Abstract:AIM: To compare the monotheraphy efficacy of the brand latanoprost Xalatan and a similar latanoprost(Drenatan)regarding intraocular pressure(IOP)reduction in patients with primary open angle glaucoma(POAG).

METHODS: Sixty two patients(119 eyes)were enrolled in this observational, retrospective study. In the first visit, the patient came in using the brand latanoprost(Xalatan)and it was changed to the similar latanoprost(Drenatan). In the second visit, 12wk later, a complete ophtalmologic exam including slit lamp examination, Goldmann applanation tonometry, stereoscopic fundus examination, gonioscopy, ultrasound pachymetry, automated visual field testing was performed.

RESULTS:The mean IOP was 12.30±2.02mmHg and 12.38±2.05mmHg with using Xalatan and Drenatan, respectively. The P=0.559 demonstrates this relation. In fact, a correlation between the groups of R=0.987 points out the remarkable resemblance of both groups.

CONCLUSION: Both Drenatan and Xalatan have similar efficacy in reducing IOP. Such finding is pivotal to public health to reduce cost and maintain its policies concerning drug efficacy and safety, this is especially significant in countries in which treatment cost is a barrier for patient adhesion to treatment.

Abstract:AIM: To evaluate the efficacy and safety of a new implant, Suprajet(VSY Biotechnology, Istanbul, Turkey), which is developed for supraciliary and suprachoroidal drainage of aqueous humour.

METHODS: Five rabbits were included in the study. One Suprajet shunt was implanted in one eye of each rabbit. Implantation was performed by a superior clear corneal incision through the anterior chamber into the suprachoroidal space. Proximal end of the implant was placed in the iris root resting against the scleral spur, distal end was placed in the suprachoroidal space. Rabbits were followed for 4wk. Preoperative and postoperative intraocular pressure(IOP)levels were measured with Tonopen AVIA. At last follow-up visit animals were sacrificed and eyes were enucleated. Macroscopic and histopathologic evaluation of the eyes were made.

RESULTS: Mean preoperative IOP was 18.6±6.1 mmHg. Mean postoperative IOP was 8.4±1.1 mmHg, at one week. At the 2^nd week of the follow-up period one rabbit died. Thereafter, only 4 rabbits were followed. Mean postoperative IOP was 11.0±2.8 mmHg at the 2^nd week, 9.50±3.1 mmHg at the 3^rd week and 11.3 ±3.3 mmHg at 4^th week after the operation. When mean preoperative IOP was compared with the postoperative IOP values, only the IOP at the first week was found as significantly lower(P=0.042). There was no statistically significant difference between mean preoperative IOP level and mean IOP level at 2, 3 and 4wk postoperatively(P=0.66, P=0.66 and P=0.102, respectively). As an intraoperative complication, minimal hyphema was noted in three eyes during the surgery. However, the next day hyphema cleared completely. Macroscopic evaluation of the enucleated material showed that in one eye the distal end of the implant was in the vitreous instead of suprachoroidal space, in the other 3 eyes the distal end of the implant was noted in the suprachoroidal space. In all eyes, proximal end of the implant was localized in the anterior chamber angle. Histopathologic evaluation of the enucleated eyes showed deposition of irregular collagen bundles and fibroplasia including numerous fibroblastic and histiocytic cells around the implant.

CONCLUSION: This preliminary animal study showed that implantation of Suprajet in glaucoma is a promising procedure. Further studies are needed to evaluate its efficacy and safety profile.

Abstract:AIM: To evaluate the therapeutic effect of aflibercept in patients with suboptimal response to ranibizumab therapy in the early period.

METHOD: Thirty-eight patients with wet type age related macular degeneration(W-AMD)were involved in this study. Eighteen patients with suboptimal response were shifted to 3 doses monthly intravitreal aflibercept therapy(IVA)and left 20 patients with suboptimal response went on 3 more monthly intravitreal ranibizumab(IVR). All changes were evaluated with fluorescein anigography(FA)and optical coherence tomography(OCT).

RESULTS: Preoperative mean visual acuity(VA)and central macular thickness(CMT)of patients were 0.84±0.47 logMAR and 360±84 μm, respectively. One month after last IVR and IVA treatments, VA of patients were 1.1±0.34(P=0.11)logMAR and 0.48±0.37(P=0.019)logMAR and CMTs were 300±79 μm(P=0.002)and 271±51 μm(P=0.002), respectively.

CONCLUSION: To eliminate repeated therapy for patients with suboptimal response to ranibizumab therapy, aflibercept might be a good alternative for early visual rehabilitation.

Abstract:AIM: To perform a new method for orbital implant and contracted socket through one time and its results.

METHODS: Totally 114 patients 114 eyes, from January 2008 to June 2014, with contracted socket participated in this study. We incised the bulbar conjunctiva horizontally and excised scar tissue, then implanted the hydroxyapatite in the four extraocular muscles and tightly sutured the Tenon' capsule. After that, we put the superior and inferior conjunctival petals backwards and sutured them to the Tenon's capsule. All the patients were divided into four groups according to the vertical diameter length of the conjunctival defect area: Group Ⅰ: ≤5mm; Group Ⅱ: 6-10mm; Group Ⅲ: 11-15mm; and Group Ⅳ: ≥16mm. These patients were followed up for 6mo to 3y to observe the conjunctival sac shaping and growth of conjunctiva.

RESULTS: There were 64 cases in Group Ⅰ, 31 cases in Group Ⅱ, 16 cases in Group Ⅲ and 3 cases in Group Ⅳ. All patients' conjunctival defect was covered by new conjunctiva and scar tissue 4 to 6wk after surgeries. Ten cases had contracted socket; 2 cases had orbital implant exposure, requiring reoperation. Of the 114 cases, 8 had contracted socket and could use a smaller conformer, 106 could use a normal size conformer.

CONCLUSION: When the conjunctival defect was ≤15mm, this new method can address the orbital implant and contracted socket at the same time. While it was ≥16mm, flap transplantation is necessary.

Abstract:AIM: To investigate the effects of amnion epithelial cell(AEC)suspension liquid on the biological behavior of the rabbit's corneal epithelium, combined with the in vitro and in vivo experiments.

METHODS: The rabbit's corneal epithelium were cultured in the lower chamber of transwell, and AEC suspension liquid was dropwised in the upper chamber. There was only culture medium in the upper chamber of the control group. The proliferation of rabbit's corneal epithelium was observed with CCK-8 automated colorimetry and the expression of PCNA was detected by immunocytochemistry. We used the scratch wound assay to detect the migration of corneal epithelial cell(CEC). The in vivo models were established by placing a 10mm diameter corneal trephine in the center of the cornea, within 1mol/L NaOH for 1min. We divided those into three groups: treatment group of AEC suspension liquid eye drop, AEC suspension liquid subconjunctival injection and the control group without any treatment. Using the slit-lamp biomicroscope and fluorescence staining to observe the cornea per week. After 28d we took the eyeballs with the HE staining. The expression of VEGF was detected by immunohistochemistry.

RESULTS: The activity of CEC with AEC treatment was much higher than the control group(P<0.05). The expression of PCNA increased in AEC group(P<0.05). And the migration of CEC in the AEC group was faster than the control one. In vivo, the inflammation of the corneal and the CNV of the AEC group were all significantly reduced compared with the control group(P<0.05). There were less invasive cells and more ordered organization arrangement in ACE group observed by the HE staining. The expression of VEGF and mcp-1 in these two AEC treatment groups all significantly decreased compared with the control group(P<0.05).

CONCLUSION: AEC suspension liquid can promote the proliferation and migration of the rabbit's corneal epithelium. The potential of AEC suspension liquid as a therapy for acute corneal alkali burn.

Abstract:AIM: To discuss the protective effects and possible mechanisms of 17β-estradiol on human retinal pigment epithelial(RPE)cells induced by high glucose.

METHODS: RPE cells were cultured and divided into four groups according to randomized controlled method: blank control group: the cells were treated with 5.5mmol/L routine glucose medium for processing; high glucose group: cells were treated with 100mmol/L glucose for 12h; 17β-estradiol low concentration group: after treated with 10 μmol/L 17β-estradiol, cells were treated with 100mmol/L glucose for 12h; 17β-estradiol high concentration group: after treated with 100 μmol/L 17β-estradiol, cells were treated with 100mmol/L glucose for 12h. Cell viability were tested by MTT colorimetric detection. Cells apoptosis were detected by Hochest33258 staining. Intracellular reactive oxygen species(ROS)level were detected by H₂DCFDA staining. Expression of CAT, SOD and MDA were tested by colorimetric detection.

RESULTS: RPE cell activity decreased with the concentration of glucose increased; 17β-estradiol inhibited high glucose-induced cell viability decrease in RPE cells, decreased the apoptosis rate of RPE cells and intracellular ROS generation; besides, 17β-estradiol significantly increased the expression of CAT, SOD and decreased the expression of MDA in RPE cells.

CONCLUSION: The 17β-estradiol effectively inhibited high glucose -induced RPE cells damage, which provide reliable experimental basis for the treatment of injuries in RPE cells.

Abstract:AIM: To explore the effect of different concentrations of salidroside on H₂O₂ induced oxidative stress damage in human lens epithelium cells(HLEC).

METHODS: HLEC were cultured and divided into negative control group: cultured in normal cultivation; oxidative damage group: treated with 100μmol/L H₂O₂ for 12h; Salidroside low concentration group: 10μmol/L salidroside treated for 24h and H₂O₂ treated for 12h; Salidroside high concentration group: 100μmol/L salidroside treated for 24h and H₂O₂ treated for 12h. MTT method was applied to observe the effect of salidroside on HLEC survival rate. Morphological change of each group were observed and recorded under inverted microscope. DCFH-DA fluorescent probe was applied to detect intracellular ROS changes; content of malondialdehyde(MDA), superoxide dismutase(SOD)and glutathione peroxidase(GSH-Px)in supernatants were detected by pectrophotometer.

RESULTS: Salidroside obviously inhibited H₂O₂-induced HLEC vitality decline, inhibited ROS generation in cells, causing SOD, GSH-Px levels increased and MDA levels decreased.

CONCLUSION: Salidroside inhibited H₂O₂ induced HLEC injury by decreasing the intracellular MDA content levels and increasing SOD, GSH-Px content levels, which conclude that salidroside may have a certain role in the treatment of HLEC damage.

Abstract:AIM: To study the visual quality, dry eye and biomechanical stability of patients with myopia and astigmatism after different corneal refractive surgeries.

METHODS: A total of 986 patients with myopia and astigmatism were selected as the research object in our hospital from July 2015 to July 2016, according to the operation mode of the selection of the research object, the 986 patients were randomly divided into small incision lenticule extraction(SMILE)group, femtosecond laser in situ keratomileusis(FS-LASIK)group, sub-bowman-keratomileusis(SBK)group and laser-assisted in situ keratomileusis(LASIK)group. The postoperative visual quality was determined by comparing the diopter, uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA)and high-order image difference of 25d, 90d. The postoperative dry eye condition was determined by comparing the postoperative tear secretion test(Schirmer Ⅰ test), tear film rupture time(BUT)and fluorescence staining(FS). The biomechanical stability of the patients was determined by comparing the corneal hysteresis(CH)and corneal resistance factor(CRF)values of the four groups.

RESULTS: The diopter, UCVA, BCVA and high-order aberration comparison of FS-LASIK group, SBK group and LASIK group between before and after surgery, showed no significant difference(P>0.05); on diopter, BCVA, UCVA, there was no significant difference between before and after surgery in SMILE group(P>0.05), but statistical significance difference on high order aberration(P<0.05). The BUT and FS value of the four groups decreased obviously after operation, and the difference was statistically significant(P<0.05). In LASIK group SIt after operation significantly decreased, with statistically significant compared with that before operation(P<0.05). After operation, CH and CRF of the four groups decreased with significant differences(P<0.05).

CONCLUSION: SMILE, FS-LASIK, SBK and LASIK are equally safe, effective and stable in the treatment of myopia and astigmatism.

Abstract:AIM: To compare and analyze the effect of recombinant bovine basic fibroblast growth factor(bFGF)eye drops and hydroxyl indican eye drops on the tear film stability and dry eye symptoms after age-related cataract surgery.

METHODS: A total of 115 patients(115 affected eyes)with dry eyes after age-related cataract surgery were divided into the bFGF group, the hydroxyl indican group and the blank control group by the random number table method. The blank control group was only given routine anti-inflammatory treatment, and on the basis, the bFGF group and the hydroxyl indican group were treated with bFGF eye drops and hydroxyl indican eye drops respectively. The clinical efficacy, adverse reactions, changes in scores of dry eye symptoms, Schirmer test(SⅠt), tear film break-up time(BUT)and corneal fluorescein staining(CFS)scores at different time points were compared among the three groups.

RESULTS: The total markedly effective rates in the bFGF group(89.5%)was higher than that in the hydroxyl indican group(70.3%)or the blank control group(47.5%)(P<0.05). Scores of dry eye symptoms, CFS, SⅠt and BUT in the three groups at 2 and 5wk after surgery were significantly different(P<0.05). The above-mentioned indexes in the bFGF group at 2 and 5wk after surgery were significantly better than those in the hydroxyl indican group and the blank control group, and better in the hydroxyl indican group than the blank control group(P<0.05). There were no obvious adverse reactions.

CONCLUSION: The tear film is unstable in early stage after age-related cataract surgery, and there are dry eye symptoms. The intervention with bFGF eye drops and hydroxyl indican eye drops can effectively restore the tear film stability and significantly relieve dry eye symptoms, and the effect of bFGF eye drops is more significant.

Abstract:AIM:To observe the clinical efficacy and safety of vincamine sustained release capsules on non-arteritic anterior ischemic optic neuropathy(NAION).

METHODS:Patients who were diagnosed with monocular onset NAION in acute stage from January to September 2015 were divided into two groups. Routine treatment such as steroid pulse therapy and neurotrophic treatment were given to all the patients. Vincamine was added to the treatment group patients with 30mg twice a day for 3mo. The best corrected visual acuity(BCVA), mean deviation(MD)of visual field, retinal nerve fiber layer(RNFL), ganglion cell complex(GCC), pattern visual evoked potential(PVEP)and OCT results were analyzed before and after the treatment.

RESULTS: Totally 42 eyes of 42 patients were enrolled in our study. There were 27 patients in the treatment group, aged from 33 to 79 years old, the average value was 55.55±11.83 years old. The control group has 15 patients, aged from 40 to 70 years old, the average value was 55.71±10.06 years old. There were no statistical differences between the two groups in the baseline. After 3mo of the treatment, MD value of the two groups were lower compared with the baseline, the difference was statistically significant in the treatment and control group respectively(t=2.342, 2.692; P=0.027, 0.041). The difference of PVEP amplitude and potential of the two groups before and after the treatment were not statistically significant. The thickness of retinal nerve fiber layer and the ganglion cell complex were all lower than the baseline, and the difference was statistically significant(P<0.001). The treatment of the two groups were both effective, the treatment group has better treatment effect than the control group. Adverse events related to the treatment of vincamine had not been found.

CONCLUSION: Vincamine is helpful in the treatment of non-arteritic anterior ischemic optic neuropathy.

Abstract:Internal limiting membrane(ILM)peeling is commonly used in the operation of idiopathic macular hole(IMH)surgery. The success of ILM peeling has been greatly improved with the assistance of vital dyes. Currently, several kinds of vital dyes such as indocyanine green(ICG), brilliant blue G(BBG)are applied in the ILM staining. However, all of the vital dyes have potential toxicity and side effects on the retina. In recent years, many kinds of dyes and staining improved emerge in endlessly. This paper reports the progress in the application of different colorants in the operation of IMH.

Abstract:Long non-coding RNA(LncRNA)is a class of transcript(>200 nucleotides)that do not encode proteins. It plays an important role in epigenetic regulation and gene expression at transcriptional or post transcriptional level. The abnormal expression of LncRNA may lead to various pathological processes. Diabetic retinopathy(DR)is a multifactorial disease. Recent studies have shown that many specific expressions of LncRNAs are closely related to the genesis of DR. In this review, we summarized the recent advances in the function of LncRNA, the regulatory mechanisms of LncRNA involved in the development of DR, and the related therapies.

Abstract:Age-related macular degeneration(AMD)is the main cause of blindness in the people older than 50 years old. In recent years, following the improvement of imaging techniques in ophthalmology, the pathogenesis of the disease, the level of diagnosis and efficacy evaluation ability greatly improved. In this paper, we reviewed and discussed the recent advancement on imaging research of age-relate d macular degeneration.

Abstract:The stability of the intraocular lens(IOL)after cataract surgery is composed of decentration, tilt, rotation, and the change of anterior chamber depth. Its stability is an important factor affecting postoperative visual quality. By analyzing the related factors which influence the stability of intraocular lens, improvements can be identified for future cataract operations. The stability of intraocular lens is influenced by many factors: intraocular structure, the size and the symmetry of intraoperative capsulorhexis, the position of the intraocular lens, the material and design of the intraocular lens, etc. In order to improve the patient's vision, cataract surgeries have been experiencing an evolution. IOL material have also been contributing to such innovations.

Abstract:Aqueous humor is the product of the ciliary body. It provides nutrition for the iris, cornea, lens, and trabecular meshwork. Compared to the blood, the aqueous humor can better reflect the intraocular environment. Therefore, the detection of cytokines in the aqueous humor has become one of the hot topics in ophthalmology in recent years. Altered cytokine levels in the aqueous humor have been observed in many ocular diseases, including glaucoma. Some investigators hypothesized that cytokines in the aqueous humor are associated with the pathophysiology of glaucoma, and even affect the prognosis of glaucoma filtering surgery. In this paper, the changes of several cytokines in the aqueous humor of glaucoma eyes were summarized, and the relationship between them was analyzed.

Abstract:Alzheimer's disease(AD), a neurodegenerative disease, can result in memory loss,cognitive and behavioral deficits. The pathological hallmarkes are β amyloid plaques and neurofibrillary tangles which lead loss of neurons in brain. As the extension of the central nervous system, retina has a similar tissue anatomy with central nervous system. The β amyloid plaques have also been detected in retina of AD. Furthermore, according to eye examinations of AD patients, we have found the loss of retinal ganglion cells, the attenuation of retinal nerve fiber layer thickness, the smaller changes of macula lutea, the decline of vascular density and so on. And then, there occurs the visual field loss and the decline of contrast sensitivity and so on in AD patients. Thus, the retina has occurred nerve degenerative changes in AD. Meanwhile, there has been proved that the retina nerve degeneration is even earlier than senile plaques formation in brain. In addition,curcumin, a natural and safe fluorescent dye, can be used to label β amyloid plaques in retina. The above suggests that retina can be a window for the early diagnosis of AD.

Abstract:Myopia is not only a global public health problem, but also a significant socio-economic problem. There are various hypotheses about the pathogenesis of myopia, which is basically the result of the combination of environmental and genetic factors. Although a large number of epidemiological studies have been carried out on the influencing factors of myopia, most of them are cross-sectional studies, longitudinal cohort studies are relatively few. This paper will summarize the influencing factors of myopia at homeland and abroad in recent years.

Abstract:AIM:To compare the effect of three types of pterygium surgery and on tear film in patients with type 2 diabetes mellitus.

METHODS:A total of 102 patients(102 eyes)with pterygium combined with type 2 diabetes mellitus treated in our hospital from March 2013 to March 2016 were analyzed retrospectively. The patients were divided into three groups including the 34 cases(34 eyes)with simple excision of pterygium(resection group), pterygium excision combined with conjunctival flap transplantation in 34 cases(34 eyes, as conjunctival flap group)and pterygium excision combined with limbal stem cell transplantation in 34 cases(34 eyes, as stem cell group). The wound repair time, complications, recurrence rate, uncorrected visual acuity(UCVA), tear film break-up time(BUT)and basal tear secretion test(SⅠt)were observed before, and 6 and 12mo after surgery in the three groups, respectively.

RESULTS: The postoperative UCVA of the three groups was significantly higher than that preoperation(P=0.039, 0.013, 0.024), and there was no significant difference among the three groups(P=0.317). The wound repair time was 5.67±1.45d in the resection group, which was significantly higher than that in the conjunctival flap group(4.18±0.76d)and the stem cell group(4.09±0.79 d)(P<0.001), there was no significant difference between the conjunctival flap group and the stem cell group(P=0.937). There were 4 cases in resection group reappeared, and the recurrence rate was 11.8%, which was significantly higher than the other two groups(P=0.037). There were 1 recurrences in the conjunctival flap group, and the recurrence rate was 2.9%, while the patients in the stem cell group had no obvious recurrence. SⅠt and BUT increased significantly after operation(P<0.05), especially in conjunctival flap group and stem cell group(P<0.001). There was no significant difference between the conjunctival flap group and the stem cell group(P=0.845, 0.894).

CONCLUSION: Pterygium excision combined with conjunctival flap transplantation or limbal stem cell transplantation for the treatment of type 2 diabetic patients with normal blood glucose and tear film function has the similar effect, and is better than simple pterygium excision.

Abstract:AIM: To compare the effect of small incision extracapsular cataract extraction and phacoemulsification on corneal endothelial cells and explore the differences between these two most commonly used surgeries for grade Ⅱ-Ⅲ lens nucleus.

METHODS: Retrospective study. We retrospectively evaluated the data of age-related cataract patients who had completed surgery in our hospital between June 2013 and December 2015. There were 84 eyes of 84 patients. The corneal endothelial cell density of all the patients were greater than 2000/mm² and lens nucleus were grade Ⅱ-Ⅲ. The patients were divided into manual small incision cataract surgery(MSICS)group and phacoemulsification(Phaco)group. MSICS group included 42 cases(42 eyes)and Phaco group included 42 cases(42 eyes). Postoperative evaluations were performed at 1d, 1wk, 1mo and 6mo and included uncorrected visual acuity(UCVA), corneal endothelial cell density and the proportion of hexagonal cells.

RESULTS: There were no statistically significant differences of the two groups in preoperative basic data, UCVA, corneal endothelial cell density and the proportion of hexagonal cells, nuclear classification. The postoperative UCVA were significantly improved in both groups(χ²=148.01, P<0.001; χ²=165.97, P<0.001). The postoperative UCVA were on the rise as time goes on. The postoperative corneal endothelial cell density was obviously reduced in both groups compared with the preoperative(F=37.74, P<0.001; F=24.56, P<0.001). The proportion of hexagonal cells in Phaco group was declined at 1d(P=0.002)after the operation and returned to baseline by 1wk(P=0.894)after surgery. There was no significant difference between the two groups in UCVA, corneal endothelial cell density and the proportion of hexagonal cells at each observation point (P>0.05).

CONCLUSION: Manual small incision cataract surgery and phacoemulsification can indiscriminately improve UCVA and decrease the density of corneal endothelial cells. However, the change of hexagonal cells proportion was not obvious. These two surgeries for cataract patients with corneal endothelial cell density greater than 2000/mm², grade Ⅱ-Ⅲ lens nucleus have similar efficacy and safety.

Abstract:AIM: To investigate the curative effect of phacoemulsification and intraocular lens(IOL)implantation combined with goniosynechialysis in the treatment of age-related cataract merging with primary angle-closure glaucoma(PACG).

METHODS: Totally 80 patients with age-related cataract merging with PACG were in our hospital from January 2014 to January 2016. The preoperative average intraocular pressure(IOP)was 33.22±3.17mmHg; the average depth of anterior chamber was 2.07±0.15mm; the dynamic situation of primary angle closure ≤1/2 cycle by gonioscope. They were randomly divided into Group A and B for doing a study. All the two groups were treated with phacoemulsification and intraocular lens implantation. And the Group A was with goniosynechialysis. The following up period was 2mo, and we observed the IOP, chamber depth and the anterior chamber angle.

RESULTS: The change of chamber depth and intraocular pressure about the two groups: the average intraocular pressure of the Group A was 15.11±3.67mmHg,the chamber depth was 3.11±0.08mm; those of the Group B were 17.24±1.67mmHg, 2.76±0.15mm respectively; the differences had statistical significance(P<0.05). Postoperatively, there were 28 eyes(70%)in Group A with fully open anterior chamber angle, and 18 eyes(45%)in Group B(P<0.05).

CONCLUSION: The phacoemulsification and intraocular lens implantation combined with goniosynechialysis in the treatment of age-related cataract merging with primary angle-dosure glaucoma is safe and reliable. It's simple to operate, and do not increase the risk of surgery.

Abstract:AIM: To evaluate the effects of 23G vs 20G pars plana vitrectomy(PPV)combined with internal limiting membrane peeling, phacoemulsification and intraocular lens implantation for macular epiretinal membrane with cataract.

METHODS: Totally 45 eyes of 45 patients with macular epiretinal membrane and cataract were enrolled in this retrospective non-randomized controlled clinical study. All eyes were treated with PPV combined with internal limiting membrane peeling, phacoemulsification and intraocular lens implantation. There were 20 eyes in 23G PPV group, and 25 eyes in 20G PPV group. The best corrected visual acuity(BCVA), intraocular pressure(IOP), counting of corneal endothelial cells(CEC)and central retinal thickness(CRT)were examined before surgery. BCVA results were converted to the logarithm of the minimum angle of resolution(LogMAR)visual acuity. All operations were performed by the same doctor. Operation time for vitrectomy and membrane peeling, average ultrasound energy(AVE)and effective phacoemulsification time(EPT)were recorded. BCVA and CRT were observed postoperatively at 30d and 90d, counting of CEC was observed postoperatively at 90d. IOP was observed postoperatively at 1d and 7d.

RESULTS: The mean operation time for vitrectomy were 12.57±1.35min in 23G group and 17.30±1.19min in 20G group. The difference was statistically significant(t=-12.488, P<0.01). There were no statistical significances in operation time for membrane peeling, AVE and EPT between 23G and 20G groups(t=-0.68,-1.186,-0.737,P=0.500, 0.242,0.465). On 1d after surgery, IOP in 23G group was lower than that in 20G group, the difference was statistically significant(t=-2.345, P=0.024). The BCVA and CRT of the two groups both improved after operations. There were no statistically significant differences between two groups in terms of IOP, BCVA, and CRT(F=0.465, 1.895, 0.689; P=0.499, 0.176, 0.411). IOP, BCVA and CRT were significant statistical different in different time-point within each group(F=291.245, 103.06, 665.402, P<0.01). Different surgical methods of 23G and 20G had interactive effects on IOP with different time points(F=13.245, P<0.01), but different surgeries had no interactive effects on BCVA and CRT with different time points(F=1.212, 2.293; P=0.283, 0.129). The counting CEC in 23G group was more than that in 20G group postoperatively at 90d, the difference was statistically significant(t=2.049, P=0.048).

CONCLUSION: The 23G PPV combined with internal limiting membrane peeling, phacoemulsification, intraocular lens implantation for macular epiretinal membrane with cataract is effective. Compared with 20G PPV, 23G PPV has advantages in operation time for vitrectomy and counting CEC. But lower IOP is likely in 23G PPV on 1d after surgery

Abstract:AIM: To observe the clinical effect of combined cataract and primary open-angle glaucoma underwent phacoemulsification and glaucoma drainage device implantation.

METHODS: We selected in our hospital from January 2014 to February 2016, 42 cases(42 eyes)with primary open-angle glaucoma with cataract. According to random number table method, all of the patients were randomly divided into two groups, control group and study group. In control group, 21 patients(21 eyes)underwent trabecular resection combined phacoemulsification; in study group patients, 21 patients(21 eyes), underwent EX-PRESS glaucoma drainage device combined phacoemulsification. Compared parameters included postoperative complications and filtering bleb, visual acuity, intraocular pressure(IOP)and other clinical indicators between two groups.

RESULTS: Preoperative IOP of two groups was no significantly different(P>0.05). Postoperative IOP at each time point was significantly lower than before treatment(P<0.05). At 1d, 1 and 4wk after treatment, IOP of the study group was significantly lower than the control group(all P<0.05); at 12wk after treatment, IOP of the two groups was not significantly different(P>0.05). At 12wk after treatment, surgical success rate of study group was 95%, significantly higher than that of control group 71%(P<0.05). The postoperative best corrected visual acuity of two groups was no significantly different(P>0.05). At 12wk after treatment, 21 patients in study group were shown as functional filtering bleb, while in the control group 18 cases was functional filtering bleb.

CONCLUSION:Using EX-PRESS glaucoma drainage device combined with phacoemulsification in treating cataract with primary open-angle glaucoma is reliable, the curative effect is better than that by trabeculectomy combined with phacoemulsification treatment.

Abstract:AIM: To analyze the change of serum inflammatory factors in glaucoma patients at different stages and its clinical significance.

METHODS:Totally 70 cases of 128 eyes with primary open-angle glaucoma in our hospital from January 2014 to August 2016 were selected. According to the mean defect of visual field, they were divided into light(observation Group 1), moderate(observation Group 2)and heavy group(observation Group 3). Another 65 cases of 130 eyes with cataract were taken as the control group in our hospital. The observation and expression of serum cytokines in these patients with glaucoma were taken.

RESULTS: There was no significant difference in serum IL-2 and IFN- γ levels between the two groups(P>0.05). The sIL-2R and IL-4 levels in the glaucoma group were higher than those in the control group, and the levels of IL-6 and IL-12 were lower than those of the control group(P<0.05). The IOP and proportion of myopia in the glaucoma group was higher than that in the control group, the difference was not statistically significant(P<0.05). The ratio of moderate myopia to severe myopia in each group was not statistically significant(P>0.05). To observe the low myopia ratio in Group 3 of patients, it was less than observation Group 1 and observation Group 2(P>0.05). There was no statistically significant difference between observation Group 1 and 2 of patients on IL-2, sIL-2R, IL-4, IL-6 and IFN-γ levels(P>0.05). The level of sIL-2R in the Group 3 was higher than that in the Group 1, and the level of IL-12 was lower than that in the Group 1 and in the Group 2(P<0.05). There was no significant difference in IL-2, IL-4, IL-6 and IFN-γ levels between the glaucoma patients(P>0.05). The IOP level and the proportion of myopia in the Group 3 were higher than those in the Group 1 and the Group 2 were observed, the difference was statistically significant(P<0.05). The intraocular pressure was higher in Group 2 than in group 1(P<0.05). There was no statistically significant difference on proportion of myopia between observation Group 1 and observation Group 2(P>0.05).

CONCLUSION: The levels of serum IL-12, sIL-2R and intraocular pressure in patients with primary open-angle glaucoma fluctuated significantly at different stages of the nerve injury, indicating that the immune response and intraocular pressure were involved in the process of optic nerve damage.

Abstract:AIM:To study the clinical effects of using sodium hyaluronate in the glaucoma trabeculectomy.

METHODS: Totally 46 patients were included in our research and they were divided into two groups. In the study group(23 cases 23 eyes), we used slice with MMC of 0.4mg/mL in trabeculectomy. Before the conjunctiva flap was sewed, a small amount of sodium hyaluronate was injected into the space under scleral flap and the anterior chamber. In control group(23 cases 23 eyes), we only used MMC. After trabeculetomy, shallow anterior chambe formation, intraocular pressure, corneal endothelial injury and the formation of filter-bubble were observed in long term.

RESULTS: IOP of study group at 1d after operation was higher than that of control group(P<0.05), but not significant different at 3d, 1 and 6mo after operation(P>0.05). At 3d after operation, visual acuity decreased in 2 eyes(9%)of study group, 8 eyes(35%)in control group with significant different(P=0.035). At 6mo after operation, visual acuity decreased in 0 of study group, 5 eyes(22%)in control group with significant different(P=0.025). The differences on the occurrence of shallow anterior chamber at 7d after operation, formation of filter-bubble at 6mo after operation and corneal endothelial count were significant(P<0.05). There were less postoperative complications in study group than in control group.

CONCLUSION: Using sodium hyaluronate combined with MMC in trabeculectomy can greatly prevent the formation of shallow anterior chamber, filter-bubble scarring, and corneal endothelium dropout, make it possible to a safer surgery and a better outcome.

Abstract:AIM: To investigate the effect and safety of intravitreous injection of conbercept(0.5mg)on macular edema secondary to central retinal vein occlusion(CRVO).

METHODS: According to the selective criteria, from October 2014 to October 2015, 48 cases(48 eyes)of patients with macular edema secondary to CRVO were collected, which were divided randomly into conbercept group(24 cases, 24 eyes)and control group(triamcinolone acetonide 4mg/0.1mL, 24 cases,24 eyes). The best-corrected visual acuity(BCVA), intraocular pressure, intravitreous injection, fundus oculi, central macular thickness(CMT)and related complications were observed before and 1wk, 1, 3, 6 and 12mo after intravitreous injection.

RESULTS: There was no difference on BCVA, intraocular pressure, intravitreous injection, fundus oculi and CMT between the two groups before operations(P>0.05). There were no significant differences(P>0.05)of the BCVA between two groups after treatment for 1wk, 1, 3, 6 and 12mo. Before and after treatment, the decrease of CMT in conbercept group was respectively 130.17±1.72μm, 253.33 ±3.14μm, 318.00±1.41μm, 20.01±1.21μm and 15.09±1.41μm, and no related complications. The decrease of CMT in control group was respectively 132.5±2.07μm, 249.67±1.21μm, 317.50±4.23μm, 18.01±1.41μm and 16.09±1.31μm, and no related complications. There were no significant differences(F=6.882, P=0.663>0.05)of CMT between two groups after treatment for 1wk, 1, 3, 6 and 12mo. Injection times were respectively 2.83±0.72 and 3.17±0.71 in control group and conbercept group, and the difference between two groups has no statistical significance(P>0.05). There were 4 cases(17%)of paracentesis of anterior chamber, 3 cases(13%)of intraocular hypertension and 1 case(4%)of complicated cataract in control group. There was no related complications in conbercept group.

CONCLUSION: Intravitreous injection of conbercept for macular edema secondary to CRVO is effective, safe and less complications.

Abstract:AIM: To investigate the difference of cognitive impairment and depression between age-related macular degeneration(AMD)group and the control group patients.

METHODS: A prospective case-control study was performed from November 2014 to August 2016 in the hospital for AMD patients and sex-matched control group. The Mini-Mental State Examination(MMSE)and the Geriatric Depression Scale(GDS)score of each patient were collected for statistical analyzing.

RESULTS: There were total 84 cases(168 eyes)included in the study. The difference of visual acuity between the two group was statistically significant(F=8.953, P=0.004)by baseline data analyzing. There were no significant differences in MMSE scores between the two groups according to educational status(P>0.05), while the prevalence of cognitive impairment in each group was statistically significant(χ²=4.14, P=0.042). The difference of GDS scores, prevalence of total and mild depression between two groups were both statistically significant(F=5.852, P=0.018; χ²=6.372, P=0.012; χ²=5.674, P=0.017). However, there was no statistically significant difference in the prevalence of moderate to severe depression(χ²=0.672, P=0.412).

CONCLUSION: AMD patients have a higher prevalence of depression. Although MMSE score differences were not statistically significant in subgroup analysis by educational levels, AMD patients are more likely to have cognitive impairment overall.

Abstract:AIM: To investigate the effects and mechanism of anti-vascular endothelial growth factor(VEGF)assisted pars plana vitrectomy(PPV)in the treatment of proliferative diabetic retinopathy(PDR).

METHODS: A total of 92 patients(92 eyes)with PDR treated by PPV were divided into the simple PPV group(41 patients with 41 affected eyes)and the combined treatment group(51 patients with 51 affected eyes)according to whether the patient underwent intravitreal injection of Ranibizumab(IVR). The combined treatment group was treated with IVR at 5-7d before PPV. The surgical time, times of electrocoagulation, silicone oil filling rate, the incidence of postoperative complications, LogMAR BCVA of affected eyes, levels of VEGF and pigment epithelium derived factor(PEDF)in aqueous humor and vitreous body were compared between the two groups.

RESULTS: The surgical time was shorter, the times of electrocoagulation was less, the silicone oil filling rate and the incidence rates of iatrogenic retinal hole and vitreous body hematocele were lower in the combined treatment group than in the simple PPV group(P<0.05). Levels of VEGF and PEDF in aqueous humor and vitreous body of the combined treatment group during PPV were lower than those in the simple PPV group(P<0.05). The LogMAR BCVA of the affected eyes of the combined treatment group in 3mo after surgery was better than that of the simple PPV group(P<0.05).

CONCLUSION: IVR combined with PPV can reduce the perioperative levels of VEGF and PEDF, reduce the times of electrocoagulation and the incidence of iatrogenic retinal hole and vitreous body hematocele, and improve the visual acuity of patients with PDR.

Abstract:AIM: To evaluate the effects and safety of intravitreal injection of triamcinolone acetonide(TA)or conbercept combined with macular laser grid photocoagulation in the treatment of macular edema secondary to retinal vein occlusion(RVO).

METHODS: Fifty cases(50 eyes)with macular edema secondary to retinal vein occlusion were selected and assigned to 2 groups: intravitreal injection of TA or conbercept, and laser photocoagulation after 7d. Best corrected visual acuity(BCVA), fundus examination, optical coherence tomography(OCT)and intraocular pressure(IOP)were examined before intravitreous injection and 14d, 1 and 3mo after laser, fundus fluorescein angiography(FFA)were examined 3mo after treatment. The postoperative results at each time point were compared with preoperative values.

RESULTS: Two kinds of treatment compared with preoperative, the BCVA all increased in various degrees. At 14d after intravitreous injection, 1 and 3mo after laser, the ratio of vision improved in TA group was 76%, 80%,68%, conbercept group was 88%, 92%, 88%, BCVA of two groups in each period all had varying degrees of increase than preoperative. The best BCVA acquired at 1mo after treatment. The macular thickness after treatment was significantly lower than preoperative in two groups. At preoperative, 14d, 1 and 3mo after treatment, the macular thickness in TA group was 557.5±150.9, 301.7±120.1, 262.7±131.2, 338.1±146.5μm; the macular thickness in conbercept group was 569.4±135.9, 282.3±133.5, 259.5±116.4, 307.8±122.6μm. The macular thickness of the two groups were significantly different between preoperative and postoperative.

CONCLUSION: The combination of intravitreous injection of TA or conbercept with macular laser grid photocoagulation can be an effective method in the treatment of macular edema secondary to RVO, conbercept treatment is more effective and security.

Abstract:AIM: To investigate the changes of first order kernel(FOK)and second order kernel(SOK)of multifocal electroretinogram(mf-ERG)in detecting the early retinal abnormalities in sub-clinical stage of diabetic retinopathy.

METHODS: Totally 32 patients(58 eyes)with type 2 diabetes mellitus(DM)without apparent diabetic retinopathy(DR)were detected by mf-ERG, from June 2014 to May 2015. Thirty cases(60 eyes)of normal control group had also been taken to compare the difference of the amplitude and latency between the two groups.

RESULTS: Compared with the control group: there was no statistical difference in the FOK b-wave latency of the diabetic group, and the FOK b-wave amplitude was significantly decreased(t=3.099, P=0.012). The SOK b-wave latency in diabetes group was statistically delayed(t=2.643, P=0.025), and the SOK b-wave amplitude statistically decreased(t=4.833, P<0.01). There was no statistically difference in the a-wave latency and amplitude of FOK and SOK. The b-wave amplitude of FOK and SOK was negatively correlated with the course of the disease. However, the b-wave amplitude was not statistically correlated with the duration of diabetes mellitus.

CONCLUSION: The function of the post-polar outer and inner retina detected by FOK and SOK had been damage even before retinopathy. The anomaly is mainly reflected by the decreasing amplitude of b-wave.

Abstract:AIM: To investigate the clinical effect of carbomer eye gel combined with polyethylene glycol eye drops on the treatment of dry eye.

METHODS: Totally 120 dry eye patients(240 eyes)were randomly divided into the observation group(n=60 cases)and the control group(n=60 cases). Two groups were given the polyethylene glycol eye drops. On the basis of this, the observation group were given the carbomer eye gel. The course of treatment was 1mo. The levels of IL-1β and TNF-α, eye symptom score \〖ocular surface disease index(OSDI), break-up time(BUT), Schirmer Ⅰ test(SⅠt), corneal fluorescein staining(FL)\〗, efficacy and adverse reactions in two groups were compared.

RESULTS: After treatment, the levels of IL-1β and TNF-α, OSDI and FL in two groups were significantly lower than those before treatment and BUT and SⅠT were significantly higher than those before treatment, showing statistically significant differences(P<0.05). Moreover, the levels of IL-1β and TNF-α, OSDI, BUT, SⅠT, FL in the observation group were improved better than those in the control group(P<0.05). The total effective rate of the control group was significantly lower than that of the observation group, indicating statistically significant difference(χ²=5.065, P=0.024). There were no ocular symptoms and drug intolerance in two groups.

CONCLUSION: Carbomer eye gel combined with polyethylene glycol eye drops has obvious curative effect on dry eye, which is better than that treated by polyethylene glycol eye drops, and this combination does not increase the adverse reactions.

Abstract:AIM: To analyze the electronic product use time, writing time, playing piano time and outdoor activity time and the distribution of myopia in 586 cases of school age children in our hospital.

METHODS: A retrospective analysis of 586 cases of children aged 6 to 12 years old in the outpatient department was established. Personalized files were used to record the uncorrected visual acuity, optometry, slit lamp, fundus mirror and strabismus. The cumulative use time of electronic products(including computer, mobile phone, iPad), writing time, whether to play the piano and outdoor activities time with the eye situation were recorded. Statistical analysis of the age group of myopia, the cumulative use of electronic age in different age groups, writing time, whether playing piano and outdoor activities and the distribution of myopia occurred.

RESULTS:(1)With the increasing of age, the distribution of uncorrected eyesight was in children mostly mild myopia, and the proportion of mild myopia was significantly higher than that of moderate and high myopia.(2)Electronic products use time distribution: the proportion of playing electronic products(including mobilephone, computers, iPad)accounted for 76.8%, of which 9 years old, 10 years old the cumulative use of electronic products with a long time was higher than other age groups.(3)Distribution of writing time: the proportion of write homework ≤1h was significantly lower than the proportion of writing homework> 1h(37.2% vs 62.8%), of which 9 and 10 years old children cumulative write time was higher than other age group.(4)Distribution of playing the piano: the proportion of playing piano time less than 1h was significantly higher than the proportion of playing piano time more than 1h(89.1% vs 10.9%).(5)Distribution of outdoor activities: the proportion of outdoor activities ≤1h in children at school age was significantly higher than that of outdoor activities > 1h(91.8% vs 8.9%).

CONCLUSION: With the age exposure to electronic products becoming younger, heavy learning tasks and less outdoor activities, myopia occurred in advance of age. So health examination and eye guidance, reducing the amount of work appropriately, increasing outdoor activities will slow the development of early childhood myopia.

Abstract:AIM:To investigate the effect of case-based learning(CBL)teaching combination with paper review method in the teaching of ophthalmology residents.

METHODS: The study was conducted from 2015 to 2016. The residents in Department of Ophthalmology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital were included in the research. During the year of 2015, the traditional lecture-based learning(LBL)method was applied(as a control group). During the year of 2016, the CBL teaching combination with paper review teaching method was applied(as an experimental group). At the end of the course, exams and questionnaires were conducted to evaluate the teaching effect of two different methods. The exams consisted of theoretical and operational assessment. The teaching satisfactions, learning interests, scientific research interests and clinical abilities were included in the questionnaires. The data was analyzed by SPSS 16.0.

RESULTS: The results of final exams indicated that the scores of the experimental group(88.2±6.5)were higher than the control group(75.6±6.0). The difference showed statistically significant(t=6.68, P<0.05). The results of questionnaires indicated that students showed much more satisfied with CBL teaching combination with paper review teaching method(91%)than traditional teaching method(50%, χ²=8.84, P<0.05). Students in the experimental group improved learning interest(χ²=6.29, P<0.05), increased research interest(χ²=4.54, P<0.05)and approved clinical ability(χ²=4.25, P<0.05). The comparison of two groups showed the statistically difference(P<0.05).

CONCLUSION: CBL teaching combination with paper review teaching method is beneficial to improve the teaching effect, and it is also beneficial to train residents' clinical skills and research abilities.

Abstract:AIM: To report the long-term clinical outcomes of accelerated trans-epithelial corneal cross-linking(CXL)protocols using KXL System(Avedro, USA)in the treatment of progressive keratoconus.

METHODS: Totally 52 patients(102 eyes)with progressive keratoconus between December 2014 and February 2017 \〖maximum keratometry values(Kmax)≤60.0D, minimum corneal thickness(Thk)≥400m\〗 were treated with an accelerate trans-epithelial CXL protocol(UV-A irradiation intensity 45mW/cm² with a total fluence of 7.2J/cm²)using KXL system(Avedro, USA)in Southwest Hospital. The average follow-up time was 11.65mo(range: 9-26mo). Uncorrected distance visual acuity(UDVA), corrected distance visual acuity(CDVA), intra-ocular pressure(IOP), slit-lamp microscope examination, Kmax and average keratometry values(AveK), corneal stromal demarcation line depth and endothelial cell density(ECD)were evaluated.

RESULTS: The 52 patients(102 eyes)were included in this research, male 36(70 eyes)and female 16(32 eyes), average age was 19.5±4.6 years. Preoperative CDVA was 0.84±0.89(LogMAR), postoperative CDVA was 0.69±0.72(P=0.398). Preoperative UDVA was 1.02±0.62(LogMAR), postoperative UDVA was 0.85±0.59(P=0.154). Preoperative IOP was 12.95±4.40mmHg, postoperative IOP was 11.92±3.66mmHg(P=0.272). No statistical difference(P=0.552)has been found between preoperative and postoperative ECD. Nevertheless, on the Sirius anterior system(Sirius, CSO, Itlay), significant statistical difference(P=0.017)was confirmed between preoperative Kmax(50.83±3.48D)and postoperative Kmax(52.05±3.63D). Meanwhile, the postoperative Avek(47.74±2.51D)was significantly lower(P=0.041)than the preoperative Avek(48.73±4.33D). The average corneal stromal demarcation line depth(192±23.6μm)was detected by the anterior segment OCT. No statistical difference(P=0.816)has been found between preoperative and postoperative Thk. No severe complication was observed in all cases.

CONCLUSION: Accelerated trans-epithelial CXL was effective in decreasing keratometry values for progressive keratoconus in this research, and the outcomes remained stable during the follow-up time. No endothelium damage or other severe complications were observed in this clinical research. The accelerated trans-epithelial CXL is as effective as the standard CXL.

Abstract:AIM: To explore the histopathologic changes of Reis-Bücklers corneal dystrophy(RBCD).

METHODS: Cornea buttons were obtained from patients in 1 pedigree who underwent lamella keratoplasty. Sections with HE and special staining which included symplectic blue staining and Masson staining and Congo red staining were observed under light microscope. Two normal cornea specimens(donated corneas from eye bank)were used as control.

RESULTS: In those patients, the bowman's membrane disappeared. The main lesion was in bowman's membrane through HE staining, positive through PAS Congo red staining and Masson staining, negative through symplectic blue staining.

CONCLUSION: The Reis - Bücklers corneal dystrophy is characterized as geographic map-like lesion of bowman's membrane, and the abnormal extracellular deposit is amyloid protein fiber.

Abstract:AIM: To explore the effects of mindfulness-based stress reduction(MBSR)on anxiety, compliance and visual function in primary open angle glaucoma(POAG)patients.

METHODS:Totally 64 patients, who were treated with topical medication and were diagnosed with POAG in the department of ophthalmology at Shaanxi Provincial People's Hospital, were randomly divided into the intervention group(n=32)and the control group(n=32). Both groups received conventional mental health education while the intervention group was complemented with MBSR intervention. The patient's anxiety status, compliance rates and MD before and after the intervention were evaluated.

RESULTS:After the MBSR intervention, the scores of HAMA of the intervention group were significantly lower than that of the control group(P<0.01). The compliance of patients in intervention group was higher than that of the control group(P<0.01).

CONCLUSION:The MBSR intervention can effectively relieve the anxiety of patients and improve the compliance in primary open angle glaucoma patients. It can be promoted and put into clinical application.

Abstract:AIM: To evaluate the ability of spectral domain optic coherence tomography(SD-OCT)parameters to detect progressive structural damage in primary open angle glaucoma(POAG)by contrasting with visual field.

METHODS: Retrospectively we evaluated 48 subjects(48 eyes)of POAG, followed up 14 to 62mo. The parameters of SD-OCT and visual field were obtained. The correlation between the change of visual field measurements and OCT measurements were analyzed. Visual field progression was defined as reproducible drop of at least 2dB of mean deviation(MD)from the baseline visit. ROC curve was made to evaluated the ability of OCT parameters in detect progression of POAG.

RESULTS: The 25 eyes were classified in progression group and 23 eyes were in non-progression group. No significant correlation was seen between OCT parameters and visual field in non-progression group. In progression group, OCT parameters which were significantly correlated with MD reduce were rim volume(r=-0.5997,P=0.0007), C/D vertical ratio(r=-0.6309, P=0.0003), RNFL(r=0.4201, P=0.0260), and GCC(r=0.7080,P<0.01). ROC curves showed the GCC reflected the reduce of MD accurately(P=0.013).

CONCLUSION: Part parameters of SD-OCT can reflect the progression of POAG accurately and provided a new method to detect the damage of visual function of POAG.

Abstract:AIM: To investigate the effect of intravitreal ranibizumab(IVR)in the treatment of exudative age-related macular degeneration(AMD)with serous retinal pigment epithelium detachment(SPED)in elderly patients.

METHODS: We Selected 60 elderly patients(60 eyes)with AMD and SPED in our hospital from February 2015 to February 2016, treated by intravitreal injection of ranibizumab. The best corrected visual acuity(BCVA), PED height and volume, central fovea thickness(CFT)and aqueous humor vascular endothelial growth factor(VEGF)were measured before and after treatment.

RESULTS: The BCVA of patients with after treatment for 1, 3 and 6mo were 0.6±0.1, 0.4±0.1 and 0.3 ±0.1, and were significantly higher than those before treatment(P<0.05). At 1, 3 and 6mo after treatment PED height and volume were significantly lower than before treatment(P<0.05), of which 6mo after the treatment PED height and volume were 240.02±35.10μm and 0.310±0.120mm³. At 6mo after treatment CFT was 290.02±33.10μm, significantly lower than before and 1mo after treatment(P<0.05). At 1, 3 and 6mo after treatment VEGF were lower than those before treatment(P<0.05), in which 6mo after the treatment aqueous humor VEGF was 149.11±28.89pg/mL. No endophthalmitis, uveitis and so on adverse reactions were observed during treatment.

CONCLUSION: IVR has a good effect in the treatment of exudative AMD in elderly patients with serous PED, which can effectively improve the visual acuity of patients, reduce the height and volume of PED and the concentration of VEGF in aqueous humor, and it is safe and reliable.

Abstract:AIM: To investigate the change of myopic choroidal neovascularization treated by ranibizumab and evaluate their value in monitoring the effect of anti- vascular endothelial growth factor(VEGF)therapy.

METHODS: The study enrolled 30 patients(30 eyes)diagnosed with myopic choroidal neovascularization. All affected eyes were treated with intravitreal ranibizumab 0.05mL(10mg/mL). Best corrected visual acuity(BCVA), non-contact tonometer, ophthalmoscope, fundus fluorescein angiograph(FFA)and OCTA were evaluated monthly until 6mo. The changes of BCVA and central macular thickness(CMT)were compared at 1, 3 and 6mo after treatment.

RESULTS: All patients received an average of 1.70±0.65 injections. BCVA was 0.96±0.17(LogMAR)before therapy, and BCVA 1, 3 and 6mo after treatment respectively improved by 0.23±0.09, 0.34±0.07, 0.38±0.11. The differences were significant(t=5.461, 8.191, 8.894; P<0.05). Mean CMT decreased form 281.07±13.72μm to 261.33±13.13μm, 243.47±16.65μm, 234.73±17.52μm respectively 1, 3 and 6mo after treatment, showing significant differences(t=12.007, 13.360, 9.531; P<0.05). OCTA revealed a progressively smaller vascular lesion and reduction in capillary density.

CONCLUSION: Intravitreal ranibizumab for CNV secondary to pathologic myopia is effective and safe; OCTA is a noninvasive and time-saving new technology, and it also is a promising tool for clinicians to make preliminary diagnosis and assess treatment efficacy in the follow-up visits.

Abstract:AIM:To observe the clinical effects of intravitreal injection of triamcinolone acetonide(TA)before vitrectomy for retinal detachment associated with choroidal detachment.

METHODS: Totally 23 cases(23 eyes)of retinal detachment associated with choroidal detachment in our hospital were treated by intravitreal injection of TA 4-5d before 23-Gauge micro-invasive vitrectomy combined with silicone oil injection. All the cases were followed up between 6 to 9mo. The anatomic retinal reattachment, visual acuity, intraocular pressure and postoperative complications were observed and analyzed.

RESULTS: After the surgery, the visual acuity of all patients were improved, with 9 eyes better than 0.3(39%), and 18 eyes better than 0.05(78%). The BCVA at 1wk, 1 and 3mo and last follow up were different compared with before operations(P<0.05). The mean intraocular pressure was 4.02±1.47mmHg before injection, 13.69±4.68mmHg before operation(P<0.05), and 17.72±5.87 mmHg after operation(P<0.05). The retina of all patients treated were reattached 2wk post-operatively. The retinal reattachment rate after the primary surgery and the secondary surgery was 87% and 100%, respectively. Post-operative complications included 7 eyes of transient high intraocular pressure, occurred during 12-14d after operations and returned to normal after less glucocorticoid eye drops and giving IOP lowering drugs. There were no intraocular hemorrhage, iatrogenic retinal breaks, infections, or lens injuries.

CONCLUSION: Intravitreal injection of TA before vitrectomy for retinal detachment associated with choroidal could improve the clinical effects, and decrease the difficulty of surgery while the injection itself is pretty safe.

Abstract:AIM: To explore the nursing cooperation highlights of eight osteopetrosis patients underwent optic nerve decompression via transsphenoidal microsurgical approach instead of routine pathway, and to improve the quality of nursing cooperation.

METHODS: We enrolled 8 cases(left eye in 3 cases, right eye in 5 cases)of osteopetrosis patients referred from the Eye Hospital of Wenzhou Medical University during February 2012 to November 2016. Patients received ophthalmic examinations including visual acuity and diagnostic imaging tests in pre-operation and post-operation. All eyes were performed surgical optic nerve decompression through endoscopic approach in assist of image guidance system. We retrospectively analyzed the clinical data and surgical cooperation procedure of these cases and summarized nursing cooperation experience.

RESULTS: The operations of 8 patients were completed successfully without massive hemorrhage. Mean visual acuity improved from pre-operation(2.5±2.1)to post-operation(3.4±1.9). Cerebrospinal fluid leakage occurred in 1 patient and was instantly repaired during the operation. We performed the nursing strategy as postural drainage, condition monitoring and conscious assessment intra-and post-operation.

CONCLUSION: It is the critical for this kind of surgery that both circulating nurse's high-skilled cooperation to the connection and operation of the navigation system, to treat with complication during the surgery, and scrub nurse's sufficient preparation of surgical instruments and consumables, proficient equipment delivery, meticulous management, use and maintenance of equipment.

Abstract:AIM: To investigate the effect of intense pulsed light on the meibomian gland dysfunction(MGD), and to observe whether the intense pulsed light can improve the symptoms and objective indexes of the patients with meibomian gland dysfunction.

METHODS: A retrospective noncomparative interventional case series was conducted. Totally 21 MGD patients(42 eyes)were selected from November 2016 to February 2017 in Renmin Hospital of Wuhan University, the results of the following tests is recorded: OSDI score, corneal fluorescein staining, tear break-up time, ocular surface analyzer, scanning confocal microscopy, all patients respectively were received intense pulsed light treatment 3 times at 3wk intervals, and followed up after 1mo. Paired sample t test was used to analyze the difference in outcome.

RESULTS: In the 21 cases(42 eyes), the OSDI score decreased, the mean value before treatment was 30.18±4.07, and the mean value after treatment was 24.87±4.32. The first tear film break-up time(first, BUT)increased, the mean value before treatment was 5.37±0.82s, the mean value after treatment was 7.12±0.74s. The mean value of meibomian gland secretion scores before the treatment was 1.57±0.52,the mean value after treatment was 1.22±0.52. The mean value of corneal fluorescence staining before treatment was 0.82±0.41, and the mean value after treatment was 0.51±0.53, the difference was statistically significant(t=11.2, 2.68, 3.31, 2.78, 2.61; P<0.05).

CONCLUSION: Intense pulsed light can effectively improve the subjective symptoms of patients with MGD and alleviate the obstruction of meibomian glands. It is an important method for MGD treatment.

Abstract:AIM: To assess the effect of two different suture methods on the degree of pain and corneal epithelium healing condition after pterygium excision combined with autologous conjunctival flap graft transplantation.

METHODS: Retrospective case-series study. According to the suture method, a total of 92 patients(92 eyes)with pterygium who received treatment in the First Affiliated Hospital of Huzhou University from June 2015 to June 2016 were divided into two group. There were 48 patients(48 eyes)in Group A were received intermittent suture, and 44 patients(44 eyes)in Group B were received continuous interlocking suture. The degree of pain after surgery were evaluated between the two groups at 2h, 1d and 1wk after surgery by visual analogue score(VAS). The healing status of corneal epithelium were observed between the two groups at 1d and 1wk after surgery by fluorescent staining.

RESULTS: There was no significant difference in the average pain value 2h after surgery between Group A and Group B(P>0.05). The average pain values 1d and 1wk after surgery in Group B was lower than that in Group A respectively(P<0.01). Mean scores of corneal epithelium healing condition at 1wk were significantly better in Group B than in Group A(0.54±0.32 vs 0.86±0.34, P<0.05), while not significantly different at 1d after the surgery(4.04±1.46 vs 4.30±1.42, P>0.05).

CONCLUSION: Compared to intermittent suture, continuous interlocking suture can release pain response after pterygium excision combined with autologous conjunctival flap graft transplantation and promote the healing status of corneal epithelium.

Abstract:AIM: To evaluate the efficacy and safety of orbital decompression in the treatment of Graves ophthalmopathy.

METHODS: Totally 55 patients 77 eyes with Graves eye disease were selected in our hospital from February 2011 to February 2016. All eyes underwent orbital decompression, the visual acuity, exophthalmos and complications of the patients were followed up for 6mo.

RESULTS:Postoperatively 6mo, the best corrected visual acuity were 0.23±0.09, which were better than that of preoperative 0.46±0.07(P<0.05). Postoperatively 6mo, the degree of exophthalmos of the patients were 16.20±1.99mm, which was significantly lower than that preoperative 20.13±1.87mm(P<0.05). Postoperative CAS score was ≤3 points in 56 eyes(73%), significantly increased compared with preoperative 15 eyes(19%), the difference was statistically significant(P<0.05). There were 50 eyes(65%)with color vision disorder before operation; after operation, 42 eyes(55%)had significant improvement in visual impairment, and there was no change in the eye in 8 eyes(10%). Postoperatively 6mo, the average decreased degree of exophthalmos were 3.87±1.03mm; 5 cases were found postoperative diplopia, new diplopia rate was 10%; followed up for 3mo, diplopia disappeared.

CONCLUSION:Orbital decompression is an effective method for the treatment of Graves ophthalmopathy, but attention should be paid to postoperative complications such as diplopia.

Abstract:AIM: To observe the treatment for ptosis patients with severe undercorrection after frontal muscle flap suspension surgery.

METHODS: Totally 46 patients(67 eyes)were randomly divided into 2 groups: 23 cases(33 eyes)in Group A were given conjoint fascial sheath(CFS)suspension surgery; 23 cases(34 eyes)in Group B Whitnall ligament suspension. Postoperative follow-up was 6mo. Corrected rate, recurrence rate and postoperative adverse reactions were compared and analyzed.

RESULTS:The corrected rates of the two groups were both satisfied without significant difference between the two groups(P>0.05). the Whitnall ligament suspension surgery had less recurrence than CFS suspension surgery, but the difference was not statistically significant(P>0.05). The rate of hypophasis after CFS suspension surgery was significantly less than that after Whitnall ligament suspension(P<0.05).

CONCLUSION: The two operations both have satisfied corrected rate and low recurrence rate, the Whitnall ligament suspension surgery is less damaging and more easy to operate, while CFS suspension surgery is repeatable and less rate of hypophasis.

Abstract:AIM: To analyze the postoperative infection of pathological myopia with pocket scleral reinforcement.

METHODS: The clinical data of 167 cases of pathological myopia treated with pocket scleral reinforcement in June to December 2014 were analyzed. The postoperative infection rate, the resistance of pathogenic bacteria were analyzed, and the related factors of infection were analyzed.

RESULTS: A total of 286 eyes were obtained in 167 patients. The infection rate was 6.3% in 10 patients(18 eyes). There were 30 pathogenic bacteria isolated from the 18 infected eyes, in which were 10 Staphylococcus aureus, 10 Staphylococcus epidermidis, 6 Klebsiella pneumoniae, 4 Pseudomonas aeruginosa infection. Gram positive bacteria showed higher resistance to penicillin, ampicillin and ciprofloxacin, and were sensitive to vancomycin. The resistance rates of gram negative bacteria to cefotaxime were higher, but to imipenem was low. The two groups of patients age, culture level, operation time, the number of operation, intraoperative nursing staff seniority, postoperative medication compliance rate was statistically significant(P<0.05), which related to the infection after pocket scleral reinforcement.

CONCLUSION: The infection caused by Staphylococcus aureus is the most common after pocket scleral reinforcement, and it is sensitive to vancomycin, and gram negative bacteria is sensitive to imipenem. Shortening the operation time, using the experienced nursing staff to cooperate, reducing the number of operation and improving the compliance of the patients can reduce the postoperative infection.

Abstract:AIM: To study the KIF21A gene mutation in a Han family with concomitant exotropia.

METHODS: The genomic DNA of five family members was extracted from peripheral blood leukocytes and amplified with PCR. The PCR products were purified for DNA sequencing. DNA sequences were aligned with the human KIF21A gene sequences registered in GenBank.

RESULTS:Mutation analysis of all exons of the pedigree's KIF21A gene reveals no gene mutation in any of the families.

CONCLUSION: Our study demonstrates that the KIF21A gene maybe is not virulence gene in this pedigree.

Abstract:AIM: To analyze the amblyopia morbidity status of young children in Shaanxi city of Xi'an Province, and to explore the related risk factors.

METHODS: Totally 10 268 children between 3-6 years old were screened in 8 kindergartens in our city from March 2012 to April 2016 via a simple non-repeated sampling method, and sight, eye position, eye movement examination were mainly implemented; 10g/L atropine mydriatic optometry was taken to detect eye fundus examination, and to eliminate organic lesion. There were 528 amblyopic children were set as the observation group, 500 healthy children who were treated in our hospital at the same time were set as the control group. Single factor analysis and multiple logistic regression analysis were carried out for children with amblyopia.

RESULTS: In a survey, the incidence rate of amblyopia among young children in Shaanxi Xi'an was 5.14%. Ametropic amblyopia accounted for the highest proportion(61.4%), and lesion extent was usually mild to moderate, ametropic amblyopia accounted for 24.1%, which was inferior to that was the strabismus accounted as 12.9%, rare were form deprivation amblyopia accounted for 1.7%. General data analysis showed that, there were significant differences between the two groups in maternal gestational age, gestational weeks and times of pregnancy, smoking history of parents, family genetic history of myopia(P<0.05). Multivariate logistic regression analysis showed that pregnancy when old, mother's smoking history, family genetic history of myopia and short gestational weeks were risk factors for amblyopia in young children(P<0.05).

CONCLUSION: There is a certain oneset risk of amblyopia in young children in Shaanxi Xi'an. Attention should be paid to educate eye care knowledge, organize regular visual screening, ensure early detection, early diagnosis, early treatment.

Abstract:AIM:To analyze the clinical significance of axial length, diopter and retinal nerve fiber layer thickness in hyperopia children with anisometropia amblyopia.

METHODS: From January 2015 to January 2017 in our hospital for treatment, 103 cases, all unilateral, were diagnosed as hyperopia anisometropia amblyopia. The eyes with amblyopia were as experimental group(103 eyes), another normal eye as control group(103 eyes). We took the detection with axial length, refraction, foveal thickness, corrected visual acuity, diopter and the average thickness of retinal nerve fiber layer.

RESULTS: Differences in axial length and diopter and corrected visual acuity were statistically significant between the two groups(P<0.05). The two groups had no significant difference in retinal nerve fiber layer thickness(P>0.05). There was statistical significance difference on the foveal thickness(P<0.05). There was a negative correction correlation between the visual acuity, axial length with foveal and peripapillary nerve fiber layer thickness, but no significant difference in correlation(P>0.05). The positive correlation between diopter with nerve fiber layer thickness of foveal and around the optic disc were no statistically significant difference(P>0.05).

CONCLUSION: Retinal thickness of the fovea in the eye with hyperopic anisometropia amblyopia were thicker than those in normal eyes; the nerve fiber layer of around the optic disc was not significantly different between the amblyopic eyes and contralateral eyes. The refraction and axial length had no significant correlation with optic nerve fiber layer and macular foveal thickness.

Abstract:AIM: To evaluate flight attendants' ocular surface after different refractive corrections.

METHODS: Forty-two flight attendants(84 eyes)were enrolled in the study. Those flight attendants, who were followed up from September 2014 to September 2016, all followed the doctor's orders. According to different refractive corrections, those flight attendants were divided into 4 groups: corneal refractive surgery group, soft contact lens group, rigid gas permeable contact lens(RGP)group and control group without any refractive corrections. OSDI scores, tear meniscus heights, BUTs, fluorescein staining scores and Schirmer's tests were taken and analyzed.

RESULTS: Compared with the control group, OSDI scores were worse, tear meniscus heights(TMH)were reduced, BUTs were shortened, fluorescein staining(FS)scores were worse, Schirmer's Tests(SⅠt)were shorter in soft contact lens group and corneal refractive surgery group(P<0.05). However, the above parameters did not change significantly in RGP group(P>0.05). There was no significant difference in lid margin abnormalities among the four groups(F=3.82, P=0.45).

CONCLUSION: RGP can improve flight attendants' ocular surface micro-environment.

Abstract:AIM: To analyze the characteristics of neurological ophthalmology manifestation of patients with neurosyphilis.

METHODS: Retrospective and nonrandomized case analysis were used. Totally 22 cases of 39 eyes were included. They were 17 males and 5 females, aged from 34 to 65 years old. The average age were 49.6 years old.

RESULTS: The optic nerve atrophy presented in 11 cases of 22 eyes. One eye of them accompanied by left eye oculomotor nerve palsy; 5 eyes in 3 cases expressed as optic neuritis acute phase; neuroretinitis appeared in 4 cases of 6 eyes; 1 case of 2 eyes expressed as chorioretinitis accompanied by optic disc edema; central retinal artery occlusion were found in 1 case of 1 eye. Argyll-Robertson pupil was as only manifestation in 2 cases of 3 eyes. In all cases, Argyll-Robertson pupil signs can be seen in 19 eyes. Treponema pallidum particle agglutination test(TPPA)were positive in all 22 cases. Syphilis rapid plasma reactin test(RPR)were positive in 19 of 21 cases. All patients underwent lumbar puncture and cerebrospinal fluid were detected for RPR, cerebrospinal fluid protein, white blood cell count. Cerebrospinal fluid RPR were positive in 13 cases. Cerebrospinal fluid protein were greater than 450mg/L in 18 cases. Cerebrospinal fluid white blood cell count were greater than 5/mm³ in 13 cases.

CONCLUSION: Neurosyphilis involving neuro-ophthalmology often occurs in middle-aged men and subacute onset. Both eyes can suffered from optic nerve disease simultaneously or sequencely. A few can be expressed as other cranial nerve palsy, which may lead to misdiagnosis. Considering medical history, clinical manifestations, ophthalmic examination, serum and cerebrospinal fluid laboratory tests can improve the diagnostic rate.