Abstract:AIM: To perform the determination ofthe burden of dry eye syndrome among information technology(IT)professionals and examine association of dry eye syndrome between various daily activities.

METHODS: This was a pilot cross-sectional study conducted for a period of 3mo from October-December, 2013 in Chennai, South India. The study population was enrolled from three IT companies in a city in Chennai. The inclusion criteria consisted of individuals working in the IT industry at least for a period of 6mo, aged 18y or above and giving voluntary, written informed consent. Variable information was gathered by using series of questionnaires and ophthalmic assessment. Information about sociodemographic characteristics was also gathered. Schirmer's test was performed for ophthalmic assessment. All of the analysis was performed by using SPSS vs.16.

RESULTS: About one fifth(n=36, 18%)of the participants were suspected to have dry eyes, with mean age of 29y(SD=7), and majority of them being males, graduates/ postgraduates, single, living in extended families in urban areas. Windy environment significantly showed to aggravate redness(P=0.04)and burning sensation of the eyes(P=0.000). Similarly, watching television significantly showed to aggravate gritty sensation(P=0.01)and led to excess mucous in the eyes(P=0.02).

CONCLUSION:Based on the results of our study, it can be concluded that the exposure to various daily activities such as watching television, using computer, reading, and use of air conditioning and windy environments(dry environments)were associated with signs and symptoms of dry eyes. Also, watching television and windy environment were significantly positively correlated with some of the signs of dry eye. This study emphasizes the urgent need of multi-factorial approach including policy measures for addressing the burden of dry eye in population.

Abstract:AIM: To compare the measurement of anterior segment parameters by partial coherence interferometry(PCI)and contact ultrasonic(US)axial scan(A-scan). The accuracy in predicting postoperative refraction and the reproducibility of each biometry measurement were also estimated in a prospective study of eyes that underwent phacoemulsification with IOL implantation.

METHODS: Preoperative measurement of anterior segment parameters were prospectively obtained in 137 eyes of 121 subjects with the PCI compared with the US. The postoperative best corrected visual acuity and postoperative refraction were obtained and compared with each biometric method.

RESULTS: There was an excellent correlation between PCI and US measurements for the anterior chamber depth(ACD; r=0.823; P<0.001)and axial length(AL; r=0.996; P<0.001). The mean values of the parameters measured by IOLMaster and US were, respectively, as follows: ACD, 2.94±0.49mm, 2.69±0.51mm; AL, 24.17±1.64mm, 23.81±1.83mm. The mean differences of ACD and AL values between IOLMaster and US measurements were 0.25±0.22mm, 0.36±0.24mm respectively, proved to be statistically significant(P<0.001). With the 95% limits of agreement from -0.08mm to +0.48mm for ACD and from -0.09mm to+0.69mm for AL. For IOLMaster, the mean prediction error -0.15±0.38D, the mean absolute prediction error was 0.29±0.27D with 96% of the eyes within 1D from the predicted refraction. Applanation ultrasonography after optimisation yielded a greater absolute prediction error than the IOLMaster biometry, 0.41±0.38D with 88% of the eyes within 1D from the predicted refraction. For IOLMaster biometry, the intraobserver variability(SD)was ±25.6μm for AL, ±33.4μm for ACD and ±12.9μm for corneal radius. The coefficients of variation(COV)were 0.11%, 0.52%, and 0.17%, respectively. The interobserver variability(SD)was ±21.5μm for AL, ±29.8μm for ACD and ±15.9μm for corneal radius. The COV were 0.09%, 0.62%, and 0.21%, respectively. The reliability was 99.9% for AL, 97.8% for ACD, and 99.8%/99.5% for corneal radius(r₁/r₂).

CONCLUSION: PCI using the IOLMaster provides the more accurate and reliable anterior segment parameters measurement values. A high degree of agreement between US and IOLMaster was noted. The IOLMaster not only has the advantage of performing noncontact examinations, but also produces various additional data simultaneously and may thus obviate the need for multiple examinations.

Abstract:AIM: To investigate and compare anterior chamber depths(ACDs)measured using the Pentacam, the IOLMaster, and ultrasound pachymetry(US).

METHODS: The present study was observational in nature. ACDs were measured in 138 eyes of 69 myopic patients, by the same operator, using the Pentacam, the IOLMaster, and US. We assessed the agreement among the three methods using Bland-Altman plots. The repeatability among the three methods was evaluated by within-subject standard deviation.

RESULTS: The means±SDs of ACDs measured using the Pentacam, the IOLMaster, and US were 3.77±0.24, 3.73±0.23, and 3.69±0.22mm respectively. Bland-Altman analysis showed that Pentacam and IOLMaster data were in good agreement(CoA, 0.04mm; LoA,0.05 to 0.13mm), as were US and IOLMaster data(CoA, 0.04mm; LoA, 0.17 to 0.08mm), but the Pentacam ACD values were slightly greater than the US figures(CoA, 0.08mm; LoA, 0.06 to 0.22mm). Measurements of the ACD with the three devices also showed high repeatability(S_w=0.03, 0.02, and 0.03; 2.77 S_w=0.08, 0.06, and 0.08, respectively). The three depth estimates were positively correlated(r=0.946, 0.987, and 0.951; P<0.001).

CONCLUSION: Measurement of ACDs using the Pentacam, the IOLMaster, and US showed good agreement and repeatability. The Pentacam and IOLMaster ACDs, and the IOLMaster and US ACDs, agreed reasonably well, but agreement between the Pentacam and US data was poorer. However, both the absolute differences and the coefficients of variation were small, and the observed variability was likely not clinically significant.

Abstract:AIM: To investigate the effectand mechanism of glucocorticoids on retinal nerve tissue in diabetes mellitu(DM)rats.

METHODS: The DM model was established by a single injection of streptozotocin. Diabetic rats were intravitreal injected with adenovirus vehicle(DM group), or carried glucocorticoids receptor antisense(siGR group), or scrambled nucleotide(scRNA group). Control group(CON group)were normal SD rats intravitreal injected with adenovirus vehicle. Twelve weeks later, the density of retinal ganglion cell(RGC)and retinal thickness were detected by HE staining, and the expression of ROCK was observed by immunohistochemical staining and Western-blot.

RESULTS: Compared with CON group, glucocorticoid concentrations were significantly increased in DM group, siGR group and scRNA group(P<0.01, respectively). DM group and scRNA group showed reduction of RGC density and retinal thickness, and up-regulation of ROCK(P<0.01, respectively). While no alterations was detected between CON group and siGR group(P>0.05, respectively).

CONCLUSION: Inhibition of glucocorticoids in diabetes reverses the expression of retinal ROCK, RGC density, and retinal thickness.

Abstract:AIM: To analyze the correlation and clinical significance of fungal smear, fungal culture and pathological examination in the diagnosis of fungalkeratitis.

METHODS:One hundred and ten cases(110 eyes)with fungal keratitis from January 2012 to December 2014 were collected. The results of fungal smear, fungal culture and pathological examination results were analyzed retrospectively. Fungal smear was detected by 10% KOH wet microscopy and gram staining microscopy. Fungal culture was used potato dextrose agar(PDA)medium. The specimens of pathological examination were from corneal transplantation surgery. paraffin section, HE and hexamine silver and PAS staining was used in the pathological examination.

RESULTS:Of the 110 cases of fungal keratitis, fungal smear positive were observed in 50 cases(45.5%), fungal culture positive were observed in 55 cases(50.0%); pathological examination positive were observed in 88 cases(80.0%). Fifty cases were both fungal smear and pathological examination positive and 22 cases were both fungal smear and pathological examination negative. The coincidence rate of fungal smear and pathologic examination was 65.5%. Fifty-five cases were both fungal culture and pathological examination positive and 22 cases were both fungal culture and pathological examination negative. The coincidence rate of fungal culture and pathologic examination was 70.0%. In the 60 cases of fungal smear negative results, 38 cases(63.3%)were confirmed positive through pathological examination. In the 55 cases of fungus culture negative results, 33 cases(60.0%)were confirmed positive by pathological examination.

CONCLUSION:The accuracy of pathological examination is the highest. The combined application of fungal smear, fungal culture and pathological examination can improve the diagnostic accuracy of fungal keratitis.

Abstract:AIM: To investigate the effect of Ginkgo leaf extract on the neural protection of diabetic retinopathy(DR).

METHODS: Ninety-eight patients(196 eyes)with type 2 DR were collected from January 2011 to December 2013 in our hospital. According to the visiting sequence, they were randomly divided into control group and treatment group. The control group was given oral hypoglycemic drugs and/or insulin therapy. The treatment group was given Ginkgo leaf extract and oral hypoglycemic drugs and/or insulin therapy. The fasting blood glucose, glycosylated hemoglobin, OCT and electrophysiology were performed before treatment, 3, 6, 9 and 12mo after treatment. The follow-up time was 12mo.

RESULTS: The glucose and glycosylated hemoglobin in the control group were similar to those of the treatment group. The differences between two groups had no statistical significance(before glucose treatment: t=1.632, P=0.106; 3mo after treatment: t=0.096, P=0.924; 6mo after treatment: t=1.381, P=0.171; 9mo after treatment: t=1.459, P=0.148; 12mo after treatment: t=0.358, P=0.721. before glycosylated hemoglobin treatment: t=0.512, P=0.610; 3mo after treatment: t=0.020, P=0.984; 6mo after treatment: t=0.252, P=0.802; 9mo after treatment: t=0.852, P=0.397; 12mo after treatment: t=0.281, P=0.779). The amplitude of Ops wave in the control group was lower than that in the treatment group. The differences of 6, 9 and 12mo between groups were statistically significant(6mo t=2.454, P=0.015; 9mo t=3.415, P=0.001; 12mo t=3.573, P<0.01). The latency of Ops wave in the control group was longer than that in the treatment group. The differences of 9 and 12mo between groups were statistically significant(9mo t=2.708, P=0.007; 12mo t=3.005, P=0.003). The amplitude of P₁₀₀ wave in the control group was lower than that in the treatment group. The differences of 6, 9 and 12mo between groups were statistically significant(6mo t=3.314, P=0.001; 9mo t=5.542, P<0.01; 12mo t=5.986, P<0.01). The latency of P₁₀₀ wave in the control group was longer than that in the treatment group. The differences of 3, 6, 9 and 12mo between groups were statistically significant(3mo t=2.335, P=0.021; 6mo t=2.777, P=0.006; 9mo t=5.350, P<0.01; 12mo t=8.440, P<0.01). The retinal nerve fiber layer thickness in the control group was thicker than that in the treatment group. The differences of 3, 6, 9 and 12mo between groups were statistically significant(3mo t=5.146, P<0.01; 6mo t=10.484, P<0.01; 9mo t=10.528, P <0.01; 12mo t=18.378, P<0.01).

CONCLUSION: Ginkgo leaf extract can reduce macular edema, improve the retinal ganglion cell function in patients with DR.

Abstract:AIM: To observe the efficacy of puerarin eye drops for patients with glaucoma and its influence on the optic disc parameters and antioxidant capacity.

METHODS: Sixty patients with glaucoma(113 eyes)were randomly divided into the control group(30 cases, 55 eyes). and the observation group(30 cases, 58 eyes). The patients in control group took based treatment, and those in observation group were treated by combined with puerarin eye drops. Then the disease-related visual acuity, visual field, intraocular pressure of two groups were compared, and optic disc parameters and antioxidant indexes capacity before and after treatment of two groups were also compared.

RESULTS: After 2, 6wk of treatment, the visual acuity and light sensitivity of observation group were higher than those of control group, while the intraocular pressure and visual field defect were smaller than those of control group(P<0.05); the rim area, rim volume, optic disc volume and horizontal diameter ratio cups of observation group were higher than those of control group, and the vertical diameter ratio cups was higher than that of control group(P<0.05); the levels of SOD, GSH-Px, TAC, CAT of observation group were all higher than those of control group, and the MDA was lower than that of control group(P<0.05).

CONCLUSION:Puerarin eye drops play the effect of reducing intraocular pressure and improving vision, the visual field loss and optic disc for patients with glaucoma through the inhibition of oxidative stress response of aqueous, and puerarin eye drops has positive significance in the treatment of glaucoma.

Abstract:AIM: To explore the possible alteration of refraction and estimate the potential impact of visual quality, investigate the impact of intraocular structure between the simple operation and the combination of phacoemulsification and intraocular lens implantation, and observe the influence among various tamponade materials application.

METHODS: Ultrasound biomicroscopy(UBM)and intraocular len(IOL)Master were measured for simple vitrectomy patients(the simple group, 37 eyes)and vitrectomy combined with cataract surgery patients(the combined group, 11 eyes). Several parameters were measured such as the anterior chamber depth(ACD), angle opening distance(AOD), trabecular iris angle(TIA), axial length(AL), et al. The simple group was further divided into three sub-groups by various tamponade materials in vitreous: silicone oil group, gas group and equilibrium liquid group. All patients were measured including ACD, AOD250, AOD500, TIA500, AL and corneal curvature(K1, K2)parameters preoperatively and 2wk postoperatively.

RESULTS: AOD250, AOD500, TIA500 and AL were decreased 0.13±0.21mm, 0.16±0.22mm, 8.68°±9.72° and 0.18±0.24mm(all P<0.05)respectively in the simple group postoperatively. ACD, AOD250, AOD500, TIA500 and AL in combined group increased 0.95±0.54mm, 0.13±0.12mm, 0.22±0.20mm, 11.49°±11.06°, and 0.45±0.30mm(all P<0.05)respectively after operation. Alteration of ACD, AOD250, AOD500, TIA500 and AL were different between simple group and combined group(P<0.05). Of data from various tamponade materials sub-groups, ACD, AOD250, AOD500 and TIA500 of the gas group reduced 0.19±0.17mm, 0.14±0.09mm, 0.20±0.12mm, and 12.02°±6.64° respectively after operation(P<0.05), the AOD250, AOD500, TIA500 and axial length of silicone oil group decreased 0.19±0.25mm, 0.21±0.26mm, 10.44°±9.67° and 0.23±0.19mm respectively after operation(P<0.05), while equilibrium liquid group had no significant changed in all intraocular structure(P>0.05). However, neither the corneal thickness nor curvature(K1, K2)were changed postoperatively(P>0.05).

CONCLUSION: Alteration of anterior segment and axial length in combined group are different from that of the simple group, while the corneal thickness and corneal curvature(K1, K2)are not obviously changed in all groups. Meanwhile, various tamponade materials can also cause different impact on intraocular structure and refraction. In brief, alterations of intraocular structure might cause discrepant refractive changes and potential influence of visual quality.

Abstract:AIM: To investigate the difference of retinal nerve fiber layer(RNFL)thickness measured with OCT between obstructive sleep apnea(OSA)patients and normal people and discuss the relativity between decresse of RNFL and OSA.

METHODS: The articles on the association of RNFL thickness and OSA were retrieved by searching international and national databases. The qualified articles were assessed by Meta-analysis with Stata11.0 software.

RESULTS: Totally 10 studies enrolled 1 488 eyes were included in the Meta-analysis. The results of Meta-analysis showed that in OSA patients, there was a significant average RNFL thickness reduction compared with the control group. There were significant differences in superior, nasal and inferior RNFL thickness between the two groups. WMD with a 95%CI were \〖-2.97, 95%CI:(-4.65～-1.30), P<0.01\〗, \〖-3.05, 95%CI:(-4.93～-1.17), P=0.002\〗, \〖-3.81, 95%CI:(-6.95～-0.68), P=0.02\〗, \〖-4.16, 95%CI:(-7.63～-0.68), P=0.02\〗 respectively.

CONCLUSION: RNFL thickness is reduced in OSA patients compared with the control group. OCT may become a standard part of the evaluation of patients in OSA.

Abstract:AIM:To investigate the changes of subfoveal choroidal thickness(SFCT)in central serous chorioretinopathy(CSCR)eyes and to compare them with normal control eyes.

METHODS: This was a case-control study and a Meta-analysis. Forty-six CSCR patients diagnosed by the fundus pre-set lens, fundus fluorescein angiography(FFA)and indocyanine green angiography(ICGA)were enrolled in this study. Sixty two age-, sex-, diopter- and axial length-matched 62 normal subjects(62 eyes)were enrolled in this study as the control group. Using enhanced depth imaging optical coherence tomography(EDI-OCT), SFCT of CSCR eyes and normal control eyes were measured and compared. Univariate and multivariate linear regression analysis were performed to assess the association between SFCT and clinical factors. The Meta-analysis were conducted using the Stata software package to calculate the summary weighted mean differences(WMDs).

RESULTS:The mean SFCT of the CSCR group and the normal control group was 397.34±83.91μm and 274.48±62.57μm, respectively. The CSCR eyes had a thicker choroid than the control eyes at the SFCT(P<0.01). Univariate and multivariable linear regression analysis showed that the SFCT was significantly thicker in association with the CSCR diagnosis. The result of our case-control study was consistent with the results of the further Meta-analysis with the pooled WMD of 156.13μm(95% CI: 137.43, 174.83)for SFCT.

CONCLUSION:Along with the comprehensive Meta-analysis, SFCT in CSCR eyes was thicker than that of normal control eyes. Increased SFCT might be associated with CSCR.

Abstract:Dry eye is one of the most frequently ocular surface diseases. Recent researches found that many reasons caused decrease of ocular surface damage and the quality of tears, such as the change of ocular surface, immuno-inflammatory responses, apoptosis and the reduction of sex hormone. It is reported that the decline of ovarian function and hormone level in postmenopausal women which leads to abnormal structure and function of tear film is more likely to develop dry eye. In this paper, the ocular surface, pathogenesis and progresses of treatment on postmenopausal women with dry eye are reviewed.

Abstract:SUMOylation is a post-translational modification consisting of covalent conjugation of ubiquitin-like proteins called small ubiquitin related modifier(SUMO). SUMO modification has been shown to significantly alter protein activity, which can modulate protein stability, affect protein-protein interactions, and modify protein localization and trafficking.This process adds another layer of control in eukaryote gene expression, and it regulates both transcriptional activation and repression. This article reviews the current situation and future development of SUMOylation in ophthalmology.

Abstract:With the improvement of cataract operation, the cataract surgery has become increasingly perfect. The cataract patients show greater expectation for the result of cataract operation. As a result, refractive cataract surgery has become the main trend. Detailed investigations of corneal diseases, lens density, corneal topography, preferable intraocular lens(IOL)choice, and IOL power calculation can help us get a better knowledge of preoperative conditions on patients, which can be conducted with pentacam. So we can have a better forecast of post-operative outcome and improve the quality of vision for cataract patients after surgery.

Abstract:Diabetic retinopathy(DR)is one of the most serious microvascular complications of diabetes. It also is a world's major causes of blind eye diseases. Although the injection of anti-vascular endothelial growth factor intraocular drug is becoming a hotspot of current research. Pan retinal photocoagulation(PRP)remains the effective and economical treatment for DR. As a destructive treatment, PRP will inevitably cause some changes on the normal morphology and function of the retinal and cornea. Currently, with the development of the optical coherence tomography, confocal microscopy and other auxiliary examination, we have more accurate and objective research to better understand the laser-neural tissue interaction. This may help us to protect the patient's visual function more efficiently.

Abstract:Age-related macular degeneration(AMD)is one of the major reasons of blindness among the elderly in the developed countries. As AMD patients are increasing year by year, AMD has become one of the important topics of ophthalmic research to prevent blindness. Its pathogenesis is not fully understood, but many studies have shown that vascular endothelial growth factor(VEGF)plays an important role in the pathogenesis. With the development and application of anti-VEGF drugs, there are a variety of drugs applied to the disease. This article introduces conbercept for the treatment of AMD.

Abstract:The treatment of myopic amblyopia and myopic anisometropic amblyopia is difficult and usually resultless and it has been the obstacle of amblyopic treatment. Corneal contact lens, corneal refractive surgery and phakic intraocular lens as new methods can significantly improve visual acuity of patients with high myopic amblopia and myopic anisometorpic ambyopia. For correcting myopia and myopic anisometropic amblyopia it provides a new method. This paper discusses the availibility and safty of above methods for the treatment of myopic amblyopia and myopic anisometropic amblyopia.

Abstract:AIM: To study a large glaucoma family by screening the disease-causing genes in order to understand the pathogenesis mechanism of glaucoma.

METHODS: The diagnosis of glaucoma family was made by ophthalmological examination; peripheral blood was collected and the pedigree map was drawn. The genome DNA of the patients was extracted. The exons of MYOC, CYP1B1, OPTN, and WDR36 were amplified by PCR and sequenced. The data were analyzed by comparing the corresponding reference sequence in the database. Based on the target gene region capture technology, ophthalmic chip was used for further analysis. We were hoping to identify disease gene of the family or discover the new pathogenic site.

RESULTS: Among all exons of MYOC, CYP1B1, OPTN, and WDR36, was no mutation gene identified as the disease causing gene, excluded most known candidate gene mutation of glaucoma and found 5 suspicious sites by the ophthalmic chip.

CONCLUSION: Glaucoma is a polygenic disease, the known glaucoma-causing genes may not be involved the pathogenesis of the glaucoma in this family. Further studies are needed to identify the molecular basis of this family with glaucoma.

Abstract:AIM:To evaluate the safety and effectiveness of Orthokeratology in correcting and curing mild and moderate myopia for teenager patients by investigating the clinical response of wearing Orthokeratology at day or night and further analyze the underlying factors.

METHODS: Eighty-nine eyes(spherical equivalent refraction≤-6.00D, astigmatism with the rule ≤-1.50D and astigmatism against the rule ≤-0.75D)of 45 teenagers aged between nine and twenty wearing Orthokeratology contact lens from 2012 to 2014 were selected and then randomly divided into two groups, twenty-nine eyes wearing at day and sixty eyes wearing at night. The lens were put on eight to ten hours each time. Uncorrected visual acuity, residual spherical equivalent refraction, central corneal thickness, corneal curvature were examined punctually in addition to checking any kind of eye damage or complication after Orthokeratology at 1wk, 1, 3 and 6mo.

RESULTS:Uncorrected visual acuity was markedly corrected while residual spherical equivalent refraction was reduced after one wk contact lens wearing treatment. The above results were of statistical significance(P<0.01). Notably corneal curvature became more flattened after one wk, and the average K value got decreased from 42.28±1.13D to 40.79±1.26D(wearing at day)and 42.18±1.03D to 40.35±0.99D(wearing at night)respectively. The corneal curvature results had a statistically significant difference comparing one wk after wearing Orthokeratology than before(P<0.05), but there was no such difference comparing one wk with one, three or six mo(P>0.05). Central corneal thickness at one mo had the most obvious change which decreased 7.26±1.38μm(wearing at day)and 15.15±0.50μm(wearing at night)respectively, showing great statistical significance(P<0.01). The positive cases of corneal epithelium dyeing after orthokeratology were nine(wearing at day)and twenty-eight(wearing at night), which correspondingly accounted for 31% and 47%.

CONCLUSION: Orthokeratology can effectively reduce myopic diopter and improve uncorrected visual acuity. However, we still can not neglect the risk and should make sure of the safety by standardizing the optometry process and improving the fitting skills.

Abstract:AIM:To evaluate the changes of corneal high-order aberration(including Coma, Spab, RMSh)after laser in situ keratomileusis(LASIK)with femtosecond laser, sub-Bowman keratomileusis(SBK)and laser epithelial keratomileusis(LASEK).

METHODS: Of 82 myopic patients(164 eyes), 31 patients(62 eyes)were treated by FS-LASIK, 31 patients(62 eyes)were treated by SBK, 20 patients(40 eyes)were treated by LASEK. Sirius system was used for measuring the coma aberration, spherical aberration, and high order aberration at 1, 15d,1, 3mo after surgery.

RESULTS: 1)Vision: The uncorrected visual acuity of the three groups had no differences(P>0.05). 2)Corneal aberrations: Three kinds of surgical procedure for patients with corneal aberration had significant impact. The C7, C8, C12 and RMSh of three groups were increased significantly(P<0.05). The C7, C8, C12 and RMSh were not recovered to preoperative levels after 3mo. But the increase of patients after FS-LASIK was smaller than the other two groups, with statistical significance(P<0.05).

CONCLUSION: Compared with SBK and LASEK,FS-LASIK has better visual acuity in the early postoperative and corneal higher-order aberrations increase is relatively small.

Abstract:AIM: To research the practicability of manual small incision cataract surgery(MSICS).

METHODS: Three hundred and six eyes age-related cataract were taken MSICS and 306 eyes received phacoemulsification(Phaco group). Visual acuity, the refractive and the loss ratio of cornea endothelia cells were observed and compared after surgery.

RESULTS: Uncorrected visual acuity of 33 eyes(10.78%)and 76 eyes(24.84%)was >1.0 in 7d and 3mo after MSICS. The loss ratio of cornea endothelia cells was 8.7%, The recursive of corneal astigmatism was on average 0.75D compared with preoperation. Uncorrected visual acuity of 63 eyes(20.59%)and 92 eyes(30.07%)was >1.0 in 7d and 3mo after phacoemulsification. The loss ratio of cornea endothelia cells was 21.67%. The average corneal astigmatism was -0.5DC and -0.45DC in MSICS group and Phaco group respectively, but 3mo after surgery, there was no significant difference on corneal astigmatism between the two groups(P>0.05).

CONCLUSION: Due to the use of Phaco machine, the cost is higher in Phaco group, and the Phaco mechanical stimulation, injury, ultrasonic energy and perfusion solutions have effects on corneal endothelium, visual acuity recovery at early postoperative is slow. However, MSICS dose not use Phaco machine, works by hands, the cost is lower, and visual acuity recovery at early postoperative is faster.

Abstract:AIM: To compare the clinical outcomes after implantation of toric multifocal and monofocal intraocular lens(IOL)after phacoemulsification.

METHODS: A total 34 patients(40 eyes)were recruited for this study. All the patients were diagnosed as age-related cataract and implanted toric multifocal or monofocal IOL after phacoemulsification. All the patients were divided into two groups: patients in group A were implanted with Acrysof IQ Toric ReSTOR+3D IOL(18 cases, 20 eyes); those in group B received Acrysof IQ Toric IOL implantation(16 cases, 20 eyes). The uncorrected and best corrected distance visual acuity(UCDVA and BCDVA), uncorrected and best corrected near visual acuity(UCNVA and BCNVA), residual astigmatism 1, 6mo postoperative and contrast sensitivity with and without glare was measured 6mo postoperative.

RESULTS: There were no statistically significant differences in UCDVA, BCDVA and DCNVA(P>0.05), but UCNVA was statistically significant difference between the two groups at 1 and 6mo after surgery(P<0.05); At 1mo after surgery, the whole residual astigmatism in group A was 0.65±0.25D, while 0.52±0.27D in group B, and no significant difference was found between the two groups(P>0.05). The same result was also found at 6mo postoperative 0.54±0.23D vs 0.40±0.20D(P>0.05). After 6mo, contrast sensitivity with and without glare were significant differences between the two groups at high spatial frequencies(P>0.05).

CONCLUSION: Acrysof IQ Toric ReSTOR+3D IOL provides better distance and near vision for cataract patients with greater corneal astigmatism and obviously improves visual quality at the early postoperative period.

Abstract:AIM:To explore the diagnosis value of retina nerve fiber layer(RNFL)and ganglion cell complex(GCC)in the early stage of chronic primary angle-closure glaucoma(CPACG), and investigate their relationship with mean defect(MD)of visual field.

METHODS: Twenty-one patients with CPACG(38 eyes), 25 patients with suspected glaucoma(SG)(46 eyes)and 25 normal controls(49 eyes)were selected to perform SD-OCT. Statistical difference was analyzed the thickness of RNFL and GCC of average and all quadrants, and correlation between RNFL, GCC and MD of visual field.

RESULTS:There were significant differences in average and all quadrant thickness of RNFL and GCC between CPACG group and control group(P<0.01).The significant differences were found in RNFL thickness(RNFL-Avg, P<0.01; RNFL-Sup, P<0.01; RNFL-Inf, P<0.05)and in GCC thickness(average and all quadrant thickness, P<0.01)between CPACG group and SG group. The positive correlations were showed between MD and RNFL(r=0.65), GCC(r=0.72)in CPACG group.

CONCLUSION:RNFL and GCC are useful to diagnose and monitor the early stage of CPACG, and GCC may be more significant for the disease.

Abstract:AIM: To evaluate the efficacy and safety of the internal limiting membrane(ILM)peeling combined with 23G vitrectomy for early treatment of foveoschisis with high myopia and explore more suitable operation methods.

METHODS: Twenty-nine high myopia patients(29 eyes)with foveoschisis in our hospital from January, 2013 to June, 2014 were selected and divided into two groups: the experimental group(15 eyes)was treated by 23G vitrectomy combined with ILM peeling and intraocular gas injection therapy, and the control group(14 eyes)was treated only with 23G vitrectomy combined with ILM peeling. The best spectacle-correction and foveoschisis reattachment were postoperatively followed up.

RESULTS:The best spectacle-correction and foveoschisis reattachment were improved significantly compared with preoperative in two groups(P<0.05). There was no significant difference between the two groups at postoperative(P>0.05).

CONCLUSION: 23G vitrectomy with ILM peeling is more effective for early treatment of foveoschisis with high myopia.

Abstract:AIM: To compare the clinical effects between pars plana vitrectomy(PPV)and PPV with internal limiting membrane peeling(ILMP)for macular hole in high myopia eyes.

METHODS:The clinical data of 33 high myopia with macular hole patients(36 eyes)with or without retinal detachment caused by macular hole were retrospectively analyzed. The patients were divided into two groups according to different operation methods: 15 eyes in groupⅠhad undergone PPV; 21 eyes in groupⅡhad undergone PPV with ILMPP peeling. According to different conditions of patients,different auxiliary methods were accepted, such as silicone oil tamponade, C₃F₈ tamponade, photocoagulation, condensation, etc. The follow-up period was 3～12mo. Best corrected visual acuity(BCVA), macular hole closure rate and retinal reattachment rate were continuous checked after operation. Then we evaluated the outcome in the two groups by statistical analysis.

RESULTS: The postoperative mean BCVA increased by 0.167 in group Ⅰand 0.456 in group Ⅱ than preoperative, the difference was significant(t=2.46,6.753; P=0.027,0.000). And the difference of BCVA improvement was significant between those two groups(t=-2.943, P=0.006). The macular hole closed in 7 eyes(46.67%)in group Ⅰ,and 18 eyes(85.71%)in group Ⅱ; The difference was significant between those two groups(χ²=6.287,P=0.025).Retinal reattachment was found in 11 eyes(91.67%)in group Ⅰ and 19 eyes(94.73%)in group Ⅱ. The difference was not significant between the two groups(χ²=0.856, P=0.418).

CONCLUSION: PPV with ILMPP peeling for macular hole in high myopia eyes can obviously improve closure of macular hole and postoperative visual acuity. But the difference of retinal reattachment rate was not significant between peeling and unpeeling of ILMP.

Abstract:AIM: To observe the comparison of vitrectomy combined drug therapy(Ranibizumab injection)and single vitrectomy for proliferatived diabetic retinopathy(PDR)and the influence of the curative effect and prognosis of patients.

METHODS: In this study, 112 cases(125 eyes)with PDR were selected and randomly divided into experimental group and control group(n=56). Fifty-six cases(61 eyes)in experimental group were injected by drug therapy of 0.5mg ranibizumab and received vitrectomy; In control group, 56 cases(64 eyes)were received single vitrectomy. The intraoperative and postoperative differences of clinical indicators were analyzed in two groups.

RESULTS: The average operation time, intraoperative electric coagulation hemostasis rate and iatrogenic hiatal incidence of the experimental group were lower than that of the control group:(95.00±13.00)min vs(133.00±14.5)min, 11% vs 34%, 5% vs 20%, respectively(P<0.05). The anterior chamber and vitreous body cavity hemorrhage rate within postoperative 1mo in the experimental group were lower than that of the control group: 7% vs 23%, 5% vs 12%, respectively(P<0.05). The postoperative visual acuity of experimental group was better than that of the control group: 0.375±0.210 vs 0.261±0.170, respectively(P<0.05).

CONCLUSION: Patients with PDR injected with ranibizumab in vitreous cavity before vitrectomy can effectively reduce the operation time, less intraoperative blood loss, the incidence of iatrogenic hiatus, and intraoperative and postoperative complications. The postoperative visual acuity was better than before.

Abstract:AIM:To evaluate the clinical characteristics in retinal nerve fiber layer(RNFL)thickness of the 8～17 years old near sightedness, provide the basis for juvenile glaucoma diagnosis, to avoid missed diagnosis and misdiagnosis.

METHODS: A total of 165 eyes from 99 healthy subjects(age range 8～17 years)were divided into low, moderate, high myopia and normal group. Cirrus HD OCT was used to measure the RNFL thickness. Each subject was performed circular scans around the optic nerve with a circle size of 3.46mm. Total average, mean quadrant and clock-hour RNFL thicknesses were recorded and compared between the four groups. The characteristics of the RNFL thickness of myopia were observed.

RESULTS: Compared myopia groups with normal group, the mean RNFL thickness decreased, there was statistically significant difference in high myopia group(P<0.05). The mean RNFL thickness of superior, inferior and nasal quadrant decreased, temporal quadrant was thickened. Compared moderate and high myopia groups with normal group, superior, inferior quadrant RNFL thickness were thinning, temporal quadrant was thickening, the differences had statistical significance(P<0.05). The RNFL measurements were statistically significant thinner in the myopia groups compared with normal group at 1:00, 5:00, 6:00 and 12:00 o'clock(P<0.05)and thicker at 8:00, 9:00, 10:00 o'clock(P<0.05). The RNFL measurement was statistically significant thicker in the low myopia group compared with normal group at 3:00 o'clock(P<0.05).

CONCLUSION: Compared adolescent myopia with normal, the Avg(mean RNFL thickness), S(superior quadrant RNFL thickness), I(inferior quadrant RNFL thickness), 1:00, 5:00, 6:00 and 12:00 o'clock RNFL thickness is thinner, which is decreased with the increasing SE. While the temporal(T)quadrant, 8:00, 9:00, 10:00 o'clock RNFL thickness is thicker, which increased with the increasing SE. Analysis of RNFL thickness in the evaluation of glaucoma should always be interpreted with reference to the refractive status, so as not to cause misdiagnosis of glaucoma. The highest diagnosis efficiency position of glaucoma is infratemporal(7:00～8:00 o'clock)and superior temporal(10:00～11:00 o'clock), which is not thinner in juvenile myopia, if these positions become thinner, it may be the possibility of glaucoma.

Abstract:AIM:To evaluate the morphological changes of peripapillary atrophy(PPA)and retinal thickness(RT)in high myopia under different best corrected visual acuity(BCVA).

METHODS: A retrospective review of medical records in 55 high myopia patients(104 eyes)was carried out, whose spherical equivalent(SE)refractive errors ranged from -6～-27D. Groups A, B and C were divided according to different BCVA. The parameters including optic disc(OD)size, PPA size, the biggest width of OD along the horizontal axis, the biggest width of PPA along the horizontal axis, the size of the peripapillary chorioretinal atrophy(PCA), the average 6mm center retinal thickness(ACRT), the center retinal thickness(CRT), the total 6mm center retinal volume(TCRV)were evaluated. All the data were analyzed respectively by one-way ANOVA with edition SPSS 13.0.

RESULTS: There were significant differences among three groups on PPA size(8.29±4.82, 4.31±3.05, 2.49±2.60mm² in groups A, B and C, respectively), PPA width(1.88±0.83, 1.31±0.66, 0.86±0.61mm in groups A, B and C, respectively)(all P<0.01). The PCA size was increased significantly in group A(4.26±4.27mm²)than other groups(group B: 1.23±1.74mm², group C: 0.62±1.53mm²)(F=19.58, P<0.01). The OD size and width had no significant differences among three groups(F=1.1, P=0.33; F=0.44, P=0.64). ACRT and TCRV reduced significantly in group A(ACRT: 211.34±118.32μm; TCRV: 6.09±3.65mm³)than in other groups(F=4.28, P=0.01; F=3.35, P=0.03), but no significant difference between groups B and C. CRT was not changed in three groups(F=2.23, P=0.11).

CONCLUSION: PCA increase, ACRT and TCRV decrease assist to evaluate visual function in high myopia. PPA increase indicates the myopia progress.

Abstract:AIM:To evaluate the recovery about the visual cortex function of stereopsis in anisometropic amblyopia after regular amblyopia treatment 6, 12 and 18mo with blood oxygenation level dependent-function magnetic resonance imaging techniques(BOLD-fMRI).

METHODS: In this study, self-controlled study before and after treatment was used, and blocks-designed fMRI was performed on 11 children which was the first phase of research for amblyopic treatment. Functional MRI data were processed by using SPM8 which based on the Matlab 7.12.0.635. Through the hypothesis drive method, the differences range of activated area in each group were compared by before and after amblyopia treatment matched t-test.

RESULTS: The functional area that was left occipital lobe(BA18), middle occipital gyrus(BA19), limbic lobe(BA19), lingualis gyrus of the right occipital lobe(BA17)and the bilateral parietal lobe(BA7)expanded after amblyopia treatment 6, 12mo, compared those treatment phase, mean t value was 1.5762, 1.6856 respectively(P<0.001). However, the difference of activated intensity was lower after 18mo, mean t value was 1.1473(0.001<P<0.01).

CONCLUSION: In children anisometropic amblyopia, the speed of function reconstruction about visual cortical functional mediating stereopsis increase slowly after amblyopia treatment 1a.

Abstract:AIM:To compare 10-0 nylon suture with 8-0 absorbable suture on conjunctival incision in microscopy strabismus surgery.

METHODS:The patients undergone esotropia or exotropia surgery in our hospital were selected and randomly divided into two groups: conjunctival incision of 32 patients(41 eyes)was sutured using 10-0 nylon in control group and that of 30 patients(38 eyes)used 8-0 absorbable suture in observation group. All patients of two group were sutured using intermittently, knot buried method. Wound healing, patients perceived irritation were observed and compared at postoperative 1, 2wk and 1mo.

RESULTS: Postoperative 1 and 2wk, the number of suture absorption and incision gaping were 7 and 15 eyes in observation group, with total incidence rate of 39%, while there was no suture absorption and incision gaping occurred in control group, the incidence was 0, the difference was statistically significant between the two groups(P<0.05). One month after operation, 33 eyes' incision in observation group had some discomforts such as stitches residue, hyperemia, foreign body sensation, who were proposal to remove stitches, the stitches rate was 87%. Incision healed well after 2wk in the control group, all 41 eyes were stitched and stitches rate was 100%. There was no statistically significant difference(P>0.05). Comparing the mean postoperative wound healing time, it was 22.30±5.45d in observation group and 15.50±1.76d in control group, the difference was statistically significant(P<0.05). There was no significant difference on ocular comfort score between the two groups after 1, 2wk(P>0.05). Postoperative 1mo, ocular comfort scores in control group(2.57±0.50)was higher than that in observation group(1.813±0.64), the difference was statistically significant(P<0.05).

CONCLUSION: There was no difference using 10-0 nylon suture or 8-0 absorbable suture to suture conjunctival incision in microscopy strabismus surgery. Due to premature absorption of sutures, the incision healed delayed. 10-0 suture is recommend to suture bulbar conjunctiva in microscopy strabismus surgery.

Abstract:AIM:To investigate prevalence and causes of blindness and low vision of type 2 diabetes(T2DM)in Yangxin county, Hubei province.

METHODS: A total of 8 316 permanent residents, to carry out epidemiological survey of blindness and low vision. Carolina First T2DM patients were in the observation group, the other subjects admitted to the control group. Prevalence and etiology of blind and low vision were compared. Then the data only in the observation group were analyzed.

RESULTS:The rate of blindness and low vision appeared significantly higher, cataracts and retinopathy appeared significantly higher. With the increases of age, prevalence of blindness and low vision appeared significantly increased in the observation group. The rate of low vision was higher in women. Blind and low vision appeared significantly higher in junior high school educations. The above analysis was statistically significant(P<0.05).

CONCLUSION: The prevalence of blindness and low vision of T2DM patients in our region were significantly higher than the unconsolidated. Blind and low vision in T2DM patients has a certain relationship with age, sex, education.

Abstract:AIM:To investigate the effect of problem-based learning(PBL)combined with standardized patient(SP)in the teaching of basic science of ophthalmology.

METHODS: Sixty-four students of Optometry in grade 2012 were randomly divided into experimental group(n=32)and control group(n=32). Traditional teaching method was implemented in control group while PBL combined with SP was applied in experimental group. At the end of term students were interviewed using self-administered questionnaire to obtain their evaluation for teaching effect. Measurement data were expressed as (-overx)±s and analyzed by independent samples t test. Enumeration data were analyzed by χ² test, and P<0.05 significantly statistical differences.

RESULTS:The mean scores of theory test(83.22±3.75)and experimental test(94.28±2.20)in experimental group were significantly higher than theory test(70.72±3.95)and experimental test(85.44±3.52)in control group(all P<0.01). The mean scores of diagnose inquiry, ophthalmologic examination, clinical diagnosis and medical record writing were higher than that in the control group, difference had statistical significance(P<0.01). The students in experimental group had a significantly better self-assessment than the control group in learning enthusiasm, consciousness of team cooperation, ability of language expression, comprehensive analysis ability, self-learning ability, innovation ability, summarizing ability, practice ability, and systematic knowledge structure. The differences were statistically significant in questionnaire between the two groups(all P<0.05).

CONCLUSION:Using PBL combined with SP teaching mode in basic science of ophthalmology can highly improve learning enthusiasm of students and cultivate self-learning ability of students, practice ability and ability of clinical analysis.

Abstract:AIM: To observe the clinical curative effect of sparse wind clearing heat method combined with western medicine treatment on epithelial herpes simplex keratitis(HSK).

METHODS: A total of 75 cases(75 eyes)of patients with epithelial HSK were divided into the treatment group 38 cases(38 eyes)and the control group 37 cases(37 eyes). The patients of the control group were treated with ganciclovir drop and symptomatic treatment. On the basis of the above treatment plan, the patients of the treatment group were treated with sparse wind clearing heat decoction. Clinical curative effect was observed and analyzed.

RESULTS:In the treatment group, curative rate was 79% and effective rate was 95%. In the control group, curative rate was 54% and effective rate was 78%. The differences had significant difference between the two groups(P<0.05). The corneal lesion healing index in the treatment group was better than that in the control group(P<0.05). At 6mo follow-up the recurrence rate was 10% in the treatment group, and the control group with 40%, and there was significant difference between the two groups(P<0.05). The average healing time of the treatment group was 14.74±8.58d, and the control group was 19.68±8.71d. There was significant difference between the two groups(P<0.05).

CONCLUSION: Sparse wind clearing heat method combined with western medicine treatment on epithelial HSK has preferably curative effect.

Abstract:AIM:To observe the recovery of corneal subbasal nerves after laser-assisted subepithelial keratomileusis(LASEK), laser in situ keratomileusis(LASIK), femto-second lenticule extraction(FLEx)and small incision lenticule extraction(SMILE).

METHODS: Confocal microscopy was used to observe subbasal nerves 1mo after surgery in 12 eyes of 12 LASEK patients, 12 eyes of 12 LASIK patients, 12 eyes of 12 FLEx patients and 12 eyes of 12 SMILE patients as well as some other follow-up times.

RESULTS: Subbasal nerves 1mo after SMILE were almost complete and regular, showing no significant differences from those 2wk after surgery or even unoperated eyes. The nerves cut off at the incision were well involuted 1mo after surgery. Subbasal nerves were damaged in different degrees and got repaired to form communicating branches with time lapse after LASEK, LASIK and FLEx.

CONCLUSION: SMILE exerted small infections on subbasal nerves. It may be superior to other corneal refractive surgeries in terms of postoperative nerve recovery.

Abstract:AIM:To analyze the cause of posterior capsular rupture in small incision non-phacoemulsification cataract surgery and investigate the treatment methods.

METHODS: The clinical data of 108 cases(121 eyes)undergone small incision non-phacoemulsification cataract surgery combined with intraocular lenses(IOL)implantation were retrospectively analyzed. The causes of posterior capsular rupture and treatment of 6 patients(6 eyes)after surgery were analyzed and summarized.

RESULTS: Six cases(6 eyes, 4.96%)occurred posterior capsular rupture during the operation, of which 2 cases(2 eyes)underwent posterior chamber IOL implantation intraoperative, 2 cases(2 eyes)received Ⅱ stage IOL implantation in the ciliary sulcus at 1wk postoperative, 2 cases(2 eyes)were given anterior chamber IOL implantation. One case(1 eye)whose vision acuity <0.1 was macular degeneration; One case(1 eye )whose vision acuity=0.3 was diabetic retinopathy; 0.4～0.6 in 2 cases(2 eyes), 0.6～0.8 in 2 cases(2 eyes)after 1～3mo postoperatively. No severe syndrome was found after surgery.

CONCLUSION: Posterior capsular rupture which occurs in different stages of the operation is the commonest intraoperative complication in small lincision non-phacoemulsification cataract surgery. With improving operative techniques, and continuously accumulating experience, incidence of posterior capsular rupture can be effectively reduced. Even posterior capsular rupture occurs intraoperative, patients can still get a good outcome after timely and proper treatment.

Abstract:AIM: To prove the clinical efficacy of double-incision operation of combining phacoemulsification and intraocular lens implantation and trabeculectomy with topical anesthesia.

METHODS: Fifty-four patients(60 eyes)with primary angle-closure glaucoma patients with cataract were randomly divided to single-incision group and double-incision group. Both were treated by phacoemulsification and intraocular lens implantation and trabeculectomy, followed up for 3mo. Intraoeular pressure(IOP), best corrected visual acuity(BCVA), inflammation of anterior chamber were observed.

RESULTS: 1)IOP: Postoperative, the average IOP had no statistical significance between two groups(P>0.05). 2)BCVA: the level of BCVA in double-incision group was 0.31±0.27 on 1d after surgery, single-incision group was 0.19±0.22, the differences had statistical significance(P<0.05). But on 1wk, 1, 3mo, the differences between two groups had no statistical significance(P>0.05). 3)Inflammation of anterior chamber after surgery: on 1d there were 9 eyes in double-incision group and 18 eyes in single-incision group, the differences had statistical significance(χ²=5.45, P<0.05). By anti-inflammatory treatment the differences between two groups had no statistical significance(P>0.05)on 1wk, 1, 3mo postoperative.

CONCLUSION: Double-incision operation of combining phacoemulsification and intraocular lens implantation and trabeculectomy is an effective and safe therapeutic method for patients with primary closed-angle glaucoma and cataract.

Abstract:AIM: To observe the clinical effect of phacoemulsification combined with goniosynechialysis in the treatment of primary acute angle-closure glaucoma with cataract.

METHODS: A retrospective analysis included of 34 cases(42 eyes)diagnosed as primary angle-closure glaucoma with cataract in our hospital. The patients were treated with phacoemulsification combined with goniosynechialysis and intraocular lens implantation. Preoperative and postoperative visual acuities, intraocular pressure(IOP), chamber angle changes and complications were recorded with following-up for 3mo～1a. The clinical effect was compared between before and after treatment.

RESULTS: Best corrected visual acuity was improved in 36 eyes(86%)after operation. The IOP of 2 eyes was above 25mmHg after operation 1wk, and the rest was controlled in 11～20mmHg, the average level(14.6±5.7)mmHg. There were statistical differences at pre- and post-operation(P<0.05). The postoperative cases of the anterior chamber angle closure of more than 180° were significantly lower than that of the preoperative(P<0.05).

CONCLUSION: Phacoemulsification combined with multiple goniosynechialysis in the treatment of angle-closure glaucoma patients with cataract is safe, convenient, and effective. It can significantly open anterior chamber angle, reduce IOP, and improve visual acuity.

Abstract:AIM: To compare the clinical outcomes of torsional microcoaxial phacoemulsification by using different shape tips, including Centurion ultrasound tips and Infinity tips.

METHODS:A randomized prospective study was conducted. 132 patients(132 eyes)with age-related cataract, were randomly divided into study group(Centurion ultrasound tips)and control group(Infinity ultrasound tips), 66 cases(66 eyes)in each group. Under the same parameter of the Centurion phacoemulsification instrument, all the patients received normal microcoaxial phacoemulsification and intraocular lens implantation. The cumulative dissipated energy(CDE)was recorded during the operation. The best corrected visual acuity(BCVA), corneal endothelial cell density(CD)and central corneal thickness(CCT)were compared at 1wk and 1mo after surgery. Statistical analysis of the data was performed using Student's t test and Chi-square test.

RESULTS: There was significant difference on CDE(P<0.05)between these two groups. On 1wk after surgery, the study group showed better BCVA(LogMAR)as compared that of control group, the difference was statistically significant(P<0.05). The CCT of study group was smaller than the control group on 1wk after surgery(P<0.01), but there was no significant difference on 1mo(P>0.05).

CONCLUSION: Centurion ultrasound tips can significantly reduce the cumulative dissipated energy and cause less damage to corneal endothelial cells. These findings suggest that centurion vision system phacoemulsification surgery could get earlier visual rehabilitation postoperative.

Abstract:AIM: To evaluate the clinical therapeutic efficacy of the Qi ming granule for macular edema(ME)in diabetic patients after phacoemulsification.

METHODS:In this was a prospective clinical comparison study, 57 diabetic patients(76 eyes)who underwent phacoemulsification were recruited and divided into two groups: treatment group(34 eyes)and control group(42 eyes). All the patients in treatment group were given oral administration Qi ming granule(4.5g, tid)and vitamin C(0.1g, tid)for 6mo postoperatively, while vitamin C(0.1g, tid)for the controls. General clinical examinations, including blood glucose and glycated hemoglobin, as well as comprehensive standardized ophthalmic examinations were performed. Optical coherence tomography(OCT)were used to detect macular edema incidence and measure central field retinal thickness.

RESULTS: No significant difference was found in the levels of blood glucose,glycated hemoglobin, course of disease, and macular thickness between the two groups during the initial visits. At the 6^th month, 2 eyes(6%)eyes had clinically apparent macular edema in treatment group, while 6(14%)eyes had clinically apparent macular edema in control group(P=0.285). The central subfield retinal thickness values were significantly lower in the treatment group(211.76±41.21μm)than those in control group(278.36±48.94μm)(P<0.01).

CONCLUSION:Qi ming granule can significantly reduce the incidences of macular edema and suppresses increasing retinal thickening after phacoemulsification in patients with diabetes mellitus.

Abstract:AIM: To investigate the clinical value of dark adaptation 3.0 oscillatory potentials in central retinal vein occlusion.

METHODS: Eighty-four patients(84 eyes)with central retinal vein occlusion were divided into 4 groups: no wave type(16 cases), grossly decreased type(27 cases), middle decreased type(20 cases)and slightly decreased type(21 cases)accorded to the normal value of this experiment. The initial diagnosis was the examination of oscillatory potentials. No wave and grossly decreased type were first diagnosed as ischemic central retinal vein occlusion, middle and slightly decreased type were first diagnosed as non-ischemic central retinal vein occlusion. The patients were followed up for 6mo, recorded and contrasted the examination results between anterior and posterior. There were 76 cases having integrated data(8 cases were lost).

RESULTS: No wave and grossly decreased type were ultimately diagnosed as ischemic central retinal vein occlusion(34 cases, 83%), middle decreased type(5 cases, 25%)and slightly decreased type(0 case). There was statistically significant difference between the three groups(χ²=34.5, P<0.01). The statistical difference still existed comparing the grossly decreased type and the middle decreased type with slightly decreased type(P<0.01). However, there was no significant difference between the middle and slightly decreased type(P=0.036).

CONCLUSION: The early oscillatory potential amplitudes of central retinal vein occlusion is decreased, which has important significance for early classification and prognosis of central retinal vein occlusion.

Abstract:AIM: To evaluate the effect of preoperative intravitreal injection of Ranibizumab in patients undergoing pars plana vitrectomy for proliferative diabetic retinopathy(PDR).

METHODS: In this retrospective research, 52 patients(52 eyes)with PDR in Peking Union Medical College Hospital from April 2013 to August 2014 were recruited. The experimental group included 23 eyes treated with ranibizumab intravitreal injection, 0.5mg, 6～14d before vitrectomy, and 29 eyes underwent direct vitrectomy were analyzed as control group. Main outcome measures were surgical time, intraoperative hemorrhage, incidence of iatrogenic retinal breaks, types of tamponade, and percentage of reoperation were recorded. Visual acuity at pre-operative, post-operative and last follow-up were observed.

RESULTS: Mean surgical time was 70.52±26.18min in experimental group vs 99.45±27.75min in control group(t=-3.827, P=0.000); intraoperative bleeding 5 eyes(21.7%)vs 19 eyes(65.5%),(χ²=9.892, P=0.002); iatrogenic retinal breaks 3 eyes(13.0%)vs 15 eyes(51.7%),(χ²=8.479, P=0.004); silicone oil tampanade 8 eyes(34.8%)vs 19 eyes(65.5%),(χ²=4.854, P=0.028). No complications were recorded after intravitreal ranibizumab. Post-operative visual acuity and visual acuity at last follow-up elevated to some extent contrast to pre-operative visual acuity, there were 20 eyes(86.9%)in experimental group which visual acuity at last follow-up ≥0.1 vs 16 eyes(55.2%)in control group. Mean pre-operative visual acuity, post-operative visual acuity were not significantly different separately(t=-1.659,

-0.084; P=0.103, 0.933); visual acuity at last follow-up was significantly different between two groups(t=-2.662, P=0.010).

CONCLUSION: Ranibizumab intravitreal injection as an adjunct before vitrectomy in the treatment of patients with PDR can facilitate vitrectomy procedures, reduce active neovascularization, minimize the incidence of intraoperative haemorrhage and iatrogenic retinal breaks and shorten the operation time significantly, finally, benefits in improving visual outcome.

Abstract:AIM:To determine the incidence of retinopathy of prematurity(ROP)and to investigate the appropriate criteria for the screening ROP in Shantou.

METHODS: A total of 1 813 infants with birth weight ≤2 000g or gestational age ≤34wk in neonatal intensive care units(NICU)of four hospitals in Shantou were screened with binocular indirect ophthalmoscope and(or)wild-field digital pediatric retinal imaging system(RetCamⅡ )from January 2011 to December 2014. All infants were followed up until the retina was completely vascularized or until the disease regressed.

RESULTS:In all infants, ROP was detected in 388 eyes of 202 cases(11.14%), including 85 eyes of 43 cases(2.37%)suffering from severe ROP(threshold or pre-threshold type Ⅰ ROP). 34 severe cases(67 eyes)were screened out in 408 infants with birth weight <1 500g, accounted for 79.07% in all severe cases. GEE model analysis indicated that low birth weight, small gestational age and oxygen therapy were high risk factors of ROP.

CONCLUSION:The detection rate of ROP is 11.14% in Shantou NICU. However, the detection rate of severe ROP is lower, mainly in the infants with birth weight <1 500g and gestational age ≤34wk; Low birth weight, small gestational age and oxygen therapy are high risk factors of ROP.

Abstract:AIM: To study the risk factors of endophthalmitis after cataract surgery and prognosis of endophthalmitis after vitrectomy.

METHODS: One thousand nine hundred patients(1 900 eyes)of receiving cataract surgery in our hospital were selected and divided into infection group and control group according to the incidence of endophthalmitis. The influence of clinical index in the endophthalmitis after cataract surgery as well as related risk factors based on single factor and multi-factor Logistic regression was analyzed. All patients with endophthalmitis were received vitrectomy, and the prognosis of endophthalmitis after vitrectomy was observed.

RESULTS: Based on single factor analysis, the risk factors of endophthalmitis after cataract surgery including age, hypertension, diabetes mellitus, vitreous loss, operation time, common operating room and nonuse of anesthetics in the required time lead to the ocurrence of endophthalmitis after cataract surgery(P<0.05). Based on multi-factor Logistic regression, the independent risk factors of endophthalmitis after cataract surgery included age(≥70 years old), hypertension, diabetes mellitus, vitreous loss, operation time(≥10min), common operating room and nonuse of anesthetics in the required time(P<0.05). After vitrectomy, the vision of patients was significantly improved(P<0.05).

CONCLUSION: The risk factors of endophthalmitis after cataract surgery include age, hypertension, diabetes mellitus, vitreous loss, operation time, common operating room and nonuse of anesthetics in the required time. Vitrectomy can significantly improve the vision of patients.

Abstract:AIM:To investigate triple channel double ring guided treatment of lacrimal obstruction and its clinical therapeutic effect.

METHODS: Fifty cases(54 eyes)of lacrimal obstruction were treated by laser or micro-drill under triple channel lacrimal endoscope with double ring guided intubation created by our department. The silicone tube was extracted at 3～6mo of postoperation. All cases were followed up 3～6mo.

RESULTS:Of total 54 eyes, 47 eyes were cured, and lacrimal passage was clearly flushed without epiphora; 5 eyes were improved, but lacrimal passage was clearly flushed with slight epiphora; 2 eyes were recurred, and lacrimal passage was not clearly flushed with epiphora. Total effective rate was 96%.

CONCLUSION:Triple channel double ring guided treatment of lacrimal obstruction has greatly improved traditional operation. It has dramatically increased success rate of lacrimal obstruction operation with little invasion, avoiding formation of false lacrimal passage, quick recovery and less complications.

Abstract:AIM:To investigate the change of tear meniscus after using topical anesthetics on tear meniscus in dry eyes patients.

METHODS:Fifty cases with dry eyes were chosen in this clinical trial. They were randomly divided into two groups, one group as the experimental group, using topical instillation; another group as the control group, with 9g/L saline instillation. After 15min, anterior segment optical coherence tomography(AS-OCT)was used to measure tear meniscus height(TMH), tear meniscus depth(TMD)and tear meniscus area(TMA)before and after treated with topical anesthetics eye drops, and the changes were compared.

RESULTS:After treated with topical anesthetics eye drops, the value of TMH was 0.173±0.040mm; TMD was 0.166±0.019mm; TMA was 0.049±0.013mm².They were significant different from the values before treated with topical anesthetics(t_TMH=2.78, P<0.01; t_TMD=2.31, P<0.01; t_TMA=2.69, P<0.01). After treated with topical anesthetics eye drops and saline instillation, the value of TMH,TMD,TMA were different between two groups(t_TMH =5.87, P<0.01; t_TMD=2.04, P<0.05; t_TMA=4.63, P<0.01).

CONCLUSION:Topical anesthetics can effectively relieve the tear meniscus in patients with dry eyes,which need to arouse awareness in clinical work.

Abstract:AIM: To evaluate postoperative reaction and the recurrence rate of two difference operation methods for the treatment of primary pterygium between Uygur and Han patients

METHODS: A retrospective analysis was carried out in 91 cases(107 eyes)with primary pterygium undergone surgical treatment in the Second Affiliated Hospital of Xinjiang Medical University. Excluded the patients who lost to follow, 54 eyes(Uighur 25 eyes, Han 29 eyes)underwent pterygium simple resection, 45 eyes(Uighur 20 eyes, Han 25 eyes)received pterygium excision combined with limbal stem cell transplantation. Postoperative corneal epithelium integrity recovery time, foreign body sensation disappeared time, the occurrence of pterygium recurrence rate and complications were observed. The patients were followed up 6～24mo,

RESULTS: In the patients undergone pterygium simple resection, 11 eyes(44%)of Uighur and 8 eyes(27.59%)of Han recurred. 0 eye of Uighur and 1 eye of Han patient occurred symblepharon. In the patients received pterygium excision combined with limbal stem cell transplantation, 3 eyes(15%)of Uighur and 1 eye(4%)of Han recurred. No symblepharon occurred in Han patients, and 1 eye of Uighur occurred symblepharon.During 6～24mo of follow-up, Chi-square test was used to compare the recurrence rate between two groups, and there was statistical significance(χ²_Uighur=4.36, χ²_Han=3.81; P<0.05). In two groups, there was no statistically significant difference on pterygium recurrence rate between Uighur and Han(χ²_simple=1.59, χ²_combine=2.14; P>0.05).

CONCLUSION: Whether it is for Uighur or Han, pterygium excision combined with limbal stem cell transplantation has lower pterygium recurrence rate than pterygium simple excision, it is more appropriate to local residents.

Abstract:AIM: To observe the clinical outcomes of interlocking suture combined with simple continuous suture in pterygium excision with conjunctival translocation.

METHODS:Sixty-two patients(78 eyes)with pterygium from August, 2011 to June, 2014 were randomly divided into two groups with 36 eyes in group A and 42 eyes in group B. Interrupted suture and interlocking suture combined with simple continuous suture were performed in group A and group B respectively. The time taking in suture during surgery and in taking out stitches 1wk after operation were recorded. Suture conjunctival flap time, postoperative 1wk stitching time and foreign body sensation of patients were compared in two groups. Intertion status of conjunctival incision, inflammatory reaction and pterygium recurrence were also observed during the 3mo follow-up.

RESULTS: Eyewinker feeling was much weaker reported by patients in group B than group A at 1, 3d and 1wk postoperatively. The average surgical time was 14.2±3.1min for group A and 10.4±2.5 min for group B(t=5.99, P<0.01). The average time of removing stitches was 9.5±2.2min in group A and 5.3±2.7min in group B(t=7.45, P<0.01). Pterygium recurred in 4 cases in group A and 2 cases in group B. Conjunctival wound dehiscence occurred in 12 cases in group A and 6 cases in group B.

CONCLUSION: Interlocking suture combined with simple continuous suture is a good way of suture in pterygium excision. It can improve the efficiency of operation and removal of the suture and reduce complication and discomfort of the operation.

Abstract:AIM: To compare the curative effect of autologous corneal limbus stem cell with bulbar conjunctiva transplantation of supprior-inferior bulbar conjunctiva in the treatment of pterygium and effect of postoperative scarring on bulbar conjunctiva on performing glaucoma filtration surgery in the future.

METHODS: A total of 182 patients(252 eyes)with initial pterygium were divided into two groups by sortition randomization method. Eighty-five patients of the group A(110 eyes)accepted pterygium resection combined stem cell transplantation of supprior autologous corneal limbus, while 97 patients of the group B(142 eyes)of pterygium excision combined stem cell transplantation of inferior autologous corneal limbus in treatment of pterygium. Postoperative follow-up from 1～12mo. Recurrence rate and conjunctival scar formation after autologous corneal limbus stem cells being taken were observed in the two groups to judge the impact on the future glaucoma filtration surgery.

RESULTS: After follow-up from 1～12mo, there was no significant difference of postoperative recurrence between the group A and group B(χ²=0.015, P>0.05). Stem cell taken from supprior autologous corneal limbus in the group A caused supprior bulbar conjunctiva scarring, while it caused inferior scarring in the group B. For routine glaucoma filtration surgery usually is being done in the upper bulbar conjunctiva, on the nose or superior bulbar conjunctival area above the temporal region, and the above healthy bulbar conjunctiva has being kept in the group B which retained area for future glaucoma filtration surgery.

CONCLUSION: Autologous corneal limbus stem cell transplantation of supprior-inferior bulbar conjunctiva could be effective in the treatment of pterygium, but stem cell transplantation of inferior autologous corneal limbus could keep area for glaucoma filtration surgery.

Abstract:AIM:To analyze the clinical features, computer tomography(CT)image findings and treatment experience of color Doppler ultrasound for children with periorbital dermoid cyst.

METHODS: The clinic data of 114 cases which dermoid cyst was illustrated by pathological histology after surgery was retrospectively analyzed. All patients were performed color Doppler ultrasound and some patients were underwent CT. Surgical incisions were designed according to the position of cyst.

RESULTS:Among 114 cases, 61 cases in right eye, 53 cases in left eye. The location of cyst was at superior temporal in 68 cases(59.6%), supraorbital in 27 cases(23.7%), medial superior in 13 cases(11.4%), medial inferior in 5 cases(4.4%), infraorbital in 1 case(0.9%). Cyst was adhered to periostea in 49 cases. Color Doppler ultrasound showed the clear cyst boundary in 100 cases(87.7%), hypoecho in 105 cases(92.1%), homogeneous in 61 cases(53.5%), fluid dark area in 4 cases and no-blood flow inside cyst in 107 cases(93.9%). Forty patients were performed by CT, and CT value ranged from -55～32Hu and bony destruction surrounding cyst was showed in 7 cases. According to the position of cyst, eye brow incision were designed in 72 cases, upper eyelid crease incision in 10 cases, skin incision upper the cyst in 30 cases, fornix incision in 2 cases. All patients were followed up for 3mo～4a, no complications and recurrence.

CONCLUSION:Combination with color Doppler and CT can make an accurate and locative diagnose of periorbital dermoid cyst in children before surgery. Surgical incision designed by lesion position and complete removal of the cyst wall is the key to get better cosmetic appearance and avoid recurrence.

Abstract:AIM: To evaluate the efficacy of simultaneous surgery for correcting senile blepharoptosis combined with upper eyelid entropion.

METHODS: From June 2010 to June 2013, 30 cases(60 eyes)patients with senile blepharoptosis combined with upper eyelid entropion, received simultaneous surgery. The simultaneous surgery was upper eyelid entropion correction with levator palpebrae superioris muscle shortening and advancement.

RESULTS: All cases were performed surgery successfully. The position of upper eyelid and the management of upper eyelid entropion were observed. The upper eyelid margin rested 1.68±0.71mm below the superior limbus at 1wk, 1.71±0.69mm below the superior limbus at 1mo, and 1.70±0.65mm below the superior limbus at 6mo. Compared with the preoperative values, the difference were statistically significant(P<0.05). No postoperative complications such as exposure keratitis and overcorrection were observed.

CONCLUSION: Most of patients with senile upper eyelid entropion has senile blepharoptosis, Ophthalmologists should pay attention to those patients and give them the correct surgery techniques. It is effective to use upper eyelid entropion correction with levator palpebrae superioris muscle shortening and advancement to correct senile blepharoptosis with upper eyelid entropion.

Abstract:AIM: To observe and compare efficacy of the lower eyelid twitch shift joint outer canthal ligament shortening surgery and orbicularis muscle resection surgery to treat degenerative entropion.

METHODS: Patients with degenerative entropion in our hospital were selected. The test group was 40 cases(70 eyes), of which double eyes with attack(30 cases), and lower eyelid twitch shift joint outer canthal ligament shortening surgery was applied to the test group. Control group was 20 cases(26 eyes), of which double eyes with attack(6 cases), and the control group was used by orbicularis muscle resection surgery. The correction rate, double eyelid symmetry and overcorrection rate were observed in two groups at postoperative 1wk. The long- term recurrence rate, double eyelid symmetry and overcorrection rate with follow-up 6mo were observed.

RESULTS: After 1wk, the correction rate of experimental group 98.6%,undercorrection rate of that was 1.4%, all the eyelid was symmetry, only one eye with a slight overcorrection. Correction rate of control group was 92.3%; all the eyelid was symmetry, and the poor rate of this group was 7.7%. After 6mo, correction rate of experimental group was 95.2%; undercorrection rate of experimental group was 3.2%, and overcorrection rate was 1.6%. Correction rate of control group was 87%, and 2 eyes of recurrence, 1 eye with a poor overcorrection. Double eyelid was symmetry, overcorrection rate difference was not statistically significant(P>0.05), and the correction rate were significantly different(P<0.05).

CONCLUSION: Compared toorbicularis muscle resection surgery, postoperative recurrence rate of lower eyelid twitch shift joint outer canthal ligament shortening surgery is significantly lowered.

Abstract:AIM:To compare the difference between diopter of refration measured after cycloplegic mydriasis with retinoscopy and hand-held autorefractor so as to explore the feasibility of using hand-held autorefractor for refraction screening in cadet candidates.

METHODS:Respectively using hand-held autorefractor and streak retinoscope to do optometry examination in 317 cadet candidates students(634 eyes)after mydriasis. Main index of refraction values(spherical, cylindrical mirror degree and axial)were analyzed by difference test and correlation analysis. And the elimination rate was comparatively analyzed.

RESULTS:Diopters of sphere and cyclic refraction measured by hand-held autorefration were significantly higher than those by retinoscopy(P<0.05), but the correction analysis showed that there was high correlation(r=0.733, 0.694), axial of refration measured by these two methods were non-significant(P>0.05). The disqualifying rate using autorefraction was much higher than that using retinoscopy. It was easy to be wrongly eliminated.

CONCLUSION:Because of the high correlation between diopters of autorefraction measured by retinascopy and autorefractor, autorefraction has application value in refraction screening in cadet candidates with normal vision.

Abstract:AIM: To observe the effect of surgery for paralytic horizontal strabismus and the paralytic horizontal strabismus performed by Jensen procedure with antagonist muscle of paralytic muscle recession and medial or lateral rectus extra large resection/recession.

METHODS: Fifteen cases(17 eyes)with complete or nearly complete paralytic horizontal strabismus from January 2005 to August. 2014 in our hospital were assessed retrospectively,7 eyes of 7 cases with treatment group A were performed Jensen procedure combined antagonist muscle of paralytic muscle recession, 10 eyes of 8 cases with treatment group B were performed medial or lateral rectus extra large resection/recession. seventeen eyes of 15 cases with an average of 21±8.71mo follow-up were observed.

RESULTS: All 17 eyes of 15 cases after the operation obtained satisfied effects, 16 eyes of 14 cases obtained ideal long-term effect. One eye of a patient with a 6mo follow-up was undercorrected of 30^△. We found a varying degree of postoperative improvement in visual function. There was a significant reduction in the strabismus angle for distance and near(t=28.71, P<0.001; t=36.21, P<0.001), broadening of the field of binocular single vision(t=17.96, P<0.001), and increase in the motor ability of the paralytic muscle(t=9.20,P<0.001).

CONCLUSION: Jensen procedure combined antagonist muscle of paralytic muscle recession and medial or lateral rectus extra large resection/recession is a safe and successful method of treatment in complete or nearly complete paralysis horizontal strabismus. Patients achieve orthophoria, improvement of the motor ability, and larger field of binocular single vision for long time.