Abstract:AIM: To evaluate the outcomes, success rate and complications encountered following viscocanalostomy and phacoviscocanalostomy. And to quantify our need, complications and results following Nd:YAG goniopuncture.

METHODS: Data was collected prospectively on eyes undergoing viscocanalostomy or phacoviscocanalostomy and evaluation was carried out at 1 year. In addition Nd:YAG laser goniopuncture(LGP)was performed at any stage for uncontrolled post-operative IOP.

RESULTS: Post-operative data was available for 100 eyes. Eyes achieving complete success(defined as IOP≤18mmHg without any glaucoma medication)was 76%(n=76), and those with a qualified success(defined as a total of eyes with an IOP≤18mmHg without or with 1 permanent glaucoma medications)was 88%(n=88). Sixty-three percent(n=63)of eyes achieved a 30% reduction in IOP without a need for medication and 67%(n=67)in total without or with 1 permanent glaucoma medication. The Kaplan-Meier survival analysis suggests phacoviscocanalostomy is superior at lowering the IOP to less than 18mmHg without medication, log rank test P=0.005. Sixteen eyes required post operative LGP at various time points, a majority(40%)of episodes were around 6 months post surgery. There was a 24.8% post LGP reduction in mean IOP(P=0.0002). For LGP at 12 months an IOP less than 18mmHg without glaucoma treatment was achieved in 94%(n=15)following LGP. All patients maintained a drop in IOP at least 3 months following LGP, longer follow up data was to follow.

CONCLUSION: Our data show viscocanalostomy and phacoviscocanalostomy are highly successful at 1 year. Nd:YAG laser goniopuncture was also efficacious at lowering and maintaining the IOP. Complications were scarce.

Abstract:AIM:To describe the aetiology and clinical profile of non-glaucomatous optic atrophy in a tertiary hospital in Malaysia.

METHODS: A retrospective case series was conducted on patients diagnosed with non-glaucomatous optic atrophy who presented to the Eye Clinic of Hospital Universiti Sains Malaysia from 2007 until 2011 with a minimum of one year follow-up. Medical records of these patients were reviewed and the findings compiled.

RESULTS: Of the 100 patients who met the selection criteria, 56% had bilateral involvement. The chief presenting symptom was visual blurring(61%), followed by visual blurring with neurological symptoms(18%)and visual field constriction(9%). Most patients(63%)had a presenting visual acuity worse than 3/60 in the affected eye. The main aetiologies were space-occupying intracranial lesions(26%), congenital/hereditary diseases(13%), hydrocephalus(12%), trauma(12%), and vascular causes(12%). The majority of cases(67%)were managed conservatively. Regardless of aetiology, optic atrophy was associated with variable degrees of visual dysfunction. At the end of one year, 50% of the patients had some degree of visual impairment.

CONCLUSION: The main aetiology of optic atrophy was space-occupying intracranial lesions, followed by congenital/hereditary, trauma and vascular problems. Visual or neurological symptoms usually preceded the diagnosis, and visual acuity was significantly affected by the disease. A high level of suspicion is required in order to make an early diagnosis of optic atrophy, as the main complaint of visual blurring is usually non-specific.

Abstract:AIM: To investigate the role of NgR-Rock signaling pathway in the retinal ganglion cells(RGCs)which are damaged by high concentration of glucose.

METHODS: Studies were performed with control group, high glucose concentration(HGC)group, SiNgR group(HGC medium including AAV2-SiNgR virus)and SiRNA control group(HGC medium including the negative sequence of nucleotides). Three days after culture, RGCs was observed by microscope, expressions of NgR, Rock and F-actin were detected by Western blot, cell vitality was determined by MTT, and cell morphology was also detected by F-actin immunohistochemical staining.

RESULTS: Compared with control group, in HGC and control SiRNA groups, cell volume decreased with less processes, light refraction was strengthened, and the expressions of Rock and NgR were significantly increased(P<0.05, respectively), while the expression of F-actin was reduced(P<0.05); Compared with control group, there was no obvious difference in the expression of NgR, Rock and F-actin, and cell vitality between SiNgR group and control group(P>0.05).

CONCLUSION: The activation of NgR-Rock signaling pathway may plays an important role in HGC impairing RGCs.

Abstract:AIM: To study the influences of dexamethasone on the immunogenicity of porcine cornea cryopreserved in liquid nitrogen and the involved mechanism.

METHODS: Fresh porcine corneas were drilled down by 13mm-diameter trephine. Then the samples were put into four kinds of cryoprotectants in turn for cooling equilibrium with “simplified four-step” method and then stored in liquid nitrogen. All samples were thawed in water at 40℃ before being used. The samples treated with dexamethasone were made and the preceding three cooling steps were same. But the samples were additionally incubated in 0.01, 0.03, 0.05mg/mL dexamethasone for 18h at 4℃ before the last cooling step. Totally 50 BALB/c mice were randomly divided into 5 groups including 10 mice in each group: the control group; routine cooling group which were treated through four cooling steps; dexamethasone group I, dexamethasone group II and dexamethasone group III which were treated with 0.01, 0.03, 0.05mg/mL dexamethasone successively. After treatment, corneal samples were transplanted into the hypodermis on the back of mice. After 14d, the samples were taken out, imbedded in paraffin, and stained by HE and CD25/FasL immunohistochemistry. All the samples were investigated under light microscope.

RESULTS: On the 14th day, all the samples were taken out. We found the samples which adhered to surrouding tissues swelled obviously and showed translucent and a bit yellow. Through HE staining, fresh corneal samples in the control group were infiltrated with large amount of lymphocytes throughout each layer; the amount of infiltrating cells in the routine cooling group was less than the control group in which most cells were distributed in endodermis and epitheliums. In the dexamethasone-treated groups, the amount of infiltrated cells were the least. Immunohistochemical results showed that compared with the the routine cooling group and dexamethasone-treated groups, the amount of CD25 and FasL in the control group was the most, the difference was significant. Compared with dexamethasone-treated groups, the amount of CD25 and FasL positive infiltrating cells in the routine cooling group were more. ALL the differences were significant. But there was no significant difference in the amount of CD25 and FasL positive infiltrating cells among each dexamethasone treated group.

CONCLUSION: Corneas in dexamethasone-treated groups showed the lowest immunogenicity. Corneal immunogenicity was irrelevant with the concentration of dexamethasone at the range of 0.01-0.05mg/mL.

Abstract:AIM: To investigate the effect of different concentrations of 10-hydroxycamptothecin(HCPT)on the cell cycle and cytotoxicity of human Tenon's capsule fibroblasts(HTFs), and to explore its mechanism in anti-fibrosis.

METHODS:The Tenon's capsule tissue of fresh eyes(<6h)of our hospital eye bank was taken, in vitro culture of fibroblasts was done by tissue block culture; A flow cytometry(FCM)was used to evaluate the effect of different concentrations of HCPT(0, 0.25, 1, 4mg/L)and mitomycin C(MMC: 0, 0.025, 0.1, 0.4mg/L)on HTFs cell cycle; Trypan blue staining was adopted to determine whether the inhibitory effect of HCPT and MMC on HTFs was caused by their cytotoxicity; RT- PCR was employed to detect the level of Smad7mRNA gene expression of HTFs after HCPT and MMC were used for 24h.

RESULTS:HTFs were cultured successfully in vitro, and can be used in our study; compared with the control groups, the cell cycle of HTFs which was affected by different concentrations of HCPT was significantly different in G2 phase(P<0.05). As for MMC, there were significant differences in G1 phase between groups with different concentrations of MMC and the control group(P<0.05). There was no significant difference in the rate of HTFs living cells between HCPT group(or MMC group)to which HCPT and MMC were added for 24h and the control group(P>0.05). After HFTs was affected by 0.4mg/L MMC or 4mg/L HCPT for 24h, RT PCR found that the level of Smad7 mRNA expression was significantly increased(P<0.05).

CONCLUSION: HCPT mainly blocks HTFs in G2 phase, MMC mainly impacts the G1 phase. The inhibitory effect of HCPT and MMC on HTFs proliferation is not relevant to cytotoxicity induced by the two drugs. The mechanism that HCPT inhibits the proliferation of HTFs may be due to the increasing Smad7 mRNA expression to block TGF-β signaling pathway.

Abstract:AIM:To construct the mice model with lentivirus expressing AHNAK1 shRNA in CD4⁺ T cells, and to study its inhibitory effect on the thyroid-associated ophthalmopathy(TAO)in mice.

METHODS: The shRNA sequence with good disturbing potency towards AHNAK1 was designed and selected; then the shRNA was packed into lentivirus; and the CD4⁺ T cells were infected. The infected CD4⁺ T cells of mice by the packed lentivirus were observed to detect the inhibition effect on T cells. And then the immunotherapeutic effects of AHNAK1^-/- on TAO were observed by experimental animal model.

RESULTS: The shRNA with good disturbing potency was successfully screened and correctly inserted into the lentivirus. The titer of the recombinant lentivirus was 1.0×10⁶TU/mL. The CD4⁺ T cells infected by lentivirus showed the anergy trend and restrained the immune response of inflammation. Suppressing the expression of AHNAK1 in T cells of animal model can effectively control the occurring and proceeding of TAO, which can significantly reduce the expression of IL-2 /IL-1β/IFN-γ in the T cells of the control group.

CONCLUSION: This paper successfully constructs mice model with the recombinant lentivirus expressing AHNAK1 shRNA, which has a favorable inhibitory effect on secretion of IL-2, IL-1β, IFN-γ by T cells. The recombinant lentivirus can effectively inhibit the occurring and proceeding of TAO in mice.

Abstract:AIM: To observe the effects of puerarin of different concentrations on relaxing and contraction factors produced by cultured bovine retinal vascular endothelial cells(RVECs).

METHODS: The eighth generation of bovine RVECs was used for the research. The RVECs were cultivated in nutrient solution with different concentrations of puerarin in experimental group and in nutrient solution without drug, growth factor and serum in the control group. Expressions of eNOS and ET-1 in each group were measured by Western blotting method after 48h.

RESULTS:Compared with the negative comparison group, relative expression of eNOS in puerarin group increased(P<0.01), and eNOS expression also enhanced with the increase of the concentration of drugs; the ET-1 relative expressions of puerarin group decreased(P<0.01), and ET-1 expression also decreased with the increase of the concentration of drugs.

CONCLUSION:By up-regulating eNOS expression, down-regulating the ET-1 expression and regulating vascular nitric oxide endothelin(NO/ET)ratio, puerarin can relax retinal vascular smooth muscle.

Abstract:AIM:To investigate the role of mitochondrial membrane potential(△ψm)and Caspase 3 in the ACC-2 cell apoptosis induced by As₂O₃.

METHODS:ACC-2 cells were cultured. The As₂O₃ of different drug concentration gradients(0, 1.0, 2.0, 4.0, 8.0μmol/L)were applied to ACC-2 cells respectively. The changes in △ψm of ACC-2 cells before and after As₂O₃'s inducing(8.0μmol/L for 24h)were detected by flow cytometry with Rh123 staining. Caspase 3 activity was detected by the multifunctional microplate reader.

RESULTS: Rh123 fluorescence intensity in ACC-2 cells was strongest in the control group, while it weakened in ACC-2 cells in 8.0μmol/L As₂O₃ treatment group. The difference between two groups was significant(P<0.05). With the increase of As₂O₃ concentration(0, 1.0, 2.0, 4.0, 8.0μmol/L), Caspase 3 enzyme activity unit in ACC-2 cells gradually increased.

CONCLUSION: As₂O₃ can induce apoptosis of ACC-2 cells by reducing △ψm. Caspase 3 enzyme activity unit of ACC-2 cells gradually increases with As₂O₃ concentration increases, which results in activation of the expression of Caspase 3, and the cells' irreversible apoptosis process coming immediately.

Abstract:AIM:To observe the ultrastructural changes of retinal pigment epithelium(RPE)-photoreceptor complex in early aging rats.

METHODS: Retinas of 3-month old and 12-month old rats were prepared into semi-thin sections and then observed under transmission electron microscope to evaluate the changes of RPE-photoreceptor complex.

RESULTS: Apoptosis of RPE cells and degenerative changes of RPE-photoreceptor complex were found in retinas of 12-month old rats.

CONCLUSION: RPE-photoreceptor complex degeneration is an early manifestation of the retinal aging.

Abstract:AIM: To evaluate the effects of burst mode, ozil burst mode and ozil continue mode in phacoemulsification for cataract extraction.

METHODS:Totally 159 eyes with age related cataract in Ⅲ-Ⅳ nuclear subgroup treated by phacoemulsification were divided into burst mode group(41 eyes), ozil burst mode group(63 eyes)and ozil continue mode(55 eyes). The number of corneal edema cells before the operation and two weeks after the operation, and the loss rate of corneal edema cells, cumulative dissipated energy(CDE)in phacoemulsification and the best-corrected visual acuity on the second week were compared among the three groups.

RESULTS:Two weeks after operation, the CDE in burst mode for Ⅲ nuclear subgroup and Ⅳ nuclear subgroup were obviously lower than the result of ozil burst mode and that of ozil continue mode(P<0.05), and the differences were statistically significant. Endothelial cell loss rate postoperatively for Ⅲ nuclear subgroup was higher in the burst mode than that in the ozil burst mode and that in the ozil continue mode. So does that of the Ⅳ nuclear subgroup. Best-corrected visual acuity on the second week after treatment of burst mode, ozil burst mode and ozil continue mode for both Ⅲ nuclear subgroup and Ⅳ nuclear subgroup had no statistically significant differences among the three groups(P>0.05).

CONCLUSION:Burst mode, ozil burst mode and ozil continue mode are all safe and effective for the phacoemulsification on cataract. The efficiency of cataract surgery with ozil burst mode and ozil continue mode are better than that with burst mode, and they can protect endothelial cell better.

Abstract:AIM: To evaluate the efficacy of Ahmed glaucoma valve implantation in neovascular glaucoma(NVG).

METHODS: This retrospective study collected a total of 28 eyes of 28 neovascular glaucoma patients who underwent Ahmed glaucoma valve implantation in our hospital from January 2011 to December 2012. Change of intraocular pressure, the best corrected visual acuity, numbers of anti-glaucoma medication and postoperative complications were followed up at 1d, 1wk, 1, 3, 6mo, and every 6 months after surgery. Data were analyzed by repeated measures analysis of variance for comparison of intraocular pressure between different time points, rank sum test for paired nonparametric numbers of medication, and rank sum test for visual acuity between pre-operation and the last following-up.

RESULTS: Compared with the pre-operation, the intraocular pressure was significant decreased after surgery at all time points(F=11.23, P<0.05). The numbers of anti-glaucoma medication were significant reduced from 4.12±0.23 of pre-operation to 0.56±0.11 of postoperative(Z=9.224, P<0.05). The visual acuity was not significant difference between pre-operation and the last following-up(Z=-1.922, P>0.05). At the last following-up, the complete success rate was 71%, and qualified success rate was 86%. The postoperative complications including encapsulated cystic blebs around the plate, shallow anterior chamber and low intraocular pressure were controlled with additional treatment.

CONCLUSION: Ahmed glaucoma valve implantation is safe and effective in the management of neovascular glaucoma.

Abstract:AIM: To compare the retinal macular thickness and macular volume between amblyopic eyes and non-amblyopic eyes in adolescent with unilateral anisometropic amblyopia by optical coherence tomography(OCT).

METHODS: Thirty-one juveniles with unilateral anisometropic amblyopia were selected. Macular retinal thickness and macular volume were measured by OCT with both eyes in all participants, and the differences between amblyopic eyes and non-amblyopic eyes were compared. Axial length(AL)was measured by A-ultrasound. The relationship between AL and the factors of macula was analyzed.

RESULTS: The central sector region and the nasal inner region in amblyopic eyes were thicker than those in normal eyes(P=0.0358, 0.0003), but there was no significant difference in any other region between amblyopic eyes and normal eyes(P>0.05). No significant difference was found in macular volume between amblyopic eyes and normal eyes(P>0.05). The factors of the macula in both eyes were not significantly related to the AL.

CONCLUSION: There exists some difference in structure of macula between amblyopic eyes and non-amblyopic eyes in adolescent with unilateral anisometropic amblyopia.

Abstract:AIM:To evaluate the comfort and security of ultra-thin corneal flap made by VisuMax femtosecond laser and Moria One Use-Plus SBK microkeratome.

METHODS:This retrospective case series study included 1 556 eyes of 778 consecutive patients. The eyes were assigned to two groups according to the method of the corneal flap made. VisuMax femtosecond laser group(group A)included 768 eyes of 384 consecutive patients. Moria One Use-Plus SBK microkeratome group(group B)included 788 eyes of 394 consecutive patients. We compared the comfort score in the surgery, the incidence of the corneal flap-related complications, the corneal flap incision bleeding and the subconjunctival hemorrhage, in order to evaluate the comfort and security between the VisuMax femtosecond laser and the Moria One Use-Plus SBK microkeratome.

RESULTS:There were 5 patients(1.3%)feeling very uncomfortable and unbearable in group A while 28 patients(7.1%)feeling the same in group B. Four eyes(0.5%)occurred the intraoperative corneal flap incision bleeding in group A, while 74 eyes(9.4%)occurred in group B. The subconjunctival hemorrhage existed in 18 eyes(2.3%)in group A while the same situation happened to 82 eyes(10.4%)in group B. No eyes(0%)occurred corneal flap edge missing in group A, but 94 eyes(11.9%)occurred the symptom in group B. Four eyes(0.5%)of the corneal flap epithelial part exfoliated, however, that did not affect the successful flap surgery in group A. Fifty-three eyes(6.9%)occurred Opaque Bubble Layer(OBL)in group A. There was no other corneal flap-related complication.

CONCLUSION:The two methods are safe and reliable, and there are no corneal flap-related complications which seriously impact the visual quality after the surgery.

Abstract:Crystallin is a major structural protein within the lens, some post-translational modifications(PTM)can change the structure or solubility of crystallin and result in the opacity of lens while others may related to the protection of lens protein. Especially the decline of the chaperon activity of α crystallin results in the aggregation of some crystallins and the inactivation of enzymes, which is closely associated with the pathogenesis of age-related cataract(ARC). The exact etiology of ARC is still unknown. Although much effort has been directed towards slowing progression or preventing the occurrence of cataract, the main management of cataract remains surgical. The current research progress of crystallin and its contribution to age-related cataract was reviewed in this article.

Abstract:Idiopathic macular hole(IMH)refers to full-thickness defects of retina in macular area with no clear reasons. With the progress of vitrectomy and study of internal limiting membrane peeling, the treatment techniques of IMH becomes increasingly mature. In this paper, we reviewed the progress of IMH in terms of the pathogenesis, preoperative prognostic evaluation, surgical treatment and so on.

Abstract:Proliferative vitreoretinopathy(PVR)is a disease process that follows the proliferation of ectopic cell sheets in the vitreous and/or periretinal area, causing periretinal membrane formation, shrink and traction, in patients with rhegmatogenous retinal detachments. Pars plana vitrectomy is the standard treatment currently. There are many new drug therapies according to the functions of cytokines and growth factors in PVR, including anti-inflammatories, antineoplastic agents, antigrowth factors, and so on.

Abstract:Retinopathy of prematurity(ROP)is a disease of retinal vascular proliferative lesions which occurs in premature and low birth weight infants. The incidence is increasing in view of the rising numbers of preterm deliveries and improved neonatal care. Traditional modalities of treatment include cryotherapy and laser therapy, which are laborious and require special training. Hence, research is on the way to find novel treatment modalities used for early stage of the disease with the characteristics of easy operation, safety and efficacy. We reviewed the published and unpublished literature on newer methods of ROP management.

Abstract:Meibomian gland dysfunction(MGD)is a chronic disffuse abnormality of the meibomian glands, commonly characterized by terminnal duct obstruction and/or qualitative/quatitative changes in the glandular secretion. The evaporative dry eye disease is mainly caused by MGD. In recent years, the morbidity of the evaporative dry eye disease which caused by MGD is raising, researchers both at home and abroad pay more attention on that. There is no uniform standard on MGD' treatment internationally. It is mainly centered on removing the cause and applicating the local and systemic therapy, including physicotherapeutics, drug therapy, artificial tears replacement therapy, nutrition support therapy, hormonotherapy, Chinese medicine treatment etc. The literature review is mainly talking about the treatment of dry eye which caused by MGD on both at home and abroad.

Abstract:AIM: To observe the influence on the corneal endothelial cells after the cataract ultrasonic emulsification combined with intraocular lens implantation in patients with diabetes.

METHODS:Diabetic group: 52 eyes from 39 cataract patients with diabetes. Control group: 33 eyes from 31 cataract patients without diabetes. The density and the percentage of hexagonal cells of the corneal endothelium were measured by corneal endothelial detector preoperatively and 1d, 1wk, 1mo after the surgery. The results were analyzed.

RESULTS:The density, ratio of hexagonal cells of the corneal endothelial cells were significantly lower than before(P<0.05)postoperative in two groups, there was no significant difference the two groups before treatment, but the corneal endothelium loss in diabetes group was more than those in control group at 1d after treatment(P<0.05). Diabetes group is divided into three groups according to age 50-60 years old, 61-70 years old,71-80 years old, the postoperative corneal endothelial cell loss had no statistical significance(P<0.05).

CONCLUSION: The cataract ultrasonic emulsification damages the corneal endothelium, and it is more easy to be damaged in diabetics. Diabetic corneal endothelial injury has nothing to do with age.

Abstract:AIM: To study the clinical effects of recombinant human interferonα-2b eye drops combined with ganciclovir ophthalmic gel on the treatment of epithelial herpes simplex viral keratitis(HSK).

METHODS: Totally 50 cases(50 eyes)with epithelial HSK diagnosed in Ophthalmology Department of Jingmen Traditional Chinese Medicine Hospital from April 2011 to October 2012 were enrolled. All the patients were divided into control group and experimental group randomly. Control group was treated by 1.5g/L ganciclovir ophthalmic gel, 6 times per day, while experimental group was treated by 1.5g/L ganciclovir ophthalmic gel combined with recombinant human interferon α-2b eye drops, 6 times per day. All patients were treated for 4 weeks. Then the therapeutic effects of two groups, including the cure rate, time of corneal ulcer healing, pain relief and vision improvement, were compared and analyzed.

RESULTS: No significant differences in general condition between two groups was detected before treatment(P>0.05).The therapeutic effects of experimental group was better than the control group. The cure rate was 69% for experimental group and 42% for control group. The clinical cure rate in experimental group was significantly higher than that of the control group, there was statistically significant difference between the two groups(P<0.05). The time for corneal ulcer healing and pain relief in experimental group was significantly shorter than that for the control group(P<0.05).

CONCLUSION: The application ofganciclovir ophthalmic gel combined with recombinant human interferon α-2b eye drops in epithelial herpes simplex viral keratitis, which improves visual acuity and the cure rate and shortens the course of disease, is the ideal treatment of epithelial herpes simplex viral keratitis at present.

Abstract:AIM: To compare the effects of one-site vs two-site phacotrabeculectomy, intraocular lens implantation with trabeculectomy in the treatment of glaucoma with cataract.

METHODS: This prospective, randomized study including 60 patients(78 eyes)with glaucoma and cataract. One-site approach was performed in 31 patients(40 eyes)and two-site approach in 29 patients(38 eyes). Visual acuity, intraocular pressure(IOP), filtration, astigmatism and complications were observed at 2wk and 1mo after operation.

RESULTS: Postoperative visual acuitywas improved in 78 eyes. There was no significant difference of visual acuity between two groups at 2wk and 1mo after operation(P>0.05). The IOP at 2wk and 1mo after operation were lower than that of preoperation in two groups(P<0.05), and there was no significant difference between two groups(P>0.05). The number of eyes with functional filtration has no significant difference between two groups at 2wk and 1mo after operation(P>0.05); 2wk after operation, the astigmatism in one-site approach was bigger than preoperative astigmatism, also bigger than that of two-site approach(P<0.05), and there was no significant difference of astigmatism between two groups at 1mo after operation(P>0.05). There were 3 cases with few hemorrhage in anterior chamber after operation, 12 cases with slight corneal epithelial edema, descemet membrane folds, 6 cases with cellulose exudation in anterior chamber.

CONCLUSION: It is an ideal operation that two-site approachphacoemulsification and intraocular lens implantation combined with trabeculectomy in cataract and glaucoma patients, and has the advantages of simple operation, good treatment effect.

Abstract:AIM: To study the efficacy and safety of the combined four-surgery of vitreous humour extraction, phacoemulsification cataract, artificial lens implantation, and compound trabeculectomy in managing sustained high intraocular hypertension of acute angle-closure glaucoma.

METHODS: Retrospectively analyzed the post-operation result of 62 patients(62 eyes), consisting of 26 males(26 eyes)and 36 females(36 eyes), who were diagnosed as acute angle-closure glaucoma with anterior chamber depth of shallow class-I-IIa. Their IOP were greater than 40mmHg after 48-72h being dosed at the maximum. The patients were divided into two groups with their preoperative visual acuity. The combined four-surgery of vitreous humour extraction, phacoemulsification cataract, artificial lens implantation, and compound trabeculectomy were performed on 33 patients(33 eyes)in the experimental group, while the binary-sugery of anterior chamber paracentesis and compound trabeculectomy was performed on 29 patients(29 eyes)in the control group. Post-operative visual acuity, IOP, complications and filtering bleb were observed to compare the treatment results.

RESULTS: The high IOP of all eyes were controlled after surgeries. The IOP of the four-surgery group was obviously lower than the binary-surgery group after 1wk post the surgeries(P<0.05). Both groups were observed for 6mo. Post-operative visual acuity and complete success rate of the four-surgery were distinctly better than the binary-surgery, and no distinct difference was found in complications and filtering bleb occurrence(P>0.05).

CONCLUSION: The combined four-surgery of vitreous humour extraction, phacoemulsification cataract, artificial lens implantation, and compound trabeculectomy is safe and effective in managing acute angle-closure glaucoma with extremely shallow anterior chamber and sustained high IOP. Such surgeries should be actively performed on the patients with sustained high IOP to rescue their visual acuity.

Abstract:AIM: To investigate the effect of retinal inner limiting membrane peeling(ILMP)without staining on the vision and prognosis in idiopathic macular hole(IMH)patients.

METHODS: Totally 83 patients(83 eyes)with idiopathic macular hole in our hospital were selected and randomly divided into two groups according to the inner limiting membrane peeling approach. The 42 cases of A group underwent inner limiting membrane peeling stained with brilliant blue G(BBG), while the other 41 cases of B group received inner limiting membrane peeling without staining. And at the corresponding period, 40 patients without inner limiting membrane peeling was selected as the control group.

RESULTS: Patients were followed up for 6mo, the amount of cases with healed macular hole in the A and B group(41, 40 patients respectively)was larger than that of the control group(25 patients)(P<0.05); the visual acuity recovery in A and B group was significantly better than the control group(P<0.05); evaluated by multifocal ERG, the P1 response densities of ring 1 and 2 of first-order function were significantly higher(P<0.05)than the control group; operation time spent in inner limiting membrane peeling was longer for group A(234.7±9.2s)than group B(168.4±7.2s)(P<0.05).

CONCLUSION: Application ofvitrectomy without inner limiting membrane staining can achieve better visual functional recovery with less surgical time. Meanwhile, it avoids the retinal toxicity caused by coloring agent. It is worthy of wider promotion and application.

Abstract:AIM: To evaluate the clinical effects of argon laser photocoagulation combined with intravitreous injection of Lucentis on ischemic central retinal vein occlusion(CRVO)associated with macular edema and neovascular retina.

METHODS: This retrospective study analyzed therapeutic effects of argon laser photocoagulation combined with intravitreous injection of Lucentis performed on 24 patients(24 eyes)with CRVO between January in 2012 and May in 2013. Observation was made in terms of clinical data including patients' best-corrected visual acuity, intraocular pressure, optical coherence tomography and fluoresce infundus angiography before treatment and 1wk, 1, 3, 6mo after treatment. Comparative analysis was made regarding the manifestations by fundus fluorescein angiography(FFA)and the changes of central macular retinal thickness central macular retinal thickness(CMT)by optical coherence tomography(OCT)before treatment and 1, 3, 6mo after treatment.

RESULTS: Followed for more than 6mo, 20 patients'(83%)best-corrected visual acuity were improved inordinately; 17 patients'(71%)macular edema was obviously alleviated or disappeared; 4 patients, visual acuities weren't improved. Iris neovascularization gradually disappeared after 1mo treatment and secondary neovascular glaucoma didn't occur in one patient.

CONCLUSION: Argon laser photocoagulation combined with intravitreous injection of Lucentis is an effective method to treat ischemic central retinal vein occlusion. It can improve visual acuity, promote the absorption of retinal hemorrhage, effusion and macular edema, reduce neovascularizations caused by CRVO and obviously prevent the occurrence of secondary neovascular glaucoma.

Abstract:AIM: To investigate the application of 23-gauge trans-conjunctival sutureless vitrectomy system in the treatment of vitreoretinopathy disease and evaluate its therapeutic effect and complications.

METHODS: This retrospective study analyzed 46 patients(48 eyes)who were performed 23-gauge vitrectomy in this hospital from October 2011 to October 2013. Among all the eyes, idiopathic macular hole 8 appeared in eyes(16.7%), idiopathic macular epiretinal membrane presented in 5 eyes(10.4%), vitreous hemorrhage appeared in 19 eyes(39.6%); PDR(stage V-VI)occurred in 8 eyes(16.7%); and RRD 8 eyes(16.7%). Observation was made on intraocular pressure before and after surgery, surgical effects, surgical time, best corrected visual acuity, intraoperative and postoperative complications. The follow-up time lasted form 1-12mo.

RESULTS:All cases were successfully performed surgery and, there was no statistical difference in intraocular pressure between the two group(P>0.05)after measuring it pre-operatively, 1, 7d and 1mo after surgery at each group. The postoperative best corrected visual acuity were improved to some different degree. The differences between postoperative and preoperative BCVA were statistically significant(P<0.01). The surgery time was 70.12±7.86min; few complications appeared after surgery. The intraoperative complications included intubation tube slippage in 2 eyes, subconjunctival hemorrhage in 5 eyes and bubble under conjunctivain in 3 eyes. No serious post-operative complication was observed during the follow-up time in all cases.

CONCLUSION: 23-gauge trans-conjunctival sutureless vitrectomy has advantages including micro-invasive cut and short surgical time. Due to its quick postoperative recovery, good curative effect and rare complication, it is an effective and safe surgical technique in the management of vitreoretinopathy disease.

Abstract:AIM:To compare the intraocular pressure measurements of the college students of Uyghur and Han by Goldmann tonometer, non-contact tonometer and Schiotz tonometer.

METHODS:This cross-sectional study measured the intraocular pressure of college students of Uyghur and Han with Goldmann tonometer, non-contact tonometer and Schiotz tonometer respectively; comparison was made in the intraocular pressure measurements between the two races, between the two genders in the same race, and between the right and left eyes by three different ophthalmotonometers.

RESULTS: The differences in intraocular pressure measurements by the same tonometer between college students of Uyghur and Han were statistically significant(P<0.05); the differences in the measurements between different genders in one race by the same tonometer were not statistically significant(P>0.05); the differences in the measurements between the right and left eyes with the same tonometer were not statistically significant(P>0.05); the intraocular pressure measurements of college students of Han were higher than that of college students of Uyghur(P<0.05); measurements by non-contact tonometer were higher than those by Goldmann tonometer(P<0.05); measurements by non-contact tonometer were lower than those by Schiotz tonometer(P<0.05).

CONCLUSION: There are no differences in the measurements between the two genders and between the right and left eyes by the same tonometer; the measurements of college students of Han are higher than those of college students of Uyghur; measurements by Schiotz tonometer are significantly higher than those by non-contact tonometer; measurements by non-contact tonometer are higher than those by Goldmann tonometer.

Abstract:AIM: To investigate the long-term effect of different incisions on the tear film after phacoemulsification.

METHODS: Sixty-four patients(76 eyes)without dry eyes were selected and received phacoemulsification. The patients were divided into two groups randomly. Group A 30 patients(38 eyes)was performed with a 2.5mm mini-incision coaxial phacoemulsification and group B 34 patients(38 eyes)was performed with a sub 1.8mm micro-incision cataract surgery(MICS). Schirmer I test(SⅠt), tear break-up time(BUT), corneal fluorescein staining(CFS)and tear osmolarity were observed at 3d preoperatively and 1wk, 1, 3, 6mo and 1a postoperatively. The results were analyzed using a chi-square test and t-test with SPSS 19.0.

RESULTS:(1)Schirmer Ⅰ test(SⅠt): there was a significant increase in SIt at 1wk postoperatively. The difference between group A and group B was significant(P<0.01)at 1wk postoperatively, but it was insignificant at other postoperative time points(P>0.05).(2)Tear break-up time(BUT): there was a large reduction in BUT at 1wk, 1, 3mo postoperatively. The difference between group A and group B was significant(P<0.05). However, there were no significant differences between the two groups at other times(P>0.05).(3)CFS score: there was a large increase in CFS at 1wk, 1, 3mo postoperatively. The difference between group A and group B was significant(P<0.05). However, there were no significant differences between the two groups at other times(P>0.05).(4)Tear osmolarity: there was a large increase in tear osmolarity at 1wk, 1mo postoperatively. The difference between group A and group B was significant(P<0.01). However, there were no significant differences between the two groups at other times(P>0.05).

CONCLUSION: The stability of tear film in patients underwent sub 1.8mm micro-incision cataract surgery(MICS)is much better than in patients received 2.5mm mini-incision coaxial phacoemulsification, but symptomys of dry eye in patients operated with MICS are much more serious during the early postoperative period. There is no significant difference in the long-term effects on tear film between the two types of incision.

Abstract:AIM: To evaluate tear film recoveries and effects of sodium hyaluronate eye drops, deproteinized calf blood extract eye gel on tear film after vitrectomy.

METHODS: In 120 cases after vitrectomy, the patients were randomly divided into four groups, 30 cases for each group, group A were given the conventional medicine, group B in addition to conventional medicine, with sodium hyaluronate eye drops, group C in addition to conventional medicine, with deproteinized calf blood extract eye gel, group D in addition to conventional medicine with sodium hyaluronate eye drops and deproteinized calf blood extract eye gel. Tear break-up time(BUT), Schirmer I test(SⅠt)corneal fluorescein staining were measrued at 1d preoperatively plus 1, 3, 7, 14, 30d postoperatively. The results were analyzed statistically.

RESULTS:(1)Statistical significance was found in BUT, Sit at 1d preoperatively and 1, 3, 7, 14d postoperatively(P<0.01); BUT, ST recoveried original level 30d postoperatively.(2)All the four methods could recover fear film, but the result of group D was significantly better than other three groups.

CONCLUSION:Sodium hyaluronate eye drops combined with deproteinized calf blood extract eye gel as early as possible can accelerate the recovery of tear film after vitrectomy.

Abstract:AIM: To provide a reference to improve postoperative effects by screening the related factors causing corneal opacity after sub-Bowman keratomileusis(SBK)by mechanical microkeratome.

METHODS: In this retrospective cases study, 896 eyes underwent sub-Bowman keratomileusis with and they were followed up for 3mo postoperatively. Record was made on whether the corneal opacity occurred. These eyes were divided into 2 groups corneal opacity group and clear cornea group. The gender, age, preoperative intraocular pressure(IOP), preoperative central cornea thickness(CCT), K1, K2, mean K, preoperative spherical equivalent(SE)were statistically analyzed.

RESULTS:There were 52 males and 48 females in haze group, mean age were(24.5±6.1)year, preoperative IOP were(14.26±2.24)mmHg, preoperative CCT were(487.37±18.52)μm, K₁, K₂, mean K were(44.24±1.23)D,(43.33±1.13)D,(43.79±1.15)D, respectively, preoperative SE were(-4.65±1.44)D. There were 412 males and 384 females in without haze group, mean age were(24.3±5.8)year, preoperative IOP were(16.72±7.01)mmHg, preoperative CCT were(533.11±28.74)μm, K₁, K₂, mean K were(43.90±1.47)D,(42.88±1.35)D,(43.39±1.37)D, respectively, preoperative SE were(-5.04±1.96)D. The difference of sex(χ²=0.002, P=0.964), age(t=0.404, P=0.686), preoperative SE(t=1.949, P=0.052)between the 2 groups were insignificant. The difference of preoperative IOP(t=-3.486, P=0.001), preoperative CCT(t=-15.543, P=0.000), K₁(t=2.249, P=0.025), K₂(t=3.172, P=0.002), mean K(t=2.763, P=0.006)between the two groups of haze after mechanical microkeratome SBK.

CONCLUSION: The incidence of corneal opacity is high in patients with thin preoperative CCT, low IOP and high corneal curvature after SBK surgery by microkeratome. Gender, age and preoperative spherical equivalent are not related to the incidence of corneal opacity after SBK surgery.

Abstract:AIM: To explore the effect of different diameters corneal epithelial trephine on laser epithelium keratomileusis

METHEDS: 264 cases(528 eyes)with myopia were divided into the observed group and the control group randomly, then underwent LASEK surgery using 7mm and 8mm diameters corneal epithelial trephine respectively to make corneal epithelial flap. The comparisons between groups were conducted in terms of corneal irritation, the time of the epithelium healing at 1, 3, 5d, visual recovery at 1mo, and the degree of haze at 3mo.

RESULTS: Corneal irritation at postoperative 1, 3, 5d and the epithelium healing at postoperative 5d in the observed group was much better than that in the control group, there was significant difference(P<0.05). There was no significant difference in visual recovery at 1mo and haze at 3mo between two groups(P>0.05).

CONCLUSION: LASEK with the smaller diameter corneal epithelial trephine is a safe and efficient method to correct myopia than with the bigger diameter with the advantages of having milder irritating symptom, a shorter time of the epithelium healing and the visual recovery.

Abstract:AIM: To investigate the clinical effect of Modified Zhujing Formula combined with Lucentis on treating macular hemorrhage of pathological myopia.

METHODS: Forty-two patients(42 eyes)were divided into 2 groups:Modified Zhu Jing Formula group, 25 cases(25 eyes), were treated with Modified Zhu Jing Formula, and combined treatment group administrated Modified Zhu Jing Formula with intravitreal Lucentis injection(17 eyes in 17 cases). Central retinal thickness was measured by optical coherence tomography before and after the treatment. Three months after the treatment, the therapeutic effect was observed.

RESULTS: Three months after the treatment, the total effective rate of combined treatment group was 82%, while that of Modified Zhu Jing Formula group was 60%. The total effective rate of fundus hemorrhage absorption for combined treatment group was 88%, while that of Modified Zhu Jing Formula group was 64%. In terms of reducing central retinal thickness, the difference between pre-treatment and post-treatment for each group and the difference between two groups were both significant(P<0.05).

CONCLUSION: Modified Zhu Jing Formula can slow down disease progression, decrease recurrent risk and improve patients' vision.

Abstract:AIM: To investigate the variation in retinal nerve fiber layer(RNFL)thickness and macular thickness of children with refractory amblyopia by using optical coherence tomography(OCT). The aim was to understand the refractory retinal morphology and its variation law of amblyopia thus inferred the peripheral pathogenesis in refractory amblyopia children.

METHODS: Each group included 30 eyes from refractory amblyopia group(group A), non-refractory amblyopia group(group B)and normal children's group(group C). The average thickness in nasal, superior, temporal and inferior retinal thickness of macular fovea, the central area(diameter≤1mm), macular parafovea(1mmRESULTS: The retina thickness at the superior was thickest, and the inferior and nasal sides ofparafovea were thicker than the temporal. After comparing the retinal thickness of macular fovea, the central area(diameter≤1mm), we found that group A was thicker than group B, group A was thicker than group C and group B was thicker than group C, and the thickness differences were statistical significance(P<0.05). After comparing the average values in nasal, superior, temporal and inferior retinal thickness of macular parafovea, we found that there was no statistical significance(P>0.05). In group C, the superior RNFL thickness was the thickest, followed by the inferior and then the temporal, the nasal was the thinnest, but in group A and group B, the superior and inferior RNFL thickness were similar, the nasal and temporal were also similar but were thinner than the superior and inferior. The nasal and inferior RNFL thickness of group A were significantly thicker than group C(P<0.05), and the temporal and superior RNFL thickness compared with group C had no statistical significance(P>0.05). Although the average values in RNFL thickness were thicker than group C, there was no statistical significance(P>0.05). In group A and group B, the superior, inferior, nasal, temporal and the average values in RNFL thickness were all similar, there was no statistical significance(P>0.05).

CONCLUSION: The dysplasia of macular fovea and the central area maybe one of the causes on refractory amblyopia. The macular parafover, outside the macular parafover and peripapillary RNFL are not involved, this shows that these regions may not participate in the occurrence of amblyopia.

Abstract:AIM: To investigate the alterations of optic radiations(ORs)in monocular amblyopic children underwent treatment by using diffusion tensor imaging(DTI),and to explore its underlying neuromechanism.

METHODS: Eighteen children with anisometropic amblyopia(all left eyes)were recruited for amblyopia therapy. DTI data of ORs were acquired for each patient twice: before and after 9mo amblyopia therapy. The fractional anisotropy(FA)values and apparent diffusion coefficient(ADC)values were campared between the previous and posterior scans.

RESULTS: On both sides of ORs, the FA values of posterior therapy were higher than those of previous therapy(P<0.05), while the ADC values of posterior therapy were lower than those of previous therapy(P<0.05). The alterations of FA values and ADC values of ORs on the right side were greater than those of ORs on the left side after therapy(P<0.05).

CONCLUSION: Both sides of ORs in monocular amblyopic children are modified to varying degrees after myopia therapy.

Abstract:AIM: To investigate the incidence and demographic characteristics of blindness and low vision, and to set out a specific eye health education in Zaozhuang, Shandong Province.

METHODS: The medical records of admission screening in preschoolers, cataract extraction project and medical outreach program in Zaozhuang were retrospective studied. A total of 12 685 people participated in the study, among those 7 962 were males, and 4 723 were females. 2 262 cases were in low age group(aged 2.5-15), 4 684 cases were in young age group(aged 15-50), and 5 739 cases were in elder age group(aged>50). The examination protocol included visual acuity testing, intraocular pressure, computer optometry, anterior segment examination using slit lamp biomicroscopy, and fundus examination. The family history, ocular trauma, surgery and drug treatment were also recorded.

RESULTS: The incidence of blindness and low vision in low age group(423 patients)was 3.33%. The leading causes were amblyopia, ametropia, ocular trauma, and retinopathy of the premature, etc. The incidence of blindness and low vision in young age group(239 patients)was 1.88%. The main causes were ocular trauma, high myopia, and retinal detachment, etc. The incidence of blindness and low vision in old age group(597 patients)was 4.71%. The primary causes were cataract, diabetic retinopathy, and age-related macular degeneration, etc. The incidence of blindness and low vision increased with the age, and it was higher in females.

CONCLUSION: The incidence of blindness and low vision in all groups, of which the leading causes are different, is higher than that of China. Early detection and treatment are important for low age patients, which can significantly increase the visual outcome. It's necessary for young patients to receive health education on common ocular diseases and labor protection. For elder patients, early cataract extraction surgery and treatment for ocular fundus disease are critical.

Abstract:AIM:To analyze the vision and refractive state in graduates from senior high schools and to provide prevention and treatment of myopia.

METHODS: Visual acuity and refractive state in 10 593 graduates from 8 senior high schools from 2011 to 2013 were examined. The results were analyzed statistically.

RESULTS: The morbidity of myopia in graduated students in Tianxin district, Changsha was up to 88.76%, 88.40% in 2011, 88.91% in 2012 and 88.95% in 2013 respectively. There was no obvious differences(P>0.05). The prevalence of myopia in major schools was higher than that in ordinary schools, and the girls were higher than the boys. The differences were statistically significant(P<0.01).

CONCLUSION: The high morbidity of myopia in graduates should be paid attention, and the effective strategies should be taken to prevent the occurrence and development of myopia.

Abstract:AIM: To explore new methods and ideas about strengthening the clinical teaching of junior ophthalmologist.

METHODS: The methods were summarized and refined from the experiences of clinical teaching practice point and applied and confirmed in practices.

RESULTS: Visualization of theory knowledge learning, mastering eye check-up skillfully, systemaltization of sub-specialization knowledge, inspiring the divergent and thorough thinking and going back from clinical practice to theory should be advocated to master professional knowledge and skills with a better understanding. Follow these teaching ideas, resident training was effective.

CONCLUSION: The specialization of ophthalmology is stronger and residents preliminary stepping into ophthalmology department for clinical working are unsubstantial in professional foundation whose teaching implement needs to be combined with the specialist characteristics.

Abstract:AIM: To explore the clinical effect of cataract phacoemulsification in eyes with filtered primary angle closure glaucoma(PACG).

METHODS: Forty-eight patients(48 eyes)with cataract with filtered PACG received phacoemulsification, and were followed up for 3-12mo to observe the visual acuity, intraocular pressure(IOP), and postoperative complications situation.

RESULTS: Postoperative visual acuity improved obviously, 85% patients reached to 0.3-0.8. All cases have normal IOP. There was no significant effect on postoperative IOP, which was within normal range. No serious complications happened.

CONCLUSION: Cataract phacoemulsification after anti-glaucoma surgery can significantly improve visual acuity, have no impact on IOP, filtering blebs and have fewer complications. It's safe and effective.

Abstract:AIM: To discuss clinical therapeutic effect of syringe needle suction method in treating white expansion cataract capsulorhexis.

METHODS: Continuous circular capsulorhexis(CCC)treatment for white expansion cataract was adopted in 166 eyes by applying syringe needle suction method including using 15° stab knife as auxiliary incision at 3:00 place, injecting trypan blue stain with sterilized air about 0.1mL to staining anterior capsule, injecting sodium hyaluronate into anterior chamber, using a 3.2mm stab knife as above transparent corneal incision, keeping primary incision a bit smaller, using a 1cc 27G syringe needle to puncture into anterior capsule with the slope upwards to suct the liquefied cortex, sloping lateral rotation without expanding the forward puncture incision, oppressing gently lens nucleus, continuing to suck up liquefied cortex which had moved forward, and filling in anterior chamber with enough sodium hyalurantae. And then after using a 3.2mm stab knife to expand corneal incision, CCC was finished.

RESULTS: A total of 166 eyes with white expansion cataract applied this method. The circular capsulorhexis were completed successfully in 155 eyes with a success rate of 93.4%.

CONCLUSION:CCC treatment applying syringe needle suction method in white expansion cataract capsulorhexis can not only reduce the pressure of lens and capsular bag to realize the goal of posterior continuous curvilinear capsulorhexis, but also reduce the inconvenience of surgical operation brought by the incompleteness of capsule and complication. It is a safe, simple and effective operation method, which is easy to master and apply.

Abstract:AIM: To explore the effect of the cataract after small incision non-phacoemulsification in the treatment of trabecular resection.

METHODS:From Jun. 2011 to Jan. 2013, 60 patients with cataract after glaucoma trabeculectomy, were opted for small incision non-phacoemulsification cataract extraction with intraocular lens implantation for cataract operation. Sixty cases were followed up for more than 6mo. The recovery of visual acuity and complications in patients were observed.

RESULTS: In sixty patients, postoperative visual acuity≥0.5 was 51%, which developed a lot. The average intraocular pressure decreased. The complications were iris damage, corneal edema and iris inflammation, which were improved after treatment.

CONCLUSION:The cataract after small incision non-phacoemulsification in the treatment of trabecular resection can preserve good original glaucoma filtering bleb, well maintained intraocular pressure, and the recovery of visual acuity is good, which is a safe and reliable surgery.

Abstract:AIM: To discuss the feasibility and safety ofsmall incision non-phacoemulsification cataract surgery combined with intraocular lens implantation under surface anaesthesia.

METHODS:Small incision cataract surgery and intraocular lens implantation under surface anaesthesia with 40g/L Alcaine eye drops were performed on 92 patients(96 eyes)from September, 2010 to December, 2010. The pain during the operation, complications and curative effect were observed and recorded.

RESULTS: Surgery was successfully performed on 92 patients(94 eyes)under surface anaesthesia. 95% patients considered the intraoperative aches-and-pains index, eye movements and blepharospasm as tolerable and they were satisfied with the operation. Subconjunctival injection(50 eyes, 52%)was the most painful operating procedure, followed by fixed suture of superior rectus(31 eyes, 32%), cautery of sclera vascular(16 eyes, 17%), nuclear extraction(13 eyes, 14%), sclera tunnel incision(12 eyes, 12%), irrigating-aspirating viscoelastic agent(9 eyes, 9%)and lens implantation(1 eye, 1%). There was significant difference in the pain caused by these operating procedures(P<0.05).

CONCLUSION: In the prevention of blindness caused by cataract in the rural area, small incision cataract surgery combined with intraocular lens implantation under surface anaesthesia is safe and feasible when utility measure is taken for pain. It can improve the efficiency of the cataract surgery for prevention of blindness.

Abstract:AIM:To analyze the clinical data of patients with cataract in our hospital practicing clinical pathway and evaluate the value of clinical pathway.

METHODS:Two hundred eyes(200 eyes)of two hundred patients who suffered cataract from January 2012 to December 2012 were treated with ultrasound emulsification and intraocular lens planting by managing with clinical path. They are considered as clinical pathway group. The control group was another 200 patients(200 eyes)from December 2010 to December 2011 who suffered the same disease and treated with the same surgery not by managing with clinical path. The average length of stay, preoperative average length of stay, average cost of hospitalization(except the cost of IOL), drug cost, inspection fee, curative effect, degree of satisfaction of patients and medical staff, and readmission rate were analyzed.

RESULTS:In the clinical pathway group, the average length of stay was 6.01±0.13d, the preoperative average length of stay was 1.02±0.15d, the average cost of hospitalization was 4401.23± 129.07 Yuan, drug cost was 720.35±23.21 Yuan, inspection fee was 700.37±46.25 Yuan, and patient satisfaction was 96.4%. In the control group, the average length of stay was 10.21±0.05d, the preoperative average length of stay was 2.20±0.07d, average hospitalization cost was 4827.43±132.13 Yuan, drug cost was 1206.21±53.64 Yuan, inspection fee was 850.35±24.26 Yuan, and patient satisfaction was 93.1%. The difference between the two groups was significant(P<0.05). The cure rate was 97.2% in the clinical pathway group and 96.2% in the control group. The difference was not statistically significant(P>0.05). Satisfaction of the medical staff was 98.2% in the clinical pathway group and 96.4% in the control group, with no statistically significant difference(P>0.05). Clinical pathway group and control group had a readmission rate of 1% and 0.9%, with no statistically significant difference(P>0.05).

CONCLUSION: Implementation of clinical pathway on cataract patients will not reduce the quality of medical care. On the contrary, it will standardize the medical behavior, improve patient satisfaction, and reduce health care costs, and ease the tension in the doctor-patient relationship, and provide a theoretical basis for the realization of the medical system of prepaid.

Abstract:AIM: To analyze the therapeutic effects of trabeculectomy for primary angle-closure glaucoma with persistent high intraocular pressure.

METHODS:A total of 39 primary angle-closure glaucoma patients(39 eyes)with persistent high intraocular pressure(40-77mmHg)were seclected for the observation group and another 30 patients(30 eyes)with intraocular pressure less than 40mmHg were chosen as the control group. And the success rate of surgery, distance vision, peripheral anterior chamber depth, intraocular pressure and bleb formation during 12mo follow-up in two groups were compared.

RESULTS:There were no statistically significant differences in terms of the success rate of surgery between the two groups(89.7% vs 86.7%)(P>0.05). There were no statistically significant differences in the distance vision, peripheral anterior chamber depth, intraocular pressure and bleb formation between the two groups(P>0.05).

CONCLUSION:The trabeculectomy for primary angle-closure glaucoma with persistent high intraocular pressure is safe and reliable treatment, which can reduce further damage to the optic nerve of patients and improve the visual function in patients and has a good clinical value of application.

Abstract:AIM: To explore efficacy of intravitreous injection of Bevacizumab combined with trabeculectomy and glaucoma valve implantation in patients with neovascular glaucoma.

METHODS: Totally 22 patients(23 eyes)with neovascular glaucoma from May 2008 to May 2010 were analyzed retrospectively. All patients were treated with intravitreous injection of Bevacizumab. After 3-5d, 13 eyes were treated with glaucoma valve implantation(group A)and 10 eyes were treated with trabeculectomy(group B). The period of follow-up was 12-26mo. The postoperative visual acuity, intraocular pressure, iris neovascularization and complication rate were compared between the two groups.

RESULTS: Iris neovascularization in group A and group B decreased or completely disappeared after 3-5d intravitreous injection of Bevacizumab. The success rate was 100%. The ratio of improved visual acuity in group A was significantly higher than that of group B(P<0.05), what's more, visual acuity of one patient decreased in group B. Compared with that before operation, intraocular pressure in group A and group B significantly decreased(P<0.05), but the average of intraocular pressure in group A was lower than that of group B during the long term follow-up(P<0.05). Complication rate had no statistical difference between group A and group B(P>0.05).

CONCLUSION: Intravitreous injection of Bevacizumab combined with glaucoma valve implantation is worth clinical application for improving visual acuity. Compared with trabeculectomy, it can control intraocular pressure better and reduce complication in patients with neovascular glaucoma.

Abstract:AIM: To investigate the effects of photocoagulation with 577-nm laser combined with calcium dobesilate on diabetic retinopathy(DR).

METHODS: From January 2012 to June 2012, 104 patients(180 eyes)with diabetic retinopathy were selected and randomly divided into medicine group, 577-nm laser group and combined treatment group. The medicine group consisting of 32 cases(56 eyes)received calcium dobesilate, and 577-nm laser group including 50 cases(86 eyes)were treated by photocoagulation with 577-nm laser. And 22 cases(38 eyes)of combined treatment group were treated with both methods above. The follow-up period was 6mo. The effects were evaluated by visual acuity and fundus fluorescein angiography(FFA).

RESULTS: Compared with medicine group, the rate of disappeared retinal capillary nonperfusion areas and regressed neovascularization was higher in 577-nm laser group. And the visual acuity of 577-nm laser group was improved significantly more than the medicine group. The difference was statistically significant(P<0.05). The combined treatment group achieved more favorable results than every single treatment group(P<0.05).

CONCLUSION: Photocoagulation with 577-nm laser combined with calcium dobesilate is effective for diabetic retinopathy and it is worth making more application in clinic.

Abstract:AIM: To analyze the related factors and clinical therapeutic effect of retinal vein occlusion(RVO).

METHODS: The clinical data of 122 patients(124 eyes)with RVO were retrospectively analyzed, which including 12 eyes(9.7%)of ischemia type branch retinal vein occlusion in patients with ischemic, 6 eyes(4.8%)of ischemia type central retinal vein occlusion, 59 eyes(47.6%)of non-ischemia type central retinal vein occlusion, and 47 eyes(37.9%)of non-ischemia type central retinal vein occlusion. Among all the patients, the average age were 60.6±11.8 years old, there were 48 patients(39.3%)with hypertension, 10 patients(8.2%)with diabetes, 20 patients(16.4%)with more than one related diseases, and 37 patients(30.3%)with none relevant history. Among them, 68 patients were treated only by drug conservative treatment, 49 patients were treated with the help of laser, and only 1 patient was treated by the vitrectomy surgery.

RESULTS:Seventy-two eyes(58.1%)had obvious effects; 22 eyes(17.7%)were significantly effective; 15 eyes(12.1%)were invalid; and 15 eyes(12.1%)became even worse.

CONCLUSION: CRVO is formed by both the local and systemic pathogenic factors. Clinical therapy should be treated dialectically. And the complete diagnostic evaluation combined with fundus angiography should be conducted according to the fundus hemorrhage time, the involvement extent and location so that personalized treatment can be used to improve the patient's treatment effect.

Abstract:AIM:To evaluate the clinical effects of fasudil therapy on nonarteritic anterior ischemic optic neuropathy(NAION).

METHODS:Seventy eyes of 70 patients with NAION in our hospital were collected and randomly divided into treatment group(35 patients)which was intravenously injected fasudil, and control group(35 patients)which was intravenously injected composite salvia miltiorrhiza injection. At the 4wk of follow-up, the best corrected visual acuity(BCVA)and visual field were observed and compared.

RESULTS: The total effective rate of BCVA in treatment group was 86%, in control group was 57%. The difference in two groups had statistical significance(P<0.05). The improvement rate of visual field in treatment group was 83% and in control group was 57%. The difference in two groups had statistical significance(P<0.05)

CONCLUSION:The clinical effects of fasudil on NAION are better than conventional medication.

Abstract:AIM: To investigate the safety and efficacy after removal of silicone oil, and to analyze risk factors for silicone oil emulsification.

METHODS: A retrospective analysis of 63 cases(63 eyes)underwent silicone oil removal in this hospital between November in 2012 and April in 2013. Intraocular pressure(IOP)was observed 1d before surgery, 1, 2, 3d; 1mo after surgery; vision was analyzed 1d before surgery and 1mo after surgery; clinical data of patients were analyzed and risk factors for silicone oil emulsification were explored.

RESULTS: After silicone oil removal in 63 eyes, retinal anatomic reduction was in 57 eyes(90%). The difference between preoperative and postoperative IOP at each time point had statistical significance(P<0.05), and postoperative IOP was lower than preoperative IOP. Compared with preoperative IOP, best-corrected visual acuity at one postoperative month was improved in 37 eyes(59%)(P=0.002), unchanged in 18 eyes(29%), and decreased in 8 eyes(13%). Silicone oil emulsion 23 eyes(37%), and risk factors associated with silicone oil emulsion was elevation of low density lipoprotein(LDL)(P<0.05).

CONCLUSION: The rate of retinal anatomic reduction is satisfactory after silicone oil removal. IOP and visual acuity were improved significantly after surgery. Control of cholesterol levels may slow down the process of silicone oil emulsion.

Abstract:AIM: To observe theclinical effect of using triamcinolone acetonide(TA)to recognize posterior vitreous cortex(PVC)and help effective residual vitreous posterior cortex on pars plana vitrectomy(PPV).

METHODS: Thirty-five patients(35 eyes)underwent PPV with TA. An amount of 0.1mL TA solution was injected on the retinal surface to visualize and peel posterior vitreous cortex, epiretinal membranes(ERM)or internal limiting membrane(ILM)in these eyes. Among them, 16 cases were filled with silcon silicon oil and 9 cases were filled with C₂F₆. The follow-up time was for 6-12mo.

RESULTS: In 35 cases,intraoperative staining with TA consistently improved direct visualization and delineation of the posterior hyaloids, ERM or ILM and facilitated their removal. Among them, vitreous posterior cortex left in 13 cases and PVD was found in 19 cases. Postoperatively, macular hole closure rate reached at 100%, and retina reposition rate was 84.6%.

CONCLUSION: The good visibilityof TA formed during surgery is effective in recognizing residual vitreous posterior cortex, reducing the mechanical trauma to the retina, and improving operation success rate. And no serious complication related to TA was found in the study.

Abstract:AIM:To study expression of Bcl-2 and Bax in conjunctival tissue samples of conjunctivochalasis patients.

METHODS: To observe the histopathological change of conjunctivochalasis by HE staining of conjunctival tissue. Immunohistochemical staining was applied to compare the expression situation of Bcl-2 and Bax in conjunctival tissue of conjunctivochalasis patient(20 samples)and the normal conjunctiva tissue(10 samples).

RESULTS: There were lymphocyte and plasmocyte infiltration in the conjunctivochalasis tissue. The expression of Bcl-2 in the conjunctivochalasis was similar with the normal conjunctiva tissue(P>0.05). The expression of Bax in the two tissues showed significant difference(P<0.05). Spearman rank correlation analysis(r=0.432, P>0.05)indicated that there was no correlation between the expression of Bcl-2 and Bax.

CONCLUSION: Unbalanced expression of Bcl-2 and Bax in conjunctival tissue may play a significant role in the occurrence and development of conjunctivochalasis.

Abstract:AIM: To compare the effect of interrupted suture and continuous interlocking suture in the surgery of pterygium excision combined with autologous coneal limbus stem cell transplantation.

METHODS: A total of 435 patients(482 eyes)with pterygium were randomly divided into two groups: 239 patients(263 eyes)in group A received interrupted suture, while 196 patients(219 eyes)in group B received continuous interlocking suture. During the postoperative follow-up of 6-12 months, the period of time from operation to opening eyes naturally(the time of opening eyes), the conditions of postoperative conjunctival granuloma and the postoperative recurrence rate were calculated.

RESULTS: The average time of opening eyes was 4.8±1.8d in group A and 2.6±1.1d in group B, respectively, demonstrating statistical difference(t=2.932, P<0.05). Nine eyes experienced concurrent appearance of conjunctival granuloma in group A and none appeared in group B, demonstrating statistical difference(χ²=7.637, P<0.05). Recurrence of pterygium occurred in 15 eyes(5.7%)in group A and in 11 eyes(5.0%)in group B, respectively, demonstrating no significant differences(χ²=0.108, P>0.05).

CONCLUSION: Compared to interrupted suture, continuous interlocking suture does not reduce the recurrence rate for the patients receiving excision of pterygium combined with autologous coneal limbus stem cell transplantation. But it can significantly reduce the probability of the concurrent appearance of conjunctival granuloma, and obviously relieve the symptoms of eyes irritation.

Abstract:AIM: To observe clinical outcomes of lacrimal passage probing in the treatment of neonatal dacryocystitis with inhalation anesthesia

MEHTODS: There were 116 patients(129 eyes), with neonatal dacryocystitis from 2009 to 2011 of no improvement under conservative treatment, and were divided into two groups: 75 patients(86 eyes)in 6 to 12-month-old group, 41 patients(43 eyes)in group at the age older than 1 year. With no surgical taboo found, sevoflurane was selected as inhalation anaesthetic. Lacrimal passage probing was operated with sufficient anaesthesia. With clear lacrimal passage washed in the operation, there was no need to wash again postoperatively. Successful cases were defined with clear lacrimal passage and absence of symptoms as epiphora and pyorrhea, while incidence of those symptoms showed treatment in vain.

RESULTS: The recovery rate of 6 to 12-month-old group was 100%, while the recovery rate of group at the age older than 1 year was 97.7% The difference was statistical significance(P<0.05).

CONCLUSION:Lacrimal passage probing by inhalation anesthesia in use of sevoflurane is safe and effective with fast revival, small operative injury, high successful rate of probing, and it has great clinical application value.

Abstract:AIM: To explore the clinical efficacy and safety of self Yiqi Yangyin Sanyu Fang in treatment of dry eyes syndrome.

METHODS: Totally 78 patients(96 eyes)were randomly divided into two groups from January 2009 to December 2012 in Ophthalmology Department of our hospital, control group was given local artificial tears, the observation group was given artificial tears and Chinese medicine Yiqi Yangyin Sanyu Fang, Schirmer Ⅰ test(SⅠt), tear break-up time(BUT), corneal fluorescein staining(FL)and clinical efficacy of the two groups were compared.

RESULTS: After treatment, SⅠt, BUT of two groups were higher than that of before treatment, FL was lower than that of before treatment, the difference was statistically significant(P<0.05), after treatment SⅠt, BUT of observed group were higher than that of the control group, FL was lower than the control group, the difference was statistically significant(P<0.05); the efficiency rate of observation group was 83%, control group 71%, there were statistically significant differences in the two groups(Ridit z=24.382, P=0.000), the observation group effect was better than that of control group.

CONCLUSION: Chinese medicine Yiqi Yangyin Sanyu Fang have no obvious side effect, it can improve the clinical symptoms of dry eye syndrome and is worthy clinical application.

Abstract:AIM: To observe the effects of using 0.1g/L mitomycin-C(MMC)to prevent the formation of haze in laser-assisted subepithelial keratomileusis(LASEK)for moderate and high myopia.

METHODS: Totally 78 cases(156 eyes)were randomly divided into two groups. With group MMC including 86 eyes, 0.1g/L MMC and balanced salt solution(BSS)within sponges dip the ablated zone; The control group(70 eyes)used BBS in the same way. Uncorrected visual acuity(UCVA), corneal epithelial healing time, and the formation of corneal haze 1, 3, 5 and 7d; 2wk; 1,3 and 6mo after surgery were observed.

RESULTS: The incidence of haze of group MMC was lower than the control group, the difference was statistically significant(P<0.05); the corneal epithelial healing time and the postoperative UCVA between the two group had no significant difference(P>0.05).

CONCLUSION: The application of 0.1g/L MMC during LASEK can prevent the formation of haze.

Abstract:AIM: To investigate the effect of both myopic and hyperopic anisometropia on binocular vision.

METHODS:Totally 238 patients with corrected anisometropia and 30 normal children were tested with both stereogram and synoptophore for their near stereoacuity and binocular vision. The correlation of anisometropia and binocular vision was studied statistically.

RESULTS: The number of normal near stereoacuity and distance fusion range of myopic anisometropia was significantly higher than that of hyperopic anisometropia. A few of hyperopic anisometropia had normal stereopsis. Most of low anisometropia group had sub-normal stereopsis, while high, severe anisometropia group without stereopsis. Most of myopic anisometropia group had normal stereopsis or sub-normal stereopsis.

CONCLUSION: The hyperopic anisometropia produces a more profound effect. Relationship between anisometropia and stereopsis are analyzed according to nature.