Abstract:AIM: To evaluate the effect of pan-retinal photocoagulation(PRP)on vision related quality of life and daily visual functioning in patients having proliferative diabetic retinopathy(PDR).

METHODS: Thirty patients(13 males, 17 females)with PDR and undergoing PRP were included in this study. Visual Function Questionnaire(VFQ-25)developed by the National Eye Institute(NEI)of America, was used to evaluate the vision-related quality of life and daily visual functioning before and after PRP. The VFQ-25 was filled in by the authors before and at 6mo after the completion of PRP in order to compare any changes in visual related quality of life and daily visual functioning. The pre and post treatment VFQ-25 scores were compared using paired t-test.

RESULTS: Mean VFQ-25 composite score before PRP was 74.79±15.7 and after PRP treatment it was 74.08±19.1(P=0.875). The difference between pre and post PRP VFQ-25 composite scores was not statistically significant.

CONCLUSION: PRP has no significant detrimental effect on vision related quality of life and daily visual functioning in patients having PDR.

Abstract:AIM: To observe the results of intravitreal injection ranibizumab after pars plana vitrectomy in severe proliferative diabetic retinopathy.

METHODS: In this retrospective non-comparative interventional case series, twelve patients had undergone pars plana vitrectomy with silicone oil tamponade, perfluoropropane tamponade or balanced salt solution tamponade. At the end of the surgery, ranibizumab was injected into vitreous cavity.

RESULTS: Average follows up was 2.75mo. Twelve eyes include vitreous haemorrhage(1/12), vitreous haemorrhage with fibrovascular proliferation(1/12), tractional retinal detachment with vitreous haemorrhage(3/12), tractional retinal detachment with fibrovascular proliferation(2/12), tractional retinal detachment with vitreous haemorrhage and neovascular glaucoma(1/12), tractional retinal detachment with vitreous haemorrhage and fibrovascular proliferation(2/12), tractional retinal detachment with vitreous haemorrhage and fibrovascular proliferation and neovascular glaucoma(1/12), traction-rhegmatogenous retinal detachment with vitreous haemorrhage(1/12). Among these 12 eyes, 8/12 had silicone oil tamponade, 2/12 had perfluoropropane tamponade, and 2/12 had balanced salt solution tamponade. All the patients did not have any therapy before. The retinal attachment rate was 10/10. One patient(1/12)had hyphema after surgery. Postoperative best-corrected visual acuity improved in 9 eyes(9/12), was unchanged in one(2/12), decreased in(1/12)eyes. Eight eyes(8/12)did not have diabetic macular edema after surgery from the optical coherence tomography examination.

CONCLUSION: Intravitreal ranibizumab after pars plana vitrectomy is useful in severe proliferative diabetic retinopathy. It can improve the success rate of surgery; improve postoperative best-corrected visual acuity; minimize the frequence of diabetic macular edema; minimize the frequence of operations and postoperative complications.

Abstract:AIM: To compare the effectiveness and outcome of two different methods for removing metal foreign bodies and rust rings from cornea.

METHODS: Forty outpatients with cornea metal foreign body injuries were recruited. They were divided into two groups according to the methods used to remove the foreign body and the rust ring(group 1 using needle + forceps; group 2 using needle only). The effectiveness and outcome were compared across groups in term of the duration of the surgery, pain scores, and the recovery of epithelial damage, as well as the integrity of the removed rust rings, which was associated with the difficulty of the surgery.

RESULTS: In group 1, rust rings were removed readily in one piece in one or two attempts, while in group 2, the rings were broken into several pieces before they were totally removed. The averaged surgery duration for patients in group 1 was 1.9min(37.3%)shorter than that in group 2(P<0.001). The pain score of group 1 was also significantly lower than that of group 2 during and 1d after the surgery. In group 1, a full recovery of the corneal epithelium, indicated by negative fluorescent staining, was seen in 80% of cases 1d after the surgery, while in group 2, this was only 55%.

CONCLUSION: The method in group 1 is easier to perform and results in better outcomes than the conventional method in group 2 for removing the rust rings formed by corneal metal foreign bodies.

Abstract:AIM: To evaluate the outcomes of indocyanine green compared with brilliant blue G used for internal limiting membrane(ILM)peeling in macular hole surgery.

METHODS: All studies about indocyanine green compared with brilliant blue G for assisting internal limiting membrane peeling during macular hole surgery all over the world were searched. PubMed, Ovid, ScineceDirect, NGC, EBSCO, EMBASE, CNKI, CBM were searched. Two reviewers independently screened the studies for eligibility, evaluated the quality and extracted the data from the eligible studies, with confirmation by cross-checking. Divergence of opinion was settled by discussion or consulted by the expert. Meta-analysis was processed by Rev Man 5.3.

RESULTS: Seven trials on indocyanine green compared with brilliant blue G for assisting internal limiting membrane peeling during macular hole surgery involving 598 cases met the inclusion criteria in meta-analysis. The baseline of patients' characteristics were comparable in all studies. By comparing the three common criteria, including best corrected visual acuity(BCVA), macular hole closure rate and postoperative complications, we found that brilliant blue G was better than indocyanine green on improving best corrected visual acuity at 6mo postoperatively\〖Z=2.10(P=0.04), OR=0.10, 95% CI (0.01, 0.19)\〗. While there was no statistical difference between two groups on macular hole closure rate\〖Z=0.69(P=0.49), OR=0.95, 95% CI(0.82, 1.10)\〗. And there were no statistical differences in term of postoperative complications between two groups(P>0.05).

CONCLUSION: The available evidence indicates that the short-term recovery of best corrected visual acuity is significantly better in brilliant blue G(BBG)group than in indocyanine green(ICG)group, especially at 6mo after surgery. The long-term prognosis of BCVA which one study only reported need further study. There were no significant differences on macular hole closure rate and adverse events between two groups.The results indicate that BBG is preferable to ICG for use during macular hole surgery.

Abstract:AIM: To evaluate the efficacy and safety of iontophoresis-assisted transepithelial corneal cross-linking(I-CXL)in a population of patients younger than 18y.

METHODS: Fifteen eyes of 12 patients aged 18y or younger(mean age, 15.8±2.08y; range, 12-18y)were treated. After 0.1% riboflavin-distilled water solution was administered by iontophoresis-assisted(Current 1mA)transepithelial method for 5min in total, standard surface UVA irradiation(370 nm, 3 mW/cm² )was performed for 30min. The uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), K₁, K₂, K_max, K_mean, corneal refractive astigmatism, endothelial cell density, intraocular pressure(IOP), the corneal apex thickness and the thinnest corneal thickness were measured preoperatively 3mo and 12mo postoperatively. Corneal parameters were assessed by corneal topography(Wavelight, Allergro Topolyzer & Topolyzer Vario, Germany). Corneal endothelium was photographed with a noncontact Specular Microscope(SP 2000, Topcon, Japan).

RESULTS: Twelve months after the procedure, no significant changes occurred in the UCVA, BCVA, K₁, K₂, K_max, K_mean, corneal refractive astigmatism, endothelial cell density and IOP. The thinnest corneal thickness decreased from 468.08±33.40 μm to 447.46±40.20 μm(t=4.379, P=0.001). The corneal apex thickness decreased from 476.07±35.96 μm to 454.60±49.32 μm(t=4.270, P=0.001). The differences of the above were both statistically significant.

CONCLUSION:I-CXL using 0.1% riboflavin-distilled water solution for pediatric keratoconus is effective and safe which can halt deterioration of keratoconus within 1y, but permanent effects still need to be observed.

Abstract:AIM: To investigate the effects of reinforcing yang from yin of a traditional Chinese patent medicine called YouguiWan for PI3K/Akt pro-survival signal channel in diabetic retinopathy rat.

METHODS: A total of 80 SPF SD rats were selected, 10 rats were selected to set up normal group. The remaining 70 rats were given streptozotocin(60mg/kg)peritoneal injection combined with intravitreal injection of VEGF(0.05μg)to establish proliferative diabetic retinopathy rat model. After the model successful, the rats were divided into four groups: YouguiWan high dose group, YouguiWan middle dose group, YouguiWan low dose group and model group. The treatment groups were fed daily YouguiWan concentrate, model group and the normal group received daily doses of distilled water. After intragastric administration for 3mo, the PI3K, Akt expression of retinal tissue were observed by SP-immunohistochemistry and Western-blot method respectively.

RESULTS: Immunohistochemical observation showed PI3K, Akt expression immunohistochemical staining, were brown particles on the retina. Normal PI3K, Akt expression weakly positive immunological reaction unit located in the ganglion cell layer. The kernel was also a small amount of expression. Model group, each YouguiWan treatment group rat retinal ganglion cell layer, inner plexiform layer and the inner and outer layer of the particles had a positive expression. Compared with the model group, YouguiWan high dose group PI3K, Akt expression were decreased. YouguiWan low dose group decreased expression was not obvious. Compared with the low dose group, YouguiWan high dose group PI3K, Akt expression was decreased. The expression of the strength of the YouguiWan, high dose group showed no significant difference. Western-blot test results showed that compared with the normal group, model group, treatment group, the expression difference was statistically significant(P<0.01). Model group, treatment group, PI3K, Akt protein levels were significantly increased. Compared with the model group, the YouguiWan high-dose group was statistically significant(P<0.05). YouguiWan high dose group PI3K, Akt protein expression were decreased, YouguiWan low dose group was no significant difference(P>0.05). Compared with the low dose group, YouguiWan high-dose group was statistically significant(P<0.05). YouguiWan high dose group PI3K, Akt expression levels were decreased. YouguiWan high dose group was not statistically significant difference(P>0.05).

CONCLUSION: Reinforcing yang from yin of YouguiWan can affect PI3K, Akt protein expression and inhibit PI3K/Akt signaling pathway, delay the disease process of diabetic retinopathy, propose new ideas and scientific basis for the treatment of diabetic retinopathy and blindness prevention treatment.

Abstract:AIM: To investigate the protective effect of VAS2870 on mice oxygen-induced retinopathy(OIR)and the possible underlying mechanisms.

METHODS: Neonatal C57BL/6J mice were divided randomly into three groups: normoxic control group, PBS injection of OIR group and VAS2870 injection of OIR group. The mice of the latter two groups were exposed to 75% oxygen from the postnatal 7d(P7)to the postnatal 12d(P12)to induced OIR. VAS2870 was administered by intravitreal injection(0.5μL)in a mice model of OIR in P12. Another set of mice model of OIR were received a similar treatment with PBS. All eyes were collected at P17. The right eyes were whole mounted and stained with Lectin to observe the growth of retinal vessels; The eyes were enucleated to assess the levels of reactive oxygen species ROS/RNS. The expression of vascular endothelial growth factor(VEGF)and Nox4 mRNA were detected by western blot and RT-PCR, respectively.

RESULTS: In the retina of OIR, VAS2870 reduced the retinal avascular area and neovascularization, the hypoxia-induced increase in ROS levels, the protein expression of VEGF and gene expression of Nox4 mRNA.

CONCLUSION: NOX4 enzyme inhibition with VAS2870 has potent anti-oxidative stress effects in the retina, indicating its potential as a treatment for retinopathy of prematurity.

Abstract:AIM: To investigate the effects of Janus Kinase 2-Signal Transducers and Activator of Transcription 3(JAK2/STAT3)gene polymorphism on the voriconazole plasma concentration in patient with fungal corneal ulcer.

METHODS: A total of 56 cases(56 eyes)with fungal corneal ulcer wererecruited in our hospital from March 2012 to February 2015. The concentration of voriconazole plasma in each patient was detected by high performance liquid chromatography with fluorescence detection. Meanwhile, the JAK2/STAT3 genotype analysis was performed by polymerase chain reaction restriction fragment length polymorphism(PCR-RFLP).

RESULTS:All patients were divided into high voriconazole plasma concentration group(35 cases, 62.50%)and low voriconazole plasma concentration group(21 cases, 37.50%)by using standard median as boundary value. There was no significant difference on the male proportion, height, weight, daily dose and adverse reaction of the patients between high and low serum voriconazole concentration group(P>0.05). The median trough concentration and the median standardized serum concentration in the high serum voriconazole concentration group were significantly higher than those of the low serum voriconazole concentration group(P<0.05). The effective rate of high serum voriconazole concentration group was better than that of low serum voriconazole concentration group(P<0.05). In the seven polymorphic loci of JAK2-STAT3 gene, the JAK2, rs10119004, GA allele, GG allele and the STAT3, rs12948909 TT allele of high serum voriconazole concentration group showed significant difference as compared with the low serum voriconazole concentration group(P<0.05).

CONCLUSION:The JAK2-STAT3 gene polymorphism shows significant effects on the serum voriconazole concentration and clinical efficacy of voriconazole, indicating that pharmacogenetic study of great significance for clinical rational used of voriconazole.

Abstract:AIM: To observe the influence in ocular surface of patients with cataract and diabetes after cataract phacoemulsification.

METHODS: A total of 74 patients with cataract and diabetes(100 eyes)who underwent phacoemulsification of senile cataract combined with intraocular lens(IOL)implantation were selected in our hospital from Apr.2014 to Dec.2014, and they were divided into the group A and group B according to with/without a history of diabetes. A total of 34 patients(50 eyes)with a history of diabetes more than 3y were assigned to group A, and 40 patients(50 eyes)without history of diabetes were assigned to group B. The dry eye-related symptom score, corneal fluorescein(FL)score, tear film break-up time(BUT), Schirmer Ⅰ test(SⅠt)and corneal endothelial cells were examined and compared in pre-therapy and post-treatment, respectively.

RESULTS: Before operation, there was no significant difference on the dry eye-related symptom score, FL score, BUT, SⅠt and corneal endothelial cells between the two groups(P>0.05). After operation, the dry eye-related symptom score in group A and B were both greatly higher than that before operation(P<0.05). The FL score and SⅠt in group A after operation were both higher but BUT was lower than that before operation(P<0.05). In group B, the FL score and SⅠt were both higher on first day, 1 week, and 2 weeks after operation than that before operation, However, the BUT was lower on 1d and 1wk after operation than that before operation(P<0.05). All the observation indexes were restored in 1mo after operation. After operation, endothelial cell area in the two groups were both larger than that before operation, and the significant difference were found from 2wk after operation in group A but only 1wk after operation in group B(P<0.05). The number of corneal endothelial cells in group A and B after operation were both less than that before operation(P<0.05). All the observation targets between group A and B had a significant difference in 1mo after operation(P<0.05).

CONCLUSION: The cataract phacoemulsification has a significant influence in ocular surface of patients with cataract and diabetes than that without diabetes.

Abstract:Sjögren's syndrome(SS)is a kind of chronic inflammation auto-immune disorder, which characterized by dysfunction and destruction of exocrine glands. The presentation of SS in eyes we called keratoconjunctivitis sicca(KCS). Although significant advances in both basic and clinical research have been made over the past years, the pathophysiological mechanisms of KCS are still imprecise. In vivo confocal microscopy(IVCM)is a newly emerging, noninvasive with high-resolution technology, which allows the observation of corneal cells, corneal nerves, immune and inflammatory cells, conjunctiva and meibomian gland structures on a cellular level. Therefore, it could improve the understanding of the pathogenesis and pathophysiology of the KCS. In this study, we reviewed the articles of IVCM to obtain an integrated, morphological and functional evaluation of the whole ocular surface in KCS patients with SS.

Abstract:One of the main reasons affecting visual acuity after cataract extraction and intraocular lens implantation is postoperative astigmatism. The postoperative astigmatism is the vectorial sum of preoperative and surgically induced astigmatism. The surgically induced astigmatism is a vector which includes size and direction. And the analysis of surgically induced astigmatism is the necessary step before cataract and refractive surgery. This paper has summarized the method of calculation of surgically induced astigmatism.

Abstract:Diabetic retinopathy(DR)is the leading cause of blindness due to diabetes in developed countries. The major therapies including vitrectomy and laser photocoagulation. This article provides an overview about the systemic factors of the postoperative curative of diabetic retinopathy.

Abstract:Age-related macular degeneration(AMD)is one of the main diseases in the world leading to vision loss in the elderly, and is a multi-factorial and multi-mechanism mediated chronic degenerative eye disease. The exact pathogenesis of AMD is still not clear, and many studies found that age, genetic factors, nutritional imbalance, epigenetics, oxidative stress, a variety of complement factors activation and inflammatory reaction were involved in the pathogenesis. Recent studies have found that vitamin D levels and DNA methylation were closely related to AMD. Thus, a simple generalization of vitamin D deficiency and DNA methylation in the pathogenesis of AMD were made.

Abstract:Anti-vascular endothelial growth factor(anti-VEGF)drugs are widely used in the ophthalmology. The main indications are wet age-related macular degeneration(wAMD). By searching the related literature, we draw a lot of anti-VEGF drugs' rare application case reports and clinical research progress in Ophthalmic diseases except wAMD. There are still gaps between vitro and the clinical use of those researches. The prospect of the application of anti-VEGF drugs is hopeful and attractive. More researches is needed.

Abstract:Blueberries, which can also be called cranberries, has many nicknames such as Benedict, persimmon and so on. It is a kind of berries which has high nutritional value and mainly cultivated in Shandong peninsula and large areas of Xiao Hinggan Mountains. It has strong antioxidant activity and radical scavenging ability because of the rich anthocyanins. It also has many advantages, such as the advantages of high efficiency, low toxicity and high bioavailability. Also, it can reduce blood pressure, hematic fat, to have remedial effect caused by diabetes capillaries disease anti-inflammatory, anti-tumor, preventing Alzheimer's, helping support vision, decreasing the symptom of eye fatigue, promoting vascular circulation around our eyes, slowing down the aging of the retinal cell and prevent cardiovascular and cerebrovascular disease. This article mainly takes anthocyanin, which is extracted from blueberry for example to research its property, pharmacological effects and eye disease, such as slowing down the symptom of eye fatigue ametropia, ocular surface disease, cataract, glaucoma, retinopathy and so on. We believe that in the coming future, the pharmacological mechanism of procyanidins could be clarified much more clearly and exert its greater medical value. It will become effective drugs that provide more economic in ophthalmic clinical application and provides much more benefit to the patients.

Abstract:AIM: To research the clinical characteristics and identify the disease-causing gene mutation in Chinese patients with Peters syndrome. All these cases will be useful foundations for clinical diagnosis, medical therapy and pathogenesis.

METHODS: Ten congenital corneal opacities affected patients were enrolled from our pediatric and genetic eye clinic. Medical and ophthalmic histories were obtained. Genomic DNA was prepared from venous leukocytes after informed consent conforming was obtained from each participant. The coding regions and the flanking exon-intron junctions of this gene were amplified by polymerase-chain reaction(PCR)and subsequently analyzed by direct sequencing. Variations detected were further evaluated in 100 normal controls by direct sequencing.

RESULTS: One affected individual characterized by systemic changes such as congenital heart anomalies and hearing loss showed the consistent phenotypes with Peters syndrome. Sequence analysis of the PITX2 gene revealed one novel mutation, c. 788G>A. Nucleotide sequence analysis showed that this mutation led to the functional abnormal of this gene, however, no mutation was observed in any unaffected member or 100 normal unrelated individuals.

CONCLUSION: A novel mutation in the PITX2 gene have been identified, this is the first report on a mutation in a Chinese Peters syndrome and the result expand the mutation spectrum of PITX2, further clarify the clinical features of the disease. All these will be useful foundations for clinical diagnosis, medical therapy and pathogenesis.

Abstract:AIM:To explore the effect of the cataract patients after cataract surgery by the treatment of different focal intraocular lens implantation.

METHODS: A total of 65 cases of cataract patients who received treatment in our hospital were selected. According to the different division of implanted crystal, 32 cases(43 eyes)of multifocal intraocular lens were selected as the observation group, 33 cases(47 eyes)with monofocal intraocular lens were selected as the control group. We compared distant and near visual acuity in two groups who received operations after 1 and 3mo. We analyzed the contrast sensitivity values and the results of questionnaire in two groups.

RESULTS: The values of UDVA, CDVA, UNVA and CNVA in the observation group were higher than those in the control group at 3mo after operation(P<0.05); the space frequency detection sensitivity in the observation group received surgery after 3mo was significantly better than that of the control group in 3, 6, 12 and 18c/d whether glare or not, the difference was statistically significant(P<0.05); the two groups of patients who received the operation after 3mo were investigated, there were no differences in factor of nocturnal disorders and dizziness in the glare(P>0.05). We compared different of the night action disorder and glare dizziness in two groups of patients, the difference was no statistical difference(P>0.05). And overall satisfaction in the observation group was significantly higher than the control group(P<0.05).

CONCLUSION: Postoperative visual acuity of the patients who used multifocal intraocular lens is better, and contrast sensitivity have increased, the overall satisfaction is high, it can meet the visual life needs of patients.

Abstract:AIM: To discuss the effect of biochemical indexes on condition of middle aged and senior people with cataract.

METHODS: A total of 132 patients with cataract from Jan. 2014 to Jan. 2016 in our hospital were collected as the observation group. And 156 patients besides cataract were chosen as the control group. All entrants were divided into group A(40-59y), group B(60-79y)and group C(≥80y)according to the age. The biochemical indexes of all entrants were checked, including ALB, GLB, TP, GLU, BUN, UA, Cr, ALT, LDH, ALP, TC, Ca, Na, K and P. And all indicators were given phase relationship analysis.

RESULTS:There were no statistically significant in the level of ALP, ALT, K, P, LDH between observation group and control group. The level of ALB, GLB, TP, GLU, BUN, Cr, TC, Ca, Na in observation group were higher than those in the control group. The results of Logistic regression between two groups were as follow the level of ALB, GLU, BUN, Cr, Ca might be enrolled as risk factors for cataract. In group A, the level of ALB, GLU, Na in observation group were higher than those in the control group. In group B, the level of ALB, BUN, Cr, GLU, Na in observation group were higher than those in the control group. In group C, the level of BUN, Cr, GLU, Na in observation group were higher than those in the control group(P<0.05).

CONCLUSION: The level of ALB, TP, BUN, Cr, TC, Ca was significantly increased which suggested that those change might associate with the pathogenesis of cataract.

Abstract:AIM:To explore the clinical effect of carboxymethylcellulose sodium eye drops and recombined human epidermal growth factor(rhEGF)on the cataract patients with dry eye after phacoemulsification.

METHODS: A total of 150 patients with cataract(150 eyes)referred to our hospital from Oct.2015 to May 2016 were randomly divided into trial group and control group, 75 cases in each group. All patients after cataract phacoemulsification were received the treatment of dry eye according to different groups. In treatment goup, patients were treated by carboxymethylcellulose sodium eye drops and rhEGF. In control group, patients were treated by carboxymethylcellulose sodium eye drops. The subjective dry eye symptoms, as well as fluorescein staining(FL), Schirmer Ⅰ test(SⅠt)and tear break-up time(BUT)were recorded before treatment, 1wk, 1mo after treatment.

RESULTS: Before treatment, there were no significant differences between groups in the subjective dry eye symptoms and the results of BUT, FL and SⅠt(P>0.05). After treatment, all the index in two groups significantly improved over time(P<0.01), and all the index were better in treatment group than those in control group(P<0.05). The treatment group had less severe subjective dry eye symptoms, longer BUT, fewer FL, and more SⅠt.

CONCLUSION:Combined use of carboxymethylcellulose sodium eye drops and rhEGF can relieve the dry eye symptoms and maintain the tear film stable after phacoemulsification effectively. Therapeutic effects of combined utilization are better than that of carboxymethylcellulose sodium eye drops used alone.

Abstract:AIM:To investigate the preventive effect of 1g/L bromfenac sodium hydrate ophthalmic solution on macular edema after phacoemulsification.

METHODS:In this prospective, randomized, controlled clinical trial, the cases with age related cataract after phacoemulsification combined with intraocular lens implantation were randomly divided into two groups, each group of 118 eyes. The cases in experimental group received the treatment of 1g/L bromfenac sodium hydrate ophthalmic solution for 2d preoperatively and 4wk postoperatively, combined with tobramycin dexamethasone eye drops for 2wk postoperatively. The cases in control group received the treatment of tobramycin dexamethasone eye drops for 2wk postoperatively. Central subfield mean thickness(CSMT)was measured within 2d before surgery as well as on 1d, 1, 4, 12wk after surgery and the incidence of macular edema was calculated after surgery.

RESULTS:There was no significant difference in CSMT between two groups before surgery and on 1d, 1, 12wk after surgery(P>0.05). CSMT was significantly lower in experimental group(251.57±6.814μm)than in control group(262.41±7.295μm)on 4wk after surgery(P<0.05). The incidence of macular edema in experimental group on 1d, 1, 4, 12wk after surgery were 0, 0, 0.9% and 0.9%, respectively, while in control group were 0, 0.9%, 8.5% and 1.7%, respectively. There was significant difference in the incidence of macular edema between two groups only on 4wk after surgery(P<0.05).

CONCLUSION:The thickening of central subfield can be effectively prevented and the incidence of macular edema can be reduced with 1g/L bromfenac sodium hydrate ophthalmic solution performed before and after phacoemulsification.

Abstract:AIM: To analyze the clinical effect of adjuvant therapy with glucocorticoid in surgical treatment of uveitis complicated cataract. In order to provide reference for clinical diagnosis and treatment.

METHODS: Clinical data of patients with uveitis complicated cataract who received treatment at our hospital from 2013 to 2015 were analyzed. Patients were divided into two groups by different therapies, Group A: intraoperative injection with triamcinolone, Group B: without treatment of triamcinolone. The near and future curative effect in the two groups patients were compared.

RESULTS: A total of 68 patients were analyzed, Group A had 35 cases(37 eyes), Group B had 33 cases(34 eyes). Group A patients had a higher rate of patients with a corrected visual acuity more than 0.5 than that of Group B patients(χ²=4.094, P=0.043). There was no significant difference in intraocular pressure between the two groups(P>0.05). Anterior chamber inflammation of the observation group patients were lower than the control group, the difference was statistically significant(χ²=15.900, P=0.001).Seven days after surgery, Group A patients had a higher levels of SOD in aqueous humour and lower levels of MDA and TNF-α in aqueous humour than these of Group B patients(P>0.05). Group A patients had a lower 1 year recurrence rate than that of Group B patients(14%,5/35 vs 33%,11/33; Log-rank χ²=4.004, P=0.045).

CONCLUSION: Intraoperative anterior chamber injection with triamcinolone can significantly improve the curative effect in surgical treatment of uveitis complicated cataract.

Abstract:AIM: To analyze the long term effection and early complications of inner-scleral and trabeculectomy in the treatment of glaucoma.

METHODS: A retrospective analysis was made in the anterior chamber depth, postoperative intraocular pressure(IOP)and long term filtering bleb after trabeculectomy in 122 eyes of 102 patients with glaucoma.

RESULTS: After 1, 3 and 6d, the shallow anterior chamber was 50.8%, 44.3% and 4.1%, respectively. The postoperative follow-up was 12mo, the normal rate of IOP control was 89.3%, and postoperative functional filtering bleb was 86.9%.

CONCLUSION: Inner-scleral and trabeculectomy is an effective method for the treatment of glaucoma, the effection was better than traditional trabeculectomy. Although early postoperative shallow anterior chamber occurred rate is highly, but proper treatment to the long-term effect of surgery have no influence.

Abstract:AIM: To study the panretinal photocoagulation on severe peripapillary RNFL thickness NPDR and early PDR patients.

METHODS: Fifty-six cases were diagnosed as diabetic eye disease in our hospital from Jan.2014 to Dec.2015. According to the actual condition, the patients were divided into early PDR group and severe NPDR group. The two groups were given the whole retinal photocoagulation.

RESULTS: The upper part of the severe NPDR group was(114.26±18.26)μm, which significantly higher than that of postoperative(105.55±11.73)μm(t=2.085, P=0.042). The lower part was(118.85±20.16)μm, which significantly higher than that of(107.37±16.38)μm(t=2.296, P=0.026). Preoperative nasal side, the temporal side was slightly higher than the postoperative, but the difference was not statistically significant(P>0.05). The average thickness was(90.16±14.81)μm, which significantly lower than that of(99.85±17.28)μm(t=2.212, P=0.031). The upper part of the PDR group was significantly lower than that before operation, and the difference was statistically significant(P<0.01). At the nasal side, the temporal side was slightly lower than the preoperative, the difference between two groups was not statistically significant(P>0.05). The average thickness was(87.58±16.08)μm, which significantly lower than that before operation(97.17±13.46)μm(t=2.463, P=0.017). There was no significant difference in the average thickness of the temporal and the early PDR group(P>0.05)in the upper and lower sides of the severe group NPDR after 6mo. The nasal side of severe NPDR group was(66.29±9.36)μm, which significantly higher than that in early PDR group(59.88±11.71)μm, and the difference was statistically significant(t=2.252, P=0.028).

CONCLUSION: Laser photocoagulation has a significant influence on the thickness and the average thickness of the upper and lower quadrant of the retina, which leads to the thinning of retinal RNFL, and the clinical attention should be paid to the injury of retinal nerve cells.

Abstract:AIM:To investigate the clinical therapeutic effects of intravitreous injection of Conbercept for macular edema secondary to retinal vein occlusion(RVO).

METHODS:Twenty-seven eyes of 27 patients with RVO received initially intravitreous injection of Conbercept combined with selective peripheral retinal or panrentinal photocoagulation. Best-corrected visual acuity(BCVA, logMAR vision)and central retina thickness(CRT)were performed before and after the injection. These indicators before treatment, after 12wk treatment of 8 patients(8 eyes)of central retinal vein occlusion(CRVO)who received no less than three times intravitreous injection treatments were analyzed. And also analyze these indicators of before treatment, after 4wk treatment of 19 patients(19 eyes)of branch retinal vein occlusion(BRVO)who received at less singal intravitreous injection treatment.

RESULTS:The mean BCVA and CRT of 27 patients were 0.8822±0.5601,(713.8±224.8)μm and 0.5963±0.4481,(376.7±185.5)μm before treatment and at the last follow-up visit, respectively. The mean injection time was 4.75 and the mean following month was 13 of 8 patients of CRVO. Before treatment, the mean BCVA of these 8 patients(8 eyes)was 0.9802±0.6663, after received three times intravitreous injection treatment was 0.7082±0.4629 and 0.8517±0.5895 at the final follow-up. The improvement was no significant difference(P>0.05). The mean CRT at 3mo and the last follow-up were respectively(306.8±117.7)μm and(487.5±201.6)μm, which significantly(P<0.05)improved from(835.1±289.3)μm before treatment. The mean injection time of 19 patients of BRVO was 2.2 and the mean following month was 9. The mean BCVA was 0.8124±0.4529 before treatment,after received the first time intravitreous injection treatment and at the final follow-up were 0.4789±0.2792 and 0.4888±0.3163, respectively. The improvement was significantly(P<0.05). The mean CRT at 1mo and the last follow-up were(283.8±129.3)and(330.6±161.4)μm, which also significantly(P<0.05)improved from(662.7±176.6)μm before treatment. No serious complications were observed.

CONCLUSION:Intravitreous injection with Conbercept is effective in macular edema of RVO, reducing CRT and enhancing the visual acuity. And the duration of efficacy is longer of BRVO than CRVO, single injection can maintain around about 1y.

Abstract:AIM: To observe the clinical effect of 532nm laser combined with a traditional Chinese patent called He xue ming mu tablets in the treatment of diabetic retinopathy in patients with severe non proliferative diabetic retinopathy.

METHODS: A total of 120 patients(226 eyes)diagnosed by the clinic for severe non-proliferative diabetic retinopathy diabetic retinopathy patients were randomly divided into treatment group and control group. The patients underwent combined therapy defined as treatment group(Group A), the treatment process and took He xue ming mu tablets orally for 1-3mo defines a separate line. The patients with laser photocoagulation treatment as the control group(Group B). After 1, 2 and 3mo after treatment, the retinal hemorrhage and visual function of the patients in the two groups were observed, and the fundus fluorescein angiography in 3mo after treatment was observed.

RESULTS: Two groups of patients in the different treatment measures were taken after 1-2mo, patients suffering from eye visual function recovery was significantly better than the control group(P<0.05). But up to 2mo after the treatment, the treatment group and the control group eyes visual function index was no significant difference. Compared with the control group, the patients in the treatment group had significant advantages in terms of retinal hemorrhage, exudation, edema and fundus(P<0.05).

CONCLUSION: The severe non-proliferative diabetic retinopathy diabetic retinopathy treated by laser combined with He xue ming mu tablets treatment, can effectively shorten the eyes with visual function recovery speed, and can promote the absorption of retinal hemorrhage and exudation rate, reduce the secondary damage to the laser has a certain role.

Abstract:AIM: To identify the effective and safety of ranibizumab intravitreal injection in patients with macular edema(ME)caused by diabetic macular(DM)and retinal vein obstruction(RVO).

METHODS: Thirty-eight eyes of thirty-five patients was retrospectively evaluated, twenty-three with ME caused by DM and fifteen with RVO, who received intravitreal ranibizumab(0.5mg/0.05ml)and were followed up for at least a month., The best corrected visual acuity(BCVA), central retinal thickness(CRT)and intraocular pressure(IOP)were followed up at 1, 3d, 1wk and 1mo respectively. The effect of the DME and RVO-ME were compared.

RESULTS: DME and RVO- ME group after treatment in 1, 3d, 1wk, the BCVA were obviously improved, and the differences were statistically significant(P<0.05). But compared the BCVA in 1mo with before showed no statistically significant difference(P>0.05). DME and RVO-ME group after treatment in 1, 3d, 1wk and 1mo, CRT was obviously improved, and the differences were statistically significant(P<0.05). The BCVA and CRT of treatment showed no statistically significant difference between DME with RVO-ME(P>0.05).

CONCLUSION: Bevacizumab intravitreal injection for ME caused by DM and RVO was safe and effective.

Abstract:AIM: To investigate the feasibility and significance of the application of optical coherence tomography(OCT)in screening diabetic retinopathy(DR)in community hospitals.

METHODS: Retrospective analysis. A total of 378 cases with type 2 diabetes mellitus in Fushun, 184 males(193 eyes)and 194 females(207 eyes), aged from 43 to 76(averaged 59.0±9.7), were chosen in JiangJun community hospital. According to DR staging standard, 278 patients(300 eyes)with fundus changing were divided into 3 groups: DR1, DR2 and DR3. A total of 100 patients(100 eyes)with no fundus changing were as a control group. Spectralis OCT(Heidelberg, German)was used to scan retina of 3.4mm range around the optic disc with fast scanning mode and the thickness of retinal nerve fiber layer(RNFL)with different areas were recorded. Independent sample t-test and one-way ANOVA were used to compare the difference of RNFL thickness in each group.

RESULTS: The averaged thickness of RNFL in control, DR1, DR2, and DR3 group were 109.52±7.13μm, 108.51±7.09μm, 99.37±8.92μm and 98.48±8.57μm, respectively. Significant differences were found in the RNFL thickness between control group and DR 1-3 group(P<0.05). Comparison of the RNFL thickness in different areas: the distributions of RNFL thickness in control and DR groups were similar, where the RNFL in nasal and temporal optic disc was thinnest and superior and inferior temporal RNFL was thickest. There was statistic difference between the thinnest and thickest RNFL(P<0.05). The differences of the nasal, superior temporal and inferior nasal RNFL were found between DR1 group and control group(P<0.05); the differences of the nasal, superior temporal and inferior nasal RNFL were found between DR2 group and control group(P<0.05); the differences of RNFL in each area were found between DR3 group and control group(P<0.05). No difference of RNFL in each area was found between DR1 and DR2 group(P>0.05); the differences of RNFL in each area were found between DR1 and DR3 group(P<0.05)except temporal RNFL; the differences of RNFL in each area were found between DR2 and DR3 group(P<0.05)except temporal RNFL.

CONCLUSION: The RNFL thickness is one of the sensitive indexes for early diagnosis of DR. The application of OCT in community hospitals for DR screening is helpful to the early prediction and the assessment of DR progression.

Abstract:AIM: To analysis and compare the influence of surround luminance and pupil diameter on neural contrast sensitivity function(NCSF)and contrast sensitivity function(CSF).

METHODS: Ten healthy male volunteers(10 eyes)were recruited in this study, and the right eye was tested in this experiment. Different surround luminance levels and glare were set by Vision Monitor System to measure CSF curves of normal pupil, 3.0mm pupil and 5.0mm pupil. Modulation transfer function(MTF)curves of 3.0mm pupil and 5.0mm pupil were measured by Optical Quality Analysis System. NCSF was the ratio of CSF and MTF.

RESULTS:NCSF and CSF curves went downward considerably and the curve waves shifted towards low spatial frequency as the surround luminance decreases. Compared with NCSF, the curve waves of CSF shifted towards lower spatial frequency. The change of CSF was affected by NCSF and MTF. When pupil diameter increases, MTF curve went downward. While the NCSF and CSF curves mounted up at low spatial frequency in the mesopic and photopic visual environment and showed downward trend at high spatial frequency in excessive bright environment or with glare. In the scotopic visual environment, the slight pupil diameter change cannot considerably affect CSF and NCSF curves.

CONCLUSION:CSF is influenced by MTF and NCSF which reflects the function of the retina-brain neural system. The curve shape of CSF is similar to NCSF, but the curve wave is at lower spatial frequency. NCSF and CSF curves go downward as the surround luminance decreases. As the pupil diameter increases, NCSF and CSF curves mount up at low spatial frequency but show downward trend at high spatial frequency in excessive bright environment or with glare.

Abstract:AIM: To analysis the clinical effect of lacrimal plug treated refractory dry eye video terminal.

METHODS:A total of 80 patients with video terminals resistant dry eyes were selected in our hospital between Mar.2013 to Mar.2015. A prospective randomized controlled study used the software SAS9.2. All the patients were randomly divided into control group and observation group, 40 patients in each group. The control group treated with drops of ophthalmic, observation group treated with lacrimal duct embolus. A course included 30d, a total of 3 courses were in the treatment. The two groups before and after treatment in patients with tear secretion test and integral-rupture time and symptoms were observed and compared.

RESULTS: Observation group number of therapy effective and efficient eye were significantly larger than control group, and number of invalid eyes was less than that of control group, the total efficiency was higher than control group, the difference was statistically significant(P<0.05). Before treatment, the tear secretion test and tear film break-up time in two groups had no significant difference, after treatment, the above indexes of the two groups all increased, while observation group increased more significantly(P<0.05). Before treatment, scores of dry senses, foreign body sensation, visual fatigue and the total scores of symptoms in the two groups had no significant difference. After treatment, the above indexes of the two groups all decreased and the observation group decreased more significantly(P<0.05).

CONCLUSION:Lacrimal plug has good treatment effect on the video terminal refractory dry eye, which can significantly improve the patient's clinical symptoms, with good clinical application value.

Abstract:AIM: To investigate changes in tear film stability and corneal biomechanics after femtosecond laser small incision lenticule extraction(SMILE)and femtosecond laser LASIK(F-LASIK)for one year.

METHODS:A total of 43 patients(86 eyes)with SMILE and 47 patients(94 eyes)with F-LASIK were chosen from Jun.2014 to Jul.2015, whose surgery all successfully and medical records were complete. Average tear film break-up time(aBUT), Schirmer Ⅰ test(SⅠt)and Pentacam were obtained before surgery and at 1, 6 and 12mo after surgery. The paired t-test were used to analyze the collected data.

RESULTS: There was no significant difference in age, central corneal thickness(CCT)and optometry before surgery. The mean fellow time after surgery was(14±1.92)mo. The values of aBUT and SⅠt was no significantly different in before surgery and 1mo after surgery. There was significantly different in aBUT between 2 groups in 6 and 12mo after surgery(P<0.05). The SⅠt value only show different in 6mo after surgery. After one year, the posterior elevation of the thinnest point in SMILE and F-LASIK were(4.11±2.35)μm,(4.21±2.09)μm. The data of the central point were(1.33±0.94)μm,(1.23±0.93)μm. Whatever preparation or long time after surgery, there was no significantly different in 2 groups(P>0.05).

CONCLUTION: SMILE surgeries have superiority over F-LASIK in tear film stability. There is no change in corneal biomechanics, the posterior corneal surface is stable for long- term after SMILE or F-LASIK.

Abstract:AIM: To investigate the satisfaction and satisfaction score of myopic patients after small incision lenticule extraction(SMILE).

METHODS: Myopic patients treated with SMILE were enrolled from Jan. to Dec.2013 in Henan Eye Institute. The patients were divided into different myopia groups according to spherical equivalent, and were divided into low age group and high age group according to age. The satisfaction survey was performed 18-30mo after SMILE. The differences of response rate and satisfaction score among different myopia groups were performed by Chi-square test and One-way ANOVA, respectively. The differences of satisfaction score between different age groups were performed by sample t-test. The differences of satisfaction score between postoperative symptomatic group and asymptomatic group were performed by sample t-test.

RESULTS: A total of 239 eyes of 120 patients were enrolled. A total of 183 eyes of 92 patients replied, the response rate was 76.6%. The average age was(25.6±5.3)years, the mean preoperative spherical equivalent was(-4.87±1.37)D. The response rates were not statistically significant among different myopia groups(χ²=12.00, P>0.05). The percentage of patients that were very satisfied with surgery was 98.9%, and they would like to recommend the surgery to their families or friends. The satisfaction score of moderate myopia group was significantly higher than that of low myopia group and high myopia group(P<0.05). The satisfaction score of low age group was higher than that of high age group(t=2.95, P<0.05). The incidence of dry eyes, poor night vision, glare and eye discomfort was 15.3%, 9.8%, 7.7%, and 7.1% after operation. The satisfaction score of dry eye was lower than that of asymptomatic patients(P<0.05). There were no significant differences between asymptomatic patients and poor night vision, glare or eye discomfort patients(P>0.05).

CONCLUSION: The satisfaction extent of myopic patients after SMILE is very high. The satisfaction score of moderate myopia group and low age group was high, and the postoperative satisfaction score of dry eye is low.

Abstract:AIM: To train the ability of clinical diagnosis and treatment by seminar teaching method combined with case-based teaching method for the undergraduate teaching in the Department of Ophthalmology.

METHODS:Grade 2011 clinical undergraduate students were the research objects. Three and four classes were divided into experimental group(114 students)applied seminar teaching method combined with case-based teaching method. Five and six classes were divided into control group(112 students)applied traditional teaching method. We asked the students to carry out a questionnaire and exam after the end of the course. The data were analyzed by SPSS 19.0.

RESULTS:The comparison data of questionnaire included understanding the knowledge points, improving learning interest, approving the self-learning ability. The expression ability, cultivation of clinical thinking and memory theoretical knowledge were statistically significant(P<0.05). The comparison test scores of two groups were statistically significant(P<0.05).

CONCLUSION:Seminar teaching method combined with case-based teaching method can help to cultivate students' thinking ability of clinical diagnosis and treatment.

Abstract:Ophthalmology is a specialized subject that studies the occurrence,development and prevention of visual disease. It has strong professional characteristics,and itrequires high quality specialists for scientific and clinical research. Uveitis is one of the leading cause of blindness with high incidence rate,and closely related with various systems of the body. The traditional cramming method of teaching is not suitable for cultivation of graduate students majored in uveitis on today's society,which requires ophthalmology teachers to explore new teaching mode in accordance with the training practice and innovation ability of medical postgraduates.

Abstract:AIM:To observe the safety and efficacy of topically administered bevacizumab by ways of subconjunctival injection and eye drops in the treatment of stable corneal neovascularization.

METHODS: With the way of comparison before and after treatment, 32 eyes(25 patients)diagnosed corneal neovascularization(CNV)were administrated bevacizumab by means of subconjunctival injection(2.5mg)and eye drops(4 times/d)15d, which included Alkali burn 6 inpatients 8 eyes, Chronic keratitis 14 inpatients 19 eyes and Simple corneal penetrating injury 5 inpatients 5 eyes. After one month, the patients were treated in the same way again. The treatments were total 3 times. Visual acuity, intraocular pressure(IOP), flare of the anterior chamber, area and length of CNV, corneal pannus, blood pressure and heart rate were observed before and after treatment. The efficacies, safety and frequency of Bevacizumab were discussed before treatments and after the three times treatments ending at 1, 2 and 6mo.

RESULTS: In 32 eyes, IOP, flare of the anterior chamber, blood pressure and heart rate were not changed and corneal pannus were alleviated in varying degrees after the treatments. Compared with the eyes before treatment, the efficacies after the three times treatments in 1, 2 and 3mo were statically significant differences(F=5.574, 6.221, 6.221; P<0.05). After the treatments of one month, visual acuity of 18 eyes were improved above two row(56%); area of CNV of 20 eyes were reduced(63%)and the efficacy was 56%. After the treatments of three months, visual acuity of 23 eyes were improved above two row(72%); area of CNV of 25 eyes were reduced(78%)and the efficacy was 72%. Changes after six months were the same as those after three months. As the different cases of CNV, the therapy of Bevacizumab was efficient. In 32 eyes, the improvements of Bevacizumab treatment in eyesight and CNV were 44% in one time, 56% in two times, and 63% in three times, the times of Bevacizumab treatment were statically significant differences compared one time with two or three times(χ²=46.274, 48.532; P<0.05).

CONCLUSION: The mean of topically administered Bevacizumab by ways of subconjunctival injection and eye drops in the treatment of stable corneal neovascularization is simple, efficient and safe without local or systemic adverse effects in a short phase.

Abstract:AIM: To compare central corneal thickness(CCT)using Germany Allegro Oculyzer; Germany Heidelberg OCT Spectralis and Pachymetry SP-3000.

METHODS:A total of 74 cases(148 eyes)were collected in the refractive surgery center in our hospital. The cornea thickness was measured by Germany Allegro Oculyzer; Germany Heidelberg OCT Spectralis and PachymetrySP-3000 respectively. The difference of CCT was compared using t-test, the correlation and agreement was analyzed among the three methods with Pearson-test and Bland-Altman-test.

Results: Mean CCT reading of Allegro Oculyzer; Heidelberg OCT Spectralis and PachymetrySP-3000 were 532.17±22.94μm, 526.53±24.52μm and 532.62±23.59μm. The t-test showed difference between Allegro Oculyzer and Pachymetry SP-3000(P<0.05). There was significant difference between Allegro Oculyzer and Heidelberg OCT Spectralis(P<0.05). There was no significant difference between Heidelberg OCT Spectralis and PachymetrySP-3000(P>0.05). There was significant linear correlation among the three methods(r=0.972, 0.964, 0.973; P<0.05). There was good agreement among the three methods.

CONCLUSION:CCT measured by Allegro Oculyzer; Heidelberg OCT Spectralis and PachymetrySP-3000 have high correlation and agreement. The three methods are complement of each other. All can be used in measurement of CCT.

Abstract:AIM: To investigate the improvement and effect of adjustable suture in glaucoma filtering operation.

METHODS:Retrospective study included the clinical effect of modified adjustable suture in 46 cases(49 eyes)with glaucoma filtering surgery.

RESULTS: A total of 46 cases(49 eyes)were operated with this method, the filtering bleb formation was satisfied, the intraocular pressure was well controlled, and no obvious foreign body sensation was during the suture, and the suture was simple and convenient.

CONCLUSION:This suture method is one of the most suitable, effective and convenient methods for the adjustable suture methods in glaucoma filtering operation.

Abstract:AIM: To observe the effects of intravitreous injection of anti-VEGF drug and PRP combined with filtering surgery for neovascular glaucoma.

METHODS:Twenty-three eyes of 21 patients with neovascular glaucoma were enrolled. The patients of ocular media transparency were treated with intravitreous injection of anti-VEGF drug and PRP combined with filtering surgery. The patients of ocular media opacity were treated with vitrectomy or cataract surgery in the meantime. All cases were followed for 3mo, IOP control were observed after treatment.

RESULTS:One patient visual acuity improved significantly, all remaining stable or slightly improve visual acuity. All case showed regress at different degree of the iris neovessels. There was significant difference between before and after treatment(P=0.00).

CONCLUSION:The intravitreous injection of anti-VEGF drug and PRP combined with filtering surgery for neovascular glaucoma provide more rapid control of IOP. It is a better choice of neovascular glaucoma.

Abstract:AIM: To study the ocular hypotensive effect and security of travoprost drops solution in the treatment of primary open-angle glaucoma and ocular hypertension.

METHODS: Eighty cases(eighty eyes)of patients with primary open-angle glaucoma and ocular hypertension in our hospital from Mar.2013 to Mar.2016 were randomly selected. These patients were divided into two groups according to the treatment methods, namely travoprost drops solution group(n=40)and latanoprost eye drops group(n=40), the clinical efficacy, visual acuity, astigmatism, intraocular pressure and adverse events of the two groups were analyzed.

RESULTS: The total treatment efficiency of the travoprost drops solution group 95%(38/40)was significantly higher than the latanoprost eye drops group 80%(32/40)(P<0.05). The eyesight was significantly higher(P<0.05), the astigmatism, intraocular pressure was significantly lower(P<0.05). The incidence of adverse reactions 25%(10/40)was significantly lower than the latanoprost eye drops group 53%(21/40)(P<0.05).

CONCLUSION: Travoprost drops solution in the treatment of primary open-angle glaucoma and ocular hypertension has better ocular hypotensive effect and higher safety than latanoprost eye drops.

Abstract:AIM: To investigate the curative effect of malignant glaucoma postoperative glaucoma combined cataract with anterior segment vitrectomy incision.

METHODS: Retrospective analysis. A total of 16 eyes of 14 patients with malignant glaucoma who had a history of cataract phacoemulsification removement +IOL combined with trabeculectomy(Phaco+IOL+Trab)were selected from Jun.2010 to Jun.2015 in our hospital. Due to ineffective conservative treatment, they were performed anterior segment vitrectomy. Through a clear corneal incision, iris retractor exposed 6 o'clock position of artificial crystal complex edge. Anterior and posterior capsular part resection combined with the corresponding parts of the anterior vitreous resection were performed.

RESULTS: All patients were followed up for 12mo, all cases were successful in anterior chamber reconstruction. The mean best corrected visual acuity(BCVA, logMAR)was from 0.2±0.17 in the pre-operative to 0.5±0.29 in the last follow-up(P<0.05). The mean intraocular pressure(IOP)was 42.6±4.23mmHg in the pre-operative to 15.89±4.72mmHg in the last follow-up(P<0.05). Among them, 2 eyes needed a kind of anti-glaucoma drugs, 2 eyes with two kinds of anti-glaucoma drugs, the total success rate was 75%, partial success rate was 25%, the success rate was 100%. The mean anterior chamber depth was 0.62±0.23mm in the pre-operative to 3.49±0.57mm in the last follow-up(P<0.05). After the treatment, ciliary and choroidal detachment occurred in 2 cases were treated with conservative treatment, there were no serious complications such as corneal endothelial dysfunction, intraocular lens deviation, choroidal hemorrhage and retinal detachment in all patients during follow-up.

CONCLUSION: Anterior segment vitrectomy is effective, simple, safe, easy to grasp and has less complications in treated the malignant glaucoma after surgery glaucoma combined with cataract compared with the posterior segment vitrectomy.

Abstract:AIM: To investigate the diagnostic value of Application of optical coherence tomography(OCT)angiography for early primary open angle glaucoma(POAG).

METHODS: Thirty-one eyes of 31 cases with early POAG were detected by OCT angiography. The split-spectrum amplitude-decorrelation angiography(SSADA)algorithm was used to compute optic disc angiography. The vessel density of capillaries and caliber of large vessels around the optic disc were analyzed for the correlation with nerve fiber layer(NFL)thickness and mean defect of visual field.

RESULTS: The vessel density of capillaries was 7.34±1.40 in superior and 7.76±1.34 in inferior, which showed a significant linear correlation with the NFL thickness(P<0.05). The caliber of large vessels was 94.71±11.20μm, which had a linear correlation with the mean defect of visual field.(P<0.05).

CONCLUSION: OCT angiography is a convenient technology to non-invasively measure optic disc perfusion and may be useful in the early diagnosis of primary open angle glaucoma.

Abstract:AIM:To observe the clinical efficacy of trabeculectomy and endoscope-assisted vitrectomy combined with retinal photocoagulation in management of late neovascular glaucoma.

METHODS: Fifteen cases(15 eyes)with late neovascular glaucoma with above light perception vision in our hospital between Jul.2012 to Jul.2013 were treated with trabeculectomy and endoscope-assisted vitrectomy combined with retinal photocoagulation. The clinical data were retrospectively analyzed.

RESULTS: All the patients were followed up for 6mo. A total of 15 cases(15 eyes)of mean postoperative intraocular pressure(IOP)(12.53±3.73mmHg)(1mmHg=0.133kPa)at 1 week compared with preoperative IOP(58.81±5.9mmHg)was decreased obviously(P<0.05). One month(18.26±4.31mmHg), 3mo(17.06±3.65mmHg)and 6mo(16.13±3.66mmHg)mean postoperative IOP respectively compared with preoperative IOP(58.81±5.91mmHg)were significantly difference(P<0.05). The postoperative visual acuity improved in 2 eyes(13%), had no change in 11 eyes(73%)and decreased in 2 eyes(13%). During follow-up period, 4 eyes IOP were higher than 21mmHg and decreased to the normal range after the drug treatment. The pain of patients was alleviated. The iris neovascularization of all patients eliminated. No eyeball atrophy, retinal or choroidal detachment occurred during follow-up period.

CONCLUSION: Trabeculectomy and endoscope-assisted vitrectomy combined with retinal photocoagulation is a safe and effective therapy to reduce IOP, saving the residual vision and relieve suffering of patients with NVG.

Abstract:AIM: To investigate effects of minimal dose surgery in the treatment of rhegmatogenous retinal detachment.

METHODS: A total of 102 eyes 89 cases of rhegmatogenous retinal detachment were selected from Jan.2014 to Feb.2016 in our hospital. All patients underwent simple scleral pad pressure combined with condensation surgery without liquid. The therapeutic effect was observed.

RESULTS: The 84 eyes(82.4%)were the first time reset after surgery. And 10 eyes(9.8%)were the second time reset after surgery. The visual acuity of 35 eyes(34.3%)after surgery were <0.1, 38 eyes(37.3%)were 0.1-0.3, 29 eyes(28.4%)were > 0.3, better than the preoperative corrected visual acuity. The difference was statistically significant(P<0.05). The main postoperative complications were corneal edema(20.6%)and temporary intraocular hypertension(9.8%), given the corresponding treatment. They had been effectively alleviated.

CONCLUSION: The effect of minimum dose surgery for the treatment of rhegmatogenous retinal detachment is good, the surgery is simple.

Abstract:AIM: To investigate the clinical effect and safety of intravitreal injection of Conbercept for the treatment of macular edema secondary to retinal vein obstruction.

METHODS: A total of 22 patients with macular edema secondary to retinal vein occlusion were treated in our hospital during January 2016 to Marth 2016. A total of 22 patients were given three intravitreal injections of Conbercept 0.05mL(0.5mg). Defore and after treatment, best-corrected visual acuity, fundus photography,fundus fluoreseein angiograph(FFA),optical coherence tomography(OCT)were examined.

RESULTS: A total of 22 patients were treated with intravitreal injection of Conbercept had different degrees of increase in the mean visual acuity at 1wk, 1, 2 and 3mo. The difference is statistically significant(P<0.05). OCT images show that the thickness of the central retinal thickness of the macular becomes thinner, and the difference is statistically significant(P<0.05). The FFA at 3mo showed a significant reduction in retinal leakage, obvious absorption of retinal hemorrhage.

CONCLUSION: Intravitreal injection of anti-VEGF drugs Conbercept is an effective way to treat macular edema secondary to retinal vein occlusion, it is worth to promot, but the long-term efficacy and drug injection frequency still need to study further.

Abstract:AIM:To investigate clinical efficacy of intravitreal ketorolac for the treatment of chronic cystoid macular edema after cataract surgery.

METHODS:A total of 38 patients with postoperative cystoid macular edema after cataract surgery coming to our hospital for treatment at 2014-2016 were collected. And the patients were treated with intravitreal ketorolac. After treatment, the patients were clinical examined with using optical coherence tomography(OCT)and fundus fluorescein angiography(FFA). And the clinical efficacy was observed. The corrected visual acuity, intraocular pressure and central retinal thickness of the cystoid macular area after cataract surgery were compared and analyzed before and after treatment in different periods(2 and 4wk, 3 and 6mo).

RESULTS:Comparing with before treatment, the leakage was significantly reduced at the FFA after intravitreal ketorolac for the treatment of chronic cystoid macular edema. And the cystoid macular edema in patients regressed. At the same time, the corrected visual acuity was significantly increased(P<0.05), and the intraocular pressure was significantly improved(P<0.05), and the average macular thickness was significantly reduced(P<0.05). The difference was statistically significant.

CONCLUSION:Intravitreal ketorolac for the treatment of chronic cystoid macular edema after cataract surgery has a good clinical efficacy. There is a important clinical significance.

Abstract:AIM: To compare three kinds of surgical treatment of nasolacrimal duct obstruction secondary to the efficacy and safety of dacryocystitis, and to explore the clinical treatment of nasolacrimal duct obstruction secondary to the best operation for dacryocystitis.

METHODS: A total of 348 cases with nasolacrimal duct obstruction secondary dacryocystitis patients(397 eyes)were selected in Jan.2010 to Jan.2016 of our hospital as the research object. According to the treatment of surgery, the research subjects were divided into three groups respectively. The lacrimal duct laser group(130 patients, 152 eyes), the nasolacrimal duct group(113 patients, 127 eyes)and the nasal endoscopy group(105 patients, 118 eyes)of lacrimal duct laser group patients accepted the treatment of lacrimal duct laser lines. Nasolacrimal duct group patients received artificial nose tube stents implantation treatment, patients with nasal endoscopy group underwent anastomosis of lacrimal sac nasal endoscope. The therapeutic effect in three groups of patients and the incidence of adverse reactions were analyzed.

RESULTS: After 1mo, 3 groups of eye treatment effect were statistically significant difference(P<0.05). Lacrimal duct effect of laser treatment group significantly was better than that of the nasolacrimal duct and nasal endoscopy group(P<0.05). The nasolacrimal duct group compared with the effect of nasal endoscopic treatment group was no statistically significant difference(P>0.05). Postoperative 4mo, 3 groups of eye treatment effect comparison results were completely accorded with postoperative 1mo. But the three groups of 4mo after treatment were significantly difference with postoperative 1mo(P<0.05). The incidence of adverse reactions difference in 3 groups was statistically significant(P<0.05). The incidence of adverse reactions of lacrimal duct laser group was significantly lower than the nasolacrimal duct and nasal endoscopy group(P<0.05). The nasolacrimal duct incidence of adverse reactions compared differences between groups with and nasal endoscopy had no statistically significant(P>0.05). Three groups of eye recurrence rate comparison difference had no statistically significant(P>0.05).

CONCLUSION: For the treatment of lacrimal duct laser lines nasolacrimal duct obstruction secondary efficacy and safety of dacryocystitis were good.

Abstract:AIM: To analyze clinical effect of different treatments in treating infant dacryocystitis.

METHODS: A retrospective study included 218 cases(356 eyes)of infant dacryocystitis were collected and were divided into lacrimal sac massage group, lacrimal passage pressure washing group, lacrimal duct probing group, lacrimal probing combined hormones wash group. The cure rate of different groups was observed.

RESULTS: As the age grows, the total cure rate showed a downward trend; lacrimal passage pressure washing group showed significant higher cure rate than that of lacrimal sac massage group. Lacrimal duct probing group showed significant higher cure rate than that of lacrimal sac massage group and lacrimal passage pressure washing group. Lacrimal probing combined hormones wash group showed significant higher cure rate than that of lacrimal probing without hormones wash group. The cure rate of upper lacrimal point probing group was significantly better than that of the lower lacrimal point. Meanwhile, as the age grows, the cure rate of the lacrimal sac massage, lacrimal passage pressure washing group and lacrimal probing group decreased(respectively r=0.553, 0.437, 0.742, P<0.05). The best therapeutic effect of infants and young children who under the age of 1 is the lacrimal sac massage. For patients under 2 years old, lacrimal probing showed a better cure rate, especially upper lacrimal point probing. For patients over 2 years of age, lacrimal probing combined hormone therapy showed a better cure rate.

CONCLUSION: For smaller months, patients under 1-year-old, we prefer the lacrimal sac massage, and for patients over 1 year and under 2 years old, lacrimal probing is firstly recommended, upper lacrimal point probing would be better. For patients more than 4 years old should recommend lacrimal probing combined hormones wash treatment.

Abstract:AIM: To analyze the clinical features and histopathological types of recurrent lacrimal gland tumors.

METHODS: Retrospective study was performed to analyze the clinical manifestation, relapse, histopathological classification and prognosis by the clinical and pathological data of 25 relapsed patients who confirmed by pathological examination in our department from Jan.2004 to Feb.2014.

RESULTS: A total of 21 cases were the first time in 25 patients with recurrence, 1 case was 3 times of relapse, 3 cases of recurrence of 2 times. The last surgery last time to recurrence interval ranged from 1 month to 28 years(mean 1 year). The patients aged from 17.5 to 70 years(mean 47.9 years). The pathological examination showed that: 4 cases were Pleomorphic adenoma, including 2 cases of malignant transformation,10 cases were adenoid cystic carcinoma, 3 cases were epithelial-myoepithelial carcinoma, 3 cases were malignant pleomorphic adenoma and 1 case was adenocarcinoma, 1 case was mesenchymal tissue tumor, 1 case was mucosa-associated lymphoid tissue lymphoma.

CONCLUSION: There are many different kinds of recurrent tumor in the lacrimal gland, with adenoid cystic carcinoma most, the second is pleomorphic adenoma. Relapse rates are higher in the malignant tumor. Pleomorphic adenomas first complete resection surgery is very important to the prevention of postoperative recurrence and canceration. Early and longer-term follow-up is also important to find recurrent tumor.

Abstract:AIM: To discuss the clinical features of dry eye in diabetics according to the comprehensive analysis of clinical symptoms and the clinical index on dry eye in diabetics and non-diabetics.

METHODS: Ninety patients with dry eye were collected from Jun.2014 to Feb.2016 in our hospital. A total of 45 cases of patients(90 eyes)with dry eye in diabetics and 45 cases of patients(90 eyes)with dry eye in non-diabetics were included. Patients in the two groups were provided with questionnaire survey of ocular surface disease index scale Chinese Version(COSDI). And tear break-up time(BUT), Schirmer Ⅰ test(Schirmer Ⅰ), corneal fluorescein staining(FL)were measured.

RESULTS:The OSDI index of dry eye in the diabetic group(46.88±18.51)was higher than that in the non-diabetic group(39.76±13.62). The difference was statistically significant(P<0.05). The corneal fluorescein staining score(1.57±1.33)in the diabetic group was higher than that in the non-diabetic group(1.19±0.82). The difference was statistically significant(P<0.05). The value of Schirmer Ⅰ test in the diabetic group(4.30±1.80)was lower than that in the non-diabetic group(4.80±1.52). The difference was statistically significant(P<0.05). The different value of BUT between two groups was not statistically significant(P>0.05).

CONCLUSION: Based on symptoms, tear secretion and corneal epithelial defects, the influence is more serious inthe diabetic group than that in the non-diabetic group. Eye screening in patients with diabetes mellitus should include dry eye related clinical indexes of examination. So the patients with dry eye in diabetics would be provided timely and effective suggestion and treatment. The symptoms of dry eye and the quality of life would be improved.

Abstract:AIM: To assess the impact of binocular diplopia on vision-related quality of life in adult patients with ocular motility disorders.

METHODS: Retrospective case-series study. A total of 112 binocular diplopic patients with ocular motility disorders who received treatment in the First Affiliated Hospital of Huzhou University and 40 normal subjects were included in this study from Oct.2013 to Mar.2016. Vision-related quality of life was evaluated by the Chinese version of the 25-item National Eye Institute Visual Functioning Questionnaire(CHI-NEI-VFQ-25).

RESULTS: Statistically significant differences between binocular diplopic patients with ocular motility disorders and normal group were found in general health status, overall vision, near activities, distant activities, social functional, mental health, social role difficulties, independency, driving, and perimetry, except for the degree of eye pain(P=0.31)and color vision(P=0.34).

CONCLUSION: This study suggests that binocular diplopic status maybe an important factor affecting vision-related quality of life seriously for patients with ocular motility disorders. Physicians treating binocular diplopic patients with ocular motility disorders should recognize these quality of life issues and address them accordingly.

Abstract:AIM: To compare the effects of different injection sites of type A botulinum toxin in the treatment of blepharospasm.

METHODS:Eighty-five patients(136 eyes)with blepharospasm treated in our hospital between June 2012 and June 2015 were selected as the study subjects and were divided into group A(43 cases, 66 eyes)and group B(42 cases, 70 eyes)by the random number table method. Both groups were treated with type A botulinum toxin injection. Complete injection model was adopted in group A while injection sites except lower eyelid was adopted in group B. The Jankovic rating scale(JRS)scores, blepharospasm disability index(BSDI), break-up time(BUT)and tear meniscus height(TMH)before treatment and at 3wk after treatment, incidence of side effects and recurrence rate in 90d of follow-up were compared between the two groups.

RESULTS: There were no significant differences in JRS score and BSDI between two groups before treatment(all P>0.05); 1 week after treatment, BUT and TMH increased in both groups. Three weeks after treatment, JRS scores and BSDI were lower than those before treatment(P<0.05)but there were no significant differences between groups(P>0.05). After treatment, there were no significant differences in JRS scores, BSDI and BUT between groups(P>0.05). TMH of group A was higher than that of groups B(P<0.05). Ninety days of follow-up showed that the recurrence rates in group A and group B were 14.0% and 11.9%, respectively, and the incidence rates of side effects were 23.3% and 16.7%, respectively(P>0.05).

CONCLUSION: Both of complete injection and injection sites except lower eyelid of botulinum toxin type A in the treatment of blepharospasm can effectively relieve symptoms and the effects on daily life. The 90 d recurrence rates are similar. Injection sites except lower eyelid can reduce the interference to the stability of tear film and lacrimal fluid drainage, with slight advantage.

Abstract:AIM: To measure the changes of anterior chamber morphology after laser subepithelial keratomileusis(LASEK)surgery with Sirius anterior segment analysis system.

METHODS:A total of 53 cases(106 eyes)with myopia underwent LASEK were randomly selected from Jan.2015 to Aug.2015. Applications of Sirius anterior segment analyzer measure the eyes' central anterior chamber depth, anterior chamber angle and anterior chamber volume before operation and at 1, 3, 6mo, 1y after operation.

RESULTS: Within 1 year after LASEK, central anterior chamber depth and volume compared with the preoperative decreased significantly(P<0.05). The anterior chamber angle than preoperative no change(P>0.05). Each time point within 1 year after LASEK, central anterior chamber depth, anterior chamber angle, anterior chamber volume did not change(P>0.05).

CONCLSION: The central anterior chamber depth and anterior chamber volume is decreased after LASEK, but the depth of the anterior chamber and the volume of the anterior chamber are unchanged in 1 years after the operation. The anterior chamber angle is not changed after LASEK operation. Therefore, in the follow-up period, the morphology of the anterior chamber is stable after LASEK.

Abstract:AIM: To analyze the effects on binocular vision after wearing Ortho K(OK)contact lens for myopic anisometropia.

METHODS: A total of 40 cases of myopic anisometropia corrected by Ortho K contact lens were collected. The average age of participants was 11.32±2.56y. The refractive error varied from -1.25D to -5.75D, on average -3.18±1.12D. The amount of myopic anisometropia was -4.64±1.52D. All the cases were followed-up for 3mo. The uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), refraction and binocular vision were checked pre-wearing Ortho K contact lens, and 3mo post wearing respectively.

RESULTS:The mean UCVA was 4.0±0.2, and BCVA was 4.96±0.2, the amount of myopic anisometropia was -4.64±1.52D pre-wearing OK contact lens. The mean UCVA was 4.97±0.07, and BCVA was 4.99±0.1, the amount of myopic anisometropia was 0.23±0.12D, at post wearing OK lens 3 months respectively. The UCVA, BCVA, the amount of myopic anisometropia at post correction was significantly difference with pre-correction(P<0.05). Before correction, 36 cases got simultaneous binocular visions, 21 cases got combined visions, 13 cases got long distance stereopsis visions. Simultaneous binocular visions existed in 40 cases, combined visions existed in 36 cases, long distance stereopsis visions existed in 23 cases post correction 3mo. Compared with pre-correction, the difference was significantly. Before correction, 14 cases had macular fovea stereo vision. Abnormal stereo vision existed in 26 cases, including 13 cases with macula stereo vision, 7 cases with peripheral stereo vision, and 6 cases with stereo vision blind. Macular fovea stereo vision was found in 27 cases, Abnormal stereo vision existed in 13 cases, including 7 cases with macula stereo vision, 3 cases with peripheral stereo vision, and 3 cases with stereo vision blind after wearing Ortho K contact lens 3mo.

CONCLUSION:Most myopic anisometropia patients can improve their visual acuity, reduce the refractive difference, and increase combined and stereopsis vision after wearing Ortho K contact lens 3mo.

Abstract:AIM: To observe the visual function of anisometropia amblyopia training effect for the treatment of late amblyopia eyes visual function recovery.

METHODS:Group of 23 children on the basis of quantitative cover glasses and adjust the disinhibition, monocular amblyopia eyes, eyes set training, eyes like training, eyes scanning training, eye movement, such as training, the control group of 20 children on the basis of quantitative cover glasses and only the brush, red flashing light, such as grating, fine mesh training amblyopia training.

RESULTS:Between experimental group and the control way comparison before and after treatment in stereoscopic, AMP, AF, the NRA, PRA, the NPC has significant difference(P<0.05), the experimental group compared with control group in the group with no difference between the data before the treatment, the experimental group and control group after treatment in group and the contrast stereoscopic, AMP, AF, PRA, NPC has significant difference(P<0.05)while the NRA no difference(P>0.05), but the experimental group was better than control group from the data.

CONCLUSION:Binocular visual function training in amblyopia treatment later joined significantly improve the therapeutic efficacy of binocular visual function recovery.