Abstract:AIM: To measure the interleukin-8(IL-8)and tumor necrosis factor-α(TNF-α)levels in vitreous samples obtained the patients undergoing pars plana vitrectomy(PPV)due to diabetic retinopathy(DR), then to compare these results with those of the control group and to state their impact on DR pathogenesis.

METHODS: From Istanbul Bilim University Ophthalmology Department, 57 eyes of 57 diabetes mellitus(DM)patients who had been diagnosed with proliferative diabetic retinopathy and 22 cases of macular hole, with no proliferative vitreoretinopathy were included in the study as the study and the control groups respectively. All of the 79 patients underwent a 3-port, 20 gauge PPV. Vitreous samples of 0.5mL were aspirated with vitrector at the beginning of the PPV operation before the intraocular infusion and being diluted. Samples were transferred to the freezer to be stored at -70℃. Results of IL-8 and TNF-α were calculated as pg/mL with ELISA method.

RESULTS: IL-8 levels \〖82.7891±74.08700(0.08- 307.09)pg/mL\〗 in which vitreous samples obtained DR patients during vitrectomy were significantly elevated when compared to IL-8 levels \〖2.9805±3.77546(0.08-18.53)pg/mL\〗 of control patients(P<0.001). Similarly, TNF-α level \〖18.0007±13.90015(2.32-51.11)pg/mL\〗 was also significantly elevated in DR patients when compared to control patients' TNF-α level \〖1.7005±1.26949(0.1- 5.17)pg/mL\〗(P<0.001).

CONCLUSION: The levels of TNF- α, which plays a role in retinal neovascularization, and, IL-8, which acts as an inflammatory and angiogenic mediator were found to be high in DR patients.

Abstract:AIM: To compare the efficacy of subthreshold micropulse diode(SDM)laser treatment and argon ion laser treatment for diabetic macular edema(DME).

METHODS: A prospective, randomized controlled trial was carried out in 84 patients(99 eyes), in which, 49 eyes received argon ion laser treatment and 50 eyes received SDM laser treatment. The changes in best corrected visual acuity(BCVA), baseline fluorescein angiography and optic coherence tomography measurements were evaluated in both groups. Follow-up visit was over 6 months from baseline.

RESULTS: Ninety-nine eyes(84 patients )complete the study. Six months after treatment, the BCVA improved 22.4% and 20.0% eyes in argon ion laser group and SDM laser group respectively. 55.1% and 58.0% eyes received steady BCVA. Edema partial regression was accounted for 49% in argon ion laser group, while that was 56% in SDM laser group. No statistically significant changes were found in each group.

CONCLUSION: No matter argon ion laser or SDM laser is effective to keep or improve the VA in DME. After 6-month follow-up, there is no statistically significant difference between them.

Abstract:AIM: To establish animal models of posterior capsule opacification(PCO)in New Zealand white rabbits and detect the expression of the Livin in PCO tissue.

METHODS:Thirty healthy adult New Zealand white rabbits were randomly divided into experimental group and control group. Ultrasonic phacoemulsifications were performed in the 25 experiment rabbits under intramuscular injection anesthesia. The rabbits'eyes were examined by slit lamp microscope to observe the development of PCO after surgery and at 3d, 7d, 14d and 28d. The 5 rabbits in control group were executed to take the posterior capsule of right eyes. Reverse transcription polymerase(RT-PCR)and western-blotting were performed to detect the expression of Livin in PCO at different time points postoperatively.

RESULTS: Both RT-PCR and western-blotting method indicated that different levels of expression of Livin could be detected in the tissue of PCO in group B, C, D, E except control group and group A that instantly after surgery. The two methods indicated that Livin reached the peak in group C and decreased in group D, lower in group E and in group B reached the bottom.

CONCLUSION:The expression of Livin can be detected in the tissue of PCO in a certain similar time. The study indicated that Livin correlates with the pathogenesis of PCO. It may provide a novel tool for the investigation of gene therapy for PCO.

Abstract:AIM: To compare the effectiveness of different protein extraction method in the cataract lens protein extract, and look for the best protein extraction method suitable for cataract proteomics research.

METHODS: Cataract lens samples were dissolved in lysis buffer and sonication; the samples were extracted by TCA/acetone and protein extraction kit after centrifugation. Lens proteins of the samples were analyzed by two-dimensional electrophoresis(2-DE), gel electrophoresis and staining, image acquisition and image analysis.

RESULTS: According to the results obtained from two-dimensional electrophoresis gel image, the molecular weight of protein points were localized at 14-97.4kDa, PI5-9. The molecular weight of high abundance crystallins were localized at 20-31kDa, the molecular weight of lower abundance crystallins were localized at 35-45kDa. The 2-DE image background of cataract lens sample with hyaluronic acid extracted by TCA /acetone was clear, no obvious vertical bands, point of proteins were more clear, and 35 to 40 protein points were detected.

CONCLUSION: TCA/acetone extraction method has better purification compared to other methods in human cataract lens proteomics, and provides the reliable two-dimensional polyacrylamide gel Image for human cataract lens proteomics mass spectrometry analysis.

Abstract:AIM:To establish the model of age-related macular degeneration through blue light burning human retinal pigment epithelium(hRPE)cells in vitro and to investigate the possible mechanism of lycium barbarum polysaccharide(LBP)protecting the hRPE cells from blue light irradiation-induced damage.

METHODS: hRPE cells were cultured in Dulbecco's modified eagle's medium with high glucose and were pretreated with different concentrations(0.01mg/mL, 0.1mg/mL and 1mg/mL, respectively)of LBP solution, respectively. Further, hRPE cells were irradiated with different intensities(2000±500 LUX)of blue light(wave length 470-520nm)for 12h and the cellular morphology was observed by inverted phase contrast microscopy for every sample. Using flow cytometry, the alterations in the levels of reactive oxygen species, mitochondrial membrane potential and apoptosis were determined, respectively.

RESULTS: The level of reactive oxygen species in hRPE cells in blue-light treatment group was the highest, whereas the level in control group was the lowest. The fluorescent level of reactive oxygen species among different concentrations of LBP-treatment groups had specifically significant differences compared with that in blue light irradiation group(P<0.05). The amounts of apoptotic cells in different concentrations of LBP-treatment groups were specifically significant differences compared with that in blue light irradiation group(P<0.05); There were no apparent significant difference between 1mg/mL LBP-treatment group and normal control group(P>0.05).

CONCLUSION: LBP can efficiently inhibit apoptosis induced by blue light irradiation in hRPE cells and 1mg/mL of LBP has the strongest protective ability in blue light irradiation-induced damage in hRPE cells. The possible mechanism may attribute to the protective effect of LBP in inhibiting the overgeneration of reactive oxygen species and apoptosis in hRPE cells.

Abstract:AIM: To observe histopathology changes of spot regional in chinchilla rabbit's retina at different periods after frequency-doubled 532nm laser irradiation.

METHODS: Twenty healthy rabbits were randomly divided into two groups: 16 in group A(laser group)and 4 in group B(normal control group). According to different time after laser photocoagulation rabbits were divided into four subgroups: 1d, 1 week, 2 weeks, 1month, group A with 4 for each subgroup; group B with 1 for each subgroup. To observe the histopathologic changes we used fundus photograph, light microscope, electron microscope and spot diameter calculating in different time points.

RESULTS:(1)Fundus photography: the spot region changed from thick white edema appearance on 1d after the surgery to melanoma attachment by 1 month;(2)Light microscopy: the main damage spot region was concentrated in the outer retina after photocoagulation. Photoreceptor cell appeared necrosis and apoptosis. With the passage of time, glial cells, pigment cells filled injury regional, and fibrous proliferation was formed;(3)Electron microscope: after photocoagulation, structure of membranous disc blurred and arranged in disorder; mitochondrial cristae became vague, fracture or even disappear; obvious vacuolization appeared. It began to appear apoptosis after 1 week, and gradually the fibroblast proliferation appeared;(4)Spot size: the spot size was the maximum at 1d, then gradually became smaller, spot size down to 85% at one-week time, 80% at 2-week time, and 79% at one-month time.

CONCLUSION: Frequency-doubled 532nm laser irradiation of pigmented macular, spot reaction is most obvious at 1d and stabilized at about 2 weeks.

Abstract:AIM: To develope a type of absorbable punctal plug.

METHODS:To produce punctal plugs with polylactic acid. To model the dry eye rabbits by removing of the main lacrimal gland, the third eyelid and Harder's gland; To record the results of Schirmer test and the pyrogen test before and after the implantation of punctal plugs; Schirmer test and pyrogen test were performed before and after punctal plug implantation. The lacrimal plugs histocompatibility and the degradation time were also observed.

RESULTS: It can significantly improve the Schirmer test of dry eye rabbits to implant punctual plugs. No pyrogenic reactions had been discovered. Good histocompatibility was achieved and the plugs would degrade within 2 months.

CONCLUSION:The plugs produced by polylactic acid biodegradable material, which is widely used in biomedical fields, have no toxic effects on rabbits. It's safe and inexpensive, so it's valuable for further research and clinical application.

Abstract:AIM: To compare the clinic effects of implanting two kinds of artificial lens(Bigbag and US)in patients of high myopia with cataract.

METHODS: A total of 56 cases were studied retrospectively. Patients in group A(31 cases with 55 eyes)were implanted in Bigbag intraocular lens and patients in group B(25 cases with 40 eyes)were implanted in US intraocular lens. Best corrected visual acuity(BCVA), anterior chamber depth, and post operative complications were measured and compared 3 months after surgery.

RESULTS: There was no significantly difference between group A and B in BCVA 3 months after surgery. Anterior depth of group A was deeper than group B, which was statistically significant difference(P<0.05). Three month after surgery, patients in group A(5 eyes, 9.1%)who felt more floating shadows were less than patients in group B(10 eyes, 25.0%), which was statistically significant difference(P<0.05); The incidence of posterior capsule opacification(PCO)in group A(2 eyes, 3.6%)is less than patients in group B(3 eyes, 7.5%), which was statistically significant difference(P<0.05).

CONCLUSION: Bigbag has obvious advantages such as reducing complications and the incidence of PCO than US for patients of high myopia with cataract.

Abstract:AIM: To compare the prediction errors(PE)in cataract surgery with Lenstar and conventional ultrasound.

METHODS: The data of age-related cataract patients were retrospectively analyzed from March, 2013 to June, 2013 in our hospital. Preoperative measurements of ocular biological parameters and calculation of intraocular lens(IOL)degree using SRK/T's formula with ultrasound, keratometry and Lenstar were performed. Cataract extraction combined with IOL implantation in capsule was taken in every patient. Retinoscopy was taken postoperatively after 3 months. Comparison of the two inspection methods for measuring axial length, mean corneal curvature and postoperative refractive PE and absolute value of PE(APE).

RESULTS: Preoperative axial length was 24.68±1.70mm and 24.42±1.65mm with Lenstar and ultrasound, respectively, and there was significant difference(t=-12.688, P<0.001)and significant correlation(r=0.992, P<0.001)between different measurement, and the 95% LoA was in the range between -0.18mm and 0.69mm. Preoperative corneal curvature was 44.22±1.03D and 44.19±1.04D with Lenstar and keratometry, respectively, there was no statistical differences between two methods(t=-1.241, P=0.217), but was the significant correlation(r=0.963, P<0.001), and 95% LoA between 0.52D and 0.58D. PE was 0.05±0.23D and -0.35±0.76D with Lenstar and ultrasound, respectively(t=-5.494, P<0.001). APE were 0.18±0.14D and 0.56±0.62D with Lenstar and conventional ultrasound, respectively(t=6.379, P<0.001).

CONCLUSION: Accurate ocular biological parameters can be achieved with Lenstar, and postoperative PE is more precise with Lenstar compared with conventional ultrasound. Lenstar can be used for precise calculation of IOL degree in cataract operation.

Abstract:AIM:To observe the clinical curative effects of phacoemulsification aspiration and intraocular lens implantation for the treatment of high myopia with cataract.

METHODS: From January, 2011 to December, 2012, 110 patients with high myopia cataract were selected as the research objects in our hospital. They were randomly divided into observation group(emulsification aspiration and intraocular lens implantation group, n=56)and control group(conventional surgery group, n=54), the visual recovery and postoperative complications were observed in two groups and a comprehensive analysis were made.

RESULTS: This study showed: in observation group, 30 cases with the visual recovery back to above 0.5, 24 cases with the vision of 0.3-0.5, 2 cases with the vision of less than 0.3; In control group, 20 cases with the visual recovery back to above 0.5, 22 cases with the vision of 0.3-0.5, 12 cases with the vision of less than 0.3; The values were better than the control group, there was statistical significant differences(P<0.05). In observation group, 2 case was postoperative capsular membrane rupture, 2 cases were detached vitreous, the complication rate was 7.1%; In control group, 3 cases were postoperative capsular membrane rupture, 3 cases were detached vitreous, 2 cases were suspensory ligament rupture, the complication rate was 14.8%; there was statistical significance when compared observation group with the control group(P<0.05). The study showed: the observation group in postoperative refractive deviation <±0.50D in 46 cases(82.1%), refractive error value >±0.50D in 10 cases(17.9%), the control group with postoperative refractive deviation <±0.50D in 38 cases(70.4%), refractive error >±0.50D in 16 cases(29.6%), compared to the observation group and the control group, the difference was statistically significant(P<0.05).

CONCLUSION: The curative effects of phacoemulsification aspiration and intraocular lens implantation for the treatment of high myopia with cataract is effective, and it has the advantages of small incision, less intraocular tissue injury and short postoperative visual function recovery time. Therefore, it is an effective and safe treatment for high myopia with cataract, and it is recommended in clinical application.

Abstract:AIM: To survey the application of dynamic contour tonometer(DCT)in normal tension glaucoma(NTG)patients, primary open angle glaucoma(POAG)patients and healthy controls. And to analyze the factors that influence the ocular pulse amplitude(OPA).

METHODS: In this case-control study, twenty NTG patients, twenty-one POAG patients and twenty health people were included in the study. Intraocular pressure(IOP)was measured in each group with GAT and DCT. Correlation between the value of IOP measured with DCT and GAT were analyzed. Meanwhile, central corneal thickness(CCT), axial length(AL), systolic blood pressure(SBP), diastolic blood pressure(DBP)and heart rate(HR)were also measured to evaluate the influencing factor of OPA.

RESULTS: There were significant statistical differences of IOP, OPA, SBP and DBP among NTG patients, POAG patients and healthy controls. There were no significant statistical differences of CCT, AL and HR among those subjects. The OPA were 1.7±0.9mmHg in NTG patients, 2.8±0.7mmHg in POAG patients and 2.4±0.6mmHg in normal controls. There was no significant statistical difference of OPA between POAG patients and normal controls(P=0.502), whereas significant statistical difference of OPA between POAG patients and NTG patients(P=0.001)was observed. Significant statistical difference of OPA between NTG patients and normal controls(P=0.005)was detected. The results of Pearson correlation analysis showed that there was significant correlation between OPA with AL, SBP and DBP(P<0.05). No significant correlation was found between OPA with IOP, HR and CCT(P>0.05).

CONCLUSION: There are differences of OPA among NTG patients, PAOG patients and normal controls. And OPA is influenced by AL, SBP and DBP.

Abstract:AIM: To compare unilateral lateral rectus recession surgery and unilateral small lateral rectus recession combines with small medial rectus shortening surgery treatment efficacy for small strabismus degree of basic intermittent exotropia.

METHODS: The 73 cases of small strabismus degree(strabismus degree in -15～-30PD)of basic intermittent exotropia hospitalized patients were analyzed retrospectively. The selected cases are divided into A, B groups: Group A underwent unilateral lateral rectus recession surgery; Group B unilateral small lateral rectus recession combines with small medial rectus shortening surgery. Eyes position, the same time visual, fusion visual, far and near stereoscopic visual postoperative follow-up 6 months were observed and analyzed in both groups.Compare postoperative eyes position anteroposterior rate, undercorrection rate and overcorrection rate; Compare binocular vision recovery rate, undercorrection rate and overcorrection rate. Compare relationships between age and binocular vision recovery rate.

RESULTS: Postoperative anteroposterior ratio of eye position follow-up 6 months: group B was significantly higher than that of group A and difference between the two groups is statistically significance. Postoperative follow-up 6 months binocular fusion function, far and near stereoscopic visual function recovery rate, group B was significantly higher than that of group A and difference between the two groups is statistically significance(P<0.05); Postoperative follow-up 6 months age and single eyes visual function recovery rate: binocular fusion function, far and near stereoscopic visual function recovery rate, 4-12 years old group are higher than 13-30 years old group, difference between the two age groups is statistically significance(P<0.05).

CONCLUSION: Using unilateral small lateral rectus recession combines with small medial rectus shortening surgery curative effect for the treatment of small strabismus degree of intermittent exotropia. Postoperative anteroposterior ratio eye position, binocular single visual function recovery rate are better than unilateral lateral rectus recession surgery; Early surgery is more advantageous to the binocular visual function recovery.

Abstract:Gene therapy has increasingly shown a significant role in clinical trials in recent years, and has become a new treatment for the central nervous system diseases which conventional methods are difficult to cure. Herpes simplex virus(HSV), a common human natural pathogen, has a natural neural tropism and can naturally infect post-mitotic neurons from retrograde infection of peripheral nerves into the central nervous system(CNS)and has a long-term incubation. Therefore, HSV can be used as a means of delivery of exogenous genes. The optic nerve belongs to the CNS, thus, HSV vectors may be considered for gene therapy after optic nerve injury. In this paper, we reviewed the research progress of HSV as a vector for gene therapy after CNS injury and explained the feasibility of HSV for gene repair after optic nerve injury.

Abstract:Herpes simplex keratitis(HSK)is the leading cause of infectious blindness. In general, diagnosis of HSK is based on clinical findings, which often are not confirmatory. With the development of molecular biology, a variety of laboratory methods that helped in achieving a diagnosis including in vivo confocal microscopy(IVCM), loop-mediated isothermal amplification(LAMP), real-time polymerase chain reaction(rt-PCR), nested PCR and multiplex PCR. They are considered as accurate and fast diagnostic techniques, thus characteristics of these are reviewed in this paper.

Abstract:This paper reflected upon the clinical confusion over the classification and definition of primary angle-closure glaucoma proposed by International Society of Geographical and Epidemiological Ophthalmology(ISGEO). It is pointed out that lack of unified standards for glaucoma is the root of the confusion, and a preliminary discussion is made on the definition of glaucoma.

Abstract:Retinopathy ofprematurity(ROP)is one of the major cause of childhood blindness worldwide. Previously, the treatment for ROP for the patients at the threshold period and before high-risk period is mainly the retinal laser and cryotherapy. However, cryotherapy and laser therapy are destructive, which can inevitably result in permanent peripheral field loss and more complications. Some patients' states of illness can't be controlled after surgery and end with total loss of vision. Hence, a new treatment method should be explored. Recently, many clinical data showed that anti-vascular endothelial growth factor therapy may be effective in treating retinopathy of prematurity. This article reviewed the recent literature on the research and progress of anti-vascular endothelial growth factor(anti-VEGF)drugs in the treatment of retinopathy of prematurity.

Abstract:Apoptosis of retinal ganglion cells(RGCs)is an important step in the mechanism of a variety of diseases such as glaucoma, diabetic retinopathy, optic neuritis etc. In these diseases, oxidative stress induces the aopoptosis of RGCs. In recent years, many experimental studies have found that anti-oxidative stress drugs have a powerful protective efficacy in RGCs. This article reviewed the recent advances in the researches on oxidative stress-induced apoptosis of RGCs and related anti-oxidative stress drugs.

Abstract:With the rapid development of information era, video display terminal(VDT)has entered people's lives, and the operator's health problems have been recognized, which is so called VDT syndrome. At the same time, the frequency of children's exposure to the VDT is higher and higher. Childhood is the critical period of visual development. As the data show that the excessive use of VDT can cause eye fatigue, myopia, dry eye, abnormal blinking, headache and other symptoms. In this article, we will talk about the symptoms, mechanism, and the prevention and treatment of children's VDT syndrome.

Abstract:AIM: To assess the safety and efficacy of combination therapy using anterior stromal puncture(ASP)and bandage contact lens for recurrent epithelial defects.

METHODS: ASP was used as a treatment for 23 eyes of 22 outpatients with recurrent epithelial defects. At the mean time, they wore bandage contact lens and used eyedrops. All patients report foreign-body sensation, blepharospasm, tearing and photophobia in the morning or evening, some with visual impairment. ASP was performed on every patient with a self-made 41/2 needle under surface anesthesia. The patients worn contact lens after the surgery. We observed symptoms of foreign-body sensation, photophobia, vision,epithelial and stromal scar healing at 3d; 1,2,4,8,12wk. The average follow-up period was 3 months, range 4wk-10mo.

RESULTS: Twenty-two eyes became completely asymptomatic and 19 eyes(83%)were once cured.

CONCLUSION:ASP with bandage contact lens turns out to be an effective, convenient, economical and repeatable therapeutic option for patients with recurrent epithelial defects, which can control the severe foreign-body sensation quickly.

Abstract:AIM: To explore vision effect and safety for implanting the ultrasonic emulsification gettering combined artificial lens in Ⅱ diabetes patients with cataract.

METHODS: Atotal of 103 cases(112 eyes)Ⅱ diabetes patients with cataract treated in our hospital were as observation object, and 100 cases(110 eyes)of elderly patients with pure without diabetes cataract were for comparison, with the same set for medical ultrasound emulsification gettering technique combined IOL implantation, two groups in the near future vision, long-term vision and complications were compared.

RESULTS: Vision in the observation group patients after 1d, 1 week and preoperative had obviously improved(Z=7.63, 8.59, P<0.05), Vision in the control group patients after 1d, 1 week and preoperative had obviously improved(Z=5.36, 4.38, P<0.05); observation group after 1d, 1 week vision had obviously improved compared with the control group(Z=5.48, 4.68, P<0.05), best corrected visual acuity in observation group was better than the control group, the difference was statistically significant(Z=8.987, P<0.05); observation group after 1 month, 3 months visual acuity were lower than the control group, the difference were statistically significant(Z=13.21, 11.48, P<0.05), and there was no significant difference between the two groups 6 months postoperatively(Z=3.141,P>0.05).

CONCLUSION: Using ultrasonic emulsification combined IOL implantation for Ⅱ diabetes patients with cataract in good glycemic control can significantly improve patients visual acuity and found no obvious complications, curative effect is reliable.

Abstract:AIM: To study the clinical effectiveness of trabeculectomy combined with small incision extracapsular cataract extraction and intraocular lens(IOL)implantation for the treatment of primary open angle glaucoma coexisting with cataract.

METHODS: A total of 34 eyes of 34 patients with primary open angle glaucoma and cataract had trabeculectomy combined with small incision extracapsular cataract extraction and intraocular lens implantation from January 2011 to January 2013. The postoperative visual acuity, intraocular pressure(IOP), filtering bleb and complications were observed.

RESULTS: The follow up duration was 6-24 months. The best corrected visual acuity(BCVA)was 0.1～<0.3 in 4 eyes(12%)and 0.3～1.0 in 30 eyes(88%). The postoperative IOP was 14.7±0.8mmHg at postoperative month 6. The functional filtering blebs were presented in 34 eyes in the first week and 28 eyes after 6 weeks, the filtering blebs were not obvious in 4 eyes, and encapsulated filtering blebs were presented in 2 eyes. Postoperative complications included corneal edema in 12 eyes(35%), fibrous exudates in 5 eyes(15%), shallow anterior chamber in 6 eyes(18%)and after cataract in 6 eyes(18%).

CONCLUSION: Trabeculectomy combined with small incision extracapsular cataract extraction and IOL implantation are effective as an initial surgical treatment for open angle glaucoma patients coexisting with cataract.

Abstract:AIM: To evaluate the characteristics, safety and effectiveness of phacoemulsification with complicated cataract after vitrectomy surgery.

METHODS:Thirty-nine patients(39 eyes)with complicated cataract after vitrectomy were operated by phacoemulsification, among which 23 eyes after silicon oil tamponade were combined with silicon oil removal. Preoperative and postoperative best corrected visual acuity(BCVA)and complications were recorded. The mean follow-up period was 10 months, with the range from 3 to 24 months.

RESULTS:There were no serious surgical complications. Postoperatively, BCVA improved in 37 eyes(95%), and did not change in 2 eyes(5%). No decreased visual acuity was observed on the patients. One case had recurrent retinal detachment at two weeks after silicon oil removal, and one case had vitreous hemorrhage at one month. Both eyes were treated with vitrectomy and silicon oil tamponade and were cured. Postoperative complications, such as choroidal hemorrhage, ocular hypotension and so on were not observed.

CONCLUSION: Cataract is complicated and surgery can be much more challenging after vitrectomy. Phacoemulsification is safe and effective for complicated cataract in vitrectomized eyes.

Abstract:AIM: To evaluate the effect and safety in the treatment of neovascular glaucoma(NVG)by using intravitreous injection of bevacizumab combined with Ex-press miniature glaucoma device implant with MMC.

METHODS: Nineteen eyes of 18 patients with angle-closure NVG were treated by intravitreous injection of bevacizumab combined with Ex-press miniature glaucoma device implant with MMC after atrophy of iris neovascularization. The regressions of iris neovascularization, changes of intraocular pressure, characters of filtering bleb and complications of intravitreous injection and surgery were observed in a 12 months follow-up period.

RESULTS: Iris neovascularization was completely regressed during 2-7d after injection in 16 eyes. There was no significant difference between before and after injection. The IOPs of 11 eyes were less than 21mmHg without any drugs and of 5 eyes with 1-2 kinds of anti-glaucoma drugs after combined Ex-press implant. No serious complications were observed after intravitreous injection and ex-press implant with MMC.

CONCLUSION: Intravitreous injection of bevacizumab could significantly reduce the regression of iris neovascularization, avoid haemorrhage during subsequently Ex-press implanting, relieve postoperative inflammation. It improves the successful rate of Ex-press implant with MMC and remains visual function. However, the treatment of the protopathy and potential medical treatment risk of intravitreal bevacizumab should be mentioned.

Abstract:AIM: To compare the efficiency of intravitreal injection of triamcinolone acetonide(TA)or general treatment for the treatment of macular edema in retinal vein occlusion.

METHODS: Seventy-five eyes of 75 patients with macular edema of retinal vein occlusion were diagnosed by examination of regular inspection, fundus fluorescein angiography(FFA)and optic coherence tomography(OCT). There were 31 patients in general treatment group and 44 patients in TA group. There were no significant differences between the two groups with regards to patient's age, duration of disease, intraocular pressure(IOP), best-corrected visual acuity(BCVA), central macular thickness(CMT)at baseline. Comprehensive ophthalmic evaluation was performed at baseline and at week 4 and 12 after treatment. Main outcome measures included IOP, BCVA and CMT by OCT.

RESULTS: Separate within-group analysis of showed significant reduction in CMT from baseline in TA group at week 12. The results showed significant improvement in BCVA in TA group and general treatment group. But no significant interaction between groups were observed of BCVA at week 4 and 12. There was a significant increase in IOP(>5mmHg)in the TA group when compared with the general treatment group at week 4, but no significant interaction between groups at week 12.

CONCLUSION: The result shows that general approach and intravitreal injection of triamcinolone acetonide are well tolerated wiht a significant improvement in BCVA and decrease in macular edema in retinal vein occlusion. But we must be attention to the increased IOP after intravitreal injection of TA.

Abstract:AIM: To investigate the effect and safety of combined surgery with scleral buckling and drainage operation in the treatment of rhegmatogenous retinal detachment.

METHODS: Totally 88 patients(88 eyes)with rhegmatogenous retinal detachment accepted in our hospital from January 2009 to January 2013 were selected as study objects. All patients were given scleral operation and divided into two groups according to the operation mode. Patients in group A(44 eyes of 44 cases)were treated with combined surgery with scleral buckling and nondrainage operation, while patients in group B(44 eyes of 44 cases)were given combined surgery with scleral buckling and drainage operation. The retinal reattachment rate, postoperative visual acuity and complications between groups were compared after treatment.

RESULTS:The anatomic reduction rates of eyes in group A and B were respectively 93% and 89%, with no significant differences between groups(P>0.05). There were 37 eyes(84%)improved in eyesight after operation in group A, only 34 eyes(77%)in group B. And visual acuity recovery rate of group A was evidently higher than that of group B, with significant differences between them(P<0.05). Furthermore, the postoperative complication rate of group A was significantly lower than that of group B(11% vs 32%, P<0.05).

CONCLUSION: It is efficient and secure for combined surgery with scleral buckling and drainage operation to treat patients with rhegmatogenous retinal detachment, which is worthy of clinical application.

Abstract:AIM: To compare the safety and efficacy of intravitreal injection with ranibizumab combined with grid laser photocoagulation for the treatment of macular edema secondary to branch retinal vein occlusion(BRVO).

METHODS: Thirty patients(30 eyes)with BRVO were randomized into two groups: Group 1(14 eyes)received grid laser photocoagulation(GLP)treatment alone, Group 2(16 eyes)received three loading doses 0.05mL/(0.5mg)of intravitreal injection with ranibizumab at monthly interval(i.e. 0, 1 month and 2 months)plus standard laser treatment 7d after the 1^st injection. During the 6 months of follow-up, observation was made on the changes of the best-corrected visual acuity(BCVA)and central macular thickness(CMT)by OCT.

RESULTS: After 6 months follow-up, the patients' BCVA in two groups were both improved with the combined treatment group better than the simple GLP group(P<0.05); OCT display that CMT of group 1 decreased by an average of 236.4±113.0μm, CMT of group 2 decreased by an average of 386.6±195.5μm with the combined treatment group better than the simple GLP group(P<0.05).

CONCLUSION: The effect of the combined treatment is better than that of the simple GLP treatment. Intravitreal injection with ranibizumab combined with grid laser photocoagulation for the treatment of macular edema secondary to branch retinal vein occlusion is effective and safe.

Abstract:AIM: To observe the surgical effect and influential factors of idiopathic macular hole(IMH)treated with vitrectomy and internal limiting membrane peeling combined with intravitreal gas tamponade.

METHODS: The clinical data of 22 IMH patients(23 eyes)were retrospectively analyzed. All the patients were diagnosed with IMH by optical coherence tomography(OCT)and their macular hole patterns were measured before and after surgery by OCT in addition to the routine examinations. All patients were treated with vitrectomy, internal limiting membrane peeling combined with gas injection(air or inert gas). The postoperative visual acuity, macular hole closure rate and the incidence of surgical complications were observed. The correlation between the patients' age, course of disease, preoperative best corrected visual acuity(BCVA), macular hole diameter, the type of vitreous cavity filling gas, the postoperative BCVA, and the macular hole closure rate was analyzed with SPSS 13.0 statistical software.

RESULTS: Postoperative OCT examination results showed that the macular hole closure rate was 100%. The macular hole closure rate was 79%(11 eyes of 14 eyes)after the first intravitreal air injection and 100%(9 eyes)after fist intravitreal inert gas injection(100mL/L C₃F₈). There was no significant difference between the air injection and inert gas injection(χ²=2.1214, P>0.05). The mean preoperational BCVA was 0.11±0.05 and the mean postoperative BCVA 0.23±0.12; there was a statistically significant difference between them(t=4.023,P<0.05). Compared with the patients without visual acuity improvement after surgery, the diameters of the hole were smaller in the patients whose postoperative visual acuity got improved(t=3.92, P<0.05). There was a significant difference in the visual acuity before and after the surgery(P<0.05). The age of the patients(r=-0.415, P=0.256), duration of disease(r=0.193, P= 0.498), preoperative VA(r=0.152, P=0.673)had no significant influence on IMH visual outcomes.

CONCLUSION: The vitrectomy combined with internal limiting membrane peeling and intravitreal gas tamponade is an effective treatment for IMH; the macular hole diameter is the major influence factor in the postoperative closure and visual prognosis of IMH; while the preoperative visual acuity, age, duration and the type of gas filled in the visual cavity have no effects on the postoperative closure and visual prognosis in IMH.

Abstract:AIM:To observe the protective effect of calcium dobesilate on optic nerve of glaucoma patients whose intraocular pressure has been under control through operation.

METHODS: A total of 78 inpatients(89 eyes)with glaucoma in this hospital from January, 2011 to February, 2012 were enrolled. All patients were randomly divided into treatment group and control group with 6 months in a course. The visual acuity, visual field(mean sensibility, MS), and intraocular pressure were measured at the experiment onset and 6 months later to evaluate the clinical effect.

RESULTS: There were no statistically significant differences in the visual acuity, intraocular pressure between the two groups neither at the experiment onset nor after 6 months(P>0.05). The mean sensibility(MS)of the treatment group was obviously improved(14.56±5.03 vs 18.9±5.77, P<0.05)with statistically significant differences before and after the treatment, while the MS remained unchanged in the control group(14.75±5.17 vs 13.48±4.69). There are statistically significant difference between the treatment group and the control group. Compared to the ratio of improvement, stability, and deterioration in the control group(10.3%, 48.7%, 41.0%), the indexes were changed obviously in the treatment group(64.1%, 28.2%, 7.7%,P<0.05)with statistically significant difference between the two groups.

CONCLUSION:Calcium dobesilate can improve mean retinal sensitivity and protect the optic nerve in glaucoma patients whose intraocular pressure has been controlled.

Abstract:AIM: To observe the clinical effect of bandage contact lens in pterygium excision combined with conjunctival transplantation.

METHODS: The retrospective study included 114 eyes of 101 patients who underwent the pterygium excision combined with conjunctival transplantation from June 2012 to June 2013 in our hospital. The patients were divided into three groups according to the postoperative treatment. In group A, 30 cases(38 eyes)wore bandage contact lens; In group B, compression bandage was used in all the 33 cases(38 eyes); In group C, 38 eyes(38 cases)were covered with normal eye pad. All patients were examined 1, 3, 5d after surgery.

RESULTS:No complications such as corneal ulcer, granuloma, etc. or recurrence occurred in 114 eyes. Eye irritations in group A were less severe than in the other two groups. Postoperative repair time of corneal epithelium was shorter in group A and B than in group C.

CONCLUSION: Bandage contact lens can significantly reduce the irritations after pterygium excision combined with conjunctival transplantation and promote corneal epithelium repair in the defected area. Compared with traditional treatment, it can obviously increase the postoperative comfort level in patients, it is easy to promote its application, and it has lesser risks. So it has extensive clinical value.

Abstract:AIM: To observe the clinical effect of prosthodontics membrane and lip mucosa transplantation combined with hydroxy apatite(HA)orbital implantation in the treatment of severe stenosis of conjunctival sac.

METHODS: Nineteen patients with orbital socket and severe stenosis of conjunctival sac were treated with prosthodontics membrane and lip mucosa transplantation combined with HA orbital implantation in reconstruction of conjunctival sac, Survival condition of lip mucosa, HA stability and conjunctival sac depth, palpebral fissure highness and facial appearance were observed after transplantation.

RESULTS: After 3-6 months of follow-up, lip mucosal membrane grew up well and fused with eyeball conjunctiva in all patients. Depth of conjunctival sac was normal and binocular palpebral fissure elevated basically symmetry and satisfactory appearance in 18 patients. One patient was not satisfied with the improved appearance.

CONCLUSION:The method of prosthodontics membrane and lip mucosa transplantation combined with HA orbital implantation is effective and safety in conjunctival sac reconstriction, and also satisfy patients' esthetic need.

Abstract:AIM: To investigate the clinical effectiveness of houttuynia cordata eye drops combined with pemirolast potassium eye drops on the patients with allergic conjunctivitis.

METHODS: Totally, 63 patients with allergic conjunctivitis were randomly divided into the control group(31 cases)and the observation group(32 cases). The patients in the control group were treated with pemirolast potassium eye drops alone while patients in the observation group were medicated with pemirolast potassium eye drops combined with houttuynia cordata eye drops. Symptoms such as nictation, eye itching, red eye, foreign body sensation and signs such as conjunctival edema and hyperemia, upper and lower palpebral conjunctiva nipple and filtering blebs were observed before and after treatment.

RESULTS: The pretreatment symptom evaluation scored 9.38±0.71 and 9.41±0.56 respectively in the observation group and the control group and their pretreatment sign evaluation scored respectively 10.21±1.03 and 10.68±0.99, with no significant difference between the two groups. After the treatment, symptom evaluation scored 1.22±0.61 and 4.25±0.84 for the observation group and control group respectively and their sign evaluation scored respectively 1.21±0.60 and 5.78±1.29, with statistical difference between the two groups. The effective rate of the observation group(78.12%)was significantly higher than that of the control group(32.25%), and with statistical difference.

CONCLUSION: The pemirolast potassium eye drops combined with houttuynia cordata eye drops can ameliorate the clinical symtoms and signs of the patients with allergic conjunctivitis and improve the treatment efficacy.

Abstract:AIM: To evaluate the diagnostic capability of Heidelberg retinal tomography-Ⅲ(HRT-Ⅲ)for primary openangle glaucoma(POAG)at different stages.

METHODS: Sixty-five patients(116 eyes)with POAG and 60 normal persons(114 eyes)were tested by HRT-Ⅲ with optic disk tomography to observe their optic disk structure parameters. The optic disk parameters of normal persons, patients with POAG, and patients of POAG at different stages were compared and analyzed. The correlation between optic disk parameters and mean defect of the visual field of patients were analyzed.

RESULTS: There were statistical differences in cup area, rim area, cup volume, rim volume, cup/disk area ratio, rim/disk area ratio, linear cup/disk ratio, mean cup depth, maximun cup depth, mean retinal nerve fiber layer(RNFL)thickness between normal persons and patients and among patients of the three stages(early, developing and late). A positive correlation was found between cup area, cup volume, cup/disk area ratio, linear cup/disk ratio, mean cup depth and mean defect of the visual field in POAG patients, while, a negative correlation was found between rim area, rim volume, rim/disk area ratio, mean RNFL thickness and mean deviation in POAG patients.

CONCLUSION: HRT-Ⅲ can effectively reflect changes of optic disc in each stage of POAG. It shows a good correlation with visual field and provides basis for the diagnosis of POAG.

Abstract:AIM: To assess the repeatability of thickness profiles of corneal epithelium produced by aautomatic hierarchic algorithm that was applied to images obtained by a custom-built ultra-high resolution OCT( UHR-OCT)system.

METHODS: Eighteen left eyes of 18 subjects(23.2±0.9)years; mean age±standard deviation)were imaged twice on non-consecutive days by a custom-built ultra-high resolution OCT(UHR-OCT)system. A hierarchic algorithm based on the axial gradient information and a shortest path search was developed to measure the corneal epithelial thickness profiles from the SD-OCT images.

RESULTS: There was good correlation between theautomatic and manual hierarchy positions of the epithelium( p>0.05, paired t-test). The average epithelial thickness of the 6mm central corneal region determined by the automatic hierarchic algorithm was 52.1±2.1μm, ranging from 50.3±1.8μm to 53.2±2.4μm along the horizontal meridian. The epithelial thickness differences between automatic and manual hierarchy by the UHR-OCT systems were 0.4±0.3μm. The intraclass correlation coefficients(ICC)and coefficients of repeatability(CoR)with repeated UHR-OCT measurements for epithelial thickness were 0.90±0.05 and 1.44±0.01μm respectively.

CONCLUSION:Regarding UHR-OCT system, the custom-developed automatic hierarchy has good repeatability and accuracy for measuring the thickness of corneal epithelium.

Abstract:AIM: To observe the effect and clinical significance of alcohol pretreatment during the pterygium surgery.

METHODS: Totally 300 eyes with pterygium were randomly divided into two groups. Control group: 142 eyes with pterygium were peeled under local anethesia and their degenerative organization of pterygium was cleaned up followed by a transplantation of corneal limbus with an autologous conjunctival flap. Experimental group: 158 eyes with pterygium were placed with a special metal ring used in LASEK on the head of pterygium to isolate the treatment area under local anesthesis, then, the treatment area within the ring was filled with the alcohol with a concentration of 200mL/L for 40-60s, followed by an adequate flushing with saline. Subsequent surgical procedure was the same as control group.

RESULTS: Follow-up for all patients ranged from 1 month to 3 years. Postoperatively, 158 eyes of experimental group had better operative effect than control group. Experimental group had better would healing, complete tissue construction, and improved visual quality. The break-up time of tear film for experimental group was significantly prolonged than that for control group. The average corneal astigmatism and total higher-order aberrations of experimental group were significantly lower than that of control group. The recurrence rate of experimental group was also significantly lower than control group. There's no significant difference in the incidence of complications.

CONCLUSION: Alcohol pretreatment during the pterygium surgery is a safe and effective method.

Abstract:AIM: To study the correlation between genetic susceptibility to high myopia and single nucleotide polymorphisms(SNPs)in 11q24. 1 chromosome among Chinese college students.

METHOD: A total of 254 blood samples were obtained from Chinese college students who were often engaged in near work. The students were divided into high myopia group(42 cases), low to moderate myopia group(61 cases)and non-myopic group(151 cases). Genotyping technology was utilized to analyze the frequency of mutation of the SNPs alleles of four mononucleotides in the 11q24.1 chromosome, including rs577948, rs11218544, rs10892819 and rs11218553. And the Chi-square test was performed to test the difference of such mutation with myopia.

RESULTS:The frequency of the SNP alleles mutation of the mononucleotide rs577948 site in the high myopia group was significantly different from that in the low-to-moderate myopia group and the non-myopic group(P=2.28×10^-7).

CONCLUSION: There is no significant correlation between genetic susceptibility and the four variations of SNPs between mild myopic population and normal population and there is no significant difference between the two populations, either. However, A - G mutation of Rs577948 site in 11q24.1 chromosome in university students with high myopia group is closely associated with high myopia hereditary susceptibility.

Abstract:AIM: To discuss visual acuity assessment after cataract surgery by pattern reversal visual evoked potential.

METHODS:Data of 72 adult cataract patients received PRVEP before and after phaco and IOL in Department of Ophthalmology, Tongji Hospital from October 2012 to May 2013 was analyzed retrospectively. A total of 114 eyes were studied, including 76 eyes with senile cataract and 38 eyes with complicated cataract. According to the degree of lens opacity and the hardness of lens nucleus, these data were divided into two groups: Group 1(gradeⅠ, Ⅱ, Ⅲ )and Group 2(grade Ⅳ, Ⅴ )and was statistically studied with correlation analysis.

RESULTS: Group 1:(1)Preoperative: the average of visual acuity was 0.344, the incubation time of P₁₀₀ wave was 107ms and the amplitude of N₇₅- P₁₀₀ wave was 4.633μV; postoperative: the average of visual acuity was 0.672, the incubation time of P₁₀₀ wave was 104.37ms and the amplitude of N₇₅- P₁₀₀ wave was 4.400μV.(2)The visual acuity before and after operation were both significantly negatively correlated with the incubation time of P₁₀₀ wave(P<0.01)and significantly positively correlated with the amplitude of N₇₅- P₁₀₀ wave(preoperative: P<0.01,postoperative: P<0.05);(3)The improved rows of the visual acuity before and after operation showed no relationship with the change of the incubation time of P₁₀₀ wave. Group 2:(1)Preoperative: the average of visual acuity was 0.116,the incubation time of P₁₀₀ wave was 118.905ms and the amplitude of N₇₅-P₁₀₀ wave was 1.650μV; postoperative: the average of visual acuity was 0.576, the incubation time of P₁₀₀ wave was 108.429ms and the amplitude of N₇₅- P₁₀₀ wave was 5.132μV.(2)The visual acuity before operation was significantly negatively correlated with the incubation time of P₁₀₀ wave(P<0.05),while the visual acuity after operation showed no relationship with the incubation time of P₁₀₀ wave; the visual acuity before and after operation showed no relationship with the amplitude of N₇₅- P₁₀₀ wave.(3)The improved rows of the visual acuity before and after operation showed no relationship with the change of the incubation time of P₁₀₀ wave.

CONCLUSION:According to the correlation among the visual acuity, the incubation time of P₁₀₀ wave and the amplitude of N₇₅- P₁₀₀ wave, PRVEP is significantly affected by preoperative visual acuity(the degree of opacity in refractive media). PRVEP is not helpful as an indicator of visual prognosis after cataract surgery, and PRVEP before cataract surgery has no clinical significance.

Abstract:AIM:To observe the clinical effect of excimer laser in situ keratomileusis after the early application of latanoprost eye drops in prevention of refractive regression.

METHODS:Patients were randomly divided into experimental group, positive control group and blank control group, each group of 50 cases(100 eyes). In experimental group, patients used latanoprost eye drops once from the first day after the operation, and the eye drops were discontinued after three months. The positive control group applied timolol eye drops in the morning and evening respectively, and the eye drops were discontinued after three months. Blank control group without any ocular hypotensive drugs. Effect of preoperative, postoperative 1 week,1 month,3,6,12,24 months, the uncorrected visual acuity(UCVA),subjective refraction, corneal posterior surface, intraocular pressure, BUT, Schirmer test and other aspects of the change were observed.

RESULTS:There was no retreatment cases in experimental group and positive control group. Forty-eight cases of experimental group were able to adhere to employ latanoprost ophthalmic solution once daily for three months, while the positive control group had only 41 cases adhering to use timolol eye drops twice daily for three months. There was significant difference. The blank control group of 4 retreatment cases were appeared, there were significant differences compared with experimental group. No significant differences in BUT, Schirmer test among three groups were found.

CONCLUSION:Latanoprost eye drops can effectively prevent excimer laser in situ keratomileusis retreatment, with less side effects and better patient compliance.

Abstract:AIM:To investigate the progression of refractive errors of pupils in Hetian Road primary school of Shanghai Zhabei community and analyze the relationship between refractive errors progression and relative factors.

METHODS:All the 6-12 years old in-school pupils in Hetian Road primary school of Shanghai Zhabei community were invited in the study. The participates were examined first-visit in May 2011 and second-visit in May 2012. All the 303 pupils(606 eyes)were investigated the age, height(H), weight(W), uncorrected visual acuity(UCVA), diopter of spherical(DS), diopter of cylinder(DC), spherical equivalent(SE), axial length(AL), and corneal curvature(K). The progression of refractive condition was described and the relevant factors were analyzed.

RESULTS:Among 606 eyes, the progression of average SE was -0.45±0.60D and the progression of average AL was 0.32±0.25mm. The progression of SE diopter was positively correlated with the progression of AL(r=0.409, P<0.01). Among all eyes, 473 eyes of them developed to myopia(the progression of SE was negative)with the prevalence of 78.1%. To analyze the relationship between the progression of AL and W, when the pupils with the weight increased among 4-6kg/a, their progression of AL was the slowest(0.28±0.20mm, P=0.004). The youngest pupils with 6-8 years old, had the fastest progression of AL(0.39±0.24mm, P<0.01). There was no significantly different between H growth and DS, DC or SE(P>0.05). The incidence of poor sight(UCVA<1.0)in 2012(47.0%)was higher than that in 2011(31.5%), while it was also higher in 10-year older group(52%)than that in 10-year younger group(10%).

CONCLUSION:Myopia is the main progression of refractive error in the pupils of Hetian Road primary school in Shanghai Zhabei community. AL and growth development is closely related to the progression of refractive errors.

Abstract:AIM:To investigate the visual acuity, refraction and influence factors of preschool children in some nurseries in Nanjing.

METHODS: Children from 4 to 6 years old in Nanjing attended the visual acuity examination, and filled in factors questionnaire. The results were analyzed.

RESULTS:Visual acuity at P₅ was 0.4 of 4 years, 0.5 of 5 years, and 0.6 of 6 years. Refraction, gestational age, birth weight, closely using eyes, daily watching television time, daily outdoor activity time, picky eaters situation, chewing situation, parents diopter, home lighting status were associated with vision disorders. Factors score at P₅ is 5.

CONCLUSION: The visual acuity less than P₅ at each ages was abnormal vision. Child whose factors score of less than 5 had high risk of abnormal vision, and need to pay close attention to visual conditions.

Abstract:AIM: To describe the status of standardization training for ophthalmology residents in Guizhou province.

METHODS: The study made a specific analysis on the content and effect of the training in the ophthalmology department of Zunyi Medical University Affiliated Hospital. Besides, the students' professional ability, employment situation and the problems existed, were evaluated. Meanwhile, some countermeasures and suggestions were put forward to constructing security mechanism for standardization training of ophthalmology residents in Guizhou province.

RESULTS: Totaled 16 persons were trained in this region since 2006/2011, only one graduated.

CONCLUSION: Clinical ophthalmology regulatory capacity of students trained in the area is significantly increased, but the security policy is the main reason of giving up training. We suggest modern medical students to gain a graduate degree as soon as possible to shorten the cost of education.

Abstract:AIM: To retrospectively analyze the effects of sodium hyaluronate in treating fungal corneal ulcer.

METHODS: Since June, 2006, there were 178 patients(178 eyes)with fungal corneal ulcer receiving medical treatment in our hospital. Among them, 81 patients(81 eyes)as the control group received the traditional antifungal treatment with the natamycin and fluconazole being the major medicine, from June 2006 to June 2008. While, 97 patients(97 eyes)as the treatment group received sodium hyaluronate treatment based on traditional antifungal treatment during the period of June 2008 to March 2010. Effects of two therapeutic methods were compared and analyzed.

RESULTS: Of the 97 cases in the treatment group, the average hospital stay was: 14.15±4.23d, with 90 cases(92.8%)cured, 5 cases(5.2%)improved, 2 cases(2.1%)ineffective, the final visual acuity of 51.6% patients better than 0.3. Of the 81 cases in the control group, average hospital stay was: 17.26±6.23d, with 69 cases(85.2%)cured, 7 cases(8.6%)improved, 5 cases(6.2%)ineffective, the final visual acuity of 39.5% patients better than 0.3. After statistical analysis, the average hospital stay, the cure rate, the effective rate and the final visual acuity in both groups showed statistically significant difference(P<0.05). The average hospital stay of the treatment group was shorter than that of the control group, while the cure rate and effective rate and the final visual acuity was better than that of the control group.

CONCLUSION: Sodium hyaluronate can promote fungal corneal ulcer healing, improve the cure rate and reduce the formation of corneal scar.

Abstract:AIM: To study the complications of phaco-cataract surgery.

METHODS: Totally, 500 eyes underwent phaco-cataract surgery were retrospectively analysis from January 2008 to January 2011.

RESULTS: In all 500 cases(500 eyes)with age-related cataract by phaco-cataract surgery, posterior capsular rupture were occurred in 45 eyes(9.0%). Of them, 33 eyes(6.6%)were complicated by posterior capsular rupture among before 250 eyes, 12 eyes(2.4%)arose posterior capsular rupture in after 250 eyes.

CONCLUSION: Surgical treatment posterior capsular rupture must be according to different situation in phaco-cataract surgery. Choosing different modes of artificial lens implantation can achieve good treatment effect.

Abstract:AIM: To evaluate the related risk factors and treatment method of secondary glaucoma after pars plana vitrectomy and silicone oil tamponade.

METHODS: The retrospective study analyzed 114 patients(118 eyes)who were treated with pars plana vitrectomy combined with silicone oil tamponade. Lenses were reserved in 78 eyes and were taken away in 40 eyes among which intraocular lens were implanted in 17 eyes. There were 39 eyes in which the filling time of silicone was no more than 6 months while 79 eyes in which the filling time was more than 6 months. The follow-up time was(16.2±4.9)months. Primary and secondary glaucoma were excluded before the vitrectomy. Silicone oil glaucoma(SOG)was diagnosed when intraocular pressure(IOP)was measured higher than 21mmHg(1mmHg=0.133kPa)three times in succession at least 1 month after silicone oil tamponade and inflammation and neovascular glaucoma should be excluded. Anti-glaucoma drugs were administrated once SOG was diagnosed. If the IOP was not controlled after 2 weeks, the silicone oil was taken away. If the IOP was still high, the anti-glaucoma surgery was operated. The data was analyzed by the SPSS 16.0 software using a binary logistic regression analysis.

RESULTS: Among the 32 eyes of SOG, lenses were removed in 16 eyes(50%). The filling time of silicone oil was more than 6 months in 27 eyes(84.4%)and silicone oil emulsion happened in 20 eyes(62.5%). IOP returned normal in 17 eyes after administrating anti-glaucoma medication within 2 weeks. Silicone oils were taken away in 15 eyes. However, 4 eyes still had high IOP after surgery; one of them was given anti-glaucoma drugs once more; two of them underwent trabeculectomy and one of them underwent cyclophotocoagulation. The lens conditions(whether it was taken away or not, P=0.024), the silicone oil filling time(whether the time was more than 6 months, P=0.014), and the status of the silicone oil(whether emulsification occurred or not, P=0.000)were all found to be significantly related to the incidence of the secondary glaucoma.

CONCLUSION: Removal of lens, more than 6 months of silicone oil filling time and silicone oil emulsion are the risk factors of SOG and anti-glaucoma drugs are the first choice for conservative treatment. If IOP can't be controlled, the silicone oil should be removed in time.

Abstract:AIM:To compare the therapeutic effects of different incision phacoemulsification with foldable intraocular lens implantation combined with trabeculectomy in treating angle-closure glaucoma complicated with cataract.

METHODS: The retrospective study analyzed 70 patients(98 eyes)who performed phacoemulsification with foldable intraocular lens implantation combined with trabeculectomy. Single incision surgery(one-site approach)was performed on 34 patients(50 eyes), and double incision surgery(two-site approaches)was done on 36 patients(48 eyes). The differences of intraocular pressure control,filtering bleb, the density and preservation of corneal endothelium cells both pre-surgery and 1 month post-surgery or later complication. in the two groups were compared and analyzed.Follow-up was 12-24 months with a mean of 18.2 months.

RESULTS: The average postoperative intraocular pressure in one-site groups was(10.16±4.31)mmHg. The average postoperative intraocular pressure in two-site groups was(11.38±3.55)mmHg. There were no statistically significant differences between the two groups(P>0.05)regarding the postoperative intraocular pressure and the formation of filtering blebs(P>0.05). The density and area of corneal endothelium cells in the two-incision group pre-operation were comparable(P>0.05). However, in 1 month post-operation, the rate of the corneal endothelial cells loss in double incision group was superior compared to the single incision group(P<0.01).

CONCLUSION: Both single incision and double incision approach phacotrabeculectomy are effective in reducing intraocular pressure and can maintain the function of filtering blebs well. There are no statistically significant differences in the intraocular pressure reduction between the two approaches. The double incision approach is superior in minimizing the corneal endothelial cells loss compared to the single incision approach.

Abstract:AIM: To discuss the role of interleukin-6(IL-6)in the development of inflammatory glaucoma by detecting the IL-6 levels in serum and aqueous humor of inflammatory glaucoma patients.

METHODS: Totally 20 patients(20 eyes)with inflammatory glaucoma were selected as experimental group, 20 patients(20 eyes)with primary chronic glaucoma(primary chronic angle-closure glaucoma and primary chronic open angle glaucoma)as the high intraocular pressure control group, and 20 senile cataract patients(20 eyes)as the normal control group. Three specimens of serum, aqueous humor in three groups were collected and aqueous IL-6 levels were measured through electrochemiluminescence.

RESULTS: The serum IL-6 levels in Inflammatory glaucoma group, primary chronic glaucoma group, senile cataract group were 3.26±2.10, 4.20±1.94 and 3.50±2.24pg/mL, respectively, which doesn't demonstrate statistically significant differences(F=1.080, P=0.345). The aqueous IL-6 levels in the Inflammatory glaucoma group, primary chronic glaucoma group and senile cataract group aqueous were 293.77±38.72, 135.27±32.72 and 115.80±29.97pg/mL, respectively, demonstrating statistically significant differences(F=164.86, P=0.000). The Inflammatory glaucoma group was found to be significantly higher than that in the primary chronic glaucoma and senile cataract group(P<0.01; P<0.01). Comparing the aqueous IL-6 levels in the primary chronic glaucoma group with that in the senile cataract group, the differences of it were not statistically significant(P>0.05).

CONCLUSION: High expression of IL-6 levels in aqueous humor of inflammatory glaucoma patients is closely associated with inflammation, but it has no significant correlation with high intraocular pressure.

Abstract:AIM: To explore the curative effect of chymotrypsin in treating contusive hyphema at grade Ⅲ.

METHODS: Totally 84 patients(84 eyes)with contusive hyphema at grade Ⅲ were analyzed retrospectively. They were randomly divided into treatment group(42 cases)and control group(42 cases). The chymotrypsin was administrated in addition to routine treatment for treatment group, while the control group adoptedroutine treatment. Observation was made regarding the hyphema absorption time, visual recovery and complications.

RESULTS: The hyphema were absorbed after treatment in both groups, and visual acuity were improved at different levels in most patients. There were no significant differences in visual acuity after treatment in both two groups(P>0.05). The hyphema absorption time of the treatment group(7.45±0.35)d was significantly shorter than that of the control group(10.24±0.56)d. There was significant difference in the absorption time between the two groups(P<0.01). The complications occurrence was muchlower in the treatment group than that in the control group.

CONCLUSION: The hematocele of contusive hyphema patients at grade Ⅲ can be absorbed quickly through the chymotrypsin treatment, with less adverse reactions and complications.

Abstract:AIM: To observe the efficacy and side reaction of superselective ophthalmic artery chemotherapy for retinoblastoma(RB).

METHODS: Eleven cases(11 eyes)of RB, ranging from stage A to D according to the latest International Intraocular Retinoblastoma classification, were treated with melphalan infusion by the ophthalmic artery.

RESULTS: Such intra-arterial chemotherapy was administered for 23 times and the patients were followed up for 3-12 months. During the follow-up, 8 cases were effective with significant tumor shrinking and calcification; 2 patients progressed and received enucleation of eyeballs; 1 case was lost to follow-up. Postoperative transient nausea, vomiting and fever appeared in some cases, but serious complications were not found, such as death, stroke, myelosuppression,etc.

CONCLUSION: Among 9 cases from group A, B and C, 7 cases were effective, 1 case continued to progress and 1 case was lost to follow-up, and the effective rate was 88%. In the 2 cases of group D, 1 case was effective and the other continueed to progress, so the effective rate was 50%.

Abstract:AIM: To investigate the curative effect of conjunctival cryocoagulation in treatment of vernal conjunctivitis.

METHODS: Totally, 80 cases(160 eyes)with vernal conjunctivitis, treated from October 2008 to May 2010 in our hospital were randomly divided into two groups with 40 cases(80 eyes)for each group.Group A received conjunctival cryocoagulation combined with Tobradex eye dropping, and group B was managed with Tobradex eye dropping. The curative effect and adverse effect were observed and recorded 1 month, 3 months and 2 years after the treatment. The therapeutic effect was classified as cured,improved and ineffective.

RESULTS: The total effective rate in group A was higher than that in group B with a statistically significant difference(P<0.05)at 1 month, 3 months and 2 years after the treatment. The adverse effect was found in 7 cases in group A and 3 cases in group B, with no statistic difference(P>0.05).

CONCLUSION:Conjunctival cryocoagulation is an effective method for vernal conjunctivitis.

Abstract:AIM: To evaluate the sterilizing effects of 50g/L povidone Iodine used in conjunctival sag before cataract surgery.

METHODS: Totally, 58 eyes of 45 cataract patients underwent phacoemulsification aspiration with intraocular lens implantation. The cojunctival sac secretions at three time points(admission, before and after disinfection with povidone iodine)were obtained and then cultured under the same condition and at the same time. The results were observed and identified.

RESULTS: At the three points, the positive rate of bacterial culture was 79.3%, 41.9% and 3.4%, respectively. The positive rate significantly reduced gradually.

CONCLUSION: The application effect of 50g/L povidone iodine in killing conjunctival sac bacteria is remarkable, which can avoid the postoperative endophthalmitis effectively.

Abstract:AIM: To evaluate the efficiency and safety of 50g/L povidone-iodine solution in preventing postoperative endophthalmitis through comparing the incidence of postoperative endophthalmitis and adverse reactions after conjunctival sac washing with povidone-iodine of different concentrations.

METHODS: Totally 500 cataract patients were divided into 50g/L povidone-iodine group and 25g/L povidone-iodine group. All the operated eyes were observed during and after surgery.The patients' subjective discomfort was inquired and their signs of eyes were recorded.

RESULTS: The eye irritation of 50g/L povidone-iodine group was more significant than 25g/L povidone-iodine group. No significant difference in the corneal epithelial loss and endophthalmitis was observed between two groups.

CONCLUSION:Conjunctival sac washing with 50g/L povidone-iodine is an effective and safe measure to prevent endophthalmitis after cataract surgery.

Abstract:AIM: To compare the therapeutic effect of lacrimal probing through upper and lower lacrimal punctum in neonatal dacryocystitis.

METHODS: Totally, 262 cases(286 eyes)of neonatal dacryocystitis which failed in a two-week conservative treatment were selected from January 2006 to January 2013 in our outpatient department. They were randomly divided into Group A and Group B. Then, 133 cases(149 eyes)in Group A received lacrimal probing through upper lacrimal punctum, and 129 cases(137 eyes)in Group B received lacrimal probing through lower lacrimal punctum. The patients were followed up for one month and therapeutic effect and incidence of complications of the two methods were compared.

RESULTS: The cure rate of was 98.7% in Group A and 93.4% in Group B. The incidence of the complications in Group A was lower than that of Group B. The differences between the two groups were significant(P<0.05).

CONCLUSION: Lacrimal probing through upper lacrimal punctum in neonatal dacryocystitis is more effective than probing through lower lacrimal punctum,and it has a lower incidence of complications including lacrimal tear, false passage and secondary adhesion.

Abstract:AIM: To observe and compare the clinical effect and postoperative recrudescence rate and complication of pterygium surgery combined with bevacizumab or mitomycin C.

METHODS: Eighty pterygium inpatients in the Department of Ophthalmology in Integrated Chinese and Western Medicine Hospital of Zhejiang Province from January 2010 to January 2012 were randomly divided into two groups. Forty cases in group A were treated by surgery combined with subconjunctival injection of bevacizumab, Forty cases in group B were treated by surgery combined with mitomycin C sticking therapy. After following up for 1 year, the curative effect and postoperative recurrence rate and complications were compared and evaluated between the two groups.

RESULTS: The cure rate of group A and B were 88%, 85%, respectively, demonstrating no significant difference(χ²=0.105, P>0.05); The postoperative recurrence rate of group A, B were 12%, 15%, respectively, the differences of which weren't significantly different(χ²=0.105, P>0.05); The incidence of postoperative complications in group A, B were 2%, 18%, the differences of which weren't significantly different(χ²=4.517, P<0.05).

CONCLUSION: The clinical effect of pterygium surgery combined with bevacizumab or mitomycin C is significant with a low postoperative recrudescence rate, but the former has fewer complications.

Abstract:AIM:To compare the therapeutic effects of different surgical methods of treating patients with pterygium and to observe tear film stability.

METHODS:A total of 90 pterygium patients(90 eyes)were randomly divided into three groups, each 30 cases(30 eyes). The eyes in group A were treated with pterygium excision surgery; the eyes in group B were treated with 0.2g/L mitomycin-C and pterygium excision surgery intraoperatively; and the eyes in group C were treated with pterygium excision combined with self-corneal limbal stem cell transplantation. Data including Schirmer Ⅰ test(SⅠt), tear break-up time(BUT), conjunctiva fluorescein staining(CFS), and ocular surface disease index(OSDI)were recorded preoperatively and postoperatively to evaluate the clinical efficacy of surgery and the effects of tear function changes.

RESULTS: There were no significant differences in BUT in group A before the operation and one month after operation. Group B and C showed significant difference before and after operation, but differences were not statistically significant(all P<0.05); There were no statistically significant differences in all the parameters before the operation and 3 months after operation. The indexes of CFS and OSDI at postoperative 1 month and 3 months in three groups were significantly different with those before the surgery(P<0.05); the indexes of BUT, SⅠt, CFS and OSDI at postoperative 1 months in three groups were statistically significant different when compared with preoperation. The significant differences were identified by comparing the recurrence rate between group A and group B and between group A and group C(P<0.05). There was no statistically significant difference in recurrence rate between group B and group C(P>0.05).

CONCLUSION: Pterygium excision combined with self-corneal limbal stem cell transplantation is an ideal surgical method in treating pterygium, and can partly restore the tear functions into normal state in patients with pterygium.

Abstract:AIM: To compare the pain after pterygium surgery with retrograde rip method and excision method.

METHODS: Totally, 160 pterygium patients(160 eyes)accepted surgery: 80 cases(80 eyes)underwent retrograde rip method and 80 cases(80 eyes)underwent excision method. The pain experience was graded 24h after the operation, difference of which between two groups was evaluated.

RESULTS: The number of cases suffering 0, 1, 2, 3 degree of pain was 4, 45, 23, 8 in retrograde rip group and 1, 30, 33, 16 in excision group respectively, with differences of statistical significance among them(Z=-2.995, P=0.03).

CONCLUSION: The pain degree experienced in retrograde rip method is lower than that in traditional excision method. Retrograde rip method has unique advantage in treating pterygium in cephalosome tissue.

Abstract:AIM: To discuss the role of humoral immunity and cellular immunity in the development of ocular myasthenia gravis in children by analyzing the clinical value of the indices including immunoglobulin, complement and T cell subgroup in peripheral blood.

METHODS: The concentrations of serum IgG, IgA, IgM, C3 and C4 in the myasthenia gravis group and the control group were detected by immune compare turbid. The contents of CD3⁺T cell, CD4⁺T cell and CD8⁺T cell were detected by flow cytometry. Data was analyzed by Independent-Sample Test.

RESULTS: There were no significant differences in contents of IgA, IgM, CD3⁺T cell, CD8⁺T cell between ocular myasthenia gravis group in children and the control group(P>0.05). The concentrations of serum IgG, C3 and C4 for myasthenia gravis group were lower than those of the control group(P<0.05). The content of CD4⁺T cell were higher than those of the control group(P<0.05).

CONCLUSION: Complement C3, C4 and CD4⁺T cell played an important role in immunology pathogenesis mechanism for ocular myasthenia gravis in children.

Abstract:AIM: To explore the effectiveness of the self-monitoring for changes in vision with paper vision chart under the guidance of chronic disease self-management program(CDSMP).

METHODS: A total of 74 teenagers with myopia were randomly divided into the experimental group and the control group. The patients of the experimental group self-monitored their vision with paper vision chart according to the CDSMP. The patients of the control group were provided with education on tips to keep eyes healthy. All patients were followed up once every 3 months, and their myopia diopter was measured 2 years later.

RESULTS: There was no statistically significant difference in average diopter between the experimental group and the control group before research(P>0.05). However, after the research, there was statistically significant difference in average diopter(P<0.05). The average diopter in the control group progressed more significantly than that in the experimental group during the research(P<0.05).

CONCLUSION: The vision self-monitoring with paper vision chart according to CDSMP can control the progress of myopia in teenagers.

Abstract:AIM:To compare the difference and correlation of central corneal thickness(CCT)measured by Zeiss Visante Anterior Segment Optical Coherence Tomography(Visante OCT), Heidelberg Slit-Lamp Anterior Segment Optical Coherence Tomography(SL-OCT), OrbscanⅡz Computerized Topography(OrbscanⅡz )and A-mode ultrasound pachymetry.

METHODS:Forty-three patients with myopia(86 eyes)were included. Sequential measurements of CCT was performed by the same operator with two different anterior segment OCT devices(Visante^TM, Carl Zeiss, Meditec and Heidelberg Engineering^TM), OrbscanⅡz Computerized Topography(Bausch and Lomb Inc^TM)and A-mode ultrasound pachymetry. The consistency of measurements was statistically analyzed by one-way ANOVA and LSD pair-wise comparisons. The differences were analyzed by Pearson correlation coefficients.

RESULTS:The average CCT measured by Visante OCT, SL-OCT, OrbscanⅡz, and A-mode ultrasound pachymetry were(521.05±29.88)μm,(533.73±31.83)μm,(534.02±32.96)μm, and(540.60±31.11)μm, the 95% confidence interval were(514.57～527.54),(526.83～540.65),(533.85～547.35),(536.75～544.45). There was statistically significant difference of CCT between using of Visante OCT and SL-OCT(P=0.009). There was statistically significant difference of CCT using of Visante OCT and A-mode ultrasound pachymetry(P<0.01), OrbscanⅡz(P=0.008). The Visante OCT CCT measurements was significantly less than CCT with SL-OCT(12.69±9.32)μm. Compare with A-mode ultrasound pachymetry and OrbscanⅡz, the Visante OCT measurements significantly underestimated central corneal thickness by a mean of(19.55±8.64)μm and(12.96±12.21)μm. There was no significant difference of CCT between using of SL-OCT and A-mode ultrasound pachymetry(P=0.158), OrbscanⅡz(P=0.954). There was no significant difference of CCT between using of OrbscanⅡz and A-mode ultrasound pachymetry(P=0.176). There were positive correlationship among Visante OCT, SL-OCT, OrbscanⅡz, and A-mode ultrasound pachymetry in CCT measurement(P<0.01).

CONCLUSION:There are excellent correlationship among Visante OCT, SL-OCT,OrbscanⅡz, and A-mode ultrasound pachymetry in CCT measurement. The data shows that the CCT obtained by SL-OCT and OrbscanⅡz do not have significant difference as compared with that from the A-mode ultrasound pachymetry. Three optical measurement devices is more likely to be accepted by patients because of its non-contact, non-invasive, and short measurement time as compared with the A-mode ultrasound pachymetry.

Abstract:AIM: To investigate the utility of ultrasound in the diagnosis of posterior vitreous detachment(PVD).

METHODS: From September 2011 to September 2012, 506 eyes of 305 cases(male 191, female 114)of PVD patients in our hospital were checked and analyzed with ultrasound.

RESULTS: Totally, 179 eyes were diagnosed as partial PVD, the proportion was 35.4%. And 327 eyes were diagnosed as complete PVD, the proportion was 64.6%. Among the 61 eyes(12.1%)with a small amount of hemorrhage of vitreous humor,retinal breaks of 26 eyes(5.1%)were founded. Given the photocoagulation nicely heal to the breaks and then recovered.

CONCLUSION:Ultrasonography can accurately diagnose PVD. It has non-invasive,convenience, and other characteristics, and it is worthy of clinical popularization.

Abstract:AIM: To investigate and analyze the differences in central corneal thickness(CCT)measurement by anterior segment optical coherence tomography(AS-OCT), pentacam rotating Scheimpflug camera and ultrasonic pachymetry(USP).

METHODS: The retrospective study measured CCT of 43 patients(86 eyes)performed excimer laser myopia corrective surgery by the same examiner using RTVue AS-OCT with an anterior segment adaptor, pentacam rotating Scheimpflug camera, and PACSCAN300P USP. Data of three groups were compared and statistically analyzed by pair t test.

RESULTS: The mean CCT(±SD)measured by AS-OCT,pentacam and USP were 535±52, 550±52, 550±51μm, respectively. Paired-sample t test showed that the results of AS-OCT, pentacam and USP were statistically different. There were no statistically significant differences in the mean CCT between the pentacam and USP group. Significant correlations of measurement result were found between pentacam and USP(r=0.998, P<0.01), FD-OCT and USP(r=0.993, P<0.01), and AS-OCT and pentacam(r=0.991, P<0.01).

CONCLUSION:RTVue AS-OCT significantly under estimates the CCT, while the measurement results by pentacam are similar to those by USP which is regarded as the golden standard.

Abstract:AIM:To investigate the changes of corneal biomechanics after Femto LDV laser flapping in laser in situ keratomileusis(LASIK).

METHODS: Preoperatively, 3 months, 6 months after LASIK, 93 myopia patients(186 eyes)in flapping procedure by Femto LDV laser were examined by Ocular response analyzer(ORA). The central corneal thickness(CCT)was also measured by ultrasonic pachymetry. Parameters were compared between postoperative(3 months)and preoperative, postoperative(6 months). Comparisons included the corneal thickness and corneal compensated intraocular pressure(Iopcc), Goldmann correlated IOP value(Iopg), corneal resistance factor(CRF), corneal hysteresis(CH).

RESULTS:The CCT(447.61±39.57μm)were significantly changed comparing with preoperative(539.88±29.72μm)(t=-47.223; P=0.000). The CCT of 6 months postoperative(448.78±39.19μm)was slightly thicker than that of 3 months'(t=2.15,P=0.033). Iopcc, Iopg of 3 months after LASIK(13.75±2.13, 9.54±2.35)mmHg were significantly changed comparing with preoperative(16.29±2.88, 15.09±3.29 )mmHg(t=-13.604, -23.594; P=0.000, 0.000). The difference was(2.55±2.25, 5.55±3.21)mmHg. There were no significant changes between Iopcc, Iopg of 6 months(13.61±1.96,9.32±2.07)mmHg and that of 3 months after LASIK. CRF and CH of 3 months after LASIK(6.36±1.45,7.71±1.30)mmHg were significantly changed comparing with preoperative's(9.84±1.99,9.77±1.56)mmHg(t=-24.116, -19.171; P=0.000, 0.000). The difference was(3.49±1.97, 2.06±1.47)mmHg. There were no statistical differences between 6 months(6.24±1.38, 7.67±1.25)mmHg and 3 months(t=1.456, 0.636; P=0.147, 0.525).

CONCLUSION: The corneal biomechanical properties after FS- LASIK are lower than that of preoperative. Corneal biomechanics sustains steadily about 3 months after LASIK.

Abstract:AIM: To study the effect on high myopia accompanied with cataract treated by phacoemulsification and implantation of the LOW dimensionality posterior chamber intraocular lens(IOL).

METHODS: Ninety-four eyes of high myopia accompanied with cataract treated by phacoemulsification and implantation of the LOW dimensionality posterior chamber IOL. The follow-up time was for 3 months.

RESULTS: The operative complications of posterior capsule were in 2 eyes during surgery, cataract in 3 eyes after surgery.

CONCLUSION: Phacoemulsification and implantation of the LOW dimensionality posterior chamber IOL used to treat high myopia accompanied with cataract can prevent complication and recover the visual function.