Abstract:AIM: To study the changes in higher-order aberrations following non-penetrating deep sclerectomy surgery augmented with sub-Tenon injection of mitomycin C(MMC)in patients with open angle glaucoma

METHODS: Twenty eyes from 20 patients were enrolled in the study. There were 10 eyes with primary open angle glaucoma(POAG)and 10 eyes with secondary open angle(SOAG; pseudoexfoliation). Patients underwent non-penetrating deep sclerectomy surgery augmented with sub-Tenon injections(0.2 mL of MMC 0.02%)before surgery. All patients were evaluated in terms of corneal total higher-order aberrations via i-Trace analyzer before surgery and 1mo and 3mo after surgery. The intraocular pressure(IOP), best corrected visual acuity(BCVA), and bleb morphology were evaluated at each visit. The success rate of surgery was categorized as complete, relative, or failure.

RESULTS: The IOP before surgery was 24.05±3.07 mmHg with a mean of 2.85±0.67 medication, which reached to 12.30±3.32 mmHg with 0.70±0.98 medication at the 3mo follow-up. The reduction in IOP was significant at all periods of the follow-up(P<0.001). The values of total higher-order total(HOT)root mean square(RMS)and total ocular spherical-like aberrations significantly increased at 1mo follow-up after surgery and decreased over the course of 3mo. Trefoil and total ocular coma-like aberration changes were not statistically significant at all periods after surgery. The HOT RMS, coma-like and spherical-like corneal increased significantly 1mo after surgery and decreased at the 3mo follow-up. Corneal trefoil changes were not statistically significant after surgery compared to preoperative state. Patients age and IOP did not have a significant effect on changes in HOT and corneal HOT aberrations.

CONCLUSION: Corneal and ocular higher-order aberrations increased within 1mo after deep sclerectomy surgery and then decreased over a 3mo period, which showed no statistically significant change compared to preoperative state. The BCVA and spherical equivalent(SE)of the patients shown no statistically significant differences compared to the preoperative state at the 3mo follow-up.

Abstract:AIM: To compare the outcome in terms of patients comfort, graft stability, graft inflammation, recurrence and other postoperative complications between the two sizes of conjunctivolimbal autograft used in fibrin glue and suture less glue free methods of conjunctivolimbal autograft fixation for primary pterygium surgery.

METHODS: This was a prospective interventional comparative study conducted on 80 patients(80 eyes)with pterygium from December 2014 to August 2016. The study group was randomly selected and divided into two groups, i.e. people underwent fibrin glue was group 1, and those underwent suture less glue free methods of autograft fixation was group 2. For each group equal numbers of subjects were enrolled and further each group was divided into two more groups(groups A and B in group 1, groups C and D in group 2)by random selection. Group A(size of autograft same as bare sclera)and group B(size 1 mm larger than bare sclera)received fibrin glue technique; and group C(size of autograft same as bare sclera)and group D(size 1 mm larger than bare sclera)received suture less glue free technique of conjunctival autograft fixation. Each patient underwent pterygium excision with size of conjunctival autograft used as per the respective group. Follow up visits were scheduled at 1d, 1wk, 6wk, 6mo and 1y postoperatively.

RESULTS: Mean age of the patients in group 1(Fibrin glue group)was 43.525 years old and in group 2(suture less glue free group)was 42.2 years old. Females were 60 and males were 20. All the 37 patients had pterygium in RE. Average surgical time was similar in all the four groups. Postoperative parameters like patient comfort, graft retraction, graft inflammation and graft edema were similar in all the four groups during every postoperative follow-up visits except for subconjunctival haemorrhage which was significantly more in fibrin glue group until first postoperative week(P<0.0001). Grade 4 graft retraction/displacement was observed in only three patients from group 2. At 1wk postoperative, graft cyst was observed in two patients(one in group A and one in group D). Recurrence was observed in two patients(in group D)at 6mo follow-up.

CONCLUSION: Both methods are safe and effective for graft adhesion with less postoperative discomfort and complications. Compared to fibrin glue method, suture less and glue free method is very economical and outcome in this method is comparable to fibrin glue group. Since this procedure is cost effective and also have all the advantages of fibrin glue, suture less glue free method can be considered as very effective method in treating patients.

Abstract:AIM: To investigate and analyze the changes in the conjunctival flora of patients exposed to repeated antibiotic usage. In addition, determining the effects of this repeated exposure on the resistance pattern of the conjunctival flora.

METHODS: This study included 40 patients, admitted to the Retina Unit of the Research Institute of Ophthalmology. All chosen patients had a minimum of 4 consecutive, monthly intravitreal injections(IVI), some were extended to 6mo or 1y as required. The patients were randomly divided into 3 groups and each group received one kind of antibiotic which was either ofloxacin, moxifloxacin or ceftazidime. All bacterial isolates were tested for antibiotic susceptibility using Kirby-Bauer disc diffusion technique.

RESULTS: In this study the conjunctival normal flora at baseline culture varied from a predominance of Staphylococcus epidermidis (51.2%), followed by Staphylococcus aureus 14% to Micrococcus species 12.8% and other coagulase negative staphylococci(CONS)13%. Our results showed an increase in the percentage of Staphylococcus epidermidis among ceftazidime treated eyes during the four visits in comparison to baseline cultures of patients randomized to ceftazidime. In contrast, there was no noticeable increase in Staphylococcus aureus percentage from baseline. In fluoroquinolone treated eyes, we also observed an increase in percentage of Staphylococcus epidermidis from base line. In contrast to ceftazidime treated eyes, the Staphylococcus aureus percentage in fluoroquinolone treated eyes showed an increase from baseline. However, the pattern of the ocular flora composition changed with the exposure to the old and newer generation of fluoroquinolones. We noticed an increase of Staphylococcus epidermidis in moxifloxacin treated eyes than that in ofloxacin treated eyes from baseline. There was no observed difference in the pattern of Staphylococcus aureus regarding exposure to older and newer generations of fluoroquinolones.

CONCLUSION: Repeated use of ophthalmic antibiotics not only alters the composition of the normal ocular flora, but also selects for resistant strains.

Abstract:AIM:To explore the effect of amniotic lacrimal stent graft on castrated male rabbits of dry eye.

METHODS: Thirty-six adult male rabbits were divided into two groups. Group A was treated with false castration, group B was pseudo-implantation group, and group C was implanted with lacrimal canal. Fluorescein(FL)staining and scoring and SⅠt examination, and confocal microscopy were performed at 2, 4, 6wk after implantation.

RESULTS: The cornea of group A was smooth and clear, and the FL staining was not obvious. In group B, the cornea was rough, and the corneal epithelium was spotted with stained spots. The corneal surface of group C was smoother and more transparent than that of sham operation group and the punctate staining was not obviously. The FL staining scores and SⅠt examination were significant(P<0.05)at 2, 4, and 6wk after implantation. FL staining and scoring and SⅠt, tear protein determination, confocal microscopy changes in corneal nerve. Confocal microscopy showed that group A was a relatively straight plexus, the amount was large, clearly visible. In the group B, the inferior nerve of the corneal epithelial cells was visible and the number was reduced. The corneal epithelial nerve in group C was relatively straight, and the number was slightly reduced compared with the normal male rabbit corneal epithelial nerve.

CONCLUSION: The amniotic lacrimal duct stent can significantly improve the symptoms and signs of castrated castrated male rabbit dry eye syndrome, and has a therapeutic effect.

Abstract:AIM: To study the expressions of TGFBI and microtubule-associated protein 1 light chain 3 alpha(LC3)in granular corneal dystrophy, and the influences of lithium chloride(LiCl)on corneal stromal fibroblast cell proliferation by TGFBI.

METHODS: Immunohistochemistry and Western-blot assays were used to detect the expression levels of TGFBI and LC3 in corneal dystrophy and normal corneal tissues. TGFBI overexpression vector was transfected into corneal stromal fibroblasts, and then the cells were treated with 5, 10, 20, 40mmol/L LiCl for different times(0, 1, 6, 12h), and Western-blot assay was performed to evaluate the expression levels of TGFBI and LC3, and CCK-8 assay was carried out to assess cell proliferation activity.

RESULTS: TGFBI and LC3 were highly expressed in corneal tissues of patients with corneal dystrophy. TGFBI overexpression inhibited the proliferation ability of corneal stromal fibroblasts(P<0.05). LiCl inhibited the expression levels of TGFBI and LC3, and enhanced the cell proliferation activity in corneal stromal fibroblasts transfected with mutant TGFBI(P<0.05).

CONCLUSION: LiCl promoted the proliferation and autophagy of corneal stromal fibroblasts, and its mechanism may be related to down regulated expressions of TGFBI and LC3.

Abstract:AMI: To study the relationship between the infiltration of polymorphonuclear neutrophils(PMNs)and the expression of matrix metalloproteinases 9(MMP-9)in corneal stroma injury after alkali burn.

METHODS: Cornea alkali-burned model was made in 25 rabbits, then animals were grouped and sacrificed at 3d, 7d, 14d, 21d and 28d, respectively. The condition developing of alkali-burned cornea was observed by slit lamp biommicroscopy. The corneas were enucleated for histopathological examination. The infiltration of PMNs was identified by hematoxylin eosin(HE)staining and the expression of MMP-9 was identified by immunohistochemisty in different periods.

RESULTS: The quantity of PMNs and MMP-9 increased on the 3d, reached the lower level on 7d, shown a peak on the 14d, then decreased gradually. The area and depth of corneal stroma after alkali burn were the most severe on the 14d.

CONCLUSION: During the wound healing process, alkali-burned cornea has close relation with the infiltration of PMNs and the expression of MMP-9. The infiltration of PMNs and the expression of MMP-9 is positively correlated in corneal stroma injury after alkali burn.

Abstract:AIM: To evaluate the effect of different routes of dexamethasone administration on aqueous humor concentration and blood glucose in type 2 diabetic(T2DM)rats.

METHODS: The T2DM rats successfully modeled were randomly divided into the experimental group(dexamethasone sodium phosphate injection)and the control group(normal saline injection). Each group was randomly divided into three subgroups: peribulbar injection group, post-bulbar injection group and subconjunctival injection group according to different drug delivery routes. Rat tail venous blood was collected 0-24h after injection and blood glucose concentration was determined by dipstick method. After injection, dexamethasone concentration in aqueous aqueous solution of both eyes was determined by HPLC at 0.5-24h.

RESULTS: Dexamethasone sodium phosphate or normal saline injection had no significant effect on blood glucose concentration in T2DM rats(P>0.05). After dexamethasone sodium phosphate was injected in different ways for 0.5-24h, rats in the experimental group received dexamethasone concentration peak under bulbar conjunctiva injection group(957.34±3.60ng/mL)>post-bulbar injection group(859.60±3.56ng/mL)>perbulbar injection group(732.38±4.56ng/mL).

CONCLUSION: Injection of dexamethasone sodium phosphate into bulbous injection, post-bulbar injection and subconjunctival injection had no significant effect on blood glucose of T2DM rats, while subconjunctival injection was simple and could reach higher drug concentration in a short time than that injected into bulbous injection and sub-bulbous injection.

Abstract:AIM: To evaluate the effect of Ahmed glaucoma drainage valve implantation and leizumab on neovascularization glaucoma.

METHODS: Totally 80 patients(80 eyes)of neovascularization glaucoma(NVG)according to random number table method were divided into 34 cases(34 eyes)of control group and 46 cases(46 eyes)of research group, the control group was treated with Ahmed glaucoma drainage valve implantation, the research group was treated with Ahmed glaucoma valve implantation combined with rezuzumab, clinical curative effect, cytokines, intraocular pressure, vision after 6mo, and complications in both group were compared.

RESULTS: Six months after surgery, the total success rate of operation in the research group was higher than that in the control group(P<0.05). 4d before surgery, there were no significant differences in intraocular pressure between the two groups(P>0.05). 7d after surgery, intraocular pressure in both groups all decreased, and the research group was lower than that in the control group(P<0.05). 6mo after surgery, the improvement rate of vision in the research group was higher than that in the control group(P<0.05). Within 6mo of follow-up, the drainage tube obstruction and hyphema rate in the research group were lower than those in the control group(P<0.05). There was no difference in corneal edema, anterior chamber exudation, eyeball pain, shallow anterior chamber and low intraocular pressure rate between the two groups(P>0.05).

CONCLUSION:Ahmed glaucoma drainage valve implantation combined with rezumab injection can reasonably control intraocular pressure and improve visual function of patients. It is a safe and effective treatment scheme for NVG patients.

Abstract:AIM: To compare the short-term and long-term effects of sub-Bowmans keratomileusis(SBK), femtosecond laser SBK(FS-SBK)and small incision lenticule extraction(SMILE)treatments on corneal endothelial cells density(ECD)in myopia.

METHODS: Thirty-four myopia patients(34 eyes)were performed with SBK, and 41 patients(41 eyes)underwent FS-SBK, 49 patients(49 eyes)underwent SMILE. The corneal endothelial cells, in terms of central corneal ECD, the coefficient of variation(CV)and the percentage of hexagonal endothelial cells, were measured by non-contact corneal endothelial microscope(Topcon SP-1P )at 1wk and 1a preoperative, and postoperative, separately.

RESULTS:There were no significant differences in the visual acuity and diopter among three groups at preoperative, 1wk and at 1a postoperative, separately(all P>0.05). The central corneal ECDs statistically decreased at 1wk postoperative in three groups, compared to preoperatively(all P<0.01), while the ECDs recovered at 1a postoperative. The changes of CVs and the percentage of hexagonal endothelial cells at 1wk,1a after operation were not statistically significantly different compared with preoperative results in the three groups(all P>0.05).The differences of ECD, CVs, and the percentage of hexagonal endothelial cells among three groups at preoperatively and postoperatively were not statistically significant(all P>0.05).

CONCLUSION: The SBK, FS-SBK and SMILE used to treat myopia were safe for the corneal endothelium. The central corneal ECDs decreased slightly at early period after operation, and recovered 1a later in all groups. The CVs and percentages of hexagonal endothelial cells in three groups do not change at short-term and long-term postoperatively. The differences of ECD, CVs, and the percentage of hexagonal endothelial cells among three groups were not found at postoperative.

Abstract:AIM: To analyze the efficacy and influencing factors of femtosecond laser small incision lenticule extraction(SMILE)in the treatment of different curvature myopia.

METHODS: Totally 72 patients(144 eyes)with myopia who underwent SMILE were prospectively included. According to the preoperative corneal curvature, they were divided into low curvature group(<41D, n=21 cases, 42 eyes), middle curvature group(41-46D, n=26 cases, 52 eyes)and high curvature group(>46D, n=25 cases, 50 eyes). The refraction state, uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA)and corneal optical quality were compared among the groups before operation and at 1wk after operation and at 3mo after operation, and the influencing factors of SMILE visual acuity recovery in patients with myopia were screened out.

RESULTS: There were significant differences in UCVA and BCVA at different time points before and after operation within the three groups(P<0.05), and there were no significant differences at different time points among groups(P>0.05). There were no significant differences in the spherical degree, cylindrical degree and spherical equivalent degree among the three groups at different time points(P>0.05). There was a statistically significant difference in the vector change value of subjective optometry refractive power(P<0.05), and the value in low curvature group was lower than that in middle curvature group and high curvature group(P<0.05). Multivariate Logistic regression analysis showed age, ocular axial length and preoperative spherical equivalent were related factors affecting the efficacy of SMILE surgery(P<0.05).

CONCLUSION: SMILE can better improve the visual acuity of patients with different curvature myopia, and it is safe and effective, but age, ocular axial length and preoperative spherical equivalent are related factors affecting the visual acuity after SMILE.

Abstract:The invasion of the cornea by capillary or lymphatic vessels leads to corneal neovascularization and if not handled in time, it will seriously affect vision, the establishment and application of transgenic mouse models of corneal neovascularization provides a good platform for the study of corneal neovascularization mechanism, the screening of antiangiogenic drugs and the evaluation of treatments. Transgenic mouse model of corneal neovascularization is a very valuable and potential animal model. This paper mainly introduces the application of transgenic mouse models in the research of corneal neovascularization.

Abstract:Macular corneal dystrophy(MCD)refers to corneal stromal dystrophy, which can cause progressive visual field defects. MCD belongs to autosomal recessive disease. Mutation of CHST 6 gene is considered to be a pathogenic factor. In general, full-thickness penetrating keratoplasty has become a standard treatment for improving vision. Now more advanced surgical interventions such as deep anterior lamellar keratoplasty(DALK)and phototherapeutic keratectomy(PTK)have also been shown to be important in the treatment of MCD. Some new technologies, such as gene targeting therapy and enzyme replacement therapy, are also being studied as potential permanent solutions for MCD. The pathogenesis, genetic basis, clinical manifestations, treatment and prognosis of this disease are reviewed in this paper.

Abstract:Müller cells are the most important glial cells in the vertebrate retina. They extend from the inner limiting membrane to the outer membrane through the entire retina, participate in the blood-retinal barrier, and actively participate in retinal development and promote the maintenance of retinal homeostasis through many intracellular mechanisms. Müller cells play an important role in the development of diabetic retinopathy. The pathophysiological changes in diabetic retinopathy remain to be further studied. This article reviews the pathophysiological changes of Müller cells in diabetic retinopathy and the recent research progress.

Abstract:Thyroid-associated ophthalmopathy(TAO)is the most common orbital disease and is a specific autoimmune disorder, of which the etiology and pathogenesis is still unclear. TAO can affect the appearance and visual function of patients, and severe cases can lead to blindness. Tissue currently considered excessive expansion due to orbital fat is formed of one of the key pathological features TAO. The increase of orbital adipose tissue can directly lead to increased retrobulbar pressures and eyeball protrusion. As a new endocrine organ, adipose tissue can secrete a variety of adipocytokines, growth factors and protein molecules, some of which may be involved in the pathogenesis of TAO. The role of abnormal adipose tissue proliferation of TAO is reviewed from the expression of key proteins of adipose differentiation, autophagy, retrobulbar pressure and hypoxia.

Abstract:Corneal disease is one of the main ophthalmopathy that may lead to blindness in China. Infectious keratitis is the main cause of corneal blindness. For corneal infections that are difficult to control by drugs, corneal transplantation is the only hope to control the infection and restore the sight. However, the demand for suitable donor corneas is increasing much faster than the number of donors, leaving thousands of curable patients untreated and even lose their eyeballs. Thus, it's urgent to seeking new biomaterials for corneal donor. In recent years, there have come forward great progress in bioengineering cornea. Here, we reviews its application present in clinic and prospects for the future, exploring the feasibility of bioengineering cornea being the replacement of human corneal donor in corneal transplantation.

Abstract:Congenital cataract surgery could cause more complications, such as glaucoma, high intraocular pressure, iris adhesion, cystic mechanization etc. Among the complications, glaucoma could cause irreversible damage to optic nerve, which should be highly concerned by clinicians. However, it was difficult to obtain reliable data for the diagnosis of visual field and optic nerve damage in patients with congenital cataract. Therefore, accurate measurement of intraocular pressure was important for glaucoma diagnosis. Postoperative variation of corneal thickness was often found in congenital cataract, leading to inaccurate measurement of intraocular pressure. The article introduced the changes of central corneal thickness(CCT), intraocular pressure(IOP)and causes of variations after congenital cataract surgery.

Abstract:Retinal vein occlusion(RVO)is a common retinal vascular disease. Macular edema(ME)secondary to RVO is the main cause of visual impairment in patients. The mechanisms of ME secondary to RVO are intricate and have not yet been fully elucidated. Many cells and cytokines are involved in it, which disrupt the balance between fluid entry and exit in the retina. This review discusses the complex pathogenesis of ME associated with RVO and the mechanisms by which ME affects visual function.

Abstract:Optic nerve injury is a common nervous system disease. Its basic pathological features are axonal degeneration and apoptosis of retinal ganglion cells(RGCs), which causes numbers of symptoms including visual dysfunction. Axonal degeneration, including axonal selective degradation, Wallerian degeneration induced by axonal transection, and apoptosis-induced axonal degeneration(axonal apoptosis), is an important part of neurodevelopment, axonal remodeling, and injury response process. Axonal degeneration is one of the initial steps in many traumatic neurological disorders, and damaged axons are generally unable to regenerate, which leads to neuronal cell apoptosis. Neuronal apoptosis causing the degeneration of both cell bodies and axons commonly occurs during the development of brain, as a result of various neuronal damages. Studies in recent years have confirmed that calcium is the main regulator of axonal degeneration. When an optic nerve crush(ONC)occurs, the degree of acute axonal degeneration(AAD)can be reduced by using calcium channel inhibitors to prevent the influx of calcium ions into axons, which will also improve the survival rate of RGCs and accelerate the regeneration of axons.

Abstract:IgG4-RD is a newly recognized chronic and systemic disease. IgG4-positive plasma cells play a part in the occurrence and development of this disease. “IgG4-related ophthalmic disease(ROD)” was proposed for the involvement of eyes in general. The clinical manifestations of IgG4-ROD are various due to different involved parts and have unique pathologic features compared with other organs. With a better understanding on this disease in recent years, diagnosis and treatment rate has been improved. In this paper, we will discuss the definition, epidemiology, pathogenesis, clinicopathological features, diagnosis and differential diagnosis, serum biochemical indices, imaging examinations and treatment about IgG4-ROD.

Abstract:AIM: To systematically evaluate changes in dioptre, keratometry results, uncorrected visual acuity, and ocular axis in teenage patients with myopia using orthokeratology lens for different durations. To understand and determine the duration for using orthokeratology lens more accurately in these patients and to provide correct and reliable treatment guidance for these patients.

METHODS: Computerised search was conducted to retrieve studies from PubMed, CBM, WanFang Data, VIP, and CNKI databases, from the establishment of the databases to April 2019. The search yieldedrelevant studies on the use of orthokeratology to control the development of myopia in teenage patients. After two researchers independently conducted literature screening, data extraction, and methodological quality evaluation, a Meta-analysis was performed using RevMan 5.3 software.

RESULTS: Finally, 8 relevant studies were selected, which included 1 136 teenage patients with myopia. The Meta-analysis revealed that after wearing orthokeratology lens for 1wk, keratometry results changed without statistical significance \〖1wk: MD=0.91, 95% CI(-0.01-1.83), P=0.05\〗. However, after using orthokeratology lens for 1, 3, 6, and 12mo, keratometry results decreased \〖1mo: MD=0.82, 95% CI(0.12-1.53), P=0.02; 3mo: MD=1.31, 95% CI(0.63-2.00), P<0.05; 6mo: MD=1.35, 95% CI(0.62-2.09), P<0.05; 12mo: MD=1.41, 95% CI(0.68-2.41), P<0.05\〗. Further, after 12mo of using orthokeratology lens, the increase in dioptre was effectively controlled \〖12mo: MD=2.61, 95% CI(1.52-3.71), P<0.05\〗, and the uncorrected visual acuity improved \〖12mo: MD=-0.81, 95% CI(-0.84--0.79), P<0.05). The ocular axis did not show a statistically significant increase \〖12mo: MD=-0.06, 95% CI(-0.21-0.09), P=0.44\〗.

CONCLUSION: The use of orthokeratology lens cannot only reducekeratometry values, but also control the growth of the ocular axis. However, these results can be achieved only after long-term wear.

Abstract:AIM: To quantitatively compare the effects of different surface treatments and designs of intraocular lens(IOL)on posterior capsule opacification(PCO)using EPCO2000.

METHODS: A retrospective study was conducted to observe 600(971 eyes)age-related cataract patients after 1a of phacoemulsification with implantation of intraocular lens in our hospital from March to November 2016. Patients were divided into 4 groups based on the type of IOL implant: 43 eyes in ZCB00 group, 365 eyes in ZA9003 group, 340 eyes in HQ-201HEP group and 223 eyes in Human Optics group. Retroillumination slit-lamp photographs were taken after the pupil was fully dilated and the degree of PCO was scored by EPCO2000 and compared among the groups.

RESULTS: There were 167 eyes(17.2%)with PCO involving the central 3mm of the pupil and 78 eyes(8.0%)with significant PCO or Nd:YAG laser capsulotomy. According to the hydrophobicity of IOL optical surface materials, the total score of hydrophobic group 0.000(0.000, 0.012)was obviously lower than that of hydrophilic group 0.127(0.056, 0.242)(P<0.05). The total score of heparin-free group 0.127(0.056, 0.242)was lower than that of heparin-modified group 0.175(0.067, 0.371), and the difference was statistically significant(P<0.05). The total score of single-piece group 0.000(0.000, 0.012)was obviously lower than that of three-piece group 0.120(0.041, 0.247)(P<0.05). According to the different haptic angular magnitude of IOL, the total score of the 0° haptic anglulation group 0.107(0.000, 0.212)was lower than that of the 5° haptic anglulation group 0.142(0.051, 0.298), and the difference was statistically significant(P<0.05).

CONCLUSION: A single-piece, square-edged, hydrophobic acrylic IOL can reduce PCO formation more effectively.

Abstract:AIM: To observe the clinical effect of trabeculectomy combined with dexamethasone iontophoresis in the treatment of acute angle-closure glaucoma(PACG)with diabetes mellitus.

METHODS: Totally 42 eyes of 42 patients with acute PACG combined with diabetes in our hospital were selected and divided into trabeculectomy combined with iontophoresis group(group A)and trabeculectomy combined with peribulbar injection of methylprednisolone group(group B)according to different ways of controlling inflammation after surgery. Intraocular pressure, anterior chamber inflammation and complications before and after surgery were compared between the two groups.

RESULTS: The intraocular pressure of the two groups after surgery was significantly improved compared with that before surgery, and the difference was statistically significant(P<0.05). Postoperative anterior chamber inflammation was well controlled in both groups without statistical significance(P>0.05). In terms of complications, group A was significantly superior to group B.

CONCLUSION: Trabeculectomy combined with dexamethasone iontophoresis or peribulbar injection of methylprednisolone can effectively control postoperative intraocular pressure and anterior chamber inflammation in patients with acute angle-closure glaucoma complicated with diabetes mellitus. Among them, the effect of combined dexamethasone iontophoresis in reducing complications is better and patients suffer less pain.

Abstract:AIM: To probe into the treatment effects of P50 EX-PRESS drainage nail combined with biological amniotic membrane implantation in primary open angle glaucoma(POAG).

METHODS: Totally 96 cases of 96 eyes with POAG and who treated from March 2013 to January 2019 were selected as the research objects, and the patients were divided into the observation group and the control group by the random number table method, with 48 cases in each group. The control group was implanted with P50 EX-PRESS drainage nail only, while the observation group were treated with biological amniotic membrane implantation on the basis of the control group. Then, the changes of intraocular pressure, retinal nerve fiber thickness(RNFLT), complications and success rate of operation before operation and after the operation for 7d, 1mo and 3mo of two groups of patients were observed.

RESULTS: The proportion of functional filtering blebs after operation for 3mo in the observation group was significantly higher than that in the control group(P<0.05). There was no difference in preoperative intraocular pressure and RNFLT between the two groups(P>0.05). The intraocular pressure and RNFLT after operation for 7d, 1mo and 3mo in the observation group were significantly lower than those in the control group(P<0.05). The incidence of complications in the observation group and the control group were 12% and 25% respectively(P>0.05). The success rates of operation in observation group and control group were 96% and 75% respectively(P<0.05).

CONCLUSION:The application of P50 EX-PRESS drainage nail combined with biological amniotic membrane implantation for POAG, which the clinical effects are satisfactory, and which can improve the condition of filtering blebs, reduce intraocular pressure and RNFLT, thus it has good safety and high success rate.

Abstract:AIM: To investigate the relationship between single nucleotide polymorphism(SNP)in the TERT gene and risk of age-related macular degeneration(ARMD).

METHODS: Seven reported SNPs in TERT were selected and genotyped using SEQUENOM MassArray technology in 191 ARMD patients and 197 healthy normal controls. The correlations of the alleles, genotypes and the susceptibility of ARMD were evaluated by Logistic regression analysis.

RESULTS: The frequencies of SNP rs10069690 CC, CT, TT genotypes in ARMD patients were 64.4%, 31.4%, 4.2% compared with 74.6%, 22.8%, 2.5% in normal controls, respectively. Genetic model analysis revealed that SNP rs10069690 CT+TT genotypes were significantly associated with an increased risk of ARMD patients(OR=1.63, 95% CI=1.05-2.53).

CONCLUSION: SNP rs10069690 in the TERT gene is associated with the risk of ARMD.

Abstract:AIM: To investigate the effect of retinal vascular diameter on arterial stiffness of the participants stratified by age.

METHODS: Participants who took part in the 2014(fourth)physical examination and brachial-ankle pulse wave velocity(baPWV)and fundus color photography were observed. According to the WHO criteria of age, participants were divided into 3 groups by age: 18-44 years old group, 45-59 years old group and above 60 years old group. Multiple linear regression analysis was used to analyze the association between central retinal artery equivalent(CRAE)and arteriole-to-venule ratio(AVR)with baPWV in the total participants and then stratified by age. Multivariate Logistic regression model was use to analysis the influence of CRAE on arteriosclerosis(baPWV≥14.00m/s)in the total participants and then stratified by age.

RESULTS: CRAE and AVR decrease with age, in the non-atherosclerotic people. In multivariate linear regression analysis, CRAE and AVR were defeat correlated with baPWV in the 45-59 years old group and above 60 years old group. For each increase of 1 unit of CRAE and AVR, baPWV decreased by 0.01m/s, 0.02m/s, 1.99m/s and 5.58m/s, respectively. In multivariate Logistic regression analysis, the risk of arteriosclerosis decreased with the increase of CRAE by 1μm in the 45-59 years group and above 60 years old group. The OR values(95% CI)were 0.99(0.98-0.99)and 0.98(0.97-0.99), respectively.

CONCLUSION: In the 45-59 years old group and above 60 years old group, CRAE and AVR were negatively correlated with arterial stiffness, and their increase was the protective factor of arteriosclerosis.

Abstract:AIM: To evaluate the clinical efficacy of the posterior chamber intraocular lens(ICL)implantation for high myopia by the double-pass optical quality analysis system II(OQAS II).

METHODS: A total of 26 eyes of 52 patients with high myopia admitted to the First Affiliated Hospital of Anhui Medical University from December 2017 to December 2018 were selected. All patients underwent ICL implantation. Follow-up to obtain the best corrected visual acuity(BCVA)of all patients. And a series of parameters, such as uncorrected visual acuity(UCVA), object scatter index(OSI), modulation transfer function(MTF), Strehl ratio(SR)and Predicted VA of 100%,20% and 9%,were obtained before and 1wk,1 and 3mo after operation.

RESULTS: Compared with preoperative UCVA and BCVA, the 1wk, 1 and 3mo UCVA were better than preoperative and gradually improved, and the differences were statistically significant(P<0.01). Compared with OSI, MTF, SR and Predicted VA 100%, 20% and 9% before operation, the situation improved at 1wk,1 and 3mo after operation, with statistical significance(P<0.01).

CONCLUSION: ICL implantation can effectively correct high myopia and improve UCVA. Through OQAS II analysis, OSI was reduced after ICL implantation. The postoperative MTF, SR and Predicted VA of 100%, 20% and 9% higher than those before surgery. The visual quality of patients with high myopia was improved after ICL implantation.

Abstract:AIM: To observe the adolescents with different degrees of myopia who wore orthokeratology lens for 1a were visited and discuss the influence and safety of orthokeratology for curing the adolescent myopia.

METHODS: Totally 158 cases of adolescent myopia(-1.00D to -8.00D)who all wore the same brand orthokeratology lens were selected from September 2016 to December 2017. Their visual quality, including aberration detection, subjective discomfort and visual quality questionnaire was observed for 1a.

RESULTS: After wearing orthokeratology, the patients' total RMS decreased, while the RMS_h, the RMS₃(including coma)and the RMS₄(including spherical aberration)increased. The higher of baseline degree, the higher incidence of subjective visual discomfort, and the difference between pre-wearing and after was not statistically significant in subjective visual quality score(P>0.05).

CONCLUSION: The patients' objective visual quality decreased after wearing orthokeratology lens. However, the long-term observation revealed that the overall visual quality had no significant impact on lifelihood and learning, which indicates orthokeratology is a safe and effective mean of myopia curing.

Abstract:AIM:To measure and analyze the relationship between ocular biometric parameters and refractive status in hyperopia preschool children.

METHODS: Two hundred and three cases(405 eyes)of hyperopia were included in this study, who were diagnosed in Northwest Women and Children Hospital from January 2016 to December 2018.According to different mean spherical equivalent(SE)diopter, the children were divided into mild hyperopia, moderate hyperopia and high hyperopia groups though the retinoscopy after cycloplegia. Anterior chamber depth(ACD), lens thickness(LT), vitreous depth(VITR)and axial length(AL)were measured by A-scan. The value of K1, K2 were got by computer refractor. And analyze the relationship between ocular biometric parameters and refractive.

RESULTS: The mean anterior chamber depth for hyperopia preschool children was 3.08±0.38mm, the lens thickness was 3.91±0.34mm, the vitreous depth was 14.53±1.85mm, the axial length was 21.45±1.01mm and the average cornea K was 43.34±1.70D; There were statistically significant differences in AL and VITR among the three hyperopia groups(P<0.05). There were statistically significant difference in LT between low hyperopia and moderate hyperopia, moderate hyperopia and high hyperopia(P<0.05). There were statistically significant difference in ACD between low hyperopia and moderate hyperopia(P<0.05). No difference in K was found across the three groups(P>0.05); SE was negatively correlated with AL and ACD(P<0.01), but had no correlation with ACD, LT and K(P >0.05).

CONCLUSION: The change of AL plays an important role affecting the refractive state of preschoolers with hyperopia ametropia, which is manifested as higher the hyperopia diopter, the shorter AL and the shallower vitreous cavity, which are co-involved in the change of refractive state, while the hyperopic degree had no correlation with ACD, LT and K. The axial refractive error is the main refractive error in preschoolers.

Abstract:AIM: To analyze the control effect of orthokeratology(OK)combined with atropine of low concentration on moderate to low myopia in adolescents.

METHODS: Totally 76(152 eyes)adolescents with moderate to low myopia who were admitted to the department from January 2016 were enrolled. According to the voluntary principle, they were divided into orthokeratology group(OK group, n=36 cases, 72 eyes)and orthokeratology combined with atropine of low concentration group(combination group, n=40 cases, 80 eyes). The OK glasses were given for the two groups. The combination group was additionally given 0.1g/L atropine eye drops. All were followed up for 1a. The changes of uncorrected visual acuity, diopter, axial length, intraocular pressure, tear film function and corneal parameters were measured before and after wearing glasses. The incidence of complications was statistically analyzed.

RESULTS: There were no significant differences in uncorrected visual acuity, diopter, axial length and intraocular pressure between the two groups before wearing glasses and at 1a of wearing glasses(P>0.05). The change of uncorrected visual acuity before wearing glasses and at 1a of wearing glasses of combination group was higher than that of OK group while the differences in diopter and axial length were lower than those of OK group(P<0.05). Before wearing glasses, there were no significant differences in the lipid layer thickness(LLT), object scattering index(OSI)or tear film rupture time(tear film break-up time, BUT)between the two groups(P>0.05). At 1a of wearing glasses, LLT and BUT of combination group were higher than those of OK group while OSI was lower than that of OK group(P<0.05). Before wearing glasses, there were no significant differences in corneal curvature, corneal thickness or anterior chamber depth between the two groups(P>0.05). At 1a of wearing glasses, the changes of above indexes of combination group were lower than those of OK group(P<0.05). There was no significant difference in the incidence of complications between the two groups(P>0.05).

CONCLUSION:OK glasses combined with atropine of low concentration can improve the uncorrected visual acuity of adolescents with moderate to low myopia, control the increase of diopter and axial length. And there is significant negative influence on corneal morphology and tear film function, and with high safety.

Abstract:AIM: To explore the effects of sevoflurane combined with dexmedetomidine on emergence agitation(EA)in children under went general anesthesia in ophthalmology department.

METHODS: Totally 84 children underment elective ophthalmic surgery in the hospital from May to December 2018 were selected as the research objects. They were randomly divided into study group and control group with 42 cases in each group. All patients in haled sevoflurane to maintain general anesthesia. After anesthesia intubation, children in the study group were treated with intravenous injection of 0.5μg/kg of dexmedetomidine in a constant-speed while children in the control group were treated with same volume of normal saline. The monitoring data of heart rate(HR), mean arterial pressure(MAP)and serum stress response indexes such as norepinephrine(NE)and cortisol(Cor)during recovery period were obtained. The anesthesia recovery, EA and occurrence of complications were recorded.

RESULTS: There were obvious fluctuations of HR and MAP in the control group while awake, at 1min, 5min and 10min after extubation. There were significant differences at different time points(P<0.05), while there was no significant difference in study group(P>0.05). HR and MAP were significantly lower than those in control group at each time point(P<0.05). Levels of serum NE and Cor in study group while awake and at 10min after extubation were significantly lower than those in control group(P<0.05). There was no significant difference in spontaneous breathing recovery time or awake time between the two groups(P>0.05). Compared with the control group, the extubation time was significantly shorter and score of extubation quality was significantly lower in the study group(P<0.05). The incidence of EA in study group was significantly lower than that in control group(12% vs 31%)(P<0.05). There was no significant difference in the severity of EA or incidence of complications(P>0.05).

CONCLUSION: Sevoflurane combined with dexmedetomidine can effectively stabilize hemodynamics of children under went general anesthesia in ophthalmology department during recovery period, and reduce stress response, thus effectively reducing the incidence of EA, without affecting anesthesia recovery quality and with high safety. However, excessive sedation should be payed attention to.

Abstract:AIM: To explore the application effect of “diversified two-stage” teaching mode in the cultivation of master students in ophthalmology.

METHODS: A total of thirty-two master students of ophthalmology from 2017 to 2019 were randomly divided into 2 groups, 16 in each group. The study group used the “diversified two-stage” teaching mode; the control group used the traditional teaching mode. The teaching content of the same group of graduate students is the same, the teaching teachers are the same, the teaching period was 33mo of clinical practice, the research time is from 2014 to 2019, the differences between the two groups were compared in the clinical professional assessment, scientific research ability assessment, comprehensive assessment, student satisfaction and dream anxiety self-rating scores with the same examination content and the uniform scoring standard.

RESULTS: The average score of student satisfaction in the study group is(101.38±6.29), the comprehensive assessment is 84.22±4.58, and the dream anxiety score is 17.31±5.20. The average score of satisfaction in the control group is 59.13±9.61, the comprehensive assessment is 75.72±5.14, and the dream anxiety score is 25.75±3.32. The scores of clinical professional assessment, scientific research ability assessment and comprehensive assessment in the study group were higher than the control group, while the dream anxiety score was lower than the control group(both P<0.05). The dream anxiety score was negatively correlated with the teaching model satisfaction score and the student satisfaction score(r=-0.746, -0.618, both P<0.05).

CONCLUSION: The “diversified two-stage” teaching mode improves the comprehensive quality of master students' theoretical knowledge, scientific research innovation, physical and mental health. It is the best teaching mode for the master students in ophthalmology.

Abstract:AIM: To investigate the efficacy of lamellar keratoplasty(LKP)combined with accelerated(45mW/cm²)corneal cross-linking(A-CXL)on refractory fungal corneal ulcer.

METHODS: Eighteen eyes of 18 patients with refractory fungal corneal ulcer were enrolled in the Department of Ophthalmology, First Affiliated Hospital of Jiangxi Medical College from January 2017 to November 2018. The postoperative visual acuity, corneal graft transparency, the incidence and prognosis of complications such as fungal recurrence, graft rejection, secondary glaucoma and complicated cataract were all recorded.

RESULTS: All the patients succeeded in avoiding enucleation or evisceration. Postoperatively, 16 eyes(89%)gained one or more lines in uncorrected distance visual acuity 2 eyes(11%)had unchanged in uncorrected distance visual acuity. Three eyes(17%)had a graft rejection. Secondary glaucoma were detected in 2 eyes(11%), and concomitant cataract were found in 3 eyes(17%). Thirteen eyes(72%)had transparent grafts, 4 eyes(22%)had translucent transects, and the remaining one eye(6%)had a turbid graft.

CONCLUSION: LK combined with A-CXL may be feasible for refractory fungal corneal ulcer treatment by improving the cure rate.

Abstract:AIM: To investigate the difference and consistency between iTrace and Pentacam in measuring corneal spherical aberration(SphA)and curvature.

METHODS: The corneal spherical aberration and curvature were measured by iTrace and Pentacam in 63 cases(125 eyes)separately, and the SphA, the minimum corneal curvature(K1), maximum corneal curvature(K2)and corneal astigmatism(CA)were recorded respectively. Paired t-test was used for statistical analysis of econometric data, Bland-Altman analysis was used to evaluate the consistency of measurement results(SphA and curvature)measured by iTrace and Pentacam.

RESULTS: The measurement result of SphA, K1, K2 and CA were(0.230±0.086)μm,(43.01±2.38)D,(44.08±2.48)D and(1.03±0.57)D measured by iTrace, and(0.247±0.114)μm,(42.88±1.44)D,(43.86±1.51)D and(1.07±0.62)D measured by Pentacam, there was no significant difference of the measurement result of SphA, K1, K2 and CA between iTrace and Pentacam(P>0.05). The difference of SphA, K1, K2 and CA between iTrace and Pentacam was close to 0, the consistency was good because of the narrow 95% confidence interval.

CONCLUSION:There is no significant difference of the measurement result between iTrace and Pentacam, the consistency is good, and both can be used as a mutual reference in clinical.

Abstract:AIM: To evaluate ocular parameters changes after age-related cataract phacoemulsification surgery using Keratograph 5M combined with conjunctival impression cytology.

METHODS: This prospective study included 39 eyes(39 patients)from December 2016 to December 2017, who underwent cataract phacoemulsification and intraocular lens implantation in Fujian Provincial Hospital. OSDI questionnaire, tear meniscus height, tear break-up time, conjunctival hyperemia and impression cytology were performed preoperatively at 1d, 1wk, 1mo and 2mo after surgery.

RESULTS: GCD and OSDI were worsen at 1d, 1wk, 1mo, 2mo, postoperatively(P<0.05). The first-time tear break-up time was significantly shorter at 1wk(6.91±4.52, 6.12±3.55, 5.18±3.37, 6.28±4.70, 5.96±3.17s, P<0.05). The average tear break-up time was significantly shorter at 1wk(10.21±5.20, 8.89±4.47, 6.87±3.68, 7.35±3.52, 9.00±4.23s, P<0.05).

CONCLUSION: phacoemulsification will influence ocular surface parameters. The tear instability and conjunctival cell damage began at 1d postoperatively, and aggravated at 1wk postoperatively. It still couldn't return to preoperative level even at 2mo postoperatively.

Abstract:AIM: To evaluate the accuracy of the Barrett True K intraocular lens(IOL)calculation formulas in eyes with previous radial keratotomy(RK).

METHODS: From February 2017 to February 2019, 42 eyes of 22 cataract patients with previous RK were selected in our hospital. Two methods were used to calculate IOL refraction before surgery: 1)Selected the smallest anterior surface K value in the area of 3mm central corneal diameter, used SRK/T formula, the target refraction was set at -1.0D; 2)Used Barrett True K on-line calculation formula, the mode of RK was selected and the target refraction was set at -1.0D. Three months after operation, the refractive state of the eyes was examined and the refractive errors calculated by the two methods were compared.

RESULTS: The average refractive error of Barrett formula method was 0.61(-0.37, 0.88)3mo after operation, which was significantly lower than that of traditional formula method 0.35(-0.25, 0.63)D(P<0.05). There was no significant difference in absolute refractive error between the two methods(P>0.05). The refractive errors of traditional formula method in the range of ±0.5D, ±1.0D, ±2.0D accounted for 21%, 45%, 90% respectively. The refractive errors of Barrett formula method in the range of ±0.5D, ±1.0D, ±2.0D accounted for 31%, 74%, 100% respectively(P<0.05).

CONCLUSION: Barrett True K online formula applied to cataract patients after RK can achieve satisfactory refractive status.

Abstract:AIM:To investigate the efficacy of intravitreal injection of modified low-dose of triamcinolone acetonide(TA)in the treatment of pseudophakic cystoid macular edema(PCME).

METHODS: Retrospective study. Totally 12 eyes of 12 patients with PCME in our hospital were received intravitreal injection with modified low doses of TA from 2015-01 to 2018-12. The TA suspension was firstly resuspended by intraocular irrigating solution through 0.22um pore filter, then the new TA suspension(2mg/0.05mL)was injected intravitreally. The best-corrected visual acuity(BCVA), central macular thickness(CMT), intraocular pressure(IOP), and other side effects were recorded at 2wk, 1mo, 3mo and 6mo after injection, then compared the data with pre-injection(baseline)information.

RESULTS: After intravitreal injection of modified low dose TA, all patients got improved BCVA and alleviated CMT, as compare to the baseline data, and the difference was statistically significant(P<0.05), but the difference of IOP was not significant(P>0.05). All patients had no recorded ocular or systemic complication.

CONCLUSION: Intravitreal injection of modified low-dose TA is effective and safe for PCME, without significant increase in IOP. It's an affordable substitution to anti-vascular endothelial growth factor(anti-VEGF)agents. This still needs to be confirmed by the long-term follow-up study with large samples.

Abstract:AIM:To investigate the effect of internal limiting membrane(ILM)transplantation in the treatment of large macular hole.

METHODS: Totally 35 patients with large macular hole(>700μm)underwent vitrectomy in our hospital from March 2016 to March 2018 were retrospectively analyzed, in which group A(17 patients)underwent vitrectomy and internal limiting membrane peeling generally, group B(18 patients)underwent vitrectomy and internal limiting membrane transplantation. The best corrected visual acuity(BCVA)and macular hole closure rate were performed preoperative and 3mo postoperative.

RESULTS: The macular hole closure rate in group A was 65% at 3mo safter surgery, and macular hole closure rate in group B was 100% at 3mo after surgery(P<0.05). The rate of BCVA of A group which were significantly improved at 3mo postoperative(increase by 2 lines or more)compared preoperative is 35%, and the rate of BCVA of B group is 78%(P<0.05).

CONCLUSION: Internal limiting membrane transplantation can improve the closure rate of large macular hole and visual function after surgery in a certain extent. It is a safe and effective surgical method.

Abstract:AIM: To explore the clinical effect of laser photocoagulation combined with minimal doses of intravitreal ranibizumab(IVR)for aggressive posterior retinopathy of prematurity(AP-ROP).

METHODS: Medical records of 36 eyes of 18 premature infants with a primary diagnosis of AP-ROP were reviewed and analyzed retrospectively. All the lesions were located in posterior zone, with 22 eyes in zone 1 and 14 eyes in zone 2. Six eyes had iris rubeosis, while 8 eyes combined with vitreous hemorrhage. All participants were divided into injection group(0.4mg)or combined group(0.25mg)randomly. Laser photocoagulation was applied on the avascular retina, sparing two-disc diameter width temporal avascular area anterior to ridge in the combined group, meanwhile, a minimal dose(0.25mg)of IVR was conducted. Follow-up ranged from 12-24mo, with a mean of 18.7±6.3mo. The anatomical results and complications were recorded after treatment.

RESULTS: AP-ROP regressed after single therapy in two groups. No infants had localized proliferation or detachment post total treatment. The regression time of neovascular ridges and plus-diseases were 2.01±0.32 and 1.92±0.51wk respectively in injection group, and both were 1.75±0.29wk in combined group. The differences between those two groups were statistically significant(t=3.32, 4.16; P<0.05). The regression time of rubeosis was 1.59±0.07wk in injection group, 1.34±0.18wk in combined group. The differences between those two groups were statistically significant(P<0.05).

CONCLUSION: The combination of laser photocoagulation and intravitreal injection of minimal dosage of ranibizumab is safe and effective in the treatment of AP-ROP.

Abstract:AIM: To observe the efficacy of the minimal scleral buckling in the treatment of long-standing retinal detachment.

METHODS: The clinical data of 54 eyes in 54 cases of long standing retinal detachment treated by the minimal scleral buckling in our hospital during January 2014 to September 2018 were analyzed retrospective. Patients were followed up for 6mo. The rate of postoperative retinal reattachment, the best corrected visual acuity(BCVA), intraocular pressure, eye axis and astigmatism were observed. According to the preoperative time of retinal detachment, retinal detachment range, macular involvement or not and presence of PSF or not, the improvement of postoperative BCVA were analyzed.

RESULTS: The retina reattached in 49 eyes(91%)after primary operation. Postoperative persistent subretinal fluid was observed in 29 eyes of them by optical coherence tomography. At the last follow up, BCVA increased in 12 eyes(22.2%), remained unchanged in 38 eyes(70.4%), and decreased in 4 eyes(7.4%).The preoperative time of retinal detachment, retinal detachment range, macular involvement or not and presence of PSF or not had an impact on the postoperative recovery of BCVA.

CONCLUSION: The minimal sclera buckling surgery is an effective method to treat long standing retinal detachment. But postoperative visual acuity recovery is related to many factors.

Abstract:AIM: To study the single nucleotide polymorphisms(SNPs)of Macrophage Scavenger Receptor 1(MSR1)gene in xanthelasma palpebrarum patients.

METHODS: We drew peripheral venous blood from 20 xanthelasma palpebrarum patients and 20 healthy participants. We detected the SNPs of MSR1 gene with Sanger sequencing, examined serum lipids and α-lipoprotein of the patients, and scanned carotid arteries of the patients with color ultrasound. After that, we kept on observation of the participants.

RESULTS: There was no significant difference in the SNPs of MSR1 genotype between xanthelasma palpebrarum patients and healthy participants. However, in some patients with carotid atherosclerosis and hyperlipidemia, there were homozygous mutations at S2-SNP1, S5-SNP2 and S5-SNP4 in the exon region of MSR1 gene, which were related to atherosclerosis.

CONCLUSION: Xanthelasma palpebrarum is related to SNPs of MSR1 in atherosclerosis.

Abstract:AIM: To study the composition of ocular surface microflora in patients with pterygium and to explore the correlation between ocular surface microflora and pterygium.

METHODS: Primary pterygium patients were collected from September 2018 to January 2019 in our hospital. The pterygium group consisted of 26 eyes with pterygium and the control group consisted of 9 normal eyes. We used Miseq PE301+8+8+301 platform to measure the sequences of the both ends of bacterial 16S rDNA V3-V4 region. Analyze and compare the structure and composition of microbial flora on normal ocular surface and pterygium ocular surface. WILCOX test(rank sum test)was used for statistical methods.

RESULTS: A total of 1 837 OUTs were obtained from the two groups. Alpha diversity analysis showed that the species diversity of the normal control group was higher than that of the pterygium group. At the same time, the dominant flora of the two groups were similar. Corynebacterium, Staphylococcus, Streptococcus, Propionibacterium and other Gram-positive bacteria were the main constituents, followed by Gram-negative bacteria. Corynebacterium increased in pterygium group.

CONCLUSION: The diversity of ocular surface species decreased in pterygium group, and the abundance of Corynebacterium in ocular surface flora increased significantly in pterygium patients. Corynebacterium may participate in the regulation of ocular surface immune status, and affect the occurrence and development of pterygium.

Abstract:AIM: To investigate the clinical characteristics and surgical treatment fororbital wall fracture of soldiers.

METHODS: This study choose 58 soldiers(58 eyes)who had surgical treatments for orbital wall fracture in our hospital from January 1^st, 2015 to December 31^st, 2018. Their demographic characteristics, causes of injury, fracture sites, preoperative and postoperative visual acuity, eye movement, eye prominence, and operative conditions were recorded and statistically analyzed. The patients were followed up for 6mo after treatment.

RESULTS: All patients in 58 cases of orbital wall fractures were male. The P₅₀ age of them was 21, and most of them were 20-29 years old(78%). 45 cases(78%)were injured at work, in which boxing injury and impingement injury were the main causes(74%). Simple medial orbital wall, inferior wall and both of the medial and inferior wall fractures were the common types(91%). The visual acuity of all the patients did not change significantly after operation comparing with preoperative visual acuity. According to the clinical data of postoperative CT and postoperative follow up, no implant displacement, infection or other serious complications appeared. Eye movement disorder of 33 patients were improved. Abnormal suborbital perception of 7 patients disappeared. And enophthalmos of 3 patients were corrected.

CONCLUSION: Young male soldiers are the main population of orbital wall fracture. It is of great significance to improve the protection in daily training. Surgical treatment for orbital wall fractures has significant therapeutic effect. Furthermore, it is very necessary for primary hospital to develop basic diagnosis and treatment.

Abstract:AIM: To study the therapeutic effect of visual perception learning combined with occlusion on visual acuity and stereoscopic function in patients with anisometropic amblyopia, and to compare the differences in visual acuity and stereoscopic visual function enhancement.

METHODS: A total of 47 patients with monocular anisometropic amblyopia who were treated in our hospital from June 2016 to December 2017 were enrolled. The visual acuity learning system combined with occlusion for amblyopia treatment was used to observe the best corrected visual acuity of 47 patients before and after treatment, and the result of random point dynamic 2^nd order rough stereoscopic view, random point dynamic 1^st order stereoscopic view between fine and rough, random point static 0-order near, far fine stereoscopic view, and to compare the difference between visual acuity improvement and stereo vision improvement.

RESULTS: After treatment, the visual acuity improvement degree was significantly different from that of dynamic 2^nd order rough stereoscopic vision of random points, dynamic 1^st order fine stereoscopic vision of random points, static 0 order near and far fine stereoscopic vision of random points,and the degree of improvement is obviously inconsistent. The difference was statistically significant.

CONCLUSION: The degree of visual acuity in patients with anisometropic amblyopia is not synchronized with the improvement of stereopsis. The stereoscopic function of patients with basically curedvisual acuity is not basically normal. Therefore, the training and establishment of stereoscopic function in patients with anisometropic amblyopia should be concerned. The measurement of stereopsis may become a new classification method and treatment standard for amblyopia.