Abstract:AIM:To evaluate retrobulbar ocular blood flow changes after phacoemulsification.

METHODS:Prospective consecutive study. Forty-six eyes from 46 cataract patients scheduled for phacoemulsification surgery at Affiliated Eye Hospital, Wenzhou Medical College were recruited, of which 22 patients with normal blood pressure and 24 patients with hypertension. All eyes were examined by a color Doppler imaging at before, 4h, 1d after surgery. Resistance indexes(RIs), peak systolic flow velocity(PSV), end-diastolic flow velocity(EDV)were assessed in the ophthalmic artery(OA), central retinal artery(CRA), and short posterior ciliary arteries(PCA).

RESULTS:RIs of a retrobulbar ocular vessels are stable at 4h and 1d in both group postoperatively. A slight decrease in PSV of PCA in hypertension patients, while a slightly increase in normal patients at 4h postoperatively was observed(10.22±4.39 vs 11.73±4.69). There were no significant difference between them(P=0.089). PSV and EDV in CRA are lower in hypertension patients but without statistical significance compared with normal patients. There was a statistically significant decrease in EDV of the PCA in hypertension patients at 4h postoperatively compared with preoperatively(3.23±1.10 vs 3.63±1.15,P=0.036).

CONCLUSION:Retinal blood flow was disturbed at super-early after phacoemulsification. Age and hypertension are important risk factors to phacoemusification.

Abstract:AIM:To analyze the prevalence and presentation patterns of corneal astigmatism in cataract surgery candidates of Shenyang in northeast China.

METHODS:A retrospective survey was used to study the corneal astigmatism which were measured by intraocular lens(IOL)Master optical biometer before cataract surgery between Jan. 1^st, 2014 and Dec. 31^st, 2014. Descriptive statistics of corneal astigmatism data were analyzed.

RESULTS:The keratometric data from 4 543 eyes from 3 821 patients with a mean age of 66.36±10.38y(SD). In 10.50% of eyes, corneal astigmatism was between 0.5 diopters(D)or less; in 30.05% of eyes, it was 0.5-1.0 D; in 23.60%, it was 1.0-1.5 D; in 13.19%, it was 1.5-2.0 D; in 7.68%, it was 2.0-2.5 D; in 6.41%, it was 2.5-3.0 D; in 8.58%, it was 3.0 D or higher. With-the-rule astigmatism was found in 27.69% of eyes, while against-the-rule was found in 53.84% of eyes.

CONCLUSION:About 59.46% of eyes in this study had preoperative corneal astigmatism equal to or above 1.0 D. Findings indicated more surgical techniques or toric intraocular lenses to meet the potential demand of the cataract surgery candidates.

Abstract:AIM:To investigate the retinal vascular caliber, retinal nerve fiber layer(RNFL)thickness, and optic disc changes in patients after pars plana vitrectomy and adjunctive intraoperative procedures.

METHODS:We examined 40 eyes in 40 patients who had undergone unilateral pars plana vitrectomy and adjunctive intraoperative procedure at three time points:prior to surgery, and at 3mo and 6mo after the operation. The diameters of central retinal arteries and veins were measured using retinal photographs. The central retinal arteriolar equivalent(CRAE)and central retinal venular equivalent(CRVE)were calculated using the revised Parr-Hubbard formula. RNFL thickness was obtained using Stratus optical coherence tomography. The cup-to-disc vertical ratio of the optic disc was evaluated using stereo optic disc photography.

RESULTS:There were no significant differences between the eyes of individual patients before the operation. Cup-to-disc vertical ratios of the optic disc were significantly increased 3mo and 6mo postoperatively(P<0.01, P<0.01), and there was a significant difference between the operative eye and fellow eye at the same time points(P<0.01, P<0.01). Changes in CRAE and CRVE in the operative eyes were significantly larger than the fellow eyes 6mo post-operatively(P<0.01, P<0.01). The RNFL thickness showed no significant changes.

CONCLUSION:Whereas there were no changes in RNFL thickness, vitrectomy and adjunctive intraoperative procedures induced changes in the cup-to-disc vertical ratio of the optic disc and retinal vessel diameter for at least 6mo after surgery.

Abstract:AIM:To compare the intraocular lens(IOL)power calculations and refractive outcomes obtained with a new optical biometer and standard ultrasonic biometer in phacoemulsification surgery.

METHODS:Thirty-seven eyes of 37 cataract patients who underwent phacoemulsification with IOL implantation were included in this prospective comparative study. The same operator performed biometer measurements in eyes with cataract using a new optical biometer(Aladdin)and a standard ultrasonic biometer(Sonomed AB 5500). Biometric parameters; axial length(AL), keratometric(K)readings, anterior chamber depth(ACD)and IOL power obtained by two devices were recorded. Postoperative actual refractive errors and errors predicted by two devices according to SRK/T formula were analyzed. The mean estimation error(EE), mean absolute estimation error(AEE)and the biometric parameters obtained by two biometers were compared.

RESULTS:The AL measured by Aladdin(23.45±0.73 mm)was significantly longer than AL by ultrasonic biometer(23.2±0.75 mm)(P=0.01). The mean EE and AEE values obtained by Aladdin were significantly smaller than the values by ultrasonic biometer(P=0.0006 and 0.03 respectively). The higher percentage of eyes within ±0.5 and ±1.00 D of target refraction was also found by using Aladdin(67% and 97%).

CONCLUSION:The Aladdin optical biometer showed better accuracy and yielded better refractive outcomes compared with ultrasonic biometer.

Abstract:AIM: To determine the pattern, severity, and prognostic factors of ocular injuries in the southwest Ethiopia.

METHODS:A prospective hospital based study was done on all patients presented with ocular injury to Jimma University Specialized Hospital from Apr. to Sep. 2009. Each patient underwent a detailed interview and a standard comprehensive ocular examination. Data were analyzed using SPSS version 13 and P< 0.05 was considered significant.

RESULTS:The overall prevalence of ocular injury was 3.03%. Nearly 99% of ocular injuries were mechanical. The majority of the ocular injuries(53.2%)were work-related and none of these patients had eye protection at the time of injury. Out of 170 globe injuries, 57.6% were closed globe injury and 42.4% were open globe injuries. Closed globe injuries were less severe and had significantly better visual outcome than open globe injuries(P<0.05). The final visual outcome was also significantly associated with presenting visual acuity and time from diagnosis to surgical treatment(P<0.05). Eye injuries were responsible for monocular blindness in 59(34.3%)patients. Late presentation, poor presenting visual acuity, open globe injury and presence of complications were the risk factors identified for poor final visual acuity outcome.

CONCLUSION: Most ocular injuries occurred in the workplace,and a significantly larger proportion of patients with ocular injury developed monocular blindness. For the prevention of serious injuries, eye health education and safety strategies should be applied both at home and work place.

Abstract:AIM:To analyze the spectrum and antibiotic sensitivity of bacteria in the aqueous humor and vitreous immediately following the occurrence of penetrating ocular trauma.

METHODS: Aqueous humor or vitreous specimens were collected from 45 eyes of 45 patients with penetrating ocular trauma before operations. The specimens were prepared for bacterial culture and the associated sensitivity tests to several commonly used antibiotics.

RESULTS: Fifteen eyes of all the patients were found to be positive with bacterial infection, and the most frequently identified bacteria was staphylococcus epidermidis, which accounted for 67.7%(10/15)of all identified cases. All identified bacteria were sensitive to ciprofloxacin and ofloxacin, and less sensitive to cefoperazone. Most of them were resistant to gentamycin, rifampin and chloramphenicol. Accompanying intraocular foreign body or sclera wound were associated with positive bacterial cultures(χ₁²=6.544, P₁=0.016; χ₂²=4.5, P₂=0.034). Causes of injury(χ²=1.667,P=0.197), lens rupture(χ²=1.125,P=0.352)or locations where the specimen was collected(χ²=1.667,P=0.197)did not contribute to the difference in the positive rates of bacterial cultures.

CONCLUSION:In patients with penetrating ocular trauma, the major bacteria entering into the eye was staphylococcus epidermidis. Fluro-Quinolones can be used as the first-line antibiotics for prophylactic treatment. Cefoperazone can be taken as a second choice.

Abstract:AIM:To explore the discrepant gene expression profiles and the related phenotype changes in human lens epithelial cells(HLEC)after oxidative stimulation.

METHODS:Human lens epithelial cell line(HLE-B3)were cultured in normal condition or with H₂O₂ for 24h. Total RNA were extracted for gene expression profiling assay and gene ontology analysis was performed for the significantly up-regulated genes using bioinformational database DAVID. The elevated expressions of up-regulated genes in HLEC after oxidative stimulation were confirmed by RT-qPCR. The apoptosis of HLEC induced by oxidative damage was detected using 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide(MTT)assay and flow cytometry.

RESULTS:Gene expression profiling assay demonstrated that 367 genes were up-regulated in HLEC after oxidative stimulation. These genes were enriched in 310 biological processes mainly associated with p53-related signaling pathways, apoptosis, programed cell death and etc. Six genes mainly pro- or anti-apoptotic, including BCL2A1,TP53I3,FAS,ZMAT3,DDB2 and BCL2L1, were confirmed to be up-regulated by oxidative stimulation using RT-qPCR(P<0.05). Results of MTT assay and flow cytometry showed that apoptosis of HLEC gradually appeared after cells were treated with H₂O₂ and became the main consequence of oxidative stimulation.

CONCLUSION:Oxidative stimulation can induce up-regulation of proapoptotic genes and lead to apoptosis of HLEC, even though antiapoptotic genes can also be promoted.

Abstract:AIM:To investigate the protective effect and possible mechanisms of lycopene for oxidative damage induced by ultraviolet in cultured human lens epithelial cells(HLEC).

METHODS:HLEC was subcultured and divided into negative control group, oxidative injury group, lycopene low dose group and lycopene high dose group. Cell viability was assayed by MTT colorimetric. Cell morphological changes were detected by electron microscope. Reactive oxygen species(ROS)levels were detected with DCFH-DA fluorescent probe. Content of superoxide dismutase(SOD), glutathione peroxidase(GSH)and malondialdehyde(MDA)in supernatants were detected by spectrophotometer.

RESULTS:Lycopene could obviously inhibited UV-induced decline in cell activity, reduce UV-induced ROS generation within HLEC, cause SOD, GSH-Px levels increased and MDA levels decreased.

CONCLUSION:Lycopene plays its strong antioxidant role in increasing the intracellular SOD and GSH-Px content levels and decreasing MDA levels, which provide reliable experimental basis for prevent and treatment of cataracts.

Abstract:AIM:To investigate the expression and mechanism of high mobility group box protein-1(HMGB1)in the retina of diabetic rats.

METHODS:Sixty SD rats were randomly divided into diabetic group and control group. Diabetic rat model was produced by intraperitioneal injection of 1% STZ with 60mg/Kg weight. The rats in control group received intraperitioneal injection of normal saline with same dosage. After injection, the rats were sacrificed and eyeballs were enucleated for HE staining, the retina fluorescence angiography, TUNEL and Western Blot detection at 1, 2 and 4mo for the expressions of HMGB1 and NF-κB.

RESULTS:Compared with the control group, the retinal cells disorder, cell densities decreases, microvasculars occlusion were founded with inner and outer nuclear layer thinning and ganglion cell apoptosis. The fluorescence angiography showed that peripheral capillaries became circuitous and vascular occlusion and non-perfusion area could be seen. The expressions of HMGB1 and NF-κB were higher than those of control with time dependence and they had significant positive correlations(P<0.05).

CONCLUSION:The expression of HMGB1 increases in diabetic rat retina, which may involve in the occurrence of diabetic retinopathy through the NF- κB pathway.

Abstract:AIM:To study the influence on tear film by scleral tunnel incision and clear corneal tunnel incision in phacoemulsification.

METHODS:Ninety-four patients(126 eyes)who underwent cataract surgery from February 2012 to June 2015 in our hospital were selected in this study. They were divided into research group(group A)with 46 cases(63 eyes)underwent surgery though scleral tunnel incision, and the control group(group B)with 48 cases(63 eyes)through clear corneal tunnel incision. According to referencing cataract LOCS Ⅱ nuclear hardness classification standard, patients in the two groups were subdivided into AⅡgroup, BⅡ group, A Ⅲ group, B Ⅲ group, A Ⅳ group and B Ⅳ group. On preoperatively 1d, postoperatively 1, 7, 30 and 90d, subjective symptoms of dry eye questionnaire scores(SDES), break-up time(BUT), staining scores of sodium fluorescein(SCSF), and Schirmer I test(SⅠt)were determinate to analyze the influence on tear film by different incisions.

RESULTS:There were no statistically significant differences on preoperative tear film function between the two groups(P>0.05); there were statistically significant differences on tear film function of the two groups on preoperatively 1d with postoperatively 1 and 7d(P<0.05). On postoperatively 30d, only the tear film function of BⅣ group had significant difference with that on preoperatively 1d(P<0.05). SDES, SCSF and SⅠt of AⅢ group on postoperatively 1d were significantly lower than those of BⅢ group(P<0.05). SDES and SCSF of AⅣ group on postoperatively 1 and 7d were lower than those of BⅣ group(P<0.05).

CONCLUSION:In the phacoemulsification, cataract with Ⅲ and Ⅳ nuclear through clear corneal tunnel incision, can sharpen tear film function damage, surgery effect was worse than through sclera tunnel incision, especially in Ⅳ level nuclear. Therefore, scleral tunnel incision can be selected in grade Ⅳ nuclear cataract in phacoemulsification.

Abstract:AIM:To observe the changes of vision and intraocular press in patients with neovascular glaucoma after the treatment of anti-vascular endothelial growth factor(VEGF)drugs with trabeculectomy and to explore the effectiveness and safety of this combination therapy.

METHODS:Sixty patients(60 eyes)with glaucoma went to our hospital from August 2012 to August 2014 and whose follow-up periods were >6mo were divided into two groups, group A(observation group)and group B(control group), by random number method. Observation group was treated with intravitreal injection of Ranibizumab and trabeculectomy. Control group was treated with cyclocryotherapy. The changes on visual acuity, intraocular pressure(IOP), neovascularization at iris and anterior chamber angle were observed.

RESULTS:Postoperative visual acuity improved in 9 eyes in group A which was significantly more than that of group B(P<0.05)and decreased in 5 eyes in group A which was significantly less than that of group B(P<0.05). In group A, IOP after injection of ranibizumab did not decrease much, but IOP decreased significantly after trabeculectomy and kept stable. IOP of group A after treatment was 14.6±3.7mmHg which was lower than that of group B(P<0.05). IOP of group B decreased gradually after treatment, and kept stable after 1mo. IOP of group A at 1, 3 and 6mo was lower than those of group B at the same time point(P<0.05). At the final follow up of 12mo, 26 eyes(87%)were treated successfully with IOP>30mmHg in 4 eyes. But there were more patients with relieved symptoms in group A than in group B. Fourteen eyes(47%)were treated successfully in group B with IOP> 30mmHg in 13 eyes, symptoms were relieved and IOP<7mmHg in 3 cases(P=0.026). No ocular atrophied. The rate of complication in group A was 13%, which was significantly lower than that of group B(67%, P<0.05).

CONCLUSION:The anti-VEGF drugs with trabeculectomy for neovascular glaucoma can improve visual acuity, reduce IOP, and relieve symptoms with high safety.

Abstract:AIM:To analyze the impact of anxiety on the symptoms of dry eye and inflammation factors in diabetic patients after cataract surgery.

METHODS:Sixty-three diabetic patients(79 eyes)with cataract treated from January 2011 to October 2015 in our hospital were selected. All the patients were conformed to the WHO diagnosis standards of diabetes and cataract. The patients received the phacoemulsification and intraocular lens implantation. After 1d of treatment, Hamilton Anxiety Rating Scale(HAMA)was applied to evaluate the psychological state. According to the evaluation results, the patients were divided into non-anxiety group(<14 scores)and anxiety group(≥14 scores). The non-anxiety group had 34 cases and the anxiety group had 29 cases. The dry eye and inflammatory response of the two groups was compared.

RESULTS:At 1d and 3mo after treatment, the evaluation scores of dry eye of two groups were not significantly different(P>0.05); at 7d after treatment, the dry eye of anxiety group was more serious than that of non-anxiety group(P<0.05). At 1d and 3mo after treatment, the anterior chamber inflammation responses of two groups were not significantly different(P>0.05); at 7d after treatment, the inflammation response of anxiety group was more serious than that of non-anxiety group(P<0.05). At 1d and 3mo after treatment, the levels of IL-1β, IL-6 and TNF-α of the two groups were not significantly different(P>0.05); at 7d after treatment, the levels of IL-1β, IL-6 and TNF-α of anxiety group were significantly higher than those of non-anxiety group(P<0.05).

CONCLUSION: Anxiety has an obvious effect on the dry eye and inflammation response in diabetic patients after cataract surgery. Before surgery, the evaluation of anxiety and the targeted mental intervention is of great importance on the postoperative recovery.

Abstract:AIM:To explore the microfluctuation change of eye accommodation in adolescents with ametropic amblyopia under same amount comprehensive amblyopia treatment and the efficacy for dominant eye.

METHODS:Teenagers who took routine physical examination were chosen as the research object. Copper card method was used to identify the dominant eye and the main eye in adolescents with ametropic amblyopia which was the observation group, 63 cases with 63 eyes each. Sixty subjects with emmetropia were as the normal group. The research objects underwent mydriasis optometry, computer optometry and streak retinoscopes to determine the diopter. The patients with ametropic amblyopia were treated with same amount comprehensive amblyopia treatment, and wearing glasses. There was not any treatment for normal group. The curative effect of same amount comprehensive amblyopia treatment were tested between the observation group and the control group when treating at 1,3,6 and 12mo respectively. Microfluctuation changes when reading at the distance of 25, 33 and 50cm(5min for every distance)of the two groups were tested. Then the low frequencies(LFC)of microfluctuation change was calculated and analyzed. The whole eye aberration of the normal group and the observation group were tested with i-Trace Wave Scan Wavefront, and the corneal aberration was collected and calculated with Humphrey corneal topographer. Microfluctuation changes of the two groups were compared and the relation between the accommodation index and the wavefront aberration was analyzed.

RESULTS:Through statistical analysis, the LFC value of the observation group at 25, 33 and 50cm respectively was 0.086±0.022, 0.057±0.032 and 0.041±0.028D²/Hz, which was significantly higher than the LFC value of the normal group which was 0.047±0.023,0.037±0.021,0.027±0.011D²/Hz(P<0.05).

CONCLUSION:Under the same amount treatment, the short-term curative effect of dominant eyes in children with ametropic amblyopia is superior to the non-dominant ones. While the differences of medium and long-term efficacy have no statistical significance. There is no difference on corneal aberration between dominant and non-dominant eyes. At near distance, the LFC of microfluctuation change was higher in amblyopia patients than that in normals.

Abstract:Recently, the incidence of myopia increases year by year. The effectiveness of refractive surgery for the correction of ametropia is widely recognized with rapid development of ophthalmic microsurgery. The laser in situ keratomileusis(LASIK)has been accepted as a regular refractive surgery technique to correct mild and moderate myopia. However, it shows inadequacy in ability to correct high refractive errors, and in patients with thin cornea and keratoconus. In 1993, Staar Surgical(A.G. Nidau)introduced a modified intraocular collamer lens(ICL)for the correction of high myopia, which emerged as a safe and effective operation for moderate or high myopia gradually. Although it has already been proved that ICL has safety and efficacy for the correction of high myopia, several studies reported dislocation and rotation of ICL after implantation, which led decreased vision and poor satisfaction. In severe cases, secondary glaucoma, anterior subcapsular cataract happened consequentially. These potential complications have drawn more and more attention by the majority of physicians and scholars. This paper aims to discuss the potential cause of shift and rotation of ICLs after implantation.

Abstract:Immunoglobulin G4-related disease(IgG4-related disease)has received lots of attention in medical community as a recently recognized fibro-inflammatory condition. It is characterized by infiltration of IgG4-immunopositive plasmacytes and concentration of elevated serum IgG4. IgG4-related disease shows organ enlargement or nodular/hyperplastic lesions in various organs including the pancreas, hepatobiliary tract and orbit, which is called IgG4-related orbital disease. The diagnostic criteria for IgG4-related disease and IgG4-related orbital disease has recently been established, which is based on clinical, imaging and histopathologic features of the orbital lesions. Besides, attention should be drawn to the differentiation from other diseases. The treatment is empirical including corticosteroids, immunosuppressive drugs, radiotherapy, and rituximab. This article reviews clinical progression of IgG4-related orbital disease.

Abstract:Because of the clinical features, hard nuclear cataract surgery has great difficulty and increased postoperative complications(POC), which troubled clinical doctors all the time. In recent years, with the ophthalmic surgical instruments and equipments continues to be improved, also as surgical technique, the cure rate of cataract has obviously been improved. However, the operation mode selection for hard nuclear cataract has been the focus and difficulty for ophthalmologists. This review makes a summary of the recent clinical research progress on the treatment for hard nuclear cataract to analysis the advantages and disadvantages of various surgeries.

Abstract:Researches have shown that cell apoptosis participates pathogenesis of diabetic retinopathy, which is a process of polygenes regulation. The B-cell leukemia/lymphoma-2(Bcl-2)family and Fas are all important genes that can regulate apoptosis. This article reviews the relation between diabetic retinopathy and apoptosis as well as expression of some related genes.

Abstract:Diabetic retinopathy(DR),which can cause blindness, is a serious eye diseases. Diabetic macular edema(DME), often causes irreversible vision loss, can occur in any period of DR. The treatment of DME, including laser photocoagulation, anti-inflammatory therapy, anti-VEGF therapy and surgical treatment have made great progress in recent years as the researches on the pathogenesis deepening. The innovation of minimally invasive technique also proved the surgical treatment more convenience. The joint application of a variety of treatments, also become the main trend of treatment. A review of the present status and progress of the treatment was made in this paper.

Abstract:Various ocular surface disorders like alkali burns and corneal ulcers can all cause damage to the cornea and conjunctiva, and often induce corneal neovascularization(CNV)that affects the visual function. However, amniotic membranes(AM)can promote the rapid epithelization of acute injured corneas and conjunctiva defects, diminish scarring, and perform anti-inflammatory effect. Therefore, AM has been widely used in ocular surface reconstructions and treatment of CNV. But the key problem is how to fix the AM. Only ensuring the adhesive time and cover area with convenient operation and little stimulation can achieve the best curative effect. This article reviews the methods of AM fixation in AM patch technique.

Abstract:AIM:To research the efficacy and safety of diffractive aspheric multifocal intraocular lens(MIOL)in the Uighur in phacoemulsification to provide guidance for the clinical treatment of cataracts patients in Xinjiang region.

METHODS:Two hundred and twenty-eight Uygur patients(280 eyes)received phacoemulsification from April 2012 to March 2013 were randomly divided into multifocal group(106 cases with 146 eyes)and monofocal group(122 cases with 134 eyes). Patients were followed up for 3mo. The intraocular pressure(IOP), uncorrected distance visual acuity, uncorrected near vision, best-corrected distance visual acuity and best corrected near vision were measured. The delensed rate, visual quality, and satisfaction for lenses in the form of questionnaires were compared.

RESULTS:Multifocal group was better on the uncorrected near vision than monofocal group(P<0.05).The differences on uncorrected distance visual acuity, best corrected distance visual acuity, best corrected near vision between the two groups showed no significant difference(P>0.05). The contrast sensitivity of multifocal group under scotopia at spatial frequency 3c/d was lower than that of monofocal group(P<0.05), those at other spatial frequency had no difference(P>0.05). Delensed rate of multifocal group was higher than that of monofocal group(P<0.05). The satisfaction for lenses had no difference between the two groups(P>0.05).

CONCLUSION:MIOL with phacoemulsification can provide patient good full range vision, especially on good near vision. The patients with MIOL implanted have a higher delensed rate, less postoperative adverse symptoms, quicker recovery and satisfaction.

Abstract:AIM:To evaluate the clinical effect of viscocanalostomy combined with 90°trabeculotomy in patients with primary congenital glaucoma(PCG).

METHODS:A total of 37 patients(50 eyes)with primary congenital glaucoma were included in the prospective and randomized trial. These patients were divided into two groups, the study group and the contral group. Viscocanalostomy combined with 90° trabeculotomy was performed in 25 eyes as the study group and 180° trabeculotomy in the other 25 eyes as the control group. The outcomes were measured respectively, including preoperative and postoperative intraocular pressure(IOP), corneal diameter and cup/disc ratio detected by Schiots tonometer, compass and ophthalmoscope respectively when patients were under sedation by chloralic hydras coloclysis. All patients were followed up at 1wk, 1, 3 and 6mo.

RESULTS:IOP decreased respectively from preoperative 30.74±4.68mmHg in the study group and 31.96±5.15mmHg in the control group to postoperative 7.51±3.68 and 8.47±2.66mmHg, 11.79±1.84 and 13.88±6.32mmHg, 13.97±2.76 and 15.74±3.20mmHg, 14.51±0.97 and 16.51±2.44mmHg at 1wk, 1, 3 and 6mo. The differences were statistically significant(P<0.01).The postoperative corneal diameter of study group decreased significantly at 3mo after operation(P<0.05). The average cup/dish ratio decreased in 22 eyes, did not progress in 28 eyes. The patients with successful operation had less cup/dish ratio(0.60±0.24)than that(0.72±0.19)before operation(P=0.007). In the 50 eyes, there was anterior chamber hemorrhage in 11 eyes(22%), which was not related to the decrease of IOP after operation. The rest patients had no complications, such as shallow anterior chamber, hypotonia, Descemet's membrane detachment, choroidal detachment, prolapse of vitreous, synechia and intraocular infection.

CONCLUSION:Viscocanalostomy combined with 90° trabeculotomy can improve the success rates in the patients with PCG, including lowering the postoperative mean IOP and decreasing the complication rates.

Abstract:AIM:To explore the clinical efficacy of Ex - PRESS drainage device implantation for refractory glaucoma and related complications.

METHODS: Fifty-three cases(56 eyes)were randomly selected in our hospital from February 2013 to August 2014 who received Ex-press glaucoma drainage device implantation for refractory glaucoma, 39 males(41 eyes)and 14 females(15 eyes), 52.63±10.58 years old; 25 cases(26 eyes)with neovascular glaucoma, 16 patients(18 eyes)with failure of glaucoma filtration surgery, 6 cases(6 eyes)with secondary glaucoma after vitrectomy, and 6 cases(6 eyes)with glaucoma secondary to complicated ocular trauma. Postoperative visual acuity, intraocular pressure(IOP), anterior chamber depth, corneal endothelial cell density and complications, etc. at 1 and 12mo were analyzed and compared with the preoperative.

RESULTS: At 12mo after operation, the complete success rate was 62%(35 eyes), the partial success rate was 14%(8 eyes), and the total success rate was 77%. The effective rate was 85% in patients with neovascular glaucoma, 56% in patients with failure of glaucoma filtration surgery, 100% in patients with glaucoma secondary to complicated ocular trauma, 83% in patients with secondary glaucoma after vitrectomy. At 1mo after surgery, visual acuity improved in 28 eyes(50%), unchanged in 18 eyes(32%), decreased in 10 eyes(18%). At 12mo after surgery, visual acuity improved in 19 eyes(34%), unchanged in 18 eyes(32%), decreased in 19 eyes(34%). Preoperative IOP was 29.58±8.66 mmHg, that at 1mo after surgery was 12.75±5.66mmHg, and the difference was significant(P<0.05). There were 56 eyes with decreased IOP(100%). IOP at 12mo after surgery was 9.8-28.4(mean 15.42±4.09)mmHg, which was lower than that before surgery(P<0.05). IOP were increased in 2 eyes, unchanged in 0, decreased in 54 eyes(96%)at 12mo. The corneal endothelial cells was 1958.22±168.30 and 1793.99±201.55/mm², respectively, both decreased compared to that before surgery(2113.47±80.56/mm², P<0.01). The total occurrence of postoperative complications was 29%, of which the early postoperative shallow anterior chamber with ocular hypotension was in 4 eyes, transient high IOP in 3 eyes, drainage tube obstruction in 5 eyes, and hyphema in 3 eyes. Late complication of cystic bubble with local doming was found in 1 eye.

CONCLUSION: Ex-press glaucoma drainage device implantation for refractory glaucoma, although has some complications, still achieve better clinical efficacy, and is an effective method for refractory glaucoma.

Abstract:AIM:To investigate the effect of anterior chamber paracentesis combined with improved compound trabeculectomy for persistent state of high intraocular press(IOP)in patients with acute angle-closure glaucoma(AACG)failed in drug control.

METHODS:Thirty-seven AACG patients(37 eyes)with persistent state of high IOP admitted in our hospital from June 2011 to June 2015 were selected. Vision:there was light perception in 2 eyes, hand movement in 3 eyes, finger count in 6 eyes, 0.01 in 8 eyes, 0.05 in 6 eyes, 0.1 in 5 eyes, 0.2 in 3 eyes, 0.25 in 2 eyes, 0.3 in 2 eyes; IOP:40-50 mmHg in 14 eyes, 51-60 mmHg in 11 eyes, 61-70 mmHg in 7 eyes, 71-80mmHg in 5 eyes; Anterior chamber:29 patients gotⅡ grade shallow anterior chamber and 8 patients got Ⅲ grade. After 24-72h of comprehensive ocular hypotensive medications failed to control IOP, paracentesis was applied. At 1-2d after IOP dropped to 21mmHg or less, patients received trabeculectomy combined with goniosynechialysis and mitomycin(MMC). Postoperative systemic and topical anti-inflammatory, anti-infection, symptomatic treatments were applied.

RESULTS:Postoperative vision was 0.1-0.2 in 3 eyes, 0.25 in 4 eyes, 0.3 in 6 eyes, 0.4 in 8 eyes, 0.5 in 7 eyes, 0.6 in 6 eyes and 0.8 or more in 3 eyes. Postoperative IOP was controlled within 10-21mmHg without medication in 26 eyes, within 23-27mmHg with 1-2 kinds of anti-glaucoma medications in 8 eyes, 3 eyes failed in drug decompression with 2-3 medications and remained high IOP of 30-38mmHg at last underwent surgery again. The chamber grading was grade Ⅰ in 28 eyes, grade Ⅱ in 6 eyes, Ⅲ grade in 3 eyes. Filtering bleb type was type Ⅰ of functional filtering bleb in 21 eyes, type Ⅱ functional filtering bleb in 13 eyes, type Ⅲ of non-functional filtering bleb in 2 eyes, type Ⅳ of non-functional filtering bleb in 1 eyes. No case occurred complications such as fulminant choroidal hemorrhage, vitreous loss or postoperative malignant glaucoma. There were 3 eyes underwent phacoemulsification cataract combined with IOL implantation and trabeculectomy triple surgery again.

CONCLUSION:In statement of persistent high IOP in acute angle-closure glaucoma patients with acute exacerbation, anterior chamber paracentesis combined with improved compound trabeculectomy surgery is effective, safe and feasible, greatly reducing postoperative complications, significantly improving the quality and efficiency of operation, and further improving the success rate of surgery.

Abstract:AIM:To characterize the circadian fluctuation of intraocular pressure(IOP)and ocular perfusion pressure(OPP)at habitual position in newly diagnosed patients with untreated primary open angle glaucoma(POAG)and to test the feasibility of calculating nocturnal peak IOP from the diurnal mean IOP.

METHODS:Nineteen patients(19 eyes)with POAG and eighteen healthy controls(18 eyes)were included and underwent 24-hour monitoring of IOP and blood pressure. At 10:00, 14:00, 18:00 and 22:00 o'clock in the daytime, all the subjects were monitored in sitting position while at 02:00, 05:00 and 07:00 o'clock at night in supine position. For testing the feasibility of calculating nocturnal peak IOP from mean IOP in diurnal supine, all patients still needed to be monitored for IOP in supine position after lying for 5min in the daytime. Measurements were taken in diurnal supine at 2:00, 5:00 and 7:00. OPP was calculated and analyzed. Nocturnal peak IOP was calculated with known formulas and compared with the actual values.

RESULTS:The mean IOP and the fluctuation of IOP of POAG group were higher than those of healthy group in 24-hour habitual position(P<0.05). The mean peak IOP appeared at 05:00 o'clock in POAG patients while at 07:00 o'clock in healthy controls. Both groups had higher mean nocturnal IOP than diurnal(P<0.05). In both groups, the nocturnal mean ocular perfusion pressure(MOPP)was lower than diurnal(P<0.05). However, there was no obvious difference between two groups on MOPP(P>0.05). POAG group had higher fluctuation of MOPP than that of healthy group(P<0.05). Besides, there was no difference between actual peak IOP and values calculated from formulas(P>0.05).

CONCLUSION:The peak IOP of habitual position in patients with POAG and healthy people appears in the morning, and POAG group has higher mean IOP and fluctuation of IOP. Nocturnal OPP is lower than diurnal OPP in both groups, and POAG group has larger fluctuation of MOPP. It might be feasible that we could calculate nocturnal peak IOP from the diurnal mean IOP.

Abstract:AIM:To observe the protective effects of salvianolate on retinal nerve fiber layer thickness after glaucoma filtration surgery.

METHODS:In the research,We studied 65 patients(65 eyes)with acute angle-closure glaucoma who were selected from September 2012 to September 2013 and treated with trabeculectomy. During the 2wk treatment, postoperatively group A were given conventional therapy according to clinical pathway of glaucoma treatment. Besides these treatment, group B were treated with salvianolate 200mg intravenously per day. The changes of the intraocular pressure(IOP)and retinal nerve fiber layer(RNFL)thickness in the two groups were observed and analyzed statistically before surgery, at 1wk and 3mo after surgery.

RESULTS:The IOPs of the two groups at 1wk and 3mo after operation were lower than that before operation but the difference between the two groups was not significant(P>0.05). In group A, the RNFL thickness at 1wk after surgery was less than that before operation at temporal, superior, nasal and inferior(P>0.05). The RNFL thickness at 3mo after surgery was significantly less than those before operation and at 1wk after surgery at temporal, superior, nasal and inferior. In group B, the RNFL thickness at 1wk after surgery were less than that before operation, but the those at nasal and temporal were without statistical significance. The RNFL thickness at 3mo after surgery was less than that before operation(P<0.05)and that at 1wk after surgery(P>0.05). The superior and inferior RNFL thickness of group B were less than those of group A at 1wk after surgery, and the temporal, superior and inferior RNFL thickness in group B were higher than those in group A at 3mo after surgery.

CONCLUSION:Salvianolate can reduce optic RNFL edema and delay its thinning after glaucoma attack.

Abstract:AIM:To observe the effectiveness of adjustable suture to tear film in patients with acute angle-closure glaucoma in different periods after surgery.

METHODS:Sixty patients(68 eyes)with acute angle-closure glaucoma were divided into study group(trabeculectomy with adjustable suture)and control group(trabeculectomy without adjustable suture). The preoperative and postoperative data including tear break-up time(BUT), Schirmer I test(SⅠt), fluorescent(FL),and signs and symptoms of patients were analyzed respectively.

RESULTS:The results of SⅠt at 7d after surgery and FL at 3d after surgery in the study group were higher than those in the control group(P<0. 05). There were no significant differences on SⅠt and FL between the two groups since the thirtieth day after surgery. The signs of foreign body sensation, conjunctival congestion and photophobia at 1d after surgery in the study group were also higher than those in the control group(P<0.05); since the thirtieth day after surgery, there were no significant differences between two groups(P>0.05).

CONCLUSION:Using the adjustable suture in trabeculectomy will cause temporary impact on the tear film,and it will disappear soon after the suture being dismantled.

Abstract:AIM:To evaluate the clinical effect of subconjunctival injection of triamcinolone acetonide in patients with macular edema secondary to uveitis.

METHODS:Sixty-eight patients(82 eyes)with macular edema secondary to uveitis selected in our hospital from October 2014 to October 2015 were assigned into control group and experimental group according to random number table method, with 34 cases(41 eyes)in each group. Patients in the control group were treated by intraocular injection of triamcinolone acetonide, and patients in the experimental group were given subconjunctival injection of triamcinolone acetonide. Clinical effect, central macular thickness and adverse reactions in the two groups were compared.

RESULTS:There was no significant difference on the central macular thickness and best corrected visual acuity between the two groups before treatment(P>0.05). Central macular thickness in the experimental group after treatment(214.26±65.54 μm)was significantly lower than that in the control group after treatment(256.47±84.52 μm,P<0.05), and best corrected visual acuity in the experimental group after treatment(4.8±1.3)was significantly higher than that in the control group(4.0±1.4, P<0.05). The overall response rate in the observation group(98%)was obviously higher than that in the control group(83%, P<0.05). The incidence of adverse reactions in the observation group(37%)was significantly lower than that in the control group after treatment(59%, P<0.05).

CONCLUSION:Subconjunctival injection of triamcinolone acetonide exerts obvious effect in uveitis patients with macular edema, effectively improves visual acuity, alleviates macular edema and reduces the incidence of intraocular pressure increasing, conjunctival hemorrhage and other adverse reactions, which is safe and effective, thus has potential application.

Abstract:AIM:To observe the change of subfoveal choroidal thickness(SFCT)after intravitreal injections of anti-vascular endothelial growth factor monoclonal antibody Ranibizumab in patients with choroidal neovascularization(CNV)secondary to pathologic myopia(PM)and to research the relation between visual acuity and SFCT.

METHODS:This was a prospective, contrast, open-label study.Fifty pathologic myopia patients with CNV(50 eyes)were recruited in this study. Before the injection,best-corrected visual acuity detected by visual chart from Early Treatment of Diabetic Retinopathy Study(ETDRS),non-contact tonometer,ophthalmoscope,fundus photography, fundus fluorescein angiograph(FFA)and optical coherence tomography(OCT)examination were necessary. All affected eye were treated with intravitreal ranibizumab 0.05mL. Following up for 12mo, the changes of visual acuity and SFCT were compared before and after treatment, also the relation between them.

RESULTS:All eyes received an average of 2.47±2.23 injections,the final vision of follow-up increased by 13.62±8.98 letters than that before(t=6.69,P<0.05). The SFCT before therapy, 1, 6 and 12mo after treatment were 81.48±61.62, 79.63±60.98, 77.92±61.26 and 78.34±59.48μm and respectively decreased by 2.09±8.93, 3.68±7.42, 3.16±6.95μm compare to pre-treatment.The difference on SFCT at 1mo was not significant compared to before treatment(t=0.95, P>0.05).While after 6 and 12mo,the differences were significant(t=2.34, 2.61; P<0.05). Twenty-four eyes(48%)were with recurrence, mean recurrence times were 1.39±1.23. The SFCT increased from 75.7±51.6μm at 1mo to 84.4±55.9μm(by 11.5%)when recurred, there were significant differences(P<0.05). Twenty-six eyes(52%)were not with recurrence. The SFCT at 1, 6 and 12mo after treatment were 85.3±52.7, 83.6±50.5 and 84.2±54.2μm, there were no significant differences with multiple comparison(P>0.05).There were no serious systemic or local side effects during the follow up.

CONCLUSION:Intravitreal ranibizumab for CNV secondary to pathologic myopia is safe and can improve the visual acuity.Intravitreal injections of ranibizumab can induce SFCT reduction for CNV secondary to pathologic myopia.We hypothesized that increase of SFCT may be one of evaluation index for CNV activity.

Abstract:AIM:To study the therapeutic effect of intravitreal injection of Bevacizumab combined with laser photocoagulation for diabetic macular edema.

METHODS:Sixty-nine cases(82 eyes)with diabetic macular edema in our hospital form February 2014 to March 2015 were selected and they were randomly divided into two groups(41 eyes in each group).The observation group were given the combination treatment with intravitreal injection of bevacizumab and laser photocoagulation. The control group was given the laser photocoagulation only. The best corrected visual acuity(BCVA),the central macular thickness(CMT),the results of fundus fluorescein angiography(FFA),and the intraocular pressure between two groups were observed and compared.

RESULTS:BCVA and CMT of the observation group became better at 1,3 and 6mo after treatment(P<0.05).BCVA of the control group had no changes(P>0.05)and CMT decreased at 1,3 and 6mo(P<0.05), but the result of FFA rebounded at 6mo. There were significant differences between two groups on BCVA and CMT after treatment(P<0.05). None of patients in two groups got any local or systemic complication at 1,3 and 6mo after treatment.

CONCLUSION:Intravitreal injection of bevacizumab combined with laser photocoagulation for diabetic macular edema is much more effective and has less complication.It is worth promoting in clinical application.

Abstract:AIM:To investigate the efficacy related factors for idiopathic macular hole after vitrectomy.

METHODS:One hundred cases(100 eyes)with idiopathic macular hole treated in our hospital from May 2012 to September 2015 underwent vitrectomy were selected. The differences before and after operations on best corrected visual acuity(BCVA)and OCT parameters were compared. Pearson correlation analysis and multiple linear regression analysis were performed on aforementioned parameters.

RESULTS:After treatment,the BCVA(0.357±0.172)was significantly higher than that before treatment(0.137±0.115)(P<0.05). The postoperative basal diameter, minimum diameter, the height of the hole, and the thickness of the retina were significantly lower than those preoperative(P<0.05). Pearson correlation analysis results showed:the postoperative BCVA was negatively correlated with basal diameter(r=-0.397,P<0.01)and minimum diameter(r=-0.397, P<0.01); the postoperative BCVA was positively correlated with the height of the hole(r=0.399,P<0.01), the thickness of the retina(r=0.345,P<0.01), MHI(r=0.318,P=0.001)and HPF(r=0.417, P<0.01). Multivariate linear regression analysis showed that the postoperative BCVA was positively correlated with macular retinal thickness(T=2.323,P=0.022).

CONCLUSION:Vitrectomy for idiopathic macular hole has good effect,and the parameters of OCT examination were highly correlated with the recovery of postoperative visual acuity.

Abstract:AIM:To investigate the clinical efficacy of Chinese medicine formula for macular edema in the patients with phlegm intrinsic type and central serous chorioretinopathy(CSCR).

METHODS:With randomized controlled method,56 cases(71 eyes)with phlegm intrinsic type and CSCR were randomly divided into the control group and the treatment group.The control group included 28 cases(35 eyes),and the treatment group 28 cases(36 eyes).The patients in the control group received injections of 2mL compound anisodine beside superficial temporal artery,once a day.Based the above treatment,the patients in the treatment group were given 10g oral Chinese medicine formula for macular edema,twice a day.After 3mo,the overall curative effect,visual acuity,visual field mean sensitivity and the OCT in both groups were measured and evaluated.

RESULTS:After treatment,the total effective rate in treatment group was 89%,which was significantly higher than 79% in the control group(P< 0.05).Compared with the control group,the vision and visual field mean sensitivity in the treatment group significantly increased,and macular center thickness of 1mm diameter range,the average thickness of the macular area of 6mm diameter and the diameter and the central area and the total macular volume were statistically significantly lower(P<0.05).

CONCLUSION:Chinese medicine formula for macular edema may ameliorate the visual acuity and visual field in the patients with phlegm intrinsic type and central serous chorioretinopathy,reducing edema lesions and promoting the recovery of visual function.

Abstract:AIM:To investigate the effect of 0.5g/L cyclosporine A for symptom and sign scores in patients with moderate to severe dry eye.

METHODS:Eighty patients(160 eyes)with moderate to severe dry eye were divided into two groups by double-blind and random principles:40 patients(80 eyes)in observation group were treated with 10g/L sodium carboxymethyl cellulose and 0.5g/L cyclosporine A eye drops, 40 patients(80 eyes)in the control group were treated with 10g/L sodium carboxymethyl cellulose eye drops. The changes of ocular sign and symptom scores were compared between the two groups.

RESULTS:The total effective rate of observation group was 95.0%, which was significantly higher than that of control group(85.0%, P<0.05). Symptom scores before treatment in observation group and the control group were 36.1±4.4 and 36.4±4.5 points, respectively; symptom scores at 1 and 3mo after treatment were 25.2±3.2, 11.09±3.9 points in observation group, 29.4±4.1, 22.05±3.1 points in control group. The differences of the two groups before and after treatment were statistically significantly(P<0.05). The scores of observation group at 1 and 3mo after treatment were lower than those of control group(P<0.05). Before treatment, break-up time(BUT), Schirmer I test(SⅠt), fluorescein staining(FL)and ocular surface disease index(OSDI)scores had no significant differences between the two groups(P>0.05). After treatment, the four parameters of observation group were improved significantly(P<0.05), while only FL and OSDI of control group were improved(P<0.05). The four parameters of observation group were higher than those of control group(P<0.05).Three eyes in observation group felt tingling during 14-28d of the drug using, 2 eyes in control group felt tingling and one eye in control group had conjunctival congestion. All the symptoms disappeared after 2d without stopping the drugs.

CONCLUSION:The 0.5g/L cyclosporine A eye drops can effectively relieve the symptoms and signs of moderate to severe dry eye, promote tear secretion, and improve ocular surface environment. The treatment effect is good.

Abstract:AIM:To explore the therapeutic effect of cyclosporine eye drops combined with artificial tears for dry eyes.

METHODS:One hundred and two patients(204 eyes)with dry eye as the research objects were collected from January 2015 to November 2015 and randomly divided into 3 groups:control group, subgroup A, subgroup B, 34 patients(68 eyes)in each group. The control group did not do special treatment. Subgroup A was treated with artificial tears eye drops 3 times per day and subgroup B with cyclosporine eye drop first, 15min later with artificial tears, 3 times per day. All patients were treated for 8wk. Tear ferning test(TFT), corneal fluorescein staining(FL), Schirmer I test(SIt), breakup time of tear film(BUT)and conjunctive impression cytology(CIC)in each group were observed and compared.

RESULTS:(1)At 4wk after treatment, fern fractional crystallization grade of subgroup B was better than those of subgroup A and control group(χ²=16.345,P=0.003); at 8wk after treatment, fern fractional crystallization grade of subgroup B was better than those of subgroup A and control group(P<0.05).(2)The FL of control group at 8wk was worse compared with before treatment(t=-4.500,P=0.003); the FL of subgroup A and subgroup B became lighter and the scores decreased compared with before treatment(P<0.05); at 4 and 8wk after treatment, the FL scores of subgroup B were lower than those of subgroup A(t=3.553, P=0.006; t=4.523, P=0.001).(3)Compared with control group, the BUT of subgroup B at 4 and 8wk prolonged(P<0.05); the BUT of subgroup B had no difference with subgroup A(P>0.05).(4)At 8wk after treatment, conjunctival impression cytology of subgroup B was better than those of the control group and subgroup A(P<0.05).(5)At 4wk after treatment, SIt of subgroup B increased, compared with subgroup A and the control group(χ²=6.384, P=0.012); at 8wk after treatment, SIt of subgroup A and B were better than those before the treatment, SIt of the B subgroup was better than that of subgroup A(all P<0.05).

CONCLUSION:Cyclosporin eye drops combined with artificial tears can improve micro environment of the tear, increase the amount of tear secretion, extend BUT and enhance the stability of the tear film.

Abstract:AIM:To assess the efficacy of comprehensive treatment of visual physiological stimulation with three-dimensional visual training for ametropic amblyopia(anisometropic amblyopia)in children.

METHODS:All patients were divided into treatment group(comprehensive therapy group)and the control group(conventional therapy group). Control group was given conventional spectacles, covering and fine mesh therapy. Besides those, treatment group received CAM light Alexandra treatment instrument, multi-color spectral stimulation, like the amblyopia red treatment instrument, Haidinger Brush and other physiological stimulating therapy. When the visual acuity reached 0.4 or above, three-dimensional visual training was conducted into the therapy. Synoptophore was used at first. After the three-dimensional vision had been developed, the home used synoptophore(stereoscope cherioscope, red, green and three-dimensional picture Tranaglyphs)was used to reinforce the training.

RESULTS:The two groups were followed up for 2-7a, the rate of almost cured patients was 86.3% in the treatment group, there were significant differences in the basic cure rate after treatment.

CONCLUSION:Visual physiological stimulating therapy with three-dimensional visual training method is desirable for amblyopia.

Abstract:AIM:To estimate the prevalence and related risk factors of pterygium among the middle-aged and the senile in the defined rural area of Heilongjiang.

METHODS:Population-based cross-sectional study. A total number of 6 196 subjects aged 50 years or older in 35 villages in Mingshui District of Heilongjiang was studied, using cluster random sampling methods. The prevalence of pterygium, distribution patterns and risk factors in this population were studied.

RESULTS:There were 5 669 subjects(91.49%)actually received the examination and 246 patients(329 eyes)were found among the population aged 50 years or older. The prevalence of pterygium was 4.34%. The prevalence of pterygium was positively correlated with age(for every 10a of age, OR=1.616,95%CI:1.372-1.903,P<0.01). Logistic regression analysis showed:non-glasses vs wearing glasses when been outdoors(OR=5.045,95%CI :1.592-15.985,P=0.006); outdoor workers vs indoor workers(OR=3.896,95%CI:2.834-5.356,P<0.01). Pterygium was related to the age, glass-wearing and times working outdoors.

CONCLUSION:In the alpine, rural area of Honglongjiang, the prevalence of pterygium is decreased. Old age and outdoor work are the risk factors, while wearing glasses when going out is a protective factor.

Abstract:AIM:To analyze epidemiological characteristics of dry eye and the difference of prevalence in groups with different profession and ages to investigate the relevant risk factors so as to lay a scientific foundation for the diagnostics and treatment of dry eye.

METHODS:Dry eye questionnaire and ocular examination were conducted to 8 145 common persons participating in social physical examinations in Dezhou Center for Disease Control and Prevention from February 2011 to November 2014.

RESULTS:In the target population, 1 803 persons were suffering dry eye, accounting for 22.14%,the prevalence in female was higher than that in male,there was significant difference between genders(χ²=45.12,P<0.01). The prevalence was on the rise along with the age, specifically in 5-20, 21-40, 41-60 and 61-72 years old groups,it was 9.61%(109/1 134), 22.84%(789/3 455), 23.06%(433/1 878)and 28.13%(472/1 678)respectively(χ²=95.76,P<0.01). The prevalence in female was significantly higher than that in male in the 5-20, 41-60 and 61-72 years old groups. The prevalence varied significantly in different occupational populations,and the retiree accouted for the largest proportion(27.48%)(χ²=59.80,P<0.01); the top 3 main complaints were eye dryness(30.40%), blurred vision or vision fluctuation(24.73%)and photophobia(14.53%)in sequence; in addition, the multivariable Logistic regression analysis showed that visual display terminal syndrome, wearing corneal contact lens, the abuse of eye drops and air pollution were the main risk factors for the dry eye symptoms.

CONCLUSION:Dry eye prevention and treatment are badly in need in Dezhou city; and the major clinical characteristics of the disease should be grasped to make a timely and accurate diagnosis and to conduct specific health education and behavior interventional measures to people with different occupations.

Abstract:AIM:To explore the efficacy and safety of combined surgery for neovascular angle-closure glaucoma secondary to proliferative diabetic retinopathy(PDR).

METHODS:A prospective nonrandomized clinical study was performed. All enrolled patients were initially treated with intravitreal injection of ranibizumab at the dose of 0.5mg(0.05mL). After new vessels(NV)on the iris and the angle of anterior chamber regressed completely, all patients received phacoemulsification(PHACO), intraocular lens implantation(IOL), trabeculectomy(TRAB), pars plana vitrectomy(PPV)and endophotocoagulation(EPC). The changes of best corrected visual acuity(BCVA), intraocular pressure(IOP), NV and complications were observed, and followed up for 6mo.

RESULTS:Nineteen eyes of 19 patients with neovascular glaucoma(NVG)were involved in this study. After followed up for 6mo, postoperative BCVA of all was improved. Mean IOP was decreased significantly(P<0.01)from 60.00±6.98mmHg preoperatively to 9.68±2.11mmHg at 1wk, 13.32±2.38mmHg at 1mo, 16.37±3.42mmHg at 3mo, and 18.32±2.14mmHg at 6mo postoperatively. All eyes had controlled IOP(<21mmHg)at last visit in which 3 eyes needed one kind of anti-glaucoma medication, and 2 eyes needed two kinds of anti-glaucoma medication. All eyes showed regression of NV in 3-8d, and recurrent NV was detected in one eye at 36d postoperatively. No serious complications occurred.

CONCLUSION:Combined surgery of intravitreal injection of ranibizumab as adjunctive treatment for PHACO+IOL+TRAB+PPV+EPC could be safe and effect for neovascular angle-closure glaucoma secondary to PDR.

Abstract:AIM:To observe the clinical therapeutic efficacy and safety of intravitreal injection of Ranibizumab for choroidal neovascularization(CNV)in patients with non age-related macular degeneration(non-AMD).

METHODS:Continous cases that had been diagnosed as CNV in non-AMD patients from July 2011 to October 2015 and accepted intravitreal injection of ranibizumab were retrospective analyzed for the efficacy and systemic adverse reactions. The slit lamp examination, best-correct visual acuity(BCVA), fundus fluorescein angiography(FFA)and optical coherence tomography(OCT)were conducted before and after treatment. the injection number, BCVA and the central macular thickness(CMT)within diameter of 1mm at macula before and after treatment were observed.

RESULTS:The follow-up duration was 6mo to 3a in total 22 patients with 24 eyes. The BCVA was 4.50±0.34 at baseline and was improved significantly to 4.77±0.24 after treatment(P<0.01). Mean CMT decreased from 421.63±139.37μm at baseline to 317.62±55.05μm at the final follow-up(P<0.01). The average injection number was 2.6±1.3. None ocular complications and systematic side effects were observed in all cases, such as endophthalmitis, glaucoma, retinal detachment or uveitis.

CONCLUSION:The intravitreal injection of ranibizumab for CNV in non-AMD patients is effective with few side effects.

Abstract:AIM:To investigate the effect of orthokeratology on vision and corneal shape change in myopic adolescents.

METHODS:Ninety-seven young patients(176 eyes)with myopia wearing orthokeratology were randomly selected. Spherical equivalent(SE), uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), corneal curvature and central corneal thickness were examined before, after wearing at 1d, 1wk, 1, 3 and 6mo. The results were compared and analyzed.

RESULTS:SE decreased and UCVA increased at 1d, 1wk, 1, 3 and 6mo after wearing orthokeratology, the difference was statistically significant(P<0.05)when compared with before wearing. The difference of BCVA after wearing orthokeratology compared with before has no statistics significant(P>0.05). The difference of corneal curvature after wearing orthokeratology for 1d, 1wk, 1, 3 and 6mo compared with before was statistically significant(P<0.05). The central corneal thickness became thiner after wearing orthokeratology for 1wk, and the central corneal thickness after wearing orthokeratology for 1, 3, 6mo compared with before was statistically significant(P<0.05).

CONCLUSION:Orthokeratology can effectively reduce the degree of myopia, and significantly improve the uncorrected visual acuity.

Abstract:AIM:To analyze the causative gene mutation for Marfan syndrome(MFS)with autosomal dominant hereditary in a Chinese family in Liaoning Province,China.

METHODS: Venous blood was collected and candidate gene was selected to design primers according to the clinical phenotype. With genomic polymerase chain reaction(PCR)performed, the coding exons and their flanking intron in sequences of candidate gene were sequenced,DNA fragments separated by agarose gel electrophoresis and direct sequencing method was used to determine the pathogenic gene.

RESULTS:Phenotype of the proband was presented as ectopic lentis. Sequencing of the coding regions of FBN1 gene showed the presence of a heterozygous A→G transversion at nucleotide 640 in the 7 exon of FBN1 and the missense mutation made for Glycine into Serine(G214S).

CONCLUSION:A heterozygous mutation of FBN1 c.A640G(p.G214S)is responsible for the Marfan syndrome in the four generation Chinese pedigree.

Abstract:AIM:To investigate the causes and therapys of descemet membrane detachment in the patients received phacoemulsification with intraocular lens(IOL)implantation, extracapsular cataract extraction with IOL implantation and trabeculectomy respectively.

METHOD:A retrospective analysis was applied for 1 356 eyes which had received one of above-mentioned surgeries from January 2012 to March 2015. Total 29 eyes with descemet membrane detachment were noted.

RESULTS:After the appropriate treatment, no corneal endothelial decompensation happened in the 29 eyes, and the visual acuity recovered to 4.1-4.8.

CONCLUSION:The main reasons for descemet membrane detachment are the anatomical features of descemet membrane, the incision adopted in the intraocular surgeries, the injuries caused by the surgical instruments and the potential pathological changes in the patients' cornea.Timely detection of descemet membrane detachment during and post-operation and adoption of proper treatment is important for the restoring of the visual acuity.

Abstract:AIM:To compare the effect of small incision non-phacoemulsification and phacoemulsification for patients with cataract and glaucoma.

METHODS:Fifty-six patients(56 eyes)with cataract and glaucoma in our hospital from October 2011 to January 2014 were selected as research objects, and they were randomly divided into group A(small incision non-phacoemulsification group)with 28 cases and group B(phacoemulsification group)with 28 cases, then the visual acuity and intraocular pressure(IOP)before and after the treatment, incidence of complications of two groups were compared.

RESULTS:The visual acuity and IOP between group A and group B before and after the treatment had no significant differences(P>0.05). The incidence of complications of group B was slightly higher than that of group A, but without significant difference(all P>0.05). The visual acuity and IOP of group A and group B after the treatment were better than those before(all P<0.05).

CONCLUSION:The effect of small incision non-phacoemulsification and phacoemulsification patients with cataract and glaucoma has no obvious differences, while the small incision non-phacoemulsification is with wider application range.

Abstract:AIM:To research the changes of visual acuity and astigmatism after cataract surgery with individualized incision guided by wavefront.

METHODS:We collected 104 cases with cataract and divided them into group A(69 eyes)and group B(35 eyes). Detected by TOPCON KR-1W, the corneal Polar K of the group A was <0.5 and that of the B group was >0.5. The postoperative changes of visual acuity and corneal astigmatism between two groups were observed.

RESULTS:Between the two groups, the differences of Polar K before and after surgeries at 3d, 1 and 3mo were significant(P<0.05). The Polar K of group A increased by 0.25 at 3mo after surgeries and that of group B decreased by 0.3. The visual acuity of both groups improved, and the difference was significant(P<0.05).

CONCLUSION:Individualized incision guided by Topcon KR-1W has certain correction effect for eyes with Polar K>0.5. For eyes with Polar K<0.5, there is less correction effect but raising the Polar K by 0.25.

Abstract:AIM:To evaluate the therapeutic effect of phacoemulsification and intraocular lens implantation in patients with high myopia and cataract.

METHODS:Seventy-three cases(128 eyes)with cataract and high myopia were collected from January 2011 to December 2011 in the Eye Hospital of Wenzhou Medical University. Patients received phacoemulsification and intraocular lens implantation.The follow-up period was 4a. The Pre-and post-operative corrected vision and operative complications were recorded and analyzed.

RESULTS:The best corrected visual acuity was 4.33±0.51 before operation and 4.60±0.47, 4.69±0.42, 4.67±0.45, 4.65±0.30, 4.73±0.29, at 1wk, 3mo, 1, 2 and 3a after operation, respectively. Statistical difference of corrected vision was found between the before operation and each time period after operation(P<0.01). At 1wk, 3mo and 1a after operation, patients with shorter axial length(26-30mm)all got a significant better corrected vision compared to patients with longer axial length(>30mm; P=0.012, 0.003, 0.002). No complication was seen during the operation. Cystoid macular edema was found in 2 eyes(1.6%), which were cured after glucocorticoid therapy; increased intraocular pressure(IOP)in 4 eyes(3.1%), which returned to normal after IOP-lowering drugs; posterior capsular opacification was observed in 57 eyes(44.5%), in which 6 mild eyes without influence on vision were observed and 51 eyes were given Nd:YAG laser capsulectomy. The vision of the 51 eyes recovered to normal after laser. No retinal or choroidal detachment was seen after surgery.

CONCLUSION: It is effective and safe for high myopes with cataract to be treated with phacoemulsification and intraocular lens implantation and the long-term visual outcome is stable.

Abstract:AIM:To investigate the surgical skills, the causes and the treatment of the complications of intraocular lens implantation sutured in ciliary sulcus at I phase in cataract surgery.

METHODS:Thirty-six cases(37 eyes)that couldn't implant intraocular lens normally were treated with intraocular lens sutured in ciliary sulcus. The surgical effect and complications were analyzed.

RESULTS:Patients were followed up for 3-24mo. The postoperative best corrected visual acuity(BCVA)was ≥0.8 in 4 eyes(11%), 0.4-0.8 in 19 eyes(51%), 0.1-0.3 in 14 eyes(38%).There were 10 eyes(27%)with corneal endothelium edema, 3 eyes(8%)with vitreous hemorrhage, and all the symptoms disappeared after dealing. There were no serious complications and sequelae in all the patients

CONCLUSION:Intraocular lens implantation sutured in ciliary sulcus at Ⅰ phase in cataract surgery is a complement of the conventional surgery method for cataract with safety and effectiveness. It can increase the vision significantly and reduce the complications.

Abstract:AIM:To discuss and study the effect of trabeculectomy combined with compound Xueshuantong capsules on visual function damage in patients with acute angle-closure glaucoma.

METHODS:One hundred patients(120 eyes)with acute angle-closure glaucoma treated in our hospital from March 2010 to October 2014 were selected, which were divided according to the double blind method into the observation group and the control group. Fifty-two cases(60 eyes)of the observation group were treated with trabeculectomy combined with compound Xueshuantong capsules, 48 cases(60 eyes)of the control group were treated with trabeculectomy. Visual acuity and visual field recovery in the two groups were compared.

RESULTS:At 3mo after operation, intraocular pressure(IOP)returned to normal, the visual acuity of observation group increased by 0.16±0.02, which of control group increased by 0.09±0.01, and the difference was significant(P<0.05).The total effective rate of visual acuity was 96.7% in the observation group and 83.3% in the control group, and the total effective rate of visual field was 96.7% in the observation group, and 83.3% in the control group. The total effective rates of visual acuity and visual field in the observation group were significantly higher than those in the control group(both P<0.05).The incidence of complications in the observation group(1.7%)was significantly lower than that in the control group(16.7%, P<0.05).

CONCLUSION:Trabeculectomy combined with compound Xueshuantong capsules for patients with acute angle-closure glaucoma can effectively improve the visual acuity, expand the scope of vision, and reduce the incidence of complications.

Abstract:AIM:To analysis and discuss etiology of different types of uveitis.

METHODS:We selected 60 patients(120 eyes)with uveitis treated in our hospital from June 2012 to June 2015. All patients examined by the same uveitis specialist with unified standards. According to international standards, uveitis was customized into:anterior uveitis(AU), intermediate uveitis(IU), posterior uveitis(PU), panuveitis(PanU). Age, gender, type of uveitis and causes of the disease were analyzed.

RESULTS:Through the analysis of the etiology and clinical types of patients, the main types were idiopathic(26 cases, 21.7%), VKH syndrome(18 cases, 15.0%), HLA-B27 related(14 cases, 11.7%), viral(12 cases, 10.0%), Fuchs syndrome(8 cases, 6.7%), Behcet's disease(8 eyes, 6.7%), diabetes(6 eyes, 5.0%), syphilis(6 eyes, 5.0%), Posner-Schlossman syndrome(6 eyes, 5.0%), juvenile chronic arthritis(4 eyes, 3.3%), sympathetic ophthalmia(4 eyes,3.3%), traumatic(2 eyes, 1.7%), sarcoid(2 eyes, 1.7%), endophthalmitis(2 eyes, 1.7%)and others(2 eyes, 1.7%). By the observation for different types uveitis, the main cause of AU was idiopathic, followed by HLA-B27-related and viral; for PanU, it was VKH syndrome, idiopathic ones and Behcet's disease; for PU, it was idiopathic, then viral; for IU, it was idiopathic.

CONCLUSION:Through observation and analysis for clinical patients, male patients were more than female; idiopathic, caused by VKH syndrome, viral and Behcet's disease are the common types of uveitis.

Abstract:AIM:To study the effect of intravitreal injection of Bevacizumab for vitreous hemorrhage in patients with proliferative diabetic retinopathy(PDR).

METHODS:Fifty eyes in 46 PDR patients with vitreous hemorrhage were randomly divided into two groups. Thirty eyes in 28 patients were given intravitreal bevacizumab injection as the injection group. Twenty eyes in 18 patients were given the same treatment as injection group except bevacizumab injection in the control group. The absorption of vitreous hemorrhage, operation condition, best corrected visual acuity(BCVA), vitreous hemorrhage recurrence and other complications were observed. All the patients were followed up every week. If the hemorrhage was absorbed and the fundus could be seen clearly, the fundus fluorescein angiography(FFA)and laser photocoagulation were given. At 4wk after treatment, if the hemorrhage was not absorbed and became even worse, or retinal detachment occurred during the follow-ups, pars plana vitrectomy(PPV)would be taken. The follow-up time was 3mo.

RESULTS:Three months after intravitreal bevacizumab injection, the total number of the eyes avoiding vitrectomy was 10 eyes, 9 eyes(30%)in the injection group compared with 1 eye(5%)in the control group(χ²=6.108,P=0.0171). There were 19 eyes whose BCVA increased in the injection group, the proportion was 63%(19/30); there were 7 eyes whose BCVA increased in the control group,the proportion was 35%(7/20); there was statistically significant difference(χ²=6.102,P=0.014). The total number of the eyes receiving vitrectomy was 40, 5 eyes of 21(24%)were filled with silicone oil in the injection group, compared with 12 eyes of 19(63%)in the control group(χ²=5.2849, P=0.0137).

CONCLUSION:Intravitreous injection of bevacizumab for the PDR patients with vitreous hemorrhage can reduce the possibility of vitrectomy for some patients, reduce the difficulties of the vitrectomy for the others. The operation difficulty can be less and the use of silicon oil in the vitrectomy can be reduced. It is helpful in reducing the postoperative vitreous recurrent hemorrhage and improving the postoperative BCVA.

Abstract:AIM:To evaluate the effect of intravitreous injection of triamcinolone acetonide(TA)for macular edema caused by retinal vein occlusion.

METHODS:Thirty-five patients(35 eyes)with macular edema caused by retinal vein occlusion, diagnosed by ophthalmoscopy, optical coherence tomography(OCT), and fundus fluorescein angiography(FFA), were intravitreously injected with 2mg TA, then grid pattern laser photocoagulation was conducted after macular edema was relieved for 1-4wk. The visual acuity, intraocular pressure(IOP), lenses, the retinal thickness, and vascular leakage were observed during the 6mo follow-up period.

RESULTS:In central retinal vein occlusion(CRVO)group, 10 eyes were nonischemic,14 eyes were ischemic; in branch retinal vein occlusion(BRVO)group, the number was 4 and 7 eyes respectively. The final vision acuity improved in 19 eyes, remained unchanged in 11 eyes, decreased in 5 eyes. Nine eyes showed normal macular thickness after injection of TA by OCT, and the changes on FFA was disappeared or significantly improved; cystoid macular edema was impoved in 21 eyes and the changes on FFA showed that the fluorescein leakage was improved compared with that before treatment; the situation did not chang in 5 eyes, and the FFA showed that the leakage became even worse or unchanged.

CONCLUSION:Intravitreous injection of 2mg TA with laser photocoagulation can be used to treat macular edema caused by retinal vein occlusion effectively, relieve the macular edema and improve the visual acuity.

Abstract:AIM:To investigate the morphology changes of peripapillary retinal nerve fiber layer(pRNFL)and macular ganglion cell complex(GCC)in patients with Parkinson's disease.

METHODS:Eighty eyes in 40 patients with Parkinson's disease(PD)treated in Beijing Tian Tan Hospital from July 2014 to May 2015 and 60 normal eyes in 30 patients were controlled in the study. Each section of pRNFL thickness and GCC thickness were measured by optic coherence tomography(OCT). The correlation between pRNFL and GCC of Parkinson's disease group, and the difference of pRNFL and GCC between the Parkinson's disease group and normal group were evaluated and analyzed.

RESULTS:Compared with normal group, the pRNFL thickness of superior temporal(ST), superior nasal(SN), inferior nasal(IN), temporal upper(TU), inferior temporal(IT), temporal lower(TL), average, superior and inferior section significantly decreased in Parkinson's disease group(P<0.05). The GCC thickness of average, superior and inferior significantly decreased in the Parkinson's disease group compared with normal group(P<0.05).The positive correlations were seen between the pRNFL thickness and the GCC thickness of average, superior, inferior respectively(Avg:r=0.743,P=0.01; Sup:r=0.689,P=0.01; Inf:r=0.693,P=0.01).

CONCLUSION:The pRNFL thickness and GCC thinckness are significantly thinner in patients with Parkinson's disease than those in the normal controls. Average, superior, inferior pRNFL thickness is positively correlated to average, superior, inferior GCC thickness respectively in Parkinson's disease group.

Abstract:AIM:To investigate the relation of mean platelet volume(MPV), neutrophil-to-lymphocyte ratio(NLR)with diabetic retinopathy(DR)in patient with type 2 diabetes mellitus.

METHODS:Medical records of patients with type 2 diabetes mellitus admitted to our hospital from February 2013 to July 2015 were retrospectively reviewed. Their clinical characteristics, such as MPV and NLR, were extracted. Ninety-six healthy individuals were set as a control. The relation of MPV, NLR with DR were analyzed using logistic regression model.

RESULTS:A total of 379 patients with type 2 diabetes mellitus were included in this study. Among these patients, DR was observed in 51 patients(102 eyes)with DR and 328 patients were without DR. Patients with type 2 diabetes mellitus had significantly higher MPV and NLR, compared with healthy controls. Among patients with type 2 diabetes mellitus, the patients with DR had significantly higher MPV and NLR than the patients without DR. After confounders such as disease duration and hypertension were adjusted, MPV>10fl and NLR>2.6 were independently associated with DR.

CONCLUSION:Increased MPV and NLR are independently associated with DR. Further cohort studies are needed to verify whether MPV and NLR are independent risk factors for DR.

Abstract:AIM:To observe the curative effect of nasolacrimal duct obstruction treated by nasolacrimal duct stent assisted with nasal endoscope.

METHODS:Thirty-six cases(40 eyes)with nasolacrimal duct obstruction were placed in nasolacrimal stent assisted with nasal endoscope. Munk J was used to evaluate the degree of epiphora. The percentage of stent patency during long-term follow up was estimated by means of Kaplan-Meier analysis. Survival curves of the different etiology of obstruction were compared using log-rank test.

RESULTS:The overall technical success rate of stent placement was 97%. During a mean 19mo follow up, 30 cases(34 eyes)were gotten completed case records. The total effective rate was 71%. Kaplan - Meier survival curves showed that the average overall patency time was estimated for 22.69±2.30mo, 95% CI:18.18-27.19mo. Treatment with lacrimal duct stent was more successful for nasolacrimal duct obstruction without dacryocystitis than for that with dacryocystitis(P<0.05).

CONCLUSION:Nasolacrimal duct stent implantation assisted with nasal endoscope is a safe and effective method for nasolacrimal duct obstruction. The patency of idiopathic obstruction after treatment is better than that of nasolacrimal duct obstruction with chronic dacryocystitis.

Abstract:AIM:To observe the improvements and operation results of lower lid blepharoplasty for patients of different ages and eyelids.

METHODS:Sixty-seven patients(67 eyes)received the lower lid blepharoplasty from May 2010 to May 2015 in our hospital were selected. The patients were classified according to the type of eyelids. They received the different improved operations:12 eyes in group A with bulging fat adopted the trans-conjunctival approach; all the other patients adopted the trans-cutaneous approach. Nineteen eyes in group B with loosing orbicularis oculi muscle and/or loosing skin were required to remove the lower eyelid skin and orbicularis oculi muscle; 13 eyes in group C with loosing skin and bulging orbital fat and 23 eyes in group D with combined cases were both required to remove the orbital fat, skin and orbicularis oculi muscle.

RESULTS:After 5d of operation, the stitches were taken; the patients were visited for 3-6mo after treatment. The excellent rates of surgery in the four groups were 100%, 95%, 100% and 96%(P>0.05).The appearance of lower eyelid was flat; the bulging orbital fat was disappeared; the skin incision had no scar; there was 1 eye with mild ectropion, 2 eyes with sunken inferior orbital margin and 4 eyes with poor aligned incision, which were all recovered after 2mo of treatment. There were no serious complications like collapsed lower eyelid, strabismus, ambiopia, shrinks of lower eyelid, etc. The postoperative complication rates of the four groups were 8%, 11%, 8% and 13%, respectively(P>0.05).

CONCLUSION:The improved lower lid blepharoplasty has a favorable effect for different types of eyelids.

Abstract:AIM:To investigate the correlation between the severity of Meibomian gland dysfunction(MGD)and the prostaglandin E₂(PGE₂)content in Meibomian gland secretions and tear.

METHODS:Seventy-two patients with MGD were divided into mild to moderate group(36 patients with 60 eyes)and severe group(36 patients with 60 eyes).The content of PGE₂ in Meibomian gland secretions and tear were tested by ELISA. Thirty healthy adults(60 eyes)were chosen as the control group which were only tested for PGE₂ in tear.

RESULTS:The differences of the content of PGE₂ in tear in the three groups were significant(F=100.26,P<0.01),and that in the severe group was higher than that in the mild to moderate group(t=5.789,P<0.01)and the control group(t=7.468,P<0.01). There was no significant difference of the content of PGE₂ in tear between the mild to moderate group and control group(t=0.923,P>0.05). The differences of the content of PGE₂ in Meibomian gland secretions in three groups were significant and that in the severe group was much higher than that in the mild to moderate group(F=151.76,P<0.01).The content of PGE₂ in Meibomian gland secretions were positive correlated to the content of PGE₂ in tears in severe group(r=0.71,P<0.01); the content of PGE₂ in Meibomian gland secretions was positive correlated to the content of PGE₂ in tears in mild to moderate group(r=0.30,P<0.05).

CONCLUSION:The level of PGE₂ in Meibomian gland secretions and tears plays an important role in judging the severity of MGD and guiding clinical rational drug use.

Abstract:AIM:To evaluate the clinical application of CAD/CAM(computer-aided design/computer-aided manufacturing)technique in orbital reconstruction.

METHODS:Thirty-three patients(33 eyes)were included who were admitted and accepted orbital reconstructionin operation in our hospital from June 2011 and October 2015. The three-dimensional(3D)model was made by CAD/CAM technology, according to the orbital three-dimensional CT examination for each patient preoperatively, and the repairing materials were shaped under 3D entity model in operation. The patients were followed up for 3-12mo, and the orbital shape, enophthalmos, diplopia and eye movement were observed.

RESULTS:Among the 33 cases(33 eyes), except that 1 case required to remove the implants postoperative because of overcorrection, the patients were satisfied with the orbital shape. Enophthalmos were corrected. The effective rate was 97%. Among 19 cases(19 eyes)with diplopia and eye movement disorders, symptoms in 16 cases(16 eyes)were disappeared or improved, the efficiency rate was 84%. There were no operative complications.

CONCLUSION:The CAD/CAM technique is effective and practical in the reconstruction of orbital deformity with shorter operation time, higher efficacy, better outcomes and lower risk, and it is worth to be popularized in clinical application. But the fabrication of 3D model costs certain money which may bring economic pressures to poor patients.

Abstract:AIM:To investigate the effect of orthokeratology for teenager with mild to moderate myopia and the safety and effectivity of orthokeratology.

METHODS:Totally 85 patients(165 eyes, aging from 12 to 18 years old)received orthokeratolog lens treatment in our hospital from January 2014 to February 2015 were followed up for 6mo. All patients wore orthokeratology lens for 8-10h in night after standard optometry for spectacles. The visual acuity, corneal curvature, diopter, the ocular axial length and the central corneal thickness were observed, as well as the corneal endothelial cell density, coefficient of variation and the hexagonal cell ratio.

RESULTS:Followed-up for 6mo, the uncorrected visual acuity, the corneal curvature and the diopter were changed compared before wearing(P<0.05). There was no significant differences on the axial length, the central corneal thickness, the central corneal endothelial cell density, coefficient of variation or the hexagonal cell ratio before and after wearing(P>0.05). Almost all patients felt favorable after 6mo wearing. Only a few patients had a mirror patch corneal epithelium desquamation, conjunctivitis, etc and all could be restored after therapy.

CONCLUSION:Orthokeratology lenses are safe and effective for treating mild and middle myopia in teenagers. But the further study and followed-up are needed for long term wearing.

Abstract:AIM:To observe the effects of operative treatment for muscular asthenopia caused by esophoria.

METHODS:Twenty-one cases(42 eyes)with muscular asthenopia caused by esophoria were included. After examination of refraction, phoria and fusion function, all cases were given operative treatment to correct esophoria.

RESULTS:At 1wk after surgery, clinical symptoms were improved evidently in all cases, such as headache, diplopia and eye swelling. After followed up for 1a, no recrudescence was found. Before surgery, at 1wk and 1a after surgery, esophoria in the distance were 20.3^△±6.3^△,-3.1^△±1.4^△,0.7^△±1.6^△ respectively and esophoria in the near distance were 10.5^△±3.1^△,-1.3^△±0.6^△,1.5^△±0.8^△ respectively. By comparison of esophoria before and after surgery in different stages separately, the differences were statistically(P<0.01). There was no statistically difference between different stages about negative fusional power in the distance and near distance(P>0.05).

CONCLUSION:Esophoria operation may relieve obviously muscular asthenopia caused by esophoria without changing fusion function.