and 3mo(P=0.00).

CONCLUSION: Travoprost eyedrops can obviously aggravate patients' corneal irritation after treatment. Our results show abnormal decreased tear secretion and stability of tear film induced by Travoprost eyedrops over the short term.

Clinical study on high concentrations of sodium hyaluronate eye drops for moderate to severe dry eye

Yu-Jing Tian and Qin Zhang — 2014/5/22 9:13:03

AIM: To observe the efficacy of high concentrations of sodium hyaluronate(3g/L SH)for moderate to severe dry eye.

METHODS: Forty moderate to severe dry eye patients were included in the study according to the diagnosis criteria and randomized into two groups. The patients of the trial group received topical administration of high concentration sodium hyaluronate(3g/L), and those of the control group received sodium hyaluronate(1g/L)plus recombinant human epidermal growth factor. The dry eye symptom scores, ocular surface disease index(OSDI)scores, tear film break-up time(BUT), Schirmer Ⅰ test and corneal fluorescein staining score were evaluated.All the indexes were compared between the two groups 2wk before and after treatment.

RESULTS: There were no significant differences of the indicators between the two groups before treatment. After 2wk treatment, the differences were statistically significant compared to former except for the Schirmer Ⅰ test. Compared with the control group, the symptom scores and the OSDI scores were lowered. No significant differences were found in the other indicators between these two groups.

CONCLUSION: Topical usage of highconcentrations of sodium hyaluronate(3g/L)is beneficial for remitting the ocular symptoms in moderate to severe dry eyes, and also improve the quality of life of patients.

Single application on iris localization technology in excimer laser for astigmatism

Jun-Hua Hao,Yan-Jun Ren,Xia Liu,Jie Guo,Ji Li and Ya-Juan Zhang — 2014/5/22 9:13:03

AIM:To discuss the single application on iris localization technology in excimer laser for the treatment of astigmatism.

METHODS:Totally 203 cases(406 eyes)of laser in situ keratomileusis(LASIK)in the treatment of compound myopic astigmatism patients were operated from November 2011 to November 2012 in our hospital. They were divided into two groups. One was observation group using iris localization and the other was control group using routine operation. Patients in the observation group of 100 cases(200 eyes), aged 18-43 years old, spherical diopter was -1.25 to -8.75D, astigmatism was -1.0 to -3.25D. In control group, 103 patients(206 eyes), aged 19-44 years old, spherical diopter was -1.75-9.50D, astigmatism was -1.0 to -3.25D. The patients in the observation group before the application of WaveScan aberrometer check for iris image, spherical lens, cylindrical lens and astigmatism axis data operation, only single application of iris location, without using wavefront aberration guided technology, laser cutting patterns for conventional LASIK model, spherical, cylindrical mirror and astigmatism axis data source to preoperative wavefront aberration results. The control group received routine LASIK. It was applicated comprehensive optometry optometry respectively to examine astigmatism and axial, based on the computer analysis during the preoperative, 1wk after the operation, and 6mo. Analysis of using SPSS 17 statistical software, it was independent-sample t test between the two groups of residual astigmatism and astigmatism axis.

RESULTS:Postoperative residual astigmatism, the observation group was significantly better than the control group. Astigmatism axial measurement after operation, the observation group was significantly less than that of the control group. Postoperative visual acuity at 6mo, the observation group was better than that of the control group. The difference was statistically significant.

CONCLUSION: For patients who cannot complete the wavefront aberration guided treatment of astigmatism, can separate the application of wavefront aberration analyzer automatic iris recognition technology to improve precision of astigmatism treatment, give full play to advanced technical performance of equipment, which has good application value.

Analysis on tear film after LASIK by femtosecond laser with Oculus corneal topography

Yuan Zhang,Bing-Bing Jia,Yan Zhang,Dong-Mei Gao and Yu-Zhen Pang — 2014/5/22 9:13:03

AIM:To observe the changes of tear film on the patients after laser in situ keratomileusis(LASIK)with corneal flap created by femtosecond laser with Oculus corneal topography.

METHODS:Totally 120 myopic patients(240 eyes)were collected who underwent femtosecond laser surgery LASIK from August to September 2013, and these patients can be followed up for 3mo. Tear break-up time(BUT)and tear meniscus height(TMH)with Oculus corneal topography were recorded preoperatively and postoperatively at 1wk; 1, 2 and 3mo.

RESULTS: Oculus BUT: there existed obvious differences(P=0.012, 0.000, 0.023<0.05)in 1wk, 1 and 2mo compared with the preoperative level. While no such obvious difference(P=0.236>0.05)existed in 3mo compared with the preoperative level. TMH: there existed obvious differences(P=0.025, 0.019, 0.026<0.05)in 1wk, 1 and 2mo compared with the preoperative level. No such obvious difference(P=0.375>0.05 )existed in 3mo compared with the preoperative level.

CONCLUSION: Femtosecond laser surgery affects the stability of the tear film at a certain time and a certain extent. The mechanism related to many factors. It is temporary and lighted.

Safety and efficacy of undersurface ablation of the flap for regression after LASIK

Ke-Li Long and Su-Yan Li — 2014/5/22 9:13:03

AIM: To investigate the safety and efficacy of undersurface ablation of the flap(UAF)for laser in situ keratomileusis(LASIK)retreatment in eyes with regression.

METHODS: Twelve patients(22 eyes)with regression after LASIK were performed undersurface ablation of the flap. The mean of preoperative refractive error was -2.27±0.88D, the astigmatism was -0.44±0.30D, the central corneal thickness was 424.9±8.2μm. The follow-up time was 1a, including visual acuity, refractive error, the elevation of posterior cornea, WavScan. The data was analyzed with Student's t test and χ² test.

RESULTS:During the operation, the measured stromal thickness was 275.4±9.3μm, the flap thickness 144.7±7.5μm, the depth of ablation 28.1±9.3μm. The mean postoperative uncorrected visual acuity(UCVA)was 4.99±0.04, best corrected visual acuity(BCVA)5.03±0.04, at 1a follow up. There was no patient with postoperative BCVA decreasing, compared to preoperation. Mean spherical refraction decreased to -0.22±0.19 D at 1a follow up(t=10.232, P<0.001)and the astigmatism decreased to -0.24±0.26 D(t=2.365, P=0.028). The elevation of posterior cornea changed from 1.95±1.68μm preoperatively to 2.00±1.88μm after 1a, but there was no statistical significance(t=0.090, P=0.929). The coma changed from 0.283±0.112μm preoperatively to 0.331±0.149μm after 1a(no statistical significance, t=1.452, P=0.161)and the spherical aberration changed from 0.320±0.119μm to 0.341±0.103μm(no statistical significance, t=0.390, P=0.674).

CONCLUSION:UAF, as one of a choice, is an effective and safe procedure for the treatment of regression after LASIK, based on the reasonable surgery design.

Effects of Pentacam on the posterior corneal surface height changes after LASEK and LASIK operation

Qing-Song Zhang — 2014/4/21 11:07:18

AIM: To explore the application of Pentacam excimer laser epithelial keratomileusis(LASEK)and excimer laser in situ keratomileusis(LASIK)after the changes of posterior corneal surface height.

METHODS: Retrospective analysis of clinical data of 100 patients with myopia by using LASEK and LASIK for the treatment of the 50 patients(100 eyes)in our hospital from January 2013 to June 2013, surface height changes after preoperative and postoperative 3 months were compared by measuring Pentacam corneal analysis system.

RESULTS: Three months after operation, the LASEK posterior corneal surface height was 7.4±5.0mm, significantly higher than 5.6±3.4mm before operation, LASIK posterior corneal surface height was 7.5±5.1mm, significantly higher than 5.5±3.5mm before operation, the differences were statistically significant(P<0.05); 6 months after surgery, two methods of corneal surface height obtained was 1.74±3.67mm and 1.80±3.61mm, there was no significant difference(P>0.05).

CONCLUSION: LASEK and LASIK on corneal posterior surface forward, LASIK is slightly obvious in early period.

Curative effect analysis of two kinds of small incision surgery treating senile cataract patients

Hai-Ying Chen and Zhi-Li Chen — 2014/4/21 11:07:18

AIM: To research the curative effect analysis of two kinds of small incision surgery treating senile cataract patients.

METHODS: Totally 71 senile cataract patients(123 eyes), aged from 76 years to 96 years, were selected as the research objects. All 55 eyes were all treated with small incision non-phacoemulsification(group A), and 68 eyes were treated with phacoemulsification(group B), and then both received intraocular lens implantation.

RESULTS: The postoperative visual acuity of the patients between the two groups was no significant difference(P>0.05). There were 42 eyes in group A and 54 eyes in group B which suffered from corneal edema. There was no significant difference in the number of corneal edema of grade Ⅰ, grade Ⅱ and grade Ⅲ between the two groups(Chi-square =0.81, P>0.81). The ratio of corneal edema of grade Ⅲ in group A was less than that in group B. The corneal edema after surgery in patients of group A was with faster fading time than that in group B, and the eyes of corneal edema in group A fading at 1d postoperatively were more than that in group B(Chi-square=6.45, P<0.05). Endothelial cell counts in group A and group B were(2 341+238)/mm² and(2 181+282)/mm², respectively, and there was no significant difference between the two groups(P>0.05). Group A was with a low complication rate.

CONCLUSION: Small incision non-phacoemulsification treating senile cataract patients can get a good result for postoperative visual acuity recovery and correction, and it is safe and effective. It receives the similar curative effect with phacoemulsification, but takes less expense. It is worthy of clinical and wide application.

Observation on the efficacy of Mitomycin C for patients with refractory glaucoma and its influence on the serum vitamin and interleukin

Yi-Shan Hu — 2014/4/21 11:07:18

AIM: To investigate the efficacy of Mitomycin C(MMC)for patients with refractory glaucoma and its influence on the serum vitamin and interleukin.

METHODS: Patients with refractory glaucoma from January 2010 to January 2013 were randomly divided into control group(compound trabeculectomy treatment group)with 80 cases and observation group(MMC combined with compound trabeculectomy treatment group)with 80 cases, then the difference in efficacy between the two groups were counted, and the intraocular pressure, visual acuity and the levels of FA, VB12, VB6, IL-2 and IL-6 of two groups before and after the treatment were also been compared.

RESULTS: The surgical success rate of observation group was 80.9% which was significantly higher than that of control group(60.7%); after the surgery, the intraocular pressure of observation group were all lower than that of control group, and the visual acuity was better than that of control group, all P<0.05. The levels of FA, VB12, IL-2 and IL-6 of failed surgery group were significantly lower than that of control group and successful surgery group(P<0.05). The levels of FA, VB12, IL-2 and IL-6 of observation group at 3mo after the treatment were all higher than those indexes of control group,all P<0.05.

CONCLUSION: Combined with MMC could effectively improve surgical success rate of refractory glaucoma, and improve the indicators of serum vitamin, interleukin.

Postoperative influences of the torsional phacoemulsification on foveal thickness and corneal edema

Lei Li,Zhen-You Zheng,Li-Ping Chen and Ke Li — 2014/4/21 11:07:18

AIM: To report the influences onfoveal thickness and corneal edema after torsional phacoemulsification.

METHODS: Totally 52 patients(52 eyes)with age-related cataract were randomly assigned to phacoemulsification using torsional mode(26 eyes)or conventional ultrasound mode(26 eyes). The foveal thickness examined by optical coherence tomography(OCT)after surgery at 1, 4 and 12wk and corneal edema was examined by slit lamp after surgery at 1d.

RESULTS: The postoperative averagefoveal thickness datas of the two groups, comparing with corresponding preoperative datas, were significantly augmented at 1, 4 and 12wk(P<0.05); the difference of foveal thickness was obviously augmented at 1wk postoperatively(P<0.05), was no obvious differences at 4 and 12wk(P>0.05). The effects of corneal edema in torsional group were slighter(P<0.05).

CONCLUSION: The postoperative influences onfoveal thickness and corneal edema with torsional mode are slighter than that with ultrasound mode, and the postoperative reactions with torsional mode are efficiently reduced.

Analysis of related factors of macular retinal thickness in high myopia

Lu-Ping Lü and Bing Li — 2014/4/21 11:07:18

AIM: To investigate the relationship between the macular retinal thickness and diopter, dominant eye, axial length.

METHODS: Totally 128 patients with high myopia group 180 eyes were selected, including the dominant eye in 79 eyes, the non dominant eye in 101 eyes. OCT was applied to measure macular and peripheral retinal thickness and A-mode ultrasonic diagnostic equipment to axial length. Another 112 patients with emmetropia group in 180 eyes, including the dominant eye in 106 eyes and the non dominant eye in 74 eyes served as control. Obtained data were statistically analyzed.

RESULTS: The average length of ocular axis in patients with high myopia(29.57±1.57)mm were significantly prolonged, compared with the mean axial length in normal group(24.13±0.90)mm(P<0.05). The length of ocular axis and the retinal thickness of foveal inner ring area(from the foveal region of 1-3mm)above(S₁), below(I₁), temporal(T₁)and foveal outer ring area(from the foveal region of 3-6mm)above(S₂), below(I₂), nasal(N₂), temporal(T₂)existed correlation, while there was no correlation with macular central and nasal foveal inner ring area(N₁)retinal thickness. The retinal thickness of macular central area and each partition in high myopia group were obviously thinner than emmetropia group(P<0.05). There was no statistical significance(P>0.05)between dominant and non dominant eye macular retinal thickness in high myopia.

CONCLUSION: The detected values of high myopia macular retinal thickness by OCT are lower than emmetropia group. There is a negative correlation between the ocular axial length and macular retinal thickness above(S₁), below(I₁), temporal(T₁), above(S₂), below(I₂), nasal(N₂), temporal(T₂)with high myopia. Ocular dominance and non dominant eye macular retinal thickness with high myopia have no obviously difference.

Treatment of proliferative diabetic retinopathy by vitrectomy combined with retinal photocoagulation

Jun Jia,Yuan He,Hui-Feng Liu and Peng-Fei Wan — 2014/4/21 11:07:18

AIM: To evaluate clinical effect of vitrectomy combined with retinal photocoagulation for proliferative diabetic retinopathy(PDR).

METHODS:A retrospective analysis 72 patients(104 eyes)with PDR who underwent vitrectomy, postoperative fundus fluorescein angiography and retinal photocoagulation within 4wk, from July 2009 to November 2012 in our hospital. All the patients were followed up for more than 12mo, analysising the clinical data of preoperative, postoperative, final corrected vision and the operation complications.

RESULTS:The increasing rate of visual acuity after retinal photocoagulation(the last retinal photocoagulation)within 1wk was 88.5%(92/104), 1mo was 92.3%(96/104), 3mo was 90.4%(94/104)and one eye had neovascular glaucoma, 6mo was 88.5%(92/104)and one eye had retinal detachment, 12mo was 80.8%(84/104)and 2 eyes with silicone oil emulsification. Along with the development of diabetic retinopathy, the increasing rate of visual acuity declined, complications of silicone oil eye operation increased, especially in eyes with proliferative diabetic retinopathy in phase five or six.

CONCLUSION:Vitrectomy combined with retinal photocoagulation in treatment of PDR is effective and safe. Postoperative fundus fluorescein angiography can have a definite object in view of retinal photocoagulation after vitrectomy, which can reduce excessive photocoagulation and prevent light coagulation deficiencies, while improve the visual acuity effectively and reduce the complications.

Study on retinal nerve fibre layer thickness in myopia measured by Cirrus HD OCT

Ze-Bin Li,Zi-Lin Chen and Li-Li Chen — 2014/4/21 11:07:18

AIM:To investigate the characteristics of the retinal nerve fibre layer(RNFL)thickness in myopia measured by Cirrus HD optical coherence tomography(OCT), and the relationship between RNFL thickness and refractive diopter/axial length.

METHODS: Totally 106 cases(196 eyes)were divided into low, moderate and high myopia group and 38 cases(60 eyes)as normal group were included in the study. Cirrus HD OCT was used to measure the RNFL thickness. Each eye was performed circular scans around the optic nerve with a circle size of 3.46mm. The average RNFL thickness, the mean RNFL thickness in each quadrant and clock hour in each group were recorded. The difference between each myopia group and normal group and the relationship between RNFL thickness and refractive diopter was researched.

RESULTS: Compared to normal group, the average RNFL thickness, the mean RNFL thickness of superior and inferior were thinner in myopia groups, the difference between moderate, high myopia group and normal group were significant(P<0.05), the nasal quadrant RNFL thickness was also thinner, but the difference was not significant(P>0.05), the temporal quadrant RNFL thickness was thicker and the difference was significant(P<0.05); Compared to normal group, at 2:00, 6:00, 12:00 position, the RNFL thickness decreased significantly in each myopia group(P<0.05); at 8:00, 9:00, 10:00 position, the RNFL thickness increased significantly(P<0.05); at 1:00, 5:00 position in moderate, high myopia group, the RNFL thickness decreased significantly(P<0.05).

CONCLUSION: The average RNFL thickness and the RNFL thickness at superior quadrant, inferior quadrant, 2:00, 6:00, 12:00 position in myopia groups are thinner than normal group; the RNFL thickness at temporal quadrant, 8:00, 9:00 and 10:00 position are thicker. The result shows the characteristics of the RNFL thickness in myopia, which is of instructive significance to guide the diagnosis of disease. Effect of refractive diopter on RNFL should be concerned for a clinical diagnosis; The RNFL thickness at 7:00, 8:00, 10:00 and 11:00 position in myopia group are not thinner than normal group. If they become thinner, glaucoma should be considered.

Clinical observation of laser treatment for central serous chorioretinopathy choroidal diseases and study on relationship between visual acuity with leakage location

Jin Zhang,Guo-Min Xue,Qiao-Yun Zhang and Ye Cao — 2014/4/21 11:07:18

AIM:To analyze the low energy laser photocoagulation under treatment of central serous chorioretinopathy(CSC)correlation of clinical effect and visual acuity with leakage location.

METHODS:Using low energy laser on the leakage point in the parafoveal and 53 cases of central serous chorioretinopathy patients underwent laser closed, drug treatment group and 33 cases as control. Comparison of two groups was observed before and after treatment in patients with symptoms, ocular fundus, fundus fluorescein angiography(FFA)changes, fundus optical coherence tomography technology(OCT)examination, visual acuity improved in degree, and the relationship between the cure rate, relapse rate. All 126 cases were associated with visual leakage location analysis.

RESULTS:The cure rate of lasercomparison: 4 weeks after operation, the cure rate was 92.5%. The drug therapy group at 4 weeks after treatment cure rate was 30.3%.The two groups were compared(P<0.01), and there was significant difference. The laser group and treatment group after treatment in 2 weeks, 4 weeks, in March June, and there was significant difference(P<0.01). The medicine group the recurrence rate was 12.1%, the lasertreatment group and recurrence rate was 11.3%. The two groups were compared, no significant difference(P>0.05). Nonparametriccorrelation analysis method to compare the relationship between visual acuity and fluorescence leakage point location, the correlation coefficient(r=0.216, P=0.0001), there is a positive linear correlation between.

CONCLUSION:The leakage point in the parafoveal outside in early stagelaser in the treatment of low energy laser, can shorten the course of disease, improve the cure rate of visual acuity and clinical, and improve the visual quality, but can not reduce the recurrence rate. There is a positive correlation between visual acuity and leakage location, clinicalguidance for prognosis and treatment.

Image features of punctate inner choroiditis on optical coherence tomography

Hao Zhang,Dan-Dan Kong,Yong Pei and Wei-Yan Liu — 2014/4/21 11:07:19

AIM: To observe the image features of punctate inner choroiditis(PIC)at different stages by optical coherence tomography(OCT).

METHODS: A retrospective analysis was performed on 24 PIC patients(33 eyes)with the median age of 29 years old(range: 16-47), where 19 cases were female(79.2%). Among the 24 cases, 9 cases were bilateral onset(37.5%)and 19 cases were with myopia(79.2%). All of the patients were given fundus fluorescein angiography(FFA)and optical coherence tomography(OCT). Through OCT, patients with PIC at different stages were observed for morphology of outer plexiform layer(OPL)and outer nuclear layer(ONL), integrity of inside and outside connections of visual cells(IS/OS), integrity and morphology of reflective tape on retinal pigment epithelium(RPE), and light reflection intensity of choroid and sclera.

RESULTS: The results showed that during active stage and atrophic stage of PIC, there were excavation of ONL and OPL towards thechoroid, weakened or partially disappeared reflective tape of IS/OS, interrupted or fuzzy reflective tape of RPE, hillock-like protrusion of RPE towards the ONL or ONL with medium to high reflection, and strengthened reflection of choroid and sclera under the lesion partly. The rates of the above performances in active stage were 9.1%, 100%, 100%, 86.4% and 77.3%, respectively, and in recovery stage, the corresponding rates were 81.8%, 90.1%, 81.8%, 45.5%, and 90.1%. Medium to high reflection of the protrusion under ONL was more commonly seen in active stage, with P<0.05; while depression towards OPL and ONL was more commonly seen in atrophic stage, with P<0.05.

CONCLUSION: There are both common points and differences of OCT features in PIC at active stage and atrophic stage, suggesting the injury and repair pathological process of outer neural epithelium, retinal pigment epithelium and innerchoroid inflammatory.

Application of fibrin glue with bandage contact lens in pterygium surgery

Wei Liu,Ying-Ping Zhang,Mei-Fen Xie and Yan Liu — 2014/4/21 11:07:19

AIM: To explore the efficacy of fibrin glue with bandage contact lens for pain relief after pterygium surgery performed with limbal autograft transplantation.

METHODS: A prospective clinical trial was carried out in 52 patients(72 eyes)operated for primary nasal pterygium. All patients were randomly divided into the fibrin glue with bandage contact lens group(experimental group, 28 cases, 38 eyes)and suture group(control group, 24 cases, 34 eyes). Autologous limbal graft taken from the superotemporal limbus was used to cover the sclera after pterygium excision under local anesthesia with 20g/L lidocaine. In experimental group, the transplant was attached to the sclera with fibrin tissue adhesive and in control group with 10-0 Virgin silk sutures. Experimental group weared bandage contact lens after surgery while the control group did not. The degree of pain after surgery was evaluated at 1, 2, 3, 5 and 7d after surgery. Follow-up was 6mo, matching degree of graft and complication such as infection, relapse, implant healing badness and subconjunctival cyst were mainly observed and recorded.

RESULTS: The pain index scores of the experimental group were significantly less than those of control group(all P=0.000). In observation period, all conjunctival autografts in both groups were successfully attached and were intact without falling off, dissolution or recurrence and there were no complications such as infection, relapse, implant healing badness and subconjunctival cyst.

CONCLUSION: Fibrin glue with bandage contact lens could significantly release pain response afterpterygium excision surgery.

Comparison of tear function following laser in situ keratomileusis with two femtosecond laser platforms

2014/4/21 11:07:19

AIM: To evaluate changes in tear function and corneal staining in patients who underwent laser in situ keratomileusis(LASIK)using two different femtosecond lasers.

METHODS:Forty eyes underwent FS200 and 40 eyes underwent VisuMax. The tear film break-up time(TBUT), Schirmer I test(SⅠt)and fluorescein staining were assessed preoperatively at 1wk; 1 and 3mo postoperatively. The analysis of variance(ANOVA)for repeat measurements or Kruskal—Wallis ranks test were used. For the differences between FS200 and VisuMax-operated eyes, a independent-samples t test or Wilcoxon matched-samples rank sum test were used.

RESULTS: There were no statistical differences in any clinical outcome measure between the two kinds of lasers(P<0.05), although there was a trend towards slightly reductions for TBUT in FS200-operated eyes. TBUT of the two groups eyes showed the same reductions(F=100.37, P<0.01; F=112.25, P<0.01)when compared preoperative levels to 1wk; 1 and 3mo postoperatively levels. Moreover, there were obvious decreases of the Schirmer Ⅰ test were observed on any visit after the operation for both groups(F=42.15, P<0.01; F=37.27, P<0.01). Furthermore, corneal staining was significantly increased at 1wk postoperatively(FS200 Z=4.88, P<0.01; VisuMax Z=4.28, P<0.01)after LASIK compared to preoperative conditions, and recovered to the level of preoperative at 1mo postoperatively.

CONCLUSION: This study shows that changes in TBUT,Schirmer I test and corneal staining are statistically similar in LASIK using FS200 and VisuMax femtosecond lasers for flap creation. However, the VisuMax-operated eyes of TBUT after LASIK have faster recovery than in FS200 eyes.

Clinical observation of deproteinated extract of calf blood ophthalmic gel for dry eye

Ming Tan and Jin-Lan Wan — 2014/4/21 11:07:19

AIM: To observe the efficacy of deproteinated extract of calf blood ophthalmic gel with artificial tears local eye drops in treatment of dry eye.

METHODS: A randomized, parallel-control approach was adopted, 150 patients(300 eyes)with dry eye were divided into treatment group and control group equally(75 cases, 150 eyes). The treatment group was applied Dextran and Hypromellose eye drops combined with deproteinated extract of calf blood ophthalmic gel, simply Dextran and Hypromellose eye drops for control group. Clinical symptoms, SchirmerⅠ test(SⅠt), break-up time(BUT), corneal fluorescein staining and tear protein were observed. Therapeutic observation was 3mo.

RESULTS: BUT, SⅠt, and corneal fluorescein staining have statistical significance before and after treatment(P<0.05 or P<0.01), the changes in treatment group were obviously superior to that in control group(P<0.05). The total clinical effect satisfaction rates were 96% for treatment group and 75% for control group, curative effect in treatment group was obviously superior to control group(P<0.05). Tear protein was significantly improved in treatment group(P<0.05).

CONCLUSION: The deproteinated extract of calf blood ophthalmic gel with artificial tears local eye drops perform better than artificial tears eye drops only in treatment of dry eye.

Clinical therapeutic effect of Fuming tablet for optic nerve function recovery after retinal detachment surgery

Yong Li,Rui Li and Hui-Min Yuan — 2014/4/21 11:07:19

AIM: To evaluate the Fuming tablet's clinical therapeutic effect on the recovery of optic nerve function after the retinal detachment surgery.

METHODS: Group control study was performed in 60 cases of retinal detachment surgery in our hospital from Jan 2010 to Jan 2013. According to different treatments, these patients were divided into different group. Thirty patients underwent Fuming tablet treatment(observation group),whereas others received mecobalamin injection treatment(control group). All of these patients were followed-up for 6wk. During these processes, we were recording and analyzing their visual acuity, intraocular pressure, ocular fundus condition and retinal nerve fiber layer thickness(RNFLT).

RESULTS: The effective rate of visual acuity and ocular fundus in observation group were 90% and 97% respectively, and in control group were 77% and 80% respectively. The difference had statistically significance.(P<0.01). Compared with control group, post-treatment a and b wave amplitude of observation group in dark adaptation and light adaptation have significant differences, as well as the difference of a and b wave amplitude in pre-treatment and post-treatment(P<0.05). But intraocular pressure had not significantly statistical differences(P>0.05).

CONCLUSION: Fuming tablet can improve the absorption of fluid under retina after retinal detachment surgery, the recovery of optic nerve and visual function.

Influence of different phacoemulsification incision on postoperative corneal astigmatism for cataract patients

Zhao-Rong Zeng — 2014/4/21 11:07:19

AIM: To compare the effect of different phacoemulsification incision on postoperative corneal astigmatism for cataract patients.

METHODS: The cataract patients were selected in our hospital. The patients were divided into control group(corneal limbus opposite curved scleral tunnel incision group)and observation group(above the top of cornea or temporal transparent corneal incision group)randomly. At 1wk; 1 and 3mo after surgery, the change of corneal astigmatism and vision of the patients in two groups were compared and analyzed.

RESULTS:Compared with control group, 1wk; 1 and 3mo after surgery, the average corneal astigmatism and surgically induced corneal astigmatism of the patients in observation group were decreased significantly. The visual acuity and corrected visual acuity were increased significantly. There was statistically significant(P<0.05). Compared with control group, the time for the operation of the patients in observation group was shorted significantly, there were statistically significant(P<0.05).

CONCLUSION: Center distance and small incision corneal phacoemulsification can reduce postoperative astigmatism and improve postoperative visual acuity for cataract patients. It provides guarantee for further strengthen the clinical treated effect for cataract patients.

Investigation on the changes of corneal curvature after non-phacoemulsification in small-incision cataract surgery with intraocular lens implantation

Hai-Jiang Qiu,Jia Li and Ying-Na Zheng — 2014/4/21 11:07:19

AIM: To investigate the changes of corneal curvature after non-phacoemulsification in small-incision cataract surgery with intraocular lens implantation and discuss the essence of iatrogenic astigmatism.

METHODS: In this study, the horizontal corneal curvature(HCC)and vertical corneal curvature(VCC)of 99 patients(116 eyes)were documented before and after cataract surgery,with the postoperative follow-up of 3d; 1, 2wk; 1, 3, 6mo; 1, 2, 3a. The difference value of the HCC and the VCC between preoperation and postoperation were calculated and statistically analyzed.

RESULTS: The VCC was deceased by 2.01D, while the HCC was increased by 1.62D on the 3d after surgery; the difference value of the HCC and VCC were both decreased acutely in the 3mo postoperationly(the difference value of the VCC was -0.52D and HCC was 0.46D); the difference value of the HCC and VCC both were decreased mildly after 3mo of postoperation, There was no significant difference between the difference value of HCC(0.29D)and VCC(-0.29D)at 6mo(P=0.801); VCC was still smaller than that of preoperation(-0.26D), and HCC was larger than that of preoperation(0.25D)at the 3a. Paired t test was performed in these curvature differences, which both decreased apparently from 3d to 6mo after surgery(P<0.001), while they stayed still from 6mo to 3a postoperatively(VCC: P=0.284; HCC:P=1.000).

CONCLUSION: It remains astigmatism for a short time after small-incision cataract surgery and the treatment requires improvement so as to minimize the astigmatism as much as possible.

Preliminary study of the correlation between refractive error and corneal refractive power, corneal asphericity in myopic eye

Qi-Chao Han and Mei-Yan Feng — 2014/4/21 11:07:19

AIM: To investigate the correlation between myopic refractive error and relative factors, including the corneal refractive power, posterior refractive power, axial length, corneal asphericity coefficient Q value, central cornea thickness(CCT)and intraocular pressure(IOP).

METHODS:According to the degree of myopia measured by subjective refraction, 138 myopia patients were divided into three subgroups: mild group(-1.00D--3.00D), moderate group(-3.25D--6.00D), high group(>6.00D). The Pentacam anterior segment tomographer(Germany, Oculus Company)was used to measure the corneal refractive power, posterior refractive power, and corneal asphericity in the right eye. IOP, CCT and axial length were measured by a non-contact tonometer and A-scan ultrasonic, respectively. The data was analyzed with a Pearson correlation analysis and one-way ANOVA.

RESULTS: The myopic refractive error was negatively correlated with the axial length(r=-0.682, P<0.001), but was not correlated with the corneal refractive power(r=0.009, P=0.925). The axial length was negatively correlated with corneal refractive power(r=-0.554, P<0.001). The myopic refractive error was postively correlated with the Q value(r=0.674, P<0.001), which was negatively correlated with the IOP(r=-0.375, P=0.01). There was no significantly correlation between the myopic refractive error and CCT, IOP(r=-0.138, P=0.141; r=-0.121, P=0.157).

CONCLUSION:The corneal refractive power plays the role of emmetropization during the development of myopia. There is clinic significance for the correlation between Q value and refractive error, IOP to guide the corneal refractive surgery.

Study on micro differentiation elements of shuganlizhuo method in the early diabetic patients

Shuang-Ling Wang,Xiong Lü,Ming-Man Cao,Fei Huang,Shu-Qiong Zhang and Hui Tang — 2014/4/21 11:07:19

AIM:To improve the efficacy pathological changes of retinal microvessel in the early damp-heat diabetic patients from TCM theory of shuganlizhuo.

METHODS: Totally 56 patients with early damp-heat diabetic, 28 cases in treatment group and another 28 cases in control group. The treatment group treated with shuganlizhuo prescription(Shuhe capsules), the control group with Acarbose, all in a row with three courses. TCM syndrome manifestations, visual acuity, field of vision, as well as 2h postprandial blood glucose(P2HBG)and glycosylated hemoglobin(HbA1c)between the two groups before and after treatment were observed.

RESULTS: The treatment group was able to significantly improve the TCM symptoms(P<0.01), P2HBG, and HbA1c, improved visual acuity(P<0.05), reduced visual field defects MD average values(P<0.01).

CONCLUSION: The method of shuganlizhuo has improved micro lesions of early damp-heat diabetic retinal effects may be related to improve the systemic symptoms.

Analysis on tacrolimus efficacy in the treatment of vernal keratoconjunctivitis

Xin Zhang,Jing Tang,Qiong Wang and Ying-Ping Deng — 2014/3/24 14:01:50

AIM: To evaluate the curative effects of tacrolimus on vernal keratoconjunctivitis(VKC).

METHODS: A double-blind, randomized, placebo-controlled trial.Sixteen ambulatory patients from department of ophthalmology in West China Hospital of Sichuan University were randomly divided into drug treatment group and control group. Patients in treatment group were treated with tacrolimus eye drops, and control group with the basic placebo eye drops. Observation period of the trial was 28 days after taking the drops. The signs and symptoms were recorded and marked respectively. Total variation of ocular signs before or after therapy was main therapeutic index but subjective symptoms were the secondary index.

RESULTS: Comparison in groups: there were significant differences on the scores of signs and symptoms before and after medication. After the drug treatment group, consciousness of each period symptom score was lower than before the medication, and over time, symptom score gradually reduced, the difference was statistically significant, but the control group after the medication had no statistically significant differences between different periods. Compared between the groups: There were no significant differences of subjective symptoms and signs before and after medication at the first review, but there were statistically significant differences during the other two reviews. Score variation(scores before or after medication)had no significant differences in the first review but had it in the following two times.

CONCLUSION:Tacrolimus can be used to improve the signs and symptoms of VKC, especially for the severe patients who are nonresponse to the anti-anaphylaxis drops. Tacrolimus can be quick and excellent to improve the effects, so it can be applied into clinic.

Effect of 1.8mm coaxial micro-incision cataract phacoemulsification on corneal astigmatism

2014/3/24 14:01:50

AIM: To observe the effect of 1.8mm coaxial micro-incision cataract phacoemulsification on corneal astigmatism, and compared with the effect of traditional 3.2mm small incision cataract phacoemulsification.

METHODS: Totally 160 patients(168 eyes)with age-related cataract were selected, whose age from 50 to 83 years old. Their lens opacities classification was Ⅱ-Ⅴ grade. Two groups were divided randomly and each group included 84 eyes. They performed 1.8mm coaxial micro-incision(micro-vision group)and traditional 3.2mm small incision(control group)of cataract phacoemulsification respectively. After 1d, 1wk, 1mo follow-up, their naked vision and astigmatism changes were recorded. The χ²-test and t-test was used for the statistical analysis.

RESULTS: After 1d, 1wk, 1mo of the micro-incision surgery, naked vision ≥0.5 of the patients were 79%, 83% and 94% respectively. In control group, naked vision ≥0.5 were 46%, 64% and 85% respecticvely. There was significant difference between the two groups(P<0.05). The average corneal astigmatism of micro-incision group was 0.75±0.45D on 1d after surgery, and that of the control group was 1.12±0.55D. There were significant difference between two groups(P<0.01). After 1wk and 1mo, the average corneal astigmatism of micro incision group was 0.76±0.40D and 0.65±0.35D, and the average corneal astigmatism of control group was 1.05±0.53D and 0.85±0.43D. The two groups were statistically significant(P<0.05).

CONCUSION: The corneal astigmatism of 1.8mm coaxial micro-incision cataract phacoemulsification was smaller than that of the conventional phacoemulsification and visual recovery was also better after surgery.

Comparison of clinical efficacy between phacoemulsification and small incision extracapsular cataract extraction for senile cataract

Yong Li,Zhang-Xian Yue,Hai-Long Xu and Zhao-Chen Liu — 2014/3/24 14:01:50

AIM: To evaluate the clinical therapeutic effects of senile cataract on phacoemulsification and small incision cataract surgery and the influence of corneal endothelium.

METHODS: A retrospective analysis was performed in 296 cases of senile cataract in our hospital from Jan. 2009 to Jan. 2013 in the "Cataract extraction project". One hundred and forty cases underwent phacoemulsification treatment, whereas 156 cases received small incision extracapsular cataract extraction. The therapeutic efficacy and effects on corneal endothelial cells of the two groups were compared.

RESULTS: After 3d operation, the visual acuity and corneal astigmatism in phacoemulsification group were much better than that in small incision cataract surgery group(P<0.05), and the two groups were statistically significant differences before operation(P<0.05). However, after 1 and 3mo, the acuity, astigmatism and preoperative and postoperative complications had no significant differences(P>0.05).

CONCLUSION: Both phacoemulsification and small incision extracapsular cataract extraction are effective methods of treatment of cataract. However, the method of small incision cataract surgery is more economic, and it is valuable in primary hospital and the “Cataract extraction project”.

Efficacy on chopping with lens loop-pad in the small incision extracapsular cataract surgery with intraocular lens implantation

Xiao-Ning Peng,Ying-Long Li and Gang-Sheng Liu — 2014/3/24 14:01:50

AIM: To study the clinical effects of chopping with lens loop-pad in the small incision extracapsular cataract surgery with intraocular lens implantation.

METHODS:A total of 75 cases(80 eyes), in which loop-pad and chop knife were performed to chop nucleus before implanting intraocular lens. Visual acuity, postoperative astigmatism degree, intraoperative and postoperative complications were observed. The post-operative follow-up periods ranged from 3 to 12mo.

RESULTS: The visual acuity was 0.3-0.5 in 37 eyes and 0.6 or better in 21 eyes at 1d, while was respectively in 43 eyes and in 26 eyes at 1mo. Compared with preoperative astigmatism(0.85±0.29D), there were significant difference at postoperative 1wk(1.75±0.55D)(P<0.05), while there were no significant difference at postoperative 1mo(0.92±0.48D)and 3mo(0.89±0.35D)(P>0.05). Intraoperative posterior capsule rupture occurred in 4 eyes, which implantation was successful in 1 eye and 3 eyes was managed viaciliary sulcus. Two eyes had dermatoglyphic pattern edema in corneal endothelium which recovered after about 3d. Two eyes had local patchy opacities which recovered in 2wk. Two eyes had transient high intraocular pressure.

CONCLUSION: The surgery is efficient, low cost, easy process and less complications, it is worth to be popularized.

Clinical observation on the treatment of glaucoma with cataract through triple surgery

Dan Yu,Gang-Ping Zhao,Min Zhu,Yu Lei,Zhi Huang and Jing-Qiu Li — 2014/3/24 14:01:50

AIM: To observe the therapeutic effect of triple surgery in the treatment of glaucoma with cataract at different stages.

METHODS: Totally 31 patients(55 eyes)with glaucoma and cataract were treated with phacoemulsification, lens implantation and trabeculectomy. Preoperation and postoperation of visual acuity, intraocular pressure, filtering bleb and postoperation complications were observed.

RESULTS: After 6mo postoperation, the vision was significantly improved. The intraocular pressure was controlled in normal range and filtering bleb was good. There was a little complications after operation.

CONCLUSION: Phacoemulsification intraocular lens implantation with anti-glaucoma establishes new aqueous humor outflow. It can effectively decrease intraocular pressure, deepen anterior chamber and improve vision, reduce all kinds of complications after simple glaucoma surgery.

Application analysis of trabeculectomy and phaco emulsificationin treating PACG with cataract

Su-Yun Xu — 2014/3/24 14:01:50

AIM: To research the application effects of trabeculectomy and phaco emulsification in primary angle-closed glaucoma(PACG)with cataract.

METHODS: Fifty-one patients aged from 46 years to 82 years with PACG and cataract from 2011-05/2012-05, were selected in our research. 51 patients were all treated with trabeculectomy(TL)and phaco emulsification(PE), meanwhile, they were implanted intraocular lens.

RESULTS: The effects of combing treatments in reducing intraocular pressure were better, and postoperative visual acuity results were satisfactory. It can deepen the central anterior chamber depth and all researches had fewer complications, and there was no posterior capsular rupture, retinal detachment and corneal endothelial decompensation and other serious complications in all the research objects. Total surgery success rate reached 97%, and the failure rate was very low.

CONCLUSION: Trabeculectomy combined with ultrasonic emulsification treating PACG can get a good result of reducing intraocular pressure, and be good for postoperative visual acuity recovery and correction, and it can deepen anterior chamber depth. The surgical success rate is high, with low complication rates, so the general effects are better. It is worthy of clinical application and wide application.

Reproducibility studies on OCT rapid and repeated scanning method for the diagnosis of glaucoma

Yu-Hui Xu,Liang-Cheng Wu,Da-Qing Yao,Dang Xu,Cheng-Hai Weng and Shao-Lin Wang — 2014/3/24 14:01:50

AIM: To evaluate the application ofoptical coherence tomography(OCT)and retinal nerve fiber layer thickness(RNFL)measured by rapid and repeated methods in the diagnosis of glaucoma repeated significance.

METHODS: Stratus OCT were measured in 38 normal subjects and 42 patients with the primary RNFL thickness of open angle glaucoma patients. Rapid and repeated scanning was applied respectively to measure the RNFL thickness of patients with normal and primary open angle glaucoma. The average RNFL thickness's related coefficient and various coefficient of the temporal, upper, lower and nasal region made reproducibility assessment.

RESULTS: In normal and primary open angle glaucoma patients, the overall average RNFL thickness and lateral temporal, above, nasal, below RNFL thickness, in which two groups did not show differences; repeated scanning average RNFL thickness was measured in fast scanning scheme around the optic disc, and had higher ICC and lower value of CV, there were significant differences in the temporal region(P=0.042). The temporal, nasal, upper and lower area of the retinal nerve fiber layer thickness of the ICC(CV)values were as follows: fast scan was 0.918(7.2%), 0.831(6.82%), 0.856(5.12%), 0.911(7.19%); repeated scans were 0.927(3.21%), 0.962(5.01%), 0.909(6.02%), 0.869(4.67%), 0.918(6.89%).

CONCLUSION: In normal subjects and patients with primary open angle glaucoma, the application of rapid and repeated scanning in measurement of RNFL with OCT thickness has repeated significance, but repeated scanning scheme in the assessment of RNFL thickness is more accurate.

Analysis on optical coherence tomography in Vogt-Koyanagi-Harada syndrome before and after therapy

Yan Zhang and Hui Song — 2014/3/24 14:01:50

AIM: To analyze features of optical coherence tomography(OCT)in Vogt-Koyanagi-Harada syndrome before and after therapy.

METHODS: Thirty-four eyes of 17 patients, which were identified as Vogt-Koyanagi-Harada syndrome, were examined with OCT and fundus photography, after the treatment of steroid therapy, the change of retinal structure were observed after 5, 15, 30d.

RESULTS: OCT revealed retinal neuroepithelial edema and serous detachment of retinal neuroepithelia and subretinal septa that divided the subretinal space into several compartments all of cases. After steroid therapy, the retinal edema, serous detachment and subretinal septa were improved, even resolved completely.

CONCLUSION: OCT can observe retinal structural change of Vogt-Koyanagi-Harada syndrome before and after therapy, it is vital for diagnosis and treatment evaluation of the disease.

Clinical observation on panretinal photocoagulation with compound anisodine in the treatment of diabetic retinopathy

Ming Lü and Rui Zhang — 2014/3/24 14:01:50

AIM: To observe thediabetic retinopathy panretinal photocoagulation with compound anisodine para temporal superficial artery injection and simple retinal photocoagulation, and whether there are differences in the improvement of patients' diabetic retinopathy vision and retinopathy.

METHODS: A retrospective analysis of patients with diabetic retinopathy diagnosed in our hospital, divided into two groups according to the treatment method.Group A of panretinal photocoagulation after compound anisodine para temporal superficial artery injection of 66 cases of 109 eyes. Group B was treated with panretinal photocoagulation in 54 cases of 71 eyes.

RESULTS:Group A after treatment for 3mo, the visual acuity improved rate was 66.1%, the visual acuity improved in group B was 46.5%, statistically different in two groups(χ²=6.78, P<0.01). Group A after treatment for 6mo, the visual acuity improved rate was 68.8%, the visual acuity improved in group B was 49.3%, statistically different in two groups(χ²=6.89, P<0.01). The group A after 6mo of treatment for diabetic retinopathy improvement rate was 61.5%, group B of diabetic retinopathy improvement rate 39.4%, two groups had statistically significant difference(χ²=8.37, P<0.01).

CONCLUSION:The patients with diabetic retinopathy panretinal photocoagulation combined with compound anisodine para temporal superficial artery injection and simple retinal photocoagulation can better restore vision and improve diabetic retinopat.

Clinical report of the key techniques used in the external-route microsurgery for rhegmatogenous retinal detachment

Chun-Yang Zhao,Yong-Xiong Li,Dong-Lian Li and Guo-Shun Huang — 2014/3/24 14:01:50

AIM: To conclude the clinical situation of the key techniques used in the external-route microsurgery for rhegmatogenous retinal detachment.

METHODS: A total of 152 patients with rhegmatogenous retinal detachment who underwent drainage of sub-retinal fluids, cryotherapy, localization of the retinal break, silicone scleral buckling by surgical microscope.

RESULTS: Retinal reattachment were achieved in 89.5% of patients after the primary surgery and the final reattachment rate was 96.7%, and 89.8% of the eyes achieved the corrected visual acuity high above 0.05, 35.2% above 0.3 at 1mo postoperatively. In 83.6% of eyes had a succeed drainage of sub-retinal fluids by the first acupuncture, and 13.1% of eyes achieved it by the second try after silicone buckling and circling; in 82.9% of cases, the retinal tear localization directly under microscope was accurate, in 90.0% of eyes were achieved it after check and adjustment by the end of operation; in 6.6% of cases,the scleral buckling had to be adjusted to more correct position in the first operation, and 10.6% of eyes had to be adjusted in the next operation; in 95.4% of eyes, the posterior edge of silicone buckling were within 20mm behind corneal limbus, 4.6% of eyes were behind 20mm.

CONCLUSION: The external-route microsurgery can bring us expected clinical results for rhegmatogenous retinal detachment. Its key microsurgical techniques are applied in convenient, reliable, and can be adjusted timely when some deviations occurred. The observable retina under microscope range from ora serrata to 20mm behind corneal limbus, and even to 20-24mm in some high myopia eye with large axial length.

Clinical effects of 23-G micro-invasive with vitrectomy and phacoemulcification for early proliferative diabetic retinopathy and vitreous hemorrhage

Hai-Bo Wang,Yan-Hua Yang and Shao-Kai Xu — 2014/3/24 14:01:51

AIM: To investigate the surgical therapeutic effects and complications of 23-gauge(23-G)vitrectomy combined with phacoemulcification for early proliferative diabetic retinopathy(PDR)and vitreous hemorrhage.

METHODS: The 23-G micro-invasive vitrectomy combined with phacoemulcification and intraocular lens implantation were done in 48 patients(48 eyes)from Jan. 2011 to Jan. 2013. Best corrected visual acuity was recorded before or after operation 1mo. All patients were followed up for 4-18mo to observe the eye pressure, inflammatory reaction, intraocular lens location, and the changes of fundus conditions.

RESULTS: After 1mo operation, best corrected visual acuity improved 43 eyes(90%), the visual acuity of 36 eyes(75%)≥0.12, 15 eyes(31%)≥0.3, visual acuity in preoperation or postoperation was different significantly(P=0.00). There were 6 eyes(13%)with hypotony, 5 eyes(10%)with choroidal detachment, 13 eyes(27%)with inflammation in anterior chamber, 16 eyes(33%)with increased intraocular pressure, and 10 eyes(21%)with vitreous hemorrhage after operation. However, there were no vitreous retinal hyperplastic lesions, retinal detachment, iris rubeosis, and neovascular glaucoma postoperatively.

CONCLUSION: The 23-G micro-invasive vitrectomy combined with phacoemulcification and for early proliferative diabetic retinopathy is safe and effective.

Treatment of juxtafoveal central serous chorioretinopathy by compound anisodine injection

Jian-Feng Xu and Kai-Cong Chen — 2014/3/24 14:01:51

AIM: To investigate the efficiency and security of compound anisodine injection in the treatment of juxtafoveal central serous chorioretinopathy(CSC).

METHODS: Sixty patients(60 eyes)who were diagnosed of juxtafoveal CSC were assigned randomly into 2 groups: 32 cases(32 eyes, therapeutic group)were injected subcutaneously compound anisodine injection for 2mL q.d around superficial temporal arteries in the affected eyes; 28 cases(28 eyes, control group)received only traditional oral medication. Both groups received therapy for 2 to 4 courses of treatment. The main observations were the best corrected visual acuity(BCVA), subjective symptom, visual field, average light sensitivity and optical coherent topography(OCT).

RESULTS: There was no significant difference between the therapeutic group and the control group before treatment(P>0.05), but all the outcome measures at 1, 3mo in the treatment group were significantly improved as compared with control group(P<0.05). After 6mo, there were no significant difference between the two groups in all measures(P>0.05). No severe adverse reaction was noted except mild ones such as temporary dry mouth, dizziness and palpitation in a few cases.

CONCLUSION: Compound anisodine injection has remarkable effects in the treatment of juxtafoveal CSC. It can shorten the course, improved the visual function and decreased the recurrence rate of CSC.

Study of the relevant parameters of optic nerve of patients with suspected ocular hypertension

Qing-Qing Yao and Dan Liu — 2014/3/24 14:01:51

AIM: To investigate the differences of the relevant parameters of optic nerve between patients with suspected ocular hypertension and normal people.

METHODS: There were 36 eyes of suspected ocular hypertension and 43 normal eyes to test their retinal nerve fiber layer thickness(RNFL), the optic disk parameters, the thickness of macular ganglion cell complex(mGCCT)and visual field index. The analysis and comparison are made on the obtained results.

RESULTS: There was significant difference(P<0.01)between the patients with suspected ocular hypertension and normal eyes in average, inferior and superior RNFL thickness, optic disk parameters(rim area, cup volume, average C/D ratio)and the average, inferior, superior thickness of macular ganglion cell complex(P<0.01). There was statistical difference between two groups in nasal RNFL thickness(P<0.05), but there was no statistical difference in temporal RNFL thickness, cup area, mean deviation(MD)and pattern standard deviation(PSD)(P>0.05).

CONCLUSION: There is significant difference between normal and suspected ocular hypertension eyes in average, inferior and superior RNFL thickness, optic disk parameters(rim area, cup volume, average C/D ratio)and the average, inferior, superior thickness of mGCCT.

CT feature and clinical significance on course of intraorbital segment in infraorbital nerve

Lu Liu,Ming Chen,Guang-Rui Chai,Meng Wang,He-Ming Li and He Zhang — 2014/3/24 14:01:51

AIM: To investigate the clinical significance and feature of intraorbital segment course in infraorbital nevrve on computed tomography(CT).

METHODS: Using three-dimensional reconstruction and CT, 101 adults with normal orbital bone were measured with the length of infraorbital canal, the vertical distance from infraorbital foramen to infraorbital margin and to median line of skull respectively, and the included angle between infraorbital canal and antetheca of the maxilla. The average had been taken after 5 times measurement to every value. SPSS 17.0 statistical software was used to the process.

RESULTS: Measurement results of 101 adults with normal orbital bone were statistically analyzed. The left infraorbital canal lengths of 53 male were 13.21±2.73mm and the right were 12.97±2.63mm; the left infraorbital canal lengths of 48 female were 12.79±2.77mm and the right was 12.72±2.70mm; the left vertical distances from infraorbital foramen to infraorbital margin of 53 male were 9.01±2.21mm and the right were 8.69±1.98mm; the left vertical distance from infraorbital foramen to infraorbital margin of 48 female were 9.33±2.18mm and the right was 9.14±2.34mm; the left vertical distances between infraorbital foramen and median line of skull of 53 male were 33.41±3.01mm and the right were 33.34±3.33mm; the left vertical distance between infraorbital foramen and median line of skull of 48 female were 32.39±4.23mm and the right were 32.33±3.78mm; the left included angle between infraorbital canal and antetheca of the maxilla of 53 male were 81.47°±11.70° and the right were 79.80°±10.38°; the left included angle between infraorbital canal and antetheca of the maxilla of 48 female were 76.04°±14.64° and the right were 76.30°±13.51°. Pair t test was used to compare the left and right side value in male and female, and the same side value in male and female. The results had no statistical differences(P>0.05).

CONCLUSION: Through the measure of the infraorbital nerve on CT, it is good for the clinical diagnosis and treatment. In the meanwhile, it can help patients to avoid the unnecessary nerve injury in the operating.

Analysis on the causes of vitreous hemorrhage and effects of surgical treatment

Cui-Li Zhang,Ming-Mei Zhang and Xue-Yi Chen — 2014/3/24 14:01:51

AIM: To explore the causes of vitreous hemorrhage and the clinical efficacy of vitrectomy in vitreous hemorrhage.

METHODS:Totally 162 patients(173 eyes)with vitreous hemorrhage who underwent vitrectomy were analyzed.

RESULTS: Postoperative diagnosis: in 173 eyes, proliferative diabetic retinopathy 83 eyes(48.0%), branch retinal vein occlusion 24 eyes(13.9%), Eales disease 13 eyes(7.5%), central retinal vein occlusion 10 eyes(5.8%), traumatic vitreous hemorrhage 9 eyes(5.2%), retinal hole 8 eyes(4.6%), retinal detachment 9 eyes(5.2%), proliferative vitreoretinopathy 7 eyes(4.0%), pure vitreous hemorrhage 4 eyes(2.3%), retinal artery aneurysm 2 eyes(1.2%), polypoid choroidal vasculopathy 2 eyes(1.2%), chorioretinitis 1 eye(0.6%), age-related macular degeneration 1 eye(0.6%). Different causes were distributed in different ages, postoperative follow-up 3-15mo, visual acuity after treatment was compared with that before treatment, unchanged 41 eyes(23.7%), improved 115 eyes(66.5%), decreased 17 eyes(9.8%). Compared with the preoperative visual acuity difference was statistically significant(P<0.05).

CONCLUSION:Proliferative diabetic retinopathy, retinal vein occlusion and Eales disease are the main causes of vitreous hemorrhage. To some extent, vitrectomy surgery has a little complications and it can improve visual acuity. Vitreous hemorrhage is a safe and effective treatment method.

Efficacy of moderate to severe ocular chemical injury and the acute phase treatment and amniotic membrane transplantation

Bing Bai and Yan-Hong Fang — 2014/3/24 14:01:51

AIM:To discuss effective ways of scientific treatment of ocular chemical injury by analyzing the effects of moderate to severe acute ocular chemical injury and amniotic membrane transplantation.

METHODS:Totally 36 cases(43 eyes)of Ⅱ degrees and above of ocular chemical injuries were collected, and clinical efficacy was observed by analyzing the causes of injury, the degree of injury, visual acuity and complications.

RESULTS:The recovery of visual acuity was well in Ⅱ degrees of burns, and the acuity of 55.6% reached over 0.6. The recovery of visual acuity >0.3 in acid burn group was 80.0%, and the recovery of visual acuity >0.3 in alkali burn group was 56.0%. The difference between two groups was statistically significant(P<0.05). The recovery of visual acuity >0.3 in early amniotic membrane transplantation group was 69.7%, and in early no amniotic membrane transplantation group was 50.0%; the difference between two groups was statistically significant(P<0.05). The incidence of serious complications of acid burn group(60.0%)was lower than the alkali burn group(84.0%), and the difference was statistically significant(P<0.05). The incidence of serious complications in early amniotic membrane transplantation group(60.6%)was lower than in early no amniotic membrane transplantation group(40.0%), and the difference was statistically significant(P<0.05).

CONCLUSION: Early clinical treatment, and early amniotic membrane transplantation are very important for patients with ocular burn in acute phase to reduce complications and have a better recovery.

Effects of positive relative accommodation on adolescent pseudomyopia with visual training

Jiang Yue,Hui Yue,Qiu-Jin Ren,Qing Zhou and Jing Huang — 2014/3/24 14:01:51

AIM:To investigate the changes of the positive relative accommodation in adolescent pseudomyopia with visual training.

METHODS: A total of 42 cases(84 eyes)were randomly divided into the visual training group and the control group. Visual acuity, average refraction of two groups 4wk after the training were measured, as well as positive relative accommodation(5m)were checked before the training and repeated 1, 2, 4wk after the training. Correlation analysis were given.

RESULTS: There was statistically significant difference in visual acuity 4wk after the training between the two groups(P<0.05). There was no significant difference statistically in average refraction 4wk after the training between the two groups(P>0.05). There was statistically significant difference in positive relative accommodation(5m)1, 2, 4wk after the training between the two groups(P<0.05). There was statistically significant difference in positive relative accommodation(5m)between the before and 4wk after the training in the visual training group(P<0.01).

CONCLUSION: Visual training has significant effect on the positive relative accommodation on adolescent pseudomyopia.

Research on the effect of wavefront aberration-guided combining Q-value optimized LASEK on treatment of myopia

Tai-Nan Lin,Guo-Xing Xu,Shao-Bin Zheng and Xiao-Juan Zhang — 2014/3/24 14:01:51

AIM: To observe the effect of the wavefront aberration-guided combining Q-value optimized LASEK(WG-QO-LASEK).

METHODS: Retrospective analyzed the pre- and post-operative clinical data of 140 cases(280 eyes)that had gone through WG-QO-LASEK in the department of ophthalmology in our hospital. The observational index was compared in patients' visual acuity of pre- and post-operative and the subjective and objective examination of vision.

RESULTS: There were no severe postoperative complications. Totally 132 patients'(264 eyes)uncorrected visual acuity(UCVA)was achieved to the expected correction degree within ±0.5D. Best corrected visual acuity(BCVA)improved one line in 88 eyes(31.4%)and 2 lines in 46 eyes(16.4%). Postoperative scores of NEI-RQL-42 were significantly higher than preoperative ones. After operation, the proportion of higher-order aberrations increased, mainly manifested in spherical aberration and coma, but it did not influence the visual quality obviously.

CONCLUSION: WG-QO-LASEK treatment of myopia has good predictability, accuracy and safety.

Comparison of central corneal thickness measurements after LASEK by three instruments

Xiao-Juan Peng,Ye Tian,Si-Ying Liu and Ji-Sheng Chen — 2014/2/27 9:12:36

AIM: To compare the differences and the relationships of central corneal thickness(CCT)measurements among optical coherence tomography(OCT), Tomey pachymetry and ultrasound pachymetry after laser assisted subepithelial keratomileusis(LASEK).

METHODS:Forty-nine patients(96 eyes)with myopia after 6mo of LASEK were assigned to measure the CCT by OCT, Tomey pachymetry and ultrasound pachymetry. Paired t-test and Pearson correlation analysis was used for statistical analysis.

RESULTS: The mean CCT measured by OCT, Tomey pachymetry and ultrasound pachymetry was(475.15±33.67μm),(447.80±34.11μm),(465.18±34.23μm), respectively. Surgery reserved mean CCT was(431.22±35.32)μm. There were statistically differences between two comparative measured results(P<0.05). Ultrasound pachymetry had a positive correlation with OCT and Tomey pachymetry(P<0.01), and the correlation coefficient was 0.949 and 0.983, respectively. The actual CCT of 6mo post-operation was thicker than surgery reserved CCT.

CONCLUSION: The CCT measurements of three instruments were not interchangeable.

Influence of phacoemulsification on corneal endothelial cell of cataract patients with diabetes or hypertension

Ni Zhu,Zhong-Chen Zhang and Xiao-Lin Hao — 2014/2/27 9:12:36

AIM: To observe the influence of cataract phacoemulsification on corneal endothelial cell of cataract patients combined with diabetes or hypertension.

METHODS: Clinical case-control study was used. Totally 104 cases(174 eyes)of patients who underwent phacoemulsification were divided into three groups: senile cataract patients, diabetes mellitus cataract patients and hypertension cataract patients. The changes of endothelial cell density(CD), percentage of regular hexagonal cells(6A), coefficient of variation(CV)between pre-operation and post-operation at 1wk, 1mo were compared. The data were analyzed statistically by means of SPSS 13.0 software.

RESULTS: Pre-operative results: the percentage of CD and 6A cell were decreased and CV was increased in diabetes and hypertension group compared with control group. There were statistical differences in 6A and CV in diabetes group(P<0.05). There were statistical differences in 6A in hypertension group(P<0.05). Post-operative results: the percentage of CD and 6A were decreased, and CV was increased after operation of 1wk and 1mo. There were significant differences in three groups(P<0.01). CD had statistical differences(P<0.05), CV and 6A had significant differences(P<0.01)between diabetes group and control group. 6A and CV had significant differences(P<0.01)between hypertension group and control group.

CONCLUSION: Cataract phacoemulsification has certain injury on corneal endothelial cell. Cataract patients combined with diabetes or hypertension are easier to be damaged than that of senile cataract in the phacoemulsification. They are more sensitive after surgery.

25G posterior capsulotomy with anterior vitrectomy for posterior capsule opacification

2014/2/27 9:12:36

AIM: To evaluate the efficacy and complications of 25G posterior capsulotomy with anterior vitrectomy for posterior capsule opacification(PCO).

METHODS: The 25G transconjunctival sutureless vitrectomy technique was performed in 48 cases(68 eyes)of PCO eyes. The mean follow-up was 24mo. Best-corrected visual acuity(BCVA), intraocular pressure, anterior chamber reaction and complications during and after the operation were observed.

RESULTS: 4mm diameter round holes were obtained at the center of the posterior capsule in all eyes. At 1d postoperative, uncorrected visual acuity(UCVA)was 0.70±0.12(0.5-1.0), and BCVA was 0.73±0.10(0.6-1.0). At 3mo postoperative, UCVA was 0.72±0.12(0.5-1.0), and BCVA was 0.74±0.10(0.6-1.0). It was statistical significance between preoperative and postoperative UCVA(t=-45.902, P=0.000). There were no complications during the postoperative follow-up period, such as dislocation or damage of the IOL, corneal edema, endoophthalmitis, pupil vitreous hernia, vitreous prolapse, retina detachment, intraocular hypertension and reocclusion of the visual axis, etc.

CONCLUSION: The 25G transconjunctival sutureless vitrectomy technique to remove PCO is a safe and effective procedure with less complications, which can be an alternative treatment for PCO.

Application of phaco prechop with phaco chop technique in phacoemulsification

Wei Liu,Ying-Ping Zhang,Mei-Fen Xie and Yan Liu — 2014/2/27 9:12:36

AIM:To compare two phaco techniques, namely phaco prechop with phaco chop and divide and conquer, and to discuss the technical advantages of phaco prechop with phaco chop

METHODS:The study included 131 patients(156 eyes)with age-related cataract eyes divided into 2 groups, group A including 68 patients(82 eyes), in which phaco prechop with phaco chop was performed, and group B including 63 patients(74 eyes), in which divide and conquer was performed. The mean parameters including average power(AP), U/S time, accumulated energy complex parameter(AECP), mean endothelial cell count, mean endothelial cell loss, intraoperative complications, postoperative uncorrected visual acuity(UCVA)at 1d and 1wk, and corneal edema were reported in the two groups both preoperative and postoperative.

RESULTS:The subgroups with same grade of lens nucleus hardness were compared. Parameters such as AP, U/S time, AECP in group A were significantly less than those in group B. Postoperative corneal clarity and UCVA at 1d in group A was better than that in group B. No significant difference was found in UCVA at 1wk after operation between the two groups. The difference in mean endothelial cell count at 3mo postoperative between the two groups was statistically insignificant(P>0.05), however the difference in endothelial cell loss at 3mo postoperatively between the two groups was statistically significant(P<0.05). Two cases in groups A(2.4%)had posterior capsular rents compared to four cases(5.4%)in group B.

CONCLUSION:Compare with divide and conquer, phaco prechop with phaco chop utilized less phaco time, energy, and the rate of endothelial cell loss at 3mo postoperatively, and better early postoperative uncorrected visual acuity.

Effect of Ex-PRESS filtration device in primary open angle glaucoma

Wei-Hua Yang,Feng-Feng Tong and Hong Chen — 2014/2/27 9:12:36

AIM: To observe the effect of Ex-PRESS glaucoma filtration device in primary open angle glaucoma.

METHODS: Totally 41 patients(54 eyes)with primary open angle glaucoma were divided into two groups. Nineteen patients(25 eyes)in study group who underwent Ex-PRESS glaucoma filtration device implantation. Twenty-two cases(29 eyes)in control group who underwent trabeculectomy. Two groups were compared with the average operation time, post-operative visual acuity, anterior chamber, intraocular pressure, filtering bleb and other complications.

RESULTS: In study group operation time was(34.60±4.43)min, 1d postoperative shallow anterior chamber in 1 eye and hyphema in 1 eye, 1wk postoperative high intraocular pressure in 2 eyes, 3mo postoperative decreased vision in 1 eye, functional filtering blebs in 24 eyes, intraocular pressure was(11.5±5.8)mmHg. The control group operation time was(44.37±3.00)min, 1d postoperative shallow anterior chamber in 13 eyes, anterior chamber bleeding or exudation in 12 eyes, 1wk postoperative high intraocular pressure in 8 eyes, 3mo postoperative decreased vision in 6 eyes, functional filtering blebs in 25 eyes, intraocular pressure was(13.6±6.7)mmHg. The study group can shorten the operation time and reduce early postoperative shallow anterior chamber, lower intraocular pressure and incidence of anterior chamber exudation and bleeding. The study group can control postoperative IOP to a lower degree. Comparing with the traditional operation, the study group had equivalent effect in postoperative visual effects and functional filtering bleb.

CONCLUSION: Ex-PRESS glaucoma filtration device implantation in primary open angle glaucoma can shorten operation time, reduce the postoperative complications, and has the characteristics of high safety and good efficacy.

Application of Ahmed glaucoma valve implantation with sodium hyaluronate on NVG

Jin-Tao Chen,Zheng-Hui Ye and Zhi-Wei Xu — 2014/2/27 9:12:36

AIM: To investigate the effect and complication of sodium hyaluronate combined with Ahmed glaucoma valve implantation on neovascular glaucoma(NVG).

METHODS: This was a retrospective observational case series. Forty-nine patients(49 eyes)with NVG in our hospital from 2009 to 2011 were randomly divided into two groups according to the odd-even of medical record number. Ahmed glaucoma valve implantation proceeded separately in control group, while in control group combined with 0.2-0.3mL sodium hyaluronate, regularly follow-up after operation at 1mo, comparing the complications such as postoperative intraocular pressure(IOP), the changes of best corrected visual acuity(BCVA), the hemorrhage of shallow anterior chamber, hyphema and choroidal detachment, etc. IOP before and after operation between the two groups was examined by independent sample test(non-normal distribution), the complications were compared by χ² text.

RESULTS: Postoperative follow-up time was 1mo. IOP in research group was declined from 42.8±5.56mmHg preoperatively to 17.7±3.77mmHg, IOP in control group was declined from 42.5±5.36mmHg preoperatively to 18.6±5.39mmHg. Postoperative complications: shallow anterior chamber occurred in 2 patients(2 eyes)in research group and 4 patients(4 eyes)in control group. Hyphema occurred in 1 patient(1 eye)in research group and in 5 patients(5 eyes)in control group. Poor location of the anterior chamber silicone tube occurred in 1 patient in research group.

CONCLUSION:Sodium hyaluronate combined with Ahmed glaucom avalve can effectively reduce IOP in patients with NVG and decrease the postoperative hyphema, which will lead to short-term increasing IOP in patients after operation, but had no significant effect in the long run.

Effect of phacoemulsification with selective laser trabeculoplasty on primary open angle glaucoma

Pei-Yan Hua,Wei-Hua Xu and Yu-Qun Zhang — 2014/2/27 9:12:36

AIM: To compare the effect of primary open angle glaucoma(POAG)with well-controlled drugs on the intraocular pressure(IOP)using phacoemulsification combined selective laser trabeculoplasty(phacoemulsification combined SLT)versus SLT alone.

METHODS: By a prospective clinical case control study, 24 patients(30 eyes)with POAG were randomly divided into 2 groups: eleven patients(14 eyes)were treated with phacoemulsification combined SLT and 13 patients(16 eyes)were treated with SLT alone. IOP at 3, 6, 9mo, visual acuity and glaucoma medicines at 9mo were observed postoperatively.

RESULTS: The mean IOP of both groups was significantly decreased after the surgery. IOP of phacoemulsification combined SLT had decreased markedly than SLT alone after 3, 6mo. There was statistical significance between the 2 groups(P=0.001). The numbers of glaucoma drugs were markedly decreased postoperatively than preoperatively in both groups. Statistical significance were found between the 2 groups(P=0.03).

CONCLUSION: The study demonstrates that phacoemulsification with SLT and SLT can markedly reduce the IOP of POAG patients with good IOP control using drugs. The IOP-reducing effect of phacoemulsification combined SLT exceeds markedly than that of SLT alone.

Clinical therapeutic effect of two therapies on circumscribed choroidal hemangioma

Le-Le Huang,Lei Chen,Yue-Dong Hu,Rui Hua and Li-Min Liu — 2014/2/27 9:12:36

AIM:To observe the clinical therapeutic effect of photodynamic therapy(PDT)and transpupillary thermotherapy(TTT)on circumscribed choroid hemangioma(CCH).

METHODS: Totally 24 cases(24 eyes)of CCH were selected in this study. Twelve of them had undergone TTT, and the other 12 were treated by PDT. The changes of tumors were examined by best corrected visual acuity, results of fundus photography, and direct ophthalmoscopy; the changes of tumors' sizes and heights were examined by B-ultrasound examination and coloured doppler imaging; the presence of serous subretinal fluid were examined by optical coherence tomography(OCT); the leakage of tumors and complications were analyzed by fluorescence fundus angiography(FFA)and indocyanine green angiography(ICGA).

RESULTS: In all cases, the tumors shrinked back, the blood flows tuned negative, the fluorescence leakages lessened and the serous retinal detachments resolved completely according to OCT, FFA, ICGA and coloured doppler imaging. In the 12 patients treated by TTT, visual acuity improved in 33.3%, unchanged in 33.3%, and droped in 33.3% too; the results of fundus examinations showed obvious pigmentation and atrophy tumor with organized scar. In the 12 patients treated by PDT, visual acuity improved in 66.7%, unchanged in 33.3%, and none droped; the results of fundus examinations showed slight pigment derangement, atrophy tumor tuned white, and normal blood vessel undamaged.

CONCLUSION: Both TTT and PDT can make the tumor atrophy and the exudation absorbed. Unlike TTT, PDT damages little normal tissue, and has higher security.

Application and significance of OCT in central retinal artery occlusion

Jing Hao,Yi-Xia Zhang,Yun-Fei Li and Hai-Dong Lian — 2014/2/27 9:12:36

AIM: To investigate the applicationof the optical coherence tomography(OCT)in the central retinal artery occlusion(CRAO)disease, and explore whether is a correlation between inner retinal thickness and visual acuity pre and post treatment.

METHODS: A retrospective analysis of patients with central retinal artery occlusion in 11 cases. Patients' onsets to admission time, initial visual acuity, after-treatment visual acuity were collected. Retinal thickness in the macular area was measured with OCT. Retinal mean thickness of fovea, including macular fovea, the 1mm and 3mm up, down of the fovea, nasal and temporal side to the foveal pit, was measured and analyzed. The thickness of inner retinal layer was measured manually. In the inner retinal layer, 1mm nasal and temporal side to the foveal pit, nasal and temporal side was N1, T1 respectively; 3mm nasal and temporal to the foveal pit, nasal and temporal side was N3, T3 respectively.

RESULTS: The visual acuity of 8/11 patients was improved in different degree. The unhealthy eyes macular area and nasal 3mm retinal mean thickness were thicker than the healthy eye(P<0.05). Compared with the healthy eyes, the unhealthy eyes which retinal thickness under others macular area have no statistical difference(P>0.05). The unhealthy eyes were thicker than the healthy at N1, N3 and T3(P<0.05). The different values that thickness in the fovea of healthy and unhealthy eyes had a negative correlation with visual acuity of after treatment, r=-0.740(P<0.05). The different values of N1, T1 and T3 in healthy and unhealthy eyes also had a negative correlation with visual acuity of after treatment, r_N1=-0.692, r_T1=-0.754, r_T3=-0.657(P<0.05).

CONCLUSION: OCT examination has suggestive function for the recovery of patients with central retinal artery occlusion of visual acuity after-treatment.

Effect of soft corneal contact lens with different base curve on laser epithelial keratomileusis

Dong-Mei Ding — 2014/2/27 9:12:36

AIM: To explore the effect of soft corneal contact lens with different base curve on laser epithelial keratomileusis(LASEK).

METHEDS: Totally 186 cases(372 eyes)with myopia underwent LASEK surgery were divided into the observation group and the control group randomly, respectively wearing soft corneal lens -1.0D with 8.7mm and 8.5mm base curve. The comparison and observation were conducted in terms of corneal irritation at postoperative 1, 3 and 5d, the time of healing the epithelium and visual recovery in these two groups at 5d, the uncorrected visual acuity refraction at 1mo, and the degree of haze at 3mo.

RESULTS: Corneal irritation in the observation group was much better than that in the control group at postoperative 1, 3 and 5d, there was significant difference(P<0.05). There was significant difference in the healing of epithelium and uncorrected visual acuity at postoperative 5d, the difference was significant(P<0.05). There was no significant difference of the uncorrected visual acuity at postoperative 1mo(P>0.05), and there was no significant difference of haze at postoperative 3mo between two groups(P>0.05).

CONCLUSION: Wearing bigger base curve soft corneal contact lens is a safe and efficient method for LASEK than smaller with the advantages of having mild irritating symptom, a shorter time of healing the epithelium and the visual acuity.

Clinical significance of corneal refractive surgery for hyperopia anisometropia amblyopia in adults and adolescents

Ming-Hua Shi,Hai-Xiang Jiang,Xiao-Guang Niu,Jing Wang,Xu-Dong Li and Zhen Fang — 2014/2/27 9:12:36

AIM: To study the efficacy and safety of excimer laser corneal refractive surgery in treatment of hyperopic anisometropia amblyopia in adults and adolescents.

METHODS: From September 2010 to March 2013 in our hospital, 11 patients(16 eyes)with hyperopic anisometropia amblyopia were performed excimer laser corneal refractive surgery and followed up for 6mo or more, all patients age were 15 years or older. Uncorrected or best corrected visual acuity, cycloplegic refraction and stereoscopic before and after surgery were recorded. After surgery, all patients were asked if they feel visual quality was improved after surgery in everyday life and satisfied to the operation.

RESULTS: The average of 16 eyes cycloplegic refraction error(equivalent spherical)was from preoperative 5.76±1.71D reduced to postoperative 1.42±1.22D(t=13.6, P=0.00). The anisometropia of 11 patients was from preoperative 3.78±2.39D dropped to 1.14±1.50D after the operation(t=6.08, P=0.00). After surgery, the uncorrected visual acuity for distant from 0.35±0.27 rose to 0.45±0.29(t=-4.76, P<0.001); uncorrected visual acuity for near increased from 0.26±0.24 to 0.49±0.27(t=5.43, P=0.00). Preoperative worth four hole lamp examination 4 cases showed the amblyopic eye suppression. After surgery all of them were back to normal. Examined by Synoptophore, 6 cases had stereoscopisis before surgery and 10 cases after surgery. Tested by Titmus fly, the stereopsis improved significantly before and after surgery(t=-2.97, P=0.003). No obvious complications were observed during and after surgery. All patients argued of visual quality significantly improved and satisfaction to the surgery.

CONCLUSION: Excimer laser corneal refractive surgery for adults or older adolescent patients with hyperopic anisometropia amblyopiais is effective and safe, through the corrected visual acuity is improved limitedly, but the uncorrected visual acuity and stereopsis was improved obviously. This surgery improves patient visual quality and is worth to approach.

Clinical observation of changes of corneal endothelial cells before and after the cataract ultrasonic emulsification for diabetics

Chang Su and Dan Liu — 2014/1/20 9:29:55

AIM: To observe the influence on the corneal endothelial cells after the cataract ultrasonic emulsification combined with intraocular lens implantation in patients with diabetes.

METHODS:Diabetic group: 52 eyes from 39 cataract patients with diabetes. Control group: 33 eyes from 31 cataract patients without diabetes. The density and the percentage of hexagonal cells of the corneal endothelium were measured by corneal endothelial detector preoperatively and 1d, 1wk, 1mo after the surgery. The results were analyzed.

RESULTS:The density, ratio of hexagonal cells of the corneal endothelial cells were significantly lower than before(P<0.05)postoperative in two groups, there was no significant difference the two groups before treatment, but the corneal endothelium loss in diabetes group was more than those in control group at 1d after treatment(P<0.05). Diabetes group is divided into three groups according to age 50-60 years old, 61-70 years old,71-80 years old, the postoperative corneal endothelial cell loss had no statistical significance(P<0.05).

CONCLUSION: The cataract ultrasonic emulsification damages the corneal endothelium, and it is more easy to be damaged in diabetics. Diabetic corneal endothelial injury has nothing to do with age.

Treatment of epithelial herpes simplex viral keratitis by recombinant human interferon α-2b eye drops

Jin-Lan Wan and Bin Kang — 2014/1/20 9:29:55

AIM: To study the clinical effects of recombinant human interferonα-2b eye drops combined with ganciclovir ophthalmic gel on the treatment of epithelial herpes simplex viral keratitis(HSK).

METHODS: Totally 50 cases(50 eyes)with epithelial HSK diagnosed in Ophthalmology Department of Jingmen Traditional Chinese Medicine Hospital from April 2011 to October 2012 were enrolled. All the patients were divided into control group and experimental group randomly. Control group was treated by 1.5g/L ganciclovir ophthalmic gel, 6 times per day, while experimental group was treated by 1.5g/L ganciclovir ophthalmic gel combined with recombinant human interferon α-2b eye drops, 6 times per day. All patients were treated for 4 weeks. Then the therapeutic effects of two groups, including the cure rate, time of corneal ulcer healing, pain relief and vision improvement, were compared and analyzed.

RESULTS: No significant differences in general condition between two groups was detected before treatment(P>0.05).The therapeutic effects of experimental group was better than the control group. The cure rate was 69% for experimental group and 42% for control group. The clinical cure rate in experimental group was significantly higher than that of the control group, there was statistically significant difference between the two groups(P<0.05). The time for corneal ulcer healing and pain relief in experimental group was significantly shorter than that for the control group(P<0.05).

CONCLUSION: The application ofganciclovir ophthalmic gel combined with recombinant human interferon α-2b eye drops in epithelial herpes simplex viral keratitis, which improves visual acuity and the cure rate and shortens the course of disease, is the ideal treatment of epithelial herpes simplex viral keratitis at present.

Comparison of the one-site vs two-site phacotrabeculectomy in glaucoma and cataract patients

Li-Hua Hou,Xiao-Jian Cheng and Jian-Ying Du — 2014/1/20 9:29:55

AIM: To compare the effects of one-site vs two-site phacotrabeculectomy, intraocular lens implantation with trabeculectomy in the treatment of glaucoma with cataract.

METHODS: This prospective, randomized study including 60 patients(78 eyes)with glaucoma and cataract. One-site approach was performed in 31 patients(40 eyes)and two-site approach in 29 patients(38 eyes). Visual acuity, intraocular pressure(IOP), filtration, astigmatism and complications were observed at 2wk and 1mo after operation.

RESULTS: Postoperative visual acuitywas improved in 78 eyes. There was no significant difference of visual acuity between two groups at 2wk and 1mo after operation(P>0.05). The IOP at 2wk and 1mo after operation were lower than that of preoperation in two groups(P<0.05), and there was no significant difference between two groups(P>0.05). The number of eyes with functional filtration has no significant difference between two groups at 2wk and 1mo after operation(P>0.05); 2wk after operation, the astigmatism in one-site approach was bigger than preoperative astigmatism, also bigger than that of two-site approach(P<0.05), and there was no significant difference of astigmatism between two groups at 1mo after operation(P>0.05). There were 3 cases with few hemorrhage in anterior chamber after operation, 12 cases with slight corneal epithelial edema, descemet membrane folds, 6 cases with cellulose exudation in anterior chamber.

CONCLUSION: It is an ideal operation that two-site approachphacoemulsification and intraocular lens implantation combined with trabeculectomy in cataract and glaucoma patients, and has the advantages of simple operation, good treatment effect.

Study on the combined four-surgery of cataract-glaucoma in managing extremely shallow anterior chamber and sustained high intraocular pressure

Gui-Qiang Feng — 2014/1/20 9:29:55

AIM: To study the efficacy and safety of the combined four-surgery of vitreous humour extraction, phacoemulsification cataract, artificial lens implantation, and compound trabeculectomy in managing sustained high intraocular hypertension of acute angle-closure glaucoma.

METHODS: Retrospectively analyzed the post-operation result of 62 patients(62 eyes), consisting of 26 males(26 eyes)and 36 females(36 eyes), who were diagnosed as acute angle-closure glaucoma with anterior chamber depth of shallow class-I-IIa. Their IOP were greater than 40mmHg after 48-72h being dosed at the maximum. The patients were divided into two groups with their preoperative visual acuity. The combined four-surgery of vitreous humour extraction, phacoemulsification cataract, artificial lens implantation, and compound trabeculectomy were performed on 33 patients(33 eyes)in the experimental group, while the binary-sugery of anterior chamber paracentesis and compound trabeculectomy was performed on 29 patients(29 eyes)in the control group. Post-operative visual acuity, IOP, complications and filtering bleb were observed to compare the treatment results.

RESULTS: The high IOP of all eyes were controlled after surgeries. The IOP of the four-surgery group was obviously lower than the binary-surgery group after 1wk post the surgeries(P<0.05). Both groups were observed for 6mo. Post-operative visual acuity and complete success rate of the four-surgery were distinctly better than the binary-surgery, and no distinct difference was found in complications and filtering bleb occurrence(P>0.05).

CONCLUSION: The combined four-surgery of vitreous humour extraction, phacoemulsification cataract, artificial lens implantation, and compound trabeculectomy is safe and effective in managing acute angle-closure glaucoma with extremely shallow anterior chamber and sustained high IOP. Such surgeries should be actively performed on the patients with sustained high IOP to rescue their visual acuity.

Application and prognosis of inner limiting membrane peeling on macular hole

Xiao-Jin Fu — 2014/1/20 9:29:55

AIM: To investigate the effect of retinal inner limiting membrane peeling(ILMP)without staining on the vision and prognosis in idiopathic macular hole(IMH)patients.

METHODS: Totally 83 patients(83 eyes)with idiopathic macular hole in our hospital were selected and randomly divided into two groups according to the inner limiting membrane peeling approach. The 42 cases of A group underwent inner limiting membrane peeling stained with brilliant blue G(BBG), while the other 41 cases of B group received inner limiting membrane peeling without staining. And at the corresponding period, 40 patients without inner limiting membrane peeling was selected as the control group.

RESULTS: Patients were followed up for 6mo, the amount of cases with healed macular hole in the A and B group(41, 40 patients respectively)was larger than that of the control group(25 patients)(P<0.05); the visual acuity recovery in A and B group was significantly better than the control group(P<0.05); evaluated by multifocal ERG, the P1 response densities of ring 1 and 2 of first-order function were significantly higher(P<0.05)than the control group; operation time spent in inner limiting membrane peeling was longer for group A(234.7±9.2s)than group B(168.4±7.2s)(P<0.05).

CONCLUSION: Application ofvitrectomy without inner limiting membrane staining can achieve better visual functional recovery with less surgical time. Meanwhile, it avoids the retinal toxicity caused by coloring agent. It is worthy of wider promotion and application.

Clinical observation on intravitreous injection of Lucentis combined with argon laser photocoagulation for treatment of ischemic central retinal vein occlusion

Pu Wang,Yi-Qiao Xing and Zhen Chen — 2014/1/20 9:29:55

AIM: To evaluate the clinical effects of argon laser photocoagulation combined with intravitreous injection of Lucentis on ischemic central retinal vein occlusion(CRVO)associated with macular edema and neovascular retina.

METHODS: This retrospective study analyzed therapeutic effects of argon laser photocoagulation combined with intravitreous injection of Lucentis performed on 24 patients(24 eyes)with CRVO between January in 2012 and May in 2013. Observation was made in terms of clinical data including patients' best-corrected visual acuity, intraocular pressure, optical coherence tomography and fluoresce infundus angiography before treatment and 1wk, 1, 3, 6mo after treatment. Comparative analysis was made regarding the manifestations by fundus fluorescein angiography(FFA)and the changes of central macular retinal thickness central macular retinal thickness(CMT)by optical coherence tomography(OCT)before treatment and 1, 3, 6mo after treatment.

RESULTS: Followed for more than 6mo, 20 patients'(83%)best-corrected visual acuity were improved inordinately; 17 patients'(71%)macular edema was obviously alleviated or disappeared; 4 patients, visual acuities weren't improved. Iris neovascularization gradually disappeared after 1mo treatment and secondary neovascular glaucoma didn't occur in one patient.

CONCLUSION: Argon laser photocoagulation combined with intravitreous injection of Lucentis is an effective method to treat ischemic central retinal vein occlusion. It can improve visual acuity, promote the absorption of retinal hemorrhage, effusion and macular edema, reduce neovascularizations caused by CRVO and obviously prevent the occurrence of secondary neovascular glaucoma.

Clinical application of 23-gauge micro-invasive vitrectomy

Zhi-Guang Duan,Li-Yun Yu,Yin-Chao Chen,Yun-Qin Jia and Ni Mo — 2014/1/20 9:29:55

AIM: To investigate the application of 23-gauge trans-conjunctival sutureless vitrectomy system in the treatment of vitreoretinopathy disease and evaluate its therapeutic effect and complications.

METHODS: This retrospective study analyzed 46 patients(48 eyes)who were performed 23-gauge vitrectomy in this hospital from October 2011 to October 2013. Among all the eyes, idiopathic macular hole 8 appeared in eyes(16.7%), idiopathic macular epiretinal membrane presented in 5 eyes(10.4%), vitreous hemorrhage appeared in 19 eyes(39.6%); PDR(stage V-VI)occurred in 8 eyes(16.7%); and RRD 8 eyes(16.7%). Observation was made on intraocular pressure before and after surgery, surgical effects, surgical time, best corrected visual acuity, intraoperative and postoperative complications. The follow-up time lasted form 1-12mo.

RESULTS:All cases were successfully performed surgery and, there was no statistical difference in intraocular pressure between the two group(P>0.05)after measuring it pre-operatively, 1, 7d and 1mo after surgery at each group. The postoperative best corrected visual acuity were improved to some different degree. The differences between postoperative and preoperative BCVA were statistically significant(P<0.01). The surgery time was 70.12±7.86min; few complications appeared after surgery. The intraoperative complications included intubation tube slippage in 2 eyes, subconjunctival hemorrhage in 5 eyes and bubble under conjunctivain in 3 eyes. No serious post-operative complication was observed during the follow-up time in all cases.

CONCLUSION: 23-gauge trans-conjunctival sutureless vitrectomy has advantages including micro-invasive cut and short surgical time. Due to its quick postoperative recovery, good curative effect and rare complication, it is an effective and safe surgical technique in the management of vitreoretinopathy disease.

Comparative analysis of intraocular pressure in Uyghur and Han students by three types of tonometer

Ping Ma,Ying Zhu,Xue-Qing Liu,Er-Le Ge,Feng Ying and Ke-Lai A — 2014/1/20 9:29:55

AIM:To compare the intraocular pressure measurements of the college students of Uyghur and Han by Goldmann tonometer, non-contact tonometer and Schiotz tonometer.

METHODS:This cross-sectional study measured the intraocular pressure of college students of Uyghur and Han with Goldmann tonometer, non-contact tonometer and Schiotz tonometer respectively; comparison was made in the intraocular pressure measurements between the two races, between the two genders in the same race, and between the right and left eyes by three different ophthalmotonometers.

RESULTS: The differences in intraocular pressure measurements by the same tonometer between college students of Uyghur and Han were statistically significant(P<0.05); the differences in the measurements between different genders in one race by the same tonometer were not statistically significant(P>0.05); the differences in the measurements between the right and left eyes with the same tonometer were not statistically significant(P>0.05); the intraocular pressure measurements of college students of Han were higher than that of college students of Uyghur(P<0.05); measurements by non-contact tonometer were higher than those by Goldmann tonometer(P<0.05); measurements by non-contact tonometer were lower than those by Schiotz tonometer(P<0.05).

CONCLUSION: There are no differences in the measurements between the two genders and between the right and left eyes by the same tonometer; the measurements of college students of Han are higher than those of college students of Uyghur; measurements by Schiotz tonometer are significantly higher than those by non-contact tonometer; measurements by non-contact tonometer are higher than those by Goldmann tonometer.

Long-term effect of different incisions on the tear film after phacoemulsification

Ming-Hai Shen and Chuan-Kai Fang — 2014/1/20 9:29:56

AIM: To investigate the long-term effect of different incisions on the tear film after phacoemulsification.

METHODS: Sixty-four patients(76 eyes)without dry eyes were selected and received phacoemulsification. The patients were divided into two groups randomly. Group A 30 patients(38 eyes)was performed with a 2.5mm mini-incision coaxial phacoemulsification and group B 34 patients(38 eyes)was performed with a sub 1.8mm micro-incision cataract surgery(MICS). Schirmer I test(SⅠt), tear break-up time(BUT), corneal fluorescein staining(CFS)and tear osmolarity were observed at 3d preoperatively and 1wk, 1, 3, 6mo and 1a postoperatively. The results were analyzed using a chi-square test and t-test with SPSS 19.0.

RESULTS:(1)Schirmer Ⅰ test(SⅠt): there was a significant increase in SIt at 1wk postoperatively. The difference between group A and group B was significant(P<0.01)at 1wk postoperatively, but it was insignificant at other postoperative time points(P>0.05).(2)Tear break-up time(BUT): there was a large reduction in BUT at 1wk, 1, 3mo postoperatively. The difference between group A and group B was significant(P<0.05). However, there were no significant differences between the two groups at other times(P>0.05).(3)CFS score: there was a large increase in CFS at 1wk, 1, 3mo postoperatively. The difference between group A and group B was significant(P<0.05). However, there were no significant differences between the two groups at other times(P>0.05).(4)Tear osmolarity: there was a large increase in tear osmolarity at 1wk, 1mo postoperatively. The difference between group A and group B was significant(P<0.01). However, there were no significant differences between the two groups at other times(P>0.05).

CONCLUSION: The stability of tear film in patients underwent sub 1.8mm micro-incision cataract surgery(MICS)is much better than in patients received 2.5mm mini-incision coaxial phacoemulsification, but symptomys of dry eye in patients operated with MICS are much more serious during the early postoperative period. There is no significant difference in the long-term effects on tear film between the two types of incision.

Effects of sodium hyaluronate eye drops combined with deproteinized calfblood extract eye gel on tear film after vitrectomy

Xiao-Rui Liu and Hong-Wei Wang — 2014/1/20 9:29:56

AIM: To evaluate tear film recoveries and effects of sodium hyaluronate eye drops, deproteinized calf blood extract eye gel on tear film after vitrectomy.

METHODS: In 120 cases after vitrectomy, the patients were randomly divided into four groups, 30 cases for each group, group A were given the conventional medicine, group B in addition to conventional medicine, with sodium hyaluronate eye drops, group C in addition to conventional medicine, with deproteinized calf blood extract eye gel, group D in addition to conventional medicine with sodium hyaluronate eye drops and deproteinized calf blood extract eye gel. Tear break-up time(BUT), Schirmer I test(SⅠt)corneal fluorescein staining were measrued at 1d preoperatively plus 1, 3, 7, 14, 30d postoperatively. The results were analyzed statistically.

RESULTS:(1)Statistical significance was found in BUT, Sit at 1d preoperatively and 1, 3, 7, 14d postoperatively(P<0.01); BUT, ST recoveried original level 30d postoperatively.(2)All the four methods could recover fear film, but the result of group D was significantly better than other three groups.

CONCLUSION:Sodium hyaluronate eye drops combined with deproteinized calf blood extract eye gel as early as possible can accelerate the recovery of tear film after vitrectomy.

Analysis of related factors of corneal opacity after sub-Bowman keratomileusis by mechanical microkeratome

Zheng-Zai Hu,Si-Wen Zhang,Hong-Zhuan Ouyang and Lin Li — 2014/1/20 9:29:56

AIM: To provide a reference to improve postoperative effects by screening the related factors causing corneal opacity after sub-Bowman keratomileusis(SBK)by mechanical microkeratome.

METHODS: In this retrospective cases study, 896 eyes underwent sub-Bowman keratomileusis with and they were followed up for 3mo postoperatively. Record was made on whether the corneal opacity occurred. These eyes were divided into 2 groups corneal opacity group and clear cornea group. The gender, age, preoperative intraocular pressure(IOP), preoperative central cornea thickness(CCT), K1, K2, mean K, preoperative spherical equivalent(SE)were statistically analyzed.

RESULTS:There were 52 males and 48 females in haze group, mean age were(24.5±6.1)year, preoperative IOP were(14.26±2.24)mmHg, preoperative CCT were(487.37±18.52)μm, K₁, K₂, mean K were(44.24±1.23)D,(43.33±1.13)D,(43.79±1.15)D, respectively, preoperative SE were(-4.65±1.44)D. There were 412 males and 384 females in without haze group, mean age were(24.3±5.8)year, preoperative IOP were(16.72±7.01)mmHg, preoperative CCT were(533.11±28.74)μm, K₁, K₂, mean K were(43.90±1.47)D,(42.88±1.35)D,(43.39±1.37)D, respectively, preoperative SE were(-5.04±1.96)D. The difference of sex(χ²=0.002, P=0.964), age(t=0.404, P=0.686), preoperative SE(t=1.949, P=0.052)between the 2 groups were insignificant. The difference of preoperative IOP(t=-3.486, P=0.001), preoperative CCT(t=-15.543, P=0.000), K₁(t=2.249, P=0.025), K₂(t=3.172, P=0.002), mean K(t=2.763, P=0.006)between the two groups of haze after mechanical microkeratome SBK.

CONCLUSION: The incidence of corneal opacity is high in patients with thin preoperative CCT, low IOP and high corneal curvature after SBK surgery by microkeratome. Gender, age and preoperative spherical equivalent are not related to the incidence of corneal opacity after SBK surgery.

Effect of different diameters corneal epithelial trephine on laser epithelium keratomileusis

Dong-Mei Ding — 2014/1/20 9:29:56

AIM: To explore the effect of different diameters corneal epithelial trephine on laser epithelium keratomileusis

METHEDS: 264 cases(528 eyes)with myopia were divided into the observed group and the control group randomly, then underwent LASEK surgery using 7mm and 8mm diameters corneal epithelial trephine respectively to make corneal epithelial flap. The comparisons between groups were conducted in terms of corneal irritation, the time of the epithelium healing at 1, 3, 5d, visual recovery at 1mo, and the degree of haze at 3mo.

RESULTS: Corneal irritation at postoperative 1, 3, 5d and the epithelium healing at postoperative 5d in the observed group was much better than that in the control group, there was significant difference(P<0.05). There was no significant difference in visual recovery at 1mo and haze at 3mo between two groups(P>0.05).

CONCLUSION: LASEK with the smaller diameter corneal epithelial trephine is a safe and efficient method to correct myopia than with the bigger diameter with the advantages of having milder irritating symptom, a shorter time of the epithelium healing and the visual recovery.

Modified Zhujing Formula combined with Lucentis in treating macula hemorrhage of pathological myopia

2014/1/20 9:29:56

AIM: To investigate the clinical effect of Modified Zhujing Formula combined with Lucentis on treating macular hemorrhage of pathological myopia.

METHODS: Forty-two patients(42 eyes)were divided into 2 groups:Modified Zhu Jing Formula group, 25 cases(25 eyes), were treated with Modified Zhu Jing Formula, and combined treatment group administrated Modified Zhu Jing Formula with intravitreal Lucentis injection(17 eyes in 17 cases). Central retinal thickness was measured by optical coherence tomography before and after the treatment. Three months after the treatment, the therapeutic effect was observed.

RESULTS: Three months after the treatment, the total effective rate of combined treatment group was 82%, while that of Modified Zhu Jing Formula group was 60%. The total effective rate of fundus hemorrhage absorption for combined treatment group was 88%, while that of Modified Zhu Jing Formula group was 64%. In terms of reducing central retinal thickness, the difference between pre-treatment and post-treatment for each group and the difference between two groups were both significant(P<0.05).

CONCLUSION: Modified Zhu Jing Formula can slow down disease progression, decrease recurrent risk and improve patients' vision.

Analysis of optical coherence tomography in the determination of refractory amblyopia macular retinal thickness and optic disc

Zhao-Xi Ou,Guang-Hui Zhang and Yu-Zhu Yang — 2014/1/20 9:29:56

AIM: To investigate the variation in retinal nerve fiber layer(RNFL)thickness and macular thickness of children with refractory amblyopia by using optical coherence tomography(OCT). The aim was to understand the refractory retinal morphology and its variation law of amblyopia thus inferred the peripheral pathogenesis in refractory amblyopia children.

METHODS: Each group included 30 eyes from refractory amblyopia group(group A), non-refractory amblyopia group(group B)and normal children's group(group C). The average thickness in nasal, superior, temporal and inferior retinal thickness of macular fovea, the central area(diameter≤1mm), macular parafovea(1mmRESULTS: The retina thickness at the superior was thickest, and the inferior and nasal sides ofparafovea were thicker than the temporal. After comparing the retinal thickness of macular fovea, the central area(diameter≤1mm), we found that group A was thicker than group B, group A was thicker than group C and group B was thicker than group C, and the thickness differences were statistical significance(P<0.05). After comparing the average values in nasal, superior, temporal and inferior retinal thickness of macular parafovea, we found that there was no statistical significance(P>0.05). In group C, the superior RNFL thickness was the thickest, followed by the inferior and then the temporal, the nasal was the thinnest, but in group A and group B, the superior and inferior RNFL thickness were similar, the nasal and temporal were also similar but were thinner than the superior and inferior. The nasal and inferior RNFL thickness of group A were significantly thicker than group C(P<0.05), and the temporal and superior RNFL thickness compared with group C had no statistical significance(P>0.05). Although the average values in RNFL thickness were thicker than group C, there was no statistical significance(P>0.05). In group A and group B, the superior, inferior, nasal, temporal and the average values in RNFL thickness were all similar, there was no statistical significance(P>0.05).

CONCLUSION: The dysplasia of macular fovea and the central area maybe one of the causes on refractory amblyopia. The macular parafover, outside the macular parafover and peripapillary RNFL are not involved, this shows that these regions may not participate in the occurrence of amblyopia.

Optic radiation alterations in the treatment of monocular amblyopia: a diffusion tensor imaging study

Jin Wu,Hong-Wu Zeng,Dian-Gang Fang,Hui Zhong and Yue-Li Zhang — 2014/1/20 9:29:56

AIM: To investigate the alterations of optic radiations(ORs)in monocular amblyopic children underwent treatment by using diffusion tensor imaging(DTI),and to explore its underlying neuromechanism.

METHODS: Eighteen children with anisometropic amblyopia(all left eyes)were recruited for amblyopia therapy. DTI data of ORs were acquired for each patient twice: before and after 9mo amblyopia therapy. The fractional anisotropy(FA)values and apparent diffusion coefficient(ADC)values were campared between the previous and posterior scans.

RESULTS: On both sides of ORs, the FA values of posterior therapy were higher than those of previous therapy(P<0.05), while the ADC values of posterior therapy were lower than those of previous therapy(P<0.05). The alterations of FA values and ADC values of ORs on the right side were greater than those of ORs on the left side after therapy(P<0.05).

CONCLUSION: Both sides of ORs in monocular amblyopic children are modified to varying degrees after myopia therapy.

Clinical study on phacoemulsification combined with post chamber intraocular lens implantations for acute angle-closure glaucoma

De-Yong Deng,Dan-Dan Yu,Tao Peng and Mei-Na Xie — 2013/12/23 10:55:37

AIM: To investigate the clinical effects of phacoemulsification combined with post chamber intraocular lens(PC-IOL)implantations for primary acute angle-closure glaucoma.

METHODS: The clinical data of 87 cases(92 eyes)with primary acute angle-closure glaucoma complicated with cataract of which intraocular pressure(IOP)over 45.0mmHg were collected. Phacoemulsification and PC-IOL implantations were performed for 60 eyes which IOP was controlled to 25.0mmHg below by general and topic medical management. IOP of 25 eyes was over 30.0mmHg and the depth of anterior chamber was well, puncture of anterior chamber was performed to decrease the IOP. Then 1 day to 2 days later, phacoemulsification, PC-IOL implantations and goniosynechialysis were performed. IOP of 7 eyes were still over 35.0mmHg with shallow of anterior chamber, phacoemulsification and PC-IOL implantation combined with goniosynechialysis and paracentesis anterior chamber were performed after vitreous aspiration and puncture of anterior chamber. IOP, visual acuity, surgery complications, central anterior chamber depth and gonioscopie findings before and post operation were recorded and analyzed.

RESULTS: The IOP of all cases was controlled under 20.0mmHg during the follow-up 6 months to 2 years. 2% carteolol hydrochloride only need for two cases after 6 months. The visual acuity were improved for most cases, the visual acuity were better than 0.3 of 65 eyes post-operation while all were lower than 0.3 pre-operation. The depth of anterior chamber was deeper in all cases and the anterior chamber angle opening range was more than 180 degree in 87 eyes. More than 60 cases suffered the complications of anterior chamber inflammation and 16 cases anterior fibrinous exudates.

CONCLUSION: Phacoemulsification is safe and effective in management of primary acute angle-closure glaucoma complicated with cataract. Goniosynechialysis, paracentesis anterior chamber and vitreous aspirations were benefit for the patient whose IOP was uncontrolled before surgery.

Observation of curative effect of Acrysof Toric intraocular lens in cataract patients with corneal astigmatism

Lin-Yi Luo,Min-Yu Chen and Ying-Xu Zhang — 2013/12/23 10:55:38

AIM: To observe the visual quality and capsular stability after implantation ofAcrysof Toric intraocular lens(IOL)in cataract patients with corneal astigmatism.

METHODS: Totally 20 patients 23 eyes were implanted with the Acrysof Toric IOL between April 2010 and April 2012. All the patients were followed up for 12 months. The pre and post-operative uncorrected visual acuity(UCVA), preoperative corneal astigmatism, postoperative residual astigmatism, IOL axis, IOL decentration, IOL tilt and the capsule were detected and measured.

RESULTS: After 12 months, UCVA was ≥0.6 in 23 eyes(100%); ≥0.8 in 17 eyes(74%). The mean preoperative corneal astigmatism was(2.31±0.70)D and the postoperative refractive cylinder was(0.43±0.28)D, which was statistically significance(P=0.00). The mean rotation of Toric IOL in 17 eyes(74%)was(4.98±0.25)°, of which 2 cases' rotation was >10°, the maximum was 12.9°. IOL decentration was in 11 eyes(48%)in which 7 eyes(30%)<0.5mm, 0.5mm≤3 eyes(13%)≤1mm, 1 eye(4%)=1.1mm. 20 eyes(87%)was not tilted while 3 eyes(13%)was tilted an less than 5°.

CONCLUSION: Implantation of theAcrysof Toric IOL proves to be an effective, safe, and stable method of managing corneal astigmatism in cataract patients and provides patients with good visual quality. The Acrysof Toric IOL demonstrates excellent rotation and centration stability.

Clinical observation of scleral fixation posterior chamber intraocular lens implantation

Yong-Qing Dai,Jie He,Hai-Jun Li and Ya-Jun Yang — 2013/12/23 10:55:38

AIM: To observe the effect of scleral fixation posterior chamber intraocular lens implantation in the treatment of aphakia without capsule supporting after vitrectomy.

METHODS: A retrospective analysis was conducted in 14 patients(14 eyes)who had scleral fixation posterior chamber intraocular lens implantation. Loops of the three-piece foldable intraocular lens were lead from incisions beneath the scleral flap at 2 and 8 o'clock part from the corneal limbus 1.5mm and it was fixed in the pre-made scleral tunnels. Finally, scleral flap were sutured so as to cover the punctures and loops.

RESULTS: Fourteen patients were successfully implanted intraocular lens. Follow-up from 6 to 12 months, all patients received the improved visual acuity, stable IOL position, normal intraocular pressure and no other complications.

CONCLUSION: Scleral fixation posterior chamber intraocular lens implantation is a safe, simple, effective method to treat aphakia without capsule supporting after vitrectomy and worthy further observation and practice.

Surgery of cataract combined with glaucoma in management of glaucoma complicated cataract

Rui Yin,An-Zhen Mao and Xian-Hua Xie — 2013/12/23 10:55:38

AIM: To investigate the clinical effects of phacoemulsification with intraocular lens implantation and trabeculectomy in management of acute angle-closure glaucoma patients with cataract.

METHODS: Twenty-six cases(26 eyes)with acute angle-closure glaucoma patients with senile cataract all underwent phacoemulsification with intraocular lens implantation and trabeculectomy, the visual acuity, intraocular pressure and anterior chamber depth variation and postoperative bleb morphology, postoperative complications were observed.

RESULTS: Six months after operation, the visual acuity of 14 patients were ≥0.5 and 10 patients were from 0.12 to 0.4, which were improved significantly compared with preoperative, the differences were significantly(P<0.05); the mean intraocular pressure in postoperative 1 week, 3 months and 6 months were respectively 12.5±1.2mmHg, 14.3±1.5mmHg and 14.6±1.3mmHg respectively, which were lowered compared with the preoperative intraocular pressure, the differences were statistically significantly(P<0.05). The postoperative central anterior chamber depth was significantly deepened and functional diffuse blebs were formed. The main complications were corneal edema and anterior chamber inflammation.

CONCLUSION: Phacoemulsification and intraocular lens implantation and trabeculectomy in management of acute angle-closure glaucoma with senile cataract is safe and effective with minor postoperative complications, which deserves clinical application and recommendation.

Clinical application of stopping and chopping method with manual nucleus extraction in hard nucleus cataract

Shao-Xin Pan,Jing Tian,Feng Fan and Xiao-Hong Wang — 2013/12/23 10:55:38

AIM: To observe the clinical effect of stopping and chopping method with manual nucleus extraction in hard nucleus cataract, and also discuss the surgical skills.

METHODS: Totally 50 cases(50 eyes)of age-related cataract with above IV grade hard nucleus were randomly divided into two groups, 30 cases(30 eyes)were in observe group which was performed by stopping and chopping method combined with manual nucleus extraction and 20 cases(20 eyes)underwent phacoemulsification as control group, intraocular lenses implantation was performed in two groups. The processing time of nucleus, operative complications, postoperative visual acuity, the condition of corneal edema, intraocular pressure and corneal endothelial cells were observed.

RESULTS: The processing time of nucleus of observe group and control group was 60±10s, 90±15s, respectively(P<0.05). Operative complications of the observe group, which were the incidence of posterior capsular rupture, the reaction of corneal edema and the damage of corneal endothelial cells, was less than control group and no statistical significance(P<0.05). The difference of postoperative visual acuity and intraocular pressure was not obvious in two groups.

CONCLUSION: Stopping and chopping method combined with manual nucleus extraction in hard nucleus cataract has many virtues of security, faster visual recovery and less complications.It is one of the ideal treatment of age-related cataract with above IV grade hard nucleus.

Application of phacoemulsification in treating angle-closure glaucoma and primary angle closure patients with cataract

Xiao-Jing Zhao — 2013/12/23 10:55:38

AIM: To study the application value of phacoemulsification in treating angle-closure glaucoma and primary angle closure patients with cataract.

METHODS: Angle-closure glaucoma patients with cataract and primary angle closure patients were collected as research objects and given phacoemulsification combined with intraocular lens implantation for treatment. Then the preoperative and postoperative mean value of visual acuity,intraocular pressure and astigmatism and postoperative complication of treated eyes were observed.

RESULTS: The average visual acuity of treated eyes recovered from(0.15±0.02)to(0.48±0.13); the average intraocular pressure was dropped from(23.29±4.83)mmHg to(18.34±2.31)mmHg; astigmatism was dropped from(1.14±0.15)DC to(0.53±0.06)DC. As to postoperative complications, the occurrence rate of corneal edema, posterior capsular opacification and fibrous exudation in anterior chamber was 2.5%, 3.4 and 5.1%, respectively.

CONCLUSION: Phacoemulsification can effectively improve intraocular pressure and visual acuity,which has positive therapeutic significances in treating angle-closure glaucoma and primary angle closure.

Bacterial culture result in conjunctival sacs of cataract patients before cataract surgery in China: a Meta-analysis

Huan-Huan Xu,Ying-Ying Cheng,Chang-Lin Zhao,Chun-Yan Xue and Zhen-Ping Huang — 2013/12/23 10:55:38

ATM: To analyze the result of bacterial culture and antibiotics sensitivity tests in conjunctival sacs of cataract patients in China before operation, so as to provide theoretical evidence for aseptic preparation of cataract surgery.

METHODS: Database including the VIP Database for Chinese Technical periodicals, Wanfang database, CNKI and CBM Disc were searched to collect the relevant articles about bacterial culture and antibiotics sensitivity tests in conjunctival sacs of cataract patients in China before operation. The relative factors were analyzed by Meta-analysis.

RESULTS: A total of 7 reports with 11499 eyes were selected. The number of positive specimens of bacterial culture in non-infectious cataract patients before operation was 2993(26.03%)from 11499 specimens G⁺ C(86.40%), G⁺ B(8.10%), G^-B(4.13%)and G^-C(1.37%)constituted predominant bacteria in the conjunctive sac of cataract patients in China before operation, mainly staphylococcous epidermidis(67.30%), staphylococcous aureus(12.53%)and micrococcus(6.98%). Most of them were susceptible to tobramycin, vancocin, ciprofloxacin and gentamycin, and improved the tolerance of tobramycin and ciprofloxacin.

CONCLUSION: Staphylococcous epidermidis is the most frequent bacteria isolated in the conjunctival sac of eyes before cataract surgery. Most of themare susceptible to tobramycin, vancocin, ciprofloxacin and gentamycin, and improve the tolerance of tobramycin and ciprofloxacin.

Clinical study on residual triamcinolone acetonide in the treatment of idiopathic macular hole and lessening of tissue edema

Hong-Yan Du,Zhi-Min Qian,Zhong-Ying Wang,Li-Na Zhang and Lan-Gen Li — 2013/12/23 10:55:38

AIM: To evaluate the clinical effects of residual triamcinolone acetonide(TA)on the treatment of idiopathic macular hole(IMH)and lessening of tissue edema.

METHODS: A total of 32 patients(32 eyes)underwent closed vitrectomy. During the operation, TA was applied to 16 eyes of experimental group to assist internal limiting membrane peeling. A small amount of TA was left at the bottom of the macular hole. The others eyes of control group didn't use TA to assist internal limiting membrane peeling. Anatomical reduction, postoperative BCVA and macular hole index(MHI)were recorded and the statistical analysis was made.

RESULTS:All the macular holes reached the anatomical reduction after operation, the closing rate was 100%. Postoperative BCVA of the two groups were improved(P=0.000). The visual improvement between the two groups had no statistical significance(P>0.05). There is a positive correlation between postoperative BCVA and MHI, and there is no correlation between postoperative BCVA and the hole degree. The operation time in experimental group was shorter than in control group. No serious complications occurred in both groups.

CONCLUSION:Intraoperative application of TA was helpful for peeling off internal limiting membrane. Residual TA has no influence on the treatment of idiopathic macular hole or lessening of tissue edema. The MHI can be easily calculated to be used as a clinical index for visual acuity. It is an effective technique with no serious side effects.

Effect of vitreoretina surgery on corneal endothelial cell in diabetics patients

Yun-Fei Li,Yi-Xia Zhang and Hai-Dong Lian — 2013/12/23 10:55:38

AIM: To explore the effects of vitreoretinal surgery in diabetics and non-diabetic patients on corneal endothelial cell density and morphology.

METHODS:Sixty patients with diabetes(diabetic group)and 60 non-diabetic patients(control group)was collected, of which 30 cases of diabetic group and 30 cases in the control group underwent vitrectomy combined with silicone oil tamponade surgery, 30 cases of diabetic patients and 30 control patients(lenticular vitreoretinal combined with silicone oil tamponade surgery). To detect the corneal endothelial cell density(CD), coefficient of variation of endothelial cell area(CV), percentage of hexagonal cells(RHC)of two groups of patients 1 day before surgery and three months after surgery. The differences of two groups were compared before and after surgery in corneal endothelial cell changes.

RESULTS: After vitrectomy combined with silicone oil surgery, there were significant differences on the coefficient of variation of corneal endothelial cells and the percentage of hexagonal cells between the diabetic and control groups. In the diabetic and control groups, obvious differences were also found in corneal endothelial cell density, coefficient of variation and the percentage of hexagonal cells after lenticular vitreoretinal combined with silicone oil tamponade surgery. The different values for groups of diabetic and non-diabetic all were statistically significant in corneal endothelial cell density, coefficient of variation and the percentage of hexagonal cells before and after surgery.

CONCLUSION: The effects of vitrectomy combined with silicone oil tamponade surgery on cornea endothelial cell were mainly reflected on changes of corneal topography. Compared with the non-diabetic group, the changes in corneal endothelial cell shape and destiny of diabetic patients underwent lenticular vitrectomy with silicone oil tamponade surgery are more evidently. Therefore, the strict examination of preoperative corneal endothelial cell has important significant for diabetic patients postoperative visual recovery.

Investigation of mfERG and retinal thickness in fovea of NPDR without macular edema

Zhe Yuan,Li-Min Liu,Lei Liu,Rui Hua and Lei Chen — 2013/12/23 10:55:38

AIM: To analyze the relationship between retinal function and retinal thickness in fovea in the patients of nonproliferative diabetic retinopathy(NPDR)without macular edema.

METHODS:Multifocal electronic retinography(mfERG)and Spectralis optical coherence tomography(Spectralis OCT)examination were performed in 35 eyes of 20 NPDR patients without macular edema. Twenty eyes of 19 normal subjects underwent the mfERG and 15 eyes of 10 normal subjects underwent Spectralis OCT.

RESULTS: Compared with normal group, the response densities P1 wave in Ring1 decreased and the change of latency of P1 wave and N1 wave had no statistical significance(P<0.05). The retinal and neurosensory retinal thickness in fovea were thicker than normal.

CONCLUSION:The application of mfERG can detect the abnormal changes in retina without obvious structural changes, Spectralis OCT can measure the thickness of retinal layers, reflect the changes of retinal fine structure, and identify the abnormal changes of retinal structure. The associated examination of these two instruments offered available evidences in detecting visual function change in early DR, and offer information for therapy in time.

Clinical analysis of complications after vitrectomy

Yu-Qing Wang,Yan-Ping Song,Zhao-De Zhang,Wen-Ya Lin and Han-Feng Tang — 2013/12/23 10:55:38

AIM: With the advancement of pars plana vitrectomy, especially the intraocular application of inert gases and silicone oil, many serious vitreoretinal diseases, such as vitreous hemorrhage, endophthalmitis, proliferative diabetic retinopathy etc. have received effective treatment. But it is undeniable that there are many complications after vitrectomy that have seriously affected patients' vision recovery. The aim of this study is to observe the incidence and pathogenesis of various complications after vitrectomy to provide some clinical references to avoid and reduce the incidence of complications.

METHODS: This paper retrospectively analyzed records of 200 cases that underwent vitrectomy operated by the same surgeon. Inert gasesor silicone oil was filled accordingly. According to filling agent, patients were divided into simple vitrectomy group, inert-gas tamponade group and silicon-oil tamponade group; according to ocular hypertension onset, patients were divided into normal intraocular pressure group and ocular hypertension group; according to age, patients were divided into ≥50 group and <50 group. Relative analysis was made on the incidence, dangerous factors and management of complications in each group after vitrectomy.

RESULTS: According to the study, the major postoperative complications of vitrectomy were increase of introculr tension, secondary glaucoma, corneal diseases, complicated cataract, vitreous hemorrhage, retinal detachment, iatrogenic retinal hole, fibrin formation in anterior chamber, choroid and ciliary body detachment, and so on. According to statistical analysis of data of this group, it was believed that there were obvious differences among simple vitrectomy group, inert-gas tamponade group, silicon-oil tamponade group in postoperative complications. The postoperative incidence of increase of introculr tension and secondary glaucoma in inert-gas tamponade group and silicon-oil tamponade group were obviously higher than that in simple vitrectomy group. What's more, in inert-gas tamponade group, the postoperative incidence of ocular hypertension was much higher. The postoperative incidence of corneal complications and complicated cataract in inert-gas tamponade group and silicon-oil tamponade group were obviously higher than that in simple vitrectomy group and closely correlated with postoperative ocular hypertension. There were no distinct differences among every group in vitreous hemorrhage, iatrogenic retinal hole and retinal detachment, fibrin formation in anterior chamber, choroid and ciliary body detachment.

CONCLUSION:Vitrectomy is an important and effective treatment method for serious vitreoretinal diseases and most patients have obtained different visual improvement after the surgery. But postoperative complications seriously affect postoperative effect. The key to the success of vitreous retinal surgery in the future is that how to improve surgical techniques to avoid, reduce and timely dispose postoperative complications. It is also the emphasis of research of vitrectomy which deserves more exploration and research.

Related factors analysis of type 2 diabetic patients with dry eye

Cheng Liu — 2013/12/23 10:55:38

AIM: To analyze dry eye conditions of type 2 diabetes and its related factors.

METHODS: Totally 45 patients(90 eyes)with type 2 diabetes and 40 patients(80 eyes)non-diabetic patients were chosen for this study. Tear film break-up time, Schirmer test, and corneal fluorescein staining differences between indicators and its related factors were analyzed.

RESULTS:In diabetes group, the mean tear film break-up time was 6.23±2.36s, significantly shorter than that of the control group; Schirmer infiltration experiments average length of filter strips was 8.65±3.82mm, significantly lower than that of the control group; corneal fluorescein staining score was 1.89±1.31points, significantly higher. The incidence rate of dry eye was 58%, was significantly higher, the difference had statistically significant(P<0.05). The results of Logistic Multivariate analysis showed that basal secretion of tear volume and tear film break-up time were risk factors for type 2 diabetic patients with dry eye.

CONCLUSION: In type 2 diabetes patients, the tear film breakup time is shortened, and the basal tear secretion is decreased corneal fluorescein staining score increased.Basal secretion of tear volume and tear film break-up time was risk factors for type 2 diabetic patients with dry eye.

Clinical observation of pathological changes of Stargardt disease by fundus autofluorescence with spectral domain optical coherence tomography

Zheng Fu and Song-Jian Gong — 2013/12/23 10:55:39

AIM: To analyze clinical features of Stargardt disease by fundus autofluorescence(FAF)and observe microstructural changes of the retina by frequency-domain optical coherence tomography(Spectralis OCT)to explore the clinical value of combined FAF and OCT in diagnosis of Stargardt's disease.

METHODS:Non-interventional observation study. Confocal scanning laser ophthalmoscope(Heidelberg, Germany Company)was applied on 9 patients(18 eyes)with Stargardt disease for blue autofluorescence(BL-FAF, excitation 488nm, filter >500nm), Spectralis OCT examination, fundus photography, mfERG examination and fundus fluorescein angiography(FFA)examination. Seven cases also received indocyanine green angiography(ICGA)inspection. The study analyzed distribution characteristics of Stargardt's disease under FAF examination and microstructural changes of the retina under Spectralis OCT.

RESULTS:The BL-FAF of the oval macular lesions presented low fluorescence and visible edge demonstrated varying thickness and strong fluorescence. OCT showed retinal pigment epithelial lesions(RPE), photoreceptors(PR)atrophy and neurosensory meager. Under FFA examination, scattered point-like fluorescence could be seen in the early stage, and macular atrophy tumor size appears consistent with the bull's-eye fluorescence could be seen in the late stage. The disease demonstrated choriocapillaris atrophy in the late stage under ICGA examination. New vessels could be seen in rare cases.

CONCLUSION: FAF with Spectralis OCT and mf-ERG is an effective non-invasive examination methods for diagnosis of Stargardt disease. Changes of its clinical characteristics might suggest degeneration of both RPE and PR and various pathological and physiological changes of lipofuscin.

Study on the compensation effect of internal higher-order aberrations on corneal higher-order aberrations in myopia

Dai-Jin Ma,Rui-Ling Zhu and Wang Cai — 2013/12/23 10:55:39

AIM: To investigate the compensation effects of internal higher-order aberrations(HOAs)on the corneal HOAs in youth with low and moderate myopia.

METHODS: Seventy-six myopic patients(152 eyes)who received corneal refractive surgery from April to May in 2012 were included in this study. The HOAs of the anterior corneal surface and the total ocular HOAs(3-6 stage)ocular were measured using OPD Scan ARK-10 000. The root mean square values(RMS)of total HOAs, total coma(TC), total trefoil(TT)and total spherical aberration(TS)and Zernike terms of Z₃^-1, Z₃¹, Z₃^-3, Z₃³, Z₄⁰ of a pupil with a diameter of 6mm were recorded to calculate the compensation factor.

RESULTS: The corneal spherical aberration were positive in all eyes, but ocular spherical aberration were negative in 33 eyes(21.7%); The RMS values of corneal TC and Zernike terms of corneal Z₃^-1, Z₃¹ were smaller than the ocular aberration. and their CFs were negative; The RMS values of corneal HOAs, TT, TS and Zernike terms of corneal Z₃^-3, Z₃³, Z₄⁰ were higher than the ocular aberration and their CFs were positive.

CONCLUSION: Theintraocular HOAs mainly manifest compensation effect on the HOAs of the cornea; The intraocular spherical aberration compensates for the spherical aberration of cornea,which can reduce the ocular spherical aberration; The effects of intraocular coma and trefoil on corneal higher order aberrations vary widely and show partial compensation, overcompensation and superposition among subjects. The main role of coma is superposition, while that of trefoil mainly manifest as compensation action.

Observation on the effectiveness and safety of 102 juvenile myopia patients wearing orthokeratology

Li-Jiao Wei,Xiang-Yong Xie,Bi-Hua He and Zi-Ang Cheng — 2013/12/23 10:55:39

AIM: To observe the effectiveness and safety of orthokeratology in juvenile myopia patients.

METHODS: There were 204 eyes of 102 myopic patients, whose average diopter was -3.36±1.07D(spherical equivalent). The changes of mean myopia diopter, uncorrected visual acuity(UCVA), axial length, corneal thickness, visual quality and complications during two years of receiving orthokeratology treatment by the way of clinical diagnosis, general examination, slit lamp examination and corneal thickness examination were observed.

RESULTS: After receiving orthokeratology treatment for half a year, one year and two years, the naked vision and the mean myopia diopter had significant difference(P<0.05), the mean myopia diopter of all patients were decreased, and their naked vision were improve. There was no significant difference in corneal thickness and axial length(P>0.05). The corneal of patients were in good health. Discomfort symptoms due to wearing glasses can disappear after reasonable medication and adjustments with the glasses lenses.

CONCLUSION: Orthokeratology is a kind of method of effectively correcting eyesight and controlling growth of myopia. In the premise of security products, standard processes, qualified fitting technology and rigorous review, Long-term wearing orthokeratology lens is safe.

Clinical study of changes on macular retinal thickness after LASIK in myopia

Rong Di,Wen-Juan Zhuang,Xue-Qiu Yang,Shan-Shan Li and Jing-Jing Zhao — 2013/12/23 10:55:39

AIM: To investigate the changes of macular retinal thickness after laser in situ keratomileusis(LASIK)in myopia.

METHODS: Totally 138 eyes of 69 patients who underwent LASIK were recruited randomly. The average macular retinal thickness, and volume of nine zones which were the areas of 0.5mm diameter around the macular fovea, the superior, nasal lateral, anterior and bitamporal lateral of 1.5mm and 3mm diameter around from it, were measured pre-operatively and at 1 day, 1 week, 1 month, 3 and 6 months postoperatively by the use of optical coherence tomography(OCT).

RESULTS:Compared with pre-operation, the retinal thickness and volume of 1.5mm diameter around the macular fovea areas(A1, A2, A3, A4)was lower at 1 day, 1 week, and was no obvious difference on 1 month, 3 and 6 months after operation; the areas of 0.5mm(A0)and 3mm(A5, A6, A7, A8)diameter around the macular fovea was no obvious difference at 1 day, 1 month, 3 and 6 months.

CONCIUSION: The changes on part of macular retinal thickness are mild reversible in LASIK surgery.

Observation on the efficacy of vitrectomy with laser for proliferative diabetic retinopathy

Yu-Hong Gu,Zuo-Ren Zhang and Bin Chen — 2013/12/23 10:55:39

AIM: To probe into the clinical application value of vitrectomy with laser in treatment of proliferative diabetic retinopathy.

METHODS: Totally 89 patients(116 eyes)with proliferative diabetic retinopathy in our hospital were selected from March 2009 to March 2010. The patients were divided into control group(47 cases, 62 eyes)and study group(42 cases, 54 eyes)randomly. The patients in control group were treated with vitrectomy. The patients in study group were treated with vitrectomy combined with eye laser. The best-corrected visual acuity(BCVA)and FFA results of the patients before and after treatment, and occurrence of complications after treatment of the patients in two groups were compared and analyzed.

RESULTS: After treatment, the proportion of patients with best-corrected visual acuity <0.1 was reduced significantly in both groups(P<0.05), which were 40% and 28%, respectively. And the proportion of patients with a BCVA ranging from 0.5 to 1.0 was also improved significantly(P<0.05), which reached 24% and 41%, respectively. Compared with control group, the patients in study group after treatment, the rate of BCVA ranging from 0.5 to 1.0 was improved significantly, so did the rates of comprehensive regression of macular edema and partial regression of macular edema. While the rates of macular edema aggravation, retinal leakage and recurrence of vitreous bleeding were reduced significantly, the differences above were statistically significant(P<0.05).

CONCLUSION:Vitrectomy combined with laser treatment is an effective method for patients with proliferative diabetic retinopathy. It has a positive promoting role in improving postoperative visual acuity and reducing the occurrence of complications.

Study on the effects of Augentropfen Stulln Mono eye-drops on the tear dynamics of dry eyes after excimer laser surgery

Chen-Chen Xu,Ying-Ying Xu,Wen-Jia Xie,Qin-Mei Wang and Mei-Xiao Shen — 2013/12/23 10:55:39

AIM: To observe the change of tear meniscus measured by OCT to determine the effects of Augentropfen Stulln Mono eye-drops on the tear dynamics of dry eyes after and to evaluate its efficacy and persistence in treating dry eye.

METHODS: A total of 25 patients, average age being 28.60±3.77, after excimer laser surgery(more than 6 months)were selected in the study. All patients had complications such as dry and sore eye and the tear break-up times(BUT)were less than 5s. The right eyes in the experimental group were given Augentropfen Stulln Mono eye-drop and the left eyes in the control group were given 0.9% normal saline. The heights and cross-sectional areas of the upper and lower tear menisci were measured by OCT before drop instillation and at 10min, 20min and 30min after drop instillation. Differences in each eye at different times were analyzed by one-way variance and compared by sample T test.

RESULTS: The lower tear meniscus cross-sectional area(t=2.835, P=0.009)at 20min after drop instillation, and the upper tear meniscus height(UTMH)(t=2.368, P=0.026), upper tear meniscus cross-sectional area(UTMA)(t=4.293, P=0.000), lower tear meniscus height(LTMH)(t=3.060, P=0.005)and lower tear meniscus cross-sectional area(LTMA)(t=2.644, P=0.014)at 30min after drop instillation in the experimental group were significantly larger than that in the control group with no statistical differences. There were no statistically significant differences in upper and lower tear meniscus heights and cross-sectional areas between two groups before and after taking drugs(P>0.05), however, there was a trend of increase after treatment in the experimental group.

CONCLUSION:Augentropfen Stulln Mono eye-drops can increase the volumes of upper and lower tear meniscus in patients with dry eyes after operation to some degree, and can maintain effects in a relatively long time period.

Clinical reference value of retinal microvascular changes in patients with cerebral microbleeds

2014/12/2 9:06:31

AIM: To study clinical reference value of retinal microvascular changes in patients with cerebral microbleeds(CMBs)and discuss its clinical significance.

METHODS:From January 2012 to December 2013, 125 hospitalized patients were collected, including 81 cases were male, 44 cases were female, mean age 76.3±11.2 years old. For all patients, functions of liver and kidney, blood-lipoids, blood sugar and blood biochemical examination were tested, and fundus photography and cerebral MR was done. According to the fundus camera eyes, retinal arteriolar equivalent(RAE), retinal venular equivalent(RVE), retinal vein diameter ratio(AVR)and arteriovenous crossing sign(AVN)were identified, CMBs were classified with cerebral MRI. All the data were processed by SPSS statistical software.

RESULTS: The central retinal arteriolar equivalent(CRAE), central retinal venular equivalent(CRVE)and AVR values in the eyes were found no statistical difference(P<0.05). Of CMBs classification, the grade 0 in 75 cases, 1 in 27 cases, 2 in 9 cases and 3 in 14 cases were included. The RVE, AVR and AVN and the different grades of CMBs had statistically significant correlation(P<0.01). The higher CMBs classification, the more obvious retinal microvascular changes were found. In respectively to eliminate risk factors such as age, sex, blood glucose and blood pressure, AVR and AVN were still influencing factors for CMBs classification.

COCLUSION: The results show that retinal microvascular changes, especially small retinal vein arteriovenous cross width, and arteriovenous crossing phenomenon, in which CMBs will happen more likely. After sex, age, hypertension and hyperglycemia in patients with traditional cardiovascular risk factors being ruled out, the retinal microvascular changes are still relatively factors of CMB's occurrence.

Early clinical research on the femtosecond laser assisted penetrating keratoplasty

Jing Wang,Lin-Nong Wang and Ru-Xia Zhou — 2014/12/2 9:06:31

AIM: To evaluate the therapeutic effects and safety of femtosecond laser assisted penetrating keratoplasty(FS-PKP).

METHODS: In the retrospective case series study, 46 cases(48 eyes)with FS- PKP holds were analyzed. Preoperative best corrected visual acuity(BCVA)was 2.35±1.01(with a standard logarithmic eye chart). Opacities were all from epithelium to endothelium, including keratoconus, keratolukoma and corneal scarring etc. The full-thickness corneal donor-recipient grafts in different diameter and incision kerfangle were made by femtosecond laser in keratoplasty. The patients were treated according to the conventional penetrating keratoplasty after surgery. Evaluation indexes included preoperative and postoperative 1,6,10mo uncorrected visual acuity(UCVA), BCVA, corneal astigmatism(CA)and surgical complications. Forty-three cases(44 eyes)with traditional PKP were as control group. The data of two groups were analyzed by mean comparison of two groups and Chi-square test in SPSS 18.0.

RESULTS: All the operations were completed successfully, postoperative visual acuity of all patients had different degrees of increase. Comparison with the postoperative UCVA of traditional PKP surgery, UCVA was 3.48±0.43 and 2.97±1.14 at 1mo after operation, respectively, with statistically significant difference(P=0.009). The UCVA was 3.86±0.25 and 3.74±0.73 at 3mo after operation, respectively; the UCVA was 4.04±0.23 and 3.98±0.29 at 6mo after operation, respectively, with no statistically significant difference(P=0.146, P=0.56). In FS-PKP group, BCVA was better than traditional PKP surgery group, with statistically significant difference(P=0.002). While there had no statistically significant difference between two groups of BCVA at 6, 10mo after operation(P_6mo=0.132, P_10mo=0.47). The incidence of complication of FS-PKP surgery, such as postoperative astigmatism, postoperative intraocular pressure and postoperative incision dehiscence were significantly lower than the one of traditional PKP surgery(P<0.05).

CONCLUSION:Compared with traditional penetrating keratoplasty, FS-PKP provides significantly faster visual recovery in the early postoperative period, and induces significantly less corneal astigmatism and lower incidence of complication. It reflected the clinical superiority of this new technology.

Effects of two different incision phacoemulsification on corneal astigmatism

Lu Huo,Xiao-Lin Hao and Zhong-Chen Zhang — 2014/12/2 9:06:31

AIM:To compare the effect of different incision in corneal astigmatism after phacoemulsification.

METHODS: Totally 88 cases(122 eyes)with pure cataract were randomly divided into two groups. Forty cases(60 eyes)were clarity corneal incision in group A, and 48 cases(62 eyes)were sclera tunnel incision in group B. Mean corneal astigmatism, surgically induced astigmatism(SIA), uncorrected visual acuity(UCVA)and best correct vision acuity(BCVA)were observed in pre- and post-operation at 1d; 1wk; 1mo.

RESULTS: The mean astigmatism had statistically significant difference between two groups at 1d; 1wk; 1mo after operation(P<0.05). The SIA had statistically significant difference at 1d(P<0.05); The SIA had no statistically significant difference between two groups at 1mo after operation(P>0.05). UCVA≥0.5 and BCVA≥0.8 had statistically significant difference at 1d; 1wk(P<0.05). There had no statistically significant difference at 1mo after operation(P>0.05).

CONCLUSION: Phacoemulsification with scleral tunnel incision remove combined intraocular lens(IOL)implantation has small changes to corneal astigmatism. By selecting personalized corneal incision according to the corneal topography might be more beneficial.

Observation of two types of foldable scleral-fixated posterior chamber intraocular lens to treat cataract dislocation

Fang-Zhu Deng and Guo-Ping Kuang — 2014/12/2 9:06:31

AIM:To observe the clinical efficacy of two types of scleral-fixated posterior chamber intraocular lens(IOL)combined intra-capsule lens extraction to treat cataract dislocation.

METHODS: After intra-capsule lens extraction of dislocated cataract, two types of IOL were used as scleral-fixated posterior chamber IOL. First group was with four seal loops, the second group was with two open loops. All 21 patients(23 eyes)took the examination of the best corrected visual acuity, intraocular pressure, fundus, and IOL decentration using camera system attached to slit-lamp ophthalmoscope and IOL tilted using ultrasound biomicroscopy(UBM)at 6mo after surgery.

RESULTS: After 6mo, all patients had improved eye sight. There was significant difference in the mean IOL decentration between the two groups(0.57mm vs 0.79mm, P<0.05). There was significant difference in the mean IOL tilted degree between the two groups(6° vs 11°, P<0.05).

CONCLUSION: IOL with four loops are more appropriate as scleral-fixated posterior chamber IOL with less tiltness and dicentration.

Relationship of retinal lesions and postoperative visual acuity of cataract phacoemulsification

Yan Wang and Ya-Xin Yang — 2014/12/2 9:06:31

AIM: To study the relationship of retinal associated lesions and postoperative visual acuity of cataract phacoemulsification.

METHODS:From February 2013 to February 2014, 120 cases with given cataract phacoemulsification were divided into observation group and control group. Cases in observation group were with of retinal associated lesions, those in control group were without retinal associated lesions. The best corrected visual acuity, ision acuity, visual evoked potential, intraocular pressure were compared between two groups.

RESULTS:Two weeks after surgery, visual acuity in observation group was higher than those of before therapy. Visual acuity recovery rate of observation group was significantly slower than that of control group; best corrected vision, visual acuity in observation group was significantly lower than that in control group; observation group's amplitude(12.01±4.50μV)was significantly lower than control group, incubation period(114.29±11.32ms)was significantly higher than control group; After 6, 12, 24h, intraocular pressure(23.64±4.28, 24.12±5.13 and 18.28±3.22mmHg)were significantly higher than control group.

CONCLUSION: Retinal associated lesions can lead to visual evoked potential change, elevated IOP, affect postoperative visual recovery level.

Effect of micro-incision on corneal wavefront aberration and tear film in phacoemulsification

Zong-Yan Song,Feng-Hua Chen,Fang Cheng,Ai-Min Yan,Xu Qiu and Xue-Fei Lou — 2014/12/2 9:06:31

AIM: To investigate the effect of endocapsular phacoemulsification cataract extraction and intraocular lens(IOL)implantation with a 1.8mm or 3.0mm clear corneal incision on total root mean square(RMS)value of the cornea, corneal astigmatism, spherical aberration, coma, trefoil and tear film.

METHODS:In a prospective study, 156 age-related patients(196 eyes)were randomly distributed into two groups. 1.8mm-group comprised 94 eyes that had a silicone IOL inserted through a 1.8mm sutureless clear corneal incision, while, 3.0mm-group comprised 102 eyes through a 3.0mm clear corneal incision. Postoperatively, the changes in the total RMS value of the cornea, corneal astigmatism, spherical aberration, coma, trefoil and tear film at 1wk, 1 and 3mo were determined respectively.

RESULTS: In both groups, postoperatively at 1wk,there were statistically significant differences(P<0.05)in the total RMS value of the cornea, corneal astigmatism, spherical aberration, coma, trefoil and tear film, while, there were statistically minimal differences(P<0.05)between 1.8mm-group and 3.0mm-group at 1mo, but were not statistically significantly different(P>0.05)between two groups at 3mo postoperative.

CONCLUSION:This study confirms that incision size has strong impact on the corneal higher-order aberrations, especially, 3.0mm incision caused significant differences in the total RMS value of cornea, corneal astigmatism, spherical aberration, coma, trefoil and tear film compared with 1.8mm micro-incision, therefore, micro-incision is very beneficial for clinical use in phacoemulsification.

Comparative study between the features of FFA and OCT in diabetic macular edema

Qin-Hui Wang,Jiu-Ping Liu,Dong-Mei Cui,Yan He and Xin Tang — 2014/12/2 9:06:31

AIM: To assess the correlation between the features of optical coherencetomography(OCT)and fundus fluorescein angiography(FFA)in diabetic macular edema(DEM).

METHODS: Totally 70 patients(135 eyes)with diabetic retinopathy(DR)were evaluated by central vision, best corrected visual acuity(BCVA), intraocular pressure, indirect ophthalmoscopy, slit lamp microscope combined +90D front mirror mydriatic fundus examination, mydriatic fundus color photography, OCT, FFA, the correlation between FFA and OCT were analyzed.

RESULTS: In mild macular oedema cases, abnormalities in FFA was 56 eyes, abnormalities in OCT was 68 eyes(P=0.0009); FFA showed 12 normal eyes, 10 eyes in OCT were characterized by diffused macular oedema; FFA was performed with cystoid macular oedema, OCT was 46.7% with cystoid type.

CONCLUSION: DME is diagnosed by Combination FFA with OCT, OCT is an indispensable tool when following up DME, and it has advantage in early application.

Early diagnosis of sub-clinical stage of diabetic retinopathy

Xing-Hui Xu and Wu-Feng Zhang — 2014/12/2 9:06:31

AIM: To evaluate the early diagnosis of sub-clinic stage of diabetic retinopathy.

METHODS: This was cross sectional study,multifocal retina electroretinogram(mf-ERG), contrast sensitivity(CS)and central retinal artery color Doppler examination were recorded from 30 cases(30 eyes)matched control subjects, 35 cases(35 eyes)with type 2 diabetes mellitus(DM)without diabetic retinopathy(NDR)and 38 cases(38 eyes)with non-prolifera tive diabetic retinopathy(NPDR). One-way ANOVA and SNK-q test were used for data analysis.

RESULTS: P1 response density of NDR patients were found decrease, N1 implicit time were delayed. Which were related with the degree of retinopathy(P<0.05); CS of NDR patients were found significant in middle and high frequency(P<0.05), NPDR patients were found significant in full frequency(P<0.05); Central retinal artery(CRA)blood flow in the control groups and NDR groups were not found statistically significant(P>0.05), The differences between normal group, NDR group and NPDR group were found statistically significant(P<0.05).

CONCLUSION: mf-ERG and CS are sensitive indexes for early evaluation of visual function in patients with diabetes mellitus, with development of the disease, CRA blood flow also appears to decline.

mf-ERG effective evaluation of early and background diabetic retinopathy

2014/12/2 9:06:31

AIM: To measure the retinal electrical activities in patients with diabetic retinopathy(DR)by applying multifocal electroretinogram(mf-ERG)and evaluate the degree of visual damage at different stages of DR

METHODS: Thirty cases(30 eyes)aged 50～70 years old, excluding other diseases, were as normal group, and 99 cases(99 eyes )diagnosed with type 2 diabetes were as experiment group. The cases received mf-ERG examination in the standard state, respectively. The results were statistically analyzed

RESULTS: For DR patients with early and background stage, the reaction density of mf-ERG P1 wave decreased as the disease worsened, significantly reduced in non-proliferating stage and decreased more significantly in the background of the stage Ⅲ. This showed that in the macula, electrical activity had weakened before the retina without visual or morphological changes, and with the development of the disease, the electrical activity decreased more obviously.

CONCLUSION: mf-ERG can evaluate the severity of DR, especially suit in the early and background period of DR.

Clinical effects of triamcinolone acetonide combined with laser photocoagulation on patients with retinal vein occlusion

Jin-Ying Zhang,Lin Liu,Fu-Bin Wang and Jie Chen — 2014/12/2 9:06:31

AIM: To observe the effects of the coelomic cavity injection of triamcinolone acetonide(TA)combined with laser photocoagulation on patients with retinal vein occlusion.

METHODS: Fifty-six patients of retinal obstruction with macular edema were accepted from January 2010 to December 2012 in our hospital. All patients received iodized lecithin and Xueshuantong. And, patients with central retinal vein occlusion(CRVO), hemi-central retinal vein occlusion(hemi-CRVO)and branch retinal vein occlusion(BRVO)treated by TA combined with laser photocoagulation, respectively. Follow-up period was of at least 6mo

RESULTS: After the treatment of 1,3 and 6mo, the central foveal thickness was reduced significantly(P<0.05). After followed up 6-12mo, the total effective rate of CRVO, Hemi-CRVO and BRVO patients was 83%～95% and all the patients had no significant adverse reactions.

CONCLUSION: Basing on the traditional treatment, TA combined with laser photocoagulation is more effective in the treatment of retinal vein occlusion and is worthy of clinical usage.

Investigation of correlations between vascular endothelial growth factor and proliferative diabetic retinopathy

Hong-Li Zhu — 2014/12/2 9:06:32

AIM: To determine the relations between the changes of vascular endothelial growth factor(VEGF)concentration in plasma, aqueous humor and vitreous of patients with diabetic retinopathy(DR)and proliferative diabetic retinopathy(PDR), as well as to find if the condition of metabolism control of patients with DR may affect the VEGF level.

METHODS: Double antibody sandwich enzyme-linked immunosorbent assay was used to measure the levels of VEGF concentration in plasma of non-diabetic retinopathy(NDR)patients group, background diabetic retinopathy(BDR)patients group, and proliferative diabetic retinopathy(PDR)patients group. The levels of HbAlc in plasma of patients in above three groups were measured at the same time. The VEGF concentration in aqueous humor, vitreous of PDR patients group and normal group was also measured for further comprehensive analysis. Human VEGF immunoassay Quantikine with high sensibility and quality was imported from R& D Co. LTD., USA.

RESULTS: There was an increasing tendency in the VEGF concentration in aqueous humor of PDR patients group. There was no statistically significant difference as it was compared with normal group(P>0.05). The VEGF concentration in vitreous of PDR patients group was obviously increased, there was significant difference as it was compared with normal group(P<0.01). It showed an increasing tendency of VEGF concentration in turn in plasma, aqueous humor and vitreous of the 3 PDR patients selves. It showed that there was significant difference among VEGF concentration in plasma, aqueous humor and vitreous of all the PDR patients(P<0.01). In normal group there was no significant difference among VEGF concentration in plasma, aqueous humor and vitreous(P>0.05). In normal group the VEGF concentration in plasma was the highest, but in PDR patients group the VEGF concentration in vitreous was the highest.

CONCLUSION: The significantly increased VEGF concentration in eyes, especially in vitreous of PDR patients may play an important role in development and deterioration of DR. It was clear that VEGF played its normal biological functions mainly in plasma in normal human. In severe DR patients, abnormal high may come from ischemic and VEGF concentration in vitreous suggested that it hypoxic retina and there was a tendency to diffuse towards the front of eyes.

Healing effect analysis of rhegmatogenous retinal detachment in 288 myopic cases

Fan Yang and Gui-Yun Wang — 2014/12/2 9:06:32

AIM: To understand the prognostic factors of myopic rhegmatogenous retinal detachment(RRD)surgery, and provide guidance for clinical treatment.

METHODS: This retrospective study included 288 myopic RRD eyes(excluding trauma, aphakia, congenital diseases, tractional and exudative retinal detachment)from April 2007 to April 2014 in our department. The surgical anatomic reduction situation was statistically recorded, the effects of hole's size, retinal detachment duration on sight restoration and surgery success rate were analyzed

RESULTS:The statistical results showed that 245 eyes(85.1%)healed after their first operation, about 95.1% cases finally healed after their second or third operation. The degree of myopia and aging factor influenced the RRD operation: the higher degree and the older age were, the lower success rates were(P<0.05). Through surgery, postoperative visual acuity was significantly better than the preoperative ones(P<0.01). A higher degree of myopia RRD led to poor visual acuity(P<0.01). Postoperative visual acuity of 152 eyes(52.9%)were improved, of which 106 eyes' visual acuity was 0.05 or more.

CONCLUSION: Surgery is an effective means of treating myopic RRD. The older patients have lower success rates. A higher degree of myopia led lower reset rate after retinal detachment surgery and poor postoperative visual acuity. When treat myopic RRD, we should pay attention to the recovery of visual function.

Expression of matrix metrallproteinase-2 in human tears fluid after LASIK

Ai-Wei Chen,Hong-Pei Ji,Wei-Wei Zhang,Hong Gu,Zhi-Ling Zhang and Ju-Qin Fu — 2014/12/2 9:06:32

AIM: To monitor long-term changes of matrix metalloproteinase-2(MMP-2)in human tears fluid after laser in situ keratomileusis(LASIK).

METHODS: Thirty-two myopia cases(64 eyes)underwent uneventful LASIK were enrolled in the study. Tear fluid were collected and MMP-2 expression was analyzed by Western-bolt assay preoperatively and postoperatively on 15d, at 1, 3mo, and 1a.

RESULTS: LASIK increased the concentration of MMP-2 in human tear fluid. At 15d postoperatively, the magnitude of MMP-2 was 1.4 times that of preoperative, thereafter subsided, but didn't return to preoperative level by 3mo(P<0.05). Up to 1a after surgery, the concentration of MMP-2 almost recovered(P>0.05).

CONCLUSION: MMP-2 is significantly expressed in human tear fluid after LASIK, then subsided with time, but didn't return to preoperative level by 3mo and almost recovered up to 1a, indicating wound healing of LASIK would continue up at least 3mo after surgery and almost recovered 1a postoperatively.

Comparison of the Lea Symbols and HOTV charts for preschool vision screening from age 3 to 4.5 years old

Ya-Hui Zhang — 2014/12/2 9:06:32

AIM: To evaluate the applicability and the development of the normal visual acuity from age 3 to 3.5 years using Lea Symbols and HOTV charts.

METHODS: It was a survey research study. Totally, 133 preschoolers(266 eyes)between 3 to 4.5 years old recruited from two kid-gardens in Guangzhou were tested with both the Lea Symbols chart and the HOTV chart. Outcome measures were monocular logarithm of the minimum angle of resolution(logMAR)visual acuity and inter-eye acuity difference in logMAR units for each test.

RESULTS: The testability rates of the two charts were high(96.24% vs 92.48%, respectively), but difference was not statistically significant(P>0.05). The difference between the two kind of monocular vision was not statistically significant(the right eye: t=0.517, P=0.606; the left eye: t=-0.618, P=0.538). There was no significant difference between different eye(Lea Symbols chart: t=0.638, P=0.525; HOTV chart: t=-0.897, P=0.372). The visual acuities of the boys were better than those of the girls, but the difference was not statistically significant(P>0.05). The results which came from visual acuities with the two charts for the corresponding age groups(3-year-old group, 3.5-year-old group, 4-year-old group, 4.5-year-old group)indicated that the visual acuities of the preschoolers were improving with increasing age, but the difference among the visual acuities with the Lea Symbols chart was not statistically significant(the right eye: F=2.662, P=0.052; the left eye: F=1.850, P=0.143). However the difference among the visual acuities with the HOTV chart was statistically significant(the right eye: F=4.518, P=0.005; the left eye: F=3.893, P=0.011).

CONCLUSION: Both Lea Symbols and HOTV chars are accepted and appropriate for preschool vision screening from 3 to 4.5 years old. The monocular visual acuity of preschoolers from age 3 to 4.5 years could be assessed was similar using the two charts. There is no correlation between visual acuity and different eye. There is no statistical difference between the genders. The results further demonstrate that the preschoolers whose age reached three years old have the ability to accept the Subjective vision checks. Also the development of the normal visual acuity is faster in the early stage.

Investigation of the refractive status of preschool children in Xiantao, Hubei Province

Nian Guan,Hao-Ming Chen and Zhi-Guang Hu — 2014/12/2 9:06:32

AIM: To investigate the refractive status of the preschool children in Xiantao, Hubei Province in order to find out the abnormal refraction error beyond the physiological range.

METHODS: In this cross-sectional study, we investigated preschool children in kindergartens and the scattered ones were 12 716(25 432 eyes)ranging from 6mo～6 years old. 1 581 children(3 162 eyes)were diagnosed ametropia by Suresight refractive screening instrument, which were confirmed again after mydriasis optometry.

RESULTS: The incidence rate of ametropia in preschool children in Xiantao was 12.4%, and statistics showed no significant difference between boys and girls(P>0.05), but had differences of morbility rate among each age group(P<0.05). With age increasing morbility rate of the refractive error decreased. The simple hyperopia and the compound hyperopia astigmatism were dominant in all refraction error. Professional ophthalmologists diagnosed amblyopia in 261 children(522 eyes), which was 16.5%, among 1 581 abnormal refractive children(3 162 eyes)screened out by Suresight refractive screening instrument.

CONCLUSION: The incidence rate of ametropia decreases with age increasing in the preschool children from 6mo～6 years old, which imply preschool children should have mydriasis optometry in order to find out amblyopia and other congenital eye disease.

Clinical analysis of the amniotic membrane transplantation in the treatment of fungal corneal ulcer

Qing-Tao Li,Xin-Fang Zhang,Yi Liu and Rui-Jin Ran — 2014/10/31 11:03:31

AIM:To evaluate the clinical effects of amniotic membrane transplantation in the treatment of fungal corneal ulcer.

METHODS: Fifty cases(50 eyes)of fungal corneal ulcer were included in this study from January 2010 to December 2013. The cases were divided into two groups randomly, the experimental group and the control group. The experimental group was treated by antifungal drugs and amniotic membrane transplantation. The control group was treated only by antifungal drugs. The visual analogue scale(VAS)of the symptoms, the ulcer healing time, the vision and the complications were observed.

RESULTS: The symptoms of the experimental group were disappeared more quickly than the control group 1,2wk after treatment, for example Pain(t=6.463, t=10.134; P<0.05), Photophobia(t=5.02, t=7.534; P<0.05), Foreign body sensation(t=3.771, t=7.459; P<0.05). The ulcer healing time of the experimental group were shorter than that of the control group(t=9.524,P<0.05). The vision of the experimental group was got better than that of the control group 1mo later(F=6.414,P<0.05).The complications of the experimental group were fewer than that of the control group(F=29.621, P<0.05).

CONCLUSION: Amniotic membrane transplantation is an effective treatment to fungal corneal ulcer.

Clinical therapeutic effects of intravitreal Ranibizumab injection combined laser photocoagulation for macular edema in BRVO

Bin Liu,Yu-Xia Yang,Xing Liu,Wei-Li Li and Zheng-Zheng Mo — 2014/10/31 11:03:31

AIM: To evaluate the clinical therapeutic efficacy of intravitreal ranibizumab injection combined grid laser photocoagulation for macular edema secondary to branch retinal vein occlusion(BRVO).

METHODS: Forty-two confirmed cases(42 eyes)with macular edema secondary to BRVO were randomized into 3 groups, each group contained 14 eyes. The ranibizumab group was received intravitreal injection of ranibizumab(0.05mL), the laser group was received grid laser photocoagulation, and the combined group was received a second therapy of grid laser photocoagulation after 1wk of the intravitreal injection of ranibizumab. Recorded the best-corrected visual acuity(BCVA)and the central macular thickness(CMT)preoperative and at 1, 3, 6mo after therapy.

RESULTS: The BCVA and the CMT had no differences among three groups pretherapy(P>0.05). While BCVA was much better and CMT was reduced significantly posttherapy than pretherapy in all three groups(P<0.05). The BCVA and CMT in the ranibizumab group were significantly different in every time point(1, 3, 6mo)(P<0.05). The BCVA declined and the CMT was thicker as the time went on. In the laser group and the combined group, BCVA and CMT had little differences in different time point(P>0.05). While the BCVA was better and the CMT was thinner in the combined group than ranibizumab group and laser group at every time point(P<0.05). At 3 and 6mo, the BCVA was better and the CMT was thinner in laser group than Ranibizumab group(P<0.05).

CONCLUSION: The intravitreal ranibizumab injection combined grid laser photocoagulation is an effective treatment method for the macular edema secondary to BRVO, it is more effective in improving BCVA than intravitreal ranibizumab or grid laser photocoagulation alone.

Correlation between the optical coherence tomography and electroretinogram in retinal vein occlusion macular edema

Ya Xu and Xun-An Fu — 2014/10/31 11:03:31

AIM: To evaluate the correlation between retinal thickness and photopic flash electroretinogram(ERG)parameters(Cone a-wave, Cone b-wave, and 30Hz flicker)in patients with central retinal vein occlusion(CRVO)and macular edema.

METHODS: A total of 25 patients(25 CRVO eyes and 25 unaffected fellow eyes)with CRVO underwent the examination of optical coherence tomography(OCT)and photopic falsh ERG. The amplitude and implicit time of the ERG parameters were extracted from the ERG traces. Retinal thicknesses were measured by OCT in nine macular subfields. Then the correlations between ERG parameters and macular morphological parameters were analyzed.

RESULTS: The Cone b-wave and 30Hz flicker implicit time were correlated with macular retinal thickness in seven out of nine subfields, excluding the temporal subfields.

CONCLUSION: The retinal thickness of the macular edema may be associated with inner retinal function in CRVO patients.

Analysis the macular ganglion cell complex thickness in monocular strabismic amblyopia patients by Fourier-domain OCT

2014/10/31 0:00:00

AIM: To detect the macular ganglion cell complex thickness in monocular strabismus amblyopia patients, in order to explore the relationship between the degree of amblyopia and retinal ganglion cell complex thickness, and found out whether there is abnormal macular ganglion cell structure in strabismic amblyopia.

METHODS: Using a fourier-domain optical coherence tomography(FD-OCT)instrument iVue^®;(Optovue Inc, Fremont, CA), Macular ganglion cell complex(mGCC)thickness was measured and statistical the relation rate with the best vision acuity correction was compared Gman among 26 patients(52 eyes)included in this study.

RESULTS: The mean thickness of the mGCC in macular was investigated into three parts: centrial, inner circle(3mm)and outer circle(6mm). The mean thicknesses of mGCC in central, inner and outer circle was 50.74±21.51μm, 101.4±8.51μm, 114.2±9.455μm in the strabismic amblyopia eyes(SAE), and 43.79±11.92μm,92.47±25.01μm, 113.3±12.88μm in the contralateral sound eyes(CSE)respectively. There was no statistically significant difference among the eyes(P>0.05). But the best corrected vision acuity had a good correlation rate between mGcc thicknesses, which was better relative for the lower part than the upper part.

CONCLUSION:There is a relationship between the amblyopia vision acuity and the mGCC thickness. Although there has not statistically significant difference of the mGCC thickness compared with the SAE and CSE. To measure the macular center mGCC thickness in clinic may understand the degree of amblyopia.

Prevent effect of Bevacizumab and Triamcinolone acetonide on corneal neovascularization induced by penetrating keratoplasty

Lan Li,Yu-Lin Liang and Yun-Chuan Li — 2014/10/31 11:03:31

AIM: To observe the clinical effect subconjunctival bevacizumab and triamcinolone acetonide(TA)on corneal neovascularization(CNV)induced by penetrating keratoplasty.

METHODS: Nineteen patients(20 eyes)with CNV induced by penetrating keratoplasty after 3mo were selected and were divided into 4 groups randomly: Group A was control group, group B was treated by subconjunctival of bevacizumab(2.5mg, 0.1mL), group C was treated by subconjunctival of bevacizumab(2.5mg, 0.1mL)and TA(4mg, 0.1mL), group D was treated by subconjunctival of TA(4mg, 0.1mL), one time each month, twice.

RESULTS: The average follow-up period was 3a. Visual acuity of groups B and C kept stable or increase slightly. CNV and immunologic rejection were lighten(P<0.01), symptomatic of ophthalmalgia and photophobia relief synchronous.

CONCLUSION: Treatment of subconjunctival bevacizumab and TA can effectively inhibite CNV and immunologic rejection, also has the therapeutical effect to maintain implant transparence after penetrating keratoplasty.

Limbal epithelial autograft transplantation and amniotic membrane transplantation combined with pterygium excision for primary pterygium

Bing Xu,Ming-Chang Zhang and Li Gao — 2014/10/31 11:03:31

AIM:To compare the recurrence rates between primary pterygium excision with limbal epithelial autograft transplantation and amniotic membrane transplantation.

METHODS: There were 99 patients(103 eyes)with primary pterygium. These patients were randomly divided into two groups, group A received limbal epithelial autograft transplantation combined with pterygium excision(n=54)and group B received amniotic membrane transplantation(n=49). All patients were followed up with 1a. Breaking-up time(BUT)of tear film and recurrence rates were observed.

RESULTS: One year after surgery, in the limbal epithelial autograft transplantation group, 4 eyes(7.4%)had recurrence pterygium, in the amniotic membrane transplantation group, 11 eyes(22.5%)had recurrence pterygium, The recurrence rates of the two surgical methods were significantly different(P<0.05). No statistically significant difference was observed between the two groups regarding postoperative tear film BUT(P>0.05).

CONCLUSION: Limbal epithelial autograft transplantation combined with pterygium excision is superior to amniotic membrane transplantation in terms of recurrence rates.

Preliminary research on lacrimial pump function and tear proteins of patients with functional epiphora

Hao-Fang Qin,Dong Liu and Li-Qun Dong — 2014/10/31 11:03:31

AIM: To study the lacrimial pump functions and tear proteins of patients with functional Epiphora.

METHODS: One hundred cases(200 eyes)with functional epiphora and 20 cases(40 eyes)of nonfunctional controls were recruited and under routine ophthalmic examinations, including Schirmer I test, Schirmer I test while pressing the lacrimal sac, tear film break-up time(BUT). Enzyme linked immunosorbent assay(ELISA)was used to detect main tear proteins, and the results were compared with control group.

RESULTS: Compared the result of the Schirmer I test on the normal subjects while pressing the lacrimal sac with that of releasing the lacrimal sac, the difference was significant(t=-4.008, P<0.05). While the result on the functional epiphora group showed no significant difference(t=-0. 811, P>0.05). The mean BUT was significantly shorter than that in the normal subjects(t=

-5.382, P<0.01). The concentrations of lactoferrin and albumin in the functional epiphora group decreased significantly(P<0.05), and the concentrations of Lactoferrin and secretory IgA didn't show significant(P>0.05).

CONCLUSION: The damage of lacrimal pump function plays a great role in the functional epiphora and the tear proteins of functional epiphora patients changed.

Comparison of microperimetry before and after internal limiting membrane peeling assisted by different staining agents in idiopathic macular hole

Chao Feng,Jian-Hua Wu,Jing Yan and Chong Xu — 2014/10/31 11:03:32

AIM: To evaluate preoperative and postoperative the characteristics of microperimetry in patients who underwent macular surgery for idiopathic macular hole(IMH).

METHODS: Fifty eyes of 50 patients with IMH were included in the study. Patients underwent pars plana vitrectomy and peeling of the internal limiting membrane(ILM). ILM visualization was improved by using triamcinolone acetonide(TA group)or indocyanine green dye(ICG group). Macular hole closure and retinal function was assessed preoperatively and postoperatively over a period of 6mo by spectral-domain optical coherence tomography examination, best corrected visual acuity(BCVA)and MP-1 microperimetry.

RESULTS: Macular hole closure was achieved in 76%, Hole was not closed but calm in 16%, 8% was not closed in TA group and those in ICG group were 72%, 16% and 12% respectively, detected by optical coherence tomography(OCT). At 6mo, visual acuity improved in both groups(P<0.05), and there were no statistically significant differences of BCVA between groups. Mean macular sensitivity within the central 20° increased in both groups, and TA group's mean macular sensitivity was better than ICG group's.

CONCLUSION: Vitrectomy and ILM peeling assisted with either TA or infracyanine green staining improves visual acuity and mean macular sensitivity at 6mo in patients affected by IMH. Macular microperimetry could be used to evaluation visual function changes of macular after surgery.

Comparison study of pathology and ultrasonics in orbital schwannomas

Li-Min Zhu,Ting-Ting Lin,Yan-Jin He and Guo-Xiang Song — 2014/10/31 11:03:32

AIM:To summarize the pathology, B-scan ultrasound and CDI manifest of orbital neurinoma. Try to analyze the connection between the different amounts of cystic degeneration and vascular distribution and the findings in ultrasound and CDI imaging.

METHODS: A retrospective analysis was performed on 44 cases with orbital neurinoma treated during January 2001 to December 2008, including 44 cases of pathological sections and B-scan ultrasound pictures, and 42 cases of CDI pictures. The connection between them were compared.

RESULTS: The incidence of cystic changes in Antoni type A was the highest, mixed type followed, Antoni type B at least, which was statistical significance(P<0.05). Antoni type B had more blood vessel structures, mixed type followed, Antoni type A at least, which was not statistical significance. The coincidence rate between the cystic changes and nonuniform echo in ultrosonography was 50.0%. On the other hand, between the non-cystic changes and uniform echo, the coincidence rate was 69.3%. On CDI, 83.0% of Antoni type B and 59.2% of Antoni type A can be detected blood current with no statistical significance. CDI showed compliance rate of 100% between blood flow and pathology, with statistical significance.

CONCLUSION: Mixed type is the most common type in orbital neurinoma. Cystic changes are more common in Antoni type A, while blood vessel structures are more common in Antoni type B. Ultrasonography can demonstrate the site, configuration and characteristics of the tumors, which is coincidence with the cystic changes and the blood vessels.

Signal filtering and parameter variance analysis from flash electroretinogram

Yan-Hong Fang,Qiong-Hua Wang,Wen-Jun Gou,Qiang Shen,Ying-Yuan Li and Rui-Jin Ran — 2014/10/31 11:03:32

AIM: To accurately measure the implicit time and amplitude of a-, b-wave from flash electroretinogram(ERG)through filtering technology, eliminate oscillatory potentials interference.

METHODS: Full-field ERGs were recorded in 30 eyes of 15 physical check-ups, measured the implicit time and amplitude of a-, b-wave, when the passband was set at 0.6～300Hz and 0.6～70Hz, and correlation was performed among those results by paired t-test.

RESULTS: When the passband was set at 0.6～70Hz, a-, b-wave had a single peak, compared with the passband was set at 0.6～300Hz, the implicit time of a-, b-wave was prolonged, amplitude was decreased(P<0.01).

CONCLUSION: A passband of 0.6～70Hz was the best choice to obtain smooth a- and b-waves from the original ERG, It could accurately measure the implicit time and amplitude of a-, b-wave.

Subjective visual sensation research after FLEx for the correction of moderate and high myopia and myopic astigmatism

Jing Zhou and Xiao-Jin Huangfu — 2014/10/31 11:03:32

AIM: To discuss the subjective visual sensation of femtosecond lenticule extraction(FLEx)in treatment of moderate and high myopia and myopic astigmatism for 6mo follow-up, compare the efficacy with standard laser in situ keratomileusis(LASIK)and confirm FLEx had more advantages on improving visual quality after surgery.

METHODS: In a prospective study 86(172 eyes)moderate and high myopia and myopic astigmatism patients were involved. The myopia degree was -3.00～-10.00D, the astigmatism degree ≤-6.00D. Eighty-six eyes were treated with FLEx in group A, and 86 eyes were treated with LASIK in group B. All patients in the treatment group completed the final 6mo of follow-up. The higher-order aberrations and the uncorrected visual acuity(UCVA)and the best spectacle-corrected visual acuity(BSCVA), objective and manifest refractions, results of slit-lamp examination, the side effects, the corneal flap thickness, intraocular tensionare, corneal topography were noted.

RESULTS: All of operations on 172 eyes were successful without severe complications after 6mo follow-up. The total higher order aberration and spherical aberration induced by FLEx were lower than that by LASIK.

CONCLUSION:FLEx for high myopia and myopic astigmatism has obvious superiority in the aspect of improving visual quality.

Study on model to predict distant vision with diopter and distant vision standard for civil aviator recruitment in China

Yi-Rong Wang,Ya-Na Qi,Jia-Yuan Li and Huan Liu — 2014/10/31 11:03:32

AIM: To study the model to predict distant vision with diopter and to explore the distant vision standard for civil aviator recruitment in China.

METHODS: The data about distant vision and diopter of 1 219 students participating in physical examination of Civil Aviation Flight University of China from 2006 to 2013 were collected. A model of index regression curve with diopter as independent variable and distant vision as dependent variable was established. The predicted value and 95% prediction interval of distant vision to specific diopter were calculated according to the model. The error rate was calculated by formula: error rate= \〖(distant vision predicted value-actual average value)/actual average value\〗×100%.

RESULTS: The curve model with diopter to predict distant vision was: y=0.55e^0.41x+e(R²=0.968). The average error rate of predicted distant vision was 3.64%. With diopter range \〖0.00,-3.00\〗D, the 95% prediction interval of predicted distant vision \〖0.14, 0.55\〗 didn't completely coincide with the current standard(0.3≤distant vision<0.7).

CONCLUSION: The fitting effect of the model is good and can be used to predict reasonable distant vision according to diopter. It is suggested to maintain diopter standard of China's civil aviation recruitment \〖0.00, -3.00\〗D unchanged, and drop the distance vision standard to 0.1.

Clinical observation of phacoemulsification combined goniosynechialysis in treating absolute glaucoma after trabeculectomy

Jun-Yong Wang,Yi Shao,Fang-Xing Zhou and Hui Sun — 2014/9/22 14:18:23

AIM: To observe the effect of phacoemulsification combined goniosynechialysis in treating absolute glaucoma after trabeculectomy.

METHODS: Phacoemulsification combined goniosynechialysis was performed on 16 patients(16 eyes)with absolute glaucoma after trabeculectomy, and they were followed up for 6～12mo, The postoperative intraocular pressure(IOP)and anterior chamber depth, preoperative and postoperative medication types(quantity), preoperative and postoperative 1 month's status of anxiety and depression, symptoms of ocular surface were observed.

RESULTS: The IOP decreased significantly after phacoemulsification combined goniosynechialysis. The mean IOP was 35.00±15.43mmHg preoperatively, and it was 12.00±6.69mmHg, 15.00±4.26mmHg and 15.3±5.2mmHg on 1d, 6 and 12mo after the surgery. The statistic difference was found between preoperative and postoperative(t=6.22, P<0.05). The anterior chamber depth was 1.45±0.19mm before the surgery, and increased to 3.37±0.13mm after the surgery(t=6.65, P<0.05). After the surgery, 2 patients needed two kinds of drugs, 2 patients needed one kind of drug. After 12mo of follow-up, anxiety and depression status were improved in all 16 patients. Subjective discomfort symptoms of 16 patients such as eye bilges, eye pain were relieved. All of the patients' eyeballs were preserved, and no serious complications.

CONCLUSION: Phacoemulsification combined goniosynechialysis in treating absolute glaucoma after trabeculectomy is a safe and effective surgical option.

Clinical effect of femtosecond laser assisted penetrating corneal transplantation operation

Hong-Jian Zhou,Feng Wen,Bin Lu and Li-Ping Mao — 2014/9/22 14:18:23

AIM: To observe the clinical effect of femtosecond laser assisted penetrating keratoplasty.

METHODS: Twenty-four cases(24 eyes)with corneal lesions were performed with femtosecond laser assisted penetrating keratoplasty. Preoperative and postoperative endothelial cell density and visual quality were compared.

RESULTS: One week after operation, corneal grafts were clear in 21 eyes(87.5%), mild cloudy in 3 eyes(12.5%); visual acuity ≥0.5 in 18 eyes(75.0%), 0.2～0.4 in 6 eyes(25.0%). After 3mo the mean corneal astigmatism was 2.16±0.21D(range 2.25～3.09D). Compared to conventional penetrating keratoplasty which mean corneal astigmatism was average 3.67±0.38D after operation, there was significant difference between two groups(P<0.05). There were significant differences between preoperative and postoperative visual acuity and astigmatism(both P<0.05).

CONCLUSION: Femtosecond laser assisted penetrating corneal transplantation operation can improve patient's visual quality. And compared to traditional penetrating keratoplasty astigmatism decreased significantly, incision can be made in individual shape more precisely and neatly.

Clinical features and confocal microscopic imaging characteristics of 466 cases with infectious keratitis

Hui Xiao,De-Yan Zhang and Zhong-Yi Fan — 2014/9/22 14:18:23

AIM: To observe the role of confocal microscopy in infectious keratitis management.

METHODS:Totally 466 patients(467 eyes)diagnosed as infectious keratitis from January 2010 to December 2013 were retrospectively studied. the corneas were examined early by in vivo confocal microscopy. The characteristics of their images and clinical features were studied and summarized.

RESULTS:All patients were recorded, the average age was 54.4±13.0 years, in which 264 cases(56.7%)were male, and 202 cases(43.3%)were female. In the 466 patients, 190(40.8%)were fungal keratitis, 148(31.8%)were viral keratitis, 125(26.8%)were bacterial keratitis and 3(0.6%)were acanthamoeba keratitis. There were fungal hyphae in the images of fungal keratitis. Amebic cysts were found in acanthamoeba keratitis.

CONCLUSION:Confocal microscope can help the early diagnose and treatment of infectious keratitis. It is a noninvasive imaging technique that provides high resolution images of ocular structures at a cellular level and infectious keratitis represents one of its most important clinical uses.

Central corneal thickness using EX500 excimer laser workstation

Jiao Chen,Hua Wang,Shu-Xi He and Dong-Qiang Luo — 2014/9/22 14:18:23

AIM: To evaluate the accuracy of central conreal thickness(CCT)using EX500 Excimer Laser workstation(EX500)in laser in situ keratomileusis(LASIK)patients.

METHODS: The CCT of 120 eyes(63 patients)who had LASIK between January 2013 and June 2013 were measured by A-scan and EX500. Three groups were classified: >550μm, 500～550μm, <500μm according the CCT value of A-scan. The CCT were measured again by corneal flap creating by moria SBK microkeratome. The thickness of the corneal bed stroma were measured by A-scan and EX500 after keratomileusis. All outcomes were analyzed with paired t test.

RESULTS: The average preoperative CCT value was 527.9±34.3μm measured by A-scan, 528.5±34.6μm measured by EX500. There was no significant difference between these two measurements(t=1.736, P=0.085). In group which CCT >550μm, the average preoperative CCT value was 571.4±17.3μm measured by A-scan, 572.7±15.7μm measured by EX500. There was no significant difference between these two measurements(t=1.857, P=0.072). In group which CCT 500～550μm, the average preoperative CCT value was 523.4±13.1μm measured by A-scan, 524.2±12.4μm measured by EX500. There was no significant difference between these two measurements(t=1.934, P=0.058). In group which CCT <500μm, the average preoperative CCT value 484.5±9.8μm measured by A-scan, 483.7±8.9μm measured by EX500. There was no significant difference between these two measurements(t=1.395, P=0.174). The average CCT value after corneal flap lifting was 401.3±34.2μm measured by A-scan, 393.4±38.9μm measured by EX500. There was a significant difference between these two measurements(t=6.669, P=0.000). The average thickness of the corneal bed stroma value after keratomileusis was 332.6±38.3μm measured by A-scan, 307.3±37.1μm measured by EX500. There was a significant difference between these two measurements(t=17.165, P=0.000).

CONCLUSION: There is no significant difference between preoperative CCT value measured by A-scan and EX500. After corneal flap lifting and keratomileusis, the CCT value measured by EX500 is smaller than measured by A-scan.

Variety of corneal endothelial cell in glaucoma by confocal microscope

Hong-Liang Gao,Zhi-Qiang Guo,Hong-Yu Fan,Li-Juan Xu and Yan-Hua Qi — 2014/9/22 14:18:24

ATM: To define the causes of corneal endothelial cell damage, to investigate the preventive methods, and to observe the variety of corneal endothelial cell in glaucoma using confocal microscope.

METHODS: Totally, 143 eyes of 97 patients with different types of glaucoma, and matched normal people were 20 cases, all 40 eyes. The cell density, cell area and cell variable coefficient were measured used confocal microscope. These indicatives of every kind of glaucoma were compared.

RESULTS: The corneal endothelial cell density of normal group was 2 893.88±255.026/mm², the group of acute angle-closure glaucoma(AACG)was 1 674.11±683.95/mm², and the group of open angle glaucoma(OAG)was 2 687.22±391.87/mm², the group of chronic angle-closure glaucoma(CACG)was 2 706.97±351.27/mm². In all index the average cell density of corneal endothelial and the average area have statistical significance(F=62.950, 8.795; P=0.000), especially the group of AACG.

CONCLUSION: The index of corneal endothelial cell in AACG is lower than that of normal. All index in OAG and CACG is difference with that of normal, but the difference has no statistical significance. And the dominant factor of damaged corneal endothelial is the time of intraocular hypertension.

Clinical analysis of intravitreal injection of triamcinolone acetonide combined macular grid photocoagulation treatment for macular edema

Xian-Hua Jing and Chun-Yuan Song — 2014/9/22 14:18:24

AIM: To investigate the clinical efficacy and safety of intravitreal injection of triamcinolone combined macular grid photocoagulation treatment for macular edema.

METHODS: Totally 150 cases(150 eyes)with macular edema in our hospital from July 2009 to November 2013 were selected, which were randomly divided into study group(75 cases, 75 eyes)and control group(75 cases, 75 eyes). The cases in control group were treated with macular grid photocoagulation treatment, those in the study group used triamcinolone acetonide combined macular grid photocoagulation treatment. Best corrected visual acuity(BCVA), parallel optical coherence tomography(OCT)and fundus fluorescein angiography(FFA)were detected before treatment, after treatment 7d, 1, 3, and 9mo.

RESULTS:After the treatment, patients' vision were significantly improved in two groups(P<0.05). In the study group 7d, 1, 3, and 9mo after operation, the visual acuity was better than the control group and preoperative(P<0.05); fovea macular neurosensory layer thickness decreased significantly(P<0.05). In the control group, the point omentum macular neurosensory retinal thickness was not statistically significant at 7d, 1, 3, and 9mo after operation compared with before treatment(P>0.05). Fovea macular neurosensory retinal thickness in the study group was significantly lower than that in control group(P<0.05). Intraocular pressure of 7 cases in the study group increased slightly, and were normal after treatment.

CONCLUSION: Triamcinolone acetonide combined macular grid photocoagulation treatment is accurate, can effectively improve the visual acuity, reduce macular edema, it is safe and reliable, and suitable for clinical application.

Dynamic changes of photorecrptor layer in eyes with acute central serous chorioretinopathy after laser treatment by fourier-domain optical coherence tomography

Li-Qin Zhou,Yi Wang,Sheng Wang and Chen-Ke Kong — 2014/9/22 14:18:24

AIM: To dynamically observe the feeling change of the photorecrptor layer in the eyes with acute central serous chorioretinopathy(CSCR)krypton laser treatment by fourier-domain optical coherence tomography(FD-OCT), and to study their correlation with the chang of vision.

METHODS: This is a retrospective case series study. The clinical diagnosis of 52 patients with monocular initial onset of central serous chorioretinopathy, krypton laser photocoagulation before treatment, after 1, 2, 4, 6, 8wk, 6mo, FD-OCT were performed to observe the morphological changes characteristic of photoreceptor layer and changes in vision.

RESULTS: After 1wk treatment, all cases were improved; 2wk, 6 cases were cured; 4wk, 38 cases were cured; 6wk, 41 cases were cured; 8wk, 45 cases were cured, the OCT showed macular retinal neuroepithelial layer(RNL)from fully absorbed; 6mo with the same 8wk. Before and after treatment in patients with best corrected visual acuity and from the height difference between the macular region of RNL was statistically significant(P<0.05), there was a correlation between the changes of visual acuity after treatment and the macular detachment of RNL height(P<0.05), Photoreceptor layer of complete and incomplete best corrected visual acuity difference was statistically significant(P<0.01).

CONCLUSION: FD-OCT can dynamicaly observed acute central serous chorioretinopathy krypton laser treatment of photoreceptor ultrastruture changes. Photoreceptor layer of complete and incomplete best corrected visual acuity difference was statistically significant(P<0.01).

Efficacy of compound Xueshuantong combined laser therapy on central serous chorioretinopathy

Kadier·Ainiwaer and Li-Jun Xiong — 2014/9/22 14:18:24

AIM: To explore the clinical therapeutic effect of compound Xueshuantong combined with laser treatment in central serous chorioretinopathy(CSCR)patients.

METHODS: A total of 181 cases of central serous chorioretinopathy patients treated in our hospital were randomly divided into treatment group(91 cases)and control group(90 cases). The patients in control group underwent laser treatment, those in treatment group received oral compound Xueshuantong after laser treatment. Clinical curative effect, the average light sensitivity and serum testosterone, estrogen levels of two group were compared.

RESULTS: After 3wk of treatment, the total effective rate of the treatment group was 90.1%, 72.2% in the control group, the treatment group was significantly higher(χ²=10.473, P=0.001); After 6wk of treatment group, the total effective rate was also significantly higher than that in the control group(χ²=4.499, P=0.034). Healing time, visual recovery time in treatment group was significantly less than those in the control group, the mean sensitivity was significantly higher, the difference between the two groups was statistical significance(P<0.05). After the treatment the hormone of patients in the two groups were significantly decreased, the treatment to reduce the level of serum hormone level was significantly better than those in the control group, the difference between the two groups was statistical significance(P<0.05).

CONCLUSION: Compound Xueshuantong combined with laser in the treatment of central serous chorioretinopathy, can significantly improve the efficacy, shorten the course of disease, is conducive to the recovery of visual function, and worth the clinical promotion.

Effect of soft contact lens curvature on dry eye of flight attendants

Chang-Liang Meng,Jing Xu and Xiao-Ming Zeng — 2014/9/22 14:18:24

AIM: To discuss the effect of wearing customized curvature soft corneal contact lens to dry eye degree of flight attendants.

METHODS: Eighty cases(160 eyes)of flight attendants from China Southern were divided into two groups: control group 40 cases(80 eyes)wearing ready-made Bausch soft corneal contact lens(curvature 8.4); the experiment group 40 cases(80 eyes), wearing Bausch soft corneal contact lens with customized curvature. Tear break-up time(BUT), Schirmer Ⅰ test(SⅠt)and fluorescein(FL)staining were as dry eye evaluation index. The results was statistically analyzed.

RESULTS: BUT, SⅠt average shortening value of the experimental group were less than that of the control group, there was statistical significance(P<0.01). FL staining positive increase, the number of experimental group was fewer than that of control group, with statistical significance(P<0.05).

CONCLUSION: Wearing customized curvature soft corneal contact lens can prevent the flight dry eye more effectively than fixed curvature product.

Comparative analysis of Han and Uygur college students emmetropia biology measurement

Meng Liu,Yan Wang and Ning Guo — 2014/9/22 14:18:24

AIM: To observe the differences in central cornea thickness, anterior chamber depth, corneal anterior curvature and corneal posterior curvature between the Uygur and the Han nationality college emmetropia students, and analyze the relationship of corneal thickness and corneal curvature.

METHODS: More than 500 students in grade one in Xinjiang Medical University were underwent screening, 56 emmetropia eyes in Han nationality students and 51 in Uygur students were selected. Sirius corneal topography was applied to the measurement.

RESULTS:Uygur and the Han nationality college emmetropia students central cornea thickness(Uygur: 0.53±0.03mm, Han: 0.54±0.03mm), anterior chamber depth(Uygur: 2.91±0.26mm, Han: 3.14±0.25mm), corneal posterior curvature K2(Uygur: -6.30±0.23D, Han: -6.38±0.28D)had significant difference(P<0.05). Corneal anterior curvature(K1, K2)before and corneal posterior curvature K1 there was no significant difference(P>0.05). Han had no significant relationship in corneal thickness and corneal anterior curvature(r<0), or in corneal posterior curvature(r<1). Uygur has no significant relationship in corneal thickness and corneal anterior curvature(r<0), or in corneal posterior curvature(r<1).

CONCLUSION: There are significant differences between the Uygur and the Han nationality college emmetropia students in cornea thickness, anterior chamber depth and corneal posterior curvature K2. There is no significant relationship between corneal thickness and corneal curvature in Uygur and the Han nationality college students.

Comparison of the VISX WaveScan and OPD-Scan Ⅲ with the subjective refraction

Ran Zhu,Ke-Li Long,Xiu-Mei Wu and Quan-De Li — 2014/9/22 14:18:24

AIM: To compare the refractive errors measured by the VISX WaveScan, OPD-Scan Ⅲ and the subjective refraction.

METHODS: Seventy-six patients(152 eyes)were recruited from January 2013 to December 2013. All patients were measured with subjective refraction by the phoropter(NIDEK, RT-5 100), objective refraction by the WaveScan(AMO Company, USA), OPD-Scan Ⅲ(Nidek Technologies, Japan). The sphere, cylinder, axis of the three methods were compared and analyzed.

RESULTS: The sphere measured by WaveScan was lower than that by subjective refraction, the difference was 0.13±0.30D(t=3.753, P<0.001). For cylinder, the difference was 0.13±0.43D(t=3.664, P<0.001). There was no significance for sphere, cylinder, and spherical equivalent between OPD-Scan Ⅲ and subjective refraction(P>0.05). The value of the difference between WaveScan and subjective refraction was 5.87°±6.19° for the axis and the difference between OPD-Scan Ⅲ and subjective refraction was 3.82°±3.95°. There was statistic significance(t=2.817, P=0.006).

CONCLUSION: For sphere and cylinder,WaveScan generated some deviation relative to subjective refraction. The Nidek OPD-Scan Ⅲ gives more accurate measures of objective refraction when compared with subjective refraction.

Analysis of corneal diameter in myopia operation patients

Zong-Yong Deng and Ping-Hua Li — 2015/8/27 11:19:43

AIM: To explore the difference in corneal diameter between genders, right and left eyes, and the correlation between spherical equivalent(SE)by measuring the corneal diameter of myopia operation patients,.

METHODS: Corneal horizontal diameters \〖white-to-white(WTW)distance\〗 were measured with IOL Master of German Zeiss company in 126 myopia cases(252 eyes)undergone excimer laser operation, male 48 cases(96 eyes)and female 78 cases(156 eyes), aged between 18～45 years(average age 24.23±5.35 years), from March 2013 to August 2013 in our myopia outpatient. Subjective refraction was adopted by NIDEK RT-2100 comprehensive refractometer for each eye, and converted into the SE. Eyes were divided into three groups according to the SE as follows: group 1(low myopia group, -3.00DRESULTS: The average corneal diameter was 11.52±0.41mm. The average corneal diameter was 11.60±0.35mm in males compared with 11.43±0.36mm in females, the differences in gender were significant in the t-test for independent samples(t=0.021, P=0.009). The average corneal diameter was 11.53±0.40mm in right eyes and 11.51±0.42mm in left eyes, there were no significant differences between right and left eyes in the t-test for paired samples(t=-0.115, P=0.912). Corneal diameters classified with SE were 11.59±0.39mm, 11.48±0.40mm and 11.45±0.41mm respectively for low, moderate and high myopia. The corneal diameter was negatively correlated with the SE(R²=0.001, P=0.001). Differences among three groups proved to be significant in the ANOVA(F=4.487, P=0.004).

CONCLUSION: The corneal diameter in myopia operation patients is significantly greater in males than that in females, but no significant differences between the right and left eyes. The corneal diameter is negatively correlated with the SE. The higher the degree of myopia, the shorter the corneal diameter.

Observation of corneal endothelial cells in small incision phacoemulsification and phacoemulsification surgery in elderly hardcore cataract

Li Wang and Peng Li — 2015/8/27 11:19:43

AIM:To observe and compare the changes of corneal endothelial cells with after phacoemulsification and small incision non- phacoemulsification in elderly hard nuclear cataract.

METHODS:In this retrospective analysis, the patients received small incision non-phacoemulsification cataract extraction combined with intraocular lens implantation were as group A, 36 cases(40 eyes)and those underwent ultrasonic phacoemulsification combined with intraocular lens implantation were for group B, 38 cases(46 eyes). Operation time, preoperative, postoperative 1and 6mo, uncorrected visual acuity, corneal endothelial changes were compared.

RESULTS: The operation time of the two groups had no significant difference. UCVA of postoperative 1mo was ≥ 0.5 after surgery, the difference between the two groups had statistical significance(χ²=5.174, P=0.023). One month and 6mo after operation, the corneal endothelial cell counts of two groups were compared, with statistical significance(t=2.565, P=0.038; t=2.774, P=0.041)and the difference of corneal endothelial cell loss rate between two groups had statistical significance(P<0.05). The difference of AVC between two groups at postoperative 1 and 3mo had statistical significance(t=2.225, P=0.045; t=2.153, P=0.039). The coefficient variation of two groups had statistically significant difference(P<0.05).

CONCLUSION: Small incision non-phacoemulsification operation is a more safe and effective surgery method for treating elderly hardcore cataract patients.

Study on the changes of life quality before and after cataract surgery for high myopia complicated with cataract

Juan Zhang,Yong-Kang Zhang,Yong-Feng Luo,Wen-Jun Zhao and Shao-Gang Ai — 2015/8/27 11:19:43

AIM: To evaluate the effect of cataract surgery on quality of life(QOL)for the patients with high myopia complicated with cataract.

METHODS: Forty-six patients with high myopia complicated with cataract undergone cataract surgery were selected among the patients following Vision Recovery Project in Zizhou County, Shaanxi Province. Visual acuity of the patients was inspected. At the same time, the functional indexes changes of all abilities, visual function and QOL questionaire were analyzed.

RESULTS: Fourty-four patients(96%)were undergone the cataract surgery on their first eye, 2 patients(4%)on their second eye among the all 46 participants. Visual acuity after surgery was higher than before in all patients. The measurement of postoperative visual function and QOL including that of patients with visual function deterioration was higher than that of preoperative records. Functional indexes before and after operation had significant changes.

CONCLUSION: Cataract surgery with safe and excellent effects can improve QOL of the patients with high myopia complicated with cataract. It is an important method of rehabilitation in addition to basic rehabilitation and visual rehabilitation in this kind of patients.

Correlations between IL-2, IL-6 levels in peripheral blood and optic nerve damage in primary acute angle-closure glaucoma

Cui-Ling Huang,Hua Li,Sha Lü,Lu Liu,Yong-Ye Zhang and Sheng-Fang Song — 2015/8/27 11:19:44

AIM:To compare the levels of IL-2 and IL-6 between primary acute angle-closure glaucoma and normal controls at perioperative. To discuss the correlations between cytokine levels and optic nerve damage of primary acute angle-closure glaucoma.

METHODS: Hospitalized patients with primary acute angle-closure glaucoma in the Department of Ophthalmology of Yongchuan Hospital of Chongqing Medical University from May, 2013 to October, 2014 were collected as the case group(Group A), Group A was divided into three subgroups of minor, medium and severe(a, b and c)according to the degree of optic nerve injury. The patients with cataract hospitalized within the same period were selected as the control group(Group B). The concentrations of IL-2 and IL-6 in the peripheral blood of research objects were determined with the double-antibody sandwich enzyme-linked immunosorbent assay(ELISA). The differences in the mass concentration of cytokines between the two groups of A and B and the three subgroups of a, b and c were compared, and the correlation between the level of cytokines in the bodies of patients with primary acute angle-closure glaucoma and the degree of optic nerve injury was analyzed.

RESULTS: Concentrations of IL-2 and IL-6 in experimental group were significantly lower than those in the control group(P<0.05). Concentrations of IL-2 and IL-6 in glaucoma patients severe injury of optic nerve were significantly lower than those in mild injury of optic nerve( P<0.05). To discuss the correlations between cytokine levels and optic nerve damage in subgroups a, b, and c, mult-variable linear return analysis was used, the difference on IL-2 level had statistical significance(P<0.05).

CONCLUSION: In primary acute angle-closure glaucoma patient, levels of IL-2 and IL- 6 are lower than the normal. IL-2 may be associated with glaucomatous optic neuropathy.

Surgical methods and efficacy studies on traumatic angle recession glaucoma

Jiao Zhang,Jun Yuan,Ting-Ting Bai and Xiao-Ling Wang — 2015/8/27 11:19:44

AIM: To discuss the operation manner and efficacy of traumatic angle recession glaucoma.

METHODS:The clinical data of 80 patients(80 eyes)who was treated traumatic angle recession glaucoma by three different operation manners between January 2008 and December 2013 retrospectively. Of them, 66 eyes of 66 patients whose onset time after injury was 1mo～2a, preoperative IOP was 25～<30mmHg, angle recession range ≤180°, optic C/D≥0.6 received trabeculectomy; 11 eyes of 11 patients whose onset time after injury was >2～10a, preoperative IOP was 30～39mmHg, angle recession range >180°, the disc C/D =0.6～<0.8 underwent compound trabeculectomy; 3 eyes of 3 patients whose onset time after injury was >10a, preoperative IOP 39～50mmHg, angle recession range >180°, the disc C/D =0.8～1.0 selected Ahmed glaucoma valve implantation.

RESULTS: IOP of all patients in three groups decreased to the normal range after operation(t=62.16, P<0.01; t=20.39, P<0.01; t=6.78, P<0.01), without glaucoma symptoms and progressive visual field narrowing. Visual acuity in trabeculectomy and compound trabeculectomy groups increased slightly than that of preoperative, but it did no change significantly in Ahmed glaucoma valve implantation group. Sixty-five cases(98%)had effective filtering bleb in trabeculectomy group, 9 cases(82%)in compound trabeculectomy group and 3 cases in Ahmed glaucoma valve implantation group formed effectively bleb.

CONCLUSION: For those patients with ineffective drug treatment, we can choose a different surgical approach, according to onset time, angle recession range and IOP, to effectively reduce IOP, improve visual acuity, and avoid further damage to visual function.

Treatment of acute primary angle-closure glaucoma with cataract by phacoemulsification with intraocular lens implantation combined with goniosynechialysis

Tao He,Xiu-Mei Yang and Xiao-Lei Liang — 2015/8/27 11:19:44

AIM: To observe the efficacy of phacoemulsification with intraocular lens(IOL)implantation combined with goniosynechialysis in treating acute primary angle-closure glaucoma with cataract.

METHODS: Fifty-two eyes of 40 patients(52 eyes)from October 2009 to June 2014 in our department with acute primary angle-closure glaucoma combined with cataract were included in this study. All patients were undergone phacoemulsification with IOL implantation combined with goniosynechialysis through clear corneal incision at the temporal side and were followed up for 6mo.

RESULTS: Best corrected visual acuity was improved after surgery(P<0.01). The mean intraocular pressure(IOP)at 6mo after surgery was 15.76±2.09mmHg, significantly lower than preoperative IOP(P<0.01). Postoperative chamber angles were all wider than those after the surgery, and the closed quadrant of chamber angle adhesion opened in different degree. Preoperative anterior chamber depth was 1.97±0.29mm, postoperative anterior chamber depth increased to 2.83±0.35mm, and there was significant difference for the change(P<0.05). Malignant glaucoma and posterior capsule rupture was not observed during the follow-up. All IOL of operation eyes were in lens capsular bag, and the situation of deviation and clamping did not appear.

CONCLUSION: Phacoemulsification with IOL implantation combined with goniosynechialysis is a safe and effective treatment for acute primary angle-closure glaucoma combined with cataract in decreasing IOP and improving visual acuity.

Study of the change of peripapillary atrophy β zone of primary open angle glaucoma in five years

Han Wang,Jing Wang,Jin-Song Zhang and Wei-Li Yuan — 2015/8/27 11:19:44

AIM: To investigate the relationship of the change of peripapillary atrophy β zone and progress of optic disc damage in primary open angle glaucoma(POAG).

METHODS: In this retrospective study, 66 eyes of 44 POAG subjects were selceted and made the morphology evaluation of the color fundus photographs(30°)which were taken in baseline and five-year visit. The change of peripapillary atrophy β zone(β zone)and the progress of optic disc damage was detected. The disc rim/disc area ratio, β zone/disc area ratio and vertical cup/disc ratio both baseline was calculated by computer software.

RESULTS:Forty-eighty eyes had β zone in 66 POAG subjects in baseline, β zone of 20 eyes(42%)was expanded, there was no significant difference on age, refractive error, gender, vertical cup/disc ratio, rim/disc area ratio, β zone/disc area ratio of baseline between β zone-developed group and β zone-undeveloped group. After excluded the eyes' refractive error >-3.00D, β zone of 15 eyes(60%)had developed in 25 progressed glaucoma eyes and 4 eyes(21%)had undeveloped in 19 unprogressed glaucoma eyes. There was significantly different(χ²=6.67, P=0.011).

CONCLUSION: The prevalence of β zone development in progressed group is larger than unprogressed group in POAG. To monitor the change of β zone may have some effects in predicting the progress of POAG.

Association of serum vascular endothelial growth factor and tumor metastasis in uveal melanoma

Hui-Ling Bai,Qin Liu,Jin Wen and Xiao-Ling Wu — 2015/8/27 11:19:44

AIM: To identify relationship between the expression of vascular endothelial growth factor(VEGF)of uveal melanoma patients whether with uveal melanoma metastasis and prognosis.

METHODS: The peripheral blood VEGF of uveal melanoma patients and patients in normal control group were detected by enzyme-linked immunosorbent assay(ELISA). The mRNA and protein expression level of VEGF in uveal melanoma tissues were analyzed through reverse transcription-polymerase chain reaction(RT-PCR)and Western-blot. Uveal melanoma patients were followed up, and the relationship of baseline serum VEGF and postoperative metastasis was analyzed by Kaplan-Meier method.

RESULTS: The expression level of peripheral blood VEGF was significantly increased in uveal melanoma patients than that in healthy people. The mRNA and protein expression level of VEGF in the uveal melanoma patients with metastasis when seeing a doctor were higher than patients without metastasis. In the process of follow-up, the uveal melanoma patients(serum VEGF ≥700pg/mL)had higher risk for tumor metastasis.

CONCLUSION: The expression level of VEGF of uveal melanoma patients is closely related to uveal melanoma metastasis.

Clinical efficacy of Ranibizumab intravitreal injection in the treatment of recurrent diabetic macular edema

Shan-Shan Zhang — 2015/8/27 11:19:44

AIM:To observe the clinical efficacy after Ranibizumab intravitreal injection in the treatment of recurrent diabetic macular edema.

METHODS: The study was a retrospective analysis of 30 cases of recurrent diabetic macular edema(39 eyes), including 18 males(23 eyes)and 12 females(16 eyes), aged 54.20±11.50 years. The patients, who were diagnosed to be with recurrent diabetic macular edema, were further treated with intravitreal injection of 0.05mL(0.5mg)ranibizumab. All the treated patients performed best corrected visual acuity, intraocular pressure, slit lamp microscope examination, fundus pre-set lens, fundus fluorescein angiography, and optical coherence tomography(OCT)examinations. The best corrected visual acuity, intraocular pressure and macular central retinal thickness(CRT)were recorded before and after the surgery. The results obtained from the last follow-up visit were used as the index for the evaluation of curative effects.

RESULTS: The follow-up periods ranged 6～12mo with the mean±standard deviation of 8.69±2.26mo. The injection numbers for each eye ranged 1～4 times with the mean±standard deviation of 1.82 ±0.82 times. The visual acuity before the treatment was 0.14±0.09, while significantly increased to 0.33±0.21 after the treatment(t=8.11, P<0.01). The macular OCT examination showed that macular edema was significantly alleviated after the treatment. The CRT was 495.74±147.84μm before the treatment, while significantly decreased to 219.33 ± 62.17μm after the treatment(t=10.68, P<0.01). Further specifically, CRT in 2 patients decreased without improvement of vision after the treatment, and no case of vision decrease after the treatment was observed.

CONCLUSION: Ranibizumab intravitreal injection is effective and safe in the treatment of recurrent diabetic macular edema.

Clinical study of Conbercept intravitreal injection for the treatment of wet age-related macular degeneration

Xu-Ting He,Da-Long Wang,Hong Zhang and Hai-Ning He — 2015/8/27 11:19:44

AIM: To observe the clinical curative effect of conbercept intravitreal injection for the treatment of wet age-related macular degeneration.

METHODS: Sixty patients with wet age related macular degeneration were randomly divided into treatment group 30 cases and control group 30 cases according to the random number table. The treatment group was injected with Conbercept 0.05mL, the control group was injected with triamcinolone acetonide 0.1mL. The best corrected visual acuity(BCVA)was performed before and after 1d, 1 and 3mo after treatment, and the thickness of macular was detected by optical coherence tomography(OCT). The complications of patients were observed after 1d, 1 and 3mo,including inflammatory reaction, corneal edema, anterior chamber, high intraocular pressure, etc.

RESULTS:In treatment group 1d, 1 and 3mo after treatment, eyesight was improved significantly better than the control group(P<0.05), macular center concave retinal thickness was significantly lower than the control group(P<0.05). Treatment group and control group 1d, 1 and 3mo after treatment did not appear serious eye complications.

CONCLUSION: Intravitreal injection of Conbercept in the treatment of wet age-related macular degeneration can improve the curative effect.

Efficacy of first Ranibizumab intravitreal injection on macular edema caused by retinal vein occlusion

Hong Cao,Yi Sun and Qing-Yao Gao — 2015/8/27 11:19:44

AIM: To observe the efficacy of first Ranibizumab intravitreal injection on macular edema caused by retinal vein occlusion(RVO).

METHODS: Thirty-nine eyes of 39 patients with macular edema due to RVO were treated in our hospital during June 2014 to December 2014. Patients received intravitreal injection of 0.05mL ranibizumab. Best corrected visual acuity(BCVA), central macular thickness(CMT)and cube average thickness(CAT)were analyzed at 2d, 2, and 4wk after injection, respectively.

RESULTS: The baseline BCVA(LogMAR), CMT and CAT were 0.82±0. 45, 541±136μm and 382±107μm before treatment. After first ranibizumab intravitreal injection, mean BVCA significantly improved at 2d(0. 56±0.35,P<0.01), 2wk(0.48±0.39,P<0.01), 4wk(0.51±0.44, P<0.01), compared to baseline BCVA. Mean CMT also decreased at 2d(372±86μm, P<0.01), 2wk(281±74μm, P<0.01), 4wk(286±97μm, P<0.01), mean CAT also decreased at 2d(331±46μm, P<0.01), 2wk(312±54μm, P<0.01), 4wk(319±68μm, P<0.01), compared to baseline BCVA.

CONCLUSION: First intravitreal injection of ranibizumab can improve macular edema caused by RVO in short-term, but long-term effects is needed further observed.

Clinical investigation on vitrectomy reserved anterior capsule combining with extra retinal photocoagulation for proliferative diabetic retinopathy

Qiao Chen,Shang-Wu Nie and Xiao-Qin Wang — 2015/8/27 11:19:44

AIM: To evaluate the preservation of anterior capsule used in vitrectomy combined with extra retinal photocoagulation for proliferative diabetic retinopathy(PDR)stage Ⅵ with cataract.

METHODS: Retrospective analysis of 38 patients(45 eyes)with PDR stage Ⅵ with cataract in our hospital from January 2010 to June 2013, preoperative visual acuity were LP to 0.1, underwent vitrectomy reserved anterior capsule and intraoperative extra retinal photocoagulation(E-PRP)with silicone oil tamponade in all eyes. Patients were followed up for 12～26mo to observe the intraocular pressure, visual acuity, anterior and posterior segment conditions.

RESULTS: Postoperatively 32 eyes(71%)improved in visual acuity and 13 eyes(29%)didn't improve, 23 eyes with BCVA ≥0.05 there was a significant difference(χ²=16.80, P<0.01)compared with preoperative. Anatomic retinal attachment was achieved in 39 eyes(87%). There were 2 eyes(4%)of silicone oil dependence and 7 eyes(16%)with epiretinal proliferative membrane. One eye(2%)was found iris neovascularization(INV)and progressed to neovascular glaucoma, 4 INV eyes gradually subsided, but there was no significant difference compared with the preoperative(χ²=1.61, P=0.21). The postoperative complication incidence of transient intraocular pressure rise, corneal edema, anterior chamber fibrin exudation, posterior synechia and anterior capsule opacification was 24%(11 eyes), 18%(8 eyes), 13%(6 eyes), 4%(2 eyes)and 29%(13 eyes).

CONCLUSION: The preservation of anterior capsule invitrectomy combined with E-PRP is safe and effective for patients with PDR stage VI with cataract. It can improve postoperative visual acuity and reattach retina effectively, and may also reduce the incidence of iris neovascularization.

Clinical observation of visual evoked potential of optic nerve contusion treated with mouse nerve growth factor

Wen-Wen Liu,Tao Jiang,Gui-Bo Liu,Hong-Yan Wang and Li-Ping Jiang — 2015/8/27 11:19:44

AIM: To observethe changes of visual evoked potential(VEP)of optic nerve contusion treated with mouse nerve growth factor and estimate the efficacy of mouse nerve growth factor.

METHODS: Thirty-four cases(34 eyes)of optic nerve contusion enrolled from October 2013 to February 2015 were selected and randomly divided into two groups. The treatment group 22 patients(22 eyes)was given the mouse nerve growth factor 30μg, with 2.0mL dissolved in water for injection, intramuscular injection once daily, with an average treatment of 42d, while for the hormones and vitamins medication treatment. For the control group 12 cases(12 eyes), mouse nerve growth factor was not used, other drugs were the same as the treatment group. All patients were accepted a review of vision and VEP at 21, 42d after the treatment.

RESULTS: After 42d treatment, the difference of best corrected visual acuity showed statistical significance(P<0.05)and VEP P100 latent period was 104.59±7.54ms, amplitude was 5.12±1.48μV in treatment group. While, latent period was 113.25±9.21ms, amplitude was 4.69±1.89μV in control group. Also, VEP P100 latency of the two groups showed statistical significance(t=-3.132, P<0.05)after 42d treatment, while VEP P100 amplitude had the same conclusion(t=2.541, P<0.05). The effective rate was 82% in treatment group, while 42% in control group with significant difference(P=0.026).

CONCLUSION: Mouse nerve growth factor has significant efficacy on traumatic optic nerve contusion, the changes of VEP can accurately reflect the conclusion, and VEP has proved to be an important basis on estimating the clinical efficacy.

Visual quality of super-high myopia after ICL V4c implantation in short-term

Yan-Yan Zhou and Xiao-Long Zheng — 2015/8/27 11:19:44

AIM:To observe the visual quality of super-high myopia after implantation of the visian implantable collamer lens with centra-flow(ICL V4c)in the short-term.

METHODS: The clinical date of 78 patients(100 eyes)were collected, the preoperative uncorrected visual acuity(UCVA)was below 0.10, spherical refraction was -13.25±2.05(-11.25～-20.00)D. The preoperative and postoperative refrative condition, wavefront aberration, visual acuity and contrast sensitivity were examined.

RESULTS: The postoperative UCVA in 97 eyes(97%)were equal to or more than 0.7. Thirty-seven eyes(37%)were equal to or more than 1.0. Both the contrast sensitivity and glare contrast sensitivity under high spatial frequency were increased at postoperative 1mo, there were statistical differences(all P<0.05). Both the higher-order aberrations, coma, spherical, second coma and second spherical were increased at postoperative 1mo, there were statistical differences(P<0.05). At postoperative 1mo, 2 eyes' original lens had cloudy, 2 eyes' intraocular pressure had increased, 3 eyes had corneal reaction, 1 eye had glare and halos. At postoperative 6mo, all visual symptoms almost disappeared.

CONCLUSION: The visual quality of super-high myopia after implantation of ICL V4c was improved obviously in short-term.

Correlation analysis between the test results of PVEP in children with ametropic amblyopia

Xue-Yin Zhang,Xi-Ling Xu and Hong-Yan Jia — 2015/8/27 11:19:45

AIM: To analyze the impact of age on children with amblyopia and the correlation between pattern visual evoked potential(PVEP)test results and age.

METHODS: A total of 136 cases(272 eyes)of children with ametropic amblyopia in our hospital from June 2012 to June 2014 were analyzed. Based on the best corrected visual acuity(BCVA): BCVA ≥0.5, 0.3≤BCVA<0.5, BCVA<0.3, subjects were categorized into three groups: mild group, moderate group and severe group, each group was further divided into two subgroups based on age: <6 years and ≥6 years. The latency(LP100)and amplitude(AP100)of each group were tested by PVEP, an independent samples t test was used to analyze the differences between each age subgroups. Then, age was subdivided into 4 sections(4～<6 years, 6～<8 years, 8～<10 years, ≥10 years), take BCVA as the dependent variable, a Logistic multivariate regression model whose parameters included age, spherical equivalent, gender, type of amblyopia was established to analyze the correlation between age and amblyopia diagnosis.

RESULTS: With an increase in the degree of amblyopia, the LP100 increased and the AP100 decreased. The differences between 3 groups in the LP100 and AP100 were statistically significant(F=135.22, 16.74; P=0.007<0.01); Within the mild, moderate and severe amblyopic groups, the LP100 of the ≥6 years group were longer than those of the <6 years group(t=8.36, 5.37, 2.48; P=0.00, 0.00, 0.02), and the AP100 of the former were less than those of the latter(t=6.76, 4.88, 2.85; P=0.00, 0.00, 0.01). Age was an independent risk factor for amblyopia diagnosis(P <0.01, 95% CI=0.714～0.785).

CONCLUSION: Age is independently associated with the diagnosis of ametropic amblyopia, to different ages of children, the same vision represent different functional significance. In measuring the severity of amblyopia in children, different ages respond to adopt different standards.

Assessment of visual function by optical coherence tomography and visual field for craniopharyngioma patients

2015/8/27 11:19:45

AIM:To analyze the differences and correlations between ganglion cell complex(GCC), peripapillary retinal nerve fiber layer(pRNFL)and mean defect(MD), mean sensitivity(MS)of visual field(VF)in craniopharyngioma patients, to evaluate the feasibility of optical coherence tomography(OCT)in diagnosis of the visual pathway damage of craniopharyngioma patients.

METHODS:Ninety-five craniopharyngioma patients treated in Beijing Tiantan Hospital, from September 2014 to April 2015 received the VF test by Octopus 900 automated perimeter with the central 30 degree program and the mean thickness measurements of GCC and pRNFL by RTVue OCT. Spearman rank correlation coefficient(r_s)was used to assess the correlation between GCC, pRNFL and MD, MS. The changes of VF and optic disc were analyzed.

RESULTS: Abnormal pRNFL findings occurred in 53.1%(93/175), which included optic disk edema 3.4%(6/175), atrophic changes of optic nerve 47.4%(83/175)and glaucoma-like optic neuropathy 7.4%(13/175). Various visual field defect was 71.4%(125/175). The average thickness of binocular pRNFL(r_s_OD=-0.411, r_s_OS=-0.354)and GCC(r_s_OD=-0.400, r_s_OS=-0.314)had correlation with MD(P<0.01). The average thickness of pRNFL(r_s_OD=0.412, r_s_OS=0.342)and GCC(r_s_OD=0.414, r_s_OS=0.299)had correlation with MS(P<0.01).

CONCLUSION: The average thickness of pRNFL and GCC has correlation with VF damage, can evaluate the optic nerve damage of craniopharyngioma patients quantitatively. The thinner the thickness of pRNFL and GCC is, the serious damage of visual function is. During the clinical work, visual field test combined with OCT are helpful to find and assess the damage of visual pathway and prognosis.

Study on disease-causing genes screening of a pedigree with glaucoma

2015/8/5 15:43:42

AIM: To study a large glaucoma family by screening the disease-causing genes in order to understand the pathogenesis mechanism of glaucoma.

METHODS: The diagnosis of glaucoma family was made by ophthalmological examination; peripheral blood was collected and the pedigree map was drawn. The genome DNA of the patients was extracted. The exons of MYOC, CYP1B1, OPTN, and WDR36 were amplified by PCR and sequenced. The data were analyzed by comparing the corresponding reference sequence in the database. Based on the target gene region capture technology, ophthalmic chip was used for further analysis. We were hoping to identify disease gene of the family or discover the new pathogenic site.

RESULTS: Among all exons of MYOC, CYP1B1, OPTN, and WDR36, was no mutation gene identified as the disease causing gene, excluded most known candidate gene mutation of glaucoma and found 5 suspicious sites by the ophthalmic chip.

CONCLUSION: Glaucoma is a polygenic disease, the known glaucoma-causing genes may not be involved the pathogenesis of the glaucoma in this family. Further studies are needed to identify the molecular basis of this family with glaucoma.

Short-term effects of orthokeratology on corneal morphology changes for myopia teenagers

Lin Li and Shou-Min Xi — 2015/8/5 15:43:42

AIM:To evaluate the safety and effectiveness of Orthokeratology in correcting and curing mild and moderate myopia for teenager patients by investigating the clinical response of wearing Orthokeratology at day or night and further analyze the underlying factors.

METHODS: Eighty-nine eyes(spherical equivalent refraction≤-6.00D, astigmatism with the rule ≤-1.50D and astigmatism against the rule ≤-0.75D)of 45 teenagers aged between nine and twenty wearing Orthokeratology contact lens from 2012 to 2014 were selected and then randomly divided into two groups, twenty-nine eyes wearing at day and sixty eyes wearing at night. The lens were put on eight to ten hours each time. Uncorrected visual acuity, residual spherical equivalent refraction, central corneal thickness, corneal curvature were examined punctually in addition to checking any kind of eye damage or complication after Orthokeratology at 1wk, 1, 3 and 6mo.

RESULTS:Uncorrected visual acuity was markedly corrected while residual spherical equivalent refraction was reduced after one wk contact lens wearing treatment. The above results were of statistical significance(P<0.01). Notably corneal curvature became more flattened after one wk, and the average K value got decreased from 42.28±1.13D to 40.79±1.26D(wearing at day)and 42.18±1.03D to 40.35±0.99D(wearing at night)respectively. The corneal curvature results had a statistically significant difference comparing one wk after wearing Orthokeratology than before(P<0.05), but there was no such difference comparing one wk with one, three or six mo(P>0.05). Central corneal thickness at one mo had the most obvious change which decreased 7.26±1.38μm(wearing at day)and 15.15±0.50μm(wearing at night)respectively, showing great statistical significance(P<0.01). The positive cases of corneal epithelium dyeing after orthokeratology were nine(wearing at day)and twenty-eight(wearing at night), which correspondingly accounted for 31% and 47%.

CONCLUSION: Orthokeratology can effectively reduce myopic diopter and improve uncorrected visual acuity. However, we still can not neglect the risk and should make sure of the safety by standardizing the optometry process and improving the fitting skills.

Related research on corneal higher-order aberrations after different ways refractive surgery

Shu-Xi He,Dong-Wei Li,Hua Wang,Dong-Qiang Luo,Jiao Chen and Qian Li — 2015/8/5 15:43:42

AIM:To evaluate the changes of corneal high-order aberration(including Coma, Spab, RMSh)after laser in situ keratomileusis(LASIK)with femtosecond laser, sub-Bowman keratomileusis(SBK)and laser epithelial keratomileusis(LASEK).

METHODS: Of 82 myopic patients(164 eyes), 31 patients(62 eyes)were treated by FS-LASIK, 31 patients(62 eyes)were treated by SBK, 20 patients(40 eyes)were treated by LASEK. Sirius system was used for measuring the coma aberration, spherical aberration, and high order aberration at 1, 15d,1, 3mo after surgery.

RESULTS: 1)Vision: The uncorrected visual acuity of the three groups had no differences(P>0.05). 2)Corneal aberrations: Three kinds of surgical procedure for patients with corneal aberration had significant impact. The C7, C8, C12 and RMSh of three groups were increased significantly(P<0.05). The C7, C8, C12 and RMSh were not recovered to preoperative levels after 3mo. But the increase of patients after FS-LASIK was smaller than the other two groups, with statistical significance(P<0.05).

CONCLUSION: Compared with SBK and LASEK,FS-LASIK has better visual acuity in the early postoperative and corneal higher-order aberrations increase is relatively small.

Application of manual small incision cataract surgery in age-related cataract

Bi-Hua Xie,Hai-Jia Xu,Bing Han and Zhuo Chen — 2015/8/5 15:43:42

AIM: To research the practicability of manual small incision cataract surgery(MSICS).

METHODS: Three hundred and six eyes age-related cataract were taken MSICS and 306 eyes received phacoemulsification(Phaco group). Visual acuity, the refractive and the loss ratio of cornea endothelia cells were observed and compared after surgery.

RESULTS: Uncorrected visual acuity of 33 eyes(10.78%)and 76 eyes(24.84%)was >1.0 in 7d and 3mo after MSICS. The loss ratio of cornea endothelia cells was 8.7%, The recursive of corneal astigmatism was on average 0.75D compared with preoperation. Uncorrected visual acuity of 63 eyes(20.59%)and 92 eyes(30.07%)was >1.0 in 7d and 3mo after phacoemulsification. The loss ratio of cornea endothelia cells was 21.67%. The average corneal astigmatism was -0.5DC and -0.45DC in MSICS group and Phaco group respectively, but 3mo after surgery, there was no significant difference on corneal astigmatism between the two groups(P>0.05).

CONCLUSION: Due to the use of Phaco machine, the cost is higher in Phaco group, and the Phaco mechanical stimulation, injury, ultrasonic energy and perfusion solutions have effects on corneal endothelium, visual acuity recovery at early postoperative is slow. However, MSICS dose not use Phaco machine, works by hands, the cost is lower, and visual acuity recovery at early postoperative is faster.

Comparison of clinical outcomes after implantation of toric multifocal and monofocal intraocular lens

Yun Du,Kang Sun,Ying-Dan Su,Zhi-Wei Zhong and Xiang Liu — 2015/8/5 15:43:42

AIM: To compare the clinical outcomes after implantation of toric multifocal and monofocal intraocular lens(IOL)after phacoemulsification.

METHODS: A total 34 patients(40 eyes)were recruited for this study. All the patients were diagnosed as age-related cataract and implanted toric multifocal or monofocal IOL after phacoemulsification. All the patients were divided into two groups: patients in group A were implanted with Acrysof IQ Toric ReSTOR+3D IOL(18 cases, 20 eyes); those in group B received Acrysof IQ Toric IOL implantation(16 cases, 20 eyes). The uncorrected and best corrected distance visual acuity(UCDVA and BCDVA), uncorrected and best corrected near visual acuity(UCNVA and BCNVA), residual astigmatism 1, 6mo postoperative and contrast sensitivity with and without glare was measured 6mo postoperative.

RESULTS: There were no statistically significant differences in UCDVA, BCDVA and DCNVA(P>0.05), but UCNVA was statistically significant difference between the two groups at 1 and 6mo after surgery(P<0.05); At 1mo after surgery, the whole residual astigmatism in group A was 0.65±0.25D, while 0.52±0.27D in group B, and no significant difference was found between the two groups(P>0.05). The same result was also found at 6mo postoperative 0.54±0.23D vs 0.40±0.20D(P>0.05). After 6mo, contrast sensitivity with and without glare were significant differences between the two groups at high spatial frequencies(P>0.05).

CONCLUSION: Acrysof IQ Toric ReSTOR+3D IOL provides better distance and near vision for cataract patients with greater corneal astigmatism and obviously improves visual quality at the early postoperative period.

Clinical evaluation of RNFL and GCC for diagnosis in early stage of chronic primary angle-closure glaucoma

Shi Liu,Jian-Gang Yang and Shu-Hui Xing — 2015/8/5 15:43:42

AIM:To explore the diagnosis value of retina nerve fiber layer(RNFL)and ganglion cell complex(GCC)in the early stage of chronic primary angle-closure glaucoma(CPACG), and investigate their relationship with mean defect(MD)of visual field.

METHODS: Twenty-one patients with CPACG(38 eyes), 25 patients with suspected glaucoma(SG)(46 eyes)and 25 normal controls(49 eyes)were selected to perform SD-OCT. Statistical difference was analyzed the thickness of RNFL and GCC of average and all quadrants, and correlation between RNFL, GCC and MD of visual field.

RESULTS:There were significant differences in average and all quadrant thickness of RNFL and GCC between CPACG group and control group(P<0.01).The significant differences were found in RNFL thickness(RNFL-Avg, P<0.01; RNFL-Sup, P<0.01; RNFL-Inf, P<0.05)and in GCC thickness(average and all quadrant thickness, P<0.01)between CPACG group and SG group. The positive correlations were showed between MD and RNFL(r=0.65), GCC(r=0.72)in CPACG group.

CONCLUSION:RNFL and GCC are useful to diagnose and monitor the early stage of CPACG, and GCC may be more significant for the disease.

23G vitrectomy combined with internal limiting membrane peeling for early treatment of foveschisis with high myopia

Fu Gui,Hong-Xi Wu and Zhi-Peng You — 2015/8/5 15:43:42

AIM: To evaluate the efficacy and safety of the internal limiting membrane(ILM)peeling combined with 23G vitrectomy for early treatment of foveoschisis with high myopia and explore more suitable operation methods.

METHODS: Twenty-nine high myopia patients(29 eyes)with foveoschisis in our hospital from January, 2013 to June, 2014 were selected and divided into two groups: the experimental group(15 eyes)was treated by 23G vitrectomy combined with ILM peeling and intraocular gas injection therapy, and the control group(14 eyes)was treated only with 23G vitrectomy combined with ILM peeling. The best spectacle-correction and foveoschisis reattachment were postoperatively followed up.

RESULTS:The best spectacle-correction and foveoschisis reattachment were improved significantly compared with preoperative in two groups(P<0.05). There was no significant difference between the two groups at postoperative(P>0.05).

CONCLUSION: 23G vitrectomy with ILM peeling is more effective for early treatment of foveoschisis with high myopia.

Vitrectomy with internal limiting membrane peeling for macular hole in high myopia eyes

Chun-Mei Deng,Ming Ai,Shuang-Hong Jiang and Wen-Min Zheng — 2015/8/5 15:43:42

AIM: To compare the clinical effects between pars plana vitrectomy(PPV)and PPV with internal limiting membrane peeling(ILMP)for macular hole in high myopia eyes.

METHODS:The clinical data of 33 high myopia with macular hole patients(36 eyes)with or without retinal detachment caused by macular hole were retrospectively analyzed. The patients were divided into two groups according to different operation methods: 15 eyes in groupⅠhad undergone PPV; 21 eyes in groupⅡhad undergone PPV with ILMPP peeling. According to different conditions of patients,different auxiliary methods were accepted, such as silicone oil tamponade, C₃F₈ tamponade, photocoagulation, condensation, etc. The follow-up period was 3～12mo. Best corrected visual acuity(BCVA), macular hole closure rate and retinal reattachment rate were continuous checked after operation. Then we evaluated the outcome in the two groups by statistical analysis.

RESULTS: The postoperative mean BCVA increased by 0.167 in group Ⅰand 0.456 in group Ⅱ than preoperative, the difference was significant(t=2.46,6.753; P=0.027,0.000). And the difference of BCVA improvement was significant between those two groups(t=-2.943, P=0.006). The macular hole closed in 7 eyes(46.67%)in group Ⅰ,and 18 eyes(85.71%)in group Ⅱ; The difference was significant between those two groups(χ²=6.287,P=0.025).Retinal reattachment was found in 11 eyes(91.67%)in group Ⅰ and 19 eyes(94.73%)in group Ⅱ. The difference was not significant between the two groups(χ²=0.856, P=0.418).

CONCLUSION: PPV with ILMPP peeling for macular hole in high myopia eyes can obviously improve closure of macular hole and postoperative visual acuity. But the difference of retinal reattachment rate was not significant between peeling and unpeeling of ILMP.

Effect of vitrectomy combined medication hyperplastic on patients with diabetic retinopathy

Xue-Qun Yu,Guo-Ping Cao and Ming-Xia Tang — 2015/8/5 15:43:42

AIM: To observe the comparison of vitrectomy combined drug therapy(Ranibizumab injection)and single vitrectomy for proliferatived diabetic retinopathy(PDR)and the influence of the curative effect and prognosis of patients.

METHODS: In this study, 112 cases(125 eyes)with PDR were selected and randomly divided into experimental group and control group(n=56). Fifty-six cases(61 eyes)in experimental group were injected by drug therapy of 0.5mg ranibizumab and received vitrectomy; In control group, 56 cases(64 eyes)were received single vitrectomy. The intraoperative and postoperative differences of clinical indicators were analyzed in two groups.

RESULTS: The average operation time, intraoperative electric coagulation hemostasis rate and iatrogenic hiatal incidence of the experimental group were lower than that of the control group:(95.00±13.00)min vs(133.00±14.5)min, 11% vs 34%, 5% vs 20%, respectively(P<0.05). The anterior chamber and vitreous body cavity hemorrhage rate within postoperative 1mo in the experimental group were lower than that of the control group: 7% vs 23%, 5% vs 12%, respectively(P<0.05). The postoperative visual acuity of experimental group was better than that of the control group: 0.375±0.210 vs 0.261±0.170, respectively(P<0.05).

CONCLUSION: Patients with PDR injected with ranibizumab in vitreous cavity before vitrectomy can effectively reduce the operation time, less intraoperative blood loss, the incidence of iatrogenic hiatus, and intraoperative and postoperative complications. The postoperative visual acuity was better than before.

Clinical study on retinal nerve fiber layer thickness of children and adolescent measured by OCT

Hui-Min Guo,Dong-Sheng Fan and Zi-Lin Chen — 2015/8/5 15:43:42

AIM:To evaluate the clinical characteristics in retinal nerve fiber layer(RNFL)thickness of the 8～17 years old near sightedness, provide the basis for juvenile glaucoma diagnosis, to avoid missed diagnosis and misdiagnosis.

METHODS: A total of 165 eyes from 99 healthy subjects(age range 8～17 years)were divided into low, moderate, high myopia and normal group. Cirrus HD OCT was used to measure the RNFL thickness. Each subject was performed circular scans around the optic nerve with a circle size of 3.46mm. Total average, mean quadrant and clock-hour RNFL thicknesses were recorded and compared between the four groups. The characteristics of the RNFL thickness of myopia were observed.

RESULTS: Compared myopia groups with normal group, the mean RNFL thickness decreased, there was statistically significant difference in high myopia group(P<0.05). The mean RNFL thickness of superior, inferior and nasal quadrant decreased, temporal quadrant was thickened. Compared moderate and high myopia groups with normal group, superior, inferior quadrant RNFL thickness were thinning, temporal quadrant was thickening, the differences had statistical significance(P<0.05). The RNFL measurements were statistically significant thinner in the myopia groups compared with normal group at 1:00, 5:00, 6:00 and 12:00 o'clock(P<0.05)and thicker at 8:00, 9:00, 10:00 o'clock(P<0.05). The RNFL measurement was statistically significant thicker in the low myopia group compared with normal group at 3:00 o'clock(P<0.05).

CONCLUSION: Compared adolescent myopia with normal, the Avg(mean RNFL thickness), S(superior quadrant RNFL thickness), I(inferior quadrant RNFL thickness), 1:00, 5:00, 6:00 and 12:00 o'clock RNFL thickness is thinner, which is decreased with the increasing SE. While the temporal(T)quadrant, 8:00, 9:00, 10:00 o'clock RNFL thickness is thicker, which increased with the increasing SE. Analysis of RNFL thickness in the evaluation of glaucoma should always be interpreted with reference to the refractive status, so as not to cause misdiagnosis of glaucoma. The highest diagnosis efficiency position of glaucoma is infratemporal(7:00～8:00 o'clock)and superior temporal(10:00～11:00 o'clock), which is not thinner in juvenile myopia, if these positions become thinner, it may be the possibility of glaucoma.

Relationship between visual function and morphological changes of the high myopia fundus

Yan-Fang Liu and Wei-Feng Liu — 2015/8/5 15:43:43

AIM:To evaluate the morphological changes of peripapillary atrophy(PPA)and retinal thickness(RT)in high myopia under different best corrected visual acuity(BCVA).

METHODS: A retrospective review of medical records in 55 high myopia patients(104 eyes)was carried out, whose spherical equivalent(SE)refractive errors ranged from -6～-27D. Groups A, B and C were divided according to different BCVA. The parameters including optic disc(OD)size, PPA size, the biggest width of OD along the horizontal axis, the biggest width of PPA along the horizontal axis, the size of the peripapillary chorioretinal atrophy(PCA), the average 6mm center retinal thickness(ACRT), the center retinal thickness(CRT), the total 6mm center retinal volume(TCRV)were evaluated. All the data were analyzed respectively by one-way ANOVA with edition SPSS 13.0.

RESULTS: There were significant differences among three groups on PPA size(8.29±4.82, 4.31±3.05, 2.49±2.60mm² in groups A, B and C, respectively), PPA width(1.88±0.83, 1.31±0.66, 0.86±0.61mm in groups A, B and C, respectively)(all P<0.01). The PCA size was increased significantly in group A(4.26±4.27mm²)than other groups(group B: 1.23±1.74mm², group C: 0.62±1.53mm²)(F=19.58, P<0.01). The OD size and width had no significant differences among three groups(F=1.1, P=0.33; F=0.44, P=0.64). ACRT and TCRV reduced significantly in group A(ACRT: 211.34±118.32μm; TCRV: 6.09±3.65mm³)than in other groups(F=4.28, P=0.01; F=3.35, P=0.03), but no significant difference between groups B and C. CRT was not changed in three groups(F=2.23, P=0.11).

CONCLUSION: PCA increase, ACRT and TCRV decrease assist to evaluate visual function in high myopia. PPA increase indicates the myopia progress.

The 2^nd phase of research for the visual cortical functional mediating stereopsis in children anisometropic amblyopia: evidence from fMRI

Lei Yang,Zhen-Guo Yan,Hong Cao,Yue-Dong Han,Qiang-Hua Ma and Jian-Jun Ye — 2015/8/5 15:43:43

AIM:To evaluate the recovery about the visual cortex function of stereopsis in anisometropic amblyopia after regular amblyopia treatment 6, 12 and 18mo with blood oxygenation level dependent-function magnetic resonance imaging techniques(BOLD-fMRI).

METHODS: In this study, self-controlled study before and after treatment was used, and blocks-designed fMRI was performed on 11 children which was the first phase of research for amblyopic treatment. Functional MRI data were processed by using SPM8 which based on the Matlab 7.12.0.635. Through the hypothesis drive method, the differences range of activated area in each group were compared by before and after amblyopia treatment matched t-test.

RESULTS: The functional area that was left occipital lobe(BA18), middle occipital gyrus(BA19), limbic lobe(BA19), lingualis gyrus of the right occipital lobe(BA17)and the bilateral parietal lobe(BA7)expanded after amblyopia treatment 6, 12mo, compared those treatment phase, mean t value was 1.5762, 1.6856 respectively(P<0.001). However, the difference of activated intensity was lower after 18mo, mean t value was 1.1473(0.001<P<0.01).

CONCLUSION: In children anisometropic amblyopia, the speed of function reconstruction about visual cortical functional mediating stereopsis increase slowly after amblyopia treatment 1a.

Comparison of 10-0 nylon suture with 8-0 absorbable suture in strabismus surgery

Yang-Li Huang and Chi Feng — 2015/8/5 15:43:43

AIM:To compare 10-0 nylon suture with 8-0 absorbable suture on conjunctival incision in microscopy strabismus surgery.

METHODS:The patients undergone esotropia or exotropia surgery in our hospital were selected and randomly divided into two groups: conjunctival incision of 32 patients(41 eyes)was sutured using 10-0 nylon in control group and that of 30 patients(38 eyes)used 8-0 absorbable suture in observation group. All patients of two group were sutured using intermittently, knot buried method. Wound healing, patients perceived irritation were observed and compared at postoperative 1, 2wk and 1mo.

RESULTS: Postoperative 1 and 2wk, the number of suture absorption and incision gaping were 7 and 15 eyes in observation group, with total incidence rate of 39%, while there was no suture absorption and incision gaping occurred in control group, the incidence was 0, the difference was statistically significant between the two groups(P<0.05). One month after operation, 33 eyes' incision in observation group had some discomforts such as stitches residue, hyperemia, foreign body sensation, who were proposal to remove stitches, the stitches rate was 87%. Incision healed well after 2wk in the control group, all 41 eyes were stitched and stitches rate was 100%. There was no statistically significant difference(P>0.05). Comparing the mean postoperative wound healing time, it was 22.30±5.45d in observation group and 15.50±1.76d in control group, the difference was statistically significant(P<0.05). There was no significant difference on ocular comfort score between the two groups after 1, 2wk(P>0.05). Postoperative 1mo, ocular comfort scores in control group(2.57±0.50)was higher than that in observation group(1.813±0.64), the difference was statistically significant(P<0.05).

CONCLUSION: There was no difference using 10-0 nylon suture or 8-0 absorbable suture to suture conjunctival incision in microscopy strabismus surgery. Due to premature absorption of sutures, the incision healed delayed. 10-0 suture is recommend to suture bulbar conjunctiva in microscopy strabismus surgery.

Research on refractive status characteristics and anterior chamber depth after cataract surgery

Xiao-Cheng Feng,Wu-Ming Pan,Li Guo,Jian-Rong Xie and Huan-Ying Li — 2015/7/1 9:46:04

AIM:To study the refractive status characteristics aftser cataract surgery and the correlation between preoperative anterior chamber depth(ACD)and refractive status.

METHODS: Ninety-six cases of patients with cataract were randomly divided into two groups. The patients in phacoemulsification group were treated with phacoemulsification combined intraocular lens(IOL)implantation while the patients in small incision group were treated by small incision extracapsular cataract extraction combined with IOL implantation. Changes in ACD and postoperative refractive status and refractive fully corrected value were counted and the correlation of them were analyzed.

RESULTS: ACD of the phacoemulsification group s deepened 0.74mm while that of the small incision group deepened 0.78mm after treatment and there was no significant difference(P>0.05). After operation, the ACD of two groups significantly deepened(P<0.05). The postoperative visual acuity of two groups were significantly better than the uncorrected visual acuity of two groups(P<0.05). The postoperative refraction of two groups patients were mainly 0 ～+1.0D(41.67% and 54.16%)and +1.25～+2.0D(43.75% and 33.33%)(P>0.05).

CONCLUSION: ACD is significant deepened after operation. Surgeon needs full consideration of changes to improve the refractive IOL calculation accuracy.

Clinical observation of the glaucoma trabeculectomy with tunnel knife making the double-deck scleral flap

Min Fu,Qian Yu and Yong-Chun Zhuang — 2015/7/1 9:46:04

AIM: To study the trabeculectomy clinical effect of use tunnel knife to make double-deck scleral flap and to cut off the layer scleral flap of glaucoma.

METHODS:Using the random grouping method to divide 46 cases(60 eyes)of glaucoma into the treatment group of 24 cases(32 eyes)and control group of 22 cases(28 eyes). The treatment group, tunnel knife was used to make double-deck sclera flap and superficial scleral flap about the size of 5mm×5.5mm,1/3 scleral thickness, under the sclera flap made another one about the size of 3.5mm×4mm, 1/3 scleral thickness, resected the middle layer of the sclera flap, removed 2mm×2mm trabecular tissue, underwent routine peripheral iridectomy, could adjust suture the superficial scleral flap, sutured Ball fascia and bulbar conjunctiva. In control group, routine glaucoma trabeculectomy was undergone.

RESULTS:Patients were followed up for 1a, the vision in treatment group was obviously better than that in the control group, with a statistically significant difference(P<0.05). The postoperative intraocular pressure of the two groups of patients were significantly lower than that of the preoperative one. Postoperative 1 and 3mo, no statistical significant difference of intraocular pressure in two group(P>0.05). But after 6 and 12mo, the intraocular pressure of the treatment group were significantly lower than that of the control group, with statistically significant difference(P<0.05). Postopeartive 1a, the cumulative complete success rate and conditions for successful rate were 90.63% and 96.88% in the treatment group, and those were 75% and 89.29% in control group. There was significant difference between two groups(P<0.05).

CONCLUSION:The trabeculectomy have a good effect to lower the intraocular pressure by use tunnel knife to make double-deck scleral flap and to cut off the layer scleral flap. The scleral flap have uniform thickness, smooth surface, and the function of the filtering bleb maintained for a long time, less postoperative complications, suitable for various types of glaucoma, so it is worthy of clinical promotion.

Changes of tear film after trabeculectomy in glaucoma

Xue-Jun Li and Wei Liu — 2015/7/1 9:46:04

AIM: To learn the changes of the tear film before and after the trabeculectomy of glaucoma and explore the incidence of dry eye and the prevention and control measures.

METHODS: The 36 patients(60 eyes)of glaucoma were examined in detail before 3d of trabeculectomy and after the surgery at 3, 7, 14 and 30d. The examinations include lower eyelid central river of tears, break-up time(BUT), Schirmer Ⅰ test(SⅠt)and staining scores of corneal fluorescein under slit lamp microscope.

RESULTS:The tear meniscus height of central lower eyelid was increased and the tear film BUT was shortened at the same time, the scores of SⅠt was reduced and corneal fluorescein staining score was increased at postoperative 3 and 7d compared with that of preoperation. The tear meniscus height of central lower eyelid, tear film BUT and SIt and score of corneal fluorescein staining began to recover in most of the affected eyes after surgery 14d. At 30d after surgery, 22% of patients tear film failed to recover to the preoperative level; dry eye occured in 18% preoperative eyes with normal tear film.

CONCLUSION:Trabeculectomy of glaucoma may affect the stability of the tear film and some patients showeing obvious dry eye and should be intervened and treatmented timely.

Asymmetry of optic disc hemifield retinal nerve fiber layer in early primary open angle glaucoma

Wen Li,Yuan Deng,Dan Zhou,Jun Li,Ding Lin and Chang-Hua Ye — 2015/7/1 9:46:05

AIM: To examine the retinal nerve fiber layer(RNFL)changes in early primary open angle glaucoma(POAG)by comparing the superior half of the optic disc with the inferior disc half.

METHODS: It was a clinical observational study. The study included 30 patients(39 eyes)with POAG and 20 normal subjects(40 eyes). Visual field was tested by Zeiss Humphrey750 and the optic disc topographic parameters and RNFL thickness were measured by Zeiss Cirru HD-OCT. Collecting information included visual field mean defect(MD), glaucoma hemifield test(GHT), intraocular pressure(IOP), C/D ratio and RNFL thickness. Data were analyzed by statistic software SPSS18.0. The differences between two groups were assessed using t test.

RESULTS: The differences of superior RNFL minus inferior RNFL thichness on the corresponding clock-hour locations were caculated in two groups. There was a significant difference in superonasal-inferonasal RNFL thickness between two groups(t=2.526, P=0.014), and there were no significant differences in the others(all P>0.05).

CONCLUSION: The asymmetry of optic disc hemifield RNFL is found in early primary open angle glaucoma patients. The superonasal RNFL(1 o'clock for right eye, and 11 o'clock for left eye)is more fragile to loss than inferonasal RNFL(5 o'clock for right eye, and 7 o'clock for left eye).

Relationship between subfoveal choroidal thickness and both choroidal hemodynamic index and glycosylated hemoglobin in diabetic subjects

Peng-Fei Han,Shuang-Nong Li,Qiang Li and Wei-Liang Zhang — 2015/7/1 9:46:05

AIM: To investigate the relationship between the subfoveal choroidal thickness(SFCT)and both choroidal hemodynamic index and glycosylated hemoglobin in diabetic subjects.

METHODS: Seventy-eight type 2 diabetic patients(156 eyes)from ophthalmology and endocrinology ward of our hospital were enrolled in this study, including 39 females and 39 males, with a mean age of(59.8±6.2)years. According to early treatment diabetic retinopathy study(ETDRS)grading method, all samples were divided into diabetic retinopathy(DR)group, mild or moderate nonproliferative diabetic retinopathy group, severe nonproliferative diabetic retinopathy(NPDR)group and proliferative diabetic retinopathy(PDR)group. The SFCT and choroidal hemodynamic index were measured by enhanced depth imaging optical coherence tomography(EDI-OCT)and Color Doppler Imaging. Recording glycosylated hemoglobin content of all samples. Using multivariate linear regression to analyse the relationship between the SFCT and both choroidal hemodynamic index and glycosylated hemoglobin.

RESULTS: The end diastolic velocity(EDV)was significant higher and the SFCT was significant thinner in no diabetic retinopathy(NDR)group than other groups. There was no significant difference of peak systolic velocity(PSV)between four groups.The resistance index(RI)was significant higher in severe NPDR group than NDR group and mild or moderate group,the RI in PDR group was hihgest than other group with statistically significance.The SFCT was correlated positively(b=0.540,P<0.001)with the glycosylated hemoglobin. No significant correlation was found between the SFCT and the choroidal hemodynamic index(DR,P=0.341; PSV,P=0.770; EDV,P=0.131; RI,P=0.084).

CONCLUSION: Our results suggest that there is no significant correlations between the SFCT and the choroidal hemodynamic index; glycosylated hemoglobin is one of the factors that affect the SFCT in diabetic patients.

Clinical efficacy of intravitreal Ranibizumab in idiopathic choroid neovascularization type Ⅰand type Ⅱ

Yue-Ming Sun,Yu-Hong Cheng,Lin Zhang and Feng-Mei Shen — 2015/7/1 9:46:05

AIM: To evaluate the efficacy of intravitreal ranibizumab in idiopathic choroid neovascularization(ICNV), compare the difference of the curative effect between type Ⅰand Ⅱof ICNV by optical coherence tomography(OCT), further provide evidence of the to effectiveness of ranibizumab in the treatment of choroidal neovascularization to guide clinical treatment.

METHODS: A retrospective analysis on the clinical data who were diagnosed as ICNV between October 2013 and June 2014 in our hospital were carried out. Totally 31 cases(9 cases of type Ⅰ and 22 cases of type Ⅱ)accepted ranibizumab injection voluntarily.All of the patients were evaluated by ophthalmic examination, funduscopy and OCT before and after the injection, classificated according to OCT results. The best-corrected visual acuity(BCVA)and maximum of edema thickness after ranibizumab treatment at 3mo follow-up were compared.

RESULTS: After statistically analyzed, BCVA and maximum thickness of the retinal lesions of 31 patients(type Ⅰ9 cases, type Ⅱ 22 cases)before and 1, 3mo after treatment had statistical significance. In different types of retinal ICNV patients, BCVA and maximum thickness of the retinal lesions before and after treatment had no statistical significance. It was said that ranibizumab intravitreal injection had effectiveness for ICNV, however, there were no significant effectiveness for typeⅠ andⅡ ICNV.

CONCLUSION: Ranibizumab intravitreal injection has obvious effectiveness for ICNV. However, it has no effect on typeⅠ andⅡ ICNV. Its safety and long-term complications need for further study.

Macular thickness changes before and after phacoemulsification by optical coherence tomography

Qiu-Yu Shen and Dan Liu — 2015/7/1 9:46:05

AIM: To observe the influence of phacoemulsification combined with intraocular lens implantation on retinal thickness changes of macular center fovea using optical coherence tomography(OCT)in cataract patients.

METHODS: Surgical eyes of 60 cases with cataract were as surgery group, the contralateral eye were as controls group. There was no complication before and during the surgery.Macular thickness was examined by OCT preoperatively and 1wk, 1, 3, and 6mo after surgery.The retinal thickness changes of macular center fovea were compared after surgery. The SPSS 17.0 software was used for statistical analysis.The paired t-test and variance analysis were used in two groups before and after surgery for relevant statistical data analysis(α=0.05).

RESULTS: In surgery group, the retinal thickness changes of macular center fovea at 1wk, 1, 3mo after treatment had significant differences compared with preoperation(P<0.05). The retinal thickness changes of macular center fovea at 6mo after treatment had no statistical significance compared with preoperation(P>0.05). The retinal thickness changes of macular center fovea was significantly higher than other groups at 1mo after treatment(P<0.05). The center fovea appeared to be abnormally thickened in 12 eyes, including 10 eyes of single fovea thickening and 2 eyes of cystoid macular edema in 2～4wk following surgery. Eleven eyes of them were resolved till 6mo postoperatively. In control group, preoperation or after operation for 1wk, 1, 3, and 6mo respectively, P values were without statistical differences(P>0.05). There were no statistical significant differences on retinal thickness of macular center fovea between two groups before and 6mo after surgery(P>0.05), while there were significant differences at 1wk, 1 and 3mo after surgery(P<0.05)

CONCLUSION: The retinal thickness changes of macular center fovea increases significantly after phacoemulsification combined with intraocular lens implantation. In a few of cases appear macular edema, but the majority of patients can be restored, prognosis is good.

Change of retrobulbar artery hemodynamics and bulbar conjunctival microcirculation indexes of patients with optic atrophy

Dan-Hong Deng — 2015/7/1 9:46:06

AIM:To study and observe the change of retrobulbar artery hemodynamics and bulbar conjunctival microcirculation indexes of patients with optic atrophy.

METHODS: Seventy patients with optic atrophy in our hospital from April 2013 to October 2014 were selected as observation group, 70 healthy persons with the same age at the same time were the control group. Retrobulbar artery hemodynamics and bulbar conjunctival microcirculation indexes of two groups were compared, those detection indexes of observation group with different types and severity degree were compared too.

RESULTS: The retrobulbar artery hemodynamics and bulbar conjunctival microcirculation indexes of observation group were all worse than those of control group, and the detection results of observation group with severe optic atrophy were worse than those of patients with mild and moderate optic atrophy, and the detection results of patients with moderate optic atrophy were all worse than those of patients with mild optic atrophy(all P<0.05), there were all significant differences, while the detection results of patients with different types of optic atrophy had no significant differences(all P>0.05).

CONCLUSION: The change of retrobulbar artery hemodynamics and bulbar conjunctival microcirculation indexes of patients with optic atrophy are great, and the influence of the disease severity degree for the detection results are great.

Influence of mitomycin C to intraocular pressure and blood flow of glaucoma patients after trabeculectomy

Quan Gu and Hong Shen — 2015/7/1 9:46:06

AIM:To explore the efficacy and safety of mitomycin C used in trabeculectomy by analyzing intraocular pressure and blood flow.

METHODS: A total of 103 patients with glaucoma were divided into 2 groups randomly, and all patients were treated with trabeculectomy, while patients in the observation group were given mitomycin C extra. At 6～12mo follow-up were completed after operation, and the clinical efficacy, complications and hemodynamic characteristics of central retinal artery were compared between groups.

RESULTS: The clinical efficacy of the observation group was higher than that of the controls(P<0.05). There was no significant difference in complication rate between groups(P>0.05), but the complication type was differentiate to some extent. Low intraocular pressure and photophobia symptoms occurred mostly in the observation group, while cicatricial obstruction occurred mostly in the controls. Before treatment, there was no significant difference in hemodynamic characteristics between groups(P>0.05). One month after treatment, the peak systolic velocity(PSV)and end diastolic velocity(EDV)of the observation group were obviously lower, while resistance index(RI)and pulsatility index(PI)were higher than those of the controls, the difference was statistically significant(P<0.05). Six months after treatment, the PSV and EDV of the observation group were obviously higher, while RI and PI were lower than those of the controls, the difference was statistically significant(P<0.05).

CONCLUSION: Mitomycin C has a short-term harmful effect on glaucoma patients after trabeculectomy, but its long-term effect is safe and reliable.

Effect analysis of femtosecond laser micro incision corneal stroma lens removal

Yue-Jing Wang,Xin-Rong Xu,Chuan-Wei Zhang,Jing Wu and Hai-Yan Huang — 2015/7/1 9:46:06

AIM: To analyze and compare the effect of femtosecond laser micro-incision corneal stromal lens excision(SMILE)and excimer laser in situ keratomileusis(LASIK)in the treatment of myopia after operation, to explore the safety, operability and prediction of SMILE.

METHODS: In this prospective clinical controlled study, 100 cases(200 eyes)received SMILE and 100 cases(200 eyes)undergone LASI in our hospital in the same period were selected. Uncorrected visual acuity, diopter, corrected visual acuity, slit lamp examination, intraocular pressure and corneal anterior segment OCT, corneal topography(Obscan II)of two groups in 1d, 1wk, 1, 3, 6mo, 1a were compared. Independent samples t test was used for data analysis.

RESULTS: 1)Postoperative slit lamp examination: after 1d in SMILE group, there were less eyes had corneal layer between mild cloudy or edema; postoperative 1wk corneal layer disappeared, cornea became clear and transparent. 2)Postoperative vision recovery: 1d after operation, vision recovery in LASIK group was better than that in SMILE group, the difference was statistically significant(P<0.01), there were no significant differences at 1wk, 1, 3, 6mo, 1a after operation(P>0.05). 3)Obscan II examination: graphics in the SMILE group was more regular and placed in the center, no eccentric and irregular graphics, better than that in the LASIK group. 4)Anterior segment OCT examination: postoperative corneal flap in the SMILE group was more uniform and accurate, but it was thin in the center and slightly thick the peripheral part in the LASIK groups. 5)Postoperative visual quality assessment used subjective questionnaire survey. The two groups had statistically significant difference on 4 points and 1 points(P<0.05). Complains in the LASIK groups were more that that in the SMILE group. While, no complain of the SMILE group was higher than that of the LASIK group. Glare of postoperative patients with night vision and dark environment in the SMILE group was better than that of the LASIK group.

CONCLUSION: SMILE is safe, effective, stable and predictable for the correction of myopia.

Research on pattern reversal visual evoked potential of children with spastic cerebral palsy

Lu Li,Xiao-Jie Li,Yang Zhang and Hong-Bo Zhao — 2015/7/1 9:46:06

AIM: To explore the judgment of pattern reversal visual evoked potential on visual function and injured part of children with spastic cerebral palsy.

METHODS: There were two groups in this study. 30 children with spastic cerebral palsy(quadriplegia: 15, diplegia: 15)were selected as observation group, while 30 normal children were selected as control group with randomized controlled trial. The changes of half-view and full-view incubation period and amplitude were observed by pattern reversal visual evoked potential.

RESULTS: Full-view pattern reversal visual evoked potential: the P100 incubation period of the observation group was 113.55±8.14ms, and the P100 amplitude was 23.08±15.41μV. The P100 incubation period of the control group was 105.05±5.58ms, and the P100 amplitude was 31.65±7.37μV. From the comparison on P100 incubation and P100 amplitude between two groups, the difference was statistically significant(P<0.05). P100 incubation period of the spastic diplegia of full-view pattern reversal visual evoked potential was 112.73±7.22ms, and the P100 amplitude was 21.03±12.17μV. P100 incubation period of the spastic quadriplegia was 114.37±9.02ms, and the P100 amplitude was 25.14±18.06μV. From the comparison on P100 incubation and P100 amplitude between two groups, the difference had no statistically significance(P>0.05). Compared to the control group, each eye and each view latency of observation group were higher, the difference was statistically significant(P<0.05). The change of the incubation period of the full-view and half-view pattern reversal visual evoked potential took place in the lesion of the visual pathway: including optic neuropathy, some optic nerve lesion, lesion after optic chiasma, and optic chiasma lesion. Among them, the lesion after the optic chiasma was the most common.

CONCLUSION: Pattern reversal visual evoked potential can help people to understand the visual impairment and injury of children with spastic cerebral palsy in order to identify the abnormal children and early intervention.

Effects of overnight orthokeratology on correction and control of myopia in adolescents

Hong Xiao and Xin Ke — 2015/7/1 9:46:06

AIM: To evaluate the long-term efficiency and safety of overnight orthokeratology in myopia correction and control in adolescents.

METHODS: Sixty-five myopia adolescents treated in our hospital from August 2011 to February 2012 were retrospectively analyzed and followed up to 2a. Among them, 35 cases(67 eyes)wearing overnight orthokeatology were included as trial group, and 30 cases(60 eyes)wearing spectacles were included as control group. The trial group were divided into 2 subgroup according the myopic grading in the initial visit: subgroup A(35 eyes, ≤-3.00D), B subgroup(32 eyes,>-3.00D and ≤-6.00D). In the trial group, slit lamp, visual acuity, refraction, intraocular pressure, corneal tomography were collected before wearing overnight orthokeratology, 1d, 1wk, 1month, 3mo, and every 6mo after wearing overnight orthokeratology,with axial length, corneal thickness, anterior chamber depth, corneal endothelial cell count, abjective refraction and tear film were also collected before and 2a after wearing overnight orthokeratology. In the control group, slit lamp, visual acuity, refraction and intraocular pressure were collected before wearing and 2a after wearing spectacles. Paired t test were used to compare the intragroup difference. One-way analysis of variance(ANOVA)was used to compare the differences among the groups. P<0.05 was considered statistically significant.

RESULTS: The uncorrected visual acuity of the trial group was improved obviously after wearing Orthokeratology Lens 1d, the visual acuity of a group patients improved more significantly. The corneal curvature(including vertical curvature and horizontal curvature)of the trial group became more flat after wearing Orthokeratology Lens 2a and stopped 2 wk; The length of ocular axis was also increased, the growth rate of B group(0.33±0.31)mm was lower than that of group A(0.43±0.25)mm; Subjective refraction of myopia was increased 0.68±0.49D than wearing Orthokeratology Lens before, but compared with the growth(2.08±0.57)D of the control, the effect of myopia control was more obviously. Grade of dry eye was more severely than that of wearing Orthokeratology Lens before, but there was no significant difference between groups A and B. Compared with wearing Orthokeratology Lens before, corneal thickness, anterior chamber depth, corneal endothelial cell number and the intraocular pressure were all no significant differences between the trial and control group.

CONCLUSION: Orthokeratology is a safe and effective method for the correction of myopia, and long-term use of Orthokeratology Lens can effectively control the development of myopia. Controlling of moderate myopia is more effective than that of low myopia.

Correlative study between myopia and ocular relative accommodation

Qiao-Ya Lin,Han-Ying Zhou and Xue-Xi Li — 2015/7/1 9:46:06

AIM: To research the characteristics of positive relative accommodation(PRA), negative relative accommodation(NRA)and PRA/NRA ratio in myopes. To analyze the relationship among PRA, NRA, PRA/NRA ratio, spherical equivalent degree, years and habbits of wearing glasses, myopia development, and pupil diameter.

METHODS: Aretrospective study of ninety eyes in the 180^th Hospital of Quanzhou from August 2014 to December 2014. PRA, NRA and PRA/NRA ratio were compared among low, moderate, high myopes and emmetropes. The correlation were analyzed among PRA, NRA, PRA/NRA ratio, spherical equivalent degree, years and habbits of wearing glasses, myopia development and pupil diameter. PRA, NRA, PRA/NRA ratio, years and habbits of wearing glasses and pupil diameter were compared between progress group and non-progress group.

RESULTS:(1)Without statistical differences in age, sex and intraocular pressure, PRA and PRA/NRA ratio of myopes were lower than emmetropes, while NRA was higher.(2)Without statistical differences in age, sex and intraocular pressure, PRA, PRA/NRA ratio and NRA had no statistical differences while years and habbits of wearing glasses had statistical differences among low, moderate, high myopes.(3)With longer years of wearing glasses, PRA, PRA/NRA ratio were larger and NRA, pupils were smaller.(4)Without statistical differences in age, diopter and intraocular pressure, one group which were not easy to deepen degree had more often-wear-glasses myopia patiens and longer years of wearing glasses, the other group which were easy to deepen degree had more seldom-wear-glasses myopia patiens and shorter years of wearing glasses.

CONCLUSION: PRA and PRA/NRA ratio of myopes were lower than emmetropes, while NRA was higher. No correlated relation was detected among PRA, NRA, PRA/NRA ratio, spherical equivalent degree and myopia development. It suggests the onset and progress of myopia are related to many factors. Wearing-glass timely and accurately can release the decline of PRA and PRA/NRA ratio and slow down degree development in myopes.

Incision influence of small incision cataract surgery on corneal topography

Fang Liu — 2015/6/1 16:06:23

AIM: To explore the incision influence of small incision cataract surgery on corneal topography of patients, so as to provide a reference for the optimization of operation method.

METHODS: Seventy-one patients(94 eyes)were divided into two groups, which were given straight(group A)and eyebrow arched incision(group B). Patients in both groups A and B were divided into three subgroups respectively, which were given incision with different length from corneal limbus(1.5mm, 2.0mm and 2.5mm). The visual acuity level and corneal topography indexes(ACP, CYL, SAI and SRI)were compared before and after treatment.

RESULTS: There was influence on visual acuity level and corneal topography of incision morphology and length from corneal limbus(P<0.05), and there was difference in acuity level and corneal topography at different test time(P<0.05), and the influence had no interaction with test time(P>0.05). One week after surgery, the visual acuity level of all patients was higher than that before surgery, and 3mo after surgery, it was higher than that of 1wk after surgery too(P<0.05). One week after surgery, ACP, CYL, SAI, SRI level of all patients was higher than that before surgery(P<0.05), and 3mo after surgery, which decreased and had no statistical difference with preoperative levels(P>0.05). Before surgery, there was no significant difference in visual acuity level and corneal topography between groups(P>0.05). One week after surgery, the visual acuity level of subgroup 2.0mm and 2.5mm in group B was higher than the others(P<0.05), and there was no significant difference between(P>0.05). the ACP, CYL, SAI, SRI level of subgroups 2.0mm and 2.5mm in group B were lower than the others, and those of subgroup 2.5mm in group B were higher than those of subgroup 2.0mm of group B(P<0.05). Three months after surgery, there was no significant difference in visual acuity, SAI and SRI levels between groups(P>0.05), but the ACP and CYL level of subgroup 2.0mm and 2.5mm of group B were higher than those of the others(P<0.05), and there was no significant difference between(P>0.05).

CONCLUSION: Using eyebrow arched incision and appropriate distance to corneal limbus in the small incision cataract surgery can reduce the impact on corneal topography and benefit for control of postoperative astigmatism.

Clinical observation of orthokeratology on anterior segment parameters by Sirius anterior system

Di Shen,Tan Long and Wei Wei — 2015/6/1 16:06:23

AIM:To investigate the changes in anterior segment parameters by Sirius anterior system after orthokeratology and the possible mechanisms.

METHODS: Twenty-eight patients(56 eyes)with myopia in our hospital from August 2014 to October 2014 were included. Spherical equivalent were -3.83±1.19D. Data of central corneal thickness(CCT), anterior chamber depth(ACD), anterior corneal curvature(a-K)and posterior corneal curvature(p-K)were collected and analyzed at before, 1d, 1wk and 3mo after orthokeratology.

RESULTS: After orthokeratology, spherical equivalent of all eyes decreased to predicted level. There were no significant differences in CCT and p-K between different times(P>0.05). There were significant differences in a-K between different times except between 1wk and 3mo after orthokeratology(P<0.05). There were significant differences in ACD between before and 1wk after, between 1d and 3mo after, between 1wk and 3mo after orthokeratology(P<0.05). There were correlations between CCT before orthokeratology(CCTpre)and the change at 3mo after orthokeratology(CCTc-3mo), between ACD before orthokeratology(ACDpre)and the change at 1d after orthokeratology(ACDc-1d), between a-K before orthokeratology(a-Kpre)and the changes at 1d(a-Kc-1d), 1wk(a-Kc-1wk)and 3mo(a-Kc-3mo)after, respectively(all P<0.05). Multiple linear regression suggested that a-Kc-1d(P=0.016), a-Kc-1wk(P=0.047)were correlated with a-Kpre and axial, respectively. And there were correlations between a-Kpre and a-Kc-3mo(P=0.024), between ACDpre and ACDc-1d(P=0.036), between CCTpre and CCTc-3mo(P=0.012), respectively.

CONCLUSION: CCT, ACD and p-K has no significant changes after orthokeratology, while there is significant difference in a-K, which is considered one of the most key factor in orthokeratology. Sirius anterior system for examination before orthokeratology and postoperative assessment, non-invasive, reliable and has a good clinical value.

Relationship between anterior chamber depth and refractive factors in children

Hai-Jun Shi — 2015/6/1 16:06:23

AIM: To evaluate the relationship between anterior chamber depth(ACD)and age, crystalline lens power, corneal refractive power, and axial length(AL).

METHODS: Totally 44 children(88 eyes)with refractive error who underwent retinoscopy with cycloplegia, to be measured spherical equivalent refractive error. AL, corneal K and ACD were measured by a noncontact optical biometry(ZEISS IOL-Master). The crystalline lens power was calculated by using the SRK formula. Linear Correlation and Regression were used to evaluate the correlation between the ACD and the other optical parameters.

RESULTS:Totally 44 subjects, 88 eyes, average 9.04±2.39 years, spherical equivalent(SE)-3.50～+8.75D. No significant differences were found among the 3 groups about ACD. Neither between male and female. There was a negative correlation between ACD and age(r=-0.323), ACD/AL and age(r=-0.516), ACD and lens power(r=-0.392), corneal K and age(r=-0.461). While a positive correlation between lens power and age(r=0.414). A week positive correlation was found between ACD and corneal K(r=0.295).

CONCLUSION: When aging, the subjects' anterior chamber becomes more and more shallow. The ratio of ACD and AL decreases. The power of the combination lens, which is formed by cornea, crystalline lens, aqueous humor and anterior chamber, decreases. The length of vitreous chamber increases. All the above meet the requirements of emmetropization for children.

Influence of pupil on anterior chamber morphology change after darkroom provocative test in healthy subjects

Peng Zhang and Ming Ai — 2015/6/1 16:06:23

AIM: To observe intraocular pressure(IOP)and anterior chamber of healthy subjects by use of miotic in darkroom provocative test.

METHODS: Series of cases were prospectively analyzed. Thirty healthy cases(60 eyes)aged 25～35 years-old were the objects of study. All tests were performed from 10:00 a.m.～12:00 a.m. All subjects were sitted 1h in the chairs opposite to let head bend down at the back of chair for 1h in the first test. IOP and anterior segment paramater were measured by Pentacam before and after darkroom provocative test. The second test was repeated by use of pilocarpine as the above, and the data was compared with that of the previous test.

RESULTS:IOP was increased significantly than before(P=0.000), pupil size(P=0.000), anterior chamber volume reduced(P=0.008)and anterior chamber angle was widened(P=0.017)which were significant difference in the first test. But central anterior chamber depth was not siginificant(P=0.261). IOP, anterior segment volume, anterior chamber angle and central anterior chamber depth were significant difference(P=0.000)in the second test. But there was no siginificant dfifference for pupil size(P=0.193). By use of pilocarpine anterior chamber volume(P=0.002), anterior chamber angle, central anterior chamber depth and pupil size were significant difference(P=0.000). IOP was not siginificant(P=0.21).

CONCLUSION:Reduced anterior chamber volume and narrowed anterior chamber angle are the basis of positive darkroom provocative test. Pilocarpine can make anterior chamber angle widened and make it possible to decrease IOP. Physician should take pupil size into account when measure anterior segment paramater by Pentacam.

Impact assessment of uveitis macular edema on visual function

2015/6/1 16:06:23

AIM: To investigate the impact of uveitis macular edema on vision and vision field impairment.

METHODS: This study was a single center, retrospective controlled study of clinical characteristic found in the middle, rear or panuveitis treatment. Totally 132 patients(248 eyes)with uveitis macular edema were selected and accepted the vision, the frequency-domain optical coherence tomography, micro-perimetry examination.

RESULTS: Uveitis macular edema had significant correlation with visual acuity and visual field damage(P<0.05). Different types of macular edema corresponded to different visual impairment: not associated with foveal thickness increased cavity type could produce moderate visual impairment, with an average 10 letters; not associated with cysts and only foveal thickness increases type could produce a greater degree of visual impairment, with an average 19 letters; and accompanied by cysts, foveal thickness increased cystoid macular edema type could produce the greatest degree of visual impairment, with an average 26 letters. All selected macular edema had varying degrees of vision impairment: closely related to the thickness of the fovea, that the greater the thickness, the wider the range of vision impairment, the difference was statistically significant(P<0.05), regardless of whether cysts had little relationship.

CONCLUSION: The damage of macular edema corresponding visual function prompts us later in the course of uveitis treatment, the treatment of macular edema should also serve as an important aspect to focus on. Assessment of macular edema, uveitis visual impairment should be to focus on the vision and the vision of both micro and so on.

Study on the change of cytokines and retinal blood flow index for patients with diabetic retinopathy

Chun Zhou,Jia-Yuan Niu,Jie Cai and Xue-Rong Zhang — 2015/6/1 16:06:24

AIM: To investigate the relevance of serum levels of vascular endothelial growth factor(VEGF), cytokines and retinal blood flow index to patients with diabetic retinopathy(DR).

METHODS: In this study,174 cases of patients with diabetic were divided into three groups according to the retinal lesions, no DR group(NDR, 41 cases), background DR(NPDR, 68 cases)and proliferative DR group(PDR, 65 cases), and 30 healthy volunteers were included as control group. The serum levels of VEGF, TNF-α, sICAM-1, sVCAM-1, bFGF of all the subjects were detected and compared, and the hemodynamic parameters of the central retinal artery were measured by doppler ultrasonography.

RESULTS:The serum levels of VEGF, TNF-α, sICAM-1, sVCAM-1, bFGF of patients with diabetic were all higher than control group, and these index of PDR were higher than NDR and NPDR, while these index of NPDR were higher than NDR(P<0.05). The Vmax, Vmin, Vmean and PI of patients with diabetic were all lower than control group, RI was higher than control group; and the Vmax, Vmin, Vmean and PI of PDR were lower than NDR and NPDR, RI was higher than NDR and NPDR; while the Vmax, Vmin, Vmean and PI of NPDR were lower than NDR, RI was higher than NDR(P<0.05).

CONCLUSION:The changes of serum levels of VEGF, TNF-α, sICAM-1, sVCAM-1, bFGF and hemodynamics of CRA are closely related to the occurrence and development of DR, and these indexes have a good reference significance in the diagnosis and treatment of DR.

Clinical effect of Xueshuantong combined with calcium dobesilate on visual field defect caused by diabetic retinopathy

Sai-Yun Xiao and Jun Zeng — 2015/6/1 16:06:24

AIM: To research the clinical curative effect of Xueshuantong combined with calcium dobesilate on visual field defect caused by diabetic retinopathy.

METHODS: Sixty-four cases with diabetic retinopathy treated in our hospital patients were selected as the research objects. They were randomly divided into observation group and control group. The control group was treated with Xueshuantong, and the observation group was treated with combined treatment of calcium dobesilate. After 5mo, the clinical efficacy was compared between the two groups of diabetic retinopathy, and before and after treatment fundus photography, fluorescein angiography and visual field changes, observation of patients with adverse reactions and recurrence were performed.

RESULTS: The condition of patients was improved, and the effective rate of treatment group was 97%, and higher than that of the control group 78%, the differences were statistically significant(P<0.05); the patients in the observation group were significantly reduced bleeding spot, before and after treatment were significant difference, with statistical significance(P<0.05), field of vision gray, hemorrhage spots, and hemangioma changes in obsenartion group were significantly better than that of the control group, with statistical significance(P<0.05). In observation group, patients had no adverse reaction, and the recurrence rate was significantly less than the control group, and the recurrence rate were significant difference(P<0.05).

CONCLUSION: The patients with diabetic retinopathy treated with Xueshuantong combined with calcium dobesilate achieve satisfactory effect, and it can effectively reduce the recurrence rate and the adverse reactions, and improve the clinical symptoms. It would be widely applied in clinical practice.

Analysis of variationfor horizontal deviation in the primary position after the inferior oblique muscle weakening

Ming-Yu Si,Su-Yan Li,Xin-Xiang Shao and Chao Song — 2015/6/1 16:06:24

AIM: To analyse the variation of horizontal deviation in the primary position after the inferior oblique muscle weakening, and to explore the effect of the inferior oblique muscle recession on horizontal deviations in primary position.

METHODS:, In the study, 30 cases in the Department of ophthalmology of our hospital from January 2014 to September 2014 underwent the inferior oblique muscle recession as the sole without horizontal muscles surgery, who were superior obliquer paralysis and V pattern strabismus with small angle of horizontal strabismus, were analyzed. Of the 30 patients, 25 had unilateral inferior oblique muscle surgery, and then 5 had bilateral surgeries.Followed up for three to six mo, all patients were received full ophthalmologic and orthoptic examinations, including measurement of the deviation in the diagnostic positions of gaze at near 33cm and at distance 6m by prism and alternate cover test, synoptophore, Titmus stereo graph examination, Worth four lighting inspection, eye movement examination, and fundus photography preoperatively and postoperatively. The changes of horizontal deviations in the primary position after procedures were investigated.

RESULT:(1)The comparison of horizontal deviation showed significant difference pre- and post-operation in the exotropia group(P=0.00). It was postoperative respectively to reduce the original in external oblique average 3.35±2.87^△ and 4.37±2.65^△.(2)The comparison of horizontal deviation showed significant difference pre-and post-operation in the esotropia group(P=0.02), and it decreased postoperatively in average 2.43±1.99^△. There was no significant difference for horizontal deviation position between pre- and post-operation(P=0.089).

CONCLUSION:The horizontal deviation in primary position, either exotropia or esotropia, will decrease after the Inferior oblique muscle recession. This change can be compensated by the gradually improving and establishing the fusion function.

Analysis of clinical effect on post-traumatic endophthalmitis in children

Ling Gong and De-Yong Jiang — 2015/6/1 16:06:24

AIM: To analyze the outcome of treating post-traumatic endophthalmitis in children.

METHODS: Twenty-four 2～11 year-old children(24 eyes)with post-traumatic endophthalmitis that presented to our hospital from June 2006 to Feburary 2014 were retrospectively analyzed. All cases were performed intravitreal injection of vancomycin(1mg/0.1mL)and ceftazidime(2.25mg/0.1mL)and dexamethasone(0.4mg/0.1mL)immediately after being identified. The second day after injection, 23 eyes were received lensectomy and vitrectomy with silicone oil(n=10)or C₃F₈(n=3)or clean air(n=8)or irrigating solution(n=2)tamponade. Only one eye was reinjected at 72h after the first injection. The visual outcomes were evaluated.

RESULTS: After follow-up 6～78mo, the inflammation of all cases were controled, 4 cases of eyeball atrophy(3 cases of silicone oil eye). Other 7 silicone oil filled eyes were received silicone oic extraction and IOL implantation. Twelve eyes presented with visual acuity of lower than 0.02, 4 eyes achieved 0.02～0.1, 4 eyes were 0.15～0.3,only 4 eyes reached 0.5～1.0. The final visual acuity improved in 16 eyes(70%), remained unchanged in 4 eyes(17%)and decreased in 3 eyes(13%). One case did not fit.

CONCLUSION: Early diagnosis of endophthalmitis in open-globe injury, intravitreal injection of antibiotics and vitrectomy can salvage more than a half of injuried eyes in children.

Clinical observation of dry eye after different cataract surgery

Hong-Mei Dai,Bing-Cheng Wu,Lan Li,Jing Hou,Qian Cao and Peng Sun — 2015/6/1 16:06:24

AIM: To investigate dry eye in patients after two different cataract surgery.

METHODS: Sixty-three case(63 eyes)with age-related cataract who received cataract surgery in our hospital from May to July 2014 were randomly divided into two groups: 31 cases(31 eyes)with small incision non-phacoemulsificatian cataract extraction combined with intraocular lens implantation in group A, 32 case(32 eyes)with phacoemulsificatian combined with intraocular lens implantation in group B. The subjective complains of dry eye, tear break-up time(BUT)and Schirmer Ⅰ test(SⅠt)were measured preoperatively and 1 and 3mo postoperatively.

RESULTS: One month postoperative, dry eye symptoms increased significantly compared with the preoperative, BUT shortened, SⅠt reduced. There was significant difference between the two groups and compared with the preoperative(P<0.05). After 3mo, dry eye remains existed, but the extent of SⅠt and BUT recovered to preoperative levels. There was no significant difference between the two groups and compared with the preoperative(P>0.05).

CONCLUSION: The tear film stability of patients with two surgical procedures reduces in the short term. Compared with patients with phacoemulsificatian, the degree of dry eye of patients with small incision non-phacoemulsificatian is more severe, the tear function changes come to more light on the former. But this difference will reduce with the passage of time.

Clinical research of the micro-invasive treatments for chronic dacryocystitis with the fifth generation lacrimal endoscope

2015/6/1 16:06:24

AIM: To investigate the methods, effect and security of the micro-invasive treatments for chronic dacryocystitis with the fifth generation lacrimal endoscope, and to evaluate its clinical application.

METHODS:In this case-control study, 120 patients(120 eyes)with chronic dacryocystitis were collected from April 2013 to July 2014 in our department. The patients were randomly divided into observation group(the fifth generation endoscopic lacrimal microdrill with full intubation group, 62 cases 62 eyes)and control group(external dacryocystorhinostomy group, 58 cases 58 eyes). The effective rate and complication were observed and compared between two groups after operation. Statistical package SPSS 13.0 was used for statistical analysis.

RESULTS: The effective rate of observation group was 91.9%, and control group was 96.6%, there was no statistically significant difference between the two groups(P>0.05). Hemorrhage occurred in observation group and control group was 35.5% and 79.3%, respectively, additionally palpebral oedema was 19.4% and 55.2%, respectively, there were statistically significant differences between the two groups(P<0.05). There was no serious intraoperative and postoperative complications in two groups.

CONCLUSION: The fifth generation lacrimal endoscope is more flexible than traditional one-piece lacrimal endoscope during the operation, it can treat chronic dacryocystitis by directly observing nasolacrimal duct obstruction site and dredge the obstruction under microdrilling with full lacrimal intubation. It was not only good clinical curative effect, but also safer, more efficient than the external dacryocystorhinostomy, visualization and micro-invasive are its special advantage, and worthy for further clinical application.

Variability of blood pressure and blood glucose during perioperative period for patients with secondary neovascular glaucoma after silicone oil removed in PDR

Fu-Lin Gao,Lian-Na Hu,Chun-Rong Wu and Chang-Yu Qiu — 2015/6/1 16:06:25

AIM:To research blood pressure and blood glucose variability during peroperative period for patients with secondary neovasular glaucoma(NVG)after silicone oil removed in proliferative diabetic retinaopathy(PDR).

METHODS: Totally, 271 patients(271 eyes)undergone surgery of vitrectomy and silicon-oil tamponade combined with cataract were respective analyzed. Fourteen patients(14 eyes)with secondary NVG after silicon oil removed and randomly controlled group of no NVG according with ages, operation method in the same time were studied. The blood pressure and blood glucose variability during peroperative period was analyzed, and did comparison after excluded contralateral eye. The complications of 271 patients were surveyed in following-up period 1～12mo. The incidence of NVG, the time, blood pressure, blood glucose and glycated hemoglobin(Hbc%)variability during peroperative period was statisticed and compared by software of SPSS 11.0.

RESULTS: Fourteen eyes(5.2%)of 271 cases was with secondary NVG(female: 4 eyes, 28.6%; male: 10 eyes, 71.4%), average ages was 57.07 years(49～68 years). NVG presented in the 107～ 135d after vitrectomy and 7～45d(average 31.78d)after silicon-oil removed. Diabetes mellitus was 10～15(average 13.2)a. In NVG group, the variability of blood glucose was 4.0～10.2mmol/L(mean 8.52±3.24mmol/L), variable coefficient was 0.48. In NNVG group, the variability of blood glucose was 5.0～8.2mmol/L(mean 7.22±0.24mmol/L), variable coefficient was 0.43. It was significantly difference in comparison in variable coefficient(P<0.05). Hbc% was 10.52%±0.27% in NVG group and 7.60%±1.34% in NNVG group, there was a statistical difference(P<0.05). The average systolic blood pressure(SBP)was 152.3±15.1mmHg(140～180mmHg)with variable coefficient was 0.099 in NVG group and 131.4±0.1mmHg(120～150mmHg)with variable coefficient 0.061 in NVG group. While the average diastolic blood pressure(DBP)was 92.3±11.1mmHg(50～110mmHg)with variable coefficient 0.11 in NVG group and 87.3±8.1mmHG(80～100mmHg)with variable coefficient 0.08 in NNVG group. Compared the two groups, there were differences in variable coefficient(P<0.05). Blood glucose variability of perioperative in NVG group was significantly greater than that in NNVG group. Compared between the two groups, variability of daytime SBP and night DBP in NVG group were more than those in NNVG group with statistically significant differences(P<0.05). Perioperative blood glucose and blood pressure variability showed no statistical significance in 14 patients after taking oil surgery and vitrectomy with silicone oil tamponade.

CONCLUSION: There are significant variability on fasting blood glucose, daytime SBP and night DBP during perioperative in PDR patients with secondary NVG. It might be occurred 1wk after silicone oil removal surgery.

Correlation between ocular Demodex infestation and serum immunoreactivity to bacillus proteins

Jian-Jing Li,Zhen-De Lin,Yong-Ping Lin,Ya-Sha Luo and Ling Lin — 2015/6/1 16:06:25

AIM: To investigate correlation between ocular Demodex infestation and serum immunoreactivity.

METHODS:Demodex counting of 68 inpatients was performed based on eight lashes sampling. Serum immunoreactivity to two 62-kDa and 83-kDa proteins derived from B oleronius was determined by Western blot analysis.

RESULTS: These 68 patients without facialrosacea or blepharitis were age matched(P=0.888)and gender matched(P=0.595)regarding serum immunoreactivity or ocular Demodex infestation. According to the eyelash, creep mite infection was divided into positive and negative groups, age-matched(P=0.590)and sex-matched(P=0.329). There was no significant correlation between serum immunoreactivity and Demodex infestation(P=0.925). There were 27 patients with positive serum immunoreactivity in 38 patients with Demodex infestation(71%), and there were 21 patients in 30 patients without Demodex infestation(70%). There was no significant correlation between serum immunoreactivity and Demodex counting(P=0.758).

CONCLUSION: It is unnecessary to perform serum analysis when Demodex can be found in asymptomatic individuals. But treatment of reducing lashes Demodex infestation is necessary when patient with blepharitis was detected Demodex in eye lashes and positive serum immunoreactivity.

Accuracy and reproducibility of IOLMaster versus contact ultrasound biometry

Quan-Hao Bai,Yu-Qing Miao,Cui-Li Wang and Ge-Fei Zhang — 2015/6/1 16:06:25

AIM: To compare biometry results of IOLMaster and contact ultrasound(US)anterior segment parameters, and to evaluate the calculation accuracy and repeatability of intraocular lens power in both.

METHODS: Preoperative measurement of anterior segment parameters were prospectively obtained in 137 eyes of 121 subjects with the IOLMaster compared with the US. Postoperative best corrected visual acuity(BCVA)and the actual diopter were measured.

RESULTS: There was an excellent correlation between IOLMaster and US measurements for the ACD(r=0.823, P<0.01)and AL(r=0.996, P<0.01). The mean values of the parameters measured by IOLMaster and US were, respectively, as follows: ACD, 2.94±0.49mm, 2.69±0.51mm; AL, 24.17±1.64mm, 23.81±1.83mm. The mean differences of ACD and AL values between IOLMaster and US measurements were 0.25±0.22mm, 0.36±0.24mm respectively, proved to be statistically significant(P<0.01). With the 95% limits of agreement(LoA)from -0.08～+0.48mm for ACD and from -0.09～+0.69mm for AL. For IOLMaster, the mean prediction error(MPFE)-0.15±0.38D, the mean absolute prediction error(MAFE)was 0.29±0.27D with 96% of the eyes within 1D from the predicted refraction. Applanation ultrasonography after optimisation yielded a greater absolute prediction error than the IOLMaster biometry, 0.41±0.38D with 88% of the eyes within 1D from the predicted refraction. For IOLMaster biometry, the intraobserver variability(SD)was ±25.6μm for AL, ±33.4μm for ACD and ±12.9μm for corneal radius. The coefficients of variation(COV)were 0.11%, 0.52%, and 0.17%, respectively. The interobserver variability(SD)was ±21.5μm for AL, ±29.8μm for ACD and ±15.9μm for corneal radius. The COV were 0.09%, 0.62%, and 0.21%, respectively.

CONCLUSION: Partial coherence biometry using the IOLMaster provides the more accurate and reliable anterior segment parameters measurement values. A high degree of agreement between US and IOLMaster is noted. The IOLMaster not only has the advantage of performing noncontact examinations, but also produces various additional data simultaneously and may thus obviate the need for multiple examinations.

Application evaluation of anterior segment OCT in postcataract descemet membrane detachment

Yuan-Dong Ma,Lu-Lu Xia and Mei-Sen Jiang — 2015/6/1 16:06:25

AIM: To evaluate application value of anterior segment optical coherence tomography(AS-OCT)in the treatment of the postcataract descemet membrane detachment(DMD).

METHODS: Twenty-seven cases(32 eyes)with postcataract corneal edema were examined by AS-OCT. Corresponding way was taken after indentifing the reason. One case with severe DMD were processed with operative reduction.

RESULTS: All the eyes with DMD were judged and treated in time. The cornea with severe DMD were lightened evidently after surgery and transparent completely.

CONCLUSION: It is an effective method for using AS-OCT to judge DMD.

Clinical effect of anterior vitrectomy for congenital cataract

Hua He,Feng Zhou,Qi Zhu,Qian Wang,Xue-Mei Wu,Jian Ma and Ya-Yun Wang — 2015/5/5 16:34:53

AIM: To evaluate the clinical efficacy of posterior continuous curvilinear capsulorhexis(PCCC)combined with anterior vitrectomy in preventing posterior capsule opacification of congenital cataract surgery.

METHODS: Postoperative clinical follow-up data of 82 cases(87 eyes)with congenital cataract treated in Eye Center of our hospital from January 2011 to August 2014 were retrospectively analyzed. The patients were divided into the surgical control group(38 cases, 40 eyes, recieved phacoemulsification + PCCC)and the study group(44 cases, 47 eyes, accepted phacoemulsification + PCCC + anterior vitrectomy). The incidence of central optic axis opaque and postoperative visual acuity distribution were recorded at 1a follow-up. Intraoperative and postoperative complications were observed.

RESULTS: The rate of central optic axis opaque grade 0 in control group was 37.5%, compared to 76.6% in study groups. The opacity distribution ratio of grade 1,2,3 and 4 in study group were lower than that of control group, and the central optic axis opacity distribution ratio in study group was significantly better than that of control group(P<0.05). The 19 eyes(47.5%)of visual acuity testing ≤0.5 in control group, was higher than the 7 eyes(14.89%)of that in the study group, The 21 eyes(52.5%)of visual acuity testing >0.5 in control group was lower than the 40 eyes(85.11%)of that in study group. The visual acuity between two groups has statistical significance difference after 1a follow-up(P<0.05), and the visual acuity in study group was significantly better than that in the control group. The postoperative intraocular pressure at 1mo and 1a follow-up was lower than before operation in two groups(P<0.05), but there was no significant difference between two groups in intraocular pressure(P<0.05).

CONCLUSION: Combination of phacoemulsification, PCCC and anterior vitrectomy presents reliable clinical effects on postoperative central optic axis opacity distribution ratio and visual acuity, and it should be adopted to prevent the occurrence of posterior capsule opacification.

Influence of early-life and childhood exposures on age-related cataract

Wei Qu,Shu-Na Zhai and Zhi-Quan Lu — 2015/5/5 16:34:54

AIM: To evaluate the relationship of early-life and childhood exposures and age-related cataract(ARC), and provide a scientific evidence for early preventing, treating and detecting ARC.

METHODS: A hospital-based case control study was conducted from April 2011 to October 2012.A total of 360 cases(360 eyes)aged 41～60 years old for cataract extraction and 360 frequency-matched controls in the same hospital for various not related to ARC were included in the study. A structured interviewer-administrated questionnaire that included information on sociodemographic characteristics, early-life and childhood exposures was used. The risk factors of ARC were estimated with unconditioned logistic regression models.

RESULTS:Early gestational age at birth sooner and lower birth weight was significantly associated with the risk of ARC(OR=1.152,95%CI:1.029～2.235,P=0.024; OR=1.374, 95%CI:1.156～2.581,P=0.037,respectively). The maternal pre-pregnancy diabetes(OR=1.587, 95%CI:1.177～2.915,P=0.019),gestational diabetes(OR=1.763,95%CI:1.375～2.367,P=0.004), preeclampsia(OR=1.581, 95%CI: 1.139～1.996,P=0.021), and pregnancy induced hypertension(OR=1.517, 95%CI:1.032～1.963,P=0.024)could make the risk of ARC increased. Of the factors affecting the period of children, only shorter height relative to peers and overweight at age 10 were significantly associated with the risk of ARC(OR=1.329, 95%CI:1.072～2.351,P=0.038; OR=2.302, 95%CI:1.323～3.196,P=0.011, respectively).

CONCLUSION:Early gestational age at birth, low birth weight, the maternal pre-pregnancy diabetes, gestational diabetes, preeclampsia, and gestational hypertension, and shorter height and overweight relative to peers, at age 10 were risk factors of ARC. But lasted long large and prospective studies are needed to insure early risk factors for ARC in the Chinese population.

Clinical research of 1.8mm microincision phacoemulsification and intraocular lens implantation combined with trabeculectomy

Shan-Shan Li and Wei Cui — 2015/5/5 16:34:54

AIM:To evaluate the effect and safety of 1.8mm coaxial microincision phacoemulsification-trabeculetomy with ultra-thin intraocular lens(IOL)implants for treating glaucoma complicated with cataract, and to compare with the traditional 3.0mm small phacoemulsification-trabeculetomy with foldable IOL implantion.

METHODS: In this prospective study, 36 patients(36 eyes)with glaucoma and cataract in Inner Mongolia Autonomous Regian People's Hospital were collected and randomly divided into 2 groups. For the small incision group: 18 cases(18 eyes)underwent 3.0mm coaxial incision phacoemulsification-trabeculetomy with foldable IOL implantion; In th microincision group: 18 cases(18 eyes)underwent 1.8mm microincision phacoemulsification-trabeculetomy with ultra-thin IOL implantion. The two groups were recorded for 1wk, 1 and 3mo of visual acuity, corneal endothelial cell density, surgically induced astigmatism, intraocular pressure(IOP), filtering bleb and complications. Pearson's Chi-square test ande t-test were used to determine differences between the two groups.

RESULTS: At 1wk postoperatively, visual acuity in the microincision group was better than that of small incision group, the difference was statistically significant(P<0.05). At 1 and 3mo, the difference in corrected visual acuity between the 2 groups had no significant difference(P>0.05). At 1wk, 1 and 3mo, there was a significant different between the 2 groups in surgically induced astigmetism(P<0.05). At 1wk postoperatively, there was a significant difference in corneal endothelial cells density between 2 groups(P<0.05). But there were no significant difference at 1 and 3mo(P>0.05). IOP reduced after surgy(microincision group: 15.26±3.12mmHg, small incision group: 14.57±2.86mmHg), there was no significant difference between the 2 groups(P>0.05). There was no significant different between the 2 groups in blebs(P>0.05). Neither iris injury, posterior capsule rupture nor anterior chamber bleeding complications was found in any groups.

CONCLUSION: TBy compared with traditional 3.0mm coaxial small incision phacoemulsification-trabeculectomy with foldable IOL implantion, 1.8mm microincision phacoemulsification-trabeculectomy withe ultra-thin IOL implantion can effectively reduce the astigmatism operation. This operation is safe, effective, convenient surgy for treating cataract and glaucoma.

Relationship of susceptibility of primary angle-closure glaucoma with glutathione S-transferase T1 and M1 polymorphisms

Li-Dan Luo — 2015/5/5 16:34:55

AIM:To investigate the relationship of susceptibility of primary angle-closure glaucoma with glutathione S-transferase T1(GSTT1)and M1(GSTM1)polymorphisms.

METHODS: Totally,300 cases were collected from primary angle-closure glaucoma patients and 300 health volunteers were served as control group. The observation group were divided into chronic and acute primary angle-closure glaucoma groups, then multiplex PCR technology was used to detect the genetic polymorphisms of GSTM1 and GSTT1.

RESULTS:The distribution frequencies of GSTT1-null genotype were 54.3%, while it was 54.0% in the control group, statistically no significance between control group and observation group(χ²=0.053, P>0.05); The frequency GSTT1-null genotype in chronic group of primary angle-closure glaucoma was 54.9%, while it was 48.6% in the acute group of primary angle-closure glaucoma, statistically no significance between control group and acute group(χ²=0.064, P>0.05), and chronic group(χ²=0.037, P>0.05); The distribution frequencies of GSTM1-null genotype was 59.0%, while it was 55.7% in the control group, statistically no significance between control group and observation group(χ²=0.013, P>0.05); The distribution frequencies of GSTM1-null genotype was 62.3% and 58.1% in acute and chronic group of primary angle-closure glaucoma patients respectively. Acute group of primary angle-closure glaucoma has no significant compared with control group(χ²=0.005, P>0.05), Chronic group of primary angle-closure glaucoma had no significant compared with control group(χ²=0.047, P>0.05).

CONCLUSION:No statistic significance relationship is found between primary angle-closure glaucom patients and the null genotypes of GSTM1 and GSTT1 susceptibility.

Comparison of the clinical efficacy between Ahmed glaucoma valve implantation andtrabeculectomy in patients with primary open angle glaucoma

Miao Zeng,Yan-Ping Song and Wen-Qiang Zhang — 2015/5/5 16:34:55

AIM: To compare clinical efficacy between Ahmed glaucoma valve implantation and trabeculectomy in patients with primary open angle glaucoma(POAG).

METHODS: This retrospective study included 58 eyes from 45 patients with primary open angle glaucoma. And 32 eyes underwent penetrating trabeculectomy(group A), while 26 eyes were performed Ahmed glaucoma valve implantation(group B). Intraocular pressure(IOP), best-corrected visual acuity(BCVA), visual field and post-operative complications were observed between these two groups.

RESULTS:(1)IOP: the IOP of post-operation in group A were(13.56±4.91),(14.47±4.03),(17.56±5.74),(18.25±5.49),(18.13±4.24),(19.68±4.55)mm Hg at 2d, 1, and 2wk, 1, 3 and 6mo respectively; and that were(13.58±4.16),(16.00±4.83),(18.00±5.05),(19.42±5.41),(18.42±3.37),(20.00±5.37)mm Hg in group B. There was no statistically significant difference in IOP between the two groups(P>0.05).(2)BCVA: the number of visual acuity decreased eyes, with 6mo follow-up, was 7(22%)in group A; and that was 5 in group B(19%). There was no statistically significant difference in vision loss postoperatively between the two groups(χ²=0.061, P>0.05).(3)Visual field: with 6mo follow-up, there were 13 eyes(41%)which had constricted visual field in group A, while those were 10 eyes(38%)in group B; the difference of visual field loss between the two groups was not statistically significant(χ²=0.028, P>0.05).(4)Complications: six-month follow-up after operation, there were 4 eyes with shallow anterior chamber, 4 eyes with complicated cataract and 1 eyes with Descemet's membrane detachment in group A, while that was 1 eyes with shallow anterior chamber and 1 eyes with complicated cataract in group B; there was statistically significant difference in the rate of complications between the two groups(χ²=4.144, P<0.05).(5)Surgical success rate: six month after operation, the completed success rate was 37%(12 eyes)in group A, and that was 35%(9 eyes)in group B. The partial success rate was 19%(6 eyes)and 15%(4 eyes)in group A and group B respectively. The difference of success rates between the two groups was not statistically significant(χ²=0.225, P>0.05).

CONCLUSION: Both Ahmed glaucoma valve implantation and trabeculectomy are effective methods for the treatment of POAG. The clinical efficacy was no difference between the two methods. However, compared with trabeculectomy, Ahmed glaucoma valve implantation was safer and had fewer complications.

Influence of preoperative artificial tears on tear film after phacoemulsification on dry eye of diabetes patients

Rui Su and Dan Liu — 2015/5/5 16:34:55

AIM: To discuss the artificial tears on the tear film of diabetic patients with dry eye preoperatively, and the influence on the tear film's fuctional after phacoemulsification.

METHODS: Fifty-four diabetic patients with dry eye(60 eyes)were followed up before phacoemulsification. Preoperatively, group A(30 eyes in 28 cases)was treated with Hydroxyl Indican eye drops and group B(30 eyes in 26 cases)was not treated. Postoperatively, both group A and B were treated with Tobramycin Dexamethasone eye drops, Oprah Winfrey Ibuprofen eye drops and Hydroxyl Indican eye drops. Dry eye symptoms, break up time(BUT), Schirmer Ⅰ test(S Ⅰ t), fluorescein stain test(FI)were measured at 3d preoperatively, and 1, 7, 30, 90d postoperatively.

RESULTS: At 3d preoperatively, there was no statistical differences between the two groups for dry eye symptoms, BUT, SⅠt, FI(P>0.05). At 1 and 7d postoperatively, there were significant statistical differents between the two groups for dry eye symptoms(P<0.05). And dry eye symptoms scores of group A were less than that of group B. At 1, 7, 30d postoperatively, BUT was longer, FL was less, SIt was increased in group A, with significant statistical differences(all P<0.05). At 90d postoperatively, two groups of dry eye symptoms, BUT, SⅠt, FI had no statistical significance(P>0.05).

CONCLUSION: Using artificial tears before phacoemulsification can improve symptoms of the diabetic patients with dry eye and accelerate the recovery of the tear film.

Consistency analysis of Keratograph and traditional methods to evaluate tear film function

2015/5/5 16:34:55

AIM: To investigate repeatability and accuracy of a latest Keratograph for evaluating the tear film stability and to compare its measurements with that of traditional examination methods.

METHODS: The results of noninvasive tear film break-up time(NI-BUT)including the first tear film break-up time(BUT-f)and the average tear film break-up time(BUT-ave)were measured by Keratograph. The repeatability of the measurements was evaluated by coefficient of variation(CV)and intraclass correlation coefficient(ICC). Wilcoxon Signed-Rank test was used to compare NI-BUT with fluorescein tear film break-up time(FBUT)to confirm the correlation between NI-BUT and FBUT, Schirmer I test values. Bland-Altman analysis was used to evaluate consistency.

RESULTS: The study recruited 48 subjects(48 eyes)(mean age 38.7±15.2 years). The CV and ICC of BUT-f were respectively 12.6% and 0.95, those of BUT-ave were 9.8% and 0.96. The value of BUT-f was lower than that of FBUT. The difference had statistical significance(6.16±2.46s vs 7.46±1.92s, P<0.01). There was significant positive correlation between NI-BUT and FBUT, Schirmer I test values(P<0.01). The scope of 95% limits of agreement(LoA)was 4.46s in BUT-f and FBUT, while the scope of LoA was 3.64s in BUT-ave and FBUT.

CONCLUSION: Keratograph can provide NI-BUT data that has a better repeatability and reliability, which has great application prospects in diagnosis and treatment of dry eye and refractive corneal surgery.

Rapeutic effects analysis of Pranoprofen on tear dynamic abnormity induced by conjunctivochalasis

Yang Zhang,Zhi-Qiang Niu and Fan Zhang — 2015/5/5 16:34:55

AIM: To investigate the therapeutic effects of Pranoprofen on tear dynamic abnormity induced by conjunctivochalasis(CCh).

METHODS: Seventy cases(70 eyes)whose the main symptoms was epiphora induced by CCh were divided into Ⅱ, Ⅲ and Ⅳ in 3 groups according to Zhang's grading standards, meanwhile, all the patients were treated with the eye drops of Pranoprofen for 2wk. After that, the curative effect of each group was analyzed before and after treatments according to the symptoms, dye disappearance test, bitter taste test and tear break-up time.

RESULTS: After 2wk treatment of Pranoprofen, the symptom of patients at grade Ⅰ and Ⅱ improved obviously grade Ⅲ improved more, grade Ⅳ did little. The positive rate of dye disappearance was the highest in grade Ⅱ, the second in grade Ⅲ, and the third in grade Ⅳ. There was significant difference among the 3 groups(P<0.05). The time of bitter taste test was shortened(P<0.05)and the tear break-up time was prolonged(P<0.05)in grade Ⅱ after treatment, however, the time of those in grade Ⅲ and Ⅳ had not changed than before(P>0.05).

CONCLUSION: Pranoprofen has good effects on tear dynamic abnormity induced by grade Ⅱ of cch.

Analysis of incidence rate, characteristics and related risk factors of high intraocular pressure after pars plana vitrectomy

Xue-Qun Yu and Guo-Ping Cao — 2015/5/5 16:34:55

AIM:To analyze the incidence, characteristics and related risk factors of high intraocular pressure after pars plana vitrectomy(PPV).

METHODS: Totally, 146 patients(146 eyes)undergone PPV in our hospital were selected. Age, gender, eye, course and operation time of patients were compared, in order to understand the incidence rate and characteristics of high intraocular pressure. Primary diseases, intraoperative treatment methods and intraocular tamponade type were compare, in order to analyze the related risk factors of high intraocular pressure.

RESULTS: Forty-seven patients occurred high intraocular pressure after operation, the incidence rate was 32.2%. There was no significant difference in age, gender, eye, course and operation time(P>0.05). The incidence rate in diabetic patients with simple vitreous hemorrhage and with tractional retinal detachment were 21.1% and 57.6%, respectively(P<0.05). The incidence rate in retinal detachment with PVR below grade C2 and above C2 were 19.0% and 43.8%, respectively(P<0.05). The incidence rate in ocular trauma with vitreous hemorrhage and with intraocular foreign bodies were 25.0% and 70.0%, respectively(P<0.05). The incidence rate of patients treated with panretinal photocoagulation was 50.8%, significantly higher than patients without treated with panretinal photocoagulation(P<0.05). The incidence rate of patients treated with part panretinal photocoagulation was 29.5%, higher than patients without treated with panretinal photocoagulation, but there was no statistical difference(P>0.05). The incidence rate of using silicone oil, C₃F₈ and simple ventilation were 59.7%, 34.5% and 14.5%, respectively(P<0.05).

CONCLUSION: After vitrectomy intraocular hypertension incidence and preoperative, intraoperative treatment of primary disease is closely related to factors such as the way and intraocular tamponade.

Relationship between blood lead level and abnormal eye blinking in children

Fen Du,Jun Luo,Qi Long,Zhi-Gang Xiao and Li-Juan Tao — 2015/5/5 16:34:55

AIM: To study the relationship between blood lead level and abnormal eye blinking in children.

METHODS: The patients with chief complaint of frequent eye blinking, whose diagnosis of abnormal eye blinking, were randomized to experimental group. The patients in this group carried out vision and the slit-lamp examination, detected corneal fluorescein staining and tear break-up time, and improved the level of blood lead and trace elements examination. The patients in control group with chief complaint of health physical examination in our hospital, excepted of blood lead level, the other body check results were normal and were divided into boys group and girls group according to the gender. The changes of the experimental group and control group in blood lead level were compared.

RESULTS: Totally 371 cases(male: 295 cases; female: 76 cases)with mean age was 6.56±2.41 years and 6.08±2.82 years respectively were in experimental groupe. In control group, there were 300 cases(male: 186 cases; female: 114 cases)with mean age was 6.99±3.01 years and 6.56±2.80 years respectively. The average of blood lead level of boys in experimental group was 63.82±24.56μg/L and 53.98±15.42μg/L in control group. The average of blood lead level in experimental group was higher than that in control group. The difference between of the two group was statistically significant(χ²=16.96, P<0.01). The average of blood lead level of girls in experimental group was 56.96±16.69μg/L and 48.18±12.35μg/L in control group. There was no difference between of the two group(χ²=5.77, P=0.56). In control group, the average of blood lead level with <3 years, 3～6 years and >6 years children were 48.73±11.67μg/L, 51.39±14.87μg/L,52.98±14.45μg/L respectively. In expirement group, the results were 56.57±17.89μg/L, 59.92±18.46μg/L and 67.00±32.55μg/L in <3, 3～6 and >6 children, respectively. There was no significant difference with <3 years(χ²=3.54, P=0.17). The difference with 3～6 years and >6 years children were statistically significant(χ²=9.62, P=0.008)and(χ²=19.22, P=0.000)respectively. The blood lead level were divided into three grades: <50μg/L, 50～100μg/L, >100μg/L, and relative risk(RR)were 0.65, 1.22, and 10.11 respectively.

CONCLUSION: Blood lead level of experimental group is higher than that of control group. The relationship between blood lead level and abnormal eye blinking in children is positive correlation.

Clinical observation of Esculin and Digitalisglycosides eye drops and acupoint massage on patients with video display terminal asthenopia

Qing-He Sun and Feng-Ying Sun — 2015/5/5 16:34:55

AIM: To evaluate the efficacy of Esculin and Digitalisglycosides eye drops and acupoint massage alone or combination of both on video display terminal(VDT)asthenopia.

METHODS: Totally, 224 patients with VDT asthenopia were randomly divided into eye drops group(n=56)received the intervention by Esculin and Digitalisglycosides eye drops, acupoint massage group(n=56)received the intervention by acupoint massage around the eyes, and combination group(n=56)received the intervention by combination of both and control group received the intervention by ocular hygiene instruction. The effect was evaluated after 4wk. The symptoms curative effect index, tear film break-up time(BUT), Schirmer I test(SIt)and corneal fluorescein staining score were as the indexes of evaluation.

RESULTS: The symptoms curative effect index of combination group(78.96±5.29)% was higher than that of eye drops group(69.55±6.23)% and acupoint massage group(71.15±6.41)%, which of after both groups was higher than that of control group(33.01±4.26)%(P<0.01). The main effects of Esculin and Digitalisglycosides eye drops and acupoint massage and its interations for the curative effect index were statistically significant(P<0.01). BUT and SIt of after intervention in eye drops group were significantly higher than that of before intervention, acupoint massage group and combination group(P<0.05); After intervention, BUT of combination group was higher than that of eye drops group, acupoint massage group and control group; SIt of control group was lower than that of eye drops group, acupoint massage group and combination group.

CONCLUSION: Esculin and Digitalisglycosides eye drops and acupoint massage could improve symptoms and ocular physiology in patient with VDT asthenopia, and the effects of the combinative use of both are synergistic.

Effects of different position of clear corneal incision of cataract surgery on visual function and quality of life

Lin Zhou,Li Wang and Huan Huang — 2015/5/5 16:34:55

AIM: To study the effects of different position of clear corneal incision of cataract surgery on visual function and quality of life.

METHODS: In this study, 126 cases(126 eyes)in our hospital from April 2013 to April 2014 were selected, who were accepted the transparent corneal incision phacoemulsification and intraocular lens implantation in treatment of senile cataract patients. With digital method were divided into observation group and control group with 63 cases in each group, included the observation group selected the maximum refractive power of the cornea radial axial transparent angle incision, and the control group in the temporal clear corneal incision, compared the two groups of patients with postoperative visual function(VF)and quality of life(QOL), and made statistics of uncorrected visual acuity.

RESULTS: In the observation group, postoperative visual function and the scores of quality of life were 80.3±5.63 and 80.9±0.79, was significantly higher than the control group(74.9±5.24)and(76.5±0.76). And the postoperative uncorrected visual acuity of patients in the observation group was less than that of the control group, while ≤1.0 of patients than that in the control group. There was statistically significantdifference(P<0.05).

CONCLUSION: Transparent cornea in cataract surgery to choose the largest cornea diopter longitude as incision can effectively improve the therapeutic effect, especially on the visual function of patients and to improve the quality of life.

Relationship of visual quality and postoperative dominant eye changes with age-related cataract

Xiao-Ling Li — 2015/5/5 16:34:56

AIM: To investigate age-related cataract and its postoperative dominant eye changes and visual quality of patients.

METHODS: Totally 102 patients(204 eyes)with age-related cataract in our hospital from January 2013 to November 2014 were selected, and according to preoperative best corrected visual acuity(BCVA)were divided into two groups, in which the both eyes BCVA difference ≥2 lines(78 cases, 156 eyes)was group A, and both eyes BCVA difference ≤1 line(24 cases, 48 eyes)was group B. Dominant eyes were detected preoperatively and at postoperative 1 and 3mo. Contrast sensitivity and investigated visual satisfaction were tested.

RESULTS: Preoperative dominant eye corrected visual acuity was 0.34 ± 0.11, significantly higher than that of the non-dominant eye(0.15 ± 0.09), and there was statistically significant difference(P<0.05); At postoperative 1 and 3mo,between corrected visual acuity difference dominant eyes and the non-dominant eyes was not statistically significant(P>0.05); At postoperative 3mo, 17 cases in the group A had dominant eye changes, and change rate was 21.79%(17/78). At postoperative 3mo, the dominant eye change rate in the group B was 20.83%(5/24), and there was no statistical significant difference between the two groups(P>0.05). The dominant eye change group and non-change groups patients with different spatial frequency contrast sensitivity test showed no statistical significance(P>0.05), Postoperative 3mo after operationvisual satisfaction questionnaire display, score of group A was(91.35±10.26)points, score of group B was(90.15±9.75)points(P>0.05), the dominant eye change group score was(90.08±9.77)points, score non-change group was(91.43±10.22)points(P>0.05).

CONCLUSION: The dominant eye changes exist in postoperative eyes with age-related cataract, but there is no effect on visual quality.

Study on the correlation between monocular mild myopic juvenile myopia degree and dominant eye

Jian-Guo Liu,Yu-Hai Li and Ya-Qing Ai — 2015/5/5 16:34:56

AIM: To study the correlation between monocular mild myopic juvenile myopia degree and dominant eye.

METHODS: Totally 158 patients with juvenile monocularly mild myopia in our hospital from December 2012 to December 2013 were retrospectively analyzed, and cylindrical mirror astigmatism was used for spherical equivalent conversion. On the basis of the myopic degree, they were divided into three groups, 30 cases in group A(-0.25～-0.75D), 92 cases in B group(-1.0～-2.0D), 36 cases in group C(-2.25～-3.0D). The card hole method was selected to measure dominant eye for subjectsat nearly 33cm and 5m. After glasses correction of ametropia, the far and near dominant eyes were received measurement again.

RESULTS: The monocular mild myopia of dominant eye was compared with the non-dominant eye adjustment function, and there was no significant difference(P>0.05). The dominant eye, non-dominant eye mean diopter and other correlations of eyes in the three groups were compared, and there was no significant difference(P>0.05). The dominant eye of three groups at 5m was compared, and there was significant difference(P<0.05). The dominant eye of three groups at 33cm was compared, and there was significant difference(P<0.05). Dominant eye at different visual distance was compared, and there was significant difference(P<0.05). Monocular uncorrected eye was compared with dominant eye mild afte myopia glassesr, and there was significant difference(P< 0.05).

CONCLUSION: The formation of myopic anisometropia is related to the degree of clearly seeing objects, although glasses correction can improve the clarity and visual, but affect the choice of the dominant eye, because the myopic anisometropia appears most early in the dominant eye, therefore optician correction stage, which should be taken into consideration, and avoid the severity of the adolescent myopia.

Regression analysis on influence factors of orthokeratology controlling juvenile myopia progression

Jing Xie,Yun-Hong Feng,Shou-Mei Jin and Zhao-Sheng Chen — 2015/5/5 16:34:56

AIM:To explore the influence factors of orthokeratology controlling development of juvenile myopia.

Methods: A retrospective analysis of 86 cases(169 eyes)who performed orthokeratology from November 2012 to November 2013 in our hospital was carried out. Ater 2a treatment, diopter increased > -0.25D as invalid control group(54 eyes), diopter increased ≤ -0.25D as effective control group(115 eyes). The difference of various factors between two groups were compared.

RESULTS: Univariate comparison showed that the two groups had no statistical significance(P>0.05)in terms of gender, whether wear glasses in the past, anterior corneal diameter before treatment, central corneal thickness, intraocular pressure and anterior chamber depth. However, the two groups had statistical significance(P<0.05)in the terms of age, dioptre before trement, corneal curvature, and axial length basis. Logistic regression analysis showed that foundation axial length, age and corneal curvature were in line with regression model(P<0.05), these were independent factors that orthokeratology lens control juvenile myopia development.

CONCLUSION: Independent factors affecting orthokeratology control juvenile myopia development is foundation axial length, age and corneal curvature. For juvenile patients, the longer of foundation axial length, the longer the age, the greater the curvature of cornea, orthokeratology can better control the myopia's development.

Impact study of closing eyes and sleep on corneal topography and corneal astigmatism

Tao Yuan and Jing Lu — 2015/5/5 16:34:56

AIM: To observe the changes of corneal topography and astigmatism et al with various duration of closing eyes and sleep; and study the impact of closing eye and sleep causing physiological hypoxia on corneal topography.

METHODS: Sixteen volunteers were selected(32 eyes), 22-33(26.19 ± 3.95)years old, without refractive errors and other eye diseases, as well as never wearing corneal contact lens, including 10 male eyes and 22 female eyes. The main parameters received corneal simulation K value, corneal astigmatism, corneal irregular measure(CIM)and the shape factor(SF)by Zeiss corneal topographer. They were measured before and after closed eyes 10, 20, 30, 60, 120min; before sleep and after over 6h sleep, they were detected immediately as soon as they opened eyes after 10, 20, 60, 120min.

RESULTS: During closing eyes, there were no statistical significance on the changes of corneal topography, corneal astigmatism, and SF. After opening eyes and over 6h sleep, there were no statistical significance on the changes of corneal topography, corneal astigmatism, CIM, and SF.

CONCLUSION: Closing eyes and sleep don't injure the cornea substantially, so corneal topography and corneal astigmatism don't mainly change.

Relationship between platelet distribution width, fibrinogen and severity of diabetic retinopathy

Xin-Rong Wang,Jing-Ni Yu and Hui Li — 2015/4/8 9:56:57

AIM:To define the relationship between platelet distribution width(PDW), fibrinogen(FIB)and severity of diabetic retinopathy(DR).

METHODS: The survey included 99 patients with DR(48 with non-proliferative and 51 with proliferative DR)in our hospital during June 2012 and May 2014. Another 50 diabetic patients without DR and 50 healthy volunteers were matched as controls. Demographic data and disease history were gained. Fasting blood sample were collected to measure PDW, FIB, platelet count, fasting blood glucose and HbA1c.

RESULTS: Compared with healthy controls(16.6%±1.2%), a significant difference was found in PDW values among diabetic patients(all P<0.05). The higher development of DR corresponded with a significantly higher level of PDW 17.6%±1.8%, 19.1%±2.1%, and 20%±1.9% for patients without DR, non-proliferative DR and proliferative DR, respectively, the difference had statistical significance(P<0.05). A significant difference was also found in FIB values among diabetic patients and healthy controls(P<0.05). After correction for age, gender, disease duration and HbA1c, multi factor Logistic analysis showed that there were significant increased risks in the prevalence of non-proliferative(OR: 1.464, PDW)(OR: 2.199, FIB)and proliferative DR(OR: 1.652, PDW)(OR: 2.691, FIB)with the increased PDW and FIB value(all P<0.05).

CONCLUSION: The PDW and FIB value are parallel with the severity of DR, and there is increased risk of non-proliferative and proliferative DR with the PDW and FIB value increases.

Corneal histopathology changes of the soft contact lens long-time wearers

Zhi-Hua Han — 2015/4/8 9:56:57

AIM: To investigate the corneal histopathology changes induced by soft contact lenses(SCL)at diffent time.

METHODS: Central and peripheral cornea structures of myopic patients wearing SCL(150 cases)and the control goups(150 cases)were observed with confocal microscopy. The examinations were performed 1, 3, 5, 8 and 10a after contact lenses wearing respectively.

RESULTS: After wearing the contact lenses for 5a, the cell density of corneal surface epithelial was lower in SCL wearers compared with control goups(P<0.05)and the corneal vesicle and corneal gutata might be occasionally discovered. The density of Langerhans cells both in the central and peripheral cornea was higher in SCL group(P<0.05), and the tortuosity of the nerve fibers was significantly increased in the eye wearing SCL compared with control group. The densities of anterior stromal cells were lower while the microdot densities in the stroma were higher in SCL group than that in control group(P<0.05). The polymorphology of corneal endothelial cells was more obvious in SCL group, but the densities of endothelial cells were similar between two groups(P>0.05). The SCL wearers showed a thinner thickness of central corneal epithelium than control group(P<0.05).

CONCLUSION: The corneal morphologic changes are more obvious with the longer time, and the changes is not ignored.

Comparison of anterior segment parameters between fellow eyes of unilateral acute angle closure glaucoma and primary angle closure suspects

Jing-Min Guo,Xiao-Lan Xu,Hong Zhang and Jun-Ming Wang — 2015/4/8 9:56:57

AIM: To explore the differences of anterior segment parameters in the patients with fellow eyes of unilateral acute angle-closure glaucoma(AACG), primary angle-closure suspects(PACS)and normal group.

METHODS: Twenty-six eyes of 26 patients with fellow eyes of AACG, 28 eyes of 28 age- and gender-matched PACS and 34 normal eyes were imaged using optical coherence tomography(OCT)and pentacam scheimpflug system(Pentacam). Anatomical parameters including central corneal thickness(CCT), corneal volume(CV), pupillary diameter(PD), central anterior chamber depth(CACD), peripheral anterior chamber depth(PACD), anterior chamber volume(ACV)and anterior chamber angle(ACA)were obtained from Pentacam. Iris thickness(IT750,IT2 000), cross-sectional area(IS), volume(IV)and angle opening distance 500(AOD500)were estimated using OCT combined with a computer image processing. Statistic analysis was performed with SPSS.

RESULTS: There were no significant differences in corneal parameters(CCT, CV), PD and iris values(IT750, IT2 000, IS, IV)among the three groups(P>0.05). Compared with the fellow eyes of AACG and PACS, normal eyes had larger ACV, wider AOD500 and ACA, deeper CACD and PACD(P<0.05). No anatomical difference was observed between the fellow eyes of AACG and PACS(P>0.05). Using the fellow eyes of AACG as the standard to predict high risk of angle closure, areas under the receiver operating characteristic curve of the above parameters were all less than 0.7.

CONCLUSION: All the anterior segment parameters are no different significantly between the fellow eyes of AACG and PACS. They may be notaccurate criteria for determining high risk group of PACS.

Clinical study of phacoemulsification in small pupil cataract after filtering operation of glaucoma

Feng Fan and Shao-Xin Pan — 2015/4/8 9:56:57

AIM: To investigate the clinical effects of phacoemulsification and surgical techeniques in small pupil cataract after filtering operation of glaucoma.

METHODS: Thirty-six cases(36 eyes)of small pupil cataract after filtering operation of glaucoma were underwent phacoemulsification combined with foldable intraocular lens implantation. Postoperative visual acuity, intraocular pressure filtration bleb and complications were observed. The follow-up time was 3mo.

RESULTS: The preoperative uncorrected visual acuity(UCVA)or best-corrected visual acuity(BCVA)≤0.3 were in all patients. Postoperativerly, the UCVA or BCVA≥0.3 after 1wk and 3mo were achieved in 23 eyes(63.89%)and 34 eyes(94.44%). BCVA was <0.3 in 2 eyes(5.56%)including optic nerve atrophy of one eye and diabetic retinopathy of one eye. All patients were kept the level of normal intraocular pressure and completed filtering bleb, there were no serious complications.

CONCLUSION: Phacoemulsification in small pupil cataract after filtering operation of glaucoma was complex, and reasonable application of operation skills can still achieve better clinical results. The main factor of affecting the visual acuity is pre-existing retinal optic neuropathy.

Efficacy of treating the early-stage chronic angle closure glaucoma with laser peripheral iridoplasty

Xiu-Duo Liu,Chun Shi,Jian Ying,Hui-Di Xu and Wei Zhang — 2015/4/8 9:56:57

AIM: To evaluate the safety of the laser peripheral iridoplasty(LPIP)for the early-stage chronic primary angle-closure glaucoma(ECPACG).

METHODS: Sixty-five eyes of 36 patients with ECPACG received LPIP. At preoperative and postoperative, patients were examined with intraocular pressure(IOP), anterior chamber, optical coherence tomography(OCT), visual acuity, visual field, fundus and complications. The mean follow-up was 18.2±6.7mo(ranged 12～24mo).

RESULTS: The preoperative average IOP were 23.8±5.6mmHg, postoperative 1wk, 1, 3, 6, 12mo and in the last follow-up time the average IOP were 18.7±3.8, 17.9±3.2, 17.6±3.5, 18.4±3.7, 18.6±3.7, and 18.6±7.8mmHg. There was statistical difference comparing with preoperative(P<0.05, decreasing average 6.5±3.1mmHg compared with the preoperative, the difference was statistically significant(t=5.32, P<0.05). Postoperative 1wk, 1, 3, 6mo, the trabecular-iris angle(TIA500)and the angle opening distance at 500μm(AOD500)had the statistical difference comparing with preoperative(P<0.05). At Postoperative 1a and the last follow-up time, the TIA500 and AOD500 did not have statistical difference comparing with preoperative(P>0.05). The postoperative visual acuity, visual field, fundus had not changed. There were no complications found.

CONCLUSION:LPIP is safe, and has the short time effect in the treatment of ECPACG. With elapse of time, the effect of LPIP is weakened. We can repeat the treatment.

PDT combined with intravitreal injection of ranibizumab treatment for age-related macular degeneration with CNV

Xue-Yan Yang,Jin-Xian He,Xian-Jun Liang and Sheng Zeng — 2015/4/8 9:56:58

AIM: To observe the curative effect of PDT combined with intravitreal injection of ranibizumab treatment for age-related macular degeneration with choroidal neovascularization(CNV).

METHODS: In accordance with the inclusion criteria, by indocyanine green choroidalangiography(ICGA)and optical coherence tomography(OCT)examination confirmed the diagnosis of macular CNV in 27 patients(27 eyes), treated with PDT 3～7d professional intravitreal injection of ranibizumab. At 1, 3, 6mo after treatment, the results of best corrected visual acuity(BCVA), FFA, ICGA, OCT examination and complications were observed.

RESULTS: The BCVA improved in 17 eyes(63%), stable in 6 eyes(22%), and decreased in 4 eyes(15%). Before treatment, the average leakage area was 1 005.69±105.47μm, it were 875.54±103.27μm, and 423.37±79.68μm at 1 and 3mo after treatment, there were significant differences compared with before treatment(P<0.01). Average central macular thickness of retina before treatment was 485.58±122.59μm, and 398.84±105.32μm, 297.74±89.18μ m at 1 and 3mo after treatment, there were significant differences compared with before treatment(P<0.01).

CONCLUSION: The method that PDT closed CNV combined with intravitreal injection of ranibizumab can effectively block angiogenesis recurrence, reduce the number of PDT treatment again and complications, improve the therapeutic effect.

Clinical research on the relationship of central retinal vein occlusion and atherosclerosis

Dao-An Cheng,Yao-Ruo Chen,Jing-Yi Lai and Jia-Li Li — 2015/4/8 9:56:58

AIM: To explore the relationship of central retinal vein occlusion(CRVO)and atherosclerosis(AS).

METHODS: Fifty cases of CRVO patients were chosen as the observation group in our hospital from October 2012 to October 2014, other 50 patients with AS(non-CRVO)as control group. In the control group, 22 cases of AS mild stenosis, moderate stenosis in 24 cases, 4 cases of severe stenosis(3 cases implanted stent). According to the severity, two grade prevention primary prevention therapy, and cerebral vascular disease treating stroke, corresponding drug treatment was undergone. Two groups of patients were performed cervical carotid artery color Doppler ultrasound examination, including assessing plaque, carotid artery intima-media thickness(IMT), the degree of stenosis of internal carotid artery blood flow velocity and the systolic peak(PSV), end diastolic blood flow velocity(EDV), resistance index(RI)values for kinetic parameters etc. All the indexes of the two groups were compared with color Doppler ultrasound examination results, to evaluate the correlation between CRVO and AS.

RESULTS: In the observation group, 15 cases were detected of carotid artery with mild stenosis, 28 cases of arterial diameter reduced <50%, carotid artery moderate stenosis, arterial diameter was reduced from 50%～69%, 6 cases of carotid artery stenosis, arterial diameter was reduced from 70%～99%, 1 patient with ipsilateral carotid artery near occlusion. In the control group, 22 cases were of AS mild stenosis, moderate stenosis in 24 cases, 4 cases of severe stenosis(3 cases implanted stent). The eyes with CRVO increased IMT, PSV and EDV decreased, RI value increased(P<0.05). Compared with the control group, hypertension, hyperlipidemia, hypercholesterolemia, diabetes mellitus in observation group were statistically significant difference(P<0.05). The control group of 2a of follow-up showed no recurrence during CRVO.

CONCLUSION: CRVO and AS are highly correlated, the neck of Doppler ultrasound examination can clearly reflect the central retinal vein blood supply, the standard treatment for AS disease, can reduce the risk of CRVO, with certain clinical significance.

Comparison of efficacy of scleral buckling surgery for retinal detachment under microscope and under indirect ophthalmoscope

Xuan-Zhi Chen,Wen-Jie Huang and Xiao-Qing Miao — 2015/4/8 9:56:58

AIM: To observe the effects of scleral buckling surgery for retinal detachment under microscope and under indirect ophthalmoscope.

METHODS: Forty-six patients(46 eyes)with rhegmatogenous retinal detachment were retrospectively analyzed. Twenty-six patients received surgeries under microscope was retrospectively analyzed and compared to that of 20 patients who received surgeries under indirect ophthalmoscope by the same operator.

RESULTS: No statistical difference was found in patients' operation method choice, including condensation reaction reattachment situation and the retina reset operation at a time(P>0.05). The best corrected visual acuity of microscopic group after 1mo of operation was better than before operation, and the improving rate of vision after operation was higher than that of the traditional group(P<0.05).

CONCLUSION:The curative effect of external approach microsurgery has the similar efficacy with the conventional external approach surgery, and gets better visual acuity.

Changes of lacrimal film after phacoemulsification

Xiao-Peng Li,Yan Li,Jun-Jie Jiao,Shuang Wang and Jing Liu — 2015/4/8 9:56:58

AIM: To observe of cataract phacoemulsification and intraocular lens implantation in patients with postoperative tear film, and to explore its clinical significance.

METHODS: A total of 106 patients(140 eyes)undergone phacoemulsification were randomly chosen. Subjective dry foreign body sensation were observed at six nodes of period 1d, 1, 2, 3wk, and 1mo. Corneal fluorescein(FSC), basal tear secretion(SIT)and tear film break-up time(BUT)were used to detect functional changes of the tear film. And the correlation between tear film stability and corneal sensitivity was analyzed.

RESULTS: Dry eye cumulative score of postoperative 1d, 1, 2wk was higher than preoperative(t=8.53, P=0.000; t=6.27, P=0.000; t=9.02, P=0.000). There was no significant difference in dry eye cumulative score at postoperative 3wk, 1mo compared with preoperative(t=1.91, P=0.824; t=1.27, P=0.069). Corneal epithelial fluorescein staining points of postoperative 1d, 1, 2wk were increased compared with preoperative(t=11.64, P=0.000; t=9.61, P=0.000; t=8.87, P=0.001). There was no significant difference in corneal epithelial fluorescein staining points of postoperative 3wk and 1mo compared with preoperative(t=2.52, P=0.746; t=1.16, P=0.094). Corneal sensitivity detection values of postoperative 1d, 1, 2wk were significantly higher than that of preoperative(t=9.61, P=0.000; t=9.27, P=0.000; t=11.39, P=0.024), and there was no difference postoperative 3wk and 1mo compared with preoperative(t=1.19, P=0.562; t=2.17, P=0.501).

CONCLUSION: Phacoemulsification with intraocular lens implantation will reduce the tear film stability in the short term, but after a long rest will be improved to a certain extent.

Efficacy of phacoemulsification and intraocular lens implantation for high myopia with cataract

Hong Xun — 2015/4/8 9:56:58

AIM: To analyze clinical curative effect of small incision non-phacoemulsification cataract extraction and intraocular lens implantation in the treatment of the high myopia with cataract.

METHODS: Seven-four cases(78 eyes)of patients with high myopia and cataract were randomly divided into control group and observation group, 37 cases(39 eyes)in each group. The control group underwent cataract phacoemulsification and intraocular lens implantation, the observation group received small incision non-phacoemulsification cataract extraction and intraocular lens implantation. The treatment effect was analyzed.

RESULTS: After treatment, there was no significant difference in the ratio uncorrected visual acuity of 0.5 and above in two groups. IOP was significantly decreased in two groups after treatment with no significant difference. Intraoperative and postoperative complications in observation group were significantly lower than that in control group. Wound healing time of observation group was significantly shorter than that of the control group.

CONCLUSION:Small incision non-phacoemulsification cataract extraction and intraocular lens implantation in the treatment of high myopia with cataract has significant effect, lower complication rate, and is worthy of promotion in clinical.

Study of the changes in contrast sensitivity of eyes after laser in situ keratomileuses surgery among pilots

Jing Xu,Peng Peng and Si-Yu Wu — 2015/4/8 9:56:58

AIM: To observe the changes in contrast sensitivity(CS)between emmetropic pilots, glasses wearing, and after laser in situ keratomileuses(LASIK)surgery pilots, provide the basis for the physical examination standard after operation.

METHODS: The CS of 13 emmetropic pilots(26 eyes), 12 glasses wearing pilots(24 eyes)and 10 with LASIK(20 eyes), under photopic, scotopic and scotopic with glare environments at four different spatial frequencies(3, 6, 12 and 18cpd)were measured and the resluts were analyzed by statistics.

RESULTS: Under photopic environments, there was no significant difference in the low spatial frequency(3cpd)among the three groups(P>0.05). The CS of emmetropic pilots was better than that of the myopic and with LASIK, and there was significant difference(P<0.05). There was no significant difference in CS between myopic and with LASIK(P>0.05). Under scotopic environments, there was no significant difference in the low spatial frequency(3cpd)among the three groups(P>0.05). The CS of emmetropic and with LASIK pilots were better than that of the myopic, and there was significant difference(P<0.05).There was no significant difference in CS between emmetropic and with LASIK(P>0.05). Under scotopic with glare environments, the CS of emmetropic and myopic pilots were better than that of the with LASIK, and there was significant difference(P<0.05). There was no significant difference in CS between myopic and with LASIK(P>0.05).

CONCLUSION: The CS after LASIK is decreased compare with emmetropic pilot, specially under scotopic with glare environments. A perfect identification standard should be set up.

Efficacy of different locations scleral tunnel incision in phacoemulsification on preoperative corneal astigmatism

Mei-Ling Wan and Dan Liu — 2015/4/8 9:56:58

AIM: To compare the efficacy of different locations scleral tunnel incision in phacoemulsification cataract on preoperative corneal astigmatism.

METHODS:Totally 90 patients(94 eyes)in our hospital who had undergone the phaco-surgery from March 2013 to October 2014 were divided into two groups. The group A was those with 3.2mm scleral tunnel incision at the direction of 10:00～11:00 points. The group B was those with 3.2mm scleral tunnel incision at the steepest corneal meridian. Incision was not sutured. Corneal astigmatism status of preoperative and postoperative at different times were detected by corneal refractive. The impact of different surgical incision on postoperative corneal astigmatism was compared. In the two groups,patients with preoperative corneal astigmatism<1.00D, 1.00～2.00D and >2.00D were compared respectively. The changes of the uncorrected visual acuity and corneal astigmatism at postoperative 1wk, 1 and 3mo were observed.

RESULTS: The uncorrected visual acuity of the patients who were in the group B preoperative corneal astigmatism <1.00D and 1.00～2.00D was better than that in the group A. The postoperative corneal astigmatism of the patients who were in the group B preoperative corneal astigmatism <1.00D was lower than that in the group A.

CONCLUSION: On the basis of preoperative corneal astigmatism, 3.2mm scleral tunnel incision at the steepest corneal meridian to some extent can correct preoperative corneal astigmatism <1.00D, and accordingly improve the uncorrected visual acuity.

Comparison and evaluation of the surgical effect and binocular vision change before and after surgery for intermittent exotropia

Wen-Juan Hua,Yong-Hui Gu and Dan-Dan Xu — 2015/4/8 9:56:58

AIM: To investigate the preoperative binocular visual function of intermittent exotropia and the rebuilding and recovery of the postoperative binocular visual function, and analyze the effect of binocular visual function on orthophoria after surgery.

METHODS: From January 2011 to January 2014, 47 basic intermittent exotropia patients caming for treatment were collected in the clinical data. The changes in their near stereopsis, binocular visual function, binocular fusion and distance stereopsis after operations were recorded in the form of data. The preoperative binocular vision and the postoperative rebuilding were analyzed and contrasted with each other. In addition, the effect on the postoperative maintaining of orthophoria due to the existence, recovery and rebuilding of binocular visual function were observed.

RESULTS: Intermittent exotropia patients got damage in different levels on their binocular visual functions, especially on distance stereopsis, which was the heaviest and earliest. After the operation, all functions were obviously recovered and reconstructed and the improvements were statistically significant compared against those before the operation(P<0.01). Patients having binocular visual function or part of it before the operation had a higher ratio of orthophoria compared against the patients who had lost binocular visual function before the operation and the difference was statistically significant(P<0.01). The recovery and reconstruction of the postoperative binocular visual function played an important role in maintaining the orthophoria.

CONCLUSION: The intermittent exotropia cause damage to the stereopsis which happened the earliest. Obvious recovery and reconstruction of binocular visual function can be observed after the surgery. A relatively good preoperative binocular visual function may lead to the increase in the ratio of orthophoria or cure the intermittent exotropia. Performing an operation when distance stereopsis is damaged can increase the success rate for the surgery and reduce the recurrence rate.

Effect and safety of intrachamberal triamcinolone acetonide injection during cataract surgery in diabetic patients

2015/3/9 10:14:42

AIM:To evaluate the effect and safety of intrachamberal triamcinolone acetonide(TA)injection during cataract surgery on controlling postoperative inflammation and macular edema on diabetic patients.

METHODS: Three hundred patients(300 eyes)with type 2 diabetes who scheduled for cataract surgery were randomly divided into three groups: group A: 0.3% tobramycin/0.1% dexamethasone eye drops and pranoprofen eye drops treatment for 1mo postoperatively; group B: intrachamberal injection of TA 1mg after cataract surgery, and 0.5% levofloxacin eye drops treatment for one month postoperatively; group C: intrachamberal injection of TA 2mg after cataract surgery, and 0.5% levofloxacin eye drops treatment for one month postoperatively. The main measurements included visual acuity, intraocular pressure(IOP), corneal endothelial cell density, anterior chamber inflammation and the thickness of macula of the three groups.

RESULTS: All cataract surgeries were done successfully by a single surgeon. The best corrected vision of group B and C was better than that of group A 1d, 1wk and 1mo postoperatively(P<0.05). The inflammation of anterior chamber of group B and C was milder than that of group A 1d and 1wk postoperatively(P<0.05). The average IOP of group C 1d postoperatively was higher than that of group A(P<0.05). There was no significant difference between group B and group C on the best corrected vision, anterior chamber inflammation and IOP at any time point. No significant change in the macular thickness was found in patients of group B and C before and after cataract surgery, while there was thicker macula in patients of group A 3wk and 1mo postoperatively when comparing with that of the baseline(P<0.05). There was no significant difference among three groups on corneal endothelial cell density at any time point.

CONCLUSION: Intrachamberal TA injection during phacoemulsification can effectively control postoperative inflammation, reduce the macular edema and accelerate the recovery of visual acuity. Intrachamberal TA 1mg has good effect and safety.

Analysis of choroid radiographic characteristics of diabetics

Ke-Jun Li,Xiao-Bin Zhao,Qing-Min Ma and Zhi-Yang Jia — 2015/3/9 10:14:42

AIM: To observe the characteristic of choroidal circulation in diabetics and investigate its changes as well as the relationship between it and the development and progression of diabetic retinopathy(DR).

METHODS: All 45 diabetics were divided into 3 groups: no diabetic retinopathy(NDR), nonproliferative diabetic retinopathy(NPDR), proliferative diabetic retinopathy(PDR); and 20 health people were selected to be control group. All subjects were examined by FFA and indocyaine green angiography(ICGA)(Heidelberg retina tomography, Germany)at the same time. The characteristics of angiograph results were comparatively observed and the feature of diabetic choroidapathy were analyzed.

RESULTS:(1)There were no significant differences between DR groups and control group in the central retinal artery(CRA)filling time. There were significant decreases of the choroidal artery filling time in DR groups, compared to the control group(P<0.05).(2)In all DR groups, the more serious DR, the bigger proportion of reverse filling.(3)With more serious DR, the ratio increased gradually in early phase of choroidal filling deficiency angiograph and in the late phase of spot hyperfluorescence.

CONCLUSION: ICGA may be a useful adjunct to FFA in the evaluation of choroidal vascular changes in DR. The research provides that the diabetic choroidal circulation was abnormal before the occurrence of DR, which fully proved the presence of diabetic choroidopathy.

Association between the macular thickness and vision

Su-Qiong Lin,Chong-Yuan Cai and Shu-Hui Hu — 2015/3/9 10:14:42

AIM:To analyze the association between the macular thickness and emmetropic, low myopic, moderate myopic and highly myopic eyes.

METHODS: The 276 teenagers(276 eyes)between 18～28 years treated in our hospital from January, 2013 to May, 2014 were selected, whose corrective visual acuity was ≥1.0 and intraocular preasure was ≤21mmHg and who were willing to participate in this research. Forty-nine emmetropic, 72 low myopic, 104 moderate myopic and 51 highly myopic eyes were measured by optical coherence tomography(OCT)to detect the central subfield thickness, bitamporal, superior, lateral and inferior region thickness of inner and outer region, average thickness of retinal macula, foveal thickness and retinal volume. The thickness of different parts of macula lutea was measured and statistically compared among emmetropic, low myopic, moderate myopic and highly myopic eyes.

RESULTS: The central subfield thickness of emmetropic, low myopic, moderate myopic and highly myopic eyes were(225.38±20.97),(230.97±19.15),(227.01±16.92),(231.91±18.97)μm. The average thickness of retinal macula,of emmetropic, low myopic, moderate myopic and highly myopic eyes were(280.92±12.71),(278.15±11.90),(270.05±12.07),(267.93±11.08)μm. There were no significant differences of center thickness(F=1.253, P=0.291)and central subfield thickness(F=1.034, P=0.378)between emmetropic, low myopic, moderate myopic and highly myopic eyes. The macular thickness of inner and outer region in moderate myopic eyes was significantly less than that in emmetropic eyes, and there was significant difference(P<0.05). Comparison between low myopic, moderate myopic and highly myopic eyes was carried out and macular thickness of all regions of inner and outer region in moderate myopic group was significantly increased, and there was significant difference(P<0.05). There was no significant difference when compared with the macular thickness of inner and outer region of the highly myopic group(P>0.05).

CONCLUSION: In low myopic eyes of teenagers, the center macular thickness do not become thinner. However, the macular thickness of inner and outer region is thinner than that of emmetropic eyes. Furthermore, with the increase of the degree of the myopia, the amount of macular thinner gradually decreases from outer region to inner region.

Efficiency analysis by mfERG of intraocular injection with ranibizumab on retinal vein occlusion combined with macular edema

Jing Yan,Chong Xu and Jian-Hua Wu — 2015/3/9 10:14:43

AIM: To measure the retinal function in retinal vein occlusion(RVO)combined with macular edemain patients treated with ranibizumab by using multifocal ERG(mfERG), and to analyze and evaluate the effects of ranibizumab treatment on macular edema.

METHODS:A retrospective, self-control method was used. Fifteen eyes of 15 patients who were clinically diagnosed as RVO with macular edema were included in this study. All patients were routinely corrected visual acuity, slit lamp microscopes, intraocular pressure, color fundus photography, FFA and OCT, the central 10° vision field, mfERG examination, corrected visual acuity using ETDRS visual acuity table. All patients were treated with intravitreal injection of ranibizumab 0.05mL/0.5mg and follow-up 3～12mo, including the monthly review once. The best corrected visual acuity, intraocular pressure, fundus, central macular thickness, central 10° vision field, the change of mfERG of these patients were observed. According to the referral, the repeated injection treatment was decided. The end of the follow-up was the time point to determine the efficacy, and the changes of vision field and mfERG in patients were recorded and analyzed.

RESULTS: The central visual field mean defect(MD)was significantly decreased at last follow-up(t=4.01, P<0.01). The 1^st and 2^nd ring N1 wave latency and the former P1 wave latency were significantly reduced(t=13.65, 16.31, P<0.01). The density values of P1 wave from treatment response in 1^st ring were significantly increased(t=7.78, P<0.01).

CONCLUSION: Intravitreal injection of ranibizumab treatment of macular edema secondary to venous occlusion can give a better prognosis and improve the sensitivity of patients' macular. The method of mfERG can accurately and objectively reflect the retinal function changes in patients with macular edema and could be potentially used in clinical.

Correlation of retinal vein occlusion with blood lipids and carotid artery changes

Wen-Chao Yang,Fang-Fang Ren,Xiao-Bo Lu and Qun Fu — 2015/3/9 10:14:43

AIM: To investigate the correlation of retinal vein occlusion(RVO)with blood lipids and carotid artery changes.

METHODS: Forty cases(40 eyes)with RVO who presented to Eye Hospital of Xinxiang Medical University between May 2013 and April 2014 were selected as the research objects. Proceeded blood lipids and color doppler ultrasonography examination, including total cholesterol(TC), triglycerides(TG), high-density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol(LDL-C), common carotid artery intima-media thickness, carotid plaques, internal carotid artery blood flow mechanics parameters were detected. Thirty eyes(30 cases)were enrolled as control underwent above examinations.

RESULTS: TC, TG, LDL-C of RVO group was obviously higher than those of the control group(P<0.05), while HDL-C level was obviously lower than that of the control group(P<0.05). Incidence of carotid artery plaque formation in RVO group was obviously higher than that in the control group. Intima-media thickness(IMT)of common carotid artery was obviously increased in RVO group(P<0.05). Both peak systolic velocity(PSV)and end diastolic velocity(EDV)of internal carotid artery reduced(P<0.05), and Resistance index(RI)increased(P<0.05). The eyes of the sick side and the contralateral carotid artery measured value had no statistical difference(P>0.05). There were also no statistical difference between ipsilateral and contralateral carotid artery measured value of control group(P>0.05).There were no differences in age, sex between RVO group and control group(P>0.05).

CONCLUSION: Lipid metabolism disorder, carotid artery changes is closely related to the pathogenesis of RVO.

Correlation research of retinal thickness and axial length in non-proliferative diabetic retinopathy

Xin Xu,Jian-Li Wei and Wei-Ying Guo — 2015/3/9 10:14:43

AIM:To explore the correlation of center retinal thickness and axial length in non-proliferative diabetic retinopathy(DR).

METHODS:A total of 80 cases(155 eyes)of non-proliferative DR patients were divided into three groups according to the axial length, 22～24mm of 27 cases(51 eyes)were normal group, 24～26mm of 28 cases(55 eyes)were long axis group, > 26mm of 25 cases(49 eyes)were super long axis group. The center retinal thickness and ocular axial length of three groups were measured and the correlation of center retinal thickness and axial length were analyzed.

RESULTS:Among the inner ring and outer ring, the center retinal thickness of upper and lower, bitamporal and nasal side of super long axis group was thicker than that in normal group, with statistically significant difference(P<0.05); Among the inner ring and outer ring, the center retinal thickness of upper and lower, bitamporal and nasal side of super long axis group was thicker than that in long axis group, with statistically significant difference(P<0.05); The DR central macular of retinal thickness was no correlation of the axial length(P>0.05), but retinal thickness get thinning with increased of axial length on the inner ring and outer ring area, showed a negative correlation(r_inner_ring=-0.63,r_{outer ring}=-0.67, P<0.05).

CONCLUSION:Center retinal thickness and ocular axial length in non-proliferative DR patients, and center retinal thickness of super long axis patients are thinning obviously.

Qi Ming granule intervention on retinal function in the patients with simplex diabetic retinopathy

Guo Zeng,Gang Liu,Hui Liu and Jie Zhong — 2015/3/9 10:14:43

AIM: To study the effect of Qi Ming granule intervention on retinal function in the patients with simplex diabetic retinopathy.

METHODS: Eighty cases of simple diabetic retinopathy patients in our hospital from May, 2012 to May, 2014 were randomly divided into two groups, and each group had 40 cases. The control group was received conventional treatment combined with compound Xueshuantong capsule. The observation group was given conventional treatment combined with Qi Ming granule treatment.

RESULTS: The total efficiency(95%)of the observation group was higher than that(80%)of the control group, and there was statistically significant difference(P<0.05). After treatment, visual field mean sensitivity of the observation group was higher than that of the control group, and there was statistically significant difference(P<0.01). After treatment, patients with O₁ and O₃ latency, the observation group was compared with the control group, and there was statistically significant difference(P<0.05). After treatment, patients with O₁, O₃, and O₄ amplitude, the observation group was compared with the control group, and there was statistically significant difference(P<0.01). After treatment, fibrinogen and blood viscosity of low shear, plasma viscosity, and whole blood viscosity of the observation group were lower than those in the control group, and there were statistically significant differences(P<0.01). After treatment, total cholesterol and low density lipoprotein cholesterol of the observation group was less than those in the control group, and there were statistically significant differences(P<0.05). After treatment, the patients in the observation group serum insulin-like growth factor-1 and vascular endothelial growth factor serum insulin levels were lower than those of the control group of patients, and there were statistically significant differences(P<0.01).

CONCLUSION: Qi Ming granule can delay the progress of the simplex diabetic retinopathy, and it has a good effect on the treatment of early diabetic retinopathy and can improve the function of retina.

Primary clinical result about LSW1 experimental IOL power formula for patients with cataract and high myopia

2015/3/9 10:14:43

AIM: To compare the accuracy of SRK-T, SRK-Ⅱ, Haigis and LSW1 used for intraocular lens(IOL)power calculations in patients with high axial myopia undergoing cataract surgery.

METHODS: A retrospective comparative study was carried out on 97 eyes of 72 patients with axial length(AL)>26mm, who were underwent phacoemulsification with IOL implantation. Preoperative AL was measured by the IOL master, postoperative refractive errors 1mo after surgery were measured by automatic refracto-keratometry(Nidek). IOL power was calculated by SKR-II, SRK-T, Haigis and a new formula developed by the author: LSW1 formula, Power(P)= P₁+P₀, P₁=(2xP_SRK-T+P_SRK-II)÷ 3; when 101≤ 15D, P₀=0.5D; when 51≤10D, P₀=1.0D; when 01≤5D, P₀=1.5D; when P₁≤0D, P₀=3D. According to the results of postoperative refraction calculated the theoretical IOL degree(IOL theory)that could achieve emmetropia. The difference between the IOL formula from four formulas and IOL theory was IOL predictive error(PE). Then IOL PE was converted into refractive PE and absolute prediction error(AE)of each formula. The AE and PE were also analyzed by SPSS 11.0 software.

RESULTS:(1)Among all the patients selected in this study, the average age was 63.25±9.65 years(41～82 years). Average K₁=43.97±1.75, average K₂=45.14±1.98, the average central anterior chamber depth(ACD)3.59±0.38mm, average AL measured by IOL master was 28.67±2.00(26.07～33.98)mm. The average IOL diopter was 8.06±4.33(-3～-14.5)D, the chosen IOL diopter was between the results measured by SRK-T and SRK-Ⅱ formulas.(2)Refractive PE values may be reacted refractive predictable trends. The average PE of LSW1 formula, SRK-T, SRK-Ⅱ, and Haigis were -0.60±0.66D, 0.82±0.92D, -0.52±0.84D, 0.55±0.74D, and the AE of these four formulas were 0.74±0.5D, 0.94±0.79D, 0.81±0.55D, 0.73±0.55D, respectively. The proportion of hyperopia in these four formulas were LSW1 14.4%(14/97), SRK-T 82.5%(80/97), SRK-Ⅱ 20.6%(20/97), Haigis 79.4%(77/97).

CONCLUSION: The PE of Haigis formula is the smallest among all the four formulas, followed by LSW1 formula, and SRK-Ⅱ formula, and SRK-T formula. LSW1 formula and SRK-Ⅱ formula indicate a slight tendency for myopia shift; while Haigis formula and SRK-T formula indicate a tendency for hyperopic shift. SRK-T formula has a larger tendency for hyperopic shift, and cannot provide accurate IOL power calculations in cataract patients with high AL. LSW1 formula has the smallest variability and is the most suitable formula for cataract patients with high AL.

Analysis of thicknesses change of macula central fovea and retinal nerve fiber layer in children with ametropic amblyopia

Hua Chun — 2015/3/9 10:14:43

AIM: To investigate the thicknesses change of macula central fovea(MFT)and retinal nerve fiber layer(RNFL)in children with ametropic amblyopia and normal children.

METHODS: The medical records of 56 children with ametropic amblyopia and 56 normal children in our hospital during the same period were retrospectively analyzed. Optical coherence tomography(OCT)was used to measure the MFT and RNFL. The MFT and RNFL change in two groups were statistically evaluated.

RESULTS: The sex, age and axial length were no significant difference between amblyopia group and control group(P>0.05). The MFT in amblyopia group and control group were 135.15±15.15μm, 136.14±14.26μm respectively(P>0.05). The RNFL in amblyopia group and control group were 117.02±8.97μm, 110.43±7.94μm respectively, and there was significant difference(P<0.05). There was negative correlation between RNFL and axial length in control group(r=-0.36, P<0.05), but there was no significant correlation in amblyopiagroup(r=0.11, P>0.05).

CONCLUSION: There are no significant changes in MFT between children with ametropic amblyopia and normal children, but RNFL is thicker in amblyopia group than that in control group, and there is no correlation with axial length.

Clinical effect of houttuynia cordata eyedrops combined with bFGF eyedrops in treating dry eye after keratorefractive surgery

Li-Mei Gao and Yan Gao — 2015/3/9 10:14:43

AIM: To observe the clinical effect of houttuynia cordata eyedrops combined with basic fibroblast growth factor(bFGF)eyedrops in treating dry eye after keratorefractive surgery.

METHODS: Respectively, 117 patients(204 eyes)were randomly assigned to treatment group(61 patients, 113 eyes)andthe control group(56 patients, 91 eyes). In control group, the eyes were used bFGF eyedrops four times a day, one drop at a time, and the treatment group was used bFGF eyedrops and houttuynia cordata eyedrops. After 2wk and 4wk of treatment, clinic symptom, Shirmer Ⅰ test(SⅠt), break-up time of tear film(BUT)and fluorescence staining were recorded respectively.

RESULTS: After 2wk and 4wk of observation, the clinic symptom of two groups was both improved. SⅠt, BUT and fluorescence staining scores in the treatment group were significantly better than those in control group(P<0.05). After 4wk, the total effective rate of treatment group was 98%, while that in the control group was 90%, there was significant difference between the two groups(P=0.011).

CONCLUSION: Houttuynia cordata eyedrops can improve the effect of bFGF eyedrops in treating dry eye after keratorefractive surgery.

Application of cold patch in relieving pain after transepithelial photorefractive keratectomy

Yuan Zeng and Yi Li — 2015/3/9 10:14:43

AIM: To investigate the effects of a cold patch on postoperative pain and other relevant reactions to transepithelial photorefractive keratectomy.

METHODS: In this prospective, randomized controlled study, forty patients(80 eyes)scheduled to undergo transepithelial photorefractive keratectomy for myopia or myopic astigmatism were randomly and equally divided to be treated with iced balanced salt solution during the surgery(washing group, 20 cases, 40 eyes)or to wear a postoperative cold compress for 24h(cold compress group, 20 cases, 40 eyes). The main outcomes were visual analogue pain score 8, 16, 24h after surgery, postoperative eyelid edema, conjunctival hyperemia, epithelial healing time, Haze, and postoperative best-corrected visual acuity.

RESULTS: Demographic data and the pain scores during surgery were similar between the two groups. The mean postoperative pain scores of patients in the cold compress group at 8, 16, and 24h were significantly lower than that of the washing group. Scores for postoperative eyelid edema and conjunctival hyperemia in the cold compress group were also lower than in the washing group. Patients in the cold compress group applied fewer painkillers. The epithelium healing time, Haze, and early recovery of visual acuity were similar between the two groups.

CONCLUSION: Wearing a cold eye shield after transepithelial photorefractive keratectomy can effectively relieve pain and inflammation and reduce the consumption of painkillers.

Preliminary clinical evaluation of nerve growth factor gel on neuroprotecion in patients with glaucoma

Ren-Yi Wu,Chang-Quan Huang,Jie-Xuan Lü,Qian-Qian Hu,Wei-Yi Huang and Ya-Zhang Xu — 2015/1/30 15:09:36

AIM: To evaluate the neuroprotective effect of nerve growth factor(NGF)on acute angle-closure glaucoma patients after trabeculetomy.

METHODS: Patients with viral keratitis who underwent trabeculectomy in treatment of acute angle-closure glaucoma in Xiamen Eye Center of Xiamen University from December 2011 to October 2013 were selected and completed the treatment, 61 eyes of 45 cases were followed up. The treatment group of 23 cases(32 eyes)with acute angle-closure glaucoma patients were treated by NGF gel for 3mo after trabeculetomy, while in the control group 22 cases(29 eyes)were treated by normal saline replaced NGF. All patients were followed up for at least 12mo, visual acuity, perimetry, retinal nerve fiber layer(RNFL)thickness and cup/disc ratio of the patients were followed up during the treatment. The safety of topical use of NGF gel was also evaluated.

RESULTS:In all patients, the intraocular pressure(IOP)was successfully controlled under 21mmHg and the visual acuity was markedly increased in the affected eye after trabeculectomy. Compared with control group, the postoperative IOP and visual acuity had no significant differences in treatment group(P>0.05). The average light sensitivity of perimetry and mean defect were better than that in control group postoperative 6 and 12mo; The results of optical coherent tomography(OCT)and Heiderburg Retina Tomography(HRT)-Ⅲ showed that RNFL thickness was significantly greater than that in control group, while cup/disc ratio significantly less than that in control group postoperative 6 and 12mo. Ocular surface damage, corneal endothelium to reduce and other eye complication were no observed in treatment group.

CONCLUSION:Acute angle-closure glaucoma treated by NGF gel after operation is effective and safe.

Change of trace elements and body comprehensive immune state of patients with viral keratitis

Yan Jiang,Wei-Cai Fu and Yi-Kang Dai — 2015/1/30 15:09:36

AIM:To study and investigate the change situation of trace elements and body comprehensive immune state of patients with viral keratitis.

METHODS:Sixty-two patients with viral keratitis in our hospital from December 2011 to February 2014 were selected as observation group, 62 healthy persons with health education at the same time were the control group, then the serum and tear Zn, Cu, cellular immunity and erythrocyte immunity of two groups were compared, and the detection results of observation group with different types and severity degree were compared.

RESULTS:The serum and tear Zn of observation group was all lower than that in control group, serum and tear Cu was higher than that in control group, cellular immunity and erythrocyte immunity indexes were all worse than that in control group,the detection results of observation group with mild, moderate and severe infection had significant differences(P<0.05), while the detection results of observation group with herpes simplex keratitis and herpes zoster keratitis had no significant differences(P>0.05).

CONCLUSION: The change of trace elements and body comprehensive immune state of patients with viral keratitis are obvious,and the severity degree for the detection levels of keratitis are greater.

Comparison of the clinical effect of phacoemulsification and middle incision extracapsular cataract extraction

Yan-Mei Wen,Li-Hui Li and Yun-Wei Luo — 2015/1/30 15:09:36

AIM: To compare the clinical effect of phacoemulsification and middle incision extracapsular cataract extraction(MI-ECCE).

METHODS: One hundred and eighty-five eyes of phacoemulsification(137 cases)and 185 eyes of 139 cases for MI-ECCE from January 2011 to May 2013 were involved in this study. And the ratio posterior capsular rupture during surgery, visual acuity, corneal edema, corneal astigmatism and intraocular pressure post operation were followed up.

RESULTS: On 1d after surgery, uncorrected visual acuity in the group of MI-ECCE was better than that of phacoemulsification group, while from 3d; 1 and 3mo after surgery, no significant difference was found from the above two groups. On 1d postoperation, corneal edema ratio in phacoemulsification group(45 eyes)was higher than that in MI-ECCE group(20 eyes)(χ²=11.665, P=0.0006). No significant difference was found for the ratio of posterior capsule rupture during surgery in these two surgical technique groups(χ²=0.094,P=0.759). On 1wk; 1 and 3mo after surgery, significant difference was found for the average of surgical induced corneal astigmatism between two groups(u=6.661, 6.880, 4.187, P=0.00, respectively). During following up, no significant difference was found for the intraocular pressure between two groups(u=1.858, 0.963, 0.471, 1.349, 1.388; P=0.063, 0.335, 0.638, 0.177, 0.165). Intraocular pressure on 1d postoperation in phacoemulsification and MI-ECCE groups was higher than before operation(u=19.86, 19.39, P=0.00, respectively). And on 1wk; 1 and 3mo postoperation, intraocular pressure in the operated eyes in both groups was lower than before operation for 2～3mmHg.

CONCLUSION: Although phacoemulsification and MI-ECCE could both get good visual rehabilitation, with similar visual outcome, no significant effect for intraocular pressure, and no severe complications, the latter one owns the advantage that easier maneuver, quicker recovery, and cheaper instruments needed, which is suitable for the hard nuclei cataract in local hospitals. MI-ECCE is a safe, effective and easy manipulation for local hospital for large batch of cataract surgeries.

Innercapsular phacoemulsification with primary intraocular lens implantation in the treatment of lens dislocation

Qing-Guo Yang,Jun-Ling Wang,Jin Gong,Lin-Ling Wang and Ping Wang — 2015/1/30 15:09:36

AIM: To observe the clinical results of innercapsular phacoemulsification with primary intraocular lens(IOL)implantation in the treatment of lens dislocation.

METHODS: A total of 23 cases(23 eyes)of lens dislocation(IIa and IIb)were underwent innercapsular phacoemulsification combined with primary IOL implantation. IOL implantation were underwent during operation, the complications of intraoperative and postoperative, postoperative vision, intraocular pressure(IOP), corneal endothelial cell, IOL location were analyzed.

RESULTS: The operations were successfully completed for all patients in accordance with the pre-surgery program; lens nucleus or its fragments did not crash into the vitreous cavity; 20 cases of corneal edema and 17 cases of IOP presented at the first day after surgery, the deviation or displacement of IOL and serious complications such as retinal detachment were not appeared. At the first week postoperation, the average IOP was 15.81±2.10mmHg, with statistically significant differences when compared with the preoperative(P<0.01), the visual acuity in all eases increased, with statistically significant differences when compared with the preoperative(P<0.01). Corneal endothelial cell density and percentage of hexagonal cells decreased, the variation coefficient increased in first week of postoperative, with no statistically significant differences when compared with the preoperative(P>0.05)

CONCLUSION: Innercapsular phacoemulsification combined with primary IOL implantation in the treatment of the whole lens dislocation(Ⅱa and Ⅱb)can restore function in patients with diplopia and control IOP effectively, reduce corneal endothelial cell damage, which is an effective method to treat the whole traumatic lens dislocation.

Clinical observation of coaxial microincision phacoemulsification for beginners

Rong Xu,Yong Wang and Min Zhao — 2015/1/30 15:09:36

AIM: To investigate the methods of learning coaxial microincision phacoemulsification and assess the related complications.

METHODS:The clinical data of 1 080 eyes of coaxial microincision phacoemulsification performed by beginners from October 2011 to December 2013 was retrospectively analyzed. In order of surgery dates, the patients were equally divided into groups A, B, C and D, 270 eyes in each group. Comparisons were made among the four groups in operation time, cumulative dissipated energy(CDE), rate of intraoperative, and postoperative complications at 1d; and best corrected distance visual acuity(BCDVA)at 1mo postoperatively.

RESULTS: No significant differences were found in age, sex, lens grading, BCDVA at 1mo postoperatively among the four groups(P>0.05). The operation time was significantly longer in group A than in groups B, C and D(25.15±3.11min vs 15.20±3.40min, 14.71±3.02min and 14.41±2.91min, P<0.05). No significant differences were found in the operation time among the other three groups(P>0.05). The CDE of grade Ⅱ and Ⅲ was significantly higher in group A than that in groups B, C and D(95.9%, 97.8% and 98.5%)(P<0.01). The number of continuous curvilinear capsulorhexis(CCC)were performed successfully was significantly less in group A(80.7%)than the other three groups(95.9%, 97.8% and 98.5%)(P<0.01). The incidence of posterior capasular rupture of group A(7.8%)was higher than that of group B(3.7%), group C(1.1%)and group D(0.4%)(P<0.05), but there was no significant difference between group C and group D(P>0.05). There were no significant differences both in the number of corneal edema and BCDVA at 1d between group A and group B.(P=0.66, P=0.53).

CONCLUSION: With learning step by step, appropriate training program, careful case selection, and accurate managing complications, coxial microincision phacoemusification can be safe for a beginner.

Influence on long-term changes of refractive status in children after congenital cataract intraocular lens implantation

Yan Huang — 2015/1/30 15:09:36

AIM: To discuss long-term changes of refractive status in children after congenital cataract intraocular lens(IOL)implantation and analyze its related influence factors.

METHODS: Seventy cases(110 eyes)with congenital cataract from January 2013 to January 2014 in our hospital were selected, according to the age of patients, they were divided into group A(<2 years old), group B(2～6 years old), group C(7～12 years old). They were all given cataract extraction combined with IOL implantation in congenital cataract. Corneal curvature, axial length, refractive status of three groups after operation were compared, the influence factors ocular axis changes were analyzed.

RESULTS: There were no statistically significant differences in corneal curvature of groups A, B, and C after operation(P>0.05); The differences had statistical significances of the corneal curvature of group A after surgery and 3mo after operation(P<0.05), there were no significant differences of the corneal curvature of group B, group C after surgery and 3mo after operation(P>0.05); the corneal curvature 3mo after operation of group A was significantly higher than that of groups B and C(P<0.05), there were no significant differences in the corneal curvature between group B, and group C after 3mo(P>0.05); There were no statistical significances on axial length after operation in groups A, B, and C(P>0.05); Ocular axial length difference of group A 3mo after surgery was significantly higher than that of groups B and C(P<0.05), ocular axial length had no statistical difference of group B, group c 3mo after surgery(P>0.05). Refractive status of three groups after operation showed myopia moving trend, refractive change rate and refractive diopter of group A after operation was significantly higher than that of group B, group C, the difference was statistically significant(P<0.05).

CONCLUSION: After congenital cataract extraction combined with IOL implantation, patients present myopia refractive state trend. Performance of children below 2 years old is significant. The main factor of myopia is axial growth.

Clinical analysis on the pupil diameter changes of cataract patients during phacoemulsification

Hua Guo,A-Yong Yu,Yi-Fan Feng,Fei Yuan and Qin-Mei Wang — 2015/1/30 15:09:36

AIM: To study the changes of pupil diameter and its effects during phacoemulsification.

METHODS:Block design, prospective study. 60 cataract patients(60 eyes)were selected, which divided into two groups according to the age, young age group(group A, 20 eyes of 20 patients)and older age group(group B, 40 eyes of 40 patients). Two groups were all given compound tropicamide eye drops for fully mydriasis before operation, computer software to process images during operation, and according to the cornea amplification ratio measure pupil diameter during the operation phase: before the corneal tunnel incision(t1), after injection of sodium hyalurantae(t2), before artificial lens implantation(t3), at the end of the surgery(t4). Statistical analysis of data using SPSS18.0 software.

RESULTS: The pupil diameter measurements of t1-t4 were followed respectively: group A were 8.36±0.65, 8.97±0.50, 8.67±0.63, 8.72±0.96mm; group B were 7.73±0.58, 8.23±0.59, 7.89±0.16, 7.70±0.63mm. Overall comparisons between the two groups, the pupil diameter measurements had differences during the operation phase(F=26.696,P< 0.05). Comparisons between the two groups at different time points: the pupil diameter of t1-t4 in group A was larger than that in group B, with statistically differences(P<0.05). The pupil diameter of each groups had a tendency to change in different operation phrases, with no statistically differences(F=2.617,P>0.05). Comparisons in a group at different time points: the pupil diameter of t2 was larger than that in t1, with statistically differences(P>0.05), the pupil diameter of t3 and t4 were decreased in group B, with statistically differences(P<0.05).

CONCLUSION: Compound tropicamide eye drops are given for mydriasis before operation, young patients with cataract and senile patients with cataract can achieve the effect of surgery for mydriasis, the pupil stability of phacoemulsification in senile patients with cataract are lower than that in young patients with cataract.

Clinical research of limbal relaxing incision during implantable collamer lens surgery

Zhen Li,Hui-Bin Du and Yu Han — 2015/1/30 15:09:36

AIM: To evaluate the efficacy and safety of limbal relaxing incision(LRI)for correcting corneal astigmatism during implantable collamer lens(ICL)surgery.

METHODS: A total of 185 eyes of 105 patients with high myopia and corneal keratometric astigmatism were included in the study. ICL surgery with concomitant relaxing incision was performed in 105 eyes of 60 patients in LRIs group(Group A). Eighty eyes of 45 patients only underwent ICL surgery were in control group(Group B). All patients undergone ophthalmic examination that included uncorrected visual acuity(UCVA), best-corrected visual acuity(BCVA), Pentacam analysis system to observe the changes of corneal astigmatism before and 1wk, 1 and 3mo after surgery.

RESULTS: Respectively comparing UCVA between two groups in 1 and 3mo postoperatively, the P values were considered statistically significant(P<0.05). But, respectively comparing BCVA between two groups in 1wk, 1 and 3mo postoperatively, the P values were considered no statistically significant(P>0.05). Preoperative corneal astigmatism was 1.52±0.55D in group A and 1.48±0.57D in group B, there was no statistically significant difference(P>0.05). One week postoperatively, the astigmatism was 0.55±0.41D in group A and 1.20±0.48D in group B. One month postoperatively, the astigmatism was 0.60±0.38D in group A and 0.93±0.47D. Three months postoperatively, the astigmatism was 0.51±0.32D in group A and 0.96±0.40D in group B. The difference between the two groups were statistically significant(P<0.05). The difference value of corned astigmatism before surgery and 1wk, 1 and 3mo after surgery had statistical significance(P<0.05). In LRIs group, at preoperative and postoperative time points, the average corneal astigmatism changes were also considered statistically significant difference(P<0.05).

CONCLUSION: LRIs performed during ICL surgery appeared to be an effective and safer procedure to reduce pre-existing corneal astigmatism and improve UCVA as well as the visual quality.

Study of biological measurement parameters of anterior segment in primary acute angle-closure glaucoma

Jun-Jie Bian,Wei-Jia Dai and Da-Chuan Liu — 2015/1/30 15:09:36

AIM:To investigate biological measurement parameters of anterior segment in acute angle-closure glaucoma(AACG).

METHODS: Forty-six eyes of 46 patients with AACG and 52 eyes of 52 patients with shallow anterior chamber and 50 eyes of 50 normal individuals were examined. The parameters of anterior segment including chamber crowd rate(CCR), lens thickness(LT), lens position(LP)and anterior chamber depth(ACD)were measured by A-ultrasound according to different ages in each group. The data were performed statistical analysis in three groups.

RESULTS: In each age range group(≥50～59 years old, ≥60～69 years old, ≥70 years old), statistically significant differences in three groups(AACG, shallow anterior chamber group and the controls)were found in CCR, LT, LP, ACD(P<0.01). There were statistically significant differences only in CCR(P<0.01)but not in LT,LP and ACD(P>0.05)between AACG and shallow anterior chamber group in each age range group.

CONCLUSION: CCR can be used as the index of evaluating crowding state of anterior segment in AACG patients and the sensitivity is better than LT and LP.

Curative effect of minimally invasive sclera buckling on single retinal detachment

Yun-Huan Li,Zhong-Yang Yan and Shan-Yu Li — 2015/1/30 15:09:36

AIM: To investigate the curative effect of minimally invasive sclera buckling on single retinal detachment.

METHODS:Totally, 100 cases of patients with retinal detachment(106 eyes)enrolled in our hospital were randomly divided into observation group and control group, 53 eyes in each group. Patients in observation group were treated with minimally invasive sclera buckling, while patients in control group received traditional limbal conjunctival incision. After surgery, patients were all followed up for 6～18mo, during which the retinal recurrence situation, degree of vision enhancement and compliance occurrence rate was recorded.

RESULTS: The retinal reattachment rate once of observation group(96.22%)was significantly higher than that of control group(88.68%), there was statistically significance(P<0.05). The vision enhancement rate of observation group(84.90%)was significantly higher than that of control group(71.70%), there was statistically significance(P<0.05). The compliance occurrence rate of observation group(11.32%)was significantly lower than that of control group(32.08%), there was statistically significance(P<0.05).

CONCLUSION: The improved minimally invasive sclera buckling can significantly enhance the curative effect for retinal detachment, decrease the compliance occurrence rate, improve vision function, and is a scientific, practical and rigorous tool for retinal detachment treatment.

Antioxidative stress effect of probucol for nonproliferative diabetic retinopathy

Su-Ping Jiang — 2015/1/30 15:09:37

AIM: To study the antioxidative stress effect of probucol for nonproliferative diabetic retinopathy.

METHODS:Sixty-eight clinic patients with nonproliferative diabetic retinopathy were selected from January, 2012 to August, 2013. According to the random number table, the patients were divided into control group and observation group, the control group was received conventional medicine for hypoglycemic therapy, and the observation group was given probucol(0.375g, twice daily)on the basis of control group. All patients were followed up for average 11.58±0.17mo. At the same time 16 healthy volunteers matched with baseline were collected as normal control group. Changes in fasting blood glucose, postprandial blood glucose, glycosylated hemoglobin, the staging progress rate and the remission rate of diabetic retinopathy, and indicators related to oxidative stress, such as, total antioxide capacity(TAOC), superoxide dismutase(SOD), and methane dicarboxy aldehyde(MDA), of two groups of patients before and after therapy were observed.

RESULTS: Fasting blood glucose,postprandial blood glucose, and glycosylated hemoglobin of patients in two groups before and after therapy showed no significant changes, and the differences had no statistical significance. The staging remission rate and the progress rate of diabetic retinopathy of the control group after therapy were 3% and 19% respectively. The staging remission rate and the progress rate of diabetic retinopathy of the observation group after probucol therapy were 18% and 5% respectively. In comparison with the control group, the difference had statistical significance(P<0.05). TAOC, SOD, MDA of the control group before and after therapy had no obvious change, but TAOC, SOD of the observation group after therapy had significantly increased, and MDA had significantly decreased(P<0.05), with statistical significance in comparison with the changes of the patients in the control group after therapy(P<0.05).

CONCLUSION:Probucol can improve the antioxidative stress status of the patients with nonproliferative diabetic retinopathy, and enhance the therapeutic effect of the patients with diabetic retinopathy.

Comparison of scleral bulkling surgery for retinal detachment under microscope and under indirect ophthalmoscope

Min Kong,Yu Chen and Ren-Hong Tang — 2015/1/30 15:09:37

AIM:To compare the effects of external approach microsurgery and conventional external approach surgery for retinal detachment(RD).

METHODS: From January 2010 to January 2013, 60 patients(60 eyes)in our hospital were randomly divided into experimental group(29 cases, 29 eyes)and control group(31 cases, 31 eyes), the external approach microsurgery and conventional external approach surgery were performed respectively(by the same skilled doctor). Retinal reattachment rate, visual acuity improvement rate and operative time were compared between two groups.

RESULTS: It cost shorter time for the external approach microsurgery than that of conventional external approach surgery(P=0.0087). The once successful retinal reattachment rate in experimental group was 93%(27 cases), which was higher than that in control group(90%, 28 cases), there was no statistical difference. The vision improvement rate in control group was 86%(25 cases), compare to 90%(28 cases)in experimental group, there was no statistical differences.

CONCLUSION: No statistical differences showed in visual acuity improvement and the once retinal reattachment rate between the two groups for rhegmatogenous retinal detachment. However, it is believed that external approach microsurgery could be faster, easier to learn with satisfactory effect.

Significance of intraocular scattered light and contrast sensitivity to assess the true visual quality in cataract patients

Tao Wang — 2015/1/30 15:09:37

AIM: To analyze the significance of intraocular scattered light and contrast sensitivity in cataract patient's visual quality.

METHODS: Seventy-three cases of cataract patients(120 eyes)in our department from January 2012 to January 2014 were selected, of which 32 cases(52 eyes)were cortical cataract, 18 cases(33 eyes)were nuclear cataract, 23 cases(35 eyes)were posterior subcapsular cataract, and 40 normal persons(40 eyes)were as the normal group. The full-eye corneal astigmatism and total astigmatism were observed in all those enrolled. The contrast sensitivity of different perspective was checked by automatic glare contrast sensitivity tester.

RESULTS: The corneal astigmatism and full eye total astigmatism in the cortical cataract group, nuclear cataract group and the posterior capsule cataract group was significantly higher than that in the normal group(P<0.05). The total astigmatism was no significant difference cataract in three groups of patients with corneal astigmatism and total full eye astigmatism(P>0.05). The contrast sensitivity in the cortical cataract group, nuclear cataract group and posterior subcapsular cataract group in the whole band were significantly lower than the normal group(P<0.05). The contrast sensitivity of posterior subcapsular cataract group in the whole band was significantly lower than cortical cataract groups and nuclear cataract group(P<0.05).

CONCLUSION: Intraocular scatter light and contrast sensitivity joint inspection can effectively evaluate the visual quality of cataract patients, which lead to early treatment.

Relationship between the morphologic changes of central serious chorioretinopathy and visual acuity by spectral-domain optical coherence tomography

Qi Gong — 2015/1/30 15:09:37

AIM: To evaluate the relationship between the morphologic changes of central serious chorioretinopathy(CSCR)and recovery of visual acuity visual acuity(VA).

METHODS: Thirty-eight eyes of thirty-eight patients with CSCR were studied and divided according to best corrected visual acuity(BCVA). Group 1, n=17(45%), VA 6/6-6/9(logMAR 0～0.176); Group 2, n=19(50%), VA 6/9-6/18(logMAR 0.176～0.477); Group 3, n=2(5%), VA less than 6/18(logMAR 0.477). All patients inspected by spectral-domain optical coherence tomography(SD-OCT).

RESULTS: The mean age of the patients was 42.50±5.41years, the mean logMAR VA was 0.176±0.0185, retinal pigment epithelium(RPE)detachments in 21 eyes(55%), including single RPE detachments in 14 eyes(67%), and multiple confluent RPE detachments in 7 eyes(33%). Small bulge of RPE in 7 eyes(18%), granular deposition epi-RPE in 5 eyes(13%). The mean subretinal fluid height at the fovea was 259.11±128.78μm. The average photoreceptor lengths were 70.1±9.08μm, 81.6±8.16μm, and 91.9±8.03μm in groups 1, 2, and 3, respectively, the mean subretinal fluid height at the fovea was 66.5±8.13μm, 67.8±7.49μm, and 58.6±7.26μm after 6mo, respectively. The mean outer nuclear layer thickness during the active stage was 93.10μm and it was 75.69μm after 6mo(P=0.012)

CONCLUSION: In the acute CSCR, VA showed statistically significant association with greater dimensions of subretinal fluid-particularly, greater subretinal fluid height and thinning of the outer nuclear layer at the fovea. The type of pigment epithelium detachment(PED), location, or fiber deposition has nothing to associate with VA. In resolved CSCR, VA has a significant associated with a persistently thinner outer nuclear layer.

Effect of postural change on intraocular pressure fluctuation in open angle glaucoma patients after trabeculectomy

Wei Li — 2015/1/30 15:09:37

AIM:To study the effect of postural change on intraocular pressure(IOP)fluctuation in open angle glaucoma patients after trabeculectomy, and to discuss the value of this investigation on prognosis.

METHODS: Fifty-one cases(62 eyes)of primary open angle glaucoma were selected as the research object. Perkins ophthalmotonometer was used to test IOP at the time when patient seat(first seat). The patients were asked to lie supine for 25min, detected IOP, and the patients seated again(final seat), sustaining for 15min, detected IOP. According to whether the IOP range was more than 5mmHg, they were divided into high volatility fluctuation group and low volatility fluctuation group. We recorded their visual field progression(with AGIS score), HPA staging, in order to evaluate the correlation of IOP range with them. Reviews were made 3mo a time, and lasted for 1a, in order to evaluate the relation between IOP range and AGIS scores.

RESULTS: The IOP of first seat was 18.1+2.2mmHg. There was no significant difference in the same position(P>0.05). The IOP range was 4.1±1.5mmHg. Low volatility fluctuation group was more likely to have low AGIS score and to be early vision HPA(P<0.001, P<0.05). There were significantly positive correlation between IOP range and AGIS(r=0.412, P<0.001); With time increasing, the number of patients whose visual field progression was increased, and the IOP was also raised. At any time the two were positively correlated(P<0.01).

CONCLUSION: Visual field progression is related to the degree of IOP fluctuation in open angle glaucoma patients after trabeculectomy, so we can predict the prognosis of patients simply by detect IOP fluctuation. This is good to adjust the IOP control scheme.

Evaluation of diopter after cataract surgery in high myopia combined cataract

Wan-Qi Zhang and Shao-Bin Zhang — 2015/1/30 15:09:37

AIM: To observe the diopter after cataract surgery for vision gain in high myopia and its effect on visual outcomes.

METHODS: Sixty(120 eyes)high myopia combined with cataract cases received phacoemulsification and intraocular lens implantation in our hospital were retrospective studied. The patients were divided into three groups based on postoperative diopter: -1.0～-2.0D(group A), -2.25～-3.0D(group B)and -3.25～-4.0D(group C). The uncorrected distance visual acuity(UCDVA), best corrected distant visual acuity(BCDVA), uncorrected near visual acuity(UCNVA)and questionnaire of Activities of Daily Vision Scale(ADVS)were collected to assess the vision gain at 3mo after cataract surgery.

RESULTS: At 3mo after surgery, UCDVA of group A was better than that of group B, and UCDVA of group B was better than that of group C. There were no differences in BCDVA among groups. There were significant differences between the three groups' UCNVA, it was best for the group C, followed by the group B, group A was the worst. For questionnaire, no difference was observed in patients' satisfactory for surgical results, but a significant difference was detected in postoperative glasses wearing frequency between groups.

CONCLUSION:For cataract surgery in high myopia combined cataract, postoperative diopter should be calculated based on patients' daily requirements. For patients had not used to wearing glasses and near distant working condition, it's appropriated to reserve a minor degree of myopia. Conversely, for patients require near distant working and received wearing moderate and low hyperopia mirror, higher degree of myopia can be reserved.

Reason analysis and preventive treatment countermeasure of impaired vision after LASIK

Zhang-Bing Mu,Jin-Mei Xiang,Xu Huang,Qian-Ge-Mai Ren,Xiao-Hui Wu and Yin Peng — 2015/1/30 15:09:37

AIM: To analyze the reasons of impaired vision after LASIK and explore its preventive treatment measures preliminarily.

METHODS: In this retrospective study, 175 eyes of 134 patients whose vision was decreased after LASIK were included. The constituent ratio of every reason was counted and uncorrected visual acuity(UCVA)between pre-treatment and post-treatment were compared by paired t-test respectively.

RESULTS: The overall incidence of impaired vision after LASIK was 1.86%. The constituent ratio of regression was 51.43% and UCVA increased from 0.61±0.22 to 0.90±0.38(t=8.00, P<0.001)after treatment. The constituent ratio of punctate corneal epithelial defect was 32.57% and UCVA increased from 0.60±0.19 to 1.20±0.24(t=20.00, P<0.001)after treatment. The constituent ratio of accommodative spasm was 5.14% and UCVA increased from 0.76±0.21 to 1.32±0.22(t=8.14, P<0.001)after treatment. The constituent ratio of corneal flap shift and gauffer was 4% and UCVA increased from 0.29±0.26 to 1.24±0.28(t=6.33, P<0.001)after treatment. The constituent ratio of corticosteroid-induced ocular hypertension was 4% and UCVA increased from 0.57±0.05 to 1.0±0.16(t=2.53, P<0.05)after treatment. The constituent ratio of fundus lesions and diffuse lamellar keratitis(DLK)was 2.86% and UCVA all increased by different degrees after treatment.

CONCLUSION: The reasons of impaired vision after LASIK are many and varied. These cases could recover their vision by discovery and treatment in time, and the appropriate preventive measures were essential.

Clinical analysis of LASIK treatment resulted in overcorrection in Tibetan Plateau

Hong-Fa Chang,Zong-Xi Bai,Xing-Lei Qu and Dao-Yan Huang — 2015/1/30 15:09:37

AIM:To investigate the factors and solutions of Tibetan Plateau excimer laser in situ keratomileusis(LASIK)for myopia overcorrection.

METHODS: The relevant information, 32 cases(58 eyes)in 126 cases(252 eyes)had obvious overcorrection after LASIK were analyzed.

RESULTS: Two months after surgery, 32 cases(58 eyes)overcorrection(23.0%), uncorrected visual acuity of 0.5～0.8, overcorrection range of +1.50 ～ +2.25DS, subjective inserts were ≥1.0; Five case(7 eyes)overcorrection 6mo after surgery(2.8%), uncorrected visual acuity 0.8～1.0^-2, overcorrection range is +0.75 ～ +1.25DS, subjective inserts were ≥1.0. Corneal thickness of overcorrection was 500～563μm, preoperative refraction was -5.00 ～ -7.50D, astigmatism -1.50 ～ -2.75DC, preoperative best corrected visual acuity ≥1.0.

CONCLUSION: Overcorrection and long recovery time after LASIK in Tibet, possibly with local factors altitude, temperature, humidity, surgical parameters and situation.

Application of trypan blue and indocyanine green in mature and hypermature cataracts

Shuang Li,Xun-An Fu and Zhong-Ming Mei — 2014/12/30 15:26:05

AIM: To assess the efficacy and safety of trypan blue and indocyanine green(ICG)for continuous curvilineal capsulorrhexis(CCC)in mature or hypermature phacoemulsification.

METHODS:A total of 122 eyes of 122 cases with cataracts in mature and hypermature were randomly divided into three groups, trypan blue staining group was 46 eyes of 46 cases as group A, ICG staining group was 40 eyes of 40 cases as group B, control group was 36 eyes of 36 cases as group C. Staining groups were used to 0.2mL trypan blue or ICG injected into the anterior chamber during operation, respectively. The success rate of CCC, lens posterior capsule rupture and implanted intraocular lens pouch were observed and compared during operation. Anterior chamber inflammation was observed after operation, and compared with the control group to observe and analysis.

RESULTS:The success rate of CCC, implanted intraocular lens pouch were statistically significant difference in trypan blue staining group(group A)than that in control group(group C)(P<0.05). Implanted intraocular lens pouch was statistically significant difference in ICG group(group B)than that in control group(group C)(P<0.05). The rate of lens posterior capsule rupture was no statistically significant difference in all three groups(P>0.05). Anterior chamber inflammation was no significant difference in the postoperative reaction among the three groups.

CONCLUSION:The application of trypan blue or ICG for lens capsule staining before CCC in lack of red reflective mature and hypermature cataracts is safe and effective, both results are comparable. It guarantees a complete CCC and improves the success rate of phacoemulsification.

Study of modified two incisions silicone oil removal with a 23G transconjunctival sutureless vitrectomy system

Hai-Jun Yang,Feng-Hua Wang,Jing-Lin Yi,Jie Luo and Xiao-Dong Sun — 2014/12/30 15:26:05

AIM:To evaluate the efficacy and safety of silicone oil removal with a 23G transconjunctival sutureless vitrectomy system linked disposable transfusion tube and self-made suction tip.

METHODS: The suction tip was made with a 23G infusion tube be cut from the end of the 5mm. It was used to connect the disposable transfusion tube and 23G puncture cannula. The disposable transfusion tube which was cut from the end of the MaiFei's pipe was connected with the effusion box of the vitreous cutter. Intraocular silicone oil was proactive suction and removed through two incisions on pars plana ciliaris with the vitreous cutter suction system.

RESULTS: Only 13 cases(9.8%)need suture puncture ports in 132 cases in the operation. Operation time was 7-28min. The average operation time was 15.1± 6.2min. In early postoperative, there were 107 cases(81.1%)appeared lower intraocular pressure(<11mmHg)and 2 cases appeared choroid detachment in 132 cases patients. Most of the patients recovered to normal but 2 case(1.5%)high myopia macular hole retinal detachment occurred recurrent retinal detachment 1wk after operation. Silicone oil was removed cleanly in the most patients, only 4 cases(3.0%)with a little silicone oil residue.

CONCLUSION: The surgery that silicone oil is removed through two incisions with a 23G transconjunctival sutureless vitrectomy system linked disposable transfusion tube and self-made suction tip has the advantages of safe, effective, fast, economic, and it is worthy of popularization and application in clinical.

In-the-bag IOL stability of super high myopic eyes with different size of capculorhexis

Yu-Lan Wang,Min Wang,Feng Gao,Jin-Hua Tao and Yao-Hua Sheng — 2014/12/30 15:26:05

AIM: To compare the in-the-bag IOL stability of different size of continuous curvilinear capsulorhexis(CCC)in super high myopic eyes with cataract underwent phacoemulsification.

METHODS: A total of fourteen cataract patients with bilateral super high myopia were included,Phaco+IOL implantation were performed on both eyes, one eye was randomly classified into 5mm diameter CCC observation group, the fellow eye was 6mm diameter CCC observation group. Cataract extraction combined with in-the-bag intraocular lens implantation(IOL)with the type of hydrophilic acrylic aspheric intraocular lens(MCX11)by well experienced surgeon. The operation was running smoothly, the next day after operation, all patients were confirmed by Image-pro plus6.0 image analysis software for the measurement of main meridian sac diameter with target capsulorhexis diameter no more than ±0.2mm. Slit lamp examination of IOL shape and position, changes of anterior capculorhexis edge, refraction, anterior chamber depth was measured and observed of all eyes after operation 1wk; 1, 3, 6mo.

RESULTS: Compared with postoperation 1wk, the former sac diameter of two groups were slightly smaller at postoperation 1mo, with no statistically significant difference between two groups. 5mm diameter CCC observation group had slightly hyperopic shift in follow-up 1-3mo, 6mm diameter CCC observation group had hyperopic shift in follow-up 1mo, and getting stable after 1mo. Refraction change was related to anterior chamber depth changes. 5mm diameter CCC observation group had 3 minor loop folding in follw-up 3mo.

CONCLUSION: Relatively smaller continuous curvilinear capsulorhexis in super high myopic eyes underwent cataract surgery may cause a tendency of uneven construction or effective lens position change of in-the-bag IOL. Unusual refraction change or shift after operation 1mo could suggest instability of IOL, early noticing or interruption could prevent further complications.

Influence of IOL refractive index on straylight level following cataract surgery

2014/12/30 15:26:06

AIM:To investigate the influence of IOL refractive index(RI)on measurement of straylight following cataract surgery.

METHODS:In this case-control study, 77 eyes of 77 age-related cataract patients who underwent cataract phacoemulsification with posterior chamber aspherical arylic IOL implantation surgery in the Eye Hospital of China Medical University from Aug 2013 to Mar 2014, with a best corrected visual acuity(BCVA)of 0.5 or better, were classified into 3 groups randomly using 3 types of IOL: Tecnis ZCB00 Group(RI=1.47, 22 eyes of 22 subjects); Hoya PY60AD Group(RI=1.52, 24 eyes of 24 subjects); Alcon SN60WF or IQ Group(RI=1.55, 31 eyes of 31 subjects). BCVA, pupil size, astigmatism, axial length, intraocular straylight were measured respectively.

RESULTS:Age, axial length, BCVA, pupil size, astigmatism of the three groups were not significant difference(P>0.05). The straylight of Tecnis, Hoya, IQ group were 1.04±0.15, 1.19±0.14, 1.14±0.18. Straylight levels had significant differences among three groups(F=5.352, P=0.007<0.05). There was no significant correlation between BCVA and straylight value(r=-0.133, P=0.124>0.05).

CONCLUSION:Patients chosen the higher RI IOL may have a higher straylight level after the surgery.

Clinical application of posterior continuous curvilinear capsulorhexis of posterior capsular rupture in the phacoemulsification

Yong Wang and Hui Na — 2014/12/30 15:26:06

AIM: To observe the clinical effect of posterior continuous curvilinear capsulorhexis(PCCC)in phacoemulsification with posterior capsular rupture.

METHODS: Thrity-eight age-related cataract patients(38 eyes)from March 2013 to October 2013 were selected as experimental group and 50 age-related cataract patients(50 eyes)from March 2013 to October 2013 as control group. In experimental group, PCCC were used in the intraoperative posterior capsule tears in phacoemulsification. And in control group phacoemulsification was applied. The visual acuity and surgical complications were compared between two groups, the follow-up period was continued to 3mo after operation.

RESULTS: The visual acuity and corneal edema in two groups had statistically significant(P<0.05)at 1d after operation. Three months after operation, the visual acuity and corneal edema in two groups was not statistically significant(P>0.05). At 1d after operation, the intraocular pressure in two groups was not statistically significant(P>0.05). Three months after operation, the pupil and cystoid macular edema, retinal detachment in two groups was not statistically significant(P>0.05).

CONCLUSION: PCCC can improve the therapeutic effect and prevent surgical complications for phacoemulsification with posterior capsular rupture.

Impact of combined surgery on the MUC5AC levels in patients with glaucoma and cataract

Xue-Fei Wang,Ming-Zhe Li and Dong-Ju Qin — 2014/12/30 15:26:06

AIM:To investigate the effects of the MUC5AC levels and ocular function of the patients with glaucoma and cataract with combined surgery.

METHODS: Twenty-eight patients treated with glaucoma and cataract combined surgery were chosen as the observation group from December 2011 to June 2014 in our hospital, and other 28 cases of glaucoma and cataract did not undergo surgical treatment were selected as the control group, 30 healthy subjects were as healthy control group. the MUC5AC level and ocular surface score of the three subjects before surgery 1d, after 3 and 6mo were compared.

RESULTS: The NUC5AC of the two groups of patients was significantly lower than that of the healthy control group before surgery(P<0.05), the ocular function score was significantly higher than the healthy control group(P<0.05). After 1mo, the MUC5AC of the observation group were significantly lower than that of before surgery(P<0.05), after 3mo MUC5AC content gradually increased to preoperative levels, after 6mo the MUC5AC were significantly higher than before surgery(P<0.05). After 1mo, ocular function scores were significantly higher than the preoperative(P<0.05), while after 3mo, ocular function scores decreased after 6mo of ocular surface function scores were significantly lower than the preoperative(P<0.05). While the control group after 6mo, with the passage of time, the MUC5AC content gradually reduce, ocular function score increased gradually.

CONCLUSION: To treat the patients with glaucoma and cataract with combined surgery, the level of MUC5AC can temporary decrease. Ocular function score can temporary increase in, but after 3mo, it can be gradually improved.

Danggui Shaoyao Powder combined with trabeculectomy and bevacizumab on neovascular glaucoma

Jun Jiang — 2014/12/30 15:26:06

AIM: To study the effect of Danggui Shaoyao Powder combined with trabeculectomy and bevacizumab on neovascular glaucoma

METHODS:Neovascular glaucoma patients were enrolled from January 2011 to February 2014 in our hospital, according to the different methods of treatment were divided into observation group given traditional Chinese medicine and Western medicine combined with trabeculectomy, and control group received Western medicine combined with trabeculectomy. Visual acuity, intraocular pressure, retinal thickness were compared.

RESULTS: Visual acuity level: 1wk; 6, 12mo after treatment, visual acuity in observation group were significantly higher than that in control group(0.41±0.07 vs 0.27±0.04, 0.52±0.08 vs 0.38±0.06, 0.72±0.14 vs 0.54±0.08); Intraocular pressure: 1wk; 6, 12mo after treatment, intraocular pressure in observation group were significantly lower than that in control group(15.11±3.22 vs 22.32±5.34, 18.64±5.08 vs 26.67±6.22, 17.18±3.76 vs 22.42±4.32)mmHg; Retinal nerve fiber layer thickness: 12mo after treatment, nerve fiber layer thickness in observation group was significantly higher than that in control group(90.41±10.52 vs 78.64±8.24, 88.38±12.12 vs 72.37±8.82, 73.21±8.46 vs 60.25±7.23, 75.35±8.13 vs 62.63±7.29)μm.

CONCLUSION:Danggui Shaoyao Powder combined with trabeculectomy and bevacizumab on neovascular glaucoma can promote visual acuity recovery, control intraocular pressure, and improve the retinal nerve fiber layer thickness.

Effect of latanoprost combined with timolol treatment on visual function, intraocular pressure and ocular blood flow of open angle glaucoma

Yan-Xia Zhao — 2014/12/30 15:26:06

AIM: To study the effect of latanoprost combined with timolol treatment on visual function, intraocular pressure and ocular blood flow of open angle glaucoma.

METHODS:A total of 50 cases(59 eyes)with open angle glaucoma were enrolled from January 2012 to May 2014 in our hospital department of ophthalmology, and divided into observation group and control group by adopting the random number table method. Patients in observation group were treated with latanoprost combined with timolol, patients in control group were treated only with timolol. Visual function, intraocular pressure and ocular blood flow were compared.

RESULTS: 1, 2, 3 and 4wk after treatment, observation group during the day intraocular pressure, night intraocular pressure were significantly lower than that in control group, vision levels(0.27±0.03, 0.36±0.06, 0.44±0.06, 0.63±0.13)were significantly higher than that in control group; observation group peak systolic velocity(14.41±1.73)cm/s, end diastolic velocity(4.18±0.67)cm/s were significantly higher than that in control group; vascular resistance index(0.58±0.07)was significantly lower than that in control group.

CONCLUSION:Latanoprost combined with timolol treatment can reduce intraocular pressure, increase blood flow of central retinal artery, reduce vascular resistance, improve visual acuity.

Macular thickness and macular volume in diabetic patients without apparent visual loss

Xiao-Dan Peng,Jie Shen,Wei Shen,Li-Na Zhu and Lin Liu — 2014/12/30 15:26:06

AIM: To evaluate macular thickness and macular volume changes in people with diabetes mellitus but no significant decrease of visual acuity.

METHODS: A total of 87 eyes were collected in diabetic group. According to the international stage of diabetic retinopathy, these cases were divided into two subgroups: DR0 stage 54 eyes and DR1 stage 33 eyes. All the cases were received optical coherence tomography(OCT)scan in macular area; the scanning model is 512×128; recording macular average thickness and macular volume, and compared with healthy subjects.

RESULTS: Macular average thickness and macular volume were higher in DR1 group than those in DR0 stage and control group, and differences were having statistical significance. But DR0 group and control group differences of the two indexes were not statistically significant.

CONCLUSION: With the aggravation of diabetic retinopathy, the macular thickness tends to be thicken. Although without obvious visual loss, there have been slight morphological changes. Using OCT scan can find fundus changes earlier in patients with diabetes mellitus, and provide clinical basis for both early diagnosis and treatment.

Intravitreal injection with ranibizumab combined with triamcinolone acetonide sub-Tenon injection for macular edema due to CRVO

Ting-Ting Li,Tong-Tong Niu and Hai-Lin Wang — 2014/12/30 15:26:06

AIM: To evaluate the efficacy of intravitreal injection with Ranibizumab combined with sub-Tenon injection with Triamcinolone acetonide(TA)for macular edema(ME)due to central retinal venous occlusions(CRVO).

METHODS:Forty-six patients(46 eyes)were diagnosed ischemic CRVO with significant macular edema by fundus fluorescence-angiography(FFA)and optical coherence tomography(OCT). All the patients had panretinal photocoagulation(PRP), a week after the four times therapies. Twenty-three patients(23 eyes)in group A were randomly chosen to receive intravitreal injection with ranibizumab(IVR), another 23 patients(23 eyes)in group B to treat with both IVR and sub-Tenon injection with TA(PSTT). There was no significant difference on macular edema and best corrected visual activity(BCVA)between the two groups. The changes in BCVA and central macular thickness(CMT)before and 1wk; 1, 3, 6mo after treatments were analyzed.

RESULTS: One week after the treatment: the BCVA increased while the CMT decreased compared with that of pretreatment in groups A and B(P<0.05). BCVA and CMT changes between two groups were statistically significant differences(P<0.05). One month and three months after the treatment: the BCVA increased while the CMT decreased compared with that of pretreatment in group A and B(P<0.05), the difference was significant between two groups(P<0.05). Six month after the treatment: the BCVA increased while the CMT decreased compared with that of pretreatment in groups A and B. Compare BCVA difference between the groups was statistically significant change(P<0.05), CMT difference was not statistically significant(P>0.05).

CONCLUSION: Not only IVR can decrease ME caused by CRVO and increase the BCVA, but also IVR combined with PSTT can. But combined therapies can be more rapidly and have more positive effect on decreasing the ME and protecting the visual function.

Clinical effect of Danshen injection iontophoresis combined with Lumbrokinase in early retinal vein occlusion patients

Xi-Gang Zhang,Ping Wu,Ying Tong and Yin-Lan Li — 2014/12/30 15:26:06

AIM:To explore the effect of Danshen injection iontophoresis combined with lumbrukinase on early patients with retinal vein occlusion(RVO), and observe the prognosis to provide objective basis for clinical

METHODS: Eighty-two patients(117 eyes)with early RVO were randomly selected in our hospital from January, 2011 to April, 2014, 41 cases(59 eyes)of control group treated with Lumbrokinase. Forty-one cases(58 eyes)of the observation group, treated with Danshen injection iontophoresis combined with lumbrokinase. The main indexes were the treatment effect, visual acuity and retinal circulation time.

RESULTS: The total effective rate of the observation group was 85.4%(35/41), more than that of control group 68.3%(28/41), the difference was statistically significant(P<0.05).The invalid rate of the observation group was 14.6%(6/41), lower than that of the control group 31.7%(13/41), the difference was statistically significant(P<0.05). The vision of the observation group 4.8～5.0 was 53.7%(22/41), more than that of control group 41.5%(17/41), the difference was statistically significant(P<0.05). The restore vision of the observation group 4.3～4.7 was 31.7%(13/41), lower than that of the control group 41.5%(17/41), the difference was statistically significant(P<0.05). After treatment, retinal circulation time of two groups were lower than before treatment, the difference was statistically significant(P<0.05). After treatment of retinal vein circulation time of the observation group was 8.15±1.30s, 9.70±1.28s lower than that of the control group, the difference was statistically significant(P<0.05).

CONCLUSION: There is better effective on Danshen injection iontophoresis combined with Lumbrokinase for early retinal vein occlusion, and can improve the patient's visual acuity, promote the rehabilitation of patients.

Assessment of choroidal thickness of central serous chorioretinopathy by optical coherence tomography with enhanced depth imaging

Hui Hang,Xiu-Ying Wang and Qing-Huai Liu — 2014/12/30 15:26:06

AIM: To evaluate the meaning of using optical coherence tomography with enhanced depth imaging(OCT-EDI)to measure choroidal thickness of central serous retinopathy(CSC).

METHODS: With the retrospective case control study, 65 patients(65 eyes)with CSC and 50 healthy controls(50 eyes)with age, gender and diopter-matched were recruited in this study. OCT-EDI were used to measure the subfoveal choroidal thickness(SFCT)in CSC eyes, the fellow eyes and also the control eyes. Of which 40 of the 65 CSC patients self-cured, 14 of them were treated with photodynamic therapy(PDT), the left 11 accepted the laser photocoagulation(LP). SFCT were measured 3mo after that. Compared with the previous data, the statistical analysis was carried out.

RESULTS: The SFCT value of 65 CSC eyes, 65 fellow eyes and 50 control eyes were 436.23±89.50, 389.45±101.03 and 329.36±95.87μm, respectively. The SFCT of suffer and fellow eyes increased significantly compared to the control eyes(P=0.008 and 0.013, respectively). There was also significant difference in SFCT between the CSC eyes and the fellow eyes(P=0.021). The SFCT were significantly decreased after PDT(P=0.032), but with no significant changes after LP or self-cured(P=0.057 and 0.076, respectively).

CONCLUSION: OCT-EDI is a useful method to assess the choroidal topographic changes of CSC. The SFCT are significantly increased in the CSC eyes compared with that in the fellow eyes and the control eyes.

Relationship between carotid artery stenosis and ischemic ocular diseases

Qian Chen and Hong-Chao Zhao — 2014/12/30 15:26:06

AIM: To investigate the relationship between carotid artery stenosis and ischemic ocular diseases.

METHODS: The clinical data of 30 cases(37 eyes)of patients with ischemic eye diseases were collected from November 2010 to May 2014, and they were accepted the fundus fluorescein angiography(FFA), transcranial Doppler(TCD)ultrasonic blood vessels of the eye, neck vascular color Doppler flow imaging(CDFI), the neck CT angiography(CTA)and carotid artery digital subtraction angiography(DSA)examination, and then the ischemic eye disease patients with ocular symptoms were analyzed. The peak systolic velocity(PSV)and resistance index(RI)of ophthalmic artery and central retinal artery were compared. Correlation between the internal carotid artery intima-media thickness(IMT)and ophthalmic artery, central retinal artery PSV and RI correlation risk; ipsilateral internal carotid artery plaque and ophthalmic artery PSV and RI; PSV and RI associated ipsilateral internal carotid artery plaque and central retinal artery were analyzed.

RESULTS: Eye symptoms: a black dim, reduced vision, the eyes flash, and around the eye pain were 75.7%, 83.8%, 51.4% and 32.4%; The eye signs: the dilatation of retinal vein, retinal hemorrhage, arterial stenosis and cotton spot and the contralateral side were regarded as main signs. Ophthalmic artery PSV and RI value of the differences were statistically significant(P<0.05); The contralateral side of the central retinal artery PSV and RI value of the differences were statistically significant(P<0.05); The ipsilateral internal carotid artery IMT and ophthalmic artery, central retinal artery PSV and RI were not correlated(P>0.05); The ipsilateral internal carotid artery plaque and ophthalmic artery PSV had no correlation with RI values(P>0.05); PSV and RI and the ipsilateral internal carotid artery plaque and central retinal artery had no correlation(P>0.05).

CONCLUSION: The incidence of ischemic eye diseases and internal carotid artery stenosis is associated with very close, the clinical can regard the degree of internal carotid artery stenosis as an important basis for diagnosis and treatment of eye diseases.

Clinical use of AO three-dimensionally preformed titanium mesh plates for orbital fractures

Ming Chen,Guang-Rui Chai,Meng Wang,Lu Liu,He-Ming Li and He Zhang — 2014/12/30 15:26:07

AIM:To evaluate the accuracy and practicability of three-dimensionally preformed Arbeitsgemeinschaft Osteosynthese AO titanium mesh plates for orbital fractures.

METHODS:Forty-seven patients with isolated blow-out orbital fractures were included in this study. Fracture locations were as follows: floor/medial wall(n=26, 55%), medial wall(n=12, 26%), and floor(n=9, 19%). The floor fractures were exposed by a standard transconjunctival approach, whereas a combined transcaruncular transconjunctival approach was used in patients with medial wall fractures with temporary dissection of inferior oblique muscle. A three-dimensionally preformed AO titanium mesh plate was selected according to the size of the defect previously measured on the preoperative computed tomographic scan examination and fixed at the inferior orbital rim with 2 screws. The accuracy of plate positioning of the reconstructed orbit was assessed on the postoperative computed tomography(CT)scan. The practicability of clinical use of AO three-dimensionally preformed titanium mesh plates was assessed on the preoperative and postoperative clinical data.

RESULTS: Postoperative orbital CT scan showed an anatomic three-dimensional placement of the orbital mesh plates in all of the patients. All patients had a successful treatment outcome without clinical complications. 40 patients(87%)had a successful enophthalmos correction. 25 patients(86%)had a successful recovery from diplopia.

CONCLUSION: Three-dimensionally preformed AO titanium mesh plates for orbital fracture reconstruction results in an accurate anatomic restoration of the bony orbital contour with a high rate of success to correctenophthalmos and diplopia.

Application effect of recombinant human epidermal growth factor derivative Eye drops in treatment of dry eye

Paerzhati·Tuerdi and Yan-Chun Wang — 2014/12/30 15:26:07

AIM: To investigate the application effect of recombinant human epidermal growth factor derivative eye drops(Jinyinshu)in treatment of dry eye.

METHODS:Sixty cases(87 eyes)of dry eye patients were randomly divided into control group and observation group, 42 eyes and 45 eyes respectively. The control group received Chondroitin sulfate eye drops treatment, and the observation group were used for treatment of Jinyinshu. The changes of clinical efficacy, correlation index(symptom score, BUT, S I t, FL)before and after treatment, quality of life after treatment and the incidence of adverse reactions were compared.

RESULTS: In the control group, the total clinical effective rate was 71%, which was significantly lower than that in the observation group(91%), the difference was statistically significant(P<0.05); There were statistical differences of symptom scores, BUT, SⅠt and FL level of the two groups before and after treatment(P<0.05), and there were statistical differences of the above indexes after treatment between the two groups(P<0.05); The quality of life score was 142.16±10.32 of the observation group after treatment, which was significantly higher than that in the control group after treatment(115.24±7.34), the difference was statistically significant(P<0.05); The incidence of adverse reaction of the control group was 13%, 10% in the observation group, and there were no statistical differences(P>0.05).

CONCLUSION: Jinyinshu is significantly effective in the treatment of dry eye, and its clinical efficacy is better than chondroitin sulfate.

Comparative analysis of emmetropia biology measurement in Han and Kazak college students

Meng Liu,Yan Wang and Yun-Xian Gao — 2014/12/30 15:26:07

AIM:To observe the differences of central cornea thickness, anterior chamber depth, corneal anterior curvature and corneal posterior curvature between the Kazak and the Han nationality college emmetropia students, and analyze the relationship of corneal thickness and corneal curvature.

METHODS: More than 500 students in grade one in Xinjiang Medical University for screening, selected 55 emmetropia eyes in Han nationality students and 51 in Kazak students. Sirius corneal topography was applied to the measurement.

RESULTS: Kazak and the Han nationality college emmetropia students' central cornea thickness(Kazak:0.52±0.03mm, Han:0.54±0.03mm), anterior chamber depth(Kazak: 2.97±0.31mm, Han: 3.14±0.25mm)had significant difference(P<0.05). Corneal anterior curvature and corneal posterior curvature were no significant difference(P>0.05). Han had no significant relationship in corneal thickness and corneal anterior curvature(r<0), or in corneal posterior curvature(r<0.1). Kazak had no significant relationship in corneal thickness and corneal anterior curvature(r<0), or in corneal posterior curvature(r<0.1).

CONCLUSION: There are significant differences between the Kazak and the Han nationality college emmetropia students in cornea thickness, anterior chamber depth. There is no significant relationship between corneal thickness and corneal curvature(K1, K2)in Kazak and the Han nationality college emmetropia students.

Clinical analysis of asthenopia caused by wearing inappropriate glasses in college students

Li Wang,Yang Yang,Wen-Lan Liu,Jin Yan and Peng Li — 2014/12/30 15:26:07

AIM: To proposed control measures by exploring visual fatigue caused by college students wearing inappropriate glasses.

METHODS: A total of 124 cases of asthenopia patients underwent optometry students audition, checked the original spectacles; TOPCON-CL100 computer center was used to checked the original mirror glasses(glasses, the distance between the optical center); with near vision as the standard examination table nearly with vergence and regulation near point, and checked the visual function.

RESULTS: All 124 cases(248 eyes)had refractive errors, 77% were spherical mirror and 69% column mirror with error ≥±0.50D, and the pupil center distance from the lens had significant difference(U=5.27, P<0.01), 87% of the lens away from the heart for more than 2mm, 62% of mainly due to visual fatigue had glasses inappropriate.

CONCLUSION: Students wearing inappropriate spectacle asthenopia is caused by one of the main scientific wearing glasses can effectively control asthenopia.

Variation of contrast sensitivity after femtosecond laser in situ keratomileusis in changes environments

Jing Zhou and Xiao-Jin Huangfu — 2014/12/30 15:26:07

AIM: To evaluate the difference of contrast sensitivity(CS)in photopic and scotopic environments in eyes with myopia and myopic astigmatism operated with femtosecond laser in situ keratomileusis(femto-LASIK)and laser in situ keratomileusis(LASIK).

METHODS: In a prospective study 160 myopia and myopic astigmatism patients' eyes were involved, which accepted femto-LASIK or LASIK in our hospital from January 2010 to February 2012. The myopia degree was -1.50～-10.00D, the astigmatism degree ≤-6.0D. Eighty eyes were treated with femto-LASIK in group A, and 80 eyes were treated with LASIK in group B, All patients in the treatment group completed the final 6mo of follow-up. The uncorrected visual acuity(UCVA)and the best spectacle-corrected visual acuity(BSCVA), objective and manifest refractions, results of slit-lamp examination, the side effects, intraocular pressure, corneal topography, CS in photopic and scotopic environments were noted.

RESULTS: All of operations on 160 cases were successful without severe complication after 6 mo follow-up. CS of femto-LASIK group(group A)at each spatial frequency environment were higher than that of LASIK group(group B). In group A, after 1mo the photopic CS, after 3mo of scotopic CS recovered to the preoperative level, 6mo after surgery improved than before the operation. In group B, after 3mo photopic CS to the preoperative level, scotopic CS at 6mo after operation was still not recovered to the preoperative level.

CONCLUSION:Femto-LASIK for correction of myopia and myopic astigmatism, in improving the postoperative contrast sensitivity under shade environment has more advantages than LASIK.

Clinical effect of partial reduction orthokeratology and spectacles on high myopia adolescents

Ming Luo,Sheng-Sheng Ma and Hong-Yang Li — 2014/12/30 15:26:07

AIM: To observe the effect of combining partial reduction orthokeratology(Ortho-K)and spectacles on slowing myopic progressionin high myopic adolescent.

METHODS: Sixty-nine eyes of 36 high myopic adolescent(aged 9～15 years)with spherical equivalent refraction ≥-6.00 diopters(D)(spherical component ≥-5.50D)were fitted with custom-made four-zone/five-curve Ortho-K lenses. The target of reduction was to achieve -5.00D for both eyes. The residual refractive errors after at least one month of Ortho-K wear were corrected with single-vision spectacles for clear vision in the daytime. The unaided visual acuity(UVA), refractive error(RE), axial length(AL), and ocular health were assessed before the Ortho-K lens wear, and followed up for 2a after Ortho-K.

RESULTS:(1)Changes in UVA: The mean UVA was 0.09±0.05 at baseline before Ortho-K; the mean UVA was 0.27±0.14, 0.54±0.18, 0.78±0.24, and 0.81±0.19, respectively after Ortho-K wear for l night, 1wk, 1, and 3mo. The differences of UVA were significant with baseline(P<0.05), and became stable 1mo after the treatment.(2)Changes in RE: The mean RE was -6.82±0.71D at baseline before Ortho-K and -6.86±0.77D after Ortho-K wear for 1a(P>0.05 compared to baseline). The mean RE was -7.11±0.81D after Ortho-K wear for 2a, and the amount of myopia increased -0.29±0.37D compared to baseline(P<0.05).(3)Changes in AL: The mean AL was 26.18±0.57mm at baseline before Ortho-K, and it was not significantly different(P>0.05)from the AL after Ortho-K wear for 6mo(26.19±0.54mm)and for 1a(26.21±0.47mm). The AL was 26.37±0.59mm after Ortho-K wear for 2a, and the mean increase was 0.19±0.28mm compared to baseline(P<0.05).(4)Grade 1 corneal staining was observed in some subjects at each visit. However, the staining was improved after lens cleaning, discontinuing lens wear, or applying artificial tears. No other adverse events were reported in all subjects during the 2a study.

CONCLUSION:Combining partial reduction Ortho-K and spectacles completely slowed myopic progression in high myopic adolescent after receiving the treatment for 1a, and partially reduced myopia progression after 2a of treatment. No severe ocular complications were found throughout the treatment. The combination treatment appeared to be effective and safe, but its long-term effect needs to be further assessed.

Correlation research of retinal foveal thickness and children amblyopia

Jie Liu — 2014/12/30 15:26:07

AIM:To investigate correlation of children amblyopia and retinal foveal thickness and retinal nerve fiber layer(RNFL)thickness.

METHODS: Fifty-six cases of children amblyopia with vision could not be uncorrected to 0.8 in our hospital were retrospectively analyzed. 5g/L atropine was used to mydriasis, computer associates retinoscopy was used to fundus examination organization, and the third-generation optical coherence tomography(3D-OCT)was used to detect retinal foveal thickness and RNFL thickness. Fifty-six cases of normal children were selected as control group. Correlation of retinal foveal thickness and children amblyopia was analyzed.

RESULTS: The nerve fiber layer thickness of amblyopic eye was 116.92±9.54μm, that of health eye was 110.42±7.64μm, the difference was statistically significant(P<0.05). Macular center foveal thickness of amblyopic eye was 134.95±14.95μm, that of health eye was 136.62±13.86μm, the difference was not statistically significant(P>0.05). The correlation of optic nerve fiber layer thickness of healthy children and axial showed a significant negative correlation(r=-0.35, P<0.05), while the correlation of children with amblyopia was not significantly correlated(r=0.12, P>0.05).

CONCLUSION: For children with amblyopia, the difference of ametropic foveal thickness and normal eye is not significant. But RNFL thickness is significantly higher, and is correlated with axial disappears, suggesting that amblyopia can significant effect nerve fiber layer structure.

Clinical study on the treatment of cataract after peripheral iridectomy by phacoemulsification combined with goniosynechialysis

Zheng-Jun Hu,Hong-Mei Hu and Ting Li — 2015/11/27 10:32:24

AIM:To investigate the clinical efficacy of phacoemulsification combined with goniosynechialysis and only phacoemulsification on coexisted cataract after peripheral iridectomy.

METHODS:A total of 69 patients(85 eyes)with coexisted cataract after peripheral iridectomy were divided into two groups by drawing lots method. The patients in observation group(38 cases,45 eyes)were treated with phacoemulsification and IOL implantation, combined with goniosynechialysis, and the control group(31 cases,40 eyes)with phacoemulsification and IOL implantation. The follow-up time lasted 12mo. The intraocular pressure(IOP), best corrected visual acuity(BCVA), central anterior chamber depth and the change of anterior chamber angle of two groups before and after operations were compared and analyzed.

RESULTS:After 1wk, the postoperative mean IOP of observation group was 10.36±2.85mmHg,that of control group was 12.09±3.75mmHg, decreased significantly compared with preoperative(P<0.01). There was significant difference of that between two groups(t=2.41,P<0.05). The postoperative mean visual acuity of observation group and control group were 0.52±0.22 and 0.55±0.20 respectively,increased significantly compared with preoperative(P<0.01),and no significant difference between two groups(t=0.65,P>0.05). The postoperative mean central chamber thickness of observation group and control group were 3.57±0.32mm and 3.44±0.35mm respectively,increased significantly compared with preoperative(P<0.01), and no significant difference between two groups(t=1.79,P>0.05). Two months after the operation, there were 42eyes(93.33%)with adhesion range of anterior chamber angle was <90°in observation group, more than that in control group 31eyes(77.50%), the difference was significant(P<0.05).

CONCLUTION:The treatment method of phacoemulsification combined with goniosynechialysis for coexisted cataract after peripheral iridectomy can effectively open the adhesions of chamber angular, control the IOP and improve visul acuity and is safe.

Clinical observation of bromfenac sodium 0.1% eye drops on cataract surgery

Jie Chen and Gui-Qin Wang — 2015/11/27 10:32:24

AIM:To investigate the effects of combined with bromfena sodium 0.1% eye drops and steroids eye drops on cataract surgery, then further study its safety and effectiveness on phaeoemulsfieation.

METHODS:A prospective, randomized, controlled study including 100 patients(120 eyes), enrolled for cataract surgery. The patients were randomized to topical treatment with Tobramycin and Dexamethasone combined with bromfenac sodium 0.1%(trial group, 60 eyes)or Tobramycin and Dexamethasone(control group, 60 eyes). Scleral tunnel incision phacoemulsification cataract extraction and intraocular lens implantation was used. The sign, symptom, intraocular pressure(IOP)and optical coherence tomography(OCT)were determined postoperative 1, 7, 14d.

RESULTS:There were significant differences in symptoms and signs between two groups at postoperative 7 and 14d(P<0.05)and no difference at postoperative 1d(P>0.05). The value of the trial group was lower than that of the control group. Preoperative IOP was 14.657±2.605mmHg in trial group and 14.415±2.761mmHg in control group, the difference was not statistically significant(P>0.05). IOP in trial group were lower than that of control group at postoperative 1, 7, 14d, the difference was statistically significant(P<0.05). In the control group, the incidence of macular edema at postoperative 1, 7, 14d were 1.7%, 1.7% and 3.3%, respectively, which was significantly higher than those of trial group(0, 0, 1.7%). The difference was statistically significant(P<0.05).

CONCLUSION:Application of 0.1% bromfenac sodium eye drop and Tobramycin and Dexamethasone eye drops for cataract extraction and intraocular lens implantation in the treatment of postoperative inflammation has better treatment effect. It is safe and effective, and less prone to ocular hypertension and other serious complications; At the same time it can significantly reduce the incidence of postoperative macular edema, prevention of macular edema after cataract surgery, with security and reliability, worthy of clinical application.

Influence of ocular perfusion pressure fluctuation on glaucoma

Min-Zi Ren,Xu Yang and Jian-Min Deng — 2015/11/27 10:32:24

AIM:To investigate the influence of ocular perfusion pressure fluctuation on glaucoma.

METHODS:Forty patients with primary open angle glaucoma from January 2013 to June 2015 in our hospital were used as observation group and 40 families were used as control group. Circadian fluctuation of intraocular pressure, blood pressure and ocular perfusion pressure in 24h were determined to obtain systolic ocular perfusion pressure(SOPP), diastolic ocular perfusion pressure(DOPP)and mean ocular perfusion pressure(MOPP). Pearson linear correlation was used to analyze the correlation of circadian MOPP fluctuation with cup-disc ratio, mean defect(MD)and the picture standard deviation(PSD).

RESULTS:The fluctuation of MOPP, SOPP and DOPP of observation group were significantly higher than those of control group(P<0.05). MOPP fluctuation was negatively correlated with MD(r=-0.389, 95%CI:-0.612～-0.082; P=0.011), was positively correlated with PSD(r=0.512, 95%CI:0.139 ～0.782; P=0.008); no correlation was found between it and the vertical cup-disc ratio(r=0.115, 95%CI:0.056～0.369; P=0.355).

CONCLUSION:Ocular perfusion pressure fluctuations in patients with primary open angle glaucoma may reflect the severity of the disease and may make the situation aggravating. Therefore through perfusion pressure monitor in 24h may help us understand the ocular blood flow and the development of primary open-angle glaucoma.

Effectiveness evaluation of laser peripheral iridoplasty combined with iridectomy in preclinical primary angle-closure glaucoma by optical coherence tomography

Jun-Jie Bian,Wei-Jia Dai and Da-Chuan Liu — 2015/11/27 10:32:24

AIM:To evaluate the effectiveness of laser peripheral iridoplasty combined with iridectomy in preclinical primary angle-closure glaucoma(PACG)by optical coherence tomography(OCT).

METHODS:Fifty-eight eyes of 31 patients with preclinical PACG were received laser peripheral iridoplasty combined with iridectomy. Images of anterior chamber angle in three different time(before treatment,1wk after treatment and 2mo after treatment)were collected by OCT. Anterior chamber depth(ACD), lens thickness(LT), chamber crowding rate(CCR)and lens position(LP)were measured by A-ultrasound.

RESULTS:Intraocular pressure(IOP), OA, ACD, CCR, LP were statistically significant differences in three different time(IOP:F=16.845, OA:F=30.498, ACD:F=38.705, CCR:F=86.671, LP:F=46.195; P<0.05), but not LT(F=0.756, P=0.471). However, there were statistically significant differences only in CCR but not in OA, ACD and LP(P=0.067, 0.359, 0.406)between 1wk after treatment group and 2mo after treatment group(P<0.05).

CONCLUSION:OCT can be used to monitor and quantify anterior chamber of PACG. CCR can be more sensitive to reflect structural changes of anterior chamber. LPI is an effective treatment for early PACG.

Drug treatment for high IOP at early stage after vitrectomy for macular hole caused by high myopia

Yu-Juan Zhou,Jie Zhang,Xian-Yong Sun,Peng-Lin Yu and Hua-Dong Lou — 2015/11/27 10:32:24

AIM:To study the effect of only latanoprost eye drops or combined with other medicines on lowering intraocular pressure(IOP)after early pars plana vitrectomy(PPV)for macular hole without retinal detachment caused by high myopia.

METHODS:One hundred and eighty-eight cases(205 eyes)suffered from macular hole caused by high myopia without reinal detachment who underwent PPV combined with C₃F₈ tamponade were studied retrospectively and measured the IOP at 1wk after surgeries. The patients whose IOP was 22～29mmHg were named as group A. Then they were divided randomly into two subgroups, group A1(treated by carteolol eye drops)and subgroup A2(treated by latanoprost eye drops). The patients whose IOP was 30～39mmHg were named as group B. Then they were divided randomly into two subgroups, group B1(treated by both carteolol and brimonidine tartrate eye drops)and subgroup B2(treated by both latanoprost and carteolol eye drops). The patients whose IOP was ≥40mmHg were named as group C and they were all treated by rapid intravenous injection of 20% Mannitol. Meanwhile, they were divided randomly into two subgroups, group C1(treated by carteolol,brimonidine tartrate and brinzolamide eye drops )and subgroup C2(treated by carteolol,brimonidine tartrate and latanoprost eye drops). Continuous observation lasted 3d. If IOP dropped to below 21 mmHg, we considered it valid. And then,compare the effectiveness, IOP reduction and the average effective duration.

RESULTS:Eighty-nine eyes met the criteria of high IOP and IOP of 70 eyes(78.6%)increased within 3d after operations. There were 31 eyes in group A including 14 eyes in group A1 and 17 eyes in group A2.The number of effective cases of the two groups was 5(35.7%)and 13(76.5%)respectively, the difference was statistically significant(χ²=5.24,P=0.03).The IOP reduction of the two groups were 4.21±1.22mmHg(24%), 8.76±3.03mmHg(29.6%), respectively, and the difference was statistically significant(t=5.73,P<0.05).The average effective duration of the two group were 2.80±0.45, 2.08±0.49d,respectively, and the difference was statistically significant(t=2.85,P=0.012).There were 32 eyes in group B including 17 eyes in group B1 and 15 eyes in group B2.The number of effective cases of the two groups was 9(52.9%)and 11(73.3%),respectively, and the difference was not statistically significant(χ²=1.40,P=0.30 ).The IOP reduction of the two groups was 10.59±2.72mmHg(36.9%), 16.53±2.67mmHg(43.8%)respectively, and the difference was statistically significant(t=6.27,P<0.05).The average effctive duration of the two group was 2.56±0.53, 1.63±0.67d respectively, and the difference was statistically significant(t=3.34,P=0.004). There were 26 eyes in group C including 14 eyes in group C1 and 12 eyes in group C2.The number of effective cases of the two groups was 9(64.3%)and 8(66.7%)respectively, and the difference was not statistically significant(P=0.70).The IOP reduction of the two groups was 22.00mmHg(51.0%),31.45mmHg(59.3%)respectively, and the difference was statistically significant(t=18.35,P<0.05).The average effctive duration of the two group was 2.63±0.52, 1.80±0.63d respectively, and the difference was statistically significant(t=2.97,P=0.009).

CONCLUSION:PPV treating macular hole caused by high myopia is associated with highe rates of IOP increasing, which generally occurs within 3d after the operation. Alone or in combination, latanoprost eye drops can effectively reduce IOP.