Abstract:AIM: To evaluate the relationship between the density values of the lens nucleus measured using Pentacam Scheimpflug imaging and torsional phacoemulsification dynamics such as the level of ultrasound energy, as well as the duration and amount of fluid used in patients with age-related nuclear cataract.

METHODS: This was a prospective observer-masked study. Pentacam Scheimpflug imaging was performed following pupil dilation. The cataracts were automatically graded from 1 to 5 using pentacam nucleus densitometry(PND), also known as Pentacam nucleus staging(PNS)software by the same observer. After phacoemulsification, total Ultrasound(U/S)time, Cumulative dissipated energy(CDE), Torsional U/S time, and Estimated fluid use were automatically calculated and displayed on the monitor of Infiniti OZiL IP phacoemulsification system. One-way analysis of variance(ANOVA)was used to assess differences between groups. The Tamhane test was used for multiple group analysis. Spearman correlation analysis was used to assess the relationship between lens density measured by PND and the dynamics of torsional phacoemulsification. P<0.05 was considered statistically significant.

RESULTS:In the present study, 125 eyes from 125 patients were evaluated. Mean age was 69.7±9.4y(range: 48-88y), and 61 men and 64 women were included. The highest and lowest values of U/S total time, torsional U/S time, CDE, and Estimated fluid use were 0.70 - 158.90s, 0.70-158.50s, 0.11-42.65, and 21-98 mL in groups, respectively. Significant differences were found among PND groups. When the relationship between phacoemulsification dynamics and PND values were evaluated, there were significant correlations between PND value and total ultrasound time(r=0.767; P<0.01), torsional ultrasound time(r=0.767; P<0.01), CDE(r=0.758; P<0.01), and amount of fluid used(r=0.602; P<0.01).

CONCLUSION:An objective degree of nucleus density obtained by PND scoring before cataract surgery may allow antecedent determination of intraoperative phacoemulsification parameters. Thus, individualized phacoemulsification parameters should be developed for each patient. This will lead to the use of a smaller amount of phacoemulsification energy, resulting in decreased in endothelial cell loss, quicker and better visual healing, and less steroid use.

Abstract:AIM: To observe the efficacy and safety of intravitreal injection of Ranibizumab with transpupillary thermotherapy(TTT)in patients with wet age-related macular degeneration(AMD).

METHODS: Totally 160 wet age-related macular degeneration patients(160 eyes )were selected, which have been diagnosed through history, clinical symptoms and fundus angiography(FFA/ICGA)as well as optical coherence tomography(OCT)and other auxiliary examinations in our hospital. All these patients were randomly divided into the combined group and the control group. Combined group was given a single intravitreal injection Ranibizumab and applied the TTT treatment after seven days, while the control group only received the TTT treatment and was being monitored for 1y. The patients' best corrected visual acuity, fundus angiography(FFA/ICGA)and OCT examination were observed after 1wk, 1mo, 6mo and 1y of the treatment, respectively.

RESULTS: By the end of the observation period, there were 34 cases(42.50%)out of the combined group whose the best corrected visual acuity have improved, while 16 cases from the control group(20.00%)whose best corrected visual acuity have improved. The difference between the two groups showed statistically significance(P<0.05). More specifically, the fluorescent penetrant rates are(88.75%, 62.50%),(91.25%, 65.00%),(86.25%, 61.25%),(78.75%, 51.25%), respectively, in both groups after 1wk, 1mo, 6mo and 1y treatment, and also the corresponding central macular thickness(CMT)were(347.43±36.96)μm and(423.58±29.03)μm,(287.78±34.16)μm and(387.14±32.98)μm,(301.75±37.21)μm and(415.40±31.38)μm,(326.17±27.39)μm and(436.44±35.49)μm. In a nutshell, the difference between the two groups were statistically significant(P<0.05).

CONCLUSION: Intravitreal injection of Ranibizumab with TTT treatment applied among patients with wet age-related macular degeneration(AMD)could improve patients' vision, stop or reduce the leakage of the lesion, as well as promote the absorption of macular hemorrhage, edema and exudation, which could be considered as a safe, reliable and effective clinical treatment.

Abstract:AIM: To evaluate the effects of total flavonoid of chrysanthemum on the expressions of Fas and FasL in male rabbits with dry eye, and to investigate the therapeutic effects of the total flavonoid of chrysanthemum on dry eye.

METHODS: Totally 150 male Japanses white rabbits were divided into blank group(group A), sham-operated group(group B), model group(group C), androgen control treatment group(group D), and total flavonoid of chrysanthemum treatment group(group E). The dry eye model was established with orchiectomy on group C, D and E. Rabbits in group E were treated with total flavonoid of chrysanthemum. Rabbits in group D were treated with androgen intramuscular injection. Rabbits in the group A, group B, group C was treated with normal saline. All rabbits were detected with Schirmer's Ⅰ test and tear break-up time(BUT). Fas, FasL were checked on immunohistochemistry.

RESULTS: The Schirmer's I test values of group E was significantly higher than that of group C(P<0.01)and the BUT value of group E was significantly longer than that of group C(P<0.01). The quantity of positive expression of Fas in glandular tube cell and acinar epithelial celland apoptosis cells of group E after treatment at 1, 3, 5mo were significantly lower than that of group C, cell population of the positive expression of FasL was obviously higher than that of group C(P<0.01).

CONCLUSION:The main component of chrysanthemum is flavonoid, which could significantly inhibit happening of dry eye in rabbit after androgen level lowered and lacrimal gland apoptosis and keep basic tears secretory volume and tear film stability.

Abstract:AIM: To investigate the time-effect relationship between the expression of rhodopsin and recoverin and photoreceptor damage induced by N-nethl-N-nitrosourea(MNU).

METHODS: Thirty-six 7-week old Sprague-Dawley(SD)rats were intraperitoneally injected with MNU(60mg/kg)and were put to death by dislocation of cervical vertebra 6, 12, 24h; 3, 7d after injection(6 per group), respectively. As a control, six rats were injected with phosphate buffer saline(PBS)5mL/kg and sacrificed on d3 after injection. The degree of photoreceptor apoptosis was detected by HE staining, terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling(TUNEL)and transmission electron microscope(TEM)in the right eyes. The mRNA expressions of rhodopsin and recoverin were detected different time after injection by Western blot and immunohistochemical method in the left eyes.

RESULTS: The dissolution of photoreceptor nucleus and apoptosis body were first perceived at 12h by TEM; most of cells at outer nuclear layer were presented positive reaction. The apoptotic index reached peak(29.7%±2.3%)at 24h which was coincided with the observation of TEM. The results of immunohistochemistry displayed that rhodopsin and recoverin were on a declining curve with time extension. Furthermore, the results of Western blot indicated that rhodopsin had dramatic decline at 6h after injection(P<0.05), and extremely significant difference comparing to control group after 12h(P<0.01); while recoverin dramatic declined at 12h, and extremely significant difference after 24h(P<0.01).

CONCLUSION: 60mg/kg MNU intraperitoneally injection one-time may specifically induce photoreceptor apoptosis, The mechanism of down-regulation of rhodopsin and recoverin may be related to the selected apoptosis of photoreceptors.

Abstract:AIM: To investigate the repair mechanism associated with cholesterol synthesis regulated by silent information regulator 1(SIRT1)in rat model of optic nerve damage.

METHODS: Preparation of optic nerve damage in 70 rats was randomly divided into normal group(10 rats), resveratrol treatment group(experimental group 30 rats)and PBS buffer control group(30 rats). The experimental group and control group was further divided into 3 subgroups(each group 10 rats), respectively. After 7, 14, 21d injected resveratrol or PBS, optic nerve injury were observed, then the rats were sacrificed. Retina was segregated; the surviving retinal ganglion cell(RGCs)was counted. Dissection of optic nerve, cholesterol content of them were tested; RT-PCR was used to detect mRNA expression of SIRT1, SREBP2 and HMGCR; Western blot assay was used to test the protein expression levels of SIRT1, cholesterol regulatory element binding protein 2(SREBP2)and HMGCR.

RESULTS: The numbers of RGCs and cholesterol levels of rat model with optic nerve injury decreased significantly(P<0.01). The mRNA and protein expression levels of SIRT1, SREBP2 and HMGCR were all decreased in a time-dependent manner(P<0.05). Three components of the three time points, with time injuries were aggravated, and the extent of damage was significantly reduced in the treatment group compared with the control group. But in resveratrol treatment group, the cholesterol levels and mRNA or protein expression of SIRT1, SREBP2, HMGCR in optic nerve were significantly restored in a time-dependent(P<0.05). The number of surviving RGCs restored significantly in resveratrol treatment group(P<0.01)in a time-dependent manner.

CONCLUSION: Up-regulating the expression of SIRT1, SREBP2 and down-regulating HMGCR by resveratrol could repair the injury of optic nerve through promoting the synthesis of cholesterol in neurons and retinal ganglion cells in the repair process. SIRT1 may be as a promising new target for treatment on optic nerve damage.

Abstract:AIM:To construct adenovirus vector expressing mice B7-H1 gene, transfect dendritic cells(DCs), and to study the therapeutic effect of modified DC on thyroid-associated ophthalmopathy(TAO)in mice.

METHODS: We designed and constructed B7-H1 gene adenovirus expression vector, and transfected DCs from mouse bone marrow, tested the phenotype and function of modified DCs, identificated its negative regulation to immune responses. The modified DCs were infected the sicked mice. And then the immunotherapeutic effect of modified DCs to TAO were tested.

RESULTS: B7-H1 gene adenovirus vector was constructed and transfected DCs from bone marrow. The titer of the recombinant adenovirus was 1.8×10⁹PFU/mL. B7-H1 gene modified DCs characteristics of regulatory DCs, could inhibit positive immune responses. The inhibition proceeding of TAO into mice infected modified DCs, was obviously prior to the control mice. The gene modified DCs, maybe become the new immunotherapy biological agent to thy TAO.

CONCLUSION: We constructed the expression of mouse B7-H1 gene adenovirus expressed vector successfully, transfected DCs,by vector have properties of regulatory DCs, inhibiting positive immune response and the occurrence and development of thyroid eye disease. Gene modified DCs, reveal potent to the treatment of thyroid eye disease.

Abstract:AIM: To identify the changes in microRNA(miRNA)profile of human lens epithelium(HLE)induced by H₂O₂ and the role of miRNA in oxidative stress induced apoptosis.

METHODS: HLE cell line HLE-B3 was treated by 100μmol/L H₂O₂ for 24h and the total RNA were isolated by Trizol reagent. miRNA profile was generated by miRCURY^TM LNA microRNA Array. The target genes of differentially expressed miRNAs were predicted by bioinformatics software.

RESULTS:Twenty-eight miRNAs showed significantly differential expression after H₂O₂ treatment, 18 miRNAs upregulated and 10 miRNAs downregulated. The differentially expressed miRNAs may involve in apoptosis of lens epithetium and development of cataract through targeting BCL2L2 and MIP.

CONCLUSION: H₂O₂ can induce dramatically changes in miRNA profile of HLE, which may play a pivotal role in the pathogenesis and development of cataract.

Abstract:AIM: To explore the involvement of oxidative stress and apoptosis in the pathogenesis of diabetic cataract induced by Streptozotocin(STZ)and the interventions of puerarin in order to supply references for clinical treatment.

METHODS: Male SD rats were divided into four groups randomly, control group, diabetic group, apocynin group and puerarin group. The diabetic group were replicated by single injection of STZ(65mg/kg, ip). The expression of p22, p47, p67, Bax/Bcl2, Caspase 3 and P53 proteins were detected by Western Blotting.

RESULTS: The diabetic rats were replicated successfully and the expression of Bcl2 was downregulated while the expression of p22, p47, p67, Bax, Caspase 3 and P53 were upregulated in diabetic group with a significant statistical differences when compared with control group(P<0.05). Apocynin and prerarin can reverse the abnormal expression of the aforementioned proteins dramatically(P<0.05).

CONCLUSION: NADPH oxidase mediated oxidative stress and P53, Bax/Bcl2 mediated apoptosis are involved in the pathogenesis of diabetic cataract and puerarin can alleviate cataract greatly by inhibiting the aforementioned signal pathway.

Abstract:AIM: To observe the morphologic changes of of filtration blebs after trichostatin A treatment in an experimental glaucoma filtration surgery(GFS).

METHODS: Subconjunctival injection TSA, mitomycin C(MMC)and PBS during the filtering surgery in rabbits. The morphologic changes of filtration blebs were evaluated by Krofeld score method postoperatively days 3, 7, 14, 21, and 28.

RESULTS: TSA induced filteation bleds were elevated diffusely within 14d and cystic blebs formed 28d, filtration bleb score was significantly higher in TSA group than that in PBS group.

CONCLUSION: TSA can keep the aqueous humor outflow by inhibiting scar formation and prolong the existence of the filtration bleb.

Abstract:AIM:To establish an experimental model of high intraocular pressure in mice by laser photocoagulation and to prepare for future research.

METHODS: Experimental model of high intraocular pressure was induced unilaterally in 44 C57BL/6 mice. The fellow eye served as a control. TONO-PEN AVIA Tonomter was used to measure intraocular pressure(IOP)to guarantee IOP value at 1, 2, 4, 8wk. Slit-lamp biomicroscopy was performed throughout the period and the structural changes were assessed histologically. And then, their eyes were enucleated, postfixed, cryoprotected, and embedded in optimal cutting temperature medium. After hematoxylin and eosin stain(HE stain), cryosections of the retina were observed under light microscope. TdT-mediated biotin-dUTP nick end labeling(TUNEL)was performed on the retinal sections to determine apoptosis rate.

RESULTS: IOP of laser-treated eyes was significantly higher than that of control eyes from 1-8wk(P<0.05). The highest IOP was 31mmHg, but only one eye. The IOP was mainly around 20mmHg. In laser-treated eyes, the angle of anterior chamber were narrow. Number of cells in the inner nuclear layer and retial gangllion cell layer was slightly lower than that in control eyes at 2wk, but by 4 and 8wk the number of cells was significantly lower than that in the control contralateral eyes.

CONCLUSION: The laser photocoagulation of limbus causes chronic elevation of IOP and this method may be a promising experimental model for the investigation of biological mechanisms of glaucomatous retinal ganglion cell damage.

Abstract:AIM:To examine the efficacy and safety of cryotherapy in the management of Fusarium corneal ulcer.

METHODS: Retrospective contract analysis of the clinical data of 41 patients(41 eyes)who infected with Fusarium corneal ulcer. All of them underwent focal lesion keratectomy combined with amniotic membrane transplantation between January 2010 and May 2013. The cryotherapy treatment group of 22 cases(22 eyes), non-cryotherapy group of 19 cases(19 eyes). All the cases were followed up for 3～12mo. We analyzed the healing of corneal ulcer, corneal neovascularization, postoperative visual acuity, complications and ulcer recurrences.

RESULTS: There were no significant difference for the two groups at the cure rate and the recovery rate, the corneal neovascularization and postoperative visual acuity(P>0.05). The total effective rate and corneal healing time in cryotherapy group was significantly higher than that in non-cryotherapy group(P<0.05). The postoperative visual acuity of two group were higher than that of preoperatively(P<0.05). There was no complication occurred in cryotherapy group while there was 1 patient of secondary glaucoma in non-cryotherapy group.

CONCLUSION: Cryotherapy is an effective and safe method for the treatment of Fusarium corneal ulcer.

Abstract:AIM:To observed the variation regularity of corneal endothelial cells in patients with different diabetes duration after phacoemulsification, and investigate the effects of diabetes and its disease duration on corneal endothelial cells.

METHODS: Ninety-seven(135 eyes)cataract patients with diabetes were selected randomly and divided into GroupⅠ(which diabetes duration ≥10a)and GroupⅡ(which diabetes duration <10a)according to their disease duration. Additionally 62(89 eyes)age-related cataract patients were randomly selected as the control group. The corneal endothelial cell density(CD), proportion of hexagonal cell and coefficient of variation(CV)in the three group patients were measured respectively before phacoemulsification and after surgery. And the measurement results were statistically analyzed.

RESULTS: The corneal endothelial CD and proportion of hexagonal cell in the three group were decreased after surgery compared with preoperative. But the CV of corneal endothelial cells was increased on the 1^st wk and in 1^st mo after surgery compared with the preoperative. The difference was statistically significant(P<0.05). The corneal endothelial CD and proportion of hexagonal cell in the two diabetic groups were lower than the control group after surgery. However, the CV of corneal endothelial cells was higher than the control group. The difference was statistically significant(P<0.05). There was no significant difference in the corneal endothelial CD, proportion of hexagonal cell and CV between the two diabetic groups before phacoemulsification(P>0.05). The proportion of hexagonal cell in Group Ⅰ was lower than which in Group Ⅱ after surgery. While the CV was higher than which in Group Ⅱ. The difference was statistically significant(P<0.05).

CONCLUSION: Phacoemulsification has some damage on the corneal endothelial. Since the impact of diabetes on the morphology and function of corneal endothelial cell was related to the diabetic duration. So phacoemulsification has more obvious damage on the corneal endothelial in diabetic patients. And the diabetic duration was longer, the damage on the corneal endothelial in phacoemulsification was more easily.

Abstract:AIM: To investigate changes of retinal nerve fiber layer(RNFL)thickness and macular retinal thickness in patients with early diabetic retinopathy(DR)and disclose the changing trends of RNFL thickness and macular retinal thickness in different stages of early DR.

METHODS: It was a clinical case control study. Through selecting 60 patients(120 eyes)with early DR diagnosed with type 2 diabetes were divided into non-diabetic retinopathy(NDR)group(20 cases, 40 eyes)and mild non-proliferative diabetic retinopathy(NPDR)group(20 cases, 40eyes), moderate NPDR group(20 cases, 40 eyes). Twenty normal patients(40 eyes)were enrolled as control group. The RNFL thickness of optical nerve(with circle scan round optic nerve head, scan diameter of 3.45mm)and the retinal thickness of macular(around center point with 1000μm diameter)were measured by optical coherence tomography(OCT), to compare the RNFL thickness changes of the control and early DR patients.

RESULTS: Compared with the control group, the RNFL thickness of optical disc in the inferior quadrant was descended obviously in NDR group(P<0.05), with statistically significant difference,; there were no statistically significant difference in other quadrants(P>0.05). In mild NPDR group, the RNFL thickness of optical disc in the mean and inferior quadrant was significantly descended than that in the NDR group. In moderate NPDR group, the RNFL thickness of optical disc in the mean, superior and inferior quadrant was statistical significance descended than that in the NDR group(P<0.05). Compared with the NPDR group, NDR group and control group, the RNFL thickness of optical disc in each quadrant were descended significantly. There was statistically significant difference in macular retinal thickness among the NDR group, mild NPDR and moderate NPDR group(P<0.05), the retinal thickness was increased gradually in mild NPDR and moderate NPDR group.

CONCLUSION:With the development in the degree of early DR, RNFL thickness is gradually decreased and retinal thickness is increased, OCT can be observed qualitatively and quantitatively in DR.

Abstract:AIM: To compare the visual acuity and contrast sensitivity of eyes with different corneal spherical aberration implanted with the same aspherical IOL and evaluate the effect of different ocular spherical aberration on visual performance after phacoemulsification.

METHODS: It was a prospective case series study. Forty-six eyes of thirty-nine age-related cataract patients in our department were included. The patients were divided into 3 groups according to the value of preoperative corneal spherical aberration. Eyes with corneal spherical aberration≤0.2μm were assigned to group A, those with corneal spherical aberration >0.2μm and ≤0.3μm to group B, and those with corneal spherical aberration ≥0.3μm to group C. All patients underwent phacoemulcification and recieved AcrySof IQ aspheric IOL. Uncorrected visual acuity(UCVA), best-corrected visual acuity(BCVA), contrast sensitivity, and total ocular higher-order aberrations for a 6.0mm pupil were recorded 3mo postoperatively. ANOVA were used to analyze the data.

RESULTS: There were no significant differences in UCVA and BCVA between the 3 groups(P=0.287, 0.115). Contrast sensitivity was no statistically significant difference between the 3 groups at any spatial frequency under photopic、mesopic, and mesopic with glare conditions(P>0.05). With a 6.0mm pupil diameter, root mean square values for total ocular higher-order aberrations were lower in groups A and B than that in group C(P=0.000). The difference of total ocular spherical aberration was statistically significant between the 3 groups(P=0.000).Coma and trefoil were similar between the groups(P=0.788,0.590), with no statistically significant differences.

CONCLUSION: Implantation of the same aspherical IOL in eyes with different corneal spherical aberration results in similar visual acuity and contrast sensitivity. Small differences of ocular spherical aberration after phacoemulsification have no effect on visual performance.

Abstract:AIM:To make comparison of the results from the femtosecond lenticule extraction(FLEx)with that from the conventional laser in situ keratomileusis(LASIK)for the correction of moderate and high myopia and myopic astigmatism.

METHODS:In the prospective study, 86 cases(172 eyes)with moderate and high myopia astigmatism were enrolled recruited. The myopia degree was -3.00～ -10.00D, the astigmatism degree ≤-6.00D. Eighty-six eyes were treated with FLEx in group A, and 86 eyes were treated with LASIK in group B. All patients in the treatment group completed the final 6mo of follow-up. The uncorrected visual acuity(UCVA)and the best spectacle-corrected visual acuity(BSCVA), objective and manifest refractions, results of slit-lamp examination, the side effects, the corneal flap thickness, intraocular pressure, corneal topography were noted.

RESULTS:Six months postoperatively, the difference between group A and B in BSCVA increases more than one line had statistical significance(χ²=20.67, P<0.05). The difference between group A and B in diopters within ±0.50D(83.7% in group A, 53.4% in group B)had statistical significance(P<0.05). 100% UCVA was equal or greater than 1.0 in group A, 90.7% in group B, there were significant diffirences between two groups(χ²=16.62, P<0.05).

CONCLUSION: FLEx has more perfect accuracy, safety, predictability compared to standard LASIK.

Abstract:Blood-eye barrier(BEB)is one of the most important structures of organism to maintain homeostasis of the eye. However, it is the major constraint for the medication of intraocular diseases. Traditional Chinese medicines have distinctive advantages for the treatment of intraocular diseases, which can be used to regulate the physiological function of human body with low toxicity. In this article, we have briefly summarized the feature of BEB, with the domestic and foreign literatures combined, and mainly reviewed current progress in the field of study on the permeability of traditional Chinese medicines and effective components in BEB and promoting methods.

Abstract:Diabetic retinopathy is one of the serious complications of diabetes, is currently the world's second largest blinding disease. Early epidemiological data showed that the development is related to blood sugar level, diabetes duration, blood lipids, and other factors. In recent years, the correlation of gene polymorphism with DR received widespread attention. Accurately grasp the genetic mechanism in the process of development in the DR and the differences of expression, is of great significance to DR early diagnosis and prevention. So in this article, the progress of gene of DR were reviewed.

Abstract:Diabetic retinopathy(DR)is one of the main blinding eye diseases for people over the age of 50, and diabetic macular edema(DME)is the leading cause of vision loss is DR patients. The early diagnosis and early treatment is important. As OCT and FFA, mfERG, especially the retinal thickness, volume, retinal edema index quantitative indicators such as objective evaluation of macular edema, embodies the new progress of retinal imaging technology in recent years. OCT is a non-contact clinical application in recent years, noninvasive, high resolution of ophthalmic imaging examination, can do it on retinal ultrastructure observation and quantitative analysis, and the technology is relatively mature, become a routine inspection diagnosis of macular edema. Laser photocoagulation,intravitreous injection with Ranibizumab and vitrectomy is nowadays the important means for the treatment of intractable macular edema.

Abstract:Age-related macular degeneration(AMD)is the leading cause of irreversible visual loss in elderly people among white-dominated population. At percent, treatment for AMD includes anti-vascular endothelial growth factor antibody(Anti-VEGF)drug treatment, photodynamic therapy(PDT), topical application of triamcinolone acetonide(TA)and laser therapy(nanosecond laser)etc. Through comparative analysis of different treatment methods of AMD, we review the mechanism, clinical efficacy, adverse events and cost effectiveness to provide the basis for clinical treatment.

Abstract:Trachoma, a contagious keratoconjunctivitis(KC), caused by Chlamydia trachomatis infection, is rife in 57 countries in the world at present. The World Health Organization(WHO)listed the global alliance to eliminate blinding trachoma by 2020 as one of top priorities of its blindness prevention in 1998. A simplified classification system for identifying and naming trachoma, designated by WHO, and the SAFE strategy based on community intervention were extended continuously in the world in 10 years since then. The trachoma prevalence trend has showed a change compared with that in the past. China has launched the blindness prevention action, aimed to eliminate blinding trachoma by 2016. In this paper,we reviews progress in diagnosis, treatment and epidemic of trachoma since the extension of the SAFE strategy.

Abstract:AIM: To observe the effect of phacoemulsification combined goniosynechialysis in treating absolute glaucoma after trabeculectomy.

METHODS: Phacoemulsification combined goniosynechialysis was performed on 16 patients(16 eyes)with absolute glaucoma after trabeculectomy, and they were followed up for 6～12mo, The postoperative intraocular pressure(IOP)and anterior chamber depth, preoperative and postoperative medication types(quantity), preoperative and postoperative 1 month's status of anxiety and depression, symptoms of ocular surface were observed.

RESULTS: The IOP decreased significantly after phacoemulsification combined goniosynechialysis. The mean IOP was 35.00±15.43mmHg preoperatively, and it was 12.00±6.69mmHg, 15.00±4.26mmHg and 15.3±5.2mmHg on 1d, 6 and 12mo after the surgery. The statistic difference was found between preoperative and postoperative(t=6.22, P<0.05). The anterior chamber depth was 1.45±0.19mm before the surgery, and increased to 3.37±0.13mm after the surgery(t=6.65, P<0.05). After the surgery, 2 patients needed two kinds of drugs, 2 patients needed one kind of drug. After 12mo of follow-up, anxiety and depression status were improved in all 16 patients. Subjective discomfort symptoms of 16 patients such as eye bilges, eye pain were relieved. All of the patients' eyeballs were preserved, and no serious complications.

CONCLUSION: Phacoemulsification combined goniosynechialysis in treating absolute glaucoma after trabeculectomy is a safe and effective surgical option.

Abstract:AIM: To observe the clinical effect of femtosecond laser assisted penetrating keratoplasty.

METHODS: Twenty-four cases(24 eyes)with corneal lesions were performed with femtosecond laser assisted penetrating keratoplasty. Preoperative and postoperative endothelial cell density and visual quality were compared.

RESULTS: One week after operation, corneal grafts were clear in 21 eyes(87.5%), mild cloudy in 3 eyes(12.5%); visual acuity ≥0.5 in 18 eyes(75.0%), 0.2～0.4 in 6 eyes(25.0%). After 3mo the mean corneal astigmatism was 2.16±0.21D(range 2.25～3.09D). Compared to conventional penetrating keratoplasty which mean corneal astigmatism was average 3.67±0.38D after operation, there was significant difference between two groups(P<0.05). There were significant differences between preoperative and postoperative visual acuity and astigmatism(both P<0.05).

CONCLUSION: Femtosecond laser assisted penetrating corneal transplantation operation can improve patient's visual quality. And compared to traditional penetrating keratoplasty astigmatism decreased significantly, incision can be made in individual shape more precisely and neatly.

Abstract:AIM: To observe the role of confocal microscopy in infectious keratitis management.

METHODS:Totally 466 patients(467 eyes)diagnosed as infectious keratitis from January 2010 to December 2013 were retrospectively studied. the corneas were examined early by in vivo confocal microscopy. The characteristics of their images and clinical features were studied and summarized.

RESULTS:All patients were recorded, the average age was 54.4±13.0 years, in which 264 cases(56.7%)were male, and 202 cases(43.3%)were female. In the 466 patients, 190(40.8%)were fungal keratitis, 148(31.8%)were viral keratitis, 125(26.8%)were bacterial keratitis and 3(0.6%)were acanthamoeba keratitis. There were fungal hyphae in the images of fungal keratitis. Amebic cysts were found in acanthamoeba keratitis.

CONCLUSION:Confocal microscope can help the early diagnose and treatment of infectious keratitis. It is a noninvasive imaging technique that provides high resolution images of ocular structures at a cellular level and infectious keratitis represents one of its most important clinical uses.

Abstract:AIM: To evaluate the accuracy of central conreal thickness(CCT)using EX500 Excimer Laser workstation(EX500)in laser in situ keratomileusis(LASIK)patients.

METHODS: The CCT of 120 eyes(63 patients)who had LASIK between January 2013 and June 2013 were measured by A-scan and EX500. Three groups were classified: >550μm, 500～550μm, <500μm according the CCT value of A-scan. The CCT were measured again by corneal flap creating by moria SBK microkeratome. The thickness of the corneal bed stroma were measured by A-scan and EX500 after keratomileusis. All outcomes were analyzed with paired t test.

RESULTS: The average preoperative CCT value was 527.9±34.3μm measured by A-scan, 528.5±34.6μm measured by EX500. There was no significant difference between these two measurements(t=1.736, P=0.085). In group which CCT >550μm, the average preoperative CCT value was 571.4±17.3μm measured by A-scan, 572.7±15.7μm measured by EX500. There was no significant difference between these two measurements(t=1.857, P=0.072). In group which CCT 500～550μm, the average preoperative CCT value was 523.4±13.1μm measured by A-scan, 524.2±12.4μm measured by EX500. There was no significant difference between these two measurements(t=1.934, P=0.058). In group which CCT <500μm, the average preoperative CCT value 484.5±9.8μm measured by A-scan, 483.7±8.9μm measured by EX500. There was no significant difference between these two measurements(t=1.395, P=0.174). The average CCT value after corneal flap lifting was 401.3±34.2μm measured by A-scan, 393.4±38.9μm measured by EX500. There was a significant difference between these two measurements(t=6.669, P=0.000). The average thickness of the corneal bed stroma value after keratomileusis was 332.6±38.3μm measured by A-scan, 307.3±37.1μm measured by EX500. There was a significant difference between these two measurements(t=17.165, P=0.000).

CONCLUSION: There is no significant difference between preoperative CCT value measured by A-scan and EX500. After corneal flap lifting and keratomileusis, the CCT value measured by EX500 is smaller than measured by A-scan.

Abstract:ATM: To define the causes of corneal endothelial cell damage, to investigate the preventive methods, and to observe the variety of corneal endothelial cell in glaucoma using confocal microscope.

METHODS: Totally, 143 eyes of 97 patients with different types of glaucoma, and matched normal people were 20 cases, all 40 eyes. The cell density, cell area and cell variable coefficient were measured used confocal microscope. These indicatives of every kind of glaucoma were compared.

RESULTS: The corneal endothelial cell density of normal group was 2 893.88±255.026/mm², the group of acute angle-closure glaucoma(AACG)was 1 674.11±683.95/mm², and the group of open angle glaucoma(OAG)was 2 687.22±391.87/mm², the group of chronic angle-closure glaucoma(CACG)was 2 706.97±351.27/mm². In all index the average cell density of corneal endothelial and the average area have statistical significance(F=62.950, 8.795; P=0.000), especially the group of AACG.

CONCLUSION: The index of corneal endothelial cell in AACG is lower than that of normal. All index in OAG and CACG is difference with that of normal, but the difference has no statistical significance. And the dominant factor of damaged corneal endothelial is the time of intraocular hypertension.

Abstract:AIM: To investigate the clinical efficacy and safety of intravitreal injection of triamcinolone combined macular grid photocoagulation treatment for macular edema.

METHODS: Totally 150 cases(150 eyes)with macular edema in our hospital from July 2009 to November 2013 were selected, which were randomly divided into study group(75 cases, 75 eyes)and control group(75 cases, 75 eyes). The cases in control group were treated with macular grid photocoagulation treatment, those in the study group used triamcinolone acetonide combined macular grid photocoagulation treatment. Best corrected visual acuity(BCVA), parallel optical coherence tomography(OCT)and fundus fluorescein angiography(FFA)were detected before treatment, after treatment 7d, 1, 3, and 9mo.

RESULTS:After the treatment, patients' vision were significantly improved in two groups(P<0.05). In the study group 7d, 1, 3, and 9mo after operation, the visual acuity was better than the control group and preoperative(P<0.05); fovea macular neurosensory layer thickness decreased significantly(P<0.05). In the control group, the point omentum macular neurosensory retinal thickness was not statistically significant at 7d, 1, 3, and 9mo after operation compared with before treatment(P>0.05). Fovea macular neurosensory retinal thickness in the study group was significantly lower than that in control group(P<0.05). Intraocular pressure of 7 cases in the study group increased slightly, and were normal after treatment.

CONCLUSION: Triamcinolone acetonide combined macular grid photocoagulation treatment is accurate, can effectively improve the visual acuity, reduce macular edema, it is safe and reliable, and suitable for clinical application.

Abstract:AIM: To dynamically observe the feeling change of the photorecrptor layer in the eyes with acute central serous chorioretinopathy(CSCR)krypton laser treatment by fourier-domain optical coherence tomography(FD-OCT), and to study their correlation with the chang of vision.

METHODS: This is a retrospective case series study. The clinical diagnosis of 52 patients with monocular initial onset of central serous chorioretinopathy, krypton laser photocoagulation before treatment, after 1, 2, 4, 6, 8wk, 6mo, FD-OCT were performed to observe the morphological changes characteristic of photoreceptor layer and changes in vision.

RESULTS: After 1wk treatment, all cases were improved; 2wk, 6 cases were cured; 4wk, 38 cases were cured; 6wk, 41 cases were cured; 8wk, 45 cases were cured, the OCT showed macular retinal neuroepithelial layer(RNL)from fully absorbed; 6mo with the same 8wk. Before and after treatment in patients with best corrected visual acuity and from the height difference between the macular region of RNL was statistically significant(P<0.05), there was a correlation between the changes of visual acuity after treatment and the macular detachment of RNL height(P<0.05), Photoreceptor layer of complete and incomplete best corrected visual acuity difference was statistically significant(P<0.01).

CONCLUSION: FD-OCT can dynamicaly observed acute central serous chorioretinopathy krypton laser treatment of photoreceptor ultrastruture changes. Photoreceptor layer of complete and incomplete best corrected visual acuity difference was statistically significant(P<0.01).

Abstract:AIM: To explore the clinical therapeutic effect of compound Xueshuantong combined with laser treatment in central serous chorioretinopathy(CSCR)patients.

METHODS: A total of 181 cases of central serous chorioretinopathy patients treated in our hospital were randomly divided into treatment group(91 cases)and control group(90 cases). The patients in control group underwent laser treatment, those in treatment group received oral compound Xueshuantong after laser treatment. Clinical curative effect, the average light sensitivity and serum testosterone, estrogen levels of two group were compared.

RESULTS: After 3wk of treatment, the total effective rate of the treatment group was 90.1%, 72.2% in the control group, the treatment group was significantly higher(χ²=10.473, P=0.001); After 6wk of treatment group, the total effective rate was also significantly higher than that in the control group(χ²=4.499, P=0.034). Healing time, visual recovery time in treatment group was significantly less than those in the control group, the mean sensitivity was significantly higher, the difference between the two groups was statistical significance(P<0.05). After the treatment the hormone of patients in the two groups were significantly decreased, the treatment to reduce the level of serum hormone level was significantly better than those in the control group, the difference between the two groups was statistical significance(P<0.05).

CONCLUSION: Compound Xueshuantong combined with laser in the treatment of central serous chorioretinopathy, can significantly improve the efficacy, shorten the course of disease, is conducive to the recovery of visual function, and worth the clinical promotion.

Abstract:AIM: To discuss the effect of wearing customized curvature soft corneal contact lens to dry eye degree of flight attendants.

METHODS: Eighty cases(160 eyes)of flight attendants from China Southern were divided into two groups: control group 40 cases(80 eyes)wearing ready-made Bausch soft corneal contact lens(curvature 8.4); the experiment group 40 cases(80 eyes), wearing Bausch soft corneal contact lens with customized curvature. Tear break-up time(BUT), Schirmer Ⅰ test(SⅠt)and fluorescein(FL)staining were as dry eye evaluation index. The results was statistically analyzed.

RESULTS: BUT, SⅠt average shortening value of the experimental group were less than that of the control group, there was statistical significance(P<0.01). FL staining positive increase, the number of experimental group was fewer than that of control group, with statistical significance(P<0.05).

CONCLUSION: Wearing customized curvature soft corneal contact lens can prevent the flight dry eye more effectively than fixed curvature product.

Abstract:AIM: To observe the differences in central cornea thickness, anterior chamber depth, corneal anterior curvature and corneal posterior curvature between the Uygur and the Han nationality college emmetropia students, and analyze the relationship of corneal thickness and corneal curvature.

METHODS: More than 500 students in grade one in Xinjiang Medical University were underwent screening, 56 emmetropia eyes in Han nationality students and 51 in Uygur students were selected. Sirius corneal topography was applied to the measurement.

RESULTS:Uygur and the Han nationality college emmetropia students central cornea thickness(Uygur: 0.53±0.03mm, Han: 0.54±0.03mm), anterior chamber depth(Uygur: 2.91±0.26mm, Han: 3.14±0.25mm), corneal posterior curvature K2(Uygur: -6.30±0.23D, Han: -6.38±0.28D)had significant difference(P<0.05). Corneal anterior curvature(K1, K2)before and corneal posterior curvature K1 there was no significant difference(P>0.05). Han had no significant relationship in corneal thickness and corneal anterior curvature(r<0), or in corneal posterior curvature(r<1). Uygur has no significant relationship in corneal thickness and corneal anterior curvature(r<0), or in corneal posterior curvature(r<1).

CONCLUSION: There are significant differences between the Uygur and the Han nationality college emmetropia students in cornea thickness, anterior chamber depth and corneal posterior curvature K2. There is no significant relationship between corneal thickness and corneal curvature in Uygur and the Han nationality college students.

Abstract:AIM: To compare the refractive errors measured by the VISX WaveScan, OPD-Scan Ⅲ and the subjective refraction.

METHODS: Seventy-six patients(152 eyes)were recruited from January 2013 to December 2013. All patients were measured with subjective refraction by the phoropter(NIDEK, RT-5 100), objective refraction by the WaveScan(AMO Company, USA), OPD-Scan Ⅲ(Nidek Technologies, Japan). The sphere, cylinder, axis of the three methods were compared and analyzed.

RESULTS: The sphere measured by WaveScan was lower than that by subjective refraction, the difference was 0.13±0.30D(t=3.753, P<0.001). For cylinder, the difference was 0.13±0.43D(t=3.664, P<0.001). There was no significance for sphere, cylinder, and spherical equivalent between OPD-Scan Ⅲ and subjective refraction(P>0.05). The value of the difference between WaveScan and subjective refraction was 5.87°±6.19° for the axis and the difference between OPD-Scan Ⅲ and subjective refraction was 3.82°±3.95°. There was statistic significance(t=2.817, P=0.006).

CONCLUSION: For sphere and cylinder,WaveScan generated some deviation relative to subjective refraction. The Nidek OPD-Scan Ⅲ gives more accurate measures of objective refraction when compared with subjective refraction.

Abstract:AIM:To investigate the effect of problem-based learning(PBL)used in the teaching of medical students' evidence-based medicine(EBM).

METHODS: Five classes(total 147 students)were randomly selected as experimental(PBL)group, at the same time, another 5 classes(total 149 students)were also randomly selected as control group, using traditional teaching method(lecture-based learning, LBL)in 2010 grade. The final examination scores of the experimental group were compared with control at the end of term. In addition, all students were interviewed using self-administered questionnaire to obtain their evaluation for PBL practice. SPSS13.0 software was used for statistical analysis.

RESULTS: The homogeneity test in baseline survey showed that the basic characteristics between the two groups of students were no significant differences, and were comparable(P>0.05). Final exam results showed that in addition to the scores of the EBM basic knowledge indicated no significant difference between two groups of students(P>0.05), for the 5 steps of EBM procedure, namely, asking questions, finding the best evidence, evaluating the evidence, using and practicing the evidence, re-evaluating the evidence, and the total scores between the two groups, there were significant statistically differences(P<0.05). The results to student learning evaluation showed that there was no significant difference between the two groups(P>0.05)in aspects of better understanding classroom knowledge, improving language expression ability, and writing skill exercises. And other residual items had a significant difference(P<0.05), especially in aspects of improving enthusiasm for learning, self-study ability, improving learning efficiency, information analysis and utilization ability, team collaboration, and communication between teachers and students, however, there was a very significant difference(P<0.001)between the two groups.

CONCLUSION:PBL teaching mode can effectively improve teaching effectiveness and the quality of EBM teaching, so the this teaching mode is worth further popularizing.

Abstract:AIM:To discuss the related factors that affected the stability of posterior corneal surface after laser in situ keratomileusis(LASIK).

METHODS: About 64 patients(64 eyes)were enrolled. The correlation among the changes in posterior corneal surface 6 month after LASIK, surgery method, corneal flap thickness(FT), ablation thickness(AT), postoperative residual corneal stroma thickness(RCST), preoperative thinnest corneal thickness(CT), flap thickness/preoperative thinnest corneal thickness(FT/CT), ablation thickness/preoperative thinnest corneal thickness(AT/CT), postoperative residual corneal stroma thickness/preoperative thinnest corneal thickness(RCST/CT), anterior and posterior preoperative corneal height, the difference of the forward shift in posterior corneal surface(diff value)of preoperative and preoperative intraocular pressure were analyzed.

RESULTS: The changes of diff value between preoperative and postoperative were related with diopter(r=0.419, P=0.014), AT(r=0.394, P=0.023), AT/CT(r=0.501, P=0.004), Diff value of preoperative(r=0.501, P=0.004), RCST(r=-0.385, P=0.033)and RCST/CT(r=-0.401, P=0.025). The changes of height value from posterior corneal surface between preoperative and postoperative were related with diopter(r=0.520, P=0.002), AT(r=0.504, P=0.003), AT/CT(r=0.442, P=0.013), Diff value of preoperative(r=0.624, P=0.000)and RCST/CT(r=-0.394, P=0.028).

CONCLUSION: AT, RCST, AT/CT, RCST/CT and diff value of preoperative should be the key index that predicted the stability of posterior corneal surface after LASIK,the further research will give the range of safety value.

Abstract:AIM: To assess the impact of diabetes on corneal endothelial cells through the quantitative analysis of corneal endothelial cell morphology for patients with diabetics.

METHODS: The corneal thickness and endothelial cell morphology of 360 eyes of 299 cases were detected using full automatic corneal endothelial cell analyzer. The normal control group included 175 eyes of 148 cases, and there were 185 eyes of 151 cases for the patients with diabetes, 110 eyes of 92 cases for the non-proliferating phase group and 75 eyes of 59 cases for the proliferating phase group. The average density of central corneal endothelial cells, proportion of hexagonal cells, coefficient of variation and corneal thickness were compared among groups, and then the statistical analysis was conducted.

RESULTS: Compared with the cornea of the normal group, in the diabetes group, the coefficient of variation of corneal endothelial cells and central corneal thickness increased, while the average density of central corneal endothelial cells and proportion of hexagonal cells decreased, showing a significant difference(P<0.05). Compared with the cornea of non-proliferating phase group, in the proliferating phase group, the density of central corneal endothelial cells decreased, the coefficient of variation of corneal endothelial cells increased, while the proportion of hexagonal cells decreased with a significant difference(P<0.05), and the central corneal thickness increased, showing no significant difference(P>0.05).

CONCLUSION: Compared with the cornea of normal control group, in the diabetes group, the corneal endothelial cells show abnormal morphology, which aggravates with the severity of lesions, especially for the significant changes in the coefficient of variation and the proportion of hexagonal cells. As a result, the corneal resistance to damage in patients with diabetes will decrease.

Abstract:AIM: To analyze clinical data of hospitalized patients with age-related cataract treated through clinical pathway in our hospital, and to investigate the effectiveness of clinical pathway in standardizing medical behavior, advancing work efficiency, and improving quality of hospital management.

METHODS: Data of patients with age-related cataract, who were treated with phacoemulsification combined with intraocular lens implantation in Xi'an North Hospital, were retrospectively analyzed. In clinical pathway group, 220 patients underwent cataract surgery from October 2012 to May 2013 in accordance with clinical pathway. For control group, 213 patients with cataract receiving surgery from October 2010 to June 2011, comply with conventional process. Effect of cataract surgery, average length of hospitalization, average cost of hospitalization, and degree of satisfaction of patients were comprehensive investigated.

RESULTS: In 220 patients of clinical pathway group, 209(95.0%)got improved vision, the days of hospitalization was 4.5±1.4d, and the average hospitalized consumption was 4 522.3±285.1 Yuan. Whereas, in control group, visual acuity in 202(94.8%)out of 213 patients were improved, and the length and cost of hospitalization were 5.1±1.7d and 4 647.7±271.2 Yuan. The difference of the length and cost of hospitalization between these two groups were significant(P<0.05). However, there was no statistically significance in curative effect and patients satisfaction compare(P>0.05).

CONCLUSION: Practicing of age-related clinical pathway is helpful in standardizing medical heavier, optimizing clinical process, reducing health cost, improving quality of medical care, and providing evidence for hospital management innovation.

Abstract:AIM: To retrospectively evaluate the effect of lens extraction combined with vitrectomy to treat traumatic lens dislocation with secondary glaucoma.

METHODS:Thirty-one eyes(31 cases)of lens dislocation caused by blunt trauma with secondary glaucoma were treated respectively with cataract extraction combined with anterior vitrectomy, trabeculectomy and intraocular lens implantation. The visual acuity and pressure were observed 1wk, 1 and 3mo after operative.

RESULTS:Thirty-one eyes were all complete the operation successfully, and 6 eyes were given combined trabeculectomy, 9 eyes were implanted anterior chamber intraocular lens implantation(IOL)and 15 eyes were given posterior chamber suture fixation. Sixteen eyes were implanted in one-stage operation, while 8 eyes were implanted in two-stage operation. All intraocular pressure(IOP)were controlled to the normal level after operation and 23 eyes had visual acuity of more than 0.3.

CONCLUSION:Lens extraction combined with vitrectomy is an effective method for treatment of lens dislocation with secondary glaucoma. In order to control the IOP and get well visual function, we should choose IOL implantation or trabeculectomy according to the patient's condition.

Abstract:AIM:To discuss the application effect of adjustable sutures in glaucoma filtering operation after trabecular resection.

METHODS: Seventy-eight cases(101 eyes)suffered from glaucoma were randomly divided into two groups, observation group and control group. Thirty-nine cases(51 eyes)in the observation group underwent trabeculectomy with adjustable sutures, the control group(39 cases, 50 eyes)only adopted trabeculectomy.

RESULTS: Compared Preoperative IOP in two groups, the difference was not statistically significant(P>0.05). After 6mo, IOP were decreased compared with preoperative in two groups, and that in observation group was lower than control group, the difference was statistically significant(P<0.05). Six months after operation, there were 1 eye with shallow anterior chamber Ⅰ and 2 eyes with non-functional bleb in observation group, and the complication rate was 5.9%. While there were of 6 eyes with shallow anterior chamber, in which 4 eyes at grade Ⅰ, each one at grade Ⅱ and Ⅲ. Non-functional blebs in 5 eyes and a scleral flap adhesion complications rate in the control group was 24.0%, significantly higher than that in the observation group, the difference was statistically significant(P<0.01).

CONCLUSION: The adjustable sutures combined with trabeculectomy for glaucoma can significantly reduce the postoperative complications. The curative effect is exact and clinically applicable.

Abstract:AIM: To evaluate the efficacy and safety of vitrectomy combined with internal limiting membrane(ILM)peeling for treating foveoschisis in high myopia.

METHODS: Thirty high-myopia patients(30 eyes)with foveoschisis from March 2011 to March 2013 were divided two groups: the treatment group(16 eyes)was treated with vitrectomy combined with ILM peeling, and the control group(14 eyes)was treated only with vitrectomy. The foveoschisis reattachment and and best spectacle-correction were measured preoperatively and 2mo after surgery.

RESULTS: The improvement of foveoschisis reattachment and best spectacle-correction in the treatment group was significantly better than those in the control group(P<0.05).

CONCLUSION: Vitrectomy combined with ILM peeling is a safe and effective treatment for foveoschisis in high myopia.

Abstract:AIM: To evaluate the physiologic change of retinal thickness during pregnancy.

METHODS:Forty cases(80 eyes)were included two groups: 40 eyes(20 cases)in healthy pregnant women group(including in the second and last trimester), and 40 eyes(20 cases)in healthy nonpregnant women group(control group). The macular volume, average thickness, central subfield thickness and retinal thickness of other parafoveal areas were measured by optical coherence tomography scan.

RESULTS: The macular volume was 10.06±0.41mm³ and 9.87±0.30mm³ in healthy pregnant women group and control group respectively. The average thickness was 279.43±10.86μm and 274.25±8.07μm in healthy pregnant women group and control group respectively. The central subfield thickness was 235.15±15.05μm and 233.00±15.81μm in healthy pregnant women group and control group espectively. Statistically significant difference was found in macular volume and average thickness(P<0.05). The retinal thickness of 8 parafoveal areas in healthy pregnant women group increased comparing with control group, but statistical significance was only found in superior-outer area and inferior-outer area(P<0.05). OCT images of all cases were normal.

CONCLUSION: The macular retinal thickness increases during pregnancy in the second and last trimester. The physiologic change of retinal thickness should be considered when evaluating pathologic retinal disease of pregnant women.

Abstract:AIM: To introduce a new method of guiding by using 3D-OCT to treatment central serous chorioretinopathy(CSCR)with multiwavelength laser.

METHODS:Twenty-three cases(23 eyes)typicality central serous chorioretinopathy were collected in July 2010 to July 2013 in Changchun Aier Eye Hospital, using 3D-OCT model locate central serous chorioretinopathy leakage point and photocoagulation treatment with multiwavelength laser. Postoperative follow-up of 24wk, the postoperative vision and macular area retina neuroepithelial layer detachment height were observed.

RESULTS: Twenty-three cases(23 eyes)of central serous chorioretinopathy patients by the 3D-OCT guided multiwavelength laser treatment vision after 24wk of follow-up compared with before treatment. there was statistically significant(P<0.05). Visual improved obviously after treatment. OCT macular area before and after the treatment on macular area retina neuroepithelial layer detachment height(P<0.05). OCT macular area before and after the treatment of macular area retina neuroepithelial layer detachment height significantly decreased, slurry apparent absorption. Except 1 case lost visitors, 23 cases(23 eyes)with central serous chorioretinopathy did not see the whole body or eye local adverse reactions occur.

CONCLUSION: 3D-OCT guided by multiwavelength laser treatment of central serous chorioretinopathy and under the guidance of FFA in the central serous chorioretinopathy laser treatment have the same curative ratio, has certain clinical value.

Abstract:AIM: To assess the changes of macular thickness of acquire immunodeficiency syndrome(AIDS)patients.

METHODS: The study based on the data analysis of 38 human immunodeficiency virus(HIV)positive patients(64 eyes). According to CD4 count and whether cytomegalovirus retinitis(CMVR)happened, the patients were divided into 3 groups. Group A included 16 patients(32 eyes), in which CD4 count was <50cells/μL and CMVR did not happen. Group B included 10 patients(20 eyes), in which CD4 count was >50cells/μL and CMVR did not happen. Group C included 12 patients(12 eyes), in which CD4 count was <50cells/μL and CMVR just happened. Group D included 10 healthy people(20 eyes), as normal control group. By using optical coherence tomography(OCT), thickness of retina along with a 1mm diameter circle centered on macular was evaluated.

RESULTS: The mean foveal thicknesses in groups A, B, C and D were 254.03±15.63μm, 263.11±17.12μm, 304.50±50.62μm and 257.64±8.54μm in order. Compared with foveal thickness in each group, there were significant differences in general(F=12.933, P=0.000). The mean foveal thickness in groups CMVR increased, which was of significant difference(P=0.000), compared with other groups.

CONCLUSION: CMVR can impair the structure and function of macular, which then seriously affects the visual function of patients. It's helpful to understand the progress and prognosis of CMVR disease by observing macular structure with OCT in early time.

Abstract:AIM: To evaluate the effect of hexuemingmu tablet on retinal vein occlusion(ROV).

METHODS: Totally, 108 patients of 112 eyes were divided into two groups randomly. One group including 55 patients(55 eyes)were treated by hexuemingmu tablet, the other group including 53 patients(57 eyes)were treated by danhong injection. The visual acuity, fundus and FFA were evaluated before and after treatment.

RESULTS: The total effective rate in the group treated by hexuemingmu tablet was 98%, and that in control group was 82%. The hemorrhage was absorbed much more quickly than control group. Two group were different from each other in statistics(P<0.05).

CONCLUSION: Hexuemingmu tablet can accelerate hemorrhage absorbing and improve visual acuity in RVO treatment.

Abstract:AIM:To investigate the findings of the eyes which were examined preoperatively by three mirror contact lens before the implantation of implantable collamer lens(ICL). To analysis the retinal pathological changes and to explore the clinical analysis of early diagnosis and treatment in retinopathy on fundus examination before operation.

METHODS:The retrospective case series study included 127 eyes of 64 patients who underwent phakic intraocular lens implantation were received the fundus examination by three mirror from April 2011 to April 2012 in our hospital. The age, refractive diopter, the findings of Goldmann three mirror examination and the condition of retinal photocoagulation were analysed and concluded.

RESULTS: A total of 34 eyes(26.8%)out of all 127 eyes(64 cases)were found to have peripheral retinal pathological changes. Eight eyes(6.3%)with retinal holes, 15 eyes(11.8%)with retinal lattice degeneration, 5 eyes(3.9%)with retina cream degeneration, 3 eyes(2.4%)with retinal paving stone degeneration,2 eyes with vitreoretinal adhesion and traction,1 eye(0.8%)with retinal hemorrhage. Twenty-five cases were given retinal photocoagulation and then received the ICL implantation after 3mo. The follow-up time was 1a. No retinal detachment happened.

CONCLUSION:Phakic before intraocular lens implantation for fundus examination by three mirror is contributed to find the peripheral retinal pathological changes and abnormity. And make the appropriate treatment before operation for improving the security of operation, it can also give help to the postoperative follow-up of the fundus of these patients.

Abstract:AIM: To explore and analyze the image features, diagnosis and treatment of the central serous chorioretinopathy(CSCR)fundus.

METHODS: From May 2008 to May 2014, 97 cases of 121 eyes with central serous chorioretinopathy were treated in in our hospital. The imaging features were compared and analyzed through different methods.

RESULTS: Sixty-one cases(61 eyes)were ≤45 years, including 13 case with disease in both eyes, single stove leak accounted for 48.6%, multifocal leakage(25.7%), atypical leakage accounted for 25.7%. Thirty-six cases(47 eyes)were >45 years, 11 cases with disease in both eyes, single focal leakage(8.5%), multifocal leakage(48.9%), atypical leakage accounted for 42.6%. FFA results showed acute hairstyle at the beginning of 89 eyes, chronic deferment type 32 eyes. OCT examination showed that the main features were neuroepithelial detachment, as well as the change of the retinal pigment epithelium(RPE)layer, which was divided into RPE layer detachment 93 eyes, accounting for 76.9%, rough and RPE little ridges in 28 cases, accounting for 23.1%. The average thickness of macular center concave on the cortex of microns was 137.87±19.21μm, and there was no significant difference conpared with normal(137.32±4.98μm)microns(t=0.30, P>0.05). The closer leakage area to macular fovea, the worse of eyesight..

CONCLUSION: Different imaging examination on central serous chorioretinopathy can show different features. For clinical diagnosis and treatment it had different and complementary roles, but were given significant help for diseases treatment.

Abstract:AIM: To retrospectively analyze the effect of different surgical treatment on intraocular foreign bodies, according to different types and position.

METHODS: Clinical data of 46 cases diagnosed with intraocular foreign bodies from June 2010 to April 2013 were retrospectively analyzed.

RESULTS:Intraocular foreign bodies in anterior segment could be removed or magnetically attracted directly, intraocular foreign bodies in posterior segment could be attracted if there was accurate location. Vitrectomis was more favorable for the non magnetic or intraocular foreign bodies in posterior segment. In 46 cases, all intraocular foreign bodies(100%)in posterior segment were removed successfully. Among them the functional cure in 33 cases(72%), the anatomical cure in 12 cases(26%), discharged in 1 case(2%).

CONCLUSION: The aim of operation is to reconstruct of eyeball structure preserve and restore visual function. We should find more appropriate mode of operation and timing of surgery according to the foreign bodies' different types and injury of eyeball,reduce complications,preservation eyeball and improve visual function.

Abstract:AIM: To analyze the pathogens and drug sensitivity of chronic dacryocystitis in order to provide evidence for clinical drug use.

METHODS: Lacrimal secretion of 171 cases with chronic dacryocystitis was sampled for pathogenic bacteria culture identification and drug sensitivity test. Based on the results, the isolation rate of pathogens strains, the pathogens kind of chronic dacryoeystitis, main pathogens of chronic dacryocystitis, and sensitive drug for pathogens were analyzed.

RESULTS: The isolation rate of pathogens strains was 76.61%(131 cases). The pathogens constituting the chronic dacryocystitis were predominantly gram-positive coccus,the percentage was 72.52%(95 cases), among which staphylococcus hominis occupied 27.48%(36 cases), staphylococcus epidermidis 16.79%(22 cases), streptococcus viridans 12.98%(17 cases). The majority of these bacteria were sensitive to cefoperazone-sulbactam, tobramycin, gentamicin and levofloxacin. For gram-positive coccus, cefoperazone-sulbactam, gentamicin and tobramycin were the most sensitive drug. For gram-negative bacilli, cefoperazone-sulbactam, tobramycin and levofloxacin were most sensitive drug.

CONCLUSION: Staphylococcus hominis is the main pathogen of chronic dacryocystitis, tobramycin can be used as the first choice for local treatment of chronic dacryocystitis.

Abstract:AIM: To find an efficient and simple surgical procedure of the external dacryocystorhinostomy(EXT- DCR)in the treatment of chronic dacryocystitis.

METHODS: A total of 270 cases were performed in this retrospective study. A comparison of clinical effects and hemorrhage complications between the experimental group, in which 189 eyes of 167 patients that underwent traditional EXT-DCR without packing, and the control group, in which 121 eyes of 103 patients that underwent traditional EXT-DCR with Vaseline gauze were performed. The postoperative follow-up ranged from 6 to 36mo(the mean follow-up was 15±3.6mo).

RESULTS: There were no significant differences in the curative rates between the two groups(97.9% vs 97.5%, P>0.05). But the incidence rate of moderate or severe postoperative nasal bleeding was lower in the experimental group(15.9%, 30 eyes)than the control group(31.4%, 38 eyes)and P<0.01.

CONLUSION: The traditional EXT-DCR without packingis an effective procedure and is more effective in reducing moderate or severe postoperative bleeding when the intraoperative anastomose and the postoperative drainage are well done and the intraoperative bleeding is well controlled.

Abstract:AIM: To discuss the clinical applications of methods to localize nasal cut ends and the effects of Z-plasty in the surgeries for lower eyelid longitudinal laceration combined with lower lacrimal canaliculi disruption.

METHODS: From September, 2010 to October, 2013, a total of 37 patients(37 eyes)with lower eyelid longitudinal laceration combined with lower lacrimal canaliculi disruption were operated for anastomosis of lacrimal canaliculi disruption and suture of lower eyelid longitudinal. Different methods to search for the nasal cut ends of lacerated lacrimal canaliculi, such as “under a microscope directly”, “guided by probing needle” and “pigtail curved probe”. Then, to repair lower eyelid longitudinal laceration with Z-plasty transposition flaps. Follow up was 3mo～2a after operation.

RESULTS: All nasal cut ends could be found successfully on 37 patients; Lacrimal duct unobstructed in 31 patients(83.8%), improved in 5 patients(13.5%), invalid in 1 patient(2.7%),the overall successful rate was 97.3%; the eyelids repair was satisfactory, small scars, the appearance and function was normal.

CONCLUSION: The nasal cut ends can be found successfully by “directly under a microscope”, “guided by probing needle” and “pigtail curved probe”; the effect of silicone drainage tube used as lacrimal canaliculi bracket is satisfactory; most patients gained excellent recovery for both appearance and function after Z-plasty.

Abstract:AIM: To observe the efficacy of Medpor porous polyethylene implants in treatment of enophthalmos combined with orbital fracture.

METHODS: Seventeen cases(17 eyes)with enophthalmos caused by orbital fracture underwent surgical treatment with Medpor porous polyethylene implants. All accepted a 6-mo follow-up and the data of enophthalmos, eyeball movement and diplopia were collected.

RESULTS: The average difference of exophthalmos between damaged eyes and undamaged eyes was(3.4±1.5)mm preoperatively, two cases had residual 1mm enophthalmos 6mo after surgery, while other 15 cases were completely corrected. Seventeen cases suffered from eyeball movement restriction and diplopia preoperatively, 16 cases had normal eyeball movement without diplopia 6mo after surgery, 1 case with limitation of abduction and horizontal diplopia. There was no extrusion, rejection, infection or other complications occurred during follow-up.

CONCLUSION: Medpor porous polyethylene implants can effectively improve the orbit volume to repair enophthalmos caused by orbital fracture.

Abstract:AIM: To evaluate the clinical effects of modified hydroxyapatite implant in scleral shell.

METHODS:Thirty-four cases were performed eye evisceration, autogenous sclera shell anterior and posterior petaloid shape with posterior sclera fenestration, hydroxyapatite artificial eyeballs were implanted at stage I, and conjunctival wound, orbital activity and other complications were observed after surgery.

RESULTS: The follow-up was 6～12mo. There was no patients with implant exposure, sclera dissolution, conjunctival wound dehiscence, conjunctival sac constriction noted. All the patients got good activity of artificial globe, and the active range of side motion of the HA was 10°～15°.The artificial eyes looked symmetrical, and the eyes socket were full.

CONCLUSION: The modified hydroxyapatite implant in scleral shell can maintain the normal anatomy of the orbital tissue, and also can get full eyes socket and good activity, It was an easy and simple surgery which could obtain satisfactory clinical effect and less complications.

Abstract:AIM: To explore the curative effect of methylprednisolone with octreotide retrobulbar injection therapy on thyroid associated ophthalmopathy.

METHODS:Fifty-one cases(96 eyes)with thyroid associated ophthalmopathy were treated with methylprednisolone(500mg/d)for 3d, and then retrobulbar injection of octreotide(0.1mg/mo)for 3mo in one course. Symptoms and signs of the patients were observed before and after the treatment course.

RESULTS: Symptoms of 49 cases were improved significantly. In all cases, the mean value of exophthalmus of the patients was significantly decreased after the treatment by 3.1±1.4mm. The height of palpebral fissure was significantly decreased after the treatment by 2.4±0.9mm, there were statistically significant difference before and after treatment(P<0.05).

COCLUSION:Methylprednisolone with octreotide retrobulbar injection therapy can improve symptoms and signs of the patients with thyroid associated ophthalmopathy with high safety and no obvious side effect.

Abstract:AIM: To discuss the clinical treatment of bacterial conjunctivitis, and summarize the treatment experiences.

METHODS: Totally, 124 cases with bacterial conjunctivitis in the department of ophthalmology from October 2012 to April 2014 were selected as the research objects. According to the diagnosis points, they were classified. After symptomatic drug treatment, the efficacy and adverse reactions were observed.

RESULTS: The total effective rate of 124 cases after treatment was 96.8%, after treatment, patients with tears, conjunctival congestion, secretions and pain scores were significantly lower than those before treatment(P<0.05). The total score after treatment was(0.36±0.24)in this group, there were 6 cases(4.8%)of adverse reactions.

CONCLUSION: The efficacy of classification symptomatic treatment for bacterial conjunctivitis is significant and worthy of clinical reference.

Abstract:AIM: To investigate the clinical features of acquired immune deficiency syndrome(AIDS)patients associated ocular diseases in Urumqi and the relationship between ocular fundus manifestations and CD4⁺T cell count.

METHODS: The fundus of 93 AIDS patients were examined by indirect ophthalmoscopy. The clinical symptoms and CD4⁺T cell count of those patients with fundus changes were analyzed.

RESULTS: Thirteen patients were found having fundus changes which occurred in one eye of 4 patients and two eyes of 9 patients, respectively, and the total detection rate was 14.0%. Seven patients had vision changes, and the main clinical features of retinal lesion were cotton wool spot and hemorrhage of retina. Four patients were diagnosed as retinitis with cytomegalovirus(CMV)infection and 9 patients were diagnosed as HIV related retinopathy diseases. Seven patients among 37 patients with CD4⁺T cell count ≤100cell/μL had fundus changes related AIDS, and the detection rate was 18.9%; while 6 patients among 56 patients with CD4⁺T cell count >100cell/μL had fundus changes related AIDS, and the detection rate was 10.7%. There was statistical difference between the two detection rates(P<0.05).

CONCLUSION: No specificity was found of those patients with the clinical manifestation of HIV-related retinopathy, and those patients are easy to be missed diagnosis. A number of AIDS patients have fundus changes without any vision changes. Therefore, it is very useful for AIDS patients to be carried out the routine fundus examination for the early diagnosis and treatment.

Abstract:AIM: To investigate the refractive distribution and analysis risk factors for aircrew ametropia.

METHODS: The number of 49 cases with ametropia from 1031 aircrew during May 2013 to May 2014 were reviewed. Various types of refraction composition, age, type, position, time of flight with the subjective assessment of aircrew were analyzed and compared.

RESULTS: Of 49 cases, 43 cases(88%)were myopia, 6 cases(12%)were hypermetropia.,Detection rates were higher in age over 50 years aircrew and flight time more than 3000h. Detection rates were lower in self-conscious symptom heavy aircrew, fighter aircrew and good habit of using eyes.

CONCLUSION: The myopia incidence in aircrew with age >50 years and long flight time is higher, than that of fighter pilots and good habit of using eyes. We should pay attention to the increasing late-onset myopia of aviators and habit of using eyes, work intensity and time of using eyes about aircrew.