Abstract:Glaucoma is the second leading cause of blindness worldwide, and also the most common optic neuropathy. The ultimate cause of vision loss in glaucoma is thought to be retinal ganglion cell (RGC) death. Neuroprotection of RGC is therefore an important goal of glaucoma therapy. Currently, glaucoma treatment relies on pharmacologic or surgical reduction of intraocular pressure (IOP). It is critical to develop treatment approaches that actively prevent the death of RGCs at risk in glaucoma. Neurotrophic factors have the ability to promote the survival and influence the growth of neurons. Neurotrophic factor deprivation has been proposed as one mechanism leading to RGC death in glaucoma. Effective neuroprotection in glaucoma likely requires the consistent availability of the active agent for prolonged periods of time. Biodegradable microspheres are especially attractive as drug delivery vehicles for a number of reasons. Sustained GDNF delivery by biodegradable microspheres offers significant neuroprotection to injured RGC in experimental glaucoma. PLGA microsphere-delivered GDNF represents an important neuroprotective strategy in the treatment of glaucomatous optic neuropathy and provides direction for further investigations of this hypothesis.

Abstract:AIM: To investigate the influence of He-Ne laser on connective tissue growth factor (CTGF) expression and collagen formation of fibroblast in filtration site after trabeculectomy in rabbit, and to discuss the mechanism for preventing scar formation with He-Ne laser in vivo. METHODS: The upper nasal limbus area next to the upper rectus muscle in right eyes received 10 minutes He-Ne laser irradiation (200mW/cm2) every day for three days, the left eyes served as control. Twenty-four hours after the last irradiation, both eyes of the rabbits were took trabeculectomy surgery. The expressions of CTGF in the filtration area were tested on the 7th, 14th and 28th day after surgery and collagen density was tested on the 14th and 28th day after surgery. Each of the time point had 7 rabbits. RESULTS: The expression of CTGF was lower than that of the control group's on the 7th and 14th day after trabeculectomy surgery (P=0.01, P=0.005). When examined on the 14th and 28th day, the collagen density of irradiation group were significantly lower than that of the control group's (P=0.013, P=0.01). CONCLUSION: Pretreating the filtration area with 200mW/cm2 He-Ne laser may be helpful in preventing scar formation after trabeculectomy in rabbit, possibly due to downregulation of the expression of CTGF and collagen synthesis in fibroblasts. He-Ne laser may be developed into a new scar preventing method in filtration surgery.

Abstract:AIM: To evaluate the effect of EffecteneTM lipofectine mediated plasmids encoding human pcDNA4-vascular endothelia growth inhibitor (pcDNA4-VEGI) gene on corneal neovascularization (CNV). METHODS: Forty New Zealand albino rabbits were sutured by 5-0 silk on the superior cornea to establish the animal model and divided into 4 random group, ten per each group: group A: transfected by pcDNA4-VEGI gene mediated by EffecteneTM lipofectine transfection, group B: by Plasmid pcDNA4, group C: by EffecteneTM, and group D: by normal saline. Length and area of CNV were measured under slit lamp every day after transfection, immunohistochemistry was used to detected the expression of VEGI protein in cornea at 3, 7, 14 and 21 days. RESULTS: Average occurrence of CNV in the pcDNA4-VEGI gene transfected group (group A) was 6.3 days, in plasmid pcDNA4 control group (group B) was 3.1 days, in EffecteneTM lipofectine control group (group C) was 3.2 days, in normal saline control group (group D) was 3.2 days. Differences between groups A and B, C, D were statistically significant (P<0.01), while differences in groups B, C and D were meaningless (P>0.05). Lenth and average area of CNV in each period in group A was meaningful different from that in groups B, C, and D (P<0.01), while differences in group B, C and D were meaningless (P>0.05). Immunohistochemistry result: VEGI positive cells could be seen in epithelium, stroma, endothelium and the cliff of CNV in group A at 3 days after transfection. VEGI cells changed with the decrease of CNV. None positive cells were in the control groups (groups B, C and D) all the time. CONCLUSION: EffecteneTM lipofectine transfection technique can be effectively used in transfecting pcDNA4-VEGI gene into rabbit cornea and the lenth and areas of CNV can be inhibited by VEGI gene.

Abstract:AIM: To explore the effect of alloxan time administerDrug on establishing diabetic rabbit model. METHODS: Thirty-six healthy rabbits, weighed 2-2.5kg, were randomly divided into one time administerDrug group (Group A, n=12), two times administerDrug group (Group B, n=12) and three times administerDrug group(Group C, n=12). Every rabbit was injected with alloxan of 150mg/kg. The three groups were measured for fasting blood-glucose. The success rate and death rate of each group were also calculated. RESULTS: The success rate of diabetic rabbit model in Group B was higher than that in Group A (P<0.01) but its death rate was lower than that of Group A (P<0.01); the success rate of diabetic rabbit model in Group C was highest but the death rate was the lowest in the three groups. CONCLUSION: Separate administration of alloxan can improve success rate in establishing diabetic rabbit model, decrease the death rate and keep the stability of model.

Abstract:AIM: To record multifocal electroretinogram from different dosage of N2O4 injected mice. In order to provide a foundation for further study. METHODS: Normal winstar mice which were injected by different dosage of N2O4 were studied for recording multifocal electroretinogram in the same time in the evening after N2O4 injection. RESULTS: The latency and amplitude density of "b" wave of each ring of multifocal electroretinogram was studied. The latency of "b" wave of each ring of multifocal electroretinogram of each group varies to each other. But the difference of the amplitude of "b" wave of multifocal electroretinogram of each ring between each group had no significance. CONCLUSION: Recording multifocal electroretinogram of N2O4 injected mice will give more support for further study in related science and clinic research.

Abstract:AIM: To study the effects of Tetramethylpyrazine (TMP) on retinal pigment epithelium (RPE) degeneration, choroidal blood flow and oxidative stress of RPE cells. METHODS: The 35mg/kg NaIO3-induced RPE degeneration rat eyes was given 25μg 1% TMP eye drops 3 times a day for 7 days before NaIO3 injection, and then 2 to 4 weeks after NaIO3 injection. RPE function was measured with c-wave of electroretinogram (ERG). Colored microsphere technique was used for in vivo experiments to determine the choroidal blood flow in ocular hypertensive (40mmHg) rabbit eyes. Methylthiazoltetrazolium (MTT) assay was used to study in vitro effect of TMP on various oxidants induced injury in the hRPE (ARPE-19 (ATCC, Manassas, VA, USA)) . RESULTS: Two weeks after NaIO3 injection, the amplitude of ERG c-wave fell markedly in NaIO3 group to 36% of control group(P <0.01). No apparent difference was observed in TMP+NaIO3 group. Four weeks later, the NaIO3 group fell to 46% of control group (P<0.01), while the TMP+NaIO3 group fell to only 77% of control group (P<0.01). There was a 67% reversal of the ERG c-wave by TMP as compared to NaIO3 group(P<0.01). The choroidal blood flow was significantly increased at all time points (at 30, 60 and 120 minutes after TMP instillation) as compared with corresponding controls. TMP had no effect on hypoxia-(1%O2), t-BHP- and H2O2-induced damage in RPE cells. 10(g/mL TMP could reverse 1 and 3mM NaN3-induced loss of viability of RPE by 18.5% (P <0.01) and 23% (P<0.01), respectively. 30μg/mL TMP could reverse 30 and 100mM NaIO3 induced loss of viability of RPE by 18.1% (P <0.05) and 16.8% (P <0.01), respectively. CONCLUSION: TMP can significantly protect RPE from NaIO3 induced degeneration in vivo and oxidative stress in vitro and can increase choroidal blood flow markedly in vivo.

Abstract:AIM: To investigate the effect of carnosine (Car), aspirin (Asp) and a combination of Car and Asp eye drops on the change of the thiol contents from glutathione (GSH) and protein in the corneas of the diabetic rats. METHODS: All the animals were randomly divided into five groups. The normal control group received injections of vehicle only. Diabetes was induced by injection of streptozotocin (STZ) in the Sprague-Dawley (SD) rats. The untreated group rats received only the vehicle solution (the placebo). One treated group rats were treated by instillation of one drop of 10g/L Car eye drops, another were treated by 0.5g/L Asp eye drops and the last group were treated alternately by Car 10g/L and Asp 0.5g/L eye drops for a period of 8 weeks. At the end of 8 weeks, the animals were killed and the thiols contents in the corneas were investigated. RESULTS: About 15.6% of the rats (blood glucose measured <14mmol/L) were rejected. In the corneas, the levels of thiols were declined in the untreated, Asp-treated group and combination-treated group, but they went up in Car-treated group. The levels of thiols in the Car-treated groups were much higher than that in the untreated group, and there was statistically significant difference between them (P<0.05). CONCLUSION: The results indicated that diabetes decreases the levels of thiols (from GSH and proteins) in the cornea. The Car eye drops in our study may protect the cornea against the oxidative damage caused by diabetes. And the combination eye drops also may have a certain protection for the diabetic corneas.

Abstract:AIM: To access the differentiation of rat mesenchymal stem cell (MSC) in the microenvironment of retinal degeneration induced by the administration of sodium iodate. METHODS: In-vitro cultured Lewis rat MSC were injected into the sub-retinal space of NaIO3 induced retinal degeneration rat eyes (30g/L NaIO3 100mg/kg). To observe the trace and differentiation of MSC by immuno-fluorescent method successively in 5 weeks after the surgery. RESULTS: The majority of the transplanted cells stay in retinal pigment epithelium layer and cones & rods layer. From the 2nd week after transplantation, the engrafted MSC express PCK and rhodopsin under fluorescent microscope. CONCLUSION: MSC can survive mainly in the outer layer of retina in the microenvironment of retinal degeneration and differentiate forward the RPE cell and photoreceptor.

Abstract:AIM: To investigate the effect of ginsenoside-Rg3 on the expression of vascular endothelial growth factor (VEGF) and tumor necrosis factor-α (TNF-α) in retina with diabetic rats and its roles in preventing neovascularization in diabetes. METHODS: Sixty male Wistar rats were divided into 3 groups randomly: negative control group, diabetic control group and ginsenoside-Rg3 treatment group (5mg/kg, 0.2mg/mL) followed by establishing diabetic model. The expression of VEGF and TNF-α were measured after 8 weeks. RESULTS: There were significant differences among negative control group, diabetic control group and ginsenoside-Rg3 treatment group in the expression of VEGF and TNF-α (F =129.363, 211.992; all the P <0.01). VEGF and TNF-α expression were significantly higher in diabetic control group and ginsenoside-Rg3 treatment group than that in negative control group (P <0.01), with a significant reduction in ginsenoside-Rg3 treatment group than that in diabetic control group (P <0.01). CONCLUSION: Ginsenoside-Rg3 can down-regulate the expression of VEGF and TNF-α in retina, which may interfere in the development of diabetic retinopathy.

Abstract:AIM: To investigate retinal vascular endothelial growth factor (VEGF) level and retinal cells apoptosis in the early stage of diabetic NOD mouse retina. METHODS: Animals were divided into non-diabetes group, (control) (2-, 4-, 6-, 8- and 12-week sub-groups, n=30) and diabetes group (2-, 4-, 6-, 8- and 12-week sub-groups, n=30). Enzyme-linked immunosorbent assay (ELISA) was performed to detect VEGF level in both serum and retina. Transmission electron microscope method was used to examine retinal cell apoptosis. RESULTS: Compared with the control group, VEGF levels in serum and retina were increased significantly in the NOD group (12 weeks: 4.9±0.4μg/g vs 0.19±0.1μg/g in serum sample, P<0.01; 165±9μg/g vs 17±5μg/g in retinal sample, P<0.01). There exists a positive correlation between serum VEGF and retinal VEGF levels in the early diabetic NOD mice (γ=0.9902, P=0.001). The number of the cells apoptosis in the ganglion cells and endothelium can also been found increased significantly in the NOD group (P<0.01). CONCLUSION: The high VEGF expression may be contributed to increased retinal cells apoptosis. Many factors associated with retinal VEGF expression might involve in the early diabetes stage.

Abstract:AIM: To assess the cost-effectiveness of autologous retinal pigment epithelium and choroid translocation (PATCH) in neovascular age-related macular degeneration (AMD). METHODS: Visual acuity and complication rates of published patient series were used to determine the incremental utility of treatment for the patient. The utility data applied assume that the better eye was affected. Comparator was a meta-analysis of recent control groups, in which patients received best supportive care. To assess cost-effectiveness, costs per quality adjusted life years (QALYs) and costs of avoiding low vision ("legal blindness", i.e. ≤20/200) were calculated. Costs were based on a German sick fund perspective and in a scenario on US costs. Robustness of the model was investigated by univariate and probabilistic multivariate sensitivity analysis (PSA). RESULTS: Cost-utility analysis showed surgery to be the dominant ("cost-saving") strategy for Germany and for the US in both, cost-effectiveness and cost-utility analysis (costs per QALY). In the sensitivity analysis the intervention remained dominant or cost-effective in all scenarios investigated. Clinical outcomes and duration of modeling were the most influential factors in the sensitivity analyses. CONCLUSION: Therapy of neovascular AMD by PATCH is a cost-effective treatment option for selected patients, who are not well suitable for other current treatment options.

Abstract:AIM: To compare corneal endothelial structure and central corneal thickness (CCT) between type II diabetics and non-diabetic control patients. To look for correlations between diabetic status and corneal findings. METHODS: Hospital-based, observational study. 200 eyes (from 100 type II diabetic patients and 100 controls) were included. Specular microscopy and pachymetry were used to measure endothelial cell density, size, coefficient of variation in cell area, hexagonality as well as corneal thickness. Independent t-tests were used to compare variables between diabetics and controls. Pearson correlation tests were used to evaluate correlations between corneal findings and diabetic status such as duration of diabetes, haemoglobin A1c (HbA1c) level and severity of diabetic retinopathy. RESULTS: Endothelial cell density in the diabetic group (2541.6±516.4 cells/mm2) was significantly lower than that in the control group (2660.1±515.5 cells/mm2, P <0.05). The average size of endothelial cells, standard deviation (SD) of cell size and coefficient of variation (CV) of cell area were all significantly higher in diabetics. Hexagonality was significantly lower in diabetics (41.1%±19.6%) compared to non- diabetics (45.2%±20.6%). CCT was higher in diabetics but not significant (P >0.05). Duration of diabetes, HbA1c level and severity of diabetic retinopathy were not significantly correlated with corneal endothelial findings. CONCLUSION: Type II diabetes causes a significant alteration in the state of the cornea including reduction in endothelial cell density and increased pleomorphism and polymegathism. Central corneal thickness is unaffected.

Abstract:AIM: To evaluate the efficacy and safety of botulinum toxin type A (Dysport, (Ipsen Biopharm Ltd, Wrexham, UK)) injection in patients requiring temporary tarsorrhaphy to improve corneal epithelial defects. METHODS: Thirty patients were enrolled into the prospective study between March 2007 and September 2009. Doses of 15 and 30U of Dysport were injected into the levator palpebrae superioris muscle through the eyelid. The patients were followed daily until completion of ptosis and then 1-2 weekly until complete resolution of levator function and improvement of corneal condition. RESULTS: Ptosis took 2.64±1.85 days to be completed (range 1-9 days) and lasted for 12±2.19 weeks. For patients with seventh nerve palsy, 30U Dysport was appropriate to produce sufficient ptosis whereas in other patients 15U of toxin was sufficient. In 83.3% of patients ptosis was sufficient for complete recovery of corneal epithelium and 16.7% required a second procedure (Amniotic membrane transplantation, conjunctival flap). There was a direct correlation between age and duration of ptosis. In patients with seventh nerve palsy, the amount of resultant ptosis was significantly lower than that of other patients. The only adverse effects of injection were superior rectus underaction (33.3%) and diplopia (16.7%) which resolved in all patients without any intervention. CONCLUSION: Dysport injection is a safe and effective substitute for surgical tasorrhaphy with fewer complications.

Abstract:AIM: To report the short- and medium-term outcomes of sutureless large-incision manual cataract extraction using the Kongsap (SLIMCE-K) technique. METHODS: This prospective study included 73 eyes of 73 patients who underwent cataract surgery performed by using the SLIMCE-K technique. The postoperative visual acuity, intraoperative and postoperative complications, and endothelial cell loss were evaluated. A follow-up visit, at least 6 months after the surgery, was included in the study. RESULTS: All patients had improved visual acuity after surgery. Uncorrected visual acuity (UCVA) was 6/18 or better in 55 eyes (75.3%) at 1 week postoperatively and in 64 eyes (87.6%) at 6 weeks postoperatively (P=0.09). The best corrected visual acuity (BCVA) was 6/18 or better in 67 eyes (91.8%) at 1 week postoperatively and in 70 eyes (95.9%) at 6 weeks postoperatively. The results remained stable at 3 months and 6 months postoperatively. No significant intraoperative complications were encountered. The endothelial cell loss was 4.8% at the 3-month follow-up examination. CONCLUSION: When performed by an experienced surgeon, SLIMCE-K is a safe and effective procedure that can be performed independent of phacoemulsification machines. It can be used in any nuclear grading of cataract hardness that is common in developing countries.

Abstract:AIM: To detect the presence of 8-hydroxydeoxyguanosine enzyme (8-OHdG) in recurrent pterygium and its role on recurrence. METHODS: Ninty-two samples were collected of which 55 from primary pterygium, 12 from recurrent and 25 from normal conjunctiva. A cross sectional study was embarked to detect the presence of the 8-OHdG enzyme in primary, recurrent pterygium and the normal conjunctival tissue by immunohistochemistry test. RESULTS: The immunohistochemistry test showed positive results: 35 in primary, 2 in recurrent pterygia and 4 in normal conjunctiva, respectively. Significant association between primary pterygium and 8-OHdG enzyme (63.6% of samples are positive) and no significant relation was detected with recurrent pterygium (16.7% of samples are positive). CONCLUSION: 8-OHdG enzyme is associated with primary pterygium. It is also present in normal conjunctival tissue. For the first time it is detected in recurrent pterygia. This may raise question whether 8-OHdG enzyme has a role in recurrence of pterygium.

Abstract:AIM: To evaluate the anterior segment complications of phacovitrectomy and foldable intraocular lens (IOL) implantation in eyes with significant cataract and co-existing vitreoretinal diseases. METHODS: This retrospective study was consisted of 285 eyes of 238 patients with various vitreoretinal abnormalities and visually significant cataracts. Vitreoretinal surgery was combined with phacoemulsification and foldable IOL implantation. Main outcome measures were visual acuity, the preoperative data, and the anterior segment complications at postoperative 6 to 72 months. RESULTS: The most common indications for surgery were non-diabetic vitreous hemorrhage, proliferative diabetic retinopathy. Preoperative vision ranged from 20/30 to light perception and postoperative vision ranged from 20/20 to no light perception. Postoperatively, in 245 eyes (85.9%), visual acuity improved by 3 lines or more on the Snellen chart. In 24 eyes (8.4%), vision remained within 3 lines of preoperative levels and in 16 eyes (5.6%), vision had decreased at the last follow-up. The most common anterior segment pathological change was PCO in 50 eyes (17.5%), the second was corneal edema in 32 eyes (11.2%) and the third was elevated IOP in 31 eyes (10.8%). CONCLUSION: The combined vitreoretinal surgery and phacoemulsification with foldable IOL implantation is safe and effective.

Abstract:AIM: To evaluate the availability and our experience of intraoperative image-guidance in endoscopic nasocular operation. METHODS: Seven cases of endoscopic nasal surgery with intraoperative image-guidance were retropectively reviewed, including 3 cases of optic nerve injury; 3 cases of foreign object of optic behind the eyeball; 1 case of retrobulbar tumor (angeioma). RESULTS: The preoperative preparatory time would take 15 minutes, including coordination, head holder localization, conventional instrument registration. In our cases, the localization accuracy between 3-D image landmarks of navigation system and actual anatomical landmarks was less than 1.3mm. The optic nerve and other anatomical points could be orientated accurately in intraoperative procedures. No complication occurred. CONCLUSION: Nasal endoscope combined with image- guidance systems provides accurate anatomical localization of anterior skull base with enlarged operation field. It is possible for surgeons to observe important anatomical structures during endoscopic surgery. It could increase the effectiveness and decrease surgical complications, especially in complicated cases.

Abstract:? AIM: To evaluate the therapeutic efficacy of intracameral amphotericin B (ICAMB) injection in the treatment of keratomycosis. ? METHODS: The study design was a prospective controlled clinical trial. A total of 60 eyes of 60 patients were divided into two groups, 30 in the ICAMB injection group (group A) and 30 in the control group-topical application amphotericin B (group B). Serial measurements of the size of the keratomycosis-namely, two maximum linear dimensions perpendicular to each other, and the area and perimeter was done at start of therapy and follow up on day 3, 7, and 21. Rate of healing of the keratomycosis were measured as percentage decrease from the baseline parameter at each subsequent follow up. The data were analyzed by the non-parametric Wilcoxon rank sum test. ? RESULTS: The mean time to disappearance of hypopyon was 9.6±9.2 (range:1-26) days in group A and 26.8±20.8 (range:14-62) days in group B (P=0.03). The median percentage decrease in the size of the keratomycosis was significantly greater than that in the cord serum group at day 21(P＜0.05) when measured in terms of the area and perimeter. A greater number of patients showed complete re-epithelialization in group A (n=27) than in group B (n=14) (P＜0.05). None of the patients reported any side effects or discomfort with either treatment. ? CONCLUSION: ICAMB injection leads to faster healing of the keratomycosis refractory to all medical management and reducing time to disapperence of hypopyon compared to topical application amphotericin B.

Abstract:AIM: To evaluate the effect of intravitreal bevacizumab (IVB) injection 1 week before pars plana vitrectomy (PPV) in proliferative diabetic retinopathy (PDR) patients. METHODS: A retrospective research was done on 46 PDR patients who were divided into PPV group (n=28) and IVB group (n =18, PPV with preoperative IVB). Bevacizumab was injected 1 week before PPV. Main outcome measures were visual acuity, incidence of iatrogenic retinal breaks, intraoperative and postoperative bleeding. RESULTS: At 1 month after surgery, visual acuity in PPV (82.1%) and IVB group (88.9%) improved significantly (P＜0.01) and the difference between the two groups was not significant (P＞0.05). Iatrogenic retinal breaks were reported in 18 cases (64.3%) in PPV group and 4 cases (22.2%) in IVB group (P＜0.05). Intraoperative bleeding was encountered in all cases in PPV group and 7 cases (39%) in IVB group (P＜0.01). Postoperative bleeding was reported in 9 cases (32.1%) in PPV group and none in IVB group (P＜0.01). CONCLUSION: IVB injection before PPV is helpful in reducing iatrogenic retinal breaks, intraoperative and postoperative bleeding in PDR patients.

Abstract:AIM: To evaluate the efficacy and tolerability of one-site versus two-site phacotrabeculectomy in the treatment of patients with coexisting cataract and glaucoma. METHODS: A comprehensive literature meta-analysis was performed according to the Cochrane Collaboration methodology to identify controlled clinical trials comparing one-site with two-site phacotrabeculectomy. The studies meeting the predefined criteria were reviewed systematically by meta-analysis. Efficacy estimates were measured by standardised mean difference (SMD) for the percentage intraocular pressure (IOP) reduction from baseline to end point, odds ratio (OR) for the percentage having a best-corrected visual acuity (BCVA) of 0.5 or better after surgery and relative risk (RR) for complete success rates. Tolerability estimates were measured by RR for adverse events. All of outcomes were reported with 95% confidence interval (CI). Data were synthesised by Stata 10.1 for Windows. RESULTS: Two-site phacotrabeculectomy was associated with numerically greater, and significant efficacy than one-site in lowering IOP (SMD, -0.19; 95% CI, -0.33 to -0.04; P=0.01). Numerically greater, but nonsignificant proportions of two-site patients than one-site patients had a BCVA of 0.5 or better (OR, 0.65; 95% CI, 0.30 to 1.39; P=0.26).Numerically greater, but nonsignificant proportions of two-site patients than one-site patients achieved the target IOP without anti-glaucoma medication at the end point (RR, 0.94; 95% CI, 0.84 to 1.04; P=0.22). Furthermore, there was nonsignificant difference in adverse events between two surgical procedures. CONCLUSION: The efficacy of two-site phacotrabecu- lectomy appears to be superior to one-site phacotrabecul- ectomy. One-site and two-site phacotrabeculectomy are similarly tolerable in postoperative adverse events.

Abstract:AIM: To evaluate the effect of the application of sodium hyaluronate on the operation of suturing the corneal perforation. METHODS: Sodium hyaluronate was used in the operation of suturing the corneal perforation in 76 patients to form the anterior chamber, protect eye tissues and separate the anterior iris synechia. RESULTS: In the procedure of operation, the anterior chamber was stable, the prolapsed iris was easily restored, the corneal wound was easily sutured and there was no damage to the lens. Postoperatively, the corneal wound was closed well, the anterior chamber formed and there was no anterior iris synechia. Fifty-four cases had round pupils and the pupils of 22 cases were not round with defect of iris. CONCLUSION: Sodium hyaluronate in the operation of suturing the corneal perforation can help form the anterior chamber, protect the eye tissues and make the suturing corneal wound easier. It can reduce the rate of complication and promote the wound healing.

Abstract:AIM: To determine the causes, associated ocular findings and visual acuity on presentation, complications and visual outcome following treatment in patients of hyphema due to blunt injury METHODS: A retrospective study was performed in 118 patients with hyphema due to blunt injury admitted in University of Malaya Medical Centre, Kuala Lumpur, Malaysia. The gender, age, race, cause of blunt injury resulting in hyphema, eye involved, vision at admission, other associated ophthalmological findings, complications and visual outcome were noted from the case records of patients. The data were analyzed using SPSS programme. RESULTS: Males were more predominantly affected (93.2%). Two-thirds of patients (67.8%) were aged below 30 years. Sports related injury (38.1%) was the most common cause for hyphema. Hyphema disappeared within 5 days in 66.9% of patients. Iris injuries were very commonly associated in the form of mydriasis, sphincter tear and iridodialysis. Associated vitreous haemorrhage was noted in 11.9% of patients. During the hospital stay, secondary haemorrhage was observed in 3.4% of patients. The best corrected vision of 6/18 or better was noted in 85.4% of patients at the last follow-up. The follow-up of these subjects was very poor and thus the incidence of secondary glaucoma could not be established. Moderate blood staining of cornea occurred in 0.8% of patients. CONCLUSION: Sports related injury is the most common cause of hyphema in Malaysia. Good visual recovery, without serious complications, is possible with appropriate and in-time treatment in hyphema patients due to blunt injury.

Abstract:Congenital cataract is the leading cause for children's blindness in most countries. Approximately one third of all the causes of Congenital cataract are familial and autosomal dominant blindness infants. The etiology of congen ital cataract is heterogenous. With the development of molecular biology techniques, researches on the mechanism of congenital cataract have made great progress. This review focused on the molecular mechanism of congenital cataract.

Abstract:AIM: To report two cases where decreased visual acuity was the first symptom of leukaemia and optical coherence tomography (OCT) allowed identification and localization of the retinal lesions. METHODS: Retrospective, interventional, case reports. RESULTS: One case of lymphoblastic acute leukaemia and chronic lymphoid leukaemia were diagnosed following decreased visual acuity. OCT showed macular serous detachment in the first case. The second case presented hypo fluorescent retinal infiltrates which appeared as hyper reflective lesions by OCT. Retinal changes disappeared and visual acuity was recovered following complete remission of the neoplasm. CONCLUSION: OCT is a valuable, non invasive diagnostic tool permitting detection, localization and follow-up of ocular dissemination of neoplasms.