Abstract:AIM: To compare choroidal thickness at the macula in eyes with unilateral idiopathic full-thickness macular holes(FTMH)with that of unaffected fellow eyes, and eyes of normal control patients.

METHODS: Cross-sectional study. Thirty patients with unilateral idiopathic FTMH and thirty age, sex, and race-matched controls were recruited. Axial lengths were measured using laser interferometry. Enhanced depth imaging optical coherence tomography images were obtained using Heidelberg spectral-domain optical coherence tomography. Choroidal thickness was measured at the fovea, and at 1 mm and 2 mm nasally, temporally, superiorly and inferiorly from the center of the fovea. Statistical analysis was performed using independent and paired t-tests, chi-square tests, and Pearson correlation tests(P<0.05).

RESULTS: The mean subfoveal choroidal thickness was 201.0±44.0 μm in the FTMH group, 225.3±51.4 μm in the fellow eye group and 262.3±70.3 μm in the control group. The choroid was thinner in FTMH eyes at all locations when compared to control eyes(P<0.05). The fellow eye group also had thinner choroids than the control group at all locations except at 1 mm and 2 mm nasal to the fovea(P<0.05). Choroidal thickness in the FTMH group was lower than in the fellow eye group, but the differences were not statistically significant(P>0.05). Choroidal thickness was generally highest subfoveally and lowest nasally. Subfoveal choroidal thickness was negatively correlated with age(r=-0.278, P=0.032), and axial length(r=-0.328, P=0.011).

CONCLUSION: Choroidal thickness is lower in both eyes of patients with unilateral FTMH compared to healthy control eyes.

Abstract:AIM: To investigate 3-year results in our neovascular age-related macular degeneration(NV-AMD)patients treated with Ranibizumab.

METHODS: Retrospective study. Visual acuity(VA), a full biomicroscopic examination(anterior segment and fundus), and optical coherence tomography(OCT)findings were noted at every visit. All patients were followed monthly. The VA values for the visits closest to 12, 24, and 36mo were analysed. Totally 101 eyes of 73 patients were enrolled. According to the initial VA, the patients were divided three groups: initial VA ≤ 35(Group 1), 36-54(Group 2), and ≥55 letters(Group 3). After three loading doses of 0.5 mg Ranibizumab if retreatment was needed, again, 0.5 mg Ranibizumab was administered.

RESULTS: Totally 57 of the 101 eyes were from males and 44 were from females. The average age was 75.1y. The difference on the changes of VA among three groups at 24 and 36mo were statistically significant(P=0.002 and 0.0001 respectively). At the end of the 36-month follow-up the VA increase in Group 2 was significant(P=0.001). At the 12, 24 and 36mo visits most of the eyes showed no VA loss and most of these eyes were in Group 1. The average number of injections administered was 7.3 and the average number of visits was 23.9 during the follow-up.

CONCLUSION: VA improvement was significant in those with mild initial VA(36-54 letters). Most eyes showed no VA loss regardless of the initial VA. No correlation between the final VA and the average number of injections.

Abstract:AIM: To evaluate correlation of cystatin-C(Cys-C)with severity of diabetic retinopathy(DR)and acute phase reactants, including erythrocyte sedimentation rate(ESR)and high-sensitivity C-reactive protein(hs-CRP).

METHODS: All diabetic patients who were referred for diabetic retinopathy(DR)screening during 1mo were enrolled. Demographic data were recorded. All patients have undergone full ophthalmic exam. At the same day, all patients were tested for hemoglobin A1c(HbA1c), ESR, hs-CRP, and Cys-C serum levels.

RESULTS: Sixty seven diabetics were enrolled, including 19(28.3%)without retinopathy, 22(32.8%)non-proliferative retinopathy, and 26(38.8%)proliferative retinopathy patients. The mean age, sex distribution, mean duration of diabetes, prevalence of hypertension and dyslipidemia, smoking status and HbA1c levels were not significantly different among the three groups. The mean levels of Cys-C increase significantly as retinopathy progress \〖1.1±0.48; 1.22±0.38; 1.71±0.92(P=0.007), respectively\〗. In multiple regression analysis, just Cys-C was significantly associated with severity of DR(P=0.025).

CONCLUSIONS: This study revealed that serum levels of Cys-C increase while DR progress independently of acute phase reactants. Therefore, it could be used as an associated marker by primary care physicians to distinguish patients at higher risk of severe DR. Larger randomized studies are warranted to confirm findings. Reviewing physiological role of the Cys-C, we proposed that the Cys-C may be a protective response to catalytic stress rather than being a pathogenic factor in microangiopathies.

Abstract:AIM: To investigate the effect of myocilin on the expression of fibronectin(FN)and the adhesion function in trabecular meshwork cells of primary open angle glaucoma(POAG)in vitro.

METHODS: The concentration of recombinant myocilin protein was 0(control group), 0.5, 1, 1.5, 2 and 2.5μg/mL, respectively. The expression of FN in the cells and the cell culture medium were detected by Western blot and ELISA. The effect of myocilin protein on the adhesion of cultured POAG trabecular meshwork cells was detected by CCK-8 method.

RESULTS: Western blot showed that the ratio of FN/β-actin was 34.8±0.6, 33.4±1.0, 28.9±0.8, 21.6±0.9, 15.9±1.1 and 11.9±0.8; that of 0.5μg/mL group was not significantly different compared with that of control group(P=0.092); that of 1.0, 1.5, 2 and 2.5μg/mL group were significantly different compared with that of the control group(F=346.131, P<0.05). The concentration of FN in the cell culture medium was 0.4654±0.0039, 0.4596±0.0032, 0.4216±0.0037, 0.4214±0.0039, 0.4043±0.0039, 0.3806±0.0071μg/mL by ELISA; difference between that of 0.5μg/mL group and that of control group was not statistically significant(P=0.120); the difference between of 1, 1.5, 2, 2.5μg/mL group and the control group were statistically significant(F=176.054, P<0.05). The mean values of the absorbance values of each group were 1.9814±0.1624, 1.8848±0.0267, 1.4895±0.0916, 1.4120±0.1087, 1.3392±0.1391, 1.0310±0.0639 through CCK-8 method; that of 0.5μg/mL group was not significantly different compared with that of control group(P=0.300); the difference between of 1, 1.5, 2, 2.5μg/mL group and the control group were statistically significant(F=177.818, P<0.05).

CONCLUSION: Myocilin protein can inhibit the fibronectin expression in POAG trabecular meshwork cells, showing a dose dependent manner. Myocilin protein can reduce the adhesion of POAG trabecular meshwork cells.

Abstract:[THIS ARTICLE HAS BEEN RETRACTED]AIM: Through the expression of VEGF₁₆₅ and VEGF_165b in human retinal pigment epithelial cells in vitro in artificial simulated hypoxia and high glucose environment, to discuss their roles in the development of diabetic retinopathy and the relationship between each other.

METHODS: After normal inoculation and cultivation of human retinal pigment epithelial cells(RPE)in vitro, the cells was divided into the normal group(5.56mmol/L glucose, without CoCl₂), the hypoxia group(5.56mmol/L glucose + 150μmol/L CoCl₂), the high glucose group(25mmol/L glucose, without CoCl₂), the combination group(25mmol/L glucose + 150μmol/L CoCl₂), a total of four groups. The RNA of each group was extracted respectively in 12h, 24h, 36h, and 48h. We used the MTT colorimetry to detect cell vitality and growth trend; RT-PCR method to detect VEGF₁₆₅ and VEGF_165b relative expression of mRNA of RPE cells in four different time points.

RESULTS: Hypoxia and high sugar environment limited proliferation of RPE cell division and cell vitality. After comparing cells of the same group in different time points, in the normal group there was no statistically significant different expression over time(P>0.05); the expression in the hypoxia group, the high glucose group and the combination group increased over time, the difference was statistically significant(P<0.05). At the same time, differences of the expression between groups was not statistical significant in 12h(P>0.05); the difference was statistically significant in 24h, 36h, 48h(P<0.05).

CONCLUSION: Cultured RPE cells can express VEGF_165b normal. Lack of oxygen and high glucose can induce the increase of VEGF₁₆₅ mRNA, at the same time reduces the VEGF_165b mRNA expression.

Abstract:AIM:To investigate the effect of epidermal growth factor(EGF)on proliferation and migration of retinal pigment epithelial(RPE)cells.

METHODS: Human RPE cell lines(ARPE-19 cell)were treated with different doses of EGF. The methyl thiazolyl tetrazolium(MTT)assay was used to detect cell viability. The 5-bromodeoxyuridine(BrdU)incorporation assay was used to detect cell proliferation and the “scratch-wound assay” was used to detect cell migration ability. The epidermal growth factor receptor(EGFR)and protein kinase B(AKT)proteins were detected by Western blot.

RESULTS:The MTT assay results showed that treatment with 50 and 100ng/mL EGF for 12h increased ARPE-19 cell viability. The BrdU incorporation assay and the “scratch-wound assay” showed that treatment with 100ng/mL EGF for 24h increased ARPE-19 cell proliferation and migration. The Western blot results showed that treatment with 10-100ng/mL EGF for 12h or 100ng/mL EGF for 15-180min increased phosphorylation levels of EGFR and decreased total levels of EGFR. Similarly, treatment with 10-100ng/mL EGF for 12h or 100ng/mL EGF for 15-180min increased phosphorylation levels of AKT, but not affected total levels of AKT.

CONCLUSION: EGF affects ARPE-19 cell viability, proliferation and migration through inducing phosphorylation of the EGFR/AKT signaling pathway. The EGFR/AKT signaling pathway might play an important role in abnormal proliferation and migration of RPE cells in proliferative vitreoretinopathy.

Abstract:AIM: To investigate the effects of astragalus injection on the metabolic and pathological changes of the retinal free radical metabolism and pathology in high-altitude hypoxic rats.

METHODS:Sixty healthy SD rats without any eye disease were selected, and the random grouping method was divided into two groups: astragalus injection group(intervention group)and physiological saline group(control group), each group of 30 rats. In each group, 6 were randomly selected for injection of astragalus injection(15mL/kg)and physiological saline(15mL/kg)in the pre-simulated chamber. The rats were sacrificed immediately and removed the eyeballs after the rats were taken out of the simulated module. We observed the changes of retinal morphology with the HE staining method, and determine the retinal SOD and MDA content with colorimetry.

RESULTS:HE staining showed no morphological changes in the two groups of retinas at 2h, and as the time of hypoxia was prolonged, the retinal edema gradually increased, but the intervention group was less edema than the control group. The activity of SOD in both groups decreased with the increase of anoxia time of high altitude, and the comparison of different time points in the group was statistically significant(P<0.05). The content of MDA in both groups increased gradually, and the comparison between different time points in the group was statistically significant(P<0.05). The SOD in the two groups of retinas was significantly different at same time point(P<0.05), except for at 2h without statistical significance. The MDA showed the same situation as SOD.

CONCLUSION: Astragalus injection can reduce the damage degree of retinopathy in rats under the high altitude hypoxia environment, that the mechanism may be related to free radicals, enhance the activity of SOD, reduce the MDA content of lipid peroxides, and enhance antioxidant capacity.

Abstract:AIM:To observe the effects of small incision lenticule extraction(SMILE)and trans-epithelial photorefractive keratectomy(Trans-PRK)on corneal horizontal coma, vertical coma, and spherical aberration and total higher order aberrations after refractive correction for myopia.

METHODS: This was a prospective non-randomized cohort study. The cohort included 40 patients(80 eyes)with myopia, who received refraction correction surgery from December 2016 to February 2017 in Leshan Ophthalmic Center. Twenty patients(40 eyes)received SMILE surgery and the other 20 patients(40 eyes)received Trans-PRK surgery. Corneal aberrations were determined by a high-resolution Pentacam Scheimpflug camera before the surgery and at 1 and 3mo after the operation. Statistical analyses were performed using analysis of variance of repeated measures.

RESULTS: At 1 and 3mo post-operation, the uncorrected visual acuity in both groups was better than or equal to the preoperative best corrected visual acuity. The preoperative corneal aberrations showed no significant difference between the two groups(P>0.05). Significantly higher aberration was found after the surgery in both groups(P<0.05), however, no significant difference in higher aberration was found between 1 and 3mo post-operation(P>0.05). Post-operation, horizontal and vertical coma had no significant difference between the two groups(P>0.05), while SMILE group showed lower spherical aberration and lower total higher order aberration than Trans-PRK group(P<0.05).

CONCLUSION: Both SMILE and Trans-PRK increase corneal aberration and their effects on horizontal and vertical coma are similar. However, SMILE has a minor influence on spherical aberration and total high order aberration than Trans-PRK.

Abstract:AIM: To Evaluate the effects of different capsulotomy diameters during phacoemulsification on corneal and blood aqueous barrier.

METHODS: Totally 78 cases(100 eyes)with cataract were treated by femtosecond laser assisted phacoemulsification. The patients were randomly divided into two groups. There were 36 cases(50 eyes)in experimental group, in which the capsulotomy diameter was 4.7mm, and 42 cases(50 eyes)in the control group, in which the capsulotomy diameter was 6.0mm. Phacoemulsification power and time were recorded for each procedure. Follow-up exams were performed on 1d, 1wk and 2mo after surgery. Preoperative and postoperative best corrected visual acuity, central corneal thickness, aqueous flare, corneal endothelial cell count were assessed for the two groups.

RESULTS: No significant difference was found on preoperative best corrected visual acuity(BCVA), hardness of the lens nucleus, centrel corneal thickness(CCT)and the effective phaco time and the average phaco power of the two groups(P>0.05). There was also no statistically significant difference on BCVA between the two groups after surgery(P>0.05). The change of central corneal thickness and the aqueous flare cells in the experimental group were less than those in the control group at 1d and 1wk postoperatively(P<0.05), while the difference was not obvious at 2mo after(P>0.05). The rate of lost corneal endothelial cell was significantly lower in the experimental group than the control group at 2mo postoperatively(P>0.05).

CONCLUSION: The phacoemulsification with small capsulotomy diameters decreases the injury to the corneal and blood aqueous barrier. The patients recovered more quickly.

Abstract:AMI:To evaluate the clinical efficacy of the segmented bifocal intraocular lens(MIOL)SBL-3.

METHODS:Totally 26 cases(26 eyes)of age-related cataract who received phacoemulsification and implantation of MIOL SBL-3 were enrolled from February 2016 to June 2017 in our hospital as the SBL-3 group. And 28 cases(28 eyes)of age-related cataract who received phacoemulsification and implantation of single focus intraocular lens intraocular lens TecnisZA9003 were enrolled as control group. At postoperative 3mo, the uncorrected visual acuity, corrected visual acuity, contrast sensitivity and patient satisfaction were compared between two groups.

RESULTS: At preoperative, there was no statistical difference in uncorrected distance, intermediate and near visual acuity between two groups(P>0.05). At postoperatively 3mo, the uncorrected distance, intermediate and near visual acuity in patients of both groups were significantly improved(P<0.05). At postoperative 3mo, the uncorrected intermediate and near visual acuity, distance-corrected intermediate and near visual acuity, contrast sensitivity at different spatial frequencies(3, 6, 12, 18c/d)and patient satisfaction in SBL-3 group were significantly better than those of control group(P<0.05).

CONCLUSION: The MIOL SBL-3 not only could provide preferable distance visual acuity, but also could provide better intermediate visual acuity, near visual acuity and contrast sensitivity, and greatly increase the visual quality and satisfaction at postoperative in cataract patients.

Abstract:Long non-coding RNAs(lncRNAs)refer to a kind of non-coding RNA which is longer than 200 nucleotides, with the characteristic of its numerous, diversity of types and modes of action. The biological functions of lncRNA involved in genomic imprinting, chromatin remodeling, translational control of mRNA, cell cycle and cell differentiation control, immune surveillance, constituting the skeleton of nuclear sub structure, etc. LncRNA plays an important role in individual development and human diseases. This paper mainly reviewed those lncRNAs that have been published, and closely related to eye development and diseases.

Abstract:The implantable collamer lens(ICL), a posterior chamber phakic intraocular lens, a surgical technique for the correction of moderate to high myopia, has been widely accepted for its stable results, high predictability and good visual quality. However, the success of the operation largely depends on the ICL vault. High or low vault is likely to cause a series of potential complications such as ocular hypertension, cataracts, etc. This article summarizes the related factors that affect the vault after ICL implantation.

Abstract:High altitude retinopathy(HAR)is the pathological changes of retina and optic caused by hypobaric hypoxia when the body is in high altitude environment, and HAR is the major cause of visual loss for the plainsmen who went to high attitude area. With the development of economy and tourism of plateau regions, the prevalence of HAR has recently been increasing for more and more people going to high altitude areas. Currently, it is reported that the pathogenesis of HAR involves a host of mechanisms, including the integrity damage of blood-retinal barrier(BRB), retinal neuron injury, inflammatory mediators and cytokines produced excessively, retinal blood vessels regulate dysfunction, and hemodynamics abnormality, and the synergistic action between them. In this review, we report the findings from current studies on the pathogenesis of HAR, contributing to further studies and diagnosis and treatment.

Abstract:Diabetic retinopathy(DR)is one of the major diseases that causing blindness and low vision in the world. A series of systemic(hyperglycemia, hypertension, hyperlipidemia, etc.)and ocular factors can effect its occurrence and progression. Therefore, understanding these risk factors may help us to predict the prognosis and stratify the risk. Some studies have found that myopia may have a protective effect on the occurrence and progression of DR, but the results are different. Furthermore, it is also unclear which factor in myopia, the axial length, or the other refractive components is the main cause of this protective effect. This paper provides a comprehensive review of the association between myopia, axial length(AL), anterior chamber depth(ACD)and refractive components(lens biometry and corneal curvature)with DR.

Abstract:As a non-invasive ocular imaging tool, in vivo confocal microscopy(IVCM)provides micro-structural information of cornea, conjunctiva and meibomian glands at the cellular level to display their microscopic structure features. IVCM supplies a unique advantage to clinical applications and research in ocular surface. Recently, application of IVCM has progressively extended to the research area on meibomian gland dysfunction(MGD)and on other diseases about meibomian gland. Thus, this paper aims to summarize the current knowledge about the role of IVCM in the assessment of meibomian glands.

Abstract:Alzheimer's disease is a progressive neurodegenerative disorder causing irreversible deterioration in memory and loss of self-care ability, which is seriously affecting the quality of life. There is no cure for Alzheimer's disease. Medication only can control the progression of the disease. Early diagnosis and control of disease progress is of great significance in improving the quality of life of the patients and reducing the burden of family and society. Ophthalmic examination is seen as a window which can “see” brain directly, and some changes in the eye can reflect the changes of the brain most directly. This paper reviews the ophthalmic examination of Alzheimer's disease, including optical coherence tomography(OCT), visual field, contrast sensitivity and eye movements, et al. We hope to provide a new idea for the early diagnosis of Alzheimer's disease.

Abstract:Mitophagy is a selective autophagy refers to the autophagy process by which cells selectively remove mitochondria. Mitophagy plays important roles in clearing up dysfunctional mitochondria, reducing mitochondrial numbers and maintaining cell homeostasis. Its molecular mechanisms involve several proteins such as PINK1/Parkin, BNIP3, NIX, and FUNDC1. Mitochondrial dysfunction or damage may cause serious consequences, and may even lead to cell death. Studies have shown that disfunction of mitophagy is related to many eye diseases, for instance, cataract, glaucoma, age-related macular degeneration, diabetic retinopathy, etc. This review deals with the mechanisms of mitophagy and its research on ocular diseases.

Abstract:AIM:To analyze the choroidal thickness alteration in patients with obstructive sleep apnea hypopnea syndrome(OSAHS).

METHODS: Seventeen patients who were diagnosed with OSAHS initially and 31 healthy individuals were enrolled. Enhanced depth imaging choriodal scans were obtained by spectral-domain optical coherence tomography. Choroidal thickness of subfovea, 2mm superior, inferior, nasal and temporal to the fovea were measured and statistically analyzed.

RESULTS: Subfoveal choroidal thickness of the control group and the OSAHS group was 323.58±58.63μm and 316.82±46.43μm respectively, and the difference was unsignificant(t=0.409, P=0.684). Choroidal thickness at 2mm superior to the fovea of the control group and the OSAHS group was 318.29±56.89μm and 314.29±59.8μm respectively, and the difference was unsignificant(t=0.229, P=0.820). Choroidal thickness at 2mm inferior to the fovea of the control group and the OSAHS group was 308.42±54.95μm and 291.65±55.37μm respectively, and the difference was not significant(t=1.009, P=0.318). Choroidal thickness at 2mm temporal to the fovea of the control group and the OSAHS group was 308.23±54.62μm and 302.76±46.97μm respectively, and the difference was not significant(t=0.347, P=0.730). Choroidal thickness at 2mm nasal to the fovea of the control group and the OSAHS group was 266.23±58.10μm and 277.12±63.99μm respectively, and the difference was not significant(t=-0.599, P=0.552). There were no significant differences among subgroups after grading based on the severity of sleep apnea hypopnea index and blood oxygen concentration.

CONCLUSION: Compared with healthy individuals, choroidal thickness of patients with OSAHS decreases slightly(except for the location of 2mm nasal to the fovea), but the alteration is not significant. The severity of OSAHS has no effect on the choroidal thickness for the patients first diagnosis of OSAHS.

Abstract:AIM: To compare the visual quality after different multifocal lens(MIOL)implantation in cataract patients.

METHODS:Totally 78 cases(78 eyes)of cataract patients who receiving phacoemulsification and implantation of different MIOL were enrolled from February 2016 to June 2017 in our hospital. According to the different type of implanted MIOL, the 78 cases(78 eyes)were divided Group A, B and C, each group was 26 cases(26 eyes). Patients in the Group A were implanted regional refraction MIOL SBL-3; patients in the Group B implanted step progressive diffraction MIOL SN6AD1; patients in the Group C implanted all-optical plane diffraction MIOL Tecnis ZMB00. The visual acuity, contrast sensitivity, defocus testing, contrast visual acuity and satisfaction of visual quality were compared in 3 groups at postoperative 3mo.

RESULTS: There was no statistically significant difference in postoperative adverse reactions between the three groups(P>0.05). There was statistical difference in uncorrected intermediate visual acuity, uncorrected near visual acuity, distance-corrected intermediate visual acuity and distance-corrected near visual acuity in 3 groups(P<0.05), and those in the Group C were significantly worse than those of Group A and B(P<0.05). There was statistical difference in contrast sensitivity at four spatial frequencies(3, 6, 12, 18c/d)in light and light glare and three spatial frequencies(3, 6, 12c/d)in dark and dark glare in 3 groups(P<0.05), and those in the Group A were significantly better than those of Group B and C(P<0.05). According to the defocus testing of 3 groups, the visual acuity at -1.5D, -2.0D and -2.5D in Group A and B was significantly higher than Group C(P<0.05). There was statistical difference in contrast visual acuity at 20% and 9% of contrast ratio in 3 groups(P<0.05), and those in Group A were significantly better than Group B and C(P<0.05). There was statistical difference in visual quality satisfaction in 3 groups(P<0.05), and that in the Group A was significantly better than that of Group B and C(P<0.05).

CONCLUSION:The region refraction MIOL SBL-3 not only could provide better distant, intermediate and near visual acuity, but also could provide better contrast sensitivity and contrast visual acuity, thereby greatly increase visual quality satisfaction.

Abstract:AIM:To evaluate the effect of femtosecond laser assisted cataract surgery combined with triple-focus intraocular lens implantation in the treatment of cataract.

METHODS: Totally 86 cases(106 eyes)of patients with double cataract in our hospital from January 2016 to January 2017 were selected, including 49 cases(59 eyes)were set as the observation group(treated with femtosecond laser assisted phacoemulsification combined with triple-focus intraocular lens implantation), and 37 cases(47 eyes)were set as the control group(received traditional phacoemulsification combined with triple-focus intraocular lens implantation). Corneal endothelial cell density, cumulative dissipated energy(CDE), distant and near visual accommodation before and after operation were compared between the two groups, postoperative complications were observed.

RESULTS: The preoperative corneal endothelial cell density of two groups had no significant difference(P>0.05). The corneal endothelial cell density of two groups significantly decreased at postoperative 1wk, with statistic significance within groups(P<0.05), and the corneal endothelial cell density of the control group was significantly lower than that of the observation group at postoperative 1wk(P<0.05). The CDE of the observation group were lower than that of the control group, and the difference between the two groups was significant(P<0.05). There were significant differences in best corrected visual acuity at different time points between the two groups(P<0.01). The best corrected visual acuity at 1 and 3mo after operation in the observation group was higher than that in the control group, and the difference was significant(P<0.05). There was no capsular tear in the observation group, while the incidence rate was 4.3% in the control group, with no significant difference between the two groups(P>0.05). The incidence of glare and halo in the observation group was 10.2% and 8.5% in the control group, and are in the patients whose age was above 60 years old, there was no significant difference between the two groups(P>0.05).

CONCLUSION: Femtosecond laser assisted cataract surgery combined with triple-focus intraocular lens implantation in the treatment of cataract can not only improve curative effect, but also provide high safety, while the adverse events including glare, halo and other adverse visual circumstances should be considered after triple-focus intraocular lens implantation.

Abstract:AIM: To study clinical efficacy of phacoemulsification combined with goniosynechialysis in treating primary angle-closure glaucoma with age-related cataract.

METHODS: Totally 66 cases(70 eyes)of patients with primary angle-closure glaucoma with age-related cataract treated in our hospital from February 2014 to February 2017 were selected as the objects of study. Retrospective analysis was implemented to their case data. There were 36 cases(38 eyes)of patients who were treated with phacoemulsification and intraocular lens implantation combined with goniosynechialysis were set as observation group, while the other 30 cases(32 eyes)of patients who were treated with phacoemulsification and intraocular lens implantation alone were set as control group. Two groups were compared for total success rate of surgery, the situation of eyesight, intraocular pressure, chamber depth and anterior chamber angle before and after surgery, moreover, the occurrences of complications were recorded.

RESULTS: The absolute success rate of surgery in observation group was 63%, while that of control group was 47%, and the observation group was dramatically higher than control group, with statistical significance(P<0.05). The total success rate of observation group was 87%, while that of control group was 84%, and the difference had no statistical significance(P>0.05). The difference in terms of the number of people whose eyesight were <0.1, 0.1-<0.3, 0.3-0.5 or >0.5 before surgery compared with after surgeries had statistical significance(Z_{observation group}=7.545, Z_{control group}=7.213; P<0.05), while the difference between groups after surgery had no statistical significance(Z=-1.456, P>0.05). After surgery, the intraocular pressure of both groups decreased significantly(t_{observation group}=3.323, P_{observation group}=0.001; t_{control group}=10.394, P_{control group}<0.01), and the observation group was significantly lower than control group after surgery, with a difference having statistical significance(t=14.802, P<0.01). Chamber depth of both groups decreased dramatically after surgery(t_{observation group}=0.411, P_{observation group}<0.01; t_{control grou}=15.621, P_{control grou}<0.01), and the difference between groups after surgery had statistical significance(t=15.246, P<0.01). The occurrence rate of complications in observation group was 11%, while that of control group was 25%, and observation group was significantly lower than control group, having statistical significance(χ²=4.409, P=0.036).

CONCLUSION: Goniosynechialysis combined with phacoemulsification have obvious efficacy in treating primary angle-closure glaucoma complicated with age-related cataract. It performs better in controlling intraocular pressure after surgery with lower occurrence rate of complication.

Abstract:AIM: To evaluate the efficacy of anti- vascular endothelial growth factor(VEGF)and photodynamic therapy(PDT)on pathological myopia(PM)combined with choroidal neovascularization(CNV).

METHODS: Forty-three patients(45 eyes)diagnosed by fundus fluorescein angiography(FFA), indocyanine green angiography(ICGA)and optical coherence tomography(OCT)with PM combined with macular CNV were recruited in this study. The patients were randomly divided into two groups for different treatments, intravitreal injection with Ranibizumab(20 patients, 22 eyes)and PDT(23 patients, 23 eyes). After treatment, all patients had been followed up monthly for 12mo. The further treatments were operated according to referral situations. The best corrected visual acuity(BCVA)was recorded with the ETDRS chart and the mean defect(MD)of the center 10° visual field was measured. At the last follow-up, the therapy efficacy was determined by ETDRS numbers and MD and analyzed.

RESULTS: Before treatment, there was no significant difference on the baseline in ETDRS and MD between ranibizumab group and PDT group(P>0.05). After 12mo treatment, the ETDRS number in ranibizumab group(39.23±20.06)significantly increased(by 5.88±9.03, P<0.05), but the PDT group(37.38±16.95)was not significantly improved(by 0.33±6.94, P>0.05). The MD in ranibizumab group decreased significantly(P<0.05), and no significant change was found in PDT group(P>0.05).

CONCLUSION: In the treatment of macular CNV complicated by the PM, ranibizumab injection can improve visual function better than PDT.

Abstract:AIM:To investigate the effect of calcium dobesilate in the treatment of non-proliferative diabetic retinopathy(NPDR)after panretinal laser photocoagulation.

METHODS: A total of 40 patients(62 eyes)with clinically diagnosed severe NPDR were randomly divided into control group(22 cases,31 eyes)and study group(18 cases,31eyes). Two groups were all given pan-retinal photocoagulation treatment, while the study group continued to receive calcium dobesilate for 12mo after treatment. After 12mo, before treatment and 12mo after treatment, the changes of best corrected visual acuity(BCVA),average threshold sensitivity, and retinal nerve fiber layer(RNFL)thickness were compared between two groups.

RESULTS: The response rate was 55% and 84%, respectively in the control group and study group, the difference was statistically significant(P<0.05). Compared to the pre-treatment measurement, the average threshold sensitivity and RNFL were reduced at 12mo after treatment in control group, the difference were statistically significant(P<0.05). Compared to the pre-treatment measurement, the average threshold sensitivity and RNFL were reduced at 12mo after treatment in study group, the difference were not statistically significant(P>0.05). At 12mo after treatment, the difference of the average threshold sensitivity and RNFL between two groups were statistically significant(P<0.05).

CONCLUSION: calcium dobesilate could be effective in preventing the retina from damage of retinal photocoagulation in DR. Compared with simple laser photocoagulation, panretinal laser photocoagulation combined with calcium dobesilate can improve curative effect and visual acuity in NPDR patient.

Abstract:AIM: To determine the effect of anterior-posterior joint surgery on choroidal thickness in patients with proliferative diabetic retinopathy(PDR).

METHODS:A retrospective, case-control study enrolled 60 eyes of 60 patients with PDR diagnosed at Qingdao Municipal Hospital. The patients, who had conditions that warranted anterior-posterior joint surgery, were divided into a clinically significant macular edema group(PDR/CSME+; 31 patients, 31 eyes)and a non-CSME group(PDR/CSME-; 29 patients, 29 eyes). Twenty-seven eyes of 27 normal patients were included in the control group. All affected eyes underwent anterior-posterior joint surgery. After surgery, the subfoveal choroidal thickness(SFCT), and the nasal choroidal thickness(NCT)and temporal choroidal thickness(TCT), which were obtained at a distance of 1500μm from the fovea in the nasal and temporal directions, respectively, were measured in the control and PDR groups by enhanced depth imaging spectral domain optical coherence tomography(EDI-SDOCT)at 1wk, 1, 3, and 6mo after surgery. Changes in choroidal thickness after anterior-posterior joint surgery were compared between the groups.

RESULTS: The SFCT, NCT, and TCT were significantly thicker at 1mo than at 1wk, 3, and 6mo after surgery in the PDR/CSME+ and PDR/CSME- groups(P<0.05). The SFCT, NCT, and TCT were significantly thinner at 6mo than at 1wk, 1, and 3mo after surgery in the PDR/CSME+ and PDR/CSME- groups(P<0.05). The SFCT, NCT, and TCT in the PDR/CSME+ and PDR/CSME- groups at 1wk, 1, and 3mo after surgery were significantly thicker than those in the control group(all P<0.05), but the SFCT, NCT, and TCT at 6mo after surgery showed no significant difference compared with the control group(all P>0.05). There was no significant difference in the SFCT, NCT, or TCT at 1wk, 1, 3, or 6mo between the PDR/CSME+ and PDR/CSME- groups(P>0.05).

CONCLUSION: The choroidal thickness of PDR patients increases within 1mo after surgery, and decreased after 1mo, but is not significantly different between the control group and the PDR groups at 6mo after surgery. Whether PDR is associated with CSME has no effect on the choroidal thickness after surgery.

Abstract:AIM: To investigate the ocular surface and refractive change after the surgery of levator resection and frontalis suspension.

METHODS: One hundred and twenty-one patients(146 eyes)for corrective surgery of congenital ptosis were selected in our department from July 2014 to June 2016. According to the severity of congenital ptosis, all the children divided into mild group(47 eyes), moderate group(68 eyes)and severe group(31 eyes). All the children were divided into group of less than 5 years old(104 eyes)and group of more than or equal to 5 years old(42 eyes)according to the age. According to the surgical approach, all the children divided into group of levator resection(62 eyes)and group of frontalis suspension(84 eyes). The effects of the two surgeries on the ocular surface and refractive were compared. The relationship between age, severity of postoperative ptosis and postoperative ocular surface, refractive of children were analyzed.

RESULTS: There were no significant differences in break-up time(BUT), keratometry(Km)and corneal astigmatism(Ast)in the levator resection group and frontalis suspension group(P>0.05). There was significant difference between the mild, moderate and severe group on the proportion of excellent corrected to uncorrected(Z=-2.936, P=0.003). The proportion of excellent correction in mild group was higher than that of moderate and severe group(93.6%, 83.8%and 67.7%). The indexes of BUT(F=9.793, P=0.041)and Km(F=11.657, P=0.037)in the three groups decreased with the increase of severity. While the Ast(F=28.417, P<0.01)showed an increasing trend, the difference was significant. In addition, the proportion of excellent correction in <5 year old group was significantly more than ≥5 years old group(χ²=4.082, P=0.043). The index of Km(t=2.813, P=0.006)was higher and Ast(t=-7.741, P<0.01)was lower in the <5 year old group. There was no significant difference in the index of BUT between the two groups after surgery(P>0.05).

CONCLUSION: The corneal refractive power and astigmatism can be improved similarly after treated with levator resection and frontalis suspension surgery. And there is some damage of corneal epithelial in the initial postoperation, but the function of ocular surface can return to normal after a period of time. The less severity of ptosis before surgery, the better improvement of ocular surface and refractive after sugery. There is no correlation between the age and postoperative ocular surface, but earlier surgical treatment may improve the children's refractive power and astigmatism and achieve greater benefits.

Abstract:AIM:To study the effect and safety of sodium hyaluronate combined with loteprednol eye drops compared to pure sodium hyaluronate eye drops in the clinical treatment of dry eye in children.

METHODS: From August 2014 to August 2016, 128 children(256 eyes)with water deficient dry eye treated with artificial tears in our hospital were randomly divided into two groups, 64 cases(128 eyes)in each, the combined group and the control group, according to the random number table method. The combined group was given sodium hyaluronate combined with loteprednol treatment; the control group was given simple treatment of sodium hyaluronate eye drops. Before and after treatment for 2 and 6wk for ocular surface analysis system(Keratograph 5M)examination, determination of tear break-up time(BUT), tear meniscus height(TMH), meibomian gland infrared photography, slit lamp observation of corneal fluorescein staining, the observation indexes were statistically analyzed.

RESULTS: After 2wk of treatment, the TMH and BUT level of the two groups were all higher than those before treatment(P<0.05). The scores of meibomian gland score and corneal fluorescein staining were lower than those before treatment, and the difference was statistically significant(P<0.05). After 6wk of treatment, the TMH and BUT level of the two groups were all higher than those before treatment and 2wk after treatment; The meibomian gland score and scores of corneal fluorescein staining were lower than those before treatment and 2wk after treatment, the difference was statistically significant(P<0.05). After 2wk and 6wk of treatment, TMH and BUT level combined groups were higher than those in the control group, while the score of meibomian gland and corneal fluorescein staining scores were lower than those in the control group, the difference was statistically significant(P<0.05). Intraocular pressure between the two groups before and after treatment was not significantly different(P>0.05).

CONCLUSION: Sodium hyaluronate combined with loteprednol eye drops is more effective in the clinical treatment of dry eye children than the use of sodium hyaluronate eye drops, while the safety and tolerance are better.

Abstract:AIM: To investigate the effect and safety of pranoprofen treatment of keratoconjunctivitis sicca.

METHODS: Totally 100 cases(200 eyes)of keratoconjunctivitis sicca treated in our hospital in January 2014 to May 2016 were divided into control group and study group according to different treatment methods. The patients in the control group were treated with artificial tear and the patients in the study group were treated with artificial tear combined with pranoprofen eye drops. The clinical effects of the two groups were observed and analyzed.

RESULTS: In the study group, 20 cases(40 eyes)were cured, 26 cases(52 eyes)were effective. The total effective rate was 92.0% higher than that of the control group. The difference was statistically significant(P<0.05). The symptoms, BUT and FL scores of two groups after treatment were better than before treatment(P<0.05), but SⅠT score was not statistically significant(P>0.05). The symptoms and FL scores of study group after treatment were lower than those of the control group after treatment, the BUT score was higher than that of the control group(P<0.05). After treatment, the levels of TNF-α, IL-6 and IL-1β in the two groups were lower than those before treatment, and the levels of TNF-α, IL-6 and IL-1β in the study group were significantly lower than in the control group(P<0.05). the difference of patients with adverse reactions between two groups was not statistically significant(P=1.00).

CONCLUSION: Pranoprofen has a significant effect on the treatment of keratoconjunctivitis sicca, can improve symptoms and signs, control the infection, with high safety.

Abstract:AIM:To evaluate the advantages of non-mydriatic fundus photography(NMFCS)and mydriatic fundus photography(MFCS)as eye-bottom screening and diagnosis methods in compared with gold standard fluorescein fundus angiography(FFA).

METHODS: A total of 276 patients which involved in Chronic Diabetes Management Achieves within 4 streets of Pudong District Shanghai, were enrolled for diabetic retinopathy(DR)examination including NMFCS, MFCS and FFA. These DR examinations were proceeded after vision, slit-lamp and dioptroscopy tests, and reported by professionals. For those with suspicious fundus diseases, we would make appointments with specialist for further treatment.

RESULTS: A total of 1104 colorful fundus images, and 1056 images(95.65%)could be used to analyze. There were 408 appreciable images, 116 basically appreciable images and 28 unusable images in 552 NMFCS images. In addition, there were 432 appreciable images, 100 basically appreciable images and 20 unusable images in 552 MFCS images. There was no significant differences between NMFCS and MFCS(P>0.05). Compared with FFA with DRⅠ as the critical value, the specificity of digital photography for NMFCS was 95.71%, the sensitivity was 93.56%; however, MFCS are 95.43% and 98.02%. There was no statistically significant difference between the two screening methods(P>0.05). Compared with FFA with DRⅡ as the critical value, the specificity of digital photography for NMFCS was 95.35% and the sensitivity was 93.44%; however, for MFCS were 95.81% and 98.36%. There was no statistically significant difference between the two screening methods(P>0.05).

CONCLUSION: Both NMFCS and MFCS could be used for the diagnosis and screening for eye diseases. NMFCS is easier and faster for digital photography, which is suitable for mass screening. MFCS is more likely to provide detailed information about the follow-up of the disease.

Abstract:AIM: To observe the clinical effect and the changes of corneal endothelial morphology of glucocorticoid combined with antiviral therapy for viral corneal endotheliitis and evaluate the safety of this treatment.

METHODS: The clinical data like predisposing factors, history and clinical manifestation were retrospectively analyzed, the 48 patients(48 eyes)with viral corneal dermatitis from January 2014 to December 2015 in Xi'an No.4 Hospital were included. A comparative study was conducted between affected eyes and healthy eyes. The cure rate, recurrence rate and corneal endothelial morphological changes of patients treated with combined treatment of glucocorticoid and antiviral drugs after 3mo were compared and analyzed statistically.

RESULTS: Corneal endotheliitis patients had many predisposing factors and symptoms like red eye, eye pain, photophobia, tears and decreased visual acuity, blurred vision and others, clinical manifestations include decreased visual acuity, conjunctival congestion or mixed ciliary congestion, corneal edema, corneal epithelium might have small blisters, Descemet membrane folds, gray white or white like KP, intraocular pressure increased, posterior synechia, cases of several recurrent had corneal bullous occurred. After 1mo of treatment, the effective rate was 100%, the cure rate was 88%, and there was no recurrence; after 2mo of treatment the effective rate and the cure rate was 100%, a total of 1 cases(2%)recurrence; treatment for 3mo, a total of 2 cases(4%)recurrence. After 3mo of treatment cell count(t=2.952, P=0.004)and corneal thickness by OCT(t=2.584, P=0.011)of the treatment group were lower than those of the control group, the difference was statistically significant; cell pleomorphic mutation rate(45.85%±6.29%)of the treatment group was higher than that of the control group(40.62%±5.16%), the difference was statistically significant(t=4.458, P<0.001). The visual acuity of treatment group was poorer before treatment than that of the control group, the difference was statistically significant(Z=-5.766, P<0.001); after treatment, the visual acuity increased to 0.20(0.10-0.40), there were significant differences before and after the treatment(Z=-6.089, P<0.001).

CONCLUSION: The clinical manifestations and etiology of viral corneal endotheliitis is complex. Application of antiviral drugs and glucocorticoid treatment, can obtain good effect, but after the treatment, corneal thickness and corneal endothelial cell count decreased, higher requirements for the safety of the treatment is needed.

Abstract:AIM: To evaluate meibomian gland dysfunction(MGD)after phacoemulsification surgery, and to

discuss the potential impact of ocular surface.

METHODS: A perspective, self-controlled clinical trial was conducted. Fifty-six eyes of 56 patients with MGD underwent phacoemulsification and were evaluated the ocular surface disease index(OSDI), meibography score, lid margin abnormalities, Schirmer test, tear film break-up time(BUT)at preoperatively and postoperatively 2wk, 1 and 3mo.

RESULTS: Schirmer test did not change significantly postoperatively(P>0.05). The OSDI scores, meibography score, lid margin abnormalities increased at 2wk, 1 and 3mo postoperatively compared to before operation(all P<0.05); BUT decreased(P<0.05).

CONCLUSION: Meibomian gland function may be aggravated after phacoemulsification surgery.

Abstract:AIM: To compare the influence of endolaser or cryotherapy on capsule contraction syndrome(CCS)following phaco-vitrectomy and intraocular lens implantation in patients with rhegmatogenous retinal detachment.

METHODS: A total of 244 eyes were enrolled in this retrospective analysis. The surgical approach was standard vitrectomy combined with phacoemulsification and intraocular lens(IOL)implantation simultaneously. There were 198 eyes underwent endolaser and 46 eyes underwent cryotherapy during the surgery. The main outcome measures were postoperative clinical outcomes including anatomical position of retina, the capsules and the position of IOLs and best corrected visual acuity(BCVA)at 1d, 1wk, 1, 2, 3, 6mo and 1a.

RESULTS: There were 6 eyes(3.0%)of CCS occurred in endolaser group and 5 eyes(10.9%)of CCS occurred in cryotherapy group. The different procedures during the surgery were significantly associated with the incidence of CCS(odds ratio: 0.256, P=0.021, 95%CI: 0.075-0.880).

CONCLUSION: Different procedures during phaco-vitrectomy surgery are significantly associated with the incidence of CCS. Endolaser is more beneficial than cryotherapy in preventing CCS following phaco-vitrectomy and intraocular lens implantation.

Abstract:AIM: To explore the change of postoperative macular structure in primary angle closure disease(PACD)complicated with cataract.

METHODS: The clinical data of 200 cases of PACD patients complicated with cataract treated in our hospital were analyzed retrospectively. The patients were divided into the Group A(n=60, 60 eyes, treated with trabeculectomy), the Group B(n=72, 72 eyes, given the phacoemulsification combined with intraocular lens implantation)and the Group C(n=68, 68 eyes, given the trabeculectomy and phacoemulsification combined with intraocular lens implantation). The vision changes before and after treatment and the changes of intraocular pressure and macular thickness(foveal area, near central area, foveal surrounding area)before operation and at 1wk, 1 and 3mo after operation were compared and observed, and the incidence of complications was compared between the two groups.

RESULTS: There were significant differences in the improvement rate and reduction rate of visual acuity among three groups at 3mo after operation(P<0.01), and the vision improvement rate in Group C was highest, while that in the Group A was the lowest. The intraocular pressure(IOP)of the three groups at 1wk, 1 and 3mo after operation was significantly lower than that before operation(P<0.05), and the IOP in the Group B was significant higher than that in the Group A and the Group C at 1wk, 1mo after operation(P<0.05), and there were significant differences in the thickness of foveal area and near central area among three groups before and after operation(P<0.05). And the macular thickness(foveal area, near central area, foveal surrounding area)in the Group A and C at 1wk, 1 and 3mo after operation was significantly thicker than that before operation(P<0.05), and the macular thickness of foveal area in the Group B was significantly thicker at 1wk and 1mo after operation than that before operation(P<0.05). And the comparison between groups showed that the macular thickness(foveal area, near central area)in the Group C at 1wk, 1 and 3mo after operation was significantly less compared with that in the Group A and the Group B(P<0.05). There were significant differences in the incidence rate of complications among three groups(P<0.01), and the incidence rate in the Group A was significantly higher than that in the Group B and the Group C(P<0.05).

CONCLUSION: Phacoemulsification combined with intraocular lens implantation can relieve angle closure caused by pupillary block and lens factors, and can significantly improve the vision and reduce intraocular pressure of PACD patients with cataract, and it has small effects on postoperative macular edema with few complications.

Abstract:AIM: To observe the clinical effect of vitrectomy combined with cataract surgery in the treatment of proliferative diabetic retinopathy(PDR).

METHODS: Totally 80 patients(83 eyes)with PDR who underwent treatment in the hospital during the period from February 2013 to February 2017 were selected and divided into the control group and the observation group according to the treatment method. The control group was treated by vitrectomy combined with lensectomy while the observation group was treated by vitrectomy combined with phacoemulsification. The clinical curative effect was compared between the two groups.

RESULTS: After surgery, the visual acuity of the two groups was improved significantly, and the visual acuity of the observation group was better than that of the control group(P<0.05). The incidence rates of iris neovascularization(INV)and capsular opacities in the observation group after surgery were lower than those in the control group(P<0.05).

CONCLUSION: The clinical effect of vitrectomy combined with phacoemulsification is better than that of vitrectomy combined with lensectomy in the treatment of PDR.

Abstract:AIM: To analyze the clinical efficacy of phakic posterior chamber implantable contact lens(ICL)implantation on high myopia patients.

METHODS: Thirty-four patients(68 eyes)who checked and diagnosed as high myopia in our hospital from June 2014 to June 2015 were selected as the clinical research subjects, and all the patients were given phakic posterior chamber intraocular lens implantation treatment. The diopter, visual acuity recovery, central anterior chamber depth, corneal endothelial cell count, and intraocular pressure after treatment were observed.

RESULTS: The equivalent spherical refraction, central anterior chamber depth, uncorrected visual acuity and best corrected visual acuity recovery at 1, 3 and 6mo, 1 and 2a after treatment were better than those before treatment, and the differences were statistically significant(P<0.05). There were no significant differences in corneal endothelial cell count and intraocular pressure at 1, 3 and 6mo, 1 and 2a after treatment compared with those before treatment(P>0.05). There were no significant differences in uncorrected visual acuity, best corrected visual acuity, equivalent spherical refraction and central anterior chamber depth at 1, 3mo and 1 and 2a after treatment(P>0.05).

CONCLUSION: The application of phakic posterior chamber intraocular lens implantation for the treatment of high myopia patients can improve the equivalent spherical refraction and central anterior chamber depth, improve uncorrected visual acuity, meanwhile, it has less effect on the patient's intraocular pressure and corneal endometrial cells, the effect maintenance and safety is better which meet their expectations.

Abstract:AIM: To investigate the effect of phacoemulsification intraocular lens implantation combined with trabeculectomy on ocular surface in the treatment of glaucoma and cataract.

METHODS: Totally 45 cases of patients with glaucoma and cataract in our hospital from February 2016 to February 2017 were enrolled. All the patients had unilateral disease, and the medical records of the patients were analyzed retrospectively. The sicked eyes were set as the observation group and contralateral eyes were set as the control group. The dry eye score, break-up time(BUT), corneal fluorescein staining score(FL), tear secretion test(SⅠt)and conjunctival epithelium goblet cell density(CIC)was compared between two groups before operation and at 1wk, 1 and 3mo after operation.

RESULTS: The preoperative dry eye score of the observation group had no significant difference with that of the control group(P>0.05). At 1wk, 1mo after operation, data of the observation group was significantly higher than that of the control group and before operation, with statistical significance(P<0.05), no significant difference was shown at postoperative 3mo(P>0.05). Preoperative BUT of the observation group had no significant difference with that of the control group(P>0.05); at 1 wk,1 and 3mo after operation, data of the observation group was significantly lower than that of the control group and before operation, with statistical significance(P<0.05). The preoperative FL score of the observation group was significantly higher than that of the control group, while the postoperative FL score of the observation group at 1wk, 1 and 3mo had sharp difference with that before operation(P<0.05), all were significantly higher than that of the control group, there was statistical significance(P<0.05). There was no significant difference in SⅠt score between the observation group and the control group preoperatively(P>0.05), and the postoperative SⅠt scores of the observation group at 1wk, 1 and 3mo postoperatively was evidently lower than that of the control group and before operation(P<0.05). There was no significant difference in CIC density between the two groups preoperatively. While the postoperative data of the observation group at 1wk, 1 and 3mo postoperatively was significantly lower than that of the control group and before operation, with statistical points(P<0.05).

CONCLUSION: Phacoemulsification intraocular lens implantation combined with trabeculectomy for treatment of glaucoma and cataract can aggravate dry eye symptoms, as well as reduce tear film stability and tear secretion, impair conjunctival epithelium goblet cell.

Abstract:AIM: To evaluate the effects of long-term low-dose aspirin on intraoperative and preoperative hyphema of laser peripheral iridectomy(LPI).

METHODS: The included 63 cases(63 eyes)with primary angle closure glaucoma went to our hospital from January 2014 to June 2017 were divided into two groups: Group A was control group and Group B was study group, according to whether taken aspirin. The hyphema was compared between the two groups.

RESULTS: There was no significant difference between the two groups in intraoperative and postoperative hyphema(P>0.05). No serious hyphema occurred.

CONCLUSION: LPI can be performed safely without stopping aspirin.

Abstract:AIM: To analyze the clinical efficacy and safety of vitrectomy combined with cyclophotocoagulation in the treatment of traumatic glaucoma, and to provide an effective treatment for improving the quality of life of patients with traumatic glaucoma.

METHODS: Totally 90 patients(90 eyes)with traumatic glaucoma admitted in our hospital from January 2011 to July 2016 were divided into two groups(45 patients in each group)according to different treatment methods. The patients in the observation group underwent vitrectomy combined with cyclophotocoagulation under direct vision; the control group underwent vitrectomy combined with trans-scleral cyclophotocoagulation. We observed the effect of different treatment on visual acuity, intraocular pressure and complication of the two groups.

RESULTS: The visual acuity of the observation group was significantly better than that of the control group after treatment(Z=-5.689, P<0.05). There was no significant difference on intraocular pressure between the two groups before treatment(P>0.05). The change of decreased intraocular pressure in the observation group was less than that in the contral group after operation(P<0.05). After 1a follow-up, there was no significant difference on the change of decreased intraocular pressure between the two groups(P>0.05). The complications of the two groups after treatment were vitreous hemorrhage, choroidal detachment, low intraocular pressure, increased intraocular pressure and other complications, but the complication rate of two groups were no different(χ²=1.553, P=0.213).

CONCLUSION: Vitrectomy combined with cyclophotocoagulation under direct vision brings patients better visual acuity than that combined with trans-scleral cyclophotocoagulation.

Abstract:AIM: To investigate the efficacy of intravitreal injection of Conbercept in the treatment of diabetic macular edema(DME).

METHODS: Totally 95 patients(95 eyes)with diabetic macular edema treated in our hospital from January 2014 to December 2016 were retrospectively analyzed, and 42 cases received Ranibizumab intravitreal injection were included into control group, 53 cases treated with conbercept intravitreal injection were included into observation group. The changes of preoperative and postoperative follow up visual acuity and macular foveal thickness in the two groups were observed. The repeated medication, complications and medical expenses were also compared.

RESULTS: The preoperative best corrected visual acuity between groups showed no difference(P>0.01). The postoperative best corrected visual acuity between groups showed distinct difference(F=105.326, P<0.01; F=86.365, P<0.01). At 3mo after the operation, visual acuity of two groups sharply improved, a significant difference was shown within the groups(P<0.05), but held no obvious difference between groups(P>0.05). At 6mo after operation, the observation group's visual acuity was evidently higher than that at 3mo(P<0.05). The visual acuity at postoperatively 6mo of the observation group was significantly higher than that of the control group, the difference between groups was statistically marked(P<0.01). The control group's visual acuity at postoperative 3 and 6mo showed no marked difference(P>0.05). The overall changes of foveal thickness between two groups showed a significant difference(F=86.365, P<0.01; F=84.235, P<0.01). The foveal thickness reduced obviously during the postoperative 1, 3 and 6mo of followed up, which showed remarkable difference within groups(P<0.05)but no difference between groups(P>0.05). The repeated medication of observation group during the postoperative 1, 3 and 6mo of followed up was evidently less than that of the control group, the difference between groups was significant(P<0.05). There was no statistical difference between groups in complications after operation(P>0.05). The average medical cost of the observation group was obviously less than that of the control group, and the difference between the two groups was evident(P<0.01).

CONCLUSION: Intravitreal injection of conbercept in the treatment of diabetic macular edema can effectively enhance vision and relieve macular edema, as well as shows lasting efficacy, low cost and high safety.

Abstract:AIM: To observe the clinical efficacy of intravitreal injection of ranibizumab combined with retinal laser photocoagulation for macular edema secondary to branch retinal vein occlusion(BRVO).

METHODS: A total of 47 cases(47 eyes)of patients diagnosed of macular edema secondary to BRVO by fundus examination, fundus fluorescein angiography(FFA)and optical coherence tomography(OCT)were included who were admitted to our hospital from August 2013 to March 2016. All patients were divided into two groups randomly, 47 of them finished the follow up. observation group composed of 25 patients(25 eyes)who underwent ranibizumab injection and after 2wk they received retinal laser photocoagulation for blocking venous reflux area, and control group consisting of 22 cases(22 eyes)were given intravitreal injection of ranibizumab alone. The best corrected visual acuity(BCVA), intraocular pressure(IOP), central macular retinal thickness(CMT)and the incidence of complications of patients from two groups were compared at the first month after the treatment.

RESULTS: Observation group and control group's BCVA and CMT were significantly different at 1mo after treatment compared with before treatment(P<0.01), but IOP were not different(P>0.05). The BCVA at 1mo after treatment were not different between the two groups(P>0.05), the CMT were significantly different(P<0.01).

CONCLUSION: The clinical effect of ranibizumab injection combined with laser photocoagulation for blocking venous reflux area has advantages when compared with ranibizumab injection alone in the treatment of branch retinal vein occlusion, and laser photocoagulation does not stimulate macula with higher security.

Abstract:AIM: To evaluate a deep learning-assisted diagnostic system with an artificial intelligence for the detection of diabetic retinopathy(DR).

METHODS:A total of 186 patients(372 eyes)with diabetes were recruited from January to July 2017. Discrepancies between manual grades and artificial intelligence results were sent to a reading center for arbitration. The sensitivity and specificity in the detection of DR were determined by comparison with artificial intelligence diagnostic system and experts human grading.

RESULTS:Based on manual grades, the results as follows: non DR(NDR)in 42 eyes(11.3%), 330 eyes(88.7%)in different stages of DR. Among 330 DR eyes, there were mild non proliferative DR(NPDR)in 62 eyes(16.7%), moderate NPDR in 55 eyes(14.8%), severe NPDR in 155 eyes(41.7%), and proliferative DR(PDR)in 58 eyes(15.6%). Based on artificial intelligence diagnostic system, the results were as follows: NDR in 38 eyes(10.2%), PDR in 44 eyes(11.8%), others were NPDR. The sensitivity and specificity of artificial intelligence diagnostic system, compared with human expert grading, for the detection of any DR were 0.82 and 0.91, and the kappa value was 0.77(χ²=20.39, P<0.05).

CONCLUSION: This study shows that a deep learning-assisted diagnostic system with an artificial intelligence for grading diabetic retinopathy is a reliable alternative to diabetic retinopathy assessment, thus the use of this system may be a valuable tool in evaluating the DR.

Abstract:AIM: To retrospectively analyze the prevalence of retinopathy of prematurity(ROP)in 3471 neonates in Suzhou Municipal Hospital.

METHODS: A total of 3471 children(1947 males, 1524 females)were screened for ROP in Suzhou Municipal Hospital from January 2010 to September 2016 using binocular ophthalmoscope or(and)RetCamII. First examination was performed from 4-6wk after birth. The ocular findings were recorded according to the International Classification of ROP and The Early Treatment for ROP. Only the more aggressive eye of bilateral asymmetrical cases was counted for statistical purpose. Children with ROP in both binocular or single eye were counted in 1 case, and the cases required surgeries were defined as severe cases. The prevalence of ROP and severe ROP in recent 6a were analyzed retrospectively.

RESULTS: The overall relevance ratio of ROP and severe ROP was 17.03% and 1.15%. The relevance ratio of ROP and severe ROP of the males were 16.38% and 1.08%, and of the females were 17.85% and 1.25%, the results were not statistically different(χ²=1.296, P=0.255). The relevance ratio of ROP and severe ROP of the single birth infants were 17.61% and 1.13%, and of the multiple birth infants were 15.13% and 1.23%, the results were not statistically different(χ²=2.706, P=0.100). The children were divided into 5 groups according to the birth weight. The relevance ratio of ROP with birth weight <1000g, 1000-1499g,1500-1999g, 2000-2499g and ≥2500g were 75.00%, 36.17%, 10.75%, 6.86% and 3.77% respectively with significant differences(There were significant differences between the three groups which the birth weight <2000g, P<0.005). The relevance ratio of severe ROP were 36.54%, 1.68%, 0.31%, 0.19% and 0 respectively in these birth weight groups(There were significant differences between the three groups which the birth weight <2000g, P<0.005). The children were divided into 4 groups according to gestational weeks, the relevance ratio of severe ROP of gestational age <28wk, 28-31wk, 32-36wk and ≥37wk were 69.12%, 29.91%, 8.28% and 3.33% respectively with significant differences(There were significant differences between the three groups which the gestational age <37wk, P<0.005). The relevance ratio of severe ROP were 25%, 1.52%, 0.24% and 0 in these gestational age groups respectively(There were significant differences between the three groups which the gestational age <37wk, P<0.005).

CONCLUSION: The detection rate of ROP in 3471 premature infants was 17.03%, the severe ROP was 1.15%. There was no evidence that sex and birth were related to ROP, but lower birth weight and smaller gestational age increased the detection rate of ROP.

Abstract:AIM: To investigate tear film changes in children after acute conjunctivitis were treated.

METHODS: A perspective cohort study was conducted. Sixty-four acute conjunctivitis cases(64 unilateral eyes)from January 2016 to January 2017 were investigated in this study. Other tear film factors which could affect the conditions of dry eye were excluded. The height of tear meniscus, fluorescein staining(FL), tear film break up time(BUT)and Schirmer Ⅰ test(SⅠt)were checked and measured on both recovered eye and healthy eye of the patients at 3, 7, 14 and 30d after recovery, respectively.

RESULTS: The height of tear meniscus was 0.43±0.18mm in healthy eyes, 0.25±0.11mm, 0.23±0.13mm, 0.34±0.26mm in cured eyes at 3, 7 and 14d, all significantly lower than that in healthy eyes(t= -24.364, -24.042, -8.398,P<0.05), but that at 30d(0.44±0.06mm)was not different(t=1.987, P>0.05). FL scored 1.27±0.96 in healthy eyes, those of cured eyes were 2.13±0.75, 5.56±2.28, 4.21±0.91 at 3, 7 and 14d, significantly higher than that in healthy eyes(t=6.437, 18.303, 20.386; P<0.05); but that at 30d was 1.81±2.13 without difference(t=1.44, P>0.05). BUT was 13.33±2.75s in healthy eyes, those of cured eyes were 5.46±0.9s, 6.34±1.75s, 7.72±1.77s at 3, 7 and 14d, significantly lower than that in healthy eyes(t=-50.731, -50.522, -38.706; P<0.05); but that at 30d was 12.07±2.23s without difference(t=-1.470, P>0.05). SⅠT was 14.07±3.84mm/5min in healthy eyes, those of cured eyes were 8.03±1.79, 11.28±2.33, 12.59±2.56mm/5min at 3, 7 and 14d, significantly lower than that in healthy eyes(t=-20.892, -9.104, -6.710; P<0.05); but that at 30d was 13.57±3.46mm/5min without difference(t=-0.969, P>0.05).

CONCLUSION: The short-term tear film instability and reversible dry eye might be arisen in children after acute conjunctivitis recovery. Considering the drug side effects to the tear film and minimizing the unnecessary use of drugs, however, dry eye can be avoided during the treatment of acute conjunctivitis. At the same time, the artificial tears could function to reduce the occurrence of xerophthalmia.

Abstract:AIM: To evaluate the effects of foldable capsular vitreous body(FCVB)implantation on the treatment of severe ocular trauma and late silicone oil-dependent eyes due to severe ocular trauma and recurrent retinal detachment.

METHODS: We retrospectively reviewed the four patients(four eyes)with FCVB implantation at our hospital since November 2017. Out of these 4 patients, 2 were males and 2 were females, with an average age of 31.5 years and an average intraocular pressure(IOP)of 5.6mmHg pre-operatively. Among those 4 eyes, 3 eyes underwent silicone oil tamponade due to severe ocular trauma and the other one was recurrent retinal detachment in silicone oil-filled eye. Standard pars plana vitrectomy(PPV)was performed, and the FCVB was triple folded and implanted in the vitreous cavity of four eyes. The retinal was assessed, as well as visual acuity, IOP, FCVB condition before and after treatment, and applied therapy.

RESULTS: All of those 4 eyes underwent successfully implantation of FCVB, which remained its proper position. During 1-3mo follow-up, the mean visual acuity was no different compared with pre-operative values. However, the average IOP was 10mmHg postoperatively. In addition, no retinal detachment was found using B-scan ultrasound after FCVB implantation. Moreover, FCVB-supported fundus was stable and no complication was found.

CONCLUSION: FCVB implantation is a safe and effective method for the treatment of severe ocular trauma and late silicone oil- dependent eyes. It can maintain the morphology as well as IOP of those eyes.

Abstract:AIM: To observe the clinical effect of limbal conjunctival autograft transplantation(LCAT)or amniotic membrane transplantation(AMT)in treatment of primary pterygium.

METHODS: Analysis of 96 cases(96 eyes)with primary pterygium treated at Shenzhen People's Hospital from January 2013 to December 2015 was taken. Depending on the surgical methods, the patients were divided into two groups: excision of pterygium and limbal conjunctival autograft transplantation being performed in LCAT group(46 cases, 46 eyes); excision of pterygium and amniotic membrane transplantation being performed in AMT group(50 cases, 50 eyes). Two groups were followed-up for 12mo to compare the operation time, the corneal epithelium repair time, postoperative complications and the recurrence rate.

RESULTS: The operation time of LCAT and AMT group was 33.83±1.65min, 23.60±1.51min respectively, the LCAT group was higher than the AMT group(t=-31.683, P<0.001). The corneal epithelium repair time of LCAT and AMT group was 4.04±0.95d, 4.67±1.18d respectively, the LCAT group was lower than the AMT group(t=-2.922, P=0.004); 1 case was recurred in LCAT group, 3 cases were recurred in AMT group. The recurrence rate was 2% in LCAT group and 6% in AMT group, but it hadn't show a significant statistical difference between the two groups(P=0.618). One case of conjunctival granuloma was observed in 2wk after surgery of LCAT group, but no serious complications were observed in AMT group.

CONCLUSION: Limbal conjunctival autograft transplantation and amniotic membrane transplantation are effective and safe methods to primary pterygium, which have advantages of rapid recovery, fewer complications and the lower recurrence rate.

Abstract:AIM: To study the therapeutic method of XL-radiofrequency ablation skin apparatus(invented by Rehabilitation medicine, PLA General Hospital)in micro-resecting the lacrimal punctum neoplasm and to observe its clinical effects.

METHODS: XL-radiofrequency ablation skin apparatus was performed on 7 cases(7 eye lesions)of lacrimal punctum neoplasm including 3 intradermal nevus, 1 boundary nevus, 1 mixed nevus with inflammatory granuloma, 1 inflammatory granuloma, and 1 squamous papillary cell tumor by separating layer, point and flake removing methods. The clinical effect was investigated 2-6mo postoperatively and leftover was removed by twice. The postoperative follow-up durations ranged from 6 to 60mo.

RESULTS: Totally 6 cases(6 eye lesions)were cured successfully by once but 1 case by twice. They were all without recurrence, cicatrix, palpebral margin deformity, obstruction of lacrimal punctum, stenosis of lacrimal punctum or epiphora. Micro-resecting the lacrimal punctum neoplasm using the XL-radiofrequency ablation skin apparatus had several advantages, such as high accuracy, no cicatrix, no bleeding, no epiphora, no damage to the structure of lacrimal canaliculus, short operation time, little pain during the procedure, without hospitalization, slight inflammation reaction after procedure.

CONCLUSION: The efficacy of XL-radiofrequency ablation skin apparatus is significantly more evident and highly accurate in micro-resecting lacrimal punctum neoplasm.

Abstract:AIM:To investigate the clinical effect of high-frequency electric lacrimal duct plasty and annular lacrimal drainage tube implantation combined with acupuncture on upper lacrimal duct obstruction.

METHODS: A total of 86 patients(102 eyes)with upper lacrimal duct obstruction who were treated in our department from July 2013 to June 2016 were 26 males(28 eyes)and 60 females(74 eyes). The treatment was high-frequency electric lacrimal duct plasty and annular lacrimal drainage tube implantation, combined with traditional Chinese medicine acupuncture plus oral medicine made by our department for 30d, followed up for 6mo after surgery to observe the effect.

RESULTS: A total of 86 eyes(84.3%)were cured in 102 eyes, 12 eyes(11.8%)were improved, 4 eyes(3.9%)were ineffective, and the total effective rate was 96.1%.

Intraoperative complications: 1)orbital hemorrhage in 2 eyes, maybe caused by vessel injury at the front of ethmoidal sinus, the blood was stopped after press, the operation went successfully after 5d; 2)lacrimal duct rupture in 3 eyes, all because of uncareful operation or weak compliance; 3)the duct was hard to implanted in 3 eyes and iatrogenic sinus occurred, we suggested them went to superior hospital. Postoperative complications: 1)lacrimal duct rupture without epiphora in 3 eyes(2.9%); 2)the duct draw out in 5 eyes(3.9%), the duct was draw and fixed to nasal vestibule, in other 4 eyes(4.9%)with fully draw out, in one of the 4, the duct was replaced and in the rest 3 of the 4, no treatment; 3)irritation symptoms at inner canthus in 11 eyes(10.8%)with symptomatic treatment; 4)granulation tissue hyperplasia in 2 eyes(2.0%), one of them near the lacrimal punctum was cut and disappeared after tobramycin dexamethasone eye drops, one in the lacrimal ductile, the duct was draw and after tobramycin dexamethasone eye drops or compound neomycin sulfate eye drops the hyperplasia did not enlarge, but the lacrimal passage irrigation was failed.

CONCLUSION:It is effective of high-frequency electric lacrimal duct plasty and annular lacrimal drainage tube implantation combined with acupuncture on upper lacrimal duct obstruction.

Abstract:AIM: To evaluate the efficacy and safety of intravitreal injection of Conbercept as the treatment of choroidal neovascularization due to high myopia.

METHODS: The study was a retrospective analytical case series. We reviewed medical records of 15 patients(16 eyes)with choroidal neovascularization second to high myopia that had enrolled in our hospital from January 2013 to December 2016. All patients have received one or more conbercept injections based on medical condition and observed the best corrected visual acuity(BCVA)and macular retinal thickness before and after the last injection. The duration of the last follow-up was from 1.5mo to 28mo.

RESULTS: Totally 15 patients(16 eyes)were enrolled in this study. All patients received conbercept injections. Among all the patients, 6 eyes were given one treatment, 7 eyes were given two treatments and 3 eyes three treatments. Before retreatment, the mean intraocular pressure was 16.44±1.39mmHg before treatment, and the average intraocular pressure was 16.75±1.41mmHg after the last treatment. The difference was not statistically significant(P>0.05). BCVA was 1.14±0.35 before treatment, BCVA was 0.71±0.21 at the last follow-up. The difference was statistically significant(P<0.05). The thickness of the macular retina was 361.63±33.59μm before treatment, and it was 287.25±30.31μm at the last follow-up, and the difference was statistically significant(P<0.05). And there was no case of endophthalmitis, stroke, and retinal detachment during follow-up.

CONCLUSION: Intravitreal injection of conbercept can effectively improve the patient's BCVA in the short term and reduce the macular fovea retinal thickness. No significant adverse events are observed.

Abstract:AIM:To investigate and compare the application of two screening models in the detection of retinopathy of prematurity(ROP).

METHODS: The clinical data of 600 premature infants(1200 eyes)who underwent screening of eye diseases in the Department of Ophthalmology during the period from January 2016 to January 2017 were analyzed retrospectively. The fundus lesions were examined with binocular indirect ophthalmoscope(BIO)and the third generation of wide-angle digital retinal imaging system(RetCam III). The examination results and adverse events during operation were statistically analyzed.

RESULTS: In 1200 eyes of 600 patients, the probabilities of ROP detected by BIO and RetCam III were 10.92% and 10.75%, respectively(P>0.05). With BIO as the golden standard, the accuracy, sensitivity, specificity, positive predictive value and negative predictive value of RetCam III in examining ROP were 98.67%, 93.13%, 99.35%, 94.57% and 99.16%, respectively. There was no significant difference in the stage of ROP detected by BIO or RetCam III(P>0.05). The probabilities of non-ROP lesions examined by BIO and RetCam III were 4.83% and 4.58%, respectively(P>0.05). With BIO as the golden standard, the accuracy, sensitivity, specificity, positive predictive value and negative predictive value of RetCam III in examining fundus non-ROP diseases were 99.67%, 94.83%, 99.91%, 98.21% and 99.74%, respectively. During the screening of BIO and RetCam III, there were 17 cases(2.83%)and 7 cases(1.17%)with adverse events, respectively(P<0.05).

CONCLUSION: The examination results of RetCam III are basically the same as those of BIO for ROP and non-ROP diseases. However, RetCam III has more advantages in reducing adverse events during operation.