Abstract:AIM: To determine the effect of stenting and flap preservation on the outcome of endoscopic dacryocystorhinostomy.

METHODS: Retrospective study of all endoscopic dacryocystorhinostomy cases performed between 2007-2011 at Hospital Universiti Sains Malaysia. A total of 25 cases with nasolacrimal duct obstruction underwent this procedure. Outcome of endoscopic dacryocystorhinostomy was evaluated based on relief of epiphora and anatomical patency by lacrimal syringing and nasal endoscopy upon follow-up at 1, 6 and 12 months post-op. The outcome was considered to be successful only if all three criteria were fulfilled at one year follow-up post-op. Multiple logistic regression was used to determine the association of stenting and flap creation with a successful outcome.

RESULTS: Stents were inserted in 13 cases out of 25, and likewise for flaps. The success rate of endoscopic dacryocystorhinostomy at one year post-op was 64%. There was no significant association of stenting with outcome(P=0.694), whereas mucosal flap creation was significantly associated with a better outcome(adjusted OR=7.926; 95%CI: 1.172-53.620, P=0.034). The main post-operative complication was adhesions, which occurred in 50% of cases. There was no significant association between stenting or flap preservation with complications.

CONCLUSION: Preservation of a mucosal flap is significantly associated with a successful outcome of endoscopic dacryocystorhinostomy in nasolacrimal duct obstruction, while stenting is not. Neither stenting nor mucosal flap creation is significantly associated with complications.

Abstract:AIM: To investigate the relationship between chronic epiphora and meibomianitis, and to explore the efficacy of the meibomianitis treatment to improve chronic tearing.

METHODS: One thousand chronic epiphora patients chart review in Casey eye institute during 2000-2009. Review of 206(20.6%)chronic epiphora patients who underwent slit lamp examination were diagnosed meibomianitis. Diagnostic criteria were meibomian gland dysfunction, blepharitis, lid margin telangiectasia and hyperaemia punctuate superficial keratopathy. Treatment included maintenance of lid hygene, use of artificial tears, systemic and topical antibiotics, warm and moist compresses, topical corticosteroid and diet supplementation with Omega-3 fatty acids.

RESULTS: Among all the patients, 206(20.6%)meibomianitis patients(average age 65.8 years, average tearing time 2.78 years). White patients 196(95%); female 106(51.5%), male 100(48.5%). Average follow up time was 5.07mo. 152(73.79%)of 206 meibomianitis patients with tearing got improved through treatments. 43(20.87%)patients were treated without improvement. The failure reasons cannot be found in 14(6.81%)of 43 patients. 29(14.08%)of 43 pateients with chronic epiphora do not want to treat for a long time, which cause the treatment failure. 11(5.34%)of 206 meibomianitis patients lost to follow up.

CONCLUSION: The patients who presented to our office for the tearing 20.6% had meibomianitis. Through treatment of meibomianitis, tearing improved 73.78%. So patients with meibomianitis should treat it actively. Some tearing patients after the surgery still tearing should pay attention to treat meibomianitis.

Abstract:AIM: To evaluate distribution of corneal biomechanical measurements in normal myopia and myopic-astigmatism population.

METHODS:One hundred and eighty eyes with myopia and myopic-astigmatism candidated for laser refractive surgery were included in this study. Complete examination of anterior and posterior segments, manifest refraction spherical equivalent(MRSE), Orbscan and Zywave were performed preoperatively. Ocular response analyzer(ORA)was used to measure corneal hysteresis(CH), corneal resistance factor(CRF), Goldmann-correlated intraocular pressure(IOPg)and corneal compensated IOP(IOPcc). Distribution of all corneal biomechanical properties and correlation between these parameters and MRSE, age and sex were determined. Statistical analysis was performed using SPSS 17 software and a P-Value less than 0.05 was considered significant.

RESULTS: Mean age was 28.20±6.78 years. Mean MRSE was -4.21±1.19D. Mean CH, CRF, IOPg and IOPcc was 10.00±1.28mmHg, 10.17±1.45mmHg, 15.71±2.67mmHg and 16.68±2.41mmHg respectively. 28.4% of all myopic population had CH about 10mmHg, and 71% had CH, 9mmHg up to 11mmHg. CRF in 25.9% of myopic population was 10mmHg, and in 48.7% was 9mmHg up to 11mmHg. There was very poor positive correlation between MRSE& CH(Rs=0.001, P=0.71)and MRSE& CRF(Rs=0.01, P=0.18).

CONCLUSION: Our study demonstrated the distribution of corneal biomechanical properties(CH, CRF, IOPg, IOPcc)in normal myopia and myopic-astigmatism population in Iran, and confirmed that, there was no statistically significant correlation between CH, CRF and MRSE, age and sex but there was significant correlation between IOPg, IOPcc and formerly mentioned parameters.

Abstract:AIM: To explore the possibility of inducing rat mesenchymal stem cells(MSCs)into retina-like cells by the supernatant fluid of light-injured neurosensory retina in vitro.

METHODS: MSCs were isolated and attached to the wall of culture dishes by their specific adherent ability. Then the cells were characterized by flow cytometry. The neurosensory retina was isolated from retina of SD rat and it was tested by hematoxylin-eosin(HE)staining. The pathological changes of light-injured neurosensory retina was observed under transmission electron microscope. Three kinds of supernatant fluid of light-injured neurosensory retina of SD rats were prepared. The third passage of MSCs were cultured with these mixed medium for 7-8d, we used RT-PCR to see whether they could express rhodopsin, neuron-specific enolase(NSE), and glial fibrillary acidic protein(GFAP), and positive cells were counted and analyzed.

RESULTS: HE staining showed the retinal sheets included full-thickness neural retina. Neurosensory retina developed ultrastructural destructions by light injury. RT-PCR showed that the medium of mixed I expressed higher positive rate of rhodopsin(0.3915±0.00644), NSE(0.2019±0.00682), GFAP(0.1972±0.00211)than the medium of mixed Ⅱ rhodopsin(0.0983±0.00319), NSE(0.1048±0.00323), GFAP(0.1040±0.00254)and medium of mixed Ⅲ rhodopsin(0.0044±0.00126), NSE(0.0498±0.00149), GFAP(0.0467±0.00333). The difference of intergroup has statistical significance.

CONCLUTION:The supernatant fluid of light-injured neurosensory retina of SD rats can induce MSCs to differentiate into retina-like cells and provide new insights of stem cell therapy for retinopathy.

Abstract:AIM: To investigate the mechanism of retinal ganglion cells(RGCs)apoptosis in the diet-induced obese C57BL/6 mice.

METHODS: Mice were fed high-fat diet. After 19 weeks of feeding, the mice were divided into diet induced obesity-resistant(DIO-R)group and diet induced obesity(DIO)group, while mice of the control(CON)group were fed a basal diet at the same time. The apoptosis of RGCs was detected by TUNEL. Laser scanning confocal microscope was used to detect the intracellular calcium ion concentration.

RESULTS: TUNEL staining showed apoptosis cells in ganglion cell layer(GCL)in DIO group increased and the percentage of apoptotic cells was(6.7±1.2)% which was much higher than in CON and DIO-R groups(P<0.01, P<0.05). There was no significant difference between CON group and DIO-R group(P>0.05). Laser scanning confocal microscope detection showed Ca²⁺ staining intensity of RGCs in DIO group increased and its staining intensity was significantly higher than in CON and DIO-R mice(P<0.01,P<0.01), whereas there was no significant difference between CON group and DIO-R group(P>0.05).

CONCLUSION: Intracellular calcium ion overload might be involved in the RGCs apoptosis in the diet-induced obese C57BL/6 mice.

Abstract:AIM: To investigate the mechanism of retinal ganglion cell apoptosis in early stage of streptozotocin(STZ)-induced diabetic rats.

METHODS: Sixty SD rats were randomly divided into two groups: control group(CON)and diabetes mellitus group(DM). Diabetic rat model was produced by intraperitoneal injection of 1% STZ in 30 adult male SD rats. At 4, 8, 12wk,the rats were killed and eyeballs were enucleated for the HE staining, TUNEL staining, transmission electron microscopy detection respectively, and laser confocal microscope detection was used to detect the calcium ion concentration.

RESULTS:At 8wk RGCs decreased gradually and appeared disordered arrangement and got worse at 12wk in DM group. In DM group, mitochondrial swelling was detected at 4wk., and became more obvious, more in number at 8wk with reduction in some cells' volume and the number of organelles decreased. In DM group, few TUNEL positive RGCs were seen at 4wk, and became more and more at 8 and 12wk. The apoptosis index was significantly higher in DM group compared with CON group in different time points(P<0.01). Intracellular calcium ion concentration of RGCs in DM group began to elevate obviously at 8 and 12wk in contrast with CON group in the same time point(P<0.01). In DM group, Intracellular calcium ion concentration of RGCs increased difference was statistically significant between 8 and 12wk(P<0.05).

CONCLUSION: The study suggested that RGCs apoptosis occurs in early stage of diabetes, the mechanism might be associated with increased intracellular calcium ion concentration.

Abstract:AIM:To explore the effects and mechanisms of 17β-estradiol on retinopathy of prematurity in rats.

METHODS: Eighty 7-day-old SD rats were randomly divided into normol group, high oxygen group, 17β-estradiol treatment group and vegetable oil treatment group. Rats of the high oxygen group were put into the environment exposed to 75% oxygen for 5d and backed to room air for another 5d to establish the oxygen-induced retinopathy model. The treatment group was given 17β-estradiol by injection with the dose of 0.5uL/rat/d(2μg/μL)before exposed to 75% oxygen. The vegetable oil treatment group is similar to 17β-estradiol treatment group but the medicine changed to vegetable oil. Counting the endotheliocyte nuclei of new vessels which extended from retina to vitreous body in the tissue-slice of HE staining, and investigate the change of retinal blood vessels by using methods of retina flat-mount. The expression of VEGF in retina by immunohistochemistry and reverse transcription-polymerase chain reaction(RT-PCR)analysis.

RESULTS: Rats treated with E₂ showed less neovascularization than high oxygen group and oxygen-exposed rats treated with vegetable oil(P<0.05). Adenosine diphosphate-ase(ADP ase)stained retina flat- mount showed that: less free-vascular areas and new blood vessels were seen in the 17β-estradiol treatment group compared with the high oxygen group. The expression of VEGF in 17β-estradiol treatment group lower than high oxygen group and vegetable oil treatment group, but higher than normal group in immunohistochemistry and RT-PCR analysis.

CONCLUSION:17β-estradiol has prevention effects in retinal neovascularization and the mechanism may involve in its interaction with VEGF.

Abstract:AIM:To investigate the effect of specific silencing hypoxia inducible factor-1 alpha(HIF-1α)by small interference RNA(siRNA)on expression of vimentin in human uveal melanoma cell lines(OCM-1)under hypoxia, in order to discuss the role of HIF-1α on epithelial-mesenchymal transition(EMT)in uveal melanoma.

METHODS: OCM-1 cells were cultured under normoxia and hypoxia in vitro. We added chemical hypoxia inducer cobalt chloride(CoCl₂)into nutrient medium at the concentration of 100μmol/L to simulate hypoxia microenvironment inside tumor to culture cells of hypoxic group. And hypoxic group cells were divided into five groups: simple hypoxic group, interference group, positive control group, negative control group and liposome group. SiRNA(including HIF-1α-siRNA, β-actin-siRNA and negative control)were designed and synthetized in vitro. Lipofectamine^TM 2000 was taken to transfect siRNA into OCM-1 cells under hypoxia. RT-PCR and Western blot were used to check the expression status of HIF-1α and vimentin on mRNA and protein levels before and after hypoxia culture and cell transfection.

RESULTS: Compared with normoxia group, there was no obvious change on the expression level of mRNA of HIF-1α in simple hypoxia group(P>0.05), while the expression level of its protein increased obviously(P<0.01); both mRNA and protein levels of vimentin were up-regulated(P<0.01). Compared with other hypoxic groups, the expression level of mRNA of β-actin was down-regulated in positive control group(P<0.01), which indicated that our operation of cell transfection was successful. In interference group, the expression of HIF-1α and vimentin were down-regulated obviously both on mRNA and protein levels(P<0.01). There was no significant difference in the expression of HIF-1α and vimentin in negative control group and liposome group(P>0.05).

CONCLUSION: Hypoxia can up-regulate the expression of HIF-1α on protein level in OCM-1 cells, and activate the transcription of vimentin as the downstream gene of HIF-1α, up-regulate the expression of vimentin both on mRNA and protein levels. This hints that HIF-1α can regulate the EMT in uveal melanoma and plays an important role in the process of tumor invasion and metastasis. We successfully down-regulate the expression of HIF-1α and vimentin by transfecting OCM-1 with HIF-1α-siRNA. This suggests that suppression the expression of HIF-1α at the molecular level maybe can shut down the process of tumor invasion and metastasis and offer new directions for cancer treatment.

Abstract:AIM: To research the curative effect of dexamethasone on rat cornea acid burn at different periods.

METHODS: The 40 corneal acid burned eyes of the 40 SD rats were divided into 4 groups with each group of 10 eyes randomly. Ⅰ, Ⅱ, Ⅲ groups were treated with dexamethasone(1mg/mL)eye drops at three periods after the corneal burns(acute stage, 0-3d; early repair, 3-7d; late repair, 7-21d); the Ⅳ group is treated without dexamethasone. The injured eyes were photographed and dynamically observed with slit lamp microscope, and the histological changes were scrutinized with HE staining.

RESULTS: Eventually, the cornea repairing situation from good to bad is: Ⅲ, Ⅰ, Ⅳ, Ⅱ. After acid burned, corneal epithelial healing and angiogenesis area were different, the comparison between the experimental groups and control group was statistically significant(P<0.01).

CONCLUSION: After acid burned, curative effects are different with using dexamethasone at different periods. Active effects were produced after using dexamethasone in the acute stage and the late stage. However, using dexamethasone in the early stage may hinder the repairing of cornea, or even dissolve the cornea.

Abstract:AIM:To assess the biocompatibility of hydrophobic acrylic intraocular lenses after anterior surface modification with monomer vinyl pyrrolidone by studying cell adhesion using light microscopy.

METHODS: Twenty-six eyes of 13 rabbits were divided into 3 groups randomly. Nine eyes were implanted into vinyl pyrrolidone modification intraocular lenses, 8 eyes were implanted into titanium oxide modification intraocular lenses, 9 eyes were implanted into unmodified intraocular lenses following lens extraction. The intraocular lenses implanted eyes were enucleated in 90d of post operation and cell adhesion on surface of different intraocular lenses were compared under light microscopy.

RESULTS: The cells' size, number and protein films of intraocular lenses on anterior surface of vinyl pyrrolidone modification group were significantly less than that in two control groups.

CONCLUSION: The uveal biocompatibility of hydrophobic acrylic intraocular lenses after single surface modification by monomer vinyl pyrrolidone is significantly improved.

Abstract:AIM: To investigate the ocular acute toxicity of sufentanil in rabbits, in order to provide the scientific basis for its safe administration and reasonable combination.

METHODS: Sixteen healthy rabbits were randomly divided into 4 groups(groups 1-4), control(vehicle), low(5μg, 2 drops in 5min), moderate(7.5μg, 3 drops in 10min)and high doses(10μg, 4 drops in 15min)of sufentanil-treated groups. Solvent without sufentanil was administered to the left eyes in the vehicle control group(group 1). Meanwhile, 9g/L NaCl solutions were given to the right eyes in all 4 groups at equal drip rate for auto-control. After 7d, ocular toxicity was firstly evaluated.

RESULTS: Observed with naked eye and slit lamp, no changes including corneal opacity, conjunctival congestion, chemosis, eye secretions, iris abnormalities and temporal eye closed was in all groups. With slit-lamp microscope, the counts of corneal endothelium cells in all groups have no statistically significant difference. With light microscope, no pathomorphological injury in the conjunctiva, cornea, corneoscleral junction, iris, ciliary body, retina and optic nerve were found.

CONCLUSION: The ophthalmic application of sufentanil alone(5-10μg)for sedation and analgesia is safe in a short period.

Abstract:AIM: To assess the efficacy of non-penetrating trabecular surgery versus trabeculectomy for lowering the intraocular pressures(IOP)of patients with open angle glaucoma.

METHODS: We searched the Cochrane Library, PubMed(1966 to 2013), Embase(1980 to 2013)and CBMdisc(1979 to 2013)for the randomized clinical trials of non-penetrating trabecular surgery and trabeculectomy. We also screened relevant journals and references to evaluate the quality of the literatures. The Cochrane Collaboration's RevMan 4.2 software was used for Meta analysis.

RESULTS: Ten RCTs with previously untreated open angle glaucoma were included. Seven results showed that compared with non-penetrating trabecular surgery, trabeculectomy can better improve the level of postoperative IOP reduction and the success rate of surgery. But eight results showed that compared with trabeculectomy, non-penetrating trabecular surgery can reduce the incidence of postoperative complications.

CONCLUSION: Compared with non-penetrating trabecular surgery, trabeculectomy can better improve the level of postoperative IOP reduction and the success rate of surgery. But non-penetrating trabecular surgery can reduce the incidence of postoperative complications of surgery.

Abstract:AIM: To evaluate the efficacy and safety of latanoprost versus timolol for primary open angle glaucoma(POAG)and ocular hypertension(OHT).

METHODS: This was an evidence-based medicine science study. Pertinent studies of randomized controlled trial(RCT)were identified through searches of PubMed, Medline, CNKI and China Biology Medicine disc. The intensive searching by hand and internet was also designed. According to inclusion and exclusion criteria, the study object was limited. Quality of literatures were evaluated by experienced researchers according to the Jadad Score. RevMan 5.0 offered by Cochrane was used for Meta-analysis aimed at the ratio of low intraocular tension and adverse drug reaction.

RESULTS: A total of 9 RCT sadded up to 555 patients were involved. The results of meta-analysis showed that, a)the difference at 2, 6, 12wk both had statistical significance, latanoprost showed greater intraocular pressure(IOP)lowering efficacy compared with timolol. The weighted mean difference(WMD)at 2, 6, 12wk was respectively \〖-0.76, 95% CI(-1.32 to -0.20)\〗, \〖-1.15, 95% CI(-1.68 to 0.63)\〗 and \〖-1.01, 95% CI(-1.42 to -0.61)\〗. b)The difference in conjunctival congestion(OR=2.25, 95% CI 0.99 to 5.08)and foreign body sensation(OR=2.48, 95% CI 1.02 to 6.03 )between latanoprost and timolol group was not statistically significant.

CONCLUSION: Latanoprost showed greater IOP lowering efficacy at 12wk compared with timolol for OAG and OH patients. The conjunctival hyperemia, foreign body sensation, iris pigmentation deepened, vision damage of latanoprost group at 12wk compared with timolol, the difference was not significant. This conclusion is not powerful enough in proof due to the medium methodology quality of the included studies, so a large number of high-quality RCTs with large sample are needed for objectively, precisely and entirely evaluating the efficacy.

Abstract:AIM: To evaluate the clinical effect and safety for diabetic macular edema(DME)with triamcinolone acetonide(TA)by intravitreous injection and retrobulbar injection combined with macular grid laser photocoagulation.

METHODS: Fifty-two patients(sixty-two eyes)with DME were randomly divided into two groups: thirty-one eyes were treated with an intravitreous injection of triamcinolone acetonide(IVTA)(0.1mL/4mg), and thirty- one eyes were treated with a retrobulbar injection of triamcinolone acetonide(RBTA)(1mL/40mg). Macular grid laser photocoagulation was used to treat all of the patients after one month. Follow-up 9mo, the change of macular edema and the incidence of complications were observed and measured.

RESULTS: For the different follow-up times at one month, three months, six months and nine months. Best corrected visual acuity(BCVA)and the change in macular edema of all patients improved after treatment. There were statistically differences between before treatment and after treatment in the change of BCVA and macular edema(P<0.05). But there was no statistically difference between the two groups(P>0.05). The difference in the incidence of complications between the two groups showed a statistically difference(P<0.05), RBTA group was safer.

CONCLUSION: RBTA combined with grid laser photocoagulation for DME has the same effect as IVTA, and it is safer.

Abstract:AIM: To compare the clinical curative effect with lucentis and photodynamic therapy in the disease of wet age-related macular degeneration.

METHODS: A retrospective study in 23 cases with photodynamic therapy(PDT),and another 23 patients who were injected lucentis. We compared the results of best corrected visual acuity, OCT and FFA after 1mo, 3mo and 6mo.

RESULTS: Both groups had a great significant improvement in best corrected acuity visual at 1mo and 3mo later. The comparison between the two groups had no statistical significance. But the best corrected visual acuity in 2 patients(9%)of lucentis group was lower at 6mo than at 1mo and 3mo.

CONCLUSION: The study showed the two methods for treating wet age-related macular degeneration were effective in short time, but the stability at 6mo of PDT group was better than lucentis group.

Abstract:AIM: To assess the morphological features, classification, and contrastive analysis between the features of optical coherence tomography(OCT)and fundus fluorescein angiography(FFA)in clinically high myopic maculopathy.

METHODS: Totally 61 patients(101 eyes)with clinically high myopic maculopathy. Distant vision was examined through E Standard Logarithm Eyesight Table. Integrated optometry to determine the dioptre and best corrected visual acuity(BCVA). Axial length(AL)measurements obtained through IOL-Master. Fundus examinations performed in patients with high myopia after pupil dilation. OCT and FFA were done separately in each case of myopic maculopathy on the same day. FFA and indocyanine green angiogrsphy(FFA& ICGA)was done if need be. The correlation between FFA types and OCT types were analyzed, and their associations with dioptre, BCVA, AL and central foveal thickness were evaluated.

RESULTS: The prevalence of lacquer crack type was higher in the OCT type 1(57.14%)than in the choroidal neovascularization(CNV)type and macular atrophy type(21.43%)of fluorescein angiography, the difference was statistically significant(P<0.05). The prevalence of macular atrophy type was higher in the OCT type 2(67.80%)than in the lacquer crack(18.64%)and CNV type(13.56%), the difference was statistically significant(P<0.05). The macular atrophy type all belong to the OCT type 3. OCT type 1 showed the least dioptre and AL, conversely the highest central foveal thickness and/or BCVA(P<0.05). There was no obvious difference between lacquer crack type and CNV type on diopter and AL, but lacquer crack type showed better BCVA and foveal thickness(P<0.05). The diopter and AL of lacquer crack type and CNV type were significantly lower than that of macular atrophy type, while BCVA was higher(P<0.05).

CONCLUSION: There was a significant correlation between the features of OCT and FFA in high myopicmaculopathy. The analysis of clinically high myopic maculopathy based on combination of OCT and FFA can provide information that may be useful to make sure the nature of high myopia, disclose the pathogenesis and to optimize the treatment for each type.

Abstract:AIM: To find out the necessity and the appropriate method of correcting short distance refractive error in non-presbyopia patients by analyzing the relation between astigmatic refractive error and fixation distance.

METHODS: In this prospective clinical study, 166 right eyes with myopic astigmatism were selected by sequential processing to measure at distance of 5m, 40cm and 20cm. The distance corrected near vision acuity(NCNVA)and accommodative astigmatism corrected near vision acuity(ACNVA)were measured with distance-corrected glasses and near-corrected glasses, respectively, using near vision chart. The astigmatism at near were measured under monocular condition with cross-cylinder lenses, with the tested eye looking straight ahead at the line of its best corrected vision acuity in near vision chart. The degree and axis of astigmatism between two distance of the three, DCNVA and ACNVA were compared by paired t test respectively if the data are normal distribution, if not, compared by Wilcoxon matched-pairs signed-ranks test.

RESULTS: The degree of astigmatism with accommodation was increased significantly as follow order: fixating at 20cm, 40cm and distance. \〖(40cm-5m): Z=-5.316, P<0.0167;(20cm-5m): Z=-5.672, P<0.0167;(20cm-40cm): Z=-2.463; P<0.0167 respectively\〗; The axis of astigmatism showed no statistical significance among different level of accommodation \〖20cm,(0.83DC±0.52D)>40cm,(0.78DC±0.43D)>5m, 0.63DC±0.47D)\〗; The near vision acuity when fixing at 40cm and 20cm were both increased significantly when accommodative astigmatism corrected(Z=-5.741, P<0.01; Z=-6.848, P<0.01, respectively).

CONCLUSION: The degree of astigmatism has a tendency of increasing when fixating at near, and astigmatism with the rule will be followed by the axis, while this change is random and personalized, asthenopia is more likely to appear at the distance of maxium astigmatism change, so correct the refractive error at near may be a appropriate method to treat asthenopia.

Abstract:Age-related macular degeneration(AMD)is a multifactorial- and polygenic-mediated chronic degenerative disease. Parainflammation is defined as a condition of tissue adaptive response to noxious stress or malfunction, it has features which are considered as intermediate between normal/basal and inflammatory/acute states. With the genetic predispositions, increased reactive oxygen species(ROS)generation cause the complement activation, placing the neuroretina-pigment epithelium-Bruch's membrane-choriocapillaris(NR-RPE-MB-CC)in the chronic condition of parainflammation which mediate apoptosis and angiogenesis, leading to AMD.

Abstract:Age-related macular degeneration, also called ARMD, is a chronic progressive disease that occurs mostly in people over the age of 50, which is the main blinding eye disease in the elderly in developed countries, also the main cause of irreversible visual impairment in developing countries. The ARMD includes geographic atrophy and choroid neovascularization. While its specific etiology and pathogenesis unclear, most scholars believe that ARMD is a multifactor disease. The relationship between Toll-like receptor 3(TLR3)and ARMD becomes the study hotspot, this paper summarize the research progress of this spot.

Abstract:According to the study, chemokine receptor 3(CCR3)in the eye is mainly distributed in retinal pigment epithelial cells, and also expressed in the choroidal vascular endothelial cells(CECs). The specificity of CCR3's high expression in wet age-related macular degeneration(AMD)was found, and it is proved that in wet-AMD patients, it plays an important role in the formation of choroidal neovascularization(CNV). In this paper, the structure, function, the problem of current research and the future direction of CCR3 were summarized. It is believed that with the further research on CCR3, it will not only help us to find a new method of wet-AMD diagnosis and treatment, but also may provide an important reference for other CNV disease research and new anti-CNV drugs.

Abstract:Retinopathy of prematurity(ROP)is a vasoproliferative retinopathy with unmatured and low weight infants. Now in domestic, the main treatment methods are cryotherapy and laser coagulation, there are some medication treatment researches and fundamental researches that have been reported in recent years. This review describes the application of bevacizumab, ranibizumab and other research-based drugs in new progress of the treatment study for ROP.

Abstract:The retinal pigment epithelium(RPE)is a pigmented simplecuboidal monolayer of epithelial cells that located between the photoreceptors in the neural retina and the Bruch's membrane in the vascular choroid and is critical for the survival and function of retinal photoreceptors. The pathogenesis of multiple congenital RPE diseases is closely related to embryonic development. This review summarized the current knowledge of the molecular mechanisms controlling early steps of RPE development, with emphasis on basic process, critical signaling molecules, key transcription factors and pathway maintaining the RPE cell fate.

Abstract:Taurine is a common amino acid in almost all kinds of tissues of animals. Several researches have pointed out that taurine is essential for protecting retinal ganglion cells(RGCs). The mechanisms are summarized as follows: 1)Reducing the NMDA-induced RGC excitotoxicity 2)Regulating the function of Müller cells 3)Protecting function of mitochondria 4)Stimulating regeneration of the optic nerve 5)Promoting accommodative regulation 6)Improving the microcirculation of retina. Glaucoma is one kind of ophthalmopathy leading to apoptosis of RGCs. Recently, taurine has been proved to be effective in protecting the RGC in several aspects, both in vitro and vivo experiments. This indicates a potential treatment of optic nerve in glaucoma or other ophthalmic diseases.

Abstract:Choroid neovascularization(CNV)is more common in age-related macular degeneration, pathological myopia macular degeneration and central exudative chorioretinopathy and so on, and it is the leading cause of vision loss and even lost. In the treatment, laser photocoagulation, transpupillary thermotherapy(TTT)and photodynamic therapy(PDT)have been widely carried out in our country; And resistance to new blood vessels formation and pathological process of inflammatory reaction of drugs used in clinic were also significantly increased. In recent years, the new methods such as gene therapy, targeted treatment of CNV also get achievements, now we summarize the research status at home and abroad about the treatment of CNV.

Abstract:Vitreoushumour(VH)is a transparent, highly hydrated gel, which occupies the vitreous cavity. The protein composition of the VH would change in pathological conditions of the retina, which has been testified in many studies. In the last decade, proteomics analyses have been performed to study the proteome of the human VH and hope to find some specific proteins in the aetiology of diabeticretinopathy(DR). Recent proteomic studies on the VH from animal models of autoimmune uveitis have identified some specific proteins in related entophthalmia.

Abstract:AIM: To compare the differences and the relationships of central corneal thickness(CCT)measurements among optical coherence tomography(OCT), Tomey pachymetry and ultrasound pachymetry after laser assisted subepithelial keratomileusis(LASEK).

METHODS:Forty-nine patients(96 eyes)with myopia after 6mo of LASEK were assigned to measure the CCT by OCT, Tomey pachymetry and ultrasound pachymetry. Paired t-test and Pearson correlation analysis was used for statistical analysis.

RESULTS: The mean CCT measured by OCT, Tomey pachymetry and ultrasound pachymetry was(475.15±33.67μm),(447.80±34.11μm),(465.18±34.23μm), respectively. Surgery reserved mean CCT was(431.22±35.32)μm. There were statistically differences between two comparative measured results(P<0.05). Ultrasound pachymetry had a positive correlation with OCT and Tomey pachymetry(P<0.01), and the correlation coefficient was 0.949 and 0.983, respectively. The actual CCT of 6mo post-operation was thicker than surgery reserved CCT.

CONCLUSION: The CCT measurements of three instruments were not interchangeable.

Abstract:AIM: To observe the influence of cataract phacoemulsification on corneal endothelial cell of cataract patients combined with diabetes or hypertension.

METHODS: Clinical case-control study was used. Totally 104 cases(174 eyes)of patients who underwent phacoemulsification were divided into three groups: senile cataract patients, diabetes mellitus cataract patients and hypertension cataract patients. The changes of endothelial cell density(CD), percentage of regular hexagonal cells(6A), coefficient of variation(CV)between pre-operation and post-operation at 1wk, 1mo were compared. The data were analyzed statistically by means of SPSS 13.0 software.

RESULTS: Pre-operative results: the percentage of CD and 6A cell were decreased and CV was increased in diabetes and hypertension group compared with control group. There were statistical differences in 6A and CV in diabetes group(P<0.05). There were statistical differences in 6A in hypertension group(P<0.05). Post-operative results: the percentage of CD and 6A were decreased, and CV was increased after operation of 1wk and 1mo. There were significant differences in three groups(P<0.01). CD had statistical differences(P<0.05), CV and 6A had significant differences(P<0.01)between diabetes group and control group. 6A and CV had significant differences(P<0.01)between hypertension group and control group.

CONCLUSION: Cataract phacoemulsification has certain injury on corneal endothelial cell. Cataract patients combined with diabetes or hypertension are easier to be damaged than that of senile cataract in the phacoemulsification. They are more sensitive after surgery.

Abstract:AIM: To evaluate the efficacy and complications of 25G posterior capsulotomy with anterior vitrectomy for posterior capsule opacification(PCO).

METHODS: The 25G transconjunctival sutureless vitrectomy technique was performed in 48 cases(68 eyes)of PCO eyes. The mean follow-up was 24mo. Best-corrected visual acuity(BCVA), intraocular pressure, anterior chamber reaction and complications during and after the operation were observed.

RESULTS: 4mm diameter round holes were obtained at the center of the posterior capsule in all eyes. At 1d postoperative, uncorrected visual acuity(UCVA)was 0.70±0.12(0.5-1.0), and BCVA was 0.73±0.10(0.6-1.0). At 3mo postoperative, UCVA was 0.72±0.12(0.5-1.0), and BCVA was 0.74±0.10(0.6-1.0). It was statistical significance between preoperative and postoperative UCVA(t=-45.902, P=0.000). There were no complications during the postoperative follow-up period, such as dislocation or damage of the IOL, corneal edema, endoophthalmitis, pupil vitreous hernia, vitreous prolapse, retina detachment, intraocular hypertension and reocclusion of the visual axis, etc.

CONCLUSION: The 25G transconjunctival sutureless vitrectomy technique to remove PCO is a safe and effective procedure with less complications, which can be an alternative treatment for PCO.

Abstract:AIM:To compare two phaco techniques, namely phaco prechop with phaco chop and divide and conquer, and to discuss the technical advantages of phaco prechop with phaco chop

METHODS:The study included 131 patients(156 eyes)with age-related cataract eyes divided into 2 groups, group A including 68 patients(82 eyes), in which phaco prechop with phaco chop was performed, and group B including 63 patients(74 eyes), in which divide and conquer was performed. The mean parameters including average power(AP), U/S time, accumulated energy complex parameter(AECP), mean endothelial cell count, mean endothelial cell loss, intraoperative complications, postoperative uncorrected visual acuity(UCVA)at 1d and 1wk, and corneal edema were reported in the two groups both preoperative and postoperative.

RESULTS:The subgroups with same grade of lens nucleus hardness were compared. Parameters such as AP, U/S time, AECP in group A were significantly less than those in group B. Postoperative corneal clarity and UCVA at 1d in group A was better than that in group B. No significant difference was found in UCVA at 1wk after operation between the two groups. The difference in mean endothelial cell count at 3mo postoperative between the two groups was statistically insignificant(P>0.05), however the difference in endothelial cell loss at 3mo postoperatively between the two groups was statistically significant(P<0.05). Two cases in groups A(2.4%)had posterior capsular rents compared to four cases(5.4%)in group B.

CONCLUSION:Compare with divide and conquer, phaco prechop with phaco chop utilized less phaco time, energy, and the rate of endothelial cell loss at 3mo postoperatively, and better early postoperative uncorrected visual acuity.

Abstract:AIM: To observe the effect of Ex-PRESS glaucoma filtration device in primary open angle glaucoma.

METHODS: Totally 41 patients(54 eyes)with primary open angle glaucoma were divided into two groups. Nineteen patients(25 eyes)in study group who underwent Ex-PRESS glaucoma filtration device implantation. Twenty-two cases(29 eyes)in control group who underwent trabeculectomy. Two groups were compared with the average operation time, post-operative visual acuity, anterior chamber, intraocular pressure, filtering bleb and other complications.

RESULTS: In study group operation time was(34.60±4.43)min, 1d postoperative shallow anterior chamber in 1 eye and hyphema in 1 eye, 1wk postoperative high intraocular pressure in 2 eyes, 3mo postoperative decreased vision in 1 eye, functional filtering blebs in 24 eyes, intraocular pressure was(11.5±5.8)mmHg. The control group operation time was(44.37±3.00)min, 1d postoperative shallow anterior chamber in 13 eyes, anterior chamber bleeding or exudation in 12 eyes, 1wk postoperative high intraocular pressure in 8 eyes, 3mo postoperative decreased vision in 6 eyes, functional filtering blebs in 25 eyes, intraocular pressure was(13.6±6.7)mmHg. The study group can shorten the operation time and reduce early postoperative shallow anterior chamber, lower intraocular pressure and incidence of anterior chamber exudation and bleeding. The study group can control postoperative IOP to a lower degree. Comparing with the traditional operation, the study group had equivalent effect in postoperative visual effects and functional filtering bleb.

CONCLUSION: Ex-PRESS glaucoma filtration device implantation in primary open angle glaucoma can shorten operation time, reduce the postoperative complications, and has the characteristics of high safety and good efficacy.

Abstract:AIM: To investigate the effect and complication of sodium hyaluronate combined with Ahmed glaucoma valve implantation on neovascular glaucoma(NVG).

METHODS: This was a retrospective observational case series. Forty-nine patients(49 eyes)with NVG in our hospital from 2009 to 2011 were randomly divided into two groups according to the odd-even of medical record number. Ahmed glaucoma valve implantation proceeded separately in control group, while in control group combined with 0.2-0.3mL sodium hyaluronate, regularly follow-up after operation at 1mo, comparing the complications such as postoperative intraocular pressure(IOP), the changes of best corrected visual acuity(BCVA), the hemorrhage of shallow anterior chamber, hyphema and choroidal detachment, etc. IOP before and after operation between the two groups was examined by independent sample test(non-normal distribution), the complications were compared by χ² text.

RESULTS: Postoperative follow-up time was 1mo. IOP in research group was declined from 42.8±5.56mmHg preoperatively to 17.7±3.77mmHg, IOP in control group was declined from 42.5±5.36mmHg preoperatively to 18.6±5.39mmHg. Postoperative complications: shallow anterior chamber occurred in 2 patients(2 eyes)in research group and 4 patients(4 eyes)in control group. Hyphema occurred in 1 patient(1 eye)in research group and in 5 patients(5 eyes)in control group. Poor location of the anterior chamber silicone tube occurred in 1 patient in research group.

CONCLUSION:Sodium hyaluronate combined with Ahmed glaucom avalve can effectively reduce IOP in patients with NVG and decrease the postoperative hyphema, which will lead to short-term increasing IOP in patients after operation, but had no significant effect in the long run.

Abstract:AIM: To compare the effect of primary open angle glaucoma(POAG)with well-controlled drugs on the intraocular pressure(IOP)using phacoemulsification combined selective laser trabeculoplasty(phacoemulsification combined SLT)versus SLT alone.

METHODS: By a prospective clinical case control study, 24 patients(30 eyes)with POAG were randomly divided into 2 groups: eleven patients(14 eyes)were treated with phacoemulsification combined SLT and 13 patients(16 eyes)were treated with SLT alone. IOP at 3, 6, 9mo, visual acuity and glaucoma medicines at 9mo were observed postoperatively.

RESULTS: The mean IOP of both groups was significantly decreased after the surgery. IOP of phacoemulsification combined SLT had decreased markedly than SLT alone after 3, 6mo. There was statistical significance between the 2 groups(P=0.001). The numbers of glaucoma drugs were markedly decreased postoperatively than preoperatively in both groups. Statistical significance were found between the 2 groups(P=0.03).

CONCLUSION: The study demonstrates that phacoemulsification with SLT and SLT can markedly reduce the IOP of POAG patients with good IOP control using drugs. The IOP-reducing effect of phacoemulsification combined SLT exceeds markedly than that of SLT alone.

Abstract:AIM:To observe the clinical therapeutic effect of photodynamic therapy(PDT)and transpupillary thermotherapy(TTT)on circumscribed choroid hemangioma(CCH).

METHODS: Totally 24 cases(24 eyes)of CCH were selected in this study. Twelve of them had undergone TTT, and the other 12 were treated by PDT. The changes of tumors were examined by best corrected visual acuity, results of fundus photography, and direct ophthalmoscopy; the changes of tumors' sizes and heights were examined by B-ultrasound examination and coloured doppler imaging; the presence of serous subretinal fluid were examined by optical coherence tomography(OCT); the leakage of tumors and complications were analyzed by fluorescence fundus angiography(FFA)and indocyanine green angiography(ICGA).

RESULTS: In all cases, the tumors shrinked back, the blood flows tuned negative, the fluorescence leakages lessened and the serous retinal detachments resolved completely according to OCT, FFA, ICGA and coloured doppler imaging. In the 12 patients treated by TTT, visual acuity improved in 33.3%, unchanged in 33.3%, and droped in 33.3% too; the results of fundus examinations showed obvious pigmentation and atrophy tumor with organized scar. In the 12 patients treated by PDT, visual acuity improved in 66.7%, unchanged in 33.3%, and none droped; the results of fundus examinations showed slight pigment derangement, atrophy tumor tuned white, and normal blood vessel undamaged.

CONCLUSION: Both TTT and PDT can make the tumor atrophy and the exudation absorbed. Unlike TTT, PDT damages little normal tissue, and has higher security.

Abstract:AIM: To investigate the applicationof the optical coherence tomography(OCT)in the central retinal artery occlusion(CRAO)disease, and explore whether is a correlation between inner retinal thickness and visual acuity pre and post treatment.

METHODS: A retrospective analysis of patients with central retinal artery occlusion in 11 cases. Patients' onsets to admission time, initial visual acuity, after-treatment visual acuity were collected. Retinal thickness in the macular area was measured with OCT. Retinal mean thickness of fovea, including macular fovea, the 1mm and 3mm up, down of the fovea, nasal and temporal side to the foveal pit, was measured and analyzed. The thickness of inner retinal layer was measured manually. In the inner retinal layer, 1mm nasal and temporal side to the foveal pit, nasal and temporal side was N1, T1 respectively; 3mm nasal and temporal to the foveal pit, nasal and temporal side was N3, T3 respectively.

RESULTS: The visual acuity of 8/11 patients was improved in different degree. The unhealthy eyes macular area and nasal 3mm retinal mean thickness were thicker than the healthy eye(P<0.05). Compared with the healthy eyes, the unhealthy eyes which retinal thickness under others macular area have no statistical difference(P>0.05). The unhealthy eyes were thicker than the healthy at N1, N3 and T3(P<0.05). The different values that thickness in the fovea of healthy and unhealthy eyes had a negative correlation with visual acuity of after treatment, r=-0.740(P<0.05). The different values of N1, T1 and T3 in healthy and unhealthy eyes also had a negative correlation with visual acuity of after treatment, r_N1=-0.692, r_T1=-0.754, r_T3=-0.657(P<0.05).

CONCLUSION: OCT examination has suggestive function for the recovery of patients with central retinal artery occlusion of visual acuity after-treatment.

Abstract:AIM: To explore the effect of soft corneal contact lens with different base curve on laser epithelial keratomileusis(LASEK).

METHEDS: Totally 186 cases(372 eyes)with myopia underwent LASEK surgery were divided into the observation group and the control group randomly, respectively wearing soft corneal lens -1.0D with 8.7mm and 8.5mm base curve. The comparison and observation were conducted in terms of corneal irritation at postoperative 1, 3 and 5d, the time of healing the epithelium and visual recovery in these two groups at 5d, the uncorrected visual acuity refraction at 1mo, and the degree of haze at 3mo.

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

CONCLUSION: Wearing bigger base curve soft corneal contact lens is a safe and efficient method for LASEK than smaller with the advantages of having mild irritating symptom, a shorter time of healing the epithelium and the visual acuity.

Abstract:AIM: To study the efficacy and safety of excimer laser corneal refractive surgery in treatment of hyperopic anisometropia amblyopia in adults and adolescents.

METHODS: From September 2010 to March 2013 in our hospital, 11 patients(16 eyes)with hyperopic anisometropia amblyopia were performed excimer laser corneal refractive surgery and followed up for 6mo or more, all patients age were 15 years or older. Uncorrected or best corrected visual acuity, cycloplegic refraction and stereoscopic before and after surgery were recorded. After surgery, all patients were asked if they feel visual quality was improved after surgery in everyday life and satisfied to the operation.

RESULTS: The average of 16 eyes cycloplegic refraction error(equivalent spherical)was from preoperative 5.76±1.71D reduced to postoperative 1.42±1.22D(t=13.6, P=0.00). The anisometropia of 11 patients was from preoperative 3.78±2.39D dropped to 1.14±1.50D after the operation(t=6.08, P=0.00). After surgery, the uncorrected visual acuity for distant from 0.35±0.27 rose to 0.45±0.29(t=-4.76, P<0.001); uncorrected visual acuity for near increased from 0.26±0.24 to 0.49±0.27(t=5.43, P=0.00). Preoperative worth four hole lamp examination 4 cases showed the amblyopic eye suppression. After surgery all of them were back to normal. Examined by Synoptophore, 6 cases had stereoscopisis before surgery and 10 cases after surgery. Tested by Titmus fly, the stereopsis improved significantly before and after surgery(t=-2.97, P=0.003). No obvious complications were observed during and after surgery. All patients argued of visual quality significantly improved and satisfaction to the surgery.

CONCLUSION: Excimer laser corneal refractive surgery for adults or older adolescent patients with hyperopic anisometropia amblyopiais is effective and safe, through the corrected visual acuity is improved limitedly, but the uncorrected visual acuity and stereopsis was improved obviously. This surgery improves patient visual quality and is worth to approach.

Abstract:AIM: To understand the status of distribution of Panlian Town, Miyi County of ophthalmopathy through the screening, which provides reliable data for the future prevention of blindness.

METHODS: In 2013 each villages and towns area of Miyi County had a total of 227 patients with above 60 years old, visual acuity less than 0.3. Concentrated routine physical examination and eye examination were checked. Qualified for the preoperative indexes, 42 cases(42 eyes)of other diseases caused by cataract and lens nucleus of grade IV were excluded, for monocular “extracapsular cataract extraction combined with intraocular lens implantation” were performed, and observing the vision of the first postoperative day and the situation of ophthalmology.

RESULTS: Miyi County in the elderly population with low vision in 2013, the prevalence rate of cataract was 81.06%, including senile cataract(69.60%), the complicated cataract(8.81%), metabolic cataract(3.52%), other causes low vision eye disease(15.06%). Selecting 42 cases(42 eyes)underwent surgical operation. After operation, the literacy rate is up to 100%.

CONCLUSION: Publicity in senile cataract and other eye disease should be strengthened continually. Strengthening the prevention and treatment knowledge, which can cause cataract and internal medicine disease, can improve the clinic diagnostic rate and change the cataract operation mode, so as to make the development of township of Miyi County in prevention of blindness much better.

Abstract:AIM: To study 3-6 years old children's refraction, providing information for prevention and treatment of the preschool children's ametropia.

METHODS: A sample of 2 848 children from 30 kindergartens were selected randomly. Refraction was performed using SureSight vision screening instrument, and to investigate the parents questionnaire survey of related factors. Date collection was analyzed statistically.

RESULTS:Totally 2848 preschool children were participated in the survey, 2 565 of them were qualified to complete the questionnaire, the completion rate was 90.06%. The overall refractive abnormality rate was 18.13%. The detection rate of abnormal refraction in four age groups was: 11.84%, 16.28%, 20.72%, 25.62%. χ² test for trend(χ²=47.085, P<0.01)showed that the abnormal refraction detection rate increased with age trend. Refractive abnormality rate of 21.83% in boys, 13.54% in girls, the difference was statistically significant(χ²=29.378, P<0.01). The non-conditional Logistic regression analysis, parents' educational level, maternal age, premature birth, birth asphyxia, birth weight, father diopter, eye using time, eat fruits and vegetables and other factors of OR value was respectively: 2.638, 2.380, 2.316, 5.891, 9.675, 3.146, 2.079, 1.241, 6.731.

CONCLUSION: Along with the growth of the age, refraction anomaly detection rate increasing tendency. The boy's refractive abnormality rate was significantly higher than that of girls. Parents with low education level, maternal age, birth asphyxia, premature, weighing less than 2 000g or higher than 4 000g, father ametropia, long time with eyes close, eating less fruits and vegetables are the risk factors for ametropia.

Abstract:AIM: To analyze the keratoconus literatures in China and abroad and determine the growthlaw and its major influence factors.

METHODS:As the index word, quantity of literatures of keratoconus was retrieved in PubMed(from January 1, 1911 to November 10, 2013)and CNKI(from January 1, 1960 to November 10, 2013). The literature linear or curve regression analysis was preceded, and the growth law of the literatures and its main influence factors were determined.

RESULTS: Foreign annual cumulative amount of keratoconus literatures showed an increasing trend with the tendency charts of the exponential(y1=0.8824e^0.7937X, R²=0.9533). Domestic annual cumulative amount of keratoconus literatures also showed an increasing trend with the tendency charts of the exponential(y2=0.2441e^1.6073X, R²=0.9957). Ten PubMed core journals in ophthalmology included 1932 literatures, and 10 CNKI core journals in ophthalmology included 409 literatures.

CONCLUSION: The amount of keratoconus literatures in China and abroad show an upward trend, and keratoconus is still a hot spot of research. A major factor affecting the growth of foreign literature of keratoconus is the inherent discipline of its own development, but the major factor affecting the growth of the domestic literature of keratoconus is the environmental condition in which the subject develops.

Abstract:AIM: To explore the effect of evidence-based medicine(EBM)on the critical thinking ability of medical postgraduates.

METHODS: A total of 300 medical postgraduates were selected by cluster sampling method as participants. The average total score of critical thinking ability and average scores of each critical thinking disposition were measured before and after EBM by using critical thinking disposition inventory Chinese version(CTDI-CV), and the differences of scores were compared.

RESULTS:The total score of CTDI-CV was more than 280 before and after EBM, which showed positive critical thinking ability. Total score of CTDI-CV significantly increased after EBM conducted(t=5.520, P<0.001). The total score of CTDI-CV for postgraduates with different gender, age, education background before college entrance, understanding EBM or not, and whether having clinical work experience or not, increased to one degree or another. The scores of 7 items of CTDI-CV were higher after EBM was carried out. The aspects of open-mindedness, analyticity, systematicity and inquisitiveness increased significantly(P<0.001). However, there were no significant difference for aspects of truth seeking(t=0.630, P=0.529), critical thinking self-confidence(t=0.509, P=0.612)and cognitive maturity(t=1.767, P=0.079).

CONCLUSION:EBM can sufficiently mobilize the students' positivity and activeness, and improve the critical thinking ability. The questioning ability of students should be strengthened and the self-confidence should be cultivated in later teaching to give full play to advantages of EBM.

Abstract:AIM: To observe the clinical effect of 3.2mm incision manual fragmentation cataract extraction combined with intraocular lens(IOL)implantation in cataract.

METHODS: The observation group: 78 patients(95 eyes)with senile cataract in our hospital underwent 3.2mm incision and manual extraction combined with IOL implantation in nucleus cataract; the control group: 82 cases(100 eyes)with senile cataract underwent phacoemulsification and foldable IOL implantation. Operation complications and the recovery of postoperative visual acuity were observed.

RESULTS: The patients in the observation group, 2 eyes(2.1%)of posterior capsule rupture, 3 eyes(3.2%)limitations zonule; postoperative range of mild to moderate corneal edema and opacity in 18 eyes(18.9%), within one week of the flare in 22 eyes(23.2%). The control group was in 3 eyes(3.0%)happened posterior capsule rupture, 4 eyes(4.0%)limitations zonule; mild to moderate edema of corneal opacity in 21 eyes(21.0%), within one week of the flare in 26 eyes(26.0%). The two groups were no elastic membrane detachment, anterior chamber hemorrhage, wound leakage and infection. The two groups had no statistically significant difference in complication(P>0.05). The two groups had no statistically significant difference in postoperative visual acuity(P>0.05).

CONCLUSION: 3.2mm incision manual nucleus cataract extraction and IOL implantation operation is safe and convenient, has the advantages of small incision operation, suitable for clinical promotion and popularization.

Abstract:AIM: To evaluate the changes of vault and contrast sensitivity after implantable collamer lens(ICL)implantation in high myopia.

METHODS: The clinical data of 15 patients(30 eyes)were collected. The patients' average age was 28.0 years(from 20 to 40 years). Preoperative spherical refraction was(-6.50 to -22.50)D(mean -11. 05±2.50)D. The vault was measured with optical coherence topography(OCT), after operation 6mo, 1, 2, 3a; and the contrast sensitivity function was measured with vision testing instrument after operation 1 and 3a.

RESULTS: The results revealed that the vault was decreased after operation 6mo which was the highest. There was statistical difference between 6mo and 3a. While the contrast sensitivity was no statistical difference after operation between 1a and 3a and was all in the normal value.

CONCLUSION: The vault was decreased after ICL implantation in high myopia with years, but the contrast sensitivity was no obvious change. A long-time observation for the vault and contrast sensitivity should be performed.

Abstract:AIM: To investigatethe clinical effects of phacoemulsification and intraocular lens implantation for high myopia combined with cataract.

METHODS:Selected from January 2012 to December 2013, 82 patients(96 eyes)with high myopia combined with cataract in our hospital as study group. The patients were divided into control group and study group randomly. There were 40 patients(46 eyes)in control group. There were 42 patients(50 eyes)in study group. The patients in control group were treated with small incision extracapsular cataract extraction and intraocular lens implantation. The patients in study group were treated with phacoemulsification and intraocular lens implantation. The visual acuity, best-corrected visual acuity and complications of corneal edema, posterior capsule opacification and increasing intraocular pressure of the patients in two groups were compared and analyzed. The patients' fundus stations were checked in study group after surgery.

RESULTS: Compared with control group, the patients in study group after treatment, the ratio of uncorrected visual acuity from 0.1 to 0.5, 0.5 to 1.0, 1.0 to 1.5 were increased significantly. There was no statistically significant(P<0.05). Compared with control group, the patients in study group after treatment, the ratio of best-corrected visual acuity from 0.1 to 0.5 was decreased significantly, only 28%, and the ratio of best-corrected visual acuity from 0.5 to 1.0 and 1.0 to 1.5 were increased significantly, up to 58% and 14%, there was statistically significant(P<0.05). Compared with control group, the patients in study group the incidence of complications of corneal edema, posterior capsule opacification and intraocular pressure were decreased, and the incidence of corneal edema was increased significantly, there was statistically significant(P<0.05).

CONCLUSION:Phacoemulsification and intraocular lens implantation has positively significant for improving best-corrected visual acuity effectively and reducing complications of the patients with high myopia combined with cataract.

Abstract:AIM: To observe the efficacy of posterior neodymium:YAG(Nd:YAG)laser capsulotomy in patients with late capsular block syndrome(CBS)with posterior capsule opacification(PCO).

METHODS: The CBS 13 cases(18 eyes), which were identified as CBS with posterior capsule opacification, were treated with Nd:YAG laser capsulotomy. After changes of uncorrected distance visual acuity(UCDVA), intraocular pressure(IOP), aqueous humor, vitreous body and complications were observed after 1, 4, 24h; 1, 2wk postoperation.

RESULTS: Nd:YAG laser treatment of late CBS could improve patients' UCDVA. Some patients appeared anterior chamber particles, but did not cause inflammation. Some patients appeared a transient elevation of IOP after 1, 4, 24h, even needed treatment. But these changes were not statistically significant. All patients occurred the increase of vitreous opacities and floating shadow, but all recovered in 2wk.

CONCLUSION: Nd:YAG laser capsulotomy in patients with PCO associated with late CBS can increase visual acuity, but ophthalmologist should closely observe IOP and anterior chamber inflammation of patients, in order to provide prompt treatment.

Abstract:AIM: To evaluate the relationship between clinical tests(traditional and new)\〖lid-wiper epitheliopathy(LWE), lid-parallel conjunctival folds(LIPCOF)\〗 and dry eye symptoms after 3mo of phacoemulsification. The combination of these tests can improve predictive ability for the development of dry eye symptoms.

METHEDS: Tear film was monitored in 43 patients(43 eyes)afterphacoemulsification. A new clinical test was used to evaluate the dry eye symptoms after surgery. Tear meniscus height(TMH), LIPCOF, phenol red thread test(PRTT), corneal and conjunctival staining and LWE grades were observed. The results were analyzed by using SPSS 19.0. Symptoms were assessed by using the ocular surface disease index(OSDI).

RESULTS:LWE was significantly correlated to nasal nasal and temporal side LIPCOF(P<0.05). LIPCOF and LWE were significantly correlated to NIBUT and PRTT(P<0.01). Significant correlations were found between TMH and PRTT(P<0.01). OSDI scores were significantly correlated to TMH, PRTT, LIPCOF and LWE(P<0.05). Significant discriminators of OSDI+/- were nasal LIPCOF \〖area under the receiver operating characteristic curve(AUC)(0.803), TMH(0.706), PRTT(0.755), LIPCOF(temporal/sum, 0.725/0.763)and LWE(0.727), etc\〗. Best predictive ability was achieved by nasal LIPCOF.

CONCLUSION: The individual tests TMH, PRTT, LIPCOF and LWE were significantly but moderately related to OSDI scores.

Abstract:AIM: To observe the efficiency of the anterior chamber forming combined with draining out suprachoroidal fluid on ciliochoroidal detachment after glaucoma filtering operation.

METHODS: Totally 95 cases(95 eyes)diagnosed of ciliochoroidal detachment after glaucoma filtering operation were treated with anterior chamber forming combined with draining out suprachoroidal fluid surgery. Intraocular pressure, visual acuity, anterior chamber depth and choroidal gap measured by ultrasound biomicroscopy were observed after operation.

RESULTS: Intraocular pressure, visual acuity, anterior chamber depth and ciliochoroidal gap were observed after operation. The curative ratio of anterior chamber forming with draining out suprachoroidal fluid surgery was 86%, while the effective ratio was 96%.

CONCLUSION: The anterior chamber forming combined with draining out suprachoroidal fluidis an effective way of the treatment of ciliochoroidal detachment after glaucoma filtering operation.

Abstract:AIM:To investigate the treatment of ocular trauma with anterior chamber hyphema.

METHODS: According to the analysis of 55 cases of ocular trauma with anterior chamber hyphema patients with clinical manifestations, treatment and tracking analytics, the clinical efficacy were retrospectively analyzed and summarized.

RESULTS: After the treatment of hyphema absorption in 41 cases, accounting for 75%, not completely absorbed, visual acuity before admission improved but less than 0.8 in 10 cases, accounting for 18%, appeared blood staining of cornea in 2 cases, accounting for 4%, 2 cases of secondary glaucoma, accounting for 4%.

CONCLUSION: Eye traumatic hyphema, according to the amount of bleeding and the extent of the injury symptoms, takes a comprehensive treatment approach, appropriate selection of operation indication, can achieve good effect, save sight.

Abstract:AIM: To discuss the drug resistance and sensitivity of broad-spectrum antibiotics about the pathogens that resulting in infectious endophthalmitis.

METHODS: The vitreous bodies of 15 patients were extracted in our hospital during the operation of infectious endophthalmitis after their cataract operation and then did the etiological examination and analyzed the results.

RESULTS: The anterior chamber aqueous and vitreous bodies of the 15 patients were collected during the operation and did the bacterial culturing and drug sensitivity tests. Seven of the 15 cultured pathogenic bacteria. Positive rate of the bacterial culture was 46%(1 fungus, 3 staphylococcus epidermidis, 1 staphylococcus lentus, 1 coagulase negative staphylococcus, 1 aerococcus viridians). Eight of the 15 didn't culture any bacteria. Three staphylococcus epidermidis and 1 staphylococcus lentus among the positive cases showed resistance to levofloxacin in the drug sensitivity test and the MIC were all more than 4. In addition 1 coagulase negative staphylococcus and 1 aerococcus viridians showed sensitivity to levofloxacin and the MIC were all less than 2. Vancomycin and rifampicin were sensitive antibiotics and the MIC were all less than 1.

CONCLUSION: Most medical institution use levofloxacin as the prophylactic therapy routinely in inner eye operation, but this article questions this phenomenon. It's common that clinicians use drugs to resist pathogens by their experiences. When pathogens show drug resistance, empirical medication will lead to worse treatment effect or even much worse consequence without bacterial culturing and drug sensitivity tests. So it's right to choose the antibiotics according to the results of the bacterial culturing and drug sensitivity tests properly and timely. It's the first choice of standard treatments to adjust the therapeutic regimens timely.

Abstract:AIM:To analyze clinical feature and imageology characteristic of orbital neurogenic tumors, and to guide clinical diagnosis and treatment.

METHODS: Collecting clinical cases, imageology characteristic and clinical feature of four kinds of common orbital neurogenic tumors were analyzed retrospectively.

RESULTS: Orbital neurogenic tumors had each feature on the aspect of clinical manifestation and imageology characteristic.

CONCLUSION:By means of analyzing clinical feature and imageology characteristic of orbital neurogenic tumors to guide clinical diagnosis and treatment of this kind of diseases.

Abstract:AIM: To observe the operation method and clinical effect of fresh amniotic with lip mucous transplantation for exposure of orbital implant.

METHODS: Twenty-four cases suffered from exposure of orbital implant were treated with transplantation of fresh amnion and lip mucous. We observed the implants exposure or infection.

RESULTS: The conjunctival sac was shaped well. No implants exposed or infected.Patients were basically satisfied.

CONCLUSION: Fresh amnion with lip mucous transplantation is an ideal method to treat exposure of orbital implant.

Abstract:AIM: To evaluate the postoperative reaction and corneal wound healing of patients wearing therapeutic soft contact lenses after the Pterygium surgery.

METHODS: Totally 100 eyes of 88 patients with unilateral primary pterygium who underwent simple excision combined with conjunctival autograft transplantation were randomly divided into treatment group and control group(each 50 eyes). In treatment group, patients were asked to wear therapeutic soft contact lenses after the surgery while pressure bandage was performed at 2d postoperatively in control group. Antibiotic eye drops and drops to promote the corneal wound recovery were given to all patients, and then irritation symptoms and the recovery level of corneal wound were observed.

RESULTS: Healing speed of the patients' corneal wound in treatment group was faster than the control group after the surgery. At the same time, it had alleviated the corneal irritation symptoms effectively and shortened the duration compared with the control group.

CONCLUSION: Wearing therapeutic soft contact lenses after pterygium surgery can accelerate corneal wound recovery and alleviate the eye irritation symptoms effectively, as well as improve work efficiency of the medical staff. It is worthy of popularization and application.

Abstract:AIM: To analyze the difference of ocular manifestations in Sjögren's syndrome(SS)of different age groups and different disease courses. And investigate whether SS is correlated with tear dysfunction and ocular surface disorder.

METHODS: Retrospective analysis of 80 patients(160 eyes)with SS. The cases were divided into three groups according to the course. Group A: course of disease ≤1a. Group B: course of disease from 1 to 2a; Group C: course of disease >2a. At the same time, cases were divided into four groups according to the age, group A: 15-30 years old; Group B: 31-45 years old; Group C: 46-60 years old; Group D: 61-75 years old. The data including the staining of cornea fluorescein(CF), the tear break-up time(BUT), Schirmer Ⅰ test(SⅠt)and the occurrence of dry eye were collected and compared.

RESULTS: Prevalence of dry eye with SS was 36%, significantly higher than the general population. The prevalence of dry eye increased with increasing age(χ²=10.66, P=0.014)and extension of course(χ²=20.127, P=0.000), the secretion of tear decreased with increasing age(H=2.575, P=0.462)and extension of course(H=7.356, P=0.025)and the tear film break-up time become shorter with increasing age(H=11.932, P=0.008)and extension of course(H=12.969, P=0.002), the degree of staining with fluorescin on the cornea increased with increasing age(H=14.068, P=0.003)and extension of course(H=16.060, P=0.000).

CONCLUSION: Patients with SS are susceptible persons of the dry eye. The ocular surface disease in SS is characterized by a disorder of tear quantity and quality, decreased tear film stability, decreased secretion of the tear, staining with fluorescin on the cornea. The correlation of these changes and age and course is positive. BUT, SⅠt and CF should become routine tests of ophthalmology in SS.

Abstract:AIM: To analyze the reasons of dacryocystorhinostomy failure and the corresponding managements.

METHODS: From August 2003 to February 2013, 34 patients(34 eyes)who had a previous failed dacryocystorhinostomy were re-operated in my hospital. This paper analyzed the reasons of operation failure, discussed corresponding managements. The postoperative follow-up time was from 6mo to 4a. Success of the operation was achieved in 33 of these 34 eyes, not effect in 1 eye.

RESULTS: The main reasons of the failure of dacryocystorhinostomy were: anastomotic granulation tissue congestion, bone hole locations were not correct, intraoperative bleeding, bone holes were too small, the decryocysts were un-incision.

CONCLUSION: Preoperative perfect relevant examination, intraoperative careful operation, reducing intraoperative bleeding, making the perfect size and location bone hole and lacrimal duct flushing on time can reduce the occurrence of failure. Re-operation of dacryocystorhinostomy is effective in these patients who had a previous failed dacryocystorhinostomy.

Abstract:AIM: To compare the cyclopentolate hydrochloride eye drops and atropine ophthalmic gel in 12 years old of the following children with hyperopia mydriatic optometry results, in order to assess cyclopentolate hydrochloride drops of clinical value to use eye drops in hyperopia refraction.

METHODS: Fifty-one cases(102 eyes), aged 2-12 years old children with hyperopia, first with 10g/L cyclopentolate hydrochloride eye drops 5 times continuously after optometry, interval of 1d, with 10g/L atropine sulfate eye 3d mydriatic optometry gel for eyes. Analysis and comparison of two kinds of cycloplegic refraction in different groups of optometry results and systemic adverse reactions.

RESULTS: Thirty-one eyes with gentle hyperopia refraction results were no statistical difference(P>0.05), 39 eyes with moderate hyperopia refraction results were no statistical difference(P>0.05), 32 eyes with high myopia refraction results were no statistical difference(P>0.05). Systemic adverse reactions of the 10g/L cyclopentolate hydrochloride eye drops were 2%, 10g/L atropine eye gel systemic adverse reaction rate was 8%.

CONCLUSION:Cyclopentolate hydrochloride eye drops is a new cycloplegic with fast onset, strong action, short duration, safe and effective, which can be wildly used clinically.

Abstract:AIM:To investigate the stereoscopic vision and its damage in children with different types of amblyopia, in order to improve the curative ratio of amblyopia in clinic.

METHODS: Totally 321 children with different types of amblyopia from Hunan Children's Hospital were enrolled in this study. Distance stereoacuity was examined with synoptophore and random dot stereogram. Approximation zero disparity, crossed disparity and uncrossed disparity were examined with Yan's stereogram. All the datum were statistically analyzed.

RESULTS: The differences of approximation zero disparity, crossed disparity, uncrossed disparity and distance stereoacuity among each type of amblyopia group was statistically significant(P<0.05). The prevalence of stereopsis in strabismic amblyopia group and form-deprivation amblyopia group was lowest, but there was no significant difference between the two groups(P>0.05). The prevalence of stereopsis in ametropic amblyopia group was highest, and that in anisometropic amblyopia group was inferior.

CONCLUSION: All types of amblyopia can affect the development of stereoacuity in children. Strabismic amblyopia and form-deprivation amblyopia makes the greatest impact on children's stereoacuity; while the ametropic amblyopia makes the smallest impact on children's stereoacuity. The key to consolidate the curative effect of amblyopia is to pay attention on re-building the stereopsis.

Abstract:AIM: To research the impact ofdouble astigmatism axial incisions on different kinds of corneal astigmatism.

METHODS: Forty-six cases of cataract patients were collected and divided into two groups A, B according to Polar K. Group A had 20 cases(20 eyes)and group B had 26 cases(26 eyes). Detected by Orbscan, the corneal Polar K of the group A was more than 1.5 and the Polar K of group B was less than 1.5. Double astigmatism axial incisions were performed on all patients, and all cataract operations with phacoemulsification with intraocular lens implantation were implemented by the same physician. The preoperative and postoperative changes of corneal astigmatism between two groups were observed.

RESULTS: In group A, the comparisons of Polar K preoperative and postoperative had significant statistical significance. Double astigmatism axial incisions decreased about 1.3 corneal Polar K after 1mo compared with pre-operative. In group B, the comparisons of Polar K at 2wk after operation had statistically significance. The comparisons of Polar K preoperative and at 2wk after operation had statistically significance between two groups.

CONCLUSION:Double astigmatism axial incisions have strong astigmatism corrective action to high Polar K eyes and almost no corrective action to the low Polar K eyes. But it does not increase postoperative corneal Polar K.

Abstract:AIM: To evaluate ocular condition of college teachers, so that to discuss the importance of preventive health care and early treatment of ophthalmopathy.

METHODS: By reviewing the physical examination reports from 1 241 both serving and former college teachers in Chongqing Medical University, which including visual acuity, slit lamp examination, fundus examination, non-contact intraocular pressure and OCT. The results were analyzed by using statistical analysis software SPSS 19.0 and compared with the other occupational groups.

RESULTS: Totally 1119 cases(90.17%)in 1241 suffered from eye disease, including conjunctivitis(615 cases, 49.56%), conjunctival concretion(434 cases, 34.97%), cataract and post-cataract surgery(351 cases, 28.28%), fundus arteriosclerosis(326 cases, 26.27%), ametropia and post-refractive surgery(330 cases, 26.59%), maculopathy(160 cases, 12.89%).

CONCLUSION: High prevalence of eye diseases are observed in all age groups of college teachers, so that great importance should be attached to early detection and treatment.