Abstract:AIM: To analyze the awareness of retinopathy of prematurity(ROP)among parents of ROP patients in Northern China.

METHODS:A questionnaire was given to 230 parents of ROP infants and collected in person between Jan. and Apr. 2013. Basic information on the ROP infants and the parents' awareness of ROP were collected from the parents.

RESULTS:In all, 221/230(96.1%)questionnaires were returned. Based on these completed responses, 128(57.9%)premature infants received screening during hospital stays, 208(94.1%)parents were informed about screening and received a recommendation for screening by pediatricians, and 13(5.9%)parents did not receive any recommendation for screening. Only 159(71.9%)parents were aware of ROP, while 62(28.1%)were not aware of the disease. Because stages 4 and 5 of ROP had a poor prognosis, we determined whether parents were informed by pediatricians closely associated with the severity of ROP(P<0.001). However, we found no association between the grade of hospital and whether the parents were informed(P=0.625).

CONCLUSION:Awareness of ROP among parents and pediatricians in Northern China still needs to be improved. Better and more timely communication and education of parents regarding ROP from pediatricians and ophthalmologists will help.

Abstract:AIM: To compare intraocular pressure(IOP)fluctuations measured at home and in the clinic over a 24-hour period.

METHODS: A prospective investigational study. A total of 120 Chinese participants were selected from five communities in the Chengdu area. Patients underwent a clinical interview and IOP was measured both at home and in the clinic. IOP were measured at 8 a.m., 10 a.m., 12 a.m., 2 p.m., 4 p.m., 6 p.m., 8 p.m., 10 p.m., 2 a.m., 6 a.m. using the same pneumatonometer. Measurements were taken in the sitting position.

RESULTS: The average 24-hour IOP measured in the clinic was slightly lower than that at home. The mean difference in 24-hour IOP measurements between home and clinic was 0.27 mmHg. The IOP fluctuation in the clinic was higher than at home(the mean difference was 0.01 mmHg). There was no statistically significant difference in the average 24-hour IOP measured at home vs in the clinic. The average IOP measured at 2 p.m. at home(16.04±5.95 mmHg)was significantly higher compared with the measurement in the clinic(15.43±5.16 mmHg)(P<0.05). The overall agreement between 24-hour IOP measurements made in the clinic and at home in diagnosis of primary open angle glaucoma was 85.0%(K coefficient: 0.68).

CONCLUSION: The 24-hour IOP measured in the clinic was similar to that measured at home, and the method of measuring IOP in the clinic is acceptable in diagnosing primary open angle glaucoma.

Abstract:Invigorating blood and dissolving stasis method is a kind of unique therapy of Traditional Chinese Medicine(TCM)treatment, which efficacy has become increasingly prominent in the treatment of ophthalmology. With the further studies of blood stasis and invigorating blood and dissolving stasis therapy, it is widely used in clinical ophthalmology, and get good effects beyond thought, especially when western medicine has no curative effects. It improved the cure rate of fundus oculi disease from the eyelids, conjunctiva, lacrimal sac, vitreous body to the choroid and retina, optic nerve and macula lutea, from surface to fundus, or pathological changes related to inflammation, degeneration, necrosis, atrophy, hyperplasia of fibrous tissue hyperplasia. This paper is aim to explain the definition of invigorating blood and dissolving stasis and make a review of basic research and clinical application about it in several diseases.

Abstract:AIM: To evaluate association between mutations in the visual system homeobox 1(VSX1)gene and keratoconus(KCN)complicated with granular corneal dystrophy(GCD), direct sequencing was performed in an Iranian family affected by KCN and GCD in four generations.

METHODS: An Iranian pedigree with keratoconus spanning four generations along with GCD was identified. Whole blood sample was used for genomic DNA extraction. The molecular analysis by using polymerase chain reaction(PCR)of the entire coding region and intron-exon boundaries of VSX1 gene was preformed to investigate the possible linkage between KCN and GCD. Subsequently, direct sequencing was used for PCR products and mutation analysis was conducted in the patients and controls.

RESULTS: Mutation analysis in VSX1 gene did not detect evidence for association between KCN and GCD diseases and VSX1 gene. Our data excluded VSX1 as the disease-causing gene for KCN/GCD in this specific pedigree.

CONCLUSION: Despite of no association between KCN patients with GCD and VSX1 gene variations, other probable genes involved in pathogenesis of the KCN and GCD diseases need to be investigated in the patients.

Abstract:AIM: To investigate how body temperature(BT)affects choroidal thickness(CT)according to measurements taken with enhanced depth imaging optical coherence tomography(EDI-OCT).

METHODS: In this prospective study, the CT of 41 healthy patients was measured hourly from 9:00 to 17:00 at the fovea(SF-CT), 500 μm nasal to the fovea(N-CT), and 500 μm temporal to the fovea(T-CT)using EDI-OCT. BT was also measured hourly from 9:00 to 17:00 using a non-contact infrared thermometer. Possible correlations between diurnal variations of CT and BT were evaluated.

RESULTS: SF-CT values significantly differed between measurements at 9:00 and 13:00(P=0.021), 9:00 and 14:00(P=0.012), 9:00 and 16:00(P=0.048), and 9:00 and 17:00(P=0.002). N-CT values also significantly differed between measurements at 9:00 and 13:00(P=0.004), though T-CT did not significantly vary during the 8h period(P >0.05 for all).

CONCLUSION: CT is not significantly associated with hourly changes in BT from 9:00 to 17:00.

Abstract:AIM: To determine the prevalence of retinal changes in pregnancy induced hypertension(PIH)patients and to correlate between retinal changes and the severity of disease.

METHODS: A cross-sectional observation study was conducted in 100 PIH patients over a period of 6mo(Dec 2014-May 2015). Fundus examination was done in all patients. Fundus changes in right or left or both eyes, was taken as positive. The PIH graded as mild pre-eclampsia(BP >140/90 to 160/90 mmHg), severe pre-eclampsia(BP>160/90 mmHg)and eclampsia(severe pre-eclampsia and convulsions).

RESULTS:Mean age was 23.05y(19-34y). Gestation period ranged from 28 to 41wk. Sixty-two were primi gravida and 38 were multigravida. 62%, 26%, 12% of patients had mild, severe pre-eclampsia, eclampsia respectively. Retinal changes were identified in 8 patients. Grade Ⅰ, Grade Ⅱ, Grade Ⅲ, Grade Ⅳ hypertensive retinopathy(HTR), serous retinal detachment(SRD)and central serous chorioretinopathy(CSCR)observed in 1%, 0%, 2%, 2%, 1% and 2% of patients respectively. There was a statistically significant positive association of retinal changes and severity of the PIH(P=0.0001).

CONCLUSION:Retinal changes were seen in 8% of patients with PIH and there is a positive correlation between retinal changes and severity of PIH.

Abstract:AIM: To investigate the inhibition of the recombinant human endostatin adenavirus(Ad-Es)on the experimental choroidal neovascularization(CNV)models by intravitreous injection.

METHODS: Experimental CNV models were induced by semiconductor laser in 30 male Brown Norway(BN)rats and randomly divided into 3 groups with 10 rats in each group. At 21d after photocoagulation, the single administration group were given intravitreous injection with Ad-Es 0.01mL; the repeated administration group were given intravitreous injection with Ad-Es 0.01mL and a repeated injection 7d later; the saline control group were given intravitreous injection with saline 0.01mL. At 7d after final administration, the leakage of fundus fluorescein angiography(FFA)was observed. Various CNV areas were measured by using laser confocal microscopy of choroidal flatmount method. Pathology and ultrastructure were observed with light microscopy, the expressions of CD105 were measured by immunohistochemistry.

RESULTS: The leakage of CNV of the administration group abviously decreased as compared with those in the saline group, the leakage of repeated administration group decreased compared with that of single administration group(P<0.05). Laser confocal microscope quantitative CNV analysis showed that CNV area of the administration group was significantly smaller than that of control group, the area of repeated administration group was smaller than that of single administration group(P<0.05). Under the light microscope, the vascular endothelial cell number and quantity of the administration group were significantly lower than that of the control group, the cell number of repeated administration group was lower than that of single administration group. CD105 expression of the administration group was significantly weaker than that in the saline group; the expression of repeated administration group was weaker than that of single administration group.

CONCLUSION: Ad-Es can effectively inhibit semiconductor laser induced CNV in BN rats, and the inhibition effect of repeated administration group is better than that of single administration group. It may be a useful new method in the treatment of CNV.

Abstract:AIM: To investigate the effects of apelin-13 on proliferation, migration and capillary-like tube formation of a monkey choroid / retinal endothelial cell line, RF/6A, to clarify whether apelin-13 could promote retinal angiogenesis in vitro.

METHODS: RF/6A cells in good conditions were administrated with DMSO(the control group), apelin-13 at 0.1μmol/L(low dose group)or apelin-13 at 1μmol/L(high dose group). Cell proliferation, migration and capillary-like tube formation were detected by using the MTT assay, scratch assay and matrigel assay, respectively, at 24h after plating the cells.

RESULTS: Cell proliferation was promoted in both low and high dose apelin-13 groups compared to the control cells(P<0.05); the cell migration distance of both apelin-13 groups was significantly greater than that of the control group(P<0.05); and the number of capillary-like tube structures of both apelin-13 groups was significantly larger than that of the control cells(P<0.05). In addition, cell proliferation, migration and tube formation increased as the concentration of apelin-13 increased.

CONCLUSION: Apelin-13 could obviously promote the angiogenesis capacity of RF/6A cells, suggesting that apelin-13 was an important pro-angiogenic factor in retinal endothelial cells.

Abstract:AIM: To analyze the effect of pigment epithelium derived factor(PEDF)on nitrogen monoxide(NO)and expression of cysteine-containing, aspartate-specific proteases-3(caspase-3)in retinal tissues of model rats with optic nerve crush injury.

METHODS: A total of 60 SD rats were randomly divided into the blank control group, model group and PEDF group, with 20 rats in each group. Except the blank control group, the optic nerve crush injury rat models were established in the other groups, and left eyeballs were taken as samples. After successfully modeling, the model group were treated with intravitreal injection of 5μL of balanced salt solution while PEDF group were treated with intravitreal injection of 5μL of PEDF(0.2μg/μL). Two weeks later, the retinal tissues were collected, and changes of shape were observed under microscope after HE staining. The changes of NO level were measured by colorimetry assay, the expression of caspase-3 mRNA and caspase-3 protein was detected by reverse transcription-polymerase chain reaction(RT-PCR)and Western-blot.

RESULTS: HE staining showed that retinal tissues of the blank control group arranged neatly and clearly. Retinal ganglion cells(RGCs)arranged in a monolayer, and cells were oval, uniform in size and distribution, the cell nuclei were clear, closely arranged, with clear boundaries. The retinal tissues of the model group were sparse in shape, RGCs showed vacuolar changes, the overall number of cells was reduced, and cell nuclei of residual RGCs showed pyknosis and uneven staining. RGCs in PEDF group were with slightly edema and arranged closely, and the degree of injury was significantly milder than that in the model group. Levels of Caspase-3 mRNA and protein and NO levels in the three groups showed the model group > PEDF group > blank control group(all P < 0.05).

CONCLUSION: The application of PEDF can down regulate the expression of Caspase-3 and NO in rates with optic nerve injury and reduce RGCs injury.

Abstract:AIM: To investigate the effect of intravitreal injection of anti-vascular endothelial growth factor(VEGF)drug Bevacizumab on connective tissue growth factor(CTGF)and pigment epithelium derived factor(PEDF)in proliferative membranes in patients with proliferative diabetic retinopathy(PDR).

METHODS: From January 2015 to December 2016, 117 patients(126 eyes)with PDR were analyzed using the case-control study. The selected cases were randomly divided into two groups, respectively, Group A of 60 cases(63 eyes)and Group B of 57 cases(63 eyes). The Group A was treated with vitrectomy alone, while the Group B received intravitreal injection of 0.05mL/1.25mg bevacizumab before vitrectomy. The peeled epiretinal membranes in patients were stained and then the histopathological changes were observed for primitive cells and angiogenesis, the expression of CTGF and PEDF were tested.

RESULTS: The expression of CTGF and PEDF in the proliferative membrane of the two groups were expressed in the cytoplasm. The Group A showed positive expression in 38 cases, the positive rate was 60.3%. Compared with Group A, the positive expression rate of CTGF in Group B(92.1%)was significantly higher(P<0.05). The positive expression rates of PEDF in the two groups were 90.5% and 95.2% respectively, and there was no significant difference between the two groups(P>0.05).

CONCLUSION: In patients with PDR after intravitreal injection of bevacizumab, the retinal neovascularization is significantly reduced, which is conducive to vitrectomy. The positive expression rate of CTGF significantly increased in patients with PDR after intravitreal injection of bevacizumab, but there was no significant change in the expression of PEDF in the anterior membrane.

Abstract:AIM: To research the correlation factor of the anterior segment values of eyes with different axial lengths.

METHODS: In this study, 697 cases 697 eyes were included. According to axial length we divided all the cases into short axial length group, normal axial length group, mild long axial length group, moderate long axial length group and severe long axial length group. The relevant indicators of the anterior segment values of patients in the five groups was comparatively analyzed.

RESULTS: In the short axial length group, the anterior chamber volume(ACV)showed a significantly negative correlation with age; anterior chamber depth(ACD)showed a significantly negative correlation with age. In the normal axial length group, the ACV showed a significantly negative correlation with age and a significantly positive correlation with axial length(AXL); the anterior chamber angle(ACA)showed a significantly negative correlation with age and a significantly positive correlation with AXL, and a significantly positive correlation with corneal curvature; the ACD showed a significantly negative correlation with age and a significantly positive correlation with AXL. In the mild long axial length group, the ACV showed a significantly negative correlation with age and a significantly positive correlation with AXL, and a significantly negative correlation with corneal curvature; the ACA showed a significantly negative correlation with age and a significantly positive correlation with AXL, and a significantly positive correlation with corneal curvature; the ACD showed a significantly negative correlation with age and a significantly positive correlation with AXL. In the moderate long axial length group, the ACV showed a significantly negative correlation with age; the ACA showed a significantly positive correlation with AXL; the ACD showed a significantly positive correlation with AXL. In the severe long axial length group, the ACV showed a significantly negative correlation with age. There were no significant differences on ACV, ACA and ACD among mild long axial length group, moderate long axial length group and severe long axial length group(P>0.05), while the difference between other groups was significant(P<0.05).

CONCLUSION: There has a correlation between the anterior chamber values(ACV, ACA, ACD)age and AXL for eyes which AXL were 22-27mm, while the correlation would disappear as the AXL became shorter or longer. There was a significant growth trend of anterior chamber values for eyes with AXL <27mm.

Abstract:Corneal endothelial cell(CEC)is the most critical part for the cornea, of which activity can influence the postoperative vision. It is very important for the clinical cornea preservation considering the function and its self-purification of donor cornea. There are a variety of classical methods, which can significantly prolong the saving time of donor cornea with its good quality of CEC. We reviewed the published papers about present preservation methods of cornea, which can give us many suggestions for the clinical cornea preservation.

Abstract:The precise measurement in lens thickness in vivo, provides great application value for intraocular accommodation and ametropia development mechanism research. And it has great clinical significance for the diagnosis and treatment of glaucoma and cataract. Currently, many ultrasonic methods and optical methods are used in measuring lens thickness. The measurement principles, advantages, disadvantages and the accuracy of the instruments are summarized in this paper. Among these methods, Orbscan II, Pentacam, Lenstar and AS-OCT can be used to measure lens thickness instead of A-scan. More important is the fact that UL-OCT can dynamically monitor the change of the lens thickness with intraocular accommodation. Choosing an instrument with higher measuring accuracy to examine the lens thickness, can provide more accurate and convincing lens thickness data for clinical and scientific research.

Abstract:Up to now, a variety of microRNAs have been found in a number of studies, that specifically expressed in retinal neuroepithelial, lens, cornea and retinal pigment epithelium, in which miR-126 plays a certain role in the proliferation of tumor cells, the development of thymus lymphocytes and cardiovascular diseases. Some researches show that miR-126 has certain correlations with the formation of corneal neovascularization, the development of diabetic retinopathy, and the immune system related eye disease. In this paper, the current miR-126 in the role of eye disease mechanism and research progress were reviewed.

Abstract:Posterior capsule opacification(PCO)is the most common complication after cataract surgery. How to prevent and treat PCO is an urgent problem we need to solve at present. Non-coding RNA(ncRNA)is a kind of RNA, which can not encode proteins. Studies have shown that non-coding RNA is closely related to the occurrence and development of human diseases. This paper has collected the progress of research on different kinds of ncRNA in PCO and may raise new ideas and methods on the prevention and treatment of PCO.

Abstract:Myopia is the highest incidence of eye disease in society, it threated people's eye health seriously. At present, many researchers measure the structural changes of retina which caused by the extension of eye axial due to the refractive error according to the optical coherence tomography(OCT). Besides, multifocal electroretinography(mf-ERG)was used to detect the function of retina in myopia. Global flash mf-ERG can evaluate the function of retina including both outer and inner retina. Some researchers focus on the correlation between structural and functional changes in myopia using OCT and mf-ERG. More researches are needed to clarify the structural and functional changes in myopia.

Abstract:Diabetic retinopathy(DR), one of the most common retinal vascular disease, is one of the causes of blindness for people over the age of 50. In the early stage of DR, microvascular cells are damaged, expand, start to leak, form micro hemangioma, then show occlusion, and non-perfusion area come into being, eventually form new blood vessels because of ischemia and hypoxia of retina. Illness develop into proliferative diabetic retinopathy(PDR). With the aggravation of the disease, PDR can cause the formation of fibrovascular membrane, the more serious fibrillation of epiretinal membrane, resulting in traction retinal detachment(tRD). Present studies suggest that aquaporins, the essential component of new blood vessels, including aquaporin 1 and aquaporin 4, play a significant pole in the development of diabetic retinopathy, causing the destruction of blood retinal barrier, inducing retinal edema, even macular edema, and participating in the formation of retinal angiogenesis.

Abstract:Vogt-Koyanagi-Harada(VKH)syndrome is an autoimmune disease attacking against pigmented cells, resulting in blindness and usually affecting multiple organs including ears, meninges, hair and skin. Correct diagnosis and immediate treatment in the early stage is vital to visual prognosis. Currently, corticosteroids is first-line drug. In addition, VKH patients refractory to corticosteroids can choose other treatment such as immunosuppressive agents and biological agents.

Abstract:The advantages of intense pulsed light therapy in the treatment of Meibomian gland dysfunction include non-invasive, painless and good results, which has been greatly developed in the ophthalmology field. This article reviews the current situation, mechanism of action, operating procedures, treatment outcomes, safety, and other aspects of intense pulsed light therapy in the treatment of Meibomian gland dysfunction.

Abstract:Orthokeratology is a kind of rigid contact lens which have reverse geometric desi, with higher oxygen permeability and security. Overnight wearing of orthokeratology can decrease the central corneal curvature and increase peripheral corneal curvature by flatting the central department of corneal, thus reduce the refraction of myopia. Through a period of time of wearing orthokeratology lens, patients can obtain good eyesight without frame glasses. Insisting on wearing orthokeratology lens can control the development of myopia. Orthokeratology is widely applied in the control of juvenile myopia, so we need scientific evaluation system to measure the visual quality after wearing orthokeratology lens. Here are the methods that used to evaluate the visual quality after wearing orthokeratology lens.

Abstract:AIM: To analyze the effect of myopic adolescents wearing orthokeratology lens on the corneal surface curvature radius and anterior chamber depth.

METHODS: Totally 120 cases of adolescent myopia were selected, among them 58 cases with 116 eyes were divided into 11-14 years old group and 62 cases with 124 eyes were 15-18 years old group according to the age. They were treated with long-term orthokeratology lens treatment, and two groups of patients were observed before wearing lens(T0), wearing for 6mo(T1), 12mo(T2)for uncorrected visual acuity, the average refractive degree improvement, the central corneal thickness, corneal curvature changes and the incidence of complications.

RESULTS: The uncorrected visual acuity of the two groups at 12mo after wearing were better than that at 6mo which was better than that before wearing; the diopter had the same trend. The uncorrected visual acuity and the diopter of the 11-14 years old group at 6 and 12mo was better than those of 15-18 years old group with significant difference(P<0.05). The central corneal thickness of the two groups at 12mo after wearing were less than that at 6mo which was less than that before wearing. There was no significant difference of the central corneal thickness between the two groups at 6 and 12mo after wearing(P>0.05). The corneal anterior surface curvature of the two groups at 12mo after wearing were more than that at 6mo which was more than that before wearing. The axial length of the 11-14 years old group was longer than that of the 15-18 years old group with significant difference(P<0.05). There was no significant difference on the corneal posterior surface curvature of the two groups before and after wearing(P>0.05). There was no significant difference on the anterior chamber depth between the two groups at different time or between before and after wearing(P>0.05).

CONCLUSION: Long-term wearing orthokeratology lenses have a significant effect for control ling juvenile myopia, and can improve the corneal anterior surface curvature, especially in the lower age group, and has no significant effect on the anterior chamber depth.

Abstract:AIM: To study the curative effect for patients with age related cataract and shallow anterior chamber after phacoemulsification.

METHODS: Totally 38 patients(38 eyes)with age related cataract and shallow anterior chamber were selected and divided into two groups according to the depth of the anterior chamber, as mild shallow anterior chamber group(2-2.5mm)23 eyes, high risk shallow anterior chamber group(<2.0mm)15 eyes. Thirty-eight patients(38 eyes)with age related cataract with normal anterior chamber were as control group at the same period. All the patients received the operations by the same doctor and were followed up for 3mo. The observed items included visual acuity before and after operations, intraocular pressure, anterior chamber depth, corneal endothelial cell density and complications.

RESULTS: There were no significant difference on visual acuity, intraocular pressure and corneal endothelial cell density between the two groups before operations(P>0.05). The visual acuity improved significantly after operation in both groups(P<0.05). Intraocular pressure after operation decreased significantly in both groups(P<0.05). Anterior chamber depth increased significantly after operation in both groups(P<0.05). Corneal endothelial cell density decreased significantly in both groups(P<0.05). There were no significant difference on anterior chamber depth, intraocular pressure and corneal endothelial cell density between the two groups at different time point after operations(P>0.05). Posterior capsular rupture occurred in shallow anterior chamber group in 1 eye, suspensory ligament rupture in 1 eye. Posterior capsular rupture and suspensory ligament rupture occurred none in normal anterior chamber group. Postoperative corneal edema occurred in 10 eyes(26%)in shallow anterior chamber group, which occurred in 3 eyes(8%)in normal anterior chamber group. The difference on the incidence was significant(P <0.05).

CONCLUSION: Phacoemulsification should be taken timely for patients with age related cataract and shallow anterior chamber. The postoperative visual acuity can be improved and the anterior chamber depth can increase. The operation is safe and effective for those patients.

Abstract:AIM:To analyze the accuracy and the influencing factors of LAMBDA100 retinometer in predicting the visual acuity of cataract patients with high axial myopia after phacoemulsification.

METHODS: The retinal visual acuity was measured in 91 patients with 91 cataract eyes by LAMBDA100, and compared with the best corrected visual acuity 2wk after operations. If differences of predictive visual acuity and postoperative visual acuity between the two logarithmic visual acuity chart was within 2 lines, it was considered consistent.

RESULTS: The total compliance rate was 62%, the false positive rate was 2%,the false negative rate was 36%. The predictive accuracy was affected by lens opacity, the deeper opacity, the lower accuracy. The predictive accuracy of eye with axial length ≥32mm was significantly lower than that of eye with axial length <32mm, the difference was statistically significant(P<0.05). The predictive accuracy rate of group that preoperative best corrected visual acuity was ≥4.0 was 75%; the predictive accuracy rate of group that preoperative best corrected visual acuity was <4.0 was 49%, the difference was statistically significant(P<0.05).

CONCLUSION: LAMBDA100 can be used as an assistant tool for predicting postoperative visual acuity in immature stage cataract of patients with high myopia. The eye axial length, the degree of visual acuity and lens opacity can influence the predicting accuracy.

Abstract:AIM: To observe the clinical efficiency of intravitreal conbercept on diabetic macular edema(DME).

METHODS: This was a single arm, open-babel prospective study. Twenty eyes from 20 patients(12 males and 8 females)with DME diagnosed by fundus fluorescein angiography(FFA)and optical coherence tomography(OCT)were enrolled. Before the injection, best-corrected visual acuity(BCVA)of early treatment of diabetic retinopathy study(ETDRS), non-contact tonometer, ophthalmoscope, fundus photography, fundus fluoresein angiograph(FFA), and OCT were examined. All affected eyes were treated with intravitreal conbercept 0.05mL(10mg/mL). Patients were followed up for 6 to 11mo, with a mean duration of 8.55±1.96mo. Post-treatment BCVA, CMT, leakage of macular edema and complications were compared with baseline using repeat analysis.

RESULTS: The initial average visual acuity(ETDRS letters)were 43.35±17.45, range from 9 to 70. The initial average central macular thickness(CMT)was 576.30±167.92μm, range from 337 to 987μm. The mean BCVA showed significant improvement during 1, 3, 6mo post-treatment and the latest follow up, with a mean increase of 11.2±5.9, 13.8±7.9, 15.7±6.8 and 14.7±8.6, respectively(P<0.01). The changes of BCVA between before and at 1mo after treatment were different compared with the changes between before and at 6mo(P<0.01). During the latest follow up, the mean BCVA was obviously improved in 10 eyes(50%), improved in 7 eyes(35%), stable in 3 eyes(15%). Likewise, the mean CMT significantly decreased during the follow-up period with a mean CMT reduction of 183.8±159.5, 292.9±169.0, 271.4±167.2 and 286.4±166.9μm respectively(P<0.001). The CMT at 1mo were different with that 3, 6mo and final follow-up(P<0.01). During the latest follow up, macula lutea leakage disappeared in 6 eyes(30%), decreased in 12 eyes(60%)and increased in 2 eyes(10%). No adverse events such as secondary retinal detachment or endophthalmitis were found during the follow-up.

CONCLUSION: Intravitreal conbercept significantly improve visual acuity and macular edema exudation.

Abstract:AIM: To investigate the clinical effect of conbercept intravitreal injection combined with macular grid laser photocoagulation on the treatment of diabetic macular edema(DME).

METHODS: Forty patients(40 eyes)with diabetic macular edema were randomly divided into experimental group(20 cases)and control group(20 cases). Both groups received macular grid laser photocoagulation, and the experimental group combined with intravitreal injection of conbercept on the same day. At 45d later the experimental group received intravitreal injection of conbercept again. The central macular thickness(CMT)and best corrected visual acuity(BCVA)of the two groups were compared before and at 45 and 90d after treatments.

RESULTS: At 45d after the treatment, the data of CMT between two groups was significant difference(experimental group: 293.90±12.94μm, control group: 320.20±29.17μm; P<0.05). At 90d after the treatment, the data of CMT between two groups was significant difference(experimental group: 265.80±16.26μm, control group: 290.15±12.23μm; P<0.05). At 45d after the treatment, the data of BCVA between two groups was significant difference(experimental group: 0.40±0.08, control group: 0.34± 0.04, P<0.05). At 90d after the treatment, the data of BCVA between two groups was significant difference(experimental group: 0.46±0.09; control group: 0.37±0.06; P<0.05).

CONCLUSION: Conbercept intravitreal injection combined with macular grid laser photocoagulation on the treatment of DME is much better on improving visual acuity and reducing macular edema than the grid laser photocoagulation treatment alone. For extension of the time of Conbercept intravitreal injection can be more scientific or not, still needs further research.

Abstract:AIM:To investigate efficacy of ranibizumab combined with laser treatment for patients with branch retinal vein occlusion(BRVO)and macular edema.

METHODS: We selected 67 patients(67 eyes)with BRVO and macular edema in our hospital from March 2013 to June 2016, they were randomly divided into observation group(n=31)and control group(n=36). The observation group was treated with ranibizumab combined with laser treatment. The control group was treated with macular grid photocoagulation. We observed best corrected visual acuity(BCVA), centre macular thickness(CMT)and macular leakage of two groups.

RESULTS: The BCVA of observation group at 1, 2 and 3mo after treatment were 0.41±0.07, 0.42±0.05 and 0.48±0.05, significantly higher than those of the control group(P<0.05). The CMT of observation group at 1, 2 and 3mo after treatment were 203.11±59.13μm, 201.41±56.22μm and 204.22±60.13μm, significantly lower than those of the control group(P<0.05). The blood vessel leakage of observation group at 3mo after treatment was significantly better than that of the control group(P<0.05). No leakage ratio in the observation group was 71%. There were no postoperative infection, aseptic endophthalmitis and other complications in the two groups.

CONCLUSION: Ranibizumab combined with laser treatment in patients with BRVO and macular edema has better curative effect, can improve the visual acuity of patients, eliminate macular edema, and is safe and reliable.

Abstract:AIM:To investigate the clinical effect of anti-vascular endothelial growth factor(VEGF)drugs combined with laser photocoagulation for diabetic macular edema(DME).

METHODS: Totally 94 patients(141 eyes)with DME from June to December 2015 in our hospital were selected and randomly divided into combined group of 47 cases(68 eyes, ranibizumab combined with laser therapy)and the control group of 47 cases(73 eyes, laser treatment). The levels of best corrected visual acuity(BCVA), macular central retinal thickness(CRT), total macular volume(TMV)and macular edema level were compared between the two groups at different time after treatment.

RESULTS: The mean values of BCVA in the combined group were higher than those in the control group at 2, 6 and 12wk, and the difference was statistically significant(P<0.05). At 2, 6 and 12wk after treatment, the CRT and TMV values of the combined group were lower than those of the control group, the difference was statistically significant(P<0.05). After treated for 12wk, patients with macular edema of combined group was 80.9% in mild level, 17.7% in moderate level, 1.5% in severe level, those of the control group was 60.0%, 31.5%, 5.5%, the difference between the two groups was statistically significant(P<0.05).

CONCLUSION: The effect of anti-VEGF drugs combined with laser therapy for DME patients is better than that of single laser therapy alone.

Abstract:AIM: To compare the efficacy of vitrectomy combined with internal limiting membrane peeling and C₃F₈ or sterile air tamponade for idiopathic macular hole(IMH).

METHODS: In this research, 51 cases of IMH with holes diameter ≤600μm were accepted from the same doctor of department of Ophthalmology in Luoyang Central Hospital from January 2011 to January 2016. All the patients were under taken vitrectomy combined with internal limiting membrane peeling and gas tamponade. All the study subjects were divided into two groups(Group A and Group B). The Group A were tamponaded with perfluoropropane(C₃F₈)(27 eyes), while the Group B were tamponaded with sterile air(24 eyes).The closure rate and morphology of macular hole, the time of prone position, the best corrected visual acuity(BCVA), the improvement of metamorphopsia and the process of cataract were compared and statically analyzed in these two groups. While the closure rate was compared among ≤200μm, >200-400μm and >400-600μm groups. Postoperative followup time was 1wk, 1, 3mo and half a year.

RESULTS: The difference of two groups was no statistically significant in all interval according to holes diameter(P>0.05). The difference of two groups was no statistically significant in morphology of macular hole form(P>0.05). The time of prone position in Group B was significantly shorter than that in Group A, and the difference was statistically significant(P<0.01). The BCVA of postoperative was improved than preoperative, and the difference was statistically significant(P<0.01). However, there was not statistically significant between the two groups in the BCVA of postoperative(P>0.05). The metamorphopsia of postoperative was improved than preoperative in two groups while there was not statistically significant between the two groups in the BCVA of postoperative(P>0.05). Cataract progress rate was reduced in the Group B than the Group A, but the difference was not statistically significant(P>0.05).

CONCLUSION: This study shows that sterile air tamponade can obtain same closure rate, morphology of macular hole and the improvement of metamorphopsia and visual function in holes diameter ≤600μm when reducing the time of prone position and the risk of systemic diseases induced by prone position after operation.

Abstract:AIM: To explore curative effect of different drugs in treatment of senile wet macular degeneration.

METHODS: We selected 98 patients 98 eyes with senile wet macular degeneration from July 2014 to January 2016 in our hospital as the research subjects. They were divided into control group and research group as the administration sequence, 49 patients in each group. Research group was treated with ranibizumab. The control group was treated with Conbercept. Both once per month and for 3mo.

RESULTS: Uncorrected visual acuity, central macular retinal thickness and area of choroidal neovascularization(CNV)leakage before treatment of the two groups were not statistically different(P>0.05). At 1, 3 and 6mo after treatment, the uncorrected visual acuity was improved significantly, the central macular retinal thickness decreased significantly, and the area of CNV leakage decreased significantly(P<0.05). The differences on uncorrected visual acuity at 1mo after treatment, central macular retinal thickness and area of CNV were statistically significant(P<0.05), while those indexes at 3 and 6mo after treatment was not significant(P>0.05). In the follow up period, there was no severe complications in the two groups, such as persistent high intraocular pressure, retinal detachment or tear, endophthalmitis, or other systemic complications. There were subconjunctival hemorrhage in 10 eyes in research group, 8 eyes in control group, all of which recovered within 15d after treatment. Transient elevated intraocular pressure occurred in 7 eyes in research group, in 9 eyes in control group. The complication rates of the two groups were not significant(P>0.05).

CONCLUSION: In the clinical treatment of senile patients with wet macular degeneration, treatment effect of Conbercept is not obvious at the early stage, but the effect is equivalent later and more economical.

Abstract:AIM:To investigate the clinical effect of pills of six ingredients with rehmannia combined with ginkgo biloba leaf table in the prevention and treatment of early retinopathy in patients with type 2 diabetes mellitus.

METHODS:A total of 82 patients(82 eyes)with type 2 diabetes mellitus who were treated with endoscopy from January 2013 to January 2015 were randomly divided into observation group and control group according to the random number table method. The control group was given conventional western medicine treatment, the observation group in the control group was given pills of six ingredients with rehmannia combined with ginkgo leaf table treatment besides the control group treatment. The diabetic retinopathy was assessed in both groups, as well as changes in blood glucose, blood pressure, and glycosylated hemoglobin. We recorded the occurrence of adverse reactions during and after treatment.

RESULTS: The new diagnosed rate and the progress rate of observation group were lower than those of the control group, remission rate was higher, and the difference was statistically significant(P<0.05). There was no significant difference of the two groups on blood glucose, blood pressure and glycosylated hemoglobin before and after treatment(P>0.05). The incidence of adverse reactions between the two groups was not statistically significant(P>0.05).

CONCLUSION: Type 2 diabetes mellitus patients treated with pills of six ingredients with rehmannia combined with ginkgo biloba leaf table can effectively control the rate of retinopathy, the rate of progress, improve the rate of remission with high drug safety, and have the significance of further clinical research.

Abstract:AIM: To investigate the clinical effect of small incision lenticule extraction(SMILE)for super high myopia.

METHODS: Totally 64 cases(128 eyes)patients with super high myopia, were randomly divided into observation group and control group, 32 cases(64 eyes)in each group. The two groups were separately treated with SMILE or femtosecond laser LASIK(FS-LASIK). We calculated the effectiveness index and safety index by contrastive observation of clinical effects in all patients included uncorrected visual acuity, best corrected visual acuity and postoperative spherical equivalent at preoperative and postoperative 1d, 1wk, 1, 3 and 6mo.

RESULTS: The safety index: the observation group and the control group at 6mo after operation were respectively 1.10±0.10 and 1.08±0.12, the difference between the two groups was not statistically significant(P>0.05). The validity index: the observation group and the control group at 6mo after operation were respectively 1.08±0.12 and 1.06±0.14 and there was no significant difference between the two groups(P>0.05). Postoperative spherical equivalent at 6mo in the observation group was 0.09±0.36D, that in the control group was 0.36±0.46D. After 6mo, the count of spherical equivalent refraction within ±0.50D were 58 eyes(90.1%)in observation group and 49 eyes(76.6%)in the control group, within±1.0D were 64 eyes(100%)and 60 eyes(93.8%).

CONCLUSION: SMILE is safe and effective in the treatment for super high myopia. The postoperative visual acuity and diopter can be stabilized earlier by comparing with FS-LASIK.

Abstract:AIM:To observe the efficacy and safety of 1g/L bromfenac sodium hydrate ophthalmic solution in the partial substitution of glucocorticoid after laser subepithelial keratomileusis(LASEK).

METHODS: Totally 104 cases(208 eyes)were received LASEK, which were selected and divided into study group and control group. The study group were adopted 1g/L bromfenac sodium hydrate ophthalmic solution combined with tobramycin dexamethasone eye drops and fluorometholone eye drops, the control group were adopted tobramycin dexamethasone eye drops and fluorometholone eye drops. The changes of visual acuity and intraocular pressure of two groups were recorded before and after surgery, and the score of painness and the occurrence of haze were observed after surgery.

RESULTS: At postoperative 1, 2, 3d, respectively, the pain score of the study group were 1.70±0.35, 1.25±0.34, 0.82±0.32, the pain score of the control group were 2.30±0.43, 1.68±0.44, 1.12±0.33, the differences were significant(P<0.05). Before and at 2wk, 1, 3mo after surgery, respectively, uncorrected visual acuity of study group were 0.035±0.02, 0.71±0.13, 0.89±0.17, 0.88±0.18, while which of control group were 0.037±0.015, 0.73±0.15, 0.87±0.14, 0.86±0.15(P>0.05), and the differences were not significant(P>0.05). At preoperative and postoperative 1, 2wk, 1 and 3mo of surgery, respectively, the intraocular pressure of study group were 17.33±1.58, 7.54±1.28, 7.23±1.58, 7.26±1.47, and 7.30±1.36 mmHg; the intraocular pressure of control group were 17.53±1.43,7.57±1.32,7.73±1.55,7.80±1.38,7.86±1.43 mmHg,the differences were not significant between before and at 2wk after surgery(P>0.05), the differences were significant between the two groups at 2wk, 1mo and 3mo(P<0.05). At postoperative 1, 3mo of surgery, the score of haze level of the study group were 91.7% and 93.3%, respectively and which in control group were 92.0% and 92.9%, respectively, and the differences were not significant between the two groups at every time point(P>0.05).

CONCLUSION: It is safe and effective that 1g/L bromfenac sodium hydrate ophthalmic solution in the partial substitution of glucocorticoid after laser subepithelial keratomileusis. The patient has a lower intraocular pressure, has similar therapeutic effect as glucocorticoid in vision and antiinflammatory.

Abstract:AIM:To investigate the cause of blindness, except those caused by cataract, in Haimen city.

METHODS:According to the WHO's criteria of blindness, the blindness level was decided through ophthalmic tests by associate chief or chief ophthalmologists who were trained especially for disability evaluation. The analysis of the the leading cause were taken too.

RESULTS:Totally 3 266 persons were blindness, in which 2 118 were first level blindness, 1 148 persons were second lever blindness, and 1 308 persons were male, 1 958 were female. The leading cause of blindness were retina and uveitis diseases(31.58%), genetic diseases(23.47%), cornea disease(14.49%).

CONCLUSION:The leading cause of blindness are retina and uveitis diseases, genetic diseases, cornea diseases in Haimen city of Jiangsu province. Early prevention and treatment should be strengthened to reduce the occurrence of blindness.

Abstract:AIM:To observe the efficacy of intravitreal conbercept injection for chronic central serous chorioretinopathy(CSC).

METHODS: Nine eyes of 9 patients diagnosed as chronic CSC between October 2015 to May 2016 were treated with an intravitreal injection of conbercept(0.5mg/0.05mL)(six patients were given the same does of intravitreal injection again at 1mo after the first injection). Follow-up observation was at 1, 2, and 6mo after injection. Observed indicators included best-corrected visual acuity(BCVA), intraocular pressure, optical coherence tomography(OCT), fundus fluorescein angiography(FFA), choroidal indocyanine green angiography(ICGA), macular fovea thickness(CMT), subfoveal choroidal thickness(SFCT).

RESULTS:Seven of the 9 patients responded significantly to the drug, while 2 patients had no response. The CMT was 373.12±72.43μm at baseline, which decreased significantly to 332.05±67.13μm, 282.24±62.30μm and 225.56±71.08μm at 1, 2 and 6mo after the intravitreal injection. The mean thickness of SFCT was 422.11±64.82μm before treatment. The choroidal thickness of non-responsive patients before treatment was below average, respectively 353μm and 365μm. The SFCT of 1, 2, and 6mo after treatment was 391.45±75.24μm, 365.53±63.07μm, 355.40±66.65μm. Before treatment and 1mo after, there was no significant difference(P=0.074), but there was statistically significant(P<0.01)between those of before and 2mo and 6mo after. The mean BCVA of the prior treatment was 0.53±0.32, the after treatment was 0.65±0.20, there was no different between the two(P>0.05).

CONCLUSION: Intravitreal conbercept injection in chronic CSC may have some effect in accelerating subertinal fluid resolution and decreasing the CMT. The SFCT within 6mo after treatment was significantly lower than pretreatment. The SFCT may be an indicator of whether patients respond.

Abstract:AIM: To observe the efficacy of surgical excision combined with autologous limbus conjunctival flap transplantation in the treatment of pterygium accompanied with conjunctival cyst.

METHODS: Totally 126 patients 188 eyes with pterygium were hospitalized in Department of Ophthalmology of Tongji Hospital of Huazhong University of Science and Technology during August 2013 and August 2015. The patients were divided into two groups: observation group(11 eyes of 11 patients)with pterygium accompanied with conjunctival cyst and control group(177 eyes of 115 patients)with primary pterygium. All patients underwent slit lamp microscope examination, anterior segment photography, and anterior segment optical coherence tomography(OCT). The size of pterygium was calculated by multiplying neck width and length of the covered corneal. All patients underwent excision combined with autologous conjunctival flap transplantation, and the resections were performed pathological section with hematoxylin and eosin staining. All patients were followed up postoperatively for 4-28mo.

RESULTS: All cases in the observation group were confirmed by postoperative pathological examination. All cyst walls were complete, and containing single layer of epithelial cells. The mean size of pterygium of the observation group was 6.9±1.7mm², and 6.3±1.8mm² for the control group. There was no significant difference between the two groups(P>0.05). The mean postoperative healing time of observation group was 2.1±0.9d, and 1.9±0.8d for the control group. There was no significant difference between the two groups(P>0.05). Recurrence was seen in two eyes within the follow-up period in the control group, and no recurrence in the observation group.

CONCLUSION: Surgical excision combined with autologous limbus conjunctival flap transplantation is a safe and effective treatment for pterygium accompanied with conjunctival cyst.

Abstract:AIM: To comparatively analyze the application of laser confocal microscopy and corneal smear in the diagnosis of fungal keratitis.

METHODS: Totally 77 patients(77 eyes)diagnosed as fungal keratitis were selected. Laser confocal microscopy and corneal smear examination were performed to observe the characteristics of the images, and the detection rate of fungus were compared between the two methods.

RESULTS: Of the 77 patients, 66 eyes(86%)were positive and 11 eyes were negative detected by laser confocal microscopy; 51 eyes(66%)were positive and 26 eyes were negative detected by corneal smear examination, the difference was statistically significant compared between two group(P<0.05).

CONCLUSION: Laser corneal confocal microscopy is relatively safe and sensitive. If combined the application of laser corneal confocal microscopy and corneal smear examination in clinical, the diagnosis rate of fungal keratitis may be improved.

Abstract:AIM: To investigate the potential causes and management of the clusters of diffuse lamellar keratitis(DLK)after laser corneal refractive surgery.

METHODS: The study enrolled 98 eyes(53 patients)complicated with DLK after receiving laser in situ keratomileusis(LASIK), FS-LASIK or small-incision lenticule extraction(SMILE)in our center from February 10^th,2016 to February 22^th,2016. They were given clinical classification treatments according to corneal layer inflammatory extent and then followed up after 1, 3, 5, 7, 10d and 1mo.

RESULTS: The clusters of DLK occurred 5 times in the study period. The incidence and degree of DLK significantly decreased after changed the sterilization, surgical equipments, temperature and humidity of the operating room. There were 80 eyes(82%)had stage 1 DLK, 11 eyes(11%)had stage 2, 4 eyes(4%)had stage 3 and 3 eyes(3%)had stage 4. The incidence of DLK after FS-LASIK was 40%(79 eyes in 42 patients), that after LASIK assistant by Hastome keratome was 45%(10 eyes in 5 patients), that after SMILE was 20%(9 eyes in 6 patients). After intensive treatment, as glucocorticoid treatment and flap lifting flushing, all cases recovered within 1mo.

CONCLUSION: The outbreak of DLK may be associated with the disposable item, flushing liquor, temperature and humidity of the operating room. Early diagnosis, prevention and treatment are the key of decreasing the incidence of DLK.

Abstract:AIM: To observe the interocular symmetry of primary angle-closure suspects'(PACS)parameters using IOL Master.

METHODS: A cross-sectional observational study. Totally 112 eyes from 56 subjects were enrolled to detect the difference of the bilateral axial length(AL), anterior chamber depth(ACD)and white to white distance(WTW), and to evaluate the correlation between the interocular differences of △AL, △ACD and △WTW and age, gender.

RESULTS: All the parameters were analyzed by paired-samples t test and there were no significant interocular difference(P>0.05). There was no relation of ΔAL,ΔACD and ΔWTW with age and gender.

CONCLUSION: Interocular symmetry of parameters by IOL Master was observed in PACS, and we found that the symmetry would not be altered when the age and gender had changed.

Abstract:AIM: To explore the effect of radial axial incision on corneal astigmatism after phacoemulsification.

METHODS: Totally 60 cases(62 eyes)of cataract patients were selected from our hospital, divided into Group A and Group B randomly. Two groups were both required to have a corneal incision, while Group A took it in the maximum corneal refractive radial axial and the Group B took it in the traditional temporal side(right eye)or nasal side(left eye). At the same time two groups received phacoemulsification and foldable intralocular lens(IOL)implantation. We measured their date before surgery, after surgery in 1d, 1wk and 1mo respectively with CT200 corneal topography measurement. The date was compared in two groups of corneal astigmatism, surgically induced astigmatism and visual acuity. According to the corneal astigmatism and axial, surgically induced astigmatism was calculated.

RESULTS: Group A and Group B were compared in age, gender, lens nucleus hardness, visual acuity, corneal astigmatism before the surgery, which has no statistically significant differences(P>0.05). Postoperative visual acuity of both groups was higher than preoperative(P<0.05), but the difference was not statistically significant in 1d, 1wk and 1mo after surgery in two groups(P>0.05). Corneal astigmatism was not statistically significant in two groups at 1d after surgery(P>0.05). The corneal astigmatism was significantly less in Group A than that in Group B in 1wk and 1mo after surgery, and the difference was statistically significant(P<0.05). After the surgery for 1wk and 1mo, the surgically induced astigmatism of Group B was significantly higher than that of the Group A, with the difference was statistically significant(P<0.05).

CONCLUSION: Making clear corneal incision along the maximum curvature of the cornea in cataract surgery can make the corneal astigmatism and the degree of astigmatism less after surgery.

Abstract:AIM:To explore the learning curve of the Indian standardized manual small-incision cataract surgery(SICS).

METHODS:Totally 253 cases(295 eyes)of senile cataract were divided into three groups(Group A: training group, Group B and C: strengthened groups)according to the operation time from December 2012 to December 2014. All cases were performed with manual SICS by the same trainee ophthalmologist. To research the learning curve of manual SICS and evaluate surgical effects, the best corrected visual acuity and complications were observed.

RESULTS: At 1wk postoperatively, the rate of relief from blindness in all three groups after operation were 100%, the rate of relief from visual handicap in group A, B, C were 93.7%,93.0% and 91.0% respectively. Complication rates were 2.1%, 7.0% and 3.0% respectively in three groups. Posterior capsular rupture accounted for 50% of all complications. No severe postoperative complications were found, such as nucleus or IOL falling into vitreous cavity, endophthalmitis, corneal endothelial function dysfunction and expulsive choroidal hemorrhage.

CONCLUSION: Manual SICS is safe and effective. Because of helping to shorten the learning curve and decrease the incidence of complications, the standardized manual SICS training is worth using for reference.

Abstract:AIM: To explore the effect of hypertonic sugar eyes drops with local to the oxygen therapy for severe corneal edema after cataract surgery.

METHODS: Totally 68 patients(68 eyes)with severe corneal edema after phacoemulsification were selected from January 2014 to December 2015 in our hospital, who were aged 53-80(64.45±4.24), including 30 males and 38 females. According to different treatment, they were divided into treatment group(34 cases)given conventional therapy + hypertonic sugar eyes drops with local to the oxygen therapy, the control group(34 cases)given conventional treatment + hypertonic sugar eyes drops. Visual acuity and corneal situation were observed during the treatment.

RESULTS: Corneal edema fade time of treatment group was 11.62+0.53d, that of control group was 15.23±0.62d, the difference between the two groups was significant(P<0.05). Preoperative best corrected visual acuity(BCVA)and corneal endothelial cell count had no significantly difference between the two groups while the corneal endothelial cell count were significantly different compared with postoperative of the two groups(P<0.05). At 7d after treatment, the BCVA and corneal endothelial cell count had significantly difference between the two groups(P<0.05), which did not have significant difference at 1mo after treatment(P>0.05). The effective rates of the two groups was significantly different(P<0.05).

CONCLUSION: Hypertonic sugar eyes drops with local to the oxygen therapy is effective for severe corneal edema after cataract surgery.

Abstract:AIM: To discuss the details about the phacoemulsification and intraocular lens implantation combined with goniosynechialysis for the treatment of primary acute angle-closure glaucoma(PAACG).

METHODS: Totally 21 patients(21 eyes)with PAACG from February 2013 to October 2015 were performed phacoemulsification and intraocular lens implantation combined with goniosynechialysis. The details such as incision, circular capsulorhexis, water separation, intraocular lens selection, goniosynechialysis were discussed. The vision, intraocular pressure, complications were observed.

RESULTS: Postoperative intraocular pressure of all patients with were controlled under 21mmHg followed up for 1mo. Visual acuity was improved to some extent. The patients were observed with rapid recovery and fewer complications. There was 1 eye with posterior capsule rupture intraoperatively and 1 eye with decompensated corneal edema postoperatively.

CONCLUSION: It makes this surgery more safe and perfect by disposing the details during operation.

Abstract:AIM: To analyze the effect of compound xuesaitong combined with conbercept on central macular retinal thickness(CMT), fluorescein fundus angiography and best corrected visual acuity(BCVA)in pathological patients with choroidal neovascularization(CNV).

METHODS:A total of 60 cases(60 eyes)with pathological myopia and CNV who were admitted to our hospital during January to October 2016 were enrolled in the study. They were divided into observation group and control group, 30 cases in each group. Observation group was treated with compound xuesaitong combined with conbercept. Control group was treated with conbercept only. Changes of CMT, intraocular pressure(IOP), area of CNV, BCVA and serum vascular endothelial growth factor(VEGF)before surgery, 4 and 12wk after surgery were compared. Complications during follow-up were statistically analyzed.

RESULTS: At 12wk after surgery, the total effective rate was 97% in observation group, 80% in control group and the difference was significant(P<0.01). The CMT, IOP, area of CNV and serum VEGF levels were significantly lower or smaller than those before surgery while BCVA was significantly higher than that before surgery(P<0.01). There were no local complications of systematic severe complications.

CONCLUSION: Compound xuesaitong combined with conbercept can effectively reduce CMT and IOP, reduce the area of CNV and significantly improve visual acuity. Its anti-VEGF effect is obvious, safe and feasible.

Abstract:AIM:By optical coherence tomography to observe macular thickness change characteristics and foveal images of patients with retinitis pigmentosa(RP).

METHODS: From September 2014 to September 2016, 74 patients(148 eyes)with retinitis pigmentosa diagnosed in our hospital were selected, and 50 healthy subjects(100 eyes)as normal controls; two groups received optical coherence tomography and fundus camera detection. The images of the macular were obtained to observe and measure the thickness of the macular fovea and at 4mm temporal side, the center of papillo macular bundle.

RESULTS:The results showed that: the thickness of the macular fovea and at 4mm temporal side of RP patients were the same as normal controls without statistically significant(P>0.05); the thickness of the center of papillo macular bundle was less than that of normal control with statistically significant(P<0.05). There were five types characteristics in OCT imges in RP patients: macular edema in 19 patients 38 eyes; retinal pigment epithelium and choroidal capillary thinning in 18 patients 36 eyes; retinal pigment epithelium atrophy in 12 patients 24 eyes; normal in 12 patients 24 eyes; different thickness of pigment epithelium layer in 13 patients 26 eyes.

CONCLUSION: Optical coherence tomography(OCT)can be used to detect the macular lesions in a timely manner, to help understanding the development of the disease, and provide the clinical basis for the early diagnosis and treatment of patients.

Abstract:AIM:To compare the clinical effect of 23G and 25G+ vitrectomy for treatment of proliferative diabetic retinopathy(PDR).

METHODS: A total of 128 PDR patients(195 eyes)requiring vitrectomy in our hospital from November 2013 to May 2016 were randomly divided into 25G+ group and 23G group, 64 cases(97 eyes)in 25G+ group and 64 cases(98 eyes)in 23G group. In 25G+ group, patients were treated by 25G+ vitrectomy. In 23G group, patients were treated by 23G vitrectomy. The visual acuity, as well as intraocular pressure(IOP), iatrogenic injury and complications in two groups were recorded before and 1d, 1wk, 1mo after treatment. The operation time was compared between two groups.

RESULTS: The operation time in 25G+ group was lower than that in 23G group(P<0.05). The postoperative visual acuity at 1mo of two groups were improved compared with before surgery(P<0.01). However, visual acuity between two groups in the same period had no significant difference(P>0.05). IOP in 25G+ group before surgery had no significant difference compared with those after surgery at 1d,1wk, and 1mo(P>0.05), which it was the same in 23G group. IOP of two groups in the same period had no significant difference(P>0.05). The incidence rate of iatrogenic injury in 25G+ group was 4.1%, which was significant lower than that of 23G group(13.3%)(P<0.05). The incidence rate of complication in 25G+ group was 3.1%, which was significant lower than that of 23G group(11.2%)(P<0.05).

CONCLUSION: Both 23G and 25G+ vitrectomy are safe and effective treatment for PDR. However, 25G+ vitrectomy is the better choice for PDR for the shorter operation time, lower incidence rate of iatrogenic injury and fewer surgical complications.

Abstract:AIM: To evaluate the therapeutic efficacy and safety of heavy silicone oil(HSO), Densiron 68, was used as internal tamponade to treat complex vitreoretinopathy.

METHODS: A retrospective study of 30 patients(30 eyes)who underwent vitrectomy and HSO tamponade for complex retinal detachment between January 2015 and January 2016. The best corrected visual acuity(BCVA), intraocular pressure(IOP), retinal reattachment and complications after surgery were observed.

RESULTS: There were statistical significances in both the BCVA difference between pre-operation and HSO tamponade, and the BCVA difference between pre-operation and the removal of HSO for 3mo(z=-2.198, P=0.028; z=-2.682, P=0.007). The average intraocular pressure of HSO tamponade group was 20.233±8.007mmHg, and the average intraocular pressure of pre-operation group was 16.067±4.025mmHg, showing significant difference(t=-2.913, P=0.005). Between the pre-operation group and the HSO removed group 14.933±3.423mmHg, there was no significant statistical difference in the analysis of IOP(t=2.635, P=0.430). Anatomical success was achieved in 90% of cases after the removal of HSO. Most common complications were cataract formation and oil emulsification.

CONCLUSION: Densiron-68 is a safe and effective tamponade material for the treatment of complex vitreoretinopathy. However, most common complications are cataract formation and oil emulsification. So clinicians should strictly handle indications and usage during the clinical applications.

Abstract:AIM: To analyze the results of phacovitrectomy with internal limiting membrane(ILM)peeling to treat foveoschisis in ultra-high myopia.

METHODS: Totally 32 eyes of 32 ultra-high myopia patients with foveoschisis were selected retrospectively. The preoperative refractive errors ranged from -12.00D to -20.00D with the mean of -15.78±2.16D. The best corrected visiual acuity(BCVA)were converted to LogMAR acuity, and the average BCVA was 4.1±0.4. Conventional phacovitrectomy with ILM peeling by ICG dying were performed. Gas tamponade were performed to end the operation. The BCVA and the foveoschisis cavity were observed by 1-9mo after the surgery, with the mean of 4.5mo.

RESULTS: The foveoschisis cavity of 30 eyes were healed with BCVA increased and visual distortion alleviated distinctly(94%)(t=-7.91, P<0.05).

CONCLUSION: Phacovitrectomy with ILM peeling is useful in treating foveoschisis in ultra-high myopia with visual function preserving.

Abstract:AIM:To investigate the efficacy of subthreshold micropulse 577nm laser photocoagulation with intravitreous anti-vascular endothelial growth factor(anti-VEGF)treatment for macular edema secondary to branch retinal vein occlusion(BRVO).

METHODS: A retrospective case series study was sixteen patients(16 eyes)of macular edema secondary to BRVO whose course was not more than 3mo were examined by fundus fluoresceine angiography(FFA)and optical coherence tomography(OCT). Eight eyes were given subthreshold micropulse 577nm laser with anti-VEGF treatment(micropulse laser group). Meantime another 8 eyes were given conventional grid laser photocoagulation with anti-VEGF treatment(grid laser group). The followed up was 6mo. The best corrected visual acuity(BCVA)and central foveal thickness(CFT)were analyzed.

RESULTS: The baseline BCVA of the micropulse laser group was 0.34±0.18(LogMAR)and was improved to 0.07±0.01(P<0.01)at last follow-up while the grid laser group was improved from 0.75±0.52(LogMAR)to 0.15±0.18(P<0.01). CFT of the micropulase laser group at baseline was 362.25±119.33μm and decreased to 232.25±56.56μm(P<0.01)at the last follow-up while the grid laser group was from 419.75±96.30μm decreased to 229.25±43.96μm(P<0.01). For both BCVA and CFT, there were no statistic differences between the two groups(P>0.05).

CONCLUSION: Subthreshold micropulse 577nm laser with anti-VEGF and conventional grid laser photocoagulation with anti-VEGF had equivalent effects on the treatment of macular edema secondary to BRVO.

Abstract:AIM: To investigate the effect of rigid contact lens in the treatment after pterygium excision and limbal stem cell transplantation in senile patients.

METHODS: Totally 90 elderly patients diagnosed as unilateral pterygium in our hospital from March 2015 to March 2016 were selected and divided into two groups, observation group and control group, 45 case with 45 eyes in each group. Observation group was treated with limbal stem cell transplantation and rigid contact lens. Control group was treated with limbal stem cell transplantation only. The following indicators were observed and compared: corneal healing time, visual analogue score(VAS)at 1, 3, 5 and 7d after surgery and the recurrence rate of pterygium.

RESULTS: The score on corneal irritation of observation group was significantly lower than that of control group(P<0.05). Control group took more time on corneal healing than observation group(P<0.05). VAS of control group were higher than that of the observation group at 1 and 2d after treatment with significant difference(P<0.05). The recurrence rates of pterygium were not statistically significant between the two groups(P>0.05).

CONCLUSION: Autologous corneal stem cell transplantation combined with rigid contact lens for pterygium in elderly patients is effective with shorter healing time and less pain, and it does not increase the recurrence rate.

Abstract:AIM: To evaluate the efficiency and complications of single lacrimal duct intubation versus annular lacrimal duct intubation with 5-fluorouracil and tobramycin/dexamethasone eye ointment injection in lacrimal duct obstruction treatment.

METHODS:A total of 74 patients(92 eyes)with lacrimal duct obstruction who received surgical treatment by Department of Ophthalmology in Qinhuangdao Haigang Hospital were consecutively recruited between August 2015 and September 2016. They were randomly allocated to Group A or Group B. After probing of lacrimal passage, Group A(46 eyes)were treated by using single lacrimal duct intubation. Group B(46 eyes)were treated by using annular lacrimal duct intubation combined with 5-fluorouracil and tobramycin/dexamethasone eye ointment injection. Between the two groups, Mann-Whitney Rank sum test was used to comparing the operative effect, and Chi-square test was used to comparing the occurrence of complications.

RESULTS:The cure rate was 61% in Group A and 89% in Group B; the improvement rate was 22% in Group A and 4% in Group B. Group B had better effect and less complications(2 cases)than Group A(8 cases),the differences between the two groups were significantly(P<0.05).

CONCLUSION: Compared with single lacrimal duct intubation, annular lacrimal duct intubation combined with 5-fluorouracil and tobramycin/dexamethasone eye ointment injection has better operative effect and less complication in lacrimal duct obstruction treatment.

Abstract:AIM: To investigate the effect of mydriasis optometry combined with amblyopia treatment on refraction and amblyopia changes in children with mixed astigmatism and amblyopia.

METHODS: Totally 163 children(289 eyes)of mixed astigmatism and amblyopia from January 2010 to May 2011 were treated. All of the patients received mydriatic optometry and spectaculars with amblyopia therapy and were followed up for 5a to observe amblyopia efficacy and refractive status changes.

RESULTS: With 5a, main diameter diopter at distant vision decreased year by year, average decline in the first year was 0.55DS, 0.56DS in the second year, 0.72DS in the third year, 0.95DS in the fourth year, 1.89DS in the fifth year. The spherical equivalent changed from 1.12DS at distant to 0.78DS at near. The corrected visual acuity of all the patients at first visit was 0.2-0.8 with varying degrees amblyopia. After a 5-year treatment, it was effective in 268 eyes(92.7%), in which 165 eyes(57.1%)improved, 103 eyes(35.6%)cured, the results was better as the period of spectaculars wearing was longer. There was 36 eyes(37.5%)improved and 60 eyes(62.5%)cured in 1.50-2.50DC group; 118 eyes(74.2%)improved, 41 eyes(25.8%)cured in 2.50-3.50DC group; 11 eyes(32.3%)improved, 2 eyes(5.9%)cured, 21 eyes(61.8%)useless in >3.50DC Group. The differences of efficacy among the groups were significant(all P<0.05).

CONCLUSION: Appropriate spectaculars is the basic for amblyopia treatment. It is effective for most children with mixed astigmatism and amblyopia to take mydriasis optometry and amblyopia treatment.