Abstract:This article summarized the choroidal thickness systematically and followed by relevant findings which describes the influencing factors of the choroidal thickness, the changes of the choroidal thickness in ophthalmic diseases and the relationship between the blood flow and the choroidal thickness detailedly. Choroidal thickness is affected by many factors, such as age, gender, intraocular pressure, refractive error, axial length, systolic blood pressure, daily rhythm, body position, smoking history, etc. And choroid is significantly correlated with many ophthalmic diseases. Choroidal thickness is of great importance in the diagnosis and treatment of ophthalmic diseases.

Abstract:AIM:To investigate the efficacy of a novel screening software for amblyopia.

METHODS: Totally 324 preschoolers aged 3-6 years old from outpatient department participated in the study in 2017. They were assessed for amblyopia by their parents, using the screening software and were reevaluated by ophthalmologists with professional eye tests. Sensitivity, specificity of the screening software were validated by comparing the results from the screening software and those from the professional tests.

RESULTS: All 324 children(176 males and 148 females)completed all of the procedures. Four amblyopes were found by professional tests. And 3 of them were detected by the screening software. The sensitivity, specificity were 75%, 90%, respectively. Professional tests cost an average of US Dollar(US$)607/case of amblyopia detected, whereas the cost was near US$ 0/case for the screening software, except the cost of software development.

CONCLUSION:The results from this pilot study indicate that the screening software for amblyopia is a simple, and highly effective, which offers a new option of amblyopia screening for developing countries.

Abstract:AIM: To investigate the effect of docosahexaenoic acid(DHA)on photoreceptor apoptosis and phosphatidylinositol-3-kinase/threonine protein kinase(PI3K/Akt)pathway in age-related macular degeneration(ARMD)rats.

METHODS: The rats were randomly divided into blank control group, model group, low dose DHA group(L-DHA group), medium dose DHA group(M-DHA group)and high dose DHA group(H-DHA group). The rat model of dry ARMD was established by light injury. He staining was used to observe the pathological changes of retina, TUNEL method to detect the apoptosis of retinal cells, transmission electron microscopy to observe the ultrastructure of retinal ganglion cells, enzyme-linked immunosorbent assay to detect the levels of TNF - α and IL-6 in retina, Western blot to detect the expression of p-PI3K, p-Akt, Bax, Bcl-2, p-NF-κBp65 and cleved-caspase-3 protein in retina.

RESULTS: Compared with the blank control group, the total thickness of retina, the thickness of outer nuclear layer and inner nuclear layer, the expression of p-PI3K, p-Akt and Bcl-2 protein in the retina of the model group decreased(P<0.05), the apoptosis index in the ganglion cell layer and outer nuclear layer, the level of TNF-α and IL-6 in the retina, the expression of Bax, p-NF-κBp65 and cleared caspase-3 protein increased(P<0.05). Compared with the model group, the total thickness of retina, the thickness of outer nuclear layer and inner nuclear layer, the expression of p-PI3K, p-Akt and Bcl-2 protein in retina increased in M-DHA group and H-DHA group(P<0.05), the apoptosis index in ganglion cell layer and outer nuclear layer, TNF-α and IL-6 levels in retina, Bax, p-NF-κBp65 and cleved caspase-3 protein expression decreased(P<0.05).

CONCLUSION: DHA may inhibit photoreceptor apoptosis by activating PI3K /Akt pathway.

Abstract:AIM: To investigate the protective effect of small interfering RNA targeting HIF-1α in retina of diabetic retinopathy mice and its mechanism.

METHODS: Totally 40 C57BL/6 male mice were randomly divided into the normal group, diabetes group, siRNA-HIF-1α group and siRNA-NC group. The diabetic models were constructed. The histopathological change of the retina of the mice was observed in each group. The microvessel density(MVD)was detected by immunohistochemistry. The expressions of HIF-1α, VEGF,NF-κB, IL-1, IL-6 and TNF-α mRNA in the retina in each group were detected by real-time quantitative PCR. The expressions of HIF-1α, ET-1 and vWF proteins in the retina in each group were detected by Western blot.

RESULTS: The body weights of diabetes group, siRNA-NC group and siRNA-HIF-1α group were lower than the normal group, while the blood glucose levels were higher than the normal group(All P<0.05). The MVD in the diabetic group and siRNA-NC group were significantly higher than those in the normal group, while the siRNA-HIF-1α group were significantly lower than the diabetes group and siRNA-NC group(All P<0.05). Compared with the diabetes group and siRNA-NC group, the relative expression levels of HIF-1α, VEGF, NF-κB, IL-1, IL-6 and TNF-α mRNA in the retina in the siRNA-HIF-1α group were decreased(All P<0.05). Compared with the diabetes group and siRNA-NC group, the relative expression levels of HIF-1α,ET-1 and vWF proteins in the retina in the siRNA-HIF-1α group were decreased(All P<0.05).

CONCLUSION: Specific silencing of HIF-1α gene could protect the retina of DR. The mechanism may be related to the reduction of angiogenesis and vascular endothelial injury.

Abstract:AIM: To evaluate hesperidin's inhibitory effect on the proliferation of human pterygium fibroblasts(HPF)cultured in vitro and its influence on the expression of cyclin D.

METHODS: The fresh tissue of human pterygium was cultivated by adherent cell culture in vitro and adherent cells were appraised by immune fluorescence staining. HPF cells were treated with hesperidin(24μmol/L, 48μmol/L, 64μmol/L, 72μmol/L, 96μmol/L, 120μmol/L)and MMC(1.5μmol/L, 7.5μmol/L and 30.0μmol/L). The inhibition rate of cell proliferation was detected by MTT assay 24h, 48h and 72h after treatment, and appropriate concentration and time were selected. The relative expression of cyclin D in HPF was detected by Western blot.

RESULTS: When HPF were treated respectively with hesperidin(48μmol/L, 72μmol/L)and MMC(7.5μmol/L)for 48h, Western blot results showed the relative expressions of cyclin D in blank control group(normal culture), MMC group, hesperidin(48μmol/L)group and hesperidin(72μmol/L)group to be 1.20±0.02, 0.60±0.03, 0.54±0.02, 0.45±0.07(F=73.025, P=0.001)respectively. The relative expressions of cyclin D in MMC group and hesperidin group were lower than that of blank control group(P<0.05); while the relative expressions of cyclin D in MMC group and hesperidin(48μmol/L, 72μmol/L)group showed no significant difference(P>0.05).

CONCLUSION:Hesperidin can inhibit the proliferation of HPF by reducing the relative expression of cyclin D.

Abstract:AIM: To explore the effect and mechanism of paclitaxel on diabetic retinopathy model rats.

METHODS: The diabetic retinopathy model was established and randomly divided into model group, routine drug group, low dose and high dose picetaxel group with 10 rats each. In the model group, 100mg/kg normal saline was used for gavage, while in the conventional group, 100mg/kg epalrestat was used for gavage. The low dose and high dose picetaxel groups were given 100 and 200mg/kg picetaxel respectively. The retina tissue of five groups of rats was observed by optical microscope, Western blot was used to detect the expression of Bax and Bcl-2 protein, and enzyme-linked immunosorbent assay was used to detect the levels of VEGF, HIF-1 α, ANG Ⅱ, Ang-1, Ang-2 and Tie-2.

RESULTS: The ratio of Bax and Ang-1/Ang-2 in the retina of the high dose group was(1.76±0.05, 3.16±0.09)higher than that of the low dose group(1.01±0.21, 2.98±0.02)(P<0.05). The levels of Bcl-2, VEGF, HIF-1 α, ANG Ⅱ, Ang-1, Ang-2, and Tie-2 in high dose picetaxel group were(0.37±0.06, 121.89±5.45ng/mL, 0.38±0.01pg/mL, 7.58±0.10ng/mL, 8.56±0.04μg/L, 3.24±0.25μg/L, 3.00±0.04μg/L)respectively lower than the lower levels(0.96ng/mL, 0.42±0.02pg/mL, 8.12±0.09ng/mL, 9.10±0.46μg/L, 4.12±0.23μg/L, 3.46±0.15μg/L)(P<0.05).

CONCLUSION: Paclitaxel can inhibit oxidative stress injury and angiogenesis by acting on Ang/Tie receptor signaling pathway, effectively protect retinal tissue of diabetic retinopathy rats in a dose-dependent manner, which provides a theoretical basis for clinical treatment of diabetic retinopathy.

Abstract:AIM: To evaluate the effects of pranoprofen on the retinal structure and serum levels of vascular endothelial growth factor(VEGF)in patients with cataract surgery.

METHODS: One hundred and seventy two cataract patients(200 eyes)were enrolled in this study. All the patients were randomly divided into observation group and control group. The patients of observation group were treated with pranoprofen combined with normal post-operative therapy for 1mo. We set 4 points(1d, 7d, 15d and 30d after surgery)to dynamically analyze the fluctuation of inflammation score, central macular retinal thickness(CMT), macular foveola retinal thickness(MFRT), and the light receptor inner segment and outer segment layer(IS/OS). We set two points(before and 30d after surgery)to dynamically observe the alteration of superoxide dismutase(SOD), malondialdehyde(MDA)and VEGF.

RESULTS: The levels of inflammation index in control group were higher than those in observation group 7d, 15d and 30d after surgery, respectively(P<0.001). The levels of CMT in control group were higher than those in observation group 15d and 30d after surgery, respectively(P<0.001). The levels of IS/OS in control group were lower than those in observation group 7d, 15d and 30d after surgery, respectively(P<0.001). Both of two groups expressed a markedly increasing of SOD levels(P<0.001)and decreasing of MDA and VEGF levels(P<0.001)30d after surgery compared with those before surgery. The levels of SOD in control group were lower than those in observation group(P<0.001), whereas the contents of MDA and VEGF in control group were higher than those in observation group(P<0.001)30d after surgery.

CONCLUSION: Pranoprofen considerably relieve levels of inflammation injury and down-regulate circulating levels of VEGF, which contributes its promotion in the recovery of retinal structure after surgery.

Abstract:AIM: To investigate peripapillary vessel density(VD)in primary open angle glaucoma(POAG)eyes and to compare them with normal control eyes, and to evaluate the diagnostic ability of peripapillary VD in POAG.

METHODS: Sixty consecutive POAG patients from March 2018 to December 2018 were enrolled in this study. Sixty age- and sex-matched healthy volunteer were also enrolled as a control group. Using RTVue-100 optical coherence tomography(OCT), the peripapillary VD of POAG eyes and normal control eyes were measured and compared. To assess the diagnostic ability of peripapillary VD in POAG, receiver operating characteristic curves(ROC)and areas under the ROC(AUC)were used.

RESULTS: The POAG eyes had a smaller peripapillary VD than the control eyes overall(P<0.001). The mean superior and inferior peripapillary VD of the POAG patients were 52.38%±5.31% and 52.58%±5.32%, respectively. The mean superior and inferior peripapillary VD in control eyes were 58.43%±4.11% and 58.36%±3.40%, respectively. Compared to the normal control subjects, the POAG eyes had a smaller superior and inferior peripapillary VD with a significant difference(P<0.001). Multivariable linear regression analysis showed that cup/disc ratio and the peripapillary VD were significantly thinner in association with the POAG diagnosis. The ROC and AUC analyses showed that the AUC value of peripapillary VD is 0.808(95% CI:0.730-0.887)with a good diagnostic value.

CONCLUSION:The peripapillary VD in POAG eyes was smaller than that of normal control eyes. Decreased peripapillary VD might therefore be associated with POAG. The peripapillary VD had a good diagnostic value.

Abstract:Regarded as a complex biological process, lens development involves a range of signal molecules and their crosstalk networks. Recently,the role of planar cell polarity(PCP)signaling pathway in lens development has attracted increasing attention. It has been reported that PCP is critical for lens morphology and transparency maintaining. The studies performed on PCP serve to provide guidelines on how to optimize the morphology of regenerated lens. This is thought as presenting an effective therapy for infant cataract from a clinical perspective. This article will give a comprehensive review of the role of PCP signaling pathways in the lens development.

Abstract:Uveitis has been generally defined as the inflammation occurring in the intraocular tissues. Among them, non-infectious uveitis is a T cell-mediated autoimmune inflammatory response. Through systemic treatments for non-infectious uveitis are abundant, the main principle is to suppress the immune response. In this review, we reviewed the history of non-infectious uveitis systemic therapy, detailed the current status of systemic treatment, summarized the pros and cons of each treatment regimen, and expected some new treatments for non-infectious uveitis.

Abstract:Diabetic retinopathy(DR), one of the most common complications of diabetes mellitus, is the leading cause of blindness in working-age population. DR, previously regarded as a microvascular disease, is also considered as neuronopathy and low-to-moderate inflammation in retina with research progression. Microglias, the resident macrophage in the inner retina, are responsible for surveillance of the microenvironment in retina. Under abnormal conditions, microglias are activated and interact with different types of cells in retina. In DR, microglias become activated, as evidenced by the activation of the key molecules or signal transduction pathways, such as the nuclear factor kappa-light-chain-enhancer of activated B cells(NF-κB)and extracellular signal-regulated kinase(ERK)signaling pathways, which lead to the increased production of pro-inflammatory factors, chemokines, etc. At the same time, the proliferation and migration of activated microglia are enhanced, and microglias migrate to the outer retina. The over-activation of microglias causes neuronal cell apoptosis and blood-retinal barrier breakdown, resulting in vision loss.

Abstract:Dry eye syndrome refers to a general term for various diseases in which tear fluid quality orabnormality or kinetic abnormality is caused by any cause, resulting in decreased tear film stability, accompanied by ocular discomfort and/or ocular surface tissue lesion characteristics. Dry eye syndrome is a multifactorial disease that is greatly affected by age and environmental factors. Among them, oxidative stress is closely related to age-related dry eye. In this article, based on animal experiments, the role of oxidative stress in dry eye syndrome was pointed out by establishing animal models of oxidative stress and monitoring the levels of biomarkers and antioxidant defenses indicative of oxidative damage in ocular surface tissue. In addition, some interventional studies have shown that oxidative stress may be a direct target for local treatment of dry eye. Certain substances may effectively reduce oxidative stress damage, thereby achieving the effect of treating dry eye. Further research on oxidative stress in recent years has shown that oxidative stress has an increasingly important role in dry eye, providing a basis for clinical intervention against oxidative stress.

Abstract:Retinal pigmentosa(RP)is a hereditary blinding retinal disease whose pathogenesis is not fully understand. It is characterized by night blindness, progressive narrowing visual field and vision decreased. Bone spicule-shaped pigment,retinal vessel attenuation and pallor optic disc can be seen at the fundus.RP is geneticallyand phenotypically heterogeneous, autosomal recessive retinitis pigmentosa accounts for 5%-20% of RP. There are 43 pathogenic genes have been mapped in autosomal recessive retinitis pigmentosa(ARRP), 40 of them have been cloned, and new related pathogenic genes have been reporting. This article reviewsthe newest progress of the research in AGBL5, ARHGEF18, HGSNAT and ZNF408 gene relevant to ARRP.

Abstract:Idiopathic macular hole(IMH)refers to the defect of retinal nerve epidermis in macular area with unknown pathogenesis. As present, pars plana vitrectomy combined with internal limiting membrane peeling has become a normal operation for the treatment of IMH, which enables most IMH patients to achieve anatomic healing, however, it is still unclear about the healing mechanism. The role of the glial cell activation in the pathological process of nervous system injury and disease has paid more and more attention. Nearly all the injuries and diseases of nervous system(including retina)are accompanied by the activation of glial cells; and Müller cells are the main type of glial cells in the human retina. In terms of anatomy and function, they are widely related to the cell bodies and processes of neurons in all layers of the retina, and play a supporting, nutritional and information transmission role in neurons. Numerous studies have shown that the activation and proliferation of Müller cells play a leading role in closed MH. It is reviewed in this paper that the role and its related mechanisms of Müller cells in the formation and healing of IMH.

Abstract:The prognosis of fungal endophthalmitis is usually poor. Currently, it is confusing in the drugs and surgical treatment and has been explored and progressed. Traditional drugs include amphotericin B, fluconazole and flucytosine. A new generation of drugs includes liposomal amphotericin B, Voriconazole, and caspofungin. Vitrectomy combined with systemic, topical and intraocular application of drugs is particularly important for the treatment of fungal endophthalmitis. This article reviews the current and ongoing development of drugs and surgical treatment of fungal endophthalmitis.

Abstract:Proper assessment of the establishment of stereopsis after strabismus surgery continues to be challenging for the strabismus surgeon. In view of the stereopsis, the timing of surgery for strabismus has been controversial because of concerns that it may result in an overcorrection or lateness. Recent literature on the strabismus surgeon has shown that the establishment of postoperative stereoscopic vision is closely related to the age of onset, types of strabismus, course of disease and ocular deviation. This review will summarize the recent points as below.

Abstract:AIM: To investigate the effect of inclination and eccentricity of intraocular lens(IOL),on optical imaging quality via wavefront aberration optical path system.

METHODS: The spherical IOL Sensar AR40e, the aspherical monofocal IOL Tecnis ZA9003, and the aspheric multifocal IOL Tecnis ZM900 were measured at the center of the center using a laboratory-built Hartmann-Shack IOL wavefront aberration path system at 5.0mm simulated pupil diameter. 0, 0.2, 0.4, 0.6, 0.8mm, the effect on the optical imaging quality when tilting 5°, 10°, 15°, 20°, 25° to the nasal side and the temporal side, and quantitative imaging quality by high-order aberration and modulation transfer function.

RESULTS: The Temnis ZA9003 MTF value was higher than AR40e and Tecnis ZM900 when inclinationed within 5°, while the three IOL MTF values were significantly different when inclinationed 5°, 10°, 15°, and 20°. Tecnis ZA9003 The IOL inclination angle was significantly positively correlated with the coma(r=0.842, P<0.001), and there was no significant correlation with the spherical aberration(r=0.229, P=0.241). The three IOL MTF values were obtained when the eccentricity was 0.6 and 0.8 mm. Significant differences(both P<0.001), the imaging quality of the Tecnis ZM900 eccentricity greater than 0.4mm decreased significantly.

CONCLUSION: When the inclination of aspheric IOL(-0.27μm spherical aberration)is less than 5°and the eccentricity is less than 0.4mm, aspherical IOL has a better imaging quality than that of spherical IOL. Tecnis ZM900 IOL has a lower optical imaging quality than that of spherical and aspheric IOL when the eccentricity of IOL is more than 0.4mm.

Abstract:AIM: To investigate interocular differences in macular ganglion cell complex(mGCC)thickness in normal healthy subjects, and to determine cutoffs for interocular differences in mGCC thickness in normal healthy subjects.

METHODS: This was a cross-sectional study. mGCC thickness were measured in 236 healthy volunteers(472 eyes)using optical coherence tomography(OCT). The differences and the relationships of mGCC thickness between right and left eyes were analyzed.

RESULTS: For the right eyes, the mean average mGCC thickness was 91.99±6.61μm, and for the left, 91.75±9.93μm, with no significant difference. The mean mGCC thickness among superior and inferior in the right eye were 92.32±6.66μm and 91.27±8.87μm, respectively. The mean mGCC thickness among superior and inferior in the left eye were 92.05±6.55 and 91.51±6.76μm, respectively. It is comparable between the two eyes at different area. The P_2.5 and P_97.5 percentiles of interocular difference for mean average mGCC thickness were -4.82μm and 4.36μm, for superior mGCC thickness, -5.79μm and 6.42μm, and for inferior mGCC thickness, -7.21μm and 6.28μm. There was a strong correlation in the corresponding area between the right and left eyes for the mGCC thickness.

CONCLUSION: mGCC thickness shows significant interocular symmetry in normal subjects. Interocular difference exceeding the normal limits should be considered significantly asymmetrical, and may be indicative of glaucoma.

Abstract:AIM: To study the subfoveal choroidal thickness(SFCT)and its influencing factors in children with different degree of myopia.

METHODS: This is prospective cohort study. Eighty-nine eyes of 45 school-age children aged 5-14 years old were studied, and according to the equivalent sphericity(SE)into different refractive groups. Mild, moderate and high myopia groups had 27, 42 and 20 eyes respectively, apply the enhanced depth scanning mode(EDI-OCT)of an optical coherence tomography(OCT)scanner to measure SFCT to compare choroid thickness differences among myopia groups, to find out the change rule of SFCT between myopia groups, and Pearson correlation analysis was used to analyze the related influencing factors.

RESULTS:SFCT of mild myopia, moderate myopia and high myopia respectively were(253.22±43.56)μm,(223.19±54.93)μm,(185.90±50.99)μm, SFCT differences between different refractive groups were statistically significant(P<0.05), Pearson correlation analysis found that there was a significant correlation between SFCT and SE and axial length(r=0.430, -0.499, 0.425, all P<0.001); slightly related to K1 and K2, and the correlation of AL, retinal nerve fiber layer(RNFL)thickness were better than that of SE. There were statistically significant differences in family history of myopia among the myopic groups(χ²=7.44, P<0.05).

CONCLUSION: The degree of myopia in children was deepened and SFCT became thinner. The degree of myopia in children is related to the family history of myopia.

Abstract:AIM: To study the thickness of peripapillary retinal nerve fibre layer and morphological changes of optic disc in myopic subjects using optical coherence tomography(OCT).

METHODS:Prospective study. A total of 61 myopic subjects(95 eyes)with a mean age of 27.76±7.05 years and 15 controls(30 eyes)with a mean age of 28.33±3.08 years were included. All subjects underwent standard comprehensive refraction(SE), axial length(AL), intraocular pressure(IOP), dilated fundus examination,, and OCT. Based on SE, myopic subjects were divided into three groups: 14 eyes in the moderate to low myopia group(-3D≤SE<-6D), 56 eyes in the high myopia group(-6D≤SE≤-9D), and 25 eyes in the ultra-high myopia group(SE> -9D). The mean retinal nerve fiber layer thickness of the optic disc and the nerve fiber layer thickness of the four quadrants were analyzed, as well as the peripapillary atrophy area(PPA), optic disc ovality index(OI), and horizontal optic disc tilt(HOT).

RESULTS:The thickness of nerve fiber layer in each quadrant was significantly different among the four groups(P<0.01). The mean thickness of nerve fiber layer, the thickness of superior nerve fiber layer and the thickness of nasal nerve fiber layer were significantly higher in the control group than in the three myopic groups(all P<0.05). The thickness of temporal nerve fiber layer in the control group was significantly lower than that in the high myopia group and the super high myopia group(P<0.001, P=0.002), and also significantly lower in the moderate and low myopia group than that in the super high myopia group(P=0.043); the PPA of the four groups was statistically different(P<0.001), in which the super high myopia group and the high myopia group was significantly greater than that in the low myopia group and the control group(P<0.01); the HOT of the four groups was statistically different(P=0.020), in which the high myopia group and the super high myopia group was significantly higher than that in the control group(P<0.001, P<0.001). The nerve fiber layer thickness in the upper and lower quadrants was negatively correlated with OI, HOT, and PPA(all P<0.05), while the nerve fiber layer thickness in the temporal side was positively correlated with OI, HOT, and PPA(all P<0.05).

CONCLUSION: Mean and superior and inferior nerve fiber layer thickness was thinner in myopic patients, with temporal thickening and no change in the nasal side. The tilt of optic disc and the area of peripapillary atrophy were increased in high myopia, which were closely related to the thickness of nerve fiber layer.

Abstract:AIM: To determine the effect of obstructive sleep apnea syndrome(OSAS)on visual field and retinal nerve fiber layer(RNFL)thickness.

METHODS: This study consisted of 72 eyes of 72 OSAS patients who were enrolled as OSAS group, and compared with 74 eyes of 74 age-matched physical examination personnels who were enrolled as control group. Visual field sensitivities(VFS)were explored with Humphrey perimeter. Peripapillary RNFL thickness was measured by stratus optical coherence tomography(OCT). VFS and Peripapillary RNFL were divided into upper, lower, temporal and nasal regions. According to apnea-hypopnea index(AHI)scores monitored by polysomnography(PSG), VFS and peripapillary RNFL thickness in 29 patients with mild OSAS, 25 patients with moderate OSAS and 20 patients with severe OSAS were compared with those in control group.

RESULTS: There was no significant difference in VFS between OSAS group and control group in upper, lower, temporal and nasal regions(P>0.05). RNFL of nasal region in OSAS group, especially in severe OSAS patients, was significantly lower than that in control group(P=0.047). Pearson correlation analysis showed that there was negative correlation between RNFL and OSAS severity in nasal region(r= -0.9998, P=0.0138).

CONCLUSION: Severe OSAS may lead to nasal RNFL thickness reduction, and the change of RNFL thickness may be used as one of the indicators to assess the severity of OSAS.

Abstract:AIM: To investigate the effects of intravitreal injection of conbercept-assisted vitrectomy(PPV)on proliferative diabetic retinopathy(PDR)and inflammatory factors and angiopoietin-like protein 4(ANGPTL4)in the vitreous.

METHODS: Totally 90 patients with PDR(99 eyes)who underwent PPV treatment in our hospital from January to February 2018 were selected as subjects, and were divided into PPV group and IVC/PPV group according to whether intravitreal injection of conbercept(IVC).The surgical indexes of the two groups, the best corrected visual acuity(BCVA, LogMAR)and the incidence of postoperative vitreous hemorrhage(POVCH)were observed within 3mo after surgery were observed. The levels of interleukin-6(IL-6), interleukin-10(IL-10), C-reactive protein(CRP)and other inflammatory factors and ANGPTL4 in the vitreous of the two groups were measured.

RESULTS: In the IVC-assisted PPV group, the operation time, intraoperative severe hemorrhage(bleeding with electrocoagulation pen), iatrogenic retinal tears and postoperative silicone oil filling rate were significantly better than those in the PPV group(P<0.05). There was no significant difference in BVCA between the two groups(P>0.05). There was no significant difference in BVCA between the two groups(P>0.05). At 1 and 3mo after operation, BCVA decreased significantly in both groups. Visual acuity improved significantly. The BCVA(LogMAR)of the IVC combined with the PPV group was significantly lower than that of the group. Simple PPV group(P<0.05). The occurrence of POVCH The rate was significantly decreased(P<0.05), the contents of IL-6, IL-10 and CRP in the vitreous were significantly decreased(P<0.05), and the content of ANGPTL4 was significantly increased(P<0.05).

CONCLUSION: Preoperative vitreous injection of conbercept in the treatment of PDR can reduce the occurrence of intraoperative and postoperative complications, promote the recovery of visual acuity, reduce the inflammatory response in the vitreous and increase the content of ANGPTL4.

Abstract:AIM: To discuss the clinical efficacy of tobramycin dexamethasone eye ointment combined with OCuSOFT tea tree oil cleaning wipes in the treatment demodex blepharitis.

METHODS: Prospective clinical study. Totally 72 patients with demodex blepharitis were selected. They were randomly divided into three groups. The experimental group was treated with tobramycin dexamethasone eye ointment combined with OCuSOFT tea tree oil cleaning wipes. After 30d of treatment, the symptom score, the number of eyelash mites and the score of clinical signs were observed under slit lamp. The data before and after treatment were compared by paired sample t-test and analysis of variance.

RESULTS: There was significant difference in demodex count among the three groups before and after treatment(P<0.01). The difference of total symptom score was statistically significant(F=20.05, P<0.01). The difference of total score of physical signs was statistically significant(F=8.10, P<0.01).

CONCLUSION: Tobramycin dexamethasone eye ointment combined with OCuSOFT tea tree oil cleaning wipes is effective in the treatment of demodex blepharitis. Tea tree oil cleaning wipes are portable,easy to preserve and not easy to deteriorate.

Abstract:AIM:To observe and compare the therapeutic effects of intense pulsed light(IPL)combined with meibomian gland massage and eyelid fumigation massage on dry eyes associated with meibomian gland dysfunction(MGD).

METHODS: This study was a prospective randomized controlled clinical trial. Totally 73(146 eyes)outpatients with MGD-related dry eyes were selected from March 2018 to August 2018 at Xi'an No.4 Hospital. 38 patients(76 eyes)in the experimental group were given IPL combined meibomian gland massage treatment(once every three weeks, three times in all), and 35 patients(70 eyes)in the control group were given eyelid fumigation combined meibomian gland massage treatment(fumigating and cleaning the eyelid margin every day for 5d, massaging the tarsal gland on the fifth day, repeating treatment after 2wk, totally 3 times). The study lasted 12wk. The ocular surface disease index(OSDI), standard dry eye assessment questionnaire(SPEED), non-invasive tear film rupture time(NITBUT), non-invasive lacrimal river height measurement(NITMH), meibomian gland loss score(MGS), meibomian gland secretion assessment(MGYSS)before and after the first treatment, the first week, the fourth week, the seventh week and the twelfth week were recorded to evaluate the curative effect of the two treatments.

RESULTS: There was no significant difference in gender and age between the two groups(P>0.05).There was no significant difference in data between the two groups before treatment(P>0.05). Indexes except NITMH and MGS each time point after treatment in the two groups were significantly improved compared with those before treatment, and the difference was statistically significant(P<0.05). There was no significant difference in each index between the experimental group and the control group at 1wk after treatment(P>0.05); at 4, 7 and 12wk after treatment, the experimental group was superior to the control group except for NITMH and MGS, and the difference was statistically significant(P<0.05). From the change trend of the indicators, the therapeutic effect of the experimental group continued to improve after the first treatment, and was the best at the 12^th week, while that of the control group was the best at the 7^th week after the first treatment, and then the curative effect was weakened. There were no obvious complications in both groups after treatment.

CONCLUSION: Both intense pulsed light combined with palpebral gland massage and eyelid fumigation massage are convenient, safe and effective for MGD-related dry eyes, and the curative effect and maintenance time of intense pulsed light combined with palpebral gland massage are better than that of eyelid fumigation massage.

Abstract:AIM: To investigate and compare the effect of femtosecond laser-assisted in situ keratomileusis(FS-LASIK)and small incision lenticule extraction(SMILE)surgery on anterior corneal asphericity.

METHODS: There were sixty eyes of 60 patients in FS-LASIK and SMILE group respectively from November 2016 to September 2017. The Q-values of anterior corneal surface for different diameters(6, 7, 8 and 9mm)and corneal aberrations were measured with Pentacam before and 3mo after operation.

RESULTS: The Q-values of anterior corneal surface between FS-LASIK and SMILE were no significant differences. After 3mo operation, the values increased significantly; and the post-operative Q-values of 6mm in group SMILE was significant lower than group FS-LASIK(0.47±0.32 vs 0.89±0.43,P<0.05). The higher aberration and spherical aberration in FS-LASIK and SMILE were no significant differences before surgery; after 3mo operation,there were no significant difference between them. However, group FS-LASIK had significant higher spherical aberration than group SMILE(0.43±0.23μm vs 0.31±0.11μm, P<0.05).

CONCLUSION: FS-LASIK and SMILE cause significant changes of anterior corneal asphericity, Q-values all increased to positive values after surgeries; and there have less changes of Q-value and corneal aberration in SMILE than in FS-LASIK surgery.

Abstract:AIM: To investigate the compliance and the relative influencing factors of orthokeratology lens in the treatment of teenagers' and children's myopia in Dongguan,and provide a scientific basic for prevention and control of myopia.

METHODS: Totally 757 patients of teenagers' and children's myopia with orthokeratology lens in our hospital from January 2017 to December 2017 were collected. Data from medical records and return visits by telephone, short message and Wechat were collated and summarized, then grasp the compliance and the relative influencing factors of orthokeratology lens in the treatment of teenagers' and children's myopia in Dongguan by analyzing re-examine time and persistence in wearing lens.

RESULTS: Totally 757 patients with mean age at 11.82±2.234 years old, including 363 males, mean aged 11.66±2.256 years old, and 394 females, mean aged 11.96±2.206 years old, there was no significant difference in age comparison of boys and girls(t=-1.855, P>0.05). In terms of re-examination compliance and persistence on wearing lens, significant difference was observed in educational stage, studying way and parents' education level(P<0.05), no significant difference was observed in gender, area, family economic status, vision before and after wearing lens and myopia control effect(P>0.05). Multivariate Logistic regression analysis showed that educational stage, studying way and parents' education level were correlated with re-examination compliance and persistence on wearing lens(P<0.05).

CONCLUSION: Compliance of orthokeratology lens in the treatment of teenagers' and children's myopia in Dongguan was correlated with educational stage, studying way and parents' education level, to improve the compliance of orthokeratology lens in the treatment of teenagers' and children's myopia, Standardize fitting, standardize care, normative propaganda and education, review on time and regular return visits were important.

Abstract:AIM: To assess the halo size and contrast sensitivity on different levels of myopia and to analyze their correlation.

METHODS: Screening total 156 myopic patients aged 18 to 39 years old included in our hospital from March 2018 to March 2019. There were 49 subjects in high myopia group(SER>-6.00D), 54 in medium myopia group(-3.00DRESULTS: The size of glare halo in high myopia group was 106.27±25.89arc min, and 103.81±31.41arc min in medium myopia group, 102.87±32.24arc min in low myopia group, and there was no significant difference among three groups(F=0.297, P=0.825). There was no significant difference among three groups on contrast sensitivity under any different spatial frequencies(P>0.05). Correlation analysis showed a significant negative relationship between glare halo radius and contrast sensitivity at the c/d of 1.1, 2.2, 3.4, 7.1(r_s=-0.302, r_s=-0.308, r_s=-0.383, r_s=-0.257, all P<0.01), and no significant correlation was detected between halo radius and SER(P>0.05).

CONCLUSION: Glare halo size had no relationship with SE but mid-frequency contrast sensitivity.

Abstract:AIM: To analyze the clinical characteristics of patients with Peters' anomaly(PA)in Chinese, and to study the variation of PITX2 and PAX6 genes in patients with PA, so as to provide basis for clinical diagnosis and pathogenesis of this rare ophthalmopathy.

METHODS: Fifteen patients with PA were selected from 2016 to 2019 in Changzhou No. 2 People's Hospital and Changzhou No. 3 People's Hospital, and the detailed clinical data were collected. Genomic DNA was prepared from venous leukocytes after obtaining the consent of the patients and their family members. The coding regions and the flanking exon-intron junctions of the PITX2 and PAX6 genes were amplified by polymerase-chain reaction(PCR)and subsequently analyzed by direct sequencing. Variations detected were further evaluated in any unaffected member and 80 normal controls by HA-SSCP. Analyzing and comparing the mutation of PITX2 and PAX6 genes and the related phenotypes in Chinese patients with PA.

RESULTS:Sequence analysis of the PITX2 gene revealed one novel mutation c.296delG(P.R99fsx56)in fifteen patients with PA. Nucleotide sequence analysis showed that this mutation led to the functional abnormal of this gene. The clinical characteristics of the mutant patient were analyzed, the right eye of the patient was diagnosed as Axenfeld-Rieger syndrome(ARS), and the left eye was diagnosed as Peters'anomaly. However, the mutation was not found in the family members of the patient's parents and unrelated normal controls, and therefore it was a de novo mutation. No mutation was found in PAX6 gene mutation screening.

CONCLUSION: A novel PITX2 gene mutation was detected in 15 patients with PA, which was the first report of PITX2 gene mutation in a patient with Peters'anomaly complicated with ARS in China. The results enrich the mutation spectrum of PITX2 gene and further clarify the clinical characteristics of PA complicated with ARS. All these will be useful foundations for clinical diagnosis and pathogenesis. Furthermore, it enriches our knowledge of genotype-phenotype relationship of PA. In addition, our results may provide basis for the functional and genomic study of the pathogenesis of the disease in the future.

Abstract:AIM: To describe the application of image acquisition function of smart phone with slit lamp examination in the ophthalmology residency training program.

METHODS: The supporting set for smart phone can be securely connected to the ocular lens of slit lamp microscopy. The anterior or fundus photos and dynamic videos were obtained through slit lamp examination with non-contact lens, three-mirror lens or gonio lens. Acquired images or recorded videos were transmitted to ophthalmology trainee by using wireless local area network(WLAN), WeChat and other software.

RESULTS: High quality images and dynamic video could be successfully taken with smart phone and supporting set by slit lamp examination, which could clearly display tissue details and pathological features. The fast transmission of image data can enable more trainees to access clinic education resource simultaneously and communicate with each other timely and effectively.

CONCLUSION: High resolution smart phones are wildly used and supporting sets are very accessible; thus high quality of images could be easily obtained for clinical teaching purpose. Furthermore, it enriches the clinical teaching resources. So the application of image acquisition function of smart phone with slit lamp examination is worthy in the standardized training of ophthalmology residents.

Abstract:AIM: To report in vivo confocal microscopic(IVCM)in corneal edema.

METHODS: Twenty-one patients with clinically diagnosed corneal edema were involved. All cases, in addition to control group of five normal eyes, were examined with IVCM.

RESULTS: IVCM findings in corneal edema showed that epithelial bullae appeared as dark, round areas with well-defined margins in all of the patients; Subepithelial fibroblasts and scarring; Other IVCM features included absent(57%)or reduced(43%)subbasal nerves in central corneal; Apart from the associated scar tissue, BZ presented a branching pattern of fine, darklines in all of the patients. Furthermore, fine or coarse granularity with avariable degree of reflectivity were noted in the anterior stroma in 13 of the 21 cases(62%); The number of keratocytes in the stroma of corneas was less than that in the normal corneas measured by using confocal microscopy in all of the patients; Endothelial changes with total obscuration of endothelial cell borders were seen in all of the patients. IVCM findings in the control group showed normal patterns.

CONCLUSION: This is the study in which IVCM features of corneal edema have been found in detail. Subepithelial fibroblasts, reduced subbasal corneal nerves and stromal keratocyte were well documented in this study. With increasing popularity of endothelial keratoplasty this work supports the role of IVCM in quantitative evaluation of corneal edema in preoperative stages, as well as after surgery.

Abstract:AIM:To evaluate the role of 0.01% hypochlorous acid in the treatment of bacterial corneal ulcer.

METHODS: A total of 60 eyes of 60 patients with bacterial corneal ulcer who were admitted to the Department of Ophthalmology, the Affiliated Hospital of Xuzhou Medical University from August to December 2018 were randomly divided into control group and combined treatment group, 30 cases in each group. The control group was treated with antibiotic eye drops. The combined treatment group was treated with 0.01% hypochlorous acid aqueous solution on the basis of conventional treatment. The therapeutic effects of the two groups were observed and compared.

RESULTS: The ulcer healing time was significantly shortened in the combination group(P=0.005). However, there was no significant difference between the two groups in cure rate(P=0.643)and final visual acuity(P=0.787). There was a small number of patients with iridocyclitis in both groups, and the incidence was not statistically different(P=0.643). There were no complications such as corneal perforation and corneal neovascularization in both groups. Patients in the combination group had no obvious corneal irritation with 0.01% HOCI eye drops.

CONCLUSION: 0.01% hypochlorous acid eye drops can accelerate the healing rate of bacterial corneal ulcer without serious complications, indicating a promising future in the field of corneal ulcer treatment.

Abstract:AIM:To investigate whether there is a difference in the probability of partial zonular dehiscence and subluxation in patients with angle-closure glaucoma and shallow anterior chamber combined with cataract.

METHODS: A retrospective analysis was performed,for patients with angle-closure glaucoma and patients of shallow anterior chamber with cataract admitted to our hospital from February 2017 to March 2019. The patients underwent cataract surgeries and were divided into two groups: Group A(visual axis <22mm)and Group B(visual axis ≥22mm). Central anterior chamber depth(ACD)was measured with ultrasound biomicroscopy(UBM); Axial length(AL, length of optic axis)was measured with IOL-Master; Calculation of the ratio of AC depth to axial length(ACD/AL)was performed. The consistency of the anterior chamber depth in all directions in UBM images was analyzed. In cataract surgeries, partial zonulysis with or without lens subluxation was recorded.

RESULTS: The result indicated that the rate of partial zonular dehiscence in group B was higher than that in group A(8.46%±1.44% vs 7.56%±1.51%, P<0.05).

CONCLUSION: When performing cataract surgery in patients of angle-closure glaucoma and shallow anterior chamber in group B, attention should be paid to the probability of zonular abnormality.

Abstract:AIM: To analyze the efficacy and safety of goniosynechialysis or trabeculectomy combined with phacoemulsification(Phaco)in the treatment of primary angle-closure glaucoma(PACG)and coexisting cataract.

METHODS: A retrospective study. A total of 108 eyes of 96 PACG patients with age-related cataract admitted to our hospital from March 2013 to February 2018 were collected. Goniosynechialysis combined with Phaco(group A)was performed in 50 cases(54 eyes), and trabeculectomy combined with Phaco(group B)in 46 cases(54 eyes). The best corrected visual acuity, intraocular pressure, central anterior chamber depth, corneal endothelial cell count, failure rate, recurrence rate, operation time and average hospitalization days were compared between the two groups.

RESULTS: After at least 12mo of follow-up(till February 2019), the best corrected visual acuity of the two groups was significantly improved, and the intraocular pressure was significantly lower than preoperation(P<0.01). Intraocular pressure in group B was significantly lower than that in group A postoperatively(P=0.004), while the best corrected visual acuity in group B was lower than that in group A(P=0.012). The central anterior chamber depth of the two groups was significantly deeper than pre-operation(P<0.01), but there was no significant difference between the two groups(P=0.231). At the last follow-up, there was no significant difference in the percentage of hexagonal cells(P>0.05). The operation time of group A was shorter(P=0.022), and the average hospitalization days were significantly lower than those of group B(P<0.001). There was no significant difference in the failure rate(P=0.243)and recurrence rate(P=0.113)between the two groups.

CONCLUSION: Goniosynechialysis combined with Phaco in the treatment of PACG and coexisting cataract has similar efficacy and safety to trabeculectomy combined with Phaco. The former may achieve better visual acuity, shorter operation time and shorter hospitalization time, while the latter has lower failure rate and recurrence rate, which is more suitable for patients with chronic PACG.

Abstract:AIM: To investigate the curative effect of intravitreal injection of ranibizumab combined with trabeculectomy on neovascular glaucoma(NVG).

METHODS: The clinical data of 52 patients(52 affected eyes)with NVG who were admitted to the hospital between September 2015 and April 2017 were collected and retrospectively analyzed. The patients were divided into group A(intravitreal injection of ranibizumab combined with trabeculectomy, 31 affected eyes)and group B(intravitreal injection of ranibizumab combined with Ahmed glaucoma valve implantation, 21 affected eyes)according to the surgical method. They were followed up for 6mo after surgery. The intraocular pressure before surgery and after surgery, eyesight, visual field and complications after surgery were compared between two groups. The clinical curative effect was assessed.

RESULTS: The intraocular pressure of both groups decreased gradually after surgery. The intraocular pressure of group A was lower than that of group B at 7d, 1mo and 3mo after surgery(P<0.05). There was no significant difference in the improvement of eyesight between the two groups at 6mo after surgery(P>0.05). The total effective rate of treatment in group A at 6mo after surgery was obviously higher than that in group B(97% vs 71%, P=0.013). The incidence rates of corneal edema and hyphema in group A were lower than those in group B(P<0.05).

CONCLUSION: Intravitreal injection of ranibizumab combined with trabeculectomy for treating NVG can effectively decrease and maintain intraocular pressure and reduce the incidence of postoperative complications, with marked curative effect.

Abstract:AIM: To observe the clinical effects of minimally invasive scleral buckling combined with 25G cannula intra-optical fiber lighting in the treatment of rhegmatogenous retinal detachment with the help of non-contact wide angle lens.

METHODS: We retrospectively analyzed 43 patients with rhegmatogenous retinal detachment from May 2011 to March 2015 in our hospital. The retinal tear locations of these patients analyzed preoperatively by pre-set lens and three-mirror contact-lens were uncertain. We detected the retinal tears intraoperatively by non-contact wide angle lens with the help of 25G cannula intra-optical fiber lighting. The tears were sealed by minimally invasive scleral buckling. The patients were followed up at 1wk, 1mo, 3mo and 6mo postoperatively. The vison and intraocular pressure were recorded with the same equipment and methods as preoperatively did. The retina reattachment and tear sealing status were also observed.

RESULTS: The retina were reattached by one operation in 41 patients and the reattachment rate was 95.3%. One patient suffered from incomplete retina reattachment, effusion under the retina, poor position of compressed retinal area, and succeeded by minimally invasive scleral buckling once again. One patient developed new retina tear and completely reattached by vitrectomy.

CONCLUSION:For those patients with uncertain retinal detachment preoperatively, minimally invasive scleral buckling combined with 25G cannula intra-optical fiber lighting could increase the success rate. The statistical analysis in large samples and the long-term complications should be further investigated.

Abstract:AIM: To compare the difference of choroidal delamination thickness in macular fovea between patients with early active Graves ophthalmopathy and healthy subjects by optical coherence tomography(OCT)enhanced deep imaging.

METHODS:From December 2017 to May 2019, patients with early active Graves ophthalmopathy diagnosed in our hospital(GO group)and 31 patients(62 eyes)with age and sex matched healthy physical examination(control group)were selected. Diopter, best-corrected visual acuity(BCVA), intraocular pressure, exophthalmos, EDI-OCT and other examinations were performed on all the subjects. The differences of macular central concave choroidal thickness(SFCT), choroidal macrovascular layer thickness(LCVT)and choroidal capillary layer/middle vascular layer thickness(MCVT)between the two groups were compared.

RESULTS: There was no significant difference in equivalent spherical lens power, BCVA and eye axis between the two groups. However, the IOP(17.22±2.67mmHg), exophthalmos(15.44±0.92mm), SFCT(315.79±14.99μm), LCVT(234.66±14.90μm)in GO group were significantly higher than those in control group(13.35±1.54mmHg, 12.90±1.00mm, 239.00±12.67μm, 159.16±13.30μm)(all P<0.05), but there was no significant difference in MCVT between the two groups(81.13±7.46μm vs 80.13±7.63μm, P>0.05).

CONCLUSION: SFCT and LCVT in patients with early active Graves ophthalmopathy are thickened, and MCVT has no obvious change, suggesting that EDI-OCT measurement of SFCT and LCVT has certain reference value for evaluating early active Graves ophthalmopathy.

Abstract:AIM: To analyze the association between postnatal weight growth rate(PWGR)and the threshold disease of retinopathy of prematurity(TDROP)in preterm babies with very low birth weight(BW), and investigate the predictive ability of PWGR for the onset of TDROP.

METHODS: A retrospective cohort study. Totally 386 preterm infants in the First Affiliated Hospital of Xiamen University from January 2017 to December 2018, whose weight was less than 1 500g were enrolled in this study. The gender, BW, gestational age(GA), delivery mode, history of oxygen, Apgar score in 1-10min, in vitro fertilization infants, embryo number, neonatal pneumonia, PWGR with 4wk after birth, congenital heart disease were analyzed. The patients were divided into two groups: Non-ROP(NROP)group(n=298)and TDROP group(n=88). Multiple Logistic regression and receiver operating characteristic(ROC)curve were used to determine if the PWGR was independently related to TDROP development and if it was capable of predicting TDROP. This study determines the predict value by comparing the area under the ROC curve(AUC)of independent risk factors.

RESULTS: BW(t=2.264, P=0.024), GA(t=3.158, P=0.002), PWGR at 2wk(χ²=20.514, P<0.001), history of oxygen(χ²=20.514, P<0.001), had significant difference between two groups. Multiple Logistic regression analysis revealed that BW(β=0.699, P=0.016), GA(β= -0.631, P=0.039), PWGR at 2wk(β=-0.636, P=0.039), history of oxygen(β=-1.542, P<0.001)were correlated to TDROP, and their OR were 2.013 \〖95% CI: 1.140-3.553\〗, 0.532 \〖95% CI: 0.292-0.970\〗, 0.529 \〖95% CI: 0.289-0.969\〗, 0.214, \〖95% CI: 0.113-0.404\〗 respectively. Further study showed that the area of PWGF at 2wk under the ROC was 71%, and its optimal cut-off points was 4.14g/d, its sensitivity and specificity were 70.8%, 65.9% respectively.

CONCLUSION: BW and PWGF at 2wk of very low BW preterm babies is an independent risk factor for TDROP, and has certain predictive value for the onset of TDROP.

Abstract:AIM: To explore the risk factors of high intraocular pressure after vitrectomy.

METHODS: Patients who underwent vitrectomy in our hospital from June 2016 to December 2018 were retrospectively analyzed, general information of patients, intraocular pressure before and after operation and relevant information of operation were recorded, Univariate and Logistic multivariate regression analysis were performed to analyze the risk factors of high intraocular pressure after vitrectomy.

RESULTS: Early high intraocular pressure occurred in 49 of 159 eyes(30.8%). Gender and age had no significant effect on the occurrence of high intraocular pressure after vitrectomy(P=0.699; P=0.416). Early high intraocular pressure after vitrectomy was closely correlated with silicone oil filling, combined cataract surgery, total retinal laser photocoagulation and vitreous hemorrhage after vitrectomy, with statistically significant differences(P<0.05). Logistic regression analysis showed that silicone oil filling, combined cataract surgery, total retinal photocoagulation and postoperative vitreous hemorrhage were independent risk factors affecting the occurrence of early postoperative high intraocular pressure(P<0.05).

CONCLUSION: Early high intraocular pressure after vitrectomy is the result of multiple factors, which is closely related to silicone oil filling, combined cataract surgery, total retinal photocoagulation and vitreous hemorrhage after vitrectomy.

Abstract:AIM: To investigate the best time for indwelling catheter of patients with chronic dacryocystitis after lacrimal drainage tube implantation.

METHODS: Totally 143 eyes of 143 patients with chronic dacryocystitis after lacrimal drainage tube implantation were selected in our hospital. They were divided into 3 groups including group A(50 eyes of 50 cases)with indwelling catheter in 9wk after tube implantation, group B(57 eyes of 57 cases)with indwelling catheter in 12wk after tube implantation, and group C(36 eyes of 36 cases)with indwelling catheter in 6wk after tube implantation. The clinical efficacy, visual acuity, incidence of epiphora, recurrence rate and incidence of postoperative complications with followed-up among three groups were compared.

RESULTS: On the day of extubation, the total effective rates of the three groups were 94%, 93% and 39%, the difference was statistically significant(P<0.0167). The total effective rates of group A and group B were better than those of group C, and the difference was statistically significant(χ²=30.830, 32.056, P<0.001). At 3mo after extubation, the total effective rates of the three groups were 56%, 51% and 36%, there was no significant difference(χ²=3.454, P=0.178). At 3mo after extubation, there was no significant difference in the visual acuity and the incidence of epiphora among the three groups(P>0.05). At 6mo after extubation, the recurrence rates of the three groups showed no significantly different(P=0.056). The incidence of postoperative complications in three groups were 4%(2/50), 7%(4/57)and 25%(9/36), the difference was statistically significant(χ²=11.048, P=0.004). The incidence of postoperative complications in group C was higher than that in groups A and B(χ²=6.499, 5.934; P=0.011, 0.015).

CONCLUSION: The clinical benefits of 6wk and 9wk after lacrimal drainage tube implantation are better than that of 12wk.

Abstract:AIM: To compare the therapeutic effects of lacrimal duct retrograde catheterization, double loop antegrade catheterization, and lacrimal duct U-shaped catheter for patients with lacrimal duct obstruction.

METHODS: Totally 108 patients with lacrimal duct obstruction who were treated in our hospital from July 2015 to June 2018 were selected as subjects and prospectively studied. They were randomly divided into three groups: A(36 cases), B(36 cases), and C(36 cases). In group A, lacrimal duct retrograde catheterization was performed. Group B was treated with double-loop antegrade catheterization. Group C was treated with lacrimal duct U-shaped catheterization. All patients were followed up for 6mo. The intraoperative basic conditions(Lntraoperative blood loss, operation time, hospital stay), treatment efficacy, and the occurrence of complications and recurrence of lacrimal duct obstruction of the three groups were compared.

RESULTS: There were significant differences in the amount of intraoperative blood loss, operation time and hospital stay between the three groups(P<0.05). The total effective rate of treatment in group A was 91.7%, which was lower than 94.4% in group B and 97.2% in group C, but the difference in total effective rate between the three groups was statistically significant(P>0.05). The complication rate was 11.1% in group A, 5.6% higher than that in group B, and higher than 2.8% in group C(P=0.010). The recurrence rate of lacrimal duct obstruction in group A was 9.1%, higher than 5.9% in group B, higher than that in group C(P=0.029).

CONCLUSION: Retrograde catheterization of the lacrimal duct, double-loop antegrade catheterization, and lacrimal duct U-shaped tube for the treatment of patients with lacrimal duct obstruction have higher therapeutic effects, postoperative complications and less recurrence of lacrimal duct obstruction, but lacrimal passage Retrograde catheterization can reduce the amount of intraoperative blood loss, operation time, and U-shaped catheterization of the lacrimal duct can reduce the length of hospital stay, and can be widely used in clinical practice.

Abstract:AIM: To investigate the application of expanded sponge and sodium hyaluronate in dacryocystorhinostomy under nasal endoscope.

METHODS: Through the follow-up observations of the 184 eyes(153 cases)that underwent dacryocystorhinostomy under nasal endoscope in our hospital in the past 2a(2016-2018)(group A: intraoperative application of expanded sponge and sodium hyaluronate), and the comparison in efficacy of 160 eyes(138 cases)that underwent dacryocystorhinostomy under nasal endoscope in our hospital in the past 2a(group B: intraoperative lacrimal duct stent).

RESULTS:The statistics analyzed from the patency of lacrimal passage and the improvements of the lacrimation six months after surgery are as follows: the total effective rate was 90.2% in group A, which amounts to 166 eyes; and 82.5% in group B, which amounts to 132 eyes. The difference between the two was statistically significant(P<0.05). Severe complications in group A were 6 eyes, 3.3%; severe complications in group B were 20 eyes, 12.5%, and the difference was statistically significant(P<0.05).

CONCLUSION: The application of expanded sponge and sodium hyaluronate in the application of intranasal dacryocystorhinostomy can significantly improve the surgical effect and reduce complications.

Abstract:AIM: To observe the influence of the overnight orthokeratology(OK)on the ocular surface and tear film, and to assess the discomfort caused by OK wearing in adolescent myopic patients.

METHODS: This is a prospective study included 69 myopic adolescents(138 eyes)aged 12-18 years old. 31 subjects were fitted with spectacles and 38 underwent OK treatment for 12mo. All subjects were measured with the ocular surface disease index(OSDI), the corneal and conjunctival fluorescein staining(the Oxford Scheme), tear film breakup time(TBUT), noninvasive tear break-up time(NIBUT)and the Schirmer I test before wearing and at 1, 3, 6, and 12mo after wearing.

RESULTS: Compared with the spectacle group and baseline, the OSDI scores were significantly higher at all recording time, the Oxford scores were significantly higher at 6 and 12mo, and TBUT and NIBUT were significantly lower at all recording time in the OK group(all P<0.05). Conversely, no statistically differences were observed in the Schirmer I test comparing the two groups(P>0.05)while no statistically differences were observed in the Schirmer I test comparing the two groups(P>0.05).

CONCLUSION: OK wearing may increase the OSDI and the Oxford scores mildly, and decrease the stability of tear film. Special attention must be paid to the OK wearers with baseline and follow-up ocular surface, tear film condition, and discomfort symptoms.