Abstract:AIM: To evaluate the effect of ICCC based comprehensive intervention with community participation initiative on diabetic blindness prevention in Eye Health Management of Baotou.

METHODS: Totally 470 diabetic patients newly registered within 3mo in local community health center were recruited in the study by random sampling. The control group received conventional public health service from chronic disease management approach with medical organization initiative on diabetic blindness prevention, and study group received comprehensive intervention based on ICCC model with community participation initiative. Informative knowledge, beheld accurate beliefs and acting behavior(KAP)in preventing diabetic blindness were measured in baseline survey before intervention and final survey after 1 y intervention in both groups respectively to evaluate the effect of different eye health management approaches on diabetic blindness prevention. Chi-square test and t-test were used to compare the effect of intervention and multiple linear regression analysis was used for analyzing influencing factors.

RESULTS: With 235 in control group and 235 in study group in baseline survey, and 208 and 216 in final survey. For study group accurate knowledge informative rate, accurate beheld belief rate and desired acting behavior rate in all the items of questions regarding diabetic blindness and its prevention in the final survey were all significant higher than the ones in baseline survey, and were significantly higher than that in control group. Multiple linear regression analysis showed that group type, educational level and DM duration were the influencing factors on the level of the knowledge. Group type, educational level and gender were the influencing factors on the level of beheld belief. Group type and educational level were the influencing factors on the level of acting behaviors in preventing diabetic blindness.

CONCLUSION:Comprehensive intervention with community participation initiative on managing diabetic eye health to prevent diabetic blindness had better performance compared to traditional intervention, thus it is an effective strategy in promoting diabetic eye health among diabetes.

Abstract:AIM:To explore the genetic defects and prenatal diagnosis of a Chinese family with aniridia and gestational diabetes.

METHODS: We recruited a Chinese family with aniridia and gestational diabetes. Genomic DNA of the whole family individuals was extracted from the peripheral blood leukocytes. Encoding regions of the paired box 6(PAX6)gene was screened by PCR direct sequencing. Amniocentesis was carried out on the affected female at 18wk of gestation, and subsequently, genetics analysis was performed based on the result of mutation screening.

RESULTS: In this study, the patients with aniridia and congenital cataract carried a heterozygous deletion mutation(c.113_129del GGCCGTGCGACATTTCC, p.Arg38ProfsTer12)in exon 5 of PAX6. One of the patients was affected with diabetes while this lady also had gestational diabetes. The result of prenatal diagnosis suggested the fetus carried the same mutation and will be affected with the aniridia, which was confirmed by postpartum follow-up.

CONCLUSION: It was suggested that a reported deletion mutation in the PAX6 was identified again in a Chinese family with aniridia and congenital cataract. It contributed to more literature information for the human PAX6 allelic variant database and provided an analysis basis for prenatal diagnosis.

Abstract:AIM:To investigate the expression of glucose key metabolic enzymes in human lens epithelial cells(HLEB3)induced by high glucose.

METHODS:HLEB3 cells cultured in vitro were divided into normal control group(DMEM medium containing 5mmol/L of glucose), oxidative stress group(DMEM medium containing 5mmol/L of glucose and 200μmol/L of hydrogen peroxide), high glucose induction group(DMEM medium containing 30mmol/L of glucose). Apoptosis and cells were detected 24h after culture. Activity and expression of six key glucose metabolic enzymes(fructose-6-phosphate kinase-1, pyruvate kinase, hexokinase, citrate synthase, α-ketoglutarate dehydrogenase and 6-phosphate glucose dehydrogenase)were studied.

RESULTS:Apoptosis of HLEB3 cells was induced by high glucose. The cell viability of high glucose-induced group(63.43%±3.40%)was lower than that of normal control group(100.00%±0.00%)and oxidative stress group(91.90%±5.11%), and the expression levels of six key enzymes of glucose metabolism in high glucose-induced group were lower than that of normal control group and oxidative stress group(all P<0.05).

CONCLUSION:High glucose can induce the expression of glucose-key metabolizing enzymes in HLEB3 cells to decrease, induce apoptosis and affect cell activity.

Abstract:AIM: To study the anti-inflammatory mechanism of emodin in rats with Aspergillus fumigatus keratitis.

METHODS: The model of Aspergillus fumigatus keratitis was established and divided into model group and emodin group, 8 in each group and 10 in the normal group. The emodin group was treated with rhubarb, and the model group and the normal group were treated with saline of equal volume. Corneal inflammation index and pathological characteristics were observed. Tumor necrosis factor-α(TNF-α), interleukin-6(IL-6), intercellular adhesion molecule-1(ICAM-1), peroxisome proliferator-activated receptor(PPAR), MAPK and NF-κB protein were detected.

RESULTS: The corneal inflammation index, corneal inflammatory cell count, TNF-α, IL-6, ICAM-1, MAPK and NF-κB protein in emodin group were lower than those in model group, and the expression of PPAR protein was higher than that in model group(P<0.05).

CONCLUSION: Emodin can improve the levels of TNF-α, IL-6 and ICAM-1 inflammatory factors by regulating PPAR, MAPK and NF-κB proteins, and play an anti-inflammatory role in rats with Aspergillus fumigatus keratitis.

Abstract:AIM: Optical coherence tomography angiography was used to explore the effect of erlotinib on the thickness of corneal epithelium and cornea in mice.

METHODS: Totally 20 mice were randomly divided into experimental group and PBS group. Erlotinib eye drops was prepared. Erlotinib eye drops and PBS were applied to the two groups of mice at 8, 12, 16 and 20 o'clock each day. OCTA was used to measure the 17 regions of the epithelium and corneal thickness at 1wk, 2wk and 3wk before and after the eye droppings.

RESULTS: There was no significant difference in the thickness of corneal epithelium and cornea between the experimental group and PBS group(all P>0.05). Two weeks after eye dropping, the areas of M, T5, IT5, I5, IN5, N5, T6, IT6, IN6 and N6 in the epithelium and corneal of experimental group were significantly thicker than those of PBS group(all P<0.05). In the third week, 17 areas of epithelium and cornea in experimental group were significantly thicker than those of PBS group(all P<0.05). After treatment with 2 and 3wk in erotinib group and PBS group, there were differences in the average corneal epithelial thickness and the total corneal thickness between each group(all P<0.05). According to the trend analysis of the average change of corneal epithelium and corneal thickness, there were differences between the erotinib group and the PBS group(all P<0.05).

CONCLUSION: Using OCTA, it can be found that ellotini has the effect of thickening corneal epithelium and cornea, and the effect is more obvious with the increase of application times.

Abstract:AIM: To investigate the curative effect of polyethylene glycol(PEG)eye drops, polyacrylic acid(PAA)eye gel and sodium hyaluronate(SH)eye drops on dry eye syndrome after phacoemulsification.

METHODS: Patients with age-related cataract who underwent phacoemulsification and intraocular lens implantation in the hospital from February 2015 to January 2018 were enrolled in the study. They were divided into PEG group, PAA group and SH group according to the application type of artificial tears. The clinical symptom scores, Schirmer I test, break-up time(BUT)and corneal fluorescein staining were observed and analyzed at 7, 14 and 30d after operation in the three groups. The curative effects were evaluated.

RESULTS: After 14 and 30d of operation, the score of dry eye symptom, Schirmer I and BUT in SH group were significantly better than those in PEG group and PAA group(P<0.05). The staining score and tear film imaging score in SH group were significantly lower than those in the other two groups at 30 days after operation(P<0.05). There was no significant difference in all indexes between PEG group and PAA group(P>0.05).

CONCLUSION: PEG drops, PAA eye gel and SH eye drops all can alleviate the clinical symptoms of dry eye patients after cataract surgery, improve the state of tear film, which have good clinical curative effects. SH eye drops may be more advantageous.

Abstract:AIM: To investigate the changes of corneal epithelial thickness following small incision lenticule extraction(SMILE), and its relationship with the ablation depth, spherical equivalent and optical zone.

METHODS: Sixty-one myopic patients with or without astigmatism who underwent SMILE in our hospital from August 2017 to November 2017 were selected. RTvue-OCT was performed before surgery, 1wk, 1mo and 6mo after surgery, respectively, and the corneal epithelial thickness of patients were measured. The changes of corneal epithelial thickness following small incision lenticule extraction(SMILE), and its relationship with the ablation depth, spherical equivalent and optical zone were studied.

RESULTS: There was no statistically significant difference in the thickness of corneal epithelium among the three regions(central corneal region, para-central corneal region and peripheral region)before surgery(P>0.05). Compared with the baseline values before surgery, the thickness of corneal epithelium in the three areas was significantly thickened 1wk, 1mo and 6mo after surgery(P<0.05). The changes of corneal epithelium thickness in the three areas showed a significant decreasing trend from the central corneal area to the peripheral area, that is, the corneal epithelium thickened in the shape of a convex lens. The values of corneal epithelium thickness in the central and para-central areas were positively correlated with the equivalent sphericity and ablation depth, but there was no significant correlation with the optical zone.

CONCLUSION: The corneal epithelial thickness increases after SMILE in different regions, and the thickening value was positively correlated with the spherical equivalent, ablation depth.

Abstract:Serpiginous choroiditis(SC)is a rare, chronic-idiopathic inflammatory disease mainly involving choriocapillaris and the retinal pigment epithelium(RPE), characterized by grayish yellow geographic lesions. Pathogenesis is unclear, the choriocapillaris is a main pathology of SC. Based on clinical presentation, it can be classified into peripapillary, macular, and ampiginoustype. The clinical appearance of SC is varied and similar to those of acute posterior multifocal placoid pigment epitheliopathy(APMPPE), tuberculosis, toxoplasmosis and choroidal ischemia. So, it is still difficult to diagnose SC without typical fundus symptoms.With the development of science and technology, multimode imaging such asfundus fluorescein angiography, indocyanine green angiography, fundus autofluorescence and optical coherence tomography are helpful for the diagnosis of SC, assessment of lesion extent, activity, and complications. Besides, it's very important to avoid unnecessary drug use.

Abstract:With the maturity of genetic engineering technology, a variety of genetic engineering mouse models for the development of key factors and processes of choroidal neovascularization(CNV)have been adapted to meet the needs of different research points in the CNV process. For example, VEGF₁₆₄ RPE65 transgene, Tet/VMD2/VEGF, etc. which are key factors in the process of CNV. ApoE overexpression rats are an important model of spontaneous CNV formation in AMD-like lesions; Ccl2/Cx3cr1-deficient mice associated with changes in retinal pigment epithelial(RPE); choroidal neovascularization and retinal neovascularization can be seen in SOD1^-/-aging, Vldlr^-/-directed mutation, etc; retinal neovascularization secondary to choroidal neovascularization can be found in Cp^-/-Heph^-/Y knockout mice, etc. The main advantages of the CNV genetic engineering mouse model are rapid induction and short time of occurrence; strong correlation with CNV pathophysiology, which can compare various biological components of CNV and facilitate the study of its mechanism; closely relating to human CNV, and providing research methods for human CNV treatment evaluation. However, there are also limitations, such as low induction rate, low percentage and small area of CNV; frenquent occurrence of retinal angiomatous hyperplasia,which interferences CNV research. Researchers might select the appropriate model according to his own needs and modify the corresponding experimental parameters as needed.

Abstract:Dry eye disease(DED)is closely related to inflammatory diseases of the skin near the eyelids, such as ocular rosacea, etc. At present, intense pulsed light(IPL)is one of the main treatments for rosacea. Recent studies have found that patients with meibomian gland dysfunction(MGD)have alleviated the symptoms and signs of dry eyes during IPL treatment, but its specific mechanism is not clear. The purpose of this paper is to review the possible mechanisms of IPL treatment of dry eye and to discuss its rationality.

Abstract:At present, myopia has become a public health disease worldwide, and its occurrence is mostly caused by genetic and environmental factors. Single nucleotide polymorphisms(SNPs)are the changes in single base at the genomic level caused by DNA sequence polymorphisms. In recent years, it is reported that the change of SNPs in myopic related gene loci is closely related to the occurrence and development of myopia. The present paper reviewed the current status of the association between SNPs of myopia-related genes and the development of myopia, providing a new insight into the future research of pathogenesis of myopia.

Abstract:In recent years, 3D printing technology has been widely used in various fields, and it has been increasingly applied in the medical field, providing a new direction for the development of medical research. As a digital manufactural technology, 3D printing plays an important role in the evaluation, research and treatment of eye diseases. At present, 3D printed biological materials, cells, tissues and organs have gradually been applied in ophthalmology and attracted attention. Also, they are showing great potential. With the development of medical imaging technology and the advancement of printing technology, the combination of 3D printing and various medical imaging technologies can visualize ophthalmic vessels, which is conducive to the research and diagnosis of ophthalmic vascular diseases. This article reviews the application progress of 3D printing in ophthalmic vascular diseases.

Abstract:Confocal microscopy serving as an in vivo histological examination for cornea holds superiority in disease diagnosis, assessment and follow-up as well as physiological and pathological study due to it's real-time, non-invasive, quick operation with high-resolution imaging, and has been widely applied in ophthalmic clinic and research. This article reviewed the recent advances in the application of confocal microscopy in infectious or degenerative corneal diseases, and ocular surface diseases caused by systemic diseases.

Abstract:Diabetic retinopathy(DR), one of the major complications of diabetes which can causes diabetic macular edema and visual loss. Vascular changes in DR correlate with the cellular damage and pathological changes in the capillaries of blood-retinal barrier. Several cytokines have been involved in inducing neovascularization. These cytokines activate different signaling pathways which are mainly responsible for the complications of DR. MicroRNAs(miRNAs)have been introduced as the key factors in the regulation of the cytokine expression which plays a critical role in neovascularization of retinal cells. Some studies have shown that changing levels of miRNAs have essential role in the pathophysiology of vascular changes in patients with DR. This paper reviews the role of microRNAs in the pathogenesis of DR by activating the angiogenesis pathway.

Abstract:Optic neuron injury caused by glaucoma and other factors commonly considered as irreversible. However, some evidences demonstrate considerable neuroplasticity in the nervous system. In this review, we try to illuminate the mechanism of neuroplasticity, and reactivate the “silent” cell and neural transmission visual experience, alternating current stimulation, eye yoga, and anti-stress program, and so on. Predict visual change after intervention using self-organizing maps.

Abstract:Heme oxygenase-1(HO-1)is one of the most widely distributed antioxidant enzymes in the body, which can catalyze the metabolism of heme to biliverdin, iron ion and carbon monoxide, and finally exert anti-inflammatory and anti-inflammatory effects. Oxidation and the like. In diseases such as corneal disease, cataract, glaucoma, and diabetic retinopathy, HO-1 expression is up-regulated to protect tissues from oxidative damage, and its overexpression is closely related to the occurrence and development of ocular tumors. This article reviews the recent research progress between HO-1 and its metabolic end products and ophthalmic diseases.

Abstract:AIM: To evaluate the efficacy of nerve growth factor(NGF)in the treatment of glaucoma by Meta-analysis.

METHODS: Comprehensive computer search database according to Cochrane systematic evaluation method. Randomized controlled trials of glaucoma after NGF treatment in the past 5a were included, the data extraction and Meta-analysis were performed by using Revman 5.3 statistical software.

RESULTS: A total of 6 cases randomized controlled trials were included, all of which were in Chinese, totally 513 cases. At the end of the treatment period, visual acuity was detected in 5 of the studies and 6 studies were performed with intraocular pressure, the difference among cases and normal were not statistically significant \〖MD=0.10,95%CI(-0.05,0.25),P=0.19; MD= -0.90, 95%CI (-1.92, 0.11), P=0.08\〗; 5 studies were performed on the visual field and 3 studies performed visual evoked potential(VEP), included P100 wave latency and P100 wave amplitude, the difference was statistically significant \〖MD= -2.49, 95%CI (-4.02, -0.96), P=0.001; MD= -12.13, 95%CI (-17.30, -6.97), P<0.001; MD=1.34, 95%CI (0.93, 1.74), P<0.001\〗.

CONCLUSION: NGF can improve the visual field of patients with glaucoma, and also can improve image visual evoked potential P100 wave latency and P100 wave amplitude. However, the effect of improving visual acuity and reducing intraocular pressure is not obvious. In a word, the NGF can ameliorate the optic neuropathy.

Abstract:AIM: To observe the effectiveness and safety of the active-fluidics configuration with Centurion phacoemulsifier in cataract surgery.

METHODS: One hundred and thirty-three eyes with Ⅱ-Ⅳ grades cataracts were enrolled in this randomized prospective study from October to December 2018. They were divided into two groups, the experimental group used active-fluidics configuration for cataract surgery, while the control group used gravity-fluidics configuration. Cumulative dissipated energy(CDE), aspiration time(AT)and estimated fluid used(EFU)of each patient were recorded during the operation, endothelial cell density(ECD)and central corneal thickness(CCT)were measured before and one day after operation.

RESULTS: The CDE, AT and EFU were significantly lower with the active-fluidics configuration than with the gravity-fluidics configuration(P<0.05); ECD was slightly decreased and CCT was slightly increased in both groups 1d after operation, but there was no difference between the two groups(2056.06±308.10cells/mm² vs 1997.26±297.55cells/mm², 532.75±12.02μm vs 531.02±13.00μm; P>0.05). No serious ocular adverse events related to the study devices or device deficiencies were observed.

CONCLUSION:Centurion active-fluidics configuration can maintain constant intraocular pressure during the operation, improve the stability of anterior chamber effectively. So it is safer and more efficient than traditional gravity-fluidics configuration.

Abstract:AIM: To probe into the clinical values of femtosecond laser-assisted phacoemulsification combined with multifocal intraocular lens implantation in the treatment of cataract.

METHODS: Totally 94 cases(94 eyes)of patients with cataract and who treated from July 2015 to July 2018 were divided into observation group(47 eyes)and control group(47 eyes)by random number table method. The observation group wes received femtosecond laser-assisted phacoemulsification combined with multifocal intraocular lens implantation, while the control group were received traditional phacoemulsification combined with multifocal intraocular lens implantation Then, the operation related indexes, corneal endothelial cell density, visual acuity and complications of two groups were observed.

RESULTS:The time of phacoemulsification in the observation group was shorter than that in the control group, and the ultrasound energy, cumulative energy of intraoperative phacoemulsification and anterior chamber flash value after operation for 7d were lower than those in the control group(P<0.05). There was no significant difference in corneal endothelial cell density between the two groups before operation(P>0.05). The corneal endothelial cell density after operation for 3mo in the observation group was significantly higher than that in the control group(P<0.05). There was no significant difference in the best corrected visual acuity(BCVA)and uncorrected visual acuity(UCVA)between the two groups(P>0.05). The BCVA and UCVA after operation for 3mo in the observation group were better than those in the control group(P<0.05).There was no significant difference in complications between the two groups(P>0.05).

CONCLUSION: The effects of femtosecond laser-assisted phacoemulsification combined with multifocal intraocular lens implantation in treatment of cataract are significant, which can reduce the cumulative release of ultrasound energy, reduce corneal endothelial damage, and promote visual recovery of patients, thus it is safe and it is worthy to be promoted.

Abstract:AIM: To investigate the axial length(AL)and corneal curvature in patients with congenital cataract, and to provide references for development, treatment and prognosis of the disease.

METHODS: From January 2014 to December 2018, 229 patients(333 eyes)with congenital cataract aged less than 20 years old before surgery and without other ocular diseases or systemic diseases were included in the retrospective study. Their AL and corneal curvature were measured using IOL Master 500. Corneal curvature was represented by Km, which was the mean of K1 and K2.The data were statistically analyzed using partial correlation analysis, to detect the correlation between patients' AL, Km and age, and we conducted curve fitting for the correlated parameters and age. We compared bilateral and unilateral cataract's AL and Km, and we also compared male and female patients' AL and Km.

RESULTS: The correlation between patients' AL and age was significant(r =0.250, P=0.001), and the fitting curve was obtained with equation AL=20.85+0.96×ln(age), but patients' Km wasn't significantly correlated with age(r= -0.024, P=0.759). No significant difference was found in AL between male and female patients(P=0.495), but Km was significantly greater in female patients than that in male patients(P=0.018). AL wasn't significantly different between eyes from bilateral cataract and affected eyes from unilateral cataract(P=0.159), but AL was significantly shorter in bilateral cataract than that in healthy eyes from unilateral cataract(P=0.033). No significant difference was found in Km between eyes from bilateral cataract and affected eyes or healthy eyes from unilateral cataracts(P=0.483, 0.176).

CONCLUSION: Congenital cataract may affect AL growth, especially in bilateral cataract, AL was shorter in bilateral cataract than that in healthy eyes from unilateral cataract. No effect of congenital cataract was found on corneal curvature, but corneal curvature was significantly greater in female patients than that in male patients.

Abstract:AIM: To observe the changes of retina and choroid in macular region using EDI SD-OCT before and after phacoemulsification, and study the intervention and prevention effect of triamcinolone acetonide(TA)on macular edema.

METHODS: In a prospective randomized clinical trial, selected the cataract patients with NPDR in our hospital. They were randomly divided into two groups. The experimental group(group 1)received Tenon's injection of TA 40mg during phacoemulsification, while the control group(group 2)only received phacoemulsification. The changes of best corrected visual acuity(BCVA), intraocular pressure(IOP), central macular retinal thickness(CMT), subfoveal choroidal thickness(SFCT)before and after surgery were observed.

RESULTS: There were significant differences in BCVA between the two groups before and after operation(P<0.05); at 1wk after operation, the SFCT of the control group was thicker than that of the experimental group(t=2.165, P<0.05); at 2wk after operation, there were significant differences between the CMT and SFCT groups(P<0.05). There were significant differences in BCVA and CMT between the two groups(P<0.05), and no significant difference in IOP(P>0.05).The incidence of diabetic macular edema(DME)after surgery was 0 in group 1 and 11% in group 2.

CONCLUSION: Posterior subfascial injection of TA in NPDR patients during phacoemulsification may have a positive preventive effect on the occurrence of DME.

Abstract:AIM:To investigate the effect of the severity of monocular visual field loss on binocular visual field loss patients with primary angle-closure glaucoma, primary open angle glaucoma and normal tension glaucoma.

METHODS: According to the stage of binocular monocular field loss, 30 healthy and 120 glaucoma patients participants were classified as normal, early, moderate or severe. Binocular vision was determined by integrating the field of view and Esterman binocular field assessment. The monocular and binocular visual field parameters were compared within and between groups.

RESULTS:For patients with one eye at normal or early stage and the other with severe stage, the mean deviation of binocular comprehensive visual field was -2.8±1.1dB and -5.5±1.9dB, respectively, and Esterman's average score were 99.1%±1.7% and 95.6%±4.7%, respectively. When both eyes developed moderate or severe injury(moderate/moderate, moderate/severe or severe/severe), the mean deviation of binocular comprehensive visual field is lower than -6dB, and the Esterman average score of moderate/moderate group and moderate/severe group was 94.2%±6.0% and 94.3%±4.9%, respectively. However, when both eyes in the stage of severe injury, the average score of Esterman's rapidly decreased from more than 90% to 68.4%±26.3%.

CONCLUSION: If one eye is in a normal or early stage, the binocular vision can remain relatively intact. When the binocular progression to the moderate or severe stage, the mean deviation of binocular visual field defects measured by the binocular comprehensive visual field is significant, and only when the binocular progression to the severe stage, significant Esterman binocular visual field defects are detected.

Abstract:AIM: To observe the clinical efficacy and safety in the treatment for refractory glaucoma by two kinds of cyclodestructive procedures.

METHODS: A retrospective study of 50 patients(50 eyes)with refractory glaucoma diagnosed in our hospital between January 2018 and October 2018. Ultrasound cyclo plasty(UCP)were performed on 30 eyes and cyclocryotherapy were performed on 20 eyes, introcular pressure(IOP), pain grade scores and complications after operation were followed up.

RESULTS: The average IOP of the UCP group on 1d, 1wk, 1mo and 3mo were 29.27±10.40, 23.87±8.61, 25.27±9.95, 23.70±10.06mmHg compared with 43.97±10.39mmHg before operation. The average IOP of the cyclocryotherapy group on 1d, 1wk, 1mo and 3mo were 22.15±7.78, 20.80±8.44, 22.50±7.12, 24.20±8.43mmHg compared with 47.30±8.53mmHg before operation. The IOP in both group was significantly reduced(P<0.01). The pain grade scores of patients in the UCP group at 1d, 1wk, 1mo and 3mo after surgery were significantly lower than those before operation(P<0.05), but there was no significant difference in the cyclocryotherapy group at 1d after surgery(P>0.05). There were no serious complications in the UCP group, four eyes appeared conjunctival hyperemia and one eye appeared superficial punctuate keratitis; but there were 16 eyes(80.00%)in the cyclocryotherapy group: ten eyes appeared conjunctival hyperemia and six eyes appeared anterior chamber hemorrhage.

CONCLUSION: UCP is safe and convenient surgery for refractory glaucoma, and has significant effect on reducing intraocular pressure, alleviating ocular pain and decreasing complications.

Abstract:AIM: To analyze the predictive value of combined detection of plasma microRNA-93(miR-93)and microRNA-21(miR-21)in the progression of type 2 diabetic retinopathy(DR).

METHODS: Totally 76 patients with type 2 diabetic retinopathy admitted to our hospital from June 2013 to June 2014 were divided into DR non-progressive group(34 cases)and DR progressive group(42 cases)according to the follow-up results, and 45 healthy people were selected as the control group. The serum levels of miR93 and miR21 in three groups were detected; the independent risk factors of prognosis in DR patients were analyzed; and the predictive value of miR93 and miR21 in DR patients was analyzed.

RESULTS: The serum levels of miR93 and miR21 in DR progressive group were significantly higher than those in non-progressive group and control group(all P< 0.01); both of them could be used as independent risk factors affecting the progress of DR patients; the area, specificity and sensitivity under the combined detection curve were higher than those of single detection(P<0.05).

CONCLUSION: The serum levels of miR93 and miR21 are increased in DR patients, which can affect the progress of DR patients, and can be used as biomarkers for the diagnosis of DR.

Abstract:AIM: To analyze the efficacy and influencing factors of patients with proliferative diabetic retinopathy(PDR)after vitrectomy.

METHODS: Totally 94 patients(112 eyes)with stage VI of PDR in our hospital from January 2015 to January 2018 divided into maculopathy group(n=61 cases, 70 eyes)and non-maculopathy group(n=33 cases, 42 eyes)according to the OCT. The visual acuity, P1 wave amplitude density and retinal reattachment in macular area were compared between the two at 6mo of follow-up. Postoperative efficacy and influencing factors of stage VI of PDR were analyzed by taking vision improvement as a standard of efficacy evaluation.

RESULTS: The visual acuity grading in maculopathy group at 6mo after operation was better than that in non-maculopathy group(P<0.05). The P1 wave amplitude density in the(1+2)ring in maculopathy group was lower than that in non-maculopathy group(P<0.05). Among patients, there were 95 eyes(84.8%)of one-time retinal anatomical reduction, 10 eyes(8.9%)of twice reduction, 2 eyes(1.8%)of 3 times reduction, 1 eye(0.9%)of 4 times reduction and 4 eyes(3.6%)without reduction, and the total reduction rate was 96.4%. The effective rate in patients with maculopathy and patients with long course of diabetes mellitus was lower than that in patients without maculopathy and patients with short course of diabetes mellitus(P<0.05), and maculopathy and diabetes duration were independent factors affecting the postoperative efficacy of patients with severe proliferative diabetic retinopathy(P<0.05).

CONCLUSION: Vitrectomy can improve postoperative visual acuity of patients with stage VI of PDR, and preoperative combination of significant maculopathy and course of diabetes mellitus are important factors affecting postoperative efficacy in patients with severe PDR.

Abstract:AIM: To explore the mechanism of action of nucleotide-binding oligomerization domain-like receptor 3(NLRP3)/interleukin-1β(IL-1β)pathway in proliferative diabetic retinopathy.

METHODS: Totally 49 cases(49 eyes)of proliferative diabetic retinopathy(study group)and 41 cases(41 eyes)of idiopathic macular hole(control group)in ophthalmology department of our hospital from September 2015 to March 2018 were selected. The expression of NLRP3, the levels of reactive oxygen species(ROS), malondialdehyde(MDA)and the activity of superoxide dismutase(SOD)in proliferative epiretinal membrane and macular epiretinal membrane were measured. The concentrations of IL-1β and interleukin-18(IL-18)in the vitreous of the two groups were also determined.

RESULTS: The positive expression rate of NLRP3 protein in the study group was significantly higher than that in the control group(90% vs 5%, P<0.05). The concentration of IL-1β and IL-18 in the vitreous of the study group was significantly higher than that in the control group \〖(30.84±7.15)vs(4.63±0.92);(97.61±15.73)pg/mL vs(52.07±11.38)pg/mL, P<0.05\〗. The levels of ROS and MDA of the study group were significantly higher than those of the control group(P<0.05). The activity of SOD in the retina of the study group was significantly lower than that of the control group(P<0.05).

CONCLUSION: NLRP3 and IL-1β are highly expressed in proliferative diabetic retinopathy. The NLRP3/IL-1β pathway can up-regulate the expression levels of inflammatory and oxidative factors and promote disease progression.

Abstract:AIM: To study the effect and mechanism of salvia ligustrazine on non-arteriti anterior ischemic optic neuropathy.

METHODS: A total of 60 cases of non-arteriti anterior ischemic optic neuropathy were randomly divided into two groups. The control group(n=30 cases)was treated with oral prednisone acetate tablets and injection of compound anisodine. The experimental group(n=30 cases)was the same to the control group and added intravenous salvia ligustrazine, the period of treatment was 14d. The levels of IL-1β and TNF-α were detected by ELISA, and the protein expression levels of Bcl-2 and Caspase-3 were detected by Western blot.

RESULTS: The best corrected visual acuity was improved in both groups. The plasma levels of IL-1β and TNF-α were significantly lowed in the experimental group than the control group, and the difference between the two groups was statistically significant(P<0.05). The protein expression of Bcl-2 and Caspase-3 in the two groups were different from those before treatment(P<0.05), and the difference between the two groups was statistically significant(P<0.05).

CONCLUSION: Salvia ligustrazine promotes the recovery of visual function by reducing the level of inflammation and inhibiting cell apoptosis in body.

Abstract:AIM: To study the infection of Demodex folliculorum and the efficacy of tea tree essenial oil combined with fluorometholone for elderly patients with meibomian gland dysfunction(MGD).

METHODS: In this retrospective clinical control study, a total of 59 elderly patients(118 eyes)with MGD were included in Ningbo Eye Hospital during September 2017 to March 2018. Symptoms score, Demodex number, Tarsal gland morphology, tear break-up time(BUT), Fluorescein staining(FL)and Schirmer test(SIaT)were evaluated in 38 patients(76 eyes)with positive eyelash examination. The patients were divided into three groups and treated with different methods after blepharoplasty-Groups A(24 eyes), B(26 eyes)and C(26 eyes)were treated with 0.02% fluorometholone eye drops; tea tree essential oil wipes; and 0.02% fluorometholone eye drops combined with tea tree essential oil wipes, respectively. The follow-up was 4wk.

RESULTS: The eyelash Demodex was detected in 76 eyes(64.4%). The scores of subjective symptoms in the three groups were improved after treatment(P<0.05). There was no statistical difference in the number of Demodex before and after treatment in group A(P=0.11); there were statistical differences in groups B and C(P<0.01). There was no significant difference between group A(P=0.22), groups B and C had significant difference(P<0.05)in BUT before and after treatment. BUT in group C was longer than that in groups A and B, and the difference was statistically significant(P<0.05)after treatment. FL scores of the three groups before and after treatment were significantly different(P<0.05).

CONCLUSION: The infection rate of Demodex mites in eyelashes of elderly patients with MGD is higher. Tea tree essential oil wipes combined with 0.02% fluorometholone eye drops can effectively repel mites, improvement of lipid secretion by meibomian gland, and relieve local symptoms of MGD.

Abstract:AIM: To evaluate the short-term clinical efficacy of pranoprofen eye drops combined with sodium hyaluronate eye drops in the treatment of moderate to severe dry eye and its influence on the psychological status of patients.

METHODS: From January to December 2018, 318 patients with moderate to severe dry eye were selected and treated in ophthalmology department of our hospital. The patients were divided into experimental group(238 patients)and control group(80 patients)by random number table method, and the control group was treated with sodium hyaluronate eye drops, while the test group was treated with pranoprofen eye drops combined with sodium hyaluronate eye drops. The general data of the patients were statistically analyzed. Before treatment, 7d, 14d, 28d after treatment, the patients' scores of conscious symptoms and signs were investigated by questionnaire, the degree of conjunctival congestion, tear breakup time, corneal fluorescein staining and tear secretion were examined, and the degree of anxiety and depression were evaluated.

RESULTS: There was no significant difference in general data between the two groups(P>0.05). In terms of patients' scores of conscious symptoms and signs, degree of conjunctival congestion, tear breakup time, corneal fluorescein staining and tear secretion, the experimental group was significantly improved 7d after treatment, and the effect was more significant with the prolonged treatment, while the control group was gradually improved 14 or 28d after treatment. At the same treatment time point, the efficacy of the experimental group was significantly better than that of the control group, and the difference was statistically significant(P<0.05). With the improvement of the condition after treatment, the anxiety or depression symptoms of the patients were improved. The experimental group was significantly improved 7d after treatment, while the control group was gradually improved 14d or 28d after treatment. At the same treatment time point, compared with the control group,the anxiety and depression degree of the patients in the experimental group were significantly reduced(P<0.05).

CONCLUSION: Pranoprofen eye drops combined with sodium hyaluronate eye drops for treatment of dry eye syndrome had fast and significant effect, patients' self-consciousness symptoms and signs are significantly improved, conjunctival congestion and corneal fluorescein staining are reduced, tear breakup time is prolonged, tear secretion is increased, and anxiety or depression are significantly improved.

Abstract:AIM: To investigate the clinical efficacy of anterior stromal puncture(ASP)for the corneal epithelial cells dysfunction(CED).

METHODS: Sixteen patients with CED underwent ASP in Wuhan Union Hospital from September 2015 to December 2015 were included. Uncorrected visual acuity, ocular surface disease index(OSDI), corneal fluorescence staining, corneal epithelial thickness, full corneal thickness, corneal subepithelial dendritic cell density, corneal endothelial cell density and corneal epithelial nerve density were observed and recorded at preoperative, 1mo and 3mo postoperatively, respectively.

RESULTS: Totally 16 patients compared with preoperatively, there was a significant increase in uncorrected visual acuity and corneal epithelial nerve density(P<0.05)or a significant decrease in OSDI, corneal fluorescence staining, corneal epithelial thickness, full corneal thickness and corneal subepithelial dendritic cell density(P<0.05)at 1mo postoperatively; while there was no significant difference in corneal endothelial cell density(P>0.05). And compared with 1mo postoperatively, there was a significant decrease in corneal subepithelial dendritic cell density(P<0.05)and a significant increase in corneal epithelial nerve density(P<0.05)at 3mo postoperatively, while there was no significant difference in uncorrected visual acuity, OSDI, corneal fluorescence staining, corneal epithelial thickness, full corneal thickness and corneal endothelial cell density(P>0.05).

CONCLUSION: ASP was effective for CED. Corneal confocal microscopy was essential for the evaluation of ASP efficacy, which can guide the clinical work better and establish the termination of intervention.

Abstract:AIM:To explore the effect of phacoemulsification on the fluency coefficient of aqueous humor through the application of tonography.

METHODS:Participants in this study were patients who underwent standard clear corneal incision phacoemulsifcation with intraocular lens(IOL)implantation in our hospital from January to October in 2018. Intraocular pressure(IOP)was measured through non-contact tonometer 1d, 1wk, 1mo and 3mo before and after the operation. The fluency coefficient of aqueous humor was measured using electronic Schiotz tonography 1wk, 1mo and 3mo before and after the operation.

RESULTS:IOP was higher than baseline(17.09±1.70mmHg)on the first day after operation(19.01±1.81mmHg), and the average IOP at other times was lower than baseline(P<0.05). The coefficient of outflow facility 1wk, 1mo and 3mo after the operation(0.20±0.01, 0.22±0.02, 0.22±0.02)at all postoperative visits has obviously improved before the operation(0.19±0.02; P<0.05).

CONCLUSION:Phacoemulsifcation increases the coefficient of outflow facility and this partially accounts for the IOP reduction after cataract surgery with phacoemulsifcation and IOL implantation.

Abstract:AIM: To evaluate the influence of lens capsule contraction on intraocular lens(IOL)decentration after cataract surgery.

METHODS: Totally 40 cases(40 eyes)of senile cataract underwent phacoemulsification combined with IOL implantation. Within 3mo after operation, the anterior capsule opening area was measured by Photoshop software, the IOL decentration was measured by iTrace visual quality analyzer. The influence of anterior capsule opening area on IOL decentration was assessed by Pearson correlation analysis.

RESULTS: At 1d, 1mo and 3mo after operation, anterior capsule opening area was gradually reduced, the difference between different time points was statistically significant(P<0.01); IOL decentration gradually increased, and the difference between different time points was statistically significant(P<0.01); the visual acuity of patients decreased gradually, and the difference between different time points was statistically significant(P<0.01). The change of anterior capsule opening area was positively correlated with IOL decentration(r=0.566, P<0.05), but there was no significant correlation between visual acuity and IOL decentration(r= -0.104, P> 0.05), the change of anterior capsule opening area was negatively correlated with the initial anterior capsule opening area(r= -0.476, P<0.05).

CONCLUSION: The anterior capsule contraction after cataract surgery can lead to IOL decentration.

Abstract:AIM: To observe the postoperative visual quality and patient satisfaction of AT LISA Toric 909MP(909M)astigmatic corrected multifocal IOL and AT TORBI 709M(709M)astigmatic corrected single-focus IOL after phacoemulsification.

METHODS: Patients with age-related cataract and corneal astigmatism(>1.0D)were enrolled and accepted phacoemulsification combined with implantation of intraocular lens(IOL)in our hospital during December 2017 and December 2018. Forty cases(56 eyes)were divided into two groups according to which IOL they chose, multiple focal astigmatism(909M)group included 23 cases(35 eyes), single focal astigmatism(709M)group included 17 cases(21 eyes). Three months postoperatively, the visual acuity, defocus curve, residual astigmatism degree, rotational stability of the IOL, postoperative visual quality analysis and patient satisfaction were evaluated.

RESULTS: At 3mo postoperatively, uncorrected distance visual acuity(UDVA)and corrected distance acuity in the two groups were significantly improved(P<0.05). The defocus curve showed that 909M group had two visual acuity peaks at 0D and -2.5D, and a low peak at -1D, 709M group had the visual peak only at 0D. Spectacle independency was achieved by 91%(21/23)of patients in the 909M group and 18%(3/17)in the 709M group.

CONCLUSION: Both of the 909M and 709M had good correction effect for cataract combined with astigmatism. It provided better rotational stability. In addition, 909M provided excellent distance, near visual outcomes, and acceptable intermediate vision. At the same time, it improved the spectacle independency and satisfaction of cataract patients combined with astigmatism.

Abstract:AIM: To compare the clinical efficacy of two methods for treating refractory glaucoma.

METHODS: A total of 30 patients with refractory glaucoma(32 eyes)selected from our hospital from January 2014 to September 2018 were retrospectively analyzed. According to the treatment methods, they were divided into experimental group(16 eyes treated by modified Ahmed glaucoma valve implantation)and control group(16 eyes treated by traditional Ahmed glaucoma valve implantation). The visual acuity, intraocular pressure, number of anti-glaucoma drugs, the success rate, complications and average length of hospitalization were compared between the two groups, during follow-up at post operative 1d, 1wk, 1mo, 3mo and 6mo.

RESULTS:There was no significant difference in intraocular pressure between the two groups at post-operative 1d, 1wk, 1mo, 3mo, 6mo(all P>0.05). The total success rate was 87%(14/16)in experimental group while 75%(12/16)in control group(P=0.654). BCVA did not improve significantly at post operative 6 mo compared with baseline in both groups(P>0.05). The average length of hospital stay in the experimental group(4.50±1.37d)was significantly lower than that in the control group(7.63±3.69d)(P=0.003). The incidece of shallow anterior chamber was 31% in control group, while in experimental group, it was 0, which showed significant difference.

CONCLUSION: Modified Ahmed drainage valve implantation is an effective method for treating refractory glaucoma, with more simple operations, shorter hospitalizing time and lower incidence of shallow anterior chamber.

Abstract:AIM: To analyze the risk factors affecting the occurrence of vitreous hemorrhage(VH)in type 2 diabetic retinopathy(DR).

METHODS: The clinical data of 165 patients with DR admitted to the hospital from November 2016 to November 2018 were retrospectively analyzed. Multivariate Logistic regression was performed to analyze independent relevant factors of VH occurrence in patients with DR.

RESULTS: Totally 165 patients with DR, 59 cases(59 eyes)with non-proliferative diabetic retinopathy(NPDR), including 18 cases(18 eyes)with mild NPDR, 21 cases(21 eyes)with moderate NPDR and 20 cases(20 eyes)with severe NPDR. And there were 106 cases(106 eyes)with proliferative diabetic retinopathy(PDR). Among them, there were 87 cases(87 eyes)with VH, and the incidence rate was 82.1%. There were significant differences in age, systolic blood pressure, diastolic blood pressure, fasting plasma glucose(FPG), glycosylated hemoglobin(HbA1c), triglyceride(TG), cholesterol(TC), high density lipoprotein(HDL), low density lipoprotein(LDL)and creatinine(CRE)between non-VH group and VH group(P<0.05). Taking the presence or absence of VH as dependent variable, multivariate Logistic analysis showed that HbA1c was an independent risk factor for occurrence of VH(P<0.05), and HDL was an independent protective factor for occurrence of VH(P<0.05).

CONCLUSION: HbA1c and HDL are independent relevant factors influencing the occurrence of VH in patients with DR. In clinical practice, blood glucose and lipids should be strictly controlled to reduce the probability of DR progression to VH.

Abstract:AIM: To compare the efficacy of the laser photocoagulation with combination therapy of both the laser potocoagulation and ranibizumab in the treatment of diabetic macular edema(DME).

METHODS: The research was based on the randomized controlled trial(RCT). A total of 180 eyes from 134 cases diagnosed with DME were randomly divided into experimental group and control group. No statistically significant difference was found between two groups(P>0.05)with respect to age, sex, duration of disease, best corrected visual acuity(BCVA), the mean intraocular pressure(IOP)and the mean central macular thickness(CMT). Patients in the control group received the photocoagulation while the combination therapy of both laser photocoagulation and ranibizumab were employed in the experimental group. BCVA, IOP and CMT were assessed at 1wk and 3mo after treatment, and the collecting data of two groups were examined.

RESULTS: Before treatment, 1wk and 3mo after treatment, there was no significant difference of IOP(P>0.05). 1wk and 3mo after treatment, the CMT in the experimental group was significantly lower than the other(t= -7.83, -8.80, P<0.05), whilst the BCVA in the experimental group was significantly higher than that in the control group(t= -3.76, -4.09, P<0.05). The BCVA of the experimental group was increased after 1wk treatment(t=1.97, P<0.05). The recurrence rate of the experimental group was lower(χ²=4.59, P<0.05). There were no significant differences in the incidence of early intraocular pressure between the two groups(χ²=0.03, P>0.05). No retinal detachment or intraocular inflammation occurred in both groups.

CONCLUSION: Compared with the laser photocoagulation, the combination therapy of laser photocoagulation and ranibizumab could significantly lower the CMT after surgery, early improve the BCVA and decrease the recurrence rate.

Abstract:AIM: To compare the clinical efficacy and safty of 25G and 27G pars planavitrectomy(PPV)in the treatment of rhegmatogenous retinal detachment(RRD)with air tamponade.

METHODS: Sixty-three cases(63 eyes)with RRD underwent 27G or 25G PPV from May 2016 to June 2018 were retrospectively reviewed. Thirty-three eyes(33 eyes)for 25G vitrectomy and 30 eyes underwent 27G vitrectomy. The main outcome measurements of the study included the best corrected visual acuity(BCVA, LogMAR), intraocular pressure, surgicaltime, retinal reattachment rate, intraoperative and postoperative complications.

RESULTS: There were no significant differences in baseline demographic between the two groups(P>0.05). The BCVA was increased significantly in both groups(all P<0.01), but there was no significant difference in terms of visual improvement between the two groups(P>0.05). The mean surgical time in the 25G group was(44.13±5.9)min, which was no significant difference than that of 27G group(46.07±6.1)min(t=0.028, P=0.412). The retinal reattachment rate after a single operation was 91% and 93% for 25G and 27G group respectively(χ²=0.015, P=0.902). There was no significant difference about hypotony(<6mmHg, 1mmHg=0.133kPa)between the 25G group(15%)and the 27G group(10%),(χ²=0.376, P=0.540). No serious complication such as choroidal detachment and endophthalmitis was observed in both groups.

CONCLUSION: This study finds no significant differences in the surgical time, the rate of reattachment of retina, improvement of BCVA and complications between the 25G or 27G vitrectomy for rhegmatogenous retinal detachment with air tamponade. 27G vitrectomy with air tamponade seems to be a safe, economical and effective surgery for RRD.

Abstract:AIM:To evaluate the changes of macular retinal vessel density after the first intravitreal anti-vascular endothelial growth factor(VEGF)injection for macular edema secondary to retinal vein occlusion.

METHODS: A retrospective case control series, 23 cases with RVO secondary macular edema were included from April 2018 to July 2018. They were treated with 0.5mg/0.05mL intravitreal injection of conbercept. To compare the best corrected visual acuity(BCVA)before and after treatment. Optical coherence tomography angiography(OCTA)images was obtained, central macular thickness(CMT)and vessel length density and perfusion density in the superficial retinal capillary plexus were measured before and after intravitreal injection.

RESULTS: The mean interval between baseline and follow up was 1mo. The improvement of BCVA, the decreased value of average central macular thickness after treatment were better than before(P<0.05). The vessel length density and perfusion density at the central, inner and full region in the superficial retinal capillary plexus was not significantly different after intravitreal injection(P>0.05).

CONCLUSION: The average BCVA and the mean CMT of patients with RVO secondary macular edema after treatment was significantly better, and it is not progressive macular ischemia in the short-term after a single intravitreal injection of an anti-VEGF agent.

Abstract:AIM: To explore the usefulness of RS-type lacrimal drainage tube versus double silicone tube for children's lacrimal canaliculi rupture.

METHODS: A retrospective analysis from August 2016 and July 2018 were taken. Totally 37 children(37 eyes)of lacrimal canaliculi rupture were enrolled in the study and divided into two groups according to admission time sequence: treatment group(20 eyes)and control group(17 eyes). The treatment group was treated with RS-type lacrimal drainage tube. The control group underwent the implantation of double silicone tube and their efficacy was analyzed.

RESULTS: It was significant difference that the epistaxis rate between the treatment group and the control group, which was 0% and 100%. The effective rate was 95% and 88%, respectively, for the treatment group and the control group, the difference between the two groups has no significant(P=0.584). And the postoperative complication rate was 5% in treatment group, 12% in control group respectively, there was no significant statistical difference between the two groups(P=0.584).

CONCLUSION: The implantation of the RS-type lacrimal drainage tube can effectively prevent epistaxis, is safe and simple, easy to operate and extubate easily with good clinical effect in the treatment of lacrimal canaliculus fracture in children. So it can be widely carried out in basic hospitals.

Abstract:AIM: To investigate the positional relationship between the nasal ends of the lacerated lacrimal canaliculi, lacrimal caruncle, and medial canthal ligament, as well as its application in the lacrimal canalicular anastomosis.

METHODS: Sixty-five patients with traumatic lower canalicular laceration were selected. The distance from the lacrimal punctum to the temporal end was measured. The nasal ends were found under direct vision, and the positional relationship between the nasal ends, lacrimal caruncle and medial canthal ligament were quantitatively analyzed.

RESULTS: Totally 65 patients with canaliculus laceration, 39 patients had a distance of less than 6mm from the lacrimal punctum to the temporal end, where the nasal ends of 35 patients were located in the lacrimal caruncle area. There were 26 cases in which the distance from the lacrimal punctum to the temporal end was greater than 6mm, where the nasal ends of 24 cases were located in the medial canthal ligament area. The vertical distance between the nasal ends in the lacrimal caruncle area and the lacrimal mucosa was 2.1±0.7mm, and the vertical distance between the nasal ends in the medial canthal ligament area and the skin edge was 3.5±1.2mm.

CONCLUSION: The positions of nasal ends can be divided into the lacrimal caruncle area and the medial canthal ligament area, providing a basis for finding the nasal ends of the lacerated lacrimal canaliculi in the clinical practice.

Abstract:AIM: To observe the efficacy of MeroGel in the treatment of dacryocystitis with small dacryocyst by transnasal endoscope dacryocystorhinostomy.

METHODS: Totally 185 cases(185 eyes)of dacryocystitis with small dacryocyst were admitted in Hankou Aier Eye Hospital from June 2014 to December 2018. MeroGel, gelatin sponge, expansive sponge and vaseline gauze were used during the dacryocystorhinostomy. Complications and recoveries were observed.

RESULTS: Less bleeding and painless in patients who used MeroGel, and the anastomotic stoma was better than other groups, the difference was statistically significant(P<0.05).

CONCLUSION: The hemostasis effect of MeroGel reduced the bleeding after DCR.At the same time, its degradability is conducive to the epithelialization of the anastomotic stoma after EN-DCR, especially after the surgery with dacryocystitis with small dacryocyst. It can inhibit the adhesion of anastomotic stoma and the peripheral granulation tissue proliferation. The success rate of dacryocystitis with small dacryocyst was improved greatly. Compared with other filling materials, there were fewer complications and more comfortable patients after using MeroGel.

Abstract:AIM: To explore the difference of dry eyes between children and adults in terms of symptoms and laboratory examinations.

METHODS: Patients in 2018-06/2019-02 with the subjective symptoms of dry eye, and served in Xi'an First Hospital, including 52 children clinic cases(52 eyes)and 55 adult patients cases(55 eyes), all the cases were consulted and examined by slit lamp microscope in anterior segment. Both eyes of tear meniscus height(TMH), the first tear film break-up time(BUTf), the average tear film break-up time(BUTave), lipid layer thickness(LLT)and mesangial gland loss rate were measured by a Keratograph 5M non-invasive ocular surface analyzer.

RESULTS: In children, patients' TMH(0.15±0.04mm), BUTf(3.22±1.24s), BUTave(4.27±1.67s), and the rate of meibomian gland loss \〖0.00%(0.00%, 5.03%)\〗 were significantly lower than those in the adult group [0.20±0.05mm, 4.36±1.93s, 5.15±1.49s, 9.90%(5.30%, 18.40%), all P<0.01]. The LLT in the children was higher than that of the adult group, and the difference was not statistically significant(72.31±22.20nm vs 68.58±21.05nm, P>0.05). Both groups of patients had positive correlation sympathise with BUTf and BUTave, with no correlation between LLT and meibomian gland loss rate in children(r_s=-0.23,P=0.10), and adult group patients with negative correlation of LLT and meibomian gland loss rate(r_s=-0.28,P<0.05).

CONCLUSION: Children's dry eyes and adult dry eyes in the symptoms, clinical manifestations and examination are different. The main symptom is the increase in the number of blinks. The inspection is mainly characterized by a short BUT. With the decrease of TMH, the rate of meibomian gland loss is relatively insignificant.

Abstract:AIM: To observe the effect of orthokeratology on the positive relative accommodation of juvenile with myopia.

METHODS: Retrospective analysis of cases. All 122 cases(244 eyes)of juvenile with myopic from September 2016 to December 2017 in our hospital were analyzed. 63 cases were corrected by orthokeratology lens and 59 cases were corrected by glasses. data of the binocular positive relative accommodation before treatment and 6mo after treatment were compared between the two groups.

RESULTS:Before treatment, the average PRA value of the orthokeratology group(-0.83±0.23)D and the average PRA value of the glasses group(-0.77±0.24)D were no significant difference(t= -1.457, P>0.05). There was no significant difference between the two groups before treatment in eye axis(orthokeratology group 24.84±0.90mm, glasses group 24.78±0.86mm, t=0.550, P>0.05). PRA in the orthokeratology group -2.27±0.37D was significantly higher than that in the pre-treatment group -0.83±0.23D(t=37.070, P<0.001). There was no significant difference in PRA -0.83±0.24D at the end of 6mo compared with that before treatment -0.77±0.24D,(t=1.565, P>0.05). After treatment, the PRA of orthokeratology group was better than that of glasses group, and the difference was statistically significant(t=-25.271, P<0.001). The eye axis of the orthokeratology group 24.86 ±0.91mm was significantly higher than that of the control group 24.84±0.90mm(t=-2.453, P<0.05)at the end of 6mo. The eye axis of the glasses group 24.97±0.86mm was significantly different from that before treatment 24.78±0.86mm(t=39.135, P<0.001). There was no significant difference in the eye axis between the orthokeratology group and the glasses group after 6mo(t=-0.932,P>0.05).

CONCLUSION: The corrected visual acuity of juvenile myopia by orthokeratology was significantly higher than that by using glasses 6mo after treatment, but there was no significant difference between the two groups in eye axis during 6mo.

Abstract:AIM: To evaluate the clinical effect and safety of orthokeratology for minor to moderate myopia in adolescents.

METHODS:Sixty-three adolescent patients with mild to moderate myopia were selected in our hospital from January 2016 to January 2018. Visual acuity, corneal curvature, central corneal thickness, diopter, macular retinal thickness, axial length, intraocular pressure, tear film rupture time, corneal staining and complications were observed before and after wearing glasses for 1wk, 1, 6mo and 1a respectively.

RESULTS: There were significant differences in naked vision, diopter, corneal curvature and tear film rupture time before and after wearing glasses in this group(P<0.001). And there were no differences in axial length, central corneal thickness, macular retinal thickness and intraocular pressure(P>0.05).

CONCLUSION: Corneal plastic lens is a safe and effective non-surgical method for myopia correction in adolescents at the stage of growth and development.

Abstract:AIM: To evaluate the effects of visual perceptual learning on visual representation and binocular vision function of children with amblyopia.

METHODS: A total of 94 cases(94 eyes)children with amblyopia admitted to the ophthalmology clinic of our hospital from January 2014 to December 2015 were selected for the study and were grouped according to the degrees of amblyopia, and they were given visual perceptual learning for 3mo. The clinical efficacy and perceptual level of eye position and poor visual acuity before and after treatment were compared among groups, and Pearson correlation coefficient was used to analyze the relationship between difference of poor visual acuity and difference of perceptual eye position before and after treatment in children with amblyopia.

RESULTS: The total clinical effective rate of children with mild amblyopia was higher than that of children with moderate or severe amblyopia(P<0.05), and there was no significant difference in the total clinical effective rate between children with moderate amblyopia and children with severe amblyopia(P>0.05). The perception level of eye position after treatment of children with amblyopia was significantly lower than that before treatment(P<0.05). The perception level of eye position after treatment in children with mild, moderate or severe amblyopia was significantly decreased(P<0.05), and the improvement of perception level of eye position in children with mild or moderate amblyopia was more significant than that in children with severe amblyopia(P<0.05). The poor visual acuity of children with amblyopia after treatment was significantly improved compared with that before treatment(P<0.05). The poor visual acuity after treatment in children with mild, moderate or severe amblyopia was significantly improvement(P<0.05), and the improvement of poor visual acuity in children with mild or moderate amblyopia was more significant than that in children with severe amblyopia(P<0.05). The difference of poor visual acuity was positively correlated with difference of perceptual eye position before and after treatment among children with amblyopia(r=0.371, P<0.05).

CONCLUSION: Visual perceptual learning can effectively improve the visual representation and binocular vision function of children with amblyopia, and it is suitable for the clinical treatment of children with amblyopia.