Abstract:AIM: To evaluate the efficacy, safety and predictability of laser-assisted sub-epithelial keratectomy(LASEK)for the correction of hyperopia using the SCHWIND AMARIS platform.

METHODS: This retrospective single-surgeon study includes 66 eyes of 33 patients with hyperopia who underwent LASEK with mitomycin C(MMC). The median age of patients was 35.42±1.12y(ranging 18 to 56y). In each patient LASEK was performed using SCHWIND AMARIS excimer laser. Postoperatively clinical outcomes were evaluated in terms of predictability, safety, efficacy, subjective and objective refractions, uncorrected visual acuity(UCVA), best spectacle-corrected visual acuity(BSCVA)and adverse events.

RESULTS: The mean baseline refraction was 3.2±1.6 diopters(D)(ranging 0 to 7 D). The mean pre-operative and postoperative spherical equivalent(SE)were 2.34±1.76(ranging -1.25 to 7 D)and 0.30±0.84(ranging -0.2 to 0.8 D)respectively(P=0.001). The mean hyperopia was 0.63±0.84 D(ranging -1.75 to 2.76 D)6 to 12mo postoperatively. Likewise, the mean astigmatism was 0.68±0.43 D(range 0 to 2 D)with 51(77.3%)and 15(22.7%)eyes within ±1 and ±0.50 D respectively. The safety index and efficacy index were 1.08 and 1.6 respectively.

CONCLUSION:LASEK using SCHWIND AMARIS with MMC yields good visual and refractive results for hyperopia. Moreover, there were no serious complications.

Abstract:AIM: To describe the epidemiology and outcome of ocular injuries requiring hospital admission in Ladoke Akintola University of Technology Teaching Hospital(LTH), Osogbo, Nigeria.

METHODS: Retrospective chart review of all patients hospitalized for ocular injuries at LTH, Osogbo between April 2002 and March 2014 was undertaken. Information extracted from patients records were entered into a pre-designed form. Data were analyzed with Statistical Package for Social Sciences(SPSS)version 20. Logistic regression analysis was used to assess effects of different variables on the visual outcome of ocular injuries after treatment among the subjects. P<0.05 was used as test of statistical significance.

RESULTS: One hundred and twenty-seven patients were hospitalized at LTH within the study period. The median age was 22.0y(range: 0.5-70.0)and male: female ratio 2.6:1. Majority of the injuries(35.2%)occurred within the home setting. Of the 127 patients, 74(58.3%)had open globe Injuries(OGI), 34(26.8%)had closed globe injuries(CGI), 7(5.5%)had adnexal injuries, 6(4.7%)had ruptured globes, 4(3.1%)had chemical injuries, 1(0.8%)patient each had retained intraocular foreign body and thermal eye injury. Two-thirds of patients managed for ocular injuries in this series had poor visual outcome. There were statistically significant associations between poor initial visual acuity(OR=13.24)and OGI with poor visual outcome(OR=9.16).

CONCLUSION: There is an urgent need for health education and, to put in place preventive strategies for ocular injuries. Developing countries need to build up capacity to offer complex anterior and posterior segment surgeries for those with severely injured eyes so as to improve the visual outcomes.

Abstract:AIM: To compare the effect of sub-Tenon anesthesia 3 mL and 5 mL lidocaine on intraocular pressure(IOP), analgesia and akinesia. Sub-Tenon's anaesthesia is a common regional technique for cataract surgery by phacoemulsification. As a volume-based block, IOP optimization along with analgesia and akinesia is a concern for successful surgical course.

METHODS: After obtaining ethics approval and informed consent of patients, 70 patients were randomly enrolled to the study to receive sub-Tenon's block with either 3 mL(Group I)or 5 mL(Group II)lidocaine. IOP was measured before the block. IOP, analgesia and akinesia were evaluated at 10min after the block. Complications such as chemosis and subconjunctival hemorrhage were also noted.

RESULTS: Two patients were excluded from the study due to the patients' request for sedation during block administration. Patients' characteristics such as age, weight, height, axial length, American Society of Anesthesiology(ASA)physical status were comparable in-group before and after block measurement and between groups. Akinesia and analgesia were significantly better in Group II in comparison to Group I. “No eye movement” was obtained in 13 patients(38.2%)in Group II whereas none of the patients had “no eye movement” in Group I. Eighteen(56.3%)patients had “no pain” and 14(43.7%)patients had “mild pain” in Group I whereas “No pain” in 28 patients(82.4%)and “mild pain” in 6 patients(17.6%)was observed in Group II. On the other hand, IOP revealed no statistically significant alteration in both groups before and 10min after the block(P<0.05). Complications were comparable between groups.

CONCLUSION: Sub-Tenon's anaesthesia either with 3 or 5 mL lidocaine had no effects on IOP; on the other hand, analgesia and akinesia were preferably better in patients who received 5 mL lidocaine for the block during cataract surgery by phacoemulsification.

Abstract:AIM: To compare the outcomes of combined phacoemulsification and non-penetrating deep sclerectomy(P-DS)with combined phacoemulsification and trabeculectomy(P-T)in patients who have cataract and moderate-to-severe primary open angle glaucoma(POAG)or pseudoexfoliative glaucoma(PXG).

METHODS: In this prospective randomized study 40 eyes of 40 patients with cataract and POAG or PXG were evaluated. Complete eye examination and glaucoma tests were performed in all patients. Combined P-DS and P-T were performed under local anesthesia in 20 eyes in each group. Visual acuity(VA), intraocular pressure(IOP)and number of glaucoma medications were all recorded preoperatively and postoperative on 10d, 1, 3, 6 and 12mo. Complications, laser goniopuncture in P-DS group and needling in P-T group were also recorded.

RESULTS: The age(P-DS, 66.3±11.0 and P-T, 70.2±9.3y)and sex distribution(P-DS, 7 female and 13 male, P-T, 9 female and 11 male)were similar in both groups(P>0.05). Number of POAG and PXG patients were 12 and 8, and 13 and 7 in P-DS and P-T groups, respectively(P>0.05). There was no difference between groups in terms of preoperative VA(P-DS, 0.69±0.22 and P-T, 0.76±0.22 logMAR), IOP(P-DS, 17.9±1.6 and P-T, 18.1±1.9 mm Hg)and number of medications(P-DS: 2.7±0.7 and P-T: 2.9±0.8),(P>0.05). VA increased, IOP and number of medications decreased in both groups postoperatively(P<0.01). Postoperative IOPs were 15.0±1.7 and 14.5±1.6 mm Hg in P-DS and P-T groups respectively(P=0.472). Postoperative number of medications were slightly better in P-T group(0.5±0.7)than in P-DS group(0.8±0.9)(P=0.307). There were no complications in both groups. Laser goniopuncture was applied in 7 eyes(once in 5 eyes and twice in 2 eyes)in P-DS group. Needling was performed in 1 eye in P-T group.

CONCLUSION: In patients with coexisting cataract and glaucoma, both combined P-DS and P-T may be performed safely. Reliability and efficacy were similar in both groups. Follow-up of P-DS should be done cautiously and when necessary laser goniopuncture should be performed.

Abstract:AIM:To determine the expression of basic fibroblast growth factor(bFGF)in retinal pigment epithelial(RPE)cells from anterior and posterior part of guinea pig eyes with lens-induced myopia(LIM).

METHODS:Thirty two-week-aged guinea pigs were randomly divided into three groups, group A, group B and group C. Another five guinea pigs(10 eyes)were chosen as control group without any treatment. Concave lenses were worn by the 30 guinea pigs on either side of their eyes. After 6, 15 and 30d, the lenses were removed and optometry and axial length were used to make sure the myopia had formed. The retinal pigment epithelial cells of each group were cultured and passaged in vitro using enzymatic digestion method. The cultured cells at 3～6 generation was detect by immunocytolchemistory, Real-Time PCR and Western blotting to detect the expression of bFGF.

RESULTS:The expression of bFGF was located in the cytoplasm and nucleus. The results of immunocytolchemistory, Real-Time PCR and Western blotting showed that the expression of bFGF were detected at anterior and posterior part of eyes from experiment group and control group, the expression in experiment group at both part was significantly lower than those in control group(P<0.05). The positive percentage of expression of bFGF in experiment group decreased with the induced time(P<0.05). The expression of bFGF from anterior part of both experiment group and control group was as the same as that from posterior part of themselves(P>0.05).

CONCLUSION:The expression of bFGF from anterior and posterior part of experiment group was lower than those of control group.

Abstract:AIM:To construct shRNA lentivirus interference vector of mice orbital fibroblasts TLR4 and to research the therapeutic effect and mechanism of TL4^-/-fibroblasts on thyroid-associated ophthalmopathy.

METHODS:Optimal shRNA interference expression plasmid of mouse orbital fibroblasts TLR4 gene was designed, built, and screened. Then the best shRNA was introduced into lentiviral expression vector by Gateway method and recombinant lentiviral vector was used to infect mouse orbital fibroblasts. Its capability of negative regulating the immune inflammatory response was researched. At last the method of fibroblast TLR4 gene silencing in the model mice of thyroid-associated ophthalmopathy was used, the in vivo therapeutic effect was observed.

RESULTS: ShRNA sequences with the best effect of gene silencing were selected and introduced into lentiviral vectors(virus titer was 1.5×10⁶TU/mL). Balb/c mice orbital fibroblasts transfected lentivirus could negatively regulate the immune response, inhibit immune inflammatory response. The proceeding of thyroid-associated ophthalmopathyof the mice transfected TLR4^-/-recombinant lentivirus was obviously prior to that of the control mice.

CONCLUSION: Mouse fibroblast TLR4^-/- siRNA lentiviral vectors are successfully obtained, which has the favourable inhibitory effect on immune inflammatory responses. The recombinant lentivirus could protect the proceeding of thyroid-associated ophthalmopathy, therefore the TLR4 expression interference is a novel potential target for thyroid-associated ophthalmopathy.

Abstract:AIM: To investigate the changes of electroretinogram in mice with the growth and development of retina.

METHODS: The ERG of 50 mice(50 eyes)of KUNMING at the ages of postnatal 14d(P14), P21, P28, P35 and P56 were measured respectively. The implicit times and amplitudes of b wave of Rod-ERG, a and b waves of Max-ERG, a and b waves of Cone-ERG and O1 and O2 waves of OPs at different ages, as well as amplitude of Flick-ERG, were compared.

RESULTS: The Max-ERG a-waves(the 95%CI were 15.00～18.60, 12.00～15.00, 13.20～14.40, 13.20～15.00, 13.20～15.00, respectively), OPs O1(the 95%CI were 15.00～19.80, 13.80～18.00, 13.20～14.40, 13.80～15.60, 13.80～15.60, respectively)waves shared the implicit times at the different stages, and the Flick-ERG(the 95%CI were 0.97～3.28, 0.85～2.32, 0.91～3.49, 0.94～2.68, 0.98～3.69μV, respectively)shared the amplitudes also. There was no significant difference among the weeks(P>0.05). The implicit times of the Cone-ERG a-waves(the 95%CI were 25.20～55.20, 27.00～40.20, 27.00～38.40, 25.20～43.80, 23.40～37.80, respectively)between P14 and P28 were distinct with statistical difference(P<0.05). The implicit times of Cone-ERG b-waves(the 95%CI were 70.80～88.20, 56.40～78.60, 60.00～75.60, 60.60～87.00, 62.40～81.60ms, respectively)at P14 were statistically different from those at P21 and at P28. The implicit times and amplitudes of Rod-ERG b-waves(the 95%CI were 87.00～114.00, 53.40～73.80, 52.2～63.6, 55.20～71.40, 57.60～67.80ms, and 64.21～195.07, 133.79～355.71, 130.62～355.96, 190.92～448.97, 239.26～462.40μV, respectively), Max-ERG b-waves(the 95%CI were 67.20～107.40, 32.40～54.60, 31.20～36.60, 31.80～42.00, 34.20～41.40ms, and 160.64～344.48, 281.74～590.09, 284.91～716.80, 358.64～737.55, 406.98～810.55μV, respectively), and OPs O2 waves(the 95%CI were 49.8～69.6, 29.40～42.60, 28.80～33.60, 28.80～37.80, 31.20～37.20ms, and 5.43～24.84, 54.38～147.52, 65.55～201.60, 46.33～164.79, 49.07～148.32μV, respectively)at P14 were different from those at other stages, and the amplitudes of OPs O1(the 95%CI were 11.60～21.36, 6.77～53.71, 32.96～76.42, 34.06～70.37, 35.58～63.35μV, respectively)and Cone-ERG b-waves(the 95%CI were 5.10～15.85, 9.61～24.88, 14.96～40.73, 14.87～28.54, 13.83～51.98μV, respectively)were from those at other stages also, and there were significant differences. The O1 wave of OPs had been present at P14, but the second cluster of OPs of one mouse(1/10)had not been obvious at the same time.

CONCLUSION: The experiment confirms that the different waves come from different cells in retina in mice at certain degree. Due to the change of the ERG in the development of mice, so it should be considered that the different development stages will affect the results when measuring the ERG of mice.

Abstract:AIM:To observe the efficacy and safety of anterior chamber maintainer with supplementary lens in anterior-posterior combined surgery in rabbit eyes.

METHODS:Group A: anterior chamber maintainer and supplementary lens were applied in anterior-posterior combined surgery. Group B: conventional anterior-posterior combined surgery was used. The application value of this device were analyzed from the operation time, operation effect, postoperative complications.

RESULTS:The application of anterior chamber maintainer with supplementary lens in anterior-posterior combined surgery played a positive role on the stripping time(P<0.05), but there was no significant difference on operation effect and postoperative complications(P>0.05).

CONCLUSION:There are advantages of anterior chamber maintainer with supplementary lens in anterior-posterior combined surgery, such as more convenient in operation process, a wider range of observation, bimanualness, less complications and so on.

Abstract:AIM:To study the relationship between oxidative damage and the early pathological changes in rabbit lens after vitrectomy combined with nonexpansile perfluoropropane gas, by detecting T-SOD activity and MDA content at different stages after the operation.

METHODS:Fourty five healthy new zealand rabbits were divided randomly to three groups:normal group, control group and experimental group. The control group was just performed vitrectomy with BSS; the experimental group was performed vitrectomy combined with nonexpansile perfluoropropane gas. The lens were made into tissue homogenates to detect T-SOD activity and MDA content by using spectrophotometry on the 1st,3th,8th,35th and 45th day after the operation.

RESULTS:T-SOD activity: that in normal group was the hightest, that in experimental group was the lowest, and there was significant difference(P<0.01)among three groups in every periods after operation. MDA content: that in normal group was the lowest, that in experimental group was the hightest, and there was significant difference(P<0.01)among three groups after the operation except the 1st day.

CONCLUSION:Oxidative damage mechanism may be involved in the early damge of rabbit lens after vitrectomy combined with nonexpansile perfluoropropane gas.

Abstract:AIM:To discuss the diagnosis of Vogt-Koyanagi-Harada syndrome(VKHS)and evaluate the clinical effect of different corticosteroid therapies.

METHODS: Forty-five patients(90 eyes)from January 2010 to February 2014 with VKHS were enrolled in this retrospective case study. The patients were divided into two groups. Twenty-five patients(50 eyes)in observation group were treated with methylprednisolone(1.0g)for 3 days. Then the methylprednisolone was reduced to 0.5g per day in the fourth and fifth day. Twenty patients(40 eyes)in control group were treated with dexamethasone(12mg)for 5 days. Then 60mg of prednisone were given to all the 45 patients and reduced according to the patients' inflammatory, taken off 5mg every time. When the dose was reduced to 15～20mg, the treatment was sustained for 6mo at least. Then the dose was reduced again till prednisone was taken off. The total course of treatment was more than 9mo. All patients underwent B type ultrasound scan, optical coherence tomography(OCT)and fundus fluorescein angiography(FFA)before and after treatments. The changes were analyzed.

RESULTS: There was no statistical significance on vision between the two groups before treatments. Vision of all patients improved after treatments, and that in observation group(0.44±0.19)were significantly better than that in control group(0.55±0.29)at the fifth day(P<0.05). Fifteen days after treatments, vision in the two groups both improved further, that in observation group(0.32±0.17)were better than that in control group(0.39±0.22)without statistical significance(P>0.05). Thirty days after treatment, vision of the two groups was almost back to normal. According to OCT, 84 eyes(93%)had macular neuroepithelial detachment or serous macular detachment, and height of detachment was 1009.67±319.40 μm in observation group, 1098.13±283.45μm in control group. Five days after treatments, the height of detachment in observation group was 307.79±71.35μm, significantly lower than control group(434.13±88.67μm)(P<0.01). And 15 days after treatments,the subretinal fluid in macular zone was absorbed obviously, the height of detachment was 290.61±52.55μm in observation group and 296.55±61.57μm in control group, the difference was not statistically significant(P>0.05). And 30 days after treatments, the morphology of fovea was almost back to normal. One month after treatments, the FFA results were almost normal, expect 8 eyes had slightly leakage.

CONCLUSION: Large dose of methylprednisolone in early stage can improve the VKH patients' vision and promote the subretinal effusion absorption, which has better clinic effect and less adverse reaction than dexamethasone, is worth spread.

Abstract:AIM:To observe the clinical effect of conbercept to improve visual acuity of patients with wet age-related macular degeneration(wAMD).

METHODS:Seventy patients(70 eyes)with wAMD were selected and divided into study group and control group according to different therapies. The control group received intravitreal injection of triamcinolone acetonide. The study group adopted the intravitreal injection with conbercept. Uncorrected visual acuity, the score of reading ability, the central macular thickness(CMT)and the macular pigment optical density of two groups before and after treatment was observed.

RESULTS: the visual acuity of study group was 0.47±0.11 and 0.60±0.14 respectively at 6mo and 1a after treatments, those of control group were 0.27±0.09 and 0.30±0.15. The differences between the two groups at the two points were statistically significant(P<0.05). The CMT of study group was 336.8±65.4 and 301.5±76.8μm respectively at 6mo and 1a after treatments, those of control group were 379.4±88.2 and 368.6±81.3μm. The differences between the two groups at the two points were statistically significant(P<0.05). The macular pigment optical density of study group was 0.19±0.07 and 0.25±0.09DU respectively at 6mo and 1a after treatments, those of control group were 0.12±0.05 and 0.14±0.05μm. The differences between the two groups at the two points were statistically significant(P<0.05).

CONCLUSION:The intravitreal injection with conbercept has a favorable clinical effect on the treatment of wAMD, Which can greatly improve the uncorrected visual acuity and is worthy promotion.

Abstract:AIM:To observe the clinical effect of compound anisodine hydrobromide acupoint injection therapy on the changes of the multifocal electroretinography(mfERG)waves in patients with diabetic retinopathy(DR).

METHODS: In this prospective control study, 48 cases(48 eyes)with DR Ⅰ～Ⅱ period were divided into the injection group(24 eyes of 24 cases)and the control group(24 eyes of 24 cases). The cases in the control group were treated by conventional glucose-lowering therapeutic scheme. Those in the injection group were treated by compound anisodine hydrobromide acupoint injection 2mL and conventional glucose-lowering therapeutic scheme. The mfERG examination system(RETIscan 3.15 version, Roland, Germany)was applied. These waves of four quadrants of SN, IN, IT and ST, 6 rings and the sum responses from the mfERG examinations were observed and the average density of the sum response, the latent period and amplitude of P1 and N1 waves were analyzed by SPSS 13.0.

RESULTS:The average density of the sum response of P1 and N1 waves in the injection group were 39.42±6.46 and 11.12±1.34nV/deg² respectively, which were higher than those in the control group(28.50±3.73 and 6.33±1.14nV/deg²)(P1:t=6.230,P<0.01; N1: t=3.526, P<0.01). The average density of P1 in SN, IN, IT and ST quadrants in the injection group were 32.61±9.62, 32.31±7.94, 29.24±7.84 and 28.09±5.38nV/deg² respectively, which were higher than those in the control group(P<0.05), while there were no statistic differences in the N1 waves between two groups. The average density of P1 in R1～R6 and N1 in R1～R3 in the injection group were 98.11±17.53, 73.95±17.20, 64.09±14.13, 49.43±10.08, 40.24±11.55, 36.86±6.43, 25.27±12.81, 21.31±6.76 and 14.86±5.06nV/deg² respectively, which were higher than those in the control group(P<0.05). There was no significant difference on the average density of N1 in R4 ～ R6 between the two groups. The wave amplitude of P1 and N1 in IT and ST in the injection group were 1.37±0.35, 1.28±0.29, 0.31±0.05 and 0.30±0.10μV respectively, which were significantly higher than those in the control group(P<0.05)while there were no statistic differences in the P1 and N1 in SN and IN between two groups.

CONCLUSION: The compound anisodine hydrobromide acupoint injection can improve the retinal function of DR in the early period.

Abstract:Leber's hereditary optic neuropathy(LHON)is a maternally inherited blinding disease. The clinical phenotype of LHON is the degeneration of retinal ganglion cells(RGCs)and a progressive degeneration of the optic nerve. Three common mutations, G11778A, T14484C and G3460A are responsible for over 90% of cases. Differences in penetrance indicate the additional modifier genes influencing penetrance of the mitochondrial DNA mutation for LHON patients. Different types of mitochondrial haplogroups, environmental factors also have different effects on the penetrance of the mitochondrial DNA mutations. In the present paper, here the progress of the factors influencing the penetrance of Leber's hereditary optic neuropathy will be summarized.

Abstract:Corneal neovascularization(CNV)is the extensive growth of blood vessels from conjunctiva into cornea. Abnormal angiogenesis plays an important role in the process of CNV, which may result from corneal wound and self-healing. The pathologic growth of blood vessels blocks light, promotes scar formation and causes inflammation, which impairs visual acuity. It is a sight-threatening condition that can decreases eyesight and even leads to blindness. Neovascular eye disease is one of the most common eye diseases in clinical admissions. So, further mechanistic studies are the key to the prevention and treatment of CNV. Determination on the CNV animal models is essential in eye diseases researches. Several main methods of CNV models establishment are summarized in this review.

Abstract:For the children with congenital cataract, cataract surgery is the consensus. But after congenital cataract surgery,it is still controversial that whether to implant intraocular lenses, the age of the implantation and the degree of lenses. In this paper, both refractive changes in the children with congenital cataract and correction on residual refraction postoperatively were summarized.

Abstract:Neovascular glaucoma(NVG)is a common secondary glaucoma, often occurs secondary to diabetic retinopathy, central retinal vein occlusion and retinal ischemia syndrome. Its pathogenesis is complicated. Though conventional treatmentscan brieflyreduce elevated intraocular pressure, degenerate iris neovascularization, the long-term effect for controlling NVG is not obvious. The treatment of NVG ushers in a new dawn with the in-depth study on the pathogenesis of NVG and the use of vascular endothelial growth factor(VEGF)inhibitors in ophthalmic diseases. In this paper, the applications of VEGF inhibitors on the treatment of neovascular glaucoma are reviewed to provide new thoughts for the treatment of NVG.

Abstract:Open angle glaucoma is one kind of glaucoma, and also one of the leading causes of blindness. In recent years, the incidence of open angle glaucoma and the rate of blindness caused by it are increasing year by year, whereas its etiology is still not clear. Recently, researchers have found that there might be certain correlation between metabolic syndrome with its components and the occurrence and the development of open angle glaucoma, on which there is not any common understanding yet. In this paper, we try to provide a brief review on the researches of open angle glaucoma and metabolic syndrome.

Abstract:Retinal neovascularization diseases are the major causes of blindness. C-C chemokine receptor type 7(CCR7)can promote the expression of vascular endothelial growth factor(VEGF)through the extracellular signal regulated kinase(ERK)pathway, leading to vascular leakage, proliferation of vascular endothelial cell, neovascularization and etc. The detection of CCR7 can guide the diagnosis and treatments of retinal neovascularization diseases.

Abstract:Hemodialysis is an important therapeutic method of acute and chronic renal failure and other serious diseases.Many studies have shown that hemodialysis may cause changes of intraocular pressure and intracranial pressure. It may provide new approach for the establishment of glaucoma model by studying intraocular pressure and intracranial pressure changes during hemodialysis, which may contribute to the research on glaucomatous optic nerve damage. In this article, we reviewed the change of intraocular pressure and intracranial pressure during hemodialysis.

Abstract:Strabismus and amblyopia are common clinical eye diseases. Chinese and international scholars have studied them with biotechnology and computer technology from many perspectives such as their pathogen, pathogenesis and treatment, and have made great progress. The categorical study of binocular visual function in patients with strabismus and amblyopia provides comprehensive and accurate insights on the neurological mechanism and corresponding biological model, which is conducive to discovering new methods for the clinical treatment of the diseases and reconstruction of visual function. This paper introduces the definition and mechanism of perceptual learning, and discusses the possible influence factors, the duration of the treatment effect and neural mechanism of perceptual learning. The further researches were needed on the aspects of the neural mechanism of strabismus and amblyopia, the specific mechanism of the reconstruction of visual function and influence factors of perception learning. In recent years, the research on the plasticity of cerebral nerves and perceptual learning is getting more deeply. Perceptual learning has been used in clinical treatment of strabismus and amblyopia and the restoration of binocular visual function, and has achieved gratifying results. Hereby, we present a literature review on the domestic and international researches concerning the treatment of perceptual learning.

Abstract:AIM:To compare the clinical efficacy of small incision nucleus chopping surgery and phacoemulsification surgery and investigate their influence on the life quality of age-related cataract patients.

METHODS: Sixty-six cases of age-related cataract patients were divided into observation group and control group according to a randomized and controlled principle. Patients of the two groups were treated with small incision nucleus chopping surgery and phacoemulsification surgery individually. Visual acuity, astigmatism after surgery, corneal endothelium changes before and after surgery, intraoperative and postoperative complications and quality of life 2wk after surgery of the two groups were compared.

RESULTS: The uncorrected visual acuity at 1d, 1wk and 1mo after surgery, astigmatism at 1mo after surgery, quality of life at 2wk after surgery of the two groups showed no statistical significances(P>0.05). Two weeks after surgery, the number of corneal endothelial cells, corneal endothelial cells density and the ratio of hexagonal cells of two groups decreased significantly compared with pre-surgery(P<0.05), but the corneal endothelial indicators of observation group was higher than those of the control group(P<0.05).

CONCLUSION: Small incision nucleus chopping technique and phacoemulsification for age-related cataracts have good visual acuity, small postoperative astigmatism, higher quality of life for patients, but the former has less damage on corneal endothelial, which has thicker corneal endothelium after surgery.

Abstract:AIM: To investigate the clinical efficacy of Toric intraocular lens(IOL)implantation for cataract patients with corneal astigmatism.

METHODS: Thirty-eight patients(46 eyes)with corneal astigmatism undergone phacoemulsification and IOL implantation in our hospital from June 2013 to July 2014 were observed. Twenty cases(24 eyes)received Toric IOL, 18 cases(22 eyes)got Acrysof IQ IOL. The clinical efficacy of the two groups was analyzed.

RESULTS:The difference on visual acuity after surgery between the two groups was statistically significant(F=5.783, P<0.05). The uncorrected visual activity of the observed group after 1wk, 1 and 3mo was significantly higher than that before the operation, the difference was statistically significant(P<0.05); The uncorrected visual activity of the observed group was significantly higher than that in the control group, the difference was statistically significant(t=5.248, 2.573, 2.782; all P<0.05). The difference on the degree of astigmatism after surgery between the two groups was statistically significant(F=5.482, P<0.05). At 1wk, 1 and 3mo after the operation treatment, the degree of astigmatism in the observed group was lower than that before operation, the difference was statistically significant(P<0.05); The degree of astigmatism in the observed group was lower than that in the control group, the difference was statistically significant(t=6.591, 3.287, 2.167; all P<0.05). The results of distance vision study suggested that 75% patients with IOL implantation do not need to wear spectacles.

CONCLUSION: Phacoemulsification associated with Toric IOL implantation has good correction effect and prediction for cataract and corneal astigmatism patients, and can improve the visual activity significantly, so it is worthy of clinical application.

Abstract:AIM:To evaluate the clinical efficacy of phacoemulsification combined with intraocular lens(IOL)implantation for senile cataract patients with corneal astigmatism.

METHODS:Using the random number table method were enrolled 64 cases(84 eyes)with senile cataract at Eye Center of our hospital, which were divided into the astigmatism IOL group(42 eyes of 33 cases)and the spherical IOL group(42 eyes of 31 cases). The astigmatism IOL group was treated with phacoemulsification with intraocular lens implantation, and the spherical IOL group was treated with conventional temporal clarity cornea incision phacoemulsification and spherical intraocular lens implantation combined with limbal relaxing incisions on steep axial position. Distribution of vision at 3mo pre- and post-operation, astigmatism, the changes of spherical and cylindrical lens indicators(curvature, axial, non-mydriatic refraction spherical, non-mydriatic refraction cylindrical, astigmatism axial)were observed between two groups.

RESULTS:Uncorrected visual acuity of the astigmatism IOL group and the spherical IOL group were follow up to 3mo post-operation, the visual acuity was significantly improved(P<0.05)than that in pre-operation groups. Compared with the spherical IOL group of uncorrected visual acuity after operation, distribution of vision in the astigmatism IOL group was superior than that in the spherical IOL group(Z=-2.172,P=0.030<0.05). Compared with pre-operation groups, the corneal astigmatism was decreased in the astigmatism IOL group and the spherical IOL group at 3mo post-opearation, with statistically significant differences(P<0.05). Non-mydriatic refraction spherical and non-mydriatic refraction cylindrical were decreased after operation(P<0.05), astigmatism axial had no statistically significant differences compared with pre-operation(P>0.05). Non-mydriatic refraction spherical and non-mydriatic refraction cylindrical of the astigmatism IOL group were significant lower than than in the spherical IOL group at 3mo post-operation(P<0.05).

CONCLUSION:Phacoemulsification combined with intraocular lens implantation for senile cataract with corneal astigmatism have a good clinical effect.

Abstract:AIM: To observe the surgical effect, complications and assess the safety of applying anterior chamber injection of sterile air to treat instability of anterior chamber occurred at the end of cataract surgery.

METHODS:The cases with unstable anterior chamber occurred at the end of cataract surgery were retrospectively analyzed. They were divided into two groups, group A(31 eyes)received anterior chamber injection of sterile air, group B(27 eyes)underwent anterior chamber injection of balanced salt solution(BSS). The anterior chamber bubbles and the stability of anterior chamber, the influence on corneal endothelial cells, visual acuity, and intraocular pressure(IOP), the presence of other complications such as intraocular inflammation, cystoid macular edema were observed.

RESULTS:There were no statistically significant differences comparing preoperative and postoperative IOP between two groups(P>0.05). In group A, preoperative IOP was 15.29±0.53mmHg and 1d postoperative IOP was 14.58±0.6mHg, with no statistical difference(P>0.05). Preoperative corneal endothelial cell density between two group 2 435.71±194.80cells/mm²vs 2 430.74±191.95cells/mm², postoperative between two groups were 2 400.74±194.00cells/mm² vs 2 398.22±193.36cells/mm² with no statistically significant difference(P>0.05). There was no postoperative shallow anterior chamber and intraocular inflammation in the two groups. The success rate of single operation restoring the stability of anterior chamber in group A was 94%, group B was 33%, the difference had statistical significance(P<0.05).

CONCLUSION:It is safe and effective, simple and quick applying anterior chamber gas injection in the treatment of unstable anterior chamber at the end of cataract surgery.

Abstract:AIM: To study themorphological changes of anterior chamber angle in patients with primary angle-closure glaucoma(PACG)and in whom the closed anterior chamber angle was ≥180°(determined by gonioscopy dynamicly)before and after phacoemulsification combined with goniosynechialysis and to evaluate the clinical efficacy of this surgry.

METHODS:A prospective case series study. Seventy-nine cases(79 eyes)with cataract were enrolled. They went to our hospital for phacoemulsification and were diagnosed as PACG, in whom the closed anterior chamber angle was ≥180°(determined by gonioscopy dynamicly). They were observed for the changes of anterior chamber angle, intraocular pressure(IOP)and the best-corrected visual acuity(BCVA)pre- and post-operative from January to December in 2013.The angle opening distance 500(AOD500)and trabecular-iris angle 500(TIA500)before and after surgeries were analyzed using paired student t-test. The range of goniosynechia and BCVA before and after surgeries were analyzed using Kruskal-Wallis H test.

RESULTS:The IOPs of 58 eyes were normal(≤21mmHg)without any medications at 1mo after operation, and 56 eyes at 6mo after operation. The range of goniosynechia, AOD500, TIA500 and BCVA before operation had significant difference compared with those at 1 and 6mo after operation(P<0.05). The BCVA were improved except 8 eyes with optic atrophy.

CONCLUSION:Phacoemulsification combined with goniosynechialysisis is an effective method for angle closure glaucoma simply caused by pupillary block, coexisted with cataract. The angle closure glaucoma without pupillary block which has long course and the location of peripheral iris is anterior and the closure glaucoma coexisted with cataract caused by several different mechanisms should be treated with medicine management after phacoemulsification combined with goniosynechialysisis.

Abstract:AIM:To observe thickness and morphological changes of cornea and bulbar conjunctiva pre- and post acute angle closure glaucoma(AACG)therapy by optical coherence tomography(OCT).

METHODS:Twenty-five patients with AACG were recruited. Intraocular pressure(IOP)and morphological characteristic of cornea and conjunctiva were measured at their first visit, 1, 2 and 3d after they began the treatments.

RESULTS:The corneal epithelium thickness and corneal thickness of patients with acute attack of angle closure glaucoma were 72.76±11.95μm and 589.40±66.91μm; the conjunctival epithelial layer thickness was 58.88±12.87μm; the thickness of conjunctive stroma was 299.76±94.86μm; the conjunctival full thickness was 358.64±102.55μm. The corneal epithelium thickness and corneal thickness at the first day of the treatment were 69.28±12.65μm and 579.04±67.88μm; the conjunctival epithelial layer thickness was 57.04±12.05μm; the thickness of conjunctive stroma was 282.44±91.47μm; the conjunctival full thickness was 339.48±100.28μm. the corneal epithelium thickness and corneal thickness at the second day of treatment were 66.76±11.42μm and 563.32±63.87μm; the conjunctival epithelial layer thickness was 54.76±11.01μm; the thickness of conjunctive stroma was 267.00±98.54μm; the conjunctival full thickness was 322.16±106.12μm. the corneal epithelium thickness and corneal thickness of the third day treatment are 65.16±12.25μm and 550.36±71.48μm; the conjunctival epithelial layer thickness was measured 53.36±10.29μm; the thickness of conjunctive stroma was 252.76±99.32μm; the conjunctival full thickness was 306.52±107.31μm. The difference of IOP, corneal epithelial thickness, corneal thickness, conjunctival epithelial layer thickness, conjunctival stroma thickness and conjunvtival full thickness had statistically significant(P<0.05).

CONCLUSION:The corneal and conjunctival thickness in patients at acute attack of angle closure glaucom increase. The edema level decreases with IOP.

Abstract:AIM:To observe hemodynamic changes of supratrochlear artery(STCA)and posterior ball related artery in type 2 diabetic retinopathy(DR)by color Doppler ultrasound detection, analyze the occurrence and development of related factors, and provide the evidences to find the DR incidence trends at early stage, prevent the occurrence of DR and adopt effective interventions to prevent progression of DR.

METHODS: A total of 106 cases(106 eyes)with type 2 diabetes mellitus were divided into DR group(56 eyes of 56 cases ), non-diabetic retinopathy group(NDR group, 50 eyes of 50 cases), healthy volunteers were selected in our hospital outpatient medical examination in 40 cases(40 eyes)as control group(HC group). Color Doppler ultrasound was used to detect the hemodynamic changes of STCA, central retinal artery(CRA), posterior ciliary artery(PCA)of all research subjects. The changes of blood spectrum morphology and hemodynamics parameters including peak systolic diastolic blood flow velocity(PSV), end diastolic blood flow velocity(EDV)and vascular resistance index(RI)in diabetics were observed. Fasting blood glucose(FBG), serum total cholesterol(TC), triglyceride(TG), low density lipoprotein-cholesterol(LDL-C), high density lipoprotein-cholesterol(HDL-C)in all research subjects were detected. The duration of diabetes, body mass index(BMI), past medical history(hypertension, diabetes, hyperlipidemia, etc.), family genetic history, smoking and drinking history were recorded. Non-conditional Logistic regression analysis was used to analyze the related factors.

RESULTS: The results showed that the changes of blood spectrum morphology in DR and NDR group were significant. In terms of hemodynamic parameters, STCA, CRA, PCA, PSV, EDV decreased sequentially and RI increased sequentially in the CH and NDR, DR group. Compared the eye artery hemodynamic parameters of DR and NDR group with HC group, the differences were statistically significant(P<0.05). The differences on STCA, CRA PCA, PSV, EDV, RI between DR and NDR group had statistical significance(P<0.05). In aspect of the occurrence and development of related factors, diabetes duration, hypertension history, the number of cases with hyperlipidemia history, diastolic blood pressure, fasting blood glucose, triglyceride, and low density lipoprotein cholesterol of DR group were statistically different with NDR group(P<0.05).

CONCLUSION: For patients with diabetes, hemodynamics ultrasonic detection can be used as the principal means of early prevention and detection of DR. Hemodynamic ocular vascular abnormalities can occur before the retina obvious lesions, and its change degree is positively correlated with retinal lesions. Blood glucose, blood pressure, blood lipid level and duration of diabetes and other related factors are closely related to the occurrence and development of DR.

Abstract:AIM:To investigate the clinical effect of Conbercept intravitreal injection combined with 577nm micro-pulse laser on the treatment of diabetic macular edema(DME).

METHODS:From June to December in 2014, after the diagnosis was confirmed by fundus examination, fundus fluorescein angiography(FFA)and optical coherence tomography(OCT), 64 patients(64 eyes)from department of ophthalmology in Baoji People's Hospital with DME were randomly divided into experiment group(32 cases)and control group(32 cases). The experiment group received 577nm micro-pulse laser combined with intravitreal injection of Conbercept. The control group was treated with 577nm micro-pulse laser. The best corrected visual acuity(BCVA)and central macular thickness(CMT)of two groups before and after treatments were compared.

RESULTS:The ANOVA for two-way repeated measures was used to analyze the data of BCVA and CMT between two groups. The results showed that the interaction between treatment effects and time effects in BCVA and CMT was significant(F=46.92,P<0.01; F=60.231,P<0.01), the main effect of the treatment were significant(F=12.16,P<0.01; F=8.983,P<0.01). There was significant difference on the effect between the two treatments, BCVA and CMT of experiment group were better than those of control group. The main time effect was statistically significant(F=116.14,P<0.01; F=397.376,P<0.01). The BCVA means increased with the treatment time, but the CMT means decreased.

CONCLUSION: Intravitreal injection of Conbercept combined with 577nm micropulse laser on the treatment of DME was much better on reducing macular edema and improving visual acuity than the micro-pulse treatment.

Abstract:AIM: To evaluate the clinical efficacy of Huoxuetongluo granula on the treatment of qi deficiency and blood stasis type of non-arteritic anterior ischemic optic neuropathy(NAION).

METHODS: A total of 100 patients with NAION were enrolled in the randomized controlled trial. They were divided into control group(49 cases with 70 eyes)and treatment group(51 cases with 72 eyes). The patients in control group were treated with only injections of compound anisodine(CA)beside superficial temporal artery,2ml each time, once per day. The patients in treatment group received huoxuetongluo granula, 10g each time, twice per days, besides CA. Patients were followed up for 3mo, and the overall cure effect, visual acuity, mean sensitivity(MS), serum lipid levels and hemorheology indicators were measured and analyzed.

RESULTS: After treatments, the total effective rate of treatment group were 88.2%, which was significantly higher than that of the control group(71.4%)(Z=2.890,P=0.004). Compared with the control group, the visual acuity and MS of treatment group were significantly higher and the differences were statistical(t=-4.65,P<0.0001; t=-3.69,P=0.0004). The TC, TG and low-density lipoprotein cholesterol(LDL-C)levels were significantly lower, the high-density lipoprotein cholesterol(HDL-C)significantly increased than those before treatments(t=6.25, P<0.01; t=4.14,P<0.01; t=4.48, P<0.01; t=3.76, P=0.0003; t=-4.31, P<0.01). After treatments, the whole blood high shear viscosity, low shear viscosity, plasma viscosity and fibrinogen of the treatment group were significantly lower than those of control group(t=3.40, P=0.0011; t=5.75; P<0.01; t=3.61, P=0.0005; t=6.78, P<0.01; t=3.13, P=0.0025).

CONCLUSION: The combination of CA and huoxuetongluo granula can improve the visual acuity, MS, serum lipid levels and hemorheology indicators significantly.

Abstract:AIM: To evaluate the clinical effect of vitamin A palmitate eye gel on early ocular surface reconstruction after thermal or chemical injuries.

METHODS: Seventy-eight cases with thermal or chemical injuries to eyes were selected and divided into two groups by randomized, double-blind, positive drug parallel controlled method: group A(40 cases were treated with vitamin A palmitate eye gel)and group B \〖38 cases were treated with basic fibroblast growth factor(bFGF)\〗. The bFGF and vitamin A palmitate eye gel were used 4 times a day. The treatment course was 14d. Restoration of epithelial defect, Schirmer's test values, tear break-up time(BUT), and subjective assessment of symptoms and signs were observed on D1, D3, D5, D7, D10 and D14.

RESULTS: In group A, 31 cases were cured, 5 cases were effective, with the cure rate of 76% and efficiency 90%. In group B, 32 cases were cured, 3 cases were effective, with the cure rate of 84% and efficiency 92%. There were no significant differences between the two groups(P>0.05). However, there were significant differences on the results of Schirmer's test and BUT(P<0.05), those in group A were expanded compared with group B. Symptoms of dry eye, astringent and foreign body sensation of group A were significantly better than those of group B, there were significant differences(P<0.05).

CONCLUSION: Vitamin A palmitate eye gel is valuable and safe on early ocular surface reconstruction of the eyes suffered from thermal or chemical injuries.

Abstract:AIM:To investigate clinical efficacy and safety of artivicial tears combined with non-steroidal anti-inflammatory drugs(NSAID)on treating dry eyes in order to improve the level of clinical diagnosis and treatments.

METHODS:One hundred and two patients with dry eyes from July 2012 to July 2014 were selected, and they were divided into observation group(51 patients)and control group(51 patients). Patients in control group were treated with NSAID. Patients in observation group were treated with artificial tears and NSAID. Indicators of the two groups were observed before and after treatments.

RESULTS: The cure rate and total effective rate of control group were 23.5% and 76.5%, those of observation group were 35.3% and 92.2%. The differences were statistically significant(P<0.05)between two groups. The differences of the two groups before and after treatments on BUT, FL, rose Bengal, ISV, IVA, SⅠt were statistically significant(P<0.05). Adverse reactions: in control group, the rate of eyelid redness, irritated by foreign body, conjunctival hyperemia or edema, secretions, itching were 13.7%, 7.8%, 11.8%, 5.9%, 5.9% respectively, those of the observation group were 3.9%, 2.0%, 2.0%, 0, 2.0%. The differences between the two groups on those items were statistically significant(P<0.05), except on itching.

CONCLUSION:The artificial tears combined with NAISD have remarkble effect on the treatment of dry eyes and have lower rate of adverse reaction.

Abstract:AIM:To observe the change of contrast sensitivity in the middle and the old with dry eyes caused by Meibomian gland dysfunction(MGD)before and after using the artificial tears in the comprehensive therapy and to evaluate the influence of artificial tears on visual function in these patients.

METHODS:One hundred and twenty middle aged and old patients(240 eyes)who were diagnosed with dry eyes caused by MGD for the first time in our department from June 1^st 2014 to January 30^st 2015 were screened. Sixty(120 eyes)normal people were chosen as normal group. The 120 patients enrolled through inclusion criteria were divided into observation group and control group by random digits table. The patients in observation group were treated with artificial tears regularly combined with local massage and systemic treatment. Patients in control group were treated the same as those in the observation group except artificial tears. Normal group did not receive any treatment. The treatments for both observation group and control group lasted for 16wk. The follow-up period after treatment was 8wk. Observe and compare the contrast sensitivity.

RESULTS:Effective rate of observation group was 83.3%, which was obviously higher than that of control group 95.8%,the difference was statistically significant(χ²=10.05,P=0.002). BUT of observation group, control group and normal group were 3.14±2.01s, 2.54±1.01s and 12.85±2.34s respectively. SⅠt of observation group, control group and normal group were 4.56±1.86mm, 3.48±1.23mm and 15.36±2.48mm respectively. There was statistic significance on the two terms among the three groups. But the difference between observation group and control group was not significant. Before treatments, contrast sensitivity at low, middle and high frequency of both observation group and control group was lower than those of normal group(P<0.05),but there was no statistic significance between observation group and control group(P>0.05). After treated by artificial tears, contrast sensitivity of observation group at different frequency(1.8c/d,3.0c/d,6.0c/d,12c/d,18c/d,24c/d)was obviously higher than those of control group, and the difference was statistically significant(P<0.05).

CONCLUSION: After comprehensive therapy combined with artificial tears, the patients with dry eyes caused by MGD have better contrast sensitivity. The subjective symptoms are relieved. The visual acuity is improved. Besides, contrast sensitivity as a non-contact objective examination, can proved evidence to diagnosis and effect evaluation for the patients after treatments.

Abstract:AIM:To observe the clinical effect of the midperipherv additional designed lenses and adjustment training on myopia in childhood.

METHODS: Eighty childhood(160 eyes in all)with myopia were included in this study. All patients were divided into two groups according to the methods of correcting refractive error: the midperipherv additional designed lenses and adjustment training group(treatment group, 80 eyes of 40 cases)and frame glasses group(comparison group, 80 eyes of 40 cases). The two groups had been measured myopia progress indicators and adjustment function indicators for ever 3mo. The results were compared and analyzed after 1a follow-up.

RESULTS: The visual acuity, refraction, axial length had a little change after wearing lens 1a in treatment group, there was no statistically significant difference compared with wearing before(P>0.05). The visual acuity decreased, refraction and axial length increased in comparison group, the differences were statistically significant(P<0.01). There was statistically significant difference compared with two groups(P<0.01). Accommodation amplitude and adjustment reaction index were improved and AC/A value decreased 1a after treatment in treatment group, and there were statistically significant differences compared with before treatment(P<0.05). Adjustment function index in control group had no significant improvement before and after treatment, with no statistical difference(P>0.05). The difference between the two groups was statistically significant(P<0.01).

CONCLUSION: Midperipherv additional designed lenses and adjustment training treatment of juvenile myopia is effective, which can delay the diopters development of myopic children, improve the regulatory function, control the development of myopia, improve the adjustment function.

Abstract:AIM:To observe the clinical effect of on-flap and off-flap epipolis laser in situ keratomileusis(EPi-LASIK)in ametropia.

METHODS: Sixty-eight myopia patients(136 eyes)receiving surgical treatment were selected and divided into research group and control group according to different therapies. The patients in research group adopted off-flap EPi-LASIK and those in control group adopted on-flap EPi-LASIK. The index like uncorrected visual acuity, diopter and Haze of two groups before surgery, 1wk, 1 and 4mo after surgery was observed.

RESULTS: One month after surgery, the uncorrected visual acuity of research group was 1.33±0.22 while that of control group was 1.22±0.19(P<0.05); Cylindrical diopter of research group was 0.10±0.55D while that of control group was 0.30±0.82D(P<0.05). One week after surgery, Haze of research group was 0.22±0.15 while that of control group was 0.23±0.18(P<0.05).

CONCLUSION:On-flap and off-flap EPi-LASIK are safe and effective surgery approaches in the clinical treatment of ametropia. The presence of corneal epithelial flap has a certain effect in the postoperative clinical outcome at early stage. The impact will be gradually reduced over time.

Abstract:AIM:To observe the changes of visual acuity and contrast sensitivity function in teenagers with different diopters after wearing overnight orthokeratology in order to understand the effects on visual quality.

METHODS:A self-controlled study was used. Eighty four young myopic subjects(156 eyes)aged 12.60±2.03 years in which there were forty males and forty-four females with spherical equivalent(SE)-3.65±0.79D were recruited in the study from March 1^st 2013 to May 30^th 2015. Based on diopters, the subjects were divided into group A(-0.75～-2.00D), group B(-2.25～-4.00D)and group C(-4.25～-6.00D). All the lenses were worn every night over 8 hours. Uncorrected visual acuity(UCVA),subjective refraction,best corrected visual acuity(BCVA), contrast sensitivity function were examined before,1,6,12mo after the initiation of orthokeratology. The database was analyzed by SPSS17.0 using one-way ANOVA.

RESULT:1)Comparison between risual acuity and SE: The UCVA improved significantly and SE decreased after wearing orthokeratology lens 1,6,12mo in 3 groups, showing significant decline in comparison with that before orthokeratology(P<0.05). There was no significant change among 1,6,12mo after wearing orthokeratology(P>0.05). There was no significant change in BCVA(P>0.05). 2)Comparison on contrast sensitivity function: Contrast sensitivity function at all spatial frequencies in 3 groups 1,6,12mo after wearing lenses compared with those before wearing: There was no change before and after wearing at the low spatial frequency(3c/d)and the high spatial frequency(18c/d), but slight increases in group A and group B in the spatial frequency(6c/d, 12c/d)after wearing lenses. There were slight decreases in group C at all spatial frequencies after wearing.But there was no statistical significance between before and after wearing in all three groups(P>0.05).

CONCLUSION:Overnight orthokeratology can improve UCVA and has no obvious effect on the overall visual quality. It deserves to be applied and spreaded in clinical practice.

Abstract:AIM:To evaluate the efficacy and safety of the surgical correction of high myopia using a posterior chamber phakic implantable contact lens(PCPICL).

METHODS: Totally 79 eyes of 43 consecutive patients undergone ICL implantation or toric implantable contact lens(TICL)up to 2a postoperative were retrospectively analyzed. Visual acuity, refraction, intraocular pressure(IOP), average cornea endothelial cell density(ECD), central vault of the ICL and slit-lamp findings, etc. at 1d～2a after operation were observed.

RESULTS: The uncorrected visual acuity(UCVA)of all eyes was significantly improved from preoperative 3.49±0.24 to postoperative 4.89±0.17. Best corrected visual acuities(BCVA)didn't decline after operation and 91%(72 eyes)of UCVAs were better than preoperative BCVAs. The preoperative spherical equivalent was -12.14±4.14 diopters(D)while it was -0.43±0.90D at last follow-up. The difference on IOP at 1d after operation(14.82±3.46mmHg)and preoperative(15.59±2.66mmHg)had statistical significance(P<0.05), while there was no significant difference between last follow-up(15.77±2.36mmHg)and preoperative. The vaults of 1a(481±219μm)and 2a(475±196μm)after operation decreased comparing with that of 6mo(502±225μm). And the ECD of 6mo, 1 and 2a after operation slightly decreased comparing with that of preoperative. The corneal endothelial loss was 5.9%, 6.7%, 8.2% respectively. No severe complications occurred expect that 2 eyes appeared anterior lens capsules had limited opacities and the visual acuities didn't degrade with dispose in time. Other complications such as macular hemorrhage, retinal detachment, etc. were not found.

CONCLUSION: After 2a of follow-up,ICL implantation has good visual and refractive results with excellent biocompatibility and few adverse reactions. By accurate preoperative examination and measurement, intraoperative fine operation and close observation of postoperative follow-up, the complications can be effectively prevented. It still needs further observation and analysis of the cause and long-term effects of postoperative vault decline.

Abstract:AIM:To study the distribution of the dominant eye in people with myopia and astigmatism and the relationship between dominant eye and the two.

METHODS:Three hundred and eighty patients who went our hospital for optometry consecutively were enrolled, using hole-in-card method to detect the dominant eye. The records of age, gender, vision acuity and other related information were analyzed by SPSS 11.0 software.

RESULTS: 1)Most of the dominant eyes were right eyes which accounted for 66.84%, and the ametropia degree on right eyes was relatively higher; 2)Dominant eyes had no significant association with gender, age and uncorrected vision acuity(P>0.05); 3)There was no significant correlation between the dominant eyes and ametropia degree(P>0.05). But in the group which the difference of cylinder degree between two eyes were ≥1D, only 20% of the dominant eyes had higher ametropia degree, which was different from the other two groups.

CONCLUSION:High cylinder of anisometropia may affect the choice of the dominant eye. High sphere of anisometropia may be the result of the choice of dominant eye.

Abstract:AIM: To investigate the compliance of infants at different age undergoing two kinds of quantitative examinations for strabismus.

METHODS: Three hundred and ninety-two infants coming to our hospital for health examination were recruited and divided in to four groups according to the age. Each participant received two kinds of alternate prism cover test(APCT). Eye movement range and compliance rate was analyzed and compared between two methods and among four age groups.

RESULTS: More than 50% infants could cooperate with these two kinds of APCT. However, compliance rate for APCT with mobile animation video(85.2%)was significantly higher than that with classical APCT(58.7%), and the difference was statistically significant(P<0.05). Among 155 infants over 19mo old, the eye movement range was close to that of adults.

CONCLUSION: Using mobile animation video as the target can significantly improve the compliance rate of quantitative examination of strabismus in infants from 4 to 36mo old.

Abstract:AIM: To periodically evaluate the anisometropia amblyopic children's activation of the visual cortex function after training normatively by blood oxygen level dependent-functional magnetic resonance imaging(BOLD-fMRI).

METHODS:Thirteen children with anisometropia amblyopic from advanced research and subsequent research were collected. Self-controlled study before and after treatment and blocks-designed fMRI was performed. fMRI data were processed by using SPM8 which based on the Matlab 7.12.0.635. T test was used to compare and analyze the difference of the brain activation data before and 18, 24mo after amblyopia treatment and 6mo after stopped treatment.

RESULTS: The activation ranges in all these periods are Brodmann 7, 17, 18, and 19; After normalized treatment 24mo(mean T=1.014; P>0.01). and after stopped treatment 6mo(mean T=0.9793, P>0.01). The increasing of the activation ranges in visual cortex was unconspicuous.

CONCLUSION: Visual cortex is basically stable after 2a of anisometropic amblyopia treatment, and continuous treatment for amblyopia has no significant effect on visual cortex function reconstruction.

Abstract:AIM: To investigate the clinical effects and safety of phacoemulsification combined with different glaucoma surgical procedures for primary angle-closure glaucoma(PACG)coexisted with cataract.

METHODS: Thirty-four cases(47 eyes)with PACG coexisted with cataract were divided into group A and group B. Group A was defined as the closed angle of anterior chamber was less than 180°and was treated with phacoemulsification combined with goniosynechialysis. Group B as the closed angle was more than 180° was treated with phacoemulsification combined with trabeculectomy. The follow-up period was 6mo. Postoperative best corrected visual acuity(BCVA), intraocular pressure(IOP), anterior chamber depth(ACD), filtration bleb and complications were observed.

RESULTS: The IOPs were 14.37±4.83 and 15.86±3.74mm Hg at final follow-up in group A and B respectively, which were significantly decreased compared with pre-surgery(P<0.01). Similarly, the ACDs were 3.53±0.37 and 3.63±0.35mm in group A and B respectively, both deeper than those of pre-surgery(P<0.01). There was no statistically significant difference of IOP or ACD between group A and B. The median BCVAs were 0.6 and 0.5 respectively, increased markedly than those of pre-surgery. There were no serious complications.

CONCLUSION: Phacoemulsification combined with anti-glaucoma surgery can get stable control on IOP, improve visual acuity,decrease the complication risk and is safe and effective.

Abstract:AIM: To understand the hospital infection and explore its risk factors in hospitalized patients with cataract.

METHODS:The medical record information of 68 cases with hospital infection between January 2009 and December 2014 in our hospital were retrospectively analyzed. The risk factors of hospital infection in hospitalized patients were analyzed using screening cataract multiariable Logistic regression analysis.

RESULTS:The incidence of hospital infection in hospitalized patients with cataract was 1.37%, respiratory tract infections had the highest incidence in 39 cases, accounting for 57.35%. The results of multi-factor Logistic regression analysis showed that: sex examination, invasive operation, hospitalization days were risk factors for hospital infection in hospitalized patients with cataract.

CONCLUSION:Hospitalized cataract patients have risk of combined hospital infection, we should strengthen the hospital infection management, strict aseptic operation, for reducing the occurrence of hospital infection.

Abstract:AIM:To evaluate the safety and stability of knotless scleral-fixated posterior chamber intraocular lens(PCIOL).

METHODS:Thirty-nine eyes of 35 patients with dislocation of lens, capsule broken after cataract extraction or aphakic eyes after vitrectomy were retrospectively analyzed. They were undergone knotless scleral-fixated PCIOL without scleral flap from January 2009 to October 2014 at He Eye Hospital in Shenyang. Pre-operative and postoperative best-corrected visual acuity(BCVA), intraocular pressure(IOP), the stability of intraocular lens and complications were observed and analyzed.

RESULTS:The BCVA of 9 eyes(23.1%)were 0.1≤BCVA<0.3, 20(51.3%)eyes were 0.3≤BCVA<0.5, 6 eyes(15.4%)were 0.5≤BCVA<0.8, and 4 eyes(10.3%)were 0.8≤BCVA<1.0 at 3mo postoperatively. Two eyes had mild iridemia intraoperatively, which were absorbed in 2wk. Three eyes had transient ocular hypertension, and three eyes had cornea edema postoperatively, all of them were cured through drug treatment in a week. There had no corneal decompensation, ciliary detachment, retinal detachment and endophthalmitis on any patient. The mean follow-up time was 24(3～60)mo. There was no complications of IOL tilting/dislocation, suture exposure, scleral attenuation or scleral dissolution postoperatively.

CONCLUSION:The knotless scleral-fixated PCIOL is a safe and effective technique for aphakic eyes with deficient posterior capsular support, which reduces postoperative suture related complications.

Abstract:AIM:To evaluate the outcome of Ahmed glaucoma valve implantation on treating glaucoma secondary to vitrectomy surgeries.

METHODS:Twenty-three eyes in 23 patients from our hospital treated with Ahmed valve implantations for their glaucoma secondary to vitrectomy surgeries were enrolled and their data was retrospectively analyzed.

RESULTS:The average following-up was 29±3.7mo. Before implantations, the mean intraocular pressure(IOP)was 48.79±7.12mmHg. After 24mo of operations the mean IOP was 23.28±10.53mmHg, and there was significant difference compared with that pre-operation(P<0.05). at 1,12 and 24mo after operations, success rate of the implantation was 82.6%, 65.2% and 52.2%, respectively.

CONCLUSION:Ahmed valve implantation is an effective and relatively safe method for the treatment of glaucoma secondary to vitrectomy surgeries.

Abstract:AIM:To evaluate the effect of vitrectomy on treating proliferative diabetic retinopathy(PDR)in elderly.

METHODS:One hundred and thirty-six elder patients(150 eyes)with PDR treated by vitrectomy were retrospectively analyzed, the postoperative visual acuity, complications and essential points during operations were analysed.

RESULTS:Postoperative follow-ups were 6～15mo. Visual acuity improved in 115 eyes(76.7%),unchanged in 23 eyes(15.3%)and decreased in 12 eyes(8.0%). The patients whose eyes were in PDR phase Ⅳ had their visual acuity improved in 56 eyes(82.3%), unchanged in 8 eyes(11.8%)and decreased in 4 eyes(5.9%). The patients in phase V had their visual acuity improve in 36 eyes(75.0%), unchanged in 8 eyes(16.7%), and decreased in 4 eyes(8.3%). Those in phase Ⅵ had their visual acuity improve in 22 eyes(64.7%), unchanged in 12 eyes(35.3%)and decreased in 0 eyes. Visual acuity of the eyes in phase Ⅳ and V improved significantly than those in phaseⅥ after vitrectomy.

CONCLUSION:Vitrectomy has fewer complications, which is effective for PDR.

Abstract:AIM: To build the reference values of normal eye retinal nerve fiber layer(RNFL)thickness on middle aged people between 40～69 years old, and infer the baseline data for early diagnosis of glaucoma.

METHODS:A total of 180 eyes from 90 healthy subjects(age ranged from 40～69 years old)were recruited for this study. Topcon 3D optical coherence tomography(OCT)-2000(Ver 8.0)was used to measure RNFL thickness. Each subject was performed circular scans around the optic nerve with a circle size of 3.4mm. Clock-hour, quadrant and total average RNFL thicknesses were recorded. The data was analyzed with SPSS statistical. The relationship between age, gender and laterality was analyzed, and the reference value for normal eye RNFL thickness parameters was obtained,

RESULTS:Normal RNFL thickness distribution was bimodal curve type in 40～69 year-old middle aged or elderly people. RNFL thickness was decreased for temporal quadrant, followed by nasal, superior, inferior. RNFL thickness at 10 o'clock, 5 o'clock, 6 o'clock, superior got thinner with age prolong. Except 10 o'clock(P<0.05), there were no significant differences in age(P>0.05). The RNFL thickness at 11 o'clock was associated with different gender. the RNFL thickness at 11 o'clock, 12 o'clock, 1 o'clock, 4 o'clock, superior, nasal was associated with different eyes, the differences was statistically significant between different eyes(P<0.05).

CONCLUSION: Topcon 3D OCT-2000 is effectively used to measure the RNFL thickness of 40～69 years people and provide diagnostic basis for early diagnosis of glaucoma.

Abstract:AIM:To study the correlation of Cys C and blood lipid with diabetic retinopathy(DR).

METHODS:Sixty patients with DR from June 2011 to December 2014 were selected. According to international criteria, in the patients with DR, there were 28 cases without remarkable DR, 22 cases with mild, middle and sever nonproliferative diabetic retinopathy(NPDR), 10 cases with proliferative diabetic retinopathy(PDR).Sixty diabetic patients without DR were selected as NDR group. Sixty healthy people were selected as control group. Cys C, triglyceride(TG)and total cholesterol(TC)were detected.

RESULTS:In DR group, Cys C, TG and TC levels were higher than those in the NDR group and the control group, while in NDR group Cys C, TG and TC levels were higher than thoes in the control group, and the difference was statistically significant(P< 0.05). As DR aggravating, Cys C increased, and the difference was statistically significant(P<0.05). Cys C were positively correlated with the duration and blood lipid level(P<0.05).

CONCLUSION:Cys C changes abnormally in patients with DR, and with the progress of DR, Cys C trends to increase. The abnormal changes in DR patients positively associated with dyslipidemia.

Abstract:AIM: To obtain whether air tamponade is the recommended way after vitrectomy in idiopathic macular hole by surveying the closure rate, functional and morphological recovery after surgery with room air-filled.

METHODS:A total of 31 eyes of 31 patients with consecutive idiopathic macular hole, who undergone 23-gauge pars plana vitrectomy with room air-filled were retrospectively studied. Surgical outcomes were analyzed, regarding best-corrected visual acuity(BCVA), hole closure rate, damage diameter of IS/OS with spectral domain optical coherence tomography(SD-OCT), the degree of visual distortion before and after surgery, surgical complications to discuss clinical significance and value about the patients after air tamponade.

RESULTS: The closure rate was 100% among the patients with hole diameter ≤250μm. The closure rate was 88.9% among thoes 250～400μm, and it was 93.3% among those 400～600μm. Mean BCVA at baseline, 1 and 3mo was 0.12±0.08, 0.28±0.15 and 0.27±0.18, respectively. The damage diameter of IS/OS was 1962.1±510.7μm before surgery and 1245.3±396.5μm 3mo after surgery. The differences were statistically significant before and after surgery(P=0.016). The mean prone posturing period was 3.5±0.4d. The degree of visual distortion had significant improvement. There were no serious surgical complications after surgery.

CONCLUSION: Room air tamponade can obtain good closure rate, recovery of visual function, a short time in the prone position and no serious surgical complications for idiopathic macular hole. It is the recommended surgical approach after vitrectomy in idiopathic macular hole.

Abstract:AIM:To investigate the clinical effect of intravitreal conbercept on wet age-related macular degeneration(wAMD)and polypoidal choroidal vasculopathy(PCV).

METHODS: Sixteen patients(16 eyes)with wAMD and 5 patients(5 eyes)with PCV, both clinical diagnosed, were enrolled. All patients were treated with intravitreous conbercept.Additional treatments were administered if needed. Best corrected visual acuity(BCVA), central retinal thickness(CRT)and choroidal thickness(CT)were measured periodically.

RESULTS:The mean injection times at 6mo was 2.93±0.27. The mean BCVAs were 0.87±0.52 at baseline and 0.74±0.43 at 6mo, which the difference was not statistically significant. The mean CRT significantly improved from 352.24±131.82 to 251.73±69.41μm at 6mo(P<0.01). The mean CT reduced from 331.93±115.35 to 304.72±104.59μm(P<0.05).

CONCLUSION:Intravitreal conbercept can keep the visual acuity stable, reduce the retinal thickness and is safe on treating wAMD and PCV.

Abstract:AIM:To study the treatment of patients with recurrent dacryocystitis to provide a reference for clinical diagnosis and treatment.

METHODS:Eighty patients(80 eyes)with recurrent dacryocystitis admitted to our hospital for diagnosis and treatments from March 2012 to March 2015 were selected. According to a random number table, they were divided into experimental group(40 cases)and control group(40 cases). The experimental group received laser dacryocystorhinostomy combined with U-shaped lacrimal duct implantation. Patients in control group were treated with conventional dacryocystorhinostomy with skin incision. The effect of the treatments and surgical indicators of the two groups were observed and compared.

RESULTS:In experimental group, there were 28 cases were cured after treatment, 5 cases were improved, the total effective rate was 82%. In control group, there were 15 cases were cured, 13 cases were improved, the total effective rate was 70%. The operation time of experimental group was 40.06±1.35min, blood loss was 5.37±1.28mL, the time of remaining in hospital under observation was 26.28±3.42h; those of the control group were 90.14±2.61min, 14.47±6.19mL, 98.14±10.53h, respectively.

CONCLUSION:Laser dacryocystorhinostomy combined with U-shaped lacrimal duct implantation is more effective, more easy to operate, safer and has less injury and higher cure rate.

Abstract:AIM: To compare the outcomes of severe congenital ptosis treated with levator shortening and frontalis muscle flap suspension.

METHODS: Forty cases(58 eyes)with severe congenital ptosis were retrospective analyzed. Shortening levator muscle of upper eyelid was conducted in 30 eyes, and 28 eyes were treated with frontalis muscle flap suspension. All cases were followed up for 6mo. The ptosis correction rates were analyzed. Post-operative complications such as blepharelosis, hypophasis, exposure keratitis and conjunctival prolapse were recorded.

RESULTS: There was no statistically significant difference in the complete correction rate between levator shortening group and frontalis muscle flap suspension group(83% vs 82%, P>0.05). However, the levator shortening had better appearance and fewer complications, such as blepharelosis(0 vs 3), hypophasis(15 vs 23), exposure keratitis(1 vs 2), and conjunctival prolapse(2 vs 3)at 6mo after surgeries.

CONCLUSION: Both the operations are effective on the treatment of severe congenital ptosis. However, levator shortening surgery leads to fewer complications and better appearance.

Abstract:AIM:To study the effect of multilayer amniotic membrane covering therapy for the treatment of traumatic corneal injury or perforation in children.

METHODS:Sixty cases(72 eyes)were randomly selected from the children with traumatic corneal injury or perforation from May 2012 to May 2015 in our hospital. They were divided into two groups according to the different treatments, the study group(30 patients with 36 eyes)and the control group(30 patients with 36 eyes). The patients in control group were given single layer amniotic membrane covering treatment, while those in study group were given multilayer amniotic membrane covering treatment.

RESULTS:The duration of the amniotic membrane of the study group was significantly longer than that of the control group(P<0.05). The corneal edema time was significantly shorter(P<0.05). The rate of patients who had angiogenesis <3 quadrants was 28%(10/36), which was significantly higher than that of the control group 17%(6/36)(P<0.05). The rate of patients without angiogenesis was 11%(4/36), which was significantly lower than that of the control group 28%(10/36)(P<0.05). The rate of patients with the visual acuity 0.3 ～1.0 in observation group was 11%(4/36), which was significantly higher than that of the control group 3%(1/36)(P<0.05). The rate of patients with visual acuity hand motion/before eyes～0.1 was 56%(20/36), which was significantly lower than that of the control group 72%(26/36)(P<0.05).

CONCLUSION:The multilayer amniotic membrane covering therapy was effective on the treatment of traumatic corneal injury or perforation in children.

Abstract:AIM: To study the efficacy of comprehensive treatment on amblyopia in children.

METHODS: A total of 255 cases 386 eyes diagnosed as amblyopia were given refractive errors correction, multi-media training system, coveting treatment, CAM treatment and red light stimulation. The relationship of therapeutic effect with age, type and degree of amblyopia was analyzed.

RESULTS: The total effective rate was 94%, and total cure rate was 71%. Mild amblyopia, 3～6 years group, ametropia amblyopia had the highest cure rate.

CONCLUSION: Efficacy of comprehensive treatment on amblyopia is certain, which is relation with age, type and degree of amblyopia.