Abstract:AIM:Cataract surgery techniques have improved a lot over the years. The present study was designed to propose a novel and surgically easy technique of ‘in the tunnel’ trabeculectomy with lesser incidence of complications in the management of cataract with primary open angle glaucoma (POAG). METHODS:One hundred and three patients were included in a prospective, nonrandomized clinical study. 108 eyes of 103 patients with POAG and cataract were performed manual small incision cataract surgery (MSICS) combined with ‘in the tunnel’ trabeculectomy. The outcome of the surgery was evaluated in terms of the anatomical appearance of the bleb and its functional result over a period of 6 months.RESULTS:The mean intraocular pressure (IOP) on the first postoperative day was 11.4±3.1mmHg in the tunnel incision group (P=0.012). On the second postoperative day the mean IOP was 10.3±3.5mmHg (P =0.065). Shallow anterior chamber and iridocorneal touch occurred significantly less in the tunnel incision group. CONCLUSION:"Scleral tunnel incision"-trabeculectomy (STIT) appears to be steady lowering IOP during the first 6 months postoperatively. It is also relatively safe and has fewer early complications related to excessive aqueous outflow than conventional trabeculectomy (CT).

Abstract:AIM:To investigate the effect of RNA interference targeting integrin-linked kinase (ILK) on the proliferation and migration of cultured human retinal pigment epithelium (hRPE)cells.METHODS:hRPE cells were cultured, and their morphology and staining features were determined. ILK specific siRNA was designed and synthesized. siRNA was transfected into hRPE cells with Lipofectamine 2000. The effects of transfection were observed using a fluorescence microscope. RT-PCR and Western blot were used to semiquantitatively evaluate the mRNA and protein expressions of ILK. MTT assay was used to detect the proliferation of hRPE cells. Wound healing assay and transwell migration assay were used to detect the migration capability of hRPE cells.RESULTS:ILK was found in normal culture hRPE cells. The mRNA and protein expressions of ILK significantly decreased by siRNA transfection（P<0.01）.The proliferation of hRPE cells also significantly decreased（P<0.05）. The migration capability of hRPE significantly decreased by siRNA transfection, with statistically significant difference compared with the normal control group（P<0.05）. CONCLUSION:ILK-siRNA transfection significantly decreases the mRNA and protein expressions of ILK, as well as the proliferation and migration abilities of hRPE cell’s.

Abstract:AIM:To investigate the psychological character of the glaucoma patients and analyze the influence of the psychological therapy after the education on the glaucoma club METHODS:One hundred primary glaucoma patients were chosen as research objects and were randomly divided into two groups:experimental group(50 cases) and control group(50 cases). Methods symptom checklist 90 (SCL-90), Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS) and related psychological health questionnaires were used to evaluate these patients. Patients in the experimental groups would go into the glaucoma club for a half-year psychological therapy during the period of the physical therapy, while patients in the control group were only gave the physical therapy. After half of the year, all these patients filled the questionnaire again.RESULTS:After the psychological therapy, patients'' psychological status in the experimental group was significantly improved (P<0.05). It was the explanation that the therapy group had great effects compared with the control group (P<0.05). Glaucoma psychology could be attributed to eight psychological symptoms, depression was the main character.CONCLUSION:Psychological therapy in the glaucoma club is effective, however, the continue efforts in the promotion of the glaucoma club are needed.

Abstract:Waardenburg syndrome (WS) is an uncommon autosomally inherited and genetically heterogeneous disorder. The major features includes pigmentary disturbances and congenital deafness. Four subtypes of WS are recognized according to the clinical finding.A careful clinical description is needed to differentiate different types of WS and other associated diseases.

Abstract:AIM:To report a case of diffuse infiltrating retinoblastoma that proved to be diagnostic challenge because of its atypical presentation. METHODS:We described a 10 years old boy presented with cataract and features of ocular inflammation post-operatively, and was finally diagnosed as diffuse infiltrating retinoblastoma.RESULTS:The masquerading features, diagnostic approach, surgical management and histopathology findings were presented. In this case, cytology study of aqueous humor cells confirmed the diagnosis while radioimaging demonstrated a limited diagnostic value.CONCLUSION:The case highlights the diagnostic challenge of diffuse infiltrating retinoblastoma. Ophthalmologist should be aware of the atypical presentation of diffuse infiltrating retinoblastoma and must be vigilant in managing similar cases.

Abstract:AIM:To investigate the expression of cyclin dependent kinase inhibitors p21 and p27 in different ages of rabbit lens epithelial cells(LEC). METHODS:p21 and p27 in lens anterior capsule membranes in 10, 20 and 30 weeks old rabbits were measured by RT-PCR and Western blot in levels of mRNA and protein. RESULTS:p21 in rabbit lens anterior capsule membranes had similar expression with p27 in levels of mRNA and protein. Their expressions were highest in youth rabbits, while lowest in middle aged rabbits. The differences of both p21 and p27 among different ages of rabbit LEC were significant(P<0.05). CONCLUSION:p21 and p27 may play a balancing role in the process of cycle regulation in rabbit LEC, which provides a reference for researches related to prevent posterior capsular opacification(PCO).

Abstract:AIM:To investigate the neuroprotective effects of pigment epithelium-derived factor(PEDF) against oxidative stress-induced injury in differentiated retinal ganglion cell (RGC)-5 cells.METHODS:After differentiated with staurosporine, RGC-5 cells were divided into 4 groups. After every group cells were cultured for 24 hours, cell viability was determined by MTT assay; the apoptosis percent was tested by the Annexin V-FITC apoptosis kit.RESULTS:H₂O.2 may induce cell death of RGC-5 cells in a concentration-dependant manner. Exposure to 200μmol/L H₂O.2 clearly induced cell death in 40% of the cells within 24 hours. The apoptosis percent (36.60%±2.12%) after exposure to 200μmol/L H₂O₂ is higher than the control cells(6.03%±1.45%). PEDF at 100ng/mL suppressed the cell death induced by H₂O.2about 30% of the control cells. At the same concentration, PEDF also inhibited the cell apoptosis induced by H₂O₂(P<0.01).CONCLUSION:PEDF is able to effectively protect RGC against oxidative stressed injury and can be used as a very potential neuroprotective drug.

Abstract:AIM:To explore effects of curcumin on viability of high glucose concentration (HGC) cultured rhesus choroido-retinal endothelial cell (RF/6A).METHODS:RF/6A was assigned into 4 groups (n= 6/group). Control group (CONT group), high glucose concentration group (HGC group):30mmol/L glucose was administered, curcumin group (CUR group):30μmol/L curcumin was administered, curcumin-glucose group (C-G group):30mmol/L glucose and 30μmol/L curcumin were administered. Cell viability was detected by methyl thiazolyl tetrazolium (MTT) at 1, 3 and 5 day after cultivation. Moreover, malonaldehyde (MDA), activity of superoxide dismutase (SOD) and expression of proliferating cell nuclear antigen (PCNA) and anti-oncogene protein 27 (p27) were detected at day 5.RESULTS:Compared with CONT group, HGC group showed decrease of cell viability, increase of MDA, decrease of activity of SOD, down-regulation of PCNA and up-regulation of p27 (P＜0.01). While, no difference could be detected in CUR group or C-G group compared with CONT group (P＞0.05). CONCLUSION:Curcumin inhabits HGC-induced oxidative stress, reverses expression of PCNA and p27, and, therefore, contribute to curcumin maintaining RF/6A viability.

Abstract:AIM:To investigate the expression level of rabbit corneal epithelial cells'' basic fibroblast growth factor (bFGF) in vitrounder the condition of using different concentration of human amniotic homogenate supernatant, and to discuss the function of human amniotic homogenate supernatant in the process of corneal epithelial repair.METHODS:The rabbit corneal epithelial cells were cultured in vitroand they were divided into several groups. Then the experiment group was treated in DMEM culture liquid of 100mL/L fetal blood serum mixed with different concentration of human amniotic homogenate supernatant (the amniotic homogenate protein concentration was 40,80,160μg/mL respectively), with the control group treated in DMEM culture liquid of 100mL/L fetal blood serum only. By using the method of methyl thiazolyl tetrazolium(MTT) colorimetry, we aim to investigate the impact of human amniotic homogenate supernatant on rabbit corneal epithelial cells proliferation at different times (24, 48, 96 hours). At the same time, we tested the bFGF-mRNA expression level in each group by RT-PCR.RESULTS:Rabbit corneal epithelial cells proliferated at different concentrations of human amniotic homogenate supernatant (40, 80, 160μg/mL), the amount of corneal epithelial cells in each experimental group was increased significantly (0.185±0.010, 0.318±0.015, 0.501±0.014 respectively, P<0.05). As the culture time prolonged, the difference became more apparent; There was no significant difference about the expression of bFGF-mRNA between the control(0.708±0.013) and the amniotic homogenate supernatant with the concentration of 40μg/mL and 80μg/mL (0.750±0.007, 0.785±0.006 respectively), but the differences about the expression of bFGF-mRNA between the 160μg/mL group(1.013±0.120) and the 40, 80μg/mL, control group were significant respectively.CONCLUSION:Human amniotic homogenate supernatant can significantly stimulate the proliferation of rabbit corneal epithelial cells and its effect shows dose-dependant; Human amniotic homogenate supernatant could promote the expression of the bFGF-mRNA in rabbit corneal epithelium cells in vitro, which is concentration related.

Abstract:AIM:To investigate a new approach of establishing rabbit bacterial infection keratitis model after laser in situkeratomileusis (LASIK), so as to provide reference for the diagnosis and treatment of the post-LASIK bacterial infection keratitis. METHODS:Twenty healthy adult rabbits were selected to perform LASIK on their right eyes, and inoculated with staphylococcus aureus after surgery. Examinations were performed at 12 hours, on the first, 3^rd, 5^th and 10^th days after surgery using ocular, digital slit-lamp and confocal microscopy. After 10 days operation, the corneas were collected for pathological examination. RESULTS:Eighteen eyes bacterial infection keratitis model post-LASIK were successfully established. The infectious infiltrates appeared as dots or spots at the shallow layer of stroma underneath the corneal flap at the early stage, and gradually merged together over the infection time. The infectious infiltrates also spread bi-directionally towards the corneal flap and the deeper stromal layer from the flap interface, where the corneal flap showed more severe infection than the deeper stromal layer. At the late period the infection caused the corneal flap melting or dislocation, corneal flap ulcer and perforation with hypopyon. CONCLUSION:It would be feasible to establish bacterial infection keratitis after LASIK. Bacterial infection would lead to serious pathological damage after LASIK.

Abstract:AIM:To observe the expression of Glia fibrillary acidic protein(GFAP) in Müller cells on mild blunt ocular trauma in rabbits.METHODS:Twenty rabbits(40 eyes) were randomly divided into two groups:normal control group, contusion group. The rabbit retina was injured by 3J energy contusion caused by a free falling iron bar hitting the cornea. The eyes were enucleated at different time and made as paraffin sections for GFAP immunohistochemistry staining. The positive rate and gray scale value of retinal GFAP expression were measured with computer image analysis system, and analyzed statistically with package of SPSS 12.0 for Windows.RESULTS:There was little brown positive GFAP stain in internal limiting membrane in normal control group. The GFAP stain strengthened at the first day after contusion. As times went by, the GFAP stain went through internal limiting membrane to nerve fiber layer, ganglionic layer, inner plexiform, outer nuclear layer and neuroepithelial layer, statistical analysis of average gray scale and positive area ratio of GFAP also presented that there was statistical significance between normal control group and contusion group(P<0.05).CONCLUSION:The intensity of GFAP expression continues to grow up gradually after ocular contusion. Müller cells gliosis have recovery function in the early stage after ocular contusion.

Abstract:AIM:To study the impact of two different phacoe- mulsification incisions on the surgically induced postoperative corneal astigmatism inage-related cataract patients.METHODS:Patients who had undergone the phaco-surgery from August 2011 to December 2011 were randomly divided into two groups. And those with incisions on the edge of the upper sclera (11∶00 to 12∶00) were group A, thirty cases 32 eyes. And group B, thirty-two cases (35 eyes) were those with the 3.2mm wide transparent cornea of the temporal side. In order to compare the impact of two different phacoemulsification incisions on the surgically induced corneal astigmatism in group A and B, we observed and measured carefully the corneal astigmatism status in various stages of pre-operation and post-operation (we sampling four stages:pre-surgery, one week, one month and three months after surgery) under the help of the corneal curvature instrument. All experimental data were showed by the means of average value±standard D-value. We adopted ttest to make statistical analysis, which means only when P<0.05 could those differences get statistical significance.RESULTS:By comparing the corneal curvature rate of those two groups in their stage of pre-operation and one week after surgery respectively, there was no significant difference and also no statistical meaning for their results P>0.05. However, the statistical comparison of the data got from the stage of one month and three months after surgery indicated that the surgically induced corneal astigmatism of group A was more significant than group B.CONCLUSION:The phacoemulsification incisions on the transparent cornea of the temporal side owns the advantages of relatively short time, minor surgical complications and less adverse effects on corneal astigmatism. 

Abstract:AIM:To evaluate the effectiveness and safety of nerve growth factor for the treatment of diabetic retinopathy(DR).METHODS:Patients diagnosed withDR at Peking University First Hospital from June 2010 to September 2010 were enrolled to receive nerve growth factor treatment. The nerve growth factor 30μg per day was injected by intramuscular for 21 days. LogMAR vision, mean defect and electrophysiological parameters including electroretinogram (EGR) and pattern visual evoked potential (P-VEP) were examined and compared before and after the treatment. Blood routine examination, urine routine, blood-fasting sugar, liver function, renal function before and after the treatment as well as other adverse events related to the treatment were also examined to evaluate the safety of the treatment. RESULTS:Twenty-four consecutive patients were enrolled to receive nerve growth factor treatment. There were 13 males (25 eyes) and 11 females (22 eyes), with an average age of 60.4 years. The average LogMAR vision were 0.32±0.31 and 0.28±0.35 (P=0.31) respectively before and after the treatment. Mean defect before and after the treatment were -13.11±7.57dB and -11.82±7.14dB. Dark flash electroretinogram(FERG) a wave after the treatment demonstrated shorter incubation period and increased amplitude than that before treatment although there was no statistical significance. The incubation period and amplitude of P100 wave were not improved after the treatment. Liver and renal function impairments were not noted and the main adverse event was pain and hard node at the site of injection, with an incidence of 59%.CONCLUSION:Nerve growth factor shows marginal success in therapy of nerve degeneration of DR, but further study should be conducted to expand the sample size. 

Abstract:AIM:To study efficacy and security of triamcinolone acetonide for the prevention of capsule opacification after cataract surgery of diabetic. METHODS:Totally 173 diabetic patients 296 eyes who received phaco +IOL in our hospital from March 2007 to September 2011 were randomly divided into three groups. Group A (102 eyes) received balanced salt solution, and group B (93 eyes) diluted triamcinolone acetonide liquid the water separator, C group (101 eyes) using a diluted triamcinolone acetonide water separation joint anterior chamber irrigation. After 1 week; 1, 3, 6, 12 months,the best-corrected visual acuity(BCVA), posterior capsule opacification (PCO) grading situation observed in patients. RESULTS:One week postoperatively, the difference between BCVA in group A and group B, C was statistically significant (P<0.05). The rest of time points, there was no significant difference betweengroups A, B and C(P>0.05). After surgery, PCO grading in group A had statistically significant difference compared with that in group B, C(P<0.01), PCO grading in group B and group C was lower than that in group A and PCO grading in group C was lower than that in group B (P<0.05 ).CONCLUSION:Water separation and anterior chamber wash of triamcinolone acetonide can effectively reduce the incidence rate of PCO after diabetic cataract surgery. 

Abstract:AIM:To compare the change of corneal endothelial cell density (ECD) and topography parameters after cataract phacoemulsification in eyes after antiglaucoma surgery and normal eyes.METHODS:Form January 2010 to December 2010, 200 eyes after phacoemulsification were divided into experimental group (after glaucoma surgery group) and control group (normal eye group) with 100 in each group. The ECD and topography parameters, including central corneal thickness (CCT) and corneal volume(CV), were examined preoperatively and 1 month and 3 months after surgery.RESULTS:Preoperatively, the mean ECD inexperimental group(1203±245/mm²) was significantly lower than that in control group(2648±167/mm², P<0.01), and the CCT and CV in experimental group(543±32μm and 59.14±2.79mm³) were significantly greater than those in control group(525±36μm and 57.26±3.24mm³; P<0.01, P＜0.05, respectively). One month and 3 months postoperatively, the mean ECD was significantly less while the CCT and CV were significantly greater in experimental group than those in control group(P＜0.01). However, no significant difference in the percentage of cell loss was found between groups at 1 or 3 months(P=0.1145, P=0.2018, respectively). The percentage increase in CCT and CV was significantly greater in experimental group than control group in 1 month(P=0.0142, P=0.0134, respectively), although there was no significant difference at 3 months(P=0.3562,P=0.4538, respectively).CONCLUSION:More sophisticated surgery and more refined surgical procedures are needed to minimize the damage to endothelial cells, and shorten the recovery time of corneal edema, and reduce the risk of corneal endothelial decompensation in cataract eyes after antiglaucoma surgery.

Abstract:AIM:Toevaluate the efficacy of pneumatic trabeculoplasty (PNT) compared with latanoprost 0.05g/L in primary open angle glaucoma (POAG) and ocular hypertension(OH).METHODS:In a randomized clinical study, a total of 30 patients(48 eyes) with POAG and OH were dividedinto two groups randomly. 12 patients (24 eyes) of group A and 18 patients (24 eyes) of group B underwent PNT and latanoprost 0.05g/L, respectively. And vision, intraocular pressure(IOP), vision field and retinal nerve fiber layer(RNFL) were evaluated.RESULTS:One to three months after treatment, the average IOP in group A degraded significantly(P＜0.01) , and the average IOP in B group degraded significantly (P＜0.01). 1-6 months after treatment, the number of eyes with IOP reduction ≥20% in group A was 79%, 62%, 50%, 25%, 12%, 0 respectively, and that in group B was 92%, 83%, 83%, 79%, 71%, 62% respectively, there was statistically significant difference between two groups from the third month. There was no statistically significant difference in vision, IOP, vision field and RNFL during the entire follow-up duration. There were transient conjunctival congestion and subconjunctival hemorrhage in group A, but they were absorbed in a week; there were 8 eyes with significant and persistent conjunctival congestion in group B, and irritation of different degrees in 5 patients(8 eyes). CONCLUSION:PNT and latanoprost eye drops can reduce the IOP of patients with POAG and OH, but there were less side effects in group A, and there was a persistent reducing IOP effect in B group. 

Abstract:目的:通过对肝肾阴虚型干眼症患者采用“复明片”加减联合睑板腺疏通法临床治疗的疗效观察,说明中西医结合治疗肝肾阴虚型干眼症可以收到良好的效果。方法:对符合干眼症诊断标准的400例患者的性别、年龄、症状、临床表现进行详细记录并进行严格的中医辨证分型,并对辩证为“肝肾阴虚”型的干眼症患者90例随机分三组治疗:A组30例给予“复明片”加减联合睑板腺疏通法加人工泪液治疗；B组30例给予睑板腺疏通法加人工泪液治疗；C组30例给人工泪液治疗。三组患者的自觉症状、泪液分泌试验（SchirmerⅠtest,SⅠt）、泪膜破裂时间（tear break-up time,BUT）、角膜荧光素染色(fluorescein staining,FL)和角膜地形图的角膜表面规则指数（surface regularity index,SRI）和角膜表面不规则指数（surface asymmetry index,SAI）结果作为观察指标,对观察数据进行统计分析,每组治疗前后行配对资料的秩和检验；对三组的疗效行多个样本间两两比较的秩和检验。结果:A组观察指标改善情况及疗效明显优于B,C两组；B组的又优于C组；三组的有效率分别是90.0%,73.3%和53.3%；结论:对肝肾阴虚型干眼症,采用“复明片”加减联合睑板腺管疏通术和人工泪液的治疗方法可以取得良好的治疗效果。睑板腺功能障碍（MGD）直接相关或合并MGD是干眼症的病因之一；同时角膜地形图可以协助诊断和评价干眼症的严重程度和治疗效果。 

Abstract:AIM:To explore the effect of planned capsule edge release in preventing anterior capsular contraction and contrast sensitivity function(CSF) after cataract surgery.METHODS:Forty-two eyes of thirty age-related cataract patients from July 2011 to September 2011 at our Center were treated with phacoemulsification and intraocular lens(IOL) implantation or manual nuclear fraction through small incision and IOL implantation. The capsulorhexis size was 5mm in diameter. The eyes were randomly divided into two groups:edge released group(n=20) and none edge released group(n=22). In addition, visual activity, the shape of anterior capsule, capsule hole in diameter and location of IOL were also observed in the current study. The CSF and glare sensitivity function(GFS) were measured with OPTEC 6500 under distance vision conditions (with spatial frequencies of 1.5, 3.0, 6.0, 12.0, 18.0c/d). Differences and characteristics among groups were compared and analyzed.RESULTS:In the day time without glare, there was a significant difference in CSF between edge released group and none edge released group at 1.5, 2.0c/d(all P<0.05) and edge released group higher than none edge released group. While in the day time with glare, a significant difference in CSF was also found between the two groups at 1.5, 18c/d(all P<0.05) and edge released group higher than none edge released group. There was no significant difference at all other spatial frequency between the two groups.CONCLUSION:Planned capsule edge release is found to be effective in limiting the degree of anterior capsular contraction, and maintaining the better CSF much longer.

Abstract:AIM:To assess efficacy, stability, and change in cylindrical degree and axis after real-time iris recognition combined with wavefront guided laser in situkeratomileusis (LASIK) for the correction of moderate or high myopic astigmatism.METHODS:In this prospective contrast study, 115 patients (211 eyes) with moderate or high myopic astigmatism were randomly divided into two groups:the experimental group (57 cases, 104 eyes) received real-time iris recognition combined with wavefront guided LASIK, and the control group (58 cases, 107 eyes) received conventional wavefront guided LASIK. The naked visual acuity, best-corrected visual acuity(BCVA), the degree and axis of astigmatism, wavefront aberration were compared between two groups at postoperative 1 month, 3 months and 6 months.RESULTS:In experimental group, static iris recognition detected that eye cyclotorsional misalignment was 2.61°±2.08°, dynamic iris recognition detected that the intraoperative cyclotorsional misalignment range was 0°-5°. Six months after operation, the naked vision of 96 eyes(92.3%) in experimental group and 78 eyes (72.9%) surpassed the preoperative BCVA of each group(P＜0.01); the degree of astigmatism in experimental group(-0.28±0.26D) was significantly lower than that in the control group (-0.44±0.35D) (P＜0.05). In experimental group, 49 eyes became non-astigmatism 6 months after operation and in control group 31 eyes. At 6mm pupil size, there was significant different in third order coma aberration between experimental group and control group(P＜0.01).CONCLUSION:Real-time iris recognition can compensate deviation from eye cyclotorsion and pupil centroid shift, more precise treatment for the degree and axis of astigmatism, and increase visual quality in LASIK.

Abstract:Cornea is a soft tissue of human, it has the features of stress-strain curve, stress relaxation curve and creep. As aviscoelastic tissue, it has the biomechanical properties such as elastic modulus, corneal hysteresis(CH), shear modulus and lag effect. Nowadays, clinicians pay more attention to the correlation between corneal biomechanics and clinical application. Ocular response analyzer(ORA) is more convenient and practical than other methods in measuring corneal biomechanics, so it is widely used in clinic. For instance, assessing photorefractive keratectomy surgery, keratoconus, glaucoma and so on. The biomechanical features, development in measuring methods and clinical application are reviewed.

Abstract:Painful ophthalmoplegia syndrome, the Tolosa-Hunt syndrome(THS), is characterized by unilateral involvement of the IIIrd, IVth and VIth cranial nerves, as well as supra- and retro-orbital pain. The etiology is unknown, possibly related to immunodeficiency reaction, also, some scholars believe that it is related with non-specific inflammation of the superior orbital fissure or vascular lesions. The ocular symptoms vary depending on the scope, impact and severity degree of the nerve. Painful ophthalmoplegia syndrome is rare in clinic and easily misdiagnosed as ophthalmoplegic headache. Clinical diagnosis is difficult, while adrenal cortical hormone is effective in treatment. We made a review on the etiology, clinical characteristics, diagnosis, differential diagnosis and treatment of painful ophthalmoplegia syndrome.

Abstract:Thelacrimal duct obstruction is a common disease in ophthalmology, especially the nasolacrimal duct obstruction. It can be treated by probing of lacrimal passage and acryocy storhinostromy traditionally, and its curative effect is sure. With the development of endoscopic, a minimal invasion surgery method was born. In recent years, new lacrimal equipment appearance, lacrimal stent, laster or high-frequency electric applied widely in clinic. Lacrimal duct probing new lacrimal stents and other auxiliary curative''s effect are affirmation. Now at home and abroad a few hospitals carried out a minimally invasive surgery technology (lacrimal duct endoscopy) without changing the original structure. It is used in diagnosis and treatment on nasolacrimal duct obstruction. This microscopic technique in nasal lacrimal duct obstruction diseases has good development prospect. 

Abstract:Anterior segment optical coherence tomography(AS-OCT)is a new kind of scanning technology. Based on coherent light scanning, it gets anterior segment histology images and precise tissue data, including corneal, anterior chamber, lens data and intraocular lens. It is applied to ametropia, corneal diseases, cataract and glaucoma. It is the main anterior segment disease clinical measurement and effective evaluation method.

Abstract: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. 

Abstract: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.

Abstract: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.

Abstract: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.

Abstract: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.

Abstract: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.

Abstract: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.

Abstract: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.

Abstract: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.

Abstract: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.

Abstract: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.

Abstract: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.

Abstract: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.

Abstract: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.

Abstract: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 .

Abstract: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 .

Abstract: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.

Abstract: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.

Abstract: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. 

Abstract: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.

Abstract: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.

Abstract: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.

Abstract:AIM:To investigate the prevalence situation of age-related cataract, cataract operation load and the situation of patients voluntarily accept the operation in Zhongshan City, and to establish appropriate intervention policy in order to better carry out the work of prevention and cure blindness.METHODS:Cataract epidemiology investigation were performed in ≥50 year-old permanent population by cluster sampling method in east, west, south, north, center 5 townships of Zhongshan City. All subjects were examined history, visual inspection, slit-lamp microscope to check whether the crystal is muddy. Based on cataract diagnostic criteria, local prevalence of cataract was known.RESULTS:In 66 034 subjects, cataract overall prevalence rate of ≥50 year-old subjects was 46.71%. The female prevalence was higher than male, and with the growth of age, prevalence of cataract increased significantly. Cataract surgery load capacity was 15.83%, the surgery acceptance rate of patients was 43.00%.CONCLUSION:Cataract surgery load is high, while the situation of patients voluntarily accepting the operation is low. Cataract blindness prevention is a long-term work, making appropriate intervention strategies and improving the surgery acceptance rate of patients.

Abstract:AIM:To discuss the effect of problem-based teaching(PBL) method in ophthalmology for postgraduates.METHODS:Traditional teaching method was used to teach grade 2009 postgraduates in ophthalmology (control group), while PBL was used to teach grade 2010 postgraduates (experimental group) to discuss the teaching effect of different methods.RESULTS:The score of specialized courses in the experimental group was higher than that in the control group, the satisfied rate of teaching effect was also higher.CONCLUSION:PBL is worthy to be popularized in the teaching of specialized courses for ophthalmological postgraduates.

Abstract:AIM:To explore the effective surgical treatment of iritis complicated with cataract pupil adhesion.METHODS:Totally 21 cases(27 eyes) with iritis complicated with cataract and pupil adhesion were collected, all pupil diameter <4mm after tropicamide eye drops dilating the pupil. There were visual acuity of light perception to 0.2 and optical positioning uncertainty 1 case (1 eye), corneal old KP (+) 15 eyes, aqueous flare (-), pupil extensive posterior adhesions 3 eyes, occlusion of pupil 2 eyes and iris bombe high intraocular pressure 2 eyes. After separating the adhesions iris, tweezers tearing the pupil area or edge of the pupil machine membrane, fiber iris retractors dilated the pupils and conventional phacoemulsification were carried out. The postoperative reaction and visual acuity were observed.RESULTS:Visual acuity of postoperative 1 month, 25 eyes all improved compared with preoperation (93%), better than 0.5 in 16 eyes(59%), 0.3 to 0.5 in 5 eyes(19%), 0.1 to 0.3 in 3 eyes(11%), worse than 0.1 in 2 eyes, no change in 1 eye(complicated with optic nerve atrophy). Postoperative pupil was almost physiological round in 20 eyes (74%), irregular in 7 eyes (26%). There were 6 eyes (22%) pupil diameter> 7mm, 2 eyes(7%) of glare.CONCLUSION: Phacoemulsification combined with microscopic iris retractors dilating pupil can successfully completed iritis complicated with cataract pupil adhesion. Postoperative visual acuity and visual function significantly improve. It is an effective treatment. 

Abstract:AIM: To observe the clinical effect of small - incision extracapsular cataract extraction ( ECCE ) with posterior chamber intraocular lens implantation combined with goniosynechialysis and trabeculectomy for the treatment of chronic angle-closure glaucoma with cataract. METHODS:Twenty cases (26 eyes) with chronic angleclosure glaucoma and cataract were performed combined surgery. The postoperative visual acuity, intraocular pressure ( IOP ), anterior chamber angle, filtering bleb morphology and complications were all observed and reported. The follow-up was 4-10 months. RESULTS:All the patients' visual acuity were improved in different degrees, All eyes had normal IOP. The angleclosure can be partly opened and the range of goniosynechia can be decreased after surgery. Twenty - two eyes had functional filtering bleb. The major complications were anterior chamber hemorrhage and transient corneal edema. CONCLUSION:Combined surgery for the treatment of chronic angle - closure glaucoma with cataract can effectively control IOP and improve visual acuity. It is safe and effective.

Abstract:AIM:To evaluate the cause and therapy for secondary glaucoma following vitrectomy.METHODS:Twenty patients with secondary glaucoma following vitrectomy were analyzed retrospectively. In order to determine the cause of secondary glaucoma, intraocular pressure(IOP), ultrasound biomicroscopy(UBM) and chamber-angle microscopy were taken, according to the different cause of secondary glaucoma, drug or surgery was selected.RESULTS:The IOP elevation occurred mostly within two weeks to three months. The IOP was 30-50mmHg. The angle closed in 15 patients with the examination by chamber angle microscopy and UBM the others remained open. The main cause of secondary glaucoma included long-time applying topical steroid, iris neovascularization and anterior inflammation and hemorrhage.CONCLUSION:Secondary glaucoma following vitrectomy is a complicated complication. The different therapy may select according to the different cause.

Abstract:AIM: To analyze the factors and prognosis of delayed choroidal hemorrhage after glaucoma surgery.METHODS: Analysis of the cases of delayed choroidal hemorrhage after glaucoma surgery happened in our hospital during April 2003 to December 2009.RESULTS: There were 9 cases(9 eyes) of delayed suprachoroidal hemorrhage, 2 cases with high myopia, 3 cases with infantile glaucoma, 2 cases with complex glaucoma combined anterior chamber intraocular lens removal surgery, 1 case without vitreous body, another elder case with systemic vascular disease. It was all happened in 1-7 days after trabeculectomy. They were all treated with drug therapy at the early stage, 1 case accepted surgery at postoperative 11 days and the suprachoroidal hemorrhage was successfully drainaged. Other 8 cases with hemorrhage were spontaneously absorbed. After the follow-up of 14 months, no eyeball atrophy was reported and visual acuities were no significant change except 1 case of 1.0, the other 3 cases of infant can''t act in concert with examination. Intraocular pressure increased again in 4 cases at 1-12 month.CONCLUSION:Risk factors for delayed suprachoroidal hemorrhage may include prolonged high intraocular pressure before surgery, intraocular pressure suddenly dropped intraoperatively, sustained low intraocular pressure, eyes with no vitreous body, excessive myopia, complicated glaucoma, infantile glaucoma. Delayed suprachoroidal hemorrhage can firstly treated by medicine. If the hemorrhage still can not be absorbed, surgery of drainaging suprachoroidal hemorrhage can be considered to improve the prognosis.

Abstract:AIM:To analyze the etiology and the treatment of sudden high intraocular pressure (IOP) during phacoemulsification.METHODS:Three of 408 cases (557 eyes) with cataract suffered high IOP during surgery were treated by intravenous drip of 200g/L mannitol. Two cases(2 eyes) with hypertension lowered the blood pressure. The corrected visual acuity, IOP and corneal edema of postoperative 1day, 1 week were recorded.RESULTS:The IOP of 1 case (1 eye) with capsular block syndrome and 2 cases (2 eyes) with infusion misdirection syndrome decreased after treated by medicines. All the 3 cases successfully completed the phacoemulsification surgery and intraocular lens implantation. 3 cases had better postoperative corrected visual acuity and normal IOP. The classification of corneal edema was level 2 at postoperative day 1 and level 0 at postoperative 1 week.CONCLUSION:Intravenous drip of hyperosmotic agent is an effective treatment to decrease the high IOP during surgery.

Abstract:AIM:To compare the differences of central corneal thickness (CCT) measured by optical bio-measurement, Wavelight anterior segment analyzer, Galilei anterior segment analyzer, optical coherence tomography (OCT) and A-mode ultrasonic pachymeter(USP).METHODS:All 74 cases (147 eyes) with myopia were examined before refractive surgery with more than five kinds of instruments respectively, the results were compared with USP. RESULTS:CCT measured by USP was 537.52±3154μm, 535.32±29.74μm by the optical bio-measurement, which was 2.20±7.29μm less than USP（t=3.67,P<0.01）. CCT was 542.51±30.21μm by Wavelight, which was 4.99±10.45μm more than USP（t=-5.79,P<0.01）. CCT was 546.48±27.38μm by Galile, which was 895±10.44μm more than USP（t=-10.40,P<0.01）. CCT was 530.33±28.61μm by OCT, which was 7.20± 7.69μm less than USP（t=11.35,P<0.01）. There were significantly statistical differences between these four methods and USP.CONCLUSION:On CCT measurement, there is difference between 4 types of instruments and A scan measurement outcome. They can not instead each other, but as raference.

Abstract:AIM:To evaluate the effect of sodium hyaluronic eye drops on the regularity of corneal surface in dry eye patients.METHODS:We examined 52 cases (91 eyes) who were disbelieved as keratoconus or keratoconus at sub-clinical stage with SchirmerⅠtest (SⅠt) and tear film stability, then used Humphrey corneal topography system to examine corneal irregularity measurement(CIM), shape factor(SF) and mean toric keratometry(TKM) before and after instillation of sodium hyaluronic eye drops.RESULTS:The results of SⅠt were less than 10mm and BUT less than 10s in 54 eyes, there were obvious differences of CIM and SF before and after instillation of sodium hyaluronic（P<0.01）, and no obvious differences of TKM before and after instillation of sodium hyaluronic（P>0.05）. The results of SⅠt and tear film stability were normal in 37 eyes, there were no obvious differences of CIM, SF and TKM before and after instillation of sodium hyaluronic.CONCLUSION:Sodium hyaluronic eye drops can smooth the corneal surface and reduce the false positive rate of corneal topography.

Abstract:AIM:To study the clinical effect of compound anisodine hydrobromide injection for the treatment of anterior ischemic optic neuropathy (AION) on microperimetry.METHODS:Totally 66 cases (107 eyes) with AION were treated by subcutaneous injection of the affected side next to the superficial temporal artery 2mL, 1 time/day, a course of 10 days. The basic courses were 4, according to the condition it can increase 2-3 courses. Fundus optic disc morphology and changes of visual function were observed in order to reflect the clinical value.RESULTS:Vision recovery had significant effect in 55% cases after subcutaneous injection of the affected side next to the superficial temporal artery for 4 courses. The 1^st and 2^nd courses compared with the 3^rd and 4^th courses, visual field defect degrees improved significantly(P<0.05) and the visual function in the 4^th course of subcutaneous injection of the affected side next to the superficial temporal artery recovered best.CONCLUSION:Compound anisodine hydrobromide injection can effectively improve the visual acuity and visual field defect degrees in AION patients, which is convenient, fast and safe.

Abstract:AIM:To measure the concentration of nitric oxide (NO) in serum and aqueous humor of the peseudoexfoliation glaucoma (PEG) patients and to study its possible role in the pathogenesis of PEG.METHODS:The NO concentration in serum and aqueous humor of PEG patients (experimental group) and cataract patients(control group) was detected by nitric acid reductase method.RESULTS:The NO level in serum and aqueous humorin experimental group were obviously lower than that of in control group (P<0.01) .CONCLUSION:The decrease of NO concentration in serum and aqueous humor of PEG patients may be one of reasons of filtration resistomce increase.

Abstract:AIM:To investigate the efficacy ofretrograde excision and embedding plus limbal stem cell autograft for recurrent pterygium.METHODS:Fifty-six cases (56 eyes) with recurrent pterygium received retrograde excision surgery with the head of pterygium embedded in the inferior conjunctiva. Then, the limbal stem cell autograft was transplanted to the corneoscleral wound.RESULTS:The corneal wound of 53 cases was smooth without any infiltration of fibrovascular tissues during the follow-up period for 8-24 months postoperatively 3 cases recurred.CONCLUSION:The efficacy of retrograde excision and embedding pluslimbal stem cell autograft for recurrent pterygium is definite and this surgery can prevent the recurrence of pterygium effectively. As it is easy to operate and can alleviate the symptoms of postoperative discomfort, this surgery should be widely applied.

Abstract:AIM:To evaluate the long-term efficacy in eyes that had been treated with rotation conjunctival flap for pterygium by the postoperative follow-up, and to explore the incidence and causes of recurrence.METHODS:Totally 66 cases (71 eyes) of pterygium which had been operated by this way were followed up for an average of 3.85 years, observed the situation of out of shape filling with the cornea and conjunctival blood vessels of the eyes after surgery, the congestion situation in the location of the canthus wrinkles fold as well as eye movements to determine the effect of surgery.RESULTS:During the follow-up of 14 months to 9 years, 58 eyes were cured, 12 eyes were basically cured, 1 eye recurred, surgical recurrence rate was 1.4%.CONCLUSION:Rotation conjunctival flap can effectively prevent the recurrence of pterygium, which is an ideal method and can be widely used in clinic. 

Abstract:AIM:To study the pathological changes in the inferior oblique muscles and the medial muscles of V-pattern exotropia with inferior obliqued overation. METHODS:The inferior oblique muscles and the medial muscles were cut from V-pattern exotropias with inferior obliqued overation during strabismus operation treated as the strabismus group. Cross sections were stained by HE method for observing the pathological changes with light microscopy and measuring the cross-sectional area of myofibers. The inferior oblique muscles and the medial muscles were obtained from the corneal transplant donors (6 cases 6 eyes), which were treated as the control group.RESULTS:Myofibers morphology of the inferior oblique muscles of the strabismus group were presented slightly hypertrophy, hyperplasia, thicknesses differently, arranged irregularly, stripe structure obscured, and some myofiber nucleus adduction, hyaline degeneration, and a few of collagenous fibers hyperplasia. The average cross-sectional area of myofibers was 854.1±64.8μm² in the strabismus group, whereas there was no statistical difference between the control group (719.7±80.4μm²) and the strabismus group (P>0.05). Myofibers morphology of the medial muscles of the strabismus group were also founded stripe structure obscured,with some myofiber nucleus adduction, nucleus adduction and hyaline degeneration. And it mainly expresses for the decreas of myofbers, arranged loosely and irregularly, gap increased and collagenous fibers hyperplasia. The average cross-sectional area of myofibers was 324.9±633μm², while it was greatly reduced comparing with the control group(690.8±67.3μm²,P<0.05). CONCLUSION:Both of the inferior oblique muscles and the medial muscles in V-pattern exotropia with inferior obliqued overation patients showed the remarkable pathological changes.

Abstract:AIM:To summarize the complications and solutions of retrograde lacrimal dilated drainage tube implantation for the treatment of nasolacrimal duct obstruction and chronic dacryocystitis.METHODS:Totally 110 cases (113 eyes) diagnosed with nasolacrimal duct obstruction or chronic dacryocystitis were treated with retrograde lacrimal dilated drainage tube implantation. Complications from postoperation to removing the drainage tubes 4 months were observed.RESULTS:There were 26 eyes（23.0%）with difficulty in removing tubes, 5 eyes（4.4%）with drainage tube invisible in nasal cavity, 3 eyes（2.7%）with drainage tube exfoliated, 1 eye（5.9% of B tube）with lacrimal caruncle punctured, 7 eyes （6.2%）with lacrimal canaliculus stenosis, 5 eyes （4.4%）with lacrimal passage reflux.CONCLUSION:The retrograde lacrimal dilated drainage tube implantation is effective and safe for the treatment of nasolacrimal duct obstruction and chronic dacryocystitis. Only the physician operates seriously, carefully and softly, it will reduce many complications and improve the cure rate. 

Abstract:AIM:To explore the causes of dacryocystorhinostomy failure and the clinical therapeutic effects of reoperation.METHODS:Seventeen cases (17 eyes) with failure dacryocystorhinostomy were reoperated. The causes of the first operation failure were analyzed,and the reoperation skills and effects were explored.RESULTS:Patients were followed up from 4 to 12 months. All reoperations were successful. The main reason of failure was small bone hole and improper location,dacryocyst not fully incised, lower end of blind pouch and contact adhesion of anterior flap with posterior flap.CONCLUSION:Mastering the surgical skills and key points, correctly dealing with the problems of the first operation, the reoperation will be successful.

Abstract:AIM:To study the specificity of conjunctival blotting cytological examination in diagnosis of dry eye syndrome.METHODS:Totally 45 cases (90 eyes) with dry eye syndrome and 15 normal volunteers (30 eyes) were applied with conjunctival blotting cytological examination combined PAS staining. The number, morphology and change of conjunctival epithelial cells and goblet cells were observed．RESULTS:The normal volunteers presented the Nelson grade 0, the mild dry eye patients presented the Nelson grade 1, the moderate dry eye patients presented the Nelson grade 2, the severe dry eye patients presented the Nelson grade 3. The number of goblet cells was calculated, there was significant decrease in dry eye (mild:111.72±13.63/mm², moderate:53.66±6.15/mm², severe:10.18±3.2/mm²). The difference was statistically significant in the comparison of each groups（P<0.01）.CONCLUSION:The result of conjunctival blotting cytological examination is accurate and objective in diagnosis of dry eye syndrome. The method is worthy of promoting and applying.

Abstract:AIM:To compare the calculation method with diagnostic method in determining the power of rigid gas permeable contact lens (RGP), and to notice that diagnostic method is superior to calculation method.METHODS:Sixteen cases(31 eyes) with myopia or myopic astigmatism were fitted by diagnostic method, after wearing optometry combined with vertex conversion to determine the RGP diopter, then using the determined RGP base curves combined with steep add minus(SAM), flat add plus(FAP) principle and the vertex conversion to calculate the RGP refraction.RESULTS:In 31 eyes determined by calculating the RGP refraction, except 2 eyes' diopter were similar with diagnostic method, the other 29 eyes were all overcorrected, more than half (18/31) eyes were overcorrected ≥-0.50D. 30 eyes have corrected VA≥1.0 with RGP fitted with diagnostic method, while only 1 eye has corrected VA as 0.8.CONCLUSION:Calculation method can cause over correction of myopia in determining RGP power. The RGP power determined by diagnostic method is lower than that determined by calculation method.

Abstract:AIM:To summarize the nursing experience of posterior intraocular lens implantation for the correction of high myopia.METHODS:The whole nursing model was applied inposterior intraocular lens implantation for the correction of high myopia, including before, during and after hospitalization. Mental nursing, health education, general and opthalmologic nursing were carried out through the whole course.RESULTS:All 82 cases(163 eyes) got good vision without serious complications, and maintainedsatisfactory therapeutic effect during follow-up.CONCLUSION:The whole nursing model in posterior intraocular lens implantation for the correction of high myopia, providing comprehensive, whole staff, whole course humanistic nursing is very important for the success of surgery.

Abstract:AIM:Using MRI quantitative data analysis to study the vascularization of scleral cap-style of hydroxyapatite(HA) orbital implant on the basis of past research, and to evaluate the superiority of this operation.METHODS:Retrospectively analyzed the MRI manifestation of 26 cases of intraorbital HA orbital implantation. MRI (plain and enhanced) examination were performed at least once in 1-10 months after operation, and calculated the ratio of MRI(V_E/V_HA). V_E is the volume of enhanced area of orbital implant,and V_HAis the volume of orbital implant.RESULTS:No surgical complications occurred in the 26 cases of intraorbital HA orbital implantation, with 3 cases collected after 1 month, 5 cases after 2 months, 5 cases after 3 months, 7 cases after 4 months, and 6 cases after 5-10 months. Statistic processing shows that vascularization was obvious in the previous 5 months, but unchanged 5 months later.CONCLUSION:Enhanced MRI can precisely and quantitatively observe the degree and range of vascularization of orbital implant, the fully vascularization time of scleral cap-style of HA orbital implant is 5 months after operation.

Abstract:AIM:To investigate the effects and safety of pilocarpine for the treatment of anterior chamber hyphema.METHODS:There were 87 cases(87 eyes) with grade I and II anterior chamber hyphema in our hospital, which were randomly divided into experimental group and control group. The control group was treated by conventional method. The experimental group used conventional treatment and pilocarpine in additon. Secondary hemorrhage rate and blood absorption time during treatment were observed and analyzed.RESULTS:The secondary hemorrhage rate was no difference in two groups, while the blood absorption time was obviously shorter in experimental group.CONCLUSION:Pilocarpine eye drops is a safe and effective drug. It can shorten the blood absorption time effectively when timely use 2 days after anterior chamber hyphema stop bleeding, the secondary hemorrhage rate was not increased during the treatment. It is worthy of popularizing in clinic.

Abstract:AIM:To evaluate the effect of the treatment between gross stream irrigation and its combination with medical sponges used in corneal flap relocation during LASIK.METHODS:Totally 211 cases (418 eyes) from July 2011 to August 2011 in our hospital were collected. They were divided into 2 groups arranged by treatment order. The first group of 105 cases (208 eyes) used the gross stream irrigation to relocate the corneal flap while the second group of 106 cases (210 eyes) used the gross stream irrigation and medical sponges. The state of corneal flap, the best-corrected visual acuity (BCVA) and the patients'' feeling of glare were observed at the 1^st day, 1^st week and 1^st month after surgery.RESULTS:The two groups of patients were not observed any apparent replacement of corneal flap and ruffly corneal cap at the 1^st day, 1^st week and 1^st month after surgery. Three eyes in the first group were seen turtle pattern whereas two eyes were in the other group. We used Fisher''s exact probability and found there was no significant difference between the two groups (P＞0.05). The visual acuity of the two groups on the 2^nd day after surgery was 1.07±0.11 and 1.10±0.18 respectively. Univariate ttest indicated that there was no significant difference between the two groups. The postoperative uncorrected visual acuity (UCVA) is equal to the postoperative UCVA in both groups, and the patients feel well without glare.CONCLUSION:The postoperative effect of gross stream irrigation equals its combination with medical sponges used in corneal flap relocation during LASIK.

Abstract:AIM:To evaluate the antalgic effect of oral gabapendin for postoperative pain after photorefractive keratectomy(PRK).METHODS:Prospective randomized clinical trial at 88 cases undergone PRK. In additional to a standard regimen of topical antibiotics, topical steroids, and topical non-steroid Anti-Inflammatory Drugs (NSAIDs) at all patients, and 40 cases as trial group taken gabapendin protocol for herpes zoster after surgery.Patients completed a maximum pain assessment survey in postoperative 5 days using a pain scale (from zero to four, means 0= no pain,1=mild pain,2=moderate pain,3=severe pain, 4=worst severe pain.). The maximum pain values of postoperative 3 days were recorded.RESULTS:The recovery rate of pain questionnaire was 100%. In gabapendin group, there were 18 cases of 0 degree（45.00%）, 18 cases of 1 degree（45.00%）, 4 cases of 2 degree（10.00%）. In control group, there were 18 cases of 0 degree（37.50%）, 21 cases of 1 degree（43.75%）, 4 cases of 2 degree（8.33%）and 5 cases of 3 degree（10.42%）. Welch's test and Tukey post-hoc test showed no statistic significant difference between the gabapendin groups and control group in maximum pain score（P>0.05）.CONCLUSION:There was no additional contribution to PRK pain control under a postoperative standard regimen by oral gabapendin protocol in our experimental design. 

Abstract:AIM:To discovery the influence factors of infant dacrocystitis in order to provide science basis to the prevention and treatment of infant dacrocystitis. METHODS:A case-control study including cases and controls, who were matched by age and gender, was carried out in our hospital．Factors were analyzed using conditional Logistic regression.RESULTS:Multivariate analysis showed that birth way, birth order, nation and economic condition were main factors to affect infant dacrocystitis.CONCLUSION:Cesarean section delivery, the first birth, the Han rate and higher economic receive people are the main influence factors to infant dacrocystitis.

Abstract:AIM:To investigate the prevalence of visual impairment, severe visual impairment and blindness, leading cause of these impairments among adults aged ≥50 years in Haikou outskirts of Hainan.METHODS:Random sampling analysis was performed in 850 individuals chosen as the sample, aged ≥50 years in 30 villages of Sanya. Corrected vision, external eye, anterior chamber, lens, vitreous, fundus were examined by ophthalmologists. The prevalence of visual impairmen, severe visual impairment and blindness was calculated, and the main cause was analyzed.RESULTS:Totally 786 individuals among 850 were examined. The response rate was 92.47%, the prevalence of visualimpairmen, severe visual impairment and blindness is 2.67%, 0.64% and 2.54%, resulting chiefly from cataract, posterior segment ocular disease and corneal scar.CONCLUSION:The epidemiological results show that the main cause of visualimpairmen, severe visual impairment and blindness is cataract. But the other causes of blindness such as posterior segment ocular disease and corneal scar can not be neglected.