Abstract:AIM: To determine the effect of suction duration on thickness and diameter of corneal flap created by microkeratome in porcine eyes in laser in situ kerato-mileusis (LASIK). METHODS:Sixty porcine eyes were randomly assigned to three groups according to different suction durations:group 1 (10 seconds),group 2 (20 seconds),and group 3 (30 seconds).A Moria M2 microkeratome (Moria, France) with a 160μm head was used to create a corneal flap. Corneal flap thickness was measured by automated ultrasonic pachymetry, and the flap diameter was measured by a vernier caliper. RESULTS: The flap thickness of group 1, group 2 and group 3 was 146.05±13.46μm, 157.35±18.95μm and 169.25±21.02μm, respectively. There was a statistically significant difference among three groups (P=0.001). The mean flap diameter in groups 1, 2 and 3 was 8.63±0.19mm, 8.89±0.24mm and 9.06±0.18mm, respectively. A statisti-cally significant difference was found among groups (P<0.01). CONCLUSION: In LASIK in porcine eyes, an increase in suction duration resulted in a thicker and greater flap.

Abstract:AIM: To evaluate the effects of glycemic control on refraction in diabetic patients. METHODS: Twenty newly diagnosed diabetic patients were included in this study. The random blood glucose, HbA1c levels, fasting C-peptide and postprandial 2h C-peptide were measured before treatment. The patients with random blood glucose higher than 12.0mmol/L and HbA1c level higher than 10.0% were selected. Refraction, intraocular pressure, radius of the anterior corneal curvature, depth of the anterior chamber, lens thickness, vitreous length, and axial length were measured on admission and at the end of week 1, 2, 3 and 4 during glycemic control. RESULTS: A transient hyperopic change occurred in all the patients receiving glycemic control. The maximum hyperopic change was 1.60D (range 0.50±3.20D). Recovery of the previous refraction occurred between two and four weeks after insulin treatment. There was a positive correlation between the maximum hyperopic changes and the HbA1c levels on admission (r=0.84, P<0.05). There was a positive correlation between the maximum hyperopic changes and the daily rate of blood glucose reduction over the first 7 days of the treatment (r=0.53, P<0.05). During transient hyperopia, no significant changes were observed in the intraocular pressure, radius of the anterior corneal curvature, depth of the anterior chamber, lens thickness, vitreous length and axial length. CONCLUSION: Transient hyperopic changes occur after glycemic control in diabetic patients with severe hyperglycemia. The degrees of transient hyperopia are highly dependent on HbA1c levels before treatment and the rate of reduction of the blood glucose level.

Abstract:AIM: To determine the prevalence of other allergies in patients with vernal keratoconjunctivitis(VKC) and their first-degree relatives. METHODS: This prospective study was done on 520 patients with VKC over a 9-year period from April 1999 to March 2008. All information such as age, sex, types of vernal and various types of other accompanying hypersen-sitivities in patients and/or their relatives were recorded on questionnaires and analyzed statistically. RESULTS: Among 520 patients, 369 (71.0%) were male and 151 (29.0%) were female. The mean age of patients was 15.3 years (6-30 years). 242 cases (46.5%) had history of vernal or other types of hypersensitivities in themselves or their first-degree relatives. Among these positive history cases ,68 patients (28.1%) had allergic dermatitis,51 cases (21.1%)vernal conjunctivitis (in their relatives),46 cases (19.0%)asthma, 29 cases (12.0%) allergic sinusitis, 24 cases (10.0%)drugs hypersensitivity, 14 cases (5.8%) atopic dermatitis, 6 cases (2.5%) allergic rhinitis and 4 cases (1.6%) had hay fever history. CONCLUSION: Many patients with VKC have other IgE-mediated or other types of hypersensitivity in him/her self and/or their relatives. Asthma, drug induced allergy and other hypersensitivities are common in these patients. The rate of vernal in relatives of patients was high, so it may be due to genetic origin of the disease.

Abstract:A 32-year-old lady, diagnosed with anaplastic large cell non-Hodgkin’s lymphoma of the mediastinum, presented with bilateral floaters and reduced right eye vision 3 years post chemotherapy. Ophthalmic examination revealed bilateral panuveitis with multiple deep seated choroidal lesions in the left eye. Computed tomography scanning of the orbit showed enhancing and bulky optic nerve sheath at the retrobulbar part of both optic nerves. The patient was treated with involved field radiation therapy of the orbit, with cumulative dose of 30Gy. Eight months post radiation therapy, she developed retinal pigment epithelial detachment at the macula and deep chorioretinal degeneration at superotemporal and inferonasal regions of the right fundus. There was evidence of vitreoretinal traction at the margin of chorioretinal degeneration areas, thus barricade lasers were performed in the affected eye. Her visual acuity remains 6/6 in both eyes. Retinal pigment epithelial detachment is a possible complication of radiation therapy in non-Hodgkin’s lymphoma with intraocular metastasis. It is essential to alert the managing ophthalmologists about this rare complication.

Abstract:Sarcoidosis is a rare and potentially disabling disease in the paediatric age group. Clinical management of such cases is difficult and requires long-term monitoring. We report a case of a 9 years old Caucasian girl who presented initially with bilateral chronic anterior uveitis, cataracts and glaucoma secondary to sarcoidosis. She was treated with Guttae Levobunolol, topical and systemic steroids over the last 2 years but subsequently required cataract extractions with foldable intraocular lens implants (Alcon Laboratories, Inc. Acrysof IOL Model: MA60AC). Her uveitis was well controlled with both topical steroids and low dose methotrexate over the last 2 months following cataract surgery. Her full blood counts and renal functions are monitored regularly. There was no adverse effect from the methotrexate reported so far. Sarcoidosis is a multisystem disease and requires multi-disciplinary input from ophthalmologists, neurologists and paediatricians. Medical and surgical treatment of such ocular manifestations is challenging. This case highlights both the safety of low dose methotrexate in the management of childhood chronic uveitis and the need for prompt treatment in such cases to avert significant morbidity from this disease.

Abstract:AIM:To study the expressions of toll-like receptor 4(TLR4)and CD14 in lens epithelial cell(LEC). METHODS:The expressions of TLR4mRNA and CD14mRNA were detected by one-step polymerase chain reaction (PCR) with reverse transcription (RT-PCR) in cultured LEC. RESULTS: The amplified clear bands of 451bp and 348bp were obtained respectively via RT-PCR, which were confirmed to be TLR4mRNA and CD14mRNA by means of gene sequence analysis. CONCLUSION: There are expressions of TLR4 and CD14 in LEC.

Abstract:

Abstract:AIM: To investigate the expression and significance of matrix metalloproteinase-2(MMP-2) and tissue inhibitor of metalloproteinase-2(TIMP-2) in the rat traumatic cataract models. METHODS:Twenty healthy SD rats(weighing 250-300g) were used to establish traumatic cataract model on left eyes and then divided into post-traumatic 12, 24, 72 and 168 hours groups randomly. The expression of MMP-2 and TIMP-2 in lens epithelial cells(LEC) were examined by immunohistochemistry staining. RESULTS: In the post-traumatic 12 hours, lens opacity began to appear and aggravated as the time went by. Immunohistochemical results showed positive MMP-2 expression in the LEC of every traumatic groups. No expression of MMP-2 was detected in the compared eyes without surgery. But there was no statistical significance for TIMP-2 expression (P>0.05). There was no correlation between the expression of MMP-2 and TIMP-2 (P>0.05). CONCLUSION: MMP-2 takes part in the formation process of traumatic cataract. The imbalance between the expression of MMP-2 and TIMP-2 may play a critical role in the generation and development of traumatic cataract.

Abstract:AIM:To evaluate the efficacy of topical amphotericin B limposome(AmBL) injection in the management of keratomycosis in a rabbit model. METHODS: Forty New Zealand White rabbits model of aspergillus keratitis were randomized into four groups (groups A, B, C and D), with 10 eyes in each group. Group A were treated with 5g/L AmBL, group B 2.5g/L AmBL, group C were treated with 5g/L amphotericin B eye drop (AmBS), group D were treated with normal saline as the control group. After 3 days, treatments were performed every 15 minutes, totally for 4 times, then it changed to six times per day. Eye examinations were performed after 3, 5, 7, 10, 15 days. Quantitation of fungi in the cornea was achieved by culturing homogenates and counting colony-forming units. RESULTS: Corneal edema, corneal infiltration range, hypopyon, and conjunctival hyperemia revealed that after 7, 10 days treatment, group A, B was significantly different compared to the other groups (P<0.01), but not at day 3,5. Corneal new vessels in groups A, B were significantly different compared to groups C, D after 7 days treatment but not different after 10, 15 days. Quantitative cultures in groups A, B were significantly different compared to groups C, D after 7, 10 days treatment. CONCLUSION: Intracameral AmBL injection can effectively inhibit the progress of keratomycosis. 2.5g/L AmBL and 5g/L AmBL are not significantly different in therapeutic effect.

Abstract:AIM: To detect the suppression effects of culture super-natant of human amniotic membrane on the expression of vascular endothelial growth factor(VEGF) in rabbit corneal epithelial (RCE) cells. METHODS: The normal RCE cells were cultured for 7 days until there were confluences on the cultures. The cells were subcultured to plastic(3 groups,Ⅰ-Ⅲ, Ⅰ was control) and naked amniotic membrane (Ⅳ group) cultures respectively. Then one of plastic group (Ⅱ group) was cultured by culture supernatant of human amniotic membrane without epithelial layer as its medium; another plastic group (Ⅲ group) was cultured by culture supernatant of human amniotic membrane with epithelial layer as its medium; the other two groups (Ⅰand Ⅳgroup) were still cultured by DMEM (free from FBS components ).After 48 hours, the total RNAs of these cultures were extracted and detected by RT-PCR. RESULTS:There were expressions of VEGF mRNA from Ⅰ group and Ⅱ group, however, the expressions were significantly suppressed in Ⅲ group(using culture supernatant of human amniotic membrane with epithelial layer as its medium) and Ⅳ group (RCE cultered directly on naked amniotic membrane) (P<0.01, n=5). CONCLUSION: Amniotic membrane transplantation is partly through depressing the mRNA expression of VEGF in corneal cells to reduce the corneal neovascularization of injuried corneal surface. And it may be an efficient method of curing corneal neovascularization in clinic.

Abstract:AIM:To investigate the expression levels and signifi-cance of aquaporin-1 (AQP-1) and vascular endothelial growth factor(VEGF) in the retinal ischemia reper-fusion injury(RIRI). METHODS:The model of transient RIRI of the rat retina was constructed by elevation of the intraocular pressure .The expression levels of AQP-1 and VEGF was measured 6, 12, 24 and 48 hours, 3, 7 days after retinal ischemia using immunohistochemical staining. Normal retina was treated as control group. RESULTS: VEGF positive cells were not found in normal group and began to express after 12 hours in ischemia group, increased gradually and reached maximal levels 48 hours after RIRI. There was statistical difference between 48 hours group and other ischemia reperfusion group (P<0.01). AQP-1 positive cells were found in the outer retina in normal group, increased gradually in ischemia reperfusion group and also were found in the inner retina 7 days after RIRI, and the difference was significant (P<0.01). CONCLUSION: AQP-1 and VEGF may play an important role in various blinding ischemic ocular diseases, and co-effect the water metabolism of retina.

Abstract:AIM:To investigate the protection of different polarity alkaloids (fat-soluble, water-soluble, low polar, weak polar) from dendrobium nobile on H2O2 induced damage of human lens epithelial cells (HLEC). METHODS:The H2O2 and HLEC were incubated with oxidative damage model . At the same time the different polarity alkaloid were added and sustained for 24 hours. Then detection of the proliferation of HLEC was with MTT and apoptosis was detected by FCM. RESULTS:The proliferation of LEC in H2O2 group was declined. The group of fat-soluble alkaloid and water-soluble alkaloid(25μg/L) were significantly increased compared to H2O2-induced group. The group of fat-soluble alkaloids could significantly reduce the H2O2-induced apoptosis of LEC(P<0.01). CONCLUSION: Fat-soluble alkaloids(12.5μg/L) extracted from dendrobium nobile can enhance the proliferation of LEC by anti-oxidation, and inhibit the apoptosis of LEC.

Abstract:AIM: To observe the protective effect of EGb761 on retinal ganglion cells (RGC )in rabbits with optic nerve crush injury by myelin basic protein (MBP )in rabbits’ retina. METHODS: Twenty-four rabbits were divided into experimental(right eye)and control(left eye) groups. The rabbits’ optic nerves were crushed by mini-vascular nip. EGb761 60mg/kg were injected into the retrobulbar of right eye and the same volume balanced saline solution (BSS) were injected into the retrobulbar of left eye. 4, 7 and 14 days after injury, the number of the RGC was counted by image analysis system, and the immunohisto-chemical staining of the MBP was observed. RESULTS: Three to fourteen days after injury, the number of RGC in the experimental group and control group were lower than that in normal by microscope. The differences were significant (P<0.01); the number of RGC in experimental group was higher than that in the control group. The difference was significant (P<0.01); the results of immunohisto-chemical staining: expression of MBP in both experi-mental group and control group were gradually decreased after injury. The expression of MBP in experimental group was less apparent than that in BSS group and decreased obviously at 14 days, while the expression of MBP in BSS group was still obvious at 14 days. The positive rates of RGC in different durations of experi-mental group were lower than those in the BSS group. The differences were significant (P<0.01). CONCLUSION: EGb761 can reduce the content of MBP increase, the survival rate of RGC and may have the protective effect in preventing RGC from degeneration.

Abstract:AIM: To investigate the relevance of formation of fibrovascularization between vascular endothelial growth factor (VEGF) and hydroxyapatite(HA) orbital implants; and the mechanism of dexamethasone suppression on fibrovascularization of HA implants. METHODS: Twenty rabbits were randomly divided into experimental group and control group with 10 in each; each group were used HA implants implanted in rabbit eyes and tobramycine eyedrop was used 4 times per day postoperatively. Peribulbar injection of dexamethasone 0.5mg was applied in the experimental group every other day 48 hours after operation to the end of the experiment, and the growth state of conjunctiva in both groups were observed. 2 HA implants from experimental group and control group respectively were extracted for testing the positive expression of VEGF by immunohistochemistry 3,7,14,21,28 days after operation. RESULTS: There was a significant correlation between HA implants fibrovascularization and the expression of VEGF. Histological examination confirmed that after 14 days, the experimental group HA significantly reduced inflammatory cell infiltration, immunohistochemistry showed that VEGF expression in the experimental group was significantly lower than that in the control group. CONCLUSION: It is closely related between HA implant fibrovascularization and inflammatory reaction; VEGF may be involved in the formation of fibrovascularization, dexamethasone may be through inhibiting the inflamma-tory response and VEGF expression, and thus inhibit implants of fibrovascular growth.

Abstract:AIM: To observe the long-term effect and complication of biological amnion combined with Ahmed glaucoma valve implanta-tion on neovascular glaucoma. METHODS: This was a retrospective observational case series. Patients with neovascular glaucoma underwent either of the two procedures from Jan. 2008 Sept. 2009. Twenty-five cases 25 eyes underwent biological amnion combined with Ahmed glaucoma valve implan-tation,while twenty-three cases 23 eyes underwent Ahmed glaucoma valve implantation. RESULTS: The success rate of biological amnion combined with Ahmed glaucoma valve implantation was 96% at the time of discharge from hospital and 88% 3 months later, 83% 12 months later; while the rate of Ahmed glaucoma valve implantation were 91% at the time of discharge from hospital and 59% 3 months later, 55% 12 months later. The long-term effects of the two groups had statistical difference (P<0.05). CONCLUSION: It is considered the biological amnion combined with Ahmed glaucoma valve implantation surgery may be effective and safe for treating neovascular glaucoma .

Abstract:AIM: To analyze the early diagnosis of 70 cases of fungal keratitis and evaluate the application value of confocal laser corneal microscopy. METHODS: Confocal laser corneal microscopy, corneal tissue smears and fungal cultivation were performed on 70 patients of suspected fungal keratitis.The results were compared . RESULTS: Seventy patients were clinically diagnosed of fungal keratitis based on history, clinical signs. The positive rate of confocal laser corneal microscopy was 94% (66/70).The positive rate of corneal tissue smears was 31% (22/70).The positive rate of fungus cultivation was 20% (14/70). The positive rate of fungal keratitis detected by confocal laser corneal microscopy was higher than by corneal tissue smears (χ2=29.615,P<0.01) and fungal cultivation (χ2=39.433,P<0.01). CONCLUSION: Confocal laser corneal microscopy can be a non-invasive, rapid and effective imaging technique, and it is helpful in the early diagnosis ,treatment and study of fungal keratitis.

Abstract:AIM: To investigate the factors correlated with central corneal thickness(CCT) in patients with myopia. METHODS: A total of 2 027 patients 4 002 eyes of myopia were examined. CCT was measured by ultrasound corneal pachymeter. Refraction was measured by automatic refractor. Intraocular pressure (IOP) was mea-sured by non-contact tonometer. Corneal endothelia was measured by corneal topography. History of wearing soft contact lens and other factors were also analyzed. RESULTS: A negative correlation was found between CCT and history of wearing soft contact lens (t=- 4.475, P=0.000).The correlation between IOP and CCT was significant (r=2.856, P=0.000), and. CCT was nega-tively correlated with refraction (r=- 0.662, P=0.000). No signifi-cant correlation was found between CCT and corneal endothelia. CONCLUSION: The CCT in patients of myopia was correlated with history of wearing soft contact lens,refraction and IOP.

Abstract:AIM:To define the microscopic cornea changes with in vivo laser scanning confocal microscopy after phacoemul-sification. METHODS: Thirty eyes were assigned to undergo cataract extraction by ultrasonic phacoemulsification in China Medical University. The morphologies of corneal layer by layer were evaluated in vivo with the Heidelberg Retina Tomograph III-Rostock Cornea Module (HRT-III RCM) confocal microscope pre- and post-operation for up to six months. RESULTS: For morphology, some irregular segments of nerve fiber were most pronounced seven days post-operation. Stroma keratocytes were obvious compared with the pre-operative condition. Corneal endothelial cells become obviously swollen in both the cytoplasm and nucleus. At six months, corneal cell and nerve morphology recovered to normal. CONCLUSION: Microstructural abnormalities were identified at each level of the cornea recovery process after phacoemulsification and lead to corneal morphology changes, but these could be recovered to normal in six months.

Abstract:AIM: To compare the surgical effect between transs-cleral cyclophotocoagulation and cyclocryotherapy for neovascular glaucoma. METHODS: In 2006 from January to December, 38 cases(43 eyes) diagnosed with neovascular glaucoma were treated. 18 cases(18 eyes) were treated with cyclo-cryotherapy and 20 cases(25 eyes) were treated with transscleral cyclophotocoagulation. The post-surgery clinical procedure was no diffrence between two groups. The intraocular pressure(IOP), eyesight, the clinical procedure, and the complications after surgery were observed. RESULTS: During follow-up of 3 months, the IOP of 11 eyes(61%) was controlled from 11 mmHg to 24 mmHg in the cases treated with cyclocryotherapy, and 20 eyes (80%) in the cases treated with cyclophotocoagulation respectively. In each group, there was highly statistical difference between the IOP of pre-operation and post-operation(P=0.000). And there was no statistical diffe-rence between the post-operation IOP of two groups(P=0.669). The visual acuity of 10 eyes (56%) was pre-served in the cases treated with cyclocryotherapy, and 21 eyes(84%) in the cases treated with cyclophotocongula-tion respectively, the result was statistically different(P=0.040). Postoperative complications were found fewer in the cases treated with cyclophotocoagulation, included hypema, pain, anterior chamber haemorrhage, and aqueous flare. CONCLUSION: To controll the IOP of eyes with neovascular glaucoma, transscleral cyclophotocoagula-tion and cyclocryotherapy are both effective and safe. Furthermore, cyclophotocoagulation has fewer postopera-tive complications and pain,it also has higher visual acuity preservation.

Abstract:AIM: To study correlation between the thickness of retinal nerve fibre layer(RNFL)detected by OCT3 and visual field defect in Uygur patients with glaucoma. METHODS: Uygur patients with glaucoma 47 cases(79 eyes), Han nationality patients with glaucoma 21 cases (38 eyes), and Uygur normal people 15 cases (30 eyes) were included. The differences of OCT3 and visual field between Uygur patients and Uygur normal and between Uygur patients and Han nationality patients were compar-ed. The correlation between RNFL thickness and visual field defect was analyzed through Uygur patients. RESULTS: OCT 1 ∶00, 6 ∶00, 7 ∶00, 11 ∶00, 12 ∶00 the mean defect and pattern standard deviation in the superotemporal quadrant and visual field showed signifi-cant difference between Uygur patients and Uygur normal. Of OCT parameters, there was no significant difference between Uygur patients and Han nationality patients. The correlation in Uygur patients between OCT and visual field defect was stronger along with stage of glaucoma. CONCLUSION: OCT had better diagnostic value in glaucoma,RNFL and visual field defect is correlated.OCT can verify visual field. Such OCT offers measure target for glaucoma.

Abstract:AIM: To assess photoreceptor morphology in patients with retinitis pigmentosa(RP) using frequency domain optical coherence tomography (FD-OCT)and its correlation with visual acuity (VA). METHODS: Thirty eyes of 15 patients with RP were imaged with FD-OCT . Patients were selected based on history, examination, fluorescein angiography, and electroretino-graphy. Concurrently, 40 eyes of 20 normal subjects were imaged with FD-OCT. Total retinal thickness (RT),inner retinal layer (IRL) and outer retinal layer (ORL) were defined and measured on FD-OCT images in all subjects and were compared between the two groups using independent-sample t test. The RT and ORL thickness measurements in RP patients were correlated with visual acuity using Pearson correlation and linear regression. RESULTS:FD-OCT demonstrated macular photoreceptor thinning in all RP patients. The difference in IRL between RP patients and normal subjects was not statistically significant (P=0.058), but the difference in RT and ORL between the two groups was significant (P<0.01). Visual acuity showed a fair correlation with RT and an excellent correlation with ORL . CONCLUSION :In the current study using FD-OCT, a new thickness measurement termed ORL is demonstrated to quantify photoreceptor loss. ORL was statistically thinner in patients with RP than in normal eyes and showed correlation with logMAR visual acuity. ORL appears to be a probable predictor of visual acuity in RP.

Abstract:AIM:To discuss the therapeutic effect, surgical indication of scleral buckling for rhegmatogenous retinal detachment (RRD). METHODS:The major surgery were as followed : retinal breaks locating, cryotherapy, scleral buckling or encir-cling scleral buckling. Ninety-four patients(ninety-six eyes) with RRD accepted surgery, including ninety-one eyes in segmental scleral buckling and five eyes in encircling scleral buckling. Among these cases sixtyseven eyes underwent subretinal fluid drainage and nineteen eyes with combined intravitreal gas filing. RESULTS:The rate of retinal reattachment after one surgical procedure was 94% and after two procedures was 98%. And there were no serious complications in operation and post-operation. CONCLUSION:Scleral buckling appears to be safe and effective in patients with RRD.

Abstract:AIM: To find a safe, simple resection and cost-effective method for the surgical treatment of conjunctivochalasis through a prospective study with randomized comparison observation on the efficacy of treatment device for conjunctivochalasis oriented and quantitative resection. METHODS: Thirty conjunctivochalasis patients 30 eyes with standard diagnosis criteria in department of Ophthalmology of the Affiliated Putuo Hospital of Shanghai University of Traditional Chinese Medicine from Jan. 2008 to May. 2009 were recruited. Patients were randomly grouped according to the odd or even of the last number of the coding. 15 patients(15 eyes) in odd group received oriented resection and 15 patients(15 eyes) in even group received crescented resection.The improve-ment degrees of symptom release were observed 2,4 and 6 weeks after operation and tears river, BUT and Tasting of chloram-phenicol test essay were tested. RESULTS: The efficacy of symptom release in week 4 was 87% in patient group receiving oriented and quantitative resection with conjunctivochalasis treatment device. The cure rate of conjunctivochalasis in patient group receiving oriented and quantitative resection with conjunctivochalasis treatment device was 87% while 73% in patient group receiving crescented resection. There’s no significant difference(χ2=0.833, P=0.361). In patient group receiving oriented and quantitative resection with conjunctivochalasis treatment device, 87% patients were with recovery of tears river in week 4, 73% patients with BUT≥10 seconds, 53% patient with Tasting of chloram-phenicol test essay positive. In patient group receiving crescented resection, 73% patients were with recovery of tears river in week 4 (χ2 =0.833, P=0.361), 67% patients with BUT≥10 seconds (χ2=0.159, P=0.690), 60% patient with Tasting of chloramphenicol test essay positive (χ2=0.136, P=0.713). There’s no significant difference. CONCLUSION: Both operation by conjunctivochalasis treatment device for oriented and quantitative resection and conjunctivochalasis crescented resection are effective while operation by conjunctivochalasis treatment device for oriented and quantitative resection is more simple and accurate, it’s more suitable for physician with less operation experience.

Abstract:AIM: To evaluate the performance of Diaton tonometer(DT) before and after laser in situ keratomileusis(LASIK) by comparing it with non-contact tonometer (NCT). METHODS:NCT and DT were used to measure the intraocular pressure before and 1 month after LASIK, the results were analyzed with SPSS 13.0. RESULTS: One month postoperatively, NCT readings declined by 5.76±2.31mmHg, DT readings did not differ significantly(t=0.70,P=0.487); the difference between NCT and DT readings had positive correlation with declined corneal thickness, and had negative correlation with the central corneal thickness postoperatively. CONCLUSION: DT readings were not affected by corneal thickness; therefore, Diaton tonometer may be a better choice for the measurement of intraocular pressure after LASIK.

Abstract:AIM: To evaluate the predictability, stability, efficacy of laser in situ keratomileusis (LASIK) using varied size spot laser for the treatment of myopia and compound myopic astigmatism. And analyse risk factors in residual refrac-tion after LASIK. METHODS: A total of 768 samples (eyes) were enrolled in this retrospective study in our surgery center from Oct. 2008 to Oct. 2009. The inclusion criteria were spherical equivalent (SE) no more than -10.00D, follow-up periods more than one month and BCVA no less than 0.8. The samples were divided by surgery mode and power of SE. The uncorrected visual acuity (UCVA), residual refraction of one month, three months, six months, one a after surgery and the preoperative and postoperative data of regression samples were used for statistics. RESULTS: Ten samples lost the BCVA; 98.0% samples were within 0.50D of emmetropia and 99.2% of the samples were within 1.00D of conventional LASIK(conven-tional group), 97.4% and 99.3% of wavefront-guided LASIK(wavefront-guided group) respectively; the residual refraction was - 0.01±0.10D at one month, - 0.02±0.20D at three months, - 0.07±0.31D at six months, - 0.15±0.38D at one year postoperatively in conventional group and the residual refraction was -0.01±0.08D at one month, - 0.01±0.09D at three months, - 0.03±0.15D at six months, - 0.08±0.19D at one year postoperatively in conventional group. The change in visual acuity (posto-perative UCVA preoperative BCVA) was 0±0.05 and 0.01±0.04 of the two groups respec-tively. Analysis of the residual refractive error of the 23 samples of residual refraction: residual spherical (RS) was related to age and preoperative spherical, residual spherical = 1.355- 0.034 age + 0.142 preoperative spherical; residual cylinder was related to preoperative cylinder and preoperative center corneal thickness, residual cylinder =3.489+0.238 preoperative cylinder -0.007 preoperative center corneal thickness. CONCLUSION: Varied size spot LASIK is predictable, stable, and effective for the treatment of myopia and compound myopic astigmatism, wavefront-guided LASIK was better than conventional LASIK on the aspect of predictability and efficacy, both surgery modes have a good stability; age and preoperative spherical power were risk factors for residual spherical, preoperative cylinder and preoperative center corneal thickness were risk factors for residual cylinder.

Abstract:AIM: To compare and analyze the therapeutic effects of laser in situ keratomileusis(LASIK)and optimized refra-ctive keratectomy customized ablation manager(ORK)for the treatment of high astigmatism. METHODS: LASIK was performed in 44 eyes of 30 patients with high astigmatism and 44 eyes of 31 patients with high astigmatism received ORK. Uncorrected visual acuity (UCVA),astigmatism,slit-lamp examination,intraocular pressure(IOP),corneal topography were observed in these patients in 1-month follow-up to compare the clinical effects on high astigmatism . RESULTS: One month after surgury, UCVA was 0.92±0.18 of ORK and 0.85±0.18 of LASIK,there was no significant difference of UCVA between ORK and LASIK (t=1.82,P=0.07).Remnant myopia of ORK was 0.12±0.98,and 0.16±1.24 of LASIK, there was no significant difference of remnant myopia between ORK and LASIK (t=1.87,P=0.07). Remnant astigmatism of ORK was -0.61±1.12,and -1.10±1.00 of LASIK, there was significant difference of remnant astigmatism between ORK and LASIK(t=2.12,P=0.04). CONCLUSION: For high astigmatism,ORK is more effective and more predictive than LASIK.

Abstract:AIM: To observe the therapeutic effect of posterior scleral reinforcement operation on degenerative myopia. METHODS: Comparative observation on the changes of 52 cases (83 eyes) in visual acuity and axis of the eyeball was performed after 6 to 11 years’ follow-up. RESULTS: Visual acuity of all cases was significantly improved at different degrees (P<0.01). After 6 to 11 years’ follow-up, the average increased eyeball axis was 0.08, 0.10 and 0.13mm. The increased eye diopter was lower than 0.5D each year postoperatively. CONCLUSION: Posterior scleral reinforcement surgery can elevate visual acuity, delay and control the progres-sion of myopia, as well as decrease the complication of myopia. The posterior scleral reinforcement operation currently is an effective method in treatment of degene-rative myopia.

Abstract:With the new vision that diabetic retinopathy(DR) is an inflammatory disease was proposed, many researches have proved that inflammatory cytokines expressed abnormally in DR, and have close associations with the breakdown of blood-retinal barrier(BRB) and neovascularization of DR. Now we review the research progresses of inflammatory cytokines associated with DR.

Abstract:The discovery of RNA interference(RNAi)has changed people’s traditional concepts of the gene.This technique posseses advantages and potentials that traditional therapies can not compare especially in terms of its specificity and efficiency,and it is drawing more and more attentions from ophthalmologists all over the world these year. Although there are still a lot of problems in clinical use at present,various kinds of related experimental results make us firmly believe that RNAi will surely bring a new epoch for curing diseases in ophthalmology.This article provides an overview on some of the latest advances in fundus.

Abstract:Retinoblastoma is a common pediatric eye malignant tumor, it not only seriously affects children’s eyesight, but also endangers their lives. With the rapid development of biological technology, some breakthroughs have been made in retinoblastoma biological research. It has an important clinical significance to explore the pathogenesis of retinoblastoma in order to inhibit tumor growth and metastasis and improve the survival rate of children. Now the pathogenesis of retinoblastoma research is summarized.

Abstract:Bevacizumab (Avastin) is a recombinant humanized monoclonal IgG antibody. Combined with vascular endothelial growth factor (VEGF), Avastin can inhibit neovascularization, it is used to treat carcinoma of rectum initially. Nowadays it used to treat the ocular neovascular disease. In this review, we introduced the basic and clinical study of Avastin in the treatment of corneal neovascularization.

Abstract:Idiopathic parafoveal telangiectasis (IPT) is a rare eye disease. The most characteristic manifestations are decrease of retinal transparency and retinal vascular anomalies. As it can cause blind and we know nothing about its etiological factors and treatment, so to explore its disease etiology, pathogenesis, detection methods and treatment options have become a common concern.

Abstract:Diabetes is a chronic metabolic disease which can cause serious ocular complications. Recent findings indicated that in the early stage of diabetes, before the appearance of retinal capillary pathological changes, abnormal changes in neuronal structure and function in visual pathway have occurred. So the diabetic visual malfunction not only result from retinal capillary pathological changes,but also be related with the malfunction of neurons in many parts of visual pathway. This review will give latest findings about pathological changes of neurons in diabetic visual pathway from the aspects of clinic observation, visual function examine and histomorphology researches.

Abstract:Optic neuritis(ON) is a kind of optic neuropathy which can obstruct the conduction of optic nerve and result in a series of changes in visual functions. The main treatment of the ON is the medication,especially, the application of glucocorticosteroid in a combined therapy. The present paper summarized the recent advance of medicines which had been used in ophthalmologic clinic, including glucocorticosteroid, antiviral drugs and other medicines.

Abstract:Hydroxyapatite (HA) orbital implant has widely used in evisceration .It becomes the main surgical methods. HA orbital implant have some complications, such as conjunctival dehiscence, infection, implant exposure, implant exclusion, so the choice of implant, surgical approach and postoperative treatment are essential. We summarize the surgical approach in this thesis.

Abstract:Post-traumatic angle recession is a common finding after contusional eye injuries, it has larger rate in clinical case .The literature on this subject was reviewed and analyzed in order to synthesize the causation, types, pathogenesis, the relationship with the intraocular pressure, main points of diagnosis and the treatment of post-traumatic angle recession.

Abstract:Lacrimal duct obstruction disease is a common disease in Ophthalmology, it’s incidence increases these years, it’s main symptom is epiphora, and it can cause acute or chronic dacryocystitis, and become a potential source of infection in eye, so the treatment of this disease is a hot issue in Ophthalmology. Previous treatment methods were based on traditional external approach surgeries, but in recent years, with the improvement of medical standards and patient aesthetic demand, a series of new therapies gradually replaced the traditional surgeries. This article will do a review on one of them -endoscopic surgery, from the perspective of its history, application status, advantages and disadvantages.

Abstract:Dry eyes are common ocular surface disease, among them dry eye correlated with operation is very special. After many eye surgery, quality and quantity of tear are unusual or abnormal, which can cause dynamic tear film unstable and ocular surface is damaged, resulting in operation derived eye dry. Oculists should pay more attention to understanding their causes and characteristics, and take preventive measures. Surgery had to maintain the normal structure of the tear film and reduce mechanical injury to cornea and conjunctiva.In postoperative, we should pay attention to drugs’ standardization and rationality, so that patients can get better surgical results and quality of life.

Abstract:Photodynamic therapy(PDT) is a new technology which uses the photodynamic effect in disease diagnosis and treatment. It is based on photodynamic effect, which is dynamic reaction process, in which oxygen molecules participated with the biological effects happened. At first, PDT was invented to treat various cancers,but with the development of second generation of photosensitizer, PDT has been increasingly used in the treatment of eye diseases, and the efficacy is outstanding. This paper will give an overview on the application of PDT in eye diseases.

Abstract:AIM: To investigate the effect of problem based learning(PBL) teaching mode in clinical learning. METHODS: Forty-eight students were divided into 2 groups, and PBL and PPT teaching modes were applied separately, then the enthusiasm of learning was observed. The degree of accessing to knowledge and the accuracy rate of diagnosis were surveyed. RESULTS: The learning enthusiasm of PBL group was significantly higher than the other group, and a questionnaire survey showed that PBL mode was favored by students, and in the simulation of diagnostic teaching, the accuracy rate of the group of students who received PBL was obviously higher than that of the other group. CONCLUSION: PBL teaching mode can effectively enhance the initiative and enthusiasm of students, and improve the effect of clinical learning.

Abstract:AIM: To determine the prevalence and development regular pattern of astigmatism in cataract of middle aged and senior citizens in a district of Hubei. METHODS: The data of corneal astigmatism and astigmatic axial in 4558 cases with cataract of middle aged and senior citizens with cataract in a district of Hubei were measured. RESULTS: Corneal astigmatism was 50-100 degree for 31.90% in cataract of middle aged and senior citizens. The percentage of 50-100 degree of astigmatism was maximum in every age group and gender, and the tendency was that number of person against the rule was more than that with the rule in cataract of middle aged and senior citizens. CONCLUSION: Corneal astigmatism of 50-100 degree is present in most cataract of middle aged and senior citizens,it is maximum and higher in about 31.90%, with no differences between the various age groups and gender. There is tendency that the number of person against the rule astigmatism is more than that with the rule.

Abstract:AIM: To study the optic nerve head parameters and topograph features of normal subjects in Zhuang nationality in Guangxi for establishing database. METHODS: One hundred and twenty blood-unrelated nomoral volunteers living in Longlin county of Guangxi were involved in the study.Heidelberg retina tomograph-Ⅱ(HRT-Ⅱ)was used to obtain the optic nerve head parameters. RESULTS:The parameters included optic disc area 2.26±0.47mm2,cup area 0.51±0.35mm2, CUP/disk area ratio 0.21±0.12, rim/disk area ratio 0.80±0.12, cup volume 0.12mm3,rim area 1.75±0.34mm2,rim volume 0.53±0.14mm3, height variation contour 0.45±0.10mm, cup shape measure - 0.20±0.07mm, mean cup depth 0.21±0.10mm,maximum cup depth 0.60±0.22mm,mean retinal nerve fiber layer thickness 0.30±0.07mm and cross-section area 1.57±0.43mm2. A negative correlation was found between mRNFLT,RNFLA and age. There was no significant difference between right and left eyes and between different genders in all parameters. The binocular difference value of C/DAR was 0.00- 0.16 in Zhuang nationality. CONCLUSION: HRT-Ⅱ can be used to measure optic disc parameters of normal person in Zhuang nationality.There were differences in age.

Abstract:AIM: To observe the therapeutic effects of corneal transplantation combined with FK506 for herpes simplex keratitis(HSK). METHODS: Lamellar keratoplasty and penetrating keratqdasty were applied according to the different range and depth of cornea affected by HSK in 15 cases 15 eyes diagnosed with HSK, for whom anti-virus drugs had no effect. Clinical effects and complications of corneal transplantation combined with FK506 for HSK were studied postoperatively, and cases were followed up for 6-24 months. RESULTS:Visual acuity of 14 cases improved in various degrees, ranging from 0.05 to 0.6. 12 cases were of transparent grafts, 2 cases of mild turbidity grafts;1 case of apparent rejection and failure. Secondary glaucoma was in 7% (1 case)and complicated cataract 7% (1 case). CONCLUSION: It’s effective and safe that corneal transplantation combined with FK506 for treatment of HSK.

Abstract:AIM: To evaluate the efficacy of natamyc in curing fungal corneal ulcer by a case-control study of natamyc and fluconazole. METHODS: Eighty-four cases with fungal corneal ulcer were divided into two groups with 42 cases in each group. Natamyc and fluconazole were used for each group respectively. RESULTS: Twenty-one cases were cured, 34 cases were effectively and 8 cases were ineffective, the effective rate was 81% in natamyc group.In fluconazole group, the corresponding number of cases was 11,29,13 respectively, and the effectively and ineffectively,effective rate was 69%. There was no significant difference between the two groups in effective rate (χ2=1.587,P>0.05);there was a significant difference between the two groups in cure rate (χ2=5.048,P<0.05),and also a significant difference between the two groups in average period of therapy which was 16.7±7.68 days in natamyc group and 28.6±7.3 days in fluconazole group (t=7.94, P<0.01). CONCLUSION: Natamyc is more effective than fluconazole in treatment of fungal corneal ulcer, which can be generalized in clinic.

Abstract:AIM: To explore the clinical efficacy and safety of small incision non-phacoemulsification under topical anesthesia on cataract patients over the age of 90. METHODS: Twenty-four cases (25 eyes)of hyper old cataract patients were selected and they underwent small incision non-phacoemulsification and intraocular lens implantation. RRSULTS: All patients were performed smoothly operation by physicians. 17 eyes (68%) got a visual acuity of 0.6 or more 3 months after operation, of which 12 eyes (48%) got a visual acuity of 0.8 or more. No serious complications occurred and the effects were satisfactory. CONCLUSION: The careful examinations of the body and eyes before operation, especially the conditions of corneal endothelium and nuclear hardness, were the guarantee of success of the small incision non-phacoemulsification under topical anesthesia.

Abstract:AIM:To investigate the clinical efficacy of the pars plana vitrectomy combined with phacoemulsification in the treatment of cataract and proliferative diabetic retinopathy(PDR). METHODS: A retrospective review clinical data consisted of 39 eyes of 34 patients with cataract and PDR, 39 eyes were treated with the techniques of phacoemulsification and pars plana vitrectomy, intraocular lens was inserted in 32 eyes. Triamcinolone acetonide was injected in 11 eyes. RESULTS: Of 39 eyes after follow-up of 3 months to 2 years, vision <0.1 was in 12 eyes ,0.1- 0.2 in 14 eyes, 0.2- 0.5 in 9 eyes,>0.5 in 4 eyes. Postoperatively FFA indicated that fluorescein leakage disappeared and new vascularization withered in 27 eyes, there were macular edema in 16 eyes. CONCLUSION: The pars plana vitrectomy combined with phacoemulsification is effective and safe in treatment of PDR and cataract, without serious complications.

Abstract:AIM:To explore the surgical techniques and the techniques of the small pupil cataract surgery. METHODS: Small scleral tunnel incision 42 cases(46 eyes) of small pupil cataract patients. We use viscoelastic solution after blunt separation of posterior synechia, or pupillary margin of radial cut to expand the pupil, extracapsular cataract extraction, and then plant intraocular lens(IOL). RESULTS: Following up 6 to 18 months,Visual acuity improved in all cases. Postoperative best corrected visual acuity was 0.04- 0.1 in 8 eyes(17%) , 0.2- 0.5 in 18 eyes (39%),0.6-1.0 in 20 eyes (44%) . Visual acuities less than 0.1 were attributed to posterior segment abnormalities. No serious complications were found. CONCLUSION: When we select the right indications and surgical techniques properly, cataract extraction and IOL implantation through small pupils with small incision of scleral tunnel can obtain good clinical effects.

Abstract:AIM:To observe the clinical efficacy of small incision non-phacoemulsification and intraocular lens(IOL) implantation in high degree axial myopia cataract, and analyse related factors to postoperative visual acuity. METHODS: One hundred and eighty-six eyes of 158 patients with axial length ≥26mm of high myopia underwent small incision non-phacoemulsification and IOL implantation. The postoperative visual acuity and intraoperative and postoperative complications were observed in the postoperative follow-up of 6 months. RESULTS: Three months later,uncorrected visual acuity ≥0.5 was in 145 eyes(78%), 0.1- 0.4 in 33 eyes(18%), <0.1 in 8 eyes (4%); complications included posterior capsule rupture in 11 eyes, endothelial edema in 19 eyes, retinal detachment in 3 eyes, posterior capsular opacification in 13 eyes in varying degrees. CONCLUSION: The efficacy of small incision non-phacoemulsification and IOL implantation for high axial myopia cataract, is very good. It is an ideal surgical method with high saftety.

Abstract:AIM: To investigate the feasibility and saftety of superficial anesthesia in combined trabculectomy on glaucoma. METHODS: Combined trabeculectomy on glaucoma with superficial anesthesia was conducted in 81 eyes of 58 patients. Its anesthesic effect and complications in and post operations were observed. RESULTS: The operations were successfully completed with satisfactory analgesic effect in the group of patients. There were no serious complications in the operations. CONCLUSION: Superficial anesthesia have significant anesthesic effects for combined trabeculectomy on glaucoma. It is a simple, safe, and convenient choice of anesthesia.

Abstract:AIM: To investigate the effect of retrobulbar injection of triamcinolone acetonide(TA) combined with laser photocoagulation for chronic cystoid macular edema after cataract operation. METHODS: Thirty-seven patients 37 eyes with chronic cystoid macular edema after cataract operation were included. Seventeen eyes were treated with retrobulbar injection of TA combined with laser photocoagulation and twenty eyes only received laser photocoagulation. The follow-up time was 6 months. Visual acuity, fundus fluorescein angiography(FFA) and complications were observed and compared after treatment. RESULTS: All eyes had improved visual acuity after one month. At the end of the follow-up of 6 months, among the patients with retrobulbar injection of TA combined with laser photocoagulation, visual acuity was improved by 2 lines or more in 11 eyes (65%), improved within 1line or remained the same in 4 eyes (23%), decreased in 2 eyes (12%). Edema in 14 eyes (82%) was relieved after treatment. Among patients with laser photocoagulation, visual acuity was improved by 2 lines or more in 3 eyes (15%), improved within 1line or remained the same in 11 eyes (55%), edema in 9 eyes (40%) was relieved after treatment. The difference between the two groups was statistically significant (P<0.05). CONCLUSION: Retrobulbar injection of TA combined with laser photocoagulation for chronic cystoid macular edema after cataract operation is better than the operation only using laser photocoagulation

Abstract:AIM: To evaluate the role of RetCam Ⅱ in examining the anterior chamber angle in congenital glaucoma. METHODS: Eighteen infants with suspect congenital glaucoma were examined the anterior chamber angle with RetCam Ⅱ under general anesthesia. RESULTS: Among the 18 infants, 13 cases (26 eyes) were diagnosed of primary infantile glaucoma, 3 cases (6 eyes)of Axenfeld-Rieger syndrome,1 case(2 eyes) of aniridia glaucoma, and 1 case (2 eyes) of large congenital cornea. CONCLUSION: RetCam Ⅱ provides objective images of anterior chamber angle, it is useful and effective in the diagnosis of congenital glaucoma.

Abstract:AIM: To evaluate the efficacy of photodynamic therapy (PDT) with half-dose verteporfin for treating acute central serous chorioretinopathy (CSC). METHODS: Twelve eyes of 12 patients diagnosed with acute CSC from Apr.2009 to Sep.2009 received one single session of PDT using half-dose (3mg/m2) verteporfin. All eyes were imaged by three-dimensional optical coherence tomography (3D-OCT) before and 1 week, 4,12 weeks and 3 months after PDT to observe the resolution of subretinal fluid(SRF). fundus fluorenscense angiography(FFA), indocyanine green angiography(ICG), and fundus autofluorescence(FAF) were applied to measure the visual acuity(VA) and angiographic changes before and 4, 12 weeks after PDT to evaluate the reliability and effectiveness of PDT. RESULTS: Before PDT, 12 eyes presented serous neuroepithelial detachment in 3D-OCT image, showed indbot diffusion or smokestack phenomenon in FFA,and revealed dilated and tortuous choroidal vessels with diffuse hyperpermeability in ICG pictures.After one week, 3D-OCT showed that SRF was absorbed in 6 eyes. Four weeks after PDT, 9 eyes had complete resolution of SRF; 7 eyes showed a complete absence, and 3 eyes reduction of fluorescein leakage in FFA; the calibers of originally dilated and tortuous choroidal vessels appeared normal in 9 eyes and narrower in 3 eyes as shown in ICG; abnormal autofluorescence had almost resolved in all eyes. Twelve weeks after PDT, 11 eyes had complete resolution of SRF, only one eye unchanged; all eyes showed absence of fluorescein leakage in angiographic graphs and dots of hypoautofluorescence with uniform size and fluorescent intensity in the leak site. The mean VA improved from 0.43 to 0.8, with 2 eyes unchanged. None of the patients developed any systemic adverse event associated with the operation in the follow-up period. CONCLUSION: PDT with half-dose verteporfin is effective and safe in treating acute CSC.

Abstract:AIM: To discuss the antagonistic role of traditional Chinese medicine leaf of xingding extract-the ginkgo biloba injection on endothelin(ET) in diabetic retinopathy(DR) patients. METHODS: A total of 58 DR patients were enrolled in the study, DR patients were administered with 25mL ginkgo-dipyridamolum injection which was dissolved in 250mL normal saline, once a day for 15 days. The ET in their peripheral blood was measured before and after treatment. RESULTS: The mean value of plasma ET before treatment was 78.32pg/mL (reference value: 37.91-68.37pg/mL) and the highest value was 105.68pg/mL. The mean plasma ET level after treatment was 59.57pg/mL, which averagely decreased 18.75pg/mL as compared with that before the treatment. There was a significant difference between them(P<0.05). CONCLUSION: The ginkgo biloba injection can effectively decrease the plasma ET level of DR patients, which has a therapeutic effect on DR.

Abstract:AIM: To discuss the role of the triamcinolone acetonide(TA)injection applied in the pars plana vitrectomy(PPV) surgery for proliferate diabetic retinopathy(PDR). METHODS: A prospective controlled clinical study was carried out on 107 eyes from 107 patients with PDR,with 53 patients undergoing TA-assisted PPV and 54 patients in control group undergoing conventional PPV.The retinal break,retinal detachment,vitreous hemorrhage were obeserved and recorded during operation.After treatment, the changes in best-corrected visual acuity (BCVA), intraocular pressure (IOP), macular edema were recorded. RESULTS:Total 104 patients(97.2%) were followed-up for 6-12 months,51 patients(96.2%) in TA-assisted PPV, 53 patients(98.1%) in conventional PPV. The incidence of retinal breaks was significantly lower in TA-assisted PPV than in conventional PPV(P<0.05). Retinal breaks were seen in 3 eyes(5.7%)undergoing TA-assisted PPV compared with 11 eyes (20.4%) undergoing conventional PPV.Retinal detachment,vitreous hemorrhage during operation,and the BCVA,IOP, macular edema after treatment all had no significiant difference. CONCLUSION: TA-assisted PPV offers improved visu- alization, and allows surgeons to excise the epiretinal membrane(ERM) safely and effectively,reduces the incidence of retinal breaks during the surgical management of PVR for PDR. There were no serious adverse events related to the intraoperative use of TA.

Abstract:AIM: To evaluate the curative effect of Nd∶YAG laser photocoagulation in the treatment of retinal vein occlusion(RVO). METHODS: Forty-two eyes of 42 patients diagnosed as RVO by fundus fluorescein angiography(FFA) were photocoagulated by frequency-doubled Nd∶YAG laser. Different methods were applied for different types, the visual acuity were compared and fundus changes were observed by FFA after photocoagulation. RESULTS: The visual acuity of 4 eyes (10%) improved after treatment;30 eyes (71%) remained the same;8 eyes’(19%) visual acuity decreased. It was effective in 38 eyes of the patients treated with Nd∶YAG laser photoco- agulation showed by FFA, the efficiency rate was 90%. CONCLUSION: Frequency-doubled Nd∶YAG laser photo- coagulation is effective in the treatment of RVO. It not only helps the absorption of retinal edema, hemorrhage and exudation, but also prevents the occurrence of proliferative vitreoretinopathy or neovascular glaucoma.

Abstract:AIM:To investigate the relevant factors and clinical efficacy of vitreous surgery on ocular trauma. METHODS:A retrospective review was carried out in 70 cases (72 eyes) of ocular trauma received vitrectomy. RESULTS:The retina was reattached in 27 eyes (90%) postoperatively.Visual acuity after operation improved in 58 eyes(80%),not changed in 12 eyes(17%)and decreased in 2 eyes(3%). CONCLUSION:Vitrectomy is an effective method for complicated ocular trauma.Injured degree of eyeball and retina,the procedure of operation are the important factors of the visual outcome.

Abstract:AIM : To analyse the operation time and curative effect of vitrectomy for treatment of Terson syndrome. METHODS: Five patients (6 eyes) with Terson syndrome underwent vitrectomy,accompanied with exchanging the gas for the liquid or argonion laser in some cases. RESULTS: Postoperatively, the visual acuity of 6 eyes was better than before; the vitreous cavities were all clear;retinal detachments were completely reattached. CONCLUSION: Vitrectomy is a safe and effective treatment for vitreous hemorrhage in Terson syndrome. Early surgery can not only recover the patients’ visual acuity but also decrease the complications.

Abstract:AIM: To investigate the characteristics of the imaging of extraocular muscles in congenital double elevator paralysis(CDEP) and to evaluate different surgical outcomes based on imaging and clinical findings. METHODS: Sixteen patients were included in this retrospective study, from April 2006 to July 2009. Pre-operation ophthalmologic examination and orbit CT scan were performed. The choice of surgical procedure was based on the result of clinical evaluation and CT imaging. RESULTS: It showed that 81.3%(13/16) patients showed significant changes in extraocular muscles. In 68.7%(11/16) patients coronal images, the maximum cross-sectional area of superior rectus complex in affected eye became thinner than that of contralateral eye (9.95±2.82mm2 vs 24.52±5.42mm2,P<0.01),while no significant difference was found in inferior rectus(21.20±3.82mm2 vs 23.41±4.73mm2, P>0.05). In two patients, the maximum cross-sectional area of inferior rectus in affected eye became thicker than that of contralateral eye. The vertical misalignment was completely corrected in 14 patients and partially corrected in 1 patient. Psuedoptosis totally disappeared in 8 patients and partially improved in 7 patients. CONCLUSION: Either congenital hypoplasia or paresis of superior rectus muscle in affected eye may be one of the main reasons of CDEP. Surgical procedures for CDEP must be individualized according to clinical evaluation and imaging. Extraocular muscle CT imaging may give clinically valuable information for appropriate surgical planning.

Abstract:AIM:To investigate the clinical significance of anti-inflammatory therapy for dry eye syndrome. METHODS: Eighty patients with dry eye syndrome were analyzed retrospectively and divided into the artificial tears group(group A) and combined artificial tears with pranoprofen group(group B). Break-up(BUT) and corneal staining were analyzed two weeks later. RESULTS:There were significant differences in BUT and corneal staining between the two groups after treatment. The combined treatment was better than artificial tears alone in lengthening the BUT of tear film and improving corneal staining. CONCLUSION: The combined therapy of pranoprofen and artificial tears possesses important clinical application value for the patients with dry eye syndrome accompanying irritation.

Abstract:AIM: To evaluate the efficacy of soft shell technique with Sodium Tvlose and sodium hyaluronate during cataract phacoemulsification with intraocular lens(IOL) implantation. METHODS: Eighty two eyes of 76 patients with mature cataract underwent phacoemulsification with IOL implantation, including 41 eyes using the soft shell technique with Sodium Tvlose and sodium hyaluronate(study group). RESULTS:The average naked vision was 0.50±0.22, 0 51±0.27 respectively the first day after operation, the difference between the study group and control group was not statistically significant, The average naked vision was 0.61±0.17, 0.63±0.18 respectively seven days after operation, there was no statistically significant difference between the two groups. The loss rate of corneal endothelial cells 1 month after surgery was 7.1% in the study group, 6.9% in the control group. There was no statistically significant difference between the two groups. CONCLUSION: The soft shell technique with Sodium Tvlose and sodium hyaluronate is the same safe and effective in protecting corneal endothelial cells during cataract surgery in patients with mature cataract as the import material.

Abstract:AIM: To investigate the feasibility of strabismus diorthosis under microscope using general micro equipments. METHODS: Divided the cases with strabismus into two groups: 36 cases underwent strabismus diorthosis under microscope using general micro equipments; and 45 cases underwent traditional strabismus diorthosis directly. RESULTS: The follow-up lasted for 2 weeks to 6 months. The post operation reaction in the group under microscope was light, conjunctival edema and congestion disappeared quickly, wound healed well, no complication occurred. In the other group, muscle slippage occurred in 2 cases, bulbar conjunctiva hyperemia, subconjunctival hemorrhage and edema occurred in 40 cases, conjunctival scar occurred in 10 cases, conjunctiva cyst 2 cases and conjunctival polypus 3 cases. CONCLUSION: Strabismus diorthosis under microscope has clear advantages compared with traditional strabismus diorthosis (without microscope). The muscle, blood tube and the move of needle in sclera as well as the depth can be seen clearly during the operation which make the operation easy to control, so we can properly and correctly perform the operation, shorten the operation time and avoid complications like blooding, penetrate sclera which often occur during the traditional operation. The strabismus diorthosis under microscope using general micro equipments can also separate structure correctly with fewer operation steps, light reaction after operation, sooner recovery after operation, which is suit to patient who needs strabismus diorthosis.

Abstract:AIM: To evaluate the clinical effect of transpupillary thermotherapy(TTT) in the treatment of retinal arterial macroaneurysms. METHODS: The clinical data of 24 patients 24 eyes with retinal arterial macroaneurysms treated with TTT were retrospectively analyzed. According to the size of neoplasia showed by fundus fluorescein angiography(FFA), diffenent laser spot (0.8-1.2mm) and power (22.4-36.8mJ) were selected. The visual acuity,neoplasia and tube wall instauration were observed. RESULTS: All the neoplasias were atrophied after TTT, and the wall instauration returned to normal. Central vision was increased in 17 eyes. CONCLUSION: TTT is an effective method to treat retinal arterial macroaneurysms, particularly to patients with bleeding and edema.

Abstract:AIM:To identify the causes of puncta lacrimalis inflammation, and to research its clinical development and prognosis as an independent disease. METHODS: The lacrimal puncta and ocular surface of patients with puncta lacrimalis were observed by slit-lamp, and lacrimal duct was washed and then examed. The changes of puncta in those study eyes were recorded by microphoto detector. Twenty-four eyes underwent tissue resection of lacrimal puncta and pathological examination. RESULTS: The rate of lacrimal punctum obstruction which needed surgical treatment was 11.95% in the patients with puncta lacrimalis. The clinical features of puncta lacrimalis were as following: the majority happened separately, minority combined with the inflammatory lacrimal duct obstruction. The diseases have acute and chronic divisions: Acute puncta lacrimalis is less common with the symptoms of warm tears overflow, local lacrimal puncta swelling, the fitting point wall. Chronic puncta lacrimalis is common with the symptoms of cold tears overflow, lacrimal puncta wall swelling or with proliferative membrane at the mouth of the lacrimal puncta, and then gradually the lacrimal puncta becoming close and flat surrounded by the conjunctive. The surgery of opening the lacrimal puncta was helpful in that case. CONCLUSION:Puncta lacrimalis is a common disease in the lacrimal disease, and needs to be treated as an independent disease, which is very important to make the diagnosis and treatment.

Abstract:AIM: To investigate the clinical efficacy of jolethin tablets as the adjunctive treatment for vitreous hemorrhage. METHODS: Thirty-two cases 32 eyes with vitreous hemorrhage caused by oculopathy were randomly divided into two groups with 16 cases in jolethin adjunctive treatment group received not only conventional treatment of haemostasis, promoting blood flow, and expanding blood vessel, but also received lecithin complexation iodine(jolethin) tablet which was taken orally, 1.5mg(100μg iodine included in it)every time, tid. totally for 60 days, the other 16 cases were in control group only received conventional treatment of haemostasis, promoting blood flow and expanding blood vessel. The observation course was 3 months in both two groups. Visual acuity, slit-lamp microscope examination, preset lens fundus examination and the grade of vitreous hemorrhage were performed on each patient pretreatment and 2, 4,8 and 12 weeks after the treatment. RESULTS: The degree of vitreous hemorrhage in therapy group at 4 weeks after treatment was equal to the degree of vitreous hemorrhage in control group at 8 weeks after treatment. 12 weeks after treatment, the vision distribution of therapy group was as follows: none of patients was light perception - 0.1, three patients were 0.15- 0.3 and thirteen patients were over 0.3. But in control group 12 weeks after treatment, the vision distribution was as follows: two patients were light perception - 0.1, seven patients were 0.15- 0.3 and seven patients were over 0.3. The difference between the two groups had statistical significance(P<0.05). CONCLUSION: Lecithin complexation iodine(jolethin) can improve the absorption of bleeding and effusion, assistantly cure vitreous hemorrhage, decurtate recovery time of vitreous hemorrhage, and recover the better visual function.

Abstract:AIM:To evaluate the efficacy of multilayer amniotic membrane transplantation combined with antivirus and glucocorticosteroid drug to treat necrotizing herpes simplex stromal keratitis. METHODS: Eighteen patients (18 eyes) of necrotizing herpes simplex stromal keratitis were referred to the central hospital of Enshi Autonomous Prefecture between October 2002 and October 2009. Corneal inflammation persisted and corneal ulcer progressed despite topical and systemic antiviral treatment for over 1 week. Multilayer fresh amniotic transplantation was performed, and combined with antivirus and glucocorticosteroid drug after operation. RESULTS: Corneal ulcer healed after operation. Corneal transparence was achieved in 8 cases, partial corneal leucoma or macula in 10 cases. 1 of these patients, whose ulcer progressed to hole, adherent leucoma was formed, and corneal transplant was performed in 1 year. CONCLUSION:Multilayer fresh amniotic transplantation combined with antivirus and glucocorticosteroid treatment is an efficient method to treat necrotizing stromal keratitis. The method can recover some visual acuity, or keep the integrity of cornea for corneal transplantation.

Abstract:AIM: To observe the effect of treatment of retinal vein occlusion(RVO) with hexuemingmu tablet. METHODS: Sixty-four patients were treated with hexuemingmu tablet and the effect was observed. RESULTS: The cure rate was 53%, effective rate was 41%, and the total effective rate was 94%. CONCLUSION: The therapeutic effect of hexuemingmu tablet was significant and it’s a safe and convenient drug for RVO.

Abstract:AIM: To analyze the clinical treatment and curative effect of secondary glaucoma to iridocorneal endothelial(ICE) syndrome. METHODS: Ten consecutive cases (12 eyes) from August 2005 to August 2009 were performed anti-glaucoma operation in our department, the visual acuity and intraocular pressure were observed after operation. The follow-up period ranged from 3- 40 months. RESULTS: All patients performed combined trabeculectomy. Eight eyes performed successfully. Three eyes performed Ahmed valve implantation, one eye performed ciliary body photocoagulation after trabeculectomy. CONCLUSION: Combined trabeculectomy and Ahmed valve implantation is an effective way to treat glaucoma secondary to ICE syndrome.

Abstract:AIM: To improve the success rate of operation and reduce complications by rigorous observation of illness and post-operative care. METHODS: Post-operative care of 216 cases of retinal detachment in General Hospital of chinese PLA were analyzed after vitrectomy. RESULTS:In order to cooperate with the working of medical staffs, it was essential to contact well with patients, to train them the correct body position with mental nursing which can help eliminate their tension. CONCLUSION:The decreased complications, shortened rehabilitation time and satisfactory effect can be gotten through careful observation, elaborative care and correct body position after operation.

Abstract:AIM: To evaluate the clinical effect of hydroxyapatite(HA) orbital implant. METHODS: Thirty-two cases with HA orbital implant performed in our hospital were observed. In these cases,18 cases of HA orbital implants were in stage Ⅰ, 14 cases were in stage Ⅱ. RESULTS:HA orbital implants were performed in 32 cases, failed in 3 patients. 29 patients underwent successful surgery without major complications. There was no implant extrusion or exposure in the series examination.No patient had the depression of orbit or ptosis. No patient had sympathetic ophthalmia during the follow-up. CONCLUSION:In strictly selected cases, HA orbital implant is a safe and effective method for patients with severe eyeball rupture, blind, painful or atrophic eye.

Abstract:AIM: To analyze the correlative factors of extraction eyeball by ocular trauma. METHODS: The data of cases with extraction eyeball by ocular trauma from July 2005 to July 2009 were collected,and the factors of trauma time,causation,age and occupation were analyzed. RESULTS: The shortest time from being injured to extraction eyeball was 1 hour, the longest time was 40 years,average 4.9 years. The main disease causing extraction eyeball was ocular rupture, secondary glaucoma the second and suppurative endoophthalmia the third. The primary causation causing extraction eyeball was complications from operation of cataract and glaucoma, wood or stone wound was the second. Occupational composition: agriculture and construction industry were the easiest to cause extraction eyeball, individual labour and factory worker were the second. The age of extraction eyeball was chiefly from 41 years to 60 years, followed by from 21 years to 40 years. CONCLUSION: The cases of ocular trauma should be treated in time and correctly,the especial population should receive skill training about how to protect eyes,the oculist from primary hospital should be reinforced the clinical skill training.

Abstract:AIM: To observe the clinical effect of Lotemax on intraocular pressure(IOP) after laser epithelial keratomileusis(LASEK). METHODS: Two hundred cases after LASEK surgery were divided into group A of 100 cases (200 eyes) with postoperative Tobradex eyedrops for a week, group B of 100 cases (200 eyes) with joint eyedrops of Lotemax and Tobrex for a week. Ocular symptoms, vision,diopter, corneal thickness and IOP were observed in the follow-up. RESULTS: Group A was with high IOP in 12 eyes(6.0%). Group B with of high IOP in 3 eyes(1.5%). It was significantly different P<0.05. Lotemax eyedrops significantly reduced the incidence of increased IOP. CONCLUSION: Lotemax after LASEK surgery is safe and effective.

Abstract:AIM:To investigate the efficiency of limbal conjunctival autografting technique in recurrent pterygium. METHODS: Forty-four eyes of 34 patients with recurrent pterygium were treated by limbal conjunctival autografting technique and 37 eyes of 32 patients with recurrent pterygium were treated by transplantation of conjunctival pedicle flap. Recurrence was defined as fibrovascular tissue crossing the corneoscleral limbus onto clear cornea in the area of previous pterygium excision. RESULTS: The follow-up periods ranged from 12 to 24 months. All 66 patients (81 eyes) were involved in the result analysis .In the therapeutic group, the cure rate was 98% and the recurrence rate was 2%, but in the control group the cure rate was 84% and the recurrence rate was 16%.There was a statistically significant difference in the recurrence rate between the patients who underwent limbal conjunctival autografting and those who underwent transplantation of conjunctival pedicle flap (χ2=4.62,P<0.05). In addition, no significant complications were noted. CONCLUSION: Limbal conjunctival autografting is an effective surgical technique for the treatment of recurrent pterygium. It has a low recurrence rate when compared with the transplantation of conjunctival pedicle flap technique.

Abstract:AIM: To investigate the surgery method in the treatment, prevention of recurrence of pterygium. METHODS:Mitomycin C combined with limbal stem cell transplantation was used in 399 cases 469 eyes with pterygium on the basis of excision. RESULTS: Of the 399 cases 469 eyes, 456 eyes had no recurrence, only 13 eyes had recurrence. Recurrence rate was 2.8%. CONCLUSION: Limbal stem cell transplantation combined with mitomycin C for pterygium is an effective surgical method in preventing the recurrence of pterygium and worth promoting.

Abstract:AIM:To apply a new type canaliculus breakage finding apparatus in treating the complicated lacrimal canaliculi laceration. METHODS:Fifty-five cases with complicated traumatic lacrimal canaliculi laceration were treated by new type canaliculus breakage finding apparatus. RESULTS:After the follow-up of 6-12 months,49 cases (89%) obtained the anatomic reposition with unobstructed irrigation, without self-lacrimatoin. 3 cases (7%) got light self-lacrimation and little obstructed irrigation, and 2 cases (4%) got obstructed irrigation. CONCLUSION:The therapeutic method with a new type canaliculus breakage finding apparatus is an effective treatment for complicated lacrimal canaliculi laceration.

Abstract:AIM: To analyze the efficacy of stentless dacryocy- storhinostomy in the treatment of chronic dacryocystitis. METHODS:Thirty-four patients (37 eyes) with chronic dacryocystitis underwent stentless dacryocystorhinostomy, the situation of lacrimal patency was observed after treatment. RESULTS: Thirty-three cases 36 eyes (97%) were cured with lacrimal duct patency; 1 case 1 eye (3%) was improved with poor lacrimal duct patency. CONCLUSION: The stentless dacryocystorhinostomy is featured by minor surgical trauma, short time, light suffering, good results post operation, so it is an effective method for treatment of chronic dacryocystitis.

Abstract:AIM: To discuss the effect of different surgical methods effect on convergence insufficiency intermittent exotropia. METHODS: Ninety-eight recorded patients with convergence insufficiency intermittent exotropia were categorized into two groups. Group A was with the operations based on weakening procedure of the abductor oculi, group B with strengthening procedure of adducens oculi.Curative effects were analyzed in one year’s regular follow-up examinations. RESULTS: One year after surgery, the total correction rale was 88%, 86% in group A and 90% in group B. There were no obvious differences. From the comparison on convergence, group B was better than group A (P<0.05). CONCLUSION: The good surgical effect will be got based on either weakening procedure of the abductor oculi or strengthening procedure of adducens oculi, but the convengence will be better with strengthening procedure of adducens oculi.