Abstract:AIM:To evaluate predictors of patient satisfaction with vision and comfort following cataract surgery in Kandze Prefecture People's Hospital, in Dartsedo, the capital of a Tibetan region of China.

METHODS:Prospective observational study of all patients undergoing cataract surgery in Kandze Hospital in 2012. Patients categorized in terms of ocular pathology and/or surgical complications at discharge, were contacted at 3mo postoperatively by cell-phone to determine satisfaction with vision and presence of discomfort.

RESULTS:In 2012, Kandze Hospital conducted 888 cataract operations on 678 patients, 364(54%)women. Most patients(93%)presented with severe visual impairment or blindness(<6/60)in the better eye. Among the 881 eyes, the main surgical complications were corneal edema(44 cases)and vitreous loss(19 cases)while the main pathologies were retinal disorders(30 cases)and “old” iritis(11 cases). At 3mo, 508(75% of 678 cataract patients)were contacted at least once by cell-phone. Of the 588 eyes self-assessed, 485(82%)were reported “better”, 85(15%)“same”, and 18(3%)“worse” than the time of discharge for discomfort, visual acuity, or both. Significantly more eyes “with pathology” compared with “neither pathology nor complications” at discharge were reported to have discomfort or poor vision at 3mo(Chi-square=6.575, P=0.037).

CONCLUSION:The need forcataract surgical patient follow-up advice at 3mo is predictable at discharge and increasingly possible with cell-phone technology. However, the ability to assist patients with complications or ocular pathology depends on improving eye care services in the region.

Abstract:AIM:To compare the intraoperative performance and postoperative outcomes after microcoaxial torsional phacoemulsification using the straight and the curved phacotip configurations.

METHODS:Cataracts were treated using 2.2mm microcoaxial transversal phacoemulsification with either a 30°straight or 30° curved phaco tip. Intraoperative measurements analyzed included the average ultrasound(U/S)power, the total phacoemulsification time, and the effective phacoemulsification time(EPT). The central endothelial cell density(ECD)and the central corneal thickness(CCT)were evaluated preoperatively and postoperatively at 1, 7 and 30d after surgery using noncontact specular microscopy.

RESULTS:The study enrolled a total of 190 eyes(190 patients), 95 eyes in the curved tip group and 95 eyes in straight tip group. Intraoperative measurements showed significantly reduced total phacoemulsification time, and EPT in the curved-tip group, compared to the straight-tip group(P<0.05). The median total phacoemulsification time and the EPT were 25.9(13.5-45.0)s(1^st-3^rd quartiles)and 18.0(9.0-30.0)s in curved-tip group, and 38.8(16.5-73.5)s and 26.0(11.0-49.0)s in the straight-tip group, respectively.

CONCLUSION:Transversal phacoemulsification performed with a curved tip provided more effective lens removal with a less total UST and EPT in all grades, except for grades IV, compared to a straight tip.

Abstract:AIM:To evaluate the effect of surgical experience on surgically-induced astigmatism(SIA)in patients with uncomplicated phacoemulsification surgery.

METHODS:Fifty-three eyes of fifty patients, mean age 64.5±10.8y, were randomly divided into two groups(23 eyes and 30 eyes). First group was underwent surgery by cataract specialists and the second was by residents. At baseline all the patients were underwent a complete opthalmological examination including keratometry and autorefractometer measurements. Vector analysis programme including the Alpins' method was used for the calculation of SIA. All the measurements were repeated postoperative first day, first month and second month and changes were recorded. Shapiro Wilk and Mann-Whitney tests were applied for determining the statistical differences between the SIA with two groups.

RESULTS:There were no significant differences in demographic data of the groups. Intergroup analysis showed, first group was more effective results in SIA postoperative first day(P=0.002), first month(P=0.004)and the second month(P=0.001). For the first group, SIA were 0.79±0.41 diopter(D)at the first postoperative day, 0.54±0.41 D at the first postoperative month and 0.47±0.37 D at the second postoperative month. Second one was 1.27±0.66 D, 0.98±0.56 D and 0.94±0.54 D, respectively.

CONCLUSION:According to the results, surgical experience was one of the factors that affects SIA. Residents would perform more phacoemilcification surgery to obtain more surgical experience.

Abstract:AIM:To investigate the changes in intraocular pressure(IOP), central corneal thickness(CCT)and anterior chamber depth(ACD)in eyes with open angle glaucoma treated with topical latanoprost(0.005%, once a day)for 6mo.

METHODS:Thirty seven eyes of 24 newly diagnosed patients with primary open-angle glaucoma(POAG)or pseudoexfoliation glaucoma(PXG)were included. IOP was measured with Goldmann applanation tonometry, CCT was measured with ultrasound pachymeter, while ACD and ACD/axial length(AL)values were obtained by ultrasound biometry. IOP, CCT, ACD and ACD/AL measurements before treatment were compared with the recordings at the 3mo and the 6mo of treatment.

RESULTS: Mean IOP values at baseline, and at 3mo and 6mo were, 25.0±4.2, 17.5±2.0 and 16.9±1.7, respectively, showing a significant reduction after treatment. Mean CCT values at baseline, and at 3mo and 6mo were, 546.6±31.5, 541.0±29.4 and 542.2±29.3, respectively, showing a significant reduction after treatment. Mean ACD values at baseline, and at 3mo and 6mo were, 3.00±0.43, 2.95±0.42 and 2.97±0.41, respectively, showing a significant reduction at 3mo, but not at 6mo. ACD/AL changes after treatment were similar to the ACD course. The significant changes in CCT and ACD measurements were found to be related with the POAG eyes, not with the PXG eyes, when evaluated separately.

CONCLUSION:Apart from a substantial reduction in IOP, latanoprost induces corneal thinning and ACD reduction at the short term of treatment in eyes with open angle glaucoma.

Abstract:AIM:To investigate the level of miR-218 in human retinoblastoma(RB)and its effect on the potential mechanism of tumorgenesis.

METHODS:Real-time PCR was applied to detect the expression of miR-218 in human RB and the corresponding tumor-adjacent tissues to analyze the relation between miR-218 and clinic pathology characteristics. The artificial miR-218 was transiently transfected into human Y79 cells in vitro. The proliferation and apoptosis of the cells were detected by MTT assay and flow cytometry, respectively. The expression level of Bmi-1 mRNA and protein were determined by RT-PCR and Western blot.

RESULTS:The expression level of miR-218 in RB tissues was significantly lower than that in the adjacent tissues, and it was associated with optic nerve infiltration and differentiated degree. Over-expressed miR-218 in Y79 cells suppressed cell proliferation and promoted cell apoptosis, and down-regulated mRNA and protein expressions of Bmi-1.

CONCLUSION:The expression of miR-218 in RB tissues is significantly lower than that in tumor-adjacent tissues.MiR-218 could inhibit RB cell proliferation and induce apoptosis by down-regulating the expression of Bmi-1.

Abstract:AIM:To study potential mechanism and effects of resveratrol on the proliferation of human retinal vascular endothelial cells in high glucose environment.

METHODS:Human retinal vascular endothelial cells were cultured in low glucoseor high glucose environment.The MTT assay was used to detect the proliferation of each group to study the effects of resveratrol on the proliferation of human retinal vascular endothelial cells in high glucose environment. Detection of Sirtuin 1(SIRT1)expression and acetylated high mobility group box-1 protein 1(HMGB1)was performed by western-blot and coimmunoprecipitation.

RESULTS:Resveratrol inhibited the proliferation of human retinal vascular endothelial cells in high glucose in a dose-dependent manner.High glucose decreased SIRT1 expression andincrease the degree of HMGB1 deacetylation, which can be reversed by resveratrol.

CONCLUSION:Resveratrol may reverse proliferation of retinal vascular endothelial cells in high glucose through SIRT1-HMGB1 pathway.

Abstract:AIM:To explore the effects of human thermal transient receptor channel 1 gene transfection on corneal endothelial cell of rabbits.

METHODS:Research group were dealt for thermal transient receptor channel 1 gene mediated by liposome transfection to rabbit corneal endothelial cells. MTT method was used to observe its influence on cell proliferation. Immunohistochemical staining and computer image analysis system were used to test the effects for proliferation cell nucleus antigen(PCNA)expression.

RESULTS:Proliferation of corneal endothelial cell of rabbit was promoted after thermal transient receptor channel 1 gene transfected and the difference between experiment group and control group(t=3.01,P=0.013). The expression of PCNA promoted after thermal transient receptor channel 1 gene transfected(t=3.21,P=0.007)compared with control group.

CONCLUSION:The expression of PCNA in rabbit corneal endothelial cells can promote the proliferation of corneal endothelial cells of rabbits.

Abstract:AIM:To investigate the expression of Livin and Caspase-3 proteins in ocular adnexal lymphoproliferative lesions and its clinical significance.

METHODS:Patients suffering from B-cell non-Hodgkin lymphoma(NHL)(n=40)and reactive lymphoid tissue hyperplasia(RLH)(n=10)of ocular adnexal from June 1995 to June 2015 in Qingdao Affiliated Hospital were observed and the 50 paraffin sections were collected. RLH sections were selected to the control group. The patients' age, gender, pathogenic site and pathological types were selected as the classification criteria. The expression of Livin and Caspase-3 proteins were detected by immunohistochemistry and the positive expression rate between lymphomas and RLH was compared. Spearman rank correlation was used to estimate the relationbetween Livin and Caspase-3 in ocular adnexal lymphoma.

RESULTS:The expression of Caspase-3 in B-cell NHL was lower than that in lymphadenosis(P<0.05). While the expression of Livin in NHL was higher(P<0.05). The two proteins had no relation with the age, pathogenic site or gender. But they were related to pathologic type. Livin was highly increased in plasmacytoma(PL)and diffused large B-cell lymphoma(DLBCL)compared with mucosa-associated lymphoid tissue(MALT)lymphoma(P<0.05). While Caspase-3 in PL and DLBCL were lower than that in MALT lymphoma(P<0.05). There was a negative correlation between Livin and Caspase-3 in MALT(r=-0.491,χ²=7.519,P<0.05).

CONCLUSION:Over expression of Livin and low expression of Caspase-3 may play a significant role in the occurrence, development and different pathologic type of ocular lymphoma. The expression of Livin and Caspase-3 combined with each other in NHL. Combined examination of two proteins may be a valuable marker to predict the presence and differentiate the pathologic type of ocular adnexal lymphomas.

Abstract:AIM:To explore the effects of connective tissue growth factor(CTGF)on diabetic retinopathy(DR)in rats,and the potential protective mechanism of compound xueshuantong to DR.

METHODS:Sprague-Dawley(SD)rats were divided into normal group(group a,n=12)and model group(n=24). Rats in model group received intraperitoneal injection of streptozotocin(60mg/kg body weight)to get diabetic rats,which were randomly subdivided into diabetic group(group B,n=12)and xueshuantong intervention group \〖group C,1g/(kg·d),n=12\〗. At 6th and 12th wk of the experiment, 6 rats randomly selected from every group,were executed to get retinal tissue for detecting CTGF-mRNA by electron microscope.

RESULTS:Compared with group A,the content of CTGF-mRNA in retina tissue increased at 6, 12wk in both group B and C(P<0.05). Compared with group B,the content of CTGF-mRNA in retina tissue in group C decreased at 6, 12wk(P<0.05). Electron microscope showed:in group B,the capillary endothelial cells and mitochondria became swollen; the amount of pinocytosis vesicle increased; the electron density in capillary basement membrane was not homogeneous and nodular thickening phenomenon appeared; compared with group B,the changes in group C were alleviated.

CONCLUSION:CTGF may be involved in the progress of DR in diabetic rats. Compound xueshuantong may exert its protective effect through decreasing the expression of CTGF in the retina of diabetic rats.

Abstract:AIM:To explore the correlation of vascular endothelial growth factor(VEGF)level and microvascular damage degree in patients with proliferative diabetic retinopathy(DR).

METHODS:Seventy-one patients with diabetes were analyzed retrospectively, and divided into 3 groups according to the degree of DR:the pure diabetes group(n=31), the pure DR group(n=22)and the proliferative DR group(n=18). The incidence of microvascular damage was compared; At the same time, fasting venous blood of patients was extracted, and the VEGF levels were detected with ELISA kits, the endothelial cells(ECs), endothelial progenitor cells(EPCs)and circulating progenitor cells(CPCs)counts were detected with flow cytometry.

RESULTS:The incidence of diabetic nephropathy and diabetic neuropathy was significantly different in three groups, proliferative DR group was higher than pure DR group and pure diabetes group, the difference was statistically significant(P<0.05). There was difference in VEGF levels among groups, the proliferative DR group was higher than the pure DR group the pure diabetes group, and the pure DR group was higher than the pure diabetes group(P<0.05,P<0.01). VEGF levels in patients complicated with diabetic nephropathy and diabetic neuropathy were higher than the non-complicated patients, the differences were statistically significant(P<0.05). There was significant difference in ECs, EPCs and CPCs among groups, the ECs of proliferative DR group was higher than that of the pure DR group the pure diabetes group, and that of the pure DR group was higher than that of the pure diabetes group(P<0.01), but EPCs and CPCs reversed. The VEGF level had positively correlation with ECs level(P<0.01), and had negatively correlation with EPCs and CPCs levels(P<0.01)in patients with proliferative DR.

CONCLUSION:VEGF has important significance in the clinical diagnosis and medical treatment of diabetic retinopathy, especially proliferative diabetic retinopathy.

Abstract:AIM:To explore the clinical effectiveness of sodium aescinate combined with Nd:YAG laser on diabetic macular edema(DME).

METHODS:One hundred and sixty-two eyes in 113 DME patients were randomly divided into observation group treated with sodium aescinate combined with 532nm laser(55 cases with 80 eyes)and control group treated with single Nd:YAG 532nm laser(58 cases with 82 eyes). Fundus evaluation including the thickness of macular edema and best corrected visual acuity(BCVA)in all patients were measured by optical coherence tomography(OCT)to analyze the differences before and after treatments(1,2,3 and 4mo). All patients also underwent fundus fluorescein angiography(FFA)before and at 4 mo after treatments.

RESULTS:There was no statistical difference on intraocular pressure(IOP),BCVA,CMT and the number of patient with fluorescence leakage before and after treatments between the two groups(P>0.05).IOP before and after treatments had no significant differences between the two groups(P>0.05). The BCVA,CMT and number of patients with fluorescence leakage at 1,2,3 and 4mo after treatments of two groups were better than those before treatments,and the differences were statistical significant(all P<0.05).The BCVA, CMT and the number of patients with fluorescence leakage at 1,2,3 and 4mo after treatments of observation group by multiple comparison were statistical significant(all P<0.05). The BCVA at 1,2,3 and 4mo after treatments of control group were not statistical significant by multiple comparison(all P>0.05),The CMT and the number of patients with fluorescence leakage at 1,2,3 and 4mo after treatments of control group were statistical significant by multiple comparison(all P<0.05). Except for 1mo after treatments,the BCVA were not statistical significant between two groups(P>0.05). The BCVA,CMT and number of patients of fluorescence leakage of observation group at same time after treatments were better than those of control group,and the differences were statistical significant(all P<0.05).Eight patients with 9 eyes(14.5%)of observation group had upset stomach and nausea. Four cases(5 eyes)in observation group and 5 cases(5 eyes)in control group developed vitreous hemorrhage and the difference was no statistically significant(P>0.05).

CONCLUSION:It is an effective and safe therapeutic method for diabetic macular edema by sodium aescinate combined with laser.

Abstract:Corneal transparency is the basis of the normal physiological functions.However, corneal neovascularization(CNV)may occur in the infection, mechanical and chemical injury or under other pathological conditions,which make the cornea lose original transparency and severe visual impairment. In recent years, along with the development of immunology, molecular biology, biochemistry and other disciplines, there is more in-depth understanding on the CNV, and clinical treatment of CNV has made new breakthroughs. This article provides an overview of the inhibition of CNV.

Abstract:Autophagy, the main degradation process of organelles, protein and other substances in the eukaryotic cells, plays an important role in the maintenance of homeostasis. Lens is a transparent tissue without vessel, which is mainly composed of a layer of epithelium cells and differentiating fiber cells. To maintain the transparency of lens, lenticular cells degrade their organelles and abnormal aggregated protein through autophagy. Abnormal function of autophagy is closely related to the formation of cataract. This article is aimed to introduce the related knowledge of autophagy and summarize the research progress of autuphagy in the procedure of cataract formation.

Abstract:Choroideremia(CHM)is a kind of blindness-causing hereditary disease, inherited in a gene on the long arm of X chromosome, caused by the CHM gene deletion or mutation which encoding Rab escort protein 1(REP-1), and is characterized by binocular, progressive chorioretinal degeneration. This desease is X-linked recessive inherited disorder. The vision will lose gradually as the atrophying of retinal photoreceptor, RPE and choriocapillary. The virulence gene of choroideremia is CHM, located in Xq21.2, coding REP-1. Typically, in affected males, symptoms evolve from night blindness to peripheral visual field loss, with central vision preserved until late in life. Female carriers are generally asymptomatic. At present, there are detailed diagnostic criteria with CHM. Gene therapy and the retina transplantation are considered as possible treatments in recent years. The preclinical studies of AAV2 and AAV8 have been completed. A safety trial of AAV2-mediated gene therapy in human subjects with CHM has been completed.

Abstract:Glaucomais a group of diseases characterized by optic nerve damage and visual field defect, and pathological high intraocular pressure is a risk factor for glaucoma. Glaucoma is affected by the interaction of multiple genes and environmental factors, and inflammation may be involved in the pathogenesis of glaucoma. A great deal of studies have confirmed that high expression of connective tissue growth factor(CTGF), tumor necrosis factor-α(TNF-α), interleukins(ILs), nuclear factor-kappa B(NF-κB)and various cytokines in the aqueous humor of patients with glaucoma, which have a close correlation with pathogenesis of glaucoma.This article reviews the progress of inflammatory cytokines and their relationship with glaucoma.

Abstract:AIM:To systematic evaluate the preventive effect of non-steroidal anti-inflammatory drugs(NSAIDs)on the cystoid macular edema(CME)after the cataract surgery.

METHODS:Searching literature which were published by March 2015 and which were the random control test(RCT)on the preventive effect of NSAIDs on CME after the cataract surgery in PubMed, EMbase, Cochrane Library, MEDLINE, CNKI, Wanfang Data, Chongqing Weipu and Chinese biomedical literature database and through Internet with computer. Meanwhile, relevant articles, journals, conference papers and their reference were manually retrieved. According to inclusion and exclusion criteria,the study objects were limited.Revman5.0 software provided by the Cochrane Collaboration was used to analysis the incidence of CME after cataract surgeries.

RESULTS:A total of 7 RCT were included in the study(1422 cases, 712 cases in the trial group, 710 cases in the control group). Using NSAIDs before and after cataract surgeries could significantly reduce the post-operative incidence of CME(OR=0.31, 95%CI:0.18～0.52, P<0.001).

CONCLUSION:Using NSAIDs before and after cataract surgeries can significantly reduce the incidence of postoperative CME. Due to the small sample size and the medium methodological quality, the conclusion is not powerful enough. More high-quality RCTs with larger sample size are needed to make the evaluation more objective, accurate and comprehensive.

Abstract:Methylmalonicaciduia(MMA)accompanied with homocystinuria is a rare autosomal-recessive with congenital metabolic disorder of Vitamin B12. There are three subtypes, cblC, cblD, cblF, in which cblC is the most common one. The diagnostic tests are tandem mass spectrometry and gas chromatography-mass spectrometry. Tests for activity of enzyme in fibroblasts from skin, complementary assay and genetic analysis can be used to make the subtype clear. Early-onset patients, defined by onset of symptoms before the age of 1 year, may have severe ocular involvement, including visual loss, nystagmus, strabismus, retinopathy, maculopathy, optic atrophy, abnormal electroretinography. Late-onset patients, defined by onset of symptoms after the age of 4 year, rarely have ocular manifestations. The pathogenesis of the ophthalmic symptoms may be related to the high level of homocystine, oxidative stress and the abnormal development of nervous systems. The treatment for MMA accompanied with homocystinuria is mostly symptomatic based. Ophthalmic treatment is limited. Early supplement of methionine,GSH or other antioxidants may be helpful for retinopathy. There is no standard ophthalmological examination for those patients in China. It is critical to set up inter-departmental cooperation and early stage examination for the treatments and outcomes of the patients.

Abstract:The ophthalmic application of nanometer materials are mainly concentrated on controlled releasing systems. Due to the unique properties of nanometer materials,it has great advantages in carrying ophthalmic drugs compared with the conventional method, mainly in higher bioavailability and fewer side effects. As a result, nano-controlled releasing system has good application prospect in ophthalmology. At present, a variety of different types of nano-controlled releasing systems have been used to enhance the efficiency of the ophthalmic drugs, including nanomicelle, nanoparticles, nanosuspensions, liposomes,dendrimers, etc. In this paper, the research progress as well as the application of nano-controlled releasing system on ophthalmologic administration is reviewed.

Abstract:AIM:To investigate the clinical efficacy of phacoemulsification combined with goniosynechialysis and only phacoemulsification on coexisted cataract after peripheral iridectomy.

METHODS:A total of 69 patients(85 eyes)with coexisted cataract after peripheral iridectomy were divided into two groups by drawing lots method. The patients in observation group(38 cases,45 eyes)were treated with phacoemulsification and IOL implantation, combined with goniosynechialysis, and the control group(31 cases,40 eyes)with phacoemulsification and IOL implantation. The follow-up time lasted 12mo. The intraocular pressure(IOP), best corrected visual acuity(BCVA), central anterior chamber depth and the change of anterior chamber angle of two groups before and after operations were compared and analyzed.

RESULTS:After 1wk, the postoperative mean IOP of observation group was 10.36±2.85mmHg,that of control group was 12.09±3.75mmHg, decreased significantly compared with preoperative(P<0.01). There was significant difference of that between two groups(t=2.41,P<0.05). The postoperative mean visual acuity of observation group and control group were 0.52±0.22 and 0.55±0.20 respectively,increased significantly compared with preoperative(P<0.01),and no significant difference between two groups(t=0.65,P>0.05). The postoperative mean central chamber thickness of observation group and control group were 3.57±0.32mm and 3.44±0.35mm respectively,increased significantly compared with preoperative(P<0.01), and no significant difference between two groups(t=1.79,P>0.05). Two months after the operation, there were 42eyes(93.33%)with adhesion range of anterior chamber angle was <90°in observation group, more than that in control group 31eyes(77.50%), the difference was significant(P<0.05).

CONCLUTION:The treatment method of phacoemulsification combined with goniosynechialysis for coexisted cataract after peripheral iridectomy can effectively open the adhesions of chamber angular, control the IOP and improve visul acuity and is safe.

Abstract:AIM:To investigate the effects of combined with bromfena sodium 0.1% eye drops and steroids eye drops on cataract surgery, then further study its safety and effectiveness on phaeoemulsfieation.

METHODS:A prospective, randomized, controlled study including 100 patients(120 eyes), enrolled for cataract surgery. The patients were randomized to topical treatment with Tobramycin and Dexamethasone combined with bromfenac sodium 0.1%(trial group, 60 eyes)or Tobramycin and Dexamethasone(control group, 60 eyes). Scleral tunnel incision phacoemulsification cataract extraction and intraocular lens implantation was used. The sign, symptom, intraocular pressure(IOP)and optical coherence tomography(OCT)were determined postoperative 1, 7, 14d.

RESULTS:There were significant differences in symptoms and signs between two groups at postoperative 7 and 14d(P<0.05)and no difference at postoperative 1d(P>0.05). The value of the trial group was lower than that of the control group. Preoperative IOP was 14.657±2.605mmHg in trial group and 14.415±2.761mmHg in control group, the difference was not statistically significant(P>0.05). IOP in trial group were lower than that of control group at postoperative 1, 7, 14d, the difference was statistically significant(P<0.05). In the control group, the incidence of macular edema at postoperative 1, 7, 14d were 1.7%, 1.7% and 3.3%, respectively, which was significantly higher than those of trial group(0, 0, 1.7%). The difference was statistically significant(P<0.05).

CONCLUSION:Application of 0.1% bromfenac sodium eye drop and Tobramycin and Dexamethasone eye drops for cataract extraction and intraocular lens implantation in the treatment of postoperative inflammation has better treatment effect. It is safe and effective, and less prone to ocular hypertension and other serious complications; At the same time it can significantly reduce the incidence of postoperative macular edema, prevention of macular edema after cataract surgery, with security and reliability, worthy of clinical application.

Abstract:AIM:To investigate the influence of ocular perfusion pressure fluctuation on glaucoma.

METHODS:Forty patients with primary open angle glaucoma from January 2013 to June 2015 in our hospital were used as observation group and 40 families were used as control group. Circadian fluctuation of intraocular pressure, blood pressure and ocular perfusion pressure in 24h were determined to obtain systolic ocular perfusion pressure(SOPP), diastolic ocular perfusion pressure(DOPP)and mean ocular perfusion pressure(MOPP). Pearson linear correlation was used to analyze the correlation of circadian MOPP fluctuation with cup-disc ratio, mean defect(MD)and the picture standard deviation(PSD).

RESULTS:The fluctuation of MOPP, SOPP and DOPP of observation group were significantly higher than those of control group(P<0.05). MOPP fluctuation was negatively correlated with MD(r=-0.389, 95%CI:-0.612～-0.082; P=0.011), was positively correlated with PSD(r=0.512, 95%CI:0.139 ～0.782; P=0.008); no correlation was found between it and the vertical cup-disc ratio(r=0.115, 95%CI:0.056～0.369; P=0.355).

CONCLUSION:Ocular perfusion pressure fluctuations in patients with primary open angle glaucoma may reflect the severity of the disease and may make the situation aggravating. Therefore through perfusion pressure monitor in 24h may help us understand the ocular blood flow and the development of primary open-angle glaucoma.

Abstract:AIM:To evaluate the effectiveness of laser peripheral iridoplasty combined with iridectomy in preclinical primary angle-closure glaucoma(PACG)by optical coherence tomography(OCT).

METHODS:Fifty-eight eyes of 31 patients with preclinical PACG were received laser peripheral iridoplasty combined with iridectomy. Images of anterior chamber angle in three different time(before treatment,1wk after treatment and 2mo after treatment)were collected by OCT. Anterior chamber depth(ACD), lens thickness(LT), chamber crowding rate(CCR)and lens position(LP)were measured by A-ultrasound.

RESULTS:Intraocular pressure(IOP), OA, ACD, CCR, LP were statistically significant differences in three different time(IOP:F=16.845, OA:F=30.498, ACD:F=38.705, CCR:F=86.671, LP:F=46.195; P<0.05), but not LT(F=0.756, P=0.471). However, there were statistically significant differences only in CCR but not in OA, ACD and LP(P=0.067, 0.359, 0.406)between 1wk after treatment group and 2mo after treatment group(P<0.05).

CONCLUSION:OCT can be used to monitor and quantify anterior chamber of PACG. CCR can be more sensitive to reflect structural changes of anterior chamber. LPI is an effective treatment for early PACG.

Abstract:AIM:To study the effect of only latanoprost eye drops or combined with other medicines on lowering intraocular pressure(IOP)after early pars plana vitrectomy(PPV)for macular hole without retinal detachment caused by high myopia.

METHODS:One hundred and eighty-eight cases(205 eyes)suffered from macular hole caused by high myopia without reinal detachment who underwent PPV combined with C₃F₈ tamponade were studied retrospectively and measured the IOP at 1wk after surgeries. The patients whose IOP was 22～29mmHg were named as group A. Then they were divided randomly into two subgroups, group A1(treated by carteolol eye drops)and subgroup A2(treated by latanoprost eye drops). The patients whose IOP was 30～39mmHg were named as group B. Then they were divided randomly into two subgroups, group B1(treated by both carteolol and brimonidine tartrate eye drops)and subgroup B2(treated by both latanoprost and carteolol eye drops). The patients whose IOP was ≥40mmHg were named as group C and they were all treated by rapid intravenous injection of 20% Mannitol. Meanwhile, they were divided randomly into two subgroups, group C1(treated by carteolol,brimonidine tartrate and brinzolamide eye drops )and subgroup C2(treated by carteolol,brimonidine tartrate and latanoprost eye drops). Continuous observation lasted 3d. If IOP dropped to below 21 mmHg, we considered it valid. And then,compare the effectiveness, IOP reduction and the average effective duration.

RESULTS:Eighty-nine eyes met the criteria of high IOP and IOP of 70 eyes(78.6%)increased within 3d after operations. There were 31 eyes in group A including 14 eyes in group A1 and 17 eyes in group A2.The number of effective cases of the two groups was 5(35.7%)and 13(76.5%)respectively, the difference was statistically significant(χ²=5.24,P=0.03).The IOP reduction of the two groups were 4.21±1.22mmHg(24%), 8.76±3.03mmHg(29.6%), respectively, and the difference was statistically significant(t=5.73,P<0.05).The average effective duration of the two group were 2.80±0.45, 2.08±0.49d,respectively, and the difference was statistically significant(t=2.85,P=0.012).There were 32 eyes in group B including 17 eyes in group B1 and 15 eyes in group B2.The number of effective cases of the two groups was 9(52.9%)and 11(73.3%),respectively, and the difference was not statistically significant(χ²=1.40,P=0.30 ).The IOP reduction of the two groups was 10.59±2.72mmHg(36.9%), 16.53±2.67mmHg(43.8%)respectively, and the difference was statistically significant(t=6.27,P<0.05).The average effctive duration of the two group was 2.56±0.53, 1.63±0.67d respectively, and the difference was statistically significant(t=3.34,P=0.004). There were 26 eyes in group C including 14 eyes in group C1 and 12 eyes in group C2.The number of effective cases of the two groups was 9(64.3%)and 8(66.7%)respectively, and the difference was not statistically significant(P=0.70).The IOP reduction of the two groups was 22.00mmHg(51.0%),31.45mmHg(59.3%)respectively, and the difference was statistically significant(t=18.35,P<0.05).The average effctive duration of the two group was 2.63±0.52, 1.80±0.63d respectively, and the difference was statistically significant(t=2.97,P=0.009).

CONCLUSION:PPV treating macular hole caused by high myopia is associated with highe rates of IOP increasing, which generally occurs within 3d after the operation. Alone or in combination, latanoprost eye drops can effectively reduce IOP.

Abstract:AIM:To evaluate the efficacy and safety of Ahmed glaucoma valve implantation(AGVI)combined with different anti-vascular endothelial growth factor(VEGF)agent injected before surgeries for neovascular glaucoma(NVG).

METHODS:This was a retrospective case controlled study on patients with NVG in whom AGVI was performed between September 2009 and November 2013. The sample was divided into two groups according to the pretreatment:the intravitreal injection of bevacizumab or lucentis. The success rate of surgeries, intraocular pressure(IOP), the number of antiglaucoma medications used after surgeries, best correct visual acuity(BCVA), postoperative complications, regression and recurrence of iris neovascularization were analyzed between the groups.

RESULTS:Compared with preoperative, IOP, the number of antiglaucoma medications used of the two groups decreased significantly at every follow-up(P<0.05). There were no significant difference on postoperative IOP, the number of postoperative antiglaucoma medications, and BCVA between bevacizumab and lucentis groups. Kaplan-Meier survival curves showed that the success rate was 80.6% for the bevacizumab group and 79.3% for the lucentis group at endpoint of follow-up, the difference between the two groups was not significant(P=0.896). There was no significant difference on the complete success rates between the two groups(P=0.753).

CONCLUSION:Preoperative intravitreal injection of bevacizumab/ lucentis may be an effective and safe combined with AGVI on managing NVG. However, the two drugs have the similar efficacy and safety.

Abstract:AIM:To analyze and study the relation of pterygium with vascular endothelial growth factor(VEGF),stroma cell-derived factor 1(SDF-1),tumor proliferating antigen(Ki-67),proliferating cell nuclear antigen(PCNA)and survivin.

METHODS:Seventy-nine patients(106 eyes)with pterygium from January 2013 to May 2015 in our hospital were selected as observation group. Seventy-nine persons with normal conjunctiva during the same period were selected as control group. Then the number of positive cells and staining intensity classification of the two groups for VEGF,SDF-1,Ki-67,PCNA and survivin were compared,and the detection results of patients with different gender,stages and types were compared too. Then the relation between pterygium and those indexes were analyzed by the Logistic analysis.

RESULTS:The number of positive cells and staining intensity classification of observation group for VEGF,SDF-1,Ki-67,PCNA and survivin were all higher than those of control group,and the detection results of patients with different stages and types had certain differences too(all P<0.05). While the detection results of patients with different gender had no obvious differences(all P>0.05). All those indexes had close relation to pterygium by the Logistic analysis.

CONCLUSION:The expression of VEGF,SDF-1,Ki-67,PCNA and survivin in tissue of patients with pterygium all show abnormal state,and those indexes all have close relation to pterygium.

Abstract:AIM:To analyze the curative effect of pulsed radiofrequency combined with nerve block in the treatment of eyelid postherpetic neuralgia(PHN).

METHODS:Eighty-one patients(81 eyes)with eyelid herpes zoster from January 2011 to August 2014 in our hospital were randomly divided into three groups(27 patients in group A, 27 patients in group B and 27patients in group C). Patients in group A were treated with intravenous infusion of acyclovir and dexamethasone. Patients in group B were treated with intravenous infusion of acyclovir and supraorbital nerve block using compound betamethasonePatients in group C were treated with pulsed radiofrequency and nerve block along with the same medicine acyclovir. Visual analogue scale(VAS)before treatment and 1, 7, 30, 90d after treatments, clinical efficacy and complications during the treatments in the three groups were recorded and analyzed.

RESULTS:The VAS of patients in group A before treatments and 1,7,30,90d after treatments were 8.2±1.5,7.3±1.6,6.5±1.4,6.1±1.1,5.9±0.7repectively; those of group B were 8.2±1.3,6.3±1.1,5.7±0.9,5.1±1.1,4.1±0.7; those of group C were 8.1±1.5,2.1±0.7,2.2±0.8,2.9±0.7,2.7±0.8. Pain of patients in group C relieved quickly after treatments of pulsed radiofrequency combined with nerve block. After 1 and 3mo, the VAS of group C rose a little, but still significantly lower than that of the other groups.At 1, 7, 30 and 90d after treatments, differences on VAS of three groups were statistically significant(F=10.320,5.207,2.364,2.805; P<0.05).Patients in group C had no severe complications, such as corneal hypoesthesia etc. in addition to relieved pain. The occurrence of keratitis and keratohelcosis in group C were reduced.

CONCLUSION:Pulsed radiofrequency combined with nerve block can rapidly relieve the pain of PHN, reduce the complications, and may be a safety and effective method for eyelid postherpetic neuralgia.

Abstract:AIM:To explore the changes of visual quality in myopic eyes undergoing overnight orthokeratology.

METHODS:Fifty-five myopia adolescents(110 eyes)were recruited. Optical scattering index(OSI),MTF cut off, Strehl ratio, OQAS value(OV100%、OV20%、OV9%), index of highest asymmetry(IHA),index of highest decentration(IHD),aberration coefficient(ABR)were performed before and 1wk,1,3 and 6mo after wearing orthokeratology with OQASTMⅡ and corneal topography.

RESULTS:The uncorrected visual acuity(UCVA)before wearing orthokeratology lens was 0.21±0.13,but at 1wk,1,3 and 6mo after wearing were 0.48±0.15,0.72±0.14,0.93±0.13 and 1.02±0.13,respectively,and there were statistical differences before and after wearing(P<0.05).On OSI after wearing at 1,3 and 6mo compared with that before wearing, there were significant differences(P<0.05).On MTF cut off after wearing at 1,3 and 6mo compared with that before wearing, there were significant differences(P<0.05).On Strehl ratio after wearing at 1,3 and 6 mo compared with that before wearing, there were significant differences(P<0.05).On OV9% after wearing at 1,3,6 mo compared with that before wearing, there were significant differences(P<0.05).IHA were 4.13±3.59, 19.11±15.38, 17.78±17.12, 34.18±23.34 before and 1, 3 and 6 mo after wearing. Compared with that before wearing, IHA significantly increased(P<0.05). IHD were 0, 0.02±0.01, 0.02±0.02, 0.03±0.02, 0.03±0.01 before and 1wk,1, 3 and 6mo after wearing. Compared with that before wearing, IHD were significantly increased(P<0.05). ABR were 0.29±0.51, 1.23±0.71, 2.10±0.59 before and 1wk and 6mo after wearing. Compared with that before wearing, ABR were significantly decreased(P<0.05).

CONCLUSION:Orthokeratology deteriorates vision quality. But the loss is acceptable. Orthokeratology can improve UCVA quickly and effectively. It is worth of affirmation on control of myopia.

Abstract:AIM:To compare the clinical outcomes of wavefront-guided and wavefront-optimized laser in situ keratomileusis(LASIK)to correct myopia and myopic astigmatism in patients with a preoperative total ocular higher-order aberrations(HOAs)lower than 0.3μm.

METHODS:In this prospective study, 60 eyes of 30 patients with myopia with or without astigmatism in our department were included. One eye of each patient was randomized to undergo wavefront-guided LASIK, and the fellow eye received wavefront-optimized LASIK. Postoperative outcome measures at 6mo included visual acuity, refraction, ocular HOAs, and contrast sensitivity under mesopic condition. Paired t-test and χ² test were used to analyze the data.

RESULTS:Six months postoperatively, 93% of eyes in the wavefront-guided group and 90% in the wavefront-optimized group had uncorrected visual acuity of 5.0 or better; 87% and 83%, respectively, had a postoperative spherical equivalent refraction of ±0.50D diopter. The differences were not statistically significant(P>0.05). No eye in either group lost 2 lines or more BCVA. Total HOAs, spherical aberration and coma increased in both groups postoperatively(P<0.01), with no statistical differences in HOA changes between groups(P>0.05). Contrast sensitivity under mesopic conditions in both groups recovered to preoperative levels at all spatial frequencies at 6mo postoperative(P>0.05).

CONCLUSION:For eyes with preoperative HOAs lower than 0.3μm, wavefront-guided LASIK and wavefront-optimized LASIK can provide similar results in terms of visual acuity, refraction, HOAs, and contrast sensitivity.

Abstract:AIM:To compare the clinical efficacy of TransPRK and LASEK.

METHODS:This study included 120 patients(240 eyes)with high myopic, which were divided into TransPRK(60 patients with 120 eyes)group and LASEK group(60 patients with 120 eyes)randomly. Recovery status, visual acuity, haze condition and refractions of the two groups were compared respectively at 1, 2wk, 3mo and 1a.

RESULTS:The clinical results were very good for both groups. But at 1d post-operative, 86 eyes(71.7%)in TransPRK group felt no discomfort and had clear vision while there were 81 eyes(67.5%)in LASEK group having the same condition. One hundred and nine eyes(90.8%)had better UCVA than their BCVA pre-operative in TransPRK group compared to 87 eyes(72.5%)in LASEK group at 2wk post-operative. At 3mo post-operative, 113 eyes in TransPRK group had no haze(grade 0), compared to the 109 eyes in LASEK group.

CONCLUSION:TransPRK had faster recovery of visual acuity and less discomfort than LASEK. And rate of haze was statistically lower in TransPRK group(P<0.01). However, the visual acuity, refractions and vision quality at 1, 3, 6mo and 1a were not statistically different(P>0.05). Finally, there was no significant difference on the efficiency, safety and predictability of high myopia treatments between the two methods.

Abstract:AIM:To evaluate the efficiency and safety of high myopia treatments using AMARIS trans-epithelial photorefractive keratectomy(PRK).

METHODS:One hundred and thirty six eyes in 68 patients with high myopic were treated using Amaris trans-epithelial PRK during December 2012～December 2013. Post-operative pain, haze, visual acuity, refraction and intraocular pressure(IOP)were analyzed during 12mo follow-up post-operatively.

RESULTS:One hundred and eight eyes in 54 patients felt no discomfort at all, while 28 eyes in 14 patients reported dry eye, slight pain and foreign body sensation. UCVA between the two groups showed statistically different at 3, 6mo and 1a(t=2.04, P=0.047). UCVA at 3mo was the best compared with those at other time pionts, and became stable at 6mo. UCVA of all patients were above 0.8 at 12mo,and had no difference with that before operations(t=1.508, P=0.1670). Haze were hardly seen, and most of them were between grade 0～1. The patients' satisfaction was over 85% according to the survey about night vision, dry eye and asthenopia.

CONCLUSION:Because of the great advantages of no-touch, fast recovery and less side effects, trans-epithelial PRK has great efficiency, safety and satisfaction. It now is the most ideal method of surface ablation for high myopia treatments.

Abstract:AIM:To investigate the effect of different stage of primary hypertension on corneal endothelial cells by Specular Microscope.

METHODS:Case-control study was taken. The case group included 71 patients(142 eyes)diagnosed with primary hypertension, including 22 patients(44 eyes)in group stage 1, 23 patients(46 eyes)in group stage 2 and 26 patients(52 eyes)in group stage 3. The control group included 69 healthy subjects(138 eyes). There was no statistical differences in gender and age(P>0.05), and no systemic or eye disease for the both groups.Statistical analysis was made on the corneal endothelial cells including average cell area, average cell density, coefficient of variation and percentage of hexagonal cells.

RESULTS:Average cell area and average cell density had no statistical differences for both groups. Coefficient of variation increased(t=3.34, P<0.05)and percentage of hexagonal cells decreased(t=-2.07, P<0.05)for case group. There was no significant difference on average cell area and average cell density among the three subgroups in case group(P>0.05). There was significant differences for coefficient of variation and percentage of hexagonal cells(P <0.05)among the three subgroups..

CONCLUSION:Compared with the control group, corneal endothelial cells of patients with primary hypertension increases significantly on coefficient of variation and decreases on percentage of hexagonal cells. Patients with different hypertension grades have different coefficient of variation and percentage of hexagonal cells.

Abstract:AIM:To investigate the clinical effect of hypermature cataract extraction combined with intraocular lens implantation by the tongue capsulotomy method.

METHODS:A total of 380 eyes with hypermature cataract were applied tongue capsulotomy method in cataract extraction combined with intraocular lens implantation. All of eyes were observed and followed up the effect after operation.

RESULTS:The visual acuity of all cases was improved after the operation. One day after operation, 85 eyes(22.4%)were below 0.1, 162 eyes(42.6%)were between 0.1 to 0.3, 87 eyes(22.9%)were between 0.4 to 0.6, 46 eyes(12.1%)were above 0.6. One month after operation, 33 eyes(8.7%)were below 0.1, 152 eyes(40.0%)were between 0.1 to 0.3, 117 eyes(30.8%)were between 0.4 to 0.6, 78 eyes(20.5%)were above 0.6. Intraoperative or postoperative complications:intraoperative suspensory ligament broken occurred in 16 eyes(4.2%), posterior capsular rupture occurred in 25 eyes(6.6%), 53 eyes(13.9%)were found corneal edema, 12 eyes(3.2%)were found artificial crystal offset.

CONCLUSION:The tongue capsulotomy method is easy to grasp, the security of this method is better than others. It is more suitable for the use of hypermature cataract extraction combined with intraocular lens implantation during aid Africa.

Abstract:AIM:to observe the effect of modified surgery of small incision transscleral sulcus fixation of Akreos Adapt AO foldable intraocular lens.

METHODS:The study included 37 patients(37 eyes)who could not be performed the regular implantation of posterior chamber intraocular lens for the rupture of posterior capsule or for the zonular dialysis caused by trauma, congenital or surgery. Bausch & lomb Akreos Adapt AO fordable intraocular lens, VE22000 implantation device were applied in this study. Regular 2.4mm transparent cornea incision and pocket-like sclera incision were made. The intraocular lens were transscleral sulcus fixed by 10/0 prolene suture and the suture was buried within the scleral incision.

RESULTS:The intraocular lenses were all well posited and the postoperative visual acuity(VA)was improved in all patients. Three eyes(8%)were≥0.8 while 18 eyes(49%)>0.4～≤0.6 and the remaining 16(43%)were ≤ 0.4 at 3mo after surgery.Cornea astigmatism was 1.73D±1.22D and 1.62±1.34D before and after surgery, no statistic significance was observed(P<0.05). No severe complication occurred during or after surgeries except for 1 vitreous hemorrhage and 2 cornea edema. There was no suture exposure found.

CONCLUSION:The modified surgery of 2.4mm small incision transscleral sulcus fixation of Akreos Adapt AO foldable intraocular lens has the following advantages such as:good visual results, less postoperative astigmatism, small surgery incision, steady intraocular lens, less manipulation, less complication and more effective.

Abstract:AIM:To compare the differences of visual acuity and corneal astigmatism postoperatively between conventional refractive cataract surgery and that assisted by femtosecond laser.

METHODS:Sixty patients(60 eyes)with age-related cataract and cornea astigmatism were divided into femtosecond group and conventional group randomly or voluntarily. The flat shaft, steep shaft and diopter of corneal astigmatism in patients in femtosecond group were inputted into the online vector calculators to get the location and width of the incision. Then femtosecond laser was used to make corneal releasing incision, the main and auxiliary incision. Phacoemulsification and aspheric multifocal intraocular lens implantation were undergone. Patients in conventional group received full-thickness relaxing incision by cornea paracentesis knife at the steepest meridian axis during phacoemulsification. Then aspheric multifocal intraocular lenses were implanted. Uncorrected distance visual acuity(UCDVA), uncorrected near visual acuity(UCNVA)and cornea astigmatism were observed at 1d,1wk and 1mo postoperative.

RESULTS:UCVA of patients in both groups was improved after the surgeries. UCDVA and UCNVA of femtosecond group were higher than those of conventional group, while the cornea astigmatism of femtosecond group was lower than that of conventional group.

CONCLUSION:Refractile cataract surgery assisted by femtosecond laser canoffer better visual quality than conventional refractive cataract surgery because of lower cornea astigmatism and better visual acuity.

Abstract:AIM:To observe the effect of phacoemulsification on the ocular surface in patients with conjunctivochalasis and cataract.

METHODS:Totally, 150 cases(200 eyes)of cataract patients accepted phacoemulsification and intraocular lens implantation form September 2014 to December 2014 in our hospital were retrospectively analyzed. All the cases were divided into two groups, normal group(110 cases with 140 eyes)and conjunctivochalasis group(40 cases with 60 eyes)according to coexisted with conjunctivochalasis or not. Follow up lasted 3～6mo. The breakup time(BUT)of tear film, foreign body sensation, epiphora and conjunctival congestion of two groups were observed before and after operation and statistically analyzed. The time, these factors took to recover to preoperative state were observed too.

RESULTS:The differences of the BUT of two groups before and after the operation was statistically significant(t=20.93, 19.16; both P=0.00). The differences of the two groups after operations in terms of ocular foreign body sensation, epiphora and conjunctival congestion had statistical significance(P=0.00). The time these observed factors of two groups took to recover to preoperative state was significantly different(t=17.16, 14.18, 27.41; all P=0.00).

CONCLUSION:The ocular surface conditions are significantly worse after phacoemulsification and intraocular lens implantation in cataract patients. Conjunctivochalasis could significantly delay the recovery of ocular surface function after cataract surgery.

Abstract:AIM:To investigate efficacy of phacoemulsification combined with trabeculectomy for senile with cataract and glaucoma and to study the cause and the treatment for complications after the surgeries.

METHODS: This study retrospectively analyzed 35 patients(42 eyes)with cataract and glaucoma treated by phacoemulsification combined with trabeculectomy. Visual acuity, anterior chamber depth,the change of the intraocular pressure(IOP)were observed before and after operations. Postoperative complications were observed and treated too. Follow-ups lasted for 6～18mo.

RESULTS:Visual acuity of all patients had been improved with different degrees. The best corrected visual acuity(BCVA)was <0.1 in 2 eyes(5%), 0.1～0.3 in 18 eyes(43%)and >0.3 in 22 eyes(52%). The mean IOP reduced from 23.24±6.89 mmHg before operations to 16.54 ± 2.56mmHg after operations. Anterior chamber depth increased from 1.34±0.41mm to 2.81±0.53mmHg after operations. About complications, there were 14 eyes with corneal edema, 2 eyes with fibrinoid exudation, 2 eyes with anterior chamber hemorrhage; 1 eyes with shallow anterior chamber and low intraocular pressure, 2 eyes with posterior capsule opacification, 3 eyes with high IOP. After the treatment for complications, the patients were satisfied with the operation efficacy.

CONCLUSION:Phacoemulsification combined with trabeculectomy is safe and effective on the treatment of cataract coexisting with glaucoma, making little damage and quick healing. However, due to shallower anterior segment in glaucoma patients, phacoemulsification is difficult to performance. How to avoid the occurrence of complications and to treat them are the guarantee for successful operation.

Abstract:AIM:To observe the safety and clinical curative effect of trabeculectomy on continuous high intraocular pressure(IOP)in primary angle-closure glaucoma.

METHODS:From January 2013 to January 2015, 45 patients(46 eyes)with high IOP in primary angle-closure glaucoma were treated in the department of ophthalmology in our hospital. The age of patients was(56.9±9.4)years old, ranged from 43～81 years. All the patients underwent the examinations of visual acuity, best corrected visual acuity(BCVA), slit lamp, fundus IOP, perimetry and ultrasound B scan. Under local anesthesia, the patients underwent anterior chamber paracentesis, postoperative they received topical acetate prednisolone eye drops and tobramycin and dexamethasone eye ointment, combining with IOP lowering eye drops and glycerol fructose injection intravenous to further control IOP. Two days after surgery, the patients received trabeculectomy with amniotic membrane implantation and intracameral gas injection(some cases underwent pars plana puncture). Visual acuity, BCVA, IOP, slit lamp, fundus were observed postoperative and complications occurred during the operation were recorded.

RESULTS:The average IOP at 1 and 2d after anterior chamber puncture were 21.4±5.2, 20.3±4.8mmHg(1kPa=7.5mmHg), which was significantly lower than that before surgery(F=492.601, P<0.01); the average IOP after glaucoma filtration surgery was(20.1±4.8mmHg at 1d, 14.9±2.7mmHg at 3d, 13.6±2.7mmHg at 7d and 14.5±2.2mmHg at 1mo, which was significantly lower than those before surgery(F=857.508, P<0.01). After glaucoma filtration surgery, comparison between IOP at 1, 3, 7d and 1mo was performed, there was statistically significant differences were found(t=10.191, 10.950, 9.523, P<0.01). At the last visit, the functional filtering bleb formed in all cases. The fully success rate was 94%, the partially success rate was 7%. BCVA was significantly improved(P<0.05), and most of cases regain useful visual acuity. There were shallow anterior chamber in 3 eyes and chorildal detachment in 2 eyes, which were treated medically. Malignant glaucoma, retinal hemorrhage, suprachoriodal hemorrhage, eyeball atrophy and other severe complications did not occur.

CONCLUSION:For acute primary angle closure glaucoma with persistent high IOP, anterior chamber puncture and intracameral gas injection combined with trabeculectomy is a safe and effective method, which can reduce intraoperative and postoperative complications and improve the visual acuity of most patients.

Abstract:AIM:To study the incidence of familial exudative vitreoretinopathy(FEVR)and to discuss the necessity of the screening of ocular diseases for full-term infants.

METHODS:A retrospective analysis was conducted on 772 full-term infants from January 2014 to August 2015.

RESULTS:Among the 772 infants(1 544 eyes)who were enrolled the screening program,8 cases(15 eyes, 0.97%)developed FEVR, including 2 cases(2 eyes)suffering from stage 1,3 cases(5 eyes)from stage 2 in which 1 patient had an eye at stage 1,2 cases(4 eyes)from stage 3,1case(2 eyes)from stage 4,1 case(2 eyes)from stage 5.

CONCLUSION:FEVR is not uncomon in clinical but severely affected patients suffer from blindness during infancy. Neonatal and infant stage is the key time for the screening of FEVR, early detection and early intervention is the key to get better visual function in patients with FEVR.

Abstract:AIM:To evaluate the efficacy of modified staining technique of internal limiting membrane(ILM)with indocyanine green(ICG)in surgeries for idiopathic macular hole(IMH).

METHODS:Twenty-seven eyes of 27 consecutive patients with idiopathic macular hole in our hospital from March 2013 to December 2014 were retrospectively analyzed, which had undergone 23 gauge pars plana vitrectomy, ILM peeling and intraocular gas tamponade. ILM was stained around the IMH with a mixture of 5mg/ml indocyanine green, 50% hypertonic glucose and moderate viscoelastic. The application efficacy was observed.

RESULTS:The ICG-staining ILM showed viridescent with good visibility, which helped recognizing and peeling ILM. The range of peeling was about 2PD×2PD. Macular hole was closed completely in 24 eyes(88.9%)postoperatively. Macular hole was closed partly in 3 eyes(11.1%)postoperatively, but shrank in diameter. It was worth mentioning that one eye among which showed macular hole closure completely after undergoing a second surgery with an expanding peeling 2mo after the first surgery. The visual acuity of all patients improved in 6～15mo follow-up.

CONCLUSION:The modified staining technique of ICG for ILM peeling surgery can reduce residual and diffusion of ICG in eyes, and reduce the toxicity of ICG to retina, exposed epithelia and optic nerve.

Abstract:AIM:To observe the clinical characteristics of the patients with systemic lupus erythematosus(SLE)complicated with major retinal vascular occlusion.

METHODS:Seventeen patients(21 eyes)with SLE complicated with major retinal vascular occlusion were selected as the experimental group from January 2010 to January 2014 in our hospital. Thirty cases(60 eyes)of SLE patients without retinopathy were selected as the control group. Ocular and systemic examination and related laboratory tests, including various autoimmune antibodies, were taken. Clinical symptoms and signs were recorded.

RESULTS:In the experimental group, 13 cases were uniocular, 4 cases were bilocular, in which there were central retinal vein occlusion(CRVO)in 7 eyes(33%), branch retinal vein occlusion(BRVO)in 9 eyes(43%), central retinal artery occlusion(CRAO)in 3 eyes(14%),branch retinal artery occlusion(BRAO)in 1 eye(5%),CRAO combined with CRVO in 1 eye(5%). The best corrected visual acuity(BCVA)of the experimental group was significantly worse than that of the control group. The incidence of skin erythema(76%), fever(59%), arthritis(53%), central nervous system symptoms(headache and neuropsychiatric abnormalities)(76%), pleurisy(41%)were significantly higher than those of the control group. The positive rate of anti ds-DNA antibody(100%)and antiphospholipid antibody(65%), the decrease of C3(82%), the elevation of erythrocyte sedimentation rate(100%), thrombocytopenia(65%)were significantly higher than those of the control group. The score of SLEDAI(systemic lupus erythematosus disease activity index)was 20.24±4.66 prompting SLE in moderate or severe active stage.

CONCLUSION:In SLE patients with major retinal vascular occlusion, the visual acuity was severely damaged, the multi-system was affected in varying degrees, and all of the patients were in moderate and severe activity period. There may be a correlation between retinal vascular occlusion, APA, and central nervous system disease in SLE.

Abstract:AIM:To observe the clinical curative effect of electroacupuncture connecting Qiuhou(EX-HN7)and Hegu(LI-4)for eyeball movement disorder caused by acquired simplex abducens nerve palsy.

METHODS:Randomly we divided 48 cases(48 eyes)into treatment group(26 cases with 26 eyes)and control group(22 cases with 22 eyes), diagnosed with abducens nerve palsy from March 2012 to March 2015 at ophthalmology department of Beijing hospital of traditional Chinese medicine affiliated to Capital Medical University. Patients in treatment group were treated by electroacupuncture connecting Qiuhou(EX-HN7)and Hegu(LI-4), with body acupuncture and acupoints around eye. Control group took methylcobalamin(0.5mg, 3 times per day)orally and subcutaneously injection of compound anisodine hydrobromide by the superficial temporal vein(2mL, once a day)as the treatment. During the treatment, affected eyes of all the patients were covered. The course of treatments was 1mo. The improvement of eye movements was observed.

RESULTS:The date of the two groups was comparable at baseline. After 1mo treatments, the eye movement of treatment group was significantly improved from 13.06±2.31mm pre-treatment to 19.35±3.21mm post-treatment, than that of the control group. The difference was statistically significant(t=-5.43, P<0.01). The effective rate of the treatment group was 88.5%, higher than that of the control group(63.6%).The difference was statistically significant(χ²=4.16, P=0.04).

CONCLUSION:The electroacupuncture connecting Qiuhou(EX-HN7)and Hegu(LI-4)has certain effects on the treatment of eyeball movement disorder caused by simplex abduction paralysis. It is worth further clinical research.

Abstract:AIM:To discuss the effects of pranoprofen and sodium hyaluronate eye drops combined with traditional Chinese medicines in the treatments on elderly patients with diabetics and dry eyes, injuring of corneal epithelial after phacoemulsification.

METHODS:Randomly selected 82 elderly patients(108 eyes)with diabetics who were dry eyes and injuring of corneal epithelial after phacoemulsification in our hospital from March 2013 to September 2014. According to the random number methods, 82 cases were divided into experimental group with 45 cases(58 eyes)and control group with 37 cases(50 eyes). The cases in control group were treated with pranoprofen and sodium hyaluronate eye drops, besides those in experimental group were treated with grains of Qi Ming. All cases were respectively detected with Schimer test, Break-up time(BUT), Fluorescein(FL)before and after the treatments.

RESULTS:The Schimer value, BUT(10.17+3.12mm,16.21+4.29s)after the treatments were significantly higher than those(4.91+0.69mm,7.74+2.01s)before the treatments for the cases in experimental group(P<0.05). After the treatments, the Schimer value, BUT(10.17+3.12mm,16.21+4.29s)of the cases in experimental group were significantly higher than those in control group(9.01+2.87mm,16.21+4.29s)(P<0.05). The cure rate of experimental group(55.2%)was significantly higher than that of control group(34.0%), and the total effective rate(100%)of the experimental group was significantly higher than that(96.0%)of the control group(P<0.05).

CONCLUSION:The effects of pranoprofen and sodium hyaluronate eye drops combined with traditional Chinese medicines on elderly patients with diabetics and dry eyes, injuring of corneal epithelial after phacoemulsification are very good.

Abstract:AIM:To study the role of inflammatory cytokines in the pathogenesis of evaporative dry eye.

METHODS:Thirty-nine patients(65 eyes)with evaporative dry eye treated from January 2010 to January 2015 in our hospital were selected as test group. Thirty healthy check-ups(53 eyes)were selected as control group. All the patients took the anti-inflammatory drugs. Before treatments, the levels of TNF-α, IL-1, IL-6, IL-8 of two groups was compared. After 1, 4 and 10w of treatments, the levels of inflammatory cytokines of two groups was compared.

RESULTS:The levels of TNF-α, IL-1, IL-6, IL-8 of control group were significantly lower than those of test group(P<0.05). After 1, 4 and 10wk of treatments, the observed indexes of two groups were significantly different(P<0.05). With the extension of treatment time, the indexes gradually returned to normal; at 1, 4 and 10wk after treatments, the levels of TNF-α, IL-1, IL-6, IL-8 of two groups were significantly different. The mentioned indexes were gradually reduced(P<0.05).

CONCLUSION:For patients with evaporative dry eye, TNF-α, IL-1, IL-6 and IL-8 increase specifically, which are closely correlated with the occur and progress of this disease, regarded as the important reference indexes for clinical diagnosis and efficacy monitoring.

Abstract:AIM:To analyze the etiology and effective therapies of abnormal blinking in children.

METHODS:Children with abnormal blinking in our hospital were collected into the study from July 2012 to July 2015. The etiologies and corresponding treatments, according to the result of interrogation and examination of eyes were analyzed and the therapeutic effect was observed.

RESULTS:Totally, 5 561 cases were collected into the study including 4 025 cases of male, 1536 cases of female, and the ratio was 2.6:1; age range was 2～14 years old with average age was(6.9±0.6)years old. Etiologies were as follows:refractive(hyperopia, myopia and astigmatism)2054 cases(36.9%); allergic conjunctivitis 1670 cases(30.0%); children dry eyes 982 cases(17.7%); partial eclipse children with 605 cases(10.9%); lead pollution 590 care(10.6%); strabismus 156 cases(2.8%); trichiasis with 129 cases(2.3%); trace element deficiency(calcium, iron, zinc, magnesium and copper)for a total of 102 cases(1.8%); chalazion 37 cases(0.7%); keratitis and corneal injury 24 cases(0.4%), palpebral dermatitis, allergic rhinitis, dermatitis, 37 cases(0.7%); conjunctival stone 8 cases(0.1%); tic disorders of 30 patients(0.5%), asthenopia of 6 cases(0.1%); lacrimal duct obstruction, dacryocystitis 9 cases(0.1%). The etiologies of children with abnormal blinking were not caused by single factors. After examination, its etiology in children was resulted by one kind or more of a combination of factors. All of them were carried out ear acupoint application therapy and psychological intervention therapy, and symptomatic treatment was given after finding the cause. Following all the cases 1～3mo, blinking can obviously relieve,in which 4 560 cases(81.9%)were cured, 5286 cares were improved, the recovery(including cured)was 95.1%; slightly improved(including relapse cases)102 cases(1.8%); No significant changes in 173 cases(3.1%).

CONCLUSION:A variety of causes that can lead to children's abnormal blinking, refractive error, allergic conjunctivitis and children's dry eyes as the main reason. According to different causes to carry on the comprehensive treatments can get better treatment effect.

Abstract:AIM:To introduce a modified pterygium excision, so as to improve the operation quality.

METHODS:To cut the neck of the pterygiumat at limbus, then tear pterygiumat from opposite direction of head on the basis of the original excision. When resistance occurs, point of a knife(15°knife, pointed blade or diamond knife)was employed for cutting on the direction of tangent to cornea. In the process, the operation gave priority to tearing and was supplemented by cutting. A conjunctival flap was taken from the superior temporal and same size as the cut area. Conjunctival transplantation should be firmly stitched on the sclera.

RESULTS:The implementation was taken on 660 eyes. There were only 8 eyes relapsed, and the smoothness and transparency of cornea was superior to the conventional method. Recovery time was shortened obviously.

CONCLUSION:The modified method of reversal tear-cutting, conjunctival autograft and sclera reinforcement fixation is more effective than the conventional transplantation for treating pterygiumat.

Abstract:AIM:To study the relationship between inducible nitric oxide synthase(iNOS)and vascular endothelial factor CD34 with the incidence of recurrent pterygium.

METHODS:From March 2012 to October 2014, 15 patients with recurrent pterygium were treated as the experimental group of this study and 15 cases with simple pterygium were selected as the control group. iNOS and CD34 in two groups of patients were detected by immunohistochemical Envision method. Microvessel density(MVD)was calculated. The positive expression rates of iNOS and CD34 and MVD in the two groups were compared, and the effect of iNOS and CD34 on recurrent pterygium was analyzed.

RESULTS:The positive expression rate of iNOS was 7%(1 case)in the control group and 87%(13 cases)in the experimental group. The positive expression rate of CD34 in control group was 13%(2 cases)and was 80%(12 cases)in the experimental group. The positive expression rate of iNOS and CD34 in the patients with recurrent pterygium were significantly higher than those in the normal group(P<0.01). The MVD value of the experimental group was 46.02±10.88, and the control group MVD was 23.48±5.68. The MVD of the experimental group was significantly higher than that of the control group and the difference between the two groups was statistically significant(P<0.01).

CONCLUSION:iNOS and CD34 were significantly higher in the patients with recurrent pterygium. The relationship between iNOS and CD34 was related to the occurrence and development of recurrent pterygium.

Abstract:AIM:To investigate the short-term change of refractive error after strabismus surgeries with different extraocular muscles involved in.

METHODS:The study included 64 eyes of 41 patients. Patients were divided into three groups:groupⅠ(a rectus recession, 25 eyes), group Ⅱ(a rectus recession combined its antagonistic muscle shortening, 32 eyes), group Ⅲ(a rectus recession combined its antagonistic muscle shortening and oblique resection, 7 eyes). Observation on refractive indexes and vector analysis program of spherical equivalent, spherical diopter, cylinder diopter, axis of astigmatism, corneal curvature,dk value and was performed 1d prior to surgeries and 1 and 4 wk after surgeries.

RESULTS:No significant changes were noted at 1wk postoperative on spherical diopter, cylinder diopter, Kh, Kv, axis of astigmatism, corneal curvature in the centrel area in radius of 3mm, while spherical equivalent and dk value increased significantly(P=0.011; P=0.013). However, these changes were disappeared at 4wk postoperatively. Among the three groups, no significant changes were observed in group Ⅰ, while dk value were changed in group Ⅱ at 1wk postoperatively(P=0.035). Cylinder diopter, spherical equivalent, dk value of group Ⅲ significantly increased at 1wk postoperatively(P=0.022; P=0.048; P=0.014). At 4 wk postoperatively, these changes were disappeared.

CONCLUSION:Strabismus surgeries can make reversible changes to the ocular refractive status. With different strabismus surgeries, the changes on the ocular refractive status are different.

Abstract:AIM:To observe the availability and tolerance of 0.1% bromfenac sodium hydrate ophthalmic solution in the partial substitution of glucocorticoid after laser subepithelial keratomileusis(LASEK).

METHODS:Totally 180 patients(180 eyes)received LASEK were selected and divided into study group and control group according to different medications. The study group adopted 0.1% bromfenac sodium hydrate ophthalmic solution combined with glucocorticoid; the control group adopted glucocorticoid. The changes of visual acuity and intraocular pressure(IOP)of two groups were recorded before and after surgery and the occurrence of diffuse larnellar kerafitis(DLK)after surgery were observed.

RESULTS:After 1mo of surgery, visual acuity of study group was 1.25±0.22 while that of control group was 0.97±0.23(P<0.05). Visual acuity of two groups before surgery, after 1, 10d, 3 and 6mo of surgery had no significant differences(P>0.05). After 1 and 3mo of surgery, IOP of study group was 12.29±2.71 and 12.67±2.33mmHg while that of control group was 14.26±2.65 and 14.56±2.61mmHg, the difference was statistically significant(P<0.05). Before surgery and 10d and 6mo after surgery, IOP of two groups was not significantly different(P>0.05). In terms of tolerance, the control group had 4 cases(4 eyes)taking the IOP-lowering medication. The study group had no uncomfortable cases. The DLK level of the study group at 0, 1, 2 was 93.33%, 6.67%, 0%, respectively and those in control group was 75.56%, 17.78% and 6.67%, respectively, and the differences were significant(P<0.05).

CONCLUSION:0.1% bromfenac sodium hydrate ophthalmic solution can efficiently stabilize the patient's IOP after LASEK. The patient has a better visual acuity, visual function and fewer complications. The tolerance is also favorable. It is worthy of promotion.