Abstract:AIM:To investigate the awareness, knowledge and self-reported prevalence about the cataract, glaucoma and age-related macular degeneration(AMD)in Chengdu, China.

METHODS:A structured questionnaire was first designed on the awareness and knowledge of the cataract, glaucoma, and AMD. The survey was then conducted in 6 randomly selected nursing homes from Chengdu and in outpatient clinics of non-ophthalmologic departments of West China Hospital with the questionnaire. Chi-square test was applied to determine a certain factor's impact on the awareness or knowledge rates and to determine the difference between awareness rates in our research and others' studies.

RESULTS:Of the participants, the awareness rates of the cataract, glaucoma and AMD were 89.9%, 68.9% and 12.5% respectively. Among the people aware of each disease, the knowledge rates of the cataract, glaucoma and AMD were 70.9%, 48.1% and 44.9%. Educational level was a factor affecting awareness rates of all three diseases; information source was a factor affecting the knowledge rates of each ocular disease. The self-reported prevalence of the cataract, glaucoma and AMD were 7.8%, 1.1%, 0.6% in all participants, and 12.5%, 1.6%, 1.0% in the participants over 40. The proportions of the participants having taken the visual acuity test, intraocular pressure examination, and fundus examination were 72.1%, 17.9%, and 20.2%.

CONCLUSION:According to the data firstly reported in mainland China in our study, it is necessary to improve people's awareness and knowledge of the cataract, glaucoma, and AMD, especially the latter two. Meanwhile, we suggest people taking regular ophthalmologic examinations even without a history of eye diseases.

Abstract:AIM:To explore the levels of serum total adiponectin, high-molecular-weight(HMW)adiponectin and its ratio in type 2 diabetic retinopathy and to investigate risk factors of non-proliferative diabetic retinopathy.

METHODS:Three hundred and seventy-four subjects were recruited from an epidemiological survey, including 88 patients with proliferative diabetic retinopathy, 124 patients with non-proliferative diabetic retinopathy, 78 patients only with type 2 diabetes mellitus and 84 healthy volunteers. Demographics, physical and laboratory parameters were collected. Serum total and HMW adiponectin levels were detected by ELISA. The main statistical analysis included covariance analysis and cumulative logit model.

RESULTS:Total adiponectin level was higher in healthy group than in groups of only diabetes, non-proliferative and proliferative diabetic retinopathy(harmonic mean, 5.717, 3.310, 3.288, 3.822 μg/ml, F=18.792, P<0.01). Total adiponectin in proliferative diabetic retinopathy increased compared with non-proliferative diabetic retinopathy(harmonic mean, 3.822, 3.288 ug/ml, P<0.05). HMW adiponectin level of healthy group is more than other groups(harmonic mean, 2.490, 1.425, 1.409, 1.633 μg/ml, F=14.025, P<0.01). HMW adiponectin among only type 2 diabetes mellitus, non-proliferative and proliferative diabetic retinopathy groups had no differences(P>0.05). The ratio of HMW adiponectin and total adiponectin had no differences among four groups(F=0.650, P>0.05). Drug history, high levels of high density lipoprotein cholesterol, total and HMW adiponectin had protective effects to the non-proliferative diabetic retinopathy(P<0.05). Older age, long duration of diabetes, high level of tumor necrosis factor-α(TNF-α)were independent risk factors.

CONCLUSION:The lower concentrations of serum total and HMW adiponectin may result in the occurrence of non-proliferative diabetic retinopathy. And the total adiponectin level was related to the severity of diabetic retinopathy.

Abstract:AIM:To evaluate the extent of damage caused by moderate and severe glaucoma on ganglion cell inner plexiform layer(GCIPL)and to evaluate the diagnostic performance of this layer compared to the peripapillary retinal nerve fiber layer(PRNFL). This was performed by comparing their area under the curve(AUC)sensitivity and specificity.

METHODS:This study is a prospective study. Two hundred ten eyes(54 eyes of 30 moderate glaucoma subjects, 59 eyes of 34 severe glaucoma subjects and 97 eyes of 50 normal subjects)were enrolled in this study. Patients underwent complete ophthalmic examination, visual field(VF)examination and also 3D optical coherence tomography(OCT)of the disc and 3D vertical(V)OCT of the macula were performed. The GCIPL and PRNFL AUC, sensitivity and specificity were performed and compared.

RESULTS:A significantly thinner superior, inferior and total GCIPL and PRNFL thickness in moderate and severe glaucoma groups was detected(all P<0.001). In moderate glaucoma, GCIPL showed higher sensitivity and specificity than PRNFL(only the superior half shows equal sensitivity). As regard severe glaucoma the total, superior and inferior sensitivities of the GCIPL were lower than the PRNFL. The total GCIPL specificity was lower than the PRNFL. The superior GCIPL specificity was higher than the PRNFL. The lower GCIPL specificity was equal to that of the PRNFL.

CONCLUSION:The ability of the macular GC/IPL parameters to discriminate moderate and severe glaucoma is high and comparable to that of the PRNFL. A combination of both in the baseline evaluation is optimal and provides more accurate assessment of the extent of damage.

Abstract:AIM:To describe the epidemiology of work-related ocular injuries and its visual outcome in tertiary hospital in southern Malaysia.

METHODS:Retrospective review of medical records of patients diagnosed as work-related ocular injuries who attended to the eye casualty of Hospital Sultan Ismail in Johor Bahru, Malaysia from Jan. 2011 to Dec. 2013. Data for clinical presentation, types of injuries, use of eye protective device(EPD)and visual outcome were collected using a standardized proforma.

RESULTS: A total of 935 ocular injuries attended to Hospital Sultan Ismail during 3y period. Among them 440 cases were work-related ocular injuries and included in the study. There was significant male preponderance(98.19%)and commonest age group affected was 21 to 30y(45%). The most common type of injury was superficial injuries(70.91%), followed by chemical(11.13%), open globe(8.41%), closed globe(6.83%)and thermal(2.72%). Although Malays are commonly involved in work-related ocular injury accounted for 78.47%, two-thirds of open globe injuries were seen in foreign workers. Only 59 patients(13.41%)reported that they wore EPD at the time of incident. Generally, 89.86%(n=399)had good vision, 5.45%(n=24)had moderate vision and 3.86%(n=17)poor vision. Visual outcome related to specific types of injuries showed that poor outcome was higher in open globe injuries groups compared with closed globe injuries \〖odd ratio(OR)=3.33, 95% confidence interval(CI)=0.68 to 16.33\〗. Overall hospital attendance rate of work-related ocular trauma ranged from 20.7 to 51.9 per 1000 new cases and decline of approximately 1.5% per year(P<0.05)from 2011 to 2013. In contrast, the in-patient admission due to work-related ocular injuries increased over 3y period. Estimated rate of monocular blindness or low vision \〖best-corrected visual acuity(BCVA)≤3/60\〗 due to work-related ocular injury was 1.26 per 1 000 hospital attendance(95% CI=0.74 to 2.02).

CONCLUSION: Work-related ocular trauma is important cause of ocular morbidity in working forces particularly young men. Malay males between 21 to 40y have higher risk. Majority of work-related ocular trauma seen in our hospital are generally of superficial injuries and potentially preventable. This study indicates they need to improve safety measures to prevent undesirable sight loss and economic burden to society as well as to establish for eye injury registry.

Abstract:AIM: To identify the presence change of bone morphogenetic protein-2(BMP-2)in sclera of form deprivation myopic(FDM)eyes in C57BL/6 mice and to investigate its role in sclera remodeling.

METHODS: A total of 64 C57BL/6 mice which were 3～4wk were randomized into FDM-21d group(n=16),a normal control group(n=16); FDM-28d group(n=16)and a normal control group(n=16). FDM models were established by sutured 0.5mL PCR plastic caps to the skin surrounding the right eye for 21 days and 28 days in experimental group, and the fellow eyes served as the self-control eyes. Diopter and axial length of all eyes was tested by retinoscopy optometry and vernier calipers before and after the form deprivation. As the models established, the sclera of the mice were obtained and hematoxylin and eosin(H-E)staining were used for observing the morphological change in the tissue. Immunohistochemical staining and fluorescence quantificational real-time polymerase chain reaction(QRT-PCR)were applied to investigate the expression of BMP-2 protein and mRNA.

RESULTS: After 21 and 28d,the diopter of the deprived eyes was -1.60±1.03D and -3.10±1.19D and the axial length was prolonged by 16±12μm and 21±13μm respectively. The differences were statistically significant, compared to self-control eyes and to normal control groups(P<0.05). After stained by H-E, the sclera from the deprived eyes became thinner and the sequence of collagenous fiber disappeared. The results from the immunohistochemical staining and QRT-PCR showed that mRNA and protein of BMP-2 decreased significantly, and the differences were statistically significant, compared to self-control eyes and to normal control groups(P<0.05).

CONCLUSION: The expressions of the BMP-2 in sclera down-regulate significantly in FDM eyes,which suggests that BMP-2 may play an important role in sclera remodeling during myopia development.

Abstract:AIM: To apply different doses of polygona-polysaccharose(PSP)to diabetic rats model by gastrogavage that were induced by streptozotocin(STZ), then check the rats about anterior segment, F-VEP, ERG, fundus fluorescein angiography(FFA)and measure fasting blood glucose(glucose oxidase method)by inner canthus vein blood to observe the eye disease process at different time points and to discuss the protective effect of PSP on ocular lesions in DM rats and the treatment effect, to provide the experimental basis and theoretical basis for PSP treating diabetic ocular disease.

METHODS: One hundred male SD rats were randomly divided into 2 groups: diabetic model group(80 rats induced by STZ)and blank control group(20 rats). Then the diabetic model group was randomly divided into 4 subgroups. The group DM(diabetic group)had 20 rats with normal diet and 2mL physiological saline for daily gavage. PSP gavaged groups included three subgroups and with 20 rats in each group, group L(low dose of PSP gavage group, 200mg/kg), group M(medium dose of PSP gavage group, 400mg/kg), group H(high dose of PSP gavage group, 800mg/kg). Every group was gavaged with 2mL PSP. Twenty rats in group BC(blank control group), and they were gavaged saline of equal dose as control. After the success of modeling, 5 groups were under the same conditions of feeding, and gavaged every day. At 2, 4, 6, 8, 10 and 12wk, anterior segment examination and FFA were given. At 4, 8 and 12wk, F-VEP and ERG were given. Fasting blood glucose(by glucose oxidase method)was measured through inner canthus vein blood.

RESULTS: Compared to BC group, fasting blood glucose levels were significantly higher in group DM, L, M and H(P<0.05). Compared to DM group, fasting blood glucose level decreased in L, M, H group(P<0.05). The fasting blood glucose levels of L, M and H groups showed a time and dose dependent relationship. After anterior segment examination, there were 6 rates in DM group, 3 in L group, 1 in M group with different degrees of cataract symptoms which became more serious with time. The BC group was not found any abnormal in the anterior segment. Examined by F-VEP, the rats in group DM showed extension of the P100 peak latency. Compared to the group DM, PSP gavaged group showed a shortened of the extension of the P100 peak latency, while the group BC had no obvious change. In the ERG examination, the rats in group DM showed that amplitude of Max-R a, b wave decreased by 51.2%, 59.8% and amplitude of Cone-R a, b wave decreased by 31.4%, 41.2%. The Ops OS value and amplitude of 30Hz Flicker N1-P1 decreased, there was a significant difference compared to group BC. PSP gavaged group was better than group DM. In the FFA examination, in group DM, we could find the typical manifestations of diabetic retinopathy background fluorescence enhancement, distortion of the blood vessels and blood capillary dilate, retinal vascular leakage of fluorescein and intraretinal hemmorhages compared with the group BC. PSP gavaged group was better than group DM.

CONCLUSION: PSP can effectively reduce the blood glucose levels of diabetic rats,and also can delay the process of ocular complications in diabetic rats, which have an obvious therapeutic effect on ocular lesions. The mechanism is likely to improve the metabolism of glucose and lipid metabolism, increase the amount of glucose tolerance, and play a protective role in diabetic lens metabolism and retinal microvascular disease.

Abstract:AIM:To make better postoperative visual quality and satisfaction, we propose individualized plans of intraocular lens for age-related cataract patients.

METHODS:Patients with cataract who hospitalized in our department from July 2009 to April 2015 were recruited as objects. According to patients' implanted IOL types we divided them into 4 groups:spherical group, non-spherical group, astigmatism group and multi-focal group. Three months after the surgery, the patients were examined by subjective visual quality, satisfaction degree, visual acuity, total astigmatism and contrast sensitivity.

RESULTS:A total of 174 patients(254 eyes)were enrolled. The average satisfaction of the patients was 8.17±1.02 scores, and the satisfaction of the astigmatism group and the multi-focal group were higher than the other 2 groups(P<0.05). The postoperative visual acuity of the 4 groups were statistically significant higher(P<0.05)than the preoperative, in which the postoperative near visual acuity of multi-focal group was significantly higher than the other 3 groups(P<0.05). The day contrast sensitivity under 3, 6, 12 and 18c/d spatial frequency and the night contrast sensitivity under 18c/d spatial frequency of the astigmatism group was better than the other 3 groups(P<0.05).

CONCLUSION:Individualized plans of intraocular lens are aimed to recommend appropriate types of IOL according to the different ocular conditions and postoperative needs of patients. It has great significance to improve the patients' visual acuity, contrast sensitivity and satisfaction.

Abstract:AIM:To observe the clinical effect of 1.8mm clear corneal incision phacoemulsification with ultra-thin intraocular lenses(IOLs)implantation for the treatment of short eye axis cataract, and to compare with the 3.0mm traditional clear corneal incision phacoemulsification.

METHODS:A prospective randomized study. Eighty-four cases(84 eyes)with short eye axis were selected. Ocular axis ranged 17.68～21.32mm(the average axis was 20.26±1.59mm). The cases with age-related cataract were randomly divided into two groups. Micro incision group(group A):1.8mm coaxial micro-incision phacoemulsification with ultra-thin IOLs implantation; Small incision group(group B):3.0mm coaxial small incision phacoemulsification with IOLs implantation. The effective phaco time(EPT)and the mean intraoperative ultrasound energy(AVE)were recorded. The postoperative best corrected visual acuity, intraocular pressure(IOP), central anterior chamber depth, corneal endothelial cell density, surgically induced astigmatism and operation complications were observed. All cases were followed up at 1d, 1wk, 1 and 3mo.

RESULTS:The EPT of group A and group B were 6.88±3.05, 7.04±3.57s respectively, the AVE were(14.54±7.26)% and(15.08±3.67)%. The EPT and AVE had no statistically significant difference between the two groups. At postoperative 1d, 1wk, 1 and 3mo, surgically induced astigmatism of group A was lower than that of group B and there was a significant difference between the two groups(P<0.05). The best corrected visual acuity and corneal endothelial cell density had no significant difference between the two groups. Postoperative intraocular pressure was significantly decreased in two groups and postoperative anterior chamber depth was significant deepen. Anterior chamber kept stable in all patients, no complications and no incision thermal burn were found during the operation.

CONCLUSION:The 1.8mm coaxial micro-incision can effectively reduce the astigmatism,and significantly improve the early visual function for treatment of short eye axis cataract compared to traditional 3.0mm coaxial small incision phacoemulsification.

Abstract:AIM:To evaluate the clinical outcomes of the Toric intraocular lens(Toric IOL)for correction of corneal astigmatism in cataract patients with prolonged axial length.

MEHTODS:This prospective series case study included 64 eyes in 64 patients with corneal astigmatism and cataract. The experimental group consisted of 30 patients with cataract and prolonged axial length. The control group consisted of 34 patients with cataract and normal axial length. The uncorrected distance visual acuity, best corrected distance visual acuity, preoperative corneal astigmatism, predicted residual astigmatism, residual astigmatism and Toric IOL axis rotation were measured preoperatively and post operatively.

RESULTS:After the operations, the uncorrected distance visual acuity in the experimental group was 0.06±0.11 and in the control group was 0.03±0.08, both were improved compared to those before the operations(P<0.01).But there was no statistically different between the two groups(P>0.05).The residual astigmatism between the two groups(0.44±0.09 vs 0.41±0.08)was no statistically different(P>0.05).The mean IOL axis rotation in experimental group(4.43°±1.36°)was higher than that of the control group(3.59°±1.1°)and the difference was statistically significant(P<0.01).

CONCLUSION:Toric IOL rotation is greater in eyes with a prolonged axial length. But there is no differences on uncorrected visual acuity, residual astigmatism, compared with patients with normal axial length.

Abstract:AIM:To explore the main risk factors related to the incidence of cataract in China and to provide evidence for the prevention.

METHODS:The results of 17 studies on the main risk factors of cataract were analyzed by Meta-analysis method.

RESULTS:The pooled odds ratio values and 95%CI of age, hypertension, diabetes, smoking, presence of merging other eye diseases and long-term exposure to sunlight were 2.48(1.82～3.36),1.88(1.28～2.75),3.55(2.41～5.24),2.58(1.45～4.56),2.39(1.50～3.82),1.82(1.08～3.06).

CONCLUSION:The main risk factors of cataract were age, hypertension, diabetes, smoking, presence of merging other eye diseases and long-term exposure to sunlight.

Abstract:Myopia, especially high myopia, is one of the most important eye diseases in the world. For many years the researchers established a variety of animal models and animal experiments to explore the mechanism of development of myopia. Guinea pig is one of the most commonly used myopia models in recent years. It has obvious advantages in many aspects, and it is a kind of experimental animals which is worth to be further applied to different kinds of myopic experiments and to be studied thoroughly. This article reviews the induction methods and the forming process of the guinea pig myopia model.

Abstract:Despite the many advances in cataract surgery, incorrect intraocular lens(IOL)power remains a significant clinical problem which seriously affects the postoperative visual quality and satisfaction. Adjustable intraocular lens can be adjusted to provide a new way to solve this problem. The general concepts and clinical significances of adjustable IOL, as well as the designs and studies of several kinds of adjustable IOL, are described in this review. Adjustable IOL will give a new technological innovation to the cataract surgery to improve outcomes and increase expectations.

Abstract:As past epidemiological results show, in addition to cataract, glaucoma is the second major cause of blindness in the world. Among them, primary open angle glaucoma is with high incidence, low and unobvious development. Its cause and pathogenesis is complex and diverse. In the early stage, most patients have no obvious symptoms. Most of them have entered middle or late stage when they visit the doctor and the visual impairment is irreversible, which extremely harm the family and the society. Therefore, early detection and treatment is the first priority to prevent further damage to visual function in patients with glaucoma. In recent years, with the proportion of the disease increasing year by year, new methods of diagnosis and treatment is one after another. But whether in early or late stage, reducing the intraocular pressure(IOP), keeping it in the target IOP range and delaying the visual impairment are still the ultimate goal of treatments. This test will be a summary of the diagnosis and treatment of primary open angle glaucoma based on the relevant literature in recent years.

Abstract:As a kind of refractory glaucoma, the neovascular glaucoma causes severe pain and is extremely destructive with very high rate of blindness. Though there were a variety of clinical treatments to the neovascular glaucoma, their effects are very limited. With the application of new technology in recent years, many new kinds of treatment methods and strategies are applied in the clinic, such as anti-VEGF agents and glaucoma drainage devices, and the therapeutic effect is thus improved to some extent. Combined treatments can improve the efficacy from improving the blood supply for retina, anti-angiogenesis and anti-glaucoma. A more appropriate treatment coming with the individual situation of patients' visual acuity may help keep the remaining vision at the greatest extent, relieve the pain. Based on the literatures published at home and abroad during recent years, this paper gives a brief review on the advances in treatment of neovascular glaucoma.

Abstract:Curcumin as one kind of phenolic pigment extracted from dietary spice turmeric, has various pharmacological activity, which including anti-inflammatory, antioxidation, anticoagulation, hypolipidemic, anti-atherosclerotic, antineoplastic and antimutagenicity. Inducing apoptosis of tumor cells is one of the mechanisms of anti-tumor as well as anti-tumor-angiogenesis. The mechanisms of anti-angiogenesis include effecting the proliferation and apoptosis of vascular endothelial cell; inhibiting the expression of angiogenesis-promoting factor, such as inhibiting vascular endothelial growth factor(VEGF)and its receptor to inhibit the formation of angiogenesis of tumor; reducing the activity of matrix metalloproteinases(MMPs)and acting through the phosphatidylinositol-3-kinase(PI3K)signaling pathway, the mechanism of which is to down-regulating the PI3K/AKT and MAPK pathways in order to down-regulating VEGF, Ang-1,Ang-2, VEGFR-2 and etc. Further research for effects of curcumin for mechanism of anti-tumor-angiogenesis will lay the foundation of more effective therapy on anti-tumor-angiogenesis, which is useful for prevention and treatment of cancer.

Abstract:Nasolacrimal duct obstruction is a common disease, which have a high morbidity. The treatment of this disease is to take surgeries. In recent years, with new materials and various kinds of endoscopic technique gradually maturing, the treatment for nasolacrimal duct obstruction have had great advance. But after the operation,there are some people whose nasolacrimal duct obstruction happen again. The research on the mechanism of recurrence of nasolacrimal duct obstruction also increased nowadays.In this paper, the surgical treatment and the mechanism of the recurrence of nasolacrimal duct obstruction were reviewed.

Abstract:Because of the rapid improving of corneal refractive surgery with laser, its characteristics such as safety, stability, availability and predictability have already been proved by clinical practice. Laser in situ keratomileusis(LASIK), epipolis laser in situ keratomileusis(Epi-LASIK), femtosecond laser in situ keratomileusis(FS-LASIK)and small incision lenticule extraction(SMILE)are the main operational methods. SMILE has gradually been being accepted by young and middle-aged with its minimal invasive and little post-surgery complications. Dry eye syndrome is one of the most common complications that may affect the visual effect of the surgery. Specialists and patients have paid more attention to dry eye disease after corneal refractive surgery. According to clinical and experimental researches, the basic condition of ocular surface before surgery, the application of drugs in or after the surgery, the type of refractive surgery that operator choose, as well as the damage and reinnervation of corneal nerve all play important roles in post-surgery dry eye. This article reviews the pathogen of dry eye disease after surgery and the prevalence of dry eye after surgery.

Abstract:Some recent animal experiments and psychophysical studies indicate that patients with amblyopia have a structurally intact binocular visual system that is rendered functionally monocular due to suppression, and interocular suppression is a key mechanism in visual deficits experienced by patients with amblyopia. The aim of this review is to provide an overview of recent psychophysical findings that have investigated the important role of interocular suppression in amblyopia, the measurement and modulation of suppression, and new dichoptic treatment intervention that directly target suppression.

Abstract:AIM:To investigate the clinical features of acute pediatric optic neuritis and the therapeutic effect of high-dose methylprednisolone pulse therapy.

METHODS:Fifty-eight cases with acute pediatric optic neuritis hospitalized in the ophthalmological department of Nanjing Children's Hospital Affiliated to Nanjing Medical University from June 2006 to June 2014 were enrolled. The therapeutic effect of high-dose methylprednisolone pulse therapy for the patients below 16 was evaluated using comparison of changing of effected eyes' sights, fundus examination and pupil size between pre- and post-therapy.

RESULTS:Among the 58 cases, 103 eyes got acute pediatric optic neuritis, while 55.2% etiological factors were clearly related to infect. One child(2 eyes)developed to disseminated encephalomyelitis and others unclear. The visual acuity recovered up to 0.7 in 80.5% patients, including almost 2/3 eyes were ≥1.0, while only 3.9% of them were ≤0.1 at 3mo after the therapy. Only two eyes did not show a significant improvement in visual acuity, visual fields and visual evoked response at 1mo after the therapy, reaching a frequency of 1.9%. The recovery rate of high-dose glucocorticoid pulse therapy was 60.2%, while the general effective rate was 98.1%.

CONCLUSION:Infection is the main cause of pediatric optic neuritis. The therapeutic effect of high-dose glucocorticoid pulse therapy is significant, and is valuable to spread.

Abstract:AIM: To observe the clinical effects of 23-G micro-incision vitrectomy combined with 1.8mm micro-incision phacoemulsification and immediate intraocular lens(IOL)implantation.

METHODS: A retrospective analysis were done in 48 patients with 54 eyes from September 2014 to March 2015 in our hospital who received micro-incision vitrectomy combined with micro-incision phacoemulsification and immediate IOL implantation. Best corrected visual acuity(BCVA), intraocular pressure(IOP), corneal astigmatism and corneal endothelial cells were recorded before and at 1d, 1 and 3mo after operations. All patients were followed up to observe the fundus, IOL position and postoperative low IOP, corneal edema, posterior capsular opacification, ocular hypertension and other complications.

RESULTS: All procedures were successfully completed. After 3mo, BCVA increased in 49 eyes(91%)compared to that preoperative. Visual acuity did not improve in 5 eye(9%), and no visual acuity decreased. The differences on IOP and corneal endothelial cells before and after operation were significant(P<0.01). The percentage of lost corneal endothelial cells was 11.71±8.12% at 3mo. At early stage postoperatively corneal astigmatism increased(P<0.05)and there was no difference between that pre-operative and 3mo post-operatively(P>0.05).There were 6 eyes with transient high IOP(IOP greater than 25mmhg in 1mo), 7 eyes with corneal edema at early stage, 2 eyes with formed exudation in anterior chamber, and there were 3 eyes with posterior capsular opacification, in which 2 eyes were performed with YAG laser for posterior capsulotomy and whose visual acuity improved significantly. There was no retinal detachment, choroidal detachment, endophthalmitis, neovascular glaucoma, hypotony, IOL misalignment or dislocation.

CONCLUSION: Micro-incision vitrectomy combined with micro-incision phacoemulsification and immediate IOL implantation is a safe and effective method with wide application, small damage, rapid recovery and less complication, and it is worth of promotion.

Abstract:AIM:To observe the changes of anterior segment before and after phacoemulsification and intraocular lens implantation in patients with primary angle-closure glaucoma(PACG)by Pentacam system,so as to assess the efficacy and the influence factors for treating PACG.

METHODS:One hundred and sixty-three patients(178 eyes)with PACG were included in the presented study, which were classified to acute PACG(APACG, 87 patients with 92 yes)and chronic PACG(CPACG, 76 patients with 86 eyes).Phacoemulsification and posterior-chamber IOL(PC-IOL)implantations were performed for all eyes and combined with goniosynechialysis if necessary. Visual acuity, intraocular pressure(IOP), the central anterior chamber depth(ACD),anterior chamber volume(ACV)and peripheral anterior chamber angle(ACA)were examined by Pentacam system pre-operatively and 1d, 1wk, 3 and 6mo post-operatively.

RESULTS:In both groups, the IOP was significantly decreased after operations(P< 0.01), Which in patients with APACG were 51.17±6.58mmHg and 14.32±2.66mmHg and in patients with CPACG were 33.25±5.45mmHg and 15.86±3.54mmHg. The IOP significantly decreased more in patients with APACG than that in patients with CPACG(P<0.05). The visual acuity was also improved after operations(P<0.01)and it improved more in patients with APACG than that in patients with CPACG(P<0.01). Postoperative gonioscopy(at 3mo)results demonstrated that the angle of anterior chamber opened wider and the range of peripheral anterior synechiae(PAS)reduced after surgeries. The ACD, ACV and ACA were increased significantly after surgeries(P<0.01)detected by Pentacam in all patients. In patients with APACG: ACD before and after surgeries were 1.69±0.14mm vs 2.83±0.10mm respectively; ACV were 68.34±14.02μm³ vs 145.85±14.36μm³; ACA were 18.28°±4.46° vs 30.50°±4.23°. In patients with CPACG: ACD before and after surgeries were 1.96±0.20mm vs 2.82±0.10mm; ACV were 88.19±15.86μm³ vs 141.28±14.64μm³; ACA were 22.03°±4.48°vs 31.65°±4.62°. Compared to CPACG group, the ACD, ACV and ACA of patients with APACG were significantly lower before operations(P<0.01)while after operations, except for ACV, no differences were found on the three indicators(P>0.05). The changes on ACD, ACV and ACA before and after operations were significant between patients with APACG and CPACG(P<0.01).

CONCLUSION:Pentacam system can directly demonstrate the changes of anterior segment before and after phacoemulsification combined with IOL for angle-closure glaucoma. It demonstrates that the anterior segments maybe closely related to the mechanisms of PACG, the changes of which contributes significantly to the clinical effects of phacoemulsification and PC-IOL implantation for both APACG and CPACG patients. The difference of clinical efficacy for APACG and CPACG is maybe correlatied to the different mechanisms.

Abstract:AIM:To study the effect of β-blockers combined with carbonic anhydrase inhibitors on postoperative intraocular pressure(IOP)control of neovascular glaucoma.

METHODS:Seventy-four patients(80 eyes)with neovascular glaucoma received surgical treatment in our hospital from May 2012 to October 2014 were randomly divided into observation group and control group. Observation group received β-blockers combined with carbonic anhydrase inhibitors treatment. Control group received monotherapy of β-blocker. Then IOP, cytokine levels, curative effect were compared between the two groups.

RESULTS:Curative effect:the efficacy rate of observation group(93%)was significantly higher than that of control group(74%, χ²=4.931, P<0.05); IOP level:at 3mo after treatments, average IOP, IOP peak, IOP fluctuation of observation group were significantly lower than those of the control group(t=13.422, 11.555, 8.129, P<0.05); Cytokines:at 7d after treatments, serum and aqueous humor vascular endothelial growth factor(VEGF)and interleukin-6(IL-6)of observation group content were significantly lower than those of the control group, pigment epithelium derived factor(PEDF)was significantly higher than that of the control group(t=11.762, 7.608, 5.275, 3.780, 7.450, 2.625, P<0.05).

CONCLUSION: The therapy of β-blockers combined with carbonic anhydrase inhibitors can help to reduce the level of postoperative IOP in neovascular glaucoma patients, regulate the synthesis of cytokines, and then improve therapy effect.

Abstract:AIM:To evaluate the efficacy of grid pattern laser photocoagulation alone or combined with intravitreal injection of ranibizumab for the treatment of diabetic macular edema.

METHODS:Seventy-eight patients(78 eyes)with non-proliferative diabetic retinopathy(NPDR)and diabetic macular edema hospitalized in Department of Ophthalmology of Guangning People's Hospital from December 2012 to June 2015 were collected and randomly divided into two groups, combined therapy group and mono- therapy group. The 41 patients in combined therapy group received the intravitreal imjection of Ranibizumab then photocoagulation treatment at 10d after the injection. The 37 patients in mono-therapy group received the treatment of photocoagulation only. Pre- and post-treatment outcomes including best corrected visual acuity(BCVA)and central macular thickness(CMT)were compared. The period of follow-up was 6mo.

RESULTS:At the end of follow-up, the effective rate of the combined therapy group was better than that of mono-therapy group(P<0.05). In mono-therapy and combined therapy group, the CMT had been decreasing gradually after treatments(P<0.05). In the comparison of CMT between the two groups at 1, 3 and 6mo after treatments, the combined therapy group were better and the difference was statistically significant(P<0.05). Photocoagulation alone or combined with intravitreal injection of ranibizumab for the diabetic macular edema both have an effect on reducing the macular edema in a short time(in 6mo)and on improving the visual acuity, while the combined therapy has a better effect than the mono-therapy.

CONCLUSION:The grid pattern laser photocoagulation combined with intravitreal injection of ranibizumab will be the preferred therapy for DME in primary hospital in the future.

Abstract:AIM: To evaluate the efficacy and safety of panretinal photocoagulation(PRP)and sub-panretinal photocoagulation(sub-PRP)for pre-proliferative diabetic retinopathy(PPDR)and its effect for macular.

METHODS: From January to December 2014, 61 patients with PPDR were divided into observation group(24 patients with 43 eyes who received sub-PRP)and control group(37 patients with 66 eyes who received PRP). Their clinical data and follow-up results were reviewed.

RESULTS: The efficiency rate of visual acuity and of retinopathy were 77% and 81% in observation group at 6mo after treatments. The two indicators in control group were 76% and 80% and the difference on the two indicators between the two groups were not statistically significant(P>0.05).The central macular thickness and volume of macula reached peak in both group at 1mo after photocoagulation and compared to those before treatments, the differences were statistically significant(P<0.05). The central macular thickness and volume of macula in observation group was significantly lower than those of control group(P<0.05). At 3mo after treatments, the central macular thickness and volume of macula in sub-panretinal photocoagulation group had returned to the level before treatments(P>0.05), while those of panretinal photocoagulation group were higher than those before treatments and those of observation group(P<0.05). At 6mo after photocoagulation, the central macular thickness and volume of macula were lower in both groups compared to those before treatments(P<0.05).

CONCLUSION: The effect of sub-PRP on PPDR is comparable to that of PRP, while the effect on the macula is smaller.

Abstract:AIM:To investigate the effect of a Chinese medicine(Qi Ming granule)on the retinal and choroidal circulation in diabetes patients.

METHODS: According to the results of fundus fluorescein angiography(FFA), all the 45 diabetes patients were divided into no diabetic retinopathy(NDR)group and nonproliferative diabetic retinopathy(NPDR)group. All subjects were examined by FFA and indocyanine green angiography(ICGA)at the same time. After taken Qi Ming granule for 3mo, all subjects were examined by the same method. FFA and ICGA were used to evaluate the retinal and choroidal circulation and their features. The key points were filling time for the retinal and choroidal circulation before and after treatments. The accuracy data was used to evaluate the effect.

RESULTS: After taken Qi Ming granule for 3mo, there were significant decrease of the retina and the choroid filling time in NDR and NPDR groups. The occurrence rate of various abnormal angiographic features were significantly decreased.

CONCLUSION: Qi Ming granule can accelerate the blood flow of retina and choroid, improve the blood circulation in diabetes patients, and delay the occurrence and development of diabetic retinopathy.

Abstract:AIM: To observe the clinical efficacy of vitrectomy combined with two surgical methods for the treatment of complex cyclodialysis.

METHODS: The clinical data of 42 patients(42 eyes)with cyclodialysis(the range of fracture≥60°)accompanied by injured lens and vitreoretinopathy were retrospectively analyzed. They were all examined by B-ultrasound and ultrasound biomicroscopy(UBM)before surgeries. They were divided into group A(20 eyes)with vitrectomy combined with ciliary body scleral interrupted suture and group B(22 eyes)with vitrectomy combined with ciliary body scleral continuous mattress suture. In the group A, the suture was performed first, then the vitrectomy. In the group B, the lentectomy and vitrectomy were performed first, then the continuous mattress suture suture. Postoperative visual acuity, intraocular pressure(IOP), the condition of ciliary body reset and the suture time for ciliary body reset were observed and statistically analyzed.

RESULTS: After operations, the visual acuity and IOP had no significant differences between the two groups(P>0.05). Visual acuity and the IOP significantly improved postoperatively compared with that preoperatively in both groups(P<0.05). There was no significant difference on the rate of ciliary body reset, which was 90% in group A and 86.36% in group B(P>0.05). The suture time for ciliary body reset had significant difference between the two groups(P<0.05).

CONCLUSION: Vitrectomy combined with two different surgical methods for the complex cyclodialysis is safe and effective. For keeping the lens, it is appropriate to use interrupted suture method. Continuous mattress suture method is suitable for the pseudophakic or aphakic patients, especially with wide range cyclodialysis.

Abstract:AIM:To study the effect of Qijudihuang pills assisting sodium hyaluronate on visual function and tear film stability in patients with dry eye.

METHODS:Seventy-eight patients(156 eyes)with dry eye from October 2013 to July 2015 were chosen for this study and randomly divided into observation group and control group, 39 patients(78 eyes)in each group. The patients in observation group received Qijudihuang pills combined with sodium hyaluronate. The patients in control group received sodium hyaluronate only. The visual function, tear film stability, Chinese and Western medicine clinical integration and clinical curative effect were compared between the two groups.

RESULTS:Clinical curative effect:effective rate of observation group was 92% and was significantly higher than that of the control group as 74%(χ²=4.532, P<0.05). Visual function:the contrast sensitivity of observation group at 12, 18, 24 c/d was significantly higher than those of the control group(P<0.05). Tear film stability:the SIt and BUT of observation group were significantly higher than those of the control group(P<0.05). Symptoms integral:Chinese medicine clinical integral and western medicine clinical integral of observation group were significantly lower than those of the control group(P<0.05).

CONCLUSION:Qijudihuang pills combined with sodium hyaluronate can improve visual function, tear film stability and Chinese and Western medical clinic symptoms, then improve the efficacy.

Abstract:AIM:To comparae the difference on the prevalence of xerophthalmia in patients with type 2 diabetes mellitus(2-DM)or without 2-DM, and analyse the related factors which can influence the prevalence of xerophthalmia.

METHODS:One hundred and seventy-eight patients during March 2014 to May 2015 were selected, in which eighty cases were with 2-DM(as observation group), ninty-eight cases were without 2-DM(as control group). Xerophthalmia was diagnosed according to WHO standard. Statistically analyze the incidence of xerophthalmia in the two groups. The patients in the observation group were grouped according to the duration of diabetes, age, gender and blood glucose level, and the difference of xerophthalmia prevalence in the groups were analyzed.

RESULTS:The prevalence of xerophthalmia in the observation group was 49%(39/80), which was higher than that in the control group(29%)and the difference was statistically significant(P<0.01).The prevalence of xerophthalmia in patients with 2-DM was increased with age, duration and blood glucose levels, the differences were statistically significant(P<0.05). There was no significant difference in the prevalence of xerophthalmia between different genders(P>0.05).

CONCLUSION:The prevalence of xerophthalmia in 2-DM patients is higher than that in normal group, and increases with age, duration and blood glucose level. However, there is no significant difference in the prevalence of xerophthalmia between different genders.

Abstract:AIM:To investigate the therapeutic efficiency of preservative-free sodium hyaluronate eye drops on dry eye in juvenile myopia wearing rigid gas permeable contact lens(RGP).

METHODS:Ninety cases with dry eye related to wearing RGP in juvenile with myopia from January to May 2015 were selected. The patients aged 12.75±4.15 years old,with diopter of -3.50±1.50D as spherical equivalent and received normalized RGP. They were divided into 3 groups randomly,each group of 30 cases(60 eyes):group A used rewetting drops,1 drop each time,4 times per day; group B used preservative-free sodium hyaluronate eye drops(1g/L),1 drop each time,4 times per day; group C used rewetting drops at first, then sodium hyaluronate eye drops was used 15 minutes later.All cases had been detected and evaluated by subjective symptoms of dry eye,Schirmer I test(SⅠt),break-up time(BUT)and corneal fluorescent staining,at pre-therapy and 1, 2, 4wk of post-therapy.

RESULTS:The subjective symptoms of dry eye,corneal fluorescent staining and BUT of three groups had been obviously improved at 1wk after therapies than those before therapies(P<0.05). SⅠt of three groups hadn't shown significant differences after therapies(P>0.05).Every index of the three groups measured at 2 and 4wk after treatments had no significant differences compared to those measured at 1wk(P>0.05).There was no significant difference on subjective symptoms,SⅠt and BUT between group A and B(P>0.05),except on corneal fluorescent staining, on which group B was superior to group A and on which the difference was significant(P<0.05).Group C in improving the subjective symptoms of dry eye and corneal fluorescent staining was better than group A(P<0.05).Group C, on improving the subjective symptoms of dry eye, was better than group B(P<0.05).

CONCLUSION:Preservative-free sodium hyaluronate eye drops(1g/L)can stabilize the tear film and promote the repair of corneal epithelial defects and significantly improve dry eye symptoms and signs in juvenile myopia wearing RGP,so it has certain clinical application value.

Abstract:AIM:To investigate the clinical outcomes after photorefractive keratectomy(PRK)with epithelial removal by phototherapeutic keratectomy(PTK)for 1a.

METHODS:A prospective analysis for 16 consecutive patients(30 eyes)with myopia and myopic astigmatism from July 2012 to July 2014 in our hospital underwent transepithelial photorefractive keratectomy(T-PRK, PRK with epithelial removal by PTK). Uncorrected distant visual acuity(UCVA), haze formation and remaining manifest refractive spherical equivalent(MRSE)were recorded before and at 1,3,6 and 12mo after operations.

RESULTS:There were no significant differences(P>0.05)in patients had an postoperative UCVA≥0.5 at 1, 3, 6 and 12mo compared with preoperative best corrected visual acuity(BCVA), and the same as the patients had an UCVA≥1.0(P>0.006). There were significant differences in haze values between different postoperative times(F=16.751, P=0.000). The haze value at 1mo was 0.71±0.25, which was gradually reduced with the time, and no more than 2 grades. Postoperative MRSE at 1mo was 0.9±0.87D, compared with 0.5±0.65D at 3mo, the difference was statistically significant(t=2.017, P=0.048). While the difference was not statistically significant(F=2.389, P=0.098)among MRSE at 3, 6(0.5±0.45D)and 12mo(0.25±0.4D).

CONCLUSION:The study obtained good clinical visual acuity. It shows slightly hyperopic shift and corneal haze at 1mo postoperatively. Large sample and grouped clinical research should be taken for the long-term stability of refraction and visual quality.

Abstract:AIM: To study the keratoconus(KCN)and subclinical KCN in patients with astigmatism ≥2D by Pentacam anterior segment analyzer.

METHODS: Two hundred and one eyes in 107 patients with astigmatism ≥2D were included in this study. All patients underwent optometry, visual acuity, corrected visual acuity, slit lamp biomicroscopy, fundus examination, traditional corneal topography and examination with Pentacam. Changes of several parameters were observed including K1(horizontal central curvature within the scope with diameter of 3mm), K2(vertical central curvature within the scope with diameter of 3mm); Kmax(the maximum anterior corneal refractive power), corneal astigmatism(CYL), MinPachy(the thickness at the thinnest area of cornea), index of surface variation(ISV), index of vertical asymmetry(IVA), keratoconus index(KI), height of anterior corneal surface(AE)and height of posterior corneal surface(PE), etc. ROC curve was made. Cutoff value and the sensitive index of each group were compared. Mann-Whitney U test was used for analysis of several parameters obtained from Pentacam. ROC curve was analyzed to determine the best diagnosis cutoff value.

RESULTS: Mean age of the study population was 25.7±6.6 years old. Kmax, IVA, KI, AE and PE of the clinical and subclinical group were significantly higher than those of the astigmatism group, while the thickness at the thinnest area of cornea in clinical and subclinical group was lower than that of the astigmatism group(P<0.05). Sensitive index of Pentacam to diagnose keratoconus at clinical stage \〖the area under the curve(AUC)≥0.9\〗 were AE, PE, IVA, ISV, KI, Kmax, respectively. Sensitive index for the diagnosis of subclinical keratoconus \〖the area under the curve(AUC)≥0.9\〗 was PE.

CONCLUSION: The current study shows that subjects with 2D or more of astigmatism, even some of them have normal vision, should undergo corneal topography screening. Pentacam may provide more accurate information about anterior and posterior corneal anatomy especially for the height of posterior corneal surface, which plays an important role in screening of subclinical KCN.

Abstract:AIM:To investigate the effect of the Hiline rigid gas permeable contact lens(Hiline RGPCL)for keratoconus in clinical practice and the predictors for RGPCL fitting.

METHODS:Fifty-seven eyes in 36 patients with keratoconus fitted with Hiline RGPCL were divided into three groups, mild(n=10), moderate(n=24)and advanced(n=23)group. After fitting evaluation, visual acuity measurements were taken to compare the best corrected visual acuity wearing spectacle lenses and Hiline RGPCL. The predictors for RGPCL fitting by the corneal curvature were analyzed.

RESULTS:In all groups, the application of Hiline RGPCL obtained acceptable vision. There was statistically significant improvement in vision with the Hiline RGPCL than that of with spectacle lenses in mild group(t=-2.968,P=0.016), moderate group(t=-6.293,P<0.01)and advanced group(t=-12.792,P<0.01). The mean base curve of the lens was 6.8±0.75mm. The base curve of RGPCL correlated with corneal curvature. In mild group, the base curve of RGPCL correlated with Sim K steep(r=0.715,P=0.02). In moderate group, the base curve of RGPCL correlated with average K as well as 0.2mm steeper average K(r=0.495,P=0.014). In advanced group, the base curve of RGPCL correlated with every indicator, especially the corneal curvature in central area(r=0.802,P<0.01).

CONCLUSION:Guiding by corneal topography, improvement of visual acuity is successfully achieved by fitting with Hiline RGPCL. Selecting different predictors in different grades can reduce the complexity and improve the usefulness of the Hiline RGPCL in clinical practice.

Abstract:AIM:To investigate the effect of onset time(T)for macula choroidal thickness(CT)in myopia patient.

METHODS:A prospective cohort study was designed.One hundred and twenty-two myopia patients(244 eyes; 67 male and 55 female; aged 30～41 years, mean 35.1±4.6 years old)who received preoperative examinations from March 2014 to April 2015 were recruited in this study. The patients were divided into three groups according to onset time(T):group A(T≤5a), group B(5aF=1.56,P>0.05),age(F=2.13,P>0.05),best corrected visual acuity(BCVA, F=1.41,P>0.05),corneal curvature(F=1.65,P>0.05)and axial length(F=1.89,P>0.05)among the three groups. The choroid in macular region was measured by enhanced depth imaging(EDI)using spectral-domain optical coherence tomography(SD-OCT). This study recorded the CT at subfoveal(SFCT), 1mm at temporal(T_1mm), nasal(N_1mm), superior(S_1mm)and inferior(I_1mm)to the fovea and 3mm temporal(T_3mm), nasal(N_3mm), superior(S_3mm)and inferior(I_3mm)to the fovea, respectively. The differences of CT at the same position among the three groups were analyzed.

RESULTS:The mean SFCT for group A,B,C were 238.32±57.95μm, 230.58±67.21μm, 221.63±62.37μm respectively in this study. The CT was found no significant difference in different locations except N_3mm(t_A-B=4.34,P<0.05)between group A and B. The CT was found no significant difference in different locations except N_3mm(t_B-C=7.61,P<0.05)between group B and C. The CT was found significant difference in different locations, except T_3mm(t=0.76,P>0.05)between group A and C. Significant difference was found at N_3mm(t_A-B=4.31,t _B-C=7.59,t_A-C=12.18; P<0.05)among the three groups.

CONCLUSION:The choroidal thickness decreases as the myopia onset time is earlier, especially at nasal.

Abstract:AIM:To observe the efficacy and safety of intravitreal Ranibizumab injection in patiens with choroidal neovascularization(CNV)secondary to pathologic myopia.

METHODS:In this retrospective and comparative study,24 patients(25 eyes)with CNV secondary to pathologic myopia were enrolled. All patients were assessed by examinations of ETDRS visual acuity chart, preplaced-mirror ophthalmoscopy, fundus fluorescein angiography(FFA), indocyanine green angiography(ICGA)and optical coherence tomography(OCT). Patiens received intravitreally injected ranibizumab 0.5mg(0.05mL). Treatments were repeated if the follow-up indicated that it was necessary. The follow-up periods were 4～10mo. Best corrected visual acuity(BCVA), central macular thickness(CMT)and leakage of CNV before and after the treatment were compared.

RESULTS:No local or systemic complications occurred in any patients during the treatment or follow-up. The average time of injection was 1.52. The mean BCVA was 23.93±12.46 letters before the therapy. In the last follow-up, the mean BCVA was 40.63±7.25 letters, improved by 14.27±9.36 letters and the difference was statically significant(t=5.74, P<0.05). The mean CMT was 363.47±119.62μm before treatments and 190.31±37.02μm after treatments which was 72.82±60.57 μm less than the pre-treatment values and the difference was statically significant(t=3.96, P<0.05).

CONCLUSION:Intravitreal ranibizumab injection for CNV secondary to pathologic myopia is safe and effective, and this treatment can improve visual acuity, reduce retina edema and leakage of CNV.

Abstract:AIM:To observe the efficiency of limbal stem cell transplantation for treatment of limbal papilloma and to explore the treatment methods of limbal papilloma.

METHODS:Prospective study was conducted. Continuous observation was given to the patients who were diagnosed as limbal papilloma at Tongji Hospital from January to December 2014. In this study, a standard excision combined with autologous conjunctival limbal stem cell free flap transplantation was used; pathology examination for specimen was carried out after surgeries for specific pathological diagnosis. Anti-inflammatory, infection-preventing and epithelial repair-promoting medications were given after surgeries. Sutures were removed at 10～14d postoperatively. Before and after surgeries, papilloma lesion were examined using slit lamp microscope photography, anterior segment OCT measurement. All patients were followed up for 6～12mo.

RESULTS:Four patients were included in this study, 3 males and 1 female. Patients aged 48～62 years, mean 55.5±5.8; the diameter of papilloma lesion was 5～12mm, average 8.25±2.99mm; limbal encroachment range was 5～12mm, average 7.25±3.20mm. Post-operative corneal epithelial healing time was 2～5d, an average of 3.25±1.26d. Anterior segment OCT showed no Bowman membrane invasion. No recurrence was observed during follow-up period, no limbal stem cell deficiency was observed in the donor site of limbal stem cell.

CONCLUSION:Simple excision combined with autologous limbal stem cell transplantation is an effective treatment for limbal papilloma.

Abstract:AIM:To explore the changes of tear film detected by Keratograph in the patients after laser in situ keratomileusis(LASIK)with corneal flap created by femtosecond laser.

METHODS: Totally 75 myopic patients(150 eyes)were enrolled who underwent femtosecond laser LASIK from July 2014 to June 2015, including patients<30, 30～40, over 40 years old and 25 cases(50 eyes)in each group. Tear break-up time(BUT), tear meniscus height(TMH), McMonnies Dry Eye Disease Questionnaire(McMonnies Questionnaire, MQ)were checked preoperatively and postoperatively at 1wk, 1, 2 and 3mo.

RESULTS: Before surgeries, the dry eye symptoms score of three groups had no significant difference(P>0.05). After surgeries, there were significant difference at each follow-up time among the three groups on symptoms score(P<0.05), with <30 years old group the lowest and over 40 years old group the highest. Dry eye symptom scores rise obviously at postoperatively 1wk and then declined gradually. The scores of <30, 30～40 years old group fell to the preoperative levels at 2mo, while that happened in over 40 group at 3mo after surgeries. BUT and TMH of three groups had significant differences at each follow-up point(P<0.05), with <30 years old group the highest, over 40 years old group the lowest. A 1wk after surgeries, the indexes declined obviously and then rise. BUT of <30, 30～40 years old group recovered to preoperative levels at 3mo, with over 40 years old group not recovered. TMH of <30 years group recovered to preoperative levels at 2mo, with 30～40 and over 40 years old group recovered at 3mo.

CONCLUSION: LASIK can affect the dry eye symptoms and the stability of tear film, which decreased by postoperative time. And the index recovered to preoperative levels earlier in younger patients.

Abstract:AIM:To explore the operation methods and effects for wide range cyclodialysis(≥180°)sutured under the interrupted scleral flaps.

METHODS:Thirteen patients(13 eyes)with wide range traumatic cyclodialysis received surgeries. Intermittent lamellar scleral flaps were made in the region of cyclodialysis. Each flap was 5mm wide, and the distance between two flaps was 2mm. Then the deep lamellar was cut 1.5mm behind the limbus and the cyclodialysis was sutured. Intraocular pressure, visual acuity, anterior chamber depth and complications after the surgery were observed. The follow-up time was 3～6mo.

RESULTS:The visual acuity of all patients improved to varying degrees, the anterior chamber depth returned to normal, and no obvious complications such as severe corneal astigmatism, anterior segment ischemia or others occurred in all patients after the surgery. The cyclodialysis was completely fixed in 11 eyes(85%, 13 eyes in total)after the first operation. And the cyclodialysis was completely fixed in other 2 eyes(15%)after the second operation on 30d and 35d respectively. Postoperative ocular hypertension occurred in 8 eyes. Seven eyes recovered after giving medication and one eye received sustained intraocular pressure lowering drugs.

CONCLUSION:The operation of wide range cyclodialysis sutured under the interrupted scleral flaps is simple, effective and reliable, and can reduce the occurrence of complications. It is an ideal operation method.

Abstract:AIM:To analyze the clinical symptoms, treatments and prognosis of the glaucoma secondary to hypermature cataract to offer some references for the diagnosis and the treatment.

METHODS:Thirty four eyes with glaucoma secondary to hypermature cataract in 34 patients were collected from August 2011 to August 2014 in the West China Hospital, Sichuan University. Analyze different treatment methods selected according to different clinical symptoms, and corresponding prognosis.

RESULTS:Thirty four patients were hospitalized in emergency, all the eyes had visual acuity of finger counting or worse, intraocular pressure(IOP)was 35～75mmHg. All patients received comprehensive IOP-lowering therapy before the surgery. Twenty-eight patients underwent phacoemulsification, 6 patients underwent extra-capsular cataract extraction(ECCE)and 19 patients underwent primary or secondary IOL implantation. All the patients experienced pain relief after surgery, 30 of them had well-controlled postoperative IOP. One case underwent Ahmed glaucoma valve implant surgery, 3 cases gave up the treatment. Seventeen cases who had IOL implanted got great visual acuity improvement, the best postoperative visual acuity was 0.7.

CONCLUSION:As long as we have proper and prompt diagnosis and positive control of IOP and inflammation before surgery, precise surgery skills, close observation after surgery and positive anti-inflammation therapy, most of the glaucoma secondary to hypermature cataract get satisfactory outcomes.

Abstract:AIM:To discuss the application of trypan blue before continuous curvilinear capsulorhexis(CCC)during the surgery for all white or over ripe stage cataract.

METHODS:Forty-two eyes in 42 patients with cataract in all white or over ripe stage were selected. During the operations, 0.2mL trypan blue(0.6mg/mL)was injected into the anterior chambers of all the 42 eyes. The anterior capsule was stained to light blue. Then the CCC was conducted. The density of corneal endothelial cells and the percentage of corneal endothelial cells with hexagonal shape were recorded before and at 1wk and 1mo after operations. Repetitive measure analysis of variance was used in analyzing the recording results at different time points.

RESULTS:After stained with trypan blue, CCC was successfully performed in all the operations, which identified a successful basis for the following surgery. There was no significant difference in the density of corneal endothelial cells before and after operations, so as the proportion of corneal endothelial cells with hexagonal shape.

CONCLUSION:After stained with trypan blue, CCC is more feasible and safer for all white and other difficult-to-treat cataract.

Abstract:AIM:To investigate the effect of mitomycin C combined with complex trabeculectomy in treatment of refractory glaucoma.

METHODS:One hundred and ten cases(122 eyes)in our hospital from January 2014 to June 2015 were divided into observation group(55 cases with 62 eyes)and control group(55 cases with 60 eyes). All patients were treated with complex trabeculectomy, and patients in observation group were given mitomycin C. Before and at postoperatively 12mo, the intraocular pressure and visual acuity were examined. Before and at postoperatively 3mo, the levels of Vitamin B12(VB12), Vitamin B6(VB6), folic acid(FA), interleukin-2(IL-2)and interleukin-6(IL-6)in peripheral blood were detected by enzyme-linked immunosorbent assay(ELISA).

RESULTS:Preoperatively, there were no significant differences on intraocular pressure, visual acuity, VB12, VB6, FA, IL-2, IL-6 between the two groups(P>0.05). At postoperatively 1wk～12mo, the intraocular pressure of observation group was significantly lower than those of control group(P<0.01), the visual acuity was higher than those of control group(P<0.01); VB12, FA, IL-2 and IL-6 of observation group were significantly higher than those of control group(P<0.05)at postoperatively 3mo.

CONCLUSION:Mitomycin C combined with complex trabeculectomy in treatment of refractory glaucoma could control intraocular pressure, improve visual acuity, and enhance the operation success rate.

Abstract:AIM:To explore the correlation between the degree of diabetic macular edema(DME)and the level of serum sialic acid in patients with type 2 diacetic.

METHODS:Sixty-five patients with type 2 diabetes were included in this study and another 54 cases were included as health control group. The concentration of serum sialic acid was tested by colorimetric methed. The degree of DME was detected by fundus fluorescein angiography(FFA).

RESULTS:In the 65 diabetes patients,22 cases had DME(level 1:10 cases, lebel 2:5 cases, lebel 3:7 cases). The level of serum sialic acid in diabetic patients was 96.56±14.29mmol/L, that in control group was 42.44±17.68mmol/L, and the difference between the two groups was significant(P<0.05). In diabetes patients group, level of serum sialic acid was 86.53±13.39mmol/L in patients without DME and that was 110.09±18.81mmol/L in those with DME and the difference between the two groups was significant(P<0.05). Significant correlations existed between the level of serum sialic acid and DME(r=0.62,P<0.05).

CONCLUSION:The concentration of serum sialic acid increases in patients with DME, and the DME is severer as the level increasing.

Abstract:AIM:To evaluate the efficacy of intravitreal triamcinolone acetonide injection combined with grid pattern photocoagulation for macular edema secondary to retinal vein occlusion.

METHODS: Forty patients(40 eyes)with cystoid macular edema secondary to retinal vein occlusion were enrolled. In the treatment group, 20 cases(20 eyes)were treated with intravitreal injection of 2mg triamcinolone acetonide, then grid pattern photocoagulation for macular area at 1wk after the injection. Another 20 patients(20 eyes)in control group were treated with intravitreal injection of 2mg triamcinolone acetonide only. Macular retinal thickness was measured by OCT before and after treatments to analyze the absorption of the cystoid macular edema and the improvement of visual acuity.

RESULTS: The mean macular retinal thickness of treatment group before treatments was 412.67±133.04μm. At 3mo after treatments macular retinal thickness was 281.63±59.39μm. The mean macular retinal thickness of control group before treatments was 409.58±131.96μm, and at 3mo after treatments macular retinal thickness was 358.72±116.17μm. There was a significant difference between the two group on mean macular retinal thickness after treatments(t=8.97, P=0.003<0.05). After 3mo of treatments, cystoid macular edema reappeared in 4 patients and repeated intraocular injection of triamcinolone acetonide was given. In the control group, 12 cases had recurrent macular edema and were given repeated intraocular injection of triamcinolone acetonide. With Chi-square test, there was a significant difference between the two groups on the recurrence rate(χ²=6.50,P=0.022 <0.05).

CONCLUSION: Combined therapy of intravitreal injection of triamcinolone acetonide and grid pattern photocoagulation in macular area for cystoid macular edema secondary to retinal vein occlusion is effective, and the visual acuity improve significantly with fewer relapses.

Abstract:AIM: To explore the clinical significance of triamcinolone acetonide combined with compound anisodine hydrobromide injection for the treatment of mild(non ischemic)central retinal vein occlusion(CRVO)in the early stage.

METHODS: One hundred and sixteen eyes in 116 patients with non ischemic CRVO in early stage were randomly divided into four groups, group A, group B, group C, and group D. Divided by the completely random data method, each group had 29 eyes. Group A received no treatment. Group B was given compound anisodine hydrobromide injection in subcutaneous injection besides superficial temporal artery of the eye. Group C was injected with triamcinolone acetonide beside eyeballs and Group D was given triamcinolone acetonide combined with compound anisodine hydrobromide injection. In each group, we observed and recorded the best corrected visual acuity(BCVA, using EDTRS chart), bleeding, optical coherence tomography(OCT)scanning for central macular thickness(CMT), fundus fluorescence angiography(FFA)imaging check for the possibility of ischemic CRVO at 1, 2, 4, 8 and 12wk respectively. The total curative effect after 3mo was being compared among the three groups.

RESULTS: After 12 weeks' treatment, the mean BCVA was lower and the mean CMT was higher in group A than those before the treatment. The mean BCVA was increased and the mean CMT decreased in group B, C and D after treated for 3mo. Comparing Group D with the rest groups, the variation of BCVA and CMT had statistical significance(P<0.05).The variation of BCVA and CMT had no statistical significance in the multiple comparison among group A, group B and group C(P>0.05). Ischemic CRVO was found in 8 cases of group A, 6 cases of group B, 5 cases of group C, and 2 cases of group D,and the difference was not statistically significant(χ²=4.361; P=0.225). Flame-shaped bleeding was found in 14 cases of group A, 7 cases of group B, 9 cases of group C and 4 cases of group D and the difference was statistically significant(χ²=8.821; P=0.032).

CONCLUSION: The combination of triamcinolone acetonide and compound anisodine hydrobromide injection has important clinical significance on protecting eyesight of patients to a greater degree and reducing ischemic CRVO in the early non ischemic stage.

Abstract:AIM:To observe the application of direct funduscopy in screening for diabetic retinopathy in communities.

METHODS:After mydriasis, 265 patients with diabetes mellitus(DM)in communities were examined for fundus by direct funduscopy. The patients with diabetic retinopathy(DR)were further received fluorescence fundus angiography(FFA)after referral to superior hospitals.

RESULTS:Within the 265 patients with DM, 79 patients were diagnosed as DR and the positive rate of DR was 29.8%. Among the patients with DR, there were 46 patients with non- proliferative diabetic retinopathy(NPDR)and 33 patients with proliferative diabetic retinopathy(PDR); the positive rate was respectively 17.4% and 12.5%. All patients with DR were further diagnosed by FFA after referral. Three patients with NPDR were diagnosed with PDR, and 22 patients received laser treatment.

CONCLUSION:Ordinary application of direct funduscopy in patients with DM in communities would early detect the DR. It is very necessary to master direct funduscopy for general practitioners.

Abstract:AIM:To analyze the therapeutics effect of electromagnet in vitrectomy for irregular intraocular magnetic foreign body removal.

METHODS:Clinical data of 60 cases(60 eyes)from January 2012 to December 2013 with intraocular magnetic foreign bodies were retrospective analyzed. Thirty eyes underwent vitrectomy only, and electromagnet was applied in the other 30 eyes underwent vitrectomy. The success rate and complications in and after operations were compared between the two groups.

RESULTS:Twenty-eight(93%)patients had their foreign bodies removed successfully at the first time in electromagnet group and twenty(67%)patients in vitrectomy group,there was statistic significant difference(χ²=5.333,P=0.021). Fewer complications happened in and after operations when electromagnet was used.

CONCLUSION:The application of electromagnet shows advantage in vitrectomy for irregular intraocular magnetic foreign body removal and it deserves promotion.

Abstract:AIM:To investigate the clinical effect of lacrimal endoscope with canalicular incision for canaliculitis.

METHODS: A case-control study.Forty-three patients with canaliculitis were collected from September 2013 to October 2014 in our hospital. The patients were divided into case group with lacrimal endoscope with canalicular incision for 22 cases, and control group with canalicular concretion extruded and antibiotic injection within lacrimal canaliculi for 21 cases. The patients' 1a follow-up was carried out to observe the clinical effect of these two groups and to conduct statistical analysis.

RESULTS:The effective rate was 100% with 21 patients cured, one patient improved and no treatment failure for case group. The value was 71% with 10 patients cured, 5 patients improved and 6 treatment failure(surgical treatment)for control group. It had a better effective rate for canaliculitis treatment in case group, compared to control group. The difference was statistically significant(P<0.05).

CONCLUSION:The treatment of lacrimal endoscope with canalicular incision was minimally invasive, safe and effective for canaliculitis.

Abstract:AIM:To observe the clinical effect of joint implantation of straight silicon tube and spherical headed silicon tube in treatment of post-operative patients with recurrent chronic dacryadeitis.

METHODS:Forty-nine patients(50 eyes)with recurrent chronic dacryadeitis who had treated with straight silicon tube or spherical headed silicon tube were implanted with straight silicon tube combined with spherical headed silicon tube.Patients were followed up for 1a to observe the curative effect.

RESULTS:The operation was invalid in 5 cases(5 eyes)as their rigation of lacrimal passage was failure.The remaining 45 eyes in 44 cases were cured with no epiphora.The cure rate was 90% at 1a after the tubes were extracted.

CONCLUSION:The joint implantation of straight silicon tube and spherical headed silicon tube is an effective and safe technique in treatment of post-operative patients with recurrent chronic dacryadeitis,and worthy of widely use in patients with chronic dacryadeitis who have never been treated with surgeries.

Abstract:AIM:To observe the efficacy and safety of artificial tears for children xerophthalmia.

METHODS:Fifty-eight cases with 116 eyes were diagnosed as xerophthalmia by tear break-up time(BUT), Schirmer Ⅰ test(SⅠt), tear meniscus height, corneal staining, meibomian gland function test and were given artificial tears therapy for 1mo. Then the aforementioned tests were conducted again for statistical analysis.

RESULTS:The mean BUT of all the children before treatments was 6.03±1.19s, SⅠt was 7.67±2.32mm/5min, tear meniscus height was 0.20±0.02mm, corneal staining was 1.02±0.13 scores and meibomian gland function was 2.45±0.86 scores. Sixty-two eyes in 31 cases were the lipid-deficient type, 40 eyes in 20 cases were aqueous-deficient type, and 14 eyes in 7 cases were other types. According to their types, corresponding artificial tears therapy was given. At 1mo after treatments, the clinical symptoms were improved significantly. BUT was 13.72±1.83s, SⅠt was 12.38±3.64mm/5min, tear meniscus height was 0.36±0.08mm, corneal fluorescein staining was 0.03±0.24 scores and meibomian gland function was 1.57±0.93 scores. Compared with those before treatments, the difference of each observed indicators was statistically significant(P<0.05). No patient experienced any adverse reactions during treatments.

CONCLUSION:Artificial tears treatment for children xerophthalmia is safe and effective.

Abstract:AIM:To investigate the clinical application of Keratography 5M in the diagnosis and individualized treatment of dry eye patients.

METHODS:Sixteen patients who were diagnosed with dry eye in the same day were included. Tear film break-up time(BUT), lacrimal river height, and the meibomian glands were measured with a latest Keratography 5M. The patients received individualized treatment according to the examination and then recheck the items mentioned above 2wk post-treatment. The items were used for statistical analysis.

RESULTS:The scores of all subjects were 0.276±0.073mm for lacrimal river height, 6.343±3.304s for BUT, 3.78±1.36scores for deficiency area of meibomian glands in the first check-up and 0.292±0.065mm,8.876±3.670s,2.25±1.16scores respectively at 2wk post-treatment. The BUT and deficiency area of meibomian glands were both statistically significantly.

CONCLUSION:The noninvasive Keratography 5M is a conveinent and atraumatic tool in the diagnosis and treatment for dry eye. It can evaluate the treatment effectiveness objectively and systematically.

Abstract:AIM:To retrospectively analyze the myopia progression in children after oral delivery of Difrarel for 6mo.

METHODS:Collecting myopic children aged 3～13 in our hospital from June 2012 to January 2015, 36 cases(69 eyes)included, 16 males(30 eyes)and 20 females(39 eyes). After dilated by atropine eye ointment, all cases were divided into three groups according to the spherical equivalent degree. There were 30 eyes in high myopia group(>-6.00D),24 eyes in moderate myopia group(-3.00～-6.00D)and 15 eyes in mild myopia group(<-3.00D).Meanwhile all cases divided into two groups according to the age. There were 21 eyes in preschool children group(<6 years old),48 eyes in juvenile group(≥6 years old).The spherical equivalent degree,best corrected visual acuity, axial length(AL),curvatures radius of cornea(CR), the AL/CR were self-comparative analyzed before and after 6mo of oral delivery Difrarel.

RESULTS:The spherical equivalent degree, AL and AL/CR increased in mild and moderate myopia group after oral delivery of Difrarel for 6mo, but had found statistically significant differences in moderate myopia group only(P<0.05). The spherical equivalent degree and AL increased in high myopia group also, but no change in AL/CR, and all had no significant differences in high myopia group(P>0.05). The spherical equivalent degree, AL and AL/CR increased in preschool children group and juvenile group,but only AL and AL/CR had found statistically significant differences in preschool children group(P<0.05).

CONCLUSION:Short-term oral delivery of Difrarel in children can control the progression of mild and high myopia, but have no effect on moderate myopia; and short-term oral delivery of Difrarel in children can control the progression of juvenile myopia, but have no effect on preschool myopia.

Abstract:AIM:To investigate the relation of Decorin(DCN)gene and simple pathological myopia in Inner Mongolia region.

METHODS:Genomic DNA was collected from 100 control subjects and 100 patients with simple pathological myopia. The exon7 and exon8 and the flanking intron regions of DCN gene were analyzed by polymerase chain reaction(PCR)and direct sequencing. The relation of Decorin gene exon7 and exon8 with simple pathological myopia was statistically analyzed.

RESULTS:In simple pathological myopia group, 2 patients' gene mutations were identified. Both was 41775T→C,located at the flanking intron regions of exon8. No variation was found in others including control group. The gene mutation between controls and simple pathological myopia groups were not different(P>0.05).

CONCLUSION:DNC gene exon7 and exon8 mutation may not be the disease gene in this group in Inner Mongolia region.

Abstract:AIM:To observe and study the distribution of ametropia in 1 170 preschool children with low vision.

METHODS:Ten kindergartens in the urban area of Jinzhou were randomly selected. For the preschool children aged from 3 to 6, the vision conditions including sight test, ocular inspection, refraction status, conventional ophthalmic testing and stereo tests were conducted. The children with vision<0.8 received the mydriatic optometry test.

RESULTS:(1)rates of abnormal vision were 6.37% in children aged 3,7.79% in those aged 4,15.24% in those aged 5 and 8.93% in those aged 6; abnormal rate in children aged 5 was significantly higher than those in the other age groups(P<0.05);(2)eye diseases:for children with low vision, proportion of patients with ametropia was 95.61%, the rate of hyperopia was 71.67%, in which hyperopia accounted for 75.00% in those aged 3, 78.26% in those aged 4, 75.44% in those aged 5 and 54.17% in those aged 6; the rate of myopia was 17.50%, in which myopia accounted for 6.25% in those aged 3,13.04% in those aged 4,17.54% in those aged 5 and 29.17% in those aged 6; the rate of mixed astigmatism was 10.83%, in which mixed astigmatism accounted for 18.75% in those aged 3,8.70% in those aged 4,7.02% in those aged 5 and 16.67% in those aged 6;(3)amblyopia:prevalence of amblyopia was 4. 27%. According to survey results, anisometropia accounted for 36.00%, in which the rate of mild, moderate and severe cases were 66.67%, 27.78% and 5.56% respectively; strabismus accounted for 16.00%, in which the rate of mild, moderate and severe cases were 25.00%,62.50% and 12.50%; form-deprivation accounted for 2.00%, in which the rate of mild, moderate and severe cases were 0%,0% and 100.00%.

CONCLUSION:For preschool children with low vision, the abnormal rate is reduced with the increasing ages since the vision is gradually mature. Based on the results, hyperopia is the main causes for low vision in preschool children(aged from 3 to 6). Based on the factors of myopia, strabismus and amblyopia, it is important to conduct the general survey in curing eye diseases as early as possible.

Abstract:AIM:To investigate the effects of different types and differentials of anisometropia on vision development and stereopsis and to analyze the relevance between anisometropia with monocular amblyopia and stereopsis.

METHODS:From January 2013 to December 2014, 326 patients with anisometropia went for their first visits were collected with clinical data. Best corrected distant and near visions, near stereopsis after the correction were recorded, in order to analyze the proportions of amblyopia and abnormal stereopsis.

RESULTS:As the differentials of anisometropia increased, the corrected far and near vision in patients with high refractive error decreased, the incidence of amblyopia increased. There was also a growth on the incidence of abnormal stereopsis which made a statistically difference. Amblyopia and abnormail stereopsis occurred earliest and was the most in hyperopia group, which was different from other groups and the discrepancy was statistically significant.

CONCLUSION:The differentials of anisometropia affect the percentages of abnormal stereopsis and amblyopia directly. The differentials of amblyopia caused by hyperopic anisometropia is the least which is related to the lack of regulatory function in patients with high refractive error and their incapability to develop proper near vision.

Abstract:AIM:To study the refraction status in 354 amblyopia children and to investigate the related influence factors for the treatment effect.

METHODS:Three hundred and fifty-four children diagnosed as ametropia amblyopia from January 2010 to June 2015 in our hospital were selected. The children were divided into groups according to the children's age, refraction types of amblyopia and degree of amblyopia. The clinical treatment effect of different groups was compared.

RESULTS:The cure rate for amblyopia children in different groups was significantly different(P<0.05); as the ages of children increasing, the cure rate was gradually reduced. The cure rate for children with different amblyopia types was not totally the same. The cure rate of different groups was sorted from low to high:myopia groupP<0.05); the clinical efficacy for children with different amblyopia degrees was significantly different(P<0.05). As the amblyopia degrees increasing, the cure rate was also constantly declined.

CONCLUSION:The treatment effect of ametropia amblyopia is correlated with the children's age, types of amblyopia and degree of amblyopia. It has a poor treatment effect for the older children with severe myopia and amblyopia.