Abstract:·AIM:To investigate the effect of flavone on ocular blood flow in rabbit eyes and the formation of choroidal neovascularization(CNV)in rat model of age-related macular degeneration(AMD).·METHODS:In in vivo studies,colored microsphere technique was used to determine the ocular blood flow in ocular hypertensive rabbit eyes.The rat eyes were treated with 5g/L flavone eye drops 3 times a day for 1 week before and 4 weeks after laser-induced injury of Bruch’s membrane.The development of CNV was determined by fluorescein angiography(FA)performed on weeks 2 and 4.In in vitro studies,the effect of flavone on the viability of HUVECs was measured by MTT assay.·RESULTS:The ocular blood flow in rabbit eyes was significantly increased after flavone instillation.Flavone significantly inhibited the formation of laser induced CNV.In vitro results showed that flavone inhibited the proliferation of HUVECs.·CONCLUSION:Flavone could increase ocular blood flow and inhibit the formation of CNV.·

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 the control group(non-diabetes mice)(2,4,6,8,12 weeks group,n=30)and diabetes group(2,4,6,8,12 weeks group,n=30).ELISA(Enzyme-Linked Immunosorbent Assay)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 versus 0.19±0.1μg/g in serum sample,P<0.01;165.0±9.0μg/g versus 18.0±4.0μg/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 increase retinal cells apoptosis.Many factors associated with retinal VEGF expression might involve in the early diabetes stage.·

Abstract:AIM:To describe our clinical experience in treating circumscribed choroidal haemangioma(CCH)in a tertiary referral centre over a fifteen year period prior to photodynamic therapy.·METHODS:The departmental database and photographic records of a tertiary referral center were used to identify patients who were treated for CCH between 1992 and 2007.Their case records were reviewed.·RESULTS:Visual acuity improved(>2 Snellen lines)in eleven patients(69%)remained stable in one patient(6%)and deteriorated in four patients(25%).Six of the seven treated with brachytherapy and three of the four treated with transpupillary thermotherapy achieved better visual acuity after treatment.86% of patients treated within six months of onset of symptoms and 50% of patients treated after six months of onset of symptoms noted an improvement in visual acuity.Only one patient in our series had a final VA of 6/60 or worse.Mean follow-up was thirty-five months.·CONCLUSION:Visual outcome is better when treatment is performed within 6 months of symptoms.The majority of patients achieved an improvement in visual acuity without any adverse effect following treatment.·

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 localiza-tion,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 localiza-tion 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:·A male patient,39 years old,presented with symptoms of cataract,dwarf,progeria,polydactyly and genu valgum,after the extracapusular cataract extraction and intraocular lens implantation on both eyes,the visual acuity was improved and his fundus examination was normal.As the syndrome is different from any eye syndrome we have ever known,so it maybe a new one.·

Abstract:·A case of retained intralenticular iron piece with signs of mild anterior uveitis at the time of presentation is reported in a 45 year-old man.His vision improved with topical cycloplegics and corticosteroids.After six months,his vision deteriorated grossly due to cataract formation.He regained good vision following removal of foreign body,extracapsular extraction with posterior chamber intraocular lens implantation.This case highlights the conservative management of the condition till the patient develops cataract resulting in visual disability;and good visual recovery following cataract surgery with intraocular lens implantation.·

Abstract:·A 39 years old gentleman presented with red painful right eye.He had self-inflicted an injury to his right eye with a wooden stick and he saw a vision of an old man indicating him to do so.Clinically,the right eye was moderately proptosed,complete ophthalmoplegia and the periorbital skin was severely swollen.Imaging showed right orbital cellulitis with inferior ophthalmic vein thrombosis,bilateral cavernous sinus syndrome and impending cavernous sinus thrombosis.No intraorbital or intraocular foreign body was reported.Despite aggressive intraven-ous antimicrobials,the patient’s condition was not improved.Exploration done under anesthesia exposed a huge wooden stick at the inferior fornix.Patient showed a remarkable recovery after the removal of the foreign body and intensive antibiotics therapy.A diagnostic challenge may occur in psychiatry patient that a possibility of self-inflicted injury.A detail history,examination and appropriate investigations are mandatory to reveal the underlying etiology.A high index of suspicion and correlated clinical findings with imaging studies are the most helpful guide in managing intraorbital foreign body and orbital cellulitis.Prompt diagnosis and treatment could potentially prevent further serious morbidity or mortality.·

Abstract:·AIM:To determine the protection of procyanidins(PC)against UVB-induced oxidative damage of lens epithelial cells(LECs)with alkaline single cell gel electrophoresis,in order to provide an experimental foundation for cataract clinical treatment.·METHODS:LECs lines of generation 4 were divided randomly into 5 groups.As untreated group:normal cultur-ed LECs;control group:LECs + UVB;three treated groups:PC treated groups:LECs + PC + UVB;taurine(TAU)treat-ed groups:LECs + TAU + UVB;VC treated groups:LECs+VC+UVB.All groups of antioxidants were divided into 3 groups according to the final concentration from low to high(0.05,0.1,0.2mg/mL).Each treated group was treated by antioxidants 2 hours before irradiated under UVB,respectively,then conventional cultivation.The LECs of treated groups and control group were all irradiated at UVB-dose 15mJ/cm2.All of LECs in every group were collected after treatment an hour respectively and analyzed with alkaline single cell gel electrophoresis.·RESULTS:The differences of tail length,percentage of tail DNA and tail moment between PC treated groups and control group were statistically significant(P<0.01).The differences of percentage of tail DNA,tail moment in each PC treated group and untreated group were not significant(P>0.05).The results of PC treated groups were signi-ficantly smaller than those of TAU treated groups and VC treated groups,The differences of tail length,percent-age of tail DNA and tail moment in various antioxidant treated groups were statistically significant(P<0.01).·CONCULSION:Exogenetic PC has protective effect to UVB-induced LECs DNA damage.The protective effect of PC is obviously stronger than those of TAU and VC,and in a certain range of concentration,the protective effect of PC has the positive relationship of dose-effect.·

Abstract:·AIM:To investigate a possible role for the angiotensin Ⅱ(Ang Ⅱ)and vascular endothelial growth factor(VEGF)in the development of retinal neovascularization.·METHODS:It was a random control experimental study.Forty seven-day-old C57BL/6J mice were divided into two groups randomly including normal control group and hyperoxia model group.Hyperoxia model group were exposed to 75% oxygen to establish a model of oxygen-induced retinopathy.Fluorescent angiography was used to assess the vascular pattern of retina.The proliferative neovascular response was quantified by counting the nuclei of new vessels extending from the retina into the vitreous in cross-sections.Ang II and VEGF protein levels in retinas were measured by Western blot.Significant differences between groups were evaluated by independent-samples t test and Pearson correlation analysis.Statictical difference was considered significant at a P value less than 0.05.·RESULTS:Fluorescent angiography presented increasing neovascular tufts with fluorescein leakage in hyperoxia model group compared to the normal control group.The number of endothelial cells of new vessels extending from retina to vitreous were increased significantly in hyperoxia model group(43.23±2.57)as compared with normal control group(1.37±0.93)(P=0.00).The expression of Ang II protein in retinas were increased significantly in hyperoxia model group(0.365±0.004)compared with normal control group(0.035±0.003)(P=0.00).The expression of VEGF protein in retinas were increased significantly in hyperoxia model group(0.372±0.004)compared with normal control group(0.049±0.007)(P=0.00).·CONCLUSION:There is specific relation between Ang II and VEGF in angiogenesis promoting effect.Ang II participate in the occurrence and development of retinal neovascularization via the upregulation the expression of VEGF.·

Abstract:·AIM:To evaluate the expressions of nitric oxide(NO)and VEGF in vitreous humor and blood samples in patients with proliferative diabetic retinopathy(PDR)and in patients with branch retinal vein occlusion(BRVO)and to compare the levels with those of controls.·METHODS:NO concentrations were determined using the Greiss reaction in plasma and vitreous humor sam-ples.VEGF levels were assayed by ELISA.The patients in the studies were divided into four groups:16 patients with PDR,5 patients with BRVO,11 patients with rhegmato-genous retinal detachment and 10 patients with macular hole.·RESULTS:The vitreous fluid levels of NO were signifi-cantly higher in patients with PDR than those in other three groups(15.2,4.6-50.9μmol/L,all P<0.01).The con-centration of VEGF were significantly higher in patients with PDR and BRVO than other two groups(P=0.0008,1507.2,50.7-3722.0mg/L;838.8,212.7-850.6mg/L respec-tively),but highest in PDR(P=0.001).There was no significance with NO and VEGF in serum in four groups.There was no correlation with that of NO and VEGF in four groups whatever in vitreous or plasma.·CONCLUSION:The results suggest that higher levels of NO and VEGF may be related to the angiogenesis in DR.·

Abstract:·AIM:To observe the effect of antisense oligonucleotide(ASODN)hybridized epidermal growth factor receptor(EGFR)on migration of human retinal glial(RG)cells.·METHODS:Human RG cells were cultured in vitro.Modified EGFR ASODN was transfected into RG cells by lipofectin.By using an in vitro wound healing model in which a small area of a confluent monolayer of RPE cells was denuded,migration was measured by the number of cells that had entered the denuded area.·RESULTS:The cell migration was inhibited effectively by ASODN with lipofectin at 63.27%.The missense oligonucleotides showed no such effect(P<0.01).·CONCLUSION:EGFR ASODN can inhibit the migration of RG cells.·

Abstract:·AIM:To approach the effect of the MDA,SOD in the occurrence and development of retinal ultraviolet light damage.·METHODS:Totally 30 Kunming mice were randomly divided into the normal control group and experimental group.The experimental group were divided into the ultraviolet ray illumination 1,2,3,4 weeks groups respec-tively.All mice were raised in cyclic light envioronment for 7 days and then kept in darkness for 36 hours before experiment.The experimental group were exposed to 2200±138Lux illuminations of ultraviolet rays for continu-ously 8 hours every day to establish the model of retinal ultraviolet light damage.The eyes were enucleated after exposured 1,2,3,4 weeks separately the left eyes were examined the SOD activity and the MDA content change of the retinal refining.·RESULTS:There was significant difference of the SOD activity and the MDA content between the control group and the experimental group(P<0.05).·CONCLUSION:Lipin peroxidation and free radical pro-duction have a relationship with the retinal ultra-violet light damage.·

Abstract:·AIM:To observe the inhibition of krypton induced choroidal neovascularization(CNV)of brown norway(BN)rat by intravitreal triamcinolone acetonide(TA)injection after photocoagulation,and to study the mechanism of inhibition of CNV growth.·METHODS:Thirty-six healthy BN rats were divided randomly to two groups,one eye was chosen randomly as experimental eye.After establishing BN rat CNV model,8μL(320μg)TA was injected in vitreous immediately after photocoagulation in treatment group,the same volume isotonic balanced salt solution(BSS)was injected in vitreous in the contrast group.Eyes of 6 BN rats were enucleated for histological slices in 1 week,2,4 weeks.The protein expression of nuclear factor-kappa B(NF-κB),monocyte chemoattractant protein-1(MCP-1),factorⅧ-related antigen(FⅧ-RAg)was examined by immunohisto-chemical method,and the transcription of vascular endothelial growth factor mRNA(VEGFmRNA)was Examined by in situ hybridization,meanwhile semiquantitative analysis was conducted.·RESULTS:In treatment group,the positive stain optical den-sity of NF-κB,MCP-1,FⅧ-RAg,and VEGFmRNA was obvi-ously lower the contemporaneous control group(P<0.05).·CONCLUSION:TA can lower the expression of VEGF mRNA transcription and the protein expression of NF-κB,MCP-1 and FⅧ-RAg,so it can effectively inhibit the develop-ment of BN rat CNV,which indicats that TA is an effective drug to treat CNV.·

Abstract:·AIM:To investigate the effect of two selective cyclooxy-genase-2(COX-2)inhibitors(nimesulide and meloxicam)on proliferation and apoptosis of human pterygium fibroblasts(HPF)in culture and search for a new method to prevent the recurrence after pterygium surgery.·METHODS:HPF was incubated with 0-200μmol/L nime-sulide and meloxicam for 24-96 hours.The MTT method was used to assay the biologic activities of the two drugs in different time and different doses.The expression of proliferating cell nuclear antigen(PCNA)in each group was detected by immunohistochemistry method.The cell cycle distribution was measured by flow cytometic analysis.·RESULTS:Administration of 50μmol/L nimesulide or 100μmol/L meloxicam for 24 hours significantly inhibited HPF proliferation in a dose-and time-dependent manner(P<0.05).After treated with the two drugs in 100μmol/L for 48 hours,there was significant sub-G1 peak.The number of HPF in G0/G1 phase increased,but in S phase decreased(P<0.05),suggesting cells were arrested in G0/G1 phase.The nime-sulide(25-200μmol/L)and meloxicam(50-200μmol/L)inhibited the expression of PCNA in HPF in a dose-depen-dent manner(P<0.05).·CONCLUSION:Two selective COX-2 inhibitors can significantly inhibit HPF proliferation and induce its apoptosis.The higher selecti on of COX-2 has the stronger inhibition on the growth of HPF.·

Abstract:·AIM:To discuss the association of corneal hemangio-genesis,corneal inflammation with corneal lymphangio-genesis after human corneal transplantation.·METHODS:Nineteen human corneas were obtained from 19 patients undergoing a second corneal transplan-tation from 2005 to 2008.Corneal hemangiogenesis and lymphangiogenesis were examined by lymphatic vessel endothelial hyaluroman receptor(LYVE-1)and platelet endothelial cell adhesion modecule-1(PECAM-1)double immunohisto-chemistry.The state of corneal inflamma-tion was evaluat-ed by inflammation index(IF)grading.Then,the association of blood vessel counting(BVC),IF,corneal transplantation history(TH)with lymphatic vessel count-ing(LVC)was examined.·RESULTS:LVC was strongly and positively correlated with both BVC(r=0.725;P<0.01)and IF(r=0.661;P<0.01)in transplanted human corneas.However,LVC was significantly and inversely correlated with TH(r=-0.301;P<0.01).Although the development of corneal lymphangio-genesis,hemangiogenesis and inflammation was parallel in general,corneal lymphangiogenesis disappeared followed by the inflammation of corneas and corneal blood vessels.·CONCLUSION:Corneal lymphangiogenesis correlates closely with corneal hemangiogenesis and inflammation after human corneal transplantation.·

Abstract:·AIM:To evaluate the imaging features of the macular after phacoemulsification cataract surgery by spectral-domain optical coherence tomography(SD-OCT).·METHODS:A retrospective series case study.46 eyes with simple age-related cataract who had phacoemulsification from Nov.2009 to Feb.2010 in our hospital without any complications during operation were included in this study.Visual acuity,slit-lamp examination and fundus were checked.SD-OCT(Topcon 3D-OCT-1000)was used to check retinal structure at 1 month after surgery.·RESULTS:Successful cataract surgery was performed in all eyes with postoperative best-corrected visual acuity(BCVA)improved.SD-OCT showed no significant change of the macular thickness except for slight increase of the central macular thickness,which was 217.34±36.15μm compared with195.87±40.87μm of normal people at the same age.There was no statistical difference between surgical group and normal people group.However,the slight abnormal at continuity of the IS/OS layer and integrity of the RPE layer appeared in some poor visual acuity and visual function recovery patients.·CONCLUSION:The macular thickness compared with normal people has no significant change after phacoemulsification in simple age-related cataract patients without other complication before surgery.Some patients at 1 month after surgery with slight poor visual acuity and visual function is probably due to the abnormal of continuity of the IS/OS layer and integrity of the RPE layer.·

Abstract:·AIM:To investigate therapeutic effect of vitrectomy and intravitreal triamcinolone acetonide(TA)in surgical removal of idiopathic epimacular membrane.·METHODS:The data of 88 patients 101 eyes with vitrectomy and intravitreal TA with surgical removal of idiopathic epimacular membrane were reviewed and analyzed,among which 51 eyes in treatment group were injected TA and 50 eyes were not injected TA.After undergoing fluid-air-exchange,all the eyes underwent a standard three port pars plana vitrectomy and then 2.5mg TA was injected to stain,and epiretinal membrane was removed after perfusate influxed,28 eyes also were with internal limiting membrane peeling.Postoperative observa-tion was 3-24(average 17)months.The visual acuity,complications of the surgery and foveal structural changes of macula were observed in long period and analyzed its statistic meaning.·RESULTS:After observing the different degree of eyesight in treatment group for three months,the sight of 48(94.1%)eyes were improved,the vision of 2(3.9%)eyes were remained the same as before and that of 1(1.9%)eye decreased.Compared with the other group,improved eyes were 46(92.0%),unchanged eyes were 2(4.0%)and the eyesight of 2(4.0%)eyes dereased.The difference of BCVA of two groups in three months had no statistical significance(t=1.424,P>0.05),whereas the compared difference of six,twelve and twenty-four months was statistically significant(t=4.528;P<0.05).In treatment group,28 eyes with removed of combined retina with inner limiting membrane,and in compared group that was 2 eyes.All epimacular membrane were disap-peared on OCT after surgery and macular edema lessened gradually.There were obvious differences in other complications between two groups in operation and at end of observation(t=6.324;P<0.05).By the way,injecting TA in operation can show the scope of epiretinal membrane of macula more clearly.Especially the remain-ed trifled membrane and under-mature membrane can be better recognized.When necessary,it is especially helpful for doctors who are not so proficient in skills to conduct the second dissecting membrane.Early treatment was good for better acuity,and to refrain from adverse effect or other complications,which improved the success of opera-tion.The difference of eyes pressure in and after operation had no statistical significance(t=1.324,P>0.05).·CONCLUSION:Making good use of the visibility of TA in cutting operation,doctors can recognize the scope of special epiretinal membrane of macula and complement of dissecting clearly.Vitrectomy and intravitreal triam-cinolone with surgical removal of idiopathic epimacular membrane may improve operation safety,success rate,shorten operation time,decrease complications,minimize operation procedures and diminish patients’ fees.·

Abstract:·AIM:To investigate the cause of vitreous hemorrhage and constitutional characteristics.·METHODS:The clinical data of 218 eyes of 193 patients with vitreous hemorrhage were studied for the causal analysis from August 2002 to February 2007.·RESULTS:Of all the causes,proliferative diabetic retinopathy(PDR)was the principal cause(72 patients,37.3%),the second was ocular trauma(47 patients,24.4%),the third was retinal vein occlusion(RVO,36 patients,18.7%),followed by rhegmatogenous retinal detachment(10 patients,5.2%)and Eales’s disease(9 patients,4.7%).Compared to the distribution of minority,nationality and Han nation,there were no statistical differences between them(χ2=15.648,P=0.239).67 cases in youth group(<45 years old),the principal cause was ocular trauma(37 patients,55.2%),the second was PDR(12 patients,17.9%),the third was Eales’s disease(9 patients,13.4%).56 cases in middle-aged group(45-59 years old),PDR was the principal cause(28 patients,50.0%),the second was RVO(14 patients,25.0%),followed by ocular trauma(7 patients,12.5%).70 cases in old group(≥60 years old),the principal cause was PDR(32 patients,45.7%),the second was RVO(21 patients,30.0%),followed by exudative age related macular degeneration(5 patients,7.1%).There was statistically significant difference among them(χ2=115.154,P<0.01).The major causes of 124 males were ocular trauma,PDR,RVO and Eales’s disease,accounted for 34.7%,32.3%,13.7%,5.7%,respectively.The principal causes of 69 females were PDR,RVO,ocular trauma and rhegmatogen-ous retinal detachment,accounted for 46.4%,27.5%,5.8%,4.4%,respectively.There was statistically signifi-cant difference between them(χ2=36.095,P<0.01).·CONCLUSION:Ocular trauma、PDR and Eales’s disease are the main causes of the vitreous hemorrhage in youth group.PDR,RVO,ocular trauma are the main causes of the vitreous hemorrhage in middle-aged group.PDR,RVO and exudative age related macular degeneration are the main causes in old group.The major causes of males are ocular trauma,PDR,RVO and Eales’s disease.The principal causes of females are PDR,RVO,ocular trauma and rhegmatogenous retinal detachment,PDR and Eales’s disease are the major causes of bilateral vitreous hemorrh-age.The fundus neovascular cracking and bleeding and traction retinal detachment are the inherent causes.·

Abstract:·AIM:To evaluate changes of tear film and tear secretion after phacoemulsification for cataract.·METHODS:Six articles published from January 2000 to August 2009 were retrieved through the following databases:PubMed,Web of knowledge,CNKI,Chinese Bio-medicine Database along with Google web search and manual retrieval.Relative difference(RD)between preoperative and 3-month-postoperative tear film break-up time(BUT)and Schirmer Ⅰ test(S Ⅰ t)were set as the effect indexes.The data of these articles were evaluated with Meta-analysis by random model.·RESULTS:At 3-month-postoperative time,the BUT value was significantly lower than the preoperative value[weighted average value of RD is 1.34 with 95% confidence interval(CI)in(0.40,2.30),P=0.01],but the SⅠt value did not differ from preoperative value significantly[weighted aver-age value of RD is 0.80,95% CI is(-0.14,1.75),P=0.10].·CONCLUSION:At 3-month-postoperative time,the stability of tear film has not recovered yet,but the tear secretion has recovered to preoperative level in eyes underwent phacoemulsification surgery for cataract.·

Abstract:·AIM:To observe the effects of extended soft contact lens(SCL)wear on the ocular superficial epithelial and analyze the possible mechanism.·METHODS:The subjects were divided into three groups according to the wearing hours of SCL.Fluorescein vital staining(FLS),conjunctival impression cytology(CIC)were used in normal control group(35 cases 70 eyes)and experiment group(99 cases 198 eyes).The differences of FLS,goblet cell density(GCD)and grade of squamous metaplasia were analyzed.·RESULTS:There were statistical differences in FLS,GCD and grade of squamous metaplasia between the group wearing SCL for less than 12 hours,12 to 24 hours or more than 24 hours(P<0.05).However,there were no statistical differences in FLS,GCD and grade of squamous metaplasia between the group wearing SCL for 12 to 24 hours and more than 24 hours.·CONCLUSION:Extended SCL wear can cause the ocular surface injury,decrease conjunctival goblet cells and conjunctival epithelium keratinized,and the longer the wear,the obvious the change.·

Abstract:·AIM:To compare the effects of corneal wavefront aberration guided LASIK and conventional LASIK on correcting corneal higher order aberration in low to moderate myopia.·METHODS:A prospective,non-randomized,controlled study included 110 low to moderate myopia eyes of 66 consecutive patients within half a year:58 eyes of 32 patients had LASIK(A group)and 52 eyes of 34 patients had corneal wavefront aberration guided LASIK(B group).All procedures were performed Esiris ninth generation of excimer laser system and carriazo pendular microkeratome made in Germany Schwind.The Optikon keratron Scout 2000(version 4.2.0)topographer device was used to examine corneal higher order aberration related to 6mm pupil diameter before and 3 months after surgery.·RESULTS:Increase was found in corneal spherical aberration and root mean square(rms)after 3 months surgery in two groups.The average increase of corneal higher order aberration was 0.236 μm in rms,0.146 μm in coma,0.139 μm in spherical aberration and 0.054μm in trefoil in low myopia cases of A group,A group moderate myopia cases appeared 0.367μm in rms,0.284μm in spherical aberration,0.177μm in coma and 0.021μm in trefoil;B group low myopia cases appeared 0.127μm in spherical aberration,0.088μm in rms,0.051μm in trefoil and 0.042μm in coma,B group moderate myopia cases appeared 0.175μm in rms,0.162 μm in spherical aberra-tion,0.027μm in coma and 0.024μm in trefoil.It was very close in average naked vision after 3 months surgery between two groups.Ablation depth with wavefront aberration guided LASIK was larger than that with LASIK under the same conditions on correcting low to moderate myopia.·CONCLUSION:Increase change of corneal higher order aberration after LASIK is larger than the change after corneal wavefront aberration guided LASIK on correcting low to moderate myopia.·

Abstract:·AIM:To observe the clinical effect of binocular vision train-ing for patients with intermittent exotropia after surgery.·METHODS:Totally 121 patients with intermittent exotropia were divided into training group and control group randomly.After surgery,patients in training group were treated by using binocular vision training software,no training for patients in control group.Binocular vision function was examined before surgery,1 week and 12 months after surgery.·RESULTS:Twelve months after surgery,recovery rate of binocular vision of patients in training group was higher than that of patients in control group.Recession rate of eye position of patients in training group was lower than that of patients in control group.·CONCLUSION:Binocular vision training for patients with intermittent exotropia after surgery is helpful for recovery of binocular vision.Reconstruction of binocular vision is useful in keeping eye position.·

Abstract:·Central retinal vein occlusion(CRVO)is a common retinal vascular disease,macular edema is the major complication and main reason for decreased vision of CRVO.Currently,the most widely used and researched focuses in clinic are laser coagulation,intravitreal injection:triamcinolone acetonide(TA),vascular endothelial growth factor(VEGF)antibody;surgery:radial optic neurotomy,etc.·

Abstract:·Choroidal neovascularization(CNV)is the important reason for a series of fundus oculi diseases which usually lead to vision loss.The forthing and developing of the CNV are regulated and controlled mainly by vascular endothelial growth factor(VEGF)and angiopoietin-1/2.So we summarize the advance of research on the causation and the effect of the two factors.·

Abstract:·In recent years,several studies of corneal refractive surgery——laser assisted surgery in children have shown some specific advantages.However,the indications,safety,efficacy,stability and predictability of laser assist-ed refractive surgery remain considerable controversies.This article reviewed current related literatures to sum-marize and discuss some challenges on the application of pediatric refractive surgery,make clear the application perspective so as to provide certain inspirations.·

Abstract:· AIM:To analyse the influence of correcting corneal astigmatism on the accuracy of intraocular lens power prediction after cataract surgery.· METHODS:Thirty-five cases of age-related cataract 35 eyes were selected,the corneal astigmatism was reduced after phacoemulsification with superior incision and PMMA intraocular lens implantation.The keratometry was measured before operation and three months postoperatively,then the absolute forecast error of SRK Ⅱ,SRK/T,Holladay Ⅰ formula with preoperative and postoperative corneal curvature were compared.·RESULTS:The average corneal curvature was increased by 0.30±0.81D(t=-2.205,P<0.05),the corneal astigmatism was decreased by 0.70±0.71D after operation(t=5.846,P<0.01),there was correlation between them(r=-0.554,P<0.01).The absolute predict errors of SRKⅡ,SRK/T and Holladay Ⅰ formulas using preoperative curvature was respectively 0.85D,0.73D and 0.78D,there was no significant difference(χ2=4.474,P>0.05).The absolute predict error using postoperative curvature was respectively 0.72D,0.54D and 0.46D,SRKⅡ indicated statistical difference from other formulas(χ2=7.758,P<0.05).The third theoretical formula had statistical difference from using preoperative and postoperative curvature(Z=-2.208,-2.273,P<0.05).· CONCLUSION:Correcting the corneal astigmatism may cause the changes in corneal refraction,which leads to the error of the intraocular lens prediction increase,especially the accuracy of the third generation formula decrease,so it is necessary to adjust and optimize the formula accordingly.·

Abstract:·AIM:To investigate the treatment method of glucocorticoid for keratouveitis.·METHODS:Totally 27 patients 27 eyes with keratouveitis underwent small doses corticosteroids combined with anti-infective.Therapeutic effect and safety were evaluated.·RESULTS:All patients were cured,and no drug complications appeared.·CONCLUSION:Small dose of glucocorticoid is an effective,safe and practical way for keratouveitis.·

Abstract:·AIM:To analyze the drug toxicity of tobramycin dexamethasone eye drops in ocular surface and to investigate the clinical features,treatment effect of dexamethasone-induced drug-induced corneal lesions.·METHODS:The clinical findings in 14 cases 18 eyes with tobramycin dexamethasone-induced drug-induced corneal lesions after cataract surgery were retrospectively analyzed.·RESULTS:Tobramycin dexamethasone eye drops were used in 14 patients 18 eyes for more than 1 week;clinical manifestations:eye irritation:eye wear,tearing,photophobia,decreased vision.Signs:ocular ciliary hyperemia and punctate corneal erosion in 11 eyes,diffuse corneal opacity in 6 eyes,corneal stromal infiltration in 1 eye.Patients with a history of diabetes mellitus in 5 eyes,anti-glaucoma surgery in 6 eyes,2 eyes after vitrectomy,the body in good condition in 5 eyes,after drug withdrawl,eye symptoms relieved,disappeared.·CONCLUSION:Clinicians should pay attention to the toxity of tobramycin dexamethasone eye drops on cornea,and prevention and treatment,standard medication should be performed.·

Abstract:·AIM:To discuss the manual small incision cataract surgery under small pupil.·METHODS:Totally 30 patients 38 eyes with cataracts underwent the manual small incision cataract surgery and intraocular lens implantation.Different ways were performed to dilate the small pupils during the surgery and the cataract was extracted smoothly.·RESULTS:The visual acuity of 16 eyes(42%)was better than 0.5.The visual acuity of 19 eyes(50%)was between 0.5 and 0.3.The visual acuity of 3 eyes(8%)was lower than 0.3.No complication was found in all cases.·CONCLUSION:Manual small incision cataract surgery is a safe and effective way to solve cataract in small pupils.·

Abstract:·AIM:To investigate the clinical effect of small-incision extracapsular cataract extraction with posterior chamber intraocular lens implantation and trabeculectomy for glaucoma and cataract.·METHODS:Totally 17 patients with glaucoma and cataract underwent the extracapsular cataract extraction with posterior chamber intraocular lens implantation and trabeculectomy,postoperative visual acuity,intraocular pressure and complications were observed.·RESULTS:All the patients were returned to normal intraocular pressure range.Visual acuity was improved in different degrees.Early shallow anterior chamber occurred in 1 eye,and transient corneal edema occurred in 2 eyes.·CONCLUSION:The small-incision glaucoma and cataract surgery is a safe and effective way.·

Abstract:· AIM:To observe the clinical application of carbamycholine in the trabeculectomy combined with cataract phacoemulsification and intraocular lens implantation.· METHODS:Ninety-seven patients 120 eyes with chronic angle-closure glaucoma with age-related cataract from January 2007 to January 2008 were randomly divided into three groups:the observation group(group A,conjunctival sac carbamycholine dropping after phacoemulsification),the replacement group(group B,the anterior chamber carbamycholine replacement after phacoemulsification)and the retention group(group C,the anterior chamber carbamycholine detain after phacoemulsification).Intraocular pressure(IOP)vision,anterior chamber exudation,iris weeks incision and complications in each group(40 eyes,aged 60-80 years old,followed-up for 12 months)were observed.· RESULTS:Early IOP control of A,B group was significantly better than that of C group;and the difference was statistically significant(P<0.05),but later IOP control among the three groups showed no significant difference;early visual acuity of A,B group was significantly better than that of C group,the difference was statistically significant(P<0.05),but later visual acuity showed no significant difference;the moderate rate of iris incision size among the three groups showed no significant difference;the anterior chamber exudation of group A was lower than that of B,C group,the difference among the three groups was significant(P<0.05).· CONCLUSION:Carbamycholine application in glaucoma with cataract surgery can increase postoperative response,while reasonable application can significantly reduce its side effects.·

Abstract:· AIM:To study the efficacy and persistency of argon laser peripheral iridoplasty(ALPI)as a first-line treatment of acute primary angle-closure glaucoma(PACG).· METHODS:Twenty-three patients with acute PACG were recruited into the study.Each patient received topical pilocarpine(10g/L),timolol(5g/L),and immediate ALPI as primary treatment.The intraocular pressures(IOPs)2 hours,1 month,6,12,24,36 months after ALPI were documented.The angle of anterior chamber were documented at each follow-up time.Dark room,prone provocative tests were done in the follow-up.· RESULTS:The mean IOP of this group patients was reduced from 69.43±8.22mmHg before ALPI to 15.74±3.09mmHg 2 hours after ALPI.Some patients had ocular hypertension in the follow-up.The anterior chamber angle was widened on goniscope and the trabecular meshwork could be visualized widely in static state after ALPI,but the anterior chamber angle was narrowed on goniscope in some other patients in the follow-up.Dark room,prone provocative tests were positive in part of patients in the follow-up.·CONCLUSION:ALPI,without adjunctive systemic carbonic anhydrase inhibitors and hyperosmotic agents,appeared to be effective and safe in controlling the IOP in acute PACG;part of patients developed chronic angle-closure glaucoma in the 3 years follow-up.·

Abstract:·AIM:To evaluate the efficiency of transscleral cyclophotocoagulation(TSCPC)for refractory glaucoma.·METHODS:Retrospective analysis was made in 36 eyes with refractory glaucoma treated by TSCPC with lower energy power(1.5-2.1W)and more laser spots(10-32).Intraocular pressure(IOP),visual acuity,ocular symptoms and complications were observed after TSCPC.Patients were followed up for 3 months.·RESULTS:The mean preoperative IOP was 62.89±17.36mmHg which was significantly different from the final follow-up mean IOP,21.13±7.06mmHg(P<0.05).The success rate was 83%(30/36).Postoperative visual acuity remained unchanged in 6 eyes;improved in 4 eyes.The cyclocryotherapy were performed in 6 eyes whose IOP was not controlled.The pain sense disappeared or remarkably relieved.The main complications included mild uveitis and hyphemae.Atrophy of eyeball occurred in no eye.·CONCLUSION:TSCPC is a simple,safe and effective method for eyes with refractory glaucoma.·

Abstract:·AIM:To observe the changes of tear film functions in trabeculectomy by using human amniotic membrane(HAM)or mitomycin C(MMC).·METHODS:In a randomized control clinical trial,44 eyes 36 patients were divided randomly into two groups,and each group had 22 eyes.The former was underwent trabeculectomy with HAM transplanted and adjustable suture line,and the later was administrated intra-operatively with MMC and adjustable suture line.Slit-lamp microscope examination,cornea fluorescence integral(FI)staining,tear break-up time(BUT)and Schirmer Ⅰ test(SⅠt)were carried out 1 day before,1 month and 3 months after operation in the 44 eyes.·RESULTS:Compared with the data before operation,all of the cornea FI scores,SⅠt and BUT were statistically significant 1 month after operation(P<0.05),but there was no statistical significance between the two groups.3 months after operation,all of the data returned to their preoperative values in HAM group,but the tear film functions were significantly decreased in MMC group,there was statistical significance between the two groups(P<0.05).·CONCLUSION:The changes of tear film functions in the combined trabeculectomy with HAM and adjustable suture line are smaller than those in the MMC group.It is a safe and effective method for treatment of glaucoma.·

Abstract:·AIM:To compare the clinical results of laser photocoagulation and cryopexy in the scleral buckling of rhegmatogenous retinal detachment.·METHODS:The results of 42 eyes treated with laser photocoagulation and 39 eyes treated with cryopexy from February 2007 to August 2009 were analysed.·RESULTS:Retinal detachment in photocoagulation group had an anatomic success rate of 100% with one surgical procedure.Retinal detachment eyes with retinal cryopexy had a success rate of 94.9% with one operation.The postoperative visual acuity of 37 eyes(88%)in photocoagulation group was impoved.The postopertive visual acuity of 29 eyes(74%)in cryopexy group was impoved,there was no difference between them(P>0.05).·CONCLUSION:Treating the rhegmatogenous retinal detachment by laser photocoagulation in scleral buckling is as simple and effective as cryopexy.·

Abstract:·AIM:To investigate an effective treatment for primary pigmentary degeneration of retina.·METHODS:Totally 60 cases 120 eyes enrolled by standard diagnosis underwent choroids revascularization surgery associated with medicine treatment.After 24-36 months,we observed visual acuity,visual field,electroretinogram(ERG).·RESULTS:There was decrease of vision acuity in 2 eyes(1.6%),no improvement in 15 eyes(12.5%),improvement ranged from 0.02 to 0.20 in 80 eyes(66.7%),over 0.20 in 23 eyes(19.2%).The examination of peripheral fields(60°)and central visual field(30°)was performed on 56 cases 112 eyes.The sensitivity of peripheral fields could be detected in 56 eyes after the treatment(50%),whereas only in 45 eyes,and no changes in 47 eyes before the treatment.The detection rate was 83.9%.ERG was done in 59 cases 110 eyes.Wave a and wave b could not be recorded in 100 eyes before or after the treatment;wave shape could be recorded in 100 eyes after the treatment with a detection rate of 90.9%.·CONCLUSION:Choroid revascularization surgery associated with medicine treatment can control the development of primary pigmentary degeneration of retina and improve visual acuity and visual function.·

Abstract:·AIM:To study the mental and psychological problems of patients with acute idiopathic optic neuritis.·METHODS:Totally 239 cases of patients with acute idiopathic optic neuritis diagnosed and treated in Department of Ophthalmology and Department of Neurology of Xiangya Hospital of Central South University from May 2007 to October 2009 were collected.The psychological health of these patients was investigated and analyzed through symptom check list 90(SCL-90).·RESULTS:Total symptom index of the 239 cases of patients with acute idiopathic optic neuritis was 1.25±0.48,wherein,the total symptom index of the patient with acute idiopathic optic neuritis in both eyes was higher than that of the patient with acute idiopathic optic neuritis in one eye;the patients with best-corrected visual acuity below 0.3 were more than the patients with best-corrected visual acuity above 0.3.The positive items of the patients in this group were 19.In 9 subscales,the factor scores of interpersonal sensitivity,depression,anxiety and hostility were higher than normal value,wherein,the most common problems were depression and anxiety.·CONCLUSION:Patients with acute idiopathic optic neuritis have certain mental and psychological problems,wherein,the most common problems are depression and anxiety.Medical staffs should pay attention to the psychological intervention treatment of these patients.·

Abstract:· AIM:To study the effect of external route microsurgery for giant retinal tear(GRT)caused by vitreous incarceration in the inner aspect of sclerotomy sites during or after vitrectomy.· METHODS:From June 2008 to February 2010,12 cases of patients with GRT related to vitreous incarceration of sclerotomy were treated using external route microsurgery and analyzed retrospectively.The encircling,silicone buckle,transscleral cryopexy and perfluorapropane tamponade were performed under a surgical microscope.Among them,4 cases of GRT were treated intraoperatively and 8 cases were occurred and treated postoperatively.· RESULTS:The following up time ranged from 2 to 15 months(mean 6 months).The retinas were reattached in eleven eyes after one operation.The retina was redetached in one eye one month later and another microsurgery was performed.At last,retinal reattachment was achieved in all patients.The postoperative best-corrected visual acuity was lower than 0.1 in 4 eyes(33%),0.1-0.3 in 5 eyes(42%)and higher than or equal to 0.4 in 3 eyes(25%).· CONCLUSION:The GRT related to vitreous incarceration of sclerotomy is a serous surgical complication.It is a secure and effective technique that the encircling,silicone buckle,tranascleral cryopexy and perfluorapropane tamponadd are used to treat the complication under the surgical microscope.·

Abstract:·AIM:To investigate if pilocarpine can effectively prevent the acute increase of intraocular pressure(IOP)in brown eyes after Nd∶YAG laser iridectomy.·METHODS:Totally 48 cases 58 eyes with primary angle-closure glaucoma were divided into treatment and control groups,which were matched by age and sex.One drop of pilocarpine was applied into the conjunctival sac at one hour before laser iridectomy and immediately after laser iridectomy in treatment group,whereas one drop of antibiotic as placebo was applied in control group at the same time.IOP,pupil diameter were measured at 0.5,1.0,1.5,2.0,3.5 hours after laser iridectomy.·RESULTS:The maximum increase of IOP after laser iridectomy was 0.62±0.67kPa and 1.13±0.87kPa in treatment and control group respectively,there was a significant difference(P=0.03).The obvious decrease of IOP occurred at 0.5,1.0 and 1.5 hours after laser iridectomy in treatment group.No ocular and systemic side effects were found in treatment group,except pupil diameter was obviously larger in treatment group than that in control group.·CONCLUSION:20g/L pilocarpine can effectively prevent the acute increase of IOP in brown eyes after Nd∶YAG laser iridectomy.·

Abstract:·AIM:To discuss the use of auto extricated hard palate mucosa grafting plates to substitute posterior layer eyelid tissue combined with periorbital superficial muscle aponeurosis system(SMAS)flap transfer for repairing defected anterior layer eyelid skin,and the clinical curative effects for full-thickness eyelid defects caused by reconstruction of injured eyes and eyelid malignant tumor.·METHODS:For all 16 patients 16 eyes with medium to heavily full-thickness eyelid defects larger than or equal to the full length of eyelid,oral hard palate mucosa grafting plates were used to substitute tarsal plates and conjunctivas,and reconstruct posterior layer eyelids;periorbital flood-abundant SMAS flaps were transferred to cover the hard palate mucosa and substitute the defected eyelid skin and muscle layer and reconstruct anterior layer eyelids.Among them,10 cases adopted musculus orbicularis oculi single flaps,3 cases superficial temporal artery flaps,2 cases upper eyelid skin orbicular muscle double flaps,1 case on-eyebrow inversion belt flaps.During the surgery,hard palate mucosa grafting was firstly performed,then periorbital SMAS transfer flaps was designed in accordance with part and range of the eyelid anterior defects,palpebral margins was sutured upon completion,and incised after 3-6 months.·RESULTS:For all patients who were followed up for over 12-36 months,the hard palate mucosa grafting plates and their transfer flaps survived without untoward effects of contraction,dislocation,infection or necrosis.Appearance of eyelids and functional improvements were satisfactory.·CONCLUSION:Hard palate mucosa grafting plates have a similar hardness with that of tarsal plates,good supporting effect,soft mucosa surface,no after-surgery contraction,easy availability,and high survival rate.Periorbital SMAS flaps have similar thickness and color with that of eyelids,abundant flood supply,high viability,simple operation,and minor injuries.Reconstruction of full-thickness eyelid defect with hard palate mucosa grafting combined with periorbital SMAS flap transfer can repair defected skin,tarsal plates and conjunctivas with positive curative effect and highly clinical values.·

Abstract:· AIM:To evaluate the clinical effect of anterior chamber puncture and pH determination in the treatment of moderate ocular alkali burns.· METHODS:Totally 78 patients of moderate ocular alkali burns were included in this study.The patients were randomly divided into two groups.The experimental group had 39 cases,who underwent the application of anterior chamber puncture and pH value measurement combined with routine treatment.Control group had 39 cases who were treated only with conventional combined therapy.Corneal edema duration time,visual acuity,the corneal neovascularization and other complications were observed.· RESULTS:Corneal edema duration time,visual acuity,the corneal neovascularization and other complications were compared between the experimental group and control group,and the difference had statistical significance(P<0.05).· CONCLUSION:The anterior chamber puncture and the pH measurement play an active role in the treatment of moderate ocular alkali burns.·

Abstract:·AIM:To discuss the clinical effect of mitomycin C in nasal endoscopic dacryocystorhinostomy for curing chronic dacryocystitis.·METHODS:Totally 65 patients with chronic dacryocystitis were divided into treatment group and control group;the patients in treatment group received 0.4mg/mL of mitomycin C when undergoing nasal endoscopic dacryocystorhinostomy,while the patients in control group received no medicine when undergoing traditional dacryocystorhinostomy.After 12 months follow-up the patency of lacrimal passage was observed,and the area of ostomy with nasal endoscope and mycteric recovery was examined.·RESULTS:Of all 39 eyes 35 patients in treatment group,38 eyes were cured,the cure rate was 97%;of all 34 eyes 30 patients in control group,26 eyes were cured,the cure rate was 76%;a significant difference was found in cure rate between two groups(P<0.05).·CONCLUSION:The application of mitomycin C in nasal endoscopic dacryocystorhinostomy is a simple,safe and effective way to treat the chronic dacryocystitis,because it possesses the advantages of small injuries of tissue,few scar of face,small atresia of ostomy and high successful rate.·

Abstract:· AIM:To analyze and investigate the clinical effects of recessive placement of spherical headed silicone tube through lacrimal passage in treatment of nasolacrimal duct obstruction.· METHODS:Totally 101 cases 122 eyes with nasolacrimal duct obstruction were treated by recessive placement of spherical headed silicone tube through lacrimal passage and followed up for 6-24 months.The effects were observed.· RESULTS:After surgery,105 eyes(86.1%)were cured,12 eyes(9.8%)showed progress and 5 eyes(4.1%)were ineffective.The total effective rate was 95.9%.· CONCLUSION:This operation is simple,safe,time-saving,without incision,less bleeding and has high successful rate,it does not change the original anatomical structure.·

Abstract:·AIM:To evaluate the effect of conjunctival blotting cytological examination in dry eye diagnosis.·METHODS:Totally 36 patients 72 eyes with dry eye syndrome from April 2008 to September 2008 and 10 normal volunteers 20 eyes were analyzed.Conjunctival blotting cytology combined PAS staining were applied.Conjunctival epithelial cells and the number,morphology and changes of goblet cells were observed.·RESULTS:Morphologically,97% of the normal volunteer presented the Nelson grade 0,84% of mild dry eye patients presented the Nelson grade 1,79% of moderate dry eye patients presented the Nelson grade 2,98% of severe dry eye patients presented the Nelson grade 3;The number of goblet cells was calculated using five visual fields randomly under high magnification.There was significantas decrease in dry eye group(mild:101.67±15.64,moderate:40.77±5.39,severe:6.36±3.61)compared with normal group(196.10±22.53,P<0.01);There was significant decreased in severe dry eye group than in mild or moderate dry eye group and the difference was statistically significant(P<0.01).·CONCLUSION:Conjunctival blotting cytological examination is asimple,accurate and objective method,when combined with other examination methods,it has good prospects for diagnosis of dry eye.·

Abstract:·AIM:To compare the effect of continuous subcutaneous insulin injection(CSII)by using insulin pump and multiple subcutaneous insulin injection(MSII)in treatment of eye diseases in type 2 diabetes mellitus(T2DM)patients during the perioperation period.·METHODS:The study included 320 T2DM patients with eye diseases,who were divided into two groups randomly:CSII group and MSII group.The changes of some clinical indexes were compared between the two groups before and after treatment,including the plasma glucose levels,the duration to achieve the target for plasma glucose,insulin dosage,the incidence of hypoglycemia and complication,the length and expense of hospitalization.·RESULTS:The plasma glucose levels in both groups decreased evidently after the therapy(P<0.01).The plasma glucose 2 hours after meal in CSII group was lower than that in MSII group(P<0.01)with less insulin dosage(P<0.01).The duration to achieve the target for plasma glucose and the length of hospitalization in CSII group was shorter than those in MSII group(P<0.01).The incidence of hypoglycemia and complication was lower than those in MSII group(P<0.01).However,the expense of hospitalization in CSII group was higher than that in MSII group(P<0.01).·CONCLUSION:The insulin pump was safe and effective for T2DM patients with eye diseases during the peri-operation period.·

Abstract:·AIM:To research the relationship between the astigmatism of anterior corneal surface and overall astigmatism,and provide the reference for the refractive surgery design.·METHODS:Totally 358 eyes were enrolled.The astigmatic degree and axis of anterior corneal surface were obtained by the corneal surface topography examination with an topographer(TMS-4,TOMEY company,Japan);the degree and axis of the overall astigmatism were from cycloplegic refraction by an automatic refractor(RM8 000,TOPCON company,Japan).·RESULTS:The ratio of the overall astigmatism and the astigmatism of anterior corneal surface was 0.811±0.665.In 150 eyes with overall astigmatism less than 0.50D,the differences of astigmatic degree and axis between two astigmatisms were significant respectively;there was positive correlation in astigmatic degree and axis.In 122 eyes with overall astigmatism between 0.50D and 1.00D,significant difference was found in astigmatic degree but not in axis between two astigmatisms.There was no correlation in astigmatic degree and positive correlation in astigmatic axis.86 eyes with overall astigmatism more than 1.00D,significant difference was found in astigmatic axis but not in degree;There were positive correlation in astigmatic degree and axis.·CONCLUSION:The posterior corneal surface and crystalline compensate for the astigmatim of anterior corneal surface.The astigmatism of anterior corneal surface is positively correlated with the overall astigmatism.The higher the astigmatic degree,the higher the correlation.Corneal refractive surgery may be designed better according to the overall astigmatism.The incision location in refractive lens exchange and cataract surgery is determined by the astigmatism of anterior corneal surface.·

Abstract:·AIM:To observe the clinical effects and complications of orthokeratology lens for myopia,and to analyze the relevant factors.·METHODS:The medical records of orthokeratology lens wearer 302 cases 601 eyes from three eye centers were analyed and the uncorrected visual acuity,refractive status,Orbscan examination,fluorescein staining 1 week;1 month,3 months after wearing glasses were observed.The condition of all patients before treatment was regarded as control group.·RESULTS:There was significant difference 1 week;1 month,3 months after wearing glasses compared with before wearing glasses in uncorrected visual acuity(t=-95.920,-77.710,-65.362;P<0.01,<0.01,<0.01),the anterior corneal surface horizontal curvature(t=26.020,20.143,17.476;P<0.01,<0.01,<0.01)and there was significant difference 1 week,1 month,3,6 months after wearing glasses compared with before wearing glasses in the anterior corneal surface perpendicular curvature(t=22.505,20.626,21.667,25.397;P<0.01,<0.01,<0.01,<0.01);However,There were no significant difference in uncorrected visual acuity 1 week;1 month,3 months after wearing glasses compared with the corrected visual acuity before wearing glasses.(t=-1.364,0.599,0.581;P=0.174,0.550,0.562);The punctate loss of corneal epithelium and indentation of center cornea appeared in 1 week was 7.5%,1 month 6%,3 months 9.8%,of which recurrence ratio was 2.5%.·CONCLUSION:Orthokeratology has the quick,effective,safe,and reversible advantages for myopia,whereas it has certain applicability for correction of myopia.·

Abstract:·AIM:To evaluate the effects of super-thin corneal contact lens on LASEK.·METHODS:Thirty cases 57 eyes were divided into 2 groups randomly.The super-thin contact lens(NEW VISION,Korea)with 0.03mm central thinness was used in the experimental group,while the common contact lens(Bausch lomb,USA)with 0.14mm central thinness was used in the control group.The irritation,healing of corneal epithelium in 5 days postoperatively,haze and uncorrected visual acuity in 6 months postoperatively were compared.·RESULTS:Less irritation was found in the experimental group in 1 day and 5 days postoperatively,and better recovery of corneal epithelium was made in the experimental group in 5 days postoperatively.However,there was no difference in haze formation and uncorrected visual acuity in 6 months postoperatively.·CONCLUSION:Super-thin corneal contact lens can significantly reduce the early post-operative symptoms and promote healing of corneal epithelium.·

Abstract:·AIM:To observe the clinical effect of perioperative intervention treatment for dry eye in LASIK.·METHODS:Totally 568 patients 1124 eyes with myopia and astigmatism in LASIK surgery underwent preoperative screening and perioperative intervention.Dry eye symptoms were observed before and 1 week;1 month,3 months after operation.Tear secretion test,tear film break-up time and corneal fluorescein staining were performed.·RESULTS:Mild dry eye was found in 158 eyes(14.57%)1 week,136 eyes(12.10%)1 month,58 eyes(5.16%)3 months after operation.·CONCLUSION:The screening before surgery and reasonable perioperative intervention play on important role in reducing the occurrence of dry eye.·

Abstract:·AIM:To evaluate the clinical classification treatment of diffuse lamellar keratitis(DLK)after LASIK.·METHODS:Nineteen patients 21 eyes of DLK after LASIK from April 2008 to September 2009 in our hospital were collected.They were given clinical classification treatment according to corneal layer inflammatory extent.The clinical symptoms,corneal infiltration and scope of vision,refractive and intraocular pressure were observed before and after treatment 1 day,3,5,7,10 days and 1 month.·RESULTS:Most of patients presented mild symptom,including degrees Ⅰ:18 eyes,degree Ⅱ:2 eyes,degree Ⅲ:1 eye.Through the appropriate classification of glucocorticoid treatment,corneal flap lesions of inflammatory cell infiltration mostly subsided within 1 week.1 month after treatment,uncorrected visual acuity was significantly increased,reaching preoperative best-corrected visual acuity.Corneal signs,visual acuity and refractive error recovery levels among the various DLK gradings and also among the different treatments in the cases.Were not significantly differenct.There was no glucocorticoid-induced high intraocular pressure.·CONCLUSION:Clinical classification has a guiding role in glucocorticoid classification treatment of DLK.·

Abstract:·With the increase of medical disputes,traditional Chinese medical ophthalmology students should not only grasp the professional skills but also enhance communication and job skills.According to the characteristics of traditional Chinese medical ophthalmology,how to train medical students the professional skills and enhance communication were approached,which can avoid or reduce medical disputes.·

Abstract:·AM:To discuss the main points of technological management in a large number of cataract operations for prevention of blindness.·METHODS:There was a retrospective study of 732 cases 945 cataract operation eyes for prevention of blindness in Huishan region during 2007 to 2010.·RESULTS:Totally 903 eyes(95.5%)were diagnosised as the age-related cataract.At postoperative day 1,98.7% of the operative eyes reached a vision acuity of >0.05;89.5% cases reached a vision acuity of >0.3.QOL questionnaire for developing countries published by National Eye Institute,USA was used as the instrument.The quality of life and visual quality postoperatively was highly raised(P<0.05).·CONCLUSION:Phacoemulsification makes the operation for preventing blindness easy,minimally invasive with fast recovery and excellent vision acuity.·

Abstract:·AIM:To investigate the effects of amniotic membrane transplantation on persistent corneal epithelial defects.·METHODS:Amniotic membrane transplantation was performed on 15 cases caused by various reasons.All patients were followed up for 18 months and examined with slit-lamp and fluorescein staining.·RESULTS:All patients healed completely in three weeks with smooth corneal surface.The vision of 10 cases was improved.·CONCLUSION:The transplantation of amniotic membrane is an efficient method for persistent corneal epithelial defects.·

Abstract:·AIM:To choose the relatively safe anesthetic method with fewer complications,more safety,shorter time,less pain.Two different anesthetic methods were applied in phacoemulsification operation.·METHODS:Clinical data of 361 patients 398 eyes with cataract from March 2009 to March 2010 in our hospital were retrospectively analyzed.Retrobulbar anesthesia or topical anesthesia were used randomly in phacoemulsification in two groups.·RESULTS:In the retrobulbar anesthesia group,markedly effective in 184 cases and effective in 11 cases,while in topical anesthesia group,markedly effective in 190 cases and effective in 13 cases.Intraoperative complications:five cases of capsule rupture in retrobulbar anesthesia while 6 cases in topical anesthesia.Retrobulbar hemorrhage(1 eye)was found in retrobulbar anesthesia.All the corneal edema recovered to normal in 1 week.·CONCLUSION:Phacoemulsification with topical anesthesia is a safe method,which have the feature of saving time,less pain and fewer complications.·

Abstract:·AIM:To retrospectively analyze the clinical safety of large-scale low-cost cataract surgery.·METHODS:Totally 1554 patients 1772 eyes underwent sutureless extracapsular cataract extraction and intraocular lens implantation by scleral tunnel incision during the six years.All of the operation process were discussed detailly,and the data were retrospectively analyzed and summarized.·RESULTS:Visual acuity ≥0.3 on day 3 was in 1308 eyes(73.81%);≥1.0 was in 432 eyes(24.38%).There were no postoperative complications and medical dispute.·CONCLUSION:In large-scale cataract surgery,operation by "process flow" may ensure the quality and medical safety.·

Abstract:·AIM:To evaluate the results of laser photocoagulation for diabetic retinopathy after small incision nonphacoemulsification extraction combined with intraocular lens implantation and to determine the time for the laser photocoagulation.·METHODS:According to the results of fundus fluorescein angiography(FFA),totally 68 eyes of 41 cases were treated with the laser photocoagulation earlier after nonphacoemulsification extraction combined with intraocular lens implantation.·RESULTS:After one year’s follow-up,visual acuity was improved in 19 eyes(28%),remained stable in 40 eyes(59%)and decreased in 9 eyes(13%).The total effective rate was 87%.Because the macular edema was treated first,no one was found bad after photocoagulation.·CONCLUSION:Reasonable laser photocoagulation is preferable for diabetic retinopathy patients after nonphacoemulsification extraction.It can control or delay the advance of diabetic retinopathy,and steady the visual acuities in future.FFA is a very important reference for photocoagulation.·

Abstract:·AIM:To investigate the effect of phacoemulsification and intraocular lens(IOL)implantation in treatment of high myopia.·METHODS:Phacoemulsification and IOL implantation was performed in 42 cases 55 eyes wih high cateract.·RESULTS:One month after phacoemulsification,the best-corrected visual acuities were≥ 0.5 in 27 eyes(49%),0.3-0.4 in 16 eyes(29%),<0.3 in 3 eyes(5%),where these 46 eyes ocular axes were from 24.26 to 30mm;the the best postoperative corrected visual acuities were all <0.5,0.3-0.4 in 3 eyes(5%),<0.3 in 6 eyes(11%),where these 9 eyes’ ocular axes were>30mm.·CONCLUSION:Phacoemulsification and IOL implantation is a safe and effective mothed for treating high myopia and correcting refractive error.·

Abstract:·AIM:To evaluate the effect of high myopia phacoemulsification and intraocular lens implantation.·METHODS:Totally 145 patients(56 cases of transparent crystal,89 cases of cataract),average age was 55 years old;preoperative visual acuity <0.1 in 139 cases,0.1-0.3 in 6 cases;corrected visual acuity <0.1 in 21 cases,0.1-0.3 in 42 cases,0.3-0.5 in 47 cases,≥0.5 in 35 cases.After local anesthesia,phacoemulsification with posterior chamber intraocular lens implantation was performed in all cases.·RESULTS:Posterior capsule rupture of intraoperative were in 4 cases,and the complications included corneal edema in 19 cases;within 6 months after operation,retinal detachment was in 2 cases and after cataract in 3 cases;3 months after operation,visual acuity <0.1 was in 9 cases,0.1-0.3 in 49 cases,0.3-0.5 in 40 cases,≥0.5 in 47 cases;and the corrected visual acuity of 0.1-0.3 was in 28 cases,0.3-0.5 in 38 cases,≥0.5 in 79 cases.·CONCLUSION:Phacoemulsification combined with intraocular lens implantation has the faster visual recovery,great safety and effect.Before surgery patients should be explained the difficulties of near vision,particularly for patients younger than 50 years olds and long-term near work.Meanwhile,the selection of patients should avoid patients with high degree mental stress.Moreover,patients should be informed with the increased likelihood of retinal detachment after operation.·

Abstract:·AIM:To diagnose early pituitary adenoma by analyzing central visual field,peripheral visual field and head iconography in glaucoma.·METHODS:Seven cases of primary glaucoma with early pituitary adenoma,acute angle-closure glaucoma in 2 cases,chronic angle-closure glaucoma in 1 case and open angle glaucoma in 4 cases were retrospectively analyzed.Visual field of central and peripheral area,X-ray photograph of the head,computed tomography(CT)or magnetic resonance imaging(MRI)of the head were performed in all cases.·RESULTS:Beyond glaucomatous scotoma,supratemporal quadrant visual field defect was found in all cases and pituitary adenoma was revealed by the head iconography.·CONCLUSION:Visual field impairment may occur in both glaucoma and pituitary adenoma.At the early stage,the impairment locates at central area in the former while at peripheral area in the latter.The visual field on central and peripheral area should be checked in glaucoma patient to avoid the missed diagnosis or misdiagnosis of pituitary adenoma.·

Abstract:·AIM:To investigate the effect and clinical significance of psychological care for primary glaucoma.·METHODS:A randomized,parallel control study was applied.275 consecutive patients with primary glaucoma from January 2004 to December 2008 were randomly divided into experimental group,137 cases with specialist psychological care and control group,138 cases with routine treatment.After discharge,through the establishment of archives,family follow-up,hold classes and other measures,mental care was performed and the intraocular pressure(IOP),complications,visual prognosis and the quality of life were evaluated.·RESULTS:The postoperative IOP returned to normal accounted for 83.9%(115/137)in experiment group and 73.9%(102/138)in control group(χ2=4.15,P<0.05),there was significant difference in both groups.Operative complication rate(28/109,25.7%)in experimental group was significantly lower than that in control group(43/95,45.3%)(χ2=4.126,P<0.05).The quality of life in experimental group was significantly better than that in control group 3 months after surgery(χ2>3.84,P<0.05).·CONCLUSION:The psychological care can promote the recovery of normal IOP and visual function,reduce the incidence of complications in patients with primary glaucoma,especially it is beneficial to cultivate the confidence and improve the quality of life of patients,and has important clinical value.·

Abstract:·AIM:To explore ache reasons of old patients after retinal reattachment surgery and nursing care measures.·METHODS:Ache degree was measured by linear marker in 164 old patients after retinal reattachment.164 cases were divided into A and B groups.Group A including 64 cases were treated with scleral buckle whereas group B including 100 cases treated with vitrectomy surgery.In group B,62 cases were with gas tamponade and 38 cases were with silicone oil tamponade postoperatively.·RESULTS:There was significant difference between two groups(χ2=6.211,P<0.05).The ache rate and ache degree of group B were much higher than those of group A.·CONCLUSION:The incision pain is the usual cause of ache in old patients with retinal reattachment surgery.High intraocular pressure is the main reason of moderate pain.·

Abstract:· AIM:To compare the clinical effect of the implantation of the hydroxyatite(HA)artificial eye.· METHODS:Totally 24 cases 24 eyes underwent two different operation methods usingⅠstage implantation of the HA artificial eye:HA artificial eye implantation in vertebra under the double deck sclera cap and the HA artificial eye sclera cavea implantation after cutting off the cranial nerve.The complication,condition at and after operation were observed.The follow-up time was not shorter than 3 months.· RESULTS:One to three months after operation the tresis vulnus cicatrization was Ⅰstage in 24 eyes,without the exposure of the artificial eye,without the rejection and infectnon of the artificial,the eye eyehole shaping is good.Postoperation effectiveness was good in 24 cases.· CONCLUSION:Different cases are treated with two different methods;the performance is convenient;the complication is low;and postoperation effectiveness is good.·

Abstract:·AIM:To observe the effect of frontalis fascia petal suspension surgery for severe ptosis.·METHODS:Totally 52 patients 72 eyes with severe ptosis underwent the frontalis fascia petal suspension surgery.·RESULTS:After the follow-up of 1-6 yaer,mild insufficient corrections were in 2 patients 4 eyes,mild asymmetrical were in 2 patients 4 eyes;Other patients obtained the satisfactory effect,with eyelid radian and natural beautifulness.The eyelid function was restored.Some cases presented palpebral fissure dysraphism.There was no exposition keratitis occurrences.·CONCLUSION:The frontalis fascia petal suspension surgery is the most ideal method for severe ptosis.The height of upper eyelid limbus and suture position play the key effect in satisfactory operation.·

Abstract:·AIM:To investigate the clinical effect of pterygium excision with limbal stem cell autograft transplantation in the treatment of pterygium.·METHODS:Totally 52 eyes of 47 cases underwent pterygium excision with limbal stem cell autograft transplantation.The general situation of recovery of corneal epithelium and the recurrence of pterygium were observed after surgery.·RESULTS:All cases were followed up for 3 months,one eye recurred(recurrent rate was 2%)and corneal epithelium were recovered within 2-3 days.·RESULTS:Pterygium excision with limbal stem cell autograft transplantation has fairly good effect in the treatment of pterygium.·

Abstract:·AIM:To study the incidence of pterygium and pedicled conjunctival flap transfer operation for treatment of pterygium.·METHODS:Totally 180 cases 210 eyes of patients with pterygium underwent occupation analysis and pedicled conjunctival flap transfer operation.The follow-up time was 1 month-1 year.·RESULTS:The effective rate was 90.5%,and recurrent rate was 9.5%.·CONCLUSION:The occurrence of pterygium is environment-related,pedicled conjunctival flap transfer operation for treatment of pterygium has good effect,easy operation and low recurrence.·

Abstract:·AIM:To explore the long period effect of medicine joint operation treatment on idiopathic orbital inflammtory pseudotumor(IOIP).·METHODS:Eighty-eight cases 92 eyes admitted to our hospital from 1986 to 2006 were reviewed and analyzed,of which 68 cases 80 eyes were treated by medicine joint operation treatment,20 cases were treated by medicine.The follow-up ranged from one year to 14 years,with an average of 4.4 years.·RESULTS:In the 88 cases,50 cases were male,38 cases were female,right eye 51 cases,left eye 33 cases and double eyes 4 cases.The age ranged from 2.5 years to 80 years,with an average of 31.4 years old.The main clinical manifestation and physical sign included exophthalmos of 76 cases,front eye socket clearance touchable lumps of 64 cases,eyelid edema and eye socket pain of 34 cases,eye movement limitation and diplopia of 33 cases,extraocular muscles incrassation of 23 cases.The others were 27 cases of optic nerve thickening,fat pad edema,eye splice inscrassation and so on.There were 68 caeses cured by medicine,operation,and medicine joint treatment.The others were cured by pure medicine treatment.The cured cases were 43 through follow-up visit.The partly cured cases were 34.The relapse cases were 11.The effective rate was 88 percent.·CONCLUSION:The clinical manifestation of orbital inflammatory pseudotumor is solid massess.Its cure rate can be improved obviously through medicine,joint operation and comprehensive treatment.·

Abstract:·AIM:To explore the treatment technology of open eye injury in the primary hospital ophthalmology.·METHODS:According to injury site and degrees,debridement techniques were used in the 45 cases 45 eyes of open eye injuries with appropriate anesthetic and similiar suture,which create a good foundation for the second phase of the operation.·RESULTS:The postoperative visual acuity of 0.08 or above was in 41 eyes while no light perception in 4 eyes.·CONCLUSION:Treatment of open eye injury properly and control of postoperative complications timely play the key role in recovery of the injured eye and second surgery.·

Abstract:·AIM:To investigate the efficacy of probing of lacrimal passages combined with tobramycin+dexamethasone eye ointment injection for chronic dacryocystitis.·METHODS:A retrospective case series was studied.From 1990-05 to 2008-05 284 patients 308 eyes with chronic dacryocystitis in our hospital underwent probing of lacrimal passages(retention time:30 minutes-2 hours)combined with tobramycin+dexamethasone eye ointment injection(dosage:1-1.5mL).Once a week with six times one treatment phase.·RESULTS:Cases with cured were in 252 eyes(81.8%)and with improvement in 56 eyes(18.2%).·CONCLUSION:The probing of lacrimal passages combined with tobramycin+dexamethasone eye ointment injection is the simple,economical and practical way for chronic dacryocystitis in primary hospital.·

Abstract:·AIM:To analyze the curative effect of various methods to search nasal side lacrimal canaliculus and inserting epidural sebific duct.·METHODS:Under microscopy,anastomosis was carried out using an epidural duct in cases diagnosed with ruptured lacrimal canaliculus preoperatively.·RESULTS:The success ratio of operation was 100%,flushing of lacrimal passage was unobstructed.·CONCLUSION:Raise the success ratio of operation and decrease the symptoms of dacryorrhea can improve the patients’.·

Abstract:·AIM:To observe the clinical effect of dacryagogic plastic operation by KTP laser in the past ten years.·METHODS:The eyes of patients were routinely disinfected,and the lacrimal puncta were dilated.Then the dacryagogic probe with core was used to locate dacryagogatresia.The probe was removed.The transmitting light fiber of KTP laser was inserted into the position of dacryagogatresia.Laser was emitted until dacryagogatresia was open and washout of the lacrimal passages with levofloxacin was performed every other day.·RESULTS:This method was used to treat various dacryagogatresia in 766 cases,870 eyes.There was no effect in 9 cases.The cure rate was 99.0%.42 cases were treated again,and the rate was 4.8%.825 eyes were opened only once,and the rate was 94.8%.36 cases 36 eyes had no effect after the second treatment.·CONCLUSION:The dacryagogic plastic operation by KTP laser is an effective method with high curative effect for treating dacryagogatresia.·

Abstract:·AIM:To study the clinical characteristics and comorehensive treatment effect of patients with dry eye.·METHODS:According to different symptoms,68 dry eye patients were divided into mild,moderate and severe dry eye,and the corresponding comorehensive treatments were used.·RESULTS:Patients with mild to moderate dry eye obtained satisfactory results,and the severe clinical symptoms were improved.·CONCLUSION:According to the patient’s situation,different dry eye stages,different health knowledge and economic conditions,we should choose different treatment methods.·

Abstract:·AIM:To compare the clinical effect of LASEK surgery with and without epithelial flap for myopia patients and to assess the safety and effectiveness of LASEK surgery without epithelial flap.·METHODS:Fifty-seven cases 114 eyes with myopia were observed,their left eyes underwent LASEK surgery without epithelial flap(the observed group)and their right eyes underwent LASEK surgery with epithelial flap(the control group).They ere followed up for 6 months,the pain response,visual acuity were observed 1-3 days after operation and the changes of haze were assessed six months after operation·RESULTS:Both methods had good surgical results.There was no or mild pain response in the observed group after 1-3 days(54 eyes,accounting for 94.7%),and moderate pain response in 3 eyes(5.3%);However,in control group,there was no pain response in the observed group after 1-3 days(6 eyes,accounting for 10.5%),and mild(38 eyes)or moderate pain response in 13 eyes(89.5%);visual acuity was 0.8 and 0.86 at the first day and fifth day after operation in the observed group,while visual acuity was 0.69 and 0.76 in the control group.After two weeks,there was no significant difference in visual acuity in both two groups;after six months,there was no significant difference in haze in both two groups.·CONCLUSION:Compared to the conventional hand-flap LASEK,LASEK surgery without flap has milder postoperative reactions,faster visual recovery and better safety and predictability.·

Abstract:·AIM:To observe the effect of the asymmetrical surgery for concomitant strabismus·METHODS:Totally 138 patients with concomitant strabismus were analysed,incluing 88 cases concomitant exotropia and 50 cases concomitant esotropia,20 cases combined with vertical slant degree <7△,and 4 cases with mild eyeball recessiveness trembles.The average slant degree of exotropia was 30△-65△,and that of esotropia was 30△-70△.After the refraction and amblyopia treatment,the visual acuity of all patients was improved to >0.8,or the balance vision of binocular improved to 0.6,visual function was inspected with synoptophore and esotropia patients were corrected by wearing glasses for >half year.Strabismus patients with the difference of 33cm and 5m slant visual degree ≤15△ and slant visual degree within 30△-70△by triple prism underwent the asymmetrical surgery combined with the simple eye horizontal muscle withdrawal and reduction.The function training by synoptophore were performed for 10 days for patients aged from 6-14 years old 1 week after operation.·RESULTS:One month after operation:126 cases were corrected;8 cases were undercorrected;2 cases were overcorrected;2 cases were diplopia,vertical slant degree was not changed.Three months after operation:128 cases were corrected;8 cases were undercorrected;1 case was overcorrected;1 case was diplopia.Synoptophore inspection:Ⅰ,Ⅱ and Ⅲ levels visual functions were recovered after the function training,includingⅠlevel 35 cases,Ⅱlevel 58 cases and Ⅲ level 45 cases.·CONCLUSION:The asymmetrical surgery has a satisfied effect for concomitant strabismus.Function training after operation is helpful to restore visual function.·