Abstract:AIM: To investigatethe prevalence and awareness of diabetic retinopathy(DR), as well as its influential factors, among patients with diabetes mellitus in the Songnan Community of Shanghai.

METHODS: Residents with diabetes mellitus were randomly sampled in Shanghai's Songnan Community. These patients received full physical examinations. DR was diagnosed using non-mydriatic fundus photography. The patients completed a survey concerning their general knowledge and awareness of DR.

RESULTS: A total of 1120 valid questionnaires and fundus photographs were collected. The incidence of DR among patients with diabetes was 23.6%; 17.1% had mild DR, 5.1% had moderate DR and 1.4% had severe DR. Of the survey participants, 14.1% received ophthalmic examinations over the last year, 71.5% knew their normal blood glucose levels, 85.7% were aware of the possibility of systemic complications caused by diabetes, 77.2% were aware of ocular complications, 47.9% were aware of the need for regular fundus examinations, 58.0% were aware that the early treatment of DR is an important measure to prevent visual impairment, and 59.9% were willing to participate in regular health education seminars. A univariate analysis indicated that the knowledge and awareness scores regarding DR were correlated with age, education level, type of medical insurance, duration of diabetes, diet control, blood glucose monitoring, fasting blood glucose level, exercise frequency and DR stage. A logistic regression analysis indicated that the factors affecting the DR awareness scores were age, education level, type of medical insurance, stage of diabetes, diet control, exercise frequency and DR stage.

CONCLUSION: The patients with diabetes in the Songnan Community lacked sufficient awareness of DR prevention and treatment methods. The existing awareness of DR among the survey participants did not lead to effective prevention or treatment actions associated with this condition. It is necessary to educate patients with diabetes in local communities regarding DR.

Abstract:AIM: To remove orbital cavernous hemangioma by transconjunctival approach, and to examine efficacy and complications of this approach.

METHODS: We retrospectively analysed 74 patients with orbital cavernous haemangiomas between January 2007 and December 2013. Cavernous hemangioma was diagnosed preoperatively by computed tomography(CT)or magnetic resonance imaging(MRI)combined with color Doppler. Patients were underwent conjunctival approach, tumors located in the inferior, inferior lateral, or inferomedial sector using inferior fornix conjunctival incision, tumors located in super-lateral sector using the lateral conjunctival incision, tumors located in the superior and inferomedial sector using the super-nasal fornix conjunctival incision. Following exposure, the tumor was clamped and slowly pulled out. Careful dissection is necessary in case where tight adhesions are present.

RESULTS: The tumors were confirmed to be cavernous hemangiomas, consistent with preoperative diagnosis in 100%. Intraconal location was found in 58(78%), 16(22%)cases were in extraconal, including 12(16%)cases located in superlateral sector, 16(22%)cases located in superiormedial or superior sector, interior, inferiorlateral, or inferior locations occurred in 46(62%)cases. The tumor was 8mm to 59mm in diameter. All cases were underwent conjunctival approach, including 46 patients underwent inferior fornix conjunctival incision, 12 patients underwent lateral conjunctival incision, the supernasal fornix conjunctival incision was used on 16 cases. Nine patients were resected one third of the tumor firstly, then removed the rest. In 8 patients in visual acuity worsened postoperatively, 6 of them recovered after 6mo. Five patient's visual acuity improved. No patient had any residual proptosis,chemosis was occurred in 10 patients. One patient had unequal pupils as a result of a lesion of the ciliary nerve. Diplopia was spontaneously in all 6 patients in whom ocular movements were limited preoperatively, there was no diplopia in the other 68.

CONCLUSION: The transconjunctival approach of the tumor is suitable for all other than the tumour in the orbital apex, resect the whole tumor in a fractional resection way under orthophoria can effectively reduce the operation risk and improve operation safety.

Abstract:Diabetic retinopathy(DR)is the most severe complication of diabetic eye disease, which can eventually lead to irreversible blindness, thus seriously impacting on patients' quality of life. At present, surgical operation has been widely carried out on the treatment of DR in China. For the pre proliferative DR(PDR)and PDR, panretinal photocoagulation has often been adopted. By damaging the retina in ischemic area so as to reduce oxygen demand, the neovascularization can be prevented and the patient's condition can be stopped from getting worse. Traditional Chinese medicine(TCM)has an abundant and personalized therapeutic regimen for the treatment of DR. This paper reviews the research progress on combined therapy of TCM with laser photocoagulation for treatment of DR.

Abstract:AIM: To explore the inhibiting effect of FTY720 on corneal neovascularization(CNV)of rat.

METHODS: MTT assay and cells scratch were adopted to observe hyperplasia of human umbilical vein endothelial cells(HUVECs)and cell migration induced by sphingosine-1-phosphate(S1P)after using FTY720 of different concentration. The effect of FTY720 on CNV induced by S1P in a rat corneal micropocket model was detected. 30SD rats were randomly divided into group A, group B and group C with 10 rats per group. S1P and 0μg, 5μg, and 20μg FTY720 controlled-released particles were implanted into the corneal stroma. The growth of CNV and having pathological examination on 12d after the operation was observed. Findings was analyzed by one-way ANOVA.

RESULTS: 10, 10², 10³, and 10⁴ nmol/L FTY720 and HUVECs co-incubate 72h could inhibit cell proliferation(P<0.01), 24h after the function of 10,100nmol/L FTY720, it could inhibit S1P-induced cell migration and the ability of restricting cell proliferation and cell migration was enhanced with increasing concentration of FTY720. On 12d, after rat corneal micropocket controlled-release particles was implanted into groups A, B, C, the CNV area were respectively 10.05±1.19, 6.59±0.95, 2.70±0.68mm²(F=145.155, P<0.01), group A and group B was statistically different and this was the same case between group B and group C(P<0.01).

CONCLUSION: FTY720 can inhibit S1P-induced corneal neovascularization.

Abstract:AIM: To silent hypoxia inducible factor-1α(HIF-1α)gene in malignant melanoma of the choroid cell by small interference RNA(siRNA)and investigate its effect on the expression of matrix metalloproteinase-2(MMP-2)in the choroid cell line human uveal melanoma cell(OCM-1)in hypoxia environment.

METHODS: OCM-1 cells cultured on culture flask were divided into normal group and hypoxia group. Hypoxia group were divided into five groups: simple hypoxic group, and interference group, and negative control group, and positive control group, and liposome group. Normal group cells were cultured on DMEM culture flask with 10% FBS, 100U/mL penicillin, 100μg/mL streptomycin as well as high concentration of glucose. The cells were maintained at 37℃ in a humidified 5% CO₂ incubator. Cells in good condition were selected for experiment. For hypoxia group, chemical hypoxia inducer CoCl₂ was added into nutrient medium at the concentration of 100μmol/L to simulate hypoxia microenvironment. We designed and synthesised siRNA(siRNA+negative control+positive control), the target sequences of the HIF-1α to transfect hypoxic malignant melanoma of the choroid cell. SiRNA including HIF-1α siRNA, β-actin siRNA and negative control group synthesized in vitro transfected hypoxic OCM-1 cell through Lipofectamine2000. The expression of HIF-1α, MMP-2 gene and the protein were detected by RT-PCR and Western blot.

RESULTS: Compared with the normal group, the expression of HIF-1α mRNA was not obviously changed(P>0.05), but the expression of HIF-1α protein and MMP-2 mRNA protein was significantly higher(P<0.05). Compared with the other hypoxia groups,β-actin mRNA expression of positive control group decreased(P<0.05), which proved successful transfection. The expression of HIF-1α mRNA and the expression of its protein and both MMP-2 mRNA and its protein was significantly lower(P<0.05). The negative control group, liposome control group had no significant difference in the detection of factors(P>0.05).

CONCLUSION: Hypoxia status may upregulate the HIF-1α in OCM-1 cells by increasing the expression of protein. Hypoxia can also inactivate MMP-2, resulting in upregulation of MMP-2 RNA and the expression of its protein. The expression of HIF-1α and MMP-2 mRNA can be down-upregulated by transfecting OCM-1 with HIF-1α siRNA.

Abstract:AIM: To discuss the protective effect of α-mangostin on retinal light damage in mice.

METHODS: Totally 30 Balb/c mice, aged 6～8wk, were randomly divided into the control group, light-exposure group and α-mangostin group. Every group contained 10 mice. Mice of α-mangostin group were treated with alpha-mangostin at the dose of 30mg/(kg·d)body weight by intragastric administration daily for 7d, and then exposed to white light at the 5^thd. The light-exposure group and α-mangostin group were exposed to 5 000±200lx white light-emmiting diodes(LEDs)for continuously 1h to establish the mice model of retinal light damage. Flash-electroretinograme was recorded 72h after light exposure. The changes in retinal morphology of mice were observed by light microscopy. Retinas were extracted to detect the malondialdhyde(MDA)content change of the retinal homogenate.

RESULTS: Flash-electroretinogram(F-ERG)showed that retinal dysfunction was less severe in α-mangostin group than in light-exposure group(P<0.05). Light microscopy test showed that retina structural damage was less severe in α-mangostin group than in light-exposure group(P<0.05). The level of MDA in retinal tissue of α-mangostin group was significantly lower when compared with light-exposure group(P<0.05).

CONCLUSION: α-mangostin inhibits lipid peroxidation induced by light damage and protect retina against light damage.

Abstract:AIM: To investigate the protective effect of astaxanthin(AST)on human retinal pigment epithelial(RPE)cells against oxidative damage induced by hydrogen peroxide(H₂O₂).

METHODS:Human RPE cells were subcultured, cell activity was detected by MTT, rate of apoptosis was detected by flow cytometry and cell ultrastructure changes were observed under transmission electron microscope.

RESULTS:MTT results showed that cell activity elevated to(53.66%±3.25% and 70.43%±2.38% after 10^-8mol/L and 10^-4mol/L AST treated. The difference had statistically significant(P<0.05)compared with oxidative injury group(38.76%±3.74%). Flow cytometry results showed that the apoptosis rate of RPE cells decreased to 30.23%±1.91% and 12.58%±2.12% in AST pretreated group, the difference was significant(P<0.05)compared with oxidative injury group(42.50%±1.94%); Electron microscopy showed that the morphology of cells gradually improved accompanied with the concentration of AST elevated.

CONCLUSION:AST may inhibit hydrogen peroxide-induced apoptosis of RPE cells, it can provide reliable evidence for pursue effective medicine to prevent and treat retina injury.

Abstract:AIM: To explore the primary culture conditions for four kinds of lens epithelial cells(LECs)of rat, rabbit, dog, and human, and measure their growth characteristics.

METHODS: The lens capsule or anterior capsular tissue of rat, rabbit, dog and patient were removed by different methods, and they were cut into tiny pieces for primary culture by modified tissue adherent method. The morphological features of four kinds of LECs were observed under an inverted microscope.

RESULTS: Four kinds of LECs of rat, rabbit, dog and human could be cultured primarily by tissue adherent method. With the evolution of tissue source, the adherent capacity of LECs gradually strengthened, cells form were changed from irregular polygon to oval, nucleus rounded and cytoplasm enriched gradually. Four kinds of LECs had fibrotic changes after several passages.

CONCLUSION: LECs of rat, rabbit, dog and human can be primarily cultured. This method lays the foundation for the mechanism research of caratact and related fields on the cellular and molecular levels.

Abstract:AIM: To investigate expressions of matrix metalloproteinase-2(MMP-2)and extracellular matrix metalloproteinase inducer(EMMPRIN)in retinoblastoma(Rb)and the relationships between MMP-2, EMMPRIN and tumor development.

METHODS:Immunohistochemical technique was used to detect expressions of MMP-2 and EMMPRIN in 39 cases of paraffin embedded Rb samples. Quantitative analysis of expressions of MMP-2 and EMMPRIN were assessed by measuring the mean gray scale of Rb tissue with LEICA IM50 Color Pathologic Analysis System. The differences of expressions of MMP-2 and EMMPRIN in each clinical and pathological stage were statistically analyzed, and the same step was also undertaken to study the relationship between Rb with MMP-2 positive expression and that with EMMPRIN positive expression.

RESULTS: The positive expression rate of MMP-2 was 90%(Gray value: 109.64±14.52; 35/39), and that of EMMPRIN was 85%(Gray value: 108.01±13.60; 33/39). The expressions of MMP-2 and EMMPRIN were significantly higher in tumors of glaucomatous stage(Gray value: 108.21±11.47 and 107.56±14.32)than those in intraocular stage(Gray value: 121.13±11.32 and 119.34±12.66; P<0.01 and P<0.05). And the same conclusion can be concluded between those in extraocular stage(Gray value: 91.03±11.71 and 92.26±12.93)with those in glaucomatous stage(P<0.01 and P<0.05). The expressions of MMP-2 and EMMPRIN were significantly higher in tumors with optic nerve invasion(Gray value: 103.89±13.39 and 105.23±14.00)than those without optic nerve invasion(Gray value: 118.39±15.11 and 117.53±16.13)(P<0.01 and P<0.05).

CONCLUSION: The positive expression levels of MMP-2 and EMMPRIN may correlate with tumor infiltration and metastasis.

Abstract:AIM: To observe the influence ofphacoemulsification on corneal endothelial cell in patients with the different level of HbA1c.

METHODS: With case-control study, 164 eyes from 115 cataract patients were divided into four groups according to the preoperative HbA1c level. Control group A: 43 eyes from 30 cases without diabetes(HbA1c≤6.5%). Diabetes groups: group B was consisted of 38 eyes from 26 cases(HbA1c≤6.5%), 40 eyes of 28 case was in group C(6.5% 8.0%). Corneal endothelial microscopy was used to detect the parameters like endothelial cell density(CD), coefficient of variation(CV), percentage of regular hexagonal cells(6A)between pre-operation and post-operation at 1d, 1, 2wk, 1mo. The results were analyzed.

RESULTS: The endothelial cell density, CV and 6A cell had no significant difference in four groups before treatment(P>0.05). The CD and 6A were decreased and CV was increased in all groups after operation of 1d, 1, 2wk and 1mo. The difference was statistically significant(P< 0.05). There were statistical differences of 6A and CV in diabetes groups compared with control group(P< 0.05). The decreasing of CD between group A and group B had no difference(P>0.05). There were statistical differences of CD in group C and group D compared with group A(P<0.05). There were statistical differences of CD, 6A and CV within diabetes groups(P<0.05).

CONCLUSION: Cataract phacoemulsification had certain degree damage on corneal endothelial cell. Corneal endothelial appeared the minimal injury when the postoperative HbA1c≤6.5%. For diabetic cataract patients, the higher HbA1c before, the heavier damaged after the surgery.

Abstract:AIM:To observe the clinical effect of 2.2mm micro-incision phacoemulsification(Phaco)combined intraocular lens(IOL)implantation in the eyes with short axial length and compared with traditional 3.0mm incision phacoemulsification operation for clinical work and research objective information.

METHODS:In this prospective clinical control study, 60 cases(60 eyes)with cataract performed 2.2mm micro-incision phacoemulsification combined IOL implantation(micro-incision group, implanted Akreos MI60 IOL )and 3.0mm incision phacoemulsification operation(small incision group, implanted Akreos Adapt IOL), whose axial length ranged 17.68～21.32mm, average 20.35±0.61mm. Average axiall ength respectively of two groups: 20.57±0.39mm and 20.21±0.52mm. Effect Phaco time(EPT)and average ultrasonic energy(AVE)were recorded. The best corrected visual acuity(BCVA), intraocular pressure(IOP), anterior chamber depth(ACD), corneal endothelial cell density and the operative complications were observed postoperatively. All cases were followed up at 1, 7, 30 and 90d after operation.

RESULTS:EPT and AVE between two groups had no statistical significance(P>0.05). At the 1, 7 and 30d after surgery, induced astigmatism(SIA)of micro-incision group was lower than that of small-incision group. SIA between two groups had statistically significant(P<0.05), but in the 90d SIA between two groups had no statistical significance(P>0.05). At the 7d, the BCVA between two groups had statistical significance(P<0.05), but at the 30 and 90d, BCVA between two groups had no statistical significance(P>0.05). At the 7, 30 and 90d, corneal endothelial cell density of micro-incision group was higher than that of small incision group. Corneal endothelial cell density between two groups had no statistical significance. The mean ACD was significant increased postoperatively than preoperatively and had no statistical significance(P>0.05). The anterior chamber stabilized during the operation. There was not incision hot harmed during operation and postoperation.

CONCLUSION:Compared with 2.2mm micro-incision and traditional 3.0mm incision phacoemulsification, two groups have the same safety and 2.2mm micro-incision phacoemulsification has small SIA, organization small harm and improved visual acuity in early stage.

Abstract:AIM: To comprehensively evaluate of visual quality after epipolis laser in situ keratomileusis(EPI-LASIK)in mild to moderate myopia.

METHODS: Sixty cases(120 eyes)undergone EPI-LASIK with equivalent diopter(SE)were divided into two groups: mild myopia group(60 eyes)and moderate myopia group(60 eyes). Objective visual acuity, aberration, contrast sensitivity and glare sensitivity were measured before and 1wk; 1, 6mo after operation, and made comparative analysis.

RESULTS: Postoperative uncorrected visual acuity(UCVA)of two groups were better than that of preoperative(P<0.05). Postoperative 6mo, there were significant differences on total high RMS between two groups(P<0.05). Before operation and 6mo after operation, higher-order aberrations had statistically significant difference between two groups(P<0.05). After 1wk and 1mo, there were statistical significances at the five frequencies between two groups(P<0.05). After 6mo, the mild myopia group returned to preoperative levels, however, moderate myopia group in the high frequency region(18.0c/d)had significant difference with before surgery(P<0.05). 1wk after surgery, there were statistically significant differences on the 3.0, 6.0, 12.0, 18.0c/d frequency in both groups(all P<0.05), 1mo after surgery, there were significant difference at 12.0, 18.0c/d frequencies(all P<0.05), after 6mo, both groups returned to preoperative levels, showed no significant difference.

CONCLUSION: Visual quality is poorer in mild myopia patients than that in moderate myopia at early stage after EPI-LASIK. Better visual quality is observed at mid-late stage.

Abstract:AIM: To make a analysis of visual quality of iris location guided femtosecond laser assisted in situ keratomi(LASIK)and iris location guided mechanical sub-bowman keratomileusis(SBK)for high myopia treatment.

METHODS:Femtosecond LASIK(study group)was performed in 102 eyes of 51 patients with high myopia and 70 eyes of 35 patients were received mechanical SBK(control group)from January to October 2013. The spherical refraction of all the patients was from -6.00～-9.50D. Best corrected visual acuity(BCVA)of the patients was ≥1.0. Uncorrected visual acuity(UCVA), BCVA, thickness of cornea flap, contrast sensitivity function(CSF)and senior ocular aberration were examined in these patients and follow-up was 1a.

RESULTS: At 1a after surgery 94.1% UCVA in study group reached ≥1.0 and there was 94.3% in control group. There was no significant difference between two groups(P>0.05). Residual refraction of study group was -0.08±0.10 D and control group was -0.10±0.07 D. There was no significant difference of residual refraction between two groups(P>0.05). C12, C8 of senior ocular aberration and RMSH in study group was less than control group, amplification: 0.1642±0.0519 and 0.2229±0.0382(t=8.077, P<0.05), while C7 was equal in two groups: 0.1583±0.1921 and 0.1436±0.1536(t=0.556, P>0.05). C8 was 0.0950±0.069 and 0.1858±0.095(t=7.261, P<0.05). RMSh was 0.3711±0.0847 and 0.5622±0.1033(t=12.801, P<0.05). CSF was no significant difference between study group and control group(P>0.05).

CONCLUSION: Femtosecond LASIK and mechanical SBK is effective for high myopia. Compared to mechanical SBK, femtosecond LASIK shows more advantages in the senior ocular aberration and visual quality. The cornea flap is more regular from central to peripheral area with femtosecond laser.

Abstract:Uveitis is a group of inflammatory diseases causing serious impairment of visual function. The precise etiology and pathogenesis remain unclear. It can be induced by infection, trauma, tumor or autoimmune response, of which autoimmune response is the most common. In recent years, the cytokines in the process of inflammatory autoimmune diseases role has become one of research hot spots, its role in the pathogenesis and the relationship between the disease activity more and more attention. This article reviews the effects of interleukin, tumor necrosis factor, interferon and transforming growth factor-β in the pathogenesis of uveitis.

Abstract:Aldose reductase(AR)belonging to nicotinamide-adenine dinucleotide phosphate(NADPH)-dependent aldehyde-keto reductase superfamily, is the key rate-limiting enzyme in the polyol pathway which plays an important role in the body's high-sugar metabolism. AR is widely present in the kidneys, blood vessels, lens, retina, heart, skeletal muscle and other tissues and organs, converts glucose to sorbitol which easy permeability of cell membranes, cause cell swelling, degeneration, necrosis, and have a close relationship with the development of chronic complications of diabetes mellitus. Diabetic retinopathy(DR)is a multifactorial disease, the exact cause is currently unknown, but polyol pathway has been demonstrated to play an important role in the pathogenesis of DR. Clinical risk factors such as blood sugar control, blood pressure and other treatments for DR only play a part effect of remission or invalid, if we can find out DR genes associated with the disease, this will contribute to a better understanding of the pathological mechanisms and contribute to the development of new treatments and drugs. The current research progress of AR, AR gene polymorphism, Aldose reductase inhibitors to DR was reviewed in this article.

Abstract:Neovascular glaucoma(NVG)is a series of blinding and intractable eye diseases, which caused by various intraocular or extraocular diseases. The iris and angle neovascularization and vascular membrane fiber contraction may eventually lead to progressive elevation of intraocular pressure and angle closure. Because of complex etiology, the treatment of NVG is intractable and inefficient. Based on the articles published in recent years, we reviewed the progressions of the relevant cytokines and animal models.

Abstract:Retinal pigment epithelium(RPE)is a vital tissue for the maintenance of photoreceptor function and environment of outer retina, also the predominant cell type of proliferative vitreoretinopathy(PVR). It is also affected by many diseases of the retina and choroid, including diabetic retinopathy(DR), age-related macular degeneration(AMD)and retinal pigmentosa(RP). Although of neural origin, the RPE is capable of local repair, and cells may migrate and take on altered characteristics. These findings indicate that RPE-based therapy is a promising option for congenital or degenerate disease of the retina.

Abstract:The rate of blinding caused by high myopic maculopathy is high, vitrectomy is the most common treatment. However, the effectiveness of vitrectomy for high myopic patients who have serious posterior scleral staphyloma is not ideal. Recent years, posterior scleral reinforcement is used as a supplementary method with vitrectomy in clinical, treating for high myopic maculopathy. It achieves a positive curative effect especially in macular foveoschisis and macular hole cases. In this article, we introduced a review of history, current situation, material and surgery operand of scleral reinforcement. It also makes a further discussion of its prospects used in retina surgery.

Abstract:The large majority of elderly patients undergoing ophthalmic surgery take antiplatelet and anticoagulant drugs on a regular basis. Antithrombotic treatments predisposes to bleeding complications that may lead to retrobulbar haemorrhage, suprachoroidal haemorrhage and ultimately, to loss of vision. However, discontinuation of antithrombotic medication in such patients may lead to thromboembolic events with serious consequences. There are no guidelines on perioperative management of ophthalmic patients who are on antiplatelet and anticoagulant drugs. We reviewed traditional and newer agents in the context of cataract, vitreoretinal, glaucoma and oculoplastic surgery. Recommendations are given for continuation, cessation and recommencement of these agents in order to minimise the risk of bleeding and thrombotic complications.

Abstract:AIM:To study the refractive status characteristics aftser cataract surgery and the correlation between preoperative anterior chamber depth(ACD)and refractive status.

METHODS: Ninety-six cases of patients with cataract were randomly divided into two groups. The patients in phacoemulsification group were treated with phacoemulsification combined intraocular lens(IOL)implantation while the patients in small incision group were treated by small incision extracapsular cataract extraction combined with IOL implantation. Changes in ACD and postoperative refractive status and refractive fully corrected value were counted and the correlation of them were analyzed.

RESULTS: ACD of the phacoemulsification group s deepened 0.74mm while that of the small incision group deepened 0.78mm after treatment and there was no significant difference(P>0.05). After operation, the ACD of two groups significantly deepened(P<0.05). The postoperative visual acuity of two groups were significantly better than the uncorrected visual acuity of two groups(P<0.05). The postoperative refraction of two groups patients were mainly 0 ～+1.0D(41.67% and 54.16%)and +1.25～+2.0D(43.75% and 33.33%)(P>0.05).

CONCLUSION: ACD is significant deepened after operation. Surgeon needs full consideration of changes to improve the refractive IOL calculation accuracy.

Abstract:AIM: To study the trabeculectomy clinical effect of use tunnel knife to make double-deck scleral flap and to cut off the layer scleral flap of glaucoma.

METHODS:Using the random grouping method to divide 46 cases(60 eyes)of glaucoma into the treatment group of 24 cases(32 eyes)and control group of 22 cases(28 eyes). The treatment group, tunnel knife was used to make double-deck sclera flap and superficial scleral flap about the size of 5mm×5.5mm,1/3 scleral thickness, under the sclera flap made another one about the size of 3.5mm×4mm, 1/3 scleral thickness, resected the middle layer of the sclera flap, removed 2mm×2mm trabecular tissue, underwent routine peripheral iridectomy, could adjust suture the superficial scleral flap, sutured Ball fascia and bulbar conjunctiva. In control group, routine glaucoma trabeculectomy was undergone.

RESULTS:Patients were followed up for 1a, the vision in treatment group was obviously better than that in the control group, with a statistically significant difference(P<0.05). The postoperative intraocular pressure of the two groups of patients were significantly lower than that of the preoperative one. Postoperative 1 and 3mo, no statistical significant difference of intraocular pressure in two group(P>0.05). But after 6 and 12mo, the intraocular pressure of the treatment group were significantly lower than that of the control group, with statistically significant difference(P<0.05). Postopeartive 1a, the cumulative complete success rate and conditions for successful rate were 90.63% and 96.88% in the treatment group, and those were 75% and 89.29% in control group. There was significant difference between two groups(P<0.05).

CONCLUSION:The trabeculectomy have a good effect to lower the intraocular pressure by use tunnel knife to make double-deck scleral flap and to cut off the layer scleral flap. The scleral flap have uniform thickness, smooth surface, and the function of the filtering bleb maintained for a long time, less postoperative complications, suitable for various types of glaucoma, so it is worthy of clinical promotion.

Abstract:AIM: To learn the changes of the tear film before and after the trabeculectomy of glaucoma and explore the incidence of dry eye and the prevention and control measures.

METHODS: The 36 patients(60 eyes)of glaucoma were examined in detail before 3d of trabeculectomy and after the surgery at 3, 7, 14 and 30d. The examinations include lower eyelid central river of tears, break-up time(BUT), Schirmer Ⅰ test(SⅠt)and staining scores of corneal fluorescein under slit lamp microscope.

RESULTS:The tear meniscus height of central lower eyelid was increased and the tear film BUT was shortened at the same time, the scores of SⅠt was reduced and corneal fluorescein staining score was increased at postoperative 3 and 7d compared with that of preoperation. The tear meniscus height of central lower eyelid, tear film BUT and SIt and score of corneal fluorescein staining began to recover in most of the affected eyes after surgery 14d. At 30d after surgery, 22% of patients tear film failed to recover to the preoperative level; dry eye occured in 18% preoperative eyes with normal tear film.

CONCLUSION:Trabeculectomy of glaucoma may affect the stability of the tear film and some patients showeing obvious dry eye and should be intervened and treatmented timely.

Abstract:AIM: To examine the retinal nerve fiber layer(RNFL)changes in early primary open angle glaucoma(POAG)by comparing the superior half of the optic disc with the inferior disc half.

METHODS: It was a clinical observational study. The study included 30 patients(39 eyes)with POAG and 20 normal subjects(40 eyes). Visual field was tested by Zeiss Humphrey750 and the optic disc topographic parameters and RNFL thickness were measured by Zeiss Cirru HD-OCT. Collecting information included visual field mean defect(MD), glaucoma hemifield test(GHT), intraocular pressure(IOP), C/D ratio and RNFL thickness. Data were analyzed by statistic software SPSS18.0. The differences between two groups were assessed using t test.

RESULTS: The differences of superior RNFL minus inferior RNFL thichness on the corresponding clock-hour locations were caculated in two groups. There was a significant difference in superonasal-inferonasal RNFL thickness between two groups(t=2.526, P=0.014), and there were no significant differences in the others(all P>0.05).

CONCLUSION: The asymmetry of optic disc hemifield RNFL is found in early primary open angle glaucoma patients. The superonasal RNFL(1 o'clock for right eye, and 11 o'clock for left eye)is more fragile to loss than inferonasal RNFL(5 o'clock for right eye, and 7 o'clock for left eye).

Abstract:AIM: To investigate the relationship between the subfoveal choroidal thickness(SFCT)and both choroidal hemodynamic index and glycosylated hemoglobin in diabetic subjects.

METHODS: Seventy-eight type 2 diabetic patients(156 eyes)from ophthalmology and endocrinology ward of our hospital were enrolled in this study, including 39 females and 39 males, with a mean age of(59.8±6.2)years. According to early treatment diabetic retinopathy study(ETDRS)grading method, all samples were divided into diabetic retinopathy(DR)group, mild or moderate nonproliferative diabetic retinopathy group, severe nonproliferative diabetic retinopathy(NPDR)group and proliferative diabetic retinopathy(PDR)group. The SFCT and choroidal hemodynamic index were measured by enhanced depth imaging optical coherence tomography(EDI-OCT)and Color Doppler Imaging. Recording glycosylated hemoglobin content of all samples. Using multivariate linear regression to analyse the relationship between the SFCT and both choroidal hemodynamic index and glycosylated hemoglobin.

RESULTS: The end diastolic velocity(EDV)was significant higher and the SFCT was significant thinner in no diabetic retinopathy(NDR)group than other groups. There was no significant difference of peak systolic velocity(PSV)between four groups.The resistance index(RI)was significant higher in severe NPDR group than NDR group and mild or moderate group,the RI in PDR group was hihgest than other group with statistically significance.The SFCT was correlated positively(b=0.540,P<0.001)with the glycosylated hemoglobin. No significant correlation was found between the SFCT and the choroidal hemodynamic index(DR,P=0.341; PSV,P=0.770; EDV,P=0.131; RI,P=0.084).

CONCLUSION: Our results suggest that there is no significant correlations between the SFCT and the choroidal hemodynamic index; glycosylated hemoglobin is one of the factors that affect the SFCT in diabetic patients.

Abstract:AIM: To evaluate the efficacy of intravitreal ranibizumab in idiopathic choroid neovascularization(ICNV), compare the difference of the curative effect between type Ⅰand Ⅱof ICNV by optical coherence tomography(OCT), further provide evidence of the to effectiveness of ranibizumab in the treatment of choroidal neovascularization to guide clinical treatment.

METHODS: A retrospective analysis on the clinical data who were diagnosed as ICNV between October 2013 and June 2014 in our hospital were carried out. Totally 31 cases(9 cases of type Ⅰ and 22 cases of type Ⅱ)accepted ranibizumab injection voluntarily.All of the patients were evaluated by ophthalmic examination, funduscopy and OCT before and after the injection, classificated according to OCT results. The best-corrected visual acuity(BCVA)and maximum of edema thickness after ranibizumab treatment at 3mo follow-up were compared.

RESULTS: After statistically analyzed, BCVA and maximum thickness of the retinal lesions of 31 patients(type Ⅰ9 cases, type Ⅱ 22 cases)before and 1, 3mo after treatment had statistical significance. In different types of retinal ICNV patients, BCVA and maximum thickness of the retinal lesions before and after treatment had no statistical significance. It was said that ranibizumab intravitreal injection had effectiveness for ICNV, however, there were no significant effectiveness for typeⅠ andⅡ ICNV.

CONCLUSION: Ranibizumab intravitreal injection has obvious effectiveness for ICNV. However, it has no effect on typeⅠ andⅡ ICNV. Its safety and long-term complications need for further study.

Abstract:AIM: To observe the influence of phacoemulsification combined with intraocular lens implantation on retinal thickness changes of macular center fovea using optical coherence tomography(OCT)in cataract patients.

METHODS: Surgical eyes of 60 cases with cataract were as surgery group, the contralateral eye were as controls group. There was no complication before and during the surgery.Macular thickness was examined by OCT preoperatively and 1wk, 1, 3, and 6mo after surgery.The retinal thickness changes of macular center fovea were compared after surgery. The SPSS 17.0 software was used for statistical analysis.The paired t-test and variance analysis were used in two groups before and after surgery for relevant statistical data analysis(α=0.05).

RESULTS: In surgery group, the retinal thickness changes of macular center fovea at 1wk, 1, 3mo after treatment had significant differences compared with preoperation(P<0.05). The retinal thickness changes of macular center fovea at 6mo after treatment had no statistical significance compared with preoperation(P>0.05). The retinal thickness changes of macular center fovea was significantly higher than other groups at 1mo after treatment(P<0.05). The center fovea appeared to be abnormally thickened in 12 eyes, including 10 eyes of single fovea thickening and 2 eyes of cystoid macular edema in 2～4wk following surgery. Eleven eyes of them were resolved till 6mo postoperatively. In control group, preoperation or after operation for 1wk, 1, 3, and 6mo respectively, P values were without statistical differences(P>0.05). There were no statistical significant differences on retinal thickness of macular center fovea between two groups before and 6mo after surgery(P>0.05), while there were significant differences at 1wk, 1 and 3mo after surgery(P<0.05)

CONCLUSION: The retinal thickness changes of macular center fovea increases significantly after phacoemulsification combined with intraocular lens implantation. In a few of cases appear macular edema, but the majority of patients can be restored, prognosis is good.

Abstract:AIM:To study and observe the change of retrobulbar artery hemodynamics and bulbar conjunctival microcirculation indexes of patients with optic atrophy.

METHODS: Seventy patients with optic atrophy in our hospital from April 2013 to October 2014 were selected as observation group, 70 healthy persons with the same age at the same time were the control group. Retrobulbar artery hemodynamics and bulbar conjunctival microcirculation indexes of two groups were compared, those detection indexes of observation group with different types and severity degree were compared too.

RESULTS: The retrobulbar artery hemodynamics and bulbar conjunctival microcirculation indexes of observation group were all worse than those of control group, and the detection results of observation group with severe optic atrophy were worse than those of patients with mild and moderate optic atrophy, and the detection results of patients with moderate optic atrophy were all worse than those of patients with mild optic atrophy(all P<0.05), there were all significant differences, while the detection results of patients with different types of optic atrophy had no significant differences(all P>0.05).

CONCLUSION: The change of retrobulbar artery hemodynamics and bulbar conjunctival microcirculation indexes of patients with optic atrophy are great, and the influence of the disease severity degree for the detection results are great.

Abstract:AIM:To explore the efficacy and safety of mitomycin C used in trabeculectomy by analyzing intraocular pressure and blood flow.

METHODS: A total of 103 patients with glaucoma were divided into 2 groups randomly, and all patients were treated with trabeculectomy, while patients in the observation group were given mitomycin C extra. At 6～12mo follow-up were completed after operation, and the clinical efficacy, complications and hemodynamic characteristics of central retinal artery were compared between groups.

RESULTS: The clinical efficacy of the observation group was higher than that of the controls(P<0.05). There was no significant difference in complication rate between groups(P>0.05), but the complication type was differentiate to some extent. Low intraocular pressure and photophobia symptoms occurred mostly in the observation group, while cicatricial obstruction occurred mostly in the controls. Before treatment, there was no significant difference in hemodynamic characteristics between groups(P>0.05). One month after treatment, the peak systolic velocity(PSV)and end diastolic velocity(EDV)of the observation group were obviously lower, while resistance index(RI)and pulsatility index(PI)were higher than those of the controls, the difference was statistically significant(P<0.05). Six months after treatment, the PSV and EDV of the observation group were obviously higher, while RI and PI were lower than those of the controls, the difference was statistically significant(P<0.05).

CONCLUSION: Mitomycin C has a short-term harmful effect on glaucoma patients after trabeculectomy, but its long-term effect is safe and reliable.

Abstract:AIM: To analyze and compare the effect of femtosecond laser micro-incision corneal stromal lens excision(SMILE)and excimer laser in situ keratomileusis(LASIK)in the treatment of myopia after operation, to explore the safety, operability and prediction of SMILE.

METHODS: In this prospective clinical controlled study, 100 cases(200 eyes)received SMILE and 100 cases(200 eyes)undergone LASI in our hospital in the same period were selected. Uncorrected visual acuity, diopter, corrected visual acuity, slit lamp examination, intraocular pressure and corneal anterior segment OCT, corneal topography(Obscan II)of two groups in 1d, 1wk, 1, 3, 6mo, 1a were compared. Independent samples t test was used for data analysis.

RESULTS: 1)Postoperative slit lamp examination: after 1d in SMILE group, there were less eyes had corneal layer between mild cloudy or edema; postoperative 1wk corneal layer disappeared, cornea became clear and transparent. 2)Postoperative vision recovery: 1d after operation, vision recovery in LASIK group was better than that in SMILE group, the difference was statistically significant(P<0.01), there were no significant differences at 1wk, 1, 3, 6mo, 1a after operation(P>0.05). 3)Obscan II examination: graphics in the SMILE group was more regular and placed in the center, no eccentric and irregular graphics, better than that in the LASIK group. 4)Anterior segment OCT examination: postoperative corneal flap in the SMILE group was more uniform and accurate, but it was thin in the center and slightly thick the peripheral part in the LASIK groups. 5)Postoperative visual quality assessment used subjective questionnaire survey. The two groups had statistically significant difference on 4 points and 1 points(P<0.05). Complains in the LASIK groups were more that that in the SMILE group. While, no complain of the SMILE group was higher than that of the LASIK group. Glare of postoperative patients with night vision and dark environment in the SMILE group was better than that of the LASIK group.

CONCLUSION: SMILE is safe, effective, stable and predictable for the correction of myopia.

Abstract:AIM: To explore the judgment of pattern reversal visual evoked potential on visual function and injured part of children with spastic cerebral palsy.

METHODS: There were two groups in this study. 30 children with spastic cerebral palsy(quadriplegia: 15, diplegia: 15)were selected as observation group, while 30 normal children were selected as control group with randomized controlled trial. The changes of half-view and full-view incubation period and amplitude were observed by pattern reversal visual evoked potential.

RESULTS: Full-view pattern reversal visual evoked potential: the P100 incubation period of the observation group was 113.55±8.14ms, and the P100 amplitude was 23.08±15.41μV. The P100 incubation period of the control group was 105.05±5.58ms, and the P100 amplitude was 31.65±7.37μV. From the comparison on P100 incubation and P100 amplitude between two groups, the difference was statistically significant(P<0.05). P100 incubation period of the spastic diplegia of full-view pattern reversal visual evoked potential was 112.73±7.22ms, and the P100 amplitude was 21.03±12.17μV. P100 incubation period of the spastic quadriplegia was 114.37±9.02ms, and the P100 amplitude was 25.14±18.06μV. From the comparison on P100 incubation and P100 amplitude between two groups, the difference had no statistically significance(P>0.05). Compared to the control group, each eye and each view latency of observation group were higher, the difference was statistically significant(P<0.05). The change of the incubation period of the full-view and half-view pattern reversal visual evoked potential took place in the lesion of the visual pathway: including optic neuropathy, some optic nerve lesion, lesion after optic chiasma, and optic chiasma lesion. Among them, the lesion after the optic chiasma was the most common.

CONCLUSION: Pattern reversal visual evoked potential can help people to understand the visual impairment and injury of children with spastic cerebral palsy in order to identify the abnormal children and early intervention.

Abstract:AIM: To evaluate the long-term efficiency and safety of overnight orthokeratology in myopia correction and control in adolescents.

METHODS: Sixty-five myopia adolescents treated in our hospital from August 2011 to February 2012 were retrospectively analyzed and followed up to 2a. Among them, 35 cases(67 eyes)wearing overnight orthokeatology were included as trial group, and 30 cases(60 eyes)wearing spectacles were included as control group. The trial group were divided into 2 subgroup according the myopic grading in the initial visit: subgroup A(35 eyes, ≤-3.00D), B subgroup(32 eyes,>-3.00D and ≤-6.00D). In the trial group, slit lamp, visual acuity, refraction, intraocular pressure, corneal tomography were collected before wearing overnight orthokeratology, 1d, 1wk, 1month, 3mo, and every 6mo after wearing overnight orthokeratology,with axial length, corneal thickness, anterior chamber depth, corneal endothelial cell count, abjective refraction and tear film were also collected before and 2a after wearing overnight orthokeratology. In the control group, slit lamp, visual acuity, refraction and intraocular pressure were collected before wearing and 2a after wearing spectacles. Paired t test were used to compare the intragroup difference. One-way analysis of variance(ANOVA)was used to compare the differences among the groups. P<0.05 was considered statistically significant.

RESULTS: The uncorrected visual acuity of the trial group was improved obviously after wearing Orthokeratology Lens 1d, the visual acuity of a group patients improved more significantly. The corneal curvature(including vertical curvature and horizontal curvature)of the trial group became more flat after wearing Orthokeratology Lens 2a and stopped 2 wk; The length of ocular axis was also increased, the growth rate of B group(0.33±0.31)mm was lower than that of group A(0.43±0.25)mm; Subjective refraction of myopia was increased 0.68±0.49D than wearing Orthokeratology Lens before, but compared with the growth(2.08±0.57)D of the control, the effect of myopia control was more obviously. Grade of dry eye was more severely than that of wearing Orthokeratology Lens before, but there was no significant difference between groups A and B. Compared with wearing Orthokeratology Lens before, corneal thickness, anterior chamber depth, corneal endothelial cell number and the intraocular pressure were all no significant differences between the trial and control group.

CONCLUSION: Orthokeratology is a safe and effective method for the correction of myopia, and long-term use of Orthokeratology Lens can effectively control the development of myopia. Controlling of moderate myopia is more effective than that of low myopia.

Abstract:AIM: To research the characteristics of positive relative accommodation(PRA), negative relative accommodation(NRA)and PRA/NRA ratio in myopes. To analyze the relationship among PRA, NRA, PRA/NRA ratio, spherical equivalent degree, years and habbits of wearing glasses, myopia development, and pupil diameter.

METHODS: Aretrospective study of ninety eyes in the 180^th Hospital of Quanzhou from August 2014 to December 2014. PRA, NRA and PRA/NRA ratio were compared among low, moderate, high myopes and emmetropes. The correlation were analyzed among PRA, NRA, PRA/NRA ratio, spherical equivalent degree, years and habbits of wearing glasses, myopia development and pupil diameter. PRA, NRA, PRA/NRA ratio, years and habbits of wearing glasses and pupil diameter were compared between progress group and non-progress group.

RESULTS:(1)Without statistical differences in age, sex and intraocular pressure, PRA and PRA/NRA ratio of myopes were lower than emmetropes, while NRA was higher.(2)Without statistical differences in age, sex and intraocular pressure, PRA, PRA/NRA ratio and NRA had no statistical differences while years and habbits of wearing glasses had statistical differences among low, moderate, high myopes.(3)With longer years of wearing glasses, PRA, PRA/NRA ratio were larger and NRA, pupils were smaller.(4)Without statistical differences in age, diopter and intraocular pressure, one group which were not easy to deepen degree had more often-wear-glasses myopia patiens and longer years of wearing glasses, the other group which were easy to deepen degree had more seldom-wear-glasses myopia patiens and shorter years of wearing glasses.

CONCLUSION: PRA and PRA/NRA ratio of myopes were lower than emmetropes, while NRA was higher. No correlated relation was detected among PRA, NRA, PRA/NRA ratio, spherical equivalent degree and myopia development. It suggests the onset and progress of myopia are related to many factors. Wearing-glass timely and accurately can release the decline of PRA and PRA/NRA ratio and slow down degree development in myopes.

Abstract:AIM:To understand the effect on comprehensive ability of “Teaching-learning transaction” professional education of ophthalmic postgraduates which involving the teachers and students to participate in, and to explore new education model for ophthalmic postgraduate.

METHODS:We carried out retrospective investigation questionnaire in the 31 ophthalmic postgraduates of Luzhou Medical College 2010～2014 grade and the 47 medical staffs of Department of Ophthalmology of the Affiliated Hospital of Luzhou Medical College, to clarify the new professional education model whether could improve the comprehensive ability of ophthalmic postgraduates or not.

RESULTS: Carrying out the “Teaching-learning transaction” professional education could improve the comprehensive ability of ophthalmic postgraduates.

CONCLUSION: Putting teaching and learning together can improve and promote each other, and it is helpful to cultivate comprehensive ability of ophthalmic postgraduates.

Abstract:AIM: To discuss the application effect of surgical simulator to improve the microsurgical skills in junior ophthalmologist.

METHODS:Lecture teaching, training in surgical simulator and operation in animal eyes were received in all these ophthalmologists. Results of the ability of operation in cataract surgery after this training were analyzed.

RESULTS: After taught theory, students completed cataract surgical procedures on simulator and the mean test score was 75.91±6.53 points. After trained on simulator repeatedly, the mean test score was 85.57±4.64 points. There was statistically significant difference(P<0.01). During the third stage of practicing on animal eyes, the score was 89.77±7.61 points, there was statistically significant difference compared with former two stages(P<0.05).

CONCLUSION: Comprehensive training can improve microsurgical skills of junior ophthalmologist, but the long effect need to be observed.

Abstract:AIM:To retrospectively evaluate central foveal thickness in highly myopic eyes with best correct visual acuity(BCVA)METHODS: In this retrospective clinical study, we consecutively recruited 70 low highly myopic cataract subjects(70 eyes)underwent Phaco. Postoperative visits were performed at 1wk, 1 and 3mo. Postoperative BCVA were recorded and further divided into 2 groups with BCVA< and ≥ than 0.3. Central foveal thickness was measured by OCT 1 and 3mo after surgery. Chi-square test was used to compare preoperative and postoperative BCVA. Pearsion's correlation was used to evaluate relationship between postoperative BCVA and central foveal thickness.

RESULTS: The ratio of BCVA<0.05 was 30%,14%, 11% and 7% respectively for per-operation, 1wk, 1 and 3mo post-operation. After surgery, the central foveal thickness was significantly increased in group with BCVA<0.3 comparing to group with BCVA≥0.3. Three month post-operation, central foveal thickness was significantly decreased in both groups comparing to that in 1mo post-operation(P<0.01). There has significant correlation between 3mo postoperative BCVA and central foveal thickness(r=-0.716, P<0.05).

CONCLUSION: In this study, BCVA is improved after 3mo follow up. There has significant correlation between postoperative BCVA and central foveal thickness.

Abstract:AIM: To evaluate the application of phacoemulsification of different nucleus density using ozil and traditional mode.

METHODS: A total of 89 eyes(72 patients)(visual acuity was of 0.6 and above after 1mo follow-up)of different nucleus density level(LOCS Ⅱ criteria grade Ⅲ 46 eyes, grade Ⅳ and more 43 eyes)were randomly assigned into 2 groups: ozil group(group A), grade Ⅲ 22 eyes(torsional energy 80% IP on); grade Ⅳ and more 17 eyes(torsional energy 100% IP on); Traditional mode group(group B), grade Ⅲ 24 eyes(energy 50%), grade Ⅳ and more 26 eyes(energy 60%～70%). All surgeries were performed by the same experienced surgeon,who use the chop to split the nucleus in the application of phacoemulsification. Intraoperative parameters were total equivalent pawer(TEP), cumulative dissipated energy(CDE)and effective phaco time(EPT)and surgical complications. The effectiveness of the two modes in dealing with hard-core cataract phacoemulsification were compared.

RESULTS: GradeⅢ nucleus dealing: TEP of ozil group was significantly higher than that of the traditional mode group \〖(24.58±7.78)% vs(13.84±1.97)%\〗and EPT of ozil group was significantly lower than that of the traditional mode group(50.59±14.73 s vs 60.19±9.04 s, P<0.05). CDE showed no difference between two groups \〖(13.12±6.03)% vs(13.38±2.85)\〗. Grade Ⅳ and more nucleus dealing: CDE \〖(34.10±13.48)%\〗 and EPT(104.64±32.4s)of the ozil group was higher than CDE \〖(30.31±13.48)%\〗 and EPT(93.01±41.01s)of the traditional mode group, but there were no difference between two groups. Obstacles in the needle of phacoemulsification surgery: ozil group 4/17, traditional mode group 2/26(χ²=2.16, P=0.14).

CONCLUSION: Bothozil and traditional mode can deal with all kinds of nucleus effectively and safely. Ozil mode is more efficacy and quick deal in grade Ⅲ nucleus. With the increase of nucleus hardness, the traditional mode still have the advantage of high efficiency and no obstacle to dealing patients with grade Ⅳ and more nucleus. Choose according to different nuclear hardness ultrasonic model can improve the operation efficiency and security.

Abstract:AIM: To evaluate the clinical efficacy and safety of capsular tension ring(CTR)combined with iris hooks in eyes with large traumatic zonular dialysis or weakness that underwent micro-incision coaxial phacoemulsification with posterior chamber(PC)intraocular lens(IOL)implantation.

METHODS: This prospective study was carried on 21 patients(21 eyes)with traumatic cataract and traumaticzonular dialysis(<180 degrees determined pre- or intra-operatively)in our hospital from January 2011 to September 2014. After CCC, 1-4 iris hooks might be used probably and a in-the-bag CTR was inserted in order to maintain or re-establish an extended capsular diaphragm before or at any time during cataract removal. Then micro-incision coaxial phacoemulsification with foldable acrylic PC IOL implantation was performed. Zonular dialysis range, posterior capsule rupture, vitreous loss, pupil size, best corrected visual acuity(BCVA), intraocular pressure(IOP)in the pre- and post-operative periods and postoperative IOL decentration were observed after operation.

RESULTS: The mean follow-up period was 3～12mo. No serious postoperative complication was found. BCVA in our cases: <0.3 in 1 eye, 0.4～0.7 in 15 eyes, >0.8 in 5 eyes. IOPs were in normal range too. The IOLs in 20 eyes remained the required position to the final follow-up examination except one eye in which the PC IOL was dislocated into vitreous cavity due to a postoperative spontaneity PCR, and in which vitrectomy and IOL suture fixation was performed.

CONCLUSION: In cases of cataract associated with traumatic zonular dialysis(<180°), by setting the rational parameters of phacoemulsification, the CTR and iris hooks are found to be efficient in preventing IOL decentration and reducing operation complication. In our cases, the CTR combined with iris hooks is relatively safe application.

Abstract:AIM:To discuss the clinical effect and safety of the combined surgeries of phacoemulsification and goniosynechialysis for patients with primary angle-closure glaucoma(PACG).

METHODS: Eighty-three eyes of 83 patients with PACG and cataract were ranomized into two groups. Group A: 39 patients with 39 eyes of angle-closure <180°; Group B: 44 patients with 44 eyes angle-closure ≥180°. The changes of visual acuity, anterior chamber depth(ACD), anterior chamber angle and IOP after operation were measured. The follow-up period was for 1a.

RESULTS: The visual acuity was improved significantly in both group after operation. No significantly difference in ACD, anterior chamber angle after operation in two groups(P>0.05). The IOP in group A was lower than that in group B 3mo after operation, there was statistical significance(P<0.05).

CONCLUSION:Phacoemulsification and goniosynechialysis can deepen ACD significantly. This method make the anterior chamber angle open, can reduce IOP and improve the patients' visual acuity, especially in patients with PACG. It is a safe and effective approach to patients with PACG and cataract.

Abstract:AIM: To compare the results of IOL Master, contact and immersion A-scan ultrasound measurements for anterior chamber depth(ACD), and evaluate the difference and consistency.

METHODS:Fifty-eight cases(98 eyes)with age-related cataract during July to October in 2013 did the A-scan ultrasound with contact and immersion measurements and IOL Master to get the results of ACD. Difference in measurements between methods was assessed using the variance analysisi. Consistency was assessed using Bland-Altman.

RESULTS: The ACD measured by IOL Master was 2.31～3.90mm, the mean was 3.03±0.38mm. The ACD measured by contact A-scan ultrasound was 1.51～4.06mm, the mean was 2.88±0.56mm. The ACD measured by immersion A-scan ultrasound was 1.99～4.17mm, the mean was 3.17±0.38mm. The results of IOL Master and contact A-scan ultrasound had statistical differences(P=0.022<0.05). The results of IOL Master and immersion A-scan ultrasound had statistical differences(P=0.031<0.05). The results of contact A-scan ultrasound and immersion A-scan ultrasound had statistical differences(P=0.000<0.05). The consistency between three methods was poor.

CONCLUSION: The rank of ACD of patients with cataract is immersion A-scan ultrasound, IOL Master and contact A-scan ultrasound. The consistency is poor, and the three methods can't be interchanged clinically.

Abstract:AIM:To compare the efficacy and safety of latanoprost and brimonidine in the treatment of open angle glaucoma, and provide reference for rational drug use.

METHODS:A total of 121 cases(136 eyes)who were diagnosed as primary open angle glaucoma were selected in this study, and they were randomly divided into experimental group(62 cases, 70 eyes)and control group(59 cases, 66 eyes)according to different drug treatment. Patients in the control group received brimonidine eye drops twice a day, while patients in the experimental group received latanoprost eye drops once a day. The intraocular pressure, visual acuity and adverse reactions were checked of the two groups in the following 3mo.

RESULTS:The intraocular pressure of patients in the control group was 18.1±1.3mmHg, while the experimental group was 17.0±0.9mmHg after 12wk of treatment, which were both lower than before(P<0.05). The fluctuation of intraocular pressure in the experimental group was significantly lower than that of the control group. There was no significant difference in the LogMAR visual acuity between before and after treatment in the control group, while the LogMAR visual acuity of the experimental group was significantly improved. The control group had hyperemia, burning sensation, tearing, eyelid edema and other adverse side effects, and the experimental group had little adverse reactions.

CONCLUSION:Latanoprost can significantly reduce intraocular pressure in glaucoma patients with in the follow-up time, and reduce the impact of elevated intraocular pressure in the vision of glaucoma patients, with little adverse reaction, worthy of clinical application.

Abstract:AIM: To investigate the influences of 577nm panretinal photocoagulation(PRP)on the retinal thickness of macular fovea on diabetic retinopathy(DR).

METHODS: A total of 45 eyes of 37 cases suffering from preproliferative diabetic retinopathy(PPDR)and proliferative diabetic retinopathy(PDR)undergoing 577nm PRP were enrolled in this study. The alterations of the retinal thickness of macular fovea measured by optovue optical coherence tomography(OCT)before and 1, 3, 6mo following PRP were comparatively analyzed.

RESULTS: The macularfoveal retinal thickness after 1, 3mo of PRP had significantly increased that before operation(P<0.05). After 6mo postoperative follow-up, it gradually recovered to the level before PRP, with no significant difference(P>0.05).

CONCLUSION: After the treatment of PRP, it appeared a transient increase on the retinal thickness of macular fovea, but after 6mo following-up, the macular foveal retinal thickness decreased nearly to the levels before PRP.

Abstract:AIM:To investigate the features on prolonged central serous chorioretinopathy(CSCR)by optical coherent tomography(OCT)and to provide the basis of deciding the pathogenetic condition and prognosis.

METHODS: Eighty-five patients who had been diagnosed with CSCR were grouped by suffering time as below: 32 patients suffered longer than 6mo as the prolonged and 53 patients with CSCR cured within that time. The imaging features of OCT were compared between the above groups.

RESULTS:The incidence rate of neuroepithelial serous detachment extent above 500μm associated with pigmentary epithelial detachment in suffering eye and pigmentary epithelial damage in contralateral eye was significantly different between two groups. However, the incidence rate of neuroepithelial serous detachment extent above 4 000μm was not significant difference.

CONCLUSION:OCT could display clearly the change of every layer of retina with simplicity and visibility, which supplies us a new horizon to diagnose and trace CSCR. We could decide the pathogenetic condition and prognosis in accordance with the features of OCT, to provide references for the diagnosis and treatment of CSCR.

Abstract:AIM: To study the treatment effect of traditional Chinese medicine in the treatment of high myopia macular hemorrhage, using Chinese medicine etiology and pathogenesis, syndrome differentiation treatment, and provide the basis for the clinical treatment.

METHODS: Eighty patients(135 eyes)with high myopia macular hemorrhage were selected in the hospital from January 2012 to september 2014 as treatment group, and applied traditional Chinese medicine treatment. Forty-five patients(64 eyes)with the same period, as the control group, received routine western medicine treatment. After 1mo treatement, the treatment effect and vision improvement situation of two groups were observed, and after 6mo follow-up, the relapse was observed.

RESULTS: The total effective rate of treatment group was 85.19%(115/135), higher than the control group 78.13%(50/64)(P<0.05). The average corrected visual acuity of treatment group was 0.48±0.11, higher than the control group 0.36±0.09, the difference was statistically significant(P<0.05). The average diopter and macular bleeding scope of the treatment group were -9.81±0.85D and 0.51±0.27PD, lower than the control group -10.76±0.91D and 0.78±0.23PD, the differences were statistically significant(P<0.05). The eye ground hemorrhage absorption time of treatment group was 25.34±2.28d, less than the control group 29.72±2.13d, the difference was statistically significant(P<0.05). The bleeding again of the control group 7.81%(5/64), higher than the treatment group was 5.19%(7/135), the difference was statistically significant(P<0.05).

CONCLUSION: Evidence-based treatment of traditional Chinese medicine for high myopia macular hemorrhage has good clinical effect, can shorten the treatment time, and is beneficial to the recovery of postoperative vision, worthy of clinical popularization and application.

Abstract:AIM: To investigate the relationship among carotid atherosclerosis, homocysteine(Hcys)and anterior ischmic optic neuropathy(AION).

METHODS: Sixty-five AION patients enrolled in AION group and 70 non-AION controls enrolled in control group. All the participants in 2 groups were examined by carotid artery color doppler flow imaging to evaluate the incidence of carotid atherosclerosis. Plasma levels of Hcys, vitamin B12 and folate were measured by automatic biochemical analyzer. The incidence of carotid atherosclerosis, plasma levels of Hcys, vitamin B12 and folate were compared statistically between AION and control group.

RESULTS: Fifty-six AION patients(86%)exhibited carotid atherosclerosis, which was found in 43 control subjects(61%). Fifty-nine AION patients(91%)exhibited increased plasma levels of Hcys compared with that in 38 control subjects(54%). Lowered vitamin B12 was found in 37 patients with AION(57%)and in 43 control subjects(61%). Lowered folate was found in 54 AION patients(83%)and in 32 control subjects(46%). The incidence of atherosclerosis in carotid artery(P=0.001), mean Hcys level(P=0.0005)and lowered folate(P=0.0006)were different statistically between AION group and control group. Mean vitamin B12 level was indifferent between AION group and control group(P=0.0722). Logistic regression analysis showed that carotid atherosclerosis was an a risk factor for AION(OR=1.312, 95%CI: 0.927～1.772), whereas elevated Hcys level(OR=2.378, 95%CI: 1.479～3.821)was also shown to be significant risk factor for AION.

CONCLUSION: Carotid atherosclerosis and elevated Hcys were related with AION. Reducing above-mentioned risk factors related to thrombus may be crucial to the prevention and cure of AION.

Abstract:AIM: To investigate the relationship between the anterior ischemic optic neuropathy(AION)and the carotid artery change using doppler ultrasound.

METHODS:Fifty-four cases of AION patients and 54 cases of healthy control were observed, atherosclerotic spots were detected by the application of color ultrasound.

RESULTS:In AION group of 54 patients, 38 cases appeared carotid atherosclerosis, accounting for 70%. The number of cases with hard plaque, soft plaque and mixed plaques were 18, 13, and 7 respectively, accounting for 33%, 24% and 13%. In the control group, 20 cases were detected atherosclerotic change, accounting for 37%. And the number of cases with hard plaque, soft plaque and mixed plaques were 12, 5 and 3 respectively, accounting for 22%, 9%, 6%. Significant stenosis and velocity change were showed in neither AION group nor control group. Compared with the control group, AION group had more cases of atherosclerotic plaque, the difference was statistically significant(χ²=12.836, P=0.005)

CONCLUSION: The incidence of AION is correlated with carotid atherosclerosis, and carotid ultrasonography is significantly valuable for AION etiology and diagnosis.

Abstract:AIM: To investigate the operation methods and clinical effects of foldable intraocular lens secondary implantation after lens-vitrectomy in residual capsular with traumatic eyes.

METHODS: During January 2012 to January 2014, foldable intraocular lens was implanted on 47 cases following lens-vitrectomy in residual capsular with traumatic eyes 3～6mo. Follow-up period was 6～12mo, averaged(8.21±2.63)mo.

RESULTS:All of 47 eyes had successful operation at one time, and position deviation was not appeared. The naked vision of the last postoperative follow-up was(0.44±0.19). Compared with best corrected visual acuity(0.41±0.23), and There was no significant difference between visual acuity of preoperative and last follow-up period(t=0.879, P=0.342). No severe complication was found.

CONCLUSION: Secondary implantation of foldable intraocular lens is a safe and reliable method for correcting ametropia after lens-vitrectomy in residual capsular with traumatic eyes.

Abstract:AIM: To observe the effect of dacryocystorhinostomy for the treatment of chronic dacryocystitis using nasal endoscope and discuss the operation technique.

METHODS:A retrospective clinical analysis was performed on the clinical data followed up for 6～12mo from 140 patients(169 eyes)with dacryocystorhinostomy for the treatment of chronic dacryocystitis using nasal endoscope. The effect of the treatment was evaluated and the operation technique for the treatment of chronic dacryocystitis using nasal endoscope was discussed.

RESULTS: In all of cases 155 eyes(91.7%)were recovery, 3 eyes(1.8%)were improved, and 11 eyes(6.5%)were failure. The total efficiency was 93.5%, there was no significant difference compared with traditional dacryocystorhinostomy group(χ²=3.743, P>0.05).

CONCLUSION: Dacryocystorhinostomy using nasal endoscope for treatment of chronic dacryocystitis has a good curative effect.Techniques including lacrimal sac location and size, colostomy position and size, treatment of colostomy mucosal flap and nasal disease, postoperative follow-up and physical condition of patients are likely to affect the operation curative effect.

Abstract:AIM: To observe the clinical effect of slack skin excision combined with orbicularis oculi muscle shortening and orbicularis muscle shortening in the treatment of elderly patients with lower eyelid entropion, and provide the reference for the clinical treatment.

METHODS: Eighty-two(126 eyes)clinical diagnosis's elderly patients with lower eyelid entropion were collected from our department, then randomly divided into excised relaxing skin and orbicularis oculi muscle shortening treatment group and the orbicularis muscle shortening treatment group.The general data of the two groups, long term curative effect and short-term curative effect were compared.

RESULTS: The age, sex, proportion of patients with the first time operation, course of disease were no statistical significance between the observation group and the control group(P>0.05). The short-term effective rate of the observation group was 95.2%, while the short-term effective rate of the control group was 77.8%, the short-term efficiency differences between the two groups was statistical significance(χ²=4.100, P=0.043). The long-term cure rate of the observation group was 82.5%(34 cases, 52 eyes), recurrence rate was 17.5%(7 cases, 11 eyes), while the cure rate of the control group was 60.3%(25 cases, 38 eyes), recurrence rate was 39.7%(16 cases, 25 eyes), the difference of long term cure rate was statistical significance between the two groups(P<0.05).

CONCLUSION: The clinical curative effect of slack skin excision combined with orbicularis oculi muscle shortening in the treatment of senile inferior entropion is better than orbicularis muscle shortening operation, recommending application in the clinical.

Abstract:AIM: To observe the effect of anterior chamber depth and angle change after pterygium excision.

METHODS:Thirty cases(30 eyes)of primary pterygium were underwent pterygium excision. Central anterior chamber depth, four direction angle open distance(AOD)and open angle(AA)were measured preoperatively and postoperatively by ultrasound biomicroscopy(UBM)and the intraocular pressure was observed.

RESULTS:Preoperative and Postoperative intraocular pressure were 15.17±10.6 and 16.23±2.61mmHg, and the central anterior chamber depth were 2.28±0.39 and 2.33±0.24mm. The four directions of AOD and AA were no statistical difference.

CONCLUSION:The anterior chamber depth and the angle change is not obvious after pterygium excision.

Abstract:AIM: To observe the early tear film changes after trabeculectomy using Keratograph 5M.

METHODS: Fourty-one patients(46 eyes)of glaucoma who underwent trabeculectomy were involved. First tear break up time(FTBUT), average tear break up time(ATBUT), non-invasive tear meniscus height(NITMH), lipid layer thickness and meibomian gland scores were measured at 1d preoperatively and at 1d, 1wk, 1mo postoperatively.

RESULTS:At 1d, 1wk and 1mo postoperatively, FTBUT and ATBUT decreased greatly(P<0.05), as well as lipid layer thickness(P<0.017). NITMH at 1d postoperatively increased significantly, but at 1wk and 1mo postoperatively decreased greatly(P<0.05). There was no significantly difference in meibomian gland scores between preoperation and postoperation(P>0.05).

CONCLUSION:Keratograph 5M could be used to evaluate tear film function rapidly and accurately. Trabeculectomy significantly alters tear film stability and tear secretion in the short term after operation.

Abstract:AIM: To evaluate the effectiveness of Spot Vision Screener on vision screening of children without cycloplegia.

METHODS: A total of 87 children(174 eyes)aged from 2～9 years old were examined with Spot Vision Screener and optometrist before cycloplegia.

RESULTS: Statistical analysis demonstrated that the cylinder diopter and axis, the equivalent spherical diopter in both eyes, and the spherical diaopter in left eye had no significant change(P>0.05). However, the spherical diaopter in right eye had statistical significance.

CONCLUSION: Spot Vision Screener is a suitable instrument in vision screening of children without cycloplegia.

Abstract:AIM:To discuss the feasibility of microcoria optometry in screening for children ametropia.

METHODS: Totally 217 school-age children were selected, included 94 first-grade students(6～8 years old)and 123 fourth-grade students(9～12 years old). Refractive diopter was measured with automatic refractor RM-8000 to evaluate the accuracy of micocoria optometry in screening ametropia.

RESULTS: After cycloplegia, both the mean sphere diopter and cylinder diopter in grade one students changed significantly(P<0.05), the mean sphere diopter in grade four students changed significantly(P<0.05), while the mean cylinder diopter had no statistical difference(P>0.05)in grade four students. Different refractive type: before and after mydriasis spherical myopia, spherical equivalent difference was 0.263±0.618 and 0.216±0.653D, with statistical significance(P<0.01); In hyperopia group, spherical myopia, spherical equivalent difference was 0.947±0.946 and 1.039±0.984D, with statistical significance(P=0.000). The lenticular difference between the two groups were not statistically different(P>0.05). Choosing small pupil computer optometry for ≤-1.00D, ≥-0.50D child myopia or hyperopia could get more accurate value of diagnostic cutoffs, Youden index was 0.672 and 0.580.

CONCLUSION: Microcoria optometry can be as a effective method of screening of children with ametropia, but if for optometry, school-age children must accept mydriasis.

Abstract:AIM:To discuss the application of prism alternate cover test(PACT)and perimeter strabismometry in strabismic operation.

METHODS: A total of 145 patients with concomitant esotropia or exotropia, aging 2～50 years old, were included. They were examined by PACT and perimeter strabismometry before operation. The strabismic operations were performed, the orthotropia rate of postoperation was assessed.

RESULTS: Using PACT and perimeter strabismometry, there was a significantly difference of deviating angle(P<0.05)in mild and severe strabismic group. But there was no significantly difference of deviating angle(P>0.05)in moderate strabismic group. The functional cure rate of postoperation was respectively 70.83%, 67.01%; the clinical cure rate was 20.84%, 24.74%; invalid rate was 8.33%, 8.25%.

CONCLUSION: The application of PACT and perimeter strabismometry in strabismic operation design, referring to the eye axial length, this can be helpful of improving the cure rate postoperation and decreasing the danger of reopreation.

Abstract:AIM: To observe clinical effects between the laser in situ keratomileusis(LASIK)surgery and the laser subepithelial keratomileusis(LASEK)surgery as the second operation after an unsuccessful LASIK surgery.

METHODS:Forty-nine patients(98 eyes)with refractive regression after LASIK operation received the second surgery. All patients were divided into two groups: group A and B. Group A(48 eyes of 24 patients)received LASIK surgery and group B(50 eyes of 25 patients)received LASEK surgery. Inspect the main parameters included visual acuity, refraction, corneal curvature, and the total value of high-aberration after 1wk, 1mo and 1a, t-test of groups was used as statistical analysis method.

RESULTS: There was statistically significant(P<0.05)between the two groups in visual acuity after 1wk. There was no statistically significant between the two groups in visual acuity after 1mo, and there was also no statistically significant between the two groups in visual acuity, average spherical equivalent refractive degree, average corneal curvature, and the total value of high-aberration after one year(P>0.05). There developed one case of epithelium in growth after LASIK surgery, and one case of haze Ⅱ after LASEK surgery.

CONCLUSION: Both LASIK and LASEK surgery can obtain satisfactory therapeutic results after an unsuccessful LASIK surgery.

Abstract:AIM: To compare the impact of different thickness of corneal cap design on small incision lenticule extraction(SMILE)operation.

METHODS: Forty-six cases of myopia patients(92 eyes)intends to SMILE operation in our hospital were collected, and were randomly divided into 2 groups: corneal cap thickness design for 110μm in group A and 120μm in group B. Other operation parameters designs were consistent. All patients were surgeried by the same surgeon. The incidence of opaque bubble layer(OBL), the ratio of difficult separation of lens, uncorrected visual acuity(UCVA)of each time points, and spherical equivalent(SE)were compared.

RESULTS: Intraoperative OBL incidence rate of 110μm group was higher than that of 120μm group with significant difference between the two group(P<0.05). the ratio of difficult separation of lens was significantly different between the two groups: 110μm group was higher than in 120μm group(P<0.05). The UCVA in the 120μm group was better than that in the 110μm group at postoperative 1 and 7d. But with the passage of time, postoperative 1, 3, and 6mo of UCVA of 2 groups was similar, showed no significant difference(P>0.05). SE were compared at 7d and 6mo after operation, showed no significant difference(P>0.05)

CONCLUSION: Compared with 120μm group, corneal cap design SMILE operation in 110μm group are more prone to OBL and difficult separation of lens, thus affects UCVA and postoperative recovery rate. There is no significant difference in long-term UCVA.

Abstract:AIM:To investigate the visual function in myopia and hyperopia amblyopia whose corrected visual acuity have recovered to normal.

METHODS: The visual function of children(50 cases)with amblyopia eyes by binocular vision correction after treatment above 0.9 was checked. The simultaneous perception, fusion range and distance stereopsis were measured. According to the refractive condition of the children who were divided into group A(myopia, 20 cases)and group B(hyperopia, 30 cases). The statistically difference of simultaneous perception, fusion function and stereopsis in two groups was analyzed.

RESULTS:Fifteen(75%)and twenty-six(87%)children got the simultaneous perception in group A and group B respectively, and the differences between two groups were not significant(χ²=0.454,P>0.05). Group A had six children(30%)and group B had only seven children(23%)with the normal aggregative fusion range, two groups did not show any difference(χ²=0.565,P>0.05). Respectively sixteen(80%),and twenty children(67%)had the normal divided fusion range in group A and group B, the recovery rate did not show any significant difference(χ²=0.740, P>0.05). Fifteen(50%)and seven(35%)patients acquired the far stereoscopic vision in group B and group A respectively, the recovery rate also did not show any significant difference. Normal distance stereopsis of 50 cases had 22 cases(44%), and normal near stereopsis of 50 cases had 13cases(26%)Seven(23%)and 6(30%)children got the normal near stereoscopic vision in group B and group A respectively, and the recovery rate did not show any significant difference(χ²=0.195, P>0.05; χ²=0.295, P>0.05).

CONCLUSION:After amblyopia treatment, although the children got the normal visual acuity, the binocular vision still can not completely normal in the short term. Myopia and hyperopia factor will not produce significant effect on binocular vision development.

Abstract:AIM:To observe the changes of binocular vision in V-pattern exotropia children before and after surgical correction, and the effect of training in reconstructing the binocular vision after surgical corrections.

METHODS: Sixty V-pattern exotropia children were enrolled in this study and were divided into three groups according to their age: group A(4～6 years old), group B(7～9 years old), and group C(10～12 years old), 20 cases for each group. Patients received routine refraction and ophthalmic examinations. Distance and near deviation were measured by prism-covering method and synoptophore. The simultaneous perception and fusion were examined with a synoptophore, and the stereacuity was measured with stereograms(Titmus). The children who didn't reconstruct binocular vision function 1wk after surgery received binocular vision training. The data were recorded before and 1, 2, 4, and 8wk after surgery.

RESULTS: Binocular vision significantly improved among the children after surgery in group A and B(P<0.05). Significantly divergence showed between group C and the other groups 1wk after surgery(P<0.05). Binocular vision of the three groups all significantly improved 8wk after surgery, with no significant differences(P>0.05).

CONCLUSION: V-pattern exotropia children can benefit from early surgical correction and training after surgery in reconstruct binocular vision.