Abstract:AIM: To compare the difference of the calcium ions concentration between neonatal rats retinal progenitor cells(RPCs)and brain neural stem cells(NSCs)under hypoxia cultivate in vitro.

METHODS: After isolated from the neonatal SD rats and cultured in serum-free medium in vitro, RPCs and brain NSCs were identified by fluorescent immunocytochemistry. After cultured under hypoxic condition for different time duration, cell morphology were observed under light microscope, and intracellular calcium fluorescence intensity were measured via laser scanning confocal microscopy(LSCM)and calcium fluorescence probe Fluo-4AM.

RESULTS: Cultured under hypoxic conditions, brain NSCs swelled and extended protrusions were noticed earlier than RPCs. With increasing time duration of hypoxia, intracellular calcium ion fluorescence intensity of both types of cells gradually increased. After 12 hours cultured under hypoxic condition, calcium ion fluorescence intensity of RPCs showed significant difference lower than the fluorescence intensity in NSCs(P<0.05).

CONCLUSION: Under hypoxic condition for 12 hours, the concentration of calcium ion in RPCs was lower than that in brain NSCs.

Abstract:AIM:To evaluate the clinical gains 1 year after implantation of Tetraflex accommodative intraocular lens(IOLs).

METHODS:This study comprised 23 patients(23 eyes)with cataract and undergone phacoemulsification and implantation of a Tetraflex accommodative IOL. At the 12-month follow-up visit, uncorrected distance visual acuity(UCDVA)and uncorrected near visual acuity(UCNVA)were measured to determine the efficacy of the IOL. Incidence of spectacle independence, patients' satisfaction and presence of visual disturbances were investigated. In addition, anterior and posterior capsule opacification were assessed. Twenty-six patients(26 eyes)with implantation of monofocal IOLs(SN60AT, Alcon)were recruited as control group.

RESULTS:At the 12-month follow-up visit, the patients in Tetraflex accommodative IOLs group had better UCDVA and UCNVA than those in control group, but no significant difference was found(P>0.05). There were 34.7% patients of Tetraflex accommodative IOLs group and 26.9% patients of control group achieving total spectacle independence, and no significant difference was found(χ²=0.355, P=0.551). Patients' satisfaction rates with two groups did not differ significantly too(χ²=2.367, P=0.124). Anterior and posterior capsule opacification were present, respectively, in 34.8% and 7.7% of patients(χ²=3.972, P=0.046). Two cases of accommodative IOLs displacement were discovered(χ²=0.659, P=0.417). No visual disturbances were mentioned in both groups.

CONCLUSION: In the long run, compared with monofocal IOLs, Tetraflex accommodative IOLs can not provide efficient uncorrected visual acuity and had higher incidence and degree of anterior and posterior capsule opacification. Patients implanted have lower satisfaction rate due to poor accommodative ability versus expensive material. So, accommodative IOL should be implanted prudently, especially to the patients with high risk factors for capsule fibrosis.

Abstract:AIM: To study the surgical method and curative effect of non-penetrating trabeculectomy combined with 90 degrees trabeculotomy(NPTST).

METHODS:A total of 15 patients(30 eyes)with congenital infant glaucoma from January 2010 to January 2012 underwent NPTST. The change of intraocular pressure(IOP), corneal diameter and incidence rate of postoperative complications were observed respectively.

RESULTS:Compared to preoperation, the IOP in the group was lower at week 1, month 1, 3, 6 and 12, corneal diameter keep original size or a slight decrease, less complications occurred.

CONCLUSION: NPTST is a safe and effective surgical treatment of congenital infant glaucoma with high successful rate and low incidence rate of postoperative complications.

Abstract:AIM:To determine the correlation between success rate of probing and age in patients with nasolacrimal duct obstruction(NLDO).

METHODS: A total of 120 patients who underwent probing were studied. Patients were divided into three age categories: group 1(younger than 12 months), group 2(between 13 to 24 months), and group 3(between 25 to 60 months old). At first conservative management was initiated for all patients, but the obstruction didn't resolve so probing was performed as an alternative treatment. The cure rate of probing was compared between the three categories.

RESULTS: The success rate in groups 1 to 3 was 94.3%, 83.3%, and 68.4% respectively. Cure rate of probing differed significantly between the three groups(P=0.017).

CONCLUSION: Probing is associated with a higher success rate if performed early in life. Based on our observation, early intervention for NLDO, preferably in the first two years, is warranted.

Abstract:AIM: To compare the inhibitory effects of PEDF and Avastin on alkali-induced corneal neovascularization(CNV)of rat.

METHODS: Thirty eyes of 30 SD rats were chemically cauterized by applying a 3mm-diameter filter paper soaked 1mol/L NaOH solution at the central cornea for 40 seconds. All animals were randomly assigned to five groups: group A, the PEDF drops was used the day after cauterization; group B, the PEDF drops was used the third day after cauterization; group C, the Avastin drops was used the day after cauterization; group D, the Avastin drops was used the third day after cauterization; group E, normal saline solution drops was used the day after cauterization(control group). All the eye drops were applied 10μL every time and 4 times per day. The growth of CNV was observed by slit lamp microscope and the area of CNV was calculated. Expression of VEGF and CD31 was detected by immunohistochemistry on the twelfth day after experiment.

RESULTS: On the twelfth day, the area of CNV in group A was smaller than that of group B, C(P<0.01). There was no significant difference in terms of CNV areas between group B and D(P=0.215)and between group C and D(P=0.058). Immunohistochemistry revealed that the expression of VEGF and CD31 was little in group A and massive in group E. In group B, C and D, expression of VEGF and CD31 was more than that of group A.

CONCLUSION: Topical application of PEDF and Avastin can inhibit alkali-induced CNV, moreover PEDF is superior to Avastin if applied early after cauterization.

Abstract:AIM: To investigate the effect and possible mechanism of poly ADP-ribose polymerase(PARP)inhibitor 3-aminobenzene(3-AB)on the lens opacity in the diabetic rats.

METHODS: Wistar rats were randomly divided into three groups: control group, diabetic group and 3-AB group. The rats of diabetic group and 3-AB group were treated with intraperitoneal injection of streptozotocin(STZ). The rats of control group were given the same volume of citrate buffer. After the model constructed, 3-AB group was treated with 3-AB(30 mg/kg)gavage daily while the control group and diabetic group were given the same volume of 0.9% NS instead. The progress of lens opacity of rats was observed and recorded. After administrated for 2, 4 and 8 weeks, rats were sacrificed and taken lens respectively. The lens were used to detected the activity of glutathione peroxidase(GSH-px), superoxide dismutase(SOD), the level of malondialdehyde(MDA)and advanced glycation end products(AGE), the expression of matrix metalloproteinase-2(MMP-2)and basic fibroblast growth factor(bFGF)in lens epithelial cells.

RESULTS: Lens of diabetic group and 3-AB group appeared various degree of cloudy since the third week. The level of diabetic group was higher than 3-AB group(P<0.01)in the fourth and eighth week. The GSH-Px and SOD activities of diabetic group were lower than 3-AB group(all P<0.05)at the 2, 4, 8 weeks, but all of them lower than control group(P<0.01). The content of MDA increased in diabetic group and 3-AB group, compared with control group(P<0.01), and its content in diabetic group was higher than in 3-AB group(P<0.05)at the 2, 4, 8 weeks. The content of AGE in the lens that come from control group were lower than diabetic group and 3-AB group(all P<0.05)in each time. At 2, 4 weeks, its content in diabetic group was higher than in 3-AB group(P<0.05), but there was no difference at 8 weeks(P>0.05). There was rare expression of MMP-2 in control group, the MMP-2 expression of diabetic group is statistically significant higher than 3-AB group(P<0.05)in the 2, 4, 8 weeks. bFGF was expressed in the three groups, and the bFGF expression of control group was lower than diabetic group and 3-AB group(all P<0.05)in the 2, 4, 8 weeks. There was no difference between diabetic group and 3-AB group in each time.

CONCLUSION: 3-AB has a certain inhibitory effect for lens opacity in the STZ-induced diabetic rats, the possible mechanism: alleviates the oxidative damage of lens epithelial cells, reduces the level of non-enzyme glycation, and inhibits the expression of MMP-2 suggested that it can alleviate the degradation of lens epithelial cells' extracellular matrix, which lead to inhibit the lens opacity.

Abstract:AIM:To explore the effect and significance of NEP1-40 on visual cortical plasticity of monocular deprivation in adult rats.

METHODS: Totally 60 neonatal rats were randomly allocated into 6 groups: normal animals(Nor), normal animals treated with PBS(Nor+PBS)or NEP1-40(Nor+NEP), MD animals without any treatment(MD), MD animals treated with PBS(MD + PBS)or NEP1-40(MD + NEP). We subjected P21 rats to monocular deprivation model until P45. Then the deprived eyes of MD model rats were reopened and followed by NEP1-40 or PBS administration for 7 days. Ultrastructral modifications of synaptic junctions and objective visual function were examined at P52 to determine the therapeutic effects of NEP1-40.

RESULTS: The objective visual function examined by F-VEP: At P45, F-VEP showed that compared with rats in Nor group, deprived eyes of rats in MD group, MD+PBS group and MD+NEP group displayed a longer latency(P<0.05)and a smaller amplitude(P<0.05); At P52, we could see that comparing with the MD group and MD + PBS group, the latencies of F-VEP in MD+NEP group were shortened and the amplitudes were increased(P<0.05), which were similar with that of in Nor group(Nor vs MD+NEP, P>0.05). The structural modifications of synaptic junctions examined by electromicrographs: All of the structural parameters of the synaptic junction in visual cortex were altered by monocular deprivation in MD group compared with the Nor group, displaying an increased width of synaptic clefts, shortened synaptic active zone, decreased curvature of synaptic interface and decreased thickness of PSD. However, synaptic ultrastructural analysis showed that NEP1-40 treatment could recover the entire structural index in monocular deprivation rats(MD vs MD+PBS vs MD+NEP, P<0.05)but not normal rats(Nor vs Nor+PBS vs Nor+NEP, P>0.05). It was noteworthy that, although the width of synaptic clefts in MD+NEP group decreased remarkably in comparison with that of in MD group, it still had not reach the normal level(Nor vs MD+NEP, P>0.05).

CONCLUSION: NEP1-40 could recover the structural modifications of synaptic junctions of neurons in visual cortex contralateral to deprived eye, as well as the objective visual function of deprived eye, which indicated a new role for NEP1-40 in reactivation of visual cortical plasticity from monocular deprivation in adult rats and offered the theoretical foundation for curing adult patients with amblyopia in the clinic.

Abstract:AIM: To study the effect of artesunate(ART)on proliferation and expression of vascular endothelial growth factor(VEGF)in cultured human retinal capillary endothelial cells in vitro under the condition of high glucose.

METHODS: Human retinal capillary endothelial cells(HRCECs)extraction was taken from fresh human eyeand cultured in vitro. The cells of good growth in 3^rd-4^th generation were used into the experiment. The experimental subjects were divided into low glucose control group, high glucose control group and high glucose+different concentrations ART(15μg/mL, 30μg/mL, 60μg/mL, and 120μg/mL)groups. The effect of ART on the proliferation of HRCECs for 24 and 48 hours was measured by MTT assay. The effect of ART on the expression of VEGF in HRCECs was detected by immunocytochemistry.

RESULTS: The results from MTT assay showed that high glucose significantly increased the proliferation of HRCECs(P>0.05)and treatment of HRCECs with ART at the concentrations 15μg/mL,30μg/mL,60μg/mL,120μg/mL for 24 and 48 hours caused a time- and dose-dependent inhibition in the proliferation of HRCECs(P<0.05). The expression of VEGF in high glucose group was significantly higher than that in the low glucose control group(P<0.05). Compared with the high glucose control group, the expressions of VEGF in high glucose + different concentrations ART(15μg/mL,30μg/mL,60μg/mL)groups were decreased in a dose-dependent manner(P<0.05).

CONCLUSION: ART concentration-dependently inhibits high glucose-induced proliferation and VEGF overexpression in HRCECs, indicating that ART-inhibited the proliferation of HRCECs exerted by high glucose environment might be related to the inhibition of VEGF expression.

Abstract:AIM: To observe human lens epithelial cells(HLE-B3)proliferation changes when the PAX6 gene has been knocked-down.

METHODS: Four groups PAX6 shRNA lentiviral vectors and the control group lentiviral(pGCL-GFP-shRP1, 2, 3, 4, NC)infect B3 cells. Real Time PCR and Western blot analysis was used to determine PAX6 silence after infection 96 hours. Effective PAX6-silence pGCL-GFP-shRP4 was selected to infect B3 cells, MOI(Multiplicity of infection)= 10 and the changes were observed in the number of the cells. The B3 cells apoptosis was detect by flow cytometry after 48 hours in infection.

RESULTS: RNAi-virus-infected B3 cells decreased in the number of cells with infection prolonged. The flow cytometry results showed that after knock-down the PAX6 for 48 hours, apoptotic peak appeared before the G₁/G₀ phase.

CONCLUSION: Lentivirus-mediated RNA interference can effectively silence PAX6 expression in B3 cells. There is HLE-B3 apoptosis after PAX6 gene knock-down.

Abstract:AIM: To study the influences of dexamethasone to cryopreserved cornea endothelial cells.

METHODS: Fresh pig corneas were drilled down by 13mm-diameter trephine. Then the grafts were put into four kinds of cool cryoprotective media by turns and equilibriumed with ‘simplified four-step' method. All grafts were thawed in 40℃. All dexamethasone pretreatment corneas were additionally incubated in the last cool cryoprotective medium which had 0.01mg/mL, 0.03mg/mL or 0.05mg/mL dexamethasone for 18 hours in 4℃ before cryopreservation. Corneas thawed were stained by typan blue and alizarin Bordeaux. Survival rates of endothelia cells were observed.

RESULTS: There were no significant differences in endothelia survival rate among rate-freezing group and every dexamethasone pretreatment group.

CONCLUSION: In 0.01-0.05mg/mL of concentrations, dexamethasone shows no toxic effects. Survival rate of endothelial cells was more than 90%.

Abstract:AIM: To explore protective effects of curcumin on high glucose concentration induced rhesus choroido-retinal endothelial cell(RF/6A)damage.

METHODS: RF/6A was randomly assigned into 4 groups(n=6/group): Control group(CONT group, DMEM+10% FBS), high glucose concentration group(HGC group, DMEM+10% FBS+40mmol/L glucose), curcumin group(CUR group, DMEM+10% FBS+30μmol/L curcumin)and curcumin-glucose group(C-G group, DMEM+10% FBS+40mmol/L glucose+30μmol/L curcumin). Five days later, cells were observed with microscope, and cell viability was detected by methyl thiazolyl tetrazolium(MTT). Moreover, agarose gel electrophoresis was introduced to investigate DNA ladder in each group. We also detected expression of tumor necrosis factor-α(TNF-α).

RESULTS: Compared with CONT group, cell viability in HGC group was decreased(P<0.01), showing no obvious difference in CUR or C-G groups(P>0.05). HGC group presented obvious DNA ladder, while no ladder was observed in CONT, CUR or C-G group. Furthermore, compared with CONT group, TNF-α was up-regulated in HGC group(P<0.01), and no difference was detected in CUR group or C-G group(P>0.05).

CONCLUSION: Curcumin attenuates high glucose concentration induced RF/6A apoptosis, maintaining cell viability, which may result from reversing HGC-induced up-regulation of TNF-α.

Abstract:AIM: To study the effect of mobile microwave on the expression of Bax in the lens epithelial cells of rat in vitro.

METHODS: Bax expression was detected by ELISA and immunohistochemistry after the lenses of rats were cultivated in MEM culture medium.

RESULTS: The expression of Bax in the mobile microwave groups was significantly higher than the control group(P<0.05)and the expression of Bax accumulated while it was exposed in the mobile microwave.

CONCLUSION: Mobile microwave can induce the expression of Bax in the lens epithelial cells of rat and cause cataract.

Abstract:AIM: To comprehensively analyze the relationship between cataract and hypertension among Chinese population.

METHODS: An electronic search was performed inPubMed, Web of Knowledge, Wanfang data and CNKI. Afterwards we carried out a random-effect meta-analysis, followed by subgroup analysis on latitude and sample size, along with sensitivity analysis.

RESULTS: Totally 7 studies including 3247 cataract patients were eligible among 208 papers screened in our search. The odds ratio(OR)was 1.20(95%CI, 1.01-1.38). Subgroup analysis indicated latitude was covariate that led to heterogeneous. Sensitivity analysis confirmed our results' stability.

CONCLUSION: The meta-analysis results prompted hypertension can increase the risk of cataract of the Chinese population.

Abstract:AIM: To observe the effect of protein-free calf blood extract eye gel on epithelial healing after Epi-LASIK, and to improve the clinical use of postoperative eye irritation.

METHODS: Seventy-eight patients(156 eyes)performing off-flap Epi-LASIK were randomized into experimental and control groups. Forty patients(80 eyes)were in experimental group and thirty-eight patients(76 eyes)in control group. The two groups were treated with compound tobramycin eye drops, tears naturale eye drops for 7 days, four times a day, then the conventional artificial tears and 1g/L fluorometholone were given. Protein-free calf blood extract eye gel for 7 days, four times a day were given in the experimental group, the follow-up time was 6 months, the postoperative pain, time of corneal epithelial recovery, visual acuity and corneal subepithelial opacity(haze)were examined at special time in two groups. Clinical outcomes were compared between groups.

RESULTS: The mean time of corneal epithelial recovery was(2.89±1.06)days in the experimental group and(4.22±1.47)days in the control group. Compared with the control group, outcome of rapider reepithelialization was found in the experimental group, there was statistical difference(t=6.45, P<0.05). The average pain score of experimental group was(1.70±0.44)on the first day and(1.02±0.60)on the second day, the control group was(2.89±0.43)and(1.71±0.55), the experimental group obviously had milder pain, there was statistical difference(P<0.05). There was no significant difference in visual acuity and haze between the two groups(P >0.05).

CONCLUSION: Protein-free calf blood extract eye gel has effectiveness on reducing ocular pain and promoting cornea epithelial healing after Epi-LASIK, the application is safe and has shorter onset time.

Abstract:AIM: To study the change of corneal topography and morphologic to analyze the clinical effects after topography supported customized ablation(TOSCA)for high myopia with thin corneal thickness.

METHODS: Totally 60 patients(120 eyes)with high myopia received corneal refractive surgery. Preoperative spherical equivalent of patients was from -6.00D to -9.00D, and the mean was -7.20±1.18D, the mean corneal thickness was 511±17.93μm. Then the uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), residual corneal thickness, diopter, corneal topography, simulated keratoscope reading(SIMK), corneal irregularity measurement(CIM), and shapa factor(SF)were examined preoperatively and 1 month, 3 and 6 months postoperatively.

RESULTS: The percentage of UCVA exceeding and being equal to 1.0 at 1 month, 3, 6 months after TOSCA was 96%, 97%, 98%. The diopter after TOSCA was improved evidently and turned to be stable at 6 months. The percentage of corneal topographic pattem after 1 month, 3 and 6 months including smooth pattem was 86%,93%,96% respectively while was relatively stable, and other pattem was seldom. No central islet was fond. Other rectomy shape became regulating gradually. At 1 month, 3 and 6 months post-operation, Simk equivalent value and Simk difference value decreased significantly, and the value of corneal irregularity measurement(CIM)increased too. While the value of corneal shape factor changed to negative direction. These above mentioned parameters showed statistically significant difference compared with those of pre-operation(P<0.05).

CONCLUSION: Examination and analysis on the cornmeal topography before and after TOSCA can clearly display the morphological change of the corneal surface topography and morphology, which helps carry out TOSCA individually and achieve perfect correction.

Abstract:AIM: To evaluate clinical efficacies of different suture of scleral flap in trabeculectomy for the primary acute angle-closure glaucoma.

METHODS: Totally 60 cases(68 eyes)of confirmed primary acute angle-closure glaucoma were randomly divided into two groups. Group A(four-needle suture of scleral flap)were 30 cases(33 eyes). Group B(two-needle suture of scleral flap)were 30 cases(35 eyes). Postoperative intraocular pressure, anterior chamber depth and filtering bleb shape were compared. All cases were followed-up for 6 months.

RESULTS:(1)On the 2^nd postoperative day, compared intraocular pressure(IOP)of both groups, the difference was statistically significant(t = 5.8765, P <0 05); 2 weeks of post-operation, compared IOP of both groups, there was no statistically significant difference(t=1.2347, P>0.05); In the 1^st month after operation, compared IOP of both groups, the difference was not statistically significant(t=1.4350, P>0.05); In the 3^rd month postoperatively, compared IOP of both groups, the difference was not statistically significant(t=1.3548, P>0.05); 6 months after operation, compared IOP of both groups, there was no statistically significant difference(t=1.5753,P>0.05).(2)On the 2^nd postoperative day, the incidence rate of shallow anterior chamber in group A was 6%, and that of group B was 17%. Shallow anterior chamber in group A was mainly shallowⅠ. Compared the incidence rate of shallow anterior chamber between both groups, the difference was statistically significant(χ ²=6.4513, P<0.05); 1 week after operation, the incidence rate of shallow anterior chamber in group A was 0 and 3% in group B respectively. Compared the incidence rate of shallow anterior chamber between both groups, the difference was not statistically significant(χ ²=0.7341, P>0.05).(3)functional filtration bubble formation rate of patients of two groups in 1 month and 6 months postoperatively: that of 1 month after operation in group A was 97% and 94% in group B respectively, compared them between two groups, the difference was not statistically significant(χ ²=0.7301, P>0.05); That of 6 months after operation in group A was 88% and 86% in group B respectively, the difference was not statistically significant when compared them between two groups(χ ²=0.8172,P>0.05).

CONCLUSION: In primary acute closed-angle glaucoma underwent trabeculectomy, four stitches of the scleral flap can better control IOP in the short term, and reduce the incidence rate of early shallow anterior chamber.

Abstract:AIM: To observe the clinical effects of rigid gas permeable contact lens for orthokeratology, evaluate the safety and effectivity of orthokeratology for teenagers, and analyze relevant factors.

METHODS: One hundred and twenty patients(200 eyes, aging from 10 to 18 years old)were followed up for six months. All patients wore night orthokeratology lens after standard optometry for spectacles. The therapeutic effect and complications, subjective feeling were observed.

RESULTS: All patients after six months wearing felt favorable. Uncorrected visual acuity was improved after six months, the difference was significant(P<0.01). Diopters and K value were lower than the past. The difference was significant(P<0.01). There was no significant difference between the ocular axial length, corrected visual acuity of before and after treatment.

CONCLUSION: Orthokeratology lens are safe and effective for treating mild and middle myopia of teenager's. But the further study is needed to ensure the safety and effectivity for long wearing.

Abstract:Artificial lens implantation technology maturity and the perfect combination of cataract surgery make artificial lens performance to more and more close to ideal natural lens direction. To solve pure ‘target vision'(distant vision or near vision)for the purpose of artificial lens implantation, has been unable to meet the requirements of high quality vision. It is urgent that there be the advent of artificial lens suitable for all kinds of special requirements to meet the needs of the patient and make cataract surgery really become a refractive surgery. In this paper the research progress of artificial crystal were reviewed briefly.

Abstract:Age-related macular degeneration(AMD)was a main cause leading to low vision and blindness of theWestern countries elderly population. AMD has become a hotspot in the ophthalmology research. According to the clinical and pathological finding, it was divided to the dry and wet two types, and the dry type was accounting for about 90 percent. So the aim of the article was to analyze and summarize the pathophysiological mechanisms and recent drug treatment methods to the dry AMD, so as to provide evidence for the future treatment of AMD.

Abstract:Signal transducer and activator of transcription(STAT)3 is a member of the cytoplasmic transcription factors family which participates in a wide variety of physiological processes including cell growth, differentiation, proliferation, apoptosis and angiogenesis. It broadly exists in various tissues as well as retina. The expression of STAT3 plays an important role in various retinal diseases including ischemic retinopathy, diabetic retinopathy. The purpose of this paper is to review the biological functions of STAT3, and its role in various.

Abstract:Induced pluripotent stem cells(iPSCs)are reprogrammed through transduction of exogenous transcription factors, into somatic cells, reprogramming the somatic cells to embryonic stem cells-like cells with potencies of unlimited proliferation and pluripotent differentiation. This technology is a milestone in the field of regenerative medicine, and many related studies have been made these years. In the development of iPSCs technology, we have achieved a lot of progress; these will lay a foundation of cell therapy. Meanwhile, the successfully reprogrammed human somatic stem cells and good results in the study of animal models have been achieved. This article aims to emphasize the development of iPSCs in Ophthalmology.

Abstract:Keratoconjunctivitis sicca, commonly known as the ‘dry eyes', is to point to any cause to tear quality or quantity anomaly or dynamic anomaly, leading to decline tear film stability, and accompanied by eye discomfort and/or ocular surface tissue lesion characteristics of many kinds of disease body. In recent years the study on pathogeny and pathogenesis continuously go deep into the research, combining traditional Chinese and western medicine treatments of dry eyes and had made new progress. The present study reviewed nearly 3 years relevant literature researches. The combination of traditional Chinese and western medicine treatment methods are summarized.

Abstract:Amblyopia has been defined as a unilateral or bilateral decrease of best corrected visual acuity caused by unusual experience of visual, including unilateral strabismus, anisometropia, ametropia and form deprivation, which can not be detected by physical examination of the eye. The treatment of amblyopia in children has been a hot issue in ophthalmology. Although there is a progress in the research and there are varieties of methods in recent years, the best therapeutic schedule is still being discussed. For this, we reference the latest documentations to make a review in the treatment schedule of amblyopia in children and the problem existing in the schedules.

Abstract:AIM: To investigate the affecting factors that can serve as prognostic indicators of treatment outcomes, providing the first hand information for decision-making in therapy of fungal keratitis.

METHODS: Totally 105 cases(105 eyes)with fungal keratitis were enrolled, characteristics at diagnosis, laboratory examinations and treatment responses were analyzed statistically to estimate the relative risk of the main prognostic variables.

RESULTS: Among the 105 cases analyzed in the study,49 eyes(46.7%)were successfully cured, 30 eyes(28.6%)had slow-healing ulcers and 26 eyes(24.8%)were refractory to primary treatment.

CONCLUSION: The predictors of treatment failure are antifungal therapy begin at more than 7 days after symptoms appeared, ulcers that exceeded 16 mm², the presence of hypopyon that more than 2 mm and identification of Fusarium.

Abstract:AIM: To study the clinical efficacy of phacoemulsification and intraocular lens implantation for cataract patients with different angle-closure degree of angle-closure glaucoma.

METHODS: There were 31 patients 35 eyes who were with angle-closure glaucoma and cataract. According to the degree of angle closure adhesions, they were divided into groups A, B. Group A(the angle closure adhesions ≤ 90 °)had 19 eyes, group B(the angle closure adhesions 90° -180°)had 16 eyes. Phacoemulsification and intraocular lens implantation were performed for both groups. The preoperative and postoperative visual acuity, intraocular pressure(IOP), anterior chamber depth, angle changes and the length of the axial length, lens thickness, vitreous length in the two groups were observed and statistically analyzed.

RESULTS: The angle-closure glaucoma with cataract patients' visual acuity was improved and the angle deepened. Gonioscopy: The number of fully open angle was 16 in the group A(84%). And in the group B, completely open angle was 13 eyes(81%). The difference of A and B was not statistically significant(P>0.05). IOP: preoperative IOP was 35.13± 4.18mmHg in A, and in B was 45.01±5.31mmHg. After 1 week, IOP in group A was controlled in 14.25 ± 3.22mmHg and group B was 14.30±3.19mmHg, there was no statistical significance(P>0.05).

CONCLUSION: Positive relationship exists between the proportion of axial length, lens thickness and vitreous length. For angle-closure glaucoma with cataract patients, a simple surgery of the phacoemulsification can effectively treat angle-closure adhesions ≤ 180 °, and for patients with angle-closure adhesions> 180 °, the joint treatment of glaucoma surgery can be considered.

Abstract:AIM: To evaluate the effect of phacoemulsification with posterior chamber intraocular lens(PCIOL)implantation for primary angle-closure glaucoma with cataract.

METHODS: Totally 39 cases(45 eyes)of angle-closure glaucoma with cataract were performed on phacoemulsification with PCIOL implantation. The visual acuity, intraocular pressure(IOP), anterior chamber depth(ACD)and chamber angle were observed postoperatively. All cases were followed up for 3 to 24 months.

RESULTS: The best-corrected visual acuity improved in all patients and 33 eyes(73%)≥0.5. The mean IOP was significantly decreased(P<0.01), the mean ACD was significantly increased(P<0.01), and the anterior chamber angles were wider postoperatively.

CONCLUSION: Phacoemulsification with PCIOL implantation is effective and safe for primary angle-closure glaucoma with cataract. It can decrease the IOP, increase ACD and widen anterior chamber angles significantly.

Abstract:AIM:To evaluate the safety and efficacy of a modified technique for transscleral fixation of a foldable posterior chamber intraocular lens(IOL)in the absence of capsule support.

METHODS: Scleral fixation of a foldable IOL was performed by using a new small incision technique with injector implantation system via 3.2mm clear corneal incisions in 52 eyes of 52 patients who can not be normally implanted posterior chamber IOL because of posterior capsule rupture or suspensory ligament fracture. Postoperative visual acuity, corneal astigmatism and complications were observed in 6 months follow-up.

RESULTS: Postoperative uncorrected visual acuity improved in all patients, of which more than 1.0 in 8 eyes, 0.6 to 0.8 in 18 eyes, 0.4 to 0.6 in 16 eyes, less 0.4 in 10 eyes. Postoperative uncorrected visual acuity was at least 0.5 in 33 eyes(63%), 39 eyes(75%), 41 eyes(79%)at postoperative 1 week, 1 month, 3 months respectively. There was no significant difference in corneal astigmatism guided by corneal topography between preoperative and postoperative(P>0.05). During follow-up, the IOL was correctly positioned in all cases. There were no major complications, such as endophthalmitis or suture erosion through the conjunctiva at the site of fixation. No patient required further surgical interventions.

CONCLUSION: This modified technique of transscleral fixation of foldable posterior chamber IOL offers the advantages of a small incision and rapid visual rehabilitation, and minimizes the risk of intraoperative and postoperative complications.

Abstract:AIM: To analyze the effect of phacoemulsification and intraocular lens implantation for the treatment of diabetic cataract.

METHODS:Totally 65 cases 98 eyes of diabetic patients with phacoemulsification and intraocular lens implantation were retrospectively observed. Statistics analysis including visual acuity of 1 day, 30 days after surgery, complications, and the correlation between visual acuity and the duration of diabetes.

RESULTS: On the 1^st day after surgery, uncorrected visual acuity> 0.5 in 69 eyes(70.4%), 0.3 to 0.5 in 18 eyes(18.4%), 0.1 to 0.25 in 8 eyes(8.2%), and <0.1 in 3 eyes(3.1%). While on the 30^th day after surgery, visual acuity> 0.5 in 80 eyes(81.6%), 0.3 to 0.5 in 12 eyes(12.2%), 0.1 to 0.25 in 4 eyes(4.1%), <0.1 in 2 eyes(2.0%). Complications included corneal edema, anterior chamber fibrin exudation, synechia and secondary glaucoma.

CONCLUSION: Phacoemulsification and intraocular lens implantation for the treatment of diabetic cataract is safe and effective. The recovery of visual acuity is relative to the duration of diabetes and diabetic retinopathy.

Abstract:AIM: To analyze the use of different surgical methods for traumatic hyphema with secondary glaucoma patients, depending on the condition.

METHODS: Out of 63 cases 63 eyes, 18 cases 18 eyes underwent the scleral tunnel incision + transparent cornea auxiliary incision cataract aspirating needle manually suction lavage; 32 cases and 32 underwent self-closed clear corneal incision phacoemulsification infusion pumping aspiration; 13 cases and 13 underwent trabeculectomy.

RESULTS: In the 63 cases 63 eyes, visual acuity of 9 cases 9 eyes was more than 1.0, accounting for 14.3%; of 13 cases 13 eyes was 0.6 to 0.8, accounting for 20.6%; of 11 cases 11 eyes was 0.4-0.5, accounting for 17.5%; of 8 cases 8 eyes was 0.3, accounting for 12.7%; of 7 cases 7 eyes 0.2, accounting for 11.1%; of 5 cases 5 eyes was 0.15, accounting for 7.9%; of 3 cases 3 eyes was 0.1, accounting for 4.8%; of 3 cases 3 eyes was 0.01-0.05, accounting for 4.8%; of 2 cases 2 eyes was finger counting, accounting for 3.2%; of 2 cases 2 eyes was hand motion, accounting for 3.2%.

CONCLUSION: Anterior chamber hemorrhage patients, according to how much of the plot of blood volume, blood clot, the size of the cohesion of the anterior chamber, intraocular tissue injury severity, complications, respectively, using different surgical methods can receive different surgical effect. In particular, rational application of intraoperative viscoelastic agents play a very important role in improving the success rate of surgery to reduce postoperative complications.

Abstract:AIM: To determine the long-term effect of methylprednisolone's shock therapy in idiopathic demyelinated optic neuropathy.

METHODS: The data of 81 cases(104 eyes)diagnosed with idiopathic demyelinated optic neuropathy were retrospectively analyzed. The cases were divided into group A and group B. Group A were applied methylprednisolone to aid in trophic nerve and expansion blood vessels' drug therapy, group B were applied only trophic nerve and expansion blood vessels' drug therapy. The two group's eyesight, visual field and visual evoked potential's change and recurrence rate were observed after 1 year, 2, 5 years respectively.

RESULTS: There was no significant difference of eyesight improvement, vision improvement and visual evoked potential recovery between two groups at each observation time point(P>0.05). From the beginning of this disease till five years, group A's recurrence rate was been much lower than group B. There was statistical significant difference(P<0.05).

CONCLUSION: The methylprednisolone's shock therapy can reduce the recurrence of the patients.

Abstract:AIM: To probe the effect and safety of laser ablation for minor trichiasis through the contrastive study on the effect of laser ablation and mechanical epilation in trichiasis.

METHODS: Totally 59 cases(80 eyes)of minor trichiasis(less than 10)patients were involved. The phalangosis was divided into two areas according to the patient's nasal side and bitamporal and then were practiced laser ablation and mechanical epilation to them. Post-operative stimulating sign of the two areas, eyelid fovea, skin depigmentation and trichiasis recurrence were recorded and observed. Traditional treatment was practiced to those trichiasis recurrences and they were observed for half a year.

RESULTS: The success rate of first-time laser ablation intrichiasis was 62.1% and second-time treatment was up to 88.9%, while for the mechanical epilation in trichiasis it was 5.3% and 8.2% respectively. Because of its high reoccurrence rate, after two times of mechanical epilation in trichiasis, the patients received laser ablation. After receiving laser ablation, there were no red and swollen sign, no eyelid fovea and no skin depigmentation.

CONCLUSION:Mechanical epilation has a high recurrence rate in trichiasis while laser ablation has a much lower recurrence rate and has much less complications. So laser ablation is an ideal treatment for the minor trichiasis.

Abstract:AIM: To observe the application of bioadhesive fibrin adhesive and epidermal growth factor( EGF)instead of the conventional sutures in the ocular pterygium surgery.

METHODS: Totally 78 eyes in 60 cases of pterygium patients were divided into 2 groups according to the limbal violations range. Group A for the range of less than 1/2, a total of 28 cases, 34 eyes; Group B was greater than or equal to the range of 1/2, with a total of 44 eyes in 32 cases; each group was randomly divided into two groups A1, A2, B1, B2, one using absorbable sutures, the other using the improved adhesive fibrin paste method. The operation time, post-operative pain sensation, recurrence rate, and the ocular surface epithelial healing time were compared between the four groups.

RESULTS: The operation time between the group A1 and A2, B1 and B2 had significant differences(P<0.05). There was significant difference of pain assessment between the suture group and the fibrin paste group, the paste group was less pain feeling(P<0.05). The corneal epithelial healing were observed after 4 days and 6 days operation time, there was significant difference(P<0.05)of epithelial healing area in the fibrin paste group compared with the suture group. The recurrence rate during 6 months after operation was reduced in fibrin paste group, but there was no significant difference(P>0.05).

CONCLUSION:Using fibrin sealant compound in the pterygium surgery can relieve pain in patients, reduce inflammation, shorten the operation time, avoid the trouble feeling of suture after surgery, accelerate corneal epithelial healing, and reduce the relapse rate.

Abstract:AIM:To observe the difference of dry eye after small incision extracapsular cataract extraction and intraocular lens(IOL)implantation between patients with age-related cataract and patients with both diabetes and cataract.

METHODS:Seventy-five patients(78 eyes)who received small incision extracapsular cataract extraction in our hospital from January to December 2011 were divided into two groups: 35 patients(38 eyes)with age-related cataract in group A and 40 patients(40 eyes)with both diabetes and cataract in group B. The subjective complains of dry eye, tear break-up time, corneal fluorescein staining, Schirmer I test and the height of tear meniscus were measured preoperatively and 1 day, 1 week, 1 month and 3 months postoperatively respectively.

RESULTS:There was no significant difference between the two groups preoperatively(P>0.05). Compared with data before operation, the group A's subjective complains of dry eye increased and the mean tear break-up time reduced greatly at 1 day, 1 week postoperatively(P<0.05). They returned to their preoperative levels at 1 month and 3 month postoperatively(P>0.05). Compared with data before operation, the group B's subjective complains of dry eye increased and the mean tear break-up time reduced greatly at 1 day, 1 week and 1 month postoperatively(P<0.05). They returned to their preoperative levels at 3 month postoperatively(P>0.05). In the different time points after operation, the degree of subjective complains of dry eye were significantly more severe in group B than in group A, and the corneal fluorescein staining scores were significantly higher in group B than in group A(P<0.05).

CONCLUSION:The tear film stability of patients with both diabetes and cataract reduced in early stage after small incision extracapsular cataract extraction and intraocular implantation. Compared with patients with age-related cataract, patients with both diabetes and cataract recovered much more slowly. The subjective complains of dry eye were more obvious in patients with both diabetes and cataract, but they would disappear with the passage of time.

Abstract:AIM: To study the influence factors of early low vision in diabetics after phacoemulsification.

METHODS:Totally 600 eyes which were performed diabetic cataract phacoemulsification combined artificial lens implantation from 2008 to 2011 in our hospital were involved into retrospective analysis, with the best-corrected visual acuity less than 0.3 as the standard. According to the 2002 international clinical classification of diabetic retinopathy(DR), subjects were divided into: group A with 237 eyes(no retinopathy), group B( non-proliferative phase of diabetic retinopathy, NPDR)363 eyes, group B was divided into: the mild NPDR 177 eyes, moderate NPDR 150 eyes, severe NPDR 36 eyes. The related cause factors of low vision were analyzed retrospectively.

RESULTS:Seven days after the surgery, the best-corrected visual acuity <0.3 were in 41 eyes(17.3%)of group A; 103 eyes(28.4%)of group B. There was no statistical significance between 2 groups(P<0.05). According to epidemiological methods, 5 factors which affected the early postoperative visual were analyzed. Multi-factor logistic regression analysis was used. The results of the 5 factors were given out as following, crystal nucleus hardness(OR=4.065,95% CI: 2.289-7.312); HbA1c(OR=3.781,95% CI:2.256-6.439); DR stage(OR=3.987,95% CI: 2.678-6.894); postoperative corneal edema(OR=1.089, 95% CI:1.017-1.072); age(OR=1.687, 95% CI:1.171-2.416). Then the 4 factors of low vision including crystal nucleus hardness, HbA1c, DR stage and postoperative corneal edema were analyzed using analysis of variance(ANOVA)(P<0.05), and the differences were statistically significant.

CONCLUSION: Crystal nuclear hardness,glycosylated hemoglobin, DR stage, the corneal edema are the influencing factors of early postoperative low vision of diabetic cataract.

Abstract:AIM: To observe the clinical effect and visual function of laser in treatment of central serous chorioretinopathy(CSC).

METHODS: Totally 60 cases clinically diagnosed with CSC were randomly divided into laser treatment group and drug treatment group, 30 cases in each group.Visual acuity and changes of mfERG in two groups were observed, and patients were followed up for 6 months.

RESULTS: The treatment of vision effective rate in laser treatment group was 92.35% and after one month with no patient recrudesced. The treatment of vision effective rate in drug treatment group was 49.58% and the recurrence rate was 13.33%. mfERG showed the response densities of ring 2, ring 3, ring 4 and ring 5 areas in laser treatment group were significantly increased while the latencies of ring 4 of N1 wave and the latencies of ring 3, ring 4 and ring 5 of P1 wave were significantly different with drug treatment group(P<0.05).

CONCLUSION:Early treatment of CSC with laser can significantly improve visual function and recovery rate, prevent disease progression, and decrease the recurrence rate, especially at early stage of the disease.

Abstract:AIM: To study the impact of wearing single-vision spectacle lenses(SVLs)on the refractive errors at the periphery of the retina in myopic children.

METHODS: It was a self-control study. Totally 48 children aged 10 to 15 years old were involved. Cycloplegic autorefraction from right eyes was measured using Grand Seiko WAM5500 infrared refractometer and the value was at 0° at the retinal central fovea, at 10°, 20°, and 30° in the temporal and nasal visual fields. Measurements were taken on each subject both while uncorrected and while wearing SVLs.

RESULTS: The mean spherical equivalent refraction of myopia children was -3.99±1.22D. Relative peripheral hyperopia defocus was found in horizontal visual field and increased with the increase of eccentricity. Relative peripheral hyperopic defocus increased when wearing spectacle correction, comparing with the uncorrected state(P<0.05). There was no statistical significance for J₁₈₀ and J₄₅ when compared wearing spectacle and uncorrected state.

CONCLUSION: Relative peripheral hyperopic defocus increased when wearing spectacle correction, comparing with the uncorrected state in myopia children. To improve the design of the lens based on the focus state of the peripheral retina may become the new ideas of myopia correction.

Abstract:AIM: To investigate pathogeny of paralytic strabismus, the patterns of paralytic extraocular muscles and effects of paralytic strabismus on binocular vision.

METHODS: A retrospective study was done in 183 patients with paralytic strabismus who underwent squint correction in our hospital from March 2009 to March 2012.

RESULTS: Of the 183 patients reviewed, the incidence of congenital paralytic strabismus was 80.87%, acquired paralytic strabismus accounted for 19.13%. In 77.60% of the cases, the causes could not be identified, followed by trauma accounted for 14.21%. Among all vertical strabismus the ratio of superior oblique palsy, inferior rectus palsy, superior rectus palsy, double elevator palsy, inferior oblique palsy, double depression palsy accounted for 81.19%, 8.26%, 6.88%, 2.29%, 0.92%, 0.46%, respectively. Among all horizontal strabismus the rate of extra rectus palsy was 54.17%, internal rectus palsy 45.83%. 28.92% of patients who were examined with synoptophore had binocular function.

CONCLUSION: Paralytic strabismus had complex causes. The most common paralytic extraocular muscle was superior oblique muscle. It has important effects on binocular vision. Therefore, surgical treatment should be carried out as early as possible.

Abstract:AIM:To evaluate the validity, reliability and responsiveness of the quality of life scale which measures the quality of life for Chinese patients with visual impairment(SQOL-DV1)when it was used to assess the quality of life(QOL)in thyroid associated ophthalmopathy(TAO)patients.

METHODS:SQOL-DV1 was used to evaluate the QOL of 39 cases with TAO and 31 healthy people as the control group, and then it was analyzed that if the scale can be accurately and effectively assess the quality of life of the TAO patients.

RESULTS:Validity analysis: 1. content validity test. The correlation coefficient between each sub-score was about 0.62 - 0.80(P= 0.00), the correlation coefficient between sub-score and total score was about 0.88-0.89(P= 0.00). 2. Discriminant validity test. The degree scores in patients with TAO were lower than the control group in symptoms and visual function, physical function, social activities, spiritual and psychological of the sub-item scores and scale's total scores(P<0.05). Quality of life scale scores were significantly increased by the treatment(P<0.05). Reliability analysis: 1.The test-retest reliability. The correlation coefficient of repeated measurements was about 0.913(P= 0.00). 2. The Cronbach coefficient was 0.944. Reaction analysis: Effect size statistics(ES)was 0.88.

CONCLUSION: SQOL-DV1 scale is an effective, credible tool to assess the quality of life of the TAO Patients. It can be used for the measurement of quality of life of the TAO Patients in the clinical and related research.

Abstract:AIM: To assess the complications induced by wearing rigid gas permeable contact lens(RGP), and to discuss the preventions and treatments of theses complications.

METHODS: Totally 54 patients 101 eyes who underwent RGP therapy were observed alone for 1 year. The patients complains were recorded, routine eye examinations were conducted(including vision, refraction, ocular pressure, slit-lamp findings and corneal topography), the abnormal findings and the treatments were analyzed.

RESULTS: The abnormal findings included dryness in 16 eyes(15.8%), foreign body sensation 8 eyes(7.9%), spotty staining 7 eyes(6.9%), allergic inflammation of conjunctiva 3 eyes(3.0%); corneal trauma 1 eye(1.0%); improper glasses care 15 eyes(14.9%), including the scratched lens 10 eyes, lens lost 3 eyes, fragmentation 2 eyes. Patients all got satisfied outcome with symptomatic treatment except 2 cases not wearing glasses due to eye discomfort. Appropriated treatments were performed.

CONCLUSION: The detail examination, the operation and strict following up are effective methods to preserve the complications according to the RGP.

Abstract:AIM: To evaluate the reliability of preoperative examination for predicted visual acuity and visual function of the cataract eyes before phacoemulsification combined with intraocular lens(IOL)implantation.

METHODS: A total of 83 cases(83 eyes)of cataract were selected from those who underwent phacoemulsification combined with IOL implantation in our hospital. Data were collected for the correlation of preoperative examination with postoperative visual acuity and visual function index scale(VF-14).

RESULTS: Age, sex, eye axis, nuclear hardness, preoperative vision, cataract type, hypertension history, diabetes history, the contralateral vision and sicken time had correlation with postoperative VF-14 and vision; Regarding the VF-14, the predictive factors were the preoperative VF-14, diabetes history and the eye with the better vision. The predictive value was about 83.5%.

CONCLUSION: The postoperative visual acuity and visual function can be evaluated by basic data.

Abstract:AIM: To study the clinical outcome of domestic natamycin medication for the treatment of fungal corneal ulcer comparing with imported natamycin.

METHODS: Twenty eyes of 20 patients from two eye hospitals who were diagnosed as fungal corneal ulcer participated in a randomized, controlled and blinded trial(September, 2010, through March, 2011). Twelve eyes were treated with domestic natamycin eye drops(treatment group), whereas other eight eyes were treated with imported natamycin eye drops(control group). Both groups received eye drops combined with anti-fungal systematic medication at the same dosage, once 0.5 hour for 12 days, once 1 hour for 2 days, once 2 hours for 5 days and once 3 hours for 2 weeks. The clinical efficacy was evaluated between two groups after 3, 5 and 7 days of treatment. Fisher precise test was statistically analyzed for differences.

RESULTS: The clinical effective rate in treatment group was 58.3%, which showed no significant difference with the 75% rate in control group(P>0.05).

CONCLUSION: Domestic natamycin eye drops is effective in the treatment of fungal corneal ulcer.

Abstract:AIM: To investigate the non-staining continuous curvilinear capsulorhexis and phacoemulsification with intraocular lens implantation for the treatment of white cataract.

METHODS:Totally 458 eyes with white cataract underwent phacoemulsification combined intraocular lens implantation, the success rate, intraoperative complications, postoperative visual acuity, corneal edema response index were observed.

RESULTS:Of the 458 eyes, capsulorhexis was successful in 441 eyes(96.3%), 17 eyes(3.7%)film radial tear occurred with scissors, capsular flap was cut out and capsulorhexis was completed. Intraoperative rupture of posterior capsule in 9 eyes(2.0%), mild postoperative corneal edema in 94 eyes(20.5%), moderate oedema block 29 eyes(6.3%), severe edema in 8 eyes(1.7%), both in 2 to 10 days without edema, corneal endothelial decompensation. After postoperative first day, visual acuity improved in 329 eyes(71.8%)with visual acuity >0.3, postoperative one week visual acuity >0.5 in 417 eyes(91.0%).

CONCLUSION:Although non-staining continuous curvilinear capsulorhexis and phacoemulsification with intraocular lens implantation is difficult in treatment of white cataract, but after skilled operation, high success rate and good postoperative visual acuity can be obtained.

Abstract:AIM:To study theclinical effect of YAG laser techniques for after-cataract.

METHODS: Totally 203 patients 224 eyes with after-cataract were include,d after detailed ophthalmologist exams and mydriasis, they were managed by Nd:YAG laser(wavelength:1064μm). Laser aiming light was focused on posterior capsule. Posterior circular capsulotomy was used, and the diameter was about 3-4 mm. After the laser treatment, patients were checked regularly and SPSS 11.0 statistic software was used to deal with the vision before and after the treatment.

RESULTS: The posterior capsules were all successfully opened by once laser, and the success rate was 100%. Their visions were all improved. The vision before and after the treatment had significant differences by statistical disposal(P<0.01).

CONCLUSION: Nd:YAG laser is safer and effective in treating after-cataract.

Abstract:AIM: To analyze the clinical effects of cataract extraction with modified small incision non-phacoemulsification and intraocular lens implantation combined with trabeculectomy for the treatment of cataract and glaucoma.

METHODS:From March 2009 to July 2011, 100 patients with cataract and glaucoma were selected as objects in our hospital. They were all given cataract extraction with modified small incision non-phacoemulsification and intraocular lens implantation combined with trabeculectomy. We made a comparison on intraocular pressure and the vision of patients before and 6 months after surgery.

RESULTS: In the group, the average intraocular pressure was 14.1±2.73 mmHg 6 months after surgery, which was significantly lower than before(46.8±22.5mmHg). Visual acuity in 74 cases of patients was >0.3, which was significantly higher than before the surgery(0 case, P<0.05). Only 6 cases had cornea edema, which resolved with 1 week.

CONCLUSION: Cataract extraction with modified small incision non-phacoemulsification and intraocular lens implantation combined with trabeculectomy for the treatment of cataract and glaucoma can control the intraocular pressure well, make the eyesight recover faster. The cost and complication rate are lower, it has a wide range of surgical indications.

Abstract:AIM: To evaluate theefficacy of selective laser trabeculoplasty(SLT)for different age groups.

METHODS:Totally 46 patients(46 eyes)with primary open angle glaucoma treated by SLT in our hospital from April 2011 to April 2012 were reviewed. The patients were divided into two groups: 26 patients(26 eyes)in young group(<40 years); 20 patients(20 eyes)in middle-aged group(≥ 40 years). The intraocular pressure(IOP)changes between the two groups during the 6 months after SLT were compared. The decreased values of IOP between the two groups were analyzed by the t-test. The effective rates of treatment between the two groups were analyzed by Chi-square test.

RESULTS: The decreased value of IOP and the effective rate of treatment were significantly different between the two groups at all time points.

CONCLUSION: SLT is an effective option for glaucoma therapy, and the young patients are better than the middle-aged patients.

Abstract:AIM: To discuss the anatomical structure of the patients with normal group, primary angle closure suspects(PACS), primary angle closure(PAC)and primary angle-closure glaucoma(PACG).

METHODS: All persons were divided into four groups according International Society of Geographical and Epidemiological Ophthalmology(ISGEO)classification methods: normal group, PACS group, PAC group, PACG group. Anatomical structures including the anterior chamber depth(ACD), lens thickness(LT), the axial length(AL)and relative location of lens(RLL)were measured by a contact ultrasound A-scan biometry device(NIDEK, Echoscan US-1800)in 47 eyes of 47 normal persons, 157 eyes 157 of patients with PAC, 96 eyes of 96 patients with PAC and 86 eyes of 86 patients with PACG.

RESULTS: The age, LT were gradually increased from PACS, PAC to PACG, but the ACD, RLL gradually were decreased(P<0.05). There were significant differences in ACD, LT and RLL between normal group and other groups(P<0.05). ALL anatomical items were different between PACG and other groups(P<0.05). Compared with PAC, PACG had significant differences in ACD and ALL(P<0.05), but other items had no difference.

CONCLUSION: The anatomical characteristics gradually progress from PACS, PAC to PACG. The ACD, RLL can be an indicator in clinical practice for earlier PACG diagnosis.

Abstract:AIM:To investigate the operation mode selection and curative effect on the mid-term and late period of neovascular glaucoma(NVG)in primary hospitals.

METHODS: Totally 20 patients(21 eyes)of mid-term and later NVG were included,7 patients(7 eyes)were treated with cyclocryotherapy combined with trabeculectomy; 11 patients(12 eyes)were treated with panretinal cryotherapy combined with cyclocryotherapy; 2 patients(2 eyes)were treated with cyclocryotherapy combined with vortex veins near sclera lamellar resection.

RESULTS: All the patients pain symptoms were improved significantly, 19 eyes with intraocular pressure controlled under 24mmHg 3 months postoperatively, 2 eyes with intraocular pressure instability: the highest reached 28mmHg. Visual acuity was improved in 5 eyes, no change in 14 eyes, 2 eyeballs atrophy. Iris neovascularization disappeared completely in 21 eyes.

CONCLUSION: In case of the absence of good medical condition in primary hospitals or poor economic condition, the simple operation methods can also alleviate the patient's suffering, save the patient's eyeball and useful vision, and it is easy to be accepted by patients too.

Abstract:AIM: To discuss the treatment plan for glaucoma with congenital microphthalmos.

METHODS: Clinical data and treatment plans of 10 cases affected with congenital microphthalmos(20 eyes)accepted from 1998 to 2011 at ophthalmology department of Xiaogan Central Hospital were reviewed. Follow-up visit lasted 6-47 months.

RESULTS: All the 10 patients(20 eyes)were affected with medium and hyperpresbyopia as well as shallow anterior chamber, 14 eyes suffered closure glaucoma. After preliminary diagnosis, 5 eyes were detected with eye pressure between 22-40mmHg, 9 eyes with eye pressure>40mmHg. 8 eyes therein underwent trabeculectomy. 3 eyes were found with post-operational eye pressure ≤21mmHg, 3 eye with eye pressure between 21-30mmHg, and 2 eyes affected with malicious glaucoma. 6 eyes were treated by ultrasonic phacoemulsification and then trabeculectomy 3 months later. Then 4 eyes were detected with eye pressure ≤21mmHg and with eye pressure between 21-30mmHg. No malicious glaucoma was detected.

CONCLUSION: For closure glaucoma with congenital microphthalmos, treatment only with glaucoma filtration surgery may easily result in failures because of malicious glaucoma and incontrollable eye pressure. To perform cataract extraction in advance will conduces to risk reduction of malicious glaucoma and enhancement of the surgery successful rate.

Abstract:AIM: To discover the common causes of the orbital blow-out fracture and the probability of occurrence and characteristics of eye injury.

METHODS:Totally 63 hospitalized cases of orbital blow-out fracture from January 2009 to March 2011 were retrospectively analyzed in Kowloon Hospital.

RESULTS: The causes of injury of 63 cases of orbital blow-out fracture, boxing injuries in 28 cases, traffic accident in 17 cases, ocular blunt trauma 9 cases, fall injury 5 cases, crash injury 2 cases, and the others two cases. 57 cases patients with eye injury, in which the eyelid subcutaneous ecchymosis, eyelid swollen in 45 cases; eyelid laceration 16 cases; subconjunctival hemorrhage 25 cases; corneal foreign body and epithelial defect, 9 cases; hyphema 5 cases; infraorbital nerve paralysis or sensory retard 4 cases; vitreous hemorrhage in 4 cases; optic nerve contusion in 3 cases; lacrimal canalicular break 2 cases; eyeball rupture in 2 cases; retinal tears 1 case; lens subluxation 1 case.

CONCLUSION: Boxing injury and car accident injury are the main causes of orbital blow-out fracture, boxing injury often causes simple orbital fractures, car accident injuries and blunt contusion easily lead to complex orbital fractures, and often associated with eye injury. In eye injury of the orbital blowout fracture, the highest incidence of eyelid injury, cornea, conjunctiva and anterior chamber angle injury is more common, more serious eye damage such as optic nerve damage, eye rupture, retinal tears are relatively rare.

Abstract:AIM: To discuss the effect of corticosteroid on patients with meibomian gland dysfunction(MGD).

METHODS: Totally 45 patients(90 eyes)diagnosed with MGD were randomly divided into 3 groups. The control group only used the antibiotic eye drops and local physical therapy. The artificial tear group and the corticosteroid group added artificial tears and dexamethasone eye drops respectively. The symptom score, lid margin score, tear film break-up time(BUT), corneal fluorescein staining(CFS)and SchirmerⅠ test(SⅠt)were investigated and compared before and 1 week after treatment.

RESULTS: Before treatment, the data was compared among three groups; there was no statistical difference. In the control group, significant differences were noted in symptom score, lid margin score and CFS but not in BUT and SⅠt after treatment, while there were statistical differences between symptom score, BUT, CFS, SⅠt and lid margin score in both artificial tear group and corticosteroid group. Compared with the control group and the artificial tear group, the symptom score, BUT, CFS, SⅠt and lid margin score were significantly improved in the corticosteroid group after treatment which suggested that the therapy effect of the corticosteroid group was superior to that of the control group and the artificial tear group.

CONCLUSION:Corticosteroid can significantly improve the symptoms and signs for patients with MGD, and its effect is superior to that of antibiotic or/and artificial tear eye drops.

Abstract:AIM: To observe the clinical efficacy of 5-fluorouracil(5-FU)combined with limbal stem cell autograft transplantation for recurrent pterygium.

METHODS: Recurrent pterygium excision and 5-FU combined with limbal stem cell autograft transplantation was performed in 74 cases 74 eyes under microscope.

RESULTS: Postoperative follow-up ranged from 12-36 months, of the 74 cases 74 eyes, 70 cases 70 eyes were cured, 4 cases 4 eyes recurred, the cure rate was 94.6%, recurrent rate was 5.4%.

CONCLUSION: Recurrent pterygium excision and 5-FU combined with limbal stem cell autograft transplantation is an effective method for recurrent pterygium with low recurrent rate.

Abstract:AIM: To investigate the effect of 1g/L diclofenac sodium eye drops after corneal stem cell transplantation in the treatment of pterygium.

METHODS: From January 2009 toApril 2012, 76 cases 104 eyes which underwent corneal stem cell transplantation in the treatment of pterygium in our hospital were randomly divided into diclofenac sodium eye drops group(trial group)and control group. The corneal irritation, healing of epithelium, corneal scar, conjunctival wound healing time and recurrence were observed and compared between the two groups.

RESULTS: There was much lighter symptom of corneal irritation in the trial group than in the control group on 1^st, 3^rd and 5^th day after operation(P<0. 05), but the others have no significant difference(P>0. 05).

CONCLUSION:1g/L diclofenac sodium eye drops is effective and safe in reducing corneal irritation after cornealstem cell transplantation in the treatment of pterygium.

Abstract:AIM: To compare the therapeutic effects of pterygium treated by inferior corneal limbal stem cells autograft transplantation combined with rh-EGF eye drops and simple excision of pterygium.

METHODS: Totally 46 cases(50 eyes)with pterygium were divided into two groups according to the operative method. Group A had 24 cases(25 eyes)which were treated by inferior corneal limbal stem cells autograft transplantation combined with rh-EGF eye drops. Group B had 22 cases(25 eyes)which were treated by simple excision of pterygium. After following up for two years, recovered time of corneal epithelia and recurrent rate of the two groups were observed and compared.

RESULTS: The average recovery time of corneal epithelia of group A was 2.96±0.73 days. The average recovered time of corneal epithelia of group B was 5.64±1.00 days. The difference of the two groups was significant(t=2.17, P<0.05). The recurrent rate of group A was 4%. The recurrent rate of group B was 24%.The difference of the two groups was significant(χ²=4.15, P<0.05).

CONCLUSION: Inferior corneallimbal stem cells autograft transplantation combined with rh-EGF eye drops which can reduce the recurrent rate is an effective method to treat pterygium.

Abstract:AIM: To discuss the feasibility and effectiveness of a new surgical method of endoscopic dacryocystorhinostomy(EES-DCR)in simple chronic dacryocystitis patients, in which, a new self-made lacrimal sac nasal drainage stents inserted in the stoma and a nasal mucosa flap attached to the anterior wall of the anastomotic stoma.

METHODS: Consecutive 30 cases of simple chronic dacryocystitis underwent OK EES-DCR surgery, surgical operation in the traditional methods had the following major improvements: after stoma was finished, cut off most of the nasal mucosa flap, attached to the anterior wall of the stoma and a new silicone material lacrimal sac nasal drainage stents that made by ourselves placed in the stoma, making nasal mucosa flap closely phase with anterior wall of anastomotic stoma. After the surgery, regular washing of lacrimal was made, observed the stoma with nasal endoscopy, including the survival of transplanted nasal mucosa, the place of the nasal lacrimal drainage stent, whether anastomotic patency, epithelialization of the tissue surrounding the stoma. Pulled out the nasal lacrimal drainage stent after 1 month and followed up to 3 to 6 months later.

RESULTS: All 30 operations were successfully completed. The operation time ranged from 18 minutes to 55 minutes, an average of 32.3±8.7minutes. Postoperatively, the transplanted nasal mucosa of all patients successfully survived, wound healing formation, fistula were patent, there was no complications such as proliferation of granulation tissue blocked the transition ostomy mouth, artificial stent displacement or incarceration.

CONCLUSION: Self-made silica lacrimal sac nasal drainage stents placed in the stoma combining nasal mucosa flap attached to the anterior wall not only improve the success rate of the operation of EES-DCR, and reduce post-operative nursing, which is a simple, effective, safe and efficient endoscopic dacryocystorhinostomy under the new method.

Abstract:AIM:To compare the effect of nasal endoscopic modified nasolacrimal duct retrograde intubation and dacryocystorhinostomy in treatment of chronic dacryocystitis.

METHODS: A retrospective analysis of 51 cases( 53 eyes)of chronicdacryocystitis patients with nasal endoscopic operation. Intubation group had 31 cases 32 eyes, the dacryocystorhinostomy group had 20 cases 21 eyes, the follow-up was half a year.

RESULTS:Endoscopic nasolacrimal tube retrograde intubation: 15 eyes were cured, 12 improved, invalid 5, the cure rate was 47%, with an efficiency of 84%; endoscopic dacryocystorhinostomy: cured 14, improved 5, invalid 2, the cure rate was 67%, with an efficiency of 90%; there was no obvious difference.

CONCLUSION:Endoscopic modified nasolacrimal duct retrograde intubation and endoscopic dacryocystorhinostomy are minimally invasive, rapid healing, good effect, its efficacy is similar, endoscopic retrograde intubation is simple, low price, easy popularization.

Abstract:AIM: To discuss the treatment of congenital dacryocystitis method and summarize treatment effect.

METHODS: The 180 patients 252 eyes diagnosed with congenital dacryocystitis in Ophthalmology Department of Xiangxizhou Hospital were retrospectively analyzed. The average age of first diagnosis was 5.8 months. Combined lacrimal sac area massage, antibiotics eye drops, irrigation of lacrimal passage and probing the lacrimal passage were performed. Followed up for 2-12 months, with epiphora completely disappeared and lacrimal duct flushing unobstructed as cure target.

RESULTS: In 180 cases 252 eyes of infants, a total of 224 eyes were cured, cure rate 88.89%. Among them without probing and healer 54 eyes, accounting for 21.43%; Probing healer 170 eyes, accounting for 67.46%; 132 eyes were cured by one time probing, accounting for 52.38%. In addition caesarean birth children were in 126 cases, accounting for 70%.

CONCLUSION: The congenital dacryocystitis is more common in caesarean birth infant, early effective lacrimal duct agent through joint lacrimal sac area massage and antibiotics eye drops is an effective treatment for congenital dacryocystitis.

Abstract:AIM: To investigate the surgical methods and clinical effects for chronicdacryocystitis with obstruction to lacrimal canaliculi.

METHODS: Totally 46 cases(48 eyes)who suffered from chronicdacryocystitis with obstruction to lacrimal canaliculi underwent an operation to implant improved dacrocystorhinostomy combined with the silicone tube after diagnosis. All of them had a history of the tears purulent secretions. And indurations appeared on the lacrimal sac area which was swelling and even the skin ulcerated. After operation, the patients flushed lacrimal duct regularly and they were followed up 3 years in order to observe the surgical results.

RESULTS:Totally 46 eyes(96%)had no tears, purulent discharge, and the lacrimal sac district redness disappeared, irrigation of lacrimal passage was passable. 2 cases(4%)still had tears, with no purulent discharge, the lacrimal sac district redness disappearing. The lacrimal passages were unobstructed and the effective rate was 100%.

CONCLUSION: Improved dacrocystorhinostomy combined implantation with silicone tube, which helps to solve the problem of obstruction of nasolacrimal duct and lacrimal canaliculi only by one time, to alleviate patients'suffering of the reoperation and to ease their financial burden, is an effective method for chronic dacryocystitis with obstruction of lacrimal canaliculi.

Abstract:AIM: To seek an effective method to cure the large angleexotropia by unilateral surgery.

METHODS: A case-control study was used to compare two operation treatments of large angleexotropia. Totally 39 patients of large angle exotropia complied with highly amblyopic were divided into group A and group B according to the surgeon methods. Monocular normal quantity of lateral rectus recession combined the edge cutting in the external rectus and medial rectus shortening were performed in group A. The same operations except the edge cutting in the lateral rectus were performed in group B. A: B was equal to 1:2, with age and visual acuity matched. The eye position ≤±8^△ 6 months postoperative was seen as the criteria of cure. The cure rate of two groups were compared with χ²- Fisher's exact probability test.

RESULTS: The cure rate was 84.6% in group A and 46.2% in group B. There was significant difference in the cure rate between the two groups(P<0.05).

CONCLUSION: The operation that the monocular normal quantity of lateralrectus back combined the edge cutting in the external rectus is safe and effective than the traditional method.

Abstract:AIM: To evaluate clinical effects of semiretrobulbar injection of triamcinolone acetonide(TA)for the treatment of thyroid associated ophalmopathy.

METHODS: Totally 84 eyes of 46 cases with thyroid associated ophalmopathy were treated with semiretrobulbar injection of TA(40mg)with 20g/L Lidocaine(0.5 mL)for each eye once every three weeks for four times during one course of treatment. Then symptoms and signs of the patients were observed after 1 month, 3 months, 6 mouths.

RESULTS: Symptoms of 43 cases were improved significantly. In all cases, eyeball recession rate was 83.6%, the palpebral fissure width reduction was 85.2%, visual acuity improvement was 80.9%, eye movement, strabismus, and diplopia improvement was 80.5%, compared to those before the treatment.

CONCLUSION: The treatment of semiretrobulbar injection of TA for thyroid associated ophalmopathy is safe, effective and mild in side effect.

Abstract:AIM: To analyze and reveal the researching hot topics of traumatic optic neuropathy(TON), the trend of published TON related articles and focal points between different countries and agencies in the world.

METHODS: Candidate publications from January 2000 to August 2012 were collected by searching PubMed with the MeSH word ‘traumatic optic neuropathy' and without language restriction. Bibliometric techniques used in this study included a statistical analysis of publication counts by authors, countries and journals and a co-word cluster analysis of highly-frequent MeSH/subheadings words.

RESULTS: Totally 785 articles about TON were indexed in PubMed. The United States, the United Kingdom and China were the largest three producers about TON. English was the top language. Levkovitch-Verbin H published 9 papers and ranked the top, followed by Lorber B. Investigative Ophthalmology & Visual Science published 52 papers and ranked the top. 32 highly-frequent MeSH/subheadings words for more than 12 times occurrences in the papers about TON were extracted for cluster analysis. These words were classified into 6 aspects:(1)Surgery therapy for TON;(2)Physiopathology of optic nerve injury;(3)Pathological appearance and diagnosis of TON;(4)Animal model and drug therapy for TON;(5)Etiology of TON.

CONCLUSION: Slow growth has occurred in the research field of TON. The United States and the United Kingdom are the top 2 countries in this field. The international main research focus included 5 aspects. This study results provide important reference for domestic scholars in TON correlated scientific study and clinic therapy.

Abstract:AIM: To confirm the hypothesis that "Blink is the power of discharge basal tear secretion, we make many clinical observations.

METHODS: Clinical observation of 4 216 people of the following items:(1)Epiphora symptoms in the 60 lacrimal duct obstruction patients during sleeping period.(2)26 symptoms of epiphora in the 30 wakefulness closed eyes.(3)300 new birth baby's blink and epiphora.(4)observed more than 300 people's blink.(5)observed in vivo 360 eyes discharged tear effect after the lacrimal retrograde(6)observed the exposure keratitis patients' basal tear secretion.

RESULTS:(1)All causes of the different types of lacrimal duct obstruction patients stop epiphora symptoms.(2)Patients in coma and with the blepharophimosis dysraphism exposure keratitis, reflex arc did not appear.(3)26 cases with lacrimal duct obstruction meditatively without epiphora symptoms during their eyelid closing and 4 cases significantly reduced.(4)In neonates: the first crying tears was only 10%, most newborns crying tears happened 7 to 20 days after birth, all of the neonates had blink action after birth.(5)Observation in vivo the fluid levels in the lacrimal retrograde catheterization drainage tube, the level was down when eye opened, and the water liquid-level rise when eyes closed, the rate was about 2.0mm.(6)Random observed 300 normal people blink rate, rhythm and blink duration and self-restraint under the gaze of the slowest, the horizontal gaze center, and three upward gazes fastest. Downward gaze eye position to suppress the longest duration of the blink.

CONCLUSION: The clinical observations confirmed the hypothesis that “Blink is the power of discharge basal tear secretion”. But it needs further clinical and laboratory research to further verification.