Abstract:AIM: To evaluate the refractive predictability achieved with an aspheric intraocular lens(IOL)and to develop a preliminary optimized algorithm for the calculation of its power(P_IOL).

METHODS: This study included 65 eyes implanted with the aspheric IOL LENTIS L-313(Oculentis GmbH)that were divided into 2 groups: 12 eyes(8 patients)with P_IOL≥23.0 D(group A), and 53 eyes(35 patients)with P_IOL<23.0 D(group B). The refractive predictability was evaluated at 3mo postoperatively. An adjusted IOL power(P_IOLadj)was calculated considering a variable refractive index for corneal power estimation, the refractive outcome obtained, and an adjusted effective lens position(ELP_adj)according to age and anatomical factors.

RESULTS: Postoperative spherical equivalent ranged from -0.75 to +0.75 D and from -1.38 to +0.75 D in groups A and B, respectively. No statistically significant differences were found in groups A(P=0.64)and B(P=0.82)between P_IOLadj and the IOL power implanted(P_IOLReal). The Bland and Altman analysis showed ranges of agreement between P_IOLadj and P_IOLReal of +1.11 to -0.96 D and +1.14 to -1.18 D in groups A and B, respectively. Clinically and statistically significant differences were found between P_IOLadj and P_IOL obtained with Hoffer Q and Holladay I formulas(P<0.01).

CONCLUSION: The refractive predictability of cataract surgery with implantation of an aspheric IOL can be optimized using paraxial optics combined with linear algorithms to minimize the error associated to the estimation of corneal power and ELP.

Abstract:AIM: To evaluate the visual outcomes and intraoperative and postoperative complications of phacoemulsification surgery in patients with cataract and pseudoexfoliation syndrome(PEX)and the usage of proper surgical techniques and appropriate devices intraoperatively.

METHODS: Sixty-seven eyes of 53 patients with PEX and cataract who had undergone phacoemulsification and intraocular lens(IOL)implantation surgery were evaluated retrospectively. The mean age was 71.68±9.96(53-89)y, and there were 24(45%)males and 29(55%)females. Nuclear, cortical, posterior subcapsular, and mature cataracts were all represented.

RESULTS: Nuclear cataract was significantly more common than other types(P=0.00). The mean preoperative best corrected visual acuity(BCVA)was 0.99±0.30(SD)(0.40-1.50)logMAR, and the mean postoperative BCVA was 0.32±0.31(SD)(0.00-1.00)logMAR(P=0.00). Iris retractors were used in 12(18%)eyes. Capsular tension ring(CTR)implantation was used in 15(22%)eyes, it was planned in 8(12%)and unplanned in 7(10%). Posterior capsule rupture occurred in 4(6%)eyes, and vitreous loss occurred in 2(3%)eyes. Anterior vitrectomy was performed in these 2 eyes. Conversion to extracapsular cataract extraction(ECCE)was needed in these 2(3%)eyes due to large posterior capsular rupture. Persistent corneal edema was observed in 4(6%)eyes, and anterior chamber reaction in 5(7%)eyes. IOL dislocation occurred in 4(6%)eyes, but repositioning was only needed in 1(1.5%)eye. Posterior capsule opacification(PCO)requiring Nd:YAG laser capsulotomy developed in 13(20%)eyes.

CONCLUSION: Postoperative visual acuities of patients with cataract and PEX are satisfactory. However, intraoperative and postoperative complications like posterior capsule rupture, vitreous loss, conversion to ECCE, persistent corneal edema, anterior chamber reaction and IOL dislocation may be observed. To avoid these complications, proper surgical techniques and the use of appropriate devices intraoperatively are essential.

Abstract:AIM: To compare the effects on the retina inner segment and retinal pigment epithelium(RPE)of intravitreally injecting bevacizumab, ranibizumab and aflibercept into monkey eyes.

METHODS: Fourteen healthy cynomolgus monkeys(Macaca fascicularis, aged 3-8y,10 males,4 females)were raised at the Covance Laboratories under standard conditions. The 14 monkeys were grouped into 4 groups. Three of the groups with 4 monkeys each were injected intravitreally with one of the drugs, either bevacizumab, ranibizumab or aflibercept, while the 4^th group with 2 monkeys served as a negative control. On 1d and 7d of injection, 2 monkeys from each drug treatment group were sacrificed under general anaesthesia and the 4 eyes were enucleated. All the enucleated eyes were fixed in formalin, embedded in paraffin wax, cut into 4.0 μm sections and deparaffinized according to standard procedures. Image-Pro Plus was used for all the photos to measure the content of vascular endothelial growth factor(VEGF)in the inner segment and RPE. The ANOVA test from JMP10.0 statistical program was used to evaluate the results.

RESULTS: Retinal sections were checked for their anti-VEGF immune reactivity. The untreated control samples had the highest level of VEGF in the RPE and inner segment. All of these three drugs can reduce the level of VEGF in the RPE and inner segment, but Avastin seems to be more effective than Eylea in this regard. Lucentis treatment at 1d seems to be more effective than Eylea at VEGF 1d. But at 7d, both Lucentis and Eylea have the same effect on reducing VEGF expression level in the RPE and inner segment.

CONCLUSION: All of these three drugs can reduce the level of VEGF in the RPE and inner segment.

Abstract:AIM: To obtain the prevalence and risk factors of symptomatic dry eye disease(SDED)among college students in China.

METHODS:Population-based cross-sectional study.Students in Medical School of Lanzhou University were approached. A questionnaire was used to evaluate the prevalence of SDED and its risk factors. The diagnosis of SDED was based on reported symptoms and was established if the participants reported “often” or “all the time” once or more for 6-item questionnaire. Positive tests included a tear-film breakup time(TBUT)≤10s and a fluorescein staining score(FSS)≥1. Demographic information and possible factors that may contribute to SDED were analyzed in a step-wise multivariate logistic regression modelto assess risk factors of SDED.

RESULTS: There were 1139 participants(84.37% response rate)have completed the questionnaire,475 males and 664 females aged 16-26y. The prevalence of SDED was 18.70% \〖95% confidence interval(CI)=16.59-20.81\〗.A TBUT of ≤10s and a FSS≥1 were noted in 47.67%(95% CI=44.95-50.57)and 13.97%(95% CI=11.95-15.99)for all participants, respectively.The multivariate regression analysis revealed the following risk factors: daily reading time of ≥4h(OR=1.58,95% CI=1.15-2.18), daily computer use of≥4h(OR=1.52,95% CI=1.02-2.25), and constant eyeglasses wearing(OR=1.54,95% CI=1.08-2.13).The female gender, refractive surgery and contact lens(CLs)wearing were not risk factors for SDED in this analysis.

CONCLUSION:The prevalence for SDED is high in Chinese college students.The risk factors include daily reading time of≥4h,daily computer use of≥4h and constant eyeglasses wearing.

Abstract:In allusion to the training requirements of eight-year program medical students, combining with our own experience in teaching this type of the students in ophthalmology, we have done some thinking about the training methods of eight-year program medical students in order to improving their comprehensive abilities of ophthalmology. Several suggestions are made in various aspects, including the study of the basic theory of ophthalmology, the training of doctor-patient communication skills, the training of basic clinical skills, the interest developments in ophthalmology subspecialty areas and the training of basic experiment skills.

Abstract:AIM: To investigate the effect of epigallocatechin-3-gallate(EGCG)against oxidative stress induced by high glucose in human lens epithelium(HLE)cells.

METHODS: The HLE cell oxidative damage model induced by high concentration glucose was established, and was intervented with different concentrations of EGCG. Cell viability was determined by MTT assay, cell morphology was investigated by convert microscope, cells apoptosis was assayed by flow cytometry with Hoechst-PI staining. Moreover, the levels of super oxide dismutase(SOD), glutathione peroxidase(GSH-Px)and malondialdehyde(MDA)in supernatant were also tested after different treatment either with high concentration glucose or with different concentrations of EGCG.

RESULTS: MTT results showed that HLE cells activity increased to 50.33%±3.52% and 63.33%±4.63% after treated with 10 μmol/L and 100 μmol/L EGCG respectively, the difference was statistically significant compared with oxidative injury group(32.67%±3.10%)(P<0.05); HLE cells maintained better morphology intervented with EGCG under high glucose conditions, the number of apoptotic cells reduced, SOD and GSH-Px level within HLE cells increased and MDA levels decreased.

CONCLUSION: EGCG plays its strong antioxidant effect by increasing SOD, GSH-Px content and decreasing MDA content in cells, therefore provides a reliable experimental basis for the search for effective prevention and treatment of cataract drug.

Abstract:AIM: To investigate the immunosuppression of artemisinin in the early-phase response(EPR)of allergic conjunctivitis in a murine model induced by pollen.

METHODS: Twenty-five Balb/c mice were divided into five groups at random: A: model group, B: artemisinin topical treatment group, C: oral artemisinin group, D: dexamethasone topical treatment group, E: negative control group. Balb/c mice were first sensitized with mixture of ragweed crude extract and complete Freund's adjuvant by left footpad and root of tails injection at days 0. At days 7 and 14, mice were strengthen sensitized by intraperitoneal injection. Negative control group replacd with a mixture of equal amounts of Freund's adjuvant and PBS mixture. Treatment time was between 21-27d: group B received 1% topical artemisinin eye drops 4 times per day; group C received artemisinin at doses of 600mg/kg orally once per day; group D received topical dexamethasone eye drops 4 times per day. The model and naive groups replaced with solvent for control. After treatment, mice were excited by ragweed pollen crude infusion drops. Within 1h after the excitation, the eyes were taken for histopathology testing, the serum for detection of specific IgE for ragweed pollen.

RESULTS: After excitation, allergy symptoms of model group were more significantly compared with negative control group and the treatment groups; allergy symptom score, mast cell degranulation ratios and the ragweed pollen specific IgE in serum in the topical treatment groups and oral group were higher than that in the negative control group, but significantly lower than that in model group.

CONCLUSION: Artemisinin topical treatment and oral treatment for mice could inhibit the symptoms of pollen allergic conjunctivitis, early-phase response of mast cell degranulation ratio and specific IgE generation for ragweed pollen, suggesting that artemisinin has some therapeutic effect for pollen allergic conjunctivitis.

Abstract:AIM: To characterize the effects of sodium iodate on mouse retinal morphology and function.

METHODS: Sodium iodate at 35mg/kg(body weight)was administered by tail vein injection into adult 6-8wk C57BL/6J mice. Morphological and functional changes of the retina were assessed at 6h, 1, 3, 5 and 8d after injections by fundus imaging, optical coherence tomography(OCT), ERG and histology. Mice in control group were give tail vein injection of equivalent dose of normal saline. All the eyeballs were removed for paraffin section and H-E staining.

RESULTS: The fundus photographs images at 6h after injection showed obvious changes, which were light red in retina and showed retinal blood vessels radial arranged. At 6h after injection, off-white drusen-like change was found at fundus. While there were no observable changes in OCT image and ERG. At 1d after injection, the fundus lesion aggravated and the drusen increased gradually. There were retinal pigment epithelial(RPE)disorders, photoreceptors and outer nuclear layer(ONL)damage through OCT. At 3d after injection, the retina lesion aggravated further and the retina became edema. At 5d after injection, the retina edema cleared away, the optic nerve became white and the fundus lesions increased. At 8d after injection, the RPE layer, photoreceptors and ONL were destroyed obviously. In the process, ERG showed the amplitudes of a- and b-wave decreased in a time-dependent manner. H-E staining showed that cells in retina of mice in control group were neatly arranged and well-distributed. The outer layer retina of sodium iodate injection group was wave-like, the normal structure of RPE disappeared and black round sediment could be seen which increased with time. At 8d after injection, there were any normal RPE.

CONCLUSION: The tail vein injection of sodium iodate can well simulate the pathogenesis of age-related macular degeneration which can provide a good animal model for AMD.

Abstract:AIM: To study correcting effect and visual quality after laser-assisted in situ keratomileusis(LASIK)with femtosecond and posterior chamber intraocular lens(ICL)implantation in high myopia patients.

METHODS: Fifty-five patients(106 eyes)with high myopia from February 2012 to February 2015 in our hospital were analyzed. According to the different operation, patients were divided into the observation group(using ICL implantation, 27 cases with 53 eyes)and the control group(using LASIK, 28 cases with 53 eyes). Postoperative follow-up was 1a, to observe and analyze the visual quality, higher order aberration and complications of two groups.

RESULTS: Uncorrected visual acuity(UCVA), the best corrected visual acuity(BCVA), effectiveness index and security index at 1a postoperatively of observation group, were 1.04±0.86(LogMAR), 0.97±0.19(LogMAR), 104.69±18.56, 108.79±17.68, significantly higher than those of control group 0.78±0.11(LogMAR), 1.04±0.09(LogMAR), 93.78±15.65, 100.71±11.68(P<0.05). And observation group in the two kinds of light and shade environment at various spatial frequency contrast sensitivity were higher than the control group. Those under the light environment at 1.5, 3, 6, 12 c/d and under dark environment at 1.5, 3, 6, 18 c/d compared were different between the two groups(P<0.05). Spherical aberration and comatic aberration of observation group at 1a after operation were lower than those of control group(P<0.05). The difference of trefoil between the two groups was not significant(P>0.05). No severe complications were observed in both groups.

CONCLUSION: LASIK with femtosecond and ICL lens implantation can effectively improve the patient's visual quality, but for patients with high myopia, ICL lens implantation effect is more significant, the safety index of ICL implantation, as well as the effectiveness index and the visual quality are better than those of LASIK.

Abstract:AIM: To investigate the corneal high order aberrations in adults with myopia and to study its correlations with myopic degree and keratometry.

METHODS: A total of 63 patients(126 eyes)from the ophthalmology department of our hospital were included in this study during May 2014 to June 2015. Visual acuity, intraocular pressure(IOP), diopter, slit lamp examination, central corneal thickness(CCT), funduscopic examination, corneal topography and corneal total higher order aberrations(THOAs)were recorded. Right eye was selected. According to the spherical equivalence(SE), 63 eyes were divided into two groups, the mild to moderate myopia group(M-M group, SE<-6.00D)and the high myopia group(H group, SE≥-6.00D). The correlations of corneal THOAs with diopter, keratometry, IOP and CCT were analyzed. Kolmogorov-Smirnov Test was used for normality test. Independent-samples t test was used for comparison between two groups. Pearson correlation analysis was for comparison between two continuous variables.

RESULTS: Z₄₄ was found a statistic difference between the M-M group and H group(t=2.51,P=0.02). IOP was negatively correlated with Z_5-3(r=-0.52,P=0.01), and CCT was positively correlated with Z_4-4(r=0.43,P=0.03)in H group. There was no correlation between higher order aberrations and SE in M-M group(all P>0.05)Total coma aberration(TCA)was negatively correlated with SE(r=-0.57,P=0.002)and spherical degree(Sph, r=-0.55,P=0.003)in H group. Z₄₀ was positively correlated with average K(AK)(M-M group:r=0.40,P=0.02. H group:r=0.55, P=0.03), K steep(K_s)(M-M group:r=0.39, P=0.02. H group:r=0.51, P=0.01)and K flat(K_f)(M-M group:r=0.40, P=0.02. H group:r=0.57, P=0.01)in both groups. Z₅₃ was negatively correlated with K_s (r=-0.4,P=0.04)in H group.

CONCLUSION: The THOAs parameters are influenced by diopter and keratometry. TCA is negatively correlated with SE and Sph in patients with high myopia, and spherical aberration is positively correlated with keratometry.

Abstract:AIM: To investigate the influence of phacoemulsification on corneal endothelial cells and its injury risk factors in diabetic cataract patients.

METHODS: From January 2013 to October 2015,186 diabetic cataract patients(224 eyes)as diabetes group and 190 patients with simple cataract(227 eyes)as control group in our hospital were enrolled. All patients received phacoemulsification combined with intraocular lens implantation. Observation of corneal endothelial cell density, coefficient of variation and percentage of hexagonal cells preoperatively, 1d, 1wk, 1 and 3mo postoperatively were carried out, and multiple Logistic regression analysis for risk factors of corneal endothelial cell injury was taken.

RESULTS: There were no significant difference in the density of corneal endothelial cells, the coefficient of variation and the percentage of hexagonal cells between the two groups before surgery(P>0.05). Each time point after operation corneal endothelial cell density and the percentage of hexagonal endothelial cells of diabetes group were significantly lower than the preoperative and those of control group(P<0.05). Each time after operation endothelial cell coefficient of variation of diabetes group were significantly higher than the preoperative(P<0.05). The endothelial cell coefficient of variation in diabetes group of the 1wk, 1 and 3mo after operation were significantly higher than those of the control group(P<0.05). Corneal endothelial cell density and percentage of hexagonal cells of the control group at 1wk, 1 and 3mo after operation were significantly lower than the preoperative(P<0.05). The endothelial cell coefficient of variation of control group at 1wk, 1 and 3mo after operation were significantly higher than the preoperative(P<0.05). Single factor analysis showed that age, shallow anterior chamber, long ultrasonic time, short eye axis, high energy ultrasonic, high cumulative released energy, a lot of perfusate and nuclear hardness ≥ grade Ⅲ associated with corneal endothelial cell injury(P<0.05). Multivariate Logistic regression analysis showed that age, long ultrasonic time, high ultrasonic energy, high cumulative released energy and nuclear hardness ≥ grade Ⅲ were the risk factors of corneal endothelial cell injury, the OR value and 95%CI were 1.742(1.056-2.682), 1.958(1.227-3.135), 2.064(1.274-3.256), 2.585(1.493-3.682), 2.193(1.348-3.316).

CONCLUSION: The injury of corneal endothelial cells after phacoemulsification in diabetic cataract patients is more serious than in patients with simple cataract. Age,long ultrasonic time,high ultrasonic energy, high cumulative released energy and nuclear hardness ≥ grade Ⅲ are the risk factors of corneal endothelial cell injury.

Abstract:AIM: To study the changes of choroidal thickness and hemodynamic parameters in patients with diabetic retinopathy and their influencing factors.

METHODS: From January 2013 to January 2015, 100 patients(100 eyes)with type 2 diabetes were divided into 3 groups: 34 patients without diabetic retinopathy(NDR), 36 patients with non proliferative diabetic retinopathy(NPDR)group, and 30 patients with proliferative diabetic retinopathy(PDR). According to the results of OCT, the patients with diabetic retinopathy were divided into 2 groups: diabetic macular edema(DME)group(28 cases), and 38 cases without diabetic macular edema. During the same period in our hospital 35 subjects for physical examination were selected as the control group. The hemodynamic parameters of the posterior ciliary artery in different groups of patients at different distance from the center of the macular were compared, analyzing influencing factors.

RESULTS: With the aggravation of diabetic retinopathy, the choroidal thickness in different distance from the center of the macular decreased. The choroidal thickness of NPDR and PDR group were thinner than that of the control group(P<0.05). The choroidal thickness of NDR group was not different from the control group(P>0.05). There was no significant difference in the choroidal thickness between the DME patients and non DME patients(P>0.05). Pearson correlation analysis showed that there was no significant correlation between choroidal thickness of patients with diabetic retinopathy and diabetic duration, fasting blood glucose, HbA1c, eye axis length, systolic blood pressure and diastolic blood pressure(P>0.05), but there was a correlation with BCVA(logMAR)(P<0.01). EDV and PSV in NDR group and NPDR group were significantly lower than those in control group, RI was higher than that in control group. PSV and EDV in PDR group were significantly lower than those in other three groups, RI was higher than the other three groups, and the difference was statistically significant(P<0.05).

CONCLUSION: With the severity of retinopathy in type 2 diabetic patients, the choroidal thickness decreased, and the thickness of the choroid is beneficial in the comprehensive analysis of 2 diabetic retinopathy.

Abstract:AIM:To observe effect of the iris location to femtosecond-combined wavefront guided LASIK for myopia and astigmatism.

METHODS:The patients with astigmatism >1.0D during the same time and followed up for 1a were selected. A total of 129 eyes in 67 patients were treated under iris location with femtosecond-combined wavefront guided LASIK(experimental group)and 161 eyes in 82 cases with femtosecond-combined wavefront guided LASIK(control group). Laser cutting went with the same laser machine. The uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), and wavefront aberration between the two groups were compared at 1, 3, 6mo and 1a after surgery.

RESULTS:At 1 and 3mo after surgery, the number of patients with better postoperative UCVA than preoperative BCVA between the two group showed a statistically significant difference(χ²=6.423, P=0.011,χ²=14.431, P=0.01); at 1d and 1mo after surgery, the residual astigmatism showed a statistically significant difference between two groups(t=1.98, P<0.05; t=2.23, P<0.05). At 3, 6mo and 1a after surgery, the differences on the change of residual astigmatism between the two groups weren't significant(P>0.05). At 6mo and 1a after surgery, the differences on UCVA between the two groups weren't significant(P>0.05). Until 1a after surgery, the root mean square(RMS)of high order wavefront aberration of the two groups, spherical aberration and coma aberration(COMA)were all enhanced compared to before surgery(P<0.05). At 1, 3mo after surgery, the RMS showed a statistically significant difference between two groups(P<0.05). At 1, 3, 6mo, 1a after surgery, the increase of COMA in experimental group was significantly lower than that in control group(P<0.05).

CONCLUSION:Iris location technology applied in femtosecond-combined wavefront guided LASIK for myopia and astigmatism, can make the vision recovery faster, the RMS of high order and COMA increase less, the residual astigmatism less, show better and more stable treatment effect.

Abstract:Corneal collagen cross-linking(CXL)could increase the mechanical strength, biological stability and halt ectasia progression due to covalent bond formed by photochemical reaction between ultraviolet-A and emulsion of riboflavin between collagen fibers in corneal stroma. Corneal melting is an autoimmune related noninfectious corneal ulcer. The mechanism of corneal melting, major treatment, the basic fundamental of ultraviolet-A riboflavin induced CXL and the clinical researches status and experiment in CXL were summarized in the study.

Abstract:Intraoperative floppy iris syndrome is a particular symptom in phacoemulsification, and it is often occurred in patients with the history of using alpha-1 adrenergic antagonist before cataract surgery. Although the pupil be fully mydriatic before the operation, the progressive constricting of the pupil, the relaxing of iris even the iridoptosis and the unstable anterior chamber still can be found during the phacoemulsification. If treated inappropriately, severe complications and terrible outcomes may happen,which would influenced the surgery effectives. This paper reviewed the epidemiological characteristics, pathogenesis, risk factors, clinical manifestations, complications, and coping strategies of the intraoperative floppy iris syndrome.

Abstract:Primary open angle glaucoma(POAG)is one of the eye diseases which can lead to blindness. The early symptom of POAG is unconspicuous, however, it will result in irreversible optic never damage and visual field defect with the disease progress. As an index for diagnosing and evaluating the therapeutic effect of POAG, intraocular pressure(IOP)is simple and important. Clinically, although some treated patients have a target IOP at clinic time, the optic never damage still get worse. Researches indicate that higher nocturnal IOP and 24h IOP variation and lower nocturnal ocular perfusion pressure(OPP)may be the reasons for this phenomenon. The following essay will give an overview of POAG,IOP and OPP according to the relevant literatures so that we can have a better understanding.

Abstract:Ocular trauma related glaucoma is one of secondary glaucoma, which can lead to serious visual loss. According to the complex clinical findings and pathogenesis of ocular trauma related glaucoma, we divide traumatic secondary glaucoma into hyphema related glaucoma, angle recession related, lens injury related, adhesion and proliferation related.The treatment of secondary traumatic glaucoma with ocular trauma were different, specific treatment measures should be given according to the specific case to protect visual function.

Abstract:Optic neuritis(ON)is one of the most common causes of vision loss by neural eye diseases in youth and middle-aged. In the past, the diagnosis simply according to the risk position, which did not distinguish from the pathogenesis and clinical characteristics, can not meet the current clinical diagnosis and treatment needs. Combining with the etiology, clinical characteristics and prognosis, the latest classification of the current international diagnosis of ON are typical and atypical ON. Typical ON relates to multiple sclerosis(MS)or demyelinating disease of the central nervous system, it has a relatively good therapeutic effect and prognosis. Rather than, atypical ON has complex etiology, clinical manifestation, and the treatment and prognosis are also different. At present there are many international ON treatment guidelines with level I evidence-based medical evidence, but with different genetic background, geographical environment and ethnic groups, they are not been determined. China lacks of such a multicenter large sample, a wide range of research evidence. In this paper, we will summarize the progress of the diagnosis and treatment about ON, especially about the atypical ON, in order to provide some suggestions to further improve the standardization and individualization for clinical diagnosis and treatment on ON.

Abstract:Pterygium is one of the most common ocular surface diseases. Its exact etiology and pathogenesis are not completely understood. At present, it is considered that its occurrence and development is the result of many factors.Current studies have indicated that the occurrence of pterygium is closely related to the environmental factors.Long time exposure to sunlight,dust, pollen and other long-term chronic stimulation are the main incentive factors.Various factors have caused limbal barrier dysfunction, induced the level of a variety of growth factors and inflammatory factors increased, so that the conjunctival tissue degenerate and proliferate to the cornea in the formation of pterygium. In this paper, the research progress of the pathogenesis of pterygium is reviewed.

Abstract:Dry eye(DE)is a multifactorial disease of tear film and ocular surface. Inflammation in the ocular surface plays a main role in the pathogenesis of DE. Accordingly, inflammation and therapies that inhibit immune response may become topic for DE in recent years. Unfortunately, there are few studies about signaling pathway that has changed in ocular surface of DE. It is novel and there are few researches on how inflammation active signaling pathway and how it was regulated by signaling pathway on DE. This paper presents a review about inflammation active signaling pathway and its regulation on signaling pathway of DE.

Abstract:AIM: To retrospectively analyze the surgical strategies and outcome of traumatic lens dislocation.

METHODS: Retrospective study. Clinical data of 105 cases(105 eyes)diagnosed with traumatic lens dislocation from April to June 2014 in our hospital were recruited. According to position of dislocated lens and complicated situations, different surgical approaches were performed, including intracapsular lens extraction, phacoemulsification, vitrectomy through pars plana and lensectomy.Meanwhile, vitreo-retinal or anti-glaucoma surgeries were performed in complicated cases.Preoperative and postoperative LogMar(Logarithm of the Minimum Angle of Resolution)visual acuity were compared by paired t-test. Perioperative complications including expulsive choroidal hemorrhages and recurrent retinal detachment were recorded and assessed.

RESULTS: All 105 dislocated lenses were removed completely. Visual acuity of 91 eyes(86.7%)were significantly improved postoperatively.The visual acuity of most patients was 0.1-0.3(42 eyes, 40.0%)and 1 patient's visual acuity with lens subluxation reached more than 0.8 postoperatively. Expulsive choroidal hemorrhages occurred in 1 eye intraoperatively and 1 eye postoperatively. Recurrent retinal detachment was observed in 2 eyes postoperatively.

CONCLUSION: According to position of the lens dislocation, personalized surgery strategy is critical for therapy of traumatic lens dislocation.Expulsive choroidal hemorrhage is one of most several complications and should be managed properly.

Abstract:AIM: To explore the relation of homocysteine(Hcy)and its metabolic related indicators with primary angle-closure glaucoma(PACG).

METHODS: In this study, a total of 150 PACG patients and 150 controls were enrolled. The patients with PACG were diagnosed by applanation tonometer, Humphrey perimetry(HVF), optical coherence tomography(OCT), gonioscope. The normal controls were recruited from physical examination center. Blood samples were collected and the plasma was used to determine homocysteine, vitamin B12 and folic acid. DNA was extracted to determine the methylenetetrahydrofolate reductase(MTHFR)C677TT genotype and gene polymorphism.

RESULTS: There was a statistically significant difference(t=2.04,P=0.04)in mean homocysteine levels between patients with PACG(16.11±1.66μmol/L)and controls(15.74±1.52μmol/L). The level of vitamin B12 in PACG group was 248.09±119.07pg/mL and the control group was 230.21±142.93pg/mL. No statistically significant difference was found on the vitamin B12 level between the two groups(t=0.84,P=0.40). The folic acid levels showed no statistically significant differences(t=1.65,P=0.17)between the PACG group(12.02±7.81ng/mL)and the control group(13.15±6.25ng/mL). The frequency distribution of the MTHFR C677T genotypes was found to be significantly associated(χ²=6.2,P<0.05)with PCAG(CC 84.7%, CT 4.7%, TT 10.7%)as compared to the controls(CC 94.7%, CT 2.0%, TT 3.3%). The frequency distribution of TT genotypes of MTHFR C677T in the PACG group was significantly higher than that in the control group. Moreover, our findings showed significant difference(χ²=14.2,P<0.05)between the allele frequency of the C677T single nucleotide polymorphism within the MTHFR gene in POAG patients(T 87.0%, C 13.0%)and the control group(T 95.7%,C 4.3%).

CONCLUSION: These results show that the Hcy level and the TT genotypes of MTHFR C677T were higher in the PACG patients than in controls. Therefore, our data suggests that high Hcy level and the related indicators are associated with high PACG risk.

Abstract:AIM: To observe the application of phacoemulsification combined with laser peripheral iridoplasty(LPIP)for acute angle-closure glaucoma with cataract which could not be controlled well by drugs.

METHODS: From January 2011 to June 2015, 49 eyes in 47 patients with acute angle-closure glaucoma and cataract were recruited while their intraocular pressure remained higher than 40mmHg 12h after drug treatment. LPIP were performed and phacoemulsification and intraocular lens implantation were carried out 3d after. Their clinical data and follow-up results were reviewed.

RESULTS: The intraocular pressure before treatment, 1d after LPIP, 1d after phacoemulsification, 1mo after phacoemulsification and 3mo after phacoemulsification were 62.35+10.31mmHg, 17.96±4.64 mmHg, 16.58±3.19mmHg, 13.50±2.74 mmHg and 13.46±2.48 mmHg respectively(F=10.02,P<0.05); the intraocular pressure of 1d(t=4.35), 1mo(t=6.43)and 3mo(t=6.97)after phacoemulsification were all lower than the initial pressure(P<0.05). The visual acuity showed the same trendy, while the visual acuity before treatment, 1d after LPIP, 1d, 1 and 3mo after phacoemulsification were 0.06±0.02,0.20±0.18,0.45±0.19,0.60±0.11,0.65±0.09 respectively(F=8.36,P<0.05). The best corrected visual acuity at 1d, 1 and 3mo after phacoemulsification were better than that before laser treatment(t=3.97, 5.12, 5.89,P<0.05). At 1d and 3mo after phacoemulsification, the anterior chamber depth, angle opening distance, trabecular/iris angle were all better than the initial ones(P<0.05). At 1 and 3mo after phacoemulsification, the goniosynechia got better as well(P<0.05).

CONCLUSION: Phacoemulsification combined with LPIP can reduce intraocular pressure, improve the visual acuity and make the anterior chamber depth, angle opening distance, trabecular/ iris angle, goniosynechia better for patients with acute angle-closure glaucoma and cataract when drug cannot control intraocular pressure well.

Abstract:AIM: To observe the efficacy and safety of the phacoemulsification combined with goniosynechialysis and the phacoemulsification combined with trabeculectomy for angle-closure glaucoma(ACG)with different closure conditions accompanied with cataract.

METHODS: A total of 65 patients(70 eyes)with primary ACG accompanied with cataract were selected from those admitted in our hospital and were given phacoemulsification with goniosynechialysis(group A, 30 patients with 33 eyes)and the phacoemulsification with trabeculectomy(group B, 35 patients with 37 eyes)according to the conditions of the closed anterior angle, respectively. The two groups of patients were observed for preoperative and postoperative intraocular pressure(IOP), vision, anterior chamber depth, and complications, and were followed up for 6.5mo(6-8mo)on average.

RESULTS: Mean postoperative IOP in either group A or group B at 1mo after operation was of statistically significant difference, compared with mean preoperative IOP(P<0.05). Postoperative 1-week vision in each group was of statistically significant difference, compared with preoperative vision(P<0.05). Postoperative 1-month mean anterior chamber depth in each group was of statistically significant difference, compared with preoperative anterior chamber depth(P<0.05). There were no significant differences between the two groups on postoperative 1-month mean anterior chamber depth(P>0.05)and postoperative complications(P>0.05).

CONCLUSION: Clinical doctors can choose appropriate treatment according to different conditions of the closed anterior angle in patients with primary angle-closure glaucoma.

Abstract:AIM: To investigate the efficacy and safety of phacoemulsification combined with intraocular lens implantation in the treatment of shallow anterior chamber with cataract.

METHODS: Retrospective case series. From February 2014 to July 2015 in our hospital,65 eyes in 65 patients with cataract were enrolled and divided into mild and high risk of shallow anterior chamber group. Best-corrected visual acuity(BCVA), intraocular pressure(IOP), central anterior chamber dept(CACD), angle opening distance(AOD), complications pre- and post treatment, were observed and analyzed as outcome measures.

RESULTS:In this study, the mild shallow anterior chamber group included 34 eyes; postoperative BCVA were improved in 29 eyes, with 4 eyes remaining stable and decreased in 1 eye; BCVA was improved in 16 eyes, with 10 eyes remaining stable and decreased in 5 eyes in high risk of shallow anterior chamber group postoperatively. BCVA had a better prognosis in the mild shallow anterior chamber group than another group(t=-2.956, P<0.05). Meanwhile, IOP decreased by 5.71±2.07mmHg and CACD increased by 1.37±0.38mm in the mild shallow anterior chamber group, by 9.77±4.04mmHg and 1.67±0.43mm respectively in high risk group, and the difference has statistical significance(t=-5.02,-3.04; P<0.05). The mean preoperative nasal AOD500 was 200.57±33.74μm, and they were 346.62±101.37μm and 410.75±137.48μm and 398.69±122.28μm respectively at postoperative 1d, 1 and 3mo, and all nAOD500 comparing with preoperative were increased obviously, and the difference has statistical significance(F=203.75, P<0.01). And AOD500 at temporal, superior and inferior presented similar trends. Complications were corneal edema(5 eyes), transient intraocular hypertension(2 eyes), posterior capsular opacification(4 eyes), and posterior capsular rupture(1 eye).

CONCLUSION: Micro incision cataract surgery is useful, effective and safe in patients with cataract and shallow anterior chamber which can stabilize or improve BCVA, reduce IOP, deepen CACD and open the anterior chamber angle.

Abstract:AIM: To study the clinical value of non-steroidal anti-inflammatory drug in adjuvant treatment of intravitreal triamcinolone acetonide(IVTA)for macular edema caused by retinal vein occlusion(RVO).

METHODS: Forty-eight eyes in 48 patients were randomly divided into trial and control group(24 eyes each)in this prospective study. In the trial group, additional pranoprofen drops was administered from 1d before IVTA to 30d after injection. Central foveal thickness(CFT)was measured with optical coherence tomography(OCT). Available documents of best corrected visual acuity(BCVA), CFT, intraocular pressure and complications pre- and post-injection at 3d, 1,2wk, 1 and 3mo were evaluated.

RESULTS: After IVTA, BCVA was improved in both groups at different levels; but there was no statistically significant between two groups at each time point(P>0.05). The CFT values were 629±43μm vs 605±57μm before IVTA in the trail vs control groups(P>0.05). The values were 432±74μm vs 511±32μm(t=7.533, P<0.05), and 275±54μm vs 379±29μm(t=13.212, P<0.05)of the trial vs control groups at 1 and 3mo after IVTA, respectively. Ocular hypertension occurred in 5 eyes after injection in trail group, and was controlled with anti-glaucoma medication and one eye with filtration surgery. Progression of cataract was noted in 3 of 35 phakic eyes and cataract surgery was performed in 2 eyes at 4-12mo after injection in trail group. Progression of cataract was noted in 4 eyes and cataract surgery was performed in 2 eyes at 4-12mo after injection in control group. No retinal detachment and endophthalmitis happened during the whole period of follow-up.

CONCLUSION: Application of non-steroidal anti-inflammatory eye drops in perioperative period can be useful to improve the outcome of IVTA for macular edema, which needs further evaluation.

Abstract:AIM: To compare the clinical effect of 23G and 25G+ vitrectomy for retinal detachment.

METHODS: Forty seven patients with retinal detachment were treated with 23G vitrectomy(27 eyes in 27 cases as group A)and 25G+ vitrectomy(20 eyes in 20 cases as group B). The operation time and the incidence of intraoperative complications were recorded. The occurrence of retinal reposition, visual acuity, intraocular pressure(IOP)and complications were observed. Postoperative follow-up time of the two groups were 3d, 1wk, 3mo.The relevant records were statistically analyzed and compared.

RESULTS: The operation time of 23G group and 25G+ group were 50.21+4.52min, 49.15+5.14min,respectively and there was no significant difference between the two groups(P>0.05). The main complications were retinal hemorrhage and iatrogenic retinal hole. There were 3 eyes with retinal hemorrhage, 2 eyes with iatrogenic retinal hole in 23G group, and 1 eye with retinal hemorrhage, 1 eye with iatrogenic retinal hole in the 25G+ group, and the difference was statistically significant(P<0.05). The postoperative visual acuity of 23G group and 25G+ group were significantly improved, and the differences between the two groups were not statistically significant at different time points after operation(P>0.05). The number of eyes with hypotonia in 23G and 25G+ group were 3 and 1 eyes respectively, the difference was statistically significant(P<0.05). But there were no significant differences between the two groups on IOP at 1wk and 3mo after surgery(P>0.05). At the last follow-up, the results showed that 26 eyes(96%)with retinal reposition in 23G group, 19 eyes(95%)in 25G+ group, the difference was not statistically significant(P>0.05).

CONCLUSION: The clinical effect of 23G and 25G+ vitrectomy for retinal detachment is similar, but 25G+ vitrectomy can reduce incidence of complications and early postoperative low IOP.

Abstract:AIM: To observed the clinical effect of twice fluid-gas exchange in vitrectomy for retinal detachment at the equator.

METHODS: The retrospective analysis of the 74 cases(74 eyes)with retinal detachment at the equator from January 2014 to September 2015 were reviewed. All these patients were performed standard three channel 23G vitrectomy under a wide angle lens, in which, the 37 cases(37 eyes)were randomly selected and performed single fluid-gas exchange, and the other 37 cases(37 eyes)were performed twice fluid-gas exchange. The intraoperative surgical complications and the postoperative success rate of retinal reposition in 1wk, 1, 3mo after surgery of the two group patients were observed.

RESULTS: The intraoperative surgical complication rates of the twice fluid-gas exchange group were less than that of the single fluid-gas exchange group. The postoperative success rate of retinal reposition in the twice fluid-gas exchange group significantly increased in 1wk and 1mo after surgery, and the difference was statistically significant(P<0.05). But the postoperative success rate of retinal reposition in 3mo after surgery had no significant difference(P>0.05).

CONCLUSION: The twice fluid-gas exchange operation was simple and it was beneficial for beginners to master. The incomplete drainage of the single fluid-gas exchange and the pore drainage in the posterior pole or in the peripheral part of the retina were avoided during the surgery. The intraoperative surgical complication rates were reduced and the postoperative success rate of retinal reposition were improved. This operation method had great application value in clinic.

Abstract:AIM: To evaluate the clinical effects, corneal surface shape and corneal thickness variation after treated by Danzhi Xiaoyao Capsule combined with hypromellose 2910,dextran 70 and glycerol eye drops for dry eye in menopausal patients.

METHODS: Eighty menopausal patients(160 eyes)diagnosed as dry eye were randomly divided into groups A and B(40 patients each). Group A was treated with hypromellose 2910,dextran 70 and glycerol eye drops only and group B was treated with Danzhi Xiaoyao Capsule and eye drops. Before and 1mo after treatment, the clinical effects were evaluated by symptom scores, fluorescein staining(FL), tear film breakup time(BUT)and Schirmer Ⅰ test. While the corneal surface regularity index(SRI), surface asymmetry index(SAI)and central corneal thickness(CCT)were observed.

RESULTS: At 1mo after treatment, the symptoms scores and FL scores of the 2 groups decreased significantly(P<0.05); BUT and SⅠt were significantly increased(P<0.05). SRI and SAI gradually increased with dry eye exacerbations, after treatment the two parameters significantly reduced than those before treatment. SRI of group B improved significantly more than group A. CCT gradually got thinning with the dry eye condition worsened, which also significantly increased after treatment(P<0.05); but there was no difference between 2 groups before and after treatment(P>0.05).

CONCLUSION: Combination therapy of Danzhi Xiaoyao Capsule and hypromellose 2910,dextran 70 and glycerol eye drops for menopausal patients with dry eye is more effective than single eye drops, and can improve the symptoms and signs.

Abstract:AIM: To compare the changes of the contrast sensitivity after LASIK with femtosecond laser and microkeratome and to explore the influence of different methods making corneal flap on visual quality.

METHODS: There were 212 eyes in 106 myopes underwent excimer operation.According to the different methods of operation, they were divided into two groups: microkeratome group(SBK group)and femtosecond laser group(FS group). FS group: a total of 112 eyes in 56 patients received LASIK with femtosecond laser. SBK group: a total of 100 eyes in 50 patients received LASIK with microkeratome. Contrast sensitivity was detected preoperatively,and 1wk,3mo postoperatively and compared between the two groups.

RESULTS: At 1wk after operation, the contrast sensitivity under photopic environment decreased in the two groups, compared with those before operation(P<0.05). The differences of contrast sensitivity before and 3mo after operation were not significant(P>0.05). No statistical significant difference was found in contrast sensitivity under photopic environment at 1wk, 3mo between the two groups(P>0.05). At 1wk after the operation, the contrast sensitivity under scotopic environment decreased in both groups compared with those before operation(P<0.05). In SBK group, it decreased more than in FS group(P<0.05). After 3mo, the decline of 14.2c/d spatial frequency contrast sensitivity under scotopic environment in the SBK group was more than other frequency. No statistical significant difference was found in the rest frequency contrast sensitivity under scotopic environment before and after operation(P>0.05). After 1wk, contrast sensitivity with glare stimulation in both groups decreased, compared with those before operation(P<0.05), while in SBK group, it decreased more than in FS group(P<0.05).After 3mo, except that the decline of 14.2c/d spatial frequency contrast sensitivity with glare stimulation in the SBK group was significant compared with those before operation, the contrast sensitivity under glare stimulation in both groups had no significant differences compared with before operation(P>0.05).

CONCLUSION: LASIK with femtosecond laser can get a better visual quality than LASIK with microkeratome.

Abstract:AIM: To investigate the changes of nearwork induced transient myopia(NITM)in different refractive status after continuous near tasking.

METHODS: Prospective study. Thirty subjects(aged 18-24, average 20.9±2.1, 12 males and 18 females)were recruited in this study. They were divided into 3 groups according to the subjective refraction: 10 with hyperopia(H), 10 with emmetrope(E)and 10 with myopia(M). All the subjects with soft contact lens watched videos on a panel computer at near distance(33cm～40cm). Five measurements of distance refraction in the right eye were performed by using an infrared optometer before, after 30min and 60min sustained viewing task, and the mean of 5 refractive values was recorded as spherical equivalent. Then distance refraction of right eyes was done every 5s followed by stopping near tasking until NITM was disappeared completely and the decay time of NITM was recorded for each subject. The value of NITM was the difference of refractive values between before and after near tasking. Paired-t test was used to compare the changes of refractive values in the same group. ANOVA was used to determine the differences of NITM and its decaying time among three groups.

RESULTS: Compared with pre-task, no significant refractive changes were found in hyperopic group(t=1.627,P=0.138); While subjects with emmetropia and myopia showed more myopic shifts at the two time points(t_E=2.699,P_E=0.024; t_M=4.930,P_M=0.001). With continuous viewing until the 30^th min and 60^th min, significant differences of averaged NITM were found between myopic group and other 2 groups(P<0.05), but no difference was found between hyperopic group and emmetropic group(P>0.05). Significant differences of the decay time of NITM can be seen among the three groups after near tasking(F=787.983,P<0.001).

CONCLUSION: Subjects with myopia are more susceptible to produce NITM than other 2 groups during sustained nearwork for the same time and the decaying time of NITM is longer in myopia group after near tasking, thus it is suggesting that NITM might be attributed to the development and progression of myopia.

Abstract:AIM:To investigate health-related quality of life(HRQOL)state in children with intermittent exotropia using the Intermittent Exotropia Questionnaire(IXTQ)and research the effect of strabismus surgeries on HRQOL.

METHODS:In this prospective study, we chose 42 patients with intermittent exotropia(aged 5-17 years)as case group, and 42 patients(aged 5-17 years)as control group. The Chinese IXTQ was used to evaluate HRQOL at 1d preoperatively and 3mo postoperatively in the two groups, and the differences of the two groups before and after surgery and the effect of strabismus surgery on HRQOL were analyzed.

RESULTS:The scores of HRQOL in control group were statistically significant higher than that of case group(P<0.01). Every items showed a statistically significant difference except on “Kids tease me because of my eyes” and “ My eyes make it hard for me to make friends”(P<0.05).At 3mo postoperatively,the scores of HRQOL in case group significantly increased than that at 1d preoperatively(P<0.01). Child IXTQ of case group was lower on every items than those of control group after surgery(P<0.05).

CONCLUSION:Intermittent exotropia could affect the HRQOL in psychosocial and visual functional. The greatest HRQOL concerns for children with intermittent exotropia were shutting one eye when sunny, waiting for their eyes to clear up instead of taunts and friendship. The surgical treatment could improve HRQOL in children with intermittent exotropia.

Abstract:AIM: To investigate the differences between synoptophore and triple prism strabismometry and its possible cause.

METHODS: There were 347 patients with horizontal concomitant strabismus involved, in which 76 patients were esotropia, 37 patients were male while 39 were female, with average age of 13.27±7.77 years old. There were 271 patients with exotropia, 131 cases were male while 140 were female, with average age of 15.43±8.42 years old. All the patients were examined by synoptophore and prism plus shaded strabismometry in a long distance of 6m. Datas were analyzed by SPSS 17.0.

RESULTS: In the exotropia patients, the conversions of circular degree(°)and prism degree(^△)were: 1°=0.29^△～1.78^△, which was statistically significant with intermittent strabismus(P=0.001). While in the esotropia patients, the conversions were: 1°=2.01^△～2.15^△.

CONCLUSION: The diversity between the two methods is enlarged with the increase of squint angle for exotropia patients. While in esotropia patients, the diversity decreased with the increase of squint angle. Synoptophore equipped with +7.00D, defects of the triple prism itself and proximal convergence during exam may be the reasons for the diversity.

Abstract:Smart phones as a symbol of the mobile Internet appears in college classroom, which is not only a challenge, but also a great opportunities of education information. This paper applied smart phones as the carrier of the "Internet" into ophthalmology classroom. Smart phones has a lot of features, such as rich teaching resources, diverse learning methods, flexible learning time, collating and recording capabilities and the timely, comprehensive and accurate teaching feedback so on, and could be used in case teaching and interactive teaching. The implementation of smart phones into ophthalmology classroom could inspire the learning enthusiasm of the students, enhance the quality of teaching, eventually improve teaching effects.

Abstract:AIM: To improve the efficiency and quality of teaching, and to cultivate students' ability to analyze and solve clinical problems, the case-based learning(CBL)combined with problem-based learning(PBL)teaching mode is introduced into the clinical teaching of ophthalmology.

METHODS:Two classes(total 131 students)of 2013 grade major in clinical medicine, Kunming Medical University, were randomly selected as experimental group using CBL combined with PBL teaching mode, and control group using traditional teaching mode. The part of acute angle-closure glaucoma was taught. The scores of the experimental group were compared with that of control group at the end of term.

RESULTS: The mean scores of CBL combined with PBL teaching group were significantly higher than that of traditional teaching group.

CONCLUSION: The application of CBL combined with PBL in the clinical teaching of ophthalmology has obvious advantages in improving the learning interests and promoting students' self-learning ability. It is helpful in improving the students' ability of independent-thinking, analyzing and solving problem.

Abstract:AIM: To explore the effects of “one week with one case” teaching method with college-enterprise cooperation in the theoretical classes of contact lens courses, which provide the basis for teaching reform.

METHODS: Fifty-six students in optometry major of Grade 2012 from Xi'an Medical College were divided into 2 groups randomly. The experimental group of 28 students used “one week with one case” teaching method with college-enterprise cooperation; the control group of 28 people used traditional “one week with one case” teaching method. The examination scores and questionnaire were used to evaluate the teaching effects.

RESULTS: The students of experimental group acquired higher test scores in short-answer questions and the case analysis questions compared with students of control group(P<0.05). The questionnaire survey showed the “one week with one case” teaching method with college-enterprise cooperation acquired higher scores in 6 items which include the intensity of learning interest, information acquisition ability, team cooperation ability, communication skills, oral communication ability and the satisfaction of teaching method(P<0.05). Four items included participation, preparation, communication ability and team spirit of experimental group students were significantly superior to those of the control group students(P<0.05).

CONCLUSION:“One week with one case” teaching method with college-enterprise cooperation can improve comprehensive ability of students. It is an effective teaching method with the characteristics of the contact lens courses.

Abstract:AIM: To investigate the compliance in patients with topical glaucoma therapy, and identify the most frequent barriers to adherence.

METHODS: One-on-one interview and questionnaire were taken to investigate the compliance with hypotensive eye drops in 366 patients who had been diagnosed as glaucoma and received the therapy for at least 6mo in Wuhan and suburban district from July 2014 to June 2015 in Wuhan Aier Eye Hospital.

RESULTS: The proportion of compliance was 44.3%(162/366). Factors significantly influencing compliance included severity of the better eye, the severity of symptom when attacked, duration of medication and whether to administrate on the same time daily(OR=5.700,0.554,0.336,0.558,P<0.05).Age, gender, marital status, education level, economic status, domicile, knowledge of the disease, suffering from other diseases with medication, type of glaucoma, type of eye drop, frequency were not associated with a higher rate of non-compliance.

CONCLUSION: Compliance in patients with topical glaucoma therapy in Wuhan is poor.Regularly carrying out relevant health education and interventions is very important.

Abstract:AIM:To investigate and analyze the prevalence and the influencing factors on retinal arteriosclerosis in civil aviators of different ages.

METHODS:Two thousand seven hundred and seventy-eight commissioned civil aviators who received medical examination in Civil Aviation General Hospital from July 2014 to July 2015 were randomly divided into three groups: group A(1 311 aviators aged 22-39), group B(618 aviators age 40-49 ), group C(849 aviators age 50-59). Aviators over 40 years old, were divided into two groups: group with retinal atherosclerosis and group without retinal atherosclerosis according to the results of fundus examination. Medical examination data of the aviators were analyzed.

RESULTS: Of 2 778 aviators, 334(12.02%)were detected with retinal arteriosclerosis, among which 318 aviators were classified as gradeⅠ, and 16 aviators as grade Ⅱ. The retinal arteriosclerosis prevalence of group A, B, and C increased with age, and the difference was statistically significant(P<0.05). Biochemical tests showed that the prevalence of hypertension, hyperlipidemia, high fasting blood glucose and overweight increased in group with retinal arteriosclerosis compared with that in group without retinal arteriosclerosis, and the difference was statistically significant(P<0.05).

CONCLUSION: The prevalence of retinal arteriosclerosis in commissioned civil aviators was 12.02%,and most of the retinal arteriosclerosis was classified as grade Ⅰ. In aviators over 40 years old, hypertension, hyperlipidemia, high fasting blood glucose and overweight were important factors in the development of retinal arteriosclerosis.

Abstract:AIM: To evaluate the effect for refractory glaucoma by using Ex-Press miniature implantation with deep sclerectomy.

METHODS: Thirty eyes in 24 patients with refractory glaucoma were treated by Ex-Press miniature(P50)implantation with deep sclerectomy. The patients' symptom, intraocular pressure(IOP), visual acuity and complications were analyzed in a 12mo follow-up period.

RESULTS: During the follow-up period, all patients' ocular pain was reduced. The mean IOP before operation and at the last follow-up time were 51.15±2.60mmHg(1kPa=7.5mmHg)and 15.11±2.51mmHg, respectively, there was significant difference(P<0.05). Postoperative visual acuity was improved in 8 eyes,had no significant change in 22 eyes. After operation, hyphema of anterior chamber appeared in 2 eye(7%), which were obsorbed after 1wk.

CONCLUSION: Ex-Press miniature implantation combined with deep sclerectomy surgery is a relatively effective and safe treatment for the patients with refractory glaucoma. This method can significantly degrade the IOP, lessen ocular pain and reduce the complications risk.

Abstract:AIM:To observe the clinical effect of Ahmed glaucoma valve(AGV)implantation for teenagers with refractory glaucoma.

METHODS: Twenty-seven patients(27 eyes)with refractory glaucoma were treated with AGV implantation in our hospital from October 2012 to October 2014. The patients were followed up for 12mo. The success rate of the operation, postoperative intraocular pressure, the best corrected visual acuity, as well as complications were recorded.

RESULTS: The success rate of the operation was 85%. The intraocular pressure of the 27 patients decreased from 48.3±8.3mmHg before operations to 21.4±8.1mmHg(P<0.05). Visual field defect was -23.7±4.1dB before operations, -27.5±4.7dB at 12mo after operations, and the difference was statistically significant(P<0.05). There was 85% patients with improved or unchanged vision.Early postoperative complications included shallow anterior chamber(5 eyes, 19%), transient high intraocular pressure(3 eyes, 11%)and anterior chamber hemorrhage(4 eyes, 15%), drainage tube obstruction(1 eye, 4%), anterior chamber silicone tube in poor position(1 eye, 4%). There was no ambiopia, drainage erosion and exposed, plate leaked out, choroidal detachment, immune rejection of graft and other complications. Long-term complications included dyscoria(8 eyes, 30%), the back of the plate packed(3 eyes, 11%).

CONCLUSION: AGV implantation is characterized by a high success rate, simple operation, less complications and is an effective treatment for refractory glaucoma in adolescents.

Abstract:AIM: To investigate the measurement of central anterior chamber depth(ACD)in patients with acute primary angle-closure glaucoma(APACG)with A-scan ultrasound, Pentacam and ultrasonic biological microscope(UBM).

METHODS: Thirty-five patients(35 eyes)with APACG were selected, of whom central ACD were measured with A-scan ultrasound, Pentacam and UBM.

RESULTS: The measurement values of ACD with A-scan ultrasound, UBM and Pentacam were 1.5633±0.2089, 1.5783±0.2067, 1.6275±0.2296mm, which was equal variance tested by the homogeneity of variance,and was significant different by multiple comparision(F=4.074, P=0.026). The difference of ACD between the two groups of A-scan ultrasound and UBM, A-scan ultrasound and Pentacam, UBM and Pentacam were statistically significant(P=0.032, 0.023, 0.012). Altman-Bland analysis showed that the three methods were not consistent with each other.

CONCLUSION: The ACD value of the APACG with the three methods is the largest using Pentacam, followed by UBM and A-scan ultrasound. In clinical the three methods with different advantages can complement each other, but cannot be replaced. In order to obtain more accurate results, we should combine the advantage and make comprehensive analysis.

Abstract:AIM: To discuss the application of anterior segment optic coherence tomography(AS-OCT)in the diagnosis of corneal ulcer.

METHODS: The cross linear scan was used in 88 patients(88 eyes)with corneal lesion by AS-OCT to gather the image data, observe the pathological changed tissue by measuring all layers for patients with initial inspection, providing important visual images and data for treatments. All the patients were followed up for 2mo.

RESULTS: Clear images with structure of all layers were obtained. It can provide the intuitive image data and scan the same position and show the changes during the treatment.

CONCLUSION: AS-OCT can discover the important condition immediately. It also can monitor course of disease dynamically, provide the intuitive image data for clinical treatment.

Abstract:AIM: To evaluate the clinical application of IOL Master by comparing with traditional ultrasound biometry on the accuracy and characteristics of intraocular lens calculation.

METHODS:Data was analyzed from 164 patients(206 eyes)with age-related cataracts who underwent phacoemulsification and intraocular lens(IOL)implantation in our hospital from June 2014 to June 2015. Before surgery, axial length and corneal curvature were measured with IOL Master and combined application of ultrasonic or manual keratometry, respectively. Phacoemulsification and foldable lens implantation were done in the patients. IOL power calculation was carried out using the SRK-Ⅱ formula with the basis of IOL Master data. The visual acuity and refractive outcome were followed-up for 3mo postoperatively.

RESULTS:There was a significant difference between the two methods on axial length measurement which was 23.86±1.05mm by IOL Master and 23.50±0.83mm by ultrasound(P=0.025). There was also a significant difference between the two methods on corneal curvature measurement which was 44.18±1.35D by IOL Master and 43.70±1.41D by keratometry(P=0.01). The mean absolute error(MAE), at 3mo after operation, was 0.41±0.30D and 0.93±1.10D by the IOL Master and ultrasound groups, respectively, there was a significant difference between the two methods(P=0.027).

CONCLUSION:The IOL Master is a non-contact, safe, easy-to-do and patient-friendly methods for axial length and corneal curvature measurement with high accuracy, thus it can calculate the IOL power more accurate and improve the predictive value for postoperative refraction.

Abstract:AIM: To evaluate the clinical outcomes of Nd:YAG laser capsulotomy in the treatment of early stage capsular block syndrome(CBS).

METHODS: Eighteen patients(21 eyes)with early stage capsular block syndrome were treated using Nd:YAG laser by anterior capsulotomy only or combined with posterior capsulotomy from January 2010 to July 2015 in Anyang Eye Hospital. Uncorrected distance visual acuity, intraocular pressure, spherical equivalent, depth of anterior chamber were observed preoperatively and 2wk postoperatively.

RESULTS: Seventeen eyes simply underwent peripheral anterior capsulotomy with Nd: YAG laser. Four eyes were combined with posterior capsulotomy. Compared with preoperative, uncorrected distance visual acuity improved, intraocular pressure returned to normal, degree of myopia reduced, depth of anterior chamber had deepened.

CONCLUSION: Nd:YAG laser capsulotomy is an effective treatment for early stage capsular block syndrome.

Abstract:AIM: To explore the application of 25G vitreous cavity perfusion in phacoemulsification for cataract after vitrectomy.

METHODS: Forty-eight patients(50 eyes)with cataract after pars planavitrectomy in our hospital from September 2013 to September 2014 were selected to receive phacoemulsification and implantation of artificial lens with 25G vitreous cavity perfusion. Best corrected visual acuity(BCVA), intraocular pressure(IOP), postoperative discomfort, healing of scleral puncture and postoperative complications were observed.

RESULTS: All patients underwent surgery successfully. Compared to before operation, there was less patients with BCVA ≤0.1, more patients with BCVA 0.3-0.5, >0.5, >0.3(P<0.05). The visual acuity of 1 eye decreased because of vitreous hemorrhage caused by original fundus lesion recurrence. The mean IOP before operation and at 1, 7d, 6mo after operation were 14.67±0.62mmHg, 14.75±0.56mmHg, 14.86±0.58mmHg, 14.88±0.59mmHg, respectively. There were no statistically significant differences of IOP between that before operation and those at 1, 7d, 6mo after operation(P>0.05). No obvious eye discomfort and severe complications after operation were observed.

CONCLUSION: The effect of 25G vitreous cavity perfusion in phacoemulsification for cataract after vitrectomy is good and it can maintain IOP, keep anterior chamber stable and decrease the complications risk.

Abstract:AIM: To study the changes of ocular surface in cataract patients with Meibomian gland dysfunction(MGD)who treated with Meibomian gland massage before surgery.

METHODS: Totally 90 patients(93 eyes)with cataract and MGD were randomly divided into two groups. Patients in experimental group were treated with hot compress and Meibomian gland massage every day before surgery, while the patients in the control group were not taken. Two groups of patients received phacoemulsification combined with intraocular lens implantation. Lid margin abnormalities, secretion characteristics, Schimer I test(SⅠt)and tear film break-up time(BUT)were recorded and compared between two groups using slit lamp microscope inspection preoperatively and postoperatively 1wk.

RESULTS: In the control group, the postoperative score of eyelid margin and Meibomian gland secretion was increased significantly than preoperative, while the value of BUT and SⅠt was down significantly. Compared with control group, the postoperative score of eyelid margin shape and Meibomian gland secretion in the experimental group was decreased significantly, while the value of BUT and SIT improved significantly(P<0.05).

CONCLUSION: Phacoemulsification can aggravate the Meibomian gland dysfunction and have some extent of effects on the ocular surface. Meibomian gland massage before surgery can significantly improve the function of Meibomian gland and the state of ocular surface in patients with MDG.

Abstract:AIM: To investigate NO levels in tears and anterior chamber inflammation after phacoemulsification and intraocular lens implantation with trabeculectomy through different operative incisions.

METHODS: Totally 49 patients(50 eyes)with primary acute angle-closure glaucoma and cataract were randomly divided to single-incision group and double-incision group. Both were treated by phacoemulsification and intraocular lens implantation and trabeculectomy after routine IOP-lowering drugs treatment. Preoperative and postoperative NO levels in tears were compared, and the aqueous flare and cells were examined using a laser flare-cell meter(LFCM).

RESULTS: Postoperative tear NO was 9.86±0.78μmol/L in single-incision group,it was 9.13±0.67μmol/L in double-incision group, the differences was statistically significant(t=3.57,P<0.05). Postoperative aqueous flare values was 62.42±18.16 pc/ms in single-incision group; it was 52.20±17.57 pc/ms in double-incision group,the differences was statistically significant(t=2.02, P<0.05).

CONCLUSION: The early inflammatory injury of double-incision was significantly lower than that of single-incision. It has the advantages of safety. But the surgical skill should be improved to less the injuries caused by operations.

Abstract:AIM: To discuss the effect of laser exposure on visual acuity and macula.

METHODS: Retrospective and consecutive case series. A retrospective analysis of 11 patients(11 eyes)with laser retinal injury was carried out from January 2014 to June 2015 in Ophthalmology Department of No. 474 Hospital of Chinese PLA. All individuals underwent visual acuity, best corrected visual acuity(BCVA), and spectral-domain optical coherence tomography(SD-OCT)for macular at first visit, and fundus fluorescein angiography(FFA), visual field, and multifocal electroretinogram(mf ERG)were perform if necessary. Symptomatic therapies, supportive therapies and pars plana vitrectomy(PPV)were performed depended on the patient's condition. The patients were followed-up at 1, 3 and 6mo after the first visit, and patients were undertaken visual acuity, BCVA, macular SD-OCT and so on.

RESULTS: Eight patients(73%)were under 18 years old and all patients were young males, who were injured by laser pointers when playing. Three patients(27%)over 18 years old were injured accidentally at work. Ten(91%)patients' BCVA were ≤0.3, while one(9%)patient's BCVA was higher ≥0.3. Full-thickness macular holes(the diameter 224-519 μm)were detected in 10 patients(91%), while sub-foveal RPE changes and IS/OS injury in 1 patient(9%). Macular hole with traction or cystoid edema in 6 eyes(55%)were received PPV, while the other 5 eyes(4 eyes with stable macular hole and 1 eyes with RPE injury)received conservative treatment. Macular hole closed successfully in 1 eye(17%)after PPV, while macular hole in the other 5 eyes(83%)were stable after PPV of which the cystoid edema faded. The 4 patients with macular hole and 1 patient with RPE injury were stable during follow-up period. However, the BCVA in all patients had no significant improvement at end.

CONCLUSION: Exposure to laser devices could lead to severe macula injury that could reduce central vision, which is permanent.

Abstract:AIM:To investigate and analyze diabetic retinopathy(DR)in patients with type 2 diabetes in local community and risk factors of type 2 diabetic retinopathy, and to provide reference for the prevention and treatment of diabetic.

METHODS:Randomly 268 cases with type 2 diabetes from community health management files from January to March 2015 were selected. Fundus photography was read through the remote reading system, demographic data and laboratory indexes of DR were analyzed.

RESULTS:In the 268 cases with type 2 diabetes, 85 cases were diagnosed as DR(31.7%); there were statistical difference on gender, duration, systolic blood pressure, fasting glucose, glycosylated hemoglobin A1c, urine creatinine between patients with DR and without(P<0.05). Multivariable Logistic regression analysis showed, duration, systolic blood pressure, fasting glucose, glycosylated hemoglobin A1c were independent risk factors of DR(P<0.05).

CONCLUSION:Long duration, high blood pressure, high blood glucose are main risk factors of DR, we should strengthen the monitoring of blood pressure, blood glucose and prevent the happening of the DR.

Abstract:AIM:To establish a suitable normative reference value for electroretinogram(ERG)testing using electroencephalogram(EEG)skin electrodes.

METHODS: The ERG was recorded in 51 eyes(30 people)who were normal after ophthalmologic examination in our department from March to September 2015 using skin electrodes and contact lens electrodes. The recorded result was reviewed and analyzed, and all the testings were recorded by the routine program.

RESULTS: The 95% confidential interval, mean or median of values was defined in amplitudes and latencies of various responses. All the amplitudes results of skin electrodes were significantly lower than those of the contact lens electrodes and the ratio(amplitudes of skin electrodes to those of the contact lens electrodes)was 20% to 30%. The latencies results of skin electrodes were significantly shorter than those of contact lens electrodes and the ratio was 95% to 96%.

CONCLUSION: The EEG skin electrode used for patients with low compliance may provide valuable information of retinal function.

Abstract:AIM:To investigate the correlation between dry eye and different degrees of diabetic retinopathy(DR)in type 2 diabetic patients.

METHODS: In the cross-sectional study, 340 patients(340 eyes)with type 2 diabetes were enrolled. Tear film function tests including tear meniscus height, tear film breakup time(BUT), fluorescein staining, Schirmer Ⅰ test were performed followed by surveying questionnaires about dry eye. Retinal status was evaluated by retinal color photography and indirect ophthalmoscopy exam with dilated pupils to evaluate DR and whether companied by macular edema.

RESULTS: The prevalence of dry eye was 49.41%. The mean duration of diabetes in patients with dry eye was 11.15±7.07a, while 6.92±5.45a without dry eye(P<0.01). Dry eye had the positive correlation to the development of DR. The incidence of dry eye in people with mild nonproliferative diabetic retinopathy(NPDR), moderate NPDR, severe NPDR and proliferative diabetic retinopathy(PDR)was 1.097 times, 1.724 times, 2.86 times and 5.43 times respectively, compared with people without DR. The occurrence of dry eye in people with macular edema increased by 3.697 times compared with people without macular edema.

CONCLUSION: Dry eye was more prevalent in people with type 2 diabetes. The incidence of dry eye increased gradually with the occurrence and development of diabetic retinopathy.

Abstract:AIM:To explore the curative effect of dacryocystorhinostomy under endoscopy with mitomycin for the treatment of chronic dacryocystitis.

METHODS: Totally 73 cases(78 eyes)with chronic dacryocystitis were treated with dacryocystorhinostomy under endoscopy with mitomycin and followed up for 6-12mo.

RESULTS: In the 73 patients, 66 cases with 70 eyes(90%)were cured, 2 cases with 3 eyes(4%)improved, 5 cases with 5 eyes(6%)not changed. In the recurrent 5 eyes, 2 eyes were treated under endoscopy to remove granulation, enlarge the opening, then anesthetic tube was placed after cotton sheet with 0.4g/L mitomycin was put on the incision for 5min.The rest 3 eyes were treated in superior hospital with laser, and all were successful. There was no severe complication observed.

CONCLUSION:Dacryocystorhinostomy under endoscopy with mitomycin for chronic dacryocystitis is effective.

Abstract:AIM:To compare the curative effect of conjoint fascial sheath(CSF)suspension and levator muscle resection for moderate or severe congenital ptosis.

METHODS: Forty-three patients(74 eyes)with moderate or severe ptosis were treated by CSF suspension or levator muscle resection randomly, and followed up for 6mo. The normalization rates of the two operations were then compared by statistical method, and the complications of the two operations were analyzed.

RESULTS: The two operations appeared no significant difference on the normalization rate for moderate congenital ptosis(P>0.05), while the normalization rate of CSF suspension on severe congenital ptosis was significantly higher than that of levator muscle resection(P<0.05). Less complication was happened in the CSF suspension group than in the levator muscle resection group.

CONCLUSION: CSF suspension is more effective on the treatment of severe congenital ptosis than levator muscle resection, and has advantages such as less trauma, repeatable, and less complication.

Abstract:AIM: To evaluate the objective visual quality of patients who underwent corneal cross-linking for the keratoconus using double-pass analysis system.

METHODS: Advanced keratoconus patients who underwent UV-riboflavin corneal cross-linking from January to July 2015 were included.The outcomes of their objective scattering index(OSI), predicted visual acuity(VA), the cut-off frequency of modulation transfer function(MTF cut-off), the Strehl ratio(SR)were compared before and 6mo after corneal cross-linking.

RESULTS: A total of 13 patients(16 eyes)were included. There was no statistically significant difference between pre- and 6mo postoperative data in uncorrected visual acuity,best corrected visual acuity,refractions and mean value of Sim-k(P>0.05). Non-invasive average tear film break up time(NIAvg-BUT)detected by the Sirius system decreased after corneal cross-linking(P<0.05). Using double-pass analysis system, no statistically significant change was found in MTF cut off, Strehl Ratio, OSI before and after treatment(P>0.05). Tear Film Analysis Mean OSI increased at 6mo postoperatively(P<0.05).

CONCLUSION: The subjective visual quality isn't effected by corneal cross-linking. The tear stabilities of patients are influenced by these operations at 6mo postoperatively. More observations on long-term effect are needed to be taken in the future.

Abstract:AIM: To analyze clinical characteristics and postoperative outcomes after open globe injury.

METHODS: Demographic characteristics(age, gender, eye trauma, profession, cause of injury and injured part), as well as complications and prognosis were analyzed in 152 cases(152 eyes)of open globe injury.

RESULTS: Patients with open globe injury had an average age of 40.45±38.32 years old with a 5.9:1 male-to-female gender ratio. The left-to-right eye ratio was 1.27:1. Most patients were workers, farmers, or retired. The most common etiologies were scratches, boxing, and falls. Zone Ⅲ was the most commonly injured part. Iridoptosis or iris incarceration, retinal detachment, vitreal prolapse, hyphema or hypopyon, and vitreous hemorrhage were the most common complications. Visual acuity improved in 86 cases postoperatively but ophthalmectomy was still required in 25 eyes.

CONCLUSION: Vision can be improved after surgery in open globe injury. However, patients are usually seriously injured and improvement is minimal, thereby resulting in a great loss to patients and society.