Abstract:AIM: To evaluate prospectively immediate intraocular pressure (IOP) changes after the intravitreal injection of ranibizumab, 2 and 4mg triamcinolone acetonide. METHODS: Patients who underwent intravitreal injection of 0.1mL (4mg) triamcinolone acetonide (TA, Group T4), 0.05mL (2mg) TA (Group T2) and 0.05mL (0.5mg) ranibizumab (Group R) comprised the study population. Overall, 229 eyes of 205 patients were injected. Fifty-four eyes (23.6%) were in Group T4, 69 eyes (30.1%) in Group T2 and 106 eyes (46.3%) in Group R. If IOP was less than 26mmHg immediately after the injection no further measurement was performed. If IOP was ≥26mmHg, IOP was remeasured till the reading was below 26mmHg at 5, 15 and 30 minutes. RESULTS: Immediately after the injection, the IOP of 28 eyes (51.9%) in Group T4, 22 eyes (31.9%) in Group T2 and 51 eyes (48.1%) in Group R were over 25mmHg. At 30 minutes, IOP of one eye (1.9%) in group T4, two eyes (2.9%) in group T2 and two eyes (1.9 %) in Group R were over 25mmHg. Immediate post-injection IOP was significantly higher in Group T4 and Group R when compared to Group T2(P<0.001 and P<0.001,respectively). IOP was significantly higher in eyes without vitreous reflux when compared to those with vitreous reflux in all groups (P<0.001). CONCLUSION: IOP may remarkably increase immediately after the intravitreal injection of 2 or 4mg triamcinolone acetonide, and 0.5mg ranibizumab. Absence of vitreous reflux is the most important predicting factor for immediate IOP rise after the injection.

Abstract:AIM: To describe the use of a combination of 2 preserved homologous corneoscleral patches for the emergency repair of a perforated cornea with extruded lens and exposed vitreous in a lady who had undergone tectonic penetrating keratoplasty. METHODS: A 49-year-old lady had presented with an extensive fungal corneal ulcer which was complicated by a descemetocele and microperforation. She had undergone a therapeutic cum tectonic penetrating keratoplasty. However, she developed a spontaneous large corneal perforation with expulsion of her crystalline lens with exposed vitreous. In view of the urgent need to cover the defect, a double graft combining 2 preserved full-thickness corneoscleral patches were used as donor cornea was not immediately available. RESULTS: The surgery was successful in not only restoring the integrity of the globe but also saved her of evisceration. Over the next few weeks, the graft began to heal and there was good re-epithelisation except over the scleral part of the patch. There were no signs of infection and she was able to maintain a vision of hand movement. She was put on a bandage contact lens in view of the epithelial defect. She has also been advised about an elective repeat penetrating keratoplasty. CONCLUSION: In the absence of a corneal button for grafting, one or more preserved homologous corneo-scleral patch(es) may be used temporarily for covering large corneal defects.

Abstract:AIM:To report maternal and fetal adverse outcomes,in spite of appropriate treatment and regular follow up,in diabetic pregnant women with proliferative diabetic retinopathy.METHODS:Case series of four young pregnant diabetics aged between 20 and 25 years with type 1 diabetes mellitus and proliferative diabetic retinopathy.RESULTS:The maternal adverse outcomes were abortion in one patient,pre-eclampsia and preterm delivery in one patient,and renal failure requiring dialysis in one patient.The fetal adverse outcomes were neonatal death in one case and premature baby in another case.CONCLUSION:These cases highlight the fact that diabetic pregnant women should be closely followed up by the obstetricians and physicians when they have proliferative retinopathy.The proliferative diabetic retinopathy should be considered as a part of the assessment when counseling a diabetic woman in antenatal check up and also in the follow up visits during pregnancy.

Abstract:AIM:To report a case of pseudoxanthoma elasticum(PXE) in a 48-year-old woman that presented with bilateral blurry vision.METHODS:A case report.RESULTS:A 48-year-old woman presented with bilateral blurry vision and right eye metamorphopsia.The patient had a history of angioid streaks in the left eye ten years ago for which she had received laser surgery and had poor residual vision.Visual acuity was 20/60 in the right eye and count fingers at 6 feet in the left.Fundus examination showed subretinal hemorrhage and macular thickening on the right and a disciform macular scar with focal atrophic pigment epithelial lesions on the left.Both eyes had angioid streaks and peau d’orange pigmentary pattern of the retina.External examination showed several,yellow skin papules and plaques on the lateral and posterior neck,as well as prominent mental creases.Pathologic examination of skin biopsy confirmed the diagnosis of PXE,showing calcium deposition and fragmented,clumped elastic fibers in the deep reticular dermis.She responded well to intravitreal bevacizumab injections and visual acuity improved to 20/25 OD.Preventative care was emphasized and the patient was referred to cardiology,gastroenterology and human genetics for counseling.CONCLUSION:PXE is a multisystem disorder affecting the dermatologic,ocular,and cardiovascular systems.Ophthalmic findings of angioid streaks and choroidal neovascularization in the presence of stereotypical skin changes and prominent mental creases should prompt evaluation for PXE.

Abstract:AIM:To report a case of branch retinal artery obstruction(BRAO) complicated after anterior ischemic optic neuropathy(AION).METHODS:A 42-year-old woman who complained of visual disturbance was performed ophthalmological examinations such as fundus photography,fluorescent angiography(FAG) and visual field test.RESULTS:At first visit,disc swelling was noted and arterial circulation was intact,however,1 week after onset,the inferior branch retinal artery began to shrink and the flame hemorrhage intensified.Sixteen months later,the optic disc evidenced an atrophic change;additionally,a ghost vessel in the inferior branch retinal artery was found.CONCLUSION:We report a case of complications of BRAO arising after AION which caused the mechanical compression on the arterial circulation.

Abstract:AIM:To investigate the expression of IL-17 in herpes stromal keratitis(HSK).METHODS:HSK models were established with inoculating herpes simplex virus type 1(HSV-1) KOS strain at 1.0×106 plague forming unit to corneas of 35 BALB/c mice.The another 5 normal BALB/c mice served as the control group.Immunohistochemistry was performed using polyclonal antibodies to detect the expression of IL-17 in corneal sections.By flow cytometry,the expression of IL-17 surface protein on CD4+ T cells in murine peripheral blood was evaluated on the 1-3 days,7,10,14,21,28 days after corneal inoculation with HSV-1.Corneal changes were observed under slit-lamp microscope to examine the histopathological changes of corneas.RESULTS:The expression of IL-17 was visible on HSK mice corneal fibroblasts,epicytes and inflammatory cells.Absent staining for IL-17 was seen in the normal sample and negative control sample.The expression of IL-17 in the lymphocytes were harvested from the peripheral blood by flow cytometric analysis.On HSK mice inflammatory cells in stroma significantly increased and the degree of corneal opacity became significantly severe.The intensity of IL-17 expression was significantly positively correlated with the inflammation of HSK(r=0.609,P<0.01).CONCLUSION:IL-17 is overexpressed in corneal and peripheral blood of HSK mice,indicating that IL-17 may contribute to the inflammatory responses of the eye in HSK.

Abstract:AIM:To research retina and Bruch’s membrane of apolipoprotein E-deficient(ApoE-/-) mice effected by dyslipidemia.METHODS:Twenty-four 2-month-old ApoE-/-mice and 24 C57BL mice were randomly divided into group of normal chow and group of high fat chow,12 mice each group.Animals were killed four months later and plasma total cholesterol(TG) levels were determined.Light microscopy and transmission electron microscopy were used to observe retina and Bruch membrane.RESULTS:The plasma TG of the group of 6-month-old ApoE-/-mice high fat chow(HF) was significantly higher than that of control group(P<0.05).The thickness of outer nuclear layer(ONL)and retinal pigment epithelium(RPE) was statistically lower than that of control group(P<0.05),while the thickness of Bruch membrane was significantly higher than the control group(P<0.05).CONCLUSION:The pathology change of photoreceptor,RPE and Bruch membrane was similar to the change of early age-related macular degeneration(AMD).

Abstract:AIM:In present study,we evaluate the neuroprotective effect of Exenatide,and further investigate the underlying mechanism of Exenatide-induced retinal ganglion cells(RGCs) protection.METHODS:In vitro,expression of glucagon-like peptide-1 receptor(GLP-1R) in RGCs cells was detected by immunofluorescence and apoptotic models was built by using high-glucose as cell apoptotic inducer.Different concentrations of Exenatide as the intervention was added to medium and cell survival rate was evaluated by CCK-8 test.RESULTS:Immunofluorescence results showed that RGCs expressed GLP-1R.CCK-8 test results indicated that 0.5-1μg/L concentration of Exenatide could promote the survival of RGCs,and 0.5μg/L concentration of Exenatide which was the low concentration had favourable effect to protect RGCs(P<0.05).CONCLUSION:Exenatide protects RGCs from survival inhibition induced by high-glucose.The protection may depend on GLP-1R induced cell protective mechanism.

Abstract:AIM:To evaluate chondroitin sulfate on the glycerol cryopreservation of corneal endothelial cells(CEC).METHODS:Forty Wistar rats corneal pieces were divided into the experimental group:glycerol cryopreservation medium containing chondroitin sulfate(CS);and the control group:mere glycerol cryopre-servation medium.The two groups were saved at-20℃ for 2 months.All pieces were examined with trypan blue combined with alizarin red staining(viability staining) and electron-microscope examination for CEC.30 SD rats were taken to establish Wistar-SD rat model of allogenic penetrating keratoplasty.Slit lamp microscope detected the occurrence of corneal rejection,TNF-α and IFN-γ expression was examined by immunohistochemistry to test the effect of preservation.RESULTS:The staining results,electron-microscope examination and TNF-α,IFN-γ expression showed,the difference was significant in these two groups(P<0.05),the results of the experimental group was better than the control group after the saving and the corneal transplantation(P<0.05).The electron-microscope examination showed indivdual vacuoles in CEC cytoplasm,slight swelling of mitochondrial and endoplasmic reticulum in experimental group,obvious swelling of CEC mitochondrial and endoplasmic reticulum in control group.CONCLUSION:Glycerol cryopreservation can preserve the viability of CEC.Chondroitin sulfate can obviously improve the effect of preservation.

Abstract:AIM:To investigate the effects of huwangmingmusan on retinal endothelial cells of Wistar rats infected diabetic retinopathy with streptozotocin(STZ).METHODS:The Wistar rats were divided into three groups:model,Chinese medicine,and western medicine.And also,a healthy group was prepared for comparison.After successive administration for 45 days,the rats eyes were used to prepare retinal vascular digest preparations and stained with PAS routinely.The rats endothelial cells were observed.RESULTS:No proliferation and apoptosis of rat retinal vascular endothelial cells was in normal group.There were no significant differences between Chinese medicine group and the normal group in the number of endothelial cells and apoptosis(P>0.05);but there were significant differences comparing with model group and western medicine group(P<0.01,P<0.05).CONCLUSION:Huwangmingmusan can inhibit the proliferation and apoptosis of retinal capillary endothelial cells of Wistar rats infected diabetic retinopathy with STZ and have protective effect on the endothelial cells.

Abstract:AIM:To study the inhibition of p21cip1 gene on proliferation of cultured human retinal pigment epithelial(RPE) cells by application of nano-technology.METHODS:Preparation of p21cip1 gene nano-particles was transfected into cultured human RPE cells for detection of expression of p21cip1by immunohistochemistry.Cell cycle related cell volume changes were detected by flow cytometry.RESULTS:DNA content of p21cip1 nano-particles was 3%,encapsulation efficiency was 78%.Because of the protective effects of PLGA-PVA vector p21cip1 gene in the body could maintain a longer valid period than naked plasmid,overcoming problems of the naked plasmid prone to nuclease degradation in vivo.Flow cytometry results showed RPE cells of transfected object gene had G1 phase arrest,significantly inhibited cell proliferation.Immunohistochemical detection results showed RPE cells of transfected object gene had markedly stronger expression of p21cip1.CONCLUSION:p21cip1 gene may serve as a target gene,with the emerging nano-particles of gene vector,to be used for gene therapy in inhibition of cell proliferation.

Abstract:AIM:To evaluate the cutting depth,smoothness and feasibility of corneal laminal cutting with femtosecond laser on porcin eye.METHODS:Corneal laminal cutting with femtosecond laser was performed on 10 fresh in vitro porcin eyes and 10 rehydrated glycerin preserved procin eyes.Thickness of cornea and corneal flap were measured and calculated before and after laser cutting.Meanwhile,corneal flap with same diameter was made manually.Two types of cutting surfaces were observed with scanning electron microscope.RESULTS:Thickness of flap in fresh cornea and rehydrated cornea was 394.10±12.04μm and 366.30±15.28μm respectively.Cutting surfaces with laser was more smooth than that of manually made.CONCLUSION:There is difference between actual and predetermined cutting depth with femtosecond laser in vitro porcin cornea.Cutting surfaces with laser was more smooth.There should be better prospect in keratoplasty.

Abstract:AIM:To conduct a comparative assessment of effects of AcrySof Toric intraocular lens(IOL) implantation and spherical IOL implantation combined with corneal limbus lysis in cataract surgery for the correction of corneal astigmatism.METHODS:A total of 53 patients(60 eyes)who underwent cataract surgery in cataract treatment center of our hospital from March 2008 to March 2009 were selected,all patients were complicated with regular corneal astigmatism,and their astigmatism was greater than 1D.According to the different surgical procedures,the subjects were divided into two groups.26 patients(30 eyes) were in simple phacoemulsification cataract extraction combined with AcrySof Toric IOL implantation group(including senile cataract of 24 patients(27 eyes),complicated cataract of 2 patients(3 eyes),while 27 patients(30 eyes) were in spherical IOL implantation combined with corneal lumbus lysis group(including senile cataract of 24 patients(27 eyes),complicated cataract of 3 patients(3 eyes).Before and 1st day,1st week and 3rd month after cataract surgery,two groups of subjects were measured uncorrected visual acuity,best corrected visual acuity(BCVA),computer optometry,and subjective refraction and recorded the spherical degree,cylinder degree and astigmatism axis and other data.And statistical analysis and observation of intracapsular stability of AcrySof Toric IOL were conducted.RESULTS:Followed-up for 6 months,AcrySof Toric group:uncorrected visual acuity more than 0.5 accounted for 93%,more than 0.8 accounted for 67%.Limbus lysis group:uncorrected visual acuity more than 0.5 accounted for 73%,more than 0.8 accounted for 50%.Optometry results before and 3 months after operation were compared and showed cylinder degree of small pupil optometry significantly reduced in both groups 3 months after operation,postoperative corneal astigmatism in AcrySof Toric group was lower than limbal lysis group,differences between the two groups was statistically significant(P<0.05),and stability of AcrySof Toric IOL implantation in the capsular bag was good,no more than 6 degrees of rotation was found during the follow-up of 3 months.CONCLUSION:AcrySof Toric IOL implantation can significantly improve uncorrected visual acuity and best corrected visual acuity in patients,at the same time can effectively reduce the postoperative astigmatism and improve visual quality.It has stable effect of surgery and is an effective way for treatment of cataract patients with astigmatism.

Abstract:AIM:To apply factorial design to investigate the main influence factors of corneal stroma bed thickness after laser in situ keratomileusis(LASIK) and their relevance.METHODS:Sixty eyes of 30 cases were randomly selected from patients treated with LASIK.Factorial design experiments were done with the main study factors such as preoperative intraocular pressure,degrees of refraction and thickness of postoperative corneal stroma bed.RESULTS:The difference between preoperative dioptres and the difference between preoperative dioptres and preoperative intraocular pressure were no statistically significant(P>0.05),there were statistical differences in the others.There were interaction among preoperative intraocular pressure,preoperative dioptre and thickness of postoperative corneal stroma bed(P<0.05 or P<0.01).CONCLUSION:The three factors can influence the surgical results.It will be more safe if preoperative intraocular pressure was under 21mmHg,preoperative dioptre was moderate and thickness of postoperative corneal stroma bed was above 300μm.

Abstract:AIM:To compare visual function and subjective patient satisfaction after phacoemulsification with implantation of AcrySof ReSTOR Aspheric multifocal intraocular lens(IOL) with a +3.0 diopter addition power or +4.0 diopter addition power.METHODS:After small-incision phacoemulsification,+3D IOL were implanted in 56 subjects(60 eyes,experimental group),+4D IOL were implanted in 58 subjects(60 eyes,control group).Three months following bilateral implantation,uncorrected distance visual acuity(UCDVA),uncorrected Intermediate visual acuity(UCIVA),uncorrected near visual acuity(UCNVA),best-corrected distance visual acuity(BCDVA),best-corrected near visual acuity(BCNVA),corneal astigmatism and contrast sensitivity were compared between two groups.A subjective outcome questionnaire was also completed by the subjects,including visual disturbances,patient satisfaction with their vision and spectacle independence.RESULTS:Three months after phacoemulsification,UCDVA and BCDVA,UCNVA and BCNVA in the +3D group were not statistically differences from +4D group(P>0.05).Intermediate visual acuity was statistically better in the +3D group(0.68±0.13)than that in the +4D group(0.55±0.08)(P<0.05).Corneal astigmatism after phacoemulsification can be significantly reduced,astigmatism was 0.75±0.13D preoperatively and 0.41±0.15D postoperatively in the group of single-incision,and in the group of bilateral-incision was 1.25±0.18D and 0.72±0.21D respectively.In both groups,there was significant difference between preoperative and postoperative(P<0.05).There was no significant difference in contrast sensitivity postoperatively(P>0.05).There was a low incidence in visual disturbances postoperatively,including problems with night vision,glare and halos in both groups(P>0.05).+3D group provided better intermediate visual acuity and more spectacle independence than +4D group.CONCLUSION:AcrySof ReSTOR Aspheric +3D IOLs may provide excellent overall quality of vision.Especially,intermediate vision in +3D was better than + 4D.Patients reported high rate of satisfaction and spectacle independence.So,we conclude that Acrysof ReSTOR Aspheric +3.0D IOL has excellent clinical effectiveness and value.

Abstract:AIM:To assess the clinical outcome after implantation of the Tetraflex accommodating intraocular lens(IOL).METHODS:Thirty eyes of 21 patients with cataract had phacoemulsification implantation of Tetraflex accommo-dating IOL.Twenty nine eyes of 20 age-matched patients with cataract had the same surgery with a conventional monofocal IOL.Patients were examined 1 day,7,30,and 90 days after surgery.All patients had assessments of slit lamp,refraction,uncorrected and best corrected distance and near visual acuity.The amplitude of accommodation,anterior chamber depth(ACD) before and after application of 20g/L pilocarpine were examined 90 days after surgery.RESULTS:Postoperatively,both groups had excellent uncorrected distance acuity,and best corrected distance acuity.The mean uncorrected near visual acuity was significantly better in the Tetraflex group than in the conventional monofocal IOL group.The retinoscopic accomodative range was 2.25±0.35D in Tetraflex group and 0.65±0.25D in monofocal IOL group(P<0.01).The mean ACD shoaling was 0.40±0.20 and 0.15±0.11mm after pilocarpine 20g/L eyedrops.The differences between the two groups was statistically significant(P<0.01).CONCLUSION:The Tetraflex accommodating IOL is safe and effective.It can provide better distant and near visual acuity.

Abstract:AIM:To investigate the feature of intraocular pressure(IOP) and ocular pulse amplitude(OPA) measured by dynamic contour tonometer(DCT) in the chronic angle-closure glaucoma(CACG),the primary angle-open glaucoma(PAOG),the normal tension glaucoma(NTG) and the healthy controls and to analyze the relation between the IOP and OPA.METHODS:Nineteen cases of chronic angle-closure glaucoma,18 cases of primary angle-open glaucoma,15 cases of normal tension glaucoma and 20 cases of healthy controls were taken into the measure.IOP,OPA were measured by DCT at the same time.One eye of each patient were taken into analysis randomly.All the patients accepted the blood pressure and the heart rates measure at the same time.The results were taken into analysis by SPSS 14.0.RESULTS:The mean IOP were 25.42±9.95mmHg,23.12±5.47mmHg,16.52±2.23mmHg and 16.31±2.67mmHg in CACG,PAOG,NTG and normal controls group.There were significant differences of IOP between the CACG group and NTG group(P<0.001).It was also observed between the PAOG group and NTG group(P=0.003).The mean OPA were 3.84±0.88mmHg,3.29±0.90mmHg,1.85±0.47mmHg and 2.47±0.80mmHg in CACG,PAOG,NTG and normal controls group.Significant difference of OPA was observed between the CACG group and the PAOG group(P=0.038).The OPA of the NTG group had significant difference with that of the CACG,the PAOG and the normal controls group(P<0.01,P<0.01,P=0.039).There were low correlations between the IOP and OPA in four groups.CONCLUSION:The statistical differences of OPA were among the CACG,the PAOG,the NTG and the healthy controls.There was low correlation between the IOP and OPA.

Abstract:AIM:To investigate the effect of neodymium-doped yttrium aluminum garnet(Nd:YAG) laser posterior capsulotomy on foveal retina using three-dimensional ocular coherence tomography(3D-OCT) for posterior capsular opacification after uncomplicated phacoemulsification surgery and intraocular lens(IOL) implantation.METHODS:Our study included 65 patients(79 eyes) with posterior capsular opacification after phacoemul-sification surgery.Nd:YAG laser capsulotomy was performed with varied laser energy in all patients according to their different degrees of posterior opacification.3D-OCT was used to check fundus changes at 10 minutes and 7 days after the laser treatment.Best corrected visual acuity(BCVA) and anterior segment changes were also checked.RESULTS:All of the 79 eyes successfully underwent Nd:YAG capsulotomy,with improved postoperative BCVA in varying degrees.No inflammatory reactions were found in their anterior chambers,and only six of them presented pitting trace on the optical surface of IOL.At 10 minutes and 7 days after capsulotomy,the average macular retinal thickness(CMT) was 201.36±41.27μm and 197.23±36.54μm,respectively.Both were slightly thicker than that of normal group at the same age,whose CMT was 189.95±43.57μm averagely.But there were no statistically significant differences beween them(P>0.05).A discontinuous inner segment and outer segment(IS/OS) line and unclear structure of every layer on the macular area were detected in a small number of the patients.CONCLUSION:Nd:YAG laser capsulotomy is an effecitive and safe method of treating different kinds of posterior capsular opacification.Foveal thickness is similar with normal peer group and retinal structure has no obvious abnormal changes at 10 minutes and 7 days after Nd:YAG laser capsulotomy,as determined by 3D-OCT.Skilled operation techniques and appropriate laser energy could diminish its side effects on retina.

Abstract:AIM:To observe the performance of pattern visual evoked potential(PVEP)in normal eyes and eyes with different diseases and learn the meaning of PVEP in the assessment of different eye diseases.METHODS:Sixty-seven patients with different eye diseases and 48 volunteers with normal visual acuity were examined by PVEP for comparative analysis of different changes in the waveform characteristics of PVEP in different eye diseases.RESULTS:Compared with the normal eyes,the PVEP amplitude of eyes with central serous choroidoretinopathy in acute phase,retinitis pigmentosa with significantly reduced visual field,open angle glaucoma with significant defect of visual field,traumatic optic neuropathy and amblyopia was decreased and latency was delayed,but the difference of the latency of P1 and N1,amplitude of(P1+N1) between normal eyes and eyes of retinitis pigmentosa without reduced visual field and open angle glaucoma without significant defect of visual field was not significant.CONCLUSION:PVEP is sensitive to macular disease,but is not sensitive to the peripheral visual field damage.Amplitude changes are more sensitive than the latency in the two components changes of PVEP waveform.PVEP can be used to determine the prognosis of patients visual acuity in ocular trauma cases with optic nerve damage and also help to identify patients and follow-up treatment effect in the amblyopic cases.

Abstract:Age-related macular degeneration(AMD) is the main reason for blindness in the elderly in developed countries.China’s AMD is also increasing,but its pathogenesis is uncertain.In recent years,AMD’s pathogenesis has also gained concerns of a growing number of scholars.This article described the development of AMD synthetically from the perspective of the etiology of AMD.

Abstract:The article illustrates the recent advances in treatment of vernal keratoconjunctivitis from drug therapy,surgical treatment,specific immunotherapy,subconjunctival injection,cryotherapy and many other aspects and forsees the future treatment.

Abstract:Inflammation can promote the growth of corneal neovascularization.p38 mitogen-activated protein kinase signal transduction pathway may play an important role in the progress of inflammation by controlling the expressions of IL-1β,IL-6,TNF-α and so on.p38 inhibitors not only suppress the expressions of inflammatory mediators,but also block their activities.p38 inhibitors greatly curb the progress of inflammations.It is a new strategy to explore the developing mechanism of corneal neovascularization through the pathway of p38 signal transduction.

Abstract:Posterior chamber phakic intraocular lens implantation is an effective treatment for high myopia.It possess good effectiveness,safety and stability.In this paper,research progress of this method was reviewed.

Abstract:Dry eye syndrome is one of the most common ocular surface disease.Traditional Chinese medicine(TCM) has been making progress towards this disease.From the aspects of syndrome differentiation and treatment,specific prescription and medication,local therapy,and acupuncture treatment,this article reviews the advances of treatment in dry eye syndrome.

Abstract:Conjunctival papilloma is a benign and epithelial tumour,it can be classified into conjunctiva type and limbus type depending on its site.Compared to the limbus type which is common in middle-aged people the conjunctiva type which usually occurs in children or adolesents is more common.The hyperplasia of conjunctival papilloma may leads to conjunctival squamous cell carcinoma.Conjunctival papilloma can be of viral origin(human papilloma virus,HPV),which is also related to conjunctival squamous cell carcinoma,so it is very important to detect HPV in patients for treatment and follow-up.The common treatment of conjunctival papilloma is sugical excision,but simple treatment is associated with high recurrence rate.Several types of therapy have been described,including liquid nitrogen cryotherapy,cauterization,cytotoxic drug and interferon.We report a case of recurrent limbus-based papilloma treated successfully with combined therapy.

Abstract:AIM:To explore the distribution and growth of research articles on cataract,providing bibliometric information for cataract researchers.METHODS:Research articles on cataract published in PubMed from 1813 to 2010 were analyzed by bibliometric method.Distribution of No.of articles by time,characteristics of journals,language,type of article,vice mesh,characteristics of subjects,full articles and accessibility were statistically analyzed.RESULTS:During 1813-2010,there were 45868 cataract research literatures in the PubMed database.According to PubMed database literature type,they were categorized as follow:Review(n=2957),Randomized Controlled Trial(n=1890),Practice Guideline(n=22),Meta-Analysis(n=62),Letter(n=2142),Editorial(n=505),Clinical Trial(n=2897),Others(n=35767);MEDLINE(n=43838) and Others(n=2030);Nursing journals(n=457),Core clinical journals(n=4093),Others(n=41318);Man(n=18527),Woman(n=17837),Others(n=9504);Humans(n=36577),Animals(n=6015),Others(n=3290);Infant(n=3144),Child(n=5386),Adolescent(n=4392),Adult(n=10485),Aged(n=18649),80 and over(n=5993);Links to full text(n=23616),Links to free full text(n=6575),Abstracts(n=28682).From 1946 to 2010,the number of literatures by year approximated straight line(Y =598.71X-689.92,R2=0.9746).Chinese cataract literatures in PubMed appeared in 1946,and increased obviously since 1961.The cataract literatures is primarily in English(34655,75.6%),Chinese publication literatures arranged at 7th(732,1.59%).10299 literatures(23%) were retrieved in 22 journals on ophthalmology(SCI-indexed).CONCLUSION:Our results showed that cataract research was conducted at early time,but it is not a hot topic until 1960s of last century.Cataract research is still a focus by now,which is evidenced by the linear growth of the number of articles.

Abstract:AIM:To explore the importance of improving the ophthalmological teaching methods for the improvement of teaching quality.METHODS:The case teaching and the analogical teaching of condition were used in clinical teaching in the department of ophthalmology.RESULTS:A questionnaire survey showed that the case teaching mode was favored by students.Condition teaching can effectively enhance the initiative and enthusiasm of students,and improve the effect of clinical learning.CONCLUSION:Condition teaching-based case teaching mode stimulated the study initiative of students,enhanced their aggregate analysis ability of the ophthalmological diseases,improved the teaching effect.

Abstract: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.

Abstract: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.

Abstract: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.

Abstract: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.

Abstract: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.

Abstract: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.

Abstract: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.

Abstract: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.

Abstract: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.

Abstract: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.

Abstract: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.

Abstract: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.

Abstract: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.

Abstract: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).

Abstract: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.

Abstract: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.

Abstract: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.

Abstract: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.

Abstract: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.

Abstract: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.

Abstract: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.

Abstract:AIM:To investigate clinical applications of small incision non-phacoemulsification combined with anterior chamber maintainer in cataract surgery.METHODS:Totally 132 patients(148 eyes) underwent small incision non-phacoemulsification cataract surgery,with intraoperative use of anterior chamber maintainer infusion and posterior chamber intraocular lens implantation.RESULTS:All the results were successful,intraoperative anterior chamber was stable,without serious complications due to anterior chamber fluctuations.Postoperative uncorrected visual acuity was ≥0.5 in 114 eyes(77.0%).CONCLUSION:Small incision non-phacoemulsification combined with anterior chamber maintainer in cataract surgery is easy to operate,fast,and with less complication and cost.

Abstract:AIM:To study the clinical effects of the improved compound trabeculectomy for glaucoma and its complications.METHODS:A total of 26 cases(35 eyes)with primary glaucoma were randomly divided into 2 groups,observation group(17 eyes) treated with improved compound trabeculectomy,control group(18 eyes)treated with simple trabeculectomy.The follow-up time was 6 to 12 months(average 9.8 months).RESULTS:Preoperative intraocular pressure(IOP) was 54.37±6.30 mmHg in observation group,and 45.71±6.59 mmHg in control group.7 days postoperative,IOP of observation group was 13.18±1.63mmHg,that of control group was 13.33±2.11mmHg.6-12 months postoperative,IOP of observation group was 14.24±1.63mmHg,that of control group was 19.33±2.14mmHg.In observation group,15 eyes(88 %) had anterior chamber formation at 1st day postoperatively,2 eyes(12%) had shallow anterior chamber(Ⅰ & Ⅱ degree each one).In control group,only 8 eyes(44%) had anterior chamber formation at 1st day after surgery,10 of 18 eyes(56%) had shallow anterior chamber,among those Ⅰ degree was 6 eyes,Ⅱ and Ⅲ degree each 2 eyes.6-12 months postoperatively,functional filtration bleb was 88%(15/17) in observation group and 56 %(10/18) in control group respectively.CONCLUSION:The improved compound trabeculectomy significantly increases the successful rate of operation,decreases intraoperative,postoperative complications,which is an ideal glaucoma therapy.

Abstract:AIM:To evaluate the intraocular pressure(IOP) lowering efficacy of travoprost eye drops on the remnant glaucoma.METHODS:Totally 12 glaucoma patients(14 eyes) diagnosed as remnant glaucoma(21mmHg≤IOP≤30mmHg) were given travoprost eye drops once every night.The observing duration was 3 months.The IOP before and after the administration of the eye drops were observed.RESULTS:The IOP lowering efficacy was obvious in all cases.The average IOP lowering ranged between 37.69% and 38.44% in the 3 months.CONCLUSION:Travoprost can be used as the first choice for the treatment of the remnant glaucoma(21mmHg≤IOP≤30mmHg).

Abstract:AIM:To observe the effect and prognosis in patients with proliferative diabetic retinopathy(PDR) five years after panretinal photocoagulation(PRP).METHODS:Totally 92 cases(149 eyes) with PDR were reviewed one month,three months,six months,one year and then half-yearly after PRP treatment,and reviewed FFA after three months,if necessary,added photocoagulation.All patients were reviewed for the statistics and the conclusion.RESULTS:Visual acuity improved in 52 eyes,unchanged in 71 eyes,decreased in 26 eyes.So far,the final corrected visual acuity after PRP:19 eyes was≤0.01,64 eyes between>0.01-0.1,58 eyes between>0.1-0.5,8 eyes>0.5.During the follow-up after laser blood glucose level was controlled within the normal range in 63 eyes,five years later only six eyes were complicated with vitreous hemorrhage,tractive retinal detachment and other serious complications,accounting for 9.5%,while in 29 eyes of unsatisfied blood glucose levels,9 eyes(31%) occurred with above situation.CONCLUSION:The early detection and timely treatment and regular follow-up observations to reduce diabetic blindness is entirely possible.For the PDR patients,immediately PRP treatment after diagnosed and to develop regular follow-up plan,and as necessary,to review the FFA or additional laser should be conducted.At the same time,that formal medical treatment and satisfied blood glucose control can effectively reduce or delay the development of PDR should be clarified to the patient.

Abstract:AIM:To investigate the pathogenesis,risk factors,clinical presentation and curative effect of latent suprachoroidal hemorrhage.METHODS:Vitrectomy combined with radial equatorial sclerotomy was performed in 4 patients with latent suprachoroidal hemorrhage from February 2008 to September 2010 and the therapeutic effect was observed.RESULTS:Suprachoroidal hemorrhage disappeared completely in all cases.Choroidal reattachment was acquired and visual function was improved in various degrees.CONCLUSION:Latent suprachoroidal hemorrhage is a seriously blinding oculopathy.Correct diagnosis,opportune operative timing and appropriate surgical methods are helpful to relieve or even cure this disease as well as to save the eye and visual function.Vitrectomy combined with radial equatorial sclerotomy is an effective treatment for latent suprachoroidal hemorrhage.

Abstract:ATM:To investigate the anti-inflammatory effect and adverse reaction of loteprednol etabonate combined with tobramycin-dexamethasone eyedrops in treatment of anterior uveitis.METHODS:The anterior uveitis patients treated in our hospital from February 2008 to October 2010 were chosen and randomly divided into A,B and C three groups,A group used tobramycin-dexamethasone eyedrops,B group used loteprednol etabonate eyedrops,C group used loteprednol etabonate combined with tobramycin-dexamethasone eyedrops.With continuous follow-up of six weeks,inflammation disappearance and adverse reactions were observed.RESULTS:Inflammation in group A subsidised fast with short duration,but a few of patients experienced drug-induced high intraocular pressure.Inflammation in group B subsidised slower,without drug-induced high intraocular pressure.Inflammation in group C subsidised fast with short duration,but no high intraocular pressure occured.CONCLUSION:In different treatment stages of anterior uveitis patients,loteprednol etabonate combined with tobramycin-dexamethasone can quickly control inflammation,shorten the duration of symptoms,safely and effectively prevent or reduce complications.

Abstract:AIM:To investigate giant papillary conjunctivitis patients who can not be divorced from contact lenses change to frequent replacement type contact lenses and rigid gas permeable contact lenses and observe the condition of giant papillary conjunctivitis with or without changes.And to investigate the efficacy of desensitizing agents at the same time.METHODS:Totally 112 cases(208 eyes) who were diagnosed with giant papillary conjunctivitis in our center were randomly divided into four groups:Group 1(Ⅰ group) of 68 eyes were treated with frequent replacement type contact lenses combined with mingmuqing eye drops;Group 2(Ⅱ group)of 56 eyes were treated with frequent replacement type contact lenses combined with desensitizer eye drops;Group 3(Ⅲ group) of 52 eyes were treated with rigid gas permeable contact lenses combined with mingmuqing eye drops;Group 4(Ⅳ group)of 32 eyes were treated with rigid gas permeable contact lenses combined with desensitizer eye drops.RESULTS:Condition of giant papillary conjunctivitis patients in all the 4 groups were significantly improved,data of 4 groups were no statistically significant difference(P>0.05).CONCLUSION:The giant papillary conjunctivitis caused by contact lenses wearing can get effective control and cure of the disease without affecting wearing of contact lenses if the replacement of rigid gas permeable contact lenses or frequent replacement type contact lenses can be introduced timely.

Abstract:AIM:To analyse the therapeutic efficacy of traumatic optic neuropathy managed by non-surgical treatment.METHODS:Twenty-two cases(23 eyes) of traumatic optic neuropathy were treated with methylprednisolone combined with hypertonic dehydrant,vascular dilator,nutramines,neural nutrient,high-pressure oxygen and so on,and analysis of its effect were made.RESULTS:Before treatment,no light perception was in 7 eyes(30.43%),which reduced to 6 eyes after treatment(26.09%);Before treatment,light perception was in 5 eyes(21.74%),which decreased to 4 eyes(17.39%) after treatment;Before treatment,7 eyes(30.43%)whose visual acuity were 0.02-0.1,after treatment was still 7 eyes(30.43%);3 eyes(13.04%) whose visual acuity were 0.1-0.3,which increased to 4 eyes(17.39%) after treatment;Visual acuity was greater than 0.3 before treatment in 1 eye(4.35%),which increased to 2 eyes(8.70%) after treatment.Effective treatment was in 11 eyes,the total effective rate was 47.83%,12 eyes after treatment was ineffective,accounting for 52.17%.CONCLUSION:Traumatic optic neuropathy leads to severe destruction of visual function.The prognosis of visual function is poor.Non-surgical treatment of traumatic optic neuropathy can achieve a certain effect,but the overall effect was poor.

Abstract:AIM:To observe the clinical effect of lid-wiper epitheliopathy(LWE) treated by artificial tears combined with basic fibroblast growth factor(bFGF).METHODS:Eighty-six cases were divided into two groups randomly.The treated group were treated with preservative-free artificial tears(3g/L Hialid) combined with bFGF and the control group were treated with simple preservative-free artificial tears.After 3 weeks of treatment,all patients were rechecked.The observed indexes included lid-wiper staining(fluorescein and lissamine green dyes) and questionnaire survey of evaluation of dry eye.The difference of these indexes were compared between before and after treatment.RESULTS:The therapeutic effect of LWE in treated group was excellent in 74 eyes(86%),effective in 12(14%) and cure rate was 86%;versus therapeutic effect in control group was excellent in 51 eyes(59%),effective in 34 eyes(40%),ineffective in 1 eye(1%),and cure rate was 59%.There was statistically significant difference between the two groups(P<0.05).CONCLUSION:Artificial tears combined with bFGF play significant therapeutic effect in treating LWE.

Abstract:AIM:To study the effect of corneal epithelium healing time and long-term prognosis on pterygium by the surgery with reverse stripping.METHODS:To divide 56 eyes with primary pterygium into 2 groups randomly.The cases of reverse stripping group were treated by tearing the pterygium from the body to the head.The cases of conventional stripping group were treated by tearing the pterygium from the head to the body.All cases were treated by transplanting the pedicle-conjunctival flap and soaking the exposed sclera with MMC tampon during the operations.To observe the healing time of corneal epithelium and long-term prognosis.RESULTS:The reverse stripping group showed the shorter repair time of corneal epithelium(t=4.79,P<0.05)and the recurrence rate of reverse stripping group(1.6%) is significantly lower than that of conventional stripping group(10.2%,χ2=4.06,P<0.05).CONCLUSION:Pterygium treated by reverse stripping can promote the repair of corneal epithelium and reduce the postoperative recurrence.

Abstract:AIM:To discuss the mechanism,prevention and therapy of the scleral melting after pterygium excision with intraoperative application of mitomycin C(MMC).METHODS:Ten eyes with scleral melting after pterygium excision with MMC were followed up and treated with topical medicine or surgery.RESULTS:The ischemic,thinning could be found at the tissue where the pterygium was excised,and the deep pigment tissue appeared in some patients.The topical medicine and surgery were adopted according to the severity of melting.No recurrences were found during the follow-up.CONCLUSION:To reduce the recurrences after the pterygium excision,the assistant MMC treatment can be adopted,but the concentration and the duration of application should be considered,and the overdose of cauterization should be avoided to assure the enough blood supply at the wound.

Abstract:AIM:To estimate the therapeutic effects of pterygium excision combined with corneal limbal stem cells transplantation using biomedical fibrin glue in the treatment of pterygium.METHODS:In all the 59 cases(60 eyes),group 1:34 eyes received pterygium resection+limbal stem cell transplantation using biomedical fibrin glue.Group 2:26 eyes received pterygium resection+limbal stem cell transplantation without biomedical fibrin glue.RESULTS:Group 1 needed shorter time in the surgery than the group 2.Meanwhile the patients who received pterygium resection+limbal stem cell transplant using biomedical fibrin glue had less postoperative symptoms of stimulation.Limbal stem cell transplantation adhesion of 5 eyes(19%) was poor and sclera was exposed in group 2.Graft in fibrin glue group healed well,no significant local conjunctival scarring formed;the control group suffered from varying degrees of conjunctival scarring by suture irritation.After 6 months’ follow-up,both groups had no pterygium recurrence.CONCLUSION:The patients who received pterygium resection+limbal stem cell transplantation using biomedical fibrin glue have lower recurrent rate and less post-operative symptoms of stimulation.Using biomedical fibrin glue is an effective method to cope with pterygium.

Abstract:AIM:To explore the clinical application of modified autologous corneal limbal stem cell transplantation in treatment of early stage pterygium.METHODS:Totally 88 cases(100 eyes) with early stage pterygium were randomly divided into two groups.Group A(42 cases,50 eyes) were treated with modified autologous corneal limbal stem cell transplantation;group B(46 cases,50 eyes) were treated with traditional methods.The operation time,duration of postoperative discomfort,survival ratio of graft and recurrence rate of the two groups were compared.RESULTS:Compared with group B,group A had shorter operative time,shorter duration of postoperative discomfort,higher survival ratio of graft and lower recurrence rate.CONCLUSION:Compared with traditional methods,the use of modified methods has short operative time,short duration of postoperative discomfort,high survival ratio of graft and lower recurrence rate,which is worth popularizing.

Abstract:AIM:To evaluate an effective way of treating obstruction of lacrimal duct.METHODS:Totally 73 cases(73 eyes) of obstruction of lacrimal duct were treated by high-frequent electrolacryocystoplasty combined with silicone intubation.They were followed up for 6 months.RESULTS:It was showed that the curative rate was 80.82%,10.96% was effective,8.22% had no effect.CONCLUSION:High-frequent electrolacryocystoplasty combined with silicone intubation is safe and effective to treat obstruction of lacrimal duct.

Abstract:AIM:To investigate the effect of punctum plugs relieved the dry eye symptoms at the early stage after Laser in situ keratomileusis(LASIK).METHODS:Fifty-four patients(108 eyes) were treated with LASIK in our hospital.54 eyes of 27 patients received punctum plugs as treatment randomly 2 days after surgery.The other patients used artificial tear instead.Schirmer Ⅰ test(SⅠt),tear break-up time(BUT) and fluorescent staining(FL) were measured 2 weeks after surgery.RESULTS:The SⅠt in punctum plugs group was 11.90±4.20mm/5min,while 10.85±3.42mm/5min,in eye drop group.The BUT were 13.12±2.58s and 11.67±3.29s in punctum plugs group and eye drop group respectively.The FL were 6.23±1.12 and 5.42±2.10.CONCLUSION:Our results showed that there was no difference between punctum plugs group and eye drop group to relieve the dry eye symptoms at the early stage after LASIK.

Abstract:AIM:To investigate the application of confocal microscopy in the diagnosis and treatment of dry eye after trabeculectomy.METHODS:In vivo confocal microscopy(CM) examination was conducted in 42 glaucoma patients(58 eyes) 1 day before and 1 week,1 month,3 months after trabeculectomy to observe the morphology changes of corneal tissue,and combining breaking-up time(BUT),Schirmer Ⅰ test(SⅠt) to analyse ocular surface changes in the structure after trabeculectomy.RESULTS:Compared with the preoperative,postoperative 1 day,1 week corneal epithelial cell density of operated eye decreased,with disparity of the size and increased high reflective cells.SⅠt was significantly increased,BUT shortened,the difference was statistically significant(P<0.05).1 month,3 months after surgery,CM examination showed corneal epithelial cell morphology,density,SⅠt and BUT recovered to preoperative levels.Compared with the preoperative,the difference was not statistically significant(P>0.05).CONCLUSION:By confocal microscopy,trabeculectomy’s influence on ocular surface structure can be evaluated at the cellular level,which has important clinical value on the early postoperative diagnosis and treatment of dry eye.

Abstract:AIM:To investigate,evaluate and analyse the clinical characteristics of optical coherence tomography for congenital optic disc pits.METHODS:Eleven patients(11 eyes) with congenital optic disc pits underwent examination of optical coherence tomography and fluorescein fundus angiography.RESULTS:All of the cases were combined with serous maculopathy,including neuroepithelium detachment,neuroepithelium interbed split and macular hole.CONCLUSION:Optical coherence tomography may be an effective method for the investigation and diagnosis of congenital optic disc pits.

Abstract:AIM:To observe the effect of binocular or monocular medial rectus muscle resection in treatment of convergence insufficiency concomitant exotropia,sometimes lateral rectus muscles recession might be needed.METHODS:The selected 181 patients were performed binocular or monocular medial rectus muscle resection,sometimes might be associated with lateral rectus muscles recession.General ophthalmological examination,strabismometry,ocular movement and synoptophore were performed preoperation,1 week,2 months and 6 months postoperation.RESULTS:The orthotopic possibility were 80.1% after 1 week of operation,83.7% after 2 months of operation and 81.3% after 6 months of operation.The squint of post-operation had significant difference compared with that of preoperation(P<0.01).There was no significant difference between preoperation and postoperation with that of binocular visual functional restoration(P>0.05).CONCLUSION:Binocular or monocular medial rectus muscle resection in treatment of convergence insufficiency concomitant exotropia has satisfactory effect.

Abstract:AIM:To compare the reducing pain-degree when inserting needle between patients accepting modified temporal-subcutaneous injection and the traditional way,and explore the clinical feasibility of the modified temporal-subcutaneous injection.METHODS:To use the patients who accepted the compound anisodine temporal-subcutaneous injection as subject investigated,some patients accepted the way of the vertical needle(modified temporal-subcutaneous injection),the other accepted the traditional way(normal temporal-subcutaneous injection),and the pain-degree of two groups were compared.The assigned persons observed the patients’ response to pain with the Wong-Baker facial scale,collected the data of the patients’ response to pain,then made statistical analysis of the data.RESULTS:The pain-degree of modified temporal-subcutaneous injection was significantly lower than that of the traditional way.CONCLUSION:The modified temporal-subcutaneous injection can significantly reduce pain-degree when patients accept temporal-subcutaneous injection,thereby improve the compliance when patients accept the treatment of temporal-subcutaneous injection.