Abstract:AIM:To evaluate the 12mo results of intravitreal bevacizumab injection on central macular thickness(CMT)and visual acuity in the treatment of macular edema(ME)secondary to branch retinal vein occlusion(BRVO).

METHODS:Thirty-two patients who underwent intravitreal bevacizumab(Altuzan^®)0.125mg/0.05mL injection for ME secondary to BRVO at least 12mo follow up period have been studied respectively. Patients with diagnosis of ME secondary to BRVO were applied an ophthalmic examination, CMT measurement, and fluorescein angiography, so patients whose CMT above 250μm were offered intravitreal bevacizumab treatment. Patients who had macular ischemia on fluorescein angiography, neovascularisation elsewhere secondary to other types of diseases, received any intraocular treatment before(such as laser treatment, intravitreal injection or eye surgery)have been out of trial. Data of logMAR best corrected visual acuity(BCVA)and CMT in control visits have been evaluated. For statistical analysis Student's paired t-test was used by Minitab15.0 software and a P-value <0.05 was considered as statistically significant.

RESULTS: Mean logMAR BCVA changes and mean CMT changes were statistically significant compared to pre-injection values at last visit(P<0.01). Mean BCVA increment was 0.477±0.235, mean CMT decline was 257.906±88.865 compared to pre-injection at last visit. Ten(31%)of the patients had a positive response with a single injection and no recurrence of ME for a mean of 12.6±0.66mo. Five(15.6%)patients received injection two times and 17(53%)patients more than 3 injections. Mean injection per eye was 2.18±0.91(1～4)respectively. Recurrence of ME was seen aproximately in 2.45±0.63mo at the first control, 2.58±0.66mo at the second control and 3.17±0.48mo at the third control respectively. Five(15.6%)of the patients needed multiple injections for reducing ME whereas visual acuity gain was not achieved as ME reduced in those patients.

CONCLUSION: Treatment of ME secondary to BRVO with intravitreal bevacizumab seems effective, fast, safe, and commonly performed treatment. In order to achieve this lasting effect, we have to strengthen this post treatment non-edematous status by lasers or long lasting agents. Retinal venous circulation and ME must be observed on fluorescein angiography rather than making frequent injections. Reinjections must be done according to the clinical status of ME and the prediction of visual acuity gain.

Abstract:AIM:To seek a small interfering RNA(siRNA)sequence targeting rat inhibitor of nuclear factor kappa B α(IκBα)that can specifically and effectively suppress IκBα mRNA expression of rat ciliary muscles in vivo.

METHODS:Three IκBα specific double stranded siRNAs were designed and synthesized. They were transfected into rat A7r5 cells which express IκBα gene. Flow cytometry was used to assess transfected efficiency. The mRNA and protein levels of IκBα were examined by Real Time quantitative polymerase chain reaction(Real Time-PCR)and western blot to screen a candidate valid sequence with the highest inhibitory rate. The Cy3 labeled non-specific control siRNA or the candidate valid siRNA was then injected into rat anterior chamber. Distribution of Cy3-siRNA in rat ciliary muscles was viewed by fluorescence microscopy, and the inhibitory effect in vivo of the valid siRNA was identified via Real Time-PCR and immunofluorescence.

RESULTS: The suppression effect of the siRNA targeting the CTACGATGACTGTGTGTTT of IκBα gene was most obvious by vitro screening. By anterior chamber injection, this valid siRNA could reach rat ciliary muscles and effectively suppress IκBα gene expression with the highest inhibitory rate of 59.0% on mRNA level at 24h after RNAi, and 52.3% on protein level at 72h after RNAi(P<0.01).

CONCLUSION: It proves that the siRNA targeting the CTACGATGACTGTGTGTTT of IκBα gene is the valid sequence to suppress rat IκBα expression of ciliary muscles by RNAi in vivo.

Abstract:AIM: To observe the situation of rat retinal tissue DNA damage at early diabetic period, discuss the role of the blood glucose fluctuations, and provide a new method for studying the pathogenesis of diabetic retinopathy(DR).

METHODS: SD rats were randomly divided into four groups: normal control group(NC), normal fluctuation group(NF), diabetes group(DM)and diabetes fluctuation group(DF). Diabetic models were established through intraperitoneal injection of STZ. A certain amount of glucose was injected in the rats of group NF and DF in an intraperitoneal mode three times a day after the model was established, thereby causing blood glucose fluctuations. Rats were killed and the retinal tissues were taken in the 8th week. Single cell gel electrophoresis(SCGE)technique was adopted for detecting DNA injury extent in the retina tissue.

RESULTS:Groups NF and DF showed significant and regular fluctuations. The curve of blood glucose fluctuations was relatively stable. All values of MBG, SDBG, LAGE and M were significantly increased compared with group NC. Group DF was increased more significantly. It was statistically significant(P<0.01). SCGE showed that there were DNA damages in different levels in the cells of group NF, DM and DF. Indicators of cells such as TL, TDNA%, TM, OTM were higher than that in group NC. It was statistically significant(P<0.01). The comparison difference between two groups was also significant(P<0.01).

CONCLUSION: Rat retinal tissues have DNA injury during early diabetic period. DNA injury is gradually aggravated with blood glucose fluctuation. It indicates that high blood glucose and blood glucose fluctuation are involved in the mechanism of cell DNA injury, and they may be one of DR early event, have played a certain role in the incidence of DR.

Abstract:AIM:To observe the inhibition effect of endostatin(endostar)on mice choroidal neovascularization model(CNV)and compare with the Avastin.

METHODS: Using 532nm laser photocoagulation to establish a mouse model of CNV. We observed the formation of CNV by histopathological examination after 2wk later. Forty successful models of mice were randomly divided into control group(group 1, 10 rats), normal saline group(group 2, 10 rats), endostatin group(group 3, 10 rats)and avastin group(group 4, 10 rats). The drugs were injected into the mice' vitreous after photocoagulation 2wk later. Then 1wk later, we took the mice eyeballs to perform the HE and immunohistochemical staining to observe. The statistical analysis of ANOVA was done by SPSS 16.0 and the LSD-t test was used for multiple samples, taking P<0.05 as the test standards.

RESULTS: Two weeks later, HE histopathological examination was done, light microscope showed large amount of new vessels' formation, the positive rate for CNV was 72.8%. The blank control group compared with the normal saline group P>0.05, had no inhibitory effect on CNV; endostatin treated group compared with control group, P<0.05, had a certain inhibitory effect; avastin group compared with the control group, P<0.05, had an inhibitory effect on CNV; the LSD-t was performed on Avastin group and endostatin group, P<0.05, which were statistically significant. We thought that the two drugs have different inhibitory effect on mice' CNV, because (-overx)_Avastin =26.90,(-overx)_endostatin=29.13,(-overx)_Avastin<(-overx)_endostatin, we can infer that endostar had lower inhibitory effect on mice CNV than Avastin.

CONCLUSION: Laser-induced CNV animal models of colored mice C57BL/6J is of short time and high rate establishment and it is an ideal model for CNV study. Endostar has certain inhibitory effect on CNV, and it is likely to become one of the important drugs for CNV-related diseases in the future.

Abstract:AIM:To observe the expression of tumor necrosis factor- alpha(TNF-α)and its receptor I(P55)in different pterygium and discuss the role of TNF-α and receptor I(P55)in pterygium.

METHODS: Immunohistochemistical staining method(PV)was adopted to detect the expression of TNF-α and receptor I in pterygium(72 eyes)and para-pterygium conjunctival tissue(30 eyes). The relationship between the expression and clinical-pathological parameters was also analyzed.

RESULTS: The positive rates of TNF-α were 65.3%(47/72), 26.7%(8/30)in pterygium and para-pterygium conjunctival tissue. The positive expression of TNF-α had statistic difference between the two groups(χ²=12.706, P<0.01). The positive rates of TNF-α receptor I were 56.9%(41/72), 16.7%(5/30)in pterygium and para-pterygium conjunctival tissue. The positive expression of P55 had statistic difference between the two groups(χ²=13.875, P<0.01). The positive rate of TNF-α in recurrent pterygium group was higher than primary pterygium group(χ²=6.547, P=0.011). There had no statistically significance of the expression intensity between the two groups(F=1.288, P=0.393); the positive rate in advanced pterygium group was higher than quiescent pterygium group(χ²=4.082, P=0.043). The expression intensity had no statistically significance between the two groups(F=0.489, P=0.708). The positive rate of P55 in recurrent pterygium group was higher than primary pterygium group(χ²=9.907, P=0.002). There had no statistically significance of the two group's expression intensity(F=1.175, P=0.424); the positive rate in advanced pterygium group was higher than in quiescent pterygium group(χ²=11.140, P=0.001). The expression intensity had no statistically significance between the two groups(F=0.665, P=0.621).

CONCLUSION:The expression of TNF-α and P55 are changing according to the development of clinical staging and onset. The expression of TNF-α and P55 may be related to clinical classification, staging and patient's working conditions of pterygium. There has no significant difference expression intensity of TNF-α and P55 in clinical staging and onset of pterygium.

Abstract:AIM:To understand the relation between the penetrating keratoplasty rejection and the methods of cornea preservation.

METHODS: The 30 Wistar rats as donator and 60 SD rats as receptor were used to establish the animal models of penetrating keratoplasty rejection. And 60 SD rats were randomly divided into 3 groups. Donor cornea of Wistar rats preserved in different methods were used separately in 3 groups. The penetrating keratoplasty rejection index(RI), means survival time(MST)of corneal grafts and pathological changes in post-operation were analyzed.

RESULTS: The MST was(10.4±1.70)d in moist-chamber-preserved group(Ⅰ),(12.9±1.81)d in medium-term-preserved group(Ⅱ)and(16.1±2.57)d in cryopreserved group(Ⅲ). The MST in the cryopreserved group was evidently prolonged, showing a significant correlation compared with other two groups(P<0.01). The sections with HE staining revealed that the severity of inflammation in Ⅲ group was reduced compared with that of Ⅰ,Ⅱ group after 10d of keratoplasty.

CONCLUSION: The postoperative rejection of penetrating keratoplasty in rats is decreased and rejection time is delayed in cryopreserved cornea.

Abstract:AIM: To explore the feasibility of culturing human umbilical vein endothelial cells(HUVEC)on acellular corneal stroma and performing the posterior lamellar endothelial keratoplasty(PLEK)treating corneal endothelial decompensation.

METHODS: Thirty New-Zealand rabbits were divided into three groups randomly, 10 rabbits for experimental group, 10 for stroma group and 10 for control group. Corneal endothelial cells were removed to establish animal model of corneal endothelial failure. PLEK was performed on the rabbits of experimental group and stroma group, and nothing was transplantated onto the rabbits of control group with the deep layer excised only. Postoperative observation was taken for 3mo. The degree of corneal edema and central corneal thickness were recorded for statistical analysis.

RESULTS: Corneas in experimental group were relieved in edema obviously compared with that in stroma group and the control group, and showed increased transparency 7d after the operation. The average density of endothelial cells was 2 026.4±129.3cells/mm², and average central corneal thickness was 505.2±25.4μm in experimental group, while 1 535.6±114.5μm in stroma group and 1 493.5±70.2μm in control group 3mo after operation.

CONCLUSION:We achieved preliminary success in our study that culturing HUVEC on acellular corneal stroma and performing PLEK for corneal endothelial decompensation. HUVEC transplanted could survive in vivo, and have normal biological function of keeping cornea transparent. This study provides a new idea and a new way clinically for the treatment of corneal endothelial diseases.

Abstract:AIM: To observe the pathological changes of the lower segment of nasolacrimal duct mucosa in rabbits at different stages after retrograde lachrymal dilated drainage tube implantation.

METHODS: Totally 14 New Zealand rabbits were used in the present study. One side of nasolacrimal duct was obstructed to produce an experimental model and operated the reverse implantation of nasolacrimal duct intubation. Histological changes of the lower segment of nasolacrimal duct mucosa were observed by routine light microscope at 2, 4, 6, 8, 10, 12 and 14wk after the operation.

RESULTS: Compared with the control side, the group of 2 and 4wk after surgery presented the inflammatory cytokine. The group of 12wk after the operation presented isolated granuloma. Group 12 and 14wk presented scattered granuloma. The size of the granulomas was smaller and the density of epithelioid cell and fibroblast were lower in group 12wk than those in group 14wk by HE and Masson trichrome stain.

CONCLUSION: Recurrent Silicone Tube is used to treat nasolacrymal duct obstruction. Nasolacrimal duct can be narrowed and blocked again by granuloma, progressive fibrosis and adhesion of surrounding tissues when tube is in the duct more than 12wk.

Abstract:AIM: To evaluate the safety and efficacy of intravitreal bevacizumab(avastin)injection in patients with exudative age related macular degeneration(AMD).

METHODS: The records of patients treated with intravitreal injection of 1.75mg bevacizumab for AMD were retrospectively reviewed. All patients were evaluated by complete ophthalmic examination, optical coherence tomography and fundus fluorescein and/or indocyanine green angiography. Observation was made on the best corrected visual acuity(BCVA), intraocular pressure, and the changes of lens, vitreous, central retinal thickness(CFT)and total macular volume(TMV), at 1d, 3d, 7d, 1mo and 6mo after the treatment and then compared with those of pre-operation. Repeated treatment with intravitreous bevacizumab occurred if there were signs of persistent or recurrent exudation. And all cases were followed up at least 6mo. An intravitreal injection of bevacizumab(1.75mg)was given once every 6wk.

RESULTS: All 50 eyes of 48 patients with the average of 58±20.46 years old were included. The mean baseline of BCVA and CFT were 0.82±0.53, and 364.97±151.83μm respectively. Although there was no significant decrease in mean CFT and TMV one week after the injection, the mean BCVA had significant improvement. At the last visit of 9.7mo follow-up, BCVA, CRT and TMV showed significant improvements over baseline values. BCVA was improved by at least two lines in 32 eyes(64%),remained stabilization in 18 eyes(36%)at the last visit. A total of 98 injections were performed and the average number of injections was 1.98 for each eye in the group. About 50% of re-injections gained at least two lines of vision improvement one week postoperatively. There were no serious adverse events during the treatment.

CONCLUSION: Intravitreal bevacizumab(avastin)injection for managing CNV due to age-related macular degeneration is safe and few side effects. Intravitreal avastin associated with improvement in visual acuity(VA), which can reduce macular edema and choroidal neovascularization leakage.But a prolonged treatment effect needs further observation.

Abstract:AIM:To study the effect of posterior sub-Tenon's capsule injection of triamcinolone acetonide(TA)in treatment of patients with diffuse diabetic macular edema(DME)before panretinal photocoagulation(PRP).

METHODS:Retrospective analysis of the clinical data of 96 cases(96 eyes)with DME treated in our hospital from October 2008 to May 2012, and the patients were divided into the study group and control group, each group with 48 cases(48 eyes), the control group were only treated with PRP, and for the study group, TA was injected one week before PRP. At 6mo after treatment, best-corrected visual acuity(BCVA)and retinal thickness changes of two groups were compared, the changes of intraocular pressure in two groups was analyzed.

RESULTS:After treatment, two groups were followed up for 6mo, compared with before treatment, the expression of BCVA in control group was reduced, and rise in the study group, with significant difference between the two groups(P<0.05), and during the follow-up period, IOP change was in the normal range for the two groups, with no the difference(P>0.05), the study group had foveal thickness reduction of 9.6μm, the control group was increased by 31.9μm, with significant difference(P<0.05), parafoveal thickness in the study group decreased 5μm, significantly increased 22.1μm in the study group, centre concave surrounding thickness increased 0.4μm in study group and 19.4μm for the control group, with no significant difference(P>0.05).

CONCLUSION:TA injection in patients with diffuse DME before PRP is safe and effective, and it is superior to simple PRP therapy, and it can be applied in primary hospital.

Abstract:AIM:To observe the changes of macular thickness in patients after cataract operation.

METHODS: A total of 126 patients(133 eyes)were divided into two groups that were included in this study. The group(68 eyes of 64 case)with phacoemulsification combined intraocular lens implantation and(65 eyes of 62 cases)with manual small incision cataract surgery(MSICS). There was no complication before and during the surgery. Optical coherence tomography(OCT)was examined 1, 3mo before and after surgery. The visual acuity and macular thickness were compared after surgery. The SPSS 17.0 software was used for statistical analysis. The paired t-test was used before and after surgery. Independent-samples t test was used in two groups before and after surgery, α=0.05.

RESULTS: The cataract phacoemulsification group: preoperative and 1mo after surgery, the mean macular thickness was 241.3±10.9μm and 279.7±16.5μm,with significant difference(P<0.01). The mean macular thickness was 245.6±12.6μm 3mo after surgery without statistical difference compared with preoperative(P>0.05). The mean macular thickness was 279.7±16.5μm 1mo after surgery and 245.6±12.6μm 3mo after surgery with statistical difference(P<0.05). Three eyes displayed cystoid macular edema at 1mo after surgery and 2 eyes of them was resolved 3mo after surgery. The group of MSICS: preoperative and 1mo after surgery, the mean macular thickness was 240.5±11.9μm and 280.7±16.8μm,with significant difference(P<0.01).The mean macular thickness was 246.6±13.2μm 3mo after surgery without statistical difference compared with preoperative(P>0.05). One month after surgery and 3mo after surgery, the mean macular thickness were 280.7±16.8μm and 246.6±13.2μm, with statistical difference(P<0.05). Two eyes displayed cystoid macular edema at 1mo after surgery and 2 eyes were resolved 3mo after surgery. Between the two groups pre-operation or after operation for 1, 3mo respectively P values were without statistical difference(P>0.05).

CONCLUSION: The macular thickness and macular edema can be found 1mo after cataract phacoemulsification and MSICS. Three months post-operatively, macular edema disappears and does not show statistical difference compared with preoperative. The increase of macular thickness has no obvious relationship with the choice of surgery.

Abstract:AIM: To observe the therapy effect of standard prescription on ametrop amblyopia in hyperopic children.

METHODS: This study included 270 cases(54 eyes)with complete data, and followed up 24mo. All the amblyopic children were given standard prescription and were divided into progressive addition glass group, under corrected group and full corrected group. And all were observed for their therapy effect and the average healing time in low hyperopic, moderate hyperopic and high hyperopic children with ametropic amblyopia respectively.

RESULTS: In low hyperopic children, the difference of the therapy effect of the three corrected methods were insignificant in two years. The meam cure time of the three corrected methods were(7.33±2.11)mo in progressive addition glass group;(9.0±3.71)mo in under corrected grope;(12.5±5.17)mo in full corrected group. Three groups of independent samples by paired t-test showed: the difference between progressive addition glass group and under corrected grope(t=1.66, P>0.05)was statistically insignificant; the difference between progressive addition glass group and full corrected grope(t=3.92, P<0.01)was statistically significant; the difference between under corrected grope and full corrected grope(t=2.33, P<0.05)was statistically significant. In moderate hyperopic chileren, the differences of the therapy effect of the three corrected methods were significant in two years(χ²=6.75; P<0.05). The difference between progressive addition glass group and under corrected grope(χ²=6.3; P<0.01)was statistically significant; the difference between progressive addition glass group and full corrected grope(χ²=8.1; P<0.005)was statistically significant. The mean cure time of the three corrected methods were(14.0±4.87)mo in progressive addition glass group;(16.93±4.58)mo in under corrected grope;(17.93±4.42)mo in full corrected group. Three groups of independent samples by paired t-test showed: the difference between progressive addition glass group and under corrected grope(t=2.88, P<0.01)was statistically significant; the difference between progressive addition glass group and full corrected grope(t=3.9, P<0.01)was statistically significant; the difference between under corrected grope and full corrected grope(t=1.01, P>0.05)was statistically insignificant. In high hyperopic amblyopic children, the difference of the therapy effect and the healing time of the three corrected methods were insignificant in two years.(χ²=2.43, P>0.05. t=1.49, P>0.05; t=1.46,P>0.05; t=1.11, P>0.05).

CONCLUSION: Under standard prescription, application of progressive multifocal glasses provides a new effective treatment for ametropic amblyopia in hyperopic children, and makes up the deficiency of the whole straightening and under correction in clinical treatment.

Abstract:AIM: To systematic review the effectiveness of refractive multifocal intraocular lens(MIOL)ReZOOM vs diffractive MIOL ReSTOR in the treatment of cataract.

METHODS: Randomized controlled trials comparing refractive MIOL ReZOOM with diffractive MIOL ReSTOR were identified by searching CENTRAL, MEDLINE, EMbase, WANFANG MED ONLINE, CMJD, SinoMed, and CNKI. Related journals also were hand-searched. Methodological quality of randomized controlled trials(RCTs)was evaluated by simple evaluate method that recommended by the Cochrane Collaboration. Data extracted by two reviewers with designed extraction form. RevMan software(release 5.2)was used for data management and analysis.

RESULTS:A total of 7 trials(846 eyes)were included for systematic review. Subgroup analyses were used according to different model comparison of ReSTOR MIOL. The results showed a significant difference in the mean of the best distance corrected intermediate visual acuity(BDCIVA)in the ReZOOM MIOL group with WMD= -0.11, 95% CI(-0.16, -0.06)(P<0.0001). It showed a significantly difference in the mean of the uncorrected near visual acuity(UCNVA), complete spectacle independent rate, halo rate and glare rate in the ReSTOR MIOL group with WMD= 0.09, 95% CI(0.05, 0.14)(P<0.00001), WMD= 2.62, 95%CI(1.76, 3.91)(P<0.00001), WMD=1.35, 95% CI(1.15, 1.60)(P=0.0004)and WMD= 1.29, 95% CI(1.09, 1.53)(P=0.003). There was no significant difference between the two groups in the mean of the uncorrected distance visual acuity(UCDVA), the uncorrected intermediate visual acuity(UCIVA), the best corrected distance visual acuity(BCDVA)and the best distance corrected near visual acuity(BDCNVA)with WMD -0.03, 95% CI(-0.06, 0.01)(P=0.15), WMD= -0.04, 95% CI(-0.09, 0.01)(P=0.10), WMD= -0.01, 95%CI(-0.04, 0.02)(P=0.55)and WMD= 0.06, 95% CI(-0.06, 0.17)(P=0.32).

CONCLUSION: Patients implanted with ReZOOM MIOL can provide better BDCIVA; patients implanted with ReSTOR MIOL show better UCNVA, are less likely to appear light halo, glare and other visual adverse reactions; correction in spectacles cases, patients implanted with ReZOOM or ReSTOR MIOL have considerable performances in the far and near visual acuity.

Abstract:Neovascular glaucoma(NVG)is a kind of intractable eye disease with complex etiology, strong destruction and poor effect on treatment. Extensive retinal ischemia and hypoxia is the main etiology, and the key of treatment is early diagnosis, active prevention and taking effective measures to prevent the production of vascular endothelial growth factor. According to the related literature over recent years, the authors will discuss pros and cons for medical, surgical and combined treatment in this review.

Abstract:Secondary glaucoma is a kind of complications after vitrectomy, its etiologies are various and complex. Ineffective therapies might cause irreversible damage on optic nerves and visual field defect, even the loss in visual function. Nowadays, this project has been paid great attention by various researches both in China and abroad. Both the pathogens and therapies of secondary glaucoma after vitrectomy are analyzed as follows.

Abstract:At present, filtration surgery remains an important treatment of glaucoma, and filtering bleb fibrosis is the main cause for treatment failure. Filtering bleb fibrosis is a common fiber hyperplastic disease, and it relates to the activation and proliferation of fibroblasts and the excessive production of extracellular matrix(ECM)such as collagen protein. The most frequently-used drugs for filtering bleb fibrosis in clinic are 5-fluoro-2,4(1h, 3h)pyrimidinedione(5-Fu)and mitomycin(MMC). Although they are effective in some degree, they also have some serious side effects which restrict their clinical use. Triptolide(TPL)is a major active component of the medicinal plant, tripterygium wilfordii hook.f.(TWHF). TPL has multiple pharmacological activities including immunosuppressive, anti-inflammatory, anti-cancer and anti-fertility activity. Reviewing related literatures published in recent ten years, we confirmed that TPL seemed to possess a pharmacological activity in treating filtering bleb fibrosis. Since it has three major functions: 1. inhibit the activation and proliferation of fibroblasts and the excessive production of collagen protein; 2. alleviate the inflammatory reaction after surgical wound to suppress fibrous scar formation; 3.TPL has a protective effect on retinal ganglion cells(RGCs). We further find that TPL's anti-fibrosis activity mainly results from that it inhibits TGF-β/Smad,NF-κB and PI3K/AKT signal transduction pathway. This comprehensive analysis about the feasibility of Triptolide's role in treating filtering bleb fibrosis after the filtration surgery of glaucoma can help us develop new drugs for filtering bleb fibrosis and exploit TPL's clinical value on some level.

Abstract:Glaucoma is the first leading cause of irreversible blindness and the second leading cause of blindness worldwide. Numerous studies have shown that elevated intraocular pressure(IOP)is one of the major risk factors for the development and progression of glaucomatous optic nerve damage. However, there have been 50% of primary open-angle glaucoma(POAG)patients with typical glaucomatous optic neuropathy in whom the IOP measurements have always been in the normal range, and some patients develop typical glaucomatous optic neuropathy with the well controlled IOP. These phenomena cannot be explained by the theory of high intraocular pressure. The pathogenesis of glaucomatous optic nerve damage in these patients with normal IOP needs to be further discussed. Numerous studies at home and abroad have shown that: 1. the surrounding anatomy of the optic nerve including the IOP, the anatomy and biomechanics of the lamina cribrosa and retrobulbar orbital cerebrospinal fluid pressure may be of importance for the pathogenesis of the POAG; 2. patients with normal tension glaucoma had significantly lower cerebrospinal fluid pressure and a higher trans-lamina cribrosa pressure difference compared with normal subjects; 3. patients with ocular hypertension had significantly higher cerebrospinal fluid pressure, however, there is no difference in trans-lamina cribrosa pressure compared with normal subjects. Based on the above research, now we make a review about the research advance of the relation between intracranial pressure and glaucoma optic nerve damage and the available measurements about noninvasive intracranial pressure in clinical in this paper.

Abstract:Age-related macular degeneration(AMD)is one of a leading worldwide cause of blindness. AMD is a multifactorial disease, and major risk factors include increasing age, current smoking, previous cataract surgery, environmental factors, nutritional factors, genetic markers through genetic regulate complement, lipid, angiogenesis and extracellular matrix. In addition to treatment, epidemiology, risk factors and genetics research of AMD have been significantly progressed. This article will review risk factors of AMD.

Abstract:Pterygium is a common ocular surface disorder that has high rate of prevalence and recurrence. Currently, its pathogenesis is still unclear. Scholars agree that it's relevant to joint action of many factors. With the development of molecular biology, genetic and molecular studies concerning the pterygium achieved a breakthrough progress. Now the development of study in the pathogenesis of pterygium is reviewed in this paper.

Abstract:AIM: To study central corneal thickness(CCT)and correlation in different degrees of diabetic retinopathy(DR).

METHODS: A total of 65 cases(130 eyes)with different degrees of DR and 35 normal cases(70 eyes)as the age-and gender-matched control group were examined by corneal endothelial microscope, to measure CCT and statistics

RESULTS: Compared to control group, there were no significant difference of CCT both mild and medium nonproliferative diabetic retinopathy(NPDR)groups(P>0.05). While the CCT of severe NPDR group and proliferative diabetic retinopathy(PDR)group were thicker than control group, and the differences were statistically significant(P<0.05); Pairwise comparison in different degrees of DR groups: the CCT of severe NPDR and mild NPDR groups were thicker than PDR group, and the differences were statistically significant(P<0.05); compared to medium NPDR, the CCT of PDR was thicker(P<0.05); The thickness of CCT increases with severity of DR, there was positive linear correlation(r=0.173, P<0.05).

CONCLUSION: The CCT increases with severity of DR. Taking care of protecting corneal endothelium is very important in the time of therapeutic measure, especially intraocular operation, to decrease complication.

Abstract:AIM: To contrast the effect of small incision phacoemulsification and non-phacoemulsification to treat cataract.

METHODS: Totally 172 patients with cataract were divided into 2 groups(n=86)randomly. Patients in Group Phaco were treated with phacoemulsification and, while those in Group Siecs were treated with small incision extracapsular cataract surgery and intraocular lens implantation. They were all followed up for 1-3y. Functional examinations were made at 3d; 1,6mo and last follow-up. The visual acuity, intraocular pressure, anterior chamber depth, average corneal power(ACP), cylinder(CYL), surface asymmetry index(SAI)and complications were contrasted between groups.

RESULTS: At 3d after operation, the visual acuity of Group Phaco was better than that of Group Siecs(P<0.05), and CYL, SAI and intraocular pressure of Group Phaco were all significantly lower than those of Group Siecs(P<0.05). At 1mo after operation, the visual acuity of Group Phaco was better than that of Group Siecs(P<0.05), and CYL, SAI and intraocular pressure of Group Phaco were slightly lower than those of Group Siecs(P<0.05); there was no difference between the two group. At 6mo after operation, the visual acuity of Group Phaco was still better than that of Group Siecs(P<0.05), and CYL, SAI and intraocular pressure of Group Phaco were flat as those of Group Siecs(P<0.05); there was no difference between groups in those indexes above(P>0.05). Furthermore, the APC and anterior chamber depth of each point-in-time had no significant difference between groups(P>0.05). The incidences of complication were similar in two groups(P>0.05); but with individual differences, patients of GradeⅡ and Ⅲ in Group Phaco got lower complication rate(P<0.05), while those of Grade Ⅳ higher(P<0.05)than those of Group Siecs.

CONCLUSION: Our research shows that phacoemulsification has high effect in the treatment of patients with GradeⅡ and Ⅲ nuclear hardness, while small incision extracapsular cataract surgery has high effect in the treatment of patients with Grade Ⅳ nuclear hardness.

Abstract:AIM: To discuss the complications and prevention of phacoemulification in primary angle-closure glaucoma after trabeculectomy.

METHODS: Retrospective analysis of 33 cases(37 eyes)phacoemulification in primary angle-closure glaucoma after trabeculectomy in our hospital between January 2008 and June 2012, followed up 12-33mo, intraoperative and postoperative complications were observed.

RESULTS: Compared with pre-operation, intraocular pressure hadn't increased in follow-up 6mo. Iris was injured in 5 eyes, corneal edema was in 14 eyes, anterior chamber inflammation was in 16 eyes, all symptoms were improved in 3-7d. And no case with posterior capsule rupture or vitreous loss.

CONCLUSION: Phacoemulification is an effective way for the treatment of cataract after angle-closure glaucoma trabeculectomy, careful preoperative examination, intraoperative prevention can reduce or avoid the occurrence of surgical complications.

Abstract:AIM: To observe the efficiency of phacoemulsification with intraocular lens implantation in the treatment of cataract and glaucoma.

METHODS:Totally 60 patients(70 eyes)with cataract and glaucoma were included between March 2010 and March 2012 in our hospital. The phacoemulsification with intraocular lens implantation was performed. The observation of surgical efficiency, including the patient's IOP, anterior chamber depth, vision and complications, were compared before and after surgery.

RESULTS:Compared with preoperation, the patients' vision and anterior chamber depth were increased and the IOP was reduced significantly(P<0.05).

CONCLUSION: Phacoemulsification with IOL implantation is a safe and effective treatment for cataract and glaucoma.

Abstract:AIM: To compare the effect of treating cataract by sodium hyaluronate injection and lens-loop nucleus extraction of small incision cataract excision and explore more suitable method to promote the use of surgery in primary hospital.

METHODS: All 146 cataract patients(166 eyes)were allocated to two groups in random: the control group 78 patients(84 eyes)received conventional lens loop for extracapsular cataract extraction; the experiment group 68 patients(82 eyes)underwent nucleus extraction in small incision with sodium hyaluronate injection for extracapsular cataract extraction. Postoperative visual acuity and intraoperative and postoperative complications were compared between two groups.

RESULTS: Incidence of posterior capsule rupture difference was statistically significant(P<0.05)in small incision nucleus extraction with sodium hyaluronate injection compared with conventional lens loop for extracapsular cataract extraction. And there was no significant difference(P> 0.05)in postoperative visual acuity, astigmatism degree and postoperative complications compared with those of pre-operation.

CONCLUSION: Compared with the lens loop nucleus extraction, sodium hyaluronate injection for extracapsular cataract extraction can effectively protect the posterior lens capsule and can be promoted in small incision cataract surgery.

Abstract:AIM: To observe the clinical efficacy of adjunctive intravitreous injection with Lucentis for the treatment of neovascular glaucoma(NVG).

METHODS: The retrospective case series study included 25 eyes of 25 patients who underwentintravitreous injection with Lucentis. Patients firstly received an intravitreous injection with Lucentis(0.5mg/0.05mL), after the regression of neovascularization of the iris, patients accepted different surgical treatments according to different etiopathogenesis condition. Iris, chamber angle neovascularization condition, intraocular pressure, and visual acuity were observed postoperatively. The follow-up duration was 3mo.

RESULTS: After 3-7d of intravitreous Lucentis injecting, iris and chamber angle neovascularization was totally faded in 20 cases(20 eyes)and was not completely faded in 5 cases(5 eyes). Additional treatments were compound trabeculectomy(14 cases, 14 eyes), vitrectomy(4 cases, 4 eyes). The patients' mean intraocular pressure was 43.42±10.99mmHg before treatment, which decreased rapidly when they came out of the hospital(14.26±7.64mmHg, P<0.05)and stabilized during the follow-up 3mo(18.76±5.96mmHg, P<0.05). Follow-up at 3mo, visual acuity improved or remained in 20 cases(20 eyes)and decreased in 5 cases(5 eyes). The complete success, qualified success and failure were 21 eyes, 3 eyes and 1 eye, respectively.

CONCLUSION:Intravitreous injection with Lucentis can be used as an assisted treatment of NVG. According to different etiopathogenesis condition, it is an effective treatment to combine with other treatment methods for NVG.

Abstract:AIM: To investigate the effect and safety of laser peripheral iridoplasty combined with iridectomy in the unmanageable acute angle-closure glaucoma by medication.

METHODS: Totally 19 cases(21 eyes)with acute angle-closure glaucoma, including 15 cases(17 eyes)with primary glaucoma and 4 cases(4 eyes)with intumescent cataract-induced glaucoma, were recruited into the study. The intraocular pressure(IOP)of all cases were still >21mmHg after 24h drug treatment, and then were treated by laser peripheral iridoplasty combined with iridectomy. The visual accurity, IOP, cornea, peripheral anterior chamber depth, anterior chamber angle and complications were observed at 24h after the surgery.

RESULTS: The mean IOP of all cases was reduced from 53.09±11.01mmHg before the surgery to 14.98±4.21mmHg at 24h after the treatment, with significant statistical difference(P<0.01). The visual acurity of all cases increased in different degrees from handle move to 0.3 to 0.1-1.0 at 24h after the treatment. In all cases, cornea edema reduced or cleared up, peripheral anterior chamber depth increased, and anterior chamber angle reopened in different degrees. Complications included iris hemorrhage in 11 eyes(52.4%), mild iritis in 21 eyes(100%). No cornea burn was encountered.

CONCLUSION: Laser peripheral iridoplasty combined with iridectomy is an effective and safe method for the treatment of the unmanageable acute angle-closure glaucoma by medication.

Abstract:AIM: To better reveal the changing process of macula area after photodynamic therapy(PDT), the changes of tomographic imaging on macular fovea optical coherence tomography(OCT)scan at different follow-up time points after treating age-related macular degeneration(AMD)by PDT were investigated.

METHODS: This cohort study included 30 eyes of 26 patients diagnosed as AMD. The dosage of verteporfin was calculated according to manufacturer's instruction. All participants got FFA, ICG, OCT scan and best corrected visual acuity before and followed up for 2wk, 1, 2, 3mo after PDT. The standard five lines combined with 6 lines OCT scan covered key parts of lesion and the scan locations before and after were kept the same. The bilaminar foveal thickness(BFT), outer high reflectivity band thickness(OHRBT), and the total area of intraretinal fluid(IRF)and subretinal fluid(SRF)were measured at different time points. The relationship between the changes and follow up time was analyzed. Statistical analysis of the data was performed using SPSS for windows version 13.0.

RESULTS:There months after treatment, an improvement of 2 lines or better on the Snellen chart was achieved on 22 eyes, visual acuity of 3 eyes without significant change, 3 eyes got decreased, 2 cases lost follow up. The average macular thickness of improved 22 eyes before treatment was 722.5±55.6μm, 2wk after treatment, 708.3±45.3μm, 1mo, 584.4±49.3μm, 2mo, 430.7±50.2μm and 180.6 ±36.3μm at 3mo.The OHRBT before and after treatment respectively were 302.3±50.2μm, 277.5±42.3μm, 202.7±40.1μm, 180.6±35.7μm, 100.8±22.9μm. The total area of both IRF and SRF was estimated as 0.34±0.12mm², 0.25±0.07mm², 0.10±0.05mm², 0.08±0.04mm², 0.05±0.01mm².

CONCLUSION: SRF and retinal edema of patients with AMD were absorbed 1mo after PDT, and the BFT, OHRBT were significantly tend to be thin.

Abstract:AIM: To observe the clinical effects of 23-gauge(23G)transconjunctival sutureless vitrectomy for idiopathic macular hole.

METHODS: In this retrospective study, 28 eyes of 28 consecutive patients who underwent 23-gauge transconjunctival sutureless vitrectomy for idiopathic macular hole between January 2013 and October 2013 in our hospital were evaluated. The follow-up time was 3-12mo. The operation effects were analyzed.

RESULTS: The macular hole was closed in 27 eyes of 28 eyes which underwent 23G transconjunctival sutureless vitrectomy and not closed in 1 eye after surgery. Best-corrected visual acuity at postoperative 1, 3mo was significantly improved compared to pre-operation(χ²=8.65, P=0.003; χ²=10.33, P=0.001). The macular hole was closed as shown by OCT. Intraoperative incision was sutured in 5 cases(18%). There was no statistically significant difference in intraocular pressure between pre-operation and post-operation. No post-operative complications such as endophthalmitis, retinal detachment, vitreous hemorrhage came up.

CONCLUSION: 23G transconjunctival sutureless vitrectomy is observed to be safe and effective technique in the treatment of macular hole. It is therefore our preferred system for straightforward macular surgery.

Abstract:AIM:To analyze relevancy between the changes of the retinal thicknesses of children's anisometropic amblyopic macular at Area A1 before and at the end of amplyopia cure and amplyopia cure effect.

METHODS: Through randomly selecting 30 cases(60 eyes)of anisometropic amblyopic children as test group and 29 cases(58 eyes)of children with normal vision after the vision correction as control group, the changes of the retinal thicknesses of macular of the test group and the control group at Area A1 by OCT-3 was observed dynamically and analyzed.

RESULTS:Compared with first diagnosis, the comparative difference of retinal thicknesses of macular at Area A1 in control group at 3, 6mo has statistical significance. The test group was divided into amblyopia group and non-amblyopia group. There has statistical significance for the comparative difference between the retinal thicknesses of macular centre at 3, 6mo and the first diagnosis in the non-amblyopia group, the amblyopia group was divided into the invalid cure group, progress group and the cured group according to amblyopic cure effect. Compared with first diagnosis, there is no statistical significance of macular at Area A1 in invalid cure group and progress group at 3, 6mo, and in the cured group at 3mo, but in the cured group at 6mo has statistical significance.

CONCLUSION: There is a certain relationship between the changes of retinal thicknesses of macular of children with anisometropic amblyopic at Area A1 before and at the end of amblyopia treatment and amblyopia cure effect. OCT is a kind of objective auxiliary test method and provides new clues for amblyopia research.

Abstract:AIM: To observe thickness and morphological changes of bulbar conjunctiva pre- and post epidemic hemorrhagic conjunctivitis(EHC)therapy by optical coherence tomography(OCT).

METHODS: Observed morphological changes and measured the bulbar conjunctiva thicknesses of 29 cases(36 eyes)of incipient(1-2d)EHC patients, who were received and treated by department of ophthalmology, the Putuo Affiliated Hospital of Shanghai University of Traditional Chinese Medicine from May 2013 to December 2013, by OCT. Then measured the thickness again on 7, 14d after the therapy.

RESULTS: Among 29 patients(36 eyes), 7d after the EHC therapy, in 27 cured eyes, the full-thickness(before 344.00±59.91μm, after 230.19±22.16μm, t=11.75, P<0.01); epithelial thickness(before 56.52±6.19μm, after 51.37±5.53μm, t=4.61, P<0.01); and stromal thickness(before 287.11±60.56μm, after 178.81±20.20μm, t=10.69, P<0.01)of patients' bulbar conjunctiva were thicker than values measured after therapy with significant difference. Significant difference was also found for full-thickness(before 361.39±65.56μm, after 233.44±22.57μm, the difference was statistically significant, t=14.45, P<0.01); epithelial thickness(before 55.50±6.72μm, after 46.67±5.24μm, t=10.06, P<0.01)and stromal thickness(before 305.61±66.02μm, after 186.78±21.82μm, t=13.11, P<0.01)of patients' bulbar conjunctiva between values measured before and 14d after therapy.

CONCLUSION: The OCT is able to measure the thickness of bulbar conjunctiva in EHC patients. An significant increase was found in full, epithelial and stromal thickness of EHC patients' bulbar conjunctiva. With recovery from the disease, subepithelial fluid, interlaminar fluid and edema of the bulbar conjunctival stroma faded away firstly, which provide references for clinical therapies of the EHC.

Abstract:AIM: To explore the diagnosis and treatment methods of radioaction-induced optic neuritis(RION)through the clinical dates of 17 patients.

METHODS: It was a retrospective case series study. From August 2008 to October 2013, 17 cases(24 eyes)of Rion clinical dates from Chinese PLA General Hospital were studied. The diagnosis methods including visual acuity, pupil, fundus, visual field, fundus fluorescein angiography(FFA), visual electrophysiological testing, and head MRI. To analysis the clinical date of patients with diagnosis of RION by statistical description.

RESULTS: The deterioration degree of vision: 13 eyes were classified as Ⅳ, 9 eyes as Ⅲ, 2 eyes as Ⅱ. Ten eyes RAPD(+), visual electrophysiology is extinguished. The retina of 5 eyes showed flame hemorrhages and cotton wool spots exudation. Optic nerve head edema in one eye. T1-weighted MRI enhanced in 19 eyes which showed optic nerve of the intracranial and intratubal segments abnormal changed, optic chiasm and pituitary stalk signal abnormalities and enhancement of the optic nerve. Tortuous optic nerves and rough edges were observed in 5 eyes. Treatment effect: 4 eyes of visual acuity improved, 1 eye from blindness to light perception,1 eye from 0.08 to 0.2, 1 eye from 0.4 to 0.6,1 eye from 0.04 to 0.15, the rest of the cases did not see any improvement.

CONCLUSION: The unique clinical manifestation of RION can provide objective basis for clinical diagnosis in time, but there have not been proven any effective treatments.

Abstract:AIM: To analyze the application on frequency domain optical coherence tomography(OCT)technology of pathologic myopia optic disc neurosensory retinal thickness changes and its relationship with axis oculi, sex and age, and help for the early diagnosis of pathological myopia and primary open angle glaucoma.

METHODS: Collected 96 eyes of normal eyes(axis oculi 23-24mm)and 153 eyes of pathologic myopia eyes(axis oculi 25-27mm 80 eyes, >27mm 73 eyes). We measured the thickness of nerve fiber layer of the optic disc by OCT and analyzed their relationship with axis oculi, sex and age with multiple linear regression analysis.

RESULTS: The observation group showed significant smaller average thickness of peripapillary, superior, inferior, nasal than the control group(P<0.05); the difference in the temporal quadrant between the groups were no statistically significant differences(P>0.05); The partial correlation coefficient of peripapillary average thickness of nerve fiber layer and axis oculi was -1.31, gender was 5.21, age was -0.12.

CONCLUSION: The thickness of nerve fiber layer of the optic disc in the pathologic myopia eyes are decreased than normal eyes, axis oculi, sex and age are influenced factors. The pathologic myopia patients should use different index combined with optic nerve fiber layer thickness decreased to help for the diagnosis of early primary open angle glaucoma.

Abstract:AIM:To analyze the composition, distribution and characteristics of the elderly primary ocular tumors.

METHODS: This was a retrospective study and all 504 cases with primary ocular tumors aged 60 years or older were collected in Shanxi Eye Hospital, during the year 2000-2012. The onset age, location and pathological pattern were analyzed.

RESULTS: There were 346 cases of benign ocular tumors(68.7%), and 158 cases of malignancy(31.3%).Papillomas was the most common type of the benign with 83 cases(16.5%), followed by a variety of inflammatory cysts and lesions with 69 cases(13.7%)and 64 cases(12.7%)respectively. Among malignant tumors cases, eyelid basal cell carcinoma originated from epithelial was the most common with 72 cases(14.3%), followed by skin appendages sources malignant tumors with 39 cases(7.7%). Concerning the location of ocular tumors, there were 282 cases of eyelid tumor(56.0%)occupied the first position followed by conjunctival tumor with 157 cases(31.2%).

CONCLUSION: The prevalence and type of primary ocular tumor in elderly people are significant differences from the general population and children's, and the proportion of malignant tumors tended to increase along with the increase of age.

Abstract:AIM: To evaluate the effects induced by topical antiglaucomatous drugs, Travoprost eyedrops on tear film.

METHODS: Eighteen patients(32 eyes)with primary open-angle glaucoma or ocular hypertension were all treated with Travoprost eyedrops once every night. The symptom score, Schirmer's test(SⅠt), corneal fluorescein staining(FL), tear film break-up time(BUT), were observed before the treatment and 1, 2 and 3mo after the treatment.

RESULTS: The average symptom score, FL of all patients were 1.34±1.56 and 0.44±0.73 before the treatment, and 2.75±1.63, 1.08±0.84; 5.10±1.68, 1.53±0.67; 6.33±1.40, 1.98±0.50 respectively after 1, 2 and 3mo of the treatment. There was significant increase in symptom score and FL after the treatment for 1, 2 and 3mo(P=0.00). The average BUT, SⅠt of all patients were(7.76±0.92s),(8.47±2.73mm/5min)before the treatment, and(7.08±1.15s),(7.73±3.44mm/5min);(5.59±1.33s),(6.82±3.05mm/5min);(4.29±1.87s),(6.04±3.15mm/5min)respectively after 1, 2 and 3mo of the treatment. There was significant decrease in BUT and ST after the treatment for 1, 2 and 3mo(P=0.00).

CONCLUSION: Travoprost eyedrops can obviously aggravate patients' corneal irritation after treatment. Our results show abnormal decreased tear secretion and stability of tear film induced by Travoprost eyedrops over the short term.

Abstract:AIM: To observe the efficacy of high concentrations of sodium hyaluronate(3g/L SH)for moderate to severe dry eye.

METHODS: Forty moderate to severe dry eye patients were included in the study according to the diagnosis criteria and randomized into two groups. The patients of the trial group received topical administration of high concentration sodium hyaluronate(3g/L), and those of the control group received sodium hyaluronate(1g/L)plus recombinant human epidermal growth factor. The dry eye symptom scores, ocular surface disease index(OSDI)scores, tear film break-up time(BUT), Schirmer Ⅰ test and corneal fluorescein staining score were evaluated.All the indexes were compared between the two groups 2wk before and after treatment.

RESULTS: There were no significant differences of the indicators between the two groups before treatment. After 2wk treatment, the differences were statistically significant compared to former except for the Schirmer Ⅰ test. Compared with the control group, the symptom scores and the OSDI scores were lowered. No significant differences were found in the other indicators between these two groups.

CONCLUSION: Topical usage of highconcentrations of sodium hyaluronate(3g/L)is beneficial for remitting the ocular symptoms in moderate to severe dry eyes, and also improve the quality of life of patients.

Abstract:AIM:To discuss the single application on iris localization technology in excimer laser for the treatment of astigmatism.

METHODS:Totally 203 cases(406 eyes)of laser in situ keratomileusis(LASIK)in the treatment of compound myopic astigmatism patients were operated from November 2011 to November 2012 in our hospital. They were divided into two groups. One was observation group using iris localization and the other was control group using routine operation. Patients in the observation group of 100 cases(200 eyes), aged 18-43 years old, spherical diopter was -1.25 to -8.75D, astigmatism was -1.0 to -3.25D. In control group, 103 patients(206 eyes), aged 19-44 years old, spherical diopter was -1.75-9.50D, astigmatism was -1.0 to -3.25D. The patients in the observation group before the application of WaveScan aberrometer check for iris image, spherical lens, cylindrical lens and astigmatism axis data operation, only single application of iris location, without using wavefront aberration guided technology, laser cutting patterns for conventional LASIK model, spherical, cylindrical mirror and astigmatism axis data source to preoperative wavefront aberration results. The control group received routine LASIK. It was applicated comprehensive optometry optometry respectively to examine astigmatism and axial, based on the computer analysis during the preoperative, 1wk after the operation, and 6mo. Analysis of using SPSS 17 statistical software, it was independent-sample t test between the two groups of residual astigmatism and astigmatism axis.

RESULTS:Postoperative residual astigmatism, the observation group was significantly better than the control group. Astigmatism axial measurement after operation, the observation group was significantly less than that of the control group. Postoperative visual acuity at 6mo, the observation group was better than that of the control group. The difference was statistically significant.

CONCLUSION: For patients who cannot complete the wavefront aberration guided treatment of astigmatism, can separate the application of wavefront aberration analyzer automatic iris recognition technology to improve precision of astigmatism treatment, give full play to advanced technical performance of equipment, which has good application value.

Abstract:AIM:To observe the changes of tear film on the patients after laser in situ keratomileusis(LASIK)with corneal flap created by femtosecond laser with Oculus corneal topography.

METHODS:Totally 120 myopic patients(240 eyes)were collected who underwent femtosecond laser surgery LASIK from August to September 2013, and these patients can be followed up for 3mo. Tear break-up time(BUT)and tear meniscus height(TMH)with Oculus corneal topography were recorded preoperatively and postoperatively at 1wk; 1, 2 and 3mo.

RESULTS: Oculus BUT: there existed obvious differences(P=0.012, 0.000, 0.023<0.05)in 1wk, 1 and 2mo compared with the preoperative level. While no such obvious difference(P=0.236>0.05)existed in 3mo compared with the preoperative level. TMH: there existed obvious differences(P=0.025, 0.019, 0.026<0.05)in 1wk, 1 and 2mo compared with the preoperative level. No such obvious difference(P=0.375>0.05 )existed in 3mo compared with the preoperative level.

CONCLUSION: Femtosecond laser surgery affects the stability of the tear film at a certain time and a certain extent. The mechanism related to many factors. It is temporary and lighted.

Abstract:AIM: To investigate the safety and efficacy of undersurface ablation of the flap(UAF)for laser in situ keratomileusis(LASIK)retreatment in eyes with regression.

METHODS: Twelve patients(22 eyes)with regression after LASIK were performed undersurface ablation of the flap. The mean of preoperative refractive error was -2.27±0.88D, the astigmatism was -0.44±0.30D, the central corneal thickness was 424.9±8.2μm. The follow-up time was 1a, including visual acuity, refractive error, the elevation of posterior cornea, WavScan. The data was analyzed with Student's t test and χ² test.

RESULTS:During the operation, the measured stromal thickness was 275.4±9.3μm, the flap thickness 144.7±7.5μm, the depth of ablation 28.1±9.3μm. The mean postoperative uncorrected visual acuity(UCVA)was 4.99±0.04, best corrected visual acuity(BCVA)5.03±0.04, at 1a follow up. There was no patient with postoperative BCVA decreasing, compared to preoperation. Mean spherical refraction decreased to -0.22±0.19 D at 1a follow up(t=10.232, P<0.001)and the astigmatism decreased to -0.24±0.26 D(t=2.365, P=0.028). The elevation of posterior cornea changed from 1.95±1.68μm preoperatively to 2.00±1.88μm after 1a, but there was no statistical significance(t=0.090, P=0.929). The coma changed from 0.283±0.112μm preoperatively to 0.331±0.149μm after 1a(no statistical significance, t=1.452, P=0.161)and the spherical aberration changed from 0.320±0.119μm to 0.341±0.103μm(no statistical significance, t=0.390, P=0.674).

CONCLUSION:UAF, as one of a choice, is an effective and safe procedure for the treatment of regression after LASIK, based on the reasonable surgery design.

Abstract:This article discusses how to search and access ophthalmology information based on specialized websites and resources by introducing the database, search engines, electronic journals, electronic books and so on. Hope to help ophthalmic practitioners to carry out scientific research and clinical practice.

Abstract:AIM: To investigate the clinical effect for treating bullous keratopathy(BK)by anterior corneal stromal acupuncture combined with amniotic membrane transplantation.

METHODS: Totally 35 patients(35 eyes)with bullous keratopathy were treated by corneal stromal acupuncture combined with amniotic membrane transplantation. All patients preoperative and postoperative underwent anterior segment OCT, corneal topography, corneal sensitivity and confocal microscopy. To observe postoperative ocular symptoms in patients with BK, recurrence of bulla, changes in corneal thickness, corneal sensitivity and changes in the organizational structure of the layers of the cornea.

RESULTS: Thirty-five were followed up for 6-18mo. The symptom of pain disappeared in 32 cases(91%)in the first day after operation and did not recur during follow-up. The symptom of pain relieved in 3 cases(9%)in the first day after operation and disappeared in 3 days. Corneal epithelium of 9 cases(26%)were all healed within 1wk, 21 cases(60%)were all healed within 2wk, and 5 cases(14%)were all healed within 3wk. Following up for 6-18mo, there was no recurrence of symptoms or bulla. A small amount of tiny bubbles in the surrounding area appeared in 2 cases after 3 and 4wk. All patients had no neovascularization, and had smooth corneal surface. The amnions of 30 cases(86%)were thinning after 2mo, partially dissolved and absorped, not seen with the naked eye after 3mo. Thirty-four cases(97%)had no changes in vision, one case(3%)was from the light to front of the manual. After 2mo, corneal sensation decreased in 30 cases(86%), corneal thickness increased from preoperative 788±35μm to 940±43μm. After 12mo, corneal thickness increased to 1060±27μm. Results of confocal microscopy: after 3mo, the number density of the trigeminal nerve fibers under corneal basement membrane reduced, shallow stromal cells became into fibrotic stroma, deep stroma was more loose, and cells swelled significantly. The number of endothelial cells reduced and form swelled more obviously compared with preoperatively.

CONCLUSION: Corneal acupuncture combined with amniotic membrane transplantation can effectively control the symptoms of BK, prevent the recurrence of BK, and especially it is a simple, safe and practical way for patients with poor visual function.

Abstract:AIM: To investigate the preliminary clinical observation of excimer laser phototherapeutic keratectomy(PTK)assisted by anterior segment optical coherence tomography(OCT)in the treatment of non Ⅱ type granular corneal dystrophy.

METHODS: A retrospective case series were studied. Totally 8 patients(12 eyes)who were diagnosed as granular corneal dystrophy underwent PTK from April 2011 to January 2013 in our hospital. All patients were excluded from the Ⅱ type granular corneal dystrophy(Avellino corneal dystrophy)by the Avellino corneal dystrophy rapid diagnostic kit and underwent preoperative anterior segment OCT examination, so as to determine the lesion morphology and depth, and used to guide the setting of PTK parameters. They were followed up for the complications after operation, postoperative recurrence, the recovery of visual acuity.

RESULTS: All patients were followed up for 6-12mo, average 9mo after operation. All patients' best corrected visual acuity were significantly improved, superficial corneal opacity lesions were effectively removed, and the corneal opacity recurrence or serious Haze were not found during the follow-up period after operation.

CONCLUSION: In patients with non type Ⅱ granular corneal dystrophy, PTK assisted by anterior segment OCT can be accurate, effective removal of corneal lesions, obtain good effect after operation.

Abstract:AIM: To investigate the clinic efficacy and operation safety of improved small incision extracapsular cataract extraction in the sight-regaining program.

METHODS: Totally 82 cases(82 eyes)included in the sight-regaining program of the cataract patients were underwent small incision extracapsular cataract extraction conbined with improved technology(anterior capsule staining, continuous curvilinear capsulorhexis, auxiliary incision), postoperative visual recovery and operative complications were observed.

RESULTS: Postoperative visual acuity: uncorrected visual acuity when out of hospital: ≥0.3 were 67 cases(82%); 1wk after dismissed from hospital: ≥0.3 were 76 cases(93%), admist which ≥0.8 were 45 cases(55%). There is no serious complication such as posterior capsule rupture, zonular dialysis, etc. in the operation.

CONCLUSION: Combined use of improved technology can increase operation safety of small incision extracapsular cataract extraction.

Abstract:AIM: To observe the clinical effect of phacoemulsification combined with intraocular lens implantation for high myopia(axis oculi ≥30mm)cataract, and to explore the causes and treatment methods of operation complications.

METHODS: Selected 64 cases(86 eyes)of cataract with high myopia patients(axis oculi ≥30mm), vision correction≤0.1. Phacoemulsification combined with intraocular lens implantation was used. During 1a follow-up, the improvement of visual acuity and complications were observed.

RESULTS: Postoperative best corrected visual acuity was ≥0.4 in 35 eyes(41%), 0.2-0.3 in 23 eyes(27%), 0.1-0.15 in 25 eyes(29%), <0.1 in 3 eyes(3%). Posterior capsular rupture, vitreous prolapsed occurred in 2 eyes(2%). Through the anterior vitrectomy, intraocular lens was implanted to ciliary sulcus. Postoperative corneal edema in 6 eyes(7%), which was subsided after treatment; Posterior capsular opacity in 9 eyes(10%), visual acuity was recovered after incision of posterior capsule by YAG laser. Retinal detachment in 1 eyes(1%), which was cured after sclera buckling.

CONCLUSION: Phacoemulsification combined with intraocular lens implantation is a safe and ideal operation method for high myopia cataract, can obtain good effects, and the postoperative complications can be controlled. Because of the particularity of high myopia, operation should be gentle, technical parameters should be adjusted as appropriate, to achieve the best postoperative effects.

Abstract:AIM: To discuss the safety of hands chopping phacoemulsification in patients with microcoria cataract.

METHODS:Hands chopping phacoemulsification with intraocular lens implantation was used for the microcoria cataract of 30 patients(32 eyes). Their visual acuity, pupil, and complication were observed in postoperative 1d,1wk and 1mo.

RESULTS: Postoperative naked vision be or more than 0.3 were in 27 eyes(84.4%)at one day, be or more than 0.3 were in 30 eyes(93.8%)at one week, be or more than 0.5 were in 28 eyes(87.5%)at one month. All pupil returned to round or oval. No synechia happened in postoperative 1mo.

CONCLUSION:Hands chopping nucleus operation is safe and effective for uveitis combined with microcoria phacoemulsification.

Abstract:AIM: To research the application analysis of trabeculectomy combined with phacoemulsification treating patients with primary angle-closed glaucoma(PACG)and cataract.

METHODS: Seventy-three patients from September, 2011 to September, 2013, with primary angle-closed glaucoma and cataract, were selected in our research. Patients were all treated with trabeculectomy combined with ultrasonic emulsification, and the therapeutic effect was observed.

RESULTS: The effects of trabeculectomy combined with phacoemulsification treating primary angle-closed glaucoma and cataract in reducing intraocular pressure were better, and postoperative visual acuity results of the research objects were satisfactory. And it could deepen the central anterior chamber depth effectively. All the research objects had few complications.

CONCLUSION: Trabeculectomy combined with phacoemulsification treating primary angle-closed glaucoma and cataract can achieve a good result for reducing intraocular pressure, postoperative visual acuity recovery and correction, and the surgical success rate is high, with low complication rates. It is worthy of widely clinical application.

Abstract:AIM: To evaluate the effect of all capsule polishing with polishing mode for decreasing the occurrence of posterior capsular opacification(PCO).

METHODS: Totally 194 eyes(162 patients)were performed phacoemulsification, posterior chamber intraocular lens were implanted. One hundred eyes were performed with all capsule polishing with polishing mode; 94 eyes were performed with the polishing apparatus.

RESULTS: The patients were followed up for 12mo.Six eyes(6.0%)of PCO were found in the 100 eyes with polishing mode group; 15 eyes(16.0%)of PCO were found in the 94 eyes with the polishing apparatus group. The difference was significant(P<0.05).

CONCLUSION: It can decrease the occurrence of PCO by performing all capsule polishing with polishing mode.

Abstract:AIM: To evaluate the efficacy and safety of large sized continuous curvilinear capsulorhexis(CCC)involving zonular area in manual small incision cataract surgery(MSICS).

METHODS:Totally 1 443 cataract patients(1 965 eyes)underwent MSICS, in which large CCC up to 7-8mm were performed.The related conditions such as success rate of performing CCC, capsule rupture, corneal edema and visual acuity after surgery were recorded and statistically analyzed.

RESULTS:In total of 1 965 eyes, 1 942 eyes(98.83%)had successful CCC, 15 eyes(0.76%)had a radial tear which could not be saved when performing CCC, 8 eyes(0.41%)had anterior capsule opened with a cystotome or a scissor due to capsule membrane calcification. No posterior capsule rupture occurred, and intraocular lens was transplanted in all cases. Transient corneal edema was noted in 36 eyes(1.83%). One day after surgery, 1 650 eyes(83.97%)had visual acuity ≥0.5, 1 867 eyes(95.01%)≥0.3. No unstable intraocular lens was noted in all cases.

CONCLUSION: Large CCC technique for MSICS is safe and reliable,not decreasing stability capsular bag and intraocular lens. It is of high originality despite zonular area is involved so that it is worthy of application in basic medical institutions.

Abstract:AIM: To investigate the safety and effect of EX-PRESS glaucoma drainage device on open-angle glaucoma.

METHODS: A retrospective review of 40 patients(47 eyes)whose eyes were diagnosed as open angle glaucoma through the best-corrected visual acuity(BCVA), intraocular pressure(IOP), gonioscope, examination of the ocular fundus, and visual fields et al. Fourty patients 6-73y old(mean 39.90±16.50y old)with the BCVA from 0.01 to 0.6 and the IOP from 18mmHg to 65mmHg were treated with EX-PRESS glaucoma drainage device after achieving not well IOP over three drugs. Follow-up of these patients 1d, 3d and 1wk after treatment, IOP, slit lamp examination were retrospectively observed. The changes of the BCVA, IOP were used to evaluate the safety and effect before and after treatmeat.

RESULTS: The mean BCVA was 0.26±0.29 pre-operatively, while it was 0.24±0.22 after treatment one week. The mean BCVA decreased slightly, but there was no statistic difference between pre-treatment and post-treatment(t=1.56,P=0.13). The mean IOP was(36.62 ±14.01)mmHg pre-operatively,(10.04±5.77)mmHg after treatment one day,(9.59±4.93)mmHg after treatment three days,(9.47±3.06)mmHg after treatment one week. The IOP was decreased significantly in post-treatment after one day, three days, one week compared with pre-treatment(F=157.20, P<0.05). Except for 5 eyes of the IOP below 5mmHg, there was no ocular or systemic adverse events observed in all patients.

CONCLUSION: EX-PRESS glaucoma drainage device is an effective and safe treatment for the patients with open-angle glaucoma. The risk and complication are low intraoperatively and postoperatively.

Abstract:AIM: To evaluate the efficacy and complications of intravitreal injection of triamcinolone acetonide(TA)for the treatment of macular edema caused by pre-retinal membrane of the macular.

METHODS: Totally 23 patients(24 eyes)with macular edema caused by pre-retinal membrane of the macular were treated withintravitreal injection of 4mg TA. Best-corrected visual acuity(BCVA), intraocular pressure(IOP),slit-lamp examination, fundus fluorescein angiography(FFA)and optical coherence tomography(OCT)were performed before and after treatment. The SPSS 12.0 software was used for statistical analysis.

RESULTS: After 10, 30, 90d of treatment of TA, as compared with before treatment, visual acuity improved significantly(P<0.05), and central macular thickness(CMT)was significantly thinner(P<0.01). The average central macular thickness decreased from 522±126μm before treatment to 264±115μm, 245±128μm, 286±131μm at 10, 30, 90d after treatment. Macular edema reduced. IOP increased in 7 eyes(29%), one cataract case, no other complications associated with vitreous injection.

CONCLUSION:Intravitreal injection of TA in the treatment of macular edema caused by pre-retinal membrane of the macular is simple, safe and easy to operate. It can quickly reduce macular edema, and improve the visual acuity in the short term. Part of patients may recur after injection in the first half of the year.

Abstract:AIM: To identify intragenic mutation loci of the BEST-1 gene with congenital vitelliform macular dystrophy by molecular genetic analysis at one family in Northeast China.

METHODS:Genomic DNA was extracted from peripheral leukocyte of 2 patients and 5 healthy members in the family with vitelliform macular dystrophy and 100 normal controls. Ten exon sequences of BEST-1 amplified by polymerase chain reaction(PCR)were made direct DNA sequencing to define the gene mutation loci and compared with gene screening performed on 100 normal controls.

RESULTS:After the direct DNA sequencing, no mutation loci was found in all the patients of this family with vitelliform macular dystrophy.

CONCLUSION:There is no mutation in the exons of BEST-1 gene causing disease genes in this family.

Abstract:AIM: To evaluate the clinical effect of traditional Chinese medicine plus laser photocoagulation on eyes which have peripheral retinal hole with shallow detachment.

METHODS: The 227 cases(246 eyes)of retinal hole with shallow detachment were randomly divided into an integrated Chinese and western medicine group and a western medicine group. The former underwent laser photocoagulation combined with oral Chinese medicine; while the latter was treated with laser photocoagulation alone. Analyses of the effect were performed two months after treatment.

RESULTS: The total cure rate of integrated Chinese and western medicine group was 87.7%, while that of western medicine group was 71.6%, significant difference was considered between the two groups(P<0.01).

CONCLUSION: Chinese medicine combined with laser photocoagulation plays an exact role in eyes which have peripheral retinal hole with shallow detachment, especially when the detached range is greater than 1PD, and it is significantly better than western laser therapy.

Abstract:AIM: To determine whether the 23-gauge(23G)vitrecomy cutter could replace scissors in conventional 20-gauge(20G)pars plana vitrectomy for treating severe proliferative diabetic retinopathy(PDR).

METHODS:Non-comparative interventional case series. Totally 27 eyes of 27 patients with PDR stageⅥ confirmed by funduscopy and B-ultrasound scan were enrolled. They underwent 20G vitrectomy, in which 23G vitrectomy cutter replaced scissors to remove neuvascular membrane. All 27 eyes received complete panretinal photocoagulation, 17 eyes received no tamponade, 6 eyes were 12% C₃F₈ tamponade, 4 eyes were filled with silicone oil. The follow up time was 3mo. The operation duration time, iatrogenic retinal tear and retinal bleeding need electric coagulation, best corrected visual acuity(BCVA), retinal reattachment were analyzed.

RESULTS: The operative time was 35-120(average 79.19±29.82)min; intraoperative iatrogenic retinal breaks were detected in 2 eyes(7%). At the end of 3mo follow up, BCVA>0.1 were in 9 eyes, from 0.05-0.1 in 10 eyes, <0.05 in 8 eyes. Retinal reattached in 25 eyes(93%), still detached in other 2 eyes with silicone oil.

CONCLUSION: The 23G vitrectomy cutter could replace scissors in conventional 20G pars plana vitrectomy for treating severe PDR.

Abstract:AIM: To observe the efficacy, complications and ocular surface tear dynamics of the treatment for pterygium combined with conjunctivochalasis by inferior limbal-stem-cell transplantation.

METHODS: All 30 patients(46 eyes)diagnosed as pterygium combined with conjunctivochalasis in our hospital from December, 2010 to December, 2012 with a mean age of 61.2y(SD 7.2, range 49-75)were subjected to observation. After excision of nasal pterygium, an equivalent size of conjunctival flap linked with corneal limbal stem cell from inferior limbus was transplanted to the exposed sclera. Afterwards, the inferior bulbar conjunctiva was trimmed and fixed onto surface of sclera and inferior corneal limbus. After one-year follow-up, the comparisons regarding vision acuity between pre-operation and post-operation(1mo later)as well as ocular-surface tear dynamics changes including several indexes like altitude and integrity of tear meniscus, break-up time(BUT), corneal fluorescein staining and chloramphenicol gestation test before and 3mo after surgery were made. The operative complications and the recurrence rates 1y after operations were recorded.

RESULTS: Median visual acuity was 0.2(0.04-0.6)before the operation and median visual acuity was 0.4(0.04-1.0)1mo after the operation. Of total 46 eyes in 21 eyes(45.7%), visual acuity improved. No vision changes were found in other 25 eyes(54.3%). Significant difference(P<0.01)of vision acuity before and after surgery was found. In addition, break-up time(BUT), corneal fluorescein staining and chloramphenicol gestation test and altitude and integrity of tear meniscus show better results 3mo after surgery than that of pre-operation, which showed statistically significant(P<0.05). After 1y follow-up, 33 eyes(71.7%)healed while problems in 11 eyes(23%)were relieved. The total efficacy rate was 95.6%. Nonetheless, invalid surgeries were noticed in two eyes(4.4%)that affected by recurrence of pterygium. The 33 eyes(71.7%)affected by conjunctivochalasis was cured in terms of subjective evaluation and improved in 9 eyes(19.6%), but 4 eyes(8.7%)exhibited no evident improvement in terms of subjective complains. Total efficacy was 91.3%. The 41 eyes(89.1%)were reported to be normal while 5 eyes(10.9%)were revealed to be abnormal in terms of objective therapeutic evaluation. And this condition was so-call conjunctivochalasis recurrence with a recurrence rate of 10.9%. No proliferation of granulation, narrowing inferior fornix and malfunction of eye movements was found.

CONCLUSION: Inferior-limbal-stem-cell transplantation to treat pterygium combined with conjunctivochalasis obtains better results. It proves to eradicate or relieve symptoms of patients effectively and ameliorate ocular-surface tear dynamics.

Abstract:AIM: To explore the clinical efficacy of traditional Chinese acupuncture combined with conventional rehabilitation therapy onoculomotor nerve palsy patients.

METHODS: From May 2005 to September 2012, 110 cases ofoculomotor palsy were divided into treatment group and control group with 55 cases in each group according to different methods of treatment. The control group received rehabilitation therapy, the treatment group received acupuncture combined with rehabilitation therapy. Before and after 8wk treatment, the light reflex, diopter case, eye fissure width, and eye movement to improve the overall efficiency of the situation were observed between the two groups.

RESULTS: After treatment of 8wk, light reflex,diopter case, eye fissure width, and eye movement therapy total effective rate of the treatment group were all better than the control group(P<0.05); The eye movement improved in the treatment were 47 cases which accounting for 85.5%, in the control group there were 36 cases which accounting for 65.5%, the treatment group had a higher improvement(P<0.05).

CONCLUSION: Acupuncture therapy combined with rehabilitation training method significantly reduces the oculomotor nerve palsy in patients with clinical symptoms and improves the patient's quality of life.

Abstract:AIM: To study the effectiveness of hyaluronidase periocular injection combined with α-lipoic acid and Chinese medicine in the treatment of diabetic vitreous hemorrhage.

METHODS: Retrospective analysis of 67 patientswith proliferative diabetic retinophathy(PDR)and vitreous hemorrhage, were divided into two groups: treatment group and control group. There were 32 cases in every group, the treatment group were giving hyaluronidase periocular injection combined with α-lipoic acid intravenously and with traditional Chinese medicine in promoting blood circulation to remove blood stasis, control group were only given Chinese medicine treatment in promoting blood circulation to remove blood stasis.

RESULTS: Followed up 2-3mo, the total efficiency of treatment group(78%)was better than control group(57%), there was statistically significant difference(P<0.05). The efficiency of the two groups' patients with vitreous hemorrhage more than 2wk time was 22% and 25% respectively, there was no statistically significant difference in the two groups(P>0.05).

CONCLUSION: Hyaluronidase periocular injection combined with α-lipoic acid and Chinese medicine in the treatment of PDR combined with vitreous hemorrhageis more effective than only use Chinese medicine. But it only has effect for the early, over 2wk, it has no significant effect.

Abstract:AIM: To compare the clinical results of suture method and partial eyelash resection treating for pediatric eyelid trichiasis, and screen an effective method for the treatment of pediatric lower eyelid trichiasis.

METHODS: Fifty-six cases of pediatric patients with lower eyelid trichiasis were randomly divided into a control group and an observation group in accordance with the method of drawing lots, and each group was 28 cases. The control group was treated with suture method, and the observation group was treated with partial eyelash resection. The clinical efficacy, patient satisfaction before and after treatment, and the incidence of complications were compared.

RESULTS:(1)The clinically total effective rate was 74% of the control group, which was 89% of the observation group, and there were statistical differences of the clinical efficacy between the two groups(P<0.05);(2)the satisfaction scores were(3.89±1.22)points and(6.27±1.86)points of the the control group before and after treatment, which were(4.00±1.34)points and(8.95±2.34)points of the observation group, and there were statistical differences of the two groups before and after treatment(P<0.05), and the scores of the observation group were higher than that of the control group(P<0.05);(3)complications such as swelling and stitches off appeared in both groups, and the rate was 21% in the control group, which was 11% in the observation group, and there were statistical differences between the two groups(P<0.05).

CONCLUSION: The treatment of children with lower eyelid trichiasis, suture method is simple and can be performed under local anesthesia in collaboration with children, but with a higher relapse rate, some patients required reoperation; partial resection of eyelashes can be more thoroughly solve the problem of pediatric eyelid trichiasis with low recurrence rate, but children need to be under general anesthesia with some of big risk. So partial resection of eyelashes is unsuitable for using in clinical practice widely and can be used in special cases.

Abstract:AIM: To evaluate the effect of the chosen incision on corneal astigmatism after implantable collamer lens(ICL)surgery.

METHODS: The study included 195 eyes of 102 patients, and all eyes were randomly divided into two groups: the chosen incision group(Group A, 97 eyes)and temporal corneal incision(Group B, 98 eyes). Before the operation, and 1wk,1mo and 3mo after the operation, each patient was examined with corneal topography to observe the changes of corneal astigmatism.

RESULTS: Preoperative corneal astigmatisms were(1.26±0.35)D in group A and(1.28±0.38)D in group B, thus there was no statistically significant difference(P>0.05). One week postoperatively, the astigmatism were(0.93±0.29)D in group A and(1.32±0.33)D in group B. One month postoperatively, the astigmatism were(0.85±0.16)D in group A and(1.27±0.18)D in group B. Three months postoperatively, the astigmatism were(0.80±0.13)D in group A and(1.25±0.20)D in group B. The differences between the two groups were statistically significant(P<0.01).

CONCLUSION: The chosen incision can reduce postoperative astigmatism to a certain extent after ICL surgery.

Abstract:AIM: To observe the efficacy of ondansetron by intravenous injection at different time in preventing nausea and vomiting after pediatric strabismus surgery.

METHODS: Totally 90 children aged 3-11y were randomly selected for pediatric strabismus surgery from June 2013 to August 2013 in our hospital. The ASA grade of all children were Ⅰ-Ⅱ. Children were randomly divided into three groups with 30 cases each. Group A received intravenous drip of ondansetron 0.1mg/kg before surgery. Group B received intravenous drip of ondansetron 0.1mg/kg after surgery. Group C as control group was not given ondansetron. The number and severity of nausea and vomiting were observed within 24h after surgery.

RESULTS: There were no statistical significance in patients' gender, weight, age, duration of anesthesia, ketamine dosage and vital signs intraoperative between the three groups(P>0.05). The incidence rate of postoperative nausea and vomiting(PONV)of group A and B were significantly lower than group C(P<0.05). The incidence rate of PONV of group A and group B have no significant difference(P>0.05).

CONCLUSION: Using ondansetron is effective and safe in preventing PONV before and at the end of the pediatric strabismus surgery, which can also improve safety and be lower cost. It is a worthy promoting antiemetic approach for eye surgery.

Abstract:AIM: To observe the incidence of ocular fundus disease in preschool children examined by non-mydriatic fundus camera and evaluate its effectiveness compared with direct inspection shadow mirror.

METHODS: Three thousand eight hundred and ninety-six preschool children from April 2012 to October 2013 were examined by Topcon TRC-NW300 color fluorescence fundus camera and direct inspection shadow mirror, and images were saved immediately.

RESULTS: Detection rate of non-mydriatic fundus photography was higher than that of direct inspection shadow mirror. In 3 896 cases, 41 eyes were detected abnormal fundus accounting for 1.05%. The retinal myelinated nerve fibers, morning glory syndrome, retinitis pigmentosa, congenital retinoschisis were common, accounted for 24.39%, 21.95%, 14.63%, 12.20% respectively. The children eye diseases were often accompanied by abnormal vision(68.30%), ametropia(63.41%), strabismus(19.51%).

CONCLUSION: Non-mydriatic fundus photography is a mydriatic method without medicine, so it is easy for preschool children to accept. Image results could directly display the fundus lesions. It shows important significance in the screening for preschool children eye diseases.