Abstract:AIM: To evaluate retinal parameters in a sample of healthy young Caucasian adults to define the normal or physiological range of inter-ocular asymmetry in this particular age and ethnic group.

METHODS: Study sample consisted of 37 Caucasian children and young adults aged between 12 and 23 years(spherical equivalent from -3.00D to +4.00D, anisometropia <0.5D and axial length differences <0.3mm). Normal inter-ocular asymmetry values were determined and 95% inter-ocular difference tolerance values were obtained.

RESULTS: Statistically significant inter-ocular differences were found in mean(P=0.003)and superior(P=0.008)retinal nerve fiber layer(RNFL)thickness, as well as in central macular thickness(P=0.039), with larger values in the left eye in all instances, and with tolerance limits of inter-ocular asymmetry of -9.00μm to 6.00μm, -28.00μm to 9μm and -39.00μm to 29.00μm, respectively. In addition, statistically significant differences were found between males and females in mean thickness of the RNFL in the right eye(P=0.020).

CONCLUSION: The exploration of the normal asymmetries of the retina may be an effective approach to further understand myopia onset and progression, which is particularly relevant in this age group. Differences in instrumentation and sample characteristics compromise direct comparison with published research and warrant the need for further studies.

Abstract:AIM: To use in vivo spectral-domain optical coherence tomography(SD-OCT)to investigate ocular surface epithelial thickness changes in patients treated with oral isotretinoin.

METHODS: A total of 64 eyes of 64 acne vulgaris patients were enrolled into two group: thirty-two patients received 0.5 mg/kg isotretinoin daily(Group A), and the other 32 patients received 0.8 mg/kg daily(Group B). The central corneal thickness(CCT), central corneal epithelium thickness(CCET), central corneal epithelium basal membrane thickness(CCEBMT), non-epithelial central corneal thickness(NECCT)and bulbar conjunctival epithelium thickness(BCET)were evaluated using SD-OCT at baseline, at the 45^th day, at the fourth month of treatment and at the first month after the end of treatment.

RESULTS: There were 44 females(68.75%)and 20 males(31.25%)with a mean age of 21.68±3.75y. In both groups, CCET, CCT and BCET were significantly thinner at the 45^th day, at the fourth month of the treatment and at the first month after the end of treatment as compared with baseline. CCEBMT decreased significantly at the 45^th day and at the fourth month of treatment, but there was no difference between the baseline and the last visit. There were no significant difference in NECCT during and after treatment as compared with the baseline.

CONCLUSION:Ocular surface epithelial thickness decreased in patients treated with oral isotretinoin, whereas NECCT was not affected. The decreasing corneal thickness in patients treated with isotretinon is mainly due to epithelial thinning. After a one-month cessation of isotretinoin treatment, CCEBMT returned to the baseline value, and ocular surface epithelial thickness increased.

Abstract:AIM: To investigate the comparison of total antioxidant capacity in the serum of patients with pterygium and control subjects.

METHODS: This case-control study was conducted on all persons referred to Ophthalmology Clinic of teaching Hospital of Vali-Asr(peace upon to him)with clinical symptoms of pterygium during the year 2016. The control group was selected among patients referred to the Ophthalmology Clinic of Vali-Asr(peace without pterygium)that the two groups were matched in terms of age, gender and place of residence. Sixty-six persons \〖31 people(47%)in patient group and 35 people(53%)in the control group\〗 were enrolled by convenience sampling. Venous blood sample was taken from all patients after the sampling using ferric reducing antioxidant power(FRAP); FRAP- as a quick 10min measurement, the antioxidant power measurement of samples according to the conversion of ferric iron(Fe³⁺)to ferrous iron(Fe²⁺)was checked. The collected data ware entered to software SPSS 21 and were analyzed by chi-square and Mann-Whitney tests at the level of α =0.05.

RESULTS: The mean of antioxidant capacity in patients was 842.55±161.46 μmol/L and antioxidant capacity in healthy controls was 856.77±209.41 μmol/L(P=0.8). In the comparison of mean serum antioxidant capacity in healthy individuals and in the serum of people with pterygium based on gender the results showed that the antioxidant capacity mean in male control subjects has been 894.05±176.82 μmol/L and in females control 780.01±118.33 μmol/L that the observed difference have been reported statistically significant(P=0.008)but the other comparison according the gender between cases and control does not show any significant difference.

CONCLUSION: The results of this study showed that the full level of serum antioxidant capacity in patients has been less than the mean of antioxidant capacity in control subjects, however the observed difference has not been significant. The results of this study were consistent with basic results carried out on the damaging effects of oxidative stress in the pterygium pathogenesis. Recommending diet with minerals and vitamins containing antioxidants may be preventing the onset and progression of pterygium.

Abstract:AIM: To compare the corneal curvature and to investigate the agreement between three different keratometers.

METHODS: In this prospective study, keratometry was performed using an IOL Master(IM), a Bausch & Lomb manual keratometer(Man)and TOPCON KR-8800 autokeratometer(Top)on 252 eyes of patients recruited from camps for cataract surgery. The average keratometry values were recorded and compared. The agreements between the instruments were analyzed using the Bland-Altman statistical method. The main outcome measure was average keratometry values.

RESULTS:1)IOL Master and Manual keratometer: the mean corneal power was 44.62±1.52 D with the IOL Master and 44.60±1.52 D with the Manual keratometer. The paired t-test demonstrated a statistically significant difference in the mean corneal power between the IOL Master and Manual keratometer(P=0.001). The 95% LOAs of the two devices were -0.22 to 0.22 as shown in the Bland-Altman plot; 2)IOL Master and autokeratometer: the mean corneal power was 44.62±1.52 D with the IOL Master and 44.46±1.53 D with the autokeratometer. The paired t-test demonstrated a statistically significant difference in the mean corneal power between the IOL Master and autokeratometer(P<0.0001). The 95% LOAs of the two devices were -0.24 to 0.55 as shown in the Bland-Altman plot; 3)Autokeratometer and Manual keratometer: the mean corneal power was 44.60±1.52 D with Manual keratometer and 44.46±1.53 D with the autokeratometer. The paired ttest demonstrated a statistically significant difference in the mean corneal power between the autokeratometer and Manual keratometer(P<0.0001). The 95% LOAs of the two devices were -0.30 to 0.57 as shown in the Bland-Altman plot.

CONCLUSION: Keratometry data obtained with different instruments may not be interchangeable, a fact that has important implications for cataract surgeons with respect to both surgical planning and outcomes auditing.

Abstract:AIM: To observe the sustained-release effect of compound betamethasone by subconjunctival injection on immunological rejection after ostrich-rabbit lamellar keratoplasty.

METHODS: Sixteen healthy New Zealand white rabbits with 6wk old received corneal lamellar keratoplasty, and the corneal graft was ostrich acellular corneal stroma. After surgery all subjects were divided into two groups, Group A(experimental group)were administrated with subconjunctival injection of compound betamethasone injection(once every 7d), and Group B(control group)were administrated with subconjunctival injection of dexamethasone sodium phosphate(once every 7d). At 1,2wk, 1, 2mo after the surgery, rabbit corneas were taken for paraffin sections, and were observed with H-E staining, in the meantime changes of CD4⁺ and CD8⁺ T lymphocytes were observed by immunofluorescence.

RESULTS: Two months after surgery, in Group A corneal grafts remained transparenct, and showed little neovascularization; HE staining and indirect immunofluorescence showed that only a few neutrophil infiltration, no CD4⁺ and CD8⁺T lymphocytes. In Group B, the inflammatory reaction was observable at different time points, the corneal graft was turbid; and the tissue sections and indirect immunofluorescence staining showed that neutrophil infiltration was predominant, and CD4⁺, CD8⁺T lymphocytes were also seen.

CONCLUSION: Compound betamethasone is able to inhibit the ostrich-rabbit corneal transplantation immune rejection, prolong the survival time of the grafts. The present study lay the foundation for further research and clinical application.

Abstract:AIM: To study the regulation mechanism of diet containing omega-3 polyunsaturated fatty acids(ω-3 PUFAs)on retinal neovascularization in an oxygen-induced retinopathy(OIR)mouse model.

METHODS: Sixty C57BL /6J mice, seven-day-old, were classified into 3 groups: A the normal control group, B the OIR model group, C the ω-3 PUFAs diet group. Each group has twenty mice and separated fed by their lactating mice. The normal control group was fed in a standard atmosphere environment, B, C groups were first fed in a hyper-oxygen atmosphere of(75±2)% oxygen percentage for 5d, then continue fed in a standard atmosphere. The ω-3 PUFAs diet group was fed with dose base on their weight by 7.5mg/kg/d. All mice were sacrificed when they were seventeen-day-old, the relative neovascularization areas(NA)were calculated by fluorescein angiography on flat-mounted retina. The number of endothelial cell nuclei breaking through the inner linmiting membrane(ILM)was counted on hematoxylin and eosin-stained retinal section. The ω-3PUFAs/ω-6PUFAs relative amount and ratio was measured by GC-MS in the retina. A real-time PCR and Western Blot method were used to detect the mRNA, peroxisome proliferator-avtivated receptor–γ(RPAR-γ), vascular endothelial growth factor-A(VEGF-A)and vascular endothelial growth factor receptor 2(VEGFR-2)in the retina.

RESULTS: There was a significant different in all groups on the relative neovascularization areas and the number of endothelial cell nuclei breaking through the ILM(F_NA=20.45, P<0.05; F_ILM=48.66, P<0.05). NA between Group A and B had a significant difference(t=8.64, P<0.05), the same between Group C and B(t=8.91, P<0.05). The cell nuclei breaking through ILM in Group A and B was significantly different(t=38.51, P<0.05), the same in Group C and B(t=19.86, P<0.05). For the relative contain in retina of ω-3PUFAs and ω-6PUFAs, there was a significant different among all groups(F=129.86, F=112.44; all P<0.05). That of Group C was significant different than other two groups(t=23.15, 25.42; t=16.43, 11.95; P<0.05). There were significant different among all groups on ω-3PUFAs/ω-6PUFAs ratio, retinal RPAR-γmRNA expression, retinal VEGF-A mRNA expression and VEGFR-2 mRNA expression(F_ω-3/6=10.30, F_RPAR-γ=138.24, F_VEGF-A=69.12, F_VEGFR-2=52.45; P<0.05). The ω-3PUFAs/ω-6PUFAs ratio of Group C was higher than that of Group B(P<0.05). Compared to Group B, on one hand Group C had a higher expression(P<0.05), on other hand Group C had a lower expression on VEGF-A mRNA and VEGFR-2 mRNA(P<0.05).

CONCLUSION:The diet rich with ω-3 PUFAs uplifts the ω-3PUFAs/ω-6PUFAs ratio and activates RPAR-γ to lower expression of VEGF-A and VEGFR-2 to inhabit oxygen induced retinal neovascularization.

Abstract:AIM: To investigate effects of resveratrol on mitochondrial DNA copy in retinal vascular endothelial cells cultured under high glucose conditions and its mechanism.

METHODS: Human retinal vascular endothelial cells were cultured in low glucose or high glucose medium, the genomic DNA was extracted and copy number of mitochondrial DNA was detected by real-time PCR. Effects of resveratrol on the mitochondrial DNA copy in retinal vascular endothelial cells cultured under high glucose medium were studied. The expression of mitochondrial transcription factor A(TFAM)and acetylated proliferator-activated receptor coactivator-1 alpha(PGC-1α)were analyzed by Western blot and coimmunoprecipitation.

RESULTS: High glucose inhibited the copy number of mitochondrial DNA in retinal vascular endothelial cells. However, resveratrol decreased the level of acetylated PGC-1α in retinal vascular endothelial cells, increased the expression of TFAM and the copy number of mitochondrial DNA.

CONCLUSION: Resveratrol may improve mitochondrial function of retinal vascular endothelial cells exposed to a high glucose environment via activation of the PCG-1α-TFAM signaling pathway.

Abstract:AIM: To observe the mechanism of Tianma Gouteng Decoction on the protein molecular level in the optic nerve crush model rats.

METHODS: Totally 36 participants 36 male Wistar rats were divided randomly into six groups(6 in every group): normal control group, negative control group, Tianma Gouteng Decoction treatment groups(con-centrations were 0.6g/mL, 1.2g/mL, 2.4g/mL respictively)and ginkgo biloba tablets positive control group(concentrations was 1.2mg/mL). Nothing was done in the normal control group. The optic nerve of right eye in the other groups was done with the optic nerve crush model. Normal control group and negative control group was treated only with water. The average grey scale values of the N-methyl-D-aspartic acid receptor 2B(NMDA2B)receptor protein, beta - amyloid protein(Aβ)in the average grey scale values were detected.

RESULTS: The average grey scale value of Tianma Gouteng Decoction in low, medium and high dose groups about NMDA2B receptor protein was significantly less than that of the negative control group(all P<0.001), and there was no significant difference with the positive control group(P=0.092, 0.411, 0.676), the difference between normal control group and negative control group was significant(P<0.001). The high dose group of beta-amyloid's average grey scale value reduced significantly than the negative control group(P=0.030, 0.001). The low dose group than the negative control group was not obviously(P=0.614). The high dose group was not significantly different from the positive control group(P=0.927), the difference between normal control group and negative control group was significant(P<0.001).

CONCLUSION: Tianma Gouteng Decoction can go through the decrease of the NMDA2B receptor protein expression and the control of beta-amyloid deposition to reduce the retinal ganglion cell injury and apoptosis.

Abstract:AIM: To study the oxidative damage and mechanism of p75 NTR receptor in retinal pigment epithelial cells(RPE).

METHODS: The NTR p75 receptor was used to transfer the retinal pigment epithelium cells as the experimental group, and the non transfected retinal pigment epithelium cells were used as control group. The BrdU test detected the proliferation of two groups of cells. The rate of apoptosis in two sets of apoptosis was measured by PI/in the V-FITC double dye method. The laser microscope detects the ROS levels within the cell. The flow cytometer detected the levels of ROS, mitochondrial markers, cytochrome C expression in RPE cells. The Western blot method detected the expression level of Fas, Caspase-3, and VEGF165 in RPE cells.

RESULTS: The RPE cell proliferation activity was gradually decreasing(P<0.05)with the extension of the p75 NTR receptor transfer time in experimental group. The RPE cell proliferation activity in each transfection point was significantly lower in experimental group than in the control group(P<0.05). The percentage of RPE apoptosis was gradually increased with the extension of transfection time in experimental group(P<0.01). The percentage of RPE cell apoptosis in the experimental group was significantly higher than the control group(P<0.01). ROS fluorescence was significantly better in the experimental group than the control group. Flow cytometry instrument method, according to the results of the experimental group PRE ROS levels in the cell, cytochrome C was significantly higher than control group(P<0.01), RPE cell mitochondria marker levels significantly lower than the control group(P<0.01). The results of the Western blot method showed that the expression levels of VEGF165, Fas and Caspase-3 were significantly higher in the experimental group than in the control group(P<0.01).

CONCLUSION: The over expression of p75 NTR receptor could lead to damage of mitochondria in retinal pigment epithelium cells, but it could also promote the apoptosis reaction, eventually it led to the formation of choroidal neovascularization, so it could be speculated that p75 NTR receptor is the damage factors of retinal pigment epithelium.

Abstract:AIM: To compare the early results of different kinds of transepithelial corneal collagen cross-linking(TE-CXL)in the treatment of progressive keratoconus.

METHODS: Retrospective study. Twenty four patients(34 eyes)who were diagnosed with progressive keratoconus were divided into three groups. And 10 eyes in hypotonic CXL group received the treatment of hypotonic corneal collagen cross-linking; 14 eyes in I-CXL 5min group received the treatment of iontophoresis corneal collagen cross-linking for 5min, and 10 eyes from the I-CXL 10min group received the treatment of iontophoresis corneal collagen cross-linking for 10min. Uncorrected distance visual acuity, corrected distance visual acuity, Pentacam, in vivo scanning laser confocal microscopy and anterior segment optical coherence tomography were examined before and after 1wk, 1, 3 and 6mo postoperatively.

RESULTS: Six months postoperatively, corrected distance visual acuity(CDVA)(LogMAR)in I-CXL 10min group increased by -0.21±0.23(t=2.735, P=0.026); Kmax decreased by 2.32±5.21D(t=1.40,P=0.193), but the differences were not statistically significant. Uncorrected distance visual acuity(UDVA), CDVA and Kmax in hypotonic CXL group and I-CXL 5min group were stable, the differences were not statistically significant. The depth of demarcation line was 152.7±42.9μm in hypotonic CXL group, 213.6±42.3μm in I-CXL 5min group and 237.0±46.4μm in I-CXL 10min group 1wk after the surgery, the differences among groups were statistically significant(F=7.111, P=0.006).The phenomenon of stroma cell apotosis-activate-regeneration in I-CXL 10min group was the most significant after the surgery. The changes of corneal thinnest thickness and endothelial cell density in three groups were stable.

CONCLUSION: Three kinds of transepithelial CXL can halt the progression of keratoconus, among which the reaction of corneal tissue in iontophoresis CXL for 10min is the most obvious.

Abstract:AIM: To investigate the clinical significance of aberrations difference using OPD-Scan aberrations tester after phacoemulsification.

METHODS: Totally 1000 cataract patients(1 425 eyes)with nuclear grade II with phacoemulsification and IOL implantation in our hospital from January 2013 to December 2016 were selected, with 996 cases(1421 eyes)met the inclusion criteria and received corneal wavefront aberrations examination by the same technicians at preoperative 1d and postoperative 3mo to get the 6 order 27 items Zernik coefficients, RMS1～6, RMSg and RMSh, contrast on Zernik coefficient, RMS1～6 and RMSg and RMSh. Intraocular lens type and RMS's Logistic regression analysis were conducted, the IOL on postoperative RMS was analyzed.

RESULTS: The statistics showed that among 1-27 items of Zernik coefficient, only Z4, Z9, Z12 and Z24 before and after surgery showed significant difference(P<0.05), and each postoperative Zernik coefficient dropped sharply than that before surgery, there was difference before and after surgery(P<0.05). After operation, RMS1, RMS2, RMS3, RMS4, RMS5, RMS6, RMSg and RMSh decreased markedly than those before operation(P<0.05). There was no significant difference on RMS between different types of IOL before operation(P>0.05). RMS3, RMS4, RMS5, RMSg and RMSh of the aspheric surface were significantly lower than those of the spherical IOL group(P<0.05). There was no significant difference on visual acuity(LogMAR)between the two groups before operations(P>0.05). At 3mo after the operation, visual acuity were significantly better than those before surgery, and the LogMAR visual acuity was better in the aspheric IOL group(P<0.01). By Pearson analysis, the overall higher order aberrations and Z420 were negatively correlated with the best corrected visual acuity after surgery(r=-0.354, -0.269; P<0.05), while Z400 had a positive correlation with postoperative best corrected visual acuity(r=0.279, P<0.05).

CONCLUSION: RMS1～6, RMSg and RMSh aberrations reduce markedly than those before operation after phacoemulsification and IOL implantation. There is a certain relevance between the higher order aberrations and postoperative visual acuity. High-order aberrations are related to the choice of intraocular lens type, aberration measurement shall be taken to assure a reasonable and scientific selection of intraocular lens type.

Abstract:AIM: To observe whether differences exist in the retinal arteriovenous circulation time of the patients with diabetic retinopathy and exploring whether there is any correlation between the injured degree of retinal vessel and the microcirculation time.

METHODS: The study was conducted from the March 2016 to the March 2017 in order to analyze the clinical data on 60 eyes of 60 patients who were diagnosed with diabetic retinopathy by Xuanwu Hospital of Capital Medical University.According to the result, patients were divided into mild and moderate nonproliferative diabetic retinopathy(NPDR)group, severe NPDR group and proliferative diabetic retinopathy(PDR)group with 20 eyes respectively. Then we recorded the retinal arterial developing time of the three groups, namely arm-to-retinal circulation time(A1),retinal arterial branch filling time(A2), retinal venous branch laminar flow time(V1), retinal venous branch filling time(V2).

RESULTS: The findings showed that there was no statistical difference among 3 groups in the retinal arterial passage time(A2-A1)(F=1.642, P=0.157). Retinal capillary passage time(V1-A2), retinal vein passage time(V2-V1), retinal artery and vein passage time(V2-A1)were compared between the three groups, the difference was statistically significant(F=5.794, 5.180, 5.564, P=0.007, 0.009, 0.008). The PDR group was significantly longer than the mild moderate and severe NPDR group, and the severe NPDR group was significantly longer than the mild and moderate NPDR group.

CONCLUSION: The duration of DR is longer, the degree is more severely. The destruction of retinal capillaries is more serious, the time of retinal microcirculation is longer.

Abstract:AIM: To comparatively analyze curative effects of intravitreal injection of Ranibizumab and Conbercept in the treatment of diabetic macular edema.

METHODS: Retrospectively analyzed the clinical data of 110 patients(110 eyes)with diabetic macular edema treated in our hospital from January 2015 to January 2016, divided them into two groups according to the different treatment. Of these, treated 55 eyes with ranibizumab intravitreal injections(ranibizumab group)and the other with conbercept intravitreal injections(conbercept group), the injection came once a month for 8 continuous months with a 6-month follow-up. Compared the changes of visual acuity, macular thickness, postoperative comfort, clinical efficacy and complications between the two groups after treatment.

RESULTS: There was no significant difference in LogMAR visual acuity between the two groups before treatment(P>0.05). The visual acuity of the patients in the ranibizumab group and conbercept group were significantly improved after 1mo treatment, F were 42.06 and 64.02 respectively(P<0.01), but there was no significant difference between the two groups after 1mo treatment(P>0.05). The visual acuity of the conbercept group was significantly higher than that of the ranibizumab group after 3 and 6mo treatment(P<0.05). There was no significant difference in macular thickness between the two groups before treatment(P>0.05), the thickness of the macular fovea in the ranibizumab group and conbercept group was lower than that before treatment, there were statistically significant differences(P<0.01); the decline range of conbercept group were more than those of the ranibizumab group after 3 and 6mo(P<0.05). Patients comfort of the two groups improved with the passage of time after surgery, and there was no significant difference between the two groups(P>0.05), there were no significant differences in the total effective rate and complication of the ranibizumab group(87.3%, 1.8%)and the conbercept group(85.5%, 3.6%)(P>0.05).

CONCLUSION: In the treatment of diabetic macular edema, the early vision of patients with diabetic macular edema increases significantly, and the macular thickness decreases significantly. Conbercept works better and has a longer lasting effect after 3 and 6mo treatment, and conbercept is more economical.

Abstract:AIM: To systemically evaluate the clinical efficacy and safety of domestic deproteinized calf blood extract eye gel for corneal epithelial repair after laser refractive surgery.

METHODS:We performed a comprehensive search via Pubmed, Embase, Cochrane Library, VIP Chinese Science and Technology Journal Database, CNKI and Wan Fang Chinese periodical Database for the randomized controlled trials(RCTs)at home and abroad about effects of the domestic deproteinized calf blood extract eye gel for corneal epithelial repair after laser corneal refractive surgery with retrieval time from January 2007 to December 2016. According to the inclusion and exclusion criteria, 2 medical researchers independently screened documents, extracted data and evaluated the quality. Review Manager 5.3 software was used for Meta analysis.

RESULTS: Seven RCTs involving 1 042 eyes, including 523 eyes in the treatment group and 519 eyes in the control group, were selected for this Meta-analysis. The results showed that the clinical efficacy in the treatment group was better than that in the control group(OR=1.81, 95%CI: 1.39～2.35; P<0.001). And the corneal injury symptom score in the treatment group was superior to that in the control group(WMD=-0.33, 95%CI: -0.45 to -0.21; P<0.001). And the corneal healing time in the treatment group was shorter than that in the control group(WMD=-1.26, 95%CI: -1.56 to -0.97; P<0.001).

CONCLUSION: The domestic deproteinized calf blood extract eye gel can relieve the patients' symptoms after laser refractive surgery, improve the corneal epithelial recovery and the efficiency of treatment. Due to the limited quality and quantity of the studies these conclusions should be further validated by more well-designed randomized double blind controlled trials.

Abstract:The implantation of posterior chamber phackic intraocular lens(PCPIOL)has been widely carried out worldwide, and its safety and efficacy have been well recognized. How to accurately choose the length of implantable collamer lens(ICL)in order to obtain the ideal vault and reduce postoperative complications, has been a research hotspot. This paper reviews related reports on the relationship between the length of ICL and its postoperative vault.

Abstract:Heat shock protein(HSP)is a family of high expressed proteins under the different stimulus. This family is highly conserved in structure and can protect cells in function. In recent years, there are some researches illustrate that HSP 27 and HSP 70 have protective effect on retinal cells and optical nerve cells, while the HSP-27 Ab and HSP-70 Ab can promote the apoptosis of these cells. In the cell culture and animal experiment, we have observed that it is beneficial to protect retinal cells and optical cells through blocking the express of HSP-27 Ab and HSP-70 Ab. This article reviews the relationship between HSP 27 and HSP 70 with retinal diseases and optical nerve diseases.

Abstract:The application of sutureless minimally invasive vitrectomy has been used for more than 10a. High-speed cutting and fine instrumentation have been effective in the treatment of severe vitreoretinal diseases, but intraoperative and postoperative complications have also seriously affected vision recovery, including choroidal detachment is minimally invasive vitrectomy and postoperative relatively rare complications, secondary glaucoma, decreased vision, etc. The reasons and treatment of choroidal detachment during and after minimally invasive vitrectomy are summarized below.

Abstract:Retinopathy of prematurity(ROP)is an ocular disease caused by retinal ophthalmic dysplasia in premature infants, leads to strabismus, amblyopia, cataract, glaucoma, and even blindness, which seriously affects the quality of life of preterm infants. The infant blindness ratio has climbed to 6%-18%, according to figures released by the World Health Organisation. ROP is the primary cause of blindness in children of the world in recent years. But the pathogenesis of ROP is not yet clear. Gestational age, birth weight, oxygen intake, delivery mode, multiple newborns, neonatal respiratory distress syndrome, anemia, blood transfusion, sepsis, infection, hypercapnia, hyperbilirubinemia, maternal prenatal use of a drug are all the risk factors. We reviewed the risk factors and possible mechanism of ROP, in order to offer theoretical support for the study and prevention of ROP in premature infants.

Abstract:As the increasing population aging, the incidence of age-related macular degeneration is increasing, blinding rate also increasing, so it is very important for the early diagnosis and treatment of age-related macular degeneration. There are many methods to check the aging macular degeneration, such as fundus angiography, optical coherence tomography(OCT), visual field and multifocal electroretinogram(mfERG). In recent years, many emerging ophthalmic methods have emerged and are gradually applied to clinical diagnosis, including optic coherence tomography angiography(OCTA). The function of these methods has its unique advantages, but there are also limitations. This paper will review these existing methods.

Abstract:Pterygium is a common ocular disorder with a high prevalence. Surgical resection is the main method of treating pterygium. Recurrence rate of traditional surgical methods such as simple excision of pterygium is high. In recent years, amniotic membrane transplantation, autologous limbal stem cell transplantation, application of mitomycin(MMC)and some other methods become commonly used. Autologous limbal stem cell transplantation is being most widely used. Pterygium has a close relationship with dry eye, and dry eye is one of the important reasons for its recurrence. Different surgical methods have different effects on postoperative tear film. This review will summarize the recent points as below.

Abstract:Excimer laser in situ keratomileusis(LASIK)is a typical surgical technique which precisely cutting cornea to rectify refractive error with excimer laser. Since the safety, stability, predictable postoperative vision affirmed, it has been accepted by multiple myopia patients in recent years. AC/A is a significant composition of visual function. Nowadays, numerous scholars have pay close attention to its transformation after LASIK, and this paper reviewed the variation trend of AC/A, the influencing factors and its possible mechanisms.

Abstract:AIM: To observe the influence of mitomycin C on corneal endothelial cell in phacoemulsification combined trabeculectomy.

METHODS: Totally 58 patients with cataracts and glaucoma were selected and divided into 2 groups randomly, with 29 cases in each. All patients were treated with phacoemulsification combined trabeculectomy, and those of the control group used no anti-metabolism drugs in the surgery, while those of the observation group given 0.2mg/mL mitomycin C in the surgery. The visual acuity and intraocular pressure, filtering bleb form and complications were compared before and after treatment. Further more, central corneal thickness of patients was detected by corneal topography, and corneal endothelial cell density, hexagonal cell percentage, and variable coefficient of patients were detected with non-contact corneal endothelium.

RESULTS: Before surgery, there was no significant difference in visual acuity between groups(P>0.05); after surgery, the visual acuity of both groups increased, and there was no significant difference between groups either(P>0.05). Before surgery, there was no significant difference on intraocular pressure between groups(P>0.05); after surgery, the intraocular pressure of both groups decreased, and that of the observation group was lower than the controls, the difference between groups and in-groups were both had statistical significance(P<0.05). After surgery, there was no significant difference in functional filter follicle formation rate between groups(P>0.05), but the complication rate of observation group was lower than the controls(P<0.05). After operation, the central corneal thickness, corneal endothelial cell density, hexagonal cell ratio and variation coefficient of the two groups showed no significant change, and there was no statistically significant difference between groups either(P>0.05).

CONCLUSION: Using mitomycin C in the surgery of phacoemulsification combined trabeculectomy is benefit to stabilize intraocular pressure and reduce postoperative complication rate, without the risk of injuring corneal endothelial cells.

Abstract:AIM: To observe the effect of pranoprofen eye drops on corneal endothelium and tears inflammatory factors in perioperative period of cataract surgery.

METHODS: Totally 60 cases(60 eyes)of senile cataract patients were enrolled in this study. Patients with diabetes or other systemic diseases, with other eye diseases or eye surgery, drug allergy were excluded. All the patients were given ophthalmic surgery for the first time. All the patients were randomly divided into 4 groups, 15 patients per group. Each group of patients had been given levofloxacin eye drops preoperatively for 3d, 4 times per day, and tobramycin dexamethasone eye drops postoperatively, 3 times per day for the first week, 2 times per day for the second week. Group A was the control group, without any other drugs. Group B was given pranoprofen eye drops 4 times per day for 3d before the operation. Group C was given pranoprofen eye drops 4 times per day for 1wk after the operation. Group D was given pranoprofen eye drops 4 times per day for 3d before the operation and 1wk after the operation. All the surgeries were done by the same ophthalmologist, using the same phacoemulsification machine and the same ultrasound energy parameters. The loss rate of endothelial cell was measured by corneal endothelium counterometry. Interleukin-6(IL-6)and tumor necrosis factor(TNF)in the tear fluid were measured by ELISA before surgery(before using eye drops)and 1wk, 1mo and 3mo postoperatively.

RESULTS: There was no significant difference in patients' gender, age and phacoemulsification time among 4 groups. The levels of inflammatory cytokines IL-6 in the tear fluid of the Group B before surgery had no significant difference compared to that at 3mo postoperatively(P>0.05), but the differences among the other groups at different time points were statistically significant(P<0.05). There was no significant difference in preoperative among the four groups(P>0.05). At 1wk after the operation, there was significant difference between the Group A and the other three groups(P<0.05), and there was significant difference between the Group B and the Group D(P<0.05), but there was no significant difference between the Group B and the Group C, the Group C and the Group D(P>0.05). At 1mo after the operation, there was significant difference between the Group A and the other three groups(P<0.05), and there was significant difference between the Group B and the Group C, the Group C and the Group D(P<0.05), but there was no significant difference between the Group B and the Group D(P>0.05). At 3mo after the operation, there was significant difference between the Group A and the other three groups(P<0.05), but there was no significant difference between the Group B, the Group C and the Group D(P>0.05). The levels of inflammatory cytokines TNF in the tear fluid at different time points among each group were significantly different(P<0.05). There was no significant difference among the four groups in preoperative(P>0.05). At 1w after the operation, there was significant difference between the Group A and the other three groups(P<0.05), but there was no significant difference between the other three groups respectively(P>0.05). At 1mo after the operation, there was significant difference between the Group A and the other three groups(P<0.05), and there was significant difference between the Group B and the Group C, the Group C and the Group D(P<0.05), but there was no significant difference between the Group B and the Group D(P>0.05). At 3mo after the operation, there was significant difference between the Group A and the other three groups(P<0.05), but there was no significant difference between the other three groups respectively(P>0.05).

CONCLUSION: Pranoprofen eye drops have no effect on the loss rate of corneal endothelium. Pranoprofen eye drops could significantly reduced the tears inflammatory factors in perioperative period of cataract surgery. The role to reduce inflammatory cytokines in the postoperative application of pranoprofen eye drops is not obvious compared to other two modes of administration, but the difference is not statistically significant at 3mo. The administration of preoperative and postoperative use of pranoprofen eye drops has no significant advantage in reducing inflammatory cytokines compared with only preoperative use.

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

METHODS: Totally 80 patients with 80 affected eyes undergoing age-related cataract surgery in our hospital from January 2015 to October 2016 were selected as study subjects, and they were randomly divided into control group and experimental group with 40 patients(40 affected eyes)in each group. The two groups were treated with hydroxyl indican eye drops and rb-bFGF eye drops, respectively. The clinical curative effect, inflammation related factors \〖interleukin 6(IL-6), tumor necrosis factor α(TNF-α)\〗, Schirmer test(SⅠt), break-up time(BUT)of tear film, corneal sodium fluorescein staining(FL)and scores of dry eye symptoms in the two groups were observed.

RESULTS: The total treatment effective rate of experimental group after treatment was significantly higher than that of the control group(90.0% vs 72.5%; χ²=4.021, P<0.05). Before treatment, there was no significant difference in IL-6, TNF-α, SⅠt, BUT, FL score and scores of dry eye symptoms between the two groups(P>0.05). After treatment, IL-6, TNF-α, SⅠt, FL score and scores of dry eye symptoms in two groups significantly decreased while BUT significantly increased(P<0.05), and changes of the indexes were more significant in the experimental group than the control group(P<0.05).

CONCLUSION: In the treatment of patients after age-related cataract after surgery, rb-bFGF eye drops has more advantages over hydroxyl indican eye drops in regulating the expression of inflammatory factors, improving the tear film stability and relieving dry eye symptoms.

Abstract:AIM: To investigate the value of ANA, ANCA, HLA-B27, anti-dsDNA in the diagnosis of immune-related uveitis.

METHODS: Totally 70 patients with immune-related uveitis were selected and the clinical data were collected. The levels of ANA, ANCA, anti-dsDNA in serum and HLA-B27 in peripheral blood lymphocytes were measured.

RESULTS: Male patients were younger than femle patients(t=2.845, P<0.05); there were 42 cases, 12 cases, 6 cases, 5 cases, 4 cases, 1 case, repectively in spondyloarthritis, primary systemic vasculitis, systemic lupus erythematosus, primary Sjogren's syndrome, rheumatoid arthritis and juvenile idiopathic arthritis among the 70 patients with immune-related uveitis. The proportion of spondylitis and systemic lupus erythematosus between men and women had significant difference(P=0.019, 0.008). The ANA positive rate was 16%(11/70), the positive rate of ANCA was 10%(7/70), the positive rate of HLA-B27 was 59%(41/70), the positive rate of anti-dsDNA was 6%(4/70). Among the cases, in male ANA, ANCA, anti-dsDNA positive rate was lower than in women(P<0.05). The positive rate of HLA-B27 in male was higher than that in female, the difference was significant(χ²=4.427, P<0.05). The main site of the disease in 70 cases of immune-related uveitis were the anterior uvea(49%)and the entire uvea(46%). ANA was mainly expressed in systemic lupus erythematosus(83%)and primary Sjogren's syndrome(60%); ANCA was expressed in immune-related uveitis(except for spondyloarthritis and juvenile idiopathic arthritis); HLA-B27 was predominantly expressed in spondylarthritis(93%); anti-dsDNA was mainly expressed in systemic lupus erythematosus(67%)and rheumatoid arthritis(25%).

CONCLUSION: The positive rates of ANA, ANCA, HLA-B27 and anti-dsDNA are different in different immunological-related uveitis, which has a certain diagnostic effect on the classification of immune-related uveitis.

Abstract:AIM: To analyze the changes of retinal hemodynamics in patients with diabetic retinopathy(DR)by color Doppler ultrasonography.

METHODS: Totally 96 patients(96 eyes)with diabetes mellitus(DM)treated in our hospital from June 2014 to May 2017 were selected and divided into A, B, C three groups. Group A consisted of 32 DM patients(32 eyes), Group B with 32 cases(32 eyes)of non-proliferative diabetic retinopathy(NPDR), Group C 32 cases(32 eyes)of proliferative diabetic retinopathy(PDR), and 30 healthy volunteers(30 eyes)were set as control group. All patients' the central retinal artery(CRA), posterior ciliary artery(PCA), ophthalmic artery(OA)hemodynamic changes were detected by color Doppler ultrasound. And the relation of HbA1c and FBG with diabetic lesion degree were studied.

RESULTS: The hemodynamic indexes of CRA, PCA and OA in each group were statistically significant(P<0.05). The difference of PSV of CRA, PCA and OA in Group A and control group was not statistically significant(P>0.05). The PSV and EDV of CRA, PCA and OA in Group C were the lowest, and the RI was the highest, which had a significant difference between Group A and B(P<0.05). HbA1c and FBG in each group showed statistical significance(P<0.05). Course of disease in Group A and Group C only showed significantly different(P<0.05).

CONCLUSION: Color Doppler ultrasound monitoring changes of CRA, PCA, OA hemodynamics in diabetic patients can bring us more understand in retinal blood flow, and play a vital role in prevention and treatment of diabetic retinopathy.

Abstract:AIM: To observe the the effect of vitreomacular adhesion on the anti- vascular endothelial growth factor(VEGF)treatment in patients with macular edema(ME)induced by branch retinal vein occlusion(BRVO).

METHODS: A retrospective clinical study. Totally 58 patients(60 eyes)were induced in this study during April 2014 to May 2016, who were diagnosed with macular edema due to branch retinal vein occlusion. All subjects were assigned to 2 groups according to the examination of optical coherence tomography(OCT): combined with vitreomacular adhesion groups(Group A)and uncombined with vitreomacular adhesion groups(Group B). The basic situation of the two groups was as follows: Group A: 23 cases(24 eyes), the average age was 55.91±7.34, the mean disease course was 3.4±1.01mo, the mean macular central retinal thickness(CMT)was 463.26±53.73μm and the average BCVA was 0.63±0.11; Group B: 35 cases(36 eyes), the average age was 56.33±5.34, the mean disease course was 2.82±1.33mo, the mean CMT was 482.90±37.43μm and the average BCVA was 0.59±0.12. All cases received vitreous injection of 0.5mg Conbercept. Injections were repeated based on the visual changes and the OCT findings. The follow-up time was more than 6mo. BCVA, CMT, and the numbers of injections of two groups were recorded at pre-operation and postoperative 1, 6mo and the statistical analysis was conducted.

RESULTS: BCVA and CMT of the most patients were improved compared to prior treatment and the difference had statistical significance(P<0.05). There were significant differences on CMT between two groups at 1 and 6mo after treatment(t=9.13, 10.01; P<0.05). While BCVA between two groups at 1 and 6mo after treatment was not statistically different(t=2.13, 5.32; P>0.05). At 6mo after treatment, the average numbers of injections in combined vitreomacular adhesion groups were 4.38±0.97 times and the average numbers of injections in uncombined vitreomacular adhesion groups were 3.56±0.71 times. The difference had statistical significance(t=4.56, P<0.05). Systematic adverse reactions and persistent intraocular pressure elevation, retinal detachment, endophthalmitis, vitreous hemorrhage were never found in the follow-up period.

CONCLUSION: Vitreous injection of anti-VEGF treatment for macular edema induced by branch retinal vein occlusion has good clinical results. However, if there is merged with vitreomacular adhesion at the same time, the treatment effect of anti-VEGF will be weakened to some extent.

Abstract:AIM: To observe the efficacy and safety of intravitreal injection of anti-vascular endothelial growth factor(VEGF)combined with laser photocoagulation in treatment of diabetic macular edema.

METHODS: Retrospective analysis on clinical data of 86 patients(102 eyes)with diabetic macular edema and they were divided into 2 groups randomly. The control group adopted laser photocoagulation treatment; observation group accepted anti-VEGF treated basis on control group(Conbercept 0.05mL). We compared the effects and the adverse reactions of the two groups.

RESULTS: After treatment, visual acuity of the two both increased; the observation group's situation was better than the control group(P<0.05). After treatment, the total efficiency rate of the observation group was 90.9%, which was higher than that of the control group of(76.6%, P<0.05). After treatment, the macular retinal thickness(CRT)and total macular volume(TMV)levels of the two group decreased, and the CRT and TMV of observation group were lower than the control group(P<0.05); there was no significant difference between the two groups on adverse reactions(P>0.05).

CONCLUSION: The efficacy on diabetic macular edema by intravitreal injection of anti VEGF drug combined with laser photocoagulation is better, can reduce the CRT, TMV in the range of 6mm, and application security is good.

Abstract:AIM:To explore the correlation between choroidal thickness and macular hole, and to provide a theoretical basis for diagnosis and treatment of macular hole.

METHODS: This study included 40 cases of monocular idiopathic macular hole patients who were treated in ophthalmology of our hospital from June 2015 to June 2016 and 40 cases of healthy people. Sicked eyes of idiopathic macular hole patients(40 eyes)were set as the Group A, uninjured side eyes(40 eyes)were set as the Group B, eyes of 40 cases of healthy people(40 normal eyes)were set as the Group C. Choroidal thickness of macular fovea, macular fovea 1mm, 3mm at 9 points, 4 directions in the upper, lower, nasal and temporal regions were measured through coherent optical tomography of enhanced deep imaging(enhanced depth image optical coherence tomography, EDI-OCT). They were recorded as SFCT, SCT_1mm, SCT_3mm, ICT_1mm, ICT_3mm, NCT_1mm, NCT_3mm, TCT_1mm, TCT_3mm, and correlation analysis between SFCT and age was analyzed.

RESULTS: Average SFCT of Group A, B had no significant difference, data of the Group C was significantly higher than those of the Group A, B, there was statistical significance(P<0.05). SCT_1mm, SCT_3mm, ICT_1mm, ICT_3mm, NCT_1mm, NCT_3mm, TCT_1mm, TCT_3mm of the Group A, B had no significant difference(P>0.05), and choroidal thickness at each point of the Group C was significantly higher than that of Group A and B, there was statistical significance(P<0.05). Correlation analysis of age found that there was no significant correlation between SFCT and age of the Group A, B(r=-0.065, P=0.148; r=-0.057, P=0.658), SFCT of the Group C was negatively correlated with age(r=-0.343, P=0.041).

CONCLUSION: The pathogenesis of idiopathic macular hole may be related to the sharp decrease of choroidal thickness, choroidal thickness of uninjured side eyes reduces more sharply than normal population and choroidal vascular metabolism reduces may be pathogenic.

Abstract:AIM: To estimate the correlation between diabetic duration, blood glucose levels, plasma C-peptide and dry eye, and the risk factors for dry eye in patients with type 2 diabetes mellitus(T2DM)

METHODS: The clinical data of 51 patients(102 eyes)with type 2 diabetes diagnosed by the Department of Endocrinology, Jiangsu Provincial Hospital of Traditional Chinese Medicine was collected, in that 44 cases(88 eyes)of patients diagnosed with dry eye. Those patients were detected for the levels of glycosylated hemoglobin A1c(HbA1c), fasting blood-glucose(FBG), postprandial 2h blood-glucose(2h PBG), fasting plasma C-peptide and insulin, 1h C-peptide and insulin. Corneal fluorescein staining(FL), tear break-up time(BUT)and Schirmer Ⅰ test(SⅠt)were collected from all subjects. Compared biochemistry index and ocular surface index. The multiple Logistic regression was used to analyze the risk factors for dry eye in patients with T2DM.

RESULTS: There was no significant differences between the patients with different diabetic duration, on BUT, SⅠt, winking frequency, vision, FL and the scores of dry eye symptoms(P>0.05). HbA1c was significantly correlated with FL(P<0.05). There were significant differences in FL among patients with HbA1c in 8.1% to 11.8%(P<0.01). FBG was significantly correlated with FL and winking frequency(P<0.05). The 2h PBG was significantly correlated with tear secretion and vision(P<0.05). Plasma C-peptide was significantly correlated with BUT(P<0.05). There were significant differences in BUT among patients with 1h C-peptide in 3.3-5.5ng/mL(P<0.05). FBG and plasma C-peptide in T2DM patients were risk factors for occurrence of dry eye(P<0.05).

CONCLUSION: Poor function of insulin secretion and poor control of blood glucose in T2DM patients are risk factors for dry eye. Both of them can decline tear film stability. High blood glucose levels easily lead to decrease of tear secretion, vision and corneal epithelial defect.

Abstract:AIM: To study of hypertensive retinopathy and brachial ankle pulse wave velocity(baPWV)correlation.

METHODS: Totally 89 cases 140 eyes of patients with hypertensive retinopathy in our hospital from June 2015 to December 2016 and 30 healthy subjects(60 eyes)were selected as the research objects, and were divided into the observation group and the control group, respectively. All of the subjects were examined by direct ophthalmoscope, and the results were classified according to Keith-Wagener four classification. Application of OMRON health care(China)Co., Ltd. production of BP-203RPE network arteriosclerosis detection device for selected objects of baPWV detection. The levels of baPWV and the results of fundus examination were compared between the two groups, and the correlation between the two methods was analyzed.

RESULTS: Detection of baPWV in patients was higher as the hypertension severity increased, there was statistically significant differences between groups(P<0.05). The retinopathy grade was higher, the baPWV detection value was larger, the detection value of every grade was different statistically with others(P<0.05).

CONCLUSION: Elevated blood pressure is closely related to retinopathy and accelerated pulse wave velocity, relationship between the two values is notable, brachial ankle pulse wave velocity can be used to reflect the level of hypertensive retinopathy.

Abstract:AIM: To investigate the prevalence of age-related macular degeneration(ARMD)among people aged 50 years and above in Funing county, Jiangsu province.

METHODS: Survey research. Random cluster sampling was used in selecting individuals aged ≥50 years in 30 clusters in Funing county. Proportions were compared by using the χ² test and the means compared by using the t-test. Logistic regression was used to detect possible factors of ARMD such as age and gender.

RESULTS: A total of 6 145 persons aged 50 years were enumerated and 5 947(96.78%)participants were received visual acuity test and eye examination. The prevalence of ARMD was 7.53%, with a total of 448 individuals(633 eyes). The prevalence of blindness and visual impairment for presenting visual acuity were 4.13% and 11.96%, respectively. The prevalence of blindness and visual impairment for presenting visual acuity were 4.45% and 7.79%, respectively. Older were significant risk factors of ARMD(OR=1.01, P=0.04).

CONCLUSION: The prevalence of ARMD was higher among people aged 50 years and above in Funing county, Jiangsu province. ARMD is one of the leading cause of visual impairment.

Abstract:AIM: To investigate the quality of life of elderly patients with low vision and its nursing service demand, in order to improve the quality of life of elderly low vision group and provide theory basis.

METHODS: A cross-sectional study method, in a tertiary hospital in Fuzhou city elderly patients with low vision 200 cases were as the research object, USES the Chinese version of quality of life scale(CLVQOL), low vision care service demand questionnaire investigation were taken.

RESULTS: In elderly patients with low vision life quality score was 54.92±12.11, the nursing service demand score 30.34±8.93, medium and high demand was of 88%. Quality of life was negatively correlated with nursing service demand value(r=-0.266, P<0.01).

CONCLUSION: The quality of life of elderly patients with low vision was low, nursing service demand is high, especially on visual function recovery training of nursing service requirements. Aging brings important social problems in China, attaches great importance to the elderly care service demand, discussion with precise visual nursing care intervention in low vision group, it is necessary to improve the quality of life.

Abstract:AIM: To explore the relationship between the different stages of diabetic retinopathy and the related factors of vascular endothelial function, and to provide a theoretical basis for improving the function of vascular endothelium to find a way to delay or even inhibit the occurrence or progression of DR.

METHODS:We collected during March 2015 to December 2015 in Department of Ophthalmology and endocrinology in our hospital, 178 cases of type 2 diabetes mellitus patients and 62 cases of blood specimen in health control group. According to the results of fundus fluorescence angiography(FFA), they were divided into four groups, diabetes patients without retinopathy, diabetes patients with non-proliferative diabetic retinopathy(NPDR), diabetes patients with proliferative diabetic retinopathy(PDR)and healthy control group. We detected blood samples of antithrombin Ⅲ(AT-Ⅲ), fibrinolytic enzyme activation inhibitor(PAI), the original organization type fibrinolytic enzyme activator(t-PA)index and the correlation of diabetic retinopathy in installment.

RESULTS: This study showed that AT-Ⅲ was significantly different among the four groups(F=5.986, P<0.01); PAI was significantly different among the patients without DR, patients with NPDR and patients with PDR(F=7.434, P<0.01); t-PA was not significantly different among the four groups(F=2.556, P>0.05); there were relations between the different stages of diabetic retinopathy and AT-Ⅲ, PAI.

CONCLUSION: The degree of diabetic retinopathy has a close relationship with the content of antithrombin Ⅲ and plasminogen activator inhibitor, and it is closely related to the function of vascular endothelium.

Abstract:AIM: To describe the application of smart phone and supporting set for acquiring fundus images with slitlamp examination and non-contact lens in primary hospital of the rural area.

METHODS: The supporting set for smart phone was purchased from taobao and securely connected to the ocular lens of slitlamp microscopy. The fundus photos were imaged with assistance of non-contact slitlamp lens from Volk.

RESULTS: High quality images of various retinal diseases could be successfully taken with smart phone and supporting set by slitlamp examination. The fundus images were send to patients with Wechat as medical records or used for telconsultant.

CONCLUSION: High resolution smart phones are wildly used nowadays and supporting sets are very accessible; thus high quality of images could be obtained with minimal cost in rural hospitals. The digital fundus images will be beneficial for medical record and rapid diagnosis with telconsultant.

Abstract:AIM: To study the relativity between reject reaction from donation after cardiac death(DCD)and corneal endothelial cell source of corneal graft after penetrating keratoplasty.

METHODS:Totally 28 cases of corneal graft rejection after penetrating keratoplasty with cardiac death donor cornea were analyzed using corneal endothelial microscope at less than 1mo, 2-3mo, 4-6mo, 7-12mo after operation.

RESULTS:Coefficient variation of corneal endothelial cell of the 28 cases at less than 1mo,2-3mo, 4-6mo and 7-12mo were 38.23%, 49.56%, 57.18%, 65.04%. Corneal endothelial cell density were 2071.15±311.47, 1771.33±348.18, 1626.59±353.92, 1553.14±307.31. The coefficient variation of corneal endothelial cells was positively correlated with rejection(r=0.95, P<0.05). The postoperative corneal endothelial cell density was negatively correlated with rejection(r=-0.93, P<0.05).

CONCLUSION: The corneal endothelial cell coefficient variation increased gradually and the corneal endothelial cell density decreased gradually after DCD corneal allograft rejection. Corneal endothelial cell coefficient variation and corneal endothelial cell density can be used as indicators of early detection of postoperative rejection.

Abstract:AIM: To describe the outcomes of corneal stromal lenticules in repairing of corneal ulcer and/or perforation.

METHODS: This was a retrospective chart review of 6 eyes of 6 patients from January to June 2017,who underwent corneal ulcer repair with the corneal, stromal lenticules harvested from femtosecond laser refractive surgery and kept in pure glycerin for use. Three cases of infectious corneal ulcers were bacterial, fungal, and infection with foreign bodies in corneal deep layer, one each. The other 3 were corneal ulcer perforation. Making sure no air bubble between donor graft and Descemet membrane. The mean follow-up time was 3.71±1.56mo(range 1-6mo).

RESULTS: All eyes were successfully treated under control of infection without intra-operative complications, and early postoperative evaluation showed a clear graft in all cases. The last follow-up visit showed the mean best corrected visual acuity(VA)significantly improved after surgery. There was significant difference from 0.48±0.12 to 1.50±0.08(P<0.01).

CONCLUSION: The preliminary results suggest that the use of corneal stromal lenticules may be a safe and effective surgical alternative for corneal ulcer, even though the long-term outcome of the graft needs to be further observed.

Abstract:AIM: To compare CASIA SS-1000 and Sirius OCT sweep anterior segment analyzer instrument for measuring normal corneal vertex thickness(CCT)and the thinnest corneal thickness(TCT)results the difference, correlation and consistency, and provide a theoretical basis for clinical application.

METHODS: This was a prospective study. A total of 34 normal subjects were collected. The subjects were measured by the same skilled operator. The SS-1000 OCT was first used, and then the corneal thickness was measured repeatedly by Sirius anterior segment analyzer. Paired t test and Bland-Altman were used to evaluate the consistency of corneal apex and corneal thinnest point between SS-1000 OCT and Sirius anterior segment analyzer.

RESULTS: The mean corneal apex measured by SS-1000 OCT and Sirius corneal topography were 517.62±25.29μm and 518.47±27.23μm CCT, respectively. The thinnest points of SS-1000 OCT and Sirius anterior segment analyzer CCT were 513.53±25.06μm and 515.32±26.69μm, respectively. Paired t test showed that the difference on corneal thickness of vertex was not statistically significant(P>0.05), but the thinnest corneal thickness was statistically significant(P<0.05). Pearson analysis of the two devices, the correlation is 0.969, 0.965. The results of 95% consistency limiting analysis on the corneal vertex thickness by Bland-Altman was(-14.22μm, 12.52μm), that of the thinnest corneal thickness was(-15.61μm, 12.03μm), 4%(3/68)was out of the 95% consistency limiting, but the thinnest corneal thickness was of a little larger differences.

CONCLUSION: SS-1000 OCT measurement of CCT and Sirius anterior segment analyzer is highly consistent, in clinical work can be considered alternative, but the thinnest point of the cornea can not be replaced each other.

Abstract:AIM: To investigate the risk factors for malignant glaucoma occurrence after the surgery for primary angle-closure glaucoma, and to provide theoretical basis for the prevention and treatment of malignant glaucoma.

METHODS: The clinical data of 767 cases(965 eyes)of primary angle-closure glaucoma patients treated in our hospital from June 2012 to June 2016 were retrospectively analyzed. Patients were divided into two groups according to the postoperative investigation, patients with malignant glaucoma were divided into observation group, and 50 eyes without malignant glaucoma were randomly selected into control group. The gender, age, preoperative high intraocular pressure, chamber angle structure, axial length, crystal thickness, anterior chamber depth, diabetes mellitus, and hypertension of the patients in two groups were investigated. The risk factors were analyzed by single factor analysis, and the independent risk factors were analyzed by multivariate logistic regression analysis.

RESULTS: Malignant glaucoma occurred in 30 eyes after the surgery of primary angle closure glaucoma in 965 eyes with an incidence rate of 3.1%. The single factor analysis showed that age, preoperative high intraocular pressure, axial length, anterior chamber depth, lense thickness, complete closure of atrial angle were the risk factors of malignant glaucoma after primary angle closure glaucoma surgery, comparison between groups showed statistical significance(P<0.05). Multivariate logistic regression analysis showed that age(OR=2.521, 95%CI=1.434-8.876), preoperative continuous high intraocular pressure(OR=2.483, 95%CI =2.123-11.543), axial length(OR=2.654, 95%CI=1.547-12.678), complete closure of atrial angle(OR=3.212, 95%CI=1.543-8.675)were the independent risk factors for malignant glaucoma after primary angle closure glaucoma surgery.

CONCLUSION: The incidence rate of malignant glaucoma after primary angle-closure glaucoma surgery in our hospital is 3.1%. Age, preoperative high intraocular pressure, axialc length, complete closure of atrial angle can rise the risk of occurring malignant glaucoma, so special attention shall be payed for this kind of patients.

Abstract:AIM: To evaluate the efficacy and safety of intravitreous injection of Conbercept for macular edema secondary to macular branch retinal vein occlusion(MBRVO).

METHODS: Clinical records of 19 patients(19 eyes)who were diagnosed MBRVO with macular edema(ME)in our hospital, from July 2015 to September 2016 were retrospectively analysed. All patients were treated with an intravitreal dose of 0.5mg or 0.05mL conbercept ophthalmic injection by the 3+ pro re nata(PRN)project. All patients were evaluated by best corrected visual acuity(BCVA), central retinal thickness(CRT), the number of the injection, and the complications.

RESULTS: During the 1, 2, 3 and 6mo after treatment the mean BCVA all improved significantly(P<0.01), and the mean CRT reduced statistical significantly(P<0.01); 3 eyes had refractory ME, and micro-aneurysm leakage were identified by FFA, and the ME was suppressed effectively after local laser photocoagulation. No complications, such as secondary vitreous haemorrhage, retinal detachment, persistent high intraocular pressure and endophthalmitis were observed during subsequent follow-up.

CONCLUSION: Intravitreous injection of conbercept for macular edema secondary to MBRVO may reduce macular edema and improve visual acuity effectively and safely in the short term.

Abstract:AIM: To analyze the association of intrauterine growth retardation(IUGR)and retinopathy of prematurity(ROP).

METHODS: A retrospective analysis of a case series included in ROP screening from January 2011to December 2015 was performed in Suzhou Municipal Hospital. Totally 2 527 children(5 054 eyes)underwent screening. According to the gestational age, the data was divided into 4 groups(≤32wk, >32 and ≤34wk,>34 and ≤37wk, >37wk). Every group was divided into two groups(IUGR group and no IUGR group)respectively. We compared the incidence of ROP in IUGR and non IUGR group.

RESULTS: Of all the 2 527 children, IUGR group were 702 including 78 ROP children, and non IUGR group were 1825 including 329 ROP children. There were 991 children were divided into ≤32wk group, including 63 IUGR in which 27 children were screened out ROP(42.9%)and 928 non IUGR in which 274 children were screened out ROP(29.5%), the difference on the incidence of ROP was statistically significant(χ²=4.958, P=0.026). There were 1025 children were divided into >32 and ≤34wk group, including 232 IUGR in which 33 children were screened out ROP(14.2%)and 793 non IUGR in which 51 children were screened out ROP(6.4%)and the difference was statistically significant(χ²=14.488, P<0.001). There were 464 children were divided into >34 and ≤37wk group, including 374 IUGR in which 18 children were screened out ROP(4.8%)and 90 non IUGR in which 4 children were screened out ROP(4.4%)and the difference was not statistically significant(Fischer exact test, P=1). There were 47 children were divided into >37wk group, including 33 IUGR and 14 non IUGR, none were screened out in the two groups.

CONCLUSION: Intrauterine growth retardation was closely related to the incidence of ROP. In the preterm infants with gestational age less than 34wk, the incidence of ROP in children with intrauterine growth retardation is significantly higher than that in children without intrauterine growth retardation.

Abstract:AIM: To evaluate two structural predictors of visual outcome of epiretinal membrane surgery.

METHODS: Retrospective study for 30 eyes of epiretinal membrane surgery between January 2014 and October 2016. We assessed the related parameters of the optical coherence tomography and recorded the best-corrected visual acuity(BCVA)at baseline and 1, 3 and 6mo after surgery. Correlations between the final best-corrected visual acuity and photoreceptor integrity status or photoreceptor outer segment length were investigated.

RESULTS: Average best-corrected visual acuity decreased at 1mo postoperatively compared with baseline, but improved at 3 and 6mo. Central macular were more sweller at 1mo postoperatively than baseline, but a significant thickeness reduction was found at 6mo(P<0.05). Photoreceptor outer segment length were shortened at 1mo compared with preoperation(P<0.05), gradually approached the baseline level at 3 and 6mo. Multivariate regression the final best-corrected visual acuity associated with photoreceptor integrity and photoreceptor outer segment length(P=0.023, 0.004).

CONCLUSION: Photoreceptor integrity and photoreceptor outer segment length detected by OCT were significant predictors of the final best-corrected visual acuity(BCVA)after idiopathic epiretinal membrane surgery.

Abstract:AIM: To observe the effect of Nd:YAG laser ablation on vitreous floaters.

METHODS: From October 2016 to January 2017, 78 cases(84 eyes)with vitreous floaters treated with Nd:YAG laser ablation were involved. Chi-square test, Mann-Whitney Test, Kruskal-Wallis test and Spearman test were used to compare the therapeutic effect with different etiologies and grades.

RESULTS: After two-week treatment, there were 66 eyes(79%)with a significant resolution, 16 eyes(19%)with an improvement and 2 eyes(2%)invalid. The total effective rate was 98%. There was no significant difference between the therapeutic effect and times in different etiologies(H=3.842,P=0.146; χ²=0.070, P=0.966); the effective rate were 100% in grade Ⅰ and Ⅱ, 92% in grade Ⅲ, 83% in grade Ⅳ, and the grade had a negative correlation with the therapeutic effect(r_s=-0.027, P=0.013). There were 38 eyes(90%)in grade Ⅰ, 21 eyes(88%)in grade Ⅱ, 9 eyes(75%)in grade Ⅲ, and 2 eyes(33%)in grade Ⅳ needed once treatment. There was significant difference between different grades and treatment times(U=2.580, P=0.010).

CONCLUSION: Nd:YAG laser ablation is a simple and convenient operation for vitreous floaters, and could improve the symptom of vitreous floater rapidly.

Abstract:AIM: To evaluate the outcomes and safety of minimally invasive 23G pars plana vitrectomy(PPV)combined with silicone oil tamponade for the removal of giant intraocular foreign body(IOFB).

METHODS: A total of 12 cases diagnosed with giant IOFB were included in this retrospective study in which 11 eyes of 11 males and 1 eye of 1 female were treated in Changsha Aier Eye Hospital between February 2012 and March 2015. Among these patients, the preoperative best corrected visual acuity varied from light perception to 0.1 with retinal detachment identified in all 12 eyes. All patients underwent 23G minimally invasive PPV. After the vitreous was removed and the damaged retina was repaired, silicone oil was filled, and then the scleral incision was extended to remove the giant IOFB. Lens extraction and intraocular lens implantation were performed in some patients when necessary. Silicone oil was removed 6mo later.

RESULTS: The giant IOFB was removed successfully just with 1 attempt in each of 12 eyes, and no IOFB fell and reinjured the retina or damaged the cornea during the procedure. All retinas were reattached and no endophthalmitis was observed in any patients postoperatively. The silicone oil was removed successfully after 6mo, and by then the visual acuity was improved in all cases. Sixty-seven percent of patients became free of blindness and 25% free of visual disability.

CONCLUSION: Removing giant IOFB through 23G PPV assisted with silicone oil tamponade is safe and effective.

Abstract:AIM: To measure the transverse diameter of nasolacrimal duct in patients with nasolacrimal duct obstruction, and to analyze the difference of the transverse diameter of the upper, middle and lower nasal nasolacrimal ducts between the diseased eyes and the normal eyes, between the male and the female eyes, and of different ages and sexes and then explore the correlation between the diameter of nasolacrimal duct and nasolacrimal duct obstruction based on computed tomography(CT)dacryocystography.

METHODS: From April 2014 to January 2017 in Chengdu University of Traditional Chinese Medicine Affiliated Hospital of ophthalmology in tears or pus for complaints, diagnosis of nasolacrimal duct obstruction in 152 patients(179 sick eyes, 125 normal eyes). Among them 25 cases were male(sick eyes 28 eyes, normal eye 22 eyes), 127 cases were female(sick eyes 151 eyes, normal eyes 103 eyes), age from 4 to 87 years old, mean age 53.44±16.06 years old. All patients with perfusion of 30% iohexol injection in lacrimal passages, and immediately examined with CT scan, upload CT images on PACS workstation for 3D reconstruction of nasolacrimal duct, oblique coronal of nasolacrimal duct and its adjacent structure were observed. We measured and analyzed the transverse diameters of the upper, middle and lower nasal nasolacrimal ducts between men and women, diseased eyes and non diseased eyes, and between the diseased eyes of different age groups.

RESULTS: The transverse diameter of the upper, middle and lower nasal nasolacrimal duct was no significant difference between the diseased eye and the normal eye, between the male and female diseased eyes, and between the diseased eyes of different age groups(P>0.05). The transverse diameters of the upper, middle and lower nasolacrimal ducts were significantly different between the diseased eyes and the normal eyes(P<0.001), and the transverse diameter of the middle mouth was the smallest.

CONCLUSION: Transverse diameter of bony nasolacrimal duct is not a risk factor for nasolacrimal duct obstruction.

Abstract:AIM: To investigate the amniotic membrane transplantation for all the cornea or bandage contact lens after pterygium excision combine with limbal stem cell transplantation in the treatment of large pterygium.

METHODS:The 40 eyes of larger pterygium was randomly divided into 2 groups, one group, 20 eyes, with autologous limbal stem cell transplantation combine with amniotic membrane transplantation for all the cornea(amniotic membrane group); another group, 20 eyes, with bandage contact lens after limbal stem cell transplantation(bandage contact lens group). The surgery time, eye comfort postoperation, progress in corneal healing were observed at 1, 3d, 1 and 3wk.

RESULTS:The average surgery time of amniotic membrane transplantation group was 61.4±5.2min, and the bandage contact lens group was 34.5±2.7min, which was significantly shorter(Student's t-test, P<0.05). There was no difference of the degree of eye comfort between the two groups at first day after surgery. But 3d and 1wk postoperation, the degree of ocular comfort of bandage contact lens group was much better than amniotic membrane transplantation group(P<0.01), while there was no difference between the two groups 3wk after surgery(P>0.05). The corneal healing score of the two groups was 0.85±0.18 and 1.15±0.18 in the 3wk after operation respectively, and the difference between the two groups was not statistically significant(Student's t-test, P=0.25). There was only one case of recurrence in amniotic membrane group.

CONCLUSION:Treatment of larger pterygium with amniotic membrane transplantation for all the cornea or wearing bandage contact lenses after autologous limbal stem cell transplantation, can both ease eye symptoms and promote corneal wound healing. Those patients with bandage contact lens feel more comfortable and convenient than with autologous limbal stem cell transplantation. Also the bandage contact lens surgery is more economical than the other one.

Abstract:AIM: To investigate the long-term clinical effect of modified frontalis tendon flap suspension in the treatment of severe blepharoptosis in children.

METHODS: A total of 83 cases(114 eyes)of modified frontalis tendon flap suspension for children severe blepharoptosis correction were analyzed between January 2009 to December 2011 for the efficacy and complications of this surgery. Follow-up observation for 5a.

RESULTS: In the fifth year after operation, there were 84 eyes(73.7%)with correction and satisfactory correction, 30 eyes(26.3%)were corrected, and the operation was satisfactory. Postoperative complications included 4 eyes(3.5%)of inverted eyelashes, of which 3 eyes were given suture traction at 1/3 interior of the gray line, 1wk later inverted eyelashes disappeared, 1 eye of secondary surgery. Conjunctival prolapse was in 2 eyes(1.8%), the application of corticosteroids eye drops, pressure bandage were used for 1wk and conjunctival prolapse disappeared. There was no recurrence of keratitis, eyelid ectropion, septum separation, eyelid angular deformity, hematoma formation, infection and other complications. Postoperative retrograde retrogression and lateral eyelid folds disappear were the most common problems of long-term follow-up.

CONCLUSION: The study shows that this surgical technique is a satisfied method to treat severe blepharoptosis and predictable with few complications.

Abstract:AIM:To evaluate the influence on corneal biomechanics after small incision lenticule extraction(SMILE)and Femto LDV laser flapping in laser in situ keratomileusis(FS-LASIK).

METHODS: Preoperatively, 1mo after surgery, 101 patients(202 eyes)with myopia in each group respectively by SMILE and FS-LASIK were examined by ocular response analyzer(ORA). Parameters were compared between postoperative(1mo)and preoperative. Comparisons included the corneal thickness and corneal compensated intraocular pressure(Iopcc), Goldmann correlated IOP value(Iopg), corneal resistance factor(CRF), corneal hysteresis(CH).

RESULTS: SMILE group: IOPcc, IOPg(1mo postoperatively, 13.84±2.22,10.81±2.52mmHg)significantly changed comparing with preoperative(16.15±2.90, 15.95±3.08mmHg; t=-13.58, -32.91; both P<0.01). CRF and CH(1mo postoperatively, 7.52±1.41, 8.66±1.19mmHg)significantly changed comparing with preoperative(10.72±1.61, 10.60±1.43; t=-41.21, -24.03; both P<0.01). The difference were 3.19±1.10, 1.93±1.14mmHg respectively. FS-LASIK group: Iopcc and Iopg(1mo postoperatively, 13.99±2.33, 10.10±2.55mmHg)significantly changed comparing with preoperative(15.88±3.29, 14.86±3.34mmHg; t=-10.09、-23.00; both P<0.01). CRF, CH(1mo postoperaturely, 6.68±1.14, 7.90±1.27mmHg)significantly changed comparing with preoperative(9.93±1.85, 9.98±1.60mmHg; t=-24.84, -18.90; both P<0.01). The difference were 3.25±1.86, 2.08±1.57mmHg respectively. Changes of CRF and CH were significantly different between two groups(t=-0.351, -1.081; both P<0.01).

CONCLUSION: The postoperative corneal biomechanics and IOP measurements are lower than preoperative. SMILE are lower than FS-lasik in changes of CRF, CH.

Abstract:AIM:To evaluate the changes of the corneal surface morphology undergoing overnight orthokeratology treatment and assess the effect of optical center deviation in controlling the development of myopia.

METHODS: This was a retrospective clinical study. One hundred and thirty-four children(134 eyes)with myopia aged 10.66±1.79 years were treated with overnight orthokeratology lenses. The examinations of visual acuity, axial length and corneal topography were performed before and 3, 6, 12, 18 and 24mo after wearing orthokeratology. The results of right eye were taken as the object of this study, SPSS19.0 for statistical analysis.

RESULTS: The distance of decentration about 134 children at 3, 6, 12, 18 and 24mo after wearing orthokeratology were 0.84±0.45mm, 0.77±0.40mm, 0.79±0.41mm, 0.78±0.41mm, and 0.79±0.42mm respectively. The difference between these groups were not statistically significant(F=1.187,P=0.319). The mean distance of decentration after orthokeratology treatment was 0.79±0.35mm, the growth of axial length after 24mo was 0.32±0.30mm, the mean distance of decentration divided into 3 groups, mild(<0.5mm)27 eyes, medium(0.5-1.0mm)79 eyes, severe(>1.0mm)28 eyes, the growth of axial length frow 3 groups after 24mo were 0.45±0.34mm, 0.32±0.28mm, 0.23±0.29mm, were statistically significant difference between each groups(F=3.825, P=0.024). By linear-regression analysis, the growth of axial length and the mean distance of decentration after 24mo was statistically significant difference(F=7.246, P=0.008), equation of linear regression was Y=0.478-0.194X. At 24mo after wearing orthokeratology, the mean distance of decentration about 18 eyes with monocular diplopia was 1.18±0.36mm, and 116 eyes without monocular was 0.73±0.31mm, the distance of decentration were statistically significant difference(t=5.59, P<0.01).

CONCLUSION: The degree of decentration tended to be stable after 3mo of orthokeratology treatment and influenced the effect of myopia control and visual quality.

Abstract:AIM: To evaluate the long-term clinical efficacy of Shotfile software for the myopia patients with presbyopia.

METHODS: A total of 43 cases(82 eyes)over the age of 35 myopia patients were treated with laser corneal surgery in our hospital, added Shotfile software at the same time, and followed up for 3a. The uncorrected visual acuity(the distance and near vision), diopter change and visual satisfaction rate were observed at 1, 2 and 3a after operation.

RESULTS: At 1a after operation, there were 81 eyes(99%)with the uncorrected distance visual acuity reached the preoperative best corrected visual acuity, and 75 eyes(91%)with the uncorrected near visual acuity above 0.66, the average value of the spherical equivalent was(-0.64±0.63)D, the overall satisfaction rate was 91%. At 2a after operation, there were 79 eyes(96%)with the uncorrected distance visual acuity reached the preoperative best corrected visual acuity, and 69 eyes(84%)with the uncorrected near visual acuity above 0.66, the average value of the spherical equivalent was(-0.62±0.59)D, the overall satisfaction rate was 86%. At 3a after operation, There were 77 eyes(94%)with the uncorrected distance visual acuity reached the preoperative best corrected visual acuity, and 62 eyes(76%)with the uncorrected near visual acuity above 0.66, the average value of the spherical equivalent was(-0.55±0.56)D, the overall satisfaction rate was 81%. Intraoperative or postoperative serious complications were not found in all the cases, 1 eye of spherical equivalent with -10.0D was found -1.75D back after 1a, respected the willingness of patient for the second correction.

CONCLUSION: Shotfile software for the patients myopia with presbyopia is safe and stable in the long-term clinical treatment, and the patient satisfaction is higher, but the near visual ability of some patients may be weakened with the prolongation of time, preoperative communication with patients should be fully.

Abstract:AIM: To investigate the efficacy of unilateral medial rectus resection in children with residual and recurrent exotropia and analyze the influence of difference types of strabismus and methods of primary surgery on the surgical outcome.

METHODS:This investigation was a retrospective case series study that examined data from 48 pediatric patients(48 eyes)who underwent unilateral medial rectus resection between January 2009 and February 2013 for residual and recurrent exotropia. We surveyed the outcome of eye alignment, lateral incomitance, fusion function, stereoacuity in children at 1d, 6wk and at last follow-up of 6-32(mean 11.99±7.06)mo after the surgery.

RESULTS: At 1d after the surgery, the rate of surgical success was 83%(40/48), and the rate of undercorrection and overcorrection was 4%(2/48)and 13%(6/48), respectively. At 6wk after the surgery, the rate of surgical success was 81%(39/48), and the rate of undercorrection and overcorrection was 13%(6/48)and 6%(3/48), respectively. At the final follow-up of 6-32(mean 11.99±7.06)mo, the surgical success rate was 75%(36/48), and the rate of undercorrection was 25%(12/48). No patient exhibited overcorrection. There were no significant differences in the surgical success rate either among pediatric patients who had previously undergone different types of surgery or among patients who had been diagnosed with different types of exotropia(P=0.168 and P=0.50, respectively). No patients presented with lateral incomitance or limited ocular motility.

CONCLUSION: Unilateral medial rectus resection is a safe and effective surgical approach for treating in children with residual and recurrent exotropia. In addition, it may achieve the same surgical effectiveness regardless of the patients' previous surgical procedures or types of exotropia.