Abstract:AIM: To compare subfoveal choroidal thickness(SFCT)between cases with non-neovascular age-related macular degeneration(AMD)and neovascular AMD by optical coherence tomography(OCT)and to evaluate the contribution of choroidal thickness(CT)measurements to the understanding of pathogenesis of neovascularization in AMD.

METHODS: Fourty-eigth eyes of 24 patients who had neovascular AMD in one eye and non-neovascular AMD in the other eye were included in this retrospective, cross- sectional study as study group. Forty eyes of healthy,age and axial length matched individuals were selected as the control group. Eyes with drusen and/or pigmentary changes were included in the non-neovascular AMD subgroup. Eyes with subretinal or intraretinal fluid and/orlipid exudation due to the choroidal neovascularization were included in the neovascular AMD subgroup. OCT measurements were performed with RTVue 100-2(V 5.1, Optovue, Fremont, CA, USA)perpendicularly from the outer part of the hyperreflective line(retinal pigment epithelial layer)to the line corresponding to the choroido- scleral junction. Choroidal thickness was measured at 7 different points, 500μm intervals up to 1500μm temporal and nasal to the fovea in the study group and compared statistically between subgroups.

RESULTS: The mean age of patients was 72.4±8.97(60- 82)y. The mean age of healthy individuals was 71.2±8.8(58-81)y. Mean SFCT of neovascular AMD group were significantly thicker than non-neovascular AMD group(P<0.05). In non-neovascular AMD group, there was no statistically significant difference between the mean SFCT and the mean temporal-nasal choroid thickness(P>0.05). In neovascular AMD group, there was a statistically significant difference between the mean SFCT and the mean temporal-nasal choroid thickness(P<0.05).

CONCLUSION: Choroidal thickness measurements with OCT device can make a contribution to the understanding the phatophysiology of AMD and large prospective studies should be conducted to understand why SFCT was thicker in neovascular AMD.

Abstract:AIM: To assess the impact of the operational simulation training system on the cultivation of ophthalmic students.

METHODS: Four hundred and eighty ophthalmic students in China Medical University from 2009 to 2011 were chosen as objects and divided into two groups at random. The students in the experimental group used operation simulation training system combined with traditional teaching methods, while the students in the control group only used traditional teaching methods. We examined the operation skills and the confidence of all the students half a year later.

RESULTS: The improvement of the operation skills during the suture technique examination, and the confidence for operation technology were significantly different in two groups. The basic skills of the students in the examination groups improved apparently during the operational simulation training and they were full of confidence to their operational technique.

CONCLUSION: The operational simulation training is useful for promoting the clinical ability for ophthalmic students and should be widely popularized.

Abstract:AIM: To study the function and mechanism of the NgR-Rhoa-Rock signal pathways which exists in the retinal ganglion cells apoptosis in diabetes mellitus(DM)rats.

METHODS: Some healthy SD rats were operated by means of single intraperitoneal injection of 1% streptozotocin based on the standard of 50mg/kg wight, after that the blood sugar value was greater than 16.7mmol/L as DM model, then randomly divided into 3 groups, each group was 10 rats. In addition to take 10 healthy SD rats as control group. Four groups of rats were bilaterally eyeball intravitreal injection in turn with NgR-siRNA virus 10μL(siRNA group), NgR-siRNA virus diluted 10μL(DM group), NgR-siRNA virus-negative-control solution 10μL(siRNA blank group), NgR-siRNA virus diluted 10μL(normal control group), and fed normally. During that time, some life indexes like blood glucose, body mass, etc. were measured and recorded. After 12wk, the expression of NgR and Rhoa, HE staining, and TUNNEL staining were detected by Western blot analysis.

RESULTS: Western blot analysis: compared with normal control group, the expression of NgR and Rhoa in DM group and siRNA blank group increased significantly(P<0.01), while siRNA group was no significant change(P>0.05); compared with DM group and siRNA blank group, the expression of those proteins significantly lowered in siRNA group. HE staining: compared with normal control group, some extent ganglion cells arranged disorder, irregular shape, spacing not consistent were all found in three groups of model rats; compared with DM group and siRNA blank group, there was some improvement in siRNA group of ganglion cells about the order and shape size. TUNEL staining: compared with normal control group, there were retinal ganglion cells apoptosis in all of three groups of model rats. Compared with DM group and siRNA blank group, the number of retinal ganglion cells apoptotic cells was less, and the shape of cells had improved significantly in siRNA group.

CONCLUSION: In the DM phase, the expression of NgR and Rhoa were up-regulation, the condition of diabetic retinal ganglion cell apoptosis was improved after that the NgR-Rhoa-Rock signal pathways had been inhibited.

Abstract:AIM: To discuss the influence of dexamethasion on IL-1β and TNF-α expression in suture-induced rabbit corneal neovascularization(CNV)and analyze the potential mechanism.

METHODS: For 43 healthy rabbits, 40 were randomly selected for establishing CNV model in corneal stroma. The right eyes(group A)were received no medicine and the left eyes(group B)were injected dexamethasone after successfully establishing the model. The no modeling 3 rabbits were normal control group. The morphologic change of corneal was observed with slit lamp microscope and the areas of CNV was calculated every day, then 8 rabbits were randomly chosen for sacrificing at 1, 4, 7, 14, 21d respectively. The pathological characteristics of CNV were observed after HE staining, and IL-1β and TNF-α expression was detected by immunohistochemistry.

RESULTS: CNV was grown at the 4d after suture, and the 7-14d was vigorous growth period. inflammatory cell infiltration appeared after HE staining, and CNV was located at the superficial stroma of cornea. Immunohistochemistry results showed that IL-1β and TNF-α expression was gradually increased with prolonged suture time. Compared with corneal stitch group, the rabbits cured by dexamethasone were found with less inflammatory cells infiltrating and neovescularization, moreover, the expression of IL-1β and TNF-α decreased. There were statistical significance between the two groups(P<0.05).

CONCLUSION: Dexamethasone can inhibit the CNV growth by controlling the inflammation of corneal and restraining IL-1β and TNF-α expression.

Abstract:AIM: To observe the expression of N-cadherin and fibronectin in retinal pigment epithelium(RPE)cells in vitro under high glucose conditions, furthermore, to explore the effects of high glucose on epithelial-mesenchymal transition(EMT)in RPE cells.

METHODS: Human RPE(hRPE)cells were cultured in vitro. Containing a final concentration of 60mmol/L glucose was used for high glucose treatment. The cells were divided into normal glucose group(5.5mmol/L, NG)and high glucose group(24, 48 and 72h)respectively. The expression of N-cadherin and fibronectin in hRPE cells were evaluated by immunofluorescence and real-time PCR.

RESULTS:RPE cells became disorganized and swollen over time under high glucose conditions, especially in 72h subgroup. Immunohistochemical analysis revealed that the expression of N-cadherin in RPE cells under high glucose conditions was decreased compared with that in the control group, while the expression of fibronectin was increased. Real-time PCR results showed that the expression of N-cadherin mRNA in high glucose group was decreased at 24h compared with that in the control group, and declined markedly at 72h(F=12.252, P=0.000). There were no significant differences between the control group and the high glucose group at 24h, while the differences between the control group and the high glucose group(48 and 72h)were significant respectively(P<0.05). Meanwhile, the expression of fibronectin mRNA in RPE cells was increased in high glucose group at 24h, and reached the peak at 72h(F=50.543, P=0.000). There were no significant differences between the control group and the high glucose group at 24h. Compared with the control group, the expression of fibronectin mRNA in hRPE cells was increased significantly in high glucose group(48 and 72h)respectively(P=0.000, P=0.000).

CONCLUSION: The expression of epithelium marker N-cadherin is down-regulated under high glucose conditions in hRPE cells in vitro. Meanwhile, the expression of mesenchymal maker fibronectin is induced and appeared to EMT changes. Results of this study will enrich our growing understanding in proliferative diabetic retinopathy and hopefully lead to novel insights for the pathogenesis and therapeutic treatments.

Abstract:AIM: To evaluate the protective effects of intravitreal injection of cannabinoid HU-211 for optic nerve in glaucoma rats, providing the experimental evidence in the treatment of glaucoma optic nerve injury.

METHODS: Glaucoma rats(18 eyes)were modeled by electric coagulation sclera surface vein and randomized into 3 groups, group A received intravitreal injection of 1mg/0.1mL cannabinoid HU-211 every other day respectively; group B was given intravitreal injection of 0.1mL water every other day, group C was high intraocular pressure(IOP)group, 6 eyes were randomly selected for blank control group(group D). IOP was observed every day. The rats were sacrificed after treatment 4wk, froze retina section, HE stain. The density fluctuation of retinal ganglion cell(RGC)neurons assessment the optic nerve of rat model with chronic high IOP glaucoma were measured.

RESULTS: The apoptosis and damage degree of RGC in group B was obviously higher than that in group A, with statistically significant difference(P<0.05). There was no significant difference in groups B and C(P >0.05).

CONCLUSION: Intravitreal injection of cannabinoid HU-211 shows obvious protective effect on optic nerve in glaucom rat models.

Abstract:AIM:To investigate the expression of vascular endothelial cell growth factor(VEGF)and its receptors in vitreous of patients with diabetic retinopathy(DR), and to discuss its role in the development of DR.

METHODS: Selected 13 patients(16 eyes)with DR and 15 healthy people(15 eyes), the expression of VEGF and its receptors(fms-like tyrosine kinase-1, Flt-1 and kinase insert domain containing receptor, KDR)were evaluated by immunohistochemistry in vitreous. The levels of VEGF, the Flt-1 and KDR in vitreous of patients with DR were examined with enzyme linked immunosorbent assay(ELISA).

RESULTS: Immunohistochemical staining showed that the expression of VEGF, Flt-1 and KDR in vitreous vessel membrane of patients with DR was increased significantly. And the levels of VEGF, Flt-1 and KDR in vitreous of patients with DR were obviously higher than that in the control group(P<0.05 or P<0.01).

CONCLUSION: VEGF, Flt-1 and KDR were widely expressed in vitreous of patients with DR, and were positively related to micro-angiogenesis of DR patients. It proved that VEGF and its receptors played important roles in the occurrence and development of DR.

Abstract:AIM: To assess the efficiency and reliability safety of ganciclovir to herpes simplex virus keratitis.

METHODS: All of the randomized controlled trials for the study of ganciclovir versus acyclovir in the treatment of herpes simplex virus keratitis were collected from Cochrane Library, EMbase, PubMed, Chinese Bio-medicine Database, China Journal Full-text Database, VIP Database and WanFang Database. Then the data were extracted and evaluated by two reviewers independently. Risk of bias assessment was evaluated by a tool recommended by Cochrane Library. Revman 5.0 software was used for statistical analysis.

RESULTS: Finally, 14 randomized controlled trials were included, 4 820 patients totally. Subgroups were used according to the number of patients and diseased eyes as well as the difference of follow-up time. For and relapse rate, ganciclovir group was overmatch acyclovir group. There were statistical differences between the two groups \〖RR=1.22, 95%CI(1.10-1.36); OR=4.50, 95%CI(2.02-10.04); RR=0.23, 95%CI(0.10-0.52)\〗. Compared with acyclovir, ganciclovir had less side-effect. There were statistical differences between the two groups \〖RR=0.12, 95%CI(0.03-0.46)\〗. All of the side effects of the two groups can be relieved by themselves.

CONCLUSION: Current evidence suggests that the ganciclovir is more efficient and safe than acyclovir in the treatment of herpes simplex virus keratitis.

Abstract:AIM: To evaluate the safety and efficacy of intravitreal bevacizumab injection in patients with macular edema(ME)induced by retinal vein occlusion(RVO).

METHODS: The records of patients treated with intravitreal injection of 1.75mg bevacizumab for ME induced by RVO were retrospectively reviewed. All patients were evaluated by complete ophthalmic examination, optical coherence tomography(OCT)and fundus fluorescein angiography(FFA), etc. Best corrected visual acuity(BCVA), intraocular pressure, the change of lens and vitreous, central foveal thickness(CFT)were observed at 1, 2, 3, 6mo after treatment and compared with before treatment. Repeated treatment with intravitreous bevacizumab occurred if there were signs of persistent or recurrent exudation. All the cases were followed up at least 6mo. An intravitreal injection of bevacizumab(1.75mg)was given at 6wk intervals.

RESULTS: Fifty patients(56 eyes)with the average of(57±18.56)years old were included. The mean baseline of BCVA, CFT were(logMAR0.82±0.63),(626.5±178.0)μm respectively. Although there was no significant decrease in mean CFT at 1wk after injection, the mean BCVA had significant improvement. Followed up at mean 10.26±5.87mo, BCVA, CFT showed significant improvements over baseline values. The statistics of CFT at 1, 2, 3mo after injection were significant differences compared with before injection in each of the three groups. CFT at 1, 3, 12mo after injection were(365.11±23.212)μm,(333.42±35.526)μm,(267.6±116.8)μm, which had a significant difference(P<0.001), namely macular retinal thickness was thinner obviously that before treatment, ME was improved obviously. CFT was no significant difference at each time point after injection in the group of BRVO-ME and CRVO-ME(P>0.05). OCT image showed that after injection macular retinal thickness was becoming thinner. FFA showed that after injection macular fluorescein leakage decreased. BCVA was improved by at least two lines in 48 eyes(86%),remained stable in 8 eyes(14%)at the last visit. A total of 112 injections were performed and the average number of injections was 1.96 in the group. About 50% of reinjections gained at least two lines of vision improvement at 1wk following the retreatment. There was no serious complications during the treatment.

CONCLUSION: Intravitreal injection of bevacizumab can improve visual acuity(VA)of RVO(CRVO and BRVO)in patients with ME, relieve ME, reduce the leakage of CNV, and repeated treatment is better. But a prolonged treatment effect needs further observation. There are no serious ocular and systemic complications occurred in our study.

Abstract:AIM: To assess the postoperative outcomes of piggyback implantation using Acrysof Toric intraocular lens(IOL)in high myopia combined with corneal astigmatism.

METHODS: Sixty patients who had phacoemulsification with IOL implantation due to high myopia,cataract and corneal astigmatism from January 2010 to June 2013 were randomly divided into observation group(piggyback Toric IOL implantation, both an Acrysoft IQ Toric IOL and a minus foldable acrylic three piece IOL were implanted in the capsular bag, n=30)and control group(foldable IOL implantation, n=30). Postoperative follow-up went on 6mo. Information collected included uncorrected visual acuity(UCVA), IOL position, residual astigmatism and complications.

RESULTS: The UCVA increased from 3.52±0.03 preoperatively to 4.78±0.01 at 6mo postoperatively in the observation group, from 3.51±0.03 preoperatively to 4.30±0.13 at 6mo postoperatively in the control group. The observation group's postoperative UCVA was better than that of the control group. There was statistically significant difference(t=3.612, P<0.05). The preoperative corneal astigmatism was 2.97±0.87(1.70-4.27)D in the observation group and 2.92±0.97(1.50-4.90)D in the control group. The postoperative residual astigmatism was 0.48±0.23(0.25-1.00)D in the observation group and 2.87±1.11(1.00-5.20)D in the control group. There was statistically significant difference postoperatively(t=-11.995, P<0.05)between the two groups. No complications occurred.

CONCLUSION: Piggyback implantation using Toric IOL can help to solve the problem of no matching Toric IOL power for the high myopia combined with corneal astigmatism at the current stage. It improves the UCVA and reduces the astigmatism after the cataract surgery.

Abstract:Diabetes mellitus is a metabolic syndrome characterized by hyperglycemia, and is caused by complex interaction between genetic and environmental factors. Diabetes mellitus can lead to various ocular surface disorders, including dry eye, superficial punctuatekeratitis, corneal epithelial defects, and recurrent corneal erosion et al. This review focuses on the domestic and overseas research progress on dry eye in diabetics.

Abstract:PAX6 gene plays an important role in embryological development, and the mutation of this gene may result incongenital aniridia, retinoblastoma, macula hypoplasia, Peters' anomaly and so on. A brief introduction of the background PAX6 gene, and the association between PAX6 and retinal diseases were summarized in this review.

Abstract:Retinal vessel is the only visible vessels in human body and systemic microvascular lesions could be evaluated by the degree of retinal vessels. In this article, the progress of retinal vascular caliber measuring method and its influencing factors were briefly reviewed.

Abstract:AIM:To evaluate the efficacy of a variety of lacrimal duct obstruction diseases treated by Nd: YAG laser lacrimal duct forming surgery using Meta analysis.

METHODS: Relevant database in 1995-2012 and other network resources were retrieved by computer and manual, using MetaAnalyst software on the Meta analysis. Analysis of indicators: disease prevalence between men and women, the prevalence of various lacrimal duct diseases and the effective rate of Nd: YAG laser lacrimal duct forming surgery to treat a variety of lacrimal duct obstruction diseases.

RESULTS: According to the inclusion and exclusion criteria, 38 subjects were selected, the cumulative number of patients included 4 638 cases, the men combined prevalence was 23%; the women combined prevalence was 77%; lacrimal punctum occlusion combined prevalence was 6.0%, combined treatment efficiency was 88.1%; lacrimal canaliculus obstruction combined prevalence of 17.9%, combined efficiency was 85.6%; lacrimal common canaliculus obstruction combined prevalence was 14.0%, 92.7% of the combined effective rate; nasolacrimal duct obstruction combined prevalence of was 43.6%, 93.3% of the combined effective rate; chronic dacryocystitis combined prevalence was 18.4%, 76.6% of the combined efficiency. All study has heterogeneity. Selection of random effects model combined effect size. Model was statistically significant(P<0.001).

CONCLUSION: The prevalence of lacrimal duct obstruction diseases of women are higher than men, lacrimal canaliculus obstruction in the lacrimal duct obstruction is in the lowest prevalence, nasolacrimal duct obstruction is the main type of lacrimal duct obstruction disease, Nd: YAG laser lacrimal forming surgery has slightly efficacy different in various lacrimal duct obstruction diseases.

Abstract:AIM:To evaluate the clinical efficacy of corneal lamellar debridement combined with sutureless amniotic membrane transplantation for the treatment of superficial fungal keratitis.

METHODS:Totally 22 cases(22 eyes)with superficial fungal keratitis were referred to our hospital from April 2012 to October 2013. The patients with persistent cornea ulcer after treatment of local and systemic antifungal drugs underwent corneal lamellar debridement combined with sutureless amniotic membrane transplantation, and the recipient bed was covered with an amniotic membrane using fibrin sealant during the operation. All patients were still given topical antifungal therapy for 1-2mo after operation. The followed-up time was 3mo or above. We observed the corneal healing and amniotic membrane adhesion by split lamp microscope, and investigated the transformation of amniotic membrane and fungal infection recurrence with confocal microscope.

RESULTS: Corneal edema and anterior chamber reaction of 21 patients disappeared gradually, and no amniotic membrane graft dissolved and shed off within 1-2wk postoperatively. Two weeks after operation, the graft integrated into the corneal and the corneal wounds' thickness increased gradually, the corneal epithelium reconstructed and corneas became clear. Four weeks after operation, the corneal scarring developed gradually and fluorescence staining was negative. Nineteen cases' amniotic membranes that adhered with the cornea dissolved 4wk after operation. There were different degrees of corneal nebula or macula remained 3mo postoperatively. All patients' vision improved in varying degrees, except in 1 case with fungal keratitis who had been cured by lamellar keratoplasty.

CONCLUSION:Corneal lamellar debridement combined with sutureless amniotic membrane transplantation can effectively remove the foci of inflammation, improve the local efficacy, shorten the operation time, relieve the postoperative reaction, and promote cornea union, which is an effective way to treat superficial fungal keratitis.

Abstract:AIM: To observe the clinical outcome of implanting AcrySof IQ Toric intraocular lens to correct corneal astigmatism in cataract surgery, and to evaluate the result and rotational stability of AcrySof IQ Toric after cataract surgery.

METHODS: A retrospective study of 26 eyes in 21 cataract patients with corneal astigmatism. All patients implanted AcrySof IQ Toric intraocular lens. The preoperative and postoperative uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), preoperative corneal astigmatism, anticipated residual astigmatism, total astigmatism, postoperative residual astigmatism and Toric lens axis were detected and measured.

RESULTS: All patients' visual acuity and best corrected visual acuity improved significantly. The mean refractive cylinder decreased significantly after surgery from(2.05±0.57)D to(0.55±0.33)D(t=13.574, P<0.05). There was no significant difference between preoperative(0.47±0.19)D and postoperative corneal astigmatism(t=1.149, P>0.05). Three months after surgery, there was no significant difference between preoperative(2.01±0.58)D and postoperative(-1.89±0.53)D corneal astigmatism(t=1.908, P>0.05). The rotation of intraocular lens were <20°, the mean rotation was 3.65°±2.86°.

CONCLUSION: The AcrySof IQ Toric lens make cataract patients enjoy the better UCVA including good rotational stability in the correct of corneal astigmatism. The AcrySof IQ Toric implantation is an effective option for the correct of preexisting corneal astigmatism in cataract surgery.

Abstract:AIM: To evaluate the visual performance of the patients with traumatic corneal astigmatism, after the treatment of topography guided off-flap epipolis laser in situ keratomileusi(off-flap Epi-LASIK).

METHODS: This prospective clinical study was comprised of 21 eyes of 21 patients with irregular corneal astigmatism caused by trauma, they were treated by off-flap Epi-LASIK from July 2012 to December 2013. The data included uncorrected visual acuity(UCVA), best spectacle-corrected visual acuity(BSCVA), contrast sensitivity 1, 6mo before and after surgery; the healing area percentage of corneal epithelia, the healing time of corneal epithelia and pain score at 3d after surgery.

RESULTS: Postoperative 1mo both UCVA and BSCVA were improved significantly than that before surgery(t=15.703, 4.351, P<0.05); Compared with the 1mo after surgery, UCVA at 6mo after surgery raised significantly(t=6.867, P <0.05). There was no statistical significance between 6 and 1mo after surgery about BSCVA(t=1.497, P=0.140). After surgery, mean spherical equivalent(SE)was reduced from -2.43±3.02D to -0.23±0.49D(P<0.05), and the mean cylinder was reduced from -1.86±2.23D to -0.46±1.03D(P<0.05). Postoperative 1mo,4 kinds of spatial frequency and contrast sensitivity had no significant difference compared with the preoperative(P>0.05). Postoperative 6mo except the 3c/d spatial frequency, the remaining 3 spatial frequency contrast sensitivity compared with those before operation were significantly improved(P<0.05). The healing area percentage of corneal epithelia was 92.46%±8.24%(80%-100%)at 3d after surgery; The healing time of corneal epithelia was 3.50±1.56d; Pain scores at 3 and 7d after surgery was 1.54±1.32 and 0.04±0.64, respectively.

CONCLUSION: Topography-guided off-flap Epi-LASIK is safe and effective in treating the patients with traumatic corneal irregular astigmatism. The operation can improve both the contrast sensitivity and the visual performance.

Abstract:AIM: To compare the impact of different incision positions of phacoemulsification cataract exaction on corneal astigmatism.

METHODS:Totally 412 patients(456 eyes)who had undergone the phacoemulsification and IOL implantation from June 2006 to June 2013 were randomly divided into two groups(each 228 eyes): observation group(incision above the middle of the limbus for the rule astigmatism, at the temporal for against the rule astigmatism, at the top of the temporal regulation on the maximum curvature of the meridian of the cornea for oblique astigmatism, at the top of the temporal for patients without astigmatism); control group(incision at top and middle of limbus), using a 3mm cornea scleral tunnel incision without suture, 2mm from the limbus. Corneal refractive status of preoperative and postoperative at different times were detected by corneal refractive, comparing the impact of different surgical incision on postoperative corneal astigmatism.

RESULTS:The visual acuity of 1, 3mo postoperative of observation group was significantly better than the control group(P<0.05). The average astigmatism of 1, 3mo postoperative of observation group was significantly lower than the control group(P<0.05). Corneal astigmatism 3mo postoperative of observation group was significantly lower than preoperative(P<0.05). Corneal astigmatism 3mo postoperative of control group was significantly higher than preoperative(P<0.05).

CONCLUSION:Incision at the corneal curvature of the largest radial could correct preoperative astigmatism and improve visual acuity to a certain extent.

Abstract:AIM:To investigate the safety and efficacy of capsular tension ring(CTR)insertion combined with phacoemulsification and intraocular lens(IOL)implantation in patient with pseudoexfoliation syndrome after anti-glaucoma surgery.

METHODS: A retrospective study was conducted of 10 eyes from 10 cataract patients with pseudoexfoliation syndrome following trabeculectomy surgery, and who underwent CTR insertion combined with phacoemulsification and IOL implantation between January, 2012 and June, 2013. All cases had nuclear cataracts(nuclear hardness Ⅱ 1 eye, nuclear hardness Ⅲ 4 eyes, nuclear hardness Ⅳ 5 eyes). One case with Ⅳ nuclear hardness cataract had iridodonesis and lens subluxation. Postoperative visual acuity, intra- and post-operative complications, anterior capsular opening, IOL position, and postoperative intraocular pressure(IOP)were assessed. Follow-ups ranged from 3 to 14mo. The t test was used to analyze the variables studied.

RESULTS: All patients had a successful CTR insertion combined with phacoemulsification and IOL implantation. A modified CTR insertion was performed in one case, the others underwent a standard CTR insertion. The best corrected visual acuity(BCVA)was ≥0.5 in 3 eyes and 0.3-<0.5 in 2 eyes. However, BCVA was ≤0.1 in 5 eyes. No decentration and dislocation of IOL was found during follow-up. Optic atrophy of different level could be found in all cases. The mean IOP was 16.78±2.48mmHg before surgery. And the average IOP is 16.01±2.33mmHg at 3mo postoperative(t=1.9955, P>0.05). The most common intrao- and post-operative complications were corneal edema, small pupil, residual cortex, spontaneous zonular dialysis.

CONCLUSION: Suitable CTR insertion in appropriate occasion may be beneficial to patients with pseudoexfoliation syndrome after trabeculectomy during cataract surgery. It prevents the IOL decentration and decrease the surgical complication. Less complication occurs at the early stage.

Abstract:AIM: To observe the complicated cataract after glaucoma surgery, analyze the causes and summarize the treatments, in order to provide the basis for clinical treatment.

METHODS: Forty-five patients(50 eyes)with complicated cataract after glaucoma surgery treated in our hospital from October 2012 to September 2013 were selected. All patients were treated by 3.2mm tunnel incision phacoemulsification cataract operation. The postoperative complications, intraocular pressure, and visual acuity were observed.

RESULTS: After treatment, visual acuity of all patients were improved, without obvious complications, the intraocular pressure was normal.

CONCLUSION: 3.2mm tunnel incision phacoemulsification cataract operation can effectively improve the intraocular pressure and promote the recovery of visual acuity.

Abstract:AIM: To compare the curative effects of two surgical treatment methods for open angle glaucoma and cataract patients.

METHODS: Totally 69 patients with primary open angle glaucoma and cataract were divided into two groups: group A and group B. Thirty-four patients(34 eyes)in group A underwent small incision non-phacoemulsification cataract surgery combined with trabeculectomy, just combined operations, 35 patients(35 eyes)in group B underwent small incision non-phacoemulsification cataract surgery beyond 6mo after trabeculectomy, just two stage operations. Postoperative intraocular pressure at 1wk and 3mo, postoperative corrected visual acuity and filtering bleb at 3mo were observed, and intraoperative and postoperative complications were compared. All the patients were followed up for 3-6mo.

RESULTS: All the visual acuity were increased compared with that before surgery in two groups, the difference was not statistically significant. All the intraocular pressure was controlled in two groups, the difference was not statistically significant, and the difference about the filtering bleb was neither statistically significant(P>0.05). There were no serious intraoperative and postoperative complications in two groups.

CONCLUSION: The two stage operations and the combined operations both can control theintraocular pressure and improved visual acuity of open angle glaucoma and cataract. The two stage operations may prevent a second operation for post trabeculectomy cataract, allowing earlier visual rehabilitation.

Abstract:AIM: To study and observe the changes of serum, aqueous humor and tear IL-2, sIL-2, NO, TAC, and SOD of patients with cataract.

METHODS: Totally 60 patients with cataract in our hospital from November 2011 to September 2013 were included as the observation group, and 60 patients with eye traumas were as the control group. The serum, aqueous humor and tear IL-2, sIL-2, NO, TAC, and SOD of two groups were detected and compared, and the detection levels of patients with different stages were compared.

RESULTS: The serum, aqueous humor and tear IL-2, TAC, and SOD of observation group were all lower than those of control group, the sIL-2 and NO were all higher than those of control group. The serum, aqueous humor and tear detection levels of patients at different stages had obvious differences, and the aqueous humor IL-2 were lower than those of serum and tear, the sIL-2 were higher than those of serum and tear, with statistically significant differences.

CONCLUSION: The change of serum, aqueous humor and tear IL-2, sIL-2, NO, TAC, and SOD of patients are all great, and the influence of the stages for those indexes are great too, the inflammatory response state of aqueous humor are more obvious.

Abstract:AIM: To investigate the clinical efficacy of cyclocryotherapy combined trabeculectomy and single cyclocryotherapy for neovascular glaucoma(NVG).

METHODS:Totally 82 patients with NVG from February 2012 to June 2013 in our hospital were selected and randomly divided into observation group and control group, each 41 cases. Patients in control group were given single cyclocrytherapy, and patients in observation group were given cyclocryotherapy combined trabeculectomy. The visual acuity, intraocular pressure and postoperative complications of two groups were observed.

RESULTS: After postoperative six months, the improvement rate of visual acuity in observation group was 61.0%, which was significantly higher than that of control group(41.5%), the difference was statistically significant(χ²=3.843, P=0.018). Intraocular pressure of observation group was significantly lower than that of control group, the difference was statistically significant(P<0.05). The complication rates(eye pain, hyphema, and corneal edema)of observation group were 9.8%, 12.2%, and 9.8%, which were significantly lower than that of control group(51.2%, 60.9%, and 48.8%), the difference was statistically significant(χ²=7.594,P=0.007; χ²=9.276,P=0.000; χ²=6.835,P=0.013). The difference of two groups was not statistically significant on complications of conjunctival edema, anterior chamber exudation, shallow anterior chamber, and eyeball atrophy(P>0.05).

CONCLUSION: Compared with single cyclocryotherapy, cyclocryotherapy combined trabeculectomy has advantages of low intraocular pressure, less postoperative complications, and high success rate, so it is worthy of promotion.

Abstract:ATM: To measure the subfoveal choroidal thickness(SFCT)in myopia using Cirrus HD optical coherence tomography(OCT), and to explore the relationship between the SFCT, axial length and myopic refractive spherical equivalent.

METHODS: One-hundred thirty-three eyes of 70 healthy volunteers were recruited, and were divided into emmetropia group, low-degree myopia, middle-degree myopia and high-degree myopia group. SFCT were measured by Cirrus HD OCT, and the relationship between the SFCT, axial length and myopic refractive spherical equivalent were evaluated.

RESULTS: 1)Average SFCT was(275.91±55.74)μm in normals, that in emmetropia group, low-degree myopia, middle-degree myopia and high-degree myopia group were(290.03±34.82)μm,(287.64±51.51)μm,(274.95±56.83)μm,(248.37±67.98)μm; 2)the SFCT of high-degree myopia group was significant thinner than that of emmetropia group(P<0.05); 3)There was a significant negatives correlation between the SFCT and axial length(P<0.01), a significant positive correlation between SFCT and myopic refractive spherical equivalent(P<0.01).

CONCLUSION: the SFCT is inversely correlated with increasing axial length and myopic refractive error.

Abstract:AIM: To explore the changes of retrobulbar hemodynamics in diabetes via color doppler ultrasound.

METHODS: Totally 80 patients(160 eyes)with eye diseases in type 2 diabetes from June 2010 to May 2013 in our hospital were enrolled as research group. By fundus photography and direct ophthalmoscopy, patients were assigned to diabetes without retinopathy group(DNR subgroup), non-proliferative diabetic retinopathy group(NPDR subgroup)and proliferative diabetic retinopathy group(PDR subgroup). Of 60 healthy patients(120 eyes)over the same period were chosen as control group. The doppler parameters of central retinal artery(CRA), posterior ciliary artery(PCA)and ophthalmic artery(OA)were measured.

RESULTS: There were significant differences on circulatory parameters of CRA, PCA and OA between both groups(P<0.05). Significant differences were also observed on peak systolic velocity(PSV), end diastolic velocity(EDV)and resistance index(RI)of CRA, PCA and OA among DNR subgroup, NPDR subgroup and PDR subgroup(P<0.05). The EDV, RI and PSV of control group differed from those of DNR subgroup, NPDR subgroup and PDR subgroup(P<0.05).

CONCLUSION: The monitoring of retinal blood flow and analysis of blood spectrum morphology via color doppler ultrasound can effectively evaluate the degree of diabetic retinopathy lesions, especially before DR vascular disease. Early detection can reveal the hemodynamic change pattern of DR, facilitating the prevention of diabetic eye complications and improvement of the quality of life.

Abstract:AIM: To discuss the effects and security of the application of intravitreous bevacizumab(IVB)before pars plana vitrectomy(PPV)in proliferative diabetic retinopathy(PDR).

METHODS: Retrospective study of 74 patients(80 eyes)with PDR. These patients were randomly divided into two groups, some patients in PPV group and others patients in PPV+IVB group. The PPV+IVB group were treated with IVB 10d before operation. The operating time, postoperative eyesight, intraocular pressure(IOP), complications and bleeding during operation and postoperation between the two groups were observed and compared.

RESULTS: Operating time and postoperative visual acuity were significantly different between the two groups. Operating time: with an average of 108±20.6min of test group and 129±32.4min of comparison group. Postoperative visual acuity: with an average of 0.32±0.20 and 0.21±0.16, there was significantly different between the two groups(P<0.05). Three months after operation, IOP was no significantly different between the two groups with an average of 21.3±7.2mmHg and 20.6±6.7mmHg(P>0.05).

CONCLUSION:Bevacizumab can make active neovascular membranes fibrosis, reduce bleeding in the strip membranes process, so as to make the operation field clear, and can shorten the surgical time and get the better sight, no serious complications during postoperative period appeared.

Abstract:AIM: To observe the incidence of high intraocular pressure(IOP)and its risk factors in the early stage(within 7d)after 23-gauge sutureless microincisional vitrectomy.

METHODS: Retrospective case series study. Totally 98 patients(98 eyes)who had undergone 23-gauge sutureless microincisional vitrectomy were enrolled. IOP was measured by non-contact tonometry. High IOP was defined as an IOP >25mmHg at any time within 7d after surgery. The influence of age, sex, side of operation, course of disease, primary disease pre-operation, reoperation, surgical options, type of tamponade, status of lens, surgical time on postoperative high IOP were analyzed.

RESULTS:High IOP was found in 33 eyes(33.7%)within 7d after surgery. High IOP was found in 8 eyes on postoperative 1d, the incidence was 24.2%(8/33), and 25 eyes was found on postoperative 3d, the incidence was 75.8%(25/33). The incidence of high IOP of male and female were 32.8%(20/61)and 35.1%(13/37)respectively. The incidence of high IOP of right and left eye were 36.8%(21/57)and 29.3%(12/41)respectively. There were no significant differences comparing age(Z=-0.22), sex(χ²=0.057), side of operation(χ²=0.612), course of disease(Z=-0.079)and surgical time(Z=-0.553)between patients with high IOP and those without it(P>0.05). Similarly, no statistical significance was found between eyes with gas tamponade and silicone oil tamponade(χ²=1.04), traumatic eyes and non traumatic eyes(χ²=0.044), and retinal detachment eyes and without retinal detachment eyes(χ²=2.282,P>0.05). The incidence of high IOP in eyes with several operations was higher than that in eyes with the first operation(χ²=5.211,P<0.05), in eyes with combined operations eyes was significantly higher than that in eyes with pure vitrectomy(χ²=4.57,P<0.05), and in eyes with aphakic eye was higher than that in eyes with phakic eyes(χ²=4.224,P<0.05).

CONCLUSION:High IOP occurs commonly in 3d after 23-gauge sutureless microincisional vitrectomy. The risk factors of high IOP are reoperation, combined operations and aphakic eye.

Abstract:AIM:To research the association between primary progressive pterygium and tear film.

METHODS: Totally 60 cases of primary progressive pterygium from September 2012 to June 2013 in our hospital were enrolled. The pterygium eye was for observation group and the contralateral eye as the control group. The differences of eye symptoms, tear film break-up time(BUT), SchirmerⅠ test(SⅠt), corneal fluorescein staining(FL), tear ferning test(TFT)and the conjunctival impression cytology(CIC)were compared between two groups.

RESULTS: The eyes in observation group had higher symptoms score, FL score, grades of conjunctival squamous metaplasia, percentage of abnormal tear ferning, but had lower BUT and density of goblet cell, the differences had statistically significance(P<0.05); Similar SⅠt results were presented in the two groups, the difference had no statistically significance(P>0.05).

CONCLUSION: Primary progressive pterygium can cause a decrease in tear film stability, which in turn lead to some dry eye symptoms such as dry feeling and burning sensation, and its mechanism may be caused by multi-factors, such as density change of goblet cell and the tear fluid dynamics.

Abstract:AIM: To investigate the effect of Carbomer eye gel and recombinant human epidermal growth factor(rhEGF)on dry eye after cataract surgery in diabetics.

METHODS:A total of 160 patients(160 eyes)with diabetes undergone phacoemulsification with a diagnosis of dry eyes were randomized divided into two groups, treatment group(80 cases, 80 eyes)and control group(80 cases, 80 eyes). In treatment group, the patients were treated by Carbomer eye gel and rhEGF. In control group, the patients were treated by Carbomer eye gel. The subjective dry eye symptoms, tear break-up time(BUT), Schirmer I test(SⅠt)and cornea fluorescein staining(FL)were observed before treatment, 1, 4wk after treatment.

RESULTS: There was no significant difference between groups before treatment(P>0.05). After treatment at 1, 4wk, the subjective dry eye symptoms and the results of three examination(BUT, SⅠt and FL)in two groups better than those before treatment(P<0.01). And there was significant difference between experimental group and control group(P<0.05; P<0.01), the results of BUT, SIt and FL were improved in treatment group better than that in control group(P<0.01). All patients showed good tolerance to Carbomer eye gel and recombinant human epidermal growth factor.

CONCLUSION: Carbomer eye gel can relieve the dry eye symptoms of diabetes after phacoemulsification effectively, and it can be more effective to combine Carbomer eye gel with rhEGF at early stage after phacoemulsification.

Abstract:AIM: To investigate the characteristics of scale cataract operations and the effects and experiences of small incision extracapsular cataract extraction with intraocular lens(IOL)implantation in large-scale vision recovery action.

METHODS: Four thousand eight hundred ninety-two cases(4 892 eyes)of cataract were treated by small incision non-phacoemulcification cataract extraction from March 2010 to November 2011 in our hospital(Fuming No.1 surgery car of Shaanxi Province)which were retrospectively analyzed. Visual acuity, intraoperative and postoperative complications, the recovery of postoperative inflammation were observed.

RESULTS: Visual acuity reached 0.3 or more in 4 521 eyes(92.42%)at 1d after the operation, at 3d after the operation in 4 571 eyes(93.44%), there were 4 887 eyes with IOL implantation, implantation rate was 99.90%. All the cases had lesser intraoperative and postoperative complications, and the postoperative inflammation recovered quickly.

CONCLUSION: Small incision extracapsular cataract extraction with IOL implantation is simple, effective, economical, safe and adapting for large-scale vision recovery action.

Abstract:AIM:To investigate and analyze the epidemiology of serious corneal ulcer.

METHODS: A total of 133 serious corneal ulcercases from June 2010 to December 2013 in Xiangya Hospital Affiliated to Central South University were retrospectively reviewed for risk factors, demographic characteristics and diagnosis.

RESULTS: There were 91 male patients(68.4%)in the 133 patients. A peak incidence age was from 41 to 60 years old(82 cases, 44.4%). Most of patients were peasant(77 cases, 57.9%)and the percentage of the low schooling patients was 85.0%(113 cases). The number of patients who had been sick was 73 before hospitalization(54.9%)in all cases. The peak incidence season was January(34.6%). Average length of stay was 9.84d. The number of emergency cases was 44(33.1%). Most of patient were not only corneal ulcer cases but the hypopyon(92 cases, 69.2%). The figure of inpatients who received operations was 102 cases(76.7%). And the most of operations was amniotic membrane transplantation(31 cases, 39.2%). Additionally, this data was classified regard to gender differences.

CONCLUSION: The peasant of the middle age and elderly represents a distinct clinical group in the serious corneal ulcer in hospital. Severity, ocular trauma in agriculture and health awareness are the major predisposing factors.

Abstract:AIM:To evaluate the influence of phacoemulsification on corneal endothelium of senile cataract with lupus nephritis(LN).

METHODS:This clinical trial involved 40 cataract patients with lupus nephritis(40 eyes), and 50 cases(50 eyes)without lupus nephritis. All of them underwent phacoemulsification+IOL implantation. The parameters of corneal endothelial cell including central corneal endothelium cell density(CED),average area of endothelial cell(AVE)and coefficient of variation(CV)were recorded by corneal endothelial microscope pre-operation and at one month after operation. The data were analyzed by SPSS 13.0 statistical software.

RESULTS:Both LN group and control group, the morphology of coneal endothelial was statistical significant differences between pre-operation and 1mo postoperation. The CED was lower, AVE and CV were higher(P<0.05, respectively).A significant decrease in CED was seen in the LN group than did in the control group(P<0.05).Compared to control group,the post-operative AVE and CV in LN group was significantly increased(P<0.05).

CONCLUSION:The corneal endothelial cell in lupus nephritis patients is more fragile. Safe and reliable operation should be selected for these patients.

Abstract:AIM:To evaluate the clinical effect of small incision cataract extraction with a manual nucleus division technique combined with intraocular lens implantation in cataract operation of large quantities.

METHODS: Totally 105 patients(105 eyes)underwent small incision cataract extraction surgery. Visual acuity was observed, eye condition, fundus and intraocular pressure were examined by slit lamp at postoperative 1wk; 1mo.

RESULTS: The visual acuity improved significantly at postoperative 1mo, 89 cases(89 eyes)with better than 0.3(85%), 101 cases(101 eyes)with 0.1 and above(96%). It had short operation time, fewer complications and good anesthetic effect.

CONCLUSION: This operation is suitable for primary hospitals, which visual acuity improved obviously, without serious complications, and economic and feasible.

Abstract:AIM: To observe the clinical efficacy of Artisan iris-clip intraocular lens(IOL)implantation on cataract with a wide range of lens dislocation.

METHODS: Twenty-four hospital patients(28 eyes)of cataract with lens subluxation by trauma(20 patients, 20 eyes)and Marfan's syndrome(4 patients, 8 eyes)during May 2007 to December 2011 were selected. All of them underwent phacoemulsification or an anterior vitrectomy and Artisan iris-clip IOL implantation at stage Ⅰ. Postoperative visual acuity, corneal endothelial cell count, intraocular lens position and postoperative complications were observed. Follow-up time was 6mo.

RESULTS:Compared with the preoperative, postoperative best corrected visual acuity improved to varying degrees, visual acuity of 0.1-0.5 was in 20 eyes, 0.5-1.0 in 8 eyes. After followed up 1-6mo, no artificial lens shift, iris inflammation, iris atrophy and corneal decompensation and other complications were observed.

CONCLUSION: Cataract surgery with a wide range of lens dislocation is difficult, but as long as surgeons who have a wealth of clinical experience and superb skills, still can carry out phacoemulsification surgery or anterior vitrectomy and Artisan iris-clip IOL implantation and obtain a better outcome.

Abstract:AIM: To observe the curative effect of treating small-incision cataract extraction by intraocular lens implantation combined with trabeculectomy for primary angle-closure glaucoma with cataract.

METHODS: Totally 44 cases(52 eyes)of primary angle-closure glaucoma combined with cataract were selected to undergo the combined surgery, in order to observe the patients' pre- and postoperative eyesights, intraocular pressures and the postoperative complications.

RESULTS: The postoperative eyesight was improved significantly as compared with the preoperative eyesight. The intraocular pressure was declined dramatically. The result was of statistical significance(P<0.05). All the 52 cases' surgeries were performed by the same surgeon. The surgeries were processed smoothly, with 6 postoperative eyes of anterior chamber inflammation cell response, 3 eyes of anterior chamber fibrinoid exudate, 2 eyes of shallow anterior chamber through mydriasis and treatment with glucocorticoids and non-steroidal eyedrops before absorption, and no complications like malignant glaucoma, cyclodialysis, etc. were reported through mydriasis and pressure bandaging before recovery.

CONCLUSION: Treating the primary angle-closure glaucoma combined with cataract through the combined surgery has high reliability and desirable curative effect. The surgical method is simple to learn and applicable for promotion on the basic level.

Abstract:AIM: To investigate the advantage of using the medical sodium hyaluronate gel undergo goniosynechialysis, and to compare the difference of the viscoelastic agent and perfusion fluid by clinical control study.

METHODS:Totally 103 cases(103 eyes)patients who had angle-closure glaucoma(ACG)with cataract all in Beijing Tongren Hospital affiliated to Capital Medical University, from September 2012 to February 2013. All the patients had primary glaucoma or recurrence ACG with cataract. Their intraocular pressure(IOP)could be controlled in normal value using one or two anti-glaucoma medications. We divided all the patients into two groups by chance. Experimental group had 53 cases(50 eyes), and control group had 50 cases(53 eyes). Two groups all had been performed phacoemulsification combined with goniosynechialysis by the same experiential operator. But experimental group did goniosynechialysis using the medical sodium hyaluronate gel, control group did goniosynechialysis using perfusion fluid. We observed the change of IOP, central anterior chamber depth and anterior chamber structure of two groups in postoperative 1mo.

RESULTS: SPSS19.0 statistics software was utilized to analyze the data, This study selected one-side test α=0.05, adopted paired t-test or two-sample t-test. We obtained that experimental group IOP decreased 12.42±0.04mmHg, anterior chamber depth increased 1.276±0.201mm; that control group IOP decreased 6.56±0.08mmHg, anterior chamber depth increased 0.852±0.132mm. And experimental group anterior chamber angle opened more widely than the other group, the comparison had statistical significance(P<0.05).

CONCLUSION:In phacoemulsification combine with goniosynechialysis,use medical sodium hyaluronate gel do goniosynechialysis can more effectively decrease IOP. This because the medical sodium hyaluronate gel has high glutinousness, it can separate angle of anterior chamber and controlling IOP effectively.

Abstract:AIM: To observe the application effect of anti-eyebrow small incision cataract extraction combined with IOL implantation in blindness prevention and treatment

METHODS: A total of 526 cataract patients included in regaining sight project of China Disabled Persons' Federation were underwent anti-eyebrow small incision cataract extraction combined with IOL implantation from May 2010 to August 2013.

RESULTS: Postoperative 1d, uncorrected visual acuity >0.3 were 345 cases(65.6%), 0.1-0.3 were 152 cases(28.9%), <0.1 were 29 cases(5.5%); 1wk after surgery: >0.5 were 395 cases(75.1%), 0.3-0.4 were 101 cases(19.2%), <0.3 were 30 cases(5.7%). Visual recovery rate was 100%, residual rate was 92.5%. Intraoperative, 16 cases occurred posterior capsular rupture, 3 cases iridodialysis, 2 cases were Descemet's membrane avulsion. Postoperative, 56 cases ocurred corneal edema, 10 cases of central cornea stroma edema, 22 cases of secondary high intraocular pressure, were restored to normal bansis on the corresponding treatments.

CONCLUSION: Anti-eyebrow small incision cataract extractio combined with IOL implantation is effective, and has low complication rate, high security, can popularization and application in large-scale sight rehabilitating project.

Abstract:AIM: To evaluate the treatment process of toxic anterior segment syndrome(TASS)and to found out the effective treatment, aetiological agent and prognosis.

METHODS: A total of 6 cases(7 eyes)were suspected with TASS by clinical situations. Bacterial infectious endophthalmitis could be ruled out by anterior chamber and vitreous body paracentesis. All patients were treated with local application of antibiotics and glucocorticoid eyedrops, and some patients were treated with intravitreal injection of 1mg vancomycin and 2mg ceftazidime. The therapeutic effects after treatment were observed.

RESULTS: There were no bacterial growth in 6 cases(7 eyes)with TASS by anterior chamber fluid and vitreous humor culture. After administrated with antibiotics and glucocorticoid eye drops, inflammation was steady in 1 case(2 eyes). After anterior chamber irrigation and intravitreal medicine injection, anterior chamber inflammation were improved significantly in 5 cases(5 eyes). No ocular abnormality was seen in following up 6mo. Risk factors was considered as the cause of sterilization pot, the incidence decreased obviously by timely cleaning change and filter.

CONCLUSION: TASS is a rare complication of ocular anterior segment surgery. Good prognostic results will be achieved with correct analysis, criterion and effective treatment.

Abstract:AIM: To investigate the utility of optomap panoramic 200Tx in screening fundus disease among the patients after cataract surgery.

METHODS: From November 18^th to December 31^st, 2013 all 146 post-cataract surgery patients were recruited. All non-mydriatic fundus images were taken with the optomap panoramic 200Tx and were diagnosed by one masked retinal specialist. Non-mydriatic direct ophthalmoscope exam and mydriatic slit-lamp lens exam were also done by other two masked specialists. Comparisons of the three methods were made.

RESULTS: Among 146 patients(161 eyes), 40 eyes(24.8%)of retinal lesions was detected by non-mydriatic direct ophthalmoscope exam, 59(36.7%)by non-mydriatic optomap 200Tx exam, and 61(37.9%)by slit-lamp lens exam. Nine eyes(5.6%)needed medical intervention immediately. Results of optomap 200Tx exams and slit-lamp lens exams were similar without statistically significant difference(P>0.05), better than direct ophthalmoscope exam(P<0.05)with statistically significant difference.

CONCLUSION:Opacification of the refractive medium makes thorough fundus examination impossible. So post-operative fundus examination is highly necessary and should be a routine. Optomap panoramic 200Tx, which shows no statistically difference from mydriatc slit-lamp lens exam, is a convenient and feasible method in discovering fundus pathological changes.

Abstract:AIM: To investigate the curative effect of retaining the peripheral anterior lens capsule combined lensectomy with vitrectomy for ocular trauma.

METHODS: Totally 33 patients(33 eyes)with eye trauma underwent combined lensectomy with vitrectomy, retaining the peripheral anterior lens capsule and phase Ⅱ posterior chamber IOL implantation. After follow-up of 6mo, visual acuity, intraocular pressure(IOP), IOL position, and intraoperative and postoperative complications were observed.

RESULTS: Visions of all the patients were improved at varying degrees. After follow-up of 6mo, no obvious lens deflected and serious complications(glaucoma, retinal detachment)appeared.

CONCLUSION: Combined lensectomy with vitrectomy, retaining the peripheral anterior lens capsule for ocular trauma has good curative effects of lessening complications during operation and postoperation and good visual acuity recovery.

Abstract:AIM:To analyze the causes and treatments of high intraocular pressure(>21mmHg)of angle-closure glaucoma underwent compound trabeculectomy 1mo after surgery.

METHODS:This was a retrospective study of our hospital, from March 2010 to March 2013. Thirty-four(38 eyes)of angle-closure glaucoma patients were collected, who underwent compound trabeculectomy with high intraocular pressure(>21mmHg)1mo after operation. We analyzed the causes and summarized the treatments.

RESULTS:The causes which lead to early postoperative high intraocular pressure included malignant glaucoma(9 eyes of 8 cases), blood clot and connective tissue block under the scleral flap(15 eyes of 13 cases), hyphema after surgery(5 eyes of 5 cases), sclera flap incision was incarcerated with iris tissue(3 eyes of 3 cases), preoperative high intraocular pressure for a long time(5 eyes of 4 cases), 1 eye of 1 case for unknown reason. After proper treatments, intraocular pressures of all patients were bellowed 21mmHg.

CONCLUSION:Early postoperative high intraocular pressure of angle-closure glaucoma underwent compound trabeculectomy is caused by various factors, and the early prevention and timely treatment are key points of a successful operation.

Abstract:AIM:To investigate risk factors and efficacy of reoperation for neovascular glaucoma(NVG)secondary to vitrectomy in proliferative diabetic retinopathy(PDR).

METHODS:Seven cases(7 eyes)from October, 2009 to December, 2012 were analyzed retrospectively. All the patients had NVG after the primary vitrectomy for PDR and were performed secondary vitrectomy combined with laser photocoagulation.

RESULTS: The mean intraocular pressure(IOP)was(11.21±4.22)mmHg before primary surgery. The number of laser spots ranged from 622 to 1 124 during the first vitrectomy. Cataract extraction was performed in all 7 cases and intraocular lens was implanted in 5 cases. The mean IOP was(10.11±3.62)mmHg during 2mo after the primary surgery. During follow-up, all the patients had significantly progressive intraocular inflammation. Vitreous hemorrhage was not absorbed completely in 2 cases and recurrent vitreous hemorrhage occurred in the other 5 cases. Five cases had poor glycemic control and the other 2 cases had bad blood pressure control. NVG occurred in all 7cases. The mean IOP was(41.13±7.76)mmHg before the secondary surgery. After the secondary surgery, the IOP were under control in 5 cases. For the other 2 cases, the IOP was controlled in one case by transscleral cyclophotocoagulation, another one was lost in follow-up with uncontrolled IOP.

CONCLUSION: Primary vitrectomy combined with lens extraction, insufficient laser speckle, unabsorbed and recurrent vitreous hemorrhage, intraocular inflammation and systemic condition may be the risk factors associated with the occurrent of NVG after vitrectomy in PDR. Secondary vitrectomy combined with sufficient retinal photocoagulation is efficiency for NVG after vitrectomy for the PDR.

Abstract:AIM: To investigate the relationship between diabetic macular edema(DME)and serum E-selectin level.

METHODS: Totally 90 patients with diabetic retinopathy in our hospital from October 2009 to October 2013 were observed. Retrospective analysis of the correlation between macular edema degree and serum soluble E-selectin(sE-sel). Ninety patients with diabetic retinopathy were divided into two groups: DME group and non-DME group. The level of sE-sel and microalbuminuria(MA)of two groups were determined and compared.

RESULTS: There was significant difference in MA, sE-sel levels of groups(P<0.05). The value of diabetic retinopathy patients with sE-sel and MA, FBG were positively correlated(r=0.728, P<0.05; r=0.651, P<0.05).

CONCLUSION: Elevated levels of sE-sel is a risk factor for diabetic macular edema, and sE-sel was involved in the pathogenesis of diabetic microangiopathy.

Abstract:AIM: To explore the related risk factors and outcome in pregnancy-induced hypertension patients with Ⅲ phase of retinopathy.

METHODS: A total of 105 pregnancy-induced hypertension patients with Ⅲ phase of retinopathy in our hospital from Januany 2012 to December 2013 were enrolled. Clinical date of them were collected to analyze.

RESULTS: The occurrence of pregnancy-induced hypertension patients with Ⅲ phase of retinopathy were positively correlated with the course of the disease, blood pressure, proteinuria, and it was higher occurred in cold winter and spring, timely termination of pregnancy and appropriate hormone therapy can promote the recovery of vision, and improve outcomes of pregnancy.

CONCLUSION: The occurrence of pregnancy-induced hypertension patients with Ⅲ phase of retinopathy associated with season and disease severity. Timely treatment can restore normal vision, improve maternal and neonatal prognosis. Routine examination of fundus examination should be used as the pregnancy induced hypertension syndrome.

Abstract:AIM: To observe the effect of autologous stem cell transplantation in diabetic retinopathy.

METHODS:Totally 58 cases(116 eyes)who underwent autologous stem cell transplantation were confirmed as no diabetic retinopathy(18 eyes), mild non-proliferative diabetic retinopathy(NPDR)(41 eyes), mid-level NPDR(51 eyes); severe NPDR(6 eyes)by ophthalmoscope directly or indirectly and fluorescence fundus angiography(FFA). Follow-up was 6-12mo, the changes of retinopathy were observed.

RESULTS:The total effective rate of vision and retinopathy was 84.4%, 76.7%. The results of severe NPDR was statistically worse than the other groups(P< 0.05).

CONCLUSION:The stable blood glucose level and improved pancreatic function after autologous stem cell transplantation might be helpful in diabetic retinopathy, the long effects need to be researched further.

Abstract:AIM:To summarize the clinical characters of optic neuritis caused by antituberculosis drugs, and to discuss the prevention countermeasures.

METHODS: The clinical characters of optic neuritis caused by antituberculosis drugs among those outpatients and ward patients from January 2003 to January 2013 were reviewed and analyzed.

RESULTS: Optic neuritis caused by antituberculosis drugs was rare(17/60000), while retrobulbar neuritis was common. The drugs inducing optical neuritis were mainly ethambutol, followed by isoniazid and streptomycin. The vision of patients would have different degrees of improvement via the following treatment after specific diagnosis, i.e., timely stopping the tuberculosis medicine associated with optic neuritis, and taking vitamin supplements, dilating blood vessels and applying hormone therapy according to the illness.

CONCLUSION: We should pay attention to the change of the vision of patients during the usage of antituberculosis drugs. In the case of sudden eyesight deterioration, ophthalmology examination and timely treatment are advised preventing blindness.

Abstract:AIM: To evaluate the curative effect and drug tolerance in the treatment of severe bacterial keratitis and conjunctivitis by levofloxacin.

METHODS: Totally 195 patients with severe bacterial keratitis and conjunctivitis were included in this study. Based on the sequence of enrollment, they were randomly divided into three groups: group A(65 patients)received levofloxacin, group B(65 patients)received suture method under microscope, group C received suture method with loupe besides the same basic operative treatment in the two groups. The curative effect and drug tolerance were observed and compared statistically.

RESULTS: In group A, 54 cases were cured, in the rate of 83.1%, 7 cases(10.8%)were excellent, 3 cases(4.6%)were valid, 1 case(1.5%)was invalid. In group B, 25 cases(38.5%)were cured, 6 cases(9.2%)were excellent, 23 cases(35.4%)were valid, 11 cases(16.9%)were invalid. In group C, 4 cases(6.2%)were cured, 3 cases(4.6%)were excellent, 36 cases(55.4%)were valid, 22 cases(33.8%)were invalid. The curative effect and drug tolerance among groups had obvious differences(P<0.05).

CONCLUSION: Levofloxaoin is effective and safe for the treatment of bacterial conjunctivitis and keratitis, which is not resistant and worthy of promotion.

Abstract:AIM: To evaluate the effect of Hexue mingmu tablets on traumatic hyphema caused by blunt ocular trauma.

METHODS: Totally 150 patients of traumatic hyphema were divided into seven types by using ultrasound biomicroscopy combining with anterior segment abnormalities, each type was randomly classified as trial group and control group. The trial group was administered Hexue mingmu tablets, control group was treated by hemocoagulase.

RESULTS: The absorbing time of trial group was shorter than that of the control group. And there was statistical significance between the two groups(P<0.05).

CONCLUSION: Hexue mingmu tablets is an effective medicine to treat traumatic hyphema. Ultrasound biomicroscopy can be used as a routine examination method in traumatic hyphema.

Abstract:AIM: To observe the clinical efficacy of diclofenac sodium eye drops for postoperative recurrence of pterygium, and to provide safer drug regimens to prevent the recurrence of pterygium.

METHODS: From November 2011 to September 2013, 124 patients 134 eyes who underwent surgery because of pterygium in our hospital were randomly divided into trial group( diclofenac sodium eye drops and sodium hyaluronate eye drops)and control group(tobramycin dexamethasone eye drops and sodium hyaluronate eye drops), all patients were followed up for 3mo(once a week)and the cornea, intraocular pressure and recurrence of pterygium were observed and compared between the two groups.

RESULTS: Followed up for 3mo, 43 cases(45 eyes)in the trial group and 38 cases(39 eyes)in the control group had done the follow up as planned, in which 14 cases(15 eyes)showed the signs of recurrence, 2 cases(3 eyes)recurred eventually in the trial group, and in the meantime there were 12 cases(13 eyes)with signs of recurrence and 2 cases(2 eyes)with a recurrence eventually in the control group, but no statistical difference was found between the two groups(P>0.05); there were 6 cases(9 eyes)dropped out of the study with a higher intraocular pressure in the control group, compared to trial group(0 cases of 0 eye), the difference was statistically significant(P<0.05); cornea conditions between the two groups had no statistical significance(P>0.05).

CONCLUSION:Diclofenac sodium eye drops is effective and safe in preventing the recurrence of pterygium.

Abstract:AIM:To discuss the effective method of decreasing the postoperative recurrence rate of recurrent pterygium.

METHODS:Totally 126 cases(126 eyes)with recurrent pterygium were randomly divided into A group(56 cases)and B group(70 cases). Group A was treated by pterygium conjunctive reverse transplantation combined with amniotic membrane transplantation, group B was treated by amniotic membrane transplantation. The followed-up time after surgery was 6-24mo.

RESULTS:In group A, postoperative 5-7d(average 5.62±1.38d), cornea epithelium was repaired. In group B, postoperative 7-10d(average 7.38±1.12d), the corneal wound was healed. There was statistical significant difference between two groups(t=4.307,P<0.05). Three cases recurrence were noted in A therapeutic group(56 cases), the recurrent rate was 5.4%; Twelve cases recurrence were noted in B compared group(70 cases), the recurrent rate was 17.1%. There was statistical significant difference between two groups(P<0.05).

CONCLUSION:It is suggested that pterygium conjunctive reverse transplantation combined with amniotic membrane transplantation is effective in the treatment of recurrent pterygium.

Abstract:AIM: To observe the effectiveness and safety of auto-corneallimbus stem cell transplantation combined double biological amniotic membrane transplantation in the treatment of pterygium

METHODS: The patients performed pterygium surgeries in our hospital between 2010-06 and 2013-12 were selected, according to different pterygium classification grading, different surgical methods were taken. Group A: autologous corneal limbus stem cell transplantation was conducted. Group B: autologous corneal limbus stem cell transplantation combined double biological amniotic membrane transplantation were conducted. The patients were followed up 6-36mo after operation, the postoperative recurrence rate was observed.

RESULTS: A total of 149 cases with 155 eyes included in this study, including 75 eyes in group A with the application of autologous limbal stem cell transplantation: thin type grade 2, 10 eyes(1 eye recurred), grade 3, 14 eyes(2 eyes recurred); Hypertrophic 17 eyes(2 eyes recurred); Recurrence type 21 eyes(3 eyes recurred); Recovered 68 eyes(8 eyes recurred, the total recurrence rate was 10.67%); Group B: 80 eyes treated with autologous limbal stem cell transplantation combined double biological amniotic membrane transplantation, thin type above grade 3 and grade 4(no recurrence); Hypertrophic 21 eyes(1 eye recurred); Recurrence type 37 eyes(2 eyes recurred); Recovered 77 eyes(3 eyes recurred, the recurrence rate was 3.75%). Two groups of hypertrophic type, recurrence is significant in reducing the recurrence rate(P<0.05).

CONCLUSION: It indicates that recurrence rates are different when adopting different ways of operations.Autologous corneal limbus stem cell transplantation is applicable for no root type, pterygium of thin type below grade 2; Autologous corneal limbus stem cell transplantation with double biological amniotic membrane transplantation is suitable for thin type above grade 2, hypertrophic type, recurrent type of pterygium, with low recurrence rate, so it is the ideal surgical method.

Abstract:AIM:To evaluate the clinical effect of therapeutic soft corneal contact lens in combination with fresh amniotic membrane transplantation in the treatment of pterygium and its clinical value.

METHODS:This study was a retrospective analysis of 200 pterygium excision patients(200 cases, 220 eyes)in hospital from January 2010-June 2011. The patients were divided into two groups. Group 1(100 cases, 110 eyes)were patients treated with fresh amniotic membrane transplantation and therapeutic soft corneal contact lens while group 2(control group, 100 cases, 110 eyes)did not use corneal contact lens. The clinical outcomes in these two groups were compared in a 6-18mo postoperative follow-up observation.

RESULTS:In control group using corneal contact lens the epithelium repair time ranged from 2-7d with an average time of 3.8d; in group 1 the epithelial repair time ranged from 1-5d with an average time of 2.5d. The patients were followed up for 6-18mo, 9 recurrent eyes were found in control group, the recurrence rate was 8.2%; 5 recurrent eyes were found in experimental group the recurreat rate was 4.5%. There were significant differences in the 2 groups comparing treatment outcomes(P<0.05). Early stimulative symptoms after surgery can be reduced by wearing contact lenses.

CONCLUSION:The therapeutic effect of fresh amniotic membrane transplantation after pterygium excision is enhanced by the therapeutic application of corneal contact lens. The epithelial repair time is shortened, the recurrence rate is reduced after pterygium excision and stimulative symptoms including photophobia, tearing, foreign body sensation and ophthalmodynia caused by corneal epithelial defect can be relieved.

Abstract:AIM: To investigate a simple and effective method of lacrimal canalicular laceration of lacrimal canalicular nasal side in the broken end of the lower lacrimal canaliculus and to evaluate the curative effect after lower lacrimal canaliculi laceration anastomosis.

METHODS: In 55 cases(55 eyes)of lower lacrimal canalicular laceration patients, in order to look for nasal fracture of lower lacrimal canaliculus broken end. Most of them were under direct vision using surgical microscope, only a few patients injecting physiological saline(or sodium hyaluronate when necessary)from the upper lacrimal puncta. With 0.8mm outer diameter hollow silicone tube as the support material to anastomose surrounding tissue of the lacrimal canaliculus 2-3 needles. Silicone tube was indwelled for 2-3mo. All patients were followed up 6-24mo.

RESULTS: In 55 cases(55 eyes)of lower lacrimal canalicular laceration patients were all successful anastomosed. The cure rate and the effective rate were 89.1%(49/55), 9.1% cases improved(5/55), only 1 case was invalid(1.8%).

CONCLUSION: This method is an effective method of lacrimal canaliculus anastomosis operation and it is simple and effective, suitable for application in a hospital with micro operation conditions.

Abstract:AIM: To evaluate the value of silicone intubation and ring-fixed method in canalicular laceration.

METHODS: A retrospective study of 36 cases with laceration of lacrimal canaliculus. For all the patients, microscope was used to find the broken ends of the lacrimal canaliculus, and then straight insertion was performed to the distant and near broken ends through the upper and lower lacrimal points, then passed the dacryocyst to insert nasolacrimal canal and ended up in inferior nasal meatus. Thus, clinical data about forming annular support to treat laceration of lacrimal canaliculus was presented here.

RESULTS: All 36 patients with traumatic canalicular laceration were anastomosed successfully and all patients healed without infection. The surgery went well, intubation was smoothly, all patients were followed-up for another 6mo after the stent was removed. The accidental fall off of the stent was not observed during the follow-up. During the follow-up 10-18mo after extubation, when the stent was removed, 32 cases(88.9%)recovered to normal lacrimal drainage function; 4 cases(11.1%)remained epiphora with obstructed lacrimal passage. All cases were no lower eyelid ectropion.

CONCLUSION: For the patients with inferior canalicular laceration, the silicone intubation and ring-fixed method is effective, low irritation and less complication.

Abstract:AIM:To analyze the clinical results of orbicularis muscle shortening surgery and eyelid skin orbicularis muscle resection for senile entropion.

METHODS: From January 01, 2006 to December 31, 2012, senile patients with lower eyelid were divided into two groups according to different surgical methods. Group A with the orbicularis muscle shortening improved operation in 20 cases(38 eyes), group B used the eyelid skin orbicularis muscle resection in 21 cases(36 eyes). The effects of surgery were followed-up postoperatively.

RESULTS: Patients were followed up for 1-2a, 20 patients(38 eyes)in group A were cured without recurrence; 7 eyes recurred in group B, the recurrence rate was 19%, the recurrence rate after surgery both groups were statistically significant(P<0.05).

CONCLUSION: The effect of orbicularis muscle shortening improved operation for senile entropion is good and stable.

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 and microkeratome.

METHODS: Totally 150 patients(300 eyes)with myopia received operation of LASIK. Patients were divided into two groups according to the methods of making corneal flap. The patients of group one were assigned to receiving LASIK with corneal flap creation by Intralase femtosecond laser(190 eyes of 95 patients), group two were assigned to receiving LASIK with corneal flap creation by microkeratome(110 eyes of 55 patients). Dry eye symptom score, tear break-up time(BUT), Schirmer Ⅰ test(S I t), corneal fluorescein staining(FL)were recorded preoperatively and postoperatively at 1wk; 1, 3 and 6mo.

RESULTS: Dry eye symptom score: there existed obvious differences at 1wk; 1, 3mo between two groups(P<0.05). While no such obvious differences existed in the 6mo between two groups(P>0.05). BUT: there existed obvious differences at 1wk, 1, 3mo between two groups(P<0.05). While no such obvious differences existed at 6mo between two groups(P>0.05). SchirmerⅠ test: there existed obvious differences in the 1wk, 1, 3mo between two groups(P<0.05). While no such obvious differences existed in the 6mo between 2 groups(P>0.05). FL: there existed obvious differences in the 1wk, 1, 3mo between two groups(P<0.05). While no such obvious differences existed in the 6mo between two groups(P>0.05).

CONCLUSION: The early stability of tear film decrease after operation in both of the two groups. The dry eye symptoms are lighter and recover faster.

Abstract:AIM: To evaluate the clinical effect of laser in situ keratomileusis(LASIK)with the corneal flap created by FEMTO LDV femtosecond laser for myopia.

METHODS: The corneal flap was created by the FEMTO LDV femtosecond laser, and the thickness of the flap was 110μm. A total of 143 myopic patients(283 eyes)were treated with the EC5000-CXIII element laser. The optometry of the eye, best corrected visual acuity(BCVA)the thickness of the cornea, and ObscanⅡ were examined before the operation. The thickness of the flap was calculated by measuring the thickness of corneal bed during the operation in 35 eyes. The conditions of the corneal flap, complications, uncorrected visual acuity(UCVA), diopter, corneal topography were observed during and after the operation and were checked for 3mo follow-up.

RESULTS: During the operation, it appeared small flap(diameter<5mm)in 3 eyes, corneal margin incised incompletely in 5 eyes and incision bleeding in 8 eyes. Postoperative subconjunctival hemorrhage appeared in 6 eyes. The thickness of corneal flap in 35 eyes was 108.75±8.52μm(98-117μm)and the error was 6.49±8.62μm(3-12μm). There was no significant difference between the actual flap thickness and the preset flap thickness(P>0.05). The average equivalent spherical refractive was -0.29±0.47(-1.50 to +1.00)DS after the operation for 3mo and the UCVA met or exceeded preoperative BCVA in 251 eyes(88.7%).

CONCLUSION: The operation of myopia by LASIK flap created by FEMTO LDV femtosecond laser has fewer complications, and the effect is definite and safe.

Abstract:AIM: To evaluate changes in quality-of-life of adults with concomitant exotropia before and after surgery.

METHODS:A retrospective cohort method was used in this research. Sixty-five patients with concomitant exotropia(ranged from 18-30 years)were enrolled. Quality of life was studied with 2 different questionnaires \〖the Adult Strabismus-20(AS-20)and the MOS 36-item Short-Form health survey(SF-36)\〗, which patients completed preoperatively and at 3mo postoperatively.

RESULTS:With the AS-20, 3mo after surgery, the mean psychosocial and visual function scores of AS-20 improved significantly(P<0.01). Similarly, with the SF-36, the mean score in 7 of 8 areas improved significantly(P<0.01), including physiological function, role limitations due to physiological health, general health, vitality, social function, role limitations due to emotional problems, mental health and the overall mean score. However, with respect to bodily pain, no significant improvement was found after surgery(P>0.05).

CONCLUSION:Surgical treatment of concomitant exotropia in adults gives a highly significant improvement in quality-of-life scores. We should pay more attention to the impact of strabismus on quality of life clinically to improve the outcome of the surgery.