Abstract:AIM: To evaluate the visual outcomes and safety of combined pars plana vitrectomy(PPV),phaco-emulsification,and intraocular lens(IOL) implantation in the treatment of complex vitreoretinal diseases.METHODS: Retrospective consecutive interventional case series.137 eyes of 122 patients underwent combined PPV,phacoemulsification,and IOL implantation.Main outcome measures were visual acuity and complications.RESULTS: The mean follow-up was 12.8 months.The main vitreoretinal surgical indications were rhegmatogenous retinal detachment,tractional retinal detachment and proliferative diabetic retinopathy.In total,37 eyes(27.0%),55 eyes(40.1%) and 61 eyes(44.5%) gained two or more lines of vision compared with baseline at 1 month,6 months and 12 months follow-up.CONCLUSION: Combined PPV,phacoemulsification,and IOL implantation was safely and effectively used for cataracts and a variety of complex vitreoretinal diseases.

Abstract:We present a very rare case of orbital ganglioneuroma.A 13-year-old man presented with more than 5 years’ history of exophthalmos of right eye.Computed tomography(CT) scan disclosed a tumor in the right orbit.The patient received surgical treatment.Pathological examination revealed a ganglioneuroma.The patient was followed up for 12 months without recurrence.

Abstract:We describe two cases of congenital cranial dysinnervation disorders(CCDD) who were seen at our centre.The first patient was a 7-year-old Chinese girl with no medical illness,who was noted by her parents to have a habit of tilting her head to one side and "lazy eyes" since she was a toddler.Best-corrected visual acuity(BCVA) in both eyes were 6/6 on Snellen chart and her head was tilted to the right.There was limitation of abduction in both eyes on horizontal gaze.Enophthalmos was seen associated with down shooting on attempted adduction.The second case was a 10-year-old Malay boy with no medical illness,who was noted by his parents to have "poor eye movements" since birth.BCVA in both eyes were 6/6 on Snellen chart with a left face turn and bilateral ptosis.Eye movements in all gazes were restricted and force duction test was positive.Both cases were diagnosed as congenital fibrosis of extraocular muscle(CFEOM) initially,but the diagnosis of the first case was later revised as bilateral Duane syndrome.Although both Duane syndrome and CFEOM are included under CCDD,both entities have distinct pathology.The presentation of CCDD is extremely variable.Nonetheless,the treatment is often limited and surgical outcome is often unpredictable.Hence,much research is still needed to be carried out for more in depth understanding of CCDD,so as to improve the management and outcome of the disease.

Abstract:AIM: To product protoplasts of pathogenic Aspergillus fumigatus,and to observe biological properties of protoplasts from stripped the cell wall to return to full form·METHODS: 1mol/L sorbitol was used as the osmotic stabilizer to product complex enzyme including 1g/dL snailase,1g/dL cellulase and 0.1g/dL lysing enzyme.Complex enzyme was confected with 5×109/L Aspergillus fumigatus conidia liquid by volume ratio of 1∶1 to digest 2 hours in gas bath thermostatic oscillator at 30℃ and 80r/min.The activity of protoplasts was detected by the neutral red solution·RESULTS: The average generation capacity of Aspergillus fumigatus conidia protoplasts was 2.84×109/L.After digestion the activity of protoplasts at 0,6,12,18,24 hours were 86.6%,77.4%,73.9%,70.6%,66.2%.The regeneration phenomenon of protoplasts began at 18 hours after the digestion,and basically completed within 36-48 hours·CONCLUSION: The generation rate of Aspergillus fumigatus protoplasts was 56.8% with complex enzyme.The time window that we can interfere was at least 18 hours.Protoplasts could maintain a high activity in 24 hours.

Abstract:AIM: To investigate the relationship between retinal degeneration caused by high-fat diet induced obesity and oxidative stress in C57BL/6 mice·METHODS: Mice were fed a high-fat diet for 19 weeks and then divided into diet induced obesity-resistant(DIO-R) group and diet induced obesity(DIO) group,control group mice were fed a basal diet at the same time.The retinal ultrostructural changes were detected by light and transmission electron microscope.The cellular apoptosis was detected by TUNEL.Oxidative indices were detected by biochemical methods·RESULTS: The retinal and ONL thicknesses in DIO group were thinner than in control and DIO-R groups(P<0.01).The photoreceptors in DIO group showed characteristic features of apoptosis and necrosis;the photoreceptor disk membranes were disordered and some of them were dissolved and fractured;the retinal ganglion cell in DIO group showed smaller and condensation of nuclear chromatin and increased electron density of the cytoplasm.TUNEL staining showed apoptosis cells in ONL in DIO group increased and the percentage of apoptotic cells was much higher than in control and DIO-R groups(P<0.01).Compared with the control group,the level of malondialdehyde(MDA) increased(P<0.01) and the activity of superoxide dismutase(SOD) decreased significantly(P<0.05) in DIO group·CONCLUSION: High-fat diet induced obesity may cause retinal degeneration and cellular apotosis in C57BL/6 mice,which may be related with oxidative stress in some extent.

Abstract:AIM:To investigate the interference effect of Danshen injection on apoptosis of retinal cells in experimental retinal contusion·METHODS:Forty-two pigmented rabbits were selected,and the left and right eyes were in the experimental control group and Danshen injection group,respectively.The retinal contusion model was set up by Allen’s reformative hitting method.The eyeballs of the 42 pigmented rabbits were enucleated 1 hour,3 hours,1 day,3,7,14 and 28 days after the retinal contusion model was established.Another 2 pigmented rabbits were selected as the normal control,which underwent none of the contusion but eyeball extraction at the end of the observation period.TUNEL and transmission electron microscopy were used to detect the apoptosis of the retinal cells.Cell counts and statistical analysis were used to assess results·RESULTS: There was cell apoptosis in sensory layer after contusion of retina,but almost not observed in retinas from normal control,14,28 days group.They were abundant in 3 hours,1 day,3 days group,with morphological and biochemical changes of apoptosis features of apoptotic cells,in which sensory layer of the retina in the 3 days group the number of apoptotic cells reached its peak.It was also found that apoptosis cells in Danshen injection group were less than that in the experimental control group(P<0.01)·CONCLUSION: Danshen injection may inhibit the apoptosis of retinal cells in experimental retinal contusion.

Abstract:AIM: Through p27kip1-gene mediated by the emerging polylactic acid-polyglycolic acid copolymer(PLGA) nanoparticles transfecting retinal pigment epithelium(RPE),to observe the inhibition effect of RPE proliferation of the retinal detachment(RD) rabbit eye·METHODS: Preparation of p27kip1 gene nanoparticle was made and determination of gene content was measured.Animal grouping and preparation of RD animal model were made.Experimental data were analyzed using paired t-test and independent samples t-test method,there were significant differences(P<0.05)·RESULTS: At 7,14,28 days,PCNA protein expression of p27kip1 gene therapy group was significantly lower than the control group,and the difference was statistically significant(P<0.05).This indicated that PCNA protein expression were significantly inhibited by p27kip1 gene nanoparticles.At the same time,in the gene transfection group,p27kip1 protein expression was significantly increased compared with the control group at 3,7,14 days,the difference was significant(P<0.05)·CONCLUSION: p27kip1 gene may be used as a target gene,and through the emerging gene nanoparticles may be used for the gene therapy about inhibition of RPE cell proliferation.

Abstract:AIM: To investigate the mechanism of shijueming prevention and cure on cataract METHODS: Eighty rats were randomly divided into 4 groups,with 20 in each group.Ten animals in group A were taken as health control,the other animals in group B、C and D were made as D-galactose cataract models.Group A and group B were dropped with saline eyedrops;Group C was dropped with pirenoxine sodium eyedrops;Group D was dropped with extract liquid from shijueming.Then,the animals’ pupils were dilated and lens changes were observed under the slit-lamp and taken photograph at 5th,10th,15th day.At the 15th day all animals were killed,the content of SOD,GSH and GSH-PX from lens were measured·RESULTS: The content of SOD,GSH and GSH-PX was significantly higher in the group A than that in group B,C and D(P<0.01);The content of SOD,GSH and GSH-PX was significantly higher in the group D than that in group B(P<0.05).The degree of lens opacity in rats: compared with group B,group D had significantly lighter lens opacities and slower development,also slightly better than group C·CONCLUSION: Shijueming can effectively improve the antioxidant capacity of the lens,and protect the lens against cataract development.

Abstract:AIM :To investigate the effect of N-acetylcysteine(NAC) on the rat lens expression of aquaporin protein-1(AQP-1) during ultraviolet(UV) radiation injury·METHODS: Transparent lens of healthy clean grade SD rats were randomly divided into 3 groups,the model group was exposed with UV ray,the drug group added in 300μmol/L NAC besides the UV radiation,the control group did not take above measures.Respectively they were cultivated 3,12 and 24 hours to observe the degree of lens opacification and the lens hydration degree;Western blotting was used to observe the levels of AQP-1 expression·RESULTS:The control group had high expression of AQP-1;the model group low expression of AQP-1;compared with model group,the drug group had high expression of AQP-1.By statistical analysis,between the model group and the control group,the expression of AQP-1 had significant difference(P<0.01);between the model group and the drug group,the expression of AQP-1 also had significant difference(at 3 hours,P<0.05;while at 12,24 hours,P<0.01)·CONCLUSION: UV ray can reduce the expression of AQP-1 and lead to cataract,while NAC can protect cells from UV damage to ease cataract incidence by improving the expression of AQP-1.

Abstract:AIM:To study the effect of different media on the original rabbit lens epithelial cells·METHODS:Using the tissue block adhering wall method to culture the rabbit lens epithelial cells(RLEC) original generation in vitro,the situation of morphology,proliferation and differentiation of the original RLEC in the media containing different ingredients(DMEM low glucose,DMEM high glucose and DMEM/F12 medium) were learned·RESULTS:Cells cultured for 2 weeks on DMEM low and high glucose media began to differentiate and stop growing,the lens epithelial cells had significant fibrosis.DMEM/F12 medium made the cells grow well.When the cells passed on to the 5th generation,they began to transform into fibroblasts·CONCLUSION: The results indicates that the DMEM low glucose and DMEM high glucose media could inhibit the proliferation of the original RLEC to some extent,and DMED/F12 medium is suitable for the proliferation of original RLEC.

Abstract:AIM:To compare the therapeutic effects and complications in the silicon-oil-tamponaded eyes without lens between silicon oil removal with three incisions through pars plana corporis ciliaris combined with secondary posterior chamber intraocular lens(IOL) implantation into capsular bag or ciliary sulcus and silicon oil removal with two incisions combined with secondary posterior chamber IOL implantation by suturing IOL in ciliary sulcus retrospectively·METHODS: Totally 698 cases(713 eyes) from January 2004 to December 2006 and January 2007 to December 2009 in the First Hospital of China Medical University were analyzed retrospectively,they were treated by above-mentioned two kinds of silicon oil removal combined with secondary posterior chamber IOL implantation respectively.Among them,the group of two incisions was 305 cases(314 eyes),the group of three incisions was 393 cases(399 eyes),and the raise of best-corrected visual acuity and the incidence rate of intraoperative and perioperative complication,vitreous rehaemorrhagia,retina redetachment and preretinal membrane were compared·RESULTS:In the group of two incisions,best-corrected visual acuity improved above two lines occurred in 98 eyes(31.2%),corneal endothelium decompensation in 6 eyes(1.9%),intraocular hypotension in 13 eyes(4.1%),intraocular hypertension 11 eyes(3.5%),IOL dyssymmetry seriously in 17 eyes(5.4%),vitreous rehaemorrhagia in 37 eyes(11.8%),retina redetachment 24 eyes(7.6%),preretinal membrane 1 year after operation 45 eyes(14.3%);in the group of three incisions,best-corrected visual acuity improved above two lines occurred in 217 eyes(54.4%),the number of corneal endothelium decompensation and intraocular hypertension was 0,intraocular hypotension in 5 eyes(1.3%),IOL dyssymmetry seriously in 6 eyes(1.6%),vitreous rehaemorrhagia in 9 eyes(2.3%),retina redetachment 7 eyes(1.8%),preretinal membrane 1 year after operation 3 eyes(0.8%),those were significantly different between the two groups·CONCLUSION:Compared with the group of silicon oil removal with two incisions combined with secondary posterior chamber IOL implantation by suturing IOL in ciliary sulcus retrospectively,the group of silicon oil removal with three incisions through pars plana corporis ciliaris combined with secondary posterior chamber IOL implantation into capsular bag or ciliary sulcus have better therapeutic effect,a lower incidence of postoperative complications is suitable for wide application.

Abstract:AIM: To explore the changes of the serum level of basic fibroblast growth factor(bFGF),vascular endothelial growth factor(VEGF) in diabetic patients and to investigate the role of bFGF,VEGF in the pathogenesis of diabetic retinopathy(DR)·METHODS:Serum samples of DR patients with cataract were collected.The serum samples from the non-diabetic patients with cataract were chosen as the control.The serum level of the bFGF,VEGF protein was analysed by ELISA method·RESULTS: The levels of serum VEGF and bFGF were significantly higher in patients with DR than those in controls(P<0.01);The serum levels of VEGF and bFGF in patients with proliferative diabetic retinopathy(PDR) were significantly higher than those in non-PDR patients(P<0.05).The serum levels of VEGF and bFGF were associated with the severity degree of DR.Positive correlations were found between bFGF and VEGF(r=0.419,P<0.01)·CONCLUSION: bFGF and VEGF play an active role in the generation and development of DR and has a close relation with the neovascularization of the advanced stage of DR.

Abstract:AIM: To observe conjunctival inflammatory reaction and expression of inflammatory marker ICAM-1 after long time treatment with anti-glaucoma eyedrops,and to investigate the impact on conjunctiva.METHODS: Ninety primary open-angle glaucoma patients were collected.All patients were divided into three groups in accordance with the type of treatment by using the anti-glaucoma drug: combined medication group of 30 cases,single drug treatment group of 30 cases;non-drug group of 30 cases.30 cases with simple cataract acted as blank control group.Each group was divided into 3 time phrase(0-6,7-12,13-18 months)sub-groups by anti-glaucoma drug treatment time and cataract sick time,to conduct optical microscopy observation on conjunctival epithelial histomorphology and detect ICAM-1 expression.RESULTS: Single drug treatment group in applying drugs for 13-18 months had obvious bulbar conjunctival histology changes featured by its bulbar conjunctival epithelial tissue thickening,irregular shape,macrophages,lymphocytes,fibroblasts increase and irregular subconjunctival fibrous connective tissue.Combined medication group in applying drugs for 13-18 months had obvious bulbar conjunctival histology changes featured by the bulbar conjunctival tissue with varying degrees of epithelial hyperplasia or metaplasia,uneven epithelial thickness,increased number of small blood vessels in subconjunctival tissue,and macrophages,lymphocytes,fibroblasts markedly increased,goblet cells decreased.In the 13-18 months time phrase,single drug treatment group and combined medication group,compared with the other groups in ICAM-1 positive cell number of conjunctival epithelial tissue,had statistically significant differences(P<0.01).CONCLUSION:The conjunctival tissue inflammatory response and conjunctival epithelial tissue’s inflammatory marker ICAM-1 expression increased significantly.

Abstract:AIM: To study the efficacy of 1,5,25g/L of three different concentrations of povidone-iodine in reducing the rate of positive conjunctival bacteria cultures,and to observe their adverse effects.METHODS: This was a comparative study.205 patients(205 eyes) who underwent cataract phacoemulsification cataract surgery were randomly divided into three groups.At preoperative 1 day,all patients received 3g/L ofloxacin eye drops 3 times.Approximately 5-10 minutes before surgery,the conjunctival sac was irrigated with 20-30mL 1,5,25g/L povidone-iodine,correspondingly.Conjunctival cultures were obtained at the following time points: before receiving any topical medications;after application of 1-day topical 3g/L ofloxacin,before irrigating the conjunctival sac;immediately before surgery,approximately 5-10 minutes after conjunctival sac irrigation and at the end of the surgery.The rate of positive conjunctival cultures among each group was compared and significance of the difference was tested with the Pearson Chi-square test.And adverse effects of the povidone-iodine were observed.RESULTS: The rate of positive conjunctival cultures before the conjunctival irrigation in the 1g/L povidone-iodine group,5g/L povidone-iodine group and 25g/L povidone-iodine group was 63.0%,61.4% and 59.6%,respectively;after surgery was 12.3%,11.4% and 12.9%.The differences of positive rates before the conjunctival irrigation and after the surgery in the corresponding group were statistically significant(χ2=54.88;57.61;40.47,all P=0).Both before the conjunctival irrigation and after surgery,the difference of positive rate among these three groups were not statistically significant(χ2=0.15,P=0.92;χ2=0.06,P=0.96).62 cases of the 25g/L povidone-iodine group had 4 cases with conjunctival congestion and mild corneal edema,accounting for 6%,no other adverse reactions,the other two groups were found no significant adverse reactions,the difference among the three groups was statistically significant(χ2=9.4,P=0.009).CONCLUSION: Three concentrations of povidone-iodine of 1,5,25g/L have similar effects on the reduction of the bacteria in conjunctival sac,but low concentrations of povidone-iodine of 1g/L and 5g/L are more secure.

Abstract:AIM: To observe the optic neuroprotective effects of supplymenting qi and nourishing yin,activating blood and dissolving stagnation Chinese herbs on patient with controlled intraocular pressure after glaucoma surgery and to discuss the correlated mechanism action from hemorheology·METHODS: Sixty patients(99 eyes) were randomly divided into two groups,the treatment group included 30 patients(50 eyes),the control group included 30 patients(49 eyes).The treatment group were treated by supplymenting qi and nourishing yin,activating blood and dissolving stagnation Chinese herbs,while the control group were treated by Yimaikang capsules.In the course of 60 days treatment,the difference of visual acuity,intraocular pressure,visual field(average light sensitivity and average defect),pattern visual evoked potential(LP100,AP100)and hemorheology index were observed and compared·RESULTS: Visual acuity: The central visual acuity of two groups were both improved.The treatment group was better than control group(P<0.05).Intraocular pressure: pre-treatment and post-treatment,there was no statistical significance(P>0.05) between two groups.Visual field(average light sensitivity and average defect): The average light sensitivity and average defect were obviously improved(P<0.01).The treatment group was better than the control group(P<0.01).Pattern visual evoked potential(LP100,AP100): LP100 and AP100 were obviously sensitive(P<0.01).The treatment group was more sensitive than the control group(P<0.01).Hemorheology: In the treatment group,there were obviously statistical significance(P<0.01) on blood viscosity high-shear,erythrocyte electrophoresis,plasma viscosity,index of erythrocyte aggregation between pre-treatment and post-treatment,there was statistical significance(P<0.05) on blood viscosity hypo-shear between pre-treatment and post-treatment.Post-treatment.There were statistical significance(P<0.05) on blood viscosity high-shear,blood viscosity hypo-shear,erythrocyte electrophoresis,plasma viscosity,index of erythrocyte aggregation between the treatment group and the control group·CONCLUSION: Supplymenting qi and nourishing yin,activating blood and dissolving stagnation Chinese herbs have good efficiency on the optic neuroprotection in the treatment of the cases with glaucoma of controlled intraocular pressure,can elevate visual acuity,enhance average light sensitivity and average defect of visual field,enhance electrophysiology activity of optic nerve,and improve ocular hemorheology.These effects result from improving blood flow supply of optic nerve.

Abstract:AIM:To compare with the dioptric parameter in diversified myopia before and after Optimized Refractive Keratectomy-Customized Ablation Manager(ORK-CAM)guided aspheric excimer laser·METHODS:Two hundred and fifty patients(500 eyes)who received the ORK-CAM guided aspheric customized excimer laser surgery in 2010 were assigned to two groups(each group of 250 patients)according to the different degree diopter and compared the naked eye vision,mean spherical equivalent,corneal aberration RMS,SphA,Coma and Q value before and 6 months after the surgery.All data were made statistical analysis using SPSS 17.0,P<0.05 was statistically significant·RESULTS: Six months after surgery,there were no statistical differences in naked eye vision(P>0.05)between two groups.Both two groups had lowered spherical equivalent in both absolute value and reduction from baseline(P>0.05).While corneal aberration RMS,SphA,Coma and Q value increased in both groups.Group of high myopia had more increase in these parameters than another group(P<0.05)·CONCLUSION:ORK-CAM guided aspheric customized excimer laser surgery is a safe and effective technique of individualized ablation.But to further reduce the corneal aberration,spherical aberration,coma and Q value increase after high myopia surgery,further exploration is still needed.

Abstract:AIM:To investigate the effect of different pupil diameter on contrast visual acuity in dark environment·METHODS:Pupil diameter and contrast visual acuity from 42 case(84 eyes)before LASIK surgery were measured with multi-functional visual acuity tester(MFVA-100) and Allegro wavefront analyzer,comparing the contrast visual acuity related to different pupil diameter and analysing their relationships·RESULTS:Contrast visual acuity was(0.158±0.097)and(0.374±0.099) respectively when pupil diameter ranged from 4.0mm to 5.5mm on both contrast of 25% and 10%,better than the contrast visual acuity when pupil diameter ranged from 5.6mm to 7.2mm,the difference was significant(P<0.02),the difference of contrast visual acuity in 25% was more evident than that in 10%;There were no significant difference when pupil diameter ranged from 4.0mm to 5.5mm and 5.6mm to 7.2mm on both contrast of 100% and 5%(P>0.1);contrast visual acuity(100%,25%,10%,5%) were decreased with the increase of pupil diameter whether from 4.0mm to 5.5mm or from 5.6mm to 7.2mm,there was a positive correlation between them·CONCLUSION: Different pupil diameters could affect the contrast visual acuity obviously under certain conditions,and influence the night visual performance accordingly.The measurement to the pupil size on dark environment before LASIK surgery is one of the important index affecting corneal refractive surgical procedures.

Abstract:AIM:To study the wearing crowd distribution and the compliance of lens wearing·METHODS: Retrospective case investigated research.Clinical data of 454 patients with optometry of rigid gas permeable contact lens(RGPCL) from February,2008 to December,2008 were investigated.Patients with RGPCL were reviewed to study age,gender,refractive state,wearing purpose as well as the compliance of lens wearing for the first time·RESULTS: Of the 454 RGPCL wearers,the proportion of male to female was 1∶2.66;Respondents,according to age,were divided into 10-12 years group with 45 casses(9.9%),13-18 years group 243 cases(53.5%)and >18 years group 166 cases(36.6%),in which 13-18 years had the highest proportion;57.5% of patients wearing RGPCL aimed to control myopia development,51.5% of patients for correcting high myopia or hyperopia,41.2% of patients for wearing convenience;The average review time was less than 3 months in 68 cases(15.0%),3-6 months(including 6 months)in 98 cases(21.6%),7-9 months in 26 cases(5.7%),more than 9 months in 50 cases(11.0%),never to check in 212 cases(46.7%)·CONCLUSION: 13-18 age is the main stage of wearing RGP lens,to control the progress of myopia is the main purpose of the wearers.The compliance of wearing RGPCL is effected by reasons of uncomfortable wear,tedious wearing process.Wearers of all ages have no significant difference in compliance,education needs to be further strengthened.Women patients wearing propotion is more than men patients,compliance is also significantly higher than male.The survey also show that education of patients have no significant influence on fitting rate and the compliance.

Abstract:AIM:To determine the prevalence of trachoma in Ningxia and assess associated risk factors to provide the basis for the prevention and treatment of trachoma·METHODS:Study setting was Jinfeng district(city) and Hongsipu town(rural area)in Ningxia.Three thousand residents were selected by cluster randomized sampling.Ocular examination and questionnaire survey were conducted.The diagnosis was performed according to the World Health Organization(WHO) protocol.The prevalence of trachoma was determined and the related the risk factor was analyzed·RESULTS:Prevalence of trachoma was 5.50%(165/3000),2.79%(36/1290) in City and 7.54%(129/1710) in rural area.The difference of the prevalence between city and rural area was significant(χ2=31.96,P<0.05).Trachoma was diagnosed in 5.58%(36/1417) of male cases and 5.43%(86/1583) of female cases.No significant difference was found between male and female(χ2=0.03,P=0.86)·CONCLUSION: The prevalence of rural area is higher than that in urban residents in Ningxia and it may be related to environmental factors,health care and economic condition.It is important to take some interventions to reduce the trachoma prevalence.

Abstract:Aquaporins(AQPs) structural studies have further deepened the awareness of people about this small molecule membrane protein on water and solute transport.To date,two AQPs expression in the lens have been reported,that is AQP0,AQP1.This article focuses on the discussion of AQPs distribution in the lens,its function and possible relationship with cataract formation.

Abstract:Chronic ultraviolet(UV) radiation is considered to be important reason of the senile cataract formation.A large number of epidemiological investigations have shown that cortical and mixed cataracts are subjected to UV radiation.10% to 30% relative risk can be attributed to solar radiation.UV radiation,particularly UVB is an important risk factor for cortical cataract.The lens epithelial cells is not only the most active part of the lens metabolism,but also an important target tissue for UV.The over-apoptosis of lens epithelial cells and the damage of lens protein are closely relevant to the occurrence and development of cataract.

Abstract:Posterior capsule opacification is a more common complication after cataract surgery.In recent years,with the development of molecular biology and cell biology technology,growth factor-type substances such as platelet-derived growth factor(PDGF) are found closely related with proliferation,migration,and differentiation of lens epithelial cell.The appropriate regulation of PDGF may be very important for the prevention of after cataract.This paper focuses on effect of PDGF on lens epithelial cells,effect of PDGF and its receptors on after-cataract formation in a brief review.

Abstract:Neovascular glaucoma(NVG) is a kind of eye disease with strong destroy and high blindness rate.Extensive retinal ischemia is the main reason and there is lack of the effective treatment.Early diagnosis and effective treatment is the most important to control the intraocular pressure and maintain good vision.We will present the NVG treatment situation and future development trend in this paper.

Abstract:Diabetic retinopathy(DR)is one of the common and severe complications in patients with diabetes,which is the leading cause of impairment of vision in diabetic patients.In recent years,following advanced research of diabetic etiopathogenesis,further advances in pharmacotherapy have shown promise in the treatment of DR,including corticosteroids,vascular endothelial growth factor(VEGF) inhibitors,protein kinase C(PKC) inhibitors,renin-angiotensin system blockers Candesartan and fenofibrate.This review will focus on DR present and potential future pharmacologic treatments.

Abstract:Ocular neovascularization always happens in common vision impairing diseases.Current animal experiments have proven that endostatin(ES) may be used as a new drug which can inhibit ocular neovascularization effectively.In this paper,the recent advances of ES in the treatment of ocular neovascularization were reviewed.

Abstract:As a major G-actin-sequestering protein,thymosin beta4(thymosin β4,Tβ4) is in almost mammalian cells.It has a number of physiologic functions,including the promotion of cell migration,stem cell differentiation,angiogenesis,inhibition of cell apoptosis and immune regulation,which plays an important role in the wound healing,tumor metastasis,inflammation control and so on.This review summarizes relative studies about Tβ4,including its properties in cell migration,transdiffe-rentiation and research progress in ophthalmology.

Abstract:Ocular anterior segment imaging technology is one of the rapid development areas of ophthalmology now.This paper describes the principles of various imaging equipment,measurement methods and application in cataract surgery.A variety of anterior segment imaging devices continue to be introduced and are widely used in clinic,which makes the ophthalmologist get the exact value of the anterior chamber structure and provides cataract doctors the basis for correct choice of the timing of cataract surgery.

Abstract:AIM:To definitively diagnose a Best vitelliform macular dystrophy(BVMD) pedigree by molecular genetic examination of vitelliform macular dystophy 2(VMD2) gene,and to provide the basis for gene diagnosis of Best disease·METHODS: Ophthalmological examinations were performed.Mutations in the coding regions of VMD2 gene was analyzed by polymerase chain reaction(PCR) and direct DNA sequencing.VMD2 mutation screening was performed in 100 normal controls·RESULTS: Funduscopic examination of the proband revealed vitelliform lesions in the maculae of both eyes.Fundus angiography didn’t show choroidal neovascularization.Mutation analyses found a heterozygous mutation c.886A>G(Asn296Asp) in exon 8 of VMD2 gene·CONCLUSION: A novel disease-causing mutation in VMD2 gene(Asn296Asp) is found in a Best disease family.Mutation screening of VMD2 gene can be used for definite diagnosis and genetic consultation of Best disease.The possibility of Best disease should not be neglected when a case has macular abnormality.

Abstract:AIM:To analyze the effect of corneal ulcer debridement combined with antimycotic drug for fungal keratitis·METHODS:Collecting 2010-09/ 2011-09 fungal keratitis 30 cases in our hospital,all patients were treated with corneal scraping,followed with corneal ulcer debridement,and fluconazole or natamycin eyedrop according to the severity of keratitis,ineffective treatment cases resorted to the self conjunctiva cover or lamellar kemtoplasty.The therapetic results were observed with following up·RESULTS:Totally 27 cases corneal blade and fungi culture were positive,positive rate were 90%.Among these cases,6 mild keratitis cases all recovered after corneal ulcer debridement combined with fluconazole eyedrop,course 2-3weeks.The moderate keratitis were 17 cases,12 cases recovered after corneal ulcer debridement combined with natamycin eyedrop,course 4-10weeks.7 cases became serious,among which 3 cases underwent self conjunctiva cover,1 cases underwent the lamellar kemtoplasty.The total effective rate of corneal ulcer debridement combining with antimycotic drug for fungal keratitis was 70%·CONCLUSION:Corneal ulceration debridement combined with antimycotic drug is simple,economic,effective and feasible treatment for fungal keratitis.

Abstract:AIM:To evaluate the species of bacteria on the conjunctiva sac of the middle age and the elder of Han nationality in Ganzi district·METHODS:A total of 173 cases(346 eyes) of the middle age and the elder of Han nationality in Ganzi Tibetan Autonomous Prefecture were examined.The professional person embrocated the inferior palpebral conjunctiva.Then the secretion was inoculated on blood plate for 48hours,the bacteria was seperated and identified·RESULTS: The positive rate of the bacteria cultivation was 60.4.%(209/346).Totel 232 strains were cultivated.The most dominant was Staphylococcus epidermidis(115 strains,49.6%),the next was Corynebacterium(60 strains,25.9%).The positive rate of bacteria in the conjunctival sac of the elder in Guzan and Lucheng town of Kangding County were 69.2% and 65.8%,the difference was not statistically significant(χ2=0.1709,P>0.05).The positive rate of the elder in Gar town of Jiulong County was 44.3%,compared with the ones in Guzan and Lucheng town was lower.The difference was statistically significant(Guzan vs Gar:χ2=13.2002,P<0.05;Lucheng vs Gar:χ2= 9.6869,P<0.05)·CONCLUSION:Bacteria could be found in most people’s conjunctiva of Han nationality,Staphylococcus epidermidis and Corynebacterium were the dominant strain on the conjunctiva of the middle age and the elder.Different district has different positive rate of the bacteria cultivation.

Abstract:AIM:To observe the influence of phacoemulsification combined with goniosynechialysis(Phaco-GSL) on anterior chamber and intraocular pressure(IOP) for primary angle-closure glaucoma(PACG) with cataract patients·METHODS:Totally 36 patients(36 eyes) with PACG and cataract were randomly divided into observation group of 18 patients and control group of 18 patients,the observation group underwent Phaco-GSL treatment,the control group was treated with simple Phaco surgery,changes in anterior chamber structure,IOP and visual acuity were recorded before and after the surgery·RESULTS:The patients with postoperative anterior chamber angle opening greater than 270° were 18 cases(100%) in the observation group,10 cases(56%) in the control group,the comparison between two groups was statistically significant(P <0.01);Postoperative anterior chamber deepened 1.208±0.181mm in the observation group,0.883±0.074 mm in the control group,the comparison between two groups was statistically significant(P<0.01);The patients with postoperative IOP decreased to the normal range in the case of no drug treatment were 15 cases(83%)in the observation group,9 cases(50%)in the control group,the comparison between two groups was statistically significant(P<0.01);All the postoperative visual acuity had improved,but the comparison between two groups was not statistically significant(P>0.05)·CONCLUSION:Phaco-GSL can significantly improve anterior chamber structure with effective lowering IOP to achieve the desired therapeutic effect for the patients of PACG with cataract.

Abstract:AIM:To investigate the clinical effects of modified and general cataract extraction united with trabeculectomy for the treatment of glaucoma combined with cataract·METHODS:All the data of the operations of 64 eyes from January 2004 to June 2010 in our hospital were collected and analyzed.Postoperative intraocular pressure,visual acuity and functional filtering bleb were compared between the two surgical methods.The data were analyzed by SPSS 11.0 statistical software·RESULTS: There were no significant difference in intraocular pressure and functional filtering bleb between the two groups,but the difference was significant in visual acuity·CONCLUSION:As it has advantages of recovering quickly visual acuity and controlling intraocular pressure well,modified operation is an ideal method in treating glaucoma combined with cataract.

Abstract:AIM:To evaluate the clinical effect of no scleral suture trabeculectomy for glaucoma·METHODS:Totally 45 cases(57 eyes) of glaucoma were included from December 2007 to June 2010.57 eyes were randomly divided into two groups(Group A and B).24 cases(29 eyes) were treated with no scleral suture trabeculectomy(Group A) and 21 cases(28 eyes) were treated with traditional trabeculectomy(Group B).Intraocular pressure(IOP),anterior chamber,filtering bleb and complications were compared·RESULTS:No scleral suture trabeculectomy appeared more effective in IOP control and functional bleb formation whereas a lower complication rate compared with traditional surgery·CONCLUSION:No scleral suture trabeculectomy is an effective method for glaucoma.

Abstract:AIM:To evaluate the efficacy and safety of intravitreal avastin for diabetic macular edema(DME)(diabetic retinopathy Ⅳ period and macular edema above metaphase)·METHODS:Totally 60 patients who were diagnosed by fundus fluorescein angiography(FFA) from January 2009 to December 2010 with declining eyesight and diabetes of clinical treatment significance FFA showed diabetic retinopathy in Ⅳ period,optical coherence tomography(OCT) examination showed moderate or above macular edema,macular edema history did not exceed 3 months were selected.All eyes received a baseline eye examination before treatment,which included intraocular pressure,slit-lamp,best-corrected visual acuity,mydriatic fundus examination,and color retinal photography,FFA,OCT were performed.An intravitreal injection of avastin(1.25mg) was given at baseline and followed by two additional injections of four weeks intervals.Recording the first day,the second day,the third day,the third week,the third month,the sixth month of best-corrected visual acuity,intraocular pressure,the change of lens and vitreous,status of retinal leakage and observing postoperative central retinal thickness by OCT to compare·RESULTS:The intravitreous injection of avastin could improve vision function and decrease central macular thickness(CMT) obviously.The central macular thickness was(395.933±119.784)μm in preinjection and(314.200±60.528)μm in postinjection,showing a statistically significant difference between them.During the follow-up,no significant changes in intraocular pressure and cataract were observed.The retina toxicity reaction relevant to avastin and local or systemic adverse reactions were nothing·CONCLUSION:The intravitreous injection of avastin can relieve macular edema and improve visual acuity stably for diabetic retinopathy patients.However,its long-term treatment effect requires a large sample of experiments to further confirm.

Abstract:AIM:To evaluate the effectiveness of pneumatic retinopexy(PR) with cryopexy in the therapy of inferior rhegmatogenous retinal detachment(RRD)·METHODS:Twenty-two patients(22 eyes) were included in this study.The RRD diagnosis was confirmed by best-corrected visual acuity(BCVA),slit-lamp microscope,indirect ophthalmoscope and Goldman three-mirror contact lens.All patients had undergone PR with cryopexy,and the post-operative follow-up was 6 to 24 months with an average of 12 months.Post-operative BCVA and final anatomical outcome was analyzed·RESULTS:The reattachment rate of single PR was 77%(17/22 eyes),and 2 eyes required additional intravitreal injection of the gas.The total reattachment rate of PR was 86%(19/22 eyes).Three eyes needed additional scleral buckling.Final retinal reattachment was achieved in all 22 subjects(100%).Postoperative BCVA was significantly improved(P<0.01)·CONCLUSION:PR is an effective surgery for inferior RRD·

Abstract:AIM:To analyse the characteristics of retinal lesions in myopic patients scheduled for laser in situ keratomileusis(LASIK),then to assess the efficacy and safety of prophylactic laser coagulation for retinal lesions in these myopic eyes·METHODS:Retrorespective clinical research.LASIK were performed in 1100 continuous patients(2190 eyes).Before operation,the fundus was examined with direct and indirect ophthalmoscope and three mirror contact lens.The laser photocoagulation was performed in order to strengthen the retina with severe peripheral degeneration·RESULTS:Peripheral fundus abnormalities and holes both increased while refraction diopter increased,and there were statistically significant differences among groups(P<0.05).And the abnormalities were usually in the temporal fundus.A total of 2190 eyes were examined.Among them,132 eyes(6.07%) were found to have peripheral retinal degeneration:64 eyes(48.48%) had lattice degeneration,37 eyes(28.03%) had cystoid degeneration,54 eyes(40.91%) had snail track degeneration,34 eyes(25.76%) had white non-pressure change,12 eyes(9.09%) had cobblestone degeneration,14 eyes(10.61%) had retinal dry holes,4 eyes(3.03%) had hole and localized shallow detachment.The pathological changes in 43 cases(78 eyes) were treated effectively by laser photocoagulation for more than three weeks,and eventually the holes were firmly closed and the lattice degeneration,the cystoid degeneration were photocoagulated reliably.No new holes and retinal detachment occurred·CONCLUSION: It’s necessary to examine the fundus of the two eyes with the three-mirror contact lens before LASIK.To prevent retinal detachment effectively,laser photocoagulation should be performed in time on the peripheral retinal degeneration of myopia.

Abstract:AIM:To analyze the features of traumatic cyclodialysis cleft by ultrasound biomicroscopy(UBM) and summarize the results of ciliary body suture with UBM in traumatic cyclodialysis cleft·METHODS:Totally 30 eyes of 30 patients with post-traumatic ciliary body detachment were diagnosed by UBM examination,with the localization and range of cyclodialysis cleft.Among them,5 eyes of 5 patients were treated with ciliary body suture according to the results of UBM examination.Patients were examined postoperatively on visual acuity,intraocular pressure(IOP),and UBM and ultrasonography re-examination·RESULTS:All patients had cyclodialysis detachment,90%(27/30)had full cyclodialysis detachment,and 87%(26/30)had cyclodialysis cleft,the mean ACD was(1.830±0.575)mm.5 patients of them had been treated by ciliary body suture with UBM.The IOP of 4 patients was normal after the first surgery,the IOP of 1 patient was normal after the fourth surgery.Ciliary body of all patients after surgery was adhered to sclera,anterior chamber was deepened,and visual acuity was improved·CONCLUSION:UBM is a useful method for appropriate diagnosis of traumatic cyclodialysis cleft.Ciliary body suture with UBM is an effective surgery for treatment of traumatic cyclodialysis cleft.UBM can be of great value in the diagnosis,management and follow-up of patients with traumatic cyclodialysis cleft.

Abstract:AIM:To report the surgical outcomes of patients undergoing orbital fracture repair without periosteal closure·METHODS:All patients data were reviewed in a retrospective manner.Seventy-two patients(73 eyes) who underwent transconjunctival repair of isolated orbital fractures(n=51) or complex orbital fractures(n=21) without periosteal closure were included.A transconjunctival incision below the tarsus provided preseptal access to the inferior orbital rim,and transcaruncular incision provided access to the internal orbital fracture,after which the periosteum was incised for exploration and repair of orbital fracture.Forced ductions were performed after release of entrapped tissue and placement of orbital implants,and the periosteum was sutureless,conjunctiva was reapproximated with forceps and interruptedly sutured.Incidence of postoperative complications,including orbital implant exposure,infection,and migration was measured·RESULTS:All patients were followed up for 4-18(average 11) months postoperatively.One patient experienced lower lid retraction with entropion.Other complications included lateral canthal dystopia(n=3) or pyogenic granuloma at the lateral canthotomy site(n=1).There were no cases of postoperative implant exposure,infection,or migration·CONCLUSION:Forgoing closure of the periorbita after transconjunctival orbital fracture repair is associated with a low incidence of postoperative complications.This technique is applicable in the repair of both isolated orbital fracture and complex orbital fracture.

Abstract:AIM:To evaluate the effect of laser in situ keratomileusis(LASIK) and laser subepithelial keratomileusis(LASEK) on the choroidal blood flow by comparing and analyzing the ocular pulse amplitude(OPA) values before and after LASIK and LASEK·METHODS:After routine check all patients were devided into two groups and each group had 20 patients(39 eyes).After measured central corneal thickness(CCT) and corneal curvature(CCV) by Pentacam system,the two group patients which would be treated by LASIK or LASEK operation were measured intraocular pressure(IOP) and OPA by the dynamic contour tonometry(DCT) before operation and one month after operation.Finally the statistical analysis were adopted to evaluate the measurement results·RESULTS:There was no statistical difference between the OPA values of the LASIK patients or the LASEK patients before and after operation(P>0.05),and the OPA values had no statistical difference between the LASIK patients and the LASEK patients before and one month after operation(P>0.05)·CONCLUSION: LASIK and LASEK operation don’t affect the choroidal blood flow.

Abstract:AIM:To investigate changes in refractive state after scleral encircling and buckling surgery·METHODS:Twenty-three cases(23 eyes) that were successfully treated for rhegmatogenous retinal detachment with scleral encircling and buckling were measured with A-scan ultrasonography and given rtinoscopy optometry 1 day before surgery,as well as 1 week,4 weeks and 12 weeks after surgery.Refractive factors,axial length,chamber depth,lens thickness,refractive power of cornea and diopter status of the eyes were measured and compared pre-and post-operatively·RESULTS:When compared to the data obtained before surgery,significant increases in both axial length and lens thickness of the eyes were observed on the 1st,4th and 12th week after surgery(P<0.01 for both factors,but P<0.05 for diopter strength and anterior chamber shallowing refractive power increase.Diopter strength had a tendency to shift to a negative value·CONCLUSION:Axial length and diopter strength increased after surgery.This suggests that the myopic shift after scleral encircling and buckling surgery may be primarily caused by the increase of axial length.

Abstract:AIM:To compare the peripapillary retinal nerve fiber layer(RNFL) thickness of amblyopic and sound eyes in patients with unilateral anisometropic amblyopia·METHODS:Totally 38 patients with unilateral anisometropic amblyopia and without strabismus were selected.The peripapillary RNFL thickness in amblyopic and sound eyes was detected by optical coherence tomography(OCT)·RESULTS:For 38 patients with amblyopia,the mean age was 10.73 years,the average RNFL thickenss in amblyopic eyes was 106.38±12.05μm.The RNFL was thickest in the inferior quadrant 133.67±19.44μm,followed by superior 123.31±13.95μm,nasal 89.96±17.71μm and temporal 70.06±10.18μm.The RNFL thickenss in amblyopic eyes was thicker than that in sound eyes,showing statistical difference in averge and nasal RNFL thickenss(P=0.016;P=0.01)·CONCLUSION: The RNFL thickness,specially nasal and average RNFL thickness in amblyopic eyes is thicker than that in sound eyes in unilateral anisometropic amblyopia.

Abstract:AIM:To evaluate the efficacy and safety of Pranoprofen eye drops in relieving reactions of postoperative inflammation of Nd:YAG laser to treat the disease of the anterior segment of the eye·METHODS:Totally 60 cases(60 eyes) with angle-closed glaucoma were performed laser peripheral iridotomy(LPI) and laser capsulotomy,then were randomly divided into two groups,experimental group and control group,30 cases(30 eyes) of each group.Pranoprofen and TobraDex eye drops,four times each day,were administered in experimental and control group respectively.All patients had been observed for 7 days.Ocular pain,photophobia,epiphora,conjunctival congestion,keratitis,aqueous humor flare were observed and recorded to calculate a comprehensive score to assess the curative effects·RESULTS:There was no significant difference in comprehensive score between the two groups at 1 day,3,7 days postoperatively(P>0.05)·CONCLUSION:Pranoprofen eye drops have excellent efficacy and safety to control the inflammation after laser peripheral iridotomy and laser capsulotomy,it can decrease the danger of high intraocular pressure due to corticosteroid.

Abstract:AIM:To analyze the clinical features of the two Usher Syndrome families USH-001 and USH-002,and screening for possible relevant USH gene map locus·METHODS:The clinical and pedigree features of USH-001,USH-002 families were analysed.The short tandem repeat markers around the 12 known USH gene map locus were screened to choose the possible relevant genes by use of the principles and methods of linkage analysis·RESULTS: The phenotypes of the family USH-001 were similar to USH-002,night blindness occurred in 10-13 years old and gradually got worse with age,visual field gradually narrowed to tubular vision,while the decline of visual acuity were not obvious,bone cell-like retinal pigmentation was found in the peripheral retina.Hearing loss in both ears occurred in childhood,it was non-progressive sensorineural hearing loss,with mainly high-frequency hearing loss and normal vestibular function.Their clinical manifestations were consistent with the diagnosis of USH-002.The phenotype did not consecutively transmit.In USH-001 family all the patients shared the same Allele of D11S902 and D17S785 short tandem repeat markers,and all the patients in USH-002 family shared the same Allele of D1S425and D9S1776 markers·CONCLUSION: USH-001 and USH-002 are USH2 families and their genetic forms are autosomal recessive.USH1C and USH1G are likely pathogenic genes for USH-001 family,USH2A and USH2D are likely pathogenic genes for USH-002 family.

Abstract:AIM:To evaluate the aqueous humor and serum levels of chromium(Cr) in cataract patients with and without 2 type diabetes mellitus·METHODS:Levels of Cr were measured using atomic absorption spectrometry in the serum from 40 patients and aqueous humor aspirates taken during anterior segment surgery from 19 eyes of 19 patients who had diabetic cataracts(diabetic group)and from 21 eyes of 21 patients who had senile cataract only(control group)·RESULTS:The mean aqueous humor Cr concentration in eyes with diabetes cataract was significantly lower than that from eyes with senile cataract(P<0.05).There was also a statistically significant difference between the serum Cr concentrations of the diabetic group and the control group(P<0.05).Serum and aqueous humor chromium content in both groups showed no significant correlation(r=-0.142,P>0.05)·CONCLUSION:The aqueous humor and serum Cr levels are decreased in eyes with diabetic cataract.Cr has an important role in the development process of cataract in patients with diabetes.

Abstract:AIM:To investigate the related factors and trends of cataract operation by analysing the current situation of operation and surgical rate in eastern Fengxian community of Shanghai and to improve cataract surgical rate and quality and to accelerate the work progress of cataract prevention of blindness under the policy of new type of rural cooperative medical care system(NCMS)·METHODS: Data of over 55 years old patients who had accepted cataract surgery between January 2008 and August 2010 were collected and then evaluated with standard of our current cataract epidemiological survey and diagnostic criteria of World Health Organization(WHO) to blind or low vision;Gender,age,effect of surgery,health care and the causes of postoperative low vision,and the effect of policy of "NCMS"on cataract operation were statistically analyzed·RESULTS:Among 994 patients(1260 eyes),649 female(806 eyes) and 345 male(454 eyes),the number of female patients were much more than that of the male,the minimal age was 55,maximal 99 and average 74.75±7.92 years old.The age group of 70-79,including 515 patients,accounted for 51.81% of all patients.The number of patients whose postoperative corrected visual acuity was greater than or equal to 0.05 was 1241 eyes,off-blindness rate was 98.6%;greater than or equal to 0.3 was 1179 eyes,off-disability rate was 93.57%;the IOL implantation rate was 98.49%.39 eyes occurred complications,accounting for 3.10% of all patients.In the aspect of health care composition of cataract surgery patients,farm security had 561 people accounting for 56.44%;town security had 135 people accounting for 13.58%;the summation of these two items took up 70.02% of all patients·CONCLUSION: Cataract is the main cause of blindness among the elder.The morbidity of female is much higher than that of male.Under the institution of NCMS,the cataract surgical rate of Eastern Fengxian community of Shanghai is high,and so do the off-blindness rate,off-disability rate and IOL implantation rate postoperatively.Preventing blindness and improving low vision is focused on early diagnosis and treatment of cataract.Cataract is still the key of blindness prevention work.

Abstract:AIM:To determine the prevalence rate of pterygium in Ningxia region and to explore the risk factors such as age,gender,the urban-rural difference,geographical position,nationality,economic level and demographic factors·METHODS:Totally 3001 residents were selected by cluster randomized sampling in Jinfeng district and Hongsipu town.Ocular exanmination and questionnaire survey were conducted.The prevalence rate and incidence of pterygium were calculated and the related risk factor was analyzed·RESULTS:The prevalence rate of pterygium was 6.16%in Ningxia region and 5.74%in urban,6.49%in rural area,difference between the two groups was not statistically significant(χ2 = 0.717,P=0.397).As for 26-45 age group and more than 66 age group,the prevalence rate in rural area was significantly higher than urban area.No significant difference was found between male(6.30%) and female(6.82%)(χ2=0.269,P=0.604),the same as that between Hui and Han nationality(χ2=1.641,P=0.440)·CONCLUSION: The higher prevalence rate of pterygium in Ningxia is attributed to geographical position and climate condition,but not significantly associated with gender and nationality.Regarding to rural residents,the prevalence rate is higher in aged group.The course of disease is related to the economic level.

Abstract:AIM:According to the analysis of 1061 cases(1061 eyes) of cataract surgery in primary blindness-prevention project,to explore the key processes in perioperative period in order to find a safe and effective procedure.METHODS: According to the information of 1061 cases in the blindness-prevention project in 2009,the perioperative processes were summarized and regulated.RESULTS:Among these 1061 cases who accepted cataract surgery,there were 17.0% cases with the preoperative corrected vision under hand movement,22.1% under 0.1,59.0% between 0.1 to 0.3,and 1.9% better than 0.3.267 cases(25.2%) were hyper matured cataract with/without hard nucleus.There were 2 cases(0.2%) combined with lens dislocation,13 cases(1.2%) accepted anti-glaucoma surgery,3 cases(0.3%) accepted vitrectomy surgery,and 9 cases(0.8%) suffered by obsolescence uveitis,44 cases(4.1%) corneal endothelial cell counting was less than 2000 per square centimetre.Phacoemulsification were performed in 1048 cases(98.8%) and ECCE in 13 cases.The incidence of several primary complications were separately: 27 cases(2.5%) of posterior capsular rapture,54 cases(5.1%) of corneal edema at postoperative 3 days,and 1 case(0.1%) of failure to IOL implantation.None endophthalmitis happened.In 3 months postoperation,the out of blindness rate(uncorrected visual acuity >0.1) was 97.8% and the rate(best corrected visual acuity >0.3) was 84.2%.There were about 36.7% with visual acuity better than 0.6.There were so many cases combined with kinds of fundus diseases,such as retinopathy due to high myopia(3.7%),age-related macular degeneration(3.3%),and so on.CONCLUSION:The conditions of cataract patients who joined in blindness-prevention project were very complex,not only in ocular but also in systemic.The rate combined with fundus diseases was high.In order to make the cataract surgery successful,normative processes in perioperative period are very important.

Abstract:AIM:To discuss the approach of prevention for the rejection after keratoplasty·METHODS:A retrospective analysis of the rate of rejection in 73 patients(73 eyes) was made after penetrating keratoplasty·RESULTS:The immunological rejection happened in 28 eyes(38%),consisting of 21 eyes with high risk keratopathy and 7eyes with non high risk keratopathy,corneal neovascularization took up 88%.The immunological rejection happened in 2 weeks to 3 years after keratoplasty.The corneal endothelium rejection occupied 43%.The immunological rejection were restrained after medication obviously,the effective percentage was 61%·CONCLUSION:The rate of rejection is markedly increased in eyes with high risk keratopathy,which persists long time.We should take measures before,during and after keratoplasty based on different keratopathy.

Abstract:AIM:To evaluate the therapeutic efficacy of soft corneal contact lens(SCL) after extraction of corneal foreign body·METHODS:Totally 103 cases(103 eyes) in clinic department and 24 cases(28 eyes) in-patient of corneal foreign body were treated with continuous use of SCL and antibiotic eye-drops after extraction of corneal foreign body without dressing·RESULTS: Totally 127 cases(131 eyes) were cured with freely eye opening and eye closure,all of them recovered to normal work and life.The corneal epithelium was healed after use of SCL in 24-48 hours without corneal infection·CONCLUSION:Application of SCL after extraction of corneal foreign body achieve satisfactory clinical results.

Abstract:AIM:To evaluate the value and surgical technique of traction suture of inferior corneoscleral limbus in ophthalmology surgery·METHODS:Traction suture of inferior corneoscleral limbus was applied in 163 patients(181 eyes) of ophthalmic surgery,including small incision extracapsular cataract extraction with intraocular lens implantation in 86 patients(98 eyes),glaucoma trabeculectomy in 48 patients(54 eyes),cataract surgery combined with glaucoma surgery in 10 patients(10 eyes),conjunctival flap covering surgery in 8 patients(8 eyes),intravitreal gas injection in 3 patients(3 eyes),suturing reattachment of traumatic ciliary body detachment in 2 patients(2 eyes),pars plana vitrectomy in 6 patients(6 eyes).The distance from superior limbus to superior palpebral margin was measured on 12∶00 with ruler·RESULTS: Totally 160 patients 178 eyes,98.3% in ophthalmic surgery can be smoothly proceeded with traction suture of inferior corneoscleral limbus,3 cases(3 eyes,1.7%) in glaucoma patients with small palpebral fissue were also operated after canthotomy.It is 9.5±3.5mm from superior limbus to palpebral margin.No complications from traction suture occurred·CONCLUSION:Traction suture of inferior corneoscleral limbus is safe,effective and simple,it can take the place of superior rectus traction suture and worthes to be applied for doctors in ophthalmic surgery.

Abstract:AIM:To evaluate the clinical features of posterior polar cataract and the surgical technique of phacoemulsification in eyes with posterior polar cataract·METHODS: Case series of 12 patients(17 eyes) with posterior polar cataract who were treated in our hospital from October 2009 to March 2011 were collected.Patients underwent complete ophthalmological examinations including visual acuity,slit-lamp microscopy,and indirect ophthalmoscopy or B-scan ultrasonography.Under peribulbar anesthesia,phacoemulsification was carried out in all cases with foldable intraocular lens(IOL) implantation.The surgical technique,preoperative and postoperative visual acuities,and intraoperative complications were evaluated·RESULTS:All eyes were implanted foldable IOL.Eleven eyes revealed intact and transparent posterior capsule,four eyes revealed posterior capsule opacification which needed YAG laser capsulotomy later.Two eyes developed posterior capsule rupture in which one occurred during division of nucleus and another during aspiration of epinucleus.Fifteen IOL were implanted in the capsular bags,while two IOL were fixed in the ciliary sulcus.In all,16 eyes achieved a best-corrected visual acuity of 20/40 or better one month after operation·CONCLUSION:Phacoemulsification with foldable IOL implantation is an effective and safe method to treat posterior polar cataracts.By continuous curvilinear capsulorhexis,performance of careful and gentle hydrodelineation without hydrodissection,low power,low vacuum and low flux phacoemusification parameters setup,manual aspiration of epinucleus and cortex surgical technique,intraoperative complications could be decreased.

Abstract:AIM:To treat the patients with opacity of the cornea and cataract that need non-supersonic emulsification cataract extraction,intraocular lens implantation and iris optics excision(tripie procedure),and to observe and analyze the clinical effects of the triple procedure·METHODS:Thirteen cases(18 eyes) with keratoleukoma and cataract were chosen,according to the opacity degree of the cornea and the spot,the iris optics excision spot was designed.The triple procedure was perfomed and postoperative visual acuity was observed.Follow-up period lasted for 1 month to 3 months postoperatively·RESULTS:The preoperative visual acuity:12 eyes were light perception and finger counting;4 eyes <0.1;2 eyes between 0.1-0.2.The postoperative naked vision: one week after surgery open hole vision of 12 eyes was over 0.3,5 eyes over 0.1,1 eye had no improvement.After 3 months,best-corrected visual acuity was 0.6,14 eyes were over 0.2-0.3,the majority of the vision had varying degree enhancement·CONCLUSION:Non-supersonic emulsification cataract extraction,intraocular lens implantation and optics iris excision can cure the patients refracting media turbidity of eye forepart and help them to get perception function at one time.Compared to the traditional penetrating corneal transplantation and cataract extraction,the iris optics excision method is simplified,and reduces the complications of rejection and so on after cornea transplantation.The tripe procedure has high safety,low cost and low risk,which is worth promoting.

Abstract:AIM:To discuss the successful experience of primary hospital doctors in surgery transition from small incision non-phacoemulsification cataract surgery to phacoemulsification·METHODS: The treatment result and complications of 61 cases(64 eyes) which underwent phacoemulsification and intraocular lens(IOL) implantation surgery from June 2010 to June 2011 during the author surgery transition period were analyzed·RESULTS:Totally 60 cases of 63 eyes were operated well.One case was of posterior capsule rupture with vitreous loss.Postoperative visual acuity of 32 eyes(50%) were better than 0.3 after a week.Postoperative visual acuity of 30 eyes(47%) were greater than 0.5 and 2 eyes(3%) were lower than 0.1.The main complications during operation:5 eyes(8%)were of posterior capsule rupture.The main Postoperative complications:19 eyes(30%) were of corneal edema·CONCLUSION:The primary hospital doctors are also able to transform smoothly from a small incision non-phacoemulsification cataract surgery to phacoemulsification 

Abstract:AIM:To study the effect of posterior continuous curvilinear capsulorhexis(PCCC) in phacoemulsification and intraocular lens implantation·METHODS:Totally 72 cases(72 eyes) undergoing phacoemulsification and intraocular lens implantation from January 2003 to December 2010 were analyzed.PCCC were used in the intraoperative posterior capsule tears.After surgery,the best-corrected visual acuity,the count of corneal endothelial,intraocular pressure,corneal edema,anterior chamber Tyndall’s sign,pupil and position of the intraocular lens were analyzed·RESULTS:One month after surgery,comparision of the best-corrected visual acuity beyond 0.8 between the cases which used PCCC and the cases which didn’t use PCCC was statistical significant.The difference of the count of corneal endothelial,intraocular pressure,corneal edema,anterior chamber Tyndall’s sign between the cases which used PCCC and the cases which didn’t use PCCC wasn’t statistical significant·CONCLUSION: PCCC can be more effective in reducing postoperative complications in the case which can use PCCC,and the patients can attain a more stable and comfortable visual acuity.

Abstract:AIM:To discuss the application effects of air bubbles in the glaucoma trabeculectomy·METHODS:Of 30 patients with glaucoma trabeculectomy surgery,sterile air bubbles were injected into the anterior chamber to maintain anterior chamber intraoperatively,and used to form anterior chamber before surgery finished.Intraoperative anterior chamber depth,status of hyphema and postoperative shallow anterior chamber incidence were observed and compared with the control group·RESULTS:All patients were able to complete the surgery under the condition of incomplete disappearance of anterior chamber.Hyphema did not involve the pupil area,and the incidence of postoperative shallow anterior chamber was lower·CONCLUSION:Using sterile air bubbles in glaucoma trabeculectomy is simple and easy,which reduces the incidence of intraoperative and postoperative complications and their hazards,and effectively improve the safety and success rate of the surgery.

Abstract:AIM:To investigte the effective method to treat old iridocyclitis and glaucoma·METHODS:Thirty-eight patients(52 eyes) were randomly divided into two groups.Group A(17 cases,24 eyes) were treated with laser peripheral iridectomy.Group B(21 cases,28 eyes) were treated with trabeculectomy and Mitomycin C·RESULTS:Four eyes were cured in group A(17%).Twenty-six eyes were cured in group B(93%).After statistical analysis,there was significant difference between the two groups(P<0.01)·CONCLUSION:Trabeculectomy and Mitomycin C is an effective treatment of old iridocyclitis and glaucoma.

Abstract:AIM:To analyse the efficiency of nonpenetrating trabeculectomy(NPT) combined with hyaluronic acid biologic glue implantation and mitomycin C(MMC) usage in the treatment of open angle glaucoma·METHODS: A retrospective analysis was made of 20 cases(24 eyes) with open angle glaucoma which had undergone NPT combined with hyaluronic acid biologic glue implantation and MMC usage under the layer of scleral valve.All the cases were followed up for 12-36 months.The intraocular pressure(IOP),visual acuity,anterior chamber depth,and filtering bleb were observed·RESULTS:The IOP was decreased from 35.52±7.6mmHg preoperatively to 16.32±5.25,17.28±5.70,18.26±5.20mmHg postoperatively in 1 year;2,3 years respectively(P<0.01).Visual acuity was at or above the preoperative level in 22 eyes,vision decreased in 2 eyes.There were no intraoperative or postoperative shallow anterior chamber and anterior chamber inflammation.All 24 eyes had functional bleb·CONCLUSION:NPT combined with hyaluronic acid biologic glue implantation and MMC usage is safe and effective in the management of open angle glaucoma.

Abstract:AIM:To observe the relationship between the retinopothy of prematurity(ROP) and extrauterine growth·METHODS: From January 2010 to October 2010,all premature infants born in Suzhou Municipal Hospital with body weight less than 1500g or gestation age less than 34 weeks were enrolled and underwent ophthalmologic examination.According to infants’ weight deviation percentage of the first five weeks,the infants were divided into three groups.Incidence of ROP in each group were calculated to evaluate its correlation with the weight increase percentage·RESULTS:The greater weight deviation of first five weeks,the greater proportion of ROP positive cases·CONCLUSION: Extrauterine growth of prematurity is closely related to ROP incidence.Measurement of extrauterine growth,especially weight increase,perhaps become a new economic and simple method of early screening,and may provide a theoretical basis for early intervention of ROP.

Abstract:AIM:To observe the curative effect of mouse nerve growth factor combined with methylprednisolone therapy on acute optic neuritis·METHODS:A total of 55 optic neuritis inpatients who were admitted to our hospital from 1999 to 2011 were retrospectively analyzed·RESULTS:The efficient rate of treatment group was 90.6% and the efficient rate of control group was 69.7%.The result showed that curative effect of treatment group was better than that of control group(P<0.05)·CONCLUSION:With good effect,the treatment of mouse nerve growth factor combined methylprednisolone is a better method for acute optic neuritis.

Abstract:AIM:To discuss the clinical effectiveness of superior rectus and inferior rectus muscle Hummelscheim displacement in treating abducent paralytic strabismus·METHODS:Totally 20 cases(21 eyes) of severe esotropia caused by abducent paralysis were treated by superior rectus and inferior rectus muscle Hummelscheim displacement during January 2004 to June 2010 in our hospital.The effectiveness was analyzed·RESULTS:Treated by superior rectus and inferior rectus muscle Hummelscheim displacement,esotropia of 20 cases of abducent paralytic strabismus was corrected significantly.After 6 months to 3 years follow-up,the eye position kept stable and no obvious change occurred·CONCLUSION:Superior rectus and inferior rectus muscle Hummelscheim displacement is practical in treating abducent paralytic strabismus and its outcome is stable.

Abstract:AIM:To investigate the surgical method to reduce the recurrence of pterygium·METHODS: Totally 95 cases(110 eyes) were randomly divided into two groups.A group of 55 cases(63 eyes) used reverse method to separate pterygium,combined with mitomycin C(MMC) and autologous conjunctival flap transplantation intraoperatively.B group of 40 cases(47eyes) used conventional surgery.Recurrence rates and corneal epithelial healing time were observed·RESULTS:Followed up for 6-12 months,A group recurrence rate was 3.2%;B group recurrence rate was 36.2%,the difference was statistically significant(χ2 =9.57,P<0.01).Corneal epithelial wound healing time:average 4.6±1.2 days in A group,average 8.1±0.9 days in B group,the difference between the two groups was statistically significant(t=13.08,P <0.01) CONCLUSION:Reverse method combined with MMC and autologous conjunctival flap transplantation in the treatment of pterygium is convenient in drawing material,easy to learn,and with the advantages of faster recovery of corneal wound,calm conjunctiva,low recurrence rate and definite effect,which is an ideal surgical way and worth promoting in primary hospitals.

Abstract:AIM:To discuss long-term effect of limbal stem cell transplantation for treatment of recurrent pterygium·METHODS:Among 110 patients with recurrent pterygium,19 patients underwent pterygium excision with mitomycin C,91 patients underwent pterygium excision with limbal stem cell transplantation·RESULTS:In 19 patients with implementation of pterygium excision with mitomycin C,6 patients had pterygium recurrence after surgery;In 91 patients who received pterygium excision with limbal stem cell transplantation,2 patients had pterygium recurrence after Surgery·CONCLUSION:The observation on the long-term curative effect of recurrent pterygium confirms that pterygium excision with limbal stem cell transplantation is an ideal way for the treatment of recurrent pterygium.surgical recurrence rate is higher in younger patients than that in older patients.

Abstract:AIM:To evaluate the effect of individualized pterygium excision·METHODS:Three hundred and seventeen patients(379 eyes) with pterygium were enrolled in our hospital from Feb 2008 to Feb 2011.Individualized treatments were carried out according to different conditions.The effects were observed·RESULTS:Comparing with the simple pterygium excision,the recurrence rates of pterygium in all individualized pterygium excision groups were lower,there was statistical significance(P<0.05).The recurrence rates of pterygium were no statistical significance(P>0.05)between the individualized pterygium excision groups·CONCLUSION: The individualized surgical treatment is safe and has better clinical effect.

Abstract:AIM:To observe the effect of high-dose glucocorticoids to alleviate or eliminate haze after Epi-LASIK operation in short period·METHODS:Sixteen patients(32 eyes) who received Epi-LASIK operation withⅡ-Ⅲ haze were choosed.Their right eyes were used 1g/L Fluorometholone ophthalmic solution of high-dose.And left eyes of conventional extenuation doses were used as control·RESULTS:After 3 months,the haze in the right eyes was alleviated or eliminated,and the vision of right eyes was improved more than left·CONCLUSION: It is safe and effective to treat haze by 1g/L Fluorometholone ophthalmic solution of high-dose.

Abstract:AIM:To discuss the curative effect,safety and predictability of treatment in different degree myopia by laser epithelial keratomileusis(LASEK)·METHODS:Analyzing method:The different level myopia patients with complete materials were analyzed retrospectively after LASEK treatment of 184 cases(367 eyes) based on clinical records in our hospital·RESULTS:After following up three groups of the patients more than half a year,we discovered that 90.5% of the cured eyes’ error range were within ±0.50D,98.6% within ±1.00D,and the efficiency index was 0.96,the safety index was 1.02.The group of light degree(<-3.00D)had 42 eyes,100% of the eyes’ error range were within±0.50D,the efficiency index was 1.02,the safety index was 1.04.The group of medium degree(-3.00——6.00D)had 123 eyes,95.1% of the eyes’ error range were within±0.50D,100% within ±1.00D,the efficiency index was 0.98,the safety index was 1.02.The group of high degree(>-6.00D)had 202 eyes,89.2% of the eyes’ error range were within±0.50D,94.8% within±1.00D,the efficiency index and safety index were 0.88 and 1.00 respectively.There were six cases with complications,and four of them were scale 2 haze,one open angle glaucoma and one refraction regression.Of all the cases,the central corneal thickness nearly reached our expectation.No keratoconus was found on corneal topography·CONCLUSION: It’s of exactitude,safety and predictability for LASEK to treat different degree myopia.

Abstract:AIM:To investigate the effect of the distant visual aids for visual disability patients in clinical application·METHODS:Thirty-two visual disability patients were given full refractive correction and then offered binocular or monocular telescopes as low vision aids in order to improve patients’ distance visions·RESULTS:In cases,the application of the distant visual aids were obtained acceptable vision.Visual acuity of the distant visual aids(logMAR) was 0.24±0.23,but lower than that of patients who were given both full refractive correction and low vision aids,their visual acuity(logMAR) was 0.11±0.25,there was statistically significant improvement.There was a 94% rate of overcoming the handicap when they were given both full refractive correction and low vision aids,higher than that of patients who were only given low vision aids,there was statistically significant improvement·CONCLUSION:The distant visual aids is important and effective for visual disability patients.The importance of ametropic correction for rehabilitation of visual disability patients should be recognized.

Abstract:AIM:To investigate the current situation of the 3-year old preschool children’s visual acuity and refraction in Yuhuatai district of Nanjing,and compare between urban and suburban areas,gender,visual inspection method·METHODS:A sample of 1519 children(3 years old)which were selected randomly were examined by the standard logarithmic visual acuity chart and Suresight Vision Screener handheld autorefractor·RESULTS:Totally 1406 children received vision examination of visual acuity chart and the ratio of subnormal visual acuity was 12.30%,while 1501 children were used for preschool vision screening,the ratio of refractive error was 12.92%.Significant difference was found in children’s refractive error rate between urban and rural areas(6.86% vs 6.06%,P<0.01)·CONCLUSION:Ametropia is the most familiar disease in kindergarten.It is necessary to check the preschool children’s visual acuity and refraction,so as to find latent problems,and to prospect the developmental trend and offer evidences for early intervention.

Abstract:AIM:To evaluate application effect of clinical nursing pathway combined with phacoemulsification surgery and intraocular lens implantation in the treatment of age-related cataract(ARC)·METHODS:Using controlled trials,75 cases of ARC were divided into observation group with clinical nursing pathway and control group with conventional care.Evaluation index include clinical efficacy,average waiting time before surgery,average inpatient time,average hospital costs,health care quality and patient satisfaction·RESULTS:Clinical efficacy including postoperative best-corrected visual acuity,the difference between the two groups was not statistically significant(P>0.05).The average waiting time before surgery,average inpatient time,average hospital costs of observation group were significantly less than those of control group,the difference was statistically significant(P<0.05).Health care quality including the rate of disease control knowledge,the rate of health knowledge and satisfaction in the observation group were also significantly higher than those in control group,the difference was statistically significant(P<0.05)·CONCLUSION:The application of clinical nursing pathway combined with phacoemulsification surgery and intraocular lens implantation for patients with ARC can effectively shorten treatment time,reduce treatment costs and improve health care quality as well as patient satisfaction.