Abstract:AIM: To evaluate higher order aberrations(HOAs)of the corneal surface in normal and keratoconic eyes.

METHODS: Using an OPD-Scan Ⅱ wavefront analyzer, aberrometric parameters of the corneal surface in one eye of 80 patients with keratoconus(KC)and 91 participants with normal eyes were evaluated. The Zernike coefficients from third- to sixth-order as well as root mean square(RMS)of primary coma, coma-like aberrations, and total HOA were calculated and compared between both groups.

RESULTS: Statistically significant differences were found in all aberrometric parameters between the measurements of the KC and normal participants(P<0.001). All of the aberrometric parameters were significantly higher in the KC patients compared to the normal group(P<0.001).

CONCLUSION: Corneal wavefront measurements by means of OPD-Scan Ⅱ were significantly higher in keratoconic corneas than normal corneas.

Abstract:AIM: To compare the incidence of posterior capsule folds among different types of intraocular lens(IOL)to determine risk factors of posterior capsule folds.

METHODS:It was a retrospective study. We collected the cases in which the patients underwent phacoemulsification(PHACO)and IOL implantation and at least one of the three types of IOL was implanted, including 2-haptic 3-piece IOLs(HOYA PY60AD), 4-haptic 1-piece IOLs(Bausch & Lomb AO), 2-haptic 1-piece IOLs(AMO Tecnis ZCB00). The posterior capsule folds were measured using slit lamp microscope 2d after the surgery. Information of patient's age, gender, length of ocular axis, intraocular pressure, types of IOL were recorded. Posterior capsule fold risk indicators were identified by using logistic regression analysis.

RESULTS: One hundred eighty-seven patients(242 eyes)had been collected, including 80 eyes implanted with HOYA PY60AD IOLs, 81 eyes implanted with Bausch & Lomb AO IOLs, 81 eyes implanted with AMO Tecnis ZCB00 IOLs. The incidence of posterior capsule folds of patients implanted with HOYA PY60AD IOLs was significantly higher than those of patients implanted with AMO Tecnis ZCB00 IOLs(56.3% vs 38.3%, P=0.027). While the incidence of patients implanted with Bausch & Lomb AO IOLs was significantly lower than those of patients implanted with AMO Tecnis ZCB00 IOLs(14.8% vs 38.3%, P=0.001). Multi-factor logistics regression analysis demonstrated that independent risk factors were type of IOLs and length of ocular axis. Compared with AMO Tecnis ZCB00 IOLs, using HOYA PY60AD IOLs increased the risk of posterior capsule folds \〖P=0.020, OR(95%CI)=2.145(1.129,4.073)\〗, while using Bausch & Lomb AO IOLs reduced the risk \〖P=0.001, OR(95%CI)=0.274(0.127, 0.591)\〗. Shorter ocular axis might increase the risk of posterior capsule folds \〖P=0.012, OR(95%CI)=0.669(0.489, 0.915)\〗.

CONCLUSION: Haptic design should be an important consideration in IOL design. Compared with AMO Tecnis ZCB00 IOLs, using HOYA PY60AD IOLs is more likely to lead to posterior capsule folds formation, while using Bausch & Lomb AO IOLs is less likely to lead the formation. The posterior capsule folds are more engendered in eyes with shorter ocular axis.

Abstract:This study aims to describe the treatment efficacy of supratarsal injection of triamcinolone acetonide and dexamethasone sodium phosphate for paediatric vernal keratoconjuctivitis(VKC)over a 5-year-period in Hospital Universiti Sains Malaysia. Totally 10 patients were treated with this combination injection had clinical improvement by 1mo post injection. The main complication was increased intraocular pressure(4 patients). Four patients had recurrences within 6mo. We concluded that the clinical response to supratarsal combination corticosteroids in VKC is fairly similar to that reported in the literature using a single corticosteroid agent. However, the risk of increased intraocular pressure is higher.

Abstract:AIM: To investigate the effects and mechanism of miR-138 in mediating the antioxidant function of lens epithelial cells affected by age-related cataracts.

METHODS: Real-time quantitative PCR(RT-qPCR)was used to detect miR-138 expression in the anterior lens capsules of healthy people, the anterior lens capsules of patients with age-related cataracts, and human epithelial cell line(SRA01/04)cells exposed to oxidative stress. A 2', 7'-dichloro-fluorescein diacetate(DCFH-DA)probe was used to measure the levels of endogenous reactive oxygen species(ROS)in human lens epithelial cells(hLECs)exposed to 400μmol/L H₂O₂ for 1h. SRA01/04 cells were transfected with either miR-138 mimics, mimic controls, miR-138 inhibitors or inhibitor controls. After 72h, these cells were exposed to 400μmol/L H₂O₂ for 1h, then p53 and Bax mRNA expression were measured using RT-qPCR. Expression of p53 and Bax protein were also measured by western blotting analysis. Finally, cell viability was assessed using an MTS assay.

RESULTS: Compared to the control group, expression of miR-138 in the anterior lens capsules of age-related cataract patients and in SRA01/04 cells exposed to oxidative stress significantly increased(P<0.001). Levels of endogenous ROS were significantly elevated in hLECs exposed to oxidative stress(P<0.001). Compared to the mimic control group, the hLECs in the miR-138 mimic group expressed significantly higher levels of p53 and Bax mRNA and protein while cell viability was significantly reduced(P<0.001). Conversely, p53 and Bax mRNA and protein expression were significantly reduced in the miR-138 inhibitor group as compared to the control group, while the cells in this group had much higher levels of cell viability(P<0.001).

CONCLUSION: The expression of miR-138 is upregulated in the anterior lens capsules of age-related cataract patients. MiR-138 decreases the anti-oxidative stress capacity of lens epithelial cells by upregulating p53 and Bax, while inhibiting cell proliferation and repair. This finding suggests that miR-138 may play a key role in the development of age-related cataracts.

Abstract:AIM: To investigate the effect and mechanism of Caspase-1 on microglia in oxygen-induced retinal neovascularization in mice.

METHODS: Twelve 7-day-old(P7)C57BL/6J mice were randomly divided into normal group, OIR group and OIR+VX-765 group. OIR models were established in OIR group and OIR+VX-765 group. Caspase-1 inhibitor VX-765(4mg/kg, dissolved in 0.4% polyethylene glycol)or 0.4% polyethylene glycol, were intraperitoneally injected from P12 to P16 into the mice of OIR+VX-765 and OIR groups, respectively. Whole retinal flatmounts of P17 mice were prepared, and Lectin staining was performed to calculate the ratio of avascular and neovascular area to retina area. The frozen sections of the posterior ocular segment were prepared, and the distribution of Caspase-1 and activated microglial cells were detected by immunofluorescence technique. Cultured BV-2 cells were divided into control group, hypoxia group and inhibitor group. The cells of inhibitor and hypoxia groups were pre-treated with VX-765 or 0.4% polyethylene glycol for 3h, and then hypoxic incubated for 24h. The expression levels of Caspase-1, p20(active form of Caspase-1), IL-1β and VEGF were detected by Western blotting. The angiogenesis and migration capacity of cultured RF/6A cells were assessed by endothelial cell tube formation assay and migration assay, after they were incubated with supernatant of those different BV-2 groups.

RESULTS:The distribution and morphology of retinal blood vessels were normal in P17 mice of the normal group, and avascular and new blood vessel cluster were found in the mice of OIR group and OIR+VX-765 group. The ratio of avascular area was 12.23%±1.02% and that of the new blood vessel area was 2.16%±0.52% in the OIR+VX-765 group, which decreased in comparison with 16.58%±1.14% and 4.00%±0.41% of the OIR group(P<0.01). Caspase-1 was rarely detected by immunofluorescence staining in the normal retina of the mice, whereas it was mainly co-located with activated microglial cells in the ganglion cell layer and the inner plexiform layer in the mice of OIR group. The expression of Caspase-1, p20, IL-1β and VEGF increased in BV-2 cells of the hypoxia group, which were down-regulated by VX-765(P<0.05), except Caspase-1. The tube length was 271±12, and the number of migrated cells was 347±34 in RF/6A cells cultured with supernatant of BV-2 cells in the hypoxia group, which significantly decreased to 171±22 and 212±27 with inhibitor of Caspase-1(P<0.05).

CONCLUSION:Caspase-1 promotes retinal neovascularization in the mice with OIR, probably by activating the downstream inflammatory factor IL-1β in microglial cells and accelerating the release of VEGF.

Abstract:AIM: To investigate the role of small interference RNA interference targeted Integrin-linked kinase(ILK SiRNA)on the proliferation and apoptosis of human Tenon fibroblasts(HTFs)induced by transforming growth factor-β₂ (TGF-β₂).

METHODS: The HTFs were identified by immunofluorescence analysis with Vimentin and keratin. HTFs with no other addiction was as normal control; H+T group: HTFs+5μg/L TGF-β₂; H+T+NC SiRNA group: HTFs+5μg/L TGF-β₂+50nmol/L negtive SiRNA; H+T+ILK SiRNA group: HTFs+5μg/L TGF-β₂+50nmol/L ILK SiRNA. The ILK SiRNA were transfected into HTFs by lipofectamine 2000, then the cells were stimulated with 5μg/L TGF-β₂. The protein expression of ILK were analyzed by Western Blot. The proliferation levels of HTFs were analyzed by CCK-8, the apoptosis of HTFs were analyzed by Hoechst 33342/PI double staining.

RESULTS: The protein ILK were expressed in both TGF-β₂ treated and control groups, and TGF-β₂ up-regulated the expression of ILK, ILK SiRNA inhibited the protein expression of ILK(P<0.05). CCK-8 analysis showed that compared with the normal control group, the cell proliferation rate of HTFs in TGF-β₂ treated group increased, and in ILK SiRNA group the cell proliferation rate was suppressed after exposured to ILK SiRNA for 48h(P<0.05). Hoechst 33342/PI double staining showed that there was no change on the apoptosis of TGF-β₂ stimulated group(P>0.05), compared with the normal control group, however in the ILK SiRNA group, we found lots of apoptosis cells and a few of necrotic cells(P<0.05).

CONCLUSION: The ILK SiRNA attenuates the abnormal proliferation of HTFs induced by TGF-β2, thereby enhancing the apoptosis of HTFs.

Abstract:AIM:To establish a simple and efficient method for the primary culture of rabbit corneal limbus stem cells.

METHODS:Obtained the limbal tissues from rabbits,used tissue block and enzyme digestion method to culture the corneal limbus stem cells in vitro.The growth characteristics of the cultured cells in vitro were observed under inverted microscope.By means of HE,the morphology and construction features of cells were observed.And immunohistochemical method was used to identify the cultured cells.

RESULTS:Rabbit corneal limbus stem cells could be fast and simply cultured by using tissue block and enzyme digestion method.The dynamic observation under microscope showed that rabbit corneal limbus stem cells grew well with a higher proliferative capacity.In HE staining,the morphology and structure of cells were normal.AE5 and P63 cellular immune identification were positive.

CONCLUSION: Tissue block and enzyme digestion method could be a simple and efficient mode for the primary culture of rabbit corneal limbus stem cells.

Abstract:AIM: To compare the pharmacokinetic differences of the 2% diacerein eye drops between conjunctival sac multiple administration and single administration in the cornea, and to provide the experimental basis for clinicians to use the conjunctival sac multiple administration.

METHODS: Male Kunming mice were randomly divided into the multiple administration group and the single administration group. The multiple administration group were given diacerein eye drop every 2min(3 times in total). The concentrations of the metabolites of diacerein in the cornea were measured by high performance liquid chromatography after given eye drop 5, 15, 30, 60, 120, and 180min. The pharmacokinetic parameters were calculated by pharmacokinetic software(DAS2.1.1).

RESULTS: The metabolites of diacerein, rhein, was detected in the cornea at each time point. The concentration of the metabolite of diacerein in the cornea was 318.678±40.88, 210.02±25.66, 188.83±31.74, 112.24±11.70, 90.28±22.01 and 57.67±13.71μg/g after given eye drop 5, 15, 30, 60, 120, and 180min in the multiple administration group. The concentration in the single administration group was 145.17±19.29, 97.95±10.49, 71.18±18.70, 39.11±2.44, 18.10±2.34 and 9.08±2.04μg/g respectively. The concentration of rhein in the cornea was the highest at 5min after the administration in the two groups. The concentration of the multiple administration group was higher than that in the single administration group at 5, 15, 30, 60, 120, and 180min(P<0.01). The half-life of the drug was 0.89±0.31h in the single administration group.

CONCLUSION: Compared with the single administration, the conjunctival sac multiple administration has the advantages of high drug concentration and long duration. Therefor the conjunctival sac multiple administration is a more effective method to treat acute infectious corneal diseases.

Abstract:AIM: To investigate the effects of fundus laser combined with anti-vascular endothelial growth factor(VEGF)therapy on serum levels of NOS, VEGF and IL-6 in patients with diabetic macular edema.

METHODS: From May 2015 to May 2016, 106 cases(156 eyes)of patients with diabetic macular edema in hospital were be selected as the research object. According to the random number table method, 84 eyes of 56 cases were in observation group, 72 eyes of 50 cases in the control group. The control group was given retinal laser treatment, the observation group was treated by retinal laser combined with anti-VEGF therapy. We compared two groups of clinical efficiency, the best corrected visual acuity, macular thickness, complications and serum NOS, VEGF and IL-6.

RESULTS: The best corrected visual acuity significantly increased and the macular thickness significantly decreased in the observation group(P<0.05). The improvement of the best corrected visual acuity and macular thickness in the observation group was obviously better than that of the control group(P<0.05). The level of NOS, VEGF and IL-6 was not different between the two groups before treatment(P>0.05). After treatment, the levels of NOS increased significantly and VEGF and IL-6 decreased significantly in the two groups(P<0.05). The improvement of serum NOS, VEGF and IL-6 in the observation group was better than those in the control group(P<0.05). The total effective rate of clinical treatment in the control group(80.6%)was lower than that of the observation group(94.0%, P<0.05). The incidence of complications in the control group(9.7%)and the incidence of complications in the observation group(7.1%)were not significantly different(P>0.05).

CONCLUSION: This is a safe and effective treatment of fundus laser combined with anti-VEGF drugs in the treatment of diabetic macular edema. It can effectively improve serum NOS, VEGF and IL-6 levels.

Abstract:AIM:To investigate the clinical efficacy of Ranibizumab combined with laser photocoagulation in the treatment of proliferative diabetic retinopathy(PDR).

METHODS: Totally 80 patients(101 eyes)with PDR admitted to our hospital from October 2014 and October 2016 were selected and divided into the observation group and the control group, with 50 eyes and 51 eyes respectively. The patients in the control group(50 eyes)were treated with panretinal photocoagulation(PRP), and the patients in observation group(51 eyes)were treated with ranibizumab on the basis of PRP treatment. Best corrected visual acuity(BCVA)was compared before and after surgery 1, 3, and 6mo. Optical coherence tomography(OCT)was used to examine the central macular thickness(CMT)and the area of neovascularization at each timepoints. Then the laser spot number, laser energy and energy density were compared between the two groups and the adverse reactions were recorded.

RESULTS: Postoperative BCVA of the two groups significantly increased, and the BCVA of observation group were significantly higher than that of the control group after surgery 1, 3, 6mo, the difference was statistically significant(P<0.05). After treatment, the CMT and neovascularization area of the two groups significantly decreased, and those of the observation group were significantly lower than those of the control group after surgery 1, 3, 6mo, the difference was statistically significant(P<0.05). The laser spot number, laser energy and energy density of the observation group were significantly lower than those of the control group, the difference was statistically significant(P<0.05). There were 2 cases(2 eyes)in the observation group and 1 cases(1 eye)in the control group, whose intraocular pressure exceeded 28mmHg, while relieved rapidly after the treatment, and no obvious complications occurred in two groups.

CONCLUSION: Ranibizumab combined with laser in the treatment of PDR is an effective and safe way to improve BCVA, reduce CMT, and eliminate new blood vessels with less required laser energy.

Abstract:Retinal neovascular disease is not an independent eye disease, which is more common seen in many other eye diseases spontaneously and cause serious damage to vision, such as retinopathy of prematurity, diabetic retinopathy, age-related macular degeneration, retinal central venous obstruction and retina venous inflammation, which present retinal neovascularization. The loss of normal blood vessels structure and function, causing pathological bleeding, oozing, edema and retinal detachment and other pathological changes, they are the main reason for loss of vision, which has become a worldwide blindness disease. At present, the main treatment for the disease include of laser occlusion, vitrectomy, repeated vitreous cavity injection of anti-vascular endothelial growth factor, those treatment has significant curative effect, but cannot prevent relapse of the disease. There is still no long-term effective treatment method nowadays. The emergence of stem cell therapy has provided potential alternative therapies. In this review, the latest application of bone marrow mesenchymal stem cells(BMSCs)in retinal neovascular disease will be discussed and present its migration advantages and promising clinical application prospects.

Abstract:Rodents have been used widely in the research of eye diseases to study visual function in animal models. Two methods of visual acuity testing in animals have been internationally recognized: the electrophysiological visual acuity test and the behavioral visual acuity test. Both of these methods have their advantages and limitations. The electrophysiology test(visual evoked potential)is invasive, and animals need recovery time after being implanted with electrodes. Also, the electrophysiological visual acuity test only reflects the electrical activity of a single cell or nuclei, it does not reflect the overall visual function of the animal. The widely used behavioral visual acuity test is able to compensate for these limitations. This paper gives a brief overview of the methods of the behavioral visual acuity test for rodents(rats, mice, guinea pigs, etc.).

Abstract:The common feature of retinal neovascularization is the formation of pathological neovascularization. The primary one of endogenous retinal neovascularization factor in current research is vascular endothelial growth factor(VEGF). SFlt-1, the soluble form of splicing in mRNA extracellular region of VEGFR-1, which is short of intracellular tyrosine kinase domain can only encode the extracellular domain. Therefore, it only can bind with ligands but can not transmit signals, thus preventing the formation of neovascularization. SFlt-1, as a hot research topic in recent years, may provide a new gene therapy method for this disease. This review focus on the mechanism and research progress of sFlt-1 in retinal neovascularization.

Abstract:At present, the orbital wall fracture is a very common facial trauma. The orbital contents are often incarcerated in the fracture cracks resulting in changes in the orbital eye position, then can bring a lifetime of diplopia and enophthalmos, which greatly affects the visual acuity and facial appearance. The purpose of repairing of orbital fracture is reconstructing orbital wall, repairing defect to correct eye position, avoiding enophthalmos and recovering visual function. The review will provide a comprehensive overview of orbital fracture reconstruction.

Abstract:Chronic dacryocystitis is often seen in middle-aged and old women, especially in menopause. The opening of the obstruction of the nasolacrimal duct is the key to the treatment of chronic dacryocystitis. At present, surgical treatment is the main type of operation. The commonly used methods include the transnasal canthus skin dacryocystorhinostomy and the endoscopic dacryocystorhinostomy. With the development of technology, the application of laser technology and new lacrimal duct silicon rubber tube makes the clinical treatment of chronic dacryocystitis more perfect. Lacrimal endoscope technology can obtain more intuitive image of lacrimal duct data, to determine the nature, location and degree of obstruction of lacrimal passage and treatment plan is particularly important, is a major breakthrough in the field of diagnosis and treatment of lacrimal duct obstruction, diagnosis and treatment method is currently the most advanced in the field.

Abstract:Dry eye is a common ocular surface disease, which seriously affects the work and quality of life of the patients. In recent years, physical therapies for dry eye have developed rapidly. This paper summarizes the traditional physical therapies such as fumigation, atomization, eye massage, hot compress, moisture chamber glasses and so on, and bandage contact lenses and scleral contact lenses, intense pulsed light treatment, Blephasteam wet chamber warming device, LipiFlow heat pulse therapy and other advanced physical treatment methods widely used in recent years. We review the recent research progress about physical therapies for dry eye to provide reference for clinical treatment.

Abstract:Eye position control is essential for the management of intermittent exotropia, which it may be a caritia for the surgery intervention, as well as a indicator for the severity of the deviation. Thus, the quantitaties of intermittent exotropia eye position control ability is crucial. This article aims to review the assessment method of the eye position control of intermittent exotropia, so as to clearly a need for a well planned, prospective clinical intervention.

Abstract:AIM: To observe the pupil diameter in different environment on myopia control effect of orthokeratology.

METHODS: The optometry, pupil diameter and eye axial length were examined in 70 patients aged 8- to 13-year-old with low and moderate myopia, whom then were given night wear lenses, and we measured the length of eye axis and pupil diameter before wearing lenses, 6, 12 and 24mo after wearing. In two different light environment groups, each group took the average pupil diameter as the dividing and divided into two subgroups; the pupil diameter higher than the mean group(19 cases, 17 cases respectively), the pupil diameter lower than the mean group(16 case, 18 cases respectively). The paired t-test, independent sample t-test, repeated measures ANOVA and Pearson correlation analysis were adopted to analyze.

RESULTS: Whether in darkroom or exposed to natural light, the axial length of pupils whose diameter was lower than the mean diameter increased faster than that above the average diameter of pupils(P<0.01). The initial pupil diameter was significantly negatively correlated with the growth of the eye axis at the end of the 24-month follow-up(r=-0.4267,P<0.05; r=-0.4925,P<0.01).

CONCLUSION: The myopia controlling effect of orthokeratology under two different illumination conditions showed that the effect of myopia control in children with larger pupils is better than that in children with smaller pupils, which may be that the larger pupil makes the orthokeratology maintain stronger intervention on peripheral retina myopic defocus.

Abstract:AIM: To investigate the effect of femtosecond laser assisted cataract surgery and conventional phacoemulsification surgery on corneal endothelial cell morphology and function.

METHODS: This study included 80 cases of cataract patients(88 sicked eyes)treated in our hospital from January 2016 to January 2017. All patients underwent phacoemulsification combining with intraocular lens implantation for treatment. Based on the review of treatment, 40 cases(43 sicked eyes)receiving femtosecond laser assisted cataract surgery were included into the observation group, 40 cases(45 sicked eyes)receiving conventional phacoemulsification only were divided into the control group. The proportion of patients whose postoperative uncorrected visual acuity >0.5 of the two groups were compared, and sac diameter, capsule size, intraoperative cumulative energy release(CDE)were recorded, the corneal endothelial cell density and variation were recorded before and after operation, the preoperative and postoperative ratio of hexagonal cells were compared between the two groups subsequently.

RESULTS: At 1d postoperatively, uncorrected visual acuity >0.5 of the observation group was no significant difference with that of the control group; the ratio was 74% at 6mo after surgery, which was significantly higher than that of the control group(53%), there was statistical significance(P<0.05). The diameter of the anterior capsulotomy, the size of the capsule, the grade II nuclear CDE, and the grade III nuclear CDE of the observation group were sharply different from those of the control group, there was statistical significance(P<0.05). The differences of corneal endothelial cell density and variation, proportion of hexagonal cells before and after surgery of the two groups were significant, and the difference after 6mo between the two groups was huge, there was statistical meaning(P<0.05).

CONCLUSION: Femtosecond laser assisted cataract surgery can reduce the effect of ultrasound energy on cornea, and can sharply decrease the damage to corneal endothelial cell morphology and function.

Abstract:AIM: To compare the clinical effects of 2.2mm coaxial micro-incision and 3.0mm standard incision in cataract phacoemulsification surgery.

METHODS: A total of 67 patients(80 eyes)were randomly divided into two groups. Cataract phacoemulsification and artificial lens implantation surgery was carried out with 2.2mm coaxial micro-incision(Group A, 40 eyes)and 3.0 mm standard incision(Group B, 40 eyes), respectively. The effective phacoemulsification time and average ultrasound energy, corneal endothelial cell count, corneal edema, corneal astigmatism, postoperative visual acuity and postoperative complications were compared between the two groups.

RESULTS: Effective phacoemulsification time of Group A and Group B was 8.18±11.22s and 7.82±2.12s, respectively, and the difference had no statistical significance(P>0.05); average ultrasonic energy was(17.25±4.22)% and(17.64±4.27)%, respectively, and the difference was not statistical significance(P>0.05). There was no significant difference in endothelial cells between the two groups of corneal endothelial cells at 1wk after surgery compared with that before operation(P>0.05). On the first day after surgery, corneal edema was observed in some patients. There were 9 eyes in Group A, 6 eyes in Group B, corneal edema relief or subsidence after 3d to 5d. There was significant difference in corneal astigmatism change between the two groups at 1wk(P<0.05), but there was no significant difference at 1 and 3mo after operation(P>0.05). The changes of corneal astigmatism before and after operation in Group A were insignificant(P>0.05), while the changes of corneal astigmatism before and after operation in Group B were significantly different(P<0.05). At 1 and 3mo after operation, the astigmatism of each group tended to be stable, and the corneal astigmatism in the two groups after 1 and 3mo had no statistical significant difference(P>0.05). The uncorrected visual acuity(UCVA)differences of the two groups was statistically significant at 1d, 1wk and 1mo after operation(P<0.05), but there was no significant difference between the two groups in UCVA after 3mo(P>0.05).

CONCLUSION: For soft or medium-hard nucleus cataract, compared with the traditional 3.0mm small-incision coaxial phacoemulsification, the 2.2mm micro-incision coaxial phacoemulsification can effectively reduce the surgically induced astigmatism, and the astigmatism state is relatively stable, and conducive to early recovery of visual acuity.

Abstract:AIM:To investigate the efficacy of Bevacizumab intravitreal injection combined with EX-PRESS in the treatment of refractory glaucoma.

METHODS: The research objects were 150 cases(150 eyes)of patients with refractory glaucoma from June 2014 to December 2016 in our hospital. All patients were treated with EX-PRESS glaucoma drainage device implantation, and their medicine data were analyzed retrospectively. Totally 70 cases(70 eyes)were treated with EX-PRESS only were set as the control group; 80 cases(80 eyes)received bevacizumab intravitreal injection on the basis of the treatment of the control group were set as the observation group. The successful rate of operation was evaluated, the intraocular pressure was measured before operation and at 7d, 1, 3, 6mo after treatment by non-contact conometer, followed by record of the visual acuity and complications before and after 6mo of treatment.

RESULTS: The observation group's total surgical success rate was 72.5%, which was sharply higher than that of the control group(58.6%); while the partial success rate was 17.5%, which was significantly lower than that of the control group(30.0%), with statistical significance(χ²=5.453, P=0.028; χ²=4.213, P=0.047). Two groups' surgical failure rate had no distinct difference(χ²=0.000, P=1.000). There was no significant difference in visual acuity of the two groups before and after operation(P>0.05). There was no significant difference in intraocular pressure between the two groups(F_groups=982.27, P<0.05; F_time=941.88, P<0.05). The intraocular pressure of the two groups decreased significantly after treatment, and at the 7d observation group was significantly higher than that of the control group after operation(P<0.05). After 1, 3, 6mo of operation, there was no abvious difference between two groups on IOP(P>0.05). The observation group's low intraocular pressure, anterior chamber bleeding and shallow anterior chamber incidence were significantly lower than those of the control group, there was statistical meaning(P<0.05).

CONCLUSION: Intravitreal injection of bevacizumab combined with EX-PRESS in the treatment of refractory glaucoma can improve the complete success rate, as well as perform effective control on complications such as short-term intraocular pressure, hyphema, low intraocular pressure.

Abstract:AIM: To compare clinical effects and cost of panretinal photocoagulation(PRP)combined with Ranibizumab or triamcinolone acetonide(TA)for diabetic macular edema(DME).

METHODS: Forty-eight patients(48 eyes)with DME and diabetic retinopathy(DR)receiving PRP were randomly assigned to two groups, which were respectively intravitreally injected ranibizumab(0.5mg)and TA(4mg). Ranibizumab(0.5mg)was intravitreal injected every 4wk for 3 times. The effects of injection for DME were evaluated using best-corrected visual acuity(BCVA), central macular thickness(CMT)and intraocular pressure(IOP). During the follow-up, other injections were performed to eyes which had CMT greater than 400μm. The medical costs were calculated at 12wk and 24wk.

RESULTS: BCVA and CMT between 2 groups were not significantly different(P>0.05); BCVA and CMT among different time points were significantly different(P<0.05); the treatments and the time points had significant interaction on BCVA(P<0.05). BCVA was improved in two groups at all the time after injection(P<0.05), except 1wk after injection of TA(P=0.33). There was significant difference between the two groups at 12wk and 16wk on BCVA and that injected with ranibizumab was better(P=0.03, 0.045). CMT decreased in two groups at all the time after injection(P<0.05). There was significant difference only between the two groups at 1wk(P<0.01). All intraocular pressures were in the normal range, except one needed ocular hypotensive agents. The medical costs(yuan)of the ranibizumab group in 12wk and 24wk were 38 736 and 42 564,which of the TA group were 5 790 and 7 053, respectively.

CONCLUSION: Both PRP combined with ranibizumab or TA for DME can effectively control disease progression in short time. Therapeutic effect is not significant between two methods, but PRP combined with TA is more economic.

Abstract:AIM: To investigate the therapeutic effect of intravitreal injection of Ranibizumab combined with laser for diabetic macular edema(DME).

METHODS: Totally 60 cases(60 eyes)of DME patients treated in ophthalmology department of our hospital from June 2014 to June 2016 were selected and divided into the observation group and the control group. The control group were treated with laser therapy, and the observation group received intravitreal injection of ranibizumab on the basis of the treatment of the control group. Comparison between two groups on the best corrected visual acuity before operation and at 1wk, 1, 3, 6mo after operation was taken. The non-contact tonometer was used to measure intraocular pressure before and after treatment. The optical coherence tomography(OCT)was conducted to assess preoperative and postoperative central macular thickness(CMT).The postoperative complications of two groups were recorded subsequently.

RESULTS: The two groups' postoperative visual acuity was significantly improved, data of the observation group at 1, 3mo after operation was sharply higher than that of the control group, there was statistical significance(P<0.05), and data at 1wk, 6mo after operation had no evident difference(P>0.05). After 1wk of treatment, the two groups' intraocular pressure increased, with statistical significance(P<0.05); there was no significant difference between the two groups on intraocular pressure before treatment and at 1, 3, 6mo after treatment(P>0.05). The postoperative CMT of two groups significantly decreased, data of the observation group at 1, 3mo after treatment was evidently lower than that of the control group, there was statistical significance(P<0.05), and data before treatment, at 1wk, 6mo after treatment showed no significant difference(P>0.05). In the observation group, 5 cases(5 eyes)recurred within 6mo, the recurrence rate was 17%. In the control group, 10 cases(10 eyes)relapsed, the recurrence rate was 33%, the difference was statistically significant(P<0.05). At postoperatively 2d, 2 cases(2 eyes)of the observation group and 3 cases(3 eyes)of the control group had high intraocular pressure, and then returned to normal by given the carteolol eye drops.

CONCLUSION: Compared with laser therapy alone, intravitreal injection of ranibizumab combined with laser therapy has a significant and safe short-term treatment effective for DME patients with a fast visual acuity recovery.

Abstract:AIM: To discuss the curative effect of extra-panretinal photocoagulation on proliferative diabetic retinopathy(PDR)during vitreous operation.

METHODS: We conducted a retrospective analysis of 70 diabetic retinopathy patients(70 eyes)who accepted vitreous surgery in our hospital due to vitreous hemorrhage or vitreous retina traction change from March 2011 to March 2013. In follow-up clinics, according to the difference of patient's retinal photo-coagulation range, we divided it into extra-panretinal photocoagulation group(40 patients)and panretinal photocoagulation(30 patients), respectively observed the best corrected visual acuity, intraocular pressure and retinal vessel changes in two groups and made statistical analysis.

RESULTS: Through comparing the eye condition, visual acuity after 3mo, intraocular pressure between the two groups patients, the difference had no statistical significance(all of the P>0.05). Comparing the incidence of retinal blood vessel leak, posterior pole exudate, and posterior pole bleeding points in two groups patients, the difference had statistically significant(all of the P<0.05). Comparing the incidence of no-perfusion area of retina, prepapillary vascular leak in two groups patients, the difference had statistically significant(P=0.04, 0.02). Comparing the incidence of macular edema in two groups patients after operation, the difference had no statistically significance(P=1.00). Comparing the extinction time of macular edema, the difference had statistically significant(P<0.05), extra-panretinal photocoagulation group was better than panretinal photocoagulation.

CONCLUSION: To cure proliferation diabetic retinopathy, adopting the extra-panretinal photocoagulation has a better curative effect than panretinal photocoagulation on curing no-perfusion area of retina, retinal blood vessel leak, prepapillary vascular leak in operation on vitreous. However, the excessive retinal photocoagulation has a clear damage on retina and choroid. Therefore, in the treatment, while covering the retinopathy as far as possible, it is important to master the laser energy and spot number preventing the complications.

Abstract:AIM: To study the effect of calcium dobesilate combined with panretinal photocoagulation on severe non-proliferative diabetic retinopathy patients(NPDR).

METHODS:A total of 92 patients(184 eyes)with severe NPDR were collected in our hospital from December 2014 to April 2017, and divided into laser group and combined treatment group by random number table method. The laser group was treated with panretinal laser photocoagulation, and the combined treatment group received calcium dobesilate combined with retinal laser photocoagulation. The effect of the two groups was compared on the retinal microcirculation parameters.

RESULTS: Seven weeks after treatment, treatment effective rate in combined treatment group was higher than that in laser group(P<0.01). Fundus examination parameter such as Ops OS2, subfoveal choroid thickness(SFCT)in combined treatment group were higher than those in laser group(P<0.01). Retinal microcirculation parameters such as PSV, MV in combined treatment group were higher than the level of the laser group, RI, PI levels were lower than those in laser group(P<0.01).

CONCLUSION: Calcium dobesilate combines with panretinal photocoagulation in severe NPDR patients can effectively improve the overall effect and optimize the fundus structure and retinal microcirculation.

Abstract:AIM: To investigate the effect of sodium hyaluronate eye drops on ocular inflammatory response and dry eye after phacoemulsification combined with intraocular lenses(IOL)implantation for age-related cataract.

METHODS: The clinical data of age-related cataract patients treated with phacoemulsification combined with IOL implantation in 200 cases(200 eyes)of our hospital from June 2016 to July 2017 were retrospectively analyzed. According to the different postoperative application of eye drops they were divided into observation group and control group(100 cases each). The observation group was given sodium hyaluronate eye drops and the control group was given tobramycin dexamethasone eye drops. The results of BUT, FL, proteins concentration in aqueous and ocular surface disease index(OSDI)score were compared before and at the first day, the seventh day and the fourteenth day after the operation. And the incidence of conjunctival hyperemia and ciliary hyperemia was compared between 1d after surgery and 14d after surgery.

RESULTS: There was no significant difference in OSDI scores between the two groups before and at 1d after surgery(P>0.05). The OSDI score of the two groups was higher than that before the operation on the first, the seventh and the fourteenth day after surgery(P<0.05). The OSDI score of the two groups decreased gradually after reaching the highest level on the first day after surgery(P<0.05). The OSDI scores of the observation group on the 7 and 14d after surgery were lower than those in the control group(P<0.05). There was no significant difference in the BUT between the two groups before and at 1d after surgery(P>0.05). The levels of BUT in the two groups were lower than those before operation on the first, the seventh and the fourteenth day after surgery(P<0.05). BUT levels in both groups increased gradually after reaching the lowest level on the first day(P<0.05), the levels of BUT in the observation group were higher than those in the control group on the 7 and 14d after operation(P<0.05). There was no significant difference in FL level between the two groups before and the first day after operation(P>0.05). The levels of FL in the two groups were different from those before operation(P<0.05)on the first, the seventh and the fourteenth day after operation(P<0.05). FL levels in the two groups decreased gradually after reaching the highest level on the first day after surgery(P<0.05), the levels of FL in the observation group on the 7th day and the 14th day after operation were lower than those in the control group(P<0.05). There was no significant difference in the incidence of conjunctival hyperemia and ciliary congestion between the two groups on the first day after operation(P>0.05); the incidence of conjunctival hyperemia and ciliary hyperemia in the two groups on the fourteenth day after surgery was lower than that on the first day after surgery(P<0.05). However, the incidence of conjunctival hyperemia and ciliary congestion on the fourteenth day after operation was significantly lower in the control group than in the observation group(P<0.05). Postoperatively 1, 7, 14d, aqueous humor protein concentration in the two groups of patients compared with preoperative had difference(P<0.05), and two groups of patients with aqueous humor at postoperatively 1d after reaching the highest protein concentration decreased(P<0.05), aqueous humor protein concentrations of the control group 7, 14d after operation were lower than the observation group(P<0.05).

CONCLUSION: The effect of sodium hyaluronate eye drops on improving dry eye after age-related cataract phacoemulsification combined with IOL implantation is greater than that of tobramycin dexamethasone eye drops, but it is less effective for eye inflammation than tobramycin dexamethasone eye drops. After comprehensive consideration, for the patients with light inflammation, small incision phacoemulsification combined with IOL implant, sodium hyaluronate eye drops is a good selection.

Abstract:AIM: To explore clinical effect of pranoprofen combined with deproteinized calf blood extract eye drops for moderate to severe dry eye.

METHODS: A total of 84 patients(132 eyes)who received treatment at the Zhengzhou Second Hospital were selected from January 2016 to January 2017. According to random number table method they were divided into control group 42 cases(68 eyes)and observation group 42 cases(64 eyes), the control group using polyvinyl alcohol eye drops with pranoprofen, observation group with pranoprofen with deproteinized extract of calf blood eye drops. Subjective and objective scores before and after treatment were recorded.

RESULTS: There was no statistically significant difference on the four objective indicators of pretreatment FL, BUT, SⅠt, and vision between the two groups(P>0.05). Dry eye symptom scores of the two groups decreased after treatment, both with significantly different(P<0.05); after treatment, the symptom scores of the observation group were significantly lower than those in the control group, and the difference was statistically significant(P<0.05), indicating that the subjective symptoms of the observation group were better than that of the control group after treatment. After treatment of the control group and the observation group, the FL index was significantly lower than before treatment, BUT, SⅠt and vision were significantly higher than before treatment, and the differences within either group were statistically significant(P<0.05); those indexes of observation group were different compared with control group(P<0.05), indicating that the objective symptoms of the observation group were better than that of the control group after treatment. None of the patients showed serious adverse reactions.

CONCLUSION: The clinical effect of praprofen on the treatment of moderate to severe dry eye with the deproteinized calf blood extract is better.

Abstract:AIM:To investigate the clinical efficacy of 3g/L sodium hyaluronate eye drops combined with bromhexine hydrochloride tablets on the treatment of dry eye.

METHODS:Totally 200 patients with dry eye were randomly divided into the control group(n=100)and observation group(n=100). Patients in two groups were given 3g/L sodium hyaluronate eye drops and physiotherapy. On the basis of this, the observation group were treated with bromhexine hydrochloride tablets. The inflammatory factors(IL-6, IL-10, TNF-α and IL-1β)levels and ocular symptom scores(OSDI, BUT, SⅠt, FL)in the two groups were compared between before and after treatment. And the clinical efficacy and adverse reactions were evaluated.

RESULTS: After treatment, the IL-6, IL-10, TNF-α, IL-1β, OSDI and FL scores in two groups were significantly lower than those before treatment, and BUT and SⅠt were significantly higher than those before treatment. Moreover, the improvement degree of the above indexes in the observation group were better than those in the control group, showing statistically significant difference(P<0.05). The total effective rate of the observation group was higher than that of the control group(χ²=5.531, P=0.019), but there was no significant difference in the incidence of adverse reactions between the two groups(χ²=0.307, P=0.579).

CONCLUSION:As for the patients with dry eye, the combination of 3g/L sodium hyaluronate eye drops with bromhexine hydrochloride tablets can significantly decrease the level of inflammatory factors, improve the eye symptoms and the clinical total efficiency, without increasing treatment-related adverse effects.

Abstract:AIM:To compare the similarities and differences of central corneal thickness(CCT)measured by different devices, so as to provide a safe, effective, simple and accurate method for measuring corneal thickness.

METHODS: Totally 95 eyes of 95 cataract patients enrolled continuously for preoperative examination in ophthalmology department of Putuo Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from September 2016 to December 2016. Handheld automatic PachPen ultrasonic pachymetry(USP), anterior segment optical coherence tomography(AS-OCT)and specular microscopy were respectively used to measure the central corneal thickness, and intraocular pressure was measured at the same time. The similarities and differences of these three different devices to measure the central corneal thickness and their correlations with intraocular pressure were observed. Then the data were analyzed statistically.

RESULTS: The CCT value measured by PachPen ultrasonic pachymetry was 544.43±36.61μm, the CCT value measured by AS-OCT was 527.09±35.54μm, and the CCT value measured by specular microscopy was 533.20±30.17μm. There was significant difference between these three groups(F=6.272, P=0.002), and the CCT value measured by PachPen ultrasonic pachymetry was significantly higher than the other two groups. The correlation coefficients between the CCT values of these three groups and intraocular pressure were 0.290, 0.277 and 0.204(P<0.05)respectively, of which the correlation between the CCT measured by PachPen ultrasonic pachymetry and the intraocular pressure was the highest. There was statistically significant correlation between the CCT values measured by these three measurements(P<0.001).

CONCLUSION: The CCT value measured by PachPen ultrasonic pachymetry is the highest. The second CCT value is measured by specular microscopy, and the smallest CCT value is measured by AS-OCT. Obvious correlation and good consistency were found in the CCT values measured by three types of devices, and the CCT values were all correlated with intraocular pressure. Therefore, we should take more attention in clinic.

Abstract:AIM: To evaluate the safety and postoperative complications of femtosecond laser-assisted small incision lenticule extraction(SMILE).

METHODS: Retrospective case series. A total of 1127 patients(2 236 eyes)who were treated with SMILE for myopia or myopia astigmatism between June 2016 and May 2017 were enrolled in this study. Eyes that developed postoperative complications were noted and identified. The incidence, risk factors, management and prognosis were analyzed. The follow-up was 6mo.

RESULTS: The rate of postoperative complications was 8.05%, included diffuse lamellar keratitis(3.31%), delayed visual acuity(2.59%), minor interface residue(0.63%), and ghost images(1.52%). These complications had an impact on best corrected visual acuity(BCVA)at 3mo in only 1 eye with decentered ablation and was re-treated with topography-guided laser-assisted subepithelial keratomileusis(LASEK). Good visual outcomes were achieved in all eyes finally.

CONCLUSION: Although few eyes suffered postoperative complications, SMILE is an acceptable safe surgery. Careful surgical skill, appropriate surgical parameter, and rational postoperative medication can decrease the risk of complication.

Abstract:AIM:To investigate the factors related to the decrease of corneal endothelial cell number after phacoemulsification in cataract patients.

METHODS: We selected 98 patients(120 eyes)in Ophthalmic Center from July 2014 to July 2016 underwent phacoemulsification and they were retrospectively analyzed. According to the central corneal endothelial cell density before and 2mo after the operation, they were divided into serious loss group of 52 cases(67 eyes, density of central corneal endothelial cells loss rate no less than 12.3%), the general loss group of 46 cases(53 eyes, the density of central corneal endothelial cell loss rate <12.3%). Relevant indicators of general information, operation of the two groups were compared, the influence factors of non conditional Logistic regression analysis method was used to investigate the effect for corneal endothelial cell loss in cataract patients.

RESULTS: Serious loss group and the general group on gender, rate with hypertension, rate with diabetes, rate with high blood lipids, with shallow anterior chamber, corneal diameter and suction time comparison, had no statistically significant differences(P>0.05). Nuclear hardness classification of Emery lens, ultrasonic power, ultrasonic emulsification time, age between groups were significantly different(P<0.05). By using Logistic analysis method, the results showed that increased Emery lens nucleus grading, ultrasonic energy, phacoemulsification time, age were independent risk factors for corneal endothelial cells after phacoemulsification(P<0.05).

CONCLUSION: The main factors that influence the decrease of corneal endothelial cell number after phacoemulsification are Emery lens, higher grade of nucleus of lens, increase of ultrasonic energy, longer time of phacoemulsification and increased age.

Abstract:AIM: To describe the protocol and economic cost of the Day-care Unit cataract surgery procedure in northwest of China.

METHODS: Patients who received phacoemulcification and intraocular lens implantation in both Day-care Unit and regular Unit were recruited from January 2016 to December 2016. The baseline data and average cost were recorded and analyzed. Furthermore, satisfaction questionnaire of patients were collected.

RESULTS: Patients with Day-care Unit showed shorter registration duration, less cost including housing and nursing charge as well as higher rate of patient satisfaction. Meanwhile, Day-care Unit shorten the time the doctors and nurses spending on filling the medical charts.

CONCLUSION:Day-care Unit cataract surgery procedure could benefit both patients and medical staffs and is worthy to generalize.

Abstract:AIM: To investigate the clinical characteristics of secondary glaucoma caused by lens suspensory ligament laxity or occult subluxation, and to analyze the influence of operation on visual acuity and intraocular pressure(IOP).

METHODS: Totally 38 cases(38 eyes)of the secondary glaucoma caused by lens suspensory ligament laxity or occult subluxation in ophthalmology department of our hospital from December 2014 to December 2016 were enrolled and their medical records were analyzed retrospectively to observe the clinical characteristics of glaucoma. Preoperative mydriasis was carried out and surgical methods were chosen according to the lenses location and extent of suspensory ligament. Preoperative and postoperative anterior chamber depth, corneal endothelial cell density, IOP, visual field, visual acuity and complications were analyzed.

RESULTS: The average intraocular pressure was 18.17±1.43mmHg at postoperatively 10d, which was significantly lower than 38.77±2.45mmHg before operation, the difference had statistical significance(P<0.05). The IOP of 25 eyes returned to normal(≤21mmHg)at 3d after surgery. The IOP of 34 eyes with the usage of IOP lowering medication returned to normal at postoperative 10d. The IOP of 4 eyes came to normal after undergoing glaucoma drainage valve implantation again. There were 5 eyes with visual acuity ranged 0.1 to <0.2, 17 eyes 0.2 to <0.5, 16 eyes ≥0.5 preoperatively, and 2 eyes, 17 eyes and 19 eyes postoperatively, the difference was not significant(P>0.05). The postoperative anterior chamber depth was 2.45±0.44mm, which was significantly higher than 1.23±0.35mm before operation, the difference had statistical significance(P<0.05). The postoperative corneal endothelial cell density was 878.34±322.12/mm² and decreased significantly, compared with 1735.32±340.32/mm² before operation, the difference had statistical significance(P<0.05). There were 8 eyes with corneal edema, 4 eyes with iris adhesion or varying degrees of atrophy, 3 eyes with anterior chamber hemorrhage, and 2 eyes with pupil exudate at 3d after surgery.

CONCLUSION: Clinical symptoms and signs of secondary glaucoma in patients with lens suspensory ligament laxity or occult subluxation are more complex, which needs to be distinguished with other types of glaucoma in clinical treatment, and its surgical methods shall be chosen according to different suspensory ligament site and lens subluxation scope.

Abstract:AIM: To analyze the curative effect and safety in early stage primary open angle glaucoma(POAG)between simple Ex-PRESS shunt implantation and its combination with biological amniotic membrane implantation.

METHODS: The clinical data of 53 cases for POAG treated with simple EX-PRESS shunt implantation(22 cases, 34 eyes)as control group and its combination with biological amniotic membrane implantation(31 cases, 38 eyes)as experimental group were retrospectively analyzed. Intraocular pressure(IOP)preoperatively and postoperatively were statistically evaluated. Filtering bleb and incidences of postoperative complications were observed in our hospital during the period of January of 2015 to April of 2017.

RESULTS: At each time point after the operation, the mean IOP of the experimental group and the control group decreased distinctly respectively, the difference was statistically significant(P<0.05). There was no significant difference on the mean IOP between the experimental group and the control group at 1d and 1wk after operation(P<0.05). The mean IOP in the control group was higher than experimental group at 3 and 6mo(P<0.05). The rate of functional filtration blebs were different between experimental group and control group during at postoperatively 3mo(P<0.05). The complications included shallow anterior chamber, hemorrhage, posterior synechia of the iris, and corneal edema after surgery, and its incidences was not different between two groups(P<0.05).

CONCLUSION: EX-PRESS shunt combined with biological amniotic membrane implantation can effectively and safely reduce intraocular pressure, and improve the condition of filtering bleb after operation, and has long-term effect on IOP.

Abstract:AIM:To explore the effectiveness of a new non-inverted pedicle internal limiting membrane(ILM)flap transposition technique in the treatment of large macular holes(MH).

METHODS: This was a prospective pilot study which included 9 patients with 10 eyes in Jiangsu Province People's Hospital from December 2016 to February 2017. All patients was diagnosed with large MH(size >400μm)by the spectra-domain optical coherence tomography(SD-OCT)and underwent the non-inverted pedicle ILM flap transposition surgery. Best-corrected visual acuity(BCVA), SD-OCT images, and MP-1 microperimetry tests were performed pre-operation, 1d, 1wk, 1, 3, and 6mo post-operation.

RESULTS: The macular hole closure rate after 6mo was 100%. The averaged BCVA improved from 1.19±0.54(LogMAR)pre-operation to 0.70±0.50(LogMAR)post-operation(P=0.005). The mean retinal sensitivity within 8° and 2° improved from 3.14±4.52dB to 8.91±5.53dB(P=0.008), and 1.46±2.94dB to 6.33±4.90dB(P=0.008)respectively. Preoperative unstable fixation in seven eyes resolved at the last postoperative follow-up.

CONCLUSION: Our non-inverted pedicle internal ILM flap transposition technique shows effectiveness in the treatment of large macular holes with high MH closure rate and improving visual function.

Abstract:AIM: To investigate the relationship between the thickness of choroid and the development of idiopathic macular epiretinal membrane(IMEM).

METHODS: A retrospective analysis on 48 cases(48 eyes)of idiopathic macular epiretinal membrane patients(the IMEM group)was taken in our hospital from January 2014 to December 2016, and 50 right eyes in 50 healthy persons with physical examination were selected the control group, comparison on subfoveal choroidal thickness(SFCT)levels of sicked eyes, normal eyes in IMEM group and the control group were made, postoperative SFCT level change of sicked eyes in IMEM patients and normal eyes were investigated via follow-up, and analysis on correlation between postoperative choroidal thickness and the best corrected visual acuity was taken.

RESULTS: The SFCT of sicked eyes in IMEM group 362.22±40.75μm was significantly lower than that of the contralateral eyes(410.56±38.45μm)and the right eyes of the control group(420.73±39.63μm), and data of the contralateral eyes was lower than right eyes of the control group, distinct difference was shown between groups(P<0.05). The IMEM group's SFCT of sicked eyes and normal eyes at postoperative 1wk had no significant difference with that before operation(P>0.05), and at postoperative 1mo, SFCT of sicked eyes and normal eyes evidently increased, showing sharp difference compared with that before operation(P<0.05). After that, the SFCT value stabilized, but there was no obvious difference between the sicked eyes and healthy eyes at postoperatively 1mo(P>0.05). The numbers of patients whose postoperative BCVA ≥0.5 with different preoperative SFCT values had statistically significant differences(P<0.05), and those with BCVA ≥0.5 of SFCT values> 380μm were significantly higher than those with <320μm and 320μm-380μm groups. Fisher exact probability analysis showed that the differences were significant. Pearson analysis showed that there was a positive correlation between the postoperative choroid thickness and the best corrected visual acuity of IMEM group(r=0.629, P<0.05).

CONCLUSION: Choroidal thinning may be an important cause of IMEM, and preoperative choroidal thickness also has an influential effect on postoperative visual recovery.

Abstract:AIM: To investigate the clinical efficacy of Qi Ming granule combined with macular grid laser photocoagulation in the treatment of diabetic retinopathy(DR)with diabetic macular edema(DME).

METHODS: The clinical data of 50 patients(98 eyes)with DME treated in our hospital from March 2014 to March 2017 were retrospectively analyzed. Patients were randomly divided into two group, 25 patients(48 eyes)treated with macular grid laser photocoagulation were included into the control group. On the basis of this, 25 patients(50 eyes)treated with Qi Ming granule were included into observation group. The central macular thickness(CMT)and best corrected visual acuity(BCVA)between two groups were evaluated and compared after detected by optical coherence tomography(OCT)and fundus fluorescein angiography(FFA)at 7d, 1 and 3mo post-treatment.

RESULTS: The total effective rate was 94% in the observation group with 47 effective eyes, which was was significantly higher than 83% in the control group with 40 effective eyes(P<0.05). The BCVA was significantly improved in the two groups after treatment; the BCVA of the observation group was significantly higher than that of the control group after 7d, 1 and 3mo treatment, the difference was statistically significant(P<0.05). CMT in the two groups after treatment decreased significantly; the CMT of the observation group was significantly lower than that of the control group after 7d, 1 and 3mo treatment, with statistical significance(P<0.05). The intraocular hypertension occurred in observation group(2 eyes)and the control group(1 eyes), and relieved quickly after receiving medication, without any other obvious adverse reactions.

CONCLUSION: The clinical efficacy of Qi Ming granule combined with macular grid laser photocoagulation in the treatment of diabetic retinopathy with macular edema is effective, which can reduce CMT, improve eyesight.

Abstract:AIM: To investigate the relationship between the severity of diabetic retinopathy(DR)in middle-aged and elderly diabetic patients with serum HbA1c and TNF-α.

METHODS: Totally 200 patients with diabetes mellitus was selected, 60 patients with diabetes mellitus(DM group), 80 patients with non-proliferative diabetic retinopathy(NPDR)and 60 patients with diabetic retinopathy(PDR), and 80 healthy subjects were selected as normal control group(NC group). Patient's physical examination index was observed, the levels of fasting plasma glucose(FPG), 2h postprandial blood glucose(2hPG), serum lipids, serum HbA1c, serum tumor necrosis factor-α(TNF-α)and tear TNF-α of patients were measured.

RESULTS:There were significant differences in body mass index(BMI), FPG, 2hPG, total cholesterol(TC), trilycerides(TG), high density lipoprotein(HDL-C)and low-density lipoprotein(LDL-C)among the four groups(F=37.211, 395.421, 42.515, 7.385, 121.764, 121.568, 34.567, P<0.05). The levels of BMI, FPG, 2hPG, TC, TG, HDL-C and LDL-C of DM, NPDR and PDR groups were significantly higher than those in the NC group(P<0.05). The levels of BMI, FPG, 2hPG, TC, TG, HDL-C and LDL-C of PDR group were significantly higher than those in the NPDR group(P<0.05). The differences of serum TNF-α, tear TNF-α and serum HbA1c in four groups were statistically significant(F=337.256, 215.471, 40.522, P<0.05). The levels of serum TNF-α, tear TNF-α and serum HbA1c in the DM, NPDR and PDR groups were significantly higher than those in the NC group; the serum levels of serum TNF-α, tear TNF-α and serum HbA1c of the NPDR and PDR groups were significantly higher than those in the DM group(P<0.05), the serum levels of serum TNF-α, tear TNF-α and serum HbA1c of PDR group were significantly higher than those in the NPDR group(P<0.05). There was a positive correlation between tear TNF - α and serum TNF–α(r=0.289, P<0.01), and a positive correlation between serum TNF-α and serum HbA1c(r=0.375, P<0.01).

CONCLUSION: The tear TNF-α levels in middle-aged patients with diabetic retinopathy is higher than normal, and with the increase of retinopathy severity, tear TNF-α levels increases. There is a positive correlation between TNF-α in tear fluid and serum TNF-α and HbA1c.

Abstract:AIM:To research the correlation between dry eye and diabetic retinopathy(DR)in type 2 diabetes mellitus patients.

METHODS:A total of 150 patients with type 2 diabetes mellitus collected from August 2015 to February 2017 were separated to three groups: without diabetic retinopathy(DR), with nonproliferative diabetic retinopathy(NPDR)and with proliferative diabetic retinopathy(PDR). Each group contained 50 cases(100 eyes). Another 50 dry eye patients without diabetes were as control. All patients were provided with questionnaire survey of ocular surface disease index(OSDI), SchirmerⅠtest(SⅠt), break-up time(BUT)and fluorescein staining(FL), to compare the prevalence and the severity of dry eye in these groups.

RESULTS: The prevalence of dry eye in type 2 diabetes mellitus patients without DR group was 44%, in type 2 diabetes mellitus patients with NPDR group was 51% and in type 2 diabetes mellitus patients with PDR group was 59%. To compare dry eye patients without DR with the control group, there were no difference in OSDI, SIt, BUT and FL(P>0.05). Dry eye in the patients with NPDR was more serious than in the patients without DR, there were statistical difference in OSDI, SⅠt, BUT and FL(P<0.05). Dry eye in the patients with PDR was more serious than in the patients with NPDR, there were statistical difference in SIt, BUT and FL(P<0.05). But OSDI was lower and showed no difference with patients without DR(P>0.05).

CONCLUSION: The incidence and the severity of dry eye increase gradually with the occurrence and development of diabetic retinopathy in type 2 diabetes mellitus patients. However, the symptoms may be reduced in patients with severe DR.

Abstract:AIM: To compare the application effect on patients with retinopathy of prematurity(ROP)screened by wide-angle digital retinal imaging system(RetCam)and binocular indirect ophthalmoscope(BIO).

METHODS: Totally 1 624 cases(3 248 eyes)of premature infants were detected by RetCam and BIO in our hospital from May 2014 to May 2017. The screening results of ROP and occurrence of adverse events were compared between two checking methods.

RESULTS: In the 1 624 cases(3 248 eyes)of premature infants, 196 cases(392 eyes)of premature infants were detected by RetCam and 189 cases(378 eyes)of premature infants were detected by BIO, there was no statistical significance on staging results and partition pathological results between RetCam and BIO(P>0.05). Taking inspection result of BIO as standard, the sensibility, specificity, false positive rate and positive predictive value was 100.00%, 99.51%, 3.57% and 96.43%, respectively. The adverse event rate of RetCam and BIO was 0.18% and 0.22%, respectively, there was no statistical significance(P>0.05).

CONCLUSION: RetCam and BIO have similar application efficacy for screening ROP, and RetCam could take the place of BIO as the screening method of ROP.

Abstract:AIM: To analyze the related risk factors for children's multiple chalazion.

METHODS: In experimental group, 300 cases(600 eyes)of children with multiple chalazion and the control group, 236 cases(472 eyes)of similar eye examination of the normal children in case-control studies, using Logistic regression method to analyze many factors to screen out the main risk factors.

RESULTS: By Logistic regression analysis, we found the meibomian gland function, tear secretion reduces, family history, constipation, partial eclipse, living environment were correlated with the occurrence of multiple meibomian gland cyst in children, and no significant correlation with visual acuity, blood cholesterol, trace elements, and bacterial infection.

CONCLUSION: The meibomian gland function, tear secretion reduce, family history, constipation, partial eclipse, living environment for children, are main risk factors for multiple chalazion. We should pay attention to those factors to prevent it.

Abstract:AIM: To evaluate the clinical effect of fresh amniotic membrane transplantation in combination with bandage type corneal contact lens in the treatment of pterygium.

METHODS: This study was a prospective analysis of 600 pterygium excision patients(600 cases, 600 eyes)in the He Eye Hospital from January 2016 to June 2016. The patients were randomly and evenly divided into two groups: observation group and control group, 300 cases in each group(300 eyes). Observation group wore the bandage type corneal contact lens after surgery and took it down at fifth day. The control group did not. The degree of pain after surgery were evaluated at 2h, 1, 3 and 5d after surgery. The clinical outcomes in these two groups were compared in a 12mo postoperative follow-up observation.

RESULTS: There were no significant differences between the observation and control group in the percentage of age and gender and size of the pterygium(P>0.05). After surgery, the degree of pain of treatment group significantly decreased compared to control group, the difference was statistically significant(P<0.01). There were no significant differences between the 2 groups comparing treatment outcomes as the recurrence rate(P>0.05).

CONCLUSION: Bandage contact lenses could significantly release pain response after pterygium excision. But it can not reduce the recurrence rate.

Abstract:AIM: To early massage lacrimal sac to prevent and reduce the neonatal dacryocystitis.

METHODS: We collected 4 048 cases of neonatal, there were 2 650 cases of natural birth including 5 300 eyes and 1 398 cases of Cesarean section including 2 796 eyes. There were 2 131 cases with preventive massage on lacrimal sac including 1 396 cases in natural labor, 2 792 eyes, and 735 cases in cesarean delivery, 1 470 eyes. Then, we determined whether neonatal dacryocystitis occurrence in the observation period.

RESULTS: After preventive massage on lacrimal sac, there were 104 cases of neonatal dacryocystitis that included 68 cases of natural labor, 75 eyes and 36 cases of cesarean delivery, 47 eyes; 140 cases of neonatal dacryocystitis that included 49 cases of natural labor, 57 eyes and 91 cases of cesarean delivery, 148 eyes, in the neonatal without massage. In the comparison of preventive massage group with control group, there were significant differences of the incidence of neonatal dacryocystitis(χ ²=32.141, P<0.01).

CONCLUSION: The preventative massage on lacrimal sac significantly reduce the incidence of neonatal dacryocystitis.

Abstract:AIM: To analyze the relationship between tear film break-up time(BUT)and systemic factors.

METHODS: From January 2015 to July 2016 in the medical examination center of Fuzhou General Hospital or hospitalized, there were 747 cases included. All participants were observed for systolic and diastolic blood pressure, blood glucose, total cholesterol, high density lipoprotein cholesterol, low density lipoprotein, break-up time equivalent. The relationship between tear film rupture time and systemic factors was analyzed with simple and multiple linear regression analysis by SPSS19.0.

RESULTS: Simple linear regression analysis results showed that the diastolic pressure and tear break-up time were positively correlated(P<0.05); age, systolic blood pressure, blood glucose, cholesterol, high density lipoprotein, low density lipoprotein was negatively correlated with BUT(P<0.05), but no correlation between triglyceride and tear film break up time(P=0.227). Multiple linear regression analysis suggested that the tear film rupture time was positively correlated with diastolic blood pressure(P<0.001), but negatively correlated with systolic blood pressure(P<0.001), blood glucose(P<0.001)and high-density lipoprotein(P=0.019). The time of tear film rupture was not related to age, cholesterol, triglyceride, low density lipoprotein.

CONCLUSION: The correlation between blood glucose and tear film BUT is the most significant among all the indexes involved, indicating that ocular surface damage may occur in diabetic patients.

Abstract:AIM: To observe the clinical efficacy of fumigation treatment of traditional Chinese medicine(Four Yellow Qing Ling Water)for dry eye, and to provide the reference for clinical treatment of dry eye.

METHODS: Totally 82 patients(164 eyes)were randomly divided into two groups from June 2016 to December 2016 in Ophthalmology Department of our hospital. The patients in control group were given artificial tears; the patients in the observation group were given artificial tears and fumigation treatment of traditional Chinese(Four Yellow Qing Ling Water)once a day. After treatment for 14d, the Schirmer Ⅰ test(SⅠt), break-up time(BUT), cornea fluorescein staining(FL)and clinical efficacy of two groups were compared.

RESULTS: The efficiency rate of observation group was significantly better than the control group(87.8% vs 70.7%, P<0.5). The SⅠt and BUT in the observation group were significantly higher than those in the control group(8.43±2.51mm/5min vs 6.38±2.52mm/5min, P<0.05; 8.60±2.47s vs 6.35±2.29s, P<0.05); the FL in the observation group(0.84±0.75 vs 1.26±0.84, P<0.05)significantly lower than those in the control group.

CONCLUSION: The fumigation treatment of traditional Chinese medicine(Four Yellow Qing Ling Water)combined with artificial tears for dry eyes can improve the clinical symptoms of dry eye syndrome.

Abstract:AIM: To evaluate the ocular surface in the patients after strabismus surgery.

METHODS: One hundred and eighty-eight hospitalized patients(240 eyes)with strabismus from May 2015 to October 2016 in Aier Hospital were divided into 3 groups according to the type of incision: 85 cases(100 eyes)with the corneal limbus incision in Group A; 35 cases(50 eyes)with the cross-muscle incision in Group B; 68 cases(90 eyes)with the adjacent-fornix incision(including Parks incisions and improved Parks incisions)in Group C. And 75 eyes with single extraoeular muscle surgery, 110 eyes with 2 extraoeular muscle surgery, 55 cases with 3 extraoeular muscle surgery. The first noninvasive tear film break-up time(NITBUTf)and the tear meniscus height(TMH)were tested by Oculus anterior segment analyzer preoperatively and 1d, 1, 2 and 4wk postoperatively. The data were studied by statistics.

RESULTS: Comparing with preoperative, TMH increased significantly at post-operatively 1d in all group, NIKBUTf reduced significantly(P<0.05). NIKBUTf was recovered in Group A at post-operative 2wk. NIKBUTf were recovered in Group B and C at post-operative 1wk. TMH were recovered in Group A and B at post-operative 2wk. TMH was recovered in Group C at post-operative 1wk. NIKBUTf and TMH were recovered with the single extraoeular muscle surgery at post-operative 1wk. They were recovered at post-operative 2wk with the 2 and 3 extraoeular muscle surgery.

CONCLUSION: Surgical incision and surgical muscle number may affect the ocular surface of the people after strabismus surgery. The adjacent fornix conjunctival incision has less effect. The less number of muscles in strabismus surgery, the less effect on ocular surface.