Abstract:AIM:To study metalloproteinases(MMP) and tissue inhibitors of metalloproteinases(TIMP) expresion in cornea of mice with alkaline burns treated with amniotic membrane transplantation (AMT),and to evaluate the effect of AMT in treatment of alkaline burns.METHODS:Forty Balb/c mice were divided into two groups (experimental group and control group) and their right eye corneas were burned with alkali(NaOH).The cornea was treated with AMT and secured with a tarsorrhaphy in experimental group,while the control group underwent tarsorrhaphy alone.At different time points(0,2,7,14 days) after AMT,mice were killed and the expressions of MMP and TIMP in cornea were measured by the Western blot technique,and the results were analyzed by enhanced chemiluminescent(ECL).RESULTS:In control group,MMP -2,8,9 expressed in the stromal cells and epithelial inflammatory cells.The level of MMP -2,8,9 elevated from the 2nd day,peaked on the 14th day.TIMP-1 expression was only slightly upregulated after alkaline burn at day 2,and expressed on the 7th day,peaked on the 14th day.TIMP-2 expression was increased at 2nd day,and significantly increased at 14th day.At the same time point,the level of MMP -2,8,9 in AMT group were greatly lower than that in control group(all P<0.01),while the level of TIMP-1,2 in AMT group were greatly higher than that in control group(all P<0.01).CONCLUSION:AMT may inhibit MMP expression and promote TIMP expression in cornea,lower rapid resolution of corneal inflammation and ulceration,and play a vital role in corneal remodeling.

Abstract:AIM:To report unusual exacerbation of recurrent acquired ocular toxoplasmosis and improvement of visual outcome with proper treatment in an immunocompetent individual.METHODS:Case report.RESULTS:A 21-year-old Bisaya girl,otherwise healthy,with contact history with cats,presented with right eye painless and progressive blurring of vision for two weeks.The visual acuity was 6/15 in the right eye and 6/6 in the left eye.Fundus examination showed focal retinitis in the posterior pole with swollen hyperemic optic disc in the right eye and old retinochoroidal scars in the periphery of both eyes.She had right recurrent ocular toxoplasmosis that was confirmed with toxoplasma serology.Initially,she responded to two different treatments such as bactrim and azithromycin.Unfortunately,she developed two episodes of exacerbation of toxoplasmosis in right eye during the course of treatment.Her right eye visual acuity was decreased to 6/60.The medication regime consisted of oral azithromycin with tapering doses of corticosteroids was subsequently initiated in this patient for 6 weeks.The toxoplasmic retinitis in the right eye was resolved and there was no recurrence during the last 1 year follow-up.Her final visual acuity was 6/30 in right eye and 6/6 in left eye.CONCLUSION:Recurrent acquired ocular toxoplasmosis in an immunocompetent individual is not common.Delayed diagnosis and treatment result in permanent blindness.Prompt,adequate and compliance of treatment are essential to prevent this devastating visual complication.

Abstract:AIM:To evaluate the effect of adeno-associated virus (rAAV)mediated encoding endostatin(ES) gene transfection for inhibiting experimental corneal neovascularization (CNV).METHODS:Sixty healthy SD rats were sutured on the superior cornea.Animals were randomly divided into 4 groups(A,B,C,D).50μL of rAAV-ES solution was injected into subconjunctiva immediately after sutured in the group A.After scraping off epithelium,the cornea was soaked in the rAAV-ES solution for 10minutes in the group B.After scraping off epithelium,the cornea was soaked in the rAAV-ES solution for 10minutes and 50μL of rAAV-ES solution was injected into subconjunctiva in the group C.50μL of saline was injected into subconjunctiva in the group D.Eyes were examined by a slit-lamp biomicroscope and a surgical microscope was used to monitor angiogenesis in response to rAAV-ES transduction.The size of CNV area was measured and calculated.The ES gene expression in inflammatory cornea of rats was detected by immunohistochemistry after transduction with rAAV-ES.The sections were stained with hematoxylin and eosin to measure the CNV density.RESULTS:The occurrence and development of CNV were observed by slit-lamp microscope after transduction with rAAV-ES.After suturing,CNV increased gradually,peaked on day 14,and decreased gradually,degenerated on day 21 after suture induction.Analysis of variance of repeated data showed that there was crossover effect of time and treatment factors(F=175.810,P<0.01).At each transducted group,there was a significant difference between any two groups(F=2243.816,P<0.01).The size of CNV areas of group C was significantly smaller than that of the group A,B and D at each time point.Accordingly,the size of CNV areas of group D was the largest,but the size of CNV areas of group C was the smallest after transduction with rAAV-ES.At each time point,there was a significant difference between any two groups(F=1060.854,P<0.01).Inhibition ratio of CNV was increased gradually after transduction,and the highest inhibition ratio of CNV was detected in group C on day 28 after suture induction.CNV density was lower in transducted group than in control group.The ES gene expression in inflammatory cornea of rats was detected by immunohistochemistry after transduction with rAAV-ES.Only corneal epithelium was stained brown in group A,some of corneal epithelium and NV endothelial cells in superficial stroma of cornea were stained brown in group B,and most of corneal epithelium and NV endothelial cells in superficial stroma of cornea were stained brown in group C,but corneal cells were not stained at all in group D.The sections were stained with hematoxylin and eosin to measure the CNV density.CNV density was lower in transducted group than in control group.CONCLUSION:There was a significant inhibitory effect on neovascularization in rat inflammatory CNV model after rAAV-ES transduction.The inhibitory effect on CNV was higher by use of combined delivery approaches than by use of either one,i.e.the cornea was soaked in the rAAV-ES solution after scraping off epithelia or the rAAV-ES viral particles were injected into subconjunctiva.

Abstract:AIM:To evaluate the role of intercellular adhesion molecule-1(ICAM-1) in the pathogenesis of diabetic cataract,and to investigate the effects of transforming growth factorβ-1(TGF - β1) on the expression of ICAM-1 in the lens epithelium cells.METHODS:Totally 120 SD rats were randomly divided into two groups:normal control group and diabetic cataract group.Diabetic model was built in diabetic cataract group.Immunohistochemical streptavidin-peroxidases(SP) method was used to observe changes of the expression of ICAM-1 in the lens epithelium cells in two groups.RT-PCR method was used to detect the effects of TGF-β1 and TGF-β1 antibody on the expression of ICAM-1 in the cultured human lens epithelium cells.RESULTS:The expression of ICAM-1 in the lens epithelium cells was significantly higher in diabetic cataract group than that in normal control group,and increasing with the development of disease (P<0.01).The expression of ICAM-1 in the lens epithelium cells was significantly increased in TGF-β1 cultured group,which had statistical significance compared with normal serum cultured group(P<0.05).The expression of ICAM-1 was significantly inhibited in TGF-β1 antibody cultured group,which had statistical significance compared with TGF-β1 cultured group(P<0.05).CONCLUSION:TGF-β1 could induce the expression of ICAM-1 in the lens epithelium cells,and played an important role in the occurence of diabetic cataract through promoting attachment and proliferation of lens epithelium cells.

Abstract:AIM:To investigate the protective effect of ZnSO4 on ultraviolet-induced oxidative damage of rat lens.METHODS:Rat lens were randomly divided into 3 groups:negative control group (normal group),positive control group (UV radiation group) and experimental group (treated by UV radiation and ZnSO4).After cultured,the turbid level of lens was observed;the contents of glutathione peroxidase(GSH-Px) and superoxide dismutase(SOD) in tissue as well as the expression changes of heat shock protein 70(HSP70) in rat lens epithelial cells were determined.RESULTS:The turbid level of lens in experimental group was lower than that in positive control group at the same time,the differences were statistically significant (P<0.05).The expression of HSP70 in experimental group significantly increased after UV radiation,there was significant difference compared with that in positive control group (P<0.05).The contents of GSH-Px and SOD in positive control group were much lower than that in negative control group,the differences were statistically significant (P<0.05),while the contents of GSH-Px and SOD in experimental group were significantly higher than that in positive control group,the differences were statistically significant (P<0.05).CONCLUSION:ZnSO4 can induce HSP70 expression in rat lens epithelial cells,which may play a vital role in lens oxidative damage protection.

Abstract:AIM:To explore gap junctional intercellular communication(GJIC) in cultured human Tenon’s capsule fibroblasts(HTFs) and detect the expression and distribution of connexin43(Cx43).METHODS:GJIC were demonstrated by scrape-loading and Lucifer yellow dye transfer methods.RT-PCR and Western blot were carried out to detect mRNA and protein expression of Cx43.Immunocytochemistry was performed to observe the distribution of Cx43.RESULTS:Cultured HTFs demonstrated functional GJIC in vitro.The transporting degree of Lucifer yellow dye was more than 6 grades.The mRNA and protein expression of Cx43 were also detected.Cx43 were located on cells’ membrane by immunocytochemistry.CONCLUSION:Cultured HTFs have GJIC function which confer these cells the ability to establish and maintain intercellular communication mediated by Cx43.This property may be critical in maintaining function synchronization of fibroblasts during wound-healing process.

Abstract:AIM:To culture the human Tenon’s capsule fibroblast (HTF) in vitro and observe its proliferative activity.METHODS:Human Tenon’s capsule was obtained from strabismus surgery patients.Fibroblasts were primarily cultured and identified by immunofluorescence staining.Represented by growth curve,the cell viability was detected by cell counting kit-8(CCK-8).Cell cycle was observed by flow cytometer analysis and proliferation index were calculated.RESULTS:HTF were cultured successfully from culture in vitro.There was no significant difference of proliferative activity in different passages of HTF(P>0.05).CONCLUSION:HTF is an ideal target cell in the study on anti-fibrosis of human Tenon’s capsule due to its convenience of culturing and stable proliferative activity.

Abstract:AIM:To investigate the effects of ERG in rats at simulated plateau-hypoxia environment.METHODS:Forty-five healthy Wistar rats were randomly divided into 650m(the altitude of Urumchi)altitude group,simulated 3000m altitude group and simulated 5000m altitude group.Rats in simulated 3000m altitude group and simulated 5000m altitude were put into the 3000m altitude hypobaric chamber and the 5000m altitude hypobaric chamber respectively.All of them underwent F-ERG a wave,b wave and Ops tests at the 7th day after bred.RESULTS:The amplitudes of F-ERG a wave,b wave and Ops in the simulated 5000m altitude group were significantly lower than those in the 650m altitude group and the simulated 3000m altitude group.The latencies of ERG and Ops were delayed in the simulated 3000m altitude group rats,without significant differences compared with the 650m altitude group(P>0.05).There were significant differences in the latencies of ERG and Ops between the 650m altitude group and the simulated 5000m altitude group,the simulated 3000m altitude group and the simulated 5000m altitude group(P<0.05).But there were no significant differences in the latencies of ERG and Ops between the simulated 3000m altitude group and the 650m altitude group(P>0.05).CONCLUSION:The retinal neurons were damaged in the simulated 5000m altitude group,which was not significant in the simulated 3000m altitude group.

Abstract:AIM:To investigate the effects of subconjunctival gentamicin injection on rabbit retina.METHODS:Ten healthy rabbits weighted 2.0-2.5kg without binocular disorders were selected,and divided into 4 groups,3 experimental group(3 rabbits 6 eyes of each group),1 control group(1 rabbit 2 eyes).3 experimental groups received binocular subconjunctival gentamicin injection 5000μ,10000μ,20000μrespectively.Control group received binocular normal saline injection.Aqueous and vitreous fluid were extracted from these ten rabbits every day and measured the concentration with TDX/FLX.At the third day,retinas were taken to make light microscope samples in order to observe cytohistomorphology of retina,and using TUNEL to detect the apoptosis.RESULTS:The gentamicin concentration of rabbit aqueous and vitreous fluid increased as the subconjuctival injection dosage increased.Obvious pathological changes were observed in retina of experimental group.The number of apoptotic retina cells of the experimental group evidently increased than which in the control team.CONCLUSION:Subconjunctival injection of gentamicin should be prohibited in clinic for its obvious retinal toxicity.

Abstract:AIM:To investigate the expression of matrix metalloproteinase-2(MMP-2)and matrix metalloproteinase-14 (MMP-14) in retinoblastoma (Rb),and their relationships with tumor development stage.METHODS:Immunohistochemitry was used to detect the expression of MMP-2 and MMP-14 in 50 cases of paraffin embedded Rb samples.Quantitative analysis of the expression of MMP-2 and MMP-14 was assessed by HMIAS-2000 Color Pathologic Analysis System.The differences of the expression of MMP-2 and MMP-14 in each clinical and pathological stage were analyzed statistically.RESULTS:Positive expression rate of MMP-2 was 76% (38 cases)and of MMP-14 was 82%(41 cases).The expression of MMP-2 and MMP-14 was significantly higher in tumors with optic nerve invasion than in tumors without optic nerve invasion (P<0.01);the expression of MMP-2 and MMP-14 was significantly higher in tumors of extra-ocular stage than in tumors of glaucomatous stage or intra-ocular stage (P<0.01);There was a statistically significant positive correlation between the expression of MMP-2 and the expression of MMP-14 (P<0.01).CONCLUSION:MMP-2 and MMP-14 exist in retinoblastoma cells.The level of MMP-2 and MMP-14 is related to optic nerve invasion and clinical stage of Rb,which suggests the expression of MMP-2 and MMP-14 could be connected to the invasion and development of tumor cells.Further research is needed for deeper understanding of the biological behavior and better evaluation of the prognosis of Rb.

Abstract:AIM:To detect the thickness and structural profiles of the retina and choroid in guinea pig eyes by optical coherence tomography (OCT),and discuss the correlation of thickness of the retina and choroids in guinea pig and histology examination.METHODS:Five guinea pigs (3 weeks old) underwent refractive evaluation in both eyes followed by routine OCT for posterior pole of the fundus.Then these 5 guinea pigs were euthanized and underwent histology examination.RESULTS:There was a highly positive correlation in retinal thickness between OCT and histology (r=0.77,P<0.01).The retina thickness by OCT was 15-20μm thicker than that by histology.But there was no significant correlation in choroid thickness between OCT and histology (r=0.19,P=0.203).CONCLUSION:Thickness of the retina and choroid in guinea pigs both can be detected by routine OCT.

Abstract:AIM:To study the effects of multifocal intraocular lens implantation (MIOL) in cataract refrective surgery.METHODS:After small incision phacoemulsification,MIOL was inserted into the eyes of 19 cases (25 eyes),monofocal intraocular lens (SIOL) was inserted into the eyes of 14 cases (20 eyes).30-52 months after intraocular lens implantation,near visual acuity,intermediate visual acuity at different contrast and postoperative spectacle dependency were evaluated.RESULTS:At 40cm 100% contrast,MIOL got 54.64±10.80 scores and SIOL got 47.05±6.39 scores.There was statistically significant differences between MIOL and SIOL (P<0.05).At 40cm 10% contrast,MIOL got 42.60±6.47 scores and SIOL got 34.55±5.86 scores.There was statistically significant differences between MIOL and SIOL (P<0.05).Score of visual acuity at 63cm and 100cm at different contrast was no significantly statistical difference between two groups.Multifocal group of near use had a higher spectacle independence rate.CONCLUSION:MIOL provides a satisfactory vision at different contrast.

Abstract:AIM:To compare the differences of the intraocular pressure(IOP) measured by four methods:non-contact tonometer (NCT),Goldmann applanation tonometer (GAT),dynamic contour tonometer (DCT) and Pentacam three-dimensional anterior segment analyzer,and to study the relationship between these measuring methods with central corneal thickness (CCT) and central corneal curvature (CCV).METHODS:After measured CCT and CCV by Pentacam system,the IOP of 143 patients (286 eyes) which would be treated by LASIK operation was measured by NCT,GAT and DCT respectively.Then 5 methods were used:Ehlers,Shah,Dresden,Orssengo/ Pye and Kohlhaas proposed by Pentacam system to correct the IOP which was measured by NCT.Finally analysis of variance(ANOVA),correlation and linear regression analysis were adopted to evaluate the IOP data.RESULTS:IOP of DCT was the highest.There was significantly different between DCT and other methods (P<0.01);There was difference between GAT and DCT,Kohlhaas,Shah (P<0.05) and no difference between GAT and other methods;Each group IOP had good correlation,GAT and DCT had strongest correlation (r=0.702);CCT had more influences on NCT IOP,CCV had more influences on GAT,there was no correlation between DCT,Dresden,Orssengo/ Pye,Shah and CCT,CCV (P>0.05).CONCLUSION:The healthy persons with normal CCT and CCV are recommended using applanation tonometer for glaucoma screening.The suspected patients whose CCT and CCV are departure from normal are suggested to check farther by DCT or to correct IOP by Pentacam system.

Abstract:AIM:To compare Wavelight Allgegrotto Wave Eye-Q and Zeiss Meditec MEL 80 Excimer Lasers about corneal ablation depth after customized aspheric ablation to correct mild and moderate myopia.METHODS:Prospective comparative study.58 cases(108 eyes) with myopia were randomly divided into two groups.31 cases(55 eyes) in group A were treated by Lasik with Wavelight Allgegrotto Wave Eye-Qand the other 27 cases(53 eyes) in group B were treated by Meditec Mel 80.The patients in group A were divided into group A1 and A2 according to the shortsighted degree,representing mild and moderate subsets respectively.The patients in group B were divided into group B1 and B2 as well.Both excimer lasers applied Q-index optimized ablation profile.Moria M2 Automatic Microkeratome was used to operate corneal flap.Treatment zone diameter and optical zone diameter were uniform in all cases.Corneal thickness were measured before and 1 month after surgery.Multiple independent sample mean used single-factor analysis of variance statistically.RESULTS:The actual corneal ablation depth and the theoretical corneal ablation depth didn’t differ significantly in A1 and A2(P=0.081,0.444).The actual corneal ablation depth was less significantly than theoretical corneal ablation depth in B1 and B2(P=0.000,0.000).The theoretical corneal ablation depth in group A1 was significantly less than that in group B1(P=0.001) and similar in moderate subset groups(P=0.000).Actual corneal ablation depth was no different between group A1 and B1(P=0.832)and similar in moderate subset groups(P=0.884).CONCLUSION:Wavelight Allegretto Wave Eye-Q and Mel 80 excimers laser have similar actual corneal ablation depth.Theoretical corneal ablation depth in group A has no difference from the actual one and can be used to predict postoperative corneal thickness exactly.Theoretical corneal ablation depth in group B is much more than the actual one.

Abstract:Worldwide experiences with pediatric cataract surgery and intraocular lens (IOL) implantation are constantly evolving.Expectations of good outcomes by the patients,families,and surgeons are also increasing,therefore continued efforts to improve surgery techniques,perfect surgery method and select suitable IOL are critical to prognosis.

Abstract:As a special kind of calmodulin,oncomodulin (OncoM or OCM) has always been considered as a regulatory factor in the occurrence,growth of tumor only.However,researches of recent years showed that OCM also played an important role in optic nerve repair,which provided a broad field for the treatment of optic nerve injury.Roles and research advance of OCM in optic nerve repair are reviewed in this paper.

Abstract:Ophthalmic gel in situ is the use of polymeric materials respond to external stimulation,so that the polymer in physiological conditions occur dispersion state or conformational reversible change,completed by the solution to gel process.This article introduced the ophthalmic gel classification,characteristics and other aspects in detail,and summarizes pharmaceutical research progress.

Abstract:Anisometropia is when meridian is different in one or both eyes in refractive power.Anisometropia is a common cause of amblyopia in children.Its incidence shows a gradual upward trend with age.Anisometropia is not only due to differences in axial length but also other causes.Amblyopia is caused by integration difficulties and decreased stereopsis when anisometropia reached a certain degree.The pathogenesis of anisometropic amblyopia is complex.In recent years the neural mechanism has been achieved some results by magnetic resonance.At present correction methods of anisometropia included glasses,coverage and drug treatment,rigid gas permeable contact lenses (RGP),refractive surgery,et al.Glasses combined with coverage and drug treatment are the most traditional treatments.Glasses has weekness which can not be avoided but RGP can overcome this difficulty.Refractive surgery can avoid optical aberrations and improve stereopsis better than RGP and glasses.

Abstract:AIM:To analyse the relationship between amplitude of accommodation(AMP) and stereopsis and the different refractive status of college students.METHODS:Refractive data of 150 college students were performed objective and synthetic optometry and related binocular visual functional examination including stereopsis,AMP,et al.Refractive error data were converted into spherical equivalent (SE).According to myopia existence,students were divided into emmetropia group (11 students,+0.75D≤SE<- 0.50D) and myopia group (139 students,SE≥-0.5D).According to refractive status,myopia were subdivided into low myopia of 51 cases (-0.5D≤SE≤-3.0D),moderate myopia of 69 cases (-3.0D<SE≤- 6.0D),and high myopia of 19 cases(SE>- 6.0D).Depending on whether there was anisometropia or not,subjects was defined as anisometropic group of 27 cases(spherical degree difference was≥-1.5D,cylinder degree difference was≥-1.0D)and non-anisometropic group of 123 cases(spherical degree difference was<1.5D,cylinder degree difference was<1.0D).Then the different binocular visual functions of the different groups were analysed.RESULTS:The AMP of emmetropia was lower than that of myopia group(t= 1.16,P<0.05).There was difference in the AMP among the three subdivided groups of myopia (F=1.474,P<0.05).The deeper degree of myopia,the higher level of AMP,but only the high myopia had significant difference from the other ones(P<0.05).There was no significant difference in stereopsis between emmetropia and myopia (χ2=0.325,P>0.05).There were no significant differences among low,moderate and high myopia (χ2=0.16,P>0.05).The anisometropia had an impact on stereopsis,people who had anisometropia had a poor stereopsis,the result was statistically significant(Fisher,P<0.05).CONCLUSION:The AMP of emmetropia is lower than the myopia group.In myopia,the AMP and the degree of myopia is positively correlated.People who have anisometropia have a poor stereopsis.

Abstract:AIM:To explore good method for preventing and curing amblyopia by epidemiological analysis of amblyopia for preschool children in Suizhou urban area.METHODS:First,the preschool children were trained before the vision test by the nursery school teacher.Second,their vision were tested by the ophthalmologist in our hospital again and again.The naked vision less than 0.8 and strabismus were classified as further mydriasis optometry examination object.Then full-time pediatric ophthalmologists performed pupil dilation,refractive stromal and fundus examination to exclude the ocular organic disease.Retinoscopy optometry and corrected visual acuity were checked.Then the relation of amblyopia with low vision,gender,age,various types of amblyopia and the distribution ratio of different fixation properties were observed.RESULTS:Male and female had no significant difference in the preschool children with low vision and the prevalence of amblyopia,.In the 3- 6 years age group,the rate of low vision had a very significant difference.In ametropic amblyopia,the largest proportion was mild amblyopia,followed by moderate amblyopia,only 1 case of severe amblyopia.In anisometropic and strabismic amblyopia,the largest proportion was moderate amblyopia.In form deprivation and other amblyopia,severe amblyopia occupied the largest proportion.The higher the hyperopic ametropia degree,the larger the proportion of moderate amblyopia.Strabismic amblyopia was always associated with hyperopia.Concomitant strabismus and refractive errors were closely related.It was generally believed that there was a relationship between concomitant strabismus and hyperopia,and little relationship between exotropia and myopia.CONCLUSION:For preschool children in kindergarten,vision screening,early detection of amblyopia and early treatment is necessary.In children with amblyopia,it is mainly ametropic,mild to moderate and central fixation amblyopia,timely treatment is very helpful to recovery of children.Combination therapy was commonly used in treatment of amblyopia.The knowledge of amblyopia and its harmfulness publicity should be increased,parents and social awareness and attention on amblyopia should be improved.

Abstract:AIM:To evaluate the effect of deep lamellar keratoplasty for the treatment of keratoconus.METHODS:Deep lamellar keratoplasty was applied for treatment of 132 cases (140 eyes) with keratoconus.The effectiveness of operation was clinically observed and evaluated.Postoperative follow-up were 6- 48 months.RESULTS:The postoperative corrected vision was 0.2- 0.4 in 13 cases (14 eyes),>0.4- 0.8 in 92 cases (96 eyes),>0.8 in 27 cases (30 eyes).Rejection occurred in 5 eyes,clear graft in 131 cases (139 eyes),semitransparent in 1 cases (1 eye),8 eyes appeared Descemet’s layer folds.CONCLUSION:Deep lamellar keratoplasty with fewer complications,can reduce the incidence of endothelial rejection.Postoperative visual acuity is good,and there is less demanding on the donor material,etc.It provides a safe and effective choice for the treatment of keratoconus.

Abstract:AIM:To investigate the surgically induced refractive change after phacoemulsification with selective maximum astigmatic axis clear corneal incision.METHODS:All 96 cases (112 eyes) with cataract were randomly divided into three groups,group A received temporal transparent corneal incision (34 cases,39 eyes);group B received transparent corneal incision at 11 O’clock(26 cases,31 eyes);group C received highly selective transparent corneal incision at steepest corneal meridian guided by corneal curvature (36 cases,42 eyes).RESULTS:There was no statistically significant difference in visual acuity in three groups before and 1 week after operation (P>0.05).The visual acuity in group C was much better than that in group A and B before and 1 month,3 months after operation (P<0.05),but there was no statistically significant difference between group A and B(P>0.05).The corneal astigmatism degree of group C was much lower than that of group A and B 1 month and 3 months after operation (P<0.05).CONCLUSION:The incision at the steepest corneal meridian guided by corneal curvature has the least effect on corneal astigmatism and can improve visual acuity rapidly.The surgically induced astigmatism can be controlled effectively and patients can gain better visual acuity.

Abstract:AIM:To establish a method for rapid detection of clinical suspect fungal corneal ulcer by reverse transcription-polymerase chain reaction(RT-PCR).METHODS:A pair of oligonucleotide sequences,which was based on the conserved region of 18srRNA shared by medically important conditioned fungi,was used as the general primers to amplify the DNAs from clinical suspect fungal corneal ulcer in a RT-PCR assay,and the result was compared with culture.RESULTS:A 400bp specific DNA product was successfully amplified.The positive rate of fungi culture among 26 clinical specimens was 61.9%,while that of RT-PCR amplification was 73.8%.In addition,the accuracy of PCR method in this study was 83.8%,the sensitivity was 100.0%,and the specialty was 33.3%.CONCLUSION:PCR with the general primers is suitable for rapid detection of fungal corneal ulcer because of quickness and high positive rate.

Abstract:AIM:To study the clinical effects of compound trabeculectomy in the second filtration surgery and compare the safety and effectiveness between traditional trabeculectomy and compound trabeculectomy.METHODS:Totally 24 cases(24 eyes)of glaucoma for the second filtration surgery were randomly divided into two groups,14 cases (14 eyes) who underwent compound trabeculectomy(traditional trabeculectomy combined with mitomycin and adjustable sutured scleral flap) were observation group and 10 cases (10 eyes) underwent trabeculectomy(traditional trabeculectomy combined with mitomycin) as control to compare the postoperative intraocular pressure(IOP),filtration,the depth of anterior chamber and postoperative complications between the two groups.RESULTS:Twenty-four eyes were successful.In the follow-up of 12 months,on the first day of postoperation,the incidence rate of shallow anterior chamber in observation group and control group were 7% and 30% respectively(P<0.05).12 months later,the rate of IOP from 6-21 mmHg in observation group and control group were 86% and 40% respectively (P<0.05).Functional filtering bubbles were 86% and 40% respectively (P<0.05).CONCLUSION:Compound trabeculectomy is effective and safe in the second filtration surgery and superior to the traditional trabeculectomy.The key of successful operation lies in using mitomycin and adjustable sutured scleral flap.

Abstract:AIM:To investigate the effect of mitomycin C in the surgery of trabeculectomy combined with extracapsular cataract extraction and IOL implantation.METHODS:Thirty-two patients with glaucoma and cataract were chosen and randomized to two groups,mitomycin group and control group.Both of the two groups were performed trabeculectomy combined with extracapsular cataract extraction and IOL implantation.0.2g/L mitomycin C was used for 3minutes in the mitomycin group.The complications,operative effect and postoperative visual acuity were compared 12 months after surgery.RESULTS:There were no significant differences in shallow anterior chamber,best corrected visual acuity and patients who needed Nd:YAG posterior capsulotomy in two groups,but the incidence of functional filter bleb in mitomycin group was significant more than that of control group,and the failure of the surgery in mitomycin group was significant less than that of control group.Both groups had no bleb leak,malignant glaucoma or endophthalmitis in follow-up.CONCLUSION:Mitomycin C can certainly increase the success of triple surgery without increasing the incidence of complications.

Abstract:AIM:To discuss the treating method and the clinical efficacy on combined surgery of glaucoma with cataract.METHODS:Phacoemulsification and intraocular lens implantation combined with trabeculectomy inside the tunnel was performed on 45 cases(45 eyes) of glaucoma with cataract.RESULTS:There were 32 eyes of which the preoperative visual acuity was﹤0.1,0.1- 0.3 in 13 eyes.There were 6 eyes (13%)of which the postoperative visual acuity was<0.1,0.1- 0.5 in 22 eyes (49%),>0.5 in 17 eyes(38%).The postoperative IOP was normal in 42 cases.The average value of IOP was 12.78±2.70mmHg.The main postoperative complications included corneal edema and iritis.The follow-up after surgery was 6-12 months.No case of IOP increased.Visual acuity declined in 3 cases.CONCLUSION:The phacoemulsification and intraocular lens implantation combined with trabeculectomy inside the tunnel is an ideal method in treating glaucoma with cataract.

Abstract:AIM:To investigate the influence to dilated pupil’s diameter of cataract patients with nonprohferative diabetic retinopathy (NPDR) by manual small incision cataract surgery (MSICS) and phacoemulsification(Phaco).METHODS:Pilot study.Sixty eyes of cataract patients with NPDR were divided into two groups,MSICS group of 30 eyes and Phaco group of 30 eyes.The pupil was dilated by Compound Tropicamide.The diameter of dilated pupil was compared before and after the cataract surgery.RESULTS:Before surgery,the dilated pupil’s diameter of MSICS group was 6.23±0.83mm,and Phaco group was 6.26±0.85mm.There was no significant difference between the two groups(P>0.05).Before and after the surgery,the difference of the dilated pupil’s diameter of MSICS group was 0.11±0.094mm,Phaco group was 0.17±0.119mm.The difference was significant(P<0.01).There was significant difference between the MSICS group and Phaco group in those above(P<0.05).CONCLUSION:Both MSICS and Phaco can reduce the diameter of dilated pupil of the cataract patients with NPDR.The phacoemulsification seems to reduce more.

Abstract:AIM:To evaluate the efficacy of intravitreaI Becacizumab (IVB)combined with grid photocoagulation for the treatment of cystoid macular edema(CME)associated with central retinaI vein occlusion(CRVO).METHODS:Tirty-two cases(32 eyes)of CME associated with CRVO made a definite diagnosis by FFA were divided into two groups randomly.IVB combined with grid photocoagulation group(A group):16 eyes.Grid photocoagulation group(B group):16 eyes.Best corrected visual acuity(BCVA),central macular thickness(CMT),intraocular pressure(IOP) and complications at 4 weeks,12 weeks,24 weeks after treatment in these eyes were examined and compared between the two groups.RESULTS:BCVA of A group had improved and CMT were 351.81±57.68μm,320.44±58.94μm,296.50±52.15μm respectively at 4,12,24 weeks after treatment.Both of them had statistical significant difference before and after treatment.CMT of B group were 526.56±88.92μm,441.06±94.06μm,374.31±106.07μm respectively at 4,12,24 weeks after treatment.There was statistical significant difference before and after treatment.IOP of the two groups had no statistical significant difference before and after treatment.The energy and laser spots of B group were much more than those of A group.CONCLUSION:IVB combined with grid photocoagulation for the treatment of CME associated with CRVO has better efficacy than grid photocoagulation alone.

Abstract:AIM:To observe the effectiveness and safety of the treatment on vitreous hemorrhage by combining the injection of urokinase (UK) in vitreous cavity with triamcinolone acetonide (TA).METHODS:Totally 52 cases (52 eyes) who were finally diagnosed as vitreous hemorrhage during April,2009 to February,2011 in the ophthalmology department of our hospital were analyzed retrospectively.The patients with an average age of 54.2,who aged from 29 to 65,were given the treatment of injection of UK (10000U/0.1 mL) in vitreous cavity along with TA (4mg/0.1mL).The results showed that their vision,intraocular pressure(IOP) and ocular fundus have changed.All the patients involved were followed-up for more than 3 months,and 14 of them were followed-up for over 16 months.RESULTS:Before the treatment,the eyesight of every patient involved was hand movement to 0.02.After the treatment,the eyesight of the most effective case,who suffered from vitreous hemorrhage caused by retinal vein occlusion,was improved to 1.0.Of all the cases involved,37 (71%) were cured,26 (93%) of the 28 cases with the problem of blooding caused by retinal vein occlusion were cured,9 (45%) of the 20 cases with the problem of blooding caused by diabetic retinopathy were cured,and 2 (50%) of the 4 cases with the problem of blooding caused by retinal periphlebitis were cured.And other 15 cases were found having no difference in the eyesight after the treatment.Of the 37 effective cases,1 year later,2 cases got vitreous hemorrhage caused by retinal vein occlusion who recovered after the operation of vitrectomy,and 1 of the 37 cases,who was the patient of diabetic retinopathy,suffered from shallow retinal detachment,and he was given the retinal reattachment after the operation of vitrectomy combined with silicone oil tamponade,but his eyesight was not well recovered.None of the 52 cases suffered from the increase in IOP or endophthalmitis,etc.CONCLUSION:The treatment to vitreous hemorrhage by combining the injection of UK in vitreous cavity with TA is very effective,especially for the cure of vitreous hemorrhage caused by retinal vein occlusion,which is worth promoting.

Abstract:AIM:To evaluate the efficacy of fluorescein sodium on dyeing residual vitreous during the vitrectomy.To discuss the effect of fluorescein sodium which can demarcate the residue vitreous on vitrectomy and whether there are statistical significance on postoperative intraocular pressure(IOP) and visual acuity with comparison group and whether it can decrease the complications or not during vitrectomy.To investigate whether the fluorescein sodium can produce retinal toxicity or not through clinical study.METHODS:The study included 60 cases (60 eyes) who underwent vitrectomy in the first clinical hospital of Harbin medical university from September,2009 to September,2010.The 60 cases were proliferative vitreous retinopathy or detachment of retina,without operation experience of posterior segment in the past.There were not any condition affecting the ocular disease.All the patients could endure the vitrectomy,and they had had common body examination and ocular examination.All eyes were examined by slit-lamp biomicroscopy,binocular indirect ophthalmoscopy,B-scan and electroretinography before operation.The condition of cornea,anterior chamber,lens,vitreous body,retina,etc.were learned about.60 cases with vitrectomy were divided into study group and control group.Fluorescein sodium injection was taken orally in 30 eyes of study group before the surgery.Fluorescein sodium was not used in the 30 eyes of control group.All eyes were examined by slit-lamp biomicroscopy,binocular indirect ophthalmoscopy,B-scan after operation.The mean follow-up was 1 month after operation,visual acuity and IOP of the two groups were compared and analyzed.RESULTS:The location and coverage of the residual vitreous cortex were clearly shown by fluorescein sodium and the residual vitreous cortex was conveniently to be recognized and removed There was neither difference in visual acuity,IOP before and after operation nor obvious ocular complications related to fluorescein sodium,and no evident differences in comparison between the two groups.CONCLUSION:Location and coverage of the residual vitreous cortex were clearly shown by fluorescein sodium.It has the surgery safety,without obvious adverse reactions,and decreases the complicating diseases such as incidence of iatrogenic retinal break.It is profitable to protect and recover visual function without intraocular toxicity.

Abstract:AIM:To observe the clinical efficacy of different types of fundus disease with vitrectomy.METHODS:Clinical data of different types of fundus disease in 91 cases(96 eyes) with vitrectomy were analyzed retrospectively,in which fundus disease combined with proliferative diabetic retinopathy were 54 cases (59 eyes),with high intraocular pressure were 21 cases;purely high intraocular pressure retinopathy,8 cases (8 eyes);purely retinal detachment,17 cases (17 eyes);other reasons such as trauma,proliferative vitreoretinopathy,12 cases(12 eyes),and the reasons for poor visual recovery after surgery were summed up.RESULTS:All patients were followed up for 1 month to 6 months,the postoperative vision of 71 eyes in 96 eyes which was compared with preoperative vision improved to varying degrees,accounting for 74% of the total number of eyes (71/96),including the postoperative vision of 18 eyes improved from light perception,hand movement and finger counting to over 0.1,accounting for 19% of the total number of eyes (18/96);the postoperative vision of 9 eyes increased to over 0.02 but below 0.1,accounting for 9% of the total number of eyes (9/96);the postoperative vision was not improved in 20 eyes,accounting for 21% of the total number of eyes (20/96);the postoperative vision decreased in 5 eyes,accounting for 5% of the total number of eyes (5/96).CONCLUSION:Vitrectomy which treats different types of fundus disease is obviously effective and safe,which can improve visual function in most eyes and has fewer complications.

Abstract:AIM:To seek the reasons and effective methods to treat the intractable high intraocular pressure (IOP) after vitrectomy of proliferative diabetic retinopathy (PDR).METHODS:Postoperative IOP of eyes with PDR after vitrectomy were retrospectively analyzed within 2 years in our hospital.RESULTS:Twenty-five eyes (21.0%) occurred intractable high IOP in 119 eyes.IOP in 18 (72.0%) of 25 eyes could be controlled by using medical treatment,while 7 eyes required surgery.19 (76.0%) of 25 eyes had high IOP within one week after surgery,the other 6 eyes had high IOP at 2 to 18 months after surgery.The reasons of postoperative high IOP happened in 3 months after surgery included pupil atresia in one eye and neovascular glaucoma in 4 eyes.These 4 eyes with neovascular glaucoma had received phacoemulsification cataract surgery.In 119 eyes,silicone oil injection was in 42 eyes (35.3%),C3F8 injection in 12 eyes (10.1%).In 25 eyes with postoperative high IOP,11 eyes had received vitrectomy combined with silicone oil injection (44%,P= 0.41).IOP had no statistically significant difference between the eyes with and without silicone oil.2 eyes were injected C3F8 (7.7%,P=0.83),IOP had no statistically significant difference between the eyes with and without C3F8.CONCLUSION:The intractable high IOP after vitrectomy treating PDR usually can be controlled by medication.Silicone oil as intraocular tamponade is not the primary factor for postoperative high IOP.As long-dated high IOP may be associated with neovascular glaucoma.Intraoperative or postoperative cataract extraction requires carefully consideration.

Abstract:AIM:To study the essentiality of combining use of computer-assisted imaging system of indirect ophthalmoscope and wide-field digital retinal imaging system and analyze the result of two methods in the retinopathy of premature (ROP) screening.METHODS:Using the computer-assisted imaging system of indirect ophthalmoscope and wide-field digital retinal imaging system,the ophthalmologist examined the premature infants regularly in the ophthalmologic clinic,neonate department and neonate intensive care department from the 1st October 2009 to the 31st October 2010.The examination would be finished till infants’ retinal vascularization completed in nasal and temple retina.The ROP infants’ information would be preserved and their eye disease process would be followed up timely.It would be chosen to be operated on for those patients whose disease process developed to the pre-threshold and threshold and be followed up regularly till their ROP were complete regression and stationary.Finally the data of ROP patients were statistically analysed.RESULTS:From the 1st October 2009 to the 31st October 2010,1431 premature infants who were the objects of ROP screening (gestational age :27-35 weeks;birth weight:0.8-2.5kg)were examined and followed up regularly and found 111 ROP cases(7.76%).53 ROP cases were examined only by RetCamⅡ,and 58 ROP cases who were borderline cases were examined with combining use of computer-assisted imaging system of indirect ophthalmoscope and wide-field digital retinal imaging system.67.57% of patients were found their disease regression after follow-up.19 cases’diseases developed to styleⅠ of the pre-threshold and 15 cases developed to or above the threshold,34 cases were done by laser photocoagulation and 31 cases had good outcomes after operation and 2 ROP 4A stage cases had bad outcome.CONCLUSION:The study was found when the premature infants were shorter in their gestational weeks and the lighter in birth weight,their incidence of ROP were higher and their disease extent were more serious,and they needed ROP screening timely and early intervention treatment.Combining use of computer-assisted imaging system of indirect ophthalmoscope and wide-field digital retinal imaging system is helpful to increase the rate of ROP diagnosis,to preserve the object data and to ROP screening training.

Abstract:AIM:To investigate the histopathologic features and incidence of primary blepharal neoplasms.METHODS:The clinical pathological data of 291 primary blepharal neoplasms in Southwestern Eye Hospital from January 2003 to December 2009 were collected and analyzed retrospectively.RESULTS:Benign blepharal neoplasms were 172 cases(59.1%),the top ten in the ranking in turn were papilloma,pigmented nevus,inflammatory granuloma,dermoid cyst or epidermoid cyst,amyloid degeneration,warts,hemangioma,xanthoma,plasma cell granuloma,trichoepithelioma.Malignant blepharal neoplasms were 119 cases(40.9%),the top five in the ranking in turn were basal cell carcinoma,squamous cell carcinoma(including spindle cell carcinoma),sebaceous gland carcinoma,malignant lymphoma,malignant melanoma.The clinical epidemiological data of the top three malignant blepharal neoplasms were summarized.The eyelid restoration after neoplasms ablation were discussed.CONCLUSION:The classification of blepharal neoplasms was various,the clinical pathological analysis of primary blepharal neoplasms was helpful to correct diagnosis and treatment.

Abstract:AIM:To discuss the clinical effects of artificial tears and recombinant bovine basic fibroblast growth factor (rb-bFGF) eyedrops on dry eye after glaucoma filtering surgery.METHODS:All 60 cases(60 eyes)with dry eye symptom after glaucoma filtering surgery were chosen and randomly divided into two groups,treatment group and control group.In treatment group,the patients were treated by artificial tears and rb-bFGF eyedrops.In control group,the patients were treated by artificial tears.The subjective dry eye symptoms,fluorescein staining(FL),the time of tear secretion (Schirmer Ⅰ test,SⅠ t)and tear break-up time(BUT)were observed by slit lamp before treatment,2 weeks and 4 weeks after treatment.RESULTS:There was no statistical difference between the two groups before treatment (P>0.05).After treatment,the subjective dry eye symptoms,FL,S I t and BUT were significantly different (P<0.01).CONCLUSION:Artificial tears combined with rb-bFGF eyedrops can be effective to relieve the dry eye symptoms after glaucoma filtering surgery.

Abstract:AIM:To observe ultra-thin-flap and thick-flap LASIK in treatment of low and moderate myopia before and after operation and to analyze the advantage or limitation in ultra-thin-flap LASIK.METHODS:A total of 154 cases of low and moderate myopia were chosen,81 cases(159 eyes) underwent the Moria 110 thick-flap LASIK in group 1,the other 73 cases(145 eyes) underwent the Moria 90 ultra-thin-flap LASIK in group 2.The actual corneal flap thickness and the corneal flap shape in the surgery,the complication between two groups before and after surgery,the cornea thickness,corneal flap thickness,surplus corneal stroma thickness,postoperative vision and intraocular pressure were observed.RESULTS:The actual corneal flap thickness of group 1 was 134.0±2.5μm;and that of group 2 was 93.5±5.9μm.There was significant difference between two groups (P< 0.05).There was no significant difference between two groups (P>0.05) in corneal flap shape,the complication,vision and intraocular pressure postoperative.There was fewer complication and thicker surplus corneal stroma thickness in group2 (P< 0.05).CONCLUSION:Ultra-thin-flap LASIK can produce the same good effect as the thick-flap LASIK.But the former can retain thicker corneal stroma bed,it can do wider diopter treatment with better security and wider adaptation scope,and will be the best choice for myopia people.

Abstract:AIM:To observe the effectiveness and safety of clear lens extraction and Acrysof ReSTOR multi-focal intraocular lens(IOL) implantation to correct high myopia in middle-and old-aged patients.METHODS:Phacoemulsification and implantation of Acrysof ReSTOR multi-focal IOL were performed on 44 eyes of 26 high myopic patients with clear crystalline lens.Preoperative and postoperative visual acuity,refractive error,corneal curvature,IOP,endothelial cell counting,stereoscopic vision,spectacles independent rate,vision habit,and satisfaction,of the patients were observed.RESULTS:No complications occurred intraoperatively.Postoperative uncorrected and best-corrected distant and near visual acuity,corneal curvature,and stereoscopic vision all improved than before surgery about 95.5% patients never wore spectacles,and 97.7% patients were satisfied with the refractive results.After operation,except for a transient increased intraocular pressure,no posterior capsular opacification,cystoid macular edema and retinal detachment were found during the follow-up period.CONCLUSION:Clear lens phacoemulsification and Acrysof ReSTOR multi-focal IOL implantation to correct high myopia in middle-and old-aged patients is a safe,effective procedure serving as a refractive surgery.Further follow-up over a longer period is needed to fully assess the effectiveness and complications of this operation.

Abstract:AIM:To investigate the treatments of epithelial ingrowth(EI)after laser in situ keratomileusis (LASIK),analyse the related factors,and evaluate efficacy of the treatment.METHODS:Ten patients (16 eyes) with EI were analyzed from 2666 paients(5212 eyes) who underwent LASIK from September 2006 to November 2011 in our hospital.The reason for occurrence of EI aftere LASIK was analyzed,the different treatment methods were used,and their efficacy was evaluated.RESULTS:The incidence rate of EI was 0.31% in 2666 paients(5212 eyes);According to the occurrence reasons,the occurrence time,the range and position,the different treatment methods were used.Four paients(5 eyes)were treated with 10g/L Prednisolone Acetate Ophthalmic Solution (Pred Forte)and intraocular pressure-lowering ophthalmic solution,EI disappeared;other six paients (11 eyes)were treated with pharmaceutical and surgery.The EI were cleaned up,and the corneal flap was dried in the open air for 1minute after repositioning the flap,and contact lens were used for 1-2 days after surgery.They were treated with Pred Forte and intraocular pressure-lowering ophthalmic solution after surgery.All paients had good visual acuity and no recurrence occured in the six months to four years follow-up.CONCLUSION:EI after LASIK is an special complication.Excluding contraindication preoperatively,operating normatively,early diagnosis and active treatment are effective treatment methods for EI.

Abstract:AIM:To evaluate the impact of ultrasonic atomization of methylcobalamin on corneal nerve recovery after LASIK.METHODS:Seventy-two patients in our hospital underwent LASIK,refraction degree -1.50-- 4.50D were randomly divided into A,B,C three groups,each group 24 cases.After LASIK surgery,all patients were treated as following:group A (control group) without anti-dry eye treatment;group B using artificial tears after surgery;group C(ultrasonic atomization methylcobalamin group) using ultrasonic spray methylcobalamin treatment after surgery.We observed tear film break up time (BUT),tear secretion amount and corneal anterior stromal layer of nerve fiber density in three groups preoperative and postoperative 1 week,1 month and 3 months.RESULTS:Compared with the group A,BUT in group B after 1 month significantly increased,and it significantly increased in group C postoperative 1 week,1 month and 3 months(P<0.05).Compared with group A,tear secretion amount in group B and C during different periods increased significantly(P<0.05).Compared with group B,tear secretion amount in group C after 1 month and 3 months increased significantly(P<0.05).Nerve fibers in the central district area of newborn increased significantly in group C compared with group A and B after LASIK corneal surgery(P<0.05).CONCLUSION:Ultrasonic atomization of methylcobalamin on patients after LASIK corneal surgery can reduce the occurrence of dry eye and repair the damaged corneal sensory nerves.

Abstract:AIM:To observe the safety and predictability of excimer laser surgery by measuring the thickness of corneal flap,and to provide help for clinic.METHODS:The operative eyes were divided into 4 groups according to the preparation types of corneal flap.Fifty-five eyes were treated with laser in situ keratomileusis with 90μm femtosecond laser flap preparation (group A).Sixty-one eyes were treated with laser in situ keratomileusis with Moria-Ⅱ 90 microkeratomy flap preparation (group B).Thirty eyes were treated with laser in situ keratomileusis with Moria-Ⅱ110 microkeratomy flap preparation (group C).One hundred and five eyes were treated with laser assisted subepithelial keratectomy (group D).Ultrasonic pachymetry was employed to measure the flap thickness of these four groups.The results were analyzed with t-test or linear-regression by SPSS software.RESULTS:The average thickness of these 4 groups were 90.95±10.82μm (group A),133.61±11.97μm (group B),147.70±16.16μm (group C),66.35±11.95μm (group D).They were compared with t-test and showed statistical difference.Correlations between the thickness and the preoperative parameters were analyzed.Group A showed a weak correlation with the spherical equivalent diopter.Group B revealed a moderate correlation with the spherical equivalent diopter and weak correlation with the preoperative intraocular pressure,the average curvature of the cornea,the stall of the microkeratomy of Moria-Ⅱ.Group D showed moderate correlation with flap preparation,weak correlation with spherical equivalent diopter.There was no statistical difference between the thickness of the flap and the used times of the cone in group A,as well as the used times of the blade in Moria-Ⅱ in group B and C and the eyes either right or left in group D.CONCLUSION:Although the thickness was stable in every group,there was difference in the average thickness of these 4 groups.Spherical equivalent diopter may be one reason for the influence of the corneal thickness.It is more predictable and flexible in the thickness of the corneal flap with femtosecond than with the microkeratomy of Moria-Ⅱ.With the thinnest flap thickness,LASEK is the safest operation

Abstract:AIM:To evaluate the clinical results of laser subepithelial keratomileusis (LASEK) in the correction of high and super-high myopia.METHODS:LASEK was performed on 271 cases(493 eyes) with myopia who were divided into a high myopia group(6.00-10.00D) and a super-high myopia group(≥10.00D) on the basis of the preoperative spherical equivalent refraction.The high myopia group was 311 eyes and the other group was 182 eyes.The follow-up time was 1 year.The postoperative uncorrected visual acuity(UCVA),haze and other complications were compared between the two groups.RESULTS:The postoperative UCVA raised in all eyes.At the end of 1 year,there were 255 eyes (82.0%) in high myopia group and 110 eyes (60.4%) in the other one of which the postoperative UCVA was better than the preoperative best-corrected visual acuity (BCVA).The differences were statistically significant between the two groups (P<0.01).The all hazes were within 2 grade.There weren’t apparent cornea irritation and severe complications.CONCLUSION:LASEK was a safe,effective method for high myopia,but not effective for super-high myopia.

Abstract:AIM:To look for a approach which is simple,has no need for special equipment and fewer complications,and can quickly take out the lens nucleus.METHODS:Totally 746 cases of cataract surgery were performed in our hospital in 2010,from which 352 cases(352 eyes)of grade Ⅱ～Ⅳ nucleus senile simple cataract patients were chosen and randomly divided into two groups.During 2010- 03-29/05-15 conventional snare method fornuclear extraction was performed in 176 cases;During 2010- 06- 01/10-22 improved sodium hyaluronate and needle method for nuclear extraction was used in 176 cases.RESULTS:Statistical analysis showed:an average operative time of about 2.55min per patient was saved in improvement group than in conventional group,the difference was very significant (P<0.01).As for visual recovery of two groups 1week after surgery,the conventional group was 81.25% in off-disability rate,the improvement group was 92.61%,the difference was significant (P<0.05).As for visual recovery 1～3 month after surgery,the conventional group was≥0.5 in 139 cases (78.98%),the improvement group was≥0.5 in 165 cases (93.75%),the difference was significant(P<0.05).Intraoperative and postoperative complications in improvemeht group was also significantly less than those in the conventional group.CONCLUSION:The method of nuclear extractionin improvement group is simple,has no need for special equipment,saves time,has fewer complications and good visual recovery.It is suitable for the primary hospital,but also conducive to large-scale prevention of blindness in rural areas.

Abstract:AIM:To explore the surgery techniques of phacoemulsification for treatment of microcoria cataract.METHODS:Ninety-eight cases (116 eyes) of microcoria cataract were firstly operated by using,intraocular lens positioning hook or iris restorer,capsular membrane shear,rearing iris surface organization membrane and any other methods to expand the pupil to 4-5mm,and completed phacoemulsification combined with intraocular lens surgery in capsular bag.RESULTS:Intraoperative 116 eyes (100%) expanded pupils to 4-5mm and successfully completed and phacoemulsification.The postoperative pupils recovered normal in 106 eyes (91.4%),of which 8 eyes(6.9%) had posterior capsule rupture,20 eyes (17.2%) had corneal edema which disappeared in 3-5 days,6 eyes (5.2%) had not intraocular lens implantation.CONCLUSION:Using intraocular lens positioning hook,capsular membrane shear and any other methods can simply and effectively expand the pupil without damaging,also maintaining the pupil circular postoperatively,and existing papillary light reaction.So phacoemulsification can successfully complete and preserve the pupil function at the same time.

Abstract:AIM:To evaluate the clinical comparative observation of three methods for treating cataract complicated with glaucoma.METHODS:Ninety-six cases (96 eyes) with cataract complicated with glaucoma were equally divided into three groups,A group were treated by the cataract phacoemulsification and intraocular lens implantation.B group were treated by the cataract phacoemulsification,intraocular lens implantation combined with trabeculectomy.C group were treated by the combined trabeculectomy surgery.RESULTS:The intraocular pressure (IOP) decrease of A group and B group was significantly higher than that of C group (P<0.05).The IOP decrease of B group was the best,but had no significant difference (P>0.05) compared to the A group.The visual acuity of A group and B group was obviously better than C group (P<0.05).The deepening amplitude of anterior chamber depth of A,B group was significantly higher than that of C group (P<0.05).The deepening amplitude of anterior chamber depth of B group was higher than that of A group,but had no significant difference (P>0.05).CONCLUSION:The phacoemulsification,intraocular lens implantation combined with trabeculectomy can significantly deepen the anterior chamber,open chamber angle,and effectively decrease IOP and improve visual function,which is a safe and effective surgical method for treating cataract complicated with glaucoma.

Abstract:AIM:To study the method and effect of using Nd:YAG laser in treating posterior capsular opacities after mydriasis.METHODS:After mydriasis posterior capsular opacities treated with Nd:YAG laser posterior capsulotomy.RESULTS:The success rate of the operation was 99.8%.The best corrected visual acuity (BCVA) was improved significantly in 97.2% cases(BCVA≥0.4) by Nd:YAG laser therapy after mydriasis.CONCLUSION:After mydriasis,Nd:YAG laser posterior capsulotomy is a kind of effective,safe,simple and low-rate complication technique in treating after cataract.

Abstract:AIM:To evaluate the clinical efficacy and application value of Cyclosporin A (CsA) and 5-Fluorouracil (5-FU) in glaucoma filtration surgery through comparing the results of CsA and 5-FU in the surgery.METHODS:Sixty cases(90 eyes)with intractable glaucomatous patients were randomly studied by treatment with CsA or 5-FU following trabeculectomy,each group consisting of 30 cases(45 eyes).20g/L CsA and 25mg/mL 5-FU were used for treatment of each group respectively for 4minutes.The follow-up was ranged 15 months.RESULTS:The 15th month life-table success rate of functional bleb formation was (81.25±10.13)% in CsA group and (61.75±8.12)% in 5-FU group,the difference being statistically significant(P<0.05).The 15th month life-table complete and qualified success rates were (81.25±10.13)% and (92.62±3.38)% in CsA group,(61.75±8.12)% and (79.37±6.12)% in 5-FU group,the difference being statistically significant(P<0.05).Toxic and side effcts induced by CsA were more rare than 5-FU,No severe complications were found.CONCLUSION:CsA is more safe than 5-FU in glaucoma filtration surgery.

Abstract:AIM:To observe the therapeutic effect of anterior chamber paracentesis in glaucoma patients with sustained high intraocular pressure(IOP).METHODS:Thirty-six cases of glaucoma patients with sustained high intraocular pressure,including 16 cases of acute angle-closure glaucoma in acute outbreak period,4 cases of chronic angle-closure glaucoma,5 cases of neovascular glaucoma,5 cases of glaucoma secondary to traumatic hyphema,2 cases of age-related cataract at intumescent stage and 4 cases of glaucoma after cataract surgery.Using slit lamp microscope,anterior chamber paracentesis was performed when the IOP can not decrease effectively after conventional drug therapy.RESULTS:The IOP in all the patients decreased rapidly after anterior chamber paracentesis,with the relief of eye pain and headache at the same time.Complications were hyphema in 5 cases,adhesion of iris and cornea puncture site in 2 cases and lens injury in 1 case.CONCLUSION:Anterior chamber paracentesis is a simple,rapid and effective treatment to the glaucoma patients with sustained high intraocular pressure,which can reduce the visual function damage,and avoid the side effects of long-term use of systemic hypotensive drugs.

Abstract:AIM:To study whether exercise therapy is an effective treatment of diabetic retinopathy or not.METHODS:Eighty-four selected patients with diabetic retinopathy were randomly divided into two groups,simple drug treatment was used for the control group,while drug treatment combined with exercise therapy for treatment group.Before and after treatment visual acuity,fundus,blood glucose,glycated hemoglobin were tested,and Hamilton Anxiety Scale,Hamilton Depression Rating Scale were used to score.RESULTS:The fundus improvement before and after treatment of experimental group was superior to that of control group.After movement intervention,blood glucose and glycated hemoglobin of experimental group significantly decreased;anxiety and depression symptoms in patients significantly reduced.CONCLUSION:Exercise therapy is an effective treatment of diabetic retinopathy.

Abstract:AIM:To observe and discuss the contributory factors of high intraocular pressure (IOP),and the clinical signs for follow up.METHODS:Twenty-nine cases with high IOP were observed for IOP,vision field,optic disc and optic nerve fiber.These cases were followed up for 3-4 (mean 3.5) years.RESULTS:During the follow-up,the IOP of 25 cases had no change.The IOP in 2 cases went down,2 cases increased.CONCLUSION:Many factors may contribute to high IOP,the patients must be observed frequently.In case of suspected glaucoma changes,anti-glaucoma treatment should be actively pursued.

Abstract:AIM:To assess the efficacy of vitreous surgery for treatment of open ocular trauma with no light perception(NLP).METHODS:Vitreoretinal surgery was performed on 9 cases(9 eyes) with NLP after serious ocular trauma,and the efficacy was observed.The follow-up time was 6-24 months(average 10 months).RESULTS:Postoperatively,4 of 9 cases had visual acuities of light perception or above.5 cases remained NLP.NLP after ocular trauma was mainly due to severe refractive media opacity,retinal damage,detachment and choroidal edema.CONCLUSION:Some patients with NLP after ocular trauma may get certain visual acuities after surgical treatment of vitrectomy.

Abstract:AIM:To investigate fundus changes in patients infected by human immunodeficiency virus.METHODS:The study included 120 cases with an HIV infection that underwent ophthalmologic examinations.None of the patients has any systemic opportunistic infection and other system diseases found.The CD4+ T lymphocyte counts were no less than 200×106/L.They didn’t undergo highly active antiretroviral therapy.RESULTS:In all the 120 patients,the visual acuity in 114 cases(95%)of 221 eyes(92.1%) were no less than 1.0.Three cases (2.5%) of 4 eyes (1.7%) were found point and sheet bleeding in retinal posterior pole.1 case (0.8%)of 1 eye was found cotton-wool spots in the posterior pole.Retinal microvascular abnormalities were found in 4 cases (3.3%).CONCLUSION:Retinal microvasculopathy is the early fundus changes of the patients infected by the immunodeficiency virus.It happened seldom when the CD4+ T lymphocyte counts were no less than 200×106/L,and without significant effect on visual acuity.

Abstract:AIM:To evaluate the effect of improved suture correction of idiopathic lower eyelid entropion trichiasis in children.METHODS:Improved suture treatment was applied for idiopathic lower eyelid entropion trichiasis in children.RESULTS:Of all the 72 cases,43 cases were cured,25 cases improved,4 cases failed.The total effective rate was 94%.CONCLUSION:Improved suture treatmenthas a good effect,simple operation and less damage for idiopathic lower eyelid entropion trichiasis in children.

Abstract:AIM:To observe the clinical effect of avastin in treatment of recurrent pterygium.METHODS:Sixty-senven eyes were divided into two groups:one group (avastin group)was treated with subconjunctiva injection of avastin,the other group (laser group) was treated with the laser therapy.RESULTS:After 6 months follow-up,it showed that the inefficiency rate of the avastin group was 10%(3/31) and the laser group was 28%(10/36).There was significant difference between the two group (P<0.05).CONCLUSION:Avastin therapy for treatment of recurrent pterygium is an effective and notable method.

Abstract:AIM:To compare the effects of two kinds of surgery in pterygium in order to investigate the necessity of conjunctival suture.METHODS:Totally 65 cases (76 eyes) were randomly divided into two groups,one group was treated by mitomycin-C and sutureless method (group MMC,36 eyes),the other group was treated by autologous corneal limbal stem cell transplantation with conjunctival flap(group ALCT,40 eyes).After removal of the pterygium,the time of the surface’s recovery and the relapse rate were compared.RESULTS:There were no statistical difference in the time of the surface’s recovery and relapse rate between the two groups (P>0.05).CONCLUSION:It is concise and has less trauma in sutureless surgery,and can avoid iatrogenic perforation of the sclera,more suitable to those elders and those who have difficulties to walk in the sight rehabilitating engineering.

Abstract:AIM:To observe early synthetic methods for treatment of ocular thermal burns by hot metal liquid.METHODS:Fifty-six eyes (52 cases) received removement of metal remnant and conjunctival injection of idios blood serum at once.The gelatin sponge absorbed with recombinant bovine basic fibroblast growth factor eye-gel,lomefloxacin eye-gel,and atropine eye onintment,were put into the conjunctival sac and corneal surface.The gelatin sponge were changed every 3 days.The intravenous antibiotic,glucocorticoid and xuesaitong were used to control infection and inflammation and to promote nutrition.On 6th day after injury we stopped using glucocorticoid.Amniotic membrane transplantation was used for the case with the risk of corneal perforation.RESULTS:The eyeballs were all saved in 56 eyes,and nebula in 17 eyes,macula in 9 eyes,leucoma in 7 eyes,pseudo-pterygium in 18 eyes,entropion in 11 eyes,ectropion in 1 eye,symblepharon in 2 eyes.CONCLUSION:Early synthetic therapy for ocular thermal burns by hot metal liquid can promote eye conditions,prevent or reduce complications,and create a good condition for surgery.

Abstract:AIM:To observe the related factors that effected tear film functions due to pars plana vitrectomy (PPV).METHODS:Ninety eyes of participants who had received PPV were observed.The related factors (sex,age,IOP,diabetes mellitus (DM),the modus operandi,the period of surgery)were analyzed respectively,Logistic regression analytic manner in normal conditions was used to study all the related factors.RESULTS:The factors of age and the period of surgery effected tear film functions.There were not relationship between sex,IOP,DM,modus operandi and the dry eye.CONCLUSION:The age and the period of surgery are dangerous factors that effect tear film functions after PPV.

Abstract:AIM:To investigate the clinical treatment method and efficacy of the artificial nasolacrimal duct and silicone tube conjunct implantation in treatment of lacrimal puncta or lacrimal canaliculus stenosis with nasolacrimal duct obstruction or chronic dacryocystitis.METHODS:Twenty-three cases (28 eyes) were diagnosed with lacrimal puncta or lacrimal canaliculus stenosis with nasolacrimal duct obstruction or chronic dacryocystitis,after nasolacrimal duct probing they were treated with the artificial nasolacrimal duct and silicone tube conjunct implantation.RESULTS:Removed the artificial nasolacrimal duct and silicone tube at the end of the fourth month after surgery and followed-up for 1 year.23 eyes of 23 cases (28 eyes) were cured with no epiphora,the cure rate was 82%.2 eyes were improved with slight epiphora,the improvement rate was 7%.Lacrimal canaliculi were still obstructive in 2 eyes,and 1 eyes reappeared pyoid secretion,which were ineffective,the ineffective rate was 11%.CONCLUSION:The artificial nasolacrimal duct and silicone tube conjunct implantation is effective in treatment of lacrimal puncta or lacrimal canaliculus stenosis with nasolacrimal duct obstruction or chronic dacryocystitis.

Abstract:AIM:To observate the therapeutic effects of canaliculotomy combined with retrograde intubation of lacrimal passage in the treatment of canaliculitis.METHODS:Forty cases of canaliculitis were treated with canaliculotomy combined with retrograde intubation of lacrimal passage,and postoperatively followed up for 3months.RESULTS:In all patients,28 cases were cured,12 cases improved.The effective rate was 100%.CONCLUSION:Canaliculotomy combined with retrograde intubation of lacrimal passage is a safe and effective way.

Abstract:AIM:To investigate the therapeutic effect of KTP laser combined with new lacrimal drainage device for the treatment of lacrimal duct obstruction.METHODS:Lacrimal probe with needle core was penetrated into the lacrimal passage,and the KTP laser fibre was put into the passage to remove the obstruction.Unobstruction of lacrimal passage was confirmed by irrigation.Then,two ends of the lacrimal drainage tube were put into the nose through upper and lower puncta and reopened lacrimal duct.An permanent tie was made with the two ends of lacrimal drainage tube and excess tube was removed.Antibiotic eye drops was applied after the operation.The tube was removed 3 months later.RESULTS:Totally 426 cases (482 eyes) of lacrimal duct obstruction were treated in this way.445 eyes were cured successfully and 37 eyes failed,which accounted for 92.3% and 7.7% respectively.CONCLUSION:KTP laser combined with lacrimal drainage tube is a very simple way to treat lacrimal duct obstruction with the advantages of wide application,minimal tissue damage and no scar.Moreover,it is an outpatient surgery without pain,which takes only 5minutes.

Abstract:AIM:To investigate the safety and efficacy of the cake-type posterior scleral reinforcement surgery for the treatment of high myopia.METHODS:Cake-type posterior scleral reinforcement surgery was performed in 20 cases (39 eyes) with high myopia,and the follow-up lasted for 3 years.RESULTS:There was no progressive extension of the eye axis in patients of postoperation compared to the preoperative.The diopter of myopia compared with the preoperative,the difference also was not significant.In addition,corrected visual acuities of the patients were improved at varying degrees.CONCLUSION:The cake-type posterior scleral reinforcement surgery has few complications.It can stabilize axial length,stabilize and improve vision.It has been proved to be a safe and effective way to prevent and treat high myopia.

Abstract:AIM:To analyze the causes of dry eye syndrome after LASIK.METHODS:During January 2008 to January 2011,122 patients (244 eyes) who were diagnosed dry eye syndrome in outpatient clinic were selected.Patients were performed the examination of visual acuity,Schirmer Ⅰ test (SⅠ t),dry eye questionnaire,and 15minutes later examining the anterior segment with slit lamp,the tear breakup time (BUT) and fluorescein (FL) staining.RESULTS:The most common symptoms of dry eye patients was visual fatigue,accounting for 88.5% of total number;dry eye in 75 patients,accounting for 61.5%;vision fluctuation in 93 patients,accounting for 76.2%;foreign body sensation in 84 patients,accounting for 68.9%;itching eyes in 83 patients,accounting for 68.0%.CONCLUSION:The causes of dry eye syndrome after LASIK are cornea integrity damage,nerve missing and failed follow-up after LASIK.

Abstract:AIM:To observe the effects of sevoflurane inhalation anesthesia on strabismus operation in children.METHODS:Sixty children of ASA (American society of anaesthetist)grade Ⅰ-Ⅱ were randomly divided into two groups,each group had 30 cases.Group A was treated with sevoflurane,midazolam and vecuronium for induction,sevoflurane for maintenance.Group B was treated with propofol-remifentanil plus ketamine,midazolam and vecuronium for induction,propofol-remifentanil for maintenance.The haemodynamics of pre-intubation,intubation,operation and recovery period were monitored.The time of respiratory recovery,extubation and awareness recovery were recorded.The anaesthetic complication were also recorded.RESULTS:The changes of HR and BP in Group A during intubation increased more than those in Group B,the variances were statistically different between two groups (P <0.05).The variances of haemodynamics were statistically different between Group A and Group B (P<0.05).The eye-heart reflex in Group A was less than those in Group B and the variances were statistically different between two groups (P<0.01).The postoperative agitation in Group A were more than those in Group B and the variances were statistically different (P<0.01).CONCLUSION:The haemodynamics with sevoflurane inhalation anesthesia on strabismus operation in children are stable,and it can significantly reduce the eye-heart reflex.The recovery is more rapidly,but the postoperative agitation is higher.

Abstract:AIM:To explore the nursing care of intravitreal Lucentis injection to treat the patients withage-related macular degeneration(AMD).METHODS:Thirty patients(30 eyes) were diagnosed as AMD.They would be treated by intravitreal Lucentis injection.The preoperative psychological nursing was emphasized.Complications,especially intraocular pressure were observed.RESULTS:Twenty-one eyes were improved in visual acuity in all 30 eyes.The intraocular pressure(20.1-24.6mmHg) in 4 eyes were higher than preoperative,which was normal 24 hours later.No complications were observed in the follow-up.CONCLUSION:It is very important to enhance the peri-injection,mid-injection and post-injection nursing for assuring the treatment efficacy.

Abstract:AIM:To investigate the long-term effect of the nursing care based on differentiation of symptoms and signs on the Vogt-Koyanagi-Harada’s syndrome (VKH).METHODS:Ninety-six patients with VKH were randomly divided into an experimental group (48 cases,treated with conventional therapy and nurse combined with nursing care based on differentiation of symptoms and signs) and a control group (48 cases,treated with conventional therapy and nurse).After that,the differences in long-term effect between two groups were compared.RESULTS:There were significant differences in long-term effect between the experimental group (the excellent effect:40 cases;the inferior excellent effect:7 cases;the bad effect:1 cases) and the control group (the excellent effect:30 cases;the inferior excellent effect:15 cases;the bad effect:3 cases).Long-term effect in experimental group was significantly better than that in control group (P<0.05).CONCLUSION:The nursing care based on differentiation of symptoms and signs possesses important long-term clinical application value for the patients with VKH.