Abstract:AIM:To investigate the effect of flavone on oxidation-induced injury in retinal pigment epithelium(RPE) cells. ·METHODS:In in vivo studies,NaIO3-induced RPE degeneration in rat eyes were treated with 5g/L flavone eye drops 3 times a day for 1 week before and 4 weeks after NaIO3 injection. At the end of 2 and 4 weeks,all rats were measured c-wave by electroretinogram(ERG). In in vitro studies,ARPE-19 cells were treated with hypoxia,H2O2,NaN3 and t-BHP to induce cell damages. MTT assay was used to measure the viable cells. ·RESULTS:The ERG c-wave results showed that flavone reversed NaIO3-induced injury at the end of 4 weeks. In vitro results showed flavone reversed the various oxidants-induced injuries in RPE cells. ·CONCLUSION:Flavone could prevent the RPE from oxidation-induced injury both in vivo and in vitro.

Abstract:AIM:To evaluate the efficacy and tolerability of one-site versus two-site phacotrabeculectomy in the treatment of patients with coexisting cataract and glaucoma. ·METHODS:A comprehensive literature meta-analysis was performed according to the Cochrane Collaboration methodology to identify controlled clinical trials comparing one-site with two-site phacotrabeculectomy. The studies meeting the predefined criteria were reviewed systematically by meta-analysis. Efficacy estimates were measured by standardised mean difference (SMD) for the percentage intraocular pressure (IOP) reduction from baseline to end point,odds ratio (OR) for the percentage having a best-corrected visual acuity (BCVA) of 0.5 or better after surgery and relative risk (RR) for complete success rates. Tolerability estimates were measured by RR for adverse events. All of outcomes were reported with 95% confidence interval (CI). Data were synthesised by Stata 10.1 for Windows. ·RESULTS:Two-site phacotrabeculectomy was associated with numerically greater,and significant efficacy than one-site in lowering IOP(SMD,-0.19;95% CI,-0.33 to-0.04; P=0.01). Numerically greater,but nonsignificant proportions of two-site patients than one-site patients had a BCVA of 0.5 or better (OR,0.65; 95% CI,0.30 to 1.39; P=0.26).Numerically greater,but nonsignificant proportions of two-site patients than one-site patients achieved the target IOP without anti-glaucoma medication at the end point (RR,0.94; 95% CI,0.84 to 1.04; P=0.22). Furthermore,there was no significant difference in adverse events between two surgical procedures.·CONCLUSION:The efficacy of two-site phacotrabeculectomy appears to be superior to one-site phacotrabeculectomy. One-site and two-site phacotrabeculectomy are similarly tolerable in postoperative adverse events.

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

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

Abstract:AIM:To evaluate the effect of operation on an eye of a 54-year-old female who developed a posterior capsular hole during pars plana vitrectomy for diabetic retinopathy. ·METHODS:We performed phacoemulsification using the "inside-out hydrodelineation" technique. ·RESULTS:The procedure was successful; a posterior chamber intraocular lens(PC-IOL) was also implanted. ·CONCLUSION:Accurate diagnosis by meticulous examination after maximal mydriasis,and a detailed discussion with the patient are required to successfully care for a patient with a preexisting posterior capsule defect.

Abstract:Sarcoidosis typically affects young adults with bilateral hilar lympadenopathy,lung parenchymal disease and/or skin lesion. Childhood sarcoidosis is relatively a rare entity. Concurrent ocular and renal involvements are extremely uncommon especially in childhood sarcoidosis. We presented a case of an Asian teenager with bilateral recurrent anterior uveitis and features of renal failure due to childhood sarcoidosis. He showed remarkable clinical improvements after combination of oral corticosteroids and methotrexate. His final visual outcome was satisfactory following augmented trabeculectomy in both eyes due to intractable glaucoma. It is essential to make a prompt diagnosis and initiate proper management to avoid ocular mobidity in this unusual presentation.

Abstract:AIM:To study the effect of glutamine(Gln) on the expression of heat shock protein 70(HSP70) and NF-κB in vitro. ·METHODS:HSP70 and NF-κB expression was detected by ELISA in different times(3,12,24 hours)after the lenses of rats were cultivated in MEM cultural medium. ·RESULTS:The expression of HSP70 in the Gln group was significantly higher than that of the control group(P<0.05;On the contrary,the expression of NF-κB in the Gln group was significantly lower than that of control group(P<0.05). ·CONCLUSION:Gln can induce the expression of HSP70 in the lens epithelial cells of rat and inhibit the expression of NF-κB.

Abstract:AIM:To observe the efficiency of cultivation of retinal stem cells (RSC)in vitro by tissue cultivation method. ·METHODS:The tissue of ciliary body of postnatal 10 days rat was isolated and divided into small bits,then cultivated with non-serum DMEM/F12 medium,20μg/L bFGF,20μg/L EGF and 1×B27 supplement at the same time,the embryonic brain derived neural stem cells (NSC) were isolated and cultivated with routine method as positive control. These two kinds of cells were identified by detection of nestin with immunofluorescence method,which was known as a marker of neural stem cells. The characteristic of differentiation of RSC was identified in the induced condition of 100mL/L FBS medium. ·RESULTS:In the primary cultivation,cell spheres with high refraction were observed 48 hours after isolation and cultivation. The cell spheres enlarged and the amount increased gradually in the fourth or fifth day of cultivation. The passage of the cells occurred in the seventh day of cultivation,and the cells of the next passage can also formed the sphere shape. The marker nestin was detected both in RSC and NSC by immunofluorescence method. The RSC became adherent with the bottom of the culture dish in the induced condition with serum,and some of the cells differentiated into cells with neural cell shapes. The characteristics of the shape,proliferation and differentiation of RSC were similar with NSC. ·CONCLUSION:Tissue cultivation has the characteristics of less damage and convenience,which can be used in the isolation and cultivation of RSC successfully.

Abstract:AIM:To investigate the killing effects of tumor cells specific vector of suicide gene of CDglyTK driven by hTERT promoter on retinoblastoma Y79 cells in vitro. ·METHODS:At first,the recombinant plasmid was transfered into Y79 cells with electroblot as a delivery system. RT-PCR and Western blot analysis were used to determine the CDTK mRNA and protein expression in Y79 cells which had been transfected by pcDNA3.1-CMV-hTERT-CDTK plasmid vector. The conversion efficiency of 5-FC into 5-FU in CDglyTK-expressing Y79 cells was measured by HPLC. The killing effects of double suicide genes on Y79 cells that treated with 5-FC,GCV of different concentrations were determined by the method of MTT. ·RESULTS:The expression of CDTK gene in Y79 cells was certificated by RT-PCR and Western blot and a 59kD protein was obtaind which was equal to the sequence expection of CDTK gene. In MTT analysis,there was significant difference between transfected and non-transfected survival Y79 cells(P<0.05).The survival Y79 cells treated with 5-FC and GCV was lower than 5-FC or GCV. ·CONCLUSION:The recombinant plasmid vector pcDNA3.1-CMV-hTERT-CDTK can be transcribed and translated into CDTK fusion protein in Y79 cells.The transfer of the CDglyTK fusion gene into Y79 cells followed by the administration of 5-FC or GCV can kill Y79 cells in vitro. The killing effect of two predrugs is stronger than that of one predrug.

Abstract:AIM:To investigate the effect of celecoxib on the inhibitor of apoptosis protein Bcl-2 in retinas of early diabetic rats. ·METHODS:Forty Wistar rats were used to establish diabetic models by intraperitoneal injecting with streptozotocin,and divided into diabetes mellitus group (n=20) and celecoxib group (n=20),ten else rats were in normal control group. All of the rats were executed 3 months later. Immunohistochemistry and computer-picture analytic system were used to observe the expression of Bcl-2 protein in retinas of rats. ·RESULTS:The expression of Bcl-2 in normal group was higher than that of celecoxib group and lower than that of diabetes mellitus group(all P<0.01). ·CONCLUSION:Celecoxib can inhibit the expression of Bcl-2 in retina of diabetes mellitus.

Abstract:AIM:To understand the effect of Chitosan gelatin absorbable stent on alleviating the rabbits eyes of filtering bleb scarring. ·METHODS:Preparation of Chitosan gelatin absorbable membrane as implants were applied in rabbit eye filtration surgery under the conjunctiva ,and the control group was established. The postoperative filtering bleb condition was observed by slit-lamp. Eyes were removed to stain with HE on postoperative day 7 and 14,and the percentage of the filtering bleb area in the conjunctiva was calculated,and the effect of Chitosan gelatin absorbable membrane was analyzed according to the filtering bleb formation and fibrosis by independent-samples t test. ·RESULTS:In the postoperative day 7,the bulging diffuse bleb could be seen in both groups. In the postoperative day 14,flat bleb could be seen in the experimental group and no bleb but a large number of fibrous tissue in the control group. The percentage of the filtering bleb area in the conjunctiva were 6.16%±1.02%,5.96%±0.85% in the experimental and control group,respectively in the postoperative day 7 and there was no statistical difference.However,in the postoperative day 14,The percentage of the filtering bleb area in the conjunctiva was 1.09%±0.13% in the experimental group,but no filtering bleb in the control. The percentage was higher in the experimental group than in the control group by the independent-samples t test (t=8.52 and P=0.012). ·CONCLUSION:It is effective to prevent filtering bleb scarring with the Chitosan gelatin absorbable membrane.

Abstract:AIM:To investigate the retinoic acid receptor-β(RAR-β) expression in guinea pig eyes and study the relationship between the RAR-β expression and experimental myopia. ·METHODS:Fifty guinea pigs were randomized into the normal control group(n=10),defocusⅠgroup(n=20) and defocusⅡgroup(n=20). Guinea pigs in the defocus groups wore-10.00D lenses on the right eyes:defocusⅠgroup,wore lens for 14 days,and defocusⅡ group for 28 days. The left eyes didn’t wear lenses as self-control eyes. The refraction and axial length were measured before and after wearing lenses respectively. The protein expression of RAR-β in retina was detected by immunohistochemisty and Western blot. RT-PCR was used to observed the level of RAR-β mRNA in retina. ·RESULTS:Compared with the control eyes,the lens-worn eyes of defocusⅠand Ⅱgroups became myopic and elongated(P<0.05,respectively),and the degree of myopia was lower and axial length was shorter in groupⅠthan those of groupⅡ(P<0.05). The protein expression and the mRNA level of RAR-β in retina of the defocus groups increased significantly (P<0.05),while decreased significantly in choroid and sclera(P<0.05). ·CONCLUSION:Expression of RAR-β in guinea pig may play a role in the lens induced myopia.

Abstract:AIM:To study the distribution of Q-values on corneal anterior surface and analyze its correlation with corneal spherical aberration (C12) and total spherical aberration (C12) respectively. ·METHODS:One hundred myopia eyes were evaluated with TOPOLYSER,Humphrey and WASCA,and the eccentricities (e-value) of corneal surface (20°,25° and 30°),CTS data and total spherical aberration (diameter=6.0mm) were recorded respectively. The e-values were analyzed using formula (Q=-e2) to obtain Q-value. CTS data were analyzed using Matlab software to obtain the spherical aberration of cornea (diameter=6.0mm). ·RESULTS:The Q-values of corneal anterior surface (20°,25° and 30°) were-0.144(M),-0.213±0.110 and-0.277±0.108,respectively. The corneal and total spherical aberrations (diameter=6.0mm) were 0.25712±0.06914μm and 0.06630±0.10823μm,respectively. Q-value of 25° had high correlation (r=0.673,P=0.000) with corneal spherical aberration,but low correlation (r=0.241,P=0.016) with total spherical aberration. ·CONCLUSION:Firstly,corneal surface is much flatter from center to periphery and the absolute values of Q become much larger. Secondly,the Q-value of 25° has high correlation with corneal spherical aberration but low correlation with total spherical aberration.

Abstract:AIM:To evaluate and compare the influence of laser in situ keratomileusis(LASIK) and sub-Bowmans keratomileusis(SBK) on the elevation of posterior corneal surface in moderate to mild myopia. ·METHODS:Totally 108 patients with mild to moderate myopia were included. One eye in each patient was randomly selected to have LASIK(Group LASIK,n=108),and SBK was performed in the follow eye(Group SBK,n=108). Changes in the elevation of posterior corneal surface were measured with Pentacam system (Pentacam,OCULUS) preoperatively and 1 week,1,3,and 6 months postoperatively. ·RESULTS:After surgery,the acuity of vision in all eyes reached or exceeded that of preoperative. The posterior corneal surface in Group SBK displayed a mean elevation of 7.08±4.10μm,6.54±4.27μm,6.48±3.41μm,6.63±3.11μm and 6.59±3.23μm,in preoperative,1 week,1 month,3 months and 6 months postoperatively,respectively. In Group LASIK were 7.29±3.83μm,7.07±3.92μm,7.04±4.13μm,7.15±2.80μm,7.09±3.01μm respectively. None of the elevation of posterior corneal surface of Group LASIK or SBK was found to have a significant change after surgery. ·CONCLUSION:LASIK and SBK don’t affect the elevation of posterior corneal surface significantly.

Abstract:AIM:To evaluate the correlation among the blood sugar,acute inflammation before phacoemulsification and posterior capsule opacification (PCO) in diabetes cataract. ·METHODS:According to the different ranges of blood sugar before the phacoemulsification,46 patients with diabetes mellitus(DM) were dividing into 2 groups. 22 patients in group 1,with the blood sugar(BS) <8.5mmol/L,average (8.04±0.54)mmol/L;24 patients in group 2,with the BS >8.5mmol/L,average(12.26±0.80)mmol/L. The degree of acute inflammation,the incident rate of pupillary fibrin membrane in 1 week and the onset rate of POC 6 months after the surgery were compared. ·RESULTS:The average degree of inflammation in group 1 was (1.27±0.46),and disappeared in (5.18±0.96) days; while in group 2,the average degree of inflammation were (1.33±0.48),and disappeared in (5.21±1.29) days. There were no significant differences between the average degree of inflammation,the incident rate of pupillary fibrin membrane and PCO. ·CONCLUSION:Patients with poor sugar controlled can undertake the phacoemulsification when the blood sugar is around 13.0mmol/L without serious complications.

Abstract:AIM:To observe the effects of domestic mydriatic before and during phacoemulsification. ·METHODS:The selected 200 patients were divided equally into the experiment group (zhoubian group) and the control group(Mydrin-P groups) randomly. The pupil diameter 15,20,25 minutes after three times dropping mydriatics was recorded respectively and the time of pupil started to recession one day before operation. After dropping mydriatic one hour before operation,the pupil diameter was recorded before operation,after sodium hyaluronate injected and at the end of operation. The entire operation time and the effective phaco-time was recorded. Then the data obtained from 2 groups were compared. ·RESULTS:The max-diameter of pupils in the experiment group and the control group were (7.45±0.72) mm and (7.22±0.97) mm respectively 20 minutes after dropping the mydriatic,there was no difference between the 2 groups.But the recession time in the experiment group and the control group were (2.85±0.74) hours and (2.49±0.75) hours,the difference between two groups was significant.The maintenance effect of mydriasis during phacoemulsification also has no difference between two groups regarding to the same lens nucleus hardness. ·CONCLUSION:The domestic mydriatic zhuobian has the same effect of mydriasis preoperation and during operation,but in zhoubian group the recession time was shorter than Mydrin-P group,and the difference was significant.

Abstract:AIM:To observe and investigate the method and clinical effectiveness of using the N-Octyl-Cyanoacrylate/N-Butyl-Cyanoacryl-ate(N-OCA/N-BCA) on sticking scleral flap in trabeculectomy. ·METHODS:We chose prospective-clinical-contrast study,randomly devided those 40 patients who received glaucoma trabeculectomy into 2 groups:20 patients 25 eyes in the bonding group using cyanoacrylate to stick scleral flap,20 patients 28 eyes in the sutures group using 10-0 nylon line to suture scleral flap. We evaluated the benefits of them with respect to surgical effects,responses,complications,intraocular pressure(IOP),vision,field of vision and so on. ·RESULTS:After following up for 6-24 months,compared the bonding group(25 eyes of 20 cases) with the sutures group(28 eyes of 20 cases),the difference of the postoperative IOP was not statistically significant(P>0.05); After surgery,in bonding group,3 eyes’ (1 eye on two weeks later,2 eyes on one month later) IOP >21mmHg,through local drugs therapy,it fell down to normal level; in sutures group,2 eyes’(7 days later) IOP >21mmHg,through local drugs therapy,1 eye became normal,but another eye failed in this way and took the second surgery six months later; The eyes in two groups mainly tended to form type Ⅱ blebs according to Kronfeld classification,the functional filtration bleb was 84% and 82% in bonding group and sutures group,respectively; Complications in both groups were few; Vision and field of vision almost had no change after surgery,without statistical significance. ·CONCLUSION:The using of N-OCA/N-BCA instead of lines to stick scleral flap in trabeculectomy makes the surgery safer and easier,and can surpass sutures to some extent.It is worth spreading and studying for clinical use.

Abstract:AIM:To describe the applications,clinical features and effect of the divesting of retinal inner limiting membrane in secondary epiretinal membrane in macular. ·METHODS:Retrospective series of consecutive but noncomparative cases from 2000 to 2006 was reviewed. There were 32 patients 32 eyes underwent vitreoretinal surgery(par plana vitrectomy)for secondary macular epiretinal membrane.26 cases were male and 6 case were female;age ranged from 13 to 69 yeas old ,and the average was 41.5 years old. Course of illness was from 3 to 69 months,and the average was 21.6 months.6 cases lasted for more than one year. The records of 5 cases 5 eyes were diagnosed as intraocular foreign body associated with siderosis bulbi in macular.During the operation,divesting of retinal inner limiting membrane was performed after peeling epiretinal membrane. A part of patient were targeted with TA. Air intraocular tamponaded for about a week. The follow-up was 6-38 months. ·RESULTS:Postoperative visual acuity of suffering eyes ranged from 0.05 to 0.7. There was significant difference between the preoperative vision and the postoperative vision(fisher’s exact test,P<0.05),and there was also significant difference between the foveal thickness of preoperative and postoperative (Friedman test,P<0.05).Serious complication of tearing retinal inner limiting membrane was not discovered. ·CONCLUSION:The application of tearing retinal inner limiting membrane is used in vitreoretinal surgery more and more. It not only could relieve the traction of retinal inner limiting membrane to retina and clivus of fovea but also could get rid of the virose substance adhered firmly to the surface of macular,improve the macular’s metabolization,accelerate the furbish of the function of macular.

Abstract:AIM:To explore the changes of the concentration of serum adiponectin(APN) and high sensitivity C-reactive protein (hs-CRP) in type 2 diabetes mellitus patients with diabetic retinopathy (DR). ·METHODS:The concentration of serum APN and hs-CRP in 49 no-DR(NDR) patients were determined by ELISA and ratenephelometry and compared with those in 46 no-PDR (NPDR) patients,41 proliferative diabetic retinopathy(PDR) patients and 45 controls. Data were evaluated using analysis of SPSS version 11.0. Results were expressed as means standard deviation of the mean. Statistical comparisons were performed by One-way analysis of variance and the means compared each other using q test. ·RESULTS:The serum APN and hs-CRP in NDR patients were 8.76±3.61mg/L,3.12±1.24mg/L; in NPDR patients were 6.22±2.53mg/L,4.89±1.66mg/L; in PDR patients were 3.98±1.86mg/L,6.95±2.59mg/L and in controls were 13.55±5.87mg/L,2.01±0.85mg/L. There were significant differences in serum APN and hs-CRP between controls and NDR patients,NDR and NPDR patients NPDR and PDR patients (q=5.4401,P=0.000; q=2.4367,P=0.0017. q=3.1535,P=0.002; q=2.0572,P=0.003. q=4.8756,P=0.000; q=2.6184,P=0.001). There was significant negative correlation between serum APN and hs-CRP in DR patients(r=-0.643,P<0.01). ·CONCLUSION:There is significant negative correlation between serum APN and hs-CRP in DR patients. The serum APN concentration decreases while the serum hs-CRP concentration increases,which may contribute to the development of DR.

Abstract:AIM:To analyze the expression changes of tumor necrosis factor α (TNF-α),interleukin-6 (IL-6) and interleukin-8 (IL-8) in conjunctivochalasis tears. ·METHODS:Tears samples were obtained from 25 conjunctivochalasis cases and 13 normal controls. Fifteen microliters of tears were collected by microcapillary tubes from each eye. The tear concentrations of TNF-α,IL-6 and IL-8 were analyzed by radioimmunoassay method and compared the statistical difference between conjunctivochalasis and normal controls. ·RESULTS:The concentration of TNF-α in conjunctiv-ochalasispatients was 19.05±6.35ng/mL,in normal control group was 14.13±7.76ng/mL; conjunctivochalasis concentration of IL-6 was 13.16±8.97pg/mL,normal control group concentration of IL-6 was 4.24±3.97pg/mL; conjunctivochalasis concentration of IL-8 was 34.40±20.73pg/mL,normal control group concentration of IL-8 was 18.31±11.62pg/mL. The difference between the two groups was significant (P<0.05). ·CONCLUSION:Radioimmunoassay method could detect levels of cytokines in tears. The tear concentrations of the three cytokines from the conjunctivochalasis group were significantly higher,which may indicate conjunctivochalasis is related to the increase of cytokines and immune response.

Abstract:AIM:To investigate the variance of the irregular index of diabetics under ordinary circumstances and after sustained eye opening. ·METHODS:In 13 consecutive diabetics and 13 cases of non-diabetic controls (age and sex matched),we performed the Schirmer Ⅰ test (SⅠt),tear break-up time (BUT),fluorescein staining (FL) and symptom of dry eye questionnaires. Irregular index of corneal topography was also measured under routine circumstances and after sustained eye opening for 10 seconds,as a simulation of daily acts of gazing,which is defined as looking at an object with involuntary blink suppression. ·RESULTS:More diabetics (9/13 vs the control group 6/13) complained the presence of one or more symptoms of dry eye once a weak. When compared with the control group diabetics showed significantly decreased SⅠt (11.4±2.5 vs 14.9±3.3mm/5min,P<0.01 ) and BUT (10.9±4.7 vs 13.6±3.4s,P=0.02).None of values differed between FL of two groups (0.59±0.65 vs 0.29±0.54,P=0.06). The ordinary irregular index was higher in diabetics although the differences were not significant (1.36±0.46,1.11±0.45,P=0.06). However,after 10 seconds of sustained eye opening,the irregular index increased significantly to 4.23±1.32 in the diabetic group,whereas it remained at 2.08±0.60 in controls (P<0.01). ·CONCLUSION:In diabetics,reflex tearing and the tear film stability are demonstrated to be decreased. The SRI of diabetics increases when the eyes are kept open.

Abstract:AIM:To develop a type of measuring instrument which is capable of automatically,accurately measuring the varying degrees of compensatory head posture. ·METHODS:According to the physiological characteristics of human head and neck,we put the liquid compass in the helmet for the development of automatic compensatory head posture measuring instrument,for the electronic liquid compass can accurately record different axial range of activities. The measuring instrument was mainly composed of inductor (liquid compass department),helmet,data processor and voltage regulator devices. The range of the activity of head and neck was perceived by the inductor embedded in the helmet,the change was conducted to the data processor through a data line,and the result was recorded after instant data-processing. This result was compared with the range on the dial installed on the model to verify the accuracy of the data. ·RESULTS:The helmet was put on the model’s head and the data was recorded on the automatic compensatory head posture measuring instrument at that time,then the model’s head was turned in three dimensional directions; and the data were recorded respectively. The difference between pre-and post-rotation was the final data. To check the data against the dial on the model,we found that the error didn’t exceed 1 degree. ·CONCLUSION:The automatic compensatory head posture measuring instrument plays an important role in clinical practice. It is a simple way to accurately measure three-dimensional orientation of head and neck,and it has a much larger measuring range than the physiological range of the activity of human head and neck. It has won the National Invention Patent of China (Patent Application No. 200820022027.0).

Abstract:AIM:To investigate the value of sera FT3,FT4,TSH,TPOAb in exophthalmos patients with Graves’ disease(GD);and to summarize and analyze the topography of the clinical manifestation of GD,such as exophthalmos,lid retraction and lid fullness,hypophasis,hyperremia and edema of conjunctiva,disorder of ocular movement and so on. ·METHODS:The clinical manifestations of 207 patients with GD who underwent radioiodine therapy were collected and analyzed,and sera FT3,FT4,TSH,TPOAb levels were measured and compared in patients with GD and exophthalmos (n=125) and GD patients(n=82). ·RESULTS:Exophthalmos were present in 125 cases (60.4%);lid retraction in 169 cases (81.6%);hypophasis in 176 cases(85.0%),lid fullness in 88 cases (42.5%);hyperremia and edema of conjunctiva in 92 cases(44.4%);disorder of ocular movement in 16 cases(7.7%); corneal edema or ulcer in 3 cases(1.4%);sera FT3,FT4,TSH,TPOAb levels in two groups had no significant difference(P>0.05). ·CONCLUSION:Both groups are all in high secretor state; different ocular manifestations are present in over 85% patients. Diagnosis and treatment of thyroid-associated ophthalmopathy(TAO) can’t be ignored.

Abstract:Corneal collagen cross-linking( CCL) is the latest corneal shape technology in clinical application in 21 century. Riboflavin,a photosensitizer,can be applied to local irradiation of the cornea by 370nm ultraviolet and it can stimulate collagen cross-linking,and increase corneal rigidity. The technology is expected to become more familiar with the corneal molding techniques such as conductive keratoplasty and corneal ring implantation for secondary treatment in clinic. These corneal molding surgeries are expected to open up a new field,and treated with new corneal disease. Ophthalmologists can reshape the corneal structure without penetrating keratoplasty or lamellar keratoplasty and other invasive techniques by CCL. Instead of corneal ring implantation,it can improve significantly treatment effect of keratoconus. Technical methods with CCL has been improved,and the treatment range has also increased. Besides progressive kera-toconus,the refractory corneal ulcer,corneal degenera-tion,corneal expansion diseases were all applied.

Abstract:Keratoplasty rejection is the main failure factor of keratoplasty. Immunotolerance is antigen-specific immune non-response. Inducing receptors of the immunotolerance against the graft was the fundamental method to completely overcome the transplant rejection. Kerato-plasty rejection is a complex process. All kinds of immunocytes play a critical role in suppressing rejection and inducing immunotolerance.

Abstract:A part of patients have discomfort symptoms of eyes after cataract surgery,such as reduction of cornea sensation,sensation of dryness,foreign body sensation,burning sensation,and the effect of cataract surgery incision to tear film. We analyzed the pathogenesis and mechanism systematically,and the analysis would be helpful to the choice of the appropriate method to do the operation and the reduction of complications after cataract surgery.

Abstract:The treatment effect was not satisfactory for patient wiht the complexity detached retina using traditional silicone oil in the operation. So the heavy silicone oil was produced. We introduce the physicochemical property of the heavy silicone oil,the advantage and disadvantage,and the clinical application advances and complications,and we prospect that the heavy silicone oil couble be extensivly used in the future.

Abstract:Many clinical studies have implicated the importance of vascular endothelial growth factor (VEGF) in the pathogenesis of diabetic retinopathy(DR). VEGF inhibitors were combined with VEGF molecules to counteract its function. There are achievements in the therapy for treating neovascularization and vascular leak-age of DR. This article makes a review in the classification,mechanism of function,safety as well as applied development of VEGF inhibitors for DR.

Abstract:The hormone has good functions about anti-inflamma-tion,anti-allergy and immunosuppression,improvement of metabolism. Recently reports indicated that any admini-stration route may cause eye pressure increase,especially by the way of eye dropping. Some patients presented the hormone glaucoma such as glaucoma optic nerve harm,the field of vision damage and the vision decrease. In this review,we research and summary the status about intraocular pressure elevation related with local hormone.

Abstract:Tumor necrosis factor related apoptosis-inducing ligand (TRAIL) is a new member of TNF superfamily. TRAIL preferentially induces apoptosis in tumor cells,trans-formed or virus-infected cells,but not in normal cells,thus it has greatly spurred our attention. Eye tumor therapy has always been the challenge to ophthalmo-logists. This review introduces TRAIL and its receptors’ structures and functions,the mechanism of inducing apoptosis and the applications in eye tumors therapy.

Abstract:Amblyopia is a developmental disorder that occurs during a period of neural plasticity early in life. The sensitive period of visual development is a critical period for amblyopia. It is generally considered untreatable for older children who fall outside the period of cortical plas-ticity. However,there are numerous reports of therapy for amblyopia in older children recent years. This review updates the treatment advances for amblyopia in older children.

Abstract:AIM:To explore the application effect of the integration of problem-based learning (PBL) with case-based learning (CBL) teaching method in ophthalmology nursing teaching. ·METHODS:Totally 105 nursing students of two classes in grade 2007 were randomized into two groups:experimental group (n=55)and control group(n=50). The integration of PBL with CBL teaching method was used in the experimental group and the traditional teaching method was used in the control group. ·RESULTS:There were significant differences between the experimental group and the control group in the actors including the scores of the theory tests,the degree of students’ satisfaction and the excellence rate of the teachers(P<0.01),·CONCLUSION:The integration of PBL with CBL teaching method is benefit for the cultivation of the students’ comprehensive quality,which is better than the traditional teaching method.

Abstract:AIM:To improve the self-nursing ability for patients with angle-closure glaucoma. ·METHODS:By means of the form of glaucoma club to achieve this purpose. ·RESULTS:Health education of self-nursing could reduce the angle-closure glaucoma onset times,onset level,and the average length of hospitalization. It also could increase treatment compliance,improve therapeutic effects and reduce the damage of visual function,thereby enhancing the life quality. ·CONCLUSION:Glucaoma club has a positive impact on treating,preventing and nursing patients with angle-closure glaucoma.

Abstract:AIM:To investigate the influence of surgery interven-tion on the prognosis of fungal corneal ulcer,and to discuss the importance of surgery for the treatment of serious corneal ulcer. ·METHODS:Altogether 39 patients with fungal corneal ulcer underwent focus of infection cleaning,focus of infection cleaning with amniotic membrane grafting or focus of infection cleaning with conjunctival flap covering surgery separately,followed with standard medical treatment. The outcome of the treatment was recorded and evaluated through follow-up visit of more than six months. ·RESULTS:Thirty-four patients were cured through one time surgery,two patients were cured through two time surgery,while the other three eyeballs were eviscerated due to corneal perforation and secondary endophthal-mitis. ·CONCLUSION:Surgery may play an important role in the rescue of the anatomy and function of eyeballs infected with fungus.

Abstract:AIM:To observe the effect of treatment of fungal keratitis with local debridement combined with 50g/L anerdian type 3 disinfectant dilution used in conjunctival sac and medication. ·METHODS:Sixty-one patients 61 eyes were treated with local debridement combined with 50g/L anerdian type 3 disinfectant dilution used in conjunctival sac and medication and the effects were observed. ·RESULTS:The cure rate was as the follows:of the mild 100%,of the moderate 78%,of the serious 27%. ·CONCLUSION:The treatment result of local debride-ment combined with 50g/L anerdian type 3 disinfectant dilution used in conjunctival sac and medication is better for the mild and the moderate,yet not effective for the serious cases.

Abstract:AIM:To assess the accuracy and variability of corneal thickness in myopic eyes obtained by ultrasound pachy-meter,OrbscanⅡ system and Pentacam Scheimpflug imaging system. ·METHODS:First,Pentacam system,OrbscanⅡ system and A-scan ultrasonic pachymeter were used to measure the corneal thickness on 56 myopic cases(56 right eyes)undergoing laser in situ keratomileusis(LASIK);Then,the results were compared. ·RESULTS:The value of corneal thickness measured by Pentacam,OrbscanⅡ and A-scan ultrasonic pachymetry was 547.04±3.65μm,535.41±32.93μm and 539.46±29.15μm respectively; there was no significant difference between the results with one-way ANOVA; these three kinds of instruments of measuring corneal thickness had a good linear correlation; Pentacam system had good repeatability in the measurement of corneal thickness. ·CONCLUSIONS:The Pentacam system offers an accep-table method for evaluating corneal thickness,which is useful in corneal refractive surgery.

Abstract:AIM:To investigate the clinical effect of small incision extracapsular cataract extraction and intraocular lens implantation. ·METHODS:From the April 2007 to December 2008,312 cases who underwent the small incision extracapsular cataract extraction and intraocular lens implantation analyzed retrospectively. ·RESULTS:Postoperative visual acuity increased signifi-cantly,≥ 0.05 were in 307 cases,off blindness rate accounted for 98.4%; ≥ 0.3 were in 285 cases,and off disability rate accounted for 91.3%. Intraoperative and postoperative complications:posterior capsule rupture 4 eyes accounted for 1.3%; corneal edema 75 eyes account-ed for 24.0%; iris damage 2 eyes accounted for 0.6%; temporary high intraocular pressure 5 eyes accounted for 1.6%; pupil mild deformity 6 eyes accounted for 1.9%; intraocular lens gripping 2 eyes accounted for 0.6%; postoperative uveitis 12 eyes accounted for 3.8%; withnot artificial lens implanted 5 eyes accounted for 1.6%; The average corneal astigmatism was 1.53±1.32 in the posto-perative day 7,and no serious complications occurred. ·CONCLUSION:Small incision cataract extraction and intraocular lens implantation has a significant effect and fewer complications,and it is safety and easy surgery,especially in primary hospital for the prevention of blindness.

Abstract:AIM:To evaluate the visual performance of the Acrysof ReSTOR +3D intraocular lens (IOL) (SN6AD1,Alcon) implantation. ·METHODS:Totally 32 patients 48 eyes were implanted with the Alcon ReSTOR +3D apodized diffractive multifocal IOL. The mean follow-up was 4±1.5 months(range form 3 to 6 months). Distant uncorrected ,best-corrected visual acuity; near uncorrected,best-corrected visual acuity; intermediate visual acuity,best-corrected visual acuity,spectacle independency and the position of the IOLs were observed. ·RESULTS:Distance uncorrected visual acuity was 0.85±0.17 and distant best-corrected visual acuity was 0.96±0.14. Near uncorrected visual acuity was 0.64±0.13 and near best-corrected visual acuity was 0.77±0.15. Inter-mediate uncorrected visual acuity was 0.65±0.15 and intermediate best-corrected visual acuity was 0.69±0.17. Spectacle independency was 84%. No tilt or decentration of the IOL were observed. Posterior capsular opacification was not found in the follow-up. ·CONCLUSION:The Acrysof ReSTOR +3D IOL provides a satisfactory full range of vision.

Abstract:AIM:To investigate the safety and efficaty of topical anesthesia in non-phacoemutsification cataract extraction and introcular lens (IOL) implantation using small incision. ·METHODS:Under topical anesthesia,small incision non-phacoemulsification cataract extraction and IOL implantation were done in 79 patients 86 eyes,and the effectiveness of topical anesthesia and postoperative visual acuity were surveyed. ·RESULTS:Sixty-four patients 71 eyes complained no pain. 15 patients 15 eyes complained distending pain,and another topical anesthetic was given during operation.The mean duration of the operation was about 18 minutes. The vision ≥0.5 was 83% (at first postoperative day)and 92%(at 1 week postoperatively) respectively. ·CONCLUSION:Small incision non-phacoemulsification cataract extraction and IOL implantation under topical anesthesia is simple and spends little time. The recovery of eyesight is quick and stable. The cost of operation is very cheap. This operation has many advantages in our country.

Abstract:AIM:To explore the effects of sodium hyalurantae in complex trabeculectomy. ·METHODS:Case-control studies. 56 eyes with primary glaucoma who need complex trabeculectomy were randomly divided into observation group and control group with 28 eyes in each group. Patients in the observation group were applied the sodium hyalurantae,and the control group were not applied during the operation. The changes in anterior chamber,bleb,IOP and corneal endothelial cells in two groups were observed. ·RESULTS:The anterior chambers of 28 eyes in observation group formed early postoperatively. The shapes of filter blebs in observation group were better than control group at three months after operation. Functional filtering bleb appeared in 27 eyes(96%) in observation group and functional filtering bleb appeared in 26 eyes (93%) in control group. IOP of observation group is slightly higher than that of control group early postoperatively,and three months after operation,IOP of observation group was somewhat lower than that of control group. There was no statistical difference between the corneal endothelial cells of preoperation and postoperation in two groups. ·CONCLUSION:It can make the anterior chamber form better by using sodium hyalurantae in complex trabeculectomy,and it can support filtration path to inhibit scar formation and increase the successful rate of complex trabeculectomy.

Abstract:AIM:To investigate the outcome and treatment parameter of transscleral diode laser cyclophotocoagula-tion in refractory glaucoma. ·METHODS:Fifty patients 50 eyes of refractory glaucoma were treated with the transscleral diode laser cyclo-photocoagulation,the power,area,points of photocoa-gulation,points of blast were recorded,intraocutar pressure(IOP),symptom,visual acuity,the representa-tion of anterior segment before and after treatment and the complication were observed. ·RESULTS:The average of IOP was 18.50±2.50mmHg after treatment,obviously decreased after treatment (P<0.01). The pain decreased in 46 eyes,the decreasing amount of IOP was not obviously correlated with power,but had relativity with area and points of cyclo-photocoagulation,and had obvious positive relativity with points of blast. ·CONCLUSION:It is a safe and effective method to treat the refractory glaucoma with transscleral diode laser cyclophotocoagulation; and it is important to design the treatment parameter acording to the IOP before treatment and different type glaucoma.

Abstract:AIM:To investigate the diagnonsis effect of optical coherence tomography (OCT),standard automatic permetry (SAP) in the early glaucoma. ·METHODS:Forty-two patients 68 eyes with glaucoma (binoculus/ ocellanae:25/18,male/female:29/13,left/right:32/36,open/close:18/50) aged 36-82 years old,the average age was 60.8±0.92. Visual disks C/D and retinal nerve fibers layer thickness were inspected by automatic vision inspection and OCT scanners. ·RESULTS:The positive rate of diagnonsis of automatic vision inspection and OCT was 84.37% and 93.75%,respectively. The positive rate of inspection in OCT was higher than that of automatic vision inspection for early glaucoma patients. ·CONCLUSION:For glaucoma patient,the loss of retinal nerve fibers is earlier than the change in field of vision defects. Combined of visual field and OCT method can qualitatively and quantitatively get an objective assessment for vision defects of glaucoma.

Abstract:AIM:To evaluate the effect of treating the glaucoma with phacoemulsification replacing phacofragmentation without perfluorocarbon liquid to remove the dislocated lens in vitreous cavity. ·METHODS:Between November 2007 and March 2010,a series glaucomatous cases of 16 patients 16 eyes with posterior dislocation lens because of ocular trauma or cataract surgery were studied retrospectively. The total vitrectomy combined with intravitreal phacoemulsification devoid of the silicone sleeve was used to remove dislo-cation of the lens. The main outcome measures were visual acuity,intraocular pressure,retina and sclera heal-ing postoperatively. ·RESULTS:All dislocated lenses were successfully removed. There was no retinal detachment,retinal hemorrh-age and sclera burning. No complications occurred during phacoemulsification. After operation,Visual acuity was counting fingers in 2 eyes,0.1-0.3 in 7 eyes,more than 0.3 in 5 eyes and was unchanged in 2 eyes. The postoperative intraoclar pressure was located between 15-20mmHg in 14 eyes and lowered to mormal range in another two eyes using anti-glaucoma medical drops. ·CONCLUSION:The conventional phacoemulsification probe devoid of the silicone sleeve can be used to remove the dislocaed lens of vitreous cavity in vitrectomy surgery. This technique has minor injury,convenience and short time and doesn’t need the perfluorocarbon injection. It is preferred to treat the glaucoma due to the dislocation of lens.

Abstract:AIM:To evaluate the characterization of macular hemorrhage in pathological myopia (PM) with optical coherence tomography (OCT) and fundus fluorescein angiography (FFA). ·METHODS:A series of retrospective cases study was designed. OCT,FFA and color photography were perform-ed on 42 patients 43 eyes of PM with macular hemorrhages. ·RESULTS:The causes and symptoms of PM with macular hemorrhage could be divided into two forms:new veins:macular hemorrhage with choroidal neovascularization (CNV) of 24 patients 24 eyes. The fundus characteristics were macular hemorrhage demonstrated oval,less than 1 disk diameter (PD),with rare edema and exudation around. And new membrana vasculosa can be seen partially. The FFA characterisitics were classic CNV of 17 eyes (71%) and occult CNV of 7 eyes (29%). The characteristics of OCT were 21 eyes (87.5%),spindle shape or circular conglomerate,strong or medium reflection,sticking out upwards from retinal pigment epithelial layers,under the epithelial layers of retinal neuroepithelial; 3 eyes (12.5%) CNV were irre-gular reflection signal which may aggregate disorder,and located on the level of retinal pigment epithelial layers. Simplex:macular hemorrhage without CNV of 18 patients 19 eyes. The fundus characteristics were flat hemorrhagic focus with different sizes and less-orderly boundary,without any exudation or edemas around. The FFA characterisitics were fluorescence blocked by hemorrh-age,without CNV high fluorescence pheno-menon. Lacquer cracks sometimes appeared at the sites of macular hemorrhage or around the hemorrhage. The characteristics of OCT were the protruded low reflection area under the retinal pigment epithelial. Choriocapillary layer with consistent photonic band. ·CONCLUSION:Most of macular hemorrhage in patho-logical myopia with new veins is caused by typical CNV. Typical figures of OCT are fusiform shape in pigment epithelium layers or quasicircular strong reflection mass,with clear boundary. Retinal protruded upwards,and choroids under it can be a shield. Simplex macular hemorrhage demonstrates as limited retinal pigment epithelial hemorrhagic detachment. OCT exami-nations were favorable for identifying the characteristics and reasons of macular hemorrhage in pathological myopia,and were helpful for diagnosis,prevention,guide and treatment.

Abstract:AIM:To discuss the therapeutic effect and surgical indication with scleral buckling for long-standing retinal detachment. ·METHODS:The major surgery was as follows:retinal breaks locating,cryotherapy,scleral buckling or encircl-ing scleral buckling. Thirty-eight patients 38 eyes with long-standing retinal detachment accepted surgery,including thirty-six eyes in scleral buckling among which nineteen eyes encircling scleral buckling and silicone encircling,and two eyes underwent encircling scleral buckling merely. Among these cases twenty-six eyes underwent subretinal fluid drainage and seven eyes combined with 532 nm laser photocoagulation. ·RESULTS:The rate of retinal reattachment after one surgical procedure was 87% and after two procedures was 92%. And there were no serious complications occurred in operation and postoperation. ·CONCLUSION:Scleral encircling and buckling proce-dures can be used effectively to treat selected cases of long-standing retinal detachment,and the choice of operation should be individualized for each patient.

Abstract:AIM:To investigate the outcome of primary 23-gauge(23G) pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD). ·METHODS:In this prospective case series,20 eyes of 20 consecutive patients with RRD underwent primary 23G PP with intraocular gas tamponade and sclerotomy suturing. Postoperative mean follow-up was 6 months. Main outcome measures included post-operative anatomical status,visual acuity,intraocular pressure,and operative complications. ·RESULTS:The primary anatomical success rate was 100%. The mean postoperative visual acuity at postopera-tive month 3 improved from 0.02-0.5(logMAR was 1.187±0.616) to 0.3-0.8 (logMAR was 0.276±0.114) (t=5.756,P<0.001) and from 0.8-1.0 (logMAR was 0.218±0.276) to 0.6-1.0 (logMAR was 0.312±0.285) (t=-1.0,P=0.374) in macular-off and macular-on cases,respectively. No patients had hypotony or developed choroidal detach-ments,endophthalmitis,and PVR. Postoperative cataract progression occurred in 4 eyes(20%). Early ocular hyper-tension in 5 eyes was controlled with 1-2 kinds of anti-glaucoma drops. ·CONCLUSION:23G PPV is an effective surgical technique in the management of RRD. Complications are rare with sclerotomy suturing.

Abstract:AIM:To investigate the efficacy and complications of phacoemulsification combined with vitrectomy in the treatment of proliferative diabetic retinopathy and cataract. ·METHODS:Retrospectively analyzed the information of 55 patients 68 eyes with cataract and proliferative diabetic retinopathy,which were treated with vitrectomy com-bined lens phacoemulsification and intraocular lens im-plantation,the postoperative visual acuity and compli-cations in and after operation were observeed. ·RESULTS:The follow-up period was 3-24 months with the average of 8.5 months. Postoperative visual acuity improved or remained unchanged in 51 eyes (75% ); and decreased in 17 eyes (25% ). Complication in operation is iatrogenic retinal tear in 15 eyes (22%). Postoperation complications consisted of anterior chamber fibrin exudation in 30 eyes (44% ); vitreous hemorrhage in 11 eyes (16%); retinal detachment in 3 eyes (4%); rubeosis of iris in 5 eyes (7%); neovascular glaucoma in 2 eyes (3%). Retinal photocoagulation was performed in 31(46%) eyes after surgery. ·CONCLUSION:Vitrectomy combined lens phacoemul-sification and intraocular lens implantation to treat cataract proliferative diabetic retinopathy is safe and efficient,which can improve the visual acuity of majority of patients. The key point is to select suitable patients and the key influencing factor of postoperative visual acuity is the degree of retinal damage.

Abstract:AIM:To investigate the therapeutic effect of photo-dynamic therapy (PDT) combined with bevacizumab on central exudative chorioretinopthy(CEC). ·METHODS:Clinical data of 40 patients who had undergone PDT combined with bevacizumab because of choroidal neovascularisation caused by CEC,diagnosed by examination of best-corrected visual acuity (BCVA),ocular fundus fluorescein angiography (FFA),and optical coherence tomography (OCT),were retrospectively an-alyzed. The changes of the BCVA,ocular fundus charac-teristics,and the results of FFA and OCT before and after combined therapy were observed and analyzed. The numeration of the times of retreatment and the safety of the combination therapy were analyzed. ·RESULTS:At the end of the follow-up period after combination therapy,the BCVA improved more than 2 lines in 34 eyes,stabled in 5 eyes,lost more than 2 lines in 1 eye. ·CONCLUSION:PDT combined with bevacizumab the-rapy is an effective and safety therapy for most patients with CEC.

Abstract:AIM:To observe the ocular hemodynamic changes in the eyes of patients with rhematigenous retinal detachment before and after the scleral encircling procedure with the encircling band shorten in a certain range. ·METHODS:Central retinal arteries (CRA)were studied with color Doppler imaging (CDI) in 28 patients with unilateral rhematogenous retinal detachment,the fellow eyes served as control.The measured parameters included peak systolic velocity(Vmax),end diastolic velocity(Vmin),mean velocity(V),resistance index(RI) and pulsatility index(PI). ·RESULTS:A comparison of the indexes of CRA in both the sick eyes before the operations and the eyes in the control group found the differences among them no statistical significance. The Vmax,Vmin,RI and PI of the CRA of the sick eyes all increased 14 days after the operations,but not reached statistical significant difference,and showed no statistical significance as compared with those in the control group. ·CONCLUSION:Scleral buckling procedure with the encircling band shorten in a certain range can not change blood flow in retinal tissue for a short time after surgery. Color Doppler imaging is a useful tool for the studies of ocular hemodynamics changes.

Abstract:AIM:To observe the clinical effects of vitrectomy combined with intravitreal injection of vancomycin for endophthalmitis. ·METHODS:We carried out retrospective analysis of endophthalmitis in 30 cases 30 eyes. We observed the culture results of vitreous bacteria and fungi. All cases were injected vancomycin into vacuum vitreous after vitrectomy.We further observed the situation in the eyes,including the best-corrected visual acuity and complications. ·RESULTS:During the follow-up time,the endophthalmictis in 29 eyes (97%) were controlled without retinal complication. One case of 1 eye (3%) was panophthalmitis and removal of eye ball. Visual acuities of 19 eyes (63%) were improved,of 7 eyes(23%)were same,of 4 eyes(13%) were decreased. ·CONCLUSION:Vitrectomy combined with intravitreal injection of vancomycin is effective in treating endo-phthalmitis.

Abstract:AIM:To evaluate the clinical curative effect of amniotic membrane grafting for ocular chemical burn and thermal burn. ·MEHTODS:We collected 24 patients 28 eyes with ocular chemical and thermal burn,which had been treated with amniotic membrane grafting in our hospital. The follow-up time ranged from 6-24 months. The posto-perative visual acuity,the condition of amniotic mem-brane transplant,renovation of cornea,healing time of corneal epithelium and complication were observed. ·RESULTS:Postoperative corrected visual acuity:visual acuity was improved in 22 eyes(79%)and was not changed in 6 eyes(21%)after amniotic membrane grafting,no visual acuity appearances declined,and there was no statistical significance between preoperative visual acuity and postoperative visual acuity. Status of amniotic membrane implant:amniotic membrane survived in 24 eyes and the survival rate was up to 86%.Conditions of cornea:8 eyes recovered to transparent; nebula emerged in 12 eyes eventually,corneal macula emerged in 5 eyes and 3 eye ended up with leukoma. Time of corneal epi-thelium healing:corneal epithelium of 28 eyes recovered entirely,22 eyes of which recovered within 3 weeks. Symblepharon condition improved in all 4 patients who suffered from preoperative atretoblepharia,including three cases completely separate. ·CONCLUTION:Amniotic membrane grafting is an effective method to deal with ocular surface burn.

Abstract:AIM:To compare the effects of excision of pterygium with gliding the corneal limbal stem cells beside pterygium-neck(A operation) and classical pterygium excision combined with corneal limbal stem cells trans-plantation(B operation) on different eyes of homobody. ·METHODS:There were 105 patients 210 eyes with initial pterygium in two eyes,one eye got A operation and the other got B operation. The postoperative follow-up period was 12 months. The duration of complaint symptoms,the time of corneal epithelium healing and recurrence of pterygium were observed after operation. ·RESULTS:Eight eyes of 105 eyes that got A operation were recurred,the rate of recurred was 7.8%. 6 eyes of 105 eyes that got B operation were recurred,the rate of recurred was 5.9%. The difference was not significantly different(P>0.05). 87.6% patients complained that the eyes got B operation were more uncomfortable.The duration of complaint symptoms after operation was significantly different between two operation(P<0.01). The time of corneal epithelium healing was also signifi-cantly different(P<0.05). ·CONCLUSION:The excision of pterygium with gliding the corneal limbal stem cells beside pterygium-neck is a convenient,micro-injury and light compliant symptoms surgery. The rate of recurred is not significantly different between this operation and classical pterygium excision combined with corneal limbal stem cells transplantation.

Abstract:AIM:To observe the influence of head down tilt simulated weightlessness on electrophysiology of vision. ·METHODS:Head-down tilt for -6° was adopted in 6 healthy volunteers. Pattern visual evoked potential (P-VEP) under different space frequency,flash electroretino-graphy (ERG),including rod response,maximal res-ponse,cone response,oscillatory potentials (OPs) and 30Hz flicker were recorded,and the latency and amplitude from each wave were analyzed before,two days and five days after trial. The record procedure followed the ISCEV standard for full-field clinical ERG (2008 update). ·RESULTS:No significant difference was detected in the latencies of P100 under different space frequency. The amplitude of P100 had significant change under high space frequency between pre-test and 2,5 days after test (P<0.05). But not the same happened in middle and low space frequency. No significant differences were detected in the latencies and amplitudes of cone response and 30 Hz flicker among various time points(P>0.05). The latencies were significantly prolonged in rod and maximal responses between pre-test and 2 days after test (P<0.05),but no obvious change was found in amplitudes(P>0.05). There were no significant differences detected in the ∑OPs (P>0.05). ·CONCLUSION:Head-down tilt simulated weightlessness induce the abnormality of VEP and ERG which influence the visual function of healthy people.

Abstract:AIM:To compare the visual refractive outcome and complication of laser in situ keratomileusis (LASIK) treated with 5g/L loteprednol etabonate and 1g/L fluorometholone ophthalmic suspension after operation. ·METHODS:Totally 160 consecutive eyes that received 5g/L loteprednol etabonate ophthalmic suspension(group A) and 1g/L fluorometholone ophthalmic suspension (group B) after LASIK were reviewed. Manifest refrac-tion,uncorrected visual acuity(UCVA),best spectacle-corrected visual acuity (BSCVA),and intraocular pres-sure (IOP) were recorded before and 1 day,1 week,1 month,3 months after treatment.Diffuse lamellar keratitis (DLK),postoperative complications,and frequency of retreatments were observed. ·RESULTS:There was no difference in manifest refraction,UCVA,BSCVA and DLK after operation between two groups. Preoperatively IOP didn’t differ significantly between two groups. IOP in group A and B were 13.3±3.5mmHg and 16.4±4.9mmHg respectively 3 months after operation. IOP in group A was lower significantly than the later. ·CONCLUSION:Loteprednol etabonate ophthalmic suspension 5g/L can suppress the inflammation response caused by LASIK effectively. Compared with traditional steroid suspension,5g/L Etabonate ophthalmic suspen-sion can obviously reduce occurrence of high IOP.

Abstract:AIM:To evaluate the effect of recovery of stereovision in far and near after operation in patients with partially accommodative esotropia. ·METHODS:Eighty-three cases of stereovision in far and near with partially accommodative esotropia after operation were observed. ·RESULTS:In 83 cases,56 cases had obtained stereovi-sion in far,35 cases had obtained stereovision in fovea centralis. The difference in stereovision between pre-and post-operation was significant(P<0.01);the younger the age of onset,the poorer the recovery of stereovision after operation. The early age of operation,the higher recovery of stereovision after operation and the older age of operation,the poorer recovery of stereovision after operation(P<0.01). ·CONCLUSION:The partially accommodative esotropia has an important influence in the development of stereovi-sion.The early correction of eye position will benefit the recovery of stereovision in far and near.

Abstract:AIM:To investigate the prevalence of blindness and low vision,leading cause of blindness among adults aged ≥50 years in Sanya outskirts of Hainan,China. ·METHODS:Random sampling analysis was performed in 2 569 individuals chosen as the sample aged ≥50 years in 28 villages of Sanya. Corrected vision,external eye,anterior chamber,lens,vitreous,fundus were examined by ophthalmologists. The prevalence of blindness and low vision was calculated,and the main cause of blind-ness was analyzed. ·RESULTS:Totally 2206 individuals among 2569 were examined. The response rate was 85.87%,the prevalence of blindness was 1.90% and the prevalence of low vision was 3.85%,resulting chiefly from cataract,glaucoma,keratitis,eyelid disease and pterygium. ·CONCLUSION:The epidemiological results show that the main cause of blindness and low vision is cataract. But the other causes of blindness such as eyelid disease and pterygium can not be neglected.

Abstract:AIM:To evaluate the efficiency of amniotic membrane transplantation to treat fungal keratitis. ·METHODS:Totally 26 cases 26 eyes with fungus keratitis and bad effect of drug treatment underwent thorough corneal infection elimination and the amniotic membrane transplantation. ·RESULTS:From 3 to 36 months follow-up,no rejection took place. Keratohelcosis healed in 21 cases,cornea restored transparency in 7 cases,and cornea formed the limited spot nebula or the floccosoids in 14 cases. Vision improved in 21 cases (81%). ·CONCLUSION:Amniotic membrane transplantation is an efficient method to treat fungal keratitis.

Abstract:AIM:To investigate clinical effect of temporal small incision extracapsular cataract extraction (ECCE) and intraocular lens implantation with topical and subcon-junctival anesthesia. ·METHODS:Totally 32 patients 40 eyes with cataract after trabeculectomy underwent the small incision ECCE and intraocular lens implantation surgery by topical anesthesia and subconjunctival anesthesia (20g/L lidocaine),the anesthetic and therapeutic effect of surgery were evaluated. ·RESULTS:All patients had the desired analgesic effect and successful surgery procedure,postoperative visual acuity <0.1 in 5 eyes (12.5%) ,,visual acuity from 0.1 to 0.4 in 9 eyes (22.5%),visual acuity ≥ 0.5 in 26 eyes (65.0%); All the visual acuity were improved. ·CONCLUSION:The temporal small incision ECCE and intraocular lens implantation surgery by topical anesthesia combined with subconjunctival anesthesia is a simple and effective surgery for the patients with cataract after trabeculectomy surgery,especially in primary hospitals with cheap surgical equipment.

Abstract:AIM:To observe clinical effect of phacoemulsification and goniosynechialysis for angle-closure glaucoma with cataract. ·METHODS:Totally 56 patients 60 eyes with cataract and angle-closure glaucoma underwent transparency corneal incision cataract phacoemulsification and goniosyne-chialysis by topical anaesthesia. ·RESULTS:Intraocular pressure (22-28mmHg) elevated in 3 eyes in 1 week,and in the follow-up of 3 to 12 months,intraocular pressure decreased to normal range after treatment. Visual acuity,central anterior chamber depth and angle were improved after operation. ·CONCLUSION:For patients with angle-closure glaucoma and cataract,phacoemulsification and goniosynechialysis is a convenient,safe and effective method,and have the effects of depressurization and improving vision.

Abstract:AIM:To investigate the clinical effect of plane chopping method in small incision hard nucleus cataract surgery. ·METHODS:Hard nucleus(≥Ⅳ) small incision cataract surgery was performed with the puncture forceps and split nucleus knife. ·RESULTS:Totally 86 cases of hard nucleus cataract (≥Ⅳ) underwent the plane chopping surgery and succeeded with the 6mm incision. Visual acuity≥0.5 in 70 eye (81%) and 79 eyes (92%) in postoperative day 3 and day 7,respectively. Postoperative astigmatism degree was 0.85±0.55D. ·CONCLUSION:The puncture nucleus-forceps and plane chopping is a suitable and ideal chopping method for small incision hard nucleus cataract.

Abstract:AIM:To observe the therapeutic effect of poly-wavelength krypton lasers on the branch retinal vein occlusion (BRVO),and discuss its therapeutic significance for treatment of BRVO. ·METHODS:One hundred and forty-two patients 142 eyes with BRVO were treated with poly-wavelength krypton lasers. The changes in visual acuity,IOP were observed,and slit-lamp,ophthalmoscope,FFA were applied after 3 months. The changes in visual acuity,absorp-tion of retinal hemorrhage,macular edema were analyzed. ·RESULTS:Retinal hemorrhage was absorbed more than 1/2 in 51 eyes(35.9%),between 1/2 to 3/4 in 62 eyes (43.7%),and completely absorbed or more than 3/4 in 29 eyes(20.4%). Macular edema disappeared completely in 33 eyes(23.2%),reduced partially in 96 eyes (67.6%) and absorbed lightly or unchanged in 13 eyes(9.2%) after photocoagulation. Retinal neovascularization disappeared completely accounting for 71.2%,disappeared partially accounting for 28.6%,only 0.2% cases were increased or unchanged in FFA after 3 months. ·CONCLUSION:Retinal photocoagulation with poly-wavelength krypton lasers on BRVO promptly can improve visual acuity,promote absorption of retinal hemorrhage or macular edema,and avoid serious complications.

Abstract:AIM:To evaluate the clinical effects of frontal muscle flap suspension surgery for severe congenital ptosis. ·METHODS:Totally 28 patients 35 eyes with severe congenital ptosis underwent the frontal muscle flap suspension surgery. Complications and therapy effect at operation and postoperation were observed. ·RESULTS:All cases were corrected satisfactorily,no severe postoperative complications appeared. ·CONCLUSION:The frontal muscle flap suspension surgery is a reliable and effective method for severe congenital ptosis.

Abstract:AIM:To explore the outcome of mitomycin C combined with autologous limbal stem cell transplantation for treatment of recurrent pterygium. ·METHODS:Totally 69 cases 87 eyes with recurrent pterygium were randomly divided into two groups. The treatment group:35 cases 45 eyes after pterygium exci-sion were treated with mitomycin C combined with autologous limbal stem cell transplantation. The control group:34 cases 42 eyes after pterygium excision were treated with autologous limbal stem cell transplantation. ·RESULTS:During a follow-up of 3 to 12 months,in the treatment group 44 eyes were cured and the cure rate was 98%; with 1 eye of recurrence,the recurrence rate was 2%; in the control group,36 eyes were cured and the cure rate was 86%; with 6 eyes of recurrence,the recurrence rate was 14%. Recurrence rate of the two groups was statisti-cally significant (χ2 = 4.273,P=0.039). ·CONCLUSION:Mitomycin C combined with autologous limbal stem cell transplantation significantly increases the cure rate and reduces the recurrent rate,worthy of promotion in clinical therapy.

Abstract:AIM:To observe the therapeutic efficacy of pedicle conjunctival transplantation and mitomycin C (MMC) for pterygium,and explore the optimal surgery with minimum recu-rrence ratio. ·METHODS:Totally 131 cases 131 eyes underwent the excision of pterygium,pedicle conjunctival transplanta-tion and MMC,and recombination calf fibroblast growth factor and ofloxacin were applied. ·RESULTS:In the follow-up of 6 months to 2 years,4 eyes recurred in all 131 patients 131 eyes,and recurrence ratio was 3.1%. ·CONCLUSION:The pedicle conjunctival transplantation and MMC surgery have the lower recurrence ratio,the simpler operation protocol,and the cheaper cost,which is suitable for the primary hospital and is a suitable way for pterygium.

Abstract:AIM:To evaluate the effect of contact lens applied in pterygium excision. ·METHODS:Totally 33 patients 40 eyes underwent pterygium excision combined with conjunctival flap transplantation in our hospital and they were divided equally into A group(contact lens for 5 days) and B group(routine ensheathe withnot contact lens)at random. Corneal irritation and healing of epithelium were observed in these two groups. ·RESULTS:Corneal irritation in A group was much better than that of the B group on the postoperation day 1 and 3. Shorter time healing of epithelium was seen in A group. ·CONCLUSION:Contact lens can alleviate corneal irritation significantly after pterygium excision; shorten the healing time of epithelium.

Abstract:AIM:To evaluate the therapeutic effect of localized mitomycin C(MMC) applied in operation for treating patients with pterygium. ·METHODS:Totally of 259 patients 279 eyes with pterygium by corneal incursion more than 2mm were received 0.2mg/mL MMC on sclerae for 3 minutes after pterygium resection under microscope. Subsequently,all eyes were treated with tobramycin and dexamethasone eyedrop (qid) and tobramycin and dexamethasone ointment (qn) for 1 week postoperatively. The corneal infiltration,blood vessels and plump degree of pterygium were observed. The follow-up of 12 to 18 months were carried out to all of patients. ·RESULTS:After operation,271 eyes with pterygium were cured,which occupied 97.1%. Recrudescence was found in other 8 eyes with proportion of 2.9%,the patients suffered unilateral pteygium in one eye,unilateral pterygium in both eyes and bilateral pterygia in one eye were 1.8%,2.5%,14.3% respectively. ·CONCLUSION:Localized MMC intraoperatively is an effective treatment for primary pterygium when it only occurred in one eye with low recrudescence and without side-effect. However,the unilateral pterygium in both eyes or bilateral pterygia in one eye are still have high incidences to recur.

Abstract:AIM:To evaluate the effect of limbal stem cell autograft transplantation combined with mitomycin C in the treat-ment of pterygium. ·METHODS:Totally 258 cases 272 eyes patients of newly developed pterygium (229 eyes) and recurrent pterygium (43 eyes) were performed limbal stem cell autograft transplantation combined with mitomycin C. The postoperative follow-up period ranged from 12 to 24 months. ·RESULTS:Fourteen eyes of newly developed pterygium and 3 eyes of recurrent pterygium (6.3%) were recurred. ·CONCLUSION:The method of limbal stem cell autograft transplantation combined with mitomycin C drops can reduce the recurernce rate.

Abstract:AIM:To observe clinical effect of pterygium excision combined with autologous limbal stem cell transplantation under microscope. ·METHODS:Totally 102 patients 104 eyes with primary pterygium underwent pterygium excision combined with autologous limbal stem cell transplantation by microscope and the postoperative recurrence rate was observed. ·RESULTS:All patients were followed up from 3 to 12 months. 6 cases recurred after surgery,and the recurrence rate was 5.8%. ·CONCLUSION:Pterygium excision combined with autologous limbal stem cell transplantation under microscope can reduce the recurrence rate of primary pterygium,and is a surgical method worth extending in primary hospital.

Abstract:AIM:To discuss the major determinant factors of visual pro-gnosis of mechanical ocular trauma by statistical analysis and retrospective study of the 300 patients. ·METHODS:This is a retrospective study on 300 cases with mechanical ocular trauma in recent 5 years.We recorded and analyzed the following details:general state of health,left or right eye,cause of injury,whether treated in time,vision of admission,vision of discharge. ·RESULTS:Sex distribution:male 8/9,female 1/9. Most of patients fell in the age group of between 5-10 and 35-45,and with the highest sex distribution of 14:1 at the age group of 15-20. Open wound of eyeball,ocular and its appendages contusion were most frequently seen. Injury caused by foreign object was most frequently seen in open wound of eyeball. Most of patients had a significant visual improvement at the time of discharge (P<0.05). The major determinant factors of the visual prognosis after treatment were summarized as following:causes of the injury;whe-ther treated within 24 hours. ·CONCLUSION:Most of the ocular trauma comes from blunt injury,sharp instrument injury and explosion injury. The major determinant factors of the visual prognosis after treatment are summarized as following:cause of the injury,whether treated within 24 hours.

Abstract:AIM:To discuss the method of finding the rupture point of the lacrimal canaliculus and the result of applying the line-drafted silicone tube in the nasolacrimal anastomosis. ·METHODS:Retrospectly 18 cases 18 eyes with lacrimal canaliculus rupture in our hospital in the past five years were studied,the research contained the method of seeking the rupture point of the lacrimal canaliculus under the operating microscope and the result of using of the silicone tube as a support for lacrimal canaliculus for nasolacrimal anastomosis. ·RESULTS:Totally 18 cases were all successful and irrigation of lacrinal passages was good in half a year. ·CONCLUSION:Seeking the rupture point of the lacrimal canaliculus under the operating microscope is easy and implanting the silicone tube as a support can make patients more comfortable and reduce postoperative complications.

Abstract:AIM:Many ophthalmologists prevent the lacrimal duct stenosis by injecting ointment or gel into lacrimal,but sometimes the formation of granuloma by overflow ointment or gel. In this article,we explore the surgical treatment for this disease. ·METHODS:From April 2004 to December 2009,9 patients with granuloma by overflow ointment or gel in our hospital with medial lower eyelid induration in 7 cases,the medial upper eyelid induration with ptosis in 2 cases,respectively. Skin incision was taken under the lower eyelid eyelashes (1.5mm)and the upper double eyelid line; subcutaneous tissue was separated; after that,the induration was exposed and removed; Upper eyelid ptosis was corrected. Removed tissues were sent for pathological examination. ·RESULTS:After followed up for 3 months to 6 years,all 9 patients had symmetrical appearence with the induration and bulge disappeared,and the eyelid of depression and ectropion did not occur. Ptosis had the satisfactory effect. Pathological results were granulation hyperblastosis. ·CONCLUSION:False passage formed by the uncorrected probing of lacrimal passages without anatomy path,after that,the injected ointment or gel can overflow into the subcutaneous,and stimulate the granuloma proliferation.The original matrix of drugs may be the main stimulus;Besides,allergic constitution is also one of the main reasons. No visible scars occur after surgery on the ower eyelid and upper eyelid line under (1.5mm). After complete removal of mass granuloma,no relapse occurred. Removing the tumor quickly is the only treatment method of this disease.

Abstract:AIM:To explore the clinical characteristics of ocular cicatricial pemphigoid,and provide assistance in clinical diagnosis and therapy. ·METHODS:The data of 35 cases of ocular cicatricial pemphcgoid from January,2002 to January,2008 was retrospectively analyzed. ·RESULTS:The average age of ocular cicatricial pemphigoid was 62.4 years,and the rate of male and female gender was 20/15. The average history was 3.3 years. The oral mucosa was firstly invaded in 51.43% patients,ocular mucosa in 31.43% ones,and other mucosa in 17.14% ones. In eye-involved patients,the rate of eyelid entropium and trichiasis,dry eye and chronic conjunctivitis,and corneopathy was 5/4/2. After treatment,71.43%(25/35) cases were cured,while 14.29% (5/35)cases were not cured,and 14.29%(5/35)cases did not accomplished the regimen. In the course of treatment,the complications were found in 37.14% (13/35)cases,and among these,abnormal liver function was found in 6 cases and 2 cases withdrew from treatment,abnormal kidney function in 2 cases and 1 case discontinued the protocal,abnormal blood system in 3 cases and 1 case quitted the regimen,myocardial infarction in 1 case who gave up the treatment,and apparent blood hypertension in 1 case. ·CONCLUSION:Cicatricial pemphigoid is a chronic ailment and often involved in the elderly. Male patients are more than female ones,and ocular tissue is often involved. Dry eye disease,symblepharon,entropion and trichisis are all its manifestations. The treatment of cicatricial pemphigoid is complicated,and multidisciplinary collaboration is required.

Abstract:AIM:To study the effect of 2.5g/L tropicamide eye drops for treating pseudomyopia in school-aged children. ·METHOD:The clinical data of 135 cases (270 eyes) treated by 2.5g/L tropicamide eye drops were retrospec-tively analyzed. ·RESULT:After treating by 2.5g/L tropicamide eye drops,children’s distant vision improved and myopia degree decreased,no drug adverse reaction was observed. ·CONCLUSION:Tropicamide eye drops 2.5g/L is safe and effective for treating pseudomyopia in school-aged children.